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Sample records for modified anterior approach

  1. A modified anterior temporal approach for low-position aneurysms of the upper basilar complex

    PubMed Central

    Katsuno, Makoto; Tanikawa, Rokuya; Izumi, Naoto; Hashimoto, Masaaki

    2015-01-01

    Background: Although surgery for aneurysms of the upper basilar complex is generally accomplished by a pterional or subtemporal approach, both techniques have disadvantages. Therefore, attempts have been made to combine both the approaches, such as an anterior temporal approach, which exposes the anterior aspect of the temporal lobe during standard fronto-temporal craniotomy. However, in all these techniques, the temporal vein is sacrificed to allow posterior retraction of the temporal lobe, which may cause venous infarction in the temporal lobe. Methods: Our institutional review board approved this prospective study. We modified the anterior temporal approach for low-position aneurysms of the upper basilar complex by performing posterior clinoidectomy as necessary, thereby preventing the sacrifice of all vessels. Results: From 2007 to 2014, seven patients were operated on using this modified approach, and four patients underwent additional posterior clinoidectomy. Complete clip ligation was performed for all aneurysms without sacrificing any vessels, and there were no permanent complications attributable to manipulation for clipping or posterior clinoidectomy. Conclusions: The modified anterior temporal approach allows a wider operating field within the retro-carotid space, without sacrificing any vessels, and permits safer posterior clinoidectomy and aneurysm clipping in patients with low-position aneurysms of the basilar complex. PMID:25657863

  2. Modified Stoppa Approach versus Ilioinguinal Approach for Anterior Acetabular Fractures; A Systematic Review and Meta-Analysis

    PubMed Central

    Meena, Sanjay; Sharma, Pankaj Kumar; Mittal, Samarth; Sharma, Jyoti; Chowdhury, Buddhadev

    2017-01-01

    Introduction: Modified Stoppa approach was introduced as an alternative to ilioinguinal approach for management of anterior fractures of acetabulum in order to reduce complications of the latter. However, the efficacy of either approach over other is not well established. The aim of this meta-analysis is to compare the efficacy of modified stoppa and ilioinguinal approach in the management of acetabular fractures in terms of a) quality of reduction achieved b) complication rates c) functional outcomes d) operative time e) intra-operative blood loss. Methods: Databases of PubMed, EMBASE and Cochrane registry of controlled trials were taken into consideration for studies on modified Stoppa approach versus Ilioinguinal approach group for the treatment of anterior acetabular fractures. Dichotomous variables were presented as risk ratios (RRs) /Odds Ratio (OR) with 95% confidence intervals (CIs), and continuous data was measured as mean differences, with 95% CIs. Result: Four studies involving 375 patients were included in this meta-analysis. Out of those 375 patients, 192 were managed with ilioinguinal approach and 183 were managed with modified Stoppa approach. Anatomical reduction was significantly higher in Stoppa group (p=0.052, RR=1. 19 (1.02, 1.37), p=0. 90, I2=0%). The complication rate was significantly higher in the Ilioinguinal approach as compared with the Stoppa approach (p=0.01, RR 0.63 (0.44 to 0.91), p=0.73 (I2= 0%). The operative time was significantly shorter with modified Stoppa approach (MD = -48.79 (-80.29 to -17.30), p=0.002). No significant differences were found between the two groups in terms of their functional outcomes (p=0.63, RR 0.96 (-0.80 to 1.15), p=0. 56, I2=0%) and blood loss (MD= -212.89 (-476.27 to 50.49) p=0. 06, I2=71%). Conclusion: Anterior acetabular fractures, if operated with the modified Stoppa approach were found to have better reduction and lower complication rates with less operative time, when compared to ilioinguinal

  3. Correction of anterior crossbite using modified transparent aligners: An esthetic approach

    PubMed Central

    Abraham, K. Korath; James, Arun Roy; Thenumkal, Elza; Emmatty, Tharian

    2016-01-01

    Anterior crossbite results from the abnormal axial inclination of one or more anterior teeth. It is a major esthetic and functional anomaly which has to be corrected in the primary and early mixed dentition period to allow the normal development of maxilla and mandible as well as the occlusion. Several treatment options are available to correct the problem. A unique appliance, “modified transparent tray aligners” was used to correct the anterior crossbite in an 8-year-old child. The clinical presentation, fabrication of the appliance, and the outcome are discussed. PMID:27630508

  4. A Novel Approach to Regain Anterior Space Using Modified 2 by 3 Fixed Appliance: A Report of Two Cases.

    PubMed

    Mohammad, Ziauddin; Cheruku, Sampath Reddy; Penmetcha, Sarada; Bagalkotkar, Apeksha; Kumari, Surabhi

    2015-10-01

    Early loss of permanent anterior teeth in growing children has a psychological impact on the child. Anterior teeth are important both aesthetically and functionally. When a permanent tooth is lost, the teeth adjacent to the created space tend to migrate into the space resulting in the space loss. Management of regaining space with the removable appliance always depends on child cooperation for using the appliance as well as for the recall visits. The advantages of fixed appliances over the removable appliances are minimal discomfort, reduced need for patient cooperation and increased control of tooth movements in all three directions of space. Thus, a short course of fixed appliance like the modified 2 by 3 fixed appliance followed by fixed functional space maintainer could be an ideal treatment option for such cases.

  5. Modified anchor shaped post core design for primary anterior teeth.

    PubMed

    Rajesh, R; Baroudi, Kusai; Reddy, K Bala Kasi; Praveen, B H; Kumar, V Sumanth; Amit, S

    2014-01-01

    Restoring severely damaged primary anterior teeth is challenging to pedodontist. Many materials are tried as a post core but each one of them has its own drawbacks. This a case report describing a technique to restore severely damaged primary anterior teeth with a modified anchor shaped post. This technique is not only simple and inexpensive but also produces better retention.

  6. Modified Anchor Shaped Post Core Design for Primary Anterior Teeth

    PubMed Central

    Rajesh, R.; Baroudi, Kusai; Reddy, K. Bala Kasi; Praveen, B. H.; Kumar, V. Sumanth; Amit, S.

    2014-01-01

    Restoring severely damaged primary anterior teeth is challenging to pedodontist. Many materials are tried as a post core but each one of them has its own drawbacks. This a case report describing a technique to restore severely damaged primary anterior teeth with a modified anchor shaped post. This technique is not only simple and inexpensive but also produces better retention. PMID:25379294

  7. Anterior EEG asymmetry and the Modifier Model of Autism.

    PubMed

    Burnette, Courtney P; Henderson, Heather A; Inge, Anne Pradella; Zahka, Nicole E; Schwartz, Caley B; Mundy, Peter C

    2011-08-01

    Individual differences in the expression of autism complicate research on the nature and treatment of this disorder. In the Modifier Model of Autism (Mundy et al. 2007), we proposed that individual differences in autism may result not only from syndrome specific causal processes, but also from variability in generic, non-syndrome specific modifier processes that affect the social and emotional development of all people. One study supporting this model found that measures of resting anterior EEG asymmetry, a measure reflecting complex brain processes associated with generic individual differences in approach and avoidance motivation, may help explain differences in the expression of autism in children without intellectual disabilities (Sutton et al. 2005). In the current study, we partially replicated the observation that children with autism who exhibited a pattern of left frontal EEG asymmetry tended to display milder levels of social symptoms, although in the current sample this pattern applied only to HFA children with relatively lower verbal IQs. New observations indicated that left frontal EEG asymmetry was also associated with retrospective parent reports of significantly later age of onset of symptoms, but also higher levels of self-reported outward expressions of anger as well as symptoms of obsessive compulsive disorder in school-age higher functioning children with ASD. Therefore, the results of this study provide a new and fully independent set of observations, which indicate that individual differences in anterior EEG asymmetry may significantly moderate the expression and developmental course of autism. This observation may have clinical implications for identifying meaningful diagnostic sub-groups among children with autism.

  8. Minimally invasive surgery of the anterior skull base: transorbital approaches

    PubMed Central

    Gassner, Holger G.; Schwan, Franziska; Schebesch, Karl-Michael

    2016-01-01

    Minimally invasive approaches are becoming increasingly popular to access the anterior skull base. With interdisciplinary cooperation, in particular endonasal endoscopic approaches have seen an impressive expansion of indications over the past decades. The more recently described transorbital approaches represent minimally invasive alternatives with a differing spectrum of access corridors. The purpose of the present paper is to discuss transorbital approaches to the anterior skull base in the light of the current literature. The transorbital approaches allow excellent exposure of areas that are difficult to reach like the anterior and posterior wall of the frontal sinus; working angles may be more favorable and the paranasal sinus system can be preserved while exposing the skull base. Because of their minimal morbidity and the cosmetically excellent results, the transorbital approaches represent an important addition to established endonasal endoscopic and open approaches to the anterior skull base. Their execution requires an interdisciplinary team approach. PMID:27453759

  9. Modified intracanal post for severely mutilated primary anterior teeth

    PubMed Central

    Rallan, Mandeep; Rallan, Neelakshi Singh; Navit, Pragati; Malhotra, Garima

    2013-01-01

    Early childhood caries leads to early damage, discolouration and gross destruction of the maxillary anterior teeth. This leads to difficulty in speech, decreased masticatory efficiency, development of abnormal tongue thrust and subsequent malocclusion, psychological problems and problem with self-esteem, if aesthetics are compromised. Thus, restoration of severely mutilated primary anterior teeth is often considered as a special challenge, especially in an emotionally immature child. This case documents the restoration of severely mutilated incisors in a patient with early childhood caries. PMID:23605834

  10. Anterior vitrectomy and partial capsulectomy via anterior approach to treat chronic postoperative endophthalmitis

    PubMed Central

    Güler, Mete; Yılmaz, Turgut

    2013-01-01

    AIM To describe the results of vitrectomy and partial capsulectomy via anterior approach surgical technique in treatment of chronic postoperative endophthalmitis (CPE). METHODS Clinical records of 9 patients treated for CPE between 2006 and 2010 were reviewed retrospectively. All of these patients were treated with vitrectomy and partial capsulectomy via anterior approach. RESULTS Six of 9 patients were male. The average patients' age was (60±8.1) years. The average period between cataract extraction and onset of signs and symptoms was (3.6±1.3) weeks. The average presenting visual acuity was 0.3±0.1 and the average final post operative visual acuity was 0.7±0.2. The mean follow-up period was (28.1±8.9) weeks. In all patients, the inflammation subsided after surgery. CONCLUSION Our results suggest that anterior vitrectomy and partial capsulectomy via anterior approach may be considered as potentially useful and relatively less invasive technique to treat CPE. PMID:23550103

  11. Combined operative technique with anterior surgical approach and video-assisted thoracoscopic surgical lobectomy for anterior superior sulcus tumours.

    PubMed

    Yokoyama, Yuhei; Chen, Fengshi; Aoyama, Akihiro; Sato, Toshihiko; Date, Hiroshi

    2014-11-01

    Video-assisted thoracoscopic surgery (VATS) has been widely used, but surgical resections of superior sulcus tumours remain challenging because of their anatomical location. For such cases, less-invasive procedures, such as the anterior transcervical-thoracic and transmanubrial approaches, have been widely performed because of their excellent visualization of the subclavian vessels. Recently, a combined operative technique with an anterior surgical approach and VATS for anterior superior sulcus tumours has been introduced. Herein, we report three cases of anterior superior sulcus tumours successfully resected by surgical approaches combined with a VATS-based lobectomy. In all cases, operability was confirmed by VATS, and upper lobectomies with hilar and mediastinal lymph node dissections were performed. Subsequently, dissections of the anterior inlet of the tumours were performed using the transmanubrial approach in two patients and the anterior trans-cervical-thoracic approach in one patient. Both approaches provided excellent access to the anterior inlet of the tumour and exposure of the subclavian vessels, resulting in radical resection of the tumour with concomitant resection of the surrounding anatomical structures, including the chest wall and vessels. In conclusion, VATS lobectomy combined with the anterior surgical approach might be an excellent procedure for the resection of anterior superior sulcus tumours.

  12. Modified Occlusal Rim Design and Use of Phonetics to Determine Anterior Tooth Position and Vertical Dimension: A Clinical Report.

    PubMed

    Romero, Mario F; DeRosa, Thomas A

    2016-06-01

    Prosthetic rehabilitation of edentulous patients can sometimes pose many clinical challenges for the clinician. The importance of correct vertical and horizontal positioning of the anterior teeth so that the completed denture is esthetically pleasing while being functionally correct has been well documented in the literature. Different techniques have been proposed whereby a conventional occlusal rim is used. The wax-rim thickness of this design can interfere with the neutral zone, making normal phonetics difficult. In this report, a completely edentulous patient received treatment using a modified occlusal rim so that phonetics could be used to determine the anterior tooth position and vertical dimension, following a strict adherence to a clinical protocol. The methodology involved the use of heat-processed resin record bases and a thin segment of baseplate wax that mimics anterior teeth. This approach resulted in a more natural feeling for the patient and provided the clinician the necessary information for the laboratory, which was easily communicated.

  13. Anterior EEG Asymmetry and the Modifier Model of Autism

    ERIC Educational Resources Information Center

    Burnette, Courtney P.; Henderson, Heather A.; Inge, Anne Pradella; Zahka, Nicole E.; Schwartz, Caley B.; Mundy, Peter C.

    2011-01-01

    Individual differences in the expression of autism complicate research on the nature and treatment of this disorder. In the Modifier Model of Autism (Mundy et al. 2007), we proposed that individual differences in autism may result not only from syndrome specific causal processes, but also from variability in generic, non-syndrome specific…

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

    PubMed Central

    van der Watt, Christelle; de Beer, Joe F

    2015-01-01

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

  15. The Transcallosal Anterior Interfoniceal Approach: A Microsurgical Anatomy Study

    PubMed Central

    Graziano, F.; Ganau, M.; Meccio, F.; Iacopino, D. G.; Ulm, A. J.

    2014-01-01

    Objectives A plethora of surgical strategies have been described to reach deep-seated lesions situated within the third ventricle including the Rosenfeld, or transcallosal anterior interfoniceal (TAIF), approach. First introduced in 2001, it consists of a small callosotomy followed by the midline transseptal dissection of fornices to enter the roof of the third ventricle. The aim of this microsurgical anatomy study is to describe and show each stage of the surgical procedure, focusing on the possible trajectories to anatomical landmarks. Participants A total of 20 adult cadaveric specimens were used in this study. Using ×3 to ×40 magnifications, the surgical dissection was performed in a stepwise fashion, and the transcallosal anterior interforniceal approach was performed, analyzed, and described. Results In 5 specimens of 10, a cavum septum pellucidum was depicted. In 5 cases of 20 after the callosotomy ,the lateral ventricular cavities were reached. Different orientation of the microscope allowed us to define three surgical trajectories to visualize the region of interest without exposing important functional areas. Conclusion The TAIF represents a minimally invasive approach to the third ventricle; its tricky surgical steps make appropriate anatomical dissection training essential to become confident and skilled in performing this approach. PMID:26225299

  16. A multi-disciplinary approach to congenitally missing anterior teeth.

    PubMed

    Galler, David; Quiong, Caroline; Galler, Jeffrey

    2009-01-01

    Congenitally missing teeth are not an unusual occurrence. What makes this case study unique is the combination of restorative challenges offered. The patient presented with the permanent upper right cuspid and lower anterior right and left central incisors congenitally missing, and with an underdeveloped upper right lateral incisor. Distinctive existing occlusion and tooth alignment difficulties precluded a simple approach of merely extracting the residual primary teeth and replacing the missing teeth prosthetically. Using orthodontics to create ideal interocclusal and interarch space was critical in preparing this case for prosthetic restoration.

  17. Anatomical reconstruction of the anterior cruciate ligament: a logical approach.

    PubMed

    Gali, Julio Cesar

    2015-01-01

    We describe the surgical approach that we have used over the last years for anterior cruciate ligament (ACL) reconstruction, highlighting the importance of arthroscopic viewing through the anteromedial portal (AMP) and femoral tunnel drilling through an accessory anteromedial portal (AMP). The AMP allows direct view of the ACL femoral insertion site on the medial aspect of the lateral femoral condyle, does not require guides for anatomic femoral tunnel reaming, prevents an additional lateral incision in the distal third of the thigh (as would be unavoidable when the outside-in technique is used) and also can be used for double-bundle ACL reconstruction.

  18. Anatomical reconstruction of the anterior cruciate ligament: a logical approach

    PubMed Central

    Gali, Julio Cesar

    2015-01-01

    We describe the surgical approach that we have used over the last years for anterior cruciate ligament (ACL) reconstruction, highlighting the importance of arthroscopic viewing through the anteromedial portal (AMP) and femoral tunnel drilling through an accessory anteromedial portal (AMP). The AMP allows direct view of the ACL femoral insertion site on the medial aspect of the lateral femoral condyle, does not require guides for anatomic femoral tunnel reaming, prevents an additional lateral incision in the distal third of the thigh (as would be unavoidable when the outside-in technique is used) and also can be used for double-bundle ACL reconstruction. PMID:26417571

  19. Current approach in diagnosis and management of anterior uveitis

    PubMed Central

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

    2010-01-01

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

  20. Keyhole Approach Combined With External Ventricular Drainage for Ruptured, Poor-Grade, Anterior Circulation Cerebral Aneurysms

    PubMed Central

    Zheng, Shu-Fa; Yao, Pei-Sen; Yu, Liang-Hong; Kang, De-Zhi

    2015-01-01

    Abstract Poor-grade ruptured anterior circulation cerebral aneurysms are frequently associated with severe vasospasm and high morbidity rates despite recent remarkable advances in endovascular coiling. Here, we explored the feasibility of keyhole approach combined with external ventricular drainage for ruptured, poor-grade, anterior circulation cerebral aneurysms. We retrospectively assessed the records of 103 patients with ruptured, Hunt and Hess grade IV or V, anterior circulation cerebral aneurysms. The patients were divided into 2 groups (conservative group and surgical group). In surgical group, patients were divided into 2 subgroups according to surgical time (within 24 hours and at 24–48 hours). Clinical outcome was assessed at the 6-month follow-up and categorized according to modified Rankin Scale (mRS) score. Twenty percent of patients (9/44) in conservative group obtained good outcome, while 54% (32/54) in surgical group (P < 0.05). Mortality was 73% in conservative group and 40% in surgical group, respectively. In surgical group, age, Hunt and Hess grade (IV or V), and timing of intervention (<24 hours or later) influenced the clinical outcome of the patients (P < 0.05), while sex, Fisher grade, hydrocephalus, the location of aneurysms, and cerebral vasospasm (CVS) not (P > 0.05). Furthermore, 65% of patients (22/34) operated within 24 hours after onset of hemorrhage had a good outcome compared with 20% of patients (5/25) operated at 24 to 48 hours in surgical group (P < 0.05). The results indicate that keyhole approach combined with external ventricular drainage is a safe and reliable treatment for ruptured, poor-grade, anterior circulation cerebral aneurysms in early stage, which will reduce mortality. PMID:26705215

  1. Transthoracic approach for lesions involving the anterior dorsal spine: A multidisciplinary approach with good outcomes

    PubMed Central

    Balasubramaniam, Srikant; Tyagi, Devendra K; Zafar, Sheikh H; Savant, Hemant V

    2016-01-01

    Introduction: Anterior approach provides excellent visualization and access to the anterior thoracic spine. It may be used alone, in combination with a posterior midline approach or in a staged or sequential fashion. Aims: To analyse our institutional experience in transthoracic approaches and to determine the safety and benefit of this approach in our patient series. Materials and Methods: A total of 16 patients were operated for varying lesions of body of dorsal vertebra by the transthoracic approach. The study was for a period of 5 years from January 2011 to December 2015. Patients age ranged from 25 to 61 years with an average of 36.4 yrs. There were 7 males and 9 females. In our series 9 patients had Kochs spine, 4 patients were traumatic fracture spine and 3 had neoplastic lesion. Majority of patients had multiple symptoms with backache being present in all patients. Results: There was one post operative mortality which was unrelated to surgery. One patient had post operative delayed kyphosis. Remaining patients improved in their symptoms following surgery. Conclusion: With careful coordination by thoracic surgeons, neurospinal surgeons and anaesthetists, the anterior spine approach for dorsal spine is safe and effective. Adequate preoperative evaluation should stratify the risk and institute measures to reduce it. Accurate surgical planning and careful surgical technique are the key to yield a good outcome and to reduce the risk of complications. PMID:27891033

  2. [Therapeutic approaches using genetically modified cells].

    PubMed

    Anliker, Brigitte; Renner, Matthias; Schweizer, Matthias

    2015-11-01

    Medicinal products containing genetically modified cells are, in most cases, classified as gene therapy and cell therapy medicinal products. Although no medicinal product containing genetically modified cells has been licensed in Europe yet, a variety of therapeutic strategies using genetically modified cells are in different stages of clinical development for the treatment of acquired and inherited diseases. In this chapter, several examples of promising approaches are presented, with an emphasis on gene therapy for inherited immunodeficiencies and on tumour immunotherapy with genetically modified T-cells expressing a chimeric antigen receptor or a recombinant T-cell receptor.

  3. Image-guided modified deep anterior lamellar keratoplasty (DALK) corneal transplant using intraoperative optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Tao, Yuankai K.; LaBarbera, Michael; Ehlers, Justis P.; Srivastava, Sunil K.; Dupps, William J.

    2015-03-01

    Deep anterior lamellar keratoplasty (DALK) is an alternative to full-thickness corneal transplant and has advantages including the absence of allograft rejection; shortened duration of topical corticosteroid treatment and reduced associated risk of glaucoma, cataract, or infection; and enables use of grafts with poor endothelial quality. DALK begins by performing a trephination of approximately 80% stromal thickness, as measured by pachymetry. After removal of the anterior stoma, a needle is inserted into the residual stroma to inject air or viscoelastic to dissect Descemet's membrane. These procedures are inherently difficult and intraoperative rates of Descemet's membrane perforation between 4-39% have been reported. Optical coherence tomography (OCT) provides high-resolution images of tissue microstructures in the cornea, including Descemet's membrane, and allows quantitation of corneal layer thicknesses. Here, we use crosssectional intraoperative OCT (iOCT) measurements of corneal thickness during surgery and a novel micrometeradjustable biopsy punch to precision-cut the stroma down to Descemet's membrane. Our prototype cutting tool allows us to establish a dissection plane at the corneal endothelium interface, mitigates variability in cut-depths as a result of tremor, reduces procedure complexity, and reduces complication rates. iOCT-guided modified DALK procedures were performed on 47 cadaveric porcine eyes by non-experts and achieved a perforation rate of ~5% with a mean corneal dissection time <18 minutes. The procedure was also successful performed on a human donor eye without perforation. Our data shows the potential for iOCT-guided precision anterior segment surgery without variability as a result of tremor and improvements to standard clinical care.

  4. A Modified Dual-plane Technique Using the Serratus Anterior Fascia in Primary Breast Augmentation

    PubMed Central

    Hwang, Dong Yeon; Park, Sang Hoon

    2017-01-01

    Background: Breast augmentations are commonly performed aesthetic surgical procedures. As the breast is a changeable structure, the ideal location of an implant would be a plane that can adjust to the dynamic changes of the breast. We present a modified dual-plane technique for breast augmentation using the fascia for thin patients. Methods: Between June 2014 and June 2015, 27 patients with small breasts underwent breast augmentation using the modified dual-plane technique. The average age was 29.4 years (range, 20–41 y). The mean body mass index was 18.9 kg/m2 (range, 17.6–20.4 kg/m2). Results: The mean size of the implant was 288.9 ml (range, 255–360 ml) on the right side and 281.6 ml (range, 255–360 ml) on the left side. All the patients returned to daily-life activities within 1 week. There have been no complications during minimum follow-up periods of 18 months. The mean follow-up was 25.6 months (range, 18–36 mo). Conclusions: Visible, palpable implants and rippling after breast augmentation with implants are relatively common problems. Our modified dual-plane technique with the serratus anterior fascia can reduce visible rippling and yields a natural-looking breast, especially in thin patients. PMID:28280660

  5. Retractorless Surgery for Anterior Circulation Aneurysms via a Pterional Keyhole Approach.

    PubMed

    Yu, Liang-Hong; Yao, Pei-Sen; Zheng, Shu-Fa; Kang, De-Zhi

    2015-12-01

    Brain retraction is required during many intracranial procedures to provide more working space. However, it is difficult to avoid brain retraction injury. Here, we report on retractorless surgery for anterior circulation aneurysms via a pterional keyhole approach. All patients undergoing a minimally invasive pterional keyhole approach within 3 days after hemorrhage by the same surgeon were included in the study. Patients were randomly assigned into group I (with the retractorless technique) and group II (with fixed retractors). Data on adequate clipping level, intraoperative ischemia induced by retraction, operation time, brain retraction injury, intraoperative blood loss, intraoperative aneurysm rupture, and modified Rankin Scale were collected for the 2 groups. A consecutive series of 47 patients (21 patients in group I, 26 patients in group II) successfully underwent a minimally invasive pterional keyhole approach. Statistical analysis revealed no significant between-group differences with regard to sex, age, Hunt-Hess grade, adequate clipping level, operation time, intraoperative blood loss, and aneurysm rupture (P > 0.05). However, no intraoperative ischemia was detected in group I, whereas 23.1% (6 of 26) of patients in group II had reversible ischemia. Furthermore, the proportion of brain retraction injuries in group I (5.3%) was lower than that in group II (34.6%). In addition, a better prognosis was obtained in patients who underwent retractorless surgery. With the careful and accurate use of a handheld suction device and operating instruments, the retractorless technique can replace fixed retraction, reduce brain retraction injury, and is applicable to surgeries on anterior circulation aneurysms via pterional keyhole approaches.

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

    PubMed Central

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

    2015-01-01

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

  7. Modified Pfannenstiel approach for radical retropubic prostatectomy.

    PubMed

    Manoharan, M; Gomez, Pablo; Sved, Paul; Soloway, Mark S

    2004-08-01

    Radical retropubic prostatectomy is traditionally performed using a vertical midline incision and occasionally using a transverse Pfannenstiel incision. We describe a technique for performing radical retropubic prostatectomy using a modified Pfannenstiel approach. This involves a Y incision of the rectus sheath, instead of a pure transverse incision, and provides both excellent exposure and better cosmetic results.

  8. Neglected anterior dislocation of shoulder with large Hillsach's lesion & deficient glenoid: Treated by autogenous bone graft & modified Latarjet procedure☆

    PubMed Central

    Peshin, Chetan; Jangira, Vivek; Gupta, Ravi Kumar; Jindal, Rohit

    2015-01-01

    Neglected anterior dislocation of shoulder is rare in spite of the fact that the anterior dislocation of the shoulder is seen in around 90% of the acute cases. Most of the series of neglected dislocation describe posterior dislocation to be far more common.1,2 We hereby report a case of the neglected anterior shoulder dislocation in a 15 year old boy who had a history of epilepsy. There was a large Hill Sachs lesion in humeral head which was impacted in glenoid inferiorly and glenoid was eburnated at that margin. The humeral head was reconstructed with a tricortical iliac graft. Glenoid was reconstructed by transfer of coracoids process of scapula to antero-inferior glenoid (modified Latarjet procedure). This case is unique because management of humeral head defect with bone graft is not mentioned in anterior dislocation. PMID:26566343

  9. Use of a modified anterior inclined plane in the treatment on the dentoskeletal Class II division 2 patient.

    PubMed

    Rao, S A; Thomas, A M; Chopra, S

    2010-01-01

    Class II malocclusions are seen due to the underdevelopment of the mandible in most of the cases. To compensate for the mandible retrusive position, there is flaring of the lower anterior teeth or retroclination of the central incisors as a compensatory mechanism seen in Class II division 2 type of malocclusion. This case report evaluates the skeletal and dental changes when a 12-year-old female patient with Class II div 2 malocclusion was treated with a modified anterior inclined plane. The postreatment data suggested that there were no significant changes in the vertical skeletal parameters. The upper central incisors were significantly realigned by proclination along with retroclination of the lateral incisors. There was significant increase in the mandibular length. The results revealed that the modified anterior inclined plane showed good results in the treatment of a case of Class II div 2 malocclusion.

  10. A Guided, Conservative Approach for the Management of Localized Mandibular Anterior Tooth Wear.

    PubMed

    Mehta, Shamir B; Francis, Selar; Banerji, Subir

    2016-03-01

    The successful management of the worn mandibular anterior dentition may present an awkward challenge to the dental operator. The purpose of this article is to describe a case report illustrating the use of a guided, three-dimensional protocol for the ultra-conservative and predictable restoration of the worn lower anterior dentition using direct resin composite. This technique utilizes information based on established biomechanical and occlusal principles to fabricate a diagnostic wax-up, which is duplicated in dental stone. This is used to prepare a vacuum-formed modified stent, assisting the clinician to place directly bonded resin composite restorations to restore the worn lower anterior dentition. The technique, described in 2012 and referred to as 'injection moulding' has the potential to offer optimal form, function and an aesthetic outcome in an efficient manner. CPD/Clinical Relevance: This article aims to describe an alternative technique to simplify the processes involved with restoration of worn lower anterior teeth.

  11. Anterior Ridge Extension Using Modified Kazanjian Technique in Mandible- A Clinical Study

    PubMed Central

    Kumar, Jagannadham Vijay; Chakravarthi, Pandi Srinivas; Sridhar, Meka; Devi, Kolli Naga Neelima; Lingamaneni, Krishna Prasad

    2016-01-01

    Introduction Good alveolar ridge is a prerequisite for successful conventional/ implant supported partial/complete denture. Extensively resorbed ridges with shallow vestibule and high insertion of muscles in to the ridge crest, leads to failure of prosthesis. Success of prosthesis depends on surgical repositioning of mucosa and muscle insertions, which increases the depth of vestibule and denture flange area for retention. So, the study was planned to provide good attached gingiva with adequate vestibular depth using Modified Kazanjian Vestibuloplasty (MKV). Aim To evaluate efficacy of MKV technique for increasing vestibular depth in anterior mandible so that successful prosthesis can be delivered. Efficacy of the technique was evaluated through operating time required, vestibular depth achieved, scarring or relapse and any postoperative complications associated with the healing. Materials and Methods Total of 10 patients were included in the study, who had minimum 20mm of bone height and less than 5mm of vestibular depth for MKV procedure. The results were tabulated and statistical analysis was carried out to assess vestibular depth achieved i.e. from crest of the ridge to junction of attached mucosa both pre and postoperatively. The study results were compared with existing literature. Results Healing of raw surface was uneventful with satisfactory achievement of vestibular depth. The average gain in vestibular depth was 11 mm. The patients had good satisfaction index for prosthesis. Conclusion Even in the era of implant prosthesis Modified Kazanjian technique is worth to practice to achieve good results and overcorrection is not required as that of standard Kazanjian technique. It provides adequate attached gingiva for successful prosthesis. Extension of vestibular depth enables fabrication of better denture flange with improved oral hygiene. This technique does not require hospitalization and additional surgery for grafts. PMID:27042579

  12. Surgical treatment of Lenke 5 adolescent idiopathic scoliosis: Comparison of anterior vs posterior approach

    PubMed Central

    Abel, Mark F; Singla, Anuj; Feger, Mark A; Sauer, Lindsay D; Novicoff, Wendy

    2016-01-01

    AIM To compare the posterior vs anterior approaches for fusion of Lenke 5 adolescent idiopathic scoliosis curves, matched for curve magnitude and for the distal level of fixation (dLOF) standardized to the third lumbar vertebrae (L3). METHODS A prospectively collected multicenter database was used for this retrospective comparative study. Our dependent variables included sagittal and coronal radiographic measurements, number of fused vertebrae, estimated blood loss, length of hospitalization and SRS total and individual domain scores at the two-year follow-up. Subject demographics were similar for all group comparisons. Independent t-test was used to compare groups for all analyses at P < 0.01. RESULTS For all matched cases of Lenke 5 curves, a selective approach was used only 50% of the time in cases undergoing a posterior fusion. When comparing a posterior selective approach to an anterior selective approach, surgeons utilizing a posterior approach fused significantly more levels than surgeons using an anterior approach with no other significant differences in radiographic or SRS outcomes (Ant = 4.8 ± 1.0 levels vs post = 6.1 ± 1.0 levels, P < 0.0001). When the dLOF was standardized to L3, the anterior approached provided significantly greater lumbar Cobb percent correction than the posterior approach (Ant = 69.1% ± 12.6% vs post = 54.6% ± 16.4%, P = 0.004), with no other significant radiographic or SRS score differences between approaches. CONCLUSION Surgeons treating Lenke 5c curves with a posterior instrumentation and fusion vs an anterior approach include more motion segments, even with a selective fusion. When controlled for the distal level of fixation, the anterior approach provides greater correction of the thoracolumbar curve. PMID:27672568

  13. Constructal approach to bio-engineering: the ocular anterior chamber temperature

    NASA Astrophysics Data System (ADS)

    Lucia, Umberto; Grisolia, Giulia; Dolcino, Daniela; Astori, Maria Rosa; Massa, Eugenio; Ponzetto, Antonio

    2016-08-01

    The aim of this work was to analyse the pressure inside the eyes anterior chamber, namedintraocular pressure (IOP), in relation to the biomechanical properties of corneas. The approach used was based on the constructal law, recently introduced in vision analysis. Results were expressed as the relation between the temperature of the ocular anterior chamber and the biomechanical properties of the cornea. The IOP, the elastic properties of the cornea, and the related refractive properties of the eye were demonstrated to be dependent on the temperature of the ocular anterior chamber. These results could lead to new perspectives for experimental analysis of the IOP in relation to the properties of the cornea.

  14. Constructal approach to bio-engineering: the ocular anterior chamber temperature

    PubMed Central

    Lucia, Umberto; Grisolia, Giulia; Dolcino, Daniela; Astori, Maria Rosa; Massa, Eugenio; Ponzetto, Antonio

    2016-01-01

    The aim of this work was to analyse the pressure inside the eyes anterior chamber, namedintraocular pressure (IOP), in relation to the biomechanical properties of corneas. The approach used was based on the constructal law, recently introduced in vision analysis. Results were expressed as the relation between the temperature of the ocular anterior chamber and the biomechanical properties of the cornea. The IOP, the elastic properties of the cornea, and the related refractive properties of the eye were demonstrated to be dependent on the temperature of the ocular anterior chamber. These results could lead to new perspectives for experimental analysis of the IOP in relation to the properties of the cornea. PMID:27492652

  15. Clinical approach to anterior adhesive restorations using resin composite veneers.

    PubMed

    Mangani, Francesco; Cerutti, Antonio; Putignano, Angelo; Bollero, Raffaele; Madini, Lorenzo

    2007-01-01

    Scientific progress in adhesive dentistry has led to more conservative techniques, both direct and indirect, to solve esthetic problems in anterior teeth. This article will discuss only indirect techniques, which are clearly superior in complex cases in which it will be difficult to recreate harmonious tooth shape and color. After reviewing the literature and highlighting the properties of this technique, the indications and benefits compared to the direct technique will be assessed. This is followed by a step-by-step description of operative procedures, from treatment planning to relining and polishing of the cemented adhesive restoration. The long-term success of veneers depends mainly on the tooth preparation, which should be confined to enamel, involve proximal contact areas, maintain the cervical enamel margin, and incorporate the incisal edge to increase veneer resistance and enable correct placement. Although no clinical follow-up similar to that of ceramic materials is available, the latest-generation resin composites offer interesting features. They can withstand mechanical stress, have excellent esthetic properties, and, most importantly, can be repaired intraorally without impairing their physicochemical and mechanical properties.

  16. Application of the cervical subaxial anterior approach at C2 in select patients.

    PubMed

    Zhang, Ying; Zhang, Jing; Wang, Xinwei; Chen, Deyu; Yuan, Wen

    2013-05-01

    The purpose of this study was to assess the feasibility and radiographic indications of using the subaxial anterior approach for decompression and fusion at C2. Anterior exposure at C2 was difficult and associated with increased morbidity. The subaxial anterior approach is easy and familiar to spine surgeons but did not provide satisfying exposure in all patients. This article describes a series of patients undergoing anterior surgery involving C2 through the subaxial anterior approach. Patients were selected based on lateral extension radiographs showing a mandibular angle higher than the C3 upper endplate. Forty-two patients (29 men and 13 women) with average age of 45 years and an average follow-up of 9.7 months were reviewed. Etiologies included Hangman's fracture (n=35), traumatic disk herniation at C2-C3 (n=1), C3 fracture (n=2), ossification of the posterior longitudinal ligament (n=2), and tumor (n=2). Single-level diskectomy (n=36) and corpectomy (n=6) were performed. Exposure was satisfactory, and operations went smoothly in all patients except in 1 man with a muscular neck. One (2.4%) postoperative complication of choking and trouble swallowing liquids was observed and diminished in 3 months with no treatment. Pre- and postoperative Japanese Orthopaedic Association scores were 13.86 ± 2.25 and 16.50 ± 0.76, respectively, with an improvement rate of 85% ± 24% in 14 patients who had preoperative neurological dysfunction. A fusion rate of 100% was achieved. The subaxial anterior approach may be simple and safe for exposure at C2 in select patients. Complicated exposure, such as the transoral or retropharyngeal approach, should be avoided in these patients.

  17. Perioperative Outcomes in Patients Undergoing the Transglabellar/Subcranial Approach to the Anterior Skull Base

    PubMed Central

    Pepper, Jon-Paul; Ward, P. Daniel; Lin, Erin M.; Sullivan, Stephen E.; Hecht, Sarah L.; Marentette, Lawrence J.

    2011-01-01

    We analyzed the effect of predefined patient demographic, disease, and perioperative variables on the rate of complications in the perioperative period following subcranial surgery for anterior skull base lesion. A secondary goal of this study was to provide a benchmark rate of perioperative mortality and morbidity through comprehensive analysis of complications. Retrospective review of a consecutive series of patients (n = 164) who underwent the transglabellar/subcranial approach to lesions of the anterior skull base between December 1995 and November 2009 in a tertiary referral center. Main outcome measures were perioperative morbidity and mortality. No perioperative mortalities were observed over the period of consecutive review. The overall complication rate was 28.7%, with 30 (18%) patients experiencing major complication. Multivariate analysis revealed that the following variables were independent predictors of perioperative complication of any type: positive margins on final pathology, perioperative lumbar drain placement, and dural invasion. The subcranial approach provides excellent access to the anterior skull base with zero mortality and acceptable morbidity in comparison with other contemporary open surgical approaches. It should be considered a procedure with distinct advantages in terms of perioperative morbidity and mortality when selecting a therapeutic approach for patients with anterior skull base lesions. PMID:22470264

  18. Aesthetic approach for anterior teeth with enamel hypoplasia

    PubMed Central

    Martos, Josué; Gewehr, Andréa; Paim, Emanuele

    2012-01-01

    Enamel hypoplasia is a developmental defect of the enamel that is produced by a disturbance in the formation of the organic enamel matrix, clinically visible as enamel defects. Disorders that occur during the stages of enamel development and maturation reduce the amount or thickness of the enamel, resulting in white spots, tiny grooves, depressions and fissures in the enamel surface. The complexity and intensity of the dental deformity lesions will conduct the ideal treatment-associating conservative techniques. This article presents a case report of a restorative treatment of enamel hypoplasia using hybrid composite resin to mask color alteration and enamel defects. An aesthetic appearance that respects the tooth polychromatic and the self-esteem of the patient can be achieved with this approach. PMID:22629075

  19. Giant Anterior Chest Wall Basal Cell Carcinoma: An Approach to Palliative Reconstruction

    PubMed Central

    Prendergast, Christina; Leis, Amber

    2016-01-01

    Anterior chest wall giant basal cell carcinoma (GBCC) is a rare skin malignancy that requires a multidisciplinary treatment approach. This case report demonstrates the challenges of anterior chest wall GBCC reconstruction for the purpose of palliative therapy in a 72-year-old female. Surgical resection of the lesion included the manubrium and upper four ribs. The defect was closed with bilateral pectoral advancement flaps, FlexHD, and pedicled VRAM. The palliative nature of this case made hybrid reconstruction more appropriate than rigid sternal reconstruction. In advanced metastatic cancers, the ultimate goals should be to avoid risk for infection and provide adequate coverage for the defect. PMID:28083152

  20. Clinical utility of a multigated modified anterior projection in the detection of left ventricular inferior and apical wall motion abnormalities

    SciTech Connect

    Polak, J.F.; Bianco, J.A.; Kemper, A.J.; Tow, D.E.

    1982-04-01

    Recent evidence indicates that the left anterior oblique projection (LAO) multigated radionuclide ventriculogram (RVG) underestimates presence and extent of apical and inferior left ventricular (LV) wall motion abnormalities. We investigated, prospectively, the sensitivity and specificity of a modified anterior projection (MAP), which incorporates cephalad tilting. Thirty-three consecutive patients undergoing cardiac catheterization suspected to have coronary artery disease were studied with RVG, using both the MAP and LAO views. LAO views were analyzed using the ejection fraction image (REFI), and the regional ejection fraction (REF) of the inferoapical region. The MAP studies were analyzed using stroke volume image (SVI) to evaluate apical and inferior LV regions. Results were as follows: (Formula: see text), Both intraobserver and interobserver variabilities were comparable to those of conventional angiographic studies used in detection of apical and inferior asynergy. It is concluded that the multigated MAP offers additional information about abnormalities of the LV inferior and apical regions.

  1. Anterior approach for operative fixation of coronoid fractures in complex elbow instability.

    PubMed

    Reichel, Lee M; Milam, Graham S; Reitman, Charles A

    2012-06-01

    The coronoid process has been shown to play a critical role in ulnohumeral stability. Coronoid process fractures can occur in isolation or as part of a complex injury pattern. The most common complex pattern, known as the "terrible triad," includes a radial head fracture and elbow dislocation along with the coronoid fracture. Failure to address these fractures and ligamentous injuries can result in recurrent instability and progression to painful arthrosis. Both medial and lateral approaches to the coronoid have been popularized in recent literature, but there is no universally accepted approach. Common fixation techniques include suture lasso, suture anchors, lag screws, and plating all of which have various drawbacks. We describe a direct anterior approach to address coronoid process fractures made in addition to a lateral approach to address radial head and lateral collateral ligament injuries. Coronoid fractures addressed through the anterior approach were stabilized with anterior to posterior screw fixation combined with buttress plating, which allowed anatomic reduction and stable internal fixation at short-term follow-up.

  2. Comparison of accuracy of anterior and superomedial approaches to shoulder injection: an experimental study

    PubMed Central

    Chernchujit, Bancha; Zonthichai, Nutthapon

    2016-01-01

    Introduction: We aimed to compare the accuracy between the standard anterior technique of shoulder injection and the new superomedial technique modified from Neviaser arthroscopic portal placement. Intra-articular placement, especially at the long head of biceps (LHB) tendon, and needle depth were evaluated. Methods: Fifty-eight patients (ages 57 ± 10 years) requiring shoulder arthroscopy in the beach-chair position were recruited. Needle punctures for both techniques were performed by an experienced sports medicine orthopedist. Patients were anesthetized, and the shoulder placed in the neutral position. A single needle was passed through the skin, with only one redirection allowed per trial. The superomedial technique was performed, then the anterior technique. Posterior-portal arthroscopy determined whether needle placement was inside the joint. The percentage of intra-articular needle placements for each technique defined accuracy. When inside the joint, the needle’s precise location was determined and its depth measured. A marginal χ2 test compared results between techniques. Results: The superomedial technique was significantly more accurate than the anterior technique (84% vs. 55%, p < 0.05). For superomedial versus anterior attempts, the LHB tendon was penetrated in 4% vs. 28% of patients, respectively, and the superior labrum in 35% vs. 0% of patients, respectively; the needle depth was 42 ± 7 vs. 32 ± 7 mm, respectively (all p < 0.05). Conclusions: The superomedial technique was more accurate, penetrating the LHB tendon less frequently than the standard anterior technique. A small-diameter needle was needed to minimize superior labral injury. The superomedial technique required a longer needle to access the shoulder joint. PMID:27163102

  3. Mini Transsternal Approach to the Anterior High Thoracic Spine (T1–T4 Vertebrae)

    PubMed Central

    Thakur, Bhaskar; Tsoti, Sandra Maria; Anichini, Giulio; Vergani, Francesco; Malik, Irfan

    2016-01-01

    Purpose. The anterior high thoracic spine is one of the most complex segments to be accessed surgically due to anatomical constraints and transitional characteristics. We describe in detail the mini transsternal approach to metastatic, infective, traumatic, and degenerative pathologies of T1 to T4 vertebral bodies. We analyse our surgical series, indications, and outcomes. Methods. Over a 5-year period 18 consecutive patients with thoracic myelopathy due to metastatic, infective, traumatic, and degenerative pathologies with T1 to T4 vertebral bodies involvement received a mini transsternal approach with intraoperative monitoring. Frankel scoring system was used to grade the neurological status. Results. Mean follow-up was 40 months. 78% patients improved in Frankel grade after surgery and 22% patients remained unchanged. Average operation time was 210 minutes. There were no intraoperative complications. One patient developed postoperative pneumonia successfully treated with antibiotics. Conclusion. The mini transsternal is a safe approach for infective, metastatic, traumatic, and degenerative lesions affecting the anterior high thoracic spine and the only one allowing an early and direct visualisation of the anterior theca. This approach overcomes the anatomical constraints of this region and provides adequate room for optimal reconstruction and preservation of spinal alignment in the cervicothoracic transition zone with good functional patient outcomes. PMID:27218104

  4. Mini Transsternal Approach to the Anterior High Thoracic Spine (T1-T4 Vertebrae).

    PubMed

    Brogna, Christian; Thakur, Bhaskar; Fiengo, Leslie; Tsoti, Sandra Maria; Landi, Alessandro; Anichini, Giulio; Vergani, Francesco; Malik, Irfan

    2016-01-01

    Purpose. The anterior high thoracic spine is one of the most complex segments to be accessed surgically due to anatomical constraints and transitional characteristics. We describe in detail the mini transsternal approach to metastatic, infective, traumatic, and degenerative pathologies of T1 to T4 vertebral bodies. We analyse our surgical series, indications, and outcomes. Methods. Over a 5-year period 18 consecutive patients with thoracic myelopathy due to metastatic, infective, traumatic, and degenerative pathologies with T1 to T4 vertebral bodies involvement received a mini transsternal approach with intraoperative monitoring. Frankel scoring system was used to grade the neurological status. Results. Mean follow-up was 40 months. 78% patients improved in Frankel grade after surgery and 22% patients remained unchanged. Average operation time was 210 minutes. There were no intraoperative complications. One patient developed postoperative pneumonia successfully treated with antibiotics. Conclusion. The mini transsternal is a safe approach for infective, metastatic, traumatic, and degenerative lesions affecting the anterior high thoracic spine and the only one allowing an early and direct visualisation of the anterior theca. This approach overcomes the anatomical constraints of this region and provides adequate room for optimal reconstruction and preservation of spinal alignment in the cervicothoracic transition zone with good functional patient outcomes.

  5. Stoppa Approach for Anterior Plate Fixation in Unstable Pelvic Ring Injury

    PubMed Central

    Choo, Suk Kyu; Kim, Jung-Jae; Lee, Mark

    2016-01-01

    Background The Stoppa (intrapelvic) approach has been introduced for the treatment of pelvic-acetabular fractures; it allows easy exposure of the pelvic brim, where the bone quality is optimal for screw fixation. The purpose of our study was to investigate the surgical outcomes of unstable pelvic ring injuries treated using the Stoppa approach for stable anterior ring fixation. Methods We analyzed 22 cases of unstable pelvic ring injury treated with plate fixation of the anterior ring with the Stoppa approach. We excluded cases of nondisplaced rami fracture, simple symphyseal diastasis, and parasymphyseal fractures, which can be easily treated with other techniques. The average age of the study patients was 41 years (range, 23 to 61 years). There were 10 males and 12 females. According to the Young and Burgess classification, there were 12 lateral compression, 4 anteroposterior compression, and 6 vertical shear fracture patterns. The fracture location on the anterior ring was near the iliopectineal eminence in all cases and exposure of the pelvic brim was required for plate fixation. All patients were placed in the supine position. For anterior plate fixation, all screws were applied to the anterior ramus distally and directed above the hip joint proximally. Radiologic outcomes were assessed by union time and quality of reduction by Matta method. The Merle d'Aubigne-Postel score was used to evaluate the functional results. Results The average radiologic follow-up period was 16 months (range, 10 to 51 months). All fractures united at an average of 3.5 months (range, 3 to 5 months). According to the Matta method, the quality of reduction was classified as follows: 16 anatomical (73%) and 6 nearly anatomical (27%) reductions. There were no cases of screw or implant loosening before bone healing. The functional results were classified as 7 excellent (32%), 12 good (55%), and 3 fair (13%) by the Merle d'Aubigne-Postel score. There were no wound complications

  6. Fully endoscopic supraorbital keyhole approach to the anterior cranial base: A cadaveric study

    PubMed Central

    Akçakaya, Mehmet Osman; Aras, Yavuz; İzgi, Nail; Gayretli, Özcan; Sabancı, Pulat Akın; Aydoseli, Aydın; Gürses, İlke Ali; Sencer, Altay; Öztürk, Adnan; Hepgül, Kemal

    2015-01-01

    Introduction: The supraorbital keyhole approach for anterior cranial base lesions has been increasingly used in clinical practice. Anatomical studies focusing on the endoscopic anatomy via this approach are few, although the microscopic anatomy has been well studied. The aim of this study is to describe the anatomical features and surgical exposure provided by the endoscopic supraorbital keyhole approach using quantitative measurements. Materials and Methods: Nine formalin-fixed human cadavers from the inventory of the Anatomy department were used. A total of 18 supraorbital keyhole cranitomies were conducted. The distances between the target anatomical structures and the dura mater at the craniotomy site, and the distances between deep anatomical structures were measured with purpose-designed hooks. Results: The distance between the dura mater and optic canal was measured as 69.5 ± 6.7 mm (62–83 mm); optic chiasm as 76.2 ± 5.4 mm (67–86 mm); anterior communicating artery as 82.6 ± 6.1 mm (71–93 mm); internal carotid artery (ICA) bifurcation as 74.7 ± 6.0 mm (66–84 mm) and the basilar tip as 94.9 ± 7.0 mm (87–111 mm). The mean diameter of the optic canal was 7.4 ± 1.3 mm (6–11 mm), whereas the mean diameter of diaphragma sellae was measured as 8.4 ± 1.1 mm (7–10 mm). Conclusions: The results of this study showed that the anterior and medial aspects of the anterior cranial fossa can be visualized properly. Dissection of the ipsilateral arteries of Circle of Willis can be performed easily using an endoscopic supraorbital keyhole approach. PMID:26167020

  7. Anterior limbal approach in the treatment of a late and extensive post-traumatic retrobulbar abscess.

    PubMed

    Karslioglu, Safak; Serin, Didem; Simsek, Ilke Bahceci

    2006-01-01

    The authors report a case of acute development of an extensive retrobulbar abscess 3 weeks after an orbital floor fracture. Urgent drainage of the abscess was performed by an anterior transconjunctival approach. A dramatic recovery was observed a few days following the operation. The visual acuity increased from hand motions to 0.7 to 0.8 in the early postoperative period and to 1.0 shortly thereafter. The severity of infection, the importance of antibiotic prophylaxis for blowout fractures, and the efficacy of the transconjunctival approach on the final visual and functional outcome are described.

  8. Exhaustible Resource Depletion: A Modified Graphical Approach.

    ERIC Educational Resources Information Center

    Tisato, Peter

    1995-01-01

    Presents a graphical analysis of the exhaustible resource depletion problem. Applies Hotelling's "r percent rule" as a new approach that operates in an "N"-period context. Includes two figures illustrating the approach. (CFR)

  9. Superciliary Keyhole Approach for Unruptured Anterior Circulation Aneurysms: Surgical Technique, Indications, and Contraindications

    PubMed Central

    2014-01-01

    Neurosurgeons have been trying to reduce surgical invasiveness by applying minimally invasive keyhole approaches. Therefore, this paper clarifies the detailed surgical technique, its limitations, proper indications, and contraindications for a superciliary keyhole approach as a minimally invasive modification of a pterional approach. Successful superciliary keyhole surgery for unruptured aneurysms requires an understanding of the limitations and the use of special surgical techniques. Essentially, this means the effective selection of surgical indications, usage of the appropriate surgical instruments with a tubular shaft, and refined surgical techniques, including straightforward access to the aneurysm, clean surgical dissection, and the application of clips with an appropriate configuration. A superciliary keyhole approach allows unruptured anterior circulation aneurysms to be clipped safely, rapidly, and less invasively on the basis of appropriate surgical indications. PMID:25535512

  10. Subtemporal-anterior transtentoral approach to middle cranial fossa microsurgical anatomy.

    PubMed

    Xu, Zhiming; Wang, Weimin; Zhang, Jingjing; Liu, Wei; Feng, Yugong; Li, Gang

    2014-11-01

    This study aimed to describe the topography of inferior and external dura mater of the middle cranial fossa through subtemporal-anterior transpetrosal approach and discuss the feasibility of improving the approach. Eight formalin-fixed adult cadaveric heads were studied, with the bones milled away in the lateral triangle region of the petrous bone, Kawase rhombus region, and inner triangle region of the petrous apex. The distances between the targets in these regions, as well as the angles after the dissection of zygomatic arch, were measured, and then the exposed petroclival and retrochiasmatic areas were observed under the microscope. There were significant variations in the distances between targets in the 3 milled regions among the specimens. After the dissection of zygomatic arch, the surgical view got an average increase of 12 degrees. The subtemporal anterior transpetrosal approach, as an improved subtemporal approach, can expose the lesions optimally, causing no injury to the hearing and reducing injuries to temporal lobe. On the other hand, the lateral bone of the petrous parts of the temporal bone is removed so as to improve the view to the retrochiasmatic area and expand the operative field.

  11. Esthetic Rehabilitation of Primary Anterior Teeth using Temporization Material: A Novel Approach

    PubMed Central

    Pandit, IK; Gupta, Monika; Nagpal, Jyoti

    2017-01-01

    Pediatric dentists should always aim for esthetic and functional rehabilitation of decayed/traumatized primary teeth. The most common method for restoring such teeth involves the use of “strip crowns” with composites, while the recent trend is toward using other extracoronal restorations including preve-neered stainless steel crowns and zirconia crowns. All these restorative options have shown good success rates, but also have some limitations. This case series depicts novel clinical technique of using a temporization material for full-coronal restoration(s) in primary anterior teeth. This included the chair-side custom fabrication of full-coronal restoration using temporization material, which has resulted in good immediate esthetics and might be a cost-effective alternative for restoring primary anterior teeth in future. How to cite this article Gugnani N, Pandit IK, Gupta M, Nagpal J. Esthetic Rehabilitation of Primary Anterior Teeth using Temporization Material: A Novel Approach. Int J Clin Pediatr Dent 2017;10(1):111-114.

  12. Kerboull-type plate in a direct anterior approach for severe bone defects at primary total hip arthroplasty: technical note

    PubMed Central

    Matsumoto, Mikio; Baba, Tomonori; Ochi, Hironori; Ozaki, Yu; Watari, Taiji; Homma, Yasuhiro; Kaneko, Kazuo

    2017-01-01

    Introduction: For cases with extensive acetabular bone defects, we perform surgery combining the Kerboull-type (KT) plate and bone graft through direct anterior approach (DAA) in primary total hip arthroplasty (THA) requiring acetabular reconstruction as minimally invasive surgery. This paper provides the details of the surgical procedure. Methods: The basic structure of the Kerboull-type plate is a cruciform plate. Since the hook of the Kerboull-type plate has to be applied to the tear drop, a space for it was exposed. The tear drop is located in the anterior lower region in surgery through DAA in supine position. It was also confirmed by fluoroscopy as needed. The bone grafting was performed using an auto- or allogeneic femoral head for bone defects in the weight-bearing region of the hip joint. Results: Of 563 patients who underwent primary THA between 2012 and 2014, THA using the KT plate through DAA was performed in 21 patients (3.7%). The mean duration of postoperative follow-up was 31.8 months. The mean operative time was 188.4 min, and the mean blood loss was 770 g. The patients became able to walk independently after 2.4 days on average (1–4 days). On clinical evaluation, the modified Harris Hip Score was 45.6 ± 12.4 before surgery, and it was significantly improved to 85.3 ± 8.97 on the final follow-up. Discussion: DAA is a true intermuscular approach capable of conserving soft tissue. Since it is applied in a supine position, fluoroscopy can be readily used, and it was very useful to accurately place the plate. PMID:28287388

  13. Agility to INBONE: anterior and posterior approaches to the difficult revision total ankle replacement.

    PubMed

    DeVries, J George; Scott, Ryan T; Berlet, Gregory C; Hyer, Christopher F; Lee, Thomas H; DeOrio, James K

    2013-01-01

    Total ankle replacement is now acknowledged as a viable alternative to ankle arthrodesis for end-stage ankle arthritis. The authors present a series of 14 patients who were converted from the Agility total ankle replacement to an INBONE total ankle replacement. This report is unique in that anterior and posterior approaches are discussed and detailed. Although the authors present successful conversion of the Agility total ankle replacement to an INBONE total ankle replacement, the difficulty of this procedure is demonstrated by the high complication rate and 2 early failures.

  14. Appraisal, work-up and diagnosis of anterior uveitis: a practical approach.

    PubMed

    Herbort, Carl P

    2009-10-01

    This article presents a comprehensive approach of the diagnosis of anterior uveitis and appropriate investigational tests based on clinical signs.Uveitis has classically been presented by uveitis specialists as an obscure and complicated field in ophthalmology that was supposed to be restricted to the happy few who had the knowledge, which in some countries was even prevented from being diffused. The effect was that ophthalmologists turned away from uveitis or were not correctly armed when they chose to take care of uveitis patients. The consequences of this situation often fell upon the patients. Since more than 15 years our group has been represented by the Society for Ophthalmo-Immunoinfectiology in Europe (SOIE), which has been working to alter this image of uveitis and ensure that the knowledge of the basics of uveitis reaches the practicing ophthalmologist. Our firm believe is that up to 70% of uveitis cases, especially anterior uveitis, can be taken care of by the practicing ophthalmologist following a structured approach in the appraisal of the uveitis case. Judging from the attendance obtained, the response to our approach in every country (where we organise courses) has been inversely proportional to the previous disinterest since we started publicizing it.

  15. Appraisal, Work-Up and Diagnosis of Anterior Uveitis: A Practical Approach

    PubMed Central

    Herbort, Carl P.

    2009-01-01

    This article presents a comprehensive approach of the diagnosis of anterior uveitis and appropriate investigational tests based on clinical signs. Uveitis has classically been presented by uveitis specialists as an obscure and complicated field in ophthalmology that was supposed to be restricted to the happy few who had the knowledge, which in some countries was even prevented from being diffused. The effect was that ophthalmologists turned away from uveitis or were not correctly armed when they chose to take care of uveitis patients. The consequences of this situation often fell upon the patients. Since more than 15 years our group has been represented by the Society for Ophthalmo-Immunoinfectiology in Europe (SOIE), which has been working to alter this image of uveitis and ensure that the knowledge of the basics of uveitis reaches the practicing ophthalmologist. Our firm believe is that up to 70% of uveitis cases, especially anterior uveitis, can be taken care of by the practicing ophthalmologist following a structured approach in the appraisal of the uveitis case. Judging from the attendance obtained, the response to our approach in every country (where we organise courses) has been inversely proportional to the previous disinterest since we started publicizing it. PMID:20404984

  16. A Combined Intradural Presigmoid-Transtransversarium-Transcondylar Approach to the Whole Clivus and Anterior Craniospinal Region

    PubMed Central

    Ammirati, Mario; Ma, Jianya; Canalis, Rinaldo; Martin, Neil; Black, Keith; Cheatham, Mel; Bloch, Joseph; Becker, Donald

    1993-01-01

    Surgical exposure of the clivus is difficult because of its proximity to vital neurovascular structures. The anatomic bases of a new surgical approach to this area are discussed. A supra-auricular skin incision is extended toward the posterior border of the sternocleidomastoid muscle. The vertebral artery is exposed from C2 to the occiput unroofing the foramen transversarium of C1. The bone removal consists of a posterior temporal craniotomy, a suboccipital craniectomy, including mastoidectomy with sigmoid sinus unroofing, removal of the lateral margin of the foramen magnum, of the medial third of the occipital condyle, and retrolabyrinthine petrous drilling. Posterior retraction of the vertebral artery facilitates occipital condyle drilling. Intradural exposure of the petroclival region is achieved by L-shaped cutting of the dura with the long branch placed infratentorially anterior to the sigmoid sinus. Intradural exposure of the craniospinal/upper cervical areas is achieved by cutting of the dura medial to the distal sigmoid sinus and by longitudinal cutting of the dura anterior to the vertebral artery. This approach allows multiple ports of entry to the clivus with full control of the vertebrobasilar system, and of the dural sinuses, and is anatomically suited for controlled removal of tumors located in these areas. This approach, or segments of it, has been used successfully in the treatment of large neoplasms of the craniovertebral junction. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10Figure 11 PMID:17170911

  17. Radical resection of a craniopharyngioma via the extradural anterior temporal approach with zygomatic arch osteotomy

    PubMed Central

    Ota, Nakao; Tanikawa, Rokuya; Miyama, Masataka; Miyazaki, Takanori; Kinoshita, Yu; Matsukawa, Hidetoshi; Yanagisawa, Takeshi; Sakakibara, Fumihiro; Saito, Norihiro; Miyata, Shiro; Noda, Kosumo; Tsuboi, Toshiyuki; Takeda, Rihei; Kamiyana, Hiroyasu; Tokuda, Sadahisa

    2016-01-01

    Background: Though the extradural anterior temporal approach (EDATA) with zygomatic osteotomy is useful, there are only few reports of this approach being used for craniopharyngioma resection. Herein, we report our surgical case series and the technical importance of EDATA for the radical removal of a craniopharyngioma. Methods: We report 7 cases of craniopharyngiomas treated surgically between April 1999 and October 2015. The surgical approaches, clinical presentation, pre and postoperative radiographic examination results, surgical outcomes, and morbidity were analyzed. Results: The mean follow-up period was 89.1 months. The surgical approach was EDATA with zygomatic osteotomy in 4, combined interhemispheric translamina terminalis approach (IHTLA) and trans-sylvian anterior temporal approach (ATA) in 2, and IHTLA in 1 patient. Complete tumor resection was achieved in all cases, without any recurrence during the follow-up period. Transient morbidities were oculomotor nerve palsy in 2, and meningitis and hydrocephalus in 1 patient. There was 1 case of permanent morbidity due to hydrocephalus that needed a ventriculoperitoneal shunt, and 1 case of blindness on the operative side. Visual acuity and visual field improved in 4 cases, showed no change in 2 cases, and deteriorated in 1 case. Though the pituitary stalk was preserved in 2 cases, all 7 cases needed total hormone replacement therapy. Conclusion: EDATA with zygomatic osteotomy ensures sufficient mobility of the internal carotid artery, and provides a good lateral and look up operative view. Hence, it can be used effectively for radical resection of craniopharyngiomas through the opticocarotid space and retrocarotid space. PMID:28194297

  18. Anterior Petrosectomy: Consecutive Series of 46 Patients with Attention to Approach-Related Complications

    PubMed Central

    Gompel, Jamie J. Van; Alikhani, Puya; Youssef, A. Samy; Loveren, Harry R. van; Boyev, K. Paul; Agazzi, Sivero

    2015-01-01

    Objective Anterior petrosectomy(AP) was popularized in the 1980s and 1990s as micro-neurosurgery proliferated. Original reports concentrated on the anatomy of the approach and small case series. Recently, with the advent of additional endonasal approaches to the petrous apex, the morbidity of AP remains unclear. This report details approach-related morbidity around and under the temporal lobe. Methods A total of 46 consecutive patients identified from our surgical database were reviewed retrospectively. Results Of the 46 patients, 61% were women. Median age of the patients was 50 years (mean: 48 ± 2 years). Median follow-up of this cohort was 66 months. Most procedures dealt with intradural pathology (n = 40 [87%]). Approach-related morbidity consisted of only two patients (4%) with new postoperative seizures. There were only two significant postoperative hemorrhages (4%). Cerebrospinal fluid leakage occurred in two patients (4%) requiring reoperation. Conclusion Approach-related complications such as seizures and hematoma were infrequent in this series, < 4%. This report describes a contemporary group of patients treated with open AP and should serve as a comparison for approach-related morbidity of endoscopic approaches. Given the pathologies treated with this approach, the morbidity appears acceptable. PMID:26401480

  19. Anterior Petrosectomy: Consecutive Series of 46 Patients with Attention to Approach-Related Complications.

    PubMed

    Van Gompel, Jamie J; Alikhani, Puya; Youssef, A Samy; Loveren, Harry R van; Boyev, K Paul; Agazzi, Sivero

    2015-09-01

    Objective Anterior petrosectomy(AP) was popularized in the 1980s and 1990s as micro-neurosurgery proliferated. Original reports concentrated on the anatomy of the approach and small case series. Recently, with the advent of additional endonasal approaches to the petrous apex, the morbidity of AP remains unclear. This report details approach-related morbidity around and under the temporal lobe. Methods A total of 46 consecutive patients identified from our surgical database were reviewed retrospectively. Results Of the 46 patients, 61% were women. Median age of the patients was 50 years (mean: 48 ± 2 years). Median follow-up of this cohort was 66 months. Most procedures dealt with intradural pathology (n = 40 [87%]). Approach-related morbidity consisted of only two patients (4%) with new postoperative seizures. There were only two significant postoperative hemorrhages (4%). Cerebrospinal fluid leakage occurred in two patients (4%) requiring reoperation. Conclusion Approach-related complications such as seizures and hematoma were infrequent in this series, < 4%. This report describes a contemporary group of patients treated with open AP and should serve as a comparison for approach-related morbidity of endoscopic approaches. Given the pathologies treated with this approach, the morbidity appears acceptable.

  20. High complication rate in the early experience of minimally invasive total hip arthroplasty by the direct anterior approach

    PubMed Central

    2012-01-01

    Background and purpose There is growing interest in minimally invasive surgery techniques in total hip arthroplasty (THA). In this study, we investigated the learning curve and the early complications of the direct anterior approach in hip replacement. Methods In the period January through December 2010, THA was performed in 46 patients for primary osteoarthritis, using the direct anterior approach. These cases were compared to a matched cohort of 46 patients who were operated on with a conventional posterolateral approach. All patients were followed for at least 1 year. Results Operating time was almost twice as long and mean blood loss was almost twice as much in the group with anterior approach. No learning effect was observed in this group regarding operating time or blood loss. Radiographic evaluation showed adequate placement of the implants in both groups. The early complication rate was higher in the anterior approach group. Mean time of hospital stay and functional outcome (with Harris hip score and Oxford hip score) were similar in both groups at the 1-year follow-up. Interpretation The direct anterior approach is a difficult technique, but adequate hip placement was achieved radiographically. Early results showed no improvement in functional outcome compared to the posterolateral approach, but there was a higher early complication rate. We did not observe any learning effect after 46 patients. PMID:22880711

  1. A team approach to anterior lumbar spine surgery in the military.

    PubMed

    Dua, Anahita; Fox, Jennifer; Patel, Bhavin; Martin, Eric; Rosner, Michael; Fox, Charles J

    2014-08-01

    We report a five year military experience with anterior retroperitoneal spine exposure combining vascular and neurosurgical spine teams. From August 2005 through April 2010 (56 months), hospital records from a single institution were retrospectively reviewed. Complications, estimated blood loss, transfusions, operative time and length of stay were documented. Eighty-four patients with lumbar spondylosis underwent primary (63, 75%) or secondary exposure (21, 25%) of a single- (66, 79%) or multilevel disc space (18, 21%). Median operative time and estimated blood loss were 127 minutes (range, 30-331 minutes) and 350 mL (range, 0-2940 mL). The overall complication rate was 23.8%. Postoperative complications included six blood transfusions (7%), three patients with retrograde ejaculation (3.57%) or surgical site infection; two with a prolonged ileus (2.38%) or ventral hernia and one each with a bowel obstruction (1, 1.19%), deep venous thrombosis or lymphocele. All-cause mortality was 1%. In conclusion, a team approach can minimize complications while offering the technical benefits and durability of an anterior approach to the lumbar spine.

  2. Anterior Approach Total Ankle Arthroplasty: Superficial Peroneal Nerve Branches at Risk.

    PubMed

    McAlister, Jeffrey E; DeMill, Shyler L; Hyer, Christopher F; Berlet, Gregory C

    2016-01-01

    In ankle arthroplasty, little attention has been given to intraoperative nerve injury and its postoperative sequelae. The aim of the present anatomic study was to determine the relationship of the superficial peroneal nerve to the standard anterior approach for total ankle arthroplasty. The superficial peroneal nerve was dissected in 10 below-the-knee cadaver specimens. The medial and intermediate dorsal cutaneous branches were identified. A needle was placed at the ankle joint. The following measurements were recorded: bifurcation into the medial and intermediate dorsal cutaneous branches, reference needle to the branches of the medial and intermediate superficial peroneal nerve, and the crossing branches of the medial dorsal cutaneous nerve. Two specimens (20%) had a medial dorsal cutaneous branch cross from medially to laterally. Eight specimens (80%) had a crossing branch of the medial dorsal cutaneous branch within 5 cm of the incision. No intermediate dorsal cutaneous branches were within the incision. The results from the present cadaver study suggest that during an anterior ankle approach, aberrant branches of the superficial peroneal nerve could require transection in 20% of patients at the joint level and ≤80% of patients with distal extension >35 mm from the ankle joint. The risk of injury to branches of the superficial peroneal nerve is substantial. The risk of nerve injury can be decreased with meticulous operative technique, smaller incisions, and the avoidance of aggressive retraction.

  3. Anhidrosis after anterior retroperitoneal approach for L4-L5 artificial disc replacement.

    PubMed

    Kasliwal, Manish K; Deutsch, Harel

    2011-07-01

    Description of injury to the sympathetic nervous system after the anterior approach to the lumbosacral spine remains restricted to reports of retrograde ejaculation in males occurring in 2% to 20% of patients. The authors describe a 46-year-old female who presented with low back pain for several years due to degenerative disk disease at L4-L5 that had been treated with an L4-L5 artificial disc replacement though a left anterior retroperitoneal approach. She has had an excellent outcome with complete resolution of her back pain, but noticed the development of dryness of her left lower limb with anhidrosis and skin breakdown, which has caused persistent discomfort. The complication had persisted at her 1-year follow up. Damage to the sympathetic system may often go unrecognized but present with subtle symptoms, as described in the present report. Sympathetic injury in women is often not addressed and remains unrecognized except for a few reports of vaginal dryness or anaesthesia. A short description of this unusual and underappreciated complication, which may be a cause of discomfort despite successful surgery, is presented.

  4. Retrocrural splanchnic nerve alchohol neurolysis with a CT-guided anterior transaortic approach

    SciTech Connect

    Fields, S.

    1996-01-01

    Retrocrural splanchnic nerve alcohol neurolysis with a CT-guided anterior transonic approach, a new method for splanchnic block alleviation of chronic abdominal pain, is described. Ten patients with chronic abdominal pain requiring narcotic treatment, six with pancreatic carcinoma, one with gastric carcinoma, two with chronic pancreatitis, and one with pain of unknown etiology, were referred for splanchnic nerve neurolysis. With CT guidance, a 20 gauge needle was placed through the aorta into the retrocrural space at T11-T12, and 5-15 ml 96% alcohol was injected into the retrocrural space. Following the procedure, 6 of 10 patients were pain free, 2 patients had temporary pain relief, and 2 patients were without response. There were no significant complications. CT-guided anterior transaortic retrocrural splanchnic nerve alcohol neurolysis is technically feasible, easier to perform than the classic posterolateral approach, and may have less risk of complications. The success rate in this initial trial was reasonable and, therefore, this technique provides an additional method for the treatment of abdominal pain. 12 refs., 2 figs.

  5. Biologic Approaches for the Treatment of Partial Tears of the Anterior Cruciate Ligament

    PubMed Central

    Dallo, Ignacio; Chahla, Jorge; Mitchell, Justin J.; Pascual-Garrido, Cecilia; Feagin, John A.; LaPrade, Robert F.

    2017-01-01

    Background: Anterior cruciate ligament reconstruction (ACLR) has been established as the gold standard for treatment of complete ruptures of the anterior cruciate ligament (ACL) in active, symptomatic individuals. In contrast, treatment of partial tears of the ACL remains controversial. Biologically augmented ACL-repair techniques are expanding in an attempt to regenerate and improve healing and outcomes of both the native ACL and the reconstructed graft tissue. Purpose: To review the biologic treatment options for partial tears of the ACL. Study Design: Review. Methods: A literature review was performed that included searches of PubMed, Medline, and Cochrane databases using the following keywords: partial tear of the ACL, ACL repair, bone marrow concentrate, growth factors/healing enhancement, platelet-rich plasma (PRP), stem cell therapy. Results: The use of novel biologic ACL repair techniques, including growth factors, PRP, stem cells, and bioscaffolds, have been reported to result in promising preclinical and short-term clinical outcomes. Conclusion: The potential benefits of these biological augmentation approaches for partial ACL tears are improved healing, better proprioception, and a faster return to sport and activities of daily living when compared with standard reconstruction procedures. However, long-term studies with larger cohorts of patients and with technique validation are necessary to assess the real effect of these approaches. PMID:28210653

  6. Esthetic Rehabilitation of a Severely Compromised Anterior Area: Combined Periodontal and Restorative Approach

    PubMed Central

    Censi, Rachele; Vavassori, Virna; Borgonovo, Andrea Enrico; Re, Dino

    2014-01-01

    The complete oral rehabilitation of patients demanding a beautiful and attractive smile involves a multidisciplinary approach that includes the change of both the morphological aspect of the teeth and the architecture of gum tissues. This clinical report describes a successful interdisciplinary approach for the treatment of an esthetically compromised dentition. In a first phase, the periodontal plastic surgery was performed for root coverage and, in particular, it was decided for the execution of a coronally advanced flap for the treatment of multiple recession defects. Once complete healing of soft tissues was obtained, six lithium disilicate veneers were placed over the anterior maxillary teeth. Lithium disilicate is a glass-based ceramic which presents excellent aesthetics and allows the passage of light without creating unnatural reflections. This feature has made it possible to recreate a natural aspect of teeth that in combination with the harmonic architecture of soft tissue has permitted obtaining a beautiful and pleasant smile. PMID:24715999

  7. Retrospective Evaluation of Efficiency and Safety of an Anterior Percutaneous Approach for Cervical Discectomy

    PubMed Central

    Schubert, Michael

    2014-01-01

    Study Design Retrospective case series. Purpose The purpose of the study was to evaluate the efficiency and complication rate of a percutaneous anterior approach to herniated cervical disks with or without concomitant foraminal stenosis and/or spondylosis. Overview of Literature Recent publications reflect that minimally invasive procedures gain in importance in patients and spine surgeons as they are generally associated with less tissue damage and shorter recovery times. However, for anterior percutaneous cervical discectomy, very little data is available for relevant patient populations. Methods Charts from patients with herniated cervical disc confirmed by magnetic resonance imaging, mainly radicular symptoms and irresponsive to conservative treatment who underwent anterior percutaneous discectomy were evaluated retrospectively. All patients were asked to return questionnaires that included visual analogue scores (VAS), MacNab score as well as subjective satisfaction data 2 years after surgery. Results Ninety-five patients were included. There were no neurological or vascular complications; only one patient suffered from transient hoarseness. During the two years after surgery, 9 patients underwent reoperation. 90.5% of the patients returned the questionnaire at 2 years' follow-up. 87.7% of them reported excellent or good outcome, 11.1% rated results as fair and 1.2% as unsatisfactory. On average, arm and neck pain improved significantly by 6.1 points and 5.8 points respectively on a ten point VAS. 94.5% stated that they would choose the same procedure again. Conclusions This procedure has proved a safe and sufficient option for symptomatic cervical disk herniations with or without concomitant spondylosis and/or foraminal stenosis. PMID:25187857

  8. Plant mediated green synthesis: modified approaches.

    PubMed

    Das, Ratul Kumar; Brar, Satinder Kaur

    2013-11-07

    Plant mediated green synthesis of different metallic nanoparticles has emerged as one of the options for implementation of green chemistry principles, and successfully made an important contribution towards green nanotechnology. However, beyond the synthesis and application aspects, the science of green synthesis has carried some wrong perceptions in an unforeseen fashion. In this review, some of the key issues related to the green synthesis of metallic nanoparticles employing plants as reducing/capping agents have been addressed. Random selection of plants and its overall impact on the different aspects of green synthesis have been discussed. Emphasis is given to the setting of some standard selection criteria to be adopted for selecting a plant for use in green synthesis. How selection of a plant can positively or negatively influence both procedure and products of a green synthesis process is the prime concern of this article. In addition to selection, the key issue of biocompatibility associated with green synthesized metallic nanoparticles has been considered. Both selection of plant and biocompatibility were reconsidered for their minute details in terms of synthesis, analysis and data interpretation in the green synthesis approach. The key factors capable of fine tuning the core meaning of "green" in the synthesis of any metallic nanoparticles were taken into consideration. This article is an effort towards keeping the core meaning of green synthesis.

  9. [Operative neurosurgery: personal view and historical backgrounds (3). Anterior circulation--pterional approach].

    PubMed

    Yonekawa, Yasuhiro

    2007-07-01

    Under the title of anterior circulation aneurysms and the pterional approach, followings are presented and emphasized along with mentioning their historical development in our present performance status. Pterional approach: head positioning with Mayfield-Kees fixation apparatus using one pin around the processus matoideus and the other 2 pins on the contralateral side behind the hair line the head turned 30 degrees and reclined chin-up l5-20 grade. Skin incision beginning just in front of the tragus ending up at the midline hair line in a curvilinear fashion always including the superficial temporal artery STA in its frontal branch and the facial nerve (frontal branch) in the skin flap. A muscle fascial preparation is so fashioned such that a strip of myofascial cuff is left at the linea temporalis and the temporal musculature is reflected and retracted towards the postero-basal direction in order to expose the pterion, for which a small short myofascial incision is added parallel to the skin incision towards the tragus up to several cm above it to prevent postoperative trismus. Bone flap is sawed out usually using three burr holes, at the key hole just at the proximal part of the linea temporalis, frontomedially on the squama frontalis and on the sutura squamosa, so that the Sylvian fissure and the superior temporal gyrus are exposed enough for further procedure. The sphenoid ridge is drilled away until the most lateral corner of the superior orbital fissure comes into view. Thus one has drilled away enough to do surgery in question at the skull base even at the time of "angry brain" due to subarachnoid hemorrhage SAH. This procedure can be followed by selective extradural anterior clinoidectomy SEAC in case of necessity. The dura is opened in a curvilinear fashion so that the dura can be reflected over the drilled sphenoid wing and so that the Sylvian fissure and the superior temporal gyrus is exposed for the treatment of aneurysms of the internal carotid artery

  10. "Lazy" far-lateral approach to the anterior foramen magnum and lower clivus.

    PubMed

    Moscovici, Samuel; Umansky, Felix; Spektor, Sergey

    2015-04-01

    The far-lateral approach (FLA) has become a mainstay for skull base surgeries involving the anterior foramen magnum and lower clivus. The authors present a surgical technique using the FLA for the management of lesions of the anterior/ anterolateral foramen magnum and lower clivus. The authors consider this modification a "lazy" FLA. The vertebral artery (VA) is both a critical anatomical structure and a barrier that limits access to this region. The most important nuance of this FLA technique is the management of this critical vessel. When the lazy FLA is used, the VA is reflected laterally, encased in its periosteal sheath and wrapped in the dura, greatly minimizing the risk for vertebral injury while preserving a wide working space. To accomplish this step, drilling is performed lateral to the point where the VA pierces the dura. The dura is incised medial to the VA entry point by using a slightly curved longitudinal cut. Drilling of the condyle and the C-1 lateral mass is performed in a manner that preserves craniocervical stability. The lazy FLA is a true FLA that is based on manipulation of the VA and lateral bone removal to obtain excellent exposure ventral to the spinal cord and medulla, yet it is among the most conservative FLA techniques for management of the VA and provides a safer window for bone work and lesion management. Among 44 patients for whom this technique was used to resect 42 neoplasms and clip 2 posterior inferior cerebral artery aneurysms, there was no surgical mortality and no injury to the VA.

  11. Retrograde approach to an ostial left anterior descending chronic total occlusion through a left internal mammary artery graft.

    PubMed

    Hari, Pawan; Kirtane, Ajay J; Bangalore, Sripal

    2016-05-01

    Retrograde approach to chronic total occlusions (CTO) has been described via saphenous vein grafts, septal and epicardial collaterals. We report for the first time a successful retrograde approach to an ostial left anterior descending (LAD) artery CTO through a failed left internal mammary artery (LIMA) to LAD anastamosis. This case demonstrates the technical aspects of using a LIMA conduit as a retrograde approach to CTO. © 2015 Wiley Periodicals, Inc.

  12. Anterior stromal puncture with staining: A modified technique for preoperative reference corneal marking for toric lenses and its retrospective analyses

    PubMed Central

    Bhandari, Sahil; Nath, Manas

    2016-01-01

    Introduction: Toric intraocular lenses (IOLs) are an effective way of compensating preexisting corneal astigmatism during cataract surgery. To achieve success, it is imperative to align the toric IOLs in desired position and preoperative reference marking is one among the three important steps for accurate alignment. To make the marking procedure simpler and effective, we have modified the conventional three-step slit lamp-based technique. Materials and Methods: Patient is seated in front of the slit lamp and asked to keep the chin over chin rest. A 26-gauge bent needle with tip stained by sterile blue ink marker is used to make anterior stromal puncture (ASP) at the edges of horizontal 180° axis near the limbus. Results: A total of 58 eyes were retrospectively evaluated. Mean (+/-SD) IOL deviation on day 1 and day 30 was 5.7 ± 6.5° and 4.7 ± 5.6°, respectively. Median IOL misalignment on day 1 and day 30 was 3°. Redialing of IOL was required in 2 (3.4%) eyes only, all of which were performed within 1 week of surgery. In total, 2 (3.7%) eyes had a residual astigmatism of − 0.5 Dcyl and − 1.0 Dcyl, respectively. Conclusion: ASP is an effective technique for reference marking, technically simpler and can be practiced by most of the surgeons. It avoids the necessity of high-end sophisticated machinery and gives a better platform for the reference corneal marking along with the benefit of reproducibility and simplicity. PMID:27688275

  13. Comparative study of the clinical effect and safety of anterior surgical approach and posterior surgical approach in the treatment of thoracolumbar spinal fracture

    PubMed Central

    Dengfeng, Zhang; Haojie, Wu; Xiao, Wang

    2015-01-01

    The clinical effect and safety of the anterior surgical approach and posterior surgical approach in the treatment of thoracolumbar spinal fracture was compared. Retrospective analyses of clinical data for 91 patients observed from March 2010 to September 2014 were made. The pre-operation and post-operation comparisons between two sets of Cobb’s angle, affected vertebra height, Frankel’s classification of spinal nerves, motion functions, and tactile functions showed statistically significant differences (P<0.05). After having the operation, the Cobb’s angle and affected vertebra height of the patient in the anterior approach group were both significantly higher than that of patients in the posterior approach group (P<0.05). The bone graft fusion rate of the patients in the anterior approach group 3 months after operation was higher than that of patients in the control group while the status of complications was worse than that of patients in the posterior approach group, both with a remarkable difference (P<0.05). Both the anterior surgical approach and posterior surgical approach have good clinical outcome for spinal fractures but they all have their respective adaption diseases. The key in the treatment of thoracolumbar spinal fractures lies in choosing proper operative approach. PMID:28352728

  14. Combining classical and molecular approaches elaborates on the complexity of mechanisms underpinning anterior regeneration.

    PubMed

    Evans, Deborah J; Owlarn, Suthira; Tejada Romero, Belen; Chen, Chen; Aboobaker, A Aziz

    2011-01-01

    The current model of planarian anterior regeneration evokes the establishment of low levels of Wnt signalling at anterior wounds, promoting anterior polarity and subsequent elaboration of anterior fate through the action of the TALE class homeodomain PREP. The classical observation that decapitations positioned anteriorly will regenerate heads more rapidly than posteriorly positioned decapitations was among the first to lead to the proposal of gradients along an anteroposterior (AP) axis in a developmental context. An explicit understanding of this phenomenon is not included in the current model of anterior regeneration. This raises the question what the underlying molecular and cellular basis of this temporal gradient is, whether it can be explained by current models and whether understanding the gradient will shed light on regenerative events. Differences in anterior regeneration rate are established very early after amputation and this gradient is dependent on the activity of Hedgehog (Hh) signalling. Animals induced to produce two tails by either Smed-APC-1(RNAi) or Smed-ptc(RNAi) lose anterior fate but form previously described ectopic anterior brain structures. Later these animals form peri-pharyngeal brain structures, which in Smed-ptc(RNAi) grow out of the body establishing a new A/P axis. Combining double amputation and hydroxyurea treatment with RNAi experiments indicates that early ectopic brain structures are formed by uncommitted stem cells that have progressed through S-phase of the cell cycle at the time of amputation. Our results elaborate on the current simplistic model of both AP axis and brain regeneration. We find evidence of a gradient of hedgehog signalling that promotes posterior fate and temporarily inhibits anterior regeneration. Our data supports a model for anterior brain regeneration with distinct early and later phases of regeneration. Together these insights start to delineate the interplay between discrete existing, new, and then

  15. A tissue engineering approach to anterior cruciate ligament regeneration using novel shaped capillary channel polymer fibers

    NASA Astrophysics Data System (ADS)

    Sinclair, Kristofer D.

    2009-12-01

    Ruptures of the anterior cruciate ligament (ACL) are the most frequent of injuries to the knee due to its role in preventing anterior translation of the tibia. It is estimated that as many as 200,000 Americans per year will suffer from a ruptured ACL, resulting in management costs on the order of 5 billion dollars. Without treatment these patients are unable to return to normal activity, as a consequence of the joint instability found within the ACL deficient knee. Over the last thirty years, a variety of non-degradable, synthetic fibers have been evaluated for their use in ACL reconstruction; however, a widely accepted prosthesis has been unattainable due to differences in mechanical properties of the synthetic graft relative to the native tissue. Tissue engineering is an interdisciplinary field charged with the task of developing therapeutic solutions for tissue and organ failure by enhancing the natural wound healing process through the use of cellular transplants, biomaterials, and the delivery of bioactive molecules. The capillary channel polymer (CC-P) fibers used in this research were fabricated by melt extrusion from polyethylene terephthalate and polybutylene terephthalate. These fibers possess aligned micrometer scale surface channels that may serve as physical templates for tissue growth and regeneration. This inherent surface topography offers a unique and industrially viable approach for cellular contact guidance on three dimensional constructs. In this fundamental research the ability of these fiber channels to support the adhesion, alignment, and organization of fibroblasts was demonstrated and found to be superior to round fiber controls. The results demonstrated greater uniformity of seeding and accelerated formation of multi-layered three-dimensional biomass for the CC-P fibers relative to those with a circular cross-section. Furthermore, the CC-P geometry induced nuclear elongation consistent with that observed in native ACL tissue. Through the

  16. A microsurgical anterior cervical approach and the immediate impact of mechanical retractors: A case control study

    PubMed Central

    Ramos-Zúñiga, Rodrigo; Díaz-Guzmán, Laura Rocío; Velasquez, Shannen; Macías-Ornelas, Ana Magdalena; Rodríguez-Vázquez, Martín

    2015-01-01

    Introduction: A microsurgical anterior cervical approach with discectomy and fusion (MACDF) is one of the most widely used procedures for treating radicular disorders. This approach is highly successful; however, it is not free from complications. These can be associated with soft tissue injuries. Aim of the Study: The recognition of the risks for these complications should be identified for timely prevention and safe treatment. Materials and Methods: Study Design: Retrospective case control study. This study includes a retrospective case series of 37 patients, paying special attention to immediate complications related to the use of mechanical retraction of soft tissue (dysphagia, dysphonia, esophageal lesions and local hematoma); and a comparative analysis of the outcomes after changes in the retraction method. Results: All selected cases had a positive neurological symptom response in relation to neuropathic pain. Dysphagia and dysphonia were found during the first 72 h in 94.1% of the cases in which automatic mechanical retraction was used for more than one hour during the surgical procedure. A radical change was noted in the reduction of the symptoms after the use of only manual protective blades without automatic mechanical retraction: 5.1% dysphagia and 0% dysphonia in the immediate post-operative period, P = 0.001. Conclusions: Soft tissue damage due to the use of automatic retractors in MACDF is not minor and leads to general discomfort in the patient in spite of good neurological results. These problems most often occur when automatic retractors are used continuously for more than 1 hour, as well as when they are used in multiple levels. Dysphagia, dysphonia and local pain decreased with the use of transient manual blades for retraction, and with intermittent release following minimally invasive principles. PMID:26167011

  17. A Modified Spontaneously Closed Defunctioning Tube Ileostomy After Anterior Resection of the Rectum for Rectal Cancer with a Low Colorectal Anastomosis.

    PubMed

    Sheng, Qin-Song; Hua, Han-Ju; Cheng, Xiao-Bin; Wang, Wei-Bing; Chen, Wen-Bin; Xu, Jia-He; Lin, Jian-Jiang

    2016-04-01

    The aim of this study is to introduce a new technique of modified spontaneously closed defunctioning tube ileostomy after anterior resection of the rectum for rectal cancer with a low colorectal anastomosis. Patients with rectal cancer who underwent anterior resection of rectum with a low colorectal anastomosis and chose a modified defunctioning tube ileostomy between March 2012 and August 2013 were retrospectively reviewed. Data on the success of the operation procedures, post-operative hospital stay, and post-operative tube ileostomy-related complications were analyzed. One hundred fifty-two patients (87 males and 65 females; 57.1 ± 17.4 years) undergoing the modified defunctioning tube ileostomy after anterior resection for rectal cancer were included. The post-operative hospital stay was 11.9 ± 3.2 days. The tube was removed on days 22.6 ± 4.1 after operation and the ileostomy wound closed spontaneously within 13.1 ± 1.9 days. Twenty-five patients felt tube-associated pain or discomfort, which was relieved after a period of adaptation and appropriate tube adjustment. Nine patients suffered from tube blockage and were treated successfully with saline irrigation. Two patients had intestinal obstruction, which was resolved with conservative treatment. Three patients developed leakage of the distal anastomosis: two were successfully treated with conservative measures and the other completely recovered after reoperation. The modified spontaneously closed defunctioning tube ileostomy appears efficacious and safe. This technique may be used to protect the distal anastomosis and simultaneously decrease the ileostomy complications, and minimize the morbidity and mortality associated with stoma takedown.

  18. A musculoskeletal modeling approach for estimating anterior cruciate ligament strains and knee anterior-posterior shear forces in stop-jumps performed by young recreational female athletes.

    PubMed

    Kar, Julia; Quesada, Peter M

    2013-02-01

    The central goal of this study was to contribute to the advancements being made in determining the underlying causes of anterior cruciate ligament (ACL) injuries. ACL injuries are frequently incurred by recreational and professional young female athletes during non-contact impact activities in sports like volleyball and basketball. This musculoskeletal-neuromuscular study investigated stop-jumps and factors related to ACL injury like knee valgus and internal-external moment loads, knee anterior-posterior (AP) shear forces, ACL strains and internal forces. Motion capture data was obtained from the landing phase of stop-jumps performed by eleven young recreational female athletes and electromyography (EMG) data collected from quadriceps, hamstring and gastrocnimius muscles which were then compared to numerically estimated activations. Numerical simulation tools used were Inverse Kinematics, Computed Muscle Control and Forward Dynamics and the knee modeled as a six degree of freedom joint. Results showed averaged peak strains of 12.2 ± 4.1% in the right and 11.9 ± 3.0% in the left ACL. Averaged peak knee AP shear forces were 482.3 ± 65.7 N for the right and 430.0 ± 52.4 N for the left knees, approximately equal to 0.7-0.8 times body weight across both knees. A lack of symmetry was observed between the knees for valgus angles (p < 0.04), valgus moments (p < 0.001) and muscle activations (p < 0.001), all of which can be detrimental to ACL stability during impact activities. Comparisons between recorded EMG data and estimated muscle activations show the relation between electrical signal and muscle depolarization. In summary, this study outlines a musculoskeletal simulation approach that provides numerical estimations for a number of variables associated with ACL injuries in female athletes performing stop-jumps.

  19. DNA enrichment approaches to identify unauthorized genetically modified organisms (GMOs).

    PubMed

    Arulandhu, Alfred J; van Dijk, Jeroen P; Dobnik, David; Holst-Jensen, Arne; Shi, Jianxin; Zel, Jana; Kok, Esther J

    2016-07-01

    With the increased global production of different genetically modified (GM) plant varieties, chances increase that unauthorized GM organisms (UGMOs) may enter the food chain. At the same time, the detection of UGMOs is a challenging task because of the limited sequence information that will generally be available. PCR-based methods are available to detect and quantify known UGMOs in specific cases. If this approach is not feasible, DNA enrichment of the unknown adjacent sequences of known GMO elements is one way to detect the presence of UGMOs in a food or feed product. These enrichment approaches are also known as chromosome walking or gene walking (GW). In recent years, enrichment approaches have been coupled with next generation sequencing (NGS) analysis and implemented in, amongst others, the medical and microbiological fields. The present review will provide an overview of these approaches and an evaluation of their applicability in the identification of UGMOs in complex food or feed samples.

  20. Inguinal hernia: preperitoneal placement of a memory-ring patch by anterior approach. Preliminary experience.

    PubMed

    Pélissier, E P

    2006-06-01

    The aim of this prospective study was to set up and evaluate a technique allowing, by the mean of a memory ring, easy placement of the patch in the preperitoneal space (PPS), directly via the hernia orifice, so as to associate the advantages of the preperitoneal patch, anterior approach and minimally invasive surgery. The memory-ring patch was made by basting a PDS cord around a 14 x 7.5 cm oval shaped polypropylene mesh. The hernia sac was dissected, blunt dissection of the PPS was carried out through the hernia orifice and the patch was introduced in the PPS via the orifice. Spreading of the patch in the PPS was facilitated by the memory-ring. One hundred and twenty nine hernias, classified as Nyhus Type IIIa, IIIb and IV, were operated on 126 patients; 11 were big pantaloon or sliding hernias. The anesthesia was spinal in 116 cases and local in 10 cases. There were three benign postoperative complications (2.3%) related to the hernia repair. Ninety six percent of the patients were evaluated with a mean follow up of 24.5 months (12-42). Two recurrences (1.6%) occurred, 7 patients (5.6%) felt some degree of light pain, but not any case of disabling pain was observed. This technique offers many advantages. It is tension-free and almost sutureless. The patch is placed in the PPS through the hernia orifice without any remote opening in the abdominal wall. The patch applied directly to the deep surface of the fascia reinforces the weak inguinal area by restoring the normal anatomic disposition. The good preliminary results are encouraging and justify further randomized evaluation.

  1. Single Anterior Tooth Replacement by a Cast Lingual Loop Connector - A Conservative Approach

    PubMed Central

    Dandekeri, Savita

    2014-01-01

    One of the most challenging and complex treatment modality is replacement of single anterior tooth. This can be overcome by different treatment options such as implant-supported restorations as well as conventional porcelain-fused-to-metal and resin-bonded fixed partial dentures. Drifting of teeth into the edentulous area may reduce the available pontic space; whereas a diastema existing before an extraction may result in excessive mesiodistal dimension to the pontic space. Loop connector fixed partial denture (FPD) may be the simplest and best solution to maintain the diastema and provide optimum restoration of aesthetics. This article describes the procedure for the fabrication of a loop connector FPD to restore an excessively wide anterior edentulous space in a patient with existing spacing between the maxillary anterior teeth. PMID:25386535

  2. The nonlinear modified equation approach to analyzing finite difference schemes

    NASA Technical Reports Server (NTRS)

    Klopfer, G. H.; Mcrae, D. S.

    1981-01-01

    The nonlinear modified equation approach is taken in this paper to analyze the generalized Lax-Wendroff explicit scheme approximation to the unsteady one- and two-dimensional equations of gas dynamics. Three important applications of the method are demonstrated. The nonlinear modified equation analysis is used to (1) generate higher order accurate schemes, (2) obtain more accurate estimates of the discretization error for nonlinear systems of partial differential equations, and (3) generate an adaptive mesh procedure for the unsteady gas dynamic equations. Results are obtained for all three areas. For the adaptive mesh procedure, mesh point requirements for equal resolution of discontinuities were reduced by a factor of five for a 1-D shock tube problem solved by the explicit MacCormack scheme.

  3. Surgical treatment of thoracic disc herniations using a modified transfacet approach

    PubMed Central

    Yang, Xizhong; Liu, Xinyu; Zheng, Yanping

    2014-01-01

    Background: Ideal surgical treatment for thoracic disc herniation (TDH) is controversial due to variations in patient presentation, pathology, and possible surgical approach. Althougth discectomy may lead to improvements in neurologic function, it can be complicated by approach related morbidity. Various posterior surgical approaches have been developed to treate TDH, but the gold standard remains transthoracic decompression. Certain patients have comorbidities and herniation that are not optimally treated with an anterior approach. A transfacet pedicle approach was first described in 1995, but outcomes and complications have not been well described. The aim of this work was to evaluate the clinical effect and complications in a consecutive series of patients with symptomatic thoracic disc herniations undergoing thoracic discectomy using a modified transfacet approach. Materials and Methods: 33 patients with thoracic disc herniation were included in this study. Duration of the disease was from 12 days to 36 months, with less than 1 month in 13 patients. Of these, 15 patients were diagnosed with simple thoracic disc herniation, 6 were associated with ossified posterior longitudinal ligament, and 12 with ossified or hypertrophied yellow ligament. A total of 45 discs were involved. All the herniated discs and the ossified posterior longitudinal ligaments were excised using a modified transfacet approach. Laminectomy and replantation were performed for patients with ossified or hypertrophied yellow ligament. The screw–rod system was used on both sides in 14 patients and on one side in l9 patients. Results: 29 patients were followed up for an average of 37 months (range 12-63 months) and 4 patients were lost to followup. Evaluation was based on Epstein and Schwall criteria.5 15 were classified as excellent and 10 as good, accounting for 86.21% (25/29); 2 patients were classified as improved and 2 as poor. All the patients recovered neurologically after surgery. A

  4. Post-traumatic deformity of the anterior frontal table managed by the placement of a titanium mesh via an endoscopic approach.

    PubMed

    Arcuri, Francesco; Baragiotta, Nicola; Poglio, Giuseppe; Benech, Arnaldo

    2012-06-01

    We describe delayed treatment of a post-traumatic fracture of the anterior table of the frontal sinus with a titanium mesh using an endoscopic approach. To our knowledge this is the first case of a delayed post-traumatic deformity of the anterior table being treated by this method.

  5. Electromyographic amplitude ratio of serratus anterior and upper trapezius muscles during modified push-ups and bench press exercises.

    PubMed

    Martins, Jaqueline; Tucci, Helga T; Andrade, Rodrigo; Araújo, Rodrigo C; Bevilaqua-Grossi, Débora; Oliveira, Anamaria S

    2008-03-01

    Imbalance and weakness of the serratus anterior and upper trapezius force couple have been described in patients with shoulder dysfunction. There is interest in identifying exercises that selectively activate these muscles and including it in rehabilitation protocols. This study aims to verify the UT/SA electromyographic (EMG) amplitude ratio, performed in different upper limb exercises and on two bases of support. Twelve healthy men were tested (average age = 22.8 +/- 3.1 years), and surface EMG was recorded from the upper trapezius and serratus anterior using single differential surface electrodes. Volunteers performed isometric contractions over a stable base of support and on a Swiss ball during the wall push-up (WP), bench press (BP), and push-up (PU) exercises. All SEMG data are reported as a percentage of root mean square or integral of linear envelope from the maximal value obtained in one of three maximal voluntary contractions for each muscle studied. A linear mixed-effect model was performed to compare UT/SA ratio values. The WP, BP, and PU exercises showed UT/SA ratio mean +/- SD values of 0.69 +/- 0.72, 0.14 +/- 0.12, and 0.39 +/- 0.37 for stable surfaces, respectively, whereas for unstable surfaces, the values were 0.73 +/- 0.67, 0.43 +/- 0.39, and 0.32 +/- 0.30. The results demonstrate that UT/SA ratio was influenced by the exercises and by the upper limb base of support. The practical application is to show that BP on a stable surface is the exercise preferred over WP and PU on either surfaces for serratus anterior muscle training in patients with imbalance between the UT/SA force couple or serratus anterior weakness.

  6. Modified lateral extracavitary approach for vertebral column resection and expandable cage reconstruction of thoracic spinal metastases

    PubMed Central

    Jandial, Rahul; Chen, Mike Y.

    2012-01-01

    Background: Spinal metastasis is common and can be associated with considerable morbidity. Vertebral resection and reconstruction have been shown to preserve neurological function and decrease pain. Most commonly, two-stage, combined anterior/posterior approaches are performed to surgically address significant vertebral metastasis. Recently, single-stage posterior approaches for vertebrectomies have been performed more often as a result of advances in instrumentation and anesthesia. The objective is to describe a series of patients with metastatic thoracic spine tumors who were treated using a modified, lateral extracavitary approach for a posterior-only vertebral column resection and expandable cage reconstruction. Methods: A retrospective analysis of 21 cases and 20 patients was performed. Results: The average estimated blood loss and length of surgery were 1700 ml (range, 200–7600 ml) and 6.8 h (range, 4–9 h), respectively. The mean follow-up was 14 months (range, 4–30 months). One patient had a permanent neurological deficit as a result of a postoperative hematoma. Of the five patients who were unable to walk prior to surgery, two regained the ability to ambulate. The total complication rate was 43% with majority being minor. A total of 94% of patients had durable preservation of the neurological function. Conclusion: The posterior approach for vertebral column resection and reconstruction is a viable alternative to the standard combined approach. We demonstrate the feasibility of performing the lateral extracavitary approach through a midline incision from T1 to T12. This less invasive approach continues to evolve as instrumentation becomes more advanced and possesses significant advantages in the oncologic setting. PMID:23230517

  7. The Effectiveness of Injury Prevention Programs to Modify Risk Factors for Non-Contact Anterior Cruciate Ligament and Hamstring Injuries in Uninjured Team Sports Athletes: A Systematic Review

    PubMed Central

    Monajati, Alireza; Larumbe-Zabala, Eneko; Goss-Sampson, Mark; Naclerio, Fernando

    2016-01-01

    Background Hamstring strain and anterior cruciate ligament injuries are, respectively, the most prevalent and serious non-contact occurring injuries in team sports. Specific biomechanical and neuromuscular variables have been used to estimate the risk of incurring a non-contact injury in athletes. Objective The aim of this study was to systematically review the evidences for the effectiveness of injury prevention protocols to modify biomechanical and neuromuscular anterior cruciate and/or hamstring injuries associated risk factors in uninjured team sport athletes. Data Sources PubMed, Science Direct, Web of Science, Cochrane Libraries, U.S. National Institutes of Health clinicaltrials.gov, Sport Discuss and Google Scholar databases were searched for relevant journal articles published until March 2015. A manual review of relevant articles, authors, and journals, including bibliographies was performed from identified articles. Main Results Nineteen studies were included in this review. Four assessment categories: i) landing, ii) side cutting, iii) stop-jump, and iv) muscle strength outcomes, were used to analyze the effectiveness of the preventive protocols. Eight studies using multifaceted interventions supported by video and/or technical feedback showed improvement in landing and/or stop-jump biomechanics, while no effects were observed on side-cutting maneuver. Additionally, multifaceted programs including hamstring eccentric exercises increased hamstring strength, hamstring to quadriceps functional ratio and/or promoted a shift of optimal knee flexion peak torque toward a more open angle position. Conclusions Multifaceted programs, supported by proper video and/or technical feedback, including eccentric hamstring exercises would positively modify the biomechanical and or neuromuscular anterior cruciate and/or hamstring injury risk factors. PMID:27171282

  8. Congenital midline cervical cleft: clinical approach to a congenital anterior neck defect.

    PubMed

    Crippa, Beatrice Letizia; Bedeschi, Maria Francesca; Cantarella, Giovanna; Colombo, Lorenzo; Agosti, Viola; Amodeo, Ilaria; Fumagalli, Monica; Mazzola, Isabella; Mosca, Fabio

    2015-05-01

    Numerous malformations can affect the anterior part of the neck presenting at birth as a real diagnostic challenge for the pediatrician or the primary care physician who initially evaluate the baby. Congenital midline cervical cleft represents a rare defect of the midline neck, which is sometimes wrongly diagnosed as a thyroglossal duct anomaly, dermoid cyst, branchial cleft anomaly or "birthmark". A prompt clinical diagnosis and surgical treatment during early infancy are essential to ensure both functional and aesthetic outcome. We report a case of a female neonate with a midline cervical cleft diagnosed immediately after birth. The main features of other congenital anomalies of the anterior neck are also discussed referring to their embryologic origin.

  9. Class III Restoration of Anterior Primary Teeth: In Vitro Retention Comparison of Conventional, Modified and Air-abrasion Treated Preparations.

    PubMed

    Asl Aminabadi, Naser; Najafpour, Ebrahim; Erfanparast, Leila; Samiei, Mohammad; Haghifar, Monireh; Sighari Deljavan, Alireza; Jamali, Zahra; Pournaghi Azar, Fatemeh; Shokravi, Marzieh

    2014-01-01

    Background and aims. Anterior esthetic restoration is challenging in pediatric dentistry, due to limited durability and poor retention of the restoration.This study assessed the effect of air abrasion on tensile failure load of composite class III restorations using different preparation techniques. Materials and methods. 100 extracted human anterior primary teeth were divided, based on the preparation methods, into four groups each consisting of 25 subjects : conventional (A), labial surface bevel (B), conventional + air abrasion (C), and labial surface bevel + air abrasion (D). After restoring cavities, tensile failure load of samples was measured in Newton by Universal testing machine at a crosshead speed of 1 mm per minute. The data were analyzed by Kruskal-Wallis and Mann Whitney U tests using SPSS software. Results. There were statistically significant differences between groups A and C (P = 0.003), groups A and B (P & 0.001), groups A and D (P & 0.001), groups B and C (P = 0.028), groups B and D (P = 0.027), and also groups C and D (P& 0.001). Group D demonstrated the highest mean tensile failure load. Conclusion. Labial surface bevel treated by air abrasion showed significantly more retention of composite restoration.

  10. Reconstructing the anterior part of the nervous system of Gordius aquaticus (Nematomorpha, cycloneuralia) by a multimethodological approach.

    PubMed

    Henne, Stephan; Friedrich, Frank; Hammel, Jörg U; Sombke, Andy; Schmidt-Rhaesa, Andreas

    2017-01-01

    The Nematomorpha (horsehair worms) and Nematoda (round worms) are sister taxa (together Nematoida) and closely related to Scalidophora (Priapulida, Kinorhyncha, Loricifera). To date, all species were assumed to possess a specific brain type, i.e., the "cycloneuralian" brain that forms a ring-shaped neuropil around the pharynx and is composed of anteriorly and posteriorly located somata. However, descriptions of the nematomorph nervous system are rare and somewhat variable, calling in to question the validity of the cycloneuralian condition. To clarify whether there is a typical cycloneuralian pattern in the nematomorph brain, we investigated the anterior end of Gordius aquaticus with different methods: histology, immunohistochemistry and micro-CT analysis. Three-dimensional reconstructions were made from histological serial sections. The brain is composed of a central neuropil and a ring-shaped structure with associated somata. The unpaired ventral nerve cord emerges from the posteroventral part of the brain. A pharynx/esophagus is absent. In addition to the brain, a peripheral nerve plexus was detected. In summary, we interpret the architecture of the brain as potentially derived from a cycloneuralian structure, but being highly modified. The central position of the neuropil is possibly a consequence of the reduction of the anterior intestinal system as a result of the parasitic lifestyle. The ring-shaped arrangement of the somata may be a remnant of a cycloneuralian arrangement, after the two rings of somata (= cycloneuralian condition) either fused or one ring was reduced to form one massive ring-shaped structure in G. aquaticus. J. Morphol. 278:106-118, 2017. ©© 2016 Wiley Periodicals,Inc.

  11. Dark energy or modified gravity? An effective field theory approach

    SciTech Connect

    Bloomfield, Jolyon; Flanagan, Éanna É.; Park, Minjoon; Watson, Scott E-mail: eef3@cornell.edu E-mail: gswatson@syr.edu

    2013-08-01

    We take an Effective Field Theory (EFT) approach to unifying existing proposals for the origin of cosmic acceleration and its connection to cosmological observations. Building on earlier work where EFT methods were used with observations to constrain the background evolution, we extend this program to the level of the EFT of the cosmological perturbations — following the example from the EFT of Inflation. Within this framework, we construct the general theory around an assumed background which will typically be chosen to mimic ΛCDM, and identify the parameters of interest for constraining dark energy and modified gravity models with observations. We discuss the similarities to the EFT of Inflation, but we also identify a number of subtleties including the relationship between the scalar perturbations and the Goldstone boson of the spontaneously broken time translations. We present formulae that relate the parameters of the fundamental Lagrangian to the speed of sound, anisotropic shear stress, effective Newtonian constant, and Caldwell's varpi parameter, emphasizing the connection to observations. It is anticipated that this framework will be of use in constraining individual models, as well as for placing model-independent constraints on dark energy and modified gravity model building.

  12. A Practical Approach to Modified Condition/Decision Coverage

    NASA Technical Reports Server (NTRS)

    Hayhurst, Kelly J.; Veerhusem, Dan S.

    2001-01-01

    Testing of software intended for safety-critical applications in commercial transport aircraft must achieve modified condition/decision coverage (MC/DC) of the software structure. This requirement causes anxiety for many within the aviation software community. Results of a survey of the aviation software industry indicate that many developers believe that meeting the MC/DC requirement is difficult, and the cost is exorbitant. Some of the difficulties stem, no doubt, from the scant information available on the subject. This paper provides a practical 5-step approach for assessing MC/DC for aviation software products, and an analysis of some types of errors expected to be caught when MC/DC is achieved1.

  13. The Emory method: a modified approach to Norplant implants removal.

    PubMed

    Sarma, S P; Hatcher, R

    1994-06-01

    Norplant implants were removed from fifty (50) patients using a modified approach to Norplant implant removal (Emory Method). Eighty-eight percent (88%) of the removals were accomplished in less than 10 minutes using this technique. The average time for removal of Norplant implants from 50 women included in the current study was 8 minutes. The Emory Method for Norplant implant removal includes three steps which are different from the technique developed by the Population Council. More anesthesia, a slightly longer incision and vigorous disruption of the tissue encapsulation surrounding the implants are recommended. The Emory Method is fast, safe and easy to perform. It has been successfully taught to over twenty-five clinicians.

  14. Modified Sediment Rating Curve Approach for Supply-dependent Conditions

    NASA Astrophysics Data System (ADS)

    Wright, S. A.; Topping, D. J.; Rubin, D. M.; Melis, T. S.

    2007-12-01

    particularly suited to such an approach because it is substantially sediment supply-limited such that transport rates are dependent on both flow and sediment supply; also, there is a rich dataset available for constraining the empirical parameters and testing the hybrid model. Though more empirical in nature than the morphodynamic models, this modified sediment rating curve approach may have broad potential application because its simplicity allows for relatively rapid evaluation of long-term sediment budgets under a range of flow regimes and sediment supply conditions.

  15. Prognosis of anterior cruciate ligament reconstruction: a data-driven approach

    PubMed Central

    Chandra, Abhijit; Kar, Oliva; Wu, Kuan-Chuen; Hall, Michelle; Gillette, Jason

    2015-01-01

    Individuals who suffer anterior cruciate ligament (ACL) injury are at higher risk of developing knee osteoarthritis (OA) and almost 50% display symptoms 10–20 years post injury. Anterior cruciate ligament reconstruction (ACLR) often does not protect against knee OA development. Accordingly, a multi-scale formulation for data-driven prognosis (DDP) of post-ACLR is developed. Unlike traditional predictive strategies that require controlled off-line measurements or ‘training’ for determination of constitutive parameters to derive the transitional statistics, the proposed DDP algorithm relies solely on in situ measurements. The proposed DDP scheme is capable of predicting onset of instabilities. As the need for off-line testing (or training) is obviated, it can be easily implemented for ACLR, where such controlled a priori testing is almost impossible to conduct. The DDP algorithm facilitates hierarchical handling of the large dataset and can assess the state of recovery in post-ACLR conditions based on data collected from stair ascent and descent exercises of subjects. The DDP algorithm identifies inefficient knee varus motion and knee rotation as primary difficulties experienced by some of the post-ACLR population. In such cases, levels of energy dissipation rate at the knee, and its fluctuation may be used as measures for assessing progress after ACL reconstruction. PMID:27547072

  16. Novel Nanomicellar Formulation Approaches for Anterior and Posterior Segment Ocular Drug Delivery

    PubMed Central

    Cholkar, Kishore; Patel, Ashaben; Vadlapudi, Aswani Dutt; Mitra, Ashim K

    2014-01-01

    One of the most challenging areas of pharmaceutical research is ocular drug delivery. The unique anatomy and physiology of the eye impedes drug permeation to deeper ocular tissues. Nanosized carrier systems such as nanoparticles, liposomes, suspensions, dendrimers, and nanomicelles are being explored for ocular drug delivery. In this review, we have focused on application of emerging nanomicellar carrier systems in ocular drug delivery. Nanomicelles are nanosized vesicular carriers formed from amphiphilic monomer units. Surfactant and polymeric micellar nanocarriers provide an amenable means to improve drug solubilization, develop clear aqueous formulations and deliver drugs to anterior and posterior ocular tissues. Nanomicelles due to their amphiphilic nature encapsulate hydrophobic drugs and aid in drug delivery. Various methods are employed to develop nanosized micellar formulations depending upon the physicochemical properties of the drug. Nanomicellar carriers appear to be promising vehicles with potential applications in ocular drug delivery. In this review, we attempted to discuss about the progress in ocular drug delivery research using nanomicelles as carriers from the published literature and issued patents. Also, with regards to ocular static and dynamic barriers which prevent drug permeation, a brief discussion about nanomicelles, types of nanomicelles, their methods of preparation and micellar strategy to overcome ocular barriers, delivering therapeutic levels of drugs to anterior and posterior ocular tissues are discussed. PMID:25400717

  17. Postburn neck anterior contracture treatment in children with scar-fascial local trapezoid flaps: a new approach.

    PubMed

    Grishkevich, Viktor M; Grishkevich, Max; Menzul, Vasiliy

    2015-01-01

    One of the dramatic consequences of burns is scar contracture and deformities of the neck. Cervical contracture in children is especially dangerous, leading to face disfigurement and kyphosis; therefore, early reconstruction is indicated. Despite the existence of many various surgical techniques, the successful neck contracture treatment in pediatric patients remains a challenge for surgeons. Eleven children (aged 5 to 14 years) with postburn neck anterior contractures were studied to develop a new approach for reconstruction that would employ the use of local scar-fascial flaps. The new approach and technique for postburn pediatric contracture treatment was developed which is especially effective in the treatment of children who cannot undergo complex and long surgical procedures that are aimed at both contracture elimination and neck skin restoration. The technique consists of two trapezoid scar-fascial flaps mobilization which includes all the anterior neck surfaces and consists of scars, fat layer, platysma, and deep cervical fascia. Counter transposition of flaps with tension elongated neck anterior surface was 100 to 200%. The contracture was fully eliminated, and neck contours, mentocervical angle, and head movement were restored. In case of severe contracture, residual wound in submandibular region and above clavicles were skin-grafted. The full range of head motion (functional results) was achieved in all the 11 patients. The flaps continued to grow and the skin grafts shrinkage was moderate. Local trapeze-flap plasty allows neck contracture elimination in children in the cases when a more complex technique is impossible or undesirable to use. Early surgical intervention prevents secondary complications, allotting enough time for patients to mature and be ready for more complex procedures.

  18. Single-Session Combined Anterior-Posterior Approach for Treatment of Ankylosing Spondylitis with Obvious Displaced Lower Cervical Spine Fractures and Dislocations

    PubMed Central

    Yang, Baohui; Lu, Teng

    2017-01-01

    For patients with AS and lower cervical spine fractures, surgical methods have mainly included the single anterior approach, single posterior approach, and combined anterior-posterior approach. However, various surgical procedures were utilized because the fractures have not been clearly classified according to presence of displacement in these previous studies. Consequently, controversies have been raised regarding the selection of the surgical procedure. This study retrospective analysis was conducted in 12 patients with AS and lower cervical spine fractures and dislocations and explored single-session combined anterior-posterior approach for the treatment of AS with obvious displaced lower cervical spine fractures and dislocations which has demonstrated advantages such as good stabilization, satisfied fracture healing, and easy postoperative cares. However, to some extent, the difficulty and risk of this approach should be considered. Attention should be paid to the prevention of perioperative complications. PMID:28133616

  19. Single-Session Combined Anterior-Posterior Approach for Treatment of Ankylosing Spondylitis with Obvious Displaced Lower Cervical Spine Fractures and Dislocations.

    PubMed

    Yang, Baohui; Lu, Teng; Li, Haopeng

    2017-01-01

    For patients with AS and lower cervical spine fractures, surgical methods have mainly included the single anterior approach, single posterior approach, and combined anterior-posterior approach. However, various surgical procedures were utilized because the fractures have not been clearly classified according to presence of displacement in these previous studies. Consequently, controversies have been raised regarding the selection of the surgical procedure. This study retrospective analysis was conducted in 12 patients with AS and lower cervical spine fractures and dislocations and explored single-session combined anterior-posterior approach for the treatment of AS with obvious displaced lower cervical spine fractures and dislocations which has demonstrated advantages such as good stabilization, satisfied fracture healing, and easy postoperative cares. However, to some extent, the difficulty and risk of this approach should be considered. Attention should be paid to the prevention of perioperative complications.

  20. The Pterional Approach and Extradural Anterior Clinoidectomy to Clip Paraclinoid Aneurysms

    PubMed Central

    Kim, Jung Soo; Jeon, Kyoung Dong; Choi, Byeong Sam

    2013-01-01

    Objective The surgical clipping of paraclinoid segment internal carotid artery aneurysms is considered difficult because of the complex anatomical location and important neighboring structures. Our experiences of pterional craniotomy and extradural anterior clinoidectomy (EAC) to clip paraclinoid aneurysms are reported herein. Methods We present two patients with paraclinoid aneurysms who underwent surgical clipping using pterional craniotomy and EAC. The clinical results and operative techniques were reviewed from the patients' medical records. Results EAC improves the surgical field in the suprasellar and periclinoid regions. Clinically, a good outcome was obtained in both cases. No surgical complications directly resulting from the EAC were observed. Conclusion Favorable surgical results can be obtained with pterional craniotomy and EAC for the clipping of paraclinoid aneurysms. EAC is advocated for the clipping of paraclinoid aneurysms. PMID:24167811

  1. Runx2-Modified Adipose-Derived Stem Cells Promote Tendon Graft Integration in Anterior Cruciate Ligament Reconstruction.

    PubMed

    Zhang, Xin; Ma, Yong; Fu, Xin; Liu, Qiang; Shao, Zhenxing; Dai, Linghui; Pi, Yanbin; Hu, Xiaoqing; Zhang, Jiying; Duan, Xiaoning; Chen, Wenqing; Chen, Ping; Zhou, Chunyan; Ao, Yingfang

    2016-01-08

    Runx2 is a powerful osteo-inductive factor and adipose-derived stem cells (ADSCs) are multipotent. However, it is unknown whether Runx2-overexpressing ADSCs (Runx2-ADSCs) could promote anterior cruciate ligament (ACL) reconstruction. We evaluated the effect of Runx2-ADSCs on ACL reconstruction in vitro and in vivo. mRNA expressions of osteocalcin (OCN), bone sialoprotein (BSP) and collagen I (COLI) increased over time in Runx2-ADSCs. Runx2 overexpression inhibited LPL and PPARγ mRNA expressions. Runx2 induced alkaline phosphatase activity markedly. In nude mice injected with Runx2-ADSCs, promoted bone formation was detected by X-rays 8 weeks after injection. The healing of tendon-to-bone in a rabbit model of ACL reconstruction treated with Runx2-ADSCs, fibrin glue only and an RNAi targeting Runx2, was evaluated with CT 3D reconstruction, histological analysis and biomechanical methods. CT showed a greater degree of new bone formation around the bone tunnel in the group treated with Runx2-ADSCs compared with the fibrin glue group and RNAi Runx2 group. Histology showed that treatment with Runx2-ADSCs led to a rapid and significant increase at the tendon-to-bone compared with the control groups. Biomechanical tests demonstrated higher tendon pullout strength in the Runx2-ADSCs group at early time points. The healing of the attachment in ACL reconstruction was enhanced by Runx2-ADSCs.

  2. Improved social interaction and increased anterior cingulate metabolism after group reminiscence with reality orientation approach for vascular dementia.

    PubMed

    Akanuma, Kyoko; Meguro, Kenichi; Meguro, Mitsue; Sasaki, Eriko; Chiba, Kentaro; Ishii, Hiroshi; Tanaka, Naofumi

    2011-06-30

    A group reminiscence approach (GRA) with reality orientation (RO) is widely used as a psychosocial intervention for dementia. Since clinical effectiveness was reported for the intervention, interest has been directed toward areas of the neuronal network that might be being stimulated. We hypothesized that the frontal lobe associated with social interaction was being stimulated. To test this hypothesis, we studied 24 patients with vascular dementia. In addition to conventional care, a 1-h session of GRA with RO was provided once a week for 3 months in the GRA-RO arm (n=12). Only supportive care was provided in the control arm (n=12). Before and after the interventions, cognitive function, depressive state, and social activities were assessed. Since glucose metabolism is associated with brain function, cerebral glucose metabolism was measured by positron emission tomography (PET). Regarding behavioral improvement, 10 patients in the GRA-RO arm showed improvement compared with only two patients in the control arm, a significant difference. PET demonstrated that metabolism in the anterior cingulate was increased in the GRA-RO arm, whereas no significant changes were observed in the control arm. These results suggest that GRA-RO stimulates the anterior cingulate and has a positive effect on social interaction.

  3. [Drainage of the Frontal Sinus to Cure Epidural and Brain Abscesses Developed after Surgery via Anterior Interhemispheric Approach].

    PubMed

    Bando, Kazuhiko; Ebisutani, Daizo

    2015-08-01

    We report a woman whose anterior communicating artery (AcomA) aneurysm was clipped via an anterior interhemispheric approach when she was 49 years old. At the age of 51, she presented with a subcutaneous abscess and osteomyelitis, so the cranioplastic bone was removed. Six months later, she underwent cranioplasty using hydroxyapatite. Her subcutaneous abscess recurred and the epidural abscess and hydroxyapatite were removed 11 years later after the first operation. The patient underwent observation therapy for the next 4 years, as the dura was ossified. She presented with frontal swelling 15 years after aneurysmal clipping, and neither abscess puncture nor the administration of antibacterial drugs was curative. The patient also complained of chill, thirst, and tremor, and developed disorientation 25 days later. Computed tomography (CT) and magnetic resonance imaging (MRI) showed extension of the epidural and subcutaneous abscesses to a frontal brain abscess. After consulting an otolaryngologist, we performed frontal drainage into the nasal cavity. After making a bicoronal skin incision, the subcutaneous, epidural, and intracapsular brain abscesses were removed while taking care not to damage the capsules. A silicone T-tube was placed in the bifrontal epidural cavity (previous frontal sinus), and its tip was inserted into the nasal cavity through the nasofrontal duct for abscess drainage. After 3 months, the tube was removed. A CT scan acquired 10 years later showed no brain abscess, perifocal edema, or epidural and subcutaneous abscesses.

  4. Surgical Simulation of Extradural Anterior Clinoidectomy through the Trans-superior Orbital Fissure Approach Using a Dissectable Three-dimensional Skull Base Model with Artificial Cavernous Sinus.

    PubMed

    Mori, Kentaro; Yamamoto, Takuji; Nakao, Yasuaki; Esaki, Takanori

    2010-07-01

    Extradural anterior clinoidectomy via the trans-superior orbital fissure (SOF) approach can provide extensive exposure of the anterior clinoid process and safe drilling under direct view. This technique requires peeling of the dura propria of the temporal lobe from the lateral wall of the SOF. Therefore, cadaveric dissection is mandatory to acquire surgical technique. However, chances for cadaveric dissection are limited. We propose modification of our three-dimensional (3-D) skull base model made from surgically dissectable artificial bone with artificial cavernous sinus including multiple membranous layers and neurovascular structures to simulate extradural anterior clinoidectomy via the trans-SOF approach. The 3-D skull base model precisely reproduced the dura propria of the temporal lobe, periosteal bridge, and inner reticular layer in the cavernous sinus and SOF using silicone and varnish. The cranial nerves and blood vessels were made from rubber fibers and vinyl tube. Simulation of extradural anterior clinoidectomy via the trans-SOF approach could be performed on the model using a high-speed drill under the operating microscope. The steps of reconstruction of the skull base model and dissection promote clear understanding of the 3-D anatomy and techniques of extradural anterior clinoidectomy via the trans-SOF approach.

  5. Conjunctival lymphoma: Results and treatment with a single anterior electron field. A lens sparing approach

    SciTech Connect

    Dunbar, S.F.; Linggood, R.M.; Doppke, K.P.; Duby, A.; Wang, C.C. )

    1990-08-01

    Lymphoma of the conjunctiva is rare. It presents in older patients as a mass lesion and usually remains localized. Surgery is limited to biopsy, and radiation therapy is the definitive treatment of choice. The entire conjunctiva is treated. Relatively high doses (approximately 30 Gy) are required for local control, which may lead to cataract formation. Twelve patients with conjunctival lymphoma were treated at the Massachusetts General Hospital between 1979 and 1988. Ten of 12 patients presented with a unilateral lesion; 2 of 12 with bilateral lesions. Two of 12 patients were found to have systemic disease at the time of presentation. One patient developed conjunctival lymphoma 5 years after the diagnosis of generalized disease. Using electron beam, all patients were treated with a single anterior circular field to total doses ranging from 24 Gy to 30 Gy delivered in 8 to 16 fractions over 9 to 20 days. In all cases, the lens was shielded by a specially designed plastic contact lens bearing a 12 mm diameter lead shield. The lens dose was determined at varying depths beneath the shield for 6 MeV and 9 MeV electron beams and ranged from a minimum of 5% to an absolute maximum of 18% of the total dose delivered to the tumor. Local control was maintained in all patients with follow-up to 9 1/2 years. One patient relapsed distantly 3 years after treatment. One of 12 patients died of systemic disease 4 years after treatment of the ocular lesion. Two patients developed cataracts 4 and 5 years after treatment; one had bilateral cataract, although only one eye had been treated. Both patients were over 75 years old. In both cases, the cataracts were felt to be senile cataracts which are ophthalmologically and radiographically distinguishable from radiation induced lesions.

  6. Heat Shock Protein Beta-1 Modifies Anterior to Posterior Purkinje Cell Vulnerability in a Mouse Model of Niemann-Pick Type C Disease

    PubMed Central

    Dell’Orco, James M.; Qin, Zhaohui S.; Kalyana-Sundaram, Shanker; Chinnaiyan, Arul M.; Shakkottai, Vikram G.; Lieberman, Andrew P.

    2016-01-01

    Selective neuronal vulnerability is characteristic of most degenerative disorders of the CNS, yet mechanisms underlying this phenomenon remain poorly characterized. Many forms of cerebellar degeneration exhibit an anterior-to-posterior gradient of Purkinje cell loss including Niemann-Pick type C1 (NPC) disease, a lysosomal storage disorder characterized by progressive neurological deficits that often begin in childhood. Here, we sought to identify candidate genes underlying vulnerability of Purkinje cells in anterior cerebellar lobules using data freely available in the Allen Brain Atlas. This approach led to the identification of 16 candidate neuroprotective or susceptibility genes. We demonstrate that one candidate gene, heat shock protein beta-1 (HSPB1), promoted neuronal survival in cellular models of NPC disease through a mechanism that involved inhibition of apoptosis. Additionally, we show that over-expression of wild type HSPB1 or a phosphomimetic mutant in NPC mice slowed the progression of motor impairment and diminished cerebellar Purkinje cell loss. We confirmed the modulatory effect of Hspb1 on Purkinje cell degeneration in vivo, as knockdown by Hspb1 shRNA significantly enhanced neuron loss. These results suggest that strategies to promote HSPB1 activity may slow the rate of cerebellar degeneration in NPC disease and highlight the use of bioinformatics tools to uncover pathways leading to neuronal protection in neurodegenerative disorders. PMID:27152617

  7. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test.

    PubMed

    Vigotsky, Andrew D; Lehman, Gregory J; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg) performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated. Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61); z(22) = 2.08; p = 0.0372; Pearson's r = 0.43 (0.02, 0.72)) was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = -1.39° (-5.53, +2.75); t(22) = -0.70; p = 0.4933; Cohen's d = - 0.15 (-0.58, 0.29)) or rectus femoris length (change = -0.005 (-0.013, +0.003); t(22) = -1.30; p = 0.2070; Cohen's d = - 0.27 (-0.70, 0.16)) were not due to chance alone. Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol.

  8. Endoscopic image-guided odontoidectomy for decompression of basilar invagination via a standard anterior cervical approach. Technical note.

    PubMed

    Wolinsky, Jean-Paul; Sciubba, Daniel M; Suk, Ian; Gokaslan, Ziya L

    2007-02-01

    Symptomatic irreducible basilar invagination has traditionally been approached through a transoral-transpharyngeal route with resection of the anterior portion of C-1 and the odontoid. Modification of this exposure with either a Le Fort osteotomy or a transmandibular osteotomy and circumglossal approach has increased the access to pathological conditions in this region. These traditional routes all require traversing the oral cavity and accepting the associated potential complications. The authors have developed a novel surgical approach, an endoscopic transcervical odontoidectomy, which allows access for resection of the odontoid and for brainstem and spinal cord decompression without traversing the oral cavity. In this paper they describe the technique and its advantages and present three cases in which patients underwent the endoscopic transcervical odontoidectomy for basilar invagination. Three consecutive patients (age range 42-74 years) who had irreducible basilar invagination underwent the endoscopic transcervical odontoidectomy. All were symptomatic and had neck pain and myelopathy. All were evaluated preoperatively and postoperatively with computed tomography and magnetic resonance imaging. In all cases the procedure resulted in complete decompression. There were no serious complications. No patient required prolonged intubation, tracheostomy, or enteral tube feeding. One patient had an intraoperative cerebrospinal fluid leak, which had no postoperative sequelae. The authors present an alternative surgical approach for treating ventral compression of the brainstem and spinal cord. The technique is safe and effective for decompression and provides a surgical route that can be added to the armamentarium of treatments for pathological conditions in this region.

  9. [Surgical approach to the axillary nerve via an anterior trans-coracoid route].

    PubMed

    Chabernaud, D; Baulot, E; Turlin, F; Perez, A; Grammont, P M

    1996-09-01

    The surgical approach to the circumflex nerve is difficult. Based on an illustrative clinical example, the authors describe a method using a coracoid osteotomy that permits a simplified approach to the circumflex nerve. This trick permits en bloc retraction of the superficial plane of the brachial plexus without sectioning of the muscle and without excessive traction on the musculocutaneous nerve. The stable fixation of the coracoid at the end of the procedure permits early and effective rehabilitation.

  10. A contemporary approach for treatment planning of horizontally resorbed alveolar ridge: Ridge split technique with simultaneous implant placement using platelet rich fibrin membrane application in mandibular anterior region.

    PubMed

    Parthiban, Prathahini S; Lakshmi, R Vijaya; Mahendra, Jaideep; Sreekumar, K; Namasivayam, Ambalavanan

    2017-01-01

    Treatment of edentulous sites with horizontal atrophy represents a clinical situation in which the positioning of endosseous implants might be complex or sometimes impossible without a staged regenerative approach. This case report presents management of horizontally deficient mandibular anterior ridge with a contemporary approach to treatment planning and application of platelet-rich fibrin membrane for ridge split technique and simultaneous implant placement. Implants in anterior mandibular area are considered to be most predictable, stable, with high success rate and patients' satisfaction with implant esthetics. In contrast to traditional ridge augmentation techniques, ridge splitting allows for immediate implant placement following surgery and eradicates the possible morbidity from a second surgical site.

  11. The Use of a Modified Semantic Features Analysis Approach in Aphasia

    ERIC Educational Resources Information Center

    Hashimoto, Naomi; Frome, Amber

    2011-01-01

    Several studies have reported improved naming using the semantic feature analysis (SFA) approach in individuals with aphasia. Whether the SFA can be modified and still produce naming improvements in aphasia is unknown. The present study was designed to address this question by using a modified version of the SFA approach. Three, rather than the…

  12. Pathological Location of Cranial Nerves in Petroclival Lesions: How to Avoid Their Injury during Anterior Petrosal Approach

    PubMed Central

    Borghei-Razavi, Hamid; Tomio, Ryosuke; Fereshtehnejad, Seyed-Mohammad; Shibao, Shunsuke; Schick, Uta; Toda, Masahiro; Yoshida, Kazunari; Kawase, Takeshi

    2015-01-01

    Objectives Numerous surgical approaches have been developed to access the petroclival region. The Kawase approach, through the middle fossa, is a well-described option for addressing cranial base lesions of the petroclival region. Our aim was to gather data about the variation of cranial nerve locations in diverse petroclival pathologies and clarify the most common pathologic variations confirmed during the anterior petrosal approach. Method A retrospective analysis was made of both videos and operative and histologic records of 40 petroclival tumors from January 2009 to September 2013 in which the Kawase approach was used. The anatomical variations of cranial nerves IV–VI related to the tumor were divided into several location categories: superior lateral (SL), inferior lateral (IL), superior medial (SM), inferior medial (IM), and encased (E). These data were then analyzed taking into consideration pathologic subgroups of meningioma, epidermoid, and schwannoma. Results In 41% of meningiomas, the trigeminal nerve is encased by the tumor. In 38% of the meningiomas, the trigeminal nerve is in the SL part of the tumor, and it is in 20% of the IL portion of the tumor. In 38% of the meningiomas, the trochlear nerve is encased by the tumor. The abducens nerve is not always visible (35%). The pathologic nerve pattern differs from that of meningiomas for epidermoid and trigeminal schwannomas. Conclusion The pattern of cranial nerves IV–VI is linked to the type of petroclival tumor. In a meningioma, tumor origin (cavernous, upper clival, tentorial, and petrous apex) is the most important predictor of the location of cranial nerves IV–VI. Classification of four subtypes of petroclival meningiomas using magnetic resonance imaging is very useful to predict the location of deviated cranial nerves IV–VI intraoperatively. PMID:28035290

  13. Pathological Location of Cranial Nerves in Petroclival Lesions: How to Avoid Their Injury during Anterior Petrosal Approach.

    PubMed

    Borghei-Razavi, Hamid; Tomio, Ryosuke; Fereshtehnejad, Seyed-Mohammad; Shibao, Shunsuke; Schick, Uta; Toda, Masahiro; Yoshida, Kazunari; Kawase, Takeshi

    2016-02-01

    Objectives Numerous surgical approaches have been developed to access the petroclival region. The Kawase approach, through the middle fossa, is a well-described option for addressing cranial base lesions of the petroclival region. Our aim was to gather data about the variation of cranial nerve locations in diverse petroclival pathologies and clarify the most common pathologic variations confirmed during the anterior petrosal approach. Method A retrospective analysis was made of both videos and operative and histologic records of 40 petroclival tumors from January 2009 to September 2013 in which the Kawase approach was used. The anatomical variations of cranial nerves IV-VI related to the tumor were divided into several location categories: superior lateral (SL), inferior lateral (IL), superior medial (SM), inferior medial (IM), and encased (E). These data were then analyzed taking into consideration pathologic subgroups of meningioma, epidermoid, and schwannoma. Results In 41% of meningiomas, the trigeminal nerve is encased by the tumor. In 38% of the meningiomas, the trigeminal nerve is in the SL part of the tumor, and it is in 20% of the IL portion of the tumor. In 38% of the meningiomas, the trochlear nerve is encased by the tumor. The abducens nerve is not always visible (35%). The pathologic nerve pattern differs from that of meningiomas for epidermoid and trigeminal schwannomas. Conclusion The pattern of cranial nerves IV-VI is linked to the type of petroclival tumor. In a meningioma, tumor origin (cavernous, upper clival, tentorial, and petrous apex) is the most important predictor of the location of cranial nerves IV-VI. Classification of four subtypes of petroclival meningiomas using magnetic resonance imaging is very useful to predict the location of deviated cranial nerves IV-VI intraoperatively.

  14. Improving Student Group Marketing Presentations: A Modified Pecha Kucha Approach

    ERIC Educational Resources Information Center

    Oliver, Jason; Kowalczyk, Christine

    2013-01-01

    Student presentations can often seem like a formality rather than a lesson in representing oneself or group in a professional manner. To improve the quality of group presentations, the authors modified the popular presentation style of Pecha Kucha (20 slides, 20 seconds per slide) for marketing courses to help students prepare and deliver…

  15. Modified lattice-statics approach to dislocation calculations. I - Formalism

    NASA Technical Reports Server (NTRS)

    Esterling, D. M.

    1978-01-01

    A modified lattice-statics method to calculate the atomic displacements associated with a screw dislocation is outlined. The model incorporates an anharmonic region wherein the forces are derived from a pair potential. Appropriate energy and force expressions are derived. The modifications necessary for the implementation of the conjugate-gradient function minimization method are also derived.

  16. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    PubMed Central

    Lehman, Gregory J.; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H.

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg) performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated. Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61); z(22) = 2.08; p = 0.0372; Pearson’s r = 0.43 (0.02, 0.72)) was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = −1.39° (−5.53, +2.75); t(22) = −0.70; p = 0.4933; Cohen’s d = − 0.15 (−0.58, 0.29)) or rectus femoris length (change = −0.005 (−0.013, +0.003); t(22) = −1.30; p = 0.2070; Cohen’s d = − 0.27 (−0.70, 0.16)) were not due to chance alone. Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol. PMID:26421244

  17. Laparoscopic left and right adrenalectomy from an anterior approach – is there any difference? Outcomes in 176 consecutive patients

    PubMed Central

    Kokorak, Lukas; Vladovic, Peter; Marko, Lubomir

    2016-01-01

    Introduction Traditionally, in open surgery, right adrenalectomy is considered technically more demanding than its left-sided counterpart. This belief is supposed to be attributable mainly to different anatomic characteristics of the adrenal veins. Whether this opinion is also correct for laparoscopic adrenalectomy remains elusive. Aim To compare the outcomes of left versus right laparoscopic adrenalectomy from an anterior approach. Material and methods Retrospective statistical analysis of a prospectively compiled database of consecutive patients undergoing laparoscopic adrenalectomy in a single center with focus on potential differences in the left- versus right-sided procedure in terms of demographic parameters, tumor size, operating time, occurrence of serious intraoperative complications, conversion, length of hospital stay and re-operation rate. Results One hundred seventy-six patients underwent elective laparoscopic adrenalectomy – 80 left-sided (45.45%) and 96 right-sided (54.55%). No significant difference was found between the groups in terms of age (54.09 ±11.2 vs. 56.27 ±11.6; p = 0.2), tumor size (3.39 ±1.86 vs. 3.26 ±1.66; p = 0.64), operating time (71.84 ±22.33 vs. 72.06 ±30.99; p = 0.95), occurrence of serious intraoperative complications (7.5% vs. 10.4%; p = 0.5), conversion (1.25% vs. 1.04%; p = 0.9), length of hospital stay (4.52 ±1.30 vs. 4.37 ±1.91; p = 0.55) or reoperation rate (5% vs. 1%; p = 0.11). There was no mortality. Conclusions No significant difference was found between the left and right laparoscopic adrenalectomy in terms of operating time, occurrence of serious intraoperative complications, conversion rate or postoperative outcome. Therefore, the opinion that the right-sided procedure is more difficult does not seem to be justified for laparoscopic adrenalectomy from the anterior approach. PMID:28194247

  18. Operative surgical nuances of modified extradural temporopolar approach with mini-peeling of dura propria based on cadaveric anatomical study of lateral cavernous structures

    PubMed Central

    Otani, Naoki; Wada, Kojiro; Toyooka, Terushige; Fujii, Kazuya; Kobayashi, Yasushi; Mori, Kentaro

    2016-01-01

    Background: Extradural temporopolar approach (ETA) has been modified as less invasive manner and named as trans-superior orbital fissure (SOF) approach with mini-peeling technique. The present study discusses the operative nuances of this modified technique on the basis of cadaveric study of lateral cavernous structures. Methods: In five consecutive cadaveric specimens, we performed an extradural anterior clinoidectomy with mini-peeling of the dura propria to expose the anterior clinoid process entirely. We also investigated the histological characteristics of the lateral cavernous sinus (CS) between the dura propria and periosteal dura at the SOF, foramen rotundum (FR), and foramen ovale (FO) levels, and of each trigeminal nerve division. Results: Coronal histological examination of the lateral wall of the CS showed invagination of the dura propria and periosteal dura into the SOF. In contrast, no such invagination was observed at the levels of the FR and FO. This finding supports the technical rationale of the only skeletonization of the SOF for peeling of the dura propria but not FR. In addition, our modified ETA method needs only minimal dural incision between the SOF and FR where no cranial nerves are present. Conclusion: Our technical modification of ETA may be recommended for surgical treatment of paraclinoid lesions to reduce the risk of intraoperative neurovascular injury. PMID:27500005

  19. The Third-Difference Approach to Modified Allan Variance

    NASA Technical Reports Server (NTRS)

    Greenhall, C. A.

    1995-01-01

    This study gives strategies for estimating the modified Allan variance (mvar) and formulas for computing the equivalent degrees of freedom (edf) of the estimators. A third-difference formulation of mvar leads to a tractable formula for edf in the presence of power-law phase noise. The effect of estimation stride on edf is tabulated. First-degree rational-function approximations for edf are derived.

  20. Quantitative analysis of surgical exposure and surgical freedom to the anterosuperior pons: comparison of pterional transtentorial, orbitozygomatic, and anterior petrosal approaches.

    PubMed

    Lee, Jung-Shun; Scerrati, Alba; Zhang, Jun; Ammirati, Mario

    2016-10-01

    Surgical approaches to the pons lump together different areas of the pons, such as the anterosuperior and the anteroinferior pons. These areas are topographically different, and different approaches may be best suited for one or the other area. We evaluated the exposure of the anterosuperior pons using different surgical approaches. We quantify the surgical exposure and surgical freedom to the anterosuperior pons afforded by the pterional transtentorial (PT), the orbitozygomatic with anterior clinoidectomy (OZ), and the anterior petrosal (AP) approaches. Five embalmed cadaver heads were used. The three approaches were executed on each side, for a total of 30 approaches. The area of maximal exposure of the anterosuperior pons was measured with the aid of neuronavigation. We also evaluated the feasible angles of approach in the vertical and horizontal planes. We were able to successfully expose the anterosuperior pons using all the selected approaches. In the PT and OZ approaches, mobilization of the sphenoparietal sinus can prevent over-retraction of the temporal bridging veins, while use of the endoscope can help in preserving the integrity of the fourth nerve while cutting the tentorium. The mean exposure area was largest for the AP and smallest for the PT; the surgical freedom was similar among all the approaches. However, there was no statistically significant difference among all the approaches in the exposure area or in the surgical freedom. There is no significant difference among the three evaluated approaches in exposure of the anterosuperior pons.

  1. "Structured Discovery": A Modified Inquiry Approach to Teaching Social Studies.

    ERIC Educational Resources Information Center

    Lordon, John

    1981-01-01

    Describes structured discovery approach to inquiry teaching which encourages the teacher to select instructional objectives, content, and questions to be answered. The focus is on individual and group activities. A brief outline using this approach to analyze Adolf Hitler is presented. (KC)

  2. Modified risk graph method using fuzzy rule-based approach.

    PubMed

    Nait-Said, R; Zidani, F; Ouzraoui, N

    2009-05-30

    The risk graph is one of the most popular methods used to determine the safety integrity level for safety instrumented functions. However, conventional risk graph as described in the IEC 61508 standard is subjective and suffers from an interpretation problem of risk parameters. Thus, it can lead to inconsistent outcomes that may result in conservative SILs. To overcome this difficulty, a modified risk graph using fuzzy rule-based system is proposed. This novel version of risk graph uses fuzzy scales to assess risk parameters and calibration may be made by varying risk parameter values. Furthermore, the outcomes which are numerical values of risk reduction factor (the inverse of the probability of failure on demand) can be compared directly with those given by quantitative and semi-quantitative methods such as fault tree analysis (FTA), quantitative risk assessment (QRA) and layers of protection analysis (LOPA).

  3. Gravitational wave memory: A new approach to study modified gravity

    NASA Astrophysics Data System (ADS)

    Du, Song Ming; Nishizawa, Atsushi

    2016-11-01

    It is well known that two types of gravitational wave memory exist in general relativity (GR): the linear memory and the nonlinear, or Christodoulou, memory. These effects, especially the latter, depend on the specific form of the Einstein equation. It can then be speculated that, in modified theories of gravity, the memory can differ from the GR prediction and provides novel phenomena to study these theories. We support this speculation by considering scalar-tensor theories, for which we find two new types of memory: the T memory and the S memory, which contribute to the tensor and scalar components of a gravitational wave, respectively. Specifically, the former is caused by the burst of energy carried away by scalar radiation, while the latter is intimately related to the no scalar hair property of black holes in scalar-tensor gravity. We estimate the size of these two types of memory in gravitational collapses and formulate a detection strategy for the S memory, which can be singled out from tensor gravitational waves. We show that (i) the S memory exists even in spherical symmetry and is observable under current model constraints, and (ii) while the T memory is usually much weaker than the S memory, it can become comparable in the case of spontaneous scalarization.

  4. Surgical planning and Neurologic Outcome after anterior approach to remove a disc herniation at the C7-T1 Level in 19 patients.

    PubMed

    Falavigna, Asdrubal; Righesso, Orlando; Betemps, Alejandro; de Los Rios, Pablo Fernando Vela; Guimarães, Rangel; Ziegler, Marcus; de Souza, Olivia Egger; da Silva, Pedro Guarise; Riew, Daniel K

    2013-11-18

    Study Design. Retrospective cohort study.Objective. The purpose of this study was to report the neurological presentation, outcome and surgical planning in a series of patients with a symptomatic single level C7-T1 disc herniation who underwent anterior surgical discectomy and fusion.Summary of Background Data. Disc herniations at C7-T1 are uncommon and there are few large series in the literature describing anterior treatment of such herniations.Methods. We performed a retrospective study of patients who underwent surgery for a C7-T1 disc herniation and reviewed the medical records, operative reports, and imaging studies. The surgeons' view line was drawn and its relation to the manubrium and the great vessels was determined on T1 sagittal magnetic resonance imaging (MRI). The location of the herniated disc in the spinal canal was determined using a T2 axial MRI and classified as central, foraminal and central/foraminal. Loss of muscle strength was evaluated preoperatively and at the last follow-up according to the classification of the Medical Research Council (MRC). The disc space was approached anteriorly by a standard cervical supramanubrial Smith-Robinson approach.Results. We identified 19 patients who had undergone C7-T1 discectomy and fusion. The mean age of the sample was 54.26 (±8.65) years. There was a higher proportion of male patients (57.9%, 11/19). The clinical presentation was predominantly motor deficit in 15/19 cases (78.9%) in intrinsic hand muscles, and usually improved after surgery. The mean follow-up period was 27.05 (± 15.10) months. All the patients underwent an anterior cervical supramanubrial approach with microdiscectomy and fusion. Anterior cervical plate fixation was used in 9/19 cases (47.3%). In the rest of the cases, a stand-alone intervertebral device was placed.Conclusion. An anterior cervical supramanubrial approach was easily accomplished in all patients. Motor deficit was the most common surgical indication.

  5. Degloving Injuries of the Oral Cavity Change the Operative Approach to Fractures of the Anterior Segment of the Mandible

    PubMed Central

    Pollock, Richard A.; Huber, Katherine M.; Sickels, Joseph E. Van

    2011-01-01

    No report to date describes the added risk traumatic, degloving injuries of the oral cavity may pose when treating fractures of the mandible. The authors describe the oral degloving injury, characterized by separation of periosteum and soft tissue of the anterior floor of the mouth from the inner cortex of the anterior segment. Vascular anatomy of the floor of the mouth is reviewed as a prelude to a description of pathomechanics of the injury and a case report. The higher incidence of oral degloving in youth and in young adulthood and parallels in elective, orthognathic surgery are identified. When this unusual clinical presentation occurs, and when open reduction of fractures of the anterior segment is chosen, a vestibular incision is best avoided. Instead, a submental or upper neck incision is chosen for sufficient exposure to allow reduction and the application of appliances. Meticulous closure of the intraoral void is achieved using one of two techniques, depending on the level of degloving. PMID:22942942

  6. Cervical intervertebral disc herniation treatment via radiofrequency combined with low-dose collagenase injection into the disc interior using an anterior cervical approach

    PubMed Central

    Wang, Zhi-Jian; Zhu, Meng-Ye; Liu, Xiao-Jian; Zhang, Xue-Xue; Zhang, Da-Ying; Wei, Jian-Mei

    2016-01-01

    Abstract This study aimed to determine the therapeutic effect of radiofrequency combined with low-dose collagenase injected into the disc interior via an anterior cervical approach for cervical intervertebral disc herniation. Forty-three patients (26–62-year old; male/female ratio: 31/12) with cervical intervertebral disc herniation received radiofrequency combined with 60 to 100 U of collagenase, injected via an anterior cervical approach. The degree of nerve function was assessed using the current Japanese Orthopaedic Association (JOA) scoring system at 3 and 12 months postoperation. A visual analogue scale (VAS) was used to evaluate the degree of pain preoperation and 7 days postoperation. The preoperative and 3 month postoperative protrusion areas were measured and compared via magnetic resonance imaging (MRI) and picture archiving and communication systems (PACS). Compared with the preoperative pain scores, the 7-day postoperative pain was significantly reduced (P <0.01). The excellent and good rates of nerve function amelioration were 93.0% and 90.7% at 3 and 12 months postoperation, respectively, which was not significantly different. Twenty-seven cases exhibited a significantly reduced protrusion area (P <0.01) at 3 months postoperation. No serious side effects were noted. To our knowledge, this is the first study to demonstrate that the use of radiofrequency combined with low-dose collagenase injection into the disc interior via an anterior cervical approach is effective and safe for the treatment of cervical intervertebral disc herniation. PMID:27336892

  7. Successful treatment of adult Arnold-Chiari malformation associated with basilar impression and syringomyelia by the transoral anterior approach.

    PubMed

    Kohno, K; Sakaki, S; Shiraishi, T; Matsuoka, K; Okamura, H

    1990-04-01

    A case of adult type I Arnold-Chiari malformation associated with basilar impression, syringomyelia, atlantoaxial dislocation, and occipitalization of the atlas is reported. Preoperative magnetic resonance imaging clearly revealed evidence of severe anterior compression of the cervicomedullary junction due to basilar impression and a sharp clivoaxial angle. Therefore, transoral anterior decompression and fusion were performed, resulting in an improvement of the patient's neurologic signs and symptoms. Postoperative magnetic resonance imaging showed an obvious reduction of the tonsillar herniation and syringomyelia, as well as an improvement of the cervicomedullary compression.

  8. Probing modified gravity with atom-interferometry: A numerical approach

    NASA Astrophysics Data System (ADS)

    Schlögel, Sandrine; Clesse, Sébastien; Füzfa, André

    2016-05-01

    Refined constraints on chameleon theories are calculated for atom-interferometry experiments, using a numerical approach consisting in solving for a four-region model the static and spherically symmetric Klein-Gordon equation for the chameleon field. By modeling not only the test mass and the vacuum chamber but also its walls and the exterior environment, the method allows one to probe new effects on the scalar field profile and the induced acceleration of atoms. In the case of a weakly perturbing test mass, the effect of the wall is to enhance the field profile and to lower the acceleration inside the chamber by up to 1 order of magnitude. In the thin-shell regime, results are found to be in good agreement with the analytical estimations, when measurements are realized in the immediate vicinity of the test mass. Close to the vacuum chamber wall, the acceleration becomes negative and potentially measurable. This prediction could be used to discriminate between fifth-force effects and systematic experimental uncertainties, by doing the experiment at several key positions inside the vacuum chamber. For the chameleon potential V (ϕ )=Λ4 +α/ϕα and a coupling function A (ϕ )=exp (ϕ /M ), one finds M ≳7 ×1016 GeV , independently of the power-law index. For V (ϕ )=Λ4(1 +Λ /ϕ ), one finds M ≳1014 GeV . A sensitivity of a ˜10-11 m /s2 would probe the model up to the Planck scale. Finally, a proposal for a second experimental setup, in a vacuum room, is presented. In this case, Planckian values of M could be probed provided that a ˜10-10 m /s2 , a limit reachable by future experiments. Our method can easily be extended to constrain other models with a screening mechanism, such as symmetron, dilaton and f(R) theories.

  9. The modified equation approach to the stability and accuracy analysis of finite-difference methods

    NASA Technical Reports Server (NTRS)

    Warming, R. F.; Hyett, B. J.

    1974-01-01

    The stability and accuracy of finite-difference approximations to simple linear partial differential equations are analyzed by studying the modified partial differential equation. Aside from round-off error, the modified equation represents the actual partial differential equation solved when a numerical solution is computed using a finite-difference equation. The modified equation is derived by first expanding each term of a difference scheme in a Taylor series and then eliminating time derivatives higher than first order by certain algebraic manipulations. The connection between 'heuristic' stability theory based on the modified equation approach and the von Neumann (Fourier) method is established. In addition to the determination of necessary and sufficient conditions for computational stability, a truncated version of the modified equation can be used to gain insight into the nature of both dissipative and dispersive errors.

  10. Single-level lumbar pyogenic spondylodiscitis treated with minimally invasive anterior debridement and fusion combined with posterior fixation via Wiltse approach.

    PubMed

    Lin, Yang; Chen, Wen-jian; Zhu, Wen-tao; Li, Feng; Fang, Huang; Chen, An-min; Xiong, Wei

    2013-10-01

    The effect and safety of anterior debridement and fusion with a minimally invasive approach combined with posterior fixation via the Wiltse approach were assessed in the single-level lumbar pyogenic spondylodiscitis. Seventeen patients from 2007 to 2009 underwent anterior debridement and fusion with a minimally invasive approach combined with posterior fixation via the Wiltse approach. Postoperative follow-up time was 24-41 months. Data included the patients' general information, microbiology, operative time, intraoperative blood loss, postoperative complications, intervertebral fusion rate, and preoperative and final follow-up scores for American Spinal Injury Association (ASIA) impairment, visual analogue scale (VAS), and Oswestry Disability Index (ODI). Ten patients had undergone a prior spinal invasive procedure, and 7 had hematogenous infection. The infected segments included L1-2, L2-3, L3-4, and L4-5 in 1, 2, 5, and 9 cases, respectively. Thirteen bacterial cultures were positive for Staphylococcus aureus (5 cases), Staphylococcus epidermidis (4), Streptococcus (3), and Escherichia coli (1). The operative time was 213.8±45.6 min, and the intraoperative blood loss was 180.6±88.1 mL. Postoperative complications consisted of urinary retention (2 cases), constipation (3), and deep vein thrombosis (2). On the final follow-up, VAS scores and ODIs were significantly lower than those of preoperation, while the ASIA grades improved. All the cases achieved good intervertebral bony fusion. Anterior debridement and fusion with a minimally invasive approach combined with posterior fixation via the Wiltse approach can successfully treat single-level lumbar pyogenic spondylodiscitis, with less trauma and reliable immobilization. It is a viable option for clinical application.

  11. Modified approach for extraperitoneal laparoscopic staging for locally advanced cervical cancer.

    PubMed

    Gil-Moreno, A; Maffuz, A; Díaz-Feijoo, B; Puig, O; Martínez-Palones, J M; Pérez, A; García, A; Xercavins, J

    2007-12-01

    Describe a modified approach to the technique for staging laparoscopic extraperitoneal aortic and common iliac lymph node dissection for locally advanced cervical cancer.Retrospective, nonrandomized clinical study. (Canadian Task Force classification II-2), setting in an acute-care, teaching hospital. Thirty-six patients with locally advanced cervical cancer underwent laparoscopic surgical staging via extraperitoneal approach with the conventional or the modified technique from August 2001 through September 2004. Clinical outcomes in 23 patients who were operated on with the conventional technique using index finger for first trocar entrance; 12 patients with the modified technique using direct trocar entrance, were compared. One patient was excluded due to peritoneal carcinomatosis. Technique, baseline characteristics, histopathologic variables and surgical outcome were measured. There were no significant differences in patients basal characteristics on comparative analysis between conventional and modified technique. With our proposed modified technique, we obtained a reduced surgical procedure duration and blood loss. The proposed modified surgical technique offers some advantages, is an easier approach because the parietal pelvic peritoneum is elastic and this helps to avoid its disruption at time of trocar insertion, size of incision is shorter, we achieved no CO2 leak through the trocar orifice, and wound suture is fast and simple.

  12. Internal carotid artery dissection after anterior cervical disc replacement: first case report and literature review of vascular complications of the approach.

    PubMed

    Loret, Jean-Edouard; Francois, Patrick; Papagiannaki, Chrysanthi; Cottier, Jean-Philippe; Terrier, Louis-Marie; Zemmoura, Ilyess

    2013-07-01

    We report the case of a 41-year-old woman who underwent cervical total disc replacement at C4C5 and C5C6 levels and fusion at C6C7 level through an anterior right-side approach. After anesthesia recovery, the patient presented left hemiparesia and facial palsy due to large right hemispheric stroke. Diffusion-weighted magnetic resonance imaging was performed as soon as the patient developed neurologic symptoms of stroke and revealed a right internal carotid artery dissection. Digital substraction angiography, endovascular stenting, angioplasty and thrombectomy were performed. Six months after treatment, clinical examination showed mild left-arm spasticity. To the best of our knowledge, only two cases of internal carotid artery stroke without dissection or thrombosis are reported. In conclusion, although vascular complications are rare after anterior cervical spine procedure, internal carotid artery dissection can occur. Suspected risk factors are prolonged retraction of the carotid artery and neck extension.

  13. Two column lesions in the thoracolumbar junction: anterior, posterior or combined approach? A comparative biomechanical in vitro investigation.

    PubMed

    Bence, Tibor; Schreiber, Ulrich; Grupp, Thomas; Steinhauser, Erwin; Mittelmeier, Wolfram

    2007-06-01

    There are various surgical techniques for the treatment of spinal fractures in the thoracolumbar region. Several implants have been developed for anterior or posterior instrumentation. Optimal treatment of unstable thoracolumbar osseous and ligamentous injuries remains controversial. To compare the stabilizing effects of an antero-lateral, thoracoscopically implantable plate system (macsTL, Aesculap, Germany) with the stability provided by a fixateur interne (SOCON, Aesculap, Germany), this in vitro investigation examined six human bisegmental (T12-L2) spinal units. Specimens were tested intact, and with simulation of osseous lesions in the anterior and ligamentous lesions in the posterior column (combined A/B-fracture). While loaded in the main anatomical planes such as flexion/extension, left and right lateral bending and left and right axial rotation with a bending moment of 7.5 Nm in a special testing jigs, motion analysis was performed. Quantitative interpretation of the stabilizing effect was achieved using a contactless three-dimensional motion analysis system. Each specimen was tested in four different scenarios: the first step measured movements of intact spinal segments. For the second step, specimens underwent simulation of combined A/B-fracture provided with bisegmental (T12/L2) antero-lateral fixation and bone strut graft from the iliac crest. For the third step, segments were additionally stabilized by the fixateur interne. The last measurement (fourth step) was performed after removing the anterior instrumentation. Range of motion (ROM) values were compared and statistically evaluated. Compared to the intact specimens the anterior instrumentation of the combined lesion, simulated A/B-fracture, leads to a stabilizing effect in flexion/extension and lateral bending. In contrast to these findings the torsional instability increased for the upper segment and bisegmentally. A maximum rigidity, beyond intact values, was registered for each anatomical plane

  14. Total spondylectomy of C2 and circumferential reconstruction via combined anterior and posterior approach to cervical spine for axis tumor surgery.

    PubMed

    Wu, Wei; Li, Feng; Fang, Zhong; Xiong, Wei; Guan, Han-feng; Xiao, Jun; Guo, Feng-jin; Chen, An-min

    2013-02-01

    As a result of the complex anatomy in upper cervical spine, the operative treatment of axis neoplasms is always complicated. Although the procedure for the second cervical vertebra (C2) surgery had been described previously in diverse approaches and reconstruction forms, each has its own limitations and restrictions that usually result in less satisfactory conclusions. The purpose of this study was to evaluate the operation efficacy for axis tumors by using a combined anterior (retropharyngeal) cervical and posterior approach in achieving total resection of C2 and circumferential reconstruction. Eight consecutive C2 tumor patients with mean age of 47.6 years in our institute sequentially underwent vertebra resection and fixation through aforementioned approach from Jan. 2006 to Dec. 2010. No surgical mortality or severe morbidity occurred in our group. In terms of complications, 2 cases developed transient difficulty in swallowing liquids (one of them experienced dysphonia) and 1 developed cerebrospinal fluid leakage (CSFL) that was resolved later. During a mean follow-up period of 31.9 months, the visual analogue scale (VAS) and Japanese orthopedic association (JOA) score revealed that the pain level and neurological function in all patients were improved postoperatively, and there was no evidence of fixation failure and local recurrence. It is concluded that the anterior cervical retropharyngeal approach permits a visible exposure to facilitate the C2 vertebra resection and perform an effective anterior reconstruction at the same time. The custom-made mesh cage applied in our cases can be acted as a firm and convenient implant in circumferential fixation.

  15. Modified Scaled Hierarchical Equation of Motion Approach for the Study of Quantum Coherence in Photosynthetic Complexes

    SciTech Connect

    Zhu, J.; Kais, S.; Rebentrost, P.; Aspuru-Guzik, Alan

    2011-02-17

    We present a detailed theoretical study of the transfer of electronic excitation energy through the Fenna-Matthews-Olson (FMO) pigment-protein complex, using the newly developed modified scaled hierarchical approach (Shi, Q.; et al. J. Chem. Phys.2009, 130, 084105). We show that this approach is computationally more efficient than the original hierarchical approach. The modified approach reduces the truncation levels of the auxiliary density operators and the correlation function. We provide a systematic study of how the number of auxiliary density operators and the higher-order correlation functions affect the exciton dynamics. The time scales of the coherent beating are consistent with experimental observations. Furthermore, our theoretical results exhibit population beating at physiological temperature. Additionally, the method does not require a low-temperature correction to obtain the correct thermal equilibrium at long times.

  16. Mathematical Understanding and Proving Abilities: Experiment with Undergraduate Student by Using Modified Moore Learning Approach

    ERIC Educational Resources Information Center

    Maya, Rippi; Sumarmo, Utari

    2011-01-01

    This paper reports findings of a post test experimental control group design conducted to investigate the role of modified Moore learning approach on improving students' mathematical understanding and proving abilities. Subjects of study were 56 undergraduate students of one state university in Bandung, who took advanced abstract algebra course.…

  17. A Child is Not a Little Adult: Modified Approaches to Sport for Australian Children.

    ERIC Educational Resources Information Center

    Winter, Gillian; And Others

    This publication reports on competitive sports played by 6 to 12 year old children in Australia. The information in this two-part report is directed toward teachers, coaches, and parents. Part I, "Modified Approaches to Junior Sport," provides discussion of aspects of physical, social, and emotional development associated with children…

  18. "In Their Shoes": Exploring a Modified Approach to Peer Observation of Teaching in a University Setting

    ERIC Educational Resources Information Center

    Kenny, Ailbhe; Mitchell, Eamonn; Chróinín, Déirdre Ní; Vaughan, Elaine; Murtagh, Elaine

    2014-01-01

    Peer observation of teaching (POT) has become common practice in many universities. However, it could be argued that existing models often have limited scope for understanding the student experience. This study presents a modified approach to POT in which the researchers adopted the roles of (1) lecturer, (2) peer-participant and (3)…

  19. Therapy for thoracic lumbar and sacral vertebrae tumors using total spondylectomy and spine reconstruction through posterior or combined anterior-posterior approaches

    PubMed Central

    YANG, PINGLIN; HE, XIJING; LI, HAOPENG; ZANG, QUANJIN; WANG, GUOYU

    2016-01-01

    The present study aimed to analyze the indications, feasibility, safety and clinical effects of total spondylectomy and spine reconstruction through posterior or combined anterior-posterior approaches for thoracic lumbar and sacral vertebrae tumors. Between December 2009 and May 2012, 10 patients with thoracic lumbar and sacral vertebrae tumors were retrospectively analyzed. Different surgical indications and approaches were used according to the affected segments, the extent of lesion involvement and the specific pathology results. One-stage posterior or combined anterior-posterior total spondylectomy and reconstruction was used for the treatment of complicated thoracic lumbar and sacral vertebral malignant tumors and invasive benign tumors. The duration of surgery, levels of intraoperative blood loss and transfusions, and the clinical effects were observed. The average surgical duration was 6.8 h (range, 4.8–12 h), with an average blood loss level of 3,200 ml (range, 1,500–10,000 ml) and an average transfusion level of 2,500 ml. During the average 15 months (range, 3–29 months) follow up, two patients succumbed and one patient experienced tumor recurrence. Neither tumor reoccurrence nor metastasis was observed in all other patients. Personalized surgical indications and approaches according to the affected segments, the extent of lesion involvement and the specific pathology results would aid in the reduction of pain, the improvement of nerve function and the reduction of tumor recurrence. PMID:26998076

  20. Performance of the modified Poisson regression approach for estimating relative risks from clustered prospective data.

    PubMed

    Yelland, Lisa N; Salter, Amy B; Ryan, Philip

    2011-10-15

    Modified Poisson regression, which combines a log Poisson regression model with robust variance estimation, is a useful alternative to log binomial regression for estimating relative risks. Previous studies have shown both analytically and by simulation that modified Poisson regression is appropriate for independent prospective data. This method is often applied to clustered prospective data, despite a lack of evidence to support its use in this setting. The purpose of this article is to evaluate the performance of the modified Poisson regression approach for estimating relative risks from clustered prospective data, by using generalized estimating equations to account for clustering. A simulation study is conducted to compare log binomial regression and modified Poisson regression for analyzing clustered data from intervention and observational studies. Both methods generally perform well in terms of bias, type I error, and coverage. Unlike log binomial regression, modified Poisson regression is not prone to convergence problems. The methods are contrasted by using example data sets from 2 large studies. The results presented in this article support the use of modified Poisson regression as an alternative to log binomial regression for analyzing clustered prospective data when clustering is taken into account by using generalized estimating equations.

  1. A monolateral TMJ replacement under intraoral endoscopic assistance for jaw osteomielitis: a modified approach.

    PubMed

    Belli, E; Mici, E; Mazzone, N; Catalfamo, L; Fini, G; Liberatore, G M

    2015-01-01

    Alloplastic replacement has become a valid treatment for TMJ endstage disease. The Alkayat and Bramley pre-auricular approach combined with the submandibular incision are the current surgical approaches for TMJ surgery. The present study shows a modified approach using intraoral endoscopic assistance. A female patient affected by jaw osteomielitis with condylar detachment was treated with total left TMJ alloplastic replacement combined with a right TMJ arthroplasty. No subamandibular incision was performed and, subsequently, the risks for permanent or temporary damage to the marginalis mandibulae nerve and surgical submandibular scar were avoided. Postoperative CT-Scan evidenced a good prosthesis position. No complications occurred after two years of follow-up.

  2. Anterior Knee Pain (Chondromalacia Patellae).

    ERIC Educational Resources Information Center

    Garrick, James G.

    1989-01-01

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

  3. Anterior single odontoid screw placement for type II odontoid fractures: our modified surgical technique and initial results in a cohort study of 15 patients

    PubMed Central

    Munakomi, Sunil; Tamrakar, Karuna; Chaudhary, Pramod Kumar; Bhattarai, Binod

    2016-01-01

    Objective: Anterior odontoid screw fixation for type II odontoid fracture is the ideal management option. However in the context of unavailability of an O-arm or neuro-navigation and poor images from the available C-arm may be an obstacle to ideal trajectory and placement of the odontoid screw. We herein detail  our surgical technique so as to ensure a correct trajectory and subsequent good fusion in Type II odontoid fractures. This may be advantageous  in clinical set ups lacking state of the art facilities.  Methods and Results: In this cohort study we included 15 consecutive patients who underwent anterior odontoid screw placement. We routinely dissect the longus colli to completely visualize the entire width of C3 body. We then perform a median C2-C3 disectomy followed by creating a gutter in the superior end of C3 body. We then guide the Kirchsner (K) wire purchasing adequate anterior cortex of C2. Rest of the procedure follows the similar steps as described for odontoid screw placement. We achieved 100% correct trajectory and screw placement in our study. There were no instances of screw break out, pull out or nonunion. There was one patient mortality following myocardial infarction in our study. Conclusion: Preoperative imaging details, proper patient positioning, meticulous dissection, thorough anatomical knowledge and few added surgical nuances are the cornerstones in ideal odontoid screw placement. This may be pivotal in managing  patients in developing nations having rudimentary neurosurgical set up. PMID:27990259

  4. Computer-aided analysis of Landsat-1 MSS data - A comparison of three approaches, including a 'modified clustering' approach

    NASA Technical Reports Server (NTRS)

    Fleming, M. D.; Berkebile, J. S.; Hoffer, R. M.

    1975-01-01

    Three approaches for analyzing Landsat-1 data from Ludwig Mountain in the San Juan Mountain range in Colorado are considered. In the 'supervised' approach the analyst selects areas of known spectral cover types and specifies these to the computer as training fields. Statistics are obtained for each cover type category and the data are classified. Such classifications are called 'supervised' because the analyst has defined specific areas of known cover types. The second approach uses a clustering algorithm which divides the entire training area into a number of spectrally distinct classes. Because the analyst need not define particular portions of the data for use but has only to specify the number of spectral classes into which the data is to be divided, this classification is called 'nonsupervised'. A hybrid method which selects training areas of known cover type but then uses the clustering algorithm to refine the data into a number of unimodal spectral classes is called the 'modified-supervised' approach.

  5. Pterional or Subfrontal Access for Proximal Vascular Control in Anterior Interhemispheric Approach for Ruptured Pericallosal Artery Aneurysms at Risk of Premature Rupture

    PubMed Central

    Park, Jaechan

    2017-01-01

    Objective Cases of a ruptured pericallosal artery aneurysm with a high risk of intraoperative premature rupture and technical difficulties for proximal vascular control require a technique for the early and safe establishment of proximal vascular control. Methods A combined pterional or subfrontal approach exposes the bilateral A1 segments or the origin of the ipsilateral A2 segment of the anterior cerebral artery (ACA) for proximal vascular control. Proximal control far from the ruptured aneurysm facilitates tentative clipping of the rupture point of the aneurysm without a catastrophic premature rupture. The proximal control is then switched to the pericallosal artery just proximal to the aneurysm and its intermittent clipping facilitates complete aneurysm dissection and neck clipping. Results Three such cases are reported: a ruptured pericallosal artery aneurysm with a contained leak of the contrast from the proximal side of the aneurysm, a low-lying ruptured pericallosal artery aneurysm with irregularities on its proximal wall, and a multilobulated ruptured pericallosal artery aneurysm with the parasagittal bridging veins hindering surgical access to the proximal parent artery. In each case, the proposed combined pterional-interhemispheric or subfrontal-interhemispheric approach was successfully performed to establish proximal vascular control far from the ruptured aneurysm and facilitated aneurysm clipping via the interhemispheric approach. Conclusion When using an anterior interhemispheric approach for a ruptured pericallosal artery aneurysm with a high risk of premature rupture, a pterional or subfrontal approach can be combined to establish early proximal vascular control at the bilateral A1 segments or the origin of the A2 segment. PMID:28264247

  6. Results of a modified posterolateral approach for the isolated posterolateral tibial plateau fracture

    PubMed Central

    Liu, Guan-Yi; Xiao, Bai-Ping; Luo, Cong-Feng; Zhuang, Yun-Qiang; Xu, Rong-Ming; Ma, Wei-Hu

    2016-01-01

    Background: There are few posterolateral approaches that do not require the common peroneal nerve (CPN) dissection. With the nerve exposure, it would pose a great challenge and sometimes iatrogenic damage over the surgical course. The purpose was to present a case series of patients with posterolateral tibial plateau fractures treated by direct exposure and plate fixation through a modified posterolateral approach without exposing the common peroneal nerve (CPN). Materials and Methods: 9 consecutive cases of isolated posterior fractures of the posterolateral tibial plateau were operated by open reduction and plate fixation through the modified posterolateral approach without exposing the CPN between June 2009 and January 2012. Articular reduction quality was assessment according to the immediate postoperative radiographs. At 24 month followup, all patients had radiographs and were asked to complete a validated outcome measure and the modified Hospital for Special Surgery (HSS) Knee Scale. Results: All patients were followedup, with a mean period of 29 months (range 25–40 months). Bony union was achieved in all patients. In six cases, the reduction was graded as best and in three cases the reduction was graded as middle according to the immediate postoperative radiographs by the rank order system. The average range of motion arc was 127° (range 110°–134°) and the mean postoperative HSS was 93 (range 85–97) at 24 months followup. None of the patients sustained neurovascular complication. Conclusions: The modified posterolateral approach through a long skin incision without exposing the CPN could help to expand the surgical options for an optimal treatment of this kind of fracture, and plating of posterolateral tibial plateau fractures would result in restoration and maintenance of alignment. This approach demands precise knowledge of the anatomic structures of this region. PMID:27053799

  7. A systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?

    PubMed Central

    Duncan, Koji J; Chopp-Hurley, Jaclyn N; Maly, Monica R

    2016-01-01

    Purpose Among a variety of conservative and surgical options to treat anterior cruciate ligament (ACL) injuries, we do not understand which options could potentially prevent knee osteoarthritis (OA). The aim of this systematic review was to examine the evidence pertaining to exercise treatment of ACL injuries in the context of knee OA. Methods Medline, Embase, CINAHL, PubMed, and PEDro (Physiotherapy Evidence Database) databases were systematically searched using keywords encompassed within four primary key terms: knee, osteoarthritis, anterior cruciate ligament, and exercise. Clinical studies evaluating the effect of an exercise treatment for ACL injuries on the development of knee OA in adult humans were included. The PEDro scale was used to critically assess the studies included in the review. Results Eighteen studies were included in this review, with a median PEDro score of 6/11 (range, 2/11–9/11). Three studies provided statistical evidence that exercise following ACL injury lowered the risk for knee OA development. Nine studies demonstrated no benefit of exercise in preventing knee OA incidence relative to either operative treatment or the contralateral, unaffected knee. However, exercise resulted in higher knee instability. Nonetheless, there were no significant differences in subjective or objective knee outcomes for early versus late ACL reconstruction. Limitations This review was not registered through PROSPERO. Conclusion The relationship between a rehabilitative exercise for ACL injuries and long-term knee OA prevalence is inconclusive. However, research suggests initial conservative treatment with optional late ACL reconstruction because this treatment strategy may reduce the risk of knee OA. More research, ideally randomized controlled trials or comparable designs, is required prior to establishing clinical guidelines for ACL injury management. PMID:27843365

  8. Measured noise reductions resulting from modified approach procedures for business jet aircraft

    NASA Technical Reports Server (NTRS)

    Burcham, F. W., Jr.; Putnam, T. W.; Lasagna, P. L.; Parish, O. O.

    1975-01-01

    Five business jet airplanes were flown to determine the noise reductions that result from the use of modified approach procedures. The airplanes tested were a Gulfstream 2, JetStar, Hawker Siddeley 125-400, Sabreliner-60 and LearJet-24. Noise measurements were made 3, 5, and 7 nautical miles from the touchdown point. In addition to a standard 3 deg glide slope approach, a 4 deg glide slope approach, a 3 deg glide slope approach in a low-drag configuration, and a two-segment approach were flown. It was found that the 4 deg approach was about 4 EPNdB quieter than the standard 3 deg approach. Noise reductions for the low-drag 3 deg approach varied widely among the airplanes tested, with an average of 8.5 EPNdB on a fleet-weighted basis. The two-segment approach resulted in noise reductions of 7 to 8 EPNdB at 3 and 5 nautical miles from touchdown, but only 3 EPNdB at 7 nautical miles from touchdown when the airplanes were still in level flight prior to glide slope intercept. Pilot ratings showed progressively increasing workload for the 4 deg, low-drag 3 deg, and two-segment approaches.

  9. 17 beta-estradiol modifies nitric oxide-sensitive guanylyl cyclase expression and down-regulates its activity in rat anterior pituitary gland.

    PubMed

    Cabilla, Jimena P; Díaz, María del Carmen; Machiavelli, Leticia I; Poliandri, Ariel H; Quinteros, Fernanda A; Lasaga, Mercedes; Duvilanski, Beatriz H

    2006-09-01

    Previous studies showed that 17 beta-estradiol (17 beta-E2) regulates the nitric oxide (NO)/soluble guanylyl cyclase (sGC)/cGMP pathway in many tissues. Evidence from our laboratory indicates that 17 beta-E2 disrupts the inhibitory effect of NO on prolactin release, decreasing sGC activity and affecting the cGMP pathway in anterior pituitary gland of adult ovariectomized and estrogenized rats. To ascertain the mechanisms by which 17 beta-E2 affects sGC activity, we investigated the in vivo and in vitro effects of 17 beta-E2 on sGC protein and mRNA expression in anterior pituitary gland from immature female rats. In the present work, we showed that 17 beta-E2 acute treatment exerted opposite effects on the two sGC subunits, increasing alpha1 and decreasing beta1 subunit protein and mRNA expression. This action on sGC protein expression was maximal 6-9 h after 17 beta-E2 administration. 17beta-E2 also caused the same effect on mRNA expression at earlier times. Concomitantly, 17 beta-E2 dramatically decreased sGC activity 6 and 9 h after injection. These effects were specific of 17 beta-E2, because they were not observed with the administration of other steroids such as progesterone and 17 alpha-estradiol. This inhibitory action of 17beta-E2 on sGC also required the activation of estrogen receptor (ER), because treatment with the pure ER antagonist ICI 182,780 completely blocked 17 beta-E2 action. 17 beta-E2 acute treatment caused the same effects on pituitary cells in culture. These results suggest that 17 beta-E2 exerts an acute inhibitory effect on sGC in anterior pituitary gland by down-regulating sGC beta 1 subunit and sGC activity in a specific, ER-dependent manner.

  10. Approaches for the Identification of Genetic Modifiers of Nutrient Dependent Phenotypes: Examples from Folate

    PubMed Central

    Zinck, John W. R.; MacFarlane, Amanda J.

    2014-01-01

    By combining the sciences of nutrition, bioinformatics, genomics, population genetics, and epidemiology, nutrigenomics is improving our understanding of how diet and nutrient intake can interact with or modify gene expression and disease risk. In this review, we explore various approaches to examine gene–nutrient interactions and the modifying role of nutrient consumption, as they relate to nutrient status and disease risk in human populations. Two common approaches include the use of SNPs in candidate genes to identify their association with nutritional status or disease outcomes, or genome-wide association studies to identify genetic polymorphisms associated with a given phenotype. Here, we examine the results of various gene–nutrient interaction studies, the association of genetic polymorphisms with disease expression, and the identification of nutritional factors that modify gene-dependent disease phenotypes. We have focused on specific examples from investigations of the interactions of folate, B-vitamin consumption, and polymorphisms in the genes of B-vitamin dependent enzymes and their association with disease risk, followed by an examination of the strengths and limitations of the methods employed. We also present suggestions for future studies, including an approach from an on-going large scale study, to examine the interaction of nutrient intake and genotypic variation and their impact on nutritional status. PMID:25988111

  11. The Effect of Different Sagittal Angles of the Tibial Guide on Aperture Widening of the Tibial Tunnel during Modified Transtibial Anterior Cruciate Ligament Reconstruction: A Randomized In Vivo Study

    PubMed Central

    Kim, Young Chan; Tawonsawatruk, Tulyapruek; Woon, Hyeong Hwa; Yum, Ji Woong; Shin, Myung Jin; Bravo, Rodolfo S.; Nha, Kyung Wook

    2017-01-01

    Purpose The effect of sagittal plane angle of the tibial tunnel on the severity of tibial intra-articular aperture expansion caused by iatrogenic re-reaming in anterior cruciate ligament (ACL) reconstruction using a modified transtibial technique is unknown. The purpose of this study was to compare the severity of intra-articular aperture widening at different angles (40°, 45°, and 50°) of the tibial guide (TG). Materials and Methods Ninety-seven patients who underwent modified transtibial ACL reconstruction were randomly allocated to TG 40°, 45°, and 50° groups. Intra-articular tibial aperture width (TW) and tibial tunnel length (TTL) were measured intraoperatively using an arthroscopic ruler and a depth gauge. Results The TG 50° group had significantly greater tibial aperture widening than the TG 40° group. There was a significant difference among TG 40°, 45°, and 50° groups and the percentage of knees with TTL <35 mm was 8%, 9% and 3%, respectively. There were 2 females with TTL <35 mm in TG 40° and 45° groups each. The average mediolateral length of the tibial plateau was 75 mm. Conclusions This study shows that the TG angle of 40° would reduce the severity of intra-articular aperture widening of the tibial tunnel compared to 45° or 50° in modified transtibial ACL reconstruction. PMID:28231645

  12. 20 Years of hypertension research using genetically modified animals: no clinically promising approaches in sight.

    PubMed

    Stingl, Lavinia; Völkel, Manfred; Lindl, Toni

    2009-01-01

    The incidence of essential or primary hypertension is increasing, especially in the northern hemisphere, but although the disease displays clear symptoms, its aetiology appears very complex, and thus no causal treatment is available yet. In the 1990's, genetically modified animals (GMO) were considered to be the key to solving this problem of high complexity. However, until now, although a few approaches have shown that old, well-known drugs have a positive effect (decrease of blood pressure) on such animal models of hypertension, no approach has appeared in the literature of this area of research which might indicate a direct connection between GMO and a therapeutic strategy to treat or prevent this type of hypertension in humans. Instead, criticism of the GMO approach has accumulated in the last years, arguing that it is misleading as this disease does not have a monogenic cause and so complementary regulatory mechanisms could prevent the true identification of the function of the modified genes. Furthermore, the technology is best developed in mice, whose physiology of blood pressure is different from that of humans. Because of species specificity, it is not easy to extrapolate the results from animal models of hypertension to human hypertension. Also, in the years 2000 to 2004 a reorientation of the technology and the aims of this kind of research took place. Therefore, although these approaches are without exception deemed "very promising" in the literature, it cannot be expected that research on GMO will make any contribution to a new therapeutic strategy in the near future.

  13. Robotic sialoadenectomy of the submandibular gland via a modified face-lift approach.

    PubMed

    De Virgilio, A; Park, Y M; Kim, W S; Lee, S Y; Seol, J H; Kim, S-H

    2012-11-01

    The purpose of this study was to describe and analyse the advantages and disadvantages of submandibular gland (SMG) resection using a robotic surgical system through a modified face-lift approach. The authors performed robotic sialoadenectomy of the SMG on 5 patients using the daVinci robot system through a modified face-lift approach. Three robotic arms were inserted through a modified face-lift incision; a face-down 30-degree endoscopic arm and two operative arms. The right arm was equipped with a harmonic scalpel and the left arm with a Maryland forceps. In all patients, robotic sialoadenectomy of the SMG was completed successfully. Diagnoses were sialolithiasis in two patients, pleomophic adenoma in two patients, and ranula in one patient. The mean robotic operative time was 90.2 min (range 62-185 min) and that for setting the robotic system was 8.2 min (range 5-15 min). No significant intra-operative or postoperative complications were observed. All patients were satisfied with the outcome and especially the cosmetic results at their last follow-up visit. In the authors opinion robotic sialoadenectomy of the SMG is technically feasible and secures a better cosmetic outcome than endoscopic submandibular resection.

  14. Prosthetic-restorative approach for the restoration of tooth wear. Vdo increase, rehabilitation of anatomy and function and aesthetic restoration of anterior teeth. Case report

    PubMed Central

    GARGARI, M.; CERUSO, F.M.; PRETE, V.; PUJIA, A.

    2012-01-01

    SUMMARY Prosthetic-restorative approach for the restoration of tooth wear. Case report Objective This article presents a case report of combined prosthetic-adhesive rehabilitation in a patient with a generalized tooth wear. Methods A combined treatment adhesive - prosthetic was proposed to a male patient of 65 years old having a clinically significant tooth wear, with dentine exposure and with a reduction in clinical crown height. The erosive/abrasive worn dentition have been reconstructed with direct resin composite restorations on the posterior teeth and with zirconia crown on the anterior teeth. Results Direct composite restorations have a number of distinct advantages. These restorations have proved durable and aesthetic, protect tooth structure and posterior occlusal contact is predictably re-established. Conclusions. A combinations of direct and indirect restorations, based on the new vertical dimension of occlusion (VDO), can help to reestablish anatomy and function. PMID:23285409

  15. [Modified lateral approach for surgery of thoracic disk herniation. Technical note].

    PubMed

    Rossitti, S

    1994-06-01

    The thoracic spine may be approached by different ways: posterior, posterolateral, anterolateral and anteriorly, with associated removal of diverse osseous structures as facet joints, costal processes, pedicles and ribs, subsequently imposing the use of diverse fusion procedures in some cases. The extreme lateral approach to the thoracic disc space produces minimum disruption of the normal spinal musculoskeletal anatomy, avoids retraction of the spinal cord and preserves the intercostal neurovascular bundle and the segmental radicular arteries. The operation is carried out with the patient in the prone position, and the patient is rotated away from the surgeon as necessary when the deeper levels are accessed. Radioscopy is used to identify the correct level after positioning of the patient. A straight transversal paravertebral incision is recommended in single-level operations. Alternatively an elliptical incision, concave medially and centered at the marked rib, is done and the skin flap is refleted medially. The muscles are partially divided at right angles over the rib to be excised and refleted cranial and caudally, exposing the rib and transverse process. The target disc is approached by removal of about 5 cm of the rib which has its insertion at the disc level, if necessary associated with partial removal of the transverse process, followed by partial pediculotomy (exclusively at the base of the pedicle) and a little lateral rachotomy (vertebral body ressection), which permits opening of the spinal canal exclusively ventral to the intervertebral foramen. In this way any kind of hemilaminectomy or facectomy is avoided. The discectomy is then carried out. This is a minimally invasive approach in comparison to the current ones.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Modified Pfannenstiel approach for radical retropubic prostatectomy: a 3-year experience.

    PubMed

    Manoharan, M; Ayyathurai, R; Nieder, A M; Soloway, M S

    2008-01-01

    A modified Pfannenstiel approach for radical retropubic prostatectomy (RRP) has been described previously. We present our experience with this approach for performing a RRP over the past 3 years. Between January 2003 and July 2006, 544 consecutive RRPs by modified Pfannenstiel approach between January 2003 and July 2006 were performed. We analyzed blood loss, transfusions, use of drain, pain score, analgesia and hospital stay. Patients were followed up at 6 weeks, three monthly for a year and six monthly thereafter. All clinical and operative variables were entered into a database and analyzed. A total of 544 men underwent RRP with median follow-up of 11 (s.d.+/-10.5) months. The mean age was 60 (s.d.+/-7) years. About 83, 91 and 95% of patients had nerve sparing, bladder neck preservation and a lymph node dissection, respectively. Fifty-three patients had a concurrent inguinal hernia repair through the same incision. Mean estimated blood loss was 431 (s.d.+/-267) ml. The pathological staging distribution was T2, 82%; T3a, 9%; and T3b, 9%. The mean pain score at days 1 and 7 were 3.7 (s.d.+/-2.5) and 3.3 (s.d.+/-3), respectively. The median hospital stay was 36 h (s.d.+/-24). About 5.5% have had biochemical recurrence. At 12 months 97% were continent and 46% potent. RRP using a modified Pfannenstiel approach offers safety and efficacy. It facilitates repair of associated inguinal hernia through the same incision.

  17. A monolateral TMJ replacement under intraoral endoscopic assistance for jaw osteomielitis: a modified approach

    PubMed Central

    BELLI, E.; MICI, E.; MAZZONE, N.; CATALFAMO, L.; FINI, G.; LIBERATORE, G.M.

    2015-01-01

    Alloplastic replacement has become a valid treatment for TMJ end-stage disease. The Alkayat and Bramley pre-auricular approach combined with the submandibular incision are the current surgical approaches for TMJ surgery. The present study shows a modified approach using intraoral endoscopic assistance. A female patient affected by jaw osteomielitis with condylar detachment was treated with total left TMJ alloplastic replacement combined with a right TMJ arthroplasty. No subamandibular incision was performed and, subsequently, the risks for permanent or temporary damage to the marginalis mandibulae nerve and surgical submandibular scar were avoided. Postoperative CT-Scan evidenced a good prosthesis position. No complications occurred after two years of follow-up. PMID:25827669

  18. Chemical treatment of the intra-canal dentin surface: a new approach to modify dentin hydrophobicity

    PubMed Central

    GAITAN-FONSECA, Cesar; COLLART-DUTILLEUL, Pierre-Yves; SEMETEY, Vincent; ROMIEU, Olivier; CRUZ, Roel; FLORES, Hector; CUISINIER, Frédéric; PÉREZ, Elías; POZOS-GUILLEN, Amaury

    2013-01-01

    Objective: This study evaluated the hydrophobicity of dentin surfaces that were modified through chemical silanization with octadecyltrichlorosilane (OTS). Material and Methods: An in vitro experimental study was performed using 40 human permanent incisors that were divided into the following two groups: non-silanized and silanized. The specimens were pretreated and chemically modified with OTS. After the chemical modification, the dentin hydrophobicity was examined using a water contact angle measurement (WCA). The effectiveness of the modification of hydrophobicity was verified by the fluid permeability test (FPT). Results and Conclusions: Statistically significant differences were found in the values of WCA and FPT between the two groups. After silanization, the hydrophobic intraradicular dentin surface exhibited in vitro properties that limit fluid penetration into the sealed root canal. This chemical treatment is a new approach for improving the sealing of the root canal system. PMID:23559114

  19. Analysis of higher harmonic contamination with a modified approach using a grating analyser.

    PubMed

    Gupta, Rajkumar; Modi, Mohammed H; Kumar, M; Chakera, J A; Lodha, G S

    2014-04-01

    Soft x-ray spectra of the toroidal grating monochromator (TGM) at the reflectivity beamline of Indus-1 synchrotron source are analyzed for higher harmonic contribution. A diffraction grating of central line spacing 1200 l/mm is used to disperse the monochromatic beam received from TGM to quantify the harmonic contents in the 50-360 Å wavelength range. In order to calculate the harmonic contamination, conventionally the intensity of higher order peak is divided by first order peak intensity of the desired wavelength. This approach is found to give wrong estimate as first order peak itself is overlapped by higher order peaks. In the present study, a modified approach has been proposed to calculate harmonic contamination where the intensity contributions of overlapping orders have been removed from the first order diffraction peak of the desired wavelength. It is found that the order contamination in the TGM spectra is less than 15% in the wavelength range of 90-180 Å. The total harmonic contribution increases from 6%-60% in the wavelength range of 150-260 Å. The critical wavelength of Indus-1 is 61 Å hence the harmonic contamination below 90 Å is significantly low. The results obtained with modified approach match well with those obtained by quantitative analysis of multilayer reflectivity data. The obtained higher harmonics data are used to fit the transmission of aluminum edge filter in the 120-360 Å wavelength range.

  20. Analysis of higher harmonic contamination with a modified approach using a grating analyser

    SciTech Connect

    Gupta, Rajkumar Modi, Mohammed H.; Lodha, G. S.; Kumar, M.; Chakera, J. A.

    2014-04-15

    Soft x-ray spectra of the toroidal grating monochromator (TGM) at the reflectivity beamline of Indus-1 synchrotron source are analyzed for higher harmonic contribution. A diffraction grating of central line spacing 1200 l/mm is used to disperse the monochromatic beam received from TGM to quantify the harmonic contents in the 50–360 Å wavelength range. In order to calculate the harmonic contamination, conventionally the intensity of higher order peak is divided by first order peak intensity of the desired wavelength. This approach is found to give wrong estimate as first order peak itself is overlapped by higher order peaks. In the present study, a modified approach has been proposed to calculate harmonic contamination where the intensity contributions of overlapping orders have been removed from the first order diffraction peak of the desired wavelength. It is found that the order contamination in the TGM spectra is less than 15% in the wavelength range of 90–180 Å. The total harmonic contribution increases from 6%–60% in the wavelength range of 150–260 Å. The critical wavelength of Indus-1 is 61 Å hence the harmonic contamination below 90 Å is significantly low. The results obtained with modified approach match well with those obtained by quantitative analysis of multilayer reflectivity data. The obtained higher harmonics data are used to fit the transmission of aluminum edge filter in the 120–360 Å wavelength range.

  1. Pertussis toxin modifies the characteristics of both the inhibitory GTP binding proteins and the somatostatin receptor in anterior pituitary tumor cells

    SciTech Connect

    Mahy, N.; Woolkalis, M.; Thermos, K.; Carlson, K.; Manning, D.; Reisine, T.

    1988-08-01

    The effects of pertussis toxin treatment on the characteristics of somatostatin receptors in the anterior pituitary tumor cell line AtT-20 were examined. Pertussis toxin selectively catalyzed the ADP ribosylation of the alpha subunits of the inhibitory GTP binding proteins in AtT-20 cells. Toxin treatment abolished somatostatin inhibition of forskolin-stimulated adenylyl cyclase activity and somatostatin stimulation of GTPase activity. To examine the effects of pertussis toxin treatment on the characteristics of the somatostatin receptor, the receptor was labeled by the somatostatin analog (125I)CGP 23996. (125I)CGP 23996 binding to AtT-20 cell membranes was saturable and within a limited concentration range was to a single high affinity site. Pertussis toxin treatment reduced the apparent density of the high affinity (125I)CGP 23996 binding sites in AtT-20 cell membranes. Inhibition of (125I)CGP 23996 binding by a wide concentration range of CGP 23996 revealed the presence of two binding sites. GTP predominantly reduced the level of high affinity sites in control membranes. Pertussis toxin treatment also diminished the amount of high affinity sites. GTP did not affect (125I)CGP 23996 binding in the pertussis toxin-treated membranes. The high affinity somatostatin receptors were covalently labeled with (125I) CGP 23996 and the photoactivated crosslinking agent n-hydroxysuccinimidyl-4-azidobenzoate. No high affinity somatostatin receptors, covalently bound to (125I)CGP 23996, were detected in the pertussis toxin-treated membranes. These results are most consistent with pertussis toxin uncoupling the inhibitory G proteins from the somatostatin receptor thereby converting the receptor from a mixed population of high and low affinity sites to only low affinity receptors.

  2. A modified Becker's split-window approach for retrieving land surface temperature from AVHRR and VIRR

    NASA Astrophysics Data System (ADS)

    Quan, Weijun; Chen, Hongbin; Han, Xiuzhen; Liu, Yonghong; Ye, Caihua

    2012-04-01

    In order to provide a long time-series, high spatial resolution, and high accuracy dataset of land surface temperature (LST) for climatic change research, a modified Becker and Li's split-window approach is proposed in this paper to retrieve LST from the measurements of Advanced Very High Resolution Radiometer (AVHRR) onboard National Oceanic and Atmospheric Administration (NOAA)-7 to -18 and the Visible and InfraRed Radiometer (VIRR) onboard FY-3A. For this purpose, the Moderate Resolution Transmittance Model (MODTRAN) 4.1 was first employed to compute the spectral radiance at the top of atmosphere (TOA) under a variety of surface and atmosphere conditions. Then, a temperature dataset consists of boundary temperature T s (which is one of the input parameters to MODTRAN), and channels 4 and 5 brightness temperatures ( T 4 and T 5) were constructed. Note that channels 4 and 5 brightness temperatures were simulated from the MODTRAN output spectral radiance by convolving them with the spectral response functions (SRFs) of channels 4 and 5 of AVHRRs and VIRR. The coefficients of modified Becker and Li's split-window approach for various AVHRRs and VIRR were subsequently regressed based on this temperature dataset using the least square method. As an example of validation, one AVHRR satellite image over Beijing acquired at 0312 UTC 27 April 2008 by AVHRR onboard NOAA-17 was selected to retrieve the LST image using the modified Becker and Li's approach. The comparison between this LST image and that from the MODIS level-2 LST product provided by the University of Tokyo in Japan indicates that the correlation coefficient is 0.88, the bias is 0.6 K, and the root mean square deviation (RMSD) is 2.1 K. Furthermore, about 70% and 37% pixels in the LST difference image, which is the result of retrieved LST image from AVHRR minus the corresponding MODIS LST image, have the values within ±2 and ±1 K, respectively.

  3. RELIABILITY AND VALIDITY OF A MODIFIED ISOMETRIC DYNAMOMETER IN THE ASSESSMENT OF MUSCULAR PERFORMANCE IN INDIVIDUALS WITH ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

    PubMed Central

    de Vasconcelos, Rodrigo Antunes; Bevilaqua-Grossi, Débora; Shimano, Antonio Carlos; Paccola, Cleber Jansen; Salvini, Tânia Fátima; Prado, Christiane Lanatovits; Junior, Wilson A. Mello

    2015-01-01

    Objectives: The aim of this study was to evaluate the reliability and validity of a modified isometric dynamometer (MID) in performance deficits of the knee extensor and flexor muscles in normal individuals and in those with ACL reconstructions. Methods: Sixty male subjects were invited to participate of the study, being divided into three groups with 20 subjects each: control group (GC), group of individuals with ACL reconstruction with patellar tendon graft (GTP, and group of individuals with ACL reconstruction with hamstrings graft (GTF). All individuals performed isometric tests in the MID, muscular strength deficits collected were subsequently compared to the tests performed on the Biodex System 3 operating in the isometric and isokinetic mode at speeds of 60°/s and 180o/s. Intraclass ICC correlation calculations were done in order to assess MID reliability, specificity, sensitivity and Kappa's consistency coefficient calculations, respectively, for assessing the MID's validity in detecting muscular deficits and intra- and intergroup comparisons when performing the four strength tests using the ANOVA method. Results: The modified isometric dynamometer (MID) showed excellent reliability and good validity in the assessment of the performance of the knee extensor and flexor muscles groups. In the comparison between groups, the GTP showed significantly greater deficits as compared to the GTF and GC groups. Conclusion: Isometric dynamometers connected to mechanotherapy equipments could be an alternative option to collect data concerning performance deficits of the extensor and flexor muscles groups of the knee in subjects with ACL reconstruction. PMID:27004175

  4. Experimental and Numerical Analysis of Triaxially Braided Composites Utilizing a Modified Subcell Modeling Approach

    NASA Technical Reports Server (NTRS)

    Cater, Christopher; Xiao, Xinran; Goldberg, Robert K.; Kohlman, Lee W.

    2015-01-01

    A combined experimental and analytical approach was performed for characterizing and modeling triaxially braided composites with a modified subcell modeling strategy. Tensile coupon tests were conducted on a [0deg/60deg/-60deg] braided composite at angles of 0deg, 30deg, 45deg, 60deg and 90deg relative to the axial tow of the braid. It was found that measured coupon strength varied significantly with the angle of the applied load and each coupon direction exhibited unique final failures. The subcell modeling approach implemented into the finite element software LS-DYNA was used to simulate the various tensile coupon test angles. The modeling approach was successful in predicting both the coupon strength and reported failure mode for the 0deg, 30deg and 60deg loading directions. The model over-predicted the strength in the 90deg direction; however, the experimental results show a strong influence of free edge effects on damage initiation and failure. In the absence of these local free edge effects, the subcell modeling approach showed promise as a viable and computationally efficient analysis tool for triaxially braided composite structures. Future work will focus on validation of the approach for predicting the impact response of the braided composite against flat panel impact tests.

  5. Experimental and Numerical Analysis of Triaxially Braided Composites Utilizing a Modified Subcell Modeling Approach

    NASA Technical Reports Server (NTRS)

    Cater, Christopher; Xiao, Xinran; Goldberg, Robert K.; Kohlman, Lee W.

    2015-01-01

    A combined experimental and analytical approach was performed for characterizing and modeling triaxially braided composites with a modified subcell modeling strategy. Tensile coupon tests were conducted on a [0deg/60deg/-60deg] braided composite at angles [0deg, 30deg, 45deg, 60deg and 90deg] relative to the axial tow of the braid. It was found that measured coupon strength varied significantly with the angle of the applied load and each coupon direction exhibited unique final failures. The subcell modeling approach implemented into the finite element software LS-DYNA was used to simulate the various tensile coupon test angles. The modeling approach was successful in predicting both the coupon strength and reported failure mode for the 0deg, 30deg and 60deg loading directions. The model over-predicted the strength in the 90deg direction; however, the experimental results show a strong influence of free edge effects on damage initiation and failure. In the absence of these local free edge effects, the subcell modeling approach showed promise as a viable and computationally efficient analysis tool for triaxially braided composite structures. Future work will focus on validation of the approach for predicting the impact response of the braided composite against flat panel impact tests.

  6. The effectiveness of different approaches to media literacy in modifying adolescents' responses to alcohol.

    PubMed

    Chen, Yi-Chun Yvonnes

    2013-01-01

    Fearing the negative effect that alcohol advertising might have on adolescents' receptiveness to the consumption of alcohol, health educators have used media literacy as an effective strategy to mitigate the effect of these messages in the media. The present study applied parental mediation to the design and evaluations of a media literacy curriculum that targets alcohol decision-making processes illustrated in the message interpretation process model. The authors conducted a pretest-posttest quasi-experiment of 171 adolescents to examine the effect of a negative evaluative approach and a balanced evaluative approach (a combination of negative and positive evaluative strategies) to media literacy on modifying adolescents' responses to alcohol messages. Results showed that different media literacy approaches had varying degrees of effectiveness on adolescent boys and girls. After receiving a negative media literacy lesson, adolescent boys regarded television characters as less realistic and believed that drinking alcohol had negative consequences. In contrast, adolescent girls benefited more from a balanced evaluative approach as their media skepticism attitude was enhanced. Results suggest that health educators should choose tailored pedagogical approaches that are based on gender to improve decision making regarding alcohol consumption.

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

    PubMed Central

    Kielar, Maciej

    2016-01-01

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

  8. Approaches to the treatment of early rheumatoid arthritis with disease-modifying antirheumatic drugs.

    PubMed

    Sizova, Lyudmila

    2008-08-01

    This paper reviews recent approaches to treatment of early rheumatoid arthritis (RA) with disease-modifying antirheumatic drugs (DMARDs). The literature on treatment the early RA published between 1995 and 2007 was accessed through the PubMed database from the National Library of Medicine. Keywords were 'early rheumatoid arthritis', 'disease-modifying antirheumatic drugs', 'biologic agents' and 'combination therapy'. Only results of trials on human subjects that directly measured the effects of DMARDs or biological agents on clinical, laboratory parameters and radiological progression of early RA were selected. Combination therapy suppresses RA activity and radiological progression more effectively than monotherapy. If better control of RA is evident after 3-6 months of treatment with the combination of DMARDs, one must still decide whether to stop the first DMARD, stop the second, or continue with the combination. Combination therapy biological agents (infliximab, adalimumab) with methotrexate and etanercept therapy alone may induce remission in many patients with early RA. It is a method of choice in patients with an adverse prognosis. The main indications for combination therapy 'standard' DMARDs or combination 1 DMARDs with a biological agent are such variables as detection of a shared epitope, increase of concentration of anticyclic citrullinated peptide antibodies, rheumatoid factor, C-reactive protein, 28-joint disease activity score, Sharp score and presence of erosion in joints. The majority of rheumatologists believe that patients with RA should be treated with DMARDs earlier rather than later in the disease process. Further trials should establish the optimal approaches to early RA therapy.

  9. Modified Riccati approach to partially solvable quantum Hamiltonians. II. Morse-oscillator-related family

    NASA Astrophysics Data System (ADS)

    Montemayor, R.; Salem, L. D.

    1991-12-01

    We extend the scope of the modified Riccati approach to partial solubility in quantum mechanics introduced in a previous work [L. D. Salem and R. Montemayor, Phys. Rev. A 43, 1169 (1991)]. With the use of adequate mappings u(x), we show the convenience of the modified Riccati approach to analyze potentials that can be written as rational functions on u. The necessary conditions for a Hamiltonian to be solvable are discussed in detail. By considering the exponential mapping u=e-x, we construct a family of potentials related to the exactly solvable Morse oscillator. Within this family, we have identified a three-parameter quasiexactly solvable potential, which, depending on the value of its coupling constants, leads to a symmetric or asymmetric confining potential, with a single-well or a double-well structure. Explicit expressions for the energies and eigenfunctions are given for particular cases. The analytic continuation of the symmetric subset gives rise to a quasiexactly solvable periodic potential.

  10. Dorsal dumb-bell melanotic schwannoma operated on by posterior and anterior approach: case report and a review of the literature.

    PubMed

    De Cerchio, Leonardo; Contratti, Filiberto; Fraioli, Mario F

    2006-10-01

    The schwannomas are benign tumors originating from Schwann cells which constitute the nerve sheath. The dorsal pigmented type of schwannomas is relatively rare (Goldstein in Am J Med Genet 86:62-65, 2004; Kurtkaya-Yapicier in Histol Histopathol 18(3):925-934, 2003). There are two distinct types of melanotic schwannoma: the sporadic melanotic schwannomas and the psammomatous melanotic schwannomas of Carney complex. We report a case of a patient harboring a right dorsal dumb-bell melanotic schwannoma and left adrenal mass. The patient underwent a surgical procedure for en bloc total removal of the mass by a posterior and anterior approach. Histopathological examination revealed the diagnosis of melanotic schwannoma. At present, we have no reliable marker of histopathological malignancy of melanotic schwannoma so the follow-up period ought to continue for a period of more than 5 years. As the total removal of the melanotic neurinomas is mandatory to prevent possible malignant transformation of the tumor recurrence or regrowth, we believe that the posterior and trans-thoracic approach are the most suitable one for the dorsal dumb-bell schwannoma.

  11. Segmental alveolar osteotomy by palatal approach to correct excessive angulated dental implants in anterior and posterior maxilla.

    PubMed

    Akkas, Ismail; Toptas, Orcun; Akpinar, Yusuf Ziya; Ozan, Fatih

    2015-04-01

    Dental implants have been used for a long time to achieve better prosthetic and health conditions in the mouth. With the increase in their usage, more complications have occurred, and methods of solving these problems have been developed. One complication is insertion of the implant in the wrong direction. The aim of this case report is to describe an osteotomy technique to reposition a malpositioned dental implant. A female patient, aged 38 years, and a male patient aged 48 years, were referred complaining of the malpositioned osseointegrated implants, which had been placed in the region of the left maxillary first premolar and molar tooth, and in the region of the left maxillary lateral incisor. Due to severe buccal positioning of the implant fixtures, acceptable prosthetic treatment was not possible. Alveolar osteotomy procedure was used to reposition the implants. Satisfactory results were obtained by osteotomy for 18-month of follow up. We conclude that inadequately axially inclined implants can be successfully treated by alveolar osteotomy. The preservation of marginal gingiva permits obtaining better prosthetic results. To avoid the recession of attached gingiva, palatal approach technique may help the clinicians.

  12. SCHEUERMANN'S KYPHOSIS: COMPARISON BETWEEN THE POSTERIOR APPROACH ASSOCIATED WITH SMITH-PETERSEN OSTEOTOMY AND COMBINED ANTERIOR-POSTERIOR FUSION

    PubMed Central

    Temponi, Eduardo Frois; de Macedo, Rodrigo D'Alessandro; Pedrosa, Luiz Olímpio Garcia; Fontes, Bruno Pinto Coelho

    2015-01-01

    Objective: Surgical treatment of Scheuermann's kyphosis (SK) remains a subject under discussion. In view of the controversy over the best form of surgical tr otomy. Methods: This was a descriptive case-control study with cross-sectional analysis. Twenty-eight patients, split into two groups conducted at different times, were evaluated. Results: The first group comprised patients treated using the double approach, with an average age of 19 years, preoperative kyphosis of 77.6°, postoperative kyphosis of 35.8° and average correction of 53.2%. The second group comprised patients treated using the posterior route associated with Smith-Petersen osteotomy, with a mean age of 27.3 years, preoperative kyphosis of 72.9°, postoperative kyphosis of 44.3° and average correction of 39.3%. Analysis between the two groups showed statistically significant differences in the following variables: age (p = 0.02), postoperative kyphosis (p = 0.04) and degree and percentage of kyphosis correction (p = 0.001). There was no difference concerning preoperative kyphosis (p = 0.33). In the assessment of postoperative pain (VAS), the first group presented an average of 0.6, versus 0.5 in the second group. There were only minor complications: seven in the first group and two in the second. Conclusion: The two surgical techniques studied proved to be adequate for treating SK. In the present study, the deformity correction was greater in the first group, while the pain VAS results were better in the second group, with lower incidence of complications. PMID:27047831

  13. Modified linear predictive coding approach for moving target tracking by Doppler radar

    NASA Astrophysics Data System (ADS)

    Ding, Yipeng; Lin, Xiaoyi; Sun, Ke-Hui; Xu, Xue-Mei; Liu, Xi-Yao

    2016-07-01

    Doppler radar is a cost-effective tool for moving target tracking, which can support a large range of civilian and military applications. A modified linear predictive coding (LPC) approach is proposed to increase the target localization accuracy of the Doppler radar. Based on the time-frequency analysis of the received echo, the proposed approach first real-time estimates the noise statistical parameters and constructs an adaptive filter to intelligently suppress the noise interference. Then, a linear predictive model is applied to extend the available data, which can help improve the resolution of the target localization result. Compared with the traditional LPC method, which empirically decides the extension data length, the proposed approach develops an error array to evaluate the prediction accuracy and thus, adjust the optimum extension data length intelligently. Finally, the prediction error array is superimposed with the predictor output to correct the prediction error. A series of experiments are conducted to illustrate the validity and performance of the proposed techniques.

  14. A modified dynamic evolving neural-fuzzy approach to modeling customer satisfaction for affective design.

    PubMed

    Kwong, C K; Fung, K Y; Jiang, Huimin; Chan, K Y; Siu, Kin Wai Michael

    2013-01-01

    Affective design is an important aspect of product development to achieve a competitive edge in the marketplace. A neural-fuzzy network approach has been attempted recently to model customer satisfaction for affective design and it has been proved to be an effective one to deal with the fuzziness and non-linearity of the modeling as well as generate explicit customer satisfaction models. However, such an approach to modeling customer satisfaction has two limitations. First, it is not suitable for the modeling problems which involve a large number of inputs. Second, it cannot adapt to new data sets, given that its structure is fixed once it has been developed. In this paper, a modified dynamic evolving neural-fuzzy approach is proposed to address the above mentioned limitations. A case study on the affective design of mobile phones was conducted to illustrate the effectiveness of the proposed methodology. Validation tests were conducted and the test results indicated that: (1) the conventional Adaptive Neuro-Fuzzy Inference System (ANFIS) failed to run due to a large number of inputs; (2) the proposed dynamic neural-fuzzy model outperforms the subtractive clustering-based ANFIS model and fuzzy c-means clustering-based ANFIS model in terms of their modeling accuracy and computational effort.

  15. A Modified Dynamic Evolving Neural-Fuzzy Approach to Modeling Customer Satisfaction for Affective Design

    PubMed Central

    Kwong, C. K.; Fung, K. Y.; Jiang, Huimin; Chan, K. Y.

    2013-01-01

    Affective design is an important aspect of product development to achieve a competitive edge in the marketplace. A neural-fuzzy network approach has been attempted recently to model customer satisfaction for affective design and it has been proved to be an effective one to deal with the fuzziness and non-linearity of the modeling as well as generate explicit customer satisfaction models. However, such an approach to modeling customer satisfaction has two limitations. First, it is not suitable for the modeling problems which involve a large number of inputs. Second, it cannot adapt to new data sets, given that its structure is fixed once it has been developed. In this paper, a modified dynamic evolving neural-fuzzy approach is proposed to address the above mentioned limitations. A case study on the affective design of mobile phones was conducted to illustrate the effectiveness of the proposed methodology. Validation tests were conducted and the test results indicated that: (1) the conventional Adaptive Neuro-Fuzzy Inference System (ANFIS) failed to run due to a large number of inputs; (2) the proposed dynamic neural-fuzzy model outperforms the subtractive clustering-based ANFIS model and fuzzy c-means clustering-based ANFIS model in terms of their modeling accuracy and computational effort. PMID:24385884

  16. Co-Crystals: A Novel Approach to Modify Physicochemical Properties of Active Pharmaceutical Ingredients

    PubMed Central

    Yadav, A. V.; Shete, A. S.; Dabke, A. P.; Kulkarni, P. V.; Sakhare, S. S.

    2009-01-01

    Crystal form can be crucial to the performance of a dosage form. This is especially true for compounds that have intrinsic barriers to drug delivery, such as low aqueous solubility, slow dissolution in gastrointestinal media, low permeability and first-pass metabolism. The nature of the physical form and formulation tends to exhibit the greatest effect on bioavailability parameters of water insoluble compounds that need to be given orally in high doses. An alternative approach available for the enhancement of drug solubility, dissolution and bioavailability is through the application of crystal engineering of co-crystals. The physicochemical properties of the active pharmaceutical ingredients and the bulk material properties can be modified, whilst maintaining the intrinsic activity of the drug molecule. This article covers the advantages of co-crystals over salts, solvates (hydrates), solid dispersions and polymorphs, mechanism of formation of co-crystals, methods of preparation of co-crystals and application of co-crystals to modify physicochemical characteristics of active pharmaceutical ingredients along with the case studies. The intellectual property implications of creating co-crystals are also highly relevant. PMID:20502540

  17. Modified neural dynamic surface approach to output feedback of MIMO nonlinear systems.

    PubMed

    Sun, Guofa; Li, Dongwu; Ren, Xuemei

    2015-02-01

    We report an adaptive output feedback dynamic surface control (DSC), maintaining the prescribed performance, for a class of uncertain nonlinear systems with multiinput and multioutput. Designing neural network observers and modifying the DSC method achieves several control objectives. First, to achieve output feedback control, the finite-time echo state networks (ESN) observer with fast convergence is designed to obtain the online system states. Thus, the immeasurable states in traditional state feedback control are estimated and the unknown functions are approximated by ESN. Then, a modified DSC approach is developed by introducing a high-order sliding mode differentiator to replace the first-order filter in each step. Thus, the effect of filter performance on closed-loop stability is reduced. Furthermore, the input to state stability guarantees that all signals of the whole closed-loop system are semiglobally uniformly ultimately bounded. Specifically, the performance functions make the tracking errors converge to a compact set around equilibrium. Two numerical examples illustrated the proposed control scheme with satisfactory results.

  18. A new approach for rhenium(VII) recovery by using modified brown algae Laminaria japonica adsorbent.

    PubMed

    Xiong, Ying; Xu, Jia; Shan, Weijun; Lou, Zhenning; Fang, Dawei; Zang, Shuliang; Han, Guangxi

    2013-01-01

    Brown algae Laminaria japonica was chemically modified with sulfuric acid to obtain a crosslinked brown algae gel (CAS). The CAS gel showed a high affinity for Re(VII) comparing with other biomass gels, and the maximum adsorption capacity was evaluated as 37.20 mg g(-1) in case of pH 6, which could be explained by their different adsorption mechanisms. The adsorption equilibrium, kinetics and thermodynamic study for Re(VII) on the CAS gel was discussed in detail by the several models, such as Langmuir, Freundlich, Temkin and Dubinin-Radushkevich model for kinetics analysis, the pseudo first, the second-order, the Elovich and intraparticle diffusion equation for equilibrium analysis. Reutilization of the CAS gel was confirmed up to three adsorption-elution cycles in column-mode operation with no damage of gel, packed in the column. The result also provides a new approach for the recovery of Re(VII) from Re-containing wastewater by using the modified brown algae gel.

  19. Detection and assessment of wood decay in glulam beams using a modified impulse-echo approach

    NASA Astrophysics Data System (ADS)

    Senalik, Adam; McGovern, Megan E.; Beall, Frank C.; Reis, Henrique

    2009-03-01

    A glulam beam retired from the field and without visible indications of wood decay was used. Towards detection and assessing wood decay, X-ray computer tomography and ultrasonic measurements were carried out. It was observed that decrease in mass density with increasing levels of wood decay affects x-rays attenuation and allows radioscopy to detect and assess wood decay. To detect and assess decay when only one lateral side of the beam is available, a modified impulse-echo was developed. The modified impulse-echo approach is based on observing the dynamic response of the glulam beams to the drop of a steel sphere onto a steel plate coupled to the glulam beam lamina. It was observed that monitoring certain frequency bands allows detection and assessment of wood decay. The selection of these frequency bands requires knowledge of the nominal beam transverse dimensions. Because of the high ultrasonic material attenuation values of decayed wood as compared with those of sound wood, the area under the power spectral density in these frequency bands is smaller in regions of decayed wood. Results show that results from both X-ray computer tomography and impulse-echo measurements are consistent with each other and can be used to detect and assess wood decay in structural lumber.

  20. The CAP Approach to Modifying Vocational Programs for Handicapped Students. Vol. 1: Agriculture with an Example in Horticulture.

    ERIC Educational Resources Information Center

    Tindall, Lloyd W.; Morehouse, Nancy

    This combination teaching guide and student workbook, the first in a five-volume series (see note), presents an approach to teaching horticulture for handicapped students. The guide discusses a functional approach to modifying agriculture programs to accomodate cognitive, affective, and psychomotor (CAP) domain handicaps. The discussion centers on…

  1. Lax Triad Approach to Symmetries of Scalar Modified Kadomtsev–Petviashvili Hierarchy

    NASA Astrophysics Data System (ADS)

    Deng, Xiao; Chen, Kui; Zhang, Da-Jun

    2017-02-01

    By means of Lax triads we reconstruct isospectral and nonisospectral scalar modified Kadomtsev–Petviashvili (mKP) hierarchies. In this approach the argument y is treated as an independent variable which is independent of time parameters \\{{t}1,{t}2,\\ldots \\}. Consequently, the isospectral and nonisospectral scalar mKP flows can have clear zero curvature representations, which enables us to handle investigation of symmetries of the scalar isospectral mKP hierarchy as freely as for (1+1)-dimensional systems. As a result, we obtain Lie algebraic structures of the scalar mKP flows and construct symmetries for the scalar isospectral mKP hierarchy. Supported by the National Natural Science Foundation of China under Grant No. 11371241

  2. The minimal invasive direct anterior approach in combination with large heads in total hip arthroplasty - is dislocation still a major issue? a case control study

    PubMed Central

    2014-01-01

    Background There have been increasing numbers of publications in recent years on minimally invasive surgery (MIS) for total hip arthroplasty (THA), reporting results with the use of different head sizes, tribologic and functional outcomes. This study presents the results and early complication rates after THA using the direct anterior approach (DAA) in combination with head sizes ≥ 36 mm. Methods A total of 113 patients with THA were included in the study. The Harris Hip Score (HHS) was determined, a radiographic evaluation was carried out, and complications were recorded. The minimum follow-up period was 2 years (means 35 ± 7 months). Results The HHS improved from 43.6 (± 12) to 88.2 (± 14; P < 0.01). One early infection occurred, one periprosthetic fracture, and three cases of aseptic stem loosening. No incorrect positioning of the implants was observed, and there were no dislocations. Conclusion THA with the minimally invasive DAA in combination with large heads is associated with good to very good functional results in the majority of cases. The complication rates are not increased. The rate of dislocation mainly as an complication of the first two years can be markedly reduced in particular. PMID:24621189

  3. Approaches to the treatment of early rheumatoid arthritis with disease-modifying antirheumatic drugs

    PubMed Central

    Sizova, Lyudmila

    2008-01-01

    This paper reviews recent approaches to treatment of early rheumatoid arthritis (RA) with disease-modifying antirheumatic drugs (DMARDs). The literature on treatment the early RA published between 1995 and 2007 was accessed through the PubMed database from the National Library of Medicine. Keywords were ‘early rheumatoid arthritis’, ‘disease-modifying antirheumatic drugs’, ‘biologic agents’ and ‘combination therapy’. Only results of trials on human subjects that directly measured the effects of DMARDs or biological agents on clinical, laboratory parameters and radiological progression of early RA were selected. Combination therapy suppresses RA activity and radiological progression more effectively than monotherapy. If better control of RA is evident after 3–6 months of treatment with the combination of DMARDs, one must still decide whether to stop the first DMARD, stop the second, or continue with the combination. Combination therapy biological agents (infliximab, adalimumab) with methotrexate and etanercept therapy alone may induce remission in many patients with early RA. It is a method of choice in patients with an adverse prognosis. The main indications for combination therapy ‘standard’ DMARDs or combination 1 DMARDs with a biological agent are such variables as detection of a shared epitope, increase of concentration of anticyclic citrullinated peptide antibodies, rheumatoid factor, C-reactive protein, 28-joint disease activity score, Sharp score and presence of erosion in joints. The majority of rheumatologists believe that patients with RA should be treated with DMARDs earlier rather than later in the disease process. Further trials should establish the optimal approaches to early RA therapy. PMID:18537958

  4. Making better scar: Emerging approaches for modifying mechanical and electrical properties following infarction and ablation.

    PubMed

    Holmes, Jeffrey W; Laksman, Zachary; Gepstein, Lior

    2016-01-01

    Following myocardial infarction (MI), damaged myocytes are replaced by collagenous scar tissue, which serves an important mechanical function - maintaining integrity of the heart wall against enormous mechanical forces - but also disrupts electrical function as structural and electrical remodeling in the infarct and borderzone predispose to re-entry and ventricular tachycardia. Novel emerging regenerative approaches aim to replace this scar tissue with viable myocytes. Yet an alternative strategy of therapeutically modifying selected scar properties may also prove important, and in some cases may offer similar benefits with lower risk or regulatory complexity. Here, we review potential goals for such modifications as well as recent proof-of-concept studies employing specific modifications, including gene therapy to locally increase conduction velocity or prolong the refractory period in and around the infarct scar, and modification of scar anisotropy to improve regional mechanics and pump function. Another advantage of scar modification techniques is that they have applications well beyond MI. In particular, ablation treats electrical abnormalities of the heart by intentionally generating scar to block aberrant conduction pathways. Yet in diseases such as atrial fibrillation (AF) where ablation can be extensive, treating the electrical disorder can significantly impair mechanical function. Creating smaller, denser scars that more effectively block conduction, and choosing the location of those lesions by balancing their electrical and mechanical impacts, could significantly improve outcomes for AF patients. We review some recent advances in this area, including the use of computational models to predict the mechanical effects of specific lesion sets and gene therapy for functional ablation. Overall, emerging techniques for modifying scar properties represents a potentially important set of tools for improving patient outcomes across a range of heart diseases

  5. Drought in a human-modified world: reframing drought definitions, understanding, and analysis approaches

    NASA Astrophysics Data System (ADS)

    Van Loon, Anne F.; Stahl, Kerstin; Di Baldassarre, Giuliano; Clark, Julian; Rangecroft, Sally; Wanders, Niko; Gleeson, Tom; Van Dijk, Albert I. J. M.; Tallaksen, Lena M.; Hannaford, Jamie; Uijlenhoet, Remko; Teuling, Adriaan J.; Hannah, David M.; Sheffield, Justin; Svoboda, Mark; Verbeiren, Boud; Wagener, Thorsten; Van Lanen, Henny A. J.

    2016-09-01

    In the current human-modified world, or Anthropocene, the state of water stores and fluxes has become dependent on human as well as natural processes. Water deficits (or droughts) are the result of a complex interaction between meteorological anomalies, land surface processes, and human inflows, outflows, and storage changes. Our current inability to adequately analyse and manage drought in many places points to gaps in our understanding and to inadequate data and tools. The Anthropocene requires a new framework for drought definitions and research. Drought definitions need to be revisited to explicitly include human processes driving and modifying soil moisture drought and hydrological drought development. We give recommendations for robust drought definitions to clarify timescales of drought and prevent confusion with related terms such as water scarcity and overexploitation. Additionally, our understanding and analysis of drought need to move from single driver to multiple drivers and from uni-directional to multi-directional. We identify research gaps and propose analysis approaches on (1) drivers, (2) modifiers, (3) impacts, (4) feedbacks, and (5) changing the baseline of drought in the Anthropocene. The most pressing research questions are related to the attribution of drought to its causes, to linking drought impacts to drought characteristics, and to societal adaptation and responses to drought. Example questions include

    • (i) What are the dominant drivers of drought in different parts of the world? (ii) How do human modifications of drought enhance or alleviate drought severity? (iii) How do impacts of drought depend on the physical characteristics of drought vs. the vulnerability of people or the environment? (iv) To what extent are physical and human drought processes coupled, and can feedback loops be identified and altered to lessen or mitigate drought? (v) How should we adapt our drought analysis to

    • Quantum harmonic Brownian motion in a general environment: A modified phase-space approach

      SciTech Connect

      Yeh, L. |

      1993-06-23

      After extensive investigations over three decades, the linear-coupling model and its equivalents have become the standard microscopic models for quantum harmonic Brownian motion, in which a harmonically bound Brownian particle is coupled to a quantum dissipative heat bath of general type modeled by infinitely many harmonic oscillators. The dynamics of these models have been studied by many authors using the quantum Langevin equation, the path-integral approach, quasi-probability distribution functions (e.g., the Wigner function), etc. However, the quantum Langevin equation is only applicable to some special problems, while other approaches all involve complicated calculations due to the inevitable reduction (i.e., contraction) operation for ignoring/eliminating the degrees of freedom of the heat bath. In this dissertation, the author proposes an improved methodology via a modified phase-space approach which employs the characteristic function (the symplectic Fourier transform of the Wigner function) as the representative of the density operator. This representative is claimed to be the most natural one for performing the reduction, not only because of its simplicity but also because of its manifestation of geometric meaning. Accordingly, it is particularly convenient for studying the time evolution of the Brownian particle with an arbitrary initial state. The power of this characteristic function is illuminated through a detailed study of several physically interesting problems, including the environment-induced damping of quantum interference, the exact quantum Fokker-Planck equations, and the relaxation of non-factorizable initial states. All derivations and calculations axe shown to be much simplified in comparison with other approaches. In addition to dynamical problems, a novel derivation of the fluctuation-dissipation theorem which is valid for all quantum linear systems is presented.

    • Anterior cruciate ligament - updating article.

      PubMed

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

      2016-01-01

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

    • Feasibility of robot-assisted modified radical neck dissection by post-auricular facelift approach.

      PubMed

      Tae, K; Ji, Y B; Song, C M; Sung, E S; Chung, J H; Lee, S H; Park, H J

      2016-11-01

      The aim of this study was to evaluate the technical feasibility and safety of robot-assisted modified radical neck dissection (MRND) for head and neck cancer patients with a clinically node-positive neck. The cases of 10 head and neck cancer patients who underwent unilateral therapeutic robot-assisted MRND by post-auricular facelift approach were analyzed. The robot-assisted MRND was completed successfully in all patients without any conversion to conventional neck dissection. The mean number of lymph nodes removed was 36.7±8.6. The mean duration of surgery for robot-assisted MRND was 274±65min (range 175-395min). Transient marginal nerve palsy occurred in two patients and partial necrosis of the skin flap occurred in one patient. In terms of cosmetic satisfaction, 70% of patients were very satisfied or satisfied with postoperative cosmesis. In conclusion, robot-assisted MRND by post-auricular facelift approach is technically feasible and safe in selected patients with head and neck cancer, and yields excellent postoperative cosmesis.

    • Functional in vitro tension measurements of fascial tissue – a novel modified superfusion approach

      PubMed Central

      Schleip, R.; Klingler, W.; Wearing, S.; Naylor, I.; Zuegel, M.; Hoppe, K.

      2016-01-01

      Introduction: While two laboratory techniques are commonly used to assess the tensile properties of muscle tissue, emerging evidence suggests that the fascial components of these tissues also serve an active role in force generation. Hence, we investigated whether these techniques are sensitive for assessment of fascial micromechanics. Methods: Force measurements on dissected fascial tissue were performed either using the classical immersion organ bath or using an improved superfusion approach simulating pulsed pharmacological triggers. Rat deep dorsal fascial strips as well as rat testicular capsule were pharmacologically challenged either with mepyramine or oxytocin. Results: The classical immersion technique yielded a lower force response to mepyramine than the superfusion method (median: 367.4 vs. 555.4µN/mm2). Pause in irrigation before application reduced irregularities during bolus application. The superfusion approach was improved further by the following points: The high sensitivity of the superfusion method to bolus addition was voided by deviation of fluid supply during bolus addition. Conclusion: Although both methods demonstrated pharmacologically induced contractile responses in lumbar fascia samples, the modified superfusion method may improve force registrations of slow contracting fascial tissue and minimize artefacts of fluid application. PMID:27609040

    • Giant Cavernous Haemangioma of the Anterior Mediastinum

      PubMed Central

      Kaya, Seyda Ors; Samancılar, Ozgur; Usluer, Ozan; Acar, Tuba; Yener, Ali Galip

      2015-01-01

      Cavernous hemangiomas of the anterior mediastinum is rare. We present a case of a 56-year-old male patient with a giant cavernous hemangioma of the anterior mediastinum, 18 cm in diameters, approached by left posterolateral thoracotomy. To the best of our knowledge, such a unique case has not been previously presented in the literature. PMID:26644773

    • Bioengineered anterior cruciate ligament

      NASA Technical Reports Server (NTRS)

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

      2001-01-01

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

    • A modified treatment approach for fabricating a mandibular distal-extension partial denture: a clinical report.

      PubMed

      Prasad, Soni; Monaco, Edward A

      2010-03-01

      An altered cast impression technique is routinely used for fabricating distal-extension partial dentures. The advantages of an altered cast impression technique are that it evenly distributes stresses between hard and soft tissues and reduces stresses to the abutment teeth. However, there is some controversy among clinicians as to the technique and requirements of both tooth and tissue management of the distal-extension partial denture. A modified approach of fabricating a distal-extension partial denture is presented using a laboratory-processed functional reline method. The functional reline is performed after the removable partial denture is processed to perfect the fit of the denture base to the residual ridge. This enables the partial denture to be constructed from a cast made from a single impression and results in a prosthesis that is stable and has well-extended borders. Not only is it easy and less technique-sensitive for the operator, but it also results in increased comfort and reduced need for multiple adjustment visits for the patient.

    • Modified approach to use of DOE-STD-3009 example risk matrices.

      SciTech Connect

      Atwood, Ginger A.

      2008-04-01

      DOE-STD-3009, Preparation Guide for US Department of Energy Non-reactor Nuclear Facilities Documented Safety Analyses, identifies a methodology for selection of high risk accidents and hazard scenarios for Hazard Category 1, 2, and 3 Nuclear Facilities and their controls. It provides examples of risk matrices which can be used as a part of this methodology. It also states, 'There is no one correct approach or presentation'. Sandia has used a modified version of these examples to focus control selection on controls that provide the highest risk to the public and the workers. Sandia's matrix assigns a lower risk level to high probability, low consequence events that are covered by institutional safety programs. The objective of this paper is to serve as a point of discussion on the benefits of using this modification to the DOE-STD-3009 examples. The paper relates to the workshop subtopic of Lessons Learned and Hazards Analysis since it provides lessons learned in hazard analysis process at SNL.

    • Simulation of emotional contagion using modified SIR model: A cellular automaton approach

      NASA Astrophysics Data System (ADS)

      Fu, Libi; Song, Weiguo; Lv, Wei; Lo, Siuming

      2014-07-01

      Emotion plays an important role in the decision-making of individuals in some emergency situations. The contagion of emotion may induce either normal or abnormal consolidated crowd behavior. This paper aims to simulate the dynamics of emotional contagion among crowds by modifying the epidemiological SIR model to a cellular automaton approach. This new cellular automaton model, entitled the “CA-SIRS model”, captures the dynamic process ‘susceptible-infected-recovered-susceptible', which is based on SIRS contagion in epidemiological theory. Moreover, in this new model, the process is integrated with individual movement. The simulation results of this model show that multiple waves and dynamical stability around a mean value will appear during emotion spreading. It was found that the proportion of initial infected individuals had little influence on the final stable proportion of infected population in a given system, and that infection frequency increased with an increase in the average crowd density. Our results further suggest that individual movement accelerates the spread speed of emotion and increases the stable proportion of infected population. Furthermore, decreasing the duration of an infection and the probability of reinfection can markedly reduce the number of infected individuals. It is hoped that this study will be helpful in crowd management and evacuation organization.

    • Heterogeneous ensemble approach with discriminative features and modified-SMOTEbagging for pre-miRNA classification

      PubMed Central

      Lertampaiporn, Supatcha; Thammarongtham, Chinae; Nukoolkit, Chakarida; Kaewkamnerdpong, Boonserm; Ruengjitchatchawalya, Marasri

      2013-01-01

      An ensemble classifier approach for microRNA precursor (pre-miRNA) classification was proposed based upon combining a set of heterogeneous algorithms including support vector machine (SVM), k-nearest neighbors (kNN) and random forest (RF), then aggregating their prediction through a voting system. Additionally, the proposed algorithm, the classification performance was also improved using discriminative features, self-containment and its derivatives, which have shown unique structural robustness characteristics of pre-miRNAs. These are applicable across different species. By applying preprocessing methods—both a correlation-based feature selection (CFS) with genetic algorithm (GA) search method and a modified-Synthetic Minority Oversampling Technique (SMOTE) bagging rebalancing method—improvement in the performance of this ensemble was observed. The overall prediction accuracies obtained via 10 runs of 5-fold cross validation (CV) was 96.54%, with sensitivity of 94.8% and specificity of 98.3%—this is better in trade-off sensitivity and specificity values than those of other state-of-the-art methods. The ensemble model was applied to animal, plant and virus pre-miRNA and achieved high accuracy, >93%. Exploiting the discriminative set of selected features also suggests that pre-miRNAs possess high intrinsic structural robustness as compared with other stem loops. Our heterogeneous ensemble method gave a relatively more reliable prediction than those using single classifiers. Our program is available at http://ncrna-pred.com/premiRNA.html. PMID:23012261

    • Key elements in a strategic approach to capacity building in the biosafety of genetically modified organisms.

      PubMed

      Araya-Quesada, Marianela; Degrassi, Giuliano; Ripandelli, Decio; Craig, Wendy

      2010-01-01

      In recent times, it has become imperative for countries to define and implement policy in biosafety due to the widespread adoption of genetically modified crops. As such, countries wishing to utilise transgenic technologies in the development of advanced agricultural products must have regulations in place coupled with trained personnel in national competent authorities able to contribute effectively to the decision-making process. Capacity building initiatives play an important role in supporting such individuals, institutions and governmental authorities by providing training and/or physical structures/equipment and technical assistance. There are many types of capacity building activities; however not all have the same relevance in different regions of the world. For capacity building to be effective, a strategic approach incorporating a variety of forms and disciplines is desired. This commentary discusses the importance of factors such as: the targeting of support to relevant beneficiary(ies); the identification of specific needs and the incorporation of socio-economic conditions when elaborating effective strategies designed to help building capacity. Moreover, the importance of interaction and collaboration amongst the various capacity builders is also discussed such that unnecessary duplication of efforts and best use of available human and economic resources results.

    • Cancelling ECG Artifacts in EEG Using a Modified Independent Component Analysis Approach

      NASA Astrophysics Data System (ADS)

      Devuyst, Stéphanie; Dutoit, Thierry; Stenuit, Patricia; Kerkhofs, Myriam; Stanus, Etienne

      2008-12-01

      We introduce a new automatic method to eliminate electrocardiogram (ECG) noise in an electroencephalogram (EEG) or electrooculogram (EOG). It is based on a modification of the independent component analysis (ICA) algorithm which gives promising results while using only a single-channel electroencephalogram (or electrooculogram) and the ECG. To check the effectiveness of our approach, we compared it with other methods, that is, ensemble average subtraction (EAS) and adaptive filtering (AF). Tests were carried out on simulated data obtained by addition of a filtered ECG on a visually clean original EEG and on real data made up of 10 excerpts of polysomnographic (PSG) sleep recordings containing ECG artifacts and other typical artifacts (e.g., movement, sweat, respiration, etc.). We found that our modified ICA algorithm had the most promising performance on simulated data since it presented the minimal root mean-squared error. Furthermore, using real data, we noted that this algorithm was the most robust to various waveforms of cardiac interference and to the presence of other artifacts, with a correction rate of 91.0%, against 83.5% for EAS and 83.1% for AF.

    • A modified MS-PCR approach to diagnose patients with Prader-Willi and Angelman syndrome.

      PubMed

      Dos Santos, Jéssica Fernandes; Mota, Laís R; Rocha, Pedro Henrique Silva Andrade; Ferreira de Lima, Renata Lúcia L

      2016-11-01

      Prader-Willi (PWS) and Angelman (AS) syndromes are clinically distinct neurodevelopmental genetic diseases with multiple phenotypic manifestations. They are one of the most common genetic syndromes caused by non-Mendelian inheritance in the form of genomic imprinting, and can be attributable to the loss of gene expression due to imprinting within the chromosomal region 15q11-q13. Clinical diagnosis of PWS and AS is challenging, and the use of molecular and cytomolecular studies is recommended to help in determining the diagnosis of these conditions. The methylation analysis is a sensible approach; however there are several techniques for this purpose, such as the methylation-sensitive polymerase chain reaction (MS-PCR). This study aims to optimize the MS-PCR assay for the diagnosis of potential PWS and AS patients using DNA modified by sodium bisulfite. We used the MS-PCR technique of PCR described by Kosaki et al. (1997) adapted with betaine. All different concentrations of betaine used to amplify the methylated and unmethylated chromosomal region 15q11-q13 on the gene SNRPN showed amplification results, which increased proportionally to the concentration of betaine. The methylation analysis is a technically robust and reproducible screening method for PWS and AS. The MS-PCR assures a faster, cheaper and more efficient method for the primary diagnosis of the SNRPN gene in cases with PWS and AS, and may detect all of the three associated genetic abnormalities: deletion, uniparental disomy or imprinting errors.

    • A Sternum-Disk Distance Method to Identify the Skin Level for Approaching a Surgical Segment without Fluoroscopy Guidance during Anterior Cervical Discectomy And Fusion

      PubMed Central

      Lee, Gun Woo; Ahn, Myun-Whan; Shin, Ji-Hoon; Park, Jae Woo; Uh, Jae-Hyung; Park, Jong-Ho; Lee, Ji-Hoon; Kim, Dong-Wook; Yeom, Jin S.

      2017-01-01

      Study Design A retrospective review of prospectively collected data. Purpose To introduce the sternum-disk distance (SDD) method for approaching the exact surgical level without C-arm guidance during anterior cervical discectomy and fusion (ACDF) surgery and to evaluate its accuracy and reliability. Overview of Literature Although spine surgeons have tried to optimize methods for identifying the skin level for accessing the operative disk level without C-arm guidance during ACDF, success has rarely been reported. Methods In total, 103 patients who underwent single-level ACDF surgery with the SDD method were enrolled. The primary outcome measure was the accuracy of the SDD method. The secondary outcome measures were the mean SDD value at each cervical level from the cranial margin of the sternum in the neutral and extension positions of the cervical spine and the inter- and intra-observer reliability of the SDD outcome determined using repeated measurements by three orthopedic spine surgeons. Results The SDD accuracy (primary outcome measure) was indicated in 99% of the patients (102/103). The mean SDD values in the neutral-position magnetic resonance imaging (MRI) were 108.8 mm at C3–C4, 85.3 mm at C4–C5, 64.4 mm at C5–C6, 44.3 mm at C6–C7, and 24.1 mm at C7–T1; and those in the extension-position MRI were 112.9 mm at C3–C4, 88.7 mm at C4–C5, 67.3 mm at C5–C6, 46.5 mm at C6–C7, and 24.3 mm at C7–T1. The Cohen kappa coefficient value for intra-observer reliability was 0.88 (excellent reliability), and the Fleiss kappa coefficient value for inter-observer reliability as reported by three surgeons was 0.89 (excellent reliability). Conclusions Based on the results of the present study, we recommend performing ACDF surgery using the SDD method to determine the skin level for approaching the surgical cervical segment without fluoroscopic guidance. PMID:28243369

    • Anterior Cervical Spine Surgery for Degenerative Disease: A Review

      PubMed Central

      SUGAWARA, Taku

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

  1. Assuring the safety of genetically modified (GM) foods: the importance of an holistic, integrative approach.

    PubMed

    Cockburn, Andrew

    2002-09-11

    Genes change continuously by natural mutation and recombination enabling man to select and breed crops having the most desirable traits such as yield or flavour. Genetic modification (GM) is a recent development which allows specific genes to be identified, isolated, copied and inserted into other plants with a high level of specificity. The food safety considerations for GM crops are basically the same as those arising from conventionally bred crops, very few of which have been subject to any testing yet are generally regarded as being safe to eat. In contrast a rigorous safety testing paradigm has been developed for GM crops, which utilises a systematic, stepwise and holistic approach. The resultant science based process, focuses on a classical evaluation of the toxic potential of the introduced novel trait and the wholesomeness of the transformed crop. In addition, detailed consideration is given to the history and safe use of the parent crop as well as that of the gene donor. The overall safety evaluation is conducted under the concept known as substantial equivalence which is enshrined in all international crop biotechnology guidelines. This provides the framework for a comparative approach to identify the similarities and differences between the GM product and its comparator which has a known history of safe use. By building a detailed profile on each step in the transformation process, from parent to new crop, and by thoroughly evaluating the significance from a safety perspective, of any differences that may be detected, a very comprehensive matrix of information is constructed which enables the conclusion as to whether the GM crop, derived food or feed is as safe as its traditional counterpart. Using this approach in the evaluation of more than 50 GM crops which have been approved worldwide, the conclusion has been that foods and feeds derived from genetically modified crops are as safe and nutritious as those derived from traditional crops. The lack of

  2. A modified Delphi approach to standardize low back pain recurrence terminology.

    PubMed

    Stanton, Tasha R; Latimer, Jane; Maher, Chris G; Hancock, Mark J

    2011-05-01

    Lack of standardization of terminology in low back pain (LBP) research has significantly impeded progress in this area. The diversity in existing definitions for a 'recurrence of an episode of LBP' and 'recurrent LBP' is an important example. The variety of definitions used by researchers working in this area has prevented comparison of results between trials and made meta-analyses of this data unfeasible. The aim of this study was to use a modified Delphi approach to gain consensus on definitions for a 'recurrence of an episode of LBP' (e.g. outcome event) and for 'recurrent LBP' (e.g. patient population). Existing definitions for both constructs were classified into the main features comprising the definition (e.g. 'duration of pain') and the items that defined each feature (e.g. 'pain lasting at least 24 h'). In each round, participants were asked to rate the importance of each feature to a definition of a 'recurrence of an episode of LBP', and a definition of 'recurrent LBP' and rank the items (defining each feature) in order of decreasing importance. Forty-six experts in LBP research, from nine different countries, participated in this study. Four rounds were completed with responses rates of 94, 91, 83, and 97% in rounds 1, 2, 3, and 4, respectively. Consensus definitions were reached in both areas with 95% of panel members supporting the definition of a 'recurrence of an episode of LBP' and 92% of panel members supporting the definition of 'recurrent LBP'. Future research is necessary to evaluate these definitions.

  3. Modified approach to the characterization of adrenal nodules using a standard abdominal magnetic resonance imaging protocol

    PubMed Central

    Matos, António P.; Semelka, Richard C.; Herédia, Vasco; AlObaidiy, Mamdoh; Gomes, Filipe Veloso; Ramalho, Miguel

    2017-01-01

    Objective To describe a modified approach to the evaluation of adrenal nodules using a standard abdominal magnetic resonance imaging protocol. Materials and Methods Our sample comprised 149 subjects (collectively presenting with 132 adenomas and 40 nonadenomas). The adrenal signal intensity index was calculated. Lesions were grouped by pattern of enhancement (PE), according to the phase during which the wash-in peaked: arterial phase (type 1 PE); portal venous phase (type 2 PE); and interstitial phase (type 3 PE). The relative and absolute wash-out values were calculated. To test for mean differences between adenomas and nonadenomas, Student's t-tests were used. Receiver operating characteristic curve analysis was also performed. Results The mean adrenal signal intensity index was significantly higher for the adenomas than for the nonadenomas (p < 0.0001). Chemical shift imaging showed a sensitivity and specificity of 94.4% and 100%, respectively, for differentiating adenomas from nonadenomas. Of the adenomas, 47.6%, 48.5%, and 3.9%, respectively, exhibited type 1, 2, and 3 PEs. For the mean wash-in proportions, significant differences were found among the enhancement patterns. The wash-out calculations revealed a trend toward better lesion differentiation for lesions exhibiting a type 1 PE, showing a sensitivity and specificity of 71.4% and 80.0%, respectively, when the absolute values were referenced, as well as for lesions exhibiting a type 2 PE, showing a sensitivity and specificity of 68.0% and 100%, respectively, when the relative values were referenced. The calculated probability of a lipid-poor lesion that exhibited a type 3 PE being a nonadenoma was > 99%. Conclusion Subgrouping dynamic enhancement patterns yields high diagnostic accuracy in differentiating adenomas from nonadenomas. PMID:28298728

  4. Atomic-layer electroless deposition: a scalable approach to surface-modified metal powders.

    PubMed

    Cappillino, Patrick J; Sugar, Joshua D; El Gabaly, Farid; Cai, Trevor Y; Liu, Zhi; Stickney, John L; Robinson, David B

    2014-04-29

    Palladium has a number of important applications in energy and catalysis in which there is evidence that surface modification leads to enhanced properties. A strategy for preparing such materials is needed that combines the properties of (i) scalability (especially on high-surface-area substrates, e.g. powders); (ii) uniform deposition, even on substrates with complex, three-dimensional features; and (iii) low-temperature processing conditions that preserve nanopores and other nanostructures. Presented herein is a method that exhibits these properties and makes use of benign reagents without the use of specialized equipment. By exposing Pd powder to dilute hydrogen in nitrogen gas, sacrificial surface PdH is formed along with a controlled amount of dilute interstitial hydride. The lattice expansion that occurs in Pd under higher H2 partial pressures is avoided. Once the flow of reagent gas is terminated, addition of metal salts facilitates controlled, electroless deposition of an overlayer of subnanometer thickness. This process can be cycled to create thicker layers. The approach is carried out under ambient processing conditions, which is an advantage over some forms of atomic layer deposition. The hydride-mediated reaction is electroless in that it has no need for connection to an external source of electrical current and is thus amenable to deposition on high-surface-area substrates having rich, nanoscale topography as well as on insulator-supported catalyst particles. STEM-EDS measurements show that conformal Rh and Pt surface layers can be formed on Pd powder with this method. A growth model based on energy-resolved XPS depth profiling of Rh-modified Pd powder is in general agreement. After two cycles, deposits are consistent with 70-80% coverage and a surface layer with a thickness from 4 to 8 Å.

  5. The influence of anterior coupling on mandibular movement.

    PubMed

    Brose, M O; Tanquist, R A

    1987-03-01

    The need for and use of anterior coupling in occlusal rehabilitation has been discussed. The anterior teeth can often be coupled to the posterior controls by modifying contours with selective grinding, full or partial coverage restorations, or composite. When anterior guidance is provided, the anterior teeth should harmonize with the TMJs so that the posterior teeth will disclude in excursive mandibular movements. Significant functional, esthetic, and phonetic alterations that change the anterior guidance must be carefully planned because the anterior guidance affects all excursive tooth contacts. Anterior coupling, as described, is often an overlooked entity in restorative dentistry. Evidence of its role in separating the posterior teeth, reducing parafunctional activity, and harmonizing the temporomandibular complex has been presented.

  6. USE OF MODELING APPROACHES TO UNDERSTAND POTENTIAL IMPACTS OF GENETICALLY MODIFIED PLANTS ON PLANT COMMUNITIES

    EPA Science Inventory

    Model development is of interest to ecologists, regulators and developers, since it may assist theoretical understanding, decision making in experimental design, product development and risk assessment. In order to predict the potential impacts of genetically modified (GM) plants...

  7. Approaches in the risk assessment of genetically modified foods by the Hellenic Food Safety Authority.

    PubMed

    Varzakas, Theodoros H; Chryssochoidis, G; Argyropoulos, D

    2007-04-01

    Risk analysis has become important to assess conditions and take decisions on control procedures. In this context it is considered a prerequisite in the evaluation of GM food. Many consumers worldwide worry that food derived from genetically modified organisms (GMOs) may be unhealthy and hence regulations on GMO authorisations and labelling have become more stringent. Nowadays there is a higher demand for non-GM products and these products could be differentiated from GM products using the identity preservation system (IP) that could apply throughout the grain processing system. IP is the creation of a transparent communication system that encompasses HACCP, traceability and related systems in the supply chain. This process guarantees that certain characteristics of the lots of food (non-GM origin) are maintained "from farm to fork". This article examines the steps taken by the Hellenic Food Safety Authority to examine the presence of GMOs in foods. The whole integrated European legislation framework currently in place still needs to be implemented in Greece. Penalties should be enforced to those who import, process GMOs without special licence and do not label those products. Similar penalties should be enforced to those companies that issue false certificates beyond the liabilities taken by the food enterprises for farmers' compensation. We argue that Greece has no serious reasons to choose the use of GMOs due to the fact that the structural and pedologic characteristics of the Greek agriculture favour the biological and integrated cultivation more. Greece is not in favour of the politics behind coexistence of conventional and GM plants and objects to the use of GMOs in the food and the environment because the processor has a big burden in terms of money, time and will suffer a great deal in order to prove that their products are GMO free or that any contamination is adventitious or technically unavoidable. Moreover, Greece owns a large variety of genetic

  8. Seasonal rationalization of river water quality sampling locations: a comparative study of the modified Sanders and multivariate statistical approaches.

    PubMed

    Varekar, Vikas; Karmakar, Subhankar; Jha, Ramakar

    2016-02-01

    The design of surface water quality sampling location is a crucial decision-making process for rationalization of monitoring network. The quantity, quality, and types of available dataset (watershed characteristics and water quality data) may affect the selection of appropriate design methodology. The modified Sanders approach and multivariate statistical techniques [particularly factor analysis (FA)/principal component analysis (PCA)] are well-accepted and widely used techniques for design of sampling locations. However, their performance may vary significantly with quantity, quality, and types of available dataset. In this paper, an attempt has been made to evaluate performance of these techniques by accounting the effect of seasonal variation, under a situation of limited water quality data but extensive watershed characteristics information, as continuous and consistent river water quality data is usually difficult to obtain, whereas watershed information may be made available through application of geospatial techniques. A case study of Kali River, Western Uttar Pradesh, India, is selected for the analysis. The monitoring was carried out at 16 sampling locations. The discrete and diffuse pollution loads at different sampling sites were estimated and accounted using modified Sanders approach, whereas the monitored physical and chemical water quality parameters were utilized as inputs for FA/PCA. The designed optimum number of sampling locations for monsoon and non-monsoon seasons by modified Sanders approach are eight and seven while that for FA/PCA are eleven and nine, respectively. Less variation in the number and locations of designed sampling sites were obtained by both techniques, which shows stability of results. A geospatial analysis has also been carried out to check the significance of designed sampling location with respect to river basin characteristics and land use of the study area. Both methods are equally efficient; however, modified Sanders

  9. Modified automatic teller machine prototype for older adults: a case study of participative approach to inclusive design.

    PubMed

    Chan, Chetwyn C H; Wong, Alex W K; Lee, Tatia M C; Chi, Iris

    2009-03-01

    The goal of this study was to enhance an existing automated teller machine (ATM) human-machine interface in order to accommodate the needs of older adults. Older adults were involved in the design and field test of the modified ATM prototype. The design of the user interface and functionality took the cognitive and physical abilities of older adults into account. The modified ATM system included only "cash withdrawal" and "transfer" functions based on the task demands and needs for services of older adults. One hundred and forty-one older adults (aged 60 or above) participated in the field test by operating modified or existing ATM systems. Those who operated the modified system were found to have significantly higher success rates than those who operated the existing system. The enhancement was most significant among older adults who had lower ATM-related abilities, a lower level of education, and no prior experience of using ATMs. This study demonstrates the usefulness of using a universal design and participatory approach to modify the existing ATM system for use by older adults. However, it also leads to a reduction in functionality of the enhanced system. Future studies should explore ways to develop a universal design ATM system which can satisfy the abilities and needs of all users in the entire population.

  10. Mini-open anterior lumbar interbody fusion.

    PubMed

    Gandhoke, Gurpreet S; Ricks, Christian; Tempel, Zachary; Zuckerbraun, Brian; Hamilton, D Kojo; Okonkwo, David O; Kanter, Adam S

    2016-07-01

    In deformity surgery, anterior lumbar interbody fusion provides excellent biomechanical support, creates a broad surface area for arthrodesis, and induces lordosis in the lower lumbar spine. Preoperative MRI, plain radiographs, and, when available, CT scan should be carefully assessed for sacral slope as it relates to pubic symphysis, position of the great vessels (especially at L4/5), disc space height, or contraindication to an anterior approach. This video demonstrates the steps in an anterior surgical procedure with minimal open exposure. The video can be found here: https://youtu.be/r3bC4_vu1hQ .

  11. Using a modified team-based learning approach to teach nursing students about communicable disease control and community health nursing.

    PubMed

    Elliott, Shannon

    2014-11-01

    Team-based learning (TBL) is an active learning approach that is becoming increasingly more popular in nursing education. When nurse educators flip the classroom and use methods such as TBL, students are often more engaged and are active participants in their own learning. This article outlines how a teaching team in an undergraduate nursing program used a modified TBL method to teach about community health nursing. The traditional method of TBL is described, as well as limitations of this approach and recommendations for future teaching.

  12. A modified coupled pair functional approach. [for dipole moment calculation of metal hydride ground states

    NASA Technical Reports Server (NTRS)

    Chong, D. P.; Langhoff, S. R.

    1986-01-01

    A modified coupled pair functional (CPF) method is presented for the configuration interaction problem that dramatically improves properties for cases where the Hartree-Fock reference configuration is not a good zeroth-order wave function description. It is shown that the tendency for CPF to overestimate the effect of higher excitations arises from the choice of the geometric mean for the partial normalization denominator. The modified method is demonstrated for ground state dipole moment calculations of the NiH, CuH, and ZnH transition metal hydrides, and compared to singles-plus-doubles configuration interaction and the Ahlrichs et al. (1984) CPF method.

  13. New approach of maxillary protraction using modified C-palatal plates in Class III patients

    PubMed Central

    Bayome, Mohamed; Park, Jae Hyun; Kim, Ki Beom; Kim, Seong-Hun; Chung, Kyu-Rhim

    2015-01-01

    Maxillary protraction is the conventional treatment for growing Class III patients with maxillary deficiency, but it has undesirable dental effects. The purpose of this report is to introduce an alternative modality of maxillary protraction in patients with dentoskeletal Class III malocclusion using a modified C-palatal plate connected with elastics to a face mask. This method improved skeletal measurements, corrected overjet, and slightly improved the profile. The patients may require definitive treatment in adolescence or adulthood. The modified C-palatal plate enables nonsurgical maxillary advancement with maximal skeletal effects and minimal dental side effects. PMID:26258067

  14. A Modified Combined Transseptal/Transnasal Binostril Approach for Pituitary Lesions in Patients with a Narrow Nasal Space: Technical Note

    PubMed Central

    TAKEMURA, Mitsuhiro; FUJIMOTO, Yasunori; KOBAYASHI, Taisuke; KOMORI, Masahiro; STAMM, Aldo C; VELLUTINI, Eduardo; MARIANI, Pedro; KAWANISHI, Yu; SHIMIZU, Keiji

    2014-01-01

    We describe a modification of the combined transseptal/transnasal binostril approach using a two-surgeon, four-handed technique (modified Stamm's approach) for pituitary lesions in patients with narrow nasal spaces. This approach comprises of a transseptal route through one nostril and a transnasal route without harvesting a pedicled nasoseptal flap (NSF) through the other. On the transseptal side, the nasal septum was removed using an endoscopic septoplasty technique. On the transnasal side, the mucosa containing the septal branch of the sphenopalatine artery over the face of the sphenoid and nasal septum was preserved for harvesting the NSF if an intraoperative cerebrospinal fluid leak was encountered. This approach was performed in six patients with pituitary lesions, including four nonfunctioning macroadenomas, one growth hormone-producing macroadenoma, and one Rathke's cleft cyst, all of which were associated with a severe deviation of the nasal septum and/or narrow nasal space. The meticulous and comfortable manipulation of an endoscope and instruments were achieved in all six patients without surgical complications. Our findings, although obtained in a limited number of cases, suggest that the modified Stamm's approach may be useful for selected patients, particularly those with a severe deviation of the nasal septum, without considerable damage to the nasal passages. PMID:25070018

  15. Inquiry Based Learning: A Modified Moore Method Approach To Encourage Student Research

    ERIC Educational Resources Information Center

    McLoughlin, M. Padraig M. M.

    2008-01-01

    The author of this paper submits that a mathematics student needs to learn to conjecture and prove or disprove said conjecture. Ergo, the purpose of the paper is to submit the thesis that learning requires doing; only through inquiry is learning achieved, and hence this paper proposes a programme of use of a modified Moore method (MMM) across the…

  16. Identification of Core Competencies for an Undergraduate Food Safety Curriculum Using a Modified Delphi Approach

    ERIC Educational Resources Information Center

    Johnston, Lynette M.; Wiedmann, Martin; Orta-Ramirez, Alicia; Oliver, Haley F.; Nightingale, Kendra K.; Moore, Christina M.; Stevenson, Clinton D.; Jaykus, Lee-Ann

    2014-01-01

    Identification of core competencies for undergraduates in food safety is critical to assure courses and curricula are appropriate in maintaining a well-qualified food safety workforce. The purpose of this study was to identify and refine core competencies relevant to postsecondary food safety education using a modified Delphi method. Twenty-nine…

  17. Comments on "A modified reachability tree approach to analysis of unbounded Petri nets".

    PubMed

    Ru, Yu; Wu, Weimin; Hadjicostis, Christoforos N

    2006-10-01

    The above paper introduced the construction of a modified reachability tree (MRT) for (unbounded) Petri nets and its application to reachability, liveness, and deadlock analysis. This note shows via a counterexample that some of the MRT properties claimed in the above paper are incorrect.

  18. Anterior Cruciate Ligament (ACL) Injuries

    MedlinePlus

    ... Week of Healthy Breakfasts Shyness Anterior Cruciate Ligament (ACL) Injuries KidsHealth > For Teens > Anterior Cruciate Ligament (ACL) ... and Recovery Coping With an ACL Injury About ACL Injuries A torn anterior cruciate ligament (ACL) is ...

  19. [Anterior tarsal tunnel syndrome].

    PubMed

    Miliam, Palle B; Basse, Peter N

    2009-03-30

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

  20. [Isolated anterior cervical hypertrichosis].

    PubMed

    Monteagudo, B; Cabanillas, M; de las Heras, C; Cacharrón, J M

    2009-01-01

    Anterior cervical hypertrichosis was described by Trattner and coworkers in 1991. It consists of a of hair at the anterior cervical level just above the laryngeal prominence. To date, only 28 cases of anterior cervical hypertrichosis have been reported. Although it is normally an isolated finding, it may be associated with mental retardation, hallux valgus, retinal disorders, other hair disorders, facial dysmorphism, or sensory and motor peripheral neuropathy. We report the case of a 27-year-old woman who presented with this condition as an isolated finding.

  1. Modified teaching approach for an enhanced medical physics graduate education experience.

    PubMed

    Rutel, Ib

    2011-10-01

    Lecture-based teaching promotes a passive interaction with students. Opportunities to modify this format are available to enhance the overall learning experience for both students and instructors. The description for a discussion-based learning format is presented as it applies to a graduate curriculum with technical (formal mathematical derivation) topics. The presented hybrid method involves several techniques, including problem-based learning, modeling, and online lectures, eliminating didactic lectures. The results from an end-of-course evaluation show that the students appear to prefer the modified format over the more traditional methodology of "lecture only" contact time. These results are motivation for further refinement and continued implementation of the described methodology in the current course and potentially other courses within the department graduate curriculum.

  2. Complex AO type C3 distal femur fractures: Results after fixation with a lateral locked plate using modified swashbuckler approach

    PubMed Central

    Agrawal, Anuj; Kiyawat, Vivek

    2017-01-01

    Background: Complex AO type C3 fractures of the distal femur are challenging injuries, fraught with complications such as malunion and stiffness. We prospectively evaluated a consecutive series of patients with complex AO type C3 distal femur fractures to determine the clinicoradiological outcome after fixation with a single locked plate using modified swashbuckler approach. Materials and Methods: 12 patients with C3 type distal femur fractures treated with a lateral locked plate, using a modified swashbuckler approach, were included in the study. The extraarticular component was managed either by compression plating or bridge plating (transarticular approach and retrograde plate osteosynthesis) depending on the fracture pattern. Primary bone grafting was not done in any case. The clinical outcome at 1 year was determined using the Knee Society Score (KSS). The presence of any secondary osteoarthritis in the knee joint was noted at final followup. Results: All fractures united at a mean of 14.3 ± 4.7 weeks (range 6–26 weeks). There were no significant complications such as nonunion, deep infection, and implant failure. One of the patients underwent secondary bone grafting at 3 months. The mean range of motion of the knee was 120° ± 14.8° (range 105°–150°). Seven patients had excellent, three patients had good and two patients had a fair outcome according to the KSS at 1 year. At a mean followup of 17.6 months, three patients showed radiological evidence of secondary osteoarthritis of the knee joint. However, only one of these patients was symptomatic. Conclusion: The results of complex C3 type distal femur fractures, fixed with a single lateral locked plate using a modified swashbuckler approach, are encouraging, with a majority of patients achieving good to excellent outcome at 1 year. PMID:28216747

  3. Intrinsic optical fiber sensor for sensing organophosphate nerve agent using the modified cladding approach

    NASA Astrophysics Data System (ADS)

    Bansal, Lalitkumar; El-Sherif, Mahmoud

    2004-03-01

    The concept of modified cladding based sensors represents the largest class of intrinsic fiber optic chemical sensors. In this design, the passive cladding of the optical fiber is replaced by an active coating, called modified cladding. The analyte in this case diffuses into the coating and induces changes in the absorbance, fluorescence, or some other spectroscopic property of the modified cladding, the coating acts as a chemo-chromic transducer and sensing takes place by intensity modulation. This design i.e. of the coating based sensors, has found enormous applicability in the realm of chemical and biochemical sensing which also includes environmental monitoring and detection of chemical warfare agents. In this paper, the development of an intrinsic fiber optic sensor for detection of organophosphate dimethyl-methyl phoshopnate (DMMP) is presented. DMMP is a chemical precursor to the nerve agent sarin. The chemo-chromic transducer material used as a modified coating on the fiber core is NDSA (Naphthalene disulphonic acid) doped polypyrrole. This coating material shows conductivity and absorbance change when exposed to DMMP. The fabrication of the sensor device is a three step process which involves (a) etching a small section of the optical fiber to expose the core, (b) coating the etched section of the optical fiber with the polymer, (c) integration of sensor components and testing. Thin film characterization is done using the UV-Vis spectrophotometer on in-situ coated films of polypyrrole on a glass substrate to check for absorbance change upon exposure to DMMP. The development procedure is presented next and encouraging results are discussed.

  4. Measurement of anterior chamber diameter and biometry of anterior segment by Scheimpflug slitlamp photography

    SciTech Connect

    Lerman, S.; Hockwin, O.

    1985-03-01

    Twenty-eight fresh donor eyes (Georgia Lions Eye Bank) ranging in age from four months to 87 years were used for an in vitro study to determine the feasibility of obtaining accurate anterior chamber diameter measurements with our Scheimpflug ultraviolet-visible slitlamp densitography apparatus. The in vivo study was performed on 16 hybrid monkeys (of varying age). These data were within 0.1 mm of measurements obtained with a modified paracentesis needle specially designed to obtain such measurements. The results of the foregoing study demonstrate that the Scheimpflug slitlamp photographic analyses can provide an accurate measurement of the anterior chamber diameter without entering the globe surgically. This will enable the surgeon to determine the diameter and order an anterior chamber IOL of a specified size prior to surgery. The authors have devised an automated program to analyze the negatives and provide direct anterior chamber diameter measurements.

  5. The Modified POSAS: A Novel Approach to Defining Pathologic and Non-Pathologic Scarring

    PubMed Central

    Fearmonti, Regina; Bond, Jennifer; Erdmann, Detlev; Levin, L. Scott; Pizzo, Salvatore V; Levinson, Howard

    2010-01-01

    Background Scarring is a highly prevalent and multifactorial process, yet no studies to date have attempted to distinguish pathologic from non-pathologic scarring. Methods This article defines and proposes methods of classifying pathologic scarring as it pertains to clinical presentation. Results We propose a new scar scale that incorporates pain and functional impairment. Conclusion The modified POSAS scar assessment scale is the first of its kind to factor in the functional deficits, pain and pruritus of scarring into measurements of associated morbidity. This has great potential in evaluating patient response to treatment and analyzing clinical outcomes. PMID:21200219

  6. Holographik, the k-essential approach to interactive models with modified holographic Ricci dark energy

    NASA Astrophysics Data System (ADS)

    Forte, Mónica

    2016-12-01

    We make a scalar representation of interactive models with cold dark matter and modified holographic Ricci dark energy through unified models driven by scalar fields with non-canonical kinetic term. These models are applications of the formalism of exotic k-essences generated by the global description of cosmological models with two interactive fluids in the dark sector and in these cases they correspond to the usual k-essences. The formalism is applied to the cases of constant potential in Friedmann-Robertson-Walker geometries.

  7. A modified reachability tree approach to analysis of unbounded Petri nets.

    PubMed

    Wang, Fei-Yue; Gao, Yanqing; Zhou, MengChu

    2004-02-01

    Reachability trees, especially the corresponding Karp-Miller's finite reachability trees generated for Petri nets are fundamental for systematically investigating many characteristics such as boundedness, liveness, and performance of systems modeled by Petri nets. However, too much information is lost in a FRT to render it useful for many applications. In this paper, modified reachability trees (MRT) of Petri nets are introduced that extend the capability of Karp-Miller's FRTs in solving the liveness, deadlock, and reachability problems, and in defining or determining possible firing sequences. The finiteness of MRT is proved and several examples are presented to illustrate the advantages of MRT over FRT.

  8. Evaluating Potential Response-Modifying Factors for Associations between Ozone and Health Outcomes: A Weight-of-Evidence Approach

    PubMed Central

    Owens, Elizabeth O.; Nichols, Jennifer L.; Ross, Mary; Brown, James S.; Sacks, Jason D.

    2014-01-01

    Background: Epidemiologic and experimental studies have reported a variety of health effects in response to ozone (O3) exposure, and some have indicated that certain populations may be at increased or decreased risk of O3-related health effects. Objectives: We sought to identify potential response-modifying factors to determine whether specific groups of the population or life stages are at increased or decreased risk of O3-related health effects using a weight-of-evidence approach. Methods: Epidemiologic, experimental, and exposure science studies of potential factors that may modify the relationship between O3 and health effects were identified in U.S. Environmental Protection Agency’s 2013 Integrated Science Assessment for Ozone and Related Photochemical Oxidants. Scientific evidence from studies that examined factors that may influence risk were integrated across disciplines to evaluate consistency, coherence, and biological plausibility of effects. The factors identified were then classified using a weight-of-evidence approach to conclude whether a specific factor modified the response of a population or life stage, resulting in an increased or decreased risk of O3-related health effects. Discussion: We found “adequate” evidence that populations with certain genotypes, preexisting asthma, or reduced intake of certain nutrients, as well as different life stages or outdoor workers, are at increased risk of O3-related health effects. In addition, we identified other factors (i.e., sex, socioeconomic status, and obesity) for which there was “suggestive” evidence that they may increase the risk of O3-related health effects. Conclusions: Using a weight-of-evidence approach, we identified a diverse group of factors that should be considered when characterizing the overall risk of health effects associated with exposures to ambient O3. Citation: Vinikoor-Imler LC, Owens EO, Nichols JL, Ross M, Brown JS, Sacks JD. 2014. Evaluating potential response-modifying

  9. Effective action approach to cosmological perturbations in dark energy and modified gravity

    SciTech Connect

    Battye, Richard A.; Pearson, Jonathan A. E-mail: jp@jb.man.ac.uk

    2012-07-01

    In light of upcoming observations modelling perturbations in dark energy and modified gravity models has become an important topic of research. We develop an effective action to construct the components of the perturbed dark energy momentum tensor which appears in the perturbed generalized gravitational field equations, δG{sup μν} = 8πGδT{sup μν}+δU{sup μν} for linearized perturbations. Our method does not require knowledge of the Lagrangian density of the dark sector to be provided, only its field content. The method is based on the fact that it is only necessary to specify the perturbed Lagrangian to quadratic order and couples this with the assumption of global statistical isotropy of spatial sections to show that the model can be specified completely in terms of a finite number of background dependent functions. We present our formalism in a coordinate independent fashion and provide explicit formulae for the perturbed conservation equation and the components of δU{sup μ}{sub ν} for two explicit generic examples: (i) the dark sector does not contain extra fields, L = L(g{sub μν}) and (ii) the dark sector contains a scalar field and its first derivative L = L(g{sub μν},φ,∇{sub μ}φ). We discuss how the formalism can be applied to modified gravity models containing derivatives of the metric, curvature tensors, higher derivatives of the scalar fields and vector fields.

  10. Modifiability of fluid intelligence in aging: a short-term longitudinal training approach.

    PubMed

    Plemons, J K; Willis, S L; Baltes, P B

    1978-03-01

    The aim of this study was to examine to what degree fluid intelligence can be modified in aged subjects. The effectiveness of a cognitive training program designed to enhance one primary component of fluid intelligence, Figural Relations, was assessed by comparing the posttraining performances of 15 experimental and 15 control subjects (mean age: 69; age range 59-85) using a transfer paradigm and three posttraining assessments conducted approximately 1 week, 1 mo, and 6 mo following training. The post-training performance of the two groups was compared on three near (fluid intelligence) and one far (crystallized intelligence) transfer measures. A hierarchical pattern was predicted with the magnitude of training effects ordering themselves in descending order from near to far transfer measures. The training program was successful in enhancing performance on the fluid-nearest measure on all three posttests and for the next fluid-near measure on the first posttest. In addition, significant retest effects resulted which, however, were neither task-specific nor hierarchically ordered, but general and therefore indicative of ability-extraneous factors, such as test sophistication. The findings contribute to a position implying that intellectual performance in old age is more modifiable through short-term behavioral intervention than traditionally assumed.

  11. Vision-based displacement measurement sensor using modified Taylor approximation approach

    NASA Astrophysics Data System (ADS)

    Liu, Bingyou; Zhang, Dashan; Guo, Jie; Zhu, Chang'an

    2016-11-01

    The development of image sensors and optics lenses has contributed to the rapidly increasing use of vision-based methods as noncontact measurement methods in many areas. A high-speed camera system is developed to realize the displacement measurement in real time. Conventional visual measurement algorithms are commonly subjected to various shortcomings, such as complex processes, multiparameter adjustments, or integer-pixel accuracy. Inspired from the combination of block-matching algorithm and simplified optical flow, a motion estimation algorithm that uses modified Taylor approximation is proposed and applied to the vision sensor system. Simplifying integer-pixel searching with a rounding-iterative operation enables the modified algorithm to rapidly accomplish one displacement extraction within 1 ms and yield satisfactory subpixel accuracy. The performance of the vision sensor is evaluated through a simulation test and two experiments on a grating ruler motion platform and a steering wheel system of a forklift. Experimental results show that the developed vision sensor can extract accurate displacement signals and accomplish the vibration measurement of engineering structures.

  12. STABILITY OF COSMIC-RAY MODIFIED SHOCKS: TWO-FLUID APPROACH

    SciTech Connect

    Saito, Tatsuhiko; Hoshino, Masahiro; Amano, Takanobu

    2013-10-01

    The stability of cosmic-ray modified shocks (CRMSs) is studied by means of numerical simulations. Owing to the nonlinear feedback of cosmic-ray (CR) acceleration, a downstream state of the modified shock can no longer be uniquely determined for given upstream parameters. It is known that up to three distinct solutions exist, which are characterized by CR production efficiency as the 'efficient', 'intermediate', and 'inefficient' branches. The stability of these solutions is investigated by performing direct time-dependent simulations of a two-fluid model. It is found that both the efficient and inefficient branches are stable even against a large-amplitude perturbation, while the intermediate one is always unstable and evolves into the inefficient state as a result of nonlinear time development. This bistable feature is robust in a wide range of parameters and does not depend on the injection model. Fully nonlinear time evolution of a hydrodynamic shock with injection results in the least efficient state in terms of CR production, consistent with the bistable feature. This suggests that the CR production efficiency in supernova remnant shocks may be lower than previously discussed in the framework of the nonlinear shock acceleration theory considering the efficient solution of the CRMS.

  13. A soft computing based approach using modified selection strategy for feature reduction of medical systems.

    PubMed

    Zuhtuogullari, Kursat; Allahverdi, Novruz; Arikan, Nihat

    2013-01-01

    The systems consisting high input spaces require high processing times and memory usage. Most of the attribute selection algorithms have the problems of input dimensions limits and information storage problems. These problems are eliminated by means of developed feature reduction software using new modified selection mechanism with middle region solution candidates adding. The hybrid system software is constructed for reducing the input attributes of the systems with large number of input variables. The designed software also supports the roulette wheel selection mechanism. Linear order crossover is used as the recombination operator. In the genetic algorithm based soft computing methods, locking to the local solutions is also a problem which is eliminated by using developed software. Faster and effective results are obtained in the test procedures. Twelve input variables of the urological system have been reduced to the reducts (reduced input attributes) with seven, six, and five elements. It can be seen from the obtained results that the developed software with modified selection has the advantages in the fields of memory allocation, execution time, classification accuracy, sensitivity, and specificity values when compared with the other reduction algorithms by using the urological test data.

  14. Species Differences in the Geometry of the Anterior Segment Differentially Affect Anterior Chamber Cell Scoring Systems in Laboratory Animals

    PubMed Central

    Eaton, J. Seth; Timberlake, Matthew J.; Miller, Paul E.; Matsumoto, Steven; Murphy, Christopher J.

    2016-01-01

    Abstract Purpose: To determine the impact of anterior segment geometry on ocular scoring systems quantifying anterior chamber (AC) cells in humans and 7 common laboratory species. Methods: Using normative anterior segment dimensions and novel geometric formulae, ocular section volumes measured by 3 scoring systems; Standardization of Uveitis Nomenclature (SUN), Ocular Services On Demand (OSOD), and OSOD–modified SUN were calculated for each species, respectively. Calculated volumes were applied to each system's AC cell scoring scheme to determine comparative cell density (cells/mm3). Cell density values for all laboratory species were normalized to human values and conversion factors derived to create modified scoring schemes, facilitating interspecies comparison with each system, respectively. Results: Differences in anterior segment geometry resulted in marked differences in optical section volume measured. Volumes were smaller in rodents than dogs and cats, but represented a comparatively larger percentage of AC volume. AC cell density (cells/mm3) varied between species. Using the SUN and OSOD–modified SUN systems, values in the pig, dog, and cat underestimated human values; values in rodents overestimated human values. Modified normalized scoring systems presented here account for species-related anterior segment geometry and facilitate both intra- and interspecies analysis, as well as translational comparison. Conclusions: Employment of modified AC cell scoring systems that account for species-specific differences in anterior segment anatomy would harmonize findings across species and may be more predictive for determining ocular toxicological consequences in ocular drug and device development programs. PMID:26539819

  15. A novel approach to the use of genetically modified herbicide tolerant crops for environmental benefit.

    PubMed Central

    Dewar, Alan M; May, Mike J; Woiwod, Ian P; Haylock, Lisa A; Champion, Gillian T; Garner, Beulah H; Sands, Richard J N; Qi, Aiming; Pidgeon, John D

    2003-01-01

    The proposed introduction of genetically modified herbicide tolerant (GMHT) crops, with claims of improved weed control, has prompted fears about possible environmental impacts of their widespread adoption, particularly on arable weeds, insects and associated farmland birds. In response to this, we have developed a novel weed-management system for GMHT sugar beet, based on band spraying, which exploits the flexibility offered by the broad-spectrum partner herbicides. Here, we show the results from two series of field experiments which, taken together, demonstrate that, by using this system, crops can be managed for enhanced weed and insect biomass without compromising yield, thus potentially offering food and shelter to farmland birds and other wildlife. These results could be applicable widely to other row crops, and indicate that creative use of GMHT technology could be a powerful tool for developing more sustainable farming systems in the future. PMID:12639311

  16. Modified Wilson’s Osteotomy for Hallux Valgus Deformity. A New Approach

    PubMed Central

    Xarchas, Konstantinos C; Mavrolias, Dimitrios; Kyriakopoulos, Georgios

    2014-01-01

    We introduce a new set of modifications and present the results from 48 patients (a total of 60 feet operated), who underwent this modified Wilson’s osteotomy for the correction of Hallux Valgus. Patients were of an average age of 52 years old (from 21 to 75 years of age) and were followed up for a mean of 12 months post-operatively. Patient evaluation was made with the symptom scoring system as presented by Kataraglis et al., with the final outcome being satisfactory in all of the cases. This set of modifications introduced to the original Wilson’s osteotomy, proved to offer a stable, predictable and satisfactory outcome in all cases and we strongly recommend it. PMID:25352929

  17. A Modified Error in Constitutive Equation Approach for Frequency-Domain Viscoelasticity Imaging Using Interior Data

    PubMed Central

    Diaz, Manuel I.; Aquino, Wilkins; Bonnet, Marc

    2015-01-01

    This paper presents a methodology for the inverse identification of linearly viscoelastic material parameters in the context of steady-state dynamics using interior data. The inverse problem of viscoelasticity imaging is solved by minimizing a modified error in constitutive equation (MECE) functional, subject to the conservation of linear momentum. The treatment is applicable to configurations where boundary conditions may be partially or completely underspecified. The MECE functional measures the discrepancy in the constitutive equations that connect kinematically admissible strains and dynamically admissible stresses, and also incorporates the measurement data in a quadratic penalty term. Regularization of the problem is achieved through a penalty parameter in combination with the discrepancy principle due to Morozov. Numerical results demonstrate the robust performance of the method in situations where the available measurement data is incomplete and corrupted by noise of varying levels. PMID:26388656

  18. Modified lip repositioning: A surgical approach to treat the gummy smile

    PubMed Central

    Rao, Aditya Gopinath; Koganti, Vijay Prasad; Prabhakar, Ashok Kodangala; Soni, Sweta

    2015-01-01

    Gummy smile has been an esthetic concern for many patients. This clinical report describes a successful surgical coverage obtained by modified lip repositioning, thus surgically treating the gummy smile. The technique was performed to limit the retraction of elevator muscles (e.g., zygomaticus minor, orbicularis oris, leviator anguli oris and levator labi oris.) The technique is fulfilled by removing two strips of mucosa from maxillary buccal vestibule on both the sides leaving the frenum untouched and creating a partial thickness flap between mucogingival junction and upper lip musculature, and suturing the lip mucosa with mucogingival junction, resulting in a narrow vestibule and restricted muscle pull, thereby reducing gingival display. This technique is different from the conventional surgical lip repositioning as labial frenum is left untouched over here as it helps in maintain Litton the midline for lip repositioning and reduces the morbidity associated with it. PMID:26229285

  19. A multimodality imaging approach for guiding a modified endovascular coil embolization of a single intrahepatic portosystemic shunt in dogs.

    PubMed

    Knapp, Teja; Navalòn, Iolanda; Medda, Massimo; Pradelli, Danitza; Borgonovo, Simone; Crosta, Cristina; Bussadori, Claudio Maria

    2015-12-01

    Intrahepatic portosystemic shunts (IHPSS) in dogs are aberrant vascular anomalies that connect the portal and the systemic venous vessels. In most of the patients, the surgical approach is unfavourable due to the difficulties in isolating the IHPSS, making the option of a percutaneous transvenous coil embolization (PTCE) one of the safer occlusive procedures. This study describes the treatment of eight dogs with a single IHPSS using a multimodality imaging approach to guide the modified PTCE procedure. This new technique results in a decrease of 71% of the time of the entire procedure with the reduction of 91% in the time required involved the IHPSS identification and in the fluoroscopy exposure time avoiding the need for iodinated contrast agents during the procedure. Moreover, the placement of the catheter before the caval stent ensures its greater stability, enhancing the procedural safety in the phase when the coils are released and avoiding the risk of their dislocation.

  20. An empirical analysis of online gamers' perceptions of game items: modified theory of consumption values approach.

    PubMed

    Park, Bong-Won; Lee, Kun Chang

    2011-01-01

    The aims of this article are (1) to propose a modified theory of consumption values (MTCV) for investigation of online gamer perceptions of the value of purchasable game items and (2) to apply the developed MTCV to multiple game genres and player age groups. To address these aims, 327 valid questionnaires were obtained and analyzed. The original theory of consumption values (TCV) was modified to apply to the specific characteristics of online games. The original TCV specifies five types of consumption values: functional value, social value, emotional value, conditional value, and epistemic value. After revising the TCV to apply to the examination of online games, we proposed that the MTCV be composed of character competency value, enjoyment value, visual authority value, and monetary value. The validity of the MTCV was proven by statistically analyzing the responses provided by the 327 valid questionnaires. To examine the second aim, experiments were conducted to examine the MTCV in three online game genres-massive multiplayer online role-playing games, first-person shooters games, and casual games. The second aim was also studied via questionnaires that examined the ages of online gamers. It was determined that massive multiplayer online role-playing games players regard visual authority value and monetary value as more important than do casual gamers. It was also determined that younger gamers tend to be more interested in visual authority, whereas older gamers tend to be more interested in character competency. This research provides a foundation for future studies to extend the MTCV to consider other user factors, such as cultural effects.

  1. Modeling resilience to schizophrenia in genetically modified mice: a novel approach to drug discovery

    PubMed Central

    Mihali, Andra; Subramani, Shreya; Kaunitz, Genevieve; Rayport, Stephen; Gaisler-Salomon, Inna

    2012-01-01

    Complex psychiatric disorders, such as schizophrenia, arise from a combination of genetic, developmental, environmental and social factors. These vulnerabilities can be mitigated by adaptive factors in each of these domains engendering resilience. Modeling resilience in mice using transgenic approaches offers a direct path to intervention, as resilience mutations point directly to therapeutic targets. As prototypes for this approach, we discuss the three mouse models of schizophrenia resilience, all based on modulating glutamatergic synaptic transmission. This motivates the broader development of schizophrenia resilience mouse models independent of specific pathophysiological hypotheses as a strategy for drug discovery. Three guiding validation criteria are presented. A resilience-oriented approach should identify pharmacologically tractable targets and in turn offer new insights into pathophysiological mechanisms. PMID:22853787

  2. Optical tracking of organically modified silica nanoparticles as DNA carriers: a nonviral, nanomedicine approach for gene delivery.

    PubMed

    Roy, Indrajit; Ohulchanskyy, Tymish Y; Bharali, Dhruba J; Pudavar, Haridas E; Mistretta, Ruth A; Kaur, Navjot; Prasad, Paras N

    2005-01-11

    This article reports a multidisciplinary approach to produce fluorescently labeled organically modified silica nanoparticles as a nonviral vector for gene delivery and biophotonics methods to optically monitor intracellular trafficking and gene transfection. Highly monodispersed, stable aqueous suspensions of organically modified silica nanoparticles, encapsulating fluorescent dyes and surface functionalized by cationic-amino groups, are produced by micellar nanochemistry. Gel-electrophoresis studies reveal that the particles efficiently complex with DNA and protect it from enzymatic digestion of DNase 1. The electrostatic binding of DNA onto the surface of the nanoparticles, due to positively charged amino groups, is also shown by intercalating an appropriate dye into the DNA and observing the Forster (fluorescence) resonance energy transfer between the dye (energy donor) intercalated in DNA on the surface of nanoparticles and a second dye (energy acceptor) inside the nanoparticles. Imaging by fluorescence confocal microscopy shows that cells efficiently take up the nanoparticles in vitro in the cytoplasm, and the nanoparticles deliver DNA to the nucleus. The use of plasmid encoding enhanced GFP allowed us to demonstrate the process of gene transfection in cultured cells. Our work shows that the nanomedicine approach, with nanoparticles acting as a drug-delivery platform combining multiple optical and other types of probes, provides a promising direction for targeted therapy with enhanced efficacy as well as for real-time monitoring of drug action.

  3. Optical tracking of organically modified silica nanoparticles as DNA carriers: A nonviral, nanomedicine approach for gene delivery

    NASA Astrophysics Data System (ADS)

    Roy, Indrajit; Ohulchanskyy, Tymish Y.; Bharali, Dhruba J.; Pudavar, Haridas E.; Mistretta, Ruth A.; Kaur, Navjot; Prasad, Paras N.

    2005-01-01

    This article reports a multidisciplinary approach to produce fluorescently labeled organically modified silica nanoparticles as a nonviral vector for gene delivery and biophotonics methods to optically monitor intracellular trafficking and gene transfection. Highly monodispersed, stable aqueous suspensions of organically modified silica nanoparticles, encapsulating fluorescent dyes and surface functionalized by cationic-amino groups, are produced by micellar nanochemistry. Gel-electrophoresis studies reveal that the particles efficiently complex with DNA and protect it from enzymatic digestion of DNase 1. The electrostatic binding of DNA onto the surface of the nanoparticles, due to positively charged amino groups, is also shown by intercalating an appropriate dye into the DNA and observing the Förster (fluorescence) resonance energy transfer between the dye (energy donor) intercalated in DNA on the surface of nanoparticles and a second dye (energy acceptor) inside the nanoparticles. Imaging by fluorescence confocal microscopy shows that cells efficiently take up the nanoparticles in vitro in the cytoplasm, and the nanoparticles deliver DNA to the nucleus. The use of plasmid encoding enhanced GFP allowed us to demonstrate the process of gene transfection in cultured cells. Our work shows that the nanomedicine approach, with nanoparticles acting as a drug-delivery platform combining multiple optical and other types of probes, provides a promising direction for targeted therapy with enhanced efficacy as well as for real-time monitoring of drug action. nonviral vector | ORMOSIL nanoparticles | confocal microscopy

  4. Development of sampling approaches for the determination of the presence of genetically modified organisms at the field level.

    PubMed

    Sustar-Vozlic, Jelka; Rostohar, Katja; Blejec, Andrej; Kozjak, Petra; Cergan, Zoran; Meglic, Vladimir

    2010-03-01

    In order to comply with the European Union regulatory threshold for the adventitious presence of genetically modified organisms (GMOs) in food and feed, it is important to trace GMOs from the field. Appropriate sampling methods are needed to accurately predict the presence of GMOs at the field level. A 2-year field experiment with two maize varieties differing in kernel colour was conducted in Slovenia. Based on the results of data mining analyses and modelling, it was concluded that spatial relations between the donor and receptor field were the most important factors influencing the distribution of outcrossing rate (OCR) in the field. The approach for estimation fitting function parameters in the receptor (non-GM) field at two distances from the donor (GM) field (10 and 25 m) for estimation of the OCR (GMO content) in the whole receptor field was developed. Different sampling schemes were tested; a systematic random scheme in rows was proposed to be applied for sampling at the two distances for the estimation of fitting function parameters for determination of OCR. The sampling approach had already been validated with some other OCR data and was practically applied in the 2009 harvest in Poland. The developed approach can be used for determination of the GMO presence at the field level and for making appropriate labelling decisions. The importance of this approach lies in its possibility to also address other threshold levels beside the currently prescribed labelling threshold of 0.9% for food and feed.

  5. Experimental Design Approach for Methylene Blue Dye Removal in Aqueous Environment by Nitrilotriacetic Modified Banana Pith.

    PubMed

    Lee, Shi-Ling; Liew, Shu-Wei; Ong, Siew-Teng

    2016-01-01

    Native banana pith (NBP) was modified by using nitrilotriacetic acid to increase its efficiency and adsorption capacity for methylene blue (MB) dye. The effect of various parameters such as pH, contact time and initial dye concentration, sorption isotherm and adsorbent dosage were studied. The maximum adsorption capacity of the NBP and NTA-BP is 100 and 142.86 mg/g, respectively. The IR spectrum of NBP and NTA-BP showed the presence of both carboxyl and hydroxyl groups. From the SEM micrographs, the surface morphology of NTA-BP before adsorption appeared to be smoother as compared to that after adsorption process. The pH(pzc) of NBP is 5.6 whereas for NTA-BP is 7.6. The experimental data fitted well into Langmuir isotherm with R(2) of 0.992. Plackett-Burman design was applied to identify the significant factors in affecting the uptake whereas the interaction between the factors and their optimum levels for the maximum percentage uptake of MB were determined using response surface methodology (RSM). Based on the results, the optimum condition for adsorption of MB was by using 0.06 g of NTA-BP in dye solution at pH 6 with 120 minutes contact time. The maximum adsorption of MB by NTA-BP achieved 99.42% under the optimum condition.

  6. A novel approach to assess the population health impact of introducing a Modified Risk Tobacco Product.

    PubMed

    Weitkunat, Rolf; Lee, Peter N; Baker, Gizelle; Sponsiello-Wang, Zheng; González-Zuloeta Ladd, Angela M; Lüdicke, Frank

    2015-06-01

    Based on the Food and Drug Administration's Modified Risk Tobacco Product (MRTP) Application draft guideline, Philip Morris International (PMI) has developed a Population Health Impact Model to estimate the reduction in the number of deaths over a period following the introduction of an MRTP. Such a model is necessary to assess the effect that its introduction would have on population health, given the lack of epidemiological data available prior to marketing authorization on any risks from MRTPs. The model is based on publicly available data on smoking prevalence and on the relationships between smoking-related disease-specific mortality and various aspects of the smoking of conventional cigarettes (CCs), together with an estimate of exposure from the MRTP relative to that from CCs, and allows the exploration of possible scenarios regarding the effect of MRTP introduction on the prevalence of CC and MRTP use, individually and in combination. By comparing mortality attributable in a scenario where the MRTP is introduced with one where it is not, the model can estimate the mortality attributable to CCs and the MRTP, as well as the reduction in the deaths attributable to the introduction of the MRTP.

  7. Effects of modified pharmacologic stress approaches on hyperemic myocardial blood flow

    SciTech Connect

    Czernin, J.; Auerbach, M.; Sun, K.T.

    1995-04-01

    Pharmacologic stress testing with 0.56 mg/kg of intravenous dipyridamole is frequently used to noninvasively detect coronary artery disease (CAD). However, high-dose dipyridamole (0.80 mg/kg) or the combination of standard-dose dipyridamole (0.56 mg/kg) with the isometric handgrip maneuver might evoke a greater coronary hyperemic response. To evaluate the effect of modified pharmacologic stress tests, myocardial blood flow was quantified in 11 male subjects (mean age: 27 {plus_minus} 7 yr) during standard-dose dipyridamole (0.56 mg/kg), high-dose dipyridamole (0.80 mg/kg) and standard-dose dipyridamole combined with the isometric handgrip exercise using dynamic PET and a two-compartment model for {sup 13}N-ammonia. Systolic blood pressure, heart rate and rate pressure product remained unchanged from standard to high-dose dipyridamole but increased with the addition of the isometric handgrip. Myocardial blood flow was unchanged from standard to high-dose dipyridamole but was lower with the addition of the isometric handgrip. The hyperemic response induced by standard-dose dipyridamole cannot be further enhanced by high-dose dipyridamole. The addition of the isometric handgrip exercise results in a modest, but significant decline in hyperemic blood flow possibly due to increased extravascular resistive forces or an increase in a mediated coronary vasoconstriction associated with exercise. 31 refs., 2 figs., 1 tab.

  8. Improving high school physical science students' understanding of the electromagnetic spectrum: A modified diagram approach

    NASA Astrophysics Data System (ADS)

    Quebedeaux, James Edward

    The focus of this study was to identify major conceptual difficulties that selected public high school physical science students encounter in understanding a standard electromagnetic spectrum diagram. A research-driven, modified version of that standard diagram was used in this study to determine the value added to student understanding of electromagnetic waves. A content analysis was performed on electromagnetic spectrum diagrams found in US textbooks from the 1950s through the present. A class of public high school physical science students participated in a study consisting of four activities conducted during a three-week unit. Students were given a pre- and post-achievement test and a pre- and post-survey on the regions of the electromagnetic spectrum. At the conclusion of each activity, selected students were interviewed and each co-constructed a concept map with the researcher. The Electromagnetic Spectrum Literacy Rubric (ESLR) was designed and used to assess students' conceptual understanding periodically as they proceeded through the unit study. A mixed methods analysis was performed, employing both qualitative and quantitative data. A paired t-test determined that there was a statistically significant difference (p = 0.014) between the pre- and post-achievement test scores for the class of students participating in the unit study. Effect sizes also determined that students have difficulties with mathematical calculations and wave properties. These topics present conceptual challenges which must be overcome to understand and use an electromagnetic spectrum diagram effectively.

  9. Modified superposition: A simple time series approach to closed-loop manual controller identification

    NASA Technical Reports Server (NTRS)

    Biezad, D. J.; Schmidt, D. K.; Leban, F.; Mashiko, S.

    1986-01-01

    Single-channel pilot manual control output in closed-tracking tasks is modeled in terms of linear discrete transfer functions which are parsimonious and guaranteed stable. The transfer functions are found by applying a modified super-position time series generation technique. A Levinson-Durbin algorithm is used to determine the filter which prewhitens the input and a projective (least squares) fit of pulse response estimates is used to guarantee identified model stability. Results from two case studies are compared to previous findings, where the source of data are relatively short data records, approximately 25 seconds long. Time delay effects and pilot seasonalities are discussed and analyzed. It is concluded that single-channel time series controller modeling is feasible on short records, and that it is important for the analyst to determine a criterion for best time domain fit which allows association of model parameter values, such as pure time delay, with actual physical and physiological constraints. The purpose of the modeling is thus paramount.

  10. Chemically Modified Bacteriophage as a Streamlined Approach to Noninvasive Breast Cancer Imaging

    DTIC Science & Technology

    2013-12-01

    Tessier, T. E.; Bryant, H. C.; Huber, D. L.; Larson, R. S.; Flynn, E. R. Detection of breast cancer cells using targeted magnetic nanoparticles and ultra...sensitive magnetic field sensors. Breast Cancer Res. 2011, 13, R108. (29) Wang, M.; Thanou, M. Targeting Nanoparticles to Cancer . Pharmacol. Res...Streamlined Approach to Noninvasive Breast Cancer Imaging PRINCIPAL INVESTIGATOR: Michelle E. Farkas, Ph.D. CONTRACTING ORGANIZATION

  11. New approaches for tracking earth orbiters using modified GPS ground receivers

    NASA Technical Reports Server (NTRS)

    Lichten, S. M.; Young, L. E.; Nandi, S.; Haines, B. J.; Dunn, C. E.; Edwards, C. D.

    1993-01-01

    A Global Positioning System (GPS) flight receiver provides a means to precisely determine orbits for satellites in low to moderate altitude orbits. Above a 5000-km altitude, however, relatively few GPS satellites are visible. New approaches to orbit determination for satellites at higher altitudes could reduce DSN antenna time needed to provide navigation and orbit determination support to future missions. Modification of GPS ground receivers enables a beacon from the orbiter to be tracked simultaneously with GPS data. The orbit accuracy expected from this GPS-like tracking (GLT) technique is expected to be in the range of a few meters or better for altitudes up to 100,000 km with a global ground network. For geosynchronous satellites, however, there are unique challenges due to geometrical limitations and to the lack of strong dynamical signature in tracking data. We examine two approaches for tracking the Tracking and Data Relay Satellite System (TDRSS) geostationary orbiters. One uses GLT with a global network; the other relies on a small 'connected element' ground network with a distributed clock for short-baseline differential carrier phase (SB Delta Phi). We describe an experiment planned for late 1993, which will combine aspects of both GLT and SB Delta Phi, to demonstrate a new approach for tracking the Tracking and Data Relay Satellites (TDRSs) that offers a number of operationally convenient and attractive features. The TDRS demonstration will be in effect a proof-of-concept experiment for a new approach to tracking spacecraft which could be applied more generally to deep-space as well as near-Earth regimes.

  12. Morbidity Profile and Functional Outcome of Modified Facial Translocation Approaches for Skull Base Tumors

    PubMed Central

    Kekatpure, Vikram D.; Rajan, Gunesh P.; Patel, Daxesh; Trivedi, Nirav P.; Arun, P.; Iyer, Subramania; Kuriakose, Moni Abraham

    2011-01-01

    The primary objective of this study was to evaluate morbidity associated with facial translocation approaches for skull base and results of various technical modifications. Forty consecutive patients who underwent facial translocation approaches for accessing skull base tumors from July 2005 to June 2010 were included in this study. There were 25 patients who underwent standard facial translocation, 4 patients medial mini, and 11 patients underwent extended facial translocation. Thirteen patients had benign disease and 27 patients had malignant disease. Resection was R0 in 36 and R1 in 4 patients. Most patients had acceptable cosmetic results. None of the patients had problems related to occlusion or speech and swallowing. The commonest complication observed was nasal crusting in 16 patients. Grade 2 trismus and exposure of mini plate was seen in three patients. Two patients developed necrosis of translocated bone. Three patients developed palatal fistula before modification of palatal incision. Facial translocation provides a satisfactory access for adequate clearance of skull base tumors with satisfactory aesthetic and functional results. With modifications of the surgical technique and implementation of new surgical tools, the morbidity of facial translocation approaches will continue to decrease. PMID:22470269

  13. A New Approach of Modified Submerged Patch Clamp Recording Reveals Interneuronal Dynamics during Epileptiform Oscillations

    PubMed Central

    Morris, Gareth; Jiruska, Premysl; Jefferys, John G. R.; Powell, Andrew D.

    2016-01-01

    Highlights Simultaneous epileptiform LFPs and single-cell activity can be recorded in the membrane chamber.Interneuron firing can be linked to epileptiform high frequency activity.Fast ripples, unique to chronic epilepsy, can be modeled in ex vivo tissue from TeNT-treated rats. Traditionally, visually-guided patch clamp in brain slices using submerged recording conditions has been required to characterize the activity of individual neurons. However, due to limited oxygen availability, submerged conditions truncate fast network oscillations including epileptiform activity. Thus, it is technically challenging to study the contribution of individual identified neurons to fast network activity. The membrane chamber is a submerged-style recording chamber, modified to enhance oxygen supply to the slice, which we use to demonstrate the ability to record single-cell activity during in vitro epilepsy. We elicited epileptiform activity using 9 mM potassium and simultaneously recorded from fluorescently labeled interneurons. Epileptiform discharges were more reliable than in standard submerged conditions. During these synchronous discharges interneuron firing frequency increased and action potential amplitude progressively decreased. The firing of 15 interneurons was significantly correlated with epileptiform high frequency activity (HFA; ~100–500 Hz) cycles. We also recorded epileptiform activity in tissue prepared from chronically epileptic rats, treated with intrahippocampal tetanus neurotoxin. Four of these slices generated fast ripple activity, unique to chronic epilepsy. We showed the membrane chamber is a promising new in vitro environment facilitating patch clamp recordings in acute epilepsy models. Further, we showed that chronic epilepsy can be better modeled using ex vivo brain slices. These findings demonstrate that the membrane chamber facilitates previously challenging investigations into the neuronal correlates of epileptiform activity in vitro. PMID:27881950

  14. A modified approach for estimating the aquatic critical load of acid deposition in northern Saskatchewan, Canada

    NASA Astrophysics Data System (ADS)

    Whitfield, Colin J.; Mowat, Aidan C.; Scott, Kenneth A.; Watmough, Shaun A.

    2016-12-01

    Acid-sensitive ecosystems are found in northern Saskatchewan, which lies downwind of major sulphur (S) and nitrogen (N) emissions sources associated with the oil sands extraction industry. In order to protect these ecosystems against acidification, tolerance to acid deposition must be quantified. The suitability of the central empirical relationship used in the Steady-State Water Chemistry (SSWC) model to predict historical sulphate (SO4) concentrations was investigated, and an alternate approach for determining aquatic critical loads of acidity (CL(A)) was employed for the study lakes (n = 260). Critical loads of acidity were often low, with median values of 12-16 mmolc m-2 yr-1, with the lower value reflecting a region-specific limit for acid-neutralizing capacity identified in this study. Uncertain levels of atmospheric deposition in the region, however, are problematic for characterizing acidification risk. Accurate S and chloride (Cl) deposition are needed to identify catchment sources (and sinks) of these elements in the new approach for CL(A) calculation. Likewise, accurate depiction of atmospheric deposition levels can prove useful for evaluation of lake runoff estimates on which estimates of CL(A) are contingent. While CL(A) are low and exceedance may occur according to projected increases in S deposition in the near-term, S retention appears to be an important feature in many catchments and risk of acidification may be overstated should long-term S retention be occurring in peatlands.

  15. A synergistic approach for soil moisture estimation using modified Dubois model with dual-polarized SAR and optical satellite data

    NASA Astrophysics Data System (ADS)

    Thanabalan, P.; Vidhya, R.

    2016-05-01

    This paper discusses about an estimation of soil moisture in agricultural region using SAR data with the use of HH and HV polarization. In this study the semi empirical approach derived by Dubois et al (1) was modified to work using (σdegHH) and σ°VV) so that soil moisture can be obtained for the larger area extent. The optical remote sensing is helps to monitor changes in vegetation biomass and canopy cover surface reflectance by using NDVI and LAI from which the site suitability from different land use/land cover are identified. The second use involves retrieve the backscattering coefficient valuesσ°) derived from SAR for soil moisture studies. In SAR techniques, the relative surface roughness can be directly estimate using surface roughness derivation empirical algorithms. The mid incidence angle is used to overcome the incidence angle effect and it worked successfully to this study. The modified Dubois Model (MDM) in combination with The Topp's et al (2) model is used to retrieve soil moisture. These two models have equations (HH, VV) and two independent variables i.e. root mean square height (s) and dielectric constant (epsilon). The linear regression analysis is performed and the surface roughness derived from SAR is well correlated with ground surface roughness having the value of (r2 = 0.69). By using the dielectric constant (epsilon) the modified Dubois model in combination with Topp's model are performed and the soil moisture is derived from SAR having value of (r2 = 0.60). Thus, the derived model is having good scope for soil moisture monitoring with present availability of SAR datasets.

  16. Does erectile tissue angioarchitecture modify with aging? An immunohistological and morphometric approach.

    PubMed

    Costa, Carla; Vendeira, Pedro

    2008-04-01

    angioarchitecture was modified with aging. The decrease in SMCs and the considerable enlargement of vascular lumens may limit the basic function of penile vascular tree in the elderly.

  17. The use of EMG biofeedback for learning of selective activation of intra-muscular parts within the serratus anterior muscle: a novel approach for rehabilitation of scapular muscle imbalance.

    PubMed

    Holtermann, A; Mork, P J; Andersen, L L; Olsen, H B; Søgaard, K

    2010-04-01

    Motor control and learning possibilities of scapular muscles are of clinical interest for restoring scapular muscle balance in patients with neck and shoulder disorders. The aim of the study was to investigate whether selective voluntary activation of intra-muscular parts within the serratus anterior can be learned with electromyographical (EMG) biofeedback, and whether the lower serratus anterior and the lower trapezius muscle comprise the lower scapula rotation force couple by synergistic activation. Nine healthy males practiced selective activation of intra-muscular parts within the serratus anterior with visual EMG biofeedback, while the activity of four parts of the serratus anterior and four parts of the trapezius muscle was recorded. One subject was able to selectively activate both the upper and the lower serratus anterior respectively. Moreover, three subjects managed to selectively activate the lower serratus anterior, and two subjects learned to selectively activate the upper serratus anterior. During selective activation of the lower serratus anterior, the activity of this muscle part was 14.4+/-10.3 times higher than the upper serratus anterior activity (P<0.05). The corresponding ratio for selective upper serratus vs. lower serratus anterior activity was 6.4+/-1.7 (P<0.05). Moreover, selective activation of the lower parts of the serratus anterior evoked 7.7+/-8.5 times higher synergistic activity of the lower trapezius compared with the upper trapezius (P<0.05). The learning of complete selective activation of both the lower and the upper serratus anterior of one subject, and selective activation of either the upper or lower serratus anterior by five subjects designates the promising clinical application of EMG biofeedback for restoring scapular muscle balance. The synergistic activation between the lower serratus anterior and the lower trapezius muscle was observed in only a few subjects, and future studies including more subjects are required

  18. A nonlinear quality-related fault detection approach based on modified kernel partial least squares.

    PubMed

    Jiao, Jianfang; Zhao, Ning; Wang, Guang; Yin, Shen

    2017-01-01

    In this paper, a new nonlinear quality-related fault detection method is proposed based on kernel partial least squares (KPLS) model. To deal with the nonlinear characteristics among process variables, the proposed method maps these original variables into feature space in which the linear relationship between kernel matrix and output matrix is realized by means of KPLS. Then the kernel matrix is decomposed into two orthogonal parts by singular value decomposition (SVD) and the statistics for each part are determined appropriately for the purpose of quality-related fault detection. Compared with relevant existing nonlinear approaches, the proposed method has the advantages of simple diagnosis logic and stable performance. A widely used literature example and an industrial process are used for the performance evaluation for the proposed method.

  19. A modified approach to estimating sample size for simple logistic regression with one continuous covariate.

    PubMed

    Novikov, I; Fund, N; Freedman, L S

    2010-01-15

    Different methods for the calculation of sample size for simple logistic regression (LR) with one normally distributed continuous covariate give different results. Sometimes the difference can be large. Furthermore, some methods require the user to specify the prevalence of cases when the covariate equals its population mean, rather than the more natural population prevalence. We focus on two commonly used methods and show through simulations that the power for a given sample size may differ substantially from the nominal value for one method, especially when the covariate effect is large, while the other method performs poorly if the user provides the population prevalence instead of the required parameter. We propose a modification of the method of Hsieh et al. that requires specification of the population prevalence and that employs Schouten's sample size formula for a t-test with unequal variances and group sizes. This approach appears to increase the accuracy of the sample size estimates for LR with one continuous covariate.

  20. Two-nucleon scattering in a modified Weinberg approach with a symmetry-preserving regularization

    NASA Astrophysics Data System (ADS)

    Behrendt, J.; Epelbaum, E.; Gegelia, J.; Meißner, Ulf-G.; Nogga, A.

    2016-09-01

    We consider the nucleon-nucleon scattering problem by applying time-ordered perturbation theory to the Lorentz-invariant formulation of baryon chiral perturbation theory. We employ a higher-derivative symmetry-preserving regularization to obtain an integral equation for the scattering amplitude, which permits a non-perturbative treatment of subleading contributions to the nucleon-nucleon potential. The resulting formulation is used to quantify finite regulator artefacts in two-nucleon phase shifts as well as in the chiral extrapolations of the S-wave scattering lengths and the deuteron binding energy. Our approach can be straightforwardly extended to analyse few-nucleon systems and processes involving external electroweak sources.

  1. Taguchi optimization approach for Pb(II) and Hg(II) removal from aqueous solutions using modified mesoporous carbon.

    PubMed

    Zolfaghari, Ghasem; Esmaili-Sari, Abbas; Anbia, Mansoor; Younesi, Habibollah; Amirmahmoodi, Shahram; Ghafari-Nazari, Ali

    2011-09-15

    Using the Taguchi method, this study presents a systematic optimization approach for removal of lead (Pb) and mercury (Hg) by a nanostructure, zinc oxide-modified mesoporous carbon CMK-3 denoted as Zn-OCMK-3. CMK-3 was synthesized by using SBA-15 and then oxidized by nitric acid. The zinc oxide was loaded to the modified CMK-3 by the equilibrium adsorption of Zn(II) ions from aqueous solution followed by calcination to convert zinc nitrate to zinc oxide. The CMK-3 had porous structure and high specific surface area which can accommodate zinc oxide in a spreading manner, the zinc oxide connects to the carbon surface via oxygen atoms. The controllable factors such as agitation time, initial concentration, temperature, dose and pH of solution have been optimized. Under optimum conditions, the pollutant removal efficiency (PRE) was 97.25% for Pb(II) and 99% for Hg(II). The percentage contribution of each controllable factor was also determined. The initial concentration of pollutant is the most influential factor, and its value of percentage contribution is up to 31% and 43% for Pb and Hg, respectively. Our results show that the Zn-OCMK-3 is an effective nanoadsorbent for lead and mercury pollution remediation. Langmuir and Freundlich adsorption isotherms were used to model the equilibrium adsorption data for Pb(II) and Hg(II).

  2. Total synthesis of trifluorobutyryl-modified, globally protected sialyl Lewis x by a convergent [2+2] approach

    PubMed Central

    Akçay, Gizem; Ramphal, John Y.; d’Alarcao, Marc; Kumar, Krishna

    2014-01-01

    Structural and quantitative changes in the expression of sialic acid residues on the surface of eukaryotic cells profoundly influence a broad range of biological processes including inflammation, antigen recognition, microbial attachment, and tumor metastasis. Uptake and incorporation of sialic acid analogues in mammalian cells enable structure-function studies and perturbation of specific recognition events. Our group has recently shown that a trifluorobutyryl-modified sialic acid metabolite diminishes the adhesion of mammalian cells to E and P-selectin, presumably by leading to the expression of fluorinated sLex epitopes on cell surfaces, and interfering with the sLex-selectin interactions that are well known in mediating tumor cell migration.1 For studies directed towards understanding the molecular basis of this reduced adhesion, chemical synthesis of trifluorobutyrylated sialyl Lewis x (C4F3--sLex) was crucial. We have developed a highly efficient [2+2] approach for the assembly of C4F3-sLex on a preparative scale that contains versatile protective groups allowing the glycan to be surface immobilized or solubilized as needed for biophysical studies to investigate selectin interactions. This strategy can, in principle, be used for preparation of other N-modified sLex analogues. PMID:25530638

  3. Harmonic analysis approach to the 'TunneLadder' - A modified Karp circuit for millimeter-wave TWTA's

    NASA Technical Reports Server (NTRS)

    Kosmahl, H. G.; Palmer, R. W.

    1982-01-01

    A field approach to the summed harmonic analysis of the TunneLadder structure, or modified forward-wave Karp circuit, is developed by combining TM(01) and TE(11) modes. Results suggest the suitability of this structure as a high-impedance, about 1-% bandwidth circuit, millimeter-wave forward-wave-type amplifier that is voltage tunable over about a 5-% frequency range and has excellent power handling ability. Theory gives good agreement with experimental results obtained by Karp in omega-beta dispersion and predicts qualitatively the appearances of the antisymmetric mode discussed and of the so called Hightron mode that was discussed earlier in White, Enderby and Birdsall (1964), and Enderby (1964), in addition to the desired symmetric mode.

  4. Harmonic analysis approach to the 'TunneLadder' - A modified Karp circuit for millimeter-wave TWTA's

    NASA Astrophysics Data System (ADS)

    Kosmahl, H. G.; Palmer, R. W.

    1982-05-01

    A field approach to the summed harmonic analysis of the TunneLadder structure, or modified forward-wave Karp circuit, is developed by combining TM(01) and TE(11) modes. Results suggest the suitability of this structure as a high-impedance, about 1-% bandwidth circuit, millimeter-wave forward-wave-type amplifier that is voltage tunable over about a 5-% frequency range and has excellent power handling ability. Theory gives good agreement with experimental results obtained by Karp in omega-beta dispersion and predicts qualitatively the appearances of the antisymmetric mode discussed and of the so called Hightron mode that was discussed earlier in White, Enderby and Birdsall (1964), and Enderby (1964), in addition to the desired symmetric mode.

  5. Total synthesis of the proposed structure of 8-deshydroxyajudazol A: a modified approach to 2,4-disubstituted oxazoles.

    PubMed

    Birkett, Stephen; Ganame, Danny; Hawkins, Bill C; Meiries, Sébastien; Quach, Tim; Rizzacasa, Mark A

    2013-01-04

    The total synthesis of the proposed structure for the minor myxobacterial metabolite 8-deshydroxyajudazol A (3) is described. The isochromanone moiety present in the eastern fragment was constructed by an intramolecular-Diels-Alder (IMDA). Difficulties were encountered with the formation of the 2,4-disubstituted oxazole, so this was synthesized via a modified approach. This involved selective acylation of the diol 7 with acid 8, azide displacement of the secondary alcohol, and subsequent azide reduction in the presence of base which induced an O,N shift to give the hydroxyamide 23. Cyclodehydration then gave the desired oxazole 24 and deprotection followed by mesylation and elimination produced the C15 alkene 5. Sonogashira coupling with the eastern fragment vinyl iodide 6 and partial reduction yielded 8-deshydroxyajudazol A (3).

  6. A systems approach to designing next generation vaccines: combining α-galactose modified antigens with nanoparticle platforms

    NASA Astrophysics Data System (ADS)

    Phanse, Yashdeep; Carrillo-Conde, Brenda R.; Ramer-Tait, Amanda E.; Broderick, Scott; Kong, Chang Sun; Rajan, Krishna; Flick, Ramon; Mandell, Robert B.; Narasimhan, Balaji; Wannemuehler, Michael J.

    2014-01-01

    Innovative vaccine platforms are needed to develop effective countermeasures against emerging and re-emerging diseases. These platforms should direct antigen internalization by antigen presenting cells and promote immunogenic responses. This work describes an innovative systems approach combining two novel platforms, αGalactose (αGal)-modification of antigens and amphiphilic polyanhydride nanoparticles as vaccine delivery vehicles, to rationally design vaccine formulations. Regimens comprising soluble αGal-modified antigen and nanoparticle-encapsulated unmodified antigen induced a high titer, high avidity antibody response with broader epitope recognition of antigenic peptides than other regimen. Proliferation of antigen-specific CD4+ T cells was also enhanced compared to a traditional adjuvant. Combining the technology platforms and augmenting immune response studies with peptide arrays and informatics analysis provides a new paradigm for rational, systems-based design of next generation vaccine platforms against emerging and re-emerging pathogens.

  7. Fatigue of pseudoelastic NiTi within the stress-induced transformation regime: a modified Coffin-Manson approach

    NASA Astrophysics Data System (ADS)

    Maletta, C.; Sgambitterra, E.; Furgiuele, F.; Casati, R.; Tuissi, A.

    2012-11-01

    Strain controlled fatigue tests of a pseudoelastic nickel-titanium (NiTi) shape memory alloy (SMA) have been carried out in this investigation. In particular, flat dog-bone shaped specimens, obtained from commercial NiTi sheets, have been analyzed, under pull-pull loading conditions, in two subsequent steps: (i) material stabilization and (ii) fatigue life estimation. The first step was carried out to obtain a stable pseudoelastic response of the SMA, i.e. with no residual deformations upon unloading, and it can be regarded as a preliminary processing condition of the alloy. Results on functional fatigue, i.e. in terms of stabilized pseudoelastic response, and on structural fatigue, in terms of cycles to failure, are reported and discussed. Furthermore, a modified Coffin-Manson approach for fatigue life estimation of SMAs is proposed, which takes into account the strain mechanisms involved during repeated stress-induced martensitic transformations.

  8. Endoscopic Resection of the Tibialis Anterior Tendon Bursa.

    PubMed

    Lui, Tun Hing

    2016-10-01

    The tibialis anterior tendon bursa is located between the tibialis anterior tendon and the medial cuneiform bone and close to the tendon insertion. Bursitis can occur as a result of excessive local friction, infection, arthritides, or direct trauma. Endoscopic resection of the bursa is indicated in case of symptomatic bursitis that is not responding to conservative treatment or infection is suspected. It is contraindicated if there is skin infection at the portal sites. The purpose of this technical note is to describe a minimally invasive approach of endoscopic resection of the tibialis anterior tendon bursa through anterior tibial tendoscopy.

  9. A modified approach to actively remove high viscosity silicone oil through 23-gauge cannula

    PubMed Central

    Song, Zong-Ming; Hu, Xu-Ting; Wang, Lei; Hu, Zhi-Xiang; Zhao, Pei-Quan; Chen, Ding

    2016-01-01

    AIM To report a simple approach to actively remove high viscosity silicone oil through a 23-gauge cannula via pars plana. METHODS Forty-eight eyes of 48 patients underwent silicone oil (5700 centistokes) removal (SOR) were enrolled. A section of blood transfusion set was prepared to connect a standard 23-gauge cannula and vitrectomy machine. Silicone oil was removed with suction of 500-mm Hg vacuum through the cannula. Main outcome measures were SOR duration, number of sutured sites, intraocular pressure (IOP), best-corrected visual acuity (BCVA), and complications. RESULTS Silicone oil was successfully removed in all cases. The mean SOR time was 5.70±0.85min. Nine eyes (18.75%) needed suture partial sclerotomies. No intraoperative complications were noted. Transient hypotony (≤8 mm Hg) was seen in 3 eyes (6.25%) on postoperative day 1, but all resolved within 1wk. Retinal reattachment was achieved in all cases and no other postoperative complications were noted during 3-month following-up. BCVA at the final visit improved or stabilized in all patients comparing to the preoperative level. CONCLUSION Active removal of high viscosity silicone oil through a 23-gauge instrument cannula jointed with blood transfusion set is a practical and reliable technique when considering two sides of efficacy and safety. PMID:27672594

  10. Case Report: Modified Laparoscopic Subtotal Cholecystectomy: An Alternative Approach to the “Difficult Gallbladder”

    PubMed Central

    Segal, Michael S.; Huynh, Richard H.; Wright, George O.

    2017-01-01

    Patient: Male, 56 Final Diagnosis: Acute cholecystitis Symptoms: Abdominal pain Medication:— Clinical Procedure: Laparoscopic subtotal cholecystectomy Specialty: Surgery Objective: Unusual clinical course Background: Laparoscopic cholecystectomy is a commonly performed surgical procedure. In certain situations visualization of the Callot triangle can become difficult due to inflammation, adhesions, and sclerosing of the anatomy. Without being able to obtain the “critical view of safety” (CVS), there is increased risk of damage to vital structures. An alternative approach to the conventional conversion to an open cholecystectomy (OC) would be a laparoscopic subtotal cholecystectomy (LSC). Case Report: We present a case of a 56-year-old male patient with acute cholecystitis with a “difficult gallbladder” managed with LSC. Due to poor visualization of the Callot triangle due to adhesions, safe dissection was not feasible. In an effort to avoid injury to the common bile duct (CBD), dissection began at the dome of the gallbladder allowing an alternative view while ensuring safety of critical structures. Conclusions: We discuss the potential benefits and risks of LSC versus conversion to OC. Our discussion incorporates the pathophysiology that allows LSC in this particular circumstance to be successful, and the considerations a surgeon faces in making a decision in management. PMID:28220035

  11. Benchmark of a modified iterated perturbation theory approach on the fcc lattice at strong coupling

    NASA Astrophysics Data System (ADS)

    Arsenault, Louis-François; Sémon, Patrick; Tremblay, A.-M. S.

    2012-08-01

    The dynamical mean-field theory approach to the Hubbard model requires a method to solve the problem of a quantum impurity in a bath of noninteracting electrons. Iterated perturbation theory (IPT) has proven its effectiveness as a solver in many cases of interest. Based on general principles and on comparisons with an essentially exact continuous-time quantum Monte Carlo (CTQMC) solver, here we show that the standard implementation of IPT fails away from half-filling when the interaction strength is much larger than the bandwidth. We propose a slight modification to the IPT algorithm that replaces one of the equations by the requirement that double occupancy calculated with IPT gives the correct value. We call this method IPT-D. We recover the Fermi liquid ground state away from half-filling. The Fermi liquid parameters, density of states, chemical potential, energy, and specific heat on the fcc lattice are calculated with both IPT-D and CTQMC as benchmark examples. We also calculated the resistivity and the optical conductivity within IPT-D. Particle-hole asymmetry persists even at coupling twice the bandwidth. A generalization to the multiorbital case is suggested. Several algorithms that speed up the calculations are described in appendixes.

  12. A modified statistical pattern recognition approach to measuring the crosslinguistic similarity of Mandarin and English vowels.

    PubMed

    Thomson, Ron I; Nearey, Terrance M; Derwing, Tracey M

    2009-09-01

    This study describes a statistical approach to measuring crosslinguistic vowel similarity and assesses its efficacy in predicting L2 learner behavior. In the first experiment, using linear discriminant analysis, relevant acoustic variables from vowel productions of L1 Mandarin and L1 English speakers were used to train a statistical pattern recognition model that simultaneously comprised both Mandarin and English vowel categories. The resulting model was then used to determine what categories novel Mandarin and English vowel productions most resembled. The extent to which novel cases were classified as members of a competing language category provided a means for assessing the crosslinguistic similarity of Mandarin and English vowels. In a second experiment, L2 English learners imitated English vowels produced by a native speaker of English. The statistically defined similarity between Mandarin and English vowels quite accurately predicted L2 learner behavior; the English vowel elicitation stimuli deemed most similar to Mandarin vowels were more likely to elicit L2 productions that were recognized as a Mandarin category; English stimuli that were less similar to Mandarin vowels were more likely to elicit L2 productions that were recognized as new or emerging categories.

  13. Qualitative mathematical modelling of coupled coast and estuary morphodynamics: a modified Boolean network approach

    NASA Astrophysics Data System (ADS)

    French, J.; Burningham, H.

    2011-12-01

    A major challenge in coastal geomorphology is the prediction of morphological change at a meso-scale (10 to 100 km; 10 to 100 yr). This scale sits awkwardly between understanding of geomorphological processes at the micro-scale, and broader aspects of coastal evolution informed by the Holocene stratigraphic record. In this paper, we explore the potential of a new kind of qualitative mathematical model implemented at a system level. Qualitative models derive predictions from the structure of the system rather from the detailed physics of the underlying processes. Although systems thinking is well established in geomorphology methodologies for converting system diagrams into simulation tools have not been widely investigated. In a recent Defra-funded project in the UK, a Boolean network approach was piloted and applied to the simulation of generic aspects of estuary response to environmental and anthropogenic forcing. We build on this to present a generic approach to the construction of system diagrams for estuaries and adjacent open coasts and their conversion into a network graph. In a Boolean model, each node of this graph is assigned a binary value, the state of which is determined by a logical function that specifies the combined influence of other nodes to which it is connected. System evolution is simulated by specifying a set of initial conditions and repeatedly evaluating the logical functions until an equilibrium condition is reached (either a steady state or a cyclical sequence between two end states). In our enhanced Boolean scheme, changes in morphology are allowed to feed back into intrinsic process variables (e.g. estuary waves or tidal prism), although some processes are externally imposed (e.g. sea-level rise). Arbitrary time lags condition the response of morphology to a change in process, such that some landforms adjust more rapidly than others. We also present a simulator architecture based around a solver and externally specified model components

  14. Giant anterior cervical osteophyte leading to Dysphagia.

    PubMed

    Hwang, Jin Seop; Chough, Chung Kee; Joo, Won Il

    2013-09-01

    Large anterior cervical osteophytes can occur in degeneration of the cervical spine or in diffuse idiopathic skeletal hyperostosis(DISH). Large osteophytes can produce otolaryngological symptoms such as dysphagia, dysphonia, and foreign body sensation. We describe a DISH patient with giant anterior cervical osteophyte causing chronic dysphagia and dysphonia. A 56-year-old man presented with increasing dysphagia, dysphonia, neck pain and neck stiffness. Physical examination of the neck showed a non-tender and hard mass on the left side at the level of C4-5. Radiography showed extensive ossification of anterior longitudinal ligament along the left anterolateral aspect of vertebral bodies from C2 to T1. The ossification was espe cially prominent at the level of C4-5 and linear breakage was noted at same level. Esophagogram revealed a filling defect along the pharynx and lateral displacement of the esophagus. Giant anterior cervical osteophyte was removed through the leftsided anterolateral cervical approach to the spine. Anterior cervical interbody fusion at C4-5 was followed by posterior cervical fixation using lateral mass screws from C3 to C6. After surgery, dysphagia and dysphonia improved immediately. One year later, cervical CT showed bone fusion at C4-5 bodies and no recurrence of osteophyte. DISH is a common cause of anterior cervical osteophyte leading to progressive dysphagia. Keeping this clinical entity in the differential diagnosis is important in patients with progressive neck stiffness, dysphagia or dysphonia. And surgical treatment of symptomatic anterior cervical osteophyte due to DISH should be considered with a solid fusion procedure preventing postoperative instability or osteophyte progress.

  15. SLS Flight Software Testing: Using a Modified Agile Software Testing Approach

    NASA Technical Reports Server (NTRS)

    Bolton, Albanie T.

    2016-01-01

    NASA's Space Launch System (SLS) is an advanced launch vehicle for a new era of exploration beyond earth's orbit (BEO). The world's most powerful rocket, SLS, will launch crews of up to four astronauts in the agency's Orion spacecraft on missions to explore multiple deep-space destinations. Boeing is developing the SLS core stage, including the avionics that will control vehicle during flight. The core stage will be built at NASA's Michoud Assembly Facility (MAF) in New Orleans, LA using state-of-the-art manufacturing equipment. At the same time, the rocket's avionics computer software is being developed here at Marshall Space Flight Center in Huntsville, AL. At Marshall, the Flight and Ground Software division provides comprehensive engineering expertise for development of flight and ground software. Within that division, the Software Systems Engineering Branch's test and verification (T&V) team uses an agile test approach in testing and verification of software. The agile software test method opens the door for regular short sprint release cycles. The idea or basic premise behind the concept of agile software development and testing is that it is iterative and developed incrementally. Agile testing has an iterative development methodology where requirements and solutions evolve through collaboration between cross-functional teams. With testing and development done incrementally, this allows for increased features and enhanced value for releases. This value can be seen throughout the T&V team processes that are documented in various work instructions within the branch. The T&V team produces procedural test results at a higher rate, resolves issues found in software with designers at an earlier stage versus at a later release, and team members gain increased knowledge of the system architecture by interfacing with designers. SLS Flight Software teams want to continue uncovering better ways of developing software in an efficient and project beneficial manner

  16. Anterior tarsal tunnel syndrome.

    PubMed

    DiDomenico, Lawrence A; Masternick, Eric B

    2006-07-01

    Compression of the deep peroneal nerve is commonly referred to as anterior tarsal tunnel syndrome. Although rare, this syndrome remains poorly diagnosed. The syndrome is characterized by pain, weakness, and sensory changes of the foot and ankle. Non-operative measures should be attempted to reduce or remove the external compression along the anterior aspect of the foot and ankle. Other options include shoe modifications, cortisone injections,and physical therapy. If conservative management fails to relieve the symptoms, surgical decompression of the entrapped nerve can be performed. The deep peroneal nerve is released from compressive forces in the entrapment site. This can be performed at the more proximal level at the extensor retinaculum or more distally at the level of the tarsal metatarsal site.

  17. [Anterior pseudodiverticulum after laryngectomy].

    PubMed

    Pitzer, G; Oursin, C; Wolfensberger, M

    1998-01-01

    An anterior neopharyngeal pseudodiverticulum is a mucosal pouch located between the tongue and hypopharynx due to an epiglottis-like posterior tissue band that forms after total laryngectomy. This condition has rarely been mentioned in literature. Incidence, symptoms, treatment, and possible etiologic factors were examined. Twenty post-laryngectomy patients were questioned about swallowing disorders and were examined clinically and by barium swallow. Eleven patients were found to have a pseudodiverticulum, of which 9 patients suffered from dysphagia. We found no correlation between the formation of a pseudodiverticulum and radiotherapy or post-laryngectomy complications. All symptomatic patients were treated by dissecting the posterior tissue band endoscopically with a CO2-laser, bringing complete relief of symptoms in 8 of 9 patients. Our study showed that the anterior pseudodiverticulum can be a frequent cause of dysphagia after laryngectomy. It can easily be diagnosed clinically and radiologically. Endoscopic treatment with a CO2-laser is simple and effective.

  18. ENVIRONMENTAL AUDITING: An Aquifer Vulnerability Assessment of the Paluxy Aquifer, Central Texas, USA, Using GIS and a Modified DRASTIC Approach.

    PubMed

    Fritch; McKnight; Yelderman; Arnold

    2000-03-01

    / The Paluxy aquifer in north-central Texas is composed primarily of Lower Cretaceous clastics. This aquifer provides water for both domestic and agricultural purposes in the region. The study area for this investigation incorporates the outcrop and recharge areas, as well as the confined and unconfined portions of the aquifer. The purpose of this investigation is to perform a groundwater vulnerability assessment on the Paluxy aquifer using the GRASS 4.1 geographic information system combined with a modified DRASTIC approach. DRASTIC is an acronym for the variables that control the groundwater pollution potential (Depth to water, net Recharge, Aquifer media, Soil media,Topography, Impact of the vadose zone, andConductivity of the aquifer). Using such an approach allows one to investigate the potential for groundwater contamination on a regional, rather than site-specific, scale. Based upon data from variables such as soil permeability, depth to water, aquifer hydraulic conductivity, and topography, subjective numerical weightings have been assigned according to the variable's relative importance in regional groundwater quality. The weights for each variable comprise a GIS map layer. These map layers are combined to formulate the final groundwater pollution potential map. Using this method of investigation, the pollution potential map for the study area classifies 47% of the area as having low pollution potential, 26% as having moderate pollution potential, 22% as having high pollution potential, and 5% as having very high pollution potential.

  19. An aquifer vulnerability assessment of the Paluxy Aquifer, central Texas, USA, using GIS and a modified DRASTIC approach

    SciTech Connect

    Fritch, T.G.; McKnight, C.L.; Yelderman, J.C. Jr.; Arnold, J.G.

    2000-03-01

    The Paluxy aquifer in north-central Texas is composed primarily of Lower Cretaceous clastics. This aquifer provides water for both domestic and agricultural purposes in the region. The study area for this investigation incorporates the outcrop and recharge areas, as well as the confined and unconfined portions of the aquifer. The purpose of this investigation is to perform a groundwater vulnerability assessment on the Paluxy aquifer using the GRASS 4.1 geographic information system combined with a modified DRASTIC approach. DRASTIC is an acronym for the variables that control the groundwater pollution potential (Depth to water, net Recharge, Aquifer media, Soil media, Topography, Impact of the vadose zone, and Conductivity of the aquifer). Using such an approach allows one to investigate the potential for groundwater contamination on a regional, rather than site-specific, scale. Based upon data from variables such as soil permeability, depth to water, aquifer hydraulic conductivity, and topography, subjective numerical weightings have been assigned according to the variable's relative importance in regional groundwater quality. The weights for each variable comprise a GIS map layer. These map layers are combined to formulate the final groundwater pollution potential map. Using this method of investigation, the pollution potential map for the study area classified 47% of the area as having low pollution potential, 26% as having moderate pollution potential, 22% as having high pollution potential, and 5% as having very high pollution potential.

  20. A comparison of a modified sequential oral sensory approach to an applied behavior-analytic approach in the treatment of food selectivity in children with autism spectrum disorder.

    PubMed

    Peterson, Kathryn M; Piazza, Cathleen C; Volkert, Valerie M

    2016-09-01

    Treatments of pediatric feeding disorders based on applied behavior analysis (ABA) have the most empirical support in the research literature (Volkert & Piazza, 2012); however, professionals often recommend, and caregivers often use, treatments that have limited empirical support. In the current investigation, we compared a modified sequential oral sensory approach (M-SOS; Benson, Parke, Gannon, & Muñoz, 2013) to an ABA approach for the treatment of the food selectivity of 6 children with autism. We randomly assigned 3 children to ABA and 3 children to M-SOS and compared the effects of treatment in a multiple baseline design across novel, healthy target foods. We used a multielement design to assess treatment generalization. Consumption of target foods increased for children who received ABA, but not for children who received M-SOS. We subsequently implemented ABA with the children for whom M-SOS was not effective and observed a potential treatment generalization effect during ABA when M-SOS preceded ABA.

  1. Functional consequences of a section of the anterior part of the body of the corpus callosum: evidence from an interhemispheric transcallosal approach.

    PubMed

    Peltier, Johann; Roussel, Martine; Gerard, Yasmina; Lassonde, Maryse; Deramond, Hervé; Le Gars, Daniel; Gars, Daniel Le; De Beaumont, Louis; Beaumont, Louis De; Godefroy, Olivier

    2012-09-01

    The aim of this study was to determine the neuropsychological consequences of a middle interhemispheric approach for the removal of tumors of the third or lateral ventricles. A retrospective analysis of eight callosotomized patients for ventricular tumors (three males/five females; mean age: 48.7 ± 11.2 years; education level: 11.9 ± 2.9 years) and eight healthy subjects was performed. An extensive neuropsychological test battery was used to evaluate global intellectual efficiency, memory capacities, executive functions, and interhemispheric transfer of a procedural learning task (serial reaction time task/SRTT). Neuropsychological results showed that: (1) five of eight patients operated through a middle transcallosal approach had disturbances of verbal or visual memory; (2) three of eight patients displayed a dysexecutive cognitive syndrome(two of eight of whom presenting with a deficit of verbal fluency); (3) two of eight patients presented a dysexecutive behavior syndrome; and (4) with regard to the SRTT, although all participants learned the task, in contrast to controls, the callosotomized patients showed an increase in reaction times and an absence of interhemispheric transfer of learning from one hand to the other. The transcallosal approach transects a large number of callosal fibers. This damage accounts for the deficits of memory, the dysexecutive cognitive and behavioral syndrome, and disturbances in interhemispheric transfer of learning.

  2. Quantitative assessment of hyperspectral imaging in detection of plasmonic nanoparticles: a modified contrast-detail analysis approach

    NASA Astrophysics Data System (ADS)

    Wang, Jianting; Chen, Yu; Pfefer, T. Joshua

    2016-03-01

    Hyperspectral reflectance imaging (HRI) is an emerging imaging modality being applied for clinical indications such as tissue oximetry, and cancer detection based on endogenous biological constituents including plasmonic nanoparticles. However, there is currently a lack of standardized test methods for objective, quantitative evaluation of HRI system performance. Contrast-detail analysis (CDA) is a phantom-based test method commonly used to evaluate medical imaging devices (e.g., mammography systems) in terms of their lower detection limit. We investigated a modified CDA (mCDA) method to quantify the detectability of gold nanoparticles by HRI systems. Silicone-based turbid phantoms containing micro-fluidic channels were developed for the mCDA tests. Polydimethylsiloxane (PDMS) phantom materials were doped with chromophores and scatterers to achieve biologically relevant optical properties (OPs). Molds were used to produce cylindrical channels of diameters 0.3 to 1.65 mm and depths of 0.2 mm inside the phantoms. Channels were filled with a mixture of hemoglobin and concentrations of gold nanorods (GNR) and measured with our HRI system. The contrast of GNRs was solved with a spectral unmixing algorithm from the reflectance spectra. The lowest detectable concentration was determined as a function of inclusion size and depth and plotted as modified contrast detail curve (mCDC). mCDCs were used to compare the detectabilities of the HRI system with different data processing algorithms. It is demonstrated that our mCDA test method involving turbid microchannel phantoms can help to elucidate the combined performance of imaging devices and plasmonic nanoparticle contrast agents. This approach may be useful for performing clinical trial standardization and device re-calibration, thus ensuring quality control and clinical performance.

  3. Anterior knee pain.

    PubMed

    LLopis, Eva; Padrón, Mario

    2007-04-01

    Anterior knee pain is a common complain in all ages athletes. It may be caused by a large variety of injuries. There is a continuum of diagnoses and most of the disorders are closely related. Repeated minor trauma and overuse play an important role for the development of lesions in Hoffa's pad, extensor mechanism, lateral and medial restrain structures or cartilage surface, however usually an increase or change of activity is referred. Although the direct relation of cartilage lesions, especially chondral, and pain is a subject of debate these lesions may be responsible of early osteoarthrosis and can determine athlete's prognosis. The anatomy and biomechanics of patellofemoral joint is complex and symptoms are often unspecific. Transient patellar dislocation has MR distinct features that provide evidence of prior dislocation and rules our complication. However, anterior knee pain more often is related to overuse and repeated minor trauma. Patella and quadriceps tendon have been also implicated in anterior knee pain, as well as lateral or medial restraint structures and Hoffa's pad. US and MR are excellent tools for the diagnosis of superficial tendons, the advantage of MR is that permits to rule out other sources of intraarticular derangements. Due to the complex anatomy and biomechanic of patellofemoral joint maltracking is not fully understood; plain films and CT allow the study of malalignment, new CT and MR kinematic studies have promising results but further studies are needed. Our purpose here is to describe how imaging techniques can be helpful in precisely defining the origin of the patient's complaint and thus improve understanding and management of these injuries.

  4. Fast registration and reconstruction of aliased low-resolution frames by use of a modified maximum-likelihood approach.

    PubMed

    Alam, M S; Bognar, J G; Cain, S; Yasuda, B J

    1998-03-10

    During the process of microscanning a controlled vibrating mirror typically is used to produce subpixel shifts in a sequence of forward-looking infrared (FLIR) images. If the FLIR is mounted on a moving platform, such as an aircraft, uncontrolled random vibrations associated with the platform can be used to generate the shifts. Iterative techniques such as the expectation-maximization (EM) approach by means of the maximum-likelihood algorithm can be used to generate high-resolution images from multiple randomly shifted aliased frames. In the maximum-likelihood approach the data are considered to be Poisson random variables and an EM algorithm is developed that iteratively estimates an unaliased image that is compensated for known imager-system blur while it simultaneously estimates the translational shifts. Although this algorithm yields high-resolution images from a sequence of randomly shifted frames, it requires significant computation time and cannot be implemented for real-time applications that use the currently available high-performance processors. The new image shifts are iteratively calculated by evaluation of a cost function that compares the shifted and interlaced data frames with the corresponding values in the algorithm's latest estimate of the high-resolution image. We present a registration algorithm that estimates the shifts in one step. The shift parameters provided by the new algorithm are accurate enough to eliminate the need for iterative recalculation of translational shifts. Using this shift information, we apply a simplified version of the EM algorithm to estimate a high-resolution image from a given sequence of video frames. The proposed modified EM algorithm has been found to reduce significantly the computational burden when compared with the original EM algorithm, thus making it more attractive for practical implementation. Both simulation and experimental results are presented to verify the effectiveness of the proposed technique.

  5. Functional categorization of carbapenemase-mediated resistance by a combined genotyping and two-tiered Modified Hodge Test approach.

    PubMed

    Wong, Marcus H; Li, Yi; Chan, Edward W; Chen, Sheng

    2015-01-01

    The functional relationship between the detection of carbapenemase activity and phenotypic resistance in Gram-negative bacterial pathogens is often ill-defined. To address this issue, we developed a two-tiered Modified Hodge Test approach for carbapenemase detection and typing, in which the use of Pseudomonas aeruginosa strain PAO1 and Escherichia coli as indicator strains conferred two levels of sensitivities to carbapenemases. When applied alongside PCR genotyping tests for existence of known carbapenemase genes in 92 carbapenem resistant clinical isolates, this method is extremely useful in elucidating the relative role by which different enzymes contributed to the prevalent carbapenem-resistance phenotypes. With this study approach, we showed that the proportion of P. aeruginosa and Acinetobacter baumannii strains whose carbapenem resistance phenotypes could at least be partially attributed to carbapenemase were 34 and 89%, respectively. Our data also facilitates detailed functional categorization of carbapenem resistance phenotypes on the basis of the types and activities of detectable carbapenemase produced by the test organism. For example, six A. baumannii isolates harboring the bla OXA-51/23-like gene without detectable enzymatic activities were identified, suggesting that other resistance mechanisms may be involved. On the other hand, there were seven P. aeruginosa strains which produced carbapenemase phenotype without harboring known carbapenemase genes, inferring the existence of some hitherto unknown resistance determinants. Findings in this work therefore provide a comprehensive view on the cellular basis of carbapenem resistance phenotypes in major Gram-negative bacterial species, paving the way for development of novel strategies to reverse the effects of the major resistance mechanisms concerned.

  6. [Approaches for the prevention of overweight through modified beverage consumption in the elementary school setting. The "trinkfit" study].

    PubMed

    Muckelbauer, R; Libuda, L; Clausen, K; Kersting, M

    2011-03-01

    There is still little evidence for effective interventions that prevent childhood overweight. A number of behavioral interventions have been implemented, but in order to achieve sustainable preventive effects, they should be combined with environmental interventions which target the obesogenic environment. A modifiable obesogenic factor is beverage consumption and targeting this behavior seems promising to prevent overweight in children. The behavioral and environmental approaches were combined in the "trinkfit" study, and effectiveness and feasibility were tested in a controlled intervention study. In order to prevent overweight, the intervention focused on increased water consumption of children in elementary schools. The intervention consisted of lessons on water given by the teachers (behavioral intervention) and the provision of water fountains and water bottles (environmental intervention). After one school year, the intervention had been effective in decreasing the risk of overweight in the children of the intervention group. However, this preventive effect was not observed among children with an immigrant background. Process evaluation results indicate that the combined intervention focusing on increased water consumption was sustainable and feasible in the school setting.

  7. Modifying the photoelectric behavior of bacteriorhodopsin by site-directed mutagenesis: electrochemical and genetic engineering approaches to molecular devices

    NASA Astrophysics Data System (ADS)

    Hong, F. T.; Hong, F. H.; Needleman, R. B.; Ni, B.; Chang, M.

    1992-07-01

    Bacteriorhodopsins (bR's) modified by substitution of the chromophore with synthetic vitamin A analogues or by spontaneous mutation have been reported as successful examples of using biomaterials to construct molecular optoelectronic devices. The operation of these devices depends on desirable optical properties derived from molecular engineering. This report examines the effect of site-directed mutagenesis on the photoelectric behavior of bR thin films with an emphasis on their application to the construction of molecular devices based on their unique photoelectric behavior. We examine the photoelectric signals induced by a microsecond light pulse in thin films which contain reconstituted oriented purple membrane sheets isolated from several mutant strains of Halobacterium halobium. A recently developed expression system is used to synthesize mutant bR's in their natural host, H. halobium. We then use a unique analytical method (tunable voltage clamp method) to investigate the effect of pH on the relaxation of two components of the photoelectric signals, B1 and B2. We found that for the four mutant bR's examined, the pH dependence of the B2 component varies significantly. Our results suggest that genetic engineering approaches can produce mutant bR's with altered photoelectric characteristics that can be exploited in the construction of devices.

  8. Reactivation of organophosphate-inhibited human, Cynomolgus monkey, swine and guinea pig acetylcholinesterase by MMB-4: A modified kinetic approach

    SciTech Connect

    Worek, Franz; Wille, Timo; Aurbek, Nadine; Eyer, Peter; Thiermann, Horst

    2010-12-15

    Treatment of poisoning by highly toxic organophosphorus compounds (OP, nerve agents) is a continuous challenge. Standard treatment with atropine and a clinically used oxime, obidoxime or pralidoxime is inadequate against various nerve agents. For ethical reasons testing of oxime efficacy has to be performed in animals. Now, it was tempting to investigate the reactivation kinetics of MMB-4, a candidate oxime to replace pralidoxime, with nerve agent-inhibited acetylcholinesterase (AChE) from human and animal origin in order to provide a kinetic basis for the proper assessment of in vivo data. By applying a modified kinetic approach, allowing the use of necessary high MMB-4 concentrations, it was possible to determine the reactivation constants with sarin-, cyclosarin-, VX-, VR- and tabun-inhibited AChE. MMB-4 exhibited a high reactivity and low affinity towards OP-inhibited AChE, except of tabun-inhibited enzyme where MMB-4 had an extremely low reactivity. Species differences between human and animal AChE were low (Cynomolgus) to moderate (swine, guinea pig). Due to the high reactivity of MMB-4 a rapid reactivation of inhibited AChE can be anticipated at adequate oxime concentrations which are substantially higher compared to HI-6. Additional studies are necessary to determine the in vivo toxicity, tolerability and pharmacokinetics of MMB-4 in humans in order to enable a proper assessment of the value of this oxime as an antidote against nerve agent poisoning.

  9. Anterior vitrectomy for shallow anterior chamber after cataract extraction.

    PubMed

    Dottan, S; Levartovsky, S; Oliver, M

    1982-06-01

    Pars plana anterior vitrectomy was performed in 9 patients with shallow anterior chamber after cataract extraction. Five patients had choroidal and/or ciliary body effusion (CCBE), and 4 had aphakic pupillary block (APB). Vitrectomy was performed only after medical treatment failed to restore a normal anterior chamber depth. In all patients the anterior chamber restored during surgery and remained so thereafter, although in patients with CCBE, the fundal pathology subsided days or even months later. The only surgical complication was a longstanding cystoid macular oedema in one patient. Pars plana vitrectomy would appear to have advantages over other surgical techniques, in similar circumstances.

  10. A Modified Approach of Percutaneous Endoscopic Lumbar Discectomy (PELD) for Far Lateral Disc Herniation at L5-S1 with Foot Drop

    PubMed Central

    Chun, Eun Hee

    2016-01-01

    Foraminal or extraforaminal Far Lateral Disc Herniations (FLDH) extending into or beyond the foraminal zone have been recognized as between 7-12% of all lumbosacral disc herniations. Conventional posterior laminectomy may not provide good access to a herniation that lies far lateral to the lateral margin of the pedicle. Use of the endoscopic technique through a percutaneous approach to treat such FLDH patients can decrease the surgical morbidity while achieving better outcomes. We made an effort to utilize the advantages of percutaneous endoscopic lumbar discectomy (PELD) and to determine the appropriate approach for FLDH at the level between the 5th Lumbar and first Sacral vertebrae(L5-S1). The authors present a case of an endoscopically resected lumbar extruded disc of the left extraforaminal zone with superior foraminal migration at the level of L5-S1, which had led to foot drop, while placing the endoscope in the anterior epidural space without facetectomy. PMID:26839673

  11. Modified posterior vertebral column resection for Kümmell disease

    PubMed Central

    Liu, Feng-Yu; Huo, Li-Shuang; Liu, Sen; Wang, Hui; Zhang, Li-Jun; Yang, Da-Long; Ding, Wen-Yuan

    2017-01-01

    Abstract Rationale: Kümmell's disease is defined as delayed traumatic vertebral collapse disease in which patients develop a kyphosis after asymptomatic minor spinal trauma. Both anterior approach and posterior approach have been reported, however, there is no standard treatment for Kümmell's disease. Patient concerns: We described a successful modified posterior vertebral column resection in a patient with Kümmell's disease. A 65-year-old woman reported persistent back pain for almost three months. Diagnoses: Kümmell's disease was diagnosed based on computer tomography (CT) and magnetic resonance imaging (MRI). Interventions: Modified posterior vertebral column resection combined with short-segment fixation was designed to treat this disease. Outcomes: The procedure was successful without any complications. Patient reported that symptoms were obviously improved in one week after operation. Lessons: Modified posterior vertebral column resection combined with short-segment fixation is an effective treatment option for Kümmell's disease. PMID:28151882

  12. Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 2: a review of prevention programs aimed to modify risk factors and to reduce injury rates.

    PubMed

    Alentorn-Geli, Eduard; Myer, Gregory D; Silvers, Holly J; Samitier, Gonzalo; Romero, Daniel; Lázaro-Haro, Cristina; Cugat, Ramón

    2009-08-01

    Soccer is the most commonly played sport in the world, with an estimated 265 million active soccer players participating in the game as on 2006. Inherent to this sport is the higher risk of injury to the anterior cruciate ligament (ACL) relative to other sports. ACL injury causes a significant loss of time from competition in soccer, which has served as the strong impetus to conduct research that focuses to determine the risk factors for injury, and more importantly, to identify and teach techniques to reduce this injury in the sport. This research emphasis has afforded a rapid influx of literature aimed to report the effects of neuromuscular training on the risk factors and the incidence of non-contact ACL injury in high-risk soccer populations. The purpose of the current review is to sequence the most recent literature relating the effects of prevention programs that were developed to alter risk factors associated with non-contact ACL injuries and to reduce the rate of non-contact ACL injuries in soccer players. To date there is no standardized intervention program established for soccer to prevent non-contact ACL injuries. Multi-component programs show better results than single-component preventive programs to reduce the risk and incidence of non-contact ACL injuries in soccer players. Lower extremity plyometrics, dynamic balance and strength, stretching, body awareness and decision-making, and targeted core and trunk control appear to be successful training components to reduce non-contact ACL injury risk factors (decrease landing forces, decrease varus/valgus moments, and increase effective muscle activation) and prevent non-contact ACL injuries in soccer players, especially in female athletes. Pre-season injury prevention combined with an in-season maintenance program may be advocated to prevent injury. Compliance may in fact be the limiting factor to the overall success of ACL injury interventions targeted to soccer players regardless of gender. Thus

  13. Scheimpflug imaging in anterior megalophthalmos

    PubMed Central

    Nemeth, Gabor; Hassan, Ziad; Berta, Andras; Modis, Laszlo

    2013-01-01

    We report an anterior megalophthalmos case with decreased corneal thickness and show the findings using Scheimpflug imaging. A 25-year-old male was diagnosed with anterior megalophthalmos. In both eyes, enlarged corneal length was measured. Beside a comparatively good visual acuity, a thin but clear cornea, a fairly deep anterior chamber, and central lens opacity were found. Scheimpflug images were taken using Pentacam HR. Scheimpflug-based imaging can provide us new data at the examination of this syndrome affecting the whole anterior segment. PMID:23275220

  14. Application of anterior segment optical coherence tomography in glaucoma.

    PubMed

    Sharma, Reetika; Sharma, Ajay; Arora, Tarun; Sharma, Sourabh; Sobti, Amit; Jha, Bhaskar; Chaturvedi, Neha; Dada, Tanuj

    2014-01-01

    Optical coherence tomography (OCT) is a cross-sectional, three-dimensional, high-resolution imaging modality that uses low coherence interferometry to achieve axial resolution in the range of 3-20 μm. Two OCT platforms have been developed: time domain (TD-OCT) and spectral (or Fourier) domain (SD/FD-OCT). Visante anterior segment OCT (Carl Zeiss Meditec) is a TD-OCT widely used for anterior segment imaging. The SD-OCT systems with both posterior and anterior segment imaging capabilities include the RTVue, iVue (Optovue), the Cirrus (Carl Zeiss Meditec), and the Spectralis (Heidelberg Engineering, Inc.). Each of the SD-OCTs has a wavelength in the range of 820-879 nm. Anterior segment OCT is a non-contact method providing high resolution tomographic cross-sectional imaging of anterior segment structures. Anterior segment OCT provides qualitative and quantitative assessment of the anterior segment structures important to the pathogenesis and the anatomical variations of glaucoma, and the approach to and success of treatment. We summarize the clinical applications of anterior segment OCT in glaucoma.

  15. Towards Tailored Patient's Management Approach: Integrating the Modified 2010 ACR Criteria for Fibromyalgia in Multidimensional Patient Reported Outcome Measures Questionnaire.

    PubMed

    El Miedany, Yasser; El Gaafary, Maha; Youssef, Sally; Ahmed, Ihab

    2016-01-01

    Objectives. To assess the validity, reliability, and responsiveness to change of a patient self-reported questionnaire combining the Widespread Pain Index and the Symptom Severity Score as well as construct outcome measures and comorbidities assessment in fibromyalgia patients. Methods. The PROMs-FM was conceptualized based on frameworks used by the WHO Quality of Life tool and the PROMIS. Initially, cognitive interviews were conducted to identify item pool of questions. Item selection and reduction were achieved based on patients as well as an interdisciplinary group of specialists. Rasch and internal consistency reliability analyses were implemented. The questionnaire included the modified ACR criteria main items (Symptom Severity Score and Widespread Pain Index), in addition to assessment of functional disability, quality of life (QoL), review of the systems, and comorbidities. Every patient completed HAQ and EQ-5D questionnaires. Results. A total of 146 fibromyalgia patients completed the questionnaire. The PROMs-FM questionnaire was reliable as demonstrated by a high standardized alpha (0.886-0.982). Content construct assessment of the functional disability and QoL revealed significant correlation (p < 0.01) with both HAQ and EQ-5D. Changes in functional disability and QoL showed significant (p < 0.01) variation with diseases activity status in response to therapy. There was higher prevalence of autonomic symptoms, CVS risk, sexual dysfunction, and falling. Conclusions. The developed PROMs-FM questionnaire is a reliable and valid instrument for assessment of fibromyalgia patients. A phased treatment regimen depending on the severity of FMS as well as preferences and comorbidities of the patient is the best approach to tailored patient management.

  16. Towards Tailored Patient's Management Approach: Integrating the Modified 2010 ACR Criteria for Fibromyalgia in Multidimensional Patient Reported Outcome Measures Questionnaire

    PubMed Central

    El Miedany, Yasser; El Gaafary, Maha; Youssef, Sally; Ahmed, Ihab

    2016-01-01

    Objectives. To assess the validity, reliability, and responsiveness to change of a patient self-reported questionnaire combining the Widespread Pain Index and the Symptom Severity Score as well as construct outcome measures and comorbidities assessment in fibromyalgia patients. Methods. The PROMs-FM was conceptualized based on frameworks used by the WHO Quality of Life tool and the PROMIS. Initially, cognitive interviews were conducted to identify item pool of questions. Item selection and reduction were achieved based on patients as well as an interdisciplinary group of specialists. Rasch and internal consistency reliability analyses were implemented. The questionnaire included the modified ACR criteria main items (Symptom Severity Score and Widespread Pain Index), in addition to assessment of functional disability, quality of life (QoL), review of the systems, and comorbidities. Every patient completed HAQ and EQ-5D questionnaires. Results. A total of 146 fibromyalgia patients completed the questionnaire. The PROMs-FM questionnaire was reliable as demonstrated by a high standardized alpha (0.886–0.982). Content construct assessment of the functional disability and QoL revealed significant correlation (p < 0.01) with both HAQ and EQ-5D. Changes in functional disability and QoL showed significant (p < 0.01) variation with diseases activity status in response to therapy. There was higher prevalence of autonomic symptoms, CVS risk, sexual dysfunction, and falling. Conclusions. The developed PROMs-FM questionnaire is a reliable and valid instrument for assessment of fibromyalgia patients. A phased treatment regimen depending on the severity of FMS as well as preferences and comorbidities of the patient is the best approach to tailored patient management. PMID:27190648

  17. Control of the dynamics of coupled atomic-molecular Bose-Einstein condensates: Modified Gross-Pitaevskii approach

    SciTech Connect

    Gupta, Moumita; Dastidar, Krishna Rai

    2009-10-15

    We study the dynamics of the atomic and molecular Bose-Einstein condensates (BECs) of {sup 87}Rb in a spherically symmetric trap coupled by stimulated Raman photoassociation process. Considering the higher order nonlinearity in the atom-atom interaction we analyze the dynamics of the system using coupled modified Gross-Pitaevskii (MGP) equations and compare it with mean-field coupled Gross-Pitaevskii (GP) dynamics. Considerable differences in the dynamics are obtained in these two approaches at large scattering length, i.e., for large values of peak-gas parameter x{sub pk}{>=}10{sup -3}. We show how the dynamics of the coupled system is affected when the atom-molecule and molecule-molecule interactions are considered together with the atom-atom interaction and also when the strengths of these three interactions are increased. The effect of detuning on the efficiency of conversion of atomic fractions into molecules is demonstrated and the feasibility of maximum molecular BEC formation by varying the Raman detuning parameter at different values of time is explored. Thus by varying the Raman detuning and the scattering length for atom-atom interaction one can control the dynamics of the coupled atomic-molecular BEC system. We have also solved coupled Gross-Pitaevskii equations for atomic to molecular condensate formation through magnetic Feshbach resonance in a BEC of {sup 85}Rb. We found similar features for oscillations between atomic and molecular condensates noted in previous theoretical study and obtained fairly good agreement with the evolution of total atomic condensate observed experimentally.

  18. [Biocompatibility and pharmacokinetics of hydroxypropyl methylcellulose (HPMC) in the anterior chamber of the rabbit eye].

    PubMed

    Ehrich, W; Höh, H; Kreiner, C F

    1990-06-01

    The biocompatibility and pharmacokinetics of hydroxypropylmethylcellulose (HPMC) 2% (Adatocel) and Tylose 2% (MH 1000) were investigated. A modified anterior chamber implantation test on the rabbit eye is suitable for testing both the biocompatibility and the pharmacokinetics of visco-surgical substances. Both substances were well tolerated. From the fourth day onward, HPMC was no longer detectable in the anterior chamber by infrared spectroscopy.

  19. [Anterior cervical hypertrichosis: case report].

    PubMed

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

    2016-10-01

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

  20. Cataract Surgery in Anterior Megalophthalmos: A Review

    PubMed Central

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

    2015-01-01

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

  1. Fabrication of BaTiO3-Based Dielectrics for Ultrathin-Layer Multilayer Ceramic Capacitor Application by a Modified Coating Approach

    NASA Astrophysics Data System (ADS)

    Tian, Zhibin; Wang, Xiaohui; Zhang, Yichi; Song, Tae-Ho; Hur, Kang Heon; Li, Longtu

    2011-02-01

    The development of multilayer ceramic capacitor (MLCC) with base metal electrode (BME) requires precise controlling of the microstructure in a very thin dielectric layer (<1 µm). In this paper, a modified coating approach for high coverage of BaTiO3 powder for further MLCC application has been developed. The well dispersed and coated BaTiO3 powders are prepared and the relative mechanism has been discussed. Furthermore, the ultrafine grained X7R dielectric ceramics were produced by both conventional mixing and modified coating methods. Compared with the conventional mixing method, the ceramics prepared by the coating approach exhibited better TCC (the temperature coefficient of capacitance) performance, with dielectric constant over 2000 and grain size below 150 nm. In addition, it is found through the coating method the content of additives can be reduced to a relatively smaller amount than that required in conventional mixing method.

  2. Correction of anterior open bite in a case of achondroplasia.

    PubMed

    Karpagam, S; Rabin, K; George, Mathew; Santhosh, Koshy

    2005-01-01

    Treatment planning for patients with skeletal deformities is often considered challenging. This article reports a female patient with achondroplasia who presented with severe maxillary retrognathism and vertical excess along with anterior open bite. The clinical and cephalometric findings of the patient are detailed here. The treatment plan consisted of modified anterior maxillary osteotomy for simultaneous vertical and sagittal augmentation along with orthodontic intervention. The course of surgical-orthodontic treatment and the results are presented. This treatment is to be followed by correction of vertical maxillary excess after completion of growth. This paper concludes that the dentoalveolar component of a skeletal deformity can be handled independent of the craniofacial management.

  3. Revision Anterior Cruciate Ligament Reconstruction

    PubMed Central

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

    2014-01-01

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

  4. A Modified Moore Approach to Teaching Mathematical Statistics: An Inquiry Based Learning Technique to Teaching Mathematical Statistics

    ERIC Educational Resources Information Center

    McLoughlin, M. Padraig M. M.

    2008-01-01

    The author of this paper submits the thesis that learning requires doing; only through inquiry is learning achieved, and hence this paper proposes a programme of use of a modified Moore method in a Probability and Mathematical Statistics (PAMS) course sequence to teach students PAMS. Furthermore, the author of this paper opines that set theory…

  5. Crossing the Bridge to Higher Mathematics: Using a Modified Moore Approach to Assist Students Transitioning to Higher Mathematics

    ERIC Educational Resources Information Center

    McLoughlin, M. Padraig M. M.

    2008-01-01

    The author of this paper submits that a mathematics student needs to learn to conjecture and prove or disprove said conjecture. Ergo, the purpose of the paper is to submit the thesis that learning requires doing; only through inquiry is learning achieved, and hence this paper proposes a programme of use of a modified Moore method in a Bridge to…

  6. A Modified Approach to Inducing Bone Marrow Stromal Cells to Differentiate into Cells with Mature Schwann Cell Phenotypes.

    PubMed

    Liu, Yutian; Chen, Jianghai; Liu, Wei; Lu, Xiaocheng; Liu, Zhenyu; Zhao, Xiaobo; Li, Gongchi; Chen, Zhenbing

    2016-02-15

    Marrow stromal cells (MSCs) can be induced to differentiate into Schwann-like cells under classical induction conditions. However, cells derived from this method are unstable, exhibiting a low neurotrophin expression level after the induction conditions are removed. In Schwann cell (SC) culture, progesterone (PROG) enhances neurotrophic synthesis and myelination, specifically regulating the expression of the myelin protein zero (P0)- and peripheral myelin protein 22 (PMP22)-encoding genes by acting in concert or in synergy with insulin and glucocorticoids (GLUCs). In the present study, we investigated whether combined PROG, GLUC, and insulin therapy induced MSCs to differentiate into modified SC-like cells with phenotypes similar to those of mature SCs. After being cultured for 2 weeks in modified differentiation medium, the modified SC-like cells showed increased expression of P0 and PMP22. In addition, morphological and phenotypic characterizations were conducted over a period of over 2 weeks, and functional characteristics persisted for more than 3 weeks after the induction reagents were withdrawn. The transplantation of green fluorescent protein-labeled, modified SC-like cells into transected sciatic nerves with a 10-mm gap significantly increased the proliferation of the original SCs and improved axon regeneration and myelination compared with original BM-SCs. Immunostaining for P0 revealed that more of the transplanted modified SC-like cells retained the phenotypic characteristics of SCs. Taken together, these results reveal that the combined application of PROG, GLUC, and insulin induces MSCs to differentiate into cells with phenotypic, molecular, and functional properties of mature SCs.

  7. Restoring primary anterior teeth.

    PubMed

    Waggoner, William F

    2002-01-01

    A variety of esthetic restorative materials are available for restoring primary incisors. Knowledge of the specific strengths, weakness, and properties of each material will enhance the clinician's ability to make the best choice of selection for each individual situation. Intracoronal restorations of primary teeth may utilize resin composites, glass ionomer cements, resin-modified ionomers, or polyacid-modified resins. Each has distinct advantages and disadvantages and the clinical conditions of placement may be a strong determining factor as to which material is utilized. Full coronal restoration of primary incisors may be indicated for a number of reasons. Crowns available for restoration of primary incisors include those that are directly bonded onto the tooth, which generally are a resin material, and those crowns that are luted onto the tooth and are some type of stainless steel crown. However, due to lack of supporting clinical data, none of the crowns can be said to be superior to the others under all circumstances. Though caries in the mandibular region is rare, restorative solutions for mandibular incisors are needed. Neither stainless steel crowns nor celluloid crown forms are made specifically for mandibular incisors. Many options exist to repair carious primary incisors, but there is insufficient controlled, clinical data to suggest that one type of restoration is superior to another. This does not discount the fact that dentists have been using many of these crowns for years with much success. Operator preferences, esthetic demands by parents, the child's behavior, and moisture and hemorrhage control are all variables which affect the decision and ultimate outcome of whatever restorative treatment is chosen.

  8. The orbitozygomatic stich: A technical modification of the lateral supraorbital approach

    PubMed Central

    Lazukova, Miroslava; Andrade-Barazarte, Hugo; Makhamov, Mahkham; Kivelev, Juri; Goehre, Felix; Jahromi, Behnam Rezai; Ibrahim, Tarik F.; Araujo, Ricardo; Lehto, Hanna; Hernesniemi, Juha A.

    2016-01-01

    Background: The lateral supraorbital approach (LSO) provides access to a variety of pathologies including anterior and some posterior circulation aneurysms, sellar and suprasellar lesions, and anterior fossa tumors. Technical modifications of LSO improve the surgical exposure of the skull base. Methods: We retrospectively analyzed 73 consecutive patients treated by the senior author (Juha A. Hernesniemi), at the Department of Neurosurgery, Helsinki University Hospital in Helsinki, Finland from May 2013 to October 2013. This study cohort underwent a modified LSO to access anterior circulation aneurysms, sellar and suprasellar tumors, and anterior fossa tumors. The studied population comprised 30 men and 43 women, with a mean age at treatment of 54 years (9–83 years). Results: LSO was successfully used to access anterior circulation aneurysms in 59 (81%) patients, 10 (14%) patients with anterior cranial fossa tumors, and 4 (5%) patients with suprasellar tumors. The skull base drilling provided a mean of 6.8 mm (1.7–22 mm) in increased exposure. Conclusion: LSO provides adequate access to vascular and neoplastic lesions of the anterior cranial fossa, by drilling approximately 6.8 mm (1.7–22 mm) of the lateral orbital wall and sphenoid wing. This enhances surgical exposure and trajectory. An additional trick while performing an LSO is to place a single or multiple stiches (orbitozygomatic stich) at the base of the dura once opened, eliminating the dead space between the dura and anterior skull base. PMID:27168949

  9. An improved dual approach to post bariatric contouring — Staged liposuction and modified medial thigh lift: A case series

    PubMed Central

    Jandali, Zaher; Loh, Charles Yuen Yung; Athanassopoulos, Thanassi; Müller, Klaus

    2014-01-01

    Objective: Following massive weight loss (MWL) medial contouring of the thigh is frequently requested to improve appearance and function. Thigh lifting can be associated with significant complications. We present a case series of post bariatric patients undergoing thigh lift using staged the liposuction, a modified T incision and a buried de-epithelialised dermal flap. Materials and Methods: From January to December 2012, 21 consecutive patients underwent a modified medial thigh lift. A retrospective review of the case notes was performed to assess complications that occurred. Results: There were no major post-operative complications in terms of reoperation, hematoma, thromboembolism and no seromas. Seven patients, all of which were smokers had minor superficial wound healing complications. Aesthetic outcomes were satisfactory for all patients at a minimum follow-up of 6 months. Conclusions: The modified ‘T’ incision with staged liposuction is described. We have found the technique to be useful for a variety of different thighs. It is a reproducible method for contouring the medial thigh in MWL patients. In this series, our overall complications were low, and no seromas occurred. PMID:25190920

  10. Coulomb-hole summations and energies for GW calculations with limited number of empty orbitals: A modified static remainder approach

    NASA Astrophysics Data System (ADS)

    Deslippe, Jack; Samsonidze, Georgy; Jain, Manish; Cohen, Marvin L.; Louie, Steven G.

    2013-04-01

    Ab initio GW calculations are a standard method for computing the spectroscopic properties of many materials. The most computationally expensive part in conventional implementations of the method is the generation and summation over the large number of empty orbitals required to converge the electron self-energy. We propose a scheme to reduce the summation over empty states by the use of a modified static remainder approximation, which is simple to implement and yields accurate self-energies for both bulk and molecular systems requiring a small fraction of the typical number of empty orbitals.

  11. A public health approach to the impact of climate change on health in southern Africa - identifying priority modifiable risks.

    PubMed

    Myers, J; Young, T; Galloway, M; Manyike, P; Tucker, T

    2011-11-01

    Anthropogenic climate change and anticipated adverse impacts on human health as outlined by the Intergovernmental Panel on Climate Change (IPCC) are taken as given. A conceptual model for thinking about the spectrum of climate-related health risks ranging from distal and infrastructural to proximal and behavioural and their relation to the burden of disease pattern typical of sub-Saharan Africa is provided. The model provides a tool for identifying modifiable risk factors with a view to future research, specifically into the performance of interventions to reduce the impact of climate change.

  12. Preprosthetic movement of anterior teeth.

    PubMed

    Melsen, B

    1982-05-01

    Preprosthetic movement of anterior teeth is often performed on patients with missing anterior teeth, providing a better basis for subsequent bridgework. This can often be achieved by horizontal tooth movements of a tipping or translatory art whilst other patients present problems of a vertical nature with a deep overbite inconsistent with a healthy periodontal status. Intrusive tooth movements are needed as changes in facial height are not tolerated. The importance of understanding the biological basis for tooth movements in the planning of the biomechanics is stressed. Forces should be monitored according to the amount of general and local bone loss.

  13. Reliability and Validity of the Anterior Knee Pain Scale: Applications for Use as an Epidemiologic Screener

    PubMed Central

    2016-01-01

    A screening instrument’s ability to provide clinicians with consistent and reproducible information is crucial to intervention. Despite widespread acceptance and clinical use of the Kujala Anterior Knee Pain Scale (AKPS) in orthopedics and sports medicine, few studies have reported on its reliability and no such studies have concentrated on child or adolescent samples exclusively, segments of the population for which this instrument is often used. The purpose of the current study was to describe and report on the reliability and validity of the AKPS for use with high school female athletes participating in interscholastic athletics. The study was a secondary analysis of prospective epidemiologic data using established scale validation methods. The records of 414 female athletes 11.0 to 18.1 years of age (Mean 13.9 yrs, SD = 1.7 yrs) were used for analysis. Four different approaches to scoring and scale reduction of the AKPS were evaluated, including the original, ordinal 13-item form, a modified, ordinal 6-item form, a modified, dichotomous 13-item form, and a modified, dichotomous 6-item form. Three different types of reliability (internal consistency, equivalence across forms, standard error of measurement) and one type of validity (criterion-related) were estimated for the AKPS in the current sample. The four scoring formats of the AKPS scale were found to have high internal consistency (αcoef = 0.83 to 0.91), equivalence across the short and long forms (r = 0.98), acceptable standard errors of measurement (0.82 to 3.00), and moderate to high criterion related validity—as determined by physican’s diagnosis: 0.92 (13-item form), 0.90 (6-item form). The Kujala AKPS is a valid and reliable measure of anterior knee pain and appropriate for use as an epidemiologic screening tool with adolescent female athletes. PMID:27441381

  14. Identification of liver protein targets modified by tienilic acid metabolites using a two-dimensional Western blot-mass spectrometry approach

    NASA Astrophysics Data System (ADS)

    Methogo, Ruth Menque; Dansette, Patrick M.; Klarskov, Klaus

    2007-12-01

    A combined approach based on two-dimensional electrophoresis-immuno-blotting and nanoliquid chromatography coupled on-line with electrospray ionization mass spectrometry (nLC-MS/MS) was used to identify proteins modified by a reactive intermediate of tienilic acid (TA). Liver homogenates from rats exposed to TA were fractionated using ultra centrifugation; four fractions were obtained and subjected to 2D electrophoresis. Following transfer to PVDF membranes, modified proteins were visualized after India ink staining, using an anti-serum raised against TA and ECL detection. Immuno-reactive spots were localized on the PVDF membrane by superposition of the ECL image, protein spots of interest were excised, digested on the membrane with trypsin followed by nLC-MS/MS analysis and protein identification. A total of 15 proteins were identified as likely targets modified by a TA reactive metabolite. These include selenium binding protein 2, senescence marker protein SMP-30, adenosine kinase, Acy1 protein, adenosylhomocysteinase, capping protein (actin filament), protein disulfide isomerase, fumarylacetoacetase, arginase chain A, ketohexokinase, proteasome endopeptidase complex, triosephosphate isomerase, superoxide dismutase, dna-type molecular chaperone hsc73 and malate dehydrogenase.

  15. Coherence between legal requirements and approaches for detection of genetically modified organisms (GMOs) and their derived products.

    PubMed

    Holst-Jensen, Arne; De Loose, Marc; Van den Eede, Guy

    2006-04-19

    Analytical methods for the qualitative and quantitative detection of genetically modified (GM) products may serve multiple purposes. Legal requirements differ among jurisdictions, ranging from no requirements to mandatory use of event-specific quantitation and implementation of production chain traceability. Although efforts have been taken to harmonize the analytical methodology at national, regional, and international levels, no normative international standards have yet been established. Lack of coherence between analytical methodologies and their applicabilities, on the one hand, and legislation, on the other hand, is a major problem. Here, key points where coherence is lacking are discussed. These include the definition of units of measurements, expression of GM material quantities, terminology, and inconsistent legal status of products derived from related but slightly different transformation routes. Finally, recommendations to improve the coherence are brought forward, including guidance to stakeholders for prediction of product-specific GM material quantities from gene ratios in the originating seed.

  16. Cytotoxicity of ZnO Nanoparticles Can Be Tailored by Modifying Their Surface Structure: A Green Chemistry Approach for Safer Nanomaterials.

    PubMed

    Punnoose, Alex; Dodge, Kelsey; Rasmussen, John W; Chess, Jordan; Wingett, Denise; Anders, Catherine

    2014-07-07

    ZnO nanoparticles (NP) are extensively used in numerous nanotechnology applications; however, they also happen to be one of the most toxic nanomaterials. This raises significant environmental and health concerns and calls for the need to develop new synthetic approaches to produce safer ZnO NP, while preserving their attractive optical, electronic, and structural properties. In this work, we demonstrate that the cytotoxicity of ZnO NP can be tailored by modifying their surface-bound chemical groups, while maintaining the core ZnO structure and related properties. Two equally sized (9.26 ± 0.11 nm) ZnO NP samples were synthesized from the same zinc acetate precursor using a forced hydrolysis process, and their surface chemical structures were modified by using different reaction solvents. X-ray diffraction and optical studies showed that the lattice parameters, optical properties, and band gap (3.44 eV) of the two ZnO NP samples were similar. However, FTIR spectroscopy showed significant differences in the surface structures and surface-bound chemical groups. This led to major differences in the zeta potential, hydrodynamic size, photocatalytic rate constant, and more importantly, their cytotoxic effects on Hut-78 cancer cells. The ZnO NP sample with the higher zeta potential and catalytic activity displayed a 1.5-fold stronger cytotoxic effect on cancer cells. These results suggest that by modifying the synthesis parameters/conditions and the surface chemical structures of the nanocrystals, their surface charge density, catalytic activity, and cytotoxicity can be tailored. This provides a green chemistry approach to produce safer ZnO NP.

  17. Cytotoxicity of ZnO Nanoparticles Can Be Tailored by Modifying Their Surface Structure: A Green Chemistry Approach for Safer Nanomaterials

    PubMed Central

    2015-01-01

    ZnO nanoparticles (NP) are extensively used in numerous nanotechnology applications; however, they also happen to be one of the most toxic nanomaterials. This raises significant environmental and health concerns and calls for the need to develop new synthetic approaches to produce safer ZnO NP, while preserving their attractive optical, electronic, and structural properties. In this work, we demonstrate that the cytotoxicity of ZnO NP can be tailored by modifying their surface-bound chemical groups, while maintaining the core ZnO structure and related properties. Two equally sized (9.26 ± 0.11 nm) ZnO NP samples were synthesized from the same zinc acetate precursor using a forced hydrolysis process, and their surface chemical structures were modified by using different reaction solvents. X-ray diffraction and optical studies showed that the lattice parameters, optical properties, and band gap (3.44 eV) of the two ZnO NP samples were similar. However, FTIR spectroscopy showed significant differences in the surface structures and surface-bound chemical groups. This led to major differences in the zeta potential, hydrodynamic size, photocatalytic rate constant, and more importantly, their cytotoxic effects on Hut-78 cancer cells. The ZnO NP sample with the higher zeta potential and catalytic activity displayed a 1.5-fold stronger cytotoxic effect on cancer cells. These results suggest that by modifying the synthesis parameters/conditions and the surface chemical structures of the nanocrystals, their surface charge density, catalytic activity, and cytotoxicity can be tailored. This provides a green chemistry approach to produce safer ZnO NP. PMID:25068096

  18. A theoretical introduction to "combinatory SYBRGreen qPCR screening", a matrix-based approach for the detection of materials derived from genetically modified plants.

    PubMed

    Van den Bulcke, Marc; Lievens, Antoon; Barbau-Piednoir, Elodie; MbongoloMbella, Guillaume; Roosens, Nancy; Sneyers, Myriam; Casi, Amaya Leunda

    2010-03-01

    The detection of genetically modified (GM) materials in food and feed products is a complex multi-step analytical process invoking screening, identification, and often quantification of the genetically modified organisms (GMO) present in a sample. "Combinatory qPCR SYBRGreen screening" (CoSYPS) is a matrix-based approach for determining the presence of GM plant materials in products. The CoSYPS decision-support system (DSS) interprets the analytical results of SYBRGREEN qPCR analysis based on four values: the C(t)- and T(m) values and the LOD and LOQ for each method. A theoretical explanation of the different concepts applied in CoSYPS analysis is given (GMO Universe, "Prime number tracing", matrix/combinatory approach) and documented using the RoundUp Ready soy GTS40-3-2 as an example. By applying a limited set of SYBRGREEN qPCR methods and through application of a newly developed "prime number"-based algorithm, the nature of subsets of corresponding GMO in a sample can be determined. Together, these analyses provide guidance for semi-quantitative estimation of GMO presence in a food and feed product.

  19. Restoring primary anterior teeth: updated for 2014.

    PubMed

    Waggoner, William F

    2015-01-01

    The purpose of this paper was to review the current literature associated with the techniques and materials for the restoration of primary anterior teeth and make clinical recommendations based upon the available literature. A variety of esthetic restorative materials are available to utilize for restoring primary incisors. Awareness of the specific strengths, weakness, and properties of each material can enhance the clinician's ability to make the best choice of selection for each individual situation. Intracoronal restorations of primary teeth may utilize resin composites, glass ionomer cements, resin-modified ionomers, or polyacid-modified resins. Full coronal restoration of primary incisors may be indicated for a number of reasons. Crowns available for restoration of primary incisors include those that are directly bonded onto the tooth, which generally are a resin material, and crowns that are luted onto the tooth and are either some type of stainless steel or zirconia crown. There is insufficient controlled, clinical data to suggest that one type of restoration is superior to another. Operator preferences, esthetic demands by parents, the child's behavior, the amount of tooth structure remaining, and moisture and hemorrhage control are all variables that affect the decision and ultimate outcome of whatever restorative solution is chosen.

  20. Modifying soul food for the Dietary Approaches to Stop Hypertension diet (DASH) plan: implications for metabolic syndrome (DASH of Soul).

    PubMed

    Rankins, Jenice; Wortham, Jaleena; Brown, Linda L

    2007-01-01

    This article presents results of a community-based participatory study (DASH of Soul) designed to produce soul food that meets the nutrient criteria of the DASH diet plan. DASH of Soul was tested during a 10-month period with two sub-groups of low-income African American women: (1) a focus group cooking club recruited from among "early adopters" of a previous intervention; and (2) a broader peer group dinner club recruited through a health center serving the neighborhood of the focus group. Methods for the cooking club included 10 filmed cooking labs to: (a) modify traditional soul food (MSF) to reduce food energy, total fat, saturated fat, sugar, and sodium; (b) evaluate and improve upon sensory acceptability; (c) integrate acceptable MSF into the DASH diet plan (MS-DASH); (d) produce VHS- and DVD-formatted MS-DASH cooking shows. Methods for the dinner club included monthly participation in weekly promotional dinner meetings that featured the cooking show and a different DASH food group each month for 8 months. Based on computer software analysis, the nutrient composition of a sample MS-DASH menu developed by the cooking club was consistent with nutrient levels for the DASH diet plan. The authors concluded from the focus group interviews and intercept surveys that, with continued motivation, the potential is good for the study population to make MS-DASH a lifestyle choice, reducing their risks for diet-related diseases that cluster to comprise metabolic syndrome.

  1. Esthetic Restoration of Multiple Congenitally Missing Anterior Teeth with Oral Implants: A Clinical Case Report.

    PubMed

    Wang, Jiawei; Teng, Fangjun; He, Hong; Ding, Huifen; Li, Yong

    Having multiple congenitally missing anterior teeth heavily influences the patient's countenance and pronunciation. There are few reports on the esthetic restoration of such situations with oral implants. This clinical case history report presents a multidisciplinary approach to treat a young woman with multiple congenitally missing anterior teeth using implant-supported prostheses. The treatment steps and clinical implications are discussed.

  2. A Novel Approach to Decrease Sialic Acid Expression in Cells by a C-3-modified N-Acetylmannosamine*

    PubMed Central

    Wratil, Paul R.; Rigol, Stephan; Solecka, Barbara; Kohla, Guido; Kannicht, Christoph; Reutter, Werner; Giannis, Athanassios; Nguyen, Long D.

    2014-01-01

    Due to its position at the outermost of glycans, sialic acid is involved in a myriad of physiological and pathophysiological cell functions such as host-pathogen interactions, immune regulation, and tumor evasion. Inhibitors of cell surface sialylation could be a useful tool in cancer, immune, antibiotic, or antiviral therapy. In this work, four different C-3 modified N-acetylmannosamine analogs were tested as potential inhibitors of cell surface sialylation. Peracetylated 2-acetylamino-2-deoxy-3-O-methyl-d-mannose decreases cell surface sialylation in Jurkat cells in a dose-dependent manner up to 80%, quantified by flow cytometry and enzyme-linked lectin assays. High-performance liquid chromatography experiments revealed that not only the concentration of membrane bound but also of cytosolic sialic acid is reduced in treated cells. We have strong evidence that the observed reduction of sialic acid expression in cells is caused by the inhibition of the bifunctional enzyme UDP-GlcNAc-2-epimerase/ManNAc kinase. 2-Acetylamino-2-deoxy-3-O-methyl-d-mannose inhibits the human ManNAc kinase domain of the UDP-GlcNAc-2-epimerase/ManNAc kinase. Binding kinetics of the inhibitor and human N-acetylmannosamine kinase were evaluated using surface plasmon resonance. Specificity studies with human N-acetylglucosamine kinase and hexokinase IV indicated a high specificity of 2-acetylamino-2-deoxy-3-O-methyl-d-mannose for MNK. This substance represents a novel class of inhibitors of sialic acid expression in cells, targeting the key enzyme of sialic acid de novo biosynthesis. PMID:25278018

  3. Low-energy anterior hip dislocation in a dancer.

    PubMed

    Stein, Drew A; Polatsch, Daniel B; Gidumal, Ramesh; Rose, Donald J

    2002-10-01

    In this article, we report the case of a healthy young woman who sustained an anterior hip dislocation while participating in a noncontact activity (ballet dancing). The patient's atraumatic dislocation failed closed reduction secondary to interposition of anterior capsule and rectus femoris muscle. Open reduction using a Smith-Petersen approach was concentric and stable. Postinjury femoral nerve neuropraxia resolved within 6 weeks. At 2-year follow-up, the patient was without complications of the injury-including avascular necrosis and posttraumatic arthritis. She returned to dancing and is now asymptomatic.

  4. Is antibiotic prophylaxis in nasal packing for anterior epistaxis needed?

    PubMed

    Pérez, Francisco; Rada, Gabriel

    2016-01-07

    Epistaxis is an extremely common problem that sometimes requires anterior nasal packing. Antibiotics are frequently indicated to prevent infectious complications, although the role of this measure is controversial. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified one systematic review including three primary studies, none of them randomized. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded it is not clear whether prophylactic antibiotics reduce infectious complications in patients with nasal packing for anterior epistaxis because the certainty of the evidence is very low.

  5. Anterior visceral endoderm SMAD4 signaling specifies anterior embryonic patterning and head induction in mice.

    PubMed

    Li, Cuiling; Li, Yi-Ping; Fu, Xin-Yuan; Deng, Chu-Xia

    2010-09-27

    SMAD4 serves as a common mediator for signaling of TGF-β superfamily. Previous studies illustrated that SMAD4-null mice die at embryonic day 6.5 (E6.5) due to failure of mesoderm induction and extraembryonic defects; however, functions of SMAD4 in each germ layer remain elusive. To investigate this, we disrupted SMAD4 in the visceral endoderm and epiblast, respectively, using a Cre-loxP mediated approach. We showed that mutant embryos lack of SMAD4 in the visceral endoderm (Smad4(Co/Co);TTR-Cre) died at E7.5-E9.5 without head-fold and anterior embryonic structures. We demonstrated that TGF-β regulates expression of several genes, such as Hex1, Cer1, and Lim1, in the anterior visceral endoderm (AVE), and the failure of anterior embryonic development in Smad4(Co/Co);TTR-Cre embryos is accompanied by diminished expression of these genes. Consistent with this finding, SMAD4-deficient embryoid bodies showed impaired responsiveness to TGF-β-induced gene expression and morphological changes. On the other hand, embryos carrying Cre-loxP mediated disruption of SMAD4 in the epiblasts exhibited relatively normal mesoderm and head-fold induction although they all displayed profound patterning defects in the later stages of gastrulation. Cumulatively, our data indicate that SMAD4 signaling in the epiblasts is dispensable for mesoderm induction although it remains critical for head patterning, which is significantly different from SMAD4 signaling in the AVE, where it specifies anterior embryonic patterning and head induction.

  6. evaluation of the bioconversion of genetically modified switchgrass using simultaneous saccharification and fermentation ans a consolidated bioprocessing approach

    SciTech Connect

    Yee, Kelsey L; Rodriguez, Jr., Miguel; Tschaplinski, Timothy J; Engle, Nancy L; Martin, Madhavi Z; Fu, Chunxiang; Wang, Zeng-Yu; Hamilton-Brehm, Scott; Mielenz, Jonathan R

    2012-01-01

    Abstract Background: The inherent recalcitrance of lignocellulosic biomass is one of the major economic hurdles for the production of fuels and chemicals from biomass. Additionally, lignin is recognized as having a negative impact on enzymatic hydrolysis of biomass, and as a result much interest has been placed on modifying the lignin pathway to improve bioconversion of lignocellulosic feedstocks. Results: Previous results showed down-regulation of the caffeic acid 3-O-methyl transferase (COMT) gene in the lignin pathway yielded switchgrass (Panicum virgatum) that was more susceptible to bioconversion after dilute acid pretreatment. Here we examined the response of these plant lines to milder pretreatment conditions with yeast-based SSF, CBP with Clostridium thermocellum, and fermentations with the cellulolytic extreme thermophiles, Caldicellulosiruptor bescii and Caldicellulosiruptor obsidiansis. Unlike the S. cerevisiae SSF conversions, fermentations of pretreated down-regulated COMT transgenic switchgrass with C. thermocellum showed an apparent inhibition of fermentation not observed in the wild-type switchgrass. This inhibition can be eliminated by hot water extraction of the pretreated biomass which resulted in superior conversion yield with transgenic versus wild-type switchgrass for C. thermocellum, also exceeding the yeast-based SSF yield. Further fermentation evaluation of the transgenic switchgrass indicated differential inhibition for the Caldicellulosiruptor strains, which could not be rectified by additional processing conditions. Gas chromatography-mass spectrometry metabolite profiling was used to examine the fermentation broth to elucidate the relative abundance of lignin derived aromatic compounds. The types and abundance of fermentation-derived lignin constituents varied between C. thermocellum and each of the Caldicellulosiruptor strains. Conclusions: The down-regulation of the COMT gene improves the bioconversion of switchgrass relative to the

  7. 38 CFR 3.379 - Anterior poliomyelitis.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  8. Extradural anterior clinoidectomy. Technical note.

    PubMed

    Noguchi, Akio; Balasingam, Vijayabalan; Shiokawa, Yoshiaki; McMenomey, Sean O; Delashaw, Johnny B

    2005-05-01

    The anterior clinoid process (ACP), located on the skull base, is a relatively small structure, although its removal provides enormous gain in facilitating the management of lesions--either tumors or aneurysms--in the paraclinoid region and upper basilar artery. The extensive surgical field gained contributes to safer exposure of the neurovascular elements in the vicinity while avoiding excessive and hazardous retraction of the brain. In this report the authors present a technically simpler avenue for performing an extradural anterior clinoidectomy after reviewing the anatomy of the ACP and its anatomical variations. Additionally, the original Dolenc procedure and its subseqtient derivatives are compared and contrasted to the authors' simpler and less laborious technique. Different clinical situations in which to use the procedure are described based on the authors' experience from 60 cases (40 aneurysm cases and 20 tumor cases) during a 4-year period.

  9. A Personalized Approach in Progressive Multiple Sclerosis: The Current Status of Disease Modifying Therapies (DMTs) and Future Perspectives.

    PubMed

    D'Amico, Emanuele; Patti, Francesco; Zanghì, Aurora; Zappia, Mario

    2016-10-17

    Using the term of progressive multiple sclerosis (PMS), we considered a combined population of persons with secondary progressive MS (SPMS) and primary progressive MS (PPMS). These forms of MS cannot be challenged with efficacy by the licensed therapy. In the last years, several measures of risk estimation were developed for predicting clinical course in MS, but none is specific for the PMS forms. Personalized medicine is a therapeutic approach, based on identifying what might be the best therapy for an individual patient, taking into account the risk profile. We need to achieve more accurate estimates of useful predictors in PMS, including unconventional and qualitative markers which are not yet currently available or practicable routine diagnostics. The evaluation of an individual patient is based on the profile of disease activity.Within the neurology field, PMS is one of the fastest-moving going into the future.

  10. A Personalized Approach in Progressive Multiple Sclerosis: The Current Status of Disease Modifying Therapies (DMTs) and Future Perspectives

    PubMed Central

    D’Amico, Emanuele; Patti, Francesco; Zanghì, Aurora; Zappia, Mario

    2016-01-01

    Using the term of progressive multiple sclerosis (PMS), we considered a combined population of persons with secondary progressive MS (SPMS) and primary progressive MS (PPMS). These forms of MS cannot be challenged with efficacy by the licensed therapy. In the last years, several measures of risk estimation were developed for predicting clinical course in MS, but none is specific for the PMS forms. Personalized medicine is a therapeutic approach, based on identifying what might be the best therapy for an individual patient, taking into account the risk profile. We need to achieve more accurate estimates of useful predictors in PMS, including unconventional and qualitative markers which are not yet currently available or practicable routine diagnostics. The evaluation of an individual patient is based on the profile of disease activity.Within the neurology field, PMS is one of the fastest-moving going into the future. PMID:27763513

  11. Fault diagnosis of nonlinear and large-scale processes using novel modified kernel Fisher discriminant analysis approach

    NASA Astrophysics Data System (ADS)

    Shi, Huaitao; Liu, Jianchang; Wu, Yuhou; Zhang, Ke; Zhang, Lixiu; Xue, Peng

    2016-04-01

    It is pretty significant for fault diagnosis timely and accurately to improve the dependability of industrial processes. In this study, fault diagnosis of nonlinear and large-scale processes by variable-weighted kernel Fisher discriminant analysis (KFDA) based on improved biogeography-based optimisation (IBBO) is proposed, referred to as IBBO-KFDA, where IBBO is used to determine the parameters of variable-weighted KFDA, and variable-weighted KFDA is used to solve the multi-classification overlapping problem. The main contributions of this work are four-fold to further improve the performance of KFDA for fault diagnosis. First, a nonlinear fault diagnosis approach with variable-weighted KFDA is developed for maximising separation between the overlapping fault samples. Second, kernel parameters and features selection of variable-weighted KFDA are simultaneously optimised using IBBO. Finally, a single fitness function that combines erroneous diagnosis rate with feature cost is created, a novel mixed kernel function is introduced to improve the classification capability in the feature space and diagnosis accuracy of the IBBO-KFDA, and serves as the target function in the optimisation problem. Moreover, an IBBO approach is developed to obtain the better quality of solution and faster convergence speed. On the one hand, the proposed IBBO-KFDA method is first used on Tennessee Eastman process benchmark data sets to validate the feasibility and efficiency. On the other hand, IBBO-KFDA is applied to diagnose faults of automation gauge control system. Simulation results demonstrate that IBBO-KFDA can obtain better kernel parameters and feature vectors with a lower computing cost, higher diagnosis accuracy and a better real-time capacity.

  12. De Novo proteome analysis of genetically modified tumor cells by a metabolic labeling/azide-alkyne cycloaddition approach.

    PubMed

    Ballikaya, Seda; Lee, Jennifer; Warnken, Uwe; Schnölzer, Martina; Gebert, Johannes; Kopitz, Jürgen

    2014-12-01

    Activin receptor type II (ACVR2) is a member of the transforming growth factor type II receptor family and controls cell growth and differentiation, thereby acting as a tumor suppressor. ACVR2 inactivation is known to drive colorectal tumorigenesis. We used an ACVR2-deficient microsatellite unstable colon cancer cell line (HCT116) to set up a novel experimental design for comprehensive analysis of proteomic changes associated with such functional loss of a tumor suppressor. To this end we combined two existing technologies. First, the ACVR2 gene was reconstituted in an ACVR2-deficient colorectal cancer (CRC) cell line by means of recombinase-mediated cassette exchange, resulting in the generation of an inducible expression system that allowed the regulation of ACVR2 gene expression in a doxycycline-dependent manner. Functional expression in the induced cells was explicitly proven. Second, we used the methionine analog azidohomoalanine for metabolic labeling of newly synthesized proteins in our cell line model. Labeled proteins were tagged with biotin via a Click-iT chemistry approach enabling specific extraction of labeled proteins by streptavidin-coated beads. Tryptic on-bead digestion of captured proteins and subsequent ultra-high-performance LC coupled to LTQ Orbitrap XL mass spectrometry identified 513 proteins, with 25 of them differentially expressed between ACVR2-deficient and -proficient cells. Among these, several candidates that had already been linked to colorectal cancer or were known to play a key role in cell growth or apoptosis control were identified, proving the utility of the presented experimental approach. In principle, this strategy can be adapted to analyze any gene of interest and its effect on the cellular de novo proteome.

  13. SAAFEC: Predicting the Effect of Single Point Mutations on Protein Folding Free Energy Using a Knowledge-Modified MM/PBSA Approach

    PubMed Central

    Getov, Ivan; Petukh, Marharyta; Alexov, Emil

    2016-01-01

    Folding free energy is an important biophysical characteristic of proteins that reflects the overall stability of the 3D structure of macromolecules. Changes in the amino acid sequence, naturally occurring or made in vitro, may affect the stability of the corresponding protein and thus could be associated with disease. Several approaches that predict the changes of the folding free energy caused by mutations have been proposed, but there is no method that is clearly superior to the others. The optimal goal is not only to accurately predict the folding free energy changes, but also to characterize the structural changes induced by mutations and the physical nature of the predicted folding free energy changes. Here we report a new method to predict the Single Amino Acid Folding free Energy Changes (SAAFEC) based on a knowledge-modified Molecular Mechanics Poisson-Boltzmann (MM/PBSA) approach. The method is comprised of two main components: a MM/PBSA component and a set of knowledge based terms delivered from a statistical study of the biophysical characteristics of proteins. The predictor utilizes a multiple linear regression model with weighted coefficients of various terms optimized against a set of experimental data. The aforementioned approach yields a correlation coefficient of 0.65 when benchmarked against 983 cases from 42 proteins in the ProTherm database. Availability: the webserver can be accessed via http://compbio.clemson.edu/SAAFEC/. PMID:27070572

  14. A new approach to gene therapy using Sleeping Beauty to genetically modify clinical-grade T cells to target CD19.

    PubMed

    Singh, Harjeet; Huls, Helen; Kebriaei, Partow; Cooper, Laurence J N

    2014-01-01

    The advent of efficient approaches to the genetic modification of T cells has provided investigators with clinically appealing methods to improve the potency of tumor-specific clinical grade T cells. For example, gene therapy has been successfully used to enforce expression of chimeric antigen receptors (CARs) that provide T cells with ability to directly recognize tumor-associated antigens without the need for presentation by human leukocyte antigen. Gene transfer of CARs can be undertaken using viral-based and non-viral approaches. We have advanced DNA vectors derived from the Sleeping Beauty (SB) system to avoid the expense and manufacturing difficulty associated with transducing T cells with recombinant viral vectors. After electroporation, the transposon/transposase improves the efficiency of integration of plasmids used to express CAR and other transgenes in T cells. The SB system combined with artificial antigen-presenting cells (aAPC) can selectively propagate and thus retrieve CAR(+) T cells suitable for human application. This review describes the translation of the SB system and aAPC for use in clinical trials and highlights how a nimble and cost-effective approach to developing genetically modified T cells can be used to implement clinical trials infusing next-generation T cells with improved therapeutic potential.

  15. Approaching over 10 000-fold sensitivity increase in chiral capillary electrophoresis: Cation-selective exhaustive injection and sweeping cyclodextrin-modified micellar electrokinetic chromatography.

    PubMed

    Mikuma, Toshiyasu; Iwata, Yuko T; Miyaguchi, Hajime; Kuwayama, Kenji; Tsujikawa, Kenji; Kanamori, Tatsuyuki; Kanazawa, Hideko; Inoue, Hiroyuki

    2016-11-01

    A novel and simple method that combines an online concentration technique with an enantioseparation technique for capillary electrophoresis-namely, cation-selective exhaustive injection and sweeping cyclodextrin-modified micellar electrokinetic chromatography (CSEI-sweeping CD-modified MEKC)-realizes the effective enantioseparation of cationic analytes while keeping a significant increase of detection sensitivity. This technique consists of a slight modification of the basic CSEI-sweeping MEKC. The main idea is to simply add an anionic CD as a chiral selector into the micellar buffer including sodium dodecyl sulfate, but not to change any other buffers in order to preserve the online concentration mechanism. When applied to analysis of the street drug, methamphetamine, the method achieved not only a baseline enantioseparation but also limits of detection (LODs; S/N = 3) of 70-90 pg/mL (ppt) for each isomer. This translates to a more than 10 000-fold improvement compared to the LODs by the usual injection method. The present technique, which was made from a slight modification of CSEI-sweeping MEKC, would give an attractive approach that is applicable to almost any analytes for which CSEI-sweeping MEKC is applicable; all that is required is the selection of an appropriate anionic CD to be added to the micellar buffer.

  16. Robotic Anterior and Midline Skull Base Surgery: Preclinical Investigations

    SciTech Connect

    O'Malley, Bert W. Weinstein, Gregory S.

    2007-10-01

    Purpose: To develop a minimally invasive surgical technique to access the midline and anterior skull base using the optical and technical advantages of robotic surgical instrumentation. Methods and Materials: Ten experimental procedures focusing on approaches to the nasopharynx, clivus, sphenoid, pituitary sella, and suprasellar regions were performed on one cadaver and one live mongrel dog. Both the cadaver and canine procedures were performed in an approved training facility using the da Vinci Surgical Robot. For the canine experiments, a transoral robotic surgery (TORS) approach was used, and for the cadaver a newly developed combined cervical-transoral robotic surgery (C-TORS) approach was investigated and compared with standard TORS. The ability to access and dissect tissues within the various areas of the midline and anterior skull base were evaluated, and techniques to enhance visualization and instrumentation were developed. Results: Standard TORS approaches did not provide adequate access to the midline and anterior skull base; however, the newly developed C-TORS approach was successful in providing the surgical access to these regions of the skull base. Conclusion: Robotic surgery is an exciting minimally invasive approach to the skull base that warrants continued preclinical investigation and development.

  17. Demetalization of oils resulting from recycled tires by liquid-liquid extraction using modified superheated water An environmentally friendly approach.

    PubMed

    Morales-Muñoz, S; Luque-García, J L; Luque de Castro, M D

    2004-05-28

    An approach based on continuous pressurized liquid-liquid extraction with 20% HNO(3)/1M KCl/10(-3)M EDTA as extractant has been developed for the extraction of metals from the oil resulting from recycled tires. A multivariate optimization of the main variables affecting the extraction process has been performed. The method has been applied to three oil samples with different contents in V, Ni, Zn, Fe and Cu. The target metals have been determined in both untreated and treated oil by flame atomic absorption spectrometry (FAAS) in order to obtain the extraction efficiency. Under the optimum conditions, recoveries higher than 90% have been obtained with a repeatability and within-laboratory reproducibility, expressed as relative standard deviations, ranging from 2.75 to 6.91 and 2.97 to 8.16%, respectively. For applications where the demetalization does not require being complete, a study of the demetalization degree achieved depending on the extraction temperature and extractant composition has also been performed. This study provides useful data about the cheapest working conditions to be used in order to obtain a given demetalization level.

  18. A New Approach to Modify Plant Microbiomes and Traits by Introducing Beneficial Bacteria at Flowering into Progeny Seeds

    PubMed Central

    Mitter, Birgit; Pfaffenbichler, Nikolaus; Flavell, Richard; Compant, Stéphane; Antonielli, Livio; Petric, Alexandra; Berninger, Teresa; Naveed, Muhammad; Sheibani-Tezerji, Raheleh; von Maltzahn, Geoffrey; Sessitsch, Angela

    2017-01-01

    The microbial component of healthy seeds – the seed microbiome – appears to be inherited between plant generations and can dynamically influence germination, plant performance, and survival. As such, methods to optimize the seed microbiomes of major crops could have far-reaching implications for plant breeding and crop improvement to enhance agricultural food, feed, and fiber production. Here, we describe a new approach to modulate seed microbiomes of elite crop seed embryos and concomitantly design the traits to be mediated by seed microbiomes. Specifically, we discovered that by introducing the endophyte Paraburkholderia phytofirmans PsJN to the flowers of parent plants we could drive its inclusion in progeny seed microbiomes, thereby inducing vertical inheritance to the offspring generation. We demonstrated the introduction of PsJN to seeds of monocot and dicot plant species and the consequential modifications to seed microbiome composition and growth traits in wheat, illustrating the potential role of novel seed-based microbiomes in determining plant traits. PMID:28167932

  19. Foreign Body Embedded in Anterior Chamber Angle

    PubMed Central

    Graffi, Shmuel; Tiosano, Beatrice; Ben Cnaan, Ran; Bahir, Jonathan; Naftali, Modi

    2012-01-01

    Introduction. We present a case of a metallic foreign body embedded in the anterior chamber angle. After standing in close proximity to a construction worker breaking a tile, a 26-year-old woman using soft contact lens for the correction of mild myopia presented to emergency department for evaluation of a foreign body sensation of her right eye. Methods and Results. Diagnosis was confirmed by gonioscopic examination and a noncontrast CT scan of head and orbits. The foreign body was removed by an external approach without utilizing a magnet. The patient's final outcome was favorable. Discussion. The above is a rare clinical situation, which is impossible to detect on slit-lamp examination without a gonioscopic view. Proper imaging and a specific management are mandatory in order to achieve favorable outcome. PMID:23091762

  20. Foreign body embedded in anterior chamber angle.

    PubMed

    Graffi, Shmuel; Tiosano, Beatrice; Ben Cnaan, Ran; Bahir, Jonathan; Naftali, Modi

    2012-01-01

    Introduction. We present a case of a metallic foreign body embedded in the anterior chamber angle. After standing in close proximity to a construction worker breaking a tile, a 26-year-old woman using soft contact lens for the correction of mild myopia presented to emergency department for evaluation of a foreign body sensation of her right eye. Methods and Results. Diagnosis was confirmed by gonioscopic examination and a noncontrast CT scan of head and orbits. The foreign body was removed by an external approach without utilizing a magnet. The patient's final outcome was favorable. Discussion. The above is a rare clinical situation, which is impossible to detect on slit-lamp examination without a gonioscopic view. Proper imaging and a specific management are mandatory in order to achieve favorable outcome.

  1. Anterior Skull Base Glomangioma-Induced Osteomalacia

    PubMed Central

    Gresham, Malia S.; Shen, Steven; Zhang, Yi J.; Gallagher, Kelly

    2017-01-01

    Oncogenic osteomalacia (OO) is an uncommon but treatable cause of osteomalacia related to tumor production of FGF23, usually caused by benign mesenchymal neoplasms. Paranasal sinus glomangiomas are a rare cause of OO, with only one previously reported case. Here we describe a second case (first reported in English) of paranasal sinus glomangioma-induced osteomalacia in a 42-year-old man. He presented with weakness and multiple spontaneous fractures, and was found to have an ethmoid sinus glomangioma with intracranial extension. The tumor was removed via endoscopic endonasal approach to the anterior skull base, which resulted in complete resolution of symptoms and no further evidence of disease 1 year postoperatively. PMID:28180054

  2. Anterior Cruciate Ligament Injuries in Growing Skeleton

    PubMed Central

    AlHarby, Saleh W.

    2010-01-01

    Anterior cruciate ligament (ACL) injuries in the adult patients are thoroughly studied and published in orthopedic literature. Until recently, little was known about similar injuries in skeletally growing patients. The more frequent involvement of this age group in various athletic activities and the improved diagnostic modalities have increased the awareness and interest of ACL injuries in skeletally immature patients. ACL reconstruction in growing skeleton is controversial and carries some risks to the tibial and femoral growth plate. A guarded approach to ACL reconstruction is recommended in skeletally immature patients. Modification of activity of ACL injured young patient, proper rehabilitation and prudent planning of adolescent age ACL reconstruction carries the least risks of growth plate violation. PMID:21475528

  3. The effect of anterior proton beams in the setting of a prostate-rectum spacer.

    PubMed

    Christodouleas, John P; Tang, Shikui; Susil, Robert C; McNutt, Todd R; Song, Danny Y; Bekelman, Justin; Deville, Curtiland; Vapiwala, Neha; Deweese, Theodore L; Lu, Hsiao-Ming; Both, Stefan

    2013-01-01

    Studies suggest that anterior beams with in vivo range verification would improve rectal dosimetry in proton therapy for prostate cancer. We investigated whether prostate-rectum spacers would enhance or diminish the benefits of anterior proton beams in these treatments. Twenty milliliters of hydrogel was injected between the prostate and rectum of a cadaver using a transperineal approach. Computed tomography (CT) and magnetic resonance (MR) images were used to generate 7 uniform scanning (US) and 7 single-field uniform dose pencil-beam scanning (PBS) plans with different beam arrangements. Pearson correlations were calculated between rectal, bladder, and femoral head dosimetric outcomes and beam arrangement anterior scores, which characterize the degree to which dose is delivered anteriorly. The overall quality of each plan was compared using a virtual dose-escalation study. For US plans, rectal mean dose was inversely correlated with anterior score, but for PBS plans there was no association between rectal mean dose and anterior score. For both US and PBS plans, full bladder and empty bladder mean doses were correlated with anterior scores. For both US and PBS plans, femoral head mean doses were inversely correlated with anterior score. For US plans and a full bladder, 4 beam arrangements that included an anterior beam tied for the highest maximum prescription dose (MPD). For US plans and an empty bladder, the arrangement with 1 anterior and 2 anterior oblique beams achieved the highest MPD in the virtual dose-escalation study. The dose-escalation study did not differentiate beam arrangements for PBS. All arrangements in the dose-escalation study were limited by bladder constraints except for the arrangement with 2 posterior oblique beams. The benefits of anterior proton beams in the setting of prostate-rectum spacers appear to be proton modality dependent and may not extend to PBS.

  4. The effect of anterior proton beams in the setting of a prostate-rectum spacer

    SciTech Connect

    Christodouleas, John P.; Tang, Shikui; Susil, Robert C.; McNutt, Todd R.; Song, Danny Y.; Bekelman, Justin; Deville, Curtiland; Vapiwala, Neha; DeWeese, Theodore L.; Lu, Hsiao-Ming; Both, Stefan

    2013-10-01

    Studies suggest that anterior beams with in vivo range verification would improve rectal dosimetry in proton therapy for prostate cancer. We investigated whether prostate-rectum spacers would enhance or diminish the benefits of anterior proton beams in these treatments. Twenty milliliters of hydrogel was injected between the prostate and rectum of a cadaver using a transperineal approach. Computed tomography (CT) and magnetic resonance (MR) images were used to generate 7 uniform scanning (US) and 7 single-field uniform dose pencil-beam scanning (PBS) plans with different beam arrangements. Pearson correlations were calculated between rectal, bladder, and femoral head dosimetric outcomes and beam arrangement anterior scores, which characterize the degree to which dose is delivered anteriorly. The overall quality of each plan was compared using a virtual dose-escalation study. For US plans, rectal mean dose was inversely correlated with anterior score, but for PBS plans there was no association between rectal mean dose and anterior score. For both US and PBS plans, full bladder and empty bladder mean doses were correlated with anterior scores. For both US and PBS plans, femoral head mean doses were inversely correlated with anterior score. For US plans and a full bladder, 4 beam arrangements that included an anterior beam tied for the highest maximum prescription dose (MPD). For US plans and an empty bladder, the arrangement with 1 anterior and 2 anterior oblique beams achieved the highest MPD in the virtual dose-escalation study. The dose-escalation study did not differentiate beam arrangements for PBS. All arrangements in the dose-escalation study were limited by bladder constraints except for the arrangement with 2 posterior oblique beams. The benefits of anterior proton beams in the setting of prostate-rectum spacers appear to be proton modality dependent and may not extend to PBS.

  5. Influence of nail prominence and insertion point on anterior knee pain after tibial intramedullary nailing.

    PubMed

    Chen, Chun-Yu; Lin, Kai-Cheng; Yang, Shan-Wei; Tarng, Yih-Wen; Hsu, Chien-Jen; Renn, Jenn-Huei

    2014-03-01

    Chronic anterior knee pain is the most common complication after tibial nail insertion. Its etiology remains unknown, and multifactorial sources have been suggested. The authors believe that nail prominence and the insertion point of the nail are important in the development of anterior knee pain. The purpose of this retrospective study was to evaluate the roles of the insertion point and nail prominence in anterior knee pain after tibial intramedullary nailing using a transtendinous approach and a common nail type. A total of 108 patients with tibial shaft fractures underwent reamed intramedullary nailing using a transtendinous approach between 2006 and 2009. Mean follow-up was 26.8±5.0 months. A visual analog scale (0-100) was used to estimate anterior knee pain severity while patients performed 7 activities retrospectively. Radiographic assessments, including nail prominence and insertion point, were performed. Sixty (55.6%) patients experienced knee pain (group P) and 48 (44.4%) did not (group N). Significant differences were not found between the groups with respect to demographics, nail diameters, or fracture classifications. Less superior and more anterior nail prominences in radiographic assessments were significantly associated with anterior knee pain. When the insertion point was over the bottom half of the anterior cortex, the influence of anterior nail prominence was more obvious. Nail removal resulted in diminished pain during the 7 assessed activities. Nail insertion should be over the bottom half of the anterior cortex, with minimal anterior nail prominence. If anterior knee pain occurs, removal of the nail should be considered.

  6. Modified cyanobacteria

    SciTech Connect

    Vermaas, Willem F J.

    2014-06-17

    Disclosed is a modified photoautotrophic bacterium comprising genes of interest that are modified in terms of their expression and/or coding region sequence, wherein modification of the genes of interest increases production of a desired product in the bacterium relative to the amount of the desired product production in a photoautotrophic bacterium that is not modified with respect to the genes of interest.

  7. Multipronged approach to managing beta-glucan contaminants in the downstream process: control of raw materials and filtration with charge-modified nylon 6,6 membrane filters.

    PubMed

    Gefroh, Eva; Hewig, Art; Vedantham, Ganesh; McClure, Megan; Krivosheyeva, Alla; Lajmi, Ajay; Lu, Yuefeng

    2013-01-01

    (1→3)-β-D-Glucans (beta-glucans) have been found in raw materials used in the manufacture of recombinant therapeutics. Because of their biological activity, beta-glucans are considered process contaminants and consequently their level in the product needs to be controlled. Although beta-glucans introduced into the cell culture process can readily be removed by bind-and-elute chromatography process steps, beta-glucans can also be introduced into the purification process through raw materials containing beta-glucans as well as leachables from filters made from cellulose. This article reports a multipronged approach to managing the beta-glucan contamination in the downstream process. Raw material screening and selection can be used to effectively limit the level of beta-glucan introduced into the downstream process. Placement of a cellulosic filter upstream of the last bind-and-elute column step or effective preuse flushing can also limit the level of contaminant introduced. More importantly, this article reports the active removal of beta-glucan from the downstream process when necessary. It was discovered that the Posidyne(®) filter, a charge-modified nylon 6,6 membrane filter, was able to effectively remove beta-glucans from buffers at relatively low pH and salt concentrations. An approach of using low beta-glucan buffer components combined with filtration of the buffer with a Posidyne membrane has been successfully demonstrated at preparative scale. Additionally, the feasibility of active removal of beta-glucan from in-process product pools by Posidyne membrane filtration has also been demonstrated. Based on the data presented, a mechanism for binding is proposed, as well as a systematic approach for sizing of the Posidyne filter.

  8. Quality by Design approach in the development of a solvent-modified micellar electrokinetic chromatography method: finding the design space for the determination of amitriptyline and its impurities.

    PubMed

    Furlanetto, S; Orlandini, S; Pasquini, B; Del Bubba, M; Pinzauti, S

    2013-11-13

    A solvent-modified micellar electrokinetic chromatography method was set up for the simultaneous determination of the tricyclic antidepressant amitriptyline (AMI) and its main impurities. The method was developed following Quality by Design (QbD) principles according to ICH Guideline Q8(R2). QbD approach made it possible to find the design space (DS), where quality was assured. After a scouting phase, aimed at selecting a suitable capillary electrophoresis pseudostationary phase, risk assessment tools were employed to define the critical process parameters (CPPs) to be considered in a screening phase (applied voltage, concentration and pH of the background electrolyte, concentration of the surfactant sodium dodecyl sulphate, of the cosurfactant n-butanol and of the organic modifiers acetonitrile and urea). The effects of the seven selected CPPs on critical quality attributes (CQAs), namely resolution values between critical peak pairs and analysis time, were investigated throughout the knowledge space by means of a symmetric screening matrix. Response surface study was then carried out on four selected CPPs by applying a Doehlert Design. Monte-Carlo simulations were performed in order to estimate the probability of meeting the desired specifications on CQAs, and thus to define the DS by means of a risk of failure map. Additional points at the edges of the DS were tested in order to verify the requirements for CQAs to be fulfilled. A control strategy was implemented by defining system suitability tests. The developed method was validated following ICH Guideline Q2(R1), including robustness assessment by Plackett-Burman design, and was applied to the analysis of real samples of amitriptyline coated tablets.

  9. Mismatch repair genes Mlh1 and Mlh3 modify CAG instability in Huntington's disease mice: genome-wide and candidate approaches.

    PubMed

    Pinto, Ricardo Mouro; Dragileva, Ella; Kirby, Andrew; Lloret, Alejandro; Lopez, Edith; St Claire, Jason; Panigrahi, Gagan B; Hou, Caixia; Holloway, Kim; Gillis, Tammy; Guide, Jolene R; Cohen, Paula E; Li, Guo-Min; Pearson, Christopher E; Daly, Mark J; Wheeler, Vanessa C

    2013-10-01

    The Huntington's disease gene (HTT) CAG repeat mutation undergoes somatic expansion that correlates with pathogenesis. Modifiers of somatic expansion may therefore provide routes for therapies targeting the underlying mutation, an approach that is likely applicable to other trinucleotide repeat diseases. Huntington's disease Hdh(Q111) mice exhibit higher levels of somatic HTT CAG expansion on a C57BL/6 genetic background (B6.Hdh(Q111) ) than on a 129 background (129.Hdh(Q111) ). Linkage mapping in (B6x129).Hdh(Q111) F2 intercross animals identified a single quantitative trait locus underlying the strain-specific difference in expansion in the striatum, implicating mismatch repair (MMR) gene Mlh1 as the most likely candidate modifier. Crossing B6.Hdh(Q111) mice onto an Mlh1 null background demonstrated that Mlh1 is essential for somatic CAG expansions and that it is an enhancer of nuclear huntingtin accumulation in striatal neurons. Hdh(Q111) somatic expansion was also abolished in mice deficient in the Mlh3 gene, implicating MutLγ (MLH1-MLH3) complex as a key driver of somatic expansion. Strikingly, Mlh1 and Mlh3 genes encoding MMR effector proteins were as critical to somatic expansion as Msh2 and Msh3 genes encoding DNA mismatch recognition complex MutSβ (MSH2-MSH3). The Mlh1 locus is highly polymorphic between B6 and 129 strains. While we were unable to detect any difference in base-base mismatch or short slipped-repeat repair activity between B6 and 129 MLH1 variants, repair efficiency was MLH1 dose-dependent. MLH1 mRNA and protein levels were significantly decreased in 129 mice compared to B6 mice, consistent with a dose-sensitive MLH1-dependent DNA repair mechanism underlying the somatic expansion difference between these strains. Together, these data identify Mlh1 and Mlh3 as novel critical genetic modifiers of HTT CAG instability, point to Mlh1 genetic variation as the likely source of the instability difference in B6 and 129 strains and suggest that MLH1

  10. Mismatch Repair Genes Mlh1 and Mlh3 Modify CAG Instability in Huntington's Disease Mice: Genome-Wide and Candidate Approaches

    PubMed Central

    Pinto, Ricardo Mouro; Dragileva, Ella; Kirby, Andrew; Lloret, Alejandro; Lopez, Edith; St. Claire, Jason; Panigrahi, Gagan B.; Hou, Caixia; Holloway, Kim; Gillis, Tammy; Guide, Jolene R.; Cohen, Paula E.; Li, Guo-Min; Pearson, Christopher E.; Daly, Mark J.; Wheeler, Vanessa C.

    2013-01-01

    The Huntington's disease gene (HTT) CAG repeat mutation undergoes somatic expansion that correlates with pathogenesis. Modifiers of somatic expansion may therefore provide routes for therapies targeting the underlying mutation, an approach that is likely applicable to other trinucleotide repeat diseases. Huntington's disease HdhQ111 mice exhibit higher levels of somatic HTT CAG expansion on a C57BL/6 genetic background (B6.HdhQ111) than on a 129 background (129.HdhQ111). Linkage mapping in (B6x129).HdhQ111 F2 intercross animals identified a single quantitative trait locus underlying the strain-specific difference in expansion in the striatum, implicating mismatch repair (MMR) gene Mlh1 as the most likely candidate modifier. Crossing B6.HdhQ111 mice onto an Mlh1 null background demonstrated that Mlh1 is essential for somatic CAG expansions and that it is an enhancer of nuclear huntingtin accumulation in striatal neurons. HdhQ111 somatic expansion was also abolished in mice deficient in the Mlh3 gene, implicating MutLγ (MLH1–MLH3) complex as a key driver of somatic expansion. Strikingly, Mlh1 and Mlh3 genes encoding MMR effector proteins were as critical to somatic expansion as Msh2 and Msh3 genes encoding DNA mismatch recognition complex MutSβ (MSH2–MSH3). The Mlh1 locus is highly polymorphic between B6 and 129 strains. While we were unable to detect any difference in base-base mismatch or short slipped-repeat repair activity between B6 and 129 MLH1 variants, repair efficiency was MLH1 dose-dependent. MLH1 mRNA and protein levels were significantly decreased in 129 mice compared to B6 mice, consistent with a dose-sensitive MLH1-dependent DNA repair mechanism underlying the somatic expansion difference between these strains. Together, these data identify Mlh1 and Mlh3 as novel critical genetic modifiers of HTT CAG instability, point to Mlh1 genetic variation as the likely source of the instability difference in B6 and 129 strains and suggest that MLH1 protein

  11. Incidental Anterior Cruciate Ligament Calcification: Case Report

    PubMed Central

    Hayashi, Hisami; Fischer, Hans

    2016-01-01

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

  12. Anterior Cruciate: Methods of Physical Examination

    PubMed Central

    Grant, John; Kirby, R. Lee

    1982-01-01

    Tear of the anterior cruciate ligament is a common, serious injury. Since the long-range consequences of uncorrected anterior cruciate incompetence are better understood, and surgical and rehabilitative measures improved, early accurate diagnosis is increasingly important. Besides a careful history, diagnosis requires the use of specific physical examination methods to reproduce the symptomatic subluxation (anterior shift or internal rotation) and to assess functional performance of the knee. ImagesFig. 1Fig. 2Fig. 3 PMID:21286055

  13. Thrombosis of the Azygos Anterior Cerebral Artery

    PubMed Central

    Avelino, Marcelo Coelho; Bastos, Breno Braga; Moreira de Sousa, Rafael Soares

    2017-01-01

    The azygos anterior cerebral artery is a rare variant, characterized by the absence of the anterior communicating artery and the union of two proximal segments of the anterior cerebral artery, forming a single trunk and ascending through the interhemispheric fissure. The incidence in the population varies from 0.3 to 2%. The presence of occlusion for this vessel causes bifrontal infarcts, with potentially devastating functional consequences, hence the importance of recognizing this anatomical variation in imaging exams. PMID:28299225

  14. Intrinsic Vertebral Markers for Spinal Level Localization in Anterior Cervical Spine Surgery: A Preliminary Report

    PubMed Central

    Thakur, Anil; Jain, Mukul; Arya, Arvind; Tripathi, Chandrabhushan; Kumari, Rima; Kushwaha, Suman

    2016-01-01

    Study Design Prospective clinical study. Purpose To observe the usefulness of anterior cervical osteophytes as intrinsic markers for spinal level localization (SLL) during sub-axial cervical spinal surgery via the anterior approach. Overview of Literature Various landmarks, such as the mandibular angle, hyoid bone, thyroid cartilage, first cricoid ring, and C6 carotid tubercle, are used for gross cervical SLL; however, none are used during cervical spinal surgery via the anterior approach. We present our preliminary assessment of SLL over anterior vertebral surfaces (i.e., intrinsic markers) in 48 consecutive cases of anterior cervical spinal surgeries for the disc-osteophyte complex (DOC) in degenerative diseases and granulation or tumor tissue associated with infectious or neoplastic diseases, respectively, at an ill-equipped center. Methods This prospective study on patients undergoing anterior cervical surgery for various sub-axial cervical spinal pathologies aimed to evaluate the feasibility and accuracy of SLL via intraoperative palpation of disease-related morphological changes on anterior vertebral surfaces visible on preoperative midline sagittal T1/2-weighted magnetic resonance images. Results During a 3-year period, 48 patients (38 males,10 females; average age, 43.58 years) who underwent surgery via the anterior approach for various sub-axial cervical spinal pathologies, including degenerative disease (n= 42), tubercular infection (Pott's disease; n=3), traumatic prolapsed disc (n=2), and a metastatic lesion from thyroid carcinoma (n=1), comprised the study group. Intrinsic marker palpation yielded accurate SLL in 79% of patients (n=38). Among those with degenerative diseases (n=42), intrinsic marker palpation yielded accurate SLL in 76% of patients (n=32). Conclusions Intrinsic marker palpation is an attractive potential adjunct for SLL during cervical spinal surgeries via the anterior approach in well-selected patients at ill-equipped centers (e

  15. Unilateral ophthalmoplegia secondary to anterior clinoid process mucocele.

    PubMed

    Forer, Boaz; Hui, Ng Yuk; Sethi, Dharmbir Singh

    2010-12-01

    A 50-year-old Chinese man presented with rapidly progressive unilateral ophthalmoplegia and then an ipsilateral afferent pupil defect. CT and MRI revealed a mass centered in the anterior clinoid process causing bone destruction and showing high T1 and T2 signal intensity indicative of mucosal protein secretion. These imaging features suggested a mucocele, which may have resulted from sequestration of a clinoidal extension of the sphenoid sinus. The sphenoid sinus was opened via an image-guided endoscopic approach, and the lesion incised. There were no complications. The ophthalmoplegia and afferent pupil defect had completely resolved within 1 week of surgery. This is the eighth reported case of anterior clinoidal mucocele, a rare cause of ophthalmoplegia or optic neuropathy. Advances in endoscopic instrumentation, navigation systems, and intraoperative imaging have reduced the operative risk and made the endoscopic approach a feasible and safer alternative to open surgery for this condition.

  16. A single posterior approach for multilevel modified vertebral column resection in adults with severe rigid congenital kyphoscoliosis: a retrospective study of 13 cases.

    PubMed

    Wang, Yan; Zhang, Yonggang; Zhang, Xuesong; Huang, Peng; Xiao, Songhua; Wang, Zheng; Liu, Zhengsheng; Liu, Baowei; Lu, Ning; Mao, Keya

    2008-03-01

    We report a multilevel modified vertebral column resection (MVCR) through a single posterior approach and clinical outcomes for treatment of severe congenital rigid kyphoscoliosis in adults. Transpedicular eggshell osteotomies and vertebral column resection are two techniques for the surgical treatment of rigid severe spine deformities. The authors developed a new technique combining the two surgical methods as a MVCR, through a single posterior approach, for surgical treatment of severe congenital rigid kyphoscoliosis in adults. Thirteen adult patients with severe rigid congenital kyphoscoliosis deformity were treated by a single posterior approach using a MVCR technique. The surgery processes included a one-stage posterior transpedicular eggshell technique first, and then expanded the eggshell technique to adjacent intervertebra space through abrasive reduction of the vertebral cortices from inside out. All posterior vertebral elements were removed including the cortical vertebral bone around the neural canal. Range of resection of the vertebral column at the apex of the deformity included apical vertebra and both cephalic and/or caudal adjacent wedged vertebrae. Totally, 32 vertebrae had been removed in 13 patients, with 2.42 vertebrae being removed on average in each case. The average fusion extent was 7.69 vertebrae. Mean operation time was 266 min with average blood loss of 2,411.54 ml during operation. Patients were followed up for an average duration of 2.54 years. Deformity correction was 59% in the coronal plane (from 79.7 degrees to 32.4 degrees ) postoperatively and 33.7 degrees (57% correction) at 2 years follow-up. In the sagittal plane, correction was from preoperative 85.9 degrees to 27.5 degrees immediately after operation, and 32.0 degrees at 2 years follow-up. Postoperative pain was reduced from preoperative 1.77 to 0.54 at 2 years follow-up in visual analog scale. SRS-24 scale was from 38.2 preoperatively to 76.9 at 2 years follow

  17. Moving forward through consensus: protocol for a modified Delphi approach to determine the top research priorities in the field of orthopaedic oncology

    PubMed Central

    Evaniew, Nathan; Rendon, Juan Sebastian; McKay, Paula; Randall, R Lor; Turcotte, Robert; Vélez, Roberto; Bhandari, Mohit; Ghert, Michelle

    2016-01-01

    Introduction Orthopaedic oncology researchers face several obstacles in the design and execution of randomised controlled trials, including finite fiscal resources to support the rising costs of clinical research and insufficient patient volume at individual sites. As a result, high-quality research to guide clinical practice has lagged behind other surgical subspecialties. A focused approach is imperative to design a research programme that is economical, streamlined and addresses clinically relevant endpoints. The primary objective of this study will be to use a consensus-based approach to identify research priorities for international clinical trials in orthopaedic oncology. Methods and analysis We will conduct a 3-phase modified Delphi method consisting of 2 sequential rounds of anonymous web-based questionnaires (phases I and II), and an in-person consensus meeting (phase III). Participants will suggest research questions that they believe are of particular importance to the field (phase I), and individually rate each proposed question on 5 criteria (phase II). Research questions that meet predetermined consensus thresholds will be brought forward to the consensus meeting (phase III) for discussion by an expert panel. Following these discussions, the expert panel will be asked to assign scores for each research question, and research questions meeting predetermined criteria will be brought forward for final ranking. The expert panel will then be asked to rank the top 3 research questions, and these 3 research questions will be distributed to the initial group of participants for validation. Ethics and dissemination An ethics application is currently under review with the Hamilton Integrated Research Ethics Board in Hamilton, Ontario, Canada. The results of this initiative will be disseminated through peer-reviewed publications and conference presentations. PMID:27221129

  18. Novel Strategies for Anterior Segment Ocular Drug Delivery

    PubMed Central

    Cholkar, Kishore; Patel, Sulabh P.; Vadlapudi, Aswani Dutt

    2013-01-01

    Abstract Research advancements in pharmaceutical sciences have led to the development of new strategies in drug delivery to anterior segment. Designing a new delivery system that can efficiently target the diseased anterior ocular tissue, generate high drug levels, and maintain prolonged and effective concentrations with no or minimal side effects is the major focus of current research. Drug delivery by traditional method of administration via topical dosing is impeded by ocular static and dynamic barriers. Various products have been introduced into the market that prolong drug retention in the precorneal pocket and to improve bioavailability. However, there is a need of a delivery system that can provide controlled release to treat chronic ocular diseases with a reduced dosing frequency without causing any visual disturbances. This review provides an overview of anterior ocular barriers along with strategies to overcome these ocular barriers and deliver therapeutic agents to the affected anterior ocular tissue with a special emphasis on nanotechnology-based drug delivery approaches. PMID:23215539

  19. Anterior axial ultrasound in monitoring infants with Pavlik harness.

    PubMed

    El Ferzli, Julie; Abuamara, Saad; Eurin, Danielle; Le Dosseur, Patrick; Dacher, Jean-Nicolas

    2004-01-01

    Real-time ultrasonography has been used for diagnosis and screening of developmental dysplasia of the hip for several years. If diagnostic criteria are well established, the use of sonography in follow-up of treated infants remains extremely variable. The aims of this study were (a). to describe the normal sonographic anatomy of the infant abducted hip on an anterior axial view, and (b). to define the role of this approach in the follow-up of developmental dysplasia treated by Pavlik harness. Thirty-eight patients with Pavlik harness had anterior axial sonograms in addition to their usual clinical and sonographic follow-up. Normal anatomy was inferred from the examination of 25 clinically proven normal hips in the same population. The best criterion of a normal positioning of the femoral head appears to be the alignment of the pubic bone and the femoral metaphysis. Pavlik harness was the only treatment in 32 patients. It was directly efficient in 22, after readjustment in 10 patients. Reduction was shown by anterior sonography in all of them. In 6 children, sonography showed no reduction and subsequent treatment by closed or open reduction was carried out. Anterior axial sonogram can show reduction of a dislocated hip in children with Pavlik harness, but it does not evaluate its stability. It helps optimize the settings of the harness, and may predict a poor outcome, but it does not identify the cause of non-reducibility.

  20. Molecular phylogeny and a modified approach of character-based barcoding refining the taxonomy of New Caledonian freshwater gastropods (Caenogastropoda, Truncatelloidea, Tateidae).

    PubMed

    Zielske, Susan; Haase, Martin

    2015-08-01

    The islands of New Caledonia represent one of the world's biodiversity hotspots with many endemic species including freshwater gastropods of the family Tateidae. A phylogenetic analysis based on the mitochondrial COI and 16S rRNA and the nuclear ITS2 genes revealed two cryptic genera, Crosseana gen. n. and Novacaledonia gen. n. In order to provide character-based diagnoses we modified a DNA barcoding approach identifying strings of pairwise diagnostic characters, i.e. alignment positions, at which two genera are alternatively fixed for different nucleotides. The combination or string of all pairwise diagnostic characters was unique for each genus. Inconsistent mitochondrial and nuclear topologies suggest that Hemistomia cockerelli Haase and Bouchet, 1998 and H. fabrorum Haase and Bouchet, 1998, two morphologically well-defined species, hybridize. The age of the most recent common ancestor of the New Caledonian radiation of Tateidae was estimated at 24.6±9.5 MY. These findings are in line with the notion that New Caledonia is rather a Darwinian island that was colonized after an extended phase of submergence - in case of the tateids probably from Australia - despite being a fragment of Gondwanaland.

  1. A new kinetic-mechanistic approach to elucidate electrooxidation of doxorubicin hydrochloride in unprocessed human fluids using magnetic graphene based nanocomposite modified glassy carbon electrode.

    PubMed

    Soleymani, Jafar; Hasanzadeh, Mohammad; Shadjou, Nasrin; Khoubnasab Jafari, Maryam; Gharamaleki, Jalil Vaez; Yadollahi, Mehdi; Jouyban, Abolghasem

    2016-04-01

    A novel magnetic nanocomposite was synthesized in one step using polymerization of magnetic graph oxide grafted with chlorosulfonic acid (Fe3O4-GO-SO3H) in the presence of polystyrene. The prepared magnetic nanocomposite was characterized using transmission electron microscopy (TEM), dynamic differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), (Thermo-gravimetric/differential thermal analysis (DTA)), Fourier transform infrared (FTIR), and UV-Vis techniques. Magnetic nanocomposite was casted on the surface of the glassy carbon electrode (PS/Fe3O4-GO-SO3H/GCE) and used for the detection and determination of doxorubicin hydrochloride (DOX) in human biological fluids. The cyclic voltammograms (CVs) of the modified electrode in aqueous solution displayed a pair of well-defined, stable and irreversible reductive/oxidation redox systems. CV study indicated that the oxidation process is irreversible and adsorption controlled. In addition, CV results indicated that DOX is oxidized via two electrons and three protons which is an unusual approach for the oxidation of DOX. A sensitive and time-saving procedure was developed for the analysis of DOX in plasma, cerebrospinal fluid, and urine with detection limit of 4.9 nM, 14 nM and 4.3 nM, respectively.

  2. Developing a modified preservative efficacy testing approach as a predictive tool for the evaluation of preservative systems in liquid home care products under variable test conditions.

    PubMed

    Hoyt, Anne L; Bushman, Don; Lewis, Nathan; Faber, Robert

    2012-01-01

    How can a formulator have confidence that a preservative system will perform as expected under adverse conditions? Extreme conditions that can lead to the development of "off odors" in the product can be a serious challenge for companies providing home care products in the global market. Formulation and stability testing occur under controlled parameters that simulate limited environmental conditions and microbial challenges are typically performed with a standard inoculum level. While this is an acceptable and dependable process, it does not necessarily assess how well a preservative system can perform under extreme environmental conditions or against unusually high levels of bacterial challenges. This is especially true when formulations are diluted and stored by the end-user. By modifying microbial challenge testing of a liquid dishwashing product to include unexpected dilution schemes, increased microbial assaults, and elevated temperatures, a pattern of preservative efficacy was established. The resulting approach proved to be a useful tool when developing use directions, recommended dilution levels, the overall surfactant system, preservative type, and storage restrictions.

  3. Tongji-GRACE01: A GRACE-only static gravity field model recovered from GRACE Level-1B data using modified short arc approach

    NASA Astrophysics Data System (ADS)

    Chen, Qiujie; Shen, Yunzhong; Zhang, Xingfu; Chen, Wu; Hsu, Houze

    2015-09-01

    The modified short arc approach, where the position vector in force model are regarded as pseudo observation, is implemented in the SAtellite Gravimetry Analysis Software (SAGAS) developed by Tongji university. Based on the SAGAS platform, a static gravity field model (namely Tongji-GRACE01) complete to degree and order 160 is computed from 49 months of real GRACE Level-1B data spanning the period 2003-2007 (including the observations of K-band range-rate, reduced dynamic orbits, non-conservative accelerations and altitudes). The Tongji-GRACE01 model is compared with the recent GRACE-only models (such as GGM05S, AIUB-GRACE03S, ITG-GRACE03, ITG-GRACE2010S, and ITSG-GRACE2014S) and validated with GPS-leveling data sets in different countries. The results show that the Tongji-GRACE01 model has a considered quality as GGM05S, AIUB-GRACE03S and ITG-GRACE03. The Tongji-GRACE01 model is available at the International Centre for Global Earth Models (ICGEM) web page (http://icgem.gfz-potsdam.de/ICGEM/).

  4. Chemical improvement of chitosan-modified beads for the immobilization of Enterococcus faecium DBFIQ E36 L-arabinose isomerase through multipoint covalent attachment approach.

    PubMed

    Manzo, Ricardo M; de Sousa, Marylane; Fenoglio, Cecilia L; Gonçalves, Luciana Rocha Barro; Mammarella, Enrique J

    2015-10-01

    D-tagatose is produced from D-galactose by the enzyme L-arabinose isomerase (L-AI) in a commercially viable bioprocess. An active and stable biocatalyst was obtained by modifying chitosan gel structure through reaction with TNBS, D-fructose or DMF, among others. This led to a significant improvement in L-AI immobilization via multipoint covalent attachment approach. Synthetized derivatives were compared with commercial supports such as Eupergit(®) C250L and glyoxal-agarose. The best chitosan derivative for L-AI immobilization was achieved by reacting 4 % (w/v) D-fructose with 3 % (w/v) chitosan at 50 °C for 4 h. When compared to the free enzyme, the glutaraldehyde-activated chitosan biocatalyst showed an apparent activity of 88.4 U g (gel) (-1) with a 211-fold stabilization factor while the glyoxal-agarose biocatalyst gave an apparent activity of 161.8 U g (gel) (-1) with an 85-fold stabilization factor. Hence, chitosan derivatives were comparable to commercial resins, thus becoming a viable low-cost strategy to obtain high active L-AI insolubilized derivatives.

  5. MRI of anterior knee pain.

    PubMed

    Samim, Mohammad; Smitaman, Edward; Lawrence, David; Moukaddam, Hicham

    2014-07-01

    Anterior knee pain is the most common knee complaint. It may be due to a variety of soft tissue or osseous abnormalities. Knowledge of the radiologic appearance of the abnormalities allows more accurate diagnosis of the cause of the pain including chondral abnormalities, patellar instability and dislocation, femoral trochlear dysplasia, abnormal patellar location, bipartite patella, various tendinopathies, bursal inflammation, traction apophysitis in pediatric and adolescent patients, and miscellaneous diseases including mediopatellar plica syndrome and Hoffa's disease. Radiographs are often obtained to exclude acute osseous abnormalities, such as fractures. Magnetic resonance (MR) imaging offers superior soft tissue contrast resolution and allows for more accurate evaluation of the underlying etiology and therefore may improve treatment and possible surgical planning.

  6. Anteriorly Based Partial Thickness Sternocleidomastoid Muscle Flap Following Parotidectomy.

    PubMed

    Dalmia, Deepak; Behera, Sanjaya Kumar; Bhatia, Jas Simran Singh

    2016-03-01

    The anteriorly based partial thickness sternocleidomastoid (SCM) muscle flap is among the various methods described to correct parotidectomy defects, but its indications and limitations are not clearly demonstrated in several reports. This study was done to test the aesthetic outcome of this method, its indications and limitations. At Dr. Babasaheb Ambedkar Memorial hospital, Mumbai, 20 patients presenting with benign parotid tumors underwent parotidectomy. 16 underwent superficial parotidectomy and 3 underwent adequate parotidectomy, 1 had total parotidectomy. The anteriorly based partial thickness SCM muscle flap was used to correct the contour deformity and to prevent Frey syndrome. The aesthetic result was evaluated by assessing and scoring the overall appearance of the scar, the degree of symmetry of the reconstructed parotid region and the site of the donor muscle in comparison to their contralateral normal sides. The overall aesthetic appearance was good in 17 patients, and moderate in 3 patients. 17/20 patients had an overall deep satisfaction with the result. The residual hollowness following total parotidectomy defect and the poor quality of scars were the main reasons affecting the aesthetic outcome. Superficial parotidectomy through modified Blair's incision with immediate reconstruction with anteriorly based partial thickness SCM flap allows a satisfactory aesthetic outcome and minimal donor site morbidity. Scores of the above two parameters were accessed. Patients' satisfaction was assessed by patients questionnaire.

  7. Implementation of Open and Closed Kinetic Chain Quadriceps Strengthening Exercises after Anterior Cruciate Ligament Reconstruction.

    ERIC Educational Resources Information Center

    Ross, Michael D.; Denegar, Craig R.; Winzenried, Jay A.

    2001-01-01

    Reviews the effects of open kinetic chain (OKC) and closed kinetic chain (CKC) exercise on anterior cruciate ligament (ACL) strain and patellofemoral joint stress, suggesting a combination of the two for quadriceps strengthening after ACL reconstruction. Both OKC and CKC exercises may be modified and implemented for quadriceps strengthening after…

  8. Modifying toxicokinetics with antidotes.

    PubMed

    Baud, F J; Borron, S W; Bismuth, C

    1995-12-01

    Five approaches may be described through which antidotes can modify toxicokinetics: (1) Decreased bioavailability of the toxins; (2) Cellular redistribution of the toxin in the organism; (3) Promotion of elimination in an unchanged form; (4) Slowing of metabolic activation pathways; (5) Acceleration of metabolic deactivation pathways. However, the ability to modify toxicokinetics with a new treatment, while demonstrating an understanding of the mechanism of action, must never be construed to be, in and of itself, the goal of therapy. The ultimate evaluation of an antidote modifying toxicokinetics is strictly clinical.

  9. Establishment and characterization of dairy cow growth hormone secreting anterior pituitary cell model.

    PubMed

    Wang, Jian-Fa; Fu, Shou-Peng; Li, Su-Nan; Yang, Zhan-Qing; Xue, Wen-Jing; Li, Zhi-Qiang; Wang, Wei; Liu, Ju-Xiong

    2014-02-01

    A dairy cow anterior pituitary cell (DCAPC) model was established in vitro for the study of growth hormone (GH) synthesis and secretion in the anterior pituitary gland of the dairy cow. Pituitary glands were obtained from Holstein dairy cows' heads cut by electric saw, and the posterior pituitary glands were removed to obtain integrated anterior pituitary glands. Immunohistochemistry assay of GH in the anterior pituitary glands showed that most somatotrophs were located within the lateral wings of the anterior pituitary. Tissues of the lateral wings of the anterior pituitary were dispersed and cultured in Dulbecco's modified Eagle's medium supplemented with 10% fetal bovine serum. The DCAPCs displayed a monolayer, cobblestone, epithelial-like morphology which are the typical characteristics of the anterior pituitary cells. The DCAPCs were subcultured continuously over ten passages. GH immunoreactivity was present in DCAPCs at passage 10. The transcription of the bovine GH mRNA in DCAPCs at passage 10 was decreased to below 50% compared with the lateral wings of the anterior pituitary tissues. Thus, our DCAPCs model is effective for the in vitro examination of GH synthesis and secretion in the dairy cow anterior pituitary gland. The effects of transforming growth factor beta 1 (TGF-β1) and interferon-γ (IFN-γ) on the expression of GH mRNA in DCAPCs at passage 3 were also investigated. There were no obvious changes in transcription of the GH gene after treatment with TGF-β1 for 24 h, while IFN-γ increased transcription of the GH gene in a dose-dependent manner.

  10. Anterior cervical hypertrichosis: a sporadic case

    PubMed Central

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

    2016-01-01

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

  11. Anterior cervical hypertrichosis: a sporadic case.

    PubMed

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

    2016-03-01

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

  12. Comparison of Anterior Capsule Stability Following Implantation of Three Single Piece Acrylic Intraocular Lenses with Different Haptic Design

    PubMed Central

    Yang, Soonwon; Lim, Sung A; Na, Kyung-Sun

    2017-01-01

    Purpose To compare the anterior capsule contraction and intraocular lens (IOL) decentration among three types of IOL to determine the influence of haptic design on anterior capsule stability. Methods One hundred fifty patients were enrolled in this prospective, randomized study and 260 eyes underwent implantation of one of the following IOLs: modified L-haptic IOL (n = 74), modified C-haptic IOL (n = 97), or a plate-haptic IOL (n = 89). The area of the anterior capsule opening, IOL decentration, and capsule overlap were measured using retroillumination photospot 1 day and 2 months after cataract surgery. Results The area of capsule opening at postoperative day 1 was significantly different between the three IOLs (p < 0.01). All IOLs showed reduction of the anterior capsule opening from 1 day to 2 months after surgery, and greater reduction was shown in the modified C-haptic IOL (p < 0.001). At postoperative month 2, IOL decentration was significantly different between the IOLs and showed a positive correlation with the mean area reduction during month 2. Conclusions The degree of anterior capsule contraction and IOL decentration in modified L-haptic IOLs were less than those in modified C-haptic IOLs and comparable to those in plate-haptic IOLs. PMID:28243021

  13. Anterior capsulotomy using the CO2 laser

    NASA Astrophysics Data System (ADS)

    Barak, Adiel; Ma-Naim, Tova; Rosner, Mordechai; Eyal, Ophir; Belkin, Michael

    1998-06-01

    Continuous circular capsulorhexis (CCC) is the preferred technique for removal of the anterior capsule during cataract surgery due to this technique assuring accurate centration of the intraocular lens. During modern cataract surgery, especially with small or foldable intra ocular lenses, centration of the lens is obligatory. Radial tears at the margin of an anterior capsulotomy may be associated with the exit of at least one loop of an intraocular lens out of the capsular bag ('pea pod' effect) and its subsequent decentration. The anterior capsule is more likely to ream intact if the continuous circular capsulorhexis (CCC) technique is used. Although manual capsulorhexis is an ideal anterior capsulectomy technique for adults, many ophthalmologists are still uncomfortable with it and find it difficult to perform, especially in complicated cases such as these done behind small pupil, cataract extraction in children and pseudoexfoliation syndrome. We have developed a technique using a CO2 laser system for safe anterior capsulotomy and tested it in animal eyes.

  14. Dissection of left iliac artery during anterior lumbar interspace fusion: Report of a case.

    PubMed

    Fischer, Uwe M; Davies, Mark G; El Sayed, Hosam

    2015-04-01

    Vascular injury is an uncommon complication of spine surgery. Among the different approaches, anterior lumbar interbody fusion has increased potential for vascular injuries, since the great vessels and their branches overly the disc spaces to be operated on, and retraction of these vessels is necessary to gain adequate surgical exposure. The reported incidence for anterior lumbar interbody fusion-associated vascular injuries ranges from 0% to 18.1%, with venous laceration as the most common type. We report a case of anterior lumbar interbody fusion-associated left common iliac artery dissection leading to delayed acute limb ischemia developing in early post-operative period.

  15. Amelogenesis imperfecta and anterior open bite: Etiological, classification, clinical and management interrelationships.

    PubMed

    Alachioti, Xanthippi Sofia; Dimopoulou, Eleni; Vlasakidou, Anatoli; Athanasiou, Athanasios E

    2014-01-01

    Although amelogenesis imperfecta is not a common dental pathological condition, its etiological, classification, clinical and management aspects have been addressed extensively in the scientific literature. Of special clinical consideration is the frequent co-existence of amelogenesis imperfecta with the anterior open bite. This paper provides an updated review on amelogenesis imperfecta as well as anterior open bite, in general, and documents the association of these two separate entities, in particular. Diagnosis and treatment of amelogenesis imperfecta patients presenting also with anterior open bite require a lengthy, comprehensive and multidisciplinary approach, which should aim to successfully address all dental, occlusal, developmental, skeletal and soft tissue problems associated with these two serious clinical conditions.

  16. Pyrolysis-field ionization mass spectrometry of rhizodeposits - a new approach to identify potential effects of genetically modified plants on soil organisms.

    PubMed

    Melnitchouck, Alexei; Leinweber, Peter; Broer, Inge; Eckhardt, Kai-Uwe

    2006-01-01

    The objectives of the present study were (1) to investigate the qualitative composition of rhizodeposits leached from soils cropped with non-transgenic and genetically modified (GM) potatoes, and disclose if there were GM-specific modifications in potato rhizodeposition, and (2) to compare these results with conventional bulk parameters of microbial activity in soil. We have raised potatoes from a non-transgenic line (Solanum tuberosum L. cv. Désirée) and three GM lines, which expressed a gene for the resistance to kanamycin (DLH 9000) and a gene for T4 lysozyme (DL10 and DL12). A sandy soil placed in 340 cm3-"CombiSart" containers was used, from which the rhizodeposit was leached after a six-week growth period. The freeze-dried leachates were analyzed by pyrolysis-field ionization mass spectrometry (Py-FIMS). The Py-FI mass spectra gave detailed molecular-chemical information about the composition of leachates, indicating that the potato growth generally altered the composition of the soil solution. Moreover, a principal component analysis of the mass spectra showed differences between the leachates from the non-transgenic parent line and the GM potatoes as well as among the latter group. However, these differences in molecular composition could not be assigned to the release of T4-lysozyme into soil. Dehydrogenase activity and substrate-induced soil respiration as more common bulk parameters of soil microbial activity failed to disclose any significant effects of the various potatoes grown. The limitations of the described rhizodeposit leaching and analysis for risk assessment of GM potato cropping under field conditions are discussed critically. However, it could be concluded that the Py-FI mass spectrometric "fingerprint" can be developed as a fast, comprehensive, highly sensitive and reproducible analytical approach to discern any effects GM-crops may exert on soil ecological parameters.

  17. Smile design for the adolescent patient--interdisciplinary management of anterior tooth size discrepancies.

    PubMed

    Waldman, Alexander B

    2008-05-01

    Adolescent patients often seek orthodontic treatment to correct spacing of the maxillary anterior teeth. If the spacing is caused by a tooth size discrepancy that affects one or more anterior teeth, an interdisciplinary treatment plan involving orthodontic, restorative, and periodontal treatment is recommended to achieve a harmonious esthetic result. This article describes a clinical approach for treatment of these complex cases, focusing on the importance of tooth form, gingival esthetics, and treatment sequencing.

  18. Ameloblastoma of the anterior mandible

    PubMed Central

    Hariram; Mohammad, Shadab; Malkunje, Laxman R.; Singh, Nimisha; Das, Sugata; Mehta, Gagan

    2014-01-01

    Ameloblastoma or adamantinoma is the rarest of the three forms of tumor of the odontogenic type. They are benign, locally aggressive neoplasms arising from ameloblasts, which typically occur at the angle of the mandible, and are often associated with an un-erupted tooth and must, therefore, be differentiated from a dentigerous cyst which will be centered on the crown. When in the maxilla (less common), they are located in the premolar region, and can extend up in the maxillary sinus. Ameloblastoma is reported to constitute about 1-3% of tumors and cysts of the jaws. The tumor is by far more common in the mandible than in the maxilla and shows predilection for various parts of the mandible in different racial groups. The relative frequency of the mandible to maxilla is reported as varying from 80-20% to 99-1%. Here, we are representing a case of ameloblastoma of anterior mandible which was considered as a rare site of occurrence. PMID:25298718

  19. Anterior Cruciate Ligament Graft Choices

    PubMed Central

    Macaulay, Alec A.; Perfetti, Dean C.; Levine, William N.

    2012-01-01

    Context: Reconstruction of the anterior cruciate ligament (ACL) is a common surgical procedure; however, there is no consensus to what the best graft option is to replace the injured ACL. The main options available consist of allografts and autografts, which include patellar tendon, hamstring tendon, and quadriceps tendon autografts. Evidence Acquisition: The PubMed database was searched in August 2010 for English-language articles pertaining to ACL grafts. Results: Postoperative outcome variables were analyzed to determine similarities and differences among the different graft options. These variables include stability, strength, function, return to sports, patient satisfaction, complications, and cost. Conclusions: Both allografts and the 3 main options for autografts can provide excellent results in ACL reconstruction and lead to a high percentage of satisfied patients. However, differences exist among the graft choices. Both the similarities and the differences are important to discuss with a patient who will be undergoing ACL reconstruction so that he or she has the best information available when making a choice of graft. PMID:23016071

  20. Decompression of Posterior Ankle Impingement With Concomitant Anterior Ankle Pathology by Posterior Ankle Arthroscopy in the Supine Position.

    PubMed

    Lui, Tun Hing

    2016-10-01

    Posterior ankle endoscopy is a safe and effective approach for treatment of posterior ankle impingement. This is usually performed with the patient in prone position. The purpose of this technical note is to describe an arthroscopic approach of decompression of posterior ankle impingement with the patient in supine position. This is indicated if there is posterior ankle impingement together with other ankle pathology requiring anterior ankle arthroscopy. This approach allows treatment of both anterior ankle and posterior ankle pathology with the patient in the supine position. Concomitant anterior ankle arthroscopy can be performed with the usual orientation without the need of change of patient's position.

  1. Estrogens sensitize anterior pituitary gland to apoptosis.

    PubMed

    Pisera, D; Candolfi, M; Navarra, S; Ferraris, J; Zaldivar, V; Jaita, G; Castro, M G; Seilicovich, A

    2004-10-01

    Tissue homeostasis results from a balance between cell proliferation and cell death by apoptosis. Estradiol affects proliferation as well as apoptosis in hormone-dependent tissues. In the present study, we investigated the apoptotic response of the anterior pituitary gland to lipopolysaccharide (LPS) in cycling female rats, and the influence of estradiol in this response in ovariectomized (OVX) rats. The OVX rats were chronically estrogenized with implanted Silastic capsules containing 1 mg of 17beta-estradiol (E2). Cycling or OVX and E2-treated rats were injected with LPS (250 microg/rat ip). Apoptosis was determined by the terminal deoxynucleotidyl-mediated dUTP nick-end labeling (TUNEL) method in sections of the anterior pituitary gland and spleen. Chronic estrogenization induced apoptosis in the anterior pituitary gland. Acute endotoxemia triggered apoptosis of cells in the anterior pituitary gland of E2-treated rats but not of OVX rats. No differences were observed in the apoptotic response to LPS in spleen between OVX and E2-treated rats. The apoptotic response of the anterior pituitary to LPS was variable along the estrous cycle, being higher at proestrus than at estrus or diestrus I. Approximately 75% of the apoptotic cells were identified as lactotropes by immunofluorescence. In conclusion, our results indicate that estradiol induces apoptosis and enables the proapoptotic action of LPS in the anterior pituitary gland. Also, our study suggests that estrogens may be involved in anterior pituitary cell renewal during the estrous cycle, sensitizing lactotropes to proapoptotic stimuli.

  2. 3D spectral imaging system for anterior chamber metrology

    NASA Astrophysics Data System (ADS)

    Anderson, Trevor; Segref, Armin; Frisken, Grant; Frisken, Steven

    2015-03-01

    Accurate metrology of the anterior chamber of the eye is useful for a number of diagnostic and clinical applications. In particular, accurate corneal topography and corneal thickness data is desirable for fitting contact lenses, screening for diseases and monitoring corneal changes. Anterior OCT systems can be used to measure anterior chamber surfaces, however accurate curvature measurements for single point scanning systems are known to be very sensitive to patient movement. To overcome this problem we have developed a parallel 3D spectral metrology system that captures simultaneous A-scans on a 2D lateral grid. This approach enables estimates of the elevation and curvature of anterior and posterior corneal surfaces that are robust to sample movement. Furthermore, multiple simultaneous surface measurements greatly improve the ability to register consecutive frames and enable aggregate measurements over a finer lateral grid. A key element of our approach has been to exploit standard low cost optical components including lenslet arrays and a 2D sensor to provide a path towards low cost implementation. We demonstrate first prototypes based on 6 Mpixel sensor using a 250 μm pitch lenslet array with 300 sample beams to achieve an RMS elevation accuracy of 1μm with 95 dB sensitivity and a 7.0 mm range. Initial tests on Porcine eyes, model eyes and calibration spheres demonstrate the validity of the concept. With the next iteration of designs we expect to be able to achieve over 1000 simultaneous A-scans in excess of 75 frames per second.

  3. The anterior open bite problem (infraclusion).

    PubMed

    Champagne, M

    1995-06-01

    Anterior open bite is a major orthodontic problem that is very difficult to treat (Fig. 1). It may not be the most frequent problem but it is a major functional problem. Quite often it is very difficult to correct an anterior open bite problem and even more difficult to treat in an adult after growth. Most of the time anterior open bite is a myofunctional problem related to a bad habit like thumb or finger sucking and/or is related to a breathing and swallowing problem. How can we understand the functional open bite problem? What are the available treatment options? This article will try to answer some of these questions.

  4. Opposite effects of dihydrotestosterone and estradiol on apoptosis in the anterior pituitary gland from male rats.

    PubMed

    Magri, María Laura; Gottardo, María Florencia; Zárate, Sandra; Eijo, Guadalupe; Ferraris, Jimena; Jaita, Gabriela; Ayala, Mariela Moreno; Candolfi, Marianela; Pisera, Daniel; Seilicovich, Adriana

    2016-03-01

    Hormones locally synthesized in the anterior pituitary gland are involved in regulation of pituitary cell renewal. In the pituitary, testosterone (T) may exert its actions per se or by conversion to dihydrotestosterone (DHT) or 17β-estradiol (E2) by 5α-reductase and aromatase activity, which are expressed in this gland. Previous reports from our laboratory showed that estrogens modulate apoptosis of lactotropes and somatotropes from female rats. Now, we examined the in vitro and in vivo effects of gonadal steroids on apoptosis of anterior pituitary cells from adult male rats. T in vitro did not modify apoptosis in anterior pituitary cells from gonadectomized (GNX) male rats. DHT, a non-aromatizable androgen, exerted direct antiapoptotic action on total anterior pituitary cells and folliculo-stellate cells, but not on lactotropes, somatotropes, or gonadotropes. On the contrary, E2 exerted a rapid apoptotic effect on total cells as well as on lactotropes and somatotropes. Incubation of anterior pituitary cells with T in presence of Finasteride, an inhibitor of 5α-reductase, increased the percentage of TUNEL-positive cells. In vivo administration of DHT to GNX rats reduced apoptosis in the anterior pituitary whereas E2 exerted proapoptotic action and reduced cells in G2/M-phase of the cell cycle. In summary, our results indicate that DHT and E2 have opposite effects on apoptosis in the anterior pituitary gland suggesting that local metabolization of T to these steroids could be involved in pituitary cell turnover in males. Changes in expression and/or activity of 5α-reductase and aromatase may play a role in the development of anterior pituitary tumors.

  5. Treatment strategies for frontal sinus anterior table fractures and contour deformities.

    PubMed

    Delaney, Sean W

    2016-08-01

    Anterior table frontal sinus fractures can result in aesthetically displeasing contour deformities. Acute anterior table frontal sinus fractures that are depressed may be reduced with an open, closed, or endoscope-assisted approach. Delayed contour deformity camouflage can be achieved using bone grafts, titanium meshes, methyl methacrylate, hydroxyapatite cement, and polyether ether ketone implants. The selection of surgical approach to repair a frontal sinus contour deformity depends on the fracture severity, chronicity, complexity, patient comorbidities, and surgeon preference and experience. Advancement in endoscopic technology and expertise has created a paradigm shift toward a less invasive approach to the frontal region, with considerably less morbidity than conventional open techniques.

  6. Pupil Tracking for Real-Time Motion Corrected Anterior Segment Optical Coherence Tomography

    PubMed Central

    Carrasco-Zevallos, Oscar M.; Nankivil, Derek; Viehland, Christian; Keller, Brenton; Izatt, Joseph A.

    2016-01-01

    Volumetric acquisition with anterior segment optical coherence tomography (ASOCT) is necessary to obtain accurate representations of the tissue structure and to account for asymmetries of the anterior eye anatomy. Additionally, recent interest in imaging of anterior segment vasculature and aqueous humor flow resulted in application of OCT angiography techniques to generate en face and 3D micro-vasculature maps of the anterior segment. Unfortunately, ASOCT structural and vasculature imaging systems do not capture volumes instantaneously and are subject to motion artifacts due to involuntary eye motion that may hinder their accuracy and repeatability. Several groups have demonstrated real-time tracking for motion-compensated in vivo OCT retinal imaging, but these techniques are not applicable in the anterior segment. In this work, we demonstrate a simple and low-cost pupil tracking system integrated into a custom swept-source OCT system for real-time motion-compensated anterior segment volumetric imaging. Pupil oculography hardware coaxial with the swept-source OCT system enabled fast detection and tracking of the pupil centroid. The pupil tracking ASOCT system with a field of view of 15 x 15 mm achieved diffraction-limited imaging over a lateral tracking range of +/- 2.5 mm and was able to correct eye motion at up to 22 Hz. Pupil tracking ASOCT offers a novel real-time motion compensation approach that may facilitate accurate and reproducible anterior segment imaging. PMID:27574800

  7. Modifying Cookbook Labs.

    ERIC Educational Resources Information Center

    Clark, Robert, L.; Clough, Michael P.; Berg, Craig A.

    2000-01-01

    Modifies an extended lab activity from a cookbook approach for determining the percent mass of water in copper sulfate pentahydrate crystals to one which incorporates students' prior knowledge, engenders active mental struggling with prior knowledge and new experiences, and encourages metacognition. (Contains 12 references.) (ASK)

  8. [Management of Odontoid Fractures with Compression Screw and Anterior Transarticular Screw Fixation in Elderly Patients].

    PubMed

    Kočiš, J; Kelbl, M; Veselý, R; Kočiš, T

    2017-01-01

    PURPOSE OF THE STUDY In the management of dens axis fractures in patients older than 65 years of age the posterior approach is preferred due to osteoporosis and the risk of a failure of anterior osteosynthesis. The posterior approach, however, is associated with a higher incidence of complications. A combination of anterior transarticular fixation of C1/2 (ATS) with compression osteosynthesis of dens axis significantly increases the stability of osteosynthesis. MATERIAL AND METHODS In the period from 2009 to 2015 our hospital admitted 13 patients older than 65 years of age with a diagnosed type III dens axis fracture based on AO classification. 8 patients sustained a dens axis fracture combined with a stable atlas fracture. The cohort consisted of 13 women aged 67 to 90 years, with the mean age of 82.3 years. None of the female patients were affected neurologically. The dens axis fracture was treated by anterior approach. Once the screw was inserted in the dens axis, two more screws were added, the entrance points of those screws were medial and lateral to the odontoid screw and direction was divergently via C1/2 joints in order to reinforce stability. The patients were monitored at 6-week, 3-, 6- and 12-month follow-ups. Bone healing was confirmed by CT scan. RESULTS No complications were recorded during the surgery in any of the 13 patients. In one female patient the stabilization failed in the early postoperative period. A reoperation from anterior approach with the use of the same method was necessary. In eleven patients bone healing occurred after 6 to 12 months. In two patients pseudoarthrosis was formed with no clinical symptoms. No neurological deterioration or a patient s death was reported in the monitored period within 12 months after the treatment. DISCUSSION Where dens axis fractures in elderly patients are managed operatively, the posterior approach and transarticular fixation of C1/2 with sublaminar loop are preferred. This procedure is considered

  9. Searching for disease modifiers-PKC activation and HDAC inhibition - a dual drug approach to Alzheimer's disease that decreases Abeta production while blocking oxidative stress.

    PubMed

    Kozikowski, Alan P; Chen, Yihua; Subhasish, Tapadar; Lewin, Nancy E; Blumberg, Peter M; Zhong, Zhenyu; D'Annibale, Melissa A; Wang, Weng-Long; Shen, Yong; Langley, Brett

    2009-07-01

    amyloid processing while showing neuroprotection. These findings may offer a new approach to therapies that exhibit disease-modifying effects, as opposed to symptomatic relief, in the treatment of AD.

  10. Quality indicators for the detection and management of chronic kidney disease in primary care in Canada derived from a modified Delphi panel approach

    PubMed Central

    Tu, Karen; Bevan, Lindsay; Hunter, Katie; Rogers, Jess; Young, Jacqueline; Nesrallah, Gihad

    2017-01-01

    Background: The detection and management of chronic kidney disease lies within primary care; however, performance measures applicable in the Canadian context are lacking. We sought to develop a set of primary care quality indicators for chronic kidney disease in the Canadian setting and to assess the current state of the disease's detection and management in primary care. Methods: We used a modified Delphi panel approach, involving 20 panel members from across Canada (10 family physicians, 7 nephrologists, 1 patient, 1 primary care nurse and 1 pharmacist). Indicators identified from peer-reviewed and grey literature sources were subjected to 3 rounds of voting to develop a set of quality indicators for the detection and management of chronic kidney disease in the primary care setting. The final indicators were applied to primary care electronic medical records in the Electronic Medical Record Administrative data Linked Database (EMRALD) to assess the current state of primary care detection and management of chronic kidney disease in Ontario. Results: Seventeen indicators made up the final list, with 1 under the category Prevalence, Incidence and Mortality; 4 under Screening, Diagnosis and Risk Factors; 11 under Management; and 1 under Referral to a Specialist. In a sample of 139 993 adult patients not on dialysis, 6848 (4.9%) had stage 3 or higher chronic kidney disease, with the average age of patients being 76.1 years (standard deviation [SD] 11.0); 62.9% of patients were female. Diagnosis and screening for chronic kidney disease were poorly performed. Only 27.1% of patients with stage 3 or higher disease had their diagnosis documented in their cumulative patient profile. Albumin-creatinine ratio testing was only performed for 16.3% of patients with a low estimated glomerular filtration rate (eGFR) and for 28.5% of patients with risk factors for chronic kidney disease. Family physicians performed relatively better with the management of chronic kidney disease

  11. Anterior regeneration in the hemichordate Ptychodera flava

    PubMed Central

    Rychel, Amanda L.; Swalla, Billie J.

    2008-01-01

    Ptychodera flava is a hemichordate whose anterior structures regenerate reproducibly from posterior trunk pieces when amputated. We characterized the cellular processes of anterior regeneration with respect to programmed cell death and cell proliferation, following wound healing. We found scattered proliferating cells at day two of regeneration using a PCNA antibody. On day four, most proliferating cells were associated with the nerve tract under the epidermis, and on day six, a small proboscis derived from proliferated cells was regenerated, and a mouth had broken though the epidermis. TUNEL detected elevated levels of apoptosis in the endoderm that began furthest away from the region of wound healing, then moved anteriorly over eight days. Posterior to anterior apoptosis is likely to remove digestive endoderm for later differentiation of pharyngeal endoderm. We hypothesize that P. flava regeneration is nerve dependent and that remodeling in the gut endoderm plays an important role in regeneration. PMID:18924231

  12. Anterior Eye Imaging with Optical Coherence Tomography

    NASA Astrophysics Data System (ADS)

    Huang, David; Li, Yan; Tang, Maolong

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

  13. Anterior condylar displacement: its diagnosis and treatment.

    PubMed

    Weinberg, L A

    1975-08-01

    A deflective slide in centric relation to centric occlusion does not necessarily mean anterior condylar displacement. Its diagnosis and treatment depend on the correlation of three factors: the direction and magnitude of the mandibular slide from centric relation to centric occlusion, the change in vertical dimension of occlusion during the slide, and the position of the condyles in the fossae when the teeth are in the maximum occlusion (centric occlusion). When the change in vertical dimension almost equals to amount of slide from the deflective contact in centric relation to maximum intercuspation, very little anterior condylar displacement would be expected. Conversely, with proportionately little change in vertical dimension, more anterior condylar translation is required for a given degree of anterior slide. Examples of each type of anterior slide were related to the TMJ radiographs of the condylar position. If the direction and magnitude of the deflective occlusal contact can be correlated with the TMJ radiographs, the centric relation is "functional,'' and the clinically retruded mandibular position should be used. When this correlation does not exist, the centric relation is "dysfunctional'' and the terminal hinge position (retruded mandibular position) should not be used for restorative or corrective procedures. Examples of anterior condylar displacement were given, including deviation, with a comparison of "before'' and "after'' TMJ radiographs.

  14. Anterior Insula Volume and Guilt

    PubMed Central

    Belden, Andy C.; Barch, Deanna M.; Oakberg, Timothy J.; April, Laura M.; Harms, Michael P.; Botteron, Kelly N.; Luby, Joan L.

    2016-01-01

    IMPORTANCE This is the first study to date to examine volumetric alterations in the anterior insula (AI) as a potential biomarker for the course of childhood major depressive disorder (MDD). OBJECTIVES To examine whether children with a history of preschool-onset (PO) MDD show reduced AI volume, whether a specific symptom of PO MDD (pathological guilt) is related to AI volume reduction (given the known relationship between AI and guilt processing), and whether AI volumes predict subsequent likelihood of having an episode of MDD. DESIGN, SETTING, AND PARTICIPANTS In a prospective longitudinal study, 306 children (age range, 3.00–5.11 years) and caregivers completed DSM diagnostic assessments at 6 annual time points during 10 years as part of the Preschool Depression Study. Magnetic resonance imaging was completed on a subset of 145 school-age children (age range, 6.11–12.11 years). MAIN OUTCOMES AND MEASURES Whole-brain–adjusted AI volume measured using magnetic resonance imaging at school age and children’s diagnosis of MDD any time after their imaging. RESULTS Compared with children without a history of PO MDD, school-age children previously diagnosed as having PO MDD had smaller left and right AI volumes (Wilks Λ = 0.94, F2,124 = 3.37, P = .04, Cohen d = 0.23). However, the effect of PO MDD on reduced AI volumes was better explained by children’s experience of pathological guilt during preschool (Λ = 0.91, F2,120 = 6.17, P = .003, d = .30). When covarying for children’s lifetime history of MDD episodes, their experience of pathological guilt during preschool, as well as their sex and age at the time of imaging, schoolchildren’s right-side AI volume was a significant predictor of being diagnosed as having an MDD episode after imaging (odds ratio, 0.96; 95% CI, 0.01–0.75; P = .03). CONCLUSIONS AND RELEVANCE These results provide evidence that structural abnormalities in AI volume are related to the neurobiology of depressive disorders starting in

  15. Eye contact reveals a relationship between Neuroticism and anterior EEG asymmetry.

    PubMed

    Uusberg, Helen; Allik, Jüri; Hietanen, Jari K

    2015-07-01

    Although anterior functional brain asymmetry has been linked to individual differences in affect and motivation, its relations with the Five Factor Model personality traits remain unclear. We investigated anterior EEG alpha-activity asymmetry in response to variable degrees of social contact induced by different gaze directions of a "live" model. Neuroticism was negatively related to the anterior EEG asymmetry scores in response to direct gaze, indicating that higher levels of Neuroticism were associated with avoidance-related, relative right-sided functional brain asymmetry. Neuroticism was also related to behavioral direct gaze avoidance and subjective averted gaze preference. These relationships arose primarily from the Withdrawal aspect factor, suggesting that two subdomains of Neuroticism may be differentially related to approach-avoidance tendencies. These findings demonstrate that experimental manipulations of social contact can reveal personality related differences in anterior EEG asymmetry responsiveness, offering a motivationally salient alternative to resting state measures.

  16. Successful Treatment of Severe Sympathetically Maintained Pain Following Anterior Spine Surgery

    PubMed Central

    Woo, Jae Hee

    2014-01-01

    Sympathetic dysfunction is one of the possible complications of anterior spine surgery; however, it has been underestimated as a cause of complications. We report two successful experiences of treating severe dysesthetic pain occurring after anterior spine surgery, by performing a sympathetic block. The first patient experienced a burning and stabbing pain in the contralateral upper extremity of approach side used in anterior cervical discectomy and fusion, and underwent a stellate ganglion block with a significant relief of his pain. The second patient complained of a cold sensation and severe unexpected pain in the lower extremity of the contralateral side after anterior lumbar interbody fusion and was treated with lumbar sympathetic block. We aimed to describe sympathetically maintained pain as one of the important causes of early postoperative pain and the treatment option chosen for these cases in detail. PMID:25289130

  17. Polarimetric glucose sensing in an artificial eye anterior chamber

    NASA Astrophysics Data System (ADS)

    Malik, Bilal H.; Pirnstill, Casey W.; Coté, Gerard L.

    2012-03-01

    The application of optical polarimetry to glucose sensing in the anterior chamber of the eye has emerged as a potential technique to noninvasively ascertain blood glucose levels. One of the major limiting factors preventing the realization of such a device is the time varying corneal birefringence due to motion artifact in the eye. The varying birefringence confounds the optical activity of glucose, and thus, needs to be taken into account in order to successfully predict the glucose concentration in the aqueous humor of the eye. Our group has developed a multi-spectral optical polarimetric approach which can minimize the effect of corneal birefringence coupled with motion artifact by treating it as common mode noise to multiple wavelengths. Here, we present the application of a real-time closed-loop dual wavelength polarimeter to ex vivo glucose sensing in excised New Zealand White rabbits' corneas mounted on an artificial anterior chamber. Our PID control system can reach stability in less than 100 ms which is fast enough to overcome motion artifact due to heart beat and respiration. The system can predict the glucose concentration with a standard error of less than 26 mg/dL in the physiologic glucose range of 0 - 500 mg/dL. Our results indicate that dualwavelength polarimetry has the potential to noninvasively probe glucose through the anterior chamber of the eye.

  18. Modified procedure of uniportal video-assisted thoracoscopic lobectomy with muscle sparing incision

    PubMed Central

    Liu, Zhengcheng; Shao, Feng; Pan, Yanqing

    2016-01-01

    Background To describe modified procedure for uniportal video-assisted thoracoscopic surgery (UVATS) lobectomy with a small, total muscle-sparing incision. Methods Forty-eight UVATS leucotomy were attempted and successfully completed. A single incision of approximately 3 cm was made in an intercostal space along the anterior axillary line. Muscle-sparing technique was applied with this single-incision approach using muscle sparing technique. Results Incision size was kept to a minimum, with a median of 3 cm. Mediastinal lymph node dissection was performed in all patients with malignancy. Overall median operative time was 1.3 hours. Median hospitalization was 13.5 days (range, 6–21 days). Morbidity rate was low at 3%. There were no other postoperative complications, mortality, or re-admissions. Conclusions Modified procedure of lobectomy with UVATS might be easy to operate with less surgical time and morbidity rate, muscle sparing technique might reduce post-operation pain. PMID:27826570

  19. Biological response modifiers

    SciTech Connect

    Weller, R.E.

    1988-10-01

    Much of what used to be called immunotherapy is now included in the term biological response modifiers. Biological response modifiers (BRMs) are those agents or approaches that modify the relationship between the tumor and host by modifying the host's biological response to tumor cells with resultant therapeutic effects. Most of the early work with BRMs centered around observations of spontaneous tumor regression and the association of tumor regression with concurrent bacterial infections. The BRM can modify the host response by increasing the host's antitumor responses through augmentation and/or restoration of effector mechanisms or mediators of the host's defense or decrease the deleterious component by the host's reaction, increasing the host's defenses by the administration of natural biologics (or the synthetic derivatives thereof) as effectors or mediators of an antitumor response, augmenting the host's response to modified tumor cells or vaccines, which might stimulate a greater response by the host or increase tumor-cell sensitivity to an existing response, decreasing the transformation and/or increase differentiation (maturation) of tumor cells, or increasing the ability of the host to tolerate damage by cytotoxic modalities of cancer treatment.

  20. Biological response modifiers

    SciTech Connect

    Weller, R.E.

    1991-10-01

    Much of what used to be called immunotherapy is now included in the term biological response modifiers. Biological response modifiers (BRMs) are defined as those agents or approaches that modify the relationship between the tumor and host by modifying the host's biological response to tumor cells with resultant therapeutic effects.'' Most of the early work with BRMs centered around observations of spontaneous tumor regression and the association of tumor regression with concurrent bacterial infections. The BRM can modify the host response in the following ways: Increase the host's antitumor responses through augmentation and/or restoration of effector mechanisms or mediators of the host's defense or decrease the deleterious component by the host's reaction; Increase the host's defenses by the administration of natural biologics (or the synthetic derivatives thereof) as effectors or mediators of an antitumor response; Augment the host's response to modified tumor cells or vaccines, which might stimulate a greater response by the host or increase tumor-cell sensitivity to an existing response; Decrease the transformation and/or increase differentiation (maturation) of tumor cells; or Increase the ability of the host to tolerate damage by cytotoxic modalities of cancer treatment.

  1. Arthroscopy of the Nondistractable Hip: A Novel Extracapsular Approach

    PubMed Central

    Doron, Ran; Amar, Eyal; Rath, Ehud; Sampson, Thomas; Ochiai, Derek; Matsuda, Dean K.

    2014-01-01

    Adequate traction to achieve hip joint distraction is essential for avoiding iatrogenic injury to the joint during hip arthroscopy. An inability to distract the joint is a relative contraindication for hip arthroscopy. This report describes a novel technique involving an extracapsular approach to gain safe access to a hip joint that fails a trial of traction during positioning for hip arthroscopy. The anterolateral portal is established under fluoroscopic guidance. The arthroscope is positioned on the lateral rim of the acetabulum. A shaver, introduced through a modified anterior portal, is used to facilitate capsular exposure. An arthroscopic capsular incision is made proximal to the lateral acetabular rim and extended anteriorly with a radiofrequency probe. Osteoplasty of the anterolateral acetabular rim is carried out with a burr while protecting the labrum. Distraction of the hip is then possible, allowing safe central-compartment access and subsequent chondrolabral procedures. PMID:25685682

  2. Age and Modified European LeukemiaNet Classification to Predict Transplant Outcomes: An Integrated Approach for Acute Myelogenous Leukemia Patients Undergoing Allogeneic Stem Cell Transplantation.

    PubMed

    Oran, Betül; Jimenez, Antonio M; De Lima, Marcos; Popat, Uday R; Bassett, Roland; Andersson, Borje S; Borthakur, Gautam; Bashir, Qaiser; Chen, Julianne; Ciurea, Stefan O; Jabbour, Elias; Cortes, Jorge; Kebriaei, Partow; Khouri, Issa F; Qazilbash, Muzaffar H; Ravandi, Farhad; Rondon, Gabriela; Lu, Xinyan; Shpall, Elizabeth J; Champlin, Richard E

    2015-08-01

    We evaluated the prognostic significance of a modified European LeukemiaNet (ELN) classification for patients with acute myelogenous leukemia (AML) undergoing hematopoietic stem cell transplantation (HSCT) while in first complete remission (CR1). We analyzed 464 AML patients with matched related (n = 211, 45.5%), matched unrelated (n = 176, 37.9%), and mismatched donors (n = 77, 16.6%). Patients were classified into 4 modified ELN risk groups (favorable, intermediate-I, intermediate-II, and adverse) separately for 354 patients age < 60 years and 110 patients age ≥ 60 years. In this modified version of ELN classification, patients with normal cytogenetic were classified by FLT3-ITD mutational status: favorable risk if FLT3-ITDwild and intermediate-I if FLT3-ITDmut. The best outcomes occurred in the ELN favorable and intermediate-II groups in younger AML patients and in the favorable and intermediate-I groups in older AML patients. Older AML patients had worse transplant outcomes within each modified ELN risk group except intermediate-I when compared with younger patients; leukemia-free survival at 3 years was 67.8% versus 49.8% in favorable, 53.4% versus 50.7% in intermediate-I, 65.7% versus 20.2% in intermediate-II, and 44.6% versus 23.8% in adverse group younger and older patients, respectively. Among lesion-specific abnormalities, del5q/-5 and abnl(17p) had the worse transplant outcomes, with 3-year leukemia-free survival rates of 18.4% and 20% in younger CR1 patients. In conclusion, the modified ELN prognostic classification developed for chemotherapy outcomes also identifies prognostic groups for HSCT, which is useful for a selection of patients for post-transplant strategies to improve outcomes.

  3. Trading experience modulates anterior insula to reduce the endowment effect

    PubMed Central

    Tong, Lester C. P.; Ye, Karen J.; Asai, Kentaro; Ertac, Seda; List, John A.; Nusbaum, Howard C.; Hortaçsu, Ali

    2016-01-01

    People often demand a greater price when selling goods that they own than they would pay to purchase the same goods—a well-known economic bias called the endowment effect. The endowment effect has been found to be muted among experienced traders, but little is known about how trading experience reduces the endowment effect. We show that when selling, experienced traders exhibit lower right anterior insula activity, but no differences in nucleus accumbens or orbitofrontal activation, compared with inexperienced traders. Furthermore, insula activation mediates the effect of experience on the endowment effect. Similar results are obtained for inexperienced traders who are incentivized to gain trading experience. This finding indicates that frequent trading likely mitigates the endowment effect indirectly by modifying negative affective responses in the context of selling. PMID:27482098

  4. Selective importance of the rat anterior thalamic nuclei for configural learning involving distal spatial cues.

    PubMed

    Dumont, Julie R; Amin, Eman; Aggleton, John P

    2014-01-01

    To test potential parallels between hippocampal and anterior thalamic function, rats with anterior thalamic lesions were trained on a series of biconditional learning tasks. The anterior thalamic lesions did not disrupt learning two biconditional associations in operant chambers where a specific auditory stimulus (tone or click) had a differential outcome depending on whether it was paired with a particular visual context (spot or checkered wall-paper) or a particular thermal context (warm or cool). Likewise, rats with anterior thalamic lesions successfully learnt a biconditional task when they were reinforced for digging in one of two distinct cups (containing either beads or shredded paper), depending on the particular appearance of the local context on which the cup was placed (one of two textured floors). In contrast, the same rats were severely impaired at learning the biconditional rule to select a specific cup when in a particular location within the test room. Place learning was then tested with a series of go/no-go discriminations. Rats with anterior thalamic nuclei lesions could learn to discriminate between two locations when they were approached from a constant direction. They could not, however, use this acquired location information to solve a subsequent spatial biconditional task where those same places dictated the correct choice of digging cup. Anterior thalamic lesions produced a selective, but severe, biconditional learning deficit when the task incorporated distal spatial cues. This deficit mirrors that seen in rats with hippocampal lesions, so extending potential interdependencies between the two sites.

  5. Selective importance of the rat anterior thalamic nuclei for configural learning involving distal spatial cues

    PubMed Central

    Dumont, Julie R; Amin, Eman; Aggleton, John P

    2013-01-01

    To test potential parallels between hippocampal and anterior thalamic function, rats with anterior thalamic lesions were trained on a series of biconditional learning tasks. The anterior thalamic lesions did not disrupt learning two biconditional associations in operant chambers where a specific auditory stimulus (tone or click) had a differential outcome depending on whether it was paired with a particular visual context (spot or checkered wall-paper) or a particular thermal context (warm or cool). Likewise, rats with anterior thalamic lesions successfully learnt a biconditional task when they were reinforced for digging in one of two distinct cups (containing either beads or shredded paper), depending on the particular appearance of the local context on which the cup was placed (one of two textured floors). In contrast, the same rats were severely impaired at learning the biconditional rule to select a specific cup when in a particular location within the test room. Place learning was then tested with a series of go/no-go discriminations. Rats with anterior thalamic nuclei lesions could learn to discriminate between two locations when they were approached from a constant direction. They could not, however, use this acquired location information to solve a subsequent spatial biconditional task where those same places dictated the correct choice of digging cup. Anterior thalamic lesions produced a selective, but severe, biconditional learning deficit when the task incorporated distal spatial cues. This deficit mirrors that seen in rats with hippocampal lesions, so extending potential interdependencies between the two sites. PMID:24215178

  6. Early adversity and combat exposure interact to influence anterior cingulate cortex volume in combat veterans☆

    PubMed Central

    Woodward, Steven H.; Kuo, Janice R.; Schaer, Marie; Kaloupek, Danny G.; Eliez, Stephan

    2013-01-01

    Objective Childhood and combat trauma have been observed to interact to influence amygdala volume in a sample of U.S. military veterans with and without PTSD. This interaction was assessed in a second, functionally-related fear system component, the pregenual and dorsal anterior cingulate cortex, using the same sample and modeling approach. Method Anterior cingulate cortical tissues (gray + white matter) were manually-delineated in 1.5 T MR images in 87 U.S. military veterans of the Vietnam and Persian Gulf wars. Hierarchical multiple regression modeling was used to assess associations between anterior cingulate volume and the following predictors, trauma prior to age 13, combat exposure, the interaction of early trauma and combat exposure, and PTSD diagnosis. Results As previously observed in the amygdala, unique variance in anterior cingulate cortical volume was associated with both the diagnosis of PTSD and with the interaction of childhood and combat trauma. The pattern of the latter interaction indicated that veterans with childhood trauma exhibited a significant inverse linear relationship between combat trauma and anterior cingulate volume while those without childhood trauma did not. Such associations were not observed in hippocampal or total cerebral tissue volumes. Conclusions In the dorsal anterior cingulate cortex, as in the amygdala, early trauma may confer excess sensitivity to later combat trauma. PMID:24179818

  7. Surgical anatomy of the anterior clinoid process.

    PubMed

    Huynh-Le, Phuong; Natori, Yoshihiro; Sasaki, Tomio

    2004-04-01

    We studied the surgical anatomy of the anterior clinoid process (ACP) and its adjacent structures in cadaver heads. We paid special attention to the anatomical relationships between the ACP and adjacent structures to determine the surgical landmarks for safe anterior clinoidectomy. Thirty-five cadaver heads were dissected and the ACP regions were examined in 55 skull sides. We observed that in eight sides the ACP had been pneumatized from the sphenoid sinus. The caroticoclinoid foramen was revealed in only eight sides. The extra-ocular nerves ran forward to the superior orbital fissure at the inferolateral aspect of the ACP, with the oculomotor nerve being closest. The posterolateral area of the carotico-oculomotor membrane was thin and incomplete in nine sides. The study clarified the anatomical relationship between the ACP and its surrounding structures, and identified the major variations experienced. We used these to identify anatomical landmarks to assist the surgeon in the planning of a safe and effective anterior clinoidectomy.

  8. Differential pulse anodic stripping voltammetry for detection of As (III) by Chitosan-Fe(OH)3 modified glassy carbon electrode: A new approach towards speciation of arsenic.

    PubMed

    Saha, Suparna; Sarkar, Priyabrata

    2016-09-01

    An efficient electrochemical sensor for As(III) was developed based on adsorption of arsenic on a specially modified electrodes at some applied potential and subsequent i) stripping at a fixed potential by anodic stripping voltammetry ii) analysis by generating surface plasmon resonance (SPR). The working glassy carbon electrode was modified by Chitosan-Fe(OH)3 composite and a reducing agent L-cysteine. The composite enhanced adsorption of As(III) and subsequent reduction to As(O) moieties and measurement by anodic stripping. The surface property of modified electrode was characterized by SEM, AFM, FTIR, XPS and electrochemistry was analyzed by impedance spectroscopy (EIS). Surface Plasmon resonance (SPR) was also employed to investigate the As(III) binding capability of polymer matrix. Several optimum voltammetric parameters e.g supporting electrolyte; 0.1M acetate buffer (pH 5.2) deposition potential, -0.9V; deposition time, 100s were established for anodic stripping voltammetry (ASV). A linear correlation was obtained in the range of 2-100ppb for ASV (R(2) 0.974) with limit of detection 0.072ppb. A variety of common coexistent ions such as Mn, Zn, Pb, Cu, Cd in water samples showed no interferences on the As (III) determination. The method was applied successfully to real samples collected from arsenic affected areas of West Bengal, India.

  9. Anterior ischemic optic neuropathy following dengue fever.

    PubMed

    Ramakrishnan, Reshma; Shrivastava, Saurabh; Deshpande, Shrikant; Patkar, Priyanka

    2016-01-01

    Dengue fever is caused by a flavivirus. This infection is endemic in the tropics and warm temperate regions of the world. Ocular manifestations of dengue fever include subconjunctival, vitreous, and retinal haemorrhages; posterior uveitis; optic neuritis; and maculopathies, haemorrhage, and oedema. However anterior ischemic optic neuropathy is a rare presentation. Optic nerve ischemia most frequently occurs at the optic nerve head, where structural crowding of nerve fibers and reduction of the vascular supply may combine to impair perfusion to a critical degree and produce optic disc oedema. Here we present a case of anterior ischemic optic neurapathy associated with dengue fever.

  10. Anterior ischemic optic neuropathy following dengue fever

    PubMed Central

    Ramakrishnan, Reshma; Shrivastava, Saurabh; Deshpande, Shrikant; Patkar, Priyanka

    2016-01-01

    Dengue fever is caused by a flavivirus. This infection is endemic in the tropics and warm temperate regions of the world. Ocular manifestations of dengue fever include subconjunctival, vitreous, and retinal haemorrhages; posterior uveitis; optic neuritis; and maculopathies, haemorrhage, and oedema. However anterior ischemic optic neuropathy is a rare presentation. Optic nerve ischemia most frequently occurs at the optic nerve head, where structural crowding of nerve fibers and reduction of the vascular supply may combine to impair perfusion to a critical degree and produce optic disc oedema. Here we present a case of anterior ischemic optic neurapathy associated with dengue fever. PMID:27843231

  11. Surgical experience of minipterional craniotomy with 102 ruptured and unruptured anterior circulation aneurysms.

    PubMed

    Figueiredo, Eberval Gadelha; Welling, Leonardo C; Preul, Mark C; Sakaya, Gabriel Reis; Neville, Iuri; Spetzler, Robert F; Teixeira, Manoel Jacobsen

    2016-05-01

    The pterional approach was described in the 1970s and has become the most utilized cranial approach with many variations described, including the minipterional technique. Although described recently as an alternative to the pterional approach for anterior circulation aneurysms, to our knowledge a large series of cases using the minipterional approach in both ruptured and unruptured aneurysms has not been described. We present our clinical experience with the minipterional craniotomy in more than 100 ruptured and unruptured anterior circulation aneurysms. The results of 86 consecutive patients with 102 ruptured non-giant, anterior circulation aneurysms treated with early surgery utilizing the minipterional craniotomy were analyzed. Postoperative angiography was carried out in all cases. Outcome results were classified as excellent in 67 (77.9%), and good in seven (8.1%), while 16 (13.9%) patients died. The minipterional technique provides adequate surgical exposure and excellent outcomes for both ruptured and unruptured anterior circulation aneurysm clipping. It constitutes a safe and effective alternative to the pterional approach, with equivalent or potentially better aesthetic and functional outcomes.

  12. An Experiential Learning Approach to Teaching Social Entrepreneurship, Triple Bottom Line, and Sustainability: Modifying and Extending Practical Organizational Behavior Education (PROBE)

    ERIC Educational Resources Information Center

    Gundlach, Michael J.; Zivnuska, Suzanne

    2010-01-01

    When teaching social entrepreneurship and sustainability, using an experiential learning approach can be more effective than a traditional lecture approach. Social and environmental entrepreneurs often have a deep passion for their work that is important for students to develop early in their careers. Experiential learning enables students to…

  13. Modified Arthroscopic Brostrom Procedure With Bone Tunnels.

    PubMed

    Lui, Tun Hing

    2016-08-01

    The open anatomic repair of the anterior talofibular and calcaneofibular ligaments (modified Brostrom procedure) is widely accepted as the standard surgical stabilization procedure for lateral ankle instability that does not respond to conservative measures. Arthroscopic Brostrom procedures with a suture anchor have been reported to achieve both anatomic repair of the lateral ankle ligaments and management of the associated intra-articular lesions. However, the complication rates are higher than open Brostom procedures. Many of these complications are associated with the use of a suture anchor. We report a modified arthroscopic Brostrom procedure in which the anterolateral ankle capsule is anchored to the lateral malleolus through small bone tunnels instead of suture anchors.

  14. Video endoscopic oro-nasal visualisation of the anterior wall of maxillary sinus: a new technique.

    PubMed

    Trimarchi, M; Tomazic, P V; Bertazzoni, G; Rathburn, A; Bussi, M; Stammberger, H

    2014-08-01

    The anterior wall of the maxillary sinus represents a blind spot in maxillary sinus endoscopic surgery because of the absence of proper visualisation and instrumentation to reach it. The aim of this study was to validate a new approach through the oral cavity into the nose with a flexible video endoscope (oro-nasal endoscopic approach; ONEA) to visualise the entire anterior maxillary wall including the anteromedial angle. We started from a dried bone cadaver model, and then dissected fresh-frozen cadavers. The maxillary sinus was explored with a rigid and a flexible endoscope entering from the nose. Next, a flexible endoscope was introduced through the mouth and back up through the choana, it accessed the maxillary middle antrostomy, entering inside the sinus and looking at the anterior wall. A small ruler inserted inside the sinus demonstrated all the angles visualised. The new ONEA technique allows complete visualisation of the anterior wall of the maxillary sinus with inspection of all blind spots. It is therefore possible to detect lesions that would normally not be visible with a normal rigid endoscope. We demonstrate the validity of a novel technique that allows visualisation of the infero-medial angle of the anterior wall of the maxillary sinus.

  15. Endoscopic extradural anterior clinoidectomy and optic nerve decompression through a pterional port.

    PubMed

    Beer-Furlan, André; Evins, Alexander I; Rigante, Luigi; Burrell, Justin C; Anichini, Giulio; Stieg, Philip E; Bernardo, Antonio

    2014-05-01

    Since the first description of the intradural removal of the anterior clinoid process, numerous refinements and modifications have been proposed to simplify and enhance the safety of the technique. The growing use of endoscopes in endonasal and transcranial approaches has changed the traditional management of many skull base lesions. We describe an endoscopic extradural anterior clinoidectomy and optic nerve decompression through a minimally invasive pterional port. Minimally invasive optic nerve decompression, with endoscopic extradural anterior clinoidectomy, through a pterional keyhole craniotomy was performed on five preserved cadaveric heads. The endoscopic pterional port provided a shorter and more direct route to the anterior clinoid region, and helped avoid unnecessary and extensive bone removal. An extradural approach helped minimize complications associated with infraction of the subdural space and allowed for the maintenance of visibility while drilling with continuous irrigation. Adequate 270° bone decompression of the optic canal was achieved in all specimens. Endoscopic extradural anterior clinoidectomy and optic nerve decompression is feasible through a single minimally invasive pterional port.

  16. Anorgasmia in anterior spinal cord syndrome.

    PubMed

    Berić, A; Light, J K

    1993-05-01

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

  17. The anterior pituitary gland: lessons from livestock.

    PubMed

    Scanes, C G; Jeftinija, S; Glavaski-Joksimovic, A; Proudman, J; Arámburo, C; Anderson, L L

    2005-07-01

    There has been extensive research of the anterior pituitary gland of livestock and poultry due to the economic (agricultural) importance of physiological processes controlled by it including reproduction, growth, lactation and stress. Moreover, farm animals can be biomedical models or useful in evolutionary/ecological research. There are for multiple sites of control of the secretion of anterior pituitary hormones. These include the potential for independent control of proliferation, differentiation, de-differentiation and/or inter-conversion cell death, expression and translation, post-translational modification (potentially generating multiple isoforms with potentially different biological activities), release with or without a specific binding protein and intra-cellular catabolism (proteolysis) of pituitary hormones. Multiple hypothalamic hypophysiotropic peptides (which may also be produced peripherally, e.g. ghrelin) influence the secretion of the anterior pituitary hormones. There is also feedback for hormones from the target endocrine glands. These control mechanisms show broadly a consistency across species and life stages; however, there are some marked differences. Examples from growth hormone, prolactin, follicle stimulating hormone and luteinizing hormone will be considered. In addition, attention will be focused on areas that have been neglected including the role of stellate cells, multiple sub-types of the major adenohypophyseal cells, functional zonation within the anterior pituitary and the role of multiple secretagogues for single hormones.

  18. Luxury perfusion following anterior ischemic optic neuropathy.

    PubMed

    Friedland, S; Winterkorn, J M; Burde, R M

    1996-09-01

    We present five patients who developed luxury perfusion following anterior ischemic optic neuropathy in whom fluorescein angiography was misinterpreted as "capillary hemangioma" or neovascularization of the disc. In each case, the segment of disc hyperemia corresponded to a spared region of visual field. Luxury perfusion represents a reparative autoregulatory reaction to ischemia.

  19. Two cases of isolated anterior cervical hypertrichosis.

    PubMed

    Reddy, Swapna; Antaya, Richard J

    2010-01-01

    Two unrelated Hispanic females, ages 4 and 3 years, respectively, each presented with a solitary patch of excessive terminal hair growth in the midline of the neck. This rare form of congenital localized hypertrichosis, known as anterior cervical hypertrichosis, is reported here as an isolated defect with no other underlying abnormalities.

  20. Anterior Chamber Live Loa loa: Case Report

    PubMed Central

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

    2016-01-01

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

  1. Anterior Chamber Live Loa loa: Case Report.

    PubMed

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

    2016-01-01

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

  2. Anterior Segment Ischemia after Strabismus Surgery

    PubMed Central

    Göçmen, Emine Seyhan; Atalay, Yonca; Evren Kemer, Özlem; Sarıkatipoğlu, Hikmet Yavuz

    2017-01-01

    A 46-year-old male patient was referred to our clinic with complaints of diplopia and esotropia in his right eye that developed after a car accident. The patient had right esotropia in primary position and abduction of the right eye was totally limited. Primary deviation was over 40 prism diopters at near and distance. The patient was diagnosed with sixth nerve palsy and 18 months after trauma, he underwent right medial rectus muscle recession. Ten months after the first operation, full-thickness tendon transposition of the superior and inferior rectus muscles (with Foster suture) was performed. On the first postoperative day, slit-lamp examination revealed corneal edema, 3+ cells in the anterior chamber and an irregular pupil. According to these findings, the diagnosis was anterior segment ischemia. Treatment with 0.1/5 mL topical dexamethasone drops (16 times/day), cyclopentolate hydrochloride drops (3 times/day) and 20 mg oral fluocortolone (3 times/day) was initiated. After 1 week of treatment, corneal edema regressed and the anterior chamber was clean. Topical and systemic steroid treatment was gradually discontinued. At postoperative 1 month, the patient was orthophoric and there were no pathologic symptoms besides the irregular pupil. Anterior segment ischemia is one of the most serious complications of strabismus surgery. Despite the fact that in most cases the only remaining sequel is an irregular pupil, serious circulation deficits could lead to phthisis bulbi. Clinical properties of anterior segment ischemia should be well recognized and in especially risky cases, preventative measures should be taken. PMID:28182149

  3. Arthroscopic Findings in Anterior Shoulder Instability

    PubMed Central

    Hantes, Michael; Raoulis, Vasilios

    2017-01-01

    Background: In the last years, basic research and arthroscopic surgery, have improved our understanding of shoulder anatomy and pathology. It is a fact that arthroscopic treatment of shoulder instability has evolved considerably over the past decades. The aim of this paper is to present the variety of pathologies that should be identified and treated during shoulder arthroscopy when dealing with anterior shoulder instability cases. Methods: A review of the current literature regarding arthroscopic shoulder anatomy, anatomic variants, and arthroscopic findings in anterior shoulder instability, is presented. In addition, correlation of arthroscopic findings with physical examination and advanced imaging (CT and MRI) in order to improve our understanding in anterior shoulder instability pathology is discussed. Results: Shoulder instability represents a broad spectrum of disease and a thorough understanding of the pathoanatomy is the key for a successful treatment of the unstable shoulder. Patients can have a variety of pathologies concomitant with a traditional Bankart lesion, such as injuries of the glenoid (bony Bankart), injuries of the glenoid labrum, superiorly (SLAP) or anteroinferiorly (e.g. anterior labroligamentous periosteal sleeve avulsion, and Perthes), capsular lesions (humeral avulsion of the glenohumeral ligament), and accompanying osseous-cartilage lesions (Hill-Sachs, glenolabral articular disruption). Shoulder arthroscopy allows for a detailed visualization and a dynamic examination of all anatomic structures, identification of pathologic findings, and treatment of all concomitant lesions. Conclusion: Surgeons must be well prepared and understanding the normal anatomy of the glenohumeral joint, including its anatomic variants to seek for the possible pathologic lesions in anterior shoulder instability during shoulder arthroscopy. Patient selection criteria, improved surgical techniques, and implants available have contributed to the enhancement of

  4. Cytological organization of the alpha component of the anterior olfactory nucleus and olfactory limbus

    PubMed Central

    Larriva-Sahd, Jorge

    2012-01-01

    This study describes the microscopic organization of a wedge-shaped area at the intersection of the main (MOB) and accessory olfactory bulbs (AOBs), or olfactory limbus (OL), and an additional component of the anterior olfactory nucleus or alpha AON that lies underneath of the AOB. The OL consists of a modified bulbar cortex bounded anteriorly by the MOB and posteriorly by the AOB. In Nissl-stained specimens the OL differs from the MOB by a progressive, antero-posterior decrease in thickness or absence of the external plexiform, mitral/tufted cell, and granule cell layers. On cytoarchitectual grounds the OL is divided from rostral to caudal into three distinct components: a stripe of glomerular-free cortex or preolfactory area (PA), a second or necklace glomerular area, and a wedge-shaped or interstitial area (INA) crowned by the so-called modified glomeruli that appear to belong to the anterior AOB. The strategic location and interactions with the main and AOBs, together with the previously noted functional and connectional evidence, suggest that the OL may be related to both sensory modalities. The alpha component of the anterior olfactory nucleus, a slender cellular cluster (i.e., 650 × 150 μm) paralleling the base of the AOB, contains two neuron types: a pyramidal-like neuron and an interneuron. Dendrites of pyramidal-like cells (P-L) organize into a single bundle that ascends avoiding the AOB to resolve in a trigone bounded by the edge of the OL, the AOB and the dorsal part of the anterior olfactory nucleus. Utrastructurally, the neuropil of the alpha component contains three types of synaptic terminals; one of them immunoreactive to the enzyme glutamate decarboxylase, isoform 67. PMID:22754506

  5. Modified pterional craniotomy without "MacCarty keyhole".

    PubMed

    Moscovici, Samuel; Mizrahi, Cezar José; Margolin, Emil; Spektor, Sergey

    2016-02-01

    Pterional craniotomy is one of the most widely used approaches in neurosurgery. The MacCarty keyhole has remained the preferred means of beginning the craniotomy to achieve a low access point; however, the bone opening may result in a residual defect and an aesthetically unpleasant depression in the periorbital area. We present our modification of the traditional technique. Instead of drilling the keyhole in the frontoperiorbital area, the classical location, we perform a 5 × 15 mm strip craniectomy at the lowest accessible point in the infratemporal fossa, corresponding to the projection of the most lateral point of the sphenoid ridge. The anterior half of this opening exposes the basal frontal dura, while the posterior half brings the temporal dura into view. This modified technique was applied in 48 pterional craniotomies performed for removal of a variety of neoplasms during 2014-2015. There were no approach-related complications. Aesthetic outcomes and patient acceptance have been good; no patient developed skin depression in the periorbital area. In our experience, craniotomy for a pterional approach with the lowest possible access to the frontotemporal skull base may be performed by drilling a narrow oblong opening, without the use of any keyhole or burr hole, to create a smaller skull defect and achieve optimal aesthetic outcomes.

  6. Aneurysm of azygos anterior cerebral artery: A report of two cases

    PubMed Central

    Ghanta, Rajesh Kumar; Kesanakurthy, Murthy V. S. N.; Vemuri, Varaprasad N.

    2016-01-01

    Aneurysms of azygos anterior cerebral artery (ACA) are rare with very few cases reported in medical literature. We report here two cases of aneurysm of azygos ACA among 105 patients with subarachnoid hemorrhage. The two aneurysms were successfully clipped by using the bifrontal basal interhemispheric approach. PMID:27366270

  7. Anterior insular cortex is necessary for empathetic pain perception

    PubMed Central

    Gu, Xiaosi; Gao, Zhixian; Wang, Xingchao; Liu, Xun; Knight, Robert T.; Hof, Patrick R.

    2012-01-01

    Empathy refers to the ability to perceive and share another person’s affective state. Much neuroimaging evidence suggests that observing others’ suffering and pain elicits activations of the anterior insular and the anterior cingulate cortices associated with subjective empathetic responses in the observer. However, these observations do not provide causal evidence for the respective roles of anterior insular and anterior cingulate cortices in empathetic pain. Therefore, whether these regions are ‘necessary’ for empathetic pain remains unknown. Herein, we examined the perception of others’ pain in patients with anterior insular cortex or anterior cingulate cortex lesions whose locations matched with the anterior insular cortex or anterior cingulate cortex clusters identified by a meta-analysis on neuroimaging studies of empathetic pain perception. Patients with focal anterior insular cortex lesions displayed decreased discrimination accuracy and prolonged reaction time when processing others’ pain explicitly and lacked a typical interference effect of empathetic pain on the performance of a pain-irrelevant task. In contrast, these deficits were not observed in patients with anterior cingulate cortex lesions. These findings reveal that only discrete anterior insular cortex lesions, but not anterior cingulate cortex lesions, result in deficits in explicit and implicit pain perception, supporting a critical role of anterior insular cortex in empathetic pain processing. Our findings have implications for a wide range of neuropsychiatric illnesses characterized by prominent deficits in higher-level social functioning. PMID:22961548

  8. Analysis of Gene Expression Changes in the Rat Hippocampus After Deep Brain Stimulation of the Anterior Thalamic Nucleus

    PubMed Central

    Selvakumar, Tharakeswari; Alavian, Kambiz N.; Tierney, Travis

    2015-01-01

    Deep brain stimulation (DBS) surgery, targeting various regions of the brain such as the basal ganglia, thalamus, and subthalamic regions, is an effective treatment for several movement disorders that have failed to respond to medication. Recent progress in the field of DBS surgery has begun to extend the application of this surgical technique to other conditions as diverse as morbid obesity, depression and obsessive compulsive disorder. Despite these expanding indications, little is known about the underlying physiological mechanisms that facilitate the beneficial effects of DBS surgery. One approach to this question is to perform gene expression analysis in neurons that receive the electrical stimulation. Previous studies have shown that neurogenesis in the rat dentate gyrus is elicited in DBS targeting of the anterior nucleus of the thalamus1. DBS surgery targeting the ATN is used widely for treatment refractory epilepsy. It is thus of much interest for us to explore the transcriptional changes induced by electrically stimulating the ATN. In this manuscript, we describe our methodologies for stereotactically-guided DBS surgery targeting the ATN in adult male Wistar rats. We also discuss the subsequent steps for tissue dissection, RNA isolation, cDNA preparation and quantitative RT-PCR for measuring gene expression changes. This method could be applied and modified for stimulating the basal ganglia and other regions of the brain commonly clinically targeted. The gene expression study described here assumes a candidate target gene approach for discovering molecular players that could be directing the mechanism for DBS. PMID:25867749

  9. A new approach to the study of intramolecular electron-transfer reactions of metalloproteins: Pulse radiolysis of NO[sub 2]-modified tyrosine derivatives of plastocyanin

    SciTech Connect

    Govindaraju, K.; Christensen, H.E.M.; Lloyd, E.; Tomkinson, N.P.; Sykes, A.G. ); Olsen, M. ); Salmon, G.A. )

    1993-01-06

    Single NO[sub 2]-modified derivatives of plastocyanin, with modifications at Tyr83 (spinach) and Tyr83/Tyr62 (parsley, deletions at 57 and 58), have been prepared and characterized by peptide mapping. All three products give a TyrNO[sub 2] UV-vis absorbance band at 355 nm ([epsilon] = 3,900 M[sup [minus]1] cm[sup [minus]1]) at pH < 7.5, assigned to NO[sub 2], which shifts to 428 nm on increasing the pH to > 9.0 due to acid dissociation of the phenolic group. Pulse radiolysis experiments in which the reductant CO[sub 2][sup [sm bullet][minus

  10. 129Xe nuclear magnetic resonance study of pitch-based activated carbon modified by air oxidation/pyrolysis cycles: a new approach to probe the micropore size.

    PubMed

    Romanenko, Konstantin V; Py, Xavier; d'Espinose de Lacaillerie, Jean-Baptiste; Lapina, Olga B; Fraissard, Jacques

    2006-02-23

    (129)Xe NMR has been used to study a series of homologous activated carbons obtained from a KOH-activated pitch-based carbon molecular sieve modified by air oxidation/pyrolysis cycles. A clear correlation between the pore size of microporous carbons and the (129)Xe NMR of adsorbed xenon is proposed for the first time. The virial coefficient delta(Xe)(-)(Xe) arising from binary xenon collisions varied linearly with the micropore size and appeared to be a better probe of the microporosity than the chemical shift extrapolated to zero pressure. This correlation was explained by the fact that the xenon collision frequency increases with increasing micropore size. The chemical shift has been shown to vary very little with temperature (less than 9 ppm) for xenon trapped inside narrow and wide micropores. This is indicative of a smooth xenon-surface interaction potential.

  11. Thermodynamics properties study of diatomic molecules with q-deformed modified Poschl-Teller plus Manning Rosen non-central potential in D dimensions using SUSYQM approach

    NASA Astrophysics Data System (ADS)

    Suparmi, A.; Cari, C.; Pratiwi, B. N.

    2016-04-01

    D-dimensional Dirac equation of q-deformed modified Poschl-Teller plus Manning Rosen non-central potential was solved using supersymmetric quantum mechanics (SUSY QM). The relativistic energy spectra were analyzed by using SUSY QM and shape invariant properties from radial part of D dimensional Dirac equation and the angular quantum numbers were obtained from angular part of D dimensional Dirac equation. The SUSY operators was used to generate the D dimensional relativistic wave functions both for radial and angular parts. In the non-relativistic limit, the relativistic energy equation was reduced to the non-relativistic energy. In the classical limit, the partition function of vibrational, the specific heat of vibrational, and the mean energy of vibrational of some diatomic molecules were calculated from the equation of non-relativistic energy with the help of error function and Mat-lab 2011.

  12. Specific internalization and synergistic anticancer effect of docetaxel-encapsulated chitosan-modified polymeric nanocarriers: a novel approach in cancer chemotherapy

    NASA Astrophysics Data System (ADS)

    Asthana, Shalini; Gupta, Pramod K.; Konwar, Rituraj; Chourasia, Manish K.

    2013-09-01

    Nanocarriers can be surface engineered to increase endocytosis for applications in delivery of chemotherapeutics. This study investigated the chitosan (CS)-mediated effects on the anticancer efficacy and uptake of docetaxel-loaded nanometric particles (<250 nm) by MCF-7 tumor cells. Herein, negatively charged poly lactic- co-glycolic acid (PLGA) nanoparticles (-18.4 ± 2.57 mV, 162 ± 6.34 nm), poorly endocytosed by the MCF-7 cells, were subjected to surface modification with CS. It demonstrated significant increase (>5-fold) in intracellular uptake as well as antitumor efficacy of modified nanoparticles (NPs) that explicate the possibility of saccharide marker-mediated tumor targeting along with synergism via proapoptotic effect of CS. Additionally, high positivity of optimized tailored nanocarrier (+23.3 ± 2.02 mV, 242.8 ± 9.42 nm) may have accounted for the increased adsorption-mediated endocytosis, preferably toward tumor cells with negative potential. Developed drug carrier system showed high stability in human blood which is in compliance with mucoadhesive property of CS. Transmission electron microscopy technique was applied to observe shape and morphological features of NPs. Furthermore, in vivo tissue toxicity study revealed safe use of drug at 20 mg/kg dose in nanoparticulate form. Moreover, the enhanced in vitro uptake of these NPs and their cytotoxicity against the tumor cells along with synergistic effect of CS clearly suggest that CS-modified carrier system is a promising candidate for preclinical studies to achieve wider anti-tumor therapeutic window and lower side effects.

  13. A chemometrics approach applied to Fourier transform infrared spectroscopy (FTIR) for monitoring the spoilage of fresh salmon (Salmo salar) stored under modified atmospheres.

    PubMed

    Saraiva, C; Vasconcelos, H; de Almeida, José M M M

    2017-01-16

    The aim of this work was to investigate the potential of Fourier transform infrared spectroscopy (FTIR) to detect and predict the bacterial load of salmon fillets (Salmo salar) stored at 3, 8 and 30°C under three packaging conditions: air packaging (AP) and two modified atmospheres constituted by a mixture of 50%N2/40%CO2/10%O2 with lemon juice (MAPL) and without lemon juice (MAP). Fresh salmon samples were periodically examined for total viable counts (TVC), specific spoilage organisms (SSO) counts, pH, FTIR and sensory assessment of freshness. Principal components analysis (PCA) allowed identification of the wavenumbers potentially correlated with the spoilage process. Linear discriminant analysis (LDA) of infrared spectral data was performed to support sensory data and to accurately identify samples freshness. The effect of the packaging atmospheres was assessed by microbial enumeration and LDA was used to determine sample packaging from the measured infrared spectra. It was verified that modified atmospheres can decrease significantly the bacterial load of fresh salmon. Lemon juice combined with MAP showed a more pronounced delay in the growth of Brochothrix thermosphacta, Photobacterium phosphoreum, psychrotrophs and H2S producers. Partial least squares regression (PLS-R) allowed estimates of TVC and psychrotrophs, lactic acid bacteria, molds and yeasts, Brochothrix thermosphacta, Enterobacteriaceae, Pseudomonas spp. and H2S producer counts from the infrared spectral data. For TVC, the root mean square error of prediction (RMSEP) value was 0.78logcfug(-1) for an external set of samples. According to the results, FTIR can be used as a reliable, accurate and fast method for real time freshness evaluation of salmon fillets stored under different temperatures and packaging atmospheres.

  14. Surgical Management of Intramyocardial Left Anterior Descending Artery.

    PubMed

    De Salvatore, Sergio; Segreto, Antonio; Chiusaroli, Alessandro; Congiu, Stefano; Bizzarri, Federico

    2015-11-01

    An intramyocardial left anterior descending artery can be found in up to 30% of patients undergoing coronary artery bypass graft procedures. We review the various techniques available to identify an intramyocardial left anterior descending artery.

  15. Delayed Failure after Endoscopic Staple Repair of an Anterior Spine Surgery Related Pharyngeal Diverticulum

    PubMed Central

    Al-Khudari, Samer; Succar, Eric; Ghanem, Tamer; Gardner, Glendon M.

    2013-01-01

    We present a rare complication of endoscopic staple repair of a pharyngeal diverticulum related to prior anterior cervical spine surgery. A 70-year-old male developed a symptomatic pharyngeal diverticulum 2 years after an anterior cervical fusion that was repaired via endoscopic stapler-assisted diverticulectomy. He initially had improvement of his symptoms after the stapler-assisted approach. Three years later, the patient presented with dysphagia and was found to have erosion of the cervical hardware into the pharyngeal lumen at the site of the prior repair. We present the first reported case of late hardware erosion into a pharyngeal diverticulum after endoscopic stapler repair. PMID:24454395

  16. Extraction of Iron from the Rabbit Anterior Chamber with Reverse Iontophoresis

    PubMed Central

    Sun, Shoubin; Diao, Huijie; Zhao, Fali; Bai, Jianhai; Zhou, Yuan; Cui, Hao; Zhang, Liqiong

    2015-01-01

    Ocular siderosis is a common eye disease caused by retention of an iron-containing intraocular foreign body in the eye. Iron-containing intraocular foreign bodies may cause severe inflammatory reaction and affect visual function. Currently the optimal treatment method of ocular siderosis is a moot point. This study used the reverse iontophoresis technique to noninvasively extract iron from the rabbit anterior chamber. By slit lamp observation and histological examination, reverse iontophoresis treatment has a good effect on ocular siderosis. Reverse iontophoresis seems to be a noninvasive and promising approach to extract iron from the anterior chamber to treat ocular siderosis. PMID:26257921

  17. Comparison between Two Scheimpflug Anterior Segment Analyzers

    PubMed Central

    Baradaran-Rafii, Alireza; Motevasseli, Tahmineh; Yazdizadeh, Forouzan; Karimian, Farid; Fekri, Sahba; Baradaran-Rafii, Amir

    2017-01-01

    Purpose: To compare the anterior segment indices measured by two Scheimpflug camera machines; Galilei and Pentacam. Methods: In this observational case series, the anterior segment indices of myopic healthy subjects seeking for refractive surgery were measured by Pentacam and Galilei on the same day. Analyzed parameters were anterior and posterior best fit spheres (BFS), axial curvature, true corneal power, central corneal thickness (CCT), anterior chamber (AC) depth, AC volume, AC angle, and pupil diameter. Results: This study included 176 eyes of 88 participants. Mean radius of the anterior BFS was 7.79 ± 0.34 mm versus 7.75 ± 0.39 mm measured by Pentacam and Galilei, respectively (r = 0.877, P < 0.001). Corresponding values for the mean radius of posterior BFS were 6.42 ± 0.32 and 6.47 ± 0.38 mm, respectively (r = 0.879, P < 0.001). Anterior corneal mean power was 43.8 ± 1.9 diopters (D) with Pentacam and 43.8 ± 2.4 D with Galilei (r = 0.905,P < 0.001). Posterior corneal mean power was measured − 6.3 ± 0.3 and − 6.3 ± 0.4 D using Pentacam and Galilei, respectively (r = 0.873, P < 0.001). True corneal power was 43.9 ± 1.9 D with Pentacam and 43.5 ± 2.3 D with Galilei (r = 0.909, P < 0.001). CCT was 537 ± 44 and 553 ± 51 μm measured by Pentacam and Galilei, respectively (r = 0.796, P < 0.001). AC depth measurements using Pentacam and Galilei were 3.29 ± 0.4 and 3.3 ± 0.38 mm (P < 0.001), respectively; AC volume was 207 ± 50 and 129 ± 39 mm3≥ (P = 0.004), and AC angle was 39.7 ± 9.2 and 54.2 ± 5.2 degrees (P = 0.051), respectively. Average pupil diameter was measured 3.91 ± 1.77 mm by Pentacam and 3.34 ± 0.89 mm by Galilei (P = 0.018). Conclusions: There was a significant correlation between the Pentacam and Galilei in all measured parameters except AC angle, AC volume, and average pupil diameter. PMID:28299003

  18. Neurosurgical management of anterior meningo-encephaloceles about 60 cases

    PubMed Central

    Rifi, Loubna; Barkat, Amina; El Khamlichi, Abdeslam; Boulaadas, Malek; El Ouahabi, Abdessamad

    2015-01-01

    Anterior meningo-encephaloceles (AME) are congenital malformations characterized by herniation of brain tissue and meninges through a defect in the cranium, in frontal, orbital, nasal and ethmoidal regions. The management of this complex congenital malformation is controversial according to whether use, an intracranial, extra-cranial or combined approach. This is the first largest series published in Africa, in which we present our experience in the operative management of AME; we share our recommendation in technical consideration for surgical approach with review of the literature. All patients beneficed of neuro-radiological investigations including Plan X rays, Spiral Three dimensional CT scan and MRI. Ophthalmologic and maxillo-facial evaluations were done in all the cases. MEA are surgically approached in various ways, mainly on the basis of its location and type, by cranio-facial approach in one-step, or in two stages by intracranial approach followed by facial approach, only by cranial approach or facial approach. The surgical results were evaluated in the follow up on the basis of disappearance of cranio-facial tumefaction with correction of hypertelorism. 60 children with AME were treated in our department between January 1992 and December 2012. The mean age at time of surgery was 14 months (20 days to 18 years) with slight men predominance (28 females/32 males). Cranio-facial team operated 21 patients, 16 were operated in two stages by intracranial approach followed by facial approach, 20 cases beneficed the neurosurgical approach and three only the facial approach Some post operative complications were observed: 2 cases of post operative hydrocephalus underwent shunt; CSF fistulas in three cases cured by spinal drainage, one death due to per operative hypothermia, 3 cases of recurrence how needed second surgery. After mean follow up for 80 months (1 year to 19 years) theses techniques permitted a good cosmetics results in 42 cases, average cosmetics

  19. A Modified Posterolateral Approach for Radiofrequency Denervation of the Medial Branch of the Cervical Segmental Nerve in Cervical Facet Joint Pain Based on Anatomical Considerations.

    PubMed

    van Eerd, Maarten; Lataster, Arno; Sommer, Micha; Patijn, Jacob; van Kleef, Maarten

    2016-10-13

    The cervical facet joints, also called the zygapophyseal joints, are a potential source of neck pain (cervical facet joint pain). The cervical facet joints are innervated by the cervical medial branches (CMBs) of the cervical segmental nerves. Cervical facet joint pain has been shown to respond to multisegmental radiofrequency denervation of the cervical medial branches. This procedure is performed under fluoroscopic guidance. Currently, three approaches are described and used. Those three techniques of radiofrequency treatment of the CMBs, classified on the base of the needle trajectory toward the anatomical planes, are as follows: the posterolateral technique, the posterior technique, and the lateral technique. We describe the three techniques with their advantages and disadvantages. Anatomical studies providing a topographic anatomy of the course of the CMBs are reviewed. We developed a novel approach based on the observed strengths and weaknesses of the three currently used approaches and based on recent anatomical findings. With this fluoroscopic-guided approach, there is always bone (the facet column) in front of the needle, which makes it safer, and the insertion point is easier to determine without the risk of positioning the radiofrequency needle too dorsally.

  20. Modified maxillomandibular advancement for obstructive sleep apnoea: towards a better outcome for Asians.

    PubMed

    Liao, Y-F; Chiu, Y-T; Lin, C-H; Chen, Y-A; Chen, N-H; Chen, Y-R

    2015-02-01

    Excluding tracheostomy, maxillomandibular advancement (MMA) is the most effective surgical treatment for obstructive sleep apnoea (OSA). However, the anticipated facial changes may prevent acceptance of this procedure by patients with bimaxillary protrusion, a common feature of Asian faces. We therefore developed a modified MMA technique for such cases, consisting of anterior segmental osteotomies together with standard Le Fort I and bilateral sagittal split osteotomies. A prospective study of 20 consecutive Taiwanese adults with moderate-to-severe OSA who underwent modified MMA and postsurgical orthodontics was undertaken to evaluate the efficacy with regard to OSA and the postoperative facial appearance and dental occlusion. After modified MMA, the mean apnoea-hypopnoea index decreased from 41.6±19.2 n/h to 5.3±4.0 n/h (P<0.001). All patients had a successful outcome. No patient was dissatisfied with their postoperative facial appearance. The mean Peer Assessment Rating score decreased from 21.9±14.3 to 1.7±1.6 (P=0.001). The data suggest that the modified MMA is effective in treating patients with moderate-to-severe OSA without negatively affecting facial appearance or dental occlusion. To achieve a better outcome, surgical-orthodontic integration is warranted. The surgery-first approach can achieve early improvement.

  1. A checklist for endonasal transsphenoidal anterior skull base surgery.

    PubMed

    Laws, Edward R; Wong, Judith M; Smith, Timothy R; de Los Reyes, Kenneth; Aglio, Linda S; Thorne, Alison J; Cote, David J; Esposito, Felice; Cappabianca, Paolo; Gawande, Atul

    2016-06-01

    OBJECT Approximately 250 million surgical procedures are performed annually worldwide, and data suggest that major complications occur in 3%-17% of them. Many of these complications can be classified as avoidable, and previous studies have demonstrated that preoperative checklists improve operating room teamwork and decrease complication rates. Although the authors' institution has instituted a general preoperative "time-out" designed to streamline communication, flatten vertical authority gradients, and decrease procedural errors, there is no specific checklist for transnasal transsphenoidal anterior skull base surgery, with or without endoscopy. Such minimally invasive cranial surgery uses a completely different conceptual approach, set-up, instrumentation, and operative procedure. Therefore, it can be associated with different types of complications as compared with open cranial surgery. The authors hypothesized that a detailed, procedure-specific, preoperative checklist would be useful to reduce errors, improve outcomes, decrease delays, and maximize both teambuilding and operational efficiency. Thus, the object of this study was to develop such a checklist for endonasal transsphenoidal anterior skull base surgery. METHODS An expert panel was convened that consisted of all members of the typical surgical team for transsphenoidal endoscopic cases: neurosurgeons, anesthesiologists, circulating nurses, scrub technicians, surgical operations managers, and technical assistants. Beginning with a general checklist, procedure-specific items were added and categorized into 4 pauses: Anesthesia Pause, Surgical Pause, Equipment Pause, and Closure Pause. RESULTS The final endonasal transsphenoidal anterior skull base surgery checklist is composed of the following 4 pauses. The Anesthesia Pause consists of patient identification, diagnosis, pertinent laboratory studies, medications, surgical preparation, patient positioning, intravenous/arterial access, fluid management

  2. Quantitative anatomical labeling of the anterior abdominal wall

    NASA Astrophysics Data System (ADS)

    Allen, Wade M.; Xu, Zhoubing; Asman, Andrew J.; Poulose, Benjamin K.; Landman, Bennett A.

    2013-03-01

    Ventral hernias (VHs) are abnormal openings in the anterior abdominal wall that are common side effects of surgical intervention. Repair of VHs is the most commonly performed procedure by general surgeons worldwide, but VH repair outcomes are not particularly encouraging (with recurrence rates up to 43%). A variety of open and laparoscopic techniques are available for hernia repair, and the specific technique used is ultimately driven by surgeon preference and experience. Despite routine acquisition of computed tomography (CT) for VH patients, little quantitative information is available on which to guide selection of a particular approach and/or optimize patient-specific treatment. From anecdotal interviews, the success of VH repair procedures correlates with hernia size, location, and involvement of secondary structures. Herein, we propose an image labeling protocol to segment the anterior abdominal area to provide a geometric basis with which to derive biomarkers and evaluate treatment efficacy. Based on routine clinical CT data, we are able to identify inner and outer surfaces of the abdominal walls and the herniated volume. This is the first formal presentation of a protocol to quantify these structures on abdominal CT. The intra- and inter rater reproducibilities of this protocol are evaluated on 4 patients with suspected VH (3 patients were ultimately diagnosed with VH while 1 was not). Mean surfaces distances of less than 2mm were achieved for all structures.

  3. Endoscopic anterior tarsal tunnel release: a case report.

    PubMed

    Lui, Tun Hing

    2014-01-01

    Anterior tarsal tunnel syndrome is a rare entrapment neuropathy of the deep peroneal nerve beneath the inferior extensor retinaculum of the ankle. We report a patient with anterior tarsal tunnel syndrome who was successfully treated with endoscopic anterior tarsal tunnel release. Our endoscopic technique, because it preserves the inferior extensor retinaculum, is potentially less traumatic than traditional surgical techniques for repairing this entrapment neuropathy.

  4. An OCT Study of Anterior Nodular Episcleritis and Scleritis

    PubMed Central

    2017-01-01

    Anterior scleritis and episcleritis are a well-known presentation in tuberculosis. The case of a female patient with presumed tuberculous anterior scleritis and episcleritis is discussed in this article. Anterior segment OCT was efficient in diagnosis and evaluation of the therapeutic outcome. Antituberculosis chemotherapy was sufficient to achieve clinical remission. PMID:28348907

  5. [Esthetic restorations of primary anterior teeth].

    PubMed

    Elqadir, A Jamil; Shapira, J; Ziskind, K; Ram, D

    2013-04-01

    Esthetic treatment of primary teeth is one of the greatest challenges to pediatric dentists. A variety of restorative options using full coverage are available for anterior primary teeth. In the last half century the emphasis on treatment of severely decayed primary teeth shifted from extraction to restoration. In the past, restorations consisted of placement of stainless steel crowns on severely decayed teeth. However, they are esthetically unacceptable today. Over the last decade parents expect a higher esthetic standard for their children's primary teeth. Thus, the restoration should provide esthetic appearance and durability in addition to restoring function. The purpose of this review is to describe the types of full coverage options for anterior primary teeth currently available.

  6. Lethal arthrogryposis with anterior horn cell disease.

    PubMed

    Vuopala, K; Ignatius, J; Herva, R

    1995-01-01

    Fifteen infants (11 families) with lethal arthrogryposis and anterior horn motor neuron loss are described. The clinical presentation was the fetal akinesia deformation sequence (FADS) with multiple contractures and facial anomalies. At autopsy neurogenic muscular atrophy was present in all infants. The spinal cord showed a paucity of anterior horn motor neurons in the 12 infants studied. Both male and female infants were affected. Nine cases were sporadic, whereas in two families there were three affected cases. Consanguinity between the parents was reported in one family with one affected child. This and the recurrence of the condition speak for autosomal recessive inheritance. Detailed neuropathological examination and documentation of the clinical features are needed for a better delineation of and genetic counseling for perinatally lethal arthrogryposis.

  7. Anterior Insular Cortex and Emotional Awareness

    PubMed Central

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

    2014-01-01

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

  8. The extracellular matrix component laminin promotes gap junction formation in the rat anterior pituitary gland.

    PubMed

    Horiguchi, Kotaro; Kouki, Tom; Fujiwara, Ken; Kikuchi, Motoshi; Yashiro, Takashi

    2011-03-01

    Folliculo-stellate (FS) cells in the anterior pituitary gland are believed to have multifunctional properties. FS cells connect to each other not only by mechanical means, but also by gap junctional cell-to-cell communication. Using transgenic rats that express green fluorescent protein (GFP) specifically in FS cells in the anterior pituitary gland (S100b-GFP rats), we recently revealed that FS cells in primary culture markedly change their shape, and form numerous interconnections with neighboring FS cells in the presence of laminin, an extracellular matrix (ECM) component of the basement membrane. Morphological and functional changes in cells are believed to be partly modified by matricrine signaling, by which ECM components function as cellular signals. In the present study, we examined whether gap junction formation between FS cells is affected by matricrine cues. A cell sorter was used to isolate FS cells from male S100b-GFP rat anterior pituitary for primary culture. We observed that mRNA and protein levels of connexin 43 in gap junction channels were clearly higher in the presence of laminin. In addition, we confirmed the formation of gap junctions between FS cells in primary culture by electron microscopy. Interestingly, we also observed that FS cells in the presence of laminin displayed well-developed rough endoplasmic reticulum and Golgi apparatus. Our findings suggest that, in anterior pituitary gland, FS cells may facilitate functional roles such as gap junctional cell-to-cell communication by matricrine signaling.

  9. Radius graft pedicled on the anterior interosseous artery for recurrent ulnar nonunion.

    PubMed

    Andro, C; Richou, J; Schiele, P; Hu, W; Le Nen, D

    2011-06-01

    Recurrent ulnar nonunion challenges the functional prognosis and raises major problems concerning the best therapeutic strategy to follow. The case of a female patient presenting recurrent nonunion of the ulnar diaphysis despite successive treatments is reported. The radius graft pedicled on the anterior interosseous artery from a retrograde approach obtained bone union in 3 months with no functional sequelae. For the first time, we propose a therapeutic alternative calling on a proximally pedicled anterior interosseous flap. This technique can be performed under locoregional anesthesia and does not sacrifice the main artery of the forearm. However, the size of the graft does not entirely compensate for segmentary bone loss. The radius graft pedicled on the anterior interosseus artery is an inventive technique that can solve the problem of difficult ulna nonunions without the disadvantages of vascularized fibula harvesting.

  10. Successful Coil Embolization for a "Three-Hump" Internal Carotid Artery Anterior Wall Aneurysm

    PubMed Central

    Fukushima, Y.; Miyasaka, Y.; Takagi, H.; Kurata, A.; Suzuki, S.; Fujii, K.

    2006-01-01

    Summary We describe an unusually shaped aneurysm arising from the anterior wall of the internal carotid artery (ICA) that was treated successfully with Guglielmi detachable coils (GDCs). A 38-year-old woman presented with sudden onset of headache and was transferred to our hospital. Computed tomography revealed thin subarachnoid hemorrhage in the basal cisterns. Three-dimensional rotational angiography clearly showed a "three-hump" anterior wall aneurysm of the ICA. The two distal humps of the aneurysm were successfully obliterated with GDCs, but the proximal hump was too small to treat by coil embolization. The patient was discharged without neurological deficit. Anterior wall (blisterlike) aneurysms of the ICA have a high risk of rupture due to fragility of the wall. These aneurysms are considered difficult to manage by traditional surgical approaches. Our experience suggests that endovascular GDC embolization is a good alternative treatment modality for patients with such an aneurysm. PMID:20569593

  11. Amelogenesis imperfecta and anterior open bite: Etiological, classification, clinical and management interrelationships

    PubMed Central

    Alachioti, Xanthippi Sofia; Dimopoulou, Eleni; Vlasakidou, Anatoli; Athanasiou, Athanasios E

    2014-01-01

    Although amelogenesis imperfecta is not a common dental pathological condition, its etiological, classification, clinical and management aspects have been addressed extensively in the scientific literature. Of special clinical consideration is the frequent co-existence of amelogenesis imperfecta with the anterior open bite. This paper provides an updated review on amelogenesis imperfecta as well as anterior open bite, in general, and documents the association of these two separate entities, in particular. Diagnosis and treatment of amelogenesis imperfecta patients presenting also with anterior open bite require a lengthy, comprehensive and multidisciplinary approach, which should aim to successfully address all dental, occlusal, developmental, skeletal and soft tissue problems associated with these two serious clinical conditions. PMID:24987656

  12. Anterior ilioinguinal incision for drainage of high-located perianal abscess.

    PubMed

    Peng, K-T; Hsieh, M-C; Hsu, W-H; Li, Y-Y; Yeh, C-H

    2013-08-01

    Most perianal abscesses originate from infected anal glands at the base of the anal crypts. Most abscesses below are usually drained through perianal incision and can be treated successfully. However, when perianal abscesses extend to the high intrapelvic cavity, it may be inadequate treatment through a single route incision through a perianal approach. The aim of this technical note is to show that combined anterior ilioinguinal and perianal incisions may provide optimal surgical field and multiple drainages. Here, we report a 56-year-old male patient with perianal-originating parapsoas abscesses. Residual abscess still remained after initial perianal incision and drainage after 1-month treatment. We presented combined anterior ilioinguinal and perianal incision technique methods for proper drainage in this complicated case. No recurrent or residual abscess remained after 2 weeks of operation. So, combined anterior ilioinguinal incision is feasible for high-located perianal abscess.

  13. Three-dimensional retraction of anterior teeth with orthodontic miniplates in patients with temporomandibular disorder.

    PubMed

    Nelson, Gerald; Ahn, Hyo-Won; Jeong, Sung-Hee; Kim, Jun-Shik; Kim, Seong-Hun; Chung, Kyu-Rhim

    2012-11-01

    Vertical dimension control is critical for adults with Class II high-angle malocclusions. If the patient has a temporomandibular disorder, this requirement is exacerbated. When extraction is planned, the treatment challenge is further increased. This article reports on a new biomechanical design (C-therapy) appropriate for anterior segment retraction with excellent control of the vertical dimension, even in a Class II high-angle patient with a temporomandibular disorder. Maximum retraction of the maxillary anterior segment can be achieved with a lingual retractor and a palatal miniplate without appliances on the maxillary posterior segments. Mandibular anterior vertical height was well controlled by a second miniplate in the mental region. This device also contributed to mandibular anchorage reinforcement. A patient with temporomandibular disorder symptoms treated with this approach is shown.

  14. Esthetic rehabilitation of crowded maxillary anterior teeth utilizing ceramic veneers: a case report

    PubMed Central

    Ulusoy, Kivanç Utku

    2009-01-01

    Introduction In attempting to provide a solution for cases that have been compromised by malpositioned anterior teeth, clinicians traditionally decide orthodontic approach. Nevertheless, in some cases changes in tooth morphology, tooth size, and shape is compulsory for optimal aesthetics. The advent in contemporary aesthetic materials and preparation techniques empowered the clinicians to deliver a promising result with minimal biologic cost. This article presents the clinical considerations that must be addressed when providing a prosthetic restoration for crowded teeth. Case presentation A 23 years old Turkish female patient who had malaligned anterior teeth was rehabilitated with ceramic veneers due to her rejection of orthodontic treatment. The paper describes ceramic veneers can be an alternative treatment to orthodontic therapy under variety of preparation forms when patient has anterior malalignment and rejects the orthodontic treatment. Conclusion The new smile line was satisfactory for the patient and the esthetics was considered as excellent. PMID:19830068

  15. Cervical vertebral fusion with anterior meningocele

    PubMed Central

    Chavredakis, Emmanuel; Carter, David; Bhojak, Manesh; Jenkinson, Michael D; Clark, Simon R

    2015-01-01

    We present the first described case of cervical vertebral fusion associated with anterior meningocele and syringomyelia. A 45-year-old woman presented with minor trauma, and plain cervical spine radiographs highlighted a congenital deformity of the cervical vertebral bodies. She had a normal neurological examination; however, further imaging revealed a meningocele and syringomyelia. This case highlights the importance of thorough imaging investigation when presented with a congenital deformity in order to detect and prevent development of degenerative spinal cord pathologies. PMID:25923673

  16. Symptomatic anterior subtalar arthrosis after ankle arthrodesis.

    PubMed

    Lui, Tun Hing

    2014-05-13

    A 76-year-old man reported right lateral heel pain 11 years after ankle arthrodesis. Clinically, there was tenderness in the right sinus tarsi and over the junction point between the talonavicular and calcaneocuboid joints. Radiographs showed that the joint spaces of the posterior subtalar joint and the talonavicular joint were preserved although there were osteophytes at both joints. Arthroscopic findings showed degeneration of the anterior subtalar and talonavicular joints. The symptoms subsided after arthroscopic debridement.

  17. Endoscopic Anatomy and Features of Anterior Cervical Foraminotomy by Destandau Technique

    PubMed Central

    Mostofi, Keyvan; Khouzani, Reza Karimi

    2016-01-01

    BACKGROUND: Minimally invasive spine surgery limits surgical trauma and avoids traditional open surgery so in the majority of cases, recovery is much quicker and patients have less pain after surgery. AIM: The authors describe an endoscopic approach to anterior cervical foraminotomy (ACF) by Destandau’s method. MATERIAL AND METHODS: Anterior cervical foraminotomy by Destandau’s method is carried out under general anaesthesia. A 3 cm transverse skin incision is used just slightly past the anterior border of the sternocleidomastoid’s muscle laterally. After exposing and dissecting superficial cervical fascia, platysma muscle, and deep cervical fascia, Endospine material designed by Destandau will be inserted. As from this moment, the procedure will continue using endoscopy. RESULTS: the Endoscopic approach to anterior cervical foraminotomy by Destandau’s method offers a convenient access to the cervical foraminal stenosis with fewer complications and negligible morbidity and gives maximum exposure to discal space with the goal of minimising cutaneous incision. CONCLUSION: Contrary to the other minimally invasive approaches, the visual field in foraminotomy by Destandau technique is broad and depending on the workability of Endospine an adequate access to cervical disc is possible. PMID:28028407

  18. The thoracic anterior spinal cord adhesion syndrome

    PubMed Central

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

    2012-01-01

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

  19. Feasibility of obtaining in situ nanocapsules through modified self-microemulsifying drug delivery systems. A new manufacturing approach for oral route administration.

    PubMed

    Llera-Rojas, Viridiana Gisela; Del Real L, Alicia; Mendoza-Muñoz, Néstor; Melgoza-Contreras, Luz María; Quintanar-Guerrero, David

    2017-06-01

    Nanocapsules (NCs) are submicron-sized core shell systems which present important advantages such as improvement of drug efficacy and bioavailability, prevention of drug degradation, and provision of controlled-release delivery. The available methods for NC production require expensive recovery and purification steps which compromised the morphology of NCs. Industrial applications of NCs have been avoided due to the aforementioned issues. In this study, we developed a new method based on a modified self-microemulsifying drug delivery system (SMEDDS) for in situ NCs production within the gastrointestinal tract. This new methodology does not require purification and recovery steps and can preserve the morphology and the functionality of NCs. The in situ formed NCs of Eudragit(®) RL PO were compared with nanospheres (NEs) in order to obtain evidence of their core-shell structure. NCs presented a spherical morphology with a size of 126.2 ± 13.1 nm, an ibuprofen encapsulation efficiency of 31.3% and a zeta-potential of 37.4 mV. Additionally, NC density and release profile (zero order) showed physical evidence of the feasibility of NCs in situ creation.

  20. AChE Inhibition-based Multi-target-directed Ligands, a Novel Pharmacological Approach for the Symptomatic and Disease-modifying Therapy of Alzheimer's Disease

    PubMed Central

    Wang, Yu; Wang, Hao; Chen, Hong-zhuan

    2016-01-01

    Alzheimer's disease (AD) is the most common form of dementia in elder people, characterised by a progressive decline in memory as a result of an impairment of cholinergic neurotransmission. To date acetylcholinesterase inhibitors (AChEIs) have become the most prescribed drugs for the symptomatic treatment of mild to moderate AD. However, the traditional “one molecule-one target” paradigm is not sufficient and appropriate to yield the desired therapeutic efficacy since multiple factors, such as amyloid-β (Aβ) deposits, neuroinflammation, oxidative stress, and decreased levels of acetylcholine (ACh) have been thought to play significant roles in the AD pathogenesis. New generation of multi-target drugs is earnestly demanded not only for ameliorating symptoms but also for modifying the disease. Herein, we delineated the catalytic and non-catalytic functions of AChE, and summarized the works of our group and others in research and development of novel AChEI-based multi-target-directed ligands (MTDLs), such as dual binding site AChEIs and multi-target AChEIs inhibiting Aβ aggregation, regulating Aβ procession, antagonizing platelet-activating factor (PAF) receptor, scavenging oxygen radical, chelating metal ions, inhibiting monoamine oxidase B (MAO-B), blocking N-methyl-D-aspartic acid (NMDA) receptor and others. PMID:26786145

  1. A novel approach for preparation of modified-biochar derived from marine macroalgae: Dual purpose electro-modification for improvement of surface area and metal impregnation.

    PubMed

    Jung, Kyung-Won; Hwang, Min-Jin; Jeong, Tae-Un; Ahn, Kyu-Hong

    2015-09-01

    In the present study, an aluminum electrode-based electrochemical process was newly adopted as a modification method for fabricating physically and chemically modified biochar derived from marine macroalgae. Specifically, a current density of 93.96 mA cm(-2) was applied for 5 min at pH 3.0. Subsequently, the mixture was stirred continuously for 30 min without electric field, and the dried sample was then pyrolyzed at 450 °C under a N2 environment for 2 h. SEM-EDS and XRD analyses clearly indicated that nano-sized aluminum crystals (beohemite, AlOOH) were uniformly present on the EM-biochar surface. Adsorption equilibrium tests showed that the phosphate adsorption onto EM-biochar agreed well with the Langmuir-Freundlich adsorption isotherm model, with a maximum adsorption capacity of 31.28 mg-P g(-1). These findings suggest that this novel and simple electro-modification method is a reasonable and effective option for simultaneously upgrading both the surface area and chemical properties of biochar.

  2. Evaluation of Different Wastewater Treatment Processes and Development of a Modified Attached Growth Bioreactor as a Decentralized Approach for Small Communities

    PubMed Central

    Valipour, Alireza; Sithebe, Thami

    2013-01-01

    This study was undertaken to evaluate the potential future use of three biological processes in order to designate the most desired solution for on-site treatment of wastewater from residential complexes, that is, conventional activated sludge process (CASP), moving-bed biofilm reactor (MBBR), and packed-bed biofilm reactor (PBBR). Hydraulic retention time (HRT) of 6, 3, and 2 h can be achieved in CASP, MBBR, and PBBR, respectively. The PBBR dealt with a particular arrangement to prevent the restriction of oxygen transfer efficiency into the thick biofilms. The laboratory scale result revealed that the overall reduction of 87% COD, 92% BOD5, 82% TSS, 79% NH3-N, 43% PO4-P, 95% MPN, and 97% TVC at a HRT of 2 h was achieved in PBBR. The microflora present in the system was also estimated through the isolation, identification, and immobilization of the microorganisms with an index of COD elimination. The number of bacterial species examined on the nutrient agar medium was 22 and five bacterial species were documented to degrade the organic pollutants by reducing COD by more than 43%. This study illustrated that the present PBBR with a specific modified internal arrangement could be an ideal practice for promoting sustainable decentralization and therefore providing a low wastage sludge biomass concentration. PMID:24327802

  3. Evaluation of different wastewater treatment processes and development of a modified attached growth bioreactor as a decentralized approach for small communities.

    PubMed

    Azizi, Shohreh; Valipour, Alireza; Sithebe, Thami

    2013-01-01

    This study was undertaken to evaluate the potential future use of three biological processes in order to designate the most desired solution for on-site treatment of wastewater from residential complexes, that is, conventional activated sludge process (CASP), moving-bed biofilm reactor (MBBR), and packed-bed biofilm reactor (PBBR). Hydraulic retention time (HRT) of 6, 3, and 2 h can be achieved in CASP, MBBR, and PBBR, respectively. The PBBR dealt with a particular arrangement to prevent the restriction of oxygen transfer efficiency into the thick biofilms. The laboratory scale result revealed that the overall reduction of 87% COD, 92% BOD₅, 82% TSS, 79% NH₃-N, 43% PO₄-P, 95% MPN, and 97% TVC at a HRT of 2 h was achieved in PBBR. The microflora present in the system was also estimated through the isolation, identification, and immobilization of the microorganisms with an index of COD elimination. The number of bacterial species examined on the nutrient agar medium was 22 and five bacterial species were documented to degrade the organic pollutants by reducing COD by more than 43%. This study illustrated that the present PBBR with a specific modified internal arrangement could be an ideal practice for promoting sustainable decentralization and therefore providing a low wastage sludge biomass concentration.

  4. A hierarchical Bayesian approach to the modified Bartlett-Lewis rectangular pulse model for a joint estimation of model parameters across stations

    NASA Astrophysics Data System (ADS)

    Kim, Jang-Gyeong; Kwon, Hyun-Han; Kim, Dongkyun

    2017-01-01

    Poisson cluster stochastic rainfall generators (e.g., modified Bartlett-Lewis rectangular pulse, MBLRP) have been widely applied to generate synthetic sub-daily rainfall sequences. The MBLRP model reproduces the underlying distribution of the rainfall generating process. The existing optimization techniques are typically based on individual parameter estimates that treat each parameter as independent. However, parameter estimates sometimes compensate for the estimates of other parameters, which can cause high variability in the results if the covariance structure is not formally considered. Moreover, uncertainty associated with model parameters in the MBLRP rainfall generator is not usually addressed properly. Here, we develop a hierarchical Bayesian model (HBM)-based MBLRP model to jointly estimate parameters across weather stations and explicitly consider the covariance and uncertainty through a Bayesian framework. The model is tested using weather stations in South Korea. The HBM-based MBLRP model improves the identification of parameters with better reproduction of rainfall statistics at various temporal scales. Additionally, the spatial variability of the parameters across weather stations is substantially reduced compared to that of other methods.

  5. Using a Modified Intervention Mapping Approach to Develop and Refine a Single-Session Motivational Intervention for Methamphetamine-Using Men Who Have Sex With Men

    PubMed Central

    Zule, William A; Coomes, Curtis M; Karg, Rhonda; Harris, Jennie L; Orr, Alex; Wechsberg, Wendee M

    2010-01-01

    There is an ongoing need for the development and adaptation of behavioral interventions to address behaviors related to acquisition and transmission of infectious diseases and for preventing the onset of chronic diseases. This paper describes the application of an established systematic approach to the development of a behavioral intervention to reduce sexual risk behaviors for HIV among men who have sex with men and who use methamphetamine. The approach includes six steps: (1) a needs assessment; (2) preparing matrices of proximal program objectives; (3) selecting theory-based methods and practical strategies; (4) producing program components and materials; (5) planning for program adoption, implementation, and sustainability; and (6) planning for evaluation. The focus of this article is on the intervention development process; therefore the article does not describe steps 5 and 6. Overall the process worked well, although it had to be adapted to fit the sequence of events associated with a funded research project. This project demonstrates that systematic approaches to intervention development can be applied even in research projects where some of the steps occur during the proposal writing process rather than during the actual project. However, intervention developers must remain flexible and be prepared to adapt the process to the situation. This includes being ready to make choices regarding intervention efficacy versus feasibility and being willing to select the best intervention that is likely to be delivered with available resources rather than an ideal intervention that may not be practical. PMID:20657716

  6. A Rare Embryologic Variation: Anterior Communicating Artery Aneurysm Associated with Carotid—Anterior Cerebral Artery Anastomosis or Infraoptic Course of the Anterior Cerebral Artery

    PubMed Central

    Yurt, Alaattin; Uçar, Kubilay; Özer, Füsun; Oran, İsmail; Arda, Nuri

    2008-01-01

    Aneurysms of the complex of the anterior cerebral artery are frequently associated with anatomic variations of the circle of Willis. We describe a case of aneurysmal rupture of the anterior communicating artery, a variant of the anterior cerebral artery. The aneurysm appeared to be situated on this vessel proximal to the infered site of the AcoA. Surgery was performed at the 6th day after hemorrhage. The anterior communicating artery aneurysm was clipped. The post operative course was unventful, with complete recovery. In our case, an extremely rare variation of the proximal tract of the anterior cerebral artery, i.e. an infraoptic course of the proximal precommunicating tract under the optic nerve, with the distal A1 tract anterior to the chiasm and positioned between the optic nerves, is presented. PMID:24179361

  7. [Two cases of anterior cerebral artery aneurysm associated with accessory anterior cerebral artery: review of the literature and points of diagnosis].

    PubMed

    Maeda, Kazushi; Tanaka, Shunya; Hatae, Ryusuke; Maeda, Yoshihisa; Miyazono, Masayuki

    2014-05-01

    The accessory anterior cerebral artery (AccACA) is an anomalous vessel arising from the anterior communicating artery. Although AccACA is not particularly rare, aneurysms arising from the AccACA is extremely rare. Here, we report two cases of unruptured AccACA aneurysms. Patient 1 was a 58-year-old woman with an unruptured distal AccACA aneurysm. Magnetic resonance imaging and three-dimensional computed tomography angiography(3D-CTA)demonstrated a left middle cerebral artery aneurysm that was subsequently clipped successfully by direct surgery. No aneurysm was detected in the distal anterior cerebral artery(ACA)due to the narrow imaging range at that time. Postoperatively, an aneurysm of the distal ACA was incidentally identified on 3D-CTA. This AccACA aneurysm was also clipped by direct surgery about 5 months later, and the patient was discharged without any neurological deficits. Patient 2 was a 46-year-old woman with an aneurysm at the proximal portion of the AccACA. Since the aneurysm was small and patient was asymptomatic, the observation-approach was selected. In introducing these cases, we discuss AccACA aneurysms and the process of diagnosis. Aneurysm can arise over the entire length of the ACA, from the anterior communicating artery to the peripheral portion, particularly the supracallosal portion, so observation and imaging of the peripheral region is important in cases where an AccACA is present.

  8. Pseudophakic flat anterior chamber following retinal detachment repair.

    PubMed

    Taylor, B C; Winslow, R L

    1981-09-01

    Flat anterior chambers were caused by varying mechanisms in 10 of 70 consecutive pseudophakic eyes operated on for retinal detachment. With iris or capsular implant fixation, three of 46 (7%) developed flat anterior chambers, and with anterior chamber lenses, the occurrence was seven of 24 (29%). Events initiating flat chambers included wound leak, pupillary block, and choroidal detachment. In eyes with flat anterior chambers, the retina could not be reattached in one case, extensive peripheral anterior synechia with persistent intraocular pressure elevation occurred in another case, and bullous keratopathy remained in two additional instances. Endothelial cell densities were obtained in eight eyes and were low on an age-related basis.

  9. Efficient approach to improving the flame retardancy of poly(vinyl alcohol)/clay aerogels: incorporating piperazine-modified ammonium polyphosphate.

    PubMed

    Wang, Yu-Tao; Liao, Shi-Fu; Shang, Ke; Chen, Ming-Jun; Huang, Jian-Qian; Wang, Yu-Zhong; Schiraldi, David A

    2015-01-28

    Ammonium polyphosphates (APP) modified with piperazine (PA-APP) was used to improve the flame retardancy of poly(vinyl alcohol) (PVA)/montmorillonite (MMT) aerogels, which were prepared via an environmentally friendly freeze-drying method. The thermal stabilities of the samples were evaluated by thermogravimetric analysis (TG); the flammability behaviors of samples were investigated by limiting oxygen index (LOI), vertical burning test (UL-94) and cone calorimeter (CC) tests. TG test results showed that the 5% weight loss temperature (T5%) of PVA/MMT/PA-APP was 10 °C higher than that of PVA/MMT/APP. In combustion testing, all of PVA/MMT/PA-APP aerogels achieved V-0 ratings and have a higher LOI values than the unmodified PVA/MMT aerogel. Moreover, the aerogel with 1% PA-APP5, which means that the content of piperazine is 5% in PA-APP, decreased the cone calorimetry THR value to 5.71 MJ/m(2), and increased the char residue to 52%. The compressive modulus of PVA/MMT/PA-APP was increased by 93.4% compared with PVA/MMT/APP because of the increase in interfacial adhesion between matrix and PA-APP fillers. The densities of the PVA/MMT/PA-APP samples were slightly lower than those of the unmodified aerogels because of reduced shrinkage in the presence of PA-APP. All the tests results indicated that the incorporation of PA-APP not only improved the thermal stability and flame retardancy of aerogels but also maintained their mechanical properties.

  10. Synchronous anterior celiotomy and posterior drainage of pancreatic abscess.

    PubMed

    Berne, T V; Donovan, A J

    1981-05-01

    Pancreatic abscess has been characterized by a high rate of reoperation for persistent sepsis and by a high mortality. Nine patients with pancreatic abscess have undergone synchronous anterior celiotomy and posterior drainage following resection of the 12th rib. Pancreatic abscess was secondary to acute pancreatitis in seven of the cases. In two cases, the combined procedure was a secondary operation to treat abscess that developed following surgery for pancreatic trauma. All of these nine patients survived. One patient required reoperation for drainage of a left retrocolic abscess. A synchronous approach permits adequate exploration of the abdomen, provides the exposure necessary to remove necrotic tissue, and allows dependent drainage of the left subphrenic space without fear of splenic, pancreatic, or vascular injury.

  11. Traumatic sinolacrimocutaneous fistula managed with endonasal dacryocystorhinostomy and anterior ethmoidectomy.

    PubMed

    Shams, Pari N; Selva, Dinesh

    2012-10-01

    A 31-year-old man with epiphora and mucous discharge from a traumatic lacrimal fistula underwent a computed tomographic dacryocystogram, revealing a fistula extending from the anterior ethmoid air cells through the lacrimal sac to the overlying skin with coexisting nasolacrimal duct obstruction. Endoscopic dacryocystorhinostomy enabled complete marsupialization of the lacrimal sac and agger nasi air cell, removing the tract between these structures. Simultaneous probing of the common canaliculus and fistula tract under direct visualization allowed the identification of the internal fistula origin in relation to the internal ostium on the lateral sac wall. The fistula was excised with a trephine over a guide wire via an external approach. Use of the endoscopic technique for excision of acquired lacrimal fistulas may be especially helpful in cases with coexisting nasolacrimal duct obstruction where the fistula extends to the sinus cavity or suspected foreign bodies.

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

    PubMed

    Range, Ryan C; Wei, Zheng

    2016-05-01

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

  13. Integrated Anterior, Central, and Posterior Skull Base Unit – A New Perspective

    PubMed Central

    Brand, Yves; Waran, Vicknes; Zulkiflee, Abu Bakar; Lim, Elizabeth; Prepageran, Narayanan

    2015-01-01

    The skull base is one of the most complex anatomical regions and forms the floor of the cranial cavity. Skull base surgery involves open, microscopic, and endoscopic approaches to the anterior, middle, or posterior cranial fossa. A multispecialty team approach is essential in treating patients with skull base lesions. Traditionally, rhinologists are involved in providing access to anterior skull base lesions while otologists are involved in the treatment of lesions of the posterior skull base. This is the case in most skull base centers today. In this article, we share a new perspective of an integrated skull base unit where a team of otolaryngologists and neurosurgeons treat anterior, middle, and posterior skull base pathologies. The rationale for this approach is that most technical skills required in skull base surgery are interchangeable and apply whether an endoscopic or microscopic approach is used. We show how the different skills apply to the different approaches and share our experience with an integrated skull base unit. PMID:26258128

  14. Gross, Arthroscopic, and Radiographic Anatomies of the Anterior Cruciate Ligament: Foundations for Anterior Cruciate Ligament Surgery.

    PubMed

    Irarrázaval, Sebastián; Albers, Marcio; Chao, Tom; Fu, Freddie H

    2017-01-01

    The anterior cruciate ligament (ACL) is one of the more studied structures in the knee joint. It is not a tubular structure, but is much narrower in its midsubstance and broader at its ends, producing an hourglass shape. The ACL is composed of 2 functional bundles, the anteromedial and posterolateral bundles, that are named for their location of insertion on the anterior surface of the tibial plateau. Although the relative contribution in terms of total cross-sectional area of the ACL has been noted to be equal in regards to each bundle, dynamically these bundles demonstrate different properties for knee function.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  17. Anterior-to-Posterior Migration of a Lumbar Disc Sequestration: Surgical Remarks and Technical Notes about a Tailored Microsurgical Discectomy

    PubMed Central

    Frati, Alessandro; Palmieri, Mauro; Vangelista, Tommaso; Caruso, Riccardo; Salvati, Maurizio; Raco, Antonino

    2017-01-01

    Extrusion of disc material within the spinal canal complicates up to 28.6% of lumbar disc herniations. Due to the anatomical “corridors” created by the anterior midline septum and lateral membranes, relocation occurs with an anterior and anterolateral axial topography. Posterior migration is an extremely rare condition and anterior-to-posterior circumferential migration is an even rarer condition. Its radiological feature can be enigmatic and since, in more than 50% of cases, clinical onset is a hyperacute cauda equina syndrome, it may imply a difficult surgical decision in emergency settings. Surgery is the gold standard but when dealing with such huge sequestrations, standard microdiscectomy must be properly modified in order to minimize the risk of surgical trauma or traction on the nerve roots. PMID:28163949

  18. A methodological approach to the application of a vermiculite modified carbon paste electrode in interaction studies: Influence of some pesticides on the uptake of Cu(II) from a solution to the solid phase.

    PubMed

    Svegl, I G; Ogorevc, B; Hudnik, V

    1996-03-01

    A new methodological approach, for studying metal ion binding interactions with a clay mineral is presented. A carbon paste electrode (CPE) modified with vermiculite clay mineral was used as a model for a soil-like solid phase and Cu(II) ions were chosen as the test ions. The application of this model is demonstrated and explained by investigating the influence of seven pesticides (bromofenoxim, fenamiphos, phenmedipham, atrazine and its three natural degradation products) on the uptake of Cu(II) ions from a solution to the vermiculite, included in a CPE. Different conditions (pH, concentration, exposure time etc.) were considered and the amount of bound copper, accumulated when no potential was applied, was then determined by stripping voltammetry.

  19. The Avoidance of Microsurgical Complications in the Extradural Anterior Clinoidectomy to Paraclinoid Aneurysms

    PubMed Central

    Son, Hee Eon; Park, Moon Sun; Kim, Seong Min; Jung, Sung Sam; Park, Ki Seok

    2010-01-01

    Objective Paraclinoid segment internal carotid artery (ICA) aneurysms have historically been a technical challenge for neurovascular surgeons. The development of microsurgical approach, advances in surgical techniques, and endovascular procedures have improved the outcome for paraclinoid aneurysms. However, many authors have reported high complication rates from microsurgical treatments. Therefore, the present study reviews the microsurgical complications of the extradural anterior clinoidectomy for treating paraclinoid aneurysms and investigates the prevention and management of observed complications. Methods Between January 2004 and April 2008, 22 patients with 24 paraclinoid aneurysms underwent microsurgical direct clipping by a cerebrovascular team at a regional neurosurgical center. Microsurgery was performed via an ipsilateral pterional approach with extradural anterior clinoidectomy. We retrospectively reviewed patients' medical charts, office records, radiographic studies, and operative records. Results In our series, the clinical outcomes after an ipsilateral pterional approach with extradural anterior clinoidectomy for paraclinoid aneurysms were excellent or good (Glasgows Outcome Scale : GOS 5 or 4) in 87.5% of cases. The microsurgical complications related directly to the extradural anterior clinoidectomy included transient cranial nerve palsy (6), cerebrospinal fluid leak (1), worsened change in vision (1), unplanned ICA occlusion (1), and epidural hematoma (1). Only one of the complications resulted in permanent morbidity (4.2%), and none resulted in death. Conclusion Although surgical complications are still reported to occur more frequently for the treatment of paraclinoid aneurysms, the permanent morbidity and mortality resulting from a extradural anterior clinoidectomy in our series were lower than previously reported. Precise anatomical knowledge combined with several microsurgical tactics can help to achieve good outcomes with minimal

  20. Risk Factors for Anterior Cruciate Ligament Injury

    PubMed Central

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

    2012-01-01

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

  1. Anatomical variations and morphometric study of the optic strut and the anterior clinoid process

    PubMed Central

    Kapur, Eldan; Mehić, Amina

    2012-01-01

    The optic strut and the anterior clinoid process represent bony structures that are closely related to anatomically and clinically significant elements such as the cavernous sinus, the internal carotid artery, the optic nerve and the pituitary gland. The objective of our study was to quantify dimensions of the optic strut and anterior clinoid process, and to determine variations in positions and forms of these structures. A descriptive anatomical study was performed on 200 dry human skulls. We analyzed dimensions and variations in position of the optic strut, dimensions of the anterior clinoid process as well as the incidence and forms of the caroticoclinoid foramen. The average thickness of the optic strut on skulls belonging to males was 3 mm and 2.8 mm on those belonging to females. The optic strut was most commonly attached to the anterior two fifths on the lower side of the anterior clinoid process. On the male skulls the average width of the anterior clinoid process was 9.4 mm (right) and 9.1 mm (left). Its length was 9.9 and 9.3 mm. On female skulls the average width of the process was 8.7 mm (right) and 8.3 mm (left), while the length measured 9.3 mm on the right and 8.9 mm on the opposite side. In our sample, a complete caroticoclinoid foramen appeared in 4.25%, a contact form in 2.75%. At last, an incomplete form of the foramen was observed in 9.75%. The anatomic variations of the investigated structures must be considered during the approaches to the cavernous sinus and neurovascular elements of the sellar region. PMID:22642592

  2. Anatomical variations and morphometric study of the optic strut and the anterior clinoid process.

    PubMed

    Kapur, Eldan; Mehić, Amina

    2012-05-01

    The optic strut and the anterior clinoid process represent bony structures that are closely related to anatomically and clinically significant elements such as the cavernous sinus, the internal carotid artery, the optic nerve and the pituitary gland. The objective of our study was to quantify dimensions of the optic strut and anterior clinoid process, and to determine variations in positions and forms of these structures. A descriptive anatomical study was performed on 200 dry human skulls. We analyzed dimensions and variations in position of the optic strut, dimensions of the anterior clinoid process as well as the incidence and forms of the caroticoclinoid foramen. The average thickness of the optic strut on skulls belonging to males was 3 mm and 2.8 mm on those belonging to females. The optic strut was most commonly attached to the anterior two fifths on the lower side of the anterior clinoid process. On the male skulls the average width of the anterior clinoid process was 9.4 mm (right) and 9.1 mm (left). Its length was 9.9 and 9.3 mm. On female skulls the average width of the process was 8.7 mm (right) and 8.3 mm (left), while the length measured 9.3 mm on the right and 8.9 mm on the opposite side. In our sample, a complete caroticoclinoid foramen appeared in 4.25%, a contact form in 2.75%. At last, an incomplete form of the foramen was observed in 9.75%. The anatomic variations of the investigated structures must be considered during the approaches to the cavernous sinus and neurovascular elements of the sellar region.

  3. Quality-of-Life after Anterior Skull Base Surgery: A Systematic Review

    PubMed Central

    Kirkman, Matthew A.; Borg, Anouk; Al-Mousa, Alaa; Haliasos, Nikolaos; Choi, David

    2013-01-01

    Background Improved treatment and survival of patients with skull base tumors has made the assessment of quality-of-life (QoL) in this population increasingly important. This article provides a comprehensive systematic review pertaining to QoL assessment in adults undergoing anterior skull base surgery. Methods We performed a literature search using the electronic databases of Ovid Medline and Embase. Additional articles were identified through a search using the phrase anterior skull base. Further articles were sought through hand-searching relevant journals and reference lists of identified articles. Results Our search strategy identified 29 articles for inclusion in our systematic review, with considerable variation between studies in population characteristics, methodological design and quality, follow-up length, and outcome assessment. The most commonly used QoL tools were the Karnofsky Performance Status and the Anterior Skull Base Questionnaire. QoL following anterior skull base surgery appears to improve beyond preoperative levels in the months after surgery. For patients undergoing endoscopic skull base surgery, the gain in QoL appears to be greater and may manifest earlier, with no clear long-term deleterious effect on sinonasal outcomes compared with open surgery. Conclusions QoL after anterior skull base surgery in adults appears to improve within several months of surgery, but earlier and to a larger extent if the endoscopic approach is used. Given the relative paucity and heterogeneity of anterior skull base tumors, large-scale prospective multicentre studies utilizing valid and reliable multidimensional QoL tools are required. This may result in improved patient care, by understanding patients' needs better and facilitating the provision of reliable outcome data for clinical trials. PMID:24719794

  4. Psychosocial Effects of Fractured Anterior Teeth among Rural Children

    PubMed Central

    Naveen, Mohan; Teja, Ravi; Paulindraraj, Shankar; Vallabhaneni, Sai K; Arumugam, Selva B

    2016-01-01

    ABSTRACT Aim: The aim of the study is to determine how rural children view children with visible incisor fracture. Materials and methods: Class 7 (aged 11-12 years) and class 10 (aged 14-15 years) schoolchildren (the participants) were invited to make a social judgment about the color photograph of two children (the subjects). Participants were randomly allocated either (i) pictures of children without incisor fracture or (ii) pictures of the same children whose photographs had been digitally modified to visible incisor fracture. Using a child-centered questionnaire, participants rated subjects using a four-point Likert scale for three negative and six positive attributes. Total attribute scores were tested for significant differences, according to whether the subject had visible incisor fracture or not, using multivariate analysis of variance (p < 0.05). Results: Both class 7 and 10 children rated subjects with visible incisor fracture more negatively than the subjects without incisor fracture. Female participants of class 10 have rated the male subject with incisor fracture significantly negatively (p < 0.01) than male subject without incisor fracture. How to cite this article: Venkatesan R, Naveen M, Teja R, Paulindraraj S, Vallabhaneni SK, Arumugam SB. Psychosocial Effects of Fractured Anterior Teeth among Rural Children. Int J Clin Pediatr Dent 2016;9(2):128-130. PMID:27365933

  5. A portable microkeratome for harvesting the human anterior corneal surface.

    PubMed

    Sarayba, Melvin A; Tungsiripat, Tulaya; Sweet, Paula M; Chuck, Roy S

    2004-07-01

    A portable, gas-driven turbine microkeratome device capable of harvesting the entire anterior corneal surface for lamellar transplantation on human donor globes was evaluated. The device consisted of a modified LASIK microkeratome with an enlarged suction ring, head, and blade. Vacuum was achieved by a simple hand pump. Lamellar keratectomy was performed on 5 fresh human donor globes. Lenticule dimensions were measured on days 0, 3, 6, and 9 after storage in preservation media at 4 degrees C. On day 0, the obtained lenticules were 13.9 +/- 0.9 mm and 13.5 +/- 0.4 mm, vertical and horizontal diameters, respectively. The average central lenticule thickness was 152.2 +/- 52 microm. Each lenticule was uniform in thickness over 5 measurement points (P = 0.74). Repeat measurements of corneal thickness over the 9 days showed no statistically significant difference (P = 0.51). On day 9 lenticules were 14.6 +/- 0.3 mm and 14.6 +/- 0.4 mm, vertical and horizontal diameters, respectively. When day 0 was compared to day 9, vertical diameter also showed no statistically significant difference (P = 0.16), whereas horizontal diameter was significantly different (P < 0.001). This device proves to be an economical alternative to electric-powered systems for the harvest of transplantable corneal sections.

  6. Regression of anterior disc-osteophyte complex following cervical laminectomy and fusion for cervical spondylotic myelopathy

    PubMed Central

    Ashana, Adedayo O.; Cohen, Jeremiah R.; Evans, Brandon; Holly, Langston T.

    2014-01-01

    Study Design Retrospective case control study Objective To investigate whether posterior cervical laminectomy and fusion modifies the natural course of anterior disc-osteophyte complex in patients with multilevel CSM Summary of Background Data Dorsal migration of the spinal cord is the main purported mechanism of spinal cord decompression following cervical laminectomy and fusion but other potential mechanisms have received scant attention in the literature. This study was conducted to investigate whether cervical laminectomy and fusion affects the size of anterior disc osteophyte complex. Methods The medical records and radiographical imaging of 44 patients that underwent cervical laminectomy and fusion for CSM between 2006 and 2013 were analyzed. The size of the anterior disc osteophyte complex was measured pre and postoperatively on MR images taken at an interval of > 3 months apart. A control group consisted of 20 non-operatively treated advanced cervical spondylosis patients. Patients in the control met the same inclusion and exclusion criteria and also had sequential MRI taken at an interval of > 3 months apart. Results The nonoperative and operative groups were statistically similar in the pertinent patient demographics and characteristics including gender, age, time to second MRI, size of anterior disc-osteophyte complex on baseline MRI, mean number of levels affected, and percentage of patients with T2 signal change. As expected the mJOA scores were significantly lower in the operative versus nonoperative cohort (13.6 vs. 16.5, P<0.01). A significant decrease in the size of anterior disc osteophyte was observed in the operative group postoperatively (P<0.01). In comparison, there was no statistically significant change in the size of the anterior disc osteophyte complex in the control group (P > 0.05). The magnitude of the change in disc size between the two groups was statistically significant (P <0.01). Conclusion The findings of this study suggest that

  7. Anterior segment spectral domain optical coherence tomography imaging of patients with anterior scleritis.

    PubMed

    Levison, Ashleigh L; Lowder, Careen Y; Baynes, Kimberly M; Kaiser, Peter K; Srivastava, Sunil K

    2016-08-01

    The purpose of the study was to describe the findings seen on anterior segment spectral domain optical coherence tomography (SD-OCT) in patients with anterior scleritis and determine the feasibility of using SD-OCT to image and grade the degree of scleral inflammation and monitor response to treatment. All patients underwent slit lamp examination by a uveitis specialist, and the degree of scleral inflammation was recorded. Spectral domain OCT imaging was then performed of the conjunctiva and scleral tissue using a standardized acquisition protocol. The scans were graded and compared to clinical findings. Twenty-eight patients with anterior scleritis and ten patients without ocular disease were included in the study. Seventeen of the scleritis patients were followed longitudinally. Common findings on SD-OCT in patients with active scleritis included changes in hyporeflectivity within the sclera, nodules, and visible vessels within the sclera. There was significant variation in findings on SD-OCT within each clinical grade of active scleritis. These changes on SD-OCT improved with treatment and clinical improvement. SD-OCT imaging provided various objective measures that could be used in the future to grade inflammatory activity in patients with anterior scleritis. Longitudinal imaging of patients with active scleritis demonstrated that SD-OCT may have great utility in monitoring response to treatment.

  8. Rostral anterior cingulate activity generates posterior versus anterior theta activity linked to agentic extraversion.

    PubMed

    Chavanon, Mira-Lynn; Wacker, Jan; Stemmler, Gerhard

    2011-06-01

    Recent research using the resting electroencephalogram (EEG) showed that posterior versus anterior theta activity (around 4-8 Hz) is consistently associated with agency, reflecting the dopaminergic core of extraversion (i.e., incentive motivation, positive emotion). Neuroimaging studies using various methodologies and experimental paradigms have converged on the anterior cingulate cortex (ACC) as a neurophysiological correlate of extraversion. The aim of the present study is integrate these lines of research by testing the hypothesis that posterior versus anterior EEG theta is at least partly based on ACC theta activity. Resting EEG data were analyzed in N = 78 healthy, male participants extremely high or low in agentic extraversion (aE). Using the low-resolution electromagnetic tomography algorithm, we localized the sources of aE-dependent intracerebral theta activity within rostral subdivisions of the ACC. The posterior versus anterior index and theta current density within the rostral ACC were significantly correlated (r = -.52), and both displayed high retest stability across 5 hr and were associated with traits from the aE spectrum. These neurophysiological correlates of aE and their possible functional significance are discussed.