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Sample records for femoral tunnel orientation

  1. Knee moment and shear force are correlated with femoral tunnel orientation after single-bundle anterior cruciate ligament reconstruction.

    PubMed

    Wang, Hongsheng; Fleischli, James E; Hutchinson, Ian D; Zheng, Naiquan Nigel

    2014-10-01

    Increasing evidence has shown that anatomic single-bundle anterior cruciate ligament reconstruction (ACLR) better restores normal knee kinematics and functionality than nonanatomic ACLR. Whether anatomic reconstruction results in better knee kinetics during daily activities has not been fully investigated. To assess the relationship between femoral tunnel angle and kinetic parameters of the knee joint during walking after single-bundle ACLR and to compare the radiographic and kinetic results of patients who underwent anatomic ACLR with those of patients who underwent nonanatomic ACLR. Controlled laboratory study. Twenty-one patients who underwent unilateral ACLR were recruited, and 20 healthy subjects from a previous study were used as a control group. All surgical procedures were performed by a single surgeon, 11 using the transtibial (TT) technique and 10 using the anteromedial portal (AMP) technique. Femoral tunnel orientation was measured from posterior-to-anterior radiographs. Dynamic knee joint moments and shear forces during gait were evaluated using 3-dimensional motion analysis and inverse dynamics. Relationships between femoral tunnel angles and kinetic results were evaluated via linear regression. Results were compared between 2 ACLR groups and controls using 1-way analysis of variance. Femoral tunnel angle had significant correlations with peak external knee flexion moment and posterior shear force during early stance. The TT group had a significantly smaller (more vertical) mean femoral tunnel angle (19.4° ± 4.1°) than the AMP group (36.4° ± 5.8°). Significant reductions were found in the normalized peak external knee flexion moment (TT, 0.15 ± 0.12 Nm/kg·m; AMP, 0.25 ± 0.12 Nm/kg·m; control, 0.25 ± 0.16 Nm/kg·m) (P = .032) and posterior shear force (TT, 0.64 ± 0.55 N/kg; AMP, 1.10 ± 0.58 N/kg; control, 1.35 ± 0.55 N/kg) (P = .024) in the TT group compared with controls, but not in the AMP group. Moreover, a significantly greater medial

  2. Can we use intraoperative femoral tunnel length measurement as a clue for proper femoral tunnel placement on coronal plane during ACL reconstruction?

    PubMed

    Celiktas, Mustafa; Kose, Ozkan; Sarpel, Yaman; Gulsen, Mahir

    2015-04-01

    Successful anterior cruciate ligament (ACL) reconstruction is dependent on correct placement of both tibial and femoral tunnels. The purpose of this study is to investigate whether we can use intraoperative femoral tunnel length measurement to estimate the correct femoral tunnel placement on coronal plane. This prospective study comprised 164 consecutive patients who underwent ACL reconstruction surgery. Transtibial or anteromedial portal technique is used for drilling the femoral tunnels. The length of the femoral tunnel was measured during the operation. The femoral tunnel coronal plane angle was calculated on the postoperative tunnel radiographs. A statistical comparison was made of the lengths of the tunnel, the techniques used drilling and the femoral tunnel angles. The far anteromedial portal was used in 81 (49%) cases and the transtibial technique in 83 (51%) cases. The mean femoral tunnel length was 42 ± 6.4 mm and the mean femoral tunnel coronal angle was 41.1° ± 11.6. The tunnel angle in the transtibial technique was determined as significantly low compared to the far anteromedial portal technique (32.6°:49.8°) and the tunnel length was significantly longer (45.8:38.1 mm) (p < 0.001). In the statistical analysis, it was found that a patient with a tunnel length of 41 mm and above had a 92.1% likelihood of femoral tunnel angle below 45°. Femoral tunnel length can be used as a clue for intraoperative evaluation of the femoral tunnel position. If the femoral tunnel length is greater than 41 mm, the coronal plane orientation of the femoral tunnel will be improper and not at a desired position.

  3. Medial Patellofemoral Ligament Reconstruction Femoral Tunnel Accuracy

    PubMed Central

    Hiemstra, Laurie A.; Kerslake, Sarah; Lafave, Mark

    2017-01-01

    Background: Medial patellofemoral ligament (MPFL) reconstruction is a procedure aimed to reestablish the checkrein to lateral patellar translation in patients with symptomatic patellofemoral instability. Correct femoral tunnel position is thought to be crucial to successful MPFL reconstruction, but the accuracy of this statement in terms of patient outcomes has not been tested. Purpose: To assess the accuracy of femoral tunnel placement in an MPFL reconstruction cohort and to determine the correlation between tunnel accuracy and a validated disease-specific, patient-reported quality-of-life outcome measure. Study Design: Case series; Level of evidence, 4. Methods: Between June 2008 and February 2014, a total of 206 subjects underwent an MPFL reconstruction. Lateral radiographs were measured to determine the accuracy of the femoral tunnel by measuring the distance from the center of the femoral tunnel to the Schöttle point. Banff Patella Instability Instrument (BPII) scores were collected a mean 24 months postoperatively. Results: A total of 155 (79.5%) subjects had adequate postoperative lateral radiographs and complete BPII scores. The mean duration of follow-up (±SD) was 24.4 ± 8.2 months (range, 12-74 months). Measurement from the center of the femoral tunnel to the Schöttle point resulted in 143 (92.3%) tunnels being categorized as “good” or “ideal.” There were 8 failures in the cohort, none of which occurred in malpositioned tunnels. The mean distance from the center of the MPFL tunnel to the center of the Schöttle point was 5.9 ± 4.2 mm (range, 0.5-25.9 mm). The mean postoperative BPII score was 65.2 ± 22.5 (range, 9.2-100). Pearson r correlation demonstrated no statistically significant relationship between accuracy of femoral tunnel position and BPII score (r = –0.08; 95% CI, –0.24 to 0.08). Conclusion: There was no evidence of a correlation between the accuracy of MPFL reconstruction femoral tunnel in relation to the Schöttle point and

  4. Femoral tunnel malposition in ACL revision reconstruction.

    PubMed

    Morgan, Joseph A; Dahm, Diane; Levy, Bruce; Stuart, Michael J

    2012-11-01

    The Multicenter Anterior Cruciate Ligament (ACL) Revision Study (MARS) group was formed to study a large cohort of revision ACL reconstruction patients. The purpose of this subset analysis study of the MARS database is to describe specific details of femoral tunnel malposition and subsequent management strategies that surgeons chose in the revision setting. The design of this study is a case series. The multicenter MARS database is compiled from a questionnaire regarding 460 ACL reconstruction revision cases returned by 87 surgeons. This subset analysis described technical aspects and operative findings in specifically those cases in which femoral tunnel malposition was cited as the cause of primary ACL reconstruction failure. Of the 460 revisions included for study, 276 (60%) cases cited a specific "technical cause of failure." Femoral tunnel malposition was cited in 219 (47.6%) of 460 cases. Femoral tunnel malposition was cited as the only cause of failure in 117 cases (25.4%). Surgeons judged the femoral tunnel too vertical in 42 cases (35.9%), too anterior in 35 cases (29.9%), and too vertical and anterior in 31 cases (26.5%). Revision reconstruction involved the drilling of an entirely new femoral tunnel in 91 cases (82.1%). For primary reconstruction, autograft tissue was used in 82 cases (70.1%). For revision reconstruction, autograft tissue was used in 61 cases (52.1%) and allograft tissue in 56 cases (47.9%). Femoral tunnel malposition in primary ACL reconstruction was the most commonly cited reason for graft failure in this cohort. Graft selection is widely variable among surgeons. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  5. Bacterial colonization is decreased after tunneling femoral perineural catheters.

    PubMed

    Compere, Vincent; Daccache, George; Amdjar, Nora; Fourdrinier, Véronique; Moriceau, Jérôme; Foutel, Anne; Frebourg, Noël; Mourgeon, Eric; Houivet, Esthelle; Dureuil, Bertrand

    2016-12-01

    Infection of perineural catheter is rare, although bacterial colonization is frequent. An observational study reported that subcutaneous tunneling perineural catheter could decrease its colonization rate. We performed a comparative study to assess the incidence of catheter related bacterial colonization of tunnelized femoral perineural catheters. This bicentric, randomized, single-blind, controlled and intention-to-treat study was conducted from December 2009 to December 2011. The catheter was secured with adhesive strips in the control group and was tunneled subcutaneously in the tunnelization group. Primary endpoint was catheter colonization rate assessed by by Brun-Buisson quantitative culture. Secondary endpoints included catheter-related infection, inadvertent catheter dislodgement rate, incidence of technical problems with subcutaneous tunneling and, risk factors for catheter-related colonization. Of the total 338 patients included, 2 patients were later excluded and 78 were lost to follow-up for primary endpoint. Inadvertent removal of femoral catheter accounted for 33 of these 78 patients (10 for the tunnelization group versus 23 for the control group, P=0.02). There was a lower colonization rate in the patient group with tunnelization compared to the control group without tunnelization (6% versus 13.5%, respectively; OR=2.4; 95% CI: 1.1-5.3; P=0.02). No infection was observed. Coagulase-negative staphylococci is present in 61%. The absence of tunnelization is the only risk factor of colonization. For 7 patients, accidental perforation of perineural catheter during procedure was observed. Tunneled subcutaneous perineural catheter decreased the incidence of colonization. Moreover, tunnelization is an effective technique for securing the perineural catheter.

  6. Creation of femoral tunnel by outside-in technique for ACL reconstruction: an analysis.

    PubMed

    Sinha, Skand; Naik, Ananta K; Meena, Durgashankar; Jain, Vijay K; Arya, Rajendra K

    2014-12-01

    To study the outcome of ACL reconstruction by retrograde outside-in (OI) creation of femoral tunnel. ACL reconstruction was done in 41 cases by OI technique. The tip of 115° femoral guide was placed at posterior aspect of femoral foot print of ACL. Reaming was done from outside-in over guide pin. The length of femoral tunnel was obtained by measuring guide pin. The location of intra-articular femoral tunnel aperture and graft was recorded. Tibial tunnel was created with 50° guide placed at tibial foot print of ACL. Post-operative digital radiograph was taken. Antero-posterior view was used to calculate coronal inclination of femoral tunnel. On lateral view femoral tunnel location was marked in relation to the intersection of Blumensaat line and posterior femoral cortical line. Lysholm scoring and pivot shift test were performed at follow-up. Objective measurement of anterior tibial translation was done by rolimeter (aircast) at 1 year. The mean femoral tunnel length recorded was 39.5 mm (±3.4). There was no incidence of femoral tunnel blow out or graft impingement. All cases had femoral tunnel aperture location posterior to posterior femoral cortical line and inferior to Blumensaat line. The mean coronal angle of femoral tunnel was 30.39° (±4.6). The mean preoperative Lysholm score of 53.5 (±13) increased to 95.2 (±3.5) 1 year after surgery. All the patients had full range of motion. The pivot shift test was negative and instrumented measurement of anterior translation of tibia was near normal in all cases. OI technique of ACL reconstruction is a simple reproducible technique. The unconstrained placement and angling of femoral guide result in a femoral tunnel which is through footprint of ACL. The graft is placed very low, oblique and as posterior as possible on femoral side mimicking the native ACL. III.

  7. Femoral tunnel placement in anterior cruciate ligament reconstruction: rationale of the two incision technique

    PubMed Central

    Garofalo, Raffaele; Moretti, Biagio; Kombot, Cyril; Moretti, Lorenzo; Mouhsine, Elyazid

    2007-01-01

    Endoscopic anterior cruciate ligament (ACL) reconstruction can be performed through one-incision or two-incision technique. The current one-incision endoscopic ACL single bundle reconstruction techniques attempt to perform an isometric repair placing the graft along the roof of the intercondylar notch, anterior and superior to the native ACL insertion. However the ACL isometry is a theoretical condition, and has not stood up to detailed testing and investigation. Moreover this type of reconstruction results in a vertically oriented non-anatomic graft, which is able to control anterior tibial translation but not the rotational component of the instability. Femoral tunnel obliquity has a great effect on rotational stability. To improve the obliquity of graft, an anatomical ACL reconstruction should be attempt. Anatomical insertion of ACL on the femur lies very low in the notch, spreading between 11 and 9–8 o'clock position and the center lies lower than at 11 o'clock position. Femoral aiming devices through the tibial tunnel aim at an isometric placement, and they do not aim at an anatomic position of the graft. Also, a placement of tunnel in a position of 11 o'clock is unable to restore rotational stability. The two-incision technique, with the possibility to position femoral tunnel independently by tibial tunnel, allows us to place femoral tunnel entrance in a position of 10 'clock that can most accurately reproduce the anatomic behaviour of the ACL and can potentially improve the response of the graft to rotatory loads. This positioning results in a more oblique graft placement, avoiding problem related to PCL impingement during knee flexion. Further studies are required to understand if this kind of reconstruction can ameliorate proprioception as well as clinical outcome at a long-term follow-up. PMID:17511888

  8. Transphyseal ACL Reconstruction in Skeletally Immature Patients: Does Independent Femoral Tunnel Drilling Place the Physis at Greater Risk Compared With Transtibial Drilling?

    PubMed

    Cruz, Aristides I; Lakomkin, Nikita; Fabricant, Peter D; Lawrence, J Todd R

    2016-06-01

    Most studies examining the safety and efficacy of transphyseal anterior cruciate ligament (ACL) reconstruction for skeletally immature patients utilize transtibial drilling. Independent femoral tunnel drilling may impart a different pattern of distal femoral physeal involvement. To radiographically assess differences in distal femoral physeal disruption between transtibial and independent femoral tunnel drilling. We hypothesized that more oblique tunnels associated with independent drilling involve a significantly larger area of physeal disruption compared with vertically oriented tunnels. Cross-sectional study; Level of evidence, 3. We analyzed skeletally immature patients aged between 10 and 15 years who underwent transphyseal ACL reconstruction utilizing an independent femoral tunnel drilling technique between January 1, 2008, and March 31, 2011. These patients were matched with a transtibial technique cohort based on age and sex. Radiographic measurements were recorded from preoperative magnetic resonance imaging and postoperative radiographs. Ten patients in each group were analyzed. There were significant differences between independent drilling and transtibial drilling cohorts in the estimated area of physeal disruption (1.64 vs 0.74 cm(2); P < .001), femoral tunnel angles (32.1° vs 72.8°; P < .001), and medial/lateral location of the femoral tunnel (24.2 vs 36.1 mm from lateral cortex; P = .001), respectively. There was a significant inverse correlation between femoral tunnel angle and estimated area of distal femoral physeal disruption (r = -0.8255, P = .003). Femoral tunnels created with an independent tunnel drilling technique disrupt a larger area of the distal femoral physis and create more eccentric tunnels compared with a transtibial technique. As most studies noting the safety of transphyseal ACL reconstruction have utilized a central, vertical femoral tunnel, surgeons should be aware that if an independent femoral tunnel technique is utilized

  9. Comparison of Anterior Cruciate Ligament Graft Isometry between Paired Femoral and Tibial Tunnels.

    PubMed

    Cain, E Lyle; Biggers, Marcus D; Beason, David P; Emblom, Benton A; Dugas, Jeffrey R

    2017-03-10

    Accurate tunnel placement is important for a successful anterior cruciate ligament (ACL) reconstruction. Controversy exists concerning the preferred method of femoral tunnel preparation, with proponents of both medial portal and transtibial drilling techniques. Current ACL literature suggests that placement of the femoral ACL attachment site posterior or "low" in the ACL footprint leads to more anatomically correct ACL mechanics and better rotational control. There is limited literature focusing on ACL graft displacement through knee range of motion based on specific paired placement of femoral and tibial tunnels. Our purpose was to assess ACL isometry between multiple combinations of femoral and tibial tunnels. We hypothesized that placement of the graft at the posterior aspect of the ACL footprint on the femur would be significantly less isometric and lead to more graft displacement as compared with central or anterior placement. The ACL of matched pairs of cadaveric knees was arthroscopically debrided while leaving the soft tissue footprint on the femur and tibia intact. One knee from each pair underwent notchplasty. In all knees, three femoral and three tibial tunnels were created at the anterior, central, and posterior aspects of the ACL footprint. A suture was passed through each tunnel combination (nine potential pairs), and the change in isometry was measured throughout full knee range of motion. Placement of the femoral tunnel along the posterior aspect of the ACL footprint was less isometric compared with a central or anterior position in the femoral footprint. Placement of a posterior tibial tunnel also led to decreased isometry, but tibial tunnel placement affected isometry to a lesser extent than femoral tunnel placement. The combination of a posterior femoral and posterior tibial tunnel resulted in greater than 1 cm of graft excursion from full flexion to extension. Placement of ACL tunnels at anisometric sites may adversely affect the mechanical

  10. Femoral tunnel enlargement after anterior cruciate ligament reconstruction using RigidFix compared with extracortical fixation.

    PubMed

    Lopes, Osmar Valadao; de Freitas Spinelli, Leandro; Leite, Luiz Henrique Cunha; Buzzeto, Bruce Quatrin; Saggin, Paulo Renato Fernades; Kuhn, André

    2017-05-01

    The aim of this study was to compare femoral tunnel enlargement after anterior cruciate ligament (ACL) reconstruction surgery using hamstring autograft tendons fixed by bioabsorbable femoral trans-tunnel pins with that in patients in which the graft was fixed with extracortical fixation. Forty-three patients were randomly selected from our database and included in the study. Femoral tunnel diameter was measured by computed tomography in 20 patients who underwent ACL reconstruction via anteromedial portal technique using autologous quadruple hamstrings, fixed with two bioabsorbable trans-tunnel pins, RigidFix, on the femoral side and compared with 23 patients in whom extracortical fixation, EndoButton CL, was used. The diameter of the femoral tunnel was measured at a distance of 5 mm from the tunnel entrance and at the largest diameter along the tunnel axis. Data were compared with the diameter of the drill used during surgery. Clinical evaluation was performed using the Lysholm score, IKDC subjective score and anterior knee laxity measurements. Femoral tunnel enlargement 5 mm from the entrance and at the largest diameter was greater in the RigidFix group than the EndoButton group. There were no significant differences between the two groups regarding age, gender, post-operative Lysholm score, IKDC subjective score or knee laxity measurements. The present study showed greater enlargement of the femoral bone tunnel when a bioabsorbable trans-tunnel pin system was used with the medial portal technique when compared to extracortical fixation. These findings confirm that femoral tunnel widening should be considered when RigidFix was used in ACL reconstruction by anteromedial portal technique. III.

  11. Accuracy and Learning Curve of Femoral Tunnel Placement in Medial Patellofemoral Ligament Reconstruction.

    PubMed

    Hiemstra, Laurie Anne; Kerslake, Sarah; O'Brien, Catherine L; Lafave, Mark R

    2017-02-13

    The purpose of this study was to assess the accuracy of femoral tunnel placement in a medial patellofemoral ligament reconstruction (MPFL-R) cohort. The secondary purpose was to establish the evidence of a learning curve to achieve acceptable femoral tunnel placement during MPFL-R. Two surgeons, using lateral radiographs, assessed 73 subjects post-MPFL-R. Femoral tunnel accuracy and direction of tunnel error were measured in relation to Schöttle's point (A-T distance). Interrater reliability (intraclass correlation coefficient 2,k) of these measures was calculated. Learning curve of accurate femoral tunnel placement was examined by dividing the patient cohort into quartiles. A one-way analysis of variance was used to assess the quartiles for accuracy of femoral tunnel position and surgical time. In relation to Schöttle's point, 66/73 (90.4%) femoral tunnels were categorized as being in a "good" or "excellent" position and 7/73 (9.6%) were categorized as being in a "poor" position. Evidence of an MPFL-R learning curve was established via a statistically significant difference in the mean A to T distance for the four quartiles (F [3, 69] = 6.41, p = 0.001). There was also a statistically significant difference in the surgical time for the four quartiles (F [3, 69] = 8.71, p = 0.001). In this series, accurate femoral tunnels were placed more than 90% of the time during MPFL-R. A clear learning curve for accurate femoral tunnel placement was demonstrated both with respect to distance of the tunnel from Schöttle point and with regard to surgical time. Level of evidence was IV.

  12. Correlation between Femoral Guidewire Position and Tunnel Communication in Double Bundle Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Lee, Sang Hyuk; Choi, Jun Young; Kim, Dong Hee; Kang, Bun Jung; Nam, Dae Cheol; Yoon, Hong Kwon

    2014-01-01

    Purpose The object of this study was to determine the shortest possible distances of antero-medial (AM) and postero-lateral (PL) guide wire tunnel positions required to prevent femoral bone tunnel communication in double-bundle anterior cruciate ligament (ACL) reconstruction using human cadaver knees. Materials and Methods The centers of femoral AM and PL bundles of 16 cadaveric knees were drilled with guide wires and the distances of guide wires, were measured upon entrance into the bone. Femoral tunnel drilling was performed using transportal technique. The diameters of AM and PL graft were 8 mm and 6 mm, respectively. CT scans were taken on each knee, and 3-dimensional models were constructed to identify the femoral tunnel position and to create AM and PL tunnel virtual cylinders. Thickness of the bone bridge between the two tunnels was measured. Results In four out of six specimens, in which the guide wires were placed at less than or equal to 9 mm, communication was noted. In specimens with guide wires placed at distances greater than or equal to 10 mm, communication was not noted. The two groups showed a statistically significant difference (p=0.008). In cases where the distance between the AM and PL femoral tunnel guide wires was 12 mm, the bone bridge thickness was greater than 2 mm along the tunnel. Conclusion The technique for double bundle-anterior cruciate ligament (DB-ACL) reconstruction that we show here can avoid bone tunnel communication when AM and PL femoral guide wires are placed at least 10 mm apart, and 12 mm should be kept to preserve 2 mm bone bridge thickness. PMID:25323896

  13. Using tunneled femoral vein catheters for "urgent start" dialysis patients: a preliminary report.

    PubMed

    Hingwala, Jay; Bhola, Cynthia; Lok, Charmaine E

    2014-01-01

    Multiple benefits of arteriovenous fistulas (AVF) and arteriovenous grafts (AVGs) exist over catheters. As part of a strategy to preserve thoracic venous sites and reduce internal jugular (IJ) vein catheter use, we inserted tunneled femoral vein catheters in incident "urgent start" dialysis patients while facilitating a more appropriate definitive dialysis access. "Urgent start" dialysis patients between January 15, 2013 and January 15, 2014 who required chronic dialysis, and did not have prior modality and vascular access plans, had tunneled femoral vein catheters inserted. We determined the femoral vein catheter associated infections rates, thrombosis, and subsequent dialysis access. Eligible patients were surveyed on their femoral vein catheter experience. Twenty-two femoral vein catheters were inserted without complications. Subsequently, one catheter required intraluminal thrombolytic locking, while all other catheters maintained blood flow greater than 300 ml/min. There were no catheter-related infections (exit site infection or bacteremia). Six patients continued to use their tunneled catheter at report end, one transitioned to peritoneal dialysis, thirteen to an arteriovenous graft, and two to a fistula. One patient received a tunneled IJ vein catheter. Of the patients who completed the vascular access survey, all indicated satisfaction with their access and that they had minimal complaints of bruising, bleeding, or swelling at their access sites. Pain/discomfort at the exit site was the primary complaint, but they did not find it interfered with activities of daily living. Femoral vein tunneled catheters appear to be a safe, well tolerated, and effective temporary access in urgent start dialysis patients while they await more appropriate long-term access.

  14. Patency of Femoral Tunneled Hemodialysis Catheters and Factors Predictive of Patency Failure

    SciTech Connect

    Burton, Kirsteen R.; Guo, Lancia L. Q.; Tan, Kong T.; Simons, Martin E.; Sniderman, Kenneth W.; Kachura, John R.; Beecroft, John R.; Rajan, Dheeraj K.

    2012-12-15

    Purpose: To determine the patency rates of and factors associated with increased risk of patency failure in patients with femoral vein tunneled hemodialysis catheters. Methods: All femoral tunneled catheter insertions from 1996 to 2006 were reviewed, during which time 123 catheters were inserted. Of these, 66 were exchanges. Patients with femoral catheter failure versus those with femoral catheter patency were compared. Confounding factors, such as demographic and procedural factors, were incorporated and assessed using univariate and multivariable Cox proportional hazards regression analyses. Results: Mean catheter primary patency failure time was 96.3 days (SE 17.9 days). Primary patency at 30, 60, 90, and 180 days was 53.8%, 45.4%, 32.1%, and 27.1% respectively. Crude rates of risk of catheter failure did not suggest a benefit for patients receiving catheters introduced from one side versus the other, but more cephalad location of catheter tip was associated with improved patency. Multivariate analysis showed that patients whose catheters were on the left side (p = 0.009), were of increasing age at the time of insertion (p = 0.002) and that those who had diabetes (p = 0.001) were at significantly greater risk of catheter failure. The catheter infection rate was 1.4/1000 catheter days. Conclusion: Patients who were of a more advanced age and had diabetes were at greater risk of femoral catheter failure, whereas those who received femoral catheters from the right side were less at risk of catheter failure.

  15. Experience of 70-cm-long femoral tunnelled twin Tesio catheters for chronic haemodialysis.

    PubMed

    Bertoli, Silvio V; Ciurlino, Daniele; Musetti, Claudio; Mazzullo, Tiziana; Villa, Margarita; Traversi, Lara; Tedoldi, Silvia; Procaccio, Mirella

    2010-05-01

    Tunnelled femoral catheters with their tip in the lower inferior vena cava (IVC) are proposed only in few cases, but they often provide less than optimal blood flows and frequently have complications. The aim of this prospective observational study is to evaluate the use of 70-cm-long tunnelled cuffed femoral twin Tesio catheters with their tip in the upper IVC for haemodialysis. Between May 2007 and May 2009, 25 tunnelled femoral catheters (fCVC) have been placed in 25 patients (77.7 +/- 10.8 years) with exhausted thoracic venous accesses or old patients with several comorbidities. Two 10 Fr carbothane 70-cm-long Tesio catheters with a Dacron cuff at 45 cm from the tip were placed in the femoral vein of each patient and then tunnelled; tips were in the upper third of the IVC. fCVCs were removed for either malfunction (Qb < 200 ml/min) or infection that did not resolve with antibiotics. Technical success of placement was 100%. The 6- and 12-month assisted primary patency rate were respectively 67 +/- 13% and 54 +/- 17%. The mean session Kt/V was 1.45 +/- 0.19, and the blood flow was 270 +/- 17 ml/min. Six fCVCs have been removed: three for infection, one for accidental damaging and two for the making of a different vascular access. The main complications were 2 catheter tip thrombi, 3 tunnel infections and 11 fCVC-related bacteraemia (1.77 episodes per 1000 CVC-days). The placement of twin fCVCs with their tip in the high IVC can provide an adequate dialysis and can be considered for patients with no remaining thoracic accesses.

  16. Overestimation of femoral tunnel length during anterior cruciate ligament reconstruction using the retrograde outside-in drilling technique.

    PubMed

    Okazaki, Ken; Osaki, Kanji; Nishikawa, Kazutaka; Matsubara, Hirokazu; Tashiro, Yasutaka; Iwamoto, Yukihide

    2016-08-01

    When the femoral tunnel socket is reamed in an oblique direction from the wall of inter-condylar notch in anterior cruciate ligament (ACL) reconstruction, the tunnel length can be shorter at the periphery than at the centre. Because surgeons can manipulate the direction of tunnel in the outside-in femoral tunnel drilling technique, this length mismatch would vary depending on the direction of the tunnel. The purpose of this study was to investigate this length mismatch when reamed in various directions. In total of thirteen points were defined as femoral drilling entry points on concentric lines with 0, 1, 2, and 3 cm radius from the lateral epicondyle of a three-dimensional bone model from 40 subjects. Femoral tunnel drilling was simulated on the models by connecting the centre of the ACL footprint with each defined point on the lateral femoral surface. The mismatch length was measured between the centre and the shortest peripheral side of the tunnel socket. When the distance between the drilling entry point on the lateral femoral surface and the lateral epicondyle was increased to anterior proximal direction, there was a significant increase in the mismatch length. The mismatch length became more than 2 mm when the entry point was located more than 2 cm away from the lateral epicondyle. When the drilling entry point is set far away from the lateral epicondyle, a significant increase was observed in tunnel length mismatch between the centre of the tunnel and its shortest peripheral side. Because the tunnel length is measured with a guide pin introduced at the centre of the tunnel before reaming in retrograde outside-in technique, this length mismatch could cause an overestimation of the tunnel length. Surgeons should recognise this mismatch when preparing the length of graft and socket to optimise the graft insertion length into the socket.

  17. Valgus slipped capital femoral epiphysis: subcapital growth plate orientation analysis.

    PubMed

    Koczewski, Paweł

    2013-11-01

    The aim of the study was to determine the risk factors of unusual, lateral direction of epiphyseal displacement in primarily unilateral slipped capital femoral epiphysis (SCFE) patients with a special focus on radiological parameters of an unaffected hip. A total of 115 patients (75 boys, 40 girls), mean age 13.2 years (8.4-18.6), were analyzed. The mean follow-up time was 11 years (2-29). The proportion of valgus slip among SCFE patients was 11 of 115 cases (9.6%). The patients with valgus slip compared with the classic ones were predominantly females (55 vs. 33%), were younger (11.1 vs. 13.4 years), had a greater epiphyseal-shaft angle (67.4 vs. 59.1°), smaller displacement in the frontal plane (absolute value 6.7 vs. 15°), and a lower risk of contralateral slip (27 vs. 65%). There was no difference in the neck-shaft angle and epiphyseal-neck angle value. A more horizontal orientation of the subcapital growth plate, assessed by epiphyseal-shaft angle, can be considered a conducive factor in the valgus direction of epiphyseal slip in SCFE. In valgus SCFE cases, there is a smaller degree of epiphyseal displacement in both the sagittal and the coronal plane and a lower risk of consecutive contralateral slip.

  18. Femoral and tibial graft tunnel parameters after transtibial, anteromedial portal, and outside-in single-bundle anterior cruciate ligament reconstruction.

    PubMed

    Osti, Michael; Krawinkel, Alessa; Ostermann, Michael; Hoffelner, Thomas; Benedetto, Karl Peter

    2015-09-01

    Anatomic graft tunnel placement is recommended in anterior cruciate ligament (ACL) reconstruction to restore knee joint stability and function. Transtibial (TT), anteromedial portal (AMP), and outside-in (OI) retrograde drilling surgical techniques have been described for tibial and femoral bone tunnel preparation. The purpose of this study was to evaluate the bone tunnel parameters and compare the ability of 3 different surgical techniques to achieve placement of the ACL femoral and tibial bone tunnels at the center of the native ACL femoral and tibial attachment sites. The hypothesis was that tunnel placement using an AMP or OI technique would result in optimized tunnel parameters and more closely reconstruct the center of the native ACL femoral attachment site. Cohort study; Level of evidence, 3. The study population consisted of 100 patients undergoing anatomic single-bundle ACL reconstruction using multiple-stranded hamstring tendon grafts. In group 1 (n = 36), the femoral tunnel was drilled using a TT surgical technique; in group 2 (n = 32), the femoral tunnel was drilled through an AMP; and in group 3 (n = 32), the femoral tunnel was created by use of an OI technique with retrograde drilling. Computed tomography (CT) scans were obtained postoperatively, and characteristics of femoral and tibial tunnel apertures were correlated to femoral and tibial measurement grid systems. The position of the resulting tibial and femoral bone tunnels for each group was compared with the center of the native ACL attachment sites. There were statistically significant differences (P < .05) for the ACL femoral tunnel between the 3 groups with respect to intercondylar height, total tunnel length, graft fixation length, tunnel axis, and tunnel entry angle. Statistically significant differences (P < .05) were found for the ACL tibial tunnel with respect to anteroposterior tunnel position and sagittal tunnel axis between the TT and both the OI and AMP techniques. The OI surgical

  19. Physeal-Sparing Technique for Femoral Tunnel Drilling in Pediatric Anterior Cruciate Ligament Reconstruction Using a Posteromedial Portal

    PubMed Central

    Lemos, Stephen E.; Keating, Patrick M.; Scott, Timothy P.; Siwiec, Ryan M.

    2013-01-01

    Pediatric anterior cruciate ligament (ACL) tears present a technical dilemma for orthopaedic surgeons. Multiple surgical techniques have been described to protect the distal femoral and proximal tibial physes. We present an ACL reconstruction technique performed on a 12-year-old girl with open physes who sustained an ACL tear after a noncontact twisting injury while playing soccer. A hamstring autograft reconstruction was performed by use of a posteromedial portal to drill the femoral tunnel in an all-epiphyseal fashion at the anatomic footprint of the native ACL. This case provides a new surgical technique to achieve anatomic fixation for ACL reconstruction in a skeletally immature individual using a posteromedial portal to drill a physeal-sparing lateral femoral tunnel for anatomic ACL reconstruction. This advancement may make drilling the femoral tunnel less technically challenging compared with other proposed methods while maintaining the lateral wall of the distal femur. PMID:24892013

  20. A quantitative technique to create a femoral tunnel at the averaged center of the anteromedial bundle attachment in anatomic double-bundle anterior cruciate ligament reconstruction

    PubMed Central

    2013-01-01

    Background In the anatomic double-bundle ACL reconstruction, 2 femoral tunnel positions are particularly critical to obtain better clinical results. Recently, a few studies have reported quantitative identification methods for posterolateral (PL) bundle reconstruction. Concerning anteromedial (AM) bundle reconstruction, however, no quantitative clinically available methods to insert a guide wire at the center of the direct attachment of the AM mid-substance fibers have been reported to date. Methods First, we determined the center of the femoral attachment of the AM mid-substance fibers using 38 fresh frozen cadaveric knees. Based on this anatomical sub-study, we developed a quantitative clinical technique to insert a guide wire at the averaged center for anatomic double-bundle ACL reconstruction. In the second clinical sub-study with 63 patients who underwent anatomic ACL reconstruction with this quantitative technique, we determined the center of an actually created AM tunnel. Then, we compared the results of the second sub-study with those of the first sub-study to validate the accuracy of the quantitative technique. In both the sub-studies, we determined the center of the anatomical attachment and the tunnel outlet using the “3-dimensional clock” system. The tunnel outlet was evaluated using the “transparent” 3-dimensional computed tomography. Results The averaged center of the direct attachment of the AM bundle midsubstance fibers was located on the cylindrical surface of the femoral intercondylar notch at “10:37” (or “1:23”) o’clock orientation in the distal view and at 5.0-mm from the proximal outlet of the intercondylar notch (POIN) in the lateral view. The AM tunnel actually created in ACL reconstruction was located at “10:41” (or “1:19”) o’clock orientation in the average and at 5.0-mm from the POIN. There was no significant difference between the 2 center locations. Conclusions The quantitative technique enabled us to easily

  1. A new technique for femoral and tibial tunnel bone grafting using the OATS harvesters in revision anterior cruciate ligament reconstruction.

    PubMed

    Said, Hatem G; Baloch, Khalid; Green, Marcus

    2006-07-01

    Revision anterior cruciate ligament (ACL) reconstruction is becoming more frequent, especially in specialized centers, because of the large numbers of primary ACL procedures performed. In 2-stage revisions, bone grafting of the tunnels may be undertaken if the primary position was inaccurate or if osteolysis has caused widening of the tunnels. This will allow the desired placement of the new tunnels without the risk of loss of structural integrity. It is technically difficult to deliver and impact bone graft into the femoral tunnel with the standard surgical and arthroscopic instruments. We describe a new technique for femoral and tibial tunnel impaction grafting in 2-stage ACL revisions, using the OATS grafting instruments (Osteochondral Autologous Transfer System; Arthrex, Naples, FL). The appropriately sized OATS harvester is chosen 1 mm larger than the tunnel size and is used to harvest bone graft from the iliac crest through a percutaneous approach. This provides a cylindrical graft, which is delivered to the femoral tunnel through the arthroscopic portal. The inside punch of the harvester is tapped and this allows delivery of the graft in a controlled manner and its impaction into the tunnel. The same is repeated for the tibial tunnel while providing support for the proximal end of the tunnel.

  2. A three-dimensional axis for the study of femoral neck orientation.

    PubMed

    Bonneau, Noémie; Libourel, Paul-Antoine; Simonis, Caroline; Puymerail, Laurent; Baylac, Michel; Tardieu, Christine; Gagey, Olivier

    2012-11-01

    A common problem in the quantification of the orientation of the femoral neck is the difficulty to determine its true axis; however, this axis is typically estimated visually only. Moreover, the orientation of the femoral neck is commonly analysed using angles that are dependent on anatomical planes of reference and only quantify the orientation in two dimensions. The purpose of this study is to establish a method to determine the three-dimensional orientation of the femoral neck using a three-dimensional model. An accurate determination of the femoral neck axis requires a reconsideration of the complex architecture of the proximal femur. The morphology of the femoral neck results from both the medial and arcuate trabecular systems, and the asymmetry of the cortical bone. Given these considerations, two alternative models, in addition to the cylindrical one frequently assumed, were tested. The surface geometry of the femoral neck was subsequently used to fit one cylinder, two cylinders and successive cross-sectional ellipses. The model based on successive ellipses provided a significantly smaller average deviation than the two other models (P < 0.001) and reduced the observer-induced measurement error. Comparisons with traditional measurements and analyses on a sample of 91 femora were also performed to assess the validity of the model based on successive ellipses. This study provides a semi-automatic and accurate method for the determination of the functional three-dimensional femoral neck orientation avoiding the use of a reference plane. This innovative method has important implications for future studies that aim to document and understand the change in the orientation of the femoral neck associated with the acquisition of a bipedal gait in humans. Moreover, the precise determination of the three-dimensional orientation has implications in current research involved in developing clinical applications in diagnosis, hip surgery and rehabilitation. © 2012 The

  3. Femoral Graft-Tunnel Angles in Posterior Cruciate Ligament Reconstruction: Analysis with 3-Dimensional Models and Cadaveric Experiments

    PubMed Central

    Kim, Sung-Jae; Chun, Yong-Min; Moon, Hong-Kyo; Jang, Jae-Won

    2013-01-01

    Purpose The purpose of this study was to compare four graft-tunnel angles (GTA), the femoral GTA formed by three different femoral tunneling techniques (the outside-in, a modified inside-out technique in the posterior sag position with knee hyperflexion, and the conventional inside-out technique) and the tibia GTA in 3-dimensional (3D) knee flexion models, as well as to examine the influence of femoral tunneling techniques on the contact pressure between the intra-articular aperture of the femoral tunnel and the graft. Materials and Methods Twelve cadaveric knees were tested. Computed tomography scans were performed at different knee flexion angles (0°, 45°, 90°, and 120°). Femoral and tibial GTAs were measured at different knee flexion angles on the 3D knee models. Using pressure sensitive films, stress on the graft of the angulation of the femoral tunnel aperture was measured in posterior cruciate ligament reconstructed cadaveric knees. Results Between 45° and 120° of knee flexion, there were no significant differences between the outside-in and modified inside-out techniques. However, the femoral GTA for the conventional inside-out technique was significantly less than that for the other two techniques (p<0.001). In cadaveric experiments using pressure-sensitive film, the maximum contact pressure for the modified inside-out and outside-in technique was significantly lower than that for the conventional inside-out technique (p=0.024 and p=0.017). Conclusion The conventional inside-out technique results in a significantly lesser GTA and higher stress at the intra-articular aperture of the femoral tunnel than the outside-in technique. However, the results for the modified inside-out technique are similar to those for the outside-in technique. PMID:23709438

  4. Complications, effects on dialysis dose, and survival of tunneled femoral dialysis catheters in acute renal failure.

    PubMed

    Klouche, Kada; Amigues, Laurent; Deleuze, Sebastien; Beraud, Jean-Jacques; Canaud, Bernard

    2007-01-01

    Availability of a functional vascular access is a mandatory prerequisite for extracorporeal renal replacement therapy in patients with acute renal failure. The femoral site of insertion commonly is chosen because it is an easy and convenient access. However, an array of complications may substantially alter the quality of treatment, and it appears that catheter-related morbidity and dysfunction are more frequent with the femoral than internal jugular site. This study is designed to evaluate the potential benefits of using soft silicone tunneled catheters ((ST)Caths) at the femoral site. Thirty patients with acute renal failure treated by intermittent hemodialysis (IHD) and/or continuous venovenous hemodiafiltration (CVVHDF) were assigned to either twin (ST)Caths or twin polyurethane nontunneled femoral catheters. Time necessary for catheter insertion, catheter-related complications, and catheter lifespan were monitored. Catheter performance during IHD and the effect of catheter type on dialysis dose were evaluated. The time necessary for (ST)Cath insertion was significantly longer. The incidence of vein thrombosis and catheter-related infection was lower, and the ratio of venous return pressure to catheter blood flow was better with an (ST)Cath. Recirculation rates were similar for both types of catheters. Whether treated by using IHD or CVVHDF, patients with an (ST)Cath benefited from a greater delivered dialysis dose. Multivariate analysis confirmed that (ST)Cath use was a determinant factor to optimize dialysis dose delivery. (ST)Cath patency was significantly longer. In patients with acute renal failure, use of an (ST)Cath minimizes catheter-related morbidity and improves dialysis efficiency compared with conventional femoral catheters.

  5. ACL Roof Impingement Revisited: Does the Independent Femoral Drilling Technique Avoid Roof Impingement With Anteriorly Placed Tibial Tunnels?

    PubMed

    Tanksley, John A; Werner, Brian C; Conte, Evan J; Lustenberger, David P; Burrus, M Tyrrell; Brockmeier, Stephen F; Gwathmey, F Winston; Miller, Mark D

    2017-05-01

    Anatomic femoral tunnel placement for single-bundle anterior cruciate ligament (ACL) reconstruction is now well accepted. The ideal location for the tibial tunnel has not been studied extensively, although some biomechanical and clinical studies suggest that placement of the tibial tunnel in the anterior part of the ACL tibial attachment site may be desirable. However, the concern for intercondylar roof impingement has tempered enthusiasm for anterior tibial tunnel placement. To compare the potential for intercondylar roof impingement of ACL grafts with anteriorly positioned tibial tunnels after either transtibial (TT) or independent femoral (IF) tunnel drilling. Controlled laboratory study. Twelve fresh-frozen cadaver knees were randomized to either a TT or IF drilling technique. Tibial guide pins were drilled in the anterior third of the native ACL tibial attachment site after debridement. All efforts were made to drill the femoral tunnel anatomically in the center of the attachment site, and the surrogate ACL graft was visualized using 3-dimensional computed tomography. Reformatting was used to evaluate for roof impingement. Tunnel dimensions, knee flexion angles, and intra-articular sagittal graft angles were also measured. The Impingement Review Index (IRI) was used to evaluate for graft impingement. Two grafts (2/6, 33.3%) in the TT group impinged upon the intercondylar roof and demonstrated angular deformity (IRI type 1). No grafts in the IF group impinged, although 2 of 6 (66.7%) IF grafts touched the roof without deformation (IRI type 2). The presence or absence of impingement was not statistically significant. The mean sagittal tibial tunnel guide pin position prior to drilling was 27.6% of the sagittal diameter of the tibia (range, 22%-33.9%). However, computed tomography performed postdrilling detected substantial posterior enlargement in 2 TT specimens. A significant difference in the sagittal graft angle was noted between the 2 groups. TT grafts were

  6. Femoral and Tibial Tunnel Widening following Anterior Cruciate Ligament Reconstruction using Various Modalities of Fixation: A Prospective Observational Study

    PubMed Central

    Kanthila, Mahesha; Saya, Rama Prakasha; Vidyasagar, JVS

    2016-01-01

    Introduction Bone tunnel enlargement after Anterior Cruciate Ligament Reconstruction (ACL-R) is a well-accepted phenomenon but there are very few published data comparing the extent of tunnel widening by various methods of fixation after ACL-R. Aim To compare the femoral and tibial tunnel widening following ACL-R with different methods of fixation using CT scan. Materials and Methods This one year prospective study included all patients with chronic Anterior Cruciate Ligament (ACL) injury who underwent primary arthroscopic ACL-R using tripled hamstring tendon autograft. The graft was fixed to the tibial tunnel by Interference Screw (IFS) or Suture Disc (SD) and to the femoral tunnel by IFS, SD, Cross-Pin (CP) or Endo-button CL (Smith & Nephew). The widening of the tibial and femoral tunnels in different methods of fixation was assessed by Computed Tomography (CT) at 12 months follow-up; and was compared using paired sample test. Results A total of 63 patients were included in the study of which 58 (92%) were males and 5 (8%) were females, with a mean age of 29.1 ± 5.9 years. The tibial tunnel widening at one year follow-up was 1.680 ± 1.08794 (19.37%) and 1.517 ± 0.94834 mm (17.39%) by IFS and SD methods respectively. Femoral tunnel widening at one year follow-up was 1.294 ± 0.231, 1.809 ± 0.912, 1.320 ± 0.238, 1.779 ± 0.889 mm by IFS, SD, EB, and CP methods respectively. Femoral tunnel widening following suture disc method of fixation was very highly significant (p<0.001) in comparison with other methods. Conclusion Femoral tunnel and tibial tunnel widening varies with different methods of fixation and was maximum with suture disc method compared to others at one year follow-up after ACL-R. PMID:28050456

  7. The orientation distribution of tunneling-related quantities

    NASA Astrophysics Data System (ADS)

    Seif, W. M.; Refaie, A. I.; Botros, M. M.

    2017-09-01

    In the nuclear tunneling processes involving deformed nuclei, most of the tunneling-related quantities depend on the relative orientations of the participating nuclei. In the presence of different multipole deformations, we study the variation of a few relevant quantities for the α-decay and the sub-barrier fusion processes, in an orientation degree of freedom. The knocking frequency and the penetration probability are evaluated within the Wentzel-Kramers-Brillouin approximation. The interaction potential is calculated with Skyrme-type nucleon-nucleon interaction. We found that the width of the potential pocket, the Coulomb barrier radius, the penetration probability, the α-decay width, and the fusion cross-section follow consistently the orientation-angle variation of the radius of the deformed nucleus. The orientation distribution patterns of the pocket width, the barrier radius, the logarithms of the penetrability, the decay width, and the fusion cross-section are found to be highly analogous to pattern of the deformed-nucleus radius. The curve patterns of the orientation angle distributions of the internal pocket depth, the Coulomb barrier height and width, as well as the knocking frequency simulate inversely the variation of the deformed nucleus radius. The predicted orientation behaviors will be of a special interest in predicting the optimum orientations for the tunneling processes.

  8. Knee rotation influences the femoral tunnel angle measurement after anterior cruciate ligament reconstruction: a 3-dimensional computed tomography model study.

    PubMed

    Tang, Jing; Thorhauer, Eric; Marsh, Chelsea; Fu, Freddie H; Tashman, Scott

    2014-07-01

    Femoral tunnel angle (FTA) has been proposed as a metric for evaluating whether ACL reconstruction was performed anatomically. In clinic, radiographic images are typically acquired with an uncertain amount of internal/external knee rotation. The extent to which knee rotation will influence FTA measurement is unclear. Furthermore, differences in FTA measurement between the two common positions (0° and 45° knee flexion) have not been established. The purpose of this study was to investigate the influence of knee rotation on FTA measurement after ACL reconstruction. Knee CT data from 16 subjects were segmented to produce 3D bone models. Central axes of tunnels were identified. The 0° and 45° flexion angles were simulated. Knee internal/external rotations were simulated in a range of ± 20°. FTA was defined as the angle between the tunnel axis and femoral shaft axis, orthogonally projected into the coronal plane. Femoral tunnel angle was positively/negatively correlated with knee rotation angle at 0°/45° knee flexion. At 0° knee flexion, FTA for anterio-medial (AM) tunnels was significantly decreased at 20° of external knee rotation. At 45° knee flexion, more than 16° external or 19° internal rotation significantly altered FTA measurements for single-bundle tunnels; smaller rotations (± 9° for AM, ± 5° for PL) created significant errors in FTA measurements after double-bundle reconstruction. Femoral tunnel angle measurements were correlated with knee rotation. Relatively small imaging malalignment introduced significant errors with knee flexed 45°. This study supports using the 0° flexion position for knee radiographs to reduce errors in FTA measurement due to knee internal/external rotation.

  9. RISKS AND CONSEQUENCES OF USING THE TRANSPORTAL TECHNIQUE IN RECONSTRUCTING THE ANTERIOR CRUCIATE LIGAMENT: RELATIONSHIPS BETWEEN THE FEMORAL TUNNEL, LATERAL SUPERIOR GENICULAR ARTERY AND LATERAL EPICONDYLE OF THE FEMORAL CONDYLE

    PubMed Central

    Astur, Diego Costa; Aleluia, Vinicius; Santos, Ciro Veronese; Arliani, Gustavo Gonçalves; Badra, Ricardo; Oliveira, Saulo Gomes; Kaleka, Camila Cohen; Cohen, Moisés

    2015-01-01

    Objective: Define a security zone to avoid possibles vascular and ligamentar complications during anterior cruciate ligament reconstruction. Methods: Arthroscopic reconstruction using the transtibial and transportal technique in cadaver knees was performed followed by dissection and measurement of the distance between the femoral tunnel and the proximal attachment of the lateral collateral ligament and the femoral tunnel and the lateral superior genicular artery. Results: The measure of the analysed distances show us an aproximation between the major branch of the lateral superior genicular artery and the femoral insertion of the colateral lateral ligament and the femoral tunnel during the transportal technique. Conclusion: We realize that the use of technical ship it to arthroscopic ACL reconstruction has a higher probability of injury to the lateral geniculate artery and insertion of the lateral collateral ligament, promoting post-surgical complications such as instability of the knee, osteonecrosis of the femoral condyle and ligamentização graft. PMID:27047873

  10. Functional and computed tomography correlation of femoral and tibial tunnels in single-bundle anterior cruciate ligament reconstruction: Use of accessory anteromedial portal

    PubMed Central

    Mathai, Naveen Joseph; Amaravathi, Rajkumar S; Pavan, KV; Sekaran, Padmanabhan; Sharma, Gaurav; Codanda, Belliappa

    2016-01-01

    Background: An accessory anteromedial portal (AAMP) has been shown to be effective in placing an anatomically ideal femoral tunnel. It is well known that this is due to the independent femoral drilling which is possible with the AAMP. However very little is known regarding the significance of this reconstruction technique in influencing the functional outcomes of anatomic anterior cruciate ligament reconstruction (ACLR). This study documents the influence of tibial and femoral tunnel positions on functional outcomes of anatomic ACLR using the AAMP. Materials and Methods: 41 patients who underwent anatomic ACLR between 2011 and 2013 were included in this prospective cohort study. The primary outcome involved the documentation of femoral and tibial tunnel positions with volume rendering imaging using a three-dimensional computed tomography (3D-CT) done at the end of 1 year. The tunnel position evaluations from the CT images were performed by an independent observer specializing in radiodiagnosis. Functional outcome measures included preoperative and postoperative Lysholm and International Knee Documentation Committee (IKDC) scores (subjective) documented by an independent investigator who was not involved with the surgical procedure, at the end of 1 year. Results: The minimum followup was 1 year. All patients achieved good clinical and functional outcomes postoperatively with no reported complications. Tunnel position evaluations with 3D-CT revealed the average tibial tunnel distance to be 15.5 mm (standard deviation [SD] =2.52) from the anterior border of the tibial plateau and the average femoral tunnel distance to be 14.33 mm (SD = 2.6) from the inferior margin of the medial surface of lateral femoral condyle and 13.72 mm (SD = 2.8) from the posterior margin of the medial surface of lateral femoral condyle. The average tunnel diameters were found to be 7.9 mm (SD = 0.72) for the tibial tunnels and 8.6 mm (SD = 1.07) for the femoral tunnels. Statistically

  11. 3D Computed Tomography Evaluation of Morphological Changes in the Femoral Tunnel After Medial Patellofemoral Ligament Reconstruction With Hamstring Tendon Graft for Recurrent Patellar Dislocation.

    PubMed

    Kita, Keisuke; Tanaka, Yoshinari; Toritsuka, Yukiyoshi; Amano, Hiroshi; Uchida, Ryohei; Shiozaki, Yoshiki; Takao, Rikio; Horibe, Shuji

    2017-06-01

    Reconstruction of the medial patellofemoral ligament (MPFL) for recurrent lateral patellar dislocation is gaining popularity. However, the morphological changes in the femoral tunnel after MPFL reconstruction are still not fully documented. This study used 3-dimensional (3D) computed tomography to evaluate morphological changes in the femoral tunnel after MPFL reconstruction with hamstring tendon graft to investigate factors affecting the phenomenon and to elucidate whether it is associated with clinical outcomes. Case series; Level of evidence, 4. Twenty-three patients with recurrent patellar dislocation were prospectively enrolled in this study. The patients included 6 males and 17 females with a mean age of 24 years (range, 14-53). The MPFL was reconstructed by creating 2 patellar bone sockets and 1 femoral bone socket anatomically under X-ray control, and the semitendinosus autograft was fixed with cortical suspension devices. Computed tomography scans obtained 3 weeks and 1 year after surgery were reconstructed into 3D constructs with a volume analyzer. Cross-sectional areas (CSAs) of the aperture and inside the femoral tunnel were compared between the 2 time points. Likewise, the location of tunnel walls and center of the femoral tunnel footprint were evaluated. Relationships were assessed between femoral tunnel morphological changes and potential risk factors-such as age, body mass index, sex, femoral tunnel positioning, patellar height, sulcus angle, congruence angle, lateral tilt angle, degree of trochlear dysplasia, lateral deviation of the tibial tubercle, and Kujala score. No patient reported recurrence of patellar dislocation during the follow-up period. The CSA of the femoral tunnel aperture enlarged by 41.1% ± 34.7% ( P < .01). The center, anterior border, and proximal border of the femoral tunnel significantly shifted in the anterior direction ( P < .01). The distal border significantly shifted in both anterior and distal directions ( P < .01

  12. Does Orientation of the Femoral Head Affect Acetabular Development? An Experimental Study in Lamb.

    PubMed

    Moraleda, Luis; Bravo, Christian; Forriol, Francisco; Albiñana, Javier

    2017-03-21

    Derotational osteotomy of the proximal femur has proved to be effective in the treatment of residual acetabular dysplasia. However, the reason why this osteotomy is effective remains debatable. The purpose of this study is to investigate if an alteration of femoral head orientation affects acetabular growth. A proximal femoral osteotomy was performed in 21 lambs aged 3 months: 5 varus osteotomies (110 degrees), 4 valgus osteotomies (150 degrees), and 12 derotation osteotomies. Results were compared with a control group (5 animals). Osteotomy was fixed with a screw-plate device. Version was controlled intraoperatively with K-wires. Animals were killed 3 months after surgical procedure. A morphometric study of both proximal femur and acetabulum was performed, including deepness, volume and diameters of the acetabulum, neck-shaft angle and femoral version. The average neck-shaft angle for the normal, anteversion, and retroversion groups was 129 degrees, whereas it was 110 degrees for the varus group and 149 degrees for the valgus group. The average femoral version for the normal, valgus, and varus groups was 21 degrees of anteversion, whereas it was 38 degrees of anteversion for the so-called anteversion group and 17 degrees of retroversion for the retroversion group. Nor the neck-shaft angle, nor the femoral version correlated with the acetabular anteroposterior diameter (P=0.698, 0.6, respectively), the acetabular inferosuperior diameter (P=0.083, 0.451, respectively) or the acetabular deepness (P=0.14, 0.371, respectively). The neck-shaft angle correlated significantly with acetabular volume (P=0.023), so that the lower the neck-shaft angle, the higher the acetabular volume (r=-0.453). The femoral version did not correlated with acetabular volume (P=0.381). Decreasing the neck-shaft angle provokes an increase in acetabular volume, whereas changes in femoral version do not affect the acetabular growth. Extra-articular osteotomies that alter femoral orientation

  13. Comparison of Knee Kinematics After Single-Bundle Anterior Cruciate Ligament Reconstruction via the Medial Portal Technique With a Central Femoral Tunnel and an Eccentric Femoral Tunnel and After Anatomic Double-Bundle Reconstruction: A Human Cadaveric Study.

    PubMed

    Herbort, Mirco; Domnick, Christoph; Raschke, Michael Johannes; Lenschow, Simon; Förster, Tim; Petersen, Wolf; Zantop, Thore

    2016-01-01

    Anatomic femoral tunnel placement in anterior cruciate ligament (ACL) reconstruction is considered to be a key to good primary stability of the knee. There is still no consensus on whether a centrally placed single bundle in the anatomical femoral footprint can compare with anatomic double-bundle (DB) reconstruction. The purpose of this study was to determine knee kinematics after single-bundle ACL reconstruction via the medial portal technique using 2 different femoral tunnel positions and to compare results with those of the anatomic DB technique. The hypotheses were that (1) single-bundle reconstruction using the medial portal technique with a centrally placed femoral tunnel relative to the native footprint (SB-central technique) would more closely restore intact knee kinematics compared with the same reconstruction technique with an eccentric femoral tunnel drilled in the anteromedial bundle footprint (SB-AM technique) and (2) DB reconstruction would result in superior kinematics compared with the SB-central technique. Controlled laboratory study. Knee kinematics was examined in 10 fresh-frozen human cadaveric knees using a robotic/universal force-moment sensor system. Kinematics in simulated pivot-shift and 134-N anterior tibial loading tests were determined in different conditions within the same specimen: (1) intact ACL, (2) deficient ACL, (3) SB-AM, (4) SB-central, and (5) DB. All reconstruction techniques significantly reduced anterior tibial translation (ATT) compared with a deficient ACL at 0°, 15°, 30°, 60°, and 90° in the anterior tibial loading test (P < .01, repeated-measures analysis of variance) and at 0°, 15°, and 30° in the simulated pivot-shift test (P < .001). There were no significant differences in the SB-central group and the DB group compared with the intact ACL. Reconstruction in the SB-AM group resulted in significantly increased ATT compared with the intact ACL in near-to-extension angles in both tests (0°, 15°, and 30°; P

  14. Detection of coxarthrosis in femoral head radiographic images seems limited mainly to vertically oriented pattern features.

    PubMed

    Rapan, Sasa; Jovanović, Savo; Gulan, Gordan; Kurbel, Sven

    2013-03-01

    Out of 120 conventional hip joint X-rays, two indepenendent examiners have chosen 27 healthy and 62 coxarthrotic joints. Central parts of femoral head images were digitalized (300 points/inch) and pixel density values analysed. Two methods were applied separately to horizontal rows and to vertical columns: variance coefficient calculation and power coefficients of Fourier harmonics. The arithmetic mean and median of variance coefficient for 256 pixel columns were both significantly higher in data of osteoarthrotic femurs (Mann-Whitney U-test, p = 0.0046 and p = 0.0011, respectively), while no difference was found for horizontal rows. The arithmetic mean and median of variance coefficient for 128 pixels long columns were significantly lower in data of osteoarthrotic femurs (p < 0.001) with wider standard deviation (p = 0.0274), while standard deviation was significantly lower in rows of coxarthrotic heads (p < 0.001). Fourier analysis of 128 pixel vertical columns showed significantly higher values in coxarthrotic femoral heads (from 1st harmonic, wave length of 10.8 mm to 33rd harmonic, wave length of 0.328 mm, p < 0.05). Fourier analysis of 128 pixel horizontal rows did not differ much between coxarthrotic and normal femoral heads. Only valuds for the 60th and 61st harmonic (wavelength near 0.2 mm) showed significantly lower power in coxarthrotic images than in controls (p < 0.01). Results suggest that in the analyzed set of digitalized x-ray femoral head images, information regarding osteoarthrotic changes in the central part of femoral head is detectable mainly through mathematic postprocessing of vertically oriented patterns.

  15. 3D CT analysis of femoral and tibial tunnel positions after modified transtibial single bundle ACL reconstruction with varus and internal rotation of the tibia.

    PubMed

    Youm, Yoon-Seok; Cho, Sung-Do; Eo, Jin; Lee, Ki-Jae; Jung, Kwang-Hwan; Cha, Jae-Ryong

    2013-08-01

    We analyzed the location of femoral and tibial tunnels by three-dimensional (3D) CT reconstruction images after modified transtibial single bundle (SB) anterior cruciate ligament (ACL) reconstruction, creating a femoral tunnel with varus and internal rotation of the tibia. Data from 50 patients (50 knees) analyzed by 3D CT after modified transtibial SB ACL reconstructions were evaluated. 3D CT images were analyzed according to the quadrant method by Bernard at the femur and the technique of Forsythe at the tibia. The mean distance of the femoral tunnel center locations parallel to the Blumensaat's line was 29.6%±1.9% along line t measured from the posterior condylar surface. The mean distances perpendicular to the Blumensaat's line were 37.9%±2.5% along line h measured from the Blumensaat's line. At the tibia, the mean anterior-to-posterior distance for the tunnel center location was 37.8%±1.2% and the mean medial-to-lateral distance was 50.4%±0.9%. The femoral and tibial tunnels after modified transtibial SB ACL reconstruction creating a femoral tunnel with varus and internal rotation of the tibia (figure-of-4 position) were located between the anatomical anteromedial and posterolateral footprints. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. Can markers injected into a single-loop anterior cruciate ligament graft define the axes of the tibial and femoral tunnels? A cadaveric study using roentgen stereophotogrammetric analysis.

    PubMed

    Smith, Conrad; Hull, M L; Howell, S M

    2008-08-01

    Lengthening of a soft-tissue anterior cruciate ligament (ACL) graft construct over time, which leads to an increase in anterior laxity following ACL reconstruction, can result from relative motions between the graft and fixation devices and between the fixation devices and bone. To determine these relative motions using Roentgen stereophotogrammetry (RSA), it is first necessary to identify the axes of the tibial and femoral tunnels. The purpose of this in vitro study was to determine the error in using markers injected into the portions of a soft-tissue tendon graft enclosed within the tibial and femoral tunnels to define the axes of these tunnels. Markers were injected into the tibia, femur, and graft in six cadaveric legs the knees of which were reconstructed with single-loop tibialis grafts. The axes of the tunnels were defined by marker pairs that were injected into the bones on lines parallel to the walls of the tibial and femoral tunnels (i.e., standard). By using marker pairs injected into the portions of the graft enclosed within the tibial and femoral tunnels and the marker pairs aligned with the tunnel axes, the directions of vectors were determined by using RSA, while a 150 N anterior force was transmitted at the knee. The average and standard deviations of the angle between the two vectors were 5.5+/-3.3 deg. This angle translates into an average error and standard deviation of the error in lengthening quantities (i.e., relative motions along the tunnel axes) at the sites of fixation of (0.6+/-0.8)%. Identifying the axes of the tunnels by using marker pairs in the graft rather than marker pairs in the walls of the tunnels will shorten the surgical procedure by eliminating the specialized tools and time required to insert marker pairs in the tunnel walls and will simplify the data analysis in in vivo studies.

  17. Femoral and Tibial Tunnel Diameter and Bioabsorbable Screw Findings After Double-Bundle ACL Reconstruction in 5-Year Clinical and MRI Follow-up

    PubMed Central

    Kiekara, Tommi; Paakkala, Antti; Suomalainen, Piia; Huhtala, Heini; Järvelä, Timo

    2017-01-01

    Background: Tunnel enlargement is frequently seen in short-term follow-up after anterior cruciate ligament reconstruction (ACLR). According to new evidence, tunnel enlargement may be followed by tunnel narrowing, but the long-term evolution of the tunnels is currently unknown. Hypothesis/Purpose: The hypothesis was that tunnel enlargement is followed by tunnel narrowing caused by ossification as seen in follow-up using magnetic resonance imaging (MRI). The purpose of this study was to evaluate the ossification pattern of the tunnels, the communication of the 2 femoral and 2 tibial tunnels, and screw absorption findings in MRI. Study Design: Case series; Level of evidence, 4. Methods: Thirty-one patients underwent anatomic double-bundle ACLR with hamstring grafts and bioabsorbable interference screw fixation and were followed with MRI and clinical evaluation at 2 and 5 years postoperatively. Results: The mean tunnel enlargement at 2 years was 58% and reduced to 46% at 5 years. Tunnel ossification resulted in evenly narrowed tunnels in 44%, in conical tunnels in 48%, and fully ossified tunnels in 8%. Tunnel communication increased from 13% to 23% in the femur and from 19% to 23% in the tibia between 2 and 5 years and was not associated with knee laxity. At 5 years, 54% of the screws were not visible, with 35% of the screws replaced by a cyst and 19% fully ossified. Tunnel cysts were not associated with worse patient-reported outcomes or knee laxity. Patients with a tibial anteromedial tunnel cyst had higher Lysholm scores than patients without a cyst (93 and 84, P = .03). Conclusion: Tunnel enlargement was followed by tunnel narrowing in 5-year follow-up after double-bundle ACLR. Tunnel communication and tunnel cysts were frequent MRI findings and not associated with adverse clinical evaluation results. PMID:28203605

  18. An in Vivo 3D Computed Tomographic Analysis of Femoral Tunnel Geometry and Aperture Morphology Between Rigid and Flexible Systems in Double-Bundle Anterior Cruciate Ligament Reconstruction Using the Transportal Technique.

    PubMed

    Kim, Jae Gyoon; Chang, Min Ho; Lim, Hong Chul; Bae, Ji Hoon; Lee, Seung Yup; Ahn, Jin Hwan; Wang, Joon Ho

    2015-07-01

    The aim of this study was to compare femoral tunnel length, femoral graft-bending angle, posterior wall breakage, and femoral aperture morphologic characteristics between rigid and flexible systems after double-bundle (DB) anterior cruciate ligament (ACL) reconstruction using the transportal (TP) technique. We evaluated 3-dimensional computed tomography (3D-CT) results for 54 patients who underwent DB ACL reconstruction using the TP technique with either a flexible system (n = 27) or a rigid system (n = 27). The femoral tunnel length, femoral graft-bending angle, posterior wall breakage, femoral tunnel aperture height to width (H:W) ratio, aperture axis angle, and femoral tunnel position were assessed using OsiriX Imaging Software and Geomagic Qualify 2012 (Geomagic, Cary, NC). The mean anteromedial (AM) femoral tunnel length of the flexible group was significantly longer than that of the rigid group (P = .009). The mean femoral graft-bending angles in the flexible group were significantly less acute than those in the rigid group (AM, P < .001; posterolateral [PL], P = .003]. Posterior wall breakage was observed in both groups (P = 1.00). The mean H:W ratios in the rigid group were significantly larger (more elliptical) than those of the flexible group (AM, P < .001; PL, P = .006). The mean aperture axis angle of the PL femoral tunnel in the rigid group was more parallel to the femoral shaft axis than that in the flexible group (P < .001). There were no significant differences in femoral tunnel position between the 2 groups. The AM femoral tunnel length and the AM/PL femoral graft-bending angle of the flexible system were significantly longer and less acute than those of the rigid system. However, the aperture morphologic characteristics of the AM/PL femoral tunnel and the aperture axis angle of the PL femoral tunnel in the rigid system were significantly more elliptical and closer to parallel to the femoral shaft axis than those of the flexible system. Level

  19. In vivo evaluation of femoral and tibial graft tunnel placement following all-inside arthroscopic tibial inlay reconstruction of the posterior cruciate ligament.

    PubMed

    Osti, Michael; Krawinkel, Alessa; Benedetto, Karl Peter

    2014-12-01

    The arthroscopic all-inside tibial inlay technique represents a novel procedure for posterior cruciate ligament (PCL) reconstruction. However, in vivo investigations that evaluate the accuracy of this technique regarding anatomic graft tunnel placement are few. The objective of this study was to analyse the femoral and tibial tunnel apertures using computed tomography (CT) and compare these findings to recommendations in the literature. CT scans were obtained in 45 patients following single-bundle PCL reconstruction. The centres of the tibial and femoral tunnel apertures were correlated to measurement grid systems used as a radiographic reference. The centre of the femoral tunnel aperture was located at 42.9% ± 9.4% of the total intercondylar depth and at 12.9% ± 7.2% of the total intercondylar height. The angle α for the femoral tunnel position was measured at 64.2° ± 10.0°. The centre of the tibial tunnel aperture was found at 51.8% ± 4.1% of the total mediolateral diameter of the tibial plateau. The superoinferior distance of the tibial tunnel aperture to the joint line was 9.6 mm ± 4.4 mm on frontal and 9.3 mm ± 3.4 mm on sagittal 3D-CT scans. The distance of the tibial tunnel aperture to the former physis line averaged to 0.8 mm ± 3.4 mm. Comparison to the corresponding reference values revealed no statistically significant difference. Arthroscopic tibial inlay reconstruction is an efficient procedure for precise replication of the anatomical footprint of the PCL. IV, prospective case series. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Does a trochanteric lag screw improve fixation of vertically oriented femoral neck fractures? A biomechanical analysis in cadaveric bone.

    PubMed

    Hawks, Michael A; Kim, Hyunchul; Strauss, Joseph E; Oliphant, Bryant W; Golden, Robert D; Hsieh, Adam H; Nascone, Jason W; O'Toole, Robert V

    2013-10-01

    We assessed the biomechanical performances of a trochanteric lag screw construct and a traditional inverted triangle construct in the treatment of simulated Pauwels type 3 femoral neck fractures. An inverted triangle construct (three 7.3-mm cannulated screws placed in inverted triangle orientation) and a trochanteric lag screw construct (two 7.3-mm cannulated screws placed across the superior portion of the femoral neck and one 4.5-mm lag screw placed perpendicular to the fracture in superolateral to inferomedial orientation) were tested in nine matched pairs of non-osteoporotic human cadaveric femora. We used a previously described vertically oriented femoral neck fracture model and testing protocol that incrementally loaded the constructs along the mechanical axis of the femur to 1400 N. Specimens that survived incremental loading underwent cyclic loading. Apparent construct stiffness, force at 3mm of displacement, and survival of incremental loading were recorded. The trochanteric lag screw group had a 70% increase in stiffness (261 N/mm [29 standard deviation] versus 153 N/mm [16 standard deviation]; P=0.026) and a 43% increase in force required for displacement (620 N versus 435 N; P=0.018) compared with the inverted triangle group. One trochanteric lag screw and no inverted triangle specimen survived incremental loading. A trochanteric lag screw construct applied to vertically oriented femoral neck fractures provides marked improvement in mechanical performance compared with the inverted triangle construct. © 2013.

  1. Orientation and depth estimation for femoral components using image sensor, magnetometer and inertial sensors in THR surgeries.

    PubMed

    Jiyang Gao; Shaojie Su; Hong Chen; Zhihua Wang

    2015-08-01

    Malposition of the acetabular and femoral component has long been recognized as an important cause of dislocation after total hip replacement (THR) surgeries. In order to help surgeons improve the positioning accuracy of the components, a visual-aided system for THR surgeries that could estimate orientation and depth of femoral component is proposed. The sensors are fixed inside the femoral prosthesis trial and checkerboard patterns are printed on the internal surface of the acetabular prosthesis trial. An extended Kalman filter is designed to fuse the data from inertial sensors and the magnetometer orientation estimation. A novel image processing algorithm for depth estimation is developed. The algorithms have been evaluated under the simulation with rotation quaternion and translation vector and the experimental results shows that the root mean square error (RMSE) of the orientation estimation is less then 0.05 degree and the RMSE for depth estimation is 1mm. Finally, the femoral head is displayed in 3D graphics in real time to help surgeons with the component positioning.

  2. The predictive effect of anatomic femoral and tibial graft tunnel placement in posterior cruciate ligament reconstruction on functional and radiological outcome.

    PubMed

    Osti, Michael; Hierzer, Doris; Krawinkel, Alessa; Hoffelner, Thomas; Benedetto, Karl Peter

    2015-06-01

    Biomechanical reports have advocated anatomic graft tunnel placement for reconstruction of the posterior cruciate ligament (PCL) to restore knee joint stability and facilitate optimal functional outcome. However, in vivo investigations that correlate tunnel position to functional results are lacking so far. This study evaluates the anatomic accuracy of femoral and tibial tunnel apertures on postoperative computed tomography (CT) scans and compares these findings to subjective and objective clinical outcome parameters. After single-bundle PCL reconstruction, 29 patients were stratified into several subgroups according to the anatomic accuracy of femoral and tibial tunnel apertures measured on postoperative CT scans. A threshold value for the centres of the tunnel apertures was determined using a measurement grid system as a radiographic reference. To evaluate the functional and radiological results, visual analogue scale, International Knee Documentation Committee (IKDC), Tegner, Lysholm, Knee Injury and Osteoarthritis Outcome Score and osteoarthritis scores were obtained. Comparison between functional outcome and tunnel position yielded a statistically significant difference for subjective IKDC score and angle segment α and for objective stability and tunnel position P3 but no statistically significant difference with respect to intercondylar depth, intercondylar height and tibial tunnel position P2. No correlation was found between anatomic tunnel position and present or progressive osteoarthritis on follow-up. Of the patients, 72 % classified their result as excellent and good and 90 % would repeat surgical treatment. Despite a small sample size and subject to the threshold values we used, our data indicate a potentially minor effect of anatomic tunnel placement on midterm functional outcome following PCL reconstruction.

  3. The Role of the Indirect Femoral Insertion of the Anterior Cruciate Ligament in Restraining Tibial Translation and Rotation: Implications for Anatomic Femoral Tunnel Placement

    PubMed Central

    Pathare, Neil P.; Nicholas, Stephen J.; Colbrunn, Rob; McHugh, Malachy P.

    2013-01-01

    Objectives: Despite a trend toward lowering the femoral tunnel and thus positioning ACL grafts partially within the indirect insertion of the ACL attachment, the biomechanical role of the indirect insertion has not been described. The purpose of this study was to determine the effect of debridement of the indirect femoral ACL insertion on tibiofemoral translation and rotation. It was hypothesized that debridement would have a negligible affect on tibiofemoral kinematics. Methods: Knee kinematics in six degrees of freedom were measured on a robotic device in nine cadaveric knees. Measurements were made with the ACL intact, following debridement of the indirect insertion, and following complete sectioning of the ACL. Three loading conditions were used: (1) a 134 N anterior tibial load, (2) a combined 10 Nm valgus and 5 Nm internal rotation torque, and (3) a simulated, robotic pivot shift. Debridement involved exposing 5-6 mm of bone from the central, inferior aspect of the direct ACL attachment to the inferior cartilage margin. Anterior tibial translation (ATT) was recorded in response to an anterior tibial load and combined rotatory loads at 0°, 15°, 30°, 45°, 60°, and 90° of knee flexion. Additionally, posterior tibial translation and external tibial rotation were recorded during a simulated, robotic pivot shift. Based on pilot data, it was estimated that 9 specimens would be required to detect a 1.4 mm difference in ATT between different experimental conditions with 80% power at an alpha level of 0.05. Data were analyzed using repeated measures ANOVA. Results: For the anterior tibial loading condition, debridement of the indirect insertion increased tibial translation by 0.37±0.24 mm at 0º (P<.01) and by 0.16±0.19 mm at 15º (P<.05; increases were < 1 mm in all specimens). ACL deficiency increased ATT in response to an anterior tibial load (P<.0001) with maximum effect at 15º (11.26±1.15 mm vs. ACL intact; 11.04±1.08 mm vs. indirect insertion

  4. Anatomic single-bundle anterior cruciate ligament reconstruction using the outside-in femoral tunnel drilling technique: a prospective study and short- to mid-term results.

    PubMed

    Abdelkafy, Ashraf

    2015-03-01

    Anatomic positioning of the femoral and tibial tunnels in the native ACL femoral and tibial footprints requires an independent drilling either via an accessory medial portal (trans-portal drilling) or using an outside-in drilling technique. Conventional trans-tibial drilling (dependant drilling) was found to lack the ability to accurately position the femoral tunnel in the native ACL footprint. The purpose of the current study was to evaluate the functional outcome results of anatomic single-bundle ACLR using the OI femoral tunnel drilling technique. Single surgeon single center prospective case series study. 64 patients having complete ACL tears were included in the current study. Average follow-up was 15.8 months (range 8-25). Objective and subjective IKDC scores, Lysholm knee score, SF-36 score, VAS for patients' satisfaction, VAS for pain and Kellgren and Lawrence (K/L) classification of osteoarthritis were used for follow-up evaluation. Objective IKDC score revealed that 60 patients had grade ''A'' and 4 had grade ''B'', while no single patient had neither grade ''C'' nor ''D''. The average Lysholm Score was 92.4, average subjective IKDC was 91.5. Average SF-36 score was 96.7. The average VAS for operation satisfaction was 9.7. Average VAS for pain was 0.3. Forty-nine patients were classified as normal K/L classification, 7 were grade ''1'', 8 were grade ''2''. Comparing pre-operative and follow-up Objective IKDC, Subjective IKDC, Lysholm, SF-36 and VAS for pain scores revealed statistically significant differences (P value <0.05). Arthroscopic-assisted ACL reconstruction using the outside-in femoral tunnel drilling technique shows a good and satisfactory functional outcome results at short- to mid-term follow-up. Level IV.

  5. Is the Grafted Tendon Shifted Anteriorly in the Femoral Tunnel at the Postremodeling Phase After Anterior Cruciate Ligament Reconstruction? A Clinical MRI Study

    PubMed Central

    Onodera, Jun; Yasuda, Kazunori; Masuda, Tetsuro; Tanabe, Yoshie; Kitamura, Nobuto; Yagi, Tomonori; Kondo, Eiji

    2017-01-01

    Background: Based on previous in vitro studies, it has been commonly believed that during anterior cruciate ligament (ACL) reconstruction with hamstring tendon, the grafted tendon is shifted anteriorly in the tunnel permanently after the graft is anchored to the tunnel wall. However, this has not been proven by in vivo studies. Hypothesis: At 1 year after anatomic double-bundle ACL reconstruction, the grafted tendons may not be shifted anteriorly in the femoral tunnel but anchored to the bony wall at the center of the tunnel. Study Design: Case series; Level of evidence, 4. Methods: Participants consisted of 40 patients who underwent anatomic double-bundle ACL reconstruction. The grafted tendons located in the femoral tunnel were examined 1 year after surgery using 2 different magnetic resonance imaging (MRI) protocols. In the first substudy, with 20 patients, the grafted tendon location was evaluated on an inclined sagittal multiplanar reconstruction (MPR) image taken using a standard T2-weighted protocol. In the second substudy with the remaining 20 patients, tendon location was evaluated on a pure axial MPR image taken using a VISTA (volume isotropic turbo spin echo acquisition) protocol. Results: On the inclined sagittal T2-weighted images of the anteromedial (AM) graft, the anterior width of the newly formed fibrous tissue, which surrounded the tendon graft, was significantly greater than the posterior width (P = .001). The center of the grafted tendon was slightly (mean, 2.5% of the tunnel diameter) but significantly (P = .0310) shifted posteriorly from the tunnel center. On the axial T2-VISTA images, the center of the AM graft was slightly but significantly shifted posteriorly (3.9%; P = .022) and medially (5.5%; P = .002) from the tunnel center. The center of the posterolateral (PL) graft was not significantly shifted to any direction from the center of the tunnel. Conclusion: The grafted tendons were not shifted anteriorly in the femoral tunnel 1 year

  6. Confinement orientation effects in S/D tunneling

    NASA Astrophysics Data System (ADS)

    Medina-Bailon, C.; Sampedro, C.; Gámiz, F.; Godoy, A.; Donetti, L.

    2017-02-01

    The most extensive research of scaled electronic devices involves the inclusion of quantum effects in the transport direction as transistor dimensions approach nanometer scales. Moreover, it is necessary to study how these mechanisms affect different transistor architectures to determine which one can be the best candidate to implement future nodes. This work implements Source-to-Drain Tunneling mechanism (S/D tunneling) in a Multi-Subband Ensemble Monte Carlo (MS-EMC) simulator showing the modification in the distribution of the electrons in the subbands, and, consequently, in the potential profile due to different confinement direction between DGSOIs and FinFETs.

  7. The effect of femoral tunnel widening on one-year clinical outcome after anterior cruciate ligament reconstruction using ZipLoop® technology for fixation in the cortical bone of the femur.

    PubMed

    Basson, Benjamin; Philippot, Rémi; Neri, Thomas; Meucci, Jean François; Boyer, Bertrand; Farizon, Frédéric

    2016-03-01

    The effect of femoral tunnel widening on clinical outcomes of anterior cruciate ligament (ACL) reconstruction has been rarely investigated. In this study, ACL reconstructions were performed using semitendinosus and gracilis (STG) tendon grafts and single cortical fixation on the femoral side. The aim was to analyze femoral tunnel widening at one year and to evaluate its effect on clinical and laximetric outcomes. A total of 46 patients were enrolled in this prospective continuous single-operator monocenter study. Clinical protocol included pre-operative and one-year evaluation with subjective and objective International Knee Documentation Committee (IKDC) clinical scores. Computed tomography (CT) scan was used for radiographic examination during the follow-up period. The femoral tunnel widening was measured as a three-dimensional (3D) image using OsiriX software. The cross-sectional area of each tunnel was measured at four different locations. The subjective preoperative IKDC score was 50 and one-year postoperative score was 81.8. The side-to-side difference in knee laxity decreased from 2.94 to 0.74 mm. The objective IKDC score during the final follow-up was rated A in 27 patients and B in 17. CT scan data revealed an average of 49.32% cone-shaped widening of the femoral tunnel. Femoral tunnel widening at the level of the joint (F4) was negatively correlated with the IKDC subjective score at one year. This study revealed a significant widening of the femoral tunnel by demonstrating its conical shape at one year post-surgery. A significant correlation could be established between femoral tunnel widening close to the joint and IKDC scores. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Radiological analysis on femoral tunnel positioning between isometric and anatomical reconstructions of the anterior cruciate ligament☆☆☆

    PubMed Central

    Vieira, Rodrigo Barreiros; de Pinho Tavares, Leonardo Augusto; Pace Lasmar, Rodrigo Campos; da Cunha, Fernando Amaral; de Melo Lisboa, Lucas Araujo

    2014-01-01

    Objective the aim of this study was to radiologically evaluate the femoral tunnel position in anterior cruciate ligament (ACL) reconstructions using the isometric and anatomical techniques. Methods a prospective analytical study was conducted on patients undergoing ACL reconstruction by means of the isometric and anatomical techniques, using grafts from the knee flexor tendons or patellar tendon. Twenty-eight patients were recruited during the immediate postoperative period, at the knee surgery outpatient clinic of FCMMG-HUSJ. Radiographs of the operated knee were produced in anteroposterior (AP) view with the patient standing on both feet and in lateral view with 30° of flexion. The lines were traced out and the distances and angles were measured on the lateral radiograph to evaluate the sagittal plane. The distance from the center of the screw to the posterior cortical bone of the lateral condyle was measured and divided by the Blumensaat line. In relation to the height of the screw, the distance from the center of the screw to the joint surface of the lateral condyle of the knee was measured. On the AP radiograph, evaluating the coronal plane, the angle between the anatomical axis of the femur and a line traced at the center of the screw was measured. Results with regard to the p measurement (posteriorization of the interference screw), the tests showed that the p-value (0.4213) was greater than the significance level used (0.05); the null hypothesis was not rejected and it could be stated that there was no statistically significant difference between the anatomical and isometric techniques. With regard to the H measurement (height of the screw in relation to the lower cortical bone of the knee), the p-value observed (0.0006) was less than the significance level used (0.05); the null hypothesis was rejected and it could be stated that there was a statistically significant difference between the anatomical and isometric techniques. It can be concluded that the

  9. Free anterolateral thigh flap with vascularized lateral femoral cutaneous nerve for the treatment of neuroma-in-continuity and recurrent carpal tunnel syndrome after carpal tunnel release.

    PubMed

    Yamamoto, Takumi; Narushima, Mitsunaga; Yoshimatsu, Hidehiko; Yamamoto, Nana; Mihara, Makoto; Koshima, Isao

    2014-02-01

    Treatment of recurrent carpal tunnel syndrome (CTS) is challenging, especially in a case with recurrent CTS and a neuroma formation. Resection of the neuroma causing the syndrome, reconstruction of the nerve gap of the median nerve, and covering up the reconstructed median nerve with well-vascularized soft tissue for prevention of CTS re-recurrence are the essential procedures. We report a case of recurrent CTS with severe pain due to a neuroma-in-continuity successfully treated using a free anterolateral thigh (ALT) flap with a vascularized lateral femoral cutaneous nerve (LFCN). A 2 cm neuroma existed in the median nerve and was resected. The nerve gap was repaired using a vascularized LFCN included in the ALT flap. The ALT flap was transferred to the wrist to cover the median nerve. The severe pain disappeared completely and the sensory and motor impairment of the median nerve improved 5 months after the free flap surgery, as the Tinel's sign moved distally away from the wrist and disappeared. The result of the Semmes-Weinstein test improved from 5.08 to 4.31 and she was able to flex and extend the right wrist and fingers without pain. CTS did not recur 15 months after the surgery. A free ALT flap with vascularized LFCN allows nerve reconstruction for the median nerve gap created after neuroma resection and coverage of the median nerve with well-vascularized soft tissue to prevent adhesion and CTS recurrence. Copyright © 2013 Wiley Periodicals, Inc.

  10. Functional integrative analysis of the human hip joint: the three-dimensional orientation of the acetabulum and its relation with the orientation of the femoral neck.

    PubMed

    Bonneau, Noémie; Baylac, Michel; Gagey, Olivier; Tardieu, Christine

    2014-04-01

    In humans, the hip joint occupies a central place in the locomotor system, as it plays an important role in body support and the transmission of the forces between the trunk and lower limbs. The study of the three-dimensional biomechanics of this joint has important implications for documenting the morphological changes associated with the acquisition of a habitual bipedal gait in humans. Functional integration at any joint has important implications in joint stability and performance. The aim of the study was to evaluate the functional integration at the human hip joint. Both the level of concordance between the three-dimensional axes of the acetabulum and the femoral neck in a bipedal posture, and patterns of covariation between these two axes were analysed. First, inter-individual variations were quantified and significant differences in the three-dimensional orientations of both the acetabulum and the femoral neck were detected. On a sample of 57 individuals, significant patterns of covariation were identified, however, the level of concordance between the axes of both the acetabulum and the femoral neck in a bipedal posture was lower than could be expected for a key joint such as the hip. Patterns of covariation were explored regarding the complex three-dimensional biomechanics of the full pelvic-femoral complex. Finally, we suggest that the lower degree of concordance observed at the human hip joint in a bipedal posture might be partly due to the phylogenetic history of the human species.

  11. Systemic Review of Anatomic Single- Versus Double-Bundle Anterior Cruciate Ligament Reconstruction: Does Femoral Tunnel Drilling Technique Matter?

    PubMed

    Zhang, Yang; Xu, Caiqi; Dong, Shiqui; Shen, Peng; Su, Wei; Zhao, Jinzhong

    2016-09-01

    To provide an up-to-date assessment of the difference between anatomic double-bundle anterior cruciate ligament (ACL) reconstruction (DB-ACLR) and anatomic single-bundle ACL reconstruction (SB-ACLR). We hypothesized that anatomic SB-ACLR using independent femoral drilling technique would be able to achieve kinematic stability as with anatomic DB-ACLR. A comprehensive Internet search was performed to identify all therapeutic trials of anatomic DB-ACLR versus anatomic SB-ACLR. Only clinical studies of Level I and II evidence were included. The comparative outcomes were instrument-measured anterior laxity, Lachman test, pivot shift, clinical outcomes including objective/subjective International Knee Documentation Committee (IKDC) score, Lysholm score, Tegner activity scale and complication rates of extension/flexion deficits, graft failure, and early osteoarthritis. Subgroup analyses were performed for femoral tunnel drilling techniques including independent drilling and transtibial (TT) drilling. Twenty-two clinical trials of 2,261 anatomically ACL-reconstructed patients were included in the meta-analysis. Via TT drilling technique, anatomic DB-ACLR led to improved instrument-measured anterior laxity with a standard mean difference (SMD) of -0.42 (95% confidence interval [CI] = -0.81 to -0.02), less rotational instability measured by pivot shift (SMD = 2.76, 95% CI = 1.24 to 6.16), and higher objective IKDC score with odds ratio (OR) of 2.28 (95% CI = 1.19 to 4.36). Via independent drilling technique, anatomic DB-ACLR yielded better pivot shift (SMD = 2.04, 95% CI = 1.36 to 3.05). Anatomic DB-ACLR also revealed statistical significance in subjective IKDC score compared with anatomic SB-ACLR (SMD = 0.27, 95% CI = 0.05 to 0.49). Anatomic DB-ACLR showed better anterior and rotational stability and higher objective IKDC score than anatomic SB-ACLR via TT drilling technique. Via independent drilling technique, however, anatomic DB-ACLR only showed superiority

  12. Optimization of Anteromedial Portal Femoral Tunnel Drilling With Flexible and Straight Reamers in Anterior Cruciate Ligament Reconstruction: A Cadaveric 3-Dimensional Computed Tomography Analysis.

    PubMed

    Forsythe, Brian; Collins, Michael J; Arns, Thomas A; Zuke, William A; Khair, Michael; Verma, Nikhil N; Cole, Brian J; Bach, Bernard R; Inoue, Nozomu

    2017-05-01

    To use 3-dimensional custom CAD technology to evaluate how knee flexion angle affects femoral tunnel length and distance to the posterior wall when using curved and straight guides for drilling through the anteromedial portal (AMP). Six cadaveric knees were placed in an external fixator at various degrees of flexion (90°, 110°, 125°, and maximum 135° to 140°). Computed tomography scans were obtained at all flexion points for 3-dimensional point-cloud models. Using custom CAD software, surgical guides through the AMP were replicated along with virtual tunnels at each flexion angle. Distance from the posterior cortex and tunnel dimensions were collected after 8-mm and 10-mm tunnel creation. At 90° of flexion, the average tunnel length down the posterior aspect of 8-mm tunnel was 25.0 mm (95% confidence interval [CI] 16.2-33.8) and 12.0 mm (95% CI 7.3-16.7) for curved and straight guides, respectively; 31.0 mm (95% CI 26.8-35.2) and 28.6 mm (95% CI 24.8-32.4) at 110°; 33.8 mm (95% CI 30.1-37.5) and 31.1 mm (95% CI 26.8-35.4) at 125°; and 35.0 mm (95% CI 34.1-35.9) and 35.5 mm (95% CI 34.2-36.8) with maximal flexion. Values between curved and straight guides are significantly different (P < .001), with straight guides breaching the posterior wall at 90° and 110° of flexion in some specimens. The average distance to the posterior wall cortex was 0.9 mm (95% CI -1.5 to 3.3) and -0.6 mm (95% CI -2.3 to 1.1) for curved and straight guides, respectively, at 90° of flexion (P = .014); 2.3 mm (95% CI -0.2 to 4.8) and -0.1 mm (95% CI -2.4 to 2.2) at 110° (P = .001); 4.4 mm (95% CI 2.8-6.0) and 3.9 mm (95% CI 1.9-5.9) at 125° (P = .299); and 6.7 mm (95% CI 6.2-7.2) and 8.3 mm (95% CI 6.1-10.5) at maximal flexion (P = .184). Posterior wall blowout was noted when using 10-mm straight guides at both 90° (2 specimens) and 110° (3 specimens). Using 10-mm curved guides posterior blowout was noted in 1 specimen at 90°. Maximum footprint

  13. Atomistic Insights Into the Oriented Attachment of Tunnel-Based Oxide Nanostructures

    SciTech Connect

    Yuan, Yifei; Wood, Stephen M; He, Kun; Yao, Wentao; Tompsett, David; Lu, Jun; Nie, Anmin; Islam, M. Saiful; Shahbazian-Yassar, Reza

    2016-01-01

    Controlled synthesis of nanomaterials is one of the grand challenges facing materials scientists. In particular, how tunnel-based nanomaterials aggregate during synthesis while maintaining their well-aligned tunneled structure is not fully understood. Here, we describe the atomistic mechanism of oriented attachment (OA) during solution synthesis of tunneled α-MnO2 nanowires based on a combination of in situ liquid cell transmission electron microscopy (TEM), aberration-corrected scanning TEM with subangstrom spatial resolution, and first-principles calculations. It is found that primary tunnels (1 × 1 and 2 × 2) attach along their common {110} lateral surfaces to form interfaces corresponding to 2 × 3 tunnels that facilitate their short-range ordering. The OA growth of α-MnO2 nanowires is driven by the stability gained from elimination of {110} surfaces and saturation of Mn atoms at {110}-edges. During this process, extra [MnOx] radicals in solution link the two adjacent {110} surfaces and bond with the unsaturated Mn atoms from both surface edges to produce stable nanowire interfaces. Our results provide insights into the controlled synthesis and design of nanomaterials in which tunneled structures can be tailored for use in catalysis, ion exchange, and energy storage applications.

  14. Resonant spin tunneling in randomly oriented nanospheres of Mn12 acetate

    DOE PAGES

    Lendínez, S.; Zarzuela, R.; Tejada, J.; ...

    2015-01-06

    We report measurements and theoretical analysis of resonant spin tunneling in randomly oriented nanospheres of a molecular magnet. Amorphous nanospheres of Mn₁₂ acetate have been fabricated and characterized by chemical, infrared, TEM, X-ray, and magnetic methods. Magnetic measurements have revealed sharp tunneling peaks in the field derivative of the magnetization that occur at the typical resonant field values for the Mn₁₂ acetate crystal in the field parallel to the easy axis.Theoretical analysis is provided that explains these observations. We argue that resonant spin tunneling in a molecular magnet can be established in a powder sample, without the need for amore » single crystal and without aligning the easy magnetization axes of the molecules. This is confirmed by re-analyzing the old data on a powdered sample of non-oriented micron-size crystals of Mn₁₂ acetate. In conclusion, our findings can greatly simplify the selection of candidates for quantum spin tunneling among newly synthesized molecular magnets.« less

  15. Induced Superconductivity and Engineered Josephson Tunneling Devices in Epitaxial (111)-Oriented Gold/Vanadium Heterostructures.

    PubMed

    Wei, Peng; Katmis, Ferhat; Chang, Cui-Zu; Moodera, Jagadeesh S

    2016-04-13

    We report a unique experimental approach to create topological superconductors by inducing superconductivity into epitaxial metallic thin film with strong spin-orbit coupling. Utilizing molecular beam epitaxy technique under ultrahigh vacuum conditions, we are able to achieve (111) oriented single phase of gold (Au) thin film grown on a well-oriented vanadium (V) s-wave superconductor film with clean interface. We obtained atomically smooth Au thin films with thicknesses even down to below a nanometer showing near-ideal surface quality. The as-grown V/Au bilayer heterostructure exhibits superconducting transition at around 3.9 K. Clear Josephson tunneling and Andreev reflection are observed in S-I-S tunnel junctions fabricated from the epitaxial bilayers. The barrier thickness dependent tunneling and the associated subharmonic gap structures (SGS) confirmed the induced superconductivity in Au (111), paving the way for engineering thin film heterostructures based on p-wave superconductivity and nano devices exploiting Majorana Fermions for quantum computing.

  16. Analysis of acetabular orientation and femoral anteversion using images of three-dimensional reconstructed bone models.

    PubMed

    Park, Jaeyeong; Kim, Jun-Young; Kim, Hyun Deok; Kim, Young Cheol; Seo, Anna; Je, Minkyu; Mun, Jong Uk; Kim, Bia; Park, Il Hyung; Kim, Shin-Yoon

    2017-05-01

    Radiographic measurements using two-dimensional (2D) plain radiographs or planes from computed tomography (CT) scans have several drawbacks, while measurements using images of three-dimensional (3D) reconstructed bone models can provide more consistent anthropometric information. We compared the consistency of results using measurements based on images of 3D reconstructed bone models (3D measurements) with those using planes from CT scans (measurements using 2D slice images). Ninety-six of 561 patients who had undergone deep vein thrombosis-CT between January 2013 and November 2014 were randomly selected. We evaluated measurements using 2D slice images and 3D measurements. The images used for 3D reconstruction of bone models were obtained and measured using [Formula: see text] and [Formula: see text] (Materialize, Leuven, Belgium). The mean acetabular inclination, acetabular anteversion and femoral anteversion values on 2D slice images were 42.01[Formula: see text], 18.64[Formula: see text] and 14.44[Formula: see text], respectively, while those using images of 3D reconstructed bone models were 52.80[Formula: see text], 14.98[Formula: see text] and 17.26[Formula: see text]. Intra-rater reliabilities for acetabular inclination, acetabular anteversion, and femoral anteversion on 2D slice images were 0.55, 0.81, and 0.85, respectively, while those for 3D measurements were 0.98, 0.99, and 0.98. Inter-rater reliabilities for acetabular inclination, acetabular anteversion and femoral anteversion on 2D slice images were 0.48, 0.86, and 0.84, respectively, while those for 3D measurements were 0.97, 0.99, and 0.97. The differences between the two measurements are explained by the use of different tools. However, more consistent measurements were possible using the images of 3D reconstructed bone models. Therefore, 3D measurement can be a good alternative to measurement using 2D slice images.

  17. Risk of fracture of the acromion depends on size and orientation of acromial bone tunnels when performing acromioclavicular reconstruction.

    PubMed

    Dyrna, Felix; de Oliveira, Celso Cruz Timm; Nowak, Michael; Voss, Andreas; Obopilwe, Elifho; Braun, Sepp; Pauzenberger, Leo; Imhoff, Andreas B; Mazzocca, Augustus D; Beitzel, Knut

    2017-10-06

    Current techniques for anatomic repair of the dislocated acromioclavicular (AC) joint aim on reconstruction of the AC ligaments and utilize tunnels drilled through the acromion . This improves the stability of the reconstruction but might also increase the risk of fractures at the acromion. The purpose of this study was to evaluate the fracture risk for the acromion after transacromial tunnel placement for anatomic AC joint stabilization procedure. It was hypothesized that the risk of fracture of the acromion is correlated to size and orientation of bone tunnels commonly used for anatomic AC joint reconstruction. A finite element analysis was used to simulate multiple bone tunnels and incoming force vectors (lateral vs. superior). Different tunnels were analysed, horizontal meaning an anterior-posterior orientation versus a vertical inferior-superior orientation through the acromion. Two tunnel diameters were simulated (2.4 vs. 4.5 mm). Furthermore, the tunnel length and distance between tunnels were altered. Forty-five cadaveric specimens (median age: 64 years, range 33-71 years) were utilized for data acquisition. Out of these, 30 specimens were used to evaluate basic tunnel orientations and drill diameters using a MTS 858 servohydraulic test system. With regard to the tunnel orientation and drill hole size, the loads to failure were limited. The acromion is at higher fracture risk, with a superior to inferior directed incoming force. Position, size and direction of bone tunnels influenced the loads to failure. Horizontal tunnels with a higher diameter (4.5 mm) had the most impact on load to failure reduction. A long horizontal tunnel with a diameter of 4.5 mm reduced the load to failure with medial direction of force to 25% of the native acromion. The identical tunnel with a diameter of 2.4 mm reduced the load to failure to 61%. Both 2.4-mm horizontal tunnels with a medium and short length did not reduce the load to failure. Tunnels placed at the acromion

  18. Fabrication of [001]-oriented tungsten tips for high resolution scanning tunneling microscopy

    PubMed Central

    Chaika, A. N.; Orlova, N. N.; Semenov, V. N.; Postnova, E. Yu.; Krasnikov, S. A.; Lazarev, M. G.; Chekmazov, S. V.; Aristov, V. Yu.; Glebovsky, V. G.; Bozhko, S. I.; Shvets, I. V.

    2014-01-01

    The structure of the [001]-oriented single crystalline tungsten probes sharpened in ultra-high vacuum using electron beam heating and ion sputtering has been studied using scanning and transmission electron microscopy. The electron microscopy data prove reproducible fabrication of the single-apex tips with nanoscale pyramids grained by the {011} planes at the apexes. These sharp, [001]-oriented tungsten tips have been successfully utilized in high resolution scanning tunneling microscopy imaging of HOPG(0001), SiC(001) and graphene/SiC(001) surfaces. The electron microscopy characterization performed before and after the high resolution STM experiments provides direct correlation between the tip structure and picoscale spatial resolution achieved in the experiments. PMID:24434734

  19. Fabrication of [001]-oriented tungsten tips for high resolution scanning tunneling microscopy.

    PubMed

    Chaika, A N; Orlova, N N; Semenov, V N; Postnova, E Yu; Krasnikov, S A; Lazarev, M G; Chekmazov, S V; Aristov, V Yu; Glebovsky, V G; Bozhko, S I; Shvets, I V

    2014-01-17

    The structure of the [001]-oriented single crystalline tungsten probes sharpened in ultra-high vacuum using electron beam heating and ion sputtering has been studied using scanning and transmission electron microscopy. The electron microscopy data prove reproducible fabrication of the single-apex tips with nanoscale pyramids grained by the {011} planes at the apexes. These sharp, [001]-oriented tungsten tips have been successfully utilized in high resolution scanning tunneling microscopy imaging of HOPG(0001), SiC(001) and graphene/SiC(001) surfaces. The electron microscopy characterization performed before and after the high resolution STM experiments provides direct correlation between the tip structure and picoscale spatial resolution achieved in the experiments.

  20. A Comprehensive in vivo Kinematic, Quantitative MRI and Functional Evaluation Following ACL Reconstruction – a Comparison between Mini-Two Incision and Anteromedial Portal Femoral Tunnel Drilling

    PubMed Central

    Lansdown, Drew A.; Allen, Christina; Zaid, Musa; Wu, Samuel; Subburaj, Karupppasamy; Souza, Richard; Feeley, Brian T.; Li, Xiaojuan; Ma, C. Benjamin

    2015-01-01

    Introduction Multiple techniques are used for femoral tunnel drilling in ACL reconstruction, including the Mini-Two Incision method (MT) and Anteromedial Portal technique (AM). Both techniques allow for independent placement of the femoral tunnel, though there are no reports comparing kinematics and cartilage health after these reconstructions. We hypothesized that both techniques would result in the restoration of normal knee kinematics and show no evidence of early cartilage degeneration. Methods A total of 20 patients were evaluated one year after ACL reconstruction, including 10 patients after MT and 10 patients after AM. MR-imaging was acquired bilaterally with the knee loaded in extension and flexion to evaluate kinematics of the reconstructed knee compared to the normal knee. Quantitative cartilage imaging was obtained and compared to 10 matched control subjects. The Marx Activity Rating Scale and KOOS survey were administered. Results The tibia was positioned significantly more anteriorly in extension and flexion relative to the contralateral knee for the MT group. The tibial position in the AM group was not significantly different from the patient’s contralateral knee. T1ρ values in the central-medial tibia were significantly elevated in the MT group compared to the Control group. KOOS Symptom scores were significantly better for the MT group compared to the AM group. Conclusions We have observed in vivo differences in knee kinematics and early cartilage degeneration between patients following MT and AM ACL reconstruction. Both techniques allow for anatomic ACL reconstruction, though the MT group shows significant early differences compared to the patient’s normal knee. PMID:25982298

  1. Mechanism of Orientation-Dependent Asymmetric Charge Transport in Tunneling Junctions Comprising Photosystem I

    PubMed Central

    2016-01-01

    Recently, photoactive proteins have gained a lot of attention due to their incorporation into bioinspired (photo)electrochemical and solar cells. This paper describes the measurement of the asymmetry of current transport of self-assembled monolayers (SAMs) of the entire photosystem I (PSI) protein complex (not the isolated reaction center, RCI), on two different “director SAMs” supported by ultraflat Au substrates. The director SAMs induce the preferential orientation of PSI, which manifest as asymmetry in tunneling charge-transport. We measured the oriented SAMs of PSI using eutectic Ga–In (EGaIn), a large-area technique, and conducting probe atomic force microscopy (CP-AFM), a single-complex technique, and determined that the transport properties are comparable. By varying the temperatures at which the measurements were performed, we found that there is no measurable dependence of the current on temperature from ±0.1 to ±1.0 V bias, and thus, we suggest tunneling as the mechanism for transport; there are no thermally activated (e.g., hopping) processes. Therefore, it is likely that relaxation in the electron transport chain is not responsible for the asymmetry in the conductance of SAMs of PSI complexes in these junctions, which we ascribe instead to the presence of a large, net dipole moment present in PSI. PMID:26057523

  2. Differentiating amino acid residues and side chain orientations in peptides using scanning tunneling microscopy.

    PubMed

    Claridge, Shelley A; Thomas, John C; Silverman, Miles A; Schwartz, Jeffrey J; Yang, Yanlian; Wang, Chen; Weiss, Paul S

    2013-12-11

    Single-molecule measurements of complex biological structures such as proteins are an attractive route for determining structures of the large number of important biomolecules that have proved refractory to analysis through standard techniques such as X-ray crystallography and nuclear magnetic resonance. We use a custom-built low-current scanning tunneling microscope to image peptide structures at the single-molecule scale in a model peptide that forms β sheets, a structural motif common in protein misfolding diseases. We successfully differentiate between histidine and alanine amino acid residues, and further differentiate side chain orientations in individual histidine residues, by correlating features in scanning tunneling microscope images with those in energy-optimized models. Beta sheets containing histidine residues are used as a model system due to the role histidine plays in transition metal binding associated with amyloid oligomerization in Alzheimer's and other diseases. Such measurements are a first step toward analyzing peptide and protein structures at the single-molecule level.

  3. What is the orientation of the tip in a scanning tunneling microscope?

    NASA Astrophysics Data System (ADS)

    Mándi, Gábor; Teobaldi, Gilberto; Palotás, Krisztián

    2015-05-01

    The atomic structure and electronic properties of the tip apex can strongly affect the contrast of scanning tunneling microscopy (STM) images. This is a critical issue in STM imaging given the, to date unsolved, experimental limitations in precise control of the tip apex atomic structure. Definition of statistically robust procedures to indirectly obtain information on the tip apex structure is highly desirable as it would open up for more rigorous interpretation and comparison of STM images from different experiments. To this end, here we introduce a statistical correlation analysis method to obtain information on the local geometry and orientation of the tip used in STM experiments based on large scale simulations. The key quantity is the relative brightness correlation of constant-current topographs between experimental and simulated data. This correlation can be analyzed statistically for a large number of modeled tip orientations and geometries. Assuming a stable tip during the STM scans and based on the correlation distribution, it is possible to determine the tip orientations that are most likely present in an STM experiment, and exclude other orientations. This is especially important for substrates such as highly oriented pyrolytic graphite (HOPG) since its STM contrast is strongly tip dependent, which makes interpretation and comparison of STM images very challenging. We illustrate the applicability of our method considering the HOPG surface in combination with tungsten tip models of two different apex geometries and 18,144 different orientations. We calculate constant-current profiles along the < 1 1 bar 0 0 > direction of the HOPG(0 0 0 1) surface in the | V | ⩽ 1V bias voltage range, and compare them with experimental data. We find that a blunt tip model provides better correlation with the experiment for a wider range of tip orientations and bias voltages than a sharp tip model. Such a combination of experiments and large scale simulations opens up

  4. Restoration of patency in failing tunneled hemodialysis catheters: a comparison of catheter exchange, exchange and balloon disruption of the fibrin sheath, and femoral stripping.

    PubMed

    Janne d'Othée, Bertrand; Tham, Jacques C; Sheiman, Robert G

    2006-06-01

    To compare median patency times after treatment of malfunctioning tunneled hemodialysis catheters by one of three techniques: over-the-wire catheter exchange (CE), fibrin sheath stripping (FSS) from a femoral vein approach, and over-the-wire catheter removal with balloon dilation of fibrin sheath (DFS) followed by catheter replacement with use of the same tract. Retrospective study was conducted of 66 consecutive procedures performed over a period of 47 months for poor flow through tunneled hemodialysis catheters despite tissue plasminogen activator infusion trials (CE, n=33; FSS, n=18; DFS, n=15). Baseline parameters (time since initial catheter placement, number of previous catheter interventions, catheter access site, and patient age and sex) were recorded to identify possible pretreatment differences among groups. Outcome comparison was based on duration of adequate catheter function on dialysis during follow-up. No significant differences in baseline parameters were identified among the three groups (P>.05). Mean follow-up duration (67+/-89 days; range, 0-398 d) was similar among the three groups. The immediate technical success rate was 100%, and there were no complications. Cumulative catheter patency rates were 73% (CE), 72% (FSS), and 65% (DFS) at 1 month; 43% (CE), 60% (FSS), and 39% (DFS) at 3 months; and 28% (CE), 45% (FSS), and 39% (DFS) at 6 months. Median duration of patency was similar among groups (P=.60). All three therapies were equivalent in terms of immediate technical success, complication rates, and durability of catheter function during later follow-up. Hence, when one technique is chosen over another, factors other than the period of secondary patency should be considered, such as cost and patient and physician preference.

  5. Biomechanical Analysis Of The Proximal Femoral Locking Compression Plate: Do Quality Of Reduction And Screw Orientation Influence Construct Stability?

    PubMed

    Zderic, Ivan; Oh, Jong-Keon; Stoffel, Karl; Sommer, Christoph; Helfen, Tobias; Camino, Gaston; Richards, R Geoff; Nork, Sean E; Gueorguiev, Boyko

    2017-08-22

    To investigate biomechanically in a human cadaveric model the failure modes of the Proximal Femoral Locking Compression Plate (PF-LCP) and explore the underlying mechanism. Twenty-four fresh-frozen paired human cadaveric femora with simulated unstable intertrochanteric fractures (AO/OTA 31-A3.3) were assigned to four groups with six specimens each for plating with PF-LCP. The groups differed in the quality of fracture reduction and plating fashion of the first and second proximal screws as follows: 1) anatomical reduction with on-axis screw placement; 2) anatomical reduction with off-axis screw placement; 3) malreduction with on-axis screw placement; 4) malreduction with off-axis screw placement. The specimens were tested until failure using a protocol with combined axial and torsional loading. Mechanical failure was defined as abrupt change in machine load-displacement data. Clinical failure was defined as 5° varus tilting of the femoral head as captured with optical motion tracking. Initial axial stiffness (N/mm) in groups 1 to 4 was 213.6±65.0, 209.5±134.0, 128.3±16.6 and 106.3±47.4, respectively. Numbers of cycles to clinical and mechanical failure were 16642±10468 and 8695±1462 in group 1, 14076±3032 and 7449±5663 in group 2, 8800±8584 and 4497±2336 in group 3 and 9709±3894 and 5279±4119 in group 4. Significantly higher stiffness as well as numbers of cycles to both clinical and mechanical failure were detected in group 1 in comparison to group 3, P≤0.044. Generally, malreduction led to significantly earlier construct failure. The observed failures were cut-out of the proximal screws in the femoral head, followed by either screw bending, screw loosening or screw fracture. Proper placement of the proximal screws in anatomically reduced fractures led to significantly higher construct stability. Our data also indicates that once the screws are placed off-axis (>5 degrees), the benefit of an anatomic reduction is lost.

  6. Band to band tunneling in III-V semiconductors: Implications of complex band structure, strain, orientation, and off-zone center contribution

    SciTech Connect

    Majumdar, Kausik

    2014-05-07

    In this paper, we use a tight binding Hamiltonian with spin orbit coupling to study the real and complex band structures of relaxed and strained GaAs. A simple d orbital on-site energy shift coupled with appropriate scaling of the off-diagonal terms is found to correctly reproduce the band-edge shifts with strain. Four different 〈100〉 strain combinations, namely, uniaxial compressive, uniaxial tensile, biaxial compressive, and biaxial tensile strain are studied, revealing rich valence band structure and strong relative orientation dependent tunneling. It is found that complex bands are unable to provide unambiguous tunneling paths away from the Brillouin zone center. Tunneling current density distribution over the Brillouin zone is computed using non-equilibrium Green's function approach elucidating a physical picture of band to band tunneling.

  7. Mechanical properties of isolated loops of nylon leader material, polyethylene cord, and polyethylene tape and mechanical properties of those materials secured to cadaveric canine femurs via lateral femoral fabellae, toggles placed through bone tunnels, or bone anchors.

    PubMed

    Choate, Christina J; Pozzi, Antonio; Lewis, Daniel D; Hudson, Caleb C; Conrad, Bryan P

    2012-10-01

    To determine mechanical properties of various prosthetic materials secured to cadaveric canine femurs via various methods and to compare results with those for isolated loops of prosthetic material. 80 femurs obtained from cadavers of skeletally mature large-breed dogs. 10 femoral constructs in each of 8 groups (single circumfabellar loop of polyethylene cord, double loop of polyethylene tape secured via a bone anchor [BAPT], single or double circumfabellar loops of nylon leader material [CNL] or polyethylene tape [CPT], or single or double loops of polyethylene tape secured via a toggle placed through a bone tunnel [BTPT]) and 10 isolated loops of prosthetic material in each corresponding configuration were tested. Stress relaxation, creep, elongation, load at 3 mm of displacement, stiffness, and peak load at failure were determined. 5 single CNL constructs failed before completion of testing. Double CNL and single circumfabellar polyethylene cord constructs had the lowest loads at 3 mm of displacement. Single and double CPT constructs had the highest stiffness. Double BTPT and CPT constructs had the highest peak loads at failure. Double BTPT, double CPT, and BAPT constructs were mechanically superior on the basis of lower creep and stress relaxation and higher stiffness and load at 3 mm of displacement versus other constructs. Stiffness of femoral constructs was 28% to 69% that of corresponding isolated prosthetic loops. Double BTPT, double CPT, and BAPT constructs were mechanically superior to other constucts. Mechanical properties and methods of anchorage and securing of free ends of prostheses contributed to mechanical properties of constructs.

  8. Electron-bombarded 〈110〉-oriented tungsten tips for stable tunneling electron emission

    SciTech Connect

    Yamada, T. K.; Abe, T.; Nazriq, N. M. K.; Irisawa, T.

    2016-03-15

    A clean tungsten (W) tip apex with a robust atomic plane is required for producing a stable tunneling electron emission under strong electric fields. Because a tip apex fabricated from a wire by aqueous chemical etching is covered by impurity layers, heating treatment in ultra-high vacuum is experimentally known to be necessary. However, strong heating frequently melts the tip apex and causes unstable electron emissions. We investigated quantitatively the tip apex and found a useful method to prepare a tip with stable tunneling electron emissions by controlling electron-bombardment heating power. Careful characterizations of the tip structures were performed with combinations of using field emission I–V curves, scanning electron microscopy, X-ray diffraction (transmitted Debye-Scherrer and Laue) with micro-parabola capillary, field ion microscopy, and field emission microscopy. Tips were chemically etched from (1) polycrystalline W wires (grain size ∼1000 nm) and (2) long-time heated W wires (grain size larger than 1 mm). Heating by 10-40 W (10 s) was found to be good enough to remove oxide layers and produced stable electron emission; however, around 60 W (10 s) heating was threshold power to increase the tip radius, typically +10 ± 5 nm (onset of melting). Further, the grain size of ∼1000 nm was necessary to obtain a conical shape tip apex.

  9. POSTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH AUTOGRAFT OF THE DOUBLE SEMITENDINOSUS MUSCLES AND MIDDLE THIRD OF THE QUADRICEPS TENDON WITH DOUBLE FEMORAL AND SINGLE TIBIAL TUNNELS: CLINICAL RESULTS IN TWO YEARS FOLLOW UP

    PubMed Central

    Cury, Ricardo de Paula Leite; Severino, Nilson Roberto; Camargo, Osmar Pedro Arbix; Aihara, Tatsuo; de Oliveira, Victor Marques; Avakian, Roger

    2015-01-01

    Objective: To evaluate the surgical aspects that may offer good anatomic and functional results in posterior cruciate ligament (PCL) reconstruction using an autologous graft of the quadriceps tendon and double semitendinosus through a double femoral tunnel. Methods: Fourteen patients with isolated PCL lesions, instability and pain were operated on by arthroscopy and evaluated according to the International Knee Documentation Committee (IKDC) and Lysholm scales. Posterior knee laxity was examined with a KT1000 arthrometer. Results: The mean postoperative posterior side-to-side difference was between 0-2 mm in 57.1% of patients and between 3 and 5 mm in 35.7% of cases. The average Lysholm score was 93 points in the final follow-up. In the IKDC evaluation, 3 patients were graded A, 10 were graded B, and 1 patient was graded C. Conclusions: Double bundle arthroscopic PCL reconstruction based on the anatomical positioning of the tunnels, with double semitendinosus tendon and single quadriceps, provides a clinically evident reduction in symptoms and restores satisfactory stability, although no statistically significant difference was found due to the small sample. PMID:27027083

  10. Resonant spin tunneling in randomly oriented nanospheres of Mn12 acetate

    SciTech Connect

    Lendínez, S.; Zarzuela, R.; Tejada, J.; Terban, M. W.; Billinge, S. J. L.; Espin, J.; Imaz, I.; Maspoch, D.; Chudnovsky, E. M.

    2015-01-06

    We report measurements and theoretical analysis of resonant spin tunneling in randomly oriented nanospheres of a molecular magnet. Amorphous nanospheres of Mn₁₂ acetate have been fabricated and characterized by chemical, infrared, TEM, X-ray, and magnetic methods. Magnetic measurements have revealed sharp tunneling peaks in the field derivative of the magnetization that occur at the typical resonant field values for the Mn₁₂ acetate crystal in the field parallel to the easy axis.Theoretical analysis is provided that explains these observations. We argue that resonant spin tunneling in a molecular magnet can be established in a powder sample, without the need for a single crystal and without aligning the easy magnetization axes of the molecules. This is confirmed by re-analyzing the old data on a powdered sample of non-oriented micron-size crystals of Mn₁₂ acetate. In conclusion, our findings can greatly simplify the selection of candidates for quantum spin tunneling among newly synthesized molecular magnets.

  11. Lateral femoral cutaneous neuralgia: an anatomical insight.

    PubMed

    Dias Filho, L C; Valença, M M; Guimarães Filho, F A V; Medeiros, R C; Silva, R A M; Morais, M G V; Valente, F P; França, S M L

    2003-07-01

    A detailed anatomic study was carried out on the lateral femoral cutaneous nerve to better understand the etiology and treatment of lateral femoral cutaneous neuralgia. As it passed from the pelvis into the thigh, the lateral femoral cutaneous nerve ran through an "aponeuroticofascial tunnel," beginning at the iliopubic tract and ending at the inguinal ligament; as it passed through the tunnel, an enlargement in its side-to-side diameter was observed, suggesting that the fascial structures proximal to the inguinal ligament may be implicated in the genesis of lateral femoral cutaneous neuralgia. The finding of pseudoneuromas at this location, distant from the inguinal ligament, supports this hypothesis. The anterior superior iliac spine is located approximately 0.7 cm from the lateral femoral cutaneous nerve and serves as the bony landmark for nerve localization. Within the first 3 cm of leaving the pelvis, the lateral femoral cutaneous nerve was observed deep to the fascia lata; therefore, surgical dissection within the subcutaneous fascia may be conducted with relative impunity near the anterior superior iliac spine just inferior to the inguinal ligament. In 36% of cases there was no posterior branch of the nerve, which is correlated to lateral femoral cutaneous neuralgia symptoms often being limited to the anterior branch region. An accessory nerve was found in 30% of cases. Copyright 2003 Wiley-Liss, Inc.

  12. Magnetic properties of epitaxial Fe{sub 3}O{sub 4} films with various crystal orientations and tunnel magnetoresistance effect at room temperature

    SciTech Connect

    Nagahama, Taro Matsuda, Yuya; Tate, Kazuya; Kawai, Tomohiro; Takahashi, Nozomi; Hiratani, Shungo; Watanabe, Yusuke; Yanase, Takashi; Shimada, Toshihiro

    2014-09-08

    Fe{sub 3}O{sub 4} is a ferrimagnetic spinel ferrite that exhibits electric conductivity at room temperature (RT). Although the material has been predicted to be a half metal according to ab-initio calculations, magnetic tunnel junctions (MTJs) with Fe{sub 3}O{sub 4} electrodes have demonstrated a small tunnel magnetoresistance (TMR) effect. Not even the sign of the tunnel magnetoresistance ratio has been experimentally established. Here, we report on the magnetic properties of epitaxial Fe{sub 3}O{sub 4} films with various crystal orientations. The films exhibited apparent crystal orientation dependence on hysteresis curves. In particular, Fe{sub 3}O{sub 4}(110) films exhibited in-plane uniaxial magnetic anisotropy. With respect to the squareness of hysteresis, Fe{sub 3}O{sub 4} (111) demonstrated the largest squareness. Furthermore, we fabricated MTJs with Fe{sub 3}O{sub 4}(110) electrodes and obtained a TMR effect of −12% at RT. The negative TMR ratio corresponded to the negative spin polarization of Fe{sub 3}O{sub 4} predicted from band calculations.

  13. Femoral nerve dysfunction

    MedlinePlus

    Neuropathy - femoral nerve; Femoral neuropathy ... Craig EJ, Clinchot DM. Femoral neuropathy. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation . 3rd ...

  14. Experimental study of a co-flowing jet in ONERA’s F2 research wind tunnel by 3D background oriented schlieren

    NASA Astrophysics Data System (ADS)

    Nicolas, F.; Donjat, D.; Plyer, A.; Champagnat, F.; Le Besnerais, G.; Micheli, F.; Cornic, P.; Le Sant, Y.; Deluc, J. M.

    2017-08-01

    This paper describes the first application of 3D density reconstruction from a limited number of background oriented schlieren (BOS) images in a large research-type low speed wind tunnel. The tested flow is an ad hoc co-flowing hot jet generated at the wingtip of a simplified airfoil. Ray deviation maps captured by 12 synchronized cameras are combined to reconstruct the three dimensional density field of the jet, in the line of the direct 3D BOS technique described in Nicolas et al (2016 Exp. Fluids 57 1-21). A comparison with thermocouple sampling shows consistent results and highlights the efficiency of this new method for thermal measurement of a low speed convective flow. Finally, we underline the new possibilities for fluid dynamic characterization offered by combining stereo particle image velocimetry and 3D BOS measurements.

  15. Slipped capital femoral epiphysis

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/000972.htm Slipped capital femoral epiphysis To use the sharing features on this page, please enable JavaScript. A slipped capital femoral epiphysis is a separation of the ball ...

  16. [Femoral arteriovenous fistula: a late uncommon complication of central venous catheterization].

    PubMed

    Conz, P A; Malagoli, A; Normanno, M; Munaro, D

    2007-01-01

    A 77-year-old woman was admitted due to AV graft thrombosis; given the technical impossibility of performing other native AV fistulas, we chose to insert a tunnelled central venous catheter. Considering the vascular history of the patient, the central venous catheter could not be placed into the internal jugular vein; it was therefore put into the left femoral vein. Following a 3-month-period of the catheter working properly, the patient was hospitalized due to sudden acute pain in the left thigh. In a few days the patient developed an important haematoma with serious anemization in the left lower limb. Ultrasonography showed the presence of a fistula between the left common femoral artery and the femoral vein, leading to the subsequent successful positioning of a stent into the common femoral artery through right trans-femoral access. Angiography examination showed the femoral vein patency along the proximal stretch with respect to the function of the tunnelled venous catheter.

  17. Femoral bowing plane adaptation to femoral anteversion

    PubMed Central

    Akman, Alp; Demirkan, Fahir; Sabir, Nuran; Oto, Murat; Yorukoglu, Cagdas; Kiter, Esat

    2017-01-01

    Background: Femoral bowing plane (FBP) is the unattended subject in the literature. More over the femoral shaft with its bowing is neglected in established anteversion determination methods. There is limited information about the relationship between FBP and anteversion. Thus we focused on this subject and hypothesized that there could be an adaptation of FBP to anteversion. Materials and Methods: FBP is determined on three-dimensional solid models derived from the left femoral computerized tomography data of 47 patients which were taken before for another reason and comparatively evaluated with anteversion. There were 20 women and 27 men. The mean age of patients was 56 years (range 21–84 years). Results: The anteversion values were found as the angle between a distal condylar axis (DCA) and femoral neck anteversion axis (FNAA) along an imaginary longitudinal femoral axis (LFA) in the true cranio-caudal view. The FBP was determined as a plane that passes through the centre-points of three pre-determinated sections on the femoral shaft. The angles between DCA, FNAA and FBP were comparatively evaluated. The independent samples t-test was used for statistical analysis. At the end, it was found that FBP lies nearly perpendicular to the anteversion axis for the mean of our sample which is around 89° in females and 93° in males (range 78–102°). On the other hand, FBP does not lie close to the sagittal femoral plane (SFP); instead, there is an average 12.5° external rotation relative to the SFP. FBP is correlated well with anteversion in terms of FBP inclination from SFP and femoral torsion (i.e., angle between FBP and femoral neck anteversion axis (P < 0.001; r = 0.680 and r = −0.682, respectively). Combined correlation is perfect (R2 = 1) as the FBP, SFP, and posterior femoral plane forms a triangle in the cranio-caudal view. Conclusions: We found that FBP adapts to anteversion. As FBP lies close to perpendicularity for the mean, femoral component positioning

  18. Femoral impaction grafting

    PubMed Central

    Scanelli, John A; Brown, Thomas E

    2013-01-01

    Femoral impaction grafting is a reconstruction option applicable to both simple and complex femoral component revisions. It is one of the preferred techniques for reconstructing large femoral defects when the isthmus is non-supportive. The available level of evidence is primarily derived from case series, which shows a mean survivorship of 90.5%, with revision or re-operation as the end-point, with an average follow-up of 11 years. The rate of femoral fracture requiring re-operation or revision of the component varies between several large case series, ranging from 2.5% to 9%, with an average of 5.4%. PMID:23362469

  19. Electric field control of spin re-orientation in perpendicular magnetic tunnel junctions—CoFeB and MgO thickness dependence

    SciTech Connect

    Meng, Hao; Naik, Vinayak Bharat; Liu, Ruisheng; Han, Guchang

    2014-07-28

    We report an investigation of electric-field (EF) control of spin re-orientation as functions of the thicknesses of CoFeB free layer (FL) and MgO layer in synthetic-antiferromagnetic pinned magnetic tunnel junctions with perpendicular magnetic anisotropy. It is found that the EF modulates the coercivity (Hc) of the FL almost linearly for all FL thicknesses, while the EF efficiency, i.e., the slope of the linearity, increases as the FL thickness increases. This linear variation in Hc is also observed for larger MgO thicknesses (≥1.5 nm), while the EF efficiency increases only slightly from 370 to 410 Oe nm/V when MgO thickness increases from 1.5 to 1.76 nm. We have further observed the absence of quasi-DC unipolar switching. We discuss its origin and highlight the underlying challenges to implement the EF controlled switching in a practical magnetic memory.

  20. Vertical shear fractures of the femoral neck. A biomechanical study.

    PubMed

    Baitner, A C; Maurer, S G; Hickey, D G; Jazrawi, L M; Kummer, F J; Jamal, J; Goldman, S; Koval, K J

    1999-10-01

    A biomechanical cadaver study was performed to compare the strength and stability of three cannulated cancellous lag screws with a sliding hip screw for fixation of a vertically oriented fracture of the femoral neck (Pauwels Type III). Using eight matched pairs of human cadaveric femurs, vertically oriented femoral neck osteotomies were created, reduced, and randomized to one of the two fixation methods. The constructs were tested with incremental axial loading from 100 N to 1200 N and cyclical loading at 1000 N for 10,000 cycles; fracture displacements and ultimate load to failure were determined. The specimens stabilized using a sliding hip screw showed less inferior femoral head displacement, less shearing displacement at the osteotomy site, and a much greater load to failure than did those stabilized with multiple cancellous lag screws. These results support the use of a sliding hip screw for treatment of vertically oriented fractures of the femoral neck.

  1. Tunnel closure calculations

    SciTech Connect

    Moran, B.; Attia, A.

    1995-07-01

    When a deeply penetrating munition explodes above the roof of a tunnel, the amount of rubble that falls inside the tunnel is primarily a function of three parameters: first the cube-root scaled distance from the center of the explosive to the roof of the tunnel. Second the material properties of the rock around the tunnel, and in particular the shear strength of that rock, its RQD (Rock Quality Designator), and the extent and orientation of joints. And third the ratio of the tunnel diameter to the standoff distance (distance between the center of explosive and the tunnel roof). The authors have used CALE, a well-established 2-D hydrodynamic computer code, to calculate the amount of rubble that falls inside a tunnel as a function of standoff distance for two different tunnel diameters. In particular they calculated three of the tunnel collapse experiments conducted in an iron ore mine near Kirkeness, Norway in the summer of 1994. The failure model that they used in their calculations combines an equivalent plastic strain criterion with a maximum tensile strength criterion and can be calibrated for different rocks using cratering data as well as laboratory experiments. These calculations are intended to test and improve the understanding of both the Norway Experiments and the ACE (Array of conventional Explosive) phenomenology.

  2. Relationship between bony tunnel and knee function in patients after patellar dislocation triple surgeries—a CT-based study

    PubMed Central

    Qin, Le; Li, Mei; Yao, Weiwu; Shen, Ji

    2017-01-01

    We aimed to assess the CT-based bony tunnel valuations and their correlation with knee function after patellar dislocation triple surgeries. A retrospective study was performed on 66 patients (70 knees) who underwent patellar dislocation triple surgeries. The surgery was MPFL reconstruction primarily, combined with lateral retinaculum release and tibial tubercle osteotomy. CT examinations were performed to determine the femoral tunnel position, along with the patellar and femoral tunnel width 3 days and more than 1 year after operation for follow-up. Functional evaluation based on Kujala and Lysholm scores was also implemented. We compared tunnel width of the first and last examinations and correlated femoral tunnel position of the last examination with knee function. At the last follow-up, femoral tunnel position in the anterior-posterior direction was moderately correlated with knee function. Femoral tunnel position in the proximal-distal direction was not associated with postoperative knee function. Patellar and femoral tunnel width increased significantly at the last follow-up. However, no significant functional difference was found between patients with and without femoral tunnel enlargement. Our results suggested that the tunnel malposition in anterior-posterior position based on CT was related to impaired knee function during the follow-ups. PMID:28120923

  3. Relationship between bony tunnel and knee function in patients after patellar dislocation triple surgeries—a CT-based study

    NASA Astrophysics Data System (ADS)

    Qin, Le; Li, Mei; Yao, Weiwu; Shen, Ji

    2017-01-01

    We aimed to assess the CT-based bony tunnel valuations and their correlation with knee function after patellar dislocation triple surgeries. A retrospective study was performed on 66 patients (70 knees) who underwent patellar dislocation triple surgeries. The surgery was MPFL reconstruction primarily, combined with lateral retinaculum release and tibial tubercle osteotomy. CT examinations were performed to determine the femoral tunnel position, along with the patellar and femoral tunnel width 3 days and more than 1 year after operation for follow-up. Functional evaluation based on Kujala and Lysholm scores was also implemented. We compared tunnel width of the first and last examinations and correlated femoral tunnel position of the last examination with knee function. At the last follow-up, femoral tunnel position in the anterior-posterior direction was moderately correlated with knee function. Femoral tunnel position in the proximal-distal direction was not associated with postoperative knee function. Patellar and femoral tunnel width increased significantly at the last follow-up. However, no significant functional difference was found between patients with and without femoral tunnel enlargement. Our results suggested that the tunnel malposition in anterior-posterior position based on CT was related to impaired knee function during the follow-ups.

  4. Correlation Between Femoral Neck Shaft Angle and Surgical Management in Trainees With Femoral Neck Stress Fractures.

    PubMed

    Chalupa, Robyn L; Rivera, Jessica C; Tennent, David J; Johnson, Anthony E

    2016-01-01

    The most common overuse injury leading to medical discharge of military recruits is a stress fracture. One of the high-risk stress fractures is of the lateral femoral neck which risks osteonecrosis of the femoral head, the need for arthroplasty and permanent disability. To prevent fracture progression early surgical intervention is recommended. Surgical repairs are performed in about 25% of cases of femoral neck stress fractures at military treatment facilities. Hip geometry is an important intrinsic risk for stress fractures. Loads in the average loading direction will not cause a fracture, but loads of extreme magnitude or extreme orientation may. The purpose of this study was to determine if, in the presence of femoral neck stress fracture, there is a correlation between femoral neck shaft angle, surgical treatment and outcomes. The results of this study suggest there is no correlation between return to full military duty rates, treatment, femoral neck shaft angle or fracture grade on MRI. Patients who underwent surgical fixation had greater fracture grade and pain than those that did not have surgery. Individuals who did not return to duty tended to have higher pain scores at initial evaluation.

  5. Graft bending angle is correlated with femoral intraosseous graft signal intensity in anterior cruciate ligament reconstruction using the outside-in technique.

    PubMed

    Ahn, Jin Hwan; Jeong, Hwa Jae; Lee, Yong Seuk; Park, Jai Hyung; Lee, Jin Ho; Ko, Taeg Su

    2016-08-01

    The purposes of this study were as follows: 1) to determine the correlation between the bending angle of the anterior cruciate ligament (ACL) graft at the femoral tunnel and the magnetic resonance imaging (MRI) signal intensity of the ACL graft and 2) to analyze the difference in the MRI signal intensity of the reconstructed ACL graft in different areas of the graft after single-bundle hamstring autograft ACL (SB ACL) reconstruction using an outside-in (OI) technique with bone-sparing retro-reaming. Thirty-eight patients who underwent SB ACL reconstruction with the hamstring tendon autograft using the OI technique were enrolled in this study. All patients were assessed using three-dimensional computed tomography (CT) to evaluate femoral tunnel factors, including tunnel placement, tunnel length, tunnel diameter, and femoral tunnel bending angle. At a mean of 6.3±0.8months after surgery, 3.0-T MRI was used to evaluate the graft signal intensity using signal/noise quotient for high-signal-intensity lesions. Among various femoral tunnel factors, only the femoral tunnel bending angle in the coronal plane was significantly (p=0.003) correlated with the signal/noise quotient of the femoral intraosseous graft. The femoral intraosseous graft had significantly (p=0.009) higher signal intensity than the other graft zone. Five cases (13.2%) showed high-signal-intensity zones around the femoral tunnel but not around the tibial tunnel. After ACL reconstruction using the OI technique, the graft bending angle was found to be significantly correlated with the femoral intraosseous graft signal intensity, indicating that increased signal intensity by acute graft bending might be related to the maturation of the graft. This was a retrospective comparative study with Level III evidence. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Inelastic electron tunneling spectroscopy

    NASA Technical Reports Server (NTRS)

    Khanna, S. K.; Lambe, J.

    1983-01-01

    Inelastic electron tunneling spectroscopy is a useful technique for the study of vibrational modes of molecules adsorbed on the surface of oxide layers in a metal-insulator-metal tunnel junction. The technique involves studying the effects of adsorbed molecules on the tunneling spectrum of such junctions. The data give useful information about the structure, bonding, and orientation of adsorbed molecules. One of the major advantages of inelastic electron tunneling spectroscopy is its sensitivity. It is capable of detecting on the order of 10 to the 10th molecules (a fraction of a monolayer) on a 1 sq mm junction. It has been successfully used in studies of catalysis, biology, trace impurity detection, and electronic excitations. Because of its high sensitivity, this technique shows great promise in the area of solid-state electronic chemical sensing.

  7. A Simple Radiographic Sign of Vertical Anterior Cruciate Ligament Tunnel Placement.

    PubMed

    Farrow, Lutul Dashaun; Morris, Parisa M; Huston, Kellen L; Hall, Evan Tyler; Kaar, Scott

    2015-10-01

    The purpose of this study is to describe a novel radiographic sign indicative of vertical tunnel placement following anterior cruciate ligament (ACL) reconstruction. We reviewed 190 consecutive ACL reconstructions. Operative records, patient charts, arthroscopic images, and preoperative and postoperative orthogonal plain radiographic images were reviewed. We made special note of the operative technique. Note was made of tunnel position and whether the posterior (proximal) aspect of Blumensaat line was violated on standard lateral knee radiographic images. Of 190 patients, 17 patients did not have postoperative imaging and were excluded. Of the 173 remaining knees, 163 were primary ACL reconstructions and 10 were revision ACL reconstructions. We found that no anatomically placed ACL femoral tunnel violated Blumensaat line. In all revision cases exhibiting violation of Blumensaat line, a new femoral tunnel was able to be drilled while completely avoiding the previously placed, nonanatomic ACL femoral tunnel. The principal findings of our study demonstrate that violation of Blumensaat line following ACL reconstruction is an indicator of vertical, nonanatomic femoral tunnel placement. Furthermore, presence of this radiographic sign indicates that an anatomically placed femoral tunnel may be drilled while completely avoiding the existing femoral tunnel during cases of revision ACL reconstruction.

  8. Accurate Positioning of Femoral and Tibial Tunnels in Single Bundle Anterior Cruciate Ligament Reconstruction Using the Indigenously Made Bernard and Hurtle Grid on a Transparency Sheet and C-arm.

    PubMed

    Kumar, Sudeep; Kumar, Anup; Kumar, Ravi

    2017-06-01

    Many factors determine the outcome of the anterior cruciate ligament reconstruction surgery. The single most important factor, also well within the control of a surgeon, is tunnel placement. It is difficult to accurately determine the center of the anterior cruciate ligament foot print, and many a times it is also difficult to accurately define the intercondylar and bifurcate ridge. This makes determination of the accurate entry point of the guidewire difficult. We have printed our indigenously formed grid (equidistant boxes) on an old-fashioned transparency sheet. We use a fluoroscopy (C-arm) shot intraoperatively in the lateral position and superimpose this sheet to determine the position of the guidewire by calculating the percentage of boxes. We aim at 27.7% in proximal to distal and 37.5% in anterior to posterior on the femur side and 45% in front to back and medial to lateral on the tibial side. C-arm is freely available, but the inbuilt grid facility may be available in only the higher version of C-arms. Our indigenously designed grid can be easily used across the globe with ease to achieve accuracy in tunnel placement without violating anatomy and without any extra cost.

  9. [Slipped capital femoral epiphysis].

    PubMed

    Klein, C; Haraux, E; Leroux, J; Gouron, R

    2017-03-01

    Slipped capital femoral epiphysis (SFCE) is a disorder of the hip, characterized by a displacement of the capital femoral epiphysis from the metaphysic through the femoral growth plate. The epiphysis slips posteriorly and inferiorly. SCFE occurs during puberty and metabolic and epidemiologic risk factors, such as obesity are frequently found. Most chronic slips are diagnosed late. Sagittal hip X-rays show epiphysis slip. In case of untreated SCFE, a slip progression arises with an acute slip risk. Treatment is indicated to prevent slip worsening. The clinical and radiological classification is useful to guide treatment and it is predictive of the prognosis. In situ fixation of stable and moderately displaced SCFE with cannulated screws gives excellent results. Major complications are chondrolysis and osteonecrosis and the major sequelae are femoroacetabular impingement and early arthritis.

  10. Aerodynamic evaluation of wing shape and wing orientation in four butterfly species using numerical simulations and a low-speed wind tunnel, and its implications for the design of flying micro-robots.

    PubMed

    Ortega Ancel, Alejandro; Eastwood, Rodney; Vogt, Daniel; Ithier, Carter; Smith, Michael; Wood, Rob; Kovač, Mirko

    2017-02-06

    Many insects are well adapted to long-distance migration despite the larger energetic costs of flight for small body sizes. To optimize wing design for next-generation flying micro-robots, we analyse butterfly wing shapes and wing orientations at full scale using numerical simulations and in a low-speed wind tunnel at 2, 3.5 and 5 m s(-1). The results indicate that wing orientations which maximize wing span lead to the highest glide performance, with lift to drag ratios up to 6.28, while spreading the fore-wings forward can increase the maximum lift produced and thus improve versatility. We discuss the implications for flying micro-robots and how the results assist in understanding the behaviour of the butterfly species tested.

  11. Comparison of femur tunnel aperture location in patients undergoing transtibial and anatomical single-bundle anterior cruciate ligament reconstruction.

    PubMed

    Lee, Dae-Hee; Kim, Hyun-Jung; Ahn, Hyeong-Sik; Bin, Seong-Il

    2016-12-01

    Although three-dimensional computed tomography (3D-CT) has been used to compare femoral tunnel position following transtibial and anatomical anterior cruciate ligament (ACL) reconstruction, no consensus has been reached on which technique results in a more anatomical position because methods of quantifying femoral tunnel position on 3D-CT have not been consistent. This meta-analysis was therefore performed to compare femoral tunnel location following transtibial and anatomical ACL reconstruction, in both the low-to-high and deep-to-shallow directions. This meta-analysis included all studies that used 3D-CT to compare femoral tunnel location, using quadrant or anatomical coordinate axis methods, following transtibial and anatomical (AM portal or OI) single-bundle ACL reconstruction. Six studies were included in the meta-analysis. Femoral tunnel location was 18 % higher in the low-to-high direction, but was not significant in the deep-to-shallow direction, using the transtibial technique than the anatomical methods, when measured using the anatomical coordinate axis method. When measured using the quadrant method, however, femoral tunnel positions were significantly higher (21 %) and shallower (6 %) with transtibial than anatomical methods of ACL reconstruction. The anatomical ACL reconstruction techniques led to a lower femoral tunnel aperture location than the transtibial technique, suggesting the superiority of anatomical techniques for creating new femoral tunnels during revision ACL reconstruction in femoral tunnel aperture location in the low-to-high direction. However, the mean difference in the deep-to-shallow direction differed by method of measurement. Meta-analysis, Level II.

  12. Current-induced switching of magnetic tunnel junctions: Effects of field-like spin-transfer torque, pinned-layer magnetization orientation, and temperature

    SciTech Connect

    Tiwari, R. K.; Jhon, M. H.; Ng, N.; Gan, C. K.; Srolovitz, D. J.

    2014-01-13

    We study current-induced switching in magnetic tunnel junctions in the presence of a field-like spin-transfer torque and titled pinned-layer magnetization in the high current limit at finite temperature. We consider both the Slonczewski and field-like torques with coefficients a{sub J} and b{sub J}, respectively. At finite temperatures, σ=b{sub J}/a{sub J}=±1 leads to a smaller mean switching time compared that with σ=0. The reduction of switching time in the presence of the field-like term is due to the alignment effect (for σ>0) and the initial torque effect.

  13. Prospective evaluation of femoral head viability following femoral neck fracture

    SciTech Connect

    Binkert, B.; Kroop, S.A.; Nepola, I.V.; Grantham, A.S.; Alderson, P.O.

    1984-01-01

    The bone scans of 33 patients (pts) with recent subcapital fractures (fx) of the femur were evaluated prospectively to determine their value in predicting femoral head visability. Each of the 33 pts (ll men, 22 women, age range 30-92) had a pre-operative bone scan within 72 hrs of the fx (23 pts within 24 hrs). Anterior and posterior planar views of both hips and pinhole views (50% of pts) were obtained 2 hrs after administration of Tc-99m HDP. The femoral head was classified as perfused if it showed the same activity as the opposite normal side or if it showed only slightly decreased activity. Femoral heads showing absent activity were classified as nonperfused. Overall, 20 of the 33 pts showed a photopenic femoral head on the side of the fx. Only 2 pts showed increased activity at hte site of the fx. Internal fixation of the fx was performed in 23 pts, 12 of whom had one or more follow-up scans. Five of these 12 pts showed absent femoral head activity on their initial scan, but 2 showed later reperfusion. The other 7 pts showed good perfusion initially, with only 1 later showing decreased femoral head activity. The other 10 pts (7 of whom had absent femoral head activity) had immediate resection of the femoral head and insertion of a Cathcart prosthesis. The results suggest that femoral head activity seen on a bone scan in the immediate post-fx period is not always a reliable indicator of femoral head viability. Decreased femoral head activity may reflect, in part, compromised perfusion secondary to post-traumatic edema, with or without anatomic disruption of the blood supply.

  14. Laparoscopic repair of femoral hernia

    PubMed Central

    Yang, Xue-Fei

    2016-01-01

    Laparoscopic repair of inguinal hernia is mini-invasive and has confirmed effects. Femoral hernia could be repaired through the laparoscopic procedures for inguinal hernia. These procedures have clear anatomic view in the operation and preoperatively undiagnosed femoral hernia could be confirmed and treated. Lower recurrence ratio was reported in laparoscopic procedures compared with open procedures for repair of femoral hernia. The technical details of laparoscopic repair of femoral hernia, especially the differences to laparoscopic repair of inguinal hernia are discussed in this article. PMID:27826574

  15. Wrist and carpal tunnel size and shape measurements: effects of posture.

    PubMed

    Mogk, Jeremy P M; Keir, Peter J

    2008-11-01

    Wrist anthropometrics and posture have been implicated in the development of carpal tunnel syndrome, yet it remains unclear how external measurements relate to carpal tunnel parameters in neutral and non-neutral postures. The purposes of this study were (i) to evaluate the effect of slice orientation on several indices of carpal tunnel size and shape and (ii) to examine the relationship between carpal tunnel and external wrist dimensions. Three-dimensional static models were generated to measure carpal tunnel and wrist parameters for six wrists in three wrist postures (30 degrees flexion, neutral and 30 degrees extension). A simulated imaging plane enabled measurement of four carpal tunnel dimensions and two shape indices throughout the tunnel length, using "axial" and "tunnel" slice orientations (perpendicular to forearm and tunnel, respectively). Correction for tunnel orientation eliminated posture-related changes in tunnel size and shape noted at the distal end using "axial" alignment. "Tunnel" alignment reduced average carpal tunnel area and depth by nearly 15% in extension, but generally less than 5% in neutral and 2% in flexion. Subsequently, "tunnel" alignment also decreased carpal tunnel and non-circularity ratios to reveal a flatter, more elliptical shape throughout the tunnel in extension than neutral and flexion. Wrist dimensions correlated significantly with tunnel dimensions, but not tunnel shape, while wrist shape correlated significantly with tunnel shape, area and depth. Slice alignment with the carpal tunnel may improve the consistency of findings within and between patient and control populations, and enhance the diagnostic utility of imaging in clinical settings.

  16. Three-Dimensional Reconstruction Computed Tomography Evaluation of Tunnel Location during Single-Bundle Anterior Cruciate Ligament Reconstruction: A Comparison of Transtibial and 2-Incision Tibial Tunnel-Independent Techniques

    PubMed Central

    Ahn, Jin Hwan; Ko, Chun-Suk; Ko, Taeg Su; Kim, Jang Hwan

    2013-01-01

    Background Anatomic tunnel positioning is important in anterior cruciate ligament (ACL) reconstructive surgery. Recent studies have suggested the limitations of a traditional transtibial technique to place the ACL graft within the anatomic tunnel position of the ACL on the femur. The purpose of this study is to determine if the 2-incision tibial tunnel-independent technique can place femoral tunnel to native ACL center when compared with the transtibial technique, as the placement with the tibial tunnel-independent technique is unconstrained by tibial tunnel. Methods In sixty-nine patients, single-bundle ACL reconstruction with preservation of remnant bundle using hamstring tendon autograft was performed. Femoral tunnel locations were measured with quadrant methods on the medial to lateral view of the lateral femoral condyle. Tibial tunnel locations were measured in the anatomical coordinates axis on the top view of the proximal tibia. These measurements were compared with reference data on anatomical tunnel position. Results With the quadrant method, the femoral tunnel centers of the transtibial technique and tibial tunnel-independent technique were located. The mean (± standard deviation) was 36.49% ± 7.65% and 24.71% ± 4.90%, respectively, from the over-the-top, along the notch roof (parallel to the Blumensaat line); and at 7.71% ± 7.25% and 27.08% ± 7.05%, from the notch roof (perpendicular to the Blumensaat line). The tibial tunnel centers of the transtibial technique and tibial tunnel-independent technique were located at 39.83% ± 8.20% and 36.32% ± 8.10%, respectively, of the anterior to posterior tibial plateau depth; and at 49.13% ± 4.02% and 47.75% ± 4.04%, of the medial to lateral tibial plateau width. There was no statistical difference between the two techniques in tibial tunnel position. The tibial tunnel-independent technique used in this study placed femoral tunnel closer to the anatomical ACL anteromedial bundle center. In contrast, the

  17. Current concepts in management of slipped capital femoral epiphysis.

    PubMed

    Bittersohl, Bernd; Hosalkar, Harish S; Zilkens, Christoph; Krauspe, Rüdiger

    2015-01-01

    Slipped capital femoral epiphysis (SCFE) is a common hip condition that can be disabling. In this review, we provide an orientation on current trends in the clinical management of SCFE including conventional procedures and specialised surgical developments. Different methods of fixation of the epiphysis, risks of complications, and the rationale of addressing deformity, primarily or secondarily, are presented. Although improved understanding of the anatomy, vascularity and implications of residual deformity have changed management strategies, the best modality of treatment that would restore complete vascularity to the femoral head and prevent any residual deformity, impingement and early osteoarthritis remains elusive.

  18. Technical note: Anterior cruciate ligament reconstruction in the presence of an intramedullary femoral nail using anteromedial drilling.

    PubMed

    Lacey, Matthew; Lamplot, Joseph; Walley, Kempland C; DeAngelis, Joseph P; Ramappa, Arun J

    2017-05-18

    To describe an approach to anterior cruciate ligament (ACL) reconstruction using autologous hamstring by drilling via the anteromedial portal in the presence of an intramedullary (IM) femoral nail. Once preoperative imagining has characterized the proposed location of the femoral tunnel preparations are made to remove all of the hardware (locking bolts and IM nail). A diagnostic arthroscopy is performed in the usual fashion addressing all intra-articular pathology. The ACL remnant and lateral wall soft tissues are removed from the intercondylar, to provide adequate visualization of the ACL footprint. Femoral tunnel placement is performed using a transportal ACL guide with desired offset and the knee flexed to 2.09 rad. The Beath pin is placed through the guide starting at the ACL's anatomic footprint using arthroscopic visualization and/or fluoroscopic guidance. If resistance is met while placing the Beath pin, the arthroscopy should be discontinued and the obstructing hardware should be removed under fluoroscopic guidance. When the Beath pin is successfully placed through the lateral femur, it is overdrilled with a 4.5 mm Endobutton drill. If the Endobutton drill is obstructed, the obstructing hardware should be removed under fluoroscopic guidance. In this case, the obstruction is more likely during Endobutton drilling due to its larger diameter and increased rigidity compared to the Beath pin. The femoral tunnel is then drilled using a best approximation of the graft's outer diameter. We recommend at least 7 mm diameter to minimize the risk of graft failure. Autologous hamstring grafts are generally between 6.8 and 8.6 mm in diameter. After reaming, the knee is flexed to 1.57 rad, the arthroscope placed through the anteromedial portal to confirm the femoral tunnel position, referencing the posterior wall and lateral cortex. For a quadrupled hamstring graft, the gracilis and semitendinosus tendons are then harvested in the standard fashion. The tendons are whip

  19. Technical note: Anterior cruciate ligament reconstruction in the presence of an intramedullary femoral nail using anteromedial drilling

    PubMed Central

    Lacey, Matthew; Lamplot, Joseph; Walley, Kempland C; DeAngelis, Joseph P; Ramappa, Arun J

    2017-01-01

    AIM To describe an approach to anterior cruciate ligament (ACL) reconstruction using autologous hamstring by drilling via the anteromedial portal in the presence of an intramedullary (IM) femoral nail. METHODS Once preoperative imagining has characterized the proposed location of the femoral tunnel preparations are made to remove all of the hardware (locking bolts and IM nail). A diagnostic arthroscopy is performed in the usual fashion addressing all intra-articular pathology. The ACL remnant and lateral wall soft tissues are removed from the intercondylar, to provide adequate visualization of the ACL footprint. Femoral tunnel placement is performed using a transportal ACL guide with desired offset and the knee flexed to 2.09 rad. The Beath pin is placed through the guide starting at the ACL’s anatomic footprint using arthroscopic visualization and/or fluoroscopic guidance. If resistance is met while placing the Beath pin, the arthroscopy should be discontinued and the obstructing hardware should be removed under fluoroscopic guidance. When the Beath pin is successfully placed through the lateral femur, it is overdrilled with a 4.5 mm Endobutton drill. If the Endobutton drill is obstructed, the obstructing hardware should be removed under fluoroscopic guidance. In this case, the obstruction is more likely during Endobutton drilling due to its larger diameter and increased rigidity compared to the Beath pin. The femoral tunnel is then drilled using a best approximation of the graft’s outer diameter. We recommend at least 7 mm diameter to minimize the risk of graft failure. Autologous hamstring grafts are generally between 6.8 and 8.6 mm in diameter. After reaming, the knee is flexed to 1.57 rad, the arthroscope placed through the anteromedial portal to confirm the femoral tunnel position, referencing the posterior wall and lateral cortex. For a quadrupled hamstring graft, the gracilis and semitendinosus tendons are then harvested in the standard fashion. The

  20. Mycotic femoral aneurysm.

    PubMed

    Wilson, Richard Scott; Bennett, Kenneth R

    2007-05-01

    After several weeks of fever and chills, a 31-year-old logger developed pain in his right thigh. Upon examination a tender, pulsating upper thigh mass was found with a long loud bruit arising from it. Severe aortic insufficiency was present; however, blood cultures were negative. An angiogram, captured blood with contrast spewing from the profunda femoral artery to fill a 5 x 10 cm sac. A false aneurysm was diagnosed and resected; numerous gram positive cocci were present in cut sections, but cultures from the cavity grew the gram negative bacteria Salmonella and Alcaligenes. After one month of intravenous ampicillin the aortic valve was replaced after being destroyed by endocarditis. Ampicillin was continued and recovery was uneventful. Mycotic aneurysms are commonly caused by Salmonella (10%), which was second only to Staphylococcus (30%). The femoral artery accounts for 38% of all mycotic aneurysms. They typically present with a pulsatile mass (52%), bruit (50%), and fever (48%). This diagnosis can be supported by leukocytosis (64-71%), positive blood cultures (50-85%), and a history of arterial trauma (51%) (injection drug use, intravascular procedure, or trauma) or endocarditis (10%).

  1. Correlation between fixation systems elasticity and bone tunnel widening after ACL reconstruction

    PubMed Central

    Giorgio, Nicola; Moretti, Lorenzo; Pignataro, Paolo; Carrozzo, Massimiliano; Vicenti, Giovanni; Moretti, Biagio

    2016-01-01

    Summary Background Femoral and tibial tunnel widening (TW) after ACL reconstruction is a phenomenon increasing talk in the literature. It is underlying biological and mechanical causes. Objective The aim of this study was to evaluate the relationship between bone tunnel enlargement and two different ACL fixation systems. Patients and Methods 40 patient underwent ACL reconstruction with hamstring; randomly divided into group A with 20 patients treated with stiff systems (femoral Rigidfix and tibial interference screw), and into group B, with 20 patients treated with morel elastic system (femoral and tibial Tight-rope). Evaluated postoperatively with knee MRI at 40 days, 3 months, 6 months to measure bone tunnel diameters widening. Results At 40 days tunnel widening between two groups shows no statistically difference. At 3 months postoperatively, femoral bone tunnel widening amounted on average to 1.84 mm in middle of tunnel and 1 mm at the mouth in joint in group A, and respectively 3.2 mm and 2.5 mm in group B (p<0.05). Tibial tunnel widening was 1.24 mm at the mouth in joint and 1.3 mm in middle in group A and respectively 2.26 mm and 2.43 mm in group B (p<0.05). At 6 months femoral tunnel widening amounted on average to 2.45 mm in middle and 1.35 mm at the mouth in joint in group A and respectively 3.5 mm and 2.7 mm in group B (p<0.01). Tibial tunnel widening amounted on average to 1.27 at mouth in joint and 1 mm in middle of tunnel in group A and respectively 2.6 mm and 2.3 mm in group B (p<0.01). Conclusions This study results suggest elastic fixation system increases bone tunnel enlargement after ACL reconstruction with hamstring without correlation with worse clinical performance. Level of evidence IV. PMID:28217568

  2. Recognition Tunneling

    PubMed Central

    Lindsay, Stuart; He, Jin; Sankey, Otto; Hapala, Prokop; Jelinek, Pavel; Zhang, Peiming; Chang, Shuai; Huang, Shuo

    2010-01-01

    Single molecules in a tunnel junction can now be interrogated reliably using chemically-functionalized electrodes. Monitoring stochastic bonding fluctuations between a ligand bound to one electrode and its target bound to a second electrode (“tethered molecule-pair” configuration) gives insight into the nature of the intermolecular bonding at a single molecule-pair level, and defines the requirements for reproducible tunneling data. Simulations show that there is an instability in the tunnel gap at large currents, and this results in a multiplicity of contacts with a corresponding spread in the measured currents. At small currents (i.e. large gaps) the gap is stable, and functionalizing a pair of electrodes with recognition reagents (the “free analyte” configuration) can generate a distinct tunneling signal when an analyte molecule is trapped in the gap. This opens up a new interface between chemistry and electronics with immediate implications for rapid sequencing of single DNA molecules. PMID:20522930

  3. Femoral offset following trochanteric femoral fractures: a prospective observational study.

    PubMed

    Buecking, Benjamin; Boese, Christoph Kolja; Seifert, Vinzenz; Ruchholtz, Steffen; Frink, Michael; Lechler, Philipp

    2015-10-01

    Reconstruction of the femoral offset reportedly improves outcome following total hip arthroplasty, but little is known of its influence following hip fractures. We aimed to establish the effect of the femoral offset on the medium-term functional outcome in elderly patients who had sustained trochanteric fractures requiring proximal femoral nailing. We measured the rotation corrected femoral offset (FORC) and relative femoral offset (FORL) on plain anteroposterior radiographs of the hip in 188 patients (58 male, 130 female) with a trochanteric fracture who underwent proximal femoral nailing at our institution. The primary outcome measure was the Harris hip score (HSS) 6 and 12 months postoperatively; the Barthel index was assessed as a secondary outcome. The mean FORC after surgery was 58 mm (±11 mm), while the mean FORL was 1.21 (±0.22). At final follow up, we found significant inverse relationships (Spearman's rank correlation coefficient, ρ) between FORC and FORL and the functional outcome assessed by the HSS (FORC: ρ = -0.207, p = 0.036; FORL: ρ = -0.247, p = 0.012), and FORL and the Barthel index (FORC: ρ = -147, p = 0.129; FORL: ρ = -0.192, p = 0.046). A consistent trend was observed after adjustment for confounding variables. Our results underline the biomechanical importance of the femoral offset for medium-term outcomes in elderly patients with trochanteric fractures. In contrast with the published findings on total hip arthroplasty, we found an inverse correlation between functional outcome and the extent of the reconstructed femoral offset. Level I - Prognostic study. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. The Channel Tunnel

    NASA Technical Reports Server (NTRS)

    2006-01-01

    The Channel Tunnel is a 50.5 km-long rail tunnel beneath the English Channel at the Straits of Dover. It connects Dover, Kent in England with Calais, northern France. The undersea section of the tunnel is unsurpassed in length in the world. A proposal for a Channel tunnel was first put forward by a French engineer in 1802. In 1881, a first attempt was made at boring a tunnel from the English side; the work was halted after 800 m. Again in 1922, English workers started boring a tunnel, and advanced 120 m before it too was halted for political reasons. The most recent attempt was begun in 1987, and the tunnel was officially opened in 1994. At completion it was estimated that the project cost around $18 billion. It has been operating at a significant loss since its opening, despite trips by over 7 million passengers per year on the Eurostar train, and over 3 million vehicles per year.

    With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER images Earth to map and monitor the changing surface of our planet.

    ASTER is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of Economy, Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products.

    The broad spectral coverage and high spectral resolution of ASTER provides scientists in numerous disciplines with critical information for surface mapping, and monitoring of dynamic conditions and temporal change. Example applications are: monitoring glacial advances and retreats; monitoring potentially active volcanoes; identifying crop stress; determining cloud morphology and physical properties; wetlands evaluation; thermal pollution monitoring; coral reef degradation; surface temperature mapping of soils and geology; and measuring

  5. Stress changes ahead of an advancing tunnel

    USGS Publications Warehouse

    Abel, J.F.; Lee, F.T.

    1973-01-01

    Instrumentation placed ahead of three model tunnels in the laboratory and ahead of a crosscut driven in a metamorphic rock mass detected stress changes several tunnel diameters ahead of the tunnel face. Stress changes were detected 4 diameters ahead of a model tunnel drilled into nearly elastic acrylic, 2??50 diameters ahead of a model tunnel drilled into concrete, and 2 diameters ahead of a model tunnel drilled into Silver Plume Granite. Stress changes were detected 7??50 diameters ahead of a crosscut driven in jointed, closely foliated gneisses and gneissic granites in an experimental mine at Idaho Springs, Colorado. These results contrast markedly with a theoretical elastic estimate of the onset of detectable stress changes at 1 tunnel diameter ahead of the tunnel face. A small compressive stress concentration was detected 2 diameters ahead of the model tunnel in acrylic, 1.25 diameters ahead of the model tunnel in concrete, and 1 diameter ahead of the model tunnel in granite. A similar stress peak was detected about 6 diameters ahead of the crosscut. No such stress peak is predicted from elastic theory. The 3-dimensional in situ stress determined in the field demonstrate that geologic structure controls stress orientations in the metamorphic rock mass. Two of the computed principal stresses are parallel to the foliation and the other principal stress is normal to it. The principal stress orientations vary approximately as the foliation attitude varies. The average horizontal stress components and the average vertical stress component are three times and twice as large, respectively, as those predicted from the overburden load. An understanding of the measured stress field appears to require the application of either tectonic or residual stress components, or both. Laboratory studies indicate the presence of proportionately large residual stresses. Mining may have triggered the release of strain energy, which is controlled by geologic structure. ?? 1973.

  6. Femoral Head and Neck Excision.

    PubMed

    Harper, Tisha A M

    2017-07-01

    Femoral head and neck excision is a surgical procedure that is commonly performed in small animal patients. It is a salvage procedure that is done to relieve pain in the coxofemoral joint and restore acceptable function of the limb. Femoral head and neck excision is most commonly used to treat severe osteoarthritis in the coxofemoral joint and can be done in dogs and cats of any size or age. The procedure should not be overused and ideally should not be done when the integrity of the coxofemoral joint can be restored. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Anterior cruciate ligament reconstruction using the Bio-TransFix femoral fixation device and anteromedial portal technique.

    PubMed

    Hantes, Michael E; Dailiana, Zoe; Zachos, Vasilios C; Varitimidis, Sokratis E

    2006-05-01

    The cross-pin femoral fixation technique for soft tissue grafts is a popular option in anterior cruciate ligament (ACL) reconstruction. One of these devices is the Bio-TransFix (Arthrex Inc., Naples, FL, USA) which provides high fixation strength. According to the manufacturer, the femoral tunnel is created by placing the femoral aiming device through the tibial tunnel (transtibial technique). However, using this technique it is very difficult or even impossible to place the graft at the anatomical ACL attachment site at the "10 o'clock" position. In this report, we describe the use of the Bio-TransFix device with an anteromedial portal technique. Using this technique, the surgeon has more freedom to place the graft in an anatomical position, while combining the advantages of the excellent biomechanical properties of this device.

  8. Correlation of tunnel widening and tunnel positioning with short-term functional outcomes in single-bundle anterior cruciate ligament reconstruction using patellar tendon versus hamstring graft: a prospective study.

    PubMed

    Biswal, Udit Kumar; Balaji, Gopisankar; Nema, Sandeep; Poduval, Murali; Menon, Jagdish; Patro, Dilip Kumar

    2016-08-01

    To study the correlation between tunnel widening and tunnel position with short-term functional outcomes post-ACL reconstruction with patellar tendon and hamstring autografts in young adults. A total of 33 patients who underwent ACL reconstruction between October 2013 and February 2015 were included and followed up for 6 months. A standardized surgical technique was used for each graft type. Intra-op arthroscopy findings and drilled tunnel diameters were noted. They were followed up for 3 and 6 months. Radiological assessment was done at 3 and 6 months with clinical score assessment at 6 months. At 6 months, clinical scores were comparable in both groups. Tunnel widening in both femoral and tibial tunnel at 3 and 6 months were significantly higher in STG group (p values <0.05). The rate of widening was higher in 0-3 months and reduced in 3-6 months. There was statistically significant negative correlation between femoral tunnel widening by CT and IKDC score at 6 months (p value 0.049). We found a positive correlation between posterior positioning of femoral tunnel and Lysholm and IKDC scores. The correlation with Lysholm scores was statistically significant (p value 0.046). To conclude, tunnel widening is more with hamstrings graft. Femoral tunnel widening has significant negative correlation with that of IKDC scores at 6 months. Posterior femoral tunnel positioning and Lysholm scores at 6 months had significant correlation.

  9. Tunnel-to-tunnel correlation

    NASA Technical Reports Server (NTRS)

    Steinle, F. W., Jr.

    1982-01-01

    Flow quality is discussed. Incremental comparisons of: (1) the angle of attack, (2) the axial force coefficient, and (3) the base cavity axial force coefficient against the normal force coefficient are presented. Relative blockage determination, relative buoyancy corrections, and boundary layer transition length are discussed. Blockage buoyancy caused by tunnel model wall dynamic interaction is discussed in terms of adaptive walls. The effect of 'transonic turbulence factor' is considered.

  10. Femoral head cartilage disarticulation disorder

    USDA-ARS?s Scientific Manuscript database

    Femoral head cartilage disarticulation disorder and necrosis is a major skeletal problem in broiler breeders since they are maintained for a long time in the farm. The etiology of this disease is not well understood. A field study was conducted to understand the basis of this metabolic disease. Six ...

  11. Cardiac resynchronization therapy: Femoral approach.

    PubMed

    Brandão, Luís; Miranda, Rita; Almeida, Sofia; Ribeiro, Luciano; Alvarenga, Carlos; João, Isabel; Pereira, Hélder

    2017-04-01

    We describe the case of a 62-year-old female patient with bilateral subclavian vein occlusion, in whom a cardiac resynchronization system was implanted via a femoral vein. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Carpal Tunnel Syndrome

    MedlinePlus

    ... Just a passing cramp? It could be carpal tunnel syndrome. The carpal tunnel is a narrow passageway of ligament and bones ... from irritated tendons or other swelling narrows the tunnel and causes the nerve to be compressed. Symptoms ...

  13. Looking into Tunnel Books.

    ERIC Educational Resources Information Center

    Hinshaw, Craig

    1999-01-01

    Describes how to make tunnel books, which are viewed by looking into a "tunnel" created by accordion-folded expanding sides. Suggests possible themes. Describes how to create a walk-through tunnel book for first grade students. (CMK)

  14. Cryogenic Wind Tunnels.

    DTIC Science & Technology

    1980-07-01

    CRYOGENIC WIND TUNNEL by J.D.CadweD 18 A CRYOGENIC TRANSONIC INTERMITTENT TUNNEL PROJECT: THE INDUCED -FLOW CRYOGENIC WIND-TUNNEL T2 AT ONERA/CERT by...CRYOGENIC TUNNELS The types of tunnel drive and test gas currently exploited in cryogenic wind tunnels include: Drive Test Gas fan nitrogen induced flow...reduce other heat fluxes. Other sources can arise from thermally induced oscillations under both storage and transfer con- ditions. 1.3 (c) Reduction

  15. Tibio-femoral and patello-femoral joint kinematics during navigated total knee arthroplasty with patellar resurfacing.

    PubMed

    Belvedere, C; Ensini, A; Leardini, A; Dedda, V; Feliciangeli, A; Cenni, F; Timoncini, A; Barbadoro, P; Giannini, S

    2014-08-01

    In total knee arthroplasty, surgical navigation systems provide tibio-femoral joint (TFJ) tracking for relevant bone preparation, disregarding the patello-femoral joint (PFJ). Therefore, the important intra-operative assessment of the effect of component positioning, including the patella, on the kinematics of these two joints is not available. The objective of this study is to explore in vivo whether accurate tracking of the patella can result in a more physiological TFJ and PFJ kinematics during surgery. Ten patients underwent navigated knee replacement with patellar resurfacing. A secondary system was used to track patellar motion and PFJ kinematics using a special tracker. Patellar resection plane position and orientation were recorded using an instrumented probe. During all surgical steps, PFJ kinematics was measured in addition to TFJ kinematics. Abnormal PFJ motion patterns were observed pre-operatively at the impaired knee. Patellar resection plane orientation on sagittal and transverse planes of 3.9° ± 9.0° and 0.4° ± 4.1° was found. A good restoration of both TFJ and PFJ kinematics was observed in all replaced knees after resurfacing, in particular the rotations in the three anatomical planes and medio-lateral patellar translation. Patella tracking results in nearly physiological TFJ and PFJ kinematics in navigated knee arthroplasty with resurfacing. The intra-operative availability also of PFJ kinematics can support the positioning not only of the patellar component in case of resurfacing, but also of femoral and tibial components.

  16. Tunnel widening prevention with the allo-Achilles tendon graft in anterior cruciate ligament reconstruction: Surgical tips and short term followup

    PubMed Central

    Suh, Dong Won; Han, Seung Beom; Yeo, Woo Jin; Lee, Won Hee; Kwon, Jae Ho; Kyung, Bong Soo

    2017-01-01

    Background: Tunnel widening (TW) after anterior cruciate ligament (ACL) reconstruction can be a serious complication, and there is controversy over how to prevent it. This study aimed to suggest surgical approaches to prevent TW using an allo-Achilles tendon graft, and then to evaluate TW after these surgical tips were applied. Materials and Methods: Sixty two patients underwent ACL reconstruction with an allo-Achilles tendon graft. Four surgical approaches were used: Making a tibial tunnel by bone impaction, intraarticular reamer application, bone portion application for the femoral tunnel, and an additional bone plug application for the tibial tunnel. After more than 1-year, followup radiographs including anteroposterior and lateral views were taken in 29 patients encompassing thirty knees. The diameter of the tunnels at postoperation day 1 (POD1) and at followup was measured and compared. Results: In 18 knees (60%), there were no visible femoral tunnel margins on the radiographs at POD1 or followup. In the other 12 cases, which had visible femoral tunnel margins on followup radiographs, the mean femoral tunnel diameter was 8.6 mm. In the tibial tunnel, the mean diameters did not increase on all three levels (proximal, middle, and distal), and there was no statistically significant difference between the diameters at POD1 and followup. Conclusion: The suggested tips for surgery involving an allo-Achilles tendon graft can effectively prevent TW after ACL reconstruction according to this case series. These surgical tips can prevent TW. PMID:28400663

  17. Three-Dimensional Reconstruction Computed Tomography Evaluation of the Tunnel Location and Angle in Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction: A Comparison of the Anteromedial Portal and Outside-in Techniques

    PubMed Central

    Kim, Kang-Il; Lee, Sang Hak; Bae, Chanil; Bae, Sung Hae

    2017-01-01

    Purpose The purpose of this study was to compare the geometry and position of the femoral tunnel between the anteromedial portal (AMP) and outside-in (OI) techniques after anatomic single-bundle anterior cruciate ligament (ACL) reconstruction. Materials and Methods We evaluated 82 patients undergoing single-bundle ACL reconstruction with hamstring autografts using either the AMP (n=40) or OI (n=42) technique. The locations of the tunnel apertures were assessed by postoperative 3-dimensional computed tomography imaging. The femoral graft bending angle, femoral tunnel aperture shape, femoral tunnel length, and posterior wall breakage were also measured. Results The mean femoral tunnel position parallel to the Blumensaat line was more caudally positioned in the AMP group than in the OI group (p=0.025) The mean femoral graft angle in the OI group (99.6°±7.1°) was significantly more acute than that of the AMP group (108.9°±10.2°, p<0.001). The mean height/width ratio of the AMP group (1.21±0.20) was significantly more ellipsoidal than that of the OI group (1.07±0.09, p<0.001). Conclusions The mean femoral tunnel position was significantly shallower in the AMP technique than in the OI technique. The OI technique might be more disadvantageous than the AMP technique in terms of the more acute bending angle. PMID:28231643

  18. [Femoral shaft fractures in children].

    PubMed

    Dietz, H-G; Schlickewei, W

    2011-05-01

    Femoral shaft fractures in children represent 1.5% of all fractures in childhood. Up to the age of 4 years, conservative treatment in a hip spica or short-term overhead traction is the therapy of choice. Femoral shaft fractures between the age of 5 and 16 years should be treated surgically. In over 90% of these cases elastic stable intramedullary nailing (ESIN) is the premier treatment option. Additional end caps can be used for unstable fractures and in length discrepancy. The external fixator and the locking plate are reserved for fractures with severe soft tissue injuries, vascular problems and some specific situations mentioned later on. By adhering to these standards good results can be achieved with a low complication rate.

  19. [Osteonecrosis of the femoral head].

    PubMed

    Lafforgue, Pierre

    2002-03-15

    The femoral head is the main location of avascular osteonecrosis. The lesion remains asymptomatic for several months or years before causing non specific hip pain. Risk factors have been identified, mainly femoral neck fractures, corticosteroid therapy and related conditions (lupus erythematosus, organ transplantations), alcohol abuse, dyslipidemia, sickle cell disease, HIV infection, caisson workers, Gaucher's disease, male sex. When typical radiological signs are lacking, MRI is the best investigation. Progression toward hip joint damage highly depends on the necrotic volume assessed at MRI. The combination of plain radiographs which help staging the severity of osteonecrosis, and MRI which indicates the prognosis of the lesion, determines the therapeutic options: symptomatic pain relief therapies or surgical treatment (core decompression, osteotomy or total hip replacement).

  20. Electron tunnel sensor technology

    NASA Technical Reports Server (NTRS)

    Waltman, S. B.; Kaiser, W. J.

    1989-01-01

    The recent development of Scanning Tunneling Microscopy technology allows the application of electron tunneling to position detectors for the first time. The vacuum tunnel junction is one of the most sensitive position detection mechanisms available. It is also compact, simple, and requires little power. A prototype accelerometer based on electron tunneling, and other sensor applications of this promising new technology are described.

  1. Increased lateral tibial posterior slope is related to tibial tunnel widening after primary ACL reconstruction.

    PubMed

    Sabzevari, Soheil; Rahnemai-Azar, Amir Ata; Shaikh, Humza S; Arner, Justin W; Irrgang, James J; Fu, Freddie H

    2017-03-04

    The purpose of the study was to determine the influence of femoral and tibial bone morphology on the amount of femoral and tibial tunnel widening after primary anatomic ACL reconstruction. It was hypothesized that tibial and femoral bone morphology would be significantly correlated with tunnel widening after anatomic ACL reconstruction. Forty-nine consecutive patients (mean age 21.8 ± 8.1 years) who underwent primary single-bundle anatomic ACL reconstruction with hamstring autograft were enrolled. Two blinded observers measured the bone morphology of tibia and femur including, medial and lateral tibial posterior slope, medial and lateral tibial plateau width, medial and lateral femoral condyle width, femoral notch width, and bicondylar width on preoperative magnetic resonance imaging (MRI) scans. Tibial and femoral tunnel width at three points (aperture, mid-section, and exit) were measured on standard anteroposterior radiograph from 1 week and 1 year postoperatively (mean 12.5 ± 2 months). Tunnel width measurements at each point were compared between 1 week and 1 year to calculate percent of tunnel widening over time. Multivariable linear regression was used to analyze correlations between bone morphology and tunnel widening. Increase in lateral tibial posterior slope was the only independent bony morphology characteristics that was significantly correlated with an increased tibial tunnel exit widening (R = 0.58). For every degree increase in lateral tibial posterior slope, a 3.2% increase in tibial tunnel exit width was predicted (p = 0.003). Excellent inter-observer and intra-observer reliability were determined for the measurements (ICC = 0.91 and 0.88, respectively). Increased lateral tibial posterior slope is an important preoperative anatomic factor that may predict tunnel widening at the tibial tunnel exit. In regard to clinical relevance, the results of this study suggest that lateral tibial posterior slope be measured

  2. Arthroplasty in Femoral Head Osteonecrosis

    PubMed Central

    Nam, Dong Cheol; Jung, Kwangyoung

    2014-01-01

    Osteonecrosis of the femoral head is a destructive joint disease requiring early hip arthroplasty. The polyethylene-metal design using a 22-mm femoral head component, introduced by Charnley in 1950, has been widely used for over half a century. Since then, different materials with the capacity to minimize friction between bearing surfaces and various cement or cementless insert fixations have been developed. Although the outcome of second and third generation designs using better bearing materials and technologies has been favorable, less favorable results are seen with total hip arthroplasty in young patients with osteonecrosis. Selection of appropriate materials for hip arthroplasty is important for any potential revisions that might become inevitable due to the limited durability of a prosthetic hip joint. Alternative hip arthroplasties, which include hemiresurfacing arthroplasty and bipolar hemiarthroplasty, have not been found to have acceptable outcomes. Metal-on-metal resurfacing has recently been suggested as a feasible option for young patients with extra physical demands; however, concerns about complications such as hypersensitivity reaction or pseudotumor formation on metal bearings have emerged. To ensure successful long-term outcomes in hip arthroplasty, factors such as insert stabilization and surfaces with less friction are essential. Understanding these aspects in arthroplasty is important to selection of proper materials and to making appropriate decisions for patients with osteonecrosis of the femoral head. PMID:27536561

  3. [Slipped upper femoral epiphysis (SUFE)].

    PubMed

    Wirth, T

    2011-08-01

    A slipped upper femoral epiphysis (SUFE) is the most common disease of the hip among adolescents. In the light of our current knowledge on the development of coxarthrosis, it represents a first line model case that has led to a series of novel ideas in the therapy for SUFE. The development of coxarthrosis from a cam impingement, i.e., the loss of offset of the neck of the femur and degenerative damage to the acetabular lip as its early form, is seen again in the clinical picture of slipped upper femoral epiphysis. Depending on the degree of slippage, we see a varying severity of the loss of offset and thus also different extents of the potential damage to the hip joint. This knowledge is by no means new. The questions of reorientation of the epiphysis of the humeral head and thus restoration of the anatomy of the coxal end of the femur have been addressed by renowned surgeons and answered with the development of widely varying procedures for surgical correction. However, within the framework of the surgical techniques introduced for treatment of impingement syndromes of the hip, these therapeutic options have been supplemented and broadened. The current discussion about the best therapeutic strategies emphasizes the fascination of the clinical entity of upper femoral epiphysis and constitutes a central component of this article. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Variations of relative anteversion of the femoral neck during walking.

    PubMed

    Quesnel, T

    1998-01-01

    Based on the geometric model developed by Netter [11], we determined the different positions of the femoral neck during monopodal support in walking in relation to a fixed frontal plane of reference (relative anteversion). This "relative anteversion" ranges on average from 24 degrees of retroversion at the beginning of support to 15 degrees of anterversion at the end if loading. We then studied the relations possibly existing between relative anteversion and acetabular orientation on the one hand, and the orientation of the resultant of the articular stresses on the other (both being variables during monopodal support in walking). The results showed that relative anteversion is well correlated with variations of position of the acetabulum since, at most, the deviation between the respective axes did not exceed the anatomic deviation due to absolute anteversion of the femoral neck and acetabulum. Lastly, analysis of the relations obtained with the orientation of the resultant of the articular stresses allowed a better comprehension of the functional distribution of forces.

  5. Femoral Nerve Palsy with Patella Fracture

    PubMed Central

    Lee, Sang Hyoung; Lee, Tong Joo; Woo, Min Su

    2013-01-01

    Femoral neuropathy may be associated with various etiologies and can cause severe walking disability. We present the case of a 25-year-old woman who underwent surgical repair for a patella fracture and complained of lower extremity pain, paresthesia, and weakness postoperatively. Electromyography and magnetic resonance imaging (MRI) revealed partial peripheral neuropathy of the left femoral nerve associated with the patella fracture. To our knowledge, this is the first reported case of femoral neuropathy associated with a patella fracture. PMID:24369003

  6. Tissue sparing total femoral arthroplasty: technical note.

    PubMed

    Willimon, Samuel Clifton; Bolognesi, Michael P; Attarian, David E

    2011-01-01

    It is predicted that the number of revision hip and knee arthroplasties will double by the years 2026 and 2015, respectively. As the burden of end-stage prosthetic disease increases, there will be a greater potential need for total femoral arthroplasty. This report describes a patient with a femoral neck fracture nonunion with an ipsilateral multiply revised failed total knee arthroplasty treated by a tissue sparing total femoral arthroplasty. The technique is described, and potential benefits are reviewed.

  7. Cryogenic wind tunnels. II

    NASA Technical Reports Server (NTRS)

    Kilgore, Robert A.

    1987-01-01

    The application of the cryogenic concept to various types of tunnels including Ludwieg tube tunnel, Evans clean tunnel, blowdown, induced-flow, and continuous-flow fan-driven tunnels is discussed. Benefits related to construction and operating costs are covered, along with benefits related to new testing capabilities. It is noted that cooling the test gas to very low temperatures increases Reynolds number by more than a factor of seven. From the energy standpoint, ambient-temperature fan-driven closed-return tunnels are considered to be the most efficient type of tunnel, while a large reduction in the required tunnel stagnation pressure can be achieved through cryogenic operation. Operating envelopes for three modes of operation for a cryogenic transonic pressure tunnel with a 2.5 by 2.5 test section are outlined. A computer program for calculating flow parameters and power requirements for wind tunnels with operating temperatures from saturation to above ambient is highlighted.

  8. FEMORAL INSERTION OF THE POSTERIOR CRUCIATE LIGAMENT: AN ANATOMICAL STUDY

    PubMed Central

    de Paula Leite Cury, Ricardo; Severino, Nilson Roberto; Camargo, Osmar Pedro Arbix; Aihara, Tatsuo; Neto, Leopoldo Viana Batista; Goarayeb, Dedley Nelson

    2015-01-01

    Objective: To identify objective parameters to guide correct location of the posterior cruciate ligament (PCL) in the femur. Methods: The PCLs of 20 human cadavers were resected. The following portions were measured: distance from the most distal portion of the PCL, close to the roof, to the most anterior edge of the cartilage (AB); distance from the most proximal portion of the PCL, close to the roof, to the most anterior cartilage (AC); distance between the two parts of the ligament close to the roof (BC); distance from the distal edge in its posterior portion, to the more posterior joint edge (DE); distance from the distal edge of the ligament in its posterior portion, to the intercondylar roof (DF); and finally, the format of the ligament insertion and area of coverage on the femoral condyle. Results: The PCL has the shape of a quarter ellipse, with an average area of 153.5mm2. The mean distances found were: AB of 2.1mm, AC of 10.7mm, BC of 8.6mm DE of 12.4mm and DF of 16.8mm. Conclusions: The edge close to the roof of the anterolateral bundle is closer to the joint cartilage (2.1mm) than the posteromedial bundle is, which is 12.4mm from the edge proximal to the cartilage. These references should assist in better and more accurate positioning of femoral tunnels in PCL reconstruction. PMID:27027059

  9. [Effect of continuous femoral nerve catheter length on blockade of femoral nerve, lateral femoral cutaneous nerve and obturator nerve].

    PubMed

    Zhu, Feng; Hu, Yan; Zhang, Wei

    2013-02-18

    To assess the effects of length of continuous femoral catheter on blockade of femoral nerve, lateral femoral cutaneous nerve and obturator nerve. In the study, 70 patients with American Association of Anesthesiologist grades I-II undergoing total knee arthroplasty were randomly divided into three groups, femoral nerve catheters were inserted 5 cm, 10 cm or 20 cm with assistance of a nerve stimulator, patient-controlled analgesia pumps were connected after load of 30 mL 0.3% ropivacaine via the catheters. Sensory blockade of the femoral nerve, lateral femoral cutaneous nerve and obturator nerve were recorded at 24 h postoperatively. Visual analog scale (VAS) pain scores during rest and motion were recorded at 24 h and 48 h postoperatively. The blockade effect of lateral femoral nerve in the 20 cm group was the best. There was no significant difference in sensory blockade between the 5 cm group and the 10 cm group. There was no significant difference in VAS score among the three groups. When continuous femoral nerve block is used for postoperative analgesia after total knee arthroplasty surgery, the catheters that are inserted 5 cm, 10 cm or 20 cm could provide similar and satisfying analgesia effect.

  10. Inelastic insights for molecular tunneling pathways: bypassing the terminal groups.

    PubMed

    Troisi, Alessandro; Ratner, Mark A

    2007-05-21

    As an example of the use of inelastic transport to deduce structure in molecular transport junctions, we compute the orientation dependence of the Inelastic Electron Tunneling (IET) spectrum of the 1-pentane monothiolate. We find that upon increasing the tilting angle of the molecule with respect to the normal to the electrode the spectrum changes as the intensity of some vibrations is enhanced. These differences occur because for higher tilting angles the tunneling path that bypasses the terminal group grows in importance. IETS can therefore be used to establish the molecular orientation in junctions terminating with alkyl chains and to investigate experimentally the relative importance of the available tunneling paths.

  11. Outcomes after trifocal femoral fractures.

    PubMed

    Griffin, Michelle; Dick, Alastair G; Umarji, Shamim

    2014-01-01

    Trifocal femur fractures are those of the femoral neck, diaphysis, and distal femur. These high-energy injuries predominantly occur in young people with the potential for long-term complications and disability. We present the cases of two men who were treated with proximal dynamic hip screws and distal periarticular locking plates to effectively manage trifocal femur fractures. Our cases have shown union at 2 years with good functional outcomes without the need for reintervention. We provide evidence for a successful surgical treatment option for these rare and complex injuries.

  12. Outcomes after Trifocal Femoral Fractures

    PubMed Central

    Griffin, Michelle; Dick, Alastair G.; Umarji, Shamim

    2014-01-01

    Trifocal femur fractures are those of the femoral neck, diaphysis, and distal femur. These high-energy injuries predominantly occur in young people with the potential for long-term complications and disability. We present the cases of two men who were treated with proximal dynamic hip screws and distal periarticular locking plates to effectively manage trifocal femur fractures. Our cases have shown union at 2 years with good functional outcomes without the need for reintervention. We provide evidence for a successful surgical treatment option for these rare and complex injuries. PMID:24800097

  13. Measurement of bone mineral density in the tunnel regions for anterior cruciate ligament reconstruction by dual-energy X-ray absorptiometry, computed tomography scan, and the immersion technique based on Archimedes' principle.

    PubMed

    Tie, Kai; Wang, Hua; Wang, Xin; Chen, Liaobin

    2012-10-01

    To determine, for anterior cruciate ligament (ACL) reconstruction, whether the bone mineral density (BMD) of the femoral tunnel was higher than that of the tibial tunnel, to provide objective evidence for choosing the appropriate diameter of interference screws. Two groups were enrolled. One group comprised 30 normal volunteers, and the other comprised 9 patients with ACL rupture. Dual-energy X-ray absorptiometry was used to measure the BMD of the femoral and tibial tunnel regions of the volunteers' right knees by choosing a circular area covering the screw fixation region. The knees were also scanned by spiral computed tomography (CT), and the 3-dimensional reconstruction technique was used to determine the circular sections passing through the longitudinal axis of the femoral and tibial tunnels. Grayscale CT values of the cross-sectional area were measured. Cylindrical cancellous bone blocks were removed from the femoral and tibial tunnels during the ACL reconstruction for the patients. The volumetric BMD of the bone blocks was measured using a standardized immersion technique according to Archimedes' principle. As measured by dual-energy X-ray absorptiometry, the BMD of the femoral and tibial tunnel regions was 1.162 ± 0.034 g/cm(2) and 0.814 ± 0.038 g/cm(2), respectively (P < .01). The CT value of the femoral tunnel region was 211.7 ± 11.5 Hounsfield units, and the value of the tibial tunnel region was 104.9 ± 7.4 Hounsfield units (P < .01). The volumetric BMD of the bone block from the femoral tunnel (2.80 ± 0.88 g/cm(3)) was higher than the value from the tibial tunnel (1.88 ± 0.59 g/cm(3)) (P < .01). Comparing the data between male and female patients, we found no significant difference in both femoral and tibial tunnel regions. For ACL reconstruction, the BMD of the femoral tunnel is higher than that of the tibial tunnel. This implies that a proportionally larger-diameter interference screw should be used for fixation in the proximal tibia than that

  14. Femoral Aperture Fixation Improves Anterior Cruciate Ligament Graft Function When Added to Cortical Suspensory Fixation

    PubMed Central

    Porter, Mark D.; Shadbolt, Bruce

    2016-01-01

    Background: Recommendations for bone tunnel placement during anterior cruciate ligament (ACL) reconstruction have become more precise. However, these recommendations differ neither with the choice of graft nor with the method of fixation used. The influence of the method of femoral fixation used on the biomechanical function of a soft tissue ACL graft remains unknown. Hypothesis: Our null hypothesis was that adding femoral aperture fixation to femoral cortical fixation, using the same bone tunnels, will not alter the control of anterior translation (AT) and internal rotation (IR) during ACL reconstruction using a hamstring graft. Study Design: Controlled laboratory study. Methods: A total of 22 patients with an acute isolated ACL rupture underwent reconstruction using a single-bundle autologous hamstring graft. Computer navigation was used intraoperatively to plot the AT and IR during the pivot-shift test before reconstruction, after ACL reconstruction using cortical suspensory fixation, and after the addition of femoral aperture fixation. Statistical analysis (analysis of variance) was used to compare the AT and IR during the pivot shift at each stage in the procedure. Results: Before ACL reconstruction, the mean (±SD) AT was 14.2 ± 7.3 mm and mean IR was 17.2° ± 5.5°. After reconstruction using femoral cortical suspension, these figures were significantly reduced to 6.2 ± 3.5 mm and 12.5° ± 3.20°, respectively (P < .001). The addition of the aperture fixation was associated with a further significant reduction to 4.6 ± 3.2 mm and 10.4° ± 2.7°, respectively (P < .001). Conclusion: The addition of femoral aperture fixation to suspensory fixation results in a significant reduction in both the AT and IR that occurs during the pivot-shift assessment immediately after ACL reconstruction using autologous hamstring graft. Clinical Relevance: The most precise positioning of bone tunnels during soft tissue ACL reconstruction needs to take into consideration

  15. 4. 'Ring Stones & Tunnel Sections, Tunnel #33,' Southern Pacific ...

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

    4. 'Ring Stones & Tunnel Sections, Tunnel #33,' Southern Pacific Standard Double-Track Tunnel, ca. 1913. Compare to photos in documentation sets for Tunnel 18 (HAER No. CA-197), Tunnel 34 (HAER No. CA-206), and Tunnel 1 (HAER No. CA-207). - Central Pacific Transcontinental Railroad, Sacramento to Nevada state line, Sacramento, Sacramento County, CA

  16. Unusual presentation of a femoral stress fracture

    PubMed Central

    Ejnisman, Leandro; Wajnsztejn, Andre; Queiroz, Roberto Dantas; Ejnisman, Benno

    2013-01-01

    Stress fractures are common injuries in sports medicine. Among these fractures, femoral neck stress fractures frequently have a benign course, especially when it happens in the medial aspect of the neck. This case report describes a stress fracture of the medial aspect of the femoral neck that developed a complete fracture and underwent surgical fixation. PMID:23283621

  17. Relaxation response in femoral angiography.

    PubMed

    Mandle, C L; Domar, A D; Harrington, D P; Leserman, J; Bozadjian, E M; Friedman, R; Benson, H

    1990-03-01

    Immediately before they underwent femoral angiography, 45 patients were given one of three types of audiotapes: a relaxation response tape recorded for this study, a tape of contemporary instrumental music, or a blank tape. All patients were instructed to listen to their audiotape during the entire angiographic procedure. Each audiotape was played through earphones. Radiologists were not told the group assignment or tape contents. The patients given the audiotape with instructions to elicit the relaxation response (n = 15) experienced significantly less anxiety (P less than .05) and pain (P less than .001) during the procedure, were observed by radiology nurses to exhibit significantly less pain (P less than .001) and anxiety (P less than .001), and requested significantly less fentanyl citrate (P less than .01) and diazepam (P less than .01) than patients given either the music (n = 14) or the blank (n = 16) control audiotapes. Elicitation of the relaxation response is a simple, inexpensive, efficacious, and practical method to reduce pain, anxiety, and medication during femoral angiography and may be useful in other invasive procedures.

  18. The Channel Tunnel

    NASA Image and Video Library

    2006-08-11

    The Channel Tunnel is a 50.5 km-long rail tunnel beneath the English Channel at the Straits of Dover. It connects Dover, Kent in England with Calais, northern France. This image was acquired by NASA Terra spacecraft.

  19. Carpal tunnel repair - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100078.htm Carpal tunnel repair - series—Normal anatomy To use the sharing ... in the wrist and the wrist bones (carpal tunnel). Review Date 5/9/2015 Updated by: C. ...

  20. The Tunnels of Samos

    NASA Technical Reports Server (NTRS)

    Apostol, Tom M. (Editor)

    1995-01-01

    This 'Project Mathematics' series video from CalTech presents the tunnel of Samos, a famous underground aquaduct tunnel located near the capital of Pithagorion (named after the famed Greek mathematician, Pythagoras, who lived there), on one of the Greek islands. This tunnel was constructed around 600 BC by King Samos and was built under a nearby mountain. Through film footage and computer animation, the mathematical principles and concepts of why and how this aquaduct tunnel was built are explained.

  1. Variable Density Tunnel

    NASA Technical Reports Server (NTRS)

    1931-01-01

    Variable Density Tunnel in operation. Man at far right is probably Harold J. 'Cannonball' Tuner, longtime safety officer, who started with Curtiss in the teens. This view of the Variable Density Tunnel clearly shows the layout of the Tunnel's surroundings, as well as the plumbing and power needs of the this innovative research tool.

  2. Removal of a broken guide wire entrapped in a fractured femoral neck.

    PubMed

    Zhu, Qing-hua; Ye, Tian-wen; Guo, Yong-fei; Wang, Chong-li; Chen, Ai-min

    2013-01-01

    Guide wire plays an important role in the fixation of femoral neck fracture with dynamic hip screw (DHS). Breakage of a guide wire during operation is a very rare condition. We met such a dilemma in DHS fixation of a 54-year-old male patient who sustained Garden type IV fracture of the right femoral neck. The distal end of the guide wire broke and was entrapped in the fractured femoral neck. We tried to get the broken part out by a cannulated drill. Reaming was started with the cannulated drill slowly rotating around the guide K-wire until the reamer fully contained the target under fluoroscope. A bone curette was used to get the broken wire out but failed, so we had to use the cannuated drill to dredge this bone tunnel. Finally the broken wire end was taken out, mixed with blood and bone fragments. Through the existing drilling channel, DHS fixation was easily finished. The patient had an uneventful recovery without avascular necrosis of femoral head or non-union of the fracture at one year's follow-up. A few methods can be adopted to deal with the broken guide wire. The way used in our case is less invasive but technically challenging. When the guide wire is properly positioned, this method is very practical and useful.

  3. All-Epiphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients: A Surgical Technique Using a Split Tibial Tunnel

    PubMed Central

    Lykissas, Marios G.; Nathan, Senthil T.; Wall, Eric J.

    2012-01-01

    Many techniques have been described for anterior cruciate ligament (ACL) reconstruction in skeletally immature patients, including extra-articular, complete or partial transphyseal, and physeal-sparing techniques. An all-epiphyseal technique places the tendon and its tunnels and fixation all within the child's epiphysis, leaving the growth plates untouched. We describe an all-epiphyseal quadruple-hamstring ACL reconstruction using a split tibial tunnel. The split tibial tunnels drop the tunnel size down to 4.5 to 5.5 mm from 7 to 8 mm because only half the total graft diameter passes through each of the split tunnels. This increases the safety margin for keeping the tunnel within the tibial epiphysis, in addition to avoiding damage into the growth plate. The bone bridge between the 2 tunnels serves as a solid low-profile fixation post. Femoral graft fixation is achieved with an interference screw, which allows precise tensioning and low-profile fixation entirely within the femoral tunnel. By placing the graft at the native ACL's anatomic attachment points without spanning or violating the growth plates at any step of the procedure, an all-epiphyseal ACL reconstruction with a split tibial tunnel theoretically minimizes the risk of growth disturbance in an ACL-deficient child. PMID:23766968

  4. Treatment of neglected femoral neck fracture

    PubMed Central

    Jain, Anil K; Mukunth, R; Srivastava, Amit

    2015-01-01

    Intra-capsular femoral neck fractures are seen commonly in elderly people following a low energy trauma. Femoral neck fracture has a devastating effect on the blood supply of the femoral head, which is directly proportional to the severity of trauma and displacement of the fracture. Various authors have described a wide array of options for treatment of neglected/nonunion (NU) femoral neck fracture. There is lack of consensus in general, regarding the best option. This Instructional course article is an analysis of available treatment options used for neglected femoral neck fracture in the literature and attempt to suggest treatment guides for neglected femoral neck fracture. We conducted the “Pubmed” search with the keywords “NU femoral neck fracture and/or neglected femoral neck fracture, muscle-pedicle bone graft in femoral neck fracture, fibular graft in femoral neck fracture and valgus osteotomy in femoral neck fracture.” A total of 203 print articles were obtained as the search result. Thirty three articles were included in the analysis and were categorized into four subgroups based on treatment options. (a) treated by muscle-pedicle bone grafting (MPBG), (b) closed/open reduction internal fixation and fibular grafting (c) open reduction and internal fixation with valgus osteotomy, (d) miscellaneous procedures. The data was pooled from all groups for mean neglect, the type of study (prospective or retrospective), classification used, procedure performed, mean followup available, outcome, complications, and reoperation if any. The outcome of neglected femoral neck fracture depends on the duration of neglect, as the changes occurring in the fracture area and fracture fragments decides the need and type of biological stimulus required for fracture union. In stage I and stage II (Sandhu's staging) neglected femoral neck fracture osteosynthesis with open reduction and bone grafting with MPBG or Valgus Osteotomy achieves fracture union in almost 90% cases

  5. Clinical-radiographic correlation of the femoral insertion point of the graft in reconstruction of the medial patellofemoral ligament☆

    PubMed Central

    Pinheiro Júnior, Lúcio Flávio Biondi; Cenni, Marcos Henrique Frauendorf; Nicolai, Oscar Pinheiro; Carneiro, Guilherme Galvão Barreto; de Andrade, Rodrigo Cristiano; de Moraes, Vinícius Vidigal

    2015-01-01

    Objective To analyze the radiographic positioning of the femoral tunnel and correlate this with the postoperative clinical results among patients undergoing reconstruction of the medial patellofemoral ligament (MPFL) alone. Method This was a retrospective study in which 30 knees of 26 patients with recurrent dislocation of the patella that underwent MPFL reconstruction were evaluated. The femoral insertion point of the graft and the postoperative clinical condition were analyzed and correlated using the Kujala and Lysholm scales. Results 22 knees presented a femoral tunnel in the anatomical area (group A) and 8 outside of this location (group B). In group A, the mean score on the Kujala scale was 89.68 points and on the Lysholm scale was 92.45 points. In group B, the mean score on the Kujala scale was 84.75 points and on the Lysholm scale was 92 points. The difference between the means was not significant on either of the two scales. Conclusion Correlation with the clinical results did not show any difference in relation to the positioning of the femoral insertion of the graft. PMID:27218083

  6. Autonomous Robotic Inspection in Tunnels

    NASA Astrophysics Data System (ADS)

    Protopapadakis, E.; Stentoumis, C.; Doulamis, N.; Doulamis, A.; Loupos, K.; Makantasis, K.; Kopsiaftis, G.; Amditis, A.

    2016-06-01

    In this paper, an automatic robotic inspector for tunnel assessment is presented. The proposed platform is able to autonomously navigate within the civil infrastructures, grab stereo images and process/analyse them, in order to identify defect types. At first, there is the crack detection via deep learning approaches. Then, a detailed 3D model of the cracked area is created, utilizing photogrammetric methods. Finally, a laser profiling of the tunnel's lining, for a narrow region close to detected crack is performed; allowing for the deduction of potential deformations. The robotic platform consists of an autonomous mobile vehicle; a crane arm, guided by the computer vision-based crack detector, carrying ultrasound sensors, the stereo cameras and the laser scanner. Visual inspection is based on convolutional neural networks, which support the creation of high-level discriminative features for complex non-linear pattern classification. Then, real-time 3D information is accurately calculated and the crack position and orientation is passed to the robotic platform. The entire system has been evaluated in railway and road tunnels, i.e. in Egnatia Highway and London underground infrastructure.

  7. Stiffness characteristics of hamstring tendon graft fixation methods at the femoral site.

    PubMed

    Benfield, D; Otto, D D; Bagnall, K M; Raso, V J; Moussa, W; Amirfazli, A

    2005-02-01

    In ACL reconstruction, stiffness and strength of a tendon graft complex are important features for knee stability and rehabilitation. The fixation between tendon and bone is known to be one of the weakest components of the graft complex. We examined the tensile load-displacement characteristics of looped semitendinosus tendons in a porcine femoral tunnel. Two groups of six cadaveric semitendinosus tendons and porcine femurs were tested, secured with either an aperture or non-aperture fixation method. Constructs were tested at 1 mm/s until failure in a materials testing machine, which allowed force and displacement data to be recorded. The non-aperture fixation group was significantly less stiff for the first 4 mm of displacement and had significantly higher ultimate failure loads. Provided that adequate ultimate strength can be achieved, stiffness properties of a tendon graft will be improved by using aperture fixation in femoral-site ACL reconstruction.

  8. Cross Pins versus Endobutton Femoral Fixation in Hamstring Anterior Cruciate Ligament Reconstruction: Minimum 4-Year Follow-Up

    PubMed Central

    Kong, Chae-Gwan; Kim, Geon-Hyeong; Ahn, Chi-Young

    2012-01-01

    Purpose We aimed to compare cross-pin fixation and Endobutton femoral fixation for hamstring anterior cruciate ligament (ACL) reconstruction with respect to clinical and radiographic results, including tunnel widening and the progression of knee osteoarthritis (OA). Materials and Methods Between August 2002 and August 2005, 126 autogenous hamstring ACL reconstructions were performed using either cross pins or Endobutton for femoral fixation. Fifty-six of 75 patients in the cross-pin group and 35 of 51 patients in the Endobutton group were followed up for a minimum of 4 years. We compared the clinical and radiological results between the groups using the International Knee Documentation Committee (IKDC) evaluation form, the KT-2000 arthrometer side to side difference, the amount of tunnel widening and the advancement of OA on radiographs. Results There were no significant differences in the IKDC grades between the groups at the 4 year follow-up. There was no significant difference in the side to side difference according to KT-2000 arthrometer testing. Also, there were no significant differences in terms of tunnel widening or advancement of OA on radiographs. Conclusions Endobutton femoral fixation showed good results that were comparable to those of cross pins fixation in hamstring ACL reconstruction. PMID:22570850

  9. An unusual complication of femoral vein catheterisation: pneumoperitoneum.

    PubMed

    Yildizdas, D; Tepe, T; Parlak, M; Akcali, M

    2007-12-01

    A 2-month-old girl with severe pneumonia required a central venous line. Femoral vein catheterisation was attempted but insertion was difficult. Pneumoperitoneum developed, which is a rare complication of femoral vein catheterisation. It is important when undertaking femoral vein catheterisation to use the correct landmarks in the femoral triangle below the inguinal ligament and an appropriate size of catheter.

  10. Unilateral Isolated Proximal Femoral Focal Deficiency

    PubMed Central

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

    2013-01-01

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

  11. Modeling a Shallow Rock Tunnel Using Terrestrial Laser Scanning and Discrete Fracture Networks

    NASA Astrophysics Data System (ADS)

    Cacciari, Pedro Pazzoto; Futai, Marcos Massao

    2017-05-01

    Discontinuity mapping and analysis are extremely important for modeling shallow tunnels constructed in fractured rock masses. However, the limited exposure and variability of rock face orientation in tunnels must be taken into account. In this paper, an automatic method is proposed to generate discrete fracture networks (DFNs) using terrestrial laser scanner (TLS) geological mapping and to continuously calculate the volumetric intensities ( P 32) along a tunnel. The number of fractures intersecting rectangular sampling planes with different orientations, fitted in tunnel sections of finite lengths, is used as the program termination criteria to create multiple DFNs and to calculate the mean P 32. All traces and orientations from three discontinuity sets of the Monte Seco tunnel (Vitória Minas Railway) were mapped and the present method applied to obtain the continuous variation in P 32 along the tunnel. A practical approach to creating single and continuous DFNs (for each discontinuity set), considering the P 32 variations, is also presented, and the results are validated by comparing the trace intensities ( P 21) from the TLS mapping and DFNs generated. Three examples of 3DEC block models generated from different sections of the tunnel are shown, including the ground surface and the bedrock topographies. The results indicate that the proposed method is a practical and powerful tool for modeling fractured rock masses of uncovered tunnels. It is also promising for application during tunnel construction when TLS mapping is a daily task (for as-built tunnel controls), and the complete geological mapping (traces and orientations) is available.

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

    PubMed Central

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

    2015-01-01

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

  13. Subtrochanteric Femoral Fracture during Trochanteric Nailing for the Treatment of Femoral Shaft Fracture

    PubMed Central

    Oh, Chi Hun; Yi, Ju Won

    2013-01-01

    We report on three cases of subtrochanteric femoral fractures during trochanteric intramedullary nailing for the treatment of femoral shaft fractures. Trochanteric intramedullary nails, which have a proximal lateral bend, are specifically designed for trochanteric insertion. When combined with the modified insertion technique, trochanteric intramedullary nails reduce iatrogenic fracture comminution and varus malalignment. We herein describe technical aspects of trochanteric intramedullary nailing for femoral shaft fractures to improve its application and prevent implant-derived complications. PMID:24009910

  14. Meralgia paresthetica and femoral acetabular impingement: a possible association.

    PubMed

    Ahmed, Aiesha

    2010-12-11

    Meralgia paresthetica consists of pain and dysesthesia in the anterolateral thigh. Etiology is divided into spontaneous and iatrogenic causes. To my knowledge this has never been attributed to femoral acetabular impingement. This case highlights the presence of lateral femoral cutaneous neuropathy in the setting of femoral acetabular impingement syndrome thus raising the possibility of an association. Femoral acetabular impingement; Lateral femoral cutaneous nerve; Dysesthesia; Nerve conduction studies.

  15. Meralgia Paresthetica and Femoral Acetabular Impingement: A Possible Association

    PubMed Central

    Ahmed, Aiesha

    2010-01-01

    Meralgia paresthetica consists of pain and dysesthesia in the anterolateral thigh. Etiology is divided into spontaneous and iatrogenic causes. To my knowledge this has never been attributed to femoral acetabular impingement. This case highlights the presence of lateral femoral cutaneous neuropathy in the setting of femoral acetabular impingement syndrome thus raising the possibility of an association. Keywords Femoral acetabular impingement; Lateral femoral cutaneous nerve; Dysesthesia; Nerve conduction studies PMID:22043261

  16. Flows In Model Human Femoral Arteries

    NASA Technical Reports Server (NTRS)

    Back, Lloyd H.; Kwack, Eug Y.; Crawford, Donald W.

    1990-01-01

    Flow is visualized with dye traces, and pressure measurements made. Report describes experimental study of flow in models of human femoral artery. Conducted to examine effect of slight curvature of artery on flow paths and distribution of pressure.

  17. Precision of a novel computed tomographic method for quantification of femoral varus in dogs and an assessment of the effect of femoral malpositioning.

    PubMed

    Oxley, Bill; Gemmill, Toby J; Pink, Jonathan; Clarke, Stephen; Parry, Andrew; Baines, Stephen; Malcolm McKee, W

    2013-08-01

    To assess the precision of a novel protocol for determination of femoral varus angle (FVA) using computed tomography (CT) in dogs, and to quantify the effect of femoral rotational and sagittal plane malpositioning on measured FVA. Cross-sectional study. Femora (n = 66) from dogs that had pelvic limb CT examination for patellar instability (26) or other reasons (10). Three observers measured FVA of each of 66 femora on three separate occasions. Standardized orientation of a volume rendered image was achieved by superimposition of the caudal and distal aspects of the femoral condyles on a lateral projection, definition of a sagittal plane axis, and finally rotation through 90° to yield a cranial projection. Intra- and inter-observer variability were estimated using the intra-class correlation coefficient. The effect of variation in rotational and sagittal plane orientation on measured FVA was subsequently quantified using 6 femora with FVAs between -0.4° and 19°. Intra-class correlation coefficients for the 3 observers, indicating intra-observer variation, were 0.982, 0.937, and 0.974. The intra-class correlation coefficient of the means of the results from each observer, indicating inter-observer variation, was 0.976. Consistent linear variations in measured FVA occurred as a result of rotational malpositioning in all 6 tested femora, and as a result of sagittal plane malpositioning in femora with FVAs ≥ 7.9°. The reported protocol for the measurement of FVA in dogs is repeatable and reproducible. Small variations in femoral orientation, as might be expected with conventional radiography, lead to clinically significant alterations in measured FVA. © Copyright 2013 by The American College of Veterinary Surgeons.

  18. Current Concepts in Paediatric Femoral Shaft Fractures

    PubMed Central

    John, Rakesh; Sharma, Siddhartha; Raj, Gopinathan Nirmal; Singh, Jujhar; C., Varsha; RHH, Arjun; Khurana, Ankit

    2017-01-01

    Pediatric femoral shaft fractures account for less than 2% of all fractures in children. However, these are the most common pediatric fractures necessitating hospitalization and are associated with prolonged hospital stay, prolonged immobilization and impose a significant burden on the healthcare system as well as caregivers. In this paper, the authors present a comprehensive review of epidemiology, aetiology, classification and managemement options of pediatric femoral shaft fractures. PMID:28603567

  19. Femoral nerve entrapment: a new insight.

    PubMed

    Vázquez, M T; Murillo, J; Maranillo, E; Parkin, I G; Sanudo, J

    2007-03-01

    Compression of the femoral nerve in the iliac fossa has been reported as a consequence of several pathologies, but never as a result of muscular compression. Aberrant slips of iliacus, however, have occasionally been reported to cover or split the femoral nerve. This study aimed to assess such variations as potential factors in femoral nerve compression. A large and homogeneous sample of 121 embalmed cadavers (242 specimens) was studied. Statistical comparisons were made using the chi-squared test. Muscular slips from iliacus and psoas, piercing or covering the femoral nerve, were found in 19 specimens (7.9%). No significant differences by sex or side were found. The more frequent variation was piercing of the femoral nerve by a muscular slip (17 specimens, 7.0%). The nerve then entered the thigh as one or more branches. The less frequent variation found was a muscular slip or sheet covering the femoral nerve as it lay on iliacus (2 specimens, 0.8%). Each disposition may be a potential risk for nerve entrapment.

  20. Radiographic location of the femoral footprint of the cranial cruciate ligament in dogs.

    PubMed

    Bolia, A; Winkels, P; Böttcher, P

    2015-01-01

    To describe the radiographic location of the center of the femoral footprint of the cranial cruciate ligament (CrCL) in dogs. Using femora from 49 adult, orthopedically sound dogs (bodyweight≥20 kg), a radiopaque marker was placed on the cranial border of the femoral footprint of the CrCL. Computed tomography and threedimensional (3D) reconstruction of each femur was performed subsequently, followed by manual segmentation of the footprint on the 3D models and calculation of its center. Finally, virtual digital radiographs in two planes were produced and the location of the calculated center of the CrCL was expressed using three different methods (4x4 box grid method and percentage position for the medio-lateral projection; o'clock position for the disto-proximal projection). In the medio-lateral radiographs the center of the femoral footprint was consistently located in the second rectangle from the top of the most caudal column of the 4x4 grid. The mean percentage caudo-cranial and proximo-distal location was 20.2% (±2.2) and 33.8% (±3.7), respectively. In the disto-proximal radiograph, the o'clock position of the CrCL center was between 2 and 3 o'clock in 97.6% of cases. The radiographic location of the center of the femoral footprint can be consistently predicted in medio-lateral and disto-proximal stifle radiographs of dogs over 20 kg. The reported data can be used to plan and verify the placement of the femoral tunnel opening for intra-articular anatomic CrCL repair.

  1. The cryogenic wind tunnel

    NASA Technical Reports Server (NTRS)

    Kilgore, R. A.

    1976-01-01

    Based on theoretical studies and experience with a low speed cryogenic tunnel and with a 1/3-meter transonic cryogenic tunnel, the cryogenic wind tunnel concept was shown to offer many advantages with respect to the attainment of full scale Reynolds number at reasonable levels of dynamic pressure in a ground based facility. The unique modes of operation available in a pressurized cryogenic tunnel make possible for the first time the separation of Mach number, Reynolds number, and aeroelastic effects. By reducing the drive-power requirements to a level where a conventional fan drive system may be used, the cryogenic concept makes possible a tunnel with high productivity and run times sufficiently long to allow for all types of tests at reduced capital costs and, for equal amounts of testing, reduced total energy consumption in comparison with other tunnel concepts.

  2. Simulator of Road Tunnel

    NASA Astrophysics Data System (ADS)

    Danišovič, Peter; Schlosser, František; Šrámek, Juraj; Rázga, Martin

    2015-05-01

    A Tunnel Traffic & Operation Simulator is a device of the Centre of Transport Research at the University of Žilina. The Simulator allows managing technological equipment of virtual two-tube highway tunnel, which is interconnected with simulation of vehicle traffic in tunnel. Changes of the traffic-operation states and other equipment are reflecting at the simulated traffic, as well as simulations of various emergency events in traffic initiate changes in tunnel detecting and measuring devices. It is thus possible to simulate emergency states, which can be affected by various faults of technology as well as by climatic conditions. The solutions can be found in irreplaceable experiences of Slovak road tunnel operators, changes of trafficoperation states, visualizations of operator technological display screens, technological devices labelling in order to increase operational safety of road tunnels.

  3. Treatment of periprosthetic femoral fractures following total hip arthroplasty with femoral component revision.

    PubMed

    Springer, Bryan D; Berry, Daniel J; Lewallen, David G

    2003-11-01

    Revision total hip arthroplasty is indicated for most periprosthetic fractures that occur around the stem of the femoral implant. The purpose of the present study was to assess the results and complications of revision total hip arthroplasty for the treatment of periprosthetic femoral fractures. We evaluated 118 hips in 116 patients who underwent revision total hip arthroplasty because of an acute Vancouver type-B periprosthetic femoral fracture. The femoral implant used for the revision was a cemented stem in forty-two hips, a proximally porous-coated uncemented stem in twenty-eight, an extensively porous-coated stem in thirty, and an allograft-prosthesis composite or tumor prosthesis in eighteen. The mean duration of follow-up was 5.4 years. Kaplan-Meier analysis demonstrated that the probability of survival was 90% at five years and 79.2% at ten years with revision or removal of the femoral implant for any reason as the end point. Sixteen femoral components were rerevised: ten were rerevised because of loosening; three, because of loosening in association with a fracture nonunion; two, because of recurrent dislocation; and one, because of a new periprosthetic fracture. Additionally, six femoral implants were resected because of deep infection (five) or prosthetic loosening (one). Radiographs of the ninety-six hips with a surviving implant showed that twenty-one had evidence of loosening of the femoral implant, four had a nonunion of the femoral fracture, and two had both a nonunion and loosening of the femoral implant. Revision total hip arthroplasty for the treatment of a periprosthetic fracture around the stem of the femoral implant successfully restored function for most patients. The greatest long-term problems were prosthetic loosening and fracture nonunion. Better results were seen when an uncemented, extensively porous-coated stem was used.

  4. Analysis of risk factors for femoral head necrosis after internal fixation in femoral neck fractures.

    PubMed

    Wang, Tao; Sun, Jun-Ying; Zha, Guo-Chun; Jiang, Tao; You, Zhen-Jun; Yuan, De-Jing

    2014-12-01

    Femoral head necrosis is a rare but devastating complication following femoral neck fracture. The reported incidence of avascular necrosis after femoral neck fracture fixation varies widely, and there is no consensus regarding its risk factors. The aim of this study was to analyze the risk factors for femoral head necrosis after internal fixation in femoral neck fracture. This retrospective study included 166 patients with femoral neck fractures treated with surgical reduction and internal fixation at the authors' institution from January 2004 to December 2008. Eight patients died for reasons unrelated to the surgery, and 12 patients were lost to follow-up. The remaining 146 patients (146 fractures) were followed until union or until conversion to total hip arthroplasty. The patients included 61 males and 85 females with an average age of 47.5 years (range, 18-68 years). The authors analyzed the following factors: age, sex, Garden classification, reduction quality, surgical methods, injury-to-surgery interval, preoperative traction, weight-bearing time, and implant removal. All patients were followed for a mean of 52 months (range, 6-90 months). The incidence of femoral head necrosis was 14.4% (21/146). Garden classification (P=.012), reduction quality (P=.008), implant removal (P=.020), and preoperative traction (P=.003) were significantly associated with femoral head necrosis. Patient age (P=.990), sex (P=.287), injury-to-surgery interval (P=.360), weight-bearing time (P=.868), and surgical methods (P=.987) were not significantly associated with femoral head necrosis. In multivariate logistic regression analysis, implant removal was not a significant risk factor for femoral head necrosis development (P=.498). Garden classification, reduction quality, and preoperative traction had a significant effect on femoral head necrosis development. Copyright 2014, SLACK Incorporated.

  5. Charge Islands Through Tunneling

    NASA Technical Reports Server (NTRS)

    Robinson, Daryl C.

    2002-01-01

    It has been recently reported that the electrical charge in a semiconductive carbon nanotube is not evenly distributed, but rather it is divided into charge "islands." This paper links the aforementioned phenomenon to tunneling and provides further insight into the higher rate of tunneling processes, which makes tunneling devices attractive. This paper also provides a basis for calculating the charge profile over the length of the tube so that nanoscale devices' conductive properties may be fully exploited.

  6. Pipetron Tunnel Construction Issues

    SciTech Connect

    Friant, James E.; Bauer, Robert A.; Gross, David L.; May, Michael; Lach, Joseph

    1997-01-01

    This report examines issues involved in the civil construction aspects of the tunneling that could be done in the region of Fermilab to support the Pipetron along, moderately deep, tunnel loop. Cost, technical and political aspects of tunneling are addressed in this preliminary guide for further study. At Snowmass 96, in a series of informal, but comprehensive discussions, several guidelines were developed to frame this report.

  7. In vivo bone tunnel evaluation of nanoparticle-grafts using an ACL reconstruction rabbit model.

    PubMed

    Grant, Sheila A; Smith, Sarah E; Schmidt, Hilary; Pfeiffer, Ferris; Kuroki, Kei; Sherman, Seth; White, Richard; Grant, David A

    2017-04-01

    Acellular human gracilis tendons conjugated with gold nanoparticles (AuNP) and hydroxyapatite nanoparticles (nano-HAp) were used as a graft in an anterior cruciate ligament (ACL) reconstruction rabbit model. The ACLs of 11 New Zealand rabbits were reconstructed using grafts conjugated without nanoparticles, with AuNP only, and with both AuNP and nano-HAp. Semi-quantitative histological scoring of bone tunnel portion of grafts was performed after 14 weeks. Bone tunnels were scored for graft degeneration, graft remodeling, percentage of new host fibrous connective, collateral connection, head-to-head connection, graft collagen fiber organization, new host fibrous connective tissue organization, and graft and interface vascularity. All grafts were intact at 14 weeks. Results of bone tunnel scoring indicate remodeling in all graft types with new organized host fibrous connective tissue, head-to-head connection to bone and mild inflammation associated with remodeling. Components of the 20 nm AuNP grafts have significantly more graft degeneration, more new host fibrous connective tissue, and more vascularity compared to crosslinked grafts. Comparison between femoral and tibial tunnel scores indicate more degeneration in femoral tunnels compared to tibial tunnels. Overall results indicated potentially enhanced remodeling from the use of 20 nm AuNP grafts. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1071-1082, 2017.

  8. Tunnelling in Dante's Inferno

    NASA Astrophysics Data System (ADS)

    Furuuchi, Kazuyuki; Sperling, Marcus

    2017-05-01

    We study quantum tunnelling in Dante's Inferno model of large field inflation. Such a tunnelling process, which will terminate inflation, becomes problematic if the tunnelling rate is rapid compared to the Hubble time scale at the time of inflation. Consequently, we constrain the parameter space of Dante's Inferno model by demanding a suppressed tunnelling rate during inflation. The constraints are derived and explicit numerical bounds are provided for representative examples. Our considerations are at the level of an effective field theory; hence, the presented constraints have to hold regardless of any UV completion.

  9. Giant tunnelling magnetoresistance at room temperature with MgO (100) tunnel barriers.

    PubMed

    Parkin, Stuart S P; Kaiser, Christian; Panchula, Alex; Rice, Philip M; Hughes, Brian; Samant, Mahesh; Yang, See-Hun

    2004-12-01

    Magnetically engineered magnetic tunnel junctions (MTJs) show promise as non-volatile storage cells in high-performance solid-state magnetic random access memories (MRAM). The performance of these devices is currently limited by the modest (< approximately 70%) room-temperature tunnelling magnetoresistance (TMR) of technologically relevant MTJs. Much higher TMR values have been theoretically predicted for perfectly ordered (100) oriented single-crystalline Fe/MgO/Fe MTJs. Here we show that sputter-deposited polycrystalline MTJs grown on an amorphous underlayer, but with highly oriented (100) MgO tunnel barriers and CoFe electrodes, exhibit TMR values of up to approximately 220% at room temperature and approximately 300% at low temperatures. Consistent with these high TMR values, superconducting tunnelling spectroscopy experiments indicate that the tunnelling current has a very high spin polarization of approximately 85%, which rivals that previously observed only using half-metallic ferromagnets. Such high values of spin polarization and TMR in readily manufactureable and highly thermally stable devices (up to 400 degrees C) will accelerate the development of new families of spintronic devices.

  10. Femoral neck shortening after internal fixation of a femoral neck fracture.

    PubMed

    Zielinski, Stephanie M; Keijsers, Noël L; Praet, Stephan F E; Heetveld, Martin J; Bhandari, Mohit; Wilssens, Jean Pierre; Patka, Peter; Van Lieshout, Esther M M

    2013-07-01

    This study assesses femoral neck shortening and its effect on gait pattern and muscle strength in patients with femoral neck fractures treated with internal fixation. Seventy-six patients from a multicenter randomized controlled trial participated. Patient characteristics and Short Form 12 and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were collected. Femoral neck shortening, gait parameters, and maximum isometric forces of the hip muscles were measured and differences between the fractured and contralateral leg were calculated. Variables of patients with little or no shortening, moderate shortening, and severe shortening were compared using univariate and multivariate analyses. Median femoral neck shortening was 1.1 cm. Subtle changes in gait pattern, reduced gait velocity, and reduced abductor muscle strength were observed. Age, weight, and Pauwels classification were risk factors for femoral neck shortening. Femoral neck shortening decreased gait velocity and seemed to impair gait symmetry and physical functioning. In conclusion, internal fixation of femoral neck fractures results in permanent physical limitations. The relatively young and healthy patients in our study seem capable of compensating. Attention should be paid to femoral neck shortening and proper correction with a heel lift, as inadequate correction may cause physical complaints and influence outcome. Copyright 2013, SLACK Incorporated.

  11. Aetiology of femoral hernias revisited: bilateral femoral hernia in a young male (two cases).

    PubMed

    Kochupapy, R T; Ranganathan, G; Dias, S; Shanahan, D

    2013-01-01

    Bilateral femoral hernias are less common in men than in women and rare in young adults. Only one case of a bilateral femoral hernia in a young man has been reported in the literature before. Three main theories have been postulated for femoral hernias. The theory that they are an acquired disease is the most accepted due to the common occurrence of such hernias in multiparous women but the theory lacks enough evidence. We report two cases in young men. Anatomical variations in the femoral canal could be the primary aetiological factor in these patients. A unilateral femoral hernia in young men with acquired aetiological factors requires a clinical examination of the opposite side.

  12. Effects of in-plane magnetization orientation on magnetic and electronic properties in a Bcc Co (001)/rock salt MgO (001)/Bcc Co (001) magnetic tunnel junction system: ab initio calculations.

    PubMed

    Yoo, Dong Su; Chae, Kisung; Chung, Yong-Chae

    2012-04-01

    Ab initio calculations were performed on a fully epitaxial bcc Co (001)/rock salt MgO (001)/bcc Co (001) magnetic tunnel junction system for two cases where the magnetization is parallel to bcc Co [100] and to bcc Co [110]. Structural optimization reveals that the two cases are equivalent systems and that the Co electrodes contract in the z-direction whereas the MgO insulating barrier expands. The magnetic moments of each monolayer vary slightly in each case; furthermore, only the magnetic moment at the surface of the Co atom shows any enhancement (12%). The layer decomposed density of states profiles reveals that the bonding character of the junction interface is derived mainly from the 2p-3d hybridization of the MgO and Co interfacial atoms.

  13. Correlation of ultrasound appearance, gross anatomy, and histology of the femoral nerve at the femoral triangle.

    PubMed

    Lonchena, Tiffany K; McFadden, Kathryn; Orebaugh, Steven L

    2016-01-01

    Correlation between ultrasound appearance, gross anatomic characteristics, and histologic structure of the femoral nerve (FN) is lacking. Utilizing cadavers, we sought to characterize the anatomy of the FN, and provide a quantitative measure of its branching. We hypothesize that at the femoral crease, the FN exists as a group of nerve branches, rather than a single nerve structure, and secondarily, that this transition into many branches is apparent on ultrasonography. Nineteen preserved cadavers were investigated. Ultrasonography was sufficient to evaluate the femoral nerve in nine specimens; gross dissection was utilized in all 19. Anatomic characteristics were recorded, including distances from the inguinal ligament to femoral crease, first nerve branch, and complete arborization of the nerve. The nerves from nine specimens were excised for histologic analysis. On ultrasound, the nerve became more flattened, widened, and less discrete as it coursed distally. Branching of the nerve was apparent in 12 of 18 images, with mean distance from inguinal ligament of 3.9 (1.0) cm. However, upon dissection, major branching of the femoral nerve occurred at 3.1 (1.0) cm distal to the inguinal ligament, well proximal to the femoral crease. Histologic analysis was consistent with findings at dissection. The femoral nerve arborizes into multiple branches between the inguinal ligament and the femoral crease. Initial branching is often high in the femoral triangle. As hypothesized, the FN exists as a closely associated group of nerve branches at the level of the femoral crease; however, the termination of the nerve into multiple branches is not consistently apparent on ultrasonography.

  14. Three-dimensional orientation of the acetabulum.

    PubMed

    Suzuki, Daisuke; Nagoya, Satoshi; Takashima, Hiroyuki; Tateda, Kenji; Yamashita, Toshihiko

    2017-09-01

    This study was designed specifically to determine the normal acetabular orientation and femoral head covering, and whether these are affected by age or sex. Computed tomographic images of normal Japanese hip joints were used (males 60, females 60; mean age 48.3 years, range 15-79 years). Male and female age profiles were matched. The reconstructed 3-D pelvic images were aligned in the anatomical pelvic coordinate system. The acetabular orientation angles and femoral covering angles were measured in the sagittal, coronal, and horizontal planes. In the sagittal plane, the acetabular orientation angle was operative anteversion (O-av), and the femoral covering angles were the anterior and posterior center-edge angles (ACE and PCE). In the coronal plane, they were the Sharp angle (SA) and the lateral center-edge angle (LCE). In the horizontal plane, they were anatomical anteversion (A-av) and the anterior and posterior sector angles (ASA and PSA). The O-av, SA, and A-av were smaller in the male than the female acetabulum (P < 0.01). SA in both males and females was inversely correlated with age (P < 0.01). Both male PCE and PSA were significantly smaller than those of females, while male ASA was larger than female ASA (P < 0.05). The male acetabulum is directed further outward and downward than the female one. However, this does not indicate that the male acetabulum covers the femoral head more, because there is no significant sex difference in the LCE. Femoral coverage is more posteriorly biased in females than in males owing to pelvic inclination. Clin. Anat. 30:753-760, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  15. Electron-Tunneling Magnetometer

    NASA Technical Reports Server (NTRS)

    Kaiser, William J.; Kenny, Thomas W.; Waltman, Steven B.

    1993-01-01

    Electron-tunneling magnetometer is conceptual solid-state device operating at room temperature, yet offers sensitivity comparable to state-of-art magnetometers such as flux gates, search coils, and optically pumped magnetometers, with greatly reduced volume, power consumption, electronics requirements, and manufacturing cost. Micromachined from silicon wafer, and uses tunneling displacement transducer to detect magnetic forces on cantilever-supported current loop.

  16. Shotcrete in tunnel design

    SciTech Connect

    Golser, J.; Galler, R.; Schubert, P.; Rabensteiner, K.

    1995-12-31

    Shotcrete is an important structural element for tunnel support. Green shotcrete is exposed to compression strain rates and tunnel design requires a realistic material law for shotcrete. A modified rate of flow method simulates shotcrete behavior very well and can be incorporated in Finite Element calculations.

  17. The carpal tunnel.

    PubMed

    Ellis, Harold

    2009-12-01

    The carpal bones are deeply convex anteriorly. This bony gutter is converted by the flexor retinaculum into a tube - the carpal tunnel, which conveys the median nerve, together with the long flexor tendons of the fingers and thumb, into the hand. It is of special interest to the surgeon because it is the site of a common nerve entrapment, the carpal tunnel syndrome.

  18. Femoral lipectomy increases postprandial lipemia in women

    PubMed Central

    Hernandez, Teri L.; Bessesen, Daniel H.; Cox-York, Kimberly A.; Erickson, Christopher B.; Law, Christopher K.; Anderson, Molly K.; Wang, Hong; Jackman, Matthew R.

    2015-01-01

    Femoral subcutaneous adipose tissue (SAT) appears to be cardioprotective compared with abdominal SAT, possibly through better triglyceride (TG) sequestration. We hypothesized that removal of femoral SAT would increase postprandial TG through a reduction in dietary fatty acid (FA) storage. Normal-weight (means ± SD; BMI 23.9 ± 2.6 kg/m2) women (n = 29; age 45 ± 6 yr) were randomized to femoral lipectomy (LIPO) or control (CON) and followed for 1 yr. Regional adiposity was measured by DEXA and CT. A liquid meal labeled with [14C]oleic acid was used to trace the appearance of dietary FA in plasma (6-h postprandial TG), breath (24-h oxidation), and SAT (24-h [14C]TG storage). Fasting LPL activity was measured in abdominal and femoral SAT. DEXA leg fat mass was reduced after LIPO vs. CON (Δ−1.4 ± 0.7 vs. 0.1 ± 0.5 kg, P < 0.001) and remained reduced at 1 yr (−1.1 ± 1.4 vs. −0.2 ± 0.5 kg, P < 0.05), as did CT thigh subcutaneous fat area (−39.6 ± 36.6 vs. 4.7 ± 14.6 cm2, P < 0.05); DEXA trunk fat mass and CT visceral fat area were unchanged. Postprandial TG increased (5.9 ± 7.7 vs. −0.6 ± 5.3 × 103 mg/dl, P < 0.05) and femoral SAT LPL activity decreased (−21.9 ± 22.3 vs. 10.5 ± 26.5 nmol·min−1·g−1, P < 0.05) 1 yr following LIPO vs. CON. There were no group differences in 14C-labeled TG appearing in abdominal and femoral SAT or elsewhere. In conclusion, femoral fat remained reduced 1 yr following lipectomy and was accompanied by increased postprandial TG and reduced femoral SAT LPL activity. There were no changes in storage of meal-derived FA or visceral fat. Our data support a protective role for femoral adiposity on circulating TG independent of dietary FA storage and visceral adiposity. PMID:25968576

  19. Tissue level microstructure and mechanical properties of the femoral head in the proximal femur of fracture patients

    NASA Astrophysics Data System (ADS)

    Lü, Linwei; Meng, Guangwei; Gong, He; Zhu, Dong; Gao, Jiazi; Fan, Yubo

    2015-04-01

    This study aims to investigate the regional variations of trabecular morphological parameters and mechanical parameters of the femoral head, as well as to determine the relationship between trabecular morphological and mechanical parameters. Seven femoral heads from patients with fractured proximal femur were scanned using a micro-CT system. Each femoral head was divided into 12 sub-regions according to the trabecular orientation. One trabecular cubic model was reconstructed from each sub-region. A total of 81 trabecular models were reconstructed, except three destroyed sub-regions from two femoral heads during the surgery. Trabecular morphological parameters, i.e. trabecular separation (Tb.Sp), trabecular thickness (Tb.Th), specific bone surface (BS/BV), bone volume fraction (BV/TV), structural model index (SMI), and degree of anisotropy (DA) were measured. Micro-finite element analyses were performed for each cube to obtain the apparent Young's modulus and tissue level von Mises stress distribution under 1 % compressive strain along three orthogonal directions, respectively. Results revealed significant regional variations in the morphological parameters (). Young's moduli along the trabecular orientation were significantly higher than those along the other two directions. In general, trabecular mechanical properties in the medial region were lower than those in the lateral region. Trabecular mechanical parameters along the trabecular orientation were significantly correlated with BS/BV, BV/TV, Tb.Th, and DA. In this study, regional variations of microstructural features and mechanical properties in the femoral head of patients with proximal femur fracture were thoroughly investigated at the tissue level. The results of this study will help to elucidate the mechanism of femoral head fracture for reducing fracture risk and developing treatment strategies for the elderly.

  20. Coherent revival of tunneling

    NASA Astrophysics Data System (ADS)

    Hsu, Liang-Yan; Rabitz, Herschel

    2015-07-01

    We introduce a tunneling effect by a driving field, referred to as coherent revival of tunneling (CRT), corresponding to complete tunneling (transmission coefficient =1 ) that is revived from the circumstance of total reflection (transmission coefficient ≈0 ) through application of an appropriate perpendicular high-frequency ac field. To illustrate CRT, we simulate electron transport through fish-bone-like quantum-dot arrays by using single-particle Green's functions along with Floquet theory, and we explore the corresponding current-field amplitude characteristics as well as current-polarization characteristics. In regard to the two characteristics, we show that CRT exhibits entirely different features than coherent destruction of tunneling and photon-assisted tunneling. We also discuss two practical conditions for experimental realization of CRT.

  1. The Stability Tunnel

    NASA Technical Reports Server (NTRS)

    1943-01-01

    Engineers operate the controls of the Stability Tunnel: Plans for a new tunnel to study stability problems began in the late thirties. The Stability Tunnel was authorized in 1939 and began operations in June 1941. The installation was completed in December that year with the completion of a new 10,000 Horsepower Diesel-electric generating plant. It was a single return, closed jet tunnel with a 6-foot square test section. The tunnel was disassembled and shipped to Virginia Polytechnic Institute and State University in 1958. The tunnel had two separate test sections: one for curved flow, the other for rolling flow. 'The facility...simulates the motion of the aircraft in curved or rolling flight. This is done by actually curving or rolling the airstream as it passes over the model and at the same time providing the proper velocity distribution.' (From AIAA-80-0309) >From Alan Pope, Wind-Tunnel Testing: 'The only tunnel directly designed for dynamic stability work is located at the Langley Field branch of the NACA. Its most vital feature is its ability to subject the models to curving air streams that simulate those actually encountered when an airplane rolls, pitches, or yaws. the rotating airstream for simulating roll is produced by a motor-driven paddle just ahead of the test section. Curved air of properly varying velocity for simulating pitch and yaw is produced by a combination of a curved test section and velocity screens. The proper use of this apparatus makes possible the determination of the stability derivatives.' Published in F.H. Lutze, 'Experimental Determination of Pure Rotary Stability Derivatives using a Curved and Rolling Flow Wind Tunnel,' AIAA-80-0309, AIAA 18th Aerospace Sciences Meeting, Pasadena, CA, January 14-16, 1980; Alan Pope, Wind-Tunnel Testing (New York: John Wiley & Sons, 1947).

  2. Nerve Tissue Prefabrication Inside the Rat Femoral Bone: Does It Work?

    PubMed

    Ozbek, Zuhtu; Kocman, Atacan Emre; Ozatik, Orhan; Soztutar, Erdem; Ozkara, Emre; Kose, Aydan; Arslantas, Ali; Cetin, Cengiz

    2017-01-01

    To investigate whether nerve regeneration can be induced in the tubular bone between distal and proximal cut nerve ends. Twenty adult Wistar rats were used for the study. Rats were divided into three groups; femoral bone conduit group, nerve transection group, sham group. The sciatic nerve was surgically cut and from both ends inserted into the adjacent femoral bone tunnel in the femoral bone conduit group. The sciatic nerve was cut transversely in the nerve transection group. In the Sham group, only sciatic nerve exploration was performed, without a nerve cut. The groups were evaluated functionally and morphologically. All results showed that axonal growth existed through the osseous canal. To the best of our knowledge, this is the first study to evaluate neural regeneration inside the bone. We can speculate that the bone marrow provides a convenient microenvironment for peripheral nerve regeneration. In addition to prefabricating peripheral nerves, this novel model may help to establish further strategies for engineering of other tissues in the bone marrow.

  3. Development of Background-Oriented Schlieren for NASA Langley Research Center Ground Test Facilities

    NASA Technical Reports Server (NTRS)

    Bathel, Brett F.; Borg, Stephen; Jones, Stephen; Overmeyer, Austin; Walker, Eric; Goad, William; Clem, Michelle; Schairer, Edward T.; Mizukaki, Toshiharu

    2015-01-01

    This paper provides an overview of recent wind tunnel tests performed at the NASA Langley Research Center where the Background-Oriented Schlieren (BOS) technique was used to provide information pertaining to flow-field density disturbances. The facilities in which the BOS technique was applied included the National Transonic Facility (NTF), Transonic Dynamics Tunnel (TDT), 31-Inch Mach 10 Air Tunnel, 15-Inch Mach 6 High-Temperature Air Tunnel, Rotor Test Cell at the 14 by 22 Subsonic Tunnel, and a 13-Inch Low-Speed Tunnel.

  4. A three-dimensional finite element stress analysis for tunnel placement and buttons in anterior cruciate ligament reconstructions.

    PubMed

    Au, Anthony G; Raso, V James; Liggins, Adrian B; Otto, David D; Amirfazli, A

    2005-04-01

    This communication reports the results of a three-dimensional finite element (FE) model of stresses in a surgically altered femur and tibia. The model incorporated a novel approach in implementing orthotropic and inhomogeneous bone properties and non-uniform distributed loading. Cortical, cancellous, and subchondral bone of the femur and the tibia were modeled. Mechanical properties for the cortical and cancellous bone were mapped from published data characterizing the anisotropy and inhomogeneity of the bone properties. Mesh adequacy was determined using stress convergence and strain energy error convergence. Qualitatively, the results of the study compare well with experimental principal compressive strains from the literature. With respect to tunnel placement in anterior cruciate ligament reconstruction, the model predicted stress-shielding at the postero-lateral region of the tunnel wall, and increased stress at the postero-medial region of the tunnel wall. The stresses in the cancellous bone beneath the tunnel were, in general, lower than those above the tunnel. Prolonged stress shielding leads to bone resorption of the posterior tunnel wall leading to tunnel enlargement, and possible compromise of the ACL reconstruction. The stresses on the femoral cortex produced from a button-type fixation were noticeable for low levels of loading; the stress levels were very similar in models incorporating bone properties of patients aged 45 and 65. Repeated compression of the femoral cortex at these stress levels may cause microdamage to the cortex eventually resulting in fatigue failure.

  5. [Fracture arthroplasty of femoral neck fractures].

    PubMed

    Braun, K F; Hanschen, M; Biberthaler, P

    2016-04-01

    A paradigm shift in the treatment of elderly patients has recently taken place leading to an increase in joint replacement surgery. The aim of this article is to highlight new developments and to present a treatment algorithm for femoral neck fractures. The age limit must be individually determined considering the comorbidities and perioperative risk profile. Pertrochanteric femoral fractures are nearly exclusively treated by osteosynthesis regardless of age. The situation for femoral neck fractures is more complex. Patients younger than 65 years should generally be treated by osteosynthesis but patients older than 65 years benefit from hemiarthroplasty or total hip arthroplasty. In patients aged between 65 and 75 years with high functional demands and a justifiable perioperative risk, total joint replacement is the treatment of choice. In physically less active patients older than 75 years and poor general condition, preference should be given to hemiarthroplasty.

  6. Optimizing Stability in Femoral Neck Fracture Fixation.

    PubMed

    Ye, Ye; Hao, Jiandong; Mauffrey, Cyril; Hammerberg, E Mark; Stahel, Philip F; Hak, David J

    2015-10-01

    Optimizing stability of femoral neck fracture fixation is important in obtaining a successful outcome. The mechanical problems and strategies for achieving optimal stability differ depending on patients' age and degree of osteoporosis. Femoral neck fractures in younger adults usually result from high-energy trauma and have a vertical fracture pattern. Strategies for optimizing fixation stability in this group include placing additional screws at right angles to the fracture plane and medial buttress plate augmentation. In elderly patients, screw position relative to the intact cortical femoral neck bone is of critical importance. Additional strategies for optimizing fixation stability in this group include the concept of length stable fixation, use of adjunctive calcium phosphate cement, and use of novel fixed angle fixation implants. Copyright 2015, SLACK Incorporated.

  7. The terminal branches of the medial femoral circumflex artery: the arterial supply of the femoral head.

    PubMed

    Lazaro, L E; Klinger, C E; Sculco, P K; Helfet, D L; Lorich, D G

    2015-09-01

    This study investigates and defines the topographic anatomy of the medial femoral circumflex artery (MFCA) terminal branches supplying the femoral head (FH). Gross dissection of 14 fresh-frozen cadaveric hips was undertaken to determine the extra and intracapsular course of the MFCA's terminal branches. A constant branch arising from the transverse MFCA (inferior retinacular artery; IRA) penetrates the capsule at the level of the anteroinferior neck, then courses obliquely within the fibrous prolongation of the capsule wall (inferior retinacula of Weitbrecht), elevated from the neck, to the posteroinferior femoral head-neck junction. This vessel has a mean of five (three to nine) terminal branches, of which the majority penetrate posteriorly. Branches from the ascending MFCA entered the femoral capsular attachment posteriorly, running deep to the synovium, through the neck, and terminating in two branches. The deep MFCA penetrates the posterosuperior femoral capsular. Once intracapsular, it divides into a mean of six (four to nine) terminal branches running deep to the synovium, within the superior retinacula of Weitbrecht of which 80% are posterior. Our study defines the exact anatomical location of the vessels, arising from the MFCA and supplying the FH. The IRA is in an elevated position from the femoral neck and may be protected from injury during fracture of the femoral neck. We present vascular 'danger zones' that may help avoid iatrogenic vascular injury during surgical interventions about the hip.

  8. Effect of femoral neck modularity upon the prosthetic range of motion in total hip arthroplasty.

    PubMed

    Turley, Glen A; Griffin, Damian R; Williams, Mark A

    2014-08-01

    In total hip arthroplasty, aseptic loosening and dislocation are associated with not being able to achieve the correct prosthetic component orientation. Femoral neck modularity has been proposed as a solution to this problem by allowing the surgeon to alter either the neck-shaft or version angle of the prosthetic femoral component intra-operatively. A single replicate full factorial design was used to evaluate how effective a modular femoral neck cementless stem was in restoring a healthy prosthetic range of motion in comparison with a leading fixed-neck cementless stem with the standard modular parameters. It was found that, if altered to a large enough degree, femoral neck modularity can increase the amount of prosthetic motion as well as alter its position to where it is required physiologically. However, there is a functional limit to the amount that can be corrected and there is a risk with regard to the surgeon having to select the optimum modular neck before any benefit is realised.

  9. Tunneling magnetoresistance of silicon chains

    SciTech Connect

    Matsuura, Yukihito

    2016-05-28

    The tunneling magnetoresistance (TMR) of a silicon chain sandwiched between nickel electrodes was examined by using first-principles density functional theory. The relative orientation of the magnetization in a parallel-alignment (PA) configuration of two nickel electrodes enhanced the current with a bias less than 0.4 V compared with that in an antiparallel-alignment configuration. Consequently, the silicon chain-nickel electrodes yielded good TMR characteristics. In addition, there was polarized spin current in the PA configuration. The spin polarization of sulfur atoms functioning as a linking bridge between the chain and nickel electrode played an important role in the magnetic effects of the electric current. Moreover, the hybridization of the sulfur 3p orbital and σ-conjugated silicon 3p orbital contributed to increasing the total current.

  10. Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures

    PubMed Central

    Dumbre Patil, Sampat S; Karkamkar, Sachin S; Patil, Vaishali S Dumbre; Patil, Shailesh S; Ranaware, Abhijeet S

    2016-01-01

    Background: When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN) or surface implants like Dynamic Condylar Screw (DCS) are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the reverse distal femur locking compression plate (LCP) of the contralateral side in such cases undergoing revision surgery. This implant has multiple options of fixation in proximal femur and its curvature along the length matches the anterior bow of the femur. We aimed to evaluate the efficacy of this implant in salvage situations. Materials and Methods: Twenty patients of failed primary proximal femoral fractures who underwent revision surgery with reverse distal femoral locking plate from February 2009 to November 2012 were included in this retrospective study. There were 18 subtrochanteric fractures and two ipsilateral femoral neck and shaft fractures, which exhibited delayed union or nonunion. The study included 14 males and six females. The mean patient age was 43.6 years (range 22–65 years) and mean followup period was 52.1 months (range 27–72 months). Delayed union was considered when clinical and radiological signs of union failed to progress at the end of four months from initial surgery. Results: All fractures exhibited union without any complications. Union was assessed clinically and radiologically. One case of ipsilateral femoral neck and shaft fracture required bone grafting at the second stage for delayed union of the femoral shaft fracture. Conclusions: Reverse distal femoral LCP of the contralateral side can be used as a salvage option for failed fixation of proximal femoral fractures exhibiting nonunion. PMID:27512218

  11. Management of femoral head osteonecrosis: Current concepts

    PubMed Central

    Tripathy, Sujit Kumar; Goyal, Tarun; Sen, Ramesh Kumar

    2015-01-01

    Osteonecrosis of femoral head (ONFH) is a disabling condition of young individuals with ill-defined etiology and pathogenesis. Remains untreated, about 70-80% of the patients progress to secondary hip arthritis. Both operative and nonoperative treatments have been described with variable success rate. Early diagnosis and treatment is the key for success in preserving the hip joint. Once femoral head collapses (>2 mm) or if there is secondary degeneration, hip conservation procedures become ineffective and arthroplasty remains the only better option. We reviewed 157 studies that evaluate different treatment modalities of ONFH and then a final consensus on treatment was made. PMID:25593355

  12. Anatomy of the medial femoral circumflex artery with respect to the vascularity of the femoral head.

    PubMed

    Zlotorowicz, M; Szczodry, M; Czubak, J; Ciszek, B

    2011-11-01

    We performed a series of 16 anatomical dissections on Caucasian cadaver material to determine the surgical anatomy of the medial femoral circumflex artery (MFCA) and its anastomoses. These confirmed that the femoral head receives its blood supply primarily from the MFCA via a group of posterior superior nutrient arteries and the posterior inferior nutrient artery. In terms of anastomoses that may also contribute to the blood supply, the anastomosis with the inferior gluteal artery, via the piriformis branch, is the most important. These dissections provide a base of knowledge for further radiological studies on the vascularity of the normal femoral head and its vascularity after dislocation of the hip.

  13. Ultrafast scanning tunneling microscopy

    SciTech Connect

    Botkin, D.A. |

    1995-09-01

    I have developed an ultrafast scanning tunneling microscope (USTM) based on uniting stroboscopic methods of ultrafast optics and scanned probe microscopy to obtain nanometer spatial resolution and sub-picosecond temporal resolution. USTM increases the achievable time resolution of a STM by more than 6 orders of magnitude; this should enable exploration of mesoscopic and nanometer size systems on time scales corresponding to the period or decay of fundamental excitations. USTM consists of a photoconductive switch with subpicosecond response time in series with the tip of a STM. An optical pulse from a modelocked laser activates the switch to create a gate for the tunneling current, while a second laser pulse on the sample initiates a dynamic process which affects the tunneling current. By sending a large sequence of identical pulse pairs and measuring the average tunnel current as a function of the relative time delay between the pulses in each pair, one can map the time evolution of the surface process. USTM was used to measure the broadband response of the STM`s atomic size tunnel barrier in frequencies from tens to hundreds of GHz. The USTM signal amplitude decays linearly with the tunnel junction conductance, so the spatial resolution of the time-resolved signal is comparable to that of a conventional STM. Geometrical capacitance of the junction does not appear to play an important role in the measurement, but a capacitive effect intimately related to tunneling contributes to the measured signals and may limit the ultimate resolution of the USTM.

  14. Tunnelled tensor fascia lata flap for complex abdominal wall reconstruction

    PubMed Central

    Wang, Frederick; Buonocore, Samuel; Narayan, Deepak

    2011-01-01

    This study describes the treatment of two patients with recurrent, infected abdominal wall defects using bilateral delayed and tunnelled pedicled tensor fascia lata (TFL) myofascial flaps. TFL flaps were elevated and delayed for 4 weeks in both cases. In the second case, Parietex Composite mesh was positioned underneath the TFL flap and allowed to incorporate. After a delay of 4 weeks, the flaps were harvested and tunnelled subcutaneously to repair the abdominal wall defect. Both patients have stable repairs but had donor site seromas requiring drainage. Cadaver dissection was also performed to identify structures related to TFL flap harvest. We identified a variant of lateral femoral cutaneous nerve that traversed the TFL flap, necessitating meticulous dissection during surgery. In summary, we describe a new technique of incorporating mesh into the TFL prior to flap harvest for reconstruction of complex abdominal wall. PMID:22707661

  15. Postoperative femoral component rotation and femoral anteversion after total knee arthroplasty in patients with distal femoral deformity.

    PubMed

    Lim, Hong-Chul; Bae, Ji-Hoon; Kim, Seung-Ju

    2013-08-01

    We asked whether total knee arthroplasty (TKA) in patients with distal femoral deformity (DFD) would change femoral component rotation (FCR) and investigated the correlation between DFD and femoral anteversion (FA). 75 patients were divided into two groups according to the preoperative posterior condylar angle (PCA); group A without DFD (PCA<7°), group B with DFD (PCA>7°). We evaluated the different angles on the CT scan: (1) PCA, (2) angle between the line which is perpendicular to the Whiteside's line and PCL (WLP), and (3) FA. The mean FCRs were external rotation of 0.21°+2.75° in group A and internal rotation of 4.48°+2.51° in group B (P=0.001). The mean preoperative and postoperative FAs were similar in group A but were significantly different in group B (P=0.035). DFD resulted in excessive internal rotation of the femoral component. There was a secondary decrease in FA in patients with DFD. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Domain wall orientation in magnetic nanowires.

    PubMed

    Vedmedenko, E Y; Kubetzka, A; von Bergmann, K; Pietzsch, O; Bode, M; Kirschner, J; Oepen, H P; Wiesendanger, R

    2004-02-20

    Scanning tunneling microscopy reveals that domain walls in ultrathin Fe nanowires are oriented along a certain crystallographic direction, regardless of the orientation of the wires. Monte Carlo simulations on a discrete lattice are in accordance with the experiment if the film relaxation is taken into account. We demonstrate that the wall orientation is determined by the atomic lattice and the resulting strength of an effective exchange interaction. The magnetic anisotropy and the magnetostatic energy play a minor role for the wall orientation in that system.

  17. Review of evolution of tunnel position in anterior cruciate ligament reconstruction

    PubMed Central

    Rayan, Faizal; Nanjayan, Shashi Kumar; Quah, Conal; Ramoutar, Darryl; Konan, Sujith; Haddad, Fares S

    2015-01-01

    Anterior cruciate ligament (ACL) rupture is one of the commonest knee sport injuries. The annual incidence of the ACL injury is between 100000-200000 in the United States. Worldwide around 400000 ACL reconstructions are performed in a year. The goal of ACL reconstruction is to restore the normal knee anatomy and kinesiology. The tibial and femoral tunnel placements are of primordial importance in achieving this outcome. Other factors that influence successful reconstruction are types of grafts, surgical techniques and rehabilitation programmes. A comprehensive understanding of ACL anatomy has led to the development of newer techniques supplemented by more robust biological and mechanical concepts. In this review we are mainly focussing on the evolution of tunnel placement in ACL reconstruction, focusing on three main categories, i.e., anatomical, biological and clinical outcomes. The importance of tunnel placement in the success of ACL reconstruction is well researched. Definite clinical and functional data is lacking to establish the superiority of the single or double bundle reconstruction technique. While there is a trend towards the use of anteromedial portals for femoral tunnel placement, their clinical superiority over trans-tibial tunnels is yet to be established. PMID:25793165

  18. [Anterior tarsal tunnel syndrome].

    PubMed

    Miliam, Palle B; Basse, Peter N

    2009-03-30

    Anterior tarsal tunnel syndrome is a rare entrapment neuropathy of the deep peroneal nerve beneath the extensor retinaculum of the ankle. It may be rare because it is underrecognized clinically.We present a case regarding a 29-year-old man, drummer, who for one and a half year experienced clinical symptoms of anterior tarsal tunnel syndrome. A surgical decompression of the anterior tarsal tunnel was performed, and at the check three months later the symptoms where gone. One year after, there were still no symptoms.

  19. Tunnel widening after ACL reconstruction with aperture screw fixation or all-inside reconstruction with suspensory cortical button fixation: Volumetric measurements on CT and MRI scans.

    PubMed

    Mayr, Raul; Smekal, Vinzenz; Koidl, Christian; Coppola, Christian; Fritz, Josef; Rudisch, Ansgar; Kranewitter, Christof; Attal, René

    2017-10-01

    Tunnel widening after anterior cruciate ligament reconstruction (ACLR) is influenced by the surgical and fixation techniques used. Computed tomography (CT) is the most accurate image modality for assessing tunnel widening, but magnetic resonance imaging (MRI) might also be reliable for tunnel volume measurements. In the present study tunnel widening after ACLR using biodegradable interference screw fixation was compared with all-inside ACLR using button fixation, with tunnel volume changes being measured on CT and MRI scans. Randomized controlled trial; Level of evidence, 2. Thirty-three patients were randomly assigned to hamstring ACLR using a biodegradable interference screw or all-inside cortical button fixation. CT and MRI scanning were done at the time of surgery and six months after. Tunnel volume changes were calculated and compared. On CT, femoral tunnel volumes changed from the postoperative state (100%) to 119.8% with screw fixation and 143.2% with button fixation (P=0.023). The changes in tibial tunnel volumes were not significant (113.9% vs. 117.7%). The changes in bone tunnel volume measured on MRI were comparable with those on CT only for tunnels with interference screws. Tibial tunnels with button fixation were significantly underestimated on MRI scanning (P=0.018). All-inside ACLR using cortical button fixation results in increased femoral tunnel widening in comparison with ACLR with biodegradable interference screw fixation. MRI represents a reliable imaging modality for future studies investigating tunnel widening with interference screw fixation. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Carpal tunnel syndrome

    MedlinePlus

    ... carpal tunnel is caused by typing on a computer, using a mouse, or repeating movements while working, ... special devices, such as keyboards, different types of computer mouse, cushioned mouse pads, and keyboard drawers Having ...

  1. Tarsal tunnel syndrome

    MedlinePlus

    Tibial nerve dysfunction; Neuropathy - posterior tibial nerve; Peripheral neuropathy - tibial nerve; Tibial nerve entrapment ... tunnel syndrome is an unusual form of peripheral neuropathy . It occurs when there is damage to the ...

  2. Vacuum tunneling in gravity

    NASA Astrophysics Data System (ADS)

    Cho, Y. M.; Pak, D. G.

    2011-08-01

    Topologically non-trivial vacuum structures in gravity models with Cartan variables (vielbein and contortion) are considered. We study the possibility of vacuum spacetime tunneling in Einstein gravity assuming that the vielbein may play a fundamental role in quantum gravitational phenomena. It has been shown that in the case of RP3 space topology, the tunneling between non-trivial topological vacuums can be realized by means of Eguchi-Hanson gravitational instanton. In the Riemann-Cartan geometric approach to quantum gravity, the vacuum tunneling can be provided by means of contortion quantum fluctuations. We define a double self-duality condition for the contortion and give explicit self-dual configurations which can contribute to vacuum tunneling amplitude.

  3. Endoscopic cubital tunnel release.

    PubMed

    Cobb, Tyson K

    2010-10-01

    A minimally invasive endoscopic approach has been successfully applied to surgical treatment of cubital tunnel syndrome. This procedure allows for smaller incisions with faster recovery time. This article details relevant surgical anatomy, indications, contraindications, surgical technique, complications, and postoperative management.

  4. Quantum tunneling with friction

    NASA Astrophysics Data System (ADS)

    Tokieda, M.; Hagino, K.

    2017-05-01

    Using the phenomenological quantum friction models introduced by P. Caldirola [Nuovo Cimento 18, 393 (1941), 10.1007/BF02960144] and E. Kanai [Prog. Theor. Phys. 3, 440 (1948), 10.1143/ptp/3.4.440], M. D. Kostin [J. Chem. Phys. 57, 3589 (1972), 10.1063/1.1678812], and K. Albrecht [Phys. Lett. B 56, 127 (1975), 10.1016/0370-2693(75)90283-X], we study quantum tunneling of a one-dimensional potential in the presence of energy dissipation. To this end, we calculate the tunneling probability using a time-dependent wave-packet method. The friction reduces the tunneling probability. We show that the three models provide similar penetrabilities to each other, among which the Caldirola-Kanai model requires the least numerical effort. We also discuss the effect of energy dissipation on quantum tunneling in terms of barrier distributions.

  5. Holographic tunneling wave function

    NASA Astrophysics Data System (ADS)

    Conti, Gabriele; Hertog, Thomas; van der Woerd, Ellen

    2015-12-01

    The Hartle-Hawking wave function in cosmology can be viewed as a decaying wave function with anti-de Sitter (AdS) boundary conditions. We show that the growing wave function in AdS familiar from Euclidean AdS/CFT is equivalent, semiclassically and up to surface terms, to the tunneling wave function in cosmology. The cosmological measure in the tunneling state is given by the partition function of certain relevant deformations of CFTs on a locally AdS boundary. We compute the partition function of finite constant mass deformations of the O( N ) vector model on the round three sphere and show this qualitatively reproduces the behaviour of the tunneling wave function in Einstein gravity coupled to a positive cosmological constant and a massive scalar. We find the amplitudes of inhomogeneities are not damped in the holographic tunneling state.

  6. Energy-Filtered Scanning Tunneling Microscopy using a Semiconductor Tip

    NASA Astrophysics Data System (ADS)

    Sutter, P.

    2003-12-01

    Semiconductor probe tips are explored as a tool for spectroscopic scanning tunneling microscopy (STM). Sharp tips capable of atomic-resolution STM are obtained by cleaving (001) oriented InAs wafers. Tunneling spectra measured with InAs tips on graphite show clear signatures of the bulk band structure of the tip. The influence of the tip electronic structure on the tunneling probability can be used to achieve energy-filtered imaging in filled-state constant-current STM with cleaved [111]-oriented InAs tips. Energy gaps in the projected bulk band structure of the tip suppress tunneling, so that only sample states not aligned with a gap contribute significantly to the tunneling current. On Si(111)-(7×7), such energy filtering enables state-selective imaging. Dangling bonds localized on different near-surface Si atoms — adatoms and rest atoms — are mapped selectively at different tip-sample bias. Our findings suggest an important role of the bulk band structure of the probe tip in determining the tunneling current in STM, which may be used to develop novel paradigms of spectroscopic imaging at the atomic scale.

  7. Interferometer-free Fourier-synthesized laser field generator estimated by molecular tunnelling ionization

    NASA Astrophysics Data System (ADS)

    Ohmura, H.; Saito, N.

    2017-07-01

    Intense nanosecond four-colour Fourier-synthesized laser fields induce orientation-selective ionization based on directionally asymmetric molecular tunneling ionization. The interferometer-free laser field generator ensures high stability and high reproducibility. Phase-sensitive, orientation-selective molecular tunneling ionization provides a simple way to estimate the relative phase differences between the fundamental light and each harmonic by data-fitting analysis.

  8. Pathologic femoral neck fractures in children.

    PubMed

    Shrader, M Wade; Schwab, Joseph H; Shaughnessy, William J; Jacofsky, David J

    2009-02-01

    Pathologic fractures in children occur in a variety of malignant and benign pathologic processes. Pediatric pathologic femoral neck fractures are particularly rare. Until now, all reported cases have been isolated cases, small series, or cases reported in series of adult pathologic hip fractures. The present article is the first report of a relatively large series of pathologic femoral neck fractures in a pediatric population. We identified pathologic femoral neck fractures, including 2 basicervical fractures, in 15 children (9 boys, 6 girls) ranging in age from 18 months to 15 years (mean age, 9 years) and treated between 1960 and 2000. The pathologic diagnoses were fibrous dysplasia (5 children), unicameral bone cyst (2), Ewing's sarcoma (2), osteomyelitis (2), leukemia (1), rhabdomyosarcoma (1), osteogenesis imperfecta (1), and osteopetrosis (1). Treatment methods, including time to reduction and fixation, were reviewed in detail. One patient was lost to follow-up. All others were followed until union; mean long-term follow-up was 7 years (range, 1-16 years). All patients ultimately went on to union. Mean time to union was 19 weeks (range, 5-46 weeks). However, 2 patients died before 2 years. There was a 40% complication rate, with limb-length discrepancy being the most common (4 children). No patient developed avascular necrosis. Pathologic femoral neck fractures are rare in children. Pediatric patients who present with a pathologic hip fracture are at significant risk for complications. Physicians and family should be alerted to the prolonged course involved in treating these fractures to union.

  9. EPIDEMIOLOGICAL STUDY OF CHILDREN DIAPHYSEAL FEMORAL FRACTURES

    PubMed Central

    Hoffmann, Cassiano Ricardo; Traldi, Eduardo Franceschini; Posser, Alexandre

    2015-01-01

    Objective: To evaluate the personal, fracture, treatment and complication characteristics among patients with pediatric femoral shaft fractures attended at the pediatric orthopedic service of the Joana de Gusmão Children's Hospital. Methods: This was a retrospective cross-sectional study on a population consisting of patients with femoral shaft fractures, aged between birth and 14 years and 11 months, who were divided into four age groups. Information was obtained from medical records and was transferred to a survey questionnaire to present personal, fracture, treatment and complication variables. Results: The study population consisted of 96 patients. Their mean age was 6.8 years. The cases were predominantly among males, comprising closed fractures on the right side, in the middle third with a single line. Regarding fracture etiology, traffic accidents predominated overall in the sample. Most of the patients (74 to 77.1%) presented femoral fractures as their only injury. Conservative treatment predominated in the group younger than six years of age, and surgical treatment in the group aged 6 to 14 years and 11 months. The complications observed until bone union were: discrepancy, infection and movement limitation. The mean time taken for consolidation was 9.6 ± 2.4 weeks, varying with age. Conclusion: The features of these fractures were similar to those described in the literature and the treatment used showed good results. The Joana de Gusmão Children's Hospital has used the treatment proposed in the literature for pediatric femoral shaft fractures. PMID:27042619

  10. Femoral Prosthesis Infection by Rhodotorula mucilaginosa▿

    PubMed Central

    Savini, Vincenzo; Sozio, Federica; Catavitello, Chiara; Talia, Marzia; Manna, Assunta; Febbo, Fabio; Balbinot, Andrea; Di Bonaventura, Giovanni; Piccolomini, Raffaele; Parruti, Giustino; D'Antonio, Domenico

    2008-01-01

    This case report is a case history of a femoral prosthesis infection caused by Rhodotorula mucilaginosa in a human immunodeficiency virus patient. Though the pathogenicity of this organism for bone tissue has been previously reported, this is the first reported case of an orthopedic prosthesis infection by this species of the genus Rhodotorula. PMID:18753353

  11. Femoral development in chronically centrifuged rats

    NASA Technical Reports Server (NTRS)

    Smith, S. D.

    1977-01-01

    Groups of 30-d-old male and female rats were centrifuged at 2.00 G (RE, Rotation Experimental), 1.05 G (RC, Rotation Control) or exposed to the noise and wind of the centrifuge at 1.00 G (EC, Earth Control) for periods of 1, 2, 4, 8, and 16 weeks. Measurements of their femurs indicated that exposure to centrifugation a) decreased femoral length in RE animals, b) increased femoral length in RC animals, c) reduced femoral diameter in RE and RC animals, d) increased L/D ratios in RC animals, e) decreased L/D ratios in RE animals, f) increased femur length/body weight in RE animals, g) decreased cortical thickness (CT) in RE animals, h) increased relative CT in RE animals, and decreased it in RC animals, i) accelerated ossification in RC femoral heads, j) thinned and distorted RE epiphyseal plates, and k) thickened condylar cartilage in RE females. The effects tended to be strongly sexually dimorphic, with females more severely affected by the stress than males.

  12. [Femoral venous catheter: an unusual complication].

    PubMed

    Garcia, P; Mora, A; Trambert, P; Maler, E; Courant, P

    2000-08-01

    We report an erratic course of a venous femoral catheter which was in the abdominal cavity in a patient with an haemoperitoneum and an hepatic injury. This complication led to an inefficiency of the transfusion and a worsening of the haemoperitoneum.

  13. Influence of Femoral Component Design on Retrograde Femoral Nail Starting Point.

    PubMed

    Service, Benjamin C; Kang, William; Turnbull, Nathan; Langford, Joshua; Haidukewych, George; Koval, Kenneth J

    2015-10-01

    Our experience with retrograde femoral nailing after periprosthetic distal femur fractures was that femoral components with deep trochlear grooves posteriorly displace the nail entry point resulting in recurvatum deformity. This study evaluated the influence of distal femoral prosthetic design on the starting point. One hundred lateral knee images were examined. The distal edge of Blumensaat's line was used to create a ratio of its location compared with the maximum anteroposterior condylar width called the starting point ratio (SPR). Femoral trials from 6 manufacturers were analyzed to determine the location of simulated nail position in the sagittal plane compared with the maximum anteroposterior prosthetic width. These measurements were used to create a ratio, the femoral component ratio (FCR). The FCR was compared with the SPR to determine if a femoral component would be at risk for retrograde nail starting point posterior to the Blumensaat's line. The mean SPR was 0.392 ± 0.03, and the mean FCR was 0.416 ± 0.05, which was significantly greater (P = 0.003). The mean FCR was 0.444 ± 0.06 for the cruciate retaining (CR) trials and was 0.393 ± 0.04 for the posterior stabilized trials; this difference was significant (P < 0.001). The FCR for the femoral trials studied was significantly greater than the SPR for native knees and was significantly greater for CR femoral components compared with posterior stabilized components. These findings demonstrate that many total knee prostheses, particularly CR designs, are at risk for a starting point posterior to Blumensaat's line.

  14. Full Scale Wind Tunnel

    NASA Technical Reports Server (NTRS)

    1931-01-01

    Construction of motor fairing for the fan motors of the Full-Scale Tunnel (FST). The motors and their supporting structures were enclosed in aerodynamically smooth fairings to minimize resistance to the air flow. Close examination of this photograph reveals the complicated nature of constructing a wind tunnel. This motor fairing, like almost every other structure in the FST, represents a one-of-a-kind installation.

  15. Electron tunnel sensor technology

    NASA Technical Reports Server (NTRS)

    Kenny, T. W.; Waltman, S. B.; Reynolds, J. K.; Kaiser, W. J.

    1991-01-01

    Researchers designed and constructed a novel electron tunnel sensor which takes advantage of the mechanical properties of micro-machined silicon. For the first time, electrostatic forces are used to control the tunnel electrode separation, thereby avoiding the thermal drift and noise problems associated with piezoelectric actuators. The entire structure is composed of micro-machined silicon single crystals, including a folded cantilever spring and a tip. The application of this sensor to the development of a sensitive accelerometer is described.

  16. The Beginner's Guide to Wind Tunnels with TunnelSim and TunnelSys

    NASA Technical Reports Server (NTRS)

    Benson, Thomas J.; Galica, Carol A.; Vila, Anthony J.

    2010-01-01

    The Beginner's Guide to Wind Tunnels is a Web-based, on-line textbook that explains and demonstrates the history, physics, and mathematics involved with wind tunnels and wind tunnel testing. The Web site contains several interactive computer programs to demonstrate scientific principles. TunnelSim is an interactive, educational computer program that demonstrates basic wind tunnel design and operation. TunnelSim is a Java (Sun Microsystems Inc.) applet that solves the continuity and Bernoulli equations to determine the velocity and pressure throughout a tunnel design. TunnelSys is a group of Java applications that mimic wind tunnel testing techniques. Using TunnelSys, a team of students designs, tests, and post-processes the data for a virtual, low speed, and aircraft wing.

  17. The effect of femoral component rotation on the five-year outcome of cemented mobile bearing total knee arthroplasty.

    PubMed

    Rienmüller, Anna; Guggi, Thomas; Gruber, Gerald; Preiss, Stefan; Drobny, Tomas

    2012-10-01

    Performing total knee replacement, accurate alignment and neutral rotation of the femoral component are widely believed to be crucial for the ultimate success. Contrary to absolute bone referenced alignment, using a ligament balancing technique does not automatically rotate the femoral component parallel to the transepicondylar axis. In this context we established the hypothesis that rotational alignment of the femoral component parallel to the transepicondylar axis (0° ± 3°) results in better outcome than alignment outside of this range. We analysed 204 primary cemented mobile bearing total knee replacements five years postoperatively. Femoral component rotation was measured on axial radiographs using the condylar twist angle (CTA). Knee society score, range of motion as well as subjective rating documented outcome. In 96 knees the femoral component rotation was within the range 0 ± 3° (neutral rotation group), and in 108 knees the five-year postoperative rotational alignment of the femoral component was outside of this range (outlier group). Postoperative CTA showed a mean of 2.8° (±3.4°) internal rotation (IR) with a range between 6° external rotation (ER) and 15° IR (CI 95). No difference with regard to subjective and objective outcome could be detected. The present work shows that there is a large given natural variability in optimal rotational orientation, in this study between 6° ER and 15° IR, with numerous co-factors determining correct positioning of the femoral component. Further studies substantiating pre- and postoperative determinants are required to complete the understanding of resulting biomechanics in primary TKA.

  18. Novel tunnelling barriers for spin tunnelling junctions

    NASA Astrophysics Data System (ADS)

    Sharma, Manish

    A tunnel junction consists of two metal electrodes separated by an insulating barrier thin enough for electrons to tunnel across. With ferromagnetic electrodes, a spin-dependent tunnelling (SDT) effect, electrons of one spin tunnelling preferentially over those of the other, is observed. When the electrodes are switched from a parallel to an anti-parallel alignment, the tunnelling current changes and gives rise to tunnelling magnetoresistance (TMR). Since 1995, interest in SDT junctions has increased as TMR in excess of 15% has been achieved, making viable their use in non-volatile memory and magnetic sensors applications. In this work, two key issues of SDT junctions are addressed: spin polarization of the electrode and the tunnel barrier. Spin polarization, a measure of electron states of up and down spins, is widely believed to be an intrinsic property of the electrode. In junctions with barriers formed by plasma oxidation of composite Ta/Al films, the surprising effect of the resistance being lower with the electrodes aligned antiparallel was observed. Junctions with Ta/Al barriers and those with Al/Ta barriers behave opposite to each other and exhibit an inversion only when the Ta side of the barrier is biased positive. This demonstrates the spin polarization is also influenced by the barrier material. Half-metallic materials such as magnetite (Fe3O4) have a gap in one of the spins' states at the fermi level, thus having a theoretical spin polarization of 100%. In this work, an ultrathin Fe3O 4 layer was added between the Al2O3 barrier and the NiFe electrode. The TMR increased sharply from 4% to 16% for thicknesses less than 0.5nm. As the tunnel barrier must be thinner than 2nm, choice of the barrier material becomes critical. Presently, Al2O3 is the best known barrier. In looking for alternative materials, AlN and AlON were formed by plasma nitridation and oxy-nitridation of deposited Al films. TMR results of up to 18% and resistance-area products down to 3

  19. Ultrasonographic Diagnosis of Slipped Capital Femoral Epiphysis

    PubMed Central

    Palaniappan, Manikandan; Indiran, Venkatraman; Maduraimuthu, Prabakaran

    2017-01-01

    Summary Background Slipped capital femoral epiphysis (SCFE), a fracture through the physis with resultant slip of the epiphysis, is the most common hip abnormality in adolescents and is a major cause of early osteoarthritis. Plain radiograph is the initial modality used to evaluate patients with painful hip joints. Ultrasonography and magnetic resonance imaging (MRI), which do not involve radiation exposure, have also been used. This case report supports the view that ultrasound can be used as an initial, cost-effective and radiation-free modality for the evaluation of suspected SCFE. Case Report A 15-year-old male patient presented with pain in the right hip for 5 days, following a slip and fall accident while playing soccer. The patient was referred to the Department of Radio-diagnosis for ultrasound. A posterior displacement of the femoral head epiphysis with a physeal step was seen on the longitudinal section obtained over the right hip joint region. The anterior physeal step (APS) measured ~3.8 mm on the right side. The distance between the anterior rim of the acetabulum and the metaphysis measured ~20.4 mm on the affected right side and ~23.6 mm on the left side. A plain radiograph in frog leg position showed a widening of the right proximal physis below the right femoral head, with a medial and posterior slip of the right femoral head. A frontal radiograph of the pelvis taken six months before showed a widening of the proximal right femoral physis. Conclusions Although MRI appears to be the most sensitive modality for identifying slips early, ultrasound may be used as a cost-effective and radiation-free alternative before proceeding with further evaluation of suspected SCFE, especially considering the demographics of the affected population. PMID:28382187

  20. Ultrasonographic Diagnosis of Slipped Capital Femoral Epiphysis.

    PubMed

    Palaniappan, Manikandan; Indiran, Venkatraman; Maduraimuthu, Prabakaran

    2017-01-01

    Slipped capital femoral epiphysis (SCFE), a fracture through the physis with resultant slip of the epiphysis, is the most common hip abnormality in adolescents and is a major cause of early osteoarthritis. Plain radiograph is the initial modality used to evaluate patients with painful hip joints. Ultrasonography and magnetic resonance imaging (MRI), which do not involve radiation exposure, have also been used. This case report supports the view that ultrasound can be used as an initial, cost-effective and radiation-free modality for the evaluation of suspected SCFE. A 15-year-old male patient presented with pain in the right hip for 5 days, following a slip and fall accident while playing soccer. The patient was referred to the Department of Radio-diagnosis for ultrasound. A posterior displacement of the femoral head epiphysis with a physeal step was seen on the longitudinal section obtained over the right hip joint region. The anterior physeal step (APS) measured ~3.8 mm on the right side. The distance between the anterior rim of the acetabulum and the metaphysis measured ~20.4 mm on the affected right side and ~23.6 mm on the left side. A plain radiograph in frog leg position showed a widening of the right proximal physis below the right femoral head, with a medial and posterior slip of the right femoral head. A frontal radiograph of the pelvis taken six months before showed a widening of the proximal right femoral physis. Although MRI appears to be the most sensitive modality for identifying slips early, ultrasound may be used as a cost-effective and radiation-free alternative before proceeding with further evaluation of suspected SCFE, especially considering the demographics of the affected population.

  1. The influence of femoral internal and external rotation on cartilage stresses within the patellofemoral joint.

    PubMed

    Besier, Thor F; Gold, Garry E; Delp, Scott L; Fredericson, Michael; Beaupré, Gary S

    2008-12-01

    Internal and external rotation of the femur plays an important role in defining the orientation of the patellofemoral joint, influencing contact areas, pressures, and cartilage stress distributions. The purpose of this study was to determine the influence of femoral internal and external rotation on stresses in the patellofemoral cartilage. We constructed finite element models of the patellofemoral joint using magnetic resonance (MR) images from 16 volunteers (8 male and 8 female). Subjects performed an upright weight-bearing squat with the knee at 60 degrees of flexion inside an open-MR scanner and in a gait laboratory. Quadriceps muscle forces were estimated for each subject using an electromyographic-driven model and input to a finite element analysis. Hydrostatic and octahedral shear stresses within the cartilage were modeled with the tibiofemoral joint in a "neutral" position and also with the femur rotated internally or externally by 5 degrees increments to +/-15 degrees . Cartilage stresses were more sensitive to external rotation of the femur, compared with internal rotation, with large variation across subjects. Peak patellar shear stresses increased more than 10% with 15 degrees of external rotation in 75% of the subjects. Shear stresses were higher in the patellar cartilage compared to the femoral cartilage and patellar cartilage stresses were more sensitive to femoral rotation compared with femoral cartilage stress. Large variation in the cartilage stress response between individuals reflects the complex nature of the extensor mechanism and has clinical relevance when considering treatment strategies designed to reduce cartilage stresses by altering femoral internal and external rotation.

  2. Volume and contact surface area analysis of bony tunnels in single and double bundle anterior cruciate ligament reconstruction using autograft tendons: in vivo three-dimensional imaging analysis.

    PubMed

    Yang, Jae-Hyuk; Chang, Minho; Kwak, Dai-Soon; Wang, Joon Ho

    2014-09-01

    Regarding reconstruction surgery of the anterior cruciate ligament (ACL), there is still a debate whether to perform a single bundle (SB) or double bundle (DB) reconstruction. The purpose of this study was to analyze and compare the volume and surface area of femoral and tibial tunnels during transtibial SB versus transportal DB ACL reconstruction. A consecutive series of 26 patients who underwent trantibial SB ACL reconstruction and 27 patients with transportal DB ACL reconstruction using hamstring autograft from January 2010 to October 2010 were included in this study. Three-dimensional computed tomography (3D-CT) was taken within one week after operation. The CT bone images were segmented with use of Mimics software v14.0. The obtained digital images were then imported in the commercial package Geomagic Studio v10.0 and SketchUp Pro v8.0 for processing. The femoral and tibial tunnel lengths, diameters, volumes and surface areas were evaluated. A comparison between the two groups was performed using the independent-samples t-test. A p-value less than the significance value of 5% (p < 0.05) was considered statistically significant. Regarding femur tunnels, a significant difference was not found between the tunnel volume for SB technique (1,496.51 ± 396.72 mm(3)) and the total tunnel volume for DB technique (1,593.81 ± 469.42 mm(3); p = 0.366). However, the total surface area for femoral tunnels was larger in DB technique (919.65 ± 201.79 mm(2)) compared to SB technique (810.02 ± 117.98 mm(2); p = 0.004). For tibia tunnels, there was a significant difference between tunnel volume for the SB technique (2,070.43 ± 565.07 mm(3)) and the total tunnel volume for the DB technique (2,681.93 ± 668.09 mm(3); p ≤ 0.001). The tibial tunnel surface area for the SB technique (958.84 ± 147.50 mm(2)) was smaller than the total tunnel surface area for the DB technique (1,493.31 ± 220.79 mm(2); p ≤ 0.001). Although the total femoral tunnel volume was similar between two

  3. Femoral neck structure in adult female athletes subjected to different loading modalities.

    PubMed

    Nikander, Riku; Sievänen, Harri; Heinonen, Ari; Kannus, Pekka

    2005-03-01

    Loading modality is a strong external determinant of structure and concomitant strength of the femoral neck. Particularly effective seem to be loadings, which arise from high impacts or impacts from atypical loading directions. Physical loading plays an important role, not only in the process of bone modeling and remodeling, but also in shaping a mechanically appropriate bone structure. This study aimed at testing the hypothesis that the type of loading partly determines the femoral neck structure. A total of 255 premenopausal female athletes representing volleyball, hurdling, squash-playing, soccer, speed skating, step aerobics, weight-lifting, orienteering, cross-country skiing, cycling, and swimming and their 30 nonathletic counterparts were measured with DXA. Besides the conventional areal BMD (aBMD) of the femoral neck, the hip structure analysis (HSA) was used to estimate the cross-sectional area (CSA), subperiosteal width (W), and section modulus (Z, an index of bone strength) at the narrowest section of the femoral neck. Also, training history, muscle strength, and calcium intake were assessed. The above-mentioned sports were classified according to the type of loading they apparently produce at the hip region; that is, high-impact loading (volleyball, hurdling), odd-impact loading (squash-playing, soccer, speed-skating, step aerobics), high-magnitude loading (weightlifting), low-impact loading (orienteering, cross-country skiing), and nonimpact loading (swimming, cycling). High-impact and odd-impact loading sports were associated with the highest age-, weight-, and height-adjusted aBMD (23% and 29% higher values compared to nonathletic referents), CSA (22% and 27%), and Z (22% and 26%). In contrast, repetitive, nonimpact loading sports were not associated with any clear benefit in any bone value compared with the referents. The W at the narrowest femoral neck section was similar in all groups. Body height and weight accounted virtually for one-half of the

  4. 'Oxide-free' tip for scanning tunneling microscopy

    NASA Technical Reports Server (NTRS)

    Colton, R. J.; Baker, S. M.; Baldeschwieler, J. D.; Kaiser, W. J.

    1987-01-01

    A new tip for scanning tunneling microscopy and a tip repair procedure that allows one to reproducibly obtain atomic images of highly oriented pyrolytic graphite with previously inoperable tips are reported. The tips are shown to be relatively oxide-free and highly resistant to oxidation. The tips are fabricated with graphite by two distinct methods.

  5. Background-Oriented Schlieren Pattern Optimization

    DTIC Science & Technology

    2011-12-01

    Orion Launch Abort Vehicle Wind Tunnel Model using Background-Oriented Schlieren”. volume AIAA 2010-1736. US Air Force Test and Evaluation Days, Nashville...1 1.2 System Description . . . . . . . . . . . . . . . . . . . . . 4 1.3 Existing Work...extensively been through trial and error and PIV particle size recommendations. 3 1.2 System Description The BOS technique is based on analyzing the

  6. Direct measurement of electron transfer distance decay constants of single redox proteins by electrochemical tunneling spectroscopy.

    PubMed

    Artés, Juan M; Díez-Pérez, Ismael; Sanz, Fausto; Gorostiza, Pau

    2011-03-22

    We present a method to measure directly and at the single-molecule level the distance decay constant that characterizes the rate of electron transfer (ET) in redox proteins. Using an electrochemical tunneling microscope under bipotentiostatic control, we obtained current−distance spectroscopic recordings of individual redox proteins confined within a nanometric tunneling gap at a well-defined molecular orientation. The tunneling current decays exponentially, and the corresponding decay constant (β) strongly supports a two-step tunneling ET mechanism. Statistical analysis of decay constant measurements reveals differences between the reduced and oxidized states that may be relevant to the control of ET rates in enzymes and biological electron transport chains.

  7. The remnant preservation technique reduces the amount of bone tunnel enlargement following anterior cruciate ligament reconstruction.

    PubMed

    Yanagisawa, Shinya; Kimura, Masashi; Hagiwara, Keiichi; Ogoshi, Atsuko; Nakagawa, Tomoyuki; Shiozawa, Hiroyuki; Ohsawa, Takashi; Chikuda, Hirotaka

    2017-08-18

    The aim of the present study was to investigate the correlation between postoperative tunnel enlargement after ACLR and remnant tissue preservation using the hamstring tendon. One hundred and ninety-two subjects (male, n = 101; female, n = 91; mean age 27.1) who had undergone double-bundle ACL reconstruction were included in the present study. The patients were divided into two groups: the remnant tissue preservation group (Group R) and the non-remnant tissue preservation group (Group N). Computed tomographic scans of the operated knee were obtained at 2 weeks and 6 months after surgery. The area of the tunnel aperture for the anteromedial femoral tunnel (FAMT), posterolateral femoral tunnel (FPLT), anteromedial tibial tunnel (TAMT), and posterolateral tibial tunnel (TPLT) was measured. The area at 2 weeks after ACLR was subtracted from the area at 6 months after ACLR and then divided by the area at 2 weeks after ACLR. The differences in the outcomes and characteristics of the two groups were evaluated. Seventy-seven knees were classified into Group R, and 115 knees were classified into Group N. The age, gender, and body mass index did not differ to a statistically significant extent. The percentages of FAMT and TAMT enlargement in Group R were significantly smaller in comparison with Group N (P = 0.003 and P = 0.03, respectively). The percentage of FPLT and TPLT enlargement in the two groups did not differ to a statistically significant extent. The remnant-preserving technique reduces the amount of bone tunnel enlargement. The present findings indicate the advantages of the remnant-preserving ACLR technique, and therefore the remnant-preserving technique should be recommended. II.

  8. Femoral remodeling may influence patient outcomes in slipped capital femoral epiphysis.

    PubMed

    DeLullo, James A; Thomas, Eric; Cooney, Timothy E; McConnell, Sharon J; Sanders, James O

    2007-04-01

    Clinical studies of patients treated for slipped capital femoral epiphysis have found limited functional impairment and femoral neck deformity causing eventual coxarthrosis. Since patient-focused assessments minimize bias and reflect health-related quality of life status, we coupled their use to a clinical examination to obtain a more patient-centered picture of slipped capital femoral epiphyseal outcomes. The impact of residual deformity on outcomes also was examined. Of 78 patients treated for slipped capital femoral epiphyses between 1972 and 1998, 29 (38 hips) were evaluated at a mean followup of 7.6 years (range, 1.4-26 years). The average patient age was 21.8 years (range, 14.6-39 years), 55% were female, and the average body mass index was 28.7 (range, 16.1-50.2). Most slips were stable (92%, 35 of 38) and mild or moderate in severity (98%, 36 of 37). Followup examinations revealed slight deficits in range of motion, strength, and limb length. Radiographs showed slight improvements in head-shaft angle and reduced but persistent femoral neck deformity. Osteoarthritic changes were absent or negligible in 84% (32 of 38) of the hips. The average Iowa hip score was 90.5 (range, 51-100). Patient outcome scores for the AAOS Hip/Knee Questionnaire fell slightly below 50th percentile norms. Neither slip stability, severity, nor body mass index impacted outcome. Femoral neck deformity correlated with function, pain, and Boyer grade. Overall, patients had minor functional deficits and pain that may have been related to femoral neck deformity, but longer followup is warranted.

  9. Suppression of tunneling rate fluctuations in tunnel field-effect transistors by enhancing tunneling probability

    NASA Astrophysics Data System (ADS)

    Mori, Takahiro; Migita, Shinji; Fukuda, Koichi; Asai, Hidehiro; Morita, Yukinori; Mizubayashi, Wataru; Liu, Yongxun; O'uchi, Shin-ichi; Fuketa, Hiroshi; Otsuka, Shintaro; Yasuda, Tetsuji; Masahara, Meishoku; Ota, Hiroyuki; Matsukawa, Takashi

    2017-04-01

    This paper discusses the impact of the tunneling probability on the variability of tunnel field-effect transistors (TFETs). Isoelectronic trap (IET) technology, which enhances the tunneling current in TFETs, is used to suppress the variability of the ON current and threshold voltage. The simulation results show that suppressing the tunneling rate fluctuations results in suppression of the variability. In addition, a formula describing the relationship between the tunneling rate fluctuations and the electric field strength is derived based on Kane’s band-to-band tunneling model. This formula indicates that the magnitude of the tunneling rate fluctuations is proportional to the magnitude of the fluctuations in the electric field strength and a higher tunneling probability results in a lower variability. The derived relationship is universally valid for any technologies that exploit enhancement of the tunneling probability, including IET technology, channel material engineering, heterojunctions, strain engineering, etc.

  10. Orienteering injuries

    PubMed Central

    Folan, Jean M.

    1982-01-01

    At the Irish National Orienteering Championships in 1981 a survey of the injuries occurring over the two days of competition was carried out. Of 285 individual competitors there was a percentage injury rate of 5.26%. The article discusses the injuries and aspects of safety in orienteering. Imagesp236-ap237-ap237-bp238-ap239-ap240-a PMID:7159815

  11. Single Electron Tunneling

    SciTech Connect

    Ruggiero, Steven T.

    2005-07-25

    Financial support for this project has led to advances in the science of single-electron phenomena. Our group reported the first observation of the so-called ''Coulomb Staircase'', which was produced by tunneling into ultra-small metal particles. This work showed well-defined tunneling voltage steps of width e/C and height e/RC, demonstrating tunneling quantized on the single-electron level. This work was published in a now well-cited Physical Review Letter. Single-electron physics is now a major sub-field of condensed-matter physics, and fundamental work in the area continues to be conducted by tunneling in ultra-small metal particles. In addition, there are now single-electron transistors that add a controlling gate to modulate the charge on ultra-small photolithographically defined capacitive elements. Single-electron transistors are now at the heart of at least one experimental quantum-computer element, and single-electron transistor pumps may soon be used to define fundamental quantities such as the farad (capacitance) and the ampere (current). Novel computer technology based on single-electron quantum dots is also being developed. In related work, our group played the leading role in the explanation of experimental results observed during the initial phases of tunneling experiments with the high-temperature superconductors. When so-called ''multiple-gap'' tunneling was reported, the phenomenon was correctly identified by our group as single-electron tunneling in small grains in the material. The main focus throughout this project has been to explore single electron phenomena both in traditional tunneling formats of the type metal/insulator/particles/insulator/metal and using scanning tunneling microscopy to probe few-particle systems. This has been done under varying conditions of temperature, applied magnetic field, and with different materials systems. These have included metals, semi-metals, and superconductors. Amongst a number of results, we have

  12. Autologous Hamstring Anterior Cruciate Ligament Graft Failure Using the Anteromedial Portal Technique With Suspensory Femoral Fixation

    PubMed Central

    Galdi, Balazs; Reyes, Allan; Brabston, Eugene W.; Levine, William N.

    2015-01-01

    Background: The anteromedial portal technique for drilling of the femoral tunnel during anterior cruciate ligament (ACL) reconstruction has been advocated by many surgeons as allowing improved access to the anatomical footprint. Furthermore, suspensory fixation of soft tissue grafts has become popularized because of complications associated with cross-pin fixation. Concerns regarding the use of both have recently arisen. Purpose: To raise awareness of the increased risk of graft failure when using the anteromedial portal technique with suspensory femoral fixation during ACL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: From November 1998 to August 2012, a total of 465 primary ACL reconstructions were performed using quadrupled hamstring autograft tendons, with drilling of the femoral tunnel performed via the transtibial portal. Graft fixation on the femur was achieved with cross-pin fixation, while interference screw fixation was used on the tibia. From September 2012 to October 2013, there were 69 reconstructions performed through an anteromedial portal. While there was no change in graft choice, a change was made to using suspensory femoral fixation. No other surgical or postoperative rehabilitation changes were made. Results: During the 14-year period in which ACL reconstructions were performed via the transtibial portal and with cross-pin fixation, 2 graft failures (0.4% failure rate) were reported. After switching to the anteromedial portal with suspensory fixation, 7 graft failures (10.1% failure rate) were reported over a 13-month period. These were 5 male and 2 female patients, with a mean age of 18.8 years—all elite athletes. The same surgical technique was used in all patients, and all patients had at least an 8 mm–diameter graft. Patients were cleared to return to sport at an average of 8.4 months postoperatively, after completing functional performance tests. Of the 7 patients, 6 sustained a rerupture of the graft within

  13. Carpal Tunnel Syndrome

    PubMed Central

    Zimmerman, Gregory R.

    1994-01-01

    Carpal tunnel syndrome is a neuropathy resulting from compression of the median nerve as it passes through a narrow tunnel in the wrist on its way to the hand. The lack of precise objective and clinical tests, along with symptoms that are synonymous with other syndromes in the upper extremity, cause carpal tunnel syndrome to appear to be a rare entity in athletics. However, it should not be ruled out as a possible etiology of upper extremity paralysis in the athlete. More typically, carpal tunnel syndrome is the most common peripheral entrapment neuropathy encountered in industry. Treatment may include rest and/or splinting of the involved wrist, ice application, galvanic stimulation, or iontophoresis to reduce inflammation, and then transition to heat modalities and therapeutic exercises for developing flexibility, strength, and endurance. In addition, an ergonomic assessment should be conducted, resulting in modifications to accommodate the carpal tunnel syndrome patient. ImagesFig 3.Fig 4.Fig 5.Fig 6.Fig 7. PMID:16558255

  14. Condensate Mixtures and Tunneling

    SciTech Connect

    Timmermans, E.

    1998-09-14

    The experimental study of condensate mixtures is a particularly exciting application of the recently developed atomic-trap Bose-Einstein condensate (BEC) technology: such multiple condensates represent the first laboratory systems of distinguishable boson superfluid mixtures. In addition, as the authors point out in this paper, the possibility of inter-condensate tunneling greatly enhances the richness of the condensate mixture physics. Not only does tunneling give rise to the oscillating particle currents between condensates of different chemical potentials, such as those studied extensively in the condensed matter Josephson junction experiments, it also affects the near-equilibrium dynamics and stability of the condensate mixtures. In particular, the stabilizing influence of tunneling with respect to spatial separation (phase separation) could be of considerable practical importance to the atomic trap systems. Furthermore, the creation of mixtures of atomic and molecular condensates could introduce a novel type of tunneling process, involving the conversion of a pair of atomic condensate bosons into a single molecular condensate boson. The static description of condensate mixtures with such type of pair tunneling suggests the possibility of observing dilute condensates with the liquid-like property of a self-determined density.

  15. Excitation of molecular vibrational modes with inelastic scanning tunneling microscopy processes: examination through action spectra of cis-2-butene on Pd(110).

    PubMed

    Sainoo, Yasuyuki; Kim, Yousoo; Okawa, Toshiro; Komeda, Tadahiro; Shigekawa, Hidemi; Kawai, Maki

    2005-12-09

    Inelastically tunneled electrons from a scanning tunneling microscope (STM) were used to induce vibrationally mediated motion of a single cis-2-butene molecule among four equivalent orientations on Pd(110) at 4.8 K. The action spectrum obtained from the motion clearly detects more vibrational modes than inelastic electron tunneling spectroscopy with a STM. We demonstrate the usefulness of the action spectroscopy as a novel single molecule vibrational spectroscopic method. We also discuss its selection rules in terms of resonance tunneling.

  16. Intracorporeal knotting of a femoral nerve catheter.

    PubMed

    Ghanem, Mohamed; Schnoor, Jörg; Wiegel, Martin; Josten, Christoph; Reske, Andreas W

    2015-01-01

    Peripheral nerve catheters are effective and well-established tools to provide postoperative analgesia to patients undergoing orthopedic surgery. The performance of these techniques is usually considered safe. However, placement of nerve catheters may be associated with a considerable number of side effects and major complications have repeatedly been published. In this work, we report on a patient who underwent total knee replacement with spinal anesthesia and preoperative insertion of femoral and sciatic nerve catheters for postoperative analgesia. During insertion of the femoral catheter, significant resistance was encountered upon retracting the catheter. This occurred due to knotting of the catheter. The catheter had to be removed by operative intervention which has to be considered a major complication. The postoperative course was uneventful. The principles for removal of entrapped peripheral catheters are not well established, may differ from those for neuroaxial catheters, and range from cautious manipulation up to surgical intervention.

  17. Intracorporeal knotting of a femoral nerve catheter

    PubMed Central

    Ghanem, Mohamed; Schnoor, Jörg; Wiegel, Martin; Josten, Christoph; Reske, Andreas W.

    2015-01-01

    Peripheral nerve catheters are effective and well-established tools to provide postoperative analgesia to patients undergoing orthopedic surgery. The performance of these techniques is usually considered safe. However, placement of nerve catheters may be associated with a considerable number of side effects and major complications have repeatedly been published. In this work, we report on a patient who underwent total knee replacement with spinal anesthesia and preoperative insertion of femoral and sciatic nerve catheters for postoperative analgesia. During insertion of the femoral catheter, significant resistance was encountered upon retracting the catheter. This occurred due to knotting of the catheter. The catheter had to be removed by operative intervention which has to be considered a major complication. The postoperative course was uneventful. The principles for removal of entrapped peripheral catheters are not well established, may differ from those for neuroaxial catheters, and range from cautious manipulation up to surgical intervention. PMID:26504733

  18. Spontaneous stress fractures of the femoral neck

    SciTech Connect

    Dorne, H.L.; Lander, P.H.

    1985-02-01

    The diagnosis of spontaneous stress fractures of the femoral neck, a form of insufficiency stress fracture, can be missed easily. Patients present with unremitting hip pain without a history of significant trauma or unusual increase in daily activity. The initial radiographic features include osteoporosis, minor alterations of trabecular alignment, minimal extracortical or endosteal reaction, and lucent fracture lines. Initial scintigraphic examinations performed in three of four patients showed focal increased radionuclide uptake in two and no focal abnormality in one. Emphasis is placed on the paucity of early findings. Evaluation of patients with persistent hip pain requires a high degree of clinical suspicion and close follow-up; the sequelae of undetected spontaneous fractures are subcapital fracture with displacement, angular deformity, and a vascular necrosis of the femoral head.

  19. Femoral bifurcation disease: balloon or knife.

    PubMed

    Bosiers, Marc; Deloose, Koen

    2009-10-01

    Arterial occlusive disease at the level of the femoral bifurcation mostly occurs in combination with inflow and/or outflow lesions. Surgical endarterectomy of the femoral bifurcation is a well-proven low-risk and easy surgical intervention with known durable success, while, although proven to be safe, evidence is lacking about the durability of the endovascular approach. Based on the evidence at hand, the surgical approach should be recommended for the vast majority of patients and the endovascular approach should only be indicated as the first strategy in selected cases presenting with factors that might compromise the outcome of surgery in the groin. If feasible, the hybrid approach with endarterectomy at the level of the bifurcation and endovascular repair of the inflow and outflow lesions is preferred in patients with multilevel disease.

  20. When femoral fracture fixation fails: salvage options.

    PubMed

    Petrie, J; Sassoon, A; Haidukewych, G J

    2013-11-01

    Most hip fractures treated with modern internal fixation techniques will heal. However, failures occasionally occur and require revision procedures. Salvage strategies employed during revision are based on whether the fixation failure occurs in the femoral neck, or in the intertrochanteric region. Patient age and remaining bone stock also influence decision making. For fractures in young patients, efforts are generally focused on preserving the native femoral head via osteotomies and repeat internal fixation. For failures in older patients, some kind of hip replacement is usually selected. Disuse osteopenia, deformity, bone loss, and stress-risers from previous internal fixation devices all pose technical challenges to successful reconstruction. Attention to detail is important in order to minimise complications. In the majority of cases, good outcomes have been reported for the various salvage strategies.

  1. Postcatheterization Femoral Arteriovenous Fistulas: Endovascular Treatment with Stent-Grafts

    SciTech Connect

    Onal, Baran Kosar, Sule; Gumus, Terman; Ilgit, Erhan T.; Akpek, Sergin

    2004-09-15

    Purpose: To report our results of stent-graft implantation for the endovascular treatment of postcatheterization femoral arteriovenous fistulas (AVFs) occurring between the deep femoral artery and the femoral vein.Methods: Endovascular treatment of iatrogenic femoral AVFs as a result of arterial puncture for coronary angiography and/or angioplasty was attempted in 10 cases. Balloon-expandable stent-grafts, one for each lesion, were used to repair the fistulas, which were between the deep femoral artery and the femoral vein in all cases. Stent-graft implantation to the deep femoral artery was performed by a contralateral retrograde approach.Results: All stent-grafts were deployed successfully. Complete closure of the fistulas was accomplished immediately in nine of 10 cases. In one case, complete closure could not be obtained but the fact that the complaint subsided was taken to indicate clinical success. In three cases, side branch occlusion of the deep femoral artery occurred. No complications were observed after implantation. Follow-up for 8-31 months (mean 18.5 months) with color Doppler ultrasonography revealed patency of the stented arterial segments without recurrent arteriovenous shunting in those nine patients who had successful immediate closure of their AVFs.Conclusion: Our results with a mean follow-up 18.5 months suggest that stent-graft implantation for the closure of postcatheterization femoral AVFs originating from the deep femoral artery is an effective, minimally invasive alternative procedure.

  2. Synchronous femoral hernias diagnosed during endoscopic inguinal hernia repair.

    PubMed

    Putnis, Soni; Wong, April; Berney, Christophe

    2011-12-01

    During totally extraperitoneal (TEP) endoscopic repair of inguinal hernias, it is possible to see the internal opening of the femoral canal. The aim of our study was to determine the incidence of synchronous femoral hernias found in patients undergoing TEP endoscopic inguinal hernia repair. This was a retrospective review of prospectively collected data on 362 consecutive patients who underwent 484 TEP endoscopic inguinal hernia repairs during a 5-year period, May 2005 to May 2010. During surgery, both inguinal and femoral canal orifices were routinely inspected. The presence of unilateral or bilateral inguinal and femoral hernias was recorded and repaired accordingly. There were a total of 362 patients. More males (343, 95%) underwent a TEP hernia repair than females (19, 5%). There were more cases of unilateral (240/362, 66%) than bilateral (122/362, 34%) inguinal hernias. A total of 18 cases of synchronous femoral hernias were found during operation. There was a higher incidence of femoral hernia in females (7/19, 37%) compared to males (11/343, 3%) (P < 0.001). None of the femoral hernias were clinically detectable preoperatively. Females undergoing elective inguinal hernia repair are more likely to have a synchronous femoral hernia than males. We suggest that all women presenting with an inguinal hernia also have a formal assessment of the femoral canal. TEP endoscopic inguinal hernia repair is an ideal approach as both inguinal and femoral orifices can be assessed and hernias repaired simultaneously during surgery.

  3. 203. Lickstone Ridge Tunnel. All but three of the tunnel ...

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

    203. Lickstone Ridge Tunnel. All but three of the tunnel have minimum height of 13, which accommodates most large recreational vehicles. This tunnel has the lowest clearance at 11-3. - Blue Ridge Parkway, Between Shenandoah National Park & Great Smoky Mountains, Asheville, Buncombe County, NC

  4. View down tank tunnel (tunnel no. 2) showing pipes and ...

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

    View down tank tunnel (tunnel no. 2) showing pipes and walkway of metal grating, side tunnel to tank 3 is on the left - U.S. Naval Base, Pearl Harbor, Diesel Purification Plant, North Road near Pierce Street, Pearl City, Honolulu County, HI

  5. [Avascular necrosis of the femoral head].

    PubMed

    Porubský, Peter; Trč, Tomáš; Havlas, Vojtěch; Smetana, Pavel

    Avascular necrosis of the femoral head in adults is not common, but not too rare diseases. In orthopedic practice, it is one of the diseases that are causing implantation of hip replacement at a relatively early age. In the early detection and initiation of therapy can delay the implantation of prosthesis for several years, which is certainly more convenient for the patient and beneficial. This article is intended to acquaint the reader with the basic diagnostic procedures and therapy.

  6. Femtosecond scanning tunneling microscope

    SciTech Connect

    Taylor, A.J.; Donati, G.P.; Rodriguez, G.; Gosnell, T.R.; Trugman, S.A.; Some, D.I.

    1998-11-01

    This is the final report of a three-year, Laboratory Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). By combining scanning tunneling microscopy with ultrafast optical techniques we have developed a novel tool to probe phenomena on atomic time and length scales. We have built and characterized an ultrafast scanning tunneling microscope in terms of temporal resolution, sensitivity and dynamic range. Using a novel photoconductive low-temperature-grown GaAs tip, we have achieved a temporal resolution of 1.5 picoseconds and a spatial resolution of 10 nanometers. This scanning tunneling microscope has both cryogenic and ultra-high vacuum capabilities, enabling the study of a wide range of important scientific problems.

  7. Uncooled tunneling infrared sensor

    NASA Technical Reports Server (NTRS)

    Kenny, Thomas W. (Inventor); Kaiser, William J. (Inventor); Podosek, Judith A. (Inventor); Vote, Erika C. (Inventor); Muller, Richard E. (Inventor); Maker, Paul D. (Inventor)

    1995-01-01

    An uncooled infrared tunneling sensor in which the only moving part is a diaphragm which is deflected into contact with a micromachined silicon tip electrode prepared by a novel lithographic process. Similarly prepared deflection electrodes employ electrostatic force to control the deflection of a silicon nitride, flat diaphragm membrane. The diaphragm exhibits a high resonant frequency which reduces the sensor's sensitivity to vibration. A high bandwidth feedback circuit controls the tunneling current by adjusting the deflection voltage to maintain a constant deflection of the membrane. The resulting infrared sensor can be miniaturized to pixel dimensions smaller than 100 .mu.m. An alternative embodiment is implemented using a corrugated membrane to permit large deflection without complicated clamping and high deflection voltages. The alternative embodiment also employs a pinhole aperture in a membrane to accommodate environmental temperature variation and a sealed chamber to eliminate environmental contamination of the tunneling electrodes and undesireable accoustic coupling to the sensor.

  8. Aorto-ventricular tunnel

    PubMed Central

    McKay, Roxane

    2007-01-01

    Aorto-ventricular tunnel is a congenital, extracardiac channel which connects the ascending aorta above the sinutubular junction to the cavity of the left, or (less commonly) right ventricle. The exact incidence is unknown, estimates ranging from 0.5% of fetal cardiac malformations to less than 0.1% of congenitally malformed hearts in clinico-pathological series. Approximately 130 cases have been reported in the literature, about twice as many cases in males as in females. Associated defects, usually involving the proximal coronary arteries, or the aortic or pulmonary valves, are present in nearly half the cases. Occasional patients present with an asymptomatic heart murmur and cardiac enlargement, but most suffer heart failure in the first year of life. The etiology of aorto-ventricular tunnel is uncertain. It appears to result from a combination of maldevelopment of the cushions which give rise to the pulmonary and aortic roots, and abnormal separation of these structures. Echocardiography is the diagnostic investigation of choice. Antenatal diagnosis by fetal echocardiography is reliable after 18 weeks gestation. Aorto-ventricular tunnel must be distinguished from other lesions which cause rapid run-off of blood from the aorta and produce cardiac failure. Optimal management of symptomatic aorto-ventricular tunnel consists of diagnosis by echocardiography, complimented with cardiac catheterization as needed to elucidate coronary arterial origins or associated defects, and prompt surgical repair. Observation of the exceedingly rare, asymptomatic patient with a small tunnel may be justified by occasional spontaneous closure. All patients require life-long follow-up for recurrence of the tunnel, aortic valve incompetence, left ventricular function, and aneurysmal enlargement of the ascending aorta. PMID:17922908

  9. Aorto-ventricular tunnel.

    PubMed

    McKay, Roxane

    2007-10-08

    Aorto-ventricular tunnel is a congenital, extracardiac channel which connects the ascending aorta above the sinutubular junction to the cavity of the left, or (less commonly) right ventricle. The exact incidence is unknown, estimates ranging from 0.5% of fetal cardiac malformations to less than 0.1% of congenitally malformed hearts in clinico-pathological series. Approximately 130 cases have been reported in the literature, about twice as many cases in males as in females. Associated defects, usually involving the proximal coronary arteries, or the aortic or pulmonary valves, are present in nearly half the cases. Occasional patients present with an asymptomatic heart murmur and cardiac enlargement, but most suffer heart failure in the first year of life. The etiology of aorto-ventricular tunnel is uncertain. It appears to result from a combination of maldevelopment of the cushions which give rise to the pulmonary and aortic roots, and abnormal separation of these structures. Echocardiography is the diagnostic investigation of choice. Antenatal diagnosis by fetal echocardiography is reliable after 18 weeks gestation. Aorto-ventricular tunnel must be distinguished from other lesions which cause rapid run-off of blood from the aorta and produce cardiac failure. Optimal management of symptomatic aorto-ventricular tunnel consists of diagnosis by echocardiography, complimented with cardiac catheterization as needed to elucidate coronary arterial origins or associated defects, and prompt surgical repair. Observation of the exceedingly rare, asymptomatic patient with a small tunnel may be justified by occasional spontaneous closure. All patients require life-long follow-up for recurrence of the tunnel, aortic valve incompetence, left ventricular function, and aneurysmal enlargement of the ascending aorta.

  10. Subtrochanteric fractures after retrograde femoral nailing

    PubMed Central

    Mounasamy, Varatharaj; Mallu, Sathya; Khanna, Vishesh; Sambandam, Senthil

    2015-01-01

    Secondary fractures around femoral nails placed for the management of hip fractures are well known. We report, two cases of a fracture of the femur at the interlocking screw site in the subtrochanteric area after retrograde femoral nailing of a femoral shaft fracture. Only a few reports in the existing literature have described these fractures. Two young men after sustaining a fall presented to us with pain, swelling and deformity in the upper thigh region. On enquiring, examining and radiographing them, peri-implant fractures of subtrochanteric nature through the distal interlocking screws were revealed in both patients who also had histories of previous falls for which retrograde intramedullary nailing was performed for their respective femora. Both patients were managed with similar surgical routines including removal of the existing hardware, open reduction and ace cephallomedullary antegrade nailing. The second case did show evidence of delayed healing and was additionally stabilized with cerclage wires. Both patients had uneventful postoperative outcomes and union was evident at the end of 6 mo postoperatively with a good range of motion at the hip and knee. Our report suggests that though seldom reported, peri-implant fractures around the subtrochanteric region can occur and pose a challenge to the treating orthopaedic surgeon. We suggest these be managed, after initial stabilization and resuscitation, by implant removal, open reduction and interlocking intramedullary antegrade nailing. Good results and progression to union can be expected in these patients by adhering to basic principles of osteosynthesis. PMID:26495251

  11. Monitoring femoral component installation using vibration testing.

    PubMed

    Giardini, Seana; Cornwell, Phillip; Meneghini, R Michael

    2005-01-01

    With emerging minimally invasive surgical techniques in total hip arthroplasty, there has been anecdotal evidence of an increase in fractures associated with the insertion of the prosthesis into the femur. The diminished visibility associated with minimally invasive surgical techniques necessitates a greater emphasis on the surgeon's tactile and auditory senses. These senses are used to ascertain the femoral component position of maximum stability and interference fit, as well as to prevent further component impaction and subsequent fracture of the femur. The work described herein attempts to identify a means to supplement the surgeon's tactile and auditory senses by using damage identification techniques normally used in civil and mechanical structures to monitor the insertion process of the prosthesis. It is hypothesized that vibration characteristics of the impact process may be used intraoperatively to determine at what position the femoral component has reached appropriate interference fit and stability in the femur. Such information may be used to prevent further impaction of the femoral component past a threshold that could result in a periprosthetic fracture. A piezoelectric accelerometer and impact hammer will be used to monitor the impact process. The acceleration time history data were analyzed by using low and high pass filters to allow frequency analysis of the time history signals. This paper will summarize features derived from the measured data that will be used to develop an insertion process termination indicator.

  12. High-speed Wind Tunnels

    NASA Technical Reports Server (NTRS)

    Ackeret, J

    1936-01-01

    Wind tunnel construction and design is discussed especially in relation to subsonic and supersonic speeds. Reynolds Numbers and the theory of compressible flows are also taken into consideration in designing new tunnels.

  13. Future tunnelling projects in Iceland

    SciTech Connect

    Jonsson, B. )

    1992-04-01

    More than 300 km of hydro tunnels and 80-90 km of road tunnels could be excavated in Iceland before the year 2050. In order to complete this task, an average of 6-7 km of tunnel per year would have to be driven. This volume of tunnelling is estimated to cost more than $US1 billion, which could be divided as follows: (a) about 100 km of 3.5-m-wide diversion hydro tunnels (unsupported), for a total of $90 million; (b) approx. 100 km of 5-m-wide hydro tunnels (supported), for a total of $210 million; (c) about 100 km of 7.6-m-wide hydro tunnels (supported), for a total of $380 million; and (d) approx. 85 km of road tunnels with 25 m[sup 2] cross-section, for a total of $435 million. 5 refs., 5 figs., 4 tabs.

  14. Tunneling in axion monodromy

    NASA Astrophysics Data System (ADS)

    Brown, Jon; Cottrell, William; Shiu, Gary; Soler, Pablo

    2016-10-01

    The Coleman formula for vacuum decay and bubble nucleation has been used to estimate the tunneling rate in models of axion monodromy in recent literature. However, several of Coleman's original assumptions do not hold for such models. Here we derive a new estimate with this in mind using a similar Euclidean procedure. We find that there are significant regions of parameter space for which the tunneling rate in axion monodromy is not well approximated by the Coleman formula. However, there is also a regime relevant to large field inflation in which both estimates parametrically agree. We also briefly comment on the applications of our results to the relaxion scenario.

  15. Instrumentation in wind tunnels

    NASA Technical Reports Server (NTRS)

    Takashima, K.

    1986-01-01

    Requirements in designing instrumentation systems and measurements of various physical quantities in wind tunnels are surveyed. Emphasis is given to sensors used for measuring pressure, temperature, and angle, and the measurements of air turbulence and boundary layers. Instrumentation in wind tunnels require accuracy, fast response, diversity and operational simplicity. Measurements of force, pressure, attitude angle, free flow, pressure distribution, and temperature are illustrated by a table, and a block diagram. The LDV (laser Doppler velocimeter) method for measuring air turbulence and flow velocity and measurement of skin friction and flow fields using laser holograms are discussed. The future potential of these techniques is studied.

  16. Orientation and the Young Orienteer

    NASA Astrophysics Data System (ADS)

    Walsh, S. E.; Martland, J. R.

    Orientation within orienteering is dependent on the use of two basic strategies; that is, either a compass or Magnetic-North-based strategy, which relies on the use of one set of information; or the use of a map and landmark-based strategy which relies on the use of at least two sets of information. Walsh and found that, when given the choice, young children use the compass-based strategy when following complex potentially disorientating routes.The efficacy of these two basic orientation strategies was investigated within three different orienteering environments: (1) a familiar known environment; (2) a familiar unknown environment and (3) an unfamiliar unknown environment.Subjects, age range from 9 to 10think aloud particularly the introduction of basic skills to young performers. They support the argument that is essential to introduce the map and compass simultaneously and that relocation and orientation skills should be coached concurrently.

  17. Zero-Time Tunneling - Revisited

    NASA Astrophysics Data System (ADS)

    Nimtz, Günter; Aichmann, Horst

    2017-08-01

    Since 1931, the nonclassical process of tunneling was conjectured to have a zero-time delay in the barrier. These theories have been rejected and denied. However, photonic and recent electronic tunneling experiments have proven the zero-time prediction. Tunneling is due to virtual wave packets in electromagnetic, elastic, and Schrödinger wave fields up to the macroscopic level. In this article we cite theoretical and experimental studies on zero-time tunneling, which have proven this striking behavior.

  18. Femoral stem fracture and in vivo corrosion of retrieved modular femoral hips.

    PubMed

    Huot Carlson, J Caitlin; Van Citters, Douglas W; Currier, John H; Bryant, Amber M; Mayor, Michael B; Collier, John P

    2012-08-01

    A series of 78 retrieved modular hip devices were assessed for fretting and corrosion. Damage was common at both the head-neck junction (54% showing corrosion; 88% showing fretting) and at the stem-sleeve junction (88% corrosion; 65% fretting). Corrosion correlated to in vivo duration, patient activity, and metal (vs ceramic) femoral heads but did not correlate to head carbon content. Femoral stem fatigue fracture was observed in seven retrievals; all had severe corrosion, were under increased stress, and were in vivo longer than the non-fractured cohort. This study emphasizes the potential for stem fracture when small diameter femoral stems with large offsets are used in heavy and active patients. Designs which reduce fretting and corrosion in modular implants is warranted as patients demand longer lasting implants.

  19. Hybrid approach to limb salvage in the setting of an infected femoral-femoral bypass graft.

    PubMed

    Jones, Douglas W; Meltzer, Andrew J; Schneider, Darren B

    2014-08-01

    Prosthetic vascular graft infection in patients with advanced peripheral arterial disease can lead to multiple additional procedures, including extra-anatomic bypass or even amputation. We report the case of an 88-year-old woman with critical limb ischemia and an infected prosthetic femoral-femoral bypass graft. Using a planned hybrid 2-stage approach, we performed endovascular recanalization of the native left iliac arterial system using remote access via the superficial femoral artery to avoid infected groin wounds. Recanalization of the patient's Trans-Atlantic Inter-Society Consensus II D chronic iliac occlusion allowed for removal of the infected graft and placement of a profunda femoris artery to proximal posterior tibial artery bypass, thereby restoring inflow and avoiding the infected left groin. Newer endovascular techniques coupled with open surgical options may lead to limb salvage in patients with previously unreconstructable peripheral arterial disease.

  20. Morphological changes in tibial tunnels after anatomic anterior cruciate ligament reconstruction with hamstring tendon graft.

    PubMed

    Ohori, Tomoki; Mae, Tatsuo; Shino, Konsei; Tachibana, Yuta; Sugamoto, Kazuomi; Yoshikawa, Hideki; Nakata, Ken

    2017-09-15

    postero-lateral direction reflected by the ACL fiber orientation 1 year after the ATB ACL reconstruction. The proper tibial tunnel location in the ACL reconstruction should be determined considering the tunnel enlargement in postero-lateral direction after surgery.

  1. Management and outcome of interprosthetic femoral fractures.

    PubMed

    Platzer, Patrick; Schuster, Rupert; Luxl, Monika; Widhalm, Harald Kurt; Eipeldauer, Stefan; Krusche-Mandl, Irena; Ostermann, Roman; Blutsch, Beate; Vécsei, Vilmos

    2011-11-01

    Interprosthetic femoral fractures following ipsilateral hip and knee arthroplasty are a rare but serious complication in clinical practice. In most cases, adequate management of these injuries might constitute a challenging problem. However, the literature provides only few data regarding the treatment and outcome of interprosthetic femoral fractures, and there are only few classifications available, which might assist in finding an appropriate treatment concept. The purpose of this study was to analyse our experience in the management of interprosthetic femoral fractures following ipsilateral hip and knee joint replacement. We reviewed the clinical and radiographic records of 23 patients (15 female and eight male, average age: 79.2 years) with an interprosthetic fracture after ipsilateral hip and knee joint replacement between 1992 and 2008. For the classification of interprosthetic femoral fractures, the fractures were divided into three types, depending on the fracture site and the adjacency to the prostheses. All patients underwent operative stabilisation, either by lateral plate fixation (n=19), by revision arthroplasty using a long stem (n=2) or by plate fixation and revision arthroplasty (n=2). Referring to the clinical outcome, 16 patients returned to their pre-injury activity level and were satisfied with their clinical outcome. In six patients, we saw a relevant decrease of hip or knee function and severe limitations in gait and activities of daily living. We had a mean Harris Hip Score (HHS) of 78.4 points, and a mean Knee injury and Osteoarthritis Outcome Score (KOOS) of 71.8 points. Relating to the radiographic outcome, successful fracture healing was achieved in 19 of 22 patients (86%) within 6 months. Failures of reduction and fixation were noted in four (18%) of 22 patients. We had a satisfactory outcome following individualised treatment of interprosthetic femoral fractures following ipsilateral hip and knee joint replacement. Compared to the rare

  2. Scanning tunneling microscope nanoetching method

    DOEpatents

    Li, Yun-Zhong; Reifenberger, Ronald G.; Andres, Ronald P.

    1990-01-01

    A method is described for forming uniform nanometer sized depressions on the surface of a conducting substrate. A tunneling tip is used to apply tunneling current density sufficient to vaporize a localized area of the substrate surface. The resulting depressions or craters in the substrate surface can be formed in information encoding patterns readable with a scanning tunneling microscope.

  3. Large ceramic femoral heads: what problems do they solve?

    PubMed

    Rodriguez, J A; Cooper, H J

    2013-11-01

    Large ceramic femoral heads offer several advantages that are potentially advantageous to patients undergoing both primary and revision total hip replacement. Many high-quality studies have demonstrated the benefit of large femoral heads in reducing post-operative instability. Ceramic femoral heads may also offer an advantage in reducing polyethylene wear that has been reported in vitro and is starting to become clinically apparent in mid-term clinical outcome studies. Additionally, the risk of taper corrosion at a ceramic femoral head-neck junction is clearly lower than when using a metal femoral head. With improvements in the material properties of both modern ceramic femoral heads and polyethylene acetabular liners that have reduced the risk of mechanical complications, large ceramic heads have gained popularity in recent years.

  4. Incomplete transposition of the common femoral artery and vein.

    PubMed

    Leite, J O; Carvalho Ventura, I; Botelho, F E; Costa Galvao, W

    2010-02-01

    Anatomical variations of the great saphenous vein, femoral artery and femoral vein at the inguinal level are rare. Modifications in the anatomical relationships among theses vessel can cause technical difficulties. There are two reports in the literature of the complete transposition of the femoral artery and vein. Both patients had large varicose veins only in the limb that presented the variation, which suggested an extrinsic compression. In the present paper, we report a case study of a patient with an incomplete transposition of the femoral artery and vein. Specifically, the common femoral vein and the saphenofemoral junction were completely overlapped by the common femoral artery. Although this anatomical variation did not present any clinical signs, it required a more complex surgical procedure.

  5. Femoral neuropathy and meralgia paresthetica secondary to an iliacus hematoma.

    PubMed

    Yi, Tae Im; Yoon, Tae Hee; Kim, Joo Sup; Lee, Ga Eun; Kim, Bo Ra

    2012-04-01

    Compressive femoral and lateral femoral cutaneous neuropathies from an iliacus hematoma are unusual presentation. We report a case of a 16-year-old boy who developed right femoral and lateral femoral cutaneous neuropathies as a complication of traumatic ipsilateral iliacus hematoma formation. The patient complained of numbness in the right thigh and calf as well as right leg weakness, and pain in the right inguinal area. Nerve conduction study and needle electromyography identified the neuropathies. After the electrodiagnostic studies, the pelvic bone MRI revealed a large, 9×5×4.5 cm right iliacus hematoma. As a result, diagnosis of a right iliacus hematoma compressing the femoral and lateral femoral cutaneous nerves was made, and the patient underwent an operation to remove the hematoma. Symptoms and neurological signs showed notable improvement after surgical decompression. Subsequent follow-up electrodiagnostic studies after 11 weeks demonstrated regeneration evidence.

  6. Femoral Neuropathy and Meralgia Paresthetica Secondary to an Iliacus Hematoma

    PubMed Central

    Yi, Tae Im; Kim, Joo Sup; Lee, Ga Eun; Kim, Bo Ra

    2012-01-01

    Compressive femoral and lateral femoral cutaneous neuropathies from an iliacus hematoma are unusual presentation. We report a case of a 16-year-old boy who developed right femoral and lateral femoral cutaneous neuropathies as a complication of traumatic ipsilateral iliacus hematoma formation. The patient complained of numbness in the right thigh and calf as well as right leg weakness, and pain in the right inguinal area. Nerve conduction study and needle electromyography identified the neuropathies. After the electrodiagnostic studies, the pelvic bone MRI revealed a large, 9×5×4.5 cm right iliacus hematoma. As a result, diagnosis of a right iliacus hematoma compressing the femoral and lateral femoral cutaneous nerves was made, and the patient underwent an operation to remove the hematoma. Symptoms and neurological signs showed notable improvement after surgical decompression. Subsequent follow-up electrodiagnostic studies after 11 weeks demonstrated regeneration evidence. PMID:22639754

  7. Analyzing Orientations

    NASA Astrophysics Data System (ADS)

    Ruggles, Clive L. N.

    Archaeoastronomical field survey typically involves the measurement of structural orientations (i.e., orientations along and between built structures) in relation to the visible landscape and particularly the surrounding horizon. This chapter focuses on the process of analyzing the astronomical potential of oriented structures, whether in the field or as a desktop appraisal, with the aim of establishing the archaeoastronomical "facts". It does not address questions of data selection (see instead Chap. 25, "Best Practice for Evaluating the Astronomical Significance of Archaeological Sites", 10.1007/978-1-4614-6141-8_25) or interpretation (see Chap. 24, "Nature and Analysis of Material Evidence Relevant to Archaeoastronomy", 10.1007/978-1-4614-6141-8_22). The main necessity is to determine the azimuth, horizon altitude, and declination in the direction "indicated" by any structural orientation. Normally, there are a range of possibilities, reflecting the various errors and uncertainties in estimating the intended (or, at least, the constructed) orientation, and in more formal approaches an attempt is made to assign a probability distribution extending over a spread of declinations. These probability distributions can then be cumulated in order to visualize and analyze the combined data from several orientations, so as to identify any consistent astronomical associations that can then be correlated with the declinations of particular astronomical objects or phenomena at any era in the past. The whole process raises various procedural and methodological issues and does not proceed in isolation from the consideration of corroborative data, which is essential in order to develop viable cultural interpretations.

  8. [Slipped capital femoral epiphysis associated with hyperparathyroidism. A case report].

    PubMed

    Khiari, Karima; Cherif, Lotfi; Ben Abdallah, Nejib; Maazoun, Imen; Hadj Ali, Insaf; Bentaarit, Chokri; Turki, Sami; Ben Maïz, Hedi

    2003-12-01

    Slippage of the upper femoral epiphysis can occur in association with multiple endocrine imbalances. A case of slipped femoral epiphysis with primary hyperparathyroidism is reported. The patient was an adolescent, 16 Years of age, who presented bilateral slipped epiphysis. Investigation showed that he had hypercalcemia (3.1 mmol/l) related to primary hyperparathyroidism. A parathyroid adenoma was removed. Outcome was favorable and the slipped femoral epiphyses did not require a specific treatment.

  9. Femoral neck structure and function in early hominins.

    PubMed

    Ruff, Christopher B; Higgins, Ryan

    2013-04-01

    All early (Pliocene-Early Pleistocene) hominins exhibit some differences in proximal femoral morphology from modern humans, including a long femoral neck and a low neck-shaft angle. In addition, australopiths (Au. afarensis, Au. africanus, Au. boisei, Paranthropus boisei), but not early Homo, have an "anteroposteriorly compressed" femoral neck and a small femoral head relative to femoral shaft breadth. Superoinferior asymmetry of cortical bone in the femoral neck has been claimed to be human-like in australopiths. In this study, we measured superior and inferior cortical thicknesses at the middle and base of the femoral neck using computed tomography in six Au. africanus and two P. robustus specimens. Cortical asymmetry in the fossils is closer overall to that of modern humans than to apes, although many values are intermediate between humans and apes, or even more ape-like in the midneck. Comparisons of external femoral neck and head dimensions were carried out for a more comprehensive sample of South and East African australopiths (n = 17) and two early Homo specimens. These show that compared with modern humans, femoral neck superoinferior, but not anteroposterior breadth, is larger relative to femoral head breadth in australopiths, but not in early Homo. Both internal and external characteristics of the australopith femoral neck indicate adaptation to relatively increased superoinferior bending loads, compared with both modern humans and early Homo. These observations, and a relatively small femoral head, are consistent with a slightly altered gait pattern in australopiths, involving more lateral deviation of the body center of mass over the stance limb.

  10. Ovčiarsko tunnel – interpretation of the results of the geotechnical monitoring

    NASA Astrophysics Data System (ADS)

    Ondráček, Jakub

    2017-09-01

    The Ovčiarsko twin-tube tunnel is part of the development of the Hričovské Podhradie – Lietavská Lúčka section of the D1 motorway, running southwest of the Žilina town. The D1 motorway overcomes the detached mass of an overthrust sheet and the western adge of the Paleogene fill of the Žilina Basin through the Ovčiarsko tunnel. The 2T – 8 category is designated for the Ovčiarsko tunnel with the total length of the northern tunnel tube 2360 m and southern tunnel tube 2367 m. the tunnel orientation to the cardinals is on the west-east axis, the marking of tunnel portals and tunnels tubes is distinguished according to it. The design speed is 100 km/h, respectively 90 km/h under worsened weather conditions. Parts of the tunnel are three cross passages passable for vehicles and five cross passages passable for pedestrians, serving as protected escape routes. This report describes geotechnical monitoring, construction technology and procedures with respect to complicated geological conditions. The geological conditions require the operative approach of the project owner, contractor, designer and geologist to the optimum solution for the running of the tunnel construction.

  11. Validation of the femoral anteversion measurement method used in imageless navigation

    PubMed Central

    Turley, Glen A.; Ahmed, Shahbaz M.Y.; Williams, Mark A.; Griffin, Damian R.

    2012-01-01

    Total hip arthroplasty restores lost mobility to patients suffering from osteoarthritis and acute trauma. In recent years, navigated surgery has been used to control prosthetic component placement. Furthermore, there has been increasing research on what constitutes correct placement. This has resulted in the definition of a safe-zone for acetabular cup orientation. However, there is less definition with regard to femoral anteversion and how it should be measured. This study assesses the validity of the femoral anteversion measurement method used in imageless navigation, with particular attention to how the neutral rotation of the femur is defined. CT and gait analysis methodologies are used to validate the reference which defines this neutral rotation, i.e., the ankle epicondyle piriformis (AEP) plane. The findings of this study indicate that the posterior condylar axis is a reliable reference for defining the neutral rotation of the femur. In imageless navigation, when these landmarks are not accessible, the AEP plane provides a useful surrogate to the condylar axis, providing a reliable baseline for femoral anteversion measurement. PMID:22681336

  12. Validation of the femoral anteversion measurement method used in imageless navigation.

    PubMed

    Turley, Glen A; Ahmed, Shahbaz M Y; Williams, Mark A; Griffin, Damian R

    2012-01-01

    Total hip arthroplasty restores lost mobility to patients suffering from osteoarthritis and acute trauma. In recent years, navigated surgery has been used to control prosthetic component placement. Furthermore, there has been increasing research on what constitutes correct placement. This has resulted in the definition of a safe-zone for acetabular cup orientation. However, there is less definition with regard to femoral anteversion and how it should be measured. This study assesses the validity of the femoral anteversion measurement method used in imageless navigation, with particular attention to how the neutral rotation of the femur is defined. CT and gait analysis methodologies are used to validate the reference which defines this neutral rotation, i.e., the ankle epicondyle piriformis (AEP) plane. The findings of this study indicate that the posterior condylar axis is a reliable reference for defining the neutral rotation of the femur. In imageless navigation, when these landmarks are not accessible, the AEP plane provides a useful surrogate to the condylar axis, providing a reliable baseline for femoral anteversion measurement.

  13. Full Scale Tunnel model

    NASA Technical Reports Server (NTRS)

    1929-01-01

    Interior view of Full-Scale Tunnel (FST) model. (Small human figures have been added for scale.) On June 26, 1929, Elton W. Miller wrote to George W. Lewis proposing the construction of a model of the full-scale tunnel . 'The excellent energy ratio obtained in the new wind tunnel of the California Institute of Technology suggests that before proceeding with our full scale tunnel design, we ought to investigate the effect on energy ratio of such factors as: 1. small included angle for the exit cone; 2. carefully designed return passages of circular section as far as possible, without sudden changes in cross sections; 3. tightness of walls. It is believed that much useful information can be obtained by building a model of about 1/16 scale, that is, having a closed throat of 2 ft. by 4 ft. The outside dimensions would be about 12 ft. by 25 ft. in plan and the height 4 ft. Two propellers will be required about 28 in. in diameter, each to be driven by direct current motor at a maximum speed of 4500 R.P.M. Provision can be made for altering the length of certain portions, particularly the exit cone, and possibly for the application of boundary layer control in order to effect satisfactory air flow.

  14. Carpal Tunnel Syndrome

    MedlinePlus

    ... affected and will not perform normally during the test. Diagnostic ultrasonography and MRI have been used to help diagnose carpal tunnel syndrome and exclude other causes of hand and wrist symptoms. These technologies can identify swelling of the median nerve and ...

  15. Carpal Tunnel Syndrome

    MedlinePlus

    ... affected and will not perform normally during the test. Diagnostic ultrasonography and MRI have been used to help diagnose carpal tunnel syndrome and exclude other causes of hand and wrist symptoms. These technologies can identify swelling of the median nerve and ...

  16. Magnetic Fluxtube Tunneling

    NASA Technical Reports Server (NTRS)

    Dahlburg, Russell B.; Antiochos,, Spiro K.; Norton, D.

    1996-01-01

    We present numerical simulations of the collision and subsequent interaction of two initially orthogonal, twisted, force free field magnetic fluxtubes. The simulations were carried out using a new three dimensional explicit parallelized Fourier collocation algorithm for solving the viscoresistive equations of compressible magnetohydrodynamics. It is found that, under a wide range of conditions, the fluxtubes can 'tunnel' through each other. Two key conditions must be satisfied for tunneling to occur: the magnetic field must be highly twisted with a field line pitch much greater than 1, and the magnetic Lundquist number must be somewhat large, greater than or equal to 2880. This tunneling behavior has not been seen previously in studies of either vortex tube or magnetic fluxtube interactions. An examination of magnetic field lines shows that tunneling is due to a double reconnection mechanism. Initially orthogonal field lines reconnect at two specific locations, exchange interacting sections and 'pass' through each other. The implications of these results for solar and space plasmas are discussed.

  17. Tunneling path toward spintronics

    NASA Astrophysics Data System (ADS)

    Miao, Guo-Xing; Münzenberg, Markus; Moodera, Jagadeesh S.

    2011-03-01

    The phenomenon of quantum tunneling, which was discovered almost a century ago, has led to many subsequent discoveries. One such discovery, spin polarized tunneling, was made 40 years ago by Robert Meservey and Paul Tedrow (Tedrow and Meservey 1971 Phys. Rev. Lett. 26 192), and it has resulted in many fundamental observations and opened up an entirely new field of study. Until the mid-1990s, this field developed at a steady, low rate, after which a huge increase in activity suddenly occurred as a result of the unraveling of successful spin tunneling between two ferromagnets. In the past 15 years, several thousands of papers related to spin polarized tunneling and transport have been published, making this topic one of the hottest areas in condensed matter physics from both fundamental science and applications viewpoints. Many review papers and book chapters have been written in the past decade on this subject. This paper is not exhaustive by any means; rather, the emphases are on recent progress, technological developments and informing the reader about the current direction in which this topic is moving.

  18. Carpal tunnel syndrome

    PubMed Central

    2014-01-01

    Introduction Carpal tunnel syndrome is a collection of clinical symptoms and signs caused by compression of the median nerve within the carpal tunnel. However, the severity of symptoms and signs does not often correlate well with the extent of nerve compression. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments, non-drug treatments, and surgical treatments for carpal tunnel syndrome? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 33 studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: carpal tunnel release surgery (open and endoscopic), diuretics, local corticosteroids injection, non-steroidal anti-inflammatory drugs (NSAIDs), therapeutic ultrasound, and wrist splints.

  19. Carpal tunnel syndrome

    PubMed Central

    2010-01-01

    Introduction Carpal tunnel syndrome is a neuropathy caused by compression of the median nerve within the carpal tunnel. However, the severity of symptoms and signs does not often correlate well with the extent of nerve damage. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments, non-drug treatments, surgical treatments, and postoperative treatments for carpal tunnel syndrome? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 53 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupuncture, carpal tunnel release surgery (open and endoscopic), diuretics, internal neurolysis, local and systemic corticosteroids, massage therapy, nerve and tendon gliding exercises, non-steroidal anti-inflammatory drugs (NSAIDs), pyridoxine, therapeutic ultrasound, and wrist splints. PMID:21718565

  20. Wind Tunnel Balances

    NASA Technical Reports Server (NTRS)

    Warner, Edward P; Norton, F H

    1920-01-01

    Report embodies a description of the balance designed and constructed for the use of the National Advisory Committee for Aeronautics at Langley Field, and also deals with the theory of sensitivity of balances and with the errors to which wind tunnel balances of various types are subject.

  1. Dry wind tunnel system

    NASA Technical Reports Server (NTRS)

    Chen, Ping-Chih (Inventor)

    2013-01-01

    This invention is a ground flutter testing system without a wind tunnel, called Dry Wind Tunnel (DWT) System. The DWT system consists of a Ground Vibration Test (GVT) hardware system, a multiple input multiple output (MIMO) force controller software, and a real-time unsteady aerodynamic force generation software, that is developed from an aerodynamic reduced order model (ROM). The ground flutter test using the DWT System operates on a real structural model, therefore no scaled-down structural model, which is required by the conventional wind tunnel flutter test, is involved. Furthermore, the impact of the structural nonlinearities on the aeroelastic stability can be included automatically. Moreover, the aeroservoelastic characteristics of the aircraft can be easily measured by simply including the flight control system in-the-loop. In addition, the unsteady aerodynamics generated computationally is interference-free from the wind tunnel walls. Finally, the DWT System can be conveniently and inexpensively carried out as a post GVT test with the same hardware, only with some possible rearrangement of the shakers and the inclusion of additional sensors.

  2. Tunnelling with wormhole creation

    SciTech Connect

    Ansoldi, S.; Tanaka, T.

    2015-03-15

    The description of quantum tunnelling in the presence of gravity shows subtleties in some cases. We discuss wormhole production in the context of the spherically symmetric thin-shell approximation. By presenting a fully consistent treatment based on canonical quantization, we solve a controversy present in the literature.

  3. The Mystery Tunnel

    ERIC Educational Resources Information Center

    McCormack, Alan J.

    1974-01-01

    Describes a mystery tunnel, constructed by teachers, which provides a variety of non-visual, sensory experiences for children as they crawl through it. It is designed to help primary children develop basic abilities to use their own senses to better observe, discriminate among observations, and describe their own perceptions accurately. (JR)

  4. Clinical Results of Internal Fixation of Subcapital Femoral Neck Fractures.

    PubMed

    Kang, Joon Soon; Moon, Kyoung Ho; Shin, Joong Sup; Shin, Eun Ho; Ahn, Chi Hoon; Choi, Geon Hong

    2016-06-01

    Subcapital femoral neck is known to cause many complications, such as avascular necrosis (AVN) of the femoral head or nonunion, compared with other femoral neck fractures. The purpose of this study was to analyze the incidence of AVN and fixation failures in patients treated with internal fixation using cannulated screws for the subcapital femoral neck fractures. This study targeted a total of 84 cases of subcapital femoral neck fractures that underwent internal fixation using cannulated screws. The average follow-up time after surgery was 36.8 months (range, 24 to 148 months). Nine hips (10.7%) showing AVN of the femoral head and 6 hips (7.1%) showing fixation failures were observed. The factors affecting the incidence of AVN of the femoral head after sustaining fractures correlated well with fracture types in the Garden classification (p = 0.030). The factors affecting fixation failure were the degree of reduction (p = 0.001) measured by the Garden alignment index and firm fixation (p = 0.009) assessed using the technique of 3-point fixation through the inferomedial cortical bone of the femoral neck. The complication rates for subcapital femoral neck fractures were lower than those previously reported; hence, internal fixation could be a primary treatment option for these fractures.

  5. [Isolated true aneurysm of the deep femoral artery].

    PubMed

    Salomon du Mont, L; Holzer, T; Kazandjian, C; Saucy, F; Corpataux, J M; Rinckenbach, S; Déglise, S

    2016-07-01

    Aneurysms of the deep femoral artery, accounting for 5% of all femoral aneurysms, are uncommon. There is a serious risk of rupture. We report the case of an 83-year-old patient with a painless pulsatile mass in the right groin due to an aneurysm of the deep femoral artery. History taking revealed no cardiovascular risk factors and no other aneurysms at other localizations. The etiology remained unclear because no recent history of local trauma or puncture was found. ACT angiography was performed, revealing a true isolated aneurysm of the deep femoral artery with a diameter of 90mm, beginning 1cm after its origin. There were no signs of rupture or distal emboli. Due to unsuitable anatomy for an endovascular approach, the patient underwent open surgery, with exclusion of the aneurysm and interposition of an 8-mm Dacron graft to preserve deep femoral artery flow. Due to their localization, the diagnosis and the management of aneurysms of the deep femoral artery can be difficult. Options are surgical exclusion or an endovascular approach in the absence of symptoms or as a bridging therapy. If possible, blood flow to the distal deep femoral artery should be maintained, the decision depending also on the patency of the superficial femoral artery. In case of large size, aneurysms of the deep femoral artery should be treated without any delay.

  6. A76-0634. 1/50 Scale Model Of The 80X120 Foot Wind Tunnel Model (Nfac) In The Test Section Of The 40X80 Foot Wind Tunnel.

    NASA Image and Video Library

    1996-06-27

    (03/12/1976) 1/50 scale model of the 80x120 foot wind tunnel model (NFAC) in the test section of the 40x80 foot wind tunnel. Model mounted on a rotating ground board designed for this test, viewed from the west, oriented for North wind.

  7. Energy-Filtered Scanning Tunneling Microscopy using a Semiconductor Tip

    NASA Astrophysics Data System (ADS)

    Sutter, P.; Zahl, P.; Sutter, E.; Bernard, J. E.

    2003-04-01

    The use of cleaved, [111]-oriented monocrystalline InAs probe tips enables state-specific imaging in constant-current filled-state scanning tunneling microscopy. On Si(111)-(7×7), the adatom or rest-atom dangling-bond states can thus be mapped selectively at different tip-sample bias. This state-selective imaging is made possible by energy gaps in the projected bulk band structure of the semiconductor probe. The lack of extended bulk states in these gaps gives rise to efficient energy filtering of the tunneling current, to which only sample states not aligned with a gap contribute significantly.

  8. Correlation Between Residual Displacement and Osteonecrosis of the Femoral Head Following Cannulated Screw Fixation of Femoral Neck Fractures.

    PubMed

    Wang, Chen; Xu, Gui-Jun; Han, Zhe; Jiang, Xuan; Zhang, Cheng-Bao; Dong, Qiang; Ma, Jian-Xiong; Ma, Xin-Long

    2015-11-01

    The aim of the study was to introduce a new method for measuring the residual displacement of the femoral head after internal fixation and explore the relationship between residual displacement and osteonecrosis with femoral head, and to evaluate the risk factors associated with osteonecrosis of the femoral head in patients with femoral neck fractures treated by closed reduction and percutaneous cannulated screw fixation.One hundred and fifty patients who sustained intracapsular femoral neck fractures between January 2011 and April 2013 were enrolled in the study. All were treated with closed reduction and percutaneous cannulated screw internal fixation. The residual displacement of the femoral head after surgery was measured by 3-dimensional reconstruction that evaluated the quality of the reduction. Other data that might affect prognosis were also obtained from outpatient follow-up, telephone calls, or case reviews. Multivariate logistic regression analysis was applied to assess the intrinsic relationship between the risk factors and the osteonecrosis of the femoral head.Osteonecrosis of the femoral head occurred in 27 patients (18%). Significant differences were observed regarding the residual displacement of the femoral head and the preoperative Garden classification. Moreover, we found more or less residual displacement of femoral head in all patients with high quality of reduction based on x-ray by the new technique. There was a close relationship between residual displacement and ONFH.There exists limitation to evaluate the quality of reduction by x-ray. Three-dimensional reconstruction and digital measurement, as a new method, is a more accurate method to assess the quality of reduction. Residual displacement of the femoral head and the preoperative Garden classification were risk factors for osteonecrosis of the femoral head. High-quality reduction was necessary to avoid complications.

  9. Introduction to cryogenic wind tunnels

    NASA Technical Reports Server (NTRS)

    Goodyer, M. J.

    1985-01-01

    The background to the evolution of the cryogenic wind tunnel is outlined, with particular reference to the late 60's/early 70's when efforts were begun to re-equip with larger wind tunnels. The problems of providing full scale Reynolds numbers in transonic testing were proving particularly intractible, when the notion of satisfying the needs with the cryogenic tunnel was proposed, and then adopted. The principles and advantages of the cryogenic tunnel are outlined, along with guidance on the coolant needs when this is liquid nitrogen, and with a note on energy recovery. Operational features of the tunnels are introduced with reference to a small low speed tunnel. Finally the outstanding contributions are highlighted of the 0.3-Meter Transonic Cryogenic Tunnel (TCT) at NASA Langley Research Center, and its personnel, to the furtherance of knowledge and confidence in the concept.

  10. Femoral shaft medialisation and neck-shaft angle in unstable pertrochanteric femoral fractures.

    PubMed

    Pajarinen, J; Lindahl, J; Savolainen, V; Michelsson, O; Hirvensalo, E

    2004-12-01

    We analysed the time-dependent mean changes in the femoral neck length, neck-shaft angle and hip offset in a randomised study comprising 48 patients who were treated with the dynamic hip screw (DHS) or the proximal femoral nail (PFN) for an unstable intertrochanteric femoral fracture. As a consequence of fracture compression, the mean post-operative neck length was significantly shorter in patients treated with the DHS. During the first 6 weeks after the operation, a mean decrease of 4.6 degrees was observed in the neck-shaft angle, but there was not a significant difference between the treatment groups. The radiographic measures remained virtually unaffected during the interval from 6 weeks to 4 months in both groups. When the operated hip was compared to the opposite hip, patients who had received the DHS showed significantly greater medialisation of the femoral shaft at 4 months than those treated with the PFN. We thus recommend that unstable intertrochanteric fractures should be initially reduced in a slight valgus position in order to achieve an outcome after healing that is as normal as possible. As a result of differences in operative technique and implant stability, the PFN may be superior to the DHS in retaining the anatomical relations in the hip region in unstable intertrochanteric fractures.

  11. Pitfalls of femoral titanium elastic nailing.

    PubMed

    Salonen, A; Lahdes-Vasama, T; Mattila, V M; Välipakka, J; Pajulo, O

    2015-06-01

    Despite several potential complications of elastic intramedullary nailing, it is currently the treatment of choice for femoral diaphyseal fractures in school-aged children. This study aimed to critically evaluate the complications of titanium elastic nailing in pediatric femoral shaft fractures. This study evaluated patients with a diaphyseal femoral fracture treated with titanium elastic nailing (TEN) in Tampere University Hospital in Finland. The study group included 32 children with a mean age of 9 years during a 5-year period, from 1 January 2003 to 31 December 2007. Data were collected from medical records and x-rays. Mean follow-up time was 42 months. Of 32 patients, 9 (28%) reported a postoperative complication. Complications were associated with nail prominence in five (16%) patients and instability in four (12%) patients. In patients with nail prominence, the titanium elastic nailing-nail ends were unbent and 10-35 mm outside the cortex of the distal femur. The nail prominence caused pain and delayed knee mobilization until the nail was removed after a mean time of 4 months. In patients with fracture instability, the mean titanium elastic nailing-nail/medullary canal diameter ratio was 46% and periosteal callus formation was 5.4 mm at the first control. In those with stable fractures, the values were 66% and 9.2 mm, respectively. Based on this study, two types of pitfalls in a small volume center were found. Titanium elastic nail ends were left unbent and too long. We recommend palpating the nail ends to exclude nail prominence and to verify free movement of the knee after nail cutting and bending. Fracture instability was caused by inserting titanium elastic nailing-nails that were too narrow. To avoid this complication, careful preoperative planning to select the proper-size titanium elastic nailing-nails and intraoperative testing of fracture stability under continuous fluoroscopy after the operation is advised. © The Finnish Surgical Society 2014.

  12. Tunnel magnetoresistance properties and film structures of double MgO barrier magnetic tunnel junctions

    NASA Astrophysics Data System (ADS)

    Gan, H. D.; Ikeda, S.; Shiga, W.; Hayakawa, J.; Miura, K.; Yamamoto, H.; Hasegawa, H.; Matsukura, F.; Ohkubo, T.; Hono, K.; Ohno, H.

    2010-05-01

    The authors fabricated double MgO barrier magnetic tunnel junctions (MTJs) with 3-nm-thick Co40Fe40B20 free layer. When annealed at 350 °C, tunnel magnetoresistance (TMR) ratio at room temperature was 130%, much lower than that (297%) of single MgO barrier MTJs processed and annealed under the same condition. The middle CoFeB free layer sandwiched between the two MgO barriers was found to be mostly amorphous. Replacement of the Co40Fe40B20 free layer by a highly oriented Co50Fe50 layer and a composite Co50Fe50/Co40Fe40B20 layer led to the enhanced TMR ratios up to 165% and 212% at annealing temperature of 350 °C, respectively.

  13. Overgrowth of the femoral neck after hip fractures in children.

    PubMed

    Kuo, Feng-Chih; Kuo, Shu-Jui; Ko, Jih-Yang

    2016-04-26

    Overgrowth after pediatric femoral shaft fractures is well documented; however, overgrowth of the femoral neck after hip fractures has not been especially reported previously. The purpose of this study was to evaluate the incidence and characteristics of femoral neck overgrowth after hip fractures in children. From January 1990 to December 2012, there were 30 consecutive patients with pediatric hip fractures. We retrospectively reviewed the medical record of all the patients, including age at injury, gender, injury mechanism, fracture type, methods of treatment, time to bony union, and complications. The functional outcome was evaluated by Ratliff's criteria. The radiography of the pelvis was performed in controlled positions of abduction and external rotation. The length of the femoral neck was measured by two observers. The overgrowth of the femoral neck was defined as lengthening more than 3 mm in comparison with the uninjured hip. At a mean follow-up of 4.9 years (range 2-8 years), 12 patients (40 %) had an overgrowth of the femoral neck. The average overgrowth of the femoral neck was 6.2 mm (range 3.2-8.5 mm). The patients with femoral neck overgrowth were younger (p = 0.0002), have lower rate of avascular necrosis of the femoral head (p = 0.0006), and have better functional outcome (p = 0.0026). Our results provide evidence that overgrowth of the femoral neck following hip fractures may occur in children and the overgrowth phenomenon in the femoral neck was a predictor of good outcomes after treatment.

  14. Role of Sonography in Clinically Occult Femoral Hernias.

    PubMed

    Brandel, David W; Girish, Gandikota; Brandon, Catherine J; Dong, Qian; Yablon, Corrie; Jamadar, David A

    2016-01-01

    The purpose of this article is to evaluate the diagnostic accuracy of sonography in clinically occult femoral hernias and to describe our sonographic technique. The clinical and imaging data for 93 outpatients referred by general surgeons, all of whom underwent sonographic evaluation and surgery, were reviewed retrospectively. Of these, 55 patients who underwent surgical exploration for groin hernias within 3 months of sonography and met all inclusion criteria were included in the study. The sonographic technique involves using the pubic tubercle as an osseous landmark to identify and appropriately visualize the femoral canal. The Valsalva maneuver is then used to differentiate the movement of normal fat (a potential pitfall) from true herniation in the femoral canal. Surgical findings were used as the reference standard by which sonographic results were judged. Two-by-two contingency tables were used to calculate the sensitivity, specificity, positive predictive value, and negative predictive value. In these 55 patients, surgery revealed 15 femoral hernias. Eight femoral hernias occurred in women, and 7 occurred in men. For diagnosing femoral hernias, sonography demonstrated sensitivity of 80%, specificity of 88%, a positive predictive value of 71%, and a negative predictive value of 92%. True-positive cases of femoral hernias have a sonographic appearance of a hypoechoic sac with speckled internal echoes. When examining during the Valsalva maneuver, a femoral hernia passes deep to the inguinal ligament, expands the femoral canal, displacing the normal canal fat, and effaces the femoral vein. Sonography can exclude femoral hernias with high confidence in light of its exceptional negative predictive value. With attention to technique and imaging criteria, the diagnostic accuracy of sonography can be enhanced.

  15. Femoral neck preservation in total hip replacement.

    PubMed

    Pipino, F; Molfetta, L

    1993-01-01

    Preservation of the femoral neck in hip arthroplasty creates a particular biomechanical situation which is clearly different from what is found even after partial neck removal. The femoral neck consists in fact of a "cylinder of cortical bone" that can be used as the "base" for anchoring the stem to the femur, in contrast to the press-fit procedure or other solutions. The mechanical and biological advantages are as follows: 1) Primary triplanar stem stability, in particular rotational stability. Rotational movements of the stem are blocked by the tough lateral cortical cylinder of the neck. Resistance to varus-valgus stress and collapse is also increased vertically and frontally. 2) Proximal cortical fixation. Primary fixation of the stem is provided by the neck cortex, whereas its mid-distal part is merely held by the metaphyseal cancellous bone and the tip is undersized with respect to the medullary canal. 3) Stress loads distributed along physiological lines of stress. Retention of the neck permits preservation of the trabecular systems, along which the stress is distributed towards the diaphysis and the greater trochanter. 4) Elasticity of the bone-prosthesis system. Most of the stem is contained within the metaphyseal cancellous bone that lies between the prosthesis and the cortical bone, creating a bone-prosthesis module with variable and integrated elasticity. 5) Preservation of the bone-stock. The amount of residual bone following implant of the prosthesis increases, not only because of the presence of the femoral neck, but also as a result of the preservation of most of the metaphyseal cancellous bone. There is therefore greater bone-ingrowth, which is also favoured by the fewer changes in the endosteal blood supply. 6) Prosthesis revision is simpler, since the stem can easily be removed and a second neck resection performed. Our clinical and experimental studies, together with those of Freeman et al., confirm that the femoral neck is present for a long

  16. An anatomical measurement of medial femoral torsion.

    PubMed

    Kim, Ha Y; Lee, Sang K; Lee, Neung K; Choy, Won S

    2012-11-01

    Medial femoral torsion (MFT) can be corrected with derotational osteotomy. Derotational osteotomies can be performed in the proximal or the distal part of the femur. Similar results have been reported for these two procedures. The aim of this study was to evaluate the pathologic location of the MFT by measuring the degree of infratrochanteric and supratrochanteric torsion (STT) of the femur using computed tomography (CT) scans. The current study was carried out in patients with the chief complaint of an in-toeing gait because of the MFT. Sixty-seven patients were enrolled in the study. Forty-one patients (72 lower extremities) were included in the intervention group; 20 patients were included in the cerebral palsy (CP) group (35 lower extremities) and 21 patients were included in the developmental MFT group [developmental femoral torsional (DF) group, 37 lower extremities]. The control group included 26 patients (33 lower extremities) with uninjured limbs with a femoral or a tibial fracture. In this study, torsional angles [MFT, STT and infratrochanteric torsion (ITT)] were measured on CT scan using picture archiving and communication system measurement tools. To measure the STT and ITT, the most prominent points of the lesser and the greater trochanter were marked on CT scans; these two points were connected and were defined as the intertrochanteric line (ITL). The angle between the ITL and the axis of the femoral neck was defined as the STT. The angle between the ITL and the axis of the condylar axis was defined as the ITT. Two authors measured the MFT, STT, and ITT angles of each femur independently. The twisting of the femur had occurred in a different location for each case. In all groups, however, STT was reduced with increasing age; this change was statistically significantly. ITT of the each group showed a random distribution. The means of the ITT in the control group and the DF group did not change significantly, and that of the CP group tended to decrease

  17. The effect of a twin tunnel on the propagation of ground-borne vibration from an underground railway

    NASA Astrophysics Data System (ADS)

    Kuo, K. A.; Hunt, H. E. M.; Hussein, M. F. M.

    2011-12-01

    Accurate predictions of ground-borne vibration levels in the vicinity of an underground railway are greatly sought after in modern urban centres. Yet the complexity involved in simulating the underground environment means that it is necessary to make simplifying assumptions about this system. One such commonly made assumption is to ignore the effects of neighbouring tunnels, despite the fact that many underground railway lines consist of twin-bored tunnels, one for the outbound direction and one for the inbound direction. This paper presents a unique model for two tunnels embedded in a homogeneous, elastic fullspace. Each of these tunnels is subject to both known, dynamic train forces and dynamic cavity forces. The net forces acting on the tunnels are written as the sum of those tractions acting on the invert of a single tunnel, and those tractions that represent the motion induced by the neighbouring tunnel. By apportioning the tractions in this way, the vibration response of a two-tunnel system is written as a linear combination of displacement fields produced by a single-tunnel system. Using Fourier decomposition, forces are partitioned into symmetric and antisymmetric modenumber components to minimise computation times. The significance of the interactions between two tunnels is quantified by calculating the insertion gains, in both the vertical and horizontal directions, that result from the existence of a second tunnel. The insertion-gain results are shown to be localised and highly dependent on frequency, tunnel orientation and tunnel thickness. At some locations, the magnitude of these insertion gains is greater than 20 dB. This demonstrates that a high degree of inaccuracy exists in any surface vibration prediction model that includes only one of the two tunnels. This novel two-tunnel solution represents a significant contribution to the existing body of research into vibration from underground railways, as it shows that the second tunnel has a significant

  18. Bone tunnel change develops within two weeks of double-bundle anterior cruciate ligament reconstruction using hamstring autograft: A comparison of different postoperative immobilization periods using computed tomography.

    PubMed

    Shimizu, Ryo; Adachi, Nobuo; Ishifuro, Minoru; Nakamae, Atsuo; Ishikawa, Masakazu; Deie, Masataka; Ochi, Mitsuo

    2017-10-01

    The purpose of this study was to evaluate bone tunnel changes following anterior cruciate ligament (ACL) reconstruction during the early postoperative period using computed tomography (CT), and to understand the impact of postoperative immobilization on these changes. Twenty patients who underwent double-bundle ACL reconstruction using hamstring tendon autografts were included. We subcategorized patients into two groups: patients who underwent isolated ACL reconstruction and had three days of knee immobilization (Group A, n=10); and patients with concomitant meniscus injuries who underwent ACL reconstruction and meniscus repair simultaneously (Group B, n=10) had their knees immobilized for two weeks after surgery. Bone tunnel enlargement was evaluated using CT imaging at one to three days, two weeks, one month, three months and six months after surgery. The cross-sectional area of the femoral and tibial tunnels was measured, and enlargement rate was calculated. The tunnel center location at two weeks after surgery was also evaluated. The mean cross-sectional area adjacent to the joint space of the femoral and tibial tunnels significantly increased immediately after surgery, especially in the first month (P<0.01). However, after one to six months they were not increased (P>0.01). There was no significant difference in tunnel enlargement rate between group A and B. Tunnel center location changed even in the first two weeks. Bone tunnel enlargement following double-bundle ACL reconstruction occurred at an earlier time point after surgery than anticipated. Postoperative immobilization could not prevent bone tunnel enlargement, but might prevent tunnel migration. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. The Role of Fibers in the Femoral Attachment of the Anterior Cruciate Ligament in Resisting Tibial Displacement

    PubMed Central

    Kawaguchi, Yasuyuki; Kondo, Eiji; Takeda, Ryo; Akita, Keiichi; Yasuda, Kazunori; Amis, Andrew A.

    2015-01-01

    to reconstruct the ACL to restore normal knee function, including where is the best place for ACL graft tunnels. This study found that the most important area on the femur, in terms of resisting displacement of the tibia, was in the central-anterior part of the femoral ACL attachment, near the roof of the intercondylar notch. The testing protocol did not lead to data that would support using a large ACL graft tunnel that attempts to cover the whole natural femoral attachment area. PMID:25530509

  20. An evaluation of CT-scan to locate the femoral head centre and its implication for hip surgeons.

    PubMed

    Viste, Anthony; Trouillet, Franck; Testa, Rodolphe; Chèze, Laurence; Desmarchelier, Romain; Fessy, Michel-Henri

    2014-04-01

    The aim of this preliminary study was to determine the accuracy of CT-scan to locate the femoral head centre. Eleven dried femurs were included for study. Three techniques were compared to determine femoral head centre (FHC) location: CT-scan, Motion Analysis and Faro-Arm. Markers were stuck on each femur to create a system of coordinates. Femurs lied on their posterior parts (bicondylar plane). Several points around the femoral head were palpated (Motion Analysis and Faro-Arm) or determined (Amira software for CT-scans). By a least-square regression method, the FHC location in 3D was defined for each technique. The results of the FHC location determined by the CT-scan technique were compared with those measured by the faro-arm and the Motion Analysis techniques. The coordinates (X, Y, Z) of the FHC were compared between the three methods, and no statistical difference was found (p = 0.99). In a 3D plot, this gave a mean difference of 1.3 mm. The mean radius of the femoral head was of 22.5 mm (p = 0.6). CT-scan is as accurate and reliable as gold-standard techniques (motion and faro-arm). Locating FHC before and after hip arthroplasty would allow hip surgeons to determine and compare 3D orientation of the upper-end of femur: offset, height and anteversion.

  1. "Phantom" carpal tunnel syndrome.

    PubMed

    Braverman, D L; Root, B C

    1997-10-01

    Phantom sensation is ubiquitous among persons who have had amputation; however, if it develops into phantom pain, a thorough clinical investigation must ensue. We illustrate this with the case of a 49-year-old woman, 14 years after traumatic amputation of her left 2nd through 5th fingers, and 10 years after traumatic left transfemoral amputation. She had had phantom sensation in her absent fingers for years and developed progressive pain in her phantom fingers 3 months before presentation. Nerve conduction study revealed a high-normal distal motor latency of the left median nerve and a positive Bactrian test (sensitivity 87%). She was diagnosed with "phantom" carpal tunnel syndrome and treated with a resting wrist splint, decreased weight bearing on the left upper limb, and two corticosteroid carpal tunnel injections with marked improvement. Clinicians should recognize that phantom pain may be referred from a more proximal region and may be amenable to conservative management.

  2. Uncooled tunneling infrared sensor

    NASA Technical Reports Server (NTRS)

    Kenny, Thomas W. (Inventor); Kaiser, William J. (Inventor); Podosek, Judith A. (Inventor); Vote, Erika C. (Inventor); Rockstad, Howard K. (Inventor); Reynolds, Joseph K. (Inventor)

    1994-01-01

    An uncooled infrared tunneling sensor in which the only moving part is a diaphragm which is deflected into contact with a micromachined silicon tip electrode prepared by a novel lithographic process. Similarly prepared deflection electrodes employ electrostatic force to control the deflection of a silicon nitride, flat diaphragm membrane. The diaphragm exhibits a high resonant frequency which reduces the sensor's sensitivity to vibration. A high bandwidth feedback circuit controls the tunneling current by adjusting the deflection voltage to maintain a constant deflection of the membrane which would otherwise change deflection depending upon incident infrared radiation. The resulting infrared sensor will meet or exceed the performance of all other broadband, uncooled, infrared sensors and can be miniaturized to pixel dimensions smaller than 100 .mu.m. The technology is readily implemented as a small-format linear array suitable for commercial and spacecraft applications.

  3. Tunneling in axion monodromy

    DOE PAGES

    Brown, Jon; Cottrell, William; Shiu, Gary; ...

    2016-10-06

    The Coleman formula for vacuum decay and bubble nucleation has been used to estimate the tunneling rate in models of axion monodromy in recent literature. However, several of Coleman’s original assumptions do not hold for such models. Here we derive a new estimate with this in mind using a similar Euclidean procedure. We find that there are significant regions of parameter space for which the tunneling rate in axion monodromy is not well approximated by the Coleman formula. However, there is also a regime relevant to large field inflation in which both estimates parametrically agree. As a result, we alsomore » briefly comment on the applications of our results to the relaxion scenario.« less

  4. Tunneling in axion monodromy

    SciTech Connect

    Brown, Jon; Cottrell, William; Shiu, Gary; Soler, Pablo

    2016-10-06

    The Coleman formula for vacuum decay and bubble nucleation has been used to estimate the tunneling rate in models of axion monodromy in recent literature. However, several of Coleman’s original assumptions do not hold for such models. Here we derive a new estimate with this in mind using a similar Euclidean procedure. We find that there are significant regions of parameter space for which the tunneling rate in axion monodromy is not well approximated by the Coleman formula. However, there is also a regime relevant to large field inflation in which both estimates parametrically agree. As a result, we also briefly comment on the applications of our results to the relaxion scenario.

  5. Possibility of hyperbolic tunneling

    SciTech Connect

    Lobo, Francisco S. N.; Mimoso, Jose P.

    2010-08-15

    Traversable wormholes are primarily useful as 'gedanken experiments' and as a theoretician's probe of the foundations of general relativity. In this work, we analyze the possibility of having tunnels in a hyperbolic spacetime. We obtain exact solutions of static and pseudo-spherically symmetric spacetime tunnels by adding exotic matter to a vacuum solution referred to as a degenerate solution of class A. The physical properties and characteristics of these intriguing solutions are explored, and through the mathematics of embedding it is shown that particular constraints are placed on the shape function, that differ significantly from the Morris-Thorne wormhole. In particular, it is shown that the energy density is always negative, and the radial pressure is positive, at the throat, contrary to the Morris-Thorne counterpart. Specific solutions are also presented by considering several equations of state, and by imposing restricted choices for the shape function or the redshift function.

  6. Tunnel boring machine

    SciTech Connect

    Snyder, L. L.

    1985-07-09

    A tunnel boring machine for controlled boring of a curvilinear tunnel including a rotating cutter wheel mounted on the forward end of a thrust cylinder assembly having a central longitudinal axis aligned with the cutter wheel axis of rotation; the thrust cylinder assembly comprising a cylinder barrel and an extendable and retractable thrust arm received therein. An anchoring assembly is pivotally attached to the rear end of the cylinder barrel for anchoring the machine during a cutting stroke and providing a rear end pivot axis during curved cutting strokes. A pair of laterally extending, extendable and retractable arms are fixedly mounted at a forward portion of the cylinder barrel for providing lateral displacement in a laterally curved cutting mode and for anchoring the machine between cutting strokes and during straight line boring. Forward and rear transverse displacement and support assemblies are provided to facilitate cutting in a transversely curved cutting mode and to facilitate machine movement between cutting strokes.

  7. Photon scanning tunneling microscopy

    SciTech Connect

    Goudonnet, J.P.; Salomon, L.; De Fornel, F.; Chabrier, G. . Lab. de Physique du Solide); Warmack, R.J.; Ferrell, T.L. )

    1990-01-01

    The Photon Scanning Tunneling Microscopy (PSTM) is the photon analogue of the electron Scanning Tunneling Microscope (STM). It uses the evanescent field due to the total internal reflection of a light beam in a Total Internal Reflection (TIR) prism. The sample, mounted on the base of the prism, modulates the evanescent field. A sharpened optical fiber probes this field, and the collected light is processed to generate an image of the topography and the chemical composition of the surface. We give, in this paper, a description of the microscope and discuss the influence of several parameters such as -- polarization of light, angle of incidence, shape of the end of the fiber -- on the resolution. Images of various samples -- glass samples, teflon spheres -- are presented. 8 refs., 7 figs.

  8. Tunnel magnetoresistance of diamondoids

    NASA Astrophysics Data System (ADS)

    Matsuura, Yukihito

    2016-10-01

    Tunnel magnetoresistance (TMR) of diamondoids has been predicted by first principles density functional theory. Diamantane was used as a basic molecular proxy for diamondoids because hydrogen atoms in the apical position are easily substituted for a thiol group. The pristine diamantane exhibited a low TMR ratio of 7%, and boron-substitution considerably decreased the TMR ratio. Conversely, nitrogen-substitution enhanced the TMR ratio by up to 20%. Heteroatom-substitution changes the tunneling probabilities by varying the molecular bond lengths. Furthermore, when the spins of the electrodes are parallel, the heteroatoms resulted in transmittance probabilities at an energy range near the Fermi level. Consequently, heteroatom-substitution can control the TMR ratios of diamondoids very well.

  9. Epitaxial complex oxide tunnel barriers

    NASA Astrophysics Data System (ADS)

    Son, Junwoo; Moetakef, Pouya; Cagnon, Joël; Stemmer, Susanne

    2009-03-01

    Tunnel junctions with complex oxide thin film barriers are of interest for studies of the critical thickness of ferroelectricity, of phonon modes in ultrathin films and of traps by inelastic tunneling spectroscopy. We show that high-quality epitaxial SrTiO3 and BaTiO3 tunnel barriers can be grown on Pt bottom electrodes. Coherent, epitaxial Pt films with roughness of less than a unit cell were grown on (001) SrTiO3 to serve as bottom electrodes for epitaxial SrTiO3 and BaTiO3 tunnel barriers. All interfaces were atomically abrupt as confirmed by atomic resolution Z-contrast imaging. The IV characteristics were non-linear, demonstrating good insulating properties. For the SrTiO3 barriers and voltage sweeps up to ± 0.5 V, the measured tunnel current was independent of the sweep direction. At low biases, dynamic conductance curves showed a symmetrical parabolic shape around the origin in both resistance states. At high bias, deviation from the ideal tunnel behavior was observed. A large increase of the tunnel conductance occurred above a minimum positive bias. A dramatic decrease of tunnel conductance occurred for a large negative bias, indicating bipolar switching. We show the contributions to the resistive switching. Phonon modes and traps are determined using inelastic tunneling spectroscopy with both paraelectric and ferroelectric tunnel barriers.

  10. Full Scale Tunnel (FST)

    NASA Technical Reports Server (NTRS)

    1930-01-01

    Installation of Full Scale Tunnel (FST) power plant. Virginia Public Service Company could not supply adequate electricity to run the wind tunnels being built at Langley. (The Propeller Research Tunnel was powered by two submarine diesel engines.) This led to the consideration of a number of different ideas for generating electric power to drive the fan motors in the FST. The main proposition involved two 3000 hp and two 1000 hp diesel engines with directly connected generators. Another, proposition suggested 30 Liberty motors driving 600 hp DC generators in pairs. For a month, engineers at Langley were hopeful they could secure additional diesel engines from decommissioned Navy T-boats but the Navy could not offer a firm commitment regarding the future status of the submarines. By mid-December 1929, Virginia Public Service Company had agreed to supply service to the field at the north end of the King Street Bridge connecting Hampton and Langley Field. Thus, new plans for FST powerplant and motors were made. Smith DeFrance described the motors in NACA TR No. 459: 'The most commonly used power plant for operating a wind tunnel is a direct-current motor and motor-generator set with Ward Leonard control system. For the FST it was found that alternating current slip-ring induction motors, together with satisfactory control equipment, could be purchased for approximately 30 percent less than the direct-current equipment. Two 4000-horsepower slip-ring induction motors with 24 steps of speed between 75 and 300 r.p.m. were therefore installed.'

  11. Diffraction as tunneling

    NASA Technical Reports Server (NTRS)

    Nussenzveig, H. M.; Wiscombe, W. J.

    1987-01-01

    A new approximation to the short-wavelength scattering amplitude from an impenetrable sphere is presented. It is uniform in the scattering angle and it is more accurate than previously known approximations (including Fock's theory of diffraction) by up to several orders of magnitude. It remains valid in the transition to long-wavelength scattering. It leads to a new physical picture of diffraction, as tunneling through an inertial barrier.

  12. Tarsal tunnel syndrome.

    PubMed

    Gould, John S

    2011-06-01

    Tarsal tunnel syndrome, unlike its similar sounding counterpart in the hand, is a significantly misunderstood clinical entity. Confusion concerning the anatomy involved, the presenting symptomatology, the appropriateness and significance of various diagnostic tests, conservative and surgical management, and, finally, the variability of reported results of surgical intervention attests to the lack of consensus surrounding this condition. The terminology involved in various diagnoses for chronic heel pain is also a hodgepodge of poorly understood entities.

  13. Counter Tunnel Project

    DTIC Science & Technology

    2014-03-01

    ADMINISTRATIVE INFORMATION The work described in this report was performed by the Unmanned Systems Science & Technology Branch (Code 71710) and the...Earth™ is a trademark of Google Inc. Released by T. Pastore, Head Unmanned Systems Science & Technology Branch Under authority of A. D...Ramirez. Head Advanced Systems & Applied Sciences Division EXECUTIVE SUMMARY Covert cross-border tunnels are a security vulnerability that enables

  14. Compressive femoral neuropathy: a rare complication of anticoagulation.

    PubMed

    Ong, H S

    2007-03-01

    The most common coagulation disorder associated with warfarin use is bleeding, but compressive femoral neuropathy is an unusual presentation. A 63-year-old man with compressive femoral neuropathy from an iliacus haematoma is reported. The diagnosis was confirmed on magnetic resonance imaging and treated conservatively with good clinical response and radiological evidence of resolution.

  15. Routine femoral head fluoroscopy to reduce complications in coronary catheterization

    PubMed Central

    Jacobi, Joshua A.; Schussler, Jeffrey M.

    2009-01-01

    We tested whether routine preprocedure fluoroscopy of the femoral head would improve sheath placement or reduce the incidence of groin complications. Patients were randomized to receive either fluoroscopy or “blind” sheath placement using palpation alone. The location of the femoral sheath was established by femoral artery angiography. Sheath placement in relation to the femoral head, arterial location, and complication rates were compared. Placement was considered “ideal” if the sheath was in the common femoral artery and in the top or middle third of the femoral head. A total of 256 patients were enrolled. There was no difference in average age, body mass index (BMI), or rate of anticoagulation between the groups. There was no major bleeding in either group. The overall risk of minor bleeding was not statistically different. The treatment group showed higher “ideal” placement relative to the femoral head. In patients who had a BMI ≥30 kg/m2, the difference between the groups was statistically significant (treatment 69% vs control 50%). In conclusion, routine femoral fluoroscopy prior to sheath placement in coronary angiography and angioplasty did not significantly alter bleeding or complication rates but did increase the likelihood of ideal placement, especially in obese patients. PMID:19169390

  16. Peripheral blood stem cell transplantation for ischemic femoral head necrosis.

    PubMed

    Song, H-J; Lan, B-Sh; Cheng, B; Zhang, K-F; Yan, H-W; Wang, W-Zh; Gao, Z-Q

    2010-06-01

    Avascular necrosis of the femoral head (ANFH) is a highly mutilating disease. There is no effective way to treat femoral head ischemia. This study was designed to show the curative effects of peripheral blood stem cell transplantation to induce vascular regeneration and improve ischemic femoral head necrosis in rabbits. Twenty New Zealand white rabbits underwent ischemic femoral head necrosis in both hindlimbs using liquid-nitrogen refrigeration. One cohort of rats was intraperitoneally injected with granulocyte-specific colony-stimulating factor (250 microg/kg/d), and control animals received equivalent saline solution. The right side was used as the transplantation group and the left as the control. After separation of peripheral blood, a stem cell suspension was poured into the right femoral artery and saline solution into the left femoral artery. At 4 weeks after peripheral stem cell transplantation, standing ability and activity of the the transplanted right hindlimb were remarkably improved, but there were no obvious changes in the control limbs. The experimental rabbits underwent arteriography of bilateral femoral heads, which indicated increased and thickened blood supply to the transplanted right hindlimb compared with the left control. Peripheral blood stem cell transplantation improved ischemic femoral head necrosis.

  17. REcanalisation and Balloon-Oriented Puncture for Re-Insertion of Dialysis Catheter in Nonpatent Central Veins (REBORN).

    PubMed

    Too, Chow Wei; Sayani, Raza; Lim, Elvin Yuan Ting; Leong, Sum; Gogna, Apoorva; Teo, Terence K

    2016-08-01

    To describe a technique involving REcanalisation and Balloon-Oriented puncture for Re-insertion of dialysis catheter in Nonpatent central veins (REBORN) and to report long-term results. This is a retrospective study of ten subjects in whom dialysis catheters were inserted using the REBORN technique from March 2012 to October 2014 and followed up till April 2016. Data on the duration of catheter usage, complications and reasons for removal were obtained. Seven patients had partially occluded lower internal jugular veins (IJV) recanalised in an antegrade fashion via a more cranial puncture. The balloon was then inflated at usual puncture site with an 18G needle. The collapsed balloon was cannulated with a guide wire, and both balloon and guide wire were advanced together into the superior vena cava. This was followed by tunnelled catheter placement using standard techniques. Two patients had catheters placed in the subclavian vein using a similar antegrade technique, and one patient had catheter placed via the left IJV following retrograde recanalisation from a right femoral puncture. Mean duration of catheter use was 278 days (range 32-503). Three catheters were removed due to matured arteriovenous accesses. Four patients had successful catheter change over the same subcutaneous track due to catheter malfunction. One catheter was removed after 7 months because of sepsis. No complications were reported. The REBORN technique allows for the preservation of central veins for future haemodialysis access, which can be challenging in patients requiring long-term dialysis.

  18. Evaluating tunnel kiln performance

    SciTech Connect

    O`Connor, K.R.; Carty, W.M.; Ninos, N.J.

    1997-08-01

    Process improvements in the production of whitewares provide the potential for substantial savings for manufacturers. A typical whiteware manufacturer incurs an annual defective product loss of {approximately}$20 million when accounting for raw materials, energy, labor and waste disposal. Reduction in defective product loss of 1% could result in a savings in excess of $1 million annually. This study was designed to establish benchmarks for two conventional tunnel kilns used to bisque-fire dinnerware at Buffalo China Inc. (Buffalo, NY). The benchmark was established by assessing the current conditions and variability of the two tunnel kilns as a function of the fracture strength of sample bars that were made from production body. Sample bars were fired in multiple locations in both kilns to assess the conditions and variability of firing within each kiln. Comparison of strength results between the two kilns also was assessed. These comparisons were accomplished through applied statistical analysis, wherein significant statistical variations were identified and isolated for both tunnel kilns. The statistical methods and tools used in this analysis are readily accessible to manufacturers, thus allowing implementation of similar analysis, or benchmarking, in-house.

  19. Resonant Tunneling Spin Pump

    NASA Technical Reports Server (NTRS)

    Ting, David Z.

    2007-01-01

    The resonant tunneling spin pump is a proposed semiconductor device that would generate spin-polarized electron currents. The resonant tunneling spin pump would be a purely electrical device in the sense that it would not contain any magnetic material and would not rely on an applied magnetic field. Also, unlike prior sources of spin-polarized electron currents, the proposed device would not depend on a source of circularly polarized light. The proposed semiconductor electron-spin filters would exploit the Rashba effect, which can induce energy splitting in what would otherwise be degenerate quantum states, caused by a spin-orbit interaction in conjunction with a structural-inversion asymmetry in the presence of interfacial electric fields in a semiconductor heterostructure. The magnitude of the energy split is proportional to the electron wave number. Theoretical studies have suggested the possibility of devices in which electron energy states would be split by the Rashba effect and spin-polarized currents would be extracted by resonant quantum-mechanical tunneling.

  20. Photon scanning tunneling microscopy

    SciTech Connect

    Reddick, R.C.; Warmack, R.J.; Chilcott, D.W.; Sharp, S.L.; Ferrell, T.L. Department of Physics and Astronomy, University of Tennessee, Knoxville, TN )

    1990-12-01

    An optical tunneling microscope is presented that operates in exactly the same way as the electron scanning tunneling microscope (ESTM). It takes advantage of evanescent fields generated by the total internal reflection (TIR) of light at the interface between materials of different optical densities. The photon scanning tunneling microscope (PSTM) employs an optically conducting probe tip to map spatial variations in the evanescent and scattered field intensity distributions adjacent to a sample surface, which forms or is placed on the TIR surface. These variations are due to the local topography, morphology, and optical activity of the surface and form the basis of imaging. Evanescent field theory is discussed and the evanescent field intensity as a function of surface-probe separation is calculated using several probe tip models. After a description of PSTM construction and operation, evanescent field intensity measurements are shown to agree with the model calculations. PSTM images of various sample surfaces demonstrate subwavelength resolution exceeding that of conventional optical microscopy, especially in the vertical dimension. Limitations and interpretation of PSTM images are discussed as well as the PSTMs applicability to other forms of surface analysis.

  1. Smart tunnel: Docking mechanism

    NASA Technical Reports Server (NTRS)

    Schliesing, John A. (Inventor); Edenborough, Kevin L. (Inventor)

    1989-01-01

    A docking mechanism is presented for the docking of a space vehicle to a space station comprising a flexible tunnel frame structure which is deployable from the space station. The tunnel structure comprises a plurality of series connected frame sections, one end section of which is attached to the space station and the other end attached to a docking module of a configuration adapted for docking in the payload bay of the space vehicle. The docking module is provided with trunnions, adapted for latching engagement with latches installed in the vehicle payload bay and with hatch means connectable to a hatch of the crew cabin of the space vehicle. Each frame section comprises a pair of spaced ring members, interconnected by actuator-attenuator devices which are individually controllable by an automatic control means to impart relative movement of one ring member to the other in six degrees of freedom of motion. The control means includes computer logic responsive to sensor signals of range and attitude information, capture latch condition, structural loads, and actuator stroke for generating commands to the onboard flight control system and the individual actuator-attenuators to deploy the tunnel to effect a coupling with the space vehicle and space station after coupling. A tubular fluid-impervious liner, preferably fabric, is disposed through the frame sections of a size sufficient to accommodate the passage of personnel and cargo.

  2. Industrial Orientation.

    ERIC Educational Resources Information Center

    Rasor, Leslie; Brooks, Valerie

    These eight modules for an industrial orientation class were developed by a project to design an interdisciplinary program of basic skills training for disadvantaged students in a Construction Technology Program (see Note). The Drafting module overviews drafting career opportunities, job markets, salaries, educational requirements, and basic…

  3. Cemented femoral stems in patients with DDH.

    PubMed

    Garcia-Cimbrelo, E

    2007-01-01

    Total hip arthroplasty is the procedure of choice for most adult patients with symptomatic arthrosis secondary to developmental dysplasia (DDH), but it requires complex reconstructive techniques, is usually performed in young patients, and has an increased risk of complications. THA is indicated in presence of severe pain and when osteotomy is contraindicated. The complexity of surgery is related to the degree of dysplasia. Anatomic abnormalities in the acetabulum and femur are the cause of the complexity and complications of this procedure. Acetabular bone deficiency requires reconstructive techniques before implanting the cup at the anatomic acetabular location, such as bone autograft augmentation, implanting the cup at higher level of the hip center and cup medialization. Femoral shortening and special cemented or uncemented stems are currently used to avoid intraoperative complications. While a cemented stem needs metaphyseal femoral shortening, subtrochanteric shortening requires a cementless stem. Because of these patients' age, alternative bearing surfaces, such as alumina-on-alumina couples are recommended when possible. Although the long-term results of total hip arthroplasty in DDH are inferior to those in a general population, the results show a high level of pain relief and functional improvement.

  4. Failed internal fixation of femoral neck fractures.

    PubMed

    Hoelsbrekken, Sigurd Erik; Opsahl, Jan-Henrik; Stiris, Morten; Paulsrud, Øyvind; Strømsøe, Knut

    2012-06-12

    There are two types of surgical treatment for fractures of the femoral neck; internal fixation and arthroplasty. Internal fixation is associated with a higher risk of complications such as secondary displacement, non-union and avascular necrosis. To improve treatment results of internal fixation, we have tried to identify procedure related risk-factors associated with fixation failure. A retrospective study was conducted based on the medical records and X-ray images of 337 patients sustaining intracapsular fractures of the hip during the period 1999-2000. The patients were treated with closed reduction and internal fixation at Oslo University Hospital, Aker. The reduction of the fracture and the placement of the fixation implants were evaluated and scored (six points representing best achievable result). Fixation failed in 23 (18,3 %) out of 126 patients with displaced fractures awarded six points for the reduction. In contrast, fixation failed in five (50 %) out of ten patients given a score of three points or less (p = 0.017). The risk of non-union increased when patients were treated more than 48 hours after the initial injury. In this group, 5 (25 %) out of 20 patients developed non-union compared to 16 (8 %) out of 200 patients treated within 48 hours (p = 0.014). Our findings emphasize the importance of achieving anatomical reduction of displaced femoral neck fractures, and to perform surgery within 48 hours unless an acute medical condition needs to be stabilized.

  5. Femoral head banking: NUH tissue bank experience.

    PubMed

    Nather, Aziz; David, Vikram

    2007-04-01

    National University Hospital Tissue Bank protocol follows guidelines recommended by the American Association of Tissue Banks and the European Association of Tissue Banks using donor selection criteria: medical history, clinical examination, chart review and laboratory tests for acquired immunodeficiency syndrome (AIDS), hepatitis B, hepatitis C, syphilis, and specimen for culture/sensitivity tests. For living donors, repeat testing is performed for AIDS and hepatitis C approximately 180 days after procurement. Femoral heads are procured using the "sterile double jar technique" and stored at -80 degrees C. Our first study of 273 consecutive potential donors undergoing hemiarthroplasty from 1989 to 1994 showed that a high percentage (42.5%) was unsuitable for use. A second study involving 175 potential donors was conducted from 1995 to 2003 after hepatitis C screening was introduced. The bacterial contamination rates in both studies (3.5% and 5.7%) are low. The incidence of other diseases also are low: hepatitis B, 2.3% and syphilis, 1.8% in the first study and hepatitis B, 5.7%; hepatitis C, 0.6%; and syphilis, 5.1% in the second cohort. No cases of AIDS were reported in either study. By 2003, femoral heads were transplanted in 205 patients with a low complication rate of 2.9%.

  6. Femoral bone marrow aspiration in live mice.

    PubMed

    Chung, Young Rock; Kim, Eunhee; Abdel-Wahab, Omar

    2014-07-05

    Serial sampling of the cellular composition of bone marrow (BM) is a routine procedure critical to clinical hematology. This protocol describes a detailed step-by-step technical procedure for an analogous procedure in live mice which allows for serial characterization of cells present in the BM. This procedure facilitates studies aimed to detect the presence of exogenously administered cells within the BM of mice as would be done in xenograft studies for instance. Moreover, this procedure allows for the retrieval and characterization of cells enriched in the BM such as hematopoietic stem and progenitor cells (HSPCs) without sacrifice of mice. Given that the cellular composition of peripheral blood is not necessarily reflective of proportions and types of stem and progenitor cells present in the marrow, procedures which provide access to this compartment without requiring termination of the mice are very helpful. The use of femoral bone marrow aspiration is illustrated here for cytological analysis of marrow cells, flow cytometric characterization of the hematopoietic stem/progenitor compartment, and culture of sorted HSPCs obtained by femoral BM aspiration compared with conventional marrow harvest.

  7. Continuous blood gas monitoring in femoral arteries

    NASA Astrophysics Data System (ADS)

    Schlain, Les A.; Spar, Steven M.; Dellinger, Bart

    1995-05-01

    Continuous intra-arterial blood gas monitoring is a potentially valuable tool in the surgical and intensive care arenas. Patient oxygenation and acid base status can change rapidly and without warning. The ability to monitor pHa, PaCO2 and PaO2 in arterial blood will be a major medical advance for the anesthesiologist and intensivist. Intra-arterial blood gas sensors are typically placed in radial arteries. In certain patient populations accurate monitoring is not possible in radial arteries due to arterial environmental factors such as hypotension, vasoconstriction and atherosclerotic disease. These same factors can make radial cannulation difficult resulting in traumatic catheter insertion, thereby further compromising flow conditions. In situations where radial artery flow is expected to be compromised, selecting a large vessel for sensor placement is desirable. We report an initial feasibility study of our blood gas monitoring system using the femoral artery as the sensing site. Clinical results are presented as well as potential advantages and disadvantages associated with monitoring in the femoral artery.

  8. Insights into the Dynamic Response of Tunnels in Jointed Rocks

    SciTech Connect

    Heuze, F E

    2004-11-01

    Tunnels in jointed rocks can be subjected to severe dynamic loads because of rock bursts, coal bumps, and large earthquakes. A series of 3-dimensional simulations was performed, based on discrete element analysis to gain insights into the parameters that influence the response of such tunnels. The simulations looked at the effect of joint set orientation, the effect of joint spacing, the effect of pulse shape for a given displacement, and the influence of using rigid versus deformable blocks in the analyses. The results of this modeling were also compared to field evidence of dynamic tunnel failures. This comparison reinforced the notion that 3-dimensional discrete element analysis can capture very well the kinematics of structures in jointed rock under dynamic loading.

  9. Giant spin-dependent thermoelectric effect in magnetic tunnel junctions.

    PubMed

    Lin, Weiwei; Hehn, Michel; Chaput, Laurent; Negulescu, Béatrice; Andrieu, Stéphane; Montaigne, François; Mangin, Stéphane

    2012-03-20

    Thermoelectric effects in magnetic nanostructures and the so-called spin caloritronics are attracting much interest. Indeed it provides a new way to control and manipulate spin currents, which are key elements of spin-based electronics. Here we report on a giant magnetothermoelectric effect in a magnetic tunnel junction. The thermovoltage in this geometry can reach 1 mV. Moreover a magnetothermovoltage effect could be measured with ratio similar to the tunnel magnetoresistance ratio. The Seebeck coefficient can then be tuned by changing the relative magnetization orientation of the two magnetic layers in the tunnel junction. Therefore, our experiments extend the range of spintronic devices application to thermoelectricity and provide a crucial piece of information for understanding the physics of thermal spin transport.

  10. Klein tunneling in driven-dissipative photonic graphene

    NASA Astrophysics Data System (ADS)

    Ozawa, Tomoki; Amo, Alberto; Bloch, Jacqueline; Carusotto, Iacopo

    2017-07-01

    We theoretically investigate Klein tunneling processes in photonic artificial graphene. Klein tunneling is a phenomenon in which a particle with Dirac dispersion going through a potential step shows a characteristic angle- and energy-dependent transmission. We consider a generic photonic system consisting of a honeycomb-shaped array of sites with losses, illuminated by coherent monochromatic light. We show how the transmission and reflection coefficients can be obtained from the steady-state field profile of the driven-dissipative system. Despite the presence of photonic losses, we recover the main scattering features predicted by the general theory of Klein tunneling. Signatures of negative refraction and the orientation dependence of the intervalley scattering are also highlighted. Our results will stimulate the experimental study of intricate transport phenomena using driven-dissipative photonic simulators.

  11. [Distal femoral periprosthetic fractures: classification and therapy].

    PubMed

    Tomás, T; Nachtnebl, L; Otiepka, P

    2010-06-01

    Periprosthetic fracture is one of the most serious complication of total knee arthroplasty. In our retrospective clinical study we designed our classification with rules for treatment of those fractures. During the last thirty years we treated 53 distal femoral periprosthetic fractures in our orthopaedic department. In our clinical study we reviewed our group of distal femoral periprosthetic fractures with on the basis of X-ray findings, the treatment method used and treatment outcomes. According to our findings we divided distal femoral periprosthetic fractures into six groups: Type I Nondisplaced fractures, 5.7%; treatment failure rate, 33%. Type II a Fractures with lateral comminution (the most often type of fractures), 37.7%; treatment failure rate, 20%. Type II b Fractures with medial comminution, 7.5%; treatment failure rate, 60%. Type II c Fractures above TKA (the second most often type), 34%; treatment failure rate, 18%. Type II d Comminuted fractures, 5.7%; treatment failure rate, 18%. Type IIIFractures with loosening of TKA, 9.4%; treatment failure rate, 20%. For the treatment of fractures we used various methods according to the type of fracture: Plate osteosynthesis in 32 cases, with failure in seven. Three failures in IIa group due to incorrect osteosynthesis with condylar plate, treated by reosteosteosynthesis with same implant. One in IIb group treated primarily with cement plomb, after second failure treated with revision total knee arthroplasty. Two failures in IIc group, treated by reosteosynthesis with spongioplasty using the same implant. One failure in III group solved with revision TKA. Intramedullary nail in nine cases , with failure in two. One failure in IIb group treated by reosteosynthesis with condylar plate and cement plombage. One in IIc group due to infection, solved with extraction of material and second stage revision TKA. Conservative treatment in three cases,with failure in two. One in I group treated with condylar plate. One in

  12. Distal femoral osteotomy using a novel deformity reduction device.

    PubMed

    Panichi, Enrico; Cappellari, Fulvio; Olimpo, Matteo; Piras, Lisa A; Radasch, Robert; Ferretti, Antonio; Peirone, Bruno

    2016-09-20

    Distal femoral osteotomy is a surgical procedure used to correct patellar luxation, secondary to a femoral deformity. A distal femoral osteotomy using the tibial plateau levelling osteotomy-jig to temporarily provide stability of the distal femoral osteotomy, maintaining limb alignment in the frontal and axial planes prior to internal plate fixation of the osteotomy, has been described. This report describes a novel jig named Deformity Reduction Device (DRD). This device was developed with the specific aim of increasing precision and predictability during corrective osteotomy execution in order to be consistent with the preoperative planning. The distal femoral osteotomy DRD-assisted procedure is described in detail, discussing the theoretical and practical principles of the application.

  13. Extensively coated cementless femoral components in revision hip arthroplasty.

    PubMed

    Greidanus, N; Antoniou, J; Paprosky, W

    2000-01-01

    A septic loosening and osteolysis can compromise the available host bone in patients requiring revision hip arthroplasty. Secure fixation of revision femoral components may not be possible if reliant only on proximal femoral bone for biologic fixation or cement interdigitation. The challenge for the revision arthroplasty surgeon is to find the best method to secure the implant in a femur with deficient bone proximally that will provide stability for load bearing and motion. In addition to providing stability, the implant must be durable and maintain long-term fixation. With over 16 years of experience with fully porous coated femoral revision implants, we have found that maximizing prosthetic-bone fit in the proximal femoral diaphyseal bone provides reliable long-term fixation in the majority of femoral revision cases.

  14. Extensively Coated Cementless Femoral Components in Revision Hip Arthroplasty.

    PubMed

    Greidanus, Nelson; Antoniou, John; Paprosky, Wayne

    2000-10-01

    A septic loosening and osteolysis can compromise the available host bone in patients requiring revision hip arthroplasty. Secure fixation of revision femoral components may not be possible if reliant only on proximal femoral bone for biologic fixation or cement interdigitation. The challenge for the revision arthroplasty surgeon is to find the best method to secure the implant in a femur with deficient bone proximally that will provide stability for load bearing and motion. In addition to providing stability, the implant must be durable and maintain long-term fixation. With over 16 years of experience with fully porous coated femoral revision implants, we have found that maximizing prosthetic-bone fit in the proximal femoral diaphyseal bone provides reliable long-term fixation in the majority of femoral revision cases.

  15. Submucosal tunneling techniques: current perspectives.

    PubMed

    Kobara, Hideki; Mori, Hirohito; Rafiq, Kazi; Fujihara, Shintaro; Nishiyama, Noriko; Ayaki, Maki; Yachida, Tatsuo; Matsunaga, Tae; Tani, Johji; Miyoshi, Hisaaki; Yoneyama, Hirohito; Morishita, Asahiro; Oryu, Makoto; Iwama, Hisakazu; Masaki, Tsutomu

    2014-01-01

    Advances in endoscopic submucosal dissection include a submucosal tunneling technique, involving the introduction of tunnels into the submucosa. These tunnels permit safer offset entry into the peritoneal cavity for natural orifice transluminal endoscopic surgery. Technical advantages include the visual identification of the layers of the gut, blood vessels, and subepithelial tumors. The creation of a mucosal flap that minimizes air and fluid leakage into the extraluminal cavity can enhance the safety and efficacy of surgery. This submucosal tunneling technique was adapted for esophageal myotomy, culminating in its application to patients with achalasia. This method, known as per oral endoscopic myotomy, has opened up the new discipline of submucosal endoscopic surgery. Other clinical applications of the submucosal tunneling technique include its use in the removal of gastrointestinal subepithelial tumors and endomicroscopy for the diagnosis of functional and motility disorders. This review suggests that the submucosal tunneling technique, involving a mucosal safety flap, can have potential values for future endoscopic developments.

  16. Volumetric Damage to the Femoral Physis During Double-Bundle Posterior Cruciate Ligament Reconstruction: A Magnetic Resonance Imaging Computer Modeling Study.

    PubMed

    Shea, Kevin G; Grimm, Nathan L; Nichols, Francesca R; Jacobs, John C

    2015-06-01

    The purpose of this study was to use computer models to evaluate the volume of femoral physeal disruption in double-bundle posterior cruciate ligament (PCL) reconstruction in patients with open physes. Ten skeletally immature patients (6 girls and 4 boys) were selected for this study. The magnetic resonance imaging scans of each patient were converted into a 3-dimensional model using computer-aided design/computer-aided manufacturing software. The software allowed the users to differentiate the epiphyseal, physeal, and metaphyseal tissues. This allowed for quantification of volume removed of each tissue type. Furthermore, we used the 3-dimensional models to simulate an anatomic double-bundle technique using 6-, 7-, 8-, and 9-mm-diameter tunnels. The software method reflects an inside-out drilling technique. For drill holes of all diameters, the posteromedial tunnels exited the knee inferior to the physis, thus avoiding physeal damage. In contrast, all the anterolateral tunnels perforated the physis. The results for the percent of total physis removed are as follows: 6-mm tunnel, 1.79% ± 0.99%; 7-mm tunnel, 2.23% ± 1.19%; 8-mm tunnel, 3.00% ± 1.54%; and 9-mm tunnel, 3.84% ± 1.73%. This computer modeling simulation of double-bundle PCL reconstruction in skeletally immature knees found that the posteromedial tunnel avoided disruption of the distal femoral physis. In contrast, the anterolateral tunnel did disrupt the physis with all drill hole sizes (6 to 9 mm), but all had a less than 4% volume of total physis removed. A clear understanding of the drill hole position may reduce the volume of physeal injury during double-bundle PCL reconstruction. This study shows that physeal disruption of less than the experimental 7% threshold that has been shown to cause physeal arrest may not cause arrest, but this is still speculative. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  17. Tunneling above the crossover temperature.

    PubMed

    Alvarez-Barcia, Sonia; Flores, Jesús R; Kästner, Johannes

    2014-01-09

    Quantum mechanical tunneling of atoms plays a significant role in many chemical reactions. The crossover temperature between classical and quantum movement is a convenient preliminary indication of the importance of tunneling for a particular reaction. Here we show, using instanton theory, that quantum tunneling is possible significantly above this crossover temperature for specific forms of the potential energy surface. We demonstrate the effect on an analytic potential as well as a chemical system. While protons move asynchronously along a Grotthuss chain in the classical high-temperature range, the onset of tunneling results in a synchronization of their movement.

  18. Ferroelectric tunneling under bias voltages

    NASA Astrophysics Data System (ADS)

    Ma, Z. J.; Chen, G.; Zhou, P.; Mei, Z. H.; Zhang, T. J.

    2017-01-01

    Theoretical investigations of ferroelectric tunneling in a SrRuO3/BaTiO3/Pt junction were conducted, and critical expressions for the surface charge density in the electrodes and the potential distribution across the tunnel junction were derived. It was found that the screening charges associated with the ferroelectric polarization and the charging effect of the capacitor jointly contribute to the charges in the electrodes. A current-voltage study simulating the ‘read’ operation indicated that the tunneling electroresistance effect increases with the ferroelectric thickness, and the tunneling electroresistance values agree well with experimental results.

  19. Nonlinear coherent destruction of tunneling

    SciTech Connect

    Luo Xiaobing; Xie Qiongtao; Wu Biao

    2007-11-15

    We study theoretically two coupled periodically curved optical waveguides with Kerr nonlinearity. We find that the tunneling between the waveguides can be suppressed in a wide range of parameters. This suppression of tunneling is found to be related to the coherent destruction of tunneling in a linear medium, which in contrast occurs only at isolated parameter points. Therefore, we call this suppression nonlinear coherent destruction of tunneling. This localization phenomenon can be observed readily with current experimental capability; it may also be observable in a different physical system, the Bose-Einstein condensate.

  20. Magnetic tunnel junction pattern technique

    NASA Astrophysics Data System (ADS)

    Chen, Eugene; Schwarz, Benjamin; Choi, Chang Ju; Kula, Witold; Wolfman, Jerome; Ounadjela, Kamel; Geha, Sam

    2003-05-01

    We have developed a magnetic tunnel junction (MTJ) pattern technique that involves transforming the magnetic layer above the tunnel barrier in unwanted areas into an insulator, thus providing insulation between different MTJ devices without suffering common tunnel barrier shorting problems. With this technique, 90%-100% yielding MTJ devices have been observed. MTJ results using this process are superior to an etching based process. Switching distribution of patterned magnetic bits is also narrower using this novel technique. Process control and the ability to stop on the tunnel barrier have been demonstrated.

  1. Microbubble tunneling in gel phantoms

    PubMed Central

    Caskey, Charles F.; Qin, Shengping; Dayton, Paul A.; Ferrara, Katherine W.

    2009-01-01

    Insonified microbubbles were observed in vessels within a gel with a Young’s modulus similar to that of tissue, demonstrating shape instabilities, liquid jets, and the formation of small tunnels. In this study, tunnel formulation occurred in the direction of the propagating ultrasound wave, where radiation pressure directed the contact of the bubble and gel, facilitating the activity of the liquid jets. Combinations of ultrasonic parameters and microbubble concentrations that are relevant for diagnostic imaging and drug delivery and that lead to tunnel formation were applied and the resulting tunnel formation was quantified. PMID:19425620

  2. Practical Aspects of Nontunneled and Tunneled Hemodialysis Catheters

    PubMed Central

    Clark, Edward; Kappel, Joanne; MacRae, Jennifer; Dipchand, Christine; Hiremath, Swapnil; Kiaii, Mercedeh; Lok, Charmaine; Moist, Louise; Oliver, Matthew; Miller, Lisa M.

    2016-01-01

    Nontunneled hemodialysis catheters (NTHCs) are typically used when vascular access is required for urgent renal replacement therapy. The preferred site for NTHC insertion in acute kidney injury is the right internal jugular vein followed by the femoral vein. When aided by real-time ultrasound, mechanical complications related to NTHC insertion are significantly reduced. The preferred site for tunneled hemodialysis catheters placement is the right internal jugular vein followed by the left internal jugular vein. Ideally, the catheter should be inserted on the opposite side of a maturing or planned fistula/graft. Several dual-lumen, large-diameter catheters are available with multiple catheter tip designs, but no one catheter has shown significant superior performance. PMID:28270920

  3. Practical Aspects of Nontunneled and Tunneled Hemodialysis Catheters.

    PubMed

    Clark, Edward; Kappel, Joanne; MacRae, Jennifer; Dipchand, Christine; Hiremath, Swapnil; Kiaii, Mercedeh; Lok, Charmaine; Moist, Louise; Oliver, Matthew; Miller, Lisa M

    2016-01-01

    Nontunneled hemodialysis catheters (NTHCs) are typically used when vascular access is required for urgent renal replacement therapy. The preferred site for NTHC insertion in acute kidney injury is the right internal jugular vein followed by the femoral vein. When aided by real-time ultrasound, mechanical complications related to NTHC insertion are significantly reduced. The preferred site for tunneled hemodialysis catheters placement is the right internal jugular vein followed by the left internal jugular vein. Ideally, the catheter should be inserted on the opposite side of a maturing or planned fistula/graft. Several dual-lumen, large-diameter catheters are available with multiple catheter tip designs, but no one catheter has shown significant superior performance.

  4. Topography-specific isotropic tunneling in nanoparticle monolayer with sub-nm scale crevices.

    PubMed

    Wang, Guisheng; Jiao, Weihong; Yi, Lizhi; Zhang, Yuejiao; Wu, Ke; Zhang, Chao; Lv, Xianglong; Qian, Lihua; Li, Jianfeng; Yuan, Songliu; Chen, Liang

    2016-10-07

    Material used in flexible devices may experience anisotropic strain with identical magnitude, outputting coherent signals that tend to have a serious impact on device reliability. In this work, the surface topography of the nanoparticles (NPs) is proposed to be a parameter to control the performance of strain gauge based on tunneling behavior. In contrast to anisotropic tunneling in a monolayer of spherical NPs, electron tunneling in a monolayer of urchin-like NPs actually exhibits a nearly isotropic response to strain with different loading orientations. Isotropic tunneling of the urchin-like NPs is caused by the interlocked pikes of these urchin-like NPs in a random manner during external mechanical stimulus. Topography-dependent isotropic tunneling in two dimensions reported here opens a new opportunity to create highly reliable electronics with superior performance.

  5. Topography-specific isotropic tunneling in nanoparticle monolayer with sub-nm scale crevices

    NASA Astrophysics Data System (ADS)

    Wang, Guisheng; Jiao, Weihong; Yi, Lizhi; Zhang, Yuejiao; Wu, Ke; Zhang, Chao; Lv, Xianglong; Qian, Lihua; Li, Jianfeng; Yuan, Songliu; Chen, Liang

    2016-10-01

    Material used in flexible devices may experience anisotropic strain with identical magnitude, outputting coherent signals that tend to have a serious impact on device reliability. In this work, the surface topography of the nanoparticles (NPs) is proposed to be a parameter to control the performance of strain gauge based on tunneling behavior. In contrast to anisotropic tunneling in a monolayer of spherical NPs, electron tunneling in a monolayer of urchin-like NPs actually exhibits a nearly isotropic response to strain with different loading orientations. Isotropic tunneling of the urchin-like NPs is caused by the interlocked pikes of these urchin-like NPs in a random manner during external mechanical stimulus. Topography-dependent isotropic tunneling in two dimensions reported here opens a new opportunity to create highly reliable electronics with superior performance.

  6. Distal femoral physeal growth arrest secondary to a cemented proximal femoral endoprosthetic replacement.

    PubMed

    Gaston, C L; Tillman, R M; Grimer, R J

    2011-05-01

    We report a case of spontaneous physeal growth arrest of the distal femur in a nine-year-old child with Ewing's sarcoma of the proximal femur treated with chemotherapy and endoprosthetic replacement. Owing to the extent of disuse osteoporosis at the time of surgery, the entire intramedullary canal up to the distal femoral physis was filled with cement. Three years later, the femur remained at its pre-operative length of 19 cm. Pre-operative calculations of further growth failed to account for the growth arrest, and the initial expandable growing prosthesis inserted has been revised to a longer one in order to address the leg-length discrepancy. To our knowledge, this is the only reported case of distal femoral physeal growth arrest following cemented endoprosthetic replacement of the proximal femur.

  7. In-situ TEM observation on STM tunneling gap

    NASA Astrophysics Data System (ADS)

    Kim, Suhyun; Tanishiro, Yasumasa; Takayanagi, Kunio

    2009-03-01

    Transmission Electron Microscope and Scanning Tunneling Microscope in an ultra high vacuum environment (UHV-TEM-STM) have been combined to simultaneously perform both high resolution TEM and atomically resolved STM experiments. This system was constructed for in-situ investigation of physical property of impurity atoms embedded below semiconductor surface. To image TEM and STM at the same time, crucial requirement is that, the STM image must be acquired under the electron beam irradiation. As a preliminary test, we used HOPG (Highly Oriented Pyrolytic Graphite) sample and tungsten tip as schematically shown in Fig 1(a). Fig 1(b) shows an atomic resolution STM image of HOPG obtained with 300mV sample bias and 3nA tunneling current even in the condition of the electron beam irradiation on the tip. TEM image can be simultaneously acquired by performing In-situ TEM observation on STM tunneling gap formed between the tip and a thin sample. Fig 1(a) Geometry of STM observation on STM tunneling gap Fig 1(b) STM image of HOPG obtained with 300mV sample bias and 3nA tunneling current

  8. Tunnelling anomalous and planar Hall effects (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Matos-Abiague, Alex; Scharf, Benedikt; Han, Jong E.; Hankiewicz, Ewelina M.; Zutic, Igor

    2016-10-01

    We theoretically show how the interplay between spin-orbit coupling (SOC) and magnetism can result in a finite tunneling Hall conductance, transverse to the applied bias. For two-dimensional tunnel junctions with a ferromagnetic lead and magnetization perpendicular to the current flow, the detected anomalous Hall voltage can be used to extract information not only about the spin polarization but also about the strength of the interfacial SOC. In contrast, a tunneling current across a ferromagnetic barrier on the surface of a three-dimensional topological insulator (TI) can induce a planar Hall response even when the magnetization is oriented along the current flow[1]. The tunneling nature of the states contributing to the planar Hall conductance can be switched from the ordinary to the Klein regimes by the electrostatic control of the barrier strength. This allows for an enhancement of the transverse response and a giant Hall angle, with the tunneling planar Hall conductance exceeding the longitudinal component. Despite the simplicity of a single ferromagnetic region, the TI/ferromagnet system exhibits a variety of functionalities. In addition to a spin-valve operation for magnetic sensing and storing information, positive, negative, and negative differential conductances can be tuned by properly adjusting the barrier potential and/or varying the magnetization direction. Such different resistive behaviors in the same system are attractive for potential applications in reconfigurable spintronic devices. [1] B. Scharf, A. Matos-Abiague, J. E. Han, E. M. Hankiewicz, and I. Zutic, arXiv:1601.01009 (2016).

  9. Avascular necrosis of the femoral head after osteosynthesis of femoral neck fracture.

    PubMed

    Min, Byung-Woo; Kim, Sung-Jin

    2011-05-18

    The reported incidence of avascular necrosis after femoral neck fracture fixation varies widely, and there is no consensus regarding its risk factors. We evaluated the incidence of avascular necrosis of the femoral head with the use of contemporary techniques for femoral neck fracture fixation. We then sought to determine what potential risk factors influenced the development of avascular necrosis.Between 1990 and 2005, one hundred sixty-three intracapsular femoral neck fractures in 163 patients were treated with internal fixation at our level-I trauma center. All patients were monitored until conversion to total hip arthroplasty or for a minimum of 2 years postoperatively. Ten patients (10 hips) died and 7 patients (7 hips) were lost to follow-up. The remaining 146 patients (146 hips) had a mean 5.2 years of follow-up (range, 3 months to 17 years). The incidence of avascular necrosis was 25.3% (37 hips). The average time to diagnosis of avascular necrosis was 18.8 months (range, 3-47 months). Patient sex, age, interval from injury to surgery, and mechanism of injury were statistically not associated with the development of avascular necrosis. The quality of fracture reduction, adequacy of fixation, degree of displacement, and comminution of the posterior cortex were significantly associated. After we controlled for patient and radiographic characteristics, multivariate analyses indicated that the important predictors for avascular necrosis are poor reduction (odds ratio=13.889) and initial displacement of the fracture (odds ratio=4.693). Copyright 2011, SLACK Incorporated.

  10. Defining the common femoral artery: Insights from the femoral arterial access with ultrasound trial.

    PubMed

    Seto, Arnold H; Tyler, Jeffrey; Suh, William M; Harrison, Alexander T; Vera, Jesus A; Zacharias, Soni J; Daly, Timothy S; Sparling, Jeffrey M; Patel, Pranav M; Kern, Morton J; Abu-Fadel, Mazen

    2017-06-01

    We sought to establish the typical location of the common femoral artery (CFA) bifurcation, the origin and most inferior reflection of the inferior epigastric artery (IEA) relative to the femoral head (FH) and whether patient demographics predicted anatomical variations. In the absence of ultrasound guidance or prior imaging, the precise location of the CFA bifurcation and IEA can only be determined following access site angiography. Fluoroscopic landmarks are commonly used to estimate the location of the CFA bifurcation, but the position of the IEA is less well characterized. Prospectively collected data on 989 patients with femoral angiography in the FAUST trial were analyzed. The level of CFA bifurcation and the origin and most inferior reflection of the IEA were classified by angiography. Logistic regression was used to explore whether baseline demographics were associated with anatomic variations. The CFA bifurcation occurs below the middle 1/3(rd) of the femoral head in 95% of patients, and no patient factors are predictive of a high bifurcation. The IEA origin has a more variable anatomically pattern, with high BSA, male gender, and white race associated with a low IEA origin. Operators should attempt to access the CFA at the level of the middle 1/3(rd) of the FH to maximize the chance of CFA cannulation. However, this location carries an 11% risk of being at or above the IEA origin. Baseline demographics were of limited utility for predicting anatomic variants of the CFA bifurcation and the course of the IEA. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Single-electron tunneling. [Microwave scanning tunneling microscope

    SciTech Connect

    Ruggiero, S.T.

    1993-01-01

    Pictures using the low-temperature microwave scanning tunneling microscope, have been made of particles and tunneling IV characteristics determined. Strong, sometimes periodic negative differential resistance was observed in small-particle systems. Au and Ag droplets and particles were studied. 4 figs.

  12. Full Scale Tunnel (FST)

    NASA Technical Reports Server (NTRS)

    1930-01-01

    Construction of Full Scale Tunnel (FST). In November 1929, Smith DeFrance submitted his recommendations for the general design of the Full Scale Wind Tunnel. The last on his list concerned the division of labor required to build this unusual facility. He believed the job had five parts and described them as follows: 'It is proposed that invitations be sent out for bids on five groups of items. The first would be for one contract on the complete structure; second the same as first, including the erection of the cones but not the fabrication, since this would be more of a shipyard job; third would cover structural steel, cover, sash and doors, but not cones or foundation; fourth, foundations; an fifth, fabrication of cones.' DeFrance's memorandum prompted the NACA to solicit estimates from a large number of companies. Preliminary designs and estimates were prepared and submitted to the Bureau of the Budget and Congress appropriated funds on February 20, 1929. The main construction contract with the J.A. Jones Company of Charlotte, North Carolina was signed one year later on February 12, 1930. It was a peculiar structure as the building's steel framework is visible on the outside of the building. DeFrance described this in NACA TR No. 459: 'The entire equipment is housed in a structure, the outside walls of which serve as the outer walls of the return passages. The over-all length of the tunnel is 434 feet 6 inches, the width 222 feet, and the maximum height 97 feet. The framework is of structural steel....' (pp. 292-293)

  13. Full Scale Tunnel (FST)

    NASA Technical Reports Server (NTRS)

    1930-01-01

    Construction of Full-Scale Tunnel (FST). In November 1929, Smith DeFrance submitted his recommendations for the general design of the Full Scale Wind Tunnel. The last on his list concerned the division of labor required to build this unusual facility. He believed the job had five parts and described them as follows: 'It is proposed that invitations be sent out for bids on five groups of items. The first would be for one contract on the complete structure; second the same as first, including the erection of the cones but not the fabrication, since this would be more of a shipyard job; third would cover structural steel, cover, sash and doors, but not cones or foundation; fourth, foundations; and fifth, fabrication of cones.' DeFrance's memorandum prompted the NACA to solicit estimates from a large number of companies. Preliminary designs and estimates were prepared and submitted to the Bureau of the Budget and Congress appropriated funds on February 20, 1929. The main construction contract with the J.A. Jones Company of Charlotte, North Carolina was signed one year later on February 12, 1930. It was a peculiar structure as the building's steel framework is visible on the outside of the building. DeFrance described this in NACA TR No. 459: 'The entire equipment is housed in a structure, the outside walls of which serve as the outer walls of the return passages. The over-all length of the tunnel is 434 feet 6 inches, the width 222 feet, and the maximum height 97 feet. The framework is of structural steel....' (pp. 292-293).

  14. Carpal tunnel syndrome

    PubMed Central

    Aroori, Somaiah; Spence, Roy AJ

    2008-01-01

    Carpal tunnel syndrome is one of the most common peripheral neuropathies. It affects mainly middle aged women. In the majority of patients the exact cause and pathogenesis of CTS is unclear. Although several occupations have been linked to increased incidence and prevalence of CTS the evidence is not clear. Occupational CTS is uncommon and it is essential to exclude all other causes particularly the intrinsic factors such as obesity before attributing it to occupation. The risk of CTS is high in occupations involving exposure to high pressure, high force, repetitive work, and vibrating tools. The classic symptoms of CTS include nocturnal pain associated with tingling and numbness in the distribution of median nerve in the hand. There are several physical examination tests that will help in the diagnosis of CTS but none of these tests are diagnostic on their own. The gold standard test is nerve conduction studies. However, they are also associated with false positive and false negative results. The diagnosis of CTS should be based on history, physical examination and results of electrophysiological studies. The patient with mild symptoms of CTS can be managed with conservative treatment, particularly local injection of steroids. However, in moderate to severe cases, surgery is the only treatment that provides cure. The basic principle of surgery is to increase the volume of the carpal tunnel by dividing transverse carpal ligament to release the pressure on the median nerve. Apart from early recovery and return to work there is no significant difference in terms of early and late complications and long-term pain relief between endoscopic and open carpal tunnel surgery. PMID:18269111

  15. The impact of proximal femoral morphology on failure strength with a mid-head resection short-stem hip arthroplasty.

    PubMed

    Olsen, Michael; Al Saied, Mohamed; Morison, Zachary; Sellan, Michael; Waddell, James P; Schemitsch, Emil H

    2014-12-01

    Mid-head resection short-stem hip arthroplasty is a conservative alternative to conventional total hip replacement and addresses proximal fixation challenges in patients not suitable for hip resurfacing. It is unclear whether proximal femoral morphology impacts the ultimate failure load of mid-head resection implanted femurs, thus the aim of this study was to investigate the effect of native neck-shaft angle (NSA) and coronal implant alignment on proximal femoral strength. In total, 36 synthetic femurs with two different proximal femoral morphologies were utilized in this study. Of them, 18 femurs with a varus NSA of 120° and 18 femurs with a valgus NSA of 135° were each implanted with a mid-head resection prosthesis. Femurs within the two different femoral morphology groups were divided into three equal coronal implant alignment groups: 10° valgus, 10° varus or neutral alignment. Prepared femurs were tested for stiffness and to failure in axial compression. There was no significant difference in stiffness nor failure load between femurs implanted with valgus-, varus- or neutrally aligned implants in femurs with a NSA of 120° (p = 0.396, p = 0.111, respectively). Femurs implanted in valgus orientation were significantly stiffer and failed at significantly higher loads than those implanted in varus alignment in femurs with a NSA of 135° (p = 0.001, p = 0.007, respectively). A mid-head resection short-stem hip arthroplasty seems less sensitive to clinically relevant variations of coronal implant alignment and may be more forgiving upon implantation in some femoral morphologies, however, a relative valgus component alignment is recommended. © IMechE 2014.

  16. Single molecule tunneling spectroscopy investigation of reversibly switched dipolar vanadyl phthalocyanine on graphite

    SciTech Connect

    Zhang, Jialin; Wang, Zhunzhun; Li, Zhenyu E-mail: phycw@nus.edu.sg; Niu, Tianchao; Chen, Wei E-mail: phycw@nus.edu.sg

    2014-03-17

    We report a spatially resolved scanning tunneling spectroscopy (STS) investigation of reversibly switchable dipolar vanadyl phthalocyanine (VOPc) on graphite by using low temperature scanning tunneling microscopy. VOPc molecule can be switched between O-up and O-down configurations by changing the polarity of the pulse voltage applied to the tip, actuated by the inelastic tunneling electrons. The spatially resolved STS measurements allow the identification of the electronic structures of VOPc with different dipole orientation. The present approach provides geometry images and electronic characterization of a molecular switch on surface spontaneously.

  17. Imaging graphite in air by scanning tunneling microscopy - Role of the tip

    NASA Technical Reports Server (NTRS)

    Colton, R. J.; Baker, S. M.; Driscoll, R. J.; Youngquist, M. G.; Baldeschwieler, J. D.; Kaiser, W. J.

    1988-01-01

    Atomically resolved images of highly oriented pyrolytic graphite (HOPG) in air at point contact have been obtained. Direct contact between tip and sample or contact through a contamination layer provides a conduction mechanism in addition to the exponential tunneling mechanism responsible for scanning tunneling microscopy (STM) imaging. Current-voltage (I-V) spectra were obtained while scanning in the current imaging mode with the feedback circuit interrupted in order to study the graphite imaging mechanism. Multiple tunneling tips are probably responsible for images without the expected hexagonal or trigonal symmetry. The observations indicate that the use of HOPG for testing and calibration of STM instrumentation may be misleading.

  18. Painful Spastic Hip Dislocation: Proximal Femoral Resection

    PubMed Central

    Albiñana, Javier; Gonzalez-Moran, Gaspar

    2002-01-01

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

  19. Intestinal Obstruction due to Bilateral Strangulated Femoral Hernias

    PubMed Central

    Nikolopoulos, Ioannis; Oderuth, Eshan; Ntakomyti, Eleni; Kald, Bengt

    2014-01-01

    Introduction. Femoral hernias are at high risk of strangulation due to the narrow femoral canal and femoral ring. This can lead to symptoms of obstruction or strangulation requiring emergency surgery and possible bowel resection. To our knowledge, there is only one previous published report of bilateral strangulated femoral hernia. We present our case of this phenomenon. Case Report. An 86-year-old woman presented with symptoms of small bowel obstruction. Examination revealed two tender lumps in the area of the femoral triangle. CT scan revealed bilateral femoral hernias. Both hernias were repaired and a small bowel resection on the right side was performed with side to side anastomosis. She made an uneventful recovery. Conclusion. Bilateral femoral hernias are a rare occurrence with only one reported case of bilateral strangulation. Our case highlights the importance of meticulous history taking and clinical examination as any delay in diagnosis will increase the risk of mortality and morbidity for the patient. Hernias should always be considered as a cause if one presents with symptoms of abdominal pain or obstruction. PMID:25057426

  20. Femoral neck radiography: effect of flexion on visualization.

    PubMed

    Garry, Steven C; Jhangri, Gian S; Lambert, Robert G W

    2005-06-01

    To determine whether flexion improves radiographic visualization of the femoral neck when the femur is externally rotated. Five human femora, with varying neck-shaft and anteversion angles, were measured and immobilized. Degree of flexion required to bring the femoral neck horizontal was measured, varying the rotation. Next, one bone was radiographed in 16 positions, varying rotation in 15 degrees and flexion in 10 degrees increments. Radiographs were presented in randomized blinded fashion to 15 staff radiologists for scoring of femoral neck visualization. Following this, all 5 bones were radiographed in 4 positions of rotation and at 0 degree and 20 degrees flexion, and blinded randomized review of radiographs was repeated. Comparisons between angles and rotations were made using the Mann-Whitney test. The flexion angle required to bring the long axis of the femoral neck horizontal correlated directly with the degree of external rotation (p < 0.05). Visualization of the femoral neck in the extended position progressively deteriorated from 15 degrees internal rotation to 30 degrees external rotation (p < 0.01). However, when 20 degrees flexion was applied to bones in external rotation, visualization significantly improved at 15 degrees (p < 0.05) and 30 degrees (p < 0.01). Flexion of the externally rotated femur can bring the femoral neck into horizontal alignment, and a relatively small amount (20 degrees) of flexion can significantly improve radiographic visualization. This manoeuvre could be useful for radiography of the femoral neck when initial radiographs are inadequate because of external rotation of the leg.

  1. Femoral Access and Delivery of Continuous Renal Replacement Therapy Dose.

    PubMed

    Bellomo, Rinaldo; Mårtensson, Johan; Lo, Serigne; Kaukonen, Kirsi-Maija; Cass, Alan; Gallagher, Martin

    2016-01-01

    The study aims to describe the use of dialysis catheters in critically ill patients treated with continuous renal replacement therapy (CRRT) and to study the impact of femoral versus non-femoral access on CRRT dose. Statistical analysis and predictive modelling of data from the Randomized Evaluation of Normal vs. Augmented Level renal replacement therapy trial. The femoral vein was the first access site in 937 (67%) of 1,399 patients. These patients had higher Acute Physiology and Chronic Health Evaluation and Sequential Organ Failure Assessment scores (p = 0.009) and lower pH (p < 0.001) but similar mortality to patients with non-femoral access (44 vs. 45%; p = 0.63). Lower body weight was independently associated with femoral access placement (OR 0.97, 95% CI 0.96-0.98). Femoral access was associated with a 1.03% lower CRRT dose (p = 0.05), but a 4.20% higher dose was achieved with 13.5 Fr catheters (p = 0.03). Femoral access was preferred in lighter and sicker patients. Catheter gauge had greater impact than catheter site in CRRT dose delivery. Video Journal Club "Cappuccino with Claudio Ronco" at http://www.karger.com/?doi=439581. © 2015 S. Karger AG, Basel.

  2. Measuring femoral and rotational alignment: EOS system versus computed tomography.

    PubMed

    Folinais, D; Thelen, P; Delin, C; Radier, C; Catonne, Y; Lazennec, J Y

    2013-09-01

    Computed tomography (CT) is currently the reference standard for measuring femoral and tibial rotational alignment. The EOS System is a new biplanar low-dose radiographic device that allows 3-dimensional lower-limb modelling with automated measurements of femoral and tibial rotational alignment (torsion). Femoral and tibial torsion measurements provided by the EOS System are equivalent to those obtained using CT. In a retrospective analysis of 43 lower limbs in 30 patients, three senior radiologists measured femoral and tibial torsion on both CT and EOS images. Agreement between CT and EOS values was assessed by computing Pearson's correlation coefficient and interobserver reproducibility by computing the intraclass correlation coefficient (ICC). Femoral torsion was 13.4° by EOS vs. 13.7° by CT (P=0.5) and tibial torsion was 30.8° by EOS vs. 30.3° by CT (P=0.4). Strong associations were found between EOS and CT values for both femoral torsion (P=0.93) and tibial torsion (P=0.89). With EOS, the ICC was 0.93 for femoral torsion and 0.86 for tibial torsion; corresponding values with CT were 0.90 and 0.92. The EOS system is a valid alternative to CT for lower-limb torsion measurement. EOS imaging allows a comprehensive evaluation in all three planes while substantially decreasing patient radiation exposure. Level III, case-control. Copyright © 2013. Published by Elsevier Masson SAS.

  3. Percutaneous femoral arterial and venous catheterisation during neonatal intensive care.

    PubMed

    Wardle, S P; Kelsall, A W; Yoxall, C W; Subhedar, N V

    2001-09-01

    Femoral vessel catheterisation is generally avoided in the neonatal period because of technical difficulties and the fear of complications. To review the use of femoral arterial and venous catheters inserted percutaneously on the neonatal intensive care unit. Infants admitted to one of two regional neonatal intensive care units who underwent femoral vessel catheterisation were identified. Information collected included basic details, indication for insertion of catheter, type of catheter and insertion technique, duration of use, and any catheter related complications. Sixty five femoral catheters were inserted into 53 infants. The median gestational age was 29 weeks (range 23-40). Twenty three femoral arterial catheters (FACs) were inserted into 21 infants and remained in situ for a median of three days (range one to eight). Twelve (52%) FACs remained in place until no longer required, and four (17%) infants developed transient ischaemia of the distal limb. Forty two femoral venous catheters (FVCs) were inserted into 40 infants and remained in situ for a median of seven days (range 1-29). Twenty seven (64%) FVCs remained in place until no longer required, and eight (19%) catheters were removed because of catheter related bloodstream infection. FACs and FVCs are useful routes of vascular access in neonates when other sites are unavailable. Complications from femoral vessel catheterisation include transient lower limb ischaemia with FACs and catheter related bloodstream infection.

  4. Percutaneous femoral arterial and venous catheterisation during neonatal intensive care

    PubMed Central

    Wardle, S; Kelsall, A; Yoxall, C; Subhedar, N

    2001-01-01

    BACKGROUND—Femoral vessel catheterisation is generally avoided in the neonatal period because of technical difficulties and the fear of complications.
AIM—To review the use of femoral arterial and venous catheters inserted percutaneously on the neonatal intensive care unit.
METHODS—Infants admitted to one of two regional neonatal intensive care units who underwent femoral vessel catheterisation were identified. Information collected included basic details, indication for insertion of catheter, type of catheter and insertion technique, duration of use, and any catheter related complications.
RESULTS—Sixty five femoral catheters were inserted into 53 infants. The median gestational age was 29 weeks (range 23-40). Twenty three femoral arterial catheters (FACs) were inserted into 21infants and remained in situ for a median of three days (range one to eight). Twelve (52%) FACs remained in place until no longer required, and four (17%) infants developed transient ischaemia of the distal limb. Forty two femoral venous catheters (FVCs) were inserted into 40 infants and remained in situ for a median of seven days (range 1-29). Twenty seven (64%) FVCs remained in place until no longer required, and eight (19%) catheters were removed because of catheter related bloodstream infection.
CONCLUSIONS—FACs and FVCs are useful routes of vascular access in neonates when other sites are unavailable. Complications from femoral vessel catheterisation include transient lower limb ischaemia with FACs and catheter related bloodstream infection.

 PMID:11517206

  5. Recurrent tarsal tunnel syndrome.

    PubMed

    Gould, John S

    2014-09-01

    Recurrence of tarsal tunnel syndrome after surgery may be due to inadequate release, lack of understanding or appreciation of the actual anatomy involved, variations in the anatomy of the nerve(s), failure to execute the release properly, bleeding with subsequent scarring, damage to the nerve and branches, persistent hypersensitivity of the nerves, and preexisting intrinsic damage to the nerve. Approaches include more thorough release, use of barrier materials to decrease adherence of the nerve to surrounding tissues to avoid traction neuritis, excisions of neuromas using conduits, and consideration of nerve stimulators and systemic medications to deal with persistent neural pain.

  6. Resonant tunneling IR detectors

    NASA Technical Reports Server (NTRS)

    Woodall, Jerry M.; Smith, T. P., III

    1990-01-01

    Researchers propose a novel semiconductor heterojunction photodetector which would have a very low dark current and would be voltage tunable. A schematic diagram of the device and its band structure are shown. The two crucial components of the device are a cathode (InGaAs) whose condition band edge is below the conduction band edge of the quantum wells and a resonant tunneling filter (GaAs-AlGaAs). In a standard resonant tunneling device the electrodes are made of the same material as the quantum wells, and this device becomes highly conducting when the quantum levels in the wells are aligned with the Fermi level in the negatively biased electrode. In contrast, the researchers device is essentially non-conducting under the same bias conditions. This is because the Fermi Level of the cathode (InGaAs) is still well below the quantum levels so that no resonant transport occurs and the barriers (AlGaAs) effectively block current flow through the device. However, if light with the same photon energy as the conduction-band discontinuity between the cathode and the quantum wells, E sub c3-E sub c1, is shone on the sample, free carriers will be excited to an energy corresponding to the lowest quantum level in the well closest to the cathode (hv plue E sub c1 = E sub o). These electrons will resonantly tunnel through the quantum wells and be collected as a photocurrent in the anode (GaAs). To improve the quantum efficiency, the cathode (InGaAs) should be very heavily doped and capped with a highly reflective metal ohmic contact. The thickness of the device should be tailored to optimize thin film interference effects and afford the maximum absorption of light. Because the device relies on resonant tunneling, its response should be very fast, and the small voltages needed to change the responsivity should allow for very high frequency modulation of the photocurrent. In addition, the device is tuned to a specific photon energy so that it can be designed to detect a fairly

  7. Icing Research Tunnel

    NASA Technical Reports Server (NTRS)

    Chennault, Jonathan

    2004-01-01

    The Icing Research Tunnel in Building 11 at the NASA Glenn Research Center is committed to researching the effects of in flight icing on aircraft and testing ways to stop the formation of hazardous icing conditions on planes. During this summer, I worked here with Richard DelRosa, the lead engineer for this area. address one of the major concerns of aviation: icing conditions. During the war, many planes crashed (especially supply planes going over the.Himalayas) because ice built up in their wings and clogged the engines. To this day, it remains the largest ice tunnel in the world, with a test section that measures 6 feet high, 9 feet long, and 20 feet wide. It can simulate airspeeds from 50 to 300 miles per hour at temperatures as low as -50 Fahrenheit. Using these capabilities, IRT can simulate actual conditions at high altitudes. The first thing I did was creating a cross reference in Microsoft Excel. It lists commands for the DPU units that control the pressure and temperature variations in the tunnel, as well as the type of command (keyboard, multiplier, divide, etc). The cross reference also contains the algorithm for every command, and which page it is listed in on the control sheet (visual Auto-CAD graphs, which I helped to make). I actually spent most of the time on the computer using Auto-CAD. I drew a diagram of the entire icing tunnel and then drew diagrams of its various parts. Between my mentor and me, we have drawings of every part of it, from the spray bars to the thermocouples, power cabinets, input-output connectors for power systems, and layouts of various other machines. I was also responsible for drawing schematics for the Escort system (which controls the spray bars), the power system, DPUs, and other electrical systems. In my spare time, I am attempting to build and program the "toddler". Toddler is a walking robot that I have to program in PBASIC language. When complete, it should be able to walk on level terrain while avoiding obstacles in

  8. Icing Research Tunnel

    NASA Technical Reports Server (NTRS)

    Chennault, Jonathan

    2004-01-01

    The Icing Research Tunnel in Building 11 at the NASA Glenn Research Center is committed to researching the effects of in flight icing on aircraft and testing ways to stop the formation of hazardous icing conditions on planes. During this summer, I worked here with Richard DelRosa, the lead engineer for this area. address one of the major concerns of aviation: icing conditions. During the war, many planes crashed (especially supply planes going over the.Himalayas) because ice built up in their wings and clogged the engines. To this day, it remains the largest ice tunnel in the world, with a test section that measures 6 feet high, 9 feet long, and 20 feet wide. It can simulate airspeeds from 50 to 300 miles per hour at temperatures as low as -50 Fahrenheit. Using these capabilities, IRT can simulate actual conditions at high altitudes. The first thing I did was creating a cross reference in Microsoft Excel. It lists commands for the DPU units that control the pressure and temperature variations in the tunnel, as well as the type of command (keyboard, multiplier, divide, etc). The cross reference also contains the algorithm for every command, and which page it is listed in on the control sheet (visual Auto-CAD graphs, which I helped to make). I actually spent most of the time on the computer using Auto-CAD. I drew a diagram of the entire icing tunnel and then drew diagrams of its various parts. Between my mentor and me, we have drawings of every part of it, from the spray bars to the thermocouples, power cabinets, input-output connectors for power systems, and layouts of various other machines. I was also responsible for drawing schematics for the Escort system (which controls the spray bars), the power system, DPUs, and other electrical systems. In my spare time, I am attempting to build and program the "toddler". Toddler is a walking robot that I have to program in PBASIC language. When complete, it should be able to walk on level terrain while avoiding obstacles in

  9. Magnetic tunnel junctions with monolayer hexagonal boron nitride tunnel barriers

    SciTech Connect

    Piquemal-Banci, M.; Galceran, R.; Bouzehouane, K.; Anane, A.; Petroff, F.; Fert, A.; Dlubak, B.; Seneor, P.; Caneva, S.; Martin, M.-B.; Weatherup, R. S.; Kidambi, P. R.; Robertson, J.; Hofmann, S.; Xavier, S.

    2016-03-07

    We report on the integration of atomically thin 2D insulating hexagonal boron nitride (h-BN) tunnel barriers into Co/h-BN/Fe magnetic tunnel junctions (MTJs). The h-BN monolayer is directly grown by chemical vapor deposition on Fe. The Conductive Tip Atomic Force Microscopy (CT-AFM) measurements reveal the homogeneity of the tunnel behavior of our h-BN layers. As expected for tunneling, the resistance depends exponentially on the number of h-BN layers. The h-BN monolayer properties are also characterized through integration into complete MTJ devices. A Tunnel Magnetoresistance of up to 6% is observed for a MTJ based on a single atomically thin h-BN layer.

  10. Tunneling Anisotropic Magnetoresistance in Fe Nanoparticles Embedded in MgO Matrix

    NASA Astrophysics Data System (ADS)

    Pham, T. V.; Miwa, S.; Suzuki, Y.

    2016-05-01

    The tunnel magnetoresistance (TMR) effect is related to the relative orientation of the magnetizations of the two ferromagnetic electrodes in magnetic tunnel junctions (MTJs). The tunnel anisotropic magnetoresistance (TAMR) effect is related to the orientation of the magnetization with respect to the current direction or the crystallographic axes. Beyond the TMR, the TAMR is not only present in MTJs in which both electrodes are ferromagnetic but may also appear in tunnel structures with a single magnetic electrode. We investigated the magnetotransport properties in an Au/MgO/Fe nanoparticles/MgO/Cu tunnel junction. We found that both the TMR and TAMR can appear in tunnel junctions with Fe nanoparticles embedded in an MgO matrix. The TMR is attributed to spin-dependent tunneling between Fe nanoparticles, so the device resistance depends on the magnetization directions of adjacent Fe nanoparticles. The TAMR is attributed to the interfacial spin-orbit interaction, so the device resistance depends on each magnetization direction of an Fe nanoparticle. This is the first observation of the TAMR in Fe nanoparticles embedded in an MgO matrix.

  11. Femoral articular geometry and patellofemoral stability.

    PubMed

    Iranpour, Farhad; Merican, Azhar M; Teo, Seow Hui; Cobb, Justin P; Amis, Andrew A

    2017-06-01

    Patellofemoral instability is a major cause of anterior knee pain. The aim of this study was to examine how the medial and lateral stability of the patellofemoral joint in the normal knee changes with knee flexion and measure its relationship to differences in femoral trochlear geometry. Twelve fresh-frozen cadaveric knees were used. Five components of the quadriceps and the iliotibial band were loaded physiologically with 175N and 30N, respectively. The force required to displace the patella 10mm laterally and medially at 0°, 20°, 30°, 60° and 90° knee flexion was measured. Patellofemoral contact points at these knee flexion angles were marked. The trochlea cartilage geometry at these flexion angles was visualized by Computed Tomography imaging of the femora in air with no overlying tissue. The sulcus, medial and lateral facet angles were measured. The facet angles were measured relative to the posterior condylar datum. The lateral facet slope decreased progressively with flexion from 23°±3° (mean±S.D.) at 0° to 17±5° at 90°. While the medial facet angle increased progressively from 8°±8° to 36°±9° between 0° and 90°. Patellar lateral stability varied from 96±22N at 0°, to 77±23N at 20°, then to 101±27N at 90° knee flexion. Medial stability varied from 74±20N at 0° to 170±21N at 90°. There were significant correlations between the sulcus angle and the medial facet angle with medial stability (r=0.78, p<0.0001). These results provide objective evidence relating the changes of femoral profile geometry with knee flexion to patellofemoral stability. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Femoral lengthening with a motorized intramedullary nail

    PubMed Central

    Horn, Joachim; Grimsrud, Øyvind; Dagsgard, Anita Hoddevik; Huhnstock, Stefan; Steen, Harald

    2015-01-01

    Purpose We assessed whether an intramedullary lengthening device would reduce the problems normally associated with the external fixation technique. We also wanted to determine whether it is a reliable construct for limb lengthening and deformity correction in the femur. Patients and methods We conducted a matched-pair comparison of 30 femoral lengthenings, 15 with a motorized intramedullary nail (the nail group) and 15 lengthenings with an external ring fixator (the fixator group). The patients were matched based on age, sex, amount of lengthening, and the etiology of leg length discrepancy. Mean lengthening was 35 (25–55) mm in the nail group and 38 (15–75) mm in the fixator group. Outcome measures were: lengthening and alignment achieved, consolidation index, knee range of motion (ROM), and complications. Results The pairs in this matched-pair study were similar in terms of age, sex, diagnosis, and amount of lengthening. The planned amount of lengthening was achieved in all patients in both groups and axis correction was considered sufficient. The mean radiographic consolidation index in the nail group, at 1.5 (0.9–3.0) months/cm, was better than the mean value for the fixator group (1.9 (0.9–3.4) months/cm) (p = 0.01). Knee ROM was better in the nail group during the lengthening, 6 weeks after lengthening was completed, and 6 months after lengthening was completed (p < 0.001). A larger number of complications were observed in the fixator group than in the nail group. Interpretation A lengthening nail may be superior to external fixation in femoral lengthening, when the anatomical conditions and the complexity of the deformity allow the use of an intramedullary nail. PMID:25191936

  13. Our Experience with Patello femoral joint replacement

    PubMed Central

    Ramos, Pablo; Arteaga, Gonzalo; Vargas, Medardo; Naranjo, Juan

    2017-01-01

    Background: Ten to fifteen percent of knee arthritis is reported to be isolated patellofemoral arthritis. Total knee arthroplasty is not recommended for isolated patella femoral arthritis particularly in young patients. We present the retrospective review our series in 7 years. Objectives: The aim of this presentation is to describe our experience in the management of patellofemoral osteoarthritis with the use of the partial patellofemoral arthroplasty, as well as to delineate the pitfalls and causes of revision in our initial series of 153 cases. Methods: between 2009 and 2016, our group performed 157 patellofemoral arthroplasties (PFA) 74% being in women, and 26% in men, the mean age for women was 58 yrs. And 38 yrs. for men, our initial 13 cases were managed with the Avon prosthesis (Stryker Corporation Kalamazoo, Michigan), and then we switched to the Vanguard PF (Zimmer-Biomet Warsaw In), both systems are an On-Lay design that is more flexible for addressing dysplastic trochleas that are more common in our population. Results: We performed a Knee Osteoarthritis Outcome Score (KOOS) for the assessment of the success of the procedure and obtained 87% of patients with excellent results (95 to 100), 10% with fair results (70 to 90) and 3% with poor outcomes (50), we performed a total of 3 revisions due to pain or progress to global arthritis. Conclusion: The PFA is a successful, safe and reproducible surgery that can be used in the group of patients that have isolated patellofemoral osteoarthritis. It requires a thorough knowledge of the patello femoral joint biomechanics, and physiopathology.

  14. Retrograde femoral interlocking nail in complex fractures.

    PubMed

    Anup, Khare; Mehra, M M

    2002-06-01

    Retrograde interlocking nail was used as the method of fixation in 35 different cases of combination of complex femoral fractures. We performed this procedure in fractures of femoral shaft associated with fracture neck femur, pathological fractures of proximal third of femur with trochanteric pathology, ipsilateral fracture of femur and tibia in polytrauma cases with multiple other injuries, in highly obese patients with fracture shaft femur. This technique was also used in cases of pregnancy with fracture shaft femur and in unstable pelvic fracture or dislocation hip associated with fracture shaft femur. Operative technique involved with retrograde insertion of un-reamed, non-cannulated custom made nail through entrance portal in intercondylar notch was applied for fixation of the shaft femur fracture. The other associated fracture around hip was stabilized separately using suitable implant according to type of fracture. In cases of ipsilateral fracture of femur and tibia, femur was stabilized by retrograde interlocking nail and tibia was stabilized by antigrade interlocking nail through same incision at the same sitting. The case was followed up for three years; the average union time was 12 to 18 weeks. Out of 35 cases, 31 cases regained full knee movement. Out of the remaining 4 cases, 2 cases could regain up to 90 degrees of movement, these were old fractures and non-cooperative patients. In one case, patellofemoral arthritis was developed because of an operative error where a nail was not put inside the articular surface. Mal-union was observed in an early case of the series and implant failure was nil. Retrograde interlocking nail was used as the method of fixation in complex fracture problems. Multiple fractures of long bones can be stabilized in one stage, preventing multiple operations at different stages in polytraumatized patients. This resulted in early recovery, lesser hospital stay, and early rehabilitation of patient with good results and is

  15. Treatment strategies for intramedullary nailing of femoral shaft fractures.

    PubMed

    Wild, Michael; Gehrmann, Sebastian; Jungbluth, Pascal; Hakimi, Mohssen; Thelen, Simon; Betsch, Marcel; Windolf, Joachim; Wenda, Klaus

    2010-10-11

    Intramedullary nailing has become the gold standard to treat femoral shaft fractures. It is unknown which nailing technique orthopedic surgeons prefer. The goal of this study was to determine current techniques and perioperative complications of intramedullary nailing of diaphyseal femoral fractures. Fifty-one institutions in 26 countries participated in an international survey to assess detailed descriptions of preferred operative strategies and perioperative complications. Altogether, 517 cases of diaphyseal femoral fractures were collected. The Internet-based survey incorporated information about fracture classification, time to operation, Injury Severity Score, type of nail, and operative technique, as well as perioperative complications such as infection, femoral neck fracture, and hardware failure. The preferred position for implantation was supine (91.1%). Most surgeons used a traction table (57.1%) and an antegrade implantation technique (84.5%). Intraoperative fractures of the femoral neck occurred in 1.2% of cases when a traction table was used and in 0.2% if no traction table was used, but without statistical significance (P>.16). In 59.2% of the cases, an isolated femur fracture was present, while the rest sustained multiple injuries. In polytrauma patients and patients with severe thorax injuries, most surgeons chose a delayed treatment with intramedullary femoral nails. Interestingly, 38.0% of the patients with severe thorax injuries were treated on the first day with intramedullary femoral nails. The total rate of complications for intramedullary femoral nailing was low (4.9%), but a high rate of intraoperative femoral neck fractures was observed (1.4%). Copyright 2010, SLACK Incorporated.

  16. Quadriceps force after TKA with femoral single radius.

    PubMed

    Ostermeier, Sven; Stukenborg-Colsman, Christina

    2011-06-01

    New implant designs have incorporated a single radius instead of a multiple radius to the femoral component in order to improve the mechanical function after TKA. We investigated the amount of quadriceps force required to extend the knee during an isokinetic extension cycle of different total knee designs, focusing on the radius of the femoral component (single vs. multiple). Human knee specimens (n = 12, median patient age 68 (63-70) years) were tested in a kinematic knee-simulating machine untreated and after implantation of 2 types of knee prosthesis systems, one with a single femoral radius design and one with a multiple femoral radius design. During the test cycle, a hydraulic cylinder, which simulated the quadriceps muscle, applied sufficient force to the quadriceps tendon to produce a constant extension moment of 31 Nm. The quadriceps extension force was measured from 120° to full knee extension. The shape of the quadriceps force curve was typically sinusoidal before and after TKA, reaching a maximum value of 1,493 N at 110°. With the single femoral radius design, quadriceps force was similar to that of the normal knee: 1,509 N at 110° flexion (p = 0.4). In contrast, the multiple femoral radius design showed an increase in quadriceps extension force relative to the normal knee, with a maximum of 1,721 N at 90° flexion (p = 0.03). The single femoral radius design showed lower maximum extension forces than the multiple femoral radius design. In addition, with the single femoral radius design maximum quadriceps force needed to extend a constant extension force shifted to higher degrees of knee flexion, representing a more physiological quadriceps force pattern, which could have a positive effect on knee function after TKA.

  17. [Pathological fractures of the femoral neck in hemodialyzed patients. Apropos of 26 cases].

    PubMed

    Hardy, P; Benoit, J; Donneaud, B; Jehanno, P; Lortat-Jacob, A

    1994-01-01

    This study is based on a retrospective analysis of 26 pathological fractures of the femoral neck in 19 chronic haemodialysis patients. The purpose of this study is to analyze the epidemiological and etiological factors of these fractures in relation to osteo-arthropathy of the dialyzed patient, as well as the results of various treatments, both curative and preventive. 26 pathological fractures of the femoral neck appeared in 19 chronic haemodialysis patients, 11 men and 8 women, 6 patients presented bilateral fractures. The patient's average age at the time of the fracture was 61 years (27 to 82). The average duration of dialysis was 11 years with a minimum of 2 years and a maximum of 21 years. Hyper parathyroidism was found in 14 patients, aluminic intoxication in 6 and amyloidosis at the level of the coxo-femoral joint 18 times. Surgical treatment consisted of 6 osteosynthesis, 2 cephalic arthroplasties, 13 modular arthroplasties and 5 total hip arthroplasties. For each case, we studied the presence of necrosis of the femoral neck due to aluminic intoxication, osteoporosis due to hyperparathyroidism and also the presence of amyloidosis without aluminic intoxication. Cortisonic necrosis and porosis was found 4 times out of 26 cases, hyperparathyroidism once, aluminic osteomalacy 3 times and beta-2-microglobulin amyloid 18 times. Amyloidosis remains the most frequent etiological factor. All patients had been operated for median nerve compression in the carpal tunnel, usually 2.5 years before appearance of the pathological fracture. Non surgical treatment was used 5 times in undisplaced fractures without any sign of amyloidosis and was successful 3 times and unsuccessful twice necessitating a new operation by osteosynthesis. Out of 6 osteosynthesis performed for fractures either with little or no displacement we observed 4 failures, all of them in the cases with intra-osseous amyloidosis. Best results were obtained by arthroplasties. Modular arthroplasty has given

  18. Femoral artery pseudoaneurysm as a complication of angioplasty. How can it be prevented?

    PubMed Central

    Gupta, Prabha Nini; Salam Basheer, Abdul; Sukumaran, Gireesh Gomaty; Padmajan, Sabin; Praveen, Satheesan; Velappan, Praveen; Nair, Bigesh Unnikrishnan; Nair, Sandeep Govindan; Kunjuraman, Usha Kumari; Madthipat, Unnikrishnan; R, Jayadevan

    2013-01-01

    Femoral pseudoaneurysm is a common complication of repeated femoral puncture during cardiac catheterisation. We describe here the development of femoral pseudoaneurysms in a patient with Takayasu's arteritis, which healed in response to conservative treatment, and review the literature on the prevention and treatment of femoral pseudoaneurysm. PMID:27326111

  19. Bilateral Femoral Neck Stress Fracture in Child: A Case Report

    PubMed Central

    Lee, Gun-Woo; Yoon, Taek-Rim; Eshnazarovich, Eshnazarov Kamolhuja

    2016-01-01

    A femoral neck stress fracture in child is rare, particularly in bilateral case. It is easy to miss initially or may be misdiagnosed. The authors experienced a case of bilateral femoral neck stress fracture in a 10-year-old boy with bilateral hip. The patient was successfully healed by conservative treatment. We report this rare case with a review of the literature. A femoral neck stress fracture should be included in the differential diagnosis in children who present with sustained hip or groin pain. PMID:27777920

  20. Neurapraxia of the femoral nerve in a modern dancer.

    PubMed

    Sammarco, G J; Stephens, M M

    1991-01-01

    We have presented a case of an acute onset femoral nerve neurapraxia in a pure modern dancer. Repeated mild stretching of the femoral nerve during an established dance routine over a period of several months is implicated as the etiology. The thigh muscles quickly weakened, but regained strength within 3 months. Electromyographic evidence of specific femoral nerve injury initially was negative, but was evident 6 weeks following injury. Overuse syndrome in dancers can cause rapid loss of strength. Other conditions such as herniated intervertebral disc, acute hemorrhage, trauma, iliopsoas rupture, and acute stretching must be ruled out. Complete recovery was the natural outcome.

  1. Iliopsoas tendonitis caused by overhang of a collared femoral prosthesis.

    PubMed

    Brew, Christopher J; Stockley, Ian; Grainger, Andrew J; Stone, Martin H

    2011-04-01

    Pain after total hip arthroplasty can be due to a variety of causes, one of the less common being iliopsoas tendonitis. We report an unusual case of iliopsoas tendonitis caused by overhang of the femoral calcar by a collared femoral prosthesis resulting in impingement on the iliopsoas tendon. An ultrasound-guided corticosteroid and local anesthetic diagnostic injection to the site of impingement confirmed the diagnosis with temporary symptom relief. Revision of the femoral stem to a collarless prosthesis resulted in immediate and complete resolution of symptoms.

  2. Bilateral impacted femoral neck fracture in a renal disease patient.

    PubMed

    Devkota, Pramod; Ahmad, Shiraz

    2013-09-01

    Spontaneous bilateral femoral neck facture in a renal disease patient is not common. We report a case of 47-year-old female patient with chronic renal failure and on regular hemodialysis for the past 5 years who sustained bilateral impacted femoral neck fracture without history of trauma and injury and refused any surgical intervention. The patient was mobilised on wheel chair one year after the fractures. The cause of the fracture and the literature review of the bilateral femoral neck fracture in renal disease are discussed.

  3. The Langley Wind Tunnel Enterprise

    NASA Technical Reports Server (NTRS)

    Paulson, John W., Jr.; Kumar, Ajay; Kegelman, Jerome T.

    1998-01-01

    After 4 years of existence, the Langley WTE is alive and growing. Significant improvements in the operation of wind tunnels have been demonstrated and substantial further improvements are expected when we are able to truly address and integrate all the processes affecting the wind tunnel testing cycle.

  4. Modeling Indirect Tunneling in Silicon

    NASA Astrophysics Data System (ADS)

    Chen, Edward

    Indirect tunneling in silicon p-n junctions catches people's attention again in recent years. First, the phenomenon induces a serious leakage problem, so called gate-induced drain leakage (GIDL) effect, in modern metal-oxide-semiconductor field-effect transistors (MOSFETs). Second, it is utilized to develop a novel tunneling transistor with the sharp turn-on ability for continuing ITRS roadmap. Although the indirect tunneling is important for the state-of-the-art transistor-technology, the accuracy of the present tunneling models in technology computer-aided design (TCAD) tools is still vague. In the research work, the theory of indirect tunneling in silicon has been thoroughly studied. The phonon-assisted tunneling model has been developed and compared with the existing ones in the Sentaurus-Synopsys, Medici-Synopsys, and Atlas-Silvaco TCAD tools. Beyond these existing models, ours successfully predicts the indirect tunneling current under the different field direction in silicon. In addition, bandgap narrowing in heavily-doped p-n junctions under the reverse-biased condition is also studied during the model development. At the end of the research work, the application to low standby power (LSTP) transistors is demonstrated to show the capability of our tunneling model in the device level.

  5. Supersonic Wind Tunnel Test Section

    NASA Technical Reports Server (NTRS)

    1957-01-01

    8ft x 6ft Supersonic Wind Tunnel Test-Section showing changes made in Stainless Steel walls with 17 inch inlet model installation. The model is the ACN Nozzle model used for aircraft engines. The Supersonic Wind Tunnel is located in the Lewis Flight Propulsion Laboratory, now John H. Glenn Research Center

  6. Early Childhood: Funnels and Tunnels.

    ERIC Educational Resources Information Center

    Fowlkes, Mary Anne

    1985-01-01

    Suggests using funnels and tunnels in combination with water, blocks, transportation toys, and other materials to help teach preschoolers to make predictions. Many examples are included for using funnels to understand properties of liquids and for using tunnels to predict order. (DH)

  7. Comparative repeatability of guide-pin axis positioning in computer-assisted and manual femoral head resurfacing arthroplasty.

    PubMed

    Hodgson, A; Helmy, N; Masri, B A; Greidanus, N V; Inkpen, K B; Duncan, C P; Garbuz, D S; Anglin, C

    2007-10-01

    The orientation of the femoral component in hip resurfacing arthroplasty affects the likelihood of loosening and fracture. Computer-assisted surgery has been shown to improve significantly the surgeon's ability to achieve a desired position and orientation; nevertheless, both bias and variability in positioning remain and can potentially be improved. The authors recently developed a computer-assisted surgical (CAS) technique to guide the placement of the pin used in femoral head resurfacing arthroplasty and showed that it produced significantly less variation than a typical manual technique in varus/valgus placement relative to a preoperatively determined surgical plan while taking a comparable amount of time. In the present study, the repeatability of both the CAS and manual techniques is evaluated in order to estimate the relative contributions to overall variability of surgical technique (CAS versus manual), surgeon experience (novice versus experienced), and other sources of variability (e.g. across specimens and across surgeons). This will enable further improvements in the accuracy of CAS techniques. Three residents/fellows new to femoral head resurfacing and three experienced hip arthroplasty surgeons performed 20-30 repetitions of each of the CAS and manual techniques on at least one of four cadaveric femur specimens. The CAS system had markedly better repeatability (1.2 degrees) in varus/valgus placement relative to the manual technique (2.8 degrees), slightly worse repeatability in version (4.4 degrees versus 3.2 degrees), markedly better repeatability in mid-neck placement (0.7 mm versus 2.5 mm), no significant dependence on surgeon skill level (in contrast to the manual technique), and took significantly less time (50 s versus 123 s). Proposed improvements to the version measurement process showed potential for reducing the standard deviation by almost two thirds. This study supports the use of CAS for femoral head resurfacing as it is quicker than the

  8. A Binary Tunnel Field Effect Transistor with a Steep Sub-threshold Swing and Increased ON Current

    NASA Astrophysics Data System (ADS)

    Asra, Ram; Murali, Kota V. R. M.; Ramgopal Rao, V.

    2010-12-01

    A variant tunnel field effect transistor structure called the binary tunnel field effect transistor (BTFET) for low voltage and near ideal switching characteristics is proposed. The BTFET relies on a binary tunneling distance (HIGH and LOW) for its operation to achieve a steep sub-threshold swing with a predicted range of 5 mV/dec. The transition of tunneling distance from HIGH to LOW state is a step-function of the gate voltage with the threshold voltage as a transition voltage. BTFET has a high on-current due to the high gate electric field and a large tunneling cross section area. An orientation dependent non-local band-to-band tunneling model was used to analyze the DC characteristics of the device.

  9. Carpal tunnel syndrome.

    PubMed

    Chammas, M

    2014-04-01

    Carpal tunnel syndrome is the commonest entrapment neuropathy and is due to combined compression and traction on the median nerve at the wrist. It is often idiopathic. Although spontaneous resolution is possible, the usual natural evolution is slow progression. Diagnosis is mainly clinical depending on symptoms and provocative tests. An electromyogram is recommended preoperatively and in cases of work-related disease. Medical treatment is indicated early on or in cases with no deficit and consists of steroid injection in the canal or a night splint in neutral wrist position. Surgical treatment is by section of the flexor retinaculum and is indicated in resistance to medical treatment, in deficit or acute cases. Mini-invasive techniques such as endoscopic and mini-open approaches to carpal tunnel release with higher learning curves are justified by the shorter functional recovery time compared to classical surgery, but with identical long-term results. The choice depends on the surgeon's preference, patient information, stage of severity, etiology and availability of material. Results are satisfactory in 90% of cases. Nerve recovery depends on the stage of severity as well as general patient factors. Recovery of force takes about 2-3 months after the disappearance of 'pillar pain'. This operation has a benign reputation with a 0.2-0.5% reported neurovascular complication rate. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  10. Tunneling in Superconductors

    NASA Astrophysics Data System (ADS)

    Giaever, Ivar

    2002-03-01

    It has been said that Thomas Edison's greatest invention was that of the "Research Laboratory" as a social institution. My greatest discovery was when I learned at 29 years of age that it was possible to work in such an institution and get paid for doing research. I had become interested in physics, gotten a job at General Electric Research Laboratory and found a great mentor in John C. Fischer, who besides instructing me in physics told me that sooner or later we all would become historians of science. I guess for me that time is now, because I have been asked to tell you about my second greatest discovery: Tunneling in superconductors. My great fortune was to be at the right place at the right time, where I had access to outstanding and helpful (not necessary an oxymoron) physicists. Hopefully I will be able to convey to you some of the fun and excitement of that area in this recollection. If you become real interested you may find a written version in my Nobel Prize talk: "Electron Tunneling and Superconductivity" Les Prix Nobel en 1973 or Science 183, 1253-1258 1974 or Reviews of Modern Physics 46 (2), 245-250 1974

  11. 15-Foot Spin Tunnel

    NASA Technical Reports Server (NTRS)

    1935-01-01

    A researcher is launching a model into the tunnel airstream of the 15-Foot Spin Tunnel. Charles Zimmerman wrote in NASA TR No. 557: 'After the observations have been made, the model is lowered into a net held in the air stream by one of the operators or into a large bowl-shaped net at the bottom of the test section. When lowered into the large net, the model is retrieved with a long- handled clamp.' (p. 267) 'The models used are generally 1/10 to 1/16 scale. The size of the models is limited by the wing span and the wing loading. The maximum allowable span is about 36 inches; the maximum wing loading is about 1.3 pounds per square foot.' (p. 266) 'Balsa wood is the usual structural material because of its low density. It is necessary to hollow out the after portion of the fuselage and to cut out a large portion of the wood in the wings to permit proper mass distribution. The wing cut-outs are covered with silk tissue paper. The leading and trailing edges and tips of the wings are fitted with strips of spruce, pattern pine, or bamboo inset into the edge of the balsa to prevent disfigurement from accidental blows or from striking the safety netting. Lead is used for ballast.' (p. 266)

  12. Tunneling magnetic force microscopy

    NASA Technical Reports Server (NTRS)

    Burke, Edward R.; Gomez, Romel D.; Adly, Amr A.; Mayergoyz, Isaak D.

    1993-01-01

    We have developed a powerful new tool for studying the magnetic patterns on magnetic recording media. This was accomplished by modifying a conventional scanning tunneling microscope. The fine-wire probe that is used to image surface topography was replaced with a flexible magnetic probe. Images obtained with these probes reveal both the surface topography and the magnetic structure. We have made a thorough theoretical analysis of the interaction between the probe and the magnetic fields emanating from a typical recorded surface. Quantitative data about the constituent magnetic fields can then be obtained. We have employed these techniques in studies of two of the most important issues of magnetic record: data overwrite and maximizing data-density. These studies have shown: (1) overwritten data can be retrieved under certain conditions; and (2) improvements in data-density will require new magnetic materials. In the course of these studies we have developed new techniques to analyze magnetic fields of recorded media. These studies are both theoretical and experimental and combined with the use of our magnetic force scanning tunneling microscope should lead to further breakthroughs in the field of magnetic recording.

  13. Two tunnels to inflation

    SciTech Connect

    Aguirre, Anthony; Johnson, Matthew C.

    2006-06-15

    We investigate the formation via tunneling of inflating (false-vacuum) bubbles in a true-vacuum background, and the reverse process. Using effective potentials from the junction condition formalism, all true- and false-vacuum bubble solutions with positive interior and exterior cosmological constant, and arbitrary mass are catalogued. We find that tunneling through the same effective potential appears to describe two distinct processes: one in which the initial and final states are separated by a wormhole (the Farhi-Guth-Guven mechanism), and one in which they are either in the same hubble volume or separated by a cosmological horizon. In the zero-mass limit, the first process corresponds to the creation of an inhomogenous universe from nothing, while the second mechanism is equivalent to the nucleation of true- or false-vacuum Coleman-De Luccia bubbles. We compute the probabilities of both mechanisms in the WKB approximation using semiclassical Hamiltonian methods, and find that--assuming both process are allowed--neither mechanism dominates in all regimes.

  14. Tunneling in thin MOS structures

    NASA Technical Reports Server (NTRS)

    Maserjian, J.

    1974-01-01

    Recent results on tunneling in thin MOS structures are described. Thermally grown SiO2 films in the thickness range of 22-40 A have been shown to be effectively uniform on an atomic scale and exhibit an extremely abrupt oxide-silicon interface. Resonant reflections are observed at this interface for Fowler-Nordheim tunneling and are shown to agree with the exact theory for a trapezoidal barrier. Tunneling at lower fields is consistent with elastic tunneling into the silicon direct conduction band and, at still lower fields, inelastic tunneling into the indirect conduction band. Approximate dispersion relations are obtained over portions of the silicon-dioxide energy gap and conduction band.

  15. High-resolution tunnel fluctuoscopy

    SciTech Connect

    Glatz, A.; Varlamov, A. A.; Vinokur, V. M.

    2014-08-01

    Electron tunneling spectroscopy pioneered by Esaki and Giaever offered a powerful tool for studying electronic spectra and density of states (DOS) in superconductors. This led to important discoveries that revealed, in particular, the pseudogap in the tunneling spectrum of superconductors above their critical temperatures. However, the phenomenological approach of Giaever and Megerle does not resolve the fine structure of low-bias behavior carrying significant information about electron scattering, interactions, and decoherence effects. Here we construct a complete microscopic theory of electron tunneling into a superconductor in the fluctuation regime. We reveal a non-trivial low-energy anomaly in tunneling conductivity due to Andreev-like reflections of injected electrons from superconducting fluctuations. Our findings enable real-time observation of fluctuating Cooper pairs dynamics by time-resolved scanning tunneling microscopy measurements and open new horizons for quantitative analysis of the fluctuation electronic spectra of superconductors.

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

    PubMed

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

    1989-08-01

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

  17. Acute femoral neuropathy secondary to an iliacus muscle hematoma.

    PubMed

    Seijo-Martínez, M; Castro del Río, M; Fontoira, E; Fontoira, M

    2003-05-15

    We present a patient with a spontaneous iliacus muscle hematoma, appearing immediately after a minor physical maneuver, presenting with pain and femoral neuropathy initially evidenced by massive quadriceps muscle fasciculations. A magnetic resonance imaging (MRI) study of the pelvic area confirmed the diagnosis, showing a hematoma secondary to a partial muscle tear. The patient was managed conservatively, and the continuous muscle activity ceased in 3 days, with progressive improvement of the pain and weakness. The recovery was complete. Femoral neuropathy is uncommon and usually due to compression from psoas muscle mass lesions of diverse nature, including hematomas. Usually subacute, femoral neuropathy may present acutely in cases of large or strategically placed compressive femoral nerve lesions, and may require surgical evacuation. The case presented herein is remarkable since the muscle hematoma appeared after a nonviolent maneuver, fasciculations were present at onset, and conservative management was sufficient for a full recovery.

  18. Giant cell tumor of the femoral neck: case report.

    PubMed

    Silva, Paulo; Amaral, Rogério Andrade do; Oliveira, Leandro Alves de; Moraes, Frederico Barra de; Chaibe, Eduardo Damasceno

    2016-01-01

    The authors present the case of a patient with a giant cell tumor of the left femoral neck, with adjacent progressive invasion of bone tissue. Initial treatment was done with local curettage and autologous bone graft from fibula, electrocauterization and filling with methyl methacrylate. A local tumoral relapse was present after one year; therefore a new surgical procedure was necessary, with proximal femoral wide resection and unconventional endoprosthesis fixation. The article discusses the clinical aspects and surgical treatment. This report aimed to demonstrate the necessity to perform wide resection for giant cell tumor of the femoral neck, prioritizing total resection of the tumor and its local extension, preserving limb integrity and demonstrating the complete failure of preserving surgery in cases of femoral neck involvement.

  19. Mechanisms of stem subsidence in femoral impaction allografting.

    PubMed

    Albert, Carolyne; Frei, Hanspeter; Duncan, Clive; Fernlund, Goran

    2011-01-01

    Failure of the femoral component of total hip arthroplasty is often accompanied by bone loss that can pose a significant challenge to the orthopaedic surgeon. Femoral impaction allografting has attractive potential for restoring bone stock in deficient femurs. However, there have been reports of problematic postoperative stem subsidence with this procedure. Subsidence is highly variable among patients, and there is disagreement over the mechanisms that cause it. This article reviews the various mechanisms that can contribute to subsidence in femoral impaction allografting. Variables such as graft density, cement penetration profile, use of synthetic graft substitutes, or other graft additives are discussed, as well as their potential impact on subsidence. Finally, recommendations are made for future studies aiming to reduce the risk of excessive subsidence in femoral impaction allografting.

  20. [How to determine the rotation of the femoral component].

    PubMed

    Matziolis, G; Roehner, E

    2015-04-01

    The different landmarks for determination of the rotation of the femoral component are shown and specific pros and cons are discussed. The videos demonstrate how to identify them intraoperatively. Georg Thieme Verlag KG Stuttgart · New York.

  1. Electromagnetics for Detecting Shallow Tunnels

    NASA Astrophysics Data System (ADS)

    Won, I.

    2006-05-01

    Detecting tunnels by geophysical means, even very shallow ones, has been difficult, to say the least. Despite heavy R&D funding from the military since the early 70s, geophysicists have not produced tools that are simple and practical enough to meet the military needs. The initial interest and R&D funding on the subject perhaps started with the Vietcong tunnels in the 60s. Tunnels in the Korean DMZ, first found in the mid 70s, sharply escalated the R&D spending. During the 90s, covert tunnels along the US-Mexico border have kept the topic alive but at a minimal funding level. Most recent interest appears to be in the terrorism-related shallow tunnels, more or less anywhere in the regions of conflict. Despite the longstanding effort in the geophysical community under heavy public funding, there is a dearth of success stories where geophysicists can actually claim to have found hitherto unknown tunnels. For instance, geophysics has not discovered a single tunnel in Vietnam or in Korea! All tunnels across the Korean DMZ were found from human intelligence. The same is true to all illicit tunnels found along the southwestern border. The tunnels under discussion are clandestine, which implies that the people who built them do not wish others to succeed in finding them. The place around the tunnel, therefore, may not be the friendliest venue for surveyors to linger around. The situation requires tools that are fast, little noticeable, and hardly intrusive. Many geophysical sensors that require ground contacts, such as geophones and electrodes that are connected by a myriad of cables, may not be ideal in this situation. On the other hand, a sensor that can be carried by vehicle without stopping, and is nothing obviously noticeable to bystanders, could be much more acceptable. Working at unfriendly environment also requires forgoing our usual practices where we collect data leisurely and make pretty maps later. To be useful, geophysical tools must be able to process

  2. Frequency driven inversion of tunnel magnetoimpedance and observation of positive tunnel magnetocapacitance in magnetic tunnel junctions

    SciTech Connect

    Parui, Subir E-mail: l.hueso@nanogune.eu; Ribeiro, Mário; Atxabal, Ainhoa; Llopis, Roger; Bedoya-Pinto, Amilcar; Sun, Xiangnan; Casanova, Fèlix; Hueso, Luis E. E-mail: l.hueso@nanogune.eu

    2016-08-01

    The relevance for modern computation of non-volatile high-frequency memories makes ac-transport measurements of magnetic tunnel junctions (MTJs) crucial for exploring this regime. Here, we demonstrate a frequency-mediated effect in which the tunnel magnetoimpedance reverses its sign in a classical Co/Al{sub 2}O{sub 3}/NiFe MTJ, whereas we only observe a gradual decrease in the tunnel magnetophase. Such effects are explained by the capacitive coupling of a parallel resistor and capacitor in the equivalent circuit model of the MTJ. Furthermore, we report a positive tunnel magnetocapacitance effect, suggesting the presence of a spin-capacitance at the two ferromagnet/tunnel-barrier interfaces. Our results are important for understanding spin transport phenomena at the high frequency regime in which the spin-polarized charge accumulation due to spin-dependent penetration depth at the two interfaces plays a crucial role.

  3. Frequency driven inversion of tunnel magnetoimpedance and observation of positive tunnel magnetocapacitance in magnetic tunnel junctions

    NASA Astrophysics Data System (ADS)

    Parui, Subir; Ribeiro, Mário; Atxabal, Ainhoa; Bedoya-Pinto, Amilcar; Sun, Xiangnan; Llopis, Roger; Casanova, Fèlix; Hueso, Luis E.

    2016-08-01

    The relevance for modern computation of non-volatile high-frequency memories makes ac-transport measurements of magnetic tunnel junctions (MTJs) crucial for exploring this regime. Here, we demonstrate a frequency-mediated effect in which the tunnel magnetoimpedance reverses its sign in a classical Co/Al2O3/NiFe MTJ, whereas we only observe a gradual decrease in the tunnel magnetophase. Such effects are explained by the capacitive coupling of a parallel resistor and capacitor in the equivalent circuit model of the MTJ. Furthermore, we report a positive tunnel magnetocapacitance effect, suggesting the presence of a spin-capacitance at the two ferromagnet/tunnel-barrier interfaces. Our results are important for understanding spin transport phenomena at the high frequency regime in which the spin-polarized charge accumulation due to spin-dependent penetration depth at the two interfaces plays a crucial role.

  4. Sufficient penetration of peracetic acid into drilled human femoral heads.

    PubMed

    Brosig, H; Jacker, H-J; Borchert, H-H; Kalus, U; Dörner, T; von Versen, R; Pruss, A

    2005-01-01

    Chemical sterilisation methods for musculoskeletal transplants have the problem of penetration into all tissue strata. The present study examined if a peracetic acid/ethanol solution penetrated to a sufficient extent into specifically prepared femoral heads. To this effect, 10 femoral heads have been provided with drillings (diameter 2 mm, depth 10 mm) at a distance of 15 mm (series B) and placed in a diffusion chamber with sterilisation solution. From an additional central drilling at the femoral neck junction, the sample drawing was made after 30 min each over a period of 4 h for the iodometric determination of peracetic acid (PAA) concentration. Ten femoral heads, which did contain only the central drilling, served as controls (series A). In 9 of the examined femoral heads of series A the defined minimum concentration of PAA of 0.2% (inactivation of bacteria, spores, fungi) has been clearly exceeded over the complete period of measurement. About 0.8% PAA (inactivation of viruses) was achieved within 4 h only with six femoral heads. Nine out of the 10 examined femoral heads in series B show a clearly improved penetration behaviour which was expressed in smaller standard deviations, a faster increase in concentration, as well as in higher starting and final concentrations (approx. 0.9%) of PAA. Previous drying in air leads to a faster penetration into the centre of the bone. Standardised drilling of de-cartilaged femoral heads creates favourable conditions for the penetration of the PAA sterilisation solution into the whole tissue and guarantees a sufficient inactivation of microorganisms.

  5. Slipped capital femoral epiphysis following radiation and chemotherapy

    SciTech Connect

    Walker, S.J.; Whiteside, L.A.; McAlister, W.H.; Silverman, C.L.; Thomas, P.R.

    1981-01-01

    Patients who received radiation to the proximal femoral epiphysis and chemotherapy in childhood appear to have an increased risk of subsequently developing epiphyseolysis. Every effort should be made to exclude the proximal femoral epiphysis from the radiation port whenever possible. If the epiphyseal plate is widened and irregular and the adjacent bone is sclerotic, prophylactic pinning may be indicated even in the absence of a grossly visible slip.

  6. Proximal femoral replacement for the treatment of periprosthetic fractures.

    PubMed

    Klein, Gregg R; Parvizi, Javad; Rapuri, Venkat; Wolf, Christopher F; Hozack, William J; Sharkey, Peter F; Purtill, James J

    2005-08-01

    A periprosthetic fracture around the femoral component is a rare but potentially problematic complication after total hip arthroplasty. Reconstruction can be challenging, especially when severe bone stock deficiency is encountered. Proximal femoral replacement is one method of treating the severely deficient proximal part of the femur. The present report describes the outcomes of revision total hip arthroplasty with use of a proximal femoral replacement in a cohort of patients who had a Vancouver type-B3 periprosthetic fracture. With use of a computerized institutional database, all patients in whom a Vancouver type-B3 fracture (characterized by severe proximal bone deficiency and a loose femoral stem) had been treated with a proximal femoral replacement were identified. A modular femoral replacement with proximal porous coating had been used in all cases. The twenty-one patients who were identified had had a mean age of 78.3 years (range, fifty-two to ninety years) at the time of the index operation. The clinical and radiographic records of these patients were reviewed. At the time of the latest follow-up (mean, 3.2 years), all but one of the patients were able to walk and had minimal to no pain. Complications included persistent wound drainage that was treated with incision and drainage (two hips), dislocation (two hips), refracture of the femur distal to the stem (one hip), and acetabular cage failure (one hip). Despite a relatively high complication rate, we believe that proximal femoral replacement is a viable option for the treatment of periprosthetic fractures in older patients with severe bone deficiency. If a proximal femoral replacement is used, the stability of the hip must be tested diligently intraoperatively and a constrained acetabular liner should be utilized if instability is encountered. In order to enhance the bone stock, the proximal part of the femur, however poor in quality, should be retained for reapproximation onto the implant.

  7. Computer-aided design and custom-made guide in corrective osteotomy for complex femoral deformity.

    PubMed

    Chai, Wei; Xu, Meng; Zhang, Guo-qiang; Zhang, Li-hai; Gou, Wen-long; Ni, Ming; Chen, Ji-ying

    2013-06-01

    Preoperative planning of corrective osteotomy with traditional radiography has limitations in regards to determining the ideal osteotomy location and orientation in three-dimensional femoral deformities. Though a successful operation can be planned preoperatively, intraoperative contingencies might adhere to the procedural plan in the performance of operation. To efficiently perform a planned procedure, proposed is a design to implement three-dimensional reconstruction photography, based on computer-tomography (CT) scan. A custom-made guide was designed to navigate the osteotomy as planned, and additionally, a personalized intramedullary nail was used for fixation after osteotomy. Three-dimensional (3D) photography of deformed femur was established based on the CT dataset and transferred into 3D photography processing software for further planning. Osteotomy planes were designed and adjusted at deformity sites to correct the 3D deformities. The methodology of a custom-made osteotomy guide was introduced in femoral corrective osteotomy, for the first time, to navigate the operation as planned. After the virtual osteotomy and reduction of bone segments, the parameters of a custom-made intramedullary nail were measured for manufacturing. Findings Virtual operation in computer shows complete correction of the 3D deformity. The osteotomy guide, obtained by rapid-prototyping techniques, navigates mimicking surgery on rapid-prototyping model of the involved femur as planned. Internal fixation was achieved using the custom-made intramedullary nail. Interpretation three-dimensional visualization introduces an advantage in preoperative planning for corrective osteotomy of 3D femoral deformity, and the custom-made osteotomy guide is crucial to realize such a deliberate plan during the actual procedures. The internal fixator, such as an intramedullary nail, can be modified or personalized for fixation in unique cases.

  8. Increased revision rate with posterior tibial tunnel placement after using the 70-degree tibial guide in ACL reconstruction.

    PubMed

    Inderhaug, Eivind; Raknes, Sveinung; Østvold, Thomas; Solheim, Eirik; Strand, Torbjørn

    2017-01-01

    To map knee morphology radiographically in a population with a torn ACL and to investigate whether anatomic factors could be related to outcomes after ACL reconstruction at mid- to long-term follow-up. Further, we wanted to assess tibial tunnel placement after using the 70-degree "anti-impingement" tibial tunnel guide and investigate any relation between tunnel placement and revision surgery. Patients undergoing ACL reconstruction involving the 70-degree tibial guide from 2003 to 2008 were included. Two independent investigators analysed pre- and post-operative radiographs. Demographic data and information on revision surgery were collected from an internal database. Anatomic factors and post-operative tibial tunnel placements were investigated as predictors of revision. Three-hundred and seventy-seven patients were included in the study. A large anatomic variation with significant differences between men and women was seen. None of the anatomic factors could be related to a significant increase in revision rate. Patients with a posterior tibial tunnel placement, defined as 50 % or more posterior on the Amis and Jakob line, did, however, have a higher risk of revision surgery compared to patients with an anterior tunnel placement (P = 0.03). Use of the 70-degree tibial guide did result in a high incidence (47 %) of posterior tibial tunnel placements associated with an increased rate of revision surgery. The current study was, however, not able to identify any anatomic variation that could be related to a higher risk of revision surgery. Avoiding graft impingement from the femoral roof in anterior tibial tunnel placements is important, but the insight that overly posterior tunnel placement can lead to inferior outcome should also be kept in mind when performing ACL surgery. IV.

  9. Orienting hypnosis.

    PubMed

    Hope, Anna E; Sugarman, Laurence I

    2015-01-01

    This article presents a new frame for understanding hypnosis and its clinical applications. Despite great potential to transform health and care, hypnosis research and clinical integration is impaired in part by centuries of misrepresentation and ignorance about its demonstrated efficacy. The authors contend that advances in the field are primarily encumbered by the lack of distinct boundaries and definitions. Here, hypnosis, trance, and mind are all redefined and grounded in biological, neurological, and psychological phenomena. Solutions are proposed for boundary and language problems associated with hypnosis. The biological role of novelty stimulating an orienting response that, in turn, potentiates systemic plasticity forms the basis for trance. Hypnosis is merely the skill set that perpetuates and influences trance. This formulation meshes with many aspects of Milton Erickson's legacy and Ernest Rossi's recent theory of mind and health. Implications of this hypothesis for clinical skills, professional training, and research are discussed.

  10. Simulations in quantum tunneling

    NASA Astrophysics Data System (ADS)

    Smith, Kevin; Blaylock, Guy

    2017-10-01

    We study the timing effects of nonrelativistic wave packet tunneling through a barrier using a numerical simulation readily accessible to an undergraduate audience. We demonstrate that the peak of the transmitted packet can sometimes emerge from the barrier ahead of the peak of an undisturbed wave packet that does not encounter a barrier. Under the right circumstances, this effect can give the appearance that transmission through the barrier occurs at superluminal speeds. We demonstrate that this seemingly paradoxical effect is not all that puzzling. Rather, components from the front of the incoming wave packet are preferentially transmitted, forming a transmitted packet ahead of the average of the incoming wave packet but not ahead of the leading edge of that packet. Our studies also show how the timing depends on barrier height and width, consistent with expectations based on the different energy components of the wave packet.

  11. Anterior tarsal tunnel syndrome.

    PubMed

    DiDomenico, Lawrence A; Masternick, Eric B

    2006-07-01

    Compression of the deep peroneal nerve is commonly referred to as anterior tarsal tunnel syndrome. Although rare, this syndrome remains poorly diagnosed. The syndrome is characterized by pain, weakness, and sensory changes of the foot and ankle. Non-operative measures should be attempted to reduce or remove the external compression along the anterior aspect of the foot and ankle. Other options include shoe modifications, cortisone injections,and physical therapy. If conservative management fails to relieve the symptoms, surgical decompression of the entrapped nerve can be performed. The deep peroneal nerve is released from compressive forces in the entrapment site. This can be performed at the more proximal level at the extensor retinaculum or more distally at the level of the tarsal metatarsal site.

  12. Tunnelling microscopy of DNA

    NASA Astrophysics Data System (ADS)

    Selci, Stefano; Cricenti, Antonio

    1991-01-01

    Uncoated DNA molecules marked with an activated tris (1-aziridinyl) phosphine oxide (TAPO) solution were deposited on gold substrates and imaged in air with a high resolution Scanning Tunnelling Microscope (STM). The STM operated simultaneously in the constant-current and gap-modulated mode. Highly reproducible STM images have been obtained and interpreted in terms of expected DNA structure. The main periodicity, regularly presented in molecules several hundred Ångstrom long, ranges from 25 Å to 35 Å with an average diameter of 22 Å. Higher resolution images of the minor groove have revealed the phosphate groups along the DNA backbones. Constant-current images of TAPO deposited on gold show a crystalline structure of rows of molecules with a side-by-side spacing of 3 Å.

  13. Full-Scale Tunnel (FST)

    NASA Technical Reports Server (NTRS)

    1930-01-01

    Steam pile driver for foundation of Full-Scale Tunnel (FST). In 1924, George Lewis, Max Munk and Fred Weick began to discuss an idea for a wind tunnel large enough to test a full-scale propeller. Munk sketched out a design for a tunnel with a 20-foot test section. The rough sketches were presented to engineers at Langley for comment. Elliott Reid was especially enthusiastic and he wrote a memorandum in support of the proposed 'Giant Wind Tunnel.' At the end of the memorandum, he appended the recommendation that the tunnel test section should be increased to 30-feet diameter so as to allow full-scale testing of entire airplanes (not just propellers). Reid's idea for a full-scale tunnel excited many at Langley but the funds and support were not available in 1924. Nonetheless, Elliot Reid's idea would eventually become reality. In 1928, NACA engineers began making plans for a full-scale wind tunnel. In February 1929, Congress approved of the idea and appropriated $900,000 for construction. Located just a few feet from the Back River, pilings to support the massive building's foundation had to be driven deep into the earth. This work began in the spring of 1929 and cost $11,293.22

  14. Full-Scale Tunnel (FST)

    NASA Technical Reports Server (NTRS)

    1930-01-01

    Pile driving for foundation of Full-Scale Tunnel (FST). In 1924, George Lewis, Max Munk and Fred Weick began to discuss an idea for a wind tunnel large enough to test a full-scale propeller. Munk sketched out a design for a tunnel with a 20-foot test section. The rough sketches were presented to engineers at Langley for comment. Elliott Reid was especially enthusiastic and he wrote a memorandum in support of the proposed 'Giant Wind Tunnel.' At the end of the memorandum, he appended the recommendation that the tunnel test section should be increased to 30-feet diameter so as to allow full-scale testing of entire airplanes (not just propellers). Reid's idea for a full-scale tunnel excited many at Langley but the funds and support were not available in 1924. Nonetheless, Elliot Reid's idea would eventually become reality. In 1928, NACA engineers began making plans for a full-scale wind tunnel. In February 1929, Congress approved of the idea and appropriated $900,000 for construction. Located just a few feet from the Back River, pilings to support the massive building's foundation had to be driven deep into the earth. This work began in the spring of 1929 and cost $11,293.22.

  15. Full-Scale Tunnel (FST)

    NASA Technical Reports Server (NTRS)

    1930-01-01

    General view of concrete column base for Full-Scale Tunnel (FST). In 1924, George Lewis, Max Munk and Fred Weick began to discuss an idea for a wind tunnel large enough to test a full-scale propeller. Munk sketched out a design for a tunnel with a 20-foot test section. The rough sketches were presented to engineers at Langley for comment. Elliott Reid was especially enthusiastic and he wrote a memorandum in support of the proposed 'Giant Wind Tunnel.' At the end of the memorandum, he appended the recommendation that the tunnel test section should be increased to 30-feet diameter so as to allow full-scale testing of entire airplanes (not just propellers). Reid's idea for a full-scale tunnel excited many at Langley but the funds and support were not available in 1924. Nonetheless, Elliot Reid's idea would eventually become reality. In 1928, NACA engineers began making plans for a full-scale wind tunnel. In February 1929, Congress approved of the idea and appropriated $900,000 for construction. Work on the foundation began in the spring of 1929 and cost $11,293.22.

  16. Mars Surface Tunnel Element Concept

    NASA Technical Reports Server (NTRS)

    Rucker, Michelle A.; Jefferies, Sharon; Howe, A. Scott; Howard, Robert; Mary, Natalie; Watson, Judith; Lewis, Ruthan

    2016-01-01

    When the first human visitors on Mars prepare to return to Earth, they will have to comply with stringent planetary protection requirements. Apollo Program experience warns that opening an EVA hatch directly to the surface will bring dust into the ascent vehicle. To prevent inadvertent return of potential Martian contaminants to Earth, careful consideration must be given to the way in which crew ingress their Mars Ascent Vehicle (MAV). For architectures involving more than one surface element-such as an ascent vehicle and a pressurized rover or surface habitat-a retractable tunnel that eliminates extravehicular activity (EVA) ingress is an attractive solution. Beyond addressing the immediate MAV access issue, a reusable tunnel may be useful for other surface applications, such as rover to habitat transfer, once its primary mission is complete. A National Aeronautics and Space Administration (NASA) team is studying the optimal balance between surface tunnel functionality, mass, and stowed volume as part of the Evolvable Mars Campaign (EMC). The study team began by identifying the minimum set of functional requirements needed for the tunnel to perform its primary mission, as this would presumably be the simplest design, with the lowest mass and volume. This Minimum Functional Tunnel then becomes a baseline against which various tunnel design concepts and potential alternatives can be traded, and aids in assessing the mass penalty of increased functionality. Preliminary analysis indicates that the mass of a single-mission tunnel is about 237 kg, not including mass growth allowance.

  17. The accuracy of femoral intramedullary guides in total knee arthroplasty.

    PubMed

    Reed, S C; Gollish, J

    1997-09-01

    Of the technical factors important in achieving a successful total knee arthroplasty, limb alignment has been demonstrated to be most influential in determining implant survival. Intramedullary femoral guide systems rely on placement of the intramedullary rod along the anatomic axis of the femur. In this article, the accuracy of the femoral intramedullary guide is investigated using radiographs and a mathematical model. The femoral anatomic axis was drawn on 40 consecutive, preoperative, 3-ft standing radiographs. Using a mathematical model, the potential angular error in the distal femoral cut from aberrant placement of the intramedullary rod was estimated. Calculated values correlated with measured values from plain radiographs and an intramedullary guide template. The anatomic axis was found to exit the distal femur at an average of 6.6 mm medial to the center of the femoral notch. Substantial malalignment error resulted from minor malposition of the intramedullary rod. Most books and diagrams demonstrating the use of intramedullary guides indicate that the entry point is at the center of the femoral notch. These results show that the true entry point is medial to the center of the notch, and rod placement error results in excessive valgus alignment. Preoperative drawing of the anatomic axis on a 3-ft or 18-inch anteroposterior radiograph is recommended. The results both demonstrate the importance of correct use of the guide and heighten cognizance among surgeons performing total knee arthroplasty as to the limitations of the intramedullary guides.

  18. Femoral neck shaft angle in men with fragility fractures.

    PubMed

    Tuck, S P; Rawlings, D J; Scane, A C; Pande, I; Summers, G D; Woolf, A D; Francis, R M

    2011-01-01

    Introduction. Femoral neck shaft angle (NSA) has been reported to be an independent predictor of hip fracture risk in men. We aimed to assess the role of NSA in UK men. Methods. The NSA was measured manually from the DXA scan printout in men with hip (62, 31 femoral neck and 31 trochanteric), symptomatic vertebral (91), and distal forearm (67) fractures and 389 age-matched control subjects. Age, height, weight, and BMD (g/cm(2): lumbar spine, femoral neck, and total femur) measurements were performed. Results. There was no significant difference in mean NSA between men with femoral neck and trochanteric hip fractures, so all further analyses of hip fractures utilised the combined data. There was no difference in NSA between those with hip fractures and those without (either using the combined data or analysing trochanteric and femoral neck shaft fractures separately), nor between fracture subjects as a whole and controls. Mean NSA was smaller in those with vertebral fractures (129.2° versus 131°: P = 0.001), but larger in those with distal forearm fractures (129.8° versus 128.5°: P = 0.01). Conclusions. The conflicting results suggest that femoral NSA is not an important determinant of hip fracture risk in UK men.

  19. Is bone tunnel osseointegration in hamstring tendon autograft anterior cruciate ligament reconstruction important?

    PubMed

    Logan, Martin; Williams, Andy; Myers, Peter

    2003-10-01

    A 27-year-old man underwent anterior cruciate ligament (ACL) reconstruction using 4-strand hamstring autograft with femoral and tibial interference screw fixation. Four weeks after surgery, he developed a discharging hematoma through the graft harvest-tibial tunnel incision, which persisted. The patient required further surgical intervention 7 weeks after the initial surgery. The wound was debrided, the tibial interference screw was removed, and the tibial tunnel was completely cleared of graft remnants. Arthroscopy of the knee was performed, in which the ACL graft appeared healthy and viable. No evidence of intra-articular sepsis was found. Postoperatively, the rehabilitation program was uneventful and, at 36 months, the patient has unrestricted activity and no clinical evidence of excessive ACL laxity. This case supports the importance of marginal articular surface healing of the ACL graft, suggesting that tibial intratunnel healing becomes redundant.

  20. Spin tunneling in conducting oxides

    SciTech Connect

    Bratkovsky, A.

    1998-12-31

    Different tunneling mechanisms in conventional and half-metallic ferromagnetic tunnel junctions are analyzed within the same general method. Direct tunneling is compared with impurity-assisted, surface state assisted, and inelastic contributions to a tunneling magnetoresistance (TMR). Theoretically calculated direct tunneling in iron group systems leads to about a 30% change in resistance, which is close to experimentally observed values. It is shown that the larger observed values of the TMR might be a result of tunneling involving surface polarized states. The authors find that tunneling via resonant defect states in the barrier radically decreases the TMR (down to 4% with Fe-based electrodes), and a resonant tunnel diode structure would give a TMR of about 8%. With regards to inelastic tunneling, magnons and phonons exhibit opposite effects: one-magnon emission generally results in spin mixing and, consequently, reduces the TMR, whereas phonons are shown to enhance the TMR. The inclusion of both magnons and phonons reasonably explains an unusually bias dependence of the TMR. The model presented here is applied qualitatively to half-metallics with 100% spin polarization, where one-magnon processes are suppressed and the change in resistance in the absence of spin-mixing on impurities may be arbitrarily large. Even in the case of imperfect magnetic configurations, the resistance change can be a few 1,000%. Examples of half-metallic systems are CrO{sub 2}/TiO{sub 2} and CrO{sub 2}/RuO{sub 2}, and an account of their peculiar band structures is presented. The implications and relation of these systems to CMR materials, which are nearly half-metallic, are discussed.

  1. EDITORIAL: Optical orientation Optical orientation

    NASA Astrophysics Data System (ADS)

    SAME ADDRESS *, Yuri; Landwehr, Gottfried

    2008-11-01

    priority of the discovery in the literature, which was partly caused by the existence of the Iron Curtain. I had already enjoyed contact with Boris in the 1980s when the two volumes of Landau Level Spectroscopy were being prepared [2]. He was one of the pioneers of magneto-optics in semiconductors. In the 1950s the band structure of germanium and silicon was investigated by magneto-optical methods, mainly in the United States. No excitonic effects were observed and the band structure parameters were determined without taking account of excitons. However, working with cuprous oxide, which is a direct semiconductor with a relative large energy gap, Zakharchenya and his co-worker Seysan showed that in order to obtain correct band structure parameters, it is necessary to take excitons into account [3]. About 1970 Boris started work on optical orientation. Early work by Hanle in Germany in the 1920s on the depolarization of luminescence in mercury vapour by a transverse magnetic field was not appreciated for a long time. Only in the late 1940s did Kastler and co-workers in Paris begin a systematic study of optical pumping, which led to the award of a Nobel prize. The ideas of optical pumping were first applied by Georges Lampel to solid state physics in 1968. He demonstrated optical orientation of free carriers in silicon. The detection method was nuclear magnetic resonance; optically oriented free electrons dynamically polarized the 29Si nuclei of the host lattice. The first optical detection of spin orientation was demonstrated by with the III-V semiconductor GaSb by Parsons. Due to the various interaction mechanisms of spins with their environment, the effects occurring in semiconductors are naturally more complex than those in atoms. Optical detection is now the preferred method to detect spin alignment in semiconductors. The orientation of spins in crystals pumped with circularly polarized light is deduced from the degree of circular polarization of the recombination

  2. Osteoid Osteoma of the Femoral Neck in Athletes: Two Case Reports Differentiating From Femoral Neck Stress Injuries.

    PubMed

    Cordova, Christopher B; Dembowski, Scott C; Johnson, Michael R; Combs, John J; Svoboda, Steven J

    2016-01-01

    The diagnosis of an intra-articular osteoid osteoma can be a challenging and lengthy process, with reports of delayed diagnosis of greater than 2 years. In the young, athletic patient with an atraumatic onset of groin pain, an overuse injury or muscle strain is the most likely etiology. However, an overuse injury of femoral neck stress fracture must be identified because of the potentially disastrous outcome of fracture completion. The similar clinical presentation of a femoral neck stress fracture and intra-articular osteoid osteoma of the femoral neck can further delay the diagnosis of the osteoid osteoma. In a patient with these differential diagnoses that do not improve with a period of nonweightbearing activity, a more intensive workup must ensue. The purpose of this case report is to describe the initial presentations, subsequent follow-up, and imaging findings leading to the diagnosis of osteoid osteoma as well as to differentiate an osteoid osteoma from femoral neck stress injuries.

  3. [Treatment of beginning juvenile detachment of the femoral head, taking growth of the femoral neck into account (author's transl)].

    PubMed

    Engelhardt, P

    1979-10-01

    Prevention of further detachment is the primary aim in the immediate treatment of beginning juvenile detachment of the femoral head. Screwing of the epiphysis of the head, first introduced by M. E. Mueller (1965), has proved successful. Besides providing immediate mechanical stability, this method, however, results in premature ossification of the joint of the femoral neck. Epiphysiodesis has a particularly unfavourable effect in early childhood, because it inhibits proper growth of the leg and development of the mechanism of the hip joint on account of the shortened femoral neck. Spiking of the epiphysis with Krischner screw wires guarantees safe fixation of the epiphyseal head on the one hand, and sufficient freedom of femoral neck growth on the other. Surgical treatment requires knowledge of the changed hip joint anatomy of the child. Preoperative planning via drawing to determine the length and position of the implantate on the basis of standardised x-ray films, will help to prevent operative failures.

  4. Nineteen year results of THA using modular 9 mm S-ROM femoral component in patients with small femoral canals.

    PubMed

    Drexler, Michael; Dwyer, Tim; Marmor, Meir; Abolghasemian, Mansour; Chakravertty, Rajesh; Chechik, Ofir; Cameron, Hugh U

    2013-10-01

    A retrospective analysis was undertaken of 30 consecutive THA performed in 25 patients with hypoplastic proximal femurs, who had received a 9-mm uncemented modular S-ROM stem. The mean patient age was 42 years (17-69 years), mean height was 152.5 cm (130-170.5 cm), mean weight was 63 kg (39-90 kg), and mean follow-up period was 19 years (range, 12-23 years). Subsidence was seen in 2 hips, with asymptomatic femoral osteolysis present in 11 hips; overall survival of the femoral stem was 93.3%, with two revisions of the femoral component required for aseptic loosening. After a mean follow-up of 19 years, the use of the S-ROM 9 mm femoral stem in the patient with the small femur was associated with a low revision rate due to aseptic loosening of the stem.

  5. Quantum Tunneling and Complex Trajectories

    NASA Astrophysics Data System (ADS)

    Meynig, Max; Haggard, Hal

    2017-01-01

    In general, the semiclassical approximation of quantum mechanical tunneling fails to treat tunneling through barriers if real initial conditions and trajectories are used. By analytically continuing classical dynamics to the complex plane the problems encountered in the approximation can be resolved. While, the complex methods discussed here have been previously explored, no one has exhibited an analytically solvable case. The essential features of the complex method will be discussed in the context of a novel, analytically solvable problem. These methods could be useful in quantum gravity, with applications to the tunneling of spacetime geometries.

  6. Tunnel Detection Using Seismic Methods

    NASA Astrophysics Data System (ADS)

    Miller, R.; Park, C. B.; Xia, J.; Ivanov, J.; Steeples, D. W.; Ryden, N.; Ballard, R. F.; Llopis, J. L.; Anderson, T. S.; Moran, M. L.; Ketcham, S. A.

    2006-05-01

    Surface seismic methods have shown great promise for use in detecting clandestine tunnels in areas where unauthorized movement beneath secure boundaries have been or are a matter of concern for authorities. Unauthorized infiltration beneath national borders and into or out of secure facilities is possible at many sites by tunneling. Developments in acquisition, processing, and analysis techniques using multi-channel seismic imaging have opened the door to a vast number of near-surface applications including anomaly detection and delineation, specifically tunnels. Body waves have great potential based on modeling and very preliminary empirical studies trying to capitalize on diffracted energy. A primary limitation of all seismic energy is the natural attenuation of high-frequency energy by earth materials and the difficulty in transmitting a high- amplitude source pulse with a broad spectrum above 500 Hz into the earth. Surface waves have shown great potential since the development of multi-channel analysis methods (e.g., MASW). Both shear-wave velocity and backscatter energy from surface waves have been shown through modeling and empirical studies to have great promise in detecting the presence of anomalies, such as tunnels. Success in developing and evaluating various seismic approaches for detecting tunnels relies on investigations at known tunnel locations, in a variety of geologic settings, employing a wide range of seismic methods, and targeting a range of uniquely different tunnel geometries, characteristics, and host lithologies. Body-wave research at the Moffat tunnels in Winter Park, Colorado, provided well-defined diffraction-looking events that correlated with the subsurface location of the tunnel complex. Natural voids related to karst have been studied in Kansas, Oklahoma, Alabama, and Florida using shear-wave velocity imaging techniques based on the MASW approach. Manmade tunnels, culverts, and crawl spaces have been the target of multi-modal analysis

  7. Pathophysiology of carpal tunnel syndrome

    PubMed Central

    Aboonq, Moutasem S.

    2015-01-01

    Carpal tunnel syndrome (CTS) is the most common median nerve neuropathy, accounting for 90% of all neuropathies. Carpal tunnel syndrome presents in 3.8% of the general population, with a higher prevalence among women. There are several risk factors associated with CTS, including both medical and non medical factors. The pathophysiologic mechanisms involved in the median nerve compression and traction are thought to be complex, and as yet are not fully understood. The present review aimed to provide an overview of the pathophysiology of median nerve neuropathy in the carpal tunnel, and subsequent development of CTS. PMID:25630774

  8. Endovascular Treatment of a Ruptured Profunda Femoral Artery Branch After Fogarty Thrombectomy of a Femoro-Femoral Crossover Arterial Graft: A Case Report and Review of the Literature

    SciTech Connect

    Manousaki, Eirini; Tsetis, Dimitrios; Kostas, Theodoros; Katsamouris, Asterios

    2010-02-15

    We present a very rare case of a life-threatening rupture of a profunda femoral artery distal branch after a Fogarty thrombectomy of a thrombosed crossover synthetic graft between the ipsilateral common femoral artery and a contralateral iliac-popliteal graft; the bleeding profunda femoral artery branch was successfully embolized with metallic coils through the axillary artery approach.

  9. [Distal femoral fixation of the iliotibial tract].

    PubMed

    Lobenhoffer, P; Gerich, T; Lattermann, C

    1994-03-01

    Two femoral fixation areas were defined in the distal iliotibial tract (ITT) system. They were named supracondylar insertion and insertion near the septum. Biomechanical studies on these insertions revealed tension peaks in the insertion near the septum with anterior translation of the knee, with varus stress and rotational movements. We conclude that the fibers inserting here are secondary restraints against anterior and lateral knee instability. 5 lateral extraarticular procedures were investigated to evaluate their biomechanical effect on knee instability. A standardized cadaver knee model was used with two basic experiments: an excentric quadriceps contraction from 0 to 90 degrees of flexion and an anterior translation with 100 N in 30 degrees of flexion. 5 knees were investigated for each procedure. Results from the excentric quadriceps contraction study imply reduced ACL strain with all extraarticular procedures except the Andrews tenodesis. The quantitative effect was related to the mechanical strength of the fixation of the ITT. All lateral procedures reduced ACL strain with anterior translation of the knee. The last part of the study included simultaneous registration of rotation and translation of the knee. We demonstrated a close relation of decreased ACL strain due to a lateral procedure and pathological external rotation of the knee. The knee no longer reached the physiological neutral rotation angle after an effective lateral tenodesis procedure. The significance of this effect is not clear at the present time.

  10. Hyperbaric oxygen therapy in femoral head necrosis.

    PubMed

    Camporesi, Enrico M; Vezzani, Giuliano; Bosco, Gerardo; Mangar, Devanand; Bernasek, Thomas L

    2010-09-01

    We evaluated hyperbaric oxygen (HBO) therapy on a cohort of patients with femoral head necrosis (FHN). This double-blind, randomized, controlled, prospective study included 20 patients with unilateral FHN. All were Ficat stage II, treated with either compressed oxygen (HBO) or compressed air (HBA). Each patient received 30 treatments of HBO or HBA for 6 weeks. Range of motion, stabilometry, and pain were assessed at the beginning of the study and after 10, 20, and 30 treatments by a blinded physician. After the initial 6-week treatment, the blind was broken; and all HBA patients were offered HBO treatment. At this point, the study becomes observational. Pretreatment, 12-month. and 7 year-follow-up magnetic resonance images were obtained. Statistical comparisons were obtained with nonparametric Mann-Whitney U test. Significant pain improvement for HBO was demonstrated after 20 treatments. Range of motion improved significantly during HBO for all parameters between 20 and 30 treatments. All patients remain substantially pain-free 7 years later: none required hip arthroplasty. Substantial radiographic healing of the osteonecrosis was observed in 7 of 9 hips. Hyperbaric oxygen therapy appears to be a viable treatment modality in patients with Ficat II FHN. Copyright 2010. Published by Elsevier Inc.

  11. Reconstruction of femoral length from fragmentary femora

    PubMed Central

    Offei, Eric Bekoe; Osabutey, Casmiel Kwabena

    2016-01-01

    The reconstruction of femoral length (FL) from fragmentary femora is an essential step in estimating stature from fragmentary skeletal remains in forensic investigations. While regression formulae for doing this have been suggested for several populations, such formulae have not been established for Ghanaian skeletal remains. This study, therefore, seeks to derive regression formulae for reconstruction of FL from fragmentary femora of skeletal samples obtained from Ghana. Six measurements (vertical head diameter, transverse head diameter, bicondylar breadth, epicondylar breadth, sub-trochanteric anterior-posterior diameter, and sub-trochanteric transverse diameter) were acquired from different anatomical portions of the femur and the relationship between each acquired measurement and FL was analyzed using linear regression. The results indicated significantly moderate-to-high correlations (r=0.580–0.818) between FL and each acquired measurement. The error estimates of the regression formulae were relatively low (i.e., standard error of estimate, 13.66–19.28 mm), suggesting that the discrepancies between actual and estimated stature were relatively low. Compared with other measurements, sub-trochanteric transverse diameter was the best estimate of FL. In the absence of a complete femur, the regression formulae based on the assessed measurements may be used to infer FL, from which stature can be estimated in forensic investigations. PMID:27722014

  12. Computer-assisted femoral head resurfacing.

    PubMed

    Hodgson, Antony J; Inkpen, Kevin B; Shekhman, Mark; Anglin, Carolyn; Tonetti, Jerome; Masri, Bassam A; Duncan, Clive P; Garbuz, Donald S; Greidanus, Nelson V

    2005-01-01

    Femoral head resurfacing is re-emerging as a surgical option for younger patients who are not yet candidates for total hip replacement. However, this procedure is more difficult than total hip replacement, and the mechanical jigs typically used to align the implant produce significant variability in implant placement and take a significant amount of time to position properly. We propose that a computer-assisted surgical (CAS) technique could reduce implant variability with little or no increase in operative time. We describe a new CAS technique for this procedure and demonstrate in a cadaver study of five paired femurs that the CAS technique in the hands of a novice surgeon markedly reduced the varus/valgus variability of the implant relative to the pre-operative plan (2 degrees standard deviation for CAS versus 5 degrees for a mechanical jig operated by an expert surgeon). We also show that the mechanical jig resulted in significantly retroverted implant placement. There was no significant difference in operative time between the two techniques.

  13. Seismic Analysis of Tunnel Boring Machine Signals at Kerckhoff Tunnel

    DTIC Science & Technology

    1983-08-01

    of the MSHA system to detect a large tunnel boring machine (TBM) operating in granite at depths in excess of 1300 ft, the degree of accuracy of the...determined that the TBM could be detected at a horizontal range of about 80000 ft and the tunnel boring machine could be accurately located within approximately 100 ft at a slant range of approximately 5000 ft.

  14. Effects of a tensioned tendon graft in a bone tunnel across the rabbit physis.

    PubMed

    Houle, J B; Letts, M; Yang, J

    2001-10-01

    Children who sustain anterior cruciate disruption often are denied the standard reconstructive procedures because of the concern that drilling across the physis of the tibia and femur and compression from a tensioned graft will result in growth plate arrest. To test this concept and to assess whether a tendon placed in the tunnel would function in a manner similar to a fat graft after the resection of a physeal bar, tunnels were made across the proximal tibial physis and distal femoral physis in a group of immature rabbits. Four tunnel diameters were used from 1.95 to 3.97 mm, in three rabbits at each diameter, with patellar tendon autografts being used as the reconstruction of the anterior cruciate ligament in two of the animals. The knees were radiographed every 4 weeks, and the animals were euthanized 4 months after surgery. The surgically treated and control knees were salvaged, and each knee was examined grossly, radiographically, and histologically. Eight of the 11 animals had growth arrest of one or both physes. The larger the drill hole diameter the more marked was the deformity. The proximal tibial physis seemed to be the most vulnerable for growth arrest, occurring in eight of the knees. The insertion of a tendon did not seem to offer any protection to physeal arrest. Because of these findings, it is not recommended that tunnels involving 1% or more of the area of the physis be placed across the tibial and femoral physis to reconstruct the anterior cruciate in very skeletally immature children.

  15. Rupture of the Deep Femoral Artery during Proximal Femoral Nailing Following an Intertrochanteric Fracture: A Case Report

    PubMed Central

    Yoon, Han Kook; Park, Junyoung; Oyunbat, Choidog; Kim, Taehwan

    2016-01-01

    Recently, we experienced a case where the diagnosis and management of a deep femoral artery rupture was delayed. This vascular complication occurred during the insertion of a distal interlocking screw of a proximal femoral nail for the fixation of an intertrochanteric femur fracture. A 79-year-old male patient was diagnosed with a right intertrochanteric fracture after a fall. We fixed the fracture with a proximal femoral nail (Zimmer® Natural Nail™ System). One day after the procedure, the patient complained of pain and swelling on the anteromedial side of his middle thigh followed by hypotension, anemia and prolonged thigh swelling. Computed tomography angiography was performed 7 days after the procedure. We found a pseudoaneurysm of the perforating artery caused by injury to the deep femoral artery and an intramuscular hematoma in the anterior thigh muscle. We successfully treated the pseudoaneurysm using coil embolization. Throughout the management of intertrochanteric femoral fractures, it is important to be aware and monitor signs and symptoms related to the possibility of blood vessel damage. When a patient presents with swelling and pain on the middle thigh and/or unexplained anemia postoperatively, the possibility that these symptoms are caused by an injury to the femoral artery must be considered. PMID:27536645

  16. A Model for the Behavior of Magnetic Tunnel Junctions

    SciTech Connect

    Baker, Bryan John

    2003-01-01

    A magnetic tunnel junction is a device that changes its electrical resistance with a change in an applied magnetic field. A typical junction consists of two magnetic electrodes separated by a nonmagnetic insulating layer. The magnetizations of the two electrodes can have two possible extreme configurations, parallel and antiparallel. The antiparallel configuration is observed to have the higher measured resistance and the parallel configuration has the lower resistance. To switch between these two configurations a magnetic field is applied to the device which is primarily used to change the orientation of the magnetization of one electrode usually called the free layer, although with sufficient high magnetic field the orientation of the magnetizations of both of the electrodes can be changed. The most commonly used models for describing and explaining the electronic behavior of tunnel junctions are the Simmons model and the Brinkman model. However, both of these models were designed for simple, spin independent tunneling. The Simmons model does not address the issue of applied magnetic fields nor does it address the form of the electronic band structure in the metallic electrodes, including the important factor of spin polarization. The Brinkman model is similar, the main difference between the two models being the shape of the tunneling barrier potential between the two electrodes. Therefore, the research conducted in this thesis has developed a new theoretical model that addresses these important issues starting from basic principles. The main features of the new model include: the development of equations for true spin dependent tunneling through the insulating barrier, the differences in the orientations of the electrode magnetizations on either side of the barrier, and the effects of the density of states function on the behavior of the junction. The present work has explored densities of states that are more realistic than the simplified free electron density

  17. DNA Tunneling Detector Embedded in a Nanopore

    PubMed Central

    2010-01-01

    We report on the fabrication and characterization of a DNA nanopore detector with integrated tunneling electrodes. Functional tunneling devices were identified by tunneling spectroscopy in different solvents and then used in proof-of-principle experiments demonstrating, for the first time, concurrent tunneling detection and ionic current detection of DNA molecules in a nanopore platform. This is an important step toward ultrafast DNA sequencing by tunneling. PMID:21133389

  18. Tunnel construction for a desertron

    SciTech Connect

    Hinterberger, H.; Huson, F.R.

    1983-03-27

    The tunnel in this model of construction is 3-1/2 feet wide by 5 feet high. It is assumed that the tunnel contains a rail system and guidance system for: (1) An enclosed car used for transport of 2 people and some tools. (2) A magnet mover. This robot could pick up a magnet and transport it at about 10 miles per hour. (3) An alignment robot. The alignment robot would intercept E.M. waves (microwaves, lasers) to determine its position in the tunnel. Then workers could come along inside the tunnel hoop and nail it together and to the floor. The trench would then be back-filled with a 1 foot berm on top. A rail system would be installed and a support stand for the magnet.

  19. Multisensor system for tunnel inspection

    NASA Astrophysics Data System (ADS)

    Idoux, Maurice

    2005-01-01

    The system is aimed at assisting inspection and monitoring of the degradation of tunnels in order to minimize maintenance and repair time. ATLAS 70 is a complete sensors/software package which enables thorough diagnosis of tunnel wall conditions. The data collected locally are stored on a computer hard disk for subsequent analysis in a remote location via elaborate dedicated software. The sensors and local computer are loaded onto a rail and/or road vehicle of specific design, i.e. with even travelling speed of 2 to 5 km/h. Originally, the system has been developed for the Paris Underground Company and has since been applied to rail and road tunnels, large town sewage systems, clean water underground aqueducts and electric cable tunnels.

  20. Carpal Tunnel Syndrome (For Kids)

    MedlinePlus

    ... tunnel syndrome may have trouble typing on the computer or playing a video game. In fact, repetitive ... times as many women as men have CTS. Computer operators, assembly-line workers, and hair stylists are ...

  1. Flatback airfoil wind tunnel experiment.

    SciTech Connect

    Mayda, Edward A.; van Dam, C.P.; Chao, David D.; Berg, Dale E.

    2008-04-01

    A computational fluid dynamics study of thick wind turbine section shapes in the test section of the UC Davis wind tunnel at a chord Reynolds number of one million is presented. The goals of this study are to validate standard wind tunnel wall corrections for high solid blockage conditions and to reaffirm the favorable effect of a blunt trailing edge or flatback on the performance characteristics of a representative thick airfoil shape prior to building the wind tunnel models and conducting the experiment. The numerical simulations prove the standard wind tunnel corrections to be largely valid for the proposed test of 40% maximum thickness to chord ratio airfoils at a solid blockage ratio of 10%. Comparison of the computed lift characteristics of a sharp trailing edge baseline airfoil and derived flatback airfoils reaffirms the earlier observed trend of reduced sensitivity to surface contamination with increasing trailing edge thickness.

  2. Tunneling Plasmonics in Bilayer Graphene.

    PubMed

    Fei, Z; Iwinski, E G; Ni, G X; Zhang, L M; Bao, W; Rodin, A S; Lee, Y; Wagner, M; Liu, M K; Dai, S; Goldflam, M D; Thiemens, M; Keilmann, F; Lau, C N; Castro-Neto, A H; Fogler, M M; Basov, D N

    2015-08-12

    We report experimental signatures of plasmonic effects due to electron tunneling between adjacent graphene layers. At subnanometer separation, such layers can form either a strongly coupled bilayer graphene with a Bernal stacking or a weakly coupled double-layer graphene with a random stacking order. Effects due to interlayer tunneling dominate in the former case but are negligible in the latter. We found through infrared nanoimaging that bilayer graphene supports plasmons with a higher degree of confinement compared to single- and double-layer graphene, a direct consequence of interlayer tunneling. Moreover, we were able to shut off plasmons in bilayer graphene through gating within a wide voltage range. Theoretical modeling indicates that such a plasmon-off region is directly linked to a gapped insulating state of bilayer graphene, yet another implication of interlayer tunneling. Our work uncovers essential plasmonic properties in bilayer graphene and suggests a possibility to achieve novel plasmonic functionalities in graphene few-layers.

  3. Tunneling Plasmonics in Bilayer Graphene

    NASA Astrophysics Data System (ADS)

    Fei, Z.; Iwinski, E. G.; Ni, G. X.; Zhang, L. M.; Bao, W.; Rodin, A. S.; Lee, Y.; Wagner, M.; Liu, M. K.; Dai, S.; Goldflam, M. D.; Thiemens, M.; Keilmann, F.; Lau, C. N.; Castro-Neto, A. H.; Fogler, M. M.; Basov, D. N.

    2015-08-01

    We report experimental signatures of plasmonic effects due to electron tunneling between adjacent graphene layers. At sub-nanometer separation, such layers can form either a strongly coupled bilayer graphene with a Bernal stacking or a weakly coupled double-layer graphene with a random stacking order. Effects due to interlayer tunneling dominate in the former case but are negligible in the latter. We found through infrared nano-imaging that bilayer graphene supports plasmons with a higher degree of confinement compared to single- and double-layer graphene, a direct consequence of interlayer tunneling. Moreover, we were able to shut off plasmons in bilayer graphene through gating within a wide voltage range. Theoretical modeling indicates that such a plasmon-off region is directly linked to a gapped insulating state of bilayer graphene: yet another implication of interlayer tunneling. Our work uncovers essential plasmonic properties in bilayer graphene and suggests a possibility to achieve novel plasmonic functionalities in graphene few-layers.

  4. Electron tunneling in proteins program.

    PubMed

    Hagras, Muhammad A; Stuchebrukhov, Alexei A

    2016-06-05

    We developed a unique integrated software package (called Electron Tunneling in Proteins Program or ETP) which provides an environment with different capabilities such as tunneling current calculation, semi-empirical quantum mechanical calculation, and molecular modeling simulation for calculation and analysis of electron transfer reactions in proteins. ETP program is developed as a cross-platform client-server program in which all the different calculations are conducted at the server side while only the client terminal displays the resulting calculation outputs in the different supported representations. ETP program is integrated with a set of well-known computational software packages including Gaussian, BALLVIEW, Dowser, pKip, and APBS. In addition, ETP program supports various visualization methods for the tunneling calculation results that assist in a more comprehensive understanding of the tunneling process. © 2016 Wiley Periodicals, Inc.

  5. Automated As-Built Model Generation of Subway Tunnels from Mobile LiDAR Data.

    PubMed

    Arastounia, Mostafa

    2016-09-13

    This study proposes fully-automated methods for as-built model generation of subway tunnels employing mobile Light Detection and Ranging (LiDAR) data. The employed dataset is acquired by a Velodyne HDL 32E and covers 155 m of a subway tunnel containing six million points. First, the tunnel's main axis and cross sections are extracted. Next, a preliminary model is created by fitting an ellipse to each extracted cross section. The model is refined by employing residual analysis and Baarda's data snooping method to eliminate outliers. The final model is then generated by applying least squares adjustment to outlier-free data. The obtained results indicate that the tunnel's main axis and 1551 cross sections at 0.1 m intervals are successfully extracted. Cross sections have an average semi-major axis of 7.8508 m with a standard deviation of 0.2 mm and semi-minor axis of 7.7509 m with a standard deviation of 0.1 mm. The average normal distance of points from the constructed model (average absolute error) is also 0.012 m. The developed algorithm is applicable to tunnels with any horizontal orientation and degree of curvature since it makes no assumptions, nor does it use any a priori knowledge regarding the tunnel's curvature and horizontal orientation.

  6. Distal femoral cut in total knee arthroplasty in a Brazilian population☆

    PubMed Central

    Costa, Marcos Areias Vieira; Mozella, Alan de Paula; Cobra, Hugo Alexandre de Araujo Barros

    2015-01-01

    Objective To determine the ideal angle for making the distal femoral cut in total knee arthroplasty in a Brazilian population. Methods Panoramic radiographs of the lower limbs bearing weight from 79 patients (57 women and 22 men) were studied, totaling 107 knees with an indication for total knee arthroplasty. The femoral anatomical axis, femoral mechanical axis and cervical-diaphyseal angle were traced out. The angle of the femoral cut was determined from the meeting point between the femoral anatomical and mechanical axes. The ideal degree of femoral valgus was compared between men and women and between knees presenting varus and valgus alignment of the lower limb. The ideal distal femoral cut was also correlated with the cervical-diaphyseal angle. Results The ideal femoral valgus angle ranged from 4.2 to 8.6 degrees, with a mean of 6.3 degrees. There was no statistically significant difference in the distal femoral cut between patients with coronal varus and valgus alignment (p = 0.180). Comparing men and women, there was no statistically significant difference regarding the ideal femoral valgus between the groups (p = 0.057). The cervical-diaphyseal angle presented an inverse relationship with the distal femoral cut. Conclusions The mean angle between the femoral mechanical and anatomical axes was 6.3 degree. Neither preoperative coronal alignment nor sex had any influence on the distal femoral cut. The cervical-diaphyseal angle presented an inverse relationship with the distal femoral cut. PMID:26229933

  7. Guidelines for tunneling in enzymes

    PubMed Central

    Moser, Christopher C.; Ross Anderson, J. L.; Dutton, P. Leslie

    2010-01-01

    Summary Here we extend the engineering descriptions of simple, single-electron-tunneling chains common in oxidoreductases to quantify sequential oxidation-reduction rates of two-or-more electron cofactors and substrates. We identify when nicotinamides may be vulnerable to radical mediated oxidation-reduction and merge electron-tunneling expressions with the chemical rate expressions of Eyring. The work provides guidelines for the construction of new artificial oxidoreductases inspired by Nature but adopting independent design and redox engineering. PMID:20460101

  8. Relativistic tunneling through opaque barriers

    SciTech Connect

    De Leo, Stefano; Leonardi, Vinicius

    2011-02-15

    We propose an analytical study of relativistic tunneling through opaque barriers. We obtain a closed formula for the phase time. This formula is in excellent agreement with the numerical simulations and corrects the standard formula obtained by the stationary phase method. An important result is found when the upper limit of the incoming energy distribution coincides with the upper limit of the tunneling zone. In this case, the phase time is proportional to the barrier width.

  9. Hypersonic Wind Tunnel Test Techniques

    DTIC Science & Technology

    1994-08-01

    AEDC TR-94-6 Hypersonic Wind Tunnel Test Techniques R. K. Matthcws and R. W. Rhudy Calspan CorporatioWAF_,DC Operations 4 August 1994 Final...REPORT TYPE ANn DATES COVERED I AuCluSt 1994 | Final --July 992 - May 1993 4. TITLE AND SUBTITLE Hypersonic Wind Tunnel Test Techniques 5 FUNDING... techniques because of the importance of defining the thermal environment of hypersonic vehicles. An overview of the materials/structures test

  10. Augmentation by cerclage wire improves fixation of vertical shear femoral neck fractures-A biomechanical analysis.

    PubMed

    Kuan, Fa-Chuan; Yeh, Ming-Long; Hong, Chih-Kai; Chiang, Florence L; Jou, I-Ming; Wang, Ping-Hui; Su, Wei-Ren

    2016-10-01

    Femoral neck fractures in young individuals are typically vertical shear fractures. These injuries are difficult to stabilize due to a significant varus displacement force across the hip with weight bearing. The purpose of this study was to evaluate the biomechanical stability offered by the addition of an augmented wire to conventional inverted triangle triple screw fixation for stabilizing vertical shear femoral neck fracture. Sixteen medium 4th-generation synthetic composite femurs (Sawbones Pacific Research Laboratories, Vashon, WA) were divided into two groups. Vertical osteotomy was performed to mimic Pauwels III femoral neck fracture. Group A (n=8) was fixed with three parallel 6.5-mm cannulated screws (Stryker) with washer in inverted triangle configuration. In group B (n=8), all the screws were set using methods identical to group A, with the addition of the cerclage wire. Both groups were tested with nondestructive axial compression test at 7 and 25° of valgus stress, respectively. Then axial cyclic loading test with 1000N was applied for 1000 cycles, and interfragmentary displacement was measured with Fastrak magnetic tracking system (Polhemus, Colchester, VT, USA). Finally, destructive axial compression test was conducted at 7°of valgus stress. Axial stiffness showed that group B had a 66% increase (879N/mm vs. 1461N/mm, P<0.01) at 7° valgus and a 46% increase (1611N/mm vs. 2349N/mm, P<0.01) at 25° valgus in comparison with group A. Interfragmentary fracture displacement after cyclic loading was significantly less for group B compared with group A (0.34 vs 0.13mm, P=0.0016). For axial failure load, there was 42% increase in group B compared with group A (2602N/mm vs. 3686N/mm, P=0.0023). Our study demonstrates that the addition of a cerclage wire to inverted triangle triple screws provides substantial improvement in mechanical performance regarding fixation of vertically oriented femoral neck fractures when compared with the conventional construct

  11. Structural and functional studies of bioobjects prepared from femoral heads

    SciTech Connect

    Kirilova, I. A. Podorozhnaya, V. T.; Sharkeev, Yu. P.; Popova, K. S. Uvarkin, P. V.

    2015-11-17

    Results of examination of physicomechanical characteristics of samples of medial femoral head cuts are presented. The samples of medial femoral head cuts resected in 6 patients with coxarthrosis in primary endoprosthetic replacement of a coxofemoral joint have been tested for micro- and nanohardness. Young’s modulus and elemental composition of bone tissue have been investigated. To estimate the architectonics of cancellous tissue of the femoral head, adjacent cuts of the same patient have been analyzed. The porosity of bone tissue was estimated from macroscopic images obtained using macrophotography. The total porosity is calculated as the ratio of the total length of straight line segments overlapping pores to the total length of secants. A three-point bending test of the samples has shown that their strength changed from 0.187 to 1.650 MPa and their elasticity modulus changes from 1.69 to 8.15 MPa. The microhardness of the samples changes in the range 220–265 MPa and the average microhardness of medial femoral head cuts is 240 MPa. The elemental composition of medial femoral head cuts is represented by basic Ca, P, O, Na and Mg elements as well as by Sn, S, Fe, Cr, and C in microamounts. The atomic Ca to P ratio for bone tissue is 1.55. It is revealed that pores of the upper part of the femoral head have a more regular shape and in the lower part they are more elongated along the cut and occupy a larger volume. The lower part of the femoral head has a higher porosity (39 and 33%) than the upper part (34 and 30%). The total porosity of all samples does not exceed 37%.

  12. Structural and functional studies of bioobjects prepared from femoral heads

    NASA Astrophysics Data System (ADS)

    Kirilova, I. A.; Sharkeev, Yu. P.; Podorozhnaya, V. T.; Popova, K. S.; Uvarkin, P. V.

    2015-11-01

    Results of examination of physicomechanical characteristics of samples of medial femoral head cuts are presented. The samples of medial femoral head cuts resected in 6 patients with coxarthrosis in primary endoprosthetic replacement of a coxofemoral joint have been tested for micro- and nanohardness. Young's modulus and elemental composition of bone tissue have been investigated. To estimate the architectonics of cancellous tissue of the femoral head, adjacent cuts of the same patient have been analyzed. The porosity of bone tissue was estimated from macroscopic images obtained using macrophotography. The total porosity is calculated as the ratio of the total length of straight line segments overlapping pores to the total length of secants. A three-point bending test of the samples has shown that their strength changed from 0.187 to 1.650 MPa and their elasticity modulus changes from 1.69 to 8.15 MPa. The microhardness of the samples changes in the range 220-265 MPa and the average microhardness of medial femoral head cuts is 240 MPa. The elemental composition of medial femoral head cuts is represented by basic Ca, P, O, Na and Mg elements as well as by Sn, S, Fe, Cr, and C in microamounts. The atomic Ca to P ratio for bone tissue is 1.55. It is revealed that pores of the upper part of the femoral head have a more regular shape and in the lower part they are more elongated along the cut and occupy a larger volume. The lower part of the femoral head has a higher porosity (39 and 33%) than the upper part (34 and 30%). The total porosity of all samples does not exceed 37%.

  13. [Femoral artery pseudoaneurysms encountered in orthopedics and traumatology].

    PubMed

    Raherinantenaina, F; Rajaonanahary, T M A; Rakoto Ratsimba, H N

    2015-12-01

    Most published articles regarding orthopedic- and trauma-related femoral artery pseudoaneurysms (FAPs) are case reports in English. Reported cases are often associated with a literature review but actually provide little robust data. We wanted to summarize the current knowledge on diagnostic and therapeutic features of these FAPs. A new case of superficial FAP is described followed by a review of the literature. A bibliographic search was performed online (PubMed, ScinceDirect) from 1964 to 2015 using the descriptors "traumatic femoral pseudoaneurysm, orthopedic surgery, osteochondroma". A total of 64 cases of FAPs was analyzed. There were 50 men with an average age of 40.72±26.45 years old. The most common clinical presentation was painful swelling (34%). Arteriography was the commonest radiological investigation used (63%). The main etiologies were orthopedic injuries (47%), surgery of the upper thigh (30%) and femoral osteochondromas (23%). Arterial injuries included superficial femoral (47%) and profunda femoris artery (50%). The treatment was open surgery (56%) or endovascular repair (36%). Deep femoral artery and its branches were embolized (47%) or ligated (38%). Endovascular stenting was performed in 30% of posttraumatic FAPs. All FAPs relating to osteochondromas were repaired surgically. Postoperative courses were uneventful in 95% of patients. Endovascular embolization is preferred in management of postsurgical FAPs which have usually involved the deep femoral artery. Endovascular stenting graft may be proposed for posttraumatic FAPs, for which the superficial femoral trunk is the most often involved vessel. Surgical repair should be performed when endovascular stenting graft is not feasible. Surgical repair is mandatory for all FAPs secondary to traumatic exostoses. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  14. Radiographic measurement of the posterior femoral offset is not precise.

    PubMed

    Jenny, Jean-Yves; Honecker, Sophie; Chammai, Yves

    2017-08-01

    The posterior femoral offset may significantly impact the final flexion range after total knee arthroplasty (TKA). The purpose of the present study was to compare a conventional, radiologic-based technique with an intra-operative, surgical navigation-based technique for the measurement of posterior femoral offset. The tested hypothesis was that the two measurement techniques produce different results both before and after TKA. One-hundred consecutive cases referred for end-stage knee osteoarthritis have been studied. Posterior femoral offsets, measured pre- and post-TKA from radiographs, as well as those measured from a navigation system intra-operatively, were analysed. The pre-TKA measured offsets, post-TKA measured offsets and the changes (pre- vs. post-TKA) in the offsets were statistically compared between the radiologic and the navigated measurement techniques at a 0.05 level of significance. The mean paired difference between pre-TKA radiologic and navigated measurement was 4 ± 4 mm (p < 0.001). There was a significant and moderate positive correlation with a good coherence between the two measurements. The mean paired difference between post-TKA radiologic and navigated measurement was 6 ± 5 mm (p < 0.001). There was a significant and moderate positive correlation but a poor coherence between the two measurements. The conventional radiologic technique for the measurement of the posterior femoral offset cannot be reliably used either for pre-TKA planning of the posterior femoral resection and antero-posterior sizing of the femoral component, or for post-TKA quality control of the reconstruction of the posterior femoral offset. Level IV.

  15. Cementless femoral components should be made from cobalt chrome.

    PubMed

    Sotereanos, N G; Engh, C A; Glassman, A H; Macalino, G E; Engh, C A

    1995-04-01

    Before 1982, the authors performed 177 primary total hip arthroplasties using a single-sized, extensively porous-coated cobalt-chrome femoral prosthesis. The current status of 122 of these arthroplasties is known. Two femoral prostheses have been revised for late symptomatic loosening, 2 for stem fracture, and 1 for infection. From 1982 to 1984, 227 primary arthroplasties were performed using the same stem in multiple sizes. Of these cases, 171 are available for followup. One stem (0.6%) has been revised for symptomatic loosening. Large osteolytic femoral lesions (average size, 8.1 cm2) developed in 3 patients, associated with an unusually large amount of polyethylene wear of their acetabular components. These patients have been treated by exchange of the polyethylene liner within the porous-coated acetabular component and allografting of the osteolytic lesions. The femoral components were not exchanged because osteolysis had not eroded the integrity of the supporting bone-implant interface to a point where loosening occurred. Before 1987, 193 patients with loose femoral components were treated with revision total hip arthroplasty, also using an extensively porous-coated cobalt-chrome femoral stem of similar design. Ten (5.7%) patients have required rerevision of the femoral prosthesis. Six of these 10 rerevisions were performed because of symptomatic loosening. Ninety-three percent of the patients in the primary series had relief of their preoperative pain and have improved functional ability; 94.2% are satisfied with their results. In the revision series, 89.1% of the patients are free of pain and function better than preoperatively, and 89.6% are fully satisfied with their results.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Quadrupolar Echo Spectra of the Tunneling CD 3Group

    NASA Astrophysics Data System (ADS)

    Olejniczak, Z.; Detken, A.; Manz, B.; Haeberlen, U.

    Deuteron NMR spectra of both single crystal and powder samples of acetylsalicylic acid-CD 3were measured using the quadrupolar-echo technique. The experiments were done in the temperature range 17-100 K, with a special emphasis on the range 20- 30 K, in which the observable tunneling frequency decreases rapidly from its low-temperature value of 2.7 down to 1.2 MHz. In the tunneling regime, modulations of the line intensities and phases as a function of the echo time τ are observed in the single-crystal spectra. The modulation frequency is equal to the orientation-dependent displacement of the inner satellite pairs (α lines) from the Larmor frequency. These effects were confirmed in numerical simulations and fully explain the phase-modulation effects observed previously in quadrupolar-echo spectra of methyl-deuterated methanol and para-xylene guest molecules in some inclusion compounds. By measuring the temperature and orientation dependence of the quadrupolar lineshapes, it was found that the echo spectra are more sensitive to the value of the tunneling frequency than the spectra obtained from the free induction decay. It is pointed out that, because of the modulation effects, special care must be taken when structural parameters are to be extracted from quadrupolar-echo spectra, in particular from spectra of powder samples.

  17. Zener tunneling in semiconductor superlattices.

    PubMed

    Romanova, J Yu; Demidov, E V; Mourokh, L G; Romanov, Yu A

    2011-08-03

    Characteristics of miniband tunneling and Wannier-Stark levels in semiconductor superlattices are studied as regards their dependence on the symmetry of the unit cells and the type of miniband structure. We modify the k ⋅ p method into a k ⋅ v form and on this basis generalize the Zener formula for the inter-band tunneling in homogeneous semiconductors to the case of inter-miniband tunneling in superlattices, account being taken of the inhomogeneity of the electron effective mass. The corresponding sum rule for the effective masses in such structures is obtained. We develop a unified matrix approach for the calculation of the inter-miniband tunneling and Wannier-Stark levels in the case of an arbitrary number of minibands. We study the electric field dependence of the probability of inter-miniband tunneling for an electron transferred through the Brillouin minizone only once. The peculiarities of the inter-miniband transitions for the case where this transfer is repeated are also examined for various unit cells and miniband structures of the superlattice. In addition, we discuss mechanisms and specific features of the resonant Zener tunneling and its manifestations in electron transport.

  18. Disparities in correlating microstructural to nanostructural preservation of dinosaur femoral bones

    NASA Astrophysics Data System (ADS)

    Kim, Jung-Kyun; Kwon, Yong-Eun; Lee, Sang-Gil; Lee, Ji-Hyun; Kim, Jin-Gyu; Huh, Min; Lee, Eunji; Kim, Youn-Joong

    2017-03-01

    Osteohistological researches on dinosaurs are well documented, but descriptions of direct correlations between the bone microstructure and corresponding nanostructure are currently lacking. By applying correlative microscopy, we aimed to verify that well-preserved osteohistological features correlate with pristine fossil bone nanostructures from the femoral bones of Koreanosaurus boseongensis. The quality of nanostructural preservation was evaluated based on the preferred orientation level of apatite crystals obtained from selected area electron diffraction (SAED) patterns and by measuring the “arcs” from the {100} and {002} diffraction rings. Unlike our expectations, our results revealed that well-preserved microstructures do not guarantee pristine nanostructures and vice versa. Structural preservation of bone from macro- to nanoscale primarily depends on original bioapatite density, and subsequent taphonomical factors such as effects from burial, pressure, influx of external elements and the rate of diagenetic alteration of apatite crystals. Our findings suggest that the efficient application of SAED analysis opens the opportunity for comprehensive nanostructural investigations of bone.

  19. 5-foot Vertical Wind Tunnel

    NASA Technical Reports Server (NTRS)

    1932-01-01

    The researcher is sitting above the exit cone of the 5-foot Vertical Wind Tunnel and is examining the new 6-component spinning balance. This balance was developed between 1930 and 1933. It was an important advance in the technology of rotating or rolling balances. As M.J. Bamber and C.H. Zimmerman wrote in NACA TR 456: 'Data upon the aerodynamic characteristics of a spinning airplane may be obtained in several ways; namely, flight tests with full-scale airplanes, flight tests with balanced models, strip-method analysis of wind-tunnel force and moment tests, and wind-tunnel tests of rotating models.' Further, they note: 'Rolling-balance data have been of limited value because it has not been possible to measure all six force and moment components or to reproduce a true spinning condition. The spinning balance used in this investigation is a 6-component rotating balance from which it is possible to obtain wind-tunnel data for any of a wide range of possible spinning conditions.' Bamber and Zimmerman described the balance as follows: 'The spinning balance consists of a balance head that supports the model and contains the force-measuring units, a horizontal turntable supported by streamline struts in the center of the jet and, outside the tunnel, a direct-current driving motor, a liquid tachometer, an air compressor, a mercury manometer, a pair of indicating lamps, and the necessary controls. The balance head is mounted on the turntable and it may be set to give any radius of spin between 0 and 8 inches.' In an earlier report, NACA TR 387, Carl Wenzinger and Thomas Harris supply this description of the tunnel: 'The vertical open-throat wind tunnel of the National Advisory Committee for Aeronautics ... was built mainly for studying the spinning characteristics of airplane models, but may be used as well for the usual types of wind-tunnel tests. A special spinning balance is being developed to measure the desired forces and moments with the model simulating the actual

  20. Magnetic tunnel junctions utilizing diamond-like carbon tunnel barriers

    NASA Astrophysics Data System (ADS)

    Cadieu, F. J.; Chen, Li; Li, Biao

    2002-05-01

    We have devised a method whereby thin particulate-free diamond-like carbon films can be made with good adhesion onto even room-temperature substrates. The method employs a filtered ionized carbon beam created by the vacuum impact of a high-energy, approximately 1 J per pulse, 248 nm excimer laser onto a carbon target. The resultant deposition beam can be steered and deflected by magnetic and electric fields to paint a specific substrate area. An important aspect of this deposition method is that the resultant films are particulate free and formed only as the result of atomic species impact. The vast majority of magnetic tunnel junctions utilizing thin metallic magnetic films have employed a thin oxidized layer of aluminum to form the tunnel barrier. This has presented reproducibility problems because the indicated optimal barrier thickness is only approximately 13 Å thick. Magnetic tunnel junctions utilizing Co and permalloy films made by evaporation and sputtering have been fabricated with an intervening diamond-like carbon tunnel barrier. The diamond-like carbon thickness profile has been tapered so that seven junctions with different barrier thickness can be formed at once. Magnetoresistive (MR) measurements made between successive permalloy strip ends include contributions from two junctions and from the permalloy and Co strips that act as current leads to the junctions. Magnetic tunnel junctions with thicker carbon barriers exhibit MR effects that are dominated by that of the permalloy strips. Since these tunnel barriers are formed without the need for oxygen, complete tunnel junctions can be formed with all high-vacuum processing.

  1. Spin-dependent tunneling in magnetic tunnel junctions

    NASA Astrophysics Data System (ADS)

    Davis, Albert Hamilton, Jr.

    In this work I present results of a theoretical study of the intrinsic response of ferromagnetic tunnel junctions (MTJ's). The goal of the work has been to understand the underlying physics in order to describe the intrinsic portion of the observed behavior. Specifically, I present a free electron tunneling model which predicts that the magneto-conductance ratio (ΔG/G) or tunneling magneto-resistance (TMR) in high quality MTJs is dominated by the intrinsic response. The model assumes an effective tunneling electronic structure which has been constructed from parameters extracted from first principles calculations and a simple barrier whose effective height and thickness are deduced from the experiments. This model does not utilize the polarization (P) of the density of states (DOS) as an input parameter, but rather calculates the conductance for each spin channel and configuration in order to calculate TMR directly. The process of matching spin-dependent tunneling states with spin-independent barrier states produces a spin-dependent T-matrix which is the main difference between this model and other prevalent models which have been built upon Julliere's model (M. Julliere, Phys. Lett. 54 225, 1975). The effect of bias is handled by increasing the chemical potential on one side of the barrier, and the effect of temperature is included via Fermi smearing and the temperature dependent magnetic band structure. The model predicts that MTJ's are quite sensitive to changes in the magnetic band structure. This explains both the large temperature dependence of TMR and the high sensitivity of MTJ's to magnetic fields. The model strongly supports the assertion that only a portion of the total DOS is relevant to spin-dependent tunneling (SDT) and that the bands which supply the tunneling electrons are essentially Stoner split. I conclude with a consideration of asymmetric TMR and a short first principles study of fcc magnetic alloys which gives some insight into the relative

  2. Tunnelling without barriers

    SciTech Connect

    Lee, K.

    1987-01-01

    The evolution in flat and curved space-time of quantum fields in theories with relative flat potential and its consequences are considered. It is shown that bubble nucleation, a quantum mechanical tunnelling process, may occur in flat space-time, having a bounce solution, even if V(phi) has no barrier. It is shown that bubble nucleation can also occur in curved space-time even though there is no bounce solution in the standard formalism for the bubble nucleation rate in curved space-time. Additionally, bubbles can nucleate during the slow rolling period on the potential in flat and curved space-time, in this case also there is no bounce solution. It is known in the new inflationary scenario that energy density perturbations caused by quantum fluctuations of the scalar field can satisfy the presently observed bounds on density perturbations. Bubble nucleation during the slow rolling period also gives rise to density perturbations. For a model potential density perturbations by bubbles are calculated at the horizon reentering. By applying the bound from the almost isotropic microwave black body radiation on these density perturbations, a constraint on the model potential is obtained. Finally, some further implications on the galaxy formation and applications in more realistic potential are discussed.

  3. Full Scale Wind Tunnel

    NASA Technical Reports Server (NTRS)

    1931-01-01

    Installation of propeller and motor fairing for east exit cone. Smith DeFrance described the propellers and motors in NACA TR No. 459. ' The propellers are located side by side and 48 feet aft of the throat of the exit-cone bell. The propellers are 35 feet 5 inches in diameter and each consists of four cast aluminum alloy blades screwed into a cast steel hub.' 'The most commonly used power plant for operating a wind tunnel is a direct-current motor and motor-generator set with Ward Leonard control system. For the FST it was found that alternating current slip-ring induction motors, together with satisfactory control equipment, could be purchased for approximately 30 percent less than the direct-current equipment. Two 4,000-horsepower slip-ring induction motors with 24 steps of speed between 75 and 300 r.p.m. were therefore installed. In order to obtain the range of speed one pole change was provided and the other variations are obtained by the introduction of resistance in the rotor circuit. This control permits a variation in air speed from 25 to 118 miles per hour. The two motors are connected through an automatic switchboard to one drum-type controller located in the test chamber. All the control equipment is interlocked and connected through time-limit relays, so that regardless of how fast the controller handle is moved the motors will increase in speed at regular intervals.' (p. 294-295)

  4. Nonorientable spacetime tunneling

    NASA Astrophysics Data System (ADS)

    González-Díaz, Pedro F.; Garay, Luis J.

    1999-03-01

    Misner space is generalized to have the nonorientable topology of a Klein bottle, and it is shown that, in a classical spacetime with multiply connected space slices having such a topology, closed timelike curves are formed. Different regions on the Klein bottle surface can be distinguished which are separated by apparent horizons fixed at particular values of the two angular variables that enter the metric. Around the throat of this tunnel (which we denote a Klein bottlehole), the position of these horizons dictates an ordinary and exotic matter distribution such that, in addition to the known diverging lensing action of wormholes, a converging lensing action is also present at the mouths. Associated with this matter distribution, the accelerating version of this Klein bottlehole shows four distinct chronology horizons, each with its own nonchronal region. A calculation of the quantum vacuum fluctuations performed by using the regularized two-point Hadamard function shows that each chronology horizon nests a set of polarized hypersurfaces where the renormalized momentum-energy tensor diverges. This quantum instability can be prevented if we take the accelerating Klein bottlehole to be a generalization of a modified Misner space in which the period of the closed spatial direction is time dependent. In this case, the nonchronal regions and closed timelike curves cannot exceed a minimum size of the order the Planck scale.

  5. 15-Foot Spin Tunnel

    NASA Technical Reports Server (NTRS)

    1935-01-01

    Interior view of model in 15-Foot Spin Tunnel. Charles Zimmerman wrote in NASA TR No. 557: 'After the observations have been made, the model is lowered into a net held in the air stream by one of the operators or into a large bowl-shaped net at the bottom of the test section. When lowered into the large net, the model is retrieved with a long-handled clamp.' (p. 267) 'The models mused are generally 1/10 to 1/16 scale. The size of the models is limited by the wing span and the wing loading. The maximum allowable span is about 36 inches; the maximum wing loading is about 1.3 pounds per square foot.' (p. 266) 'Balsa wood is the usual structural material because of its low density. It is necessary to hollow out the after portion of the fuselage and to cut out a large portion of the wood in the wings to permit proper mass distribution. The wing cut-outs are covered with silk tissue paper. The leading and trailing edges and tips of the wings are fitted with strips of spruce, pattern pine, or bamboo inset into the edge of the balsa to prevent disfigurement from accidental blows or from striking the safety netting. Lead is used for ballast.' (p. 266)

  6. Femoral placement of totally implantable venous power ports as an alternative implantation site for patients with central vein occlusions.

    PubMed

    Goltz, Jan P; Janssen, Hendrik; Petritsch, Bernhard; Kickuth, Ralph

    2014-02-01

    To evaluate the indication, technical success, clinical outcome and safety of percutaneously placed totally implantable venous power ports (TIVPPs) in a femoral position in patients with contraindications to implantation in a standard position. Retrospectively, we screened our interventional radiology department database between 12/2,009 and 3/2,013 to identify 1,729 patients with a port implantation. In 8/1,729 (0.47 %) patients (1 male, 7 female, mean age 55.5 ± 9.6 years) the TIVPP was implanted via the common femoral vein with the port placed in the anterior thigh. All devices were high-pressure injectable, implanted under local anaesthesia with sonographic as well as fluoroscopic guidance, and were tunnelled subcutaneously. Indication, technical success and complications were retrospectively analysed according to the Society of Interventional Radiology (SIR) criteria. Indications were planned chemotherapy for breast (n = 6) and oesophagus cancer (n = 1) as well as need for long-term central venous access for intravenous therapy (n = 1) with a contraindication to or failed implantation in a standard position owing to central vein occlusions. Technical success was 100 %. A number of five devices were placed in the right, three in the left thigh. Altogether 1,979 catheter days were analysed. One device was explanted owing to infection after 84 days (late complication, 0.05/100 catheter days). No early complication was observed. Our data suggest that if implantation of a TIVPP is not favourable in a standard chest, upper arm or forearm position, femoral placement of the device may alternatively be used safely and with high technical success.

  7. Electronic Signatures of all Four DNA Nucleosides in a Tunneling Gap

    NASA Astrophysics Data System (ADS)

    Chang, Shuai

    2011-03-01

    New approaches to DNA sequencing are required to reduce costs and increase the availability of personalized genomics. Using Scanning Tunneling Microscope as a tool, we report measurements of the current signals generated as free nucleosides diffuse into a tunnel junction in which both electrodes are functionalized with a reagent that presents a hydrogen bond donor and acceptor to the nucleosides. This functionalization serves to both limit the range of molecular orientations in the tunnel gap and reduce the contact resistance, increasing the selectivity of the tunneling signal, so that a direct readout may be possible with a few repeated reads. This work was supported by a grant from the Sequencing Technology Program of the National Human Genome Research Institute (HG004378).

  8. Sidewall GaAs tunnel junctions fabricated using molecular layer epitaxy.

    PubMed

    Ohno, Takeo; Oyama, Yutaka

    2012-02-01

    In this article we review the fundamental properties and applications of sidewall GaAs tunnel junctions. Heavily impurity-doped GaAs epitaxial layers were prepared using molecular layer epitaxy (MLE), in which intermittent injections of precursors in ultrahigh vacuum were applied, and sidewall tunnel junctions were fabricated using a combination of device mesa wet etching of the GaAs MLE layer and low-temperature area-selective regrowth. The fabricated tunnel junctions on the GaAs sidewall with normal mesa orientation showed a record peak current density of 35 000 A cm(-2). They can potentially be used as terahertz devices such as a tunnel injection transit time effect diode or an ideal static induction transistor.

  9. Sidewall GaAs tunnel junctions fabricated using molecular layer epitaxy

    PubMed Central

    Ohno, Takeo; Oyama, Yutaka

    2012-01-01

    In this article we review the fundamental properties and applications of sidewall GaAs tunnel junctions. Heavily impurity-doped GaAs epitaxial layers were prepared using molecular layer epitaxy (MLE), in which intermittent injections of precursors in ultrahigh vacuum were applied, and sidewall tunnel junctions were fabricated using a combination of device mesa wet etching of the GaAs MLE layer and low-temperature area-selective regrowth. The fabricated tunnel junctions on the GaAs sidewall with normal mesa orientation showed a record peak current density of 35 000 A cm-2. They can potentially be used as terahertz devices such as a tunnel injection transit time effect diode or an ideal static induction transistor. PMID:27877466

  10. Scanning Tunneling Optical Resonance Microscopy

    NASA Technical Reports Server (NTRS)

    Bailey, Sheila; Wilt, Dave; Raffaelle, Ryne; Gennett, Tom; Tin, Padetha; Lau, Janice; Castro, Stephanie; Jenkins, Philip; Scheiman, Dave

    2003-01-01

    Scanning tunneling optical resonance microscopy (STORM) is a method, now undergoing development, for measuring optoelectronic properties of materials and devices on the nanoscale by means of a combination of (1) traditional scanning tunneling microscopy (STM) with (2) tunable laser spectroscopy. In STORM, an STM tip probing a semiconductor is illuminated with modulated light at a wavelength in the visible-to-near-infrared range and the resulting photoenhancement of the tunneling current is measured as a function of the illuminating wavelength. The photoenhancement of tunneling current occurs when the laser photon energy is sufficient to excite charge carriers into the conduction band of the semiconductor. Figure 1 schematically depicts a proposed STORM apparatus. The light for illuminating the semiconductor specimen at the STM would be generated by a ring laser that would be tunable across the wavelength range of interest. The laser beam would be chopped by an achromatic liquid-crystal modulator. A polarization-maintaining optical fiber would couple the light to the tip/sample junction of a commercial STM. An STM can be operated in one of two modes: constant height or constant current. A STORM apparatus would be operated in the constant-current mode, in which the height of the tip relative to the specimen would be varied in order to keep the tunneling current constant. In this mode, a feedback control circuit adjusts the voltage applied to a piezoelectric actuator in the STM that adjusts the height of the STM tip to keep the tunneling current constant. The exponential relationship between the tunneling current and tip-to-sample distance makes it relatively easy to implement this mode of operation. The choice of method by which the photoenhanced portion of the tunneling current would be measured depends on choice of the frequency at which the input illumination would be modulated (chopped). If the frequency of modulation were low enough (typically < 10 Hz) that the

  11. Using simulation for teaching femoral arterial access: A multicentric collaboration.

    PubMed

    Gurm, Hitinder S; Sanz-Guerrero, Jorge; Johnson, Daniel D; Jensen, Andrea; Seth, Milan; Chetcuti, Stanley J; Lalonde, Thomas; Greenbaum, Adam; Dixon, Simon R; Shih, Albert

    2016-02-15

    To assess the impact of simulation training on complications associated with femoral arterial access obtained by first year cardiology fellows. Prior studies demonstrate a higher incidence of arterial access related complications among patients undergoing invasive cardiac procedures. First year cardiology fellows at four teaching hospitals in Michigan tracked their femoral access experience and any associated complications between July 2011 and June 2013. Fellows starting their academic training in July 2012 were first trained on a specially developed simulator before starting their rotation in the catheterization laboratory. The primary outcome was access proficiency, defined as five successful femoral access attempts without any complication or need to seek help from a more experienced team member. A total of 1,278 femoral access attempts were made by 21 fellows in 2011-2012 compared with 869 femoral access attempts made by 21 fellows in 2012-2013. There was a lower rate of access related complications in patients undergoing access attempts by first year fellows in year 2 compared with year 1 (2.1% versus 4.5%, P = 0.003). The number of procedures to achieve procedural proficiency was significantly higher in year 1 compared with year 2 (median 20 versus 10, P = 0.007). Incorporation of simulation in the training of first year fellows was associated with an improvement in proficiency and a clinically meaningful reduction in vascular complications. © 2015 Wiley Periodicals, Inc.

  12. Revision total hip arthroplasty: the femoral side using cemented implants.

    PubMed

    Holt, Graeme; Hook, Samantha; Hubble, Matthew

    2011-02-01

    Advances in surgical technique and implant technology have improved the ten-year survival after primary total hip arthroplasty (THA). Despite this, the number of revision procedures has been increasing in recent years, a trend which is predicted to continue into the future. Revision THA is a technically demanding procedure often complicated by a loss of host bone stock which may be compounded by the need to remove primary implants. Both cemented and uncemented implant designs are commonly used in the United Kingdom for primary and revision THA and much controversy still exists as to the ideal method of stem fixation. In this article we discuss revision of the femur using cemented components during revision THA. We focus on three clinical scenarios including femoral cement-in-cement revision where the primary femoral cement-bone interface remains well fixed, femoral cement-in-cement revision for peri-prosthetic femoral fractures, and femoral impaction grafting. We discuss the clinical indications, surgical techniques and clinical outcomes for each of these procedures.

  13. Revision total hip arthroplasty: the femoral side using cemented implants

    PubMed Central

    Hook, Samantha; Hubble, Matthew

    2010-01-01

    Advances in surgical technique and implant technology have improved the ten-year survival after primary total hip arthroplasty (THA). Despite this, the number of revision procedures has been increasing in recent years, a trend which is predicted to continue into the future. Revision THA is a technically demanding procedure often complicated by a loss of host bone stock which may be compounded by the need to remove primary implants. Both cemented and uncemented implant designs are commonly used in the United Kingdom for primary and revision THA and much controversy still exists as to the ideal method of stem fixation. In this article we discuss revision of the femur using cemented components during revision THA. We focus on three clinical scenarios including femoral cement-in-cement revision where the primary femoral cement-bone interface remains well fixed, femoral cement-in-cement revision for peri-prosthetic femoral fractures, and femoral impaction grafting. We discuss the clinical indications, surgical techniques and clinical outcomes for each of these procedures. PMID:21165618

  14. Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism

    PubMed Central

    Fujiwara, Yasuhiro; Hayashida, Tatsuro; Murakami, Koji; Makio, Satoshi; Shimizu, Yuichi; Oka, Yoshinobu; Kim, Wook-Choel; Ogura, Taku; Kubo, Toshikazu

    2017-01-01

    Slipped capital femoral epiphysis (SCFE) is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head. Valgus SCFE was diagnosed. The patient underwent in situ pinning of both sides. In situ pinning on the left side was performed as a prophylactic pinning because of endocrine abnormalities. At the 1-year follow-up, he could walk without any difficulty and there were no signs of pain. The epiphysis is commonly positioned more posteromedially in relation to the femoral neck shaft with most SCFE, but, in this case, the epiphysis slipped laterally. Differential diagnosis included femoral neck fracture (Delbet-Colonna type 1); however, this was less likely due to the absence of other clinical signs. Therefore, we diagnosed the patient as SCFE. When children complain of leg pain and limp, valgus SCFE that may not be visualized on anteroposterior radiographs needs to be considered. PMID:28154765

  15. Numerical simulation of blood flow in femoral perfusion: comparison between side-armed femoral artery perfusion and direct femoral artery perfusion.

    PubMed

    Kitamura, Shingo; Shirota, Minori; Fukuda, Wakako; Inamura, Takao; Fukuda, Ikuo

    2016-12-01

    Computational numerical analysis was performed to elucidate the flow dynamics of femoral artery perfusion. Numerical simulation of blood flow was performed from the right femoral artery in an aortic model. An incompressible Navier-Stokes equation and continuity equation were solved using computed flow dynamics software. Three different perfusion models were analyzed: a 4.0-mm cannula (outer diameter 15 French size), a 5.2-mm cannula (18 French size) and an 8-mm prosthetic graft. The cannula was inserted parallel to the femoral artery, while the graft was anastomosed perpendicular to the femoral artery. Shear stress was highest with the 4-mm cannula (172 Pa) followed by the graft (127 Pa) and the 5.2-mm cannula (99 Pa). The cannula exit velocity was high, even when the 5.2-mm cannula was used. Although side-armed perfusion with an 8-mm graft generated a high shear stress area near the point of anastomosis, flow velocity at the external iliac artery was decreased. The jet speed decreased due to the Coanda effect caused by the recirculation behind sudden expansion of diameter, and the flow velocity maintains a constant speed after the reattachment length of the flow. This study showed that iliac artery shear stress was lower with the 5.2-mm cannula than with the 4-mm cannula when used for femoral perfusion. Side-armed graft perfusion generates a high shear stress area around the anastomotic site, but flow velocity in the iliac artery is slower in the graft model than in the 5.2-mm cannula model.

  16. The self streamlining wind tunnel. [wind tunnel walls

    NASA Technical Reports Server (NTRS)

    Goodyer, M. J.

    1975-01-01

    A two dimensional test section in a low speed wind tunnel capable of producing flow conditions free from wall interference is presented. Flexible top and bottom walls, and rigid sidewalls from which models were mounted spanning the tunnel are shown. All walls were unperforated, and the flexible walls were positioned by screw jacks. To eliminate wall interference, the wind tunnel itself supplied the information required in the streamlining process, when run with the model present. Measurements taken at the flexible walls were used by the tunnels computer check wall contours. Suitable adjustments based on streamlining criteria were then suggested by the computer. The streamlining criterion adopted when generating infinite flowfield conditions was a matching of static pressures in the test section at a wall with pressures computed for an imaginary inviscid flowfield passing over the outside of the same wall. Aerodynamic data taken on a cylindrical model operating under high blockage conditions are presented to illustrate the operation of the tunnel in its various modes.

  17. Electromagnetic Tunneling and Resonances in Pseudochiral Omega Slabs.

    PubMed

    Razzaz, Faroq; Alkanhal, Majeed A S

    2017-02-06

    This paper presents theoretical investigation of the electromagnetic wave tunneling and anomalous transmission around the trapped modes in a pseudochiral omega slab. The dispersion relation, the conditions of the trapped modes, and the evanescent wave coupling and tunneling in two different reciprocal pseudochiral omega slab structures are derived. The Berreman's matrix method is applied to obtain the transmission coefficients across the pseudochiral omega slab. When the structure is perturbed, a resonance phenomenon is detected around the trapped modes. This resonance results in transmission anomalies (total transmission and total reflection) and dramatic field amplifications around the trapped modes. The number of the discrete trapped modes and then the resonance frequencies are prescribed by the parameters of the pseudochiral omega slab such as the value of the omega parameter and its orientation and the slab thickness.

  18. Piezoelectric effects in double barrier resonant tunneling structures

    SciTech Connect

    Cong, L.; Albrecht, J.D.; Nathan, M.I.; Ruden, P.P.; Smith, D.L.

    1994-10-01

    It is shown that piezoelectric effects can give rise to internal electric fields that modify the conventional current vs. voltage characteristics of III-V semiconductor double barrier resonant tunneling devices, if suitable stresses are applied. We measured current vs. voltage characteristics of symmetric, (001)-oriented AlAs/GaAs/AlAs double barrier structures as a function of external stress. Uniaxial stress was applied parallel to the (110), the (110), and the (001) directions. In order to understand the experimental results we calculated the current vs. voltage characteristics of resonant tunneling structures under uniaxial stress, including pressure effects on the band alignment and the effects associated with the piezoelectric nature of the constituent materials. Stresses along the (110) or (110) directions give rise to polarization charges at the interfaces, due to differences in the piezoelectric constants of the materials. The resulting internal electric fields are found to modulate the I-V characteristics, in good agreement with our experimental data.

  19. Electromagnetic Tunneling and Resonances in Pseudochiral Omega Slabs

    PubMed Central

    Razzaz, Faroq; Alkanhal, Majeed A. S.

    2017-01-01

    This paper presents theoretical investigation of the electromagnetic wave tunneling and anomalous transmission around the trapped modes in a pseudochiral omega slab. The dispersion relation, the conditions of the trapped modes, and the evanescent wave coupling and tunneling in two different reciprocal pseudochiral omega slab structures are derived. The Berreman’s matrix method is applied to obtain the transmission coefficients across the pseudochiral omega slab. When the structure is perturbed, a resonance phenomenon is detected around the trapped modes. This resonance results in transmission anomalies (total transmission and total reflection) and dramatic field amplifications around the trapped modes. The number of the discrete trapped modes and then the resonance frequencies are prescribed by the parameters of the pseudochiral omega slab such as the value of the omega parameter and its orientation and the slab thickness. PMID:28165058

  20. Radiographic analysis of Re-Ruptures of reconstructed ACLs - Evaluation of tunnel position as a possible cause of Failure

    PubMed Central

    Sobau, Christian; Zimmerer, Alexander; Fallscheer, Max; Ellermann, Andree

    2017-01-01

    Objectives: Previous studies detected femoral and / or tibial tunnel malpositioning as possible causes for the failure of an anterior cruciate ligament reconstruction. We investigated various radiological angles and criterias for ACL revision surgery to find possible causes for the failure of the primary reconstructed ACLs based on digital X-ray images. Materials and Methods: 529 ACL revisions after previous reconstruction were carried out between 1993 and 2013, of which we were able to include 100 patients with digital radiographs in our study. We investigated the angles of the femoral and tibial tunnel position in the coronal and sagittal plane. Furthermore we analyzed the entry point on the femur in accordance with the quadrant method described by Bernard and Hertel. We divided into: A) adequate trauma (n = 87) and non-trauma group (n = 13); B) Hamstring (n = 76) and Patella-BTB group (n = 24); C) transtibial (n = 83) and anteromedial group (n = 17). In addition we built subgroups B1/C1 adequate re-trauma or B2/C2 no adequate trauma to analyze whether there were differences in these groups. Results: The trauma group differed significantly from the non-trauma group in the measured angle of the tibial tunnel in the ap radiograph (trauma group 28.4°, non-trauma group 22.67°; p = 0.013). The Hamstring group differed significantly from the BTB group in the measured inclination angle of the femoral tunnel in the ap radiograph (HS group 54.86°, BTB group 62.78°; p = 0.015). There was also a significant difference concerning the tibial tunnel in the ap radiograph (HS group 29.56°, BTB group 21.63°; p = 0.0001). Comparing the two groups for the femoral tunnel placement-techniques we could find significant differences in the femoral ap-radiographs (inclination angle: TT = 59.04°, AM = 45.64°; p = 0.0001). The analysis of the 4 subgroups revealed differences in the tibial ap images: The BTB trauma group had an average of 23.56° relative to the BTB non-trauma group

  1. Improved multidimensional semiclassical tunneling theory.

    PubMed

    Wagner, Albert F

    2013-12-12

    We show that the analytic multidimensional semiclassical tunneling formula of Miller et al. [Miller, W. H.; Hernandez, R.; Handy, N. C.; Jayatilaka, D.; Willets, A. Chem. Phys. Lett. 1990, 172, 62] is qualitatively incorrect for deep tunneling at energies well below the top of the barrier. The origin of this deficiency is that the formula uses an effective barrier weakly related to the true energetics but correctly adjusted to reproduce the harmonic description and anharmonic corrections of the reaction path at the saddle point as determined by second order vibrational perturbation theory. We present an analytic improved semiclassical formula that correctly includes energetic information and allows a qualitatively correct representation of deep tunneling. This is done by constructing a three segment composite Eckart potential that is continuous everywhere in both value and derivative. This composite potential has an analytic barrier penetration integral from which the semiclassical action can be derived and then used to define the semiclassical tunneling probability. The middle segment of the composite potential by itself is superior to the original formula of Miller et al. because it incorporates the asymmetry of the reaction barrier produced by the known reaction exoergicity. Comparison of the semiclassical and exact quantum tunneling probability for the pure Eckart potential suggests a simple threshold multiplicative factor to the improved formula to account for quantum effects very near threshold not represented by semiclassical theory. The deep tunneling limitations of the original formula are echoed in semiclassical high-energy descriptions of bound vibrational states perpendicular to the reaction path at the saddle point. However, typically ab initio energetic information is not available to correct it. The Supporting Information contains a Fortran code, test input, and test output that implements the improved semiclassical tunneling formula.

  2. COMPARATIVE STUDY OF ACL RECONSTRUCTION WITH ANATOMICAL POSITIONING OF THE TUNNELS USING THE PATELLAR TENDON VERSUS HAMSTRING TENDON

    PubMed Central

    de Pádua, Vitor Barion Castro; Maldonado, Hilário; Vilela, Júlio César Rodrigues; Provenza, Alexandre Ribeira; Monteiro, Cleverson; de Oliveira Neto, Heleno Cavalcante

    2015-01-01

    Objective: To compare ACL reconstruction with anatomical positioning of the tunnels using the hamstring or patellar tendons. Methods: We prospectively evaluated 52 patients who underwent ACL reconstruction using the Chambat's technique, with anatomical positioning of the tunnels drilled outside in. They were divided into group A, with 27 patients, using the patellar tendon as a graft, and group B, with 25 patients, using the hamstring. Results: In group A 26 patients were very satisfied or satisfied and 1 unhappy, in group B. 25 patients were very satisfied or satisfied with the procedure (p = 0.990). According to the Lysholm scale, group A had a mean score of 96.11 and group B, 95.32 (p=0.594). In relation to preoperative IKDC, 100% of the patients in group A and 92% of those in group B were IKDC C or D (p = 0.221); in the assessment with a minimum of two-year follow-up, 96% of group A and 92% of group B were IKDC A or B (p = 0.256). The Lachman test, pivot shift, return to sports activities, and the comparative difference in anterior translation (RolimeterTM) also showed no statistically significant difference. In group A, 5 patients (18.5%) were unable to kneel on a hard surface, whereas no patient in group B had this complaint. Conclusion: The anterior cruciate ligament reconstruction presents similar results using the hamstring or patellar tendon with anatomical positioning of the tunnels. Drilling the femoral tunnel outside in is a reproducible and accurate option in the correct placement the femoral tunnel. PMID:27027082

  3. Intraoperative type 1 proximal femoral fractures: influence on the stability of hydroxyapatite-coated femoral components.

    PubMed

    Falez, F; Santori, N; Panegrossi, G

    1998-09-01

    We reviewed a series of 120 uncemented total hip replacements using the Omniflex stem with hydroxyapatite coating. Twenty minor intraoperative proximal fractures occurred. All fractures were treated with cerclage wiring after removal of the stem. Radiographic and clinical results of these 20 patients were compared with the remaining 100 implants in which this complication did not occur. In 20% of the cases of both groups, a migration of less than 2 mm was observed. No differences were detected in Harris Hip Scores, subsidence of the stem, and radiographic behavior. We concluded that a properly stabilized proximal femoral fracture above the lesser trochanter did not influence the clinical and radiographic results at more than 3 years follow-up.

  4. A micro-architectural evaluation of osteoporotic human femoral heads to guide implant placement in proximal femoral fractures

    PubMed Central

    2013-01-01

    Background and purpose The micro-architecture of bone has been increasingly recognized as an important determinant of bone strength. Successful operative stabilization of fractures depends on bone strength. We evaluated the osseous micro-architecture and strength of the osteoporotic human femoral head. Material and methods 6 femoral heads, obtained during arthroplasty surgery for femoral neck fracture, underwent micro-computed tomography (microCT) scanning at 30 μm, and bone volume ratio (BV/TV), trabecular thickness, structural model index, connection density, and degree of anisotropy for volumes of interest throughout the head were derived. A further 15 femoral heads underwent mechanical testing of compressive failure stress of cubes of trabecular bone from different regions of the head. Results The greatest density and trabecular thickness was found in the central core that extended from the medial calcar to the physeal scar. This region also correlated with the greatest degree of anisotropy and proportion of plate-like trabeculae. In the epiphyseal region, the trabeculae were organized radially from the physeal scar. The weakest area was found at the apex and peripheral areas of the head. The strongest region was at the center of the head. Interpretation The center of the femoral head contained the strongest trabecular bone, with the thickest, most dense trabeculae. The apical region was weaker. From an anatomical and mechanical point of view, implants that achieve fixation in or below this central core may achieve the most stable fixation during fracture healing. PMID:24032522

  5. Emergency Stenting of a Ruptured Infected Anastomotic Femoral Pseudoaneurysm

    SciTech Connect

    Klonaris, Chris Katsargyris, Athanasios; Matthaiou, Alexandros; Giannopoulos, Athanasios; Tsigris, Chris; Papadopouli, Katerina; Tsiodras, Sotiris; Bastounis, Elias

    2007-11-15

    A 74-year-old man presented with a ruptured infected anastomotic femoral pseudoaneurysm. Due to severe medical comorbidities he was considered unsuitable for conventional surgical management and underwent an emergency endovascular repair with a balloon-expandable covered stent. The pseudoaneurysm was excluded successfully and the patient had an uneventful postoperative recovery with long-term suppressive antimicrobials. He remained well for 10 months after the procedure with no signs of recurrent local or systemic infection and finally died from an acute myocardial infarction. To our knowledge, emergency endovascular treatment of a free ruptured bleeding femoral artery pseudoaneurysm has not been documented before in the English literature. This case illustrates that endovascular therapy may be a safe and efficient alternative in the emergent management of ruptured infected anastomotic femoral artery pseudoaneurysms when traditional open surgery is contraindicated.

  6. A Case of Late Femoral Pseudoaneurysm Caused by Stent Disconnection

    SciTech Connect

    Rivolta, Nicola; Fontana, Federico; Piffaretti, Gabriele Tozzi, Matteo; Carrafiello, Gianpaolo

    2010-10-15

    We present the case of a late superficial femoral artery stent disconnection causing an asymptomatic pseudoaneurysm successfully treated with a stent-graft. A 67-year-old female was referred to our department for evaluation of claudication of the left lower limb and was diagnosed to have a total occlusion of the superficial femoral artery. Three nitinol stents were used to revascularize this artery. At 48 months, duplex-ultrasonography control revealed the presence of a 45-mm saccular femoral dilatation; X-rays and CT angiography showed fractures of the proximal stents and the presence of a pseudoaneurysm at the site of the distal stents disconnection. The pseudoaneurysm was excluded using two stent-grafts. We conclude that patients and surgeons should be aware of structural complications with all stents. Rigorous follow-up controls should be mandatory. Endovascular repair proved to be feasible and durable to manage a previous endovascular procedure.

  7. Intimal sarcoma of the superficial femoral artery with osteosarcomatous differentiation.

    PubMed

    Ebaugh, James L; Yuan, Minsheng; Hu, Jeffery; Chen, Ahchean; Raffetto, Joseph D

    2011-05-01

    Sarcomas of the large vessels usually present centrally in the aorta, pulmonary artery, and inferior vena cava. Peripheral arterial sarcomas are exceptionally rare. They have been reported in the iliac and common or profunda femoral arteries, and are frequently undifferentiated. In this study, we describe a differentiated intimal sarcoma of the superficial femoral artery with abundant osteosarcoma within the specimen. Before knowing the diagnosis, treatment was for a presumed pseudoaneurysm using excision and bypass. Postoperatively, the patient received palliative radiation therapy. The tumor's location and histopathology are unique. A differentiated intimal sarcoma has never been reported in the superficial femoral artery, and it represents the second peripheral arterial intimal sarcoma reported with osteosarcomatous differentiation.

  8. Pantaloon femoral vein graft as "neoaorta" in infected aortic disease.

    PubMed

    Verma, Himanshu; Mohan, Satish; Tripathi, Ramesh K

    2015-10-01

    Infected abdominal aortic disease and graft infections pose a significant challenge for the vascular surgeon. Thorough radical débridement, either preceded by extra-anatomic bypass or followed by in situ aortic replacement, is the mainstay of treatment. The role of endovascular repair by stent grafts is being increasingly described but is limited to relatively less virulent mycotic aneurysms or as a "bridging" option in sick patients with florid sepsis that necessitates eventual delayed definitive surgical management. Autologous femoral vein has been an excellent conduit for aortic bifurcation reconstruction in this setting. Although various configurations of femoral vein conduit have been described for aortobi-iliac reconstruction, an in-depth knowledge of the venous anatomy, physiology, mechanisms of "profundization," and techniques of harvest and graft preparation is essential for efficient conduct of the operation and its optimal outcomes. We review in detail these aspects of "pantaloon" femoral vein graft creation as a "neoaorta".

  9. A case report of missed femoral neck stress fracture.

    PubMed

    Onibere, Oruaro Adebayo; Sugathan, Hari Kovilazhikathu

    2015-03-06

    Femoral neck stress fracture (FNSF) is an uncommon but potentially serious orthopaedic problem. This is a case report on missed femoral neck stress fracture in a 62-year-old female who was initially treated as early-onset coxarthrosis. She later presented to us with a displaced intra-capsular neck of left femur fracture and underwent total hip replacement. This case illustrates that causes other than osteoarthritis should be taken into consideration in patients presenting with anterior hip pain where symptoms are disproportionate to clinical and radiological findings. More advanced investigations such as MRI scan or regular follow up with plain radiographs should be performed. A delay in diagnosis can lead to secondary displacement of the femoral neck stress fracture.

  10. Septic arthritis of the hip after percutaneous femoral artery catheterization.

    PubMed

    Backstein, David; Hutchison, Carol; Gross, Allan

    2002-12-01

    Infection of the hip joint can cause severe articular damage. Standard treatment of septic arthritis includes surgical débridement and intravenous antibiotics. Options for definitive management in the presence of joint destruction include excision arthroplasty, arthrodesis, and total hip arthroplasty. Two cases of septic arthritis of the hip as a complication of femoral artery cannulation are presented. These cases highlight a potential complication that may not be readily appreciated by clinicians who routinely perform femoral vascular cannulation. After all evidence of ongoing infection had disappeared, both cases ultimately were treated with total hip arthroplasty. Both patients have improved function and pain at 2.5 and 5 years of follow-up. Given the frequency with which femoral intravascular catheters are used in numerous procedures, methods of avoiding infection of the hip joint must be implemented. These 2 cases emphasize the potential risks of these procedures and show management with total hip arthroplasty. Copyright 2002, Elsevier Science (USA). All rights reserved.

  11. How to Minimize Rotational Conflict between Femoral & Tibial Component in Total Knee Arthroplasty: The Use of Femoro-Tibial Axial Synchronizer (Linker)

    PubMed Central

    Seo, Jai-Gon; Moon, Young-Wan; Kim, Sang-Min

    2015-01-01

    Purpose The purpose of this study was to investigate the correlation between rotational axes of femur and tibia with the use of Linker. Materials and Methods This study was carried out from August 2009 to February 2010 on 54 patients (106 knees), who were diagnosed with simultaneous bilateral total knee arthroplasty. With the use of postoperative computed tomography scans, it was investigated how much the rotational angle of femoral and tibial components matched. Results The tibial component was internally rotated for the femoral component at an angle of 0.8°. The femoral component was externally rotated for the surgical transepicondylar axis (TEA) at an angle of 1.6 (range: from 4.8° of internal rotation to 7.9° of external rotation, SD=2.2°), and the tibial component was externally rotated for the surgical TEA at an average angle of 0.9 (range: from 5.1° of internal rotation to 8.3° of external rotation, SD=3.1°). Conclusion The femoro-tibial synchronizer helped to improve the orientation and positioning of both femoral component and tibial component, and also increase the correlation of the rotational axes of the two components. PMID:25683995

  12. Comparison of plain radiography, computed tomography, and magnetic resonance imaging in the evaluation of bone tunnel widening after anterior cruciate ligament reconstruction.

    PubMed

    Marchant, Milford H; Willimon, S Clifton; Vinson, Emily; Pietrobon, Ricardo; Garrett, William E; Higgins, Laurence D

    2010-08-01

    Bone tunnel widening poses a problem for graft fixation during revision anterior cruciate ligament (ACL) reconstruction. Large variability exists in the utilization of imaging modalities for evaluating bone tunnels in pre-operative planning for revision ACL reconstruction. The purpose of this study was to identify the most reliable imaging modality for identifying bone tunnels and assessing tunnel widening, and specifically, to validate the reliability of radiographs, MRI, and CT using intra- and inter-observer testing. Data was retrospectively collected from twelve patients presenting for revision ACL surgery. Five observers twice measured femoral and tibial tunnels at their widest point using digital calipers in coronal and sagittal planes. Measurements were corrected for magnification. Tunnel identification, diameter measurements, and cross-sectional area (CSA) calculations were recorded. A categorical classification of tunnel measurements was created to apply clinical significance to the measurements. Using kappa statistics, intra- and inter-observer reliability testing was performed. CT demonstrated excellent intra- and inter-observer reliability for tunnel identification. Intra- and inter-observer reliability was significantly less for MRI and radiographs. CT revealed superior reliability versus either radiographs or MRI for CSA analysis. Intra-observer kappa scores for tibial CSA using CT, radiographs, and MRI were 0.66, 0.5, and 0.37, respectively. Inter-observer kappa scores for tibial CSA using CT, radiographs, and MRI were 0.65, 0.39, and 0.32, respectively. Our results demonstrate CT is the most reliable imaging modality for evaluation of ACL bone tunnels as proven by superior intra- and inter-observer testing results when compared to MRI and radiographs. Radiographs and MRI were not reliable, even for simply identifying the presence of a bone tunnel.

  13. Conversion of Non-Tunneled to Tunneled Hemodialysis Catheters

    SciTech Connect

    Ha, Thuong G. Van Fimmen, Derek; Han, Laura; Funaki, Brian S.; Santeler, Scott; Lorenz, Jonathan

    2007-04-15

    Purpose. To determine the safety and efficacy of conversion of non-tunneled (temporary) catheters to tunneled catheters in hemodialysis patients. Methods. A retrospective review of 112 consecutive conversions in 111 patients was performed over a period of 4 years. Fourteen patients were lost to follow-up. The remaining 97 patients had clinical follow-up. Temporary catheters were converted to tunneled catheters utilizing the same internal jugular venotomy sites and a modified over-the-wire technique with use of a peel-away sheath . Follow-up clinical data were reviewed. Results. Technical success was achieved in all 112 procedures. None of the 97 patients with follow-up suffered early infection within 30 days. The total number of follow-up catheter days was 13,659 (range 2-790). Cases of confirmed and suspected bacteremia requiring catheter removal occurred at a frequency of 0.10 per 100 catheter days. Suspected catheter infection treated with antibiotics but not requiring catheter intervention occurred at a frequency of 0.04 per 100 catheter days. Frequency of all suspected or confirmed infections was 0.14 per 100 catheter days. Catheter interventions as a result of poor blood flow, inadvertent removal, catheter fracture, or kinking occurred at a rate of 0.18 per 100 catheter days. Life table analysis revealed primary patency rates of 86%, 64%, and 39% at 30 days, 90 days, and 180 days, respectively. Conclusion. Conversion of temporary catheters to tunneled catheters using the pre-existing venotomy sites is safe and has low rates of infection and malfunction. These rates are comparable to previously published rates for tunneled catheters placed de novo and tunneled catheter exchanges.

  14. [Antegrade femoral intramedullary nailing in a lateral position].

    PubMed

    Friederichs, J; von Rüden, C; Hierholzer, C; Bühren, V

    2015-04-01

    Intramedullary nailing is the gold standard for the treatment of femoral shaft fractures; however, rotational malalignment remains a common complication. The patient can be positioned on the fracture table in a supine position or alternatively in the lateral decubitus position without any traction. The aim of this article is to describe an effective method to control intraoperative torsion of the femur. The surgical technique described in this article is the standard procedure for femoral shaft fractures and subtrochanteric fractures in this level 1 trauma center. The patient is positioned in a lateral position on a radiolucent table with free draping of the injured leg. Using the C-arm, reduction can be performed with this technique with precise placing of the nails and torsion can be exactly adjusted and controlled with the aid of the femoral neck axis, the distal locking holes and both parallel femoral condyles. The described technique represents an effective method for the intraoperative control of femoral torsion. With an acceptable and most probably clinically irrelevant bias, this technique is able to avoid significant rotational malalignment. It does not prolong the operative procedure and does not require additional navigation settings. It has also been shown to be helpful in the treatment of subtrochanteric fractures. The surgical technique of anterograde intramedullary nailing using the lateral decubitus position without any traction device and free draping of the injured leg represents a safe and reliable treatment concept and offers logistical advantages compared to the supine position of the patient on a fracture table. Together with other described methods of intraoperative torsional control of femoral fractures, the radiological technique described in this study is an easily applicable and safe method, which needs to be confirmed in clinical studies.

  15. Sugarcane biopolymer patch in femoral vein angioplasty on dogs.

    PubMed

    de Barros-Marques, Silvio Romero; Marques-Lins, Esdras; de Albuquerque, Maria Cláudia Sodré; de Andrade-Aguiar, José Lamartine

    2012-02-01

    To evaluate the use of the sugarcane biopolymer membrane in femoral vein patch angioplasty on dogs. Eight dogs were submitted to bilateral femoral vein patch angioplasty with a sugarcane biopolymer membrane patch on one side and an expanded polytetrafluoroethylene (e-PTFE) patch on the contralateral side. This research was performed at Experimental Surgical Research Laboratory of the Centro de Ciências da Saúde at Universidade Federal de Pernambuco. The dogs underwent new surgery at 180 days after the patch angioplasty in order to harvest the femoral vein. All the animals were evaluated by clinical examination, measure of femoral vein diameter, venogram, and Doppler fluxometry. The material harvested was sent for histologic study. Each animal served as its own control. In all veins of both groups, there were no cases of infection, rupture, or pseudoaneurysm formation and thrombosis. In both groups, a chronic inflammatory reaction was observed, with lymphocytes, neutrophils, and fibrosis in the outer surface of the patches. Fibrosis was seen in the inner surfaces of all the patches. In e-PTFE patches, invasion by fibroblasts occurred. The sugarcane biopolymer membrane can be used as a patch in femoral vein angioplasty on dogs. The sugarcane biopolymer membrane is easily synthesized with a low cost of production. This membrane has been used in many areas of experimental surgery as in the healing of skin wounds, in urinary reconstruction, in reconstruction of tympanic membrane, and as an arterial substitute, but there is no report of its use as a vein substitute. In order to evaluate the possibility of using the sugarcane biopolymer membrane in venous reconstructive surgery, this study analyzed its utilization in femoral vein patch angioplasty. Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  16. Superconducting tunnel-junction refrigerator

    NASA Astrophysics Data System (ADS)

    Melton, Robert G.; Paterson, James L.; Kaplan, S. B.

    1980-03-01

    The dc current through an S1-S2 tunnel junction, with Δ2 greater than Δ1, when biased with eV<Δ1+Δ2, will lower the energy in S1. This energy reduction will be shared by the phonons and electrons. This device is shown to be analogous to a thermoelectric refrigerator with an effective Peltier coefficient π*~Δ1e. Tunneling calculations yield the cooling power Pc, the electrical power Pe supplied by the bias supply, and the cooling efficiency η=PcPe. The maximum cooling power is obtained for eV=+/-(Δ2-Δ1) and t1=T1Tc1~0.9. Estimates are made of the temperature difference T2-T1 achievable in Al-Pb and Sn-Pb junctions with an Al2O3 tunneling barrier. The performance of this device is shown to yield a maximum cooling efficiency η~=Δ1(Δ2-Δ1) which can be compared with that available in an ideal Carnot refrigerator of η=T1(T2-T1). The development of a useful tunnel-junction refrigerator requires a tunneling barrier with an effective thermal conductance per unit area several orders of magnitude less than that provided by the Al2O3 barrier in the Al-Pb and Sn-Pb systems.

  17. National Wind Tunnel Complex (NWTC)

    NASA Technical Reports Server (NTRS)

    1996-01-01

    The National Wind Tunnel Complex (NWTC) Final Report summarizes the work carried out by a unique Government/Industry partnership during the period of June 1994 through May 1996. The objective of this partnership was to plan, design, build and activate 'world class' wind tunnel facilities for the development of future-generation commercial and military aircraft. The basis of this effort was a set of performance goals defined by the National Facilities Study (NFS) Task Group on Aeronautical Research and Development Facilities which established two critical measures of improved wind tunnel performance; namely, higher Reynolds number capability and greater productivity. Initial activities focused upon two high-performance tunnels (low-speed and transonic). This effort was later descoped to a single multipurpose tunnel. Beginning in June 1994, the NWTC Project Office defined specific performance requirements, planned site evaluation activities, performed a series of technical/cost trade studies, and completed preliminary engineering to support a proposed conceptual design. Due to budget uncertainties within the Federal government, the NWTC project office was directed to conduct an orderly closure following the Systems Design Review in March 1996. This report provides a top-level status of the project at that time. Additional details of all work performed have been archived and are available for future reference.