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Sample records for pelvic floor descent

  1. MR Imaging in Diagnosis of Pelvic Floor Descent: Supine versus Sitting Position

    PubMed Central

    Renzi, Adolfo; Monaco, Luigi; Serra, Nicola; Feragalli, Beatrice; Iacomino, Aniello; Brunese, Luca; Cappabianca, Salvatore

    2016-01-01

    Introduction. Functional disorders of the pelvic floor represent have a significant impact on the quality of life. The advent of open-configuration systems allowed for the evaluation of defecation with MR imaging in sitting position. The purpose of the present study is to compare the results of static and dynamic pelvic MR performed in supine position versus sitting position, using a new MR prototype machine, in the diagnosis of pelvic floor descent. Materials and Methods. Thirty-one patients with pelvic floor disorders were enrolled, and underwent MR Defecography in supine position with 1.5 T closed magnet (MAGNETOM Symphony, Siemens, Germany) and in sitting position with a 0.25-Tesla open magnet system (G-Scan ESAOTE, Italy). Results. In rest and squeezing phases, positions of bladder, vagina, and ARJ were significantly different when the patient was imaged in supine versus sitting position. In the defecation phase, a significant difference for the bladder and vagina position was detected between the two exams whereas a significant difference for the ARJ was not found. A statistically significant difference exists when the pelvic floor descent is evaluated in sitting versus supine position. Conclusion. Our results show that MR Defecography in sitting position may represent a useful tool to correctly diagnose and grade the pelvic organ descent. PMID:26880893

  2. MR Imaging in Diagnosis of Pelvic Floor Descent: Supine versus Sitting Position.

    PubMed

    Iacobellis, Francesca; Brillantino, Antonio; Renzi, Adolfo; Monaco, Luigi; Serra, Nicola; Feragalli, Beatrice; Iacomino, Aniello; Brunese, Luca; Cappabianca, Salvatore

    2016-01-01

    Introduction. Functional disorders of the pelvic floor represent have a significant impact on the quality of life. The advent of open-configuration systems allowed for the evaluation of defecation with MR imaging in sitting position. The purpose of the present study is to compare the results of static and dynamic pelvic MR performed in supine position versus sitting position, using a new MR prototype machine, in the diagnosis of pelvic floor descent. Materials and Methods. Thirty-one patients with pelvic floor disorders were enrolled, and underwent MR Defecography in supine position with 1.5 T closed magnet (MAGNETOM Symphony, Siemens, Germany) and in sitting position with a 0.25-Tesla open magnet system (G-Scan ESAOTE, Italy). Results. In rest and squeezing phases, positions of bladder, vagina, and ARJ were significantly different when the patient was imaged in supine versus sitting position. In the defecation phase, a significant difference for the bladder and vagina position was detected between the two exams whereas a significant difference for the ARJ was not found. A statistically significant difference exists when the pelvic floor descent is evaluated in sitting versus supine position. Conclusion. Our results show that MR Defecography in sitting position may represent a useful tool to correctly diagnose and grade the pelvic organ descent.

  3. Chronic pelvic floor dysfunction.

    PubMed

    Hartmann, Dee; Sarton, Julie

    2014-10-01

    The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management.

  4. [Pelvic floor muscle training and pelvic floor disorders in women].

    PubMed

    Thubert, T; Bakker, E; Fritel, X

    2015-05-01

    Our goal is to provide an update on the results of pelvic floor rehabilitation in the treatment of urinary incontinence and genital prolapse symptoms. Pelvic floor muscle training allows a reduction of urinary incontinence symptoms. Pelvic floor muscle contractions supervised by a healthcare professional allow cure in half cases of stress urinary incontinence. Viewing this contraction through biofeedback improves outcomes, but this effect could also be due by a more intensive and prolonged program with the physiotherapist. The place of electrostimulation remains unclear. The results obtained with vaginal cones are similar to pelvic floor muscle training with or without biofeedback or electrostimulation. It is not known whether pelvic floor muscle training has an effect after one year. In case of stress urinary incontinence, supervised pelvic floor muscle training avoids surgery in half of the cases at 1-year follow-up. Pelvic floor muscle training is the first-line treatment of post-partum urinary incontinence. Its preventive effect is uncertain. Pelvic floor muscle training may reduce the symptoms associated with genital prolapse. In conclusion, pelvic floor rehabilitation supervised by a physiotherapist is an effective short-term treatment to reduce the symptoms of urinary incontinence or pelvic organ prolapse.

  5. Pelvic floor muscle training exercises

    MedlinePlus

    Kegel exercises ... Pelvic floor muscle training exercises are recommended for: Women with urinary stress incontinence Men with urinary stress incontinence after prostate surgery People who have fecal ...

  6. Functional anatomy of pelvic floor.

    PubMed

    Rocca Rossetti, Salvatore

    2016-03-31

    Generally, descriptions of the pelvic floor are discordant, since its complex structures and the complexity of pathological disorders of such structures; commonly the descriptions are sectorial, concerning muscles, fascial developments, ligaments and so on. On the contrary to understand completely nature and function of the pelvic floor it is necessary to study it in the most unitary view and in the most global aspect, considering embriology, philogenesy, anthropologic development and its multiple activities others than urological, gynaecological and intestinal ones. Recent acquirements succeeded in clarifying many aspects of pelvic floor activity, whose musculature has been investigated through electromyography, sonography, magnetic resonance, histology, histochemistry, molecular research. Utilizing recent research concerning not only urinary and gynecologic aspects but also those regarding statics and dynamics of pelvis and its floor, it is now possible to study this important body part as a unit; that means to consider it in the whole body economy to which maintaining upright position, walking and behavior or physical conduct do not share less than urinary, genital, and intestinal functions. It is today possible to consider the pelvic floor as a musclefascial unit with synergic and antagonistic activity of muscular bundles, among them more or less interlaced, with multiple functions and not only the function of pelvic cup closure.

  7. [Functional aspects of pelvic floor surgery].

    PubMed

    Wagenlehner, F M E; Gunnemann, A; Liedl, B; Weidner, W

    2009-11-01

    Pelvic floor dysfunctions are frequently seen in females. The human pelvic floor is a complex structure and heavily stressed throughout female life. Recent findings in the functional anatomy of the pelvic floor have led to a much better understand-ing, on the basis of which enormous improvements in the therapeutic options have arisen. The pelvic floor activity is regulated by three main muscular forces that are responsible for vaginal tension and suspension of the pelvic floor -organs, bladder and rectum. For different reasons laxity in the vagina or its supporting ligaments as a result of altered connective tissue can distort this functional anatomy. A variety of symptoms can derive from these pelvic floor dysfunctions, such as urinary urge and stress incontinence, abnormal bladder emptying, faecal incontinence, obstructive bowel disease syndrome and pelvic pain. Pelvic floor reconstruction is nowadays driven by the concept that in the case of pelvic floor symptoms restoration of the anatomy will translate into restoration of the physiology and ultimately improve the patients' symptoms. The exact surgical reconstruction of the anatomy is there-fore almost exclusively focused on the restoration of the lax pelvic floor ligaments. An exact identification of the anatomic lesions preoperatively is eminently necessary, to allow for an exact anatomic reconstruction with respect to the muscular forces of the pelvic floor.

  8. Pelvic floor muscle rehabilitation using biofeedback.

    PubMed

    Newman, Diane K

    2014-01-01

    Pelvic floor muscle exercises have been recommended for urinary incontinence since first described by obstetrician gynecologist Dr. Arnold Kegel more than six decades ago. These exercises are performed to strengthen pelvic floor muscles, provide urethral support to prevent urine leakage, and suppress urgency. In clinical urology practice, expert clinicians also teach patients how to relax the muscle to improve bladder emptying and relieve pelvic pain caused by muscle spasm. When treating lower urinary tract symptoms, an exercise training program combined with biofeedback therapy has been recommended as first-line treatment. This article provides clinical application of pelvic floor muscle rehabilitation using biofeedback as a technique to enhance pelvic floor muscle training.

  9. Ultrasound Imaging of the Pelvic Floor.

    PubMed

    Stone, Daniel E; Quiroz, Lieschen H

    2016-03-01

    This article discusses the background and appraisal of endoluminal ultrasound of the pelvic floor. It provides a detailed anatomic assessment of the muscles and surrounding organs of the pelvic floor. Different anatomic variability and pathology, such as prolapse, fecal incontinence, urinary incontinence, vaginal wall cysts, synthetic implanted material, and pelvic pain, are easily assessed with endoluminal vaginal ultrasound. With pelvic organ prolapse in particular, not only is the prolapse itself seen but the underlying cause related to the anatomic and functional abnormalities of the pelvic floor muscle structures are also visualized.

  10. [Functional rehabilitation of the pelvic floor].

    PubMed

    Minschaert, M

    2003-09-01

    Pelvic floor revalidation is devoted to conserve perineal functions as statics, urinary continence and sexual harmony. The therapeutics includes preventive and curative actions, and is based upon muscular and neuromuscular properties of pelvic floor. The different steps are: information, local muscular work, behavioral education, biofeedback, functional electrostimulation, intraabdominal pressure control. The therapeutics is only continued if clinical improvement is demonstrated after 10 sessions.

  11. Synthetic biomaterials for pelvic floor reconstruction.

    PubMed

    Karlovsky, Matthew E; Kushner, Leslie; Badlani, Gopal H

    2005-09-01

    Pelvic organ prolapse and stress urinary incontinence increase with age. The increasing proportion of the aging female population is likely to result in a demand for care of pelvic floor prolapse and incontinence. Experimental evidence of altered connective tissue metabolism may predispose to pelvic floor dysfunction, supporting the use of biomaterials, such as synthetic mesh, to correct pelvic fascial defects. Re-establishing pelvic support and continence calls for a biomaterial to be inert, flexible, and durable and to simultaneously minimize infection and erosion risk. Mesh as a biomaterial has evolved considerably throughout the past half century to the current line that combines ease of use, achieves good outcomes, and minimizes risk. This article explores the biochemical basis for pelvic floor attenuation and reviews various pelvic reconstructive mesh materials, their successes, failures, complications, and management.

  12. Pathophysiology of pelvic floor hypertonic disorders.

    PubMed

    Butrick, Charles W

    2009-09-01

    The pelvic floor represents the neuromuscular unit that provides support and functional control for the pelvic viscera. Its integrity, both anatomic and functional, is the key in some of the basic functions of life: storage of urine and feces, evacuation of urine and feces, support of pelvic organs, and sexual function. When this integrity is compromised, the results lead to many of the problems seen by clinicians. Pelvic floor dysfunction can involve weakness and result in stress incontinence, fecal incontinence, and pelvic organ prolapse. Pelvic floor dysfunction can also involve the development of hypertonic, dysfunctional muscles. This article discusses the pathophysiology of hypertonic disorders that often result in elimination problems, chronic pelvic pain, and bladder disorders that include bladder pain syndromes, retention, and incontinence. The hypertonic disorders are very common and are often not considered in the evaluation and management of patients with these problems.

  13. Male pelvic floor: history and update.

    PubMed

    Dorey, Grace

    2005-08-01

    Our understanding of the male pelvic floor has evolved over more than 2,000 years. Gradually medical science has sought to dispel ancient myths and untruths. The male pelvic floor has many diverse functions. Importantly, it helps to support the abdominal contents, maintains urinary and fecal continence, and plays a major role in gaining and maintaining penile erection. Weakness of the male pelvic floor muscles may cause urinary and fecal incontinence and erectile dysfunction. Function may be restored in each of these areas by a comprehensive pelvic floor muscle training program. Spasm of the pelvic floor muscles may produce pain and require relaxation techniques. Additional research is needed to add further evidence to our knowledge base.

  14. Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction

    PubMed Central

    Pedraza, Rodrigo; Nieto, Javier; Ibarra, Sergio; Haas, Eric M.

    2014-01-01

    Introduction. Pelvic floor dysfunction syndromes present with voiding, sexual, and anorectal disturbances, which may be associated with one another, resulting in complex presentation. Thus, an integrated diagnosis and management approach may be required. Pelvic muscle rehabilitation (PMR) is a noninvasive modality involving cognitive reeducation, modification, and retraining of the pelvic floor and associated musculature. We describe our standardized PMR protocol for the management of pelvic floor dysfunction syndromes. Pelvic Muscle Rehabilitation Program. The diagnostic assessment includes electromyography and manometry analyzed in 4 phases: (1) initial baseline phase; (2) rapid contraction phase; (3) tonic contraction and endurance phase; and (4) late baseline phase. This evaluation is performed at the onset of every session. PMR management consists of 6 possible therapeutic modalities, employed depending on the diagnostic evaluation: (1) down-training; (2) accessory muscle isolation; (3) discrimination training; (4) muscle strengthening; (5) endurance training; and (6) electrical stimulation. Eight to ten sessions are performed at one-week intervals with integration of home exercises and lifestyle modifications. Conclusions. The PMR protocol offers a standardized approach to diagnose and manage pelvic floor dysfunction syndromes with potential advantages over traditional biofeedback, involving additional interventions and a continuous pelvic floor assessment with management modifications over the clinical course. PMID:25006337

  15. Physical therapy for female pelvic floor disorders.

    PubMed

    Bourcier, A P

    1994-08-01

    Non-surgical, non-pharmacological treatment for female pelvic floor dysfunction is represented by rehabilitation in urogynecology. Since Kegel, in 1948, who proposed the concept of functional restoration of the perineal muscles, no specific term has actually been established. Owing to the number of specialists involved in the management of female pelvic floor disorders (such as gynecologists, urologists, coloproctologists, and neurologists) and the different types of health care providers concerned (such as physicians, physical therapists, nurses, and midwives), it is difficult to make the proper choice between 'physical therapy for pelvic floor', 'pelvic floor rehabilitation', 'pelvic muscle re-education', and 'pelvic floor training'. Because muscle re-education is under the control of physical therapists, we have chosen the term of physical therapy for female pelvic floor disorders. Muscle re-education has an important role in the primary treatment of lower urinary tract dysfunction. A multidisciplinary collaboration may be of particular interest, and a thorough evaluation is useful for a proper selection of patients.

  16. Pelvic floor and sexual male dysfunction.

    PubMed

    Pischedda, Antonella; Fusco, Ferdinando; Curreli, Andrea; Grimaldi, Giovanni; Pirozzi Farina, Furio

    2013-04-19

    The pelvic floor is a complex multifunctional structure that corresponds to the genito-urinary-anal area and consists of muscle and connective tissue. It supports the urinary, fecal, sexual and reproductive functions and pelvic statics. The symptoms caused by pelvic floor dysfunction often affect the quality of life of those who are afflicted, worsening significantly more aspects of daily life. In fact, in addition to providing support to the pelvic organs, the deep floor muscles support urinary continence and intestinal emptying whereas the superficial floor muscles are involved in the mechanism of erection and ejaculation. So, conditions of muscle hypotonia or hypertonicity may affect the efficiency of the pelvic floor, altering both the functionality of the deep and superficial floor muscles. In this evolution of knowledge it is possible imagine how the rehabilitation techniques of pelvic floor muscles, if altered and able to support a voiding or evacuative or sexual dysfunction, may have a role in improving the health and the quality of life.

  17. Total pelvic floor ultrasound for pelvic floor defaecatory dysfunction: a pictorial review.

    PubMed

    Hainsworth, Alison J; Solanki, Deepa; Schizas, Alexis M P; Williams, Andrew B

    2015-01-01

    Total pelvic floor ultrasound is used for the dynamic assessment of pelvic floor dysfunction and allows multicompartmental anatomical and functional assessment. Pelvic floor dysfunction includes defaecatory, urinary and sexual dysfunction, pelvic organ prolapse and pain. It is common, increasingly recognized and associated with increasing age and multiparity. Other options for assessment include defaecation proctography and defaecation MRI. Total pelvic floor ultrasound is a cheap, safe, imaging tool, which may be performed as a first-line investigation in outpatients. It allows dynamic assessment of the entire pelvic floor, essential for treatment planning for females who often have multiple diagnoses where treatment should address all aspects of dysfunction to yield optimal results. Transvaginal scanning using a rotating single crystal probe provides sagittal views of bladder neck support anteriorly. Posterior transvaginal ultrasound may reveal rectocoele, enterocoele or intussusception whilst bearing down. The vaginal probe is also used to acquire a 360° cross-sectional image to allow anatomical visualization of the pelvic floor and provides information regarding levator plate integrity and pelvic organ alignment. Dynamic transperineal ultrasound using a conventional curved array probe provides a global view of the anterior, middle and posterior compartments and may show cystocoele, enterocoele, sigmoidocoele or rectocoele. This pictorial review provides an atlas of normal and pathological images required for global pelvic floor assessment in females presenting with defaecatory dysfunction. Total pelvic floor ultrasound may be used with complementary endoanal ultrasound to assess the sphincter complex, but this is beyond the scope of this review. PMID:26388109

  18. Magnetic Resonance Imaging (MRI): Dynamic Pelvic Floor

    MedlinePlus

    ... a powerful magnetic field, radio waves and a computer to produce detailed pictures of the pelvic floor, ... powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, ...

  19. Pelvic floor hypertonic disorders: identification and management.

    PubMed

    Butrick, Charles W

    2009-09-01

    Patients with hypertonic pelvic floor disorders can present with pelvic pain or dysfunction. Each of the various syndromes will be discussed including elimination disorders, bladder pain syndrome/interstitial cystitis (BPS/IC), vulvodynia, vaginismus, and chronic pelvic pain. The symptoms and objective findings on physical examination and various diagnostic studies will be reviewed. Therapeutic options including physical therapy, pharmacologic management, and trigger point injections, as well as botulinum toxin injections will be reviewed in detail.

  20. [Functional rehabilitation of the pelvic floor].

    PubMed

    Minschaert, M

    2003-09-01

    Pelvic floor revalidation is devoted to conserve perineal functions as statics, urinary continence and sexual harmony. The therapeutics includes preventive and curative actions, and is based upon muscular and neuromuscular properties of pelvic floor. The different steps are: information, local muscular work, behavioral education, biofeedback, functional electrostimulation, intraabdominal pressure control. The therapeutics is only continued if clinical improvement is demonstrated after 10 sessions. PMID:14606287

  1. Female Pelvic Floor Anatomy: The Pelvic Floor, Supporting Structures, and Pelvic Organs

    PubMed Central

    Herschorn, Sender

    2004-01-01

    The development of novel, less invasive therapies for stress urinary incontinence in women requires a thorough knowledge of the relationship between the pathophysiology of incontinence and anatomy. This article provides a review of the anatomy of the pelvic floor and lower urinary tract. Also discussed is the hammock hypothesis, which describes urethral support within the pelvis and provides an explanation of the continence mechanism. PMID:16985905

  2. Physical activity and the pelvic floor.

    PubMed

    Nygaard, Ingrid E; Shaw, Janet M

    2016-02-01

    Pelvic floor disorders are common, with 1 in 4 US women reporting moderate to severe symptoms of urinary incontinence, pelvic organ prolapse, or fecal incontinence. Given the high societal burden of these disorders, identifying potentially modifiable risk factors is crucial. Physical activity is one such potentially modifiable risk factor; the large number of girls and women participating in sport and strenuous training regimens increases the need to understand associated risks and benefits of these exposures. The aim of this review was to summarize studies reporting the association between physical activity and pelvic floor disorders. Most studies are cross-sectional and most include small numbers of participants. The primary findings of this review include that urinary incontinence during exercise is common and is more prevalent in women during high-impact sports. Mild to moderate physical activity, such as brisk walking, decreases both the odds of having and the risk of developing urinary incontinence. In older women, mild to moderate activity also decreases the odds of having fecal incontinence; however, young women participating in high-intensity activity are more likely to report anal incontinence than less active women. Scant data suggest that in middle-aged women, lifetime physical activity increases the odds of stress urinary incontinence slightly and does not increase the odds of pelvic organ prolapse. Women undergoing surgery for pelvic organ prolapse are more likely to report a history of heavy work than controls; however, women recruited from the community with pelvic organ prolapse on examination report similar lifetime levels of strenuous activity as women without this examination finding. Data are insufficient to determine whether strenuous activity while young predisposes to pelvic floor disorders later in life. The existing literature suggests that most physical activity does not harm the pelvic floor and does provide numerous health benefits for

  3. Physical activity and the pelvic floor.

    PubMed

    Nygaard, Ingrid E; Shaw, Janet M

    2016-02-01

    Pelvic floor disorders are common, with 1 in 4 US women reporting moderate to severe symptoms of urinary incontinence, pelvic organ prolapse, or fecal incontinence. Given the high societal burden of these disorders, identifying potentially modifiable risk factors is crucial. Physical activity is one such potentially modifiable risk factor; the large number of girls and women participating in sport and strenuous training regimens increases the need to understand associated risks and benefits of these exposures. The aim of this review was to summarize studies reporting the association between physical activity and pelvic floor disorders. Most studies are cross-sectional and most include small numbers of participants. The primary findings of this review include that urinary incontinence during exercise is common and is more prevalent in women during high-impact sports. Mild to moderate physical activity, such as brisk walking, decreases both the odds of having and the risk of developing urinary incontinence. In older women, mild to moderate activity also decreases the odds of having fecal incontinence; however, young women participating in high-intensity activity are more likely to report anal incontinence than less active women. Scant data suggest that in middle-aged women, lifetime physical activity increases the odds of stress urinary incontinence slightly and does not increase the odds of pelvic organ prolapse. Women undergoing surgery for pelvic organ prolapse are more likely to report a history of heavy work than controls; however, women recruited from the community with pelvic organ prolapse on examination report similar lifetime levels of strenuous activity as women without this examination finding. Data are insufficient to determine whether strenuous activity while young predisposes to pelvic floor disorders later in life. The existing literature suggests that most physical activity does not harm the pelvic floor and does provide numerous health benefits for

  4. Pelvic Floor Disorders and Multiple Sclerosis

    PubMed Central

    James, Rebecca; Frasure, Heidi

    2014-01-01

    Background: Despite recent efforts to educate multiple sclerosis (MS) health-care providers about the importance of pelvic floor disorders (urinary, bowel, and sexual dysfunction), no data are currently available to assess outcomes of these efforts in terms of patient satisfaction. Methods: As part of the fall 2010 North American Research Committee on Multiple Sclerosis survey, we conducted a prospective, survey-based cohort study (N = 14,268) to evaluate patient satisfaction with the current evaluation and treatment of pelvic floor disorders. Patients were queried about 1) bother from bladder, bowel, or sexual symptoms; 2) whether they had been evaluated by a health-care provider for pelvic floor issues in the last 12 months; and 3) satisfaction with the evaluation and treatment they received, on a 5-point Likert scale. Patients were also asked whether these treatments had affected their quality of life (7-point Likert scale). Results: A total of 9397 responses were received (response rate of 65.9%); respondents were primarily white (89%) and female (77.4%). Moderate-to-severe pelvic floor symptoms were reported by one-third of patients (bladder, 41%; bowel, 30%; sexual, 42%). Most respondents had been asked about bladder (61%) or bowel (50%) issues by their health-care providers, but only 20% had been queried about sexual dysfunction. Most respondents were moderately to very satisfied with the management of their bladder and bowel disorders but significantly less satisfied with that of sexual dysfunction. Conclusions: While MS patients are generally satisfied with current management of bladder and bowel dysfunction, improvement is needed in that of sexual dysfunction. PMID:24688351

  5. Pelvic floor muscle training in males: practical applications.

    PubMed

    Siegel, Andrew L

    2014-07-01

    The pelvic floor muscles are vital to male genitourinary health. Pelvic floor muscle training may prove helpful in a variety of clinical circumstances: stress urinary incontinence that follows prostate surgery, overactive bladder, postvoid dribbling, erectile dysfunction, ejaculation issues including premature ejaculation, and pelvic pain due to levator muscle spasm.

  6. Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction

    PubMed Central

    Faubion, Stephanie S.; Shuster, Lynne T.; Bharucha, Adil E.

    2012-01-01

    Nonrelaxing pelvic floor dysfunction is not widely recognized. Unlike in pelvic floor disorders caused by relaxed muscles (eg, pelvic organ prolapse or urinary incontinence, both of which often are identified readily), women affected by nonrelaxing pelvic floor dysfunction may present with a broad range of nonspecific symptoms. These may include pain and problems with defecation, urination, and sexual function, which require relaxation and coordination of pelvic floor muscles and urinary and anal sphincters. These symptoms may adversely affect quality of life. Focus on the global symptom complex, rather than the individual symptoms, may help the clinician identify the condition. The primary care provider is in a position to intervene early, efficiently, and effectively by (1) recognizing the range of symptoms that might suggest nonrelaxing pelvic floor dysfunction, (2) educating patients, (3) performing selective tests when needed to confirm the diagnosis, and (4) providing early referral for physical therapy. PMID:22305030

  7. Tension myalgia of the pelvic floor.

    PubMed

    Sinaki, M; Merritt, J L; Stillwell, G K

    1977-11-01

    The clinical picture in and efficacy of physical treatment for pelvic floor myalgia were reviewed. The medical records of patients having a diagnosis of pyriformis syndrome, coccygodynia, levator ani spasm syndrome, proctalgia fugax, or rectal pain who had been seen at the Mayo Clinic and treated in the Department of Physical Medicine and Rehabilitation from 1970 through 1975 were retrieved. Adequate information and follow-up were available for 94 patients. Seventy-eight patients were women and 16 were men, whose ages ranged from 26 to 72 years. All patients had tenderness of the pelvic floor muscles on rectal examination. The most common associated findings were poor posture, deconditioned abdominal muscles, and generalized muscle attachment tenderness. The most effective therapeutic regimen was a combination of rectal diathermy, Thiele's massage, and relaxation exercises. Of the 94 patients, 30 had complete resolution of their symptoms, 19 had marked improvement, 17 had moderate improvement, and 14 had mild improvement. Only 14 patients had no change and 1 patient was worse after treatment.

  8. The spastic pelvic floor syndrome. A cause of constipation.

    PubMed

    Kuijpers, H C; Bleijenberg, G

    1985-09-01

    In 12 patients with constipation, it was detected by defecography that, during straining, the anorectal angle did not increase, but remained at 90 degrees. These patients were unable to excrete barium. Since the anorectal angle is a measure of activity of the pelvic floor musculature, a dysfunction of this muscle was suspected. In order to determine whether this abnormality represented a true functional disorder or just a voluntary contraction of the pelvic floor muscles due to embarrassment, we performed electromyographic, manometric, and transit time studies in these patients. The electromyographic studies confirmed the persistent contraction during defecation straining. Both manometry and electromyography revealed normal muscle function at rest and during squeezing. Colonic transit time studies demonstrated rectal retention in nine of 12 patients, indicating outlet obstruction. Persistent contraction of the pelvic floor muscles, for which we propose the name "spastic pelvic floor syndrome," represents a functional disorder of normal pelvic floor muscles, causing a functional outlet obstruction.

  9. [Translabial ultrasonography in pelvic floor prolapse and urinary incontinence diagnostics].

    PubMed

    Pietrus, Miłosz; Pityński, Kazimierz; Bałajewicz-Nowak, Marta; Wiecheć, Marcin; Knafel, Anna; Ludwin, Artur; Dziechciowski, Marek; Nocuń, Agnieszka

    2012-09-01

    Technological advances in the construction of sonographic devices and increasingly universal access to such tests considerably widens the range of diagnostic application of the sonographic examination. This situation also refers to pelvic organs prolapse. At present, sonographic sets used in everyday obstetrical-gynecological practice allow for insight into the structures forming the female pelvic floor, and the obtained images constitute a valuable addition to the physical examination. Positioning the sonographic transducer on a the perineum enables to visualize the three compartments of the female pelvis minor. After freezing the image, it is possible to assess the position of anatomical structures in relation to bones and designated surfaces, establish mutual distances and measure appropriate angles. Most information can be obtained in this manner within the range of the frontal compartment, whose damage is often linked with urinary incontinence. The examination standards developed so far, including the analysis of the quantitative parameters, greatly minimize the potential subjectivity of the assessment of the existing disorders. Apart from its low costs, the main value of the sonographic examination of the pelvic floor is the possibility to dynamically assess the changes in statics which take place during functional testing. Not only does it have a cognitive significance, but also it allows to adjust the scope of the surgical correction to the existing damages. Thus, indirectly it can contribute to the reduction of a number of subsequent remedial surgeries. Three-dimensional sonography allows to thoroughly examine the construction and functioning of the anal levators and to detect their possible damage. It is the trauma to these muscles--occurring, among others, during childbirth--that is one of the major causes of pelvic organs descent and prolapse in women. Sonographic examination also enables to visualize the artificial material, the use of which is

  10. Knowledge of the pelvic floor in nulliparous women

    PubMed Central

    Neels, Hedwig; Wyndaele, Jean-Jacques; Tjalma, Wiebren A. A.; De Wachter, Stefan; Wyndaele, Michel; Vermandel, Alexandra

    2016-01-01

    [Purpose] Proper pelvic floor function is important to avoid serious dysfunctions including incontinence, prolapse, and sexual problems. The current study evaluated the knowledge of young nulliparous women about their pelvic floor and identified what additional information they wanted. [Subjects and Methods] In this cross-sectional survey, a validated, 36 item questionnaire was distributed to 212 nulliparous women. The questionnaire addressed demography, pelvic floor muscles, pelvic floor dysfunction, and possible information sources. Descriptive statistics were generated for all variables. Stability and validity testing were performed using Kappa statistics and intra class correlation coefficients to define agreement for each question. The study was approved by the ethics Committee (B300201318334). [Results] Using a VAS scale (0 to 10), the women rated their knowledge about the pelvic floor as a mean of 2.4 (SD 2.01). A total of 93% of the women were insufficiently informed and requested more information; 25% had concerns about developing urinary incontinence, and 14% about fecal incontinence. Many of the women were unaware what pelvic floor training meant. [Conclusion] There was a significant lack of knowledge about pelvic floor function among nulliparous women. The majority of nulliparous women expressed a need for education, which might offer a way to reduce dysfunction. PMID:27313364

  11. Pelvic floor muscle functioning in women with vulvar vestibulitis syndrome.

    PubMed

    Reissing, E D; Brown, C; Lord, M J; Binik, Y M; Khalifé, S

    2005-06-01

    Vaginal sEMG biofeedback and pelvic floor physical therapists' manual techniques are being increasingly included in the treatment of vulvar vestibulitis syndrome (VVS). Successful treatment outcomes have generated hypotheses concerning the role of pelvic floor pathology in the etiology of VVS. However, no data on pelvic floor functioning in women with VVS compared to controls are available. Twenty-nine women with VVS were matched to 29 women with no pain with intercourse. Two independent, structured pelvic floor examinations were carried out by physical therapists blind to the diagnostic status of the participants. Results indicated that therapists reached almost perfect agreement in their diagnosis of pelvic floor pathology. A series of significant correlations demonstrated the reliability of assessment results across muscle palpation sites. Women with VVS demonstrated significantly more vaginal hypertonicity, lack of vaginal muscle strength, and restriction of the vaginal opening, compared to women with no pain with intercourse. Anal palpation could not confirm generalized hypertonicity of the pelvic floor. We suggest that pelvic floor pathology in women with VVS is reactive in nature and elicited with palpations that result in VVS-type pain. Treatment interventions need to recognize the critical importance of addressing the conditioned, protective muscle guarding response in women with VVS.

  12. Pelvic Floor Rehabilitation in the Treatment of Fecal Incontinence

    PubMed Central

    Scott, Kelly M.

    2014-01-01

    Fecal incontinence (FI) is a prevalent problem that can drastically affect quality of life. Pelvic floor rehabilitation is an important first-line treatment for patients with FI, and many published case reports and a small number of randomized controlled trials (RCTs) provide limited evidence for its efficacy. Pelvic floor rehabilitation approaches to the treatment of FI include pelvic floor muscle training, biofeedback, and volumetric training with rectal balloon catheters. Various forms of external electrical stimulation have also been described and may be of added benefit. Behavioral bowel retraining is an important part of a good rehabilitative approach as well. Pelvic floor rehabilitation treatment for FI is thought to be effective and safe, with reported success rates in a majority of studies at 50 to 80%. Many more high-quality RCTs are needed to define optimal treatment protocols. PMID:25320568

  13. Neural control of the female urethral and anal rhabdosphincters and pelvic floor muscles

    PubMed Central

    de Groat, William C.

    2010-01-01

    The urethral rhabdosphincter and pelvic floor muscles are important in maintenance of urinary continence and in preventing descent of pelvic organs [i.e., pelvic organ prolapse (POP)]. Despite its clinical importance and complexity, a comprehensive review of neural control of the rhabdosphincter and pelvic floor muscles is lacking. The present review places historical and recent basic science findings on neural control into the context of functional anatomy of the pelvic muscles and their coordination with visceral function and correlates basic science findings with clinical findings when possible. This review briefly describes the striated muscles of the pelvis and then provides details on the peripheral innervation and, in particular, the contributions of the pudendal and levator ani nerves to the function of the various pelvic muscles. The locations and unique phenotypic characteristics of rhabdosphincter motor neurons located in Onuf's nucleus, and levator ani motor neurons located diffusely in the sacral ventral horn, are provided along with the locations and phenotypes of primary afferent neurons that convey sensory information from these muscles. Spinal and supraspinal pathways mediating excitatory and inhibitory inputs to the motor neurons are described; the relative contributions of the nerves to urethral function and their involvement in POP and incontinence are discussed. Finally, a detailed summary of the neurochemical anatomy of Onuf's nucleus and the pharmacological control of the rhabdosphincter are provided. PMID:20484700

  14. Chronic prostatitis/chronic pelvic pain syndrome and pelvic floor spasm: can we diagnose and treat?

    PubMed

    Westesson, Karin E; Shoskes, Daniel A

    2010-07-01

    National Institutes of Health category III prostatitis, also known as chronic prostatitis/chronic pelvic pain syndrome, is a common condition with significant impact on quality of life. This clinically defined syndrome has a multifactorial etiology and seems to respond best to multimodal therapy. At least half of these patients have pelvic floor spasm. There are several approaches to therapy including biofeedback, acupuncture, and myofascial release physical therapy. However, the only multicenter study of pelvic floor physical therapy for pelvic floor spasm in men failed to show an advantage over conventional Western massage. We have proposed a clinical phenotyping system called UPOINT to classify patients with urologic chronic pelvic pain and subsequently direct appropriate therapy. Here, we review the current approach to category III prostatitis and describe how clinical phenotyping with UPOINT may improve therapy outcomes. PMID:20490725

  15. Chronic prostatitis/chronic pelvic pain syndrome and pelvic floor spasm: can we diagnose and treat?

    PubMed

    Westesson, Karin E; Shoskes, Daniel A

    2010-07-01

    National Institutes of Health category III prostatitis, also known as chronic prostatitis/chronic pelvic pain syndrome, is a common condition with significant impact on quality of life. This clinically defined syndrome has a multifactorial etiology and seems to respond best to multimodal therapy. At least half of these patients have pelvic floor spasm. There are several approaches to therapy including biofeedback, acupuncture, and myofascial release physical therapy. However, the only multicenter study of pelvic floor physical therapy for pelvic floor spasm in men failed to show an advantage over conventional Western massage. We have proposed a clinical phenotyping system called UPOINT to classify patients with urologic chronic pelvic pain and subsequently direct appropriate therapy. Here, we review the current approach to category III prostatitis and describe how clinical phenotyping with UPOINT may improve therapy outcomes.

  16. Modelling the pelvic floor for investigating difficulties during childbirth

    NASA Astrophysics Data System (ADS)

    Li, Xinshan; Kruger, Jennifer A.; Chung, Jae-Hoon; Nash, Martyn P.; Nielsen, Poul M. F.

    2008-03-01

    Research has suggested that athletes involved in high-intensity sports for sustained periods have a higher probability of experiencing prolonged second stage of labour compared to non-athletes. The mechanism responsible for this complication is unknown but may depend on the relative size or tone of the pelvic floor muscles. Prolonged training can result in enlargement and stiffening of these muscles, providing increased resistance as the fetal head descends through the birth canal during a vaginal birth. On the other hand, recent studies have suggested an association between increased muscle bulk in athletes and higher distensibility. This project aims to use mathematical modelling to study the relationship between the size and tone of the pelvic floor muscles and the level of difficulty during childbirth. We obtained sets of magnetic resonance (MR) images of the pelvic floor region for a female athlete and a female non-athlete. Thirteen components of the pelvic floor were segmented and used to generate finite element (FE) models. The fetal head data was obtained by laser scanning a skull replica and a FE model was fitted to these data. We used contact mechanics to simulate the motion of the fetal head moving through the pelvic floor, constructed from the non-athlete data. A maximum stretch ratio of 3.2 was induced in the muscle at the left lateral attachment point to the pubis. We plan to further improve our modelling framework to include active muscle contraction and fetal head rotations in order to address the hypotheses that there is a correlation between the level of difficulty and the size or tone of the pelvic floor muscles.

  17. [The spastic pelvic floor syndrome: its diagnosis and treatment].

    PubMed

    Carbognani, P; Spaggiari, L; Soliani, P; Dell'Abate, P; Rusca, M; Pavesi, G; Larini, P; Foggi, E

    1992-01-01

    The spastic pelvic floor syndrome, caused by a paradox contraction of the sphincteric apparatus at defaecation instead of relaxing, leads to constipation with difficult evacuation. Forty patients (15 males and 25 females, average age 49 years, age range 15-78) affected by serious chronic idiopathic constipation, underwent, at our Institute, from June 1989 to September 1990, the following instrumental examinations: anal manometry; electromyography of the pelvic floor; proctogram; intestinal transit time; anorectal endoscopy; in addition, in 6 cases at risk for colorectal cancer, left colonoscopy. Fifteen patients showed dyskinetic functioning of the voluntary sphincteric apparatus. The following diagnostic methods proved to be of fundamental importance: proctogram, which revealed failure to open of the anorectal angle at defaecation (mean values: at rest 88.93 degrees +/- 6.62; at defaecation 88.93 degrees +/- 9.44); electromyography of the pelvic floor, which showed the anomalous contraction of the external anal sphincter. These patients were treated by means of an air inflated endoampullary balloon to evoke the sensation of a stool and its subsequent expulsion. The correct evacuating function was resumed definitely in 9 patients (60%); for the remaining 6 patients, regular sessions of re-education are still necessary. The spastic pelvic floor syndrome is a major cause of constipation and requires an accurate diagnostic method of investigating the correct functioning of the recto-pelvic region by means of the above-mentioned methods.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Clinical assessment of pelvic floor dysfunction in multiple sclerosis: urodynamic and neurological correlates.

    PubMed

    De Ridder, D; Vermeulen, C; De Smet, E; Van Poppel, H; Ketelaer, P; Baert, L

    1998-01-01

    We present a study on the clinical assessment of pelvic floor dysfunction in 30 female patients with proven multiple sclerosis (MS). A scoring system for pelvic floor muscle testing by digital vaginal palpation is proposed. The concept of pelvic floor spasticity in MS is introduced. The relationship of our findings with the neurological findings and urodynamic data is presented. Pelvic floor spasticity correlates well with the presence of detrusor-external sphincter dyssynergia and with more severe spinal cord disease.

  19. Fecal Incontinence and Pelvic Floor Dysfunction in Women: A Review.

    PubMed

    Freeman, Alison; Menees, Stacy

    2016-06-01

    Pelvic floor dysfunction and fecal incontinence is a common and debilitating condition in women, particularly as women age, and often goes under-reported to health care providers. It is important for providers to ask patients about possible symptoms. An algorithm for evaluation and treatment is presented. Current and future therapies are described and discussed. PMID:27261895

  20. Organising a clinical service for patients with pelvic floor disorders.

    PubMed

    Chatoor, Dave; Soligo, Marco; Emmanuel, Anton

    2009-01-01

    The evolution of the multidisciplinary approach to the management of chronic conditions is a reflection of how medicine has evolved from a singular to a plural effort recognising the complex causations and consequences of such disorders. This thinking should not be confined to tertiary centres alone and should be adapted where local expertise is available. Such an approach is especially important in pelvic floor disorders, where the correlation between structure and function is not always straightforward. There is a need to avoid over-investigation by accurate clinical assessment allied to tailored investigation, leading to a step-wise approach to treatment (which may include behavioural, physiotherapy, medical or surgical management). The algorithms here on faecal incontinence, obstetric trauma, pelvic floor prolapse and chronic pelvic pain attempt to provide such a logical approach to patients.

  1. Personalizing pelvic floor reconstructive surgery in aging women.

    PubMed

    Mannella, Paolo; Giannini, Andrea; Russo, Eleonora; Naldini, Gabriele; Simoncini, Tommaso

    2015-09-01

    Pelvic floor dysfunction is a growingly frequent condition in aging individuals. Urinary or rectal incontinence, constipation, pelvic organ prolapse, pelvic pain or sexual dysfunction are common problems in this age range. Such conditions carry a severe impact on quality of life, but also limit individual independence in daily activities, favor social isolation and carry health risks. Diagnosis and treatment of pelvic floor dysfunction in aging women is tricky, since multiple interfering conditions affecting muscle tone and nerve function are common in these individuals. Diabetes mellitus, sarcopenia, use of drugs that affect cognition or impact bowel or urinary function are just a few examples. These conditions need to be thoroughly taken into account during pre-operative work up for their potential impact on the success of surgery and vice versa. Functional reconstruction aimed at treating symptoms rather than anatomic defects is key to success. The recent advancements in surgical treatment of urinary incontinence and pelvic organ prolapse allow for more options to achieve the best surgery in each patient. PMID:26142653

  2. Comparison of changes in the mobility of the pelvic floor muscle on during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction

    PubMed Central

    Jung, Halim; Jung, Sangwoo; Joo, Sunghee; Song, Changho

    2016-01-01

    [Purpose] The purpose of this study was to compare changes in the mobility of the pelvic floor muscle during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction. [Subjects] Thirty healthy adults participated in this study (15 men and 15 women). [Methods] All participants performed a bridge exercise and abdominal curl-up during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction. Pelvic floor mobility was evaluated as the distance from the bladder base using ultrasound. [Results] According to exercise method, bridge exercise and abdominal curl-ups led to significantly different pelvic floor mobility. The pelvic floor muscle was elevated during the abdominal drawing-in maneuver and descended during maximal expiration. Finally, pelvic floor muscle mobility was greater during abdominal curl-up than during the bridge exercise. [Conclusion] According to these results, the abdominal drawing-in maneuver induced pelvic floor muscle contraction, and pelvic floor muscle contraction was greater during the abdominal curl-up than during the bridge exercise. PMID:27065532

  3. Assessment of the effect of pelvic floor exercises on pelvic floor muscle strength using ultrasonography in patients with urinary incontinence: a prospective randomized controlled trial.

    PubMed

    Tosun, Ozge Celiker; Solmaz, Ulas; Ekin, Atalay; Tosun, Gokhan; Gezer, Cenk; Ergenoglu, Ahmet Mete; Yeniel, Ahmet Ozgur; Mat, Emre; Malkoc, Mehtap; Askar, Niyazi

    2016-01-01

    [Purpose] The aim of this study was to evaluate whether the effect of pelvic floor exercises on pelvic floor muscle strength could be detected via ultrasonography in patients with urinary incontinence. [Subjects and Methods] Of 282 incontinent patients, 116 participated in the study and were randomly divided into a pelvic floor muscle training (n=65) group or control group (n=51). The pelvic floor muscle training group was given pelvic floor exercise training for 12 weeks. Both groups were evaluated at the beginning of the study and after 12 weeks. Abdominal ultrasonography measurements in transverse and longitudinal planes, the PERFECT scheme, perineometric evaluation, the stop test, the stress test, and the pad test were used to assess pelvic floor muscle strength in all cases. [Results] After training, the PERFECT, perineometry and transabdominal ultrasonography measurements were found to be significantly improved, and the stop test and pad test results were significantly decreased in the pelvic floor muscle training group, whereas no difference was observed in the control group. There was a positive correlation between the PERFECT force measurement scale and ultrasonography force measurement scale before and after the intervention in the control and pelvic floor muscle training groups (r=0.632 and r=0.642, respectively). [Conclusion] Ultrasonography can be used as a noninvasive method to identify the change in pelvic floor muscle strength with exercise training. PMID:27065519

  4. [Urinary stress incontinence: rehabilitation treatment of the pelvic floor].

    PubMed

    Braccini, S; Toniazzi, P

    1995-11-01

    The authors inspected 112 patients with diagnostic urogynecologic and urodynamic criteria. They suffered from urinary stress incontinence. Forty patients effected rehabilitative therapy of the pelvic floor with visits twice weekly with a method which included: pelvic muscle exercises, biofeedback and functional electrostimulation. The patients were divided into two groups in accordance with the kind of urinary stress incontinence: in the first group there were patients with genuine urinary stress incontinence, in the second group patients with mixed urinary stress incontinence. The results at the end of treatment reported a proportion of success of 66% in the first group and of 54% in the second group.

  5. Urinary incontinence, pelvic floor dysfunction, exercise and sport.

    PubMed

    Bø, Kari

    2004-01-01

    Urinary incontinence is defined as "the complaint of any involuntary leakage of urine" and is a common problem in the female population with prevalence rates varying between 10% and 55% in 15- to 64-year-old women. The most frequent form of urinary incontinence in women is stress urinary incontinence, defined as "involuntary leakage on effort or exertion, or on sneezing or coughing". The aim of this article is to systematically review the literature on urinary incontinence and participation in sport and fitness activities with a special emphasis on prevalence and treatment in female elite athletes. Stress urinary incontinence is a barrier to women's participation in sport and fitness activities and, therefore, it may be a threat to women's health, self-esteem and well-being. The prevalence during sports among young, nulliparous elite athletes varies between 0% (golf) and 80% (trampolinists). The highest prevalence is found in sports involving high impact activities such as gymnastics, track and field, and some ball games. A 'stiff' and strong pelvic floor positioned at an optimal level inside the pelvis may be a crucial factor in counteracting the increases in abdominal pressure occurring during high-impact activities. There are no randomised controlled trials or reports on the effect of any treatment for stress urinary incontinence in female elite athletes. However, strength training of the pelvic floor muscles has been shown to be effective in treating stress urinary incontinence in parous females in the general population. In randomised controlled trials, reported cure rates, defined as <2g of leakage on pad tests, varied between 44% and 69%. Pelvic floor muscle training has no serious adverse effects and has been recommended as first-line treatment in the general population. Use of preventive devices such as vaginal tampons or pessaries can prevent leakage during high impact physical activity. The pelvic floor muscles need to be much stronger in elite athletes

  6. A shell finite element model of the pelvic floor muscles.

    PubMed

    d'Aulignac, D; Martins, J A C; Pires, E B; Mascarenhas, T; Jorge, R M Natal

    2005-10-01

    The pelvic floor gives support to the organs in the abdominal cavity. Using the dataset made public in (Janda et al. J. Biomech. (2003) 36(6), pp. 749-757), we have reconstructed the geometry of one of the most important parts of the pelvic floor, the levator ani, using NURB surfaces. Once the surface is triangulated, the corresponding mesh is used in a finite element analysis with shell elements. Based on the 3D behavior of the muscle we have constructed a shell that takes into account the direction of the muscle fibers and the incompressibility of the tissue. The constitutive model for the isotropic strain energy and the passive strain energy stored in the fibers is adapted from Humphrey's model for cardiac muscles. To this the active behavior of the skeletal muscle is added. We present preliminary results of a simulation of the levator ani muscle under pressure and with active contraction. This research aims at helping simulate the damages to the pelvic floor that can occur after childbirth. PMID:16298856

  7. Pelvic Floor Disorders Registry: Study Design and Outcome Measures.

    PubMed

    Weber LeBrun, Emily; Adam, Rony A; Barber, Matthew D; Boyles, Sarah Hamilton; Iglesia, Cheryl B; Lukacz, Emily S; Moalli, Pamela; Moen, Michael D; Richter, Holly E; Subak, Leslee L; Sung, Vivian W; Visco, Anthony G; Bradley, Catherine S

    2016-01-01

    Pelvic floor disorders affect up to 24% of adult women in the United States, and many patients with pelvic organ prolapse (POP) choose to undergo surgical repair to improve their quality of life. While a variety of surgical repair approaches and techniques are utilized, including mesh augmentation, there is limited comparative effectiveness and safety outcome data guiding best practice. In conjunction with device manufacturers, federal regulatory organizations, and professional societies, the American Urogynecologic Society developed the Pelvic Floor Disorders Registry (PFDR) designed to improve the quality of POP surgery by facilitating quality improvement and research on POP treatments. The PFDR will serve as a resource for surgeons interested in benchmarking and outcomes data and as a data repository for Food and Drug Administration-mandated POP surgical device studies. Provider-reported clinical data and patient-reported outcomes will be collected prospectively at baseline and for up to 3 years after treatment. All data elements including measures of success, adverse events, and surgeon characteristics were identified and defined within the context of the anticipated multifunctionality of the registry, and with collaboration from multiple stakeholders. The PFDR will provide a platform to collect high-quality, standardized patient-level data from a variety of nonsurgical (pessary) and surgical treatments of POP and other pelvic floor disorders. Data from this registry may be used to evaluate short- and longer-term treatment outcomes, patient-reported outcomes, and complications, as well as to identify factors associated with treatment success and failure with the overall goal of improving the quality of care for women with these conditions.

  8. Understanding multisymptom presentations in chronic pelvic pain: the inter-relationships between the viscera and myofascial pelvic floor dysfunction.

    PubMed

    Hoffman, Donna

    2011-10-01

    Patients presenting with chronic pelvic pain frequently complain of multiple symptoms that appear to involve more than one organ system, creating diagnostic confusion. The multisymptom presentation of chronic pelvic pain has been frequently described. This article describes four proposed explanations for the clinical observation of multisymptom presentations of patients with chronic pelvic pain. These include the concepts of viscerovisceral convergence; viscerosomatic convergence; hypertonicity of pelvic floor muscles creating visceral symptoms along with somatovisceral convergence; and central sensitization with expansion of receptive fields.

  9. Study on the influence of the fetus head molding on the biomechanical behavior of the pelvic floor muscles, during vaginal delivery.

    PubMed

    Silva, M E T; Oliveira, D A; Roza, T H; Brandão, S; Parente, M P L; Mascarenhas, T; Natal Jorge, R M

    2015-06-25

    Pelvic floor injuries during vaginal delivery are considered a significant risk factor to develop pelvic floor dysfunction. The molding of the fetus head during vaginal delivery facilitates the labor progress, since it adjusts to the birth canal geometry. In this work, a finite element model was used to represent the effects induced by the passage of the fetus head on the pelvic floor. The numerical model used for this simulation included the pelvic floor muscles attached to the bones, and a fetus body. The model of the fetus head included the skin and soft tissues, the skull with sutures and fontanelles, and the brain. The fetus head movements during birth in vertex position were simulated: descent, internal rotation and extension. Two models of the fetus head were compared: a rigid and a deformable one, with the inclusion of the cranial sutures. The influence of the fetus head molding on the pelvic floor muscles was analyzed by evaluating their reaction forces, stretch, and stress and strain fields. Additionally, anatomical indices for the molding of the fetal skull were obtained and compared with clinical data. The passage of the deformable fetus head through the birth canal leads to a reduction of 17.3% on the reaction forces on the pelvic floor muscles when compared to the ones of a rigid head. Furthermore, the fetus head molding implies inferior resistance to rotation resulting in a reduction of 1.86% in muscle stretching. Quantitative evaluation of the fetus head molding showed good agreement with clinical experiments.

  10. [Pelvic floor reconstruction with a Prolene net in enterocele].

    PubMed

    Vibits, H; Stage, J G; Lundvall, F; Kehlet, H

    1991-04-22

    Nine women, all of whom were multiparae with large symptom-producing enteroceles and all of whom had been submitted to operation by other methods without permanent effect, were submitted to total pelvic floor reconstruction with non-absorbable mesh. No complications of this intervention were observed and the discomfort due to enterocele disappeared in all of the patients during the follow-up period which averaged 11 months (range 1-24 months). The method is recommended in the treatment of large enteroceles where other forms of surgical treatment have failed. PMID:2028531

  11. [Electrostimulation of the pelvic floor muscles in urinary incontinence].

    PubMed

    Tjelum, K B; Lose, G; Abel, I; Pedersen, L M

    1994-04-11

    External electrical stimulation is a simple, noninvasive and inexpensive treatment modality, which is useful in the treatment of stress- and/or idiopathic urge incontinence. The mode of action arises from excitation of the pudendal nerves leading to direct and reflex contraction of pelvic floor muscles and a reflex inhibition of the detrusor. Treatment can be applied either as a weak long-term stimulation at home, as a short-term maximal stimulation in clinic, hospital or home treatment. Approximately 50%-75% of incontinent patients are either cured or improved and the adverse effects are sparse. Electrostimulation seems to be valuable in the treatment of incontinence.

  12. Epidemiological Trends and Future Care Needs for Pelvic Floor Disorders

    PubMed Central

    Dieter, Alexis A.; Wilkins, Maggie F.; Wu, Jennifer M.

    2016-01-01

    Purpose of review We sought to provide a review of the recent literature regarding the prevalence and epidemiological trends in pelvic floor disorders (PFDs) including pelvic organ prolapse (POP), urinary incontinence (UI) and fecal incontinence (FI). We also examined the current trends in surgical treatment for these disorders and discuss future care needs. Recent findings Approximately one quarter of all women suffer from at least one or more PFDs. UI represents the most common PFD with an estimated prevalence of 15–17% while FI affects approximately 9% of adult women. POP is more difficult to assess with prevalence estimates ranging from 3–8%. Surgery for PFDs is common as 20% of women undergo stress UI or POP surgery over their lifetime. As the aging population grows, the number of women with PFDs will increase substantially and the demand for care for these disorders will continue to grow through the year 2050. Summary PFDs are a significant public health issue and they negatively impact the lives of millions of adult women. The projected increase in the number of women affected by PFDs over the next 40 years will create increased demand for providers properly trained in Female Pelvic Medicine and Reconstructive Surgery. PMID:26308198

  13. Sexual Abuse History and Pelvic Floor Disorders in Women

    PubMed Central

    Cichowski, Sara B.; Dunivan, Gena C.; Komesu, Yuko M.; Rogers, Rebecca G.

    2014-01-01

    Objectives Sexual abuse rates in the general female population range between 15% and 25%, and sexual abuse is known to have a long-term impact on a woman’s health. The aim of this study was to report the prevalence of sexual abuse history in women presenting to clinicians for pelvic floor disorders (PFD) and to determine whether a history of sexual abuse is associated with a specific type of PFD. Methods We conducted a retrospective chart review of new urogynecology patients seen at the University of New Mexico Hospital. All women underwent a standardized history and physical examination and completed symptom severity and quality-of-life measures. Univariate and multivariable analyses were conducted to determine which PFDs were associated with a history of sexual abuse among women with and without a history of sexual abuse. Results A total of 1899 new urogynecology patients with complete information were identified from January 2007 and October 2011; 1260 (66%) were asked about a history of sexual abuse. The prevalence of sexual abuse was 213/1260 (17%). In the multivariable analysis, only chronic pelvic pain remained significantly associated with a history of sexual abuse. Conclusions A history of sexual abuse is common among women with PFDs, and these women were more likely to have chronic pelvic pain. PMID:24305526

  14. Laparoscopic surgery for rectal prolapse and pelvic floor disorders

    PubMed Central

    Rickert, Alexander; Kienle, Peter

    2015-01-01

    Pelvic floor disorders are different dysfunctions of gynaecological, urinary or anorectal organs, which can present as incontinence, outlet-obstruction and organ prolapse or as a combination of these symptoms. Pelvic floor disorders affect a substantial amount of people, predominantly women. Transabdominal procedures play a major role in the treatment of these disorders. With the development of new techniques established open procedures are now increasingly performed laparoscopically. Operation techniques consist of various rectopexies with suture, staples or meshes eventually combined with sigmoid resection. The different approaches need to be measured by their operative and functional outcome and their recurrence rates. Although these operations are performed frequently a comparison and evaluation of the different methods is difficult, as most of the used outcome measures in the available studies have not been standardised and data from randomised studies comparing these outcome measures directly are lacking. Therefore evidence based guidelines do not exist. Currently the laparoscopic approach with ventral mesh rectopexy or resection rectopexy is the two most commonly used techniques. Observational and retrospective studies show good functional results, a low rate of complications and a low recurrence rate. As high quality evidence is missing, an individualized approach is recommend for every patient considering age, individual health status and the underlying morphological and functional disorders. PMID:26380050

  15. Local Oestrogen for Pelvic Floor Disorders: A Systematic Review

    PubMed Central

    Weber, M. A.; Kleijn, M. H.; Langendam, M.; Limpens, J.; Heineman, M. J.; Roovers, J. P.

    2015-01-01

    Objective The decline in available oestrogen after menopause is a possible etiological factor in pelvic floor disorders like vaginal atrophy (VA), urinary incontinence (UI), overactive bladder (OAB) and pelvic organ prolapse (POP). This systematic review will examine the evidence for local oestrogen therapy in the treatment of these pelvic floor disorders. Evidence Acquisition We performed a systematic search in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the non-MEDLINE subset of PubMed from inception to May 2014. We searched for local oestrogens and VA (I), UI/OAB (II) and POP (III). Part I was combined with broad methodological filters for randomized controlled trials (RCTs) and secondary evidence. For part I and II two reviewers independently selected RCTs evaluating the effect of topical oestrogens on symptoms and signs of VA and UI/OAB. In part III all studies of topical oestrogen therapy in the treatment of POP were selected. Data extraction and the assessment of risk of bias using the Cochrane Risk of Bias Tool was undertaken independently by two reviewers. Evidence Synthesis The included studies varied in ways of topical application, types of oestrogen, dosage and treatment durations. Objective and subjective outcomes were assessed by a variety of measures. Overall, subjective and urodynamic outcomes, vaginal maturation and vaginal pH changed in favor of vaginal oestrogens compared to placebo. No obvious differences between different application methods were revealed. Low doses already seemed to have a beneficial effect. Studies evaluating the effect of topical oestrogen in women with POP are scarce and mainly assessed symptoms and signs associated with VA instead of POP symptoms. Conclusion Topical oestrogen administration is effective for the treatment of VA and seems to decrease complaints of OAB and UI. The potential for local oestrogens in the prevention as well as treatment of POP needs further research. PMID:26383760

  16. Pelvic Floor Biofeedback via a Smart Phone App for Treatment Of Stress Urinary Incontinence.

    PubMed

    Starr, Julie A; Drobnis, Erma Z; Cornelius, Chelsea

    2016-01-01

    Biofeedback can be useful for treatment of stress urinary incontinence. Many women have difficulty isolating their pelvic floor muscles and adhering to a daily exercise regimen. This case study highlights a woman's experience using PeriCoach, a home biofeedback device that assists women in strengthening their pelvic floor muscles through Bluetooth technology using a smartphone.

  17. Pelvic Floor Biofeedback via a Smart Phone App for Treatment Of Stress Urinary Incontinence.

    PubMed

    Starr, Julie A; Drobnis, Erma Z; Cornelius, Chelsea

    2016-01-01

    Biofeedback can be useful for treatment of stress urinary incontinence. Many women have difficulty isolating their pelvic floor muscles and adhering to a daily exercise regimen. This case study highlights a woman's experience using PeriCoach, a home biofeedback device that assists women in strengthening their pelvic floor muscles through Bluetooth technology using a smartphone. PMID:27281866

  18. Production of ascorbic acid releasing biomaterials for pelvic floor repair

    PubMed Central

    Mangır, Naşide; Bullock, Anthony J.; Roman, Sabiniano; Osman, Nadir; Chapple, Christopher; MacNeil, Sheila

    2016-01-01

    Objective An underlying abnormality in collagen turnover is implied in the occurrence of complications and recurrences after mesh augmented pelvic floor repair surgeries. Ascorbic acid is a potent stimulant of collagen synthesis. The aim of this study is to produce ascorbic acid releasing poly-lactic acid (PLA) scaffolds and evaluate them for their effects on extracellular matrix production and the strength of the materials. Materials and methods Scaffolds which contained either l-ascorbic acid (AA) and Ascorbate-2-Phosphate (A2P) were produced with emulsion electrospinning. The release of both drugs was measured by UV spectrophotometry. Human dermal fibroblasts were seeded on scaffolds and cultured for 2 weeks. Cell attachment, viability and total collagen production were evaluated as well as mechanical properties. Results No significant differences were observed between AA, A2P, Vehicle and PLA scaffolds in terms of fibre diameter and pore size. The encapsulation efficiency and successful release of both AA and A2P were demonstrated. Both AA and A2P containing scaffolds were significantly more hydrophilic and stronger in both dry and wet states compared to PLA scaffolds. Fibroblasts produced more collagen on scaffolds containing either AA or A2P compared to cells grown on control scaffolds. Conclusion This study is the first to directly compare the two ascorbic acid derivatives in a tissue engineered scaffold and shows that both AA and A2P releasing electrospun PLA scaffolds increased collagen production of fibroblasts to similar extents but AA scaffolds seemed to be more hydrophilic and stronger compared to A2P scaffolds. Statement of significance Mesh augmented surgical repair of the pelvic floor currently relies on non-degradable materials which results in severe complications in some patients. There is an unmet and urgent need for better pelvic floor repair materials. Our current understanding suggests that the ideal material should be able to better

  19. Characterizing and reporting pelvic floor defects: the revised New York classification system.

    PubMed

    Scotti, R J; Flora, R; Greston, W M; Budnick, L; Hutchinson-Colas, J

    2000-01-01

    The authors have devised a conceptual model and reporting system for characterizing, grading and staging pelvic floor defects. The system is user friendly and simple to learn and apply. It is based on commonly known anatomic landmarks and can be performed without memorizing or referring to a separate characterization and reporting plan. Completing the accompanying forms is self-explanatory and provides the information needed for proper comprehension and recording of anatomic defects. The model and reporting format have been used at our institutions for 5 years by medical students, residents, fellows and attendings. It has several advantages over the Pelvic Organ Prolapse Quantitation (POPQ) system: (1) it uses known anatomic landmarks rather than alphabetic labels; (2) it grades lateral wall defects which the POPQ system omits; (3) it recognizes and reports isolated defects or tears which present as bulges in the vaginal walls without downward linear descent (prolapse); (4) it uses a one-page reporting form and a one-page checklist and vaginal profile; (5) it can be done easily in both the supine and the standing positions; (6) it requires simple instruments and a disposable measuring tape available in most office settings; (7) it includes urethral hypermobility in its reporting scheme; (8) it includes cervical length, perineal descent and other measurements in its reporting scheme; and (9) it is similar enough to the POPQ system that easy conversion to, and integration with, the POPQ reporting form and vaginal profile is possible. Prospective trials testing the validity of this system and comparing it with the POPQ system for validity, reliability, reproducibility, test-retest analysis, and interobserver and intraobserver variance are warranted. PMID:10738935

  20. Modeling the contraction of the pelvic floor muscles.

    PubMed

    Brandão, Fernanda Sofia Quintela da Silva; Parente, Marco Paulo Lages; Rocha, Paulo Alexandre Gomes Gonçalves; Saraiva, Maria Teresa da Quinta E Costa de Mascarenhas; Ramos, Isabel Maria Amorim Pereira; Natal Jorge, Renato Manuel

    2016-01-01

    We performed numerical simulation of voluntary contraction of the pelvic floor muscles to evaluate the resulting displacements of the organs and muscles. Structures were segmented in Magnetic Resonance (MR) images. Different material properties and constitutive models were attributed. The Finite Element Method was applied, and displacements were compared with dynamic MRI findings. Numerical simulation showed muscle magnitude displacement ranging from 0 to 7.9 mm, more evident in the posterior area. Accordingly, the anorectum moved more than the uterus and bladder. Dynamic MRI showed less 0.2 mm and 4.1 mm muscle dislocation in the anterior and cranial directions, respectively. Applications of this model include evaluating muscle impairment, subject-specific mesh implant planning, or effectiveness of rehabilitation.

  1. Obesity and Pelvic Floor Disorders: A Review of the Literature

    PubMed Central

    Pomian, Andrzej; Lisik, Wojciech; Kosieradzki, Maciej; Barcz, Ewa

    2016-01-01

    Overweight and obesity are becoming a worldwide health problem associated with numerous co-morbidities. National costs of obesity and pelvic flor disorders have been rising since the 1950s across the world. Obesity is thought to have a very strong effect on pelvic floor disorders, and, considering the high prevalence of both problems worldwide, it is of utmost importance to evaluate the association between these pathologies as well as the impact of obesity on treatment efficacy. This review is based on a selection of reports in the literature (PubMed search), including guidelines and Cochrane reviews. Obesity seems to be a well-documented risk factor for lower urinary tract symptoms (LUTS) and is a predictor of exacerbation of stress urinary incontinence (SUI) and overactive bladder (OAB). Weight loss is also associated with improvement or resolution of SUI and OAB. In the case of pelvic organ prolapse (POP), weight loss is associated with improvement in quality of life. Although obesity is associated with POP in general, the exact role of obesity in symptomatic POP remains uncertain. While outcomes of anti-incontinence surgery among obese women are similar to those in non-obese women, postoperative urge incontinence is more likely to occur. It seems that obesity is not a risk factor for postoperative complications or short-term efficacy of POP surgical treatment. Long-term effects are still uncertain. Obesity is a strong risk factor for LUTS, but in most cases it does not affect efficacy of operative treatment. It may be associated with some post-operative complications. Weight loss in many cases allows avoiding surgical intervention. PMID:27255341

  2. Obesity and Pelvic Floor Disorders: A Review of the Literature.

    PubMed

    Pomian, Andrzej; Lisik, Wojciech; Kosieradzki, Maciej; Barcz, Ewa

    2016-01-01

    Overweight and obesity are becoming a worldwide health problem associated with numerous co-morbidities. National costs of obesity and pelvic flor disorders have been rising since the 1950s across the world. Obesity is thought to have a very strong effect on pelvic floor disorders, and, considering the high prevalence of both problems worldwide, it is of utmost importance to evaluate the association between these pathologies as well as the impact of obesity on treatment efficacy. This review is based on a selection of reports in the literature (PubMed search), including guidelines and Cochrane reviews. Obesity seems to be a well-documented risk factor for lower urinary tract symptoms (LUTS) and is a predictor of exacerbation of stress urinary incontinence (SUI) and overactive bladder (OAB). Weight loss is also associated with improvement or resolution of SUI and OAB. In the case of pelvic organ prolapse (POP), weight loss is associated with improvement in quality of life. Although obesity is associated with POP in general, the exact role of obesity in symptomatic POP remains uncertain. While outcomes of anti-incontinence surgery among obese women are similar to those in non-obese women, postoperative urge incontinence is more likely to occur. It seems that obesity is not a risk factor for postoperative complications or short-term efficacy of POP surgical treatment. Long-term effects are still uncertain. Obesity is a strong risk factor for LUTS, but in most cases it does not affect efficacy of operative treatment. It may be associated with some post-operative complications. Weight loss in many cases allows avoiding surgical intervention. PMID:27255341

  3. Voiding trial outcome following pelvic floor repair without incontinence procedures

    PubMed Central

    Wang, Rui; Won, Sara; Haviland, Miriam J.; Bargen, Emily Von; Hacker, Michele R.; Li, Janet

    2016-01-01

    Introduction and hypothesis Our aim was to identify predictors of postoperative voiding trial failure among patients who had a pelvic floor repair without a concurrent incontinence procedure in order to identify low-risk patients in whom postoperative voiding trials may be modified. Methods We conducted a retrospective cohort study of women who underwent pelvic floor repair without concurrent incontinence procedures at two institutions from 1 November 2011 through 13 October 2013 after abstracting demographic and clinical data from medical records. The primary outcome was postoperative retrograde voiding trial failure. We used modified Poisson regression to calculate the risk ratio (RR) and 95 % confidence interval (CI). Results Of the 371 women who met eligibility criteria, 294 (79.2 %) had complete data on the variables of interest. Forty nine (16.7%) failed the trial, and those women were less likely to be white (p = 0.04), more likely to have had an anterior colporrhaphy (p = 0.001), and more likely to have had a preoperative postvoid residual (PVR) ≥150 ml (p = 0.001). After adjusting for race, women were more likely to fail their voiding trial if they had a preoperative PVR of ≥150 ml (RR: 1.9; 95 % CI: 1.1–3.2); institution also was associated with voiding trial failure (RR: 3.0; 95 % CI: 1.6–5.4). Conclusions Among our cohort, postoperative voiding trial failure was associated with a PVR of ≥150 ml and institution at which the surgery was performed. PMID:26886553

  4. Vitamin D deficiency in postmenopausal women with pelvic floor disorders

    PubMed Central

    Navaneethan, Preethi Raja; Kekre, Aruna; Jacob, Kuruthukulangara Sebastian; Varghese, Lilly

    2015-01-01

    Introduction: The aim of this study is to evaluate the association of vitamin D deficiency and pelvic floor disorders (PFD) including pelvic organ prolapse (POP) and stress urinary incontinence in postmenopausal women. Materials and Methods: This is a prospective case control study on 120 women with or without symptoms of PFD. Relevant history and clinical examination were conducted. Serum 25-hydroxy vitamin D levels were measured in all women. Chi square and student t test were used to test significance of association. Logistic regression was used to adjust for age. Odds ratios and 95% confidence intervals were calculated. Results: Of the 120 postmenopausal women included, 51 had PFD on clinical examination. Of the 51 cases, 28 women had POP and 14 women had stress incontinence (SUI) while nine women had both POP and SUI. The study showed that vitamin D levels were significantly lower in women with PFD than those without PFD. Menopausal status of more than 5 years was also significantly associated with PFD. Conclusion: Findings suggest association of vitamin D deficiency and PFD in postmenopausal women. In addition, postmenopausal women have a high prevalence of vitamin D deficiency indicating a need to evaluate vitamin D levels in these women. PMID:26167056

  5. Measuring morphological parameters of the pelvic floor for finite element modelling purposes.

    PubMed

    Janda, Stepán; van der Helm, Frans C T; de Blok, Sjoerd B

    2003-06-01

    The goal of this study was to obtain a complete data set needed for studying the complex biomechanical behaviour of the pelvic floor muscles using a computer model based on the finite element (FE) theory. The model should be able to predict the effect of surgical interventions and give insight into the function of pelvic floor muscles. Because there was a lack of any information concerning morphological parameters of the pelvic floor muscle structures, we performed an experimental measurement to uncover those morphological parameters. Geometric parameters as well as muscle parameters of the pelvic floor muscles were measured on an embalmed female cadaver. A three-dimensional (3D) geometric data set of the pelvic floor including muscle fibre directions was obtained using a palpator device. A 3D surface model based on the experimental data, needed for mathematical modelling of the pelvic floor, was created. For all parts of the diaphragma pelvis, the optimal muscle fibre length was determined by laser diffraction measurements of the sarcomere length. In addition, other muscle parameters such as physiological cross-sectional area and total muscle fibre length were determined. Apart from these measurements we obtained a data set of the pelvic floor structures based on nuclear magnetic resonance imaging (MRI) on the same cadaver specimen. The purpose of this experiment was to discover the relationship between the MRI morphology and geometrical parameters obtained from the previous measurements. The produced data set is not only important for biomechanical modelling of the pelvic floor muscles, but it also describes the geometry of muscle fibres and is useful for functional analysis of the pelvic floor in general. By the use of many reference landmarks all these morphologic data concerning fibre directions and optimal fibre length can be morphed to the geometrical data based on segmentation from MRI scans. These data can be directly used as an input for building a

  6. [Functional disorders of the rectum and pelvic floor. Ambulatory/conservative therapy].

    PubMed

    Bock, J U; Jongen, J

    1997-01-01

    Early diagnosed functional disorders of the ano-rectum or pelvic floor can be treated in the office by conservative treatment or out-patient surgery. The normal anatomy of the anal canal must be restituted by reducing enlarged haemorrhoids, removing a prolapse of the anterior rectal wall with rubber-band ligation, excision of chronic fissures and prolapsing tumours. The basic therapy then consists of normalisation of bowel habits and stool consistency. An anal stenosis must be dilated. Training of the sphincter, gymnastics of the pelvic floor, electrostimulation and biofeedback are the therapy for the sphincter and pelvic floor insufficiency.

  7. Numerical simulation of the damage evolution in the pelvic floor muscles during childbirth.

    PubMed

    Oliveira, Dulce A; Parente, Marco P L; Calvo, Begoña; Mascarenhas, Teresa; Natal Jorge, Renato M

    2016-02-29

    Several studies have shown that pelvic floor injuries during a vaginal delivery can be considered a significant factor in the development of pelvic floor dysfunction. Such disorders include a group of conditions affecting women like urinary incontinence, pelvic organ prolapse and fecal incontinence. Numerical simulations are valuable tools that are contributing to the clarification of the mechanisms behind pelvic floor disorders. The aim of this work is to propose a mechanical model implemented in the finite element method context to estimate the damage in the pelvic floor muscles by mechanical effects during a vaginal delivery of a fetus in vertex presentation and occipitoanterior position. The constitutive model adopted has already been successfully used in the simulation of childbirth and the structural damage model added has previously been applied to characterize the damage process in biological soft tissues undergoing finite deformations. The constitutive parameters were fit to experimental data available in the literature and the final proposed material model is suitable to estimate the mechanical damage in the pelvic floor muscle during a vaginal delivery. The computational model predicts that even an apparently uneventful vaginal delivery inflicts injuries to the pelvic floor muscles, particularly during the extension of the fetus head, having been obtained more than 10% of damaged fibers. As a clinical evidence, the present work allows to conclude that the puborectalis component of the levator ani muscle is the most prone to damage. PMID:26895779

  8. PELVIC FLOOR SYMPTOMS AND QUALITY OF LIFE ANALYSES IN WOMEN UNDERGOING SURGERY FOR RECTAL PROLPASE

    PubMed Central

    ELLINGTON, DR; MANN, M; BOWLING, CB; DRELICHMAN, ER; GREER, WJ; SZYCHOWSKI, JM; RICHTER, HE

    2014-01-01

    Objective Characterize pelvic floor symptom distress and impact, sexual function and quality of life in women who underwent rectal prolapse surgery. Methods Subjects undergoing rectal prolapse surgery from 2004–2009 completed questionnaires including the Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire, and the Prolapse/Urinary Incontinence Sexual Questionnaire. Baseline demographic, medical, and surgical characteristics were extracted by chart review. Demographic and clinic outcomes of women undergoing transperineal and abdominal approaches were compared. Wilcoxon rank-sum test was used for continuous variables and Fisher’s exact test for categorical measures. Results 45 were identified; two deceased at follow-up. 28/43 subjects (65.1%) responded to the questionnaires. Mean time from original procedure was 3.9 ± 3.1 years. No differences in median total Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire, and subscale scores, and Prolapse/Urinary Incontinence Sexual Questionnaire scores in women undergoing open rectopexy versus transperineal proctectomy were seen (all p>0.05). 26 (60%) participants answered the Prolapse/Urinary Incontinence Sexual Questionnaire, nine reported sexual activity within the last month. All underwent abdominal procedures. Conclusion There are few colorectal or other pelvic floor symptoms after rectal prolapse repair. Robust prospective studies are needed to more fully characterize and understand issues associated with rectal prolapse surgery in women. PMID:25379122

  9. Hip and groin pain in a cyclist resolved after performing a pelvic floor fascial mobilization.

    PubMed

    Navot, Sivan; Kalichman, Leonid

    2016-07-01

    Pelvic floor muscle assessment in situations of hip/groin pain in both male and female patients can be a key element in treatment success. We present herein, a 32 year old male professional cyclist, exhibiting right hip and groin pain during cycling and prolonged sitting. The pain commenced after the patient suffered a right hip severe contusion in 2013 causing a tear in the tensor fascia lata and gluteus medius muscle. The patient did not complain of pelvic floor dysfunctions. After receiving several series of conventional physical therapy for the hip/groin pain, the patient experienced partial pain relief and slight improvement of hip range of motion. His pelvic floor muscles and fascial involvement were subsequently assessed. Two sessions of Pelvic Floor Fascial Mobilization (PFFM) were performed and the patient fully recovered. The authors suggest that PFFM, a novel fascial-oriented manual therapy of the pelvic floor approach, can be used for both hip/groin and pelvic floor pain or dysfunction. PMID:27634085

  10. Childbirth and pelvic floor dysfunction: An epidemiologic approach to the assessment of prevention opportunities at delivery

    PubMed Central

    Patel, Divya A.; Xu, Xiao; Thomason, Angela D.; Ransom, Scott B.; Ivy, Julie S.; DeLancey, John O. L.

    2006-01-01

    Female pelvic floor dysfunction is integral to the woman’s role in the reproductive process, largely because of the unique anatomic features that facilitate vaginal birth and also because of the trauma that can occur during that event. Interventions such as primary elective cesarean delivery have been discussed for the primary prevention of pelvic floor dysfunction; however, existing data about potentially causal factors limit our ability to evaluate such strategies critically. Here we consider the conceptual principles of epidemiologic function and the availability of data that are necessary to make informed recommendations about prevention opportunities for pelvic floor dysfunction at delivery. Available epidemiologic data on pelvic floor dysfunction suggest that there may be substantial opportunities for the primary prevention of pelvic organ prolapse at delivery. Although definitive recommendations await further epidemiologic studies of the potential risk and benefits of obstetric practice change, it is hoped that this discussion will provide a novel, quantitative framework for the assessment of pelvic floor dysfunction prevention opportunities. PMID:16579934

  11. Brain Mechanisms Underlying Urge Incontinence and its Response to Pelvic Floor Muscle Training

    PubMed Central

    Griffiths, Derek; Clarkson, Becky; Tadic, Stasa D.; Resnick, Neil M.

    2016-01-01

    Purpose Urge urinary incontinence is a major problem, especially in the elderly, and to our knowledge the underlying mechanisms of disease and therapy are unknown. We used biofeedback assisted pelvic floor muscle training and functional brain imaging (functional magnetic resonance imaging) to investigate cerebral mechanisms, aiming to improve the understanding of brain-bladder control and therapy. Materials and Methods Before receiving biofeedback assisted pelvic floor muscle training functionally intact, older community dwelling women with urge urinary incontinence as well as normal controls underwent comprehensive clinical and bladder diary evaluation, urodynamic testing and brain functional magnetic resonance imaging. Evaluation was repeated after pelvic floor muscle training in those with urge urinary incontinence. Functional magnetic resonance imaging was done to determine the brain reaction to rapid bladder filling with urgency. Results Of 65 subjects with urge urinary incontinence 28 responded to biofeedback assisted pelvic floor muscle training with 50% or greater improvement of urge urinary incontinence frequency on diary. However, responders and nonresponders displayed 2 patterns of brain reaction. In pattern 1 in responders before pelvic floor muscle training the dorsal anterior cingulate cortex and the adjacent supplementary motor area were activated as well as the insula. After the training dorsal anterior cingulate cortex/supplementary motor area activation diminished and there was a trend toward medial prefrontal cortex deactivation. In pattern 2 in nonresponders before pelvic floor muscle training the medial prefrontal cortex was deactivated, which changed little after the training. Conclusions In older women with urge urinary incontinence there appears to be 2 patterns of brain reaction to bladder filling and they seem to predict the response and nonresponse to biofeedback assisted pelvic floor muscle training. Moreover, decreased cingulate

  12. Application of perineometer in the assessment of pelvic floor muscle strength and endurance: a reliability study.

    PubMed

    Rahmani, Nahid; Mohseni-Bandpei, Mohammad A

    2011-04-01

    Despite different studies on the reliability of pelvic floor muscle assessment, there is still no general consensus on the most valid and reliable method. The purpose of this study was to investigate the intra-rater (within-day and between-days) reliability of perineometer in the assessment of pelvic floor muscle strength and endurance. Following ethical approval, 15 healthy women aged from 22 to 50-years old, with no history of low back pain were recruited. The Peritron perineometer instrument was used to measure pelvic floor muscle strength and endurance. Two measurements were taken on the same day with an hour interval to assess within-day reliability and the third measurement was taken five days later to determine between-days reliability. Intraclass Correlation Coefficients (ICCs) and the level of agreement between measurements were used for data analysis. The high ICC values (0.95 for strength and 0.94 for endurance) and high level of agreement between measurements indicated high within-day reliability for pelvic floor muscle strength and endurance. The perineometer was also shown to be reliable for between-days measurements with high ICC (0.88 for strength and 0.83 for endurance) and high level of agreement between measurements. The results demonstrated that the perineometer appears to be a highly reliable method of measuring pelvic floor muscle strength and endurance when measurements are taken in healthy subject by the same investigator.

  13. Effect of intravaginal electrical stimulation on pelvic floor muscle strength.

    PubMed

    Amaro, João Luiz; Gameiro, Mônica Orsi; Padovani, Carlos Roberto

    2005-01-01

    The aim of this study was to evaluate the effect of intravaginal electrical stimulation (IES) on pelvic floor muscle (PFM) strength in patients with mixed urinary incontinence (MUI). Between January 2001 and February 2002, 40 MUI women (mean age: 48 years) were studied. Urge incontinence was the predominant symptom; 92.5% also presented mild stress urinary incontinence (SUI). Selection criteria were clinical history and urodynamics. Pre-treatment urodynamic study showed no statistical differences between the groups. Ten percent of the women in each group had involuntary detrusor contractions. Patients were randomly distributed, in a double-blind study, into two groups. Group G1 (n=20), effective IES, and group G2 (n=20), sham IES, with follow-up at 1 month. The following parameters were studied: (1) clinical questionnaire, (2) examiner's evaluation of perineal muscle strength, (3) objective evaluation of perineal muscle by perineometry, (4) vaginal weight test, and (5) urodynamic study. The IES protocol consisted of three 20-min sessions per week over a 7-week period using a Dualpex Uro 996 at 4 Hz. There was no statistically significant difference in the demographic data of both groups. The number of micturitions per 24 h after treatment was reduced significantly in both groups. Urge incontinence, present in all patients before treatment, was reduced to 15% in G1 and 31.5% in G2 post-treatment. The subjective evaluation of PFM strength demonstrated a significant improvement in G1. Objective evaluation of PFM force by perineometer showed a significant improvement in maximum peak contraction post-treatment in both groups. In the vaginal weight test, there was a significant increase in average number of cone retentions post-treatment in both groups. With regard to satisfaction level, after treatment, 80% of the patients in G1 and 65% of the patients in G2 were satisfied. There was no statistically significant difference between the groups. There was a significant

  14. [Does maximum short-term electric stimulation cause contraction of the pelvic floor muscles?].

    PubMed

    Martan, A; Halaska, M; Masata, M; Voigt, R; Vering, A

    1997-04-01

    Electric stimulation is successfully used in the treatment of the stress and urgent type of incontinence. Electric stimulation of the muscles of the pelvic floor causes reflex contraction of the striated peri- and paraurethral muscles and is associated with concurrent reflex inhibition of the detrusor muscle. The therapeutic results depends greatly on the total or at least partially preserved innervation of the muscles of the pelvic floor by the pudendal nerve. One of the possible stimuli of the pelvic floor muscles is maximal electric stimulation (MES) and the objective of our study was to evaluate the effect of MES on the muscles of the pelvic floor or to detect possible changes by US and urodynamic examination. The study comprised women with the stress type of incontinence (GSI). The group was formed by 40 women with GSI, 20 were subjected to US examination and urodynamic examination (n = 20). The group of subjects subjected to urodynamic examination was extended to 40 (n = 40). For electrostimulation a Conmax apparatus was used. The applied frequency was 20 Hz, the amplitude from 0 to 90 mA (grades 0.6), pulse duration 0.75 ms. During the cystometric examination the authors recorded a significant increase of the maximal urethral closure pressure (MUCP), prolongation of the functional (FUL) and anatomical length (AUL) of the urethra during MES. During US examination the authors recorded a significant diminution of the gamma angle, a reduction of the mobility of the UV junction and prolongation of the anatomical length of the urethra during MES. From the investigation ensues that the pelvic floor muscles are contracted during MES and those changes contribute to an increase of the muscular tonus and contracting capacity of the muscles of the pelvic floor and thus cause among other things elevation of the neck of the urinary bladder. The elevation contributes to the normalization of the intraabdominal transmission of pressure to the proximal urethra and thus to

  15. Comparison of pelvic floor muscle strength evaluations in nulliparous and primiparous women: a prospective study

    PubMed Central

    Gameiro, Mônica Orsi; Sousa, Vanessa Oliveira; Gameiro, Luiz Felipe; Muchailh, Rosana Carneiro; Padovani, Carlos Roberto; Amaro, João Luiz

    2011-01-01

    OBJECTIVE: This study aimed to compare the pelvic floor muscle strength of nulliparous and primiparous women. METHODS: A total of 100 women were prospectively distributed into two groups: Group 1 (G1) (n = 50) included healthy nulliparous women, and Group 2 (G2) (n = 50) included healthy primiparous women. Pelvic floor muscle strength was subjectively evaluated using transvaginal digital palpation. Pelvic floor muscle strength was objectively assessed using a portable perineometer. All of the parameters were evaluated simultaneously in G1 and were evaluated in G2 during the 20th and 36th weeks of pregnancy and 45 days after delivery. RESULTS: In G2, 14 women were excluded because they left the study before the follow-up evaluation. The median age was 23 years in G1 and 22 years in G2; there was no significant difference between the groups. The average body mass index was 21.7 kg/m2 in G1 and 25.0 kg/m2 in G2; there was a significant difference between the groups (p = 0.0004). In G2, transvaginal digital palpation evaluation showed significant impairments of pelvic floor muscle strength at the 36th week of pregnancy (p = 0.0006) and 45 days after vaginal delivery (p = 0.0001) compared to G1. Objective evaluations of pelvic floor muscle strength in G2 revealed a significant decrease 45 days after vaginal delivery compared to nulliparous patients. CONCLUSION: Pregnancy and vaginal delivery may cause weakness of the pelvic floor muscles. PMID:21915489

  16. Registries as Tools for Clinical Excellence and the Development of the Pelvic Floor Disorders Registry.

    PubMed

    Weber LeBrun, Emily E

    2016-03-01

    Surgical device innovation has been less regulated than drug development, allowing integration of unproven techniques and materials into standard practice. Successful device registries gather information on patient outcomes and can provide postmarket surveillance of new technologies and allow comparison with currently established treatments or devices. The Pelvic Floor Disorders Registry was developed in collaboration with the Food and Drug Administration, device manufacturers, and other stakeholders to serve as a platform for industry-sponsored postmarket device surveillance, investigator-initiated research, and quality and effectiveness benchmarking, all designed to improve the care of women with pelvic floor disorders. PMID:26880512

  17. Defecography used as a screening entry for identifying evacuatory pelvic floor disorders in childhood constipation.

    PubMed

    Zhang, Shu Cheng; Wang, Wei Lin; Liu, Xin

    2014-01-01

    Defecography is one of the most valuable methods for the evaluation of pelvic floor disorders. Interest in this technique has rapidly expanded owing to its increased understanding of the multifactorial pathophysiology involving evacuation disorders. The value of defecography has reached a consensus in adulthood but is still limited in childhood. In this study, defecography was carried out in 8 volunteers and 96 constipation children. The results revealed that defecography can help to identify evacuatory pelvic floor disorders in childhood constipation. It is safe and feasible and should be used as a screening method for childhood constipation.

  18. Comparison of bony dimensions at the level of the pelvic floor in women with and without pelvic organ prolapse

    PubMed Central

    Stein, Tamara A.; Kaur, Gurpreet; Summers, Aimee; Larson, Kindra A.; Delancey, John O. L.

    2010-01-01

    Objective Compare bony pelvis dimensions at the level of pelvic support in women with and without pelvic organ prolapse (POP). Study Design Pelvic floor dimensions of 42 Caucasian women with POP ≥ 1cm beyond the hymen were compared to 42 age and parity-matched women with normal support. Bony landmarks relevant to connective tissue and levator attachments were identified on MRI. Dimensions were independently measured by two examiners and averaged for each subject. Results Measurements (cms) for cases and controls are as follows: Interspinous Diameter, 11.2±0.8 vs. 11.1±0.7, p=0.19; Anterior-Posterior Outlet Diameter, 11.7±0.7 vs. 11.7±0.8, p=0.71; Pubic Symphysis to Ischial Spine - Left, 9.5±0.5 vs. 9.5±0.4, p=0.91; -Right, 9.5±0.4 vs. 9.5±0.5, p=0.81; Sacrococcygeal junction to Ischial Spine - Left, 7.0±0.6 vs. 7.0±0.5, p=0.54; - Right, 7.0±0.6 vs. 6.9±0.4, p=0.32. Conclusion Bony pelvis dimensions are similar at the level of the muscular pelvic floor in Caucasian women with and without POP. PMID:19254580

  19. Noxious electrical stimulation of the pelvic floor and vagina induces transient voiding dysfunction in a rabbit survival model of pelvic floor dystonia

    PubMed Central

    Spettel, Sara; Schuler, Catherine; Levin, Robert M.; Dubin, Andrew H.; De, Elise J.B.

    2015-01-01

    Purpose Existing data supports a relationship between pelvic floor dysfunction and lower urinary tract symptoms. We developed a survival model of pelvic floor dysfunction in the rabbit and evaluated cystometric (CMG), electromyographic (EMG) and ambulatory voiding behavior. Materials and Methods Twelve female adult virgin rabbits were housed in metabolic cages to record voiding and defecation. Anesthetized CMG/EMG was performed before and after treatment animals (n=9) received bilateral tetanizing needle stimulation to the pubococcygeous (PC) muscle and controls (n=3) sham needle placement. After 7 days all animals were subjected to tetanizing transvaginal stimulation and CMG/EMG. After 5 days a final CMG/EMG was performed. Results Of rabbits that underwent needle stimulation 7 of 9 (78%) demonstrated dysfunctional CMG micturition contractions versus 6 of 12 (50%) after transvaginal stimulation. Needle stimulation of the PC musculature resulted in significant changes in: basal CMG pressure, precontraction pressure change, contraction pressure, interval between contractions and postvoid residual; with time to 3rd contraction increased from 38 to 53 minutes (p=0.008 vs. prestimulation). Vaginal noxious stimulation resulted in significant changes in: basal CMG pressure and interval between contractions; with time to 3rd contraction increased from 37 to 46 minutes (p=0.008 vs. prestimulation). Changes in cage parameters were primarily seen after direct needle stimulation. Conclusions In a majority of animals, tetanizing electrical stimulation of the rabbit pelvic floor resulted in voiding changes suggestive of pelvic floor dysfunction as characterized by a larger bladder capacity, longer interval between contractions and prolonged contraction duration. PMID:26682025

  20. Efficacy of transvaginal biofeedback and electrical stimulation in women with urinary urgency and frequency and associated pelvic floor muscle spasm.

    PubMed

    Bendaña, Emma E; Belarmino, James M; Dinh, Jenny H; Cook, Cynthia L; Murray, Brian P; Feustel, Paul J; De, Elise J B

    2009-01-01

    Women with urinary urgency and frequency may also have pelvic floor muscle spasm. Transvaginal biofeedback (TVBF) and electrical stimulation (EStim) is a treatment modality that has been used to treat vaginismus and chronic pelvic pain. In this study, TVBF/EStim was evaluated in women with pelvic floor muscle spasm associated with urinary symptoms. Fifty-two women underwent therapy with TVBF/EStim and reported a mean symptom improvement of 64.5%.

  1. The use of botulinum toxin in the pelvic floor for women with chronic pelvic pain-a new answer to old problems?

    PubMed

    Abbott, Jason

    2009-01-01

    Chronic pelvic pain occurs in about 15% of women and has a variety of causes requiring accurate diagnosis and appropriate treatment if pain reduction is to be effected. Superficial conditions such as provoked vestibulodynia and deeper pelvic issues such as pelvic floor myalgia were traditionally difficult to diagnose and adequately treat. For provoked vestibulodynia, there are limited data, in the form of case reports and small series, to indicate that botulinum toxin (BoNT) injections may provide short-term (3-6 months) benefit. Retreatment is reported to be successful and side effects are few. Class-I studies are essential to adequately assess this form of treatment. For pelvic floor myalgia, 1 class-I study and 3 class-II to -III studies indicate efficacy of BoNT. In the only double-blind, randomized, controlled study, significant reduction in pelvic floor pressures with significant pain reduction for some types of pelvic pain are reported compared with baseline. No differences in pain occurred compared with the control group who had physical therapy as an intervention. Physical therapy should be used as a noninvasive first-line treatment, with BoNT injections reserved for those who are refractory to treatment. Pelvic floor disorders should be considered as a cause for chronic pelvic pain in women and an attempt made to diagnose and treat such problems as a routine practice. The use of BoNT as a therapeutic option for pelvic floor muscle spasm and pain is still in its infancy. Initial reports suggest that there may be a significant role for women with chronic pain that is refractory to currently available medical and surgical treatments, however, there are very few high-quality studies and research is essential before this novel treatment can be accepted into widespread use for pelvic pain attributable to the pelvic floor.

  2. Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach

    PubMed Central

    Palleschi, Giovanni; Fuschi, Andrea; Maggioni, Cristina; Rago, Rocco; Zucchi, Alessandro; Costantini, Elisabetta; Carbone, Antonio

    2014-01-01

    Objectives: Premature ejaculation is the most common male sexual disorder. The aim of the study was to evaluate the possible therapeutic role of pelvic floor muscle rehabilitation in patients affected by lifelong premature ejaculation. Methods: We treated 40 men with lifelong premature ejaculation, reporting, a baseline intravaginal ejaculatory latency time (IELT) ≤ 1 min, with 12-week pelvic floor muscle rehabilitation. Results: At the end of the rehabilitation, mean IELTs were calculated to evaluate the effectiveness of the therapy. At the end of the treatment, 33 (82.5%) of the 40 patients gained control of their ejaculatory reflex, with a mean IELT of 146.2 s (range: 123.6–152.4 s). A total of 13 out of 33 (39%) patients were evaluated at 6 months follow up, and they maintained a significant IELT (112.6 s) compared with their initial IELT (mean 39.8 s). Conclusions: The results obtained in our subjects treated with pelvic floor rehabilitation are promising. This therapy represents an important cost reduction compared with the standard treatment (selective serotonin reuptake inhibitors). Based on the present data, we propose pelvic floor muscle rehabilitation as a new, viable therapeutic option for the treatment of premature ejaculation. PMID:24883105

  3. Dose-Effect Relationships for Individual Pelvic Floor Muscles and Anorectal Complaints After Prostate Radiotherapy

    SciTech Connect

    Smeenk, Robert Jan; Hoffmann, Aswin L.; Hopman, Wim P.M.; Lin, Emile N.J. Th. van; Kaanders, Johannes H.A.M.

    2012-06-01

    Purpose: To delineate the individual pelvic floor muscles considered to be involved in anorectal toxicity and to investigate dose-effect relationships for fecal incontinence-related complaints after prostate radiotherapy (RT). Methods and Materials: In 48 patients treated for localized prostate cancer, the internal anal sphincter (IAS) muscle, the external anal sphincter (EAS) muscle, the puborectalis muscle (PRM), and the levator ani muscles (LAM) in addition to the anal wall (Awall) and rectal wall (Rwall) were retrospectively delineated on planning computed tomography scans. Dose parameters were obtained and compared between patients with and without fecal urgency, incontinence, and frequency. Dose-effect curves were constructed. Finally, the effect of an endorectal balloon, which was applied in 28 patients, was investigated. Results: The total volume of the pelvic floor muscles together was about three times that of the Awall. The PRM was exposed to the highest RT dose, whereas the EAS received the lowest dose. Several anal and rectal dose parameters, as well as doses to all separate pelvic floor muscles, were associated with urgency, while incontinence was associated mainly with doses to the EAS and PRM. Based on the dose-effect curves, the following constraints regarding mean doses could be deduced to reduce the risk of urgency: {<=}30 Gy to the IAS; {<=}10 Gy to the EAS; {<=}50 Gy to the PRM; and {<=}40 Gy to the LAM. No dose-effect relationships for frequency were observed. Patients treated with an endorectal balloon reported significantly less urgency and incontinence, while their treatment plans showed significantly lower doses to the Awall, Rwall, and all pelvic floor muscles. Conclusions: Incontinence-related complaints show specific dose-effect relationships to individual pelvic floor muscles. Dose constraints for each muscle can be identified for RT planning. When only the Awall is delineated, substantial components of the continence apparatus are

  4. Dynamic assessment of women pelvic floor function by using a fiber Bragg grating sensor system

    NASA Astrophysics Data System (ADS)

    Ferreira, Luis A.; Araújo, Francisco M.; Mascarenhas, Teresa; Natal Jorge, Renato M.; Fernandes, António A.

    2006-02-01

    We present a novel sensing system consisting of an intravaginal probe and an optoelectronic measurement unit, which allows an easy, comfortable and quantitative dynamic evaluation of women pelvic floor muscle strength. The sensing probe is based on a silicone cylinder that transduces radial muscle pressure into axial load applied to a fiber Bragg grating strain sensor. The performance of a first sensor probe prototype with temperature referentiation and of the autonomous, portable optoelectronic measurement unit with data logging capabilities and graphical user interface is disclosed. The presented results refer to an ongoing collaboration work between researchers from the Medical, Optoelectronics and Mechanical areas, directed to the development of equipment that can assist in medical practice and help in the research of primary mechanisms responsible for several pelvic floor disorders, in particular urogenital prolapses.

  5. Organization of lumbosacral motoneuronal cell groups innervating hindlimb, pelvic floor, and axial muscles in the cat.

    PubMed

    Vanderhorst, V G; Holstege, G

    1997-05-26

    In a study on descending pathways from the nucleus retroambiguus (NRA) to hindlimb motoneurons (see accompanying paper), it appeared impossible, using data from the literature, to precisely determine which muscles were innervated by the motoneurons receiving the NRA fibers. This lack of data made it necessary to produce a detailed map of the lumbosacral motoneuronal cell groups in the cat. Therefore, 50 different muscles or muscle compartments of hindlimb, pelvic floor and lower back were injected with horseradish peroxidase (HRP) in 135 cases. The respective muscles were divided into ten groups: I, sartorius and iliopsoas; II, quadriceps; III, adductors; IV, hamstrings; V, gluteal and other proximal muscles of the hip; VI, posterior compartment of the distal hindlimb; VII, anterior compartment of the distal hindlimb; VIII, long flexors and intrinsic muscles of the foot; IX, pelvic floor muscles; and X, extensors of the lower back and tail. The L4-S2 segments were cut and incubated, and labeled motoneurons were counted and plotted. A new method was developed that made it possible, despite variations in size and segmental organization between the different cases, to compare the results of different cases. The results show that the spatial interrelationship between the hindlimb and pelvic floor lumbosacral motoneuronal cell groups remains constant. This finding enabled the authors to compose an accurate overall map of the location of lumbosacral motoneuronal cell groups. The general distribution of the motoneuronal cell groups is also discussed in respect to their dorsoventral, mediolateral, and rostrocaudal position within the lumbosacral ventral horn. PMID:9136811

  6. Chronic pelvic pain syndrome: reduction of medication use after pelvic floor physical therapy with an internal myofascial trigger point wand.

    PubMed

    Anderson, Rodney U; Harvey, Richard H; Wise, David; Nevin Smith, J; Nathanson, Brian H; Sawyer, Tim

    2015-03-01

    This study documents the voluntary reduction in medication use in patients with refractory chronic pelvic pain syndrome utilizing a protocol of pelvic floor myofascial trigger point release with an FDA approved internal trigger point wand and paradoxical relaxation therapy. Self-referred patients were enrolled in a 6-day training clinic from October, 2008 to May, 2011 and followed the protocol for 6 months. Medication usage and symptom scores on a 1-10 scale (10 = most severe) were collected at baseline, and 1 and 6 months. All changes in medication use were at the patient's discretion. Changes in medication use were assessed by McNemar's test in both complete case and modified intention to treat (mITT) analyses. 374 out of 396 patients met inclusion criteria; 79.7 % were male, median age of 43 years and median symptom duration of 5 years. In the complete case analysis, the percent of patients using medications at baseline was 63.6 %. After 6 months of treatment the percentage was 40.1 %, a 36.9 % reduction (p < 0.001). In the mITT analysis, there was a 22.7 % overall reduction from baseline (p < 0.001). Medication cessation at 6 months was significantly associated with a reduction in total symptoms (p = 0.03). PMID:25708131

  7. Chronic pelvic pain syndrome: reduction of medication use after pelvic floor physical therapy with an internal myofascial trigger point wand.

    PubMed

    Anderson, Rodney U; Harvey, Richard H; Wise, David; Nevin Smith, J; Nathanson, Brian H; Sawyer, Tim

    2015-03-01

    This study documents the voluntary reduction in medication use in patients with refractory chronic pelvic pain syndrome utilizing a protocol of pelvic floor myofascial trigger point release with an FDA approved internal trigger point wand and paradoxical relaxation therapy. Self-referred patients were enrolled in a 6-day training clinic from October, 2008 to May, 2011 and followed the protocol for 6 months. Medication usage and symptom scores on a 1-10 scale (10 = most severe) were collected at baseline, and 1 and 6 months. All changes in medication use were at the patient's discretion. Changes in medication use were assessed by McNemar's test in both complete case and modified intention to treat (mITT) analyses. 374 out of 396 patients met inclusion criteria; 79.7 % were male, median age of 43 years and median symptom duration of 5 years. In the complete case analysis, the percent of patients using medications at baseline was 63.6 %. After 6 months of treatment the percentage was 40.1 %, a 36.9 % reduction (p < 0.001). In the mITT analysis, there was a 22.7 % overall reduction from baseline (p < 0.001). Medication cessation at 6 months was significantly associated with a reduction in total symptoms (p = 0.03).

  8. Assessment of Women With Defecatory Dysfunction and Manual Splinting Using Dynamic Pelvic Floor Magnetic Resonance Imaging

    PubMed Central

    Apostolis, Costas; Wallace, Karen; Sasson, Pierre; Hacker, Michele R.; Elkadry, Eman; Rosenblatt, Peter L.

    2013-01-01

    Objective This study aimed to describe magnetic resonance imaging (MRI) findings in women with defecatory dysfunction who perform manual splinting. Methods This is a retrospective study of 29 patients from a single urogynecology center who presented with complaints of defecatory dysfunction and who reported manual splinting to assist with bowel movements. Patients were scheduled for an MRI study with a novel “splinting” protocol to evaluate the effects of their manual splinting on the pelvic floor. The protocol involved asking patients to splint during the MRI, as they normally would when trying to defecate. The goal was to evaluate any change in pelvic anatomy and compensation for an anatomic defect that could potentially lead to their defecatory dysfunction. Magnetic resonance images of the pelvis were obtained at rest, with pelvic floor contraction, with Valsalva, and during manual splinting. These images were then reviewed by radiologists who evaluated various parameters, including anorectal angle, levator ani muscle integrity, and the presence of rectocele, cystocele, apical prolapse, and enterocele. The external and internal anal sphincters were also evaluated for continuity. Results From September 2008 to October 2010, 29 women reported defecatory dysfunction and the need for manual splinting. Their mean (SD) age was 55.2 (10.5) years. Magnetic resonance images showed a rectocele in 86.2% of the study group, cystocele in 75.9%, enterocele in 10.3%, and a defect of the levator ani muscles in 17.2%. Twentyone (72.4%) women had more than 1 of these defects. In addition, 27.6% had an anorectal angle less than 90 degrees or greater than 105 degrees. Patients in the study group splinted in the vagina (58.6%), on the perineum (31.0%), or on the buttock (10.3%). In all but 1 woman (96.6%), splinting improved or completely corrected the identified defect(s) as evidenced with MRI. Among those who used vaginal splinting, 52.9% of defects were corrected and 47

  9. [Electrostimulation of the pelvic floor. A simple method of treating urinary incontinence].

    PubMed

    Schiøtz, H A; Vormdal, J

    1990-04-30

    Urinary incontinence is a very common condition affecting several hundred thousand Norwegian women. Traditional methods of treatment have often given unsatisfactory results, and many patients either do not seek help or are considered unsuitable for treatment. Electrical stimulation of the pelvic floor is a fairly new method of treating urinary incontinence. It is safe, simple, inexpensive and well tolerated. It cures or improves more than 50% of patients. More widespread use should save considerable amounts of money for the health services, and should improve the quality of life for many patients. It is recommended that electrostimulation therapy be made easily available in primary health care.

  10. Relationship among vaginal palpation, vaginal squeeze pressure, electromyographic and ultrasonographic variables of female pelvic floor muscles

    PubMed Central

    Pereira, Vanessa S.; Hirakawa, Humberto S.; Oliveira, Ana B.; Driusso, Patricia

    2014-01-01

    Background: The proper evaluation of the pelvic floor muscles (PFM) is essential for choosing the correct treatment. Currently, there is no gold standard for the assessment of female PFM function. Objective: To determine the correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the female PFM. Method: This cross-sectional study evaluated 80 women between 18 and 35 years of age who were nulliparous and had no pelvic floor dysfunction. PFM function was assessed based on digital palpation, vaginal squeeze pressure, electromyographic activity, bilateral diameter of the bulbocavernosus muscles and the amount of bladder neck movement during voluntary PFM contraction using transperineal bi-dimensional ultrasound. The Pearson correlation was used for statistical analysis (p<0.05). Results: There was a strong positive correlation between PFM function and PFM contraction pressure (0.90). In addition, there was a moderate positive correlation between these two variables and PFM electromyographic activity (0.59 and 0.63, respectively) and movement of the bladder neck in relation to the pubic symphysis (0.51 and 0.60, respectively). Conclusions: This study showed that there was a correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the PFM in nulliparous women. The strong correlation between digital palpation and PFM contraction pressure indicated that perineometry could easily be replaced by PFM digital palpation in the absence of equipment. PMID:25372005

  11. Long-term electrostimulation of the pelvic floor: primary therapy in female stress incontinence?

    PubMed

    Eriksen, B C; Eik-Nes, S H

    1989-01-01

    A prospective evaluation of the therapeutic effect of neuromuscular electrical pelvic floor stimulation was performed in 55 women with urinary stress incontinence awaiting surgical repair. Chronic stimulation was applied anally or vaginally by an integrated plug electrode for a median of 5.4 months. After therapy, 68% of the patients were continent or had improved so such that the planned operation was cancelled. At 2-year follow-up, the persisting success rate after electrostimulation was reduced to 56%, 31% had undergone surgical repair or were awaiting colposuspension, 9% were still incontinent, but refused surgery, and 4% were deceased. However, in the high-compliance group of 45 patients who had used the device regularly for at least 3 months, the success rate of pelvic floor stimulation was 72% at 2-year follow-up. The therapeutic effect could be verified objectively by positive changes in clinical stress test and dynamic urethral pressure profile. Approximately 2,300 pounds were saved for each patient avoiding surgery. A 40% reduction of the total cost of stress incontinence therapy was attained by the presented model.

  12. Update on laparoscopic, robotic, and minimally invasive vaginal surgery for pelvic floor repair.

    PubMed

    Ross, J W; Preston, M R

    2009-06-01

    Advanced laparoscopic surgery marked the beginning of minimally invasive pelvic surgery. This technique lead to the development of laparoscopic hysterectomy, colposuspension, paravaginal repair, uterosacral suspension, and sacrocolpopexy without an abdominal incision. With laparoscopy there is a significant decrease in postoperative pain, shorter length of hospital stay, and a faster return to normal activities. These advantages made laparoscopy very appealing to patients. Advanced laparoscopy requires a special set of surgical skills and in the early phase of development training was not readily available. Advanced laparoscopy was developed by practicing physicians, instead of coming down through the more usual academic channels. The need for special training did hinder widespread acceptance. Nonetheless by physician to physician training and society training courses it has continued to grow and now has been incorporated in most medical school curriculums. In the last few years there has been new interest in laparoscopy because of the development of robotic assistance. The 3D vision and 720 degree articulating arms with robotics have made suture intensive procedures much easier. Laparosco-pic robotic-assisted sacrocolpopexy is in the reach of most surgeons. This field is so new that there is very little data to evaluate at this time. There are short comings with laparoscopy and even with robotic-assisted procedures it is not the cure all for pelvic floor surgery. Laparoscopic procedures are long and many patients requiring pelvic floor surgery have medical conditions preventing long anesthesia. Minimally invasive vaginal surgery has developed from the concept of tissue replacement by synthetic mesh. Initially sheets of synthetic mesh were tailored by physicians to repair the anterior and posterior vaginal compartment. The use of mesh by general surgeons for hernia repair has served as a model for urogynecology. There have been rapid improvements in biomaterials

  13. Phased surgical treatment of barium enema-induced rectal injury and retention of barium in the pelvic floor space

    PubMed Central

    Yang, Xuefei; Xia, Ligang; Huang, Jun; Wang, Jianping

    2014-01-01

    Iatrogenic injuries caused by barium enema are rarely reported. Following a phased surgical protocol for up to one year, we have successfully treated a patient with rectal injury and severe infection of the pelvic floor space complicated with retention of large amounts of barium and vaginal fistula. In this article, the phased surgery planning for the treatment of rectal injury complicated with vaginal fistula is discussed in terms of the pros and cons, and the observed effect and evolution of barium retained in the pelvic floor space are described. PMID:25405155

  14. Mesh complications in female pelvic floor reconstructive surgery and their management: A systematic review

    PubMed Central

    Shah, Hemendra N.; Badlani, Gopal H.

    2012-01-01

    , severity and potential recurrence of pelvic floor defect. PMID:22919127

  15. Food, fibre, bile acids and the pelvic floor: An integrated low risk low cost approach to managing irritable bowel syndrome.

    PubMed

    Philpott, Hamish; Nandurkar, Sanjay; Lubel, John; Gibson, Peter R

    2015-10-28

    Patients presenting with abdominal pain and diarrhea are often labelled as suffering from irritable bowel syndrome, and medications may be used often without success. Advances in the understanding of the causes of the symptoms (including pelvic floor weakness and incontinence, bile salt malabsorption and food intolerance) mean that effective, safe and well tolerated treatments are now available.

  16. Food, fibre, bile acids and the pelvic floor: An integrated low risk low cost approach to managing irritable bowel syndrome

    PubMed Central

    Philpott, Hamish; Nandurkar, Sanjay; Lubel, John; Gibson, Peter R

    2015-01-01

    Patients presenting with abdominal pain and diarrhea are often labelled as suffering from irritable bowel syndrome, and medications may be used often without success. Advances in the understanding of the causes of the symptoms (including pelvic floor weakness and incontinence, bile salt malabsorption and food intolerance) mean that effective, safe and well tolerated treatments are now available. PMID:26525925

  17. Clinical and urodynamic evaluation of women with detrusor instability before and after functional pelvic floor electrostimulation.

    PubMed

    Arruda, R M; Castro, R A; Sartori, M G F; Takano, C C; Baracat, E C; Rodrigues de Lima, G; Girão, M J B C

    2003-01-01

    Detrusor instability is the second most frequent cause of female urinary incontinence. There are many therapeutic options, including non-invasive and surgical procedures. In this study, we evaluated the effects of pelvic floor vaginal electrostimulation using equipment designed in our institution, over three consecutive months, for treatment of 29 women with detrusor instability. After treatment 22 patients (76%) considered themselves cured or symptomatically improved; seven patients (24%) had no change in symptoms after therapy. There was objective cure and improvement in ten (34.5%) and in eight (27.5%) patients, respectively, and the urodynamic parameters did not change in 11 patients (38%). Electrical stimulation resulted in a gradual decrease in the number of urinary leakage episodes and increase in maximum cystometric capacity in first desire to void and in urinary volume.

  18. Reliability of Superficial Male Pelvic Floor Structural Measurements Using Linear-Array Transperineal Sonography

    PubMed Central

    Roll, Shawn C.; Rana, Manku; Sigward, Susan M.; Yani, Moheb S.; Kirages, Daniel J.; Kutch, Jason J.

    2014-01-01

    This study evaluated reliability of measures for superficial structures of the male pelvic floor (PF) obtained via transperineal sonography. Two embalmed cadavers were dissected to identify positioning of muscles on and around the bulb of the penis and to confirm the PF protocol. Cross-sectional area (CSA) and linear thickness of the bulb of the penis, urethra, bulbospongiosus (BS) muscles, and ischiocavernosus (IC) muscles were measured on 38 transverse images from 20 male subjects by three raters with varied study knowledge and sonographic experience. Intra- and interrater reliability were calculated with Two-way, mixed effects intra-class correlation coefficients. Measures of the bulb of the penis had the best reliability. CSA of all muscles and sagittal thickness of the BS near the central tendon had good reliability. Reliability varied for rater identified thickest muscle region and measures of the urethra. Our study suggests that structures of the male PF can be reliably evaluated using a transperineal sonographic approach. PMID:25444690

  19. Mesh Perforation into a Viscus in the Setting of Pelvic Floor Surgery-Presentation and Management.

    PubMed

    Cohen, Seth A; Goldman, Howard B

    2016-09-01

    Perforation of a viscus with a mesh product either during or subsequent to pelvic floor reconstruction can be associated with devastating outcomes. If surgeons are going to place mesh, they also need to be familiar with symptoms concerning for perforation. The index of suspicion should always be present, as these patients can present years after initial mesh placement. The best opportunity for intervention in these serious complications is the first intervention. As bits of mesh are chipped away during attempted interventions, residual mesh fragments become disjointed, frayed, and scarred further, making their removal even more challenging, in addition to traumatizing likely already weakened tissues. This review presents strategies for patient evaluation in the setting of possible mesh perforation, in addition to treatment strategies for urethral, bladder, ureteral, and colonic/rectal injury. Ultimately, the decision as to how much mesh is removed should be based on each patient's unique presentation. PMID:27438809

  20. SEXUAL FUNCTION AND PESSARY MANAGEMENT AMONG WOMEN USING A PESSARY FOR PELVIC FLOOR DISORDERS

    PubMed Central

    MERIWETHER, Kate V.; KOMESU, Yuko; CRAIG, Ellen; QUALLS, Clifford; DAVIS, Herbert; ROGERS, Rebecca G.

    2016-01-01

    Introduction Pessaries are commonly used to treat pelvic floor disorders, but little is known about the sexual function of pessary users. Aim We aimed to describe sexual function among pessary users and pessary management with regard to sexual activity. Methods This is a secondary analysis of a randomized trial of new pessary users, where study patients completed validated questionnaires on sexual function and body image at pessary fitting and 3 months later. Main outcome measures Women completed the Pelvic Organ Prolapse - Urinary Incontinence Sexual Function Questionnaire, IUGA Revised (PISQ-IR), a validated measure that evaluates the impact of pelvic floor disorders on sexual function, a modified female body image scale (mBIS), and questions regarding pessary management surrounding sexual activity. Results Of 127 women, 54% (68/127) were sexually active at baseline and 42% (64/114) were sexually active at 3 months. Sexual function scores were not different between baseline and 3 months on all domains except for a drop of 0.15 points (p=0.04) for sexually active women and a drop of 0.34 points for non-sexually active women (p=0.02) in the score related to the sexual partner. Total mBIS score did not change (p=0.07), but scores improved by 0.2 points (p=0.03) in the question related to self-consciousness. Pessary satisfaction was associated with improved sexual function scores in multiple domains and improved mBIS scores. The majority (45/64, 70%) of sexually active women removed their pessary for sex, with over half stating their partner preferred removal for sex (24/45, 53%). Conclusion Many women remove their pessary during sex for partner considerations, and increased partner concerns are the only change seen in sexual function in the first 3 months of pessary use. Pessary use may improve self-consciousness and pessary satisfaction is associated with improvements in sexual function and body image. PMID:26632106

  1. Physical therapy in the management of pelvic floor muscles hypertonia in a woman with hereditary spastic paraplegia.

    PubMed

    Ribeiro, Aline Moreira; Ferreira, Cristine Homsi Jorge; Cristine Lemes Mateus-Vasconcelos, Elaine; Moroni, Rafael Mendes; Brito, Luciane Maria Oliveira; Brito, Luiz Gustavo Oliveira

    2014-01-01

    Background. Pelvic floor (PF) hypertonic disorders are a group of conditions that present with muscular hypertonia or spasticity, resulting in a diminished capacity to isolate, contract, and relax the PF. Their presentation includes voiding and sexual dysfunctions, pelvic pain, and constipation. Various factors are associated, such as complicated vaginal birth, muscular injury, scar tissue formation, and neuropathies. Study Design. The case of a single patient will be presented, together with the management strategies employed. Case Description. A woman with hereditary spastic paraparesis and a history of muscle spasticity and urinary and fecal complaints since childhood. She presented to this institution seeking treatment for pelvic pain, pain during intercourse, constipation, and micturition problems. A physical therapy protocol was developed, with the trial of several treatment modalities. Outcome. After some failed attempts, perineal and pelvic floor stretching proved to be very efficacious therapies for this patient's complaint, leading to improved pain during intercourse, constipation, pelvic pain, and urinary stream. Discussion. PF spasticity can lead to severe disability and interfere with daily basic functions, such as micturition and evacuation. Physical therapy plays an essential role in the management of these patients and can lead to significant improvement in quality of life.

  2. Physical Therapy in the Management of Pelvic Floor Muscles Hypertonia in a Woman with Hereditary Spastic Paraplegia

    PubMed Central

    Ribeiro, Aline Moreira; Ferreira, Cristine Homsi Jorge; Cristine Lemes Mateus-Vasconcelos, Elaine; Moroni, Rafael Mendes; Brito, Luciane Maria Oliveira; Brito, Luiz Gustavo Oliveira

    2014-01-01

    Background. Pelvic floor (PF) hypertonic disorders are a group of conditions that present with muscular hypertonia or spasticity, resulting in a diminished capacity to isolate, contract, and relax the PF. Their presentation includes voiding and sexual dysfunctions, pelvic pain, and constipation. Various factors are associated, such as complicated vaginal birth, muscular injury, scar tissue formation, and neuropathies. Study Design. The case of a single patient will be presented, together with the management strategies employed. Case Description. A woman with hereditary spastic paraparesis and a history of muscle spasticity and urinary and fecal complaints since childhood. She presented to this institution seeking treatment for pelvic pain, pain during intercourse, constipation, and micturition problems. A physical therapy protocol was developed, with the trial of several treatment modalities. Outcome. After some failed attempts, perineal and pelvic floor stretching proved to be very efficacious therapies for this patient's complaint, leading to improved pain during intercourse, constipation, pelvic pain, and urinary stream. Discussion. PF spasticity can lead to severe disability and interfere with daily basic functions, such as micturition and evacuation. Physical therapy plays an essential role in the management of these patients and can lead to significant improvement in quality of life. PMID:25478261

  3. Distensibility and Strength of the Pelvic Floor Muscles of Women in the Third Trimester of Pregnancy

    PubMed Central

    Petricelli, Carla Dellabarba; Resende, Ana Paula Magalhães; Elito Júnior, Julio; Araujo Júnior, Edward; Alexandre, Sandra Maria; Zanetti, Miriam Raquel Diniz; Nakamura, Mary Uchiyama

    2014-01-01

    Objective. The objective of this study was to compare the role of the pelvic floor muscles between nulliparous and multiparous women in the third trimester of pregnancy, by analyzing the relationship between electrical activity (surface electromyography—EMG), vaginal palpation (modified Oxford scale), and perineal distensibility (Epi-no). Methods. This was an observational cross-sectional study on a sample of 60 healthy pregnant women with no cervical dilation, single fetus, gestational age between 35 and 40 weeks, and maternal age ranging from 15 to 40 years. The methods used were bidigital palpation (modified Oxford scale, graded 0–5), surface EMG (electrical activity during maximal voluntary contraction), and perineal distensibility (Epi-no device). The Pearson correlation coefficient (r) was used to analyze the Epi-no values and the surface EMG findings. The Kruskal-Wallis test was used to compare the median values from surface EMG and Epi-no, using the modified Oxford scale scores. Results. Among the 60 patients included in this study, 30 were nulliparous and 30 multiparous. The average maternal age and gestational age were 26.06 (±5.58) and 36.56 (±1.23), respectively. It was observed that nulliparous women had both higher perineal muscle strength (2.53 ± 0.57 versus 2.06 ± 0.64; P = 0.005) and higher electrical activity (45.35 ± 12.24 μV versus 35.79 ± 11.66 μV; P = 0.003), while among the multiparous women, distensibility was higher (19.39 ± 1.92 versus 18.05 ± 2.14; P = 0.013). We observed that there was no correlation between perineal distensibility and electrical activity during maximal voluntary contraction (r = − 0.193; P = 0.140). However, we found a positive relationship between vaginal palpation and surface electromyography (P = 0.008), but none between Epi-no values (P = 0.785). Conclusion. The electrical activity and muscle strength of the pelvic floor muscles of the multiparous women were damaged, in relation to the

  4. Training through gametherapy promotes coactivation of the pelvic floor and abdominal muscles in young women, nulliparous and continents

    PubMed Central

    Silva, Valeria Regina; Riccetto, Cássio; Martinho, Natalia Miguel; Marques, Joseane; Carvalho, Leonardo Cesar; Botelho, Simone

    2016-01-01

    ABSTRACT Introduction and objectives: Several studies have been investigated co-activation can enhance the effectveness of PFM training protocols allowing preventive and therapeutic goals in pelvic floor dysfunctions. The objective of the present study was to investigate if an abdominal-pelvic protocol of training (APT) using gametherapy would allow co-activation of PFM and transversus abdominis/oblique internal (TrA/OI) muscles. Patients and methods: Twenty-five nulliparous, continent, young females, with median age 24.76 (±3.76) years were evaluated using digital palpation (DP) of PFM and surface electromyography of PFM and TrA/OI simultaneously, during maximal voluntary contraction (MVC), alternating PFM and TrA/OI contraction requests. All women participated on a supervised program of APT using gametherapy, that included exercises of pelvic mobilization associated to contraction of TrA/OI muscles oriented by virtual games, for 30 minutes, three times a week, in a total of 10 sessions. Electromyographic data were processed and analyzed by ANOVA - analysis of variance. Results: When MVC of TrA/OI was solicited, it was observed simultaneous increase of electromyographic activity of PFM (p=0.001) following ATP. However, EMG activity did not change significantly during MVC of PFM. Conclusion: Training using gametherapy allowed better co-activation of pelvic floor muscles in response to contraction of TrA, in young nulliparous and continent women. PMID:27564290

  5. Influence of parity, type of delivery, and physical activity level on pelvic floor muscles in postmenopausal women

    PubMed Central

    Varella, Larissa Ramalho Dantas; Torres, Vanessa Braga; Angelo, Priscylla Helouyse Melo; Eugênia de Oliveira, Maria Clara; Matias de Barros, Alef Cavalcanti; Viana, Elizabel de Souza Ramalho; Micussi, Maria Thereza de Albuquerque Barbosa Cabral

    2016-01-01

    [Purpose] The aim of the present study was to assess the influence of parity, type of delivery, and physical activity level on pelvic floor muscles in postmenopausal women. [Subjects and Methods] This was an observational analytic cross-sectional study with a sample of 100 postmenopausal women, aged between 45 and 65 years, divided into three groups according to menopausal stage: hysterectomized and early and late postmenopause. Patients were assessed for sociodemographic and gyneco-obstetric factors and subjected to a muscle strength test and perineometry. Descriptive statistics, ANOVA, Kruskal-Wallis and multiple regression were applied. [Results] The results showed homogeneity in sociodemographic and anthropometric characteristics. There was no difference in pelvic floor muscle function among the three groups. Type of delivery, parity and physical activity level showed no influence on muscle function. [Conclusion] The findings demonstrate that parity, type of delivery, and physical activity level had no influence on pelvic floor muscle pressure in postmenopausal women. One hypothesis to explain these results is the fact that the decline in muscle function in postmenopausal women is related to the female aging process. PMID:27134366

  6. Impact of Retropubic vs. Transobturator Slings for Urinary Incontinence on Myofascial Structures of the Pelvic Floor, Adductor and Abdominal Muscles.

    PubMed

    Beilecke, K; Soeder, S; Hufenbach, E; Tunn, R

    2014-01-01

    Suburethral tension-free slings (tapes or bands) are an essential component in the operative treatment of urinary incontinence. In the present contribution the influence of the type of suburethral sling (retropubic vs. transobturator) on the myofascial structures of the abdominal, adductor and pelvic floor muscles is examined. For this purpose, 70 patients were prospectively observed clinically and physiotherapeutically. Significant differences were seen in the improvement of the pelvic floor musculature (strength, endurance, speed) after placement of a suburethral sling, irrespective of whether it was of the retropubic or the transobturator type. Thus, after surgical treatment patients should be encouraged to undertake further pelvic floor exercising or this should be prescribed for them. There were no significant changes in the abdominal and adductor muscles but there were slight increases with regard to pain level, pain on palpation, and trigger points after placement of both types of sling; thus this is not a criterion in the decision as to which type of sling to use. PMID:24741121

  7. Communication Between Physicians And Spanish-Speaking Latin American Women With Pelvic Floor Disorders: A Cycle Of Misunderstanding?

    PubMed Central

    Sevilla, Claudia; Wieslander, Cecilia K.; Alas, Alexandriah N.; Dunivan, Gena C.; Khan, Aqsa A.; Maliski RN, Sally L.; Rogers, Rebecca G.; Anger, Jennifer T.

    2013-01-01

    Objectives To assess the effect of the initial visit with a specialist on disease understanding among Spanish-speaking women with pelvic floor disorders. Methods Spanish-speaking women with referrals suggestive of urinary incontinence (UI) and/or pelvic organ prolapse (POP) were recruited from public urogynecology clinics. Patients participated in a health literacy assessment and interview before and after their physician encounter. All interviews were analyzed using Grounded Theory qualitative methods. Results Twenty-seven women with POP (N=6), UI (N=11), and POP/UI (N=10) were enrolled in this study. The mean age was 55.5 years and the majority of women had marginal levels of health literacy. From our qualitative analysis, three concepts emerged. First, was that patients had poor understanding of their diagnosis before and after the encounter regardless of how extensive the physician’s explanation or level of Spanish-proficiency. Secondly, patients were overwhelmed with the amount of information given to them. Lastly, patients ultimately put their trust in the physician, relying on them for treatment recommendations. Conclusions Our findings emphasize the difficulty Spanish-speaking women with low health literacy have in understanding information regarding pelvic floor disorders. In this specific population, the physician has a major role in influencing patients’ treatment decisions and helping them overcome fears they may have about their condition. PMID:23442506

  8. Pelvic floor muscle strength in primiparous women according to the delivery type: cross-sectional study 1

    PubMed Central

    Mendes, Edilaine de Paula Batista; de Oliveira, Sonia Maria Junqueira Vasconcellos; Caroci, Adriana de Souza; Francisco, Adriana Amorim; Oliveira, Sheyla Guimaraes; da Silva, Renata Luana

    2016-01-01

    ABSTRACT Objectives: to compare the pelvic floor muscle strength in primiparous women after normal birth and cesarean section, related to the socio-demographic characteristics, nutritional status, dyspareunia, urinary incontinence, perineal exercise in pregnancy, perineal condition and weight of the newborn. Methods: this was a cross-sectional study conducted after 50 - 70 postpartum days, with 24 primiparous women who underwent cesarean delivery and 72 who had a normal birth. The 9301 PeritronTM was used for analysis of muscle strength. The mean muscle strength was compared between the groups by two-way analysis of variance. Results: the pelvic floor muscle strength was 24.0 cmH2O (±16.2) and 25.4 cmH2O (±14.7) in postpartum primiparous women after normal birth and cesarean section, respectively, with no significant difference. The muscular strength was greater in postpartum women with ≥ 12 years of study (42.0 ±26.3 versus 14.6 ±7.7 cmH2O; p= 0.036) and in those who performed perineal exercises (42.6±25.4 11.8±4.9 vs. cmH2O; p = 0.010), compared to caesarean. There was no difference in muscle strength according to delivery type regarding nutritional status, dyspareunia, urinary incontinence, perineal condition or newborn weight. Conclusion: pelvic floor muscle strength does not differ between primiparous women based on the type of delivery. Postpartum women with normal births, with higher education who performed perineal exercise during pregnancy showed greater muscle strength. PMID:27533267

  9. Single-Blind, Randomized, Controlled Trial of Pelvic Floor Muscle Training, Electrical Stimulation, Vaginal Cones, and No Active Treatment in the Management of Stress Urinary Incontinence

    PubMed Central

    Castro, Rodrigo A.; Arruda, Raquel M.; Zanetti, Miriam R. D.; Santos, Patricia D.; Sartori, Marair G. F.; Girão, Manoel J. B. C.

    2008-01-01

    PURPOSE To compare the effectiveness of pelvic floor exercises, electrical stimulation, vaginal cones, and no active treatment in women with urodynamic stress urinary incontinence. PATIENTS AND METHODS One hundred eighteen subjects were randomly selected to recieve pelvic floor exercises (n=31), ES (n=30), vaginal cones (n=27), or no treatment (untreated control) (n=30). Women were evaluated before and after completion of six months of treatment by the pad test, quality of life questionnaire (I-QOL), urodynamic test, voiding diary, and subjective response. RESULTS In the objective evaluation, we observed a statistically significant reduction in the pad test (p=0.003), in the number of stress urinary episodes (p<0.001), and a significant improvement in the quality of life (p<0.001) in subjects who used pelvic floor exercises, electrical stimulation, and vaginal cones compared to the control group. No significant difference was found between groups in the urodynamic parameters. In the subjective evaluation, 58%, 55%, and 54% of women who had used pelvic floor exercises, electrical stimulation, and vaginal cones, respectively, reported being satisfied after treatment. In the control group, only 21% patients were satisfied with the treatment. CONCLUSION Based on this study, pelvic floor exercises, electrical stimulation, and vaginal cones are equally effective treatments and are far superior to no treatment in women with urodynamic stress urinary incontinence. PMID:18719756

  10. Evaluation of the relationship between the pelvic floor muscles and insulin resistance

    PubMed Central

    Micussi, Maria Thereza; Freitas, Rodrigo Pegado; Angelo, Priscylla Helouyse; Soares, Elvira Maria; Lemos, Telma Maria; Maranhão, Técia Maria

    2015-01-01

    Purpose The aim of this study was to evaluate the pelvic floor muscles (PFMs) in women with insulin resistance (IR) using surface electromyography and to associate the results with insulin levels. Patients and methods Through an analytical, cross-sectional study, 86 women were evaluated and divided into two groups: a control group (n=35) and an IR group (n=51). Data were collected through detailed history-taking, physical examination, and biochemical analysis. Fasting insulin levels were used for diagnosing IR. Electromyography of the PFMs was used for analyzing the tone and maximal voluntary contraction (MVC). The measures of central tendency and linear regression models were used. Results The average age was 25.3±4.5 years in the IR group and 27.2±4.4 years in the control group. The mean weight was 75.6±17.6 kg and 51.8±4.9 kg in the IR and control groups, respectively. Fasting insulin levels were 19.7±6.6 µIU/mL in the IR group and 5.4±1.8 µIU/mL in the control group (P<0.010). There were significant differences between the groups with regard to PFM tone (IR: 13.4±3.4 µV; control: 25.1±3.3 µV; P<0.001) and MVC (IR: 47.6±4.5 µV; control: 64.3±5.0 µV; P<0.001). Multiple linear regression analysis using the insulin levels as dependent variable showed a significant association for MVC (P=0.047), weight (P=0.017), and waist circumference (P=0.000). Conclusion Compared with the control group, the IR group showed lower electromyographic activity of the PFMs, and there was an association between insulin levels and electromyographic activity. PMID:26357485

  11. Botulinum neurotoxin type A injection of the pelvic floor muscle in pain due to spasticity: a review of the current literature.

    PubMed

    Bhide, Alka A; Puccini, Federica; Khullar, Vik; Elneil, Suzy; Digesu, G Alessandro

    2013-09-01

    The role of muscle spasm is not a new concept in the genesis of pain. Botulinum neurotoxin type A (BoNTA) has been successfully employed in a variety of muscular and inflammatory conditions. The aim of our study was to review the published literature on the role of BoNTA injection of the pelvic floor muscle in the management of women with chronic pelvic pain (CPP). A systematic search of the literature published up to June 2012 on the use of BoNTA in the treatment of female pelvic floor muscle spasm was carried out using relevant search terms in MEDLINE and EMBASE databases. The results were limited to full-text English language articles. Relevant trials as well as relevant reviews were selected and analyzed by two independent reviewers. Five studies (2 case reports, 1 prospective pilot study, 1 retrospective study and 1 randomised double-blind placebo controlled study) were included in this systematic review. Overall, BoNTA has shown to be beneficial in relieving CPP related to pelvic floor spasm. The role of BoNTA as a treatment of CPP has been recognized for more than 10 years. Although data are still scarce preliminary results are encouraging. BoNTA is an attractive option for refractory CPP related to pelvic floor muscle spasm, but further studies using validated and reproducible outcome measures are needed, to establish its effectiveness, safeness, technique, optimal dosage, and duration of symptom relief.

  12. Weakness of the Pelvic Floor Muscle and Bladder Neck Is Predicted by a Slight Rise in Abdominal Pressure During Bladder Filling: A Video Urodynamic Study in Children

    PubMed Central

    2016-01-01

    Purpose: To investigate the significance of slowly rising abdominal pressure (SRAP), which is often observed in nonneurogenic children during bladder filling in video urodynamic studies (VUDSs). Methods: The records of patients who underwent VUDS from July 2011 to June 2013 were reviewed. SRAP was defined as a rising curve over 5 cm H2O from the baseline abdominal pressure during the filling phase in VUDS. Bladder descent was defined when the base of the bladder was below the upper line of the pubic symphysis. An open bladder neck was defined as the opening of the bladder neck during the filling phase. Results: Of the 488 patients, 285 were male patients. The mean age at VUDS was 3.7 years (range, 0.2–17.6 years). The VUDS findings were as follows: SRAP, 20.7% (101 of 488); descending bladder, 14.8% (72 of 488); and bladder neck opening, 4.3% (21 of 488). Of the 72 patients with a descending bladder, 84.7% had SRAP. A significant difference in the presence of SRAP was found between the descending bladder and the normal bladder (P<0.001). Of the 101 patients with SRAP, 40 (39.6%) did not have a descending bladder. Of the 40 patients, 14 (35.0%) had a bladder neck opening, which was a high incidence compared with the 4.3% in all subjects (P<0.001). Conclusions: SRAP was associated with a descending bladder or a bladder neck opening, suggesting that SRAP is a compensatory response to urinary incontinence. SRAP may also predict decreased function of the bladder neck or pelvic floor muscle. PMID:27032558

  13. The pathophysiology of pelvic floor disorders: evidence from a histomorphologic study of the perineum and a mouse model of rectal prolapse

    PubMed Central

    YIOU, RENÉ; DELMAS, VINCENT; CARMELIET, PETER; GHERARDI, ROMAIN K.; BARLOVATZ-MEIMON, GEORGIA; CHOPIN, DOMINIQUE K.; ABBOU, CLÉMENT-CLAUDE; LEFAUCHEUR, JEAN-PASCAL

    2001-01-01

    The muscle changes related to pelvic floor disorders are poorly understood. We conducted an anatomical and histological study of the perineum of the normal mouse and of a transgenic mouse strain deficient in urokinase-type plasminogen activator (uPA−/−) that was previously reported to develop a high incidence of rectal prolapse. We could clearly identify the iliococcygeus (ILC) and pubococcygeus (PC) muscles and anal (SPA) and urethral (SPU) sphincters in male and female mice. The bulbocavernosus (BC), ischiocavernosus (ISC) and levator ani (LA) muscles could be found only in male mice. Histochemical analysis of the pelvic floor muscles revealed a majority of type IIA fibres. Rectal prolapses were observed only in male uPA−/− mice. The most obvious finding was an irreducible evagination of the rectal mucosa and a swelling of the entire perineal region corresponding to an irreducible hernia of the seminal vesicles through the pelvic outlet. The hernia caused stretching and thinning of the ISC, BC and LA. Myopathic damage, with degenerated and centronucleated myofibres, were observed in these muscles. The PC, ILC, SPA and SPU were not affected. This study provides an original description of a model of pelvic floor disorder and illustrates the differences existing between the perineum of humans and that of a quadruped species. In spite of these differences, the histopathologic changes observed in the pelvic floor muscles of uPA−/− mice with rectal prolapse suggest that prolonged muscular stretching causes a primary myopathic injury. This should be taken into account in the evaluation of pelvic floor disorders. PMID:11760891

  14. Prospective randomized comparison of oxybutynin, functional electrostimulation, and pelvic floor training for treatment of detrusor overactivity in women.

    PubMed

    Arruda, Raquel M; Castro, Rodrigo A; Sousa, Gabriela C; Sartori, Marair G F; Baracat, Edmund C; Girão, Manoel J B C

    2008-08-01

    The purpose of this study is to compare the effectiveness of oxybutynin, functional electrostimulation (FES), and pelvic floor training (PFT) for treatment of women with detrusor overactivity. Sixty-four subjects were randomized to oxybutynin (n=22), FES (n=21), or PFT (n=21). Women were evaluated before and after completion of 12 weeks of treatment by subjective response, voiding diary, and urodynamic test. There was subjective symptomatic improvement in 77% of the women treated with oxybutynin, 52% with FES, and 76% with PFT. Urgency resolved in 64% of women treated with oxybutynin, 52% with FES, and in 57% with PFT. Urodynamic evaluation was normal in 36% treated with oxybutynin, 57% with FES, and 52% with PFT. Maximum detrusor involuntary contraction pressure decreased in all groups (p<0.05). All treatments were equally effective. Subjective reduction of urge-incontinence episodes was associated with symptomatic improvement.

  15. [Pelvic floor functions: from the beginning of the second phase of labor to the postpartum consultation].

    PubMed

    Meyer, S; Achtari, C

    2011-10-26

    Vaginal delivery can cause lesions of the various pelvic structures responsible for the mechanisms of continence. These lesions may perhaps be prevented in the future by measuring pressure generated during childbirth. Tear of the anal sphincter during childbirth is a marker of a global impairment of the urinary, ano-rectal and sexual pelvic functions in the short and medium term. Persistence of a defect of the anal sphincter is frequent in spite of immediate suture. The correlation between these defects and ano-rectal incontinence are not established in our experience. The quality of the contraction of the sphincter complex and pubo-rectal sling seems to play a more important role in ano-rectal continence after a traumatic childbirth.

  16. Technique and complications of reconstruction of the pelvic floor with polyglactin mesh

    SciTech Connect

    Sener, S.F.; Imperato, J.P.; Blum, M.D.; Ignatoff, J.M.; Soper, T.G.; Winchester, D.P.; Meiselman, M.

    1989-06-01

    A polyglactin mesh sling was used to reconstruct the pelvis in eight patients after colorectal or urologic resections in preparation for postoperative radiation therapy. There were three perioperative complications--a pelvic abscess requiring percutaneous drainage, a wound dehiscence and a herniation of the small intestine between the pelvic sidewall and mesh requiring small intestinal resection. There were two delayed complications, both partial small intestinal obstructions. One occurred just after the conclusion of radiation treatment and the other occurred five months after the conclusion of radiation therapy. Both obstructions responded to conservative management. None of the common acute radiation effects occurred during radiotherapy. One patient with delayed partial small intestinal obstruction had possible late radiation effects. The median follow-up period after radiation therapy was 12.5 months. Despite the complications described in this report, the use of a polyglactin mesh sling as an adjunct to resection of carcinoma of the pelvis has merit and should be studied further.

  17. Biomaterials for Pelvic Floor Reconstructive Surgery: How Can We Do Better?

    PubMed Central

    Osman, Nadir I.; Bissoli, Julio; Bullock, Anthony J.; Chapple, Chris R.

    2015-01-01

    Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) are major health issues that detrimentally impact the quality of life of millions of women worldwide. Surgical repair is an effective and durable treatment for both conditions. Over the past two decades there has been a trend to enforce or reinforce repairs with synthetic and biological materials. The determinants of surgical outcome are many, encompassing the physical and mechanical properties of the material used, and individual immune responses, as well surgical and constitutional factors. Of the current biomaterials in use none represents an ideal. Biomaterials that induce limited inflammatory response followed by constructive remodelling appear to have more long term success than biomaterials that induce chronic inflammation, fibrosis and encapsulation. In this review we draw upon published animal and human studies to characterize the changes biomaterials undergo after implantation and the typical host responses, placing these in the context of clinical outcomes. PMID:25977927

  18. Functional female pelvic anatomy.

    PubMed

    Klutke, C G; Siegel, C L

    1995-08-01

    This article reviews important aspects of female pelvic anatomy with particular emphasis on the structures important for pelvic organ support and urinary control. The pelvis and supporting structures, the pelvic floor, and the relationships of the pelvic organs are described and illustrated by MR imaging.

  19. Validity and Reliability of an Instrumented Speculum Designed to Minimize the Effect of Intra-abdominal Pressure on the Measurement of Pelvic Floor Muscle Strength

    PubMed Central

    Ashton-Miller, James A.; Zielinski, Ruth; Miller, Janis M.; DeLancey, John O.L.

    2015-01-01

    Background Existing clinical measurements of pelvic floor muscle strength are contaminated by crosstalk from intra-abdominal pressure. We tested an improved instrumented speculum designed to minimize this crosstalk. The hypotheses were that the speculum yields: 1) maximum vaginal closure forces unrelated to intra-abdominal pressure, 2) discriminatory validity between women who have strong vs. weak pelvic floor muscles, and 3) acceptable test-retest reliability. Methods Maximum voluntary vaginal closure force was measured in 40 incontinent women (20–77 years) using the improved instrumented speculum on two visits spaced one month apart. At the baseline visit, intra-abdominal pressure was also estimated via intra-vesical catheterization during the vaginal closure force measurement. Subjective estimate of pelvic floor muscle strength was also assessed using digital palpation by a skilled examiner to determine group placement as “strong” (n=31) or “weak” (n=9). Findings Vaginal closure force was not significantly correlated with intra-abdominal pressure (r = −.26, p = .109). The groups with subjectively scored strong and weak pelvic floor muscles differed significantly by mean [SD] maximum vaginal closure force (3.8 [1.7] vs. 1.9 [0.8] N respectively, p < .01.) Across both time points the mean vaginal closure force was 3.42 [1.67] N with a range of .68 to 9.05 N. Mean Visit 1 and Visit 2 vaginal closure force scores did not differ (3.41 [1.8] and 3.42 [1.6] N, respectively). The vaginal closure force repeatability coefficient was 3.1 N. Interpretation The improved speculum measured maximum vaginal closure force without evidence of crosstalk from intra-abdominal pressure, while retaining acceptable discriminant validity and repeatability. PMID:25307868

  20. Preclinical animal study and human clinical trial data of co-electrospun poly(l-lactide-co-caprolactone) and fibrinogen mesh for anterior pelvic floor reconstruction

    PubMed Central

    Wu, Xujun; Wang, Yuru; Zhu, Cancan; Tong, Xiaowen; Yang, Ming; Yang, Li; Liu, Zhang; Huang, Weihong; Wu, Feng; Zong, Honghai; Li, Huaifang; He, Hongbing

    2016-01-01

    Synthetic and biological materials are commonly used for pelvic floor reconstruction. In this study, host tissue response and biomechanical properties of mesh fabricated from co-electrospun poly(l-lactide-co-caprolactone) (PLCL) and fibrinogen (Fg) were compared with those of polypropylene mesh (PPM) in a canine abdominal defect model. Macroscopic, microscopic, histological, and biomechanical evaluations were performed over a 24-week period. The results showed that PLCL/Fg mesh had similar host tissue responses but better initial vascularization and graft site tissue organization than PPM. The efficacy of the PLCL/Fg mesh was further examined in human pelvic floor reconstruction. Operation time, intraoperative blood loss, and pelvic organ prolapse quantification during 6-month follow-up were compared for patients receiving PLCL/Fg mesh versus PPM. According to the pelvic organ prolapse quantification scores, the anterior vaginal wall 3 cm proximal to the hymen point (Aa point), most distal edge of the cervix or vaginal cuff scar point (C point), and posterior fornix point (D point) showed significant improvement (P<0.01) at 1, 3, and 6 months for both groups compared with preoperatively. At 6 months, improvements at the Aa point in the PLCL/Fg group were significantly more (P<0.005) than the PPM group, indicating that, while both materials improve the patient symptoms, PLCL/Fg mesh resulted in more obvious improvement. PMID:26893556

  1. Preclinical animal study and human clinical trial data of co-electrospun poly(L-lactide-co-caprolactone) and fibrinogen mesh for anterior pelvic floor reconstruction.

    PubMed

    Wu, Xujun; Wang, Yuru; Zhu, Cancan; Tong, Xiaowen; Yang, Ming; Yang, Li; Liu, Zhang; Huang, Weihong; Wu, Feng; Zong, Honghai; Li, Huaifang; He, Hongbing

    2016-01-01

    Synthetic and biological materials are commonly used for pelvic floor reconstruction. In this study, host tissue response and biomechanical properties of mesh fabricated from co-electrospun poly(L-lactide-co-caprolactone) (PLCL) and fibrinogen (Fg) were compared with those of polypropylene mesh (PPM) in a canine abdominal defect model. Macroscopic, microscopic, histological, and biomechanical evaluations were performed over a 24-week period. The results showed that PLCL/Fg mesh had similar host tissue responses but better initial vascularization and graft site tissue organization than PPM. The efficacy of the PLCL/Fg mesh was further examined in human pelvic floor reconstruction. Operation time, intraoperative blood loss, and pelvic organ prolapse quantification during 6-month follow-up were compared for patients receiving PLCL/Fg mesh versus PPM. According to the pelvic organ prolapse quantification scores, the anterior vaginal wall 3 cm proximal to the hymen point (Aa point), most distal edge of the cervix or vaginal cuff scar point (C point), and posterior fornix point (D point) showed significant improvement (P<0.01) at 1, 3, and 6 months for both groups compared with preoperatively. At 6 months, improvements at the Aa point in the PLCL/Fg group were significantly more (P<0.005) than the PPM group, indicating that, while both materials improve the patient symptoms, PLCL/Fg mesh resulted in more obvious improvement. PMID:26893556

  2. Application of a new method in the study of pelvic floor muscle passive properties in continent women.

    PubMed

    Morin, Mélanie; Gravel, Denis; Bourbonnais, Daniel; Dumoulin, Chantale; Ouellet, Stéphane; Pilon, Jean-François

    2010-10-01

    The aim of this study was to present a new methodology for evaluating the pelvic floor muscle (PFM) passive properties. The properties were assessed in 13 continent women using an intra-vaginal dynamometric speculum and EMG (to ensure the subjects were relaxed) in four different conditions: (1) forces recorded at minimal aperture (initial passive resistance); (2) passive resistance at maximal aperture; (3) forces and passive elastic stiffness (PES) evaluated during five lengthening and shortening cycles; and (4) percentage loss of resistance after 1min of sustained stretch. The PFMs and surrounding tissues were stretched, at constant speed, by increasing the vaginal antero-posterior diameter; different apertures were considered. Hysteresis was also calculated. The procedure was deemed acceptable by all participants. The median passive forces recorded ranged from 0.54N (interquartile range 1.52) for minimal aperture to 8.45N (interquartile range 7.10) for maximal aperture while the corresponding median PES values were 0.17N/mm (interquartile range 0.28) and 0.67N/mm (interquartile range 0.60). Median hysteresis was 17.24N *mm (interquartile range 35.60) and the median percentage of force losses was 11.17% (interquartile range 13.33). This original approach to evaluating the PFM passive properties is very promising for providing better insight into the patho-physiology of stress urinary incontinence and pinpointing conservative treatment mechanisms.

  3. A process of informed consent for student learning through peer physical examination in pelvic floor physiotherapy practice.

    PubMed

    Delany, Clare; Frawley, Helena

    2012-03-01

    Peer physical examination (PPE) is a method of teaching and learning clinical skills in which students use fellow students as surrogate patients or models. PPE is recognised as useful as an experiential learning method to increase skill development for physiotherapy clinical practice. However students may feel pressured to participate despite discomfort and embarrassment when practising physical examination and treatment skills with their peers. Obtaining students' informed consent to participate in PPE is an important process to address these disadvantages of PPE. This paper proposes a three stage process for obtaining informed consent from postgraduate physiotherapy students learning pelvic floor examination and treatment skills. The process is designed to encourage educators to articulate the ethical issues that are relevant in this area of teaching; to provide information to students to enable them to understand what is involved and to choose to participate, and to offer alternatives to participation through a formalised process of informed consent. These steps mirror students' future obligations and actions when communicating with their patients.

  4. Pelvic floor muscle training for erectile dysfunction and climacturia 1 year after nerve sparing radical prostatectomy: a randomized controlled trial.

    PubMed

    Geraerts, I; Van Poppel, H; Devoogdt, N; De Groef, A; Fieuws, S; Van Kampen, M

    2016-01-01

    This study aimed to determine whether patients with persistent erectile dysfunction (ED), minimum 12 months after radical prostatectomy (RP), experienced a better recovery of erectile function (EF) with pelvic floor muscle training (PFMT) compared with patients without this intervention. Second, we aimed to investigate the effect of PFMT on climacturia. All patients, who underwent RP, with persistent ED of minimum 1 year post operation were eligible. The treatment group started PFMT immediately at 12 months post operation and the control group started at 15 months after RP. All patients received PFMT during 3 months. The sample size needed to detect with 80% power a 6 points-difference regarding the EF-domain of the International Index of Erectile Function (IIEF), was at least 12 subjects per group. Patients were evaluated using the IIEF and questioned regarding climacturia. Differences between groups at 15 months were evaluated with Mann-Whitney U-test and Fisher's exact test. As a result, the treatment group had a significantly better EF than the control group at 15 months after surgery (P=0.025). Other subdomains of the IIEF remained constant for both groups. The effect of PFMT was maintained during follow-up. At 15 months, a significantly higher percentage of patients in the treatment group showed an improvement regarding climacturia (P=0.004).

  5. Alterations in eliminative and sexual reflexes after spinal cord injury: defecatory function and development of spasticity in pelvic floor musculature.

    PubMed

    Nout, Yvette S; Leedy, Gail M; Beattie, Michael S; Bresnahan, Jacqueline C

    2006-01-01

    Spinal cord injury often results in loss of normal eliminative and sexual functions. This chapter is focused on defecatory function, although aspects of micturition and erectile function will be covered as well due to the overlap in anatomical organization and response to injury. These systems have both autonomic and somatic components, and are organized in the thoracolumbar (sympathetic), lumbosacral (somatic), and sacral (parasympathetic) spinal cord. Loss of supraspinal descending control and plasticity-mediated alterations at the level of the spinal cord, result in loss of voluntary control and in abnormal functioning of these systems including the development of dyssynergies and spasticity. There are several useful models of spinal cord injury in rodents that exhibit many of the autonomic dysfunctions observed after spinal cord injury in humans. Numerous studies involving these animal models have demonstrated development of abnormalities in bladder, external anal sphincter, and erectile function, such as detrusor-sphincter-dyssynergia and external anal sphincter hyperreflexia. Here we review many of these studies and show some of the anatomical alterations that develop within the spinal cord during the development of these hyperreflexias. Furthermore, we show that spasticity develops in other pelvic floor musculature as well, such as the bulbospongiosus muscle, which results in increased duration and magnitude of pressures developed during erectile events and increased duration of micturition. Advances and continued improvement in the use of current animal models of spinal cord injury should encourage and increase the laboratory work devoted to this relatively neglected area of experimental spinal cord injury.

  6. Elongation of textile pelvic floor implants under load is related to complete loss of effective porosity, thereby favoring incorporation in scar plates.

    PubMed

    Otto, Jens; Kaldenhoff, E; Kirschner-Hermanns, R; Mühl, Thomas; Klinge, Uwe

    2014-04-01

    Use of textile structures for reinforcement of pelvic floor structures has to consider mechanical forces to the implant, which are quite different to the tension free conditions of the abdominal wall. Thus, biomechanical analysis of textile devices has to include the impact of strain on stretchability and effective porosity. Prolift(®) and Prolift + M(®), developed for tension free conditions, were tested by measuring stretchability and effective porosity applying mechanical strain. For comparison, we used Dynamesh-PR4(®), which was designed for pelvic floor repair to withstand mechanical strain. Prolift(®) at rest showed moderate porosity with little stretchability but complete loss of effective porosity at strain of 4.9 N/cm. Prolift + M(®) revealed an increased porosity at rest, but at strain showed high stretchability, with subsequent loss of effective porosity at strain of 2.5 N/cm. Dynamesh PR4(®) preserved its high porosity even under strain, but as consequence of limited stretchability. Though in tension free conditions Prolift(®) and Prolift + M(®) can be considered as large pore class I meshes, application of mechanical strain rapidly lead to collapse of pores. The loss of porosity at mechanical stress can be prevented by constructions with high structural stability. Assessment of porosity under strain was found helpful to define requirements for pelvic floor devices. Clinical studies have to prove whether devices with high porosity as well as high structural stability can improve the patients' outcome. PMID:23625516

  7. Evaluation of early pelvic floor physiotherapy on the duration and degree of urinary incontinence after radical retropubic prostatectomy in a non-teaching hospital.

    PubMed

    Cornel, E B; de Wit, R; Witjes, J A

    2005-11-01

    The objective of this study was to study the effect of early pelvic floor re-education on the degree and duration of incontinence and to evaluate the results of radical retropubic prostatectomy (RRP) performed in a non-teaching hospital. This is a non-randomised study. From March 2000 to November 2003, 57 consecutive men, who underwent RRP for localized prostate cancer, participated in a pelvic floor re-educating program. Continence was defined as a loss of no more than 2-g urine on the 24-h pad test and no use of pads. The 24-h pad test was performed once in every 4 weeks until the patient indicated that he was continent. Diurnal and nocturnal continence was achieved after 1, 2, 3, 6 and 12 months post catheter removal in 40, 49, 70, 86 and 88% of all men, respectively. Comparison of our results with current literature suggest that the time period towards continence after a RRP can be shortened relevantly if pelvic floor re-education is started directly after catheter removal.

  8. Length Tension Function of Puborectalis Muscle: Implications for the Treatment of Fecal Incontinence and Pelvic Floor Disorders

    PubMed Central

    Mittal, Ravinder K; Sheean, Geoff; Padda, Bikram S; Rajasekaran, Mahadevan R

    2014-01-01

    Background/Aims External anal sphincter (EAS) and puborectalis muscle (PRM) play important role in anal continence function. Based on length-tension measurement, we recently reported that the human EAS muscle operates at short sarcomere length under physiological conditions. Goal of our study was to determine if PRM also operates at the short sarcomere length. Methods Length-tension relationship of the PRM muscle was studied in vivo in 10 healthy nullipara women. Length was altered by vaginal distension using custom-designed probes of 5, 10, 15, 20, 25 and 30 mm diameters as well as by distending a polyethylene bag with different volumes of water. Probes were equipped with a reverse perfuse sleeve sensor to measure vaginal pressure (surrogate of PRM tension). PRM electromyogram (EMG) was recorded using wire electrodes. Three-dimensional ultra-sound images were obtained to determine effect of vaginal distension on PRM length. Results Ultrasound images demonstrate distension volume dependent increase in PRM length. Rest and squeeze pressures of vaginal bag increased with the increase in bag volume. Similarly, the change in vaginal pressure, which represents the PRM contraction increased with the increase in the probe size. Increase in probe size was not associated with an increase in EMG activity (a marker of neural drive) of the PRM. Conclusions Probe size dependent increase in PRM contraction pressure, in the presence of constant EMG (neural input) proves that the human PRM operates at short sarcomere length. Surgically adjusting the PRM length may represent a novel strategy to improve treat anal continence and possibly other pelvic floor disorders. PMID:25273124

  9. A pilot study on the use of acupuncture or pelvic floor muscle training for mixed urinary incontinence

    PubMed Central

    Solberg, Mona; Alræk, Terje; Mdala, Ibrahimu; Klovning, Atle

    2016-01-01

    Objectives To determine the feasibility and acceptability of traditional Chinese medicine (TCM) acupuncture and pelvic floor muscle training (PFMT) in reducing symptoms and bothersomeness in women with mixed urinary incontinence (MUI); and to estimate the sample size for a full scale trial. Methods Thirty-four women with MUI were randomly assigned to either 12 sessions of TCM acupuncture, 12 sessions of PFMT, or to a waiting list control group. Outcome measures included an assessment of interest to participate in the trial, identification of successful recruitment strategies, the appropriateness of eligibility criteria, and compliance with treatment. Clinical outcomes were assessed at baseline and 12 weeks, and included the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI SF), expectations of treatment effect, and adverse events. Results Recruitment was feasible and randomisation worked adequately by means of SurveyMonkey. SurveyMonkey does not permit stratification by ICIQ-UI SF baseline score. Fourteen of 22 women found the treatment options acceptable. The dropout rate was high, especially in the control group (6/12). Outcome forms were completed by 20 of 34 women. The median (IQR) changes of the ICIQ-UI SF scores in the acupuncture, physiotherapy, and waiting list group were 5.5 (2.3 to 6.8), 1.0 (−3.0 to 4.5), and 1.5 (−1.5 to 3.0), respectively, suggesting the need for a full scale trial. Conclusions Women with MUI were willing to participate in this study. There is a need for adjusting eligibility criteria. A sample size of 129 women, 43 in three arms, is required. No major adverse events occurred. PMID:26362793

  10. Pelvic Floor Support Defect in Apical Anterior Vaginal Prolapse with Cervical Hypertrophy. Review with Case Report in a 20-year-old Cadaver

    PubMed Central

    2015-01-01

    Apical anterior vaginal wall prolapse (AVWP) with central defect is uncommon in young non hysterectomized patients causing considerable mortality after the fourth decade of life. Its high propensity to recurrence poses the greatest challenge to pelvic reconstructive surgeons. Approximately 40% of women with prolapse have hypertrophic cervical elongation and the extent of elongation increases with greater degrees of prolapse. Women with prolapse either have inherent hypertrophic elongation of the cervix which predisposes them to prolapse or the downward traction in prolapse leads to cervical elongation. The Pelvic Organ Prolapse Quantification (POP-Q) examination includes measurement of the location of the posterior fornix (point D) with the assumption that this measurement is associated with cervical elongation. Multifocal site involvement with apical and perineal descent primarily afflicts elderly, postmenopausal women after the fourth decade while cervical hypertrophic elongation with prolapse is observed in younger women less than 40 years of age. A review of the anatomical implication of the association of cervical hypertrophy in prolapse is carried out in this article. We observed a combination of distension type anterior vaginal prolapse with apical descent and cervical hypertrophy in a 20-year-old cadaver during routine dissection for undergraduate medical students at Sikkim Manipal Institute of Medical Sciences in 2013. Distension type anterior vaginal prolapse with central defect is rarer as most reported cases are of the displacement type, paravaginal defect. Hypertrophic cervical elongation is either the cause or consequence of prolapse and its identification before reconstructive surgery is paramount as uterine suspension in the face of cervical elongation is contraindicated. Inappropriate identification of all support defects and breaking of tissues is the primary cause of failure of laparoscopic pelvic reconstructive surgery. PMID:26557506

  11. [Changes in the position of the ureterovesical junction during maximal voluntary contractions and during maximal vaginal electric stimulation of the pelvic floor muscles].

    PubMed

    Martan, A; Masata, J; Halaska, M; Voigt, R

    1998-06-01

    The objective of the study was to evaluate and compare the effect of the maximal voluntary muscle contraction of the pelvic floor (PFM) and contractions of the PFM evoked by maximal electric stimulation using an electrostimulation apparatus Conmax by monitoring the position of the urethrovesical junction by ultrasound. The trial comprised 20 women with confirmed stress incontinence of urine. With the patients in a supine position with abducted lower extremities an electrostimulation probe was inserted into the vagina. This was followed by perineal ultrasound (US) examination using an ACUSON 128 XP-10 apparatus and a convex tube 5 MHz. The ultrasound examination was made using the electrostimulation probe--at rest and during maximal voluntary contraction of the PFM. This was followed by maximal electric stimulation and after five minutes during stimulation the US examination was repeated. It was performed also during maximal electric stimulation (MES) concurrently with maximal voluntary contraction of the PFM. For electrostimulation a Conmax appartus was used. The applied frequency was 50 Hz, amplitude from 0 to 90 mA (grade 0-6), duration of pulse 0.75 ms. The maximum intensity of stimulation was determined by the patient, i.e. when stimulation was not yet painful. During US the authors investigated the gamma angle, i.e. the angle between the axis of the symphysis and the connecting line between the UV junction and the lower borderline of the symphysis. The mean difference of the gamma angle during voluntary contraction of the PFM and at rest was 13.6. During contraction caused by maximal electric stimulation of the PFM and at rest this difference was 21.3. The difference did not differ significantly during maximal electric stimulation of the PFM and during maximal electric stimulation and voluntary contraction of the PFM. From the trial ensues that contraction of the pelvic floor muscles during maximal electric stimulation is stronger as compared with the

  12. Pelvic Floor Dyssynergia

    MedlinePlus

    ... we receive information (feedback) on how our bodies work. The therapist helps us to use this displayed information to modify or change abnormal responses to more normal patterns. ... Cyclic Vomiting Syndrome CVS ...

  13. Pelvic Floor Disorders

    MedlinePlus

    ... with questions about grants, contracts & research areas Training, Education & Career Development Support for Training at Universities & Other Institutions Extramural training, fellowships & career development opportunities Training at ...

  14. Pelvic Floor Dysfunction

    MedlinePlus

    Skip to main content ASCRS Patients Educational Resources Diseases and Conditions Patient Education Library Patient Success Stories Treatments and Screening Resources Find a Surgeon Hereditary Colorectal Cancer Registries Helpful Links Physicians ...

  15. The effects of training by virtual reality or gym ball on pelvic floor muscle strength in postmenopausal women: a randomized controlled trial

    PubMed Central

    Martinho, Natalia M.; Silva, Valéria R.; Marques, Joseane; Carvalho, Leonardo C.; Iunes, Denise H.; Botelho, Simone

    2016-01-01

    ABSTRACT Objective To evaluate the effectiveness of abdominopelvic training by virtual reality compared to pelvic floor muscle training (PFMT) using a gym ball (a previously tested and efficient protocol) on postmenopausal women’s pelvic floor muscle (PFM) strength. Method A randomized controlled trial was conducted with 60 postmenopausal women, randomly allocated into two groups: Abdominopelvic training by virtual reality – APT_VR (n=30) and PFMT using a gym ball – PFMT_GB (n=30). Both types of training were supervised by the same physical therapist, during 10 sessions each, for 30 minutes. The participants’ PFM strength was evaluated by digital palpation and vaginal dynamometry, considering three different parameters: maximum strength, average strength and endurance. An intention-to-treat approach was used to analyze the participants according to original groups. Results No significant between-group differences were observed in most analyzed parameters. The outcome endurance was higher in the APT_VR group (p=0.003; effect size=0.89; mean difference=1.37; 95% CI=0.46 to 2.28). Conclusion Both protocols have improved the overall PFM strength, suggesting that both are equally beneficial and can be used in clinical practice. Muscle endurance was higher in patients who trained using virtual reality. PMID:27437716

  16. [Radiological diagnosis of constipation and anal incontinence caused by changes in the pelvic floor and anal sphincter. Our experience with 38 patients with constipation with or without incontinence].

    PubMed

    Parrella, R E; Brizi, M G; Giannasio, T; Natale, L; Posi, G; Vulpio, C

    1987-11-01

    Rectal constipation, anal incontinence and constipation combined with incontinence, are often caused by organic or simply functional changes in the pelvic floor and sphincteric apparatus. Therefore morphological as well as manometric and electromyographic studies of these anatomical parts are required. This is possible by combining two techniques: Intestinal Transit Time (ITT) and Defecatory Proctogram with Balloon (DPB). Personal experience of 38 patients with constipation with or without incontinence is reported. The results lead to the following conclusions: 1) ITT is a simple and non-invasive radiological technique that provides us with objective evidence of an impairment, i.e. constipation, whose symptoms are often only subjective; especially it allows us to identify rectal constipation, that can be caused by impairment of the anal sphincteric apparatus. 2) Using an uroprophylactic with a collar that adapts to the size of the anal duct, DPB always permits visualisation of the duct with good representation of the recto-anal angle, whose changes may be the expression of organic or only functional impairments of the anal sphincteric apparatus. Increasing use of the two radiological techniques is therefore recommended in the diagnosis of alterations of the pelvic floor or anal sphincter.

  17. Randomized Multicenter Clinical Trial of Myofascial Physical Therapy in Women with Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS) and Pelvic Floor Tenderness

    PubMed Central

    FitzGerald, MP; Payne, CK; Lukacz, ES; Yang, CC; Peters, KM; Chai, TC; Nickel, JC; Hanno, PM; Kreder, KJ; Burks, DA; Mayer, R; Kotarinos, R; Fortman, C; Allen, TM; Fraser, L; Mason-Cover, M; Furey, C; Odabachian, L; Sanfield, A; Chu, J; Huestis, K; Tata, GE; Dugan, N; Sheth, H; Bewyer, K; Anaeme, A; Newton, K; Featherstone, W; Halle-Podell, R; Cen, L; Landis, JR; Propert, KJ; Foster, HE; Kusek, JW; Nyberg, *LM

    2012-01-01

    Objectives To determine the efficacy and safety of pelvic floor Myofascial Physical Therapy (MPT) in women with newly-symptomatic IC/PBS, as compared to Global Therapeutic Massage (GTM). Materials and Methods A randomized controlled trial of 10 scheduled treatments of MPT vs. GTM was performed at 11 clinical centers located in North America. We recruited women with IC/PBS with demonstrable pelvic floor tenderness on physical examination and a limitation of no more than 3 years symptom duration. The primary outcome was the proportion of responders defined as ‘moderately improved’ or ‘markedly improved’ in overall symptoms compared to baseline on a 7-point scale Global Response Assessment (GRA). Secondary outcomes included ratings for pain, urgency, frequency; the O'Leary-Sant IC Symptom and Problem Index (ICSI/ICPI) and reports of adverse events. We compared response rates between treatment arms using the exact conditional version of the Mantel-Haenszel test to control for clustering by clinical center. For secondary efficacy outcomes, cross-sectional descriptive statistics and changes from baseline were calculated. Results Eighty-one women randomized to the two treatment groups had similar symptoms at baseline. The GRA response rate was 26% in the GTM group and 59% in the MPT group (p=0.0012). Pain, urgency, and frequency ratings and in ICSI/ICPI decreased in both groups during follow-up and were not significantly different between the groups. Pain was the most common adverse event, occurring at similar rates in both groups. There were no serious adverse events reported. Conclusions A significantly higher proportion of women with IC/PBS reponded to treatment with MPT than with GTM. MPT may be a beneficial therapy in women with this syndrome. PMID:22503015

  18. Clarification and confirmation of the Knack maneuver: the effect of volitional pelvic floor muscle contraction to preempt expected stress incontinence.

    PubMed

    Miller, Janis M; Sampselle, Carolyn; Ashton-Miller, James; Hong, Gwi-Ryung Son; DeLancey, John O L

    2008-06-01

    The aim of the study was to determine the immediate effect of timing a pelvic muscle contraction with the moment of expected leakage (the Knack maneuver) to preempt cough-related stress incontinence. Women performed a standing stress test using three hard coughs without and then with the Knack maneuver. Volume of urine loss under both conditions was quantified with paper-towel test. Two groups of women were tested: nonpregnant women (n = 64) and pregnant women (n = 29). In nonpregnant women, wetted area decreased from a median (range) of 43.2 (0.2-183.7) cm2 without the Knack maneuver to 6.9 (range of 0 to 183.7 cm2) with it (p < 0.0001); while in pregnant women it decreased from 14.8 (0-169.7) cm2 to 0 (0-96.5) cm2, respectively (p = 0.001). This study confirms the effect from the Knack maneuver as immediate and provides a partial explanation for early response to widely applied pelvic muscle training regimens in women with stress incontinence. PMID:18204797

  19. Evaluation of Bioelectrical Activity of Pelvic Floor Muscles and Synergistic Muscles Depending on Orientation of Pelvis in Menopausal Women with Symptoms of Stress Urinary Incontinence: A Preliminary Observational Study

    PubMed Central

    Halski, Tomasz; Słupska, Lucyna; Dymarek, Robert; Bartnicki, Janusz; Halska, Urszula; Król, Agata; Paprocka-Borowicz, Małgorzata; Dembowski, Janusz; Zdrojowy, Romuald

    2014-01-01

    Objectives. Evaluation of resting and functional bioelectrical activity of the pelvic floor muscles (PFM) and the synergistic muscles, depending on the orientation of the pelvis, in anterior (P1) and posterior (P2) pelvic tilt. Design. Preliminary, prospective observational study. Setting. Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Participants. Thirty-two menopausal and postmenopausal women with stress urinary incontinence were recruited. Based on inclusion and exclusion criteria, sixteen women aged 55 to 70 years were enrolled in the study. Primary Outcome Measures. Evaluation of resting and functional bioelectrical activity of the pelvic floor muscles by electromyography (sEMG) and vaginal probe. Secondary Outcome Measures. Evaluation of activity of the synergistic muscles by sEMG and surface electrodes. Results. No significant differences between orientations P1 and P2 were found in functional and resting sEMG activity of the PFM. During resting and functional PFM activity, higher electrical activity in P2 than in P1 has been recorded in some of the synergistic muscles. Conclusions. This preliminary study does not provide initial evidence that pelvic tilt influences PFM activation. Although different activity of synergistic muscles occurs in various orientations of the pelvic tilt, it does not have to affect the sEMG activity of the PFM. PMID:24701567

  20. Reprogramming of Fibroblasts From Older Women With Pelvic Floor Disorders Alters Cellular Behavior Associated With Donor Age

    PubMed Central

    Wani, Prachi; Zhou, Lu; Baer, Tom; Phadnis, Smruti Madan; Reijo Pera, Renee A.; Chen, Bertha

    2013-01-01

    We aimed to derive induced pluripotent stem cell (iPSC) lines from vaginal fibroblasts from older women with pelvic organ prolapse. We examined the effect of donor age on iPSCs and on the cells redifferentiated from these iPSCs. Vaginal fibroblasts were isolated from younger and older subjects for reprogramming. iPSCs were generated simultaneously using an excisable polycistronic lentiviral vector expressing Oct4, Klf4, Sox2, and cMyc. The pluripotent markers of iPSCs were confirmed by immunocytochemistry and quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Spectral karyotyping was performed. The ability of the iPSCs to differentiate into three germ layers was confirmed by embryoid body and teratoma formation. Senescence marker (p21, p53, and Bax) expressions were determined by qRT-PCR and Western blot. The iPSCs were redifferentiated to fibroblasts and were evaluated with senescence-associated β-galactosidase (SA) activity and mitotic index using time-lapse dark-field microscopy. iPSCs derived from both the younger and older subjects expressed pluripotency markers and showed normal karyotype and positive teratoma assays. There was no significant difference in expression of senescence and apoptosis markers (p21, p53, and Bax) in iPSCs derived from the younger subject compared with the older subject. Furthermore, fibroblasts redifferentiated from these iPSCs did not differ in SA activity or mitotic index. We report successful derivation of iPSCs from women with pelvic organ prolapse. Older age did not interfere with successful reprogramming. Donor age differences were not observed in these iPSCs using standard senescence markers, and donor age did not appear to affect cell mitotic activity in fibroblasts redifferentiated from iPSCs. PMID:23341439

  1. Managing chronic pelvic pain following reconstructive pelvic surgery with transvaginal mesh.

    PubMed

    Gyang, Anthony N; Feranec, Jessica B; Patel, Rakesh C; Lamvu, Georgine M

    2014-03-01

    In 2001, the US Food and Drug Administration (FDA) approved the first transvaginal mesh kit to treat pelvic organ prolapse (POP). Since the introduction of vaginal mesh kits, some vaginal meshes have been associated with chronic pelvic pain after reconstructive pelvic floor surgery. Pelvic pain results in between 0 % and 30 % of patients following transvaginal mesh placement. Common causes of chronic pelvic pain include pelvic floor muscle spasm, pudendal neuralgia, and infection. Paucity of data exists on the effective management of chronic pelvic pain after pelvic reconstructive surgery with mesh. We outline the management of chronic pelvic pain after transvaginal mesh placement for reconstructive pelvic floor repair based on our clinical experience and adaptation of data used in other aspects of managing chronic pelvic pain conditions.

  2. Evaluation of the levator ani and pelvic wall muscles in levator ani syndrome.

    PubMed

    Hull, Margaret; Corton, Marlene M

    2009-01-01

    Chronic pelvic pain is a difficult problem to evaluate and treat. Knowledge of the pelvic floor and pelvic wall muscles may enable the provider to identify levator ani spasm syndrome, a possible cause of chronic pelvic pain.

  3. Myofascial pelvic pain.

    PubMed

    Spitznagle, Theresa Monaco; Robinson, Caitlin McCurdy

    2014-09-01

    Individuals with pelvic pain commonly present with complaints of pain located anywhere below the umbilicus radiating to the top of their thighs or genital region. The somatovisceral convergence that occurs within the pelvic region exemplifies why examination of not only the organs but also the muscles, connective tissues (fascia), and neurologic input to the region should be performed for women with pelvic pain. The susceptibility of the pelvic floor musculature to the development of myofascial pain has been attributed to unique functional demands of this muscle. Conservative interventions should be considered to address the impairments found on physical examination.

  4. Steepest Descent

    SciTech Connect

    Meza, Juan

    2010-02-12

    The steepest descent method has a rich history and is one of the simplest and best known methods for minimizing a function. While the method is not commonly used in practice due to its slow convergence rate, understanding the convergence properties of this method can lead to a better understanding of many of the more sophisticated optimization methods. Here, we give a short introduction and discuss some of the advantages and disadvantages of this method. Some recent results on modified versions of the steepest descent method are also discussed.

  5. Descent vehicles

    NASA Technical Reports Server (NTRS)

    Popov, Y. I.

    1985-01-01

    The creation of descent vehicles marked a new stage in the development of cosmonautics, involving the beginning of manned space flight and substantial progress in space research on the distant bodies of the Solar System. This booklet describes these vehicles and their structures, systems, and purposes. It is intended for the general public interested in modern problems of space technology.

  6. Pelvic Muscle Exercises Using A Home Trainer for Pelvic Muscle Dysfunction: A Case Report.

    PubMed

    Shelly, Beth

    2016-01-01

    Pelvic muscle exercises can help improve symptoms of pelvic floor muscle dysfunction. This article describes the case of a 66-year-old woman with moderate pelvic organ prolapse (POP) and mild urinary incontinence (UI) who initiated pelvic muscle exercises with the assistance of a novel, at-home trainer equipped with a vaginal sensor and accompanying smartphone app software, the PeriCoach system (Analytica, 2015). After 8 weeks of training with the device, she showed improvements in strength, endurance, and disability, as measured by manual muscle test, electromyography, and Pelvic Floor Disability Index scores. Older women can use biofeedback technology to improve pelvic floor muscle function successfully at home. PMID:27281865

  7. Biological findings from the PheWAS catalog: focus on connective tissue-related disorders (pelvic floor dysfunction, abdominal hernia, varicose veins and hemorrhoids).

    PubMed

    Salnikova, Lyubov E; Khadzhieva, Maryam B; Kolobkov, Dmitry S

    2016-07-01

    Pelvic floor dysfunction, specifically genital prolapse (GP) and stress urinary inconsistency (SUI) presumably co-occur with other connective tissue disorders such as hernia, hemorrhoids, and varicose veins. Observations on non-random coexistence of these disorders have never been summarized in a meta-analysis. The performed meta-analysis demonstrated that varicose veins and hernia are associated with GP. Disease connections on the molecular level may be partially based on shared genetic susceptibility. A unique opportunity to estimate shared genetic susceptibility to disorders is provided by a PheWAS (phenome-wide association study) designed to utilize GWAS data concurrently to many phenotypes. We searched the PheWAS Catalog, which includes the results of the PheWAS study with P value < 0.05, for genes associated with GP, SUI, abdominal hernia, varicose veins and hemorrhoids. We found pronounced signals for the associations of the SLC2A9 gene with SUI (P = 6.0e-05) and the MYH9 gene with varicose veins of lower extremity (P = 0.0001) and hemorrhoids (P = 0.0007). The comparison of the PheWAS Catalog and the NHGRI Catalog data revealed enrichment of genes associated with bone mineral density in GP and with activated partial thromboplastin time in varicose veins of lower extremity. In cross-phenotype associations, genes responsible for peripheral nerve functions seem to predominate. This study not only established novel biologically plausible associations that may warrant further studies but also exemplified an effective use of the PheWAS Catalog data.

  8. Assessment of bioelectrical activity of synergistic muscles during pelvic floor muscles activation in postmenopausal women with and without stress urinary incontinence: a preliminary observational study

    PubMed Central

    Ptaszkowski, Kuba; Paprocka-Borowicz, Małgorzata; Słupska, Lucyna; Bartnicki, Janusz; Dymarek, Robert; Rosińczuk, Joanna; Heimrath, Jerzy; Dembowski, Janusz; Zdrojowy, Romuald

    2015-01-01

    Objective Muscles such as adductor magnus (AM), gluteus maximus (GM), rectus abdominis (RA), and abdominal external and internal oblique muscles are considered to play an important role in the treatment of stress urinary incontinence (SUI), and the relationship between contraction of these muscles and pelvic floor muscles (PFM) has been established in previous studies. Synergistic muscle activation intensifies a woman’s ability to contract the PFM. In some cases, even for continent women, it is not possible to fully contract their PFM without involving the synergistic muscles. The primary aim of this study was to assess the surface electromyographic activity of synergistic muscles to PFM (SPFM) during resting and functional PFM activation in postmenopausal women with and without SUI. Materials and methods This study was a preliminary, prospective, cross-sectional observational study and included volunteers and patients who visited the Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Forty-two patients participated in the study and were screened for eligibility criteria. Thirty participants satisfied the criteria and were categorized into two groups: women with SUI (n=16) and continent women (n=14). The bioelectrical activity of PFM and SPFM (AM, RA, GM) was recorded with a surface electromyographic instrument in a standing position during resting and functional PFM activity. Results Bioelectrical activity of RA was significantly higher in the incontinent group than in the continent group. These results concern the RA activity during resting and functional PFM activity. The results for other muscles showed no significant difference in bioelectrical activity between groups. Conclusion In women with SUI, during the isolated activation of PFM, an increased synergistic activity of RA muscle was observed; however, this activity was not observed in asymptomatic women. This may indicate the important accessory contribution of these muscles in the

  9. Recognizing Myofascial Pelvic Pain in the Female Patient with Chronic Pelvic Pain

    PubMed Central

    Pastore, Elizabeth Anne; Katzman, Wendy B.

    2012-01-01

    Myofascial pelvic pain (MFPP) is a major component of chronic pelvic pain (CPP) and often is not properly identified by healthcare providers. The hallmark diagnostic indicator of MFPP is myofascial trigger points in the pelvic floor musculature that refer pain to adjacent sites. Effective treatments are available to reduce MFPP, including myofascial trigger point release, PMID:22862153

  10. Pelvic radiation - discharge

    MedlinePlus

    Radiation of the pelvis - discharge; Cancer treatment - pelvic radiation; Prostate cancer - pelvic radiation; Ovarian cancer - pelvic radiation; Cervical cancer - pelvic radiation; Uterine cancer - pelvic radiation; Rectal cancer - ...

  11. Internet-based treatment of stress urinary incontinence: 1- and 2-year results of a randomized controlled trial with a focus on pelvic floor muscle training

    PubMed Central

    Sjöström, Malin; Umefjord, Göran; Stenlund, Hans; Carlbring, Per; Andersson, Gerhard; Samuelsson, Eva

    2015-01-01

    Objectives To evaluate the long-term effects of two non-face-to-face treatment programmes for stress urinary incontinence (SUI) based on pelvic floor muscle training (PFMT). Subjects and Methods The present study was a randomized controlled trial with online recruitment of 250 community-dwelling women aged 18–70 years with SUI ≥ one time/week. Diagnosis was based on validated self-assessed questionnaires, 2-day bladder diary and telephone interview with a urotherapist. Consecutive computer-generated block randomization was carried out with allocation by an independent administrator to 3 months of treatment with either an internet-based treatment programme (n = 124) or a programme sent by post (n = 126). Both interventions focused mainly on PFMT. The internet group received continuous e-mail support from a urotherapist, whereas the postal group trained on their own. Follow-up was performed after 1 and 2 years via self-assessed postal questionnaires. The primary outcomes were symptom severity (International Consultation on Incontinence Questionnaire Short Form [ICIQ-UI SF]) and condition-specific quality of life (ICIQ-Lower Urinary Tract Symptoms Quality of Life [ICIQ-LUTSqol]). Secondary outcomes were the Patient Global Impression of Improvement, health-specific quality of life (EQ-visual analogue scale [EQ-VAS]), use of incontinence aids, and satisfaction with treatment. There was no face-to-face contact with the participants at any time. Analysis was based on intention-to-treat. Results We lost 32.4% (81/250) of participants to follow-up after 1 year and 38.0% (95/250) after 2 years. With both interventions, we observed highly significant (P < 0.001) improvements with large effect sizes (>0.8) for symptoms and condition-specific quality of life (QoL) after 1 and 2 years, respectively. No significant differences were found between the groups. The mean (sd) changes in symptom score were 3.7 (3.3) for the internet group and 3.2 (3.4) for the postal group (P = 0

  12. Pelvic actinomycosis

    SciTech Connect

    Maloney, J.J.; Cho, S.R.

    1983-08-01

    A case of actiomycosis involving the pelvic cavity is reported. The patient had a pelvic mass clinically and radiographically. Barium enema examination showed a mass with extrinsic compression and fixed narrowing of the rectum with mucosal irregularity. A computed tomographic scan showed a pelvic mass displacing the rectum.

  13. Management of pelvic organ prolapse.

    PubMed

    Ahmed, Faisal; Sotelo, Tiffany

    2011-12-01

    Symptomatic pelvic organ prolapse can afflict up to 10% of women. Urinary incontinence, voiding dysfunction or difficulty possibly related to bladder outlet obstruction are common symptoms. Infrequently hydronephrosis or defecatory dysfunction can be seen. The management of pelvic organ prolapse (POP) should start with adequate assessment of all pelvic floor complaints. If a patient is not symptomatic, surgical intervention is usually not indicated. While the use of a variety of graft materials are available today including porcine, dermal and synthetic grafts, that are used in some surgical approaches to pelvic organ prolapse, other more conservative approaches may prove beneficial to many patients. This article describes our approach to the patient with pelvic organ prolapse.

  14. Pelvic Organ Prolapse--Surgery

    MedlinePlus

    ... on PFDs Videos Bookmark These Websites Helpful Organizations Patient Privacy Concerns Community Find a Provider Break Free Upcoming ... Download Preparing for Surgery (PDF) Mesh Information for Patients with Pelvic Floor Disorders ... Us | Privacy Policy Accredited © 2016 American Urogynecologic Society. All rights ...

  15. Recognizing myofascial pelvic pain in the female patient with chronic pelvic pain.

    PubMed

    Pastore, Elizabeth A; Katzman, Wendy B

    2012-01-01

    Myofascial pelvic pain (MFPP) is a major component of chronic pelvic pain (CPP) and often is not properly identified by health care providers. The hallmark diagnostic indicator of MFPP is myofascial trigger points in the pelvic floor musculature that refer pain to adjacent sites. Effective treatments are available to reduce MFPP, including myofascial trigger point release, biofeedback, and electrical stimulation. An interdisciplinary team is essential for identifying and successfully treating MFPP.

  16. Recognizing myofascial pelvic pain in the female patient with chronic pelvic pain.

    PubMed

    Pastore, Elizabeth A; Katzman, Wendy B

    2012-01-01

    Myofascial pelvic pain (MFPP) is a major component of chronic pelvic pain (CPP) and often is not properly identified by health care providers. The hallmark diagnostic indicator of MFPP is myofascial trigger points in the pelvic floor musculature that refer pain to adjacent sites. Effective treatments are available to reduce MFPP, including myofascial trigger point release, biofeedback, and electrical stimulation. An interdisciplinary team is essential for identifying and successfully treating MFPP. PMID:22862153

  17. Ascent/Descent Software

    NASA Technical Reports Server (NTRS)

    Brown, Charles; Andrew, Robert; Roe, Scott; Frye, Ronald; Harvey, Michael; Vu, Tuan; Balachandran, Krishnaiyer; Bly, Ben

    2012-01-01

    The Ascent/Descent Software Suite has been used to support a variety of NASA Shuttle Program mission planning and analysis activities, such as range safety, on the Integrated Planning System (IPS) platform. The Ascent/Descent Software Suite, containing Ascent Flight Design (ASC)/Descent Flight Design (DESC) Configuration items (Cis), lifecycle documents, and data files used for shuttle ascent and entry modeling analysis and mission design, resides on IPS/Linux workstations. A list of tools in Navigation (NAV)/Prop Software Suite represents tool versions established during or after the IPS Equipment Rehost-3 project.

  18. Pelvic incidentalomas

    PubMed Central

    Newmark, G.M.; Thakrar, K.H.; Mehta, U.K.; Berlin, J.W.

    2010-01-01

    Abstract Recent advances in multi-detector computed tomography, magnetic resonance imaging, and ultrasound have led to the detection of incidental ovarian, uterine, vascular and pelvic nodal abnormalities in both the oncology and non-oncology patient population that in the past remained undiscovered. These incidental pelvic lesions have created a management dilemma for both clinicians and radiologists. Depending on the clinical setting, these lesions may require no further evaluation, additional immediate or serial follow-up imaging, or surgical intervention. In this review, guidelines concerning the diagnosis and management of some of the more common pelvic incidentalomas are presented. PMID:20880789

  19. How Are Pelvic Floor Disorders Commonly Treated?

    MedlinePlus

    ... articles, clinical trials, resources Clinical Trials & Clinical Research Find clinical trials, guidance for clinical researchers Health Education Campaigns & Programs Safe to Sleep, Media-Smart Youth, Maternal/Child Health Education Program NICHD Publications ...

  20. Informed Consent for Reconstructive Pelvic Surgery.

    PubMed

    Alam, Pakeeza; Iglesia, Cheryl B

    2016-03-01

    Informed consent is the process in which a patient makes a decision about a surgical procedure or medical intervention after adequate information is relayed by the physician and understood by the patient. This process is critical for reconstructive pelvic surgeries, particularly with the advent of vaginal mesh procedures. In this article, we review the principles of informed consent, the pros and cons of different approaches in reconstructive pelvic surgery, the current legal issues surrounding mesh use for vaginal surgery, and tips on how to incorporate this information when consenting patients for pelvic floor surgery.

  1. Pelvic Pain

    MedlinePlus

    Pelvic pain occurs mostly in the lower abdomen area. The pain might be steady, or it might come and go. If the pain is severe, it might get in the way ... re a woman, you might feel a dull pain during your period. It could also happen during ...

  2. Regulation of testicular descent.

    PubMed

    Hutson, John M; Li, Ruili; Southwell, Bridget R; Newgreen, Don; Cousinery, Mary

    2015-04-01

    Testicular descent occurs in two morphologically distinct phases, each under different hormonal control from the testis itself. The first phase occurs between 8 and 15 weeks when insulin-like hormone 3 (Insl3) from the Leydig cells stimulates the gubernaculum to swell, thereby anchoring the testis near the future inguinal canal as the foetus grows. Testosterone causes regression of the cranial suspensory ligament to augment the transabdominal phase. The second, or inguinoscrotal phase, occurs between 25 and 35 weeks, when the gubernaculum bulges out of the external ring and migrates to the scrotum, all under control of testosterone. However, androgen acts mostly indirectly via the genitofemoral nerve (GFN), which produces calcitonin gene-related peptide (CGRP) to control the direction of migration. In animal models the androgen receptors are in the inguinoscrotal fat pad, which probably produces a neurotrophin to masculinise the GFN sensory fibres that regulate gubernacular migration. There is little direct evidence that this same process occurs in humans, but CGRP can regulate closure of the processus vaginalis in inguinal hernia, confirming that the GFN probably mediates human testicular descent by a similar mechanism as seen in rodent models. Despite increased understanding about normal testicular descent, the common causes of cryptorchidism remain elusive.

  3. Pelvic Organ Prolapse

    MedlinePlus

    ... Prosthetics Urogynecologic Surgical Mesh Implants Pelvic Organ Prolapse (POP) Share Tweet Linkedin Pin it More sharing options ... What is Pelvic Organ Prolapse? Pelvic organ prolapse (POP) occurs when the tissue and muscles of the ...

  4. Third Floor Plan, Second Floor Plan, First Floor Plan, Ground ...

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

    Third Floor Plan, Second Floor Plan, First Floor Plan, Ground Floor Plan, West Bunkhouse - Kennecott Copper Corporation, On Copper River & Northwestern Railroad, Kennicott, Valdez-Cordova Census Area, AK

  5. Entry, Descent, Landing Animation (Animation)

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site] Click on the image for Entry, Descent, Landing animation

    This animation illustrates the path the Stardust return capsule will follow once it enters Earth's atmosphere.

  6. Chronic Pelvic Pain

    MedlinePlus

    ... found. How is chronic pelvic pain diagnosed? Your health care provider will ask about your medical history. You will have a physical exam, including a pelvic exam . Tests also may be done to find the cause. ...

  7. Valley Floor

    NASA Technical Reports Server (NTRS)

    2003-01-01

    MGS MOC Release No. MOC2-529, 30 October 2003

    This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows the floor of an ancient valley located near the Pyrrhae Chaos region of Mars. This valley might have been carved by liquid water, but today no evidence remains that a fluid ever flowed through it. Long after the valley formed, its floor was covered by large, windblown, ripple-like dunes. This picture is located near 13.0oS, 31.2oW. The image is illuminated by sunlight from the upper left and covers an area 3 km (1.9 mi) wide.

  8. Simulation Test Of Descent Advisor

    NASA Technical Reports Server (NTRS)

    Davis, Thomas J.; Green, Steven M.

    1991-01-01

    Report describes piloted-simulation test of Descent Advisor (DA), subsystem of larger automation system being developed to assist human air-traffic controllers and pilots. Focuses on results of piloted simulation, in which airline crews executed controller-issued descent advisories along standard curved-path arrival routes. Crews able to achieve arrival-time precision of plus or minus 20 seconds at metering fix. Analysis of errors generated in turns resulted in further enhancements of algorithm to increase accuracies of its predicted trajectories. Evaluations by pilots indicate general support for DA concept and provide specific recommendations for improvement.

  9. EXOMARS Descent Module GNC Performance

    NASA Astrophysics Data System (ADS)

    Portigliotti, S.; Capuano, M.; Montagna, M.; Martella, P.; Venditto, P.

    2007-08-01

    The ExoMars mission is the first ESA led robotic mission of the Aurora Programme and combines technology development with investigations of major scientific interest. Italy is by far the major contributor to the mission through the strong support of the Italian Space Agency (ASI). ExoMars will search for traces of past and present life, characterize the Mars geochemistry and water distribution, improve the knowledge of the Mars environment and geophysics, and identify possible surface hazards to future human exploration missions. ExoMars will also validate the technology for safe Entry, Descent and Landing (EDL) of a large size Descent Module (DM) carrying a Rover with medium range surface mobility and the access to subsurface. The ExoMars project is presently undergoing its Phase B1 with Thales Alenia Space-Italia as Industrial Prime Contractor. Additionally, as Descent Module responsible, a dedicated simulation tool is under development in Thales Alenia Space-Italia, Turin site, for the end-to-end design and validation / verification of the DM Entry Descent and Landing.

  10. Antoniadi's Floor

    NASA Technical Reports Server (NTRS)

    2005-01-01

    16 February 2005 This Mars Global Surveyor (MGS) Orbiter Camera (MOC) image shows landforms on the floor of Antoniadi Crater. The circular features were once meteor impact craters that have been almost completely eroded away.

    Location near: 21.6oN, 297.4oW Image width: 3.0 km (1.9 mi) Illumination from: upper left Season: Northern Summer

  11. Trough Floor

    NASA Technical Reports Server (NTRS)

    2005-01-01

    3 March 2005 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows boulders on the floor of a wide trough in Memnonia Fossae.

    Location near: 18.8oS, 150.3oW Image width: 3 km (1.9 mi) Illumination from: upper left Season: Southern Winter

  12. Floor Chemical Basics.

    ERIC Educational Resources Information Center

    Shaw, Richard

    1998-01-01

    Discusses the issues to consider when selecting floor-care chemicals, including the floor-finish systems for hard-surface floors and the care of carpeted floors. Provides thoughts on cleaning chemical usage and environmental awareness. (GR)

  13. Pelvic laparoscopy - series (image)

    MedlinePlus

    ... infections (pelvic inflammatory disease) not responsive to drug therapy suspected twisting (torsion) of an ovary ovarian cyst scar tissue (adhesions) in pelvis puncture through the uterus (uterine perforation) ...

  14. Floors: Selection and Maintenance.

    ERIC Educational Resources Information Center

    Berkeley, Bernard

    Flooring for institutional, commercial, and industrial use is described with regard to its selection, care, and maintenance. The following flooring and subflooring material categories are discussed--(1) resilient floor coverings, (2) carpeting, (3) masonry floors, (4) wood floors, and (5) "formed-in-place floors". The properties, problems,…

  15. Scalloped Floor

    NASA Technical Reports Server (NTRS)

    2006-01-01

    13 July 2006 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows erosional remnants of layered rock and large windblown ripples on the floor of a crater in the Tyrrhena Terra region of Mars. The layered rocks are most likely sedimentary.

    Location near: 15.5oS, 270.5oW Image width: 3 km (1.9 mi) Illumination from: upper left Season: Southern Autumn

  16. Tiled Floor

    NASA Technical Reports Server (NTRS)

    2006-01-01

    30 April 2006 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows a variety of materials found on the floor of an impact crater northwest of Hellas Planitia. The discontinuous, dark-toned ridges, typically running diagonally across the scene, are windblown ripples which overlie light-toned rock that is heavily fractured and cratered.

    Location near: 25.0oS, 322.9oW Image width: 3 km (1.9 mi) Illumination from: upper left Season: Southern Summer

  17. Long-term Outcomes Following Abdominal Sacrocolpopexy for Pelvic Organ Prolapse

    PubMed Central

    Nygaard, Ingrid; Brubaker, Linda; Zyczynski, Halina M.; Cundiff, Geoffrey; Richter, Holly; Gantz, Marie; Fine, Paul; Menefee, Shawn; Ridgeway, Beri; Visco, Anthony; Warren, Lauren Klein; Zhang, Min; Meikle, Susan

    2013-01-01

    Importance Over 225,000 surgeries are performed annually in the U.S. for pelvic organ prolapse (POP). Abdominal sacrocolpopexy is considered the most durable POP surgery, but little is known about long-term effectiveness and adverse events. Objective To describe anatomic and symptomatic outcomes up to 7 years after abdominal sacrocolpopexy, and to determine whether these are affected by concomitant anti-incontinence surgery (Burch urethropexy). Design, setting, participants Long-term follow-up of the randomized, masked 2-year CARE trial (Colpopexy And urinary Reduction Efforts). Participants were stress continent women undergoing abdominal sacrocolpopexy between 2002–5 for symptomatic POP randomized to concomitant urethropexy or not. 92% (215/233) of eligible 2-year CARE trial completers enrolled into this extended study with 181 (84%) and 126 (59%) completing 5 and 7 years follow-up, respectively. Median follow-up was 7 years. Main Outcome Measures POP: Symptomatic failure: POP retreatment or reporting bulge on Pelvic Floor Distress Inventory (PFDI); Anatomic failure: POP retreatment or Pelvic Organ Prolapse Quantification demonstrating descent of the vaginal apex descend below upper third of the vagina or anterior or posterior vaginal wall prolapse beyond the hymen. Urinary incontinence (UI): Stress UI: more than 1 stress urinary incontinence symptom on PFDI or interval treatment; Overall UI: score ≥ 3 on Incontinence Severity Index. Results By year 7, the estimated probabilities of failure (POP, SUI, UI) from parametric survival modeling for the urethropexy and no urethropexy groups respectively were were 0.27 and 0.22 for anatomic POP (difference 0.050; 95% CI −0.161, 0.271), 0.29 and 0.24 for symptomatic POP (0.049; −0.060, 0.162), 0.48 and 0.34 for composite POP (0.134; −0.096, 0.322), 0.62 and 0.77 for SUI (−0.153; −0.268, 0.030) 0.75 and 0.81 for overall UI (−0.064; −0.161, 0.032). Mesh erosion probability estimated by Kaplan-Meier method

  18. A new steepest descent method

    NASA Astrophysics Data System (ADS)

    Abidin, Zubai'ah Zainal; Mamat, Mustafa; Rivaie, Mohd; Mohd, Ismail

    2014-06-01

    The classical steepest descent (SD) method is known as one of the earliest and the best method to minimize a function. Even though the convergence rate is quite slow, but its simplicity has made it one of the easiest methods to be used and applied especially in the form of computer codes. In this paper, a new modification of SD method is proposed using a new search direction (dk) in the form of two parameters. Numerical results shows that this new SD has far superior convergence rate and more efficient than the classical SD method.

  19. Readability of Common Health-Related Quality-of-Life Instruments in Female Pelvic Medicine

    PubMed Central

    Alas, Alexandriah N.; Bergman, Jonathan; Dunivan, Gena C.; Rashid, Rezoana; Morrisroe, Shelby N.; Rogers, Rebecca G.; Anger, Jennifer T.

    2016-01-01

    Objectives The average American adult reads below the eighth-grade level. To determine whether self-reported health-related quality-of-life questionnaires used for pelvic floor disorders are appropriate for American women, we measured reading levels of questionnaires for urinary incontinence(UI), pelvic organ prolapse(POP), and fecalin continence (FI). Methods An online literature search identified questionnaires addressing UI, POP, and FI. Readability was assessed using Flesch-Kincaid reading level and ease formulas. Flesch-Kincaid grade level indicates the average grade one is expected to completely and lucidly comprehend the written text. Flesch-Kincaid reading ease score, from 0 to 100, indicates how easy the written text can be read. Results Questionnaires were categorized by UI, POP, FI, and combined pelvic floor symptoms. The median Flesch-Kincaid reading level was 7.2, 10.1, 7.6, and 9.7, for UI, POP, FI, and combined pelvic floor symptoms, respectively. Reading levels varied greatly between questionnaires, with only 54% of questionnaires written below the eighth-grade level. Conclusions We identified significant variation in reading levels among the questionnaires and found the 2 most commonly used questionnaires per survey in 2008 at Society of Urodynamics and Female Pelvic Medicine and Urogenital Reconstruction were above the recommended eighth-grade reading level. As specialty societies focus on standardizing questionnaires for research, reading levels should be considered so they are generalizable to larger populations of women with pelvic floor disorders. PMID:23982579

  20. Ant colony optimization and stochastic gradient descent.

    PubMed

    Meuleau, Nicolas; Dorigo, Marco

    2002-01-01

    In this article, we study the relationship between the two techniques known as ant colony optimization (ACO) and stochastic gradient descent. More precisely, we show that some empirical ACO algorithms approximate stochastic gradient descent in the space of pheromones, and we propose an implementation of stochastic gradient descent that belongs to the family of ACO algorithms. We then use this insight to explore the mutual contributions of the two techniques. PMID:12171633

  1. Numerical analysis of the orthogonal descent method

    SciTech Connect

    Shokov, V.A.; Shchepakin, M.B.

    1994-11-01

    The author of the orthogonal descent method has been testing it since 1977. The results of these tests have only strengthened the need for further analysis and development of orthogonal descent algorithms for various classes of convex programming problems. Systematic testing of orthogonal descent algorithms and comparison of test results with other nondifferentiable optimization methods was conducted at TsEMI RAN in 1991-1992 using the results.

  2. Pelvic Support Problems

    MedlinePlus

    ... special pelvic muscle exercises called Kegel exercises. A mechanical support device called a pessary helps some women. Surgery and medicines are other treatments. NIH: National Institute of Child Health and Human ...

  3. Pelvic Inflammatory Disease

    MedlinePlus

    Pelvic inflammatory disease (PID) is an infection and inflammation of the uterus, ovaries, and other female reproductive organs. It causes scarring ... United States. Gonorrhea and chlamydia, two sexually transmitted diseases, are the most common causes of PID. Other ...

  4. Quercetin for chronic prostatitis/chronic pelvic pain syndrome.

    PubMed

    Shoskes, Daniel A; Nickel, J Curtis

    2011-08-01

    Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common condition with a heterogeneous origin that responds best to multimodal therapy. The bioflavonoid quercetin has antioxidant and antiinflammatory effects that have proven useful for treating this condition. Using the clinical phenotype system UPOINT, quercetin can be helpful for those with organ-specific complaints (bladder or prostate) and pelvic floor spasm. This article discusses the current understanding of CP/CPPS and how treatment with quercetin can be used alone or as part of multimodal therapy.

  5. Gynecologic Pelvic Pain

    PubMed Central

    Kinch, Robert A.H.

    1989-01-01

    The family physician dealing with gynecologic pelvic pain (acute or chronic) enters at the beginning of the problem as diagnostician, refers the patient to a specialist in the interim, and resumes care in the follow-up period. Patients with chronic pelvic pain (pelvic pain that has lasted for at least six months) can be difficult to treat because they often have a history of dysfunctional family life, sexual and marital problems, and often a hidden history of sexual molestation or incest. The family physician can best care for the patient with empathy, a long ventilated history, complete physical and pelvic examination, and pelvic ultrasonograpy if necessary. Laparoscopy normally shows pelvic adhesions in one third of these patients, minimal endometriosis in one third, and a normal pelvis in the final third. The family physician should specifically reassure patients with normal results that they do not have cancer. The ideal therapy combines both stimulation-produced analgesia and treatment of the psychological, emotional, sociological, and environmental aspects of the disease. PMID:21248970

  6. Normal Vulvovaginal, Perineal, and Pelvic Anatomy with Reconstructive Considerations

    PubMed Central

    Yavagal, Sujata; de Farias, Thais F.; Medina, Carlos A.; Takacs, Peter

    2011-01-01

    A thorough insight into the female genital anatomy is crucial for understanding and performing pelvic reconstructive procedures. The intimate relationship between the genitalia and the muscles, ligaments, and fascia that provide support is complex, but critical to restore during surgery for correction of prolapse or aesthetic reasons. The external female genitalia include the mons pubis, labia majora and minora, clitoris, vestibule with glands, perineal body, and the muscles and fascia surrounding these structures. Through the perineal membrane and the perineal body, these superficial vulvar structures are structurally related to the deep pelvic muscle levator ani with its fascia. The levator ani forms the pelvic floor with the coccygeus muscle and provides vital support to all the pelvic organs and stability to the perineum. The internal female genital organs include the vagina, cervix, uterus, tubes, and ovaries with their visceral fascia. The visceral fascia also called the endopelvic fascia, surrounds the pelvic organs and connects them to the pelvic walls. It is continuous with the paraurethral and paravaginal fascia, which is attached to the perineal membrane. Thus, the internal and external genitalia are closely related to the muscles and fascia, and work as one functioning unit. PMID:22547969

  7. Space Shuttle Orbiter descent navigation

    NASA Technical Reports Server (NTRS)

    Montez, M. N.; Madden, M. F.

    1982-01-01

    The entry operational sequence (OPS 3) begins approximately 2 hours prior to the deorbit maneuver and continues through atmospheric entry, terminal area energy management (TAEM), approach and landing, and rollout. During this flight phase, the navigation state vector is estimated by the Space Shuttle Orbiter onboard navigation system. This estimate is computed using a six-element sequential Kalman filter, which blends inertial measurement unit (IMU) delta-velocity data with external navaid data. The external navaids available to the filter are tactical air navigation (TACAN), barometric altimeter, and microwave scan beam landing system (MSBLS). Attention is given to the functional design of the Orbiter navigation system, the descent navigation sensors and measurement processing, predicted Kalman gains, correlation coefficients, and current flights navigation performance.

  8. Correlation as Probability of Common Descent.

    ERIC Educational Resources Information Center

    Falk, Ruma; Well, Arnold D.

    1996-01-01

    One interpretation of the Pearson product-moment correlation ("r"), correlation as the probability of originating from common descent, important to the genetic measurement of inbreeding, is examined. The conditions under which "r" can be interpreted as the probability of "identity by descent" are specified, and the possibility of generalizing this…

  9. Predictability of Top of Descent Location for Operational Idle-Thrust Descents

    NASA Technical Reports Server (NTRS)

    Stell, Laurel L.

    2010-01-01

    To enable arriving aircraft to fly optimized descents computed by the flight management system (FMS) in congested airspace, ground automation must accurately predict descent trajectories. To support development of the trajectory predictor and its uncertainty models, commercial flights executed idle-thrust descents at a specified descent speed, and the recorded data included the specified descent speed profile, aircraft weight, and the winds entered into the FMS as well as the radar data. The FMS computed the intended descent path assuming idle thrust after top of descent (TOD), and the controllers and pilots then endeavored to allow the FMS to fly the descent to the meter fix with minimal human intervention. The horizontal flight path, cruise and meter fix altitudes, and actual TOD location were extracted from the radar data. Using approximately 70 descents each in Boeing 757 and Airbus 319/320 aircraft, multiple regression estimated TOD location as a linear function of the available predictive factors. The cruise and meter fix altitudes, descent speed, and wind clearly improve goodness of fit. The aircraft weight improves fit for the Airbus descents but not for the B757. Except for a few statistical outliers, the residuals have absolute value less than 5 nmi. Thus, these predictive factors adequately explain the TOD location, which indicates the data do not include excessive noise.

  10. Pelvic floor tenderness in the etiology of superficial dyspareunia.

    PubMed

    Yong, Paul J; Mui, Justin; Allaire, Catherine; Williams, Christina

    2014-11-01

    Objectif : Calculer la prévalence de la sensibilité du plancher pelvien au sein de la population des femmes qui connaissent des douleurs pelviennes et déterminer ses implications pour ce qui est des symptômes de la douleur pelvienne. Méthodes : Nous avons mené une analyse rétrospective auprès de patientes connaissant des douleurs pelviennes au sein d’un centre spécialisé tertiaire. La sensibilité du plancher pelvien a été définie comme étant une sensibilité du muscle releveur de l’anus ressentie au moins d’un côté au cours d’un examen pelvien mené au moyen d’un seul doigt. La prévalence de la sensibilité du plancher pelvien au sein de cette cohorte de femmes connaissant des douleurs pelviennes a été comparée à la même prévalence au sein d’une cohorte de femmes exemptes de douleurs fréquentant une clinique de gynécologie. Chez les femmes connaissant des douleurs pelviennes, une régression multiple a été menée en vue d’identifier les variables qui étaient associées de façon indépendante à la sensibilité du plancher pelvien. Résultats : La prévalence de la sensibilité du plancher pelvien était de 40 % (75/189) au sein de la cohorte « douleurs pelviennes »; elle était donc considérablement supérieure à la prévalence de 13 % (4/32) qui a été constatée au sein de la cohorte « absence de douleur » (RC, 4,61; IC à 95 %, 1,55 - 13,7, P = 0,005). Dans le cadre de la régression logistique multiple, la dyspareunie superficielle (RC, 4,45; IC à 95 %, 1,86 - 10,7, P = 0,001), la douleur ressentie au niveau de la paroi abdominale (RC, 4,04; IC à 95 %, 1,44 - 11,3, P = 0,005) et la sensibilité de la base de la vessie (RC, 4,65; IC à 95 %, 1,87 - 11,6, P = 0,001) étaient associées de façon indépendante à la sensibilité du plancher pelvien. Cette dernière était tout aussi présente chez les femmes qui connaissaient une endométriose sous-jacente que chez les femmes qui ne connaissaient pas une telle pathologie. Conclusion : La sensibilité du plancher pelvien est courante chez les femmes qui connaissent des douleurs pelviennes, en présence ou non d’une endométriose, et contribue à la dyspareunie superficielle. Elle a également été associée à la douleur ressentie au niveau de la paroi abdominale et à la sensibilité de la base de la vessie, ce qui semble indiquer que la sensibilisation du système nerveux est impliquée dans son étiologie.

  11. Testing of the Anorectal and Pelvic Floor Area

    MedlinePlus

    ... angles and function of the puborectalis muscle and emptying. This study is particularly useful when evaluating complaints ... of the Esophagus Achalasia GERD Disorders of the Stomach Cyclic Vomiting Syndrome CVS in Adults Dumping Syndrome ...

  12. DIFFERENTIAL DIAGNOSIS OF DEEP GLUTEAL PAIN IN A FEMALE RUNNER WITH PELVIC INVOLVEMENT: A CASE REPORT

    PubMed Central

    Podschun, Laura; Kolber, Morey J.; Garcia, Ashley; Rothschild, Carey E.

    2013-01-01

    Background: Gluteal injuries, proximal hamstring injuries, and pelvic floor disorders have been reported in the literature among runners. Some suggest that hip, pelvis, and/or groin injuries occur in 3.3% to 11.5% of long distance runners. The purpose of this case report is to describe the differential diagnosis and treatment approach for a patient presenting with combined hip and pelvic pain. Case description: A 45-year-old female distance runner was referred to physical therapy for proximal hamstring pain that had been present for several months. This pain limited her ability to tolerate sitting and caused her to cease running. Examination of the patient's lumbar spine, pelvis, and lower extremity led to the initial differential diagnosis of hamstring syndrome and ischiogluteal bursitis. The patient's primary symptoms improved during the initial four visits, which focused on education, pain management, trunk stabilization and gluteus maximus strengthening, however pelvic pain persisted. Further examination led to a secondary diagnosis of pelvic floor hypertonic disorder. Interventions to address the pelvic floor led to resolution of symptoms and return to running. Outcomes: Pain level on the Visual Analog Scale decreased from 7/10 to 1/10 over the course of treatment. The patient was able to return to full sport activity and improved sitting tolerance to greater then two hours without significant discomfort. Discussion: This case suggests the interdependence of lumbopelvic and lower extremity kinematics in complaints of hamstring, posterior thigh and pelvic floor disorders. This case highlights the importance of a thorough examination as well as the need to consider a regional interdependence of the pelvic floor and lower quarter when treating individuals with proximal hamstring pain. Level of Evidence: Level 4 PMID:24175132

  13. Surgery for Pelvic Organ Prolapse

    MedlinePlus

    ... such as pain during sex, pelvic pain, or urinary incontinence . What are the types of surgery for pelvic ... performed through the abdomen. A procedure to prevent urinary incontinence may be done at the same time. • Anterior ...

  14. Radiation of pelvic malignant disease.

    PubMed

    BARNES, A C

    1957-02-01

    At present, progress in the treatment of cancer consists of more extensive excision or more thorough irradiation. The cure rate of pelvic cancer is proportionate not so much with the form of therapy used as with the stage of the disease when first diagnosed. Any woman who consults a physician should have a pelvic examination regardless of the presence or absence of pelvic symptoms.

  15. [The end to the myth that hysterectomy has negative effects on the function of pelvic organs].

    PubMed

    Vierhout, M E

    2007-06-01

    Hysterectomy is sometimes considered the starting point of pelvic floor symptoms, such as urinary incontinence, constipation and sexual disturbances. However, it is questionable whether there is a causal relationship. Such an effect was not found in numerous prospective controlled studies. There is a striking discrepancy between prospective controlled studies and retrospective and cross-sectional studies in this regard. Retrospective and cross-sectional studies frequently report a negative effect of hysterectomy on pelvic organ function. On the basis of the recent literature it may be concluded that non-radical hysterectomy has no detrimental effect on pelvic organ functions.

  16. Descent Advisor Preliminary Field Test

    NASA Technical Reports Server (NTRS)

    Green, Steven M.; Vivona, Robert A.; Sanford, Beverly

    1995-01-01

    A field test of the Descent Advisor (DA) automation tool was conducted at the Denver Air Route Traffic Control Center in September 1994. DA is being developed to assist Center controllers in the efficient management and control of arrival traffic. DA generates advisories, based on trajectory predictions, to achieve accurate meter-fix arrival times in a fuel efficient manner while assisting the controller with the prediction and resolution of potential conflicts. The test objectives were: (1) to evaluate the accuracy of DA trajectory predictions for conventional and flight-management system equipped jet transports, (2) to identify significant sources of trajectory prediction error, and (3) to investigate procedural and training issues (both air and ground) associated with DA operations. Various commercial aircraft (97 flights total) and a Boeing 737-100 research aircraft participated in the test. Preliminary results from the primary test set of 24 commercial flights indicate a mean DA arrival time prediction error of 2.4 seconds late with a standard deviation of 13.1 seconds. This paper describes the field test and presents preliminary results for the commercial flights.

  17. Descent advisor preliminary field test

    NASA Technical Reports Server (NTRS)

    Green, Steven M.; Vivona, Robert A.; Sanford, Beverly

    1995-01-01

    A field test of the Descent Advisor (DA) automation tool was conducted at the Denver Air Route Traffic Control Center in September 1994. DA is being developed to assist Center controllers in the efficient management and control of arrival traffic. DA generates advisories, based on trajectory predictions, to achieve accurate meter-fix arrival times in a fuel efficient manner while assisting the controller with the prediction and resolution of potential conflicts. The test objectives were to evaluate the accuracy of DA trajectory predictions for conventional- and flight-management-system-equipped jet transports, to identify significant sources of trajectory prediction error, and to investigate procedural and training issues (both air and ground) associated with DA operations. Various commercial aircraft (97 flights total) and a Boeing 737-100 research aircraft participated in the test. Preliminary results from the primary test set of 24 commercial flights indicate a mean DA arrival time prediction error of 2.4 sec late with a standard deviation of 13.1 sec. This paper describes the field test and presents preliminary results for the commercial flights.

  18. Feature Clustering for Accelerating Parallel Coordinate Descent

    SciTech Connect

    Scherrer, Chad; Tewari, Ambuj; Halappanavar, Mahantesh; Haglin, David J.

    2012-12-06

    We demonstrate an approach for accelerating calculation of the regularization path for L1 sparse logistic regression problems. We show the benefit of feature clustering as a preconditioning step for parallel block-greedy coordinate descent algorithms.

  19. Anteroposterior Knee Stability During Stair Descent.

    PubMed

    Borque, Kyle A; Gold, Jonathan E; Incavo, Stephen J; Patel, Rupal M; Ismaily, Sabir E; Noble, Philip C

    2015-06-01

    This study examined the influence of tibio-femoral conformity on anteroposterior (AP) knee stability during stair descent, particularly with a dished cruciate sacrificing (CS) design. A joint simulator simulated stair descent of cadaveric knees. Tibio-femoral displacement was measured. Knees were tested in intact, ACL-deficient, and TKA with cruciate-retaining (CR), CS and posterior-stabilizing (PS) inserts. Loading during stair descent simulation caused femur displacement anteriorly prior to quadriceps contraction. Quadriceps contraction reestablished the initial femoral AP position. During simulated stair descent, AP stability was restored using PS, CR or CS inserts with an intact PCL. The CS design without the PCL did not provide AP stability. Increasing quadriceps force to restore AP stability may explain the clinical findings of pain and fatigue experienced by some patients after TKA.

  20. The Relationship Between Foot and Pelvic Alignment While Standing

    PubMed Central

    Khamis, Sam; Dar, Gali; Peretz, Chava; Yizhar, Ziva

    2015-01-01

    A normal motion and segmental interrelationship has been determined as a significant factor in normal function. Yet, the relationship between distal segments and pelvic alignment needs further investigation. The aim of this study was to investigate the interrelationship between distal and proximal lower extremity segments while standing and during induced feet hyperpronation. Changes in alignment of the pelvis and lower extremities were measured at a gait laboratory using the VICON 612 computerized motion analysis system. Thirty-five healthy volunteer subjects were recruited. Four randomized repeated-measure standing modes were used: standing directly on the floor and then on three wedges angled at 10°, 15° and 20° to induce bilateral hyperpronation for 20 seconds. A significant (p<0.05) bi-variate relationship was found between the anterior pelvic tilt and thigh internal rotation, in all four standing positions (.41≤r≤.46, in all p<0.014). A combined effect of rotational alignment between segments and the cumulative effect of foot hyperpronation on pelvic tilt revealed that only the shank significantly affected pelvic alignment, acting as a mediator between a foot and a thigh with the thigh having a crude significant effect on the pelvis. When internal rotation of the shank occurs, calcaneal eversion couples with thigh internal rotation and anterior pelvic tilt. It can be concluded that in response to induced hyperpronation, the shank is a pivotal segment in postural adjustment. PMID:26240652

  1. Cleaning up Floor Care.

    ERIC Educational Resources Information Center

    Carr, Richard; McLean, Doug

    1995-01-01

    Discusses how educational-facility maintenance departments can cut costs in floor cleaning through careful evaluation of floor equipment and products. Tips for choosing carpet detergents are highlighted. (GR)

  2. Mixed-Up Floors.

    ERIC Educational Resources Information Center

    Shaw, Richard

    2001-01-01

    Examines the maintenance management problems inherent in cleaning multiple flooring materials revealing the need for school officials to keep it simple when choosing flooring types. Also highlighted is a carpet recycling program used by Wright State University (Ohio). (GR)

  3. Incidence of pelvic organ prolapse in Nigerian women.

    PubMed Central

    Okonkwo, J. E. N.; Obiechina, N. J. A.; Obionu, C. N.

    2003-01-01

    OBJECTIVE: To establish the incidence and types of utero-vaginal prolapse. METHODS: Retrospective medical records analyses of women who were subjected to reconstructive pelvic surgery for various types of pelvic relaxation at the Nnamdi Azikiwe University Teaching Hospital, Nnewi and the University Of Nigeria Teaching Hospital, Enugu, Nigeria was carried out. The study was conducted from January 1996 to December 1999 during which there were 7515 surgical admissions. The inclusion criteria were those women who complained of feeling a mass in the vagina with demonAstrable descent of the anterior and/or posterior and/or apical vaginal walls and/or perineal descent. Excluded were patients who had other symptoms other than utero-vaginal prolapse and those whose grades and sites of prolapse were not determinable from the clinical or surgical notes. Also excluded were patients with nerve injury or disease, connective tissue disorders and neuromuscular diseases. The subjects were divided into two groups. Group I consisted of 54 women (age < or = 40 years), and group II included 105 women (age > or = 40 years). The findings between those two groups were compared with reference to sites, types and degree of prolapse. Also, coexistence of pelvic relaxation and underlying medical conditions were evaluated. RESULTS: A total of 159 subjects out of 492 charts studied met the inclusion criteria for the study. In group I, mean age was 32.839 with a standard deviation (SD) of +/- 6.012 years; and in group II the mean age was 56.543 with a SD of 8.094. Hypertrophic (elongated) cervix was determined in 15 (6.3%) subjects in group I for an incidence of 1.58% per year, cystocele (vaginal anterior wall descent) was present in 21 (8.9%) women for an incidence of 2.2% per year; rectocele (posterior vaginal wall descent) was identified in 15 (6.3%) women for an incidence of 1.58% per year; vaginal cough prolapse (apical descent) was present 21 (8.9%) women for an incidence of 2.2% per year

  4. FIRST FLOOR FRONT ROOM. SECOND FLOOR HAS BEEN REMOVED NOTE ...

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

    FIRST FLOOR FRONT ROOM. SECOND FLOOR HAS BEEN REMOVED-- NOTE PRESENCE OF SECOND FLOOR WINDOWS (THE LATTER FLOOR WAS REMOVED MANY YEARS AGO), See also PA-1436 B-12 - Kid-Physick House, 325 Walnut Street, Philadelphia, Philadelphia County, PA

  5. Botulinum Toxin Type A (BOTOX) for Refractory Myofascial Pelvic Pain

    PubMed Central

    ADELOWO, Amos; HACKER, Michele R.; SHAPIRO, Alex; Modest, Anna Merport; ELKADRY, Eman

    2013-01-01

    Objective To assess intralevator Botulinum toxin type A (Botox) injections for refractory myofascial pelvic pain with short tight pelvic floor. Methods Retrospective cohort study of all women with intralevator Botox injection (100-300 Units) from 2005 through 2010 for refractory myofascial pelvic pain. Primary outcomes were self-reported pain on palpation and symptom improvement. Secondary outcomes included post-injection complications and repeat injection. Pain was assessed during digital palpation of the pelvic floor muscles using a scale of 0-10, with 10 being the worst possible pain. Follow-up occurred at <6 weeks post-injection and again at ≥ 6 weeks. Data are presented as median (interquartile range) or proportion. Results Thirty-one patients met eligibility criteria; 2 were lost to follow up and excluded. Median age was 55.0 years (38.0-62.0). Before Botox injection, median pain score was 9.5 (8.0-10.0). Twenty-nine patients (93.5%) returned for the first follow-up visit; 79.3% reported improvement in pain, while 20.7% reported no improvement. Median pain with levator palpation was significantly lower than before injection (P<0.0001). Eighteen women (58.0%) had a second follow-up visit with a median pain score that remained lower than before injection (P<0.0001). Fifteen (51.7%) women elected to have repeat Botox injection; the median time to repeat injection was 4.0 (3.0-7.0) months. Three (10.3%) women developed de-novo urinary retention, 2 (6.9%) reported fecal incontinence and 3 (10.3%) reported constipation and/or rectal pain; all side effects resolved spontaneously. Conclusions Intralevator injection of Botox demonstrates effectiveness in women with refractory myofascial pelvic pain with few, self-limiting adverse effects. PMID:23982578

  6. Reference energy-altitude descent guidance: Simulator evaluation. [aircraft descent and fuel conservation

    NASA Technical Reports Server (NTRS)

    Abbot, K. H.; Knox, C. E.

    1985-01-01

    Descent guidance was developed to provide a pilot with information to ake a fuel-conservative descent and cross a designated geographical waypoint at a preselected altitude and airspeed. The guidance was designed to reduce fuel usage during the descent and reduce the mental work load associated with planning a fuel-conservative descent. A piloted simulation was conducted to evaluate the operational use of this guidance concept. The results of the simulation tests show that the use of the guidance reduced fuel consumption and mental work load during the descent. Use of the guidance also decreased the airspeed error, but had no effect on the altitude error when the designated waypoint was crossed. Physical work load increased with the use of the guidance, but remained well within acceptable levels. The pilots found the guidance easy to use as presented and reported that it would be useful in an operational environment.

  7. The pain cycle: implications for the diagnosis and treatment of pelvic pain syndromes.

    PubMed

    Everaert, K; Devulder, J; De Muynck, M; Stockman, S; Depaepe, H; De Looze, D; Van Buyten, J; Oosterlinck, W

    2001-01-01

    The aim of the study was to report our results of sacral nerve stimulation in patients with pelvic pain after failed conservative treatment. From 1992 to August 1998 we treated 111 patients (40 males, 71 females, ages 46 +/- 16 years) with chronic pelvic pain. All patients with causal treatment were excluded from this study. Pelvic floor training, transcutaneous electrical nerve stimulation (TENS) and intrarectal or intravaginal electrostimulation were applied and sacral nerve stimulation was used for therapy-resistant pain. The outcome of conservative treatment and sacral nerve stimulation (VAS <3/10; >50% pain relief) was related to symptoms of voiding dysfunction and dyschezia, and urodynamic proof of dysfunctional voiding, not to the pain localization or treatment modality. Outcome was inversely related to neuropathic pain. When conservative treatment failed, a test stimulation of the S3 root was effective in 16/26 patients, and 11 patients were implanted successfully with a follow-up of 36 +/- 8 months. So far no late failures have been seen. A longer test stimulation is needed in patients with pelvic pain because of a higher incidence of initial false positive tests. Our conclusion is that sacral nerve stimulation is effective in the treatment of therapy-resistant pelvic pain syndromes linked to pelvic floor dysfunction.

  8. Assessment of GPS radiosonde descent data

    NASA Astrophysics Data System (ADS)

    Venkat Ratnam, M.; Pravallika, N.; Babu, S. Ravindra; Basha, G.; Pramitha, M.; Krishna Murthy, B. V.

    2014-04-01

    Radiosondes are widely used to obtain basic meteorological parameters such as pressure (P), temperature (T), relative humidity (RH) and horizontal winds during the balloon ascent up to the altitude of balloon burst, usually ~ 32-35 km. Data from the radiosondes released from Gadanki (13.5° N, 79.2° E), a tropical station in India, have been collected during the ascent and during the descent as well without attaching any parachute or its equivalent since the year 2008. In the present study an attempt has been made to characterize the radiosonde descent data with the main objective of exploring its usefulness and reliability for scientific purposes. We compared the data obtained during ascent and descent phases of the same sounding. The mean differences in T, RH and horizontal winds between ascent and descent data are found to be small and are sometimes even within the uncertainty of the measurements and/or expected diurnal variation itself. The very good consistency observed between the ascent and the descent data shows that one more profile of the meteorological parameters can be constructed within 3 h of time of balloon launch practically at no additional cost. Further checks are done by utilizing the 3-hourly radiosonde observations collected during the Tropical Tropopause Dynamics campaigns conducted at Gadanki. In the process of checking the consistency between the radiosonde ascent and descent data, several new findings are arrived at and are reported in this study. In general, it has taken more than half an hour for the balloon to reach the ground from the burst altitude. It is also observed that the fall velocity is close to 10 m s-1 near the surface. Finally, it is suggested to record the observations also when the balloon is descending as this information is useful for scientific purposes.

  9. Assessment of GPS radiosonde descent data

    NASA Astrophysics Data System (ADS)

    Venkat Ratnam, M.; Pravallika, N.; babu, S. Ravindra; Basha, G.; Pramitha, M.; Krishna Murthy, B. V.

    2013-12-01

    Radiosondes are widely used to obtain basic meteorological parameters such as pressure (P), temperature (T), relative humidity (RH), and horizontal winds during the balloon ascent up to the altitude of balloon burst, usually ∼32-35 km. Data from the radiosondes released from Gadanki (13.5° N, 79.2° E), a tropical station in India, has been collected during the ascent and during the descent as well without attaching any parachute or its equivalent since the year 2008. In the present study an attempt has been made to characterize the radiosonde descent data with the main objective of exploring its usefulness and reliability for scientific purposes. We compared the data obtained during ascent and descent phases of the same sounding. The mean differences in T, RH and horizontal winds between ascent and descent data are found to be small and are sometimes even within the uncertainty of the measurements and/or expected diurnal variation itself. The very good consistency observed between the ascent and the descent data shows that one more profile of the meteorological parameters can be constructed within 3 h of time of balloon launch practically at no additional cost. Further checks are done by utilizing the 3 hourly radiosonde observations collected during the Tropical Tropopause Dynamics campaign conducted at Gadanki. In the process of checking the consistency between the radiosonde ascent and descent data, several new findings are arrived at and are reported in this study. In general, it has taken more than half-an-hour for the balloon to reach the ground from the burst altitude. It is also observed that the fall velocity is close to 10 m s-1 near the surface. Finally, it is suggested to record also the observations when the balloon is descending as this information is also useful for scientific purposes.

  10. Entry, Descent, and Landing With Propulsive Deceleration

    NASA Technical Reports Server (NTRS)

    Palaszewski, Bryan

    2012-01-01

    The future exploration of the Solar System will require innovations in transportation and the use of entry, descent, and landing (EDL) systems at many planetary landing sites. The cost of space missions has always been prohibitive, and using the natural planetary and planet s moons atmospheres for entry, descent, and landing can reduce the cost, mass, and complexity of these missions. This paper will describe some of the EDL ideas for planetary entry and survey the overall technologies for EDL that may be attractive for future Solar System missions.

  11. An Ectopic Pelvic Kidney

    PubMed Central

    Bhoil, Rohit; Sood, Dinesh; Singh, Yash Paul; Nimkar, Kshama; Shukla, Anurag

    2015-01-01

    Summary Background If a kidney does not ascend as it should in normal fetal development, it remains in the pelvic area and is called a pelvic kidney. Often a person with a pelvic kidney will go through his/her whole life unaware of this condition, unless it is discovered during neonatal kidney ultrasound screening or if complications arise later in life due to this or a completely different reason and the condition is noted during investigations. Generally, this is not a harmful condition but it can lead to complications like in our case. With appropriate testing and treatment, if needed, an ectopic kidney should cause no serious long-term health complications and all that may be required for the patient is reassurance with advice to follow up at regular intervals. Case Report A 28-year-old male presented with recurrent pain in his lower left abdomen for one month and an episode of hematuria 3 days earlier accompanied by an attack of acute pain lasting for 3–4 hours. He gave a history of passing 2 small (about 5 mm each) calculi in his urine after the occurrence of hematuria, following which pain decreased in intensity. No history of fever was present. Conclusions Although a simple ectopic kidney seldom causes symptoms, the association of malrotation of the renal pelvis with calculus increases the risk of hematuria and/or hydronephrosis, presenting with colicky pain as in the present case. The clinician should be aware of these in such a case. If asymptomatic, no treatment is required. However, the patient should be advised to have follow-up ultrasounds at regular intervals to detect complications like calculus, hydronephrosis, etc. With appropriate testing and treatment, if required, an ectopic kidney should not cause serious long-term health complications. PMID:26413178

  12. [Hemophilic pelvic pseudotumor].

    PubMed

    Castro-Boix, Sandra; Pradell-Teigell, Jordi; Boqué-Genovard, Ramón; Zanón-Navarro, Vicente; Nadal-Guinard, Antoni; Altisent-Roca, Carme; Armengol-Carrasco, Manel

    2007-02-01

    Surgery in hemophilic patients is a challenge for the general surgeon. Hemophilic pseudotumor is a rare complication occurring in 1-2% of hemophiliacs and affecting mainly patients with severe disease or those who have developed antibodies to factor VIII or IX. A number of alternatives are available for the management of these tumors, including conservative treatment, surgical removal, percutaneous drainage, embolization, and external radiation. The only definitive treatment is surgical excision. We report a case of hemophilic pseudotumor of the pelvic bone. Treatment consisted of surgical resection after arterial embolization using factor replacement to achieve hemostasis.

  13. [Retrovesical pelvic masses: diagnosis].

    PubMed

    Paniagua, P; Extramiana, J; Mora, M; Pamplona, M; Mañas, A; González, P; Pérez, M J; García Castaño, B

    1990-01-01

    We present two cases of pelvic masses with retrovesical localization: one consisting of a mature cystic teratoma and the other in a ganglionic metastasis of a subclinical prostate adenocarcinoma. We carry out an analysis of the clinical aspects as well as a review of the diagnostic guidelines to be followed in the light of the existence of a neoformation in this location. We analyse the possible differential diagnoses to be established with these tumours, which we should take into consideration despite their rare incidence and form of presentation.

  14. Pelvic Insufficiency Fractures

    PubMed Central

    O’Connor, Timothy J.

    2014-01-01

    Pelvic insufficiency fractures may occur in the absence of trauma or as a result of low-energy trauma in osteoporotic bone. With a growing geriatric population, the incidence of pelvic insufficiency fracture has increased over the last 3 decades and will continue to do so. These fractures can cause considerable pain, loss of independence, and economic burden to both the patient and the health care system. While many of these injuries are identified and treated based on plain radiographs, some remain difficult to diagnose. The role of advanced imaging in these cases is discussed. In addition to treating the fracture, medical comorbidities contributing to osteoporosis should be identified and corrected. Specific attention has been given to 25-OH serum vitamin D screening and repletion. Treatment generally consists of providing pain control and assisting patients with mobilization while allowing weight bearing as tolerated. In those unable to do so, invasive techniques such as sacroplasty as well as internal fixation may be beneficial. The role of operative fixation in insufficiency fractures is also discussed. PMID:26246940

  15. The hormonal control of testicular descent.

    PubMed

    Levy, J B; Husmann, D A

    1995-01-01

    Descent of the testes is a complex event mediated by hormonal and mechanical factors. At present we hypothesize that testicular descent occurs as the result of the secretion of descendin from a normal testicle. Descendin secretion results in selective growth of the gubernacular cells. Gubernacular outgrowth results in masculinization of the inguinal canal. At the beginning of testicular descent, the patent processus migrates into the inguinal canal, transmitting intraabdominal pressure to the gubernaculum. The gubernaculum in turn applies traction to the testicle to introduce the testicle into the inguinal canal. Descent of the testes into and through the inguinal canal is an interplay between intraabdominal pressure transmitted by a patent processus vaginalis and androgen-induced gubernacular regression. Specifically, we hypothesize that androgens under control of an intact fetal hypothalamic-pituitary axis alter the viscoelastic properties of the gubernaculum. Reductions in the turgidity of the gubernaculum allow intraabdominal pressure to push the testicle into the scrotum. Functional abnormalities in any of the above factors will result in cryptorchidism. PMID:8867594

  16. Research study: STS-1 Orbiter Descent

    NASA Technical Reports Server (NTRS)

    Hickey, J. S.

    1981-01-01

    The conversion of STS-1 orbiter descent data from AVE-SESAME contact programs to the REEDA system and the reduction of raw radiosonde data is summarized. A first difference program, contact data program, plot data program, and 30 second data program were developed. Six radiosonde soundings were taken. An example of the outputs of each of the programs is presented.

  17. The hormonal control of testicular descent.

    PubMed

    Levy, J B; Husmann, D A

    1995-01-01

    Descent of the testes is a complex event mediated by hormonal and mechanical factors. At present we hypothesize that testicular descent occurs as the result of the secretion of descendin from a normal testicle. Descendin secretion results in selective growth of the gubernacular cells. Gubernacular outgrowth results in masculinization of the inguinal canal. At the beginning of testicular descent, the patent processus migrates into the inguinal canal, transmitting intraabdominal pressure to the gubernaculum. The gubernaculum in turn applies traction to the testicle to introduce the testicle into the inguinal canal. Descent of the testes into and through the inguinal canal is an interplay between intraabdominal pressure transmitted by a patent processus vaginalis and androgen-induced gubernacular regression. Specifically, we hypothesize that androgens under control of an intact fetal hypothalamic-pituitary axis alter the viscoelastic properties of the gubernaculum. Reductions in the turgidity of the gubernaculum allow intraabdominal pressure to push the testicle into the scrotum. Functional abnormalities in any of the above factors will result in cryptorchidism.

  18. America's Descent into Madness

    ERIC Educational Resources Information Center

    Giroux, Henry A.

    2014-01-01

    This article describes America's descent into madness under the regime of neoliberalism that has emerged in the United States since the late 1970s. In part, this is due to the emergence of a public pedagogy produced by the corporate-owned media that now saturates Americans with a market-driven value system that undermines those formative…

  19. Ka-Band Radar Terminal Descent Sensor

    NASA Technical Reports Server (NTRS)

    Pollard, Brian; Berkun, Andrew; Tope, Michael; Andricos, Constantine; Okonek, Joseph; Lou, Yunling

    2007-01-01

    The terminal descent sensor (TDS) is a radar altimeter/velocimeter that improves the accuracy of velocity sensing by more than an order of magnitude when compared to existing sensors. The TDS is designed for the safe planetary landing of payloads, and may be used in helicopters and fixed-wing aircraft requiring high-accuracy velocity sensing

  20. Descent Assisted Split Habitat Lunar Lander Concept

    NASA Technical Reports Server (NTRS)

    Mazanek, Daniel D.; Goodliff, Kandyce; Cornelius, David M.

    2008-01-01

    The Descent Assisted Split Habitat (DASH) lunar lander concept utilizes a disposable braking stage for descent and a minimally sized pressurized volume for crew transport to and from the lunar surface. The lander can also be configured to perform autonomous cargo missions. Although a braking-stage approach represents a significantly different operational concept compared with a traditional two-stage lander, the DASH lander offers many important benefits. These benefits include improved crew egress/ingress and large-cargo unloading; excellent surface visibility during landing; elimination of the need for deep-throttling descent engines; potentially reduced plume-surface interactions and lower vertical touchdown velocity; and reduced lander gross mass through efficient mass staging and volume segmentation. This paper documents the conceptual study on various aspects of the design, including development of sortie and outpost lander configurations and a mission concept of operations; the initial descent trajectory design; the initial spacecraft sizing estimates and subsystem design; and the identification of technology needs

  1. Coping with Discrimination among Mexican Descent Adolescents

    ERIC Educational Resources Information Center

    Edwards, Lisa M.; Romero, Andrea J.

    2008-01-01

    The current research is designed to explore the relationship among discrimination stress, coping strategies, and self-esteem among Mexican descent youth (N = 73, age 11-15 years). Results suggest that primary control engagement and disengagement coping strategies are positively associated with discrimination stress. Furthermore, self-esteem is…

  2. Method of descent for integrable lattices

    NASA Astrophysics Data System (ADS)

    Bogoyavlensky, Oleg

    2009-05-01

    A method of descent for constructing integrable Hamiltonian systems is introduced. The derived periodic and nonperiodic lattices possess Lax representations with spectral parameter and have plenty of first integrals. Examples of Liouville-integrable four-dimensional Hamiltonian Lotka-Volterra systems are presented.

  3. Optimum Strategies for Selecting Descent Flight-Path Angles

    NASA Technical Reports Server (NTRS)

    Wu, Minghong G. (Inventor); Green, Steven M. (Inventor)

    2016-01-01

    An information processing system and method for adaptively selecting an aircraft descent flight path for an aircraft, are provided. The system receives flight adaptation parameters, including aircraft flight descent time period, aircraft flight descent airspace region, and aircraft flight descent flyability constraints. The system queries a plurality of flight data sources and retrieves flight information including any of winds and temperatures aloft data, airspace/navigation constraints, airspace traffic demand, and airspace arrival delay model. The system calculates a set of candidate descent profiles, each defined by at least one of a flight path angle and a descent rate, and each including an aggregated total fuel consumption value for the aircraft following a calculated trajectory, and a flyability constraints metric for the calculated trajectory. The system selects a best candidate descent profile having the least fuel consumption value while the fly ability constraints metric remains within aircraft flight descent flyability constraints.

  4. Floors: Care and Maintenance.

    ERIC Educational Resources Information Center

    Post Office Dept., Washington, DC.

    Guidelines, methods and policies regarding the care and maintenance of post office building floors are overviewed in this handbook. Procedures outlined are concerned with maintaining a required level of appearance without wasting manpower. Flooring types and characteristics and the particular cleaning requirements of each type are given along with…

  5. School Flooring Factors

    ERIC Educational Resources Information Center

    McGrath, John

    2012-01-01

    With all of the hype that green building is receiving throughout the school facility-management industry, it's easy to overlook some elements that may not be right in front of a building manager's nose. It is helpful to examine the role floor covering plays in a green building project. Flooring is one of the most significant and important systems…

  6. Maximizing Hard Floor Maintenance.

    ERIC Educational Resources Information Center

    Steger, Michael

    2000-01-01

    Explains the maintenance options available for hardwood flooring that can help ensure long life cycles and provide inviting spaces. Developing a maintenance system, knowing the type of traffic that the floor must endure, using entrance matting, and adhering to manufacturers guidelines are discussed. Daily, monthly or quarterly, and long-term…

  7. A Descent Rate Control Approach to Developing an Autonomous Descent Vehicle

    NASA Astrophysics Data System (ADS)

    Fields, Travis D.

    Circular parachutes have been used for aerial payload/personnel deliveries for over 100 years. In the past two decades, significant work has been done to improve the landing accuracies of cargo deliveries for humanitarian and military applications. This dissertation discusses the approach developed in which a circular parachute is used in conjunction with an electro-mechanical reefing system to manipulate the landing location. Rather than attempt to steer the autonomous descent vehicle directly, control of the landing location is accomplished by modifying the amount of time spent in a particular wind layer. Descent rate control is performed by reversibly reefing the parachute canopy. The first stage of the research investigated the use of a single actuation during descent (with periodic updates), in conjunction with a curvilinear target. Simulation results using real-world wind data are presented, illustrating the utility of the methodology developed. Additionally, hardware development and flight-testing of the single actuation autonomous descent vehicle are presented. The next phase of the research focuses on expanding the single actuation descent rate control methodology to incorporate a multi-actuation path-planning system. By modifying the parachute size throughout the descent, the controllability of the system greatly increases. The trajectory planning methodology developed provides a robust approach to accurately manipulate the landing location of the vehicle. The primary benefits of this system are the inherent robustness to release location errors and the ability to overcome vehicle uncertainties (mass, parachute size, etc.). A separate application of the path-planning methodology is also presented. An in-flight path-prediction system was developed for use in high-altitude ballooning by utilizing the path-planning methodology developed for descent vehicles. The developed onboard system improves landing location predictions in-flight using collected flight

  8. FIRST FLOOR REAR ROOM. SECOND FLOOR HAS BEEN REMOVED NOTE ...

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

    FIRST FLOOR REAR ROOM. SECOND FLOOR HAS BEEN REMOVED-- NOTE PRESENCE OF SECOND FLOOR WINDOWS AT LEFT. See also PA-1436 B-6 - Kid-Physick House, 325 Walnut Street, Philadelphia, Philadelphia County, PA

  9. FIRST FLOOR REAR ROOM. SECOND FLOOR HAS BEEN REMOVED NOTE ...

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

    FIRST FLOOR REAR ROOM. SECOND FLOOR HAS BEEN REMOVED-- NOTE PRESENCE OF SECOND FLOOR WINDOWS AT LEFT. See also PA-1436 B-13 - Kid-Physick House, 325 Walnut Street, Philadelphia, Philadelphia County, PA

  10. 14 CFR 23.69 - Enroute climb/descent.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Enroute climb/descent. 23.69 Section 23.69... climb/descent. (a) All engines operating. The steady gradient and rate of climb must be determined at.... The steady gradient and rate of climb/descent must be determined at each weight, altitude, and...

  11. Altered resting state neuromotor connectivity in men with chronic prostatitis/chronic pelvic pain syndrome: A MAPP

    PubMed Central

    Kutch, Jason J.; Yani, Moheb S.; Asavasopon, Skulpan; Kirages, Daniel J.; Rana, Manku; Cosand, Louise; Labus, Jennifer S.; Kilpatrick, Lisa A.; Ashe-McNalley, Cody; Farmer, Melissa A.; Johnson, Kevin A.; Ness, Timothy J.; Deutsch, Georg; Harris, Richard E.; Apkarian, A. Vania; Clauw, Daniel J.; Mackey, Sean C.; Mullins, Chris; Mayer, Emeran A.

    2015-01-01

    Brain network activity associated with altered motor control in individuals with chronic pain is not well understood. Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a debilitating condition in which previous studies have revealed altered resting pelvic floor muscle activity in men with CP/CPPS compared to healthy controls. We hypothesized that the brain networks controlling pelvic floor muscles would also show altered resting state function in men with CP/CPPS. Here we describe the results of the first test of this hypothesis focusing on the motor cortical regions, termed pelvic-motor, that can directly activate pelvic floor muscles. A group of men with CP/CPPS (N = 28), as well as group of age-matched healthy male controls (N = 27), had resting state functional magnetic resonance imaging scans as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network study. Brain maps of the functional connectivity of pelvic-motor were compared between groups. A significant group difference was observed in the functional connectivity between pelvic-motor and the right posterior insula. The effect size of this group difference was among the largest effect sizes in functional connectivity between all pairs of 165 anatomically-defined subregions of the brain. Interestingly, many of the atlas region pairs with large effect sizes also involved other subregions of the insular cortices. We conclude that functional connectivity between motor cortex and the posterior insula may be among the most important markers of altered brain function in men with CP/CPPS, and may represent changes in the integration of viscerosensory and motor processing. PMID:26106574

  12. Estimating genotypes with independently sampled descent graphs.

    PubMed

    Henshall, J M; Tier, B; Kerr, R J

    2001-12-01

    A method for estimating genotypic and identity-by-descent probabilities in complex pedigrees is described. The method consists of an algorithm for drawing independent genotype samples which are consistent with the pedigree and observed genotype. The probability distribution function for samples obtained using the algorithm can be evaluated up to a normalizing constant, and combined with the likelihood to produce a weight for each sample. Importance sampling is then used to estimate genotypic and identity-by-descent probabilities. On small but complex pedigrees, the genotypic probability estimates are demonstrated to be empirically unbiased. On large complex pedigrees, while the algorithm for obtaining genotype samples is feasible, importance sampling may require an infeasible number of samples to estimate genotypic probabilities with accuracy.

  13. Reassessing the Annual Pelvic Exam

    MedlinePlus

    ... recommendation released Tuesday, the U.S. Preventive Services Task Force said it couldn't weigh in for or ... pelvic exams based on current evidence. "The Task Force is calling for more research to better understand ...

  14. Mars Exploration Entry, Descent and Landing Challenges

    NASA Technical Reports Server (NTRS)

    Braun, Robert D.; Manning, Robert M.

    2006-01-01

    The United States has successfully landed five robotic systems on the surface of Mars. These systems all had landed mass below 0.6 metric tons (t), had landed footprints on the order of hundreds of km and landed at sites below -1.4 km MOLA elevation due the need to perform entry, descent and landing operations in an environment with sufficient atmospheric density. At present, robotic exploration systems engineers are struggling with the challenges of increasing landed mass capability to 0.8 t while improving landed accuracy to tens of km and landing at a site as high as +2 km MOLA elevation for the Mars Science Laboratory project. Meanwhile, current plans for human exploration of Mars call for the landing of 40-80 t surface elements at scientifically interesting locations within close proximity (tens of m) of pre-positioned robotic assets. This paper summarizes past successful entry, descent and landing systems and approaches being developed by the robotic Mars exploration program to increased landed performance (mass, accuracy and surface elevation). In addition, the entry, descent and landing sequence for a human exploration system will be reviewed, highlighting the technology and systems advances required.

  15. 'Spousal Revenge Syndrome'--description of a new chronic pelvic pain syndrome patient cohort.

    PubMed

    Makovey, Iryna; Dolinga, Robert; Shoskes, Daniel A

    2016-02-01

    Psychological factors may play a role in the pathophysiology of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). This case series describes a cohort of 10 men presenting with CP/CPPS whose symptoms began after an extramarital sexual encounter, who strongly believed they had a sexually transmitted infection (STI) despite negative testing, and who have had no improvement with empiric antibiotic treatment. Patients' clinical presentation and physical exam findings are reviewed. All men were clinically phenotyped with the UPOINT system. Pelvic floor spasm and not infection was prominent in these men. Treatment recommendations are proposed and compliance assessed. PMID:26892062

  16. 'Spousal Revenge Syndrome'--description of a new chronic pelvic pain syndrome patient cohort.

    PubMed

    Makovey, Iryna; Dolinga, Robert; Shoskes, Daniel A

    2016-02-01

    Psychological factors may play a role in the pathophysiology of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). This case series describes a cohort of 10 men presenting with CP/CPPS whose symptoms began after an extramarital sexual encounter, who strongly believed they had a sexually transmitted infection (STI) despite negative testing, and who have had no improvement with empiric antibiotic treatment. Patients' clinical presentation and physical exam findings are reviewed. All men were clinically phenotyped with the UPOINT system. Pelvic floor spasm and not infection was prominent in these men. Treatment recommendations are proposed and compliance assessed.

  17. Office-based behavioral therapy for management of incontinence and other pelvic disorders.

    PubMed

    Newman, Diane K; Wein, Alan J

    2013-11-01

    According to evidence-based research and guidelines, behavioral interventions are effective and are recommended as first-line office-based treatment for incontinence and other pelvic disorders. These interventions are aimed at improving symptoms through education on healthy voiding habits and lifestyle modifications. Bladder training techniques are included, which involve progressive voiding schedules together with relaxation and distraction for urgency suppression as well as, pelvic floor muscle strengthening to prevent urine leakage, control urgency, and improve bladder emptying. This article presents the model for providing these treatments in urologic practice and details specifics of each intervention, including education guides for patients.

  18. Total mesorectal excision for rectal cancer with emphasis on pelvic autonomic nerve preservation: Expert technical tips for robotic surgery.

    PubMed

    Kim, Nam Kyu; Kim, Young Wan; Cho, Min Soo

    2015-09-01

    The primary goal of surgical intervention for rectal cancer is to achieve an oncologic cure while preserving function. Since the introduction of total mesorectal excision (TME), the oncologic outcome has improved greatly in terms of local recurrence and cancer-specific survival. However, there are still concerns regarding functional outcomes such as sexual and urinary dysfunction, even among experienced colorectal surgeons. Intraoperative nerve damage is the primary reason for sexual and urinary dysfunction and occurs due to lack of anatomical knowledge and poor visualization of the pelvic autonomic nerves. The rectum is located concavely along the curved sacrum and both the ischial tuberosity and iliac wing limit the pelvic cavity boundary. Thus, pelvic autonomic nerve preservation during dissection in a narrow or deep pelvis, with adherence to the TME principles, is very challenging for colorectal surgeons. Recent developments in robotic technology enable overcoming these difficulties caused by complex pelvic anatomy. This system can facilitate better preservation of the pelvic autonomic nerve and thereby achieve favorable postoperative sexual and voiding functions after rectal cancer surgery. The nerve-preserving TME technique includes identification and preservation of the superior hypogastric plexus nerve, bilateral hypogastric nerves, pelvic plexus, and neurovascular bundles. Standardized procedures should be performed sequentially as follows: posterior dissection, deep posterior dissection, anterior dissection, posterolateral dissection, and final circumferential pelvic dissection toward the pelvic floor. In future perspective, a structured education program on nerve-preserving robotic TME should be incorporated in the training for minimally invasive surgery.

  19. Chronic proctalgia and chronic pelvic pain syndromes: New etiologic insights and treatment options

    PubMed Central

    Chiarioni, Giuseppe; Asteria, Corrado; Whitehead, William E

    2011-01-01

    This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs: chronic proctalgia, coccygodynia, pudendal neuralgia, and chronic pelvic pain. Chronic or recurrent pain in the anal canal, rectum, or other pelvic organs occurs in 7% to 24% of the population and is associated with impaired quality of life and high health care costs. However, these pain syndromes are poorly understood, with little research evidence available to guide their diagnosis and treatment. This situation appears to be changing: A recently published large randomized, controlled trial by our group comparing biofeedback, electrogalvanic stimulation, and massage for the treatment of chronic proctalgia has shown success rates of 85% for biofeedback when patients are selected based on physical examination evidence of tenderness in response to traction on the levator ani muscle-a physical sign suggestive of striated muscle tension. Excessive tension (spasm) in the striated muscles of the pelvic floor appears to be common to most of the pelvic pain syndromes. This suggests the possibility that similar approaches to diagnostic assessment and treatment may improve outcomes in other pelvic pain disorders. PMID:22110274

  20. Chronic proctalgia and chronic pelvic pain syndromes: new etiologic insights and treatment options.

    PubMed

    Chiarioni, Giuseppe; Asteria, Corrado; Whitehead, William E

    2011-10-28

    This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs: chronic proctalgia, coccygodynia, pudendal neuralgia, and chronic pelvic pain. Chronic or recurrent pain in the anal canal, rectum, or other pelvic organs occurs in 7% to 24% of the population and is associated with impaired quality of life and high health care costs. However, these pain syndromes are poorly understood, with little research evidence available to guide their diagnosis and treatment. This situation appears to be changing: a recently published large randomized, controlled trial by our group comparing biofeedback, electrogalvanic stimulation, and massage for the treatment of chronic proctalgia has shown success rates of 85% for biofeedback when patients are selected based on physical examination evidence of tenderness in response to traction on the levator ani muscle--a physical sign suggestive of striated muscle tension. Excessive tension (spasm) in the striated muscles of the pelvic floor appears to be common to most of the pelvic pain syndromes. This suggests the possibility that similar approaches to diagnostic assessment and treatment may improve outcomes in other pelvic pain disorders.

  1. Kinetic analysis of stair descent: Part 1. Forwards step-over-step descent.

    PubMed

    Cluff, Tyler; Robertson, D Gordon E

    2011-03-01

    This study examined lower extremity biomechanics during the initiation of stair descent from an upright, static posture. Seventeen healthy subjects (aged 23±2.4 years) descended a five-step, steel-reinforced, wooden laboratory staircase (34° decline). Ten trials of stair descent were separated into two blocks of five trials. Beginning from an upright posture, subjects descended the staircase at their preferred velocity (0.53±0.082 m/s) and continued the length of the laboratory walkway (∼4 m). Joint mechanics were contrasted between gait cycles. Relative to the initiation cycle at the top of the staircase, the dissipative knee extensor (K3) and hip flexor (H2) moments and powers were independent of progression velocity and approximated steady-state (i.e., constant) values after the first cycle of the trail limb (Step 5 to Step 3). In contrast, a salient relationship was observed between progression velocity and ankle joint mechanics at initial-contact. The plantiflexor moment, power and work at initial-contact (A1) increased with centre of mass velocity. Our results demonstrate that while the knee extensor moment is the primary dissipater of mechanical energy in stair descent, the ankle plantiflexors are the primary dissipaters associated with increased progression velocity. In addition, the results show that steady-state stair descent may not be attained during the first gait cycle of the trail limb. These data shed light on locomotive strategies used in stair descent and can be applied in biomechanical models of human stair gait. Researchers and practitioners should take into consideration the influence of gait cycle and progression velocity when evaluating lower extremity function in stair descent. PMID:21292489

  2. Novel Treatment of Chronic Bladder Pain Syndrome and Other Pelvic Pain Disorders by OnabotulinumtoxinA Injection

    PubMed Central

    Jhang, Jia-Fong; Kuo, Hann-Chorng

    2015-01-01

    Chronic pelvic pain (CPP) is defined as pain in the pelvic organs and related structures of at least 6 months’ duration. The pathophysiology of CPP is uncertain, and its treatment presents challenges. Botulinum toxin A (BoNT-A), known for its antinociceptive, anti-inflammatory, and muscle relaxant activity, has been used recently to treat refractory CPP with promising results. In patients with interstitial cystitis/bladder pain syndrome, most studies suggest intravesical BoNT-A injection reduces bladder pain and increases bladder capacity. Repeated BoNT-A injection is also effective and reduces inflammation in the bladder. Intraprostatic BoNT-A injection could significantly improve prostate pain and urinary frequency in the patients with chronic prostatitis/chronic pelvic pain syndrome. Animal studies also suggest BoNT-A injection in the prostate decreases inflammation in the prostate. Patients with CPP due to pelvic muscle pain and spasm also benefit from localized BoNT-A injections. BoNT-A injection in the pelvic floor muscle improves dyspareunia and decreases pelvic floor pressure. Preliminary studies show intravesical BoNT-A injection is useful in inflammatory bladder diseases such as chemical cystitis, radiation cystitis, and ketamine related cystitis. Dysuria is the most common adverse effect after BoNT-A injection. Very few patients develop acute urinary retention after treatment. PMID:26094697

  3. Novel Treatment of Chronic Bladder Pain Syndrome and Other Pelvic Pain Disorders by OnabotulinumtoxinA Injection.

    PubMed

    Jhang, Jia-Fong; Kuo, Hann-Chorng

    2015-06-18

    Chronic pelvic pain (CPP) is defined as pain in the pelvic organs and related structures of at least 6 months' duration. The pathophysiology of CPP is uncertain, and its treatment presents challenges. Botulinum toxin A (BoNT-A), known for its antinociceptive, anti-inflammatory, and muscle relaxant activity, has been used recently to treat refractory CPP with promising results. In patients with interstitial cystitis/bladder pain syndrome, most studies suggest intravesical BoNT-A injection reduces bladder pain and increases bladder capacity. Repeated BoNT-A injection is also effective and reduces inflammation in the bladder. Intraprostatic BoNT-A injection could significantly improve prostate pain and urinary frequency in the patients with chronic prostatitis/chronic pelvic pain syndrome. Animal studies also suggest BoNT-A injection in the prostate decreases inflammation in the prostate. Patients with CPP due to pelvic muscle pain and spasm also benefit from localized BoNT-A injections. BoNT-A injection in the pelvic floor muscle improves dyspareunia and decreases pelvic floor pressure. Preliminary studies show intravesical BoNT-A injection is useful in inflammatory bladder diseases such as chemical cystitis, radiation cystitis, and ketamine related cystitis. Dysuria is the most common adverse effect after BoNT-A injection. Very few patients develop acute urinary retention after treatment.

  4. Chlamydial pelvic inflammatory disease.

    PubMed

    Paavonen, J; Lehtinen, M

    1996-01-01

    Pelvic inflammatory disease (PID) is the most important complication present in the female lower genital tract, causing major medical, social and economic problems. Although PID can be caused by multiple microorganisms, it results most frequently from the ascent of sexually transmitted Chlamydia.trachomatis or Neisseria gonorrhoeae infections from the cervix to the upper genital tract. The importance of cervical chlamydial infection in the pathogenesis of PID is well recognized. Recent data from many developed countries have shown a striking decrease in the incidence of gonococcal infections, while the rates of chlamydial infections remain high in most countries. Complications of PID are common and usually irreversible. Emerging evidence suggests that universal or selected screening of defined populations for cervical chlamydial infection leads to a dramatic reduction in the incidence of PID. Recent technological advances should further enhance efforts to prevent chlamydial infection and PID. Gene amplification-based diagnostic tests, screening by testing first-void urine, and single dose antimicrobial therapy greatly facilitate chlamydia control programmes. Thus, screening for chlamydia is the key approach in the secondary prevention of PID. The obvious challenge is to make screening for chlamydia the standard for health care for young, sexually active individuals. Since PID is the most important consequence of sexually transmitted bacterial infections, it is also imperative to develop better treatments to prevent the long-term sequelae of this disease. The development and implementation of new and effective intervention programmes for prevention and control of PID is one of the major challenges for the year 2000 and beyond. PMID:9111185

  5. APOLLO 11: Lunar Module Separates for descent

    NASA Technical Reports Server (NTRS)

    1974-01-01

    Separation of the Lunar module for descent to the Lunar surface From the film documentary 'APOLLO 11:'The eagle Has Landed'', part of a documentary series on the APOLLO missions made in the early '70's and narrated by Burgess Meredith. APOLLO 11: First manned lunar landing and return to Earth with Neil A. Armstrong, Michael Collins, and Edwin E. Aldrin. Landed in the Sea of Tranquilityon July 20, 1969; deployed TV camera and EASEP experiments, performed lunar surface EVA, returned lunar soil samples. Mission Duration 195 hrs 18 min 35sec

  6. System for Estimating Horizontal Velocity During Descent

    NASA Technical Reports Server (NTRS)

    Johnson, Andrew; Cheng, Yang; Wilson, Reg; Goguen, Jay; Martin, Alejandro San; Leger, Chris; Matthies, Larry

    2007-01-01

    The descent image motion estimation system (DIMES) is a system of hardware and software, designed for original use in estimating the horizontal velocity of a spacecraft descending toward a landing on Mars. The estimated horizontal velocity is used in generating rocket-firing commands to reduce the horizontal velocity as part of an overall control scheme to minimize the landing impact. DIMES can also be used for estimating the horizontal velocity of a remotely controlled or autonomous aircraft for purposes of navigation and control.

  7. Is There a Relationship Between Pelvic Organ Prolapse and Tissue Fibrillin-1 Levels?

    PubMed Central

    Eser, Ayla; Unlubilgin, Eylem; Hizli, Fatih; Acar, Muradiye; Kamalak, Zeynep; Kosus, Aydin; Kosus, Nermin; Hizli, Deniz; Gunduz, Esra

    2015-01-01

    Purpose: Pelvic organ prolapse is a multifactorial disorder in which extracellular matrix defects are implicated. Fibrillin-1 level is reduced in stress urinary incontinence. In Marfan syndrome, which is associated with mutations in Fibrillin-1, pelvic floor disorders are commonly observed. We hypothesize that Fibrillin-1 gene expression is altered in pelvic organ prolapse. Methods: Thirty women undergoing colporrhaphy or hysterectomy because of cystocele, rectocele, cystorectocele, or uterine prolapse were assigned to a pelvic prolapse study group, and thirty women undergone hysterectomy for nonpelvic prolapse conditions were assigned to a control group. Real-time polymerase chain reaction was conducted on vaginal tissue samples to measure the expression of Fibrillin-1. Expression levels were compared between study and control groups by Mann-Whitney U test with Bonferroni revision. Results: Fibrillin-1 gene expression was not significantly lower in the study group than in the control group. Similarly, no significant correlation between Fibrillin-1 levels and grade of pelvic prolapse was found. Age over 40 years (P=0.018) and menopause (P=0.027) were both associated with reduced Fibrillin-1 levels in the pelvic prolapse group, whereas the delivery of babies weighing over 3,500 g at birth was associated with increased Fibrillin-1 expression (P=0.006). Conclusions: The results did not indicate a significant reduction in Fibrillin-1 gene expression in pelvic prolapse disorders; however, reduced Fibrillin-1 may contribute to increased pelvic organ prolapse risk with age and menopause. Increased Fibrillin-1 gene expression may be a compensatory mechanism in cases of delivery of babies with high birth weight. Further studies are needed for a better understanding of these observations. PMID:26620898

  8. Cooling Floor AC Systems

    NASA Astrophysics Data System (ADS)

    Jun, Lu; Hao, Ding; Hong, Zhang; Ce, Gao Dian

    The present HVAC equipments for the residential buildings in the Hot-summer-and-Cold-winter climate region are still at a high energy consuming level. So that the high efficiency HVAC system is an urgently need for achieving the preset government energy saving goal. With its advantage of highly sanitary, highly comfortable and uniform of temperature field, the hot-water resource floor radiation heating system has been widely accepted. This paper has put forward a new way in air-conditioning, which combines the fresh-air supply unit and such floor radiation system for the dehumidification and cooling in summer or heating in winter. By analyze its advantages and limitations, we found that this so called Cooling/ Heating Floor AC System can improve the IAQ of residential building while keep high efficiency quality. We also recommend a methodology for the HVAC system designing, which will ensure the reduction of energy cost of users.

  9. Pelvic Inflammatory Disease (PID) Treatment and Care

    MedlinePlus

    ... Herpes Gonorrhea Hepatitis HIV/AIDS & STDs Human Papillomavirus (HPV) Pelvic Inflammatory Disease ... is pelvic inflammatory disease treated? Several types of antibiotics can cure PID. Antibiotic treatment does not, however, reverse any ...

  10. Testicular descent: a hypothesis and review of current controversies.

    PubMed

    Husmann, Douglas A

    2009-06-01

    Descent of the testis into the scrotum occurs by a complex multifactorial process involving the normal development of the testis, the hormonal actions of insulin like growth factor 3, testosterone, a intact hypothalamic pituitary testicular axis, the patent processus vaginalis, gubernacular outgrowth and regression and intraabdominal pressure. The paper reviews the key components of testicular descent, the current hypothesis on how testicular descent occurs and the controversies surrounding this hypothesis.

  11. Management of Pelvic Organ Prolapse

    PubMed Central

    Choi, Kyung Hwa

    2014-01-01

    Quality of life is adversely affected by pelvic organ prolapse, the prevalence of which is increasing because of the persistently growing older population. Today, the tension-free vaginal mesh kit has grown in popularity owing to its comparable cure rate to traditional reconstructive surgery and the feasibility of an early return to normal life. However, significant debate remains over the long-term cure rate and the safety of tension-free vaginal mesh in the United States. The U.S. Food and Drug Administration recommends obtaining informed consent about the safety and cure rate when the patient chooses surgery using the tension-free vaginal mesh kit or meshes before surgery. The goal of surgery for pelvic organ prolapse is the restoration of anatomic defects. This review article provides an overview of basic surgical techniques and the results, advantages, and disadvantages of surgery for pelvic organ prolapse. PMID:25405010

  12. Gynecological indications for the use of botulinum toxin in women with chronic pelvic pain.

    PubMed

    Abbott, Jason

    2009-10-01

    Chronic pelvic pain in women is a common symptom with a wide variety of etiologies that demand accurate diagnosis and appropriate treatment if pain reduction is to be effected. Superficial conditions such as provoked vestibulodynia and problems affecting deeper structures such as pelvic floor muscle spasm are difficult to treat and can have significant impacts on quality of life for the sufferer. Apart from daily pain, symptoms such as painful intercourse (dyspareunia), painful bowel motions (dyschesia) and exacerbation of period pain (dysmenorrhea) are commonly reported by patients. For inflammatory conditions, and in areas where muscle spasm is thought to contribute to pain, botulinum toxins (BoNT) are used with considerable success. For gynecological indications, there are limited data, in the form of case reports and small series, to indicate that BoNT used in the vulva may have a benefit for 3-6 months after injection of 20-40U of BOTOX; for women with provoked vestibulodynia. Re-treatment is reported to be successful and side effects are limited. Controlled studies are essential to further explore this indication. For pelvic floor muscle spasm, a greater number of women have been studied and a double blind, randomized controlled study has reported a significant reduction in pelvic floor pressures with significant pain reduction for some types of pelvic pain compared to baseline. There were no differences in pain compared to the control group who had physical therapy as an intervention. Physical therapy could be used as a non-invasive first line treatment, with BoNT injections reserved for those who are refractory to treatment. In summary, BoNT treatment for a variety of gynecological indications seems successful with limited side effects, although there are minimal data, particularly in superficial vulval conditions. To allow recommendation for wider utilization of this treatment, it is essential that more research is performed to add further evidence to our

  13. Regression Analysis of Top of Descent Location for Idle-thrust Descents

    NASA Technical Reports Server (NTRS)

    Stell, Laurel; Bronsvoort, Jesper; McDonald, Greg

    2013-01-01

    In this paper, multiple regression analysis is used to model the top of descent (TOD) location of user-preferred descent trajectories computed by the flight management system (FMS) on over 1000 commercial flights into Melbourne, Australia. The independent variables cruise altitude, final altitude, cruise Mach, descent speed, wind, and engine type were also recorded or computed post-operations. Both first-order and second-order models are considered, where cross-validation, hypothesis testing, and additional analysis are used to compare models. This identifies the models that should give the smallest errors if used to predict TOD location for new data in the future. A model that is linear in TOD altitude, final altitude, descent speed, and wind gives an estimated standard deviation of 3.9 nmi for TOD location given the trajec- tory parameters, which means about 80% of predictions would have error less than 5 nmi in absolute value. This accuracy is better than demonstrated by other ground automation predictions using kinetic models. Furthermore, this approach would enable online learning of the model. Additional data or further knowl- edge of algorithms is necessary to conclude definitively that no second-order terms are appropriate. Possible applications of the linear model are described, including enabling arriving aircraft to fly optimized descents computed by the FMS even in congested airspace. In particular, a model for TOD location that is linear in the independent variables would enable decision support tool human-machine interfaces for which a kinetic approach would be computationally too slow.

  14. Effects of a dynamic chair on pelvic mobility, fatigue, and work efficiency during work performed while sitting: a comparison of dynamic sitting and static sitting.

    PubMed

    Tanoue, Hironori; Mitsuhashi, Toshitaka; Sako, Shunji; Goto, Ryokichi; Nakai, Tomohiro; Inaba, Ryoichi

    2016-06-01

    [Purpose] Working while sitting for long periods can cause lumbar pain, fatigue, and reduced work efficiency. How a dynamic chair with a seat that moves three-dimensionally affects pelvic mobility before and after work, work efficiency, and post-work fatigue were examined. [Subjects and Methods] Subjects were 17 healthy adults (10 males, 7 females, mean age 21.8 ± 2.7 years). Subjects performed a 30-min Kraepelin test under two conditions: sitting in a standard office chair and sitting in a dynamic sitting balance chair. Root mean square (RMS) values of pelvic movement measured by a triaxial accelerometer during 30 minutes of work, finger-floor distance before and after work, lumbar fatigue, and pelvic movement RMS values during finger-floor distance measurement were used as outcome measures. [Results] Pelvic movement RMS values collected every 5 minutes during 30 minutes of work were significantly higher while sitting in the dynamic balance chair. Changes in pelvic movement RMS values during finger-floor distance measurement after work and amount of work performed during 30 minutes were significantly higher and lumbar fatigue was significantly lower for the dynamic balance chair. [Conclusion] Dynamic sitting maintained or increased pelvic flexibility. The dynamic balance chair may effectively help workers work continuously in seated postures with little fatigue. PMID:27390410

  15. Effects of a dynamic chair on pelvic mobility, fatigue, and work efficiency during work performed while sitting: a comparison of dynamic sitting and static sitting

    PubMed Central

    Tanoue, Hironori; Mitsuhashi, Toshitaka; Sako, Shunji; Goto, Ryokichi; Nakai, Tomohiro; Inaba, Ryoichi

    2016-01-01

    [Purpose] Working while sitting for long periods can cause lumbar pain, fatigue, and reduced work efficiency. How a dynamic chair with a seat that moves three-dimensionally affects pelvic mobility before and after work, work efficiency, and post-work fatigue were examined. [Subjects and Methods] Subjects were 17 healthy adults (10 males, 7 females, mean age 21.8 ± 2.7 years). Subjects performed a 30-min Kraepelin test under two conditions: sitting in a standard office chair and sitting in a dynamic sitting balance chair. Root mean square (RMS) values of pelvic movement measured by a triaxial accelerometer during 30 minutes of work, finger-floor distance before and after work, lumbar fatigue, and pelvic movement RMS values during finger-floor distance measurement were used as outcome measures. [Results] Pelvic movement RMS values collected every 5 minutes during 30 minutes of work were significantly higher while sitting in the dynamic balance chair. Changes in pelvic movement RMS values during finger-floor distance measurement after work and amount of work performed during 30 minutes were significantly higher and lumbar fatigue was significantly lower for the dynamic balance chair. [Conclusion] Dynamic sitting maintained or increased pelvic flexibility. The dynamic balance chair may effectively help workers work continuously in seated postures with little fatigue. PMID:27390410

  16. Effects of a dynamic chair on pelvic mobility, fatigue, and work efficiency during work performed while sitting: a comparison of dynamic sitting and static sitting.

    PubMed

    Tanoue, Hironori; Mitsuhashi, Toshitaka; Sako, Shunji; Goto, Ryokichi; Nakai, Tomohiro; Inaba, Ryoichi

    2016-06-01

    [Purpose] Working while sitting for long periods can cause lumbar pain, fatigue, and reduced work efficiency. How a dynamic chair with a seat that moves three-dimensionally affects pelvic mobility before and after work, work efficiency, and post-work fatigue were examined. [Subjects and Methods] Subjects were 17 healthy adults (10 males, 7 females, mean age 21.8 ± 2.7 years). Subjects performed a 30-min Kraepelin test under two conditions: sitting in a standard office chair and sitting in a dynamic sitting balance chair. Root mean square (RMS) values of pelvic movement measured by a triaxial accelerometer during 30 minutes of work, finger-floor distance before and after work, lumbar fatigue, and pelvic movement RMS values during finger-floor distance measurement were used as outcome measures. [Results] Pelvic movement RMS values collected every 5 minutes during 30 minutes of work were significantly higher while sitting in the dynamic balance chair. Changes in pelvic movement RMS values during finger-floor distance measurement after work and amount of work performed during 30 minutes were significantly higher and lumbar fatigue was significantly lower for the dynamic balance chair. [Conclusion] Dynamic sitting maintained or increased pelvic flexibility. The dynamic balance chair may effectively help workers work continuously in seated postures with little fatigue.

  17. 5. Interior, second floor. Pressed metal ceiling, and wooden floors ...

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

    5. Interior, second floor. Pressed metal ceiling, and wooden floors visible. Overhead light source toward rear of building indicates location of skylight. - 25-27 East Hanover Street (Commercial Building), 25-27 East Hanover Street, Trenton, Mercer County, NJ

  18. Two and Three Bedroom Units: First Floor Plan, Second Floor ...

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

    Two and Three Bedroom Units: First Floor Plan, Second Floor Plan, South Elevation (As Built), North Elevation (As Built), East Elevation (As Built), East Elevation (Existing), North Elevation (Existing) - Aluminum City Terrace, East Hill Drive, New Kensington, Westmoreland County, PA

  19. STIRLING'S QUARTERS SMALL BARN: FIRST FLOOR PLAN; SECOND FLOOR PLAN; ...

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

    STIRLING'S QUARTERS SMALL BARN: FIRST FLOOR PLAN; SECOND FLOOR PLAN; SOUTH ELEVATION; EAST ELEVATION; NORTH ELEVATION; WEST ELEVATION. - Stirling's Quarters, 555 Yellow Springs Road, Tredyffrin Township, Valley Forge, Chester County, PA

  20. 16. STATIC TEST TOWER REMOVABLE FLOOR LEVEL VIEW OF FLOOR ...

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

    16. STATIC TEST TOWER REMOVABLE FLOOR LEVEL VIEW OF FLOOR THAT FOLDS BACK TO ALLOW ROCKET PLACEMENT. - Marshall Space Flight Center, Saturn Propulsion & Structural Test Facility, East Test Area, Huntsville, Madison County, AL

  1. CAST FLOOR WITH VIEW OF TORPEDO LADLE (BENEATH CAST FLOOR) ...

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

    CAST FLOOR WITH VIEW OF TORPEDO LADLE (BENEATH CAST FLOOR) AND KEEPERS OF THE CAST HOUSE FLOOR, S.L. KIMBROUGH AND DAVID HOLMES. - U.S. Steel, Fairfield Works, Blast Furnace No. 8, North of Valley Road, West of Ensley-Pleasant Grove Road, Fairfield, Jefferson County, AL

  2. Urogynecologic conditions: pelvic organ prolapse.

    PubMed

    Noor, Nabila; Garely, Alan D

    2015-03-01

    Chronic pelvic pain is a commonly encountered condition that often is multifactorial. Etiologies include gynecologic, urologic, gastrointestinal, and neurologic conditions. Laboratory tests, imaging, and surgical intervention are not always helpful in identifying the etiology of pelvic pain. For appropriate management of this complex disease process, a detailed history and physical examination, and a multidisciplinary approach are needed. Pelvic pain may be caused by endometriosis, pelvic inflammatory disease, adenomyosis, interstitial cystitis/painful bladder syndrome, or other factors. Evaluation may include keeping a pain diary; laboratory tests, such as a pregnancy test, urinalysis, or tests for sexually transmitted infections; ultrasonography of abnormalities detected on physical examination; and laparoscopy. Specific first-line treatments include nonsteroidal anti-inflammatory drugs and oral contraceptives for endometriosis; progestins, gonadotropin-releasing hormone analogs, aromatase inhibitors, or hysterectomy for adenomyosis; and education, food avoidance, and behavioral modifications for interstitial cystitis/painful bladder syndrome. Surgical options include nerve transection procedures, laparoscopic uterosacral nerve ablation, and presacral neurectomy, although data on effectiveness are limited. PMID:25756374

  3. Distributed Control by Lagrangian Steepest Descent

    NASA Technical Reports Server (NTRS)

    Wolpert, David H.; Bieniawski, Stefan

    2004-01-01

    Often adaptive, distributed control can be viewed as an iterated game between independent players. The coupling between the players mixed strategies, arising as the system evolves from one instant to the next, is determined by the system designer. Information theory tells us that the most likely joint strategy of the players, given a value of the expectation of the overall control objective function, is the minimizer of a function o the joint strategy. So the goal of the system designer is to speed evolution of the joint strategy to that Lagrangian mhimbhgpoint,lowerthe expectated value of the control objective function, and repeat Here we elaborate the theory of algorithms that do this using local descent procedures, and that thereby achieve efficient, adaptive, distributed control.

  4. 14 CFR 23.69 - Enroute climb/descent.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Enroute climb/descent. 23.69 Section 23.69... climb/descent. (a) All engines operating. The steady gradient and rate of climb must be determined at...; (3) The wing flaps retracted; and (4) A climb speed not less than 1.3 VS1. (b) One engine...

  5. 14 CFR 23.69 - Enroute climb/descent.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Enroute climb/descent. 23.69 Section 23.69... climb/descent. (a) All engines operating. The steady gradient and rate of climb must be determined at...; (3) The wing flaps retracted; and (4) A climb speed not less than 1.3 VS1. (b) One engine...

  6. 25 CFR 11.711 - Descent and distribution.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Descent and distribution. 11.711 Section 11.711 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Probate Proceedings § 11.711 Descent and distribution. (a) The court shall distribute...

  7. Hair Breakage in Patients of African Descent: Role of Dermoscopy.

    PubMed

    Quaresma, Maria Victória; Martinez Velasco, María Abril; Tosti, Antonella

    2015-09-01

    Dermoscopy represents a useful technique for the diagnosis and follow-up of hair and scalp disorders. To date, little has been published regarding dermoscopy findings of hair disorders in patients of African descent. This article illustrates how dermoscopy allows fast diagnosis of hair breakage due to intrinsic factors and chemical damage in African descent patients.

  8. Mars Science Laboratory Entry, Descent and Landing System Overview

    NASA Technical Reports Server (NTRS)

    Steltzner, Adam D.; San Martin, A. Miguel; Rivellini, Tomasso P.; Chen, Allen

    2013-01-01

    The Mars Science Laboratory project recently places the Curiosity rove on the surface of Mars. With the success of the landing system, the performance envelope of entry, descent and landing capabilities has been extended over the previous state of the art. This paper will present an overview to the MSL entry, descent and landing system design and preliminary flight performance results.

  9. Hair Breakage in Patients of African Descent: Role of Dermoscopy

    PubMed Central

    Quaresma, Maria Victória; Martinez Velasco, María Abril; Tosti, Antonella

    2015-01-01

    Dermoscopy represents a useful technique for the diagnosis and follow-up of hair and scalp disorders. To date, little has been published regarding dermoscopy findings of hair disorders in patients of African descent. This article illustrates how dermoscopy allows fast diagnosis of hair breakage due to intrinsic factors and chemical damage in African descent patients. PMID:27170942

  10. Planetary entry, descent, and landing technologies

    NASA Astrophysics Data System (ADS)

    Pichkhadze, K.; Vorontsov, V.; Polyakov, A.; Ivankov, A.; Taalas, P.; Pellinen, R.; Harri, A.-M.; Linkin, V.

    2003-04-01

    Martian meteorological lander (MML) is intended for landing on the Martian surface in order to monitor the atmosphere at landing point for one Martian year. MMLs shall become the basic elements of a global network of meteorological mini-landers, observing the dynamics of changes of the atmospheric parameters on the Red Planet. The MML main scientific tasks are as follows: (1) Study of vertical structure of the Martian atmosphere throughout the MML descent; (2) On-surface meteorological observations for one Martian year. One of the essential factors influencing the lander's design is its entry, descent, and landing (EDL) sequence. During Phase A of the MML development, five different options for the lander's design were carefully analyzed. All of these options ensure the accomplishment of the above-mentioned scientific tasks with high effectiveness. CONCEPT A (conventional approach): Two lander options (with a parachute system + airbag and an inflatable airbrake + airbag) were analyzed. They are similar in terms of fulfilling braking phases and completely analogous in landing by means of airbags. CONCEPT B (innovative approach): Three lander options were analyzed. The distinguishing feature is the presence of inflatable braking units (IBU) in their configurations. SELECTED OPTION (innovative approach): Incorporating a unique design approach and modern technologies, the selected option of the lander represents a combination of the options analyzed in the framework of Concept B study. Currently, the selected lander option undergoes systems testing (Phase D1). Several MMLs can be delivered to Mars in frameworks of various missions as primary or piggybacking payload: (1) USA-led "Mars Scout" (2007); (2) France-led "NetLander" (2007/2009); (3) Russia-led "Mars-Deimos-Phobos sample return" (2007); (4) Independent mission (currently under preliminary study); etc.

  11. Bridle Device in Mars Science Laboratory Descent Stage

    NASA Technical Reports Server (NTRS)

    2008-01-01

    This view of a portion of the descent stage of NASA's Mars Science Laboratory shows two of the stage's three spherical fuel tanks flanking the bridle device assembly. The photograph was taken in early October 2008 from the center of the descent stage looking outward. The top of the descent stage is toward the top of the image.

    The bridle device assembly is about two-thirds of a meter, or 2 feet, from top to bottom, and has two main parts. The cylinder on the top is the descent brake. The conical-shaped mechanism below that is the bridle assembly, including a spool of nylon and Vectran cords that will be attached to the rover.

    When pyrotechnic bolts fire to sever the rigid connection between the rover and the descent stage, gravity will pull the tethered rover away from the descent stage. The bridle or tether, attached to three points on the rover, will unspool from the bridle assembly, beginning from the larger-diameter portion. The rotation rate of the assembly, hence the descent rate of the rover, will be governed by the descent brake. Inside the housing of that brake are gear boxes and banks of mechanical resistors engineered to prevent the bridle from spooling out too quickly or too slowly. The length of the bridle will allow the rover to be lowered about 7.5 meters (25 feet) while still tethered to the descent stage.

    The Starsys division of SpaceDev Inc., Poway, Calif., provided the descent brake. NASA's Jet Propulsion Laboratory, Pasadena, Calif., built the bridle assembly. Vectran is a product of Kuraray Co. Ltd., Tokyo. JPL, a division of the California Institute of Technology, manages the Mars Science Laboratory Project for the NASA Science Mission Directorate, Washington.

  12. Polygons on Crater Floor

    NASA Technical Reports Server (NTRS)

    2003-01-01

    MGS MOC Release No. MOC2-357, 11 May 2003

    This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) picture shows a pattern of polygons on the floor of a northern plains impact crater. These landforms are common on crater floors at high latitudes on Mars. Similar polygons occur in the arctic and antarctic regions of Earth, where they indicate the presence and freeze-thaw cycling of ground ice. Whether the polygons on Mars also indicate water ice in the ground is uncertain. The image is located in a crater at 64.8oN, 292.7oW. Sunlight illuminates the scene from the lower left.

  13. Floor of Hellas Basin

    NASA Technical Reports Server (NTRS)

    2002-01-01

    [figure removed for brevity, see original site]

    With a diameter of roughly 2000 km and a depth of over 7 km, the Hellas Basin is the largest impact feature on Mars. Because of its great depth, there is significantly more atmosphere to peer through in order to see its floor, reducing the quality of the images taken from orbit. This THEMIS image straddles a scarp between the Hellas floor and an accumulation of material at least a half kilometer thick that covers much of the floor. The southern half of the image contains some of this material. Strange ovoid landforms are present here that give the appearance of flow. It is possible that water ice or even liquid water was present in the deposits and somehow responsible for the observed landscape. The floor of Hellas remains a poorly understood portion of the planet that should benefit from the analysis of new THEMIS data.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in

  14. Simulator Evaluation of a New Cockpit Descent Procedure

    NASA Technical Reports Server (NTRS)

    Crane, Barry; Palmer, Everett; Smith, Nancy; Rosekind, Mark (Technical Monitor)

    1996-01-01

    An experiment was conducted to evaluate flight crew performance of the "Precision Descent," a new cockpit procedure designed to support the Descent Advisor (DA), one of the components in a new air traffic control advisory system called the "Center-TRACON Automation System" (CTAS). The DA predicts when aircraft will reach a specific waypoint on the arrival route, and presents controllers with clearance advisories designed to improve the sequencing of arriving aircraft. The effectiveness of the DA depends on the aircraft's descent trajectory: where it begins descent, what speed it maintains, how fast and at what altitude it crosses the bottom-of-descent waypoint. The Precision Descent allows controllers to assign these descent parameters to the flight crew. A Field Evaluation of the DA was conducted in Denver in 1995. Three separate clearances using standard ATC phraseology were used to support the cockpit descent procedure during this evaluation. The number and length of these clearances caused problems for both controllers and flight crews, causing readback errors, repeat requests and procedure misunderstandings. These observations led to a focus group meeting in which controller and pilot participants in the 1995 FE assisted in the redesign of the procedure. The Precision Descent eliminates one clearance used in the earlier study, and greatly reduces the length of the remaining clearances. This was accomplished by using non-standard clearance phraseology that relies on a published procedure chart for correct interpretation. Eight type-rated flight crews flew eight Precision Descents in a Boeing 747-400 simulator. No training was provided: crews received either a procedure chart or a procedure chart with a flight manual bulletin describing procedure techniques. Video and digital data were recorded for each descent. Preliminary results indicate that moving information from the verbal clearance to the chart was successful: the shorter clearances and the procedure

  15. Modular Flooring System

    NASA Technical Reports Server (NTRS)

    Thate, Robert

    2012-01-01

    The modular flooring system (MFS) was developed to provide a portable, modular, durable carpeting solution for NASA fs Robotics Alliance Project fs (RAP) outreach efforts. It was also designed to improve and replace a modular flooring system that was too heavy for safe use and transportation. The MFS was developed for use as the flooring for various robotics competitions that RAP utilizes to meet its mission goals. One of these competitions, the FIRST Robotics Competition (FRC), currently uses two massive rolls of broadloom carpet for the foundation of the arena in which the robots are contained during the competition. The area of the arena is approximately 30 by 72 ft (approximately 9 by 22 m). This carpet is very cumbersome and requires large-capacity vehicles, and handling equipment and personnel to transport and deploy. The broadloom carpet sustains severe abuse from the robots during a regular three-day competition, and as a result, the carpet is not used again for competition. Similarly, broadloom carpets used for trade shows at convention centers around the world are typically discarded after only one use. This innovation provides a green solution to this wasteful practice. Each of the flooring modules in the previous system weighed 44 lb (.20 kg). The improvements in the overall design of the system reduce the weight of each module by approximately 22 lb (.10 kg) (50 %), and utilize an improved "module-to-module" connection method that is superior to the previous system. The MFS comprises 4-by-4-ft (.1.2-by- 1.2-m) carpet module assemblies that utilize commercially available carpet tiles that are bonded to a lightweight substrate. The substrate surface opposite from the carpeted surface has a module-to-module connecting interface that allows for the modules to be connected, one to the other, as the modules are constructed. This connection is hidden underneath the modules, creating a smooth, co-planar flooring surface. The modules are stacked and strapped

  16. Floor of Baldet Crater

    NASA Technical Reports Server (NTRS)

    2002-01-01

    (Released 13 June 2002) The Science This THEMIS visible image shows a remarkable array of dunes on the floor of a large impact crater named Baldet located near 22.8o N. Many of the dunes in this region are isolated features, with large, sand-free 'interdune' surfaces between the individual dunes. These isolated dunes typically occur in regions where there is a limited supply of sand. Any sand that is present moves rapidly across the interdune surfaces, which in many cases are hardened surfaces over which the sand can easily bounce, or 'saltate.' When this loose sand lands on a dune it cannot travel as quickly and is trapped within the dune. In some areas within this sand mass the dunes have grown together to form crescent dunes and dune ridges. The dunes in this image are likely active today, slowly migrating across the crater floor. THEMIS will re-image this and other dunes throughout the Mars Odyssey mission to search for any evidence of dune motion over time. Based on the asymmetrical shape of the dunes, the wind direction over much of the dune field appears to be from the right (west) or upper right (northwest). However, the topography of the crater floor apparently produces complex wind patterns within the dune field, as can be seen by the different orientations of the dunes. For example the dunes in the lower portion of the image appear to be somewhat symmetrical and aligned east-west, suggesting that the wind in this region blows from both the north (top) and south (bottom). The Story A fuzzy 'carpet' of sand dunes covers the floor of a large impact crater, which you can see almost in full in the context image to the right. While the dunes give this area a plush, tufted look, there actually isn't a lot of sand in this area. How can you tell? Large, sand-free spaces exist in between the dunes, and those usually occur when sand particles are sparse. You can see these 'interdune spaces' better if you click on the image for the more detailed view. The sand that

  17. Pain and Psychological Outcomes After Rehabilitative Treatment for a Woman With Chronic Pelvic Pain With Stage III Cervical Cancer: A Case Report

    PubMed Central

    Alappattu, Meryl J.

    2016-01-01

    Background Chronic pelvic pain and sexual dysfunction are adverse effects of treatment of cervical cancer. Surgery and radiation therapies may result in soft tissue pain and dysfunction, including spasms and trigger points of the pelvic floor muscles that result in pain. In addition to physical restrictions, negative mood associated with pain is believed to intensify and prolong the pain experience. Study Design The purpose of this case report was to describe outcomes of pelvic physical therapy in a 58-year-old woman with chronic pelvic pain after medical treatments for cervical cancer. Case Description The patient reported dyspareunia, hip pain, and lower abdominal, pelvic pain, and fatigue with activities lasting greater than 30 minutes. Interventions included pelvic floor massage, dilator use, and patient education. Symptoms were assessed at baseline and completion of physical therapy, using the Female Sexual Function Index, Fear of Pain Questionnaire–III, Pain Catastrophizing Scale, and Numerical Pain Rating Scale. Outcomes The Female Sexual Function Index score decreased from 7.8 to 2.8, the Fear of Pain Questionnaire– III score decreased from 85 to 73, the Pain Catastrophizing Scale score decreased from 18 to 8, and lower abdominal and pelvic pain decreased from 4 of 10 to 0 of 10, while bilateral hip pain remained at 4 of 10. In addition, she exhibited increased tolerance to mechanical pressure, evidenced by progression in size of a vaginal dilator. Discussion These results suggest that pelvic physical therapy may be useful in treating chronic pelvic pain after cervical cancer treatments and may also help decrease the magnitude of negative mood aspects such as pain-related fear and catastrophizing. PMID:27134605

  18. Surface erosion caused on Mars from Viking descent engine plume

    USGS Publications Warehouse

    Hutton, R.E.; Moore, H.J.; Scott, R.F.; Shorthill, R.W.; Spitzer, C.R.

    1980-01-01

    During the Martian landings the descent engine plumes on Viking Lander 1 (VL-1) and Viking Lander 2 (VL-2) eroded the Martian surface materials. This had been anticipated and investigated both analytically and experimentally during the design phase of the Viking spacecraft. This paper presents data on erosion obtained during the tests of the Viking descent engine and the evidence for erosion by the descent engines of VL-1 and VL-2 on Mars. From these and other results, it is concluded that there are four distinct surface materials on Mars: (1) drift material, (2) crusty to cloddy material, (3) blocky material, and (4) rock. ?? 1980 D. Reidel Publishing Co.

  19. Fracture Detection in Traumatic Pelvic CT Images

    PubMed Central

    Wu, Jie; Davuluri, Pavani; Ward, Kevin R.; Cockrell, Charles; Hobson, Rosalyn; Najarian, Kayvan

    2012-01-01

    Fracture detection in pelvic bones is vital for patient diagnostic decisions and treatment planning in traumatic pelvic injuries. Manual detection of bone fracture from computed tomography (CT) images is very challenging due to low resolution of the images and the complex pelvic structures. Automated fracture detection from segmented bones can significantly help physicians analyze pelvic CT images and detect the severity of injuries in a very short period. This paper presents an automated hierarchical algorithm for bone fracture detection in pelvic CT scans using adaptive windowing, boundary tracing, and wavelet transform while incorporating anatomical information. Fracture detection is performed on the basis of the results of prior pelvic bone segmentation via our registered active shape model (RASM). The results are promising and show that the method is capable of detecting fractures accurately. PMID:22287952

  20. Crater Wall and Floor

    NASA Technical Reports Server (NTRS)

    2003-01-01

    [figure removed for brevity, see original site]

    3D Projection onto MOLA data [figure removed for brevity, see original site]

    The impact crater observed in this THEMIS image taken in Terra Cimmeria suggests sediments have filled the crater due to the flat and smooth nature of the floor compared to rougher surfaces at higher elevations. The abundance of several smaller impact craters on the floor of the larger crater indicate however that the flat surface has been exposed for an extended period of time. The smooth surface of the crater floor and rougher surfaces at higher elevations are observed in the 3-D THEMIS image that is draped over MOLA topography (2X vertical exaggeration).

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

    Image information: VIS instrument. Latitude -22.9, Longitude 155.7 East (204.3 West). 19 meter/pixel resolution.

  1. Orion Entry, Descent, and Landing Simulation

    NASA Technical Reports Server (NTRS)

    Hoelscher, Brian R.

    2007-01-01

    The Orion Entry, Descent, and Landing simulation was created over the past two years to serve as the primary Crew Exploration Vehicle guidance, navigation, and control (GN&C) design and analysis tool at the National Aeronautics and Space Administration (NASA). The Advanced NASA Technology Architecture for Exploration Studies (ANTARES) simulation is a six degree-of-freedom tool with a unique design architecture which has a high level of flexibility. This paper describes the decision history and motivations that guided the creation of this simulation tool. The capabilities of the models within ANTARES are presented in detail. Special attention is given to features of the highly flexible GN&C architecture and the details of the implemented GN&C algorithms. ANTARES provides a foundation simulation for the Orion Project that has already been successfully used for requirements analysis, system definition analysis, and preliminary GN&C design analysis. ANTARES will find useful application in engineering analysis, mission operations, crew training, avionics-in-the-loop testing, etc. This paper focuses on the entry simulation aspect of ANTARES, which is part of a bigger simulation package supporting the entire mission profile of the Orion vehicle. The unique aspects of entry GN&C design are covered, including how the simulation is being used for Monte Carlo dispersion analysis and for support of linear stability analysis. Sample simulation output from ANTARES is presented in an appendix.

  2. Gradient Descent Learning for Rotor Associative Memory

    NASA Astrophysics Data System (ADS)

    Kitahara, Michimasa; Kobayashi, Masaki

    Complex-valued Associative Memory (CAM) is an extended model of Hopfield Associative Memory (HAM). The fundamental elements, such as input-output signals and connection weights of the CAM are extended to complex numbers. The CAM can deal with multi-states information. Rotor Associative Memory (RAM) is an extended model of the CAM. Rotor neurons are essentially equivalent to complex-valued neurons. Connection weights of the RAM are expressed by two by two matrices. Only hebb rule has been proposed for the learning of the RAM. Its storage capacity is small, so advanced learning methods are necessary. In this paper, we propose gradient descent learning rule for the RAM (GDR RAM). It is based on that for the CAM (GDR CAM) proposed by Lee. We solved the learning rule and performed computer simulations to compare the GDR CAM and the GDR RAM. At last, it turned out that the storage capacity of the GDR RAM is approximately twice as much as that of the GDR CAM and the noise robustness of the GDR RAM is much better than that of the GDR CAM.

  3. Auroral precipitation and descent of thermospheric NO

    NASA Astrophysics Data System (ADS)

    Kühl, Sven; Espy, Patrick; Hibbins, Robert; Paxton, Larry; Funke, Bernd

    2016-07-01

    Energetic particle precipitation in Auroras (E <20 keV) produces nitric oxide (NO) in the upper meso- and lower thermosphere region (UMLT). The subsequent descent of the NO produced in the UMLT to the lower meso- and upper stratosphere is referred to as the energetic particle precipitation indirect effect (EPP IE). The downwelling of NO produced in Auroras alters the chemistry of the mesosphere and upper stratosphere (e.g. by the NOx cycle) and possibly has important effects also on its dynamics. By observations of auroral precipitation from SSUSI(DMSP) and measurements of NO from MIPAS(ENVISAT) and SMR(ODIN) we investigate the quantitative relation of the electron fluxes and characteristic energies of auroral precipitation to the NO produced in the lower thermosphere and the subsequent downwelling of NO. Using additional ground-based (e.g. Meteor Radar, Microwave Radiometer) and satellite observations (SOFIE) we attempt to quantify the EPP IE and its impact on atmospheric chemistry and dynamics.

  4. Prediction of multilocus identity-by-descent.

    PubMed

    Hill, William G; Hernández-Sánchez, Jules

    2007-08-01

    Previous studies have enabled exact prediction of probabilities of identity-by-descent (IBD) in random-mating populations for a few loci (up to four or so), with extension to more using approximate regression methods. Here we present a precise predictor of multiple-locus IBD using simple formulas based on exact results for two loci. In particular, the probability of non-IBD X(ABC) at each of ordered loci A, B, and C can be well approximated by X(ABC) = X(AB)X(BC)/X(B) and generalizes to X(123...k) = X(12)X(23...)X(k)(-1,k)/X(k-2), where X is the probability of non-IBD at each locus. Predictions from this chain rule are very precise with population bottlenecks and migration, but are rather poorer in the presence of mutation. From these coefficients, the probabilities of multilocus IBD and non-IBD can also be computed for genomic regions as functions of population size, time, and map distances. An approximate but simple recurrence formula is also developed, which generally is less accurate than the chain rule but is more robust with mutation. Used together with the chain rule it leads to explicit equations for non-IBD in a region. The results can be applied to detection of quantitative trait loci (QTL) by computing the probability of IBD at candidate loci in terms of identity-by-state at neighboring markers.

  5. Reull Vallis Floor

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows the odd patterns of erosion on the floor of Reull Vallis, a major valley system east of the Hellas Basin in the martian southern hemisphere. Somewhat circular features in this image may have once been meteor craters that were eroded and deformed by erosive processes. This image is located near 42.1oS, 254.5oW. The picture covers an area about 3 km (1.9 mi) wide. Sunlight illuminates the scene from the upper left.

  6. Mesas on Depression Floor

    NASA Technical Reports Server (NTRS)

    2004-01-01

    3 August 2004 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows mesas and buttes on the floor of a depression in the Labyrinthus Noctis region of Mars. This is part of the western Valles Marineris. Each mesa is a remnant of a formerly more extensive sequence of rock. The image is located near 7.0oS, 99.2oW. It covers an area about 3 km (1.9 mi) across; sunlight illuminates the scene from the lower left.

  7. Rippled Valley Floor

    NASA Technical Reports Server (NTRS)

    2005-01-01

    15 September 2005 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows a ripple-covered valley floor in the Hyblaeus Fossae region. Winds blowing up and down the length of the valley have helped to concentrate windblown grains to form these large, megaripples.

    Location near: 26.3oN, 225.1oW Image width: width: 3 km (1.9 mi) Illumination from: lower left Season: Northern Autumn

  8. Crater Floor Yardangs

    NASA Technical Reports Server (NTRS)

    2004-01-01

    1 December 2004 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows a group of semi-parallel ridges--yardangs--etched by wind into layered sedimentary rock on the floor of an unnamed crater in Terra Cimmeria. Many craters on Mars have been the sites of sedimentation. Over time, these sediments have become lithified. This picture is located near 31.3oS, 214.6oW. The image covers an area approximately 3 km (1.9 mi) across. Sunlight illuminates the scene from the left/upper left.

  9. Concentric Crater Floor

    NASA Technical Reports Server (NTRS)

    2004-01-01

    8 July 2004 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows the interior of a typical crater in northern Acidalia Planitia. The floor is covered by material that forms an almost concentric pattern. In this case, the semi-concentric rings might be an expression of eroded layered material, although this interpretation is uncertain. The crater is located near 44.0oN, 27.7oW, and covers an area about 3 km (1.9 mi) wide. Sunlight illuminates the scene from the lower left.

  10. 9. LOOKING FROM FLOOR 1 UP THROUGH OPENING TO FLOOR ...

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

    9. LOOKING FROM FLOOR 1 UP THROUGH OPENING TO FLOOR 2; OPENING IN THE FLOOR IS TO ALLOW THE RUNNER STONES TO BE FLIPPED OVER FOR SHARPENING; AT THE FIRST FLOOR ARE THE POSTS SUPPORTING THE BRIDGEBEAMS ON WHICH THE BRIDGE TREES PIVOT; THE CENTER POST RISES ABOVE THE STONES TO RECEIVE THE FOOT BEARING OF THE UPRIGHT SHAFT; ALSO SEEN ARE THE STONE SPINDLWS, UNDER SIDES OF THE BED STONES, STONE NUT AND GREAT SPUR WHEEL. - Pantigo Windmill, James Lane, East Hampton, Suffolk County, NY

  11. The Role of Transcatheter Arterial Embolization in Traumatic Pelvic Hemorrhage: Not Only Pelvic Fracture

    PubMed Central

    Zatelli, Marianna; Haglmuller, Thomas; Bonatti, Giampietro

    2016-01-01

    Purpose: The most common life-threatening complication of pelvic trauma is bleeding. Arterial bleedings frequently require active management, preferably with transcatheter arterial embolization (TAE). Hemodynamic instability and/or contrast extravasation at computer tomography (CT) examination are reliable indicators of arterial injury. Unstable pelvic fractures are much more hemorrhagic than stable fractures. Nevertheless, an absent or isolated pelvic fracture does not exclude pelvic hemorrhage. Materials and Methods: A retrospective study was conducted on our institutional database by collecting data of patients who underwent pelvic angiography and/or embolization due to pelvic blunt trauma in the period between August 2010 and August 2015. Results: In a period of five years, 39 patients with traumatic pelvic bleeding underwent angiography at our institution. Thirty-six of the 39 (92%) patients did show CT signs of active pelvic bleeding. Nineteen of 39 (49%) patients were hemodynamically unstable at presentation. Three of the 39 patients did not require embolization. Technical success was 35/36 (97%), and overall mortality was 3/39 (8%). Notably, 5/39 (13%) patients did not have any pelvic fracture at presentation, and 18/39 (46%) had only isolated or stable pelvic ring fracture. Conclusions: TAE is an effective technique to treat arterial pelvic bleeding after trauma. The absence of a major pelvic fracture does not exclude the risk of active bleeding requiring prompt treatment.

  12. The Role of Transcatheter Arterial Embolization in Traumatic Pelvic Hemorrhage: Not Only Pelvic Fracture

    PubMed Central

    Zatelli, Marianna; Haglmuller, Thomas; Bonatti, Giampietro

    2016-01-01

    Purpose: The most common life-threatening complication of pelvic trauma is bleeding. Arterial bleedings frequently require active management, preferably with transcatheter arterial embolization (TAE). Hemodynamic instability and/or contrast extravasation at computer tomography (CT) examination are reliable indicators of arterial injury. Unstable pelvic fractures are much more hemorrhagic than stable fractures. Nevertheless, an absent or isolated pelvic fracture does not exclude pelvic hemorrhage. Materials and Methods: A retrospective study was conducted on our institutional database by collecting data of patients who underwent pelvic angiography and/or embolization due to pelvic blunt trauma in the period between August 2010 and August 2015. Results: In a period of five years, 39 patients with traumatic pelvic bleeding underwent angiography at our institution. Thirty-six of the 39 (92%) patients did show CT signs of active pelvic bleeding. Nineteen of 39 (49%) patients were hemodynamically unstable at presentation. Three of the 39 patients did not require embolization. Technical success was 35/36 (97%), and overall mortality was 3/39 (8%). Notably, 5/39 (13%) patients did not have any pelvic fracture at presentation, and 18/39 (46%) had only isolated or stable pelvic ring fracture. Conclusions: TAE is an effective technique to treat arterial pelvic bleeding after trauma. The absence of a major pelvic fracture does not exclude the risk of active bleeding requiring prompt treatment. PMID:27625908

  13. Laparoscopic sacrocolpopexy versus transvaginal mesh for recurrent pelvic organ prolapse.

    PubMed

    Iglesia, Cheryl B; Hale, Douglass S; Lucente, Vincent R

    2013-03-01

    Both expert surgeons agree with the following: (1) Surgical mesh, whether placed laparoscopically or transvaginally, is indicated for pelvic floor reconstruction in cases involving recurrent advanced pelvic organ prolapse. (2) Procedural expertise and experience gained from performing a high volume of cases is fundamentally necessary. Knowledge of outcomes and complications from an individual surgeon's audit of cases is also needed when discussing the risks and benefits of procedures and alternatives. Yet controversy still exists on how best to teach new surgical techniques and optimal ways to efficiently track outcomes, including subjective and objective cure of prolapse as well as perioperative complications. A mesh registry will be useful in providing data needed for surgeons. Cost factors are also a consideration since laparoscopic and especially robotic surgical mesh procedures are generally more costly than transvaginal mesh kits when operative time, extra instrumentation and length of stay are included. Long-term outcomes, particularly for transvaginal mesh procedures, are lacking. In conclusion, all surgery poses risks; however, patients should be made aware of the pros and cons of various routes of surgery as well as the potential risks and benefits of using mesh. Surgeons should provide patients with honest information about their own experience implanting mesh and also their experience dealing with mesh-related complications.

  14. Canyon Floor Deposits

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site] Context image for PIA03598 Canyon Floor Deposits

    The layered and wind eroded deposits seen in this VIS image occur on the floor of Chandor Chasma.

    Image information: VIS instrument. Latitude 5.2S, Longitude 283.4E. 17 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  15. Floor of Juventae Chasma

    NASA Technical Reports Server (NTRS)

    2002-01-01

    (Released 30 May 2002) Juventae Chasma is an enormous box canyon (250 km X 100 km) which opens to the north and forms the outflow channel Maja Vallis. Most Martian outflow channels such as Maja, Kasei, and Ares Valles begin at point sources such as box canyons and chaotic terrain and then flow unconfined into a basin region. This image captures a portion of the western floor of Juventae Chasma and shows a wide variety of landforms. Conical hills, mesas, buttes and plateaus of layered material dominate this scene and seem to be 'swimming' in vast sand sheets. The conical hills have a spur and gully topography associated with them while the flat topped buttes and mesas do not. This may be indicative of different materials that compose each of these landforms or it could be that the flat-topped layer has been completely eroded off of the conical hills thereby exposing a different rock type. Both the conical hills and flat-topped buttes and mesas have extensive scree slopes (heaps of eroded rock and debris). Ripples, which are inferred to be dunes, can also be seen amongst the hills. No impact craters can be seen in this image, indicating that the erosion and transport of material down the canyon wall and across the floor is occurring at a relatively rapid rate, so that any craters that form are rapidly buried or eroded.

  16. Fretted Terrain Valley Floor

    NASA Technical Reports Server (NTRS)

    2004-01-01

    30 December 2003 This December 2003 Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows lineated textures on the floor of a valley in the Deuteronilus region of Mars. Deuteronilus, and neighboring Protonilus and Nilosyrtis, have been known since the Mariner 9 mission as regions of 'fretted terrain.' In this context, 'fretted' does not mean 'worried,' it means 'eroded.' The fretted terrains of Mars are regions along the boundary between cratered highlands and northern lowland plains that have been broken-down into mesas, buttes, and valleys. On the floors of some of these valleys occurs a distinctive lineated and pitted texture--like the example shown here. The cause of the textures is not known, although for decades some scientists have speculated that ice is involved. While this is possible, it is far from a demonstrated fact. This picture is located near 40.1oN, 335.1oW, and covers an area approximately 3 km (1.9 mi) wide; sunlight illuminates the scene from the lower left.

  17. Candor Chasma Floor

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site] Context image for PIA03080 Candor Chasma Floor

    This VIS image shows part of the layered and wind sculpted deposit that occurs on the floor of Candor Chasma.

    Image information: VIS instrument. Latitude 6.6S, Longitude 284.4E. 17 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  18. Spallanzani Cr. Floor

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site] Context image for PIA03632 Spallanzani Cr. Floor

    This image was taken by one of the Mars Student Imaging Project (MSIP) teams. Their target is the unusual floor deposits in Spallanzani Crater. The wind may have affected the surface of the layered deposit. Small dunes have formed near the southern margin.

    Image information: VIS instrument. Latitude 57.9S, Longitude 86.5E. 17 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  19. Ascent/descent ancillary data production user's guide

    NASA Technical Reports Server (NTRS)

    Brans, H. R.; Seacord, A. W., II; Ulmer, J. W.

    1986-01-01

    The Ascent/Descent Ancillary Data Product, also called the A/D BET because it contains a Best Estimate of the Trajectory (BET), is a collection of trajectory, attitude, and atmospheric related parameters computed for the ascent and descent phases of each Shuttle Mission. These computations are executed shortly after the event in a post-flight environment. A collection of several routines including some stand-alone routines constitute what is called the Ascent/Descent Ancillary Data Production Program. A User's Guide for that program is given. It is intended to provide the reader with all the information necessary to generate an Ascent or a Descent Ancillary Data Product. It includes descriptions of the input data and output data for each routine, and contains explicit instructions on how to run each routine. A description of the final output product is given.

  20. Men of African Descent and Carcinoma of the Prostate Consortium

    Cancer.gov

    The Men of African Descent and Carcinoma of the Prostate Consortium collaborates on epidemiologic studies to address the high burden of prostate cancer and to understand the causes of etiology and outcomes among men of African ancestry.

  1. Automation for Accommodating Fuel-Efficient Descents in Constrained Airspace

    NASA Technical Reports Server (NTRS)

    Coopenbarger, Richard A.

    2010-01-01

    Continuous descents at low engine power are desired to reduce fuel consumption, emissions and noise during arrival operations. The challenge is to allow airplanes to fly these types of efficient descents without interruption during busy traffic conditions. During busy conditions today, airplanes are commonly forced to fly inefficient, step-down descents as airtraffic controllers work to ensure separation and maximize throughput. NASA in collaboration with government and industry partners is developing new automation to help controllers accommodate continuous descents in the presence of complex traffic and airspace constraints. This automation relies on accurate trajectory predictions to compute strategic maneuver advisories. The talk will describe the concept behind this new automation and provide an overview of the simulations and flight testing used to develop and refine its underlying technology.

  2. Design and Development of the MSL Descent Stage Propulsion System

    NASA Technical Reports Server (NTRS)

    Weiss, Jeffrey M.; Guernsey, Carl S.

    2013-01-01

    On August 5, 2012, The Mars Science Laboratory mission successfully landed the largest interplanetary rover ever built, Curiosity, on the surface of Mars. The Entry, Descent, and Landing (EDL) phase of this mission was by far the most complex landing ever attempted on a planetary body. The Descent Stage Propulsion System played an integral and critical role during Curiosity's EDL. The Descent Stage Propulsion System was a one of a kind hydrazine propulsion system designed specifically for the EDL phase of the MSL mission. It was designed, built, and tested at the Jet Propulsion Laboratory (JPL). The purpose of this paper is to present an overview of the design and development of the MSL Descent Stage Propulsion System. Driving requirements, system design, component selection, operational sequence of the system at Mars, new developments, and key challenges will be discussed.

  3. Descent from the Summit of 'Husband Hill'

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site] Click on the image for Descent from the Summit of 'Husband Hill' (QTVR)

    In late November 2005 while descending 'Husband Hill,' NASA's Mars Exploration Rover Spirit took the most detailed panorama so far of the 'Inner Basin,' the rover's next target destination. Spirit acquired the 405 individual images that make up this 360-degree view of the surrounding terrain using five different filters on the panoramic camera. The rover took the images on Martian days, or sols, 672 to 677 (Nov. 23 to 28, 2005 -- the Thanksgiving holiday weekend).

    This image is an approximately true-color rendering using camera's 750-, 530-, and 430-nanometer filters. Seams between individual frames have been eliminated from the sky portion of the mosaic to better simulate the vista a person standing on Mars would see.

    'Home Plate,' a bright, semi-circular feature scientists hope to investigate, is harder to discern in this image than in earlier views taken from higher up the hill. Spirit acquired this more oblique view, known as the 'Seminole panorama,' from about halfway down the south flank of Husband Hill, 50 meters (164 feet) or so below the summit. Near the center of the panorama, on the horizon, are 'McCool Hill' and 'Ramon Hill,' named, like Husband Hill, in honor of the fallen astronauts of the space shuttle Columbia. Husband Hill is visible behind the rover, on the right and left sides of the panorama. An arc of rover tracks made while avoiding obstacles and getting into position to examine rock outcrops can be traced over a long distance by zooming in to explore the panorama in greater detail.

    Spirit is now significantly farther downhill toward the center of this panorama, en route to Home Plate and other enigmatic soils and outcrop rocks in the quest to uncover the history of Gusev Crater and the 'Columbia Hills.'

  4. Osteopathy for Endometriosis and Chronic Pelvic Pain – a Pilot Study

    PubMed Central

    Sillem, M.; Juhasz-Böss, I.; Klausmeier, I.; Mechsner, S.; Siedentopf, F.; Solomayer, E.

    2016-01-01

    Introduction: Pelvic pain is a common problem in gynaecological practice. It is often unclear whether definite causality exists between reported symptoms and objective clinical findings of the female genital tract, and medical or operative treatments do not always achieve long-term resolution of symptoms. Methods: This pilot study investigated 28 patients (age 20–65, median 36.5 years) from a gynaecology practice whose only clinical finding was painful pelvic floor muscle tightness. Following standardised gynaecological and physiotherapist examination, all patients received osteopathic treatment. Pain had been present for a median of 3 years (range 1 month to 20 years). 14 patients had previously confirmed endometriosis. Treatment success was evaluated on consultation with patients in person or in writing. Results: 22 of the 28 participants completed the treatment according to plan. Overall, 17 reported symptom improvement, while 10 of the 14 patients with endometriosis did. Conclusion: Osteopathy is well received by women with painful pelvic floor muscle tightness and appears to be an effective treatment option.

  5. Osteopathy for Endometriosis and Chronic Pelvic Pain – a Pilot Study

    PubMed Central

    Sillem, M.; Juhasz-Böss, I.; Klausmeier, I.; Mechsner, S.; Siedentopf, F.; Solomayer, E.

    2016-01-01

    Introduction: Pelvic pain is a common problem in gynaecological practice. It is often unclear whether definite causality exists between reported symptoms and objective clinical findings of the female genital tract, and medical or operative treatments do not always achieve long-term resolution of symptoms. Methods: This pilot study investigated 28 patients (age 20–65, median 36.5 years) from a gynaecology practice whose only clinical finding was painful pelvic floor muscle tightness. Following standardised gynaecological and physiotherapist examination, all patients received osteopathic treatment. Pain had been present for a median of 3 years (range 1 month to 20 years). 14 patients had previously confirmed endometriosis. Treatment success was evaluated on consultation with patients in person or in writing. Results: 22 of the 28 participants completed the treatment according to plan. Overall, 17 reported symptom improvement, while 10 of the 14 patients with endometriosis did. Conclusion: Osteopathy is well received by women with painful pelvic floor muscle tightness and appears to be an effective treatment option. PMID:27681520

  6. 18. MAIN FLOOR HOLDING TANKS Main floor, looking at ...

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

    18. MAIN FLOOR - HOLDING TANKS Main floor, looking at holding tanks against the west wall, from which sluice gates are seen protruding. Right foreground-wooden holding tanks. Note narrow wooden flumes through which fish were sluiced into holding and brining tanks. - Hovden Cannery, 886 Cannery Row, Monterey, Monterey County, CA

  7. Floor Plans: Section "AA", Section "BB"; Floor Framing Plans: Section ...

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

    Floor Plans: Section "A-A", Section "B-B"; Floor Framing Plans: Section "A-A", Section "B-B" - Fort Washington, Fort Washington Light, Northeast side of Potomac River at Fort Washington Park, Fort Washington, Prince George's County, MD

  8. 18. FOURTH FLOOR BLDG. 28, RAISED CONCRETE SLAB FLOOR WITH ...

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

    18. FOURTH FLOOR BLDG. 28, RAISED CONCRETE SLAB FLOOR WITH BLOCKS AND PULLEYS OVERHEAD LOOKING NORTHEAST. - Fafnir Bearing Plant, Bounded on North side by Myrtle Street, on South side by Orange Street, on East side by Booth Street & on West side by Grove Street, New Britain, Hartford County, CT

  9. 13. Bottom floor, tower interior showing concrete floor and cast ...

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

    13. Bottom floor, tower interior showing concrete floor and cast iron bases for oil butts (oil butts removed when lighthouse lamp was converted to electric power.) - Block Island Southeast Light, Spring Street & Mohegan Trail at Mohegan Bluffs, New Shoreham, Washington County, RI

  10. Sea floor magnetic observatory

    NASA Astrophysics Data System (ADS)

    Korepanov, V.; Prystai, A.; Vallianatos, F.; Makris, J.

    2003-04-01

    The electromagnetic precursors of seismic hazards are widely accepted as strong evidence of the approaching earthquake or volcano eruption. The monitoring of these precursors are of main interest in densely populated areas, what creates serious problems to extract them at the strong industrial noise background. An interesting possibility to improve signal-to-noise ratio gives the installation of the observation points in the shelf zones near the possible earthquake places, what is fairly possible in most seismically active areas in Europe, e. g. in Greece and Italy. The serious restriction for this is the cost of the underwater instrumentation. To realize such experiments it requires the unification of efforts of several countries (e. g., GEOSTAR) or of the funds of some great companies (e. g., SIO magnetotelluric instrument). The progress in electronic components development as well as the appearance of inexpensive watertight glass spheres made it possible to decrease drastically the price of recently developed sea floor magnetic stations. The autonomous vector magnetometer LEMI-301 for sea bed application is described in the report. It is produced on the base of three-component flux-gate sensor. Non-magnetic housing and minimal magnetism of electronic components enable the instrument to be implemented as a monoblock construction where the electronic unit is placed close to the sensor. Automatic circuit provides convenient compensation of the initial field offset and readings of full value (6 digits) of the measured field. Timing by internal clock provides high accuracy synchronization of data. The internal flash memory assures long-term autonomous data storage. The system also has two-axes tilt measurement system. The methodological questions of magnetometer operation at sea bed were studied in order to avoid two types of errors appearing at such experimental cases. First is sea waving influence and second one magnetometer orientation at its random positioning on

  11. Delayed Diagnosis of Pelvic Hematoma without Fracture Due to Military Parachuting.

    PubMed

    Cunningham, Cord W; Kotwal, Russ S; Kragh, John F

    2013-01-01

    The U.S. military has been conducting static-line parachute jumps for nearly a century. Beginning with World War II, military forces have also employed full-scale airborne operations as a method for insertion into combat. Through the years, injuries from blunt trauma as a result of static-line parachute jumps have evolved little with the refinement of equipment, training, and tactics. Parachute jumps continue to invoke primarily musculoskeletal injuries, especially to the lower extremities, back, neck, and head. These injuries are usually straightforward in their presentation and diagnosis. We describe the delayed diagnosis of a pelvic hematoma due to an uncommon blunt trauma jump injury. The purpose of this case report is to increase awareness of injury patterns during paratrooper operations, as well as to review the diagnosis and management of occult hemorrhage. Specific objectives for the readers are to (1) know the common injury types and patterns for airborne operations, (2) know the descent rate of T-10C/D parachutes and factors influencing the rate, (3) recognize signs and symptoms associated with a pelvic hematoma, and (4) recognize common complications resulting from a pelvic hematoma.

  12. Delayed Diagnosis of Pelvic Hematoma without Fracture Due to Military Parachuting.

    PubMed

    Cunningham, Cord W; Kotwal, Russ S; Kragh, John F

    2013-01-01

    The U.S. military has been conducting static-line parachute jumps for nearly a century. Beginning with World War II, military forces have also employed full-scale airborne operations as a method for insertion into combat. Through the years, injuries from blunt trauma as a result of static-line parachute jumps have evolved little with the refinement of equipment, training, and tactics. Parachute jumps continue to invoke primarily musculoskeletal injuries, especially to the lower extremities, back, neck, and head. These injuries are usually straightforward in their presentation and diagnosis. We describe the delayed diagnosis of a pelvic hematoma due to an uncommon blunt trauma jump injury. The purpose of this case report is to increase awareness of injury patterns during paratrooper operations, as well as to review the diagnosis and management of occult hemorrhage. Specific objectives for the readers are to (1) know the common injury types and patterns for airborne operations, (2) know the descent rate of T-10C/D parachutes and factors influencing the rate, (3) recognize signs and symptoms associated with a pelvic hematoma, and (4) recognize common complications resulting from a pelvic hematoma. PMID:24419827

  13. A life of pelvic pain.

    PubMed

    Berkley, Karen J

    2005-10-15

    Pelvic pain associated with menstruation, i.e., dysmenorrhea, is a chronic pelvic pain that not only interferes with a woman's wellbeing for a large part of her life but also often co-occurs with other chronic painful conditions such as interstitial cystitis and irritable bowel syndrome and others. Little has been known about mechanisms underlying these chronic pelvic pains. This paper reviews 37 years of research in my laboratory at Florida State University on such mechanisms. Our research, mostly on rats, has contributed to the following findings: (1) Female reproductive organs are innervated in a topographic fashion by afferents in the pelvic (vagina/cervix) and hypogastric (cervix/uterine horn) nerves. (2) The input contributes to uterine and vaginal perceptions (nociception) that are modified by reproductive status. (3) Throughout the CNS, neurons responsive to stimulation of the reproductive tract also respond to stimulation of skin and other internal organs, in a manner modifiable by reproductive status and peripheral pathophysiology. (4) This dynamic physiological convergence may reflect extensive anatomical divergence of and interconnections between pathways entering the CNS via gateways through the spinal cord, dorsal column nuclei, and solitary nucleus. (5) The convergence also indicates the existence of extensive cross-system, viscero-visceral interactions within the CNS, that, while organized for coherent bodily functioning, serves as a substrate by which pathophysiology in one organ can influence physiology and responses to pathophysiology in other organs. (6) Some cross-system effects observed so far include: (a) Bladder inflammation reduces the rate of uterine contractions and the effects of drugs on the uterus. (b) Colon inflammation produces signs of inflammation in the otherwise healthy bladder and uterus. (c) A surgical model of endometriosis produces vaginal hyperalgesia, exacerbates pain behaviors induced by a ureteral stone, and reduces

  14. Pelvic sepsis after stapled hemorrhoidopexy

    PubMed Central

    van Wensen, Remco JA; van Leuken, Maarten H; Bosscha, Koop

    2008-01-01

    Stapled hemorrhoidopexy is a surgical procedure used worldwide for the treatment of grade III and IV hemorrhoids in all age groups. However, life-threatening complications occur occasionally. The following case report describes the development of pelvic sepsis after stapled hemorrhoidopexy. A literature review of techniques used to manage major septic complications after stapled hemorrhoidopexy was performed. There is no standardized treatment currently available. Stapled hemorrhoidopexy is a safe, effective and time-efficient procedure in the hands of experienced colorectal surgeons. PMID:18855996

  15. Stripped Crater Floor

    NASA Technical Reports Server (NTRS)

    2004-01-01

    10 February 2004 This full-resolution Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows details on the floor of an ancient meteor crater in the northeastern part of Noachis Terra. After the crater formed, layers of material--perhaps sediment--were deposited in the crater. These materials became somewhat solidified, but later were eroded to form the patterns shown here. Many windblown ripples in the scene indicate the presence of coarse-grained sediment that was not completely stripped away by wind. The picture is located near 22.1oS, 307.0oW. Sunlight illuminates this scene from the left/upper left; the image covers an area 3 km (1.9 mi) wide.

  16. Floor-plan radar

    NASA Astrophysics Data System (ADS)

    Falconer, David G.; Ueberschaer, Ronald M.

    2000-07-01

    Urban-warfare specialists, law-enforcement officers, counter-drug agents, and counter-terrorism experts encounter operational situations where they must assault a target building and capture or rescue its occupants. To minimize potential casualties, the assault team needs a picture of the building's interior and a copy of its floor plan. With this need in mind, we constructed a scale model of a single- story house and imaged its interior using synthetic-aperture techniques. The interior and exterior walls nearest the radar set were imaged with good fidelity, but the distal ones appear poorly defined and surrounded by ghosts and artifacts. The latter defects are traceable to beam attenuation, wavefront distortion, multiple scattering, traveling waves, resonance phenomena, and other effects not accounted for in the traditional (noninteracting, isotropic point scatterer) model for radar imaging.

  17. Flow Along Valley Floors

    NASA Technical Reports Server (NTRS)

    2003-01-01

    [figure removed for brevity, see original site]

    Released 9 May 2003

    Lines indicative of flow in a valley floor (east to west) cut across similar lines in a slightly smaller valley (southeast to northwest), indicating both that material flowed along the valley floor (as opposed to across it) and that relative flow ages may be determined from crosscutting relationships.

    Image information: VIS instrument. Latitude 39.6, Longitude 31.1East (328.9). 19 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  18. Urogenital disorders after pelvic ring injuries

    PubMed Central

    Ter–Grigorian, Atom A.; Pushkar, Dmitry Y.

    2013-01-01

    Introduction The close anatomical relationship between the skeletal and connective systems of the pelvis, neurological, and vascular structures and pelvic organs are predisposing factors for structural and functional damages of the urogenital system. Materials and methods We performed PUBMED and MEDLINE search using terms “pelvic ring trauma/disruption, bladder injury, urethral injury, sexual dysfunction”. Results The probability of damage of the pelvic organs increases along with the degree of disturbance of integrity of the pelvic ring. The most important risk factor of urogenital injuries is the rupture of the symphyseal joint. Patients with lesions of the urogenital system have a higher risk of mortality compared with patients without lesions of the urogenital system. Sexual dysfunctions along with urinary incontinence are a common consequence of the pelvic fracture in men and women. Conclusions Injuries of the urogenital organs during pelvic ring fractures have an important negative prognostic value in terms of morbidity and quality of life. A prerequisite for a successful therapeutic outcome in case of pelvic fractures with disturbance of pelvic ring integrity is cooperation of orthopedists and urologists, with possible early diagnosis and treatment of injuries of the urogenital organs. PMID:24707384

  19. 38 CFR 4.67 - Pelvic bones.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Pelvic bones. 4.67 Section 4.67 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.67 Pelvic bones. The variability of...

  20. 38 CFR 4.67 - Pelvic bones.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Pelvic bones. 4.67 Section 4.67 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.67 Pelvic bones. The variability of...

  1. 38 CFR 4.67 - Pelvic bones.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Pelvic bones. 4.67 Section 4.67 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.67 Pelvic bones. The variability of...

  2. 38 CFR 4.67 - Pelvic bones.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Pelvic bones. 4.67 Section 4.67 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.67 Pelvic bones. The variability of...

  3. 38 CFR 4.67 - Pelvic bones.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Pelvic bones. 4.67 Section 4.67 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.67 Pelvic bones. The variability of...

  4. What's New in Floor Care.

    ERIC Educational Resources Information Center

    Griffin, William R.

    1999-01-01

    Examines some of the new equipment, chemicals, and procedures in floor care to help educational facility managers develop floor care programs and improve performance. Trends include more mechanization, higher concentrations and environmentally preferable products for cleaning, and the use of written cleaning procedures. (GR)

  5. The relationship between pelvic alignment and dysmenorrhea

    PubMed Central

    Kim, Moon-jeong; Baek, Il-hun; Goo, Bong-oh

    2016-01-01

    [Purpose] The purpose of this study was to investigate the relationship between pelvic alignment and dysmenorrhea in general women. [Subjects and Methods] One hundred two females participated in this study. They were divided into a dysmenorrhea group and a normal group based on the results of a Visual Analogue Scale (VAS) assessment of pain and the Menstrual Distress Questionnaire (MDQ). The survey data was collecting from 5th July to 20th September, 2014. Formetric 4D was used to measure the pelvic alignment, including the values of Trunk Imbalance, Pelvic Tilt, Surface Rotation, Lateral Deviation, Kyphosis Angle, Lordosis Angle. [Results] There was a difference in the spine alignments of each group. The value of pelvic torsion was 2.4 ± 1.8 degree in those with dysmenorrhea, while it was 1.7 ± 1.1 degree in those without. [Conclusion] In conclusion, the results suggest that there is a relationship between menstrual pain and pelvic torsion. PMID:27134354

  6. Pelvic meningocele can be missed during laparoscopy.

    PubMed

    Cheung, Vincent Y T; Rosenthal, David M

    2006-01-01

    Pelvic meningocele is an uncommon condition and is frequently asymptomatic. The diagnosis easily can be mistaken as ovarian cyst on pelvic sonography. In many reported cases, the diagnosis was made during laparotomy for presumed ovarian cysts. Myelography, computerized tomography (CT), or magnetic resonance imaging (MRI) is useful for definitive diagnosis. A 49-year-old woman, who had a normal diagnostic laparoscopy 3 years prior, was referred for a persistent ovarian cyst. Repeat laparoscopy revealed a retroperitoneal cyst in the left pelvic sidewall. Both ovaries and fallopian tubes were normal. Subsequent CT and MRI were used to diagnose pelvic meningocele. We speculate that pelvic meningoceles can be missed during laparoscopy due to the increased intraperitoneal pressure and the potential reduction in the cerebrospinal fluid pressure at the lumbosacral level.

  7. Mars Descent Imager (MARDI) on the Mars Polar Lander

    USGS Publications Warehouse

    Malin, M.C.; Caplinger, M.A.; Carr, M.H.; Squyres, S.; Thomas, P.; Veverka, J.

    2001-01-01

    The Mars Descent Imager, or MARDI, experiment on the Mars Polar Lander (MPL) consists of a camera characterized by small physical size and mass (???6 ?? 6 ?? 12 cm, including baffle; <500 gm), low power requirements (<2.5 W, including power supply losses), and high science performance (1000 x 1000 pixel, low noise). The intent of the investigation is to acquire nested images over a range of resolutions, from 8 m/pixel to better than 1 cm/pixel, during the roughly 2 min it takes the MPL to descend from 8 km to the surface under parachute and rocket-powered deceleration. Observational goals will include studies of (1) surface morphology (e.g., nature and distribution of landforms indicating past and present environmental processes); (2) local and regional geography (e.g., context for other lander instruments: precise location, detailed local relief); and (3) relationships to features seen in orbiter data. To accomplish these goals, MARDI will collect three types of images. Four small images (256 x 256 pixels) will be acquired on 0.5 s centers beginning 0.3 s before MPL's heatshield is jettisoned. Sixteen full-frame images (1024 X 1024, circularly edited) will be acquired on 5.3 s centers thereafter. Just after backshell jettison but prior to the start of powered descent, a "best final nonpowered descent image" will be acquired. Five seconds after the start of powered descent, the camera will begin acquiring images on 4 s centers. Storage for as many as ten 800 x 800 pixel images is available during terminal descent. A number of spacecraft factors are likely to impact the quality of MARDI images, including substantial motion blur resulting from large rates of attitude variation during parachute descent and substantial rocket-engine-induced vibration during powered descent. In addition, the mounting location of the camera places the exhaust plume of the hydrazine engines prominently in the field of view. Copyright 2001 by the American Geophysical Union.

  8. Design of automation tools for management of descent traffic

    NASA Technical Reports Server (NTRS)

    Erzberger, Heinz; Nedell, William

    1988-01-01

    The design of an automated air traffic control system based on a hierarchy of advisory tools for controllers is described. Compatibility of the tools with the human controller, a key objective of the design, is achieved by a judicious selection of tasks to be automated and careful attention to the design of the controller system interface. The design comprises three interconnected subsystems referred to as the Traffic Management Advisor, the Descent Advisor, and the Final Approach Spacing Tool. Each of these subsystems provides a collection of tools for specific controller positions and tasks. This paper focuses primarily on the Descent Advisor which provides automation tools for managing descent traffic. The algorithms, automation modes, and graphical interfaces incorporated in the design are described. Information generated by the Descent Advisor tools is integrated into a plan view traffic display consisting of a high-resolution color monitor. Estimated arrival times of aircraft are presented graphically on a time line, which is also used interactively in combination with a mouse input device to select and schedule arrival times. Other graphical markers indicate the location of the fuel-optimum top-of-descent point and the predicted separation distances of aircraft at a designated time-control point. Computer generated advisories provide speed and descent clearances which the controller can issue to aircraft to help them arrive at the feeder gate at the scheduled times or with specified separation distances. Two types of horizontal guidance modes, selectable by the controller, provide markers for managing the horizontal flightpaths of aircraft under various conditions. The entire system consisting of descent advisor algorithm, a library of aircraft performance models, national airspace system data bases, and interactive display software has been implemented on a workstation made by Sun Microsystems, Inc. It is planned to use this configuration in operational

  9. Determinants and Management Outcomes of Pelvic Organ Prolapse in a Low Resource Setting

    PubMed Central

    Eleje, GU; Udegbunam, OI; Ofojebe, CJ; Adichie, CV

    2014-01-01

    Background: The last decade has seen significant progress in understanding of the pathophysiology, anatomy and management modalities of pelvic organ prolapse. A review of the way we manage this entity in a low resource setting has become necessary. Aim: The aim of the study is to determine the incidence, risk factors and management modalities of pelvic organ prolapse. Materials and Methods: A 5-year cross-sectional study with retrospective data collection of women who attended the gynecologic clinic in Nnamdi Azikiwe University Teaching Hospital, Nnewi, south-east Nigeria and were diagnosed of pelvic organ prolapse was made. Proforma was initially used for data collection before transfer to Epi-info 2008 (v 3.5.1; Epi Info, Centers for Disease Control and Prevention, Atlanta, GA) software. Results: There were 199 cases of pelvic organ prolapse, out of a total gynecologic clinic attendance of 3082, thus giving an incidence of 6.5%. The mean age was 55.5 (15.9) years with a significant association between prolapse and advanced age (P < 0.001). The age range was 22-80 years. The leading determinants were menopause, advanced age, multiparity, chronic increase in intra-abdominal pressure (IAP) and prolonged labor. Out of the 147 patients with uterine prolapse, majority, 60.5% (89/147) had third degree prolapse. Vaginal hysterectomy with pelvic floor repair was the most common surgery performed. The average duration of hospital stay following surgery was 6.8 (2.9) days and the most common complication was urinary tract infection, 13.5% (27/199). The recurrence rate was 13.5% (27/199). Most of the patients who presented initially with pelvic organ prolapse were lost to follow-up. Conclusion: The incidence of pelvic organ prolapse in this study was 6.5% and the leading determinants of pelvic organ prolapse were - multiparity, menopause, chronic increase in IAP and advanced age. Most were lost to follow-up and a lesser proportion was offered conservative management. Early

  10. The Ocean Floor

    NASA Astrophysics Data System (ADS)

    Fox, Paul J.

    Over a relatively short period of time Bruce Heezen made significant, imaginative and timely contributions to our understanding of the processes that govern the origin and evolution of oceanic crust in space and time. It is certainly fitting that someone of Heezen's stature be honored by a memorial volume and the collection of papers in The Ocean Floor were gathered together for this purpose. Bruce was a gifted scientist with a wide-ranging appetite for all facets of earth science, and in this respect he would have appreciated the pot pourri of marine geological topics covered in the book (e.g., continental margin investigations, sedimentological processes, plate tectonic models). Unfortunately, the book does not have an overall impact that measures up to the man that it commemorates. Too many of the papers read as if the authors, after having agreed to contribute to the volume, reached deep into their files to dredge up a neglected manuscript on one subject or another. As a consequence, many of the papers lack zest and fail to stimulate interest beyond their narrowly focused themes.

  11. Waterproof Raised Floor Makes Utility Lines Accessible

    NASA Technical Reports Server (NTRS)

    Cohen, M. M.

    1984-01-01

    Floor for laboratories, hospitals and factories waterproof yet allows access to subfloor utilities. Elevated access floor system designed for installations with multitude of diverse utility systems routed under and up through floor and requirement of separation of potentially conflicting utility services. Floor covered by continuous sheet of heat resealable vinyl. Floor system cut open when changes are made in utility lines and ducts. After modifications, floor covering resealed to protect subfloor utilities from spills and leaks.

  12. Evaluation of acute pelvic pain in women.

    PubMed

    Kruszka, Paul S; Kruszka, Stephen J

    2010-07-15

    Diagnosis of pelvic pain in women can be challenging because many symptoms and signs are insensitive and nonspecific. As the first priority, urgent life-threatening conditions (e.g., ectopic pregnancy, appendicitis, ruptured ovarian cyst) and fertility-threatening conditions (e.g., pelvic inflammatory disease, ovarian torsion) must be considered. A careful history focusing on pain characteristics, review of systems, and gynecologic, sexual, and social history, in addition to physical examination helps narrow the differential diagnosis. The most common urgent causes of pelvic pain are pelvic inflammatory disease, ruptured ovarian cyst, and appendicitis; however, many other diagnoses in the differential may mimic these conditions, and imaging is often needed. Transvaginal ultrasonography should be the initial imaging test because of its sensitivities across most etiologies and its lack of radiation exposure. A high index of suspicion should be maintained for pelvic inflammatory disease when other etiologies are ruled out, because the presentation is variable and the prevalence is high. Multiple studies have shown that 20 to 50 percent of women presenting with pelvic pain have pelvic inflammatory disease. Adolescents and pregnant and postpartum women require unique considerations.

  13. Evaluation of acute pelvic pain in women.

    PubMed

    Kruszka, Paul S; Kruszka, Stephen J

    2010-07-15

    Diagnosis of pelvic pain in women can be challenging because many symptoms and signs are insensitive and nonspecific. As the first priority, urgent life-threatening conditions (e.g., ectopic pregnancy, appendicitis, ruptured ovarian cyst) and fertility-threatening conditions (e.g., pelvic inflammatory disease, ovarian torsion) must be considered. A careful history focusing on pain characteristics, review of systems, and gynecologic, sexual, and social history, in addition to physical examination helps narrow the differential diagnosis. The most common urgent causes of pelvic pain are pelvic inflammatory disease, ruptured ovarian cyst, and appendicitis; however, many other diagnoses in the differential may mimic these conditions, and imaging is often needed. Transvaginal ultrasonography should be the initial imaging test because of its sensitivities across most etiologies and its lack of radiation exposure. A high index of suspicion should be maintained for pelvic inflammatory disease when other etiologies are ruled out, because the presentation is variable and the prevalence is high. Multiple studies have shown that 20 to 50 percent of women presenting with pelvic pain have pelvic inflammatory disease. Adolescents and pregnant and postpartum women require unique considerations. PMID:20642266

  14. Low floor mass transit vehicle

    DOEpatents

    Emmons, J. Bruce; Blessing, Leonard J.

    2004-02-03

    A mass transit vehicle includes a frame structure that provides an efficient and economical approach to providing a low floor bus. The inventive frame includes a stiff roof panel and a stiff floor panel. A plurality of generally vertical pillars extend between the roof and floor panels. A unique bracket arrangement is disclosed for connecting the pillars to the panels. Side panels are secured to the pillars and carry the shear stresses on the frame. A unique seating assembly that can be advantageously incorporated into the vehicle taking advantage of the load distributing features of the inventive frame is also disclosed.

  15. 21. VIEW OF THE FIRST FLOOR PLAN. THE FIRST FLOOR ...

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

    21. VIEW OF THE FIRST FLOOR PLAN. THE FIRST FLOOR WAS USED FOR DEPLETED AND ENRICHED URANIUM FABRICATION. THE ORIGINAL DRAWING HAS BEEN ARCHIVED ON MICROFILM. THE DRAWING WAS REPRODUCED AT THE BEST QUALITY POSSIBLE. LETTERS AND NUMBERS IN THE CIRCLES INDICATE FOOTER AND/OR COLUMN LOCATIONS. - Rocky Flats Plant, Uranium Rolling & Forming Operations, Southeast section of plant, southeast quadrant of intersection of Central Avenue & Eighth Street, Golden, Jefferson County, CO

  16. 22. VIEW OF THE SECOND FLOOR PLAN. THE SECOND FLOOR ...

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

    22. VIEW OF THE SECOND FLOOR PLAN. THE SECOND FLOOR CONTAINS THE AIR PLENUM ND SOME OFFICE SPACE. THE ORIGINAL DRAWING HAS BEEN ARCHIVED ON MICROFILM. THE DRAWING WAS REPRODUCED AT THE BEST QUALITY POSSIBLE. LETTERS AND NUMBERS IN THE CIRCLES INDICATE FOOTER AND/OR COLUMN LOCATIONS. - Rocky Flats Plant, Uranium Rolling & Forming Operations, Southeast section of plant, southeast quadrant of intersection of Central Avenue & Eighth Street, Golden, Jefferson County, CO

  17. Crew Procedures for Continuous Descent Arrivals Using Conventional Guidance

    NASA Technical Reports Server (NTRS)

    Oseguera-Lohr, Rosa M.; Williams, David H.; Lewis, Elliot T,

    2007-01-01

    This paper presents results from a simulation study which investigated the use of Continuous Descent Arrival (CDA) procedures for conducting a descent through a busy terminal area, using conventional transport-category automation. This research was part of the Low Noise Flight Procedures (LNFP) element within the Quiet Aircraft Technology (QAT) Project, that addressed development of flight guidance, and supporting pilot and Air Traffic Control (ATC) procedures for low noise operations. The procedures and chart were designed to be easy to understand, and to make it easy for the crew to make changes via the Flight Management Computer Control-Display Unit (FMC-CDU) to accommodate changes from ATC. The test runs were intended to represent situations typical of what exists in many of today's terminal areas, including interruptions to the descent in the form of clearances issued by ATC.

  18. MSL Entry, Descent and Landing Performance and Environments

    NASA Technical Reports Server (NTRS)

    Lockwood, Mary Kae; Dwyer-Cianciola, Alicia; Dyakonov, Artem; Edquist, Karl; Powell, Dick; Striepe, Scott; Way, David; Graves, Claude; Carman, Gil; Sostaric, Ron

    2005-01-01

    A viewgraph presentation on the MARS Science Laboratory (MSL) Entry, Descent and Landing (EDL) performance and environments is shown. The topics include: 1) High Altitude and Precision Landing; 2) Guided, Lifting, Ballistic Trade; 3) Supersonic Chute Deploy Altitude; 4) Guided, Lifting, Ballistic Landing Footprint Video; 5) Transition Indicator at Peak Heating Point on Trajectory; 6) Aeroheating at Peak Heating Point on Trajectory Nominal, No Uncertainty Included; 7) Comparison to Previous Missions; 8) Pork Chop Plots - EDL Performance for Mission Design; 9) Max Heat Rate Est (CBE+Uncert) W/cm2; 10) Nominal Super Chute Deploy Alt Above MOLA (km); 11) Monte Carlo; 12) MSL Option M2 Entry, Descent and Landing; 13) Entry Performance; 14) Entry Aeroheating and Entry g's; 15) Terminal Descent; and 16) How An Ideal Chute Deployment Altitude Varies with Time of Year and Latitude (JSC Chart).

  19. Locally vascularized pelvic accessory spleen.

    PubMed

    Iorio, F; Frantellizzi, V; Drudi, Francesco M; Maghella, F; Liberatore, M

    2016-01-01

    Polysplenism and accessory spleen are congenital, usually asymptomatic anomalies. A rare case of polysplenism with ectopic spleen in pelvis of a 67-year-old, Caucasian female is reported here. A transvaginal ultrasound found a soft well-defined homogeneous and vascularized mass in the left pelvis. Patient underwent MRI evaluation and contrast-CT abdominal scan: images with parenchymal aspect, similar to spleen were obtained. Abdominal scintigraphy with 99mTc-albumin nanocolloid was performed and pelvic region was studied with planar scans and SPECT. The results showed the presence of an uptake area of the radiopharmaceutical in the pelvis, while the spleen was normally visualized. These findings confirmed the presence of an accessory spleen with an artery originated from the aorta and a vein that joined with the superior mesenteric vein. To our knowledge, in the literature, there is just only one case of a true ectopic, locally vascularized spleen in the pelvis.

  20. [Patients with hemodynamic unstable pelvic fractures in extremis: pelvic packing or angiography?].

    PubMed

    Liñán-Padilla, A; Giráldez-Sánchez, M Á; Serrano-Toledano, D; Lázaro-Gonzálvez, A; Cano-Luís, P

    2013-01-01

    The multidisciplinary management of patients with pelvic trauma has improved prognosis, but mortality is still very high. The appropriate treatment strategy remains controversial, especially regarding the control of bleeding in patients whose clinical situation is extreme by using angiography or pelvic packing. We propose using a tool of evidence-based medicine (CAT) the benefit of the completion of pelvic packing in relation to a specific clinical question from a specific situation. What is best for the management of bleeding, extraperitoneal pelvic packing or angiography, in patients with hemodynamically unstable pelvic fracture in extremis? From this study we can conclude that angiography may improve control of bleeding in patients with arterial bleeding and hemodynamically stable but the packing has priority in patients with pelvic fractures and hemodynamic instability.

  1. Mars Smart Lander Simulations for Entry, Descent, and Landing

    NASA Technical Reports Server (NTRS)

    Striepe, S. A.; Way, D. W.; Balaram, J.

    2002-01-01

    Two primary simulations have been developed and are being updated for the Mars Smart Lander Entry, Descent, and Landing (EDL). The high fidelity engineering end-to-end EDL simulation that is based on NASA Langley's Program to Optimize Simulated Trajectories (POST) and the end-to-end real-time, hardware-in-the-loop simulation testbed, which is based on NASA JPL's (Jet Propulsion Laboratory) Dynamics Simulator for Entry, Descent and Surface landing (DSENDS). This paper presents the status of these Mars Smart Lander EDL end-to-end simulations at this time. Various models, capabilities, as well as validation and verification for these simulations are discussed.

  2. Flight Data Entry, Descent, and Landing (EDL) Repository

    NASA Technical Reports Server (NTRS)

    Martinez, Elmain M.; Winterhalter, Daniel

    2012-01-01

    Dr. Daniel Winterhalter, NASA Engineering and Safety Center Chief Engineer at the Jet Propulsion Laboratory, requested the NASA Engineering and Safety Center sponsor a 3-year effort to collect entry, descent, and landing material and to establish a NASA-wide archive to serve the material. The principle focus of this task was to identify entry, descent, and landing repository material that was at risk of being permanently lost due to damage, decay, and undocumented storage. To provide NASA-wide access to this material, a web-based digital archive was created. This document contains the outcome of the effort.

  3. Entry, Descent and Landing Systems Analysis Study: Phase 1 Report

    NASA Technical Reports Server (NTRS)

    DwyerCianciolo, Alicia M.; Davis, Jody L.; Komar, David R.; Munk, Michelle M.; Samareh, Jamshid A.; Powell, Richard W.; Shidner, Jeremy D.; Stanley, Douglas O.; Wilhite, Alan W.; Kinney, David J.; McGuire, M. Kathleen; Arnold, James O.; Howard, Austin R.; Sostaric, Ronald R.; Studak, Joseph W.; Zumwalt, Carlie H.; Llama, Eduardo G.; Casoliva, Jordi; Ivanov, Mark C.; Clark, Ian; Sengupta, Anita

    2010-01-01

    NASA senior management commissioned the Entry, Descent and Landing Systems Analysis (EDL-SA) Study in 2008 to identify and roadmap the Entry, Descent and Landing (EDL) technology investments that the agency needed to make in order to successfully land large payloads at Mars for both robotic and human-scale missions. This paper summarizes the motivation, approach and top-level results from Year 1 of the study, which focused on landing 10-50 mt on Mars, but also included a trade study of the best advanced parachute design for increasing the landed payloads within the EDL architecture of the Mars Science Laboratory (MSL) mission

  4. Space shuttle descent design: From development to operations

    NASA Technical Reports Server (NTRS)

    Crull, T. J.; Hite, R. E., III

    1985-01-01

    The descent guidance system, the descent trajectories design, and generating of the associated flight products are discussed. The programs which allow the successful transitions from development to STS operations, resulting in reduced manpower requirements and compressed schedules for flight design cycles are addressed. The topics include: (1) continually upgraded tools for the job, i.e., consolidating tools via electronic data transfers, tailoring general purpose software for needs, easy access to tools through an interactive approach, and appropriate flexibility to allow design changes and provide growth capability; (2) stabilizing the flight profile designs (I-loads) in an uncertain environment; and (3) standardizing external interfaces within performance and subsystems constraints of the Orbiter.

  5. The Influence of Pelvic Ramus Fracture on the Stability of Fixed Pelvic Complex Fracture

    PubMed Central

    Lei, Jianyin; Zhang, Yue; Wu, Guiying; Wang, Zhihua; Cai, Xianhua

    2015-01-01

    This study aims to evaluate the biomechanical mechanism of pelvic ring injury for the stability of pelvis using the finite element (FE) method. Complex pelvic fracture (i.e., anterior column with posterior hemitransverse lesion) combined with pelvic ramus fracture was used to evaluate the biomechanics stability of the pelvis. Three FE fracture models (i.e., Dynamic Anterior Plate-Screw System for Quadrilateral Area (DAPSQ) for complex pelvic fracture with intact pubic ramus, DAPSQ for complex pelvic fracture with pubic ramus fracture, and DAPSQ for complex pelvic fracture with fixed pubic ramus fracture) were established to explore the biomechanics stability of the pelvis. The pubic ramus fracture leads to an unsymmetrical situation and an unstable situation of the pelvis. The fixed pubic ramus fracture did well in reducing the stress levels of the pelvic bone and fixation system, as well as displacement difference in the pubic symphysis, and it could change the unstable situation back to a certain extent. The pelvic ring integrity was the prerequisite of the pelvic stability and should be in a stable condition when the complex fracture is treated. PMID:26495033

  6. Can I prevent Pelvic Organ Prolapse

    MedlinePlus

    ... Pelvic Organ Prolapse POP Symptoms & Types Can I Prevent POP? POP Diagnosis POP Treatments 3 Resources + More Bladder Control UI Symptoms & Types Can I Prevent UI? UI Diagnosis UI Treatments 3 Resources + More ...

  7. Pelvic surgical site infections in gynecologic surgery.

    PubMed

    Lachiewicz, Mark P; Moulton, Laura J; Jaiyeoba, Oluwatosin

    2015-01-01

    The development of surgical site infection (SSI) remains the most common complication of gynecologic surgical procedures and results in significant patient morbidity. Gynecologic procedures pose a unique challenge in that potential pathogenic microorganisms from the skin or vagina and endocervix may migrate to operative sites and can result in vaginal cuff cellulitis, pelvic cellulitis, and pelvic abscesses. Multiple host and surgical risk factors have been identified as risks that increase infectious sequelae after pelvic surgery. This paper will review these risk factors as many are modifiable and care should be taken to address such factors in order to decrease the chance of infection. We will also review the definitions, microbiology, pathogenesis, diagnosis, and management of pelvic SSIs after gynecologic surgery.

  8. Channel Floor Yardangs

    NASA Technical Reports Server (NTRS)

    2004-01-01

    [figure removed for brevity, see original site]

    Released 19 July 2004 The atmosphere of Mars is a dynamic system. Water-ice clouds, fog, and hazes can make imaging the surface from space difficult. Dust storms can grow from local disturbances to global sizes, through which imaging is impossible. Seasonal temperature changes are the usual drivers in cloud and dust storm development and growth.

    Eons of atmospheric dust storm activity has left its mark on the surface of Mars. Dust carried aloft by the wind has settled out on every available surface; sand dunes have been created and moved by centuries of wind; and the effect of continual sand-blasting has modified many regions of Mars, creating yardangs and other unusual surface forms.

    The yardangs in this image are forming in channel floor deposits. The channel itself is funneling the wind to cause the erosion.

    Image information: VIS instrument. Latitude 4.5, Longitude 229.7 East (133.3 West). 19 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are

  9. Tangential Floor in a Classroom Setting

    ERIC Educational Resources Information Center

    Marti, Leyla

    2012-01-01

    This article examines floor management in two classroom sessions: a task-oriented computer lesson and a literature lesson. Recordings made in the computer lesson show the organization of floor when a task is given to students. Temporary or "incipient" side floors (Jones and Thornborrow, 2004) emerge beside the main floor. In the literature lesson,…

  10. 49 CFR 393.84 - Floors.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 5 2011-10-01 2011-10-01 false Floors. 393.84 Section 393.84 Transportation Other... Miscellaneous Parts and Accessories § 393.84 Floors. The flooring in all motor vehicles shall be substantially... fumes, exhaust gases, or fire. Floors shall not be permeated with oil or other substances likely...

  11. 49 CFR 393.84 - Floors.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false Floors. 393.84 Section 393.84 Transportation Other... Miscellaneous Parts and Accessories § 393.84 Floors. The flooring in all motor vehicles shall be substantially... fumes, exhaust gases, or fire. Floors shall not be permeated with oil or other substances likely...

  12. Descents and nodal load in scale-free networks

    NASA Astrophysics Data System (ADS)

    Bareinboim, Elias; Barbosa, Valmir C.

    2008-04-01

    The load of a node in a network is the total traffic going through it when every node pair sustains a uniform bidirectional traffic between them on shortest paths. We express nodal load in terms of the more elementary notion of a node’s descents in breadth-first-search [(BFS) or shortest-path] trees and study both the descent and nodal-load distributions in the case of scale-free networks. Our treatment is both semianalytical (combining a generating-function formalism with simulation-derived BFS branching probabilities) and computational for the descent distribution; it is exclusively computational in the case of the load distribution. Our main result is that the load distribution, even though it can be disguised as a power law through subtle (but inappropriate) binning of the raw data, is in fact a succession of sharply delineated probability peaks, each of which can be clearly interpreted as a function of the underlying BFS descents. This find is in stark contrast with previously held belief, based on which a power law of exponent -2.2 was conjectured to be valid regardless of the exponent of the power-law distribution of node degrees.

  13. APOLLO 16 TECHNICIAN ATTACHES PLAQUE TO LUNAR MODULE'S DESCENT STAGE

    NASA Technical Reports Server (NTRS)

    1972-01-01

    Working inside the Apollo 16 Saturn V space vehicle at the launch pad, technician Ken Crow attaches a stainless steel plaque bearing the names of Apollo 16 astronauts John W. Young, Thomas K. Mattingly II and Charles M. Duke, Jr., to the Lunar Module's descent stage, which will remain on the Moon's surface.

  14. A Portfolio of Outstanding Americans of Mexican Descent.

    ERIC Educational Resources Information Center

    Lelevier, Benjamin, Jr.

    A cross section of Mexican American achievement is presented in a portfolio of 37 portraits of outstanding Americans of Mexican descent. Drawn in black and white on heavy paper stock by Mr. David L. Rodriguez, the sketches are suitable for display purposes. With the likenesses are biographical sketches in both English and Spanish which were…

  15. "Rosetta" Mission's "7 Hours of Terror" and "Philae's" Descent

    ERIC Educational Resources Information Center

    Blanco, Philip

    2015-01-01

    In November 2014 the "Rosetta" mission to Comet 67P/Churyumov-Gerasimenko made the headlines when its "Philae" lander completed a successful unpowered descent onto the surface of the comet nucleus after "7 hours of terror" for the mission scientists. 67P's irregular shape and rotation made this task even more…

  16. 14 CFR 23.69 - Enroute climb/descent.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... each weight, altitude, and ambient temperature within the operational limits established by the...; (3) The wing flaps retracted; and (4) A climb speed not less than 1.3 VS1. (b) One engine inoperative. The steady gradient and rate of climb/descent must be determined at each weight, altitude, and...

  17. 14 CFR 23.69 - Enroute climb/descent.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... each weight, altitude, and ambient temperature within the operational limits established by the...; (3) The wing flaps retracted; and (4) A climb speed not less than 1.3 VS1. (b) One engine inoperative. The steady gradient and rate of climb/descent must be determined at each weight, altitude, and...

  18. Whole-body angular momentum during stair ascent and descent.

    PubMed

    Silverman, Anne K; Neptune, Richard R; Sinitski, Emily H; Wilken, Jason M

    2014-04-01

    The generation of whole-body angular momentum is essential in many locomotor tasks and must be regulated in order to maintain dynamic balance. However, angular momentum has not been investigated during stair walking, which is an activity that presents a biomechanical challenge for balance-impaired populations. We investigated three-dimensional whole-body angular momentum during stair ascent and descent and compared it to level walking. Three-dimensional body-segment kinematic and ground reaction force (GRF) data were collected from 30 healthy subjects. Angular momentum was calculated using a 13-segment whole-body model. GRFs, external moment arms and net joint moments were used to interpret the angular momentum results. The range of frontal plane angular momentum was greater for stair ascent relative to level walking. In the transverse and sagittal planes, the range of angular momentum was smaller in stair ascent and descent relative to level walking. Significant differences were also found in the ground reaction forces, external moment arms and net joint moments. The sagittal plane angular momentum results suggest that individuals alter angular momentum to effectively counteract potential trips during stair ascent, and reduce the range of angular momentum to avoid falling forward during stair descent. Further, significant differences in joint moments suggest potential neuromuscular mechanisms that account for the differences in angular momentum between walking conditions. These results provide a baseline for comparison to impaired populations that have difficulty maintaining dynamic balance, particularly during stair ascent and descent.

  19. Abuse against Women with Disabilities of Mexican Descent: Cultural Considerations

    ERIC Educational Resources Information Center

    Graf, Noreen M.; Reed, Bruce J.; Sanchez, Rubi

    2008-01-01

    Although considerable attention has been focused on violence against women with disabilities, environmental and cultural factors that contribute to this violence have received limited attention. This paper examines violence against women of Mexican descent with disabilities. Recommendations are offered to researchers, educators, and service…

  20. Stress within a Bicultural Context for Adolescents of Mexican Descent.

    ERIC Educational Resources Information Center

    Romero, Andrea J.; Roberts, Robert E.

    2003-01-01

    Folkman and Lazarus's theory of stress and coping was used to develop a measure assessing the perceived stress within a bicultural context. Middle school students of Mexican descent (N=881) reported their perceived stress from intergenerational acculturation gaps, within-group discrimination, out-group discrimination, and monolingual stress.…

  1. Simulation Results for Airborne Precision Spacing along Continuous Descent Arrivals

    NASA Technical Reports Server (NTRS)

    Barmore, Bryan E.; Abbott, Terence S.; Capron, William R.; Baxley, Brian T.

    2008-01-01

    This paper describes the results of a fast-time simulation experiment and a high-fidelity simulator validation with merging streams of aircraft flying Continuous Descent Arrivals through generic airspace to a runway at Dallas-Ft Worth. Aircraft made small speed adjustments based on an airborne-based spacing algorithm, so as to arrive at the threshold exactly at the assigned time interval behind their Traffic-To-Follow. The 40 aircraft were initialized at different altitudes and speeds on one of four different routes, and then merged at different points and altitudes while flying Continuous Descent Arrivals. This merging and spacing using flight deck equipment and procedures to augment or implement Air Traffic Management directives is called Flight Deck-based Merging and Spacing, an important subset of a larger Airborne Precision Spacing functionality. This research indicates that Flight Deck-based Merging and Spacing initiated while at cruise altitude and well prior to the Terminal Radar Approach Control entry can significantly contribute to the delivery of aircraft at a specified interval to the runway threshold with a high degree of accuracy and at a reduced pilot workload. Furthermore, previously documented work has shown that using a Continuous Descent Arrival instead of a traditional step-down descent can save fuel, reduce noise, and reduce emissions. Research into Flight Deck-based Merging and Spacing is a cooperative effort between government and industry partners.

  2. A Comparison of Inexact Newton and Coordinate Descent Meshoptimization Technqiues

    SciTech Connect

    Diachin, L F; Knupp, P; Munson, T; Shontz, S

    2004-07-08

    We compare inexact Newton and coordinate descent methods for optimizing the quality of a mesh by repositioning the vertices, where quality is measured by the harmonic mean of the mean-ratio metric. The effects of problem size, element size heterogeneity, and various vertex displacement schemes on the performance of these algorithms are assessed for a series of tetrahedral meshes.

  3. The Challenge of Mars EDL (Entry, Descent, and Landing)

    NASA Technical Reports Server (NTRS)

    Sostaric, Ronald

    2010-01-01

    This slide presentation reviews the some of the challenges of Martian atmospheric entry, descent and landing (EDL) on the surface of Mars. It reviews some of the technological difficulties, and some solutions that are being developed for future unmanned missions with larger payloads than previous landers, and ultimately human spacecraft landing.

  4. The Huygens Descent Trajectory Working Group and the Reconstruction of the Huygens Probe Entry and Descent Trajectory at Titan

    NASA Astrophysics Data System (ADS)

    Atkinson, David H.; Kazeminejad, Bobby; Lebreton*, Jean-Pierre

    2015-04-01

    Cassini/Huygens, a flagship mission to explore the rings, atmosphere, magnetic field, and moons that make up the Saturn system, is a joint endeavor of NASA, the European Space Agency, and Agenzia Spaziale Italiana. Comprising two spacecraft - a Saturn orbiter built by NASA and a Titan entry/descent probe built by the European Space Agency - Cassini/Huygens was launched in October 1997 and arrived at Saturn in 2004. The Huygens probe parachuted to the surface of Titan in January 2005. During the descent, six science instruments provided measurements of Titan's atmosphere, clouds, and winds, and photographed Titan's surface. It was recognized early in the Huygens program that to correctly interpret and correlate results from the probe science experiments and to provide a reference set of data for ground truth calibration of the Cassini orbiter remote sensing observations, an accurate reconstruction of the probe entry and descent trajectory and surface landing location would be necessary. The Huygens Descent Trajectory Working Group (DTWG) was chartered in 1996 as a subgroup of the Huygens Science Working Team. With membership comprising representatives from all the probe engineering and instrument teams as well as representatives of industry and the Cassini and Huygens Project Scientists, the DTWG presented an organizational framework within which instrument data was shared, the entry and descent trajectory reconstruction implemented, and the trajectory reconstruction efficiently disseminated. The primary goal of the Descent Trajectory Working Group was to develop retrieval methodologies for the probe descent trajectory reconstruction from the entry interface altitude of 1270 km to the surface using navigation data, and engineering and science data acquired by the instruments on the Huygens Probe, and to provide a reconstruction of the Huygens probe trajectory from entry to the surface of Titan that is maximally consistent with all available engineering and science

  5. Measurement of CPAS Main Parachute Rate of Descent

    NASA Technical Reports Server (NTRS)

    Ray, Eric S.

    2011-01-01

    The Crew Exploration Vehicle Parachute Assembly System (CPAS) is being designed to land the Orion Crew Module (CM) at a safe rate of descent at splashdown. Flight test performance must be measured to a high degree of accuracy to ensure this requirement is met with the most efficient design possible. Although the design includes three CPAS Main parachutes, the requirement is that the system must not exceed 33 ft/s under two Main parachutes, should one of the Main parachutes fail. Therefore, several tests were conducted with clusters of two Mains. All of the steady-state rate of descent data are normalized to standard sea level conditions and checked against the limit. As the Orion design gains weight, the system is approaching this limit to within measurement precision. Parachute "breathing," cluster interactions, and atmospheric anomalies can cause the rate of descent to vary widely and lead to challenges in characterizing parachute terminal performance. An early test had contradictory rate of descent results from optical trajectory and Differential Global Positioning Systems (DGPS). A thorough analysis of the data sources and error propagation was conducted to determine the uncertainty in the trajectory. It was discovered that the Time Space Position Information (TSPI) from the optical tracking provided accurate position data. However, the velocity from TPSI must be computed via numerical differentiation, which is prone to large error. DGPS obtains position through pseudo-range calculations from multiple satellites and velocity through Doppler shift of the carrier frequency. Because the velocity from DGPS is a direct measurement, it is more accurate than TSPI velocity. To remedy the situation, a commercial off-the-shelf product that combines GPS and an Inertial Measurement Unit (IMU) was purchased to significantly improve rate of descent measurements. This had the added benefit of solving GPS dropouts during aircraft extraction. Statistical probability

  6. RITD - Adapting Mars Entry, Descent and Landing System for Earth

    NASA Astrophysics Data System (ADS)

    Heilimo, Jyri; Harri, Ari-Matti; Aleksashkin, Sergei; Koryanov, Valeri; Arruego, Ignacio; Schmidt, Walter; Haukka, Harri; Finchenko, Valeri; Martynov, Maxim; Ponomarenko, Andrey; Kazakovtsev, Victor; Martin, Susana

    2015-04-01

    We have developed an atmospheric re-entry and descent system concept based on inflatable hypersonic decelerator techniques that were originally developed for Mars. The ultimate goal of this EU-funded RITD-project (Re-entry: Inflatable Technology Development) was to assess the benefits of this technology when deploying small payloads from low Earth orbits to the surface of the Earth with modest costs. The principal goal was to assess and develop a preliminary EDLS design for the entire relevant range of aerodynamic regimes expected to be encountered in Earth's atmosphere during entry, descent and landing. Low Earth Orbit (LEO) and even Lunar applications envisaged include the use of the EDLS approach in returning payloads of 4-8 kg down to the surface. Our development and assessments show clearly that this kind of inflatable technology originally developed for the Martian atmosphere, is feasible for use by Earth entry and descent applications. The preliminary results are highly promising indicating that the current Mars probe design could be used as it is for the Earth. According tp our analyses, the higher atmospheric pressure at an altitude of 12 km and less requires an additional pressurizing device for the in atable system increasing the entry mass by approximately 2 kg. These analyses involved the calculation of 120 different atmospheric entry and descent trajectories. The analysis of the existing technologies and current trends have indicated that the kind of inflatable technology pursued by RITD has high potential to enhance the European space technology expertise. This kind of technology is clearly feasible for utilization by Earth entry and descent applications.

  7. 17 CFR 1.62 - Contract market requirement for floor broker and floor trader registration.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... for floor broker and floor trader registration. 1.62 Section 1.62 Commodity and Securities Exchanges....62 Contract market requirement for floor broker and floor trader registration. (a)(1) Each contract... granted a temporary license as a floor broker; or (ii) Purchase or sell solely for such person's...

  8. 17 CFR 1.62 - Contract market requirement for floor broker and floor trader registration.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... for floor broker and floor trader registration. 1.62 Section 1.62 Commodity and Securities Exchanges....62 Contract market requirement for floor broker and floor trader registration. (a)(1) Each contract... granted a temporary license as a floor broker; or (ii) Purchase or sell solely for such person's...

  9. Demonstration of Pelvic Anatomy by Modified Midline Transection that Maintains Intact Internal Pelvic Organs

    ERIC Educational Resources Information Center

    Steinke, Hanno; Saito, Toshiyuki; Herrmann, Gudrun; Miyaki, Takayoshi; Hammer, Niels; Sandrock, Mara; Itoh, Masahiro; Spanel-Borowski, Katharina

    2010-01-01

    Gross dissection for demonstrating anatomy of the human pelvis has traditionally involved one of two approaches, each with advantages and disadvantages. Classic hemisection in the median plane through the pelvic ring transects the visceral organs but maintains two symmetric pelvic halves. An alternative paramedial transection compromises one side…

  10. Relationships of pelvic structure, body measurements, pelvic area and calving difficulty.

    PubMed

    Johnson, S K; Deutscher, G H; Parkhurst, A

    1988-05-01

    Data on 186 Hereford heifers from five South Dakota ranches were collected to evaluate the relationships of pelvic structure and body measurements with calving difficulty (CD) and pelvic area. Body measurements obtained prebreeding and precalving included two internal pelvic and seven external rump measurements, three pelvic angles and two slope of rump measurements. A calving difficulty score (CDS) of 1 (unassisted) to 8 (Caesarean) was assigned at birth, and calf birth weight was recorded. Data were analyzed using both regression and discriminant analyses. Stepwise regression analysis including all 49 variables showed that calf birth weight was the most important variable influencing CDS (R2 = .33), with precalving pelvic area ranking second (cumulative R2 = .45). Prediction equations that included all variables or only prebreeding variables accounted for 63% and 25% of the variation in CDS, respectively. Pelvic angles and slope of rump variables had low correlations with CDS and pelvic area. Ratios of prebreeding and precalving pelvic areas to calf birth weight significantly decreased as CDS increased. A prebreeding ratio of 4.7 cm2/kg may be beneficial in selection of replacement heifers. In discriminant analyses, the most informative variable in differentiating among levels of CD was calf birth weight. All models significantly discriminated between two CD categories (assisted and unassisted). Models using prebreeding variables only performed as well as those based on precalving variables.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Problems in pelvic cytoreduction - Hostile pelvis.

    PubMed

    Sokmen, Selman

    2015-05-01

    Surgeons learn over time when it is appropriate to recommend an operation. This is particularly true in the management of pelvic carcinomatous disease, which often gives rise to symptoms that are debilitating and difficult to manage by non-surgical means. Radical pelvic cytoreduction, complete resection of all visible tumor, remains the established operation for the treatment of carefully selected patients with biologically favorable tumors. Complexities in pelvic surgery and pelvic cytoreduction cover the strategic evaluation, specific approaches, and management techniques. The essential principle to removal of a very advanced pelvic disease lies in the retroperitoneal surgery. The retroperitoneal approach allows for dissection of the pan-pelvic tumoral mass and deposits using the peritoneum as a pseudo-capsule while identifying vital retroperitoneal structures such as the iliac vessels and ureter. Despite the fact that there are several considerations in favor of cytoreductive surgery, overall morbidity due to its application depends not only on the extent of the surgical procedure but also on the patient's medical fitness, the experience and expertise of the operating surgeon, as well as the quality of the supportive care, particularly anesthesia and critical care. The major source of trouble is the hostile pelvis itself. The reasons are fairly clear: most patients have had incomplete 'in-line' resective attempts, irradiation, and inflammation due to prior overhealing. Many of the complications of the procedure can be ameliorated or eliminated by careful attention to patient preparation, intraoperative meticulous technique, and post-cytoreductive intensive care. Achieving success and safety with these cytoreductive techniques requires extensive knowledge of pelvic anatomy, the use of special techniques of exposure and methods of dissection, a clear understanding of the objectives of the operation, and a flexibility of mind.

  12. Pediatric pelvic fractures in side impact collisions.

    PubMed

    Arbogast, Kristy B; Mari-Gowda, Shresta; Kallan, Michael J; Durbin, Dennis R; Winston, Flaura K

    2002-11-01

    Little is known about the mechanism of pelvic injury in the pediatric population, an age range over which the pelvis undergoes tremendous structural change. We hypothesize that these structural changes influence pelvic fracture injury mechanisms. A probability sample of children under age 16 years in crashes were enrolled in an on-going crash surveillance system which links insurance claims data to telephone survey and crash investigation data. 15,725 children in side impact collisions were studied. Risk of pelvic fracture in side impact collisions was estimated and factors associated with these injuries were identified. Eight cases were examined using in-depth investigation to identify the injury mechanisms. Of our study sample, 0.10% of children suffered a pelvic fracture. The typical child with a pelvic fracture was a 12-15 year old female front row occupant of a passenger car involved in a struck side collision with intrusion. Analyses of the in-depth crash investigations determined that the developmental age of the child was the most important parameter associated with the type of pelvic fracture. Children 8-11 years experienced isolated pubic rami fractures, whereas children 12-15 years experienced multiple fractures of the pelvic ring. This distinct injury pattern is directly related to the ossification during puberty of the cartilage connecting the three bones of the pelvis. A secondary influence on the injury pattern was the geometrical and stiffness incompatibilities between impact partners that resulted in vehicle deformation and rotation of the vehicle seat. In the effort to improve the side impact protection of vehicles, attention should be paid to improved structural chassis design that minimizes the dynamic deformation of the seat. PMID:17096230

  13. [Laparoscopic therapy of functional disorders of the rectum and pelvic floor].

    PubMed

    Herold, A; Bruch, H P

    1997-01-01

    Within 4.5 years, 72 laparoscopic rectopexies were performed. The indications included rectal prolapse, morphologic outlet-constipation and a combination of both. Using a modified suture rectopexy (according to Sudeck), without taking any foreign material we resected the sigmoid in 39 patients. In four cases, a resection of the sigmoid colon was carried out. Conversion rate was 2% and complications that needed reoperation occurred in 9%. No patient died; laparotomy rate was only 4%. In the mean follow up period of 24.1 months (max. 50 months), no recurrent prolapse occurred. Incontinence was abolished or improved in 64% and outlet-constipation was improved in 85%. Laparoscopic rectopexy with or without sigmoid resection seems to be of benefit for the patient: quicker convalescence; less pain; small scars; no recurrence; and improvement of constipation and incontinence. PMID:9574296

  14. New measurements to compare soft tissue anchoring systems in pelvic floor surgery.

    PubMed

    Staat, Manfred; Trenz, Eva; Lohmann, Philipp; Frotscher, Ralf; Klinge, Uwe; Tabaza, Ruth; Kirschner-Hermanns, Ruth

    2012-05-01

    Suburethral slings as well as different meshes are widely used treating stress urinary incontinence and prolaps in women. With the development of MiniSlings and special meshes using less alloplastic material anchorage systems become more important to keep devices in place and to put some tension especially on the MiniSlings. To date, there are many different systems of MiniSlings of different companies on the market which differ in the structure of the used meshes and anchors. A new objective measurement method to compare different properties of MiniSling systems (mesh and anchor) is presented in this article. Ballistic gelatine acts as soft tissue surrogate. Significant differences in parameters like pull-out strength of anchors or shrinkage of meshes under loading conditions have been determined. The form and size of the anchors as well as the structural stability of the meshes are decisive for a proper integration. The tested anchorings sytems showed markedly different mechanical function at their respective load bearing capacity. As the stable fixation of the device in tissue is a prerequisite for a permanet reinforcement, the proposed test system permits further optimisation of anchor and mesh devices to improve the success of the surgical treatment. PMID:22287385

  15. The Evaluation of Bioelectrical Activity of Pelvic Floor Muscles Depending on Probe Location: A Pilot Study

    PubMed Central

    Słupska, Lucyna

    2013-01-01

    Objectives. The main objective was to determine how the depth of probe placement affects functional and resting bioelectrical activity of the PFM and whether the recorded signal might be dependent on the direction in which the probe is rotated. Participants. The study comprised of healthy, nulliparous women between the ages of 21 and 25. Outcome Measures. Bioelectric activity of the PFM was recorded from four locations of the vagina by surface EMG and vaginal probe. Results. There were no statistically significant differences between the results during functional sEMG activity. During resting sEMG activity, the highest bioelectrical activity of the PFM was observed in the L1 and the lowest in the L4 and a statistically significant difference between the highest and the lowest results of resting sEMG activity was observed (P = 0.0043). Conclusion. Different electrodes placement during functional contraction of PFM does not affect the obtained results in sEMG evaluation. In order to diagnose the highest resting activity of PFM the recording plates should be placed toward the anterior vaginal wall and distally from the introitus. However, all of the PFM have similar bioelectrical activity and it seems that these muscles could be treated as a single muscle. PMID:24392449

  16. [Pelvic floor rehabilitation as treatment of female urinary incontinence. Our experience].

    PubMed

    Sebastio, N; Ferri, E; Meli, S; Simonazzi, M; Incarbone, G P; Cortellini, P

    2000-01-01

    We refer herein on a simple program of rehabilitation that may be a first approach the treatment of, U.S.I. In our urodynamic service, we treated 38 female patients, affected by this condition, aged between 37-73 years. The same procedure was applied to all the patients, consisting of 10 seances twice weekly, during which we subjected the patients to biofeedback and vaginal electrostimulation of 50 Hz frequency. The results after 3 months were: 38% restored to normal, 51% improved, 11% unchanged; after 1 year were: 27% restored to normal, 49% improved, the remaining unchanged. As a whole, perineal rehabilitation by this technique can be curative in selected cases and, should it be necessary, can be repeated; its advantages are simplicity, low cost and lack of collateral effects. Motivation and compliance on the part of the patients are, anyhow, the chief factor of success. Moreover, the procedure does not preclude alternative treatments. It is suitable to chose cases where surgery is not so, or else is ill-accepted or has failed.

  17. Phenotyping chronic pelvic pain based on latent class modeling of physical examination.

    PubMed

    Fenton, B W; Grey, S F; Reichenbach, M; McCarroll, M; Von Gruenigen, V

    2013-01-01

    Introduction. Defining clinical phenotypes based on physical examination is required for clarifying heterogeneous disorders such as chronic pelvic pain (CPP). The objective of this study was to determine the number of classes within 4 examinable regions and then establish threshold and optimal exam criteria for the classes discovered. Methods. A total of 476 patients meeting the criteria for CPP were examined using pain pressure threshold (PPT) algometry and standardized numeric scale (NRS) pain ratings at 30 distinct sites over 4 pelvic regions. Exploratory factor analysis, latent profile analysis, and ROC curves were then used to identify classes, optimal examination points, and threshold scores. Results. Latent profile analysis produced two classes for each region: high and low pain groups. The optimal examination sites (and high pain minimum thresholds) were for the abdominal wall region: the pair at the midabdomen (PPT threshold depression of > 2); vulvar vestibule region: 10:00 position (NRS > 2); pelvic floor region: puborectalis (combined NRS > 6); vaginal apex region: uterosacral ligaments (combined NRS > 8). Conclusion. Physical examination scores of patients with CPP are best categorized into two classes: high pain and low pain. Standardization of the physical examination in CPP provides both researchers and general gynecologists with a validated technique.

  18. Pelvic peritoneum in male armadillo and anteater (Xenarthra, Mammalia): a comparative survey.

    PubMed

    Rezende, Lorenna Cardoso; Ferreira, Jussara Rocha

    2013-01-01

    The literature supports the hypothesis that the pelvic excavation is the bottom of the abdominal cavity, which is covered by the peritoneal serous membrane in order to promote visceral dynamics. We studied the peritoneum in eight specimens of Xenarthra (Euphractus sexcinctus, Myrmecophaga tridactyla and Tamandua tetradactyla). The animals were fixed in formaldehyde (10%). For description and analyzes of the pelvic peritoneum, dissection and photo documentation were performed. We saw that the parietal serous membrane reflected, involving the pelvic viscera. The urorectal septum is the floor of the higher pelvis as a serosa reflection between the bladder and the rectum. The bladder and gonads are completely peritonized in adult armadillo. In anteaters and young armadillos, the testicles are in a position analogous to the uterus, joined by the conjunctive septum at the midline and along with the bladder, they partially project to the higher and lower pelvis. In Myrmecophagidae, vesicogenital, rectogenital and sacrorectal recesses were observed. In Dasypodidae, the recesses are similar to those of other recent vertebrates. PMID:23317367

  19. [Robotic assisted laparoscopic colposacropexy in the treatment of pelvic organ prolapse].

    PubMed

    Moreno Sierra, Jesús; Galante Romo, Isabel; Ortiz Oshiro, Elena; Núñez Mora, Carlos; Silmi Moyano, Angel

    2007-05-01

    Laparoscopic colposacropexy has become a substitute for open surgery in the treatment of pelvic organ prolapse. In the same way, robotic assisted surgery is a new step in the evolution of the procedure. In this paper we intend to show our surgical technique and preliminary results. From November 2006 to date, 10 patients have undergone this procedure at the Hospital Clinico San Carlos. The main indication for the operation was existence of symptomatic pelvic prolapse. Both patients with or without hysterectomy have been operated, without making significant differences between them. Preoperative evaluation workout included: cystogram, urinary tract ultrasound and urodynamics in all cases; urinary tract MRI was performed only in selected cases. All patients underwent surgery under general anesthesia, with at least three robotic trocars (8 mm) and one conventional trocar for the assistant; 2 accessory trocars were necessary in some cases, mainly at the beginning of the series. Most procedures in our series were associated with a transobturator suburethral sling for the treatment of stress urinary incontinence or prevention of its appearance after prolapse repair. Our results are comparable to those reported in other larger series in terms of operative time, hospital stay and early or late complications. Pending an evaluation on the long term with larger series, we can include robot assisted colposacropexy among the therapeutic options for symptomatic pelvic floor prolapse repair.

  20. Aberrant reflexes and function of the pelvic organs following spinal cord injury in man.

    PubMed

    Craggs, Michael D; Balasubramaniam, Amirthe Vernie; Chung, Eric A L; Emmanuel, Anton V

    2006-06-30

    Spinal cord injuries can be devastating on quality of life and lost opportunities due to their impact on bladder, bowel and sexual functions. Supra-sacral spinal lesions can cause incontinence by interrupting those pathways, which normally coordinate the bladder, bowel and sphincters. From a scientific perspective, neural control of the pelvic organs is one of the most intriguing in the body, involving both somatic and autonomic pathways participating in an exquisitely fine integration of lumbo-sacral reflexes. This review details the interactions of somatic and autonomic lumbo-sacral pathways responsible for coordinating the bladder and sphincters, the nature of their aberration post-injury and those aspects of neural control of the pelvic organs that are amenable to neurophysiological examination in man. It will focus in greater detail on how measurement of pelvic floor and sphincter reflexes can be used to assess the modulatory effects of sacral autonomic pathways on sacral somatic reflexes and vice versa including the so called "guarding reflex" and vesical inhibitory reflexes. The effects of volitional modulation of these reflexes will be discussed in relation to people with both complete and incomplete lesions. Finally the possible utility of such neurophysiological measures for complementing the established neurological classification and the assessment of somatic sensory-motor impairment in spinal cord injury will be discussed.

  1. Pelvic peritoneum in male armadillo and anteater (Xenarthra, Mammalia): a comparative survey.

    PubMed

    Rezende, Lorenna Cardoso; Ferreira, Jussara Rocha

    2013-01-01

    The literature supports the hypothesis that the pelvic excavation is the bottom of the abdominal cavity, which is covered by the peritoneal serous membrane in order to promote visceral dynamics. We studied the peritoneum in eight specimens of Xenarthra (Euphractus sexcinctus, Myrmecophaga tridactyla and Tamandua tetradactyla). The animals were fixed in formaldehyde (10%). For description and analyzes of the pelvic peritoneum, dissection and photo documentation were performed. We saw that the parietal serous membrane reflected, involving the pelvic viscera. The urorectal septum is the floor of the higher pelvis as a serosa reflection between the bladder and the rectum. The bladder and gonads are completely peritonized in adult armadillo. In anteaters and young armadillos, the testicles are in a position analogous to the uterus, joined by the conjunctive septum at the midline and along with the bladder, they partially project to the higher and lower pelvis. In Myrmecophagidae, vesicogenital, rectogenital and sacrorectal recesses were observed. In Dasypodidae, the recesses are similar to those of other recent vertebrates.

  2. 26. VIEW OF CUT AWAY FLOOR BUILDING 23 2ND FLOOR ...

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

    26. VIEW OF CUT AWAY FLOOR BUILDING 23 2ND FLOOR SHOWING TYPICAL MILL CONSTRUCTION (SECTION OF FLOOR CONTAMINATED WITH HAZARDOUS MATERIAL WAS REMOVED FOR DISPOSAL) - Bryant Electric Company, 1421 State Street, Bridgeport, Fairfield County, CT

  3. Pelvic Organ Support in Animals with Partial Loss of Fibulin-5 in the Vaginal Wall

    PubMed Central

    Shi, Haolin; Balgobin, Sunil; Montoya, T. Ignacio; Yanagisawa, Hiromi; Word, R. Ann

    2016-01-01

    Compromise of elastic fiber integrity in connective tissues of the pelvic floor is most likely acquired through aging, childbirth-associated injury, and genetic susceptibility. Mouse models of pelvic organ prolapse demonstrate systemic deficiencies in proteins that affect elastogenesis. Prolapse, however, does not occur until several months after birth and is thereby acquired with age or after parturition. To determine the impact of compromised levels of fibulin-5 (Fbln5) during adulthood on pelvic organ support after parturition and elastase-induced injury, tissue-specific conditional knockout (cKO) mice were generated in which doxycycline (dox) treatment results in deletion of Fbln5 in cells that utilize the smooth muscle α actin promoter-driven reverse tetracycline transactivator and tetracycline responsive element-Cre recombinase (i.e., Fbln5f/f/SMA++-rtTA/Cre+, cKO). Fbln5 was decreased significantly in the vagina of cKO mice compared with dox-treated wild type or controls (Fbln5f/f/SMA++-rtTA/Cre-/-). In controls, perineal body length (PBL) and bulge increased significantly after delivery but declined to baseline values within 6–8 weeks. Although overt prolapse did not occur in cKO animals, these transient increases in PBL postpartum were amplified and, unlike controls, parturition-induced increases in PBL (and bulge) did not recover to baseline but remained significantly increased for 12 wks. This lack of recovery from parturition was associated with increased MMP-9 and nondetectable levels of Fbln5 in the postpartum vagina. This predisposition to prolapse was accentuated by injection of elastase into the vaginal wall in which overt prolapse occurred in cKO animals, but rarely in controls. Taken together, our model system in which Fbln5 is conditionally knock-downed in stromal cells of the pelvic floor results in animals that undergo normal elastogenesis during development but lose Fbln5 as adults. The results indicate that vaginal fibulin-5 during

  4. [Pelvic actinomycosis in Tunisia: five cases].

    PubMed

    Chelli, Dalenda; Hassini, Abdelwahed; Aloui, Fadhel; Sfar, Ezzeddine; Zouaoui, Béchir; Chelli, Héla; Chanoufi, Badis

    2008-01-01

    Actinomycosis is a rare suppurative disease due to Actinomyces species. These Gram-positive, non-acid fast anaerobic filamentous bacteria are normal inhabitants of the human body, tending to reside in the oropharynx and bowel but are occasionally found in the vagina. Pelvic actinomycosis is a rare bacterial disease in women. Clinical manifestations are various and non specific and may be acute or chronic. No consensus exists for treatment. We reviewed files and identified all five cases of pelvic actinomycosis managed at Obstetrics and Gynaecology department "A" at the Maternity Center of Tunis over an eight-year period (1998-2005). The women's average age was 39.2 years. One patient was menopausal and consulted for bleeding. The other four patients were younger and had all been using an intrauterine device (IUD) for contraception. They presented with acute clinical manifestations. Their main symptom was pelvic pain. Three women had fever, and two presented with urinary tract obstruction. All patients had surgery. A pelvic abscess was found in four cases. Laparoscopic management was possible in only one case. Laparotomy was necessary in the other four. Four women had adnexectomies, two with hysterectomy. Digestive complications occurred in three cases. Actinomycosis was diagnosed only after surgery, by the histological examination. This series confirms the difficulties encountered in the management of pelvic actinomycosis. We review the recent literature and describe the diagnostic and therapeutic procedures currently recommended. The relationship between pelvic actinomycosis and IUDs, the most common method of contraception in Tunisia, is clearly established. Clinical diagnosis of pelvic actinomycosis is difficult because the symptoms are non-specific. Laboratory tests can help by showing serious inflammation, however. Imaging findings are also non-specific and may suggest an abscess or an inflammatory or neoplastic process. Interventional radiology, specifically

  5. The surgical treatment of pelvic bone metastases.

    PubMed

    Müller, Daniel A; Capanna, Rodolfo

    2015-01-01

    Pelvic bone metastases are a growing concern in the field of orthopedic surgery. Patients with pelvic metastasis are individually different with different needs of treatment in order to attain the best possible quality of life despite the advanced stage of disease. A holistic collaboration among the oncologist, radiation therapist, and orthopedic surgeon is mandatory. Special attention has to be directed to osteolytic lesions in the periacetabular region as they can provoke pathological fractures and subsequent functional impairment. Different reconstruction techniques for the pelvis are available; the choice depends on the patient's prognosis, size of the bone defect, and response of the tumor to adjuvant treatment. If all the conservative treatments are exhausted and the patient is not eligible for surgery, one of the various percutaneous ablation procedures can be considered. We propose a pelvic analogue to the treatment algorithm in long bone metastasis and a scoring system in pelvic metastasis. This algorithm aims to simplify the teamwork and to avoid under- or overtreatment of pelvic bone metastases. PMID:25810925

  6. Pelvic-fracture urethral injury in children

    PubMed Central

    Hagedorn, Judith C.; Voelzke, Bryan B.

    2015-01-01

    Objective To review paediatric posterior urethral injuries and the current potential management options; because urethral injury due to pelvic fracture in children is rare and has a low incidence, the management of this type of trauma and its complications remains controversial. Methods We reviewed previous reports identified by searching the PubMed Medline electronic database for clinically relevant articles published in the past 25 years. The search was limited to the keywords ‘pediatric’, ‘pelvic fracture’, ‘urethral injury’, ‘stricture’, ‘trauma’ and ‘reconstruction’. Results Most paediatric urethral injuries are a result of pelvic fractures after high-impact blunt trauma. After the diagnosis, immediate bladder drainage via a suprapubic cystotomy, or urethral realignment, are the initial management options, except for a possible immediate primary repair in girls. The common complications of pelvic fracture-associated urethral injury include urethral stricture formation, incontinence and erectile dysfunction. Excellent results can be achieved with delayed urethroplasty for pelvic fracture-associated urethral injuries. Conclusion Traumatic injury to the paediatric urethra is rare and calls for an immediate diagnosis and management. These devastating injuries have a high complication rate and therefore a close follow-up is warranted to assure adequate delayed repair by a reconstructive urologist. PMID:26019977

  7. Combined acetabulum and pelvic ring injuries.

    PubMed

    Halvorson, Jason J; Lamothe, Jeremy; Martin, C Ryan; Grose, Andrew; Asprinio, David E; Wellman, David; Helfet, David L

    2014-05-01

    Combined fractures of the acetabulum and pelvic ring are more common than previously believed, with an incidence as high as 15.7%. Recent series that include combined injuries indicate that the incidence of lateral compression and anteroposterior compression pelvic ring injuries is similar and that transverse and both-column acetabular fractures are the most common acetabular fracture patterns. Combined injuries most often are the result of high-energy mechanisms, and, compared with patients who present with isolated pelvic or acetabular injury, patients with combined injury typically have higher injury severity scores, higher transfusion requirements, and lower systolic blood pressure, with reported mortality rates of 1.5% to 13%. Treatment requires a multidisciplinary approach. The first priority is resuscitation following the Advanced Trauma Life Support protocols. Once the patient is stable, acetabular fractures and pelvic ring injuries should be assessed individually, and the most appropriate treatment for each should be outlined. These treatments should then be integrated to develop the most appropriate overall treatment strategy. Although outcomes data are available for isolated acetabulum and pelvic ring disruptions, no such data currently exist for combined injuries.

  8. Transverse pelvic rotation during quiet human stance.

    PubMed

    Günther, Michael; Otto, Daniel; Müller, Otto; Blickhan, Reinhard

    2008-04-01

    The mechanism of two-legged quiet stance is unclear. This study specifically investigated biomechanical parameters characterising the mechanisms of rotation around the longitudinal axis (parallel to gravitational acceleration, i.e. in the transverse plane parallel to the ground). Subjects (10) were examined while standing quietly on two force platforms which measured the transverse component of the ground reaction torque (GRT). In addition, right and left hip kinematics were acquired by tracking markers in the sagittal plane. The pelvic rotation in the transverse plane (pelvic angle) was then calculated from the anterior-posterior coordinates of the hip markers. We verified the hypothesis that the pelvis generally may be coupled to the ground by a rotational stiffness provided by both legs. Thus, we asked whether the transverse GRT component may be proportional to the pelvic angle. This hypothesis was rejected. However, the transverse GRT component could be identified as one rotational stabilising mechanism which drove the higher-frequency (>1 Hz) deflections of the pelvic angle back to its lower-frequency fraction. The respective stiffness coefficient between transverse GRT component and relative displacement between higher- and lower-frequency pelvic angular fraction was about 2.4 Nm/degrees. Implications for the character and the localisation of active control of body rotation around the longitudinal axis are discussed.

  9. The Surgical Treatment of Pelvic Bone Metastases

    PubMed Central

    Müller, Daniel A.; Capanna, Rodolfo

    2015-01-01

    Pelvic bone metastases are a growing concern in the field of orthopedic surgery. Patients with pelvic metastasis are individually different with different needs of treatment in order to attain the best possible quality of life despite the advanced stage of disease. A holistic collaboration among the oncologist, radiation therapist, and orthopedic surgeon is mandatory. Special attention has to be directed to osteolytic lesions in the periacetabular region as they can provoke pathological fractures and subsequent functional impairment. Different reconstruction techniques for the pelvis are available; the choice depends on the patient's prognosis, size of the bone defect, and response of the tumor to adjuvant treatment. If all the conservative treatments are exhausted and the patient is not eligible for surgery, one of the various percutaneous ablation procedures can be considered. We propose a pelvic analogue to the treatment algorithm in long bone metastasis and a scoring system in pelvic metastasis. This algorithm aims to simplify the teamwork and to avoid under- or overtreatment of pelvic bone metastases. PMID:25810925

  10. Matrix metalloproteinase-3 gene promoter polymorphisms: A potential risk factor for pelvic organ prolapse

    PubMed Central

    Karachalios, Charalampos; Bakas, Panagiotis; Kaparos, Georgios; Demeridou, Styliani; Liapis, Ilias; Grigoriadis, Charalampos; Liapis, Aggelos

    2016-01-01

    Pelvic organ prolapse (POP) is a common multifactorial condition. Matrix metalloproteinases (MMPs) are enzymes capable of breaking down various connective tissue elements. Single-nucleotide polymorphisms (SNPs) in regulatory areas of MMP-encoding genes can alter their transcription rate, and therefore the possible effect on pelvic floor supporting structures. The insertion of an adenine (A) base in the promoter of the MMP-3 gene at position −1612/−1617 produces a sequence of six adenines (6A), whereas the other allele has five (5A). The aim of the present study was to investigate the possible association of MMP-3 gene promoter SNPs with the risk of POP. The patient group comprised 80 women with clinically significant POP [Stage II, III or IV; POP quantification (POP-Q) system]. The control group consisted of 80 females without any or important pelvic floor support defects (Stages 0 or I; POP-Q system). All the participants underwent the same preoperative evaluation. SNP detection was determined with whole blood sample DNA analysis by quantitative polymerase chain reaction (PCR) in LightCycler® PCR platforms, using the technique of sequence-specific hybridization probe-binding assays and melting temperature curve analysis. The results showed there was no statistically significant difference between 5A/5A, 5A/6A and 6A/6A MMP-3 gene promoter variants in the two study groups (P=0.4758). Therefore, MMP-3 gene promoter SNPs alone is insufficient to increase the genetic susceptibility to POP development. PMID:27588175

  11. Analysis of various descent trajectories for a hypersonic-cruise, cold-wall research airplane

    NASA Technical Reports Server (NTRS)

    Lawing, P. L.

    1975-01-01

    The probable descent operating conditions for a hypersonic air-breathing research airplane were examined. Descents selected were cruise angle of attack, high dynamic pressure, high lift coefficient, turns, and descents with drag brakes. The descents were parametrically exercised and compared from the standpoint of cold-wall (367 K) aircraft heat load. The descent parameters compared were total heat load, peak heating rate, time to landing, time to end of heat pulse, and range. Trends in total heat load as a function of cruise Mach number, cruise dynamic pressure, angle-of-attack limitation, pull-up g-load, heading angle, and drag-brake size are presented.

  12. Apollo LM guidance computer software for the final lunar descent.

    NASA Technical Reports Server (NTRS)

    Eyles, D.

    1973-01-01

    In all manned lunar landings to date, the lunar module Commander has taken partial manual control of the spacecraft during the final stage of the descent, below roughly 500 ft altitude. This report describes programs developed at the Charles Stark Draper Laboratory, MIT, for use in the LM's guidance computer during the final descent. At this time computational demands on the on-board computer are at a maximum, and particularly close interaction with the crew is necessary. The emphasis is on the design of the computer software rather than on justification of the particular guidance algorithms employed. After the computer and the mission have been introduced, the current configuration of the final landing programs and an advanced version developed experimentally by the author are described.

  13. A Symmetric Time-Varying Cluster Rate of Descent Model

    NASA Technical Reports Server (NTRS)

    Ray, Eric S.

    2015-01-01

    A model of the time-varying rate of descent of the Orion vehicle was developed based on the observed correlation between canopy projected area and drag coefficient. This initial version of the model assumes cluster symmetry and only varies the vertical component of velocity. The cluster fly-out angle is modeled as a series of sine waves based on flight test data. The projected area of each canopy is synchronized with the primary fly-out angle mode. The sudden loss of projected area during canopy collisions is modeled at minimum fly-out angles, leading to brief increases in rate of descent. The cluster geometry is converted to drag coefficient using empirically derived constants. A more complete model is under development, which computes the aerodynamic response of each canopy to its local incidence angle.

  14. Efficient Sensor Placement Optimization Using Gradient Descent and Probabilistic Coverage

    PubMed Central

    Akbarzadeh, Vahab; Lévesque, Julien-Charles; Gagné, Christian; Parizeau, Marc

    2014-01-01

    We are proposing an adaptation of the gradient descent method to optimize the position and orientation of sensors for the sensor placement problem. The novelty of the proposed method lies in the combination of gradient descent optimization with a realistic model, which considers both the topography of the environment and a set of sensors with directional probabilistic sensing. The performance of this approach is compared with two other black box optimization methods over area coverage and processing time. Results show that our proposed method produces competitive results on smaller maps and superior results on larger maps, while requiring much less computation than the other optimization methods to which it has been compared. PMID:25196164

  15. Helicopter optimal descent and landing after power loss

    NASA Technical Reports Server (NTRS)

    Johnson, W.

    1977-01-01

    An optimal control solution is obtained for the descent and landing of a helicopter after the loss of power in level flight. The model considers the helicopter vertical velocity, horizontal velocity, and rotor speed; and it includes representations of ground effect, rotor inflow time lag, pilot reaction time, rotor stall, and the induced velocity curve in the vortex ring state. The control (rotor thrust magnitude and direction) required to minimize the vertical and horizontal velocity at contact with the ground is obtained using nonlinear optimal control theory. It is found that the optimal descent after power loss in hover is a purely vertical flight path. Good correlation, even quantitatively, is found between the calculations and (non-optimal) flight test results.

  16. RITD - Adapting Mars Entry, Descent and Landing System for Earth

    NASA Astrophysics Data System (ADS)

    Haukka, H.; Heilimo, J.; Harri, A.-M.; Aleksashkin, S.; Koryanov, V.; Arruego, I.; Schmidt, W.; Finchenko, V.; Martynov, M.; Ponomarenko, A.; Kazakovtsev, V.; Martin, S.

    2015-10-01

    We have developed an atmospheric re-entry and descent system concept based on inflatable hypersonic decelerator techniques that were originally developed for Mars. The ultimate goal of this EU-funded RITD-project (Re-entry: Inflatable Technology Development) was to assess the benefits of this technology when deploying small payloads from low Earth orbits to the surface of the Earth with modest costs. The principal goal was to assess and develop a preliminary EDLS design for the entire relevant range of aerodynamic regimes expected to be encountered in Earth's atmosphere during entry, descent and landing. Low Earth Orbit (LEO) and even Lunar applications envisaged include the use of the EDLS approach in returning payloads of 4-8 kg down to the surface.

  17. Ploughing the deep sea floor.

    PubMed

    Puig, Pere; Canals, Miquel; Company, Joan B; Martín, Jacobo; Amblas, David; Lastras, Galderic; Palanques, Albert

    2012-09-13

    Bottom trawling is a non-selective commercial fishing technique whereby heavy nets and gear are pulled along the sea floor. The direct impact of this technique on fish populations and benthic communities has received much attention, but trawling can also modify the physical properties of seafloor sediments, water–sediment chemical exchanges and sediment fluxes. Most of the studies addressing the physical disturbances of trawl gear on the seabed have been undertaken in coastal and shelf environments, however, where the capacity of trawling to modify the seafloor morphology coexists with high-energy natural processes driving sediment erosion, transport and deposition. Here we show that on upper continental slopes, the reworking of the deep sea floor by trawling gradually modifies the shape of the submarine landscape over large spatial scales. We found that trawling-induced sediment displacement and removal from fishing grounds causes the morphology of the deep sea floor to become smoother over time, reducing its original complexity as shown by high-resolution seafloor relief maps. Our results suggest that in recent decades, following the industrialization of fishing fleets, bottom trawling has become an important driver of deep seascape evolution. Given the global dimension of this type of fishery, we anticipate that the morphology of the upper continental slope in many parts of the world’s oceans could be altered by intensive bottom trawling, producing comparable effects on the deep sea floor to those generated by agricultural ploughing on land. PMID:22951970

  18. Flooring for Schools: Unsightly Walkways

    ERIC Educational Resources Information Center

    Baxter, Mark

    2011-01-01

    Many mattress manufacturers recommend that consumers rotate their mattresses at least twice a year to help prevent soft spots from developing and increase the product's life span. It's unfortunate that the same kind of treatment can't be applied to flooring for schools, such as carpeting, especially in hallways. Being able to flip or turn a carpet…

  19. Ploughing the deep sea floor.

    PubMed

    Puig, Pere; Canals, Miquel; Company, Joan B; Martín, Jacobo; Amblas, David; Lastras, Galderic; Palanques, Albert

    2012-09-13

    Bottom trawling is a non-selective commercial fishing technique whereby heavy nets and gear are pulled along the sea floor. The direct impact of this technique on fish populations and benthic communities has received much attention, but trawling can also modify the physical properties of seafloor sediments, water–sediment chemical exchanges and sediment fluxes. Most of the studies addressing the physical disturbances of trawl gear on the seabed have been undertaken in coastal and shelf environments, however, where the capacity of trawling to modify the seafloor morphology coexists with high-energy natural processes driving sediment erosion, transport and deposition. Here we show that on upper continental slopes, the reworking of the deep sea floor by trawling gradually modifies the shape of the submarine landscape over large spatial scales. We found that trawling-induced sediment displacement and removal from fishing grounds causes the morphology of the deep sea floor to become smoother over time, reducing its original complexity as shown by high-resolution seafloor relief maps. Our results suggest that in recent decades, following the industrialization of fishing fleets, bottom trawling has become an important driver of deep seascape evolution. Given the global dimension of this type of fishery, we anticipate that the morphology of the upper continental slope in many parts of the world’s oceans could be altered by intensive bottom trawling, producing comparable effects on the deep sea floor to those generated by agricultural ploughing on land.

  20. [Chronic prostatitis with chronic pelvic pain syndrome].

    PubMed

    Balvocius, Antanas

    2002-01-01

    Almost 10% of the adult male population suffer from prostatitis. The International Prostatitis Collaborative Network has devised and validated a clinically useful classification of prostatitis that urologists and primary care clinicians will find helpful. According to this schema, chronic bacterial prostatitis is clearly an infectious disease, and patients with chronic prostatitis associated with chronic pelvic pain syndrome can have either inflammatory or noninflammatory disease. Chronic bacterial prostatitis is uncommon, chronic nonbacterial prostatitis (CPPS) is extremely common. Antibiotic therapy is indicated in management of chronic bacterial prostatitis and inflammatory chronic pelvic pain syndrome. Fluoroquinolones are safe and effective in managing chronic bacterial prostatitis. Based on literature, noninflammatory chronic pelvic pain syndrome can be treated using adrenergic blockade, analgesic, tricyclic antidepressants, benzodiazepie, physical therapy. PMID:12556633

  1. A new steepest descent method with global convergence properties

    NASA Astrophysics Data System (ADS)

    Abidin, Zubai'ah Zainal; Mamat, Mustafa; Rivaie, Mohd.

    2016-06-01

    One of the earliest and the best method to minimize a function is the classical steepest descent (SD) method. In this paper, a new modification of SD method is suggested using a new search direction, d k. The numerical results are presented based on number of iterations and CPU time. It shows that the new d k are efficient when compared to the classical SD.

  2. Effect of compliant flooring on impact force during falls on the hip.

    PubMed

    Laing, Andrew C; Tootoonchi, Iman; Hulme, Paul A; Robinovitch, Stephen N

    2006-07-01

    Compliant flooring represents a promising but understudied strategy for reducing impact force and hip fracture risk due to falls in high-risk environments such as nursing homes, hospitals, gymnasiums, and senior centers. We conducted "pelvis release experiments" with young women (n=15) to determine whether floor stiffness influences peak hip impact force during safe, low-height falls. During the trials, we used a pelvic sling and electromagnet to lift and instantly release the participant from a height of 5 cm above a force plate, which measured the force applied to the hip region during impact. Trials were conducted for rigid floor conditions and with layers of ethylene vinyl acetate foam rubber overlying the floor that we regarded as firm (1.5-cm thick; stiffness=263 kN/m), semifirm (4.5-cm thick; stiffness=95 kN/m), semisoft (7.5-cm thick; stiffness=67 kN/m), and soft (10.5-cm thick; stiffness=59 kN/m). When compared to the rigid condition, peak hip impact force averaged 8% lower in the firm condition and 15% lower in the semifirm condition. Peak forces were not significantly different between the semifirm, semisoft, and soft floor conditions, indicating that a 4.5 cm-thick foam mat provides nearly the same force attenuation as a 10.5 cm-thick mat. These results support the need for laboratory experiments to measure the effect of floor stiffness on postural stability and for clinical trials to determine the effect of compliant flooring on hip fracture incidence in high-risk environments. PMID:16705716

  3. Pelvic Fractures in Children Results from the German Pelvic Trauma Registry: A Cohort Study.

    PubMed

    Zwingmann, Jörn; Aghayev, Emin; Südkamp, Norbert P; Neumann, Mirjam; Bode, Gerrit; Stuby, Fabian; Schmal, Hagen

    2015-12-01

    As pelvic fractures in children and adolescents are very rare, the surgical management is not well delineated nor are the postoperative complications. The aim of this study using the prospective data from German Pelvic Trauma Registry study was to evaluate the various treatment approaches compared to adults and delineated the differences in postoperative complications after pelvic injuries.Using the prospective pelvic trauma registry established by the German Society of Traumatology and the German Section of the Arbeitsgemeinschaft für Osteosynthesefragen (AO), International in 1991, patients with pelvic fractures over a 12-year time frame submitted by any 1 of the 23 member level I trauma centers were reviewed.We identified a total of 13,525 patients including pelvic fractures in 13,317 adults and 208 children aged ≤14 years and compared these 2 groups. The 2 groups' Injury Severitiy Score (ISS) did not differ statistically. Lethality in the pediatric group was 6.3%, not statistically different from the adults' 4.6%. In all, 18.3% of the pediatric pelvic fractures were treated surgically as compared to 22.7% in the adult group. No child suffered any thrombosis/embolism, acute respiratory distress syndrome (ARDS), multiorgan failure (MOF), or neurologic deficit, nor was any septic MOF detected. The differences between adults and children were statistically significant in that the children suffered less frequently from thrombosis/embolism (P = 0.041) and ARDS and MOF (P = 0.006).This prospective multicenter study addressing patients with pelvic fractures reveals that the risk for a thrombosis/embolism, ARDS, and MOF is significant lower in pediatric patients than in adults. No statistical differences could be found in the ratios of operative therapy of the pelvic fractures in children compared to adults. PMID:26705223

  4. Pelvic Fractures in Children Results from the German Pelvic Trauma Registry

    PubMed Central

    Zwingmann, Jörn; Aghayev, Emin; Südkamp, Norbert P.; Neumann, Mirjam; Bode, Gerrit; Stuby, Fabian; Schmal, Hagen

    2015-01-01

    Abstract As pelvic fractures in children and adolescents are very rare, the surgical management is not well delineated nor are the postoperative complications. The aim of this study using the prospective data from German Pelvic Trauma Registry study was to evaluate the various treatment approaches compared to adults and delineated the differences in postoperative complications after pelvic injuries. Using the prospective pelvic trauma registry established by the German Society of Traumatology and the German Section of the Arbeitsgemeinschaft für Osteosynthesefragen (AO), International in 1991, patients with pelvic fractures over a 12-year time frame submitted by any 1 of the 23 member level I trauma centers were reviewed. We identified a total of 13,525 patients including pelvic fractures in 13,317 adults and 208 children aged ≤14 years and compared these 2 groups. The 2 groups’ Injury Severitiy Score (ISS) did not differ statistically. Lethality in the pediatric group was 6.3%, not statistically different from the adults’ 4.6%. In all, 18.3% of the pediatric pelvic fractures were treated surgically as compared to 22.7% in the adult group. No child suffered any thrombosis/embolism, acute respiratory distress syndrome (ARDS), multiorgan failure (MOF), or neurologic deficit, nor was any septic MOF detected. The differences between adults and children were statistically significant in that the children suffered less frequently from thrombosis/embolism (P = 0.041) and ARDS and MOF (P = 0.006). This prospective multicenter study addressing patients with pelvic fractures reveals that the risk for a thrombosis/embolism, ARDS, and MOF is significant lower in pediatric patients than in adults. No statistical differences could be found in the ratios of operative therapy of the pelvic fractures in children compared to adults. PMID:26705223

  5. Flight Management System Execution of Idle-Thrust Descents in Operations

    NASA Technical Reports Server (NTRS)

    Stell, Laurel L.

    2011-01-01

    To enable arriving aircraft to fly optimized descents computed by the flight management system (FMS) in congested airspace, ground automation must accurately predict descent trajectories. To support development of the trajectory predictor and its error models, commercial flights executed idle-thrust descents, and the recorded data includes the target speed profile and FMS intent trajectories. The FMS computes the intended descent path assuming idle thrust after top of descent (TOD), and any intervention by the controllers that alters the FMS execution of the descent is recorded so that such flights are discarded from the analysis. The horizontal flight path, cruise and meter fix altitudes, and actual TOD location are extracted from the radar data. Using more than 60 descents in Boeing 777 aircraft, the actual speeds are compared to the intended descent speed profile. In addition, three aspects of the accuracy of the FMS intent trajectory are analyzed: the meter fix crossing time, the TOD location, and the altitude at the meter fix. The actual TOD location is within 5 nmi of the intent location for over 95% of the descents. Roughly 90% of the time, the airspeed is within 0.01 of the target Mach number and within 10 KCAS of the target descent CAS, but the meter fix crossing time is only within 50 sec of the time computed by the FMS. Overall, the aircraft seem to be executing the descents as intended by the designers of the onboard automation.

  6. The African Descent and Glaucoma Evaluation Study (ADAGES): Design and Baseline Data

    PubMed Central

    Sample, Pamela A.; Girkin, Christopher A.; Zangwill, Linda M.; Jain, Sonia; Racette, Lyne; Becerra, Lida M.; Weinreb, Robert N.; Medeiros, Felipe A.; Wilson, M. Roy; De León-Ortega, Julio; Tello, Celso; Bowd, Christopher; Liebmann, Jeffrey M.

    2009-01-01

    Objective To identify factors accounting for differences in glaucoma onset and rate of progression between individuals of African descent and European descent. Design A prospective, multicenter observational cohort study of 1221 participants of African descent and European descent with no glaucoma (normal), suspected glaucoma, and glaucoma. Six hundred eighty-six patient participants in the African Descent and Glaucoma Evaluation Study will be followed up longitudinally. Four hundred thirty-six participants of European descent from the Diagnostic Innovations in Glaucoma Study (DIGS) were also included. Baseline demographics, visual function (standard automated perimetry, short-wavelength automated perimetry, frequency doubling technology perimetry), optic nerve structure (retina tomography, optical coherence tomography), clinical status, and risk factors were measured. Results Individuals of African descent had (1) thinner corneas (P<.001) across all diagnostic groups, (2) a higher percentage of reported diabetes mellitus (P<.001) and high blood pressure (P<.001) and a lower percentage of reported heart disease (P=.001), and (3) worse pattern standard deviation for standard automated perimetry fields overall (P=.001) and within normal limits (P=.01) than individuals of European descent. No differences were present for mean intraocular pressure (P=.79). Conclusions Significant baseline differences were found in a number of clinical findings between persons of African descent compared with European descent. Longitudinal data from the African Descent and Glaucoma Evaluation Study will be important for determining which baseline features are important and predictive for accurate diagnosis and follow-up in this high-risk group. PMID:19752422

  7. Biomechanical Analysis of Stair Descent in Patients with Knee Osteoarthritis

    PubMed Central

    Igawa, Tatsuya; Katsuhira, Junji

    2014-01-01

    [Purpose] The purposes of this study were to investigate the lower extremity joint kinematics and kinetics of patients with the knee osteoarthritis (knee OA) during stair descent and clarify the biomechanical factors related to their difficulty in stair descent. [Subjects and Methods] Eight healthy elderly persons and four knee OA patients participated in this study. A 3-D motion analysis system and force plates were employed to measure lower extremity joint angles, ranges of motion, joint moments, joint powers, and ratios of contribution for the joint powers while descending stairs. [Results] Knee joint flexion angle, extension moment, and negative power during the early stance phase in the knee OA group were smaller than those in the healthy subjects group. However, no significant changes in these parameters in the ankle joint were observed between the two subject groups. [Conclusion] Knee OA patients could not use the knee joint to absorb impact during the early stance phase of stair descent. Hence, they might compensate for the roles played by the intact knee joint by mainly using ipsilateral ankle kinematics and kinetics. PMID:24926119

  8. Biomechanical analysis of stair descent in patients with knee osteoarthritis.

    PubMed

    Igawa, Tatsuya; Katsuhira, Junji

    2014-05-01

    [Purpose] The purposes of this study were to investigate the lower extremity joint kinematics and kinetics of patients with the knee osteoarthritis (knee OA) during stair descent and clarify the biomechanical factors related to their difficulty in stair descent. [Subjects and Methods] Eight healthy elderly persons and four knee OA patients participated in this study. A 3-D motion analysis system and force plates were employed to measure lower extremity joint angles, ranges of motion, joint moments, joint powers, and ratios of contribution for the joint powers while descending stairs. [Results] Knee joint flexion angle, extension moment, and negative power during the early stance phase in the knee OA group were smaller than those in the healthy subjects group. However, no significant changes in these parameters in the ankle joint were observed between the two subject groups. [Conclusion] Knee OA patients could not use the knee joint to absorb impact during the early stance phase of stair descent. Hence, they might compensate for the roles played by the intact knee joint by mainly using ipsilateral ankle kinematics and kinetics.

  9. Random versus Deterministic Descent in RNA Energy Landscape Analysis

    PubMed Central

    Day, Luke; Abdelhadi Ep Souki, Ouala; Albrecht, Andreas A.; Steinhöfel, Kathleen

    2016-01-01

    Identifying sets of metastable conformations is a major research topic in RNA energy landscape analysis, and recently several methods have been proposed for finding local minima in landscapes spawned by RNA secondary structures. An important and time-critical component of such methods is steepest, or gradient, descent in attraction basins of local minima. We analyse the speed-up achievable by randomised descent in attraction basins in the context of large sample sets where the size has an order of magnitude in the region of ~106. While the gain for each individual sample might be marginal, the overall run-time improvement can be significant. Moreover, for the two nongradient methods we analysed for partial energy landscapes induced by ten different RNA sequences, we obtained that the number of observed local minima is on average larger by 7.3% and 3.5%, respectively. The run-time improvement is approximately 16.6% and 6.8% on average over the ten partial energy landscapes. For the large sample size we selected for descent procedures, the coverage of local minima is very high up to energy values of the region where the samples were randomly selected from the partial energy landscapes; that is, the difference to the total set of local minima is mainly due to the upper area of the energy landscapes. PMID:27110241

  10. Titan Explorer Entry, Descent and Landing Trajectory Design

    NASA Technical Reports Server (NTRS)

    Fisher, Jody L.; Lindberg, Robert E.; Lockwood, Mary Kae

    2006-01-01

    The Titan Explorer mission concept includes an orbiter, entry probe and inflatable airship designed to take remote and in-situ measurements of Titan's atmosphere. A modified entry, descent and landing trajectory at Titan that incorporates mid-air airship inflation (under a parachute) and separation is developed and examined for Titan Explorer. The feasibility of mid-air inflation and deployment of an airship under a parachute is determined by implementing and validating an airship buoyancy and inflation model in the trajectory simulation program, Program to Optimize Simulated Trajectories II (POST2). A nominal POST2 trajectory simulation case study is generated which examines different descent scenarios by varying airship inflation duration, orientation, and separation. The buoyancy model incorporation into POST2 is new to the software and may be used in future trajectory simulations. Each case from the nominal POST2 trajectory case study simulates a successful separation between the parachute and airship systems with sufficient velocity change as to alter their paths to avoid collision throughout their descent. The airship and heatshield also separate acceptably with a minimum distance of separation from the parachute system of 1.5 km. This analysis shows the feasibility of airship inflation on a parachute for different orientations, airship separation at various inflation times, and preparation for level-flight at Titan.

  11. A new method for forecasting the solar cycle descent time

    NASA Astrophysics Data System (ADS)

    Kakad, Bharati; Kakad, Amar; Sai Ramesh, Durbha

    2015-08-01

    The prediction of an extended solar minimum is extremely important because of the severity of its impact on the near-earth space. Here, we present a new method for predicting the descent time of the forthcoming solar cycle (SC); the method is based on the estimation of the Shannon entropy. We use the daily and monthly smoothed international sunspot number. For each nth SC, we compute the parameter [Tpre]n by using information on the descent and ascent times of the n - 3th and nth SCs, respectively. We find that [Tpre] of nth SC and entropy can be effectively used to predict the descent time of the n + 2th SC. The correlation coefficient between [Td]n+2 - [Tpre]n and [E]n is found to be 0.95. Using these parameters the prediction model is developed. Solar magnetic field and F10.7 flux data are available for SCs 21-22 and 19-23, respectively, and they are also utilized to get estimates of the Shannon entropy. It is found that the Shannon entropy, a measure of randomness inherent in the SC, is reflected well in the various proxies of the solar activity (viz sunspot, magnetic field, F10.7 flux). The applicability and accuracy of the prediction model equation is verified by way of association of least entropy values with the Dalton minimum. The prediction model equation also provides possible criteria for the occurrence of unusually longer solar minima.

  12. Factors Associated with Sleep Disturbance in Women of Mexican Descent

    PubMed Central

    Heilemann, MarySue V.; Choudhury, Shonali M.; Kury, Felix Salvador; Lee, Kathryn A.

    2014-01-01

    Aims The aims were to identify the most useful parameters of acculturation in relation to self reported sleep disturbance and describe risk factors for sleep disturbance in women of Mexican descent. Background Little is known about acculturation as a factor for poor sleep in the context of other personal factors such as income or sense of resilience or mastery for Latinas in the United States. Methods These personal factors were incorporated into a modification of the Conceptual Framework of Impaired Sleep to guide our secondary analysis of self-reported sleep disturbance. Cross sectional data from a convenience sample of 312 women of Mexican descent of childbearing age (21-40 years) located in an urban California community were collected and previously analyzed in relation to depressive symptoms and post traumatic stress disorder. The General Sleep Disturbance Scale (in English and Spanish) was used to assess sleep disturbance. Results Early socialization to the United States during childhood was the most useful acculturation parameter for understanding self reported sleep disturbance in this sample. In a multivariate regression analysis, three factors (higher acculturation, lower income, and higher depressive symptoms) were significant in accounting for 40% of the variance in sleep disturbance. Conclusion When low income Latinas of Mexican descent report sleep problems, clinicians should probe for environmental sleep factors associated with low income, such as noise, over-crowding, and exposure to trauma and violence, and refer the woman to psychotherapy and counselling rather than merely prescribe a sleep medication. PMID:22221152

  13. Entry, Descent, and Landing Performance of the Mars Phoenix Lander

    NASA Technical Reports Server (NTRS)

    Desai, Prasun N.; Prince, Jill L.; Wueen, Eric M.; Cruz, Juan R.; Grover, Myron R.

    2008-01-01

    On May 25, 2008, the Mars Phoenix Lander successfully landed on the northern arctic plains of Mars. An overview of a preliminary reconstruction analysis performed on each entry, descent, and landing phase to assess the performance of Phoenix as it descended is presented and a comparison to pre-entry predictions is provided. The landing occurred 21 km further downrange than the predicted landing location. Analysis of the flight data revealed that the primary cause of Phoenix s downrange landing was a higher trim total angle of attack during the hypersonic phase of the entry, which resulted in Phoenix flying a slightly lifting trajectory. The cause of this higher trim attitude is not known at this time. Parachute deployment was 6.4 s later than prediction. This later deployment time was within the variations expected and is consistent with a lifting trajectory. The parachute deployment and inflation process occurred as expected with no anomalies identified. The subsequent parachute descent and powered terminal landing also behaved as expected. A preliminary reconstruction of the landing day atmospheric density profile was found to be lower than the best apriori prediction, ranging from a few percent less to a maximum of 8%. A comparison of the flight reconstructed trajectory parameters shows that the actual Phoenix entry, descent, and landing was close to pre-entry predictions. This reconstruction investigation is currently ongoing and the results to date are in the process of being refined.

  14. Free-falls and parachute descents in the standard atmosphere

    NASA Technical Reports Server (NTRS)

    Webster, A P

    1947-01-01

    A detailed table of the standard equilibrium velocity and standard equilibrium time is presented for bodies falling in the standard atmosphere. This table gives the velocity at various altitudes and the time of fall from sea level to -4000 feet and from 80,000 feet to sea level. In addition to this standard table, there are given short tables and charts of an open-parachute descent and free-falls; the terminal velocity at sea level, and the variation of the weight-to-drag ratio (2w/cds)1/2 for various weight jumpers from 90 to 30 feet in open-parachute descent; and estimations of drag coefficients of silk and nylon parachutes. The table of standard equilibrium velocities and standard equilibrium times may be used directly for open-parachute descents, given the weight of the jumper, the diameter of the parachute, and the drag coefficient. For free-falls starting from horizontal flight, approximately 14 seconds must be added to the equilibrium time given in the table to obtain the total time to sea level. (author)

  15. Airborne Management of Traffic Conflicts in Descent With Arrival Constraints

    NASA Technical Reports Server (NTRS)

    Doble, Nathan A.; Barhydt, Richard; Krishnamurthy, Karthik

    2005-01-01

    NASA is studying far-term air traffic management concepts that may increase operational efficiency through a redistribution of decisionmaking authority among airborne and ground-based elements of the air transportation system. One component of this research, En Route Free Maneuvering, allows trained pilots of equipped autonomous aircraft to assume responsibility for traffic separation. Ground-based air traffic controllers would continue to separate traffic unequipped for autonomous operations and would issue flow management constraints to all aircraft. To evaluate En Route Free Maneuvering operations, a human-in-the-loop experiment was jointly conducted by the NASA Ames and Langley Research Centers. In this experiment, test subject pilots used desktop flight simulators to resolve conflicts in cruise and descent, and to adhere to air traffic flow constraints issued by test subject controllers. Simulators at NASA Langley were equipped with a prototype Autonomous Operations Planner (AOP) flight deck toolset to assist pilots with conflict management and constraint compliance tasks. Results from the experiment are presented, focusing specifically on operations during the initial descent into the terminal area. Airborne conflict resolution performance in descent, conformance to traffic flow management constraints, and the effects of conflicting traffic on constraint conformance are all presented. Subjective data from subject pilots are also presented, showing perceived levels of workload, safety, and acceptability of autonomous arrival operations. Finally, potential AOP functionality enhancements are discussed along with suggestions to improve arrival procedures.

  16. Random versus Deterministic Descent in RNA Energy Landscape Analysis.

    PubMed

    Day, Luke; Abdelhadi Ep Souki, Ouala; Albrecht, Andreas A; Steinhöfel, Kathleen

    2016-01-01

    Identifying sets of metastable conformations is a major research topic in RNA energy landscape analysis, and recently several methods have been proposed for finding local minima in landscapes spawned by RNA secondary structures. An important and time-critical component of such methods is steepest, or gradient, descent in attraction basins of local minima. We analyse the speed-up achievable by randomised descent in attraction basins in the context of large sample sets where the size has an order of magnitude in the region of ~10(6). While the gain for each individual sample might be marginal, the overall run-time improvement can be significant. Moreover, for the two nongradient methods we analysed for partial energy landscapes induced by ten different RNA sequences, we obtained that the number of observed local minima is on average larger by 7.3% and 3.5%, respectively. The run-time improvement is approximately 16.6% and 6.8% on average over the ten partial energy landscapes. For the large sample size we selected for descent procedures, the coverage of local minima is very high up to energy values of the region where the samples were randomly selected from the partial energy landscapes; that is, the difference to the total set of local minima is mainly due to the upper area of the energy landscapes.

  17. Laparoendoscopic single site in pelvic surgery.

    PubMed

    Sanchez-Salas, Rafael; Clavijo, Rafael; Barret, Eric; Sotelo, Rene

    2012-01-01

    Laparoendoscopic single site (LESS) has recently gained momentum as feasible techniques for minimal access surgery. Our aim is to describe the current status of laparoendoscopic single site (LESS) in pelvic surgery. A comprehensive revision of the literature in LESS pelvic surgery was performed. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-01 to 30-11-11. References outside the search period were obtained selected manuscript΄s bibliography. Search terms included: pelvic anatomy, less in gynecology, single port colectomy, urological less, single port, single site, NOTES, LESS and single incision. 314 manuscripts were initially identified. Out of these, 46 manuscripts were selected based in their pelvic anatomy or surgical content; including experimental experience, clinical series and literature reviews. LESS drastically limit the surgeon's ability to perform in the operative field and the latter becomes hardened by the lack of space in anatomical location like the pelvis. Potential advantages of LESS are gained with the understanding that the surgical procedure is more technically challenging. Pelvic surgical procedures related to colorectal surgery, gynecology and urology have been performed with LESS technique and information available is mostly represented by case reports and short case series. Comparative series remain few. LESS pelvic surgery remain in its very beginning and due to the very specific anatomical conditions further development of LESS surgery in the mentioned area can be clearly be facilitated by using robotic technology. Standardization ad reproducibility of techniques are mandatory to further develop LESS in the surgical arena..

  18. [Influence of the pelvic trauma registry of the DGU on treatment of pelvic ring fractures].

    PubMed

    Holstein, J H; Stuby, F M; Herath, S C; Culemann, U; Aghayev, E; Pohlemann, T

    2016-06-01

    Fractures of the pelvic ring are comparatively rare with an incidence of 2-8 % of all fractures depending on the study in question. The severity of pelvic ring fractures can be very different ranging from simple and mostly "harmless" type A fractures up to life-threatening complex type C fractures. Although it was previously postulated that high-energy trauma was necessary to induce a pelvic ring fracture, over the past decades it became more and more evident, not least from data in the pelvic trauma registry of the German Society for Trauma Surgery (DGU), that low-energy minor trauma can also cause pelvic ring fractures of osteoporotic bone and in a rapidly increasing population of geriatric patients insufficiency fractures of the pelvic ring are nowadays observed with no preceding trauma.Even in large trauma centers the number of patients with pelvic ring fractures is mostly insufficient to perform valid and sufficiently powerful monocentric studies on epidemiological, diagnostic or therapeutic issues. For this reason, in 1991 the first and still the only registry worldwide for the documentation and evaluation of pelvic ring fractures was introduced by the Working Group Pelvis (AG Becken) of the DGU. Originally, the main objectives of the documentation were epidemiological and diagnostic issues; however, in the course of time it developed into an increasingly expanding dataset with comprehensive parameters on injury patterns, operative and conservative therapy regimens and short-term and long-term outcome of patients. Originally starting with 10 institutions, in the meantime more than 30 hospitals in Germany and other European countries participate in the documentation of data. In the third phase of the registry alone, which was started in 2004, data from approximately 15,000 patients with pelvic ring and acetabular fractures were documented. In addition to the scientific impact of the pelvic trauma registry, which is reflected in the numerous national and

  19. [Imaging of acute pelvic pain in women].

    PubMed

    Genevois, A; Marouteau, N; Lemercier, E; Dacher, J N; Thiebot, J

    2008-01-01

    Acute pelvic pain in women is a routine situation in any emergency unit. The radiologist should know how to explore the patient with regards to the history and clinical findings. Ultrasonography is the primary and sometimes the only necessary imaging tool in the assessment of acute pelvic pain in women. MRI is the preferred technique in pregnant or young women. CT is more valuable for assessing nongynecologic disorders or post-partum and post-operative infections. This article reviews the contribution of each imaging technique in this clinical situation. Emphasis is put on the importance of age and clinical findings in the diagnostic strategy. PMID:18288036

  20. [Imaging of acute pelvic pain in women].

    PubMed

    Genevois, A; Marouteau, N; Lemercier, E; Dacher, J N; Thiebot, J

    2008-01-01

    Acute pelvic pain in women is a routine situation in any emergency unit. The radiologist should know how to explore the patient with regards to the history and clinical findings. Ultrasonography is the primary and sometimes the only necessary imaging tool in the assessment of acute pelvic pain in women. MRI is the preferred technique in pregnant or young women. CT is more valuable for assessing nongynecologic disorders or post-partum and post-operative infections. This article reviews the contribution of each imaging technique in this clinical situation. Emphasis is put on the importance of age and clinical findings in the diagnostic strategy.

  1. Raise the Floor When Remodeling Science Labs

    ERIC Educational Resources Information Center

    Nation's Schools, 1972

    1972-01-01

    A new remodeling idea adopts the concept of raised floor covering gas, water, electrical, and drain lines. The accessible floor has removable panels set into an adjustable support frame 24 inches above a concrete subfloor. (Author)

  2. Sea-Floor Spreading and Transform Faults

    ERIC Educational Resources Information Center

    Armstrong, Ronald E.; And Others

    1978-01-01

    Presents the Crustal Evolution Education Project (CEEP) instructional module on Sea-Floor Spreading and Transform Faults. The module includes activities and materials required, procedures, summary questions, and extension ideas for teaching Sea-Floor Spreading. (SL)

  3. Mars Science Laboratory: Entry, Descent, and Landing System Performance

    NASA Technical Reports Server (NTRS)

    Way, David W.; Powell, Richard W.; Chen, Allen; Steltzner, Adam D.; San Martin, Alejandro M.; Burkhart, Paul D.; mendeck, Gavin F.

    2006-01-01

    In 2010, the Mars Science Laboratory (MSL) mission will pioneer the next generation of robotic Entry, Descent, and Landing (EDL) systems, by delivering the largest and most capable rover to date to the surface of Mars. To do so, MSL will fly a guided lifting entry at a lift-to-drag ratio in excess of that ever flown at Mars, deploy the largest parachute ever at Mars, and perform a novel Sky Crane maneuver. Through improved altitude capability, increased latitude coverage, and more accurate payload delivery, MSL is allowing the science community to consider the exploration of previously inaccessible regions of the planet. The MSL EDL system is a new EDL architecture based on Viking heritage technologies and designed to meet the challenges of landing increasing massive payloads on Mars. In accordance with level-1 requirements, the MSL EDL system is being designed to land an 850 kg rover to altitudes as high as 1 km above the Mars Orbiter Laser Altimeter defined areoid within 10 km of the desired landing site. Accordingly, MSL will enter the largest entry mass, fly the largest 70 degree sphere-cone aeroshell, generate the largest hypersonic lift-to-drag ratio, and deploy the largest Disk-Gap-Band supersonic parachute of any previous mission to Mars. Major EDL events include a hypersonic guided entry, supersonic parachute deploy and inflation, subsonic heatshield jettison, terminal descent sensor acquisition, powered descent initiation, sky crane terminal descent, rover touchdown detection, and descent stage flyaway. Key performance metrics, derived from level-1 requirements and tracked by the EDL design team to indicate performance capability and timeline margins, include altitude and range at parachute deploy, time on radar, and propellant use. The MSL EDL system, which will continue to develop over the next three years, will enable a notable extension in the advancement of Mars surface science by delivering more science capability than ever before to the surface of

  4. Mars Science Laboratory: Entry, Descent, and Landing System Performance

    NASA Technical Reports Server (NTRS)

    Way, David W.; Powell, Richard W.; Chen, Allen; SanMartin, A. Miguel; Burkhart, P. Daniel; Mendeck, Gavin F.

    2007-01-01

    In 2010, the Mars Science Laboratory (MSL) mission will pioneer the next generation of robotic Entry, Descent, and Landing (EDL) systems, by delivering the largest and most capable rover to date to the surface of Mars. To do so, MSL will fly a guided lifting entry at a lift-to-drag ratio in excess of that ever flown at Mars, deploy the largest parachute ever at Mars, and perform a novel Sky Crane maneuver. Through improved altitude capability, increased latitude coverage, and more accurate payload delivery, MSL is allowing the science community to consider the exploration of previously inaccessible regions of the planet. The MSL EDL system is a new EDL architecture based on Viking heritage technologies and designed to meet the challenges of landing increasing massive payloads on Mars. In accordance with level-1 requirements, the MSL EDL system is being designed to land an 850 kg rover to altitudes as high as 1 km above the Mars Orbiter Laser Altimeter defined areoid within 10 km of the desired landing site. Accordingly, MSL will enter the largest entry mass, fly the largest 70 degree sphere-cone aeroshell, generate the largest hypersonic lift-to-drag ratio, and deploy the largest Disk-Gap-Band supersonic parachute of any previous mission to Mars. Major EDL events include a hypersonic guided entry, supersonic parachute deploy and inflation, subsonic heatshield jettison, terminal descent sensor acquisition, powered descent initiation, sky crane terminal descent, rover touchdown detection, and descent stage flyaway. Key performance metrics, derived from level-1 requirements and tracked by the EDL design team to indicate performance capability and timeline margins, include altitude and range at parachute deploy, time on radar, and propellant use. The MSL EDL system, which will continue to develop over the next three years, will enable a notable extension in the advancement of Mars surface science by delivering more science capability than ever before to the surface of

  5. [TREATMENT OF URINARY INCONTINENCE AFTER RADICAL PROSTATECTOMY USING TRAINING OF PELVIC MUSCLES UNDER THE CONTROL OF BIOFEEDBACK].

    PubMed

    Demidko, Yu L; Glybochko, P V; Vinarov, A Z; Rapoport, L M; Chaly, M E; Akhvlediani, N D; Esilevsky, Yu M; Demidko, L S; Bayduvaliev, A M; Myannik, S A

    2015-01-01

    Urinary incontinence (UI) is one of the most frequent complications of radical prostatectomy (RPE) performed for prostate cancer. Conservative methods of treatment include pelvic floor muscle training under the control of biofeedback (BFB). This method was applied in 87 patients who underwent radical prostatectomy. 42 (48.3%) patients for 2-4 sessions had achieved skill of isolated contraction of the perineum muscles with minimal participation of anterior abdominal wall muscles. Another 45 (51.7%) patients required support in the form of biofeedback for two EMG channels. The best time for observed regression of clinical symptoms was 5.1 months. In patients with stable skill of isolated pelvic muscle contractions this parameter was 4 months, and in the absence of sustainable skill of isolated contractions - 9.4 months (p=0.001).

  6. PELVIC ACTINOMYCOSIS MIMICKING A LOCALLY ADVANCED PELVIC MALIGNANCY--CASE REPORT.

    PubMed

    Velenciuc, Natalia; Velenciuc, I; Makkai Popa, S; Roată, C; Ferariu, D; Luncă, S

    2016-01-01

    We present the case of a former user of an intrauterine contraceptive device (IUD) for 10 years, diagnosed with a bulky, fixed pelvic tumor involving the internal genital organs and the recto sigmoid, causing luminal narrowing of the rectum, interpreted as locally advanced pelvic malignancy, probably of genital origin. Intraoperatively, a high index of suspicion made us collect a sample from the fibrous wall of the tumor mass, large Actinomyces colonies were thus identified. Surgery consisted in debridement, removal of a small amount of pus and appendectomy, thus avoiding a mutilating and useless surgery. Specific antibiotic therapy was administered for 3 months, with favorable postoperative and long-term outcomes. Pelvic actinomycosis should always be considered in the differential diagnosis of pelvic tumors in women using an IUD. The association of long-term antibiotic treatment is essential to eradicate the infection and prevent relapses. PMID:27483724

  7. 49 CFR 38.59 - Floor surfaces.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 1 2012-10-01 2012-10-01 false Floor surfaces. 38.59 Section 38.59 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES Rapid Rail Vehicles and Systems § 38.59 Floor surfaces. Floor surfaces on aisles, places for standees, and...

  8. 14 CFR 25.793 - Floor surfaces.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Floor surfaces. 25.793 Section 25.793 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Personnel and Cargo Accommodations § 25.793 Floor surfaces. The floor surface of...

  9. 49 CFR 38.59 - Floor surfaces.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 1 2013-10-01 2013-10-01 false Floor surfaces. 38.59 Section 38.59 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES Rapid Rail Vehicles and Systems § 38.59 Floor surfaces. Floor surfaces on aisles, places for standees, and...

  10. 49 CFR 38.59 - Floor surfaces.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 1 2014-10-01 2014-10-01 false Floor surfaces. 38.59 Section 38.59 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES Rapid Rail Vehicles and Systems § 38.59 Floor surfaces. Floor surfaces on aisles, places for standees, and...

  11. 7 CFR 2902.39 - Floor strippers.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Floor strippers. (a) Definition. Products that are formulated to loosen waxes, resins, or varnishes from floor surfaces. They can be in either liquid or gel form, and may also be used with or without... 7 Agriculture 15 2010-01-01 2010-01-01 false Floor strippers. 2902.39 Section 2902.39...

  12. 7 CFR 993.107 - Floor inspection.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Floor inspection. 993.107 Section 993.107 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Administrative Rules and Regulations Definitions § 993.107 Floor inspection. Floor inspection means inspection...

  13. 7 CFR 993.505 - Floor inspection.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Floor inspection. 993.505 Section 993.505 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Pack Specification as to Size Definitions § 993.505 Floor inspection. Floor inspection means...

  14. 49 CFR 38.59 - Floor surfaces.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false Floor surfaces. 38.59 Section 38.59 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES Rapid Rail Vehicles and Systems § 38.59 Floor surfaces. Floor...

  15. 7 CFR 993.505 - Floor inspection.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Floor inspection. 993.505 Section 993.505 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Pack Specification as to Size Definitions § 993.505 Floor inspection. Floor inspection means...

  16. 14 CFR 25.793 - Floor surfaces.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Floor surfaces. 25.793 Section 25.793 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... Floor surfaces. The floor surface of all areas which are likely to become wet in service must have...

  17. 7 CFR 993.107 - Floor inspection.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Floor inspection. 993.107 Section 993.107 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Administrative Rules and Regulations Definitions § 993.107 Floor inspection. Floor inspection means inspection...

  18. 36 CFR 1192.59 - Floor surfaces.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Floor surfaces. 1192.59 Section 1192.59 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE... Rail Vehicles and Systems § 1192.59 Floor surfaces. Floor surfaces on aisles, places for standees,...

  19. 14 CFR 25.793 - Floor surfaces.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Floor surfaces. 25.793 Section 25.793 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... Floor surfaces. The floor surface of all areas which are likely to become wet in service must have...

  20. 36 CFR 1192.59 - Floor surfaces.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Floor surfaces. 1192.59 Section 1192.59 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE... Rail Vehicles and Systems § 1192.59 Floor surfaces. Floor surfaces on aisles, places for standees,...

  1. 49 CFR 38.59 - Floor surfaces.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Floor surfaces. 38.59 Section 38.59 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES Rapid Rail Vehicles and Systems § 38.59 Floor surfaces. Floor...

  2. Sexual selection targets cetacean pelvic bones.

    PubMed

    Dines, James P; Otárola-Castillo, Erik; Ralph, Peter; Alas, Jesse; Daley, Timothy; Smith, Andrew D; Dean, Matthew D

    2014-11-01

    Male genitalia evolve rapidly, probably as a result of sexual selection. Whether this pattern extends to the internal infrastructure that influences genital movements remains unknown. Cetaceans (whales and dolphins) offer a unique opportunity to test this hypothesis: since evolving from land-dwelling ancestors, they lost external hind limbs and evolved a highly reduced pelvis that seems to serve no other function except to anchor muscles that maneuver the penis. Here, we create a novel morphometric pipeline to analyze the size and shape evolution of pelvic bones from 130 individuals (29 species) in the context of inferred mating system. We present two main findings: (1) males from species with relatively intense sexual selection (inferred by relative testes size) tend to evolve larger penises and pelvic bones compared to their body length, and (2) pelvic bone shape has diverged more in species pairs that have diverged in inferred mating system. Neither pattern was observed in the anterior-most pair of vertebral ribs, which served as a negative control. This study provides evidence that sexual selection can affect internal anatomy that controls male genitalia. These important functions may explain why cetacean pelvic bones have not been lost through evolutionary time.

  3. Septic Pelvic Thrombophlebitis Following Laparoscopic Hysterectomy

    PubMed Central

    Farhady, Parastoo; Lemyre, Madeleine

    2009-01-01

    Background: The diagnosis of septic pelvic thrombophlebitis is frequently one of exclusion; a suspicion should arise when fever fails to respond to standard broad-spectrum antibiotic therapy and defervesces within 48 hours of the addition of systemic anticoagulation. The risk of a thromboembolic event following minimally invasive surgery is not well defined. Case Report: We report the first case of septic pelvic thrombophlebitis following laparoscopic hysterectomy in a 51-year-old woman who developed fever on postoperative day 4. The fever workup was negative. The patient's temperature spikes were unresponsive to medical management. A clinical diagnosis of septic pelvic thrombophlebitis was made, and the patient responded excellently to anticoagulation in conjunction with antibiotic therapy. Conclusion: Although rare, septic pelvic thrombophlebitis should be suspected after laparoscopy in patients with appropriate risk factors and persistent fever despite antibiotic therapy. Considerable benefit will be derived from clinical trials that study and provide data on the risk and incidence of thromboembolism after laparoscopic procedures. PMID:19366549

  4. Pelvic fibromatoses--a rare gynecological entity.

    PubMed

    Buckshee, K; Mittal, S; Agarwal, N; Chellani, M

    1988-06-01

    A rare case of pelvic fibromatoses is reported. This condition is rarely encountered in gynecological practice but when encountered, creates a diagnostic and therapeutic challenge. The reported patient highlights the difficulties encountered in surgical excision (done twice) and illustrates the local aggressive growth behavior of this entity.

  5. [Endoscopic treatment of pelvic inflamatory disease].

    PubMed

    Baltadzhieva, B; Novachkov, V; Ilieva, A; Dimitrov, D

    2006-01-01

    The authors present their own attempt of miniinvasive management of pelvic inflammatory disease. Two groups of patients are compared--in the first one the women are treated only conservatively, while the second one has undergone miniinvasive surgical treatment. The preferences of combined therapy are pointed out.

  6. Sexual selection targets cetacean pelvic bones

    PubMed Central

    Dines, J. P.; Otárola-Castillo, E.; Ralph, P.; Alas, J.; Daley, T.; Smith, A. D.; Dean, M. D.

    2014-01-01

    Male genitalia evolve rapidly, probably as a result of sexual selection. Whether this pattern extends to the internal infrastructure that influences genital movements remains unknown. Cetaceans (whales and dolphins) offer a unique opportunity to test this hypothesis: since evolving from land-dwelling ancestors, they lost external hind limbs and evolved a highly reduced pelvis which seems to serve no other function except to anchor muscles that maneuver the penis. Here we create a novel morphometric pipeline to analyze the size and shape evolution of pelvic bones from 130 individuals (29 species) in the context of inferred mating system. We present two main findings: 1) males from species with relatively intense sexual selection (inferred by relative testes size) have evolved relatively large penises and pelvic bones compared to their body size, and 2) pelvic bone shape diverges more quickly in species pairs that have diverged in inferred mating system. Neither pattern was observed in the anterior-most pair of vertebral ribs, which served as a negative control. This study provides evidence that sexual selection can affect internal anatomy that controls male genitalia. These important functions may explain why cetacean pelvic bones have not been lost through evolutionary time. PMID:25186496

  7. MUSCLE TENDERNESS IN MEN WITH CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME: THE CHRONIC PROSTATITIS COHORT STUDY

    PubMed Central

    Shoskes, Daniel A.; Berger, Richard; Elmi, Angelo; Landis, J. Richard; Propert, Kathleen J.; Zeitlin, Scott

    2009-01-01

    Introduction Myofascial pain is a possible etiology for category III chronic prostatitis/chronic pelvic pain syndrome (CPPS), either secondary to infection/inflammation or as the primary cause. We wished to document tenderness on physical exam in a large multicenter cohort of CPPS patients, and compare to controls. Methods Data were reviewed from the NIH Chronic Prostatitis Cohort study on 384 men with CPPS and 121 asymptomatic controls who had complete unblinded physical exam data, from 7 clinical centers between 10/98 - 8/01. Tenderness in 11 sites including prostate, genitals, abdomen and pelvic floor together with prostate size and consistency was evaluated. Data was correlated with cultures and symptoms. Results Overall, 51% of CPPS patients and 7% of controls had any tenderness. The most common site was prostate (41% CPPS, 5% controls), followed by external and internal pelvic floor (13% and 14% CPPS, 0 controls) and suprapubic (9% CPPS, 0 controls). In CPPS patients, 25% had 1 tender site, 11% had 2 and 6% had 3. Tenderness did not correlate with inflammation or infection in the prostate fluid. Prostate consistency was normal in 79% of CPPS patients and in 95% of controls, and did not correlate with symptom severity. CPPS patients with any tenderness had significantly higher CPSI scores at baseline, and at 1 year (24.1 vs 21.2 and 20.2 vs 17.5, p<0.0001), compared to patients without tenderness. Conclusions Abdominal/pelvic tenderness is present in half of CPPS patients, but only 7% of controls. Extraprostatic tenderness may identify a cohort of patients with a neuromuscular source of pain. PMID:18082223

  8. Descent of the hyoid in chimpanzees: evolution of face flattening and speech.

    PubMed

    Nishimura, Takeshi; Mikami, Akichika; Suzuki, Juri; Matsuzawa, Tetsuro

    2006-09-01

    The human supralaryngeal vocal tract develops to form a unique two-tube configuration with equally long horizontal and vertical cavities. This anatomy contributes greatly to the morphological foundations of human speech. It is believed to depend on the reduced growth of the palate and on the developmental descent of the larynx relative to the palate. Anatomically, the descent of the larynx is accomplished through both the descent of the laryngeal skeleton relative to the hyoid and the descent of the hyoid relative to the palate. We have studied the development of three living chimpanzees using magnetic resonance imaging. Our previous study showed that, as in humans, chimpanzees show rapid laryngeal descent, with changes in the relative proportion of the vocal tract during early infancy. However, this is not accompanied by the descent of the hyoid relative to the palate, although it is achieved with the descent of the laryngeal skeleton relative to the hyoid. Here, we show that subsequently the chimpanzee hyoid also descends to maintain the rapid descent of the larynx, similarly to humans. We argue that the descent of the larynx probably evolved in a common ancestor of extant hominoids, originally to confer an advantage via a function unrelated to speech. Thus, the descent of the larynx per se is not unique to humans, and facial flattening was probably the major factor that paved the way for speech in the human lineage.

  9. [Modern aspects of surgical treatment of locally advanced pelvic cancer].

    PubMed

    Solovyov, I A; Vasilchenko, M V; Lychev, A B; Ambartsumyan, S V; Alekseev, V V

    2015-09-01

    The aim of investigation is to improve surgical treatment of patients with locally advanced pelvic cancer. The basis of investigation is 186 patients with locally advanced pelvic cancer. The average age of patients is 65.2 ± 5.2 years (from 43.7 to 88.4 years). Among them are 112 women and 74 men. In the period from 2007 to 2015 they were carried out combined (101 patients) and expanded (85 patients) surgical intervention in the department of naval surgery of the Military medical academy after S.M.Kirov. Pelvic evisceration was performed in 63 cases. Both patients were performed isolated vascular hyperthermic chemical pelvic perfusion. Indications for plastic surgery of peritoneum pelvic were: total infralitoral pelvic evisceration (9 patients), dorsal infralitoral pelvic evisceration (11 cases) and expanded abdominoperineal rectum extirpation (34 patients). Plastic surgery with autogenouse tissues was performed to 43 patients, with reticulate explants--to 11 patients. The rate of postoperative complications was 40.2%. The rate of postoperative lethality was 8%. Expanded and combined operations of pelvic at patients with locally advanced cancer without absolute contra-indications can be performed irrespective of age. Plastic surgery of peritoneum pelvic after total and dorsal infralitoral pelvic evisceration and expanded abdominoperineal rectum extirpation indicated in all cases. The easiest method is plastic surgery with greater omentum or peritoneum pelvic. Plastic surgery with reticulate explants is performed when autoplastic is impossible. PMID:26827515

  10. Entry, Descent, and Landing for Human Mars Missions

    NASA Technical Reports Server (NTRS)

    Munk, Michelle M.; DwyerCianciolo, Alicia M.

    2012-01-01

    One of the most challenging aspects of a human mission to Mars is landing safely on the Martian surface. Mars has such low atmospheric density that decelerating large masses (tens of metric tons) requires methods that have not yet been demonstrated, and are not yet planned in future Mars missions. To identify the most promising options for Mars entry, descent, and landing, and to plan development of the needed technologies, NASA's Human Architecture Team (HAT) has refined candidate methods for emplacing needed elements of the human Mars exploration architecture (such as ascent vehicles and habitats) on the Mars surface. This paper explains the detailed, optimized simulations that have been developed to define the mass needed at Mars arrival to accomplish the entry, descent, and landing functions. Based on previous work, technology options for hypersonic deceleration include rigid, mid-L/D (lift-to-drag ratio) aeroshells, and inflatable aerodynamic decelerators (IADs). The hypersonic IADs, or HIADs, are about 20% less massive than the rigid vehicles, but both have their technology development challenges. For the supersonic regime, supersonic retropropulsion (SRP) is an attractive option, since a propulsive stage must be carried for terminal descent and can be ignited at higher speeds. The use of SRP eliminates the need for an additional deceleration system, but SRP is at a low Technology Readiness Level (TRL) in that the interacting plumes are not well-characterized, and their effect on vehicle stability has not been studied, to date. These architecture-level assessments have been used to define the key performance parameters and a technology development strategy for achieving the challenging mission of landing large payloads on Mars.

  11. INSL3/RXFP2 signaling in testicular descent.

    PubMed

    Feng, Shu; Ferlin, Alberto; Truong, Anne; Bathgate, Ross; Wade, John D; Corbett, Sean; Han, Shuo; Tannour-Louet, Mounia; Lamb, Dolores J; Foresta, Carlo; Agoulnik, Alexander I

    2009-04-01

    Mutations of the insulin-like peptide 3 (INSL3) hormone or its receptor, RXFP2, cause intraabdominal cryptorchidism in male mice. Specific RXFP2 expression in mouse gubernacula was detected at embryonic day 14.5 and markedly increased after birth in the developing cremaster muscle, as well as in the epididymis and testicular Leydig and germ cells. INSL3 treatment stimulated cell proliferation of embryonic gubernacular and Leydig cells, implicating active INSL3-mediated signaling. The transcription factor SOX9, a known male sex determination factor, upregulated the activity of the RXFP2 promoter. INSL3 is sufficient to direct the first transabdominal phase of testicular descent in the absence of hypothalamic-pituitary-gonadal axis signaling or Hoxa10, although these factors are important for inguinoscrotal testicular descent. Similarly, conditional ablation of the androgen receptor gene in gubernacular cells resulted in disruption of inguinoscrotal descent. We performed mutation screening of INSL3 and RXFP2 in human patients with cryptorchidism and control subjects from different populations in Europe and the USA. Several missense mutations were described in both the INSL3 and RXFP2 genes. A novel V39G INSL3 mutation in a patient with cryptorchidism was identified; however, the functional analysis of the mutant peptide did not reveal compromised function. In more than 2000 patients and controls analyzed to date, the T222P RXFP2 mutation is the only one strongly associated with the mutant phenotype. The T222P mutant receptor, when transfected into 293T cells, had severely decreased cell membrane expression, providing the basis for the functional deficiency of this mutation.

  12. Powered Descent Guidance with General Thrust-Pointing Constraints

    NASA Technical Reports Server (NTRS)

    Carson, John M., III; Acikmese, Behcet; Blackmore, Lars

    2013-01-01

    The Powered Descent Guidance (PDG) algorithm and software for generating Mars pinpoint or precision landing guidance profiles has been enhanced to incorporate thrust-pointing constraints. Pointing constraints would typically be needed for onboard sensor and navigation systems that have specific field-of-view requirements to generate valid ground proximity and terrain-relative state measurements. The original PDG algorithm was designed to enforce both control and state constraints, including maximum and minimum thrust bounds, avoidance of the ground or descent within a glide slope cone, and maximum speed limits. The thrust-bound and thrust-pointing constraints within PDG are non-convex, which in general requires nonlinear optimization methods to generate solutions. The short duration of Mars powered descent requires guaranteed PDG convergence to a solution within a finite time; however, nonlinear optimization methods have no guarantees of convergence to the global optimal or convergence within finite computation time. A lossless convexification developed for the original PDG algorithm relaxed the non-convex thrust bound constraints. This relaxation was theoretically proven to provide valid and optimal solutions for the original, non-convex problem within a convex framework. As with the thrust bound constraint, a relaxation of the thrust-pointing constraint also provides a lossless convexification that ensures the enhanced relaxed PDG algorithm remains convex and retains validity for the original nonconvex problem. The enhanced PDG algorithm provides guidance profiles for pinpoint and precision landing that minimize fuel usage, minimize landing error to the target, and ensure satisfaction of all position and control constraints, including thrust bounds and now thrust-pointing constraints.

  13. Elongation of the active anterior wall of the uro-genital pelvic diaphragm, a late unusual complication of paraplegia.

    PubMed

    Jurascheck, F; Dollfus, P; Jacob-Chia, D

    1980-08-01

    The situation of the usual bladder, prostate, membranous urethra channel, can vary, according to the morphology of the perineum which can be overstretched. A case of a young man with a T10 complete upper motor neurone lesion is presented. The normal anterior angulation at the prostate and membranous urethra junction was reduced anteriorly and pushed backwards, thus causing an added indirect factor of dysuria. The mechanism is discussed in comparison with other such late, but often overlooked consequences of alterations of the pelvic floor during micturition. PMID:7422341

  14. Guidance and Control During Direct-Descent Parabolic Reentry

    NASA Technical Reports Server (NTRS)

    Foudriat, Edwin C.; Wingrove, Rodney C.

    1961-01-01

    The results of studies of four reentry guidance and control techniques for the energy management of vehicles returning to the earth at escape speeds are compared in this paper. The reentry trajectories are constrained to those of direct descent, that is, where the vehicle does not leave that portion of the atmosphere where useful aerodynamic forces are available after its initial entry. The guidance techniques compared are: (1) a piloted simulator study reference trajectory techniques; 2) An automatic controller using reference trajectory techniques; 3) A predictor system employing linear prediction (perturbation) techniques; and 4) A repetitive prediction system employing rapid-time computer techniques.

  15. Shuttle program: OFT ascent/descent ancillary data requirements document

    NASA Technical Reports Server (NTRS)

    Bond, A. C., Jr.; Knoedler, J.

    1980-01-01

    Requirements are presented for the ascent/descent (A/D) navigation and attitude-dependent ancillary data products to be generated for the space shuttle orbiter in support of the orbital flight test (OFT) flight test requirements, MPAD guidance and navigation performance assessment, and the mission evaluation team. The A/D ancillary data support for OFT mission evaluation activities is confined to providing postflight position, velocity, attitude, and associated navigation and attitude derived parameters for the Orbiter over particular flight phases and time intervals.

  16. Revalidation of the Huygens Descent Control Sub-System

    NASA Technical Reports Server (NTRS)

    2005-01-01

    The Huygens probe, part of the Cassini mission to Saturn, is designed to investigate the atmosphere of Titan, Saturn's largest moon. The passage of the probe through the atmosphere is controlled by the Descent Control Sub-System (DCSS), which consists of three parachutes and associated mechanisms. The Cassini / Huygens mission was launched in October 1997 and was designed during the early 1990's. During the time since the design and launch, analysis capabilities have improved significantly, knowledge of the Titan environment has improved and the baseline mission has been modified. Consequently, a study was performed to revalidate the DCSS design against the current predictions.

  17. OFT ascent/descent ancillary data requirements document

    NASA Technical Reports Server (NTRS)

    Bond, A. C., Jr.; Abramson, B.

    1978-01-01

    Requirements are presented for the ascent/descent (A/D) navigation and attitude-dependent ancillary data products to be generated for the space shuttle orbiter in support of orbital flight test requirements, MPAD guidance and navigation performance assessment, and the mission evaluation team. It was intended that this document serve as the sole requirements control instrument between MPB/MPAD and the A/D ancillary data users. The requirements are primarily functional in nature, but some detail level requirements are also included.

  18. Effects of pelvic adjustment on pelvic posture and angles of the lower limb joints during walking in female university students

    PubMed Central

    Cho, Misuk

    2016-01-01

    [Purpose] This study investigated the effects of pelvic adjustment on pelvic posture and lower limb joint angles during walking in female university students. [Subjects] Thirty healthy female university students were randomly assigned to an experimental group (pelvic adjustment group, n = 15) and a control group (stretching group, n = 15). [Methods] Pelvic adjustment was performed three times on the experimental group. The control group performed three sets of pelvic muscle stretching for 15 minutes. A back mapper and motion analysis equipment were used to measure pelvic posture and angles of lower limb joints for the experimental and control group. [Results] The values obtained before and after the intervention were compared. For the experimental group, the results were significantly different in terms of reduced differences in hip flexion between the left and right hips and in knee abduction between the left and right knees. Differences in pelvic position and pelvic torsion were also found in the experimental group. No significant differences in the control group were identified. [Conclusion] Pelvic adjustment affects pelvic position and torsion and this enhancement to pelvic stability decreases hip flexion and knee abduction during walking. PMID:27190468

  19. STS-1 operational flight profile. Volume 5: Descent, cycle 3. Appendix C: Monte Carlo dispersion analysis

    NASA Technical Reports Server (NTRS)

    1980-01-01

    The results of three nonlinear the Monte Carlo dispersion analyses for the Space Transportation System 1 Flight (STS-1) Orbiter Descent Operational Flight Profile, Cycle 3 are presented. Fifty randomly selected simulation for the end of mission (EOM) descent, the abort once around (AOA) descent targeted line are steep target line, and the AOA descent targeted to the shallow target line are analyzed. These analyses compare the flight environment with system and operational constraints on the flight environment and in some cases use simplified system models as an aid in assessing the STS-1 descent flight profile. In addition, descent flight envelops are provided as a data base for use by system specialists to determine the flight readiness for STS-1. The results of these dispersion analyses supersede results of the dispersion analysis previously documented.

  20. Pelvic Insufficiency Fracture After Pelvic Radiotherapy for Cervical Cancer: Analysis of Risk Factors

    SciTech Connect

    Oh, Dongryul; Huh, Seung Jae Nam, Heerim; Park, Won; Han, Youngyih; Lim, Do Hoon; Ahn, Yong Chan; Lee, Jeong Won; Kim, Byoung Gie; Bae, Duk Soo; Lee, Je Ho

    2008-03-15

    Purpose: To investigate the incidence, clinical characteristics, and risk factors of pelvic insufficiency fracture (PIF) after pelvic radiotherapy (RT) in cervical cancer. Methods and Materials: Medical records and imaging studies, including bone scintigraphy, CT, and MRI of 557 patients with cervical cancer who received whole-pelvic RT between January 1998 and August 2005 were reviewed. Results: Eighty-three patients were diagnosed as having PIF after pelvic RT. The 5-year cumulative incidence of PIF was 19.7%. The most commonly involved site was the sacroiliac joint. Pelvic pain developed in 48 patients (57.8%) at diagnosis. Eleven patients (13.3%) needed admission or narcotics because of severe pain, and others had good relief of symptoms with conservative management. In univariate analysis, age {>=}55 years (p < 0.001), anteroposterior/posteroanterior parallel opposing technique (p = 0.001), curative treatment (p < 0.001), and radiation dose {>=}50.4 Gy (p = 0.005) were the predisposing factors for development of PIF. Concurrent chemotherapy (p = 0.78) was not significant. Multivariate analysis showed that age {>=}55 years (p < 0.001), body weight <55 kg (p = 0.02), curative treatment (p = 0.03), and radiation dose {>=}50.4 Gy (p = 0.04) were significant predisposing factors for development of PIF. Conclusion: The development of PIF is not rare after pelvic RT. The use of multibeam arrangements to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture, especially in elderly women with low body weight.

  1. Conceptual design of "Exomars-2018" Descent Module developed by federal enterprise "Lavochkin Association"

    NASA Astrophysics Data System (ADS)

    Khartov, V. V.; Martynov, M. B.; Lukiyanchikov, A. V.; Alexashkin, S. N.

    2015-12-01

    Goals and tasks for "ExoMars-2018" mission and share of responsibilities between European partners and p]Russia are presented. The main design requirements for a Descent Module (DM) that define its design concept as well as design specific features are given. The structure of the descent module, thermal control, means for securing systems interaction onboard the spacecraft "ExoMars-2018", and radio communication with the descent module are examined.

  2. An evaluation of descent strategies for TNAV-equipped aircraft in an advanced metering environment

    NASA Technical Reports Server (NTRS)

    Izumi, K. H.; Schwab, R. W.; Groce, J. L.; Coote, M. A.

    1986-01-01

    Investigated were the effects on system throughput and fleet fuel usage of arrival aircraft utilizing three 4D RNAV descent strategies (cost optimal, clean-idle Mach/CAS and constant descent angle Mach/CAS), both individually and in combination, in an advanced air traffic control metering environment. Results are presented for all mixtures of arrival traffic consisting of three Boeing commercial jet types and for all combinations of the three descent strategies for a typical en route metering airport arrival distribution.

  3. Arachnid aloft: directed aerial descent in neotropical canopy spiders.

    PubMed

    Yanoviak, Stephen P; Munk, Yonatan; Dudley, Robert

    2015-09-01

    The behaviour of directed aerial descent has been described for numerous taxa of wingless hexapods as they fall from the tropical rainforest canopy, but is not known in other terrestrial arthropods. Here, we describe similar controlled aerial behaviours for large arboreal spiders in the genus Selenops (Selenopidae). We dropped 59 such spiders from either canopy platforms or tree crowns in Panama and Peru; the majority (93%) directed their aerial trajectories towards and then landed upon nearby tree trunks. Following initial dorsoventral righting when necessary, falling spiders oriented themselves and then translated head-first towards targets; directional changes were correlated with bilaterally asymmetric motions of the anterolaterally extended forelegs. Aerial performance (i.e. the glide index) decreased with increasing body mass and wing loading, but not with projected surface area of the spider. Along with the occurrence of directed aerial descent in ants, jumping bristletails, and other wingless hexapods, this discovery of targeted gliding in selenopid spiders further indicates strong selective pressures against uncontrolled falls into the understory for arboreal taxa.

  4. Mars 2020 Entry, Descent and Landing Instrumentation 2 (MEDLI2)

    NASA Technical Reports Server (NTRS)

    Hwang, Helen H.; Bose, Deepak; White, Todd R.; Wright, Henry S.; Schoenenberger, Mark; Kuhl, Christopher A.; Trombetta, Dominic; Santos, Jose A.; Oishi, Tomomi; Karlgaard, Christopher D.; Mahzari, Milad; Pennington, Steven P.

    2016-01-01

    The Mars Entry Descent and Landing Instrumentation 2 (MEDLI2) sensor suite will measure aerodynamic, aerothermodynamic, and TPS performance during the atmospheric entry, descent, and landing phases of the Mars 2020 mission. The key objectives are to reduce design margin and prediction uncertainties for the aerothermal environments and aerodynamic database. For MEDLI2, the sensors are installed on both the heatshield and backshell, and include 7 pressure transducers, 17 thermal plugs, and 3 heat flux sensors (including a radiometer). These sensors will expand the set of measurements collected by the highly successful MEDLI suite, collecting supersonic pressure measurements on the forebody, a pressure measurement on the aftbody, direct heat flux measurements on the aftbody, a radiative heating measurement on the aftbody, and multiple near-surface thermal measurements on the thermal protection system (TPS) materials on both the forebody and aftbody. To meet the science objectives, supersonic pressure transducers and heat flux sensors are currently being developed and their qualification and calibration plans are presented. Finally, the reconstruction targets for data accuracy are presented, along with the planned methodologies for achieving the targets.

  5. Arachnid aloft: directed aerial descent in neotropical canopy spiders.

    PubMed

    Yanoviak, Stephen P; Munk, Yonatan; Dudley, Robert

    2015-09-01

    The behaviour of directed aerial descent has been described for numerous taxa of wingless hexapods as they fall from the tropical rainforest canopy, but is not known in other terrestrial arthropods. Here, we describe similar controlled aerial behaviours for large arboreal spiders in the genus Selenops (Selenopidae). We dropped 59 such spiders from either canopy platforms or tree crowns in Panama and Peru; the majority (93%) directed their aerial trajectories towards and then landed upon nearby tree trunks. Following initial dorsoventral righting when necessary, falling spiders oriented themselves and then translated head-first towards targets; directional changes were correlated with bilaterally asymmetric motions of the anterolaterally extended forelegs. Aerial performance (i.e. the glide index) decreased with increasing body mass and wing loading, but not with projected surface area of the spider. Along with the occurrence of directed aerial descent in ants, jumping bristletails, and other wingless hexapods, this discovery of targeted gliding in selenopid spiders further indicates strong selective pressures against uncontrolled falls into the understory for arboreal taxa. PMID:26289654

  6. Mars Science Laboratory Entry Descent and Landing Simulation Using DSENDS

    NASA Technical Reports Server (NTRS)

    Burkhart, P. Daniel; Casoliva, Jordi; Balaram, Bob

    2013-01-01

    The most recent planetary science mission to Mars was Mars Science Laboratory (MSL) with the Curiosity rover, launched November 26, 2011 and landed at Gale Crater on August 6, 2012. This spacecraft was the first use at Mars of a complete closed-loop Guidance Navigation and Control (GN&C) system, including guided entry with a lifting body that greatly reduces dispersions during the Entry, Descent and Landing (EDL) phase to achieve a 25 km X 20 km landing error relative to the selected Gale Crater landing target. In order to confirm meeting the above landing criteria, high-fidelity simulation of the EDL phase is required. The tool used for 6DOF EDL trajectory verification analysis is Dynamics Simulator for Entry, Descent and Surface landing (DSENDS), which is a high-fidelity simulation tool from JPLs Dynamics and Real-Time Simulation Laboratory for the development, test and operations of aero-flight vehicles. DSENDS inherent capability is augmented for MSL with project-specific models of atmosphere, aerodynamics, sensors and thrusters along with GN&C flight software to enable high-fidelity trajectory simulation. This paper will present the model integration and independent verification experience of the JPL EDL trajectory analysis team.

  7. Mars Science Laboratory Entry Descent and Landing Simulation Using DSENDS

    NASA Technical Reports Server (NTRS)

    Burkhart, P. Daniel; Casoliva, Jordi; Balaram, Bob

    2013-01-01

    The most recent planetary science mission to Mars is Mars Science Laboratory (MSL) with the Curiosity rover, launched November 26, 2011 and landed at Gale Crater on August 6, 2012. This spacecraft was the first use at Mars of a complete closed-loop Guidance Navigation and Control (GN&C) system, including guided entry with a lifting body that greatly reduces dispersions during the Entry, Descent and Landing (EDL) phase to achieve a 25 km x 20 km landing error relative to the selected Gale Crater landing target. In order to confirm meeting the above landing criteria, high-fidelity simulation of the EDL phase is required. The tool used for 6DOF EDL trajectory verification analysis is Dynamics Simulator for Entry, Descent and Surface landing (DSENDS), which is a high-fidelity simulation tool from JPLs Dynamics and Real-Time Simulation Laboratory for the development, test and operations of aero-flight vehicles. DSENDS inherent capability is augmented for MSL with project-specific models of atmosphere, aerodynamics, sensors and thrusters along with GN&C flight software to enable high-fidelity trajectory simulation. This paper will present the model integration and independent verification experience of the JPL EDL trajectory analysis team.

  8. Efficient Love wave modelling via Sobolev gradient steepest descent

    NASA Astrophysics Data System (ADS)

    Browning, Matt; Ferguson, John; McMechan, George

    2016-05-01

    A new method for finding solutions to ordinary differential equation boundary value problems is introduced, in which Sobolev gradient steepest descent is used to determine eigenfunctions and eigenvalues simultaneously in an iterative scheme. The technique is then applied to the 1-D Love wave problem. The algorithm has several advantages when computing dispersion curves. It avoids the problem of mode skipping, and can handle arbitrary Earth structure profiles in depth. For a given frequency range, computation times scale approximately as the square root of the number of frequencies, and the computation of dispersion curves can be implemented in a fully parallel manner over the modes involved. The steepest descent solutions are within a fraction of a per cent of the analytic solutions for the first 25 modes for a two-layer model. Since all corresponding eigenfunctions are computed along with the dispersion curves, the impact on group and phase velocity of the displacement behaviour with depth is thoroughly examined. The dispersion curves are used to compute synthetic Love wave seismograms that include many higher order modes. An example includes addition of attenuation to a model with a low-velocity zone, with values as low as Q = 20. Finally, a confirming comparison is made with a layer matrix method on the upper 700 km of a whole Earth model.

  9. Arachnid aloft: directed aerial descent in neotropical canopy spiders

    PubMed Central

    Yanoviak, Stephen P.; Munk, Yonatan; Dudley, Robert

    2015-01-01

    The behaviour of directed aerial descent has been described for numerous taxa of wingless hexapods as they fall from the tropical rainforest canopy, but is not known in other terrestrial arthropods. Here, we describe similar controlled aerial behaviours for large arboreal spiders in the genus Selenops (Selenopidae). We dropped 59 such spiders from either canopy platforms or tree crowns in Panama and Peru; the majority (93%) directed their aerial trajectories towards and then landed upon nearby tree trunks. Following initial dorsoventral righting when necessary, falling spiders oriented themselves and then translated head-first towards targets; directional changes were correlated with bilaterally asymmetric motions of the anterolaterally extended forelegs. Aerial performance (i.e. the glide index) decreased with increasing body mass and wing loading, but not with projected surface area of the spider. Along with the occurrence of directed aerial descent in ants, jumping bristletails, and other wingless hexapods, this discovery of targeted gliding in selenopid spiders further indicates strong selective pressures against uncontrolled falls into the understory for arboreal taxa. PMID:26289654

  10. Mars Exploration Rover Terminal Descent Mission Modeling and Simulation

    NASA Technical Reports Server (NTRS)

    Raiszadeh, Behzad; Queen, Eric M.

    2004-01-01

    Because of NASA's added reliance on simulation for successful interplanetary missions, the MER mission has developed a detailed EDL trajectory modeling and simulation. This paper summarizes how the MER EDL sequence of events are modeled, verification of the methods used, and the inputs. This simulation is built upon a multibody parachute trajectory simulation tool that has been developed in POST I1 that accurately simulates the trajectory of multiple vehicles in flight with interacting forces. In this model the parachute and the suspended bodies are treated as 6 Degree-of-Freedom (6 DOF) bodies. The terminal descent phase of the mission consists of several Entry, Descent, Landing (EDL) events, such as parachute deployment, heatshield separation, deployment of the lander from the backshell, deployment of the airbags, RAD firings, TIRS firings, etc. For an accurate, reliable simulation these events need to be modeled seamlessly and robustly so that the simulations will remain numerically stable during Monte-Carlo simulations. This paper also summarizes how the events have been modeled, the numerical issues, and modeling challenges.

  11. High mammographic density in women of Ashkenazi Jewish descent

    PubMed Central

    2013-01-01

    Introduction Percent mammographic density (PMD) adjusted for age and body mass index is one of the strongest risk factors for breast cancer and is known to be approximately 60% heritable. Here we report a finding of an association between genetic ancestry and adjusted PMD. Methods We selected self-identified Caucasian women in the California Pacific Medical Center Research Institute Cohort whose screening mammograms placed them in the top or bottom quintiles of age-adjusted and body mass index-adjusted PMD. Our final dataset included 474 women with the highest adjusted PMD and 469 with the lowest genotyped on the Illumina 1 M platform. Principal component analysis (PCA) and identity-by-descent analyses allowed us to infer the women's genetic ancestry and correlate it with adjusted PMD. Results Women of Ashkenazi Jewish ancestry, as defined by the first principal component of PCA and identity-by-descent analyses, represented approximately 15% of the sample. Ashkenazi Jewish ancestry, defined by the first principal component of PCA, was associated with higher adjusted PMD (P = 0.004). Using multivariate regression to adjust for epidemiologic factors associated with PMD, including age at parity and use of postmenopausal hormone therapy, did not attenuate the association. Conclusions Women of Ashkenazi Jewish ancestry, based on genetic analysis, are more likely to have high age-adjusted and body mass index-adjusted PMD. Ashkenazi Jews may have a unique set of genetic variants or environmental risk factors that increase mammographic density. PMID:23668689

  12. Scaling on a limestone flooring

    NASA Astrophysics Data System (ADS)

    Carmona-Quiroga, P. M.; Blanco-Varela, M. T.; Martínez-Ramírez, S.

    2012-04-01

    Natural stone can be use on nearly every surface, inside and outside buildings, but decay is more commonly reported from the ones exposed to outdoor aggressively conditions. This study instead, is an example of limestone weathering of uncertain origin in the interior of a residential building. The stone, used as flooring, started to exhibit loss of material in the form of scaling. These damages were observed before the building, localized in the South of Spain (Málaga), was inhabited. Moreover, according to the company the limestone satisfies the following European standards UNE-EN 1341: 2002, UNE-EN 1343: 2003; UNE-EN 12058: 2004 for floorings. Under these circumstances the main objective of this study was to assess the causes of this phenomenon. For this reason the composition of the mortar was determined and the stone was characterized from a mineralogical and petrological point of view. The last material, which is a fossiliferous limestone from Egypt with natural fissure lines, is mainly composed of calcite, being quartz, kaolinite and apatite minor phases. Moreover, under different spectroscopic and microscopic techniques (FTIR, micro-Raman, SEM-EDX, etc) samples of the weathered, taken directly from the buildings, and unweathered limestone tiles were examined and a new mineralogical phase, trona, was identified at scaled areas which are connected with the natural veins of the stone. In fact, through BSE-mapping the presence of sodium has been detected in these veins. This soluble sodium carbonate would was dissolved in the natural waters from which limestone was precipitated and would migrate with the ascendant capilar humidity and crystallized near the surface of the stone starting the scaling phenomenon which in historic masonry could be very damaging. Therefore, the weathering of the limestone would be related with the hygroscopic behaviour of this salt, but not with the constructive methods used. This makes the limestone unable to be used on restoration

  13. Male chronic pelvic pain: An update

    PubMed Central

    Smith, Christopher P.

    2016-01-01

    Introduction: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and interstitial cystitis/bladder pain syndrome collectively referred to as urologic CPPS (UCPPS) is defined by the absence of identifiable bacterial infection as a cause for the chronic pain and urinary symptoms. Methods: A PubMed search of all recent relevant articles using the keywords/phrases: CPPS, CPPS, and male pelvic pain, was conducted. Results: CPPS has a high worldwide prevalence and its negative impact on quality of life compares with or exceeds common chronic morbidities. Triggers include certain comestibles as well as psychosocial factors that promote catastrophizing and illness focused behavior. Several validated tools are currently available to help diagnose and direct targeted therapy. Treatment should begin with the most simple and least invasive based on the presenting clinical phenotype. Conclusions: Although no gold-standard treatment exists, a multidisciplinary approach with multimodal therapy gives the UCPPS patient the best chance of symptom relief. PMID:26941492

  14. [Contraception and pelvic infection in women].

    PubMed

    Keith, L; Berger, G S; Brown, E R

    1986-01-01

    Although sexually transmitted diseases are a major public health problem at the international level, the relationship between contraception and pelvic infection is seldom examined. Numerous STDs are more difficult to diagnose, more frequent, and more serious in women than in men. Differential diagnosis between pelvic infection and other intraabdominal syndromes has been a concern for practitioners for years, and many pelvic infections are probably never diagnosed. Lower abdominal pain and sensitivity as well as fever, leucocytosis, accelerated sedimentation rate, inflammatory annexial mass evident on sonography, and microorganisms in the pouch of Douglass and presence of leucocytes in the peritoneal fluid are diagnostic criteria. Apart from errors in treatment resulting from errors in diagnosis, pelvic infections are often inadequately treated, especially in the initial phase before symptoms are confirmed. The exact incidence of pelvic infections in the US is unknown, but pelvic inflammatory disease (PID) accounted for over 200,000 hospitalizations per year between 1970-75. PID carries grave risks of subsequent ectopic pregnancy, chronic pelvic pain, and infertility which is more likely as the number of acute episodes increases. The female genital tract has diverse microenvironments propitious for growth of microorganisms of different types, aerobic and anaerobic. Each anatomic site has specific features conditioning bacterial growth. Histological modifications during the menstrual cycle and pregnancy affect the microbial flora. Except in the case of gonorrhea, it is not known how many female lower genital tract infections spread to the upper tract. Since 1970, several studies have domonstrated a growing diversity of cervical and vaginal flora in asymptomatic subjects. The principal risk factors for PID have been well described in the literature. All contraceptive methods except the IUD provide some degree of protection against PID. Even among IUD users the risk of

  15. Pelvic Retroperitoneal Cellular Leiomyoma: A Case Report.

    PubMed

    Tantitamit, Tanitra; Hamontri, Suttha; Rangsiratanakul, Likit; Suksamarnwong, Maysita

    2015-10-01

    Leiomyomas are common benign gynecological tumors and usually arise in the uterus. The retroperitoneal cellular leiomyoma, one of the unusual manifestations, is a rare tumor. Diagnosis and treatment are challenges. We report a case of 65-year-old women presented with an asymptomatic mass beneath the right posterior vaginal mucosa. CT imaging revealed heterogeneous mass 6 cm in the pelvic cavity abutted lower segment of uterus, cervix, and vagina. The provisional diagnosis was subserosal cervical leiomyoma. She underwent exploratory laparotomy. Intra-operative, a normal size uterus was found separately from retroperitoneal pelvic mass at the level of internal os. Histological report confirmed cellular leiomyoma later Total hysterectomy, bilateral salpingoophorectomy and completely excision of tumor were achieved with good outcome. Our patient represents the rare case of retroperitoneal cellular leiomyoma, which is hardly identified from internal examination and preoperative imaging. Surgical removal is essential for pathological diagnosis and treatment. PMID:26817226

  16. [Benign pelvic schwannoma. A case report].

    PubMed

    Fauchery, A; de Meeûs, J B; Turc, I; Bascou, V; Goujon, J M; Magnin, G

    1994-01-01

    A rare case of benin pelvic schwannoma was observed fortuitously during normal echographic follow-up of a cyst of the ovary. The usually silent tumours are difficult to diagnose. Computed tomography appears to be the most informative examination concerning the nature of these tumours and their relations with the surrounding structures. Nevertheless, the exact nature cannot be determined before curative surgical exeresis and pathology examination. The risk of relapse is extremely small, but does exist, justifying follow-up.

  17. Pelvic autonomic neuromonitoring: present reality, future prospects.

    PubMed

    Skinner, Stanley A

    2014-08-01

    Currently, the means to assess the autonomic nervous system primarily depend on end organ functional measurement: intravesical pressure, skin resistance, and penile strain gauge tension, for example. None of these measures has been generally accepted in the operating room. Nevertheless, the segmental and peripheral pelvic autonomic nerve supply is placed at risk during both pelvic and lower spine surgery. In this difficult era of suboptimal post-prostatectomy outcomes, the urological literature does reveal the salutary development of safer dissection techniques about the peri-prostatic and cavernous plexus. Means of reliably specific nerve identification remain elusive. The need for actual nerve monitoring (not just identification) has only recently been proposed. Data from the animal lab reinforce an appreciation of the intimate and elegant interconnectedness of autonomic and somatic structures, particularly at the segmental level. Also, the biochemistry of erectile tissue engorgement (in both sexes) is very well understood (the electrophysiology increasingly so). Understanding these principles should permit parallel investigation and implementation of neurophysiological techniques which both identify and monitor pelvic autonomic function. The predicates for these proposed new approaches in the operating room are discussed in this review.

  18. Pelvic radiation disease: Updates on treatment options

    PubMed Central

    Frazzoni, Leonardo; La Marca, Marina; Guido, Alessandra; Morganti, Alessio Giuseppe; Bazzoli, Franco; Fuccio, Lorenzo

    2015-01-01

    Pelvic cancers are among the most frequently diagnosed neoplasms and radiotherapy represents one of the main treatment options. The irradiation field usually encompasses healthy intestinal tissue, especially of distal large bowel, thus inducing gastrointestinal (GI) radiation-induced toxicity. Indeed, up to half of radiation-treated patients say that their quality of life is affected by GI symptoms (e.g., rectal bleeding, diarrhoea). The constellation of GI symptoms - from transient to long-term, from mild to very severe - experienced by patients who underwent radiation treatment for a pelvic tumor have been comprised in the definition of pelvic radiation disease (PRD). A correct and evidence-based therapeutic approach of patients experiencing GI radiation-induced toxicity is mandatory. Therapeutic non-surgical strategies for PRD can be summarized in two broad categories, i.e., medical and endoscopic. Of note, most of the studies have investigated the management of radiation-induced rectal bleeding. Patients with clinically significant bleeding (i.e., causing chronic anemia) should firstly be considered for medical management (i.e., sucralfate enemas, metronidazole and hyperbaric oxygen); in case of failure, endoscopic treatment should be implemented. This latter should be considered the first choice in case of acute, transfusion requiring, bleeding. More well-performed, high quality studies should be performed, especially the role of medical treatments should be better investigated as well as the comparative studies between endoscopic and hyperbaric oxygen treatments. PMID:26677440

  19. Crash Tests of Protective Airplane Floors

    NASA Technical Reports Server (NTRS)

    Carden, H. D.

    1986-01-01

    Energy-absorbing floors reduce structural buckling and impact forces on occupants. 56-page report discusses crash tests of energy-absorbing aircraft floors. Describes test facility and procedures; airplanes, structural modifications, and seats; crash dynamics; floor and seat behavior; and responses of anthropometric dummies seated in airplanes. Also presents plots of accelerations, photographs and diagrams of test facility, and photographs and drawings of airplanes before, during, and after testing.

  20. Evaluation of vertical profiles to design continuous descent approach procedure

    NASA Astrophysics Data System (ADS)

    Pradeep, Priyank

    The current research focuses on predictability, variability and operational feasibility aspect of Continuous Descent Approach (CDA), which is among the key concepts of the Next Generation Air Transportation System (NextGen). The idle-thrust CDA is a fuel economical, noise and emission abatement procedure, but requires increased separation to accommodate for variability and uncertainties in vertical and speed profiles of arriving aircraft. Although a considerable amount of researches have been devoted to the estimation of potential benefits of the CDA, only few have attempted to explain the predictability, variability and operational feasibility aspect of CDA. The analytical equations derived using flight dynamics and Base of Aircraft and Data (BADA) Total Energy Model (TEM) in this research gives insight into dependency of vertical profile of CDA on various factors like wind speed and gradient, weight, aircraft type and configuration, thrust settings, atmospheric factors (deviation from ISA (DISA), pressure and density of the air) and descent speed profile. Application of the derived equations to idle-thrust CDA gives an insight into sensitivity of its vertical profile to multiple factors. This suggests fixed geometric flight path angle (FPA) CDA has higher degree of predictability and lesser variability at the cost of non-idle and low thrust engine settings. However, with optimized design this impact can be overall minimized. The CDA simulations were performed using Future ATM Concept Evaluation Tool (FACET) based on radar-track and aircraft type data (BADA) of the real air-traffic to some of the busiest airports in the USA (ATL, SFO and New York Metroplex (JFK, EWR and LGA)). The statistical analysis of the vertical profiles of CDA shows 1) mean geometric FPAs derived from various simulated vertical profiles are consistently shallower than 3° glideslope angle and 2) high level of variability in vertical profiles of idle-thrust CDA even in absence of

  1. Pelvic radiotherapy and sexual function in women

    PubMed Central

    Froeding, Ligita Paskeviciute

    2015-01-01

    Background During the past decade there has been considerable progress in developing new radiation methods for cancer treatment. Pelvic radiotherapy constitutes the primary or (neo) adjuvant treatment of many pelvic cancers e.g., locally advanced cervical and rectal cancer. There is an increasing focus on late effects and an increasing awareness that patient reported outcomes (PROs) i.e., patient assessment of physical, social, psychological, and sexual functioning provides the most valid information on the effects of cancer treatment. Following cure of cancer allow survivors focus on quality of life (QOL) issues; sexual functioning has proved to be one of the most important aspects of concern in long-term survivors. Methods An updated literature search in PubMed was performed on pelvic radiotherapy and female sexual functioning/dysfunction. Studies on gynaecological, urological and gastrointestinal cancers were included. The focus was on the period from 2010 to 2014, on studies using PROs, on potential randomized controlled trials (RCTs) where female sexual dysfunction (FSD) at least constituted a secondary outcome, and on studies reporting from modern radiotherapy modalities. Results The literature search revealed a few RCTs with FSD evaluated as a PRO and being a secondary outcome measure in endometrial and in rectal cancer patients. Very limited information could be extracted regarding FSD in bladder, vulva, and anal cancer patients. The literature before and after 2010 confirms that pelvic radiotherapy, independent on modality, increases the risk significantly for FSD both compared to data from age-matched healthy control women and compared to data on patients treated by surgery only. There was only very limited data available on modern radiotherapy modalities. These are awaited during the next five years. Several newer studies confirm that health care professionals are still reluctant to discuss treatment induced sexual dysfunction with patients. Conclusions

  2. Pelvic pain after childbirth: a longitudinal population study.

    PubMed

    Bjelland, Elisabeth Krefting; Owe, Katrine Mari; Pingel, Ronnie; Kristiansson, Per; Vangen, Siri; Eberhard-Gran, Malin

    2016-03-01

    In this longitudinal population study, the aims were to study associations of mode of delivery with new onset of pelvic pain and changes in pelvic pain scores up to 7 to 18 months after childbirth. We included 20,248 participants enrolled in the Norwegian Mother and Child Cohort Study (1999-2008) without preexisting pelvic pain in pregnancy. Data were obtained by 4 self-administered questionnaires and linked to the Medical Birth Registry of Norway. A total of 4.5% of the women reported new onset of pelvic pain 0 to 3 months postpartum. Compared to unassisted vaginal delivery, operative vaginal delivery was associated with increased odds of pelvic pain (adjusted odds ratio [OR]: 1.30; 95% confidence interval [CI]: 1.06-1.59). Planned and emergency cesarean deliveries were associated with reduced odds of pelvic pain (adjusted OR: 0.48; 95% CI: 0.31-0.74 and adjusted OR: 0.65; 95% CI: 0.49-0.87, respectively). Planned cesarean delivery, young maternal age, and low Symptom Checklist-8 scores were associated with low pelvic pain scores after childbirth. A history of pain was the only factor associated with increased pelvic pain scores over time (P = 0.047). We conclude that new onset of pelvic pain after childbirth was not commonly reported, particularly following cesarean delivery. Overall, pelvic pain scores were rather low at all time points and women with a history of pain reported increased pelvic pain scores over time. Hence, clinicians should follow up women with pelvic pain after a difficult childbirth experience, particularly if they have a history of pain. PMID:26588694

  3. The pain management approach to chronic pelvic pain.

    PubMed

    Rapkin, A J; Kames, L D

    1987-05-01

    Chronic pelvic pain remains a difficult management problem that is often refractory to traditional medical or surgical therapy. The pain management center approach used successfully for the treatment of cancer pain and headache can be adapted to the treatment of chronic pelvic pain. The results of this pilot study suggest that the multidisciplinary techniques of pain management promise to be an effective modality for the treatment of chronic pelvic pain. PMID:2439689

  4. Pelvic pain after childbirth: a longitudinal population study.

    PubMed

    Bjelland, Elisabeth Krefting; Owe, Katrine Mari; Pingel, Ronnie; Kristiansson, Per; Vangen, Siri; Eberhard-Gran, Malin

    2016-03-01

    In this longitudinal population study, the aims were to study associations of mode of delivery with new onset of pelvic pain and changes in pelvic pain scores up to 7 to 18 months after childbirth. We included 20,248 participants enrolled in the Norwegian Mother and Child Cohort Study (1999-2008) without preexisting pelvic pain in pregnancy. Data were obtained by 4 self-administered questionnaires and linked to the Medical Birth Registry of Norway. A total of 4.5% of the women reported new onset of pelvic pain 0 to 3 months postpartum. Compared to unassisted vaginal delivery, operative vaginal delivery was associated with increased odds of pelvic pain (adjusted odds ratio [OR]: 1.30; 95% confidence interval [CI]: 1.06-1.59). Planned and emergency cesarean deliveries were associated with reduced odds of pelvic pain (adjusted OR: 0.48; 95% CI: 0.31-0.74 and adjusted OR: 0.65; 95% CI: 0.49-0.87, respectively). Planned cesarean delivery, young maternal age, and low Symptom Checklist-8 scores were associated with low pelvic pain scores after childbirth. A history of pain was the only factor associated with increased pelvic pain scores over time (P = 0.047). We conclude that new onset of pelvic pain after childbirth was not commonly reported, particularly following cesarean delivery. Overall, pelvic pain scores were rather low at all time points and women with a history of pain reported increased pelvic pain scores over time. Hence, clinicians should follow up women with pelvic pain after a difficult childbirth experience, particularly if they have a history of pain.

  5. Side Elevation; 1/4 Plans of Floor Framing, Floor Planking, Roof ...

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

    Side Elevation; 1/4 Plans of Floor Framing, Floor Planking, Roof Framing and Roof; Longitudinal Section, Cross Section, End Elevation - Eames Covered Bridge, Spanning Henderson Creek, Oquawka, Henderson County, IL

  6. 17. 4th floor roof, view south, 4th and 5th floor ...

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

    17. 4th floor roof, view south, 4th and 5th floor setback to left and atrium structure to right - Sheffield Farms Milk Plant, 1075 Webster Avenue (southwest corner of 166th Street), Bronx, Bronx County, NY

  7. Changes in Muscularis Propria of Anterior Vaginal Wall in Women with Pelvic Organ Prolapse

    PubMed Central

    Vetuschi, A.; D’Alfonso, A.; Sferra, R.; Zanelli, D.; Pompili, S.; Patacchiola, F.; Gaudio, E.; Carta, G.

    2016-01-01

    The objective of this study was to evaluate the morphological and immunohistochemical alterations of tissue removed from the upper third of anterior vaginal wall in a sample group of the female population presenting homogenous risk factors associated with pelvic organ prolapse (POP). The case study consisted of 14 patients with POP and there were 10 patients in the control group. Patient selection was carried on the basis of specific criteria and all of the patients involved in the study presented one or more of the recognized POP risk factors. Samples were taken from POP patients during vaginal plastic surgery following colpohysterectomy, and from control patients during closure of the posterior fornix following hysterectomy. Samples were processed for histological and immunohistochemical analyses for Collagen I and Collagen III, α-Smooth Muscle Actin (α-SMA), Platelet-Derived-Growth-Factor (PDGF), matrix metalloproteinase 3 (MMP3), tissue inhibitors metalloproteinase 1 (TIMP1), Caspase3. Immunofluorescence analyses for Collagen I and III and PDGF were also carried out. In prolapsed specimens our results show a disorganization of smooth muscle cells that appeared to have been displaced by an increased collagen III deposition resulting in rearrangement of the muscularis propria architecture. These findings suggest that the increase in the expression of collagen fibers in muscularis could probably be due to a phenotypic switch resulting in the dedifferentiation of smooth muscle cells into myofibroblasts. These alterations could be responsible for the compromising of the dynamic functionality of the pelvic floor. PMID:26972719

  8. Central and peripheral pain generators in women with chronic pelvic pain: patient centered assessment and treatment.

    PubMed

    Hoffman, Donna

    2015-01-01

    Women with chronic pelvic pain (CPP) often present without obvious cause on imaging studies, laboratory values or physical exam. Dysfunctional sensory processing in the central nervous system (CNS) may explain pain of unclear origin. Central sensitization (CS), a mechanism of centrally mediated pain, describes this abnormal processing of sensory information. Women with CPP often present with several seemingly unrelated symptoms. This can be explained by co-existing chronic pain syndromes occurring in the same patient. Central sensitization occurs in all of these pain syndromes, also described as dysfunctional pain syndromes, and thus may explain why several often occur in the same patient. Six of the most common pain disorders that co-exist in CPP include endometriosis, painful bladder syndrome/interstitial cysitis, vulvodynia, myofascial pain/ pelvic floor hypertonus, irritable bowel syndrome, and primary dysmenorrhea. Central pain generators, (pain originating from CS) and peripheral pain generators, (pain from local tissue damage), can both occur in each of these six conditions. These pain generators will be described. Chronic pain, specifically dysfunctional sensory processing, is recognized as a systemic disease process like diabetes to be managed as opposed to a local problem to be "fixed" or cured. A multi-disciplinary approach to assessment and treatment with a focus on improving emotional, physical and social functioning instead of focusing strictly on pain reduction is more effective in decreasing disability. This is best achieved by determining the patient's needs and perspective through a patient-centered approach. Algorithms for such an approach to assessment and treatment are outlined.

  9. A three-dimensional muscle activity imaging technique for assessing pelvic muscle function

    NASA Astrophysics Data System (ADS)

    Zhang, Yingchun; Wang, Dan; Timm, Gerald W.

    2010-11-01

    A novel multi-channel surface electromyography (EMG)-based three-dimensional muscle activity imaging (MAI) technique has been developed by combining the bioelectrical source reconstruction approach and subject-specific finite element modeling approach. Internal muscle activities are modeled by a current density distribution and estimated from the intra-vaginal surface EMG signals with the aid of a weighted minimum norm estimation algorithm. The MAI technique was employed to minimally invasively reconstruct electrical activity in the pelvic floor muscles and urethral sphincter from multi-channel intra-vaginal surface EMG recordings. A series of computer simulations were conducted to evaluate the performance of the present MAI technique. With appropriate numerical modeling and inverse estimation techniques, we have demonstrated the capability of the MAI technique to accurately reconstruct internal muscle activities from surface EMG recordings. This MAI technique combined with traditional EMG signal analysis techniques is being used to study etiologic factors associated with stress urinary incontinence in women by correlating functional status of muscles characterized from the intra-vaginal surface EMG measurements with the specific pelvic muscle groups that generated these signals. The developed MAI technique described herein holds promise for eliminating the need to place needle electrodes into muscles to obtain accurate EMG recordings in some clinical applications.

  10. Eastern Floor of Holden Crater

    NASA Technical Reports Server (NTRS)

    2002-01-01

    (Released 15 April 2002) The Science Today's THEMIS image covers territory on the eastern floor of Holden Crater, which is located in region of the southern hemisphere called Noachis Terra. Holden Crater is 154 km in diameter and named after American Astronomer Edward Holden (1846-1914). This image shows a mottled surface with channels, hills, ridges and impact craters. The largest crater seen in this image is 5 km in diameter. This crater has gullies and what appears to be horizontal layers in its walls. The Story With its beautiful symmetry and gullies radially streaming down to the floor, the dominant crater in this image is an impressive focal point. Yet, it is really just a small crater within a much larger one named Holden Crater. Take a look at the context image to the right to see just how much bigger Holden Crater is. Then come back to the image strip that shows the mottled surface of Holden Crater's eastern floor in greater detail, and count how many hills, ridges, channels, and small impact craters can be seen. No perfectly smooth terrain abounds there, that's for sure. The textured terrain of Holden Crater has been particularly intriguing ever since the Mars Orbital Camera on the Mars Global Surveyor spacecraft found evidence of sedimentary rock layers there that might have formed in lakes or shallow seas in Mars' ancient past. This finding suggests that Mars may have been more like Earth long ago, with water on its surface. Holden Crater might even have held a lake long ago. No one knows for sure, but it's an exciting possibility. Why? If water was once on the surface of Mars long enough to form sedimentary materials, maybe it was there long enough for microbial life to have developed too. (Life as we know it just isn't possible without the long-term presence of liquid water.) The question of life on the red planet is certainly tantalizing, but scientists will need to engage in a huge amount of further investigation to begin to know the answer. That

  11. Human Mars Entry, Descent, and Landing Architecture Study Overview

    NASA Technical Reports Server (NTRS)

    Cianciolo, Alicia D.; Polsgrove, Tara T.

    2016-01-01

    The Entry, Descent, and Landing (EDL) Architecture Study is a multi-NASA center activity to analyze candidate EDL systems as they apply to human Mars landing in the context of the Evolvable Mars Campaign. The study, led by the Space Technology Mission Directorate (STMD), is performed in conjunction with the NASA's Science Mission Directorate and the Human Architecture Team, sponsored by NASA's Human Exploration and Operations Mission Directorate. The primary objective is to prioritize future STMD EDL technology investments by (1) generating Phase A-level designs for selected concepts to deliver 20 t human class payloads, (2) developing a parameterized mass model for each concept capable of examining payloads between 5 and 40 t, and (3) evaluating integrated system performance using trajectory simulations. This paper summarizes the initial study results.

  12. Steepest descent ballistic deposition of complex shaped particles

    NASA Astrophysics Data System (ADS)

    Topic, Nikola; Pöschel, Thorsten

    2016-03-01

    We present an efficient event-driven algorithm for sequential ballistic deposition of complex-shaped rigid particles. Each of the particles is constructed from hard spheres (typically 5 … 1000) of variable radii. The sizes and relative positions of the spheres may mutually overlap and can be chosen such that the surface of the resulting particle appears relatively smooth. In the sequential deposition process, by performing steps of rolling and linear motion, the particles move along the steepest descent in a landscape formed by the boundaries and previously deposited particles. The computer time for the simulation of a deposition process depends on the total number of spheres but only weakly on the sizes and shapes of the particles. The proposed algorithm generalizes the Visscher-Bolsterli algorithm [1] which is frequently used for packing of spheres, to non-spherical particles. The proposed event-driven algorithm allows simulations of multi-million particle systems using desktop computers.

  13. On Belonging: The American Adolescent of Arab Descent.

    PubMed

    Khouri, Lama Z

    2016-08-01

    Although American families of Arab origin come from 22 countries and from varied backgrounds and cultures, reports suggest that they suffer equally from acculturation stress, stereotyping, discrimination, and the reverberations of the aftermath of September 11 as well as global affairs. However, because children and adolescents from these families, particularly those who are newly arrived immigrants, tend to do well in school, they are rarely targeted by research or policy. This article uses the narratives of 5 middle school age male students from Arab descent who were in a support group that met for 3 years (2004-2007), beginning shortly after President George W. Bush's declaration of the war on the "axis of evil." I used vignettes from this group to illustrate the stressors this population faces. The final section suggests an option for supporting this population. PMID:27472891

  14. The stabilization interval system of a tethered descent underwater vehicle

    NASA Astrophysics Data System (ADS)

    Gayvoronskiy, S. A.; Ezangina, T.; Khozhaev, I.; Efimov, S. V.

    2016-04-01

    To damp the vertical oscillations of a descent submersible caused by dusting the control system utilizing a shock-absorbing hoist located on the submersible was developed. A robust proportional-plus-integral action controller was included in the control loop to ensure acceptable dynamic properties of the system by interval variations of the module mass, the rope length, the equivalent value of stiffness of a spring linkage and the equivalent value of damping factor of the spring linkage. A parametric synthesis of the controller was carried out on the basis of the robust expansion of the coefficient method of the quality rating estimation. The system operability was confirmed by the results of the digital simulation parameters

  15. Mars Exploration Rovers Entry, Descent, and Landing Trajectory Analysis

    NASA Technical Reports Server (NTRS)

    Desai, Prasun N.; Knocke, Philip C.

    2004-01-01

    The Mars Exploration Rover mission successfully landed two rovers "Spirit" and "Opportunity" on Mars on January 4th and 25th of 2004, respectively. The trajectory analysis performed to define the entry, descent, and landing (EDL) scenario is described. The entry requirements and constraints are presented, as well as uncertainties used in a Monte Carlo dispersion analysis to statistically assess the robustness of the entry design to off-nominal conditions. In the analysis, six-degree-of-freedom and three-degree-of-freedom trajectory results are compared to assess the entry characteristics of the capsule. Comparison of the preentry results to preliminary post-landing reconstruction data shows that all EDL parameters were within the requirements. In addition, the final landing position for both "Spirit" and "Opportunity" were within 15 km of the predicted landing location.

  16. RITD - Adapting Mars Entry, Descent and Landing System for Earth

    NASA Astrophysics Data System (ADS)

    Heilimo, Jyri; Harri, Ari-Matti; Aleksashkin, Sergey; Koryanov, Vsevolod; Arruego, Ignacio; Schmidt, Walter; Haukka, Harri; Finchenko, Valery; Martynov, Maxim; Ostresko, Boris; Ponomarenko, Andrey; Kazakovtsev, Viktor; Martin, Susanna; Siili, Tero

    2014-05-01

    A new generation of inflatable Entry, Descent and Landing System (EDLS) for Mars has been developed. It is used in both the initial atmospheric entry and atmospheric descent before the semi-hard impact of the penetrator into Martian surface. The EDLS applicability to Earth's atmosphere is studied by the EU/RITD [1] project. Project focuses to the analysis and tests of the transonic behaviour of this compact and light weight payload entry system at the Earth re-entry. 1. EDLS for Earth The dynamical stability of the craft is analysed, concentrating on the most critical part of the atmospheric re-entry, the transonic phase. In Martian atmosphere the MetNet vehicle stability during the transonic phase is understood. However, in the more dense Earth's atmosphere, the transonic phase is shorter and turbulence more violent. Therefore, the EDLS has to be sufficiently dynamically stable to overcome the forces tending to deflect the craft from its nominal trajectory and attitude. The preliminary design of the inflatable EDLS for Earth will be commenced once the scaling of the re-entry system and the dynamical stability analysis have been performed. The RITD-project concentrates on mission and applications achievable with the current MetNet-type (i.e. 'Mini-1' category) of lander, and on requirements posed by other type Earth re-entry concepts. 2. Entry Angle Determination for Mini-1 - lander For successful Earth landing, the suitable re-entry angle and velocity with specific descent vehicle (DV) mass and heat flux parameters need to be determined. These key parameters in determining the Earth re-entry for DV are: qmax (kW/m2): maximal specific heat flux, Q (MJ/m2): specific integral heat flux to DV front shield, m (kg): descent vehicle (DV) mass, V (m/s): re-entry velocity and Θ (deg.): flight-path angle at Earth re-entry For Earth re-entry, the calculation results in the optimal value of entry velocity for MetNet ('Mini-1' category) -type lander, with mass of 22kg, being

  17. RITD - Adapting Mars Entry, Descent and Landing System for Earth

    NASA Astrophysics Data System (ADS)

    Heilimo, Jyri; Aleksashkin, Sergey; Martynov, Maxim; Schmidt, Walter; Harri, Ari-Matti; Vsevolod Koryanov, D.; Kazakovtcev, Victor; Haukka, Harri; Arruego, Ignacio; Finchenko, Valery; Ostresko, Boris; Ponomarenko, Andrei; Martin, Susanna; Siili, Tero

    Abstract A new generation of inflatable Entry, Descent and Landing System (EDLS) or Mars has been developed. It is used in both the initial atmospheric entry and atmospheric descent before the semi-hard impact of the penetrator into Martian surface. The EDLS applicability to Earth’s atmosphere is studied by the EU/RITD [1] project. Project focuses to the analysis and tests of the transonic behaviour of this compact and light weight payload entry system at the Earth re-entry 1. EDLS for Earth The dynamical stability of the craft is analysed, concentrating on the most critical part of the atmospheric re-entry, the transonic phase. In Martian atmosphere the MetNet vehicle stability during the transonic phase is understood. However, in the more dense Earth’s atmosphere, the transonic phase is shorter and turbulence more violent. Therefore, the EDLS has to be sufficiently dynamically stable to overcome the forces tending to deflect the craft from its nominal trajectory and attitude. The preliminary design of the inflatable EDLS for Earth will be commenced once the scaling of the re-entry system and the dynamical stability analysis have been performed. The RITD-project concentrates on mission and applications achievable with the current MetNet-type (i.e. “Mini-1” category) of lander, and on requirements posed by other type Earth re-entry concepts. 2. Entry Angle Determination for Mini-1 - lander For successful Earth landing, the suitable re-entry angle and velocity with specific descent vehicle (DV) mass and heat flux parameters need to be determined. These key parameters in determining the Earth re-entry for DV are: - qmax (kW/m2): maximal specific heat flux, - Q (MJ/m2): specific integral heat flux to DV front shield, - m (kg): descent vehicle (DV) mass, - V (m/s): re-entry velocity and - theta(deg.): flight-path angle at Earth re-entry For Earth re-entry, the calculation results in the optimal value of entry velocity for MetNet (“Mini-1” category) -type

  18. Stress within a bicultural context for adolescents of Mexican descent.

    PubMed

    Romero, Andrea J; Roberts, Robert E

    2003-05-01

    Folkman and Lazarus's theory of stress and coping was used to develop a measure assessing the perceived stress within a bicultural context. Middle school students of Mexican descent (N = 881) reported their perceived stress from intergenerational acculturation gaps, within-group discrimination, out-group discrimination, and monolingual stress. Although immigrant youths reported more total number of stressors, U.S.-born youths reported more stress from needing better Spanish and impact of parents' culture. Immigrant youths reported more stress from needing better English in school. Higher stress was associated with more depressive symptoms for both U.S.-born and immigrant youths. Although this study has identified some elements of stress, it has not identified positive coping mechanisms of the bicultural context for Latino youths.

  19. On Belonging: The American Adolescent of Arab Descent.

    PubMed

    Khouri, Lama Z

    2016-08-01

    Although American families of Arab origin come from 22 countries and from varied backgrounds and cultures, reports suggest that they suffer equally from acculturation stress, stereotyping, discrimination, and the reverberations of the aftermath of September 11 as well as global affairs. However, because children and adolescents from these families, particularly those who are newly arrived immigrants, tend to do well in school, they are rarely targeted by research or policy. This article uses the narratives of 5 middle school age male students from Arab descent who were in a support group that met for 3 years (2004-2007), beginning shortly after President George W. Bush's declaration of the war on the "axis of evil." I used vignettes from this group to illustrate the stressors this population faces. The final section suggests an option for supporting this population.

  20. Adapting Mars Entry, Descent and Landing System for Earth

    NASA Astrophysics Data System (ADS)

    Heilimo, J.; Harri, A.-M.; Aleksashkin, S.; Koryanov, V.; Guerrero, H.; Schmidt, W.; Haukka, H.; Finchenko, V.; Martynov, M.; Ostresko, B.; Ponomarenko, A.; Kazakovtsev, V.; Arruego, I.; Martin, S.; Siili, T.

    2013-09-01

    In 2001 - 2011 an inflatable Entry, Descent and Landing System (EDLS) for Martian atmosphere was developed by FMI and the MetNet team. This MetNet Mars Lander EDLS is used in both the initial deceleration during atmospheric entry and in the final deceleration before the semi-hard impact of the penetrator to Martian surface. The EDLS design is ingenious and its applicability to Earth's atmosphere is studied in the on-going project. In particular, the behavior of the system in the critical transonic aerodynamic (from hypersonic to subsonic) regime will be investigated. This project targets to analyze and test the transonic behavior of this compact and light weight payload entry system to Earth's atmosphere [1]. Scaling and adaptation for terrestrial atmospheric conditions, instead of a completely new design, is a favorable approach for providing a new re-entry vehicle for terrestrial space applications.