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Sample records for head osteonecrosis model

  1. 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

  2. A Canine Model of Femoral Head Osteonecrosis Induced by an Ethanol Injection Navigated by a Novel Template

    PubMed Central

    Wang, Cairu; Wang, Junlin; Zhang, Yongquan; Yuan, Chaofan; Liu, Da; Pei, Yanjun; Li, Xiaokang; Wu, Zhigang; Li, Yong; Guo, Zheng

    2013-01-01

    There is no consensus on how to establish models of osteonecrosis of the femoral head (ONFH) in large mammals. The aim of this study was to investigate the effectiveness of a novel canine model of ONFH, induced by a navigated injection of absolute ethanol. Using three-dimensional reconstruction and rapid prototyping manufacturing techniques, a new template was designed and processed to navigate the ethanol injection. The femoral heads of 18 adult dogs were injected with ethanol. Macroscopic, X-ray and histological examinations were performed at 3, 6, and 9 weeks after the operation. Further, computed tomography (CT), magnetic resonance imaging (MRI), and radionuclide scans were performed 6 weeks postoperatively. Three weeks after the operation, the femoral heads showed evidence of osteonecrosis including increasing numbers of empty lacunae, decreased hematopoietic cells, and destroyed adipose tissue in the medullary cavity, which increased in severity at the subsequent follow-up evaluations at 6 and 9 weeks. Fractured trabeculae and fibrous tissue were noted 9 weeks postoperatively. Image analysis also revealed evidence of osteonecrosis, such as several osteopenic areas with sclerotic rims on the X-ray, several areas of low bone mineral density with sclerosis on the CT scan, increased uptake of the nuclide species in MRI, and an inhomogeneous long T2 signal on the radioisotopic images. Ethanol injection navigated by our novel template was successful in establishing a canine model of ONFH. This model can be used to test new treatment modalities for human ONFH. PMID:24046517

  3. Prediction of femoral head collapse in osteonecrosis.

    PubMed

    Volokh, K Y; Yoshida, H; Leali, A; Fetto, J F; Chao, E Y S

    2006-06-01

    The femoral head deteriorates in osteonecrosis. As a consequence of that, the cortical shell of the femoral head can buckle into the cancellous bone supporting it. In order to examine the buckling scenario we performed numerical analysis of a realistic femoral head model. The analysis included a solution of the hip contact problem, which provided the contact pressure distribution, and subsequent buckling simulation based on the given contact pressure. The contact problem was solved iteratively by approximating the cartilage by a discrete set of unilateral linear springs. The buckling calculations were based on a finite element mesh with brick elements for the cancellous bone and shell elements for the cortical shell. Results of 144 simulations for a variety of geometrical, material, and loading parameters strengthen the buckling scenario. They, particularly, show that the normal cancellous bone serves as a strong supporting foundation for the cortical shell and prevents it from buckling. However, under the development of osteonecrosis the deteriorating cancellous bone is unable to prevent the cortical shell from buckling and the critical pressure decreases with the decreasing Young modulus of the cancellous bone. The local buckling of the cortical shell seems to be the driving force of the progressive fracturing of the femoral head leading to its entire collapse. The buckling analysis provides an additional criterion of the femoral head collapse, the critical contact pressure. The buckling scenario also suggests a new argument in speculating on the femoral head reinforcement. If the entire collapse of the femoral head starts with the buckling of the cortical shell then it is reasonable to place the reinforcement as close to the cortical shell as possible.

  4. Experimental rat model for alcohol-induced osteonecrosis of the femoral head

    PubMed Central

    Okazaki, Shunichiro; Nagoya, Satoshi; Tateda, Kenji; Katada, Ryuichi; Mizuo, Keisuke; Watanabe, Satoshi; Yamashita, Toshihiko; Matsumoto, Hiroshi

    2013-01-01

    Alcohol-induced osteonecrosis of the femoral head (ONFH) is observed in alcohol abusers and patients with alcoholic fatty liver disease. It has been reported that Toll-like receptor 4 (TLR4) signalling plays a crucial role in the pathogenesis of alcoholic fatty liver disease. We previously reported a corticosteroid-induced ONFH rat model, and suggested that TLR4 signalling contributes to the pathogenesis of ONFH. Thus, it is thought that the pathogenesis of alcohol-induced ONFH is probably similar to that of corticosteroid-induced ONFH. The aim of this study was to develop a new animal model for alcohol-induced ONFH and to evaluate the relationship between the pro-inflammatory response via TLRs and the development of ONFH in rats. Male Wistar rats were fed a Lieber–DeCarli liquid diet containing 5% ethanol (experimental group) or dextran (control group) for 1–24 weeks. Histopathological and biochemical analyses were performed. Feeding the ethanol-containing liquid diet resulted in the development of ONFH with hepatic steatosis, hepatic dysfunction and hyperlipidaemia, whereas feeding the dextran-containing diet did not cause ONFH. However, we could not recognize any relationship between the pro-inflammatory response via TLR4 and the development of alcohol-induced ONFH. Thus in this study we have developed a new rat model for alcohol-induced ONFH based on the feeding of an ethanol liquid diet. ONFH was observed within seven days from the start of feeding with 5% ethanol-containing liquid diet. Although this was linked to hepatic steatosis, a TLR4 association was not a feature of this model. PMID:24020403

  5. A canine model of osteonecrosis of the femoral head induced by MRI guided argon helium cryotherapy system

    PubMed Central

    Wang, Dong; Sun, Lixin; Zhang, Huawu; Jiang, Honglei; Liu, Ming; Tian, Jing; Hu, Na; Sun, Shui

    2015-01-01

    Objective: This study is to identify the reliability of osteonecrosis of the femoral head (ONFH) modeling established by MRI guided argon helium cryotherapy system in beagles. Methods: A total of 15 beagles were used to establish the ONFH model. The left femoral heads of the beagles received two cycles of argon helium freezing-thawing under MRI guidance and were considered as experimental group while the right femoral heads received only one cycle of argon helium freezing-thawing and were considered as the control group. X-ray, MRI, general shape and histological examinations were performed so as to identify the effect of modeling. Results: At 4 week after modeling, MRI showed obvious bilateral hip joint effusion and marked femoral head bone marrow high signal. At 8 week after surgery, abnormal signal appeared in bilateral femoral heads. T1WI showed irregular patchy low signal, T2WI showed irregular mixed signals and the joint capsule effusion showed long T1 and T2 changes. Twelve weeks after operation, T1WI showed a low signal strip with clear boundary and T2WI showed intermediate signal. The changes of the left femoral heads were significant while compared with those of the right sides. The lacunae rates of femoral heads in the experimental group at 4, 8, and 12 week after surgery (40.75 ± 3.77, 57.46 ± 4.01, 50.27 ± 2.98) were higher than those in control group (30.08 ± 3.61, 49.43 ± 2.82, 40.56 ± 2.73). Conclusion: Canine model of ONFH was successfully established using an argon helium cryotherapy system. PMID:26550205

  6. 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

  7. Current concepts on osteonecrosis of the femoral head

    PubMed Central

    Moya-Angeler, Joaquin; Gianakos, Arianna L; Villa, Jordan C; Ni, Amelia; Lane, Joseph M

    2015-01-01

    It is estimated that 20000 to 30000 new patients are diagnosed with osteonecrosis annually accounting for approximately 10% of the 250000 total hip arthroplasties done annually in the United States. The lack of level 1 evidence in the literature makes it difficult to identify optimal treatment protocols to manage patients with pre-collapse avascular necrosis of the femoral head, and early intervention prior to collapse is critical to successful outcomes in joint preserving procedures. There have been a variety of traumatic and atraumatic factors that have been identified as risk factors for osteonecrosis, but the etiology and pathogenesis still remains unclear. Current osteonecrosis diagnosis is dependent upon plain anteroposterior and frog-leg lateral radiographs of the hip, followed by magnetic resonance imaging (MRI). Generally, the first radiographic changes seen by radiograph will be cystic and sclerotic changes in the femoral head. Although the diagnosis may be made by radiograph, plain radiographs are generally insufficient for early diagnosis, therefore MRI is considered the most accurate benchmark. Treatment options include pharmacologic agents such as bisphosphonates and statins, biophysical treatments, as well as joint-preserving and joint-replacing surgeries. the surgical treatment of osteonecrosis of the femoral head can be divided into two major branches: femoral head sparing procedures (FHSP) and femoral head replacement procedures (FHRP). In general, FHSP are indicated at pre-collapse stages with minimal symptoms whereas FHRP are preferred at post-collapse symptomatic stages. It is difficult to know whether any treatment modality changes the natural history of core decompression since the true natural history of core decompression has not been delineated. PMID:26396935

  8. Hip replacement in femoral head osteonecrosis: current concepts

    PubMed Central

    Scaglione, Michelangelo; Fabbri, Luca; Celli, Fabio; Casella, Francesco; Guido, Giulio

    2015-01-01

    Summary Osteonecrosis of the femoral head is a destructive disease that usually affects young adults with high functional demands and can have devastating effects on hip joint. The treatment depends on extent and location of the necrosis lesion and on patient’s factors, that suggest disease progression, collapse probability and also implants survival. Non-idiopathic osteonecrosis patients had the worst outcome. There is not a gold standard treatment and frequently it is necessary a multidisciplinary approach. Preservation procedures of the femoral head are the first choice and can be attempted in younger patients without head collapse. Replacement procedure remains the main treatment after failure of preserving procedures and in the late-stage ONFH, involving collapse of the femoral head and degenerative changes to the acetabulum. Resurfacing procedure still has good results but the patient selection is a critical factor. Total hip arthroplasties had historically poor results in patients with osteonecrosis. More recently, reports have shown excellent results, but implant longevity and following revisions are still outstanding problems. PMID:27134633

  9. Pentosan reduces osteonecrosis of femoral head in SHRSP.

    PubMed

    Miyata, Noriaki; Kumagai, Kenji; Osaki, Makoto; Murata, Masakazu; Tomita, Masato; Hozumi, Akira; Nozaki, Yoshihiro; Niwa, Masami

    2010-01-01

    Increased oxidative stress is considered one of the main causes of steroid-induced osteonecrosis of the femoral head (ONFH). The aim of this study was to evaluate the effects of a steroid hormone and pentosan polysulfate sodium (pentosan), a heparin analog, in stroke-prone spontaneously hypertensive rats (SHRSP) as a model of ONFH. One hundred twenty-three 13-week-old male SHRSP/Izm rats were divided into four groups: a control group (group C), pentosan-administered group (group P), steroid-administered group (group S), and group administered pentosan plus steroid (group PS). Methylprednisolone acetate, as the steroid hormone, at a dose of 4 mg (15 mg/kg) was administered at 15 weeks of age. Pentosan at a dose of 3 mg/day/kg was continuously administered intraperitoneally from 13 weeks of age for 4 weeks. Rats were sacrificed at 17 weeks of age, and heart blood and both femora were collected. Triglyceride levels were significantly lower in group PS than in group S, indicating that pentosan improves lipid metabolism. The incidence of histologic ONFH was significantly lower in group P, at 14.8% (10/71 femoral heads), than in group C, at 30.4% (17/56 femoral heads), and significantly lower in group PS, at 40.8% (29/71 femoral heads), than in group S, at 91.3% (42/46 femoral heads), indicating that pentosan markedly inhibits ONFH. Immunohistochemical staining for oxidative stress showed that the stainability was significantly lower in group PS than in group S. Pentosan seems to reduce the incidence of ONFH in SHRSP by improving lipid metabolism and decreasing oxidative stress.

  10. Osteonecrosis

    MedlinePlus

    ... factors include Long-term steroid treatment Alcohol abuse Joint injuries Having certain diseases, including arthritis and cancer Doctors use imaging tests and other tests to diagnose osteonecrosis. Treatments include ... electrical stimulation and surgery. NIH: National Institute of ...

  11. Treatment of osteonecrosis of the femoral head: everything's new.

    PubMed

    Hungerford, David S

    2007-06-01

    Since the 1970s, the mantra of those treating osteonecrosis of the femoral head was to save the head at all costs. Total hip arthroplasty (THA), the only effective surgical treatment once the head has mechanically and clinically failed, had a poor track record for young active patients. Recently, THA using highly cross-linked polyethylene, metal-on-metal bearing surfaces, or ceramic-on-ceramic bearing surfaces have given promising results, changing the "save-at-all-costs" paradigm. Operations that have a low success rate, high complication rate or morbidity, or compromise subsequent THA can no longer be justified. This includes femoral osteotomy and free vascularized fibular graft. Core decompression is justified, when indicated, because of its low morbidity and absence of complications with subsequent THA.

  12. Early Steroid-Induced Osteonecrosis of Rabbit Femoral Head and Panax notoginseng Saponins: Mechanism and Protective Effects

    PubMed Central

    Qiang, Hui; Liu, Huitong; Ling, Ming; Wang, Kunzheng; Zhang, Chen

    2015-01-01

    Background. This study was aimed at investigating the pathogenesis of oxidative stress in steroid-induced avascular necrosis of the femoral head (SANFH) and at exploring the mechanism and protective effects of Panax notoginseng saponins (PNS) on early SANFH. Methods. 80 adult New Zealand rabbits were randomly divided into control group, model group, and PNS group. In model group, equine serum was injected into auricular vein; then methylprednisolone was injected into gluteus. In PNS group, PNS was applied for 14 consecutive days before methylprednisolone management. At different time points, serum and femoral heads were prepared for T-AOC, SOD, GSH-PX, ·OH, and MDA determination. Two weeks after steroid management, all femoral heads were assessed with MRI and HE staining. Results. Typical early osteonecrosis symptoms were observed in model group. Our results showed that PNS could significantly ameliorate the decrease of T-AOC level, improve SOD and GSH-PX activity, suppress ·OH ability, and augment MDA level. Besides, PNS improved MRI and pathological changes of the femoral head, markedly reducing the incidence of osteonecrosis. Conclusion. Based on our research, we found oxidative stress played a positive role in the occurrence of SANFH where reactive oxygen species was the direct cause. PNS could protect rabbits against early steroid-induced osteonecrosis of femoral head by its antioxidative effect. PMID:25866538

  13. Porous tantalum rods for treating osteonecrosis of the femoral head.

    PubMed

    Liu, Z H; Guo, W S; Li, Z R; Cheng, L M; Zhang, Q D; Yue, D B; Shi, Z C; Wang, B L; Sun, W; Zhang, N F

    2014-10-20

    This study evaluated the outcomes of using porous tantalum rods for the treatment of osteonecrosis of the femoral head (ONFH). We performed core decompression and inserted porous tantalum implants in 149 patients (168 consecutive hips) with ONFH. Hips had large (65), medium (64), or small (39) lesions; 63 lesions were lateral, 68 were central, and 35 were medial. Conversion to total hip arthroplasty (THA) was the end point of this survey. A total of 130 cases (138 hips) were followed. The mean follow-up time was 38.46 ± 5.76 months; 43 hips (31%) were converted to or needed THA. Of the 43 hips requiring THA, 33 had large lesions, including 1 medial, 3 central, and 29 lateral lesions; 9 had medium, lateral lesions, and 1 hip had a small, lateral lesion. Bone grafting was used in 59 hips, with 3 hips failing; 40 of 79 hips without bone grafts failed. The sum distances between the tops of the rods and the lateral lesion boundaries (SDTL, mm) were measured in anteroposterior and lateral radiographs. In the failure and spared groups, the average SDTLs were 7.65 ± 2.759 and 0.83 ± 2.286 mm, respectively. The survival of porous tantalum rods used for treating early-stage ONFH was affected by the size and location of the lesion, whether or not a bone graft was used, as well as the distance between top of the rod and the lateral boundary of the lesion.

  14. Susceptibility of Males, but Not Females to Developing Femoral Head Osteonecrosis in Response to Alcohol Consumption

    PubMed Central

    Shimizu, Junya; Nagoya, Satoshi; Takahashi, Nobuyuki; Kanaya, Kumiko; Mizuo, Keisuke; Hyodoh, Hideki; Watanabe, Satoshi; Yamashita, Toshihiko

    2016-01-01

    Background We previously reported that ethanol-containing liquid diet feeding induces osteonecrosis of the femoral head in male rats. Also, it was reported that a large amount of consumed ethanol and a long-term history of drinking were risk factors for osteonecrosis of the femoral head, and that the frequency of alcohol-induced osteonecrosis of the femoral head in males was much greater than in females. The higher incidence of alcohol-induced osteonecrosis of the femoral head could be due to either higher prevalence of alcohol drinking in males or due to their potential higher sensitivity to alcohol. The aim of the study is to investigate the influence of alcohol consumption and drinking period on the development of osteonecrosis of the femoral head in rats of both sex. Methods All the experimental male rats were allocated to the male one-month ethanol drinking group (M1). Female rats were randomly divided into the female one- to five-months ethanol drinking groups (F1-5). All rats were fed a Lieber-DeCarli liquid diet containing 5% ethanol for one to five months. Results One-month feeding with the ethanol-containing liquid diet resulted in the development of osteonecrosis of the femoral head in seven of twenty in the M1 group, but none in the F1 group, although the mean intake of ethanol per body weight in the M1 group was significantly lower than that in the F1 group. Furthermore, long drinking periods with a large amount of ethanol intake in the F2-5 groups did not induce osteonecrosis of the femoral head. Conclusion The present study shows that lower alcohol consumption over short periods of time that were sufficient to induce osteonecrosis of the femoral head in males had no effect on females. Even with greater alcohol consumption and longer duration, females did not develop osteonecrosis of the femoral head. Therefore, unknown factors related to sex must be responsible for the development of this condition. PMID:27788269

  15. Management of osteonecrosis of the femoral head: A novel technique

    PubMed Central

    Samy, Ahmed M

    2016-01-01

    Background: Osteonecrosis of the femoral head (ONFH) is a debilitating disease in orthopedics, frequently progressing to femoral head collapse and osteoarthritis. It is thought to be a multifactorial disease. ONFH ultimately results in femoral head collapse in 75–85% of untreated patients. Total hip arthroplasty (THA) yields satisfactory results in the treatment of the end stage of the disease. However, disease typically affects males between the ages of 20 and 40 years and joint replacement is not the ideal option for younger patients. Recently, mesenchymal stem cells and platelet rich plasma (PRP) have been used as an adjunct to core decompression to improve clinical success in the treatment of precollapse hips. Materials and Methods: A prospective study of 40 hips in 30 patients was done. There were 19 males and 11 females with a mean age 36.7 ± 6.93 years. The indication for the operation was restricted primarily to modified Ficat stages IIb and III. 16 hips (40%) had stage IIb and 24 hips (60%) had stage III ONFH. The period of follow up ranged between 36–50 months with a mean 41.4 ± 3.53 months. All patients were assessed clinically during pre- and post-operative period according to the Harris Hip Score (HHS), Visual Analog Score (VAS) and radiologically by X-rays. Magnetic resonance imaging (MRI) was done preoperatively to confirm the diagnosis and every 6 months postoperatively for assessment of healing. The operative procedure include removal of necrotic area with drilling then the cavity was filled with a composite of bone graft mixed with PRP. Results: The mean HHS improved from 46.0 ± 7.8 preoperatively to 90.28 ± 19 at the end of followup (P < 0.0001). The mean values of VAS were 78 ± 21 and 35 ± 19 at preoperatively period and final followup, respectively, with an average reduction of 43 points. Conclusion: We found that the use of PRP with collagen sheet can increase the reparable capacity after drilling of necrotic segment in stage IIb and

  16. Outcome of uncemented primary femoral stems for treatment of femoral head osteonecrosis.

    PubMed

    Hungerford, Marc W; Hungerford, David S; Jones, Lynne C

    2009-04-01

    Cementless total hip replacement has been advocated for patients with osteonecrosis of the femoral head. This study examined the outcome of the femoral stem of four generations of an uncemented, proximally porous-coated, chrome-cobalt total hip prosthesis. There were 158 cases in 141 osteonecrosis patients (74 men, 67 women) who had a mean age of 46 years (range, 17-83 years). The mean follow-up was 103 months (range, 20-235 months). The femoral components of 144 cases were not revised and had a mean Harris hip score of 84 (+/-15) at final follow-up. Of the 14 revisions (8.9%), the primary reasons for revision were loosening or significant osteolysis. There were one infection and one chronic dislocation. Proximally porous-coated, anatomic, press-fit stems provide excellent long-term results in patients with osteonecrosis of the femoral head.

  17. Asparaginase Potentiates Glucocorticoid-Induced Osteonecrosis in a Mouse Model.

    PubMed

    Liu, Chengcheng; Janke, Laura J; Kawedia, Jitesh D; Ramsey, Laura B; Cai, Xiangjun; Mattano, Leonard A; Boyd, Kelli L; Funk, Amy J; Relling, Mary V

    2016-01-01

    Osteonecrosis is a common dose-limiting toxicity of glucocorticoids. Data from clinical trials suggest that other medications can increase the risk of glucocorticoid-induced osteonecrosis. Here we utilized a mouse model to study the effect of asparaginase treatment on dexamethasone-induced osteonecrosis. Mice receiving asparaginase along with dexamethasone had a higher rate of osteonecrosis than those receiving only dexamethasone after 6 weeks of treatment (44% vs. 10%, P = 0.006). Similarly, epiphyseal arteriopathy, which we have shown to be an initiating event for osteonecrosis, was observed in 58% of mice receiving asparaginase and dexamethasone compared to 17% of mice receiving dexamethasone only (P = 0.007). As in the clinic, greater exposure to asparaginase was associated with greater plasma exposure to dexamethasone (P = 0.0001). This model also recapitulated other clinical risk factors for osteonecrosis, including age at start of treatment, and association with the systemic exposure to dexamethasone (P = 0.027) and asparaginase (P = 0.036). We conclude that asparaginase can potentiate the osteonecrotic effect of glucocorticoids. PMID:26967741

  18. Asparaginase Potentiates Glucocorticoid-Induced Osteonecrosis in a Mouse Model

    PubMed Central

    Liu, Chengcheng; Janke, Laura J.; Kawedia, Jitesh D.; Ramsey, Laura B.; Cai, Xiangjun; Mattano, Leonard A.; Boyd, Kelli L.; Funk, Amy J.; Relling, Mary V.

    2016-01-01

    Osteonecrosis is a common dose-limiting toxicity of glucocorticoids. Data from clinical trials suggest that other medications can increase the risk of glucocorticoid-induced osteonecrosis. Here we utilized a mouse model to study the effect of asparaginase treatment on dexamethasone-induced osteonecrosis. Mice receiving asparaginase along with dexamethasone had a higher rate of osteonecrosis than those receiving only dexamethasone after 6 weeks of treatment (44% vs. 10%, P = 0.006). Similarly, epiphyseal arteriopathy, which we have shown to be an initiating event for osteonecrosis, was observed in 58% of mice receiving asparaginase and dexamethasone compared to 17% of mice receiving dexamethasone only (P = 0.007). As in the clinic, greater exposure to asparaginase was associated with greater plasma exposure to dexamethasone (P = 0.0001). This model also recapitulated other clinical risk factors for osteonecrosis, including age at start of treatment, and association with the systemic exposure to dexamethasone (P = 0.027) and asparaginase (P = 0.036). We conclude that asparaginase can potentiate the osteonecrotic effect of glucocorticoids. PMID:26967741

  19. Gain-of-function mutation in TRPV4 identified in patients with osteonecrosis of the femoral head

    PubMed Central

    Mah, Wayne; Sonkusare, Swapnil K; Wang, Tracy; Azeddine, Bouziane; Pupavac, Mihaela; Carrot-Zhang, Jian; Hong, Kwangseok; Majewski, Jacek; Harvey, Edward J; Russell, Laura; Chalk, Colin; Rosenblatt, David S; Nelson, Mark T; Séguin, Chantal

    2016-01-01

    Background Osteonecrosis of the femoral head is a debilitating disease that involves impaired blood supply to the femoral head and leads to femoral head collapse. Methods We use whole-exome sequencing and Sanger sequencing to analyse a family with inherited osteonecrosis of the femoral head and fluorescent Ca2+ imaging to functionally characterise the variant protein. Results We report a family with four siblings affected with inherited osteonecrosis of the femoral head and the identification of a c.2480_2483delCCCG frameshift deletion followed by a c.2486T>A substitution in one allele of the transient receptor potential vanilloid 4 (TRPV4) gene. TRPV4 encodes a Ca2+-permeable cation channel known to play a role in vasoregulation and osteoclast differentiation. While pathogenic TRPV4 mutations affect the skeletal or nervous systems, association with osteonecrosis of the femoral head is novel. Functional measurements of Ca2+ influx through mutant TRPV4 channels in HEK293 cells and patient-derived dermal fibroblasts identified a TRPV4 gain of function. Analysis of channel open times, determined indirectly from measurement of TRPV4 activity within a cluster of TRPV4 channels, revealed that the TRPV4 gain of function was caused by longer channel openings. Conclusions These findings identify a novel TRPV4 mutation implicating TRPV4 and altered calcium homeostasis in the pathogenesis of osteonecrosis while reinforcing the importance of TRPV4 in bone diseases and vascular endothelium. PMID:27330106

  20. [Avascular osteonecrosis of femoral head and neck in an AIDS patient].

    PubMed

    Villafañe, Maria F; Corti, Marcelo E; Candela, Miguel; Perez Bianco, Raul; Tezanos Pinto, Miguel

    2004-01-01

    Avascular osteonecrosis (AON) has increased in the last few years in patients infected with the human immunodeficiency virus type-1 (HIV-1). The most commonly affected bone is the femoral head and neck. Frequently these bilateral and clinical findings include moderate to severe pain and functional impotence of the affected joints. The etiology is multifactorial and highly active antiretroviral therapy (HAART) with protease inhibitors (PI) is probably related to its development. In the evolution, a total hip replacement may be needed. We present an hemophilic patient with AIDS, who developed a bilateral AON of the femoral head and neck during HAART.

  1. Bilateral Osteonecrosis of the Femoral Head During Pregnancy Following Two Corticosteroid Injections: A Case Report and Review of the Literature

    PubMed Central

    Wood, Thomas J; Winemaker, Mitchell; Adili, Anthony

    2016-01-01

    Osteonecrosis of the femoral head during pregnancy, or shortly thereafter, is a rare clinical problem. Little is known about pregnancy as an etiological factor for femoral head osteonecrosis with only 40 reported cases in the literature. Furthermore, single or dual dose steroid-induced multifocal osteonecrosis is a controversial topic with only a handful of published cases. We present a case of a 34-year-old female with bilateral femoral head osteonecrosis that developed during the peripartum period. She received two large intramuscular injections of steroids for fetal lung maturity because early delivery was required as a result of eclampsia. She underwent total arthroplasty of the left hip due to unremitting pain and functional disability, which achieved good clinical results--relieving her pain and improving her range of motion. Literature is scarce with regard to single or dual dose steroid-induced osteonecrosis of the hip as well as pregnancy as a general etiologic factor. This case highlights the need for high clinical suspicion of osteonecrosis as a cause of postpartum hip pain.  PMID:27182470

  2. Bilateral Osteonecrosis of the Femoral Head During Pregnancy Following Two Corticosteroid Injections: A Case Report and Review of the Literature.

    PubMed

    Wood, Thomas J; Hoppe, Daniel J; Winemaker, Mitchell; Adili, Anthony

    2016-04-03

    Osteonecrosis of the femoral head during pregnancy, or shortly thereafter, is a rare clinical problem. Little is known about pregnancy as an etiological factor for femoral head osteonecrosis with only 40 reported cases in the literature. Furthermore, single or dual dose steroid-induced multifocal osteonecrosis is a controversial topic with only a handful of published cases. We present a case of a 34-year-old female with bilateral femoral head osteonecrosis that developed during the peripartum period. She received two large intramuscular injections of steroids for fetal lung maturity because early delivery was required as a result of eclampsia. She underwent total arthroplasty of the left hip due to unremitting pain and functional disability, which achieved good clinical results--relieving her pain and improving her range of motion. Literature is scarce with regard to single or dual dose steroid-induced osteonecrosis of the hip as well as pregnancy as a general etiologic factor. This case highlights the need for high clinical suspicion of osteonecrosis as a cause of postpartum hip pain.

  3. Porous Tantalum Implant in Treating Osteonecrosis of the Femoral Head: Still a Viable Option?

    PubMed Central

    Ma, Jinhui; Sun, Wei; Gao, Fuqiang; Guo, Wanshou; Wang, Yunting; Li, Zirong

    2016-01-01

    The purpose of this study is to evaluate the survivorship and risk factors for radiographic progression and conversion to total hip arthroplasty (THA) after porous tantalum implant surgery in the treatment of osteonecrosis of the femoral head (ONFH). The study comprised 90 ONFH patients (104 consecutive hips) who were treated with a porous tantalum implant combined with bone grafting between June 2008 and December 2013. The patients were 19–61 years of age (mean age, 38 years). The mean follow-up was 42 months. The outcome measures included Harris hip score (HHS), radiographic outcome measures, and survivorship analysis with conversion to THA as the endpoint. The mean postoperative HHS was significantly lower than the mean preoperative HHS (P < 0.001). The Cox proportional hazards model showed that age and Association Research Circulation Osseous (ARCO) stage were independent risk factors for conversion to THA, while age, China-Japan Friendship Hospital (CJFH) type, and ARCO stage were independent risk factors for radiological progression. Ultimately, only 52.9% hips survived. Porous tantalum implant surgery combined with bone grafting is not a viable option for treating ONFH, especially in patients >35 years of age with preoperative ARCO stage III and CJFH type L3. PMID:27324659

  4. Porous Tantalum Implant in Treating Osteonecrosis of the Femoral Head: Still a Viable Option?

    PubMed

    Ma, Jinhui; Sun, Wei; Gao, Fuqiang; Guo, Wanshou; Wang, Yunting; Li, Zirong

    2016-01-01

    The purpose of this study is to evaluate the survivorship and risk factors for radiographic progression and conversion to total hip arthroplasty (THA) after porous tantalum implant surgery in the treatment of osteonecrosis of the femoral head (ONFH). The study comprised 90 ONFH patients (104 consecutive hips) who were treated with a porous tantalum implant combined with bone grafting between June 2008 and December 2013. The patients were 19-61 years of age (mean age, 38 years). The mean follow-up was 42 months. The outcome measures included Harris hip score (HHS), radiographic outcome measures, and survivorship analysis with conversion to THA as the endpoint. The mean postoperative HHS was significantly lower than the mean preoperative HHS (P < 0.001). The Cox proportional hazards model showed that age and Association Research Circulation Osseous (ARCO) stage were independent risk factors for conversion to THA, while age, China-Japan Friendship Hospital (CJFH) type, and ARCO stage were independent risk factors for radiological progression. Ultimately, only 52.9% hips survived. Porous tantalum implant surgery combined with bone grafting is not a viable option for treating ONFH, especially in patients >35 years of age with preoperative ARCO stage III and CJFH type L3. PMID:27324659

  5. Bisphosphonate-modified gold nanoparticles: a useful vehicle to study the treatment of osteonecrosis of the femoral head

    NASA Astrophysics Data System (ADS)

    Fanord, Fedena; Fairbairn, Korie; Kim, Harry; Garces, Amanda; Bhethanabotla, Venkat; Gupta, Vinay K.

    2011-01-01

    Legg-Calvé-Perthes disease (LCPD) is a juvenile form of osteonecrosis of the femoral head that presents in children aged 2-14 years. To date, there is no effective medical therapy for treating LCPD largely due to an inability to modulate the repair process, including the predominance of bone resorption. This investigation aims to evaluate the feasibility of using gold nanoparticles (GNPs) that are surface modified with a bisphosphonate compound for the treatment of osteonecrosis at the cellular level. Studies have found osteoclast-mediated resorption to be a process that contributes significantly to the pathogenesis of femoral head deformities arising from Perthes disease. Our in vitro model was designed to elucidate the effect of alendronate-(a bisphosphonate) modified GNPs, on osteoclastogenesis and osteoclast function. RAW 264.7 macrophage cells were cultured with recombinant mouse receptor activator of NF-κB ligand (RANKL), which stimulates osteoclastogenesis, and were then treated with alendronate-modified GNPs for 24, 48, and 72 h. Cell proliferation, osteoclast function, and osteoclast morphology were evaluated by trypan blue dye exclusion assay, tartrate-resistant acid phosphatase (TRAP) staining, and transmission electron microscopy (TEM) imaging. Comparative studies were performed with GNPs that were only stabilized with citrate ions and with alendronate alone. Neither osteoclastogenesis nor osteoclast function were adversely affected by the presence of the citrate-GNP. Alendronate-modified GNPs had an enhanced effect on inducing osteoclast apoptosis and impairing osteoclast function when compared to unbound alendronate populations.

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

    PubMed Central

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

    2015-01-01

    Abstract 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. PMID:26632739

  7. Circulating exosome levels in the diagnosis of steroid-induced osteonecrosis of the femoral head

    PubMed Central

    Zhu, H-Y.; Gao, Y-C.; Wang, Y.

    2016-01-01

    Objectives Circulating exosomes represent novel biomarkers for multiple diseases. In this study, we investigated whether circulating exosome levels could be used as a diagnostic biomarker for steroid-induced osteonecrosis of the femoral head (ONFH). Methods We assessed the serum exosome level of 85 patients with steroid-induced ONFH and 115 healthy donors by Nanosight detection. We then assessed the diagnostic accuracy of serum exosomes by receiver operating characteristic curve analysis. Results The circulating exosome level of the ONFH group was significantly lower than that of control group. The area under the curve was 0.72, suggesting that the level of serum exosomes has moderate diagnostic accuracy for steroid-induced ONFH. Conclusion Circulating exosome levels are valuable in the diagnosis of steroid-induced ONFH. Cite this article: H-Y. Zhu, Y-C. Gao, Y. Wang, C-Q. Zhang. Circulating exosome levels in the diagnosis of steroid-induced osteonecrosis of the femoral head. Bone Joint Res 2016;5:276–279. DOI: 10.1302/2046-3758.56.BJR-2015-0014.R1. PMID:27357384

  8. Treatment of osteonecrosis of the femoral head with vascularized bone grafting.

    PubMed

    Millikan, Patrick D; Karas, Vasili; Wellman, Samuel S

    2015-09-01

    Osteonecrosis of the femoral head (ONFH) is a challenging diagnosis for the patient and treating surgeon. Though its cause is poorly understood, several methods of surgical treatment exist and are performed with variable success. Vascularized bone grafting is one such treatment that attempts to restore viable bone, structural support, and blood supply to the avascular portion of the femoral head. This review summarizes the various approaches to this technique that have been proposed and put into practice. The cost effectiveness of these procedures, both in time and resources, has been evaluated and found to be favorable. The use of revascularization procedures, along with the introduction of other potentiating factors, may signal an exciting future for this debilitating disease process.

  9. Imaging and histopathological aspects in aseptic osteonecrosis of the femoral head.

    PubMed

    Trăistaru, Magdalena Rodica; Kamal, Diana; Kamal, Kamal Constantin; Rogoveanu, Otilia Constantina; Popescu, Mihai; Bondari, Simona; Alexandru, Dragoş Ovidiu; Ionovici, Nina; Grecu, Dan Cristian

    2015-01-01

    Aseptic osteonecrosis causes various clinical manifestations, depending on its location, but has in common a histopathological and radiological substrate. Aseptic osteonecrosis of the femoral head is a condition whose pathogenesis remains unclear despite many theories developed so far, and the discovery of numerous risk factors. The objective of this study is to emphasize the role of imaging techniques and correlating histology and immunohistochemistry methods in order to more accurately stage the disease. This retrospective study was performed on a total of 103 patients with clinical and radiological suspicion of unilateral or bilateral osteonecrosis. For the diagnosis criteria, we used clinical information, pelvic X-ray images, magnetic resonance imaging (MRI) or computed tomography (CT). For the inclusion of patients in a disease stage, we used the Association Research Circulation Osseous (ARCO) classification system. For patients diagnosed at an advanced stage, who underwent hip arthroplasty, we harvested biological material necessary for the histopathological study. There were differences in the appearance and extent of the lesion on the histological samples compared to macroscopic examination and even those obtained through imaging means, particularly for patients in evolutionary stage III. Aspects such as the extension of the area of fibrosis, bone tissue remodeling, the density of the newly formed vascular network and degree of impairment of the cartilage, are determined more accurately using histology and immunohistochemistry techniques. Before classifying patients in a certain stage, after correlating clinical and imaging data, histopathological aspects have to be considered, particularly in patients in stages III and IV, in which total hip arthroplasty could be delayed.

  10. Conservative surgery for the treatment of osteonecrosis of the femoral head: current options

    PubMed Central

    Gasbarra, Elena; Perrone, Fabio Luigi; Baldi, Jacopo; Bilotta, Vincenzo; Moretti, Antimo; Tarantino, Umbertto

    2015-01-01

    Summary The prevention of femoral head collapse and the maintenance of hip function would represent a substantial achievement in the treatment of osteonecrosis of the femoral head; however it is difficult to identify appropriate treatment protocols to manage patients with pre-collapse avascular necrosis in order to obtain a successful outcome in joint preserving procedures. Conservative treatments, including pharmacological management and biophysical modalities, are not supported by any evidence and require further investigation. The appropriate therapeutic approach has not been identified. The choice of surgical procedures is based on patient clinical conditions and anatomopathological features; preservation of the femoral head by core decompression may be attempted in younger patients without head collapse. Biological factors, such as bone morphogenetic proteins and bone marrow stem cells, would improve the outcome of core decompression. Another surgical procedure proposed for the treatment of avascular necrosis consists of large vascularized cortical bone grafts, but its use is not yet common due to surgical technical issues. Use of other surgical technique, such as osteotomies, is controversial, since arthroplasty is considered as the first option in case of severe femoral head collapse without previous intervention. PMID:27134632

  11. Vitamin K2 Ameliorates Damage of Blood Vessels by Glucocorticoid: a Potential Mechanism for Its Protective Effects in Glucocorticoid-induced Osteonecrosis of the Femoral Head in a Rat Model

    PubMed Central

    Zhang, Yuelei; Yin, Junhui; Ding, Hao; Zhang, Changqing; Gao, You-Shui

    2016-01-01

    Glucocorticoid has been reported to decrease blood vessel number and harm the blood supply in the femoral head, which is recognized to be an important mechanism of glucocorticoid-induced osteonecrosis of the femoral head (ONFH). To prevent glucocorticoid-induced ONFH, medication that promotes both bone formation and angiogenesis would be ideal. Vitamin K2 has been revealed to play an important role in bone metabolism; however, few studies have focused on the effect of Vitamin K2 on new vascular formation. Thus, this study aimed to investigate whether Vitamin K2 promoted new blood vessel formation in the presence of glucocorticoids, both in vitro and in vivo. The effect of Vitamin K2 on viability, migration, in vitro tube formation, and VEGF, vWF, CD31, KDR, Flt and PDGFB in EAhy926 incubated with or without dexamethasone were elucidated. VEGF, TGF-β and BMP-2, angiogenesis-related proteins secreted by osteoblasts, were also detected in the osteoblast-like cell line of MG63. In addition, blood vessels of the femoral head in rats administered with or without methylprednisolone and Vitamin K2 were evaluated using angiography and CD31 staining. In vitro studies showed that Vitamin K2 significantly protected endothelial cells from dexamethasone-induced apoptosis, promoted endothelial cell migration and in vitro tube formation. Angiogenesis-related proteins both in EAhy926 and MG63 were also upregulated by Vitamin K2 when cotreated with dexamethasone. In vivo studies showed enhanced blood vessel volume and CD31-positive staining cells in rats cotreated with VK2 and methylprednisolone compared to rats treated with methylprednisolone only. Collectively, Vitamin K2 has the ability to promote angiogenesis in vitro and to ameliorate vessels of the femoral head in glucocorticoid-treated rats in vivo, indicating that Vitamin K2 is a promising drug that may be used to prevent steroid-induced ONFH. PMID:27313492

  12. Extracorporeal shockwave treatment of osteonecrosis of the femoral head in systemic lupus erythematosis.

    PubMed

    Lin, Po-Chun; Wang, Ching-Jen; Yang, Kuender D; Wang, Feng-Sheng; Ko, Jih-Yang; Huang, Chung-Cheng

    2006-09-01

    This article reported a case of systemic lupus erythematosis (SLE) with osteonecrosis of the femoral heads (ONFH-3) successfully treated with a novel extracorporeal shockwave treatment (ESWT). The follow-up at 3 years showed that both hips had no pain on activities for daily living. Magnetic resonance image (MRI) showed substantial reduction in bone marrow edema and no further collapse of the lesions. Radiographs and MRIs showed no change in the staging of the disease. ESWT provided beneficial effects for hips affected by ONFH in patients with SLE. This novel treatment modality resulted in significant pain relief and functional improvement of the hip and reduction in bone marrow edema in our patient. It appeared that ESWT might have the potential to curtail the progression of the disease and to delay the need for total hip arthroplasty in the very young patients contracted with SLE.

  13. Surgical management of osteonecrosis of the femoral head in patients with sickle cell disease

    PubMed Central

    Kamath, Atul F; McGraw, Michael H; Israelite, Craig L

    2015-01-01

    Sickle cell disease is a known risk factor for osteonecrosis of the hip. Necrosis within the femoral head may cause severe pain, functional limitations, and compromise quality of life in this patient population. Early stages of avascular necrosis of the hip may be managed surgically with core decompression with or without autologous bone grafting. Total hip arthroplasty is the mainstay of treatment of advanced stages of the disease in patients who have intractable pain and are medically fit to undergo the procedure. The management of hip pathology in sickle cell disease presents numerous medical and surgical challenges, and the careful perioperative management of patients is mandatory. Although there is an increased risk of medical and surgical complications in patients with sickle cell disease, total hip arthroplasty can provide substantial relief of pain and improvement of function in the appropriately selected patient. PMID:26601059

  14. [Is instillation of bone marrow stem cells at the time of core decompression useful for osteonecrosis of the femoral head?].

    PubMed

    Cabrolier, Jorge; Molina, Marcelo

    2016-03-24

    Osteonecrosis of the femoral head leads to degeneration of the head and finally to osteoarthritis of the hip. Decompression is the most widely used treatment, but its effectiveness is limited. It has been proposed instillation of stem cells in addition to decompression, would lead to better results. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified two systematic reviews including two randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded instillation of bone marrow stem cells at the time of core decompression probably slows progression to osteoarthritis of the hip in patients with osteonecrosis of the femoral head and might reduce the need of subsequent surgeries. It is unclear whether it has any effect on the functionality because the certainty of the evidence is very low.

  15. [Is instillation of bone marrow stem cells at the time of core decompression useful for osteonecrosis of the femoral head?].

    PubMed

    Cabrolier, Jorge; Molina, Marcelo

    2016-01-01

    Osteonecrosis of the femoral head leads to degeneration of the head and finally to osteoarthritis of the hip. Decompression is the most widely used treatment, but its effectiveness is limited. It has been proposed instillation of stem cells in addition to decompression, would lead to better results. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified two systematic reviews including two randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded instillation of bone marrow stem cells at the time of core decompression probably slows progression to osteoarthritis of the hip in patients with osteonecrosis of the femoral head and might reduce the need of subsequent surgeries. It is unclear whether it has any effect on the functionality because the certainty of the evidence is very low. PMID:27028230

  16. Failed vascularized fibular graft in treatment of osteonecrosis of the femoral head. A histopathological analysis

    PubMed Central

    MELONI, MARIA CHIARA; HOEDEMAEKER, W. RUSSALKA; FORNASIER, VICTOR

    2016-01-01

    Purpose vascularized fibular grafting has been used to treat osteonecrosis of the femoral head in younger patients. Although the results described in the literature are promising, the failure rate is still significant, especially in steroid users. This study was undertaken to learn more, on a histopathological level, about the mechanism of vascularized fibular graft failure. Methods fifteen femoral heads removed at conversion to total hip arthroplasty were analyzed. The case load comprised 10 men and 5 women. They ranged in age from 28 to 39 years and had a median age of 35 years. The interval between the vascularized fibular implant procedure and the conversion to total hip arthroplasty ranged from 22 months to 30 months; the median interval was 26 months. All the patients were steroid users. The heads were sectioned and axial and coronal sections were taken and stained using the WHO method (hematoxylin, phloxine, saffron and Alcian green). A quantitative and qualitative analysis of graft-host interaction at the head (zone 1), neck (zone 2) and epiphysis (zone 3) was performed. Results all the specimens showed recognizable collapse of the articular surface over the area of necrosis. Thirteen femoral heads showed the presence of an osteochondral flap attached only at the margins of the area of avascular necrosis, and 10 of these 13 femoral heads also showed loss of the articulating surface with an ulcer crater corresponding to the exposed area of avascular necrosis. Conclusions vascularized fibular graft failure seems to be related to a negative effect of creeping substitution: the revascularization becomes a negative force as it supports unbalanced bone resorption, which, as is well known, is enhanced by corticosteroids. Clinical relevance creeping substitution is an undermining force in the repair and revascularization of the necrotic area in the femoral head. PMID:27386444

  17. Experimental osteonecrosis: development of a model in rodents administered alendronate.

    PubMed

    Conte, Nicolau; Spolidorio, Luis Carlos; Andrade, Cleverton Roberto de; Esteves, Jônatas Caldeira; Marcantonio, Elcio

    2016-01-01

    The main objective of this study was to cause bisphosphonate-related osteonecrosis of the jaws to develop in a rodent model. Adult male Holtzman rats were assigned to one of two experimental groups to receive alendronate (AL; 1 mg/kg/week; n = 6) or saline solution (CTL; n = 6). After 60 days of drug therapy, all animals were subjected to first lower molar extraction, and 28 days later, animals were euthanized. All rats treated with alendronate developed osteonecrosis, presenting as ulcers and necrotic bone, associated with a significant infection process, especially at the inter-alveolar septum area and crestal regions. The degree of vascularization, the levels of C-telopeptide cross-linked collagen type I and bone-specific alkaline phosphatase, as well as the bone volume were significantly reduced in these animals. Furthermore, on radiographic analysis, animals treated with alendronate presented evident sclerosis of the lamina dura of the lower first molar alveolar socket associated with decreased radiographic density in this area. These findings indicate that the protocol developed in the present study opens new perspectives and could be a good starting model for future property design. PMID:27556684

  18. Preclinical Study of Cell Therapy for Osteonecrosis of the Femoral Head with Allogenic Peripheral Blood-Derived Mesenchymal Stem Cells

    PubMed Central

    Fu, Qiang; Tang, Ning-Ning; Zhang, Qian; Liu, Yi; Peng, Jia-Chen; Fang, Ning; Yu, Li-Mei; Liu, Jin-Wei

    2016-01-01

    Purpose To explore the value of transplanting peripheral blood-derived mesenchymal stem cells from allogenic rabbits (rPBMSCs) to treat osteonecrosis of the femoral head (ONFH). Materials and Methods rPBMSCs were separated/cultured from peripheral blood after granulocyte colony-stimulating factor mobilization. Afterwards, mobilized rPBMSCs from a second passage labeled with PKH26 were transplanted into rabbit ONFH models, which were established by liquid nitrogen freezing, to observe the effect of rPBMSCs on ONFH repair. Then, the mRNA expressions of BMP-2 and PPAR-γ in the femoral head were assessed by RT-PCR. Results After mobilization, the cultured rPBMSCs expressed mesenchymal markers of CD90, CD44, CD29, and CD105, but failed to express CD45, CD14, and CD34. The colony forming efficiency of mobilized rPBMSCs ranged from 2.8 to 10.8 per million peripheral mononuclear cells. After local transplantation, survival of the engrafted cells reached at least 8 weeks. Therein, BMP-2 was up-regulated, while PPAR-γ mRNA was down-regulated. Additionally, bone density and bone trabeculae tended to increase gradually. Conclusion We confirmed that local transplantation of rPBMSCs benefits ONFH treatment and that the beneficial effects are related to the up-regulation of BMP-2 expression and the down-regulation of PPAR-γ expression. PMID:27189298

  19. Efficacy of alendronate for preventing collapse of femoral head in adult patients with nontraumatic osteonecrosis.

    PubMed

    Hong, Yu-Cai; Luo, Ru-Bin; Lin, Tiao; Zhong, Hui-Ming; Shi, Jian-Bin

    2014-01-01

    The purpose of the current review was to determine the efficacy of alendronate for preventing collapse of femoral head in adult patients with nontraumatic avascular osteonecrosis of femoral head (ANFH). Five randomized controlled trials (RCTs) involving 305 hips were included in this review, of which 3 studies investigated alendronate versus control/placebo and the other 2 studies compared the combination of alendronate and extracorporeal shockwave therapy (ESWT) with ESWT alone. Our results suggested that even the patients with extensive necrosis encountered much less collapse in the alendronate group than control group. In these RCTs, their data also indicated a positive short- and middle-term efficacy of alendronate treatment in joint function improvement and hip pain diminishment. With the presence of the outlier study, only insignificant overall efficacy of alendronate could be observed with substantial heterogeneities. In addition, we did not find any additive benefits of alendronate in combination with ESWT for preventing collapse compared to ESWT alone. In conclusion, there is still lack of strong evidence for supporting application of alendronate in adult patients with nontraumatic ANFH, which justified that large scale, randomized, and double-blind studies should be developed to demonstrate the confirmed efficacies, detailed indication, and optimized strategy of alendronate treatment.

  20. Association of hip joint effusion volume with early osteonecrosis of the femoral head.

    PubMed

    Liu, Bingli; Yi, Hongli; Zhang, Zhigang; Li, Zirong; Yue, Debo; Sun, Wei

    2012-01-01

    This study aimed to examine the association between hip joint effusion volume and osteonecrosis of the femoral head (ONFH) using the Association Research Circulation Osseous (ARCO) classification. Patients (n = 403) who were diagnosed with ONFH were enrolled between February 2005 and December 2008. Only patients (n = 109) with complete clinical and imaging data and at early to mid ARCO stage (I - III) were eligible for further analysis, including 94 males and 15 females. All the included patients had hip joint radiographic examinations (anteroposterior and frog-leg views) and magnetic resonance imaging scans (axial and coronal views). Out of 109 patients included in this study, 185 hip joints were involved (unilateral disease in 33 patients and bilateral diseases in 76 patients). The patients had a mean age of 39 ± 11 years (range, 13-70). All the affected hip joints exhibited effusion, classified as grade 1 (n = 70, 37.8%), grade 2 (n = 62, 33.5%), and grade 3 (n = 53, 28.7%). The volume of joint effusion varied significantly among stage I, II, and III (X2 = 29.210, P < 0.05). The effusion volume did not differ significantly among stage IIA, IIB, and IIC (X2 = 0.103, P > 0.05), whereas it differed significantly among stage IIIA, IIIB, and IIIC (X2 =11.556, P < 0.05). The volume of hip joint effusion was associated with the ARCO stage, and increased over the staging.

  1. Use of concentrated bone marrow aspirate and platelet rich plasma during minimally invasive decompression of the femoral head in the treatment of osteonecrosis

    PubMed Central

    Martin, John R.; Houdek, Matthew T.; Sierra, Rafael J.

    2013-01-01

    The aim of this paper is to describe our surgical procedure for the treatment of osteonecrosis of the femoral head using a minimally invasive technique. We have limited the use of this procedure for patients with pre-collapse osteonecrosis of the femoral head (Ficat Stage I or II). To treat osteonecrosis of the femoral head at our institution we currently use a combination of outpatient, minimally invasive iliac crest bone marrow aspirations and blood draw combined with decompressions of the femoral head. Following the decompression of the femoral head, adult mesenchymal stem cells obtained from the iliac crest and platelet rich plasma are injected into the area of osteonecrosis. Patients are then discharged from the hospital using crutches to assist with ambulation. This novel technique was utilized on 77 hips. Sixteen hips (21%) progressed to further stages of osteonecrosis, ultimately requiring total hip replacement. Significant pain relief was reported in 86% of patients (n = 60), while the rest of patients reported little or no pain relief. There were no significant complications in any patient. We found that the use of a minimally invasive decompression augmented with concentrated bone marrow and platelet rich plasma resulted in significant pain relief and halted the progression of disease in a majority of patients. PMID:23771751

  2. THA Using an Anatomic Stem in Patients With Femoral Head Osteonecrosis

    PubMed Central

    Ha, Yong-Chan; Kim, Hee Joong; Kim, Shin-Yoon; Kim, Tae-Young

    2008-01-01

    Treating young patients with femoral head osteonecrosis (ON) remains challenging. Anatomic stems were introduced in the 1980s and 1990s to improve the proximal canal fit in an attempt to enhance long-term implant survival, an important aspect of treating young patients. We began using one design in 1993 and asked three questions to confirm whether the design criteria improved outcomes in patients with ON: (1) What is the long term survivorship of these implants?; (2) What is the amount and rate of wear?; and (3) What is the incidence of osteolysis? We retrospectively reviewed 56 patients (69 hips) who underwent THA for femoral head ON with a cementless anatomic stem proximally coated with hydroxyapatite. Four patients (four hips) were lost to followup and 16 patients (19 hips) died. In the remaining 36 patients (46 hips) the minimum followup was 10 years (mean, 11.2 years; range, 10–13 years). The mean age at operation was 48.6 years. The average Harris hip score at last followup was 87 points. Worst-case survivorship was 58.1% at 13 years and best-case was 93.3%. The average linear wear of the polyethylene liner was 2.02 mm and the average annual wear was 0.18 mm per year. Thirty-seven hips (80%) had femoral osteolysis and 14 (30%) had acetabular osteolysis. One patient who had extensive femoral osteolysis and stem loosening was revised at 11.2 years postoperatively. The high rates of polyethylene wear and osteolysis are of concern. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18327627

  3. Association of Complement Receptor 2 Gene Polymorphisms with Susceptibility to Osteonecrosis of the Femoral Head in Systemic Lupus Erythematosus

    PubMed Central

    Kim, Tae-Ho; Bae, Sang-Cheol; Lee, Sang-Han; Kim, Shin-Yoon

    2016-01-01

    Osteonecrosis of the femoral head (ONFH) is a complex and multifactorial disease that is influenced by a number of genetic factors in addition to environmental factors. Some autoimmune disorders, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and inflammatory bowel disease (IBD), are associated with the development of ONFH. Complement receptor type 2 (CR2) is membrane glycoprotein which binds C3 degradation products generated during complement activation. CR2 has many important functions in normal immunity and is assumed to play a role in the development of autoimmune disease. We investigated whether CR2 gene polymorphisms are associated with risk of ONFH in SLE patients. Eight polymorphisms in the CR2 gene were genotyped using TaqMan™ assays in 150 SLE patients and 50 ONFH in SLE patients (SLE_ONFH). The association analysis of genotyped SNPs and haplotypes was performed with ONFH. It was found that three SNPs, rs3813946 in 5′-UTR (untranslated region), rs311306 in intron 1, and rs17615 in exon 10 (nonsynonymous SNP; G/A, Ser639Asn) of the CR2 gene, were associated with an increased risk of ONFH under recessive model (P values; 0.004~0.016). Haplotypes were also associated with an increased risk (OR; 3.73~) of ONFH in SLE patients. These findings may provide evidences that CR2 contributes to human ONFH susceptibility in Korean SLE patients. PMID:27446959

  4. VEGF, eNOS, and ABCB1 genetic polymorphisms may increase the risk of osteonecrosis of the femoral head.

    PubMed

    Zhou, Z C; Gu, S Z; Wu, J; Liang, Q W

    2015-01-01

    We investigated the associations between vascular endothelial growth factors (VEGF), endothelial nitric oxide synthase (eNOS), and ATP-binding cassette subfamily B member 1 transporter (ABCB1) polymorphisms and the risk of osteonecrosis of the femoral head (ONFH). Published studies were reviewed and analyzed based on predefined selection criteria. The strength of the association between VEGF, eNOS, and ABCB1 polymorphisms and ONFH risk was evaluated based on the odds ratio with corresponding 95%CIs. Meta-analysis was performed using the Comprehensive Meta-analysis 2.0 software. A total of 135 relevant articles were retrieved, of which 10 studies met the selection criteria, and included a total of 1025 patients with ONFH and 1730 healthy controls. The meta-analysis study results revealed that the VEGF rs2010963 G>C polymorphism increased the risk of ONFH, while the VEGF rs2010963 G>C and ABCB1 rs1045642 C>T polymorphisms increased the risk of ONFH under the allele model. In conclusion, the VEGF, eNOS, and ABCB1 polymorphisms may contribute to ONFH, but further studies including larger sample sizes are needed to confirm the results. PMID:26535684

  5. Association of Complement Receptor 2 Gene Polymorphisms with Susceptibility to Osteonecrosis of the Femoral Head in Systemic Lupus Erythematosus.

    PubMed

    Kim, Tae-Ho; Bae, Sang-Cheol; Lee, Sang-Han; Kim, Shin-Yoon; Baek, Seung-Hoon

    2016-01-01

    Osteonecrosis of the femoral head (ONFH) is a complex and multifactorial disease that is influenced by a number of genetic factors in addition to environmental factors. Some autoimmune disorders, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and inflammatory bowel disease (IBD), are associated with the development of ONFH. Complement receptor type 2 (CR2) is membrane glycoprotein which binds C3 degradation products generated during complement activation. CR2 has many important functions in normal immunity and is assumed to play a role in the development of autoimmune disease. We investigated whether CR2 gene polymorphisms are associated with risk of ONFH in SLE patients. Eight polymorphisms in the CR2 gene were genotyped using TaqMan™ assays in 150 SLE patients and 50 ONFH in SLE patients (SLE_ONFH). The association analysis of genotyped SNPs and haplotypes was performed with ONFH. It was found that three SNPs, rs3813946 in 5'-UTR (untranslated region), rs311306 in intron 1, and rs17615 in exon 10 (nonsynonymous SNP; G/A, Ser639Asn) of the CR2 gene, were associated with an increased risk of ONFH under recessive model (P values; 0.004~0.016). Haplotypes were also associated with an increased risk (OR; 3.73~) of ONFH in SLE patients. These findings may provide evidences that CR2 contributes to human ONFH susceptibility in Korean SLE patients. PMID:27446959

  6. The effect of deferoxamine on angiogenesis and bone repair in steroid-induced osteonecrosis of rabbit femoral heads

    PubMed Central

    Li, Jia; Fan, Lihong; Yu, Zefeng; Dang, Xiaoqian

    2015-01-01

    In this study, we examined whether local deferoxamine (DFO) administration can promote angiogenesis and bone repair in steroid-induced osteonecrosis of the femoral head (ONFH). Steroid-induced ONFH was induced in 65 mature male New Zealand white rabbits by methylprednisolone in combination with lipopolysaccharide. Six weeks later, the rabbits received no treatment (model group, N = 15), bilateral core decompression (CD group, N = 20) or CD in combination with local DFO administration (DFO group, N = 20). Six weeks after the surgery, vascularization in the femoral head was evaluated by ink artery infusion angiography and immunohistochemical staining for von Willebrand Factor (vWF). Bone repair was assessed by histologic analysis and micro-computed tomography (micro-CT). Immunohistochemical staining was performed to analyze the expression of vascular endothelial growth factor (VEGF), hypoxia-inducible factor-1α (HIF-1α), bone morphogenetic protein-2 (BMP-2), and osteocalcin (OCN). Ink artery infusion angiography and microvessel analysis by immuohistochemical staining for vWF showed more blood vessels in the DFO group than other groups. The expression of HIF-1α, VEGF, BMP-2, and OCN, indicated by immunohistochemical staining, was higher in the DFO group compared with other groups. Micro-CT scanning results indicated that the DFO group had larger volume of newly formed bone than the CD group. This work indicated that local DFO administration improved angiogenesis and bone repair of early stage ONFH in rabbit model, and it may offer an efficient, economic, and simple therapy for early stage ONFH. PMID:25294892

  7. Bilateral Idiopathic Osteonecrosis of the Femoral Head: A Case Report With an Emphasis on Differential Diagnosis, Imaging, and Treatment

    PubMed Central

    Battaglia, Patrick J.; Gliedt, Jordan; McDaniel, Courtney; Kettner, Norman

    2014-01-01

    Objective The purpose of this case report is to describe a patient with bilateral idiopathic osteonecrosis of the femoral head (ONFH), provide a discussion of differential diagnosis for anterior hip pain, imaging, and treatment recommendations for ONFH. Clinical features A 34-year-old man was initially treated by a chiropractic physician for low back pain. At the end of a three week trial of care, the patient’s low back pain resolved. However, he reported a new complaint of mild left anterior hip stiffness. After re-examination, a homecare exercise program was prescribed. The patient returned 1 month later with substantial left anterior hip pain and walked with a noticeable limp. Radiography of the left hip demonstrated advanced ONFH. Magnetic resonance imaging of both hips demonstrated the extent of involvement of the left hip while incidentally revealing ONFH on the right. Intervention and Outcome A total hip arthroplasty was performed on the left hip and the right hip is being monitored without intervention. Conclusion Osteonecrosis of the femoral head is a challenging clinical problem with non-specific and wide-ranging signs and symptoms requiring clinicians to engage a cautious and comprehensive differential diagnosis. Prompt recognition ensures that appropriate treatment can be initiated in a timely manner and optimal patient outcomes achieved. PMID:25225469

  8. Exosomes from Human Synovial-Derived Mesenchymal Stem Cells Prevent Glucocorticoid-Induced Osteonecrosis of the Femoral Head in the Rat

    PubMed Central

    Guo, Shang-Chun; Tao, Shi-Cong; Yin, Wen-Jing; Qi, Xin; Sheng, Jia-Gen; Zhang, Chang-Qing

    2016-01-01

    Osteonecrosis of the femoral head (ONFH) represents a debilitating complication following glucocorticoid (GC)-based therapy. Synovial-derived mesenchymal stem cells (SMSCs) can exert protective effect in the animal model of GC-induced ONFH by inducing cell proliferation and preventing cell apoptosis. Recent studies indicate the transplanted cells exert therapeutic effects primarily via a paracrine mechanism and exosomes are an important paracrine factor that can be directly used as therapeutic agents for tissue engineering. Herein, we provided the first demonstration that the early treatment of exosomes secreted by human synovial-derived mesenchymal stem cells (SMSC-Exos) could prevent GC-induced ONFH in the rat model. Using a series of in vitro functional assays, we found that SMSC-Exos could be internalized into bone marrow derived stromal cells (BMSCs) and enhance their proliferation and have anti-apoptotic abilities. Finally, SMSC-Exos may be promising for preventing GC-induced ONFH. PMID:27766040

  9. The efficacy of statins in preventing glucocorticoid-related osteonecrosis in animal models

    PubMed Central

    Yang, Z.; Liu, H.; Li, D.; Xie, X.; Qin, T.; Ma, J.

    2016-01-01

    Objectives The primary purpose of this meta-analysis was to determine whether statin usage could reduce the risk of glucocorticoid-related osteonecrosis in animal models. Methods A systematic literature search up to May 2015 was carried out using the PubMed, Ovid, EBM reviews, ISI Web of Science, EBSCO, CBM, CNKI databases with the term and boolean operators: statins and osteonecrosis in all fields. Risk ratio (RR), as the risk estimate of specific outcome, was calculated along with 95% confidence intervals (CI). The methodological quality of individual studies was assessed using a quantitative tool based on the updated Stroke Therapy Academic Industry Roundtable (STAIR) recommendations. Results A total of 11 eligible studies were included according to predetermined criteria. The pooled data demonstrated that animals with statin usage, either alone or combined with other treatments, were at a decreased risk of developing glucocorticoid-related osteonecrosis (RR = 2.06, 95% confidence interval (CI) 1.71 to 2.50). Moreover, subgroup analysis revealed that compared with statins alone, statins combined with other treatments significantly decreased the risk of osteonecrosis (RR = 1.23, 95% CI 1.02 to 1.47). However, we could find no significant risk difference for different gender, or for different time points. Conclusions The present study suggests that statins combined with other treatments are efficient in preventing the development of glucocorticoid-related osteonecrosis in animals. These results might shed light on clinical practice when glucocorticoids are prescribed, and could be further investigated in high-quality clinical trials. Cite this article: Z. Yang, H. Liu, D. Li, X. Xie, T. Qin, J. Ma, P. Kang. The efficacy of statins in preventing glucocorticoid-related osteonecrosis in animal models: A meta-analysis. Bone Joint Res 2016;5:393–402. DOI: 10.1302/2046-3758.59.2000500. PMID:27660333

  10. Occult fracture of the femoral neck associated with extensive osteonecrosis of the femoral head: A case report

    PubMed Central

    Fukui, Kiyokazu; Kaneuji, Ayumi; Matsumoto, Tadami

    2015-01-01

    Introduction Although the subchondral portion of the femoral head is a common site for collapse in osteonecrosis of the femoral head (ONFH), femoral-neck fracture rarely occurs during the course of ONFH. We report a case of occult insufficiency fracture of the femoral neck without conditions predisposing to insufficiency fractures, occurring in association with ONFH. Presentation of case We report a case of occult fracture of the femoral neck due to extensive ONFH in a 60-year-old man. No abnormal findings suggestive of ONFH were identified on radiographs, and the fracture occurred spontaneously without any trauma or unusual increase in activity. The patient’s medical history, age, and good bone quality suggested ONFH as a possible underlying cause. Contrast-enhanced magnetic resonance imaging was useful in determining whether the fracture was caused by ONFH or was instead a simple insufficiency fracture caused by steroid use. Discussion The patient was treated with bipolar hemiarthroplasty, but if we had not suspected ONFH as a predisposing condition, the undisplaced fracture might have been treated by osteosynthesis, and this would have led to nonunion or collapse of the femoral head. To avoid providing improper treatment, clinicians should consider ONFH as a predisposing factor in pathologic fractures of the femoral neck. Conclusion ONFH should be included in the differential diagnosis of insufficiency fracture of the femoral neck. PMID:26275737

  11. Minimum Ten-Year Follow-Up of Cemented Total Hip Replacement in Patients with Osteonecrosis of the Femoral Head

    PubMed Central

    Fyda, Thomas M; Callaghan, John J; Olejniczak, Jason; Johnston, Richard C

    2002-01-01

    Between November 1970 and September 1984 the senior author performed fifty-three consecutive total hip arthroplasties with cement in forty-one patients with the diagnosis of osteonecrosis of the femoral head. Five hips in three patients with failed renal transplants requiring chronic hemodialysis were excluded. At the time of final review, a minimum of ten years after the procedure, twenty-one patients (twenty-eight hips) were living, fifteen patients (eighteen hips) had died, and two patients (two hips) were lost to followup. A minimum ten-year follow-up radiograph was obtained on twenty-two (79%) of the hips in surviving patients. During the follow-up period 17.4% of hips (eight hips) required revision: 3.0% (six hips) for aseptic loosening, 2.2% (one hip) for sepsis, and 2.2% (one hip) for recurrent dislocation. All eight revisions occurred in patients living at time of final review, giving a revision prevalence of 22.9% (17.1% for aseptic loosening, 2.9% for sepsis, and 2.9% for recurrent dislocation) in patients surviving ten years. The prevalence of revision of the femoral component for aseptic loosening was 6.5% (three hips) for all hips and 9.1% (three hips) in patients surviving at least ten years. The prevalence of femoral aseptic loosening, defined as those components revised for aseptic loosening and those that demonstrated definite or probable radiographic loosening, was 13.0% (six hips) for all hips and 28.6% (six hips) for hips with at least ten-year radiographic follow-up. The prevalence of revision of the acetabular component for aseptic loosening was 13.0% (six hips) for all hips and 18.2% (six hips) in patients surviving at least ten years. The prevalence of acetabular aseptic loosening was 15.2% (seven hips) for all hips and 29.2% (seven hips) for hips with at least ten-year radiographic follow-up. In patients with osteonecrosis of the femoral head survivorship was significantly inferior to that in the senior author's overall patient population

  12. Relative volume measured with magnetic resonance imaging is an articular collapse predictor in hematological pediatric patients with femoral head osteonecrosis

    PubMed Central

    Ippolito, Davide; Masetto, Alessandro; Talei Franzesi, Cammillo; Bonaffini, Pietro A; Casiraghi, Alessandra; Sironi, Sandro

    2016-01-01

    AIM To assess the potential value of femoral head (FH) volume measurements to predict joint collapse, as compared to articular surface involvement, in post-treatment osteonecrosis (ON) in pediatric patients affected by lymphoproliferative diseases. METHODS Considering 114 young patients with lymphoproliferative diseases undergone a lower-limbs magnetic resonance imaging (MRI) examination between November 2006 and August 2012 for a suspected post-treatment ON, we finally considered a total of 13 cases (7 males, mean age 15.2 ± 4.8 years), which developed a FH ON lesions (n = 23). The MRI protocol included coronal short tau inversion recovery and T1-weighted sequences, from the hips to the ankles. During the follow-up (elapsed time: 9.2 ± 2 mo), 13/23 FH articular surface (FHS) developed articular deformity. The first MRI studies with diagnosis of ON were retrospectively analyzed, measuring FH volume (FHV), FHS, ON volume (ONV) and the articular surface involved by ON (ONS). The relative involvement of FHS, in terms of volume [relative volume (RV): ONV/FHV] and articular surface [relative surface (RS): ONS/FHS], was then calculated. RESULTS By using receiver operating characteristic curve analysis (threshold of 23% of volume involvement), RV predicted articular deformity in 13/13 FHS [sensitivity 100%, specificity 90%, accuracy 95%, positive predictive value (PPV) 93%, negative predictive value (NPV) 100%]. Considering a threshold of 50% of articular involvement, RS predicted articular deformity in 10/13 femoral heads (sensitivity 77%, specificity 100%, accuracy 87%, PPV 100%, NPV 77%). CONCLUSION RV might be a more reliable parameter than RS in predicting FH deformity and could represent a potential complementary diagnostic tool in the follow-up of femoral heads ON lesions. PMID:27648169

  13. Relative volume measured with magnetic resonance imaging is an articular collapse predictor in hematological pediatric patients with femoral head osteonecrosis

    PubMed Central

    Ippolito, Davide; Masetto, Alessandro; Talei Franzesi, Cammillo; Bonaffini, Pietro A; Casiraghi, Alessandra; Sironi, Sandro

    2016-01-01

    AIM To assess the potential value of femoral head (FH) volume measurements to predict joint collapse, as compared to articular surface involvement, in post-treatment osteonecrosis (ON) in pediatric patients affected by lymphoproliferative diseases. METHODS Considering 114 young patients with lymphoproliferative diseases undergone a lower-limbs magnetic resonance imaging (MRI) examination between November 2006 and August 2012 for a suspected post-treatment ON, we finally considered a total of 13 cases (7 males, mean age 15.2 ± 4.8 years), which developed a FH ON lesions (n = 23). The MRI protocol included coronal short tau inversion recovery and T1-weighted sequences, from the hips to the ankles. During the follow-up (elapsed time: 9.2 ± 2 mo), 13/23 FH articular surface (FHS) developed articular deformity. The first MRI studies with diagnosis of ON were retrospectively analyzed, measuring FH volume (FHV), FHS, ON volume (ONV) and the articular surface involved by ON (ONS). The relative involvement of FHS, in terms of volume [relative volume (RV): ONV/FHV] and articular surface [relative surface (RS): ONS/FHS], was then calculated. RESULTS By using receiver operating characteristic curve analysis (threshold of 23% of volume involvement), RV predicted articular deformity in 13/13 FHS [sensitivity 100%, specificity 90%, accuracy 95%, positive predictive value (PPV) 93%, negative predictive value (NPV) 100%]. Considering a threshold of 50% of articular involvement, RS predicted articular deformity in 10/13 femoral heads (sensitivity 77%, specificity 100%, accuracy 87%, PPV 100%, NPV 77%). CONCLUSION RV might be a more reliable parameter than RS in predicting FH deformity and could represent a potential complementary diagnostic tool in the follow-up of femoral heads ON lesions.

  14. Meta-analysis of Factor V Leiden G1691A polymorphism and osteonecrosis of femoral head susceptibility

    PubMed Central

    SHANG, XIFU; LUO, ZHENGLIANG; LI, XU; HU, FEI; ZHAO, QICHUN; ZHANG, WENZHI

    2013-01-01

    Testing for genetic risk associations between Factor V Leiden (FVL) and the osteonecrosis of femoral head (ONFH) is common, however, inconsistent results have been previously obtained. To summarize results on the association of FVL mutation polymorphism with ONFH in various populations and to calculate the overall genetic risk factors, we performed a search of electronic databases including PubMed, Elsevier Science Direct, Chinese National Knowledge Infrastructure and the Chinese Biomedical Database to identify published studies correlating the FVL mutation with ONFH. Statistical analysis was performed using Review Manager (RevMan) version 5.0 and Stata statistical software (version 10). We identified 57 titles and included 7 studies comprising 481 cases and 867 controls in this meta-analysis. The groups were pooled, and a significant association between FVL mutation and increased ONFH was found (OR=4.55, 95% CI, 2.75–7.52, P<0.00001). This meta-analysis demonstrated that FVL plays an important role in non-Asian populations. Large sample studies including different ethnic groups and age- and gender-matched groups, as well as multiple gene polymorphism detection should be considered to clarify the association of FVL mutation polymorphism and ONFH susceptibility in the future. PMID:24648992

  15. Meta-analysis of Factor V Leiden G1691A polymorphism and osteonecrosis of femoral head susceptibility.

    PubMed

    Shang, Xifu; Luo, Zhengliang; Li, Xu; Hu, Fei; Zhao, Qichun; Zhang, Wenzhi

    2013-07-01

    Testing for genetic risk associations between Factor V Leiden (FVL) and the osteonecrosis of femoral head (ONFH) is common, however, inconsistent results have been previously obtained. To summarize results on the association of FVL mutation polymorphism with ONFH in various populations and to calculate the overall genetic risk factors, we performed a search of electronic databases including PubMed, Elsevier Science Direct, Chinese National Knowledge Infrastructure and the Chinese Biomedical Database to identify published studies correlating the FVL mutation with ONFH. Statistical analysis was performed using Review Manager (RevMan) version 5.0 and Stata statistical software (version 10). We identified 57 titles and included 7 studies comprising 481 cases and 867 controls in this meta-analysis. The groups were pooled, and a significant association between FVL mutation and increased ONFH was found (OR=4.55, 95% CI, 2.75-7.52, P<0.00001). This meta-analysis demonstrated that FVL plays an important role in non-Asian populations. Large sample studies including different ethnic groups and age- and gender-matched groups, as well as multiple gene polymorphism detection should be considered to clarify the association of FVL mutation polymorphism and ONFH susceptibility in the future.

  16. Comprehensive Genome-Wide Transcriptomic Analysis of Immature Articular Cartilage following Ischemic Osteonecrosis of the Femoral Head in Piglets

    PubMed Central

    Adapala, Naga Suresh; Kim, Harry K. W.

    2016-01-01

    Objective Ischemic osteonecrosis of the femoral head (ONFH) in piglets results in an ischemic injury to the immature articular cartilage. The molecular changes in the articular cartilage in response to ONFH have not been investigated using a transcriptomic approach. The purpose of this study was to perform a genome-wide transcriptomic analysis to identify genes that are upregulated in the immature articular cartilage following ONFH. Methods ONFH was induced in the right femoral head of 6-week old piglets. The unoperated femoral head was used as the normal control. At 24 hours (acute ischemic-hypoxic injury), 2 weeks (avascular necrosis in the femoral head) and 4 weeks (early repair) after surgery (n = 4 piglets/time point), RNA was isolated from the articular cartilage of the femoral head. A microarray analysis was performed using Affymetrix Porcine GeneChip Array. An enrichment analysis and functional clustering of the genes upregulated due to ONFH were performed using DAVID and STRING software, respectively. The increased expression of selected genes was confirmed by a real-time qRTPCR analysis. Results Induction of ONFH resulted in the upregulation of 383 genes at 24 hours, 122 genes at 2 weeks and 124 genes at 4 weeks compared to the normal controls. At 24 hours, the genes involved in oxidoreductive, cell-survival, and angiogenic responses were significantly enriched among the upregulated genes. These genes were involved in HIF-1, PI3K-Akt, and MAPK signaling pathways. At 2 weeks, secretory and signaling proteins involved in angiogenic and inflammatory responses, PI3K-Akt and matrix-remodeling pathways were significantly enriched. At 4 weeks, genes that represent inflammatory cytokines and chemokine signaling pathways were significantly enriched. Several index genes (genes that are upregulated at more than one time point following ONFH and are known to be important in various biological processes) including HIF-1A, VEGFA, IL-6, IL6R, IL-8, CCL2, FGF2, TGFB2

  17. Radial Extracorporeal Shock Wave Therapy in a Person With Advanced Osteonecrosis of the Femoral Head

    PubMed Central

    Ma, Yue Wen; Jiang, Dong Lei; Zhang, Dai; Wang, Xiao Bei; Yu, Xiao Tong

    2016-01-01

    ABSTRACT This case report describes the first patient with avascular necrosis of the femoral head of Association Research Circulation Osseous stage IV, treated with radial extracorporeal shock wave therapy. By contrast, previous studies demonstrated the efficacy of a single treatment of focused extracorporeal shock wave therapy in improving pain and Harris Hip Scale in patients with avascular necrosis of the femoral head of Association Research Circulation Osseous stage I to III. The affected hip was treated with 6000 impulses of radial extracorporeal shock wave therapy at 10 Hz and an intensity ranging from 2.5 to 4.0 bar at 7-day intervals for 24 mos. The Harris Hip Scale values were 33, 43, 56, 77, 81, 88, and 92 at baseline and 1, 3, 6, 12, 18, and 24 mos, respectively. The radiographs showed that the subluxation of the right hip was slightly aggravated. Joint effusion was reduced, bone marrow edema disappeared, the density became more uniform, and the gluteal muscles were more developed based on magnetic resonance imaging. Increased tracer uptake was evident along the joint margin and superolateral aspect of the head both before and after radial extracorporeal shock wave therapy. This case report demonstrates the feasibility of long-term radial extracorporeal shock wave therapy in Association Research Circulation Osseous stage IV patients. PMID:27003206

  18. Radial Extracorporeal Shock Wave Therapy in a Person With Advanced Osteonecrosis of the Femoral Head.

    PubMed

    Ma, Yue Wen; Jiang, Dong Lei; Zhang, Dai; Wang, Xiao Bei; Yu, Xiao Tong

    2016-09-01

    This case report describes the first patient with avascular necrosis of the femoral head of Association Research Circulation Osseous stage IV, treated with radial extracorporeal shock wave therapy. By contrast, previous studies demonstrated the efficacy of a single treatment of focused extracorporeal shock wave therapy in improving pain and Harris Hip Scale in patients with avascular necrosis of the femoral head of Association Research Circulation Osseous stage I to III. The affected hip was treated with 6000 impulses of radial extracorporeal shock wave therapy at 10 Hz and an intensity ranging from 2.5 to 4.0 bar at 7-day intervals for 24 mos. The Harris Hip Scale values were 33, 43, 56, 77, 81, 88, and 92 at baseline and 1, 3, 6, 12, 18, and 24 mos, respectively. The radiographs showed that the subluxation of the right hip was slightly aggravated. Joint effusion was reduced, bone marrow edema disappeared, the density became more uniform, and the gluteal muscles were more developed based on magnetic resonance imaging. Increased tracer uptake was evident along the joint margin and superolateral aspect of the head both before and after radial extracorporeal shock wave therapy. This case report demonstrates the feasibility of long-term radial extracorporeal shock wave therapy in Association Research Circulation Osseous stage IV patients. PMID:27003206

  19. Radial Extracorporeal Shock Wave Therapy in a Person With Advanced Osteonecrosis of the Femoral Head.

    PubMed

    Ma, Yue Wen; Jiang, Dong Lei; Zhang, Dai; Wang, Xiao Bei; Yu, Xiao Tong

    2016-09-01

    This case report describes the first patient with avascular necrosis of the femoral head of Association Research Circulation Osseous stage IV, treated with radial extracorporeal shock wave therapy. By contrast, previous studies demonstrated the efficacy of a single treatment of focused extracorporeal shock wave therapy in improving pain and Harris Hip Scale in patients with avascular necrosis of the femoral head of Association Research Circulation Osseous stage I to III. The affected hip was treated with 6000 impulses of radial extracorporeal shock wave therapy at 10 Hz and an intensity ranging from 2.5 to 4.0 bar at 7-day intervals for 24 mos. The Harris Hip Scale values were 33, 43, 56, 77, 81, 88, and 92 at baseline and 1, 3, 6, 12, 18, and 24 mos, respectively. The radiographs showed that the subluxation of the right hip was slightly aggravated. Joint effusion was reduced, bone marrow edema disappeared, the density became more uniform, and the gluteal muscles were more developed based on magnetic resonance imaging. Increased tracer uptake was evident along the joint margin and superolateral aspect of the head both before and after radial extracorporeal shock wave therapy. This case report demonstrates the feasibility of long-term radial extracorporeal shock wave therapy in Association Research Circulation Osseous stage IV patients.

  20. OPG and RANKL polymorphisms are associated with alcohol-induced osteonecrosis of the femoral head in the north area of China population in men

    PubMed Central

    Li, Yizhou; Wang, Yuan; Guo, Yongchang; Wang, Quanjian; Ouyang, Yongri; Cao, Yuju; Jin, Tianbo; Wang, Jianzhong

    2016-01-01

    Abstract Alcohol-induced osteonecrosis of the femoral head (ONFH) is an important pathogenesis of nontraumatic ONFH. However, the mechanisms of the pathogenesis are still unknown. Osteoprotegerin (OPG) and receptor activator of nuclear factor-kappa B ligand (RANKL) have been implicated in multiple functions including blocking osteoclast maturation, controlling vascular calcifications, and promoting tumor growth and metastasis. The purpose of this article was to explore the association between OPG and RANKL gene variants and alcohol-induced ONFH. Six hundred seventy male subjects (335 patients and 335 normal individuals) were enrolled in our study. We selected 24 single-nucleotide polymorphisms (SNPs) to evaluate the association between genetic susceptibility variants and alcohol-induced ONFH using the chi-square test and gene model analysis. Overall, the OPG SNPs (rs1032128 and rs11573828) were associated with the strongest increased risk of alcohol-induced ONFH in the recessive model (rs1032128: odds ratio [OR] 1.49, 95% confidence interval [CI] 1.00–2.22, P = 0.04 for G/A; rs11573828: OR 3.32, 95% CI 1.07–10.30, P = 0.03 for T/C). The RANKL SNP rs2200287 was also an increased risk factor (OR 3.65, 95% CI 1.53–8.47, P = 0.003 for T/C) in the recessive model. The rs11573856, rs3134056, and rs1564861 SNPs were considered protective factors for alcohol-induced ONFH. We concluded that OPG and RANKL polymorphisms were associated with the occurrence of alcohol-induced ONFH. PMID:27336899

  1. Comparison of bone marrow mesenchymal stem cells and core decompression in treatment of osteonecrosis of the femoral head: a meta-analysis.

    PubMed

    Li, Xu; Xu, Xian; Wu, Wei

    2014-01-01

    The study aims to compare the clinical efficacy of core decompression (CD) and bone marrow mesenchymal stem cells (BMMSC) on the patients with osteonecrosis of the femoral head (ONFH). A detailed literature search of PubMed, MEDLINE and EMBASE, Springer, Elsevier Science Direct, Cochrane Library and Google scholar for all relevant papers published was performed. Pooled odds ratio (OR) or weighted mean differences (WMD) and 95% confidence interval (CI) were used to evaluate the clinical efficacy of CD and BMMSC with the clinical outcome on the patients with ONFH. A total of 219 hips in 4 studies were indentified in this current meta-analysis. The OR of 2 separate studies consisting of 115 hips (CD group 63 hips; BMMSC group 52 hips) of patients were pooled and suggested BMMSC group had significantly less number of progressed vascularized bone grafting events than CD group (OR = 0.11; 95% CI: 0.03~0.43; P < 0.01). In addition, WMD of other 2 separate studies consisting of 104 hips (CD group 52 hips; BMMSC group 52 hips) in patients were pooled, and significant differences (P < 0.01) in Harris Hip Score (HHS) were observed between these two treatment groups at the end of follow-up study, BMMSC group had significantly better clinical outcome than CD group (WMD = 8.69; 95% CI: 3.76~13.62; P < 0.01). BMMSC may perform a better therapeutic effect than CD on the patients with osteonecrosis of the femoral head.

  2. The Fate and Distribution of Autologous Bone Marrow Mesenchymal Stem Cells with Intra-Arterial Infusion in Osteonecrosis of the Femoral Head in Dogs

    PubMed Central

    Jin, Hongting; Xu, Taotao; Chen, Qiqing; Wu, Chengliang; Wang, Pinger; Mao, Qiang; Zhang, Shanxing; Shen, Jiayi; Tong, Peijian

    2016-01-01

    This study aimed to investigate if autologous bone marrow mesenchymal stem cells (MSCs) could treat osteonecrosis of the femoral head (ONFH) and what the fate and distribution of the cells are in dogs. Twelve Beagle dogs were randomly divided into two groups: MSCs group and SHAM operated group. After three weeks, dogs in MSCs group and SHAM operated group were intra-arterially injected with autologous MSCs and 0.9% normal saline, respectively. Eight weeks after treatment, the necrotic volume of the femoral heads was significantly reduced in MSCs group. Moreover, the trabecular bone volume was increased and the empty lacunae rate was decreased in MSCs group. In addition, the BrdU-positive MSCs were unevenly distributed in femoral heads and various vital organs. But no obvious abnormalities were observed. Furthermore, most of BrdU-positive MSCs in necrotic region expressed osteocalcin in MSCs group and a few expressed peroxisome proliferator-activated receptor-γ (PPAR-γ). Taken together, these data indicated that intra-arterially infused MSCs could migrate into the necrotic field of femoral heads and differentiate into osteoblasts, thus improving the necrosis of femoral heads. It suggests that intra-arterial infusion of autologous MSCs might be a feasible and relatively safe method for the treatment of femoral head necrosis. PMID:26779265

  3. Osteonecrosis: avoiding total hip arthroplasty.

    PubMed

    Hungerford, David S

    2002-06-01

    Osteonecrosis of the femoral head afflicts approximately 20,000 new patients per year, at an average age of 38. Of the patients seen in our institution, 25% are <25 years old. Without treatment, most of these patients can be expected to need a total hip arthroplasty. Joint-preserving procedures have a significant failure rate, and some have significant morbidity. It is desirable to avoid or delay total hip arthroplasty because most patients with osteonecrosis outlive the current state-of-the-art prostheses. Four issues need to be weighed to arrive at a reasonable algorithm for the preservative treatment of osteonecrosis: i) patient risk factors, ii) morbidity of the proposed procedure, iii) size of the lesion, and iv) stage of the lesion. All of the issues must be considered to make sense out of a complex clinical situation.

  4. An exploratory clinical trial for idiopathic osteonecrosis of femoral head by cultured autologous multipotent mesenchymal stromal cells augmented with vascularized bone grafts.

    PubMed

    Aoyama, Tomoki; Goto, Koji; Kakinoki, Ryosuke; Ikeguchi, Ryosuke; Ueda, Michiko; Kasai, Yasunari; Maekawa, Taira; Tada, Harue; Teramukai, Satoshi; Nakamura, Takashi; Toguchida, Junya

    2014-08-01

    Idiopathic osteonecrosis of femoral head (ION) is a painful disorder that progresses to collapse of the femoral head and destruction of the hip joint. Although its precise pathology remains unknown, the loss of blood supply causing the loss of living bone-forming cells is a hallmark of the pathophysiology of osteonecrosis. Transplantation of multipotent mesenchymal stromal cells (MSCs) is a promising tool for regenerating the musculoskeletal system. The aim of the present study was to assess the safety and efficacy of transplantation of cultured autologous bone marrow-derived MSCs mixed with β-tricalcium phosphate (β-TCP) in combination with vascularized bone grafts for the treatment of advanced stage ION in a clinical trial. Ten patients with stage 3 ION were enrolled in this study. Autologous bone marrow-derived MSCs were cultured with autologous serum, and cells (0.5-1.0×10(8)) were transplanted after mixing with β-TCP granules in combination with vascularized iliac bone grafts. Patients were assessed 24 months after treatment. The primary and secondary endpoints were progression of the radiological stage and changes in bone volume at the femoral head, and clinical score, respectively. Nine of ten patients completed the protocol, seven of whom remained at stage 3, and the remaining two cases progressed to stage 4. The average bone volume increased from 56.5±8.5 cm(3) to 57.7±10.6 cm(3). The average clinical score according to the Japan Orthopaedic Association improved from 65.6±25.5 points to 87.9±19.0 points. One severe adverse event was observed, which was not related to the clinical trial. Although the efficacy of cell transplantation was still to be determined, all procedures were successfully performed and some young patients with extensive necrotic lesions with pain demonstrated good bone regeneration with amelioration of symptoms. Further improvements in our method using MSCs and the proper selection of patients will open a new approach for

  5. Transplantation of iliac bone flaps pedicled with sartorius muscular fascia around superficial circumflex iliac vessels in the treatment of osteonecrosis of the femoral head

    PubMed Central

    CUI, GUOFENG; WEI, RONG; HOU, CHUNYING; BI, ZHENGGANG

    2016-01-01

    The aim of this study was to evaluate the efficacy and clinical application of iliac bone flaps pedicled with sartorius muscular fascia around superficial circumflex iliac vessels for the treatment of Association for Research on Osseous Circulation (ARCO) stage II–III osteonecrosis of the femoral head (ONFH) in young adults. In total, 35 patients with ONFH at ARCO stage II–III were treated with iliac bone flaps pedicled with sartorius muscular fascia around superficial circumflex iliac vessels. Patients were classified according to etiological factors and ARCO stages. Postoperative clinical assessment was accomplished with Harris hip scores (HHSs), and ARCO stage change was evaluated with imaging. All 35 patients completed the follow-up. The HHS results indicated that hip function was improved significantly from the preoperative status of 56.53±7.66 points to the postoperative status of 87.49±5.89 points (P<0.0001). Postoperative imaging displayed apparent osteogenesis and satisfactory structural remodeling in 32 patients, presenting no staging progress. Three patients exhibited mild collapse (<2 mm) compared with preoperative collapse. No patients developed osteoarthritis or required total hip arthroplasty. The clinical success rate was 91.43%. Iliac bone flaps pedicled with sartorius muscular fascia around superficial circumflex iliac vessels is a feasible means for treating ARCO stage II–III ONFH in young adults, who have abundant blood circulation, good osteogenesis and function of the hip. It is also an effective means for retaining the femoral head. PMID:27284301

  6. Population pharmacokinetic and pharmacodynamic modeling for assessing risk of bisphosphonate-related osteonecrosis of the jaw

    PubMed Central

    Sedghizadeh, Parish P.; Jones, Allan C.; LaVallee, Chris; Jelliffe, Roger W.; Le, Anh D.; Lee, Peter; Kiss, Andrew; Neely, Michael

    2012-01-01

    Objective We hypothesized that patients with bisphosphonate (BP)-related osteonecrosis of the jaw (BRONJ) accumulate higher levels of BP in bone than those without BRONJ. Study Design Using the Pmetrics® package and published data, we designed a population pharmacokinetic model of pamidronate concentration in plasma and bone and derived a toxic bone BP threshold of 0.2 mM. With the model, and using patient individual BP duration and bone mineral content estimated from lean body weight, we calculated bone BP levels in 153 subjects. Results Mean bone BP in 69 BRONJ cases was higher than in 84 controls (0.20 vs. 0.10 mM, P<0.001) consistent with the toxic bone threshold of 0.2 mM. BRONJ was also associated with longer duration BP therapy (5.3 vs. 2.7 years, P<0.001), older age (76 vs. 70 years, P<0.001), and Asian race (49% vs. 14%, P<0.001). Conclusions Our model accurately discriminated BRONJ cases from controls, among patients on BP therapy. PMID:23246224

  7. A Model for Osteonecrosis of the Jaw with Zoledronate Treatment following Repeated Major Trauma

    PubMed Central

    Howie, R. Nicole; Borke, James L.; Kurago, Zoya; Daoudi, Asma; Cray, James; Zakhary, Ibrahim E.; Brown, Tara L.; Raley, J. Nathan; Tran, Loan T.; Messer, Regina; Medani, Fardous; Elsalanty, Mohammed E.

    2015-01-01

    This study aims to develop a reproducible rat model for post-traumatic bisphosphonate-related osteonecrosis of the jaw (BRONJ). In our previous studies using dental extraction as an inducing factor, only 30% - 60% of zoledronate-treated animals fulfilled the definition of clinical BRONJ. We modified the zoledronate regimen and introduced repeated surgical extraction to illicit quantifiable BRONJ in all animals. Eighty retired-breeder female Sprague-Dawley rats were divided between the treatment (IV zoledronate; 80 μg/kg/week for 13 weeks) and control (saline) groups. On week 13, the left mandibular first molar was surgically extracted, followed by the second molar a week later. Animals were euthanized at 1-week, 2-weeks, and 8-weeks following extraction. The occurrence and severity of BRONJ were scored in each animal based on gross and MicroCT analysis. Parameters of bone formation and osteoclast functions at the extraction site were compared between groups. All zoledronate-treated animals developed a severe case of BRONJ that fulfilled the clinical definition of the condition in humans. Osteoclast attachment continued to be defective eight weeks after stopping the treatment. There were no signs of kidney or liver toxicity. Our data confirmed that repeated surgical extraction (major trauma) by itself consistently precipitated massive bone necrosis in ZA-treated animals, eliminating the need to induce pre-existing infection or comorbidity. These results will be the basis for further studies examining the in-vivo pathogenesis and prevention of BRONJ. PMID:26186665

  8. National Osteonecrosis Foundation

    MedlinePlus

    ... Brochure Membership Form NONF Newsletter Volunteers Needed Patient Questionnaire Find A Physician Osteonecrosis - A bone disease that ... Brochure | Legg Perthes Disease Borchure | Membership Form | Patient Questionnaire | Physician Members Copyright © 2014, National Osteonecrosis Foundaton. All ...

  9. Autologous bone marrow mesenchymal stem cells associated with tantalum rod implantation and vascularized iliac grafting for the treatment of end-stage osteonecrosis of the femoral head.

    PubMed

    Zhao, Dewei; Liu, Baoyi; Wang, Benjie; Yang, Lei; Xie, Hui; Huang, Shibo; Zhang, Yao; Wei, Xiaowei

    2015-01-01

    Tantalum rod implantation with vascularized iliac grafting has been reported to be an effective method for the treatment of young patients with osteonecrosis of the femoral head (ONFH) to avert the need for total hip arthroplasty (THA). However, there have been unsatisfactory success rates for end-stage ONFH. The authors describe a modified technique using bone marrow mesenchymal stem cells (BMMSCs) associated with porous tantalum rod implantation combined with vascularized iliac grafting for the treatment of end-stage ONFH. A total of 24 patients (31 hips) with end-stage ONFH were treated with surgery; ARCO IIIc stage was observed in 19 hips and ARCO IV stage was observed in 12 hips. All patients were followed for a mean time of 64.35 ± 13.03 months (range 26-78). Operations on only five hips were converted to THA. The joint-preserving success rate of the entire group was 89.47% for ARCO stage IIIc and 75% for ARCO stage IV. The mean Harris hip score of the 31 hips improved significantly from 38.74 ± 5.88 points (range 22-50) to 77.23 ± 14.75 points (range 33-95). This intervention was safe and effective in delaying or avoiding total hip replacement for end-stage ONFH.

  10. Animal model for medication-related osteonecrosis of the jaw with precedent metabolic bone disease.

    PubMed

    Kim, Jin-Woo; Tatad, Jacquiline Czar I; Landayan, Maria Erika A; Kim, Sun-Jong; Kim, Myung-Rae

    2015-12-01

    Despite the fact that the medications used to treat abnormal bone conditions often induce osteonecrosis of the jaw (ONJ), previous attempts to establish an animal model for ONJ have shown insufficient consideration for this important prerequisite for the development of the disease. The purpose of this study was to establish an animal model with the most common metabolic bone disease, osteoporosis. Ninty-six rats were randomly divided into ovariectomy (Ov) group (n=48) and sham-operated group (n=48). Six weeks after Ov or sham surgery, rats in each group were subdivided into bisphosphonate group (n=36 each) and control group (n=12 each) and injected with zoledronic acid and normal saline, respectively, once a week. After additional 6weeks, surgical intervention was performed, and the injections were continued for 8 more weeks. The animals were then sacrificed for further macroscopic, histological, histomorphometric, radiological, and bone biomarker investigations. As histologically determined, the Ov group (77.8%) showed higher ONJ prevalence compared to the sham group (47.2%; P<0.05). Micro-structural and histomorphometric assessments revealed that rats with ONJ (ONJ group) presented with deteriorated bone architectures with higher necrotic bone fraction and lower number of osteoclasts (P<0.05). Compared to the sham-operated ONJ group, the Ov ONJ group showed significantly lower values of Tb.N, Tb.Sp, Conn.D, N.Oc/T.Ar, and TRACP 5b and CTX/TRACP (P<0.05). The ovariectomized rat model in this study successfully mimicked human ONJ lesions with an underlying bone disease and showed different bone characteristics than that of the previous ONJ model. Based on the differences, further researches for investigating pathophysiology of ONJ, including various pharmacological responses for deteriorated bone environment, are required.

  11. Substrain-Specific Differences in Survival and Osteonecrosis Incidence in a Mouse Model

    PubMed Central

    Kawedia, Jitesh D; Janke, Laura; Funk, Amy J; Ramsey, Laura B; Liu, Chengcheng; Jenkins, David; Boyd, Kelli L; Relling, Mary V

    2012-01-01

    We previously reported strain-specific susceptibility to dexamethasone-induced osteonecrosis in mice. Here we report that BALB/cJ and BALB/cAnNHsd mice display substrain-specific differences in dexamethasone-induced adverse effects. As compared with BALB/cJ mice, BALB/cAnNHsd weighed more (16.6 g compared with 13.7 g) at the beginning of dexamethasone administration on postnatal day 28 and fewer died during the dexamethasone regimen (10% compared with 50%). Although the 2 substrains had similar plasma concentrations of dexamethasone, BALB/cJ mice were more susceptible to developing dexamethasone-induced osteonecrosis. A higher dose of dexamethasone (8 mg/L) throughout the treatment period compared with a lower dose (8 mg/L loading dose during week 1 followed by 4 mg/L for the remainder of the treatment period) and earlier start of treatment (postnatal day 24 compared with postnatal day 28) was required to induce osteonecrosis with a similar frequency in BALB/cAnNHsd mice as in BALB/cJ mice. Our results show, for the first time, substrain-specific differences in the development of osteonecrosis in mice. PMID:23561879

  12. Single Nucleotide Polymorphisms Other than Factor V Leiden Are Associated with Coagulopathy and Osteonecrosis of the Femoral Head in Chinese Patients

    PubMed Central

    Peng, Kou-Ti; Huang, Kuo-Chin; Huang, Tsan-Wen; Lee, Yun-Shien; Hsu, Wei-Hsiu; Hsu, Robert W. W.; Ueng, Steve W. N.; Lee, Mel S.

    2014-01-01

    Single nucleotide polymorphisms (SNPs) of factor V Leiden have been associated with osteonecrosis of the femoral head (ONFH) in Caucasians but remains controversial in Asians. We used an SNP microarray to screen 55 loci of factor V gene in patients with ONFH of Chinese. Significantly different candidate SNPs at 14 loci were analyzed in 146 patients and 116 healthy controls using MALDI-TOF (matrix-assisted laser desorption/ionization time-of-flight) mass spectrometry and gene sequencing. The factor V Leiden (rs6025) was not found in all participants. Six SNP loci (rs9332595, rs6020, rs9332647, rs3766110, rs10919186, and rs12040141) were confirmed with significant differences in patients but not in controls. The rs6020 G-to-A polymorphism was found in 88.9% of the patients. In addition, a high percentage (87.6%) of the patients had an abnormal coagulation profile that included hyperfibrinogen, elevated fibrinogen degradation products, elevated D-dimer, abnormal protein S, abnormal protein C, or a decrease in anti-thrombin III. Patients with the rs6020 G-to-A polymorphism (mutation) had a higher risk (odds ratio: 4.62; 95% confidence interval: 1.44–14.8) of having coagulation abnormalities than did those without the mutation (wild-type) (χ2 p  =  0.006). Our findings suggested that the rs6020 polymorphism might be the genetic trait that accounts for the higher prevalence of ONFH in the Chinese population than in Westerners. Exposure to risk factors such as alcohol and steroids in patients with the rs6020 polymorphism causes coagulation abnormalities and, subsequently, thromboembolisms in the femoral head. PMID:25119470

  13. Functional investigation of bone implant viability using radiotracers in a new model of osteonecrosis

    PubMed Central

    Schiper, Luis; Faintuch, Bluma Linkowski; da Silva Badaró, Roberto José; de Oliveira, Erica Aparecida; Chavez, Victor E. Arana; Chinen, Elisangela; Faintuch, Joel

    2016-01-01

    OBJECTIVES: Conventional imaging methods are excellent for the morphological characterization of the consequences of osteonecrosis; however, only specialized techniques have been considered useful for obtaining functional information. To explore the affinity of radiotracers for severely devascularized bone, a new mouse model of isolated femur implanted in a subcutaneous abdominal pocket was devised. To maintain animal mobility and longevity, the femur was harvested from syngeneic donors. Two technetium-99m-labeled tracers targeting angiogenesis and bone matrix were selected. METHODS: Medronic acid and a homodimer peptide conjugated with RGDfK were radiolabeled with technetium-99m, and biodistribution was evaluated in Swiss mice. The grafted and control femurs were evaluated after 15, 30 and 60 days, including computed tomography (CT) and histological analysis. RESULTS: Radiolabeling achieved high (>95%) radiochemical purity. The biodistribution confirmed good blood clearance 1 hour after administration. For 99mTc-hydrazinonicotinic acid (HYNIC)-E-[c(RGDfK)2, remarkable renal excretion was observed compared to 99mTc-methylene diphosphonate (MDP), but the latter, as expected, revealed higher bone uptake. The results obtained in the control femur were equal at all time points. In the implanted femur, 99mTc-HYNIC-E-[c(RGDfK)2 uptake was highest after 15 days, consistent with early angiogenesis. Regarding 99mTc-MDP in the implant, similar uptake was documented at all time points, consistent with sustained bone viability; however, the uptake was lower than that detected in the control femur, as confirmed by histology. CONCLUSIONS: 1) Graft viability was successfully diagnosed using radiotracers in severely ischemic bone at all time points. 2) Analogously, indirect information about angiogenesis could be gathered using 999mTc-HYNIC-E-[c(RGDfK)2. 3) These techniques appear promising and warrant further studies to determine their potential clinical applications. PMID

  14. Osteonecrosis in Sickle Cell Disease.

    PubMed

    Naseer, Zan A; Bachabi, Malick; Jones, Lynne C; Sterling, Robert S; Khanuja, Harpal S

    2016-09-01

    Osteonecrosis is one of the most devastating musculoskeletal manifestations of sickle cell disease and most commonly affects the femoral head. Although the exact pathophysiology of this condition in patients with sickle cell disease is unknown, it is suggested that red cell sickling and repetitive vaso-occlusion may be associated with tissue hypoxia, inflammation, and subsequent bone necrosis and collapse. If left untreated, osteonecrosis can be extremely debilitating and may lead to severe pain, loss of function, and degenerative joint changes. Although several conservative management approaches exist, total joint arthroplasty remains the most effective treatment intervention. A multidisciplinary approach among the primary care physician, hematologist, and orthopedic surgeon is essential in optimizing patient management. PMID:27598354

  15. A novel soft-tissue in vitro model for bisphosphonate-associated osteonecrosis

    PubMed Central

    2010-01-01

    Background Bisphosphonate (BP)-associated osteonecrosis of the jaw (ONJ) has been reported in patients receiving intravenous BP, particularly zoledronic acid (ZA). The purpose of this study was to develop an in vitro model representative of the effects BP has on soft tissue secondary to its release from bone. Human gingival fibroblasts and oral epithelial cell lines were exposed to various concentrations (0-10 μM) of ZA using dentine discs (DDs) as a direct carrier of BP, which were exposed for 24 hours to ZA in normal medium (NM), washed in phosphate-buffered saline (PBS) and placed in a new co-culture with the cells. The cells were allowed to proliferate until they grew over the bone discs and then the discs either were left unchelated, or were chelated using 0.001% EDTA or EGTA to release BP from the discs and to observe the cellular effects. Direct effects were determined using direct and fluorescent imaging. Apoptotic effects were determined by vital stain, terminal dUTP nick-end labeling, and annexin V studies. The effect on cell proliferation was determined by mitochondrial tetrazolium salt assay. The level of BP release was determined based on the effect of BP directly on cells, using the DDs or the supernatant fluids resulting from chelation. Results A dose-response effect was seen on imaging, and effects on apoptosis and cell proliferation were observed with increasing ZA concentrations liberated from the DDs, particularly after calcium cleavage and release of ZA from the DDs with a variety of chelating agents. Apoptotic effects were observed microscopically after chelation at 24 hours. Release of ZA was confirmed by extracting medium from non-chelated and chelated cell culture models with DDs and applying this medium to untreated fresh cell cultures, providing appropriate controls. Conclusions The results from this study demonstrate that low concentrations of ZA released from bone can rapidly and directly affect the oral mucosal tissues, initially

  16. High-Energy Extracorporeal Shock Wave for Early Stage Osteonecrosis of the Femoral Head: A Single-Center Case Series.

    PubMed

    Gao, Fuqiang; Sun, Wei; Li, Zirong; Guo, Wanshou; Wang, Weiguo; Cheng, Liming; Wang, Bailiang

    2015-01-01

    Our retrospective study assessed the effects of treatment of early stage ONFH with extracorporeal shock wave therapy. 335 patients (528 hips) were treated with shockwave therapy in our institution. Each patient underwent two sessions. The hips were divided into two groups according to whether the lateral pillar of the femoral head (LPFH) was preserved: LPFH and non-LPFH groups. Patients were followed up at 3, 6, and 12 months after the treatment. Most of the patients (83.9% hips) demonstrated pain reduction and improved mobility of the treated joint (visual analogue scale score, P = 0.00006; Harris hip score, P = 0.00091). During the follow-up period, 16 hips failed following femoral head collapse and required hip arthroplasty (2 hips in LPFH group and 14 hips in non-LPFH group). The lesion size decreased after ESWT. However, the differences were statistically not significant (LPFH group, P = 0.091; non-LPFH group, P = 0.087). A significant reduction in bone marrow edema was observed after treatment (LPFH group, P = 0.007; non-LPFH group, P = 0.016). High-energy extracorporeal shock wave therapy resulted in considerable improvement in early stage ONFH, which can effectively relieve pain and improve the function of the hip.

  17. Core Decompression and Autologous Bone Marrow Concentrate for Treatment of Femoral Head Osteonecrosis: A Randomized Prospective Study

    PubMed Central

    Pepke, Wojciech; Kasten, Philip; Beckmann, Nicholas A.; Janicki, Patricia; Egermann, Marcus

    2016-01-01

    The aim of this study was to investigate the safety of injection of bone marrow aspirate concentrate during core decompression and to study its clinical (visual analogue scale; Harris-Hip-score) and radiological outcomes (magnetic resonance imaging). In this prospective and randomized clinical trial we evaluated 24 consecutive patients with non-traumatic femoral head necrosis (FHN) during a period of two years after intervention. In vitro analysis of mesenchymal stem cells was performed by evaluating the fibroblast colony forming units (CFU-Fs). Postoperatively, significant decrease in pain associated with a functional benefit lasting was observed. However, there was no difference in the clinical outcome between the two study groups. Over the period of two years there was no significant difference between the head survival rate between both groups. In contrast to that, we could not perceive any significant change in the volume of FHN in both treatment groups related to the longitudinal course after treating. The number of CFU showed a significant increase after centrifugation. This trial could not detect a benefit from the additional injection of bone marrow concentrate with regard to bone regeneration and clinical outcome in the short term. PMID:27114808

  18. High-Energy Extracorporeal Shock Wave for Early Stage Osteonecrosis of the Femoral Head: A Single-Center Case Series

    PubMed Central

    Gao, Fuqiang; Sun, Wei; Li, Zirong; Guo, Wanshou; Wang, Weiguo; Cheng, Liming; Wang, Bailiang

    2015-01-01

    Our retrospective study assessed the effects of treatment of early stage ONFH with extracorporeal shock wave therapy. 335 patients (528 hips) were treated with shockwave therapy in our institution. Each patient underwent two sessions. The hips were divided into two groups according to whether the lateral pillar of the femoral head (LPFH) was preserved: LPFH and non-LPFH groups. Patients were followed up at 3, 6, and 12 months after the treatment. Most of the patients (83.9% hips) demonstrated pain reduction and improved mobility of the treated joint (visual analogue scale score, P = 0.00006; Harris hip score, P = 0.00091). During the follow-up period, 16 hips failed following femoral head collapse and required hip arthroplasty (2 hips in LPFH group and 14 hips in non-LPFH group). The lesion size decreased after ESWT. However, the differences were statistically not significant (LPFH group, P = 0.091; non-LPFH group, P = 0.087). A significant reduction in bone marrow edema was observed after treatment (LPFH group, P = 0.007; non-LPFH group, P = 0.016). High-energy extracorporeal shock wave therapy resulted in considerable improvement in early stage ONFH, which can effectively relieve pain and improve the function of the hip. PMID:26609311

  19. ABCB1 C3435T and G2677T/A polymorphism decreased the risk for steroid-induced osteonecrosis of the femoral head after kidney transplantation.

    PubMed

    Asano, Takeshi; Takahashi, Kenji A; Fujioka, Mikihiro; Inoue, Shigehiro; Okamoto, Masahiko; Sugioka, Nobuyuki; Nishino, Hoyoku; Tanaka, Takashi; Hirota, Yoshio; Kubo, Toshikazu

    2003-11-01

    Advances in transplantation technology have brought about great benefits to patients suffering from organ failure, but the problem still remains of complications induced by steroids used for post-transplant immunosuppression. Among the side-effects caused by steroids, non-traumatic osteonecrosis of the femoral head (ONF) constitutes a serious problem. The same protocol for steroid administration induces ONF in some patients, but not in others, indicating the presence of individual difference in steroid sensitivity. We hypothesized that this difference might be mediated by the drug-transport protein, P-glycoprotein (P-gp), and investigated the relationship between single nucleotide polymorphisms in the multidrug resistance gene 1 (ABCB1, MDR1) encoding P-gp and ONF. Subjects comprised 136 patients receiving kidney transplantation. Thirty patients developed post-transplant ONF. Genomic DNA was extracted from peripheral blood, and genotypes of ABCB1 C3435T (exon 26) and G2677T/A (exon 21) were determined by direct sequencing. Multivariate analyses based on clinical information were performed to determine the relationship between ABCB1 genotypes and ONF. The dose/concentration (D/C) ratios of tacrolimus were also determined to estimate the activity of P-gp in patients with different genotypes of ABCB1 C3435T (CC, CT, TT), and in those who did and did not develop ONF. The ABCB1 3435TT genotype showed a significantly lower incidence of ONF (adjusted odds ratio = 0.10, P = 0.034). The D/C ratio in the 3435TT genotype was significantly higher than that in the 3435CC genotype. The D/C ratio in patients developing ONF was significantly higher than in those patients who did not develop ONF. The results suggest increased activity of P-gp in patients with the 3435TT genotype and in those who did not develop ONF. The ABCB1 2677 homozygous variant type also showed a lower incidence of ONF (adjusted odds ratio = 0.26, P = 0.056). The 3435T and 3435C alleles were in linkage

  20. Relation between the development of osteoporosis and osteonecrosis following glucocorticoid in a rabbit model

    PubMed Central

    Lin, Tao; Liu, Junbin; Yang, Shuhua; Liu, Xianzhe; Feng, Xiaobo; Fu, Dehao

    2016-01-01

    Background: There has been a recent increase in the number of patients suffering from bone and joint diseases, as a consequence of corticosteroids administration. There are more patients treated with low dose of GCs under long-term conditions in clinical, such as effect of GCs on Rheumatoid arthritis, Crohn's disease and Asthma patients. Hence, it was difficult for doctor to determine which problem occur first – OP or ON; however, there was no clinical report previously in the literature, and there was no effective animal model of OP and ON about low dose GCs. This study was conducted to develop rabbit models of glucocorticoid (GC)-induced femoral head ON and OP and to investigate the temporal relationship between the occurrence of the two events following administration of glucocorticoids. Materials and Methods: Fifty six, 6 months old female rabbits were randomly divided into the GC group and control group (C). Rabbits received gluteal injections of methylprednisolone sodium succinate once a day for 4 weeks, while normal saline solution in the control group. Rabbits were sacrificed at 0, 2, 4, and 8 weeks. Hip magnetic resonance imaging was performed before the rabbits were sacrificed. Serum calcium (Ca), phosphorus (P), total cholesterol, and triglyceride levels were also measured. The bone mineral density (BMD) of femoral head and the femoral shaft were measured by dual-energy X-ray absorptiometry. The trabecular parameters of the femur and the 4th lumbar vertebrae (L4) were measured with a micro-computed tomography (μ-CT). Also, the femoral head was stained with hematoxylin-eosin staining. Results: At 4 weeks in the GC group, the BMD of the femur reduced 33% and 22% in the femoral head and shaft; there was irregular intermediate to high T2-weighted images signals; μ-CT showed microfractures and cystic changes in the femoral head and L4 at 4 weeks. At 8 weeks in the GC group, the classical “line-like sign” indicating ON of the femoral head was observed

  1. The use of osteochondral allograft with bone marrow-derived mesenchymal cells and hinge joint distraction in the treatment of post-collapse stage of osteonecrosis of the femoral head.

    PubMed

    Gagala, J; Tarczynska, M; Gaweda, K; Matuszewski, L

    2014-09-01

    Osteonecrosis of the femoral head is an entity which occurs mainly in young and active patients aged between 20 and 50. The success of hip joint preserving treatments ranges from 15% to 50% depending on the stage and amount of osteonecrotic lesion. Total hip replacement is indicated in late post-collapse hips but it has unsatisfactory survival because of the wear and osteolysis in young and active patients. Osteochondral allografts have been reported in the treatment of large articular lesions with defects in underlying bone in knee, talus and shoulder. By combining osteoconductive properties of osteochondral allograft with osteogenic abilities of bone marrow-derived mesenchymal cells it has a potential to be an alternative to an autologous graft. The adjunct of hinged joint distraction should minimize stresses in subchondral bone to promote creeping substitution and prevent femoral head collapse. Unlike current treatment modalities, it would provide both structural support and allow bony and articular substitution.

  2. Investigating Clinical Failure of Bone Grafting through a Window at the Femoral Head Neck Junction Surgery for the Treatment of Osteonecrosis of the Femoral Head

    PubMed Central

    Sun, Wei; Zhao, Dingyan; Gao, Fuqiang; Su, Yangming; Li, Zirong

    2016-01-01

    Aims This study aimed to analyze the clinical factors related to the failure of bone grafting through a window at the femoral head-neck junction. Methods In total, 119 patients (158 hips) underwent bone grafting for treatment of avascular necrosis of the femoral head. The patients were classified by their ARCO staging and CJFH classification. All patients were clinically and radiographically followed up every three months during the first year and every six months in the following year. The clinical follow-up comprised determination of pre- and postoperative Harris hip scores, while serial AP, frog lateral radiographs, and CT scan were used for the radiographic follow-up. Results The clinical failure of bone grafting was observed in 40 patients. The clinical failure rates in patients belonging to ARCO stage II period, IIIa, and III (b + c) were 25.9%, 16.2%, and 61.5%, respectively, while those in patients belonging to (C + M + L1) type and L2, L3 type disease groups were 1.7%, 38.9%, and 39%, respectively. The clinical failure rates in patients aged below 40 and those aged 40 and over were 20.5% and 39.0%, respectively (all P < 0.05). Conclusion Disease type, disease stage, and patient age are risk factors for failure of bone graft surgery. Patients belonging to ARCO stage II and IIIa showed a good overall response rate, while patients belonging to ARCO stage IIIb and IIIc and those with necrotic lesions involving the lateral pillar (L2 and L3 type) showed high surgical failure rates. PMID:27285821

  3. Osteonecrosis (Avascular Necrosis)

    MedlinePlus

    ... computed/computerized tomography) scans (see below), MRI detects chemical changes in the bone marrow. MRI provides the doctor ... a cross-section of the body. MRI detects chemical changes in the bone marrow and can show osteonecrosis ...

  4. What Is Osteonecrosis?

    MedlinePlus

    ... always clear. Some known causes of osteonecrosis are: Steroid medications Alcohol use Injury Increased pressure inside the bone. Risk factors ... The cause, if known. If the cause is steroid or alcohol use, treatment may not work unless you stop using ...

  5. Model of beam head erosion

    SciTech Connect

    Lee, E.P.

    1980-08-08

    An analytical model of beam head dynamics is presented, leading to an estimate of the erosion rate due to the combined effects of Ohmic dissipation and scattering. Agreement with the results of a computer simulation and detailed one-dimensional computations is good in all respects except for the scaling of the erosion rate with net current.

  6. Dysbaric osteonecrosis: a reassessment and hypothesis.

    PubMed

    Hutter, C D

    2000-04-01

    described necrosis of the adult femoral head without infection (3) (aseptic necrosis of bone) and in the same year Twynam reported a case of osteonecrosis in a caisson worker (4) in which there was still a significant infective component. In 1911 Bornstein and Plate, followed later and independently by Bassoe in 1913, presented radiological confirmation of aseptic necrosis of bone in compressed air workers (5). The first report of aseptic necrosis in an underwater diver subsequently appeared in 1936 (6). The condition of aseptic necrosis of bone in association with exposure to raised ambient pressure (previously referred to as caisson disease, pressure-induced osteoarthropathy (7), 'bone rot' (8) and other synonyms (6)) is now generally known as dysbaric osteonecrosis (6). Despite detailed examination of this problem by many authorities, dysbaric osteonecrosis still remains a significant occupational hazard with serious medico-legal consequences (5-13). This suggests that preventative measures are being based upon an incomplete understanding of the pathophysiology of the disease, and that other etiological factors are perhaps being overlooked.

  7. Animal Models of Head Trauma

    PubMed Central

    Cernak, Ibolja

    2005-01-01

    Summary: Animal models of traumatic brain injury (TBI) are used to elucidate primary and secondary sequelae underlying human head injury in an effort to identify potential neuroprotective therapies for developing and adult brains. The choice of experimental model depends upon both the research goal and underlying objectives. The intrinsic ability to study injury-induced changes in behavior, physiology, metabolism, the blood/tissue interface, the blood brain barrier, and/or inflammatory- and immune-mediated responses, makes in vivo TBI models essential for neurotrauma research. Whereas human TBI is a highly complex multifactorial disorder, animal trauma models tend to replicate only single factors involved in the pathobiology of head injury using genetically well-defined inbred animals of a single sex. Although such an experimental approach is helpful to delineate key injury mechanisms, the simplicity and hence inability of animal models to reflect the complexity of clinical head injury may underlie the discrepancy between preclinical and clinical trials of neuroprotective therapeutics. Thus, a search continues for new animal models, which would more closely mimic the highly heterogeneous nature of human TBI, and address key factors in treatment optimization. PMID:16389305

  8. ACR Appropriateness Criteria Osteonecrosis of the Hip.

    PubMed

    Murphey, Mark D; Roberts, Catherine C; Bencardino, Jenny T; Appel, Marc; Arnold, Erin; Chang, Eric Y; Dempsey, Molly E; Fox, Michael G; Fries, Ian Blair; Greenspan, Bennett S; Hochman, Mary G; Jacobson, Jon A; Mintz, Douglas N; Newman, Joel S; Rosenberg, Zehava S; Rubin, David A; Small, Kirstin M; Weissman, Barbara N

    2016-02-01

    Osteonecrosis of the hip (Legg-Calvé-Perthes) is a common disease, with 10,000-20,000 symptomatic cases annually in the United States. The disorder affects both adults and children and is most frequently associated with trauma and corticosteroid usage. The initial imaging evaluation of suspected hip osteonecrosis is done using radiography. MRI is the most sensitive and specific imaging modality for diagnosis of osteonecrosis of the hip. The clinical significance of hip osteonecrosis is dependent on its potential for articular collapse. The likelihood of articular collapse is significantly increased with involvement of greater than 30%-50% of the femoral head area, which is optimally evaluated by MRI, often in the sagittal plane. Contrast-enhanced MRI may be needed to detect early osteonecrosis of the hip in pediatric patients, revealing hypoperfusion. In patients with a contraindication for MRI, use of either CT or bone scintigraphy with SPECT (single-photon emission CT) are alternative radiologic methods of assessment. Imaging helps guide treatment, which may include core decompression, osteotomy, and ultimately, need for joint replacement. The ACR Appropriateness Criteria(®) are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:26846390

  9. Combination treatment of biomechanical support and targeted intra-arterial infusion of peripheral blood stem cells mobilized by granulocyte-colony stimulating factor for the osteonecrosis of the femoral head: a randomized controlled clinical trial.

    PubMed

    Mao, Qiang; Wang, Weidong; Xu, Taotao; Zhang, Shanxing; Xiao, Luwei; Chen, Di; Jin, Hongting; Tong, Peijian

    2015-04-01

    The objective of this study was to determine the benefits of combination treatment with mechanical support and targeted intra-arterial infusion of peripheral blood stem cells (PBSCs) mobilized by granulocyte-colony stimulating factor (G-CSF) via the medial circumflex femoral artery on the progression of osteonecrosis of the femoral head (ONFH). Fifty-five patients (89 hips) with early and intermediate stage ONFH were recruited and randomly assigned to combination treatment or mechanical support treatment (control group). All hips received mechanical support treatment (porous tantalum rod implantation). Then, hips in the combination treatment group were performed targeted intra-arterial infusion of PBSCs. At each follow-up, Harris hip score (HHS) and Association Research Circulation Osseous (ARCO) classification were used to evaluate the symptoms and progression of osteonecrosis. Total hip arthroplasty (THA) was assessed as an endpoint at each follow-up. At 36 months, 9 of the 41 hips (21.95%) in the control group progressed to clinical failure and underwent THA whereas only 3 of the 48 hips (6.25%) in the combination treatment group required THA (p = 0.031). Kaplan-Meier survival analysis showed a significant difference in the survival time between the two groups (log-rank test; p = 0.025). Compared to the control group, combination treatment significantly improved the HHS at 36 months (p = 0.003). At the final follow-up examination, radiological progression was noted in 13 of 41 hips (31.71%) for the control group, but in only 4 of 48 hips (8.33%) for the combination treatment group (p = 0.005). The overall collapse rates were 15.15% (5/33 hips) and 8.11% (3/37 hips) in the control and combination treatment groups, respectively. Targeted intra-arterial infusion of PBSCs is capable of enhancing the efficacy of biomechanical support in the treatment of ONFH. This clinical trial confirmed that the combination treatment might be a safe and feasible

  10. [Aseptic bone flap osteonecrosis following cranioplasty after decompressive cranietomy].

    PubMed

    Smoll, Nicolas R; Stienen, Martin N; Schaller, Karl; Gautschi, Oliver P

    2013-06-19

    This case report discusses a case of aseptic osteonecrosis in a cranioplasty bone flap after decompressive craniectomy, which is a known, but rare complication after autologous cranioplasty. We suggest that the pathophysiology of cranial bone flap necrosis may have a similar pathophysiology to free flap necrosis/failure. The key suggested problem causing the osteonecrosis is vessel thrombosis within the smaller vessels of the bone flap due to the prothrombotic effects of the factors released during drilling of the bone flap. Suspicious local findings like wound dehiscence or fluid leakage should lead to a head computed tomography in order to discuss a prophylactic artificial second cranioplasty if necessary. PMID:23773942

  11. Osteonecrosis in genetic disorders

    PubMed Central

    Masi, Laura; Falchetti, Alberto; Brandi, Maria Luisa

    2007-01-01

    The avascular necrosis of bone is characterized by an abnormality of tissue that can occur whenever a disease process causes major cell stress. Some evidence supports a role for genetic factors in some avascular necrosis suggesting that gene mutations could play a role in the pathogenesis of osteonecrosis. These genetic studies provide hope that tools for identifying high risk patients will be available in the future. PMID:22460749

  12. The Role of 99mTc-Annexin V Apoptosis Scintigraphy in Visualizing Early Stage Glucocorticoid-Induced Femoral Head Osteonecrosis in the Rabbit

    PubMed Central

    Wang, Xiaolong; Liu, Yu; Wang, Xuemei; Liu, Rui; Li, Jianbo; Zhang, Guoliang; Li, Qiang; Wang, Lei; Bai, Zhigang; Zhao, Jianmin

    2016-01-01

    Objective. To validate the ability of 99mTc-Annexin V to visualize early stage of glucocorticoid-induced femoral head necrosis by comparing with 99mTc-MDP bone scanning. Methods. Femoral head necrosis was induced in adult New Zealand white rabbits by intramuscular injection of methylprednisolone. 99mTc-Annexin scintigraphy and 99mTc-MDP scans were performed before and 5, 6, and 8 weeks after methylprednisolone administration. Rabbits were sacrificed at various time points and conducted for TUNEL and H&E staining. Results. All methylprednisolone treated animals developed femoral head necrosis; at 8 weeks postinjection, destruction of bone structure was evident in H&E staining, and apoptosis was confirmed by the TUNEL assay. This was matched by 99mTc-Annexin V images, which showed a significant increase in signal over baseline. Serial 99mTc-Annexin V scans revealed that increased 99mTc-Annexin V uptake could be observed in 5 weeks. In contrast, there was no effect on 99mTc-MDP signal until 8 weeks. The TUNEL assay revealed that bone cell apoptosis occurred at 5 weeks. Conclusion. 99mTc-Annexin V is superior to 99mTc-MDP for the early detection of glucocorticoid-induced femoral head necrosis in the rabbit and may be a better strategy for the early detection of glucocorticoid-induced femoral head necrosis in patients. PMID:26989689

  13. Factors associated with osteonecrosis of the jaw among bisphosponate users

    PubMed Central

    Hess, Lisa M; Jeter, Joanne M; Benham-Hutchins, Marge; Alberts, David S.

    2008-01-01

    Background Bisphosphonates are medications that impact bone reformation by inhibiting osteoclast function. Osteonecrosis of the jaw has been reported among patients receiving these medications. It is unclear if the risk factors associated with osteonecrosis of the jaw among cancer patients taking bisphosphonates are also possible risk factors among patients receiving these medications for other indications. Methods A systematic review search strategy was used to identify cases of osteonecrosis of the jaw among patients taking bisphosphonates for an indication other than cancer to identify potential contributing factors. Data were analyzed according to previous models to develop a more expanded model that may explain possible mechanisms for the development of osteonecrosis of the jaw among patients without cancer. Results Ninety-nine cases of osteonecrosis of the jaw were identified among patients who were prescribed a bisphosphonate for an indication other than cancer. These cases included 85 osteoporosis patients, 10 patients with Paget’s disease, two patients with rheumatoid arthritis, one patient with diabetes and one patient with maxillary fibrous dysplasia. The mean age was 69.4 years, 87.3% were female, and 87.6% were receiving oral, but not intravenous, bisphosphonates. Of the 63 patients reporting dental care information, 88.9% had a dental procedure prior to the onset of osteonecrosis of the jaw. Of all cases providing medical information, 71% were taking at least one medication that affects bone turnover in addition to the bisphosphonate, and 81.6% reported additional underlying health conditions. Conclusions The case details suggest a multiplicity of factors associated with this condition and provide the foundation for a model outlining the potential mechanism for the development of osteonecrosis of the jaw among patients taking bisphosphonates for an indication other than cancer. PMID:18501224

  14. From the radiologic pathology archives imaging of osteonecrosis: radiologic-pathologic correlation.

    PubMed

    Murphey, Mark D; Foreman, Kristopher L; Klassen-Fischer, Mary K; Fox, Michael G; Chung, Ellen M; Kransdorf, Mark J

    2014-01-01

    Osteonecrosis is common and represents loss of blood supply to a region of bone. Common sites affected include the femoral head, humeral head, knee, femoral/tibial metadiaphysis, scaphoid, lunate, and talus. Symptomatic femoral head osteonecrosis accounts for 10,000-20,000 new cases annually in the United States. In contradistinction, metadiaphyseal osteonecrosis is often occult and asymptomatic. There are numerous causes of osteonecrosis most commonly related to trauma, corticosteroids, and idiopathic. Imaging of osteonecrosis is frequently diagnostic with a serpentine rim of sclerosis on radiographs, photopenia in early disease at bone scintigraphy, and maintained yellow marrow at MR imaging with a serpentine rim of high signal intensity (double-line sign) on images obtained with long repetition time sequences. These radiologic features correspond to the underlying pathology of osseous response to wall off the osteonecrotic process and attempts at repair with vascularized granulation tissue at the reactive interface. The long-term clinical importance of epiphyseal osteonecrosis is almost exclusively based on the likelihood of overlying articular collapse. MR imaging is generally considered the most sensitive and specific imaging modality both for early diagnosis and identifying features that increase the possibility of this complication. Treatment subsequent to articular collapse and development of secondary osteoarthritis typically requires reconstructive surgery. Malignant transformation of osteonecrosis is rare and almost exclusively associated with metadiaphyseal lesions. Imaging features of this dire sequela include aggressive bone destruction about the lesion margin, cortical involvement, and an associated soft-tissue mass. Recognizing the appearance of osteonecrosis, which reflects the underlying pathology, improves radiologic assessment and is important to guide optimal patient management. PMID:25019438

  15. Osteonecrosis of Femoral Head Treated with Extracorporeal Shock Wave Therapy: Analysis of Short-term Clinical Outcomes of Treatment with Radiologic Staging

    PubMed Central

    Lee, Jin-Young; Kwon, Jae-Woo; Park, Jung-Seob; Han, Kyeol; Shin, Woo-jin; Lee, Jeong-Gil

    2015-01-01

    Purpose To evaluate clinical results of extracorporeal shock wave therapy (ESWT) with radiographic staging on patients with avascular necrosis of femoral head (AVNFH). Materials and Methods We evaluated 24 patients diagnosed with AVNFH (32 hip joints) who were treated with ESWT from 1993 to 2012. Average follow-up period was 27 months, and the average age of patients was 47.8 years. The Association Research Circulation Osseous (ARCO) system was used to grade radiographic stage prior to treatment. For this study patients were divided into two groups based on their ARCO stage, group 1 (ARCO stages I and II) and group 2 (ARCO stage III). Comparative analyses were done between the two groups using the visual analogue scale (VAS) score and the Harris hip score (HHS) at pre-treatment and 3, 6, 12, and 24 months after treatment. Failure was defined when radiographic stage progressed or arthroplasty surgery was needed due to clinical exacerbation. Results Both groups showed clinical improvements with VAS scoring at final follow-up (group 1: median 7 to 1.5, P<0.001; group 2: mean 7 to 4, P=0.056). Using HHS, group 1 showed a significant improvement (from 65.5 to 95 [P<0.001]), while no significance was observed for group 2 (P=0.280). At final follow-up, 3 hips from group 1 and one hip from group 2 showed radiographic improvement; however, two patients underwent total hip arthroplasty due to persistent pain and dysfunction. Conclusion ESWT can be considered as an interventional option before surgical treatment in patients with not only early stage AVNFH but also with mid stage. PMID:27536633

  16. The pathogenesis of multifocal osteonecrosis

    PubMed Central

    Sun, Wei; Shi, Zhencai; Gao, Fuqiang; Wang, Bailiang; Li, Zirong

    2016-01-01

    Our objective was to study the incidence, etiology, and diagnosis of multifocal osteonecrosis (MFON) and its treatment options to facilitate an earlier diagnosis and to optimize treatment. A radiological investigation was performed in osteonecrosis patients with a high risk of MFON for a more accurate diagnosis between January 2010 and June 2015. For patients with osteonecrosis of both the hip and knee joints or for patients with a history of corticosteroid use or alcohol abuse who had osteonecrosis of one or more joints in the shoulder, ankle, wrist or elbow, magnetic resonance imaging (MRI) was also performed on other joints, regardless of whether these joints were symptomatic. Furthermore, we performed a radiological screening of 102 patients who had a negative diagnosis of MFON but were at a high risk; among them, another 31 MFON cases were successfully identified (30.4%). Thus, the incidence of MFON during the study period increased from 3.1% to 5.2%. Patients diagnosed with osteonecrosis and who are at a high risk of MFON should have their other joints radiologically examined when necessary. This will reduce missed diagnosis of MFON and facilitate an earlier diagnosis and treatment to achieve an optimal outcome. PMID:27404962

  17. A sensor-weighted overlapping-sphere head model and exhaustive head model comparison for MEG.

    PubMed

    Huang, M X; Mosher, J C; Leahy, R M

    1999-02-01

    The spherical head model has been used in magnetoencephalography (MEG) as a simple forward model for calculating the external magnetic fields resulting from neural activity. For more realistic head shapes, the boundary element method (BEM) or similar numerical methods are used, but at greatly increased computational cost. We introduce a sensor-weighted overlapping-sphere (OS) head model for rapid calculation of more realistic head shapes. The volume currents associated with primary neural activity are used to fit spherical head models for each individual MEG sensor such that the head is more realistically modelled as a set of overlapping spheres, rather than a single sphere. To assist in the evaluation of this OS model with BEM and other head models, we also introduce a novel comparison technique that is based on a generalized eigenvalue decomposition and accounts for the presence of noise in the MEG data. With this technique we can examine the worst possible errors for thousands of dipole locations in a realistic brain volume. We test the traditional single-sphere model, three-shell and single-shell BEM, and the new OS model. The results show that the OS model has accuracy similar to the BEM but is orders of magnitude faster to compute.

  18. Hydrogen-rich saline attenuates steroid-associated femoral head necrosis through inhibition of oxidative stress in a rabbit model

    PubMed Central

    HUANG, SHENG-LI; JIAO, JIAN; YAN, HONG-WEI

    2016-01-01

    A growing body of evidence suggests that hydrogen is a novel, selective antioxidant that exerts a protective effect against organ damage. The present study investigated the effect of hydrogen-rich saline on corticosteroid-induced necrosis of the femoral head in an animal model established using prednisolone. A total of 30 healthy, male, adult New Zealand white rabbits were randomly divided into two groups: Hydrogen-rich saline (treated with hydrogen-rich saline via intraperitoneal injection) and placebo (treated with normal saline). At the set time-points, the structure of the femoral head was examined using a microscope; the concentrations of glutathione (GSH), lipid peroxide (LPO), vascular endothelial growth factor (VEGF) and thrombomodulin (TM) in the plasma were measured and the microvessel density was quantified. The results showed that hydrogen-rich saline significantly decreased the levels of VEGF, TM and LPO and increased the GSH level in steroid-associated necrosis of the femoral head in the rabbit model. A significant increase in the microvessel density was observed in the hydrogen-rich saline group. Histopathological staining confirmed the results of the biochemical analysis. The present study demonstrates that hydrogen treatment may alleviate steroid-associated osteonecrosis by inhibiting oxidative stress. Hydrogen-rich saline may provide an alternative treatment for steroid-associated necrosis of the femoral head. PMID:26889236

  19. Kinematics of a Head-Neck Model Simulating Whiplash

    ERIC Educational Resources Information Center

    Colicchia, Giuseppe; Zollman, Dean; Wiesner, Hartmut; Sen, Ahmet Ilhan

    2008-01-01

    A whiplash event is a relative motion between the head and torso that occurs in rear-end automobile collisions. In particular, the large inertia of the head results in a horizontal translation relative to the thorax. This paper describes a simulation of the motion of the head and neck during a rear-end (whiplash) collision. A head-neck model that…

  20. Evaluation of the therapeutic effects of conditioned media from mesenchymal stem cells in a rat bisphosphonate-related osteonecrosis of the jaw-like model.

    PubMed

    Ogata, Kenichi; Katagiri, Wataru; Osugi, Masashi; Kawai, Takamasa; Sugimura, Yukiko; Hibi, Hideharu; Nakamura, Seiji; Ueda, Minoru

    2015-05-01

    Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is defined as an exposed necrotic bone in the oral cavity that does not heal after appropriate intervention for >8weeks with present or previous bisphosphonate treatment in the absence of radiotherapy. Until now, although several risk factors, including invasive dental procedures, infection, mechanical trauma to the jawbone, and concomitant use of immunosuppressive and chemotherapy drugs have been implicated in the etiology of BRONJ, its underlying mechanisms and treatments remain largely unknown. A study recently showed that intravenous administration of mesenchymal stem cells (MSCs) improved BRONJ, and it was hypothesized that paracrine effects by secretomes from MSCs are the main constituent. Here we used rat BRONJ models to examine the therapeutic effects with serum-free conditioned media from human MSCs (MSC-CM), including various secretomes. We showed that MSC-CM has protected rat MSCs and rat osteoclasts. MSC-CM enhanced the expression of osteogenic-related genes and neovascularization-related genes by real-time reverse-transcriptase polymerase chain reaction analysis in in vitro study. In in vivo study, 5-week-old Wistar/ST male rats received zoledronate (35μg/kg/week) and dexamethasone (1mg/kg/day) subcutaneously for 2weeks. Unilateral maxillary molars were then extracted. Two weeks later, rats were divided into non-treatment, serum-free Dulbecco's modified Eagle's medium, and MSC-CM groups. In the MSC-CM group, the open alveolar sockets in 63% of the rats with BRONJ healed with complete soft tissue coverage and socket bones, whereas the exposed necrotic bone with inflamed soft tissue remained in the other groups. Histological analysis showed new bone formation and the appearance of osteoclasts in the MSC-CM group. Osteoclasts were significantly reduced in the non-treatment group. Thus, we concluded that the antiapoptotic and antiinflammatory effects of MSC-CM dramatically regulated the turnover of

  1. A case of early detection of bisphosphonate-related osteonecrosis of the jaw.

    PubMed

    Mori, Miyu; Koide, Tetsuro; Matsui, Yuriyo; Matsuda, Toru

    2015-01-01

    Osteonecrosis of the jaws is an adverse reaction associated with the use of bisphosphonates. Although the diagnosis of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is based on symptomatology, it is often detected late because the patients become symptomatic only after osteonecrosis is well established. We describe a case of early oral BRONJ detected by magnetic resonance imaging (MRI) accidentally. Head MRI revealed low signal of T1-weight images in left mandibula. Patient had been treated with minodronate for osteoporosis during 18 months. Based on the MRI findings and medication history, early stage BRONJ could be considered. Therefore minodronate was switched to teriparatide. Thereafter mandible pares-thesias, odontalgia and exposed bone were not observed. This case suggests that MRI is useful for the early detection of BRONJ.

  2. Modeling heading in adult soccer players.

    PubMed

    Ponce, Ernesto; Ponce, Daniel; Andresen, Max

    2014-01-01

    Heading soccer balls can generate mild brain injuries and in the long run can lead to difficulty in solving problems, memory deficits, and language difficulties. Researchers evaluated the effects on the head for both correct and incorrect heading techniques. They based the head's geometry on medical images. They determined the injury's magnitude by comparing the neurological tissue's resistance with predictions of the generated stresses. The evaluation examined fast playing conditions in adult soccer, taking into account the ball's speed and the type of impact. Mathematical simulations using the finite element method indicated that correctly heading balls arriving at moderate speed presents a low risk of brain injury. However, damage can happen around the third cervical vertebra. These results coincide with medical studies. Incorrect heading greatly increases the brain injury risk and can alter the parietal area. PMID:25248195

  3. What is the pain source? A case report of a patient with low back pain and bilateral hip osteonecrosis

    PubMed Central

    Minkalis, Amy L.; Vining, Robert D.

    2015-01-01

    Background: Low back pain is a common symptom arising from many possible sources and includes the possibility of the contribution of remote pathology. This report describes a patient with bilateral osteonecrosis of the femoral heads presenting with a primary symptom of low back pain. Case presentation: A 37-year-old male presented for evaluation of dominant pain that existed for approximately 6–12 months and was located in the right low back. Milder pain was also reported in the right hip. Low back and hip pain were both aggravated by weight-bearing activities. An evidence-based diagnostic evaluation revealed little indication for a primary pain source originating from low back structures. Radiographs revealed bilateral osteonecrosis with evidence of left femoral head collapse. Conclusion: Hip osteonecrosis may have contributed to an atypical presentation of low back pain due to aberrant localization of pain and/or combined with altered biomechanical loading of musculoskeletal structures. PMID:26500365

  4. The Apparent Critical Isotherm for Cryoinsult-Induced Osteonecrotic Lesions in Emu Femoral Heads

    PubMed Central

    Goetz, Jessica E.; Pedersen, Douglas R.; Robinson, Duane A.; Conzemius, Michael G.; Baer, Thomas E.; Brown, Thomas D.

    2008-01-01

    Cryoinsult-induced osteonecrosis (ON) in the emu femoral head provides a unique opportunity to systematically explore the pathogenesis of ON in an animal model that progresses to human-like femoral head collapse. Among the various characteristics of cryoinsult, the maximally cold temperature attained is one plausible determinant of tissue necrosis. To identify the critical isotherm required to induce development of osteonecrosis in the cancellous bone of the emu femoral head, a thermal finite element (FE) model of intraoperative cryoinsults was developed. Thermal material property values of emu cancellous bone were estimated from FE simulations of cryoinsult to emu cadaver femora, by varying model properties until the FE-generated temperatures matched corresponding thermocouple measurements. The resulting FE model, with emu-bone-specific thermal properties augmented to include blood flow effects, was then used to study intraoperatively performed in vivo cryoinsults. Comparisons of minimum temperatures attained at FE nodes corresponding to the three-dimensional histologically apparent boundary of the region of osteonecrosis were made for six experimental cryoinsults. Series-wide, a critical isotherm of 3.5°C best corresponded to the boundary of the osteonecrotic lesions. PMID:18561937

  5. The Texas Head Start Metro Models.

    ERIC Educational Resources Information Center

    Riley, Mary Tom, Ed.; Flores, Alfredo R., Ed.

    The Texas Metro Network (TMN) is an informal group of Head Start Directors and Executive Directors organized for the purposes of improving the delivery of training and technical assistance and for assisting communication between large scale Head Start programs in the metropolitan areas of Texas. In pursuit of these aims, each member unit of the…

  6. An internal model of head kinematics predicts the influence of head orientation on reflexive eye movements

    NASA Astrophysics Data System (ADS)

    Zupan, L. H.; Merfeld, D. M.

    2005-09-01

    Our sense of self-motion and self-orientation results from combining information from different sources. We hypothesize that the central nervous system (CNS) uses internal models of the laws of physics to merge cues provided by different sensory systems. Different models that include internal models have been proposed; we focus herein on that referred to as the sensory weighting model (Zupan et al 2002 Biol. Cybern. 86 209-30). For simplicity, we isolate the portion of the sensory weighting model that estimates head angular velocity: it includes an inverse internal model of head kinematics and an 'idiotropic' vector aligned with the main body axis. Following a post-rotatory tilt in the dark, which is a rapid tilt following a constant-velocity rotation about an earth-vertical axis, the inverse internal model is applied to conflicting vestibular signals. Consequently, the CNS computes an inaccurate estimate of head angular velocity that shifts toward alignment with an estimate of gravity. Since reflexive eye movements known as vestibulo-ocular reflexes (VOR) compensate for this estimate of head angular velocity, the model predicts that the VOR rotation axis shifts toward alignment with this estimate of gravity and that the VOR time constant depends on final head orientation. These predictions are consistent with experimental data.

  7. An internal model of head kinematics predicts the influence of head orientation on reflexive eye movements.

    PubMed

    Zupan, L H; Merfeld, D M

    2005-09-01

    Our sense of self-motion and self-orientation results from combining information from different sources. We hypothesize that the central nervous system (CNS) uses internal models of the laws of physics to merge cues provided by different sensory systems. Different models that include internal models have been proposed; we focus herein on that referred to as the sensory weighting model. For simplicity, we isolate the portion of the sensory weighting model that estimates head angular velocity: it includes an inverse internal model of head kinematics and an 'idiotropic' vector aligned with the main body axis. Following a post-rotatory tilt in the dark, which is a rapid tilt following a constant-velocity rotation about an earth-vertical axis, the inverse internal model is applied to conflicting vestibular signals. Consequently, the CNS computes an inaccurate estimate of head angular velocity that shifts toward alignment with an estimate of gravity. Since reflexive eye movements known as vestibulo-ocular reflexes (VOR) compensate for this estimate of head angular velocity, the model predicts that the VOR rotation axis shifts toward alignment with this estimate of gravity and that the VOR time constant depends on final head orientation. These predictions are consistent with experimental data. PMID:16135883

  8. Stem Cell Therapy for the Treatment of Hip Osteonecrosis: A 30-Year Review of Progress

    PubMed Central

    Trousselier, Matthieu; Roubineau, François; Bouthors, Charlie; Chevallier, Nathalie; Rouard, Helene; Flouzat-Lachaniette, Charles-Henri

    2016-01-01

    Avascular necrosis of the femoral head is caused by a multitude of etiologic factors and is associated with collapse with a risk of hip arthroplasty in younger populations. A focus on early disease management with the use of stem cells was proposed as early as 1985 by the senior author (PH). We undertook a systematic review of the medical literature to examine the progress in cell therapy during the last 30 years for the treatment of early stage osteonecrosis. PMID:26929793

  9. Osteonecrosis and femoro-acetabular impingement: sequelae of developmental dysplasia of the hip

    PubMed Central

    Cheung, Jason Pui Yin; Chow, Wang; To, Michael

    2012-01-01

    A 2-year-old girl with developmental dysplasia of the right hip underwent open reduction and capsulorrhaphy via the anterior approach with hip spica casting in an internally rotated position. During her 26 years of follow-up, she was found to have osteonecrosis and subsequently cam-type femoro-acetabular impingement at 28 years of age. She was treated with surgical dislocation of the hip and osteochondroplasty to recreate the normal contour of the head and neck offset. PMID:22605717

  10. Osteonecrosis

    MedlinePlus

    ... American College of Rheumatology Committee on Communications and Marketing. Written by Susan Hylland, MD. This patient fact ... Lists Supporters About Us Leadership Careers at ACR Social Media Newsroom Annual Reports & Financial Statements Policies & Guidelines ...

  11. Osteonecrosis

    MedlinePlus

    ... the bone and changing its alignment to relieve stress on the bone or joint (osteotomy) Total joint replacement Removing part of the inside of the bone (core decompression) to relieve pressure and allow new blood vessels to form

  12. [Bionic model for coordinated head-eye motion control].

    PubMed

    Mao, Xiaobo; Chen, Tiejun

    2011-10-01

    The relationships between eye movements and head movements of the primate during gaze shifts are analyzed in detail in the present paper. Applying the mechanisms of neurophysiology to engineering domain, we have improved the robot eye-head coordination. A bionic control strategy of coordinated head-eye motion was proposed. The processes of gaze shifts are composed of an initial fast phase followed by a slow phase. In the fast phase saccade eye movements and slow head movements were combined, which cooperate to bring gaze from an initial resting position toward the new target rapidly, while in the slow phase the gaze stability and target fixation were ensured by the action of the vestibulo-ocular reflex (VOR) where the eyes and head rotate by equal amplitudes in opposite directions. A bionic gaze control model was given. The simulation results confirmed the effectiveness of the model by comparing with the results of neurophysiology experiments.

  13. Osmotic Model to Explain Anomalous Hydraulic Heads

    NASA Astrophysics Data System (ADS)

    Marine, I. Wendell; Fritz, Steven J.

    1981-01-01

    Laboratory experiments have shown that compacted clays act as osmotic membranes when they separate aqueous solutions of unequal ionic concentration. Theoretically, osmotically induced differential hydraulic pressure in groundwater systems can be relatively high. The magnitude depends primarily upon concentration differences across the membrane, type of ions, type of clay, and pore size. In experiments, thin, compacted clay membranes commonly exhibit varying degrees of osmotic efficiency due to ion leak-age through the clay. In natural systems the membrane and the solution containers are not as distinct and well defined as they are in the laboratory. Moreover, the membrane is commonly thick, inhomogeneous, and composite. In a buried Triassic basin at the Savannah River plant near Aiken, South Carolina, it is suspected that osmosis causes the saline water in the basin center to be slightly geopressurized in relation to freshwater in the overlying coastal plain aquifer. Two wells have heads of 7.88 and 12.98 bars (114.3 and 188.3 psi) above the head in the coastal plain aquifer. The head in each of these wells approximates the osmotic equilibrium head calculated from solution concentration of water produced by each well (12,000 and 18,500 mg/l, respectively). Other wells penetrating the top and edge of the Triassic basin probably penetrate a zone where ion leakage gives rise to less saline water. Thus these wells are not geopressurized.

  14. Head Motion Modeling for Human Behavior Analysis in Dyadic Interaction

    PubMed Central

    Xiao, Bo; Georgiou, Panayiotis; Baucom, Brian; Narayanan, Shrikanth S.

    2015-01-01

    This paper presents a computational study of head motion in human interaction, notably of its role in conveying interlocutors’ behavioral characteristics. Head motion is physically complex and carries rich information; current modeling approaches based on visual signals, however, are still limited in their ability to adequately capture these important properties. Guided by the methodology of kinesics, we propose a data driven approach to identify typical head motion patterns. The approach follows the steps of first segmenting motion events, then parametrically representing the motion by linear predictive features, and finally generalizing the motion types using Gaussian mixture models. The proposed approach is experimentally validated using video recordings of communication sessions from real couples involved in a couples therapy study. In particular we use the head motion model to classify binarized expert judgments of the interactants’ specific behavioral characteristics where entrainment in head motion is hypothesized to play a role: Acceptance, Blame, Positive, and Negative behavior. We achieve accuracies in the range of 60% to 70% for the various experimental settings and conditions. In addition, we describe a measure of motion similarity between the interaction partners based on the proposed model. We show that the relative change of head motion similarity during the interaction significantly correlates with the expert judgments of the interactants’ behavioral characteristics. These findings demonstrate the effectiveness of the proposed head motion model, and underscore the promise of analyzing human behavioral characteristics through signal processing methods. PMID:26557047

  15. Evaluation of a laboratory model of human head impact biomechanics

    PubMed Central

    Hernandez, Fidel; Shull, Peter B.; Camarillo, David B.

    2015-01-01

    This work describes methodology for evaluating laboratory models of head impact biomechanics. Using this methodology, we investigated: how closely does twin-wire drop testing model head rotation in American football impacts? Head rotation is believed to cause mild traumatic brain injury (mTBI) but helmet safety standards only model head translations believed to cause severe TBI. It is unknown whether laboratory head impact models in safety standards, like twin-wire drop testing, reproduce six degree-of-freedom (6DOF) head impact biomechanics that may cause mTBI. We compared 6DOF measurements of 421 American football head impacts to twin-wire drop tests at impact sites and velocities weighted to represent typical field exposure. The highest rotational velocities produced by drop testing were the 74th percentile of non-injury field impacts. For a given translational acceleration level, drop testing underestimated field rotational acceleration by 46% and rotational velocity by 72%. Primary rotational acceleration frequencies were much larger in drop tests (~100Hz) than field impacts (~10Hz). Drop testing was physically unable to produce acceleration directions common in field impacts. Initial conditions of a single field impact were highly resolved in stereo high-speed video and reconstructed in a drop test. Reconstruction results reflected aggregate trends of lower amplitude rotational velocity and higher frequency rotational acceleration in drop testing, apparently due to twin-wire constraints and the absence of a neck. These results suggest twin-wire drop testing is limited in modeling head rotation during impact, and motivate continued evaluation of head impact models to ensure helmets are tested under conditions that may cause mTBI. PMID:26117075

  16. Evaluation of a laboratory model of human head impact biomechanics.

    PubMed

    Hernandez, Fidel; Shull, Peter B; Camarillo, David B

    2015-09-18

    This work describes methodology for evaluating laboratory models of head impact biomechanics. Using this methodology, we investigated: how closely does twin-wire drop testing model head rotation in American football impacts? Head rotation is believed to cause mild traumatic brain injury (mTBI) but helmet safety standards only model head translations believed to cause severe TBI. It is unknown whether laboratory head impact models in safety standards, like twin-wire drop testing, reproduce six degree-of-freedom (6DOF) head impact biomechanics that may cause mTBI. We compared 6DOF measurements of 421 American football head impacts to twin-wire drop tests at impact sites and velocities weighted to represent typical field exposure. The highest rotational velocities produced by drop testing were the 74th percentile of non-injury field impacts. For a given translational acceleration level, drop testing underestimated field rotational acceleration by 46% and rotational velocity by 72%. Primary rotational acceleration frequencies were much larger in drop tests (~100 Hz) than field impacts (~10 Hz). Drop testing was physically unable to produce acceleration directions common in field impacts. Initial conditions of a single field impact were highly resolved in stereo high-speed video and reconstructed in a drop test. Reconstruction results reflected aggregate trends of lower amplitude rotational velocity and higher frequency rotational acceleration in drop testing, apparently due to twin-wire constraints and the absence of a neck. These results suggest twin-wire drop testing is limited in modeling head rotation during impact, and motivate continued evaluation of head impact models to ensure helmets are tested under conditions that may cause mTBI.

  17. [Bisphosphonate-related osteonecrosis of the jaw].

    PubMed

    Atanes-Bonome, P; Atanes-Bonome, A; Ríos-Lage, P; Atanes-Sandoval, A D

    2014-04-01

    The bisphosphonates are stable inorganic pyrophosphate analogs that have demonstrated their efficacy in treatment of osteolytic lesions associated with bony metastases, and multiple myeloma, malignant hypercalcemia, Paget's disease, and osteoporosis. Several publications within the last few years have suggested that osteonecrosis of the jaw is associated with bisphosphonate therapy. The diagnosis and management strategies of the patients with bisphosphonate-related osteonecrosis of the jaw is very difficult. It is important for patients to be informed of the risk of this complication, so that they have the opportunity to assess the need for dental treatment before starting therapy. Preventive measures must be taken before, during, and after treatment with bisphosphonates. If osteonecrosis of the jaw is present, management should be conservative: oral chlorhexidine and antibiotics. Surgical treatment should be reserved for those patients who are symptomatic.

  18. In vivo and in vitro characteristic of HIF-1α and relative genes in ischemic femoral head necrosis

    PubMed Central

    Zhang, Wanglin; Yuan, Zhe; Pei, Xinhong; Ma, Ruixue

    2015-01-01

    Background: Legg-Calvé-Perthes Disease (Perthes’ disease) is a childhood hip disorder initiated by ischemic necrosis of the growing femoral head. So far, the etiology and pathogenesis of Perthes’ disease is poorly understood. Materials and methods: Avascular osteonecrosis rat model was established to mimic the pathophysiological changes of femoral head necrosis. The chondrocytes of newborn Sprague-Dawley rats were isolated and cultured in hypoxic and normoxic condition. The expression characteristic of the hypoxia-inducible factor-1 alpha (HIF-1α) was evaluated both in vivo and in vitro models. Vascular endothelial growth factor (VEGF) and apoptotic genes in chondrocytes treated with normoxia and hypoxia were also studied. Results: HIF-1α expression increased greatly after ischemic operation and kept at relative high level in the arthromeningitis stage and declined in the stages of osteonecrosis and reconstruction. The HIF-1α mRNA levels of chondrocytes incubated at hypoxia were significantly higher than the cells treated with normoxia at 24 and 72 hours. Hypoxia inhibited VEGF expression; chondrocytes could oppose this inhibition manifested by the increasing of VEGF mRNA level after 72 hours hypoxia. The expression of apoptotic genes, Casp3, Casp8 and Casp9, elevated in chondrocytes after hypoxia with time differences. Conclusion: Hypoxia might be an etiological factor for femoral head necrosis, HIF-1α, VEGF as well as apoptotic genes participated the pathophysiological process of ischemic osteonecrosis. PMID:26261616

  19. Bisphosphonate related osteonecrosis of the jaws: a review.

    PubMed

    Stepaniuk, Kevin

    2011-01-01

    Bisphosphonate use has increased in veterinary medicine over the last decade. During this time, bisphosphonate related osteonecrosis of the jaws (BRONJ) in human patients has been identified. Only recently was a dog model for BRONJ developed for human oral surgery and medicine. Veterinary patients treated with bisphosphonates may be at an increased risk for BRONJ There has been little, to no, investigation of potential long term side-effects of bisphosphonate use in veterinary patients; potential sequelae are unknown. The history of bisphosphonates, their use, and BRONJ in veterinary patients are discussed.

  20. Modeling transient streaming potentials in falling-head permeameter tests.

    PubMed

    Malama, Bwalya; Revil, André

    2014-01-01

    We present transient streaming potential data collected during falling-head permeameter tests performed on samples of two sands with different physical and chemical properties. The objective of the work is to estimate hydraulic conductivity (K) and the electrokinetic coupling coefficient (Cl ) of the sand samples. A semi-empirical model based on the falling-head permeameter flow model and electrokinetic coupling is used to analyze the streaming potential data and to estimate K and Cl . The values of K estimated from head data are used to validate the streaming potential method. Estimates of K from streaming potential data closely match those obtained from the associated head data, with less than 10% deviation. The electrokinetic coupling coefficient was estimated from streaming potential vs. (1) time and (2) head data for both sands. The results indicate that, within limits of experimental error, the values of Cl estimated by the two methods are essentially the same. The results of this work demonstrate that a temporal record of the streaming potential response in falling-head permeameter tests can be used to estimate both K and Cl . They further indicate the potential for using transient streaming potential data as a proxy for hydraulic head in hydrogeology applications.

  1. Osteonecrosis in patients with malignant lymphoma: a review of twenty-five cases

    SciTech Connect

    Engel, I.A.; Straus, D.J.; Lacher, M.; Lane, J.; Smith, J.

    1981-09-01

    A retrospective study of 25 patients with malignant lymphoma who had osteonecrosis of either the femoral or humeral head(s) was undertaken. The common factor present among all patients was the administration of intermittent steroid-containing combination chemotherapy. Seventeen Hodgkin's disease patients received chemotherapy predominantly consisting of an alkylating agent, vincristine, procarbazine, and moderate amounts of prednisone. The non-Hodgkin's lymphoma patients were on various moderate dosage steroid-containing protocols, except three who received prolonged high-dose steroid-containing chemotherapy regimens. Sixteen of the 17 Hodgkin's disease patients and five of the eight non-Hodgkin's lymphoma patients received radiotherapy to the bones that subsequently developed osteonecrosis. Two of the three non-Hodgkin's lymphoma patients who were not irradiated were treated with high-dose steroid-containing chemotherapy regimens. Symptoms developed in patients 12 months to 32 months after completion of chemotherapy and radiotherapy, respectively. Osteonecrosis was a long-term complication of treatment between 1970 and 1979 and occurred in 1.6% of the Hodgkin's disease and 0.12% of the non-Hodgkin's lymphoma patients treated. The authors conclude that the patients at highest risk for this complication are those who receive both radiotherapy to the affected bone(s) and intermittent steroid-containing multiple drug chemotherapy.

  2. Inverse Modelling to Obtain Head Movement Controller Signal

    NASA Technical Reports Server (NTRS)

    Kim, W. S.; Lee, S. H.; Hannaford, B.; Stark, L.

    1984-01-01

    Experimentally obtained dynamics of time-optimal, horizontal head rotations have previously been simulated by a sixth order, nonlinear model driven by rectangular control signals. Electromyography (EMG) recordings have spects which differ in detail from the theoretical rectangular pulsed control signal. Control signals for time-optimal as well as sub-optimal horizontal head rotations were obtained by means of an inverse modelling procedures. With experimentally measured dynamical data serving as the input, this procedure inverts the model to produce the neurological control signals driving muscles and plant. The relationships between these controller signals, and EMG records should contribute to the understanding of the neurological control of movements.

  3. An FDTD model of scattering from meteor head plasma

    NASA Astrophysics Data System (ADS)

    Marshall, R. A.; Close, S.

    2015-07-01

    We have developed a three-dimensional finite difference time domain (FDTD) model of scattering of radar waves from meteor head plasma. The model treats the meteor head plasma as a cold, collisional, and magnetized plasma, and solves Maxwell's equations and the Langevin equation simultaneously and self-consistently in and around the plasma. We use this model to investigate scattering of radar waves from a meteor head (the "head echo") under a range of plasma densities, meteor scale sizes, and wave frequencies. In this way we relate the radar cross section (RCS) to these variable parameters. We find that computed RCS disagrees with previous analytical theory at certain meteor sizes and densities, in some cases by over an order of magnitude. We find that the calculated meteor head RCS is monotonically related to the "overdense area" of the meteor, defined as the cross-section area of the part of the meteor where the plasma frequency exceeds the wave frequency. These results provides a physical measure of the meteor size and density that can be inferred from measured RCS values from ground-based radars. Meteoroid mass can then be inferred from the meteor plasma distribution using established methods.

  4. A revised dosimetric model of the adult head and brain

    SciTech Connect

    Bouchet, L.G.; Bolch, W.E.; Weber, D.A.

    1996-06-01

    During the last decade, new radiopharmaceutical have been introduced for brain imaging. The marked differences of these tracers in tissue specificity within the brain and their increasing use for diagnostic studies support the need for a more anthropomorphic model of the human brain and head. Brain and head models developed in the past have been only simplistic representations of this anatomic region. For example, the brain within the phantom of MIRD Pamphlet No. 5 Revised is modeled simply as a single ellipsoid of tissue With no differentiation of its internal structures. To address this need, the MIRD Committee established a Task Group in 1992 to construct a more detailed brain model to include the cerebral cortex, the white matter, the cerebellum, the thalamus, the caudate nucleus, the lentiform nucleus, the cerebral spinal fluid, the lateral ventricles, and the third ventricle. This brain model has been included within a slightly modified version of the head model developed by Poston et al. in 1984. This model has been incorporated into the radiation transport code EGS4 so as to calculate photon and electron absorbed fractions in the energy range 10 keV to 4 MeV for each of thirteen sources in the brain. Furthermore, explicit positron transport have been considered, separating the contribution by the positron itself and its associated annihilations photons. No differences are found between the electron and positron absorbed fractions; however, for initial energies of positrons greater than {approximately}0.5 MeV, significant differences are found between absorbed fractions from explicit transport of annihilation photons and those from an assumed uniform distribution of 0.511-MeV photons. Subsequently, S values were calculated for a variety of beta-particle and positron emitters brain imaging agents. Moreover, pediatric head and brain dosimetric models are currently being developed based on this adult head model.

  5. A correction on coastal heads for groundwater flow models.

    PubMed

    Lu, Chunhui; Werner, Adrian D; Simmons, Craig T; Luo, Jian

    2015-01-01

    We introduce a simple correction to coastal heads for constant-density groundwater flow models that contain a coastal boundary, based on previous analytical solutions for interface flow. The results demonstrate that accurate discharge to the sea in confined aquifers can be obtained by direct application of Darcy's law (for constant-density flow) if the coastal heads are corrected to ((α + 1)/α)hs  - B/2α, in which hs is the mean sea level above the aquifer base, B is the aquifer thickness, and α is the density factor. For unconfined aquifers, the coastal head should be assigned the value hs1+α/α. The accuracy of using these corrections is demonstrated by consistency between constant-density Darcy's solution and variable-density flow numerical simulations. The errors introduced by adopting two previous approaches (i.e., no correction and using the equivalent fresh water head at the middle position of the aquifer to represent the hydraulic head at the coastal boundary) are evaluated. Sensitivity analysis shows that errors in discharge to the sea could be larger than 100% for typical coastal aquifer parameter ranges. The location of observation wells relative to the toe is a key factor controlling the estimation error, as it determines the relative aquifer length of constant-density flow relative to variable-density flow. The coastal head correction method introduced in this study facilitates the rapid and accurate estimation of the fresh water flux from a given hydraulic head measurement and allows for an improved representation of the coastal boundary condition in regional constant-density groundwater flow models.

  6. A revised dosimetric model of the adult head and brain

    SciTech Connect

    Bouchet, L.G.; Bolch, W.E.; Weber, D.A.; Atkins, H.L.; Poston, J.W. ||

    1996-07-01

    During the last decade, several new radiopharmaceuticals have been introduced for brain imaging. The marked differences of these tracers in tissue specificicity within the brain and their increasing use for diagnostic studies support the need for a more antihropomorphic model of the human brain and head. Brain and head models developed in the past have comprised only simplistic representations of this anatomic region. A new brain model has been developed which includes eight subregions: the caudate nucleus, the cerebellium, the cerebral cortex, the lateral ventricles, the lentiform nucleus, the thalamus, the third ventricle and the white matter. This brain model has been included within a slightly modified version of the head model developed by Poston et al. in 1984. The head model, which includes both the thyroid and eyes, was modified in this work to include the cerebrospinal fluid within the cranial and spinal regions. Absorbed fractions of energy for photon and electron sources located in thirteen source regions within the new head model were calculated using the EGS4 Monte Carlo radiation transport code for radiations in the energy range 10 keV to 4 MeV. S-values were calculated for five radionuclides used in brain imaging ({sup 11}C, {sup 15}O, {sup 18}F, {sup 99m}Tc and {sup 123}I) and for three radionuclides showing selective uptake in the thyroid ({sup 99m}Tc, {sup 123}I, and {sup 131}I). S-values were calculated using 100 discrete energy points in the beta-emission spectrum of the different radionuclides. 17 refs., 14 figs., 3 tabs.

  7. Computer model of catalytic combustion/Stirling engine heater head

    NASA Technical Reports Server (NTRS)

    Chu, E. K.; Chang, R. L.; Tong, H.

    1981-01-01

    The basic Acurex HET code was modified to analyze specific problems for Stirling engine heater head applications. Specifically, the code can model: an adiabatic catalytic monolith reactor, an externally cooled catalytic cylindrical reactor/flat plate reactor, a coannular tube radiatively cooled reactor, and a monolithic reactor radiating to upstream and downstream heat exchangers.

  8. Kinematics of a Head-Neck Model Simulating Whiplash

    NASA Astrophysics Data System (ADS)

    Colicchia, Giuseppe; Zollman, Dean; Wiesner, Hartmut; Sen, Ahmet Ilhan

    2008-02-01

    A whiplash event is a relative motion between the head and torso that occurs in rear-end automobile collisions. In particular, the large inertia of the head results in a horizontal translation relative to the thorax. This paper describes a simulation of the motion of the head and neck during a rear-end (whiplash) collision. A head-neck model that qualitatively undergoes the same forces acting in whiplash and shows the same behavior is used to analyze the kinematics of both the head and the cervical spine and the resulting neck loads. The rapid acceleration during a whiplash event causes the extension and flexion of the cervical spine, which in turn can cause dislocated vertebrae, torn ligaments, intervertebral disc herniation, and other trauma that appear to be the likely causes of subsequent painful headache or neck pain symptoms. Thus, whiplash provides a connection between the dynamics of the human body and physics. Its treatment can enliven the usual teaching in kinematics, and both theoretical and experimental approaches provide an interesting biological context to teach introductory principles of mechanics.

  9. Bisphophonates related osteonecrosis of the jaw

    PubMed Central

    Gupta, Swati; Gupta, Hemant; Mandhyan, Devendra; Srivastava, Sanjeev

    2013-01-01

    Objective: With sporadic reporting of BPs related osteonecrosis of jaw and in absence of definitive guidelines regarding the management of such patients, the dentists and the oral and maxillofacial surgeons need to be updated about this issue. The objective of this article was to produce an updated bibliographic review of BPs related ONJ. This paper reviews the literature regarding the same for better understanding of the problem and its management. Background: Bisphosphonates (BPs) are potent inhibitors of bone resorption and are widely used in the treatment of osteoporosis and other diseases that cause bone mass loss, such as Paget's disease, bone metastases, and multiple myeloma, to prevent pathological fractures. With increasing use, evidence is emerging that patients taking BP drugs are at risk of developing osteonecrosis of the jaws (ONJs), sometimes occurring spontaneously, but more commonly following dental extractions or oral bone surgery. Materials and Methods: A bibliographic search was carried out using PubMed, Medline, and search engines ending in April, 2013. The search terms used were: Oral BPs, dental implants, and osteonecrosis. Conclusion: On the basis of available literature, the management of patients on bisphosphonates requiring dental treatment is classified according to the duration of BPs treatment, method of administration of BPs etc. Dental treatments when planned carefully in such patients have a fair to good prognosis. PMID:24665168

  10. Mandibular osteonecrosis due to bisphosphonate use.

    PubMed

    Şalvarcı, Ahmet; Altınay, Serdar

    2015-03-01

    Due to their efficient osteoclastic inhibitor effect in bone metabolism and antiangiogenic activity, bisphosphonates are widely used in many cancer diseases particularly in prostate cancers with bone metastasis, lung cancer, breast cancer and multiple myeloma, as well as in systemic diseases such as osteoporosis, osteopenia, Paget disease and osteogenesis imperfect for the last 13 years. Prostate cancer is a common cancer in males and it is the leading cause of bone metastasis. Mandibular metastasis is rarely encountered during the course of prostate cancer. Mandibular osteonecrosis as well has begun to be observed along with the availability of more efficient and stronger formulations developed following the use of bisphosphonates. Zolendronic acid, which has been used also by our patient, has widely come into practice as a 3(rd) generation bisphosphonate. Because of prostate cancer and widespread bone metastases, our patient has been receiving zolendronic acid with maximum androgen blockage for 4 years. Tomography of the patient, who has undergone intensive treatment because of submandibular abscess, demonstrated extensive osteonecrosis in the fovea sublingual region of the mandible corpus. In large series, although, mandibular osteonecrosis was widely seen due to bisphosphonate use for the metastases of lung and breast cancers, this rate was between 9.6% and 11% for prostate cancer within the series. Although our patient had no mandibular metastasis before, mandibular necrosis was observed due to long-term bisphosphonate use. We are going to present our patient who had this rare complication with his clinical picture. PMID:26328198

  11. Mandibular osteonecrosis due to bisphosphonate use

    PubMed Central

    Şalvarcı, Ahmet; Altınay, Serdar

    2015-01-01

    Due to their efficient osteoclastic inhibitor effect in bone metabolism and antiangiogenic activity, bisphosphonates are widely used in many cancer diseases particularly in prostate cancers with bone metastasis, lung cancer, breast cancer and multiple myeloma, as well as in systemic diseases such as osteoporosis, osteopenia, Paget disease and osteogenesis imperfect for the last 13 years. Prostate cancer is a common cancer in males and it is the leading cause of bone metastasis. Mandibular metastasis is rarely encountered during the course of prostate cancer. Mandibular osteonecrosis as well has begun to be observed along with the availability of more efficient and stronger formulations developed following the use of bisphosphonates. Zolendronic acid, which has been used also by our patient, has widely come into practice as a 3rd generation bisphosphonate. Because of prostate cancer and widespread bone metastases, our patient has been receiving zolendronic acid with maximum androgen blockage for 4 years. Tomography of the patient, who has undergone intensive treatment because of submandibular abscess, demonstrated extensive osteonecrosis in the fovea sublingual region of the mandible corpus. In large series, although, mandibular osteonecrosis was widely seen due to bisphosphonate use for the metastases of lung and breast cancers, this rate was between 9.6% and 11% for prostate cancer within the series. Although our patient had no mandibular metastasis before, mandibular necrosis was observed due to long-term bisphosphonate use. We are going to present our patient who had this rare complication with his clinical picture. PMID:26328198

  12. Habitat Suitability Index Models: Yellow-Headed Blackbird

    USGS Publications Warehouse

    Schroeder, Richard L.

    1982-01-01

    Habitat preferences of the yellow-headed blackbird (Xanthocephalus xanthocephalus) are described in this publication. It is one of a series of Habitat Suitability Index (HSI) models and was developed through an analysis of available infomration on the species-habitat requirements of the species. Habitat use information is presented in a review of the literature, followed by the development of an HSI model, designed for use in impact assessment and habitat management activities.

  13. The thermal effects of lavage on 57 ox femoral heads prepared for hip resurfacing arthroplasty

    PubMed Central

    2013-01-01

    Background and purpose Previously, we have documented surface temperatures recorded by thermography great enough to cause osteonecrosis of the femoral head during hip resurfacing. We now performed an in vitro investigation with 3 questions: (1) whether water irrigation reduced bone surface temperature, (2) whether external bone temperatures were similar to core temperatures, and (3) whether blunting of the reamer affected temperature generation. Methods Using an ox-bone model, 57 femoral heads were peripherally reamed. The surface temperatures of bone were measured using a thermal camera and internal bone temperatures were measured using 2 theromocouples. We measured the effects of cooling with water at room temperature and with ice-cooled water. Progressive blunting of reamers was assessed over the 57 experiments. Results Mean and maximum temperatures generated during peripheral reaming were greater when no irrigation was used. Ice-cold saline protected femoral heads from thermal damage. External bone temperatures were much greater than internal temperatures, which were not sufficiently elevated to cause osteonecrosis regardless of lavage. Blunting of the reamer was not found to have a statistically significant effect in this study. Interpretation Cooling with ice-cooled water is recommended. Internal bone temperatures are not elevated despite the high surface temperatures reached during femoral head resurfacing. PMID:24079554

  14. The validation and application of a finite element human head model for frontal skull fracture analysis.

    PubMed

    Asgharpour, Z; Baumgartner, D; Willinger, R; Graw, M; Peldschus, S

    2014-05-01

    Traumatic head injuries can result from vehicular accidents, sports, falls or assaults. The current advances in computational methods and the detailed finite element models of the human head provide a significant opportunity for biomechanical study of human head injuries. The biomechanical characteristics of the human head through head impact scenarios can be studied in detail by using the finite element models. Skull fracture is one of the most frequent occurring types of head injuries. The purpose of this study is to analyse the experimental head impacts on cadavers by means of the Strasbourg University Finite Element Head Model (SUFEHM). The results of the numerical model and experimental data are compared for validation purpose. The finite element model has also been applied to predict the skull bone fracture in frontal impacts. The head model includes the scalp, the facial bone, the skull, the cerebral spinal fluid, the meninges, the cerebrum and the cerebellum. The model is used to simulate the experimental frontal head impact tests using a cylindrical padded impactor. Results of the computational simulation shows that the model correlated well with a number of experimental data and a global fracture pattern has been predicted well by the model. Therefore the presented numerical model could be used for reconstruction of head impacts in different impact conditions also the forensic application of the head model would provide a tool for investigation of the causes and mechanism of head injuries.

  15. Osteonecrosis of the jaw and the role of macrophages.

    PubMed

    Pazianas, Michael

    2011-02-01

    Nitrogen-containing bisphosphonates have been associated with the development of osteonecrosis of the jaws (ONJ), but the lack of reliable epidemiological data and appropriate animal models has restricted our understanding of ONJ pathophysiology and limited its management. The best available information is from histopathologic findings, which implicate bone necrosis and infection, although it is not clear which is primary. However, there are data suggesting that macrophages could well be the central factor in allowing the infection to develop first, followed by local necrosis, which could also account for the development of ONJ in patients treated with denosumab, a human monoclonal antibody to the receptor activator of nuclear factor-κB ligand. This review examines the evidence that macrophages could play a prominent role in development of ONJ and the proposal that it may be more appropriate to view ONJ as a drug and not only a bisphosphonate-related complication.

  16. Osteonecrosis of the Jaw Developed in Mice

    PubMed Central

    Park, Sil; Kanayama, Keiichi; Kaur, Kawaljit; Tseng, Han-Ching Helen; Banankhah, Sina; Quje, Davood Talebi; Sayre, James W.; Jewett, Anahid; Nishimura, Ichiro

    2015-01-01

    Osteonecrosis of the jaw (ONJ), an uncommon co-morbidity in patients treated with bisphosphonates (BP), occurs in the segment of jawbone interfacing oral mucosa. This study aimed to investigate a role of oral mucosal barrier γδ T cells in the pathogenesis of ONJ. Female C57Bl/6J (B6) mice received a bolus zoledronate intravenous injection (ZOL, 540 μg/kg), and their maxillary left first molars were extracted 1 week later. ZOL-treated mice (WT ZOL) delayed oral wound healing with patent open wounds 4 weeks after tooth extraction with characteristic oral epithelial hyperplasia. γδ T cells appeared within the tooth extraction site and hyperplastic epithelium in WT ZOL mice. In ZOL-treated γδ T cell null (Tcrd−/− ZOL) mice, the tooth extraction open wound progressively closed; however, histological ONJ-like lesions were identified in 75 and 60% of WT ZOL and Tcrd−/− ZOL mice, respectively. Although the bone exposure phenotype of ONJ was predominantly observed in WT ZOL mice, Tcrd−/− ZOL mice developed the pustule/fistula disease phenotype. We further addressed the role of γδ T cells from human peripheral blood (h-γδ T cells). When co-cultured with ZOL-pretreated human osteoclasts in vitro, h-γδ T cells exhibited rapid expansion and robust IFN-γ secretion. When h-γδ T cells were injected into ZOL-treated immunodeficient (Rag2−/− ZOL) mice, the oral epithelial hyperplasia developed. However, Rag2−/− ZOL mice did not develop osteonecrosis. The results indicate that γδ T cells are unlikely to influence the core osteonecrosis mechanism; however, they may serve as a critical modifier contributing to the different oral mucosal disease variations of ONJ. PMID:26013832

  17. Intraosseous hypertension and venous congestion in osteonecrosis of the knee.

    PubMed

    Uchio, Y; Ochi, M; Adachi, N; Nishikori, T; Kawasaki, K

    2001-03-01

    To determine whether an angiogenic factor affects the pathogenesis of the idiopathic osteonecrosis of the medial femoral condyle, intraosseous pressure and venogram in 11 knees with osteonecrosis were compared with intraosseous pressure and venogram in 11 knees with the medial type of osteoarthritis. Patients were matched by age, gender, obesity index, blood pressure, tibiofemoral angle, and clinical evaluation. The intraosseous pressure of the medial condyle of the knees with osteonecrosis (62.8 +/- 27.3 mm Hg) was significantly higher than that in the lateral condyle of the knees with osteonecrosis (25.4 +/- 18.9 mm Hg) and those of both condyles of the knees with osteoarthritis (medial, 31.6 +/- 17.4 mm Hg; lateral, 29.5 +/- 11.0 mm Hg). In contrast, there was no significant difference in the pressure between the medial and lateral condyles of the knees with osteoarthritis. Venography showed a marked disturbance of venous drainage in all patients with osteonecrosis. In addition, the average clearance time of the medium in the medial femoral condyle was significantly more prolonged in patients with osteonecrosis (17.7 +/- 6.1 minutes) than in patients with osteoarthritis (5.5 +/- 1.6 minutes). These data support the hypothesis that venous stasis within the medullar canal in the condyle increases intraosseous pressure and decreases arteriovenous pressure difference, leading to osteonecrosis. PMID:11249168

  18. Osteonecrosis caused by Bisphosphonates: a clinical case

    PubMed Central

    SPINELLI, D.; DE VICO, G.; BONINO, M.; BARLATTANI, A.; BOLLERO, P.; BARLATTANI, A.

    2010-01-01

    SUMMARY The osteonecrosis of the maxillares caused by bisphosphonates (OMB) either wrongly known or not reconised in earlier times became nowadays very important among the dentists and maxillo-facials surgeons because of the potential serious consequences that might bring in the oral cave of the patients, who are suffering already for their base condition. The goal of our work was to verify if a deep treatment and an attentive observation with a close follow-up can bring to the resolution of serious cases of ostenecrosis of the maxillares by bisphosphonantes. Although without a statistic value our case report put the basis for a chance to execute wider casistic studies. PMID:23285372

  19. On the Development of the SIMon Finite Element Head Model.

    PubMed

    Takhounts, Erik G; Eppinger, Rolf H; Campbell, J Quinn; Tannous, Rabih E; Power, Erik D; Shook, Lauren S

    2003-10-01

    The SIMon (Simulated Injury Monitor) software package is being developed to advance the interpretation of injury mechanisms based on kinematic and kinetic data measured in the advanced anthropomorphic test dummy (AATD) and applying the measured dummy response to the human mathematical models imbedded in SIMon. The human finite element head model (FEHM) within the SIMon environment is presented in this paper. Three-dimensional head kinematic data in the form of either a nine accelerometer array or three linear CG head accelerations combined with three angular velocities serves as an input to the model. Three injury metrics are calculated: Cumulative strain damage measure (CSDM) - a correlate for diffuse axonal injury (DAI); Dilatational damage measure (DDM) - to estimate the potential for contusions; and Relative motion damage measure (RMDM) - a correlate for acute subdural hematoma (ASDH). During the development, the SIMon FEHM was tuned using cadaveric neutral density targets (NDT) data and further validated against the other available cadaveric NDT data and animal brain injury experiments. The hourglass control methods, integration schemes, mesh density, and contact stiffness penalty coefficient were parametrically altered to investigate their effect on the model's response. A set of numerical and physical parameters was established that allowed a satisfactory prediction of the motion of the brain with respect to the skull, when compared with the NDT data, and a proper separation of injury/no injury cases, when compared with the brain injury data. Critical limits for each brain injury metric were also established. Finally, the SIMon FEHM performance was compared against HIC15 through the use of NHTSA frontal and side impact crash test data. It was found that the injury metrics in the current SIMon model predicted injury in all cases where HIC15 was greater than 700 and several cases from the side impact test data where HIC15 was relatively small. Side impact was

  20. Development of skull fracture criterion based on real-world head trauma simulations using finite element head model.

    PubMed

    Sahoo, Debasis; Deck, Caroline; Yoganandan, Narayan; Willinger, Rémy

    2016-04-01

    The objective of this study was to enhance an existing finite element (FE) head model with composite modeling and a new constitutive law for the skull. The response of the state-of-the-art FE head model was validated in the time domain using data from 15 temporo-parietal impact experiments, conducted with postmortem human surrogates. The new model predicted skull fractures observed in these tests. Further, 70 well-documented head trauma cases were reconstructed. The 15 experiments and 70 real-world head trauma cases were combined to derive skull fracture injury risk curves. The skull internal energy was found to be the best candidate to predict skull failure based on an in depth statistical analysis of different mechanical parameters (force, skull internal energy), head kinematic-based parameter, the head injury criterion (HIC), and skull fracture correlate (SFC). The proposed tolerance limit for 50% risk of skull fracture was associated with 453mJ of internal energy. Statistical analyses were extended for individual impact locations (frontal, occipital and temporo-parietal) and separate injury risk curves were obtained. The 50% risk of skull fracture for each location: frontal: 481mJ, occipital: 457mJ, temporo-parietal: 456mJ of skull internal energy.

  1. Outcome measures for evaluation of treatments for osteonecrosis.

    PubMed

    Jones, Lynne C; Hungerford, Marc W; Khanuja, Harpal S; Hungerford, David S

    2009-04-01

    With the advent of cell-based therapies, biologics, and pharmaceuticals for the potential treatment of osteonecrosis, it is important to conduct evaluations using scientifically accepted outcomes measures. For the treatment of osteonecrosis, most studies have focused on pain relief, surgery, or the need for surgery, disease progression (advancing stage), and change in lesion size. Quantification of imaging techniques continue to gain in sophistication but have not yet been validated for use in clinical trials. Despite recent interest in using biomarkers or genetic markers in the diagnosis and analysis of disease progression, more research is needed to determine the sensitivity and specificity of these techniques with respect to osteonecrosis.

  2. Enoxaparin Prevents Steroid-Related Avascular Necrosis of the Femoral Head

    PubMed Central

    Beckmann, Rainer; Shaheen, Hayfaa; Kweider, Nisreen; Ghassemi, Alireza; Fragoulis, Athanassios; Hermanns-Sachweh, Benita; Pufe, Thomas; Kadyrov, Mamed; Drescher, Wolf

    2014-01-01

    Nontraumatic osteonecrosis of the femoral head is still a challenging problem in orthopedic surgery. It is responsible for 10% of the 500,000 hip replacement surgeries in the USA and affects relatively young, active patients in particular. Main reasons for nontraumatic osteonecrosis are glucocorticoid use, alcoholism, thrombophilia, and hypofibrinolysis (Glueck et al., 1997; Orth and Anagnostakos, 2013). One pathomechanism of steroid-induced osteonecrosis is thought to be impaired blood flow to the femoral head caused by increased thrombus formation and vasoconstriction. To investigate the preventive effect of enoxaparin on steroid-related osteonecrosis, we used male New Zealand white rabbits. Osteonecrosis was induced by methylprednisolone-injection (1 × 20 mg/kg body weight). Control animals were treated with phosphate-buffered saline. Treatment consisted of an injection of 11.7 mg/kg body weight of enoxaparin per day (Clexane) in addition to methylprednisolone. Four weeks after methylprednisolone-injection the animals were sacrificed. Histology (hematoxylin-eosin and Ladewig staining) was performed, and empty lacunae and histological signs of osteonecrosis were quantified. Histomorphometry revealed a significant increase in empty lacunae and necrotic changed osteocytes in glucocorticoid-treated animals as compared with the glucocorticoid- and Clexane-treated animals and with the control group. No significant difference was detected between the glucocorticoid and Clexane group and the control group. This finding suggests that cotreatment with enoxaparin has the potential to prevent steroid-associated osteonecrosis. PMID:25110730

  3. Bisphosphonate-associated osteonecrosis of the jaws.

    PubMed

    Agarwal, Pankaj; Rao, Nirmala N

    2012-01-01

    Bisphosphonates constitute a group of drugs capable of modulating bone turnover and reduce its remodeling when an excessive resorption occurs. This is why they are indicated in a large group of bone diseases like postmenopausal osteoporosis or osteolysis associated with breast cancer or multiple myeloma. Over the last few years and due to their extensive use, many cases of complications associated with their use have been published. Among the most important possible adverse effects are the oral ones, with the appearance of ulcerations and, especially, osteonecrosis of the jaws associated with this therapy. In this paper, we have analyzed the general characteristics of these drugs and their mechanisms of action as well as the described adverse effects, especially oral and maxillofacial, have been made special reference, regarding the prevention of osteonecrosis of the jaws, heightened by cases described in the medical and odontological literature. The preventive protocol backs up the fundamental role of the odontologist in the effective prevention of this process before, during and after the treatment. PMID:22842261

  4. Rapidly recomputable EEG forward models for realistic head shapes.

    PubMed

    Ermer, J J; Mosher, J C; Baillet, S; Leah, R M

    2001-04-01

    With the increasing availability of surface extraction techniques for magnetic resonance and x-ray computed tomography images, realistic head models can be readily generated as forward models in the analysis of electroencephalography (EEG) and magnetoencephalography (MEG) data. Inverse analysis of this data, however, requires that the forward model be computationally efficient. We propose two methods for approximating the EEG forward model using realistic head shapes. The 'sensor-fitted sphere' approach fits a multilayer sphere individually to each sensor, and the 'three-dimensional interpolation' scheme interpolates using a grid on which a numerical boundary element method (BEM) solution has been precomputed. We have characterized the performance of each method in terms of magnitude and subspace error metrics, as well as computational and memory requirements. We have also made direct performance comparisons with traditional spherical models. The approximation provided by the interpolative scheme had an accuracy nearly identical to full BEM, even within 3 mm of the inner skull surface. Forward model computation during inverse procedures was approximately 30 times faster than for a traditional three-shell spherical model. Cast in this framework, high-fidelity numerical solutions currently viewed as computationally prohibitive for solving the inverse problem (e.g. linear Galerkin BEM) can be rapidly recomputed in a highly efficient manner. The sensor-fitting method has a similar one-time cost to the BEM method, and while it produces some improvement over a standard three-shell sphere, its performance does not approach that of the interpolation method. In both methods, there is a one-time cost associated with precomputing the forward solution over a set of grid points.

  5. BISPHOSPHONATE-INDUCED MAXILLOFACIAL OSTEONECROSIS IN OSTEOPOROTIC INDIVIDUALS

    PubMed Central

    da Silva Santos, Paulo Sérgio; Oliveira, Márcio Augusto; Felix, Valtuir Barbosa

    2015-01-01

    Bisphosphonate-related osteonecrosis of the maxillae may be an important complication of long-term osteoporosis treatment. The possibility of osteonecrosis of the maxillae in patients exposed to nitrogenated bisphosphonates was first described in 2003. Since then, case reports and retrospective studies have demonstrated higher percentages of occurrence of osteonecrosis in patients who have used or are using bisphosphonates. Although this complication may be spontaneous, invasive oral procedures have a role as risk factors associated with dental procedures such as tooth extractions and other bone operations. In addition, tooth infections and periodontal disease have been reported to be the main risk factors for development of bisphosphonate-induced osteonecrosis of the maxillae. For this reason, dentists, general clinicians, orthopedists, geriatricians and oral-maxillofacial surgeons need to be aware of this problem and work in a multidisciplinary environment, thereby stimulating early diagnosis and prevention of further potential cases. PMID:27027044

  6. [Conditionally pathogenic microorganisms in patients with bisphosphonate jaw osteonecrosis].

    PubMed

    Ivanyushko, T P; Polyakov, K A; Medvedev, Yu A; Shamanaev, S V; Trofimov, D Yu; Abramov, D D; Balyikin, R A

    2016-01-01

    The objective of the study was to define treatment strategy in cases of facial bones bisphosphonate induced osteonecrosis based on the study of the role of conditionally pathogenic oral microorganisms. Three typical clinical cases of bisphosphonate osteonecrosis of the facial bones were analyzed and 15 conditionally pathogenic oral microorganisms were identified in these patients using real-time PCR in saliva, wound and bone samples. A comparative analysis was carried out with purulent-inflammatory diseases of maxillofacial area. The study results proved an important role of conditionally pathogenic microorganisms of the oral cavity in the development of osteonecrosis of the facial bones. Wide range of bacterial species was identified in osteonecrosis of the facial bones patients. While bone tissue is most exposed to microbial communities, surgical treatment results in effective rehabilitation for a long period.

  7. Avascular osteonecrosis of the mandible following bisphosphonate therapy.

    PubMed

    Chandra, Preeti A; Chandra, Abhinav B; Todd, Gregory K

    2009-01-01

    Cancer patients receiving bisphosphonate therapy, both intravenously and orally, are predisposed to developing osteonecrosis of the jaw. We present a case of a 66-year-old man with metastatic prostate cancer who spontaneously developed avascular necrosis of the mandible after being on intravenous zoledronic acid for 1 year. Jaw osteonecrosis commonly presents with mild to severe jaw pain. Although most of the reported cases give a history of dental procedures, there have been cases of osteonecrosis developing spontaneously. In cases of established osteonecrosis of the jaw, there is little evidence to suggest that the discontinuation of bisphosphonate therapy aides in healing, as bisphosphonates have a very long half-life in the bone tissue. Treatment measures include evaluation by dental and oncological services, consideration for antibiotic therapy, and mainly a minimally to nonsurgical approach. In the absence of a definitive cure, the emphasis rests greatly on prevention.

  8. A conceptual model of emergency physician decision making for head computed tomography in mild head injury.

    PubMed

    Probst, Marc A; Kanzaria, Hemal K; Schriger, David L

    2014-06-01

    The use of computed tomographic scanning in blunt head trauma has increased dramatically in recent years without an accompanying rise in the prevalence of injury or hospital admission for serious conditions. Because computed tomography is neither harmless nor inexpensive, researchers have attempted to optimize utilization, largely through research that describes which clinical variables predict intracranial injury, and use this information to develop clinical decision instruments. Although such techniques may be useful when the benefits and harms of each strategy (neuroimaging vs observation) are quantifiable and amenable to comparison, the exact magnitude of these benefits and harms remains unknown in this clinical scenario. We believe that most clinical decision instrument development efforts are misguided insofar as they ignore critical, nonclinical factors influencing the decision to image. In this article, we propose a conceptual model to illustrate how clinical and nonclinical factors influence emergency physicians making this decision. We posit that elements unrelated to standard clinical factors, such as personality of the physician, fear of litigation and of missed diagnoses, patient expectations, and compensation method, may have equal or greater impact on actual decision making than traditional clinical factors. We believe that 3 particular factors deserve special consideration for further research: fear of error/malpractice, financial incentives, and patient engagement. Acknowledgement and study of these factors will be essential if we are to understand how emergency physicians truly make these decisions and how test-ordering behavior can be modified.

  9. Improved transcranial magnetic stimulation coil design with realistic head modeling

    NASA Astrophysics Data System (ADS)

    Crowther, Lawrence; Hadimani, Ravi; Jiles, David

    2013-03-01

    We are investigating Transcranial magnetic stimulation (TMS) as a noninvasive technique based on electromagnetic induction which causes stimulation of the neurons in the brain. TMS can be used as a pain-free alternative to conventional electroconvulsive therapy (ECT) which is still widely implemented for treatment of major depression. Development of improved TMS coils capable of stimulating subcortical regions could also allow TMS to replace invasive deep brain stimulation (DBS) which requires surgical implantation of electrodes in the brain. Our new designs allow new applications of the technique to be established for a variety of diagnostic and therapeutic applications of psychiatric disorders and neurological diseases. Calculation of the fields generated inside the head is vital for the use of this method for treatment. In prior work we have implemented a realistic head model, incorporating inhomogeneous tissue structures and electrical conductivities, allowing the site of neuronal activation to be accurately calculated. We will show how we utilize this model in the development of novel TMS coil designs to improve the depth of penetration and localization of stimulation produced by stimulator coils.

  10. Osteonecrosis of the Knee After Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Lansdown, Drew A.; Shaw, Jeremy; Allen, Christina R.; Ma, C. Benjamin

    2015-01-01

    Background: Anterior cruciate ligament (ACL) reconstruction is performed commonly, with a low risk of complication. Osteonecrosis of the knee is a potentially devastating condition and has been observed both spontaneously and after meniscectomy, although osteonecrosis has not been described as a complication after ACL reconstruction. Purpose: To describe the development of osteonecrosis of the knee in 5 patients after arthroscopic ACL reconstruction. Study Design: Case series; Level of evidence, 4. Methods: This study involved 5 patients (mean age, 33.2 years) who developed osteonecrosis of the knee after ACL reconstruction. A retrospective chart review was performed to identify clinical characteristics and surgical factors present in each of the 5 cases. Results: In 4 cases, the pathologic changes were present in both the medial and lateral femoral condyles, with isolated lateral condyle changes in the other case. The mean time to diagnosis was 11.6 months. These patients underwent an average of 1.8 additional surgical procedures after the diagnosis of osteonecrosis. Conclusion: Osteonecrosis of the knee is a rare outcome after ACL reconstruction. We are unable to identify clear risk factors for the development of this complication, although we hope the presentation of these cases will help promote the identification of other cases in future studies. PMID:26665035

  11. Combined with Bone Marrow-Derived Cells and rhBMP-2 for Osteonecrosis after Femoral Neck Fractures in Children and Adolescents: A case series

    PubMed Central

    Gao, Fuqiang; Sun, Wei; Guo, Wanshou; Wang, Bailiang; Cheng, Liming; Li, Zirong

    2016-01-01

    Osteonecrosis of the femoral head (ONFH) following femoral neck fractures is a rare, yet severe, disorder in children and adolescents. This study evaluated the effectiveness of core decompression (CD) combined with implantation of bone marrow–derived cells (BMDC) and rhBMP-2 for osteonecrosis of femoral head (ONFH) after femoral neck fractures in children and adolescents. This study included 51 patients, aged 11.4–18.1 years, with ARCO stages I–III ONFH after femoral neck fractures between 2004 and 2010. The hips were divided into two groups based on whether the lateral pillar of the femoral head (LPFH) was preserved: LPFH and non-LPFH groups. All patients were followed up clinically and radiographically for a minimum of 5 years. 44 patients (86.3%) had improved clinical outcome. Radiologically, 9 of the 51 hips (17.6%) exhibited collapse onset or progression of the femoral head or narrowing of the hip joint space, and one patient in the non-LPFH group required hip arthroplasty due to the worsened syndrome. The technique provided an effective therapeutic option for children and adolescents with ONFH following femoral neck fractures. It relieves hip pain and prevents the progression of osteonecrosis in young patients lasting more than 5 years after surgery. PMID:27477836

  12. Modeling head and neck cancer stem cell-mediated tumorigenesis.

    PubMed

    Pearson, Alexander T; Jackson, Trachette L; Nör, Jacques E

    2016-09-01

    A large body of literature has emerged supporting the importance of cancer stem cells (CSCs) in the pathogenesis of head and neck cancers. CSCs are a subpopulation of cells within a tumor that share the properties of self-renewal and multipotency with stem cells from normal tissue. Their functional relevance to the pathobiology of cancer arises from the unique properties of tumorigenicity, chemotherapy resistance, and their ability to metastasize and invade distant tissues. Several molecular profiles have been used to discriminate a stem cell from a non-stem cell. CSCs can be grown for study and further enriched using a number of in vitro techniques. An evolving option for translational research is the use of mathematical and computational models to describe the role of CSCs in complex tumor environments. This review is focused discussing the evidence emerging from modeling approaches that have clarified the impact of CSCs to the biology of cancer. PMID:27151511

  13. Treatment of bisphosphonates-associated osteonecrosis

    PubMed Central

    Migliorati, Cesar A.; Hupp, Wendy S.; Migliorati, Erica K.J.

    2007-01-01

    This mini-review will focus on the management of a patient with bisphosphonate-associated osteonecrosis (BON). In order to review the subject the authors report a case of a patient with prostate cancer and metastatic bone disease who was treated with zoledronic acid. Prior to cancer the patient was treated with risedronate for osteopenia but had discontinued this treatment when cancer was diagnosed. During the description of each aspect of the case, a discussion of the rationale used for the case management is presented with support of the available literature. Aspects of interest include the diagnosis of BON, the risk factor for BON for this particular patient, the decision making process for the management of acute and long-term oral cavity problems, and the introduction of high intensity laser therapy to help control pain and reduce infection and local bacterial load. PMID:22460756

  14. Two-dimensional finite element modelling of the neonatal head.

    PubMed

    Gibson, A; Bayford, R H; Holder, D S

    2000-02-01

    Electrical impedance tomography (EIT) could allow the early diagnosis of infant brain injury following birth asphyxia. The purpose of this work was to determine the effect of variations in skull, scalp or cerebrospinal fluid (CSF) resistivity, as these vary in clinical conditions and could degrade image quality. These factors were investigated using finite element models of the adult and neonatal head. The results suggest that there is a wide range over which the resistivity of the neonatal skull has little effect on the sensitivity to a central impedance change. The scalp and CSF appear to shunt current away from the brain; when their resistivity was decreased from normal values, this shunting effect increased and caused a decrease in sensitivity to a central resistance change. The resistivity of neonatal skull has not, to our knowledge, been directly measured and will anyway vary within and between individuals; this work suggests that EIT will be relatively insensitive to variations in neonatal skull impedance.

  15. Micromagnetic modeling of overlaid exchange-biased giant magnetoresistance head

    NASA Astrophysics Data System (ADS)

    Zheng, Yuankai; You, Dan; Wu, Yihong

    2002-05-01

    Overlaid exchange-biased structures for giant magnetoresistance head have been proposed and investigated. A home-developed three-dimensional micromagnetic modeling tool has been used to simulate synthetic antiferromagnetic spin valves of this type of biased structure with dimensions of 100 nm in width and 80 nm in height. Simulation results showed that, with a properly chosen antiferromagnetic material and structure, the exchange-biasing field could be made sufficient to suppress the noise without severely reducing the sensitivity. The sensitivity of overlaid exchange-biased spin valves is 1.73 times that of the abutted hard biased ones. Microtrack profiles showed that side reading effect could be suppressed effectively with an effective exchange-biasing field over 600 Oe.

  16. Low resolution brain electromagnetic tomography in a realistic geometry head model: a simulation study.

    PubMed

    Ding, Lei; Lai, Yuan; He, Bin

    2005-01-01

    It is of importance to localize neural sources from scalp recorded EEG. Low resolution brain electromagnetic tomography (LORETA) has received considerable attention for localizing brain electrical sources. However, most such efforts have used spherical head models in representing the head volume conductor. Investigation of the performance of LORETA in a realistic geometry head model, as compared with the spherical model, will provide useful information guiding interpretation of data obtained by using the spherical head model. The performance of LORETA was evaluated by means of computer simulations. The boundary element method was used to solve the forward problem. A three-shell realistic geometry (RG) head model was constructed from MRI scans of a human subject. Dipole source configurations of a single dipole located at different regions of the brain with varying depth were used to assess the performance of LORETA in different regions of the brain. A three-sphere head model was also used to approximate the RG head model, and similar simulations performed, and results compared with the RG-LORETA with reference to the locations of the simulated sources. Multisource localizations were discussed and examples given in the RG head model. Localization errors employing the spherical LORETA, with reference to the source locations within the realistic geometry head, were about 20-30 mm, for four brain regions evaluated: frontal, parietal, temporal and occipital regions. Localization errors employing the RG head model were about 10 mm over the same four brain regions. The present simulation results suggest that the use of the RG head model reduces the localization error of LORETA, and that the RG head model based LORETA is desirable if high localization accuracy is needed.

  17. The potential and limitations of utilising head impact injury models to assess the likelihood of significant head injury in infants after a fall.

    PubMed

    Cory, C Z; Jones, M D; James, D S; Leadbeatter, S; Nokes, L D

    2001-12-01

    The use of engineering principles in assessing head injury scenarios is of increasing significance in investigations into suspected child abuse. A fall scenario is often given as the history for a head injury to an infant. This paper addresses the basic engineering principles and factors to be considered when calculating the severity of a head impact after free-fall. The application of head injury models (HIMs) to ascertain the forces involved in childhood head injuries from impact is also discussed. Previous studies including Duhaime et al. [J. Neurosurg. 66 (1987) 409] and Nokes et al. [Forensic Sci. Int. 79 (1995) 85] have utilised HIMs for this purpose: this paper reviews those models most widely documented.The HIM currently considered the 'state-of-the-art' is the head injury criterion (HIC) and it is suggested that this model should be utilised for assessing head impact injury in child abuse cases where appropriate.

  18. Characterizing Discourse Deficits Following Penetrating Head Injury: A Preliminary Model

    ERIC Educational Resources Information Center

    Coelho, Carl; Le, Karen; Mozeiko, Jennifer; Hamilton, Mark; Tyler, Elizabeth; Krueger, Frank; Grafman, Jordan

    2013-01-01

    Purpose: Discourse analyses have demonstrated utility for delineating subtle communication deficits following closed head injuries (CHIs). The present investigation examined the discourse performance of a large group of individuals with penetrating head injury (PHI). Performance was also compared across 6 subgroups of PHI based on lesion locale. A…

  19. Closed-Head TBI Model of Multiple Morbidity.

    PubMed

    Thompson, Floyd J; Hou, Jiamei; Bose, Prodip K

    2016-01-01

    Successful therapy for TBI disabilities awaits refinement in the understanding of TBI neurobiology, quantitative measurement of treatment-induced incremental changes in recovery trajectories, and effective translation to human TBI using quantitative methods and protocols that were effective to monitor recovery in preclinical models. Details of the specific neurobiology that underlies these injuries and effective quantitation of treatment-induced changes are beginning to emerge utilizing a variety of preclinical and clinical models (for reviews see (Morales et al., Neuroscience 136:971-989, 2005; Fujimoto et al., Neurosci Biobehav Rev 28:365-378, 2004; Cernak, NeuroRx 2:410-422, 2005; Smith et al., J Neurotrauma 22:1485-1502, 2005; Bose et al., J Neurotrauma 30:1177-1191, 2013; Xiong et al., Nat Rev Neurosci 14:128-142, 2013; Xiong et al., Expert Opin Emerg Drugs 14:67-84, 2009; Johnson et al., Handb Clin Neurol 127:115-128, 2015; Bose et al., Brain neurotrauma: molecular, neuropsychological, and rehabilitation aspects, CRC Press/Taylor & Francis, Boca Raton, 2015)). Preclinical models of TBI, essential for the efficient study of TBI neurobiology, benefit from the setting of controlled injury and optimal opportunities for biometric quantitation of injury and treatment-induced changes in the trajectories of disability. Several preclinical models are currently used, and each offer opportunities for study of different aspects of TBI primary and secondary injuries (for review see (Morales et al., Neuroscience 136:971-989, 2005; Xiong et al., Nat Rev Neurosci 14:128-142, 2013; Xiong et al., Expert Opin Emerg Drugs 14:67-84, 2009; Johnson et al., Handb Clin Neurol 127:115-128, 2015; Dixon et al., J Neurotrauma 5:91-104, 1988)). The closed-head, impact-acceleration model of TBI designed by Marmarou et al., 1994 (J Neurosurg 80:291-300, 1994), when used to produce mild to moderate TBI, produces diffuse axonal injuries without significant additional focal injuries of the

  20. Closed-Head TBI Model of Multiple Morbidity.

    PubMed

    Thompson, Floyd J; Hou, Jiamei; Bose, Prodip K

    2016-01-01

    Successful therapy for TBI disabilities awaits refinement in the understanding of TBI neurobiology, quantitative measurement of treatment-induced incremental changes in recovery trajectories, and effective translation to human TBI using quantitative methods and protocols that were effective to monitor recovery in preclinical models. Details of the specific neurobiology that underlies these injuries and effective quantitation of treatment-induced changes are beginning to emerge utilizing a variety of preclinical and clinical models (for reviews see (Morales et al., Neuroscience 136:971-989, 2005; Fujimoto et al., Neurosci Biobehav Rev 28:365-378, 2004; Cernak, NeuroRx 2:410-422, 2005; Smith et al., J Neurotrauma 22:1485-1502, 2005; Bose et al., J Neurotrauma 30:1177-1191, 2013; Xiong et al., Nat Rev Neurosci 14:128-142, 2013; Xiong et al., Expert Opin Emerg Drugs 14:67-84, 2009; Johnson et al., Handb Clin Neurol 127:115-128, 2015; Bose et al., Brain neurotrauma: molecular, neuropsychological, and rehabilitation aspects, CRC Press/Taylor & Francis, Boca Raton, 2015)). Preclinical models of TBI, essential for the efficient study of TBI neurobiology, benefit from the setting of controlled injury and optimal opportunities for biometric quantitation of injury and treatment-induced changes in the trajectories of disability. Several preclinical models are currently used, and each offer opportunities for study of different aspects of TBI primary and secondary injuries (for review see (Morales et al., Neuroscience 136:971-989, 2005; Xiong et al., Nat Rev Neurosci 14:128-142, 2013; Xiong et al., Expert Opin Emerg Drugs 14:67-84, 2009; Johnson et al., Handb Clin Neurol 127:115-128, 2015; Dixon et al., J Neurotrauma 5:91-104, 1988)). The closed-head, impact-acceleration model of TBI designed by Marmarou et al., 1994 (J Neurosurg 80:291-300, 1994), when used to produce mild to moderate TBI, produces diffuse axonal injuries without significant additional focal injuries of the

  1. Osteonecrosis of the jaws and bisphosphonates. Report of three cases.

    PubMed

    Pastor-Zuazaga, Daniel; Garatea-Crelgo, Joaquín; Martino-Gorbea, Raúl; Etayo-Pérez, Amaya; Sebastián-López, Cristina

    2006-01-01

    Bisphosphonates are recently acquiring increasing relevance in the treatment of several diseases. In line with the increased use of these compounds, cases of mandibular osteonecrosis, and to a lesser extent, maxillary osteonecrosis, are being reported. This necrosis is difficult to treat in patients who usually have a previously limited quality of life. A surgical performance carried out by oral and maxillofacial surgeons, stomatologists and odontologists might lead to bone exposure. A treatment based on conservation and as harmless as possible seems to be the most advisable way of acting with these patients in order to minimize the incidence and treat the complications, once the lesions have been ascertained. We report three cases treated in our service of osteonecrosis of the jaws after exodontics. This side effect should be remembered before starting any surgical treatment in these patients.

  2. A kinematic model for 3-D head-free gaze-shifts

    PubMed Central

    Daemi, Mehdi; Crawford, J. Douglas

    2015-01-01

    Rotations of the line of sight are mainly implemented by coordinated motion of the eyes and head. Here, we propose a model for the kinematics of three-dimensional (3-D) head-unrestrained gaze-shifts. The model was designed to account for major principles in the known behavior, such as gaze accuracy, spatiotemporal coordination of saccades with vestibulo-ocular reflex (VOR), relative eye and head contributions, the non-commutativity of rotations, and Listing's and Fick constraints for the eyes and head, respectively. The internal design of the model was inspired by known and hypothesized elements of gaze control physiology. Inputs included retinocentric location of the visual target and internal representations of initial 3-D eye and head orientation, whereas outputs were 3-D displacements of eye relative to the head and head relative to shoulder. Internal transformations decomposed the 2-D gaze command into 3-D eye and head commands with the use of three coordinated circuits: (1) a saccade generator, (2) a head rotation generator, (3) a VOR predictor. Simulations illustrate that the model can implement: (1) the correct 3-D reference frame transformations to generate accurate gaze shifts (despite variability in other parameters), (2) the experimentally verified constraints on static eye and head orientations during fixation, and (3) the experimentally observed 3-D trajectories of eye and head motion during gaze-shifts. We then use this model to simulate how 2-D eye-head coordination strategies interact with 3-D constraints to influence 3-D orientations of the eye-in-space, and the implications of this for spatial vision. PMID:26113816

  3. Primary lymphoma of the mandible masquerading as bisphosphonate-related osteonecrosis of jaws.

    PubMed

    Zadik, Yehuda; Lehman, Hadas; Neuman, Tzahi; Benoliel, Rafael

    2012-10-01

    A 66-year-old osteoporotic woman suffered from long-term mental paresthesia (numbness), facial swelling, and a nonhealing extraction site. Fulfilling the three clinical diagnostic criteria for bisphosphonate-related osteonecrosis of the jaw (BRONJ; exposed bone for at least 8 weeks, current bisphosphonate [risedronate] treatment, and no history of head and neck radiation therapy), she was diagnosed and treated accordingly. Nevertheless, a later histopathologic examination revealed malignant lymphoproliferative infiltration of large and intermediate cells. Based on immunostaining and positron-emission tomography, she was diagnosed as having primary diffuse large B-cell lymphoma. This case demonstrates the limitation of the current diagnostic method of BRONJ. Thus, the clinician should be particularly cautious and aware of the differential diagnosis, including malignancy, especially when lesions are accompanied by (mental nerve) neuropathy and long-standing swelling/expansion, and even when plain radiography is not a contributing factor.

  4. [Bisphosphonate-associated osteonecrosis of the jaws in lung cancer patients].

    PubMed

    Neves, Inês; Morais, António; Magalhães, Adriana

    2013-01-01

    Osteonecrosis of the jaw (ONJ) can occur as a complication of bisphosphonate therapy. This condition has been described in cancer patients and its development has been associated with prolonged exposure to high doses of bisphosphonates. Bad dental hygiene, a history of prosthesis or dental extraction, chemotherapy, corticosteroids, and radiation therapy of the head and neck are risk factors reported. In the initial stages it may be asymptomatic, but the patient subsequently develops severe pain and progressive exposed bone. The authors describe three cases of ONJ in lung cancer patients after prolonged exposure to bisphosphonates and there were known risk factors. ONJ can seriously affect the quality of life of cancer patients. An early diagnosis may reduce or avoid the consequences of progressive bone lesion.

  5. Head and cervical spine posture in behaving rats: implications for modeling human conditions involving the head and cervical spine.

    PubMed

    Griffin, C; Choong, W Y; Teh, W; Buxton, A J; Bolton, P S

    2015-02-01

    The aim of this study was to define the temporal and spatial (postural) characteristics of the head and cervical vertebral column (spine) of behaving rats in order to better understand their suitability as a model to study human conditions involving the head and neck. Time spent in each of four behavioral postures was determined from video tape recordings of rats (n = 10) in the absence and presence of an intruder rat. Plain film radiographic examination of a subset of these rats (n = 5) in each of these postures allowed measurement of head and cervical vertebral column positions adopted by the rats. When single they were quadruped or crouched most (∼80%) of the time and bipedal either supported or free standing for only ∼10% of the time. The introduction of an intruder significantly (P < 0.0001) reduced the proportion of time rats spent quadruped (median, from 71% to 47%) and bipedal free standing (median, from 2.9% to 0.4%). The cervical spine was orientated (median, 25-75 percentile) near vertical (18.8°, 4.2°-30.9°) when quadruped, crouched (15.4°, 7.6°-69.3°) and bipedal supported (10.5°, 4.8°-22.6°) but tended to be less vertical oriented when bipedal free standing (25.9°, 7.7°-39.3°). The range of head positions relative to the cervical spine was largest when crouched (73.4°) and smallest when erect free standing (17.7°). This study indicates that, like humans, rats have near vertical orientated cervical vertebral columns but, in contrast to humans, they displace their head in space by movements at both the cervico-thoracic junction and the cranio-cervical regions.

  6. Bayesian model averaging for groundwater head prediction and uncertainty analysis using multimodel and multimethod

    NASA Astrophysics Data System (ADS)

    Li, Xiaobao; Tsai, Frank T.-C.

    2009-09-01

    This study introduces a Bayesian model averaging (BMA) method that incorporates multiple groundwater models and multiple hydraulic conductivity estimation methods to predict groundwater heads and evaluate prediction uncertainty. BMA is able to distinguish prediction uncertainty arising from individual models, between models, and between methods. Moreover, BMA is able to identify unfavorable models even though they may present small prediction uncertainty. Uncertainty propagation, from model parameter uncertainty to model prediction uncertainty, can also be studied through BMA. This study adopts a variance window to obtain reasonable BMA weights for the best models, which are usually exaggerated by Occam's window. Results from a synthetic case study show that BMA with the variance window can provide better head prediction than individual models, or at least can obtain better predictions close to the best model. The BMA was applied to predicting groundwater heads in the "1500-foot" sand of the Baton Rouge area in Louisiana. Head prediction uncertainty was assessed by the BMA prediction variance. BMA confirms that large head prediction uncertainty occurs at areas lacking head observations and hydraulic conductivity measurements. Further study in these areas is necessary to reduce head prediction uncertainty.

  7. Thrust and torque characteristics based on a new cutter-head load model

    NASA Astrophysics Data System (ADS)

    Liu, Jianqin; Ren, Jiabao; Guo, Wei

    2015-07-01

    Full face rock tunnel boring machine(TBM) has been widely used in hard rock tunnels, however, there are few published theory about cutter-head design, and the design criteria of cutter-head under complex geological is not clear yet. To deal with the complex relationship among geological parameters, cutter parameters, and operating parameters during tunneling processes, a cutter-head load model is established by using CSM(Colorado school of mines) prediction model. Force distribution on cutter-head under a certain geology is calculated with the new established load model, and result shows that inner cutters bear more force than outer cutters, combining with disc cutters abrasion; a general principle of disc cutters' layout design is proposed. Within the model, the relationship among rock uniaxial compressive strength(UCS), penetration and thrust on cutter-head are analyzed, and the results shows that with increasing penetration, cutter thrust increases, but the growth rate slows and higher penetration makes lower special energy(SE). Finally, a fitting mathematical model of ZT(ratio of cutter-head torque and thrust) and penetration is established, and verified by TB880E, which can be used to direct how to set thrust and torque on cutter-head. When penetration is small, the cutter-head thrust is the main limiting factor in tunneling; when the penetration is large, cutter-head torque is the major limiting factor in tunneling. Based on the new cutter-head load model, thrust and torque characteristics of TBM further are researched and a new way for cutter-head layout design and TBM tunneling operations is proposed.

  8. Aseptic osteonecrosis of the hip in the adult: current evidence on conservative treatment

    PubMed Central

    Klumpp, Raymond; Trevisan, Carlo

    2015-01-01

    Summary Treatment of Avascular Osteonecrosis (AVN) of the femoral head to prevent progression to an arthritic hip is a challenging subject. Many conservative treatment options have been proposed in the literature. Weight bearing restriction as a stand-alone therapy is insufficient in preventing disease progression but it may be useful when combined with pharmacological agents or surgery. Bisphosphonate treatment in AVN might be efficient in early stages of disease, however there are no clear recommendations on length of treatment and therapeutic dosage and, considered the limited evidence and potential side effects of treatment, it could be considered in a pre-collapse stage in selected cases. Current literature suggests that low molecular weight heparin could lower disease progression in idiopathic AVN with quality of evidence being very low. Also the evidence to support the use of statins or vasodilators in the treatment of osteonecrosis is very low and their use cannot be recommended. Extracorporeal shock wave therapy may improve pain and function in early stages of disease with a low evidence, but there doesn’t seem to be a significant change in time to the occurrence of femoral head collapse. Only one study has been conducted with pulsed electromagnetic fields therefore no recommendation can be given on clinical use of PEF in AVN. Evidence on hyperbaric oxygen therapy in the treatment of AVN is very limited and the high cost of treatment and the limited availability of structures that can provide the service poses other concerns about its feasibility. Based on current evidence, conservative treatment may be considered in early stages of asymptomatic AVN instead of observation only. PMID:27134631

  9. Effect of ANXA2 gene single nucleotide polymorphism (SNP) on the development of osteonecrosis in Indian sickle cell patient: a PCR-RFLP approach.

    PubMed

    Pandey, Sanjay; Ranjan, Ravi; Pandey, Sweta; Mishra, Rahasya Mani; Seth, Tulika; Saxena, Renu

    2012-07-01

    Osteonecrosis is a serious complication in sickle cell patients. The common sites of the necrosis are femoral head, head of the humerus and acetabulam. Annexin A2 (ANXA2) protein mainly functions in bone formation and bone resorption. Alteration of ANXA2 gene may affect the manifestations of osteonecrosis in the patients. PCR-RFLP is a common applicable technique for the detection of known mutation/polymorphisms. Here we are presenting application of the PCR-RFLP technique for determination of the ANXA2 gene single nucleotide polymorphism frequency and their clinical association among Indian sickle cell patients. Five known SNPs of ANXA2 gene (rs7170178, rs73435133, rs73418020, rs72746635 and rs73418025) were determined using the HpyCH4V, DdeI, HpyCH4III and Sau 961 restriction enzyme respectively. Restriction enzyme DdeI was common for rs73435133 and rs72746635 SNP. Only the rs7170178 SNP was detected among patient and control and the other four SNPs were absent in the studied groups. The frequency of ANXA2 gene rs7170178 SNP (A/G, G/G) was comparatively higher in sickle cell patients than controls and it was clinically associated with sickle cell osteonecrosis. The P value of heterozygotes (A/G) and homozygotes (G/G) genotypes were <0.001 and 0.001 respectively, which were highly significant. This study established the application of PCR-RFLP in detection of ANXA2 SNPs in sickle cell patients.

  10. Model of Head-Positioning Error Due to Rotational Vibration of Hard Disk Drives

    NASA Astrophysics Data System (ADS)

    Matsuda, Yasuhiro; Yamaguchi, Takashi; Saegusa, Shozo; Shimizu, Toshihiko; Hamaguchi, Tetsuya

    An analytical model of head-positioning error due to rotational vibration of a hard disk drive is proposed. The model takes into account the rotational vibration of the base plate caused by the reaction force of the head-positioning actuator, the relationship between the rotational vibration and head-track offset, and the sensitivity function of track-following feedback control. Error calculated by the model agrees well with measured error. It is thus concluded that this model can predict the data transfer performance of a disk drive in read mode.

  11. Correcting electrode modelling errors in EIT on realistic 3D head models.

    PubMed

    Jehl, Markus; Avery, James; Malone, Emma; Holder, David; Betcke, Timo

    2015-12-01

    Electrical impedance tomography (EIT) is a promising medical imaging technique which could aid differentiation of haemorrhagic from ischaemic stroke in an ambulance. One challenge in EIT is the ill-posed nature of the image reconstruction, i.e., that small measurement or modelling errors can result in large image artefacts. It is therefore important that reconstruction algorithms are improved with regard to stability to modelling errors. We identify that wrongly modelled electrode positions constitute one of the biggest sources of image artefacts in head EIT. Therefore, the use of the Fréchet derivative on the electrode boundaries in a realistic three-dimensional head model is investigated, in order to reconstruct electrode movements simultaneously to conductivity changes. We show a fast implementation and analyse the performance of electrode position reconstructions in time-difference and absolute imaging for simulated and experimental voltages. Reconstructing the electrode positions and conductivities simultaneously increased the image quality significantly in the presence of electrode movement.

  12. A Success Story: The Evaluation of Four Head Start Bilingual Multicultural Curriculum Models.

    ERIC Educational Resources Information Center

    Arenas, Soledad; Trujillo, Lorenzo A.

    An evaluation was made of four Head Start bilingual/ multicultural curriculum models to assess their effectiveness and impact on children, staff, and parents. Intended as a pre-post design (with 90 children at each of eight Head Start replication sites and with treatment and control groups stratified on the basis of Spanish or English language…

  13. Constructing three-dimensional detachable and composable computer models of the head and neck.

    PubMed

    Fan, Min; Dai, Peishan; Zheng, Buhong; Li, Xinchun

    2015-06-01

    The head and neck region has a complex spatial and topological structure, three-dimensional (3D) computer model of the region can be used in anatomical education, radiotherapy planning and surgical training. However, most of the current models only consist of a few parts of the head and neck, and the 3D models are not detachable and composable. In this study, a high-resolution 3D detachable and composable model of the head and neck was constructed based on computed tomography (CT) serial images. First, fine CT serial images of the head and neck were obtained. Then, a color lookup table was created for 58 structures, which was used to create anatomical atlases of the head and neck. Then, surface and volume rendering methods were used to reconstruct 3D models of the head and neck. Smoothing and polygon reduction steps were added to improve 3D rendering effects. 3D computer models of the head and neck, including the sinus, pharynx, vasculature, nervous system, endocrine system and glands, muscles, bones and skin, were reconstructed. The models consisted of 58 anatomical detachable and composable structures and each structure can be displayed individually or together with other structures.

  14. Bone end sclerosis in renal osteodystrophy simulating osteonecrosis

    SciTech Connect

    Van Lewis, L.; Keats, T.E.

    1982-08-01

    Osteosclerosis of the bone ends is an unusual manifestation of renal osteodystrophy. In evaluating this finding one should be careful to exclude clinical and radiographic evidence for osteonecrosis. In the two known cases of this entity, bone end sclerosis has been found to develop over one to two years with symmetrical involvement of multiple bones.

  15. Head out of water immersion: A simulation model of microgravity?

    NASA Astrophysics Data System (ADS)

    Verheyden, B.; Beckers, F.; Aubert, Ae.

    Introduction. It is well known that during weightlessness a redistribution of body fluids occurs towards the upper parts of the body causing altered cardiovascular reflex activities. During head out of water immersion (HOI), the hydrostatic pressure on the soft tissues of the lower limbs causes thoracic blood volume to increase, comparably with the observed haemodynamics during weightlessness. The purpose of this study was to evaluate HOI as a simulation model of microgravity concerning the cardiovascular autonomic control system. Methods. Heartbeat and continuous blood pressure (fingerplethysmography) were measured in 18 (age=22.2± 10.3yr) healthy subjects in different conditions: Supine, sitting and standing in air (25C); upright submersion in thermo neutral water (34C) up to the shoulders (HOI). After 5 minutes of accommodation to the position and condition, recordings were made for 10 minutes. Time domain parameters (MeanRR, SD, rMSSD and pNN50) as well as frequency domain parameters (Total Power, high frequency (HF), low frequency (LF)) of HRV and BPV were calculated. An index of baroreflex sensitivity was determined by the sequence method. Results from the HOI experiment were compared to results obtained from microgravity phases in parabolic flights in 5 subjects. Results. Cardiac autonomic control during HOI was characterized by a gain in vagal predominance as shown by a decrease of the LF/HF-ratio from 950 ± 130 ms2 during standing control towards 389 ± 119 ms2 during HOI and a increase of BRS by approximately 20%. As a result, heart rate decreased by approximately 28% during HOI. The same evolution was shown during the transition from a standing control position towards 0G obtained during parabolic flights. LF power of BPV, as a marker of peripheral vasomotor sympathetic activity, decreased significantly both in absolute values and normalized units during HOI compared to standing and seated control (p < 0.05). In contrast, an increase in LF power of BPV

  16. Multiregion bicentric-spheres models of the head for the simulation of bioelectric phenomena.

    PubMed

    Vatta, Federica; Bruno, Paolo; Inchingolo, Paolo

    2005-03-01

    Equations are derived for the electric potentials [electroencephalogram (EEG)] produced by dipolar sources in a multiregion bicentric-spheres volume-conductor head model. Being the equations valid for an arbitrary number of regions, our proposal is a generalization of many spherical models presented so far in literature, each of those regarded as a particular case of our multiregion model. Moreover, our approach allows considering new features of the head volume-conductor to better approximate electrical properties of the real head. PMID:15759568

  17. Development/global validation of a 6-month-old pediatric head finite element model and application in investigation of drop-induced infant head injury.

    PubMed

    Li, Zhigang; Luo, Xiao; Zhang, Jinhuan

    2013-12-01

    Drop is a frequent cause for infant head injury. To date, finite element (FE) modeling was gradually used to investigate child head dynamic response under drop impact conditions, however, two shortages still exist on this topic: (1) due to ethical reasons, none of developed 6-month-old (6MO) head FE model was found to be quantitatively validated against child cadaver tests at similar age group; (2) drop height and impact surface stiffness effects on infant head responses were not comprehensively investigated. In this study, motivated by the recently published material properties of soft tissues (skull and suture, etc.) and reported pediatric head global cadaver tests, a 6MO child head FE model was developed and simulated results compared with the child cadaver experimental data under compression and drop conditions. Comparison of results indicated that the FE model showed a fairly good biofidelic behavior in most dynamic responses. The validated FE model was further used to investigate effects of different drop heights and impact surface stiffness on the head dynamic responses. Numerical results show that the pediatric head mechanical parameters (peak acceleration, HIC, maximal vonMises stress and maximal first principal strain of skull) keep increasing with the increase in drop height, and exhibit "logarithmic function" shapes at "fast-slow" trends with increase in impact surface stiffness. Based on above analysis, the regressions were conducted to describe the relationship between drop height and impact surface stiffness and head global injury predictors (head peak acceleration, HIC, etc.). This paper provides a fundamental study of child head injury mechanism and protection under drop conditions. PMID:24008251

  18. Development, Validation and Parametric study of a 3-Year-Old Child Head Finite Element Model

    NASA Astrophysics Data System (ADS)

    Cui, Shihai; Chen, Yue; Li, Haiyan; Ruan, ShiJie

    2015-12-01

    Traumatic brain injury caused by drop and traffic accidents is an important reason for children's death and disability. Recently, the computer finite element (FE) head model has been developed to investigate brain injury mechanism and biomechanical responses. Based on CT data of a healthy 3-year-old child head, the FE head model with detailed anatomical structure was developed. The deep brain structures such as white matter, gray matter, cerebral ventricle, hippocampus, were firstly created in this FE model. The FE model was validated by comparing the simulation results with that of cadaver experiments based on reconstructing the child and adult cadaver experiments. In addition, the effects of skull stiffness on the child head dynamic responses were further investigated. All the simulation results confirmed the good biofidelity of the FE model.

  19. Aseptic necrosis of the femoral head after pregnancy: a case report

    PubMed Central

    Nassar, Kawtar; Rachidi, Wafae; Janani, Saadia; Mkinsi, Ouafa

    2016-01-01

    A documented case of beginning aseptic necrosis of the femoral head associated with pregnancy together with a review of the literature about this rare complication of pregnancy is presented. The known risk factors of osteonecrosis are; steroid use, alcoholism, organ transplantation, especially after kidney transplant or bone marrow transplantation bone, systemic lupus erythematosus, dyslipidemia especially hypertriglyceridemia, dysbaric decompression sickness, drepanocytosis and Gaucher's disease. Among the less established factors, we mention procoagulations abnormalities, HIV infection, chemotherapy. We report a case of osteonecrosis of femoral head after pregnancy. PMID:27795792

  20. Influence of head mass on temporo-parietal skull impact using finite element modeling.

    PubMed

    Sahoo, Debasis; Deck, Caroline; Yoganandan, Narayan; Willinger, Rémy

    2015-09-01

    The effect of head mass on its biomechanical response during lateral impact to the head is investigated in this computational study. The mass of the head of a state-of-the-art validated finite element head model is altered by ± 10 % from the base value of 4.7 kg. Numerical simulations of lateral head impacts for 30 cases (representing 15 human cadaver experiments × 2 mass configurations) are performed using the LS-DYNA solver at different velocities ranging from 2.4 to 6.5 m/s and three impacting conditions representing different stiffness and shapes of the contact/impact surfaces. Results are compared with the original model using the baseline head mass, thus resulting in a total of 45 simulations. Present findings show that the head mass has greater influence for peak interaction forces and the force has a greater dependency on stiffness of contact surface than the shape. Mass variations have also influence on skull strain energy. Regardless of increase/decrease in skull strain energy influenced by head mass variations used in the computational study, the 50 % fracture tolerance limit was unaltered, which was 544 mJ. The present study gives a better understanding of the mechanism of temporo-parietal skull impact.

  1. Tackling modelling error in the application of electrical impedance tomography to the head.

    PubMed

    Ouypornkochagorn, Taweechai; McCann, Hugh; Polydorides, Nick

    2015-08-01

    In the head application of Electrical Impedance Tomography (EIT), reconstruction of voltage measurements for a conductivity distribution image using an ordinary method, the absolute imaging approach, is impossible due to the traditional ignorance of modelling error. The modelling error comes from the inaccuracy of geometry and structure, which are unable to be known accurately in practice, and are usually large in head application of EIT. Difference imaging is an alternative approach which is able to reduce the size of this error, but it introduces other kinds of error. In this work, we demonstrate that in situations like head EIT, the nonlinear difference imaging approach can reconstruct difference conductivity effectively: the reduced modelling error and the new errors arising are able to be ignored, because they are much smaller than the original modelling error. The magnitude of conductivity change in the head-like situation is also investigated, and a selection scheme for the initial guess in the reconstruction process is also proposed.

  2. Realistic avatar eye and head animation using a neurobiological model of visual attention

    NASA Astrophysics Data System (ADS)

    Itti, Laurent; Dhavale, Nitin; Pighin, Frederic

    2004-01-01

    We describe a neurobiological model of visual attention and eye/head movements in primates, and its application to the automatic animation of a realistic virtual human head watching an unconstrained variety of visual inputs. The bottom-up (image-based) attention model is based on the known neurophysiology of visual processing along the occipito-parietal pathway of the primate brain, while the eye/head movement model is derived from recordings in freely behaving Rhesus monkeys. The system is successful at autonomously saccading towards and tracking salient targets in a variety of video clips, including synthetic stimuli, real outdoors scenes and gaming console outputs. The resulting virtual human eye/head animation yields realistic rendering of the simulation results, both suggesting applicability of this approach to avatar animation and reinforcing the plausibility of the neural model.

  3. A Head in Virtual Reality: Development of A Dynamic Head and Neck Model

    ERIC Educational Resources Information Center

    Nguyen, Ngan; Wilson, Timothy D.

    2009-01-01

    Advances in computer and interface technologies have made it possible to create three-dimensional (3D) computerized models of anatomical structures for visualization, manipulation, and interaction in a virtual 3D environment. In the past few decades, a multitude of digital models have been developed to facilitate complex spatial learning of the…

  4. Principle Study of Head Meridian Acupoint Massage to Stress Release via Grey Data Model Analysis

    PubMed Central

    Lee, Ya-Ting

    2016-01-01

    This paper presents the scientific study of the effectiveness and action principle of head meridian acupoint massage by applying the grey data model analysis approach. First, the head massage procedure for massaging the important head meridian acupuncture points including Taiyang, Fengfu, Tianzhu, Fengqi, and Jianjing is formulated in a standard manner. Second, the status of the autonomic nervous system of each subject is evaluated by using the heart rate variability analyzer before and after the head massage following four weeks. Afterward, the physiological factors of autonomic nerves are quantitatively analyzed by using the grey data modeling theory. The grey data analysis can point out that the status of autonomic nervous system is greatly improved after the massage. The order change of the grey relationship weighting of physiological factors shows the action principle of the sympathetic and parasympathetic nerves when performing head massage. In other words, the grey data model is able to distinguish the detailed interaction of the autonomic nervous system and the head meridian acupoint massage. Thus, the stress relaxing effect of massaging head meridian acupoints is proved, which is lacked in literature. The results can be a reference principle for massage health care in practice. PMID:26904144

  5. Principle Study of Head Meridian Acupoint Massage to Stress Release via Grey Data Model Analysis.

    PubMed

    Lee, Ya-Ting

    2016-01-01

    This paper presents the scientific study of the effectiveness and action principle of head meridian acupoint massage by applying the grey data model analysis approach. First, the head massage procedure for massaging the important head meridian acupuncture points including Taiyang, Fengfu, Tianzhu, Fengqi, and Jianjing is formulated in a standard manner. Second, the status of the autonomic nervous system of each subject is evaluated by using the heart rate variability analyzer before and after the head massage following four weeks. Afterward, the physiological factors of autonomic nerves are quantitatively analyzed by using the grey data modeling theory. The grey data analysis can point out that the status of autonomic nervous system is greatly improved after the massage. The order change of the grey relationship weighting of physiological factors shows the action principle of the sympathetic and parasympathetic nerves when performing head massage. In other words, the grey data model is able to distinguish the detailed interaction of the autonomic nervous system and the head meridian acupoint massage. Thus, the stress relaxing effect of massaging head meridian acupoints is proved, which is lacked in literature. The results can be a reference principle for massage health care in practice. PMID:26904144

  6. Augmented saliency model using automatic 3D head pose detection and learned gaze following in natural scenes.

    PubMed

    Parks, Daniel; Borji, Ali; Itti, Laurent

    2015-11-01

    Previous studies have shown that gaze direction of actors in a scene influences eye movements of passive observers during free-viewing (Castelhano, Wieth, & Henderson, 2007; Borji, Parks, & Itti, 2014). However, no computational model has been proposed to combine bottom-up saliency with actor's head pose and gaze direction for predicting where observers look. Here, we first learn probability maps that predict fixations leaving head regions (gaze following fixations), as well as fixations on head regions (head fixations), both dependent on the actor's head size and pose angle. We then learn a combination of gaze following, head region, and bottom-up saliency maps with a Markov chain composed of head region and non-head region states. This simple structure allows us to inspect the model and make comments about the nature of eye movements originating from heads as opposed to other regions. Here, we assume perfect knowledge of actor head pose direction (from an oracle). The combined model, which we call the Dynamic Weighting of Cues model (DWOC), explains observers' fixations significantly better than each of the constituent components. Finally, in a fully automatic combined model, we replace the oracle head pose direction data with detections from a computer vision model of head pose. Using these (imperfect) automated detections, we again find that the combined model significantly outperforms its individual components. Our work extends the engineering and scientific applications of saliency models and helps better understand mechanisms of visual attention.

  7. [Toxic phosphorous osteonecrosis of facial bones among drug addicts to desomorphine and pervitin. Part II].

    PubMed

    Basin, E M; Medvedev, Yu A

    2015-01-01

    Article describes literature review of "atypical" osteomyelitis--osteonecrosis of facial bones among addicts to synthetic narcotics desomorphine and pervitin, different comorbidities, treatment strategy and prognosis were outlined

  8. Experimental development of bisphosphonate-related osteonecrosis of the jaws in rodents

    PubMed Central

    Conte Neto, Nicolau; Spolidorio, Luis C; Andrade, Cleverton R; S Bastos, Alliny; Guimarães, Morgana; Marcantonio, Elcio

    2013-01-01

    Osteonecrosis of the jaw (ONJ) following the use of bisphosphonates has become of increased interest in the scientific community, due in particular to its as-yet-unsolved pathogenesis. An experimental model of ONJ was induced in normal male rats [alendronate (ALN); 1 mg/Kg/day; n = 10] and matched controls (saline solution; n = 10). After 60 days of drug treatment, all animals were subjected to extractions of the left first lower molars and were euthanized at 3 and 28 days postsurgery. The following analyses were performed: (i) descriptive and quantitative (scores) histological evaluation, (ii) stereometry of distal sockets and (iii) biochemical measurement of C-telopeptide cross-linked collagen type I (CTX) and bone-specific alkaline phosphatase (BALP). The results showed that 28 days postsurgery the animals treated with ALN had areas of exposed and necrotic bone, associated with significant infection, especially in the interalveolar septum area and crestal regions, compared with controls. The levels of CTX, BALP and bone volume, as well as the degrees of inflammation and vascularization, were significantly reduced in these animals. Therefore, analysis of the data presented suggests that ALN therapy is associated with the development of osteonecrosis in the jaws of rodents after tooth extraction. PMID:23317355

  9. Electromagnetic fields inside a lossy, multilayered spherical head phantom excited by MRI coils: models and methods.

    PubMed

    Liu, Feng; Crozier, Stuart

    2004-05-21

    The precise evaluation of electromagnetic field (EMF) distributions inside biological samples is becoming an increasingly important design requirement for high field MRI systems. In evaluating the induced fields caused by magnetic field gradients and RF transmitter coils, a multilayered dielectric spherical head model is proposed to provide a better understanding of electromagnetic interactions when compared to a traditional homogeneous head phantom. This paper presents Debye potential (DP) and Dyadic Green's function (DGF)-based solutions of the EMFs inside a head-sized, stratified sphere with similar radial conductivity and permittivity profiles as a human head. The DP approach is formulated for the symmetric case in which the source is a circular loop carrying a harmonic-formed current over a wide frequency range. The DGF method is developed for generic cases in which the source may be any kind of RF coil whose current distribution can be evaluated using the method of moments. The calculated EMFs can then be used to deduce MRI imaging parameters. The proposed methods, while not representing the full complexity of a head model, offer advantages in rapid prototyping as the computation times are much lower than a full finite difference time domain calculation using a complex head model. Test examples demonstrate the capability of the proposed models/methods. It is anticipated that this model will be of particular value for high field MRI applications, especially the rapid evaluation of RF resonator (surface and volume coils) and high performance gradient set designs.

  10. Biomechanical studies in an ovine model of non-accidental head injury.

    PubMed

    Anderson, R W G; Sandoz, B; Dutschke, J K; Finnie, J W; Turner, R J; Blumbergs, P C; Manavis, J; Vink, R

    2014-08-22

    This paper presents the head kinematics of a novel ovine model of non-accidental head injury (NAHI) that consists only of a naturalistic oscillating insult. Nine, 7-to-10-day-old anesthetized and ventilated lambs were subjected to manual shaking. Two six-axis motion sensors tracked the position of the head and torso, and a triaxial accelerometer measured head acceleration. Animals experienced 10 episodes of shaking over 30 min, and then remained under anesthesia for 6h until killed by perfusion fixation of the brain. Each shaking episode lasted for 20s resulting in about 40 cycles per episode. Each cycle typically consisted of three impulsive events that corresponded to specific phases of the head's motion; the most substantial of these were interactions typically with the lamb's own torso, and these generated accelerations of 30-70 g. Impulsive loading was not considered severe. Other kinematic parameters recorded included estimates of head power transfer, head-torso flexion, and rate of flexion. Several styles of shaking were also identified across episodes and subjects. Axonal injury, neuronal reaction and albumin extravasation were widely distributed in the hemispheric white matter, brainstem and at the craniocervical junction and to a much greater magnitude in lower body weight lambs that died. This is the first biomechanical description of a large animal model of NAHI in which repetitive naturalistic insults were applied, and that reproduced a spectrum of injury associated with NAHI. PMID:24974335

  11. [Developing a finite element model of human head with true anatomic structure mandible].

    PubMed

    Ma, Chunsheng; Zhang, Haizhong; Du, Huiliang; Huang, Shilin; Zhang, Jinhuan

    2005-02-01

    A finite element model of human mandible is developed from CT scan images by the technologies of three-dimensional reconstruction, image processing and meshing. The mandible model is connected to one modified head model of Hybrid III dummy with joint according to the anatomic structure and mechanical characteristics of the temporomandibular joint. Then a finite element model of the human head with the true anatomic structure mandible is developed. This model has been validated with the cadaver test results. It can be used in researches on the mechanism of craniofacial blunt-impact injury and on the assessment of injury severity. PMID:15762115

  12. Development of head injury assessment reference values based on NASA injury modeling.

    PubMed

    Somers, Jeffrey T; Granderson, Bradley; Melvin, John W; Tabiei, Ala; Lawrence, Charles; Feiveson, Alan; Gernhardt, Michael; Ploutz-Snyder, Robert; Patalak, John

    2011-11-01

    NASA is developing a new crewed vehicle and desires a lower risk of injury compared to automotive or commercial aviation. Through an agreement with the National Association of Stock Car Auto Racing, Inc. (NASCAR®), an analysis of NASCAR impacts was performed to develop new injury assessment reference values (IARV) that may be more relevant to NASA's context of vehicle landing operations. Head IARVs associated with race car impacts were investigated by analyzing all NASCAR recorded impact data for the 2002-2008 race seasons. From the 4015 impact files, 274 impacts were selected for numerical simulation using a custom NASCAR restraint system and Hybrid III 50th percentile male Finite Element Model (FEM) in LS-DYNA. Head injury occurred in 27 of the 274 selected impacts, and all of the head injuries were mild concussions with or without brief loss of consciousness. The 247 noninjury impacts selected were representative of the range of crash dynamics present in the total set of impacts. The probability of head injury was estimated for each metric using an ordered probit regression analysis. Four metrics had good correlation with the head injury data: head resultant acceleration, head change in velocity, HIC 15, and HIC 36. For a 5% risk of AIS≥1/AIS≥2 head injuries, the following IARVs were found: 121.3/133.2 G (head resultant acceleration), 20.3/22.0 m/s (head change in velocity), 1,156/1,347 (HIC 15), and 1,152/1,342 (HIC 36) respectively. Based on the results of this study, further analysis of additional datasets is recommended before applying these results to future NASA vehicles.

  13. Development of head injury assessment reference values based on NASA injury modeling.

    PubMed

    Somers, Jeffrey T; Granderson, Bradley; Melvin, John W; Tabiei, Ala; Lawrence, Charles; Feiveson, Alan; Gernhardt, Michael; Ploutz-Snyder, Robert; Patalak, John

    2011-11-01

    NASA is developing a new crewed vehicle and desires a lower risk of injury compared to automotive or commercial aviation. Through an agreement with the National Association of Stock Car Auto Racing, Inc. (NASCAR®), an analysis of NASCAR impacts was performed to develop new injury assessment reference values (IARV) that may be more relevant to NASA's context of vehicle landing operations. Head IARVs associated with race car impacts were investigated by analyzing all NASCAR recorded impact data for the 2002-2008 race seasons. From the 4015 impact files, 274 impacts were selected for numerical simulation using a custom NASCAR restraint system and Hybrid III 50th percentile male Finite Element Model (FEM) in LS-DYNA. Head injury occurred in 27 of the 274 selected impacts, and all of the head injuries were mild concussions with or without brief loss of consciousness. The 247 noninjury impacts selected were representative of the range of crash dynamics present in the total set of impacts. The probability of head injury was estimated for each metric using an ordered probit regression analysis. Four metrics had good correlation with the head injury data: head resultant acceleration, head change in velocity, HIC 15, and HIC 36. For a 5% risk of AIS≥1/AIS≥2 head injuries, the following IARVs were found: 121.3/133.2 G (head resultant acceleration), 20.3/22.0 m/s (head change in velocity), 1,156/1,347 (HIC 15), and 1,152/1,342 (HIC 36) respectively. Based on the results of this study, further analysis of additional datasets is recommended before applying these results to future NASA vehicles. PMID:22869304

  14. Double-stranded DNA organization in bacteriophage heads: An alternative toroid-based model

    SciTech Connect

    Hud, N.V.

    1995-10-01

    Studies of the organization of double-stranded DNA within bacteriophage heads during the past four decades have produced a wealth of data. However, despite the presentation of numerous models, the true organization of DNA within phage heads remains unresolved. The observations of toroidal DNA structures in electron micrographs of phage lysates have long been cited as support for the organization of DNA in a spool-like fashion. This particular model, like all other models, has not been found to be consistent with all available data. Recently, the authors proposed that DNA within toroidal condensates produced in vitro is organized in a manner significantly different from that suggested by the spool model. This new toroid model has allowed the development of an alternative model for DNA organization within bacteriophage heads that is consistent with a wide range of biophysical data. Here the authors propose that bacteriophage DNA is packaged in a toroid that is folded into a highly compact structure.

  15. Finite-element models of the human head and their applications in forensic practice.

    PubMed

    Raul, Jean-Sébastien; Deck, Caroline; Willinger, Rémy; Ludes, Bertrand

    2008-09-01

    Since the 1960s, predictive human head impact indices have been developed to help the investigation of causation of human head injury. Finite-element models (FEM) can provide interesting tools for the forensic scientists when various human head injury mechanisms need to be evaluated. Human head FEMs are mainly used for car crash evaluations and are not in common use in forensic science. Recent technological progress has resulted in creating more simple tools, which will certainly help to consider the use of FEM in routine forensic practice in the coming years. This paper reviews the main FEMs developed and focuses on the models which can be used as predictive tools. Their possible applications in forensic medicine are discussed.

  16. Experimental Test of Spatial Updating Models for Monkey Eye-Head Gaze Shifts

    PubMed Central

    Van Grootel, Tom J.; Van der Willigen, Robert F.; Van Opstal, A. John

    2012-01-01

    How the brain maintains an accurate and stable representation of visual target locations despite the occurrence of saccadic gaze shifts is a classical problem in oculomotor research. Here we test and dissociate the predictions of different conceptual models for head-unrestrained gaze-localization behavior of macaque monkeys. We adopted the double-step paradigm with rapid eye-head gaze shifts to measure localization accuracy in response to flashed visual stimuli in darkness. We presented the second target flash either before (static), or during (dynamic) the first gaze displacement. In the dynamic case the brief visual flash induced a small retinal streak of up to about 20 deg at an unpredictable moment and retinal location during the eye-head gaze shift, which provides serious challenges for the gaze-control system. However, for both stimulus conditions, monkeys localized the flashed targets with accurate gaze shifts, which rules out several models of visuomotor control. First, these findings exclude the possibility that gaze-shift programming relies on retinal inputs only. Instead, they support the notion that accurate eye-head motor feedback updates the gaze-saccade coordinates. Second, in dynamic trials the visuomotor system cannot rely on the coordinates of the planned first eye-head saccade either, which rules out remapping on the basis of a predictive corollary gaze-displacement signal. Finally, because gaze-related head movements were also goal-directed, requiring continuous access to eye-in-head position, we propose that our results best support a dynamic feedback scheme for spatial updating in which visuomotor control incorporates accurate signals about instantaneous eye- and head positions rather than relative eye- and head displacements. PMID:23118883

  17. Skull Defects in Finite Element Head Models for Source Reconstruction from Magnetoencephalography Signals.

    PubMed

    Lau, Stephan; Güllmar, Daniel; Flemming, Lars; Grayden, David B; Cook, Mark J; Wolters, Carsten H; Haueisen, Jens

    2016-01-01

    Magnetoencephalography (MEG) signals are influenced by skull defects. However, there is a lack of evidence of this influence during source reconstruction. Our objectives are to characterize errors in source reconstruction from MEG signals due to ignoring skull defects and to assess the ability of an exact finite element head model to eliminate such errors. A detailed finite element model of the head of a rabbit used in a physical experiment was constructed from magnetic resonance and co-registered computer tomography imaging that differentiated nine tissue types. Sources of the MEG measurements above intact skull and above skull defects respectively were reconstructed using a finite element model with the intact skull and one incorporating the skull defects. The forward simulation of the MEG signals reproduced the experimentally observed characteristic magnitude and topography changes due to skull defects. Sources reconstructed from measured MEG signals above intact skull matched the known physical locations and orientations. Ignoring skull defects in the head model during reconstruction displaced sources under a skull defect away from that defect. Sources next to a defect were reoriented. When skull defects, with their physical conductivity, were incorporated in the head model, the location and orientation errors were mostly eliminated. The conductivity of the skull defect material non-uniformly modulated the influence on MEG signals. We propose concrete guidelines for taking into account conducting skull defects during MEG coil placement and modeling. Exact finite element head models can improve localization of brain function, specifically after surgery. PMID:27092044

  18. Skull Defects in Finite Element Head Models for Source Reconstruction from Magnetoencephalography Signals

    PubMed Central

    Lau, Stephan; Güllmar, Daniel; Flemming, Lars; Grayden, David B.; Cook, Mark J.; Wolters, Carsten H.; Haueisen, Jens

    2016-01-01

    Magnetoencephalography (MEG) signals are influenced by skull defects. However, there is a lack of evidence of this influence during source reconstruction. Our objectives are to characterize errors in source reconstruction from MEG signals due to ignoring skull defects and to assess the ability of an exact finite element head model to eliminate such errors. A detailed finite element model of the head of a rabbit used in a physical experiment was constructed from magnetic resonance and co-registered computer tomography imaging that differentiated nine tissue types. Sources of the MEG measurements above intact skull and above skull defects respectively were reconstructed using a finite element model with the intact skull and one incorporating the skull defects. The forward simulation of the MEG signals reproduced the experimentally observed characteristic magnitude and topography changes due to skull defects. Sources reconstructed from measured MEG signals above intact skull matched the known physical locations and orientations. Ignoring skull defects in the head model during reconstruction displaced sources under a skull defect away from that defect. Sources next to a defect were reoriented. When skull defects, with their physical conductivity, were incorporated in the head model, the location and orientation errors were mostly eliminated. The conductivity of the skull defect material non-uniformly modulated the influence on MEG signals. We propose concrete guidelines for taking into account conducting skull defects during MEG coil placement and modeling. Exact finite element head models can improve localization of brain function, specifically after surgery. PMID:27092044

  19. The relationship of denosumab pharmacology and osteonecrosis of the jaws.

    PubMed

    Malan, John; Ettinger, Kyle; Naumann, Erich; Beirne, O Ross

    2012-12-01

    Denosumab is a new bone antiresorptive agent that has received approval by the Food and Drug Administration for use in patients with osteoporosis and metastatic cancer to the bones. Like the bisphosponates that are used as antiresorptive medications, denosumab has been associated with osteonecrosis of the jaws (ONJ). However, because the pharmacodynamics and pharmacokinetics of denosumab differ from that of the bisphosphonates, ONJ related to denosumab may resolve more rapidly with a drug holiday than bisphosphonate-related osteonecrosis of the jaws (BRONJ). This paper describes the management of a patient who developed ONJ while receiving denosumab, reviews the incidence of ONJ associated with denosumab, and compares the pharmacology of denosumab and the bisphosphonates. Because the effects of denosumab on bone turnover are more rapidly reversible than the effects of the bisphosphonates, ONJ related to denosumab may resolve more quickly with a drug holiday than BRONJ. PMID:23159111

  20. Sunitinib related osteonecrosis of jaw: a case report.

    PubMed

    Fleissig, Yoram; Regev, Eran; Lehman, Hadas

    2012-03-01

    A 58-year-old woman presented to the Oral and Maxillofacial Surgery Clinic experiencing severe limited mouth opening and exposed bone in the socket of the right mandibular third molar 8 months following the extraction of the tooth. The patient had been treated during the year before her presentation with sunitinib, an antiangiogenic drug, for renal cell carcinoma. The clinical, radiographic, and histologic picture of a chronic nonhealing extraction socket was consistent with osteonecrosis of the jaw (ONJ), although she had never been treated with bisphosphonates or corticosteroids. The treatment with sunitinib was discontinued and the patient was treated with antibiotics and physiotherapy for 12 weeks with complete recovery. Sunitinib may cause osteonecrosis of the jaw after oral surgical interventions with no previous exposure to bisphosphonates. The pathogenesis may be related to its antiangiogenic mechanism and impaired wound healing. Full recovery may require long-term cessation of the insulting drug combined with prolonged antibiotic treatment. PMID:22676833

  1. Medication-related osteonecrosis of the jaw: a dentist's nightmare.

    PubMed

    Muthukrishnan, Arvind; Bijai Kumar, Laliytha; Ramalingam, Gomathi

    2016-01-01

    Medication-related osteonecrosis of the jaw (MRONJ) is a complication in patients who are on anti-bone resorptive drugs. These drugs are prescribed for patients with multiple myeloma, osteoporosis, metastatic carcinoma and Paget's disease. Common anti-bone resorptive drugs such as bisphosphonate and monoclonal antibodies such as denosumab are prescribed for these patients to prevent bone resorption. Although very effective in preventing bone resorption, a complication arising from these groups of drugs is the development of osteomyelitis of the jaw. This medication-related osteonecrosis occurs only in the jaw bones. It could mimic a metastatic jaw tumour when a patient reports to the dental surgeon with pain and swelling in the jaw. This case report describes MRONJ in a 50-year-old Indian woman. This possible painful drug-induced complication of jaw bones can be prevented if proper medical history is taken and management protocol is followed in these patients. PMID:27053542

  2. Bisphosphonate osteonecrosis of the jaw: a historical and contemporary review.

    PubMed

    McLeod, Niall M H; Brennan, Peter A; Ruggiero, Salvatore L

    2012-02-01

    The use of bisphosphonate drugs has been popularised in the late 20th century for the management of many conditions associated with abnormalities of bone turnover, particularly metastatic and haematogenous malignancy and osteopenia. The increase in indications for the use of bisphosphonates was supported by what was thought to be a very good safety profile. However in 2003 cases of osteonecrosis related to the use of bisphosphonates were first described. The pathogenesis, and with this the explanation of why it only appears to affect the maxillofacial skeleton, and the best way of managing this problem remains unknown. In this review we examine the process of identification of this pathology and the development of guidelines from medical societies and professional bodies on the management of patients before commencing bisphosphonate therapy, requiring dental treatment whilst on therapy, or with a diagnosis of bisphosphonate associated osteonecrosis of the jaws.

  3. Mental Models: Knowledge in the Head and Knowledge in the World.

    ERIC Educational Resources Information Center

    Jonassen, David H.; Henning, Philip

    1999-01-01

    Explores the utility of mental models as learning outcomes in using complex and situated learning environments. Describes two studies: one aimed at eliciting mental models in the heads of novice refrigeration technicians, and the other an ethnographic study eliciting knowledge and models within the community of experienced refrigeration…

  4. Immunocompromised and immunocompetent mouse models for head and neck squamous cell carcinoma

    PubMed Central

    Lei, Zhen-ge; Ren, Xiao-hua; Wang, Sha-sha; Liang, Xin-hua; Tang, Ya-ling

    2016-01-01

    Mouse models can closely mimic human oral squamous epithelial carcinogenesis, greatly expand the in vivo research possibilities, and play a critical role in the development of diagnosis, monitoring, and treatment of head and neck squamous cell carcinoma. With the development of the recent research on the contribution of immunity/inflammation to cancer initiation and progression, mouse models have been divided into two categories, namely, immunocompromised and immunocompetent mouse models. And thus, this paper will review these two kinds of models applied in head and neck squamous cell carcinoma to provide a platform to understand the complicated histological, molecular, and genetic changes of oral squamous epithelial tumorigenesis. PMID:26869799

  5. Parametric comparisons of intracranial mechanical responses from three validated finite element models of the human head.

    PubMed

    Ji, Songbai; Ghadyani, Hamidreza; Bolander, Richard P; Beckwith, Jonathan G; Ford, James C; McAllister, Thomas W; Flashman, Laura A; Paulsen, Keith D; Ernstrom, Karin; Jain, Sonia; Raman, Rema; Zhang, Liying; Greenwald, Richard M

    2014-01-01

    A number of human head finite element (FE) models have been developed from different research groups over the years to study the mechanisms of traumatic brain injury. These models can vary substantially in model features and parameters, making it important to evaluate whether simulation results from one model are readily comparable with another, and whether response-based injury thresholds established from a specific model can be generalized when a different model is employed. The purpose of this study is to parametrically compare regional brain mechanical responses from three validated head FE models to test the hypothesis that regional brain responses are dependent on the specific head model employed as well as the region of interest (ROI). The Dartmouth Scaled and Normalized Model (DSNM), the Simulated Injury Monitor (SIMon), and the Wayne State University Head Injury Model (WSUHIM) were selected for comparisons. For model input, 144 unique kinematic conditions were created to represent the range of head impacts sustained by male collegiate hockey players during play. These impacts encompass the 50th, 95th, and 99th percentile peak linear and rotational accelerations at 16 impact locations around the head. Five mechanical variables (strain, strain rate, strain × strain rate, stress, and pressure) in seven ROIs reported from the FE models were compared using Generalized Estimating Equation statistical models. Highly significant differences existed among FE models for nearly all output variables and ROIs. The WSUHIM produced substantially higher peak values for almost all output variables regardless of the ROI compared to the DSNM and SIMon models (p < 0.05). DSNM also produced significantly different stress and pressure compared with SIMon for all ROIs (p < 0.05), but such differences were not consistent across ROIs for other variables. Regardless of FE model, most output variables were highly correlated with linear and rotational peak accelerations. The

  6. Parametric Comparisons of Intracranial Mechanical Responses from Three Validated Finite Element Models of the Human Head

    PubMed Central

    Ji, Songbai; Ghadyani, Hamidreza; Bolander, Richard P.; Beckwith, Jonathan G.; Ford, James C.; Mcallister, Thomas W.; Flashman, Laura A.; Paulsen, Keith D.; Ernstrom, Karin; Jain, Sonia; Raman, Rema; Zhang, Liying; Greenwald, Richard M.

    2015-01-01

    A number of human head finite element (FE) models have been developed from different research groups over the years to study the mechanisms of traumatic brain injury. These models can vary substantially in model features and parameters, making it important to evaluate whether simulation results from one model are readily comparable with another, and whether response-based injury thresholds established from a specific model can be generalized when a different model is employed. The purpose of this study is to parametrically compare regional brain mechanical responses from three validated head FE models to test the hypothesis that regional brain responses are dependent on the specific head model employed as well as the region of interest (ROI). The Dartmouth Scaled and Normalized Model (DSNM), the Simulated Injury Monitor (SIMon), and the Wayne State University Head Injury Model (WSUHIM) were selected for comparisons. For model input, 144 unique kinematic conditions were created to represent the range of head impacts sustained by male collegiate hockey players during play. These impacts encompass the 50th, 95th, and 99th percentile peak linear and rotational accelerations at 16 impact locations around the head. Five mechanical variables (strain, strain rate, strain × strain rate, stress, and pressure) in seven ROIs reported from the FE models were compared using Generalized Estimating Equation statistical models. Highly significant differences existed among FE models for nearly all output variables and ROIs. The WSUHIM produced substantially higher peak values for almost all output variables regardless of the ROI compared to the DSNM and SIMon models (p < 0.05). DSNM also produced significantly different stress and pressure compared with SIMon for all ROIs (p < 0.05), but such differences were not consistent across ROIs for other variables. Regardless of FE model, most output variables were highly correlated with linear and rotational peak accelerations. The

  7. S-values calculated from a tomographic head/brain model for brain imaging

    NASA Astrophysics Data System (ADS)

    Chao, Tsi-chian; Xu, X. George

    2004-11-01

    A tomographic head/brain model was developed from the Visible Human images and used to calculate S-values for brain imaging procedures. This model contains 15 segmented sub-regions including caudate nucleus, cerebellum, cerebral cortex, cerebral white matter, corpus callosum, eyes, lateral ventricles, lenses, lentiform nucleus, optic chiasma, optic nerve, pons and middle cerebellar peduncle, skull CSF, thalamus and thyroid. S-values for C-11, O-15, F-18, Tc-99m and I-123 have been calculated using this model and a Monte Carlo code, EGS4. Comparison of the calculated S-values with those calculated from the MIRD (1999) stylized head/brain model shows significant differences. In many cases, the stylized head/brain model resulted in smaller S-values (as much as 88%), suggesting that the doses to a specific patient similar to the Visible Man could have been underestimated using the existing clinical dosimetry.

  8. Progressive Diffuse Osteonecrosis in a Patient with Secondary Hemophagocytic Lymphohistiocytosis

    PubMed Central

    Takahashi, Takashi; Rykken, Jeffrey

    2015-01-01

    This is a case report with serial imaging showing progression of diffuse osteonecrosis in a patient after a diagnosis of secondary hemophagocytic lymphohistiocytosis (HLH). While bone marrow involvement in HLH has been long noted at histological evaluation and is itself one of the diagnosis criteria, to the best of our knowledge, there has been no previous publication addressing osseous image findings in a patient with HLH. PMID:26693376

  9. Emulating the Visual Receptive Field Properties of MST Neurons with a Template Model of Heading Estimation

    NASA Technical Reports Server (NTRS)

    Perrone, John A.; Stone, Leland S.

    1997-01-01

    We have previously proposed a computational neural-network model by which the complex patterns of retinal image motion generated during locomotion (optic flow) can be processed by specialized detectors acting as templates for specific instances of self-motion. The detectors in this template model respond to global optic flow by sampling image motion over a large portion of the visual field through networks of local motion sensors with properties similar to neurons found in the middle temporal (MT) area of primate extrastriate visual cortex. The model detectors were designed to extract self-translation (heading), self-rotation, as well as the scene layout (relative distances) ahead of a moving observer, and are arranged in cortical-like heading maps to perform this function. Heading estimation from optic flow has been postulated by some to be implemented within the medial superior temporal (MST) area. Others have questioned whether MST neurons can fulfill this role because some of their receptive-field properties appear inconsistent with a role in heading estimation. To resolve this issue, we systematically compared MST single-unit responses with the outputs of model detectors under matched stimulus conditions. We found that the basic physiological properties of MST neurons can be explained by the template model. We conclude that MST neurons are well suited to support heading estimation and that the template model provides an explicit set of testable hypotheses which can guide future exploration of MST and adjacent areas within the primate superior temporal sulcus.

  10. A dynamical model for reflex activated head movements in the horizontal plane

    NASA Technical Reports Server (NTRS)

    Peng, G. C.; Hain, T. C.; Peterson, B. W.

    1996-01-01

    We present a controls systems model of horizontal-plane head movements during perturbations of the trunk, which for the first time interfaces a model of the human head with neural feedback controllers representing the vestibulocollic (VCR) and the cervicocollic (CCR) reflexes. This model is homeomorphic such that model structure and parameters are drawn directly from anthropomorphic, biomechanical and physiological studies. Using control theory we analyzed the system model in the time and frequency domains, simulating neck movement responses to input perturbations of the trunk. Without reflex control, the head and neck system produced a second-order underdamped response with a 5.2 dB resonant peak at 2.1 Hz. Adding the CCR component to the system dampened the response by approximately 7%. Adding the VCR component dampened head oscillations by 75%. The VCR also improved low-frequency compensation by increasing the gain and phase lag, creating a phase minimum at 0.1 Hz and a phase peak at 1.1 Hz. Combining all three components (mechanics, VCR and CCR) linearly in the head and neck system reduced the amplitude of the resonant peak to 1.1 dB and increased the resonant frequency to 2.9 Hz. The closed loop results closely fit human data, and explain quantitatively the characteristic phase peak often observed.

  11. Development of Head Injury Assessment Reference Values Based on NASA Injury Modeling

    NASA Technical Reports Server (NTRS)

    Somers, Jeffrey T.; Melvin, John W.; Tabiei, Ala; Lawrence, Charles; Ploutz-Snyder, Robert; Granderson, Bradley; Feiveson, Alan; Gernhardt, Michael; Patalak, John

    2011-01-01

    NASA is developing a new capsule-based, crewed vehicle that will land in the ocean, and the space agency desires to reduce the risk of injury from impact during these landings. Because landing impact occurs for each flight and the crew might need to perform egress tasks, current injury assessment reference values (IARV) were deemed insufficient. Because NASCAR occupant restraint systems are more effective than the systems used to determine the current IARVs and are similar to NASA s proposed restraint system, an analysis of NASCAR impacts was performed to develop new IARVs that may be more relevant to NASA s context of vehicle landing operations. Head IARVs associated with race car impacts were investigated by completing a detailed analysis of all of the 2002-2008 NASCAR impact data. Specific inclusion and exclusion criteria were used to select 4071 impacts from the 4015 recorder files provided (each file could contain multiple impact events). Of the 4071 accepted impacts, 274 were selected for numerical simulation using a custom NASCAR restraint system and Humanetics Hybrid-III 50th percentile numerical dummy model in LS-DYNA. Injury had occurred in 32 of the 274 selected impacts, and 27 of those injuries involved the head. A majority of the head injuries were mild concussions with or without brief loss of consciousness. The 242 non-injury impacts were randomly selected and representative of the range of crash dynamics present in the total set of 4071 impacts. Head dynamics data (head translational acceleration, translational change in velocity, rotational acceleration, rotational velocity, HIC-15, HIC-36, and the Head 3ms clip) were filtered according to SAE J211 specifications and then transformed to a log scale. The probability of head injury was estimated using a separate logistic regression analysis for each log-transformed predictor candidate. Using the log transformation constrains the estimated probability of injury to become negligible as IARVs approach

  12. Bilateral Maxillary Reconstruction Using Fibular Flap in Bisphosphonate-related Osteonecrosis

    PubMed Central

    Fujiwara, Toshihiro; Kawai, Kenichiro; Nishimoto, Soh; Kakibuchi, Masao

    2016-01-01

    Summary: Recent reports have shown successful transfer of vascularized fibular flap in bisphosphonate-induced mandibular osteonecrosis. We present a case of a 50-year-old patient who presented with bisphosphonate-related osteonecrosis of bilateral maxilla, which is reconstructed using a fibular flap. PMID:27757355

  13. Influence of head models on neuromagnetic fields and inverse source localizations

    PubMed Central

    Ramon, Ceon; Haueisen, Jens; Schimpf, Paul H

    2006-01-01

    Background The magnetoencephalograms (MEGs) are mainly due to the source currents. However, there is a significant contribution to MEGs from the volume currents. The structure of the anatomical surfaces, e.g., gray and white matter, could severely influence the flow of volume currents in a head model. This, in turn, will also influence the MEGs and the inverse source localizations. This was examined in detail with three different human head models. Methods Three finite element head models constructed from segmented MR images of an adult male subject were used for this study. These models were: (1) Model 1: full model with eleven tissues that included detailed structure of the scalp, hard and soft skull bone, CSF, gray and white matter and other prominent tissues, (2) the Model 2 was derived from the Model 1 in which the conductivity of gray matter was set equal to the white matter, i.e., a ten tissuetype model, (3) the Model 3 consisted of scalp, hard skull bone, CSF, gray and white matter, i.e., a five tissue-type model. The lead fields and MEGs due to dipolar sources in the motor cortex were computed for all three models. The dipolar sources were oriented normal to the cortical surface and had a dipole moment of 100 μA meter. The inverse source localizations were performed with an exhaustive search pattern in the motor cortex area. A set of 100 trial inverse runs was made covering the 3 cm cube motor cortex area in a random fashion. The Model 1 was used as a reference model. Results The reference model (Model 1), as expected, performed best in localizing the sources in the motor cortex area. The Model 3 performed the worst. The mean source localization errors (MLEs) of the Model 3 were larger than the Model 1 or 2. The contour plots of the magnetic fields on top of the head were also different for all three models. The magnetic fields due to source currents were larger in magnitude as compared to the magnetic fields of volume currents. Discussion These results

  14. Bisphosphonate-associated osteonecrosis: a clinician's reference to patient management.

    PubMed

    Grewal, Varinder S; Fayans, Edgar P

    2008-08-01

    Bisphosphonates (BPs), as inhibitors of osteoclasts, are widely used in the management of metastatic bone disease and in the prevention of osteomalacia and osteoporosis. Recent cases of bone necrosis of the jaws have been associated with the use of bisphosphonate therapy. A case is presented of a patient with osteonecrosis of the maxilla with a history of long-term bisphosphonate therapy for metastatic breast cancer. The authors treated the patient and suggest appropriate patient management guidelines with reference to current knowledge. Although a definitive treatment for bisphosphonate-associated osteonecrosis has not yet been established, clinicians must be aware of the pharmacologic properties of several bisphosphonates currently available and their indications, susceptible risk factors in the development of osteonecrosis of the jaws, the clinical signs and symptoms, and recommendations for patient management, including prevention and early recognition. BPs, potent inhibitors of osteoclast-mediated bone resorption, were first introduced more than 20 years ago. Since then, they have been used widely in the management of bone diseases, including hypercalcemia related to malignancy, myeloma-related bone disease, Paget's disease and osteoporosis. They have also been shown to inhibit tumor cell proliferation and inhibit angiogenesis. These additional features have made BPs useful in the treatment of metastatic disease, including breast and prostate cancer, resulting in a rise in the medical use of these drugs. However, recent reports suggest that BPs, particularly the nitrogen-containing BPs pamidronate (Aredia) and zoledronic acid (Zometa), both manufactured by Novartis of East Hanover, NJ, are capable of causing bisphosphonate-associated osteonecrosis of the jaw (BON). With 2.5 million patients treated with pamidronate and/or zoledronate worldwide, BON occurs in about one per 10,000 treated patients (Novartis, unpublished data, 2004). Currently, the total number

  15. Comprehensive, three-dimensional head-neck model for impact and high-acceleration studies.

    PubMed

    Huston, R L; Huston, J C; Harlow, M W

    1978-01-01

    A three-dimensional, 54-degree-of-freedom computer model of the head/neck system is presented and discussed. The model consists of nine rigid bodies representing the head and vertebrae together with a series of nonlinear springs and dampers modelling the soft tissue. The soft tissue modelling involves the discs, muscles, and ligaments. The discs are modelled as two-parameter viscoelastic solids; the muscles are also modelled as two-parameter viscoelastic solids, but only able to exert force in tension; and the ligaments are modelled as nonlinear elastic bands exerting force only in tension. Equations of motion are written for this model by using Lagrange's form of d'Alembert's principle, a virtual work type principle. Computer algorithms are written to efficiently compute the numerical coefficients of these equations. The equations are integrated numerically for a number of specific cases where experimental data are available. Results show excellent agreement between the model and the experiments.

  16. Effects of uncertainty in head tissue conductivity and complexity on EEG forward modeling in neonates.

    PubMed

    Azizollahi, Hamed; Aarabi, Ardalan; Wallois, Fabrice

    2016-10-01

    In this study, we investigated the impact of uncertainty in head tissue conductivities and inherent geometrical complexities including fontanels in neonates. Based on MR and CT coregistered images, we created a realistic neonatal head model consisting of scalp, skull, fontanels, cerebrospinal fluid (CSF), gray matter (GM), and white matter (WM). Using computer simulations, we investigated the effects of exclusion of CSF and fontanels, discrimination between GM and WM, and uncertainty in conductivity of neonatal head tissues on EEG forward modeling. We found that exclusion of CSF from the head model induced the strongest widespread effect on the EEG forward solution. Discrimination between GM and white matter also induced a strong widespread effect, but which was less intense than that of CSF exclusion. The results also showed that exclusion of the fontanels from the neonatal head model locally affected areas beneath the fontanels, but this effect was much less pronounced than those of exclusion of CSF and GM/WM discrimination. Changes in GM/WM conductivities by 25% with respect to reference values induced considerable effects in EEG forward solution, but this effect was more pronounced for GM conductivity. Similarly, changes in skull conductivity induced effects in the EEG forward modeling in areas covered by the cranial bones. The least intense effect on EEG was caused by changes in conductivity of the fontanels. Our findings clearly emphasize the impact of uncertainty in conductivity and deficiencies in head tissue compartments on modeling research and localization of brain electrical activity in neonates. Hum Brain Mapp 37:3604-3622, 2016. © 2016 Wiley Periodicals, Inc.

  17. Dynamic Characterization of Motorcycle Helmets: Modelling and Coupling with the Human Head

    NASA Astrophysics Data System (ADS)

    WILLINGER, R.; BAUMGARTNER, D.; GUIMBERTEAU, T.

    2000-08-01

    Research into the protection of the human head calls for accurate modelling of both the protection system and the head. This study proposes a model incorporating both lumped parameters of the helmet and the head and their coupling during impact. The mechanical characteristics of the shell and of the helmet liner are determined by modal analysis and dynamic compression tests respectively. The coupling of these two components of the helmet is explored using numerical optimization methods based on impact tests which are also used to validate the model. A new dummy head, developed in a previous study and capable of simulating the relative brain-skull displacement was used in the parametric study of the helmet to optimize the density of the polystyrene liner. The ultimate purpose of the study is to devise methods of evaluating the protective aspects of the helmet and then to provide less-expensive methods for optimizing new products on the basis of biomechanical criteria. So far, the study has shown that the optimum density of the liner can be determined not only empirically but also theoretically. It has also shown that optimum helmet parameters depend on the mechanical properties of the dummy head used.

  18. Of lice and math: using models to understand and control populations of head lice.

    PubMed

    Laguna, María Fabiana; Laguna, Mara Fabiana; Risau-Gusman, Sebastián

    2011-01-01

    In this paper we use detailed data about the biology of the head louse (pediculus humanus capitis) to build a model of the evolution of head lice colonies. Using theory and computer simulations, we show that the model can be used to assess the impact of the various strategies usually applied to eradicate head lice, both conscious (treatments) and unconscious (grooming). In the case of treatments, we study the difference in performance that arises when they are applied in systematic and non-systematic ways. Using some reasonable simplifying assumptions (as random mixing of human groups and the same mobility for all life stages of head lice other than eggs) we model the contagion of pediculosis using only one additional parameter. It is shown that this parameter can be tuned to obtain collective infestations whose characteristics are compatible with what is given in the literature on real infestations. We analyze two scenarios: One where group members begin treatment when a similar number of lice are present in each head, and another where there is one individual who starts treatment with a much larger threshold ("superspreader"). For both cases we assess the impact of several collective strategies of treatment. PMID:21799752

  19. Of Lice and Math: Using Models to Understand and Control Populations of Head Lice

    PubMed Central

    Laguna, Mara Fabiana; Risau-Gusman, Sebastián

    2011-01-01

    In this paper we use detailed data about the biology of the head louse (pediculus humanus capitis) to build a model of the evolution of head lice colonies. Using theory and computer simulations, we show that the model can be used to assess the impact of the various strategies usually applied to eradicate head lice, both conscious (treatments) and unconscious (grooming). In the case of treatments, we study the difference in performance that arises when they are applied in systematic and non-systematic ways. Using some reasonable simplifying assumptions (as random mixing of human groups and the same mobility for all life stages of head lice other than eggs) we model the contagion of pediculosis using only one additional parameter. It is shown that this parameter can be tuned to obtain collective infestations whose characteristics are compatible with what is given in the literature on real infestations. We analyze two scenarios: One where group members begin treatment when a similar number of lice are present in each head, and another where there is one individual who starts treatment with a much larger threshold (“superspreader”). For both cases we assess the impact of several collective strategies of treatment. PMID:21799752

  20. Analysis of two colliding fractionally damped spherical shells in modelling blunt human head impacts

    NASA Astrophysics Data System (ADS)

    Rossikhin, Yury A.; Shitikova, Marina V.

    2013-06-01

    The collision of two elastic or viscoelastic spherical shells is investigated as a model for the dynamic response of a human head impacted by another head or by some spherical object. Determination of the impact force that is actually being transmitted to bone will require the model for the shock interaction of the impactor and human head. This model is indended to be used in simulating crash scenarios in frontal impacts, and provide an effective tool to estimate the severity of effect on the human head and to estimate brain injury risks. The model developed here suggests that after the moment of impact quasi-longitudinal and quasi-transverse shock waves are generated, which then propagate along the spherical shells. The solution behind the wave fronts is constructed with the help of the theory of discontinuities. It is assumed that the viscoelastic features of the shells are exhibited only in the contact domain, while the remaining parts retain their elastic properties. In this case, the contact spot is assumed to be a plane disk with constant radius, and the viscoelastic features of the shells are described by the fractional derivative standard linear solid model. In the case under consideration, the governing differential equations are solved analytically by the Laplace transform technique. It is shown that the fractional parameter of the fractional derivative model plays very important role, since its variation allows one to take into account the age-related changes in the mechanical properties of bone.

  1. A neural model of how the brain computes heading from optic flow in realistic scenes.

    PubMed

    Browning, N Andrew; Grossberg, Stephen; Mingolla, Ennio

    2009-12-01

    Visually-based navigation is a key competence during spatial cognition. Animals avoid obstacles and approach goals in novel cluttered environments using optic flow to compute heading with respect to the environment. Most navigation models try either explain data, or to demonstrate navigational competence in real-world environments without regard to behavioral and neural substrates. The current article develops a model that does both. The ViSTARS neural model describes interactions among neurons in the primate magnocellular pathway, including V1, MT(+), and MSTd. Model outputs are quantitatively similar to human heading data in response to complex natural scenes. The model estimates heading to within 1.5 degrees in random dot or photo-realistically rendered scenes, and within 3 degrees in video streams from driving in real-world environments. Simulated rotations of less than 1 degrees /s do not affect heading estimates, but faster simulated rotation rates do, as in humans. The model is part of a larger navigational system that identifies and tracks objects while navigating in cluttered environments.

  2. SCDAP/RELAP5 Modeling of Heat Transfer and Flow Losses in Lower Head Porous Debris

    SciTech Connect

    E. W. Coryell; L. J. Siefken; S. Paik

    1998-09-01

    Designs are described for implementing models for calculating the heat transfer and flow losses in porous debris in the lower head of a reactor vessel. The COUPLE model in SCDAP/RELAP5 represents both the porous and nonporous debris that results from core material slumping into the lower head. Currently, the COUPLE model has the capability to model convective and radiative heat transfer from the surfaces of nonporous debris in a detailed manner and to model only in a simplistic manner the heat transfer from porous debris. In order to advance beyond the simplistic modeling for porous debris, designs are developed for detailed calculations of heat transfer and flow losses in porous debris. Correlations are identified for convective heat transfer in porous debris for the following modes of heat transfer; (1) forced convection to liquid, (2) forced convection to gas, (3) nucleate boiling, (4) transition boiling, and (5) film boiling. Interphase heat transfer is modeled in an approximate manner. A design is also described for implementing a model of heat transfer by radiation from debris to the interstitial fluid. A design is described for implementation of models for flow losses and interphase drag in porous debris. Since the models for heat transfer and flow losses in porous debris in the lower head are designed for general application, a design is also described for implementation of these models to the analysis of porous debris in the core region. A test matrix is proposed for assessing the capability of the implemented models to calculate the heat transfer and flow losses in porous debris. The implementation of the models described in this report is expected to improve the COUPLE code calculation of the temperature distribution in porous debris and in the lower head that supports the debris. The implementation of these models is also expected to improve the calculation of the temperature and flow distribution in porous debris in the core region.

  3. Accessible and informative sectioned images and surface models of a cadaver head.

    PubMed

    Shin, Dong Sun; Jang, Hae Gwon; Park, Jin Seo; Park, Hyung Seon; Lee, Sangho; Chung, Min Suk

    2012-07-01

    The sectioned images and surface models of a cadaver head in the Visible Korean Project would be more beneficial if they were accessible and informative. To this aim, 3 policies were established: (1) the data are promptly obtainable and observable; (2) the graphic data are accompanied by explaining the anatomic terms; and (3) two-dimensional images and three-dimensional models are shown together. According to the policies, the following were attempted. Two hundred thirty-five couples of sectioned images and outlined images (intervals, 1 mm) of the head were prepared. Browsing software was developed where the 2 corresponding images were displayed simultaneously. In addition, the structures in the images were recognized with the aid of automatic labeling. From the outlined images, surface models of 178 head structures were constructed. The two-dimensional surface models including the sectioned images were embedded into the three-dimensional surface models. All the models were categorized into systems and arranged to be inputted to a PDF (portable document format) file. The finalized PDF file containing comprehensive head data could be explored on Adobe Reader. If the user clicked on the surface models, their anatomic names were highlighted. The sectioned images, outlined images, and surface models in the browsing software and PDF file can be downloaded from the homepage (anatomy.co.kr) free of charge. The state-of-the-art graphic information will hopefully assist medical students in learning head anatomy. In addition, the raw data are expected to contribute to the various clinical practice simulations. PMID:22801119

  4. A Porcine Model of Traumatic Brain Injury via Head Rotational Acceleration.

    PubMed

    Cullen, D Kacy; Harris, James P; Browne, Kevin D; Wolf, John A; Duda, John E; Meaney, David F; Margulies, Susan S; Smith, Douglas H

    2016-01-01

    Unique from other brain disorders, traumatic brain injury (TBI) generally results from a discrete biomechanical event that induces rapid head movement. The large size and high organization of the human brain makes it particularly vulnerable to traumatic injury from rotational accelerations that can cause dynamic deformation of the brain tissue. Therefore, replicating the injury biomechanics of human TBI in animal models presents a substantial challenge, particularly with regard to addressing brain size and injury parameters. Here we present the historical development and use of a porcine model of head rotational acceleration. By scaling up the rotational forces to account for difference in brain mass between swine and humans, this model has been shown to produce the same tissue deformations and identical neuropathologies found in human TBI. The parameters of scaled rapid angular accelerations applied for the model reproduce inertial forces generated when the human head suddenly accelerates or decelerates in falls, collisions, or blunt impacts. The model uses custom-built linkage assemblies and a powerful linear actuator designed to produce purely impulsive non-impact head rotation in different angular planes at controlled rotational acceleration levels. Through a range of head rotational kinematics, this model can produce functional and neuropathological changes across the spectrum from concussion to severe TBI. Notably, however, the model is very difficult to employ, requiring a highly skilled team for medical management, biomechanics, neurological recovery, and specialized outcome measures including neuromonitoring, neurophysiology, neuroimaging, and neuropathology. Nonetheless, while challenging, this clinically relevant model has proven valuable for identifying mechanisms of acute and progressive neuropathologies as well as for the evaluation of noninvasive diagnostic techniques and potential neuroprotective treatments following TBI. PMID:27604725

  5. A dynamic factor modeling framework for analyzing multiple groundwater head series simultaneously

    NASA Astrophysics Data System (ADS)

    Berendrecht, W. L.; van Geer, F. C.

    2016-05-01

    In this paper we present an approach in which we combine a dynamic factor model (DFM) and predefined response functions to analyze a set of groundwater head series simultaneously. Each groundwater head series is decomposed into: (a) one or more deterministic components as a response to known driving forces, (b) one or more common dynamic factors, representing spatial patterns not related to any of the input series and (c) one specific dynamic factor for each groundwater head series, describing unique variation for that series. The approach reduces the degrees of freedom for each response function, enables the application to irregular observed data, and exploits the correlation between residual series of a set of groundwater head series. The common dynamic factors may be interpreted as spatial patterns due to e.g. limitations in the model specification or concept, spatially correlated errors in input variables, or driving forces which have not been included in the model. In the latter case the model can be applied in the context of an alarming system, e.g. to monitor regional trends. The specific dynamic factor depicts the variation of a particular groundwater head series that cannot be related to any other time series of the set nor to any input series. Therefore the specific dynamic factor is suitable for analyzing local variations and detecting incidental measurement errors, for example in a quality control procedure. The DFM framework is illustrated with a set of 8 groundwater head series and applied for filling gaps in time series, reconstructing high-frequency data, and detecting outliers.

  6. Development of a finite element human head model partially validated with thirty five experimental cases.

    PubMed

    Mao, Haojie; Zhang, Liying; Jiang, Binhui; Genthikatti, Vinay V; Jin, Xin; Zhu, Feng; Makwana, Rahul; Gill, Amandeep; Jandir, Gurdeep; Singh, Amrinder; Yang, King H

    2013-11-01

    This study is aimed to develop a high quality, extensively validated finite element (FE) human head model for enhanced head injury prediction and prevention. The geometry of the model was based on computed tomography (CT) and magnetic resonance imaging scans of an adult male who has the average height and weight of an American. A feature-based multiblock technique was adopted to develop hexahedral brain meshes including the cerebrum, cerebellum, brainstem, corpus callosum, ventricles, and thalamus. Conventional meshing methods were used to create the bridging veins, cerebrospinal fluid, skull, facial bones, flesh, skin, and membranes-including falx, tentorium, pia, arachnoid, and dura. The head model has 270,552 elements in total. Thirty five loading cases were selected from a range of experimental head impacts to check the robustness of the model predictions based on responses including the brain pressure, relative skull-brain motion, skull response, and facial response. The brain pressure was validated against intracranial pressure data reported by Nahum et al. (1977, "Intracranial Pressure Dynamics During Head Impact," Proc. 21st Stapp Car Crash Conference, SAE Technical Paper No. 770922) and Trosseille et al. (1992, "Development of a F.E.M. of the Human Head According to a Specific Test Protocol," Proc. 36th Stapp Car Crash Conference, SAE Technical Paper No. 922527). The brain motion was validated against brain displacements under sagittal, coronal, and horizontal blunt impacts performed by Hardy et al. (2001, "Investigation of Head Injury Mechanisms Using Neutral Density Technology and High-Speed Biplanar X-Ray," Stapp Car Crash Journal, 45, pp. 337-368; and 2007, "A Study of the Response of the Human Cadaver Head to Impact," Stapp Car Crash Journal, 51, pp. 17-80). The facial bone responses were validated under nasal impact (Nyquist et al. 1986, "Facial Impact Tolerance and Response," Proc. 30th Stapp Car Crash Conference, SAE Technical Paper No. 861896

  7. Dynamic modeling and experimental results for a head tilt response.

    PubMed

    Geisinger, Dario; Ferreira, Enrique; Suarez, Alejo; Suarez, Hamlet

    2010-01-01

    The estimation of the vertical in humans is important in everyday life although the mechanisms involved are not completely understood yet. This paper presents two sets of experiments with normal subjects, using the same virtual reality setup, aiming to help in this understanding. First, a steady state experiment is presented, which is used to determine the gravitational vertical precision while the second, a dynamical transient response experiment, is used to find dynamic models of each subject response. Results show that the dynamic models are able to reproduce the results of the steady state experiment while having the benefits that a dynamic model brings to evaluate subjects performance.

  8. Phytomolecule icaritin incorporated PLGA/TCP scaffold for steroid-associated osteonecrosis: Proof-of-concept for prevention of hip joint collapse in bipedal emus and mechanistic study in quadrupedal rabbits.

    PubMed

    Qin, Ling; Yao, Dong; Zheng, Lizhen; Liu, Wai-Ching; Liu, Zhong; Lei, Ming; Huang, Le; Xie, Xinhui; Wang, Xinluan; Chen, Yang; Yao, Xinsheng; Peng, Jiang; Gong, He; Griffith, James F; Huang, Yanping; Zheng, Yongping; Feng, Jian Q; Liu, Ying; Chen, Shihui; Xiao, Deming; Wang, Daping; Xiong, Jiangyi; Pei, Duanqing; Zhang, Peng; Pan, Xiaohua; Wang, Xiaohong; Lee, Kwong-Man; Cheng, Chun-Yiu

    2015-08-01

    Steroid-associated osteonecrosis (SAON) may lead to joint collapse and subsequent joint replacement. Poly lactic-co-glycolic acid/tricalcium phosphate (P/T) scaffold providing sustained release of icaritin (a metabolite of Epimedium-derived flavonoids) was investigated as a bone defect filler after surgical core-decompression (CD) to prevent femoral head collapse in a bipedal SAON animal model using emu (a large flightless bird). The underlying mechanism on SAON was evaluated using a well-established quadrupedal rabbit model. Fifteen emus were established with SAON, and CD was performed along the femoral neck for the efficacy study. In this CD bone defect, a P/T scaffold with icaritin (P/T/I group) or without icaritin (P/T group) was implanted while no scaffold implantation was used as a control. For the mechanistic study in rabbits, the effects of icaritin and composite scaffolds on bone mesenchymal stem cells (BMSCs) recruitment, osteogenesis, and anti-adipogenesis were evaluated. Our efficacy study showed that P/T/I group had the significantly lowest incidence of femoral head collapse, better preserved cartilage and mechanical properties supported by more new bone formation within the bone tunnel. For the mechanistic study, our in vitro tests suggested that icaritin enhanced the expression of osteogenesis related genes COL1α, osteocalcin, RUNX2, and BMP-2 while inhibited adipogenesis related genes C/EBP-ß, PPAR-γ, and aP2 of rabbit BMSCs. Both P/T and P/T/I scaffolds were demonstrated to recruit BMSCs both in vitro and in vivo but a higher expression of migration related gene VCAM1 was only found in P/T/I group in vitro. In conclusion, both efficacy and mechanistic studies show the potential of a bioactive composite porous P/T scaffold incorporating icaritin to enhance bone defect repair after surgical CD and prevent femoral head collapse in a bipedal SAON emu model. PMID:25968462

  9. SCDAP/RELAP5 Modeling of Heat Transfer and Flow Losses in Lower Head Porous Debris

    SciTech Connect

    Siefken, Larry James; Coryell, Eric Wesley; Paik, Seungho; Kuo, Han Hsiung

    1999-07-01

    Designs are described for implementing models for calculating the heat transfer and flow losses in porous debris in the lower head of a reactor vessel. The COUPLE model in SCDAP/RELAP5 represents both the porous and nonporous debris that results from core material slumping into the lower head. Currently, the COUPLE model has the capability to model convective and radiative heat transfer from the surfaces of nonporous debris in a detailed manner and to model only in a simplistic manner the heat transfer from porous debris. In order to advance beyond the simplistic modeling for porous debris, designs are developed for detailed calculations of heat transfer and flow losses in porous debris. Correlations are identified for convective heat transfer in porous debris for the following modes of heat transfer; (1) forced convection to liquid, (2) forced convection to gas, (3) nucleate boiling, (4) transition boiling, and (5) film boiling. Interphase heat transfer is modeled in an approximate manner. Designs are described for models to calculate the flow losses and interphase drag of fluid flowing through the interstices of the porous debris, and to apply these variables in the momentum equations in the RELAP5 part of the code. Since the models for heat transfer and flow losses in porous debris in the lower head are designed for general application, a design is also described for implementation of these models to the analysis of porous debris in the core region. A test matrix is proposed for assessing the capability of the implemented models to calculate the heat transfer and flow losses in porous debris. The implementation of the models described in this report is expected to improve the COUPLE code calculation of the temperature distribution in porous debris and in the lower head that supports the debris. The implementation of these models is also expected to improve the calculation of the temperature and flow distribution in porous debris in the core region.

  10. Extracorporeal shockwave therapy for avascular necrosis of femoral head.

    PubMed

    Wang, Ching-Jen; Cheng, Jai-Hong; Huang, Chung-Cheng; Yip, Han-Kan; Russo, Sergio

    2015-12-01

    The etiology of osteonecrosis of the femoral head (ONFH) is multifactorial. Treatment of ONFH is disease stage dependent. For early stages, femoral head preservation procedures are preferred including core decompression, muscle pedicle grafting and de-rotational osteotomy. Core decompression with bone grafting is considered the gold standard. However, the results are inconsistence and unpredictable. An effective non-invasive method of treatment is imperative. Recently, extracorporeal shockwave therapy (ESWT) has shown beneficial effects in ONFH. ESWT improves pain and function of the hip and regression of the ONFH lesion. ESWT is more effective than core decompression with or without bone grafting, cocktail therapy that combined HBO, ESWT and oral alendronate is shown effective for patients with early osteonecrosis. The purpose of the article is to review, update and summarize the clinical treatment of ONFH using shockwave therapy.

  11. Earnings Profiles of Department Heads: Comparing Cross-Sectional and Panel Models.

    ERIC Educational Resources Information Center

    Ragan, James F., Jr.; Rehman, Qazi Najeeb

    1996-01-01

    A cross-sectional study of 842 faculty who served as department heads between 1965-92 was compared with 170 in a panel study for whom earnings were estimated using a personal effects model. The average chair received a 12% wage premium for administrative service. Skill depreciation was most severe and wage growth most adversely affected in the…

  12. BrainK for Structural Image Processing: Creating Electrical Models of the Human Head

    PubMed Central

    Li, Kai; Papademetris, Xenophon; Tucker, Don M.

    2016-01-01

    BrainK is a set of automated procedures for characterizing the tissues of the human head from MRI, CT, and photogrammetry images. The tissue segmentation and cortical surface extraction support the primary goal of modeling the propagation of electrical currents through head tissues with a finite difference model (FDM) or finite element model (FEM) created from the BrainK geometries. The electrical head model is necessary for accurate source localization of dense array electroencephalographic (dEEG) measures from head surface electrodes. It is also necessary for accurate targeting of cerebral structures with transcranial current injection from those surface electrodes. BrainK must achieve five major tasks: image segmentation, registration of the MRI, CT, and sensor photogrammetry images, cortical surface reconstruction, dipole tessellation of the cortical surface, and Talairach transformation. We describe the approach to each task, and we compare the accuracies for the key tasks of tissue segmentation and cortical surface extraction in relation to existing research tools (FreeSurfer, FSL, SPM, and BrainVisa). BrainK achieves good accuracy with minimal or no user intervention, it deals well with poor quality MR images and tissue abnormalities, and it provides improved computational efficiency over existing research packages. PMID:27293419

  13. Intensive Evaluation of Head Start Implementation in the Tucson Early Education Model.

    ERIC Educational Resources Information Center

    Rentfrow, Robert K.

    As part of the national Head Start Planned Variation Study, this study used a relatively small sample in an intensive evaluation of program implementation in one field community using the Tucson Early Education Model (TEEM). A modified Solomon four-group research design formed the organization framework. Evaluation of six TEEM classrooms and two…

  14. BrainK for Structural Image Processing: Creating Electrical Models of the Human Head.

    PubMed

    Li, Kai; Papademetris, Xenophon; Tucker, Don M

    2016-01-01

    BrainK is a set of automated procedures for characterizing the tissues of the human head from MRI, CT, and photogrammetry images. The tissue segmentation and cortical surface extraction support the primary goal of modeling the propagation of electrical currents through head tissues with a finite difference model (FDM) or finite element model (FEM) created from the BrainK geometries. The electrical head model is necessary for accurate source localization of dense array electroencephalographic (dEEG) measures from head surface electrodes. It is also necessary for accurate targeting of cerebral structures with transcranial current injection from those surface electrodes. BrainK must achieve five major tasks: image segmentation, registration of the MRI, CT, and sensor photogrammetry images, cortical surface reconstruction, dipole tessellation of the cortical surface, and Talairach transformation. We describe the approach to each task, and we compare the accuracies for the key tasks of tissue segmentation and cortical surface extraction in relation to existing research tools (FreeSurfer, FSL, SPM, and BrainVisa). BrainK achieves good accuracy with minimal or no user intervention, it deals well with poor quality MR images and tissue abnormalities, and it provides improved computational efficiency over existing research packages. PMID:27293419

  15. A Neural Model of How the Brain Computes Heading from Optic Flow in Realistic Scenes

    ERIC Educational Resources Information Center

    Browning, N. Andrew; Grossberg, Stephen; Mingolla, Ennio

    2009-01-01

    Visually-based navigation is a key competence during spatial cognition. Animals avoid obstacles and approach goals in novel cluttered environments using optic flow to compute heading with respect to the environment. Most navigation models try either explain data, or to demonstrate navigational competence in real-world environments without regard…

  16. Realistic numerical modelling of human head tissue exposure to electromagnetic waves from cellular phones

    NASA Astrophysics Data System (ADS)

    Scarella, Gilles; Clatz, Olivier; Lanteri, Stéphane; Beaume, Grégory; Oudot, Steve; Pons, Jean-Philippe; Piperno, Sergo; Joly, Patrick; Wiart, Joe

    2006-06-01

    The ever-rising diffusion of cellular phones has brought about an increased concern for the possible consequences of electromagnetic radiation on human health. Possible thermal effects have been investigated, via experimentation or simulation, by several research projects in the last decade. Concerning numerical modeling, the power absorption in a user's head is generally computed using discretized models built from clinical MRI data. The vast majority of such numerical studies have been conducted using Finite Differences Time Domain methods, although strong limitations of their accuracy are due to heterogeneity, poor definition of the detailed structures of head tissues (staircasing effects), etc. In order to propose numerical modeling using Finite Element or Discontinuous Galerkin Time Domain methods, reliable automated tools for the unstructured discretization of human heads are also needed. Results presented in this article aim at filling the gap between human head MRI images and the accurate numerical modeling of wave propagation in biological tissues and its thermal effects. To cite this article: G. Scarella et al., C. R. Physique 7 (2006).

  17. Combined radio-colour contrast in the examination of ballistic head models.

    PubMed

    Schyma, C; Greschus, S; Urbach, H; Madea, B

    2012-07-01

    The conventional analysis of ballistic gelatine is performed by transillumination and scanning of 1-cm-thick slices. Previous research demonstrated the advantages of colour and radio contrast in gelatine for computed tomography (CT). The aim of this study was to determine whether this method could be applied to head models in order to facilitate their examination. Four head models of about 14 cm in diameter were prepared from two acryl hollow spheres and two polypropylene hollow spheres. Acryl paint was mixed with barium meal and sealed in a thin foil bag which was attached to the gelatine-filled sphere which was covered with about 3-mm-thick silicone. The head models were shot at using 9 mm × 19 expanding bullets from 4 m distance. The models were examined via multislice CT. The gelatine core was removed; the bullet track was photographed and cut into consecutive slices which were scanned optically. CT images were processed with Corel Photo-Paint. Optical and radiological images were analysed using the AxioVision software. The disruption of the gelatine within the head model was visualised by extensive distribution of paint up to the end of the finest cracks and fissures and along the whole bullet track. CT imaging with excellent radio contrast in the gelatine cracks caused by the temporary cavity allowed for multiplanar reconstruction. We conclude that the combination of colour contrast in gelatine with contrast material-enhanced CT facilitates accurate measurements in ballistic head models. PMID:22576293

  18. Evaluation of multiple-sphere head models for MEG source localization

    NASA Astrophysics Data System (ADS)

    Lalancette, M.; Quraan, M.; Cheyne, D.

    2011-09-01

    Magnetoencephalography (MEG) source analysis has largely relied on spherical conductor models of the head to simplify forward calculations of the brain's magnetic field. Multiple- (or overlapping, local) sphere models, where an optimal sphere is selected for each sensor, are considered an improvement over single-sphere models and are computationally simpler than realistic models. However, there is limited information available regarding the different methods used to generate these models and their relative accuracy. We describe a variety of single- and multiple-sphere fitting approaches, including a novel method that attempts to minimize the field error. An accurate boundary element method simulation was used to evaluate the relative field measurement error (12% on average) and dipole fit localization bias (3.5 mm) of each model over the entire brain. All spherical models can contribute in the order of 1 cm to the localization bias in regions of the head that depart significantly from a sphere (inferior frontal and temporal). These spherical approximation errors can give rise to larger localization differences when all modeling effects are taken into account and with more complex source configurations or other inverse techniques, as shown with a beamformer example. Results differed noticeably depending on the source location, making it difficult to recommend a fitting method that performs best in general. Given these limitations, it may be advisable to expand the use of realistic head models.

  19. Head and brain response to blast using sagittal and transverse finite element models.

    PubMed

    Singh, Dilaver; Cronin, Duane S; Haladuick, Tyler N

    2014-04-01

    Mild traumatic brain injury caused by blast exposure from Improvised Explosive Devices has become increasingly prevalent in modern conflicts. To investigate head kinematics and brain tissue response in blast scenarios, two solid hexahedral blast-head models were developed in the sagittal and transverse planes. The models were coupled to an Arbitrary Lagrangian-Eulerian model of the surrounding air to model blast-head interaction, for three blast load cases (5 kg C4 at 3, 3.5 and 4 m). The models were validated using experimental kinematic data, where predicted accelerations were in good agreement with experimental tests, and intracranial pressure traces at four locations in the brain, where the models provided good predictions for frontal, temporal and parietal, but underpredicted pressures at the occipital location. Brain tissue response was investigated for the wide range of constitutive properties available. The models predicted relatively low peak principal brain tissue strains from 0.035 to 0.087; however, strain rates ranged from 225 to 571 s-1. Importantly, these models have allowed us to quantify expected strains and strain rates experienced in brain tissue, which can be used to guide future material characterization. These computationally efficient and predictive models can be used to evaluate protection and mitigation strategies in future analysis.

  20. [Mathematical modeling of the kinematics of a pilot's head while catapulting into an air stream].

    PubMed

    Kharchenko, V I; Golovleva, N V; Konakhevich, Iu G; Liapin, V A; Mar'in, A V

    1987-01-01

    The trajectories of head movements in the helmet and velocities of impact contact with the seat and anterior of the cockpit were calculated as applied to every stage of the catapulting process and mass-inertia parameters of helmets taken into account. Kinematic models were used to describe biomechanic parameters of the head-neck system. Special attention was given to the case of catapulting to the air flow. The effect upon the nod of aerodynamic forces acting on the human body and the catapult ejection seat at air flow velocities of 700-800 and 1300 km/hr was calculated. PMID:3586592

  1. A MODEL OF MIRA'S COMETARY HEAD/TAIL ENTERING THE LOCAL BUBBLE

    SciTech Connect

    Esquivel, A.; Raga, A. C.; RodrIguez-Gonzalez, A.; Lopez-Camara, D.; Velazquez, P. F.; Canto, J.; De Colle, F. E-mail: raga@nucleares.unam.m E-mail: pablo@nucleares.unam.m

    2010-12-20

    We model the cometary structure around Mira as the interaction of an asymptotic giant branch stellar wind from Mira A with a streaming environment. Our simulations introduce the following new element: we assume that after 200 kyr of evolution in a dense environment, Mira entered the Local Bubble (low-density coronal gas). As Mira enters the bubble, the head of the comet expands quite rapidly, while the tail remains well collimated for a >100 kyr timescale. The result is a broad-head/narrow-tail structure that resembles the observed morphology of Mira's comet. The simulations were carried out with our new adaptive grid code WALICXE, which is described in detail.

  2. Magnetic Nanoparticle-Based Hyperthermia for Head & Neck Cancer in Mouse Models

    PubMed Central

    Zhao, Qun; Wang, Luning; Cheng, Rui; Mao, Leidong; Arnold, Robert D.; Howerth, Elizabeth W.; Chen, Zhuo G.; Platt, Simon

    2012-01-01

    In this study, magnetic iron oxide nanoparticle induced hyperthermia is applied for treatment of head and neck cancer using a mouse xenograft model of human head and neck cancer (Tu212 cell line). A hyperthermia system for heating iron oxide nanoparticles was developed by using alternating magnetic fields. Both theoretical simulation and experimental studies were performed to verify the thermotherapy effect. Experimental results showed that the temperature of the tumor center has dramatically elevated from around the room temperature to about 40oC within the first 5-10 minutes. Pathological studies demonstrate epithelial tumor cell destruction associated with the hyperthermia treatment. PMID:22287991

  3. MRI-based anatomical model of the human head for specific absorption rate mapping

    PubMed Central

    Makris, Nikos; Angelone, Leonardo; Tulloch, Seann; Sorg, Scott; Kaiser, Jonathan; Kennedy, David

    2009-01-01

    In this study, we present a magnetic resonance imaging (MRI)-based, high-resolution, numerical model of the head of a healthy human subject. In order to formulate the model, we performed quantitative volumetric segmentation on the human head, using T1-weighted MRI. The high spatial resolution used (1 × 1 × 1 mm3), allowed for the precise computation and visualization of a higher number of anatomical structures than provided by previous models. Furthermore, the high spatial resolution allowed us to study individual thin anatomical structures of clinical relevance not visible by the standard model currently adopted in computational bioelectromagnetics. When we computed the electromagnetic field and specific absorption rate (SAR) at 7 Tesla MRI using this high-resolution model, we were able to obtain a detailed visualization of such fine anatomical structures as the epidermis/dermis, bone structures, bone-marrow, white matter and nasal and eye structures. PMID:18985401

  4. Osteonecrosis in systemic lupus erythematosus: an early, frequent, and not always symptomatic complication.

    PubMed

    Caramaschi, Paola; Biasi, Domenico; Dal Forno, Ilaria; Adami, Silvano

    2012-01-01

    Osteonecrosis may complicate the course of systemic lupus erythematosus and may contemporaneously affect multiple joints. The major risk factor associated with the development of osteonecrosis is the use of glucocorticoid at high doses. Recent studies using serial MRI, which represents the "gold standard" for the early detection of osteonecrosis, yielded some interesting findings about the natural history of this clinical entity. Osteonecrosis in the majority of the cases is asymptomatic and occurs early in the course of the disease. Its later occurrence is associated with lupus flare that requires the increase of corticosteroid dose. The optimal treatment of osteonecrosis is controversial. In case of silent osteonecrosis involving a small area conservative strategy is usually adequate. When lesions are symptomatic surgical treatment as core decompression or free vascularized fibular grafting is required; extracorporeal shockwave treatment may represent an alternative therapeutic approach. When the lesion has a medium-large dimension or involves a weight-bearing area bone collapse is a common complication requiring total joint replacement. Coadministration of bisphosphonate or warfarin with high doses of corticosteroid might be a promising preventive strategy of osteonecrosis.

  5. Computing interaural differences through finite element modeling of idealized human heads

    PubMed Central

    Cai, Tingli; Rakerd, Brad; Hartmann, William M.

    2015-01-01

    Acoustical interaural differences were computed for a succession of idealized shapes approximating the human head-related anatomy: sphere, ellipsoid, and ellipsoid with neck and torso. Calculations were done as a function of frequency (100–2500 Hz) and for source azimuths from 10 to 90 degrees using finite element models. The computations were compared to free-field measurements made with a manikin. Compared to a spherical head, the ellipsoid produced greater large-scale variation with frequency in both interaural time differences and interaural level differences, resulting in better agreement with the measurements. Adding a torso, represented either as a large plate or as a rectangular box below the neck, further improved the agreement by adding smaller-scale frequency variation. The comparisons permitted conjectures about the relationship between details of interaural differences and gross features of the human anatomy, such as the height of the head, and length of the neck. PMID:26428792

  6. Does littoral sand bypass the head of Mugu Submarine Canyon? - a modeling study

    USGS Publications Warehouse

    Xu, Jingping; Elias, Edwin; Kinsman, Nicole; Wang, Ping; Rosati, Julie D.; Roberts, Tiffany M.

    2011-01-01

    A newly developed sand-tracer code for the process-based model Delft3D (Deltares, The Netherlands) was used to simulate the littoral transport near the head of the Mugu Submarine Canyon in California, USA. For westerly swells, which account for more than 90% of the wave conditions in the region, the sand tracers in the downcoast littoral drift were unable to bypass the canyon head. A flow convergence near the upcoast rim of the canyon intercepts the tracers and moves them either offshore onto the shelf just west of the canyon rim (low wave height conditions) or into the canyon head (storm wave conditions). This finding supports the notion that Mugu Canyon is the true terminus of the Santa Barbara Littoral Cell.

  7. Pharmacogenetics of Bisphosphonate-associated Osteonecrosis of the Jaw.

    PubMed

    Fung, P L; Nicoletti, P; Shen, Y; Porter, S; Fedele, S

    2015-11-01

    Osteonecrosis of the jaws (ONJ) is a potentially severe disorder that develops in a subgroup of individuals who have used bisphosphonate (BP) medications. Several clinical risk factors have been associated with the risk of ONJ development, but evidence is limited and in most instances ONJ remains an unpredictable adverse drug reaction. Interindividual genetic variability can contribute to explaining ONJ development in a subset of BP users and the discovery of relevant associated gene variants could lead to the identification of individuals at higher risk. No genetic variant has been found to be robustly associated with susceptibility to ONJ.

  8. Osteonecrosis of the jaw in patient with denosumab therapy

    PubMed Central

    Olate, Sergio; Uribe, Francisca; Martinez, Felipe; Almeida, Andrés; Unibazo, Alejandro

    2014-01-01

    Osteonecrosis (ON) of the jaw has previously been linked to the use of biphosphonates; however, new drugs, also shown similar conditions. This article presents a female patient with mandibular ON related to the use of denosumab. The 55-year-old presented with bone exposure with 8 months of evolution after a dental extraction. The patient began subcutaneous injections of 60 mg denosumab four months prior to the extraction and the lesion remained after the procedure. The patient, with 14 months of follow-up, show mandible ON with no favorable evolution. The clinical condition is presented and the literature of ON associated with denosumab is discussed. PMID:25419421

  9. A link-segment model of upright human posture for analysis of head-trunk coordination

    NASA Technical Reports Server (NTRS)

    Nicholas, S. C.; Doxey-Gasway, D. D.; Paloski, W. H.

    1998-01-01

    Sensory-motor control of upright human posture may be organized in a top-down fashion such that certain head-trunk coordination strategies are employed to optimize visual and/or vestibular sensory inputs. Previous quantitative models of the biomechanics of human posture control have examined the simple case of ankle sway strategy, in which an inverted pendulum model is used, and the somewhat more complicated case of hip sway strategy, in which multisegment, articulated models are used. While these models can be used to quantify the gross dynamics of posture control, they are not sufficiently detailed to analyze head-trunk coordination strategies that may be crucial to understanding its underlying mechanisms. In this paper, we present a biomechanical model of upright human posture that extends an existing four mass, sagittal plane, link-segment model to a five mass model including an independent head link. The new model was developed to analyze segmental body movements during dynamic posturography experiments in order to study head-trunk coordination strategies and their influence on sensory inputs to balance control. It was designed specifically to analyze data collected on the EquiTest (NeuroCom International, Clackamas, OR) computerized dynamic posturography system, where the task of maintaining postural equilibrium may be challenged under conditions in which the visual surround, support surface, or both are in motion. The performance of the model was tested by comparing its estimated ground reaction forces to those measured directly by support surface force transducers. We conclude that this model will be a valuable analytical tool in the search for mechanisms of balance control.

  10. Quantitative Simulations of MST Visual Receptive Field Properties Using a Template Model of Heading Estimation

    NASA Technical Reports Server (NTRS)

    Stone, Leland S.; Perrone, J. A.

    1997-01-01

    We previously developed a template model of primate visual self-motion processing that proposes a specific set of projections from MT-like local motion sensors onto output units to estimate heading and relative depth from optic flow. At the time, we showed that that the model output units have emergent properties similar to those of MSTd neurons, although there was little physiological evidence to test the model more directly. We have now systematically examined the properties of the model using stimulus paradigms used by others in recent single-unit studies of MST: 1) 2-D bell-shaped heading tuning. Most MSTd neurons and model output units show bell-shaped heading tuning. Furthermore, we found that most model output units and the finely-sampled example neuron in the Duffy-Wurtz study are well fit by a 2D gaussian (sigma approx. 35deg, r approx. 0.9). The bandwidth of model and real units can explain why Lappe et al. found apparent sigmoidal tuning using a restricted range of stimuli (+/-40deg). 2) Spiral Tuning and Invariance. Graziano et al. found that many MST neurons appear tuned to a specific combination of rotation and expansion (spiral flow) and that this tuning changes little for approx. 10deg shifts in stimulus placement. Simulations of model output units under the same conditions quantitatively replicate this result. We conclude that a template architecture may underlie MT inputs to MST.

  11. Assessment of the exposure to WLAN frequencies of a head model with a cochlear implant.

    PubMed

    Parazzini, Marta; Sibella, Federica; Paglialonga, Alessia; Ravazzani, Paolo

    2010-10-01

    In the last few years, significant developments have taken place in the field of Wireless Local Area Networks (WLAN), and the popularity of portable devices supporting Wireless Fidelity (Wi-Fi) is continuously growing. At the same time, the number of Active Implanted Medical Devices (AIMD) being placed in patients is widely increasing and among them, cochlear implants (CI) are becoming a common aid. The goal of this study is to investigate the effect on the electromagnetic field distribution and the specific absorption rate (SAR) due to the presence of a CI in a head model during far-field exposure to Wi-Fi frequencies. The head model was obtained by image segmentation, the implant was modelled as a geometric structure, and the exposure sources were modelled as a uniform plane wave (power density = 10 W/m(2)) at 2.4, 5.2 and 5.8 GHz. Vertical and horizontal polarizations were simulated. Conditions with and without CI were compared. The findings of that are: (1) local differences in the field distribution close to the CI, comparing the head models with or without the CI; (2) higher field strength and point SAR value in the cochlear region very close to the CI; (3) negligible differences in the field strength and point SAR value in the cochlear region far from the CI; (4) negligible variations in the average SAR values in the cochlea and head due to the presence of the CI. The results of this study conclude that insertion of a CI brings moderate localized differences in the E, H and point SAR distribution when evaluated close to the electrode array in the cochlea, while negligible differences are found in the average SAR values both in the cochlea and head, independent of frequency and wave polarization. PMID:20683910

  12. Kinematic Model-Based Pedestrian Dead Reckoning for Heading Correction and Lower Body Motion Tracking.

    PubMed

    Lee, Min Su; Ju, Hojin; Song, Jin Woo; Park, Chan Gook

    2015-11-06

    In this paper, we present a method for finding the enhanced heading and position of pedestrians by fusing the Zero velocity UPdaTe (ZUPT)-based pedestrian dead reckoning (PDR) and the kinematic constraints of the lower human body. ZUPT is a well known algorithm for PDR, and provides a sufficiently accurate position solution for short term periods, but it cannot guarantee a stable and reliable heading because it suffers from magnetic disturbance in determining heading angles, which degrades the overall position accuracy as time passes. The basic idea of the proposed algorithm is integrating the left and right foot positions obtained by ZUPTs with the heading and position information from an IMU mounted on the waist. To integrate this information, a kinematic model of the lower human body, which is calculated by using orientation sensors mounted on both thighs and calves, is adopted. We note that the position of the left and right feet cannot be apart because of the kinematic constraints of the body, so the kinematic model generates new measurements for the waist position. The Extended Kalman Filter (EKF) on the waist data that estimates and corrects error states uses these measurements and magnetic heading measurements, which enhances the heading accuracy. The updated position information is fed into the foot mounted sensors, and reupdate processes are performed to correct the position error of each foot. The proposed update-reupdate technique consequently ensures improved observability of error states and position accuracy. Moreover, the proposed method provides all the information about the lower human body, so that it can be applied more effectively to motion tracking. The effectiveness of the proposed algorithm is verified via experimental results, which show that a 1.25% Return Position Error (RPE) with respect to walking distance is achieved.

  13. Kinematic Model-Based Pedestrian Dead Reckoning for Heading Correction and Lower Body Motion Tracking

    PubMed Central

    Lee, Min Su; Ju, Hojin; Song, Jin Woo; Park, Chan Gook

    2015-01-01

    In this paper, we present a method for finding the enhanced heading and position of pedestrians by fusing the Zero velocity UPdaTe (ZUPT)-based pedestrian dead reckoning (PDR) and the kinematic constraints of the lower human body. ZUPT is a well known algorithm for PDR, and provides a sufficiently accurate position solution for short term periods, but it cannot guarantee a stable and reliable heading because it suffers from magnetic disturbance in determining heading angles, which degrades the overall position accuracy as time passes. The basic idea of the proposed algorithm is integrating the left and right foot positions obtained by ZUPTs with the heading and position information from an IMU mounted on the waist. To integrate this information, a kinematic model of the lower human body, which is calculated by using orientation sensors mounted on both thighs and calves, is adopted. We note that the position of the left and right feet cannot be apart because of the kinematic constraints of the body, so the kinematic model generates new measurements for the waist position. The Extended Kalman Filter (EKF) on the waist data that estimates and corrects error states uses these measurements and magnetic heading measurements, which enhances the heading accuracy. The updated position information is fed into the foot mounted sensors, and reupdate processes are performed to correct the position error of each foot. The proposed update-reupdate technique consequently ensures improved observability of error states and position accuracy. Moreover, the proposed method provides all the information about the lower human body, so that it can be applied more effectively to motion tracking. The effectiveness of the proposed algorithm is verified via experimental results, which show that a 1.25% Return Position Error (RPE) with respect to walking distance is achieved. PMID:26561814

  14. Concomitant Factors Leading to an Atypical Osteonecrosis of the Jaw in a Patient with Multiple Myeloma

    PubMed Central

    Miranda-Rius, Jaume; Brunet-Llobet, Lluís; Lahor-Soler, Eduard; Giménez-Rubio, Josep Anton

    2014-01-01

    Osteonecrosis of the jaw (ONJ) is a site specific osseous pathology, characterized by chronic exposed bone in the mouth, which needs to be reinforced periodically within the medical literature. ONJ is a clinical entity with many possible aetiologies and its pathogenesis is not well understood. The risk factors for ONJ include bisphosphonates treatments, head and neck radiotherapy, dental procedures involving bone surgery, and trauma. Management of ONJ has centred on efforts to eliminate or reduce severity of symptoms, to slow or prevent the progression of disease, and to eradicate diseased bone. This case describes a rare case of ONJ in a 64-year-old Caucasian male diagnosed with multiple myeloma stage III. The lesion was related to a traumatic injury during mastication. Eighteen months ago in the same area the molar 37 was extracted, achieving a complete satisfactory healing, when only 2 doses of zoledronic acid had been administered. Actinomyces bacterial aggregates were also identified in the microscopic analysis. The management of this osteonecrotic lesion included antibiotic treatment and chlorhexidine topical gel administration. The evolution was monitored every two weeks until patient's death. The authors provide a discussion of the etiology, pathogenesis, diagnosis, and management. This case report may shed light on the controversies about concomitant factors and mechanisms inducing ONJ. PMID:25140178

  15. Clinical and image findings in bisphosphonate-related osteonecrosis of the jaws.

    PubMed

    Farias, Diogo Silva; Zen Filho, Edson Virgilio; de Oliveira, Thais Feitosa Leitão; Tinôco-Araújo, José Endrigo; Sampieri, Marcelo Bonifácio da Silva; Antunes, Heliton Spíndola; Santos, Paulo Sérgio da Silva

    2013-07-01

    Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is characterized as exposed bone in the jaws for more than 8 weeks in patients with current or previous history of therapy with bisphosphonates (BPs) and no history of radiotherapy in the head and neck. We report a case series of 7 patients with BRONJ and analyze the variations of clinical and imaging signs, correlating them with the presence or absence of bone exposure. Among the patients, 6 were women and 1 was a man, aged 42-79 years. Five of the patients were using zoledronic acid and the other 2 alendronate. The use of BPs varied from 3 to 13 years. In 5 patients, tooth extraction was the triggering event of injuries. Panoramic radiographs and computed tomography (CT) were evaluated by a radiologist blinded to the cases. There were persistent unremodeled extraction socket even several months after tooth extraction in 3 of the cases that were consistent wit CT findings that also showed areas of osteosclerosis and osteolysis. Patients were treated according to the recommendations of the AAOMS, with surgical debridement and antibiotic coverage with amoxicillin in the symptomatic patients. The follow-up of these patients ranged from 8 to 34 months, with a good response to treatment. The image findings in this case series were not specific and showed no difference between each stages of BRONJ (AAOMS, 2009). The image features were similar in presence or absence of exposed bone.

  16. A revised dosimetric model of the head and brain

    SciTech Connect

    Bolch, W.E.; Poston, J.W. Sr.

    1995-05-01

    The use of PET and SPECT radiopharmaceuticals in brain imaging has greatly expanded over the past several years. Many of these agents localize within particular subregions of the brain, thus allowing for detailed physiologic and metabolic imaging. Dosimetric models to support these advances in nuclear medicine have been lacking. For example, the brain within the phantom of MIRD Pamphlet No. 5 Revised is modeled simply as a single ellipsoid of tissue with no differentiation of its internal structures. To address this need, the MIRD Committee established a Task Group in 1992 to construct a revised dosimetric model of the brain to include the following subregions: the cerebral cortex, the white matter, the cerebellum, the thalamus, the caudate nucleus, the lentiform nucleus (putamen and globus pallidus), the cerebral spinal fluid (within the subarachnoid space of the brain), the lateral ventricles, and the third ventricle. Estimates of both electron and photon absorbed fractions (AF) were subsequently calculated using the EGS4 radiation transport code. For most of the internal brain structures, electron AFs are shown to fall fellow unity for all regions within the energy range of {approximately}200 keV to 4 MeV. For example, AFs for the caudate nucleus as both a source and target region and estimated as 0.98, 0.84, 0.39 for 200-keV, 1-MeV, and 4-MeV electron sources, respectively. Corresponding AFs within the white matter as a source and target region are estimated as 1.0, 0.95, and 0.79 for these same electron energies. Revised S values were subsequently calculated for a variety of beta-particle and positron emitters used in brain imaging.

  17. Double cluster heads model for secure and accurate data fusion in wireless sensor networks.

    PubMed

    Fu, Jun-Song; Liu, Yun

    2015-01-19

    Secure and accurate data fusion is an important issue in wireless sensor networks (WSNs) and has been extensively researched in the literature. In this paper, by combining clustering techniques, reputation and trust systems, and data fusion algorithms, we propose a novel cluster-based data fusion model called Double Cluster Heads Model (DCHM) for secure and accurate data fusion in WSNs. Different from traditional clustering models in WSNs, two cluster heads are selected after clustering for each cluster based on the reputation and trust system and they perform data fusion independently of each other. Then, the results are sent to the base station where the dissimilarity coefficient is computed. If the dissimilarity coefficient of the two data fusion results exceeds the threshold preset by the users, the cluster heads will be added to blacklist, and the cluster heads must be reelected by the sensor nodes in a cluster. Meanwhile, feedback is sent from the base station to the reputation and trust system, which can help us to identify and delete the compromised sensor nodes in time. Through a series of extensive simulations, we found that the DCHM performed very well in data fusion security and accuracy.

  18. Estimation of partial optical path length in the brain in subject-specific head models for near-infrared spectroscopy

    NASA Astrophysics Data System (ADS)

    Nakamura, Kotaro; Kurihara, Kazuki; Kawaguchi, Hiroshi; Obata, Takayuki; Ito, Hiroshi; Okada, Eiji

    2016-04-01

    Three-dimensional head models with the structures constructed from the MR head images of 40 volunteers were constructed to analyze light propagation in the subject-specific head models. The mean optical path length in the head and the partial optical path length in the brain at 13 fiducial points for each volunteer were estimated to evaluate the intersubject and spatial variability in the optical path lengths. Although the intersubject variability in the optical path lengths is very high, the spatial variability in the average of the mean optical path length and partial optical path length is similar to the previously reported data. The mean optical path length in the head increases, whereas the partial optical path length in the brain decreases with an increase in the depth of the brain surface. The partial optical path length is highly correlated with the depth of the brain surface in comparison to the mean optical path length in the head.

  19. Computational modeling of human head under blast in confined and open spaces: primary blast injury.

    PubMed

    Rezaei, A; Salimi Jazi, M; Karami, G

    2014-01-01

    In this paper, a computational modeling for biomechanical analysis of primary blast injuries is presented. The responses of the brain in terms of mechanical parameters under different blast spaces including open, semi-confined, and confined environments are studied. In the study, the effect of direct and indirect blast waves from the neighboring walls in the confined environments will be taken into consideration. A 50th percentile finite element head model is exposed to blast waves of different intensities. In the open space, the head experiences a sudden intracranial pressure (ICP) change, which vanishes in a matter of a few milliseconds. The situation is similar in semi-confined space, but in the confined space, the reflections from the walls will create a number of subsequent peaks in ICP with a longer duration. The analysis procedure is based on a simultaneous interaction simulation of the deformable head and its components with the blast wave propagations. It is concluded that compared with the open and semi-confined space settings, the walls in the confined space scenario enhance the risk of primary blast injuries considerably because of indirect blast waves transferring a larger amount of damaging energy to the head. PMID:23996897

  20. Rapidly re-computable EEG (electroencephalography) forward models for realistic head shapes

    SciTech Connect

    Ermer, J. J.; Mosher, J. C.; Baillet, S.; Leahy, R. M.

    2001-01-01

    Solution of the EEG source localization (inverse) problem utilizing model-based methods typically requires a significant number of forward model evaluations. For subspace based inverse methods like MUSIC [6], the total number of forward model evaluations can often approach an order of 10{sup 3} or 10{sup 4}. Techniques based on least-squares minimization may require significantly more evaluations. The observed set of measurements over an M-sensor array is often expressed as a linear forward spatio-temporal model of the form: F = GQ + N (1) where the observed forward field F (M-sensors x N-time samples) can be expressed in terms of the forward model G, a set of dipole moment(s) Q (3xP-dipoles x N-time samples) and additive noise N. Because of their simplicity, ease of computation, and relatively good accuracy, multi-layer spherical models [7] (or fast approximations described in [1], [7]) have traditionally been the 'forward model of choice' for approximating the human head. However, approximation of the human head via a spherical model does have several key drawbacks. By its very shape, the use of a spherical model distorts the true distribution of passive currents in the skull cavity. Spherical models also require that the sensor positions be projected onto the fitted sphere (Fig. 1), resulting in a distortion of the true sensor-dipole spatial geometry (and ultimately the computed surface potential). The use of a single 'best-fitted' sphere has the added drawback of incomplete coverage of the inner skull region, often ignoring areas such as the frontal cortex. In practice, this problem is typically countered by fitting additional sphere(s) to those region(s) not covered by the primary sphere. The use of these additional spheres results in added complication to the forward model. Using high-resolution spatial information obtained via X-ray CT or MR imaging, a realistic head model can be formed by tessellating the head into a set of contiguous regions (typically the

  1. Oral bisphosphonate associated osteonecrosis of the jaws: three case reports.

    PubMed

    Malden, N J; Pai, A Y

    2007-07-28

    Bisphosphonate associated osteonecrosis of the jaws (BONJ) has been well documented recently in relation to intravenous preparations of the drug. These are most commonly used as part of the management of hypercalcaemia of malignancy and metastatic bone disease but BONJ can also occur in association with oral bisphosphonate use. The oral preparations can also be prescribed in the management of metastatic bone disease but are more commonly used for the prevention and treatment of osteoporosis. Three case reports are presented in which alendronate, risedronate and ibandronate have been associated with osteonecrosis of the jaws. A review of the recent literature is used in the discussion of the management of these cases. The authors conclude, in agreement with other published authors, that prevention and early detection could be improved to reduce the occurrence and severity of this condition. However when BONJ is diagnosed, the early application of a closely monitored conservative regimen, with consideration given to discontinuation of the bisphosphonate, may give the best chance of containing or resolving the condition.

  2. A mouse model of weight-drop closed head injury: emphasis on cognitive and neurological deficiency

    PubMed Central

    Khalin, Igor; Jamari, Nor Laili Azua; Razak, Nadiawati Bt Abdul; Hasain, Zubaidah Bt; Nor, Mohd Asri bin Mohd; Zainudin, Mohd Hakimi bin Ahmad; Omar, Ainsah Bt; Alyautdin, Renad

    2016-01-01

    Traumatic brain injury (TBI) is a leading cause of death and disability in individuals worldwide. Producing a clinically relevant TBI model in small-sized animals remains fairly challenging. For good screening of potential therapeutics, which are effective in the treatment of TBI, animal models of TBI should be established and standardized. In this study, we established mouse models of closed head injury using the Shohami weight-drop method with some modifications concerning cognitive deficiency assessment and provided a detailed description of the severe TBI animal model. We found that 250 g falling weight from 2 cm height produced severe closed head injury in C57BL/6 male mice. Cognitive disorders in mice with severe closed head injury could be detected using passive avoidance test on day 7 after injury. Findings from this study indicate that weight-drop injury animal models are suitable for further screening of brain neuroprotectants and potentially are similar to those seen in human TBI. PMID:27212925

  3. Impact of head modeling and sensor types in localizing human gamma-band oscillations.

    PubMed

    Mideksa, K G; Hoogenboom, N; Hellriegel, H; Krause, H; Schnitzler, A; Deuschl, G; Raethjen, J; Heute, U; Muthuraman, M

    2014-01-01

    An effective mechanism in neuronal communication is oscillatory neuronal synchronization. The neuronal gamma-band (30-100 Hz) synchronization is associated with attention which is induced by a certain visual stimuli. Numerous studies have shown that the gamma-band activity is observed in the visual cortex. However, impact of different head modeling techniques and sensor types to localize gamma-band activity have not yet been reported. To do this, the brain activity was recorded using 306 magnetoencephalography (MEG) sensors, consisting of 102 magnetometers and 102 pairs of planar gradiometers (one measuring the derivative of the magnetic field along the latitude and the other along the longitude), and the data were analyzed with respect to time, frequency, and location of the strongest response. The spherical head models with a single-shell and overlapping spheres (local sphere) have been used as a forward model for calculating the external magnetic fields generated from the gamma-band activity. For each sensor type, the subject-specific frequency range of the gamma-band activity was obtained from the spectral analysis. The identified frequency range of interest with the highest gamma-band activity is then localized using a spatial-filtering technique known as dynamic imaging of coherent sources (DICS). The source analysis for all the subjects revealed that the gradiometer sensors which measure the derivative along the longitude, showed sources close to the visual cortex (cuneus) as compared to the other gradiometer sensors which measure the derivative along the latitude. However, using the magnetometer sensors, it was not possible to localize the sources in the region of interest. When comparing the two head models, the local-sphere model helps in localizing the source more focally as compared to the single-shell head model.

  4. Testing the dual-route model of perceived gaze direction: Linear combination of eye and head cues.

    PubMed

    Otsuka, Yumiko; Mareschal, Isabelle; Clifford, Colin W G

    2016-06-01

    We have recently proposed a dual-route model of the effect of head orientation on perceived gaze direction (Otsuka, Mareschal, Calder, & Clifford, 2014; Otsuka, Mareschal, & Clifford, 2015), which computes perceived gaze direction as a linear combination of eye orientation and head orientation. By parametrically manipulating eye orientation and head orientation, we tested the adequacy of a linear model to account for the effect of horizontal head orientation on perceived direction of gaze. Here, participants adjusted an on-screen pointer toward the perceived gaze direction in two image conditions: Normal condition and Wollaston condition. Images in the Normal condition included a change in the visible part of the eye along with the change in head orientation, while images in the Wollaston condition were manipulated to have identical eye regions across head orientations. Multiple regression analysis with explanatory variables of eye orientation and head orientation revealed that linear models account for most of the variance both in the Normal condition and in the Wollaston condition. Further, we found no evidence that the model with a nonlinear term explains significantly more variance. Thus, the current study supports the dual-route model that computes the perceived gaze direction as a linear combination of eye orientation and head orientation. PMID:27281465

  5. Influence of the head model on EEG and MEG source connectivity analyses.

    PubMed

    Cho, Jae-Hyun; Vorwerk, Johannes; Wolters, Carsten H; Knösche, Thomas R

    2015-04-15

    The results of brain connectivity analysis using reconstructed source time courses derived from EEG and MEG data depend on a number of algorithmic choices. While previous studies have investigated the influence of the choice of source estimation method or connectivity measure, the effects of the head modeling errors or simplifications have not been studied sufficiently. In the present simulation study, we investigated the influence of particular properties of the head model on the reconstructed source time courses as well as on source connectivity analysis in EEG and MEG. Therefore, we constructed a realistic head model and applied the finite element method to solve the EEG and MEG forward problems. We considered the distinction between white and gray matter, the distinction between compact and spongy bone, the inclusion of a cerebrospinal fluid (CSF) compartment, and the reduction to a simple 3-layer model comprising only the skin, skull, and brain. Source time courses were reconstructed using a beamforming approach and the source connectivity was estimated by the imaginary coherence (ICoh) and the generalized partial directed coherence (GPDC). Our results show that in both EEG and MEG, neglecting the white and gray matter distinction or the CSF causes considerable errors in reconstructed source time courses and connectivity analysis, while the distinction between spongy and compact bone is just of minor relevance, provided that an adequate skull conductivity value is used. Large inverse and connectivity errors are found in the same regions that show large topography errors in the forward solution. Moreover, we demonstrate that the very conservative ICoh is relatively safe from the crosstalk effects caused by imperfect head models, as opposed to the GPDC.

  6. [Computed tomography semiotics of osteonecrosis and sequestration in chronic hematogenic osteomyelitis].

    PubMed

    D'iachkova, G V; Mitina, Iu L

    2007-01-01

    Based on the data of computed tomography, radiography and densitometry in 39 patients the authors describe in detail the signs of osteonecrosis and sequestration of different localization and extension.

  7. Analysis of head-down tilt as an analog of weightlessness using a methematical simulation model

    NASA Technical Reports Server (NTRS)

    Leonard, J. I.

    1984-01-01

    Antiorthostasis or head down tilt of a moderate degree was used as a ground based analog of weightless space flight to study headward fluid shifts, decreased plasma volume, orthostatic intolerance and muscular skeletal degradation. A mathematical model was used to help interpret these observations. The model proved most valuable for these studies was originally developed as a description of the major circulatory, fluid and electrolyte control systems. Two different experimental studies are employed to validate the model. The first is a 24 hour head down tilt study and the second is a 7 day head down bed rest study. The major issues addressed include the reduction in plasma volume, the dynamic changes of venous pressure and cardiac output, the extent of central hypervolemia during long term zero g exposure, the existence of an early diuresis, the mechanisms which alter the renal regulating hormones during the short term and long term periods, the significance of potassium loss on other zero g responses, and the role of transcapillary filtration in adjusting fluid shifts. The use of mathematical models as an interpretive and analysis technique for experimental research for space life science is illustrated.

  8. Radiobiological modeling of interplay between accelerated repopulation and altered fractionation schedules in head and neck cancer.

    PubMed

    Marcu, Loredana G; Bezak, Eva

    2009-10-01

    Head and neck cancer represents a challenge for radiation oncologists due to accelerated repopulation of cancer cells during treatment. This study aims to simulate, using Monte Carlo methods, the response of a virtual head and neck tumor to both conventional and altered fractionation schedules in radiotherapy when accelerated repopulation is considered. Although clinical trials are indispensable for evaluation of novel therapeutic techniques, they are time-consuming processes which involve many complex and variable factors for success. Models can overcome some of the limitations encountered by trials as they are able to simulate in less complex environment tumor cell kinetics and dynamics, interaction processes between cells and ionizing radiation and their outcome. Conventional, hyperfractionated and accelerated treatment schedules have been implemented in a previously developed tumor growth model which also incorporates tumor repopulation during treatment. This study focuses on the influence of three main treatment-related parameters, dose per fraction, inter fraction interval and length of treatment gap and gap timing based on RTOG trial data on head and neck cancer, on tumor control. The model has shown that conventionally fractionated radiotherapy is not able to eradicate the stem population of the tumor. Therefore, new techniques such as hyperfractionated/ accelerated radiotherapy schedules should be employed. Furthermore, the correct selection of schedule-related parameters (dose per fraction, time between fractions, treatment gap scheduling) is crucial in overcoming accelerated repopulation. Modeling of treatment regimens and their input parameters can offer better understanding of the radiobiological interactions and also treatment outcome.

  9. Mapping the brain cortex using an analytical model of the head

    NASA Astrophysics Data System (ADS)

    Hollaender, Igor

    1995-04-01

    In neurosciences, 3D renderings of the human brain cortex based on MR tomographical measurements are often used to study cortical structures, their similarity or variability, or to depict surface distribution of a given physical quantity. We have developed a method for producing maps of the human cortex depicting the complete brain surface in one view. The mapping is based on casting rays normal to the skin surface of the head. The projection surface is then remapped to the plane. An analytical model of the head consisting of four Bezier patches is used for generating the normal rays. The contribution describes the structure of the model and its computation, the projection geometry of the mapping, and the details of the rendering phase. Examples of possible applications of the method are presented.

  10. Plain film and CBCT findings in a case of bisphosphonate-related osteonecrosis of the jaw.

    PubMed

    Singer, Steven R; Mupparapu, Muralidhar

    2009-02-01

    Imaging, along with clinical examination, plays a key role in determining the presence and extent of bisphosphonate-related osteonecrosis of the jaw (BRONJ). In this case, cone-beam computerized tomography (CBCT) was used to detect a large sequestrum and hyperstotic bone, leading to a diagnosis of bisphosphonate-related osteonecrosis of the jaw in a patient with a history of oral bisphosphonate use for treatment of osteoporosis. The radiographic features of this case of BRONJ are discussed.

  11. Head and neck resonance in a rhesus monkey - a comparison with results from a human model

    NASA Astrophysics Data System (ADS)

    Tinniswood, Adam; Gandhi, Om P.

    1999-03-01

    The use of primates for examining the effects of electromagnetic radiation on behavioural patterns is well established. Rats have also been used for this purpose. However, the monkey is of greater interest as its physiological make-up is somewhat closer to that of the human. Since the behavioural effects are likely to occur at lower field strengths for resonant absorption conditions for the head and neck, the need for determination of resonance frequencies for this region is obvious. Numerical techniques are ideal for the prediction of coupling to each of the organs, and accurate anatomically based models can be used to pinpoint the conditions for maximum absorption in the head in order to focus the experiments. In this paper we use two models, one of a human male and the other of a rhesus monkey, and find the mass-averaged power absorption spectra for both. The frequencies at which highest absorption (i.e. resonance) occurs in both the whole body and the head and neck region are determined. The results from these two models are compared for both E-polarization and k-polarization, and are shown to obey basic electromagnetic scaling principles.

  12. Development of a Human Head FE Model and Impact Simulation on the Focal Brain Injury

    NASA Astrophysics Data System (ADS)

    Watanabe, Dai; Yuge, Kohei; Nishimoto, Tetsuya; Murakami, Shigeyuki; Takao, Hiroyuki

    In this paper, a three-dimensional digital human-head model was developed and several dynamic analyses on the head trauma were conducted. This model was built up by the VOXEL approach using 433 slice CT images (512×512 pixels) and made of 1.22 million parallelepiped finite elements with 10 anatomical tissue properties such as scalp, CSF, skull, brain, dura mater and so on. The numerical analyses were conducted using a finite element code the authors have developed. The main features of the code are 1) it is based on the explicit time integration method and 2) it uses the one point integration method to evaluate the equivalent nodal forces with the hourglass control proposed by Flanagan and Belytschko(1) and 3) it utilizes the parallel computation system based on MPI. In order to verify the developed model, the head impact experiment for a cadaver by Nahum et al.(2) was simulated. The calculated results showed good agreement with the experimental ones. A front and rear impact analyses were also performed to discuss on the characteristic measure of the brain injury, in which the von-Mises stress was high in the frontal lobe in both of the analyses because of the large deformations of a frontal cranial base. This result suggests that the von-Mises stress can be a good measure of the brain injury since it is empirically well known that the frontal lobe tends to get injured regardless of the impact positions.

  13. Numerical model (switchable/dual model) of the human head for rigid body and finite elements applications.

    PubMed

    Tabacu, Stefan

    2015-01-01

    In this paper, a methodology for the development and validation of a numerical model of the human head using generic procedures is presented. All steps required, starting with the model generation, model validation and applications will be discussed. The proposed model may be considered as a dual one due to its capabilities to switch from deformable to a rigid body according to the application's requirements. The first step is to generate the numerical model of the human head using geometry files or medical images. The required stiffness and damping for the elastic connection used for the rigid body model are identified by performing a natural frequency analysis. The presented applications for model validation are related to impact analysis. The first case is related to Nahum's (Nahum and Smith 1970) experiments pressure data being evaluated and a pressure map generated using the results from discrete elements. For the second case, the relative displacement between the brain and the skull is evaluated according to Hardy's (Hardy WH, Foster CD, Mason, MJ, Yang KH, King A, Tashman S. 2001.Investigation of head injury mechanisms using neutral density technology and high-speed biplanar X-ray. Stapp Car Crash J. 45:337-368, SAE Paper 2001-22-0016) experiments. The main objective is to validate the rigid model as a quick and versatile tool for acquiring the input data for specific brain analyses. PMID:24156633

  14. Numerical model (switchable/dual model) of the human head for rigid body and finite elements applications.

    PubMed

    Tabacu, Stefan

    2015-01-01

    In this paper, a methodology for the development and validation of a numerical model of the human head using generic procedures is presented. All steps required, starting with the model generation, model validation and applications will be discussed. The proposed model may be considered as a dual one due to its capabilities to switch from deformable to a rigid body according to the application's requirements. The first step is to generate the numerical model of the human head using geometry files or medical images. The required stiffness and damping for the elastic connection used for the rigid body model are identified by performing a natural frequency analysis. The presented applications for model validation are related to impact analysis. The first case is related to Nahum's (Nahum and Smith 1970) experiments pressure data being evaluated and a pressure map generated using the results from discrete elements. For the second case, the relative displacement between the brain and the skull is evaluated according to Hardy's (Hardy WH, Foster CD, Mason, MJ, Yang KH, King A, Tashman S. 2001.Investigation of head injury mechanisms using neutral density technology and high-speed biplanar X-ray. Stapp Car Crash J. 45:337-368, SAE Paper 2001-22-0016) experiments. The main objective is to validate the rigid model as a quick and versatile tool for acquiring the input data for specific brain analyses.

  15. Management and treatment of osteonecrosis in children and adolescents with acute lymphoblastic leukemia

    PubMed Central

    te Winkel, Mariël L.; Pieters, Rob; Wind, Ernst-Jan D.; Bessems, J.H.J.M. (Gert); van den Heuvel-Eibrink, Marry M.

    2014-01-01

    There is no consensus regarding how to manage osteonecrosis in pediatric acute lymphoblastic leukemia patients. Therefore, we performed a quality assessment of the literature with the result of a search strategy using the MESH terms osteonecrosis, children, childhood cancer, surgery, bisphosphonates, 6 hydroxymethyl-glutaryl CoA reductase inhibitors, anticoagulants and hyperbaric oxygen, and terms related to these MESH terms. A randomized controlled trial showed that osteonecrosis can be prevented by intermittent, instead of continuous, corticosteroid administration. The studies on interventions after onset of osteonecrosis were of low-quality evidence. Seven pediatric acute lymphoblastic leukemia studies described non-surgical interventions; bisphosphonates (n=5), hyperbaric oxygen therapy (n=1), or prostacyclin analogs (n=1). Safety and efficacy studies are lacking. Five studies focused on surgical interventions; none was of sufficient quality to draw definite conclusions. In conclusion, preventing osteonecrosis is feasible in a proportion of the pediatric acute lymphoblastic leukemia patients by discontinuous, instead of continuous, steroid scheduling. The questions as to how to treat childhood acute lymphoblastic leukemia patients with osteonecrosis cannot be answered as good-quality studies are lacking. PMID:24598854

  16. Bisphosphonate-induced osteonecrosis of the external ear canal: a retrospective study.

    PubMed

    Froelich, K; Radeloff, A; Köhler, C; Mlynski, R; Müller, J; Hagen, R; Kleinsasser, N H

    2011-08-01

    In 2003, osteonecrosis of the jaw was described as an intraoral complication of bisphosphonate therapy. More recently, cases of avascular necrosis of the hip were reported in patients with long-lasting bisphosphonate therapy. Thus, it was the aim of the present study to analyze cases of benign osteonecrosis of the external ear canal and to retrospectively identify a possible relationship to long-lasting bisphosphonate therapy. 13 patients with osteonecrosis of the external ear canal operated on between 2005 and 2009 were included. Patient histories were reviewed for possible previous or current bisphosphonate therapy. Three patients with osteonecrosis of the external ear canal and long-term bisphosphonate therapy could be identified. They had been treated either for breast cancer or multiple myeloma. Certainly, the jaw is an area of increased risk for developing osteonecrosis with its high mechanical stress and intraoral bacterial flora. However, osteonecrosis of the hips and the external ear canal in patients receiving long-term bisphosphonate therapy necessitate further investigation of a possible systemic, bisphosphonate-related phenomenon. PMID:21327733

  17. Jaw osteonecrosis related to bisphosphonate therapy: a severe secondary disorder.

    PubMed

    Dannemann, C; Grätz, K W; Riener, M O; Zwahlen, R A

    2007-04-01

    Bisphosphonate-related osteonecrosis of the jaws (BON), first described in 2003, is gaining importance due to the increasing indication spectrum of bisphosphonate therapy [S. Takeyama, M. Ito, H. Shinoda, A novel bisphosphonate, TRK-530, for periodontitis, Bone 38 (2006) 31-31; M. Tagil, A. W-Dahl, J. Astrand, D. Little, S. Toksvig-Larsen, Decreasing the catabolic response by a single bisphosphonate infusion shortens the healing time in hemicallotasis operations, Bone 38 (2006) 84-85; E. Rodriguez, M.C. Duran, L.M. Rodriguez, R. Ros, M.R. Aleman, M. Rodriguez-Gaspar, A.M. Lopez, E. Garcia-Valdecasas, F. Santolaria, Intravenous (IV) bisphosphonates for osteopenic cancer survivor women: an alternative treatment, Bone 38 (2006) 72-73; D.G. Little, K. Ward, P. Kiely, M.C. Bellemore, J. Briody, C.T. Cowell, Bisphosphonate rescue in distraction osteogenesis: a case series, Bone 38 (2006) 80-80; R. Marx, Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic, J. Oral Maxillofac. Surg. 61 (2003) 1115-1118]. BON patients suffering from varying bony defects and symptoms are extremely restricted in their quality of life. Due to a limited knowledge of the aetiology of BON efficient evidence-based treatment strategies are lacking. Until now 23 patients with bisphosphonate-related osteonecrosis have been admitted to the Department of Cranio-Maxillofacial Surgery of the University of Zurich. A complete history has been recorded. All patients underwent clinical and radiographic examination. CT scans and MRI have been performed in selected cases. All patients had in common that, before signs of BON were observed, a local traumatic incidence had occurred. All patients showed signs of infection which could be remarkably reduced by antibacterial treatment. Furthermore, the period of bisphosphonate treatment was found to be one of the significant factors causing bisphosphonate-related osteonecrosis of the jaws. The aetiology of BON

  18. Post-traumatic osteoporotic vertebral osteonecrosis treated using balloon kyphoplasty.

    PubMed

    Wang, Genlin; Yang, Huilin; Meng, Bin; Zhu, Xuesong; Zou, Jun; Gan, Minfeng; Mei, Xin; Chen, Kangwu; Tang, Tiansi

    2011-05-01

    Nineteen patients with post-traumatic osteoporotic vertebral osteonecrosis were treated using percutaneous balloon kyphoplasty. The anterior and middle vertebral heights, as well as the kyphotic angle, were measured using a standing lateral radiograph before surgery, 2 days after surgery and at the final follow-up. At the same time points, a visual analog scale and the Oswestry Disability Index were used to evaluate pain status and functional activity, respectively. The mean follow-up was 24.7 months (range: 7-36 months). Statistically significant improvements were observed between the preoperative and postoperative assessments for each evaluated measure (p<0.05). There were no statistically significant differences between the postoperative and final follow-up assessments (p>0.05). Asymptomatic cement leakage into the intervertebral disc occurred in three patients. This study suggests that balloon kyphoplasty is a safe and effective procedure for treating this disease entity.

  19. Multi-scale/multi-physical modeling in head/disk interface of magnetic data storage

    NASA Astrophysics Data System (ADS)

    Chung, Pil Seung; Smith, Robert; Vemuri, Sesha Hari; Jhon, Young In; Tak, Kyungjae; Moon, Il; Biegler, Lorenz T.; Jhon, Myung S.

    2012-04-01

    The model integration of the head-disk interface (HDI) in the hard disk drive system, which includes the hierarchy of highly interactive layers (magnetic layer, carbon overcoat (COC), lubricant, and air bearing system (ABS)), has recently been focused upon to resolve technical barriers and enhance reliability. Heat-assisted magnetic recording especially demands that the model simultaneously incorporates thermal and mechanical phenomena by considering the enormous combinatorial cases of materials and multi-scale/multi-physical phenomena. In this paper, we explore multi-scale/multi-physical simulation methods for HDI, which will holistically integrate magnetic layers, COC, lubricants, and ABS in non-isothermal conditions.

  20. Mechanical Behaviour of Umbrella-Shaped, Ni-Ti Memory Alloy Femoral Head Support Device during Implant Operation: A Finite Element Analysis Study

    PubMed Central

    Yi, Wei; Tian, Qing; Dai, Zhipeng; Liu, Xiaohu

    2014-01-01

    A new instrument used for treating femoral head osteonecrosis was recently proposed: the umbrella-shaped, Ni-Ti memory femoral head support device. The device has an efficacy rate of 82.35%. Traditional radiographic study provides limited information about the mechanical behaviour of the support device during an implant operation. Thus, this study proposes a finite element analysis method, which includes a 3-step formal head model construction scheme and a unique material assignment strategy for evaluating mechanical behaviour during an implant operation. Four different scenarios with different constraints, initial positions and bone qualities are analyzed using the simulation method. The max radium of the implanted device was consistent with observation data, which confirms the accuracy of the proposed method. To ensure that the device does not unexpectedly open and puncture the femoral head, the constraint on the impact device should be strong. The initial position of sleeve should be in the middle to reduce the damage to the decompression channel. The operation may fail because of poor bone quality caused by severe osteoporosis. The proposed finite element analysis method has proven to be an accurate tool for studying the mechanical behaviour of umbrella-shaped, Ni-Ti memory alloy femoral head support device during an implant operation. The 3-step construct scheme can be implemented with any kind of bone structure meshed with multiple element types. PMID:24960038

  1. Neuropathological changes in a lamb model of non-accidental head injury (the shaken baby syndrome).

    PubMed

    Finnie, J W; Blumbergs, P C; Manavis, J; Turner, R J; Helps, S; Vink, R; Byard, R W; Chidlow, G; Sandoz, B; Dutschke, J; Anderson, R W G

    2012-08-01

    Non-accidental head injury (NAHI), also termed the "shaken baby syndrome", is a major cause of death and severe neurological dysfunction in children under three years of age, but it is debated whether shaking alone is sufficient to produce brain injury and mortality or whether an additional head impact is required. In an attempt to resolve this question, we used a lamb model of NAHI since these animals have a relatively large gyrencephalic brain and weak neck muscles resembling those of a human infant. Three anaesthetised lambs of lower body weight than others in the experimental group died unexpectedly after being shaken, proving that shaking alone can be lethal. In these lambs, axonal injury, neuronal reaction and albumin extravasation were widely distributed in the hemispheric white matter, brainstem and at the craniocervical junction, and of much greater magnitude than in higher body weight lambs which did not die. Moreover, in the eyes of these shaken lambs, there was damage to retinal inner nuclear layer neurons, mild, patchy ganglion cell axonal injury, widespread Muller glial reaction, and uveal albumin extravasation. This study proved that shaking of a subset of lambs can result in death, without an additional head impact being required.

  2. An optimized computed tomography protocol for metallic gunshot head trauma in a seal model.

    PubMed

    Fraga-Manteiga, Eduardo; Shaw, Darren J; Dennison, Sophie; Brownlow, Andrew; Schwarz, Tobias

    2014-01-01

    Computed tomography (CT) is commonly used to assess animals with head trauma. However, strongly attenuating objects such as metallic gunshot cause artifacts that may make accurate localization of shrapnel pieces difficult. The purpose of this study was to develop an optimized CT protocol for minimizing metal artifacts in an animal model of gunshot head trauma. A cadaver head of a stranded Gray seal (Halichoerus grypus) was shot post-mortem with a 0.223-inch caliber rifle. The head was frozen, thawed, and scanned using a multislice CT scanner and protocols with varying acquisition and reconstruction parameters. Scans were acquired with and without use of the scanner's proprietary Extended CT Scale (ECTS) mode and beam hardening reduction (Posterior Fossa Optimization [PFO]) filter. Window/level display settings were also varied. For each protocol and each of five selected metallic shrapnel pieces, a single observer measured combined metal halo artifact and shrapnel area using a hand-traced region of interest. The number of hypo- and hyper-attenuating streak artifacts was also recorded. Measurements were repeated for three different reading sessions. Metal CT artifacts were minimized with a high-frequency image reconstruction algorithm and a wide window setting. Further artifact reduction was achieved with a proprietary ECTS raw data reconstruction technique and a very wide window. This enabled a more confident evaluation of surrounding bone. On the other hand, these techniques are unfortunately not effective under conditions of soft tissue evaluation. Increasing tube voltage and use of a proprietary PFO filter did not yield a significant reduction in metal artifacts. PMID:25184173

  3. Heads Up

    MedlinePlus

    ... Juvenil HEADS UP to School Sports Online Concussion Training Coaches Parents Athletes Sports Officials HEADS UP to Schools School Nurses Teachers, Counselors, and School Professionals Parents HEADS UP ...

  4. Evaluation of three-dimensional anisotropic head model for mapping realistic electromagnetic fields of brain tissues

    NASA Astrophysics Data System (ADS)

    Jeong, Woo Chul; Wi, Hun; Sajib, Saurav Z. K.; Oh, Tong In; Kim, Hyung Joong; Kwon, Oh In; Woo, Eung Je

    2015-08-01

    Electromagnetic fields provide fundamental data for the imaging of electrical tissue properties, such as conductivity and permittivity, in recent magnetic resonance (MR)-based tissue property mapping. The induced voltage, current density, and magnetic flux density caused by externally injected current are critical factors for determining the image quality of electrical tissue conductivity. As a useful tool to identify bio-electromagnetic phenomena, precise approaches are required to understand the exact responses inside the human body subject to an injected currents. In this study, we provide the numerical simulation results of electromagnetic field mapping of brain tissues using a MR-based conductivity imaging method. First, we implemented a realistic three-dimensional human anisotropic head model using high-resolution anatomical and diffusion tensor MR images. The voltage, current density, and magnetic flux density of brain tissues were imaged by injecting 1 mA of current through pairs of electrodes on the surface of our head model. The current density map of anisotropic brain tissues was calculated from the measured magnetic flux density based on the linear relationship between the water diffusion tensor and the electrical conductivity tensor. Comparing the current density to the previous isotropic model, the anisotropic model clearly showed the differences between the brain tissues. This originates from the enhanced signals by the inherent conductivity contrast as well as the actual tissue condition resulting from the injected currents.

  5. NIR light propagation in a digital head model for traumatic brain injury (TBI).

    PubMed

    Francis, Robert; Khan, Bilal; Alexandrakis, George; Florence, James; MacFarlane, Duncan

    2015-09-01

    Near infrared spectroscopy (NIRS) is capable of detecting and monitoring acute changes in cerebral blood volume and oxygenation associated with traumatic brain injury (TBI). Wavelength selection, source-detector separation, optode density, and detector sensitivity are key design parameters that determine the imaging depth, chromophore separability, and, ultimately, clinical usefulness of a NIRS instrument. We present simulation results of NIR light propagation in a digital head model as it relates to the ability to detect intracranial hematomas and monitor the peri-hematomal tissue viability. These results inform NIRS instrument design specific to TBI diagnosis and monitoring.

  6. NIR light propagation in a digital head model for traumatic brain injury (TBI).

    PubMed

    Francis, Robert; Khan, Bilal; Alexandrakis, George; Florence, James; MacFarlane, Duncan

    2015-09-01

    Near infrared spectroscopy (NIRS) is capable of detecting and monitoring acute changes in cerebral blood volume and oxygenation associated with traumatic brain injury (TBI). Wavelength selection, source-detector separation, optode density, and detector sensitivity are key design parameters that determine the imaging depth, chromophore separability, and, ultimately, clinical usefulness of a NIRS instrument. We present simulation results of NIR light propagation in a digital head model as it relates to the ability to detect intracranial hematomas and monitor the peri-hematomal tissue viability. These results inform NIRS instrument design specific to TBI diagnosis and monitoring. PMID:26417498

  7. NIR light propagation in a digital head model for traumatic brain injury (TBI)

    PubMed Central

    Francis, Robert; Khan, Bilal; Alexandrakis, George; Florence, James; MacFarlane, Duncan

    2015-01-01

    Near infrared spectroscopy (NIRS) is capable of detecting and monitoring acute changes in cerebral blood volume and oxygenation associated with traumatic brain injury (TBI). Wavelength selection, source-detector separation, optode density, and detector sensitivity are key design parameters that determine the imaging depth, chromophore separability, and, ultimately, clinical usefulness of a NIRS instrument. We present simulation results of NIR light propagation in a digital head model as it relates to the ability to detect intracranial hematomas and monitor the peri-hematomal tissue viability. These results inform NIRS instrument design specific to TBI diagnosis and monitoring. PMID:26417498

  8. Mechanics of blast loading on the head models in the study of traumatic brain injury using experimental and computational approaches.

    PubMed

    Ganpule, S; Alai, A; Plougonven, E; Chandra, N

    2013-06-01

    Blast waves generated by improvised explosive devices can cause mild, moderate to severe traumatic brain injury in soldiers and civilians. To understand the interactions of blast waves on the head and brain and to identify the mechanisms of injury, compression-driven air shock tubes are extensively used in laboratory settings to simulate the field conditions. The overall goal of this effort is to understand the mechanics of blast wave-head interactions as the blast wave traverses the head/brain continuum. Toward this goal, surrogate head model is subjected to well-controlled blast wave profile in the shock tube environment, and the results are analyzed using combined experimental and numerical approaches. The validated numerical models are then used to investigate the spatiotemporal distribution of stresses and pressure in the human skull and brain. By detailing the results from a series of careful experiments and numerical simulations, this paper demonstrates that: (1) Geometry of the head governs the flow dynamics around the head which in turn determines the net mechanical load on the head. (2) Biomechanical loading of the brain is governed by direct wave transmission, structural deformations, and wave reflections from tissue-material interfaces. (3) Deformation and stress analysis of the skull and brain show that skull flexure and tissue cavitation are possible mechanisms of blast-induced traumatic brain injury.

  9. Mechanics of blast loading on the head models in the study of traumatic brain injury using experimental and computational approaches.

    PubMed

    Ganpule, S; Alai, A; Plougonven, E; Chandra, N

    2013-06-01

    Blast waves generated by improvised explosive devices can cause mild, moderate to severe traumatic brain injury in soldiers and civilians. To understand the interactions of blast waves on the head and brain and to identify the mechanisms of injury, compression-driven air shock tubes are extensively used in laboratory settings to simulate the field conditions. The overall goal of this effort is to understand the mechanics of blast wave-head interactions as the blast wave traverses the head/brain continuum. Toward this goal, surrogate head model is subjected to well-controlled blast wave profile in the shock tube environment, and the results are analyzed using combined experimental and numerical approaches. The validated numerical models are then used to investigate the spatiotemporal distribution of stresses and pressure in the human skull and brain. By detailing the results from a series of careful experiments and numerical simulations, this paper demonstrates that: (1) Geometry of the head governs the flow dynamics around the head which in turn determines the net mechanical load on the head. (2) Biomechanical loading of the brain is governed by direct wave transmission, structural deformations, and wave reflections from tissue-material interfaces. (3) Deformation and stress analysis of the skull and brain show that skull flexure and tissue cavitation are possible mechanisms of blast-induced traumatic brain injury. PMID:22832705

  10. MIDA: A Multimodal Imaging-Based Detailed Anatomical Model of the Human Head and Neck.

    PubMed

    Iacono, Maria Ida; Neufeld, Esra; Akinnagbe, Esther; Bower, Kelsey; Wolf, Johanna; Vogiatzis Oikonomidis, Ioannis; Sharma, Deepika; Lloyd, Bryn; Wilm, Bertram J; Wyss, Michael; Pruessmann, Klaas P; Jakab, Andras; Makris, Nikos; Cohen, Ethan D; Kuster, Niels; Kainz, Wolfgang; Angelone, Leonardo M

    2015-01-01

    Computational modeling and simulations are increasingly being used to complement experimental testing for analysis of safety and efficacy of medical devices. Multiple voxel- and surface-based whole- and partial-body models have been proposed in the literature, typically with spatial resolution in the range of 1-2 mm and with 10-50 different tissue types resolved. We have developed a multimodal imaging-based detailed anatomical model of the human head and neck, named "MIDA". The model was obtained by integrating three different magnetic resonance imaging (MRI) modalities, the parameters of which were tailored to enhance the signals of specific tissues: i) structural T1- and T2-weighted MRIs; a specific heavily T2-weighted MRI slab with high nerve contrast optimized to enhance the structures of the ear and eye; ii) magnetic resonance angiography (MRA) data to image the vasculature, and iii) diffusion tensor imaging (DTI) to obtain information on anisotropy and fiber orientation. The unique multimodal high-resolution approach allowed resolving 153 structures, including several distinct muscles, bones and skull layers, arteries and veins, nerves, as well as salivary glands. The model offers also a detailed characterization of eyes, ears, and deep brain structures. A special automatic atlas-based segmentation procedure was adopted to include a detailed map of the nuclei of the thalamus and midbrain into the head model. The suitability of the model to simulations involving different numerical methods, discretization approaches, as well as DTI-based tensorial electrical conductivity, was examined in a case-study, in which the electric field was generated by transcranial alternating current stimulation. The voxel- and the surface-based versions of the models are freely available to the scientific community. PMID:25901747

  11. Minimum-norm cortical source estimation in layered head models is robust against skull conductivity error.

    PubMed

    Stenroos, Matti; Hauk, Olaf

    2013-11-01

    The conductivity profile of the head has a major effect on EEG signals, but unfortunately the conductivity for the most important compartment, skull, is only poorly known. In dipole modeling studies, errors in modeled skull conductivity have been considered to have a detrimental effect on EEG source estimation. However, as dipole models are very restrictive, those results cannot be generalized to other source estimation methods. In this work, we studied the sensitivity of EEG and combined MEG+EEG source estimation to errors in skull conductivity using a distributed source model and minimum-norm (MN) estimation. We used a MEG/EEG modeling set-up that reflected state-of-the-art practices of experimental research. Cortical surfaces were segmented and realistically-shaped three-layer anatomical head models were constructed, and forward models were built with Galerkin boundary element method while varying the skull conductivity. Lead-field topographies and MN spatial filter vectors were compared across conductivities, and the localization and spatial spread of the MN estimators were assessed using intuitive resolution metrics. The results showed that the MN estimator is robust against errors in skull conductivity: the conductivity had a moderate effect on amplitudes of lead fields and spatial filter vectors, but the effect on corresponding morphologies was small. The localization performance of the EEG or combined MEG+EEG MN estimator was only minimally affected by the conductivity error, while the spread of the estimate varied slightly. Thus, the uncertainty with respect to skull conductivity should not prevent researchers from applying minimum norm estimation to EEG or combined MEG+EEG data. Comparing our results to those obtained earlier with dipole models shows that general judgment on the performance of an imaging modality should not be based on analysis with one source estimation method only.

  12. MIDA: A Multimodal Imaging-Based Detailed Anatomical Model of the Human Head and Neck

    PubMed Central

    Iacono, Maria Ida; Neufeld, Esra; Akinnagbe, Esther; Bower, Kelsey; Wolf, Johanna; Vogiatzis Oikonomidis, Ioannis; Sharma, Deepika; Lloyd, Bryn; Wilm, Bertram J.; Wyss, Michael; Pruessmann, Klaas P.; Jakab, Andras; Makris, Nikos; Cohen, Ethan D.; Kuster, Niels; Kainz, Wolfgang; Angelone, Leonardo M.

    2015-01-01

    Computational modeling and simulations are increasingly being used to complement experimental testing for analysis of safety and efficacy of medical devices. Multiple voxel- and surface-based whole- and partial-body models have been proposed in the literature, typically with spatial resolution in the range of 1–2 mm and with 10–50 different tissue types resolved. We have developed a multimodal imaging-based detailed anatomical model of the human head and neck, named “MIDA”. The model was obtained by integrating three different magnetic resonance imaging (MRI) modalities, the parameters of which were tailored to enhance the signals of specific tissues: i) structural T1- and T2-weighted MRIs; a specific heavily T2-weighted MRI slab with high nerve contrast optimized to enhance the structures of the ear and eye; ii) magnetic resonance angiography (MRA) data to image the vasculature, and iii) diffusion tensor imaging (DTI) to obtain information on anisotropy and fiber orientation. The unique multimodal high-resolution approach allowed resolving 153 structures, including several distinct muscles, bones and skull layers, arteries and veins, nerves, as well as salivary glands. The model offers also a detailed characterization of eyes, ears, and deep brain structures. A special automatic atlas-based segmentation procedure was adopted to include a detailed map of the nuclei of the thalamus and midbrain into the head model. The suitability of the model to simulations involving different numerical methods, discretization approaches, as well as DTI-based tensorial electrical conductivity, was examined in a case-study, in which the electric field was generated by transcranial alternating current stimulation. The voxel- and the surface-based versions of the models are freely available to the scientific community. PMID:25901747

  13. Determination of stimulation focality in heterogeneous head models during transcranial magnetic stimulation (TMS)

    NASA Astrophysics Data System (ADS)

    Lee, Erik; Hadimani, Ravi; Jiles, David

    2015-03-01

    Transcranial Magnetic Stimulation (TMS) is an increasingly popular tool used by both the scientific and medical community to understand and treat the brain. TMS has the potential to help people with a wide range of diseases such as Parkinson's, Alzheimer's, and PTSD, while currently being used to treat people with chronic, drug-resistant depression. Through computer simulations, we are able to see the electric field that TMS induces in anatomical human models, but there is no measure to quantify this electric field in a way that relates to a specific patient undergoing TMS therapy. We propose a way to quantify the focality of the induced electric field in a heterogeneous head model during TMS by relating the surface area of the brain being stimulated to the total volume of the brain being stimulated. This figure would be obtained by conducting finite element analysis (FEA) simulations of TMS therapy on a patient specific head model. Using this figure to assist in TMS therapy will allow clinicians and researchers to more accurately stimulate the desired region of a patient's brain and be more equipped to do comparative studies on the effects of TMS across different patients. This work was funded by the Carver Charitable Trust.

  14. CE-QUAL-W2 Modeling of Head-of-Reservoir Conditions at Shasta Reservoir, California

    NASA Astrophysics Data System (ADS)

    Clancey, K. M.; Saito, L.; Svoboda, C.; Bender, M. D.; Hannon, J.

    2014-12-01

    Restoration of Chinook salmon and steelhead is a priority in the Sacramento River Basin since they were listed under the Endangered Species Act in 1989 and 1998, respectively. Construction of Shasta Dam and Reservoir obstructed fish migration, resulting in severe population declines. Efforts have been undertaken to restore the fisheries, including evaluation of opportunities for reintroducing Chinook salmon upstream of the dam and providing juvenile fish passage downstream past Shasta Dam. Shasta Reservoir and the Sacramento River and McCloud River tributaries have been modeled with CE-QUAL-W2 (W2) to assess hydrodynamic and temperature conditions with and without surface curtains to be deployed in the tributaries. Expected head-of-reservoir tributary conditions of temperature and water depth are being simulated under dry, median and wet year conditions. Model output is analyzed during months of downstream migration of fish from upstream Sacramento and McCloud River tributaries. W2 will be used to determine presence of favorable conditions for juvenile rearing with proposed surface temperature curtains. Evaluation of favorable conditions for fish includes assessment of water temperature, velocities, and depth. Preliminary results for head-of-reservoir conditions and the influence of temperature curtains modeled with W2 will be presented. Study findings may assist in formulation of juvenile fish passage alternatives for Shasta Lake.

  15. Partially Automated Method for Localizing Standardized Acupuncture Points on the Heads of Digital Human Models

    PubMed Central

    Kim, Jungdae; Kang, Dae-In

    2015-01-01

    Having modernized imaging tools for precise positioning of acupuncture points over the human body where the traditional therapeutic method is applied is essential. For that reason, we suggest a more systematic positioning method that uses X-ray computer tomographic images to precisely position acupoints. Digital Korean human data were obtained to construct three-dimensional head-skin and skull surface models of six individuals. Depending on the method used to pinpoint the positions of the acupoints, every acupoint was classified into one of three types: anatomical points, proportional points, and morphological points. A computational algorithm and procedure were developed for partial automation of the positioning. The anatomical points were selected by using the structural characteristics of the skin surface and skull. The proportional points were calculated from the positions of the anatomical points. The morphological points were also calculated by using some control points related to the connections between the source and the target models. All the acupoints on the heads of the six individual were displayed on three-dimensional computer graphical image models. This method may be helpful for developing more accurate experimental designs and for providing more quantitative volumetric methods for performing analyses in acupuncture-related research. PMID:26101534

  16. Study of the influence of the laterality of mobile phone use on the SAR induced in two head models

    NASA Astrophysics Data System (ADS)

    Ghanmi, Amal; Varsier, Nadège; Hadjem, Abdelhamid; Conil, Emmanuelle; Picon, Odile; Wiart, Joe

    2013-05-01

    The objective of this paper is to investigate and to analyse the influence of the laterality of mobile phone use on the exposure of the brain to radio-frequencies (RF) and electromagnetic fields (EMF) from different mobile phone models using the finite-difference time-domain (FDTD) method. The study focuses on the comparison of the specific absorption rate (SAR) induced on the right and left sides of two numerical adult and child head models. The heads are exposed by both phone models operating in GSM frequency bands for both ipsilateral and contralateral configurations. A slight SAR difference between the two sides of the heads is noted. The results show that the variation between the left and the right sides is more important at 1800 MHz for an ipsilateral use. Indeed, at this frequency, the variation can even reach 20% for the SAR10g and the SAR1g induced in the head and in the brain, respectively. Moreover, the average SAR induced by the mobile phone in the half hemisphere of the brain in ipsilateral exposure is higher than in contralateral exposure. Owing to the superficial character of energy deposition at 1800 MHz, this difference in the SAR induced for the ipsilateral and contralateral usages is more significant at 1800 MHz than at 900 MHz. The results have shown that depending on the phantom head models, the SAR distribution in the brain can vary because of differences in anatomical proportions and in the geometry of the head models. The induced SAR in child head and in sub-regions of the brain is significantly higher (up to 30%) compared to the adult head. This paper confirms also that the shape/design of the mobile and the location of the antenna can have a large influence at high frequency on the exposure of the brain, particularly on the SAR distribution and on the distinguished brain regions.

  17. Coupled head neck torso and seat model for car seat optimization under rear-end impact

    NASA Astrophysics Data System (ADS)

    Bourdet, Nicolas; Willinger, Rémy

    2008-06-01

    The development of new protective systems must be performed on tools reliable and representative of alive human. In an earlier study, a simplified but realistic modelling of the head-neck system under moderate rear impact was performed. In order to address this issue, an original lumped model of the human torso was developed and coupled to a car seat-head rest complex. The experimental modal analysis of the human torso in a seating position performed by Kitazaki in 1992 [Paper presented at the United Kingdom Meeting on Human Response to Vibration held at I.S.V.R. University of Southampton, Southampton, UK, 28-30 September 1992.] was used in the present study for the identification of the mechanical parameters of a lumped human torso model. Despite its low complexity, this model was able to reproduce the five first experimental vibration modes and it was possible to validate it in terms of natural frequencies, damping ratio and mode shapes. In addition to the lumped approach, an external geometry of the human torso was implemented in order to provide a realistic coupling of the human body model to a finite element model of the car seat also developed in the present study. A parametric study was finally carried out in order to evaluate the influence of the torso behaviour and of the different parts of a car seat on the mechanical neck response under rear-end impact. The results of this study allow concluding that the torso behaviour has an important influence on the neck loading and therefore that the quality of a car seat depends on the human body substitute used. For instance, with the proposed torso model, a low-neck injury criterion (NIC) rearward value was obtained with low rigidity of the backrest foam and a stiff backrest net.

  18. EEG source analysis of epileptiform activity using a 1mm anisotropic hexahedra finite element head model

    PubMed Central

    Rullmann, M.; Anwander, A.; Dannhauer, M.; Warfield, S.K.; Duffy, F.H.; Wolters, C.H.

    2009-01-01

    The major goal of the evaluation in presurgical epilepsy diagnosis for medically intractable patients is the precise reconstruction of the epileptogenic foci, preferably with non-invasive methods. This paper evaluates whether surface electroencephalography (EEG) source analysis based on a 1mm anisotropic finite element (FE) head model can provide additional guidance for presurgical epilepsy diagnosis and whether it is practically feasible in daily routine. A 1mm hexahedra FE volume conductor model of the patient’s head with special focus on accurately modeling the compartments skull, cerebrospinal fluid (CSF) and the anisotropic conducting brain tissues was constructed using non-linearly co-registered T1-, T2- and diffusion-tensor- magnetic resonance imaging data. The electrodes of intra-cranial EEG (iEEG) measurements were extracted from a co-registered computed tomography image. Goal function scan (GFS), minimum norm least squares (MNLS), standardized low resolution electromagnetic tomography (sLORETA) and spatio-temporal current dipole modeling inverse methods were then applied to the peak of the averaged ictal discharges EEG data. MNLS and sLORETA pointed to a single center of activity. Moving and rotating single dipole fits resulted in an explained variance of more than 97%. The non-invasive EEG source analysis methods localized at the border of the lesion and at the border of the iEEG electrodes which mainly received ictal discharges. Source orientation was towards the epileptogenic tissue. For the reconstructed superficial source, brain conductivity anisotropy and the lesion conductivity had only a minor influence, whereas a correct modeling of the highly conducting CSF compartment and the anisotropic skull was found to be important. The proposed FE forward modeling approach strongly simplifies meshing and reduces run-time (37 Milliseconds for one forward computation in the model with 3.1 Million unknowns), corroborating the practical feasibility of the

  19. Alendronate-associated osteonecrosis of the jaws: A review of the main topics

    PubMed Central

    Paiva-Fonseca, Felipe; Santos-Silva, Alan R.; Della-Coletta, Ricardo; Vargas, Pablo A.

    2014-01-01

    Bisphosphonates is a group of inorganic pyrophosphates analogues that suppress bone resorption by inducing osteoclast inactivation, being frequently used for management of diseases affecting bone metabolism, bone metastases and bone tumors. However, since 2003 many cases describing the presence of necrotic bone exposures in the jaws have been described in patients receiving these drugs, what represent a significant complication of bisphosphonates treatment. The overall incidence of bisphosphonate-related osteonecrosis of the jaws is low, ranging from 0.7% to 12%, mainly observed in those patients receiving intravenously treatment. Osteonecrosis of the jaws associated to oral bisphosphonate, particularly alendronate, has also been reported by a number of authors. Considering that alendronate is one of the most used drugs worldwide, specially for treatment of osteoporosis, a better understanding of osteonecrosis of the jaws related to its use and how to manage these patients is extremely important. Therefore, in the current manuscript the authors aim to review the most important topics related to this pathological presentation. Key words:Bisphosphonates, alendronate, bisphosphonate-related osteonecrosis of the jaws, osteonecrosis. PMID:23986020

  20. Osteonecrosis of the Jaw in Patients Receiving Bone-Targeted Therapies: An Overview--Part I.

    PubMed

    Turner, Bruce; Drudge-Coates, Lawrence; Ali, Sacha; Pati, Jhumur; Nargund, Vinod; Ali, Enamul; Cheng, Leo; Wells, Paula

    2016-01-01

    Urologic patients receiving bone-targeted therapies are at risk of developing osteonecrosis of the jaw (ONJ). ONJ has historically been associated with bisphosphonate therapy. More recently, RANK-Ligand inhibitors (denosumab) have also been used to reduce the risk of skeletal-related events in patients who have advanced cancers with bone metastases. More than 65% of men with metastatic prostate cancer and nearly 75% of women with metastatic breast cancer are affected by bone metastases. The literature has described ONJ associated with bisphosphonate therapy as bisphosphonate-related osteonecrosis of the jaw (BRONJ). However, with evidence also linking the use of RANK-Ligand inhibitors with osteonecrosis of the jaw, we advocate use of the term "anti-bone resorption therapy-related osteonecrosis of the jaw" (ABRT-ONJ). The term "medication-related osteonecrosis of the jaw" (MRONJ) is now becoming more widespread. There is not a universally accepted definition of ABRT-ONJ, which may have hindered recognition and reporting of the condition. In Part I of this article, a review of current knowledge around the etiology of ABRT-ONJ and incidence data are provided. In Part II, we provide an audit of ONJ in a nurse consultant-led bone support clinic. In the article, we refer to zoledronic acid because this is the bisphosphonate of choice for use in men with prostate cancer in the United Kingdom. PMID:27501591

  1. Biofidelic white matter heterogeneity decreases computational model predictions of white matter strains during rapid head rotations.

    PubMed

    Maltese, Matthew R; Margulies, Susan S

    2016-11-01

    The finite element (FE) brain model is used increasingly as a design tool for developing technology to mitigate traumatic brain injury. We developed an ultra high-definition FE brain model (>4 million elements) from CT and MRI scans of a 2-month-old pre-adolescent piglet brain, and simulated rapid head rotations. Strain distributions in the thalamus, coronal radiata, corpus callosum, cerebral cortex gray matter, brainstem and cerebellum were evaluated to determine the influence of employing homogeneous brain moduli, or distinct experimentally derived gray and white matter property representations, where some white matter regions are stiffer and others less stiff than gray matter. We find that constitutive heterogeneity significantly lowers white matter deformations in all regions compared with homogeneous properties, and should be incorporated in FE model injury prediction.

  2. The isolated head model of the plasma bullet/streamer propagation: electric field-velocity relation

    NASA Astrophysics Data System (ADS)

    Sretenović, Goran B.; Krstić, Ivan B.; Kovačević, Vesna V.; Obradović, Bratislav M.; Kuraica, Milorad M.

    2014-09-01

    A model of the isolated streamer head based on Meek's criterion of the avalanche to streamer transition is applied for description of the plasma bullet propagation in a helium/air admixture. According to the model previously proposed by Kulikovsky for streamers in air, along with the knowledge of one of three parameters: electric field, ionization integral or the width of the space charge layer, the other two parameters could be determined. Furthermore, using the streamer current or radius, it is possible to determine the electric field-streamer velocity functional dependence. Obtained results showed satisfactory agreement with both the results of the fluid model from the literature and the experimental results of plasma jet studies. Finally, for the sake of comparison, streamer velocity dependence on the electric field strength range of 10-250 kV cm-1 is determined for helium, argon and air.

  3. Effect of Head Position on Cerebrospinal Fluid Pressure in Cats: Comparison with Artificial Model

    PubMed Central

    Klarica, Marijan; Radoš, Milan; Draganić, Pero; Erceg, Gorislav; Orešković, Darko; Maraković, Jurica; Bulat, Marin

    2006-01-01

    Aim To demonstrate that changes in the cerebrospinal fluid (CSF) pressure in the cranial cavity and spinal canal after head elevation from the horizontal level occur primarily due to the biophysical characteristics of the CSF system, ie, distensibility of the spinal dura. Methods Experiments in vivo were performed on cats and a new artificial model of the CSF system with dimensions similar to the CSF system in cats, consisting of non-distensible cranial and distensible spinal part. Measurements of the CSF pressure in the cranial and spinal spaces were performed in chloralose-anesthetized cats (n = 10) in the horizontal position on the base of a stereotaxic apparatus (reference zero point) and in the position in which the head was elevated to 5 cm and 10 cm above that horizontal position. Changes in the CSF pressure in the cranial and spinal part of the model were measured in the cranial part positioned in the same way as the head in cats (n = 5). Results When the cat was in the horizontal position, the values of the CSF pressure in the cranial (11.9 ± 1.1 cm H2O) and spinal (11.8 ± 0.6 cm H2O) space were not significantly different. When the head was elevated 5 cm or 10 cm above the reference zero point, the CSF pressure in the cranium significantly decreased to 7.7 ± 0.6 cm H2O and 4.7 ± 0.7 cm H2O, respectively, while the CSF pressure in the spinal space significantly increased to 13.8 ± 0.7 cm H2O and 18.5 ± 1.6 cm H2O, respectively (P<0.001 for both). When the artificial CSF model was positioned in the horizontal level and its cranial part elevated by 5 cm and 10 cm, the changes in the pressure were the same as those in the cats when in the same hydrostatic position. Conclusions The new model of the CSF system used in our study faithfully mimicked the changes in the CSF pressure in cats during head elevation in relation to the body. Changes in the pressure in the model were not accompanied by the changes in fluid volume in

  4. Infinite-impulse-response models of the head-related transfer function

    NASA Astrophysics Data System (ADS)

    Kulkarni, Abhijit; Colburn, H. Steven

    2004-04-01

    Head-related transfer functions (HRTFs) measured from human subjects were approximated using infinite-impulse-response (IIR) filter models. Models were restricted to rational transfer functions (plus simple delays) so that specific models are characterized by the locations of poles and zeros in the complex plane. The all-pole case (with no nontrivial zeros) is treated first using the theory of linear prediction. Then the general pole-zero model is derived using a weighted-least-squares (WLS) formulation of the modified least-squares problem proposed by Kalman (1958). Both estimation algorithms are based on solutions of sets of linear equations and result in efficient computational schemes to find low-order model HRTFs. The validity of each of these two low-order models was assessed in psychophysical experiments. Specifically, a four-interval, two-alternative, forced-choice paradigm was used to test the discriminability of virtual stimuli constructed from empirical and model HRTFs for corresponding locations. For these experiments, the stimuli were 80 ms, noise tokens generated from a wideband noise generator. Results show that sounds synthesized through model HRTFs were indistinguishable from sounds synthesized from original HRTF measurements for the majority of positions tested. The advantages of the techniques described here are the computational efficiencies achieved for low-order IIR models. Properties of the all-pole and pole-zero estimators are discussed in the context of low-order HRTF representations, and implications for basic and applied contexts are considered.

  5. Safety and efficacy of quadrapeutics versus chemoradiation in head and neck carcinoma xenograft model.

    PubMed

    Lukianova-Hleb, Ekaterina Y; Kim, Yoo-Shin; Aryasomayajula, Bhawani; Boulikas, Teni; Phan, Jack; Hung, Mien-Chie; Torchilin, Vladimir P; O'Neill, Brian E; Lapotko, Dmitri O

    2015-01-01

    Chemoradiation is the strongest anti-tumor therapy but in resistant unresectable cancers it often lacks safety and efficacy. We compared our recently developed cell-level combination approach, quadrapeutics, to chemoradiation therapy to establish pre-clinical data for its biodistribution, safety and efficacy in head and neck squamous cell carcinoma (HNSCC), as a clinically challenging aggressive and resistant cancer. In vitro and in vivo models of four carcinomas were treated with standard chemoradiation and quadrapeutics using identical drug and radiation doses. We applied liposomal cisplatin or doxorubicin, colloidal gold, near-infrared laser pulses and radiation, all at low safe doses. The final evaluation used a xenograft model of HNSCC. Quadrapeutics enhanced standard chemoradiation in vitro by reducing head and neck cancer cell proliferation by 1000-fold, inhibiting tumor growth in vivo by 34-fold and improving animal survival by 5-fold, and reducing the side effects to a negligible level. In quadrapeutics, we observed an "inversion" of the drug efficacy of two standard drugs: doxorubicin, a low efficacy drug for the cancers studied, was two times more efficient than cisplatin, the first choice drug in clinic for HNSCC. The radical therapeutic gain of quadrapeutics resulted from the intracellular synergy of the four components employed which we administered in a specific sequence, while the reduction in the toxicity was due to the low doses of all four components. The biodistribution, safety and efficacy data for quadrapeutics in HNSCC ensure its high translational potential and justify the possibility of clinical trials. PMID:26885444

  6. Monte Carlo modeling of light propagation in the human head for applications in sinus imaging

    NASA Astrophysics Data System (ADS)

    Cerussi, Albert E.; Mishra, Nikhil; You, Joon; Bhandarkar, Naveen; Wong, Brian J. F.

    2015-02-01

    Sinus blockages are a common reason for physician visits, affecting 1 out of 7 in the United States. Over 20 million cases of acute bacterial sinusitis become chronic and require medical treatment. Diagnosis in the primary care setting is challenging because symptom criteria (via detailed clinical history) plus objective imaging (CT or endoscopy) is recommended. Unfortunately, neither option is routinely available in primary care. Our previous work demonstrated that low-cost near infrared (NIR) transillumination instruments produced signals that correlated with the bulk findings of sinus opacity measured by CT. We have upgraded the technology, but questions remain such as finding the optimal arrangement of light sources, measuring the influence of specific anatomical structures, and determining detection limits. In order to begin addressing these questions, we have modeled NIR light propagation inside the adult human head using a mesh-based Monte Carlo algorithm (MMCLab) applied to a detailed anatomical head model constructed from CT images. In this application the sinus itself, which under healthy conditions is a void region (e.g., non-scattering), is the region of interest instead of an obstacle to other contrast mechanisms. We report preliminary simulations that characterize the changes in detected intensity due to clear (i.e., healthy) versus blocked sinuses. We also ran simulations for two of our clinical cases and compared results with the measurements. The simulations presented herein serve as a proof of concept that this approach could be used to understand contrast mechanisms and limitations of NIR imaging of the sinus cavities.

  7. Safety and efficacy of quadrapeutics versus chemoradiation in head and neck carcinoma xenograft model

    PubMed Central

    Lukianova-Hleb, Ekaterina Y; Kim, Yoo-Shin; Aryasomayajula, Bhawani; Boulikas, Teni; Phan, Jack; Hung, Mien-Chie; Torchilin, Vladimir P; O’Neill, Brian E; Lapotko, Dmitri O

    2015-01-01

    Chemoradiation is the strongest anti-tumor therapy but in resistant unresectable cancers it often lacks safety and efficacy. We compared our recently developed cell-level combination approach, quadrapeutics, to chemoradiation therapy to establish pre-clinical data for its biodistribution, safety and efficacy in head and neck squamous cell carcinoma (HNSCC), as a clinically challenging aggressive and resistant cancer. In vitro and in vivo models of four carcinomas were treated with standard chemoradiation and quadrapeutics using identical drug and radiation doses. We applied liposomal cisplatin or doxorubicin, colloidal gold, near-infrared laser pulses and radiation, all at low safe doses. The final evaluation used a xenograft model of HNSCC. Quadrapeutics enhanced standard chemoradiation in vitro by reducing head and neck cancer cell proliferation by 1000-fold, inhibiting tumor growth in vivo by 34-fold and improving animal survival by 5-fold, and reducing the side effects to a negligible level. In quadrapeutics, we observed an “inversion” of the drug efficacy of two standard drugs: doxorubicin, a low efficacy drug for the cancers studied, was two times more efficient than cisplatin, the first choice drug in clinic for HNSCC. The radical therapeutic gain of quadrapeutics resulted from the intracellular synergy of the four components employed which we administered in a specific sequence, while the reduction in the toxicity was due to the low doses of all four components. The biodistribution, safety and efficacy data for quadrapeutics in HNSCC ensure its high translational potential and justify the possibility of clinical trials. PMID:26885444

  8. Estimation of electrical conductivity of a layered spherical head model using electrical impedance tomography

    NASA Astrophysics Data System (ADS)

    Fernández-Corazza, M.; von-Ellenrieder, N.; Muravchik, C. H.

    2011-12-01

    Electrical Impedance Tomography (EIT) is a non-invasive method that aims to create an electrical conductivity map of a volume. In particular, it can be applied to study the human head. The method consists on the injection of an unperceptive and known current through two electrodes attached to the scalp, and the measurement of the resulting electric potential distribution at an array of sensors also placed on the scalp. In this work, we propose a parametric estimation of the brain, scalp and skull conductivities using EIT over an spherical model of the head. The forward problem involves the computation of the electric potential on the surface, for given the conductivities and the injection electrode positions, while the inverse problem consists on estimating the conductivities given the sensor measurements. In this study, the analytical solution to the forward problem based on a three layer spherical model is first described. Then, some measurements are simulated adding white noise to the solutions and the inverse problem is solved in order to estimate the brain, skull and scalp conductivity relations. This is done with a least squares approach and the Nelder-Mead multidimensional unconstrained nonlinear minimization method.

  9. Development of the software tool for generation and visualization of the finite element head model with bone conduction sounds

    NASA Astrophysics Data System (ADS)

    Nikolić, Dalibor; Milošević, Žarko; Saveljić, Igor; Filipović, Nenad

    2015-12-01

    Vibration of the skull causes a hearing sensation. We call it Bone Conduction (BC) sound. There are several investigations about transmission properties of bone conducted sound. The aim of this study was to develop a software tool for easy generation of the finite element (FE) model of the human head with different materials based on human head anatomy and to calculate sound conduction through the head. Developed software tool generates a model in a few steps. The first step is to do segmentation of CT medical images (DICOM) and to generate a surface mesh files (STL). Each STL file presents a different layer of human head with different material properties (brain, CSF, different layers of the skull bone, skin, etc.). The next steps are to make tetrahedral mesh from obtained STL files, to define FE model boundary conditions and to solve FE equations. This tool uses PAK solver, which is the open source software implemented in SIFEM FP7 project, for calculations of the head vibration. Purpose of this tool is to show impact of the bone conduction sound of the head on the hearing system and to estimate matching of obtained results with experimental measurements.

  10. Multistate Models for Estimation of Survival and Reproduction in the Grey-headed Albatross (Thalassarche chrysostoma)

    USGS Publications Warehouse

    Converse, Sarah J.; Kendall, William L.; Doherty, Paul F.; Ryan, Peter G.

    2009-01-01

    Reliable information on demography is necessary for conservation of albatrosses, the most threatened family of pelagic birds. Albatross survival has been estimated using mark?recapture data and the Cormack-Jolly-Seber (CJS) model. However, albatross exhibit skipped breeding, violating assumptions of the CJS model. Multistate modeling integrating unobservable states is a promising tool for such situations. We applied multistate models to data on Grey-headed Albatross (Thalassarche chrysostoma) to evaluate model performance and describe demographic patterns. These included a multistate equivalent of the CJS model (MS-2), including successful and failed breeding states and ignoring temporary emigration, and three versions of a four-state multistate model that accounts for temporary emigration by integrating unobservable states: a model (MS-4) with one sample per breeding season, a robust design model (RDMS-4) with multiple samples per season and geographic closure within the season, and an open robust design model (ORDMS-4) with multiple samples per season and staggered entry and exit of animals within the season. Survival estimates from the MS-2 model were higher than those from the MS-4 model, which resulted in apparent percent relative bias averaging 2.2%. The ORDMS-4 model was more appropriate than the RDMS-4 model, given that staggered entry and exit occurred. Annual survival probability for Greyheaded Albatross at Marion Island was 0.951 ? 0.006 (SE), and the probability of skipped breeding in a subsequent year averaged 0.938 for successful and 0.163 for failed breeders. We recommend that multistate models with unobservable states, combined with robust-design sampling, be used in studies of species that exhibit temporary emigration.

  11. Efficient Monte Carlo modelling of individual tumour cell propagation for hypoxic head and neck cancer

    NASA Astrophysics Data System (ADS)

    Tuckwell, W.; Bezak, E.; Yeoh, E.; Marcu, L.

    2008-09-01

    A Monte Carlo tumour model has been developed to simulate tumour cell propagation for head and neck squamous cell carcinoma. The model aims to eventually provide a radiobiological tool for radiation oncology clinicians to plan patient treatment schedules based on properties of the individual tumour. The inclusion of an oxygen distribution amongst the tumour cells enables the model to incorporate hypoxia and other associated parameters, which affect tumour growth. The object oriented program FORTRAN 95 has been used to create the model algorithm, with Monte Carlo methods being employed to randomly assign many of the cell parameters from probability distributions. Hypoxia has been implemented through random assignment of partial oxygen pressure values to individual cells during tumour growth, based on in vivo Eppendorf probe experimental data. The accumulation of up to 10 million virtual tumour cells in 15 min of computer running time has been achieved. The stem cell percentage and the degree of hypoxia are the parameters which most influence the final tumour growth rate. For a tumour with a doubling time of 40 days, the final stem cell percentage is approximately 1% of the total cell population. The effect of hypoxia on the tumour growth rate is significant. Using a hypoxia induced cell quiescence limit which affects 50% of cells with and oxygen levels less than 1 mm Hg, the tumour doubling time increases to over 200 days and the time of tumour growth for a clinically detectable tumour (109 cells) increases from 3 to 8 years. A biologically plausible Monte Carlo model of hypoxic head and neck squamous cell carcinoma tumour growth has been developed for real time assessment of the effects of multiple biological parameters which impact upon the response of the individual patient to fractionated radiotherapy.

  12. Efficient Monte Carlo modelling of individual tumour cell propagation for hypoxic head and neck cancer.

    PubMed

    Tuckwell, W; Bezak, E; Yeoh, E; Marcu, L

    2008-09-01

    A Monte Carlo tumour model has been developed to simulate tumour cell propagation for head and neck squamous cell carcinoma. The model aims to eventually provide a radiobiological tool for radiation oncology clinicians to plan patient treatment schedules based on properties of the individual tumour. The inclusion of an oxygen distribution amongst the tumour cells enables the model to incorporate hypoxia and other associated parameters, which affect tumour growth. The object oriented program FORTRAN 95 has been used to create the model algorithm, with Monte Carlo methods being employed to randomly assign many of the cell parameters from probability distributions. Hypoxia has been implemented through random assignment of partial oxygen pressure values to individual cells during tumour growth, based on in vivo Eppendorf probe experimental data. The accumulation of up to 10 million virtual tumour cells in 15 min of computer running time has been achieved. The stem cell percentage and the degree of hypoxia are the parameters which most influence the final tumour growth rate. For a tumour with a doubling time of 40 days, the final stem cell percentage is approximately 1% of the total cell population. The effect of hypoxia on the tumour growth rate is significant. Using a hypoxia induced cell quiescence limit which affects 50% of cells with and oxygen levels less than 1 mm Hg, the tumour doubling time increases to over 200 days and the time of tumour growth for a clinically detectable tumour (10(9) cells) increases from 3 to 8 years. A biologically plausible Monte Carlo model of hypoxic head and neck squamous cell carcinoma tumour growth has been developed for real time assessment of the effects of multiple biological parameters which impact upon the response of the individual patient to fractionated radiotherapy. PMID:18677039

  13. Experimental study of blast-induced traumatic brain injury using a physical head model.

    PubMed

    Zhang, Jiangyue; Pintar, Frank A; Yoganandan, Narayan; Gennarelli, Thomas A; Son, Steven F

    2009-11-01

    This study was conducted to quantify intracranial biomechanical responses and external blast overpressures using physical head model to understand the biomechanics of blast traumatic brain injury and to provide experimental data for computer simulation of blast-induced brain trauma. Ellipsoidal-shaped physical head models, made from 3-mm polycarbonate shell filled with Sylgard 527 silicon gel, were used. Six blast tests were conducted in frontal, side, and 45 degrees oblique orientations. External blast overpressures and internal pressures were quantified with ballistic pressure sensors. Blast overpressures, ranging from 129.5 kPa to 769.3 kPa, were generated using a rigid cannon and 1.3 to 3.0 grams of pentaerythritol tetranitrate (PETN) plastic sheet explosive (explosive yield of 13.24 kJ and TNT equivalent mass of 2.87 grams for 3 grams of material). The PETN plastic sheet explosive consisted of 63% PETN powder, 29% plasticizer, and 8% nitrocellulose with a density of 1.48 g/cm3 and detonation velocity of 6.8 km/s. Propagation and reflection of the shockwave was captured using a shadowgraph technique. Shockwave speeds ranging from 423.3 m/s to 680.3 m/s were recorded. The model demonstrated a two-stage response: a pressure dominant (overpressure) stage followed by kinematic dominant (blast wind) stage. Positive pressures in the brain simulant ranged from 75.1 kPa to 1095 kPa, and negative pressures ranged from -43.6 kPa to -646.0 kPa. High- and normal-speed videos did not reveal observable deformations in the brain simulant from the neutral density markers embedded in the midsagittal plane of the head model. Amplitudes of the internal positive and negative pressures were found to linearly correlate with external overpressure. Results from the current study suggested a pressure-dominant brain injury mechanism instead of strain injury mechanism under the blast severity of the current study. These quantitative results also served as the validation and calibration

  14. [Bisphosphonate and denosumab-related osteonecrosis of the jaw: Epidemiology, diagnosis and management].

    PubMed

    Dupic, Guillaume; Collangettes, Denise; Dillies, Anne-Françoise; Calvet, Laure; Tournilhac, Olivier; Bay, Jacques-Olivier; Mahammedi, Hakim

    2015-12-01

    Bisphosphonate-related osteonecrosis of the jaw have been widely described. Denosumab has recently been associated to ONJ. Guidance to clinicians is based on criteria established by the American Association of Oral and Maxillofacial Surgeons (AAOMS). Treatment should be multidisciplinary. Two options are available and have to be discussed on the basis of associated therapeutic, patient's general state of health and possibility of therapeutic window during cancer treatment: conservative (medication and conservative surgery like superficial debridement) and extensive surgery. Therefore, we report an update about management strategies of osteonecrosis of the jaw and two cases of patients with a stage 2 osteonecrosis of the jaw only treated with mouth rinses, antibiotics and debridement and complete healing. PMID:26607453

  15. Testosterone, anastrozole, factor V Leiden heterozygosity and osteonecrosis of the jaws.

    PubMed

    Pandit, Ramesh S; Glueck, Charles J

    2014-04-01

    Our specific aim is to describe the development of thrombotic osteonecrosis of the jaws after testosterone-anastrozole therapy in a 55-year-old white man subsequently found to have previously undiagnosed factor V Leiden heterozygosity. Before the diagnosis of V Leiden heterozygosity, he was given testosterone gel, 50 mg/day, and on testosterone, serum testosterone (963 ng/dl) and estradiol were high (50 pg/ml). Anastrozole was started, and testosterone was continued. Six months later, osteonecrosis of the jaws was diagnosed. Exogenous testosterone is aromatized to estradiol and estradiol-induced thrombophilia, when superimposed on underlying familial thrombophilia, as in this case, may lead to thrombosis and osteonecrosis. We recommend that before giving testosterone, at a minimum, screening for the factor V Leiden and G20210A mutations, and factor VIII and XI activity be carried out, to avoid unanticipated thrombosis.

  16. [Current approaches for early detection and treatment of medication-related osteonecrosis of jaw].

    PubMed

    Janovszky, Ágnes; Vereb, Tamás; Szabó, Andrea; Piffkó, József

    2014-12-01

    Owing to the increased life expectancy, the incidence of rheumatoid disorders and oncologic cases with bone metastasis has dramatically increased. Despite the beneficial effects of the applied antiresorptive and antiangiogenic drugs (e.g. bisphosphonates), serious side effects such as jaw osteonecrosis may also develop. The aim of the authors was to summarize present knowledge about the possibilities of prevention and treatment in medication-related osteonecrosis of the jaw. Based on literature data, currently used detection methods for medication-related osteonecrosis of the jaw (including their advantages and limitations) are summarized. In addition, novel trends of surgical and adjuvant therapeutic approaches are also reviewed. The authors conclude that possibilities of prevention and efficacy of therapeutic interventions in this disorder are still limited possibly due to an incomplete knowledge of the underlying pathomechanism. An interdisciplinary cooperation for prevention and attentive monitoring in order to decrease the incidence of iatrogenic oral and maxillofacial complications seems to be particularly important.

  17. Spontaneous bisphosphonate-related osteonecrosis of the left hemi-mandible: similarities with phossy jaw.

    PubMed

    Campisi, Giuseppina; Compilato, Domenico; Angelo, Itro; Lo Muzio, Lorenzo; Colella, Giuseppe

    2012-01-01

    Intravenous bisphosphonates (BP) play a key role in the treatment of bone metastases. As a long-term side effects BP, a form of avascular osteonecrosis of the jaw has been reported. Although, invasive oral local procedures are often present in clinical history of patients suffering from bisphosphonates-related osteonecrosis of the jaws (BRONJ), about up to 50% of BRONJ are spontaneous. We report a case of a 68-year-old female with a spontaneous wide bone sequestration of the left mandibular body onset after infusion of zoledronic acid for 18 cycles for osseous metastasis due to metastatic anaplastic thyroidal carcinoma. Surprisingly the clinical aspects of the patient initially reminded us of the famous pathology described in 1899 called phossy jaw. This case is remarkable not only for the spontaneity of the osteonecrosis, but, above all, for the clinical similarity with cases of phossy jaw, described for the first time in the literature, thereby suggesting a potential common pathogenesis.

  18. [A case of breast cancer with extensive osteonecrosis of maxilla induced by a bisphosphonate].

    PubMed

    Tanaka, Yoshihiro; Koga, Makoto; Yokomizo, Yuji; Inokuchi, Satoko; Koga, Chihiro; Kusukawa, Jingo

    2010-04-01

    Here, we report a case of extensive osteonecrosis of the maxilla associated with a history of bisphosphonate (BP) therapy for management of bone metastases from breast cancer. A 66-year-old woman was referred to our hospital because of a fistulation on the right side of the maxilla in May 2005 by her dentist. The patient had a medical history of breast cancer with bone metastasis that was treated by chemotherapy with 45 mg pamidronate in 2 weekly courses for 16 months. We suspected that this rare case of osteonecrosis was caused by chemotherapy with BPs. Palliative treatments, including antibiotic therapy and local irrigation, were administered. Finally, extensive osteonecrosis of the maxilla occurred.

  19. Stroke type differentiation using spectrally constrained multifrequency EIT: evaluation of feasibility in a realistic head model.

    PubMed

    Malone, Emma; Jehl, Markus; Arridge, Simon; Betcke, Timo; Holder, David

    2014-06-01

    We investigate the application of multifrequency electrical impedance tomography (MFEIT) to imaging the brain in stroke patients. The use of MFEIT could enable early diagnosis and thrombolysis of ischaemic stroke, and therefore improve the outcome of treatment. Recent advances in the imaging methodology suggest that the use of spectral constraints could allow for the reconstruction of a one-shot image. We performed a simulation study to investigate the feasibility of imaging stroke in a head model with realistic conductivities. We introduced increasing levels of modelling errors to test the robustness of the method to the most common sources of artefact. We considered the case of errors in the electrode placement, spectral constraints, and contact impedance. The results indicate that errors in the position and shape of the electrodes can affect image quality, although our imaging method was successful in identifying tissues with sufficiently distinct spectra.

  20. Rheumatoid Arthritis Exacerbates the Severity of Osteonecrosis of the Jaws (ONJ) in Mice. A Randomized, Prospective, Controlled Animal Study.

    PubMed

    de Molon, Rafael Scaf; Hsu, Chingyun; Bezouglaia, Olga; Dry, Sarah M; Pirih, Flavia Q; Soundia, Akrivoula; Cunha, Fernando Queiroz; Cirelli, Joni Augusto; Aghaloo, Tara L; Tetradis, Sotirios

    2016-08-01

    Rheumatoid arthritis (RA), an autoimmune inflammatory disorder, results in persistent synovitis with severe bone and cartilage destruction. Bisphosphonates (BPs) are often utilized in RA patients to reduce bone destruction and manage osteoporosis. However, BPs, especially at high doses, are associated with osteonecrosis of the jaw (ONJ). Here, utilizing previously published ONJ animal models, we are exploring interactions between RA and ONJ incidence and severity. DBA1/J mice were divided into four groups: control, zoledronic acid (ZA), collagen-induced arthritis (CIA), and CIA-ZA. Animals were pretreated with vehicle or ZA. Bovine collagen II emulsified in Freund's adjuvant was injected to induce arthritis (CIA) and the mandibular molar crowns were drilled to induce periapical disease. Vehicle or ZA treatment continued for 8 weeks. ONJ indices were measured by micro-CT (µCT) and histological examination of maxillae and mandibles. Arthritis development was assessed by visual scoring of paw swelling, and by µCT and histology of interphalangeal and knee joints. Maxillae and mandibles of control and CIA mice showed bone loss, periodontal ligament (PDL) space widening, lamina dura loss, and cortex thinning. ZA prevented these changes in both ZA and CIA-ZA groups. Epithelial to alveolar crest distance was increased in the control and CIA mice. This distance was preserved in ZA and CIA-ZA animals. Empty osteocytic lacunae and areas of osteonecrosis were present in ZA and CIA-ZA but more extensively in CIA-ZA animals, indicating more severe ONJ. CIA and CIA-ZA groups developed severe arthritis in the paws and knees. Interphalangeal and knee joints of CIA mice showed advanced bone destruction with cortical erosions and trabecular bone loss, and ZA treatment reduced these effects. Importantly, no osteonecrosis was noted adjacent to areas of articular inflammation in CIA-ZA mice. Our data suggest that ONJ burden was more pronounced in ZA treated CIA mice and that RA could

  1. [Osteonecrosis of the jaw and bisphophonates in oncology].

    PubMed

    Facon, Thierry; Bensadoun, René-Jean; Blanc, Jean-Louis; Confavreux, Cyril; Gourmet, René; Maes, Jean-Michel; Penel, Guillaume; Vieillard, Marie-Hélène; Woeller, Anne

    2008-04-01

    Bisphosphonates are potent osteoclastic inhibitors that are indicated in the prevention of bone complications. They could also be of interest in the prevention of bone metastases. Several recent international publications have highlighted the onset of osteonecrosis of the jaw (ONJ) in patients treated with bisphosphonates. These osteonecroses manifest in the form of bone exposure, recent tooth mobility, swelling and inflammation and, occasionally, localised pain but they can remain asymptomatic for weeks or even months. The prevalence of these osteonecroses in cancer patients treated with bisphosphonates could range from 1 to 10%. In most cases (60 to 80%), ONJ develops after alveolo-dental surgery (e.g. tooth extraction). Length of exposure to bisphosphonate probably increases the risk. Our recommendations regarding the diagnosis, classification, prevention and treatment of cases of ONJ observed during bisphosphonate administration are based on published studies and our experience. It is obvious that the use of bisphosphonates is undoubtedly beneficial in the treatment of bone complications but the incidence of ONJ during long-term treatments and at high doses warrants preventive measures. These measures are straightforward : bucco-dental repair prior to treatment, good hygiene and regular monitoring during treatment. Current, non-invasive procedures are still permitted. In other cases, the suspension of treatment is indicated until healing is complete. The increase in the incidence of ONJs, serious adverse events, raises the issue regarding duration and administration of bisphosphonate treatment in the management of bone metastases. Studies are currently underway in an attempt to answer this issue.

  2. Bisphosphonate-related osteonecrosis of the jaw: a pictorial review.

    PubMed

    Morag, Yoav; Morag-Hezroni, Michal; Jamadar, David A; Ward, Brent B; Jacobson, Jon A; Zwetchkenbaum, Samuel R; Helman, Joseph

    2009-11-01

    Bisphosphonate-related osteonecrosis of the jaw (ONJ) is characterized by nonhealing exposed bone in the maxillofacial region in patients who have undergone bisphosphonate treatment. The underlying etiology is unclear and may be multifactorial. The diagnosis is primarily clinical. Diagnostic tissue sampling may exacerbate the process and is typically avoided, necessitating other diagnostic approaches. The appearance of ONJ at diagnostic imaging is variable and includes sclerotic, lytic, or mixed lesions with possible periosteal reaction, pathologic fractures, and extension to soft tissues. There is a spectrum of signal intensity changes on T1- and T2-weighted magnetic resonance (MR) images with variable enhancement, findings that may correspond to the clinical and histopathologic stage of the process. Bone scintigraphy is sensitive with increased uptake in the area of the lesion. Although the imaging findings are nonspecific, there appears to be a role for imaging in the management of ONJ. Radiography is relatively insensitive but typically employed as the first line of radiologic investigation. Computed tomography and MR imaging are more precise in demonstrating the extent of the lesion. A number of imaging modalities have revealed lesions that may be associated with bisphosphonate exposure in asymptomatic individuals or in the context of nonspecific symptoms. The risk of these lesions advancing to overt clinical disease is unknown at this time. The radiologist should be aware of ONJ and include it in the differential diagnosis when evaluating patients with a history of bisphosphonate therapy without jaw irradiation, so as to avoid potentially harmful biopsies.

  3. Anatomical Reproducibility of a Head Model Molded by a Three-dimensional Printer

    PubMed Central

    KONDO, Kosuke; NEMOTO, Masaaki; MASUDA, Hiroyuki; OKONOGI, Shinichi; NOMOTO, Jun; HARADA, Naoyuki; SUGO, Nobuo; MIYAZAKI, Chikao

    We prepared rapid prototyping models of heads with unruptured cerebral aneurysm based on image data of computed tomography angiography (CTA) using a three-dimensional (3D) printer. The objective of this study was to evaluate the anatomical reproducibility and accuracy of these models by comparison with the CTA images on a monitor. The subjects were 22 patients with unruptured cerebral aneurysm who underwent preoperative CTA. Reproducibility of the microsurgical anatomy of skull bone and arteries, the length and thickness of the main arteries, and the size of cerebral aneurysm were compared between the CTA image and rapid prototyping model. The microsurgical anatomy and arteries were favorably reproduced, apart from a few minute regions, in the rapid prototyping models. No significant difference was noted in the measured lengths of the main arteries between the CTA image and rapid prototyping model, but errors were noted in their thickness (p < 0.001). A significant difference was also noted in the longitudinal diameter of the cerebral aneurysm (p < 0.01). Regarding the CTA image as the gold standard, reproducibility of the microsurgical anatomy of skull bone and main arteries was favorable in the rapid prototyping models prepared using a 3D printer. It was concluded that these models are useful tools for neurosurgical simulation. The thickness of the main arteries and size of cerebral aneurysm should be comprehensively judged including other neuroimaging in consideration of errors. PMID:26119896

  4. MRI-based multiscale model for electromagnetic analysis in the human head with implanted DBS.

    PubMed

    Iacono, Maria Ida; Makris, Nikos; Mainardi, Luca; Angelone, Leonardo M; Bonmassar, Giorgio

    2013-01-01

    Deep brain stimulation (DBS) is an established procedure for the treatment of movement and affective disorders. Patients with DBS may benefit from magnetic resonance imaging (MRI) to evaluate injuries or comorbidities. However, the MRI radio-frequency (RF) energy may cause excessive tissue heating particularly near the electrode. This paper studies how the accuracy of numerical modeling of the RF field inside a DBS patient varies with spatial resolution and corresponding anatomical detail of the volume surrounding the electrodes. A multiscale model (MS) was created by an atlas-based segmentation using a 1 mm(3) head model (mRes) refined in the basal ganglia by a 200  μ m(2) ex-vivo dataset. Four DBS electrodes targeting the left globus pallidus internus were modeled. Electromagnetic simulations at 128 MHz showed that the peak of the electric field of the MS doubled (18.7 kV/m versus 9.33 kV/m) and shifted 6.4 mm compared to the mRes model. Additionally, the MS had a sixfold increase over the mRes model in peak-specific absorption rate (SAR of 43.9 kW/kg versus 7 kW/kg). The results suggest that submillimetric resolution and improved anatomical detail in the model may increase the accuracy of computed electric field and local SAR around the tip of the implant.

  5. Anatomical Reproducibility of a Head Model Molded by a Three-dimensional Printer.

    PubMed

    Kondo, Kosuke; Nemoto, Masaaki; Masuda, Hiroyuki; Okonogi, Shinichi; Nomoto, Jun; Harada, Naoyuki; Sugo, Nobuo; Miyazaki, Chikao

    2015-01-01

    We prepared rapid prototyping models of heads with unruptured cerebral aneurysm based on image data of computed tomography angiography (CTA) using a three-dimensional (3D) printer. The objective of this study was to evaluate the anatomical reproducibility and accuracy of these models by comparison with the CTA images on a monitor. The subjects were 22 patients with unruptured cerebral aneurysm who underwent preoperative CTA. Reproducibility of the microsurgical anatomy of skull bone and arteries, the length and thickness of the main arteries, and the size of cerebral aneurysm were compared between the CTA image and rapid prototyping model. The microsurgical anatomy and arteries were favorably reproduced, apart from a few minute regions, in the rapid prototyping models. No significant difference was noted in the measured lengths of the main arteries between the CTA image and rapid prototyping model, but errors were noted in their thickness (p < 0.001). A significant difference was also noted in the longitudinal diameter of the cerebral aneurysm (p < 0.01). Regarding the CTA image as the gold standard, reproducibility of the microsurgical anatomy of skull bone and main arteries was favorable in the rapid prototyping models prepared using a 3D printer. It was concluded that these models are useful tools for neurosurgical simulation. The thickness of the main arteries and size of cerebral aneurysm should be comprehensively judged including other neuroimaging in consideration of errors.

  6. Genetics of glucocorticoid-associated osteonecrosis in children with acute lymphoblastic leukemia.

    PubMed

    Karol, Seth E; Yang, Wenjian; Van Driest, Sara L; Chang, Tamara Y; Kaste, Sue; Bowton, Erica; Basford, Melissa; Bastarache, Lisa; Roden, Dan M; Denny, Joshua C; Larsen, Eric; Winick, Naomi; Carroll, William L; Cheng, Cheng; Pei, Deqing; Fernandez, Christian A; Liu, Chengcheng; Smith, Colton; Loh, Mignon L; Raetz, Elizabeth A; Hunger, Stephen P; Scheet, Paul; Jeha, Sima; Pui, Ching-Hon; Evans, William E; Devidas, Meenakshi; Mattano, Leonard A; Relling, Mary V

    2015-10-01

    Glucocorticoids are important therapy for acute lymphoblastic leukemia (ALL) and their major adverse effect is osteonecrosis. Our goal was to identify genetic and nongenetic risk factors for osteonecrosis. We performed a genome-wide association study of single nucleotide polymorphisms (SNPs) in a discovery cohort comprising 2285 children with ALL, treated on the Children's Oncology Group AALL0232 protocol (NCT00075725), adjusting for covariates. The minor allele at SNP rs10989692 (near the glutamate receptor GRIN3A locus) was associated with osteonecrosis (hazard ratio = 2.03; P = 3.59 × 10(-7)). The association was supported by 2 replication cohorts, including 361 children with ALL on St. Jude's Total XV protocol (NCT00137111) and 309 non-ALL patients from Vanderbilt University's BioVU repository treated with glucocorticoids (odds ratio [OR] = 1.87 and 2.26; P = .063 and .0074, respectively). In a meta-analysis, rs10989692 was also highest ranked (P = 2.68 × 10(-8)), and the glutamate pathway was the top ranked pathway (P = 9.8 × 10(-4)). Osteonecrosis-associated glutamate receptor variants were also associated with other vascular phenotypes including cerebral ischemia (OR = 1.64; P = 2.5 × 10(-3)), and arterial embolism and thrombosis (OR = 1.88; P = 4.2 × 10(-3)). In conclusion, osteonecrosis was associated with inherited variations near glutamate receptor genes. Further understanding this association may allow interventions to decrease osteonecrosis. These trials are registered at www.clinicaltrials.gov as #NCT00075725 and #NCT00137111. PMID:26265699

  7. Temporal MRI characterization, neurobiochemical and neurobehavioral changes in a mouse repetitive concussive head injury model

    PubMed Central

    Yang, Zhihui; Wang, Ping; Morgan, Drake; Lin, Dan; Pan, Jianchun; Lin, Fan; Strang, Kevin H.; Selig, Tyler M.; Perez, Pablo D.; Febo, Marcelo; Chang, Binggong; Rubenstein, Richard; Wang, Kevin K.W.

    2015-01-01

    Single and repeated sports-related mild traumatic brain injury (mTBI), also referred to as concussion, can result in chronic post-concussive syndrome (PCS), neuropsychological and cognitive deficits, or chronic traumatic encephalopathy (CTE). However PCS is often difficult to diagnose using routine clinical, neuroimaging or laboratory evaluations, while CTE currently only can be definitively diagnosed postmortem. We sought to develop an animal model to simulate human repetitive concussive head injury for systematic study. In this study, mice received single or multiple head impacts by a stereotaxic impact device with a custom-made rubber tip-fitted impactor. Dynamic changes in MRI, neurobiochemical markers (Tau hyperphosphorylation and glia activation in brain tissues) and neurobehavioral functions such as anxiety, depression, motor function and cognitive function at various acute/subacute (1-7 day post-injury) and chronic (14-60 days post-injury) time points were examined. To explore the potential biomarkers of rCHI, serum levels of total Tau (T-Tau) and phosphorylated Tau (P-Tau) were also monitored at various time points. Our results show temporal dynamics of MRI consistent with structural perturbation in the acute phase and neurobiochemical changes (P-Tau and GFAP induction) in the subacute and chronic phase as well as development of chronic neurobehavioral changes, which resemble those observed in mTBI patients. PMID:26058556

  8. Bioinformatic and statistical analysis of the optic nerve head in a primate model of ocular hypertension

    PubMed Central

    Kompass, Kenneth S; Agapova, Olga A; Li, Wenjun; Kaufman, Paul L; Rasmussen, Carol A; Hernandez, M Rosario

    2008-01-01

    Background The nonhuman primate model of glaucomatous optic neuropathy most faithfully reproduces the human disease. We used high-density oligonucleotide arrays to investigate whole genome transcriptional changes occurring at the optic nerve head during primate experimental glaucoma. Results Laser scarification of the trabecular meshwork of cynomolgus macaques produced elevated intraocular pressure that was monitored over time and led to varying degrees of damage in different samples. The macaques were examined clinically before enucleation and the myelinated optic nerves were processed post-mortem to determine the degree of neuronal loss. Global gene expression was examined in dissected optic nerve heads with Affymetrix GeneChip microarrays. We validated a subset of differentially expressed genes using qRT-PCR, immunohistochemistry, and immuno-enriched astrocytes from healthy and glaucomatous human donors. These genes have previously defined roles in axonal outgrowth, immune response, cell motility, neuroprotection, and extracellular matrix remodeling. Conclusion Our findings show that glaucoma is associated with increased expression of genes that mediate axonal outgrowth, immune response, cell motility, neuroprotection, and ECM remodeling. These studies also reveal that, as glaucoma progresses, retinal ganglion cell axons may make a regenerative attempt to restore lost nerve cell contact. PMID:18822132

  9. Modeling Film-Coolant Flow Characteristics at the Exit of Shower-Head Holes

    NASA Technical Reports Server (NTRS)

    Garg, Vijay K.; Gaugler, R. E. (Technical Monitor)

    2000-01-01

    The coolant flow characteristics at the hole exits of a film-cooled blade are derived from an earlier analysis where the hole pipes and coolant plenum were also discretized. The blade chosen is the VKI rotor with three staggered rows of shower-head holes. The present analysis applies these flow characteristics at the shower-head hole exits. A multi-block three-dimensional Navier-Stokes code with Wilcox's k-omega model is used to compute the heat transfer coefficient on the film-cooled turbine blade. A reasonably good comparison with the experimental data as well as with the more complete earlier analysis where the hole pipes and coolant plenum were also gridded is obtained. If the 1/7th power law is assumed for the coolant flow characteristics at the hole exits, considerable differences in the heat transfer coefficient on the blade surface, specially in the leading-edge region, are observed even though the span-averaged values of h (heat transfer coefficient based on T(sub o)-T(sub w)) match well with the experimental data. This calls for span-resolved experimental data near film-cooling holes on a blade for better validation of the code.

  10. Vascular endothelial growth factor/bone morphogenetic protein-2 bone marrow combined modification of the mesenchymal stem cells to repair the avascular necrosis of the femoral head.

    PubMed

    Ma, Xiao-Wei; Cui, Da-Ping; Zhao, De-Wei

    2015-01-01

    Vascular endothelial cell growth factor (VEGF) combined with bone morphogenetic protein (BMP) was used to repair avascular necrosis of the femoral head, which can maintain the osteogenic phenotype of seed cells, and effectively secrete VEGF and BMP-2, and effectively promote blood vessel regeneration and contribute to formation and revascularization of tissue engineered bone tissues. To observe the therapeutic effect on the treatment of avascular necrosis of the femoral head by using bone marrow mesenchymal stem cells (BMSCs) modified by VEGF-165 and BMP-2 in vitro. The models were avascular necrosis of femoral head of rabbits on right leg. There groups were single core decompression group, core decompression + BMSCs group, core decompression + VEGF-165/BMP-2 transfect BMSCs group. Necrotic bone was cleared out under arthroscope. Arthroscopic observation demonstrated that necrotic bone was cleared out in each group, and fresh blood flowed out. Histomorphology determination showed that blood vessel number and new bone area in the repair region were significantly greater at various time points following transplantation in the core decompression + VEGF-165/BMP-2 transfect BMSCs group compared with single core decompression group and core decompression + BMSCs group (P < 0.05). These suggested that VEGF-165/BMP-2 gene transfection strengthened osteogenic effects of BMSCs, elevated number and quality of new bones and accelerated the repair of osteonecrosis of the femoral head.

  11. Vascular endothelial growth factor/bone morphogenetic protein-2 bone marrow combined modification of the mesenchymal stem cells to repair the avascular necrosis of the femoral head

    PubMed Central

    Ma, Xiao-Wei; Cui, Da-Ping; Zhao, De-Wei

    2015-01-01

    Vascular endothelial cell growth factor (VEGF) combined with bone morphogenetic protein (BMP) was used to repair avascular necrosis of the femoral head, which can maintain the osteogenic phenotype of seed cells, and effectively secrete VEGF and BMP-2, and effectively promote blood vessel regeneration and contribute to formation and revascularization of tissue engineered bone tissues. To observe the therapeutic effect on the treatment of avascular necrosis of the femoral head by using bone marrow mesenchymal stem cells (BMSCs) modified by VEGF-165 and BMP-2 in vitro. The models were avascular necrosis of femoral head of rabbits on right leg. There groups were single core decompression group, core decompression + BMSCs group, core decompression + VEGF-165/BMP-2 transfect BMSCs group. Necrotic bone was cleared out under arthroscope. Arthroscopic observation demonstrated that necrotic bone was cleared out in each group, and fresh blood flowed out. Histomorphology determination showed that blood vessel number and new bone area in the repair region were significantly greater at various time points following transplantation in the core decompression + VEGF-165/BMP-2 transfect BMSCs group compared with single core decompression group and core decompression + BMSCs group (P < 0.05). These suggested that VEGF-165/BMP-2 gene transfection strengthened osteogenic effects of BMSCs, elevated number and quality of new bones and accelerated the repair of osteonecrosis of the femoral head. PMID:26629044

  12. Bisphosphonate-related osteonecrosis of the jaw complicated by Ludwig's angina.

    PubMed

    Yang, Rong-Hsin; Shen, Shu-Huei; Li, Wing-Yin; Chu, Yum-Kung

    2015-01-01

    Ludwig's angina is a life-threatening cellulitis that involves the submandibular and sublingual spaces. It often occurs after an infection of the roots of the teeth. However, modern dental care and use of antibiotics for oral infections have made Ludwig's angina rare. We present here a cancer patient exhibiting the sequential features of bisphosphonate related osteonecrosis of the jaw on bone scan complicating with Ludwig's angina. This report highlights the need for medical practitioners to be alert to these rare combinations in the compromised patient after bisphosphonate therapy. To the best of our knowledge, no case of Ludwig's angina secondary to osteonecrosis of the jaw has been reported. PMID:25074798

  13. Effect of Anatomically Realistic Full-Head Model on Activation of Cortical Neurons in Subdural Cortical Stimulation—A Computational Study

    NASA Astrophysics Data System (ADS)

    Seo, Hyeon; Kim, Donghyeon; Jun, Sung Chan

    2016-06-01

    Electrical brain stimulation (EBS) is an emerging therapy for the treatment of neurological disorders, and computational modeling studies of EBS have been used to determine the optimal parameters for highly cost-effective electrotherapy. Recent notable growth in computing capability has enabled researchers to consider an anatomically realistic head model that represents the full head and complex geometry of the brain rather than the previous simplified partial head model (extruded slab) that represents only the precentral gyrus. In this work, subdural cortical stimulation (SuCS) was found to offer a better understanding of the differential activation of cortical neurons in the anatomically realistic full-head model than in the simplified partial-head models. We observed that layer 3 pyramidal neurons had comparable stimulation thresholds in both head models, while layer 5 pyramidal neurons showed a notable discrepancy between the models; in particular, layer 5 pyramidal neurons demonstrated asymmetry in the thresholds and action potential initiation sites in the anatomically realistic full-head model. Overall, the anatomically realistic full-head model may offer a better understanding of layer 5 pyramidal neuronal responses. Accordingly, the effects of using the realistic full-head model in SuCS are compelling in computational modeling studies, even though this modeling requires substantially more effort.

  14. Effect of Anatomically Realistic Full-Head Model on Activation of Cortical Neurons in Subdural Cortical Stimulation-A Computational Study.

    PubMed

    Seo, Hyeon; Kim, Donghyeon; Jun, Sung Chan

    2016-01-01

    Electrical brain stimulation (EBS) is an emerging therapy for the treatment of neurological disorders, and computational modeling studies of EBS have been used to determine the optimal parameters for highly cost-effective electrotherapy. Recent notable growth in computing capability has enabled researchers to consider an anatomically realistic head model that represents the full head and complex geometry of the brain rather than the previous simplified partial head model (extruded slab) that represents only the precentral gyrus. In this work, subdural cortical stimulation (SuCS) was found to offer a better understanding of the differential activation of cortical neurons in the anatomically realistic full-head model than in the simplified partial-head models. We observed that layer 3 pyramidal neurons had comparable stimulation thresholds in both head models, while layer 5 pyramidal neurons showed a notable discrepancy between the models; in particular, layer 5 pyramidal neurons demonstrated asymmetry in the thresholds and action potential initiation sites in the anatomically realistic full-head model. Overall, the anatomically realistic full-head model may offer a better understanding of layer 5 pyramidal neuronal responses. Accordingly, the effects of using the realistic full-head model in SuCS are compelling in computational modeling studies, even though this modeling requires substantially more effort. PMID:27273817

  15. Effect of Anatomically Realistic Full-Head Model on Activation of Cortical Neurons in Subdural Cortical Stimulation—A Computational Study

    PubMed Central

    Seo, Hyeon; Kim, Donghyeon; Jun, Sung Chan

    2016-01-01

    Electrical brain stimulation (EBS) is an emerging therapy for the treatment of neurological disorders, and computational modeling studies of EBS have been used to determine the optimal parameters for highly cost-effective electrotherapy. Recent notable growth in computing capability has enabled researchers to consider an anatomically realistic head model that represents the full head and complex geometry of the brain rather than the previous simplified partial head model (extruded slab) that represents only the precentral gyrus. In this work, subdural cortical stimulation (SuCS) was found to offer a better understanding of the differential activation of cortical neurons in the anatomically realistic full-head model than in the simplified partial-head models. We observed that layer 3 pyramidal neurons had comparable stimulation thresholds in both head models, while layer 5 pyramidal neurons showed a notable discrepancy between the models; in particular, layer 5 pyramidal neurons demonstrated asymmetry in the thresholds and action potential initiation sites in the anatomically realistic full-head model. Overall, the anatomically realistic full-head model may offer a better understanding of layer 5 pyramidal neuronal responses. Accordingly, the effects of using the realistic full-head model in SuCS are compelling in computational modeling studies, even though this modeling requires substantially more effort. PMID:27273817

  16. Quantitative relationship between axonal injury and mechanical response in a rodent head impact acceleration model.

    PubMed

    Li, Yan; Zhang, Liying; Kallakuri, Srinivasu; Zhou, Runzhou; Cavanaugh, John M

    2011-09-01

    A modified Marmarou impact acceleration model was developed to study the mechanical responses induced by this model and their correlation to traumatic axonal injury (TAI). Traumatic brain injury (TBI) was induced in 31 anesthetized male Sprague-Dawley rats (392±13 g) by a custom-made 450-g impactor from heights of 1.25 m or 2.25 m. An accelerometer and angular rate sensor measured the linear and angular responses of the head, while the impact event was captured by a high-speed video camera. TAI distribution along the rostro-caudal direction, as well as across the left and right hemispheres, was determined using β-amyloid precursor protein (β-APP) immunocytochemistry, and detailed TAI injury maps were constructed for the entire corpus callosum. Peak linear acceleration 1.25 m and 2.25 m impacts were 666±165 g and 907±501 g, respectively. Peak angular velocities were 95±24 rad/sec and 124±48 rad/sec, respectively. Compared to the 2.25-m group, the observed TAI counts in the 1.25-m impact group were significantly lower. Average linear acceleration, peak angular velocity, average angular acceleration, and surface righting time were also significantly different between the two groups. A positive correlation was observed between normalized total TAI counts and average linear acceleration (R(2)=0.612, p<0.05), and time to surface right (R(2)=0.545, p<0.05). Our study suggested that a 2.25-m drop in the Marmarou model may not always result in a severe injury, and TAI level is related to the linear and angular acceleration response of the rat head during impact, not necessarily the drop height.

  17. Quantitative Relationship between Axonal Injury and Mechanical Response in a Rodent Head Impact Acceleration Model

    PubMed Central

    Li, Yan; Kallakuri, Srinivasu; Zhou, Runzhou; Cavanaugh, John M.

    2011-01-01

    Abstract A modified Marmarou impact acceleration model was developed to study the mechanical responses induced by this model and their correlation to traumatic axonal injury (TAI). Traumatic brain injury (TBI) was induced in 31 anesthetized male Sprague-Dawley rats (392±13 g) by a custom-made 450-g impactor from heights of 1.25 m or 2.25 m. An accelerometer and angular rate sensor measured the linear and angular responses of the head, while the impact event was captured by a high-speed video camera. TAI distribution along the rostro-caudal direction, as well as across the left and right hemispheres, was determined using β-amyloid precursor protein (β-APP) immunocytochemistry, and detailed TAI injury maps were constructed for the entire corpus callosum. Peak linear acceleration 1.25 m and 2.25 m impacts were 666±165 g and 907±501 g, respectively. Peak angular velocities were 95±24 rad/sec and 124±48 rad/sec, respectively. Compared to the 2.25-m group, the observed TAI counts in the 1.25-m impact group were significantly lower. Average linear acceleration, peak angular velocity, average angular acceleration, and surface righting time were also significantly different between the two groups. A positive correlation was observed between normalized total TAI counts and average linear acceleration (R2=0.612, p<0.05), and time to surface right (R2=0.545, p<0.05). Our study suggested that a 2.25-m drop in the Marmarou model may not always result in a severe injury, and TAI level is related to the linear and angular acceleration response of the rat head during impact, not necessarily the drop height. PMID:21895482

  18. Graded model of diffuse axonal injury for studying head injury-induced cognitive dysfunction in rats.

    PubMed

    Maruichi, Katsuhiko; Kuroda, Satoshi; Chiba, Yasuhiro; Hokari, Masaaki; Shichinohe, Hideo; Hida, Kazutoshi; Iwasaki, Yoshinobu

    2009-04-01

    Diffuse axonal injury (DAI) plays a major role in the development of cognitive dysfunction, emotional difficulties and behavioral disturbances in patients following closed head injury, even when they have no definite abnormalities on conventional MRI. This study aimed to develop a highly controlled and reproducible model for DAI that simulates post-traumatic cognitive dysfunction in humans. Sprague-Dawley (SD) rats were subjected to impact acceleration head injury, using a pneumatic impact targeted to a steel disc centered onto their skull. The severity of injury was graded as three levels by adjusting the driving pressure at 60, 70 or 80 pounds per square inch. In vivo MRI was obtained 2 days post-injury. Cognitive function was evaluated using the Morris water maze at 1 and 2 weeks post-injury. HE staining and immunohistochemistry were performed to assess neuronal and axonal damages after 2 weeks. MRI demonstrated that this model induced no gross structural modification in the brain. The degree and duration of cognitive dysfunction were dependent on the force of impact. Histological analysis revealed the force-dependent damage of the neurons and microtubule-associated protein 2-positive axons in the neocortex. Hippocampal damage was much less pronounced and was not linked to cognitive dysfunction. This is the first report that precisely evaluates the threshold of impact energy to lead to neocortical damage and cognitive dysfunction in rodents. This model would be suitable for clarifying the complex mechanisms of post-traumatic brain damage and testing novel therapeutic approaches against post-traumatic cognitive dysfunction due to diffuse axonal damage.

  19. An eye model for uncalibrated eye gaze estimation under variable head pose

    NASA Astrophysics Data System (ADS)

    Hnatow, Justin; Savakis, Andreas

    2007-04-01

    Gaze estimation is an important component of computer vision systems that monitor human activity for surveillance, human-computer interaction, and various other applications including iris recognition. Gaze estimation methods are particularly valuable when they are non-intrusive, do not require calibration, and generalize well across users. This paper presents a novel eye model that is employed for efficiently performing uncalibrated eye gaze estimation. The proposed eye model was constructed from a geometric simplification of the eye and anthropometric data about eye feature sizes in order to circumvent the requirement of calibration procedures for each individual user. The positions of the two eye corners and the midpupil, the distance between the two eye corners, and the radius of the eye sphere are required for gaze angle calculation. The locations of the eye corners and midpupil are estimated via processing following eye detection, and the remaining parameters are obtained from anthropometric data. This eye model is easily extended to estimating eye gaze under variable head pose. The eye model was tested on still images of subjects at frontal pose (0 °) and side pose (34 °). An upper bound of the model's performance was obtained by manually selecting the eye feature locations. The resulting average absolute error was 2.98 ° for frontal pose and 2.87 ° for side pose. The error was consistent across subjects, which indicates that good generalization was obtained. This level of performance compares well with other gaze estimation systems that utilize a calibration procedure to measure eye features.

  20. A biomechanical impact test system for head and facial injury assessment and model development.

    PubMed

    Harris, G F; Yoganandan, N; Schmaltz, D; Reinartz, J; Pintar, F; Sances, A

    1993-01-01

    A biomechanical test system has been developed and validated to conduct controlled uniaxial impact experiments of head and facial trauma. The design reduces off-axis accelerations which are not in the direction of impact and allows accurate positioning of test specimens. Impact forces, displacement histories, impulses at impact and spectral responses are compared to free-fall test results at contact velocities representative of facial injuries (2.5, 3.1 and 3.8 m s-1). Models based on the experimental results are developed to reveal stiffness and inertial properties of impact for use in the design of biomechanically protective steering wheels, air bags and other potential impact structures. The results indicate that the system provides a flexible yet controllable method for positioning and testing impact structures reliably.

  1. Predictions of heading date in bread wheat (Triticum aestivum L.) using QTL-based parameters of an ecophysiological model.

    PubMed

    Bogard, Matthieu; Ravel, Catherine; Paux, Etienne; Bordes, Jacques; Balfourier, François; Chapman, Scott C; Le Gouis, Jacques; Allard, Vincent

    2014-11-01

    Prediction of wheat phenology facilitates the selection of cultivars with specific adaptations to a particular environment. However, while QTL analysis for heading date can identify major genes controlling phenology, the results are limited to the environments and genotypes tested. Moreover, while ecophysiological models allow accurate predictions in new environments, they may require substantial phenotypic data to parameterize each genotype. Also, the model parameters are rarely related to all underlying genes, and all the possible allelic combinations that could be obtained by breeding cannot be tested with models. In this study, a QTL-based model is proposed to predict heading date in bread wheat (Triticum aestivum L.). Two parameters of an ecophysiological model (V sat and P base , representing genotype vernalization requirements and photoperiod sensitivity, respectively) were optimized for 210 genotypes grown in 10 contrasting location × sowing date combinations. Multiple linear regression models predicting V sat and P base with 11 and 12 associated genetic markers accounted for 71 and 68% of the variance of these parameters, respectively. QTL-based V sat and P base estimates were able to predict heading date of an independent validation data set (88 genotypes in six location × sowing date combinations) with a root mean square error of prediction of 5 to 8.6 days, explaining 48 to 63% of the variation for heading date. The QTL-based model proposed in this study may be used for agronomic purposes and to assist breeders in suggesting locally adapted ideotypes for wheat phenology.

  2. Predictions of heading date in bread wheat (Triticum aestivum L.) using QTL-based parameters of an ecophysiological model

    PubMed Central

    Bogard, Matthieu; Ravel, Catherine; Paux, Etienne; Bordes, Jacques; Balfourier, François; Chapman, Scott C.; Le Gouis, Jacques; Allard, Vincent

    2014-01-01

    Prediction of wheat phenology facilitates the selection of cultivars with specific adaptations to a particular environment. However, while QTL analysis for heading date can identify major genes controlling phenology, the results are limited to the environments and genotypes tested. Moreover, while ecophysiological models allow accurate predictions in new environments, they may require substantial phenotypic data to parameterize each genotype. Also, the model parameters are rarely related to all underlying genes, and all the possible allelic combinations that could be obtained by breeding cannot be tested with models. In this study, a QTL-based model is proposed to predict heading date in bread wheat (Triticum aestivum L.). Two parameters of an ecophysiological model (V sat and P base, representing genotype vernalization requirements and photoperiod sensitivity, respectively) were optimized for 210 genotypes grown in 10 contrasting location × sowing date combinations. Multiple linear regression models predicting V sat and P base with 11 and 12 associated genetic markers accounted for 71 and 68% of the variance of these parameters, respectively. QTL-based V sat and P base estimates were able to predict heading date of an independent validation data set (88 genotypes in six location × sowing date combinations) with a root mean square error of prediction of 5 to 8.6 days, explaining 48 to 63% of the variation for heading date. The QTL-based model proposed in this study may be used for agronomic purposes and to assist breeders in suggesting locally adapted ideotypes for wheat phenology. PMID:25148833

  3. Behavior and modeling of two-dimensional precedence effect in head-unrestrained cats

    PubMed Central

    Ruhland, Janet L.; Yin, Tom C. T.

    2015-01-01

    The precedence effect (PE) is an auditory illusion that occurs when listeners localize nearly coincident and similar sounds from different spatial locations, such as a direct sound and its echo. It has mostly been studied in humans and animals with immobile heads in the horizontal plane; speaker pairs were often symmetrically located in the frontal hemifield. The present study examined the PE in head-unrestrained cats for a variety of paired-sound conditions along the horizontal, vertical, and diagonal axes. Cats were trained with operant conditioning to direct their gaze to the perceived sound location. Stereotypical PE-like behaviors were observed for speaker pairs placed in azimuth or diagonally in the frontal hemifield as the interstimulus delay was varied. For speaker pairs in the median sagittal plane, no clear PE-like behavior occurred. Interestingly, when speakers were placed diagonally in front of the cat, certain PE-like behavior emerged along the vertical dimension. However, PE-like behavior was not observed when both speakers were located in the left hemifield. A Hodgkin-Huxley model was used to simulate responses of neurons in the medial superior olive (MSO) to sound pairs in azimuth. The novel simulation incorporated a low-threshold potassium current and frequency mismatches to generate internal delays. The model exhibited distinct PE-like behavior, such as summing localization and localization dominance. The simulation indicated that certain encoding of the PE could have occurred before information reaches the inferior colliculus, and MSO neurons with binaural inputs having mismatched characteristic frequencies may play an important role. PMID:26133795

  4. The New York Head-A precise standardized volume conductor model for EEG source localization and tES targeting.

    PubMed

    Huang, Yu; Parra, Lucas C; Haufe, Stefan

    2016-10-15

    In source localization of electroencephalograpic (EEG) signals, as well as in targeted transcranial electric current stimulation (tES), a volume conductor model is required to describe the flow of electric currents in the head. Boundary element models (BEM) can be readily computed to represent major tissue compartments, but cannot encode detailed anatomical information within compartments. Finite element models (FEM) can capture more tissue types and intricate anatomical structures, but with the higher precision also comes the need for semi-automated segmentation, and a higher computational cost. In either case, adjusting to the individual human anatomy requires costly magnetic resonance imaging (MRI), and thus head modeling is often based on the anatomy of an 'arbitrary' individual (e.g. Colin27). Additionally, existing reference models for the human head often do not include the cerebro-spinal fluid (CSF), and their field of view excludes portions of the head and neck-two factors that demonstrably affect current-flow patterns. Here we present a highly detailed FEM, which we call ICBM-NY, or "New York Head". It is based on the ICBM152 anatomical template (a non-linear average of the MRI of 152 adult human brains) defined in MNI coordinates, for which we extended the field of view to the neck and performed a detailed segmentation of six tissue types (scalp, skull, CSF, gray matter, white matter, air cavities) at 0.5mm(3) resolution. The model was solved for 231 electrode locations. To evaluate its performance, additional FEMs and BEMs were constructed for four individual subjects. Each of the four individual FEMs (regarded as the 'ground truth') is compared to its BEM counterpart, the ICBM-NY, a BEM of the ICBM anatomy, an 'individualized' BEM of the ICBM anatomy warped to the individual head surface, and FEMs of the other individuals. Performance is measured in terms of EEG source localization and tES targeting errors. Results show that the ICBM-NY outperforms

  5. Head circumference

    MedlinePlus

    ... a child's head circumference Normal ranges for a child's sex and age (weeks, months), based on values that experts have obtained for normal growth rates of infants' and children's heads Measurement of the head circumference is an ...

  6. Head Lice

    MedlinePlus

    Head lice are parasitic wingless insects. They live on people's heads and feed on their blood. An adult louse ... Children ages 3-11 and their families get head lice most often. Personal hygiene has nothing to ...

  7. Follow the heart or the head? The interactive influence model of emotion and cognition.

    PubMed

    Luo, Jiayi; Yu, Rongjun

    2015-01-01

    The experience of emotion has a powerful influence on daily-life decision making. Following Plato's description of emotion and reason as two horses pulling us in opposite directions, modern dual-system models of decision making endorse the antagonism between reason and emotion. Decision making is perceived as the competition between an emotion system that is automatic but prone to error and a reason system that is slow but rational. The reason system (in "the head") reins in our impulses (from "the heart") and overrides our snap judgments. However, from Darwin's evolutionary perspective, emotion is adaptive, guiding us to make sound decisions in uncertainty. Here, drawing findings from behavioral economics and neuroeconomics, we provide a new model, labeled "The interactive influence model of emotion and cognition," to elaborate the relationship of emotion and reason in decision making. Specifically, in our model, we identify factors that determine when emotions override reason and delineate the type of contexts in which emotions help or hurt decision making. We then illustrate how cognition modulates emotion and how they cooperate to affect decision making. PMID:25999889

  8. Follow the heart or the head? The interactive influence model of emotion and cognition.

    PubMed

    Luo, Jiayi; Yu, Rongjun

    2015-01-01

    The experience of emotion has a powerful influence on daily-life decision making. Following Plato's description of emotion and reason as two horses pulling us in opposite directions, modern dual-system models of decision making endorse the antagonism between reason and emotion. Decision making is perceived as the competition between an emotion system that is automatic but prone to error and a reason system that is slow but rational. The reason system (in "the head") reins in our impulses (from "the heart") and overrides our snap judgments. However, from Darwin's evolutionary perspective, emotion is adaptive, guiding us to make sound decisions in uncertainty. Here, drawing findings from behavioral economics and neuroeconomics, we provide a new model, labeled "The interactive influence model of emotion and cognition," to elaborate the relationship of emotion and reason in decision making. Specifically, in our model, we identify factors that determine when emotions override reason and delineate the type of contexts in which emotions help or hurt decision making. We then illustrate how cognition modulates emotion and how they cooperate to affect decision making.

  9. Animal models of sports-related head injury: bridging the gap between pre-clinical research and clinical reality

    PubMed Central

    Angoa-Pérez, Mariana; Kane, Michael J.; Briggs, Denise I.; Herrera-Mundo, Nieves; Viano, David C.; Kuhn, Donald M.

    2016-01-01

    Sports-related head impact and injury has become a very highly contentious public health and medico-legal issue. Near-daily news accounts describe the travails of concussed athletes as they struggle with depression, sleep disorders, mood swings, and cognitive problems. Some of these individuals have developed chronic traumatic encephalopathy, a progressive and debilitating neurodegenerative disorder. Animal models have always been an integral part of the study of traumatic brain injury in humans but, historically, they have concentrated on acute, severe brain injuries. This review will describe a small number of new and emerging animal models of sports-related head injury that have the potential to increase our understanding of how multiple mild head impacts, starting in adolescence, can have serious psychiatric, cognitive and histopathological outcomes much later in life. PMID:24673291

  10. Induced EM field in a layered eccentric spheres model of the head: Plane-wave and localized source exposure

    SciTech Connect

    Skaropoulos, N.C.; Ioannidou, M.P.; Chrissoulidis, D.P.

    1996-10-01

    Understanding the interaction of EM radiation with humans is essential in a number of contemporary applications. Special attention is paid to the absorption of EM energy by the human head, which exhibits a resonant behavior in the frequency band 0.1--3 GHz. The use of handheld transceivers for wireless communications, which operate in close proximity to the head, has raised safety-related questions and questions concerning the effect of the head on the performance of the mobile phone antenna. The induced electromagnetic (EM) field in a layered eccentric spheres structure is determined through a concise analytical formulation based on indirect mode-matching (IMM). The exact analytical solution is applied to a six-layer model of the head. This model allows for eccentricity between the inner and outer sets of concentric spherical layers which simulate brain and skull, respectively. Excitation is provided by a nearby localized source or by an incident plane wave. The numerical application provides information about the total absorbed power, the absorption in each layer, and the spatial distribution of the specific absorption rate (SAR) at frequencies used by cellular phones. The effects of excitation frequency, eccentricity, exposure configuration, and antenna-head separation are investigated.

  11. Crista egregia: a geometrical model of the crista ampullaris, a sensory surface that detects head rotations.

    PubMed

    Marianelli, Prisca; Berthoz, Alain; Bennequin, Daniel

    2015-02-01

    The crista ampullaris is the epithelium at the end of the semicircular canals in the inner ear of vertebrates, which contains the sensory cells involved in the transduction of the rotational head movements into neuronal activity. The crista surface has the form of a saddle, or a pair of saddles separated by a crux, depending on the species and the canal considered. In birds, it was described as a catenoid by Landolt et al. (J Comp Neurol 159(2):257-287, doi: 10.1002/cne.901590207 , 1972). In the present work, we establish that this particular form results from principles of invariance maximization and energy minimization. The formulation of the invariance principle was inspired by Takumida (Biol Sci Space 15(4):356-358, 2001). More precisely, we suppose that in functional conditions, the equations of linear elasticity are valid, and we assume that in a certain domain of the cupula, in proximity of the crista surface, (1) the stress tensor of the deformed cupula is invariant under the gradient of the pressure, (2) the dissipation of energy is minimum. Then, we deduce that in this domain the crista surface is a minimal surface and that it must be either a planar, or helicoidal Scherk surface, or a piece of catenoid, which is the unique minimal surface of revolution. If we add the hypothesis that the direction of invariance of the stress tensor is unique and that a bilateral symmetry of the crista exists, only the catenoid subsists. This finding has important consequences for further functional modeling of the role of the vestibular system in head motion detection and spatial orientation.

  12. Bisphosphonate-related osteonecrosis of the jaws--a case report.

    PubMed

    Kamoh, Amandip K; Ogle, Orrett

    2012-05-01

    Bisphosphonates are commonly prescribed for the treatment of osteoporosis and bone cancers. These drugs come in both intravenous and oral forms. Because these drugs have become more prevalent, there have been increased reports of bisphosphonate-related osteonecrosis of the jaws (BRONJ). This case presentation focuses on a 50-year-old woman with a 10-year history of monthly Zometa (zoledronic acid) use for treatment of multiple myeloma, resulting in BRONJ with a very unfavorable outcome. Its purpose is to depict how the chronic use of intravenous (i.v.) bisphosphonates can lead to bisphosphonate-related osteonecrosis of the jaw (BRONJ), and to present treatment options, including conservative measures, the dentist may be able to employ in the early phases of the disease, along with the indications for jaw resection. Osteonecrosis of the jaws in association with bisphosphonate therapy is a very serious condition with which all dentists should be familiar. When the osteonecrosis begins, it can be very painful to the patient, difficult to treat, and can lead to very deleterious sequelae.

  13. Bisphosphonates, vitamin D, parathyroid hormone, and osteonecrosis of the jaw. Could there be a missing link?

    PubMed Central

    Leizaola-Cardesa, Ignacio-Osoitz; Aguilar-Salvatierra, Antonio; Gonzalez-Jaranay, Maximino; Moreu, Gerardo; Sala-Romero, María-José

    2016-01-01

    It is estimated that over 190 million bisphosphonates have been prescribed worldwide. But this drug can produce adverse effects, of which osteonecrosis of the jaw and severe hypocalcemia are the most serious. It is evident that bisphosphonate administration affects multiple and diverse biochemical mediators related to bone metabolism. This review of literature investigates four basic parameters in patients treated with bisphosphonates - parathyroid hormone (PTH), bisphosphonates, vitamin D, calcium, and jaw osteonecrosis - which are fundamental for assessing bone metabolism and so the efficacy and correct use of the drug. The imbalances generated by vitamin D and calcium deficiencies, together with their multiple systemic repercussions, have been widely researched but the outcomes of these imbalances in relation to bisphosphonate administration are not well known, and some research has indicated that they may be associated with osteonecrosis of the jaw (ONJ). The present review set out to explain the functioning of bone metabolism, the importance of different chemical mediators, the imbalances produced by incorrect use of this drug, in order to forewarn against the possible relation of these parameters with ONJ, whose physiopathology remains unknown. Medical and dental clinics should keep detailed anamneses of the use of vitamin D and calcium supplements, as it is of vital importance to maintain their correct levels in blood, given that these are related to ONJ as well as other adverse effects; this procedure is also necessary in order to ensure the correct use of the drug. Key words:Bisphosphonate-related osteonecrosis of the jaw, vitamin D, parathyroid hor PMID:26827062

  14. Thermal modeling of head disk interface system in heat assisted magnetic recording

    NASA Astrophysics Data System (ADS)

    Vemuri, Sesha Hari; Min Kim, Hyung; Seung Chung, Pil; Jhon, Myung S.

    2014-05-01

    A thorough understanding of the temperature profiles introduced by the heat assisted magnetic recording is required to maintain the hotspot at the desired location on the disk with minimal heat damage to other components. Here, we implement a transient mesoscale modeling methodology termed lattice Boltzmann method (LBM) for phonons (which are primary carriers of energy) in the thermal modeling of the head disk interface (HDI) components, namely, carbon overcoat (COC). The LBM can provide more accurate results compared to conventional Fourier methodology by capturing the nanoscale phenomena due to ballistic heat transfer. We examine the in-plane and out-of-plane heat transfer in the COC via analyzing the temperature profiles with a continuously focused and pulsed laser beam on a moving disk. Larger in-plane hotspot widening is observed in continuously focused laser beam compared to a pulsed laser. A pulsed laser surface develops steeper temperature gradients compared to continuous hotspot. Furthermore, out-of-plane heat transfer from the COC to the media is enhanced with a continuous laser beam then a pulsed laser, while the temperature takes around 140 fs to reach the bottom surface of the COC. Our study can lead to a realistic thermal model describing novel HDI material design criteria for the next generation of hard disk drives with ultra high recording densities.

  15. Thermal modeling of head disk interface system in heat assisted magnetic recording

    SciTech Connect

    Vemuri, Sesha Hari; Seung Chung, Pil; Jhon, Myung S.; Min Kim, Hyung

    2014-05-07

    A thorough understanding of the temperature profiles introduced by the heat assisted magnetic recording is required to maintain the hotspot at the desired location on the disk with minimal heat damage to other components. Here, we implement a transient mesoscale modeling methodology termed lattice Boltzmann method (LBM) for phonons (which are primary carriers of energy) in the thermal modeling of the head disk interface (HDI) components, namely, carbon overcoat (COC). The LBM can provide more accurate results compared to conventional Fourier methodology by capturing the nanoscale phenomena due to ballistic heat transfer. We examine the in-plane and out-of-plane heat transfer in the COC via analyzing the temperature profiles with a continuously focused and pulsed laser beam on a moving disk. Larger in-plane hotspot widening is observed in continuously focused laser beam compared to a pulsed laser. A pulsed laser surface develops steeper temperature gradients compared to continuous hotspot. Furthermore, out-of-plane heat transfer from the COC to the media is enhanced with a continuous laser beam then a pulsed laser, while the temperature takes around 140 fs to reach the bottom surface of the COC. Our study can lead to a realistic thermal model describing novel HDI material design criteria for the next generation of hard disk drives with ultra high recording densities.

  16. SCDAP/RELAP5 modeling of heat transfer and flow losses in lower head porous debris. Revision 1

    SciTech Connect

    Siefken, L.J.; Coryell, E.W.; Paik, S.; Kuo, H.

    1999-05-01

    Designs are described for implementing models for calculating the heat transfer and flow losses in porous debris in the lower head of a reactor vessel. The COUPLE model in SCDAP/RELAP5 represents both the porous and nonporous debris that results from core material slumping into the lower head. Currently, the COUPLE model has the capability to model convective and radiative heat transfer from the surfaces of nonporous debris in a detailed manner and to model only in a simplistic manner the heat transfer from porous debris. In order to advance beyond the simplistic modeling for porous debris, designs are developed for detailed calculations of heat transfer and flow losses in porous debris. Correlations are identified for convective heat transfer in porous debris for the following modes of heat transfer; (1) forced convection to liquid, (2) forced convection to gas, (3) nucleate boiling, (4) transition boiling, and (5) film boiling. Interphase heat transfer is modeled in an approximate ma nner. Designs are described for models to calculate the flow losses and interphase drag of fluid flowing through the interstices of the porous debris, and to apply these variables in the momentum equations in the RELAP5 part of the code. Since the models for heat transfer and flow losses in porous debris in the lower head are designed for general application, a design is also described for implementation of these models to the analysis of porous debris in the core region. A test matrix is proposed for assessing the capability of the implemented models to calculate the heat transfer and flow losses in porous debris. The implementation of the models described in this report is expected to improve the COUPLE code calculation of the temperature distribution in porous debris and in the lower head that supports the debris. The implementation of these models is also expected to improve the calculation of the temperature and flow distribution in porous debris in the core region.

  17. Brain Response to Primary Blast Wave Using Validated Finite Element Models of Human Head and Advanced Combat Helmet

    PubMed Central

    Zhang, Liying; Makwana, Rahul; Sharma, Sumit

    2013-01-01

    Blast-induced traumatic brain injury has emerged as a “signature injury” in combat casualty care. Present combat helmets are designed primarily to protect against ballistic and blunt impacts, but the current issue with helmets is protection concerning blasts. In order to delineate the blast wave attenuating capability of the Advanced Combat Helmet (ACH), a finite element (FE) study was undertaken to evaluate the head response against blast loadings with and without helmet using a partially validated FE model of the human head and ACH. Four levels of overpressures (0.27–0.66 MPa) from the Bowen’s lung iso-damage threshold curves were used to simulate blast insults. Effectiveness of the helmet with respect to head orientation was also investigated. The resulting biomechanical responses of the brain to blast threats were compared for human head with and without the helmet. For all Bowen’s cases, the peak intracranial pressures (ICP) in the head ranged from 0.68 to 1.8 MPa in the coup cortical region. ACH was found to mitigate ICP in the head by 10–35%. Helmeted head resulted in 30% lower average peak brain strains and product of strain and strain rate. Among three blast loading directions with ACH, highest reduction in peak ICP (44%) was due to backward blasts whereas the lowest reduction in peak ICP and brain strains was due to forward blast (27%). The biomechanical responses of a human head to primary blast insult exhibited directional sensitivity owing to the different geometry contours and coverage of the helmet construction and asymmetric anatomy of the head. Thus, direction-specific tolerances are needed in helmet design in order to offer omni-directional protection for the human head. The blasts of varying peak overpressures and durations that are believed to produce the same level of lung injury produce different levels of mechanical responses in the brain, and hence “iso-damage” curves for brain injury are likely different than the Bowen

  18. A Multiple Model Approach to Track Head Orientation With Delta Quaternions.

    PubMed

    Himberg, Henry; Motai, Yuichi; Bradley, Arthur

    2013-02-01

    Virtual reality and augmented reality environments using helmet-mounted displays create a sense of immersion by closely coupling user head motion to display content. Delays in the presentation of visual information can destroy the sense of presence in the simulation environment when it causes a lag in the display response to user head motion. The effect of display lag can be minimized by predicting head orientation, allowing the system to have sufficient time to counteract the delay. In this paper, anew head orientation prediction technique is proposed that uses a multiple delta quaternion (DQ) extended Kalman filter to track angular head velocity and angular head acceleration. This method is independent of the device used for orientation measurement, relying on quaternion orientation as the only measurement data. A new orientation prediction algorithm is proposed that estimates future head orientation as a function of the current orientation measurement and a predicted change in orientation, using the velocity and acceleration estimates. Extensive experimentation shows that the new method improves head orientation prediction when compared to single filter DQ prediction.

  19. An Ex Vivo Model in Human Femoral Heads for Histopathological Study and Resonance Frequency Analysis of Dental Implant Primary Stability

    PubMed Central

    Hernández-Cortés, Pedro; Galindo-Moreno, Pablo; Catena, Andrés; Ortega-Oller, Inmaculada; Salas-Pérez, José; Gómez-Sánchez, Rafael; Aguilar, Mariano; Aguilar, David

    2014-01-01

    Objective. This study was designed to explore relationships of resonance frequency analysis (RFA)—assessed implant stability (ISQ values) with bone morphometric parameters and bone quality in an ex vivo model of dental implants placed in human femoral heads and to evaluate the usefulness of this model for dental implant studies. Material and Methods. This ex vivo study included femoral heads from 17 patients undergoing surgery for femoral neck fracture due to osteoporosis (OP) (n = 7) or for total prosthesis joint replacement due to severe hip osteoarthrosis (OA) (n = 10). Sixty 4.5 × 13 mm Dentsply Astra implants were placed, followed by RFA. CD44 immunohistochemical analysis for osteocytes was also carried out. Results. As expected, the analysis yielded significant effects of femoral head type (OA versus OA) (P < 0.001), but not of the implants (P = 0.455) or of the interaction of the two factors (P = 0.848). Bonferroni post hoc comparisons showed a lower mean ISQ for implants in decalcified (50.33 ± 2.92) heads than in fresh (66.93 ± 1.10) or fixated (70.77 ± 1.32) heads (both P < 0.001). The ISQ score (fresh) was significantly higher for those in OA (73.52 ± 1.92) versus OP (67.13 ± 1.09) heads. However, mixed linear analysis showed no significant association between ISQ scores and morphologic or histomorphometric results (P > 0.5 in all cases), and no significant differences in ISQ values were found as a function of the length or area of the cortical layer (both P > 0.08). Conclusion. Although RFA-determined ISQ values are not correlated with morphometric parameters, they can discriminate bone quality (OP versus OA). This ex vivo model is useful for dental implant studies. PMID:24995307

  20. A Modeling of Cerebral Blood Flow Changes due to Head Motion for fNIRS

    NASA Astrophysics Data System (ADS)

    Takahashi, Kosuke; Tanaka, Takayuki; Nara, Hiroyuki; Kaneko, Shun'ichi; Inoue, Masao; Shimizu, Shunji; Kojima, Satoru

    2013-04-01

    A method is proposed for measuring brain activity during exercises involving head motion by using functional near-infrared spectroscopy (fNIRS), which investigates cerebral hemodynamics. Obtaining measurements during exercise is difficult because cerebral blood flow changes due to the head motion component (HMC), in addition to neural activity. HMC is an undesirable artifact in the measurement of hemodynamic response caused by neural activity, and as such, it must be estimated and eliminated. In our experiments, cerebral blood flow and head motion were measured during repeated passive forward bending of the subjects. Head motion was measured by 3-D motion capture, and HMC was estimated by deriving a relation between head motion and cerebral blood flow, where the pitch angle was found to be suitable for estimating HMC. In this research, an assumption was made that cerebral blood flow caused by neural activity and that caused by postural change were additive, and thus HMC was eliminated by subtraction.

  1. SU-C-BRF-03: PCA Modeling of Anatomical Changes During Head and Neck Radiation Therapy

    SciTech Connect

    Chetvertkov, M; Kim, J; Siddiqui, F; Kumarasiri, A; Chetty, I; Gordon, J

    2014-06-15

    Purpose: To develop principal component analysis (PCA) models from daily cone beam CTs (CBCTs) of head and neck (H and N) patients that could be used prospectively in adaptive radiation therapy (ART). Methods: : For 7 H and N patients, Pinnacle Treatment Planning System (Philips Healthcare) was used to retrospectively deformably register daily CBCTs to the planning CT. The number N of CBCTs per treatment course ranged from 14 to 22. For each patient a PCA model was built from the deformation vector fields (DVFs), after first subtracting the mean DVF, producing N eigen-DVFs (EDVFs). It was hypothesized that EDVFs with large eigenvalues represent the major anatomical deformations during the course of treatment, and that it is feasible to relate each EDVF to a clinically meaningful systematic or random change in anatomy, such as weight loss, neck flexion, etc. Results: DVFs contained on the order of 3×87×87×58=1.3 million scalar values (3 times the number of voxels in the registered volume). The top 3 eigenvalues accounted for ∼90% of variance. Anatomical changes corresponding to an EDVF were evaluated by generating a synthetic DVF, and applying that DVF to the CT to produce a synthetic CBCT. For all patients, the EDVF for the largest eigenvalue was interpreted to model weight loss. The EDVF for other eigenvalues appeared to represented quasi-random fraction-to-fraction changes. Conclusion: The leading EDVFs from single-patient PCA models have tentatively been identified with weight loss changes during treatment. Other EDVFs are tentatively identified as quasi-random inter-fraction changes. Clean separation of systematic and random components may require further work. This work is expected to facilitate development of population-based PCA models that can be used to prospectively identify significant anatomical changes, such as weight loss, early in treatment, triggering replanning where beneficial.

  2. Automated Sperm Head Detection Using Intersecting Cortical Model Optimised by Particle Swarm Optimization

    PubMed Central

    Tan, Weng Chun; Mat Isa, Nor Ashidi

    2016-01-01

    In human sperm motility analysis, sperm segmentation plays an important role to determine the location of multiple sperms. To ensure an improved segmentation result, the Laplacian of Gaussian filter is implemented as a kernel in a pre-processing step before applying the image segmentation process to automatically segment and detect human spermatozoa. This study proposes an intersecting cortical model (ICM), which was derived from several visual cortex models, to segment the sperm head region. However, the proposed method suffered from parameter selection; thus, the ICM network is optimised using particle swarm optimization where feature mutual information is introduced as the new fitness function. The final results showed that the proposed method is more accurate and robust than four state-of-the-art segmentation methods. The proposed method resulted in rates of 98.14%, 98.82%, 86.46% and 99.81% in accuracy, sensitivity, specificity and precision, respectively, after testing with 1200 sperms. The proposed algorithm is expected to be implemented in analysing sperm motility because of the robustness and capability of this algorithm. PMID:27632581

  3. Automated Sperm Head Detection Using Intersecting Cortical Model Optimised by Particle Swarm Optimization.

    PubMed

    Tan, Weng Chun; Mat Isa, Nor Ashidi

    2016-01-01

    In human sperm motility analysis, sperm segmentation plays an important role to determine the location of multiple sperms. To ensure an improved segmentation result, the Laplacian of Gaussian filter is implemented as a kernel in a pre-processing step before applying the image segmentation process to automatically segment and detect human spermatozoa. This study proposes an intersecting cortical model (ICM), which was derived from several visual cortex models, to segment the sperm head region. However, the proposed method suffered from parameter selection; thus, the ICM network is optimised using particle swarm optimization where feature mutual information is introduced as the new fitness function. The final results showed that the proposed method is more accurate and robust than four state-of-the-art segmentation methods. The proposed method resulted in rates of 98.14%, 98.82%, 86.46% and 99.81% in accuracy, sensitivity, specificity and precision, respectively, after testing with 1200 sperms. The proposed algorithm is expected to be implemented in analysing sperm motility because of the robustness and capability of this algorithm. PMID:27632581

  4. Phototheranostic Porphyrin Nanoparticles Enable Visualization and Targeted Treatment of Head and Neck Cancer in Clinically Relevant Models

    PubMed Central

    Muhanna, Nidal; Jin, Cheng S; Huynh, Elizabeth; Chan, Harley; Qiu, Yi; Jiang, Wenlei; Cui, Liyang; Burgess, Laura; Akens, Margarete K; Chen, Juan; Irish, Jonathan C; Zheng, Gang

    2015-01-01

    Head and neck cancer is the fifth most common type of cancer worldwide and remains challenging for effective treatment due to the proximity to critical anatomical structures in the head and neck region, which increases the probability of toxicity from surgery and radiotherapy, and therefore emphasizes the importance of maximizing the targeted ablation. We have assessed the effectiveness of porphysome nanoparticles to enhance fluorescence and photoacoustic imaging of head and neck tumors in rabbit and hamster models. In addition, we evaluated the effectiveness of this agent for localized photothermal ablative therapy of head and neck tumors. We have demonstrated that porphysomes not only enabled fluorescence and photoacoustic imaging of buccal and tongue carcinomas, but also allowed for complete targeted ablation of these tumors. The supremacy of porphysome-enabled photothermal therapy over surgery to completely eradicate primary tumors and metastatic regional lymph node while sparing the adjacent critical structures' function has been demonstrated for the first time. This study represents a novel breakthrough that has the potential to revolutionize our approach to tumor diagnosis and treatment in head and neck cancer and beyond. PMID:26681987

  5. Impact of Model Uncertainty Description on Assimilating Hydraulic Head into the MIKE-SHE Distributed Hydrological Model

    NASA Astrophysics Data System (ADS)

    Zhang, D.; Madsen, H.; Ridler, M. E.; Rasmussen, J.; Refsgaard, J.; Jensen, K.

    2013-12-01

    Catchment-scale hydrological models are used as prediction tools to solve major challenges in water resources management. The reliability of hydrological model predictions is inevitably affected by the amount of information available to set up and calibrate the model. Data assimilation (DA) which combines complementary information from measurements and models has proven to be a powerful and promising tool in numerous research studies to improve model predictions. Especially, the ensemble Kalman filter (EnKF) which is a popular sequential data assimilation technique, has been extensively studied in the earth sciences for assimilating in-situ measurements and remote sensing data. However, one of the major challenges in data assimilation to optimally combine model and measurements is the description of model uncertainty. Only few studies have been reported for defining appropriate model uncertainty in hydrological DA. Modeling uncertainties can be conceptually different in different applications. Traditionally, model uncertainty is represented by parameter uncertainty with corresponding parameter statistics determined by inverse modeling. In most hydrological DA applications, however, model uncertainty is defined by experience using simple statistical descriptions of different uncertainty sources. In this work, both the uncertainty derived from inverse modeling and from empirical knowledge are used and analyzed. A combination of parameter-based, forcing-based and state-based model error is implemented in the EnKF framework for assimilating groundwater hydraulic heads into a catchment-scale model of the Karup Catchment in Denmark using the distributed and integrated hydrological model MIKE SHE. A series of synthetic identical twin experiments are carried out to analyze the impact of different model error assumptions on the feasibility and efficiency of the assimilation. The optimality of the EnKF underlying twin test provides possibilities to diagnose model error

  6. Osteonecrosis of the Torus Palatinus in the Setting of Long-Term Oral Bisphosphonate Use--A Case Report.

    PubMed

    Ryan, Joshua L; Larson, Eric

    2016-01-01

    Bisphosphonates are medications used orally and intravenously for a variety of conditions including cancer metastatic to bone, hypercalcemia of malignancy, Paget's disease and osteoporosis. Osteonecrosis of the jaw has been related to bisphosphonate use. Osteonecrosis of the jaw most commonly occurs in the setting of intravenous bisphosphonate use and concomitant dental work or trauma. Oral bisphosphonates have much less risk of osteonecrosis of the jaw. We present an interesting case of a patient on an oral bisphosphonate for an extended period of time (nine years), with a torus palatinus, who burned her palate while eating a slice of pizza. Over six months later, she presented with an area of denuded bone and diagnosis consistent with osteonecrosis of the torus palatinus. PMID:26882578

  7. Concept, diagnosis and classification of bisphosphonate-associated osteonecrosis of the jaws. A review of the literature

    PubMed Central

    Bagan, Jose V.

    2016-01-01

    Background Bisphosphonates (BPs) and other antiresorptive agents such as denosumab are widely prescribed for the treatment of osteoporosis and are also used in patients with multiple myeloma and metastatic breast or prostate cancer for avoiding bone reabsorption and fractures that result in increased morbidity-mortality among such individuals. Material and Methods We made a bibliographic search to analyze the concept, diagnosis and the different classifications for bisphosphonate-associated osteonecrosis of the jaws. Results Osteonecrosis of the jaws (ONJ) is an important complication of exposure to BPs or other antiresorptive agents, and although its prevalence is low, it can pose management problems. The definition, diagnosis and classification of osteonecrosis have evolved since Marx reported the first cases in 2003. Conclusions The present study offers a literature review and update on the existing diagnostic methods and classification of the disorder, with a view to facilitating earlier and more effective treatment. Key words:Osteonecrosis, jaws, bisphosphonates. PMID:26827066

  8. Head-Down Tilt with Balanced Traction as a Model for Simulating Spinal Acclimation to Microgravity

    NASA Technical Reports Server (NTRS)

    Ballard, R. E.; Styf, J. R.; Watenpaugh, D. E.; Fechner, K.; Haruna, Y.; Kahan, N. J.; Hargens, A. R.

    1994-01-01

    Astronauts experience total body height increases of 4 to 7 cm in microgravity. Thus, stretching of the spinal cord, nerve roots, and muscular and ligamentous tissues may be responsible for the hyperreflexia, back pain, and muscular atrophy associated with exposure to microgravity. Axial compression of the spine makes 6 deg. head-down tilt (HDT) an unsuitable model for spinal acclimation to microgravity. However, this axial compression may be counteracted by balanced traction consisting of 10% body weight (sin 6 deg. = 0.1) applied to the legs. Six healthy male subjects underwent 3 days each of 60 HDT with balanced traction and horizontal bed rest (HBR), with a 2 week recovery period between treatments. Total body and spine length, lumbar disc height, back pain, erector spinae intramuscular pressure, and ankle joint torque were measured before, during and after each treatment. Total body and spine (processes of L5 - C7) lengths increased significantly more during HDT with balanced traction (22 +/- 8 mm and 25 +/- 8 mm, respectively) than during HBR (16 +/- 4 mm and 14 +/- 9 mm, respectively). Back and leg pain were significantly greater during HDT with balanced traction than during HBR. The distance between the lower end plate of L4 and the upper endplate of S1, as measured by sonography, increased significantly in both treatments to the same degree (2.9 +/- 1.9 mm, HDT with balanced traction; 3.3 +/- 1.5 mm, HBR). Intramuscular pressure of the erector spinae muscles and maximal ankle joint torque were unaltered with both models. While neither model increased height to the magnitude observed in microgravity, HDT with balanced traction may be a better model for simulating the body lengthening and back pain experienced in microgravity.

  9. Impact of Full-Day Head Start Prekindergarten Class Model on Student Academic Performance, Cognitive Skills, and Learning Behaviors by the End of Grade 2. Evaluation Brief

    ERIC Educational Resources Information Center

    Zhao, Huafang; Modarresi, Shahpar

    2013-01-01

    This brief describes the impact of the Montgomery County (Maryland) Public Schools (MCPS) 2007-2008 full-day Head Start prekindergarten (pre-K) class model on student academic performance, cognitive skills, and learning behaviors by the end of Grade 2. This is the fourth impact study of the MCPS full-day Head Start pre-K class model. The following…

  10. High Prevalence of Prothrombotic Abnormalities in Multifocal Osteonecrosis

    PubMed Central

    Peris, Pilar; Reverter, Joan Carles; Espinosa, Gerard; Martinez-Ferrer, Angeles; Monegal, Ana; Monteagudo, Juan; Tàssies, Dolors; Guañabens, Nuria

    2013-01-01

    Abstract Multifocal or multiple osteonecrosis (ON), defined by the involvement of 3 or more anatomic sites, is unusual, being observed in only 3%–10% of patients diagnosed with ON. We report the clinical characteristics of a cohort of 29 patients with multifocal ON from a single center and evaluate the prevalence of associated prothrombotic abnormalities in 26 of these patients. We conducted a retrospective study of all patients diagnosed with multifocal ON evaluated in our institution during the last 20 years. We recorded clinical manifestations and underlying diagnoses. A wide thrombophilic profile was performed, including antithrombin, protein C, protein S, lupus anticoagulant, anticardiolipin antibodies, activated protein C resistance, factor V Leiden, mutation G-20210-A of the prothrombin gene, and factor VIII. Coagulation test results were compared with those in a healthy control group and a group of patients with history of lower-extremity deep venous thrombosis. The mean age of the patients was 49.2 ± 15 years (range, 28–81 yr). The mean number of ON localizations per patient was 5.2 ± 2.3 (range, 3–11). Hips were the most commonly affected joint (82%), followed by knees (58%), shoulders (37%), and ankles (13%). Most patients had an underlying disease process, and 12 of 25 (48%) patients had coagulation test abnormalities. The most common alterations were high factor VIII levels and antiphospholipid antibody (aPL) positivity in 24% and 20% of cases, respectively. These abnormalities were more prevalent in patients with multifocal ON compared with patients in the control groups. Sixty-one percent of patients had a history of corticosteroid treatment. Patients with coagulation abnormalities had a higher number of ON localizations per patient (6.5 ± 2.7 vs. 3.88 ± 0.8; p = 0.002) and a higher prevalence of atypical ON localizations (25% vs. 0%; p = 0.05). In conclusion, in the present cohort of patients with multifocal ON, 48% of the patients had at

  11. Increased prevalence of bisphosphonate-related osteonecrosis of the jaw with vitamin D deficiency in rats.

    PubMed

    Hokugo, Akishige; Christensen, Russell; Chung, Evelyn M; Sung, Eric C; Felsenfeld, Alan L; Sayre, James W; Garrett, Neal; Adams, John S; Nishimura, Ichiro

    2010-06-01

    Necrotic bone exposure in the oral cavity has recently been reported in patients treated with nitrogen-containing bisphosphonates as part of their therapeutic regimen for multiple myeloma or metastatic cancers to bone. It has been postulated that systemic conditions associated with cancer patients combined with tooth extraction may increase the risk of osteonecrosis of the jaw (ONJ). The objective of this study was to establish an animal model of bisphosphonate-related ONJ by testing the combination of these risk factors. The generation of ONJ lesions in rats resembling human disease was achieved under the confluence of intravenous injection of zoledronate (ZOL; 35 microg/kg every 2 weeks), maxillary molar extraction, and vitamin D deficiency [VitD(-)]. The prevalence of ONJ in the VitD(-)/ZOL group was 66.7%, which was significantly higher (p < .05, Fisher exact test) than the control (0%), VitD(-) (0%), and ZOL alone (14.3%) groups. Similar to human patients, rat ONJ lesions prolonged the oral exposure of necrotic bone sequestra and were uniquely associated with pseudoepitheliomatous hyperplasia. The number of terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick-end label-positive (TUNEL(+)) osteoclasts significantly increased on the surface of post-tooth extraction alveolar bone of the VitD(-)/ZOL group, where sustained inflammation was depicted by [(18)F]fluorodeoxyglucose micro-positron emission tomography (microPET). ONJ lesions were found to be associated with dense accumulation of mixed inflammatory/immune cells. These cells, composed of neutrophils and lymphocytes, appeared to juxtapose apoptotic osteoclasts. It is suggested that the pathophysiologic mechanism(s) underpinning ONJ may involve the interaction between bisphosphonates and compromised vitamin D functions in the realm of skeletal homeostasis and innate immunity.

  12. Photon migration through fetal head in utero using continuous wave, near infrared spectroscopy: development and evaluation of experimental and numerical models

    NASA Astrophysics Data System (ADS)

    Vishnoi, Gargi; Hielscher, Andreas H.; Ramanujam, Nirmala; Chance, Britton

    2000-04-01

    In this work experimental tissue phantoms and numerical models were developed to estimate photon migration through the fetal head in utero. The tissue phantoms incorporate a fetal head within an amniotic fluid sac surrounded by a maternal tissue layer. A continuous wave, dual-wavelength ((lambda) equals 760 and 850 nm) spectrometer was employed to make near-infrared measurements on the tissue phantoms for various source-detector separations, fetal-head positions, and fetal-head optical properties. In addition, numerical simulations of photon propagation were performed with finite-difference algorithms that provide solutions to the equation of radiative transfer as well as the diffusion equation. The simulations were compared with measurements on tissue phantoms to determine the best numerical model to describe photon migration through the fetal head in utero. Evaluation of the results indicates that tissue phantoms in which the contact between fetal head and uterine wall is uniform best simulates the fetal head in utero for near-term pregnancies. Furthermore, we found that maximum sensitivity to the head can be achieved if the source of the probe is positioned directly above the fetal head. By optimizing the source-detector separation, this signal originating from photons that have traveled through the fetal head can drastically be increased.

  13. Monte Carlo modeling of light propagation in the human head for applications in sinus imaging

    NASA Astrophysics Data System (ADS)

    Cerussi, Albert E.; Mishra, Nikhil; You, Joon; Bhandarkar, Naveen; Wong, Brian

    2015-03-01

    Sinus blockages are a common reason for physician visits, affecting one out of seven people in the United States, and often require medical treatment. Diagnosis in the primary care setting is challenging because symptom criteria (via detailed clinical history) plus objective imaging [computed tomography (CT) or endoscopy] are recommended. Unfortunately, neither option is routinely available in primary care. We previously demonstrated that low-cost near-infrared (NIR) transillumination correlates with the bulk findings of sinus opacity measured by CT. We have upgraded the technology, but questions of source optimization, anatomical influence, and detection limits remain. In order to begin addressing these questions, we have modeled NIR light propagation inside a three-dimensional adult human head constructed via CT images using a mesh-based Monte Carlo algorithm (MMCLAB). In this application, the sinus itself, which when healthy is a void region (e.g., nonscattering), is the region of interest. We characterize the changes in detected intensity due to clear (i.e., healthy) versus blocked sinuses and the effect of illumination patterns. We ran simulations for two clinical cases and compared simulations with measurements. The simulations presented herein serve as a proof of concept that this approach could be used to understand contrast mechanisms and limitations of NIR sinus imaging.

  14. Monte Carlo modeling of light propagation in the human head for applications in sinus imaging

    PubMed Central

    Cerussi, Albert E.; Mishra, Nikhil; You, Joon; Bhandarkar, Naveen; Wong, Brian

    2015-01-01

    Abstract. Sinus blockages are a common reason for physician visits, affecting one out of seven people in the United States, and often require medical treatment. Diagnosis in the primary care setting is challenging because symptom criteria (via detailed clinical history) plus objective imaging [computed tomography (CT) or endoscopy] are recommended. Unfortunately, neither option is routinely available in primary care. We previously demonstrated that low-cost near-infrared (NIR) transillumination correlates with the bulk findings of sinus opacity measured by CT. We have upgraded the technology, but questions of source optimization, anatomical influence, and detection limits remain. In order to begin addressing these questions, we have modeled NIR light propagation inside a three-dimensional adult human head constructed via CT images using a mesh-based Monte Carlo algorithm (MMCLAB). In this application, the sinus itself, which when healthy is a void region (e.g., nonscattering), is the region of interest. We characterize the changes in detected intensity due to clear (i.e., healthy) versus blocked sinuses and the effect of illumination patterns. We ran simulations for two clinical cases and compared simulations with measurements. The simulations presented herein serve as a proof of concept that this approach could be used to understand contrast mechanisms and limitations of NIR sinus imaging. PMID:25781310

  15. Bisphosphonate-related osteonecrosis of jaw (BRONJ): diagnostic criteria and possible pathogenic mechanisms of an unexpected anti-angiogenic side effect.

    PubMed

    Sharma, Dileep; Ivanovski, Saso; Slevin, Mark; Hamlet, Stephen; Pop, Tudor S; Brinzaniuc, Klara; Petcu, Eugen B; Miroiu, Rodica I

    2013-01-14

    Recently, bisphosphonates (BPs) have been widely used in medical practice as anti-resorptive agents owing to their anti-osteoclatic action. In addition, these compounds are also used for their analgesic action and their potential anti-tumour effect. Patients treated with BPs may subsequently develop osteonecrosis of the jaw or maxillary bone after minor local trauma including dental work, recently labelled as bisphosphonate osteonecrosis of jaw (BRONJ). However, the etiopathogenic mechanisms of this pathological condition are poorly understood. Although, several pathways have been proposed for BRONJ occurrence, no single model can explain all morphological changes observed at the macro- and microscopic level. Recent research suggests that BPs may promote an anti-angiogenic effect which contributes directly to the clinical features associated with BRONJ. Remarkably, the anti-angiogenic effect promoting BRONJ might be in keeping with the anti-neoplastic action of BPs. The current review, presents clinical diagnostic criteria. In addition, based on our own experience we describe the histopathological criteria for diagnosis of BRONJ and the possible pathways which may lead to this frustrating pathological condition.

  16. Maximum temperatures of 89°C recorded during the mechanical preparation of 35 femoral heads for resurfacing

    PubMed Central

    2011-01-01

    Background and purpose We noticed that our instruments were often too hot to touch after preparing the femoral head for resurfacing, and questioned whether the heat generated could exceed temperatures known to cause osteonecrosis. Patients and methods Using an infra-red thermal imaging camera, we measured real-time femoral head temperatures during femoral head reaming in 35 patients undergoing resurfacing hip arthroplasty. 7 patients received an ASR, 8 received a Cormet, and 20 received a Birmingham resurfacing arthroplasty. Results The maximum temperature recorded was 89°C. The temperature exceeded 47°C in 28 patients and 70°C in 11. The mean duration of most stages of head preparation was less than 1 min. The mean time exceeded 1 min only on peripheral head reaming of the ASR system. At temperatures lower than 47°C, only 2 femoral heads were exposed long enough to cause osteonecrosis. The highest mean maximum temperatures recorded were 54°C when the proximal femoral head was resected with an oscillating saw and 47°C during peripheral reaming with the crown drill. The modified new Birmingham resurfacing proximal femoral head reamer substantially reduced the maximum temperatures generated. Lavage reduced temperatures to a mean of 18°C. Interpretation 11 patients were subjected to temperatures sufficient to cause osteonecrosis secondary to thermal insult, regardless of the duration of reaming. In 2 cases only, the length of reaming was long enough to induce damage at lower temperatures. Lavage and sharp instruments should reduce the risk of thermal insult during hip resurfacing. PMID:22066558

  17. Lithospheric Flexure and Sedimentary Basin Evolution: the Steer's Head Model Re-visited

    NASA Astrophysics Data System (ADS)

    Moore, J. D. P.; Watts, A. B.

    2015-12-01

    Backstripping studies of biostratigraphic data from deep wells show that sediment loading is one of the main factors controlling the subsidence and uplift history of sedimentary basins. Previous studies based on single layer models of elastic and viscoelastic plates overlying an inviscid fluid have shown that sediment loading, together with a tectonic subsidence that decreases exponentially with time, can explain the large-scale 'architecture' of rift-type basins and, in some cases, details of their internal stratigraphy such as onlap and offlap patterns. One problem with these so-called 'steer's head' models is that they were based on a simple rheological model in which the long-term strength of the lithosphere increased with thermal age. Recent oceanic flexure studies, however, reveal that the long-term strength of the lithosphere depends not only on thermal age, but also load age. We have used the thermal structure based on plate cooling models, together with recent experimentally-derived flow laws, to compute the viscosity structure of the lithosphere and a new analytical model to compute the flexure of a multilayer viscoelastic plate by a trapezoid-shaped sediment load at different times since basin initiation. If we define the nondimensional number Dw = τm/τt, where τm is the Maxwell time constant and τt is the thermal time constant, we find that for Dw << 1 the flexure approximates that of an elastic plate and an onlap pattern forms at the edge of basin (Fig. 1), whereas for Dw >> 1 the flexure approximates that of a viscoelastic plate and an offlap pattern develops (Fig. 2). Interestingly Dw ~ 1 produces a basin in which onlap dominates its early evolution while offlap dominates its later evolution and an unconformity separates the two different stratal patterns (Fig. 3). Therefore, when consideration is given to the fact that the long-term strength of the lithosphere depends on both thermal and load age we are able to produce stratal geometries that

  18. Lithospheric flexure and sedimentary basin evolution: depositional cycles in the steer's head model

    NASA Astrophysics Data System (ADS)

    Moore, James; Watts, Tony

    2016-04-01

    Backstripping studies of biostratigraphic data from deep wells show that sediment loading is one of the main factors controlling the subsidence and uplift history of sedimentary basins. Previous studies based on single layer models of elastic and viscoelastic plates overlying an inviscid fluid have shown that sediment loading, together with a tectonic subsidence that decreases exponentially with time, can explain the large-scale 'architecture' of rift-type basins and, in some cases, details of their internal stratigraphy such as onlap and offlap patterns. One problem with these so-called 'steer's head' models is that they were based on a simple rheological model in which the long-term strength of the lithosphere increased with thermal age. Recent oceanic flexure studies, however, reveal that the long-term strength of the lithosphere depends not only on thermal age, but also load age. We have used the thermal structure based on plate cooling models, together with recent experimentally-derived flow laws, to compute the viscosity structure of the lithosphere and a new analytical model to compute the flexure of a multilayer viscoelastic plate by a trapezoid-shaped sediment load at different times since basin initiation. The combination of basin subsidence and viscoelastic flexural response results in the fluctuation of the depositional surface with time. If we define the nondimensional number Dw= τm/τt, where τm is the Maxwell time constant and τt is the thermal time constant, we find that for Dw<<1 the flexure approximates that of an elastic plate and is dominated by "onlapping" stratigraphy which evolves through the sedimentary facies with a progressive deepening of the depositional surface. For Dw>>1 the flexure approximates that of a viscoelastic plate and is dominated by "offlapping" stratigraphy, with the basin edges evolving through shallow marine facies; though erosion late in the basin formation prevents much of this from being recorded in the stratigraphy

  19. Feasibility of Primary Tumor Culture Models and Preclinical Prediction Assays for Head and Neck Cancer: A Narrative Review

    PubMed Central

    Dohmen, Amy J. C.; Swartz, Justin E.; Van Den Brekel, Michiel W. M.; Willems, Stefan M.; Spijker, René; Neefjes, Jacques; Zuur, Charlotte L.

    2015-01-01

    Primary human tumor culture models allow for individualized drug sensitivity testing and are therefore a promising technique to achieve personalized treatment for cancer patients. This would especially be of interest for patients with advanced stage head and neck cancer. They are extensively treated with surgery, usually in combination with high-dose cisplatin chemoradiation. However, adding cisplatin to radiotherapy is associated with an increase in severe acute toxicity, while conferring only a minor overall survival benefit. Hence, there is a strong need for a preclinical model to identify patients that will respond to the intended treatment regimen and to test novel drugs. One of such models is the technique of culturing primary human tumor tissue. This review discusses the feasibility and success rate of existing primary head and neck tumor culturing techniques and their corresponding chemo- and radiosensitivity assays. A comprehensive literature search was performed and success factors for culturing in vitro are debated, together with the actual value of these models as preclinical prediction assay for individual patients. With this review, we aim to fill a gap in the understanding of primary culture models from head and neck tumors, with potential importance for other tumor types as well. PMID:26343729

  20. Dosimetric comparison of the specific anthropomorphic mannequin (SAM) to 14 anatomical head models using a novel definition for the mobile phone positioning

    NASA Astrophysics Data System (ADS)

    Kainz, Wolfgang; Christ, Andreas; Kellom, Tocher; Seidman, Seth; Nikoloski, Neviana; Beard, Brian; Kuster, Niels

    2005-07-01

    This paper presents new definitions for obtaining reproducible results in numerical phone dosimetry. Numerous numerical dosimetric studies have been published about the exposure of mobile phone users which concluded with conflicting results. However, many of these studies lack reproducibility due to shortcomings in the description of the phone positioning. The new approach was tested by two groups applying two different numerical program packages to compare the specific anthropomorphic mannequin (SAM) to 14 anatomically correct head models. A novel definition for the positioning of mobile phones next to anatomically correct head models is given along with other essential parameters to be reported. The definition is solely based on anatomical characteristics of the head. A simple up-to-date phone model was used to determine the peak spatial specific absorption rate (SAR) of mobile phones in SAM and in the anatomically correct head models. The results were validated by measurements. The study clearly shows that SAM gives a conservative estimate of the exposure in anatomically correct head models for head only tissue. Depending on frequency, phone position and head size the numerically calculated 10 g averaged SAR in the pinna can be up to 2.1 times greater than the peak spatial SAR in SAM. Measurements in small structures, such as the pinna, will significantly increase the uncertainty; therefore SAM was designed for SAR assessment in the head only. Whether SAM will provide a conservative value for the pinna depends on the pinna SAR limit of the safety standard considered.

  1. Emulating the visual receptive-field properties of MST neurons with a template model of heading estimation

    NASA Technical Reports Server (NTRS)

    Perrone, J. A.; Stone, L. S.

    1998-01-01

    We have proposed previously a computational neural-network model by which the complex patterns of retinal image motion generated during locomotion (optic flow) can be processed by specialized detectors acting as templates for specific instances of self-motion. The detectors in this template model respond to global optic flow by sampling image motion over a large portion of the visual field through networks of local motion sensors with properties similar to those of neurons found in the middle temporal (MT) area of primate extrastriate visual cortex. These detectors, arranged within cortical-like maps, were designed to extract self-translation (heading) and self-rotation, as well as the scene layout (relative distances) ahead of a moving observer. We then postulated that heading from optic flow is directly encoded by individual neurons acting as heading detectors within the medial superior temporal (MST) area. Others have questioned whether individual MST neurons can perform this function because some of their receptive-field properties seem inconsistent with this role. To resolve this issue, we systematically compared MST responses with those of detectors from two different configurations of the model under matched stimulus conditions. We found that the characteristic physiological properties of MST neurons can be explained by the template model. We conclude that MST neurons are well suited to support self-motion estimation via a direct encoding of heading and that the template model provides an explicit set of testable hypotheses that can guide future exploration of MST and adjacent areas within the superior temporal sulcus.

  2. Head Injuries

    MedlinePlus

    ... injuries internal head injuries, which may involve the skull, the blood vessels within the skull, or the brain Fortunately, most childhood falls or ... knock the brain into the side of the skull or tear blood vessels. Some internal head injuries ...

  3. Head Lice

    MedlinePlus

    ... or prescription products. Over-the-counter shampoos and lotions containing pyrethrin (one brand name: Rid) or permethrin ( ... commonly used to treat head lice. Shampoos and lotions that kill head lice contain pesticides and other ...

  4. Head MRI

    MedlinePlus

    ... the head; MRI - cranial; NMR - cranial; Cranial MRI; Brain MRI; MRI - brain; MRI - head ... the test, tell your provider if you have: Brain aneurysm clips An artificial heart valves Heart defibrillator ...

  5. Modeling of ray paths of head waves on irregular interfaces in TOFD inspection for NDE.

    PubMed

    Ferrand, A; Darmon, M; Chatillon, S; Deschamps, M

    2014-09-01

    The TOFD (Time of Flight Diffraction) technique is a classical ultrasonic inspection method used in ultrasonic non-destructive evaluation (NDE). This inspection technique is based on an arrangement of two probes of opposite beam directions and allows a precise positioning and a quantitative evaluation of the size of cracks contained in the inspected material thanks to their edges diffraction echoes. Among the typical phenomena arising for such an arrangement, head waves, which propagate along the specimen surface and are chronologically the first waves reaching the receiver, are notably observed. Head wave propagation on planar surfaces in TOFD configurations is well known. However, realistic inspection configurations often involve components with irregular surfaces, like steel excavated specimens. Surface irregularity is responsible for numerous effects on the scattering of bulk waves, causing the melting of surface and bulk mechanisms in the head wave propagation. In order to extend the classical ray approach on these complex cases, a generic algorithm of ray tracing between interface points (GIRT) has been designed. With respect to time of flight minimization (i.e. the Generalized Fermat's Principle), ray paths can be computed by GIRT for different natures of waves scattered by the complex surfaces or by flaws. The head wave fronts computed by GIRT are notably in good agreement with FEM simulated results. This algorithm, based on pure kinematic analysis of waves propagation, represents a first step in the future development of a complete ray theory for head waves simulation on irregular interfaces. PMID:24388406

  6. Subchondral insufficiency fracture of the femoral head after internal fixation for femoral neck fracture: histopathological investigation.

    PubMed

    Sonoda, Kazuhiko; Yamamoto, Takuaki; Motomura, Goro; Kido, Hidehiko; Iwamoto, Yukihide

    2014-08-01

    Late segmental collapse after internal fixation for femoral neck fracture is the phenomenon observed in post-traumatic osteonecrosis of the femoral head (ON), which has generally been reported to occur over a year or more after internal fixation. Subchondral insufficiency fracture of the femoral head (SIF) has also been recognized to cause femoral head collapse, however, only two cases of SIF after internal fixation for femoral neck fracture have been reported. We report a case with femoral head collapse observed 5 months after internal fixation for femoral neck fracture, which was histopathologically diagnosed as SIF. Clinically, differentiating SIF from ON is important because some cases of SIF have been reported to heal without surgical treatments. The timing of femoral head collapse after femoral neck fracture may be different between SIF and post-traumatic ON.

  7. Modelling an advanced ManPAD with dual band detectors and a rosette scanning seeker head

    NASA Astrophysics Data System (ADS)

    Birchenall, Richard P.; Richardson, Mark A.; Butters, Brian; Walmsley, Roy

    2012-01-01

    Man Portable Air Defence Systems (ManPADs) have been a favoured anti aircraft weapon since their appearance on the military proliferation scene in the mid 1960s. Since this introduction there has been a 'cat and mouse' game of Missile Countermeasures (CMs) and the aircraft protection counter counter measures (CCMs) as missile designers attempt to defeat the aircraft platform protection equipment. Magnesium Teflon Viton (MTV) flares protected the target aircraft until the missile engineers discovered the art of flare rejection using techniques including track memory and track angle bias. These early CCMs relied upon CCM triggering techniques such as the rise rate method which would just sense a sudden increase in target energy and assume that a flare CM had been released by the target aircraft. This was not as reliable as was first thought as aspect changes (bringing another engine into the field of view) or glint from the sun could inadvertently trigger a CCM when not needed. The introduction of dual band detectors in the 1980s saw a major advance in CCM capability allowing comparisons between two distinct IR bands to be made thus allowing the recognition of an MTV flare to occur with minimal false alarms. The development of the rosette scan seeker in the 1980s complemented this advancement allowing the scene in the missile field of view (FOV) to be scanned by a much smaller (1/25) instantaneous FOV (IFOV) with the spectral comparisons being made at each scan point. This took the ManPAD from a basic IR energy detector to a pseudo imaging system capable of analysing individual elements of its overall FOV allowing more complex and robust CCM to be developed. This paper continues the work published in [1,2] and describes the method used to model an advanced ManPAD with a rosette scanning seeker head and robust CCMs similar to the Raytheon Stinger RMP.

  8. Two-Year versus One-Year Head Start Program Impact: Addressing Selection Bias by Comparing Regression Modeling with Propensity Score Analysis

    ERIC Educational Resources Information Center

    Leow, Christine; Wen, Xiaoli; Korfmacher, Jon

    2015-01-01

    This article compares regression modeling and propensity score analysis as different types of statistical techniques used in addressing selection bias when estimating the impact of two-year versus one-year Head Start on children's school readiness. The analyses were based on the national Head Start secondary dataset. After controlling for…

  9. A Case of Variegate Porphyria in Association With Coeliac Disease and Bisphosphonate Associated Dental Osteonecrosis

    PubMed Central

    Ogundipe, Olayinka A.

    2009-01-01

    This case describes an older patient with a rare diagnosis of variegate porphyria presenting with acute abdominal pains and bloating, intermittent loose stools and jaw pains following surgical repair of an osteoporotic hip fracture. She was noted to have acute hyponatraemia. All the abdominal symptoms and the hyponatraemia were initially attributed to an acute episode of variegate porphyria with an accompanying syndrome of inappropriate antidiuretic hormone secretion. However, following further evaluations necessitated by the incomplete resolution of the abdominal symptoms, it became apparent that some of the persisting symptoms were due to a concurrent and new presentation of serology positive coeliac disease. The jaw pains were established to be due to dental osteonecrosis in association with the use of bisphosphonate therapy for treatment of osteoporosis. The various symptoms and signs subsequently settled uneventfully following institution of appropriate management options for the various coexisting diagnoses. Keywords Abdominal pain; Abdominal bloating; Loose stools; Hyponatraemia; Variegate porphyria; Coeliac disease; Osteoporosis; Bisphosphonates; Osteonecrosis PMID:22481993

  10. Biphosphonates-related osteonecrosis of the jaw: Clinical and physiopathological considerations

    PubMed Central

    Borgioli, Alberto; Viviani, Christian; Duvina, Marco; Brancato, Leila; Spinelli, Giuseppe; Brandi, Maria Luisa; Tonelli, Paolo

    2009-01-01

    Since osteonecrosis of the jaw was related to biphosphonate administration by Marx, studies showing clinical symptoms, drug and surgical therapies overwhelmed the literature. Furthermore, the literature demonstrated the correlation between chronic biphosphonate adsumption and osteonecrosis of the jaw onset. Nitrogen-containing biphosphonates are widely used for the management of metastatic cancer, for prevention and treatment of osteoporosis, for the treatment of Paget's disease, and for the management of acute hypercalcemia. According to our experience, the treatment of BRON-J's lesions is difficult and prolonged. For this reason, in order to avoid these complications it is mandatory to perform a risk staging in patients who must undergo biphosphonate administration. When pharmacologic treatments with antibiotics and local antiseptics are not able to control the development of BRON-J's complications, the clinicians should perform radical surgical treatments such as the resection of the bone involved. PMID:19436626

  11. [The rare case of osteonecrosis of the jaws in a patient treated with bisphosphonates for osteoporosis].

    PubMed

    Lewandowski, Bogumił; Brodowski, Robert; Kość, Tomasz; Migut, Małgorzata; Wojnar, Joanna

    2016-01-01

    Bisphosphonates are used primarily in patients with bone metastases and osteoporosis One of the local complications, less well-known to doctors, associated with the use of bisphosphonates is osteonecrosis of the jaw (Biophosphatate Related osteonecrosis of the jaw--BRONJ). It affects approximately 1-10% of patients and may cause diagnostic difficulties because of its similarity to a primary focus in the bone. This issue can be encountered by the doctors of various specialties who use bisphosphonates. The purpose of this study is to present a case of the patient with BRONJ symptoms following the administration of bisphosphonate therapy, which can occur in the doctors practice. Concluding, maintaining good health of the oral cavity before starting the therapy reduces the incidence of BROKJ. Before starting bisphosphonate therapy, all patients should be referred to dental consultation to assess the potential foci of infection in the mouth.

  12. Bone metabolism and clinical study of 44 patients with bisphosphonate-related osteonecrosis of the jaws

    PubMed Central

    Bocanegra-Pérez, María S.; Sosa-Henríquez, Manuel; Rodríguez-Bocanegra, Eduardo; Limiñana-Cañal, José M.; López-Márquez, Ariadna; Pérez-Plasencia, Daniel; Ramos-Macías, Angel

    2012-01-01

    Osteonecrosis of the jaws is a clinical entity described and linked to treatment with bisphosphonates in 2003. Its real incidence is unknown and it could increase due to the large number of patients treated with these drugs, and its cumulative effect on the bone. State of the art knowledge regarding its etiopathogeny, clinical course and suitable treatments is limited. Objectives: To study the clinical characteristics of 44 patients with bisphosphonate-related osteonecrosis of the jaws and the state of their bone mineral metabolism: bone remodeling state, prevalence of fractures, bone mineral density study, and assessment of the different treatment strategies. Design of the Study: Observational. Information was gathered prospectively through interviews, clinical examinations, additional tests and review of medical records. Results: We studied 16 men and 28 women with a mean age of 64.7 years. Breast cancer was the most frequent underlying disease. Zoledronate was used in 82% of the cases and in the non-oncology group of patients; alendronate was the most frequently used bisphosphonate. The mean duration of the zoledronate and alendronate treatments was 25 months and 88 months respectively. The lower jaw was the most frequent location, and previous exodontias—among the triggering factors known—were the most closely linked to its onset. We found considerable osteoblastic activity in patients suffering from neoplasia, with artifacts present in their bone densitometry and a high percentage of vertebral fractures. Conclusions: According to our results, osteonecrosis of the jaws affects elderly patients. We found a direct relationship between the duration of exposure and the accumulated dose. Other relevant factors are: Poor oral and dental health, corticoids, diabetes and teeth extractions. In essence, it is a clinical diagnosis. Prevention is the best strategy to handle this clinical entity. Key words:Alendronate, bisphosphonate, jaw, maxilla, osteonecrosis

  13. Numerical calculation of listener-specific head-related transfer functions and sound localization: Microphone model and mesh discretization

    PubMed Central

    Ziegelwanger, Harald; Majdak, Piotr; Kreuzer, Wolfgang

    2015-01-01

    Head-related transfer functions (HRTFs) can be numerically calculated by applying the boundary element method on the geometry of a listener’s head and pinnae. The calculation results are defined by geometrical, numerical, and acoustical parameters like the microphone used in acoustic measurements. The scope of this study was to estimate requirements on the size and position of the microphone model and on the discretization of the boundary geometry as triangular polygon mesh for accurate sound localization. The evaluation involved the analysis of localization errors predicted by a sagittal-plane localization model, the comparison of equivalent head radii estimated by a time-of-arrival model, and the analysis of actual localization errors obtained in a sound-localization experiment. While the average edge length (AEL) of the mesh had a negligible effect on localization performance in the lateral dimension, the localization performance in sagittal planes, however, degraded for larger AELs with the geometrical error as dominant factor. A microphone position at an arbitrary position at the entrance of the ear canal, a microphone size of 1 mm radius, and a mesh with 1 mm AEL yielded a localization performance similar to or better than observed with acoustically measured HRTFs. PMID:26233020

  14. Bisphosphonate Associated Osteonecrosis of the Jaw: An Update on Pathophysiology, Risk Factors, and Treatment

    PubMed Central

    Rasmusson, Lars

    2014-01-01

    Osteonecrosis of the jaw in patients treated with bisphosphonates is a relatively rare but well known complication at maxillofacial units around the world. It has been speculated that the medication, especially long-term i.v. bisphosphonate treatment, could cause sterile necrosis of the jaws. The aim of this narrative review of the literature was to elaborate on the pathological mechanisms behind the condition and also to gather an update on incidence, risk factors, and treatment of bisphosphonate associated osteonecrosis of the jaw. In total, ninety-one articles were reviewed. All were published in internationally recognized journals with referee systems. We can conclude that necrotic lesions in the jaw seem to be following upon exposure of bone, for example, after tooth extractions, while other interventions like implant placement do not increase the risk of osteonecrosis. Since exposure to the bacterial environment in the oral cavity seems essential for the development of necrotic lesions, we believe that the condition is in fact chronic osteomyelitis and should be treated accordingly. PMID:25254048

  15. Oral bisphosphonate-associated osteonecrosis of maxillary bone: A review of 18 cases

    PubMed Central

    Mardenlli, Fabiana; Paz, Marisa

    2014-01-01

    Biphosphonate-associated maxillary bone osteonecrosis (BPMO) is a complication related to nitrogen-containing biphosphonate therapy. This adverse effect occasionally appears in patients who are administered biphosphonates through intravenous infusion for the treatment of cancer involving bone metastases. It can also present, in a lesser degree, in patients who take these drugs orally for the treatment of osteoporosis. Lately, there has been an increase in the number of cases of osteopenia and osteoporosis due to the increasing life expectancy of the world’s population. In our country, a risk group composed mainly of older women who have been diagnosed with osteopenia or osteoporosis, and submitted to the continuous action of oral biphosphonates, is emerging. In this paper we present 18 cases of BPMO associated to the use of oral biphosphonates, diagnosed and treated in the Department of Stomatology of the School or Dentistry at Universidad Nacional de Rosario, Argentina. A protocol was designed in which the following information was recorded: age and sex of the patients, the original disease which led to therapy with oral biphosphonates, the drugs used and the period in which those drugs were administered, the clinical features and location of the lesions, together with triggering factors. Key words:Maxillary osteonecrosis, mandibular osteonecrosis, oral biphosphonates, alendronate, ibandronate. PMID:25674321

  16. Bisphosphonate-related osteonecrosis of the jaw: data from the French national pharmacovigilance database.

    PubMed

    de Boissieu, Paul; Gaboriau, Louise; Morel, Aurore; Trenque, Thierry

    2016-10-01

    The aim of this study was to describe bisphosphonate-related osteonecrosis of the jaw (BRONJ) in the French national pharmacovigilance database. BRONJ was identified with the standardized MedDRA query (SMQ) 'osteonecrosis' among all data from 1985 to 31 December 2014. Because this SMQ was not specific to the jaw localization, selection of cases based on anatomy was performed after data extraction. For each case, demographic and medical information was analysed, as well as data about notification (year of notification, year of occurrence, outcome, seriousness). Known associated factors for BRONJ were also documented: dentoalveolar surgery, glucocorticoids, chemotherapy, anti-angiogenics, denosumab. Among 1404 SMQ notifications, 663 were located in the jaws and 629 were associated with bisphosphonate use. BRONJ reported in the database mainly affected women (n = 443, 71%) with an oncological indication (n = 440, 70%). BRONJ was considered as serious in 91%. Outcome was unfavourable for 92% of cases. Associated factors were identified for 70% of the patients. A peak of notification was noted in 2014 (13% of all cases), but on analysis by year of occurrence instead of by year of notification, this peak disappeared. SMQ 'osteonecrosis' appears to be an adequate tool to analyse BRONJ in a pharmacovigilance database. PMID:27315575

  17. Alendronate-associated osteonecrosis of the jaws: a review of the main topics.

    PubMed

    Paiva-Fonseca, F; Santos-Silva, A-R; Della-Coletta, R; Vargas, P-A; Lopes, M-A

    2014-03-01

    Bisphosphonates is a group of inorganic pyrophosphates analogues that suppress bone resorption by inducing osteoclast inactivation, being frequently used for management of diseases affecting bone metabolism, bone metastases and bone tumors. However, since 2003 many cases describing the presence of necrotic bone exposures in the jaws have been described in patients receiving these drugs, what represent a significant complication of bisphosphonates treatment. The overall incidence of bisphosphonate-related osteonecrosis of the jaws is low, ranging from 0.7% to 12%, mainly observed in those patients receiving intravenously treatment. Osteonecrosis of the jaws associated to oral bisphosphonate, particularly alendronate, has also been reported by a number of authors. Considering that alendronate is one of the most used drug worldwide, specially for treatment of osteoporosis, a better understanding of osteonecrosis of the jaws related to its use and how to manage these patients is extremely important. Therefore, in the current manuscript the authors aim to review the most important topics related to this pathological presentation.

  18. Treatment of osteonecrosis of the jaw related to bisphosphonates and other antiresorptive agents

    PubMed Central

    Oñate-Sánchez, Ricardo-Elías

    2016-01-01

    Background The clinical management of medication-related osteonecrosis of the jaw (MRONJ) in patients treated with bisphosphonates and other antiresorptive agents is subject to controversy. The American Association of Oral and Maxillofacial Surgeons (AAOMS) has developed guidelines for the correct management of the disorder which are revised and updated by a panel of experts. Material and Methods The present systematic review analyzes the different treatments currently used to treat this clinical condition, based on the PRISMA® (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement published in 2009. An electronic Medline search was made of the PubMed database, covering the period 2006-2014. The last search date was 31 December 2014. Results A total of 29 articles were selected from the initial search according to the different drugs implicated in the appearance of osteonecrosis; the treatment modality used according to the stage of the disease; and the recorded success rate. Conclusions It is currently still recommended that the management of MRONJ should be decided according to the stage of the disease – conservative treatment being preferred in early stages without symptoms, while surgical management is preferred in the case of bone exposure with symptoms. Key words:Osteonecrosis, medication, bisphosphonates, treatments, review PMID:27475683

  19. A model of head-related transfer functions based on a state-space analysis

    NASA Astrophysics Data System (ADS)

    Adams, Norman Herkamp

    This dissertation develops and validates a novel state-space method for binaural auditory display. Binaural displays seek to immerse a listener in a 3D virtual auditory scene with a pair of headphones. The challenge for any binaural display is to compute the two signals to supply to the headphones. The present work considers a general framework capable of synthesizing a wide variety of auditory scenes. The framework models collections of head-related transfer functions (HRTFs) simultaneously. This framework improves the flexibility of contemporary displays, but it also compounds the steep computational cost of the display. The cost is reduced dramatically by formulating the collection of HRTFs in the state-space and employing order-reduction techniques to design efficient approximants. Order-reduction techniques based on the Hankel-operator are found to yield accurate low-cost approximants. However, the inter-aural time difference (ITD) of the HRTFs degrades the time-domain response of the approximants. Fortunately, this problem can be circumvented by employing a state-space architecture that allows the ITD to be modeled outside of the state-space. Accordingly, three state-space architectures are considered. Overall, a multiple-input, single-output (MISO) architecture yields the best compromise between performance and flexibility. The state-space approximants are evaluated both empirically and psychoacoustically. An array of truncated FIR filters is used as a pragmatic reference system for comparison. For a fixed cost bound, the state-space systems yield lower approximation error than FIR arrays for D>10, where D is the number of directions in the HRTF collection. A series of headphone listening tests are also performed to validate the state-space approach, and to estimate the minimum order N of indiscriminable approximants. For D = 50, the state-space systems yield order thresholds less than half those of the FIR arrays. Depending upon the stimulus uncertainty, a

  20. Deformation Prediction and Geometrical Modeling of Head and Neck Cancer Tumor: A Data Mining Approach

    NASA Astrophysics Data System (ADS)

    Azimi, Maryam

    Radiation therapy has been used in the treatment of cancer tumors for several years and many cancer patients receive radiotherapy. It may be used as primary therapy or with a combination of surgery or other kinds of therapy such as chemotherapy, hormone therapy or some mixture of the three. The treatment objective is to destroy cancer cells or shrink the tumor by planning an adequate radiation dose to the desired target without damaging the normal tissues. By using the pre-treatment Computer Tomography (CT) images, most of the radiotherapy planning systems design the target and assume that the size of the tumor will not change throughout the treatment course, which takes 5 to 7 weeks. Based on this assumption, the total amount of radiation is planned and fractionated for the daily dose required to be delivered to the patient's body. However, this assumption is flawed because the patients receiving radiotherapy have marked changes in tumor geometry during the treatment period. Therefore, there is a critical need to understand the changes of the tumor shape and size over time during the course of radiotherapy in order to prevent significant effects of inaccuracy in the planning. In this research, a methodology is proposed in order to monitor and predict daily (fraction day) tumor volume and surface changes of head and neck cancer tumors during the entire treatment period. In the proposed method, geometrical modeling and data mining techniques will be used rather than repetitive CT scans data to predict the tumor deformation for radiation planning. Clinical patient data were obtained from the University of Texas-MD Anderson Cancer Center (MDACC). In the first step, by using CT scan data, the tumor's progressive geometric changes during the treatment period are quantified. The next step relates to using regression analysis in order to develop predictive models for tumor geometry based on the geometric analysis results and the patients' selected attributes (age, weight

  1. Models of Emotion Skills and Social Competence in the Head Start Classroom

    ERIC Educational Resources Information Center

    Spritz, Becky L.; Sandberg, Elisabeth Hollister; Maher, Edward; Zajdel, Ruth T.

    2010-01-01

    Research Findings: Fostering the social competence of at-risk preschoolers would be facilitated by knowing which of children's emotion skills are most salient to social outcomes. We examined the emotion skills and social competence of 44 children enrolled in a Head Start program. Emotion skills were examined in terms of children's emotional…

  2. Modelling the Species Distribution of Flat-Headed Cats (Prionailurus planiceps), an Endangered South-East Asian Small Felid

    PubMed Central

    Hearn, Andrew J.; Hesse, Deike; Mohamed, Azlan; Traeholdt, Carl; Cheyne, Susan M.; Sunarto, Sunarto; Jayasilan, Mohd-Azlan; Ross, Joanna; Shapiro, Aurélie C.; Sebastian, Anthony; Dech, Stefan; Breitenmoser, Christine; Sanderson, Jim; Duckworth, J. W.; Hofer, Heribert

    2010-01-01

    Background The flat-headed cat (Prionailurus planiceps) is one of the world's least known, highly threatened felids with a distribution restricted to tropical lowland rainforests in Peninsular Thailand/Malaysia, Borneo and Sumatra. Throughout its geographic range large-scale anthropogenic transformation processes, including the pollution of fresh-water river systems and landscape fragmentation, raise concerns regarding its conservation status. Despite an increasing number of camera-trapping field surveys for carnivores in South-East Asia during the past two decades, few of these studies recorded the flat-headed cat. Methodology/Principal Findings In this study, we designed a predictive species distribution model using the Maximum Entropy (MaxEnt) algorithm to reassess the potential current distribution and conservation status of the flat-headed cat. Eighty-eight independent species occurrence records were gathered from field surveys, literature records, and museum collections. These current and historical records were analysed in relation to bioclimatic variables (WorldClim), altitude (SRTM) and minimum distance to larger water resources (Digital Chart of the World). Distance to water was identified as the key predictor for the occurrence of flat-headed cats (>50% explanation). In addition, we used different land cover maps (GLC2000, GlobCover and SarVision LLC for Borneo), information on protected areas and regional human population density data to extract suitable habitats from the potential distribution predicted by the MaxEnt model. Between 54% and 68% of suitable habitat has already been converted to unsuitable land cover types (e.g. croplands, plantations), and only between 10% and 20% of suitable land cover is categorised as fully protected according to the IUCN criteria. The remaining habitats are highly fragmented and only a few larger forest patches remain. Conclusion/Significance Based on our findings, we recommend that future conservation efforts for

  3. An impulsive state feedback control model for releasing white-headed langurs in captive to the wild

    NASA Astrophysics Data System (ADS)

    Xu, Weijian; Chen, Lansun; Chen, Shidong; Pang, Guoping

    2016-05-01

    In this paper, an impulsive state feedback control model for releasing white-headed langurs in captive to the wild is investigated. By using the geometric theory of semi-continuous dynamic system, the method of successor functions and the analogue of the Poincare criterion, it is proved that under certain conditions the system has an order-1 periodic solution with trajectory asymptotical stability, and this periodic solution remains above some critical value. The theoretical results are verified by the numerical simulations. The conclusion is that simultaneously taking the measures of both population migration and artificial breeding can effectively protect wild white-headed langurs, so that the population can continue to survive and can avoid becoming extinct.

  4. Improving inferences from short-term ecological studies with Bayesian hierarchical modeling: white-headed woodpeckers in managed forests

    PubMed Central

    Linden, Daniel W; Roloff, Gary J

    2015-01-01

    Pilot studies are often used to design short-term research projects and long-term ecological monitoring programs, but data are sometimes discarded when they do not match the eventual survey design. Bayesian hierarchical modeling provides a convenient framework for integrating multiple data sources while explicitly separating sample variation into observation and ecological state processes. Such an approach can better estimate state uncertainty and improve inferences from short-term studies in dynamic systems. We used a dynamic multistate occupancy model to estimate the probabilities of occurrence and nesting for white-headed woodpeckers Picoides albolarvatus in recent harvest units within managed forests of northern California, USA. Our objectives were to examine how occupancy states and state transitions were related to forest management practices, and how the probabilities changed over time. Using Gibbs variable selection, we made inferences using multiple model structures and generated model-averaged estimates. Probabilities of white-headed woodpecker occurrence and nesting were high in 2009 and 2010, and the probability that nesting persisted at a site was positively related to the snag density in harvest units. Prior-year nesting resulted in higher probabilities of subsequent occurrence and nesting. We demonstrate the benefit of forest management practices that increase the density of retained snags in harvest units for providing white-headed woodpecker nesting habitat. While including an additional year of data from our pilot study did not drastically alter management recommendations, it changed the interpretation of the mechanism behind the observed dynamics. Bayesian hierarchical modeling has the potential to maximize the utility of studies based on small sample sizes while fully accounting for measurement error and both estimation and model uncertainty, thereby improving the ability of observational data to inform conservation and management strategies

  5. Improving inferences from short-term ecological studies with Bayesian hierarchical modeling: white-headed woodpeckers in managed forests.

    PubMed

    Linden, Daniel W; Roloff, Gary J

    2015-08-01

    Pilot studies are often used to design short-term research projects and long-term ecological monitoring programs, but data are sometimes discarded when they do not match the eventual survey design. Bayesian hierarchical modeling provides a convenient framework for integrating multiple data sources while explicitly separating sample variation into observation and ecological state processes. Such an approach can better estimate state uncertainty and improve inferences from short-term studies in dynamic systems. We used a dynamic multistate occupancy model to estimate the probabilities of occurrence and nesting for white-headed woodpeckers Picoides albolarvatus in recent harvest units within managed forests of northern California, USA. Our objectives were to examine how occupancy states and state transitions were related to forest management practices, and how the probabilities changed over time. Using Gibbs variable selection, we made inferences using multiple model structures and generated model-averaged estimates. Probabilities of white-headed woodpecker occurrence and nesting were high in 2009 and 2010, and the probability that nesting persisted at a site was positively related to the snag density in harvest units. Prior-year nesting resulted in higher probabilities of subsequent occurrence and nesting. We demonstrate the benefit of forest management practices that increase the density of retained snags in harvest units for providing white-headed woodpecker nesting habitat. While including an additional year of data from our pilot study did not drastically alter management recommendations, it changed the interpretation of the mechanism behind the observed dynamics. Bayesian hierarchical modeling has the potential to maximize the utility of studies based on small sample sizes while fully accounting for measurement error and both estimation and model uncertainty, thereby improving the ability of observational data to inform conservation and management strategies

  6. Staging of osteonecrosis of the jaw requires computed tomography for accurate definition of the extent of bony disease.

    PubMed

    Bedogni, Alberto; Fedele, Stefano; Bedogni, Giorgio; Scoletta, Matteo; Favia, Gianfranco; Colella, Giuseppe; Agrillo, Alessandro; Bettini, Giordana; Di Fede, Olga; Oteri, Giacomo; Fusco, Vittorio; Gabriele, Mario; Ottolenghi, Livia; Valsecchi, Stefano; Porter, Stephen; Petruzzi, Massimo; Arduino, Paolo; D'Amato, Salvatore; Ungari, Claudio; Fung Polly, Pok-Lam; Saia, Giorgia; Campisi, Giuseppina

    2014-09-01

    Management of osteonecrosis of the jaw associated with antiresorptive agents is challenging, and outcomes are unpredictable. The severity of disease is the main guide to management, and can help to predict prognosis. Most available staging systems for osteonecrosis, including the widely-used American Association of Oral and Maxillofacial Surgeons (AAOMS) system, classify severity on the basis of clinical and radiographic findings. However, clinical inspection and radiography are limited in their ability to identify the extent of necrotic bone disease compared with computed tomography (CT). We have organised a large multicentre retrospective study (known as MISSION) to investigate the agreement between the AAOMS staging system and the extent of osteonecrosis of the jaw (focal compared with diffuse involvement of bone) as detected on CT. We studied 799 patients with detailed clinical phenotyping who had CT images taken. Features of diffuse bone disease were identified on CT within all AAOMS stages (20%, 8%, 48%, and 24% of patients in stages 0, 1, 2, and 3, respectively). Of the patients classified as stage 0, 110/192 (57%) had diffuse disease on CT, and about 1 in 3 with CT evidence of diffuse bone disease was misclassified by the AAOMS system as having stages 0 and 1 osteonecrosis. In addition, more than a third of patients with AAOMS stage 2 (142/405, 35%) had focal bone disease on CT. We conclude that the AAOMS staging system does not correctly identify the extent of bony disease in patients with osteonecrosis of the jaw.

  7. A "skin-skull-brain model" for the biomechanical reconstruction of blunt forces to the human head.

    PubMed

    Thali, Michael J; Kneubuehl, Beat P; Dirnhofer, Richard

    2002-02-18

    In order to create and study blunt force wound morphology, a "skin-skull-brain model" had to be designed which would make the laboratory reproduction of a blunt force injury to the head possible. During the evaluation of the "skin-skull-brain model", it was possible to show that injuries inflicted to this model are fully comparable to the morphology of equivalent real blunt forces injuries to humans. Utilization of the "skin-skull-brain model" presents some significant advantages: the model is inexpensive, easy to construct, instantly available for use, and eliminates ethics conflicts. The main advantage of such a model is, in comparison with biological substances, the high reproducibility of experimentally inflicted traumas.

  8. Myosin Head Configuration in Relaxed Insect Flight Muscle: X-Ray Modeled Resting Cross-Bridges in a Pre-Powerstroke State Are Poised for Actin Binding

    PubMed Central

    AL-Khayat, Hind A.; Hudson, Liam; Reedy, Michael K.; Irving, Thomas C.; Squire, John M.

    2003-01-01

    Low-angle x-ray diffraction patterns from relaxed insect flight muscle recorded on the BioCAT beamline at the Argonne APS have been modeled to 6.5 nm resolution (R-factor 9.7%, 65 reflections) using the known myosin head atomic coordinates, a hinge between the motor (catalytic) domain and the light chain-binding (neck) region (lever arm), together with a simulated annealing procedure. The best head conformation angles around the hinge gave a head shape that was close to that typical of relaxed M•ADP•Pi heads, a head shape never before demonstrated in intact muscle. The best packing constrained the eight heads per crown within a compact crown shelf projecting at ∼90° to the filament axis. The two heads of each myosin molecule assume nonequivalent positions, one head projecting outward while the other curves round the thick filament surface to nose against the proximal neck of the projecting head of the neighboring molecule. The projecting heads immediately suggest a possible cross-bridge cycle. The relaxed projecting head, oriented almost as needed for actin attachment, will attach, then release Pi followed by ADP, as the lever arm with a purely axial change in tilt drives ∼10 nm of actin filament sliding on the way to the nucleotide-free limit of its working stroke. The overall arrangement appears well designed to support precision cycling for the myogenic oscillatory mode of contraction with its enhanced stretch-activation response used in flight by insects equipped with asynchronous fibrillar flight muscles. PMID:12885653

  9. Immunologically augmented skin flap as a novel dendritic cell vaccine against head and neck cancer in a rat model.

    PubMed

    Inoue, Keita; Saegusa, Noriko; Omiya, Maho; Ashizawa, Tadashi; Miyata, Haruo; Komiyama, Masaru; Iizuka, Akira; Kume, Akiko; Sugino, Takashi; Yamaguchi, Ken; Kiyohara, Yoshio; Nakagawa, Masahiro; Akiyama, Yasuto

    2015-02-01

    Local recurrence is a major clinical issue following surgical resection in head and neck cancer, and the dissemination and lymph node metastasis of minimal residual disease is relatively difficult to treat due to the lack of suitable therapeutic approaches. In the present study, we developed and evaluated a novel immunotherapy using a skin flap transfer treated with sensitized dendritic cells (DC), termed the "immuno-flap," in a rat tumor model. After the local round area of skin was resected, SCC-158 cells (a rat head and neck cancer cell line) were inoculated into the muscle surface; lastly, the groin skin flap injected with mature DC was overlaid. Two weeks after the second DC injection, systemic immunological reactions and tumor size were measured. The DC-treated group showed a significant reduction in tumor size compared with the control. Although the induction of CTL activity in spleen cells was marginal, Th1 cytokines such as interleukin-2 and interferon-γ were elevated in the DC-treated group. These results suggest that a novel immunotherapy based on the immuno-flap method has the potential for clinical application to prevent the local recurrence of head and neck cancer patients.

  10. Response of a human head/neck/upper-torso replica to dynamic loading--I. Physical model.

    PubMed

    Deng, Y C; Goldsmith, W

    1987-01-01

    A human head/neck/upper-torso replica was constructed and instrumented and its response to impact and dynamic loading was studied. The model consists of a water-filled cadaver skull; plastic vertebrae, sternum and ribs; silicon rubber disks and ligaments; and fabric muscles. The static behavior of the system under sagittal plane and lateral loading was adjusted so as to correspond to that of cadaver behavior under similar loading. The structure was loaded impulsively by the sudden arrest of a supporting sled running on a track and by direct head impact with a suspended steel ball. The measured response included the head acceleration, the disk pressures, the muscle strains, the intracranial pressures and the skull strains; the sled motion was also monitored. These data were recorded with a microcomputer and oscilloscopes; the overall system deformation was observed by high-speed cameras. The muscle contraction effects were determined with the aid of microcomputer-controlled devices including a vacuum system, solenoid valves and plastic syringes.

  11. Traumatic subchondral fracture of the femoral head in a healed trochanteric fracture

    PubMed Central

    Lee, Sang Yang; Niikura, Takahiro; Iwakura, Takashi; Kurosaka, Masahiro

    2014-01-01

    An 82-year-old woman sustained a trochanteric fracture of the left femur after a fall. Fracture fixation was performed using proximal femoral nail antirotation (PFNA) II, and she was able to walk with a T-cane after 3 months. Eleven months following the operation, the patient presented with left hip pain after a fall. Radiographs showed a subchondral collapse of the femoral head located above the blade tip. The authors removed the PFNA-II and subsequently performed cemented bipolar hemiarthroplasty. Histological evaluation of the femoral head showed osteoporosis with no evidence of osteonecrosis. Repair tissue, granulation tissue and callus formation were seen at the collapsed subchondral area. Based on these findings, a traumatic subchondral fracture of the femoral head in a healed trochanteric fracture was diagnosed. A traumatic subchondral fracture of the femoral head may need to be considered as a possible diagnosis after internal fixation of the trochanteric fracture. PMID:25015169

  12. Denosumab Related Osteonecrosis of the Jaw with Spontaneous Necrosis of the Soft Palate: Report of a Life Threatening Case.

    PubMed

    Qaisi, Mohammed; Hargett, Jamie; Loeb, Matthew; Brown, Jeffrey; Caloss, Ronald

    2016-01-01

    Bisphosphonates have been used for years in the treatment of patients with distant bony metastasis and in the prevention of osteoporosis. One of main side effects of these medications is the development of bisphosphonate related osteonecrosis of the jaw (BRONJ) in a small subset of patients. A new class of medications with a shorter half-life, known as receptor activator of nuclear factor kappa-B ligand (RANKL) inhibitors, was introduced with the hopes of avoiding this side effect. However, reports of osteonecrosis of the jaw after the use of RANKL inhibitors have also been documented. We report on a patient who developed a life threatening osteonecrosis of the jaw with sepsis shortly after switching from a bisphosphonate to a RANKL inhibitor for osteoporosis treatment. This patient developed several soft tissue defects including spontaneous necrosis of the soft palate. To our knowledge this is the first time this presentation has been described. PMID:27648313

  13. Successful treatment of a humeral capitulum osteonecrosis with bone morphogenetic protein-7 combined with autologous bone grafting.

    PubMed

    Marsell, Richard; Hailer, Nils P

    2014-08-01

    We present the case of a 27-year-old female with subcortical osteonecrosis of the humeral capitulum. Percutaneous retrograde drilling of the lesion and application of recombinant human bone morphogenetic protein (BMP)-7 were combined with autologous bone grafting. At follow-up the patient was almost pain-free, had normalized her range of motion, and radiography showed consolidation of the lesion without any heterotopic bone formation. By timing surgery prior to subchondral collapse, biomechanical stability of the subchondral bone was maintained. To our knowledge, this is the first report on the treatment of an osteonecrosis in this location with a BMP, and this strategy could potentially be applied in other locations with juxta-articular osteonecrosis. PMID:25017508

  14. Denosumab Related Osteonecrosis of the Jaw with Spontaneous Necrosis of the Soft Palate: Report of a Life Threatening Case

    PubMed Central

    Hargett, Jamie; Brown, Jeffrey; Caloss, Ronald

    2016-01-01

    Bisphosphonates have been used for years in the treatment of patients with distant bony metastasis and in the prevention of osteoporosis. One of main side effects of these medications is the development of bisphosphonate related osteonecrosis of the jaw (BRONJ) in a small subset of patients. A new class of medications with a shorter half-life, known as receptor activator of nuclear factor kappa-B ligand (RANKL) inhibitors, was introduced with the hopes of avoiding this side effect. However, reports of osteonecrosis of the jaw after the use of RANKL inhibitors have also been documented. We report on a patient who developed a life threatening osteonecrosis of the jaw with sepsis shortly after switching from a bisphosphonate to a RANKL inhibitor for osteoporosis treatment. This patient developed several soft tissue defects including spontaneous necrosis of the soft palate. To our knowledge this is the first time this presentation has been described.

  15. Denosumab Related Osteonecrosis of the Jaw with Spontaneous Necrosis of the Soft Palate: Report of a Life Threatening Case

    PubMed Central

    Hargett, Jamie; Brown, Jeffrey; Caloss, Ronald

    2016-01-01

    Bisphosphonates have been used for years in the treatment of patients with distant bony metastasis and in the prevention of osteoporosis. One of main side effects of these medications is the development of bisphosphonate related osteonecrosis of the jaw (BRONJ) in a small subset of patients. A new class of medications with a shorter half-life, known as receptor activator of nuclear factor kappa-B ligand (RANKL) inhibitors, was introduced with the hopes of avoiding this side effect. However, reports of osteonecrosis of the jaw after the use of RANKL inhibitors have also been documented. We report on a patient who developed a life threatening osteonecrosis of the jaw with sepsis shortly after switching from a bisphosphonate to a RANKL inhibitor for osteoporosis treatment. This patient developed several soft tissue defects including spontaneous necrosis of the soft palate. To our knowledge this is the first time this presentation has been described. PMID:27648313

  16. Modeling distance-dependent individual head-related transfer functions in the horizontal plane using frontal projection headphones.

    PubMed

    Sunder, Kaushik; Gan, Woon-Seng; Tan, Ee-Leng

    2015-07-01

    The veracity of virtual audio is degraded by the use of non-individualized head-related transfer functions (HRTFs) due to the introduction of front-back, elevation confusions, and timbral coloration. Hence, an accurate reproduction of spatial sound demands the use of individualized HRTFs. Measuring distance-dependent individualized HRTFs can be extremely tedious, since it requires precise measurements at several distances in the proximal region (<1 m) for each individual. This paper proposes a technique to model distance-dependent individualized HRTFs in the horizontal plane using "frontal projection headphones playback" that does not require individualized measurements. The frontal projection headphones [Sunder, Tan, and Gan (2013). J. Audio Eng. Soc. 61, 989-1000] project the sound directly onto the pinnae from the front, and thus inherently create listener's idiosyncratic pinna cues at the eardrum. Perceptual experiments were conducted to investigate cues (auditory parallax and interaural level differences) that aid distance perception in anechoic conditions. Interaural level differences were identified as the prominent cue for distance perception and a spherical head model was used to model these distance-dependent features. Detailed psychophysical experiments revealed that the modeled distance-dependent individualized HRTFs exhibited localization performance close to the measured distance-dependent individualized HRTFs for all subjects.

  17. Modeling distance-dependent individual head-related transfer functions in the horizontal plane using frontal projection headphones.

    PubMed

    Sunder, Kaushik; Gan, Woon-Seng; Tan, Ee-Leng

    2015-07-01

    The veracity of virtual audio is degraded by the use of non-individualized head-related transfer functions (HRTFs) due to the introduction of front-back, elevation confusions, and timbral coloration. Hence, an accurate reproduction of spatial sound demands the use of individualized HRTFs. Measuring distance-dependent individualized HRTFs can be extremely tedious, since it requires precise measurements at several distances in the proximal region (<1 m) for each individual. This paper proposes a technique to model distance-dependent individualized HRTFs in the horizontal plane using "frontal projection headphones playback" that does not require individualized measurements. The frontal projection headphones [Sunder, Tan, and Gan (2013). J. Audio Eng. Soc. 61, 989-1000] project the sound directly onto the pinnae from the front, and thus inherently create listener's idiosyncratic pinna cues at the eardrum. Perceptual experiments were conducted to investigate cues (auditory parallax and interaural level differences) that aid distance perception in anechoic conditions. Interaural level differences were identified as the prominent cue for distance perception and a spherical head model was used to model these distance-dependent features. Detailed psychophysical experiments revealed that the modeled distance-dependent individualized HRTFs exhibited localization performance close to the measured distance-dependent individualized HRTFs for all subjects. PMID:26233016

  18. The role of cerebral spinal fluid in light propagation through the mouse head: improving fluorescence tomography with Monte Carlo modeling

    NASA Astrophysics Data System (ADS)

    Ancora, Daniele; Zacharopoulos, Athanasios; Ripoll, Jorge; Zacharakis, Giannis

    2016-03-01

    Optical Neuroimaging is a highly dynamical field of research owing to the combination of many advanced imaging techniques and computational tools that uncovered unexplored paths through the functioning of the brain. Light propagation modelling through such complicated structures has always played a crucial role as the basis for a high resolution and quantitative imaging where even the slightest improvement could lead to significant results. Fluorescence Diffuse Optical Tomography (fDOT), a widely used technique for three dimensional imaging of small animals and tissues, has been proved to be inaccurate for neuroimaging the mouse head without the knowledge of a-priori anatomical information of the subject. Commonly a normalized Born approximation model is used in fDOT reconstruction based on forward photon propagation using Diffusive Equation (DE) which has strong limitations in the optically clear regime. The presence of the Cerebral Spinal Fluid (CSF) instead, a thin optically clear layer surrounding the brain, can be more accurately taken into account using Monte Carlo approaches which nowadays is becoming more usable thanks to parallelized GPU algorithms. In this work we discuss the results of a synthetic experimental comparison, resulting to the increase of the accuracy for the Born approximation by introducing the CSF layer in a realistic mouse head structure with respect to the current model. We point out the importance of such clear layer for complex geometrical models, while for simple slab phantoms neglecting it does not introduce a significant error.

  19. Impact of head models in N170 component source imaging: results in control subjects and ADHD patients

    NASA Astrophysics Data System (ADS)

    Beltrachini, L.; Blenkmann, A.; von Ellenrieder, N.; Petroni, A.; Urquina, H.; Manes, F.; Ibáñez, A.; Muravchik, C. H.

    2011-12-01

    The major goal of evoked related potential studies arise in source localization techniques to identify the loci of neural activity that give rise to a particular voltage distribution measured on the surface of the scalp. In this paper we evaluate the effect of the head model adopted in order to estimate the N170 component source in attention deficit hyperactivity disorder (ADHD) patients and control subjects, considering faces and words stimuli. The standardized low resolution brain electromagnetic tomography algorithm (sLORETA) is used to compare between the three shell spherical head model and a fully realistic model based on the ICBM-152 atlas. We compare their variance on source estimation and analyze the impact on the N170 source localization. Results show that the often used three shell spherical model may lead to erroneous solutions, specially on ADHD patients, so its use is not recommended. Our results also suggest that N170 sources are mainly located in the right occipital fusiform gyrus for faces stimuli and in the left occipital fusiform gyrus for words stimuli, for both control subjects and ADHD patients. We also found a notable decrease on the N170 estimated source amplitude on ADHD patients, resulting in a plausible marker of the disease.

  20. Dynamics of the head-neck complex in response to the trunk horizontal vibration: modeling and identification.

    PubMed

    Fard, Mohammad A; Ishihara, Tadashi; Inooka, Hikaru

    2003-08-01

    Although many studies exist concerning the influence of seat vibration on the head in the seated human body, the dynamic response of the head-neck complex (HNC) to the trunk vibration has not been well investigated. Little quantitative knowledge exists about viscoelastic parameters of the neck. In this study, the dynamics of the HNC is identified when it is exposed to the trunk horizontal (fore-and-aft) vibration. The frequency response functions between the HNC angular velocity and the trunk horizontal acceleration, corresponding to four volunteers, are obtained in the frequency range of 0.5 Hz to 10 Hz. A fourth-order mathematical model, derived by considering a double-inverted-pendulum model for the HNC, is designed to simulate the dynamic response of the HNC to the trunk horizontal vibration. The frequency domain identification method is used to determine the coefficients of the mathematical model of the HNC. Good agreement has been obtained between experimental and simulation results. This indicates that the system, similar to the designed fourth-order model, has mainly two resonance frequencies. The viscoelastic parameters of the neck, including the spring and damping coefficients, are then obtained by use of the optimization method. PMID:12968578

  1. SU-E-T-08: A Convolution Model for Head Scatter Fluence in the Intensity Modulated Field

    SciTech Connect

    Chen, M; Mo, X; Chen, Y; Parnell, D; Key, S; Olivera, G; Galmarini, W; Lu, W

    2014-06-01

    Purpose: To efficiently calculate the head scatter fluence for an arbitrary intensity-modulated field with any source distribution using the source occlusion model. Method: The source occlusion model with focal and extra focal radiation (Jaffray et al, 1993) can be used to account for LINAC head scatter. In the model, the fluence map of any field shape at any point can be calculated via integration of the source distribution within the visible range, as confined by each segment, using the detector eye's view. A 2D integration would be required for each segment and each fluence plane point, which is time-consuming, as an intensity-modulated field contains typically tens to hundreds of segments. In this work, we prove that the superposition of the segmental integrations is equivalent to a simple convolution regardless of what the source distribution is. In fact, for each point, the detector eye's view of the field shape can be represented as a function with the origin defined at the point's pinhole reflection through the center of the collimator plane. We were thus able to reduce hundreds of source plane integration to one convolution. We calculated the fluence map for various 3D and IMRT beams and various extra-focal source distributions using both the segmental integration approach and the convolution approach and compared the computation time and fluence map results of both approaches. Results: The fluence maps calculated using the convolution approach were the same as those calculated using the segmental approach, except for rounding errors (<0.1%). While it took considerably longer time to calculate all segmental integrations, the fluence map calculation using the convolution approach took only ∼1/3 of the time for typical IMRT fields with ∼100 segments. Conclusions: The convolution approach for head scatter fluence calculation is fast and accurate and can be used to enhance the online process.

  2. Regional electric field induced by electroconvulsive therapy in a realistic finite element head model: influence of white matter anisotropic conductivity.

    PubMed

    Lee, Won Hee; Deng, Zhi-De; Kim, Tae-Seong; Laine, Andrew F; Lisanby, Sarah H; Peterchev, Angel V

    2012-02-01

    We present the first computational study investigating the electric field (E-field) strength generated by various electroconvulsive therapy (ECT) electrode configurations in specific brain regions of interest (ROIs) that have putative roles in the therapeutic action and/or adverse side effects of ECT. This study also characterizes the impact of the white matter (WM) conductivity anisotropy on the E-field distribution. A finite element head model incorporating tissue heterogeneity and WM anisotropic conductivity was constructed based on structural magnetic resonance imaging (MRI) and diffusion tensor MRI data. We computed the spatial E-field distributions generated by three standard ECT electrode placements including bilateral (BL), bifrontal (BF), and right unilateral (RUL) and an investigational electrode configuration for focal electrically administered seizure therapy (FEAST). The key results are that (1) the median E-field strength over the whole brain is 3.9, 1.5, 2.3, and 2.6 V/cm for the BL, BF, RUL, and FEAST electrode configurations, respectively, which coupled with the broad spread of the BL E-field suggests a biophysical basis for observations of superior efficacy of BL ECT compared to BF and RUL ECT; (2) in the hippocampi, BL ECT produces a median E-field of 4.8 V/cm that is 1.5-2.8 times stronger than that for the other electrode configurations, consistent with the more pronounced amnestic effects of BL ECT; and (3) neglecting the WM conductivity anisotropy results in E-field strength error up to 18% overall and up to 39% in specific ROIs, motivating the inclusion of the WM conductivity anisotropy in accurate head models. This computational study demonstrates how the realistic finite element head model incorporating tissue conductivity anisotropy provides quantitative insight into the biophysics of ECT, which may shed light on the differential clinical outcomes seen with various forms of ECT, and may guide the development of novel stimulation paradigms

  3. The Validity of Claims-Based Algorithms to Identify Serious Hypersensitivity Reactions and Osteonecrosis of the Jaw.

    PubMed

    Wright, Nicole C; Curtis, Jeffrey R; Arora, Tarun; Smith, Wilson K; Kilgore, Meredith L; Saag, Kenneth G; Safford, Monika M; Delzell, Elizabeth S

    2015-01-01

    Validation of claims-based algorithms to identify serious hypersensitivity reactions and osteonecrosis of the jaw has not been performed in large osteoporosis populations. The objective of this project is to estimate the positive predictive value of the claims-based algorithms in older women with osteoporosis enrolled in Medicare. Using the 2006-2008 Medicare 5% sample data, we identified potential hypersensitivity and osteonecrosis of the jaw cases based on ICD-9 diagnosis codes. Potential hypersensitivity cases had a 995.0, 995.2, or 995.3 diagnosis code on emergency department or inpatient claims. Potential osteonecrosis of the jaw cases had ≥1 inpatient or outpatient physician claim with a 522.7, 526.4, 526.5, or 733.45 diagnosis code or ≥2 claims of any type with a 526.9 diagnosis code. All retrieved records were redacted and reviewed by experts to determine case status: confirmed, not confirmed, or insufficient information. We calculated the positive predictive value as the number of confirmed cases divided by the total number of retrieved records with sufficient information. We requested 412 potential hypersensitivity and 304 potential osteonecrosis of the jaw records and received 174 (42%) and 84 (28%) records respectively. Of 84 potential osteonecrosis of the jaw cases, 6 were confirmed, resulting in a positive predictive value (95% CI) of 7.1% (2.7, 14.9). Of 174 retrieved potential hypersensitivity records, 95 were confirmed. After exclusion of 25 records with insufficient information for case determination, the overall positive predictive value (95% CI) for hypersensitivity reactions was 76.0% (67.5, 83.2). In a random sample of Medicare data, a claim-based algorithm to identify serious hypersensitivity reactions performed well. An algorithm for osteonecrosis of the jaw did not, partly due to the inclusion of diagnosis codes that are not specific for osteoporosis of the jaw.

  4. Mandibular osteonecrosis following herpes zoster infection in the mandibular branch of the trigeminal nerve: a case report and literature review

    PubMed Central

    2015-01-01

    Herpes zoster virus (HZV) infections are caused by reactivation of the varicella zoster virus. Reactivation symptoms commonly affect the thoracolumbar trunk, and rarely affect the mandibular branches of the trigeminal nerve. When the mandibular branches are involved, lesions appear proximal to the innervation area. This condition may be associated with exfoliation of the teeth and osteonecrosis of the jawbone. We report a case of mandibular osteomyelitis after herpes zoster infection and we present a review of the literature on mandibular-branch involvement of HZV-related osteonecrosis. PMID:26733193

  5. Temporal and Spatial Weighting of Head and Concentration Observations for a Large-Scale Transient Inverse Model

    SciTech Connect

    Scheibe, Timothy D.; Murray, Christopher J.; Xie, YuLong; Williams, Mark D.; Cole, Charles R.; Vermeul, Vince R.; Bergeron, Marcel P.

    2003-09-19

    A regional-scale, three-dimensional groundwater flow and transport modeling effort is ongoing to quantify the environmental consequences of past waste disposal activities and support environmental management activities at the U.S. Department of Energy’s 560-square-mile Hanford Site in southeastern Washington. On the order of one thousand wells in the deep surficial aquifer have been monitored over several decades of site operations (beginning in the 1940’s), and tens of thousands of observations of water table elevation (head) and contaminant concentrations (primarily tritium) have been made over that same period. These data are currently being used as the basis for a site-wide inverse modeling effort to identify model parameters and quantify model uncertainty. Several issues complicate the assignment of appropriate weights to the observations used in the inverse modeling process. The precision of available monitoring techniques has changed significantly over the modeled time period, and the associated error weighting should reflect the methods used (which were in some cases not well documented). In some cases, the detection limits are poorly defined, and some analytical techniques can give rise to non-physical results (such as negative measured concentrations). In addition, the data are strongly clustered both in space and time. This presents the possibility of the inverse solution being too strongly influenced by a cluster of similar values. However, the elimination of some data by declustering techniques, or alternatively, the adjustment of observation weights used in the objective function, raises problems with interpretation and regulatory acceptance of model predictions and uncertainty estimates. This paper presents the methods we have utilized to assign appropriate weights to head and concentration observations and discusses potential issues associated with the weighting scheme employed.

  6. Bisphosphonate-related osteonecrosis of the jaws: a potential alternative to drug holidays.

    PubMed

    Damm, Douglas D; Jones, David M

    2013-08-01

    In 2011, the American Dental Association Council on Scientific Affairs released an update by their expert panel on managing the care of patients receiving antiresorptive therapy for the prevention and treatment of osteoporosis. In this report, the panel found no study results that confirmed the effectiveness of drug holidays to prevent antiresorptive agent-induced osteonecrosis of the jaws without increasing the risks of low bone mass. The purpose of this article is to provide suggestions for a pattern of patient care for individuals who desire or require an invasive surgical procedure of the jaws, but who also have a skeleton that is at risk for osteoporotic fracture. The authors reviewed pertinent literature related to basic bone histology, the pharmacokinetics of the aminobisphosphonates (nBP), diagnostic criteria for osteopenia/osteoporosis, and clinical applications of the antiresorptive agents. The skeletal system demonstrates a mixture of resting surfaces (osteocytes, 85%), resorbing surfaces (osteoclasts, 2%), and forming surfaces (osteoblasts, 10%-12%). Deposition of nBP is not uniform, and is highly concentrated in areas of bone remodeling. A full understanding of bone remodeling and the pharmacokinetics of nBP allow for the modification of the antiresorptive therapy and the timing of the oral surgical procedure in a manner that minimizes the prevalence of osteonecrosis while at the same time continuing to protect the patient's skeleton from osteoporotic fracture. The lack of support for drug holidays by the ADA's expert panel is strongly consistent with the science behind bone remodeling and nBP pharmacokinetics. In spite of this, creative interdisciplinary patient care has the potential to dramatically reduce the prevalence of bisphosphonate-related osteonecrosis (BRON), while at the same time continuing to protect the skeleton of the osteoporotic patient. Creative interdisciplinary patient care may prove to be an effective intervention to reduce the

  7. Structure-based modeling of head-related transfer functions towards interactive customization of binaural sound systems

    NASA Astrophysics Data System (ADS)

    Gupta, Navarun

    2003-10-01

    One of the most popular techniques for creating spatialized virtual sounds is based on the use of Head-Related Transfer Functions (HRTFs). HRTFs are signal processing models that represent the modifications undergone by the acoustic signal as it travels from a sound source to each of the listener's eardrums. These modifications are due to the interaction of the acoustic waves with the listener's torso, shoulders, head and pinnae, or outer ears. As such, HRTFs are somewhat different for each listener. For a listener to perceive synthesized 3-D sound cues correctly, the synthesized cues must be similar to the listener's own HRTFs. One can measure individual HRTFs using specialized recording systems, however, these systems are prohibitively expensive and restrict the portability of the 3-D sound system. HRTF-based systems also face several computational challenges. This dissertation presents an alternative method for the synthesis of binaural spatialized sounds. The sound entering the pinna undergoes several reflective, diffractive and resonant phenomena, which determine the HRTF. Using signal processing tools, such as Prony's signal modeling method, an appropriate set of time delays and a resonant frequency were used to approximate the measured Head-Related Impulse Responses (HRIRs). Statistical analysis was used to find out empirical equations describing how the reflections and resonances are determined by the shape and size of the pinna features obtained from 3D images of 15 experimental subjects modeled in the project. These equations were used to yield "Model HRTFs" that can create elevation effects. Listening tests conducted on 10 subjects show that these model HRTFs are 5% more effective than generic HRTFs when it comes to localizing sounds in the frontal plane. The number of reversals (perception of sound source above the horizontal plane when actually it is below the plane and vice versa) was also reduced by 5.7%, showing the perceptual effectiveness of this

  8. A Novel Closed-Head Model of Mild Traumatic Brain Injury Using Focal Primary Overpressure Blast to the Cranium in Mice.

    PubMed

    Guley, Natalie H; Rogers, Joshua T; Del Mar, Nobel A; Deng, Yunping; Islam, Rafiqul M; D'Surney, Lauren; Ferrell, Jessica; Deng, Bowei; Hines-Beard, Jessica; Bu, Wei; Ren, Huiling; Elberger, Andrea J; Marchetta, Jeffrey G; Rex, Tonia S; Honig, Marcia G; Reiner, Anton

    2016-02-15

    Mild traumatic brain injury (TBI) from focal head impact is the most common form of TBI in humans. Animal models, however, typically use direct impact to the exposed dura or skull, or blast to the entire head. We present a detailed characterization of a novel overpressure blast system to create focal closed-head mild TBI in mice. A high-pressure air pulse limited to a 7.5 mm diameter area on the left side of the head overlying the forebrain is delivered to anesthetized mice. The mouse eyes and ears are shielded, and its head and body are cushioned to minimize movement. This approach creates mild TBI by a pressure wave that acts on the brain, with minimal accompanying head acceleration-deceleration. A single 20-psi blast yields no functional deficits or brain injury, while a single 25-40 psi blast yields only slight motor deficits and brain damage. By contrast, a single 50-60 psi blast produces significant visual, motor, and neuropsychiatric impairments and axonal damage and microglial activation in major fiber tracts, but no contusive brain injury. This model thus reproduces the widespread axonal injury and functional impairments characteristic of closed-head mild TBI, without the complications of systemic or ocular blast effects or head acceleration that typically occur in other blast or impact models of closed-skull mild TBI. Accordingly, our model provides a simple way to examine the biomechanics, pathophysiology, and functional deficits that result from TBI and can serve as a reliable platform for testing therapies that reduce brain pathology and deficits.

  9. Integrating deterministic lithostratigraphic models in stochastic realizations of subsurface heterogeneity. Impact on predictions of lithology, hydraulic heads and groundwater fluxes

    NASA Astrophysics Data System (ADS)

    Bianchi, Marco; Kearsey, Timothy; Kingdon, Andrew

    2015-12-01

    Realistic representations of geological complexity are important to address several engineering and environmental challenges. The spatial distribution of properties controlling physical and geochemical processes can be effectively described by the geological structure of the subsurface. In this work, we present an approach to account for geological structure in geostatistical simulations of categorical variables. The approach is based on the extraction of information from a deterministic conceptualization of the subsurface, which is then used in the geostatistical analysis for the development of models of spatial correlation and as soft conditioning data. The approach was tested to simulate the distribution of four lithofacies in highly heterolithic Quaternary deposits. A transition probability-based stochastic model was implemented using hard borehole data and soft data extracted from a 3-D deterministic lithostratigraphic model. Simulated lithofacies distributions were also used as input in a flow model for numerical simulation of hydraulic head and groundwater flux. The outputs from these models were compared to corresponding values from models based exclusively on borehole data. Results show that soft lithostratigraphic information increases the accuracy and reduces the uncertainty of these predictions. The representation of the geological structure also allows a more precise definition of the spatial distribution of prediction uncertainty, here quantified with a metric based on Shannon information entropy. Correlations between prediction uncertainties for lithofacies, hydraulic heads and groundwater fluxes were also investigated. The results from this analysis provide useful insights about the incorporation of soft geological data into stochastic realizations of subsurface heterogeneity, and emphasize the critical importance of this type of information for reducing the uncertainty of simulations considering flux-dependent processes.

  10. Normal Tissue Complication Probability Modeling of Radiation-Induced Hypothyroidism After Head-and-Neck Radiation Therapy

    SciTech Connect

    Bakhshandeh, Mohsen; Hashemi, Bijan; Mahdavi, Seied Rabi Mehdi; Nikoofar, Alireza; Vasheghani, Maryam; Kazemnejad, Anoshirvan

    2013-02-01

    Purpose: To determine the dose-response relationship of the thyroid for radiation-induced hypothyroidism in head-and-neck radiation therapy, according to 6 normal tissue complication probability models, and to find the best-fit parameters of the models. Methods and Materials: Sixty-five patients treated with primary or postoperative radiation therapy for various cancers in the head-and-neck region were prospectively evaluated. Patient serum samples (tri-iodothyronine, thyroxine, thyroid-stimulating hormone [TSH], free tri-iodothyronine, and free thyroxine) were measured before and at regular time intervals until 1 year after the completion of radiation therapy. Dose-volume histograms (DVHs) of the patients' thyroid gland were derived from their computed tomography (CT)-based treatment planning data. Hypothyroidism was defined as increased TSH (subclinical hypothyroidism) or increased TSH in combination with decreased free thyroxine and thyroxine (clinical hypothyroidism). Thyroid DVHs were converted to 2 Gy/fraction equivalent doses using the linear-quadratic formula with {alpha}/{beta} = 3 Gy. The evaluated models included the following: Lyman with the DVH reduced to the equivalent uniform dose (EUD), known as LEUD; Logit-EUD; mean dose; relative seriality; individual critical volume; and population critical volume models. The parameters of the models were obtained by fitting the patients' data using a maximum likelihood analysis method. The goodness of fit of the models was determined by the 2-sample Kolmogorov-Smirnov test. Ranking of the models was made according to Akaike's information criterion. Results: Twenty-nine patients (44.6%) experienced hypothyroidism. None of the models was rejected according to the evaluation of the goodness of fit. The mean dose model was ranked as the best model on the basis of its Akaike's information criterion value. The D{sub 50} estimated from the models was approximately 44 Gy. Conclusions: The implemented normal tissue

  11. Chronic maxillary sinusitis and diabetes related maxillary osteonecrosis: a case report

    PubMed Central

    2015-01-01

    Dental infections and maxillary sinusitis are the main causes of osteomyelitis. Osteomyelitis can occur in all age groups, and is more frequently found in the lower jaw than in the upper jaw. Systemic conditions that can alter the patient's resistance to infection including diabetes mellitus, anemia, and autoimmune disorders are predisposing factors for osteomyelitis. We report a case of uncommon broad maxillary osteonecrosis precipitated by uncontrolled type 2 diabetes mellitus and chronic maxillary sinusitis in a female patient in her seventies with no history of bisphosphonate or radiation treatment. PMID:26734561

  12. Periodontal Disease, Dental Implants, Extractions and Medications Related to Osteonecrosis of the Jaws.

    PubMed

    Shah, Neha P; Katsarelis, Helen; Pazianas, Michael; Dhariwal, Daljit K

    2015-11-01

    Patients taking bisphosphonates and other anti-resorptive drugs are likely to attend general dental practice. The term 'bisphosphonate'is often immediately associated with osteonecrosis of the jaws (ONJ). Risk assessment and subsequent management of these patients should be carried out taking into account all the risk factors associated with ONJ. The introduction of newer drugs, also shown to be associated with ONJ, demands increased awareness of general dental practitioners about these medications. CPD/CLINICAL RELEVANCE: This paper provides an update on medication-related ONJ and considers the effects of anti-resorptive drugs on the management of patients needing exodontia, treatment for periodontal disease and dental implant placement.

  13. Bisphosphonate-related osteonecrosis of the jaw (BRONJ): initial discovery and subsequent development.

    PubMed

    Ruggiero, Salvatore L

    2009-05-01

    The efficacy of bisphosphonates in controlling skeletally related events in cancer patients and fractures in osteoporotic patients coupled with a relatively low level of toxicity and adverse events resulted in a widespread use of these medications in oncology and general internal medicine. However, in early 2001 a relationship had been established between these medications and a new disease entity characterized by necrosis of bone that was isolated to the jaws. This paper will present the chronology of events that led to the discovery of this new complication now known as bisphosphonate-related osteonecrosis of the jaw and review the reaction of professional organizations, the pharmaceutical industry, and government regulators.

  14. Head injury.

    PubMed

    Hureibi, K A; McLatchie, G R

    2010-05-01

    Head injury is one of the commonest injuries in sport. Most are mild but some can have serious outcomes. Sports medicine doctors should be able to recognise the clinical features and evaluate athletes with head injury. It is necessary during field assessment to recognise signs and symptoms that help in assessing the severity of injury and making a decision to return-to-play. Prevention of primary head injury should be the aim. This includes protective equipment like helmets and possible rule changes. PMID:20533694

  15. Blunt force impact to the head using a teeball bat: systematic comparison of physical and finite element modeling.

    PubMed

    Kettner, Mattias; Ramsthaler, Frank; Potente, Stefan; Bockenheimer, Alexander; Schmidt, Peter H; Schrodt, Michael

    2014-12-01

    Blunt head trauma secondary to violent actions with various weapons is frequently a cause of injury in forensic casework; differing striking tools have varying degrees of injury capacity. The systematic approach used to examine a 19-year-old student who was beaten with a wooden teeball bat will be described. The assailant stopped beating the student when the teeball bat broke into two pieces. The surviving victim sustained bruises and a forehead laceration. The State's Attorney assigned a forensic expert to examine whether the forces exerted on the victim's head (leading to the fracture of the bat) were potentially life threatening (e.g. causing cranial bone fractures). Physical modeling was conducted using a pigskin-covered polyethylene end cap cushioned by cellulose that was connected to a piezoelectric force gauge. Experiments with teeball bats weighing 295-485 g demonstrated that 12-20 kN forces were necessary to cause a comparable bat fracture. In addition to physical testing, a computer-aided simulation was conducted, utilizing a finite-element (FE) method. In the FE approach, after selecting for wood properties, a virtual bat was swung against a hemisphere comprising two layers that represented bone and soft tissue. Employing this model, a 17.6 kN force was calculated, with the highest fracture probability points resembling the fracture patterns of the physically tested bats.

  16. Depth-compensated diffuse optical tomography enhanced by general linear model analysis and an anatomical atlas of human head

    PubMed Central

    Tian, Fenghua; Liu, Hanli

    2013-01-01

    One of the main challenges in functional diffuse optical tomography (DOT) is to accurately recover the depth of brain activation, which is even more essential when differentiating true brain signals from task-evoked artifacts in the scalp. Recently, we developed a depth-compensated algorithm (DCA) to minimize the depth localization error in DOT. However, the semi-infinite model that was used in DCA deviated significantly from the realistic human head anatomy. In the present work, we incorporated depth-compensated DOT (DC-DOT) with a standard anatomical atlas of human head. Computer simulations and human measurements of sensorimotor activation were conducted to examine and prove the depth specificity and quantification accuracy of brain atlas-based DC-DOT. In addition, node-wise statistical analysis based on the general linear model (GLM) was also implemented and performed in this study, showing the robustness of DC-DOT that can accurately identify brain activation at the correct depth for functional brain imaging, even when co-existing with superficial artifacts. PMID:23859922

  17. A Cost-effective, Gelatin-Based Phantom Model for Learning Ultrasound-Guided Fine-Needle Aspiration Procedures of the Head and Neck.

    PubMed

    Richardson, Clare; Bernard, Stewart; Dinh, Vi Am

    2015-08-01

    The rise in popularity of ultrasound imaging has seen a corresponding increase in demand for effective training tools such as phantom models. They are especially useful for teaching and practice of invasive procedures, such as fine-needle aspiration of lesions of the head and neck. We have created 2 gelatin models out of inexpensive, commonly available materials that can be used in sequence to learn head and neck fine-needle aspiration. Fundamental skills can be learned first on the flat, rectangular model, whereas the second, cylindrical model more closely represents human anatomy and can be used to develop more advanced technique. PMID:26206835

  18. Actively targeted gold nanoparticles as novel radiosensitizer agents: an in vivo head and neck cancer model

    NASA Astrophysics Data System (ADS)

    Popovtzer, Aron; Mizrachi, Aviram; Motiei, Menachem; Bragilovski, Dimitri; Lubimov, Leon; Levi, Mattan; Hilly, Ohad; Ben-Aharon, Irit; Popovtzer, Rachela

    2016-01-01

    A major problem in the treatment of head and neck cancer today is the resistance of tumors to traditional radiation therapy, which results in 40% local failure, despite aggressive treatment. The main objective of this study was to develop a technique which will overcome tumor radioresistance by increasing the radiation absorbed in the tumor using cetuximab targeted gold nanoparticles (GNPs), in clinically relevant energies and radiation dosage. In addition, we have investigated the biological mechanisms underlying tumor shrinkage and the in vivo toxicity of GNP. The results showed that targeted GNP enhanced the radiation effect and had a significant impact on tumor growth (P < 0.001). The mechanism of radiation enhancement was found to be related to earlier and greater apoptosis (TUNEL assay), angiogenesis inhibition (by CD34 level) and diminished repair mechanism (PCNA staining). Additionally, GNPs have been proven to be safe as no evidence of toxicity has been observed.

  19. Influence of Head Motion on the Accuracy of 3D Reconstruction with Cone-Beam CT: Landmark Identification Errors in Maxillofacial Surface Model

    PubMed Central

    Song, Jin-Myoung; Cho, Jin-Hyoung

    2016-01-01

    Purpose The purpose of this study was to investigate the influence of head motion on the accuracy of three-dimensional (3D) reconstruction with cone-beam computed tomography (CBCT) scan. Materials and Methods Fifteen dry skulls were incorporated into a motion controller which simulated four types of head motion during CBCT scan: 2 horizontal rotations (to the right/to the left) and 2 vertical rotations (upward/downward). Each movement was triggered to occur at the start of the scan for 1 second by remote control. Four maxillofacial surface models with head motion and one control surface model without motion were obtained for each skull. Nine landmarks were identified on the five maxillofacial surface models for each skull, and landmark identification errors were compared between the control model and each of the models with head motion. Results Rendered surface models with head motion were similar to the control model in appearance; however, the landmark identification errors showed larger values in models with head motion than in the control. In particular, the Porion in the horizontal rotation models presented statistically significant differences (P < .05). Statistically significant difference in the errors between the right and left side landmark was present in the left side rotation which was opposite direction to the scanner rotation (P < .05). Conclusions Patient movement during CBCT scan might cause landmark identification errors on the 3D surface model in relation to the direction of the scanner rotation. Clinicians should take this into consideration to prevent patient movement during CBCT scan, particularly horizontal movement. PMID:27065238

  20. Head Injuries

    MedlinePlus

    ... before. Often, the injury is minor because your skull is hard and it protects your brain. But ... injuries can be more severe, such as a skull fracture, concussion, or traumatic brain injury. Head injuries ...

  1. Head Noises.

    ERIC Educational Resources Information Center

    Senior, Tom

    2000-01-01

    Explains how a toy called "Sound Bites" can be modified to demonstrate the transmission of sound waves. Students can hear music from the toy when they press it against any bone in their heads or shoulders. (WRM)

  2. Bilateral avascular necrosis of the femoral head due to the use of heroin: A case report

    PubMed Central

    Ozkunt, Okan; Sarıyılmaz, Kerim; Sungur, Mustafa; Ilen, Ferhat; Dikici, Fatih

    2015-01-01

    Introduction Femoral head avascular necrosis is caused by disruption of the blood supply of the femoral head, which finally results in hip dysfunction. Non traumatic osteonecrosis may related with corticosteroid use, alcohol abuse, SLE, hemoglobinopathies or exposure to cytotoxic agents. But avascular necrosis of the femoral head (ANFH) due to heroin use is a rare condition. We report a patient with bilateral ANFH due to heroin use treated by simultaneous bilateral hip arthroplasty. Presentation of case 37 year-old male patient presented with bilateral hip pain that had been occurring for four years. The patient had no history of smoking, excessive drinking, using corticosteroid and the other drugs or trauma but used heroin for 10 years. In clinic and radiologic examination indicated advanced degenerative changes on both hip due to femoral head avascular necrosis. The patient was treated with simultaneous bilateral total hip arthroplasty. After 6 months postoperatively the active hip range of motion was painless. Discussion Avascular femoral head necrosis caused by the using of heroin is rare. Ultimately, osteonecrosis of the femoral head occurs through one final common pathway, which is decreased blood flow to the femoral head that leads bone ischemia and death. But it is still unknown that heroin’s systemic effects. Intravenous drug use more as a serious problem for today. There is a need for comprehensive studies to demonstrate effects of heroin on bone and vascularity metabolism. Conclusion Heroin use will be important problem for population. That’s why is crucial to understand the effect of heroin. PMID:26595896

  3. Effects of sutures and fontanels on MEG and EEG source analysis in a realistic infant head model.

    PubMed

    Lew, Seok; Sliva, Danielle D; Choe, Myong-sun; Grant, P Ellen; Okada, Yoshio; Wolters, Carsten H; Hämäläinen, Matti S

    2013-08-01

    In infants, the fontanels and sutures as well as conductivity of the skull influence the volume currents accompanying primary currents generated by active neurons and thus the associated electroencephalography (EEG) and magnetoencephalography (MEG) signals. We used a finite element method (FEM) to construct a realistic model of the head of an infant based on MRI images. Using this model, we investigated the effects of the fontanels, sutures and skull conductivity on forward and inverse EEG and MEG source analysis. Simulation results show that MEG is better suited than EEG to study early brain development because it is much less sensitive than EEG to distortions of the volume current caused by the fontanels and sutures and to inaccurate estimates of skull conductivity. Best results will be achieved when MEG and EEG are used in combination.

  4. Validation of CRASH Model in Prediction of 14-day Mortality and 6-month Unfavorable Outcome of Head Trauma Patients

    PubMed Central

    Hashemi, Behrooz; Amanat, Mahnaz; Baratloo, Alireza; Forouzanfar, Mohammad Mehdi; Rahmati, Farhad; Motamedi, Maryam; Safari, Saeed

    2016-01-01

    Introduction: To date, many prognostic models have been proposed to predict the outcome of patients with traumatic brain injuries. External validation of these models in different populations is of great importance for their generalization. The present study was designed, aiming to determine the value of CRASH prognostic model in prediction of 14-day mortality (14-DM) and 6-month unfavorable outcome (6-MUO) of patients with traumatic brain injury. Methods: In the present prospective diagnostic test study, calibration and discrimination of CRASH model were evaluated in head trauma patients referred to the emergency department. Variables required for calculating CRASH expected risks (ER), and observed 14-DM and 6-MUO were gathered. Then ER of 14-DM and 6-MUO were calculated. The patients were followed for 6 months and their 14-DM and 6-MUO were recorded. Finally, the correlation of CRASH ER and the observed outcome of the patients was evaluated. The data were analyzed using STATA version 11.0. Results: In this study, 323 patients with the mean age of 34.0 ± 19.4 years were evaluated (87.3% male). Calibration of the basic and CT models in prediction of 14-day and 6-month outcome were in the desirable range (P < 0.05). Area under the curve in the basic model for prediction of 14-DM and 6-MUO were 0.92 (95% CI: 0.89-0.96) and 0.92 (95% CI: 0.90-0.95), respectively. In addition, area under the curve in the CT model for prediction of 14-DM and 6-MUO were 0.93 (95% CI: 0.91-0.97) and 0.93 (95% CI: 0.91-0.96), respectively. There was no significant difference between the discriminations of the two models in prediction of 14-DM (p = 0.11) and 6-MUO (p = 0.1). Conclusion: The results of the present study showed that CRASH prediction model has proper discrimination and calibration in predicting 14-DM and 6-MUO of head trauma patients. Since there was no difference between the values of the basic and CT models, using the basic model is recommended to simplify the risk

  5. Measurement of Pressure Responses in a Physical Model of a Human Head with High Shape Fidelity Based on Ct/mri Data

    NASA Astrophysics Data System (ADS)

    Miyazaki, Yusuke; Tachiya, Hiroshi; Anata, Kenji; Hojo, Akihiro

    This study discusses a head injury mechanism in case of a human head subjected to impact, from results of impact experiments by using a physical model of a human head with high-shape fidelity. The physical model was constructed by using rapid prototyping technology from the three-dimensional CAD data, which obtained from CT/MRI images of a subject's head. As results of the experiments, positive pressure responses occurred at the impacted site, whereas negative pressure responses occurred at opposite the impacted site. Moreover, the absolute maximum value of pressure occurring at the frontal region of the intracranial space of the head model resulted in same or higher than that at the occipital site in each case that the impact force was imposed on frontal or occipital region. This result has not been showed in other study using simple shape physical models. And, the result corresponds with clinical evidences that brain contusion mainly occurs at the frontal part in each impact direction. Thus, physical model with accurate skull shape is needed to clarify the mechanism of brain contusion.

  6. Mathematical Modelling of Muscle Effect on the Kinematics of the Head-Neck Complex in a Frontal Car Collision: A Parameter Study.

    PubMed

    Wittek; Kajzer

    1998-01-01

    A 2-dimensional multibody model of the head-neck complex with muscle elements was developed to estimate the influence of muscles on the kinematics of the head-neck complex in a frontal car collision. With this model the authors evaluated how strongly the calculated influence of muscles depends on 3 important factors: (a) impact severity, (b) reflex time, and (c) parameters that determine characteristics of different components of the muscle model. When muscles were triggered at the beginning of impact, the maximum angle of the head flexion was decreased by the muscles by 40% in a frontal collision with an acceleration of 15 g. The influence of muscles was significant for reflex times lower than 60 (80) ms. The calculated influence of muscles was not sensitive to most parameters of the muscle model.

  7. Actinomyces osteomyelitis in bisphosphonate-related osteonecrosis of the jaw (BRONJ): the missing link?

    PubMed

    De Ceulaer, J; Tacconelli, E; Vandecasteele, S J

    2014-11-01

    Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a rare complication of bisphosphonate treatment characterized by the development of exposed, necrotic bone in the jaw with inflammatory signs. The pathogenesis of BRONJ is not yet fully understood. This review analyzes the evidence supporting the hypothesis that BRONJ may be considered as a bisphosphonate-induced Actinomyces infection of the jaw according to the modified Koch's postulates. The main arguments relies on the following factors: (1) the high prevalence of isolation of Actinomyces from bone BRONJ lesions (73.2 % in retrospective series); (2) the similar pathological appearance of BRONJ and Actinomyces osteomyelitis in most studies, although BRONJ lesions without inflammation have been reported; (3) the high incidence of events that disrupt the normal mucosal barrier as a necessary trigger to develop BRONJ in bisphosphonate-exposed patients; (4) the predilection of bisphosphonate-induced osteonecrosis for the bones of the jaws; and (5) the favorable response of BRONJ on treatment that is active on Actinomyces. If BRONJ confirms to be a bisphosphonate-induced Actinomyces osteomyelitis of the jaw, this has major consequences for the prevention and treatment of this condition.

  8. Prevention of medication-related osteonecrosis of the jaws secondary to tooth extractions. A systematic review

    PubMed Central

    Limeres, Jacobo

    2016-01-01

    Background A study was made to identify the most effective protocol for reducing the risk of osteonecrosis of the jaws (ONJ) following tooth extraction in patients subjected to treatment with antiresorptive or antiangiogenic drugs. Material and Methods A MEDLINE and SCOPUS search (January 2003 - March 2015) was made with the purpose of conducting a systematic literature review based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. All articles contributing information on tooth extractions in patients treated with oral or intravenous antiresorptive or antiangiogenic drugs were included. Results Only 13 of the 380 selected articles were finally included in the review: 11 and 5 of them offered data on patients treated with intravenous and oral bisphosphonates, respectively. No randomized controlled trials were found – all publications corresponding to case series or cohort studies. The prevalence of ONJ in the patients treated with intravenous and oral bisphosphonates was 6,9% (range 0-34.7%) and 0.47% (range 0-2.5%), respectively. The main preventive measures comprised local and systemic infection control. Conclusions No conclusive scientific evidence is available to date on the efficacy of ONJ prevention protocols in patients treated with antiresorptive or antiangiogenic drugs subjected to tooth extraction. Key words:Bisphosphonates, angiogenesis inhibitors, antiresorptive drugs, extraction, osteonecrosis. PMID:26827065

  9. Metagenomic investigation of microbes and viruses in patients with jaw osteonecrosis associated with bisphosphonate therapy

    PubMed Central

    Sedghizadeh, Parish P.; Yooseph, Shibu; Fadrosh, Douglas W.; Zeigler-Allen, Lisa; Thiagarajan, Mathangi; Salek, Hamid; Farahnik, Farid; Williamson, Shannon J.

    2013-01-01

    Objective The goal of this preliminary study was to use metagenomic approaches to investigate the taxonomic diversity of microorganisms in patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ). Study Design Samples of saliva for planktonic microbial analysis and biofilm cultivation were collected from 10 patients (5 with BRONJ and 5 non-BRONJ control subjects) who met all ascertainment criteria. Prophage induction experiments—16S rRNA polymerase chain reaction and 454 pyrosequencing—and epifluorescent microscopy were performed for characterization and enumeration of microbes and viruses. Results Three phyla of microbes—Proteobacteria (70%), Firmicutes (26.9%), and Actinobacteria (1.95%)—dominated all BRONJ samples and accounted for almost 99% of the total data. Viral abundance was ~1 order of magnitude greater than microbial cell abundance and comprised mainly phage viruses. Conclusions Individuals with jaw osteonecrosis harbored different microbial assemblages than nonaffected patients, and in general viral abundance and prophage induction increased with biofilm formation, suggesting that biofilm formation encouraged lysogenic interactions between viruses and microbial hosts and may contribute to pathogenicity. PMID:23159114

  10. A Fully Nonlinear, Dynamically Consistent Numerical Model for Solid-Body Ship Motion. I. Ship Motion with Fixed Heading

    NASA Technical Reports Server (NTRS)

    Lin, Ray-Quing; Kuang, Weijia

    2011-01-01

    In this paper, we describe the details of our numerical model for simulating ship solidbody motion in a given environment. In this model, the fully nonlinear dynamical equations governing the time-varying solid-body ship motion under the forces arising from ship wave interactions are solved with given initial conditions. The net force and moment (torque) on the ship body are directly calculated via integration of the hydrodynamic pressure over the wetted surface and the buoyancy effect from the underwater volume of the actual ship hull with a hybrid finite-difference/finite-element method. Neither empirical nor free parametrization is introduced in this model, i.e. no a priori experimental data are needed for modelling. This model is benchmarked with many experiments of various ship hulls for heave, roll and pitch motion. In addition to the benchmark cases, numerical experiments are also carried out for strongly nonlinear ship motion with a fixed heading. These new cases demonstrate clearly the importance of nonlinearities in ship motion modelling.

  11. Regional electric field induced by electroconvulsive therapy in a realistic finite element head model: Influence of white matter anisotropic conductivity

    PubMed Central

    Lee, Won Hee; Deng, Zhi-De; Kim, Tae-Seong; Laine, Andrew F.; Lisanby, Sarah H.; Peterchev, Angel V.

    2012-01-01

    We present the first computational study investigating the electric field (E-field) strength generated by various electroconvulsive therapy (ECT) electrode configurations in specific brain regions of interest (ROIs) that have putative roles in the therapeutic action and/or adverse side effects of ECT. This study also characterizes the impact of the white matter (WM) conductivity anisotropy on the E-field distribution. A finite element head model incorporating tissue heterogeneity and WM anisotropic conductivity was constructed based on structural magnetic resonance imaging (MRI) and diffusion tensor MRI data. We computed the spatial E-field distributions generated by three standard ECT electrode placements including bilateral (BL), bifrontal (BF), and right unilateral (RUL) and an investigational electrode configuration for focal electrically administered seizure therapy (FEAST). The key results are that (1) the median E-field strength over the whole brain is 3.9, 1.5, 2.3, and 2.6 V/cm for the BL, BF, RUL, and FEAST electrode configurations, respectively, which coupled with the broad spread of the BL E-field suggests a biophysical basis for observations of superior efficacy of BL ECT compared to BF and RUL ECT; (2) in the hippocampi, BL ECT produces a median E-field of 4.8 V/cm that is 1.5–2.8 times stronger than that for the other electrode configurations, consistent with the more pronounced amnestic effects of BL ECT; and (3) neglecting the WM conductivity anisotropy results in E-field strength error up to 18% overall and up to 39% in specific ROIs, motivating the inclusion of the WM conductivity anisotropy in accurate head models. This computational study demonstrates how the realistic finite element head model incorporating tissue conductivity anisotropy provides quantitative insight into the biophysics of ECT, which may shed light on the differential clinical outcomes seen with various forms of ECT, and may guide the development of novel stimulation

  12. Impingement and stability of total hip arthroplasty versus femoral head resurfacing using a cadaveric robotics model.

    PubMed

    Colbrunn, R W; Bottros, J J; Butler, R S; Klika, A K; Bonner, T F; Greeson, C; van den Bogert, A J; Barsoum, W K

    2013-07-01

    We identified and compared the impingent-free range of motion (ROM) and subluxation potential for native hip, femoral head resurfacing (FHR), and total hip arthroplasty (THA). These constructs were also compared both with and without soft tissue to elucidate the role of the soft tissue. Five fresh-frozen bilateral hip specimens were mounted to a six-degree of freedom robotic manipulator. Under load-control parameters, in vivo mechanics were recreated to evaluate impingement free ROM, and the subluxation potential in two "at risk" positions for native hip, FHR, and THA. Impingement-free ROM of the skeletonized THA was greater than FHR for the anterior subluxation position. For skeletonized posterior subluxations, stability for THA and FHR constructs were similar, while a different pattern was observed for specimens with soft tissues intact. FHR constructs were more stable than THA constructs for both anterior and posterior subluxations. When the femoral neck is intact the joint has an earlier impingement profile placing the hip at risk for subluxation. However, FHR design was shown to be more stable than THA only when soft tissues were intact. PMID:23494830

  13. Electromagnetic Head-And-Neck Hyperthermia Applicator: Experimental Phantom Verification and FDTD Model

    SciTech Connect

    Paulides, Margarethus M. . E-mail: M.Paulides@ErasmusMC.nl; Bakker, Jurriaan F.; Rhoon, Gerard C. van

    2007-06-01

    Purpose: To experimentally verify the feasibility of focused heating in the neck region by an array of two rings of six electromagnetic antennas. We also measured the dynamic specific absorption rate (SAR) steering possibilities of this setup and compared these SAR patterns to simulations. Methods and Materials: Using a specially constructed laboratory prototype head-and-neck applicator, including a neck-mimicking cylindrical muscle phantom, we performed SAR measurements by electric field, Schottky-diode sheet measurements and, using the power-pulse technique, by fiberoptic thermometry and infrared thermography. Using phase steering, we also steered the SAR distribution in radial and axial directions. All measured distributions were compared with the predictions by a finite-difference time-domain-based electromagnetic simulator. Results: A central 50% iso-SAR focus of 35 {+-} 3 mm in diameter and about 100 {+-} 15 mm in length was obtained for all investigated settings. Furthermore, this SAR focus could be steered toward the desired location in the radial and axial directions with an accuracy of {approx}5 mm. The SAR distributions as measured by all three experimental methods were well predicted by the simulations. Conclusion: The results of our study have shown that focused heating in the neck is feasible and that this focus can be effectively steered in the radial and axial directions. For quality assurance measurements, we believe that the Schottky-diode sheet provides the best compromise among effort, speed, and accuracy, although a more specific and improved design is warranted.

  14. Efficacy of laser therapy in the management of bisphosphonate-related osteonecrosis of the jaw (BRONJ): a systematic review.

    PubMed

    Weber, João Batista Blessmann; Camilotti, Renata Stifelman; Ponte, Monique Estér

    2016-08-01

    Bisphosphonate-related osteonecrosis of the jaw is a well-known potential side effect of long-term bisphosphonate therapy; the primary objective of the treatment should be to improve patient quality of life through pain and infection management, to prevent the development of new lesions, and to slow disease progression. In recent years, the use of laser for bisphosphonate-related osteonecrosis of the jaw has become more widespread, due to its use of administration and widely reported beneficial effects on tissue healing. The present systematic review of the literature sought to elucidate whether low-level laser therapy has positive effects on the treatment of bisphosphonate-related osteonecrosis of the jaw. We conducted a systematic search of the PubMed, EMBASE, and Cochrane Library electronic databases, with no restrictions on language or year of publication. Search strategies were formulated using keywords and Boolean operators. The electronic search strategy retrieved 55 records. From 55 articles, 16 were selected for full-text review, and of these, 10 were ultimately included for data analysis in this review. Our findings show that treatment modalities including laser were associated with superior outcomes in terms of cure or improvement of bisphosphonate-related osteonecrosis of the jaw lesions as compared with conventional surgical and/or conservative drug therapy. It can be concluded that combined treatment with antibiotics, minimally invasive surgery (including Er:YAG laser surgery), and low-level laser therapy in the early stages of the disease should be the gold standard for bisphosphonate-related osteonecrosis of the jaw management. PMID:27025860

  15. Genetic risk factors for the development of osteonecrosis in children under age 10 treated for acute lymphoblastic leukemia.

    PubMed

    Karol, Seth E; Mattano, Leonard A; Yang, Wenjian; Maloney, Kelly W; Smith, Colton; Liu, ChengCheng; Ramsey, Laura B; Fernandez, Christian A; Chang, Tamara Y; Neale, Geoffrey; Cheng, Cheng; Mardis, Elaine; Fulton, Robert; Scheet, Paul; San Lucas, F Anthony; Larsen, Eric C; Loh, Mignon L; Raetz, Elizabeth A; Hunger, Stephen P; Devidas, Meenakshi; Relling, Mary V

    2016-02-01

    Osteonecrosis is a dose-limiting toxicity in the treatment of pediatric acute lymphoblastic leukemia (ALL). Prior studies on the genetics of osteonecrosis have focused on patients ≥10 years of age, leaving the genetic risk factors for the larger group of children <10 years incompletely understood. Here, we perform the first evaluation of genetic risk factors for osteonecrosis in children <10 years. The discovery cohort comprised 82 cases of osteonecrosis and 287 controls treated on Children's Oncology Group (COG) standard-risk ALL protocol AALL0331 (NCT00103285, https://clinicaltrials.gov/ct2/show/NCT00103285), with results tested for replication in 817 children <10 years treated on COG protocol AALL0232 (NCT00075725, https://clinicaltrials.gov/ct2/show/NCT00075725). The top replicated single nucleotide polymorphisms (SNPs) were near bone morphogenic protein 7 [BMP7: rs75161997, P = 5.34 × 10(-8) (odds ratio [OR] 15.0) and P = .0498 (OR 8.44) in the discovery and replication cohorts, respectively] and PROX1-antisense RNA1 (PROX1-AS1: rs1891059, P = 2.28 × 10(-7) [OR 6.48] and P = .0077 [OR 3.78] for the discovery and replication cohorts, respectively). The top replicated nonsynonymous SNP, rs34144324, was in a glutamate receptor gene (GRID2, P = 8.65 × 10(-6) [OR 3.46] and P = .0136 [OR 10.8] in the discovery and replication cohorts, respectively). In a meta-analysis, the BMP7 and PROX1-AS1 variants (rs75161997 and rs1891059, respectively) met the significance threshold of <5 × 10(-8). Top replicated SNPs were enriched in enhancers active in mesenchymal stem cells, and analysis of annotated genes demonstrated enrichment in glutamate receptor and adipogenesis pathways. These data may provide new insights into the pathophysiology of osteonecrosis. PMID:26590194

  16. Genetic risk factors for the development of osteonecrosis in children under age 10 treated for acute lymphoblastic leukemia.

    PubMed

    Karol, Seth E; Mattano, Leonard A; Yang, Wenjian; Maloney, Kelly W; Smith, Colton; Liu, ChengCheng; Ramsey, Laura B; Fernandez, Christian A; Chang, Tamara Y; Neale, Geoffrey; Cheng, Cheng; Mardis, Elaine; Fulton, Robert; Scheet, Paul; San Lucas, F Anthony; Larsen, Eric C; Loh, Mignon L; Raetz, Elizabeth A; Hunger, Stephen P; Devidas, Meenakshi; Relling, Mary V

    2016-02-01

    Osteonecrosis is a dose-limiting toxicity in the treatment of pediatric acute lymphoblastic leukemia (ALL). Prior studies on the genetics of osteonecrosis have focused on patients ≥10 years of age, leaving the genetic risk factors for the larger group of children <10 years incompletely understood. Here, we perform the first evaluation of genetic risk factors for osteonecrosis in children <10 years. The discovery cohort comprised 82 cases of osteonecrosis and 287 controls treated on Children's Oncology Group (COG) standard-risk ALL protocol AALL0331 (NCT00103285, https://clinicaltrials.gov/ct2/show/NCT00103285), with results tested for replication in 817 children <10 years treated on COG protocol AALL0232 (NCT00075725, https://clinicaltrials.gov/ct2/show/NCT00075725). The top replicated single nucleotide polymorphisms (SNPs) were near bone morphogenic protein 7 [BMP7: rs75161997, P = 5.34 × 10(-8) (odds ratio [OR] 15.0) and P = .0498 (OR 8.44) in the discovery and replication cohorts, respectively] and PROX1-antisense RNA1 (PROX1-AS1: rs1891059, P = 2.28 × 10(-7) [OR 6.48] and P = .0077 [OR 3.78] for the discovery and replication cohorts, respectively). The top replicated nonsynonymous SNP, rs34144324, was in a glutamate receptor gene (GRID2, P = 8.65 × 10(-6) [OR 3.46] and P = .0136 [OR 10.8] in the discovery and replication cohorts, respectively). In a meta-analysis, the BMP7 and PROX1-AS1 variants (rs75161997 and rs1891059, respectively) met the significance threshold of <5 × 10(-8). Top replicated SNPs were enriched in enhancers active in mesenchymal stem cells, and analysis of annotated genes demonstrated enrichment in glutamate receptor and adipogenesis pathways. These data may provide new insights into the pathophysiology of osteonecrosis.

  17. Incorporating single-side sparing in models for predicting parotid dose sparing in head and neck IMRT

    SciTech Connect

    Yuan, Lulin Wu, Q. Jackie; Yin, Fang-Fang; Yoo, David; Jiang, Yuliang; Ge, Yaorong

    2014-02-15

    Purpose: Sparing of single-side parotid gland is a common practice in head-and-neck (HN) intensity modulated radiation therapy (IMRT) planning. It is a special case of dose sparing tradeoff between different organs-at-risk. The authors describe an improved mathematical model for predicting achievable dose sparing in parotid glands in HN IMRT planning that incorporates single-side sparing considerations based on patient anatomy and learning from prior plan data. Methods: Among 68 HN cases analyzed retrospectively, 35 cases had physician prescribed single-side parotid sparing preferences. The single-side sparing model was trained with cases which had single-side sparing preferences, while the standard model was trained with the remainder of cases. A receiver operating characteristics (ROC) analysis was performed to determine the best criterion that separates the two case groups using the physician's single-side sparing prescription as ground truth. The final predictive model (combined model) takes into account the single-side sparing by switching between the standard and single-side sparing models according to the single-side sparing criterion. The models were tested with 20 additional cases. The significance of the improvement of prediction accuracy by the combined model over the standard model was evaluated using the Wilcoxon rank-sum test. Results: Using the ROC analysis, the best single-side sparing criterion is (1) the predicted median dose of one parotid is higher than 24 Gy; and (2) that of the other is higher than 7 Gy. This criterion gives a true positive rate of 0.82 and a false positive rate of 0.19, respectively. For the bilateral sparing cases, the combined and the standard models performed equally well, with the median of the prediction errors for parotid median dose being 0.34 Gy by both models (p = 0.81). For the single-side sparing cases, the standard model overestimates the median dose by 7.8 Gy on average, while the predictions by the combined

  18. A New Model for Predicting Acute Mucosal Toxicity in Head-and-Neck Cancer Patients Undergoing Radiotherapy With Altered Schedules

    SciTech Connect

    Strigari, Lidia; Pedicini, Piernicola; D'Andrea, Marco; Pinnaro, Paola; Marucci, Laura; Giordano, Carolina; Benassi, Marcello

    2012-08-01

    Purpose: One of the worst radiation-induced acute effects in treating head-and-neck (HN) cancer is grade 3 or higher acute (oral and pharyngeal) mucosal toxicity (AMT), caused by the killing/depletion of mucosa cells. Here we aim to testing a predictive model of the AMT in HN cancer patients receiving different radiotherapy schedules. Methods and Materials: Various radiotherapeutic schedules have been reviewed and classified as tolerable or intolerable based on AMT severity. A modified normal tissue complication probability (NTCP) model has been investigated to describe AMT data in radiotherapy regimens, both conventional and altered in dose and overall treatment time (OTT). We tested the hypothesis that such a model could also be applied to identify intolerable treatment and to predict AMT. This AMT NTCP model has been compared with other published predictive models to identify schedules that are either tolerable or intolerable. The area under the curve (AUC) was calculated for all models, assuming treatment tolerance as the gold standard. The correlation between AMT and the predicted toxicity rate was assessed by a Pearson correlation test. Results: The AMT NTCP model was able to distinguish between acceptable and intolerable schedules among the data available for the study (AUC = 0.84, 95% confidence interval = 0.75-0.92). In the equivalent dose at 2 Gy/fraction (EQD2) vs OTT space, the proposed model shows a trend similar to that of models proposed by other authors, but was superior in detecting some intolerable schedules. Moreover, it was able to predict the incidence of {>=}G3 AMT. Conclusion: The proposed model is able to predict {>=}G3 AMT after HN cancer radiotherapy, and could be useful for designing altered/hypofractionated schedules to reduce the incidence of AMT.

  19. Four decades of modeling methane cycling in terrestrial ecosystems: Where we are heading?

    NASA Astrophysics Data System (ADS)

    Xu, X.; Yuan, F.; Hanson, P. J.; Wullschleger, S. D.; Thornton, P. E.; Tian, H.; Riley, W. J.; Song, X.; Graham, D. E.; Song, C.

    2015-12-01

    A modeling approach to methane (CH4) is widely used to quantify the budget, investigate spatial and temporal variabilities, and understand the mechanistic processes and environmental controls on CH4 fluxes across spatial and temporal scales. Moreover, CH4 models are an important tool for integrating CH4 data from multiple sources, such as laboratory-based incubation and molecular analysis, field observational experiments, remote sensing, and aircraft-based measurements across a variety of terrestrial ecosystems. We reviewed 39 terrestrial CH4 models to characterize their strengths and weaknesses and to design a roadmap for future model improvement and application. We found that: (1) the focus of CH4 models have been shifted from theoretical to site- to regional-level application over the past four decades, expressed as dramatic increases in CH4 model development on regional budget quantification; (2) large discrepancies exist among models in terms of representing CH4 processes and their environmental controls; (3) significant data-model and model-model mismatches are partially attributed to different representations of wetland characterization and inundation dynamics. Three efforts should be paid special attention for future improvements and applications of fully mechanistic CH4 models: (1) CH4 models should be improved to represent the mechanisms underlying land-atmosphere CH4 exchange, with emphasis on improving and validating individual CH4 processes over depth and horizontal space; (2) models should be developed that are capable of simulating CH4 fluxes across space and time (particularly hot moments and hot spots); (3) efforts should be invested to develop model benchmarking frameworks that can easily be used for model improvement, evaluation, and integration with data from molecular to global scales. A newly developed microbial functional group-based CH4 model (CLM-Microbe) was further used to demonstrate the features of mechanistic representation and

  20. Intracerebral hemorrhage (ICH) evaluation with a novel magnetic induction sensor: a preliminary study using the Chinese head model.

    PubMed

    Zhang, Ziyi; Liu, Peiguo; Zhou, Dongming; Zhang, Liang; Lei, Hengdong

    2014-01-01

    Biomedical magnetic induction measurement is a promising method for the detection of intracerebral hemorrhage (ICH), especially in China. Aiming at overcoming the problem of low sensitivity, a magnetic induction sensor is chosen to replace the conventional sensors. It uses a two-arm Archimedean spiral coil as the exciter and a circular coil as the receiver. In order to carry out high-fidelity simulations, the Chinese head model with real anatomical structure is introduced into this novel sensor for the first time. Simulations have been carried out upon early stage ICH measurements. By calculating the state sensitivity and time sensitivity of the perturbation phase of two types of sensors using the electromagnetic software, we conclude that the primary signal received can be largely reduced using the novel sensor, which could effectively increase the time and state sensitivity simultaneously.

  1. Salamander locomotion-induced head movement and retinal motion sensitivity in a correlation-based motion detector model.

    PubMed

    Begley, Jeffrey R; Arbib, Michael A

    2007-06-01

    We report on a computational model of retinal motion sensitivity based on correlation-based motion detectors. We simulate object motion detection in the presence of retinal slip caused by the salamander's head movements during locomotion. Our study offers new insights into object motion sensitive ganglion cells in the salamander retina. A sigmoidal transformation of the spatially and temporally filtered retinal image substantially improves the sensitivity of the system in detecting a small target moving in place against a static natural background in the presence of comparatively large, fast simulated eye movements, but is detrimental to the direction-selectivity of the motion detector. The sigmoid has insignificant effects on detector performance in simulations of slow, high contrast laboratory stimuli. These results suggest that the sigmoid reduces the system's noise sensitivity.

  2. Dynamic Head-Disk Interface Modeling and Adaptive Control of a Hybrid Actuator for Optical Data Storage Systems

    NASA Astrophysics Data System (ADS)

    Wu, Zhizheng; Li, Yang; Wang, Pei; Liu, Mei

    2015-01-01

    In the near-field recording (NFR) system, the gap between the lens and disk will drop down to 100 nm. However, the disk vibration and force disturbance make it difficult to maintain the desired flying height during disk operation, and the lens-disk collision can easily occur. It is proposed in this article to design a hybrid actuator system which combines both advantages of the flying slider used in hard disk drives and the voice coil actuator used in optical disk drives. The dynamic head-disk interface model of the hybrid actuator is first developed, then an adaptive regulation approach is proposed to control the flying height at its desired value despite the unknown disturbances. Simulation and experimental results are presented to illustrate the effectiveness of the proposed flying height control approach.

  3. Targeted molecular therapy of head and neck squamous cell carcinoma with the tyrosine kinase inhibitor vandetanib in a mouse model

    PubMed Central

    Sano, Daisuke; Fooshee, David R.; Zhao, Mei; Andrews, Genevieve A.; Frederick, Mitchell J.; Galer, Chad; Milas, Zvonimir L.; Morrow, Phuong Khanh H.; Myers, Jeffrey N.

    2010-01-01

    Background We investigated the effects of vandetanib, an inhibitor of vascular endothelial growth factor receptor 2 (VEGFR-2) and epidermal growth factor receptor (EGFR), alone and in combination with paclitaxel in an orthotopic mouse model of human head and neck squamous cell carcinoma (HNSCC). Methods The in vitro effects of vandetanib (ZACTIMA™) were assessed in two HNSCC cell lines on cell growth, apoptosis, and receptor and downstream signaling morecule expression and phosphorylation levels. We assessed in vivo effects of vandetanib and/or paclitaxel by measuring tumor cell apoptosis, endothelial cell apoptosis, microvessel density, tumor size, and animal survival. Results In vitro, vandetanib inhibited the phosphorylation of EGFR and its downstream targets in HNSCC cells and inhibited proliferation and induced apoptosis of HNSCC cells and extended survival and inhibited tumor growth in nude mice orthotopically injected with human HNSCC. Conclusion Vandetanib has the potential to be a novel molecular targeted therapy for HNSCC. PMID:20629091

  4. A systematic review of microsurgical reconstruction of the jaws using vascularized fibula flap technique in patients with bisphosphonate-related osteonecrosis

    PubMed Central

    SACCO, Roberto; SACCO, Gianluca; ACOCELLA, Alessandro; SALE, Silvana; SACCO, Nicola; BALDONI, Edoardo

    2011-01-01

    Objective The aim of this systematic review was to assess the role of microsurgical reconstruction of the jaws in patients with bisphosphonate-related osteonecrosis, and biological complications after an observation period of at least 12 months. Material and methods An electronic MEDLINE search supplemented by manual searching was conducted to identify studies reporting data of at least 12 months observation on the microsurgical reconstruction of the jaws in patients with bisphosphonate-related osteonecrosis. Results Four studies resulted eligible for the analysis yielded. Three out of five studies were free of complications, with a success rate of 100% as no recurrence of osteonecrosis was registered. Conclusions Microsurgical reconstruction of the jaws represents a valid treatment modality in patients with bisphosphonate-related osteonecrosis at 3rd stage of the disease. PMID:21952925

  5. High head pump-turbine: Pumping mode numerical simulations with a cavitation model for off-design conditions

    NASA Astrophysics Data System (ADS)

    Jese, U.; Fortes-Patella, R.; Antheaume, S.

    2014-03-01

    Flexibility and energy storage are one of the main challenges of the energy industry at the present time. Pumped Storage Power Plants (PSP), using reversible pump-turbines, are among the most cost-efficient solutions to answer these needs. To provide a rapid adjustment to the electricity grid, pump-turbines are subject of quick switching between pumping and generating modes and to extended operation under off-design conditions. In particular, at part load, instabilities in pump characteristics can occur. It can lead to unsteadiness and even to a shift of the operating point with significant modification of discharge and drop of efficiency. This unstable area is often exposed to the cavitation phenomenon, which can lead to vibrations, loss of performance and sometimes erosion. The paper focuses on the numerical analysis of the pumping mode regime, especially on the part load off-design instabilities, observed as a saddle shaped pump-turbine head curve and the presence and development of the cavitation in the part load area. The investigations were made on the reduce-scaled model of a high head pump-turbine design. Numerical calculations were performed using commercial code with implemented barotropic cavitation model. Some of the numerical results were compared to the experimental data. Flow analysis was stressed on the cavitation influence on the flow behavior and the performance of the machine. The analysis was made for various flow rates and a wide range of NPSH values. The importance of specific parts of the numerical domain for obtained results was investigated and evaluated.

  6. Modelling of waves propagation on irregular surfaces using ray tracing and GTD approaches: Application to head waves simulation in TOFD inspections for NDT

    NASA Astrophysics Data System (ADS)

    Ferrand, Adrien; Darmon, Michel; Chatillon, Sylvain; Deschamps, Marc

    2014-04-01

    The Time of Flight Diffraction (TOFD) technique is a classical ultrasonic method used in ultrasonic non-destructive evaluation, which allows a precise positioning and a quantitative size evaluation of cracks in the inspected material. Among the typical phenomena arising in the current TOFD inspection, the so-called "head wave" is the first contribution reaching the receiver. The head wave propagation on a planar interface is well known and identified as a critical refraction taking place on the material surface. On irregular surfaces, it has been shown that the head wave results from the melting of surface and bulk waves mechanisms and that surface irregularities are responsible for numerous diffractions of the incident head wave. To simulate such behaviour, a model has been developed using a ray tracing technique based on time of flight minimization (generalized Fermat's principle). It enables the calculation of the ray path and the corresponding time of flight of all waves propagating in the material, including the head wave. To obtain a complete propagation model for these waves (both trajectory and amplitude), the integration of Geometrical Theory of Diffraction (GTD) models is currently performed by coupling them with the ray-based approach discussed above.

  7. Role of Positron Emission Tomography in the Treatment of Occult Disease in Head-and-Neck Cancer: A Modeling Approach

    SciTech Connect

    Phillips, Mark H.; Smith, Wade P.; Parvathaneni, Upendra; Laramore, George E.

    2011-03-15

    Purpose: To determine under what conditions positron emission tomography (PET) imaging will be useful in decisions regarding the use of radiotherapy for the treatment of clinically occult lymph node metastases in head-and-neck cancer. Methods and Materials: A decision model of PET imaging and its downstream effects on radiotherapy outcomes was constructed using an influence diagram. This model included the sensitivity and specificity of PET, as well as the type and stage of the primary tumor. These parameters were varied to determine the optimal strategy for imaging and therapy for different clinical situations. Maximum expected utility was the metric by which different actions were ranked. Results: For primary tumors with a low probability of lymph node metastases, the sensitivity of PET should be maximized, and 50 Gy should be delivered if PET is positive and 0 Gy if negative. As the probability for lymph node metastases increases, PET imaging becomes unnecessary in some situations, and the optimal dose to the lymph nodes increases. The model needed to include the causes of certain health states to predict current clinical practice. Conclusion: The model demonstrated the ability to reproduce expected outcomes for a range of tumors and provided recommendations for different clinical situations. The differences between the optimal policies and current clinical practice are likely due to a disparity between stated clinical decision processes and actual decision making by clinicians.

  8. Comparison of spherical and realistically shaped boundary element head models for transcranial magnetic stimulation navigation

    PubMed Central

    Nummenmaa, Aapo; Stenroos, Matti; Ilmoniemi, Risto J.; Okada, Yoshio C.; Hämäläinen, Matti S.; Raij, Tommi

    2013-01-01

    Objective MRI-guided real-time transcranial magnetic stimulation (TMS) navigators that apply electromagnetic modeling have improved the utility of TMS. However, their accuracy and speed depends on the assumed volume conductor geometry. Spherical models found in present navigators are computationally fast but may be inaccurate in some areas. Realistically-shaped boundary-element models (BEMs) could increase accuracy at a moderate computational cost, but it is unknown which model features have the largest influence on accuracy. Thus, we compared different types of spherical models and BEMs. Methods Globally and locally fitted spherical models and different BEMs with either one or three compartments and with different skull-to-brain conductivity ratios (1/1 – 1/80) were compared against a reference BEM. Results The one-compartment BEM at inner skull surface was almost as accurate as the reference BEM. Skull/brain conductivity ratio in the range 1/10 – 1/80 had only a minor influence. BEMs were superior to spherical models especially in frontal and temporal areas (up to 20 mm localization and 40% intensity improvement); in motor cortex all models provided similar results. Conclusions One-compartment BEMs offer a good balance between accuracy and computational cost. Significance Realistically-shaped BEMs may increase TMS navigation accuracy in several brain areas, such as in prefrontal regions often targeted in clinical applications. PMID:23890512

  9. It's All in Your Head: Feminist and Medical Models of Menopause (Strange Bedfellows).

    ERIC Educational Resources Information Center

    Posner, Judith

    1979-01-01

    This article describes the medical model of menopause as it exists in contemporary gynecological textbooks and some popular books written by gynecologists for the general public. The feminist position on menopause is then compared and contrasted with the medical model. (Author/EB)

  10. Simulated effects of head movement on contact pressures between headforms and N95 filtering facepiece respirators-part 1: headform model and validation.

    PubMed

    Lei, Zhipeng; Ji, Xuewu; Li, Ning; Yang, James; Zhuang, Ziqing; Rottach, Dana

    2014-11-01

    In a respirator fit test, a subject is required to perform a series of exercises that include moving the head up and down and rotating the head left and right. These head movements could affect respirator sealing properties during the fit test and consequently affect fit factors. In a model-based system, it is desirable to have similar capability to predict newly designed respirators. In our previous work, finite element modeling (FEM)-based contact simulation between a headform and a filtering facepiece respirator was carried out. However, the headform was assumed to be static or fixed. This paper presents the first part of a series study on the effect of headform movement on contact pressures-a new headform with the capability to move down (flexion), up (extension), and rotate left and right-and validation. The newly developed headforms were validated for movement by comparing the simulated cervical vertebrae rotation angles with experimental results from the literature. PMID:25187034

  11. Simulations on Head-Tail Radio Galaxies Using Magnetic Tower Model

    SciTech Connect

    Gan, Zhaoming; Li, Hui; Li, Shengtai; Yuan, Feng

    2015-08-19

    The presentation is a series of slides showing diagrams, equations, and various photographs. In summary, a detailed comparison was carried out between hydrodynamic jet and MHD jet models (the magnetic tower jet, more precisely), in an effort to understand the underlying physics of observed radio galaxies, and also its possible indications for jet feedback. It was found that the results of magnetic tower model usually lie in a reasonable regime, and in several aspects, the magnetic tower jet seems more preferred than pure hydrodynamic jet models.

  12. A stylized computational model of the head for the reference Japanese male.

    PubMed

    Yamauchi, M; Ishikawa, M; Hoshi, M

    2005-01-01

    Computational models of human anatomy, along with Monte Carlo radiation transport simulations, have been used by Snyder et al. [MIRD Pamphlet No. 5, revised (The Society of Nuclear Medicine, New York, 1978)], Cristy and Eckerman [ORNL/TM-8381/VI, Oak Ridge National Laboratory, Oak Ridge, TN (1987)] and Zubal et al. [Med. Phys. 21, 299-302 (1994)] to estimate internal organ doses from internal and external radiation sources. These were created using physiological data from Caucasoid subjects but not from other races. There is a need for research to determine whether the obvious differences from the Caucasoid anatomy make these models unsuitable for estimating the absorbed dose in other races such as the Mongoloid. We used the cranial region of the adult Japanese male to represent the Mongoloid race. This region contains organs that are highly sensitive to radiation. The cranial region of a physical phantom produced by KYOTO KAGAKU Co., LTD. using numerical data from a Japanese Reference Man [Tanaka, Nippon Acta. Radiol. 48, 509-513 (1988)] was used to supply the data for the geometry of a stylized computational model. Our computational model was constructed with equations rather than voxel-based, in order to deal with as small a number of parameters as possible in the computer simulation experiment. The accuracy of our computational model was checked by comparing simulated experimental results obtained with MCNP4C with actual doses measured with thermoluminescence dosimeters (TLDs) inside the physical phantom from which our computational model was constructed. The TLDs, whose margin of error is less than +/-10%, were arranged at six positions. Co-60 was used as the radiation source. The irradiated dose was 2 Gy in terms of air kerma. In the computer simulation experiments, we used our computational model and Cristy's computational model, whose component data are those of the tissue substitute materials and of the human body as published in ICRU Report 46. The

  13. A stylized computational model of the head for the reference Japanese male

    SciTech Connect

    Yamauchi, M.; Ishikawa, M.; Hoshi, M.

    2005-01-01

    Computational models of human anatomy, along with Monte Carlo radiation transport simulations, have been used by Snyder et al. [MIRD Pamphlet No. 5, revised (The Society of Nuclear Medicine, New York, 1978)], Cristy and Eckerman [ORNL/TM-8381/VI, Oak Ridge National Laboratory, Oak Ridge, TN (1987)] and Zubal et al. [Med. Phys. 21, 299-302 (1994)] to estimate internal organ doses from internal and external radiation sources. These were created using physiological data from Caucasoid subjects but not from other races. There is a need for research to determine whether the obvious differences from the Caucasoid anatomy make these models unsuitable for estimating the absorbed dose in other races such as the Mongoloid. We used the cranial region of the adult Japanese male to represent the Mongoloid race. This region contains organs that are highly sensitive to radiation. The cranial region of a physical phantom produced by KYOTO KAGAKU Co., LTD. using numerical data from a Japanese Reference Man [Tanaka, Nippon Acta. Radiol. 48, 509-513 (1988)] was used to supply the data for the geometry of a stylized computational model. Our computational model was constructed with equations rather than voxel-based, in order to deal with as small a number of parameters as possible in the computer simulation experiment. The accuracy of our computational model was checked by comparing simulated experimental results obtained with MCNP4C with actual doses measured with thermoluminescence dosimeters (TLDs) inside the physical phantom from which our computational model was constructed. The TLDs, whose margin of error is less than {+-}10%, were arranged at six positions. Co-60 was used as the radiation source. The irradiated dose was 2 Gy in terms of air kerma. In the computer simulation experiments, we used our computational model and Cristy's computational model, whose component data are those of the tissue substitute materials and of the human body as published in ICRU Report 46. The

  14. Changes in scalp potentials and spatial smoothing effects of inclusion of dura layer in human head models for EEG simulations

    PubMed Central

    Ramon, Ceon; Garguilo, Paolo; Fridgeirsson, Egill A.; Haueisen, Jens

    2014-01-01

    The dura layer which covers the brain is less conductive than the CSF (cerebrospinal fluid) and also more conductive than the skull bone. This could significantly influence the flow of volume currents from cortex to the scalp surface which will also change the magnitude and spatial profiles of scalp potentials. This was examined with a 3-D finite element method (FEM) model of an adult subject constructed from 192 segmented axial magnetic resonance (MR) slices with 256×256 pixel resolution. The voxel resolution was 1×1×1 mm. The model included the dura layer. In addition, other major tissues were also identified. The electrical conductivities of various tissues were obtained from the literature. The conductivities of dura and CSF were 0.001 S/m and 0.06 S/m, respectively. The electrical activity of the cortex was represented by 144,000 distributed dipolar sources with orientations normal to the local cortical surface. The dipolar intensity was in the range of 0.0–0.4 mA meter with a uniform random distribution. Scalp potentials were simulated for two head models with an adaptive finite element solver. One model had the dura layer and in the other model, dura layer was replaced with the CSF. Spatial contour plots of potentials on the cortical surface, dural surface and the scalp surface were made. With the inclusion of the dura layer, scalp potentials decrease by about 20%. The contours of gyri and sulci structures were visible in the spatial profiles of the cortical potentials which were smoothed out on the dural surface and were not visible on the scalp surface. These results suggest that dura layer should be included for an accurate modeling of scalp and cortical potentials. PMID:25140148

  15. Automated MRI Segmentation for Individualized Modeling of Current Flow in the Human Head

    PubMed Central

    Huang, Yu; Dmochowski, Jacek P.; Su, Yuzhuo; Datta, Abhishek; Rorden, Christopher; Parra, Lucas C.

    2013-01-01

    Objective High-definition transcranial direct current stimulation (HD-tDCS) and high-density electroencephalography (HD-EEG) require accurate models of current flow for precise targeting and current source reconstruction. At a minimum, such modeling must capture the idiosyncratic anatomy of brain, cerebrospinal fluid (CSF) and skull for each individual subject. Currently, the process to build such high-resolution individualized models from structural magnetic resonance images (MRI) requires labor-intensive manual segmentation, even when leveraging available automated segmentation tools. Also, accurate placement of many high-density electrodes on individual scalp is a tedious procedure. The goal was to develop fully automated techniques to reduce the manual effort in such a modeling process. Approach A fully automated segmentation technique based on Statical Parametric Mapping 8 (SPM8), including an improved tissue probability map (TPM) and an automated correction routine for segmentation errors, was developed, along with an automated electrode placement tool for high-density arrays. The performance of these automated routines was evaluated against results from manual segmentation on 4 healthy subjects and 7 stroke patients. The criteria include segmentation accuracy, the difference of current flow distributions in resulting HD-tDCS models and the optimized current flow intensities on cortical targets. Main results The segmentation tool can segment out not just the brain but also provide accurate results for CSF, skull and other soft tissues with a field of view (FOV) extending to the neck. Compared to manual results, automated segmentation deviates by only 7% and 18% for normal and stroke subjects, respectively. The predicted electric fields in the brain deviate by 12% and 29% respectively, which is well within the variability observed for various modeling choices. Finally, optimized current flow intensities on cortical targets do not differ significantly

  16. Automated MRI segmentation for individualized modeling of current flow in the human head

    NASA Astrophysics Data System (ADS)

    Huang, Yu; Dmochowski, Jacek P.; Su, Yuzhuo; Datta, Abhishek; Rorden, Christopher; Parra, Lucas C.

    2013-12-01

    Objective. High-definition transcranial direct current stimulation (HD-tDCS) and high-density electroencephalography require accurate models of current flow for precise targeting and current source reconstruction. At a minimum, such modeling must capture the idiosyncratic anatomy of the brain, cerebrospinal fluid (CSF) and skull for each individual subject. Currently, the process to build such high-resolution individualized models from structural magnetic resonance images requires labor-intensive manual segmentation, even when utilizing available automated segmentation tools. Also, accurate placement of many high-density electrodes on an individual scalp is a t