49 CFR 572.198 - Pelvis acetabulum.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Pelvis acetabulum. 572.198 Section 572.198... Dummy, Small Adult Female § 572.198 Pelvis acetabulum. (a) The acetabulum is part of the lower torso... torso of the assembled dummy (drawing 180-0000). The dummy is equipped with a laterally oriented pelvis...

49 CFR 572.198 - Pelvis acetabulum.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Pelvis acetabulum. 572.198 Section 572.198... Test Dummy, Small Adult Female § 572.198 Pelvis acetabulum. (a) The acetabulum is part of the lower... pelvis accelerometer as specified in 49 CFR 572.200(d), acetabulum load cell SA572-S68, mounted as shown...

49 CFR 572.198 - Pelvis acetabulum.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Pelvis acetabulum. 572.198 Section 572.198... Test Dummy, Small Adult Female § 572.198 Pelvis acetabulum. (a) The acetabulum is part of the lower... pelvis accelerometer as specified in 49 CFR 572.200(d), acetabulum load cell SA572-S68, mounted as shown...

Accessing 3D Location of Standing Pelvis: Relative Position of Sacral Plateau and Acetabular Cavities versus Pelvis

PubMed Central

Berthonnaud, E.; Hilmi, R.; Dimnet, J.

2012-01-01

The goal of this paper is to access to pelvis position and morphology in standing posture and to determine the relative locations of their articular surfaces. This is obtained from coupling biplanar radiography and bone modeling. The technique involves different successive steps. Punctual landmarks are first reconstructed, in space, from their projected images, identified on two orthogonal standing X-rays. Geometric models, of global pelvis and articular surfaces, are determined from punctual landmarks. The global pelvis is represented as a triangle of summits: the two femoral head centers and the sacral plateau center. The two acetabular cavities are modeled as hemispheres. The anterior sacral plateau edge is represented by an hemi-ellipsis. The modeled articular surfaces are projected on each X-ray. Their optimal location is obtained when the projected contours of their models best fit real outlines identified from landmark images. Linear and angular parameters characterizing the position of global pelvis and articular surfaces are calculated from the corresponding sets of axis. Relative positions of sacral plateau, and acetabular cavities, are then calculated. Two hundred standing pelvis, of subjects and scoliotic patients, have been studied. Examples are presented. They focus upon pelvis orientations, relative positions of articular surfaces, and pelvis asymmetries. PMID:22567279

Interaction between thorax, lumbar, and pelvis movements in the transverse plane during gait at three velocities.

PubMed

Yang, Ya-Ting; Yoshida, Yasuyuki; Hortobágyi, Tibor; Suzuki, Shuji

2013-06-01

We determined the angular range of motion and the relative timing of displacement in the thorax, lumbar spine, and pelvis in the transverse plane during treadmill walking at three velocities. Nine healthy young females walked on a treadmill for three minutes at 0.40, 0.93, and 1.47 m/s. The position of seven reflective markers and three rigs placed on the thorax, lumbar spine, and pelvis were recorded at 200 Hz by an eight-camera motion capture system. As gait velocity increased, stride length increased, cycle time decreased, and angular displacement in the thorax and L1 decreased but increased at the pelvis and L5 (all P < .05). The time of maxi- mal angular rotation occurred in the following sequence: pelvis, L5, L3, L1, and thorax (P < .001). The thorax and L1 and L3 were in-phase for shorter duration as gait velocity increased, and this reduction was especially large, approx. 32% (P < .05), between thorax and pelvis. As gait velocity increased, the pelvis rotated earlier, causing the shortening of in-phase duration between thorax and pelvis. These data suggest that, as gait velocity increases, pelvis rotation dictates trunk rotation in the transverse plane during gait in healthy young females.

Biomechanical analysis of a novel hemipelvic endoprosthesis during ascending and descending stairs.

PubMed

Liu, Dongxu; Hua, Zikai; Yan, Xinyi; Jin, Zhongmin

2016-10-01

In this study, the biomechanical characteristic of a newly developed adjustable hemipelvic prosthesis under dynamic loading conditions was investigated using explicit finite element method. Both intact and reconstructed pelvis models, including pelvis, femur and soft tissues, were established referring to human anatomic data using a solid geometry of a human pelvic bone. Hip contact forces during ascending stairs and descending stairs were imposed on pelvic models. Results showed that maximum von Mises stresses in reconstructed pelvis were 421.85 MPa for prostheses and 109.12 MPa for cortical bone, which were still within a low and elastic range below the yielding strength of Ti-6Al-4V and cortical bone, respectively. Besides, no significant difference of load transferring paths along pelvic rings was observed between the reconstructed pelvis and natural pelvis models. And good agreement was found between the overall distribution of maximum principal stresses in trabecular bones of reconstructed pelvis and natural pelvis, while at limited stances, principal stresses in trabecular bone of reconstructed pelvis were slightly lower than natural pelvis. The results indicated that the load transferring function of pelvis could be restored by this adjustable hemipelvic prosthesis. Moreover, the prosthesis was predicted to have a reliable short- and long-term performance. However, due to the occurrence of slightly lower principal stresses at a few stances, a porous structure applied on the interface between the prosthesis and bone would be studied in future work to obtain better long-term stability. © IMechE 2016.

49 CFR 572.115 - Lumbar spine and pelvis.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine and pelvis. 572.115 Section 572.115... 50th Percentile Male § 572.115 Lumbar spine and pelvis. The specifications and test procedure for the lumbar spine and pelvis are identical to those for the SID dummy as set forth in § 572.42 except that the...

49 CFR 572.115 - Lumbar spine and pelvis.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Lumbar spine and pelvis. 572.115 Section 572.115... 50th Percentile Male § 572.115 Lumbar spine and pelvis. The specifications and test procedure for the lumbar spine and pelvis are identical to those for the SID dummy as set forth in § 572.42 except that the...

49 CFR 572.115 - Lumbar spine and pelvis.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Lumbar spine and pelvis. 572.115 Section 572.115... 50th Percentile Male § 572.115 Lumbar spine and pelvis. The specifications and test procedure for the lumbar spine and pelvis are identical to those for the SID dummy as set forth in § 572.42 except that the...

49 CFR 572.115 - Lumbar spine and pelvis.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false Lumbar spine and pelvis. 572.115 Section 572.115... 50th Percentile Male § 572.115 Lumbar spine and pelvis. The specifications and test procedure for the lumbar spine and pelvis are identical to those for the SID dummy as set forth in § 572.42 except that the...

49 CFR 572.115 - Lumbar spine and pelvis.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Lumbar spine and pelvis. 572.115 Section 572.115... 50th Percentile Male § 572.115 Lumbar spine and pelvis. The specifications and test procedure for the lumbar spine and pelvis are identical to those for the SID dummy as set forth in § 572.42 except that the...

Renal pelvis urothelial carcinoma of the upper moiety in complete right renal duplex: a case report.

PubMed

Zhang, Yiran; Yu, Quanfeng; Zhang, Zhihong; Liu, Ranlu; Xu, Yong

2015-01-01

Urothelial carcinoma (UC) originated from renal pelvis is the common tumor of the urinary system, however, neoplasia of the renal pelvis in duplex kidneys is extremely rare, especially in the complete renal and ureteral duplex cases. We present the first case of renal pelvis UC of the upper moiety in a complete right renal duplex. This male patient has bilateral complete renal and ureteral duplex. To the best of our knowledge, this is the first reported case of renal pelvis UC in a complete renal duplex system. After this experience we feel that the diagnosis of renal pelvis UC in duplex kidneys is not so easy, and once the diagnosis is determined, the whole renal duplex units and bladder cuff or ectopic orifice should be excised radically.

Spatial Geometry of the Human Pelvis

DTIC Science & Technology

1982-03-01

ADA118238 Spatial Geometry of the Human Pelvis , FEDERAL AVIATION ADMINISTRATION WASHINGTON DC MAR 1982 Distribution Statement A: Approved for public...OF THE HUMAN PELVIS March 1982 6. Performing Orgaenizatin Cede S. Perlorming Organizetion Report No. 7. Autitrs) Herbert M. Reynolds, Clyde C. Snow...Tdd skeletal collection. Ibrk done on this study, initiated to define and describe the spatial geomtry of the adult pelvis , was sponsored by the

Estimation of the Joint Patient Condition Occurrence Frequencies from Operation Iraqi Freedom and Operation Enduring Freedom. Volume I: Development of Methodology

DTIC Science & Technology

2011-03-28

CL CHEST 807.2 Closed Fracture of Sternum FRAC CL CHEST 808.8 Fracture of Pelvis Unspec, Closed FRAC CL PELVIS+UROGENITAL 810 Clavicle Fracture...of Pelvis Unspec, Open FRAC OP PELVIS+UROGENITAL 810.1 Clavicle Fracture, Open FRAC OP SHOULDER & UPPER ARM 810.12 Open Fracture of Shaft of Clavicle

Instantaneous progression reference frame for calculating pelvis rotations: Reliable and anatomically-meaningful results independent of the direction of movement.

PubMed

Kainz, Hans; Lloyd, David G; Walsh, Henry P J; Carty, Christopher P

2016-05-01

In motion analysis, pelvis angles are conventionally calculated as the rotations between the pelvis and laboratory reference frame. This approach assumes that the participant's motion is along the anterior-posterior laboratory reference frame axis. When this assumption is violated interpretation of pelvis angels become problematic. In this paper a new approach for calculating pelvis angles based on the rotations between the pelvis and an instantaneous progression reference frame was introduced. At every time-point, the tangent to the trajectory of the midpoint of the pelvis projected into the horizontal plane of the laboratory reference frame was used to define the anterior-posterior axis of the instantaneous progression reference frame. This new approach combined with the rotation-obliquity-tilt rotation sequence was compared to the conventional approach using the rotation-obliquity-tilt and tilt-obliquity-rotation sequences. Four different movement tasks performed by eight healthy adults were analysed. The instantaneous progression reference frame approach was the only approach that showed reliable and anatomically meaningful results for all analysed movement tasks (mean root-mean-square-differences below 5°, differences in pelvis angles at pre-defined gait events below 10°). Both rotation sequences combined with the conventional approach led to unreliable results as soon as the participant's motion was not along the anterior-posterior laboratory axis (mean root-mean-square-differences up to 30°, differences in pelvis angles at pre-defined gait events up to 45°). The instantaneous progression reference frame approach enables the gait analysis community to analysis pelvis angles for movements that do not follow the anterior-posterior axis of the laboratory reference frame. Copyright © 2016 Elsevier B.V. All rights reserved.

The Human Pelvis: Variation in structure and function during gait

PubMed Central

Lewis, Cara L.; Laudicina, Natalie M.; Khuu, Anne; Loverro, Kari L.

2017-01-01

The shift to habitual bipedalism 4–6 million years ago in the hominin lineage created a morphologically and functionally different human pelvis compared to our closest living relatives, the chimpanzees. Evolutionary changes to the shape of the pelvis were necessary for the transition to habitual bipedalism in humans. These changes in the bony anatomy resulted in an altered role of muscle function, influencing bipedal gait. Additionally, there are normal sex-specific variations in the pelvis as well as abnormal variations in the acetabulum. During gait, the pelvis moves in the three planes to produce smooth and efficient motion. Subtle sex-specific differences in these motions may facilitate economical gait despite differences in pelvic structure. The motions of the pelvis and hip may also be altered in the presence of abnormal acetabular structure, especially with acetabular dysplasia. PMID:28297184

The interrelationship of the thorax and pelvis under varying task constraints.

PubMed

Delphinus, Elias M; Sayers, Mark Gregory Leigh

2013-01-01

The purpose of this study was to investigate the interrelationship between the thorax and pelvis during coupled movement patterns. Fifty-seven participants were assessed using an infrared motion analysis system to track trunk movement during maximal pelvis and thorax rotations over four trunk inclinations and two pelvic constraint conditions. A repeated-measures multivariate analysis of variance investigated the effects of forward trunk inclination and pelvic constraint on thorax and pelvic rotation. Forward trunk inclination from neutral to 45° resulted in a 46% (p < 0.001) decrease in axial pelvic rotation and a 15% (p < 0.001) decrease in axial thorax rotation with an unconstrained pelvis. A constrained pelvis resulted in a 15% (p < 0.001) decrease in axial thorax rotation. An externally constrained pelvis allowed the thorax to achieve an average of 18° (SD = 2°) greater rotational range of motion across all angles. This study reinforced the importance of allowing the pelvis to rotate during whole body axial rotation tasks. Results indicated that maximum axial trunk rotation is best achieved in a neutral posture, when the pelvis is allowed to contribute and flexion at the hips should be minimised. For example, if a recumbent task requires rotation of the torso, then the chair seat should be allowed to swivel.

Anatomy, Development, and Function of the Human Pelvis.

PubMed

DeSilva, Jeremy M; Rosenberg, Karen R

2017-04-01

The pelvis is an anatomically complex and functionally informative bone that contributes directly to both human locomotion and obstetrics. Because of the pelvis' important role in obstetrics, it is one of the most sexually dimorphic bony elements of the human body. The complex intersection of pelvic dimorphism, locomotion, and obstetrics has been reenergized by exciting new research, and many papers in this special issue of the pelvis help provide clarity on the relationship between pelvic form (especially female) and locomotor function. Compared to the pelvis of our ape relatives, the human pelvis is uniquely shaped; it is superoinferiorly short and stout, and mediolaterally wide-critical adaptations for bipedalism that are already present in some form very early in the history of the hominin lineage. In this issue, 13 original research papers address the anatomy, development, variation, and function of the modern human pelvis, with implications for understanding the selection pressures that shaped and continue to shape this bone. This rich collection of scholarship moves our understanding of the pelvis forward, while raising dozens of new questions that we hope will serve as inspiration for colleagues and students (both current and future) puzzled by this fascinatingly complex bone. Anat Rec, 300:628-632, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Ovarian cancer

MedlinePlus

... test (serum HCG) CT or MRI of the pelvis or abdomen Ultrasound of the pelvis Surgery, such as a pelvic laparoscopy or exploratory ... uterus, or other structures in the belly or pelvis. Chemotherapy is used after surgery to treat any ...

The Human Pelvis: Variation in Structure and Function During Gait.

PubMed

Lewis, Cara L; Laudicina, Natalie M; Khuu, Anne; Loverro, Kari L

2017-04-01

The shift to habitual bipedalism 4-6 million years ago in the hominin lineage created a morphologically and functionally different human pelvis compared to our closest living relatives, the chimpanzees. Evolutionary changes to the shape of the pelvis were necessary for the transition to habitual bipedalism in humans. These changes in the bony anatomy resulted in an altered role of muscle function, influencing bipedal gait. Additionally, there are normal sex-specific variations in the pelvis as well as abnormal variations in the acetabulum. During gait, the pelvis moves in the three planes to produce smooth and efficient motion. Subtle sex-specific differences in these motions may facilitate economical gait despite differences in pelvic structure. The motions of the pelvis and hip may also be altered in the presence of abnormal acetabular structure, especially with acetabular dysplasia. Anat Rec, 300:633-642, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Evaluation of the added value of imaging the pelvis in patients with hepatocellular cancer.

PubMed

Szklaruk, Janio; Kaya, Diana; Wei, Wei

2018-02-01

The study aims to evaluate added value of the pelvic portion of the computed tomography (CT) and magnetic resonance imaging (MRI) examination in patients with a primary diagnosis of hepatocellular cancer (HCC). The study reviewed the medical records of 478 patients with 881 examinations of the abdomen and pelvis who underwent treatment at our institution between March 2015 and March 2016. These patients were reviewed for presence of pathology in the pelvis, which were classified into two categories as new or old (already known on prior imaging). Of 478 patients, 230 underwent MRI examination of the abdomen and pelvis, and the other 248 underwent CT scans of these regions. There were no findings on the CT or MRI of the pelvis in 80.5% of patients (n = 385), including 81.5% of those who had CT and 79.6% of those who had MRI. Ninety-three patients had findings in the pelvis, the most common of which were bone metastases (31 patients), ascites (27 patients), implants (seven patients), and bladder wall thickening (five patients). In only 7.9% of patients, the findings were related to metastatic disease. In 5.4% of all imaging studies revealed a new finding in the pelvis. Imaging of the pelvis (CT or MRI) does not seem to provide additional information in the majority of cases with HCC. The results suggest that the follow-up evaluation of patients with HCC may not include a pelvis exam. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

General Information about Transitional Cell Cancer of the Renal Pelvis and Ureter

MedlinePlus

... Pelvis and Ureter Treatment (PDQ®)–Patient Version General Information About Transitional Cell Cancer of the Renal Pelvis ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

Using survival analysis to determine association between maternal pelvis height and antenatal fetal head descent in Ugandan mothers.

PubMed

Munabi, Ian Guyton; Luboga, Samuel Abilemech; Mirembe, Florence

2015-01-01

Fetal head descent is used to demonstrate the maternal pelvis capacity to accommodate the fetal head. This is especially important in low resource settings that have high rates of childbirth related maternal deaths and morbidity. This study looked at maternal height and an additional measure, maternal pelvis height, from automotive engineering. The objective of the study was to determine the associations between maternal: height and pelvis height with the rate of fetal head descent in expectant Ugandan mothers. This was a cross sectional study on 1265 singleton mothers attending antenatal clinics at five hospitals in various parts of Uganda. In addition to the routine antenatal examination, each mother had their pelvis height recorded following informed consent. Survival analysis was done using STATA 12. It was found that 27% of mothers had fetal head descent with an incident rate of 0.028 per week after the 25th week of pregnancy. Significant associations were observed between the rate of fetal head descent with: maternal height (Adj Haz ratio 0.93 P < 0.01) and maternal pelvis height (Adj Haz ratio 1.15 P < 0.01). The significant associations observed between maternal: height and pelvis height with rate of fetal head descent, demonstrate a need for further study of maternal pelvis height as an additional decision support tool for screening mothers in low resource settings.

Using survival analysis to determine association between maternal pelvis height and antenatal fetal head descent in Ugandan mothers

PubMed Central

Munabi, Ian Guyton; Luboga, Samuel Abilemech; Mirembe, Florence

2015-01-01

Introduction Fetal head descent is used to demonstrate the maternal pelvis capacity to accommodate the fetal head. This is especially important in low resource settings that have high rates of childbirth related maternal deaths and morbidity. This study looked at maternal height and an additional measure, maternal pelvis height, from automotive engineering. The objective of the study was to determine the associations between maternal: height and pelvis height with the rate of fetal head descent in expectant Ugandan mothers. Methods This was a cross sectional study on 1265 singleton mothers attending antenatal clinics at five hospitals in various parts of Uganda. In addition to the routine antenatal examination, each mother had their pelvis height recorded following informed consent. Survival analysis was done using STATA 12. Results It was found that 27% of mothers had fetal head descent with an incident rate of 0.028 per week after the 25th week of pregnancy. Significant associations were observed between the rate of fetal head descent with: maternal height (Adj Haz ratio 0.93 P < 0.01) and maternal pelvis height (Adj Haz ratio 1.15 P < 0.01). Conclusion The significant associations observed between maternal: height and pelvis height with rate of fetal head descent, demonstrate a need for further study of maternal pelvis height as an additional decision support tool for screening mothers in low resource settings. PMID:26918071

A complete-pelvis segmentation framework for image-free total hip arthroplasty (THA): methodology and clinical study.

PubMed

Xie, Weiguo; Franke, Jochen; Chen, Cheng; Grützner, Paul A; Schumann, Steffen; Nolte, Lutz-P; Zheng, Guoyan

2015-06-01

Complete-pelvis segmentation in antero-posterior pelvic radiographs is required to create a patient-specific three-dimensional pelvis model for surgical planning and postoperative assessment in image-free navigation of total hip arthroplasty. A fast and robust framework for accurately segmenting the complete pelvis is presented, consisting of two consecutive modules. In the first module, a three-stage method was developed to delineate the left hemi-pelvis based on statistical appearance and shape models. To handle complex pelvic structures, anatomy-specific information processing techniques were employed. As the input to the second module, the delineated left hemi-pelvis was then reflected about an estimated symmetry line of the radiograph to initialize the right hemi-pelvis segmentation. The right hemi-pelvis was segmented by the same three-stage method, Two experiments conducted on respectively 143 and 40 AP radiographs demonstrated a mean segmentation accuracy of 1.61±0.68 mm. A clinical study to investigate the postoperative assessment of acetabular cup orientations based on the proposed framework revealed an average accuracy of 1.2°±0.9° and 1.6°±1.4° for anteversion and inclination, respectively. Delineation of each radiograph costs less than one minute. Despite further validation needed, the preliminary results implied the underlying clinical applicability of the proposed framework for image-free THA. Copyright © 2014 John Wiley & Sons, Ltd.

Influence of standing or seated pelvis on dummy responses in rear impacts.

PubMed

Viano, David C; Parenteau, Chantal S; Burnett, Roger

2012-03-01

There is a question whether the standing or seated pelvis should be used in Hybrid III dummy evaluations of seats and belt restraint systems in severe rear impacts. This study compares the standing and seated Hybrid III pelvis in matched rear sled tests. Sixteen sled tests were found at 10, 16 and 24 km/h rear delta V in Ford's archives where matched tests were run with the standing and seated pelvis in a belted Hybrid III dummy. Two new tests were conducted at 40 km/h rear delta V to extend the severity range. The head, chest and pelvis were instrumented with triaxial accelerometers and the upper and lower neck, thoracic spine and lumbar spine had transducers measuring triaxial loads and moments. Belt Loads were measured. High-speed video recorded different views of the dummy motion. Dummy kinematics and biomechanical responses were compared for all of the data with the two different Hybrid III pelvic designs. In the 40 km/h sled tests, the dummy motion and excursion were essentially similar with the standing and seated pelvis. The similarities included the lap belt interaction with the pelvis and the leg movement upward flexing the hip joint. Overall, similar biomechanic and kinematic responses were found, including the pelvic acceleration, spinal forces and moments. For the lower speed tests at 10, 16 and 24 km/h, the motion sequence was also similar with the two different pelvises, including the upward movement of the legs as the seat was loaded and rebound kinematics. The biomechanical responses were similar. The seated pelvis involves only a small portion of the upper leg molded into the vinyl skin of the pelvis and does not limit leg rotation at the hip joint. Furthermore, lap belt loads were minimal during the rearward movement of the dummy. The matched testing showed no significant difference in occupant kinematics or biomechanical responses between the standing and seated pelvis in rear sled tests. The Hybrid III dummy with the seated pelvis is suitable for FMVSS 301 and other testing of seats and belt restraint systems in severe rear impacts. Copyright © 2011 Elsevier Ltd. All rights reserved.

Hip joint kinetics in the table tennis topspin forehand: relationship to racket velocity.

PubMed

Iino, Yoichi

2018-04-01

The purpose of this study was to determine hip joint kinetics during a table tennis topspin forehand, and to investigate the relationship between the relevant kinematic and kinetic variables and the racket horizontal and vertical velocities at ball impact. Eighteen male advanced table tennis players hit cross-court topspin forehands against backspin balls. The hip joint torque and force components around the pelvis coordinate system were determined using inverse dynamics. Furthermore, the work done on the pelvis by these components was also determined. The peak pelvis axial rotation velocity and the work done by the playing side hip pelvis axial rotation torque were positively related to the racket horizontal velocity at impact. The sum of the work done on the pelvis by the backward tilt torques and the upward joint forces was positively related to the racket vertical velocity at impact. The results suggest that the playing side hip pelvis axial rotation torque exertion is important for acquiring a high racket horizontal velocity at impact. The pelvis backward tilt torques and upward joint forces at both hip joints collectively contribute to the generation of the racket vertical velocity, and the mechanism for acquiring the vertical velocity may vary among players.

Body weight support during robot-assisted walking: influence on the trunk and pelvis kinematics.

PubMed

Swinnen, Eva; Baeyens, Jean-Pierre; Hens, Gerrit; Knaepen, Kristel; Beckwée, David; Michielsen, Marc; Clijsen, Ron; Kerckhofs, Eric

2015-01-01

Efficacy studies concerning robot assisted gait rehabilitation showed limited clinical benefits. A changed kinematic pattern might be responsible for this. Little is known about the kinematics of the trunk and pelvis during robot assisted treadmill walking (RATW). The aim of this study was to assess the trunk and pelvis kinematics of healthy subjects during RATW, with different amounts of body weight support (BWS) compared to regular treadmill walking (TW). Eighteen healthy participants walked on a treadmill, while kinematics were registered by an electromagnetic tracking device. Hereafter, the kinematics of pelvis and trunk were registered during RATW (guidance force 30%) with 0%, 30% and 50% BWS. Compared to TW, RATW showed a decrease in the following trunk movements: axial rotation, anteroposterior flexion, lateral and anteroposterior translation. Besides, a decrease in lateral tilting and all translation of the pelvis was found when comparing RATW with TW. Furthermore, the anteroposterior tilting of the pelvis increased during RATW. In general, there was a decrease in trunk and pelvis movement amplitude during RATW compared with regular TW. Though, it is not known if these changes are responsible for the limited efficacy of robot assisted gait rehabilitation. Further research is indicated.

SU-E-J-152: Evaluation of TrueBeam OBI V. 1.5 CBCT Performance in An Adaptive RT Environment

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

Gardner, S; Studenski, M; Giaddui, T

2014-06-01

Purpose: To evaluate the image quality and imaging dose of the Varian TrueBeam OBIv.1.5 CBCT system in a clinical adaptive radiation therapy environment, simulated by changing phantom thickness. Methods: Various OBI CBCT protocols(Head, Pelvis, Thorax, Spotlight) were used to acquire images of Catphan504 phantom(nominal phantom thickness and 10 cm additional phantom thickness). The images were analyzed for low contrast detectability(CNR), uniformity(UI), and HU sensitivity. These results were compared to the same image sets for planning CT(pCT)(GE LightSpeed 16- slice). Imaging dose measurements were performed with Gafchromic XRQA2 film for various OBI protocols (Pelvis, Thorax, Spotlight) in a pelvic-sized phantom(nominal thicknessmore » and 4cm additional thickness). Dose measurements were acquired in the interior and at the surface of the phantom. Results: The nominal CNR[additional thickness CNR] for OBI was—Pelvis:1.45[0.81],Thorax:0.86[0.48], Spotlight:0.67[0.39],Head:0.28 [0.10]. The nominal CNR[additional thickness CNR] for pCT was— Pelvis:0.87[0.41],Head:0.60[0.22]. The nominal UI[additional thickness UI] for OBI was—Pelvis:11.5[24.1],Thorax:17.0[20.6], Spotlight:23.2[23.2], Head:15.6[59.9]. The nominal UI[additional thickness UI] for pCT was— Pelvis:9.2[8.6],Head:2.1[2.9]. The HU difference(averaged over all material inserts) between nominal and additional thickness scans for OBI: 8.26HU(Pelvis), 33.39HU(Thorax), 178.98HU(Head), 108.20HU (Spotlight); for pCT: 16.00HU(Pelvis), 19.85HU(Head). Uncertainties in electron density were calculated based on HU values with varying phantom thickness. Average electron-density deviations (ρ(water)=1)for GE-Pelvis, GE-Head, OBI-Pelvis, OBI-Thorax, OBI-Spotlight, and OBI-Head were: 0.0182, 0.0180, 0.0058, 0.0478, 0.2750, and 0.3115, respectively.The average phantom interior dose was(OBI-nominal):2.35cGy(Pelvis), 0.60cGy(Thorax), 1.87cGy(Spotlight); OBI-increased thickness: 1.77cGy(Pelvis), 0.43cGy(Thorax), 1.53cGy (Spotlight). Average surface dose(OBI-nominal): 2.29cGy(Pelvis), 0.56cGy(Thorax), 1.79cGy (Spotlight); OBI-increased thickness: 1.94cGy(Pelvis), 0.48cGy(Thorax), 1.47cGy (Spotlight). Conclusion: The OBI-Pelvis protocol offered comparable CNR and HU constancy to pCT for each geometry; other protocols, particularly Spotlight and Head, exhibited lower HU constancy and CNR. The uniformity of pCT was superior to OBI for all protocols. CNR and UI were degraded for both systems/scan types with increased thickness. The OBI interior dose decreased by approximately 30% with additional thickness. This work was funded, in part, under a grant with the Pennsylvania Department of Health. The Department of Health specifically declaims responsibility for any analyses, interpretations, or conclusions.« less

An analysis of peak pelvis rotation speed, gluteus maximus and medius strength in high versus low handicap golfers during the golf swing.

PubMed

Callaway, Sarahann; Glaws, Kate; Mitchell, Melissa; Scerbo, Heather; Voight, Michael; Sells, Pat

2012-06-01

The kinematic sequence of the golf swing is an established principle that occurs in a proximal-to-distal pattern with power generation beginning with rotation of the pelvis. Few studies have correlated the influence of peak pelvis rotation to the skill level of the golfer. Furthermore, minimal research exists on the strength of the gluteal musculature and their ability to generate power during the swing. The purpose of this study was to explore the relationship between peak pelvis rotation, gluteus medius and gluteus maximus strength, and a golfer's handicap. 56 healthy subjects. Each subject was assessed using a hand-held dynamometry device per standardized protocol to determine gluteus maximus and medius strength. The K-vest was placed on the subject with electromagnetic sensors at the pelvis, upper torso, and gloved lead hand to measure the rotational speed at each segment in degrees/second. After K-vest calibration and 5 practice swings, each subject hit 5 golf balls during which time, the sensors measured pelvic rotation speed. A one-way ANOVA was performed to determine the relationships between peak pelvis rotation, gluteus medius and gluteus maximus strength, and golf handicap. A significant difference was found between the following dependent variables and golf handicap: peak pelvis rotation (p=0.000), gluteus medius strength (p=0.000), and gluteus maximus strength (p=0.000). Golfers with a low handicap are more likely to have increased pelvis rotation speed as well as increased gluteus maximus and medius strength when compared to high handicap golfers. The relationships between increased peak pelvis rotation and gluteus maximus and medius strength in low handicap golfers may have implications in designing golf training programs. Further research needs to be conducted in order to further explore these relationships.

The study of precision measurement of pelvis spatial structure

NASA Astrophysics Data System (ADS)

Ma, Xiang; Ouyang, Jianfei; Qu, Xinghua

2010-03-01

Osteometry is fundamental for anthropometry. It provides the key technology and value to the study of palaeoanthropology, medicine, and criminal investigation. The traditional osteometry that has been widely accepted and used since 18th century has no longer met the information demand for modern research and application. It is significant and necessary to create an advanced 3-dimensional osteometry technique for anthropometry. This paper presents a new quick and accurate method to measure human pelvis through mathematical modeling. The pelvis is a complex combination of bones, which consists of three connected parts: hipbones, sacrum, and coccyx. There are over 40 items to be measured for the 1-dimension characteristics. In this paper, a combined measuring technology is developed for pelvis measurement. It uses machine vision systems and a portable measuring arm to obtain key geometry parameters of the pelvis. The mathematics models of the pelvis spatial structure and its parts are created through the process of data collecting, digging, assembling, and modeling. The experiment shows that the proposed technology can meet traditional osteometry and obtain entire 1D geometric parameters of the pelvis, such as maximum breadth and height, diameter of obstetric conjugata, inclination angle, and sakralneigungswinkel, etc. at the same time after modeling. Besides making the measurements above, the proposed technology can measure the geometry characteristics of pelvis and its parts, such as volume, surface area, curvature, and spatial structure, which are almost impossible for traditional technology. The overall measuring error is less than 0.1mm.

Somatic dysfunction and its association with chronic low back pain, back-specific functioning, and general health: results from the OSTEOPATHIC Trial.

PubMed

Licciardone, John C; Kearns, Cathleen M

2012-07-01

Somatic dysfunction is diagnosed by the presence of any of 4 TART criteria: tissue texture abnormality, asymmetry, restriction of motion, or tenderness. To measure the prevalence of somatic dysfunction in patients with chronic low back pain (LBP) and to study the associations of somatic dysfunction with LBP severity, back-specific functioning, and general health. Cross-sectional study nested within a randomized controlled trial. University-based study in Dallas-Fort Worth, Texas. A total of 455 adult research patients with non-specific chronic LBP. Somatic dysfunction in the lumbar, sacrum/pelvis, and pelvis/innominate regions, including key lesions representing severe somatic dysfunction. A 10-cm visual analog scale (VAS), the Roland-Morris Disability Questionnaire (RMDQ), and the Medical Outcomes Study Short Form-36 Health Survey (SF-36) were used to measure LBP severity, back-specific functioning, and general health, respectively. Severe somatic dysfunction was most prevalent in the lumbar (225 [49%]), sacrum/pelvis (129 [28%]), and pelvis/innominate (48 [11%]) regions. Only 30 patients (7%) had no somatic dysfunction in the lumbar, sacrum/pelvis, or pelvis/innominate regions. There were 4 statistically significant pairwise correlations for severe somatic dysfunction: thoracic (T) 10-12 with ribs; T10-12 with lumbar; lumbar with sacrum/pelvis; and sacrum/pelvis with pelvis/innominate. Having a key lesion in the lumbar region (ρ=0.80) or sacrum/pelvis region (ρ=0.71) was strongly correlated with the overall number of key lesions. There were no consistent demographic or clinical predictors of somatic dysfunction. The presence (vs absence) of severe somatic dysfunction in the lumbar region was associated with greater LBP severity (median VAS score, 4.7 vs 3.8, respectively; P=.003) and greater back-specific disability (median RMDQ score, 6 vs 4, respectively; P=.01). The presence (vs absence) of severe somatic dysfunction in the sacrum/pelvis region was associated with greater back-specific disability (median RMDQ score, 6 vs 5, respectively; P=.02) and poorer general health (median SF-36 score, 62 vs 72, respectively; P=.002). An increasing number of key lesions was associated with back-specific disability (P=.009) and poorer general health (P=.02). The present study demonstrates that somatic dysfunction, particularly in the lumbar and sacrum/pelvis regions, is common in patients with chronic LBP. Forthcoming extensions of the OSTEOPATHIC Trial will assess the efficacy of OMT according to baseline levels of somatic dysfunction.

Different coordination and flexibility of the spine and pelvis during lateral bending between young and older adults.

PubMed

Sung, Paul S

2016-04-01

This study examined coordination of the spine and pelvis during lateral bending of the trunk in older adults. Thirty-four healthy subjects (17 young and 17 older adults) demonstrated lateral bending at a controlled speed while holding a bar at approximately 180 degrees of shoulder flexion. Kinematic data collection was completed on the thoracic spine, lumbar spine, and pelvis. The coupling angle was calculated to examine the thorax-lumbar, lumbar-pelvis, and thorax-pelvis coordination patterns. The older adults demonstrated a reduced range of motion (ROM) of the lumbar spine, while both groups revealed similar ROM in the thorax and in the pelvis. The coupling angle between the straightening and bending phases was different only for the older adults in the thorax-lumbar (23.4±8.0 vs. -1.6±4.4, p=0.004) and the lumbar-pelvis (65.4±7.2 vs. 86.1±7.8, p=0.001) coordination. However, there was no group difference in the thorax-pelvis coordination. These findings indicate that age-related changes in the lumbar region affect coordination patterns only during the bending phase. The older adults preserved a similar pattern of movement to the young adults during the straightening phase, but the coordination variability of the coupling angles was greater for the older adults than for the young adults. This movement pattern suggests that the older adults lacked consistent trunk control in an attempt to optimize lateral bending coordination. Copyright © 2016 Elsevier B.V. All rights reserved.

Walking more slowly than with normal velocity: The influence on trunk and pelvis kinematics in young and older healthy persons.

PubMed

Swinnen, Eva; Baeyens, Jean-Pierre; Pintens, Seppe; Buyl, Ronald; Goossens, Maggie; Meeusen, Romain; Kerckhofs, Eric

2013-08-01

Few studies have addressed trunk and pelvis movements during gait, although they play an important role in gait control. The aim of this study was to compare trunk and pelvis kinematics between slower walking (1, 2, 3, 4kmph) and normal walking (5kmph), and between healthy adults who were young (n=15, 20-30years) and older (n=17, 50-60years). After 4min of treadmill walking, the 3-dimensional trunk and pelvis kinematics was measured (Polhemus Liberty™, 250Hz). A repeated measures ANOVA with simple contrasts was used to look for differences between the velocity conditions of walking and independent t-testing for comparison between the age groups (significance level: 5%, SPSS20). Walking more slowly than with normal velocity induces (1) a decrease in vertical center of mass of the trunk displacement, trunk lateral flexion and axial rotation and pelvis lateral and antero-posterior tilting, and (2) an increase in lateral and antero-posterior center of mass of the trunk displacement. Compared to young persons, older persons show: (1) larger pelvis axial rotations and trunk lateral and antero-posterior movements, and (2) smaller pelvis lateral tilting and trunk vertical movements and rotations. The literature reports that patients often walk slowly and that older persons show different gait patterns compared to young persons. This study shows that there are changes in trunk and pelvis kinematics (1) when walking more slowly than with normal velocity and (2) in older persons compared to young persons. These data could be taken into account in gait rehabilitation. © 2013.

Relationship between maternal pelvis height and other anthropometric measurements in a multisite cohort of Ugandan mothers

PubMed Central

Munabi, Ian Guyton; Byamugisha, Josaphat; Luboobi, Livingstone; Luboga, Samuel Abilemech; Mirembe, Florence

2016-01-01

Introduction In sub Saharan Africa, childbirth remains a challenge that creates the need for additional screening tools. Maternal pelvis height, which is currently in use by automotive engineers has previously been shown to have significant associations with various childbirth related outcomes and events. This study set out to determine the associations between maternal: Age, height, weight and number of pregnancies with maternal pelvis height in Ugandan mothers. Methods This was a secondary analysis of maternal birth records from nine Ugandan hospitals, of mothers with singleton pregnancies. Data was analyzed using multilevel regression with respect to maternal pelvis height and additional analysis for tribe and site of childbirth intraclass correlations (ICCs). Results The mean maternal pelvis height was 7.30cm for the 2068 records. Maternal pelvis height was associated with: a 0.01cm reduction per centimeter of maternal height (P=0.02), 0.01cm increase per kg of maternal weight (P<0.01), 0.04cm increase for each additional pregnancy (P=0.03) and 0.03cm increase with respect to tribe of mother (P=0.27), for a constant of 7.97cm (P<0.01). The ICC for tribe was 0.20 (SE=0.08) and 0.37 (SE=0.11) for site. Conclusion Maternal pelvis height was associated with maternal height, maternal weight and number of pregnancies. The site of childbirth had a moderate effect on the above associations with maternal pelvis height. More study on the public health screening value of these measurements in these settings is required. PMID:27800110

Relationship between maternal pelvis height and other anthropometric measurements in a multisite cohort of Ugandan mothers.

PubMed

Munabi, Ian Guyton; Byamugisha, Josaphat; Luboobi, Livingstone; Luboga, Samuel Abilemech; Mirembe, Florence

2016-01-01

In sub Saharan Africa, childbirth remains a challenge that creates the need for additional screening tools. Maternal pelvis height, which is currently in use by automotive engineers has previously been shown to have significant associations with various childbirth related outcomes and events. This study set out to determine the associations between maternal: Age, height, weight and number of pregnancies with maternal pelvis height in Ugandan mothers. This was a secondary analysis of maternal birth records from nine Ugandan hospitals, of mothers with singleton pregnancies. Data was analyzed using multilevel regression with respect to maternal pelvis height and additional analysis for tribe and site of childbirth intraclass correlations (ICCs). The mean maternal pelvis height was 7.30cm for the 2068 records. Maternal pelvis height was associated with: a 0.01cm reduction per centimeter of maternal height (P=0.02), 0.01cm increase per kg of maternal weight (P<0.01), 0.04cm increase for each additional pregnancy (P=0.03) and 0.03cm increase with respect to tribe of mother (P=0.27), for a constant of 7.97cm (P<0.01). The ICC for tribe was 0.20 (SE=0.08) and 0.37 (SE=0.11) for site. Maternal pelvis height was associated with maternal height, maternal weight and number of pregnancies. The site of childbirth had a moderate effect on the above associations with maternal pelvis height. More study on the public health screening value of these measurements in these settings is required.

Sorafenib in Treating Patients With Advanced or Metastatic Cancer of the Urinary Tract

ClinicalTrials.gov

2015-08-04

Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage III Bladder Cancer; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder

Ontogeny of the Human Pelvis.

PubMed

Verbruggen, Stefaan W; Nowlan, Niamh C

2017-04-01

The human pelvis has evolved over time into a remarkable structure, optimised into an intricate architecture that transfers the entire load of the upper body into the lower limbs, while also facilitating bipedal movement. The pelvic girdle is composed of two hip bones, os coxae, themselves each formed from the gradual fusion of the ischium, ilium and pubis bones. Unlike the development of the classical long bones, a complex timeline of events must occur in order for the pelvis to arise from the embryonic limb buds. An initial blastemal structure forms from the mesenchyme, with chondrification of this mass leading to the first recognisable elements of the pelvis. Primary ossification centres initiate in utero, followed post-natally by secondary ossification at a range of locations, with these processes not complete until adulthood. This cascade of events can vary between individuals, with recent evidence suggesting that fetal activity can affect the normal development of the pelvis. This review surveys the current literature on the ontogeny of the human pelvis. Anat Rec, 300:643-652, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Pelvi-ureteric junction obstruction related to crossing vessels: vascular anatomic variations and implication for surgical approaches.

PubMed

Panthier, Frédéric; Lareyre, Fabien; Audouin, Marie; Raffort, Juliette

2018-03-01

Pelvi-ureteric junction obstruction corresponds to an impairment of urinary transport that can lead to renal dysfunction if not treated. Several mechanisms can cause the obstruction of the ureter including intrinsic factors or extrinsic factors such as the presence of crossing vessels. The treatment of the disease relies on surgical approaches, pyeloplasty being the standard reference. The technique consists in removing the pathologic ureteric segment and renal pelvis and transposing associated crossing vessels if present. The vascular anatomy of the pelvi-ureteric junction is complex and varies among individuals, and this can impact on the disease development and its surgical treatment. In this review, we summarize current knowledge on vascular anatomic variations in the pelvi-ureteric junction. Based on anatomic characteristics, we discuss implications for surgical approaches during pyeloplasty and vessel transposition.

Classification of high-grade spondylolistheses based on pelvic version and spine balance: possible rationale for reduction.

PubMed

Hresko, Michael T; Labelle, Hubert; Roussouly, Pierre; Berthonnaud, Eric

2007-09-15

Retrospective review of a radiographic database of high-grade spondylolisthesis patients in comparison with asymptomatic controls. To analyze the sagittal spinopelvic alignment in high-grade spondylolisthesis patients and identify subgroups that may require reduction to restore sagittal balance. High-grade spondylolisthesis is associated with an abnormally high pelvic incidence (PI); however, the spatial orientation of the pelvis, determined by sacral slope (SS) and pelvic tilt (PT), is not known. We hypothesized that sagittal spinal alignment would vary with the pelvic orientation. Digitized sagittal radiographs of 133 high-grade spondylolisthesis patients (mean age, 17 years) were measured to determined sagittal alignment. K-means cluster analysis identified 2 groups based on the PT and SS, which were compared by paired t test. Comparisons were made to asymptomatic controls matched for PI. High-grade spondylolisthesis patients had a mean PI of 78.9 degrees +/- 12.1 degrees . Cluster analysis identified a retroverted, unbalanced pelvis group with high PT (36.5 degrees +/- 8.0 degrees )/low SS (40.3 degrees +/- 9.0 degrees ) and a balanced pelvic group with low PT (mean 21.3 degrees +/- 8.2 degrees )/high SS (59.9 degrees +/- 11.2 degrees ). The retroverted pelvis group had significantly greater L5 incidence and lumbosacral angle with less thoracic kyphosis than the balanced pelvic group. A total of 83% of controls had a "balanced pelvis" based on the categorization by SS and PT. Analysis of sagittal alignment of high-grade spondylolisthesis patients revealed distinct groups termed "balanced" and "unbalanced" pelvis. The PT and SS were similar in controls and balanced pelvis patients. Unbalanced pelvis patients had a sagittal spinal alignment that differed from the balanced pelvis and control groups. Treatment strategies for high-grade spondylolisthesis should reflect the different mechanical strain on the spinopelvic junction in each group; reduction techniques might be considered in patients with an unbalanced pelvis high-grade spondylolisthesis.

AN ANALYSIS OF PEAK PELVIS ROTATION SPEED, GLUTEUS MAXIMUS AND MEDIUS STRENGTH IN HIGH VERSUS LOW HANDICAP GOLFERS DURING THE GOLF SWING

PubMed Central

Glaws, Kate; Mitchell, Melissa; Scerbo, Heather; Voight, Michael; Sells, Pat

2012-01-01

Purpose/Hypothesis: The kinematic sequence of the golf swing is an established principle that occurs in a proximal-to-distal pattern with power generation beginning with rotation of the pelvis. Few studies have correlated the influence of peak pelvis rotation to the skill level of the golfer. Furthermore, minimal research exists on the strength of the gluteal musculature and their ability to generate power during the swing. The purpose of this study was to explore the relationship between peak pelvis rotation, gluteus medius and gluteus maximus strength, and a golfer's handicap. Subjects: 56 healthy subjects. Material/Methods: Each subject was assessed using a hand-held dynamometry device per standardized protocol to determine gluteus maximus and medius strength. The K-vest was placed on the subject with electromagnetic sensors at the pelvis, upper torso, and gloved lead hand to measure the rotational speed at each segment in degrees/second. After K-vest calibration and 5 practice swings, each subject hit 5 golf balls during which time, the sensors measured pelvic rotation speed. Results: A one-way ANOVA was performed to determine the relationships between peak pelvis rotation, gluteus medius and gluteus maximus strength, and golf handicap. A significant difference was found between the following dependent variables and golf handicap: peak pelvis rotation (p=0.000), gluteus medius strength (p=0.000), and gluteus maximus strength (p=0.000). Conclusion: Golfers with a low handicap are more likely to have increased pelvis rotation speed as well as increased gluteus maximus and medius strength when compared to high handicap golfers. Clinical Relevance: The relationships between increased peak pelvis rotation and gluteus maximus and medius strength in low handicap golfers may have implications in designing golf training programs. Further research needs to be conducted in order to further explore these relationships. PMID:22666643

Atezolizumab With or Without Eribulin Mesylate in Treating Patients With Recurrent Locally Advanced or Metastatic Urothelial Cancer

ClinicalTrials.gov

2018-06-05

Metastatic Urothelial Carcinoma; Recurrent Bladder Urothelial Carcinoma; Recurrent Urethral Urothelial Carcinoma; Recurrent Urothelial Carcinoma of the Renal Pelvis and Ureter; Renal Pelvis Urothelial Carcinoma; Stage III Bladder Urothelial Carcinoma AJCC v6 and v7; Stage III Renal Pelvis Cancer AJCC v7; Stage III Ureter Cancer AJCC v7; Stage III Urethral Cancer AJCC v7; Stage IV Bladder Urothelial Carcinoma AJCC v7; Stage IV Renal Pelvis Cancer AJCC v7; Stage IV Ureter Cancer AJCC v7; Stage IV Urethral Cancer AJCC v7; Ureter Urothelial Carcinoma

Note: Reconfigurable pelvis mechanism for efficient multi-locomotion: Biped and quadruped walking

NASA Astrophysics Data System (ADS)

Yoon, Byungho; Kim, Soohyun

2017-12-01

A reconfigurable pelvis mechanism that can change its length for multi-locomotion robot is introduced. From the characteristics of animals that walk in a bipedal or quadrupedal manner, we found that the length of the pelvis for each type of locomotion is related to the efficiency and stability of walking. We demonstrated the effectiveness of this mechanism in biped and quadruped walking through comparison of accumulated power of consumption. We also examined the changes of the supporting polygon according to the length of the pelvis during quadruped walking in terms of stability.

Note: Reconfigurable pelvis mechanism for efficient multi-locomotion: Biped and quadruped walking.

PubMed

Yoon, Byungho; Kim, Soohyun

2017-12-01

A reconfigurable pelvis mechanism that can change its length for multi-locomotion robot is introduced. From the characteristics of animals that walk in a bipedal or quadrupedal manner, we found that the length of the pelvis for each type of locomotion is related to the efficiency and stability of walking. We demonstrated the effectiveness of this mechanism in biped and quadruped walking through comparison of accumulated power of consumption. We also examined the changes of the supporting polygon according to the length of the pelvis during quadruped walking in terms of stability.

[Evaluation of upper urinary tract function in patients undergoing autoplastic surgery for hydronphrosis of the intrarenal pelvis].

PubMed

Kurbanaliev, R M; Usupbaev, A Ch; Kolesnichenko, I V; Sadyrbekov, N Zh; Sultanov, B M

2018-05-01

To investigate the functional state of the upper urinary tract in patients undergoing autoplastic surgery for a hydronophrosis of the intrarenal pelvis. The study comprised 78 patients with the intrarenal pelvis and impaired urinary outflow due to stricture of the ureteropelvic junction and vascular conflict (interatrial and arteriovenous narrowing), who underwent pyeloplasty using autologous tunica vaginalis. All patients underwent an incision of ureteropelvic stricture and resection of the parietal layer of the tunica vaginalis which was used to repair the obstruction site and internal stenting of the upper urinary tract. The patients were examined at baseline and during follow-up ranging from 3 months to 3 years. At three months after surgery, there was a decrease in the size of the renal pelvis and calyces with an improvement of all parameters of uro- and hemodynamics. At three years after surgery, the structural and functional parameters of the upper urinary tract were completely restored. Obstructive uropathy, resulting from the intrarenal pelvis, leads to persistently impaired urinary outflow from the upper urinary tract. Surgical intervention is the only curative treatment able to restore the urinary flow. In men with the intrarenal pelvis, the autoplastic surgery of the ureteropelvic junction obstruction using a parietal layer of the tunica vaginalis is an effective surgical modality improving renal pelvis capacity and contributing to the recovery of urinary outflow from the upper urinary tract.

Effects of experimentally increased trunk stiffness on thorax and pelvis rotations during walking.

PubMed

Wu, Wen Hua; Lin, Xiao Cong; Meijer, Onno G; Gao, Jin Tuan; Hu, Hai; Prins, Maarten R; Liang, Bo Wei; Zhang, Li Qun; Van Dieën, Jaap H; Bruijn, Sjoerd M

2014-02-01

Patients with non-specific low back pain, or a similar disorder, may stiffen their trunk, which probably alters their walking coordination. To study the direct effects of increasing trunk stiffness, we experimentally increased trunk stiffness during walking, and compared the results with what is known from the literature about gait coordination with, e.g., low back pain. Healthy subjects walked on a treadmill at 3 speeds (0.5, 1.0 and 1.5m/s), in three conditions (normal, while contracting their abdominal muscles, or wearing an orthopedic brace that limits trunk motions). Kinematics of the legs, thorax and pelvis were recorded, and relative Fourier phases and amplitudes of segment motions were calculated. Increasing trunk stiffness led to a lower thorax-pelvis relative phase, with both a decrease in thorax-leg relative phase, and an increase in pelvis-leg relative phase, as well as reduced rotational amplitude of thorax relative to pelvis. While lower thorax-pelvis relative phase was also found in patients with low back pain, higher pelvis-leg relative phase has never been reported in patients with low back pain or related disorders. These results suggest that increasing trunk stiffness in healthy subjects causes short-term gait coordination changes which are different from those seen in patients with back pain. Copyright © 2013 Elsevier B.V. All rights reserved.

Robot-assisted walking with the Lokomat: the influence of different levels of guidance force on thorax and pelvis kinematics.

PubMed

Swinnen, Eva; Baeyens, Jean-Pierre; Knaepen, Kristel; Michielsen, Marc; Clijsen, Ron; Beckwée, David; Kerckhofs, Eric

2015-03-01

Little attention has been devoted to the thorax and pelvis movements during gait. The aim of this study is to compare differences in the thorax and pelvis kinematics during unassisted walking on a treadmill and during walking with robot assistance (Lokomat-system (Hocoma, Volketswil, Switzerland)). 18 healthy persons walked on a treadmill with and without the Lokomat system at 2kmph. Three different conditions of guidance force (30%, 60% and 100%) were used during robot-assisted treadmill walking (30% body weight support). The maximal movement amplitudes of the thorax and pelvis were measured (Polhemus Liberty™ (Polhemus, Colchester, Vermont, USA) (240/16)). A repeated measurement ANOVA was conducted. Robot-assisted treadmill walking with different levels of guidance force showed significantly smaller maximal movement amplitudes for thorax and pelvis, compared to treadmill walking. Only the antero-posterior tilting of the pelvis was significantly increased during robot-assisted treadmill walking compared to treadmill walking. No significant changes of kinematic parameters were found between the different levels of guidance force. With regard to the thorax and pelvis movements, robot-assisted treadmill walking is significantly different compared to treadmill walking. It can be concluded that when using robot assistance, the thorax is stimulated in a different way than during walking without robot assistance, influencing the balance training during gait. Copyright © 2015 Elsevier Ltd. All rights reserved.

Shared occupational risks for transitional cell cancer of the bladder and renal pelvis among men and women in Sweden.

PubMed

Wilson, Robin Taylor; Donahue, Mark; Gridley, Gloria; Adami, Johanna; El Ghormli, Laure; Dosemeci, Mustafa

2008-02-01

Unlike cancer of the bladder, cancer of the renal pelvis is not considered an occupational cancer and little is known about risks among women. Using the Swedish national census and cancer registry-linked data (1971-1989), we identified transitional cell cancers of the renal pelvis (N = 1,374) and bladder (N = 21,591). Correlation between cancer sites for the standardized incidence ratios (SIR) were determined using Pearson's coefficient of the log SIR. Relative risks of job exposure matrix variables were calculated using Poisson regression. Both cancer sites were significantly elevated among women and men employed in the machine/electronics industry, sedentary work, and indoor work, and men in the metal industry. The highest proportion of the bladder (12%) and renal pelvis (14%) cancers occurred among men employed in shop and construction metal work. Risks by industry were more correlated among women (r = 0.49, P = 0.002) than men (r = 0.24, P = 0.04). Cancers of the renal pelvis were elevated in several occupational and industry groups for which there was no elevated bladder cancer risk. Cancers of the renal pelvis and bladder share common occupational risk factors that may be more frequent among women. In addition, there may be some jobs that pose an increased risk specifically for cancer of the renal pelvis but not bladder.

49 CFR 572.116 - Instrumentation and test conditions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... probe for lateral thoracic and pelvis impact tests are the same as those specified in § 572.44(a). (b... pelvis is the same as specified in § 572.44(c). (d) Head accelerometer mounting is the same as specified... Impact Tests.” (g) The mountings for the spine, rib and pelvis accelerometers shall have no resonance...

49 CFR 572.116 - Instrumentation and test conditions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... probe for lateral thoracic and pelvis impact tests are the same as those specified in § 572.44(a). (b... pelvis is the same as specified in § 572.44(c). (d) Head accelerometer mounting is the same as specified... Impact Tests.” (g) The mountings for the spine, rib and pelvis accelerometers shall have no resonance...

49 CFR 572.116 - Instrumentation and test conditions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... probe for lateral thoracic and pelvis impact tests are the same as those specified in § 572.44(a). (b... pelvis is the same as specified in § 572.44(c). (d) Head accelerometer mounting is the same as specified... Impact Tests.” (g) The mountings for the spine, rib and pelvis accelerometers shall have no resonance...

49 CFR 572.116 - Instrumentation and test conditions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... probe for lateral thoracic and pelvis impact tests are the same as those specified in § 572.44(a). (b... pelvis is the same as specified in § 572.44(c). (d) Head accelerometer mounting is the same as specified... Impact Tests.” (g) The mountings for the spine, rib and pelvis accelerometers shall have no resonance...

49 CFR 572.116 - Instrumentation and test conditions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... probe for lateral thoracic and pelvis impact tests are the same as those specified in § 572.44(a). (b... pelvis is the same as specified in § 572.44(c). (d) Head accelerometer mounting is the same as specified... Impact Tests.” (g) The mountings for the spine, rib and pelvis accelerometers shall have no resonance...

KRASH Parametric Sensitivity Study - Transport Category Airplanes

DTIC Science & Technology

1987-12-01

8217_ COPILOT PELVIS w Uj 0 •-’-AV - 24.8 -10 .Y +10 VERTICAL ACCELERATION, -i 0 COPILOT PELVIS uUoAV 4 4 -10 2891 "+15 VERTICAL ACCELERATION...j 0 " -- PILOT PELVIS Uw - - AV =47,9 • ----- 4 -15 AV INCREMENTAL VELOCITY CHANGE, FT/SEC Figure 3-65. DC-7 Test, Measured Acceleration, Eight

49 CFR 572.75 - Lumbar spine, abdomen, and pelvis assembly and test procedure.

Code of Federal Regulations, 2012 CFR

2012-10-01

... specified in Figure 42. (2) Adjust the dummy by— (i) Tightening the femur ballflange screws at each hip socket joint to 50 inch-pounds torque; (ii) Attaching the pelvis to the seating surface by a bolt D/605... drawing Figure 42. (iv) Tightening the mountings so that the pelvis-lumbar joining surface is horizontal...

49 CFR 572.75 - Lumbar spine, abdomen, and pelvis assembly and test procedure.

Code of Federal Regulations, 2013 CFR

2013-10-01

... specified in Figure 42. (2) Adjust the dummy by— (i) Tightening the femur ballflange screws at each hip socket joint to 50 inch-pounds torque; (ii) Attaching the pelvis to the seating surface by a bolt D/605... drawing Figure 42. (iv) Tightening the mountings so that the pelvis-lumbar joining surface is horizontal...

49 CFR 572.75 - Lumbar spine, abdomen, and pelvis assembly and test procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... specified in Figure 42. (2) Adjust the dummy by— (i) Tightening the femur ballflange screws at each hip socket joint to 50 inch-pounds torque; (ii) Attaching the pelvis to the seating surface by a bolt D/605... drawing Figure 42. (iv) Tightening the mountings so that the pelvis-lumbar joining surface is horizontal...

49 CFR 572.75 - Lumbar spine, abdomen, and pelvis assembly and test procedure.

Code of Federal Regulations, 2011 CFR

2011-10-01

... specified in Figure 42. (2) Adjust the dummy by— (i) Tightening the femur ballflange screws at each hip socket joint to 50 inch-pounds torque; (ii) Attaching the pelvis to the seating surface by a bolt D/605... drawing Figure 42. (iv) Tightening the mountings so that the pelvis-lumbar joining surface is horizontal...

49 CFR 572.75 - Lumbar spine, abdomen, and pelvis assembly and test procedure.

Code of Federal Regulations, 2014 CFR

2014-10-01

... specified in Figure 42. (2) Adjust the dummy by— (i) Tightening the femur ballflange screws at each hip socket joint to 50 inch-pounds torque; (ii) Attaching the pelvis to the seating surface by a bolt D/605... drawing Figure 42. (iv) Tightening the mountings so that the pelvis-lumbar joining surface is horizontal...

Computer aided three-dimensional reconstruction and modeling of the pelvis, by using plastinated cross sections, as a powerful tool for morphological investigations.

PubMed

Sora, Mircea-Constantin; Jilavu, Radu; Matusz, Petru

2012-10-01

The aim of this study was to describe a method of developing a computerized model of the human female pelvis using plastinated slices. Computerized reconstruction of anatomical structures is becoming very useful for developing anatomical teaching, research modules and animations. Although databases consisting of serial sections derived from frozen cadaver material exist, plastination represents an alternative method for developing anatomical data useful for computerized reconstruction. A slice anatomy study, using plastinated transparent pelvis cross sections, was performed to obtain a 3D reconstruction. One female human pelvis used for this study, first plastinated as a block, then sliced into thin slices and in the end subjected to 3D computerized reconstruction using WinSURF modeling system (SURFdriver Software). To facilitate the understanding of the complex pelvic floor anatomy on sectional images obtained through MR imaging, and to make the representation more vivid, a female pelvis computer-aided 3D model was created. Qualitative observations revealed that the morphological features of the model were consistent with those displayed by typical cadaveric specimens. The quality of the reconstructed images appeared distinct, especially the spatial positions and complicated relationships of contiguous structures of the female pelvis. All reconstructed structures can be displayed in groups or as a whole and interactively rotated in 3D space. The utilization of plastinates for generating tissue sections is useful for 3D computerized modeling. The 3D model of the female pelvis presented in this paper provides a stereoscopic view to study the adjacent relationship and arrangement of respective pelvis sections. A better understanding of the pelvic floor anatomy is relevant to gynaecologists, radiologists, surgeons, urologists, physical therapists and all professionals who take care of women with pelvic floor dysfunction.

The effect of boundary constraints on finite element modelling of the human pelvis.

PubMed

Watson, Peter J; Dostanpor, Ali; Fagan, Michael J; Dobson, Catherine A

2017-05-01

The use of finite element analysis (FEA) to investigate the biomechanics of anatomical systems critically relies on the specification of physiologically representative boundary conditions. The biomechanics of the pelvis has been the specific focus of a number of FEA studies previously, but it is also a key aspect in other investigations of, for example, the hip joint or new design of hip prostheses. In those studies, the pelvis has been modelled in a number of ways with a variety of boundary conditions, ranging from a model of the whole pelvic girdle including soft tissue attachments to a model of an isolated hemi-pelvis. The current study constructed a series of FEA models of the same human pelvis to investigate the sensitivity of the predicted stress distributions to the type of boundary conditions applied, in particular to represent the sacro-iliac joint and pubic symphysis. Varying the method of modelling the sacro-iliac joint did not produce significant variations in the stress distribution, however changes to the modelling of the pubic symphysis were observed to have a greater effect on the results. Over-constraint of the symphysis prevented the bending of the pelvis about the greater sciatic notch, and underestimated high stresses within the ilium. However, permitting medio-lateral translation to mimic widening of the pelvis addressed this problem. These findings underline the importance of applying the appropriate boundary conditions to FEA models, and provide guidance on suitable methods of constraining the pelvis when, for example, scan data has not captured the full pelvic girdle. The results also suggest a valid method for performing hemi-pelvic modelling of cadaveric or archaeological remains which are either damaged or incomplete. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

Changes of kinematics parameters of pelvis during walking under the influence of means facilitates treatment of cerebral palsied children.

PubMed

Czupryna, Krzysztof; Nowotny, Janusz

2012-01-01

Physiological human gait is characterized by tree-dimensional pelvis movements, which make that gait is smooth and does not require excessive energy expenditure. In children with cerebral palsy determinants of the pelvis may be affected, mainly due to pathological afferent synergisms. Therefore many specialists is looking for ways to improve this situation. The aim of this study was to verify whether the use of botulinium toxin or inhibitive casts affects the kinematic parameters of the pelvis during the gait of children with hemiparetic form of cerebral palsy. The study involved 34 hemiparetic children with cerebral palsy aged 7-14 years who reached the capacity of walking. All were improving by neurodevelop-mental treatment according to NDT-Bobath method. Two groups were created. In the first group inhibiting casting was used in 16 children. In the second group botulinium toxin was injected in 18 children. Gait analysis was performed before and after using those type of treatment. Ultrasonic CMS-HS system (Zebris) was used for three dimensional gait analysis. Despite of the characteristic for hemiplegic gait pattern asymmetry, various ab-normalities of pelvis kinematic parameters were observed. Gait symmetry was improved aafter the treatment. Using inhibiting casts also improved kinematic parameters of the pelvis, especially in those children who are found deficit of decreasing and rotation of the pelvis. 1) The use of Btx-A or inhibitive casts results in improving temporal- spatial parameters of gait of cerebral palsied children with hemiparesis. 2) The improvement of kinematic pelvis parameters are obtained through the use of inhibitive casts, while the use of Btx-A does not have a significant impact on them.

Subperitoneal extension of disease processes between the chest, abdomen, and the pelvis.

PubMed

Osman, Sherif; Moshiri, Mariam; Robinson, Tracy J; Gunn, Martin; Lehnert, Bruce; Sundarkumar, Dinesh; Katz, Douglas S

2015-08-01

The subserous space is a large, anatomically continuous potential space that interconnects the chest, abdomen, and pelvis. The subserous space is formed from areolar and adipose tissue, and contains branches of the vascular, lymphatic, and nervous systems. As such, it provides one large continuous space in which many disease processes can spread between the chest, abdomen, and the pelvis.

Explorable Three-Dimensional Digital Model of the Female Pelvis, Pelvic Contents, and Perineum for Anatomical Education

ERIC Educational Resources Information Center

Sergovich, Aimee; Johnson, Marjorie; Wilson, Timothy D.

2010-01-01

The anatomy of the pelvis is complex, multilayered, and its three-dimensional organization is conceptually difficult for students to grasp. The aim of this project was to create an explorable and projectable stereoscopic, three-dimensional (3D) model of the female pelvis and pelvic contents for anatomical education. The model was created using…

Sonographic findings of localized Castleman disease of the abdomen and pelvis.

PubMed

Zhou, Wei; Zhan, Weiwei; Zhou, Jianqiao; Zhu, Ying; Yao, Jiejie

2015-09-01

The purpose of this study was to sonographically evaluate the diagnosis of localized Castleman disease in the abdomen and pelvis. This was a retrospective analysis of 18 cases of Castleman disease localized in the abdomen and pelvis. The following features of the lesions were assessed on sonography (US): location, size, margin, echogenicity, echotexture, intralesional cystic necrosis, intralesional calcification, posterior acoustic enhancement, and blood supply. Of the 18 tumors, 16 were located in the abdomen and 2 were located in the pelvis close to iliac vessels. The most frequent appearance of localized Castleman disease in the abdomen and pelvis on US was of a single, well-defined, hypoechoic solid mass with no intralesional cystic necrosis. The internal echotexture was homogeneous in 4 cases and heterogeneous in 14 cases, with thin hyperechoic septa (n = 14) or calcifications (n = 3). Posterior acoustic enhancement was seen in 17 of the 18 cases (94%). Ninety-four percent of the lesions (17/18) had marked vascularity on color Doppler US. Localized Castleman disease in the abdomen and pelvis usually appears on US as a heterogeneously hypoechoic lesion containing thin septa, and more commonly than not, demonstrates posterior acoustic enhancement and marked vascularity. © 2014 Wiley Periodicals, Inc.

Pelvic position and movement during hip replacement.

PubMed

Grammatopoulos, G; Pandit, H G; da Assunção, R; Taylor, A; McLardy-Smith, P; De Smet, K A; Murray, D W; Gill, H S

2014-07-01

The orientation of the acetabular component is influenced not only by the orientation at which the surgeon implants the component, but also the orientation of the pelvis at the time of implantation. Hence, the orientation of the pelvis at set-up and its movement during the operation, are important. During 67 hip replacements, using a validated photogrammetric technique, we measured how three surgeons orientated the patient's pelvis, how much the pelvis moved during surgery, and what effect these had on the final orientation of the acetabular component. Pelvic orientation at set-up, varied widely (mean (± 2, standard deviation (sd))): tilt 8° (2sd ± 32), obliquity -4° (2sd ± 12), rotation -8° (2sd ± 14). Significant differences in pelvic positioning were detected between surgeons (p < 0.001). The mean angular movement of the pelvis between set-up and component implantation was 9° (sd 6). Factors influencing pelvic movement included surgeon, approach (posterior > lateral), procedure (hip resurfacing > total hip replacement) and type of support (p < 0.001). Although, on average, surgeons achieved their desired acetabular component orientation, there was considerable variability (2sd ± 16) in component orientation. We conclude that inconsistency in positioning the patient at set-up and movement of the pelvis during the operation account for much of the variation in acetabular component orientation. Improved methods of positioning and holding the pelvis are required. ©2014 The British Editorial Society of Bone & Joint Surgery.

The genital prolapse of Australopithecus Lucy?

PubMed

Chene, Gautier; Lamblin, Gery; Lebail-Carval, Karine; Chabert, Philippe; Marès, Pierre; Coppens, Yves; Mellier, Georges

2015-07-01

The female bony pelvis has to fulfil opposing functions: it has to be sufficiently closed to support the pelvic viscera in the upright position, while remaining sufficiently open to allow vaginal delivery. We aim to give an evolutionary perspective and the possible evolution of the bony pelvis from Lucy to the modern female with the implications in terms of genital prolapse. Thirteen pelvimetric measurements were performed on 178 bony pelves: 1 fossil pelvis from Australopithecus Lucy, 128 female Caucasian modern adult pelves and 49 female Catarrhine pelves (29 gorillas and 20 chimpanzees). Lucy's pelvis shape was the most transversely oval, short and broad, termed platypelloid. Modern female pelves were transversely oval only at the inlet. A protruding ischial spine, fairly small ischial tuberosities and a sacral concavity made Lucy closer to Homo sapiens and less like the great apes. In the last group, pelvic planes were anteroposteriorly oval, except in the gorilla, where the outlet was round or slightly transversely oval. The subpubic angle was narrowest in Lucy, whereas it was greater than 90° in the great apes. The female pelvis is involved in both visceral support and parturition and represents a compromise. The narrower pelvis of Australopithecus Lucy provided protection against genital prolapse, but resulted in complex obstetrical mechanics. From an evolutionary perspective, the pelvis of Homo sapiens became modified to make parturition easier, but increased the risk of genital prolapse: the ilia became wide open laterally and the sacrum broadened with a shorter distance between the sacroiliac and coxofemoral joints.

Walking with robot assistance: the influence of body weight support on the trunk and pelvis kinematics.

PubMed

Swinnen, Eva; Baeyens, Jean-Pierre; Knaepen, Kristel; Michielsen, Marc; Hens, Gerrit; Clijsen, Ron; Goossens, Maggie; Buyl, Ronald; Meeusen, Romain; Kerckhofs, Eric

2015-05-01

The goal was to assess in healthy participants the three-dimensional kinematics of the pelvis and the trunk during robot-assisted treadmill walking (RATW) at 0%, 30% and 50% body weight support (BWS), compared with treadmill walking (TW). 18 healthy participants walked (2 kmph) on a treadmill with and without robot assistance (Lokomat; 60% guidance force; 0%, 30% and 50% BWS). After an acclimatisation period (four minutes), trunk and pelvis kinematics were registered in each condition (Polhemus Liberty [240 Hz]). The results were analysed using a repeated measures analysis of variance with Bonferroni correction, with the level of suspension as within-subject factor. During RATW with BWS, there were significantly (1) smaller antero-posterior and lateral translations of the trunk and the pelvis; (2) smaller antero-posterior flexion and axial rotation of the trunk; (3) larger lateral flexion of the trunk; and (4) larger antero-posterior tilting of the pelvis compared with TW. There are significant differences in trunk and pelvis kinematics in healthy persons during TW with and without robot assistance. These data are relevant in gait rehabilitation, relating to normal balance regulation. Additional research is recommended to further assess the influence of robot assistance on human gait. The trunk and pelvis moves in a different way during walking with robot assistance. The data suggest that the change in movement is due to the robot device and the harness of the suspension system more than due to the level of suspension itself.

Ixabepilone in Treating Patients With Advanced Urinary Tract Cancer

ClinicalTrials.gov

2013-01-23

Distal Urethral Cancer; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Proximal Urethral Cancer; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage III Bladder Cancer; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Urethral Cancer Associated With Invasive Bladder Cancer

Seat Experiment Results of Full-Scale Transport Aircraft Controlled Impact Demonstration.

DTIC Science & Technology

1986-07-01

31 CONCLUSIONS . . . . . . . . . . . . . . . . . . . . .. .. .. .... 31 APPENDIX A - FLOOR, SEAT, AND PELVIS VERTICAL...ACCELERATIONS . ... A-1 APPENDIX B - FLOOR, SEAT, AND PELVIS LONGITUDINAL ACCELERATIONS .B-1 APPENDIX C - FLOOR, SEAT, AND PELVIS LATERAL ACCELERATIONS ... . C...The current asymmetry of the tracks in the 8720 and 727 causes the window-side legs of the triple- passenger seat to support twice as much load as the

Atezolizumab and CYT107 in Treating Participants With Locally Advanced, Inoperable, or Metastatic Urothelial Carcinoma

ClinicalTrials.gov

2018-05-18

Metastatic Bladder Urothelial Carcinoma; Metastatic Renal Pelvis Urothelial Carcinoma; Metastatic Ureter Urothelial Carcinoma; Metastatic Urethral Urothelial Carcinoma; Metastatic Urothelial Carcinoma; Recurrent Bladder Urothelial Carcinoma; Recurrent Renal Pelvis Urothelial Carcinoma; Recurrent Ureter Urothelial Carcinoma; Recurrent Urethral Urothelial Carcinoma; Stage III Bladder Cancer AJCC v8; Stage III Renal Pelvis Cancer AJCC v8; Stage III Ureter Cancer AJCC v8; Stage III Urethral Cancer AJCC v8; Stage IV Bladder Cancer AJCC v8; Stage IV Renal Pelvis Cancer AJCC v8; Stage IV Ureter Cancer AJCC v8; Stage IV Urethral Cancer AJCC v8; Stage IVA Bladder Cancer AJCC v8; Stage IVB Bladder Cancer AJCC v8

Evolution of the Human Pelvis.

PubMed

Rosenberg, Karen R; DeSilva, Jeremy M

2017-05-01

No bone in the human postcranial skeleton differs more dramatically from its match in an ape skeleton than the pelvis. Humans have evolved a specialized pelvis, well-adapted for the rigors of bipedal locomotion. Precisely how this happened has been the subject of great interest and contention in the paleoanthropological literature. In part, this is because of the fragility of the pelvis and its resulting rarity in the human fossil record. However, new discoveries from Miocene hominoids and Plio-Pleistocene hominins have reenergized debates about human pelvic evolution and shed new light on the competing roles of bipedal locomotion and obstetrics in shaping pelvic anatomy. In this issue, 13 papers address the evolution of the human pelvis. Here, we summarize these new contributions to our understanding of pelvic evolution, and share our own thoughts on the progress the field has made, and the questions that still remain. Anat Rec, 300:789-797, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

A complete human pelvis from the Middle Pleistocene of Spain.

PubMed

Arsuaga, J L; Lorenzo, C; Carretero, J M; Gracia, A; Martínez, I; García, N; Bermúdez de Castro, J M; Carbonell, E

1999-05-20

The Middle Pleistocene site of Sima de los Huesos in Sierra de Atapuerca, Spain, has yielded around 2,500 fossils from at least 33 different hominid individuals. These have been dated at more than 200,000 years ago and have been classified as ancestors of Neanderthals. An almost complete human male pelvis (labelled Pelvis 1) has been found, which we associate with two fragmentary femora. Pelvis 1 is robust and very broad with a very long superior pubic ramus, marked iliac flare, and a long femoral neck. This pattern is probably the primitive condition from which modern humans departed. A modern human newborn would pass through the birth canal of Pelvis 1 and this would be even larger in a female individual. We estimate the body mass of this individual at 95 kg or more. Using the cranial capacities of three specimens from Sima de los Huesos, the encephalization quotients are substantially smaller than in Neanderthals and modern humans.

Emergent ultrasound evaluation of the pediatric female pelvis.

PubMed

Back, Susan J; Maya, Carolina L; Zewdneh, Daniel; Epelman, Monica

2017-08-01

Ultrasound is the primary imaging modality of the pediatric female pelvis and is often requested to evaluate girls with pelvic or abdominal pain or abnormal bleeding. The US interpretation can help guide the clinician toward medical or surgical management. Here we discuss the normal US anatomy of the female pelvis and illustrate, through case examples, conditions encountered when performing emergent pelvic US for common and uncommon clinical scenarios.

Magnetic Resonance Imaging of Nonneoplastic Musculoskeletal Pathologies in the Pelvis.

PubMed

Alapati, Sindhura; Wadhwa, Vibhor; Komarraju, Aparna; Guidry, Carey; Pandey, Tarun

2017-06-01

Musculoskeletal pathologies in the pelvis encompass a wide variety of lesions including femoroacetabular impingement, athletic pubalgia, ischiofemoral impingement, and apophyseal avulsion injuries. Magnetic resonance imaging is the noninvasive imaging modality of choice for the diagnosis and management of these lesions. In this article, the authors discuss the nonneoplastic musculoskeletal lesions in the pelvis, with illustrations and relevant case examples. Copyright © 2017 Elsevier Inc. All rights reserved.

Surprising evidence of pelvic growth (widening) after skeletal maturity.

PubMed

Berger, Alexander A; May, Ryan; Renner, Jordan B; Viradia, Neal; Dahners, Laurence E

2011-11-01

Following an increase in length and width during childhood and adolescence, skeletal growth is generally assumed to stop. This study investigates the influence of aging on the dimensions of the pelvis and the L4 lumbar vertebra during adulthood. The dimensions of the pelvis, L4 vertebra, and femoral heads were calculated for 246 patients who had received pelvic and abdominal Computed Tomography scans from the UNC Health Care System. Linear regression analysis determined the significance of relationships between age and width of the pelvis. There was a strong correlation between increasing patient age and increasing width of the pelvis at the trochanters, (0.333 mm/year of age p<0.0001), at the iliac wings, (0.371 mm/year of age p < 0.0002), and between the femoral heads, indicating that the bony pelvis widens over 20 mm between the ages of 20 and 80. The pelvic inlet did not enlarge over time while the distance between the hips and the femoral head diameter did significantly increase. The height of L4 did not increase over time, but the L4 width did increase. These correlations were seen in both genders. Surprisingly, our results suggest that the pelvis and L4 vertebra increase in width after skeletal maturity and cessation of longitudinal growth. Copyright © 2011 Orthopaedic Research Society.

The effects of target distance on pivot hip, trunk, pelvis, and kicking leg kinematics in Taekwondo roundhouse kicks.

PubMed

Kim, Jae-Woong; Kwon, Moon-Seok; Yenuga, Sree Sushma; Kwon, Young-Hoooo

2010-06-01

The study purpose was to investigate the effects of target distance on pivot hip, trunk, pelvis, and kicking leg movements in Taekwondo roundhouse kick. Twelve male black-belt holders executed roundhouse kicks for three target distances (Normal, Short, and Long). Linear displacements of the pivot hip and orientation angles of the pelvis, trunk, right thigh, and right shank were obtained through a three-dimensional video motion analysis. Select displacements, distances, peak orientation angles, and angle ranges were compared among the conditions using one-way repeated measure ANOVA (p < 0.05). Several orientation angle variables (posterior tilt range, peak right-tilted position, peak right-rotated position, peak left-rotated position, and left rotation range of the pelvis; peak hyperextended position and peak right-flexed position of the trunk; peak flexed position, flexion range and peak internal-rotated position of the hip) as well as the linear displacements of the pivot hip and the reach significantly changed in response to different target distances. It was concluded that the adjustment to different target distances was mainly accomplished through the pivot hip displacements, hip flexion, and pelvis left rotation. Target distance mainly affected the reach control function of the pelvis and the linear balance function of the trunk.

Pelvis of Gargoyleosaurus (Dinosauria: Ankylosauria) and the Origin and Evolution of the Ankylosaur Pelvis

PubMed Central

Carpenter, Kenneth; DiCroce, Tony; Kinneer, Billy; Simon, Robert

2013-01-01

Discovery of a pelvis attributed to the Late Jurassic armor-plated dinosaur Gargoyleosaurus sheds new light on the origin of the peculiar non-vertical, broad, flaring pelvis of ankylosaurs. It further substantiates separation of the two ankylosaurs from the Morrison Formation of the western United States, Gargoyleosaurus and Mymoorapelta. Although horizontally oriented and lacking the medial curve of the preacetabular process seen in Mymoorapelta, the new ilium shows little of the lateral flaring seen in the pelvis of Cretaceous ankylosaurs. Comparison with the basal thyreophoran Scelidosaurus demonstrates that the ilium in ankylosaurs did not develop entirely by lateral rotation as is commonly believed. Rather, the preacetabular process rotated medially and ventrally and the postacetabular process rotated in opposition, i.e., lateral and ventrally. Thus, the dorsal surfaces of the preacetabular and postacetabular processes are not homologous. In contrast, a series of juvenile Stegosaurus ilia show that the postacetabular process rotated dorsally ontogenetically. Thus, the pelvis of the two major types of Thyreophora most likely developed independently. Examination of other ornithischians show that a non-vertical ilium had developed independently in several different lineages, including ceratopsids, pachycephalosaurs, and iguanodonts. Therefore, a separate origin for the non-vertical ilium in stegosaurs and ankylosaurs does have precedent. PMID:24244573

Human pelvis motions when walking and when riding a therapeutic horse.

PubMed

Garner, Brian A; Rigby, B Rhett

2015-02-01

A prevailing rationale for equine assisted therapies is that the motion of a horse can provide sensory stimulus and movement patterns that mimic those of natural human activities such as walking. The purpose of this study was to quantitatively measure and compare human pelvis motions when walking to those when riding a horse. Six able-bodied children (inexperienced riders, 8-12years old) participated in over-ground trials of self-paced walking and leader-paced riding on four different horses. Five kinematic measures were extracted from three-dimensional pelvis motion data: anteroposterior, superoinferior, and mediolateral translations, list angle about the anteroposterior axis, and twist angle about the superoinferior axis. There was generally as much or more variability in motion range observed between riding on the different horses as between riding and walking. Pelvis trajectories exhibited many similar features between walking and riding, including distorted lemniscate patterns in the transverse and frontal planes. In the sagittal plane the pelvis trajectory during walking exhibited a somewhat circular pattern whereas during riding it exhibited a more diagonal pattern. This study shows that riding on a horse can generate movement patterns in the human pelvis that emulate many, but not all, characteristics of those during natural walking. Copyright © 2014 Elsevier B.V. All rights reserved.

Validation of simplified centre of mass models during gait in individuals with chronic stroke.

PubMed

Huntley, Andrew H; Schinkel-Ivy, Alison; Aqui, Anthony; Mansfield, Avril

2017-10-01

The feasibility of using a multiple segment (full-body) kinematic model in clinical gait assessment is difficult when considering obstacles such as time and cost constraints. While simplified gait models have been explored in healthy individuals, no such work to date has been conducted in a stroke population. The aim of this study was to quantify the errors of simplified kinematic models for chronic stroke gait assessment. Sixteen individuals with chronic stroke (>6months), outfitted with full body kinematic markers, performed a series of gait trials. Three centre of mass models were computed: (i) 13-segment whole-body model, (ii) 3 segment head-trunk-pelvis model, and (iii) 1 segment pelvis model. Root mean squared error differences were compared between models, along with correlations to measures of stroke severity. Error differences revealed that, while both models were similar in the mediolateral direction, the head-trunk-pelvis model had less error in the anteroposterior direction and the pelvis model had less error in the vertical direction. There was some evidence that the head-trunk-pelvis model error is influenced in the mediolateral direction for individuals with more severe strokes, as a few significant correlations were observed between the head-trunk-pelvis model and measures of stroke severity. These findings demonstrate the utility and robustness of the pelvis model for clinical gait assessment in individuals with chronic stroke. Low error in the mediolateral and vertical directions is especially important when considering potential stability analyses during gait for this population, as lateral stability has been previously linked to fall risk. Copyright © 2017 Elsevier Ltd. All rights reserved.

The effects of virtual reality game training on trunk to pelvis coupling in a child with cerebral palsy

PubMed Central

2013-01-01

Background Good control of trunk and pelvic movements is necessary for well controlled leg movements required to perform activities of daily living. The nature of movement coupling between the trunk and pelvis varies and depends on the type of activity. Children with cerebral palsy often have reduced ability to modulate coupling between the trunk and pelvis but movement patterns of the pelvis can be improved by training. The aim of this study was to examine how pelvis to trunk coupling changed while playing a computer game driven by pelvic rotations. Methods One boy with cerebral palsy diplegia played the Goblin Post Office game on the CAREN virtual rehabilitation system for six weeks. He navigated a flying dragon in a virtual cave towards randomly appearing targets by rotating the pelvis around a vertical axis. Motion of the pelvis and trunk was captured in real-time by a Vicon 612 optoelectronic system tracking two clusters of three markers attached to the sacrum and thoracic spine. Results Convex hull areas calculated from angle-angle plots of pelvic and trunk rotations showed that coupling increased over game training (F1,11 = 7.482, p = 0.019). Reaching to targets far from the midline required tighter coupling than reaching near targets (F1,12 = 10.619, p = 0.007). Conclusions Increasing coupling appears to be an initial compensation mechanism using the better controlled trunk to drive rotation of the pelvis. Co-contractions causing increased coupling are expected to reduce over longer exposure to training. The control scheme of the training game can be set to facilitate de-coupling of pelvic movements from the trunk. Using large ranges of pelvic rotation required more coupling suggesting that training of selective pelvic movements is likely to be more effective close to a neutral pelvic posture. PMID:23391156

Defining the "Hostile Pelvis" for Intensity Modulated Radiation Therapy: The Impact of Anatomic Variations in Pelvic Dimensions on Dose Delivered to Target Volumes and Organs at Risk in Patients With High-Risk Prostate Cancer Treated With Whole Pelvic Radiation Therapy.

PubMed

Yirmibeşoğlu Erkal, Eda; Karabey, Sinan; Karabey, Ayşegül; Hayran, Mutlu; Erkal, Haldun Şükrü

2015-07-15

The aim of this study was to evaluate the impact of variations in pelvic dimensions on the dose delivered to the target volumes and the organs at risk (OARs) in patients with high-risk prostate cancer (PCa) to be treated with whole pelvic radiation therapy (WPRT) in an attempt to define the hostile pelvis in terms of intensity modulated radiation therapy (IMRT). In 45 men with high-risk PCa to be treated with WPRT, the target volumes and the OARs were delineated, the dose constraints for the OARs were defined, and treatment plans were generated according to the Radiation Therapy Oncology Group 0924 protocol. Six dimensions to reflect the depth, width, and height of the bony pelvis were measured, and 2 indexes were calculated from the planning computed tomographic scans. The minimum dose (Dmin), maximum dose (Dmax), and mean dose (Dmean) for the target volumes and OARs and the partial volumes of each of these structures receiving a specified dose (VD) were calculated from the dose-volume histograms (DVHs). The data from the DVHs were correlated with the pelvic dimensions and indexes. According to an overall hostility score (OHS) calculation, 25 patients were grouped as having a hospitable pelvis and 20 as having a hostile pelvis. Regarding the OHS grouping, the DVHs for the bladder, bowel bag, left femoral head, and right femoral head differed in favor of the hospitable pelvis group, and the DVHs for the rectum differed for a range of lower doses in favor of the hospitable pelvis group. Pelvimetry might be used as a guide to define the challenging anatomy or the hostile pelvis in terms of treatment planning for IMRT in patients with high-risk PCa to be treated with WPRT. Copyright © 2015 Elsevier Inc. All rights reserved.

The effects of virtual reality game training on trunk to pelvis coupling in a child with cerebral palsy.

PubMed

Barton, Gabor J; Hawken, Malcolm B; Foster, Richard J; Holmes, Gill; Butler, Penny B

2013-02-07

Good control of trunk and pelvic movements is necessary for well controlled leg movements required to perform activities of daily living. The nature of movement coupling between the trunk and pelvis varies and depends on the type of activity. Children with cerebral palsy often have reduced ability to modulate coupling between the trunk and pelvis but movement patterns of the pelvis can be improved by training. The aim of this study was to examine how pelvis to trunk coupling changed while playing a computer game driven by pelvic rotations. One boy with cerebral palsy diplegia played the Goblin Post Office game on the CAREN virtual rehabilitation system for six weeks. He navigated a flying dragon in a virtual cave towards randomly appearing targets by rotating the pelvis around a vertical axis. Motion of the pelvis and trunk was captured in real-time by a Vicon 612 optoelectronic system tracking two clusters of three markers attached to the sacrum and thoracic spine. Convex hull areas calculated from angle-angle plots of pelvic and trunk rotations showed that coupling increased over game training (F1,11 = 7.482, p = 0.019). Reaching to targets far from the midline required tighter coupling than reaching near targets (F1,12 = 10.619, p = 0.007). Increasing coupling appears to be an initial compensation mechanism using the better controlled trunk to drive rotation of the pelvis. Co-contractions causing increased coupling are expected to reduce over longer exposure to training. The control scheme of the training game can be set to facilitate de-coupling of pelvic movements from the trunk. Using large ranges of pelvic rotation required more coupling suggesting that training of selective pelvic movements is likely to be more effective close to a neutral pelvic posture.

Age related changes in pelvis size among adolescent and adult females with reference to parturition from Naraingarh, Haryana (India).

PubMed

Sharma, Krishan; Gupta, Puneet; Shandilya, Shailza

2016-08-01

This research examines the ontogenic patterns of changes in growth during adolescence, pelvis variations and growth during twenties and thirties of age, structural remodeling of pelvis related to childbirth and relationship of pelvis area with physique based on the cross-sectional data on 391 females from the state of Haryana. Peak growth velocity for body height and breadths of skeletal traits occurred between 11 and 12 years, much before mean age of menarche at 13.5 years; while for body weight and body mass index (BMI) occurred between 14 and 15 years, after the mean age of menarche. Untill the age 11 years, 11.87% of growth in stature was remaining, 19.37% for bi-cristal breadth, 25.96% for bi-ischial breadth and 35.82% for pelvic area. The hypothesis of critical value of pelvic width of 240mm at iliocristale for menarche to occur has been only a statistical association. Higher prevalence of malnutrition during pubertal phase than pre- and post-pubertal phases was due to greater nutritional needs during puberty. Among adult females, BMI was very poorly correlated with stature but very strongly correlated with body breadths, body breadth-stature indices and body weight. The body mass and pelvis size continued to change during 20s and first half of 30s. The continued increase of BMI was due to increase in body fat and muscle mass in females 18 years and older. To tease apart age and parturition effects on pelvis variations, the analysis showed that pelvic bones remodeling took place after the first child was born and not after the subsequent births, and it was a sign of childbirth phenotypic plasticity rather than age. Pelvis area was strongly associated with stature, BMI and age. Mean pelvic area of tall females was greater than those of medium and short stature. Females with broad shoulders had significantly greater mean pelvis area than those with narrow shoulders and medium shoulders. Females having thin/lean physique had the smallest mean pelvis area compared to those having medium and obese types of physiques. The stepwise multiple regression analysis revealed that BMI was the major determinant factor (multiple r=0.37) of pelvis area; addition of stature component increased the value of multiple r to 0.50, while addition of age marginally increased multiple r to 0.53. Copyright © 2016 Elsevier GmbH. All rights reserved.

Collecting and Studying Blood and Tissue Samples From Patients With Locally Recurrent or Metastatic Prostate or Bladder/Urothelial Cancer

ClinicalTrials.gov

2017-12-04

Healthy Control; Localized Urothelial Carcinoma of the Renal Pelvis and Ureter; Metastatic Malignant Neoplasm in the Bone; Metastatic Malignant Neoplasm in the Soft Tissues; Metastatic Urothelial Carcinoma of the Renal Pelvis and Ureter; Recurrent Bladder Carcinoma; Recurrent Prostate Carcinoma; Recurrent Urothelial Carcinoma of the Renal Pelvis and Ureter; Stage IV Bladder Cancer; Stage IV Bladder Urothelial Carcinoma; Stage IV Prostate Cancer

[Compensatory joints at the pelvis (author's transl)].

PubMed

Schumacher, G; Weber, M

1980-10-01

An osteochondrosis ischio-pubica represents a "testing site" for the integrity of the pelvis not only during child age but in adults as well. If all naturally available compensatory mechanisms have been exhausted especially following a change of range of motion in the pelvis ring structure, fatigue fractures or zones in transformation in the area typical of osteochondrosis ischio-pubica may appear. These fractures or transformation zones respectively to our mind have joint character, because they are capable of temporarily replacing lost mobility of physiological joints. Healing is achieved through rest, muscular balance and a specific physiotherapy. The purpose of this muscular training is to cushion all unphysiological motions in the pelvis and to support and boost the function of those joints still well preserved.

Sagittal Balance in Adolescent Idiopathic Scoliosis

PubMed Central

Xu, Xi-Ming; Wang, Fei; Zhou, Xiao-Yi; Liu, Zi-Xuan; Wei, Xian-Zhao; Bai, Yu-Shu; Li, Ming

2015-01-01

Abstract The relationship between spinal sagittal alignment and pelvic parameters is well known in adolescent idiopathic scoliosis. However, few studies have reported the sagittal spinopelvic relationship after selective posterior fusion of thoracolumbar/lumbar (TL/L) curves. We evaluated the relationship between spinal sagittal alignment and the pelvis, and analyzed how the pelvic sagittal state is adjusted in Lenke type 5C patients. We conducted a retrospective study of 36 patients with Lenke type 5C curves who received selective posterior TL/L curve fusion. Coronal and spinopelvic sagittal parameters were pre and postoperatively compared. Pearson coefficients were used to analyze the correlation between all spinopelvic sagittal parameters before and after surgery. We also evaluated 3 pelvic morphologies (anteverted, normal, and retroverted) before and after surgery. Preoperatively, the mean pelvic incidence was 46.0°, with a pelvic tilt and sacral slope (SS) of 8.2° and 37.8°, respectively, and 25% (9/36) of patients had an anteverted pelvis, whereas the other 75% had a normal pelvis. Postoperatively, 42% (15/36) of patients had a retroverted pelvis, 53% (19/36) had a normal pelvis, and 2 patients had an anteverted pelvis. Logistic regression analyses yielded 2 factors that were significantly associated with the risk for a postoperative unrecovered anteverted pelvis, including increased lumbar lordosis (LL) (odds ratio [OR] 4.8, P = 0.029) and increased SS (OR 5.6, P = 0.018). Four factors were significantly associated with the risk of a postoperative newly anteverted pelvis, including LL at the final follow-up (OR 6.9, P = 0.009), increased LL (OR 8.9, P = 0.003), LL below fusion (OR 9.4, P = 0.002), and increased SS (OR 11.5, P = 0.001). The pelvic state may be adjusted after selective posterior TL/L curve fusion in Lenke 5C adolescent idiopathic scoliosis patients. It is difficult to improve an anteverted pelvis in patients who have an LL that is increased by more than 11.6° or an SS that is increased by more than 4.7° after surgery. The anteverted pelvic state will generally occur with posterior correction surgery for patients with an LL that is greater than 63.7°, or an LL or SS that is respectively increased by more than 17.6° or 9.0° postoperatively. PMID:26559289

Comparison of the trunk-pelvis and lower extremities sagittal plane inter-segmental coordination and variability during walking in persons with and without chronic low back pain.

PubMed

Ebrahimi, Samaneh; Kamali, Fahimeh; Razeghi, Mohsen; Haghpanah, Seyyed Arash

2017-04-01

Inter-segmental coordination can be influenced by chronic low back pain (CLBP). The sagittal plane lower extremities inter-segmental coordination pattern and variability, in conjunction with the pelvis and trunk, were assessed in subjects with and without non-specific CLBP during free-speed walking. Kinematic data were collected from 10 non-specific CLBP and 10 non-CLBP control volunteers while the subjects were walking at their preferred speed. Sagittal plane time-normalized segmental angles and velocities were used to calculate continuous relative phase for each data point. Mean absolute relative phase (MARP) and deviation phase (DP) were derived to quantify the trunk-pelvis and bilateral pelvis-thigh, thigh-shank and shank-foot coordination pattern and variability over the stance and swing phases of gait. Mann-Whitney U test was employed to compare the means of DP and MARP values between two groups (same side comparison). Statistical analysis revealed more in-phase/less variable trunk-pelvis coordination in the CLBP group (P<0.05). CLBP group demonstrated less variable right or left pelvis-thigh coordination pattern (P<0.05). Moreover, the left thigh-shank and left shank-foot MARP values in the CLBP group, were more in-phase than left MARP values in the non-CLBP control group during the swing phase (P<0.05). In conclusion, the sagittal plane lower extremities, pelvis and trunk coordination pattern and variability could be generally affected by CLBP during walking. These changes can be possible compensatory strategies of the motor control system which can be considered in the CLBP subjects. Copyright © 2017 Elsevier B.V. All rights reserved.

Patterns of directional asymmetry in the pelvis and pelvic canal.

PubMed

Tobolsky, Victoria A; Kurki, Helen K; Stock, Jay T

2016-11-01

The human pelvis is unique among modern taxa for supporting both parturition of large brained young and obligate bipedalism. Though much work has focused on pelvic development and variation, little work has explored the presence or absence of asymmetry in the pelvis despite well-known patterns of asymmetry in other skeletal regions. This study investigated whether patterns of directional asymmetry (DA) could be observed in the pelvis or pelvic canal. Seventeen bilaterally paired osteometric measurements of the os coxae (34 measures in total) were taken from 128 skeletons (female n = 65, male n = 63) from recent human populations in five geographic regions. Paired sample t-tests and Mann-Whitney U-tests were used to investigate DA. Results from a pooled sample of all individuals showed that the pelvis exhibited a left-bias in DA. In contrast, the pelvic canal exhibited a pattern in which the anterior canal exhibited a right-bias and the posterior canal exhibited a left-bias. Neither sex nor populational differences in DA were observed in the pelvis or pelvic canal. The varying patterns of asymmetry uncovered here accord with prior work and may indicate that loading from the trunk and legs place differing stresses on the pelvis and canal, yielding these unequal asymmetries. However, this is speculative and the possible influence of genetics, biomechanics, and nutritional status on the development of pelvic and canal asymmetries presents a rich area for future study. Additionally, the potential influence of pelvic canal asymmetry on obstetric measures of pelvic capacity merits future research. Am. J. Hum. Biol. 28:804-810, 2016. © 2016Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Sorafenib in Treating Patients With Regional or Metastatic Cancer of the Urothelium

ClinicalTrials.gov

2014-05-20

Adenocarcinoma of the Bladder; Distal Urethral Cancer; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Proximal Urethral Cancer; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Squamous Cell Carcinoma of the Bladder; Stage III Bladder Cancer; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Urethral Cancer Associated With Invasive Bladder Cancer

Using Medical Claims for Policy Effectiveness Surveillance: Reimbursement and Utilization of Abdomen/Pelvis Computed Tomography Scans.

PubMed

Horný, Michal; Morgan, Jake R; Merker, Vanessa L

2015-12-01

To quantify changes in private insurance payments for and utilization of abdominal/pelvic computed tomography scans (CTs) after 2011 changes in CPT coding and Medicare reimbursement rates, which were designed to reduce costs stemming from misvalued procedures. TruvenHealth Analytics MarketScan Commercial Claims and Encounters database. We used difference-in-differences models to compare combined CTs of the abdomen/pelvis to CTs of the abdomen or pelvis only. Our main outcomes were inflation-adjusted log payments per procedure, daily utilization rates, and total annual payments. Claims data were extracted for all abdominal/pelvic CTs performed in 2009-2011 within noncapitated, employer-sponsored private plans. Adjusted payments per combined CTs of the abdomen/pelvis dropped by 23.8 percent (p < .0001), and their adjusted daily utilization rate accelerated by 0.36 percent (p = .034) per month after January 2011. Utilization rate of abdominal-only or pelvic-only CTs dropped by 5.0 percent (p < .0001). Total annual payments for combined CTs of the abdomen/pelvis decreased in 2011 despite the increased utilization. Private insurance payments for combined CTs of the abdomen/pelvis declined and utilization accelerated significantly after 2011 policy changes. While growth in total annual payments was contained in 2011, it may not be sustained if 2011 utilization trends persist. © Health Research and Educational Trust.

[Plain radiographs of the spine: static and relationships between spine and pelvis].

PubMed

Morvan, G; Wybier, M; Mathieu, P; Vuillemin, V; Guerini, H

2008-05-01

Man, with his erect posture, evolves in a world subject to the laws of gravity. His spine reflects these constraints. The morphology and static of human spine and biomechanical relationships between spine and pelvis are in direct relation with bipedia. Owing to this position the pelvis widened and straightened, characteristic sagittal spinal curves appeared and the perispinal muscles were deeply reorganized. Each pelvis is characterized by an important anatomical landmark: the pelvic incidence that reflects the sagittal morphology of the pelvis. Based on this anatomical characteristic, a chain of reactions determines the more efficient equilibrium of the whole body in the sagittal plane in term of energy consumption. Incidence affects the sacral slope, which determines lumbar lordosis, which itself influences pelvic tilt, thoracic kyphosis, and even hip and knee position. All these landmarks can easily be studied on a sagittal radiograph. Knowledge of these functional relationships is essential to understand the origin of low back pain, sagittal imbalance and above all before surgical treatment of spine disorders especially when arthrodesis is considered.

Pelvis MRI scan

MedlinePlus

... and most often available in the emergency room. Alternative Names MRI - pelvis; MRI - hips; Pelvic MRI with ... any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should ...

Gemcitabine Hydrochloride and Cisplatin With or Without Bevacizumab in Treating Patients With Advanced Urinary Tract Cancer

ClinicalTrials.gov

2018-06-11

Bladder Urothelial Carcinoma; Distal Urethral Carcinoma; Infiltrating Bladder Urothelial Carcinoma Associated With Urethral Carcinoma; Metastatic Urothelial Carcinoma of the Renal Pelvis and Ureter; Proximal Urethral Carcinoma; Recurrent Bladder Carcinoma; Recurrent Prostate Carcinoma; Recurrent Urethral Carcinoma; Recurrent Urothelial Carcinoma of the Renal Pelvis and Ureter; Regional Urothelial Carcinoma of the Renal Pelvis and Ureter; Stage IV Bladder Cancer AJCC v7; Stage IV Prostate Cancer AJCC v7; Stage IV Urethral Cancer AJCC v7; Ureter Carcinoma

Selected Static Anatomic Measures Predict Overuse Injuries in Female Military Recruits

DTIC Science & Technology

2008-04-22

caliper with a Vernier scale were placed at the widest point (iliac tubercle) on the right and left sides of the subject’s pelvis . 15 The width of...the pelvis girdle was recorded to the nearest 0.1 em. Knee Alignment Subjects were asked to stand with knees locked and feet shoulder-width apart... pelvis a~ a right angle to the table. If the leg settled above horizontal (intermediate) it was recorded as a positive I (tight ITB) test. 16 Data

Selected Static Anatomic Measures Predict Overuse Injuries in Female Military Recruits

DTIC Science & Technology

2010-05-01

caliper with a Vernier scale were placed at the widest point (iliac tubercle) on the right and left sides of the subject’s pelvis . 15 The width of...the pelvis girdle was recorded to the nearest 0.1 em. Knee Alignment Subjects were asked to stand with knees locked and feet shoulder-width apart... pelvis a~ a right angle to the table. If the leg settled above horizontal (intermediate) it was recorded as a positive I (tight ITB) test. 16 Data

Cone-Beam Computed Tomography for Image-Guided Radiation Therapy of Prostate Cancer

DTIC Science & Technology

2009-01-01

pelvis phantom was also imaged, consisting of a partial skeleton ranging from the L1 lumbar vertebra through the mid femur, embedded in lucite formed...been applied in the pelvis phantom scan to see the correction effects for a more realistic case, and the results are displayed in Fig. 5. 10 33 (a) (b...c) Figure 5: Transverse slice images of the reconstructed pelvis phantom scanned with Cu1-filter are displayed; (a) No correction, (b) scatter

The Association Between Visual Assessment of Quality of Movement and Three-Dimensional Analysis of Pelvis, Hip, and Knee Kinematics During a Lateral Step Down Test.

PubMed

Rabin, Alon; Portnoy, Sigal; Kozol, Zvi

2016-11-01

Rabin, A, Portnoy, S, and Kozol, Z. The association between visual assessment of quality of movement and three-dimensional analysis of pelvis, hip, and knee kinematics during a lateral step down test. J Strength Cond Res 30(11): 3204-3211, 2016-Altered movement patterns including contralateral pelvic drop, increased hip adduction, knee abduction, and external rotation have been previously implicated in several lower extremity pathologies. Although various methods exist for assessing movement patterns, real-time visual observation is the most readily available method. The purpose of this study was to determine whether differing visual ratings of trunk, pelvis, and knee alignment, as well as overall quality of movement, are associated with differences in 3-dimensional trunk, pelvis, hip, or knee kinematics during a lateral step down test. Trunk, pelvis, and knee alignment of 30 healthy participants performing the lateral step down were visually rated as "good" or "faulty" based on previously established criteria. An additional categorization of overall quality of movement as either good or moderate was performed based on the aggregate score of each individual rating criterion. Three-dimensional motion analysis of trunk, pelvis, hip, and knee kinematics was simultaneously performed. A faulty pelvis alignment displayed a greater peak contralateral pelvic drop (effect size [ES], 1.65; p < 0.01) and a greater peak hip adduction (ES: 1.04, p = 0.01) compared with participants with a good pelvis alignment. Participants with a faulty knee alignment displayed greater peak knee external rotation compared with participants with a good knee alignment (ES, 0.78; p = 0.02). Participants with an overall moderate quality of movement displayed increased peak contralateral pelvic drop (ES, 1.07; p = 0.01) and peak knee external rotation (ES, 0.72; p = 0.04) compared with those with an overall good quality of movement. Visual rating of quality of movement during a lateral step down test, as performed by an experienced physical therapist, is associated with differences in several kinematics previously implicated in various pathologies.

The effect of directional inertias added to pelvis and ankle on gait

PubMed Central

2013-01-01

Background Gait training robots should display a minimum added inertia in order to allow normal walking. The effect of inertias in specific directions is yet unknown. We set up two experiments to assess the effect of inertia in anteroposterior (AP) direction to the ankle and AP and mediolateral (ML) direction to the pelvis. Methods We developed an experimental setup to apply inertia in forward backward and or sideways directions. In two experiments nine healthy subjects walked on a treadmill at 1.5 km/h and 4.5 km/h with no load and with AP loads of 0.3, 1.55 and 3.5 kg to the left ankle in the first experiment and combinations of AP and ML loads on the pelvis (AP loads 0.7, 4.3 and 10.2 kg; ML loads 0.6, 2.3 and 5.3 kg). We recorded metabolic rate, EMG of major leg muscles, gait parameters and kinematics. Results & discussion Adding 1.55 kg or more inertia to the ankle in AP direction increases the pelvis acceleration and decreases the foot acceleration in AP direction both at speeds of 4.5 km/h. Adding 3.5 kg of inertia to the ankle also increases the swing time as well as AP motions of the pelvis and head-arms-trunk (HAT) segment. Muscle activity remains largely unchanged. Adding 10.2 kg of inertia to the pelvis in AP direction causes a significant decrease of the pelvis and HAT segment motions, particularly at high speeds. Also the sagittal back flexion increases. Lower values of AP inertia and ML inertias up to 5.3 kg had negligible effect. In general the found effects are larger at high speeds. Conclusions We found that inertia up to 2 kg at the ankle or 6 kg added to the pelvis induced significant changes, but since these changes were all within the normal inter subject variability we considered these changes as negligible for application as rehabilitation robotics and assistive devices. PMID:23597391

CT angiography - abdomen and pelvis

MedlinePlus

... this page: //medlineplus.gov/ency/article/007674.htm CT angiography - abdomen and pelvis To use the sharing features on this page, please enable JavaScript. CT angiography combines a CT scan with the injection ...

Assessing Urinary Tract Junction Obstruction Defects by Methylene Blue Dye Injection.

PubMed

Yun, Kangsun

2017-10-12

Urinary tract junction obstruction defects are congenital anomalies inducing hydronephrosis and hydroureter. Murine urinary tract junction obstruction defects can be assessed by tracking methylene blue dye flow within the urinary system. Methylene blue dye is injected into the renal pelvis of perinatal embryonic kidneys and dye flow is monitored from the renal pelvis of the kidney through the ureter and into the bladder lumen after applying hydrostatic pressure. Dye accumulation will be evident in the bladder lumen of the normal perinatal urinary tract, but will be constrained between the renal pelvis and the end point of an abnormal ureter, if urinary tract obstructions occur. This method facilitates the confirmation of urinary tract junction obstructions and visualization of hydronephrosis and hydroureter. This manuscript describes a protocol for methylene blue dye injection into the renal pelvis to confirm urinary tract junction obstructions.

The relationship between gluteal muscle activation and throwing kinematics in baseball and softball catchers.

PubMed

Plummer, Hillary A; Oliver, Gretchen D

2014-01-01

The purpose of this study was to determine the relationship between gluteal muscle activation and pelvis and trunk kinematics when catchers throw to second base. Forty-two baseball and softball catchers (14.74 ± 4.07 years; 161.85 ± 15.24 cm; 63.38 ± 19.98 kg) participated in this study. Muscle activity of the bilateral gluteus maximus and medius as well as pelvis and trunk kinematics throughout the throwing motion were analyzed. It was discovered that at foot contact, there were 2 significant inverse relationships between stride leg gluteus maximus activity and pelvis axial rotation (r = -0.31, r2 = 0.10, p = 0.05), and between trunk axial rotation and pelvis lateral flexion (r = -0.34, r2= 0.12, p = 0.03). In addition, at foot contact, a significant positive relationship between the drive leg (throwing arm side) and trunk flexion (r = 0.33, r2 = 0.11, p = 0.04) was present. The results of this study provide evidence of gluteal activation both concentrically and eccentrically, in attempt to control the pelvis and trunk during the throwing motion of catchers. The gluteal muscles play a direct role in maintaining the stability of the pelvis, and catchers should incorporate strengthening of the entire lumbopelvic-hip complex into their training regimen. Incorporating concentric and eccentric gluteal exercises will help to improve musculoskeletal core stability, thereby assisting in upper extremity injury prevention.

Sci-Fri AM: MRI and Diagnostic Imaging - 02: Quality Improvement: Diagnostic Reference Levels for Interior Health CT exams – L-Spine, Chest/Abdomen/pelvis, Abdomen/Pelvis, Head

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

Bjarnason, Thorarin

Diagnostic Reference Levels are used to optimize patient dose and image quality in the clinical setting. It is assumed that the majority of exams are of diagnostic quality, or the radiologists would request protocol adjustments. By investigating the dose indicator distributions from all scanners, the upper DRL can be set to the 75th percentile of the distribution and a lower DRL can be set to the 10th percentile. Scanners using doses consistently outside the upper/lower DRL range can be adjusted accordingly. 11 CT scanners, all contributing to the American College of Radiology Dose Index Registry (ACR DIR) were used inmore » this study. Dose indicator data were compiled from the ACR DIR data and local DRLs established. Scanners with median doses outside the upper/lower DRL were followed-up with. Using effective dose and exam volumes, collective dose was determined before and after protocol adjustments to evaluate the effect of this quality improvement effort. The quality initiative is complete for L-spine and Chest/Abdomen/Pelvis exams and only initial surveys were completed for Head and Abdomen/Pelvis examsg. Median Scanner Dose reductions were 8.8 and 4.9 % for L-spine and Chest/Abdomen/Pelvis exams, respectively, resulting with collective dose reductions of 0.7 and 3.2 person•Sv/yr. Follow-up is ongoing for Abdomen/Pelvis and Head exams.« less

Reliability and criterion validity of measurements using a smart phone-based measurement tool for the transverse rotation angle of the pelvis during single-leg lifting.

PubMed

Jung, Sung-Hoon; Kwon, Oh-Yun; Jeon, In-Cheol; Hwang, Ui-Jae; Weon, Jong-Hyuck

2018-01-01

The purposes of this study were to determine the intra-rater test-retest reliability of a smart phone-based measurement tool (SBMT) and a three-dimensional (3D) motion analysis system for measuring the transverse rotation angle of the pelvis during single-leg lifting (SLL) and the criterion validity of the transverse rotation angle of the pelvis measurement using SBMT compared with a 3D motion analysis system (3DMAS). Seventeen healthy volunteers performed SLL with their dominant leg without bending the knee until they reached a target placed 20 cm above the table. This study used a 3DMAS, considered the gold standard, to measure the transverse rotation angle of the pelvis to assess the criterion validity of the SBMT measurement. Intra-rater test-retest reliability was determined using the SBMT and 3DMAS using intra-class correlation coefficient (ICC) [3,1] values. The criterion validity of the SBMT was assessed with ICC [3,1] values. Both the 3DMAS (ICC = 0.77) and SBMT (ICC = 0.83) showed excellent intra-rater test-retest reliability in the measurement of the transverse rotation angle of the pelvis during SLL in a supine position. Moreover, the SBMT showed an excellent correlation with the 3DMAS (ICC = 0.99). Measurement of the transverse rotation angle of the pelvis using the SBMT showed excellent reliability and criterion validity compared with the 3DMAS.

Pelvis Ewing sarcoma: Local control and survival in the modern era.

PubMed

Ahmed, Safia K; Robinson, Steven I; Arndt, Carola A S; Petersen, Ivy A; Haddock, Michael G; Rose, Peter S; Issa Laack, Nadia N

2017-09-01

Local control for Ewing sarcoma (ES) has improved in modern studies. However, it is unclear if these gains have also been achieved for pelvis tumors. The purpose of this study is to evaluate local control and survival in pelvis ES patients treated in the modern era. All pelvis ES patients diagnosed from 1990 to 2012 and seen at Mayo Clinic were identified. Factors relevant to survival and local control were analyzed. The cohort consisted of 48 patients. Fifty-two percent had metastatic disease at diagnosis. The 5-year overall survival and event-free survival was 73% and 65%, respectively, for localized disease. The 5-year cumulative incidence of local recurrence was 19%, with a 26% incidence for radiation, 13% for surgery, and 0% for surgery + radiation (P = 0.54). All local failures occurred in-field. Sacral involvement by tumor trended toward a higher incidence of local recurrence (hazard ratio 3.06, P = 0.09). Patients treated with definitive radiation doses ≥5,600 cGy had a lower incidence of local recurrence (17% vs. 28%, P = 0.61). Our study demonstrates excellent survival for localized tumors in the modern era. Anatomical localization within the pelvis likely correlates with outcomes. Local control remains problematic, especially for patients treated with definitive radiation. Though statistically not significant, surgery + radiation and definitive radiation dose ≥5,600 cGy were associated with the lowest incidence of local failure, suggesting treatment intensification may improve local control for pelvis ES. © 2017 Wiley Periodicals, Inc.

Three-dimensional kinematics of the pelvis and hind limbs in chimpanzee (Pan troglodytes) and human bipedal walking.

PubMed

O'Neill, Matthew C; Lee, Leng-Feng; Demes, Brigitte; Thompson, Nathan E; Larson, Susan G; Stern, Jack T; Umberger, Brian R

2015-09-01

The common chimpanzee (Pan troglodytes) is a facultative biped and our closest living relative. As such, the musculoskeletal anatomies of their pelvis and hind limbs have long provided a comparative context for studies of human and fossil hominin locomotion. Yet, how the chimpanzee pelvis and hind limb actually move during bipedal walking is still not well defined. Here, we describe the three-dimensional (3-D) kinematics of the pelvis, hip, knee and ankle during bipedal walking and compare those values to humans walking at the same dimensionless and dimensional velocities. The stride-to-stride and intraspecific variations in 3-D kinematics were calculated using the adjusted coefficient of multiple correlation. Our results indicate that humans walk with a more stable pelvis than chimpanzees, especially in tilt and rotation. Both species exhibit similar magnitudes of pelvis list, but with segment motion that is opposite in phasing. In the hind limb, chimpanzees walk with a more flexed and abducted limb posture, and substantially exceed humans in the magnitude of hip rotation during a stride. The average stride-to-stride variation in joint and segment motion was greater in chimpanzees than humans, while the intraspecific variation was similar on average. These results demonstrate substantial differences between human and chimpanzee bipedal walking, in both the sagittal and non-sagittal planes. These new 3-D kinematic data are fundamental to a comprehensive understanding of the mechanics, energetics and control of chimpanzee bipedalism. Copyright © 2015 Elsevier Ltd. All rights reserved.

Automatic initialization for 3D bone registration

NASA Astrophysics Data System (ADS)

Foroughi, Pezhman; Taylor, Russell H.; Fichtinger, Gabor

2008-03-01

In image-guided bone surgery, sample points collected from the surface of the bone are registered to the preoperative CT model using well-known registration methods such as Iterative Closest Point (ICP). These techniques are generally very sensitive to the initial alignment of the datasets. Poor initialization significantly increases the chances of getting trapped local minima. In order to reduce the risk of local minima, the registration is manually initialized by locating the sample points close to the corresponding points on the CT model. In this paper, we present an automatic initialization method that aligns the sample points collected from the surface of pelvis with CT model of the pelvis. The main idea is to exploit a mean shape of pelvis created from a large number of CT scans as the prior knowledge to guide the initial alignment. The mean shape is constant for all registrations and facilitates the inclusion of application-specific information into the registration process. The CT model is first aligned with the mean shape using the bilateral symmetry of the pelvis and the similarity of multiple projections. The surface points collected using ultrasound are then aligned with the pelvis mean shape. This will, in turn, lead to initial alignment of the sample points with the CT model. The experiments using a dry pelvis and two cadavers show that the method can align the randomly dislocated datasets close enough for successful registration. The standard ICP has been used for final registration of datasets.

Three-dimensional primary and coupled range of motions and movement coordination of the pelvis, lumbar and thoracic spine in standing posture using inertial tracking device.

PubMed

Narimani, M; Arjmand, N

2018-03-01

Evaluation of spinal range of motions (RoMs) and movement coordination between its segments (thorax, lumbar, and pelvis) has clinical and biomechanical implications. Previous studies have not recorded three-dimensional primary/coupled motions of all spinal segments simultaneously. Moreover, magnitude/direction of the coupled motions of the thorax/pelvis in standing posture and lumbopelvic rhythms in the frontal/transverse planes have not been investigated. This study, hence, used an inertial tracking device to measure T1, T5, T12, total (T1-T12) thoracic, lower (T5-T12) and upper (T1-T5) thoracic, lumbar (T12-S1), and pelvis primary and coupled RoMs as well as their movement coordination in all anatomical planes/directions in twenty-two healthy individuals. RoMs were statistically compared between the anatomical planes and spinal segments as well as with available data in the literature. The spine had different primary RoMs in different planes/directions (flexion: lumbar: 55.4 ± 12.4°, pelvis: 42.8 ± 21.6°, and T1-T12 thoracic: 19.9 ± 6.4°, extension: lumbar: 23.4 ± 10.1°, thoracic: 11.7 ± 3.4°, and pelvis: 10.2 ± 6.4°, left/right lateral bending: thoracic: 24.5 ± 7.4°/26.5 ± 6.1°, lumbar: 16.4 ± 7.2°/18.3 ± 5.7°, and pelvis: 11.0 ± 4.4°/9.3 ± 6.2°, and left/right axial rotation: thoracic: 33.5 ± 10.0°/37.1 ± 11.7°, pelvis: 31.6 ± 12.5°/27.2 ± 12.0° and lumbar: 7.5 ± 4.5°/9.2 ± 7.3°). Pelvis, lumbar and thoracic spine had different/varying contributions/rhythms to generate total trunk (T1) movement, both within and between planes. Pattern of the coupled motions was inconsistent between subjects but side bending was generally associated with twisting to the same side at the thoracic spine and to the opposite side at the lumbar spine. Copyright © 2018 Elsevier Ltd. All rights reserved.

Shared Occupational Risks for Transitional Cell Cancer of the Bladder and Renal Pelvis among Men and Women in Sweden

PubMed Central

Wilson, Robin Taylor; Donahue, Mark; Gridley, Gloria; Adami, Johanna; ghormli, Laure El; Dosemeci, Mustafa

2009-01-01

Background: Unlike cancer of the bladder, cancer of the renal pelvis is not considered an occupational cancer and little is known about risks among women. Methods: Using the Swedish national census and cancer registry-linked data (1971-1989), we identified transitional cell cancers of the renal pelvis (N=1374) and bladder (N=21,591). Correlation between cancer sites for the Standardized Incidence Ratios (SIR) were determined using Pearson's coefficient of the log SIR. Relative risks of job exposure matrix variables were calculated using Poisson regression. Results: Both cancer sites were significantly elevated among women and men employed in the machine/electronics industry, sedentary work, and indoor work, as well as among men employed in the shop and construction metal industry, contributing 10-14% of cases among men. Risks by industry were more highly correlated among women (r=0.49, p=0.002) than men (r=0.24, p=0.04). Conclusion: Cancers of the renal pelvis and bladder share common occupational risk factors that may be more frequent among women. In addition, there may be several jobs that pose an increased risk specifically for cancer of the renal pelvis but not bladder. PMID:18067176

The influence of breast support on torso, pelvis and arm kinematics during a five kilometer treadmill run.

PubMed

Milligan, Alexandra; Mills, Chris; Corbett, Jo; Scurr, Joanna

2015-08-01

Many women wear sports bras due to positive benefits associated with these garments (i.e. reduction in breast movement and breast pain), however the effects these garments have on upper body running kinematics has not been investigated. Ten female participants (32 DD or 34 D) completed two five kilometer treadmill runs (9 km h(-1)), once in a low and once in a high breast support. The range of motion (ROM) and peak torso, pelvis, and upper arm Cardan joint angles were calculated over five gait cycles during a five kilometer run. Peak torso yaw, peak rotation of the pelvis, peak pelvis obliquity, ROM in rotation of the pelvis, and ROM in upper arm extension were significant, but marginally reduced when participants ran in the high breast support. The running kinematics reported in the high breast support condition more closely align with economical running kinematics previously defined in the literature, therefore, running in a high breast support may be more beneficial to female runners, with a high breast support advocated for middle distance runners. Copyright © 2015 Elsevier B.V. All rights reserved.

Kinematic gait deficits at the trunk and pelvis: characteristic features in children with hereditary spastic paraplegia.

PubMed

Adair, Brooke; Rodda, Jillian; McGinley, Jennifer L; Graham, H Kerr; Morris, Meg E

2016-08-01

To examine the kinematic gait deviations at the trunk and pelvis of children with hereditary spastic paraplegia (HSP). This exploratory observational study quantified gait kinematics for the trunk and pelvis from 11 children with HSP (7 males, 4 females) using the Gait Profile Score and Gait Variable Scores (GVS), and compared the kinematics to data from children with typical development using a Mann-Whitney U test. Children with HSP (median age 11y 4mo, interquartile range 4y) demonstrated large deviations in the GVS for the trunk and pelvis in the sagittal and coronal planes when compared to the gait patterns of children with typical development (p=0.010-0.020). Specific deviations included increased range of movement for the trunk in the coronal plane and increased excursion of the trunk and pelvis in the sagittal plane. In the transverse plane, children with HSP demonstrated later peaks in posterior pelvic rotation. The kinematic gait deviations identified in this study raise questions about the contribution of muscle weakness in HSP. Further research is warranted to determine contributing factors for gait dysfunction in HSP, especially the relative influence of spasticity and weakness. © 2016 Mac Keith Press.

Effects of fatigue on lower limb, pelvis and trunk kinematics and muscle activation: Gender differences.

PubMed

Lessi, Giovanna Camparis; Dos Santos, Ana Flávia; Batista, Luis Fylipe; de Oliveira, Gabriela Clemente; Serrão, Fábio Viadanna

2017-02-01

Muscle fatigue is associated with biomechanical changes that may lead to anterior cruciate ligament (ACL) injuries. Alterations in trunk and pelvis kinematics may also be involved in ACL injury. Although some studies have compared the effects of muscle fatigue on lower limb kinematics between men and women, little is known about its effects on pelvis and trunk kinematics. The aim of the study was to compare the effects of fatigue on lower limb, pelvis and trunk kinematics and muscle activation between men and women during landing. The participants included forty healthy subjects. We performed kinematic analysis of the trunk, pelvis, hip and knee and muscle activation analysis of the gluteal muscles, vastus lateralis and biceps femoris, during a single-leg landing before and after fatigue. Men had greater trunk flexion than women after fatigue. After fatigue, a decrease in peak knee flexion and an increase in Gmax and BF activation were observed. The increase in the trunk flexion can decrease the anterior tibiofemoral shear force resulted from the lower knee flexion angle, thereby decreasing the stress on the ACL. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pelvic incidence: a predictive factor for three-dimensional acetabular orientation-a preliminary study.

PubMed

Boulay, Christophe; Bollini, Gérard; Legaye, Jean; Tardieu, Christine; Prat-Pradal, Dominique; Chabrol, Brigitte; Jouve, Jean-Luc; Duval-Beaupère, Ginette; Pélissier, Jacques

2014-01-01

Acetabular cup orientation (inclination and anteversion) is a fundamental topic in orthopaedics and depends on pelvis tilt (positional parameter) emphasising the notion of a safe range of pelvis tilt. The hypothesis was that pelvic incidence (morphologic parameter) could yield a more accurate and reliable assessment than pelvis tilt. The aim was to find out a predictive equation of acetabular 3D orientation parameters which were determined by pelvic incidence to include in the model. The second aim was to consider the asymmetry between the right and left acetabulae. Twelve pelvic anatomic specimens were measured with an electromagnetic Fastrak system (Polhemus Society) providing 3D position of anatomical landmarks to allow measurement of acetabular and pelvic parameters. Acetabulum and pelvis data were correlated by a Spearman matrix. A robust linear regression analysis provided prediction of acetabulum axes. The orientation of each acetabulum could be predicted by the incidence. The incidence is correlated with the morphology of acetabula. The asymmetry of the acetabular roof was correlated with pelvic incidence. This study allowed analysis of relationships of acetabular orientation and pelvic incidence. Pelvic incidence (morphologic parameter) could determine the safe range of pelvis tilt (positional parameter) for an individual and not a group.

Pelvic Incidence: A Predictive Factor for Three-Dimensional Acetabular Orientation—A Preliminary Study

PubMed Central

Bollini, Gérard; Legaye, Jean; Tardieu, Christine; Prat-Pradal, Dominique; Chabrol, Brigitte; Jouve, Jean-Luc; Duval-Beaupère, Ginette; Pélissier, Jacques

2014-01-01

Acetabular cup orientation (inclination and anteversion) is a fundamental topic in orthopaedics and depends on pelvis tilt (positional parameter) emphasising the notion of a safe range of pelvis tilt. The hypothesis was that pelvic incidence (morphologic parameter) could yield a more accurate and reliable assessment than pelvis tilt. The aim was to find out a predictive equation of acetabular 3D orientation parameters which were determined by pelvic incidence to include in the model. The second aim was to consider the asymmetry between the right and left acetabulae. Twelve pelvic anatomic specimens were measured with an electromagnetic Fastrak system (Polhemus Society) providing 3D position of anatomical landmarks to allow measurement of acetabular and pelvic parameters. Acetabulum and pelvis data were correlated by a Spearman matrix. A robust linear regression analysis provided prediction of acetabulum axes. The orientation of each acetabulum could be predicted by the incidence. The incidence is correlated with the morphology of acetabula. The asymmetry of the acetabular roof was correlated with pelvic incidence. This study allowed analysis of relationships of acetabular orientation and pelvic incidence. Pelvic incidence (morphologic parameter) could determine the safe range of pelvis tilt (positional parameter) for an individual and not a group. PMID:25006461

Pelvic widening to alleviate the mechanical component of constipation in a patient with severe caudal regression and extremely narrow pelvis.

PubMed

Sathya, Chethan; Ertresvaag, Kjetil; Wright, James; Azzie, Georges

2013-05-01

Constipation in children is a commonly encountered problem with a broad variety of causes. Constipation caused by a narrow pelvis has, to our knowledge, not been reported in the human literature. Retrospective review of patient chart, in depth follow-up appointment with the patient and review of literature. A 15 year old girl with sacral agenesis and significant co-morbidities was referred for consideration of cecostomy tube placement to manage her constipation. Digital rectal exam revealed a very narrow pelvic outlet and CT scan confirmed abnormal configuration of the bony pelvis. Discussions with orthopaedic colleagues concluded that bilateral pelvic osteotomies to widen her pelvis may relieve her constipation. The procedure was uneventful and radiologic follow-up confirmed widening of the pelvic outlet and increased pelvic volume. Her stooling pattern improved postoperatively and she was satisfied with the result on follow up at one year. Although previously described only in the veterinary literature, surgical widening of a narrow pelvis can be considered for the management of constipation in the rare patient with appropriate physical and radiologic findings. Copyright © 2013 Elsevier Inc. All rights reserved.

Disproportionate growth between the spine and pelvis in patients with thoracic adolescent scoliosis: a new look into the pattern's growth.

PubMed

Bao, H; Liu, Z; Yan, P; Qiu, Y; Zhu, F

2015-12-01

A self-control ratio, the spine-pelvis index (SPI), was proposed for the assessment of patients with adolescent idiopathic scoliosis (AIS) in this study. The aim was to evaluate the disproportionate growth between the spine and pelvis in these patients using SPI. A total of 64 female patients with thoracic AIS were randomly enrolled between December 2010 and October 2012 (mean age 13 years, standard deviation (sd) 2.17; 9 to 18) and a further 73 healthy female patients with a mean age of 12.4 years (mean age 12.4 years, sd 2.24; 9 to 18), were randomly selected from a normal control database at our centre. The radiographic parameters measured included length of spine (LOS), height of spine (HOS), length of thoracic vertebrae (LOT), height of thoracic vertebrae (HOT), width of pelvis (WOP), height of pelvis (HOP) and width of thorax (WOT). SPI was defined as the ratio LOS/HOP. The SPI and LOT/HOP in patients with AIS showed a significant increase when compared with normal girls (p < 0.001 and p < 0.001 respectively), implying an abnormal pattern of growth of the spine relative to the pelvis in patients with AIS. No significant difference in SPI was found in different age groups in the control group, making the SPI an age-independent parameter with a mean value of 2.219 (2.164 to 2.239). We also found that the SPI was not related to maturity in the control group. This study, for the first time, used a self-control ratio to confirm the disproportionate patterns of growth of the spine and pelvis in patients with thoracic AIS, highlighting that the SPI is not affected by age or maturity. ©2015 The British Editorial Society of Bone & Joint Surgery.

The effect of laparotomy and external fixator stabilization on pelvic volume in an unstable pelvic injury.

PubMed

Ghanayem, A J; Wilber, J H; Lieberman, J M; Motta, A O

1995-03-01

Determine if laparotomy further destabilizes an unstable pelvic injury and increases pelvic volume, and if reduction and stabilization restores pelvic volume and prevents volume changes secondary to laparotomy. Cadaveric pelvic fracture model. Unilateral open-book pelvic ring injuries were created in five fresh cadaveric specimens by directly disrupting the pubic symphysis, left sacroliac joint, and sacrospinous and sacrotuberous ligaments. Pelvic volume was determined using computerized axial tomography for the intact pelvis, disrupted pelvis with both a laparotomy incision opened and closed, and disrupted pelvis stabilized and reduced using an external fixator with the laparotomy incision opened. The average volume increase in the entire pelvis (from the top of the iliac crests to the bottom of the ischial tuberosities) between a nonstabilized injury with the abdomen closed and then subsequently opened was 15 +/- 5% (423 cc). The average increase in entire pelvic volume between a stabilized and reduced pelvis and nonstabilized pelvis, both with the abdomen open, was 26 +/- 5% (692 cc). The public diastasis increased from 3.9 to 9.3 cm in a nonstabilized pelvis with the abdomen closed and then subsequently opened. Application of a single-pin anterior-frame external fixator reduced the pubic diastasis anatomically and reduced the average entire and true (from the pelvic brim to the ischeal tuberosities) pelvic volumes to within 3 +/- 4 and 8 +/- 6% of the initial volume, respectively. We believe that the abdominal wall provides stability to an unstable pelvic ring injury via a tension band effect on the iliac wings. Our results demonstrate that a laparotomy further destabilized an open-book pelvic injury and subsequently increased pelvic volume and pubic diastasis. This could potentially increase blood loss from the pelvic injury and delay the tamponade effect of reduction and stabilization. A single-pin external fixator prevents the destabilizing effect of the laparotomy and effectively reduces pelvic volume. These data support reduction and temporary stabilization of unstable pelvic injuries before or concomitantly with laparotomy.

49 CFR 572.19 - Lumbar spine, abdomen and pelvis.

Code of Federal Regulations, 2014 CFR

2014-10-01

... rotation joints by the attachments shown in Figure 18. Tighten the mountings so that the pelvis-lumbar... pounds torque. Remove the head and the neck and install a cylindrical aluminum adapter 2.0 inches in...

49 CFR 572.19 - Lumbar spine, abdomen and pelvis.

Code of Federal Regulations, 2011 CFR

2011-10-01

... rotation joints by the attachments shown in Figure 18. Tighten the mountings so that the pelvis-lumbar... pounds torque. Remove the head and the neck and install a cylindrical aluminum adapter 2.0 inches in...

49 CFR 572.19 - Lumbar spine, abdomen and pelvis.

Code of Federal Regulations, 2012 CFR

2012-10-01

... rotation joints by the attachments shown in Figure 18. Tighten the mountings so that the pelvis-lumbar... pounds torque. Remove the head and the neck and install a cylindrical aluminum adapter 2.0 inches in...

49 CFR 572.19 - Lumbar spine, abdomen and pelvis.

Code of Federal Regulations, 2013 CFR

2013-10-01

... rotation joints by the attachments shown in Figure 18. Tighten the mountings so that the pelvis-lumbar... pounds torque. Remove the head and the neck and install a cylindrical aluminum adapter 2.0 inches in...

49 CFR 572.19 - Lumbar spine, abdomen and pelvis.

Code of Federal Regulations, 2010 CFR

2010-10-01

... rotation joints by the attachments shown in Figure 18. Tighten the mountings so that the pelvis-lumbar... pounds torque. Remove the head and the neck and install a cylindrical aluminum adapter 2.0 inches in...

Botulinum toxin for conditions of the female pelvis.

PubMed

El-Khawand, Dominique; Wehbe, Salim; Whitmore, Kristene

2013-07-01

Botulinum toxin has recently been approved by the Food and Drug Administration (FDA) for the treatment of urinary incontinence associated with neurogenic detrusor overactivity. However, it has also been used off-label for a multitude of other conditions in the female pelvis, including urological, gynecological, and colorectal. This article reviews the most recent data regarding its efficacy and safety, and administration techniques for those conditions. A literature review of the most relevant reports published between 1985 and 2012. Urinary incontinence related to neurogenic detrusor overactivity is currently the only approved indication in the female pelvis. Other supported off-label uses include: idiopathic detrusor overactivity, interstitial cystitis/bladder pain syndrome, detrusor sphincter dyssynergia, high-tone pelvic floor dysfunction, anal fissure, anismus, and functional anal pain. Botulinum toxin may effectively and safely be used in many conditions of the female pelvis. More high quality research is needed to better clarify its role in the therapeutic algorithm for those indications.

Asymmetric adaptation in human walking using the Tethered Pelvic Assist Device (TPAD).

PubMed

Vashista, Vineet; Reisman, Darcy S; Agrawal, Sunil K

2013-06-01

Human nervous system is capable of modifying motor commands in response to alterations in walking conditions. Previous research has shown that external perturbations that induce gait asymmetry can lead to adaptation in gait parameters. Such strategies have also been shown to temporarily restore gait symmetry in subjects with post stroke hemiparesis. This work aims to develop an experimental paradigm to induce gait asymmetry in human subjects by applying external asymmetric forces on the pelvis through the Tethered Pelvic Assist Device (TPAD). These external forces on the pelvis have the potential to influence the swing and the stance phases of both legs. Eight healthy subjects participated in the experiment where a higher resistive force was applied on the pelvis during the swing phase of the left leg as compared to the right leg. We hypothesized that such asymmetrically applied forces on the pelvis will lead to asymmetric adaptation in the human walking.

Establishing national diagnostic reference levels (DRLs) for computed tomography in Egypt.

PubMed

Salama, Dina Husseiny; Vassileva, Jenia; Mahdaly, Gamal; Shawki, Mona; Salama, Ahmad; Gilley, Debbie; Rehani, Madan Mohan

2017-07-01

To establish national diagnostic reference levels (DRLs) in Egypt for computed tomography (CT) examinations of adults and identify the potential for optimization. Data from 3762 individual patient's undergoing CT scans of head, chest (high resolution), abdomen, abdomen-pelvis, chest-abdomen-pelvis and CT angiography (aorta and both lower limbs) examinations in 50 CT facilities were collected. This represents 20% of facilities in the country and all of the 27 Governorates. Results were compared with DRLs of UK, USA, Canada, Japan, Australia and France. The Egyptian DRLs for CTDI vol in mGy are for head: 30, chest (high resolution): 22, abdomen (liver metastasis): 31, abdomen-pelvis: 31, chest-abdomen-pelvis: 33 and CT angiography (aorta and lower limbs): 37. The corresponding DRLs for DLP in mGy.cm are 1360, 420, 1425, 1325, 1320 and 1320. For head CT, the Egyptian DRL for CTDI vol is 2-3 times lower than the DRLs from other countries. However, the DRL in terms of DLP is in the same range or higher as compared to others. The Egyptian DRL for chest CT (high resolution) is similar to others for DLP but higher for CTDI vol . For abdomen and abdomen-pelvis DRLs for CTDI vol are higher than others. For DLP, the DRLs for abdomen are higher than DRL in UK and lower than those in Japan, while for abdomen-pelvis they are higher than other countries. Despite lower DRLs for CTDI vol , an important consistent problem appears to be higher scan range as DRLs for DLP are higher. Copyright © 2017 Associazione Italiana di Fisica Medica. All rights reserved.

Trunk, pelvis and hip biomechanics in individuals with femoroacetabular impingement syndrome: Strategies for step ascent.

PubMed

Diamond, Laura E; Bennell, Kim L; Wrigley, Tim V; Hinman, Rana S; Hall, Michelle; O'Donnell, John; Hodges, Paul W

2018-03-01

Femoroacetabular impingment (FAI) syndrome is common among young active adults and a proposed risk factor for the future development of hip osteoarthritis. Pain is dominant and drives clinical decision-making. Evidence for altered hip joint function in this patient population is inconsistent, making the identification of treatment targets challenging. A broader assessment, considering adjacent body segments (i.e. pelvis, trunk) and individual movement strategies, may better inform treatment programs. This exploratory study aimed to compare trunk, pelvis, and hip biomechanics during step ascent between individuals with and without FAI syndrome. Fifteen participants diagnosed with symptomatic cam-type or combined (cam plus pincer) FAI who were scheduled for arthroscopic surgery, and 11 age-, and sex-comparable pain- and disease-free individuals, underwent three-dimensional motion analysis during a step ascent task. Trunk, pelvis and hip biomechanics were compared between groups. Participants with FAI syndrome exhibited altered ipsilateral trunk lean and pelvic rise towards the symptomatic side during single-leg support compared to controls. Alterations were not uniformly adopted across all individuals with FAI syndrome; those who exhibited more pronounced alterations to frontal plane pelvis control tended to report pain during the task. There were minimal between-group differences for hip biomechanics. Exploratory data suggest biomechanics at the trunk and pelvis during step ascent differ between individuals with and without FAI syndrome. Those with FAI syndrome implement a range of proximal strategies for task completion, some of which may have relevance for rehabilitation. Longitudinal investigations of larger cohorts are required to evaluate hypothesized clinical and structural consequences. Copyright © 2018 Elsevier B.V. All rights reserved.

Dynamic Responses of Intact Post Mortem Human Surrogates from Inferior-to-Superior Loading at the Pelvis.

PubMed

Yoganandan, Narayan; Moore, Jason; Arun, Mike W J; Pintar, Frank A

2014-11-01

During certain events such as underbody blasts due to improvised explosive devices, occupants in military vehicles are exposed to inferior-to-superior loading from the pelvis. Injuries to the pelvis-sacrum-lumbar spine complex have been reported from these events. The mechanism of load transmission and potential variables defining the migration of injuries between pelvis and or spinal structures are not defined. This study applied inferior-to-superior impacts to the tuberosities of the ischium of supine-positioned five post mortem human subjects (PMHS) using different acceleration profiles, defined using shape, magnitude and duration parameters. Seventeen tests were conducted. Overlay temporal plots were presented for normalized (impulse momentum approach) forces and accelerations of the sacrum and spine. Scatter plots showing injury and non-injury data as a function of peak normalized forces, pulse characteristics, impulse and power, loading rate and sacrum and spine accelerations were evaluated as potential metrics related to pathological outcomes with the focus of examining the role of the pulse characteristics from inferior-to-superior loading of the pelvis-sacrum-lumbar spine complex. Interrelationships were explored between non-fracture and fracture outcomes, and fracture patterns with a focus on migration of injuries from the hip-only to hip and spine to spine-only regions. Observations indicate that injury to the pelvis and or spine from inferior-to-superior loading is associated with pulse and not just peak velocity. The role of the effect of mass recruitment and injury migration parallel knee-thigh-hip complex studies, suggest a wider application of the recruitment concept and the role of the pulse characteristics.

Shape variation in the human pelvis and limb skeleton: Implications for obstetric adaptation.

PubMed

Kurki, Helen K; Decrausaz, Sarah-Louise

2016-04-01

Under the obstetrical dilemma (OD) hypothesis, selection acts on the human female pelvis to ensure a sufficiently sized obstetric canal for birthing a large-brained, broad shouldered neonate, while bipedal locomotion selects for a narrower and smaller pelvis. Despite this female-specific stabilizing selection, variability of linear dimensions of the pelvic canal and overall size are not reduced in females, suggesting shape may instead be variable among females of a population. Female canal shape has been shown to vary among populations, while male canal shape does not. Within this context, we examine within-population canal shape variation in comparison with that of noncanal aspects of the pelvis and the limbs. Nine skeletal samples (total female n = 101, male n = 117) representing diverse body sizes and shapes were included. Principal components analysis was applied to size-adjusted variables of each skeletal region. A multivariate variance was calculated using the weighted PC scores for all components in each model and F-ratios used to assess differences in within-population variances between sexes and skeletal regions. Within both sexes, multivariate canal shape variance is significantly greater than noncanal pelvis and limb variances, while limb variance is greater than noncanal pelvis variance in some populations. Multivariate shape variation is not consistently different between the sexes in any of the skeletal regions. Diverse selective pressures, including obstetrics, locomotion, load carrying, and others may act on canal shape, as well as genetic drift and plasticity, thus increasing variation in morphospace while protecting obstetric sufficiency. © 2015 Wiley Periodicals, Inc.

Proton magnetic resonance spectroscopy for assessment of human body composition.

PubMed

Kamba, M; Kimura, K; Koda, M; Ogawa, T

2001-02-01

The usefulness of magnetic resonance spectroscopy (MRS)-based techniques for assessment of human body composition has not been established. We compared a proton MRS-based technique with the total body water (TBW) method to determine the usefulness of the former technique for assessment of human body composition. Proton magnetic resonance spectra of the chest to abdomen, abdomen to pelvis, and pelvis to thigh regions were obtained from 16 volunteers by using single, free induction decay measurement with a clinical magnetic resonance system operating at 1.5 T. The MRS-derived metabolite ratio was determined as the ratio of fat methyl and methylene proton resonance to water proton resonance. The peak areas for the chest to abdomen and the pelvis to thigh regions were normalized to an external reference (approximately 2200 g benzene) and a weighted average of the MRS-derived metabolite ratios for the 2 positions was calculated. TBW for each subject was determined by the deuterium oxide dilution technique. The MRS-derived metabolite ratios were significantly correlated with the ratio of body fat to lean body mass estimated by TBW. The MRS-derived metabolite ratio for the abdomen to pelvis region correlated best with the ratio of body fat to lean body mass on simple regression analyses (r = 0.918). The MRS-derived metabolite ratio for the abdomen to pelvis region and that for the pelvis to thigh region were selected for a multivariate regression model (R = 0.947, adjusted R(2) = 0.881). This MRS-based technique is sufficiently accurate for assessment of human body composition.

Gait in patients with pregnancy-related pain in the pelvis: an emphasis on the coordination of transverse pelvic and thoracic rotations.

PubMed

Wu, Wenhua; Meijer, Onno G; Jutte, Paul C; Uegaki, Kimi; Lamoth, Claudine J C; Sander de Wolf, G; van Dieën, Jaap H; Wuisman, Paul I J M; Kwakkel, Gert; de Vries, Johanna I P; Beek, Peter J

2002-01-01

To quantify gait impairments in women with pregnancy-related pain in the pelvis which persisted post-partum.Design. Nine patients and nine healthy subjects were studied during treadmill walking at different velocities. Walking problems in patients with pregnancy-related pain in the pelvis have been known to exist for a long time. To date, no quantitative gait studies have been conducted in this population. Maximum attainable walking velocity was determined, amplitudes of pelvic and thoracic rotations were calculated, and spectral analysis was used to assess the harmonicity of these rotations. Coordination between pelvic and thoracic rotations was characterized as mean relative Fourier phase and weighted coherence. Maximum attainable walking velocity was highly variable between patients, but on average significantly lower than in healthy controls. Moreover, patients had a significantly lower mean relative Fourier phase (again, highly variable) and higher weighted coherence. The other parameters did not differ significantly between groups. Coordination between pelvic and thoracic rotations in the transverse plane was affected in patients with pregnancy-related pain in the pelvis. Individual patients may apply different strategies during walking to cope with the underlying problems. Pregnancy-related pain in the pelvis is poorly understood. Patients with this condition are known to have problems with locomotion. The present study reveals that gait coordination is altered. Theoretically, this underlines the importance of analysing coordination in pathological movement. Clinically, better understanding the gait problems of women with pregnancy-related pain in the pelvis may contribute to more appropriate treatments.

Spatial geometry of the human pelvis.

DOT National Transportation Integrated Search

1982-03-01

This report presents a three-dimensional description of adult female and male pelvis from the Hamann-Todd skeletal collection, Cleveland Museum of Natural History. Based on a linear height/weight matching strategy and the 1961- 1964 U.S. Health and E...

Prediction of three-dimensional femoral offset from AP pelvis radiographs in primary hip osteoarthritis.

PubMed

Merle, C; Waldstein, W; Pegg, E C; Streit, M R; Gotterbarm, T; Aldinger, P R; Murray, D W; Gill, H S

2013-08-01

In pre-operative planning for total hip arthroplasty (THA), femoral offset (FO) is frequently underestimated on AP pelvis radiographs as a result of inaccurate patient positioning, imprecise magnification, and radiographic beam divergence. The aim of the present study was to evaluate the accuracy and reliability of predicting three-dimensional (3-D) FO from standardised AP pelvis radiographs. In a retrospective cohort study, pre-operative AP pelvis radiographs, AP hip radiographs and CT scans of a consecutive series of 345 patients (345 hips, 146 males, 199 females, mean age 60 (range: 40-79) years, mean body-mass-index 27 (range: 19-57)kg/m(2)) with primary end-stage hip OA were reviewed. Patients were positioned according to a standardised protocol and all images were calibrated. Using validated custom programmes, FO was measured on corresponding radiographs and CT scans. Measurement reliability was evaluated using intra-class-correlation-coefficients. To predict 3-D FO from AP pelvis measurements and to assess the accuracy compared to CT, the entire cohort was randomly split into subgroups A and B. Gender specific regression equations were derived from group A (245 patients) and the accuracy of prediction was evaluated in group B (100 patients) using Bland-Altman plots. In the entire cohort, mean FO was 39.2mm (95%CI: 38.5-40.0mm) on AP pelvis radiographs, 44.1mm (95%CI: 43.4-44.9mm) on AP hip radiographs and 44.6mm (95%CI: 44.0-45.2mm) on CT scans. In group B, we observed no significant difference between gender specific predicted FO (males: 48.0mm, 95%CI: 47.1-48.8mm; females: 42.0mm, 95%CI: 41.1-42.8mm) and FO as measured on CT (males: 47.7mm, 95%CI: 46.1-49.4mm, p=0.689; females: 41.6mm, 95%CI: 40.3-43.0mm, p=0.607). The present study suggests that FO can be accurately and reliably predicted from AP pelvis radiographs in patients with primary end-stage hip osteoarthritis. Our findings support the surgeon in pre-operative templating on AP-pelvis radiographs and may improve offset and limb length restoration in THA without the routine performance of additional radiographs or CT. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The evolution of the human pelvis: changing adaptations to bipedalism, obstetrics and thermoregulation

PubMed Central

Gruss, Laura Tobias; Schmitt, Daniel

2015-01-01

The fossil record of the human pelvis reveals the selective priorities acting on hominin anatomy at different points in our evolutionary history, during which mechanical requirements for locomotion, childbirth and thermoregulation often conflicted. In our earliest upright ancestors, fundamental alterations of the pelvis compared with non-human primates facilitated bipedal walking. Further changes early in hominin evolution produced a platypelloid birth canal in a pelvis that was wide overall, with flaring ilia. This pelvic form was maintained over 3–4 Myr with only moderate changes in response to greater habitat diversity, changes in locomotor behaviour and increases in brain size. It was not until Homo sapiens evolved in Africa and the Middle East 200 000 years ago that the narrow anatomically modern pelvis with a more circular birth canal emerged. This major change appears to reflect selective pressures for further increases in neonatal brain size and for a narrow body shape associated with heat dissipation in warm environments. The advent of the modern birth canal, the shape and alignment of which require fetal rotation during birth, allowed the earliest members of our species to deal obstetrically with increases in encephalization while maintaining a narrow body to meet thermoregulatory demands and enhance locomotor performance. PMID:25602067

Thorax, pelvis and hip pattern in the frontal plane during walking in unilateral transtibial amputees: biomechanical analysis

PubMed Central

Molina-Rueda, Francisco; Alguacil-Diego, Isabel M.; Cuesta-Gómez, Alicia; Iglesias-Giménez, Javier; Martín-Vivaldi, Andrés; Miangolarra-Page, Juan C.

2014-01-01

Background: Lower limb amputees exhibit postural control deficits during standing which can affect their walking ability. Objectives: The primary purpose of the present study was to analyze the thorax, pelvis, and hip kinematics and the hip internal moment in the frontal plane during gait in subjects with Unilateral Transtibial Amputation (UTA). Method: The participants included 25 people with UTA and 25 non-amputees as control subjects. Gait analysis was performed using the Vicon(r) Motion System. We analyzed the motion of the thorax, pelvis, and hip (kinematics) as well as the hip internal moment in the frontal plane. Results: The second peak of the hip abductor moment was significantly lower on the prosthetic side than on the sound side (p=.01) and the control side (right: p=.01; left: p=.01). During middle stance, the opposite side of the pelvis was higher on the prosthetic side compared to the control side (right: p=.01: left: p=.01). Conclusions: The joint internal moment at the hip in the frontal plane was lower on the prosthetic side than on the sound side or the control side. Thorax and pelvis kinematics were altered during the stance phase on the prosthetic side, presumably because there are mechanisms which affect postural control during walking. PMID:25003278

The evolution of the human pelvis: changing adaptations to bipedalism, obstetrics and thermoregulation.

PubMed

Gruss, Laura Tobias; Schmitt, Daniel

2015-03-05

The fossil record of the human pelvis reveals the selective priorities acting on hominin anatomy at different points in our evolutionary history, during which mechanical requirements for locomotion, childbirth and thermoregulation often conflicted. In our earliest upright ancestors, fundamental alterations of the pelvis compared with non-human primates facilitated bipedal walking. Further changes early in hominin evolution produced a platypelloid birth canal in a pelvis that was wide overall, with flaring ilia. This pelvic form was maintained over 3-4 Myr with only moderate changes in response to greater habitat diversity, changes in locomotor behaviour and increases in brain size. It was not until Homo sapiens evolved in Africa and the Middle East 200 000 years ago that the narrow anatomically modern pelvis with a more circular birth canal emerged. This major change appears to reflect selective pressures for further increases in neonatal brain size and for a narrow body shape associated with heat dissipation in warm environments. The advent of the modern birth canal, the shape and alignment of which require fetal rotation during birth, allowed the earliest members of our species to deal obstetrically with increases in encephalization while maintaining a narrow body to meet thermoregulatory demands and enhance locomotor performance. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Kinematic and EMG Responses to Pelvis and Leg Assistance Force during Treadmill Walking in Children with Cerebral Palsy

PubMed Central

Kim, Janis; Arora, Pooja; Zhang, Yunhui

2016-01-01

Treadmill training has been used for improving locomotor function in children with cerebral palsy (CP), but the functional gains are relatively small, suggesting a need to improve current paradigms. The understanding of the kinematic and EMG responses to forces applied to the body of subjects during treadmill walking is crucial for improving current paradigms. The objective of this study was to determine the kinematics and EMG responses to the pelvis and/or leg assistance force. Ten children with spastic CP were recruited to participate in this study. A controlled assistance force was applied to the pelvis and/or legs during stance and swing phase of gait through a custom designed robotic system during walking. Muscle activities and spatial-temporal gait parameters were measured at different loading conditions during walking. In addition, the spatial-temporal gait parameters during overground walking before and after treadmill training were also collected. Applying pelvis assistance improved step height and applying leg assistance improved step length during walking, but applying leg assistance also reduced muscle activation of ankle flexor during the swing phase of gait. In addition, step length and self-selected walking speed significantly improved after one session of treadmill training with combined pelvis and leg assistance. PMID:27651955

Effects of frontal and sagittal thorax attitudes in gait on trunk and pelvis three-dimensional kinematics.

PubMed

Begon, Mickaël; Leardini, Alberto; Belvedere, Claudio; Farahpour, Nader; Allard, Paul

2015-10-01

While sagittal trunk inclinations alter upper body biomechanics, little is known about the extent of frontal trunk bending on upper body and pelvis kinematics in adults during gait and its relation to sagittal trunk inclinations. The objective was to determine the effect of the mean lateral trunk attitude on upper body and pelvis three-dimensional kinematics during gait in asymptomatic subjects. Three gait cycles were collected in 30 subjects using a motion analysis system (Vicon 612) and an established protocol. Sub-groups were formed based on the mean thorax lateral bending angle, bending side, and also sagittal tilt. These were compared based on 38 peak angles identified on pelvis, thorax and shoulder kinematics using MANOVAs. A main effect for bending side (p = 0.038) was found, especially for thorax peak angles. Statistics revealed also a significant interaction (p = 0.04993) between bending side and tilt for the thorax sagittal inclination during body-weight transfer. These results reinforce the existence of different gait patterns, which correlate upper body and pelvis motion measures. The results also suggest that frontal and sagittal trunk attitude should be considered carefully when treating a patient with impaired gait. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

The presence and distribution of alpha adrenergic receptors in human renal pelvis and calyces.

PubMed

Karabacak, Osman Raif; Yilmazer, Demet; Ozturk, Ufuk; Sener, Nevzat Can; Saltas, Hakan; Karabacak, Yurdum; Alper, Murat

2013-10-01

In this study, we aimed to demonstrate the presence of Alpha (α) 1 receptors and subtypes in human pelvis and calyces, because an agent to facilitate kidney stone movement and help decrease pain may be an α 1 adrenergic blocker, as used in ureteral stones. Twenty patients who applied to our clinic for renal cell carcinoma were enrolled to the study. All patients underwent radical nephrectomy. After the specimens were removed, excisional biopsies were performed on healthy pelvises and calyces. Mean α-receptor stain rates in renal pelvis were 2.65 ± 0.74, 1.35 ± 0.81 and 2.9 ± 0.30 for α 1A, 1B and 1D, respectively. For calyces, the rates are 2.40 ± 0.82, 1.50 ± 0.76 and 2.75 ± 0.44 for α 1A, 1B and 1D, respectively (Fig. 1). When the staining patterns were compared, α 1A and 1D were expressed more in both pelvis and calyces than α 1B (p < 0.05). After the demonstration of α-adrenergic receptors in pelvis and calyces of human kidney, it may be helpful in coming up with new alternative treatments for patients suffering from kidney stones.

Effective and organ doses from common CT examinations in one general hospital in Tehran, Iran

NASA Astrophysics Data System (ADS)

Khoramian, Daryoush; Hashemi, Bijan

2017-09-01

Purpose: It is well known that the main portion of artificial sources of ionizing radiation to human results from X-ray imaging techniques. However, reports carried out in various countries have indicated that most of their cumulative doses from artificial sources are due to CT examinations. Hence assessing doses resulted from CT examinations is highly recommended by national and international radiation protection agencies. The aim of this research has been to estimate the effective and organ doses in an average human according to 103 and 60 ICRP tissue weighting factor for six common protocols of Multi-Detector CT (MDCT) machine in a comprehensive training general hospital in Tehran/Iran. Methods: To calculate the patients' effective dose, the CT-Expo2.2 software was used. Organs/tissues and effective doses were determined for about 20 patients (totally 122 patients) for every one of six typical CT protocols of the head, neck, chest, abdomen-pelvis, pelvis and spine exams. In addition, the CT dosimetry index (CTDI) was measured in the standard 16 and 32 cm phantoms by using a calibrated pencil ionization chamber for the six protocols and by taking the average value of CT scan parameters used in the hospital compared with the CTDI values displayed on the console device of the machine. Results: The values of the effective dose based on the ICRP 103 tissue weighting factor were: 0.6, 2.0, 3.2, 4.2, 2.8, and 3.9 mSv and based on the ICRP 60 tissue weighting factor were: 0.9, 1.4, 3, 7.9, 4.8 and 5.1 mSv for the head, neck, chest, abdomen-pelvis, pelvis, spine CT exams respectively. Relative differences between those values were -22, 21, 23, -6, -31 and 16 percent for the head, neck, chest, abdomen-pelvis, pelvis, spine CT exams, respectively. The average value of CTDIv calculated for each protocol was: 27.32 ± 0.9, 18.08 ± 2.0, 7.36 ± 2.6, 8.84 ± 1.7, 9.13 ± 1.5, 10.42 ± 0.8 mGy for the head, neck, chest, abdomen-pelvis and spine CT exams, respectively. Conclusions: The highest organ doses delivered by various CT exams were received by brain (15.5 mSv), thyroid (19.00 mSv), lungs (9.3 mSv) and bladder (9.9 mSv), bladder (10.4 mSv), stomach (10.9 mSv) in the head, neck, chest, and the abdomen-pelvis, pelvis, and spine respectively. Except the neck and spine CT exams showing a higher effective dose compared to that reported in Netherlands, other exams indicated lower values compared to those reported by any other country.

Hip Injuries and Disorders

MedlinePlus

... end of the femur, which fits in a socket in the pelvis. Your hip is known as a ball-and-socket joint. This is because you have a ball ... of your femur, and it fits into a socket in your pelvis. This makes your hips very ...

Risks to the Superior Gluteal Neurovascular Bundle During Iliosacral and Transsacral Screw Fixation: A Computed Tomogram Arteriography Study.

PubMed

Maslow, Jed; Collinge, Cory A

2017-12-01

Iliosacral (IS) and transsacral (TS) screws are popular techniques to repair complicated injuries to the pelvis. The anatomy of the superior gluteal neurovasculature (SG NV bundle) is well described as running along the posterior ilium, providing innervation and perfusion to important abductor muscles. The method of pelvis fixation least likely to injure the SG NV bundle is unknown. Twenty uninjured patients with a contrasted computed tomogram of the pelvis and lower extremities (CTA) were evaluated. Starting points for an S1 IS screw and S1 and S2 TS screws were estimated on the "ghost" lateral CTA image for those pelvi with safe corridors (>9 mm diameter). The distance from the projected screw to the SG artery was measured. A distance of <3.65 mm (half of a 7.3-mm screw's diameter) was considered likely for NV bundle injury. Of 40 pelvi CTAs (single sides), 10 pelvi (25%) were determined to be inappropriate for an S1 TS screw. The average distances from the screw starting point and the artery were 25.3 mm (±9.2) for S1 IS, 12.4 mm (±9.0) for S1 TS, and 23.5 mm (±10.7) for S2 TS screws, respectively. Ten S1 TS screws (25%) and no S1 IS or S2 TS screws were projected to have caused injury to the SG NV bundle (P < 0.001). Inserting S1 IS and S2 TS screws put the SG NV anatomy at significantly less risk than S1 TS screws. This information may aid in choosing the "best" fixation option for patients with pelvic ring trauma requiring surgery.

Upper torso and pelvis linear velocity during the downswing of elite golfers

PubMed Central

2013-01-01

Background During a golf swing, analysis of the movement in upper torso and pelvis is a key step to determine a motion control strategy for accurate and consistent shots. However, a majority of previous studies that have evaluated this movement limited their analysis only to the rotational movement of segments, and translational motions were not examined. Therefore, in this study, correlations between translational motions in the 3 axes, which occur between the upper torso and pelvis, were also examined. Methods The experiments were carried out with 14 male pro-golfers (age: 29 ± 8 years, career: 8.2 ± 4.8years) who registered in the Korea Professional Golf Association (KPGA). Six infrared cameras (VICON; Oxford Metrics, Oxford, UK) and SB-Clinc software (SWINGBANK Ltd, Korea) were used to collect optical marker trajectories. The center of mass (CoM) of each segment was calculated based on kinematic principal. In addition, peak value of CoM velocity and the time that each peak occurred in each segment during downswing was calculated. Also, using cross-correlation analysis, the degree of coupling and time lags of peak values occurred between and within segments (pelvis and upper torso) were investigated. Results As a result, a high coupling strength between upper torso and pelvis with an average correlation coefficient = 0.86 was observed, and the coupling between segments was higher than that within segments (correlation coefficient = 0.81 and 0.77, respectively). Conclusions Such a high coupling at the upper torso and pelvis can be used to reduce the degree of motion control in the central nervous system and maintain consistent patterns in the movement. The result of this study provides important information for the development of optimal golf swing movement control strategies in the future. PMID:23398693

Hip kinematics and kinetics in persons with and without cam femoroacetabular impingement during a deep squat task.

PubMed

Bagwell, Jennifer J; Snibbe, Jason; Gerhardt, Michael; Powers, Christopher M

2016-01-01

Previous studies have indicated that hip and pelvis kinematics may be altered during functional tasks in persons with femoroacetabular impingement. The purpose of this study was to compare hip and pelvis kinematics and kinetics during a deep squat task between persons with cam femoroacetabular impingement and pain-free controls. Fifteen persons with cam femoroacetabular impingement and 15 persons without cam femoroacetabular impingement performed a deep squat task. Peak hip flexion, abduction, and internal rotation, and mean hip extensor, adductor, and external rotator moments were quantified. Independent t-tests (α<0.05) were used to evaluate between group differences. Compared to the control group, persons with cam femoroacetabular impingement demonstrated decreased peak hip internal rotation (15.2° (SD 9.5°) vs. 9.4° (SD 7.8°); P=0.041) and decreased mean hip extensor moments (0.56 (SD 0.12) Nm/kg vs. 0.45 (SD 0.15) Nm/kg; P=0.018). In addition persons in the cam femoroacetabular impingement group demonstrated decreased posterior pelvis tilt during squat descent compared to the control group, resulting in a more anteriorly tilted pelvis at the time peak hip flexion (12.5° (SD 17.1°) vs. 23.0° (SD 12.4°); P=0.024). The decreased hip internal rotation observed in persons with cam femoroacetabular impingement may be the result of bony impingement. Furthermore, the decrease in posterior pelvis tilt may contribute to impingement by further approximating the femoral head-neck junction with the acetabulum. Additionally, decreased hip extensor moments suggest that diminished hip extensor muscle activity may contribute to decreased posterior pelvis tilt. Copyright © 2015 Elsevier Ltd. All rights reserved.

Determining the Incidence of Gynecoid Pelvis Using Three-Dimensional Computed Tomography in Nonpregnant Multiparous Women.

PubMed

Salk, Ismail; Cetin, Meral; Salk, Sultan; Cetin, Ali

2016-01-01

To determine the incidence of gynecoid pelvis by using classical criteria and measured parameters obtained from three-dimensional computed tomography (3D CT) pelvimetry in nonpregnant multiparous women who delivered vaginally. Our hospital's picture archiving and communication system was reviewed retrospectively. All adult women who had undergone CT examination with routine abdominal protocols were identified. In the pelvic inlet, midpelvis, and pelvic outlet, classical criteria and measured parameters, both alone and in combination, were used to determine the presence of gynecoid pelvis. 3D CT pelvimetry was performed on 226 women aged 23-65 years without any history of cephalopelvic disproportion and who had at least one delivery of an average fetal size (>2,500 g). The median parity was 4, and the mean (±SD) birth weight was 3,700 ± 498 g. Compared to the classical criteria, measured parameters and their combined use with the classical criteria significantly reduced the frequency of gynecoid pelvis (51.3 and 47.8%, respectively, vs. 71.6%; p = 0.001); however, there was no significant difference between the measured parameters and their combined use with classical criteria with regard to the frequencies of gynecoid pelvis (p > 0.05). With the use of measured parameters of 3D CT pelvimetry, the incidence of gynecoid pelvis reduces to a more acceptable level (51.3%) in accordance with obstetric knowledge. Since there is no considerable decrease with the addition of classical criteria, 3D CT pelvimetry alone has merit for determining a woman's pelvic capacity for obstetric needs after the improvement and standardization of measured parameters. © 2015 S. Karger AG, Basel.

The influence of hip strength on lower-limb, pelvis, and trunk kinematics and coordination patterns during walking and hopping in healthy women.

PubMed

Smith, Jo Armour; Popovich, John M; Kulig, Kornelia

2014-07-01

Cross-sectional laboratory study. To compare peak lower-limb, pelvis, and trunk kinematics and interjoint and intersegmental coordination in women with strong and weak hip muscle performance. Persons with lower extremity musculoskeletal disorders often demonstrate a combination of weak hip musculature and altered kinematics during weight-bearing dynamic tasks. However, the association between hip strength and kinematics independent of pathology or pain is unclear. Peak hip extensor and abductor torques were measured in 150 healthy young women. Of these, 10 fit the criteria for the strong group and 9 for the weak group, representing those with the strongest and weakest hip musculature, respectively, of the 150 screened individuals. Kinematics of the hip, knee, pelvis, and trunk were measured during the stance phases of walking and rate-controlled hopping. Hip/knee and pelvis/trunk coordination were calculated using the vector coding technique. There were no group differences in peak hip, knee, or pelvis kinematics. Participants in the weak group demonstrated greater trunk lateral bend toward the stance limb during hopping (P = .002, effect size [d] = 1.88). In the transverse plane, those in the weak group utilized less inphase coordination between the hip and the knee during walking (P = .036, d = 1.45) and more antiphase coordination between the hip and knee during hopping (P = .03, d = 1.47). In the absence of pain or pathology, poor hip muscle performance does not affect peak hip or knee joint kinematics in young women, but is associated with significantly different lower-limb and trunk/pelvis coordination during weight-bearing dynamic tasks. J Orthop Sports Phys Ther 2014;44(7):525-531. Epub 10 May 2014. doi:10.2519/jospt.2014.5028.

Morphological Integration of the Human Pelvis with Respect to Age and Sex.

PubMed

Mallard, Angela M; Savell, Kristen R R; Auerbach, Benjamin M

2017-04-01

Considerable research has shown that modern human pelvic dimensions, especially of the birth canal, are sexually dimorphic. Studies also suggest that females with younger ages-at-death have narrower canal dimensions than those who die at older ages, possibly due to continued independent growth of the pubis. A recent examination of this pattern argued that it is unlikely that these differences relate to mortality, but the source of the difference in pelvic dimensions with age remains unresolved. We use pelvic dimensions to assess differences in magnitudes of morphological integration between adult females and males across ages-at-death. We first ascertain whether the sexes have different strengths of integration, and then assess if differences in magnitudes of integration are associated with age-at-death. Pelvic dimensions of all groups were moderately integrated. Females and males have similar magnitudes of integration, and there is no change in the strength of integration with age. Examining individual regions of the pelvis indicates that the ilium, pubis, and pelvic inlet and outlet have stronger integration than the overall pelvis. This was particularly true of the pelvic outlet, which demonstrated the strongest integration. Our findings suggest that regions of the pelvis are more strongly integrated internally, and less integrated with each other, which would allow for proportional growth among regions of the pelvis with age that do not affect its overall integration. No single region of the pelvis appears to be motivating the difference in pelvic dimensions between age groups. We further consider the implications of these findings on evolutionary constraints. Anat Rec, 300:666-674, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Determining the Incidence of Gynecoid Pelvis Using Three-Dimensional Computed Tomography in Nonpregnant Multiparous Women

PubMed Central

Salk, Ismail; Cetin, Meral; Salk, Sultan; Cetin, Ali

2015-01-01

Objectives To determine the incidence of gynecoid pelvis by using classical criteria and measured parameters obtained from three-dimensional computed tomography (3D CT) pelvimetry in nonpregnant multiparous women who delivered vaginally. Subjects and Methods Our hospital's picture archiving and communication system was reviewed retrospectively. All adult women who had undergone CT examination with routine abdominal protocols were identified. In the pelvic inlet, midpelvis, and pelvic outlet, classical criteria and measured parameters, both alone and in combination, were used to determine the presence of gynecoid pelvis. Results 3D CT pelvimetry was performed on 226 women aged 23-65 years without any history of cephalopelvic disproportion and who had at least one delivery of an average fetal size (>2,500 g). The median parity was 4, and the mean (±SD) birth weight was 3,700 ± 498 g. Compared to the classical criteria, measured parameters and their combined use with the classical criteria significantly reduced the frequency of gynecoid pelvis (51.3 and 47.8%, respectively, vs. 71.6%; p = 0.001); however, there was no significant difference between the measured parameters and their combined use with classical criteria with regard to the frequencies of gynecoid pelvis (p > 0.05). Conclusions With the use of measured parameters of 3D CT pelvimetry, the incidence of gynecoid pelvis reduces to a more acceptable level (51.3%) in accordance with obstetric knowledge. Since there is no considerable decrease with the addition of classical criteria, 3D CT pelvimetry alone has merit for determining a woman's pelvic capacity for obstetric needs after the improvement and standardization of measured parameters. PMID:26334957

Coordination between pelvis and shoulder girdle during walking in bilateral cerebral palsy.

PubMed

Tavernese, Emanuela; Paoloni, Marco; Mangone, Massimiliano; Castelli, Enrico; Santilli, Valter

2016-02-01

Studies revealed that pelvis and shoulder girdle kinematics is impaired in children with the diplegic form of bilateral cerebral palsy while walking. The features of 3D coordination between these segments, however, have never been evaluated. The gait analyses of 27 children with bilateral cerebral palsy (18 males; mean age 124 months) have been retrospectively reviewed from the database of a Movement Analysis Laboratory. The spatial-temporal parameters and the range-of-motions of the pelvis and of the shoulder girdle on the three planes of motion have been calculated. Continuous relative phase has been calculated for the 3D pelvis-shoulder girdle couplings on the transverse, sagittal and frontal planes of motion to determine coordination between these segments. Data from 10 typically developed children have been used for comparison. Children with bilateral cerebral palsy walk with lower velocity (P=0.01), shorter steps (P<0.0001), larger base of support (P<0.01) and increased duration of the double support phase (P=0.005) when compared to typically developed children. The mean continuous relative phase on the transverse plane has been found lower in the cerebral palsy group throughout the gait cycle (P=0.003), as well as in terminal stance, pre-swing and mid-swing. The age, gait speed and pelvis range-of-motions on the transverse plane have been found correlated to continuous relative phase on the transverse plane. Compared with typically developed children, children with bilateral cerebral palsy show a more in-phase coordination between the pelvis and the shoulder girdle on the transverse plane while walking. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reliability and comparison of trunk and pelvis angles, arm distance and center of pressure in the seated functional reach test with and without foot support in children.

PubMed

Radtka, Sandra; Zayac, Jacqueline; Goldberg, Krystyna; Long, Michael; Ixanov, Rustem

2017-03-01

This study determined test-retest reliability of trunk and pelvis joint angles, arm distance and center of pressure (COP) excursion for the seated functional reach test (FRT) and compared these variables during the seated FRT with and without foot support. Fifteen typically developing children (age 9.3±4.1years) participated. Trunk and pelvis joint angles, arm distance, and COP excursion were collected on two days using three-dimensional motion analysis and a force plate while subjects reached maximally with and without foot support in the anterior, anterior/lateral, lateral, posterior/lateral directions. Age, weight, height, trunk and arm lengths were correlated (p<0.01) with maximum arm distance reached. Maximum arm distance, trunk and pelvis joint angles, and COP with and without foot support were not significant (p<0.05) for the two test periods. Excellent reliability (ICCs>0.75) was found for maximum arm distance reached in all four directions in the seated FRT with and without foot support. Most trunk and pelvis joint angles and COP excursions during maximum reach in all four directions showed excellent to fair reliability (ICCs>0.40-0.75). Reaching with foot support in all directions was significantly greater (p<0.05) than without foot support; however, most COP excursions and trunk and pelvic angles were not significantly different. Findings support the addition of anterior/lateral and posterior/lateral reaching directions in the seated FRT. Trunk and pelvis movement analysis is important to examine in the seated FRT to determine the specific movement strategies needed for maximum reaching without loss of balance. Copyright © 2017 Elsevier B.V. All rights reserved.

Cup Implant Planning Based on 2-D/3-D Radiographic Pelvis Reconstruction-First Clinical Results.

PubMed

Schumann, Steffen; Sato, Yoshinobu; Nakanishi, Yuki; Yokota, Futoshi; Takao, Masaki; Sugano, Nobuhiko; Zheng, Guoyan

2015-11-01

In the following, we will present a newly developed X-ray calibration phantom and its integration for 2-D/3-D pelvis reconstruction and subsequent automatic cup planning. Two different planning strategies were applied and evaluated with clinical data. Two different cup planning methods were investigated: The first planning strategy is based on a combined pelvis and cup statistical atlas. Thereby, the pelvis part of the combined atlas is matched to the reconstructed pelvis model, resulting in an optimized cup planning. The second planning strategy analyzes the morphology of the reconstructed pelvis model to determine the best fitting cup implant. The first planning strategy was compared to 3-D CT-based planning. Digitally reconstructed radiographs of THA patients with differently severe pathologies were used to evaluate the accuracy of predicting the cup size and position. Within a discrepancy of one cup size, the size was correctly identified in 100% of the cases for Crowe type I datasets and in 77.8% of the cases for Crowe type II, III, and IV datasets. The second planning strategy was analyzed with respect to the eventually implanted cup size. In seven patients, the estimated cup diameter was correct within one cup size, while the estimation for the remaining five patients differed by two cup sizes. While both planning strategies showed the same prediction rate with a discrepancy of one cup size (87.5%), the prediction of the exact cup size was increased for the statistical atlas-based strategy (56%) in contrast to the anatomically driven approach (37.5%). The proposed approach demonstrated the clinical validity of using 2-D/3-D reconstruction technique for cup planning.

Upper torso and pelvis linear velocity during the downswing of elite golfers.

PubMed

Beak, Seung-Hui; Choi, Ahnryul; Choi, Seung-Wook; Oh, Seung Eel; Mun, Joung Hwan; Yang, Heegoo; Sim, Taeyong; Song, Hae-Ryong

2013-02-11

During a golf swing, analysis of the movement in upper torso and pelvis is a key step to determine a motion control strategy for accurate and consistent shots. However, a majority of previous studies that have evaluated this movement limited their analysis only to the rotational movement of segments, and translational motions were not examined. Therefore, in this study, correlations between translational motions in the 3 axes, which occur between the upper torso and pelvis, were also examined. The experiments were carried out with 14 male pro-golfers (age: 29 ± 8 years, career: 8.2 ± 4.8years) who registered in the Korea Professional Golf Association (KPGA). Six infrared cameras (VICON; Oxford Metrics, Oxford, UK) and SB-Clinc software (SWINGBANK Ltd, Korea) were used to collect optical marker trajectories. The center of mass (CoM) of each segment was calculated based on kinematic principal. In addition, peak value of CoM velocity and the time that each peak occurred in each segment during downswing was calculated. Also, using cross-correlation analysis, the degree of coupling and time lags of peak values occurred between and within segments (pelvis and upper torso) were investigated. As a result, a high coupling strength between upper torso and pelvis with an average correlation coefficient = 0.86 was observed, and the coupling between segments was higher than that within segments (correlation coefficient = 0.81 and 0.77, respectively). Such a high coupling at the upper torso and pelvis can be used to reduce the degree of motion control in the central nervous system and maintain consistent patterns in the movement. The result of this study provides important information for the development of optimal golf swing movement control strategies in the future.

78 FR 21399 - Notice of Inventory Completion: Center for Archaeological Research at the University of Texas at...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-10

... the cranial vault, the right arm, the sacrum, the pelvis, and both legs. The sex of this individual is female based on traits associated with the pelvis. A specific age range determination was not possible...

Oral metastasis from primary transitional cell carcinoma of the renal pelvis: report of a case.

PubMed

Zhang, Y; Gu, Z-Y; Tian, Z; Yang, C; Cai, X-Y

2010-07-01

Transitional cell carcinoma of the renal pelvis is initially a slow growing tumor arising from the transitional epithelium of the mucous membrane of the renal pelvis. Recurrences occur in two forms: superficial bladder cancer and distant metastases. The common metastasis is in the lung, liver, brain and bone. Oral metastasis is seldom reported. The authors report an unusual case of transitional cell carcinoma of the renal pelvis metastasized to the oral cavity and lung simultaneously in a 74-year-old man, which occurred 1 year after a left nephroureterectomy. The patient underwent six courses of chemotherapy (gemcitabine, oxaliplatin, fluorouracil and nedaplatin), and received radiotherapy for the oral lesion. The symptoms were alleviated, but the tumor recurred in the oral cavity 2 years later. Brain and liver metastases were confirmed by CT. Repeated radiotherapy for oral metastasis was performed, but the patient died 4 years after the initial nephroureterectomy due to multiple metastases. Copyright 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

[Three-dimensional Finite Element Analysis to T-shaped Fracture of Pelvis in Sitting Position].

PubMed

Fan, Yanping; Lei, Jianyin; Liu, Haibo; Li, Zhiqiang; Cai, Xianhua; Chen, Weiyi

2015-10-01

We developed a three-dimensional finite element model of the pelvis. According to Letournel methods, we established a pelvis model of T-shaped fracture with its three different fixation systems, i. e. double column reconstruction plates, anterior column plate combined with posterior column screws and anterior column plate combined with quadrilateral area screws. It was found that the pelvic model was effective and could be used to simulate the mechanical behavior of the pelvis. Three fixation systems had great therapeutic effect on the T-shaped fracture. All fixation systems could increase the stiffness of the model, decrease the stress concentration level and decrease the displacement difference along the fracture line. The quadrilateral area screws, which were drilled into cortical bone, could generate beneficial effect on the T-type fracture. Therefore, the third fixation system mentioned above (i. e. the anterior column plate combined with quadrilateral area screws) has the best biomechanical stability to the T-type fracture.

Defining the “Hostile Pelvis” for Intensity Modulated Radiation Therapy: The Impact of Anatomic Variations in Pelvic Dimensions on Dose Delivered to Target Volumes and Organs at Risk in Patients With High-Risk Prostate Cancer Treated With Whole Pelvic Radiation Therapy

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

Yirmibeşoğlu Erkal, Eda, E-mail: eyirmibesoglu@yahoo.com; Karabey, Sinan; Karabey, Ayşegül

2015-07-15

Purpose: The aim of this study was to evaluate the impact of variations in pelvic dimensions on the dose delivered to the target volumes and the organs at risk (OARs) in patients with high-risk prostate cancer (PCa) to be treated with whole pelvic radiation therapy (WPRT) in an attempt to define the hostile pelvis in terms of intensity modulated radiation therapy (IMRT). Methods and Materials: In 45 men with high-risk PCa to be treated with WPRT, the target volumes and the OARs were delineated, the dose constraints for the OARs were defined, and treatment plans were generated according to themore » Radiation Therapy Oncology Group 0924 protocol. Six dimensions to reflect the depth, width, and height of the bony pelvis were measured, and 2 indexes were calculated from the planning computed tomographic scans. The minimum dose (D{sub min}), maximum dose (D{sub max}), and mean dose (D{sub mean}) for the target volumes and OARs and the partial volumes of each of these structures receiving a specified dose (V{sub D}) were calculated from the dose-volume histograms (DVHs). The data from the DVHs were correlated with the pelvic dimensions and indexes. Results: According to an overall hostility score (OHS) calculation, 25 patients were grouped as having a hospitable pelvis and 20 as having a hostile pelvis. Regarding the OHS grouping, the DVHs for the bladder, bowel bag, left femoral head, and right femoral head differed in favor of the hospitable pelvis group, and the DVHs for the rectum differed for a range of lower doses in favor of the hospitable pelvis group. Conclusions: Pelvimetry might be used as a guide to define the challenging anatomy or the hostile pelvis in terms of treatment planning for IMRT in patients with high-risk PCa to be treated with WPRT.« less

Tumor laterality in early ovarian cancer: influence on left-right asymmetry of pelvic lymph nodes.

PubMed

Mujezinović, Faris; Takac, Iztok

2010-01-01

AIM AND BACKGROUND.:To determine whether left-right asymmetry was present in cases of early ovarian cancer and whether or not the difference between number of removed lymph nodes on both sides of the pelvis is associated with tumor laterality. We extracted from the medical data base cases of early ovarian cancer with lymphadenectomy who had been treated between 1994 and 2008. The sample was divided in three groups according to the left-right laterality of the tumor in the pelvis (bilateral, left sided, right sided). For each case, we subtracted the number of dissected lymph nodes on the left side from the number of dissected lymph nodes on the right side of the pelvis (N(Right side) - N(Left side)). We used one sample t test to determine whether the mean of differences for each group was different from zero. Results. We extracted 48 cases with early ovarian cancer who had undergone lymphadenectomy. The average number of dissected lymph nodes was 24 (SD, 12). In 3 cases, we confirmed the presence of lymph node metastasis (6.3%). In 2 of the upstaged cases, tumor and involved lymph nodes were on the right side of the pelvis. In the third case, the tumor was on the left side, whereas involved lymph nodes were on both sides of the pelvis. For bilateral tumors, tumors on the left, and those on the right side of the pelvis, the mean difference was -0.5 (95% CI, -9.9 to 8.9; t, -0.137; P = 0.90), 0.32 (95% CI, -3.8 to 4.5; t, 0.16; P = 0.87) and 3.5 (95% CI, 0.03 to 7.01; t, 2.09; P = 0.048), respectively. When the tumor was on the left or on both sides of the pelvis, there was no significant difference in the number of removed lymph nodes. In contrast, when the tumor was on the right side, the number of removed lymph nodes was significantly higher on the right hemipelvis than on the left hemipelvis.

A novel robot for imposing perturbations during overground walking: mechanism, control and normative stepping responses.

PubMed

Olenšek, Andrej; Zadravec, Matjaž; Matjačić, Zlatko

2016-06-11

The most common approach to studying dynamic balance during walking is by applying perturbations. Previous studies that investigated dynamic balance responses predominantly focused on applying perturbations in frontal plane while walking on treadmill. The goal of our work was to develop balance assessment robot (BAR) that can be used during overground walking and to assess normative balance responses to perturbations in transversal plane in a group of neurologically healthy individuals. BAR provides three passive degrees of freedom (DoF) and three actuated DoF in pelvis that are admittance-controlled in such a way that the natural movement of pelvis is not significantly affected. In this study BAR was used to assess normative balance responses in neurologically healthy individuals by applying linear perturbations in frontal and sagittal planes and angular perturbations in transversal plane of pelvis. One way repeated measure ANOVA was used to statistically evaluate the effect of selected perturbations on stepping responses. Standard deviations of assessed responses were similar in unperturbed and perturbed walking. Perturbations in frontal direction evoked substantial pelvis displacement and caused statistically significant effect on step length, step width and step time. Likewise, perturbations in sagittal plane also caused statistically significant effect on step length, step width and step time but with less explicit impact on pelvis movement in frontal plane. On the other hand, except from substantial pelvis rotation angular perturbations did not have substantial effect on pelvis movement in frontal and sagittal planes while statistically significant effect was noted only in step length and step width after perturbation in clockwise direction. Results indicate that the proposed device can repeatedly reproduce similar experimental conditions. Results also suggest that "stepping strategy" is the dominant strategy for coping with perturbations in frontal plane, perturbations in sagittal plane are to greater extent handled by "ankle strategy" while angular perturbations in transversal plane do not pose substantial challenge for balance. Results also show that specific perturbation in general elicits responses that extend also to other planes of movement that are not directly associated with plane of perturbation as well as to spatio temporal parameters of gait.

Applying a pelvic corrective force induces forced use of the paretic leg and improves paretic leg EMG activities of individuals post-stroke during treadmill walking.

PubMed

Hsu, Chao-Jung; Kim, Janis; Tang, Rongnian; Roth, Elliot J; Rymer, William Z; Wu, Ming

2017-10-01

To determine whether applying a mediolateral corrective force to the pelvis during treadmill walking would enhance muscle activity of the paretic leg and improve gait symmetry in individuals with post-stroke hemiparesis. Fifteen subjects with post-stroke hemiparesis participated in this study. A customized cable-driven robotic system based over a treadmill generated a mediolateral corrective force to the pelvis toward the paretic side during early stance phase. Three different amounts of corrective force were applied. Electromyographic (EMG) activity of the paretic leg, spatiotemporal gait parameters and pelvis lateral displacement were collected. Significant increases in integrated EMG of hip abductor, medial hamstrings, soleus, rectus femoris, vastus medialis and tibialis anterior were observed when pelvic corrective force was applied, with pelvic corrective force at 9% of body weight inducing greater muscle activity than 3% or 6% of body weight. Pelvis lateral displacement was more symmetric with pelvic corrective force at 9% of body weight. Applying a mediolateral pelvic corrective force toward the paretic side may enhance muscle activity of the paretic leg and improve pelvis displacement symmetry in individuals post-stroke. Forceful weight shift to the paretic side could potentially force additional use of the paretic leg and improve the walking pattern. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Virtual reconstruction of the Australopithecus africanus pelvis Sts 65 with implications for obstetrics and locomotion.

PubMed

Claxton, Alexander G; Hammond, Ashley S; Romano, Julia; Oleinik, Ekaterina; DeSilva, Jeremy M

2016-10-01

Characterizing australopith pelvic morphology has been difficult in part because of limited fossilized pelvic material. Here, we reassess the morphology of an under-studied adult right ilium and pubis (Sts 65) from Member 4 of Sterkfontein, South Africa, and provide a hypothetical digital reconstruction of its overall pelvic morphology. The small size of the pelvis, presence of a preauricular sulcus, and shape of the sciatic notch allow us to agree with past interpretations that Sts 65 likely belonged to a female. The morphology of the iliac pillar, while not as substantial as in Homo, is more robust than in A.L. 288-1 and Sts 14. We created a reconstruction of the pelvis by digitally articulating the Sts 65 right ilium and a mirrored copy of the left ilium with the Sts 14 sacrum in Autodesk Maya. Points along the arcuate line were used to orient the ilia to the sacrum. This reconstruction of the Sts 65 pelvis looks much like a "classic" australopith pelvis, with laterally flared ilia and an inferiorly deflected pubis. An analysis of the obstetric dimensions from our reconstruction shows similarity to other australopiths, a likely transverse or oblique entrance of the neonatal cranium into the pelvic inlet, and a cephalopelvic ratio similar to that found in humans today. Copyright © 2016 Elsevier Ltd. All rights reserved.

Abdomen/pelvis computed tomography in staging of pediatric Hodgkin Lymphoma: is it always necessary?

PubMed

Farruggia, Piero; Puccio, Giuseppe; Sala, Alessandra; Todesco, Alessandra; Terenziani, Monica; Mura, Rosamaria; D'Amico, Salvatore; Casini, Tommaso; Mosa, Clara; Pillon, Marta; Boaro, Maria Paola; Bottigliero, Gaetano; Burnelli, Roberta; Consarino, Caterina; Fedeli, Fausto; Mascarin, Maurizio; Perruccio, Katia; Schiavello, Elisabetta; Trizzino, Angela; Ficola, Umberto; Garaventa, Alberto; Rossello, Mario

2016-09-01

The purpose of the study was to determine if abdomen/pelvis computed tomography (CT) can be safety omitted in the initial staging of a subgroup of children affected by Hodgkin Lymphoma (HL). Every participating center of A.I.E.O.P (Associazione Italiana di Ematologia ed Oncologia Pediatrica) sent local staging reports of 18F-fluorodeoxyglucose positron emission tomography (PET) and abdominal ultrasound (US) along with digital images of staging abdomen/pelvis CT to the investigation center where the CT scans were evaluated by an experienced pediatric radiologist. The local radiologist who performed the US was unaware of local CT and PET reports (both carried out after US), and the reviewer radiologist examining the CT images was unaware of local US, PET and CT reports. A new abdominal staging of 123 patients performed on the basis of local US report, local PET report, and centralized CT report was then compared to a simpler staging based on local US and PET. No additional lesion was discovered by CT in patients with abdomen/pelvis negativity in both US and PET or isolated spleen positivity in US (or US and PET), and so it seems that in the initial staging, abdomen/pelvis CT can be safety omitted in about 1/2 to 2/3 of children diagnosed with HL. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Comparison of Biodynamic Responses in Standing and Seated Human Bodies

NASA Astrophysics Data System (ADS)

MATSUMOTO, Y.; GRIFFIN, M. J.

2000-12-01

The dynamic responses of the human body in a standing position and in a sitting position have been compared. The apparent mass and transmissibilities to the head, six locations along the spine, and the pelvis were measured with eight male subjects exposed to vertical whole-body vibration. In both postures, the principal resonance in the apparent mass occurred in the range 5-6 Hz, with slightly higher frequencies and lower apparent mass in the standing posture. There was greater transmission of vertical vibration to the pelvis and the lower spine and greater relative motion within the lower spine in the standing posture than in the sitting posture at the principal resonance and at higher frequencies. Transmissibilities from the supporting surface (floor or seat) to the thoracic region had similar magnitudes for both standing and sitting subjects. The lumbar spine has less lordosis and may be more compressed and less flexible in the sitting posture than in the standing posture. This may have reduced the relative motions between lumbar vertebrae and both the supporting vibrating surface and the other vertebrae in the sitting posture. The characteristics of the vibration transmitted to the pelvis may have differed in the two postures due to different transmission paths. Increased forward rotation of the pelvis in the standing posture may have caused the differences in responses of the pelvis and the lower spine that were observed between the two postures.

Roentgen Examination of Soft Tissues of the Pelvis

PubMed Central

Noonan, Charles D.

1964-01-01

With meticulous preparation of the patient and with careful technique, the soft tissues of the pelvis are identifiable in most cases. Search should be made for the traces of abnormal pelvic structures on plain-film studies. Once the normal is recognized, any variations are easily identified. The fundamental differences between various radiologic densities—air, fat, fluid, muscle, calcium, bone and metal—should be observed. Special procedures can be used to enhance the contrasts after adequate evaluation of the simplest and, on many occasions, the invaluable, plain-film study of the soft tissues of the pelvis. ImagesFigure 2.Figure 3.Figure 3.Figure 4.Figure 5.Figure 6.Figure 7.Figure 8. PMID:14232160

Geographic variations in orthopedic trauma billing and reimbursements for hip and pelvis fractures in the Medicare population.

PubMed

Dodd, Ashley C; Lakomkin, Nikita; Bulka, Catherine; Thakore, Rachel; Collinge, Cory A; Sethi, Manish K

2016-12-01

We investigated geographic variations in Medicare spending for DRG 536 (hip and pelvis fracture). We identified 22,728 patients. The median number of charges, discharges, and payments were recorded. Hospitals were aggregated into core based statistical (CBS) areas and the coefficient of variation (CV) was calculated for each area. On average, hospitals charged 3.75 times more than they were reimbursed. Medicare charges and reimbursements demonstrated variability within each area. Geographic variation in Medicare spending for hip fractures is currently unexplained. It is imperative for orthopedists to understand drivers behind such high variability in hospital charges for management of hip and pelvis fractures.

Primary malignant tumours of the bony pelvis: US-guided high intensity focused ultrasound ablation.

PubMed

Wang, Yang; Wang, Wei; Tang, Jie

2013-11-01

The aim of this review is to evaluate the value of ultrasound (US)-guided high intensity focused ultrasound (HIFU) ablation in the treatment of primary malignant tumours of the bony pelvis. Eleven patients with primary malignant tumours of the bony pelvis received US-guided HIFU ablation. The maximum tumour size ranged from 5.6 to 25.0 cm (median 10.5 cm). Treatment was curative in four patients and palliative in seven patients. During follow-up, the effectiveness of HIFU ablation was assessed by contrast-enhanced magnetic resonance (MR). Significant coagulative necrosis was obtained in all patients after scheduled HIFU ablations; the volume ablation ratio was 86.7% ± 12.5% (range 65-100%). Complete tumour necrosis was achieved in all patients receiving curative HIFU ablation. No major complications were encountered. No patients died of local tumour progression during follow-up. US-guided HIFU ablation may be a safe and effective minimally invasive technique for the local treatment of primary malignant tumours of the bony pelvis.

Unicameral Bone Cysts of the Pelvis

PubMed Central

Hammoud, Sommer; Weber, Kristy; McCarthy, Edward F

2005-01-01

Unicameral bone cysts of the pelvis are extremely rare. This study summarizes the clinical, radiologic and pathologic features of 16 cases. Patients ranged in age from nine to 69. Most lesions were in the anterior portion of the iliac wing; many appeared to be related to an open iliac crest apophysis. This suggests that the pathogenesis of unicameral bone cysts in this portion of the ilium is similar to that seen in the proximal humerus and the proximal femur. The correct diagnosis was made preoperatively in only five cases. This indicates that, although they are well documented, unicameral bone cysts of the pelvis remain a diagnostic problem. Patients received a spectrum of treatments from curettage to observation. There appeared to be no difference in the outcome after any form of treatment. Therefore, unicameral bone cysts of the pelvis can be managed conservatively. The choice to manage patients conservatively depends on making the correct diagnosis based on clinical history and imaging. The most effective imaging is a combination of plain radiographs, computed tomography (CT) and magnetic resonance imaging (MRI). PMID:16089077

Unicameral bone cysts of the pelvis: a study of 16 cases.

PubMed

Hammoud, Sommer; Weber, Kristy; McCarthy, Edward F

2005-01-01

Unicameral bone cysts of the pelvis are extremely rare. This study summarizes the clinical, radiologic and pathologic features of 16 cases. Patients ranged in age from nine to 69. Most lesions were in the anterior portion of the iliac wing; many appeared to be related to an open iliac crest apophysis. This suggests that the pathogenesis of unicameral bone cysts in this portion of the ilium is similar to that seen in the proximal humerus and the proximal femur. The correct diagnosis was made preoperatively in only five cases. This indicates that, although they are well documented, unicameral bone cysts of the pelvis remain a diagnostic problem. Patients received a spectrum of treatments from curettage to observation. There appeared to be no difference in the outcome after any form of treatment. Therefore, unicameral bone cysts of the pelvis can be managed conservatively. The choice to manage patients conservatively depends on making the correct diagnosis based on clinical history and imaging. The most effective imaging is a combination of plain radiographs, computed tomography (CT) and magnetic resonance imaging (MRI).

Correction of radiographic measurements of acetabular cup wear for variations in pelvis orientation.

PubMed

Derbyshire, Brian

2018-03-01

Radiographic measurement of two-dimensional acetabular cup wear is usually carried out on a series of follow-up radiographs of the patient's pelvis. Since the orientation of the pelvis might not be consistent at every X-ray examination, the resulting change in view of the wear plane introduces error into the linear wear measurement. This effect is amplified on some designs of cup in which the centre of the socket is several millimetres below the centre of the cup or circular wire marker. This study describes the formulation of a mathematical method to correct radiographic wear measurements for changes in pelvis orientation. A mathematical simulation of changes in cup orientation and wear vectors caused by pelvic tilt was used to confirm that the formulae corrected the wear exactly if the radiographic plane of the reference radiograph was parallel to the true plane of wear. An error analysis showed that even when the true wear plane was not parallel to the reference radiographic plane, the formulae could still provide a useful correction. A published correction formula was found to be ineffective.

Correction of radiographic measurements of acetabular cup wear for variations in pelvis orientation

PubMed Central

Derbyshire, Brian

2018-01-01

Radiographic measurement of two-dimensional acetabular cup wear is usually carried out on a series of follow-up radiographs of the patient’s pelvis. Since the orientation of the pelvis might not be consistent at every X-ray examination, the resulting change in view of the wear plane introduces error into the linear wear measurement. This effect is amplified on some designs of cup in which the centre of the socket is several millimetres below the centre of the cup or circular wire marker. This study describes the formulation of a mathematical method to correct radiographic wear measurements for changes in pelvis orientation. A mathematical simulation of changes in cup orientation and wear vectors caused by pelvic tilt was used to confirm that the formulae corrected the wear exactly if the radiographic plane of the reference radiograph was parallel to the true plane of wear. An error analysis showed that even when the true wear plane was not parallel to the reference radiographic plane, the formulae could still provide a useful correction. A published correction formula was found to be ineffective. PMID:29473454

Pelvic kinematic method for determining vertical jump height.

PubMed

Chiu, Loren Z F; Salem, George J

2010-11-01

Sacral marker and pelvis reconstruction methods have been proposed to approximate total body center of mass during relatively low intensity gait and hopping tasks, but not during a maximum effort vertical jumping task. In this study, center of mass displacement was calculated using the pelvic kinematic method and compared with center of mass displacement using the ground-reaction force-impulse method, in experienced athletes (n = 13) performing restricted countermovement vertical jumps. Maximal vertical jumps were performed in a biomechanics laboratory, with data collected using an 8-camera motion analysis system and two force platforms. The pelvis center of mass was reconstructed from retro-reflective markers placed on the pelvis. Jump height was determined from the peak height of the pelvis center of mass minus the standing height. Strong linear relationships were observed between the pelvic kinematic and impulse methods (R² = .86; p < .01). The pelvic kinematic method underestimated jump height versus the impulse method, however, the difference was small (CV = 4.34%). This investigation demonstrates concurrent validity for the pelvic kinematic method to determine vertical jump height.

Movement variability in the golf swing of male and female skilled golfers.

PubMed

Horan, Sean A; Evans, Kerrie; Kavanagh, Justin J

2011-08-01

Despite the complexity of movement, the swings of skilled golfers are considered to be highly consistent. Interestingly, no direct investigation of movement variability or coupling variability during the swings of skilled golfers has occurred. To determine whether differences in movement variability exist between male and female skilled golfers during the downswing of the full golf swing. Three-dimensional thorax, pelvis, hand, and clubhead data were collected from 19 male (mean ± SD: age = 26 ± 7 yr) and 19 female (age = 25 ± 7 yr) skilled golfers. Variability of segmental movement and clubhead trajectory were examined at three phases of the downswing using discrete (SD) and continuous analyses (spanning set), whereas variability of intersegment coupling was examined using average coefficient of correspondence. Compared with males, females exhibited higher thorax and pelvis variability for axial rotation at the midpoint of the downswing and ball contact (BC). Similarly, thorax-pelvis coupling variability was higher for females than males at both the midpoint of the downswing and BC. Regardless of thorax and pelvis motion, the variability of hand and clubhead trajectory sequentially decreased from the top of the backswing to BC for both males and females. Male and female skilled golfers use different upper body movement strategies during the downswing while achieving similarly low levels of clubhead trajectory variability at BC. It is apparent that the priority of skilled golfers is to progressively minimize hand and clubhead trajectory variability toward BC, despite the individual motion or coupling of the thorax and pelvis.

Biomechanical study of different fixation techniques for the treatment of sacroiliac joint injuries using finite element analyses and biomechanical tests.

PubMed

Lee, Chian-Her; Hsu, Ching-Chi; Huang, Po-Yuang

2017-08-01

The pelvis is one of the most stressed areas of the human musculoskeletal system due to the transfer of truncal loads to the lower extremities. Sacroiliac joint injury may lead to abnormal joint mechanics and an unstable pelvis. Various fixation techniques have been evaluated and discussed. However, it may be difficult to investigate each technique due to variations in bone quality, bone anatomy, fracture pattern, and fixation location. Additionally, the finite element method is one useful technology that avoids these variations. Unfortunately, most previous studies neglected the effects of the lumbar spine and femurs when they investigated the biomechanics of pelvises. Thus, the aim of this study was to investigate the biomechanical performance of intact, injured, and treated pelvises using numerical and experimental approaches. Three-dimensional finite element models of the spine-pelvis-femur complex with and without muscles and ligaments were developed. The intact pelvis, the pelvis with sacroiliac joint injury, and three types of pelvic fixation techniques were analyzed. Concurrently, biomechanical tests were conducted to validate the numerical outcomes using artificial pelvises. Posterior iliosacral screw fixation showed relatively better fixation stability and lower risks of implant failure and pelvic breakage than sacral bar fixation and a locking compression plate fixation. The present study can help surgeons and engineers understand the biomechanics of intact, injured, and treated pelvises. Both the simulation technique and the experimental setup can be applied to investigate different pelvic injuries. Copyright © 2017 Elsevier Ltd. All rights reserved.

Development of finite element model for customized prostheses design for patient with pelvic bone tumor.

PubMed

Iqbal, Taimoor; Shi, Lei; Wang, Ling; Liu, Yaxiong; Li, Dichen; Qin, Mian; Jin, Zhongmin

2017-06-01

The aim of this study was to design a hemi-pelvic prosthesis for a patient affected by pelvic sarcoma. To investigate the biomechanical functionality of the pelvis reconstructed with designed custom-made prosthesis, a patient-specific finite element model of whole pelvis with primary ligaments inclusive was constructed based on the computed tomography images of the patient. Then, a finite element analysis was performed to calculate and compare the stress distribution between the normal and implanted pelvis models when undergoing three different static conditions-both-leg standing, single-leg standing for the healthy and the affected one. No significant differences were observed in the stresses between the normal and reconstructed pelvis for both-leg standing, but 20%-40% larger stresses were predicted for the peak stress of the single-leg standing (affected side). Moreover, two- to threefold of peak stresses were predicted within the prostheses compared to that of the normal pelvis especially for single-leg standing case, however, still below the allowable fatigue limitation. The study on the load transmission functionality of prosthesis indicated that it is crucial to carry out finite element analysis for functional evaluation of the designed customized prostheses before three-dimensional printing manufacturing, allowing better understanding of the possible peak stresses within the bone as well as the implants for safety precaution. The finite element model can be equally applicable to other bone tumor model for biomechanical studying.

The correlation between movement of the center of mass and the kinematics of the spine, pelvis, and hip joints during body rotation.

PubMed

Wada, Osamu; Tateuchi, Hiroshige; Ichihashi, Noriaki

2014-01-01

Body rotation is associated with many activities. The concomitant movement of the center of mass (COM) is essential for effective body rotation. This movement is considered to be influenced by kinematic changes in the spine, pelvis, and hip joints. However, there is no research on the association between COM movement and kinematic changes during body rotation. We aimed to investigate the association between COM movement and the kinematics of the spine, pelvis, and hip joints during body rotation in standing. Twenty-four healthy men were included in the study. COM movement during active body rotation in a standing position was measured. We evaluated pelvic shift and changes in the angles of the spine, pelvis, and hip joints. We calculated the Pearson correlation coefficients to analyze the relationship between COM movement and kinematic changes in the spine, pelvis, and hip joints. There were significant correlations between lateral COM movement to the rotational side and pelvic shift to the rotational side, and between posterior COM movement and pelvic shift to the posterior side. In addition, lateral COM movement to the rotational side showed significant and negative correlation with spinal flexion and was significantly and positively correlated with the change in anterior pelvic tilt. Clinicians need to take particular note of both spinal and pelvic motion in the sagittal plane, as well as the pelvic shift, to speculate COM movement during body rotation in standing. Copyright © 2013 Elsevier B.V. All rights reserved.

Soft-Tissue Sarcomas of the Abdomen and Pelvis: Radiologic-Pathologic Features, Part 2-Uncommon Sarcomas.

PubMed

Levy, Angela D; Manning, Maria A; Miettinen, Markku M

2017-01-01

Soft-tissue sarcomas occurring in the abdomen and pelvis are an uncommon but important group of malignancies. Recent changes to the World Health Organization classification of soft-tissue tumors include the movement of gastrointestinal stromal tumors (GISTs) into the soft-tissue tumor classification. GIST is the most common intraperitoneal sarcoma. Liposarcoma is the most common retroperitoneal sarcoma, and leiomyosarcoma is the second most common. GIST, liposarcoma, and leiomyosarcoma account for the majority of sarcomas encountered in the abdomen and pelvis and are discussed in part 1 of this article. Undifferentiated pleomorphic sarcoma (previously called malignant fibrous histiocytoma), dermatofibrosarcoma protuberans, solitary fibrous tumor, malignant peripheral nerve sheath tumor, rhabdomyosarcoma, extraskeletal chondro-osseous sarcomas, vascular sarcomas, and sarcomas of uncertain differentiation uncommonly arise in the abdomen and pelvis and the abdominal wall. Although these lesions are rare sarcomas and their imaging features overlap, familiarity with the locations where they occur and their imaging features is important so they can be diagnosed accurately. The anatomic location and clinical history are important factors in the differential diagnosis of these lesions because metastasis, more-common sarcomas, borderline fibroblastic proliferations (such as desmoid tumors), and endometriosis have imaging findings that overlap with those of these uncommon sarcomas. In this article, the clinical, pathologic, and imaging findings of uncommon soft-tissue sarcomas of the abdomen and pelvis and the abdominal wall are reviewed, with an emphasis on their differential diagnosis.

Morphology of the pelvis and hind limb of the red panda (Ailurus fulgens) evidenced by gross osteology, radiography and computed tomography.

PubMed

Makungu, M; du Plessis, W M; Groenewald, H B; Barrows, M; Koeppel, K N

2015-12-01

The red panda (Ailurus fulgens) is a quadrupedal arboreal animal primarily distributed in the Himalayas and southern China. It is a species commonly kept in zoological collections. This study was carried out to describe the morphology of the pelvis and hind limb of the red panda evidenced by gross osteology, radiography and computed tomography as a reference for clinical use and identification of skeletons. Radiography of the pelvis and right hind limb was performed in nine and seven animals, respectively. Radiographic findings were correlated with bone specimens from three adult animals. Computed tomography of the torso and hind limb was performed in one animal. The pelvic bone had a wide ventromedial surface of the ilium. The trochlea of the femur was wide and shallow. The patella was similar to that seen in feline species. The medial fabella was not seen radiographically in any animal. The cochlea grooves of the tibia were shallow with a poorly defined intermediate ridge. The trochlea of the talus was shallow and presented with an almost flattened medial ridge. The tarsal sesamoid bone was always present. The lateral process of the base of the fifth metatarsal (MT) bone was directed laterally. The MT bones were widely spaced. The morphology of the pelvis and hind limb of the red panda indicated flexibility of the pelvis and hind limb joints as an adaptation to an arboreal quadrupedal lifestyle. © 2014 Blackwell Verlag GmbH.

Soft-Tissue Sarcomas of the Abdomen and Pelvis: Radiologic-Pathologic Features, Part 2—Uncommon Sarcomas

PubMed Central

Manning, Maria A.; Miettinen, Markku M.

2017-01-01

Soft-tissue sarcomas occurring in the abdomen and pelvis are an uncommon but important group of malignancies. Recent changes to the World Health Organization classification of soft-tissue tumors include the movement of gastrointestinal stromal tumors (GISTs) into the soft-tissue tumor classification. GIST is the most common intraperitoneal sarcoma. Liposarcoma is the most common retroperitoneal sarcoma, and leiomyosarcoma is the second most common. GIST, liposarcoma, and leiomyosarcoma account for the majority of sarcomas encountered in the abdomen and pelvis and are discussed in part 1 of this article. Undifferentiated pleomorphic sarcoma (previously called malignant fibrous histiocytoma), dermatofibrosarcoma protuberans, solitary fibrous tumor, malignant peripheral nerve sheath tumor, rhabdomyosarcoma, extraskeletal chondro-osseous sarcomas, vascular sarcomas, and sarcomas of uncertain differentiation uncommonly arise in the abdomen and pelvis and the abdominal wall. Although these lesions are rare sarcomas and their imaging features overlap, familiarity with the locations where they occur and their imaging features is important so they can be diagnosed accurately. The anatomic location and clinical history are important factors in the differential diagnosis of these lesions because metastasis, more-common sarcomas, borderline fibroblastic proliferations (such as desmoid tumors), and endometriosis have imaging findings that overlap with those of these uncommon sarcomas. In this article, the clinical, pathologic, and imaging findings of uncommon soft-tissue sarcomas of the abdomen and pelvis and the abdominal wall are reviewed, with an emphasis on their differential diagnosis. PMID:28493803

Endoscopic spray cryotherapy for genitourinary malignancies: safety and efficacy in a porcine model

PubMed Central

Power, Nicholas E.; Silberstein, Jonathan L.; Tarin, Tatum; Au, Joyce; Thorner, Daniel; Ezell, Paula; Monette, Sébastien; Fong, Yuman; Rusch, Valerie; Finley, David

2013-01-01

Objective: To examine the effects and safety of using endoscopic spray cryotherapy (ESC) on bladder, ureteral, and renal pelvis urothelium in a live porcine model. Subjects and methods: ESC treatments were systematically applied to urothelial sites in the bladder, ureter, and renal pelvis of eight female Yorkshire swine in a prospective trial. Freeze–thaw cycles ranged from 5 to 60 s/cycle for one to six cycles using a 7 French cryotherapy catheter. Tissue was evaluated histologically for treatment-related effects. Acute physiologic effects were evaluated with pulse oximetry, Doppler sonography, and postmortem findings. Results: In bladder, treatment depth was inconsistent regardless of dose, demonstrating urothelial necrosis in one, muscularis propria depth necrosis in two, and full thickness necrosis in all remaining samples. In ureter, full thickness necrosis was seen in all samples, even with the shortest spray duration (5 s/cycle for six cycles or 30 s/cycle for one cycle). Treatment to the renal pelvis was complicated by adiabatic gas expansion of liquid nitrogen to its gaseous state, resulting in high intraluminal pressures requiring venting to avoid organ perforation, even at the lowest treatment settings. At a planned dose of 5 s/cycle for six cycles of the first renal pelvis animal, treatment was interrupted by sudden and unrecoverable cardiopulmonary failure after three cycles. Repeated studies replicated this event. Ultrasound and immediate necropsy confirmed the creation of a large gaseous embolism and reproducible cardiopulmonary effects. Conclusion: ESC in a porcine urothelial treatment model results in full-thickness tissue necrosis in bladder, ureter, and renal pelvis at a minimal treatment settings of 5 s/cycle for six cycles. Adiabatic gas expansion may result in fatal pyelovenous gas embolism and collateral organ injury, as seen in both animals receiving treatment to the renal pelvis in this study. These results raise safety concerns for use of ESC as a treatment modality in urothelial tissues with current device settings. PMID:23730328

Effect of Trunk Sagittal Attitude on Shoulder, Thorax and Pelvis Three-Dimensional Kinematics in Able-Bodied Subjects during Gait

PubMed Central

Leardini, Alberto; Berti, Lisa; Begon, Mickaël; Allard, Paul

2013-01-01

It has been shown that an original attitude in forward or backward inclination of the trunk is maintained at gait initiation and during locomotion, and that this affects lower limb loading patterns. However, no studies have shown the extent to which shoulder, thorax and pelvis three-dimensional kinematics are modified during gait due to this sagittal inclination attitude. Thirty young healthy volunteers were analyzed during level walking with video-based motion analysis. Reflecting markers were mounted on anatomical landmarks to form a two-marker shoulder line segment, and a four-marker thorax and pelvis segments. Absolute and relative spatial rotations were calculated, for a total of 11 degrees of freedom. The subjects were divided into two groups of 15 according to the median of mean thorax inclination angle over the gait cycle. Preliminary MANOVA analysis assessed whether gender was an independent variable. Then two-factor nested ANOVA was used to test the possible effect of thorax inclination on body segments, planes of motion and gait periods, separately. There was no significant difference in all anthropometric and spatio-temporal parameters between the two groups, except for subject mass. The three-dimensional kinematics of the thorax and pelvis were not affected by gender. Nested ANOVA revealed group effect in all segment rotations apart those at the pelvis, in the sagittal and frontal planes, and at the push-off. Attitudes in sagittal thorax inclination altered trunk segments kinematics during gait. Subjects with a backward thorax showed less thorax-to-pelvis motion, but more shoulder-to-thorax and thorax-to-laboratory motion, less motion in flexion/extension and in lateral bending, and also less motion during push-off. This contributes to the understanding of forward propulsion and sideways load transfer mechanisms, fundamental for the maintenance of balance and the risk of falling. PMID:24204763

Relative mobility of the pelvis and spine during trunk axial rotation in chronic low back pain patients: A case-control study

PubMed Central

Ibuki, Satoko; Ichihashi, Noriaki

2017-01-01

Background Trunk axial rotation is a risk factor for chronic low back pain (CLBP). The characteristics of rotational mobility in the pelvis and spine among CLBP patients are not fully understood. Purpose The purpose of this study was to examine three-dimensional kinematic changes, and to compare the differences of rotational mobility and coupled motion, in patients with and without CLBP. Methods Fifteen patients with CLBP and 15 age and sex matched healthy subjects participated in this study. Each subject performed trunk rotation to maximum range of motion (ROM) in a standing position. The kinematics data was collected using a three-dimensional motion analysis system. The outcomes measured were the rotational ROM and the spine/pelvis ratio (SPR) in transvers plane at both maximum and 50% rotation position. The coupled angles in sagittal and frontal planes were also measured. Results No significant differences in rotational ROM of the thorax, pelvis, and spine were observed between two groups at maximum rotation position. However, there was a significant interaction between groups and rotational ROM of pelvis and spine (F = 4.57, p = 0.04), and the SPR in CLBP patients was significantly greater than that of the healthy subjects (CLBP; 0.50 ± 0.10 Control; 0.41 ± 0.12, p = 0.04). The results at 50% rotation position were similar to that at maximum rotation. This indicates a relative increase in spinal rotation in the CLBP patients during trunk rotation. Moreover, the CLBP patients exhibited a significantly higher anterior tilt of the pelvis and extension of the spine in the sagittal plane coupled with rotation. Conclusions CLBP patients had relative hyper rotational mobility of the spine as well as excessive spinal extension coupled with trunk rotation. These results suggest that uncoordinated trunk rotation might be a functional failure associated with CLBP. PMID:29040298

Effect of trunk sagittal attitude on shoulder, thorax and pelvis three-dimensional kinematics in able-bodied subjects during gait.

PubMed

Leardini, Alberto; Berti, Lisa; Begon, Mickaël; Allard, Paul

2013-01-01

It has been shown that an original attitude in forward or backward inclination of the trunk is maintained at gait initiation and during locomotion, and that this affects lower limb loading patterns. However, no studies have shown the extent to which shoulder, thorax and pelvis three-dimensional kinematics are modified during gait due to this sagittal inclination attitude. Thirty young healthy volunteers were analyzed during level walking with video-based motion analysis. Reflecting markers were mounted on anatomical landmarks to form a two-marker shoulder line segment, and a four-marker thorax and pelvis segments. Absolute and relative spatial rotations were calculated, for a total of 11 degrees of freedom. The subjects were divided into two groups of 15 according to the median of mean thorax inclination angle over the gait cycle. Preliminary MANOVA analysis assessed whether gender was an independent variable. Then two-factor nested ANOVA was used to test the possible effect of thorax inclination on body segments, planes of motion and gait periods, separately. There was no significant difference in all anthropometric and spatio-temporal parameters between the two groups, except for subject mass. The three-dimensional kinematics of the thorax and pelvis were not affected by gender. Nested ANOVA revealed group effect in all segment rotations apart those at the pelvis, in the sagittal and frontal planes, and at the push-off. Attitudes in sagittal thorax inclination altered trunk segments kinematics during gait. Subjects with a backward thorax showed less thorax-to-pelvis motion, but more shoulder-to-thorax and thorax-to-laboratory motion, less motion in flexion/extension and in lateral bending, and also less motion during push-off. This contributes to the understanding of forward propulsion and sideways load transfer mechanisms, fundamental for the maintenance of balance and the risk of falling.

Relative mobility of the pelvis and spine during trunk axial rotation in chronic low back pain patients: A case-control study.

PubMed

Taniguchi, Masashi; Tateuchi, Hiroshige; Ibuki, Satoko; Ichihashi, Noriaki

2017-01-01

Trunk axial rotation is a risk factor for chronic low back pain (CLBP). The characteristics of rotational mobility in the pelvis and spine among CLBP patients are not fully understood. The purpose of this study was to examine three-dimensional kinematic changes, and to compare the differences of rotational mobility and coupled motion, in patients with and without CLBP. Fifteen patients with CLBP and 15 age and sex matched healthy subjects participated in this study. Each subject performed trunk rotation to maximum range of motion (ROM) in a standing position. The kinematics data was collected using a three-dimensional motion analysis system. The outcomes measured were the rotational ROM and the spine/pelvis ratio (SPR) in transvers plane at both maximum and 50% rotation position. The coupled angles in sagittal and frontal planes were also measured. No significant differences in rotational ROM of the thorax, pelvis, and spine were observed between two groups at maximum rotation position. However, there was a significant interaction between groups and rotational ROM of pelvis and spine (F = 4.57, p = 0.04), and the SPR in CLBP patients was significantly greater than that of the healthy subjects (CLBP; 0.50 ± 0.10 Control; 0.41 ± 0.12, p = 0.04). The results at 50% rotation position were similar to that at maximum rotation. This indicates a relative increase in spinal rotation in the CLBP patients during trunk rotation. Moreover, the CLBP patients exhibited a significantly higher anterior tilt of the pelvis and extension of the spine in the sagittal plane coupled with rotation. CLBP patients had relative hyper rotational mobility of the spine as well as excessive spinal extension coupled with trunk rotation. These results suggest that uncoordinated trunk rotation might be a functional failure associated with CLBP.

The six degrees of freedom motion of the human head, spine, and pelvis in a frontal impact.

PubMed

Lopez-Valdes, F J; Riley, P O; Lessley, D J; Arbogast, K B; Seacrist, T; Balasubramanian, S; Maltese, M; Kent, R

2014-01-01

The goal of this study is to characterize the in situ 6-degree-of-freedom kinematics of the head, 3 vertebrae (T1, T8, and L2), and the pelvis in a 40 km/h frontal impact. Three postmortem human surrogates (PMHS) were exposed to a deceleration of 15 g over 125 ms and the motion of selected anatomical structures (head, T1, T8, L2, and pelvis) was tracked at 1000 Hz using an optoelectric stereophotogrammetric system. Displacements of the analyzed structures are reported in the sagittal and the transverse planes. Rotations of the structures are described using the finite helical axis of the motion. Anterior displacements were 530.5 ± 39.4 mm (head), 434.7 ± 20.0 mm (T1), 353.3 ± 29.6 mm (T8), 219.9 ± 19.3 mm (L2), and 78.9 ± 22.1 mm (pelvis). The ratio between peak anterior and lateral displacement was up to 19 percent (T1) and 26 percent (head). Magnitudes of the rotation of the head (69.9 ± 1.5°), lumbar (66.5 ± 9.1°), and pelvis (63.8 ± 11.8°) were greater than that of the thoracic vertebrae (T1: 49.1 ± 7.8°; T8: 47.7 ± 6.3°). Thoracic vertebrae exhibited a complex rotation behavior caused by the asymmetric loading of the shoulder belt. Rotation of the lumbar vertebra and pelvis occurred primarily within the sagittal plane (flexion). Despite the predominance of the sagittal motion of the occupant in a pure (12 o'clock) frontal impact, the asymmetry of belt loading induced other relevant displacements and rotations of the head and thoracic spine. Attempts to model occupant kinematics in a frontal impact should consider these results to biofidelically describe the interaction of the torso with the belt.

Trastuzumab in Treating Patients With Previously Treated, Locally Advanced, or Metastatic Cancer of the Urothelium

ClinicalTrials.gov

2013-05-01

Distal Urethral Cancer; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Proximal Urethral Cancer; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Urethral Cancer Associated With Invasive Bladder Cancer

49 CFR 572.43 - Lumbar spine and pelvis.

Code of Federal Regulations, 2012 CFR

2012-10-01

... laterally by a test probe conforming to § 572.44(a) at 14 fps in accordance with paragraph (b) of this... horizontally forward. (2) Place the longitudinal centerline of the test probe at the lateral side of the pelvis... vertical plane which is tangent to the back of the dummy's buttocks. (3) Align the test probe so that at...

49 CFR 572.43 - Lumbar spine and pelvis.

Code of Federal Regulations, 2013 CFR

2013-10-01

... laterally by a test probe conforming to § 572.44(a) at 14 fps in accordance with paragraph (b) of this... horizontally forward. (2) Place the longitudinal centerline of the test probe at the lateral side of the pelvis... vertical plane which is tangent to the back of the dummy's buttocks. (3) Align the test probe so that at...

49 CFR 572.43 - Lumbar spine and pelvis.

Code of Federal Regulations, 2011 CFR

2011-10-01

... laterally by a test probe conforming to § 572.44(a) at 14 fps in accordance with paragraph (b) of this... horizontally forward. (2) Place the longitudinal centerline of the test probe at the lateral side of the pelvis... vertical plane which is tangent to the back of the dummy's buttocks. (3) Align the test probe so that at...

49 CFR 572.43 - Lumbar spine and pelvis.

Code of Federal Regulations, 2014 CFR

2014-10-01

... laterally by a test probe conforming to § 572.44(a) at 14 fps in accordance with paragraph (b) of this... horizontally forward. (2) Place the longitudinal centerline of the test probe at the lateral side of the pelvis... vertical plane which is tangent to the back of the dummy's buttocks. (3) Align the test probe so that at...

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

Greenspan, A.; Norman, A.

Five cases of a rare developmental anomaly involving extraskeletal bone formation are described - four in the pelvis and one arising from the 12th rib. Three of these bony growths, called 'Pelvic digits' had well developed 'joints' or pseudoarticulations. The similarity of this anomaly to posttraumatic myositis ossificans and avulsion injuries of the pelvis (rectus femoris) is pointed out and a differential diagnosis offered.

Hypertrophic osteopathy associated with renal pelvis transitional cell carcinoma in a dog

PubMed Central

Grillo, Thais P.; Brandão, Cláudia V.S.; Mamprim, Maria J.; de Jesus, Carlos M.N.; Santos, Taizha C.; Minto, Bruno W.

2007-01-01

A 6-year-old male, Belgian shepherd dog was presented with lethargy, oliguria, hematuria, and reluctance to move. The dog developed hypertrophic osteopathy secondary to renal pelvis transitional cell carcinoma. A nephrectomy was performed and after a year, the dog was completely asymptomatic, and no evidence of metastatic disease was present. PMID:17824162

The earliest settlers of Mesoamerica date back to the late Pleistocene.

PubMed

Stinnesbeck, Wolfgang; Becker, Julia; Hering, Fabio; Frey, Eberhard; González, Arturo González; Fohlmeister, Jens; Stinnesbeck, Sarah; Frank, Norbert; Terrazas Mata, Alejandro; Benavente, Martha Elena; Avilés Olguín, Jerónimo; Aceves Núñez, Eugenio; Zell, Patrick; Deininger, Michael

2017-01-01

Preceramic human skeletal remains preserved in submerged caves near Tulum in the Mexican state of Quintana Roo, Mexico, reveal conflicting results regarding 14C dating. Here we use U-series techniques for dating a stalagmite overgrowing the pelvis of a human skeleton discovered in the submerged Chan Hol cave. The oldest closed system U/Th age comes from around 21 mm above the pelvis defining the terminus ante quem for the pelvis to 11311±370 y BP. However, the skeleton might be considerable older, probably as old as 13 ky BP as indicated by the speleothem stable isotope data. The Chan Hol individual confirms a late Pleistocene settling of Mesoamerica and represents one of the oldest human osteological remains in America.

The earliest settlers of Mesoamerica date back to the late Pleistocene

PubMed Central

Becker, Julia; Hering, Fabio; Frey, Eberhard; González, Arturo González; Fohlmeister, Jens; Stinnesbeck, Sarah; Frank, Norbert; Terrazas Mata, Alejandro; Benavente, Martha Elena; Avilés Olguín, Jerónimo; Aceves Núñez, Eugenio; Zell, Patrick; Deininger, Michael

2017-01-01

Preceramic human skeletal remains preserved in submerged caves near Tulum in the Mexican state of Quintana Roo, Mexico, reveal conflicting results regarding 14C dating. Here we use U-series techniques for dating a stalagmite overgrowing the pelvis of a human skeleton discovered in the submerged Chan Hol cave. The oldest closed system U/Th age comes from around 21 mm above the pelvis defining the terminus ante quem for the pelvis to 11311±370 y BP. However, the skeleton might be considerable older, probably as old as 13 ky BP as indicated by the speleothem stable isotope data. The Chan Hol individual confirms a late Pleistocene settling of Mesoamerica and represents one of the oldest human osteological remains in America. PMID:28854194

Types of Renal Calculi and Management Regimen for Chinese Minimally Invasive Percutaneous Nephrolithotomy.

PubMed

Gu, Si-Ping; Zeng, Guo-Hua; You, Zhi-Yuan; Lu, Yi-Jin; Huang, Yun-Teng; Wang, Qing-Mao; He, Zhao-Hui

2015-12-01

Strict selection of patients for minimally invasive percutaneous nephrolithotomy could effectively improve the success rate of surgery. This study aimed to understand the required skills and the efficacy of mini-PCNL in the treatment of five types of upper ureteral calculi. Data collected after X-ray analysis and B mode ultrasound from 633 patients with upper ureteral and renal pelvis calculi who underwent B ultrasound-guided lithotomy was reviewed, including the following: type I, upper ureteral or renal pelvis calculi with moderate hydronephrosis (154 cases); type II, upper ureteral or renal pelvis calculi with severe hydronephrosis (157 cases); type III, upper ureteral or renal pelvis calculi without hydronephrosis (61 cases); type IV, renal pelvis calculi, one or two renal calyx calculi (206 cases); and type V, renal staghorn calculi (55 cases). Operations on 611 cases were successful. The treatment method for five patients was converted to open surgery. Twelve cases were treated by indwelling double-J tube retro-catheterization and extracorporeal shock wave lithotripsy. Five patients gave up the treatment. The rate of calculus clearance was 82.3 %, and the rate of residual calculus was 17.6 %. Selective renal artery embolization was performed in nine cases. Hydropneumothorax occurred in nine cases. No intestinal fistula occurred, and no patient had to undergo nephrectomy. The difficulty and the curative effect of the operation were different because the types of calculi varied. Selection of the procedure based on the different types of calculi could effectively improve the success rate of the procedure, reduce complications, and shorten the learning curve.

Middle Pleistocene lower back and pelvis from an aged human individual from the Sima de los Huesos site, Spain.

PubMed

Bonmatí, Alejandro; Gómez-Olivencia, Asier; Arsuaga, Juan-Luis; Carretero, José Miguel; Gracia, Ana; Martínez, Ignacio; Lorenzo, Carlos; Bérmudez de Castro, José María; Carbonell, Eudald

2010-10-26

We report a nearly complete lumbar spine from the Middle Pleistocene site of the Sima de los Huesos (SH) that is assigned to the previously published SH male Pelvis 1 [Arsuaga JL, et al. (1999). Nature 399: 255-258]. The "SH Pelvis 1 individual" is a unique nearly complete lumbo-pelvic complex from the human Middle Pleistocene fossil record, and offers a rare glimpse into the anatomy and past lifeways of Homo heidelbergensis. A revised reconstruction of Pelvis 1, together with the current fossil evidence, confirms our previous hypothesis that the morphology of this pelvis represents the primitive pattern within the genus Homo. Here we argue that this primitive pattern is also characterized by sexual dimorphism in the pelvic canal shape, implying complicated deliveries. In addition, this individual shows signs of lumbar kyphotic deformity, spondylolisthesis, and Baastrup disease. This suite of lesions would have postural consequences and was most likely painful. As a result, the individual's daily physical activities would have been restricted to some extent. Reexamination of the age-at-death agrees with this individual being over 45 y old, relying on the modern human pattern of changes of the articular surfaces of the os coxae. The presence of degenerative pathological lesions and the advanced age-at-death of this individual make it the most ancient postcranial evidence of an aged individual in the human fossil record. Additional nonpathological SH lumbo-pelvic remains are consistent with previous hypotheses, suggesting a less-pronounced sagittal spinal curvature in Neandertals compared with Homo sapiens.

Is the evaluation of the anterior inferior iliac spine (AIIS) in the AP pelvis possible? Analysis of conventional X-rays and 3D-CT reconstructions.

PubMed

Krueger, David R; Windler, Markus; Geßlein, Markus; Schuetz, Michael; Perka, Carsten; Schroeder, Joerg H

2017-07-01

A hypertrophic AIIS has been identified as a cause for extraarticular hip impingement and is classified according to Hetsroni using 3D-CT reconstructions. The role of the conventional AP pelvis X-ray, which is the first standard imaging step for the evaluation of hip pain, has not been investigated yet. AP pelvis X-rays and 3D-CT reconstructions of patients were evaluated regarding their morphology of the AIIS. The conventional X-rays were categorized into three groups according to the projection of the AIIS: above (A) or below (B) the acetabular sourcil or even exceeding the anterior acetabular rim (C). They were compared to the morphologic types in the 3D-CT reconstruction (Hetsroni type I-III). Ninety patients with an equal distribution of type A, B or C projection in the AP pelvis were evaluated and compared to the morphology in the 3D-CT reconstruction. The projection of the AIIS below the acetabular sourcil (B + C) showed only moderate sensitivity (0.76) and specificity (0.64) for a hypertrophic AIIS (Hetsroni type II + III), but if the AIIS exceeds the anterior rim, all cases showed a hypertrophic AIIS in the 3D-CT reconstructions (Hetsroni type II + III). Distinct differentiation of the AIIS morphology in the AP pelvis is not possible, but the projection of the AIIS below the anterior acetabular rim represented a hypertrophic AIIS in all cases and should, therefore, be critically investigated for a relevant AIIS impingement.

The Effects of a Heel Wedge on Hip, Pelvis and Trunk Biomechanics During Squatting in Resistance Trained Individuals.

PubMed

Charlton, Jesse M; Hammond, Connor A; Cochrane, Christopher K; Hatfield, Gillian L; Hunt, Michael A

2017-06-01

Barbell back squats are a popular exercise for developing lower extremity strength and power. However, this exercise has potential injury risks, particularly to the lumbar spine, pelvis, and hip joint. Previous literature suggests heel wedges as a means of favorably adjusting trunk and pelvis kinematics with the intention of reducing such injury risks. Yet no direct biomechanical research exists to support these recommendations. Therefore, the purpose of this study was to examine the effects of heel wedges compared with barefoot on minimally loaded barbell back squats. Fourteen trained male participants performed a barbell back squat in bare feet or with their feet raised bilaterally with a 2.5-cm wooden block while 3-dimensional kinematics, kinetics, and electromyograms were collected. The heel wedge condition elicited significantly less forward trunk flexion angles at peak knee flexion, and peak external hip joint moments (p ≤ 0.05) compared with barefoot conditions. However, no significant differences were observed between conditions for trunk and pelvis angle differences at peak knee flexion (p > 0.05). Lastly, no peak or root mean square differences in muscle activity were elicited between conditions (p > 0.05). Our results lend support for the suggestions provided in literature aimed at using heel wedges as a means of reducing excessive forward trunk flexion. However, the maintenance of a neutral spine, another important safety factor, is not affected by the use of heel wedges. Therefore, heel wedges may be a viable modification for reduction of excessive forward trunk flexion but not for reduction in relative trunk-pelvis flexion during barbell back squats.

Middle Pleistocene lower back and pelvis from an aged human individual from the Sima de los Huesos site, Spain

PubMed Central

Bonmatí, Alejandro; Gómez-Olivencia, Asier; Arsuaga, Juan-Luis; Carretero, José Miguel; Gracia, Ana; Martínez, Ignacio; Lorenzo, Carlos; Bérmudez de Castro, José María; Carbonell, Eudald

2010-01-01

We report a nearly complete lumbar spine from the Middle Pleistocene site of the Sima de los Huesos (SH) that is assigned to the previously published SH male Pelvis 1 [Arsuaga JL, et al. (1999). Nature 399: 255–258]. The “SH Pelvis 1 individual” is a unique nearly complete lumbo-pelvic complex from the human Middle Pleistocene fossil record, and offers a rare glimpse into the anatomy and past lifeways of Homo heidelbergensis. A revised reconstruction of Pelvis 1, together with the current fossil evidence, confirms our previous hypothesis that the morphology of this pelvis represents the primitive pattern within the genus Homo. Here we argue that this primitive pattern is also characterized by sexual dimorphism in the pelvic canal shape, implying complicated deliveries. In addition, this individual shows signs of lumbar kyphotic deformity, spondylolisthesis, and Baastrup disease. This suite of lesions would have postural consequences and was most likely painful. As a result, the individual’s daily physical activities would have been restricted to some extent. Reexamination of the age-at-death agrees with this individual being over 45 y old, relying on the modern human pattern of changes of the articular surfaces of the os coxae. The presence of degenerative pathological lesions and the advanced age-at-death of this individual make it the most ancient postcranial evidence of an aged individual in the human fossil record. Additional nonpathological SH lumbo-pelvic remains are consistent with previous hypotheses, suggesting a less-pronounced sagittal spinal curvature in Neandertals compared with Homo sapiens. PMID:20937858

The free moment is associated with torsion between the pelvis and the foot during gait.

PubMed

Ohkawa, Takahiro; Atomi, Tomoaki; Hasegawa, Katsuya; Atomi, Yoriko

2017-10-01

During walking, the friction between the foot and the ground surface causes a free moment (FM), which influences the torsional stress on the lower extremity. However, few studies have investigated the FM during natural walking. The main aim of this study was to examine the relationship between the FM and the absolute and relative rotation angles of the foot and pelvis. The rotation angles of foot and pelvic were measured in 18 healthy men using a motion capture system. Rotation angles were measured in absolute and relative coordinates as well as in reference to the line connecting the center of pressure (CoP) line under the right and left feet to evaluate the effects of the opposite lower limb on the FM. The absolute and relative rotation angles of the foot and pelvis were entered into forced-entry linear regression models to evaluate the influence on the FM. Only the relative angle of rotation between the foot and pelvis could explain the prediction equations significantly. In the Pearson's product-moment correlation coefficient, the rotation angles of the foot and pelvis defined using the bilateral CoP points had not significantly correlated with FM. No joint rotation movement was correlated with FM. The torsion of the entire lower extremity should be performed principally through hip internal rotation. When evaluating the FM as a torsional stress, focusing on the rotation of the entire lower extremity, rather than on one segment, is beneficial. Copyright © 2017 Elsevier B.V. All rights reserved.

Identification of trunk and pelvis movement compensations in patients with transtibial amputation using angular momentum separation.

PubMed

Gaffney, Brecca M; Murray, Amanda M; Christiansen, Cory L; Davidson, Bradley S

2016-03-01

Patients with unilateral dysvascular transtibial amputation (TTA) have a higher risk of developing low back pain than their healthy counterparts, which may be related to movement compensations used in the absence of ankle function. Assessing components of segmental angular momentum provides a unique framework to identify and interpret these movement compensations alongside traditional observational analyses. Angular momentum separation indicates two components of total angular momentum: (1) transfer momentum and (2) rotational momentum. The objective of this investigation was to assess movement compensations in patients with dysvascular TTA, patients with diabetes mellitus (DM), and healthy controls (HC) by examining patterns of generating and arresting trunk and pelvis segmental angular momenta during gait. We hypothesized that all groups would demonstrate similar patterns of generating/arresting total momentum and transfer momentum in the trunk and pelvis in reference to the groups (patients with DM and HC). We also hypothesized that patients with amputation would demonstrate different (larger) patterns of generating/arresting rotational angular momentum in the trunk. Patients with amputation demonstrated differences in trunk and pelvis transfer angular momentum in the sagittal and transverse planes in comparison to the reference groups, which indicates postural compensations adopted during walking. However, patients with amputation demonstrated larger patterns of generating and arresting of trunk and pelvis rotational angular momentum in comparison to the reference groups. These segmental rotational angular momentum patterns correspond with high eccentric muscle demands needed to arrest the angular momentum, and may lead to consequential long-term effects such as low back pain. Copyright © 2016 Elsevier B.V. All rights reserved.

The coordinated movement of the spine and pelvis during running.

PubMed

Preece, Stephen J; Mason, Duncan; Bramah, Christopher

2016-02-01

Previous research into running has demonstrated consistent patterns in pelvic, lumbar and thoracic motions between different human runners. However, to date, there has been limited attempt to explain why observed coordination patterns emerge and how they may relate to centre of mass (CoM) motion. In this study, kinematic data were collected from the thorax, lumbar spine, pelvis and lower limbs during over ground running in n=28 participants. These data was subsequently used to develop a theoretical understanding of the coordination of the spine and pelvis in all three body planes during the stance phase of running. In the sagittal plane, there appeared to be an antiphase coordinate pattern which may function to increase femoral inclination at toe off whilst minimising anterior-posterior accelerations of the CoM. In the medio-lateral direction, CoM motion appears to facilitate transition to the contralateral foot. However, an antiphase coordination pattern was also observed, most likely to minimise unnecessary accelerations of the CoM. In the transverse plane, motion of the pelvis was observed to lag slightly behind that of the thorax. However, it is possible that the close coupling between these two segments facilitates the thoracic rotation required to passively drive arm motion. This is the first study to provide a full biomechanical rationale for the coordination of the spine and pelvis during human running. This insight should help clinicians develop an improved understanding of how spinal and pelvic motions may contribute to, or result from, common running injuries. Copyright © 2015 Elsevier B.V. All rights reserved.

Selective pressures in the human bony pelvis: Decoupling sexual dimorphism in the anterior and posterior spaces.

PubMed

Brown, Kirsten M

2015-07-01

Sexual dimorphism in the human bony pelvis is commonly assumed to be related to the intensity of obstetrical selective pressures. With intense obstetrical selective pressures, there should be greater shape dimorphism; with minimal obstetrical selective pressures, there should be reduced shape dimorphism. This pattern is seen in the nondimorphic anterior spaces and highly dimorphic posterior spaces. Decoupling sexual dimorphism in these spaces may in turn be related to the differential influence of other selective pressures, such as biomechanical ones. The relationship between sexual dimorphism and selective pressures in the human pelvis was examined using five skeletal samples (total female n = 101; male n = 103). Pelvic shape was quantified by collecting landmark coordinate data on articulated pelves. Euclidean distance matrix analysis was used to extract the distances that defined the anterior and posterior pelvic spaces. Sex and body mass were used as proxies for obstetrical and biomechanical selective pressures, respectively. MANCOVA analyses demonstrate significant effects of sex and body mass on distances in both the anterior and the posterior spaces. A comparison of the relative contribution of shape variance attributed to each of these factors suggests that the posterior space is more influenced by sex, and obstetrics by proxy, whereas the anterior space is more influenced by body mass, and biomechanics by proxy. Although the overall shape of the pelvis has been influenced by obstetrical and biomechanical selective pressures, there is a differential response within the pelvis to these factors. These results provide new insight into the ongoing debate on the obstetrical dilemma hypothesis. © 2015 Wiley Periodicals, Inc.

Gait coordination in pregnancy: transverse pelvic and thoracic rotations and their relative phase.

PubMed

Wu, Wenhua; Meijer, Onno G; Lamoth, Claudine J C; Uegaki, Kimi; van Dieën, Jaap H; Wuisman, Paul I J M; de Vries, Johanna I P; Beek, Peter J

2004-06-01

To examine the effects of pregnancy on the coordination of transverse pelvic and thoracic rotations during gait. Gait of healthy pregnant women and nulligravidae was studied during treadmill walking at predetermined velocities ranging from 0.17 to 1.72 m/s. pelvis-thorax coordination during walking is altered in women with postpartum pregnancy-related pelvic girdle pain. This coordination has not been investigated in a healthy pregnant population. Comfortable walking velocity was established. Amplitudes of pelvic and thoracic rotations were calculated. Their coordination was characterized by relative Fourier phase and its standard deviation. Comfortable walking velocity was significantly reduced. The amplitudes of pelvic and thoracic rotations were somewhat reduced, with significantly smaller intra-individual standard deviations. Also pelvis-thorax relative Fourier phase was somewhat smaller, its intra-individual standard deviation was negatively correlated with week of pregnancy, and significantly lower at velocities > or = 1.06 m/s. The general pattern of gait kinematics in pregnant women is very similar to that of nulligravidae. Still, it appears that pregnant women experience difficulties in realizing the more anti-phase pelvis-thorax coordination that is required at higher walking velocities. The present study shows that gait in healthy pregnancy is remarkably normal, but some differences in pelvis-thorax coordination were detected. In healthy pregnancy, anti-phase pelvis-thorax coordination appears difficult, but less so than in pregnancy-related pelvic girdle pain. Better understanding of gait in healthy pregnancy may provide insight into the gait problems of women with pregnancy-related pelvic girdle pain. Copyright 2004 Elsevier Ltd.

Pathologic fracture through a unicameral bone cyst of the pelvis: CT-guided percutaneous curettage, biopsy, and bone matrix injection.

PubMed

Tynan, Jennifer R; Schachar, Norman S; Marshall, Geoffrey B; Gray, Robin R

2005-02-01

Unicameral bone cysts of the pelvis are extremely rare. A 19-year old man presented with a pathologic fracture through a pelvic unicameral bone cyst. He was treated with computed tomography-guided percutaneous curettage, biopsy, and demineralized bone matrix injection. Treatment has proven successful in short-term follow-up.

Phase II Trial Of PS-341 (Bortezomib) In Patients With Previously Treated Advanced Urothelial Tract Transitional Cell Carcinoma

ClinicalTrials.gov

2013-06-04

Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Stage III Bladder Cancer; Stage III Urethral Cancer; Stage IV Bladder Cancer; Stage IV Urethral Cancer; Transitional Cell Carcinoma of the Bladder; Ureter Cancer

Two-Dimensional Sectioned Images and Three-Dimensional Surface Models for Learning the Anatomy of the Female Pelvis

ERIC Educational Resources Information Center

Shin, Dong Sun; Jang, Hae Gwon; Hwang, Sung Bae; Har, Dong-Hwan; Moon, Young Lae; Chung, Min Suk

2013-01-01

In the Visible Korean project, serially sectioned images of the pelvis were made from a female cadaver. Outlines of significant structures in the sectioned images were drawn and stacked to build surface models. To improve the accessibility and informational content of these data, a five-step process was designed and implemented. First, 154 pelvic…

Gemcitabine Hydrochloride and Cisplatin or High-Dose Methotrexate, Vinblastine, Doxorubicin Hydrochloride, and Cisplatin in Treating Patients With Urothelial Cancer

ClinicalTrials.gov

2014-01-27

Anterior Urethral Cancer; Localized Transitional Cell Cancer of the Renal Pelvis and Ureter; Posterior Urethral Cancer; Recurrent Bladder Cancer; Recurrent Urethral Cancer; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage III Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Ureter Cancer; Urethral Cancer Associated With Invasive Bladder Cancer

Design of a gait training device for control of pelvic obliquity.

PubMed

Pietrusinski, Maciej; Severini, Giacomo; Cajigas, Iahn; Mavroidis, Constantinos; Bonato, Paolo

2012-01-01

This paper presents the design and testing of a novel device for the control of pelvic obliquity during gait. The device, called the Robotic Gait Rehabilitation (RGR) Trainer, consists of a single actuator system designed to target secondary gait deviations, such as hip-hiking, affecting the movement of the pelvis. Secondary gait deviations affecting the pelvis are generated in response to primary gait deviations (e.g. limited knee flexion during the swing phase) in stroke survivors and contribute to the overall asymmetrical gait pattern often observed in these patients. The proposed device generates a force field able to affect the obliquity of the pelvis (i.e. the rotation of the pelvis around the anteroposterior axis) by using an impedance controlled single linear actuator acting on a hip orthosis. Tests showed that the RGR Trainer is able to induce changes in pelvic obliquity trajectories (hip-hiking) in healthy subjects. These results suggest that the RGR Trainer is suitable to test the hypothesis that has motivated our efforts toward developing the system, namely that addressing both primary and secondary gait deviations during robotic-assisted gait training may help promote a physiologically-sound gait behavior more effectively than when only primary deviations are addressed.

Gonad dose in AP pelvis radiography: Impact of anode heel orientation.

PubMed

Mraity, H A A B; England, A; Hogg, P

2017-02-01

For antero posterior (AP) pelvis radiographic examination, determine the impact of anode heel orientation on female/male gonad dose. High sensitivity thermo-luminescent dosimeters (TLDs) were used with an ATOM dosimetry phantom; the phantom was positioned for AP pelvis. TLDs were placed into the testes and ovaries. Radiation dose received by these organs was measured with the feet toward anode and feet toward the cathode. kVp, mAs and SID were manipulated to generate a range of exposures. A dose profile was also generated using Unfors Mult-O-Meter 401 along the long axis of the phantom. A decrease in dose from the central ray toward the anode was noted, with a marked increase toward the cathode. A significant reduction in dose was received by the testes with feet towards the anode compared with feet towards cathode (P˂0.001). No difference was seen for ovarian dose (P˃0.05). kVp, mAs and SID all have an effect on male and female gonad dose. For male pelvis imaging, placing feet towards the anode can be used as a simple dose reduction method. Copyright © 2016 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

Thorax and pelvis kinematics during walking, a comparison between children with and without cerebral palsy: A systematic review.

PubMed

Swinnen, Eva; Goten, Laura Vander; De Koster, Berdien; Degelaen, Marc

2016-01-01

Dysfunctional postural control and pathological thorax and pelvis motions are often observed in children with cerebral palsy (CP) and can be considered as an indicator of diminished dynamic stability. The aim of this study was to identify the differences between children with CP and typically developing children in three-dimensional thorax and pelvis kinematics during walking. Three electronic databases were searched by using different combinations of keywords. The methodological quality of the studies was assessed by two researchers with the Strobe quality checklist. Ten studies (methodological quality: 32% to 74%) with in total 259 children with CP and 220 typically developing children (mean age: 7.6 to 13.6 year) were included. Compared to typically developing children, children with bilateral CP showed an increased range of motion of the thorax, pelvis and spine during walking. The results of the children with unilateral CP were less clear. In general, children with bilateral CP showed larger movement amplitudes of the trunk compared to children without CP. This increase in movement amplitudes could influence the dynamic stability of the body during walking. In children with unilateral CP, the results were less obvious and further research on this topic is required.

Differences in axial segment reorientation during standing turns predict multiple falls in older adults.

PubMed

Wright, Rachel L; Peters, Derek M; Robinson, Paul D; Sitch, Alice J; Watt, Thomas N; Hollands, Mark A

2012-07-01

The assessment of standing turning performance is proposed to predict fall risk in older adults. This study investigated differences in segmental coordination during a 360° standing turn task between older community-dwelling fallers and non-fallers. Thirty-five older adults age mean (SD) of 71 (5.4) years performed 360° standing turns. Head, trunk and pelvis position relative to the laboratory and each other were recorded using a Vicon motion analysis system. Fall incidence was monitored by monthly questionnaire over the following 12 months and used to identify non-faller, single faller and multiple faller groups. Multiple fallers were found to have significantly different values, when compared to non-fallers, for pelvis onset (p=0.002); mean angular separation in the transverse plane between the head and trunk (p=0.018); peak angular separation in the transverse plane between the trunk and pelvis (p=0.013); and mean angular separation between the trunk and pelvis (p<0.001). Older adults who subsequently experience multiple falls show a simplified turning pattern to assist in balance control. This may be a predictor for those at increased risk of falling. Copyright © 2012 Elsevier B.V. All rights reserved.

Finite element study of human pelvis model in side impact for Chinese adult occupants.

PubMed

Ma, Zhengwei; Lan, Fengchong; Chen, Jiqing; Liu, Weiguo

2015-01-01

The occupant's pelvis is very vulnerable to side collision in road accidents. Finite element (FE) studies on pelvic injury help to design occupant protection devices to improve vehicle safety. This study was aimed to develop a highly biofidelic pelvis model of Chinese adults and assess its sensitivity to variations in pelvis cortical bone thickness, bone material properties, and loading conditions. In this study, 4 different FE models of the pelvis were developed from the computed tomography (CT) data of a volunteer representing the 50th percentile Chinese male. Two of them were meshed using entirely hexahedral elements with variable and constant cortical thickness distribution (the V-Hex and C-Hex models), and the others were modeled with hexahedral elements for cancellous bone and variable or constant thickness shell elements for cortical bone (the V-HS and C-HS models). In model developments, the semi-automatic multiblock meshing approach was employed to maintain the pelvis geometric curvature and generate a high-quality hexahedral mesh. Then, several simulations with postmortem human subjects (PMHS) tests were performed to obtain the most accurate model in predicting pelvic injury. Based on the most accurate model, sensitivity studies were conducted to analyze the effects of the cortex thickness, Young's modulus of the cortical and cancellous bone, impactor velocity, and impactor with or without padding on the biomechanical responses and injuries of pelvis. The results indicate that the models with variable cortical bone thickness can give more accurate predictions than those with constant cortical thickness. Both the V-Hex and V-HS models are favorable for simulating pelvic response and injury, but the simulation results of the V-Hex model agree with the tests better. The sensitivity study shows that pelvic response is more sensitive to alterations in the Young's modulus of cortical bone than cancellous bone. Compared to failure displacement, peak force is more sensitive to the cortical bone thickness. However, displacement is more sensitive to the Young's modulus of cancellous bone than peak force. The padding attached on the impactor plays a significant role in absorbing the impact energy and alleviating pelvic injury. The all-hex meshing method with variable cortical bone thickness has the highest accuracy but is time-consuming. The cortical bone plays a determining role in resisting pelvic fracture. Peak impact force appears to be a reasonable injury predictor for pelvic injury assessment. Some appropriate energy absorbers installed in the car door can significantly reduce pelvic injury and will be beneficial for occupant protection.

Computed tomography for occult fractures of the proximal femur, pelvis, and sacrum in clinical practice: single institution, dual-site experience.

PubMed

Mandell, Jacob C; Weaver, Michael J; Khurana, Bharti

2018-06-01

The purpose of this study was to evaluate the diagnostic performance of CT for assessment of occult fractures of the proximal femur, pelvis, and sacrum. A retrospective review was performed on patients who received a CT of the hip or pelvis for suspected occult fracture after negative or equivocal radiographs performed within 24 h. The official radiology report was utilized for the determination of CT findings and calculation of sensitivity and specificity. Surgical reports, MRI reports, and clinical follow-up were used as the standard of reference. Sensitivity and specificity were calculated with 95% confidence intervals. Seventy-four patients received CT of the hip or pelvis for clinical concern for occult fracture after negative or equivocal radiographs. By the reference standard, a total of 40 fractures were present in 25/74 (33.8%) patients, including 35 conservatively treated fractures of the greater trochanter, pelvis, and sacrum, and 5 operatively treated proximal femoral fractures. A total of 14/74 (18.9%) of patients had an MRI within 1 day of CT. MRI identified an operatively treated femoral neck fracture not seen on CT and an operatively treated intertrochanteric fracture, which CT described as a greater trochanteric fracture. There were two false negative conservatively treated pelvic fractures not seen on CT but diagnosed on MRI. On a per-patient basis, CT had an overall sensitivity of 88% (22/25; 95% confidence intervals 69-97%), specificity of 98% (48/49; 95% confidence intervals 89-100%), and negative predictive value of 94%. For the five operative proximal femoral fractures, the sensitivity of CT was 60% (3/5; 95% confidence intervals 15-95%), specificity was 99% (68/69; 95% confidence intervals 92-100%), and negative predictive value was 97%. In the clinical setting of suspected occult fracture, the sensitivity of clinical CT reports for detection of any type of fracture of the proximal femur, pelvis, or sacrum was 88%. For the small number of operatively treated proximal femoral fractures seen in the study, sensitivity of CT was 60% (3/5) and negative predictive value was 97%, although the relatively few patients needing fixation precludes statistical analysis.

Characterization of Whole Body Pain in Urologic Chronic Pelvic Pain Syndrome at Baseline – A MAPP Research Network Study

PubMed Central

Lai, H. Henry; Jemielita, Thomas; Sutcliffe, Siobhan; Bradley, Catherine S.; Naliboff, Bruce; Williams, David A.; Gereau, Robert W.; Kreder, Karl; Clemens, J. Quentin; Rodriguez, Larissa V.; Krieger, John N.; Farrar, John T.; Robinson, Nancy; Landis, J. Richard

2017-01-01

Purpose We characterized the location and spatial distribution of whole body pain among patients with urologic chronic pelvic pain syndrome (UCPPS) using a body map; and compared the severity of urinary symptoms, pelvic pain, non-pelvic pain, and psychosocial health among patients with different pain patterns. Methods 233 women and 191 men with UCPPS enrolled in a multi-center, one-year observational study completed a battery of baseline measures, including a body map describing the location of pain during the past week. Participants were categorized as having “pelvic pain only” if they reported pain in the abdomen and pelvis only. Participants who reported pain beyond the pelvis were further divided into two sub-groups based on the number of broader body regions affected by pain: an “intermediate” group (1–2 additional regions outside the pelvis) and a “widespread pain” group (3–7 additional regions). Results Of the 424 enrolled patients 25% reported pelvic pain only, and 75% reported pain beyond the pelvis of which 38% reported widespread pain. Participants with greater number of pain locations had greater non-pelvic pain severity (p<0.0001), sleep disturbance (p=0.035), depression (p=0.005), anxiety (p=0.011), psychological stress (p=0.005), negative affect scores (p=0.0004), and worse quality of life (p≤0.021). No difference in pelvic pain and urinary symptom severity were observed by increasing pain distribution. Conclusions Three-quarters of men and women with UCPPS reported pain outside the pelvis. Widespread pain was associated with greater severity of non-pelvic pain symptoms, poorer psychosocial health and worse quality of life, but not worse pelvic pain or urinary symptoms. PMID:28373134

Soft tissue displacement over pelvic anatomical landmarks during 3-D hip movements.

PubMed

Camomilla, V; Bonci, T; Cappozzo, A

2017-09-06

The position, in a pelvis-embedded anatomical coordinate system, of skin points located over the following anatomical landmarks (AL) was determined while the hip assumed different spatial postures: right and left anterior superior and posterior superior iliac spines, and the sacrum. Postures were selected as occurring during walking and during a flexion-extension and circumduction movement, as used to determine the hip joint centre position (star-arc movement). Five volunteers, characterised by a wide range of body mass indices (22-37), were investigated. Subject-specific MRI pelvis digital bone models were obtained. For each posture, the pose of the pelvis-embedded anatomical coordinate system was determined by registering this bone model with points digitised over bony prominences of the pelvis, using a wand carrying a marker-cluster and stereophotogrammetry. The knowledge of how the position of the skin points varies as a function of the hip posture provided information regarding the soft tissue artefact (STA) that would affect skin markers located over those points during stereophotogrammetric movement analysis. The STA was described in terms of amplitude (relative to the position of the AL during an orthostatic posture), diameter (distance between the positions of the AL which were farthest away from each other), and pelvis orientation. The STA amplitude, exhibited, over all postures, a median [inter-quartile] value of 9[6] and 16[11]mm, for normal and overweight volunteers, respectively. STA diameters were larger for the star-arc than for the walking postures, and the direction was predominantly upwards. Consequent errors in pelvic orientation were in the range 1-9 and 4-11 degrees, for the two groups respectively. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Study of CT Automatic Exposure Control System (CT-AEC) Optimization in CT Angiography of Lower Extremity Artery by Considering Contrast-to-Noise Ratio].

PubMed

Inada, Satoshi; Masuda, Takanori; Maruyama, Naoya; Yamashita, Yukari; Sato, Tomoyasu; Imada, Naoyuki

2016-01-01

To evaluate the image quality and effect of radiation dose reduction by setting for computed tomography automatic exposure control system (CT-AEC) in computed tomographic angiography (CTA) of lower extremity artery. Two methods of setting were compared for CT-AEC [conventional and contrast-to-noise ratio (CNR) methods]. Conventional method was set noise index (NI): 14and tube current threshold: 10-750 mA. CNR method was set NI: 18, minimum tube current: (X+Y)/2 mA (X, Y: maximum X (Y)-axis tube current value of leg in NI: 14), and maximum tube current: 750 mA. The image quality was evaluated by CNR, and radiation dose reduction was evaluated by dose-length-product (DLP). In conventional method, mean CNRs for pelvis, femur, and leg were 19.9±4.8, 20.4±5.4, and 16.2±4.3, respectively. There was a significant difference between the CNRs of pelvis and leg (P<0.001), and between femur and leg (P<0.001). In CNR method, mean CNRs for pelvis, femur, and leg were 15.2±3.3, 15.3±3.2, and 15.3±3.1, respectively; no significant difference between pelvis, femur, and leg (P=0.973) in CNR method was observed. Mean DLPs were 1457±434 mGy⋅cm in conventional method, and 1049±434 mGy·cm in CNR method. There was a significant difference in the DLPs of conventional method and CNR method (P<0.001). CNR method gave equal CNRs for pelvis, femur, and leg, and was beneficial for radiation dose reduction in CTA of lower extremity artery.

Role of Definitive Radiation Therapy in Carcinoma of Unknown Primary in the Abdomen and Pelvis

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

Kelly, Patrick; Das, Prajnan; Varadhachary, Gauri R.

2012-04-01

Objectives: Carcinoma of unknown primary (CUP) in the abdomen and pelvis is a heterogeneous group of cancers with no standard treatment. Considered by many to be incurable, these patients are often treated with chemotherapy alone. In this study, we determined the effectiveness of radiation therapy in combination with chemotherapy in patients with CUP in the abdomen and pelvis. Patients and Methods: Medical records were reviewed for 37 patients with CUP treated with radiation therapy for disease located in the soft tissues and/or nodal basins of the abdomen and pelvis at University of Texas M.D. Anderson Cancer between 2002 and 2009.more » All patients underwent chemotherapy, either before or concurrent with radiation therapy. Patients were selected for radiation therapy on the basis of histologic type, disease extent, and prior therapy response. Twenty patients underwent definitive radiation therapy (defined as radiation therapy targeting all known disease sites with at least 45 Gy) and 17 patients underwent palliative radiation therapy. Only 6 patients had surgical resection of their disease. Patient and treatment characteristics were extracted and the endpoints of local disease control, progression-free survival (PFS), overall survival (OS), and treatment-related toxicity incidence were analyzed. Results: The 2-year PFS and OS rates for the entire cohort were 32% and 57%, respectively. However, in patients treated with definitive radiation therapy, the rates were 48% and 76%, and 7 patients lived more than 3 years after treatment with no evidence of disease progression. Nevertheless, radiation-associated toxicity was significant in this cohort, as 40% experienced Grade 2 or higher late toxicities. Conclusions: The use of definitive radiation therapy should be considered in selected patients with CUP in the soft tissues or nodal basins of the abdomen and pelvis.« less

Cost effectiveness of the addition of a comprehensive CT scan to the abdomen and pelvis for the detection of cancer after unprovoked venous thromboembolism.

PubMed

Coyle, Kathryn; Carrier, Marc; Lazo-Langner, Alejandro; Shivakumar, Sudeep; Zarychanski, Ryan; Tagalakis, Vicky; Solymoss, Susan; Routhier, Nathalie; Douketis, James; Coyle, Douglas

2017-03-01

Unprovoked venous thromboembolism (VTE) can be the first manifestation of cancer. It is unclear if extensive screening for occult cancer including a comprehensive computed tomography (CT) scan of the abdomen/pelvis is cost-effective in this patient population. To assess the health care related costs, number of missed cancer cases and health related utility values of a limited screening strategy with and without the addition of a comprehensive CT scan of the abdomen/pelvis and to identify to what extent testing should be done in these circumstances to allow early detection of occult cancers. Cost effectiveness analysis using data that was collected alongside the SOME randomized controlled trial which compared an extensive occult cancer screening including a CT of the abdomen/pelvis to a more limited screening strategy in patients with a first unprovoked VTE, was used for the current analyses. Analyses were conducted with a one-year time horizon from a Canadian health care perspective. Primary analysis was based on complete cases, with sensitivity analysis using appropriate multiple imputation methods to account for missing data. Data from a total of 854 patients with a first unprovoked VTE were included in these analyses. The addition of a comprehensive CT scan was associated with higher costs ($551 CDN) with no improvement in utility values or number of missed cancers. Results were consistent when adopting multiple imputation methods. The addition of a comprehensive CT scan of the abdomen/pelvis for the screening of occult cancer in patients with unprovoked VTE is not cost effective, as it is both more costly and not more effective in detecting occult cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

In vitro bone strain distributions in a sample of primate pelves

PubMed Central

Lewton, Kristi L

2015-01-01

The pelvis is a critical link in the hindlimb locomotor system and has a central role in resisting loads associated with locomotion, but our understanding of its structural biomechanics is quite limited. Empirical data on how the pelvis responds to the loads it encounters are important for understanding pelvic adaptation to locomotion, and for testing hypotheses regarding how the pelvis is adapted to its mechanical demands. This paper presents in vitro strain gauge data on a sample of monkey and ape cadaveric specimens (Macaca, Papio, Ateles, Hylobates), and assesses strain magnitudes and distributions through the bones of the pelvis: the ilium, ischium and pubis. Pelves were individually mounted in a materials testing system, loads were applied across three hindlimb angular positions, and strains were recorded from 18 locations on the pelvic girdle. Peak principal strains range from 2000 to 3000 με, similar to peak strains recorded from other mammals in vivo. Although previous work has suggested that the bones of the pelvis may act as bent beams, this study suggests that there are likely additional loading regimes superimposed on bending. Specifically, these data suggest that the ilium is loaded in axial compression and torsion, the ischium in torsion, the pubic rami in mediolateral bending, and the pubic symphysis is loaded in a combination of compression and torsion. Compressive strains dominate the pelves of all species representatives. Shear strains change with limb position; hip flexion at 45 ° induces smaller shear strains than mid-stance (90 °) or hip extension (105 °). The pelvic girdle is a complex structure that does not lend itself easily to modeling, but finite element analyses may prove useful to generate and refine hypotheses of pelvic biomechanics. PMID:25846322

Evaluation of testicular dose and associated risk from common pelvis radiation therapy in Iran.

PubMed

Shanei, Ahmad; Baradaran-Ghahfarokhi, Milad

2014-12-01

This study aimed to investigate testicular dose (TD) and the associated risk of heritable disease from common pelvis radiotherapy of male patients in Iran. In this work, the relation between TD and changes in beam energy, pelvis size, source to skin distance (SSD) and beam directions (anterior or posterior) was also evaluated. The values of TDs were measured on 67 randomly selected male patients during common pelvis radiotherapy using 1.17 and 1.33 MeV, Theratron Cobalt-60 unit at SSD of 80 cm and 9 MV, Neptun 10 PC and 18 MV, GE Saturne 20 at SSD of 100 cm at Seyed-Al Shohada Hospital, Isfahan, Iran. Results showed that, the maximum TD was up to 12% of the tumor dose. Considering the risk factor for radiation-induced heritable disorders of 0.1% per Sv, an excess risk of hereditary disorders of 72 per 10,000 births was conservatively calculated. There was a significant difference in the measured TD using different treatment machines and energies (P < 0.001). The Pearson Correlation test showed that, as expected, there was a correlation between TD and patient's pelvis size (r = 0.275, P < 0.001). Using the student's t-tests, it was found that, there was not a significant difference between TD and beam direction (P = 0.231). Iranian male patients undergoing pelvic radiotherapy have the potential of receiving a TD of more than 1 Gy which might result in temporary azoospermia. The risk for induction of hereditary disorders in future generations should be considered as low but not negligible in comparison with the correspondent nominal risk. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Trunk-pelvis coordination during turning: A cross sectional study of young adults with and without a history of low back pain.

PubMed

Smith, Jo Armour; Kulig, Kornelia

2016-07-01

During steady-state locomotion, symptomatic individuals with low back pain demonstrate reduced ability to modulate coordination between the trunk and the pelvis in the axial plane. It is unclear if this is also true during functional locomotor perturbations such as changing direction, or if this change in coordination adaptability persists between symptomatic episodes. The purpose of this study was to compare trunk-pelvis coordination during walking turns in healthy individuals and asymptomatic individuals with a history of low back pain. Participants performed multiple ipsilateral turns. Axial plane inter-segmental coordination and stride-to-stride coordination variability were quantified using the vector coding technique. Frequency of coordination mode and amplitude of coordination variability was compared between groups using Wilcoxon signed-rank tests and paired t-tests respectively. During stance phase of the turn, there was no significant difference in either inter-segmental coordination or coordination variability between groups. Inter-segmental coordination between the trunk and the pelvis was predominantly inphase during this part of the turn. During swing phase, patterns of coordination were more diversified, and individuals with a history of low back pain had significantly greater trunk phase coordination than healthy controls. Coordination variability was the same in both groups. Changes in trunk-pelvis coordination are evident between symptomatic episodes in individuals with a history of low back pain. However, previously demonstrated decreases in coordination variability were not found between symptomatic episodes in individuals with recurrent low back pain and therefore may represent a response to concurrent pain rather than a persistent change in motor control. Copyright © 2016 Elsevier Ltd. All rights reserved.

SU-F-J-48: Effect of Scan Length On Magnitude of Imaging Dose in KV CBCT

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

Deshpande, S; Naidu, S; Sutar, A

Purpose: To study effect of scan length on magnitude of imaging dose deposition in Varian kV CBCT for head & neck and pelvis CBCT. Methods: To study effect of scan length we measured imaging dose at depth of 8 cm for head and neck Cone Beam Computed Tomography (CBCT) acquisition ( X ray beam energy is used 100kV and 200 degree of gantry rotation) and at 16 cm depth for pelvis CBCT acquisition ( X ray beam energy used is 125 kV and 360 degree of gantry rotation) in specially designed phantom. We used farmer chamber which was calibrated inmore » kV X ray range for measurements .Dose was measured with default field size, and reducing field size along y direction to 10 cm and 5 cm. Results: As the energy of the beam decreases the scattered radiation increases and this contributes significantly to the dose deposited in the patient. By reducing the scan length to 10 Cm from default 20.6 cm we found a dose reduction of 14% for head and neck CBCT protocol and a reduction of 26% for pelvis CBCT protocol. Similarly for a scan length of 5cm compared to default the dose reduction in head and neck CBCT protocol is 36% while in the pelvis CBCT protocol the dose reduction is 50%. Conclusion: By limiting the scan length we can control the scatter radiation generated and hence the dose to the patient. However the variation in dose reduction for same length used in two protocols is because of the scan geometry. The pelvis CBCT protocol uses a full rotation and head and neck CBCT protocol uses partial rotation.« less

Pitfalls of diffusion-weighted imaging of the female pelvis

PubMed Central

Duarte, Ana Luisa; Dias, João Lopes; Cunha, Teresa Margarida

2018-01-01

Diffusion-weighted imaging (DWI) is widely used in protocols for magnetic resonance imaging (MRI) of the female pelvis. It provides functional and structural information about biological tissues, without the use of ionizing radiation or intravenous administration of contrast medium. High signal intensity on DWI with simultaneous low signal intensity on apparent diffusion coefficient maps is usually associated with malignancy. However, that pattern can also be seen in many benign lesions, a fact that should be recognized by radiologists. Correlating DWI findings with those of conventional (T1- and T2-weighted) MRI sequences and those of contrast-enhanced MRI sequences is mandatory in order to avoid potential pitfalls. The aim of this review article is the description of the most relevant physiological and benign pathological conditions of the female pelvis that can show restricted diffusion on DWI. PMID:29559764

Trans-sacral resection of a solitary fibrous tumor in the pelvis: report of a case.

PubMed

Katsuno, Hidetoshi; Maeda, Koutarou; Hanai, Tsunekazu; Sato, Harunobu; Masumori, Koji; Koide, Yoshikazu; Matsuoka, Hiroshi; Noro, Tomohito; Takakuwa, Yasunari; Hanaoka, Ryouta

2011-11-01

Solitary fibrous tumors (SFTs) develop most commonly in the pleura, although they have occasionally been reported to arise in the pelvic cavity. We report a case of an SFT presenting as a painless nodule in the pelvis of a 56-year-old woman. Histologically, the tumor was composed of spindle-shaped cells arranged without pattern, with short and narrow fascicles and interspersed bundles of thick collagen, and numerous blood vessels with a focally hemangiopericytoma-like appearance. Immunohistochemically, the tumor cells strongly expressed vimentin, CD34, and bcl-2. The tumor was excised via a trans-sacral approach, without preoperative transcatheter embolization, and the patient remains well more than 2 years after her operation. To our knowledge, this is the first case of an SFT in the pelvis, which was excised completely via a trans-sacral approach.

Analysis of Activity Patterns and Performance in Polio Survivors

DTIC Science & Technology

2006-10-01

variable were inspected for asymmetry and long-tailedness and normality. When appropriate, transformations (e.g. log function) were made. Data were...thighs and a combined pelvis -HAT segment was used for our analyses. The ankles were modeled as universal joints, the knees as revolutes, and the...segment, lumped pelvis + HAT, universal ankle, revolute knee, spherical hip; pin at CP entire stance Stance sagittal knee and frontal hip

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

Teplick, J.G.; Head, G.L.; Kricun, M.E.

In 2 adults who had received thorotrast intravenously at ages 2 and 3 years, respectively, radiopaque outlines of their infantile vertebrae were seen in the adult vertebrae. Similar ghosts of the hemipelves were present in the pelvis of 1 patient. Autopsy findings and autoradiographs in 1 patient strongly suggest that persisting thorotrast deposits in the infantile vertebrae and pelvis have produced a chronic radiation osteitis and dense thickened bone trabeculae, which are more radiopaque than the surrounding adult bone.

Limb/pelvis hypoplasia/aplasia with skull defect (Schinzel phocomelia): distinctive features and prenatal detection.

PubMed

Olney, R S; Hoyme, H E; Roche, F; Ferguson, K; Hintz, S; Madan, A

2001-11-01

Schinzel phocomelia syndrome is characterized by limb/pelvis hypoplasia/aplasia: specifically, intercalary limb deficiencies and absent or hypoplastic pelvic bones. The phenotype is similar to that described in a related multiple malformation syndrome known as Al-Awadi/Raas-Rothschild syndrome. The additional important feature of large parietooccipital skull defects without meningocele, encephalocele, or other brain malformation has thus far been reported only in children with Schinzel phocomelia syndrome. We recently evaluated a boy affected with Schinzel phocomelia born to nonconsanguineous healthy parents of Mexican origin. A third-trimester fetal ultrasound scan showed severe limb deficiencies and an absent pelvis. The infant died shortly after birth. Dysmorphology examination, radiographs, and autopsy revealed quadrilateral intercalary limb deficiencies with preaxial toe polydactyly; an absent pelvis and a 7 x 3-cm skull defect; and extraskeletal anomalies including microtia, telecanthus, micropenis with cryptorchidism, renal cysts, stenosis of the colon, and a cleft alveolar ridge. A normal 46,XY karyotype was demonstrated, and autosomal recessive inheritance was presumed on the basis of previously reported families. This case report emphasizes the importance of recognizing severe pelvic and skull deficiencies (either post- or prenatally) in differentiating infants with Schinzel phocomelia from other multiple malformation syndromes that feature intercalary limb defects, including thalidomide embryopathy and Roberts-SC phocomelia. Copyright 2001 Wiley-Liss, Inc.

Accuracy and Reliability of Marker-Based Approaches to Scale the Pelvis, Thigh, and Shank Segments in Musculoskeletal Models.

PubMed

Kainz, Hans; Hoang, Hoa X; Stockton, Chris; Boyd, Roslyn R; Lloyd, David G; Carty, Christopher P

2017-10-01

Gait analysis together with musculoskeletal modeling is widely used for research. In the absence of medical images, surface marker locations are used to scale a generic model to the individual's anthropometry. Studies evaluating the accuracy and reliability of different scaling approaches in a pediatric and/or clinical population have not yet been conducted and, therefore, formed the aim of this study. Magnetic resonance images (MRI) and motion capture data were collected from 12 participants with cerebral palsy and 6 typically developed participants. Accuracy was assessed by comparing the scaled model's segment measures to the corresponding MRI measures, whereas reliability was assessed by comparing the model's segments scaled with the experimental marker locations from the first and second motion capture session. The inclusion of joint centers into the scaling process significantly increased the accuracy of thigh and shank segment length estimates compared to scaling with markers alone. Pelvis scaling approaches which included the pelvis depth measure led to the highest errors compared to the MRI measures. Reliability was similar between scaling approaches with mean ICC of 0.97. The pelvis should be scaled using pelvic width and height and the thigh and shank segment should be scaled using the proximal and distal joint centers.

Effect of staff training on radiation dose in pediatric CT.

PubMed

Hojreh, Azadeh; Weber, Michael; Homolka, Peter

2015-08-01

To evaluate the efficacy of staff training on radiation doses applied in pediatric CT scans. Pediatric patient doses from five CT scanners before (1426 scans) and after staff training (2566 scans) were compared statistically. Examinations included cranial CT (CCT), thoracic, abdomen-pelvis, and trunk scans. Dose length products (DLPs) per series were extracted from CT dose reports archived in the PACS. A pooled analysis of non-traumatic scans revealed a statistically significant reduction in the dose for cranial, thoracic, and abdomen/pelvis scans (p<0.01). This trend could be demonstrated also for trunk scans, however, significance could not be established due to low patient frequencies (p>0.05). The percentage of scans performed with DLPs exceeding the German DRLs was reduced from 41% to 7% (CCT), 19% to 5% (thorax-CT), from 9% to zero (abdominal-pelvis CT), and 26% to zero (trunk; DRL taken as summed DRLs for thorax plus abdomen-pelvis, reduced by 20% accounting for overlap). Comparison with Austrian DRLs - available only for CCT and thorax CT - showed a reduction from 21% to 3% (CCT), and 15 to 2% (thorax CT). Staff training together with application of DRLs provide an efficient approach for optimizing radiation dose in pediatric CT practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The control of upper body segment speed and velocity during the golf swing.

PubMed

Horan, Sean A; Kavanagh, Justin J

2012-06-01

Understanding the dynamics of upper body motion during the downswing is an important step in determining the control strategies required for a successful and repeatable golf swing. The purpose of this study was to examine the relationship between head, thorax, and pelvis motion, during the downswing of professional golfers. Three-dimensional data were collected for 14 male professional golfers (age 27 +/- 8 years, golf-playing experience 13.3 +/- 8 years) using an optical motion analysis system. The amplitude and timing of peak speed and peak velocities were calculated for the head, thorax, and pelvis during the downswing. Cross-correlation analysis was used to examine the strength of coupling and phasing between and within segments. The results indicated the thorax segment had the highest peak speeds and peak velocities for the upper body during the downswing. A strong coupling relationship was evident between the thorax and pelvis (average R2 = 0.92 across all directions), while the head and thorax showed a much more variable relationship (average R2 = 0.76 across all directions). The strong coupling between the thorax and pelvis is possibly a method for simplifying the motor control strategy used during the downswing, and a way of ensuring consistent motor patterns.

The role of pelvis-thorax coupling in controlling within-golf club swing speed.

PubMed

Lamb, Peter F; Pataky, Todd C

2018-02-23

Pelvis-thorax coordination has been recognised to be associated with swing speed. Increasing angular separation between the pelvis and thorax has been thought to initiate the stretch shortening cycle and lead to increased clubhead speed. The purpose of this study was to determine whether pelvis-thorax coupling played a significant role in regulating clubhead speed, in a group of low-handicap golfers (mean handicap = 4.1). Sixteen participants played shots to target distances determined based on their typical 5- and 6-iron shot distances. Half the difference between median 5- and 6-iron distance for each participant was used to create three swing effort conditions: "minus", "norm", and "plus". Ten shots were played under each swing effort condition using both the 5-iron and 6-iron, resulting in six shot categories and 60 shots per participant. No significant differences were found for X-factor for club or swing effort. X-factor stretch showed significant differences for club and swing effort. Continuous relative phase (CRP) results mainly showed evidence of the stretch shortening cycle in the downswing and that it was more pronounced late in the downswing as swing effort increased. Substantial inter-individual CRP variability demonstrated the need for individual analyses when investigating coordination in the golf swing.

Repeatability of three-dimensional thorax and pelvis kinematics in the golf swing measured using a field-based motion capture system.

PubMed

Evans, Kerrie; Horan, Sean A; Neal, Robert J; Barrett, Rod S; Mills, Peter M

2012-06-01

Field-based methods of evaluating three-dimensional (3D) swing kinematics offer coaches and researchers the opportunity to assess golfers in context-specific environments. The purpose of this study was to establish the inter-trial, between-tester, between-location, and between-day repeatability of thorax and pelvis kinematics during the downswing using an electromagnetic motion capture system. Two experienced testers measured swing kinematics in 20 golfers (handicap < or =14 strokes) on consecutive days in an indoor and outdoor location. Participants performed five swings with each of two clubs (five-iron and driver) at each test condition. Repeatability of 3D kinematic data was evaluated by computing the coefficient of multiple determination (CMD) and the systematic error (SE). With the exception of pelvis forward bend for between-day and between-tester conditions, CMDs exceeded 0.854 for all variables, indicating high levels of overall waveform repeatability across conditions. When repeatability was compared across conditions using MANOVA, the lowest CMDs and highest SEs were found for the between-tester and between-day conditions. The highest CMDs were for the inter-trial and between-location conditions. The absence of significant differences in CMDs between these two conditions supports this method of analysing pelvis and thorax kinematics in different environmental settings without unduly affecting repeatability.

Mechanical Perturbations of the Walking Surface Reveal Unaltered Axial Trunk Stiffness in Chronic Low Back Pain Patients

PubMed Central

Meijer, Onno G.

2016-01-01

Introduction Patients with chronic low back pain (CLBP) often demonstrate altered timing of thorax rotations in the transverse plane during gait. Increased axial trunk stiffness has been claimed to cause this movement pattern. Objectives The objective of this study was to assess whether axial trunk stiffness is increased in gait in CLBP patients. Methods 15 CLBP patients and 15 healthy controls walked on a treadmill that imposed rotational perturbations in the transverse plane. The effect of these perturbations on transverse pelvis, thorax and trunk (thorax relative to pelvis) rotations was evaluated in terms of residual rotations, i.e., the deviation of these movements from the unperturbed patterns. In view of the heterogeneity of the CLBP group, we additionally performed a subgroup comparison between seven patients and seven controls with maximal between-group contrast for timing of thorax rotations. Results Rotations of the walking surface had a clear effect on transverse pelvis, thorax and trunk rotations in all groups. No significant between-group differences on residual transverse pelvis, thorax and trunk rotations were observed. Conclusion Axial trunk stiffness in gait does not appear to be increased in CLBP. Altered timing of thorax rotations in CLBP does not seem to be a result of increased axial trunk stiffness. PMID:27310528

Prevalence of asymptomatic chondrocalcinosis in the pelvis.

PubMed

Stensby, James Derek; Lawrence, David A; Patrie, James T; Gaskin, Cree M

2016-07-01

To determine trends in incidentally detected age- and gender-associated chondrocalcinosis on pelvic CT. Twenty patients of each gender at the center of each decade of life who underwent a CT scan of the pelvis performed 2009-2013 were identified and selected for a total of 400 pelvic CTs. Images were reviewed independently by two radiologists for the presence or absence of chondrocalcinosis within the pelvis. Patients with hip or low back pain, known CPPD arthropathy or any known predisposing condition, prior hip arthroplasty, or articular fracture were excluded. Logistic regression was used to predict the presence/absence of chondrocalcinosis as a function of patient age and gender. The presence/absence of chondrocalcinosis was found to be associated with patient age (p = 0.016) but not patient gender (p = 0.929). In the pelvis, chondrocalcinosis was most frequently identified at the pubic symphysis. Incidental chondrocalcinosis was not identified in any patients under 50 years of age. Chondrocalcinosis increased in frequency from 12.5 at 55 years of age to 27.5 % of patients 95 years of age. Chondrocalcinosis is common and more prevalent in late adulthood, occurs without a gender predilection, and is infrequently identified in patients younger than 50 years of age.

Midline Dose Verification with Diode In Vivo Dosimetry for External Photon Therapy of Head and Neck and Pelvis Cancers During Initial Large-Field Treatments

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

Tung, Chuan-Jong; Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan; Yu, Pei-Chieh

2010-01-01

During radiotherapy treatments, quality assurance/control is essential, particularly dose delivery to patients. This study was designed to verify midline doses with diode in vivo dosimetry. Dosimetry was studied for 6-MV bilateral fields in head and neck cancer treatments and 10-MV bilateral and anteroposterior/posteroanterior (AP/PA) fields in pelvic cancer treatments. Calibrations with corrections of diodes were performed using plastic water phantoms; 190 and 100 portals were studied for head and neck and pelvis treatments, respectively. Calculations of midline doses were made using the midline transmission, arithmetic mean, and geometric mean algorithms. These midline doses were compared with the treatment planning systemmore » target doses for lateral or AP (PA) portals and paired opposed portals. For head and neck treatments, all 3 algorithms were satisfactory, although the geometric mean algorithm was less accurate and more uncertain. For pelvis treatments, the arithmetic mean algorithm seemed unacceptable, whereas the other algorithms were satisfactory. The random error was reduced by using averaged midline doses of paired opposed portals because the asymmetric effect was averaged out. Considering the simplicity of in vivo dosimetry, the arithmetic mean and geometric mean algorithm should be adopted for head/neck and pelvis treatments, respectively.« less

[3D modeling of the female pelvis by Computer-Assisted Anatomical Dissection: Applications and perspectives].

PubMed

Balaya, V; Uhl, J-F; Lanore, A; Salachas, C; Samoyeau, T; Ngo, C; Bensaid, C; Cornou, C; Rossi, L; Douard, R; Bats, A-S; Lecuru, F; Delmas, V

2016-05-01

To achieve a 3D vectorial model of a female pelvis by Computer-Assisted Anatomical Dissection and to assess educationnal and surgical applications. From the database of "visible female" of Visible Human Project(®) (VHP) of the "national library of medicine" NLM (United States), we used 739 transverse anatomical slices of 0.33mm thickness going from L4 to the trochanters. The manual segmentation of each anatomical structures was done with Winsurf(®) software version 4.3. Each anatomical element was built as a separate vectorial object. The whole colored-rendered vectorial model with realistic textures was exported in 3Dpdf format to allow a real time interactive manipulation with Acrobat(®) pro version 11 software. Each element can be handled separately at any transparency, which allows an anatomical learning by systems: skeleton, pelvic organs, urogenital system, arterial and venous vascularization. This 3D anatomical model can be used as data bank to teach of the fundamental anatomy. This 3D vectorial model, realistic and interactive constitutes an efficient educational tool for the teaching of the anatomy of the pelvis. 3D printing of the pelvis is possible with the new printers. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Genetics of canid skeletal variation: Size and shape of the pelvis

PubMed Central

Carrier, David R.; Chase, Kevin; Lark, Karl G.

2005-01-01

The mammalian skeleton presents an ideal system in which to study the genetic architecture of a set of related polygenic traits and the skeleton of the domestic dog (Canis familiaris) is arguably the best system in which to address the relationship between genes and anatomy. We have analyzed the genetic basis for skeletal variation in a population of >450 Portuguese Water Dogs. At this stage of this ongoing project, we have identified >40 putative quantitative trait loci (QTLs) for heritable skeletal phenotypes located on 22 different chromosomes, including the “X.” A striking aspect of these is the regulation of suites of traits representing bones located in different parts of the skeleton but related by function. Here we illustrate this by describing genetic variation in postcranial morphology. Two suites of traits are involved. One regulates the size of the pelvis relative to dimensions of the limb bones. The other regulates the shape of the pelvis. Both are examples of trade-offs that may be prototypical of different breeds. For the size of the pelvis relative to limb bones, we describe four QTLs located on autosome CFA 12, 30, 31, and X. For pelvic shape we describe QTLs on autosome CFA 2, 3, 22, and 36. The relation of these polygenic systems to musculoskeletal function is discussed. PMID:16339381

Genetics of canid skeletal variation: size and shape of the pelvis.

PubMed

Carrier, David R; Chase, Kevin; Lark, Karl G

2005-12-01

The mammalian skeleton presents an ideal system in which to study the genetic architecture of a set of related polygenic traits and the skeleton of the domestic dog (Canis familiaris) is arguably the best system in which to address the relationship between genes and anatomy. We have analyzed the genetic basis for skeletal variation in a population of >450 Portuguese Water Dogs. At this stage of this ongoing project, we have identified >40 putative quantitative trait loci (QTLs) for heritable skeletal phenotypes located on 22 different chromosomes, including the "X." A striking aspect of these is the regulation of suites of traits representing bones located in different parts of the skeleton but related by function. Here we illustrate this by describing genetic variation in postcranial morphology. Two suites of traits are involved. One regulates the size of the pelvis relative to dimensions of the limb bones. The other regulates the shape of the pelvis. Both are examples of trade-offs that may be prototypical of different breeds. For the size of the pelvis relative to limb bones, we describe four QTLs located on autosome CFA 12, 30, 31, and X. For pelvic shape we describe QTLs on autosome CFA 2, 3, 22, and 36. The relation of these polygenic systems to musculoskeletal function is discussed.

VEGF Trap in Treating Patients With Recurrent, Locally Advanced, or Metastatic Cancer of the Urothelium

ClinicalTrials.gov

2014-10-10

Adenocarcinoma of the Bladder; Distal Urethral Cancer; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Proximal Urethral Cancer; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Squamous Cell Carcinoma of the Bladder; Stage III Bladder Cancer; Stage III Urethral Cancer; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Urethral Cancer Associated With Invasive Bladder Cancer

Rare calcium oxalate monohydrate calculus attached to the wall of the renal pelvis.

PubMed

Grases, Felix; Costa-Bauza, Antonia; Prieto, Rafael M; Saus, Carlos; Servera, Antonio; García-Miralles, Reyes; Benejam, Joan

2011-04-01

Most renal calculi can be classified using well-established criteria in a manner that reflects both composition and fine structure under specific pathophysiological conditions. However, when a large patient population is considered, rare renal calculi invariably appear, some of which have never been classified; careful study is required to establish stone etiology in such cases. The patient in the present case report formed two types of calculi. One was attached on the wall of the renal pelvis near the ureter and part of the calculus was embedded inside pelvic renal tissue. The calculus developed on an ossified calcification located in the pelvis tissue. Current knowledge on the development of calcification in soft tissues suggests a pre-existing injury as an inducer of its development. A mechanism of calculus formation is proposed. The second stone was a typical jack-stone calculus. © 2011 The Japanese Urological Association.

Comparative anatomy of the pelvic vessels in the bearded capuchin (Sapajus libidinosus) and baboons, apes and modern humans.

PubMed

Aversi-Ferreira, Roqueline A G M F; de Souza Vieira, Vanessa; Tomaz, Carlos; Aversi-Ferreira, Tales Alexandre

2014-01-01

Cebus/Sapajus has shown high cognitive and manipulatory behaviour as well as intermittent bipedalism. Although the function of the muscles and bones of this genus has been widely investigated, the arterial system that supports these tissues has not been studied in much detail, and a full description of the blood vessels of the pelvis is still missing. Therefore, we studied the vessels of the pelvis of Sapajus libidinosus in terms of their origin, distribution and muscle irrigation and compared them with those of other primates available in the literature. In general, the distribution pattern and origin of arteries in the pelvis of the bearded capuchin are more similar to those of baboons compared to other primates. This similarity may be because both have a tail, a similar body shape and use, preferentially, quadrupedal movement. 2014 S. Karger AG, Basel

The Aristotelian kidney.

PubMed

Marandola, P; Musitelli, S; Jallous, H; Speroni, A; de Bastiani, T

1994-01-01

Aristotle incorrectly observed the absence of the kidney in fish and birds and deduced that it was not essential for the existence of a living organism. This underlies his observations on structure and function of the kidney. From examination of rhesus monkeys he generalized that the right kidney is higher than the left. Aristotle did not consider that the renal pelvis is divided by a filter membrane into 2 chambers, and wrote that no blood reaches the renal pelvis. The theory of the 'filter kidney' cannot thus be attributed to Aristotle. The function of the kidney was described as being to separate the surplus liquid from the blood inside the renal meat (not in the renal pelvis) and to transform this liquid into what Aristotle called residuum, i.e. the urine. Aristotle also considered that the kidneys acted to anchor the blood vessels to the body. He only briefly considered renal pathology.

Human pelvis loading rig for static and dynamic stress analysis.

PubMed

Zanetti, Elisabetta M; Bignardi, Cristina; Audenino, Alberto L

2012-01-01

This work is aimed at designing and constructing a loading rig for the synthetic hemi-pelvis; this system has been conceived with the goal of applying differently oriented articular forces in order to experimentally test the stress distribution and the stability of surgical reconstructions like, for example, hip arthroplasty or pelvic fixation. This device can be interfaced with a usual loading machine; it preserves the anatomy of the hemi-pelvis; it is simply constrained and it allows the simulation of all physiologic activities. Moreover, the visual accessibility of the peri-acetabular area has been guaranteed and this is imperative in order to be able to perform full-field analyses like a thermoelastic or photoelastic stress analysis. First experimental trials have shown a good repeatability of loading-unloading cycles (<1.2%), a low hysteresis (<2.4%) and a good dynamic behaviour (up to 10 Hz loading frequencies).

Evaluation of dose from kV cone-beam computed tomography during radiotherapy: a comparison of methodologies

NASA Astrophysics Data System (ADS)

Buckley, J.; Wilkinson, D.; Malaroda, A.; Metcalfe, P.

2017-01-01

Three alternative methodologies to the Computed-Tomography Dose Index for the evaluation of Cone-Beam Computed Tomography dose are compared, the Cone-Beam Dose Index, IAEA Human Health Report No. 5 recommended methodology and the AAPM Task Group 111 recommended methodology. The protocols were evaluated for Pelvis and Thorax scan modes on Varian® On-Board Imager and Truebeam kV XI imaging systems. The weighted planar average dose was highest for the AAPM methodology across all scans, with the CBDI being the second highest overall. A 17.96% and 1.14% decrease from the TG-111 protocol to the IAEA and CBDI protocols for the Pelvis mode and 18.15% and 13.10% decrease for the Thorax mode were observed for the XI system. For the OBI system, the variation was 16.46% and 7.14% for Pelvis mode and 15.93% to the CBDI protocol in Thorax mode respectively.

The sacroiliac joint: an overview of its anatomy, function and potential clinical implications

PubMed Central

Vleeming, A; Schuenke, M D; Masi, A T; Carreiro, J E; Danneels, L; Willard, F H

2012-01-01

This article focuses on the (functional) anatomy and biomechanics of the pelvic girdle and specifically the sacroiliac joints (SIJs). The SIJs are essential for effective load transfer between the spine and legs. The sacrum, pelvis and spine, and the connections to the arms, legs and head, are functionally interrelated through muscular, fascial and ligamentous interconnections. A historical overview is presented on pelvic and especially SIJ research, followed by a general functional anatomical overview of the pelvis. In specific sections, the development and maturation of the SIJ is discussed, and a description of the bony anatomy and sexual morphism of the pelvis and SIJ is debated. The literature on the SIJ ligaments and innervation is discussed, followed by a section on the pathology of the SIJ. Pelvic movement studies are investigated and biomechanical models for SIJ stability analyzed, including examples of insufficient versus excessive sacroiliac force closure. PMID:22994881

[Design of Minimal Invasive Screw on Posterior Pelvis Ring and Pelvic Finite Element Analysis].

PubMed

Tang, Fan; Min, Li; Wang, Yan-Ling; Qu, Bo; Zhou, Yong; Luo, Yi; Zhang, Wen-Li; Shi, Rui; Duan, Hong; Tu, Chong-Qi

2017-09-01

To design minimal invasive screw on posterior pelvic ring and perform threedimensional finite element analysis based on a pelvis finite element model. We measured the pelvic anatomical data of 20 healthy volunteers and identified potential designs for minimal invasive screw on posterior pelvic ring. A finite element model of pelvis was then established. Threedimensional finite element analyses were performed under static and dynamic mechanical loading,respectively. Three screw tracks on ilium (A,B and C) were identified based on a threedimensional reconstruction of pelvis. Nail track B and C had greater length and width,but shorter distance between nailing and soft tissue compared with nail track A. Static loading under an external rotation load of 500 N generated a maximum Mises Von stress of 582.05 Pa and sacral iliac complex of 107.38 Pa. The greatest strain was located at the articular cartilage on the side of the nail,followed by lateral sacral joint cartilage and symphysis pubis. The largest displacement was located at the ilium on the side of the nail,with a gradient decrease to the opposite side. The largest displacement of the anterior superior iliac spine was 0.35 cm on the side of the nail. The dynamic loading identified displacement of the anterior superior iliac spine with 1.5 mm in Z axis,1.8 mm in X axis and -0.2 mm in Y axis; and displacement of the pubic bone with 0.8 mm in Z axis,1.0 mm in X axis and 0.03 mm in Y axis. The maximum displacement appeared along the impact direction: Y axis. Relatively large equivalent stress was found in pubis and ischium,anterior superior iliac spine,sacrum,acetabular that are prone to fracture. With increased impact force,the stress of pelvis increased over time. The maximum impact force,stress and displacement of the pelvis occurred at 10 ms when peak force was reached. Under the impact of 4 000 N and 5 000 N,the bone was subject to a stress level of over 200 MPa,exceeding its average yield strength,which suggests a possibility of pelvic fracture. Taking B/C as a main screw track and A as an auxiliary screw track is a reasonable choice. The pelvic finite element model lays a foundation for further studies into sacral fracture and design of screw tracks.

Video raster stereography back shape reconstruction: a reliability study for sagittal, frontal, and transversal plane parameters.

PubMed

Schroeder, J; Reer, R; Braumann, K M

2015-02-01

As reliability of raster stereography was proved only for sagittal plane parameters with repeated measures on the same day, the present study was aiming at investigating variability and reliability of back shape reconstruction for all dimensions (sagittal, frontal, transversal) and for different intervals. For a sample of 20 healthy volunteers, intra-individual variability (SEM and CV%) and reliability (ICC ± 95% CI) were proved for sagittal (thoracic kyphosis, lumbar lordosis, pelvis tilt angle, and trunk inclination), frontal (pelvis torsion, pelvis and trunk imbalance, vertebral side deviation, and scoliosis angle), transversal (vertebral rotation), and functional (hyperextension) spine shape reconstruction parameters for different test-retest intervals (on the same day, between-day, between-week) by means of video raster stereography. Reliability was high for the sagittal plane (pelvis tilt, kyphosis and lordosis angle, and trunk inclination: ICC > 0.90), and good to high for lumbar mobility (0.86 < ICC < 0.97). Apart from sagittal plane spinal alignment, there was a lack of certainty for a high reproducibility indicated by wider ICC confidence intervals. So, reliability was fair to high for vertebral side deviation and the scoliosis angle (0.71 < ICC < 0.95), and poor to good for vertebral rotation values as well as for frontal plane upper body and pelvis position parameters (0.65 < ICC < 0.92). Coefficients for the between-day and between-week interval were a little lower than for repeated measures on the same day. Variability (SEM) was less than 1.5° or 1.5 mm, except for trunk inclination. Relative variability (CV) was greater in global trunk position and pelvis parameters (35-98%) than in scoliosis (14-20%) or sagittal sway parameters (4-8 %). Although we found a lower reproducibility for the frontal plane, raster stereography is considered to be a reliable method for the non-invasive, three-dimensional assessment of spinal alignment in normal non-scoliotic individuals in the sagittal plane and partly for scoliosis parameters, which fulfils scientific as well as practical recommendations for spine shape screening and monitoring, but cross-sectional or follow-up effect analyses should take into account the degree of reliability differing in various spine shape parameters. Further investigations should be conducted to analyse reliability in scoliosis patients with differing spinal deformities.

Estimation of pelvis kinematics in level walking based on a single inertial sensor positioned close to the sacrum: validation on healthy subjects with stereophotogrammetric system.

PubMed

Buganè, Francesca; Benedetti, Maria Grazia; D'Angeli, Valentina; Leardini, Alberto

2014-10-21

Kinematics measures from inertial sensors have a value in the clinical assessment of pathological gait, to track quantitatively the outcome of interventions and rehabilitation programs. To become a standard tool for clinicians, it is necessary to evaluate their capability to provide reliable and comprehensible information, possibly by comparing this with that provided by the traditional gait analysis. The aim of this study was to assess by state-of-the-art gait analysis the reliability of a single inertial device attached to the sacrum to measure pelvis kinematics during level walking. The output signals of the three-axis gyroscope were processed to estimate the spatial orientation of the pelvis in the sagittal (tilt angle), frontal (obliquity) and transverse (rotation) anatomical planes These estimated angles were compared with those provided by a 8 TV-cameras stereophotogrammetric system utilizing a standard experimental protocol, with four markers on the pelvis. This was observed in a group of sixteen healthy subjects while performing three repetitions of level walking along a 10 meter walkway at slow, normal and fast speeds. The determination coefficient, the scale factor and the bias of a linear regression model were calculated to represent the differences between the angular patterns from the two measurement systems. For the intra-subject variability, one volunteer was asked to repeat walking at normal speed 10 times. A good match was observed for obliquity and rotation angles. For the tilt angle, the pattern and range of motion was similar, but a bias was observed, due to the different initial inclination angle in the sagittal plane of the inertial sensor with respect to the pelvis anatomical frame. A good intra-subject consistency has also been shown by the small variability of the pelvic angles as estimated by the new system, confirmed by very small values of standard deviation for all three angles. These results suggest that this inertial device is a reliable alternative to stereophotogrammetric systems for pelvis kinematics measurements, in addition to being easier to use and cheaper. The device can provide to the patient and to the examiner reliable feedback in real-time during routine clinical tests.

Pelvic lymph node dissection in early ovarian cancer: success of retrieval of lymph nodes by individual lymph node groups in respect to pelvic laterality.

PubMed

Mujezinović, Faris; Takac, Iztok

2010-08-01

To evaluate the differences in number of harvested retroperitoneal pelvic lymph nodes by specific lymph node regions in respect to pelvic laterality. We extracted cases of early ovarian cancer (EOC) with lymphadenectomy from the medical database which were treated at our institution in the period between 1994 and 2008. Recommendations of FIGO and EGSOC (European Guidelines for Staging in Ovarian Cancer) for staging of ovarian malignancies were followed. Stage of the disease was established on the basis of intra-abdominal condition which we found during surgery and histopathologic status of retroperitoneal lymph nodes (LN). For each case and every LN group, we subtracted the number of dissected lymph nodes on the left side from the number of dissected lymph nodes on the right side of the pelvis. The result would represent the difference between number of removed LN on each side of the pelvis for specific LN group. A negative difference means that a greater number of LN was extracted from the left side and a positive difference that the greater number of LN was extracted from the right side of the pelvis. We used Wilcoxon signed-rank test for statistical analysis of differences. 48 cases with EOC underwent lymphadenectomy. In three cases, metastatic retroperitoneal pelvic lymph nodes were found. There were 79.1%, 50.0%, 45.8%, 93.8%, 52.1%, 60.4% and 70.8% of cases with left-right difference in number of removed lymph nodes in external iliac region, common iliac region, presacralic, above obturator nerve, under obturator nerve, lateral from the external ilac vessels and lateral from the common iliac vessels nodal group, respectively. The mean differences between left and right groups were in the range from 2 to 4 lymph nodes. There was no identifiable bias toward either side of the pelvis for any of the analyzed lymph node groups. There is a right and left prevalence of retrieved LN by individual LN regions in the pelvis that could be influenced by asymmetry in right-left pelvic LN distribution. However, we did not find any evidence that the observed imbalance is, on average, directed toward either side of the pelvis. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Investigation of Aircrew Protection During Emergency Escape at Dynamic Pressures up to 1600 Q.

DTIC Science & Technology

1982-05-01

Speed Ejections 14 4 Torso Airflow Stagnation Fence Arm Restraints 16 5 Upper Torso Support Restraint Garment 21 6 Multiaxial Pelvis Restraint 22 7...aircraft. Designs, such as the pelvis and leg elevating (PALE) seats, fixed reclined seats, or pressurized vests, are viable concepts for high sustained...final comment on direct energy transfer from the lower legs to the ai rmass involves aerodynamic asymmetry of the booted foot. Such asymmetry could lead

A Manual for the Performance of Protective Equipment Fit-Mapping

DTIC Science & Technology

2009-10-01

is not right, the grain would be neither perpendicular nor parallel to the floor. This causes unnecessary wrinkles and asymmetry of the right and...Prominent, anterior point on the anterior rim of the ilia. Note: The ilia are one of the three pair of bones that comprise the bony pelvis . 71...the three pair of bones that comprise the bony pelvis . Landmark Name: Iliocristale, Left and Right ISO Definition No. N/A CAESAR Name

Pelvic girdle and fin of Tiktaalik roseae

PubMed Central

Shubin, Neil H.; Daeschler, Edward B.; Jenkins, Farish A.

2014-01-01

A major challenge in understanding the origin of terrestrial vertebrates has been knowledge of the pelvis and hind appendage of their closest fish relatives. The pelvic girdle and appendage of tetrapods is dramatically larger and more robust than that of fish and contains a number of structures that provide greater musculoskeletal support for posture and locomotion. The discovery of pelvic material of the finned elpistostegalian, Tiktaalik roseae, bridges some of these differences. Multiple isolated pelves have been recovered, each of which has been prepared in three dimensions. Likewise, a complete pelvis and partial pelvic fin have been recovered in association with the type specimen. The pelves of Tiktaalik are paired and have broad iliac processes, flat and elongate pubes, and acetabulae that form a deep socket rimmed by a robust lip of bone. The pelvis is greatly enlarged relative to other finned tetrapodomorphs. Despite the enlargement and robusticity of the pelvis of Tiktaalik, it retains primitive features such as the lack of both an attachment for the sacral rib and an ischium. The pelvic fin of Tiktaalik (NUFV 108) is represented by fin rays and three endochondral elements: other elements are not preserved. The mosaic of primitive and derived features in Tiktaalik reveals that the enhancement of the pelvic appendage of tetrapods and, indeed, a trend toward hind limb-based propulsion have antecedents in the fins of their closest relatives. PMID:24449831

Biomechanical study of three kinds of internal fixation for the treatment of sacroiliac joint disruption using biomechanical test and finite element analysis.

PubMed

Wu, Tao; Ren, Xuejiao; Cui, Yunwei; Cheng, Xiaodong; Peng, Shuo; Hou, Zhiyong; Han, Yongtai

2018-06-19

To compare the stability of sacroiliac joint disruption fixed with three kinds of internal fixation using both biomechanical test and finite element analysis. Five embalmed specimens of an adult were used. The symphysis pubis rupture and left sacroiliac joint disruption were created. The symphysis pubis was stabilized with a five-hole plate. The sacroiliac joint disruption was fixed with three kinds of internal fixation in a randomized design. Displacements of the whole specimen and shifts in the gap were recorded. Three-dimensional finite element models of the pelvis, the pelvis with symphysis pubis rupture and left sacroiliac joint disruption, and three kinds of internal fixation techniques were created and analyzed. Under the vertical load, the displacements and shifts in the gap of the pelvis fixed with minimally invasive adjustable plate (MIAP) combined with one iliosacral (IS) screw were the smallest, and the average displacements of the pelvis fixed with an anterior plate were the largest one. The differences among them were significant. In finite element analysis and MIAP combined with one IS screw fixation showed relatively best fixation stability and lowest risks of implant failure than two IS screws fixation and anterior plate fixation. The stability of sacroiliac joint disruption fixed with MIAP combined with one IS screw is better than that fixed with two IS screws and anterior plate under vertical load.

The role of upper torso and pelvis rotation in driving performance during the golf swing.

PubMed

Myers, Joseph; Lephart, Scott; Tsai, Yung-Shen; Sell, Timothy; Smoliga, James; Jolly, John

2008-01-15

While the role of the upper torso and pelvis in driving performance is anecdotally appreciated by golf instructors, their actual biomechanical role is unclear. The aims of this study were to describe upper torso and pelvis rotation and velocity during the golf swing and determine their role in ball velocity. One hundred recreational golfers underwent a biomechanical golf swing analysis using their own driver. Upper torso and pelvic rotation and velocity, and torso-pelvic separation and velocity, were measured for each swing. Ball velocity was assessed with a golf launch monitor. Group differences (groups based on ball velocity) and moderate relationships (r > or = 0.50; P < 0.001) were observed between an increase in ball velocity and the following variables: increased torso-pelvic separation at the top of the swing, maximum torso-pelvic separation, maximum upper torso rotation velocity, upper torso rotational velocity at lead arm parallel and last 40 ms before impact, maximum torso-pelvic separation velocity and torso-pelvic separation velocity at both lead arm parallel and at the last 40 ms before impact. Torso-pelvic separation contributes to greater upper torso rotation velocity and torso-pelvic separation velocity during the downswing, ultimately contributing to greater ball velocity. Golf instructors can consider increasing ball velocity by maximizing separation between the upper torso and pelvis at the top of and initiation of the downswing.

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

PubMed

Tateuchi, Hiroshige; Wada, Osamu; Ichihashi, Noriaki

2011-06-01

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

[Diagnosis and differential diagnosis for solitary fibrous tumor in the abdomen and pelvis by CT].

PubMed

Liu, Huaping; Li, Wenzheng; Yi, Xiaoping; Pei, Yigang; Liu, Hui; Zhao, Wei; Liu, Wenguang; Hou, Jiale; Ghimire, Obin

2017-04-28

To study the CT features for solitary fibrous tumor (SFT) in the abdomen and pelvis and to improve the diagnostic accuracy.
 Methods: Fourteen patients with SFT were collected in our hospital from January, 2011 to December, 2015. Characteristic of images were analyzed and compared for 10 SFT, which located outside the abdominal organs with extragastrointestinal stromal tumors (EGIST), leiomyosarcoma, and schwannoma.
 Results: Necrosis and cystic formation were frequently present in SFT in the abdomen and pelvis. CE-CT showed serpentine vessels along the periphery, while pattern of enhancement was map-like inhomogeneous progressive. Comparing with the EGIST or schwannoma, the difference of CT value in non-contrast and the arterial phase were statistically significant (P<0.05). The numbers of peritumoral circuity vessel were significantly different between SFT and EGIST (χ²=18.27, P<0.008) or between SFT and schwannoma (χ²=19.25, P<0.008). Comparing with the leiomyosarcoma or schwannoma, SFT located outside the abdominal organs. We found that tumor necrosis rate was significantly different between SFT and leiomyoscarcoma (χ²=8.00, P<0.008).
 Conclusion: SFT in the abdomen and pelvis show certain CT characteristics. The CT value in non-contrast and at the arterial phase, tumor necrosis rate, and serpentine vessels along the periphery were pivotal in differentiating SFT from leiomyosarcoma, EGIST and schwannoma.

Bony Pelvis Dimensions in Women With and Without Stress Urinary Incontinence

PubMed Central

Berger, Mitchell B.; Doumouchtsis, Stergios K.; DeLancey, John O.

2012-01-01

AIMS To test the null hypothesis that bony pelvis dimensions are similar in women with and without stress urinary incontinence, both in the postpartum and midlife periods. METHODS Secondary analyses were performed of two case-control studies comparing women with stress urinary incontinence to asymptomatic controls. One study examined primiparas in the first 9–12 months postpartum; the other study involved middle-aged women. Stress urinary incontinence was confirmed by full-bladder stress test. All subjects underwent pelvic magnetic resonance imaging. The interspinous and intertuberous diameters, subpubic angle and sacrococcygeal joint-to-the inferior pubic point distance were measured from the images independently by two authors. RESULTS In the young cohorts, we compared primiparas with de novo postpartum stress urinary incontinence to both continent primiparas and nulliparas. Postpartum stress urinary incontinence is associated with a wider subpubic angle. There is also a trend towards wider interspinous and intertuberous diameters in the stress-incontinent primiparas as compared to the continent cohorts, although this did not reach statistical significance with our sample sizes. By contrast, no significant differences in bony pelvis dimensions were identified when comparing middle-aged women with stress urinary incontinence and their continent controls. CONCLUSIONS Bony pelvis dimensions are different in women with stress urinary incontinence than in matched continent controls. However, these differences are only identified in young primiparas in the postpartum period, not in middle-aged women. PMID:22674676

Utility of preoperative ferumoxtran-10 MRI to evaluate retroperitoneal lymph node metastasis in advanced cervical cancer: Results of ACRIN 6671/GOG 0233☆

PubMed Central

Atri, Mostafa; Zhang, Zheng; Marques, Helga; Gorelick, Jeremy; Harisinghani, Mukesh; Sohaib, Aslam; Koh, Dow-Mu; Raman, Steven; Gee, Michael; Choi, Haesun; Landrum, Lisa; Mannel, Robert; Chuang, Linus; Yu, Jian Qin (Michael); McCourt, Carolyn Kay; Gold, Michael

2014-01-01

Rationale and objectives To assess if ferumoxtran-10 (f-10) improves accuracy of MRI to detect lymph node (LN) metastasis in advanced cervical cancer. Materials and methods F-10 MRI component of an IRB approved HIPAA compliant ACRIN/GOG trial was analyzed. Patients underwent f-10 MRI followed by extra-peritoneal or laparoscopic pelvic and abdominal lymphadenectomy. F-10-sensitive sequences were T2* GRE sequences with TE of 12 and 21. Seven independent blinded readers reviewed f-10-insensitive sequences and all sequences in different sessions. Region correlations were performed between pathology and MRI for eight abdomen and pelvis regions. Sensitivity and specificity were calculated at participant level. Reference standard is based on pathology result of surgically removed LNs. Results Among 43 women enrolled in the trial between September 2007 and November 2009, 33 women (mean age 49 ± 11 years old) with advanced cervical cancer (12 IB2, 3 IIA, 15 IIB and 3 IIIB, 29 squamous cell carcinomas, 32 grade 2 or 3) were evaluable. Based on histopathology, LN metastasis was 39% in abdomen and 70% in pelvis. Sensitivity of all sequence review in pelvis, abdomen, and combined were 83%, 60%, and 86%, compared with 78%, 54%, and 80% for f-10 insensitive sequences (P: 0.24, 0.44 and 0.14, respectively). Mean diameter of the largest positive focus on histopathology was 13.7 mm in abdomen and 18.8 mm in pelvis (P = 0.018). Specificities of all sequence review in pelvis, abdomen, and combined were 48%, 75%, and 43%, compared with 75%, 83%, and 73% (P: 0.003, 0.14, 0.002 respectively) for f-10 insensitive sequences. Conclusion Addition of f-10 increased MRI sensitivity to detect LN metastasis in advanced cervical cancer. Increased sensitivity did not reach statistical significance and was at the expense of lower specificity. PMID:25774381

Utility of preoperative ferumoxtran-10 MRI to evaluate retroperitoneal lymph node metastasis in advanced cervical cancer: Results of ACRIN 6671/GOG 0233.

PubMed

Atri, Mostafa; Zhang, Zheng; Marques, Helga; Gorelick, Jeremy; Harisinghani, Mukesh; Sohaib, Aslam; Koh, Dow-Mu; Raman, Steven; Gee, Michael; Choi, Haesun; Landrum, Lisa; Mannel, Robert; Chuang, Linus; Yu, Jian Qin Michael; McCourt, Carolyn Kay; Gold, Michael

To assess if ferumoxtran-10 (f-10) improves accuracy of MRI to detect lymph node (LN) metastasis in advanced cervical cancer. F-10 MRI component of an IRB approved HIPAA compliant ACRIN/GOG trial was analyzed. Patients underwent f-10 MRI followed by extra-peritoneal or laparoscopic pelvic and abdominal lymphadenectomy. F-10-sensitive sequences were T2* GRE sequences with TE of 12 and 21. Seven independent blinded readers reviewed f-10-insensitive sequences and all sequences in different sessions. Region correlations were performed between pathology and MRI for eight abdomen and pelvis regions. Sensitivity and specificity were calculated at participant level. Reference standard is based on pathology result of surgically removed LNs. Among 43 women enrolled in the trial between September 2007 and November 2009, 33 women (mean age 49 ±11 years old) with advanced cervical cancer (12 IB2, 3 IIA, 15 IIB and 3 IIIB, 29 squamous cell carcinomas, 32 grade 2 or 3) were evaluable. Based on histopathology, LN metastasis was 39% in abdomen and 70% in pelvis. Sensitivity of all sequence review in pelvis, abdomen, and combined were 83%, 60%, and 86%, compared with 78%, 54%, and 80% for f-10 insensitive sequences ( P : 0.24, 0.44 and 0.14, respectively). Mean diameter of the largest positive focus on histopathology was 13.7 mm in abdomen and 18.8 mm in pelvis ( P = 0.018). Specificities of all sequence review in pelvis, abdomen, and combined were 48%, 75%, and 43%, compared with 75%, 83%, and 73% ( P : 0.003, 0.14, 0.002 respectively) for f-10 insensitive sequences. Addition of f-10 increased MRI sensitivity to detect LN metastasis in advanced cervical cancer. Increased sensitivity did not reach statistical significance and was at the expense of lower specificity.

Goniometric measurement of hip motion in cycling while standing.

PubMed

Hull, M L; Beard, A; Varma, H

1990-01-01

The purpose of this study was to develop an instrument for quantifying the motion of the hip relative to the bicycle while cycling in the standing position. Because of the need to measure hip motion on the road as well as in the laboratory, a goniometer which locates the hip using spherical coordinates was designed. The goniometer is presented first, followed by the development of the equations that enable the distance from the joint center to the pedal spindle to be determined. The orientation of this line segment is specified by calculating two angles referenced to the frame. Also outlined are the procedures used to both calibrate the goniometer and perform an accuracy check. The results of this check indicate that the attachment point of the goniometer to the rider can be located to within 2.5 mm of the true position. The goniometer was used to record the hip movement patterns of six subjects who cycled in the standing position on a treadmill. Representative results from one test subject who cycled at 6% grade and 25 km h-1 are presented. Results indicate that the bicycle is leaned from side to side with the frequency of leaning equal to the frequency of pedalling. Extreme lean angles are +/- 6 degrees. The distance from the hip to the pedal varies approximately sinusoidally with frequency equal to pedalling rate and amplitude somewhat less than crank arm length. The absolute elevation of the hip, however, exhibits two cycles for each crank cycle. Asymmetry in the plot of elevation over a single crank cycle indicates that the pelvis rocks from side to side and that the elevation of the pelvis midpoint changes. Extreme values of the pelvis rocking angle are +/- 12 degrees. Highest pelvis midpoint elevations, however, do not occur at the same crank angles as those angles at which the pelvis rocking is extreme. It appears that the vertical motion of the hips affects pedalling mechanics when cycling in the standing position.

Three-dimensional evaluation of skeletal deformities of the pelvis and lower limbs in ambulant children with cerebral palsy.

PubMed

Massaad, Abir; Assi, Ayman; Bakouny, Ziad; Sauret, Christophe; Khalil, Nour; Skalli, Wafa; Ghanem, Ismat

2016-09-01

Skeletal abnormalities, affecting posture and walking pattern, increase with motor impairment in children with cerebral palsy (CP). However, it is not known whether these skeletal malalignments occur in children with slight motor impairment. Our aim was to evaluate skeletal malalignment at the level of the pelvis and lower limbs in ambulant children with CP, with slight motor impairment, using a low dose biplanar X-ray technique. Twenty-seven children with spastic CP (mean age: 10.9±4years, 7 Hemiplegia, 20 Diplegia, GMFCS levels I:17, II:10), with no previous treatments at the hips and knees, underwent EOS(®) biplanar X-rays. A control group consisting of 22 typically developing children was also included. Three-dimensional reconstructions of the pelvis and lower limbs were performed in order to calculate 11 radiological parameters related to the pelvis, acetabulum and lower limbs. Pelvic incidence and sacral slope were significantly increased in children with CP compared to TD children (48°±7° vs. 43°±8°, 42°±7° vs. 38°±5°, respectively, p=0.003). Acetabular parameters did not significantly differ between the two groups. Femoral anteversion and neck shaft angle were significantly increased in children with CP (25°±12° vs. 14°±7°, p<0.001; 134°±5° vs. 131°±5°, p=0.005 respectively). No difference was found for tibial torsion. This study showed that even slightly impaired children with CP have an anteverted and abducted femur and present positional and morphological changes of the pelvis in the sagittal plane. The orientation of the acetabulum in 3D seems to not be affected when children with CP present slight motor impairment. Copyright © 2016 Elsevier B.V. All rights reserved.

Pelvic bone asymmetry in 323 study participants receiving abdominal CT scans.

PubMed

Badii, Maziar; Shin, Sonya; Torreggiani, William C; Jankovic, Bojana; Gustafson, Paul; Munk, Peter L; Esdaile, John M

2003-06-15

Retrospective review of all CT scans of pelvis and abdomen performed at our institution in October and November 2000. To determine the prevalence and extent of radiographic pelvic asymmetry in a population of patients not preselected for having low back pain. Pelvic asymmetry refers to asymmetric positioning of landmarks on the two sides of the pelvis and may have a structural or functional etiology. Pelvic asymmetry can be associated with the presence of true leg length discrepancy, lead to false diagnosis or inaccurate measurement of leg length discrepancy, or itself be independently associated with back pain. Although the prevalence of pelvic asymmetry has been reported in patients with back pain to be 24-91%, its prevalence in the general population is not known. A total of 323 consecutive CT scans of the pelvis/abdomen were assessed for pelvic asymmetry by one of three examiners. Pelvic asymmetry was defined as an unequal distance from the iliac crests to the acetabuli bilaterally, measured on the anteroposterior scout view of the CT scan. Measurements made on 30 randomly selected scans by the three examiners were used to assess interrater reliability of the measurement method. Pelvic asymmetry ranged in magnitude from -11 mm to 7 mm [right pelvis (mm) - left pelvis (mm)]. Pelvic asymmetry was >5 mm in 17 of 323 (5.3%) and >10 mm in 2 of 323 (0.6%) of the subjects; 172 of 323 (53.3%) had a smaller right hemipelvis (mean asymmetry = -3.0 mm). A total of 95 of 323 (29.4%) had a smaller left hemipelvis (mean asymmetry = 2.1 mm). The intraclass correlation coefficient [ICC(2,1)] between the three observers was high (0.91). Pelvic asymmetry of >5 mm was uncommon, with a prevalence of approximately 5% in the population studied. CT scanography was found to be a practical and reliable method for the assessment of suspected pelvic asymmetry.

SU-F-I-40: Impact of Scan Length On Patient Dose in Abdomen/pelvis CT Diagnosis

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

Park, I; Song, J; Kim, K

Purpose: To analysis the impact of scan length on patient doses in abdomen/pelvis CT diagnosis of each hospital. Methods: Scan length of 7 hospitals from abdomen/pelvis CT diagnosis was surveyed in Korea. Surveyed scan lengths were additional distance above diaphragm and distance below pubic symphysis except for standard scan range between diaphragm and pubic symphysis. Patient dose was estimated for adult male and female according to scan length of each hospital. CT-Expo was used to estimate the patient dose under identical equipment settings (120 kVp, 100 mAs, 10 mm collimation width, etc.) except scan length. Effective dose was calculated bymore » using tissue weighting factor of ICRP 103 recommendation. Increase rate of effective dose was calculated comparing with effective dose of standard scan range Results: Scan lengths of abdomen/pelvis CT diagnosis of each hospital were different. Also effective dose was increased with increasing the scan length. Generally increasing the distance above diaphragm caused increase of effective dose of male and female, but increasing the distance below pubic symphysis caused increase of effective dose of male. Conclusion: We estimated the patient dose according to scan length of each hospital in abdomen/pelvis CT diagnosis. Effective dose was increased by increasing the scan length because dose of organs with high tissue weighting factor such as lung, breast, testis were increased. Scan length is important factor on patient dose in CT diagnosis. If radiologic technologist interested in patient dose, decreasing the unnecessary scan length will decrease the risk of patients from radiation. This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI13C0004).« less

Endovascular Coil Embolization in a Postnephrostomy Renal Vein to Renal Pelvis Fistula

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

Anil, Gopinathan, E-mail: ivyanil10@gmail.com; Taneja, Manish

2011-02-15

We report the case of a 74-year-old man with post-percutaneous-nephrostomy venous hemorrhage from an iatrogenic fistula between the renal pelvis and a large tributary of the renal vein. Conservative management failed to contain the hemorrhage. Hence the fistula was occluded by coil embolization through the renal vein. This endovascular approach enabled rapid and effective stoppage of the venous bleed.There was no recurrence of the bleed or any pertinent complication at 3-month follow-up.

Imaging Review of Skeletal Tumors of the Pelvis Malignant Tumors and Tumor Mimics

PubMed Central

Girish, Gandikota; Finlay, Karen; Fessell, David; Pai, Deepa; Dong, Qian; Jamadar, David

2012-01-01

Malignant lesions of the pelvis are not uncommon and need to be differentiated from benign lesions and tumor mimics. Appearances are sometimes nonspecific leading to consideration of a broad differential diagnosis. Clinical history, anatomic location, and imaging characterization can help narrow the differential diagnosis. The focus of this paper is to demonstrate the imaging features and the role of plain films, computed tomography, and magnetic resonance imaging for detecting and characterizing malignant osseous pelvic lesions and their common mimics. PMID:22593667

The sacroiliac joint: an overview of its anatomy, function and potential clinical implications.

PubMed

Vleeming, A; Schuenke, M D; Masi, A T; Carreiro, J E; Danneels, L; Willard, F H

2012-12-01

This article focuses on the (functional) anatomy and biomechanics of the pelvic girdle and specifically the sacroiliac joints (SIJs). The SIJs are essential for effective load transfer between the spine and legs. The sacrum, pelvis and spine, and the connections to the arms, legs and head, are functionally interrelated through muscular, fascial and ligamentous interconnections. A historical overview is presented on pelvic and especially SIJ research, followed by a general functional anatomical overview of the pelvis. In specific sections, the development and maturation of the SIJ is discussed, and a description of the bony anatomy and sexual morphism of the pelvis and SIJ is debated. The literature on the SIJ ligaments and innervation is discussed, followed by a section on the pathology of the SIJ. Pelvic movement studies are investigated and biomechanical models for SIJ stability analyzed, including examples of insufficient versus excessive sacroiliac force closure. © 2012 The Authors. Journal of Anatomy © 2012 Anatomical Society.

A dose comparison survey in CT departments of dedicated paediatric hospitals in Australia and Saudi Arabia

PubMed Central

Mohiy, Hussain Al; Sim, Jenny; Seeram, Euclid; Annabell, Nathan; Geso, Moshi; Mandarano, Giovanni; Davidson, Rob

2012-01-01

AIM: To measure and compare computed tomography (CT) radiation doses delivered to patients in public paediatric hospitals in Australia and Saudi Arabia. METHODS: Doses were measured for routine CT scans of the head, chest and abdomen/pelvis for children aged 3-6 years in all dedicated public paediatric hospitals in Australia and Saudi Arabia using a CT phantom measurement cylinder. RESULTS: CT doses, using the departments’ protocols for 3-6 year old, varied considerably between hospitals. Measured head doses varied from 137.6 to 528.0 mGy·cm, chest doses from 21.9 to 92.5 mGy·cm, and abdomen/pelvis doses from 24.9 to 118.0 mGy·cm. Mean head and abdomen/pelvis doses delivered in Saudi Arabian paediatric CT departments were significantly higher than those in their Australian equivalents. CONCLUSION: CT dose varies substantially across Australian and Saudi Arabian paediatric hospitals. Therefore, diagnostic reference levels should be established for major anatomical regions to standardise dose. PMID:23150767

A Novel Approach to Apply Gait Synchronized External Forces on the Pelvis using A-TPAD to Reduce Walking Effort

PubMed Central

Vashista, Vineet; Khan, Moiz; Agrawal, Sunil K.

2017-01-01

In this paper, we develop an intervention to apply external gait synchronized forces on the pelvis to reduce the user’s effort during walking. A cable-driven robot was used to apply the external forces and an adaptive frequency oscillator scheme was developed to adapt the timing of force actuation to the gait frequency during walking. The external forces were directed in the sagittal plane to assist the trailing leg during the forward propulsion and vertical deceleration of the pelvis during the gait cycle. A pilot experiment with five healthy subjects was conducted. The results showed that the subjects applied lower ground reaction forces in the vertical and anterior-posterior directions during the late stance phase. In summary, the current work provides a novel approach to study the role of external pelvic forces in altering the walking effort. These studies can provide better understanding for designing exoskeletons and prosthetic devices to reduce the overall walking effort. PMID:29623294

The use of CT derived solid modelling of the pelvis in planning cancer resections.

PubMed

Bruns, J; Habermann, C R; Rüther, W; Delling, D

2010-06-01

Resection of malignant tumors of the pelvis is demanding. To avoid disabling hemipelvectomies, years ago internal hemipelvectomy combined with partial pelvic replacements had become a surgical procedure. To achieve adequate reconstructions custom-made replacements were recommended. In early stages of the surgical procedure using megaprostheses, individual pelvic models were manufactured. Since little is known about the accuracy of such models we analysed the charts of 24 patients (25 models) for whom an individual model of the osseous pelvis had been manufactured. Two patients refused surgery. In 23 patients partial resection of the bony pelvis was performed followed by a partial pelvic replacement (13x), hip transposition procedure (5x), ilio-sacral resection (4x), or revision surgery. In all patients who received a partial pelvic replacement, the fit of the replacement was optimal. No major unplanned resection was necessary. The same was observed in patients who received a hip transposition procedure or an ilio-sacral resection. Oncologically, in most of the patients we achieved wide resection margins (14x). In 5 patients the margins were marginal (4x) or intralesional (1x). In two cases the aim was a palliative resection because of a metastatic disease (1x) or benign entity (1x). Pelvic models are helpful tools to planning the manufacture of partial pelvic replacements and ensuring optimal osseous resection of the involved bone. Further attempts have to be made to evaluate the aim of navigational techniques regarding the accuracy of the osseous and soft-tissue resection.

The impact of processing delay on the exposure index value

NASA Astrophysics Data System (ADS)

Butler, M. L.; Brennan, P. C.; Last, J.; Rainford, L.

2010-04-01

Digital radiography poses the risk of unnoticed increases in patient dose. Manufacturers responded to this by offering an exposure index (EI) value to clinicians. Use of the EI value in clinical practice is encouraged by the American College of Radiology and American Association of Physicists in Medicine. This study assesses the impact of processing delay on the EI value. An anthropormorphic phantom was used to simulate three radiographic examinations; skull, pelvis and chest. For each examination, the phantom was placed in the optimal position and exposures were chosen in accordance with international guidelines. A Carestream (previously Kodak) computed radiography system was used. The imaging plate was exposed, and processing was delayed in various increments from 30 seconds to 24 hours, representing common delays in clinical practice. The EI value was recorded for each exposure. The EI value decreased considerably with increasing processing delay. The EI value decreased by 100 within 25 minutes delay for the chest, and 20 minutes for the skull and pelvis. Within 1 hour, the EI value had fallen by 180, 160 and 100 for the chest, skull and pelvis respectively. After 24 hours, the value had decreased by 370, 350 and 340 for the chest, skull and pelvis respectively, representing to the clinician more then a halving of exposure to the detector in Carestream systems. The assessment of images using EI values should be approached with caution in clinical practice when delays in processing occur. The use of EI values as a feedback mechanism is questioned.

Optimization of exposure index values for the antero-posterior pelvis and antero-posterior knee examination

NASA Astrophysics Data System (ADS)

Butler, M. L.; Rainford, L.; Last, J.; Brennan, P. C.

2009-02-01

Introduction The American Association of Medical Physicists is currently standardizing the exposure index (EI) value. Recent studies have questioned whether the EI value offered by manufacturers is optimal. This current work establishes optimum EIs for the antero-posterior (AP) projections of a pelvis and knee on a Carestream Health (Kodak) CR system and compares these with manufacturers recommended EI values from a patient dose and image quality perspective. Methodology Human cadavers were used to produce images of clinically relevant standards. Several exposures were taken to achieve various EI values and corresponding entrance surface doses (ESD) were measured using thermoluminescent dosimeters. Image quality was assessed by 5 experienced clinicians using anatomical criteria judged against a reference image. Visualization of image specific common abnormalities was also analyzed to establish diagnostic efficacy. Results A rise in ESD for both examinations, consistent with increasing EI was shown. Anatomic image quality was deemed to be acceptable at an EI of 1560 for the AP pelvis and 1590 for the AP knee. From manufacturers recommended values, a significant reduction in ESD (p=0.02) of 38% and 33% for the pelvis and knee respectively was noted. Initial pathological analysis suggests that diagnostic efficacy at lower EI values may be projection-specific. Conclusion The data in this study emphasize the need for clinical centres to consider establishing their own EI guidelines, and not necessarily relying on manufacturers recommendations. Normal and abnormal images must be used in this process.

Whole body frontal plane mechanics across walking, running, and sprinting in young and older adults.

PubMed

Kulmala, J-P; Korhonen, M T; Kuitunen, S; Suominen, H; Heinonen, A; Mikkola, A; Avela, J

2017-09-01

This study investigated the whole body frontal plane mechanics among young (26 ± 6 years), early old (61 ± 5 years), and old (78 ± 4 years) adults during walking, running, and sprinting. The age-groups had similar walking (1.6 m/s) and running (4.0 m/s) speeds, but different maximal sprinting speed (young 9.3 m/s, early old 7.9 m/s, and old 6.6 m/s). Surprisingly, although the old group exerted much lower vertical ground reaction force during running and sprinting, the hip frontal plane moment did not differ between the age-groups. Kinematic analysis demonstrated increased hip adduction and pelvis drop, as well as reduced trunk lateral flexion among old adults, especially during sprinting. These alterations in the hip and pelvis motions may reflect insufficient force production of hip abductors to stabilize the pelvis during single-limb support, while limited trunk lateral flexion may enhance control of the mediolateral balance. On the other hand, larger trunk side-to-side movement among the young and early old adults may provide a mechanism to prevent the increase of the hip frontal moment despite greater vertical ground reaction force. This, in turn, can assist hip abductors to maintain stability of the pelvis during sprinting while allowing powerful force generation by a large adductor muscle group. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Bilateral Asymmetry in the Human Pelvis.

PubMed

Kurki, Helen K

2017-04-01

Asymmetry of the human axial skeleton has received much less attention that of the limb skeleton. Pelvic morphology is subject to multiple selective factors, including bipedal locomotion and obstetrics, among others, as well as environmental factors such as biomechanical loading. How these various factors influence or restrict asymmetry of the pelvis is unknown and few studies have investigated levels and patterns of pelvic asymmetry. This study examines percentage directional (%DA) and absolute (%AA) asymmetry in 14 bilaterally paired dimensions of the pelvic canal, non-canal pelvis, and femur in female (n = 111) and male (n = 126) skeletons from nine geographically dispersed skeletal samples. Directional asymmetries were uniformly low for all measures and lacked any consistent patterning across the variables, while %AA was highest in the pelvic canal, particularly the posterior aspects. Few sex differences and no population differences were found for %DA and %AA; however the latter was correlated with coefficients of variation across the 14 variables in both sexes. While sample mean %DA were low, standard deviations of the canal variables were high and the majority of individuals in both sexes displayed %DA values >±0.5, suggesting asymmetry is common, if not directionally consistent. Biomechanical loading of the pelvic girdle may influence asymmetry of both the canal and non-canal aspects of the pelvis; however it is unlikely that these asymmetries negatively affect obstetric function, given the prevalence for %DA found in this study. Anat Rec, 300:653-665, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Trunk coordination in healthy and chronic nonspecific low back pain subjects during repetitive flexion-extension tasks: Effects of movement asymmetry, velocity and load.

PubMed

Mokhtarinia, Hamid Reza; Sanjari, Mohammad Ali; Chehrehrazi, Mahshid; Kahrizi, Sedigheh; Parnianpour, Mohamad

2016-02-01

Multiple joint interactions are critical to produce stable coordinated movements and can be influenced by low back pain and task conditions. Inter-segmental coordination pattern and variability were assessed in subjects with and without chronic nonspecific low back pain (CNSLBP). Kinematic data were collected from 22 CNSLBP and 22 healthy volunteers during repeated trunk flexion-extension in various conditions of symmetry, velocity, and loading; each at two levels. Sagittal plane angular data were time normalized and used to calculate continuous relative phase for each data point. Mean absolute relative phase (MARP) and deviation phase (DP) were derived to quantify lumbar-pelvis and pelvis-thigh coordination patterns and variability. Statistical analysis revealed more in-phase coordination pattern in CNSLBP (p=0.005). There was less adaptation in the DP for the CNSLBP group, as shown by interactions of Group by Load (p=.008) and Group by Symmetry by Velocity (p=.03) for the DP of pelvis-thigh and lumbar-pelvis couplings, respectively. Asymmetric (p<0.001) and loaded (p=0.04) conditions caused less in-phase coordination. Coordination variability was higher during asymmetric and low velocity conditions (p<0.001). In conclusion, coordination pattern and variability could be influenced by trunk flexion-extension conditions. CNSLBP subjects demonstrated less adaptability of movement pattern to the demands of the flexion-extension task. Copyright © 2015 Elsevier B.V. All rights reserved.

Computer-assisted kinematic evaluation of induced compensatory movements resembling lameness in horses trotting on a treadmill.

PubMed

Kelmer, Gal; Keegan, Kevin G; Kramer, Joanne; Wilson, David A; Pai, Frank P; Singh, Prableen

2005-04-01

To characterize compensatory movements of the head and pelvis that resemble lameness in horses. 17 adult horses. Kinematic evaluations were performed while horses trotted on a treadmill before and after shoe-induced lameness. Lameness was quantified and the affected limb determined by algorithms that measured asymmetry in vertical movement of the head and pelvis. Induced primary lameness and compensatory movements resembling lameness were assessed by the Friedman test. Association between induced lameness and compensatory movements was examined by regression analysis. Compensatory movements resembling lameness in the ipsilateral forelimb were seen with induced lameness of a hind limb. There was less downward and less upward head movement during and after the stance phase of the ipsilateral forelimb. Doubling the severity of lameness in the hind limb increased severity of the compensatory movements in the ipsilateral forelimb by 50%. Compensatory movements resembling lameness of the hind limb were seen after induced lameness in a forelimb. There was less upward movement of the pelvis after the stance phase of the contralateral hind limb and, to a lesser extent, less downward movement of the pelvis during the stance phase of the ipsilateral hind limb. Doubling the severity of lameness in the forelimb increased compensatory movements of the contralateral hind limb by 5%. Induced lameness in a hind limb causes prominent compensatory movements resembling lameness in the ipsilateral forelimb. Induced lameness in a forelimb causes slight compensatory movements resembling lameness in the ipsilateral and contralateral hind limbs.

Patient Obesity Influences Pelvic Lift During Cup Insertion in Total Hip Arthroplasty Through a Lateral Transgluteal Approach in Supine Position.

PubMed

Brodt, Steffen; Nowack, Dimitri; Jacob, Benjamin; Krakow, Linda; Windisch, Christoph; Matziolis, Georg

2017-09-01

Movement of the pelvis during implantation of total hip arthroplasty (THA) has a major influence on the positioning of the acetabular cup. Strong traction caused by retractors leads to iatrogenic pelvic lift and can thus be partly responsible for cup malpositioning. The objective of this study was to investigate such factors that influence pelvic lift. The dynamic movement of the pelvis was measured during implantation of THA in 67 patients. This was done by measuring the acceleration using the SensorLog app on a smartphone. At its maximum, the pelvis was lifted by an average of 6.7°. When impacting the press-fit cup, the surgical side was raised by 4.4° compared with the time of skin incision. This lift at the time of cup implantation correlates significantly with the body mass index and the patient's abdominal and pelvic circumference. Every surgeon performing THA must be aware of the pelvic lift during an operation. Especially in patients with a high body mass index, a large abdominal circumference, or a large pelvic circumference, there is an increased risk of malpositioning of the acetabular cup. When impacting the cup, we recommend releasing the traction of the retractor, so that the pelvis can tilt back into its natural position, and thus, the anticipated cup positioning can be implemented as exactly as possible. Copyright © 2017 Elsevier Inc. All rights reserved.

Does the Dual-Mobility Hip Prosthesis Produce Better Joint Kinematics During Extreme Hip Flexion Task?

PubMed

Catelli, Danilo S; Kowalski, Erik; Beaulé, Paul E; Lamontagne, Mario

2017-10-01

Total hip arthroplasty (THA) using dual-mobility (DM) design permits larger hip range of motion. However, it is unclear how it benefits the patients during activities of daily living. The purpose was to compare kinematic variables of the operated limb between THA patients using either DM or single-bearing (SB) implants during a squat task. Twenty-four THA patients were randomly assigned to either a DM or SB implant and matched to 12 healthy controls (CTRLs). They underwent 3-dimensional squat motion analysis before and 9 months after surgery. Sagittal and frontal plane angles of the pelvis and the hip were analyzed using statistical parametric mapping. Paired analyses compared presurgery and postsurgery squat depth. Peak sagittal pelvis angle of DM was closer to normal compared with that of SB. Both implant groups had similar hip angle patterns and magnitude but significantly lower than the CTRLs. SB reached a much large hip abduction compared with the other groups. Both surgical groups had significantly worst squat depth than the CTRLs. Neither THA implant groups were able to return pelvis and hip kinematics to the level of CTRLs. The deficit of DM implants at the pelvis combined with the poorer functional scores should caution clinicians to use this implant design in active patients. SB design causes a larger hip abduction to reach their maximum squat depth. Post-THA rehabilitation should focus on improving joint range of motion and strength. Copyright © 2017 Elsevier Inc. All rights reserved.

Recommended standardized terminology of the anterior female pelvis based on a structured medical literature review.

PubMed

Jeppson, Peter C; Balgobin, Sunil; Washington, Blair B; Hill, Audra Jolyn; Lewicky-Gaupp, Christina; Wheeler, Thomas; Ridgeway, Beri; Mazloomdoost, Donna; Balk, Ethan M; Corton, Marlene M; DeLancey, John

2018-07-01

The use of imprecise and inaccurate terms leads to confusion amongst anatomists and medical professionals. We sought to create recommended standardized terminology to describe anatomic structures of the anterior female pelvis based on a structured review of published literature and selected text books. We searched MEDLINE from its inception until May 2, 2016, using 11 medical subject heading terms to identify studies reporting on anterior female pelvic anatomy; any study type published in English was accepted. Nine textbooks were also included. We screened 12,264 abstracts, identifying 200 eligible studies along with 13 textbook chapters from which we extracted all pertinent anatomic terms. In all, 67 unique structures in the anterior female pelvis were identified. A total of 59 of these have been previously recognized with accepted terms in Terminologia Anatomica, the international standard on anatomical terminology. We also identified and propose the adoption of 4 anatomic regional terms (lateral vaginal wall, pelvic sidewall, pelvic bones, and anterior compartment), and 2 structural terms not included in Terminologia Anatomica (vaginal sulcus and levator hiatus). In addition, we identified 2 controversial terms (pubourethral ligament and Grafenberg spot) that require additional research and consensus from the greater medical and scientific community prior to adoption or rejection of these terms. We propose standardized terminology that should be used when discussing anatomic structures in the anterior female pelvis to help improve communication among researchers, clinicians, and surgeons. Copyright © 2018 Elsevier Inc. All rights reserved.

[Analysis of ancient literature on baliao points for pelvic floor diseases].

PubMed

Liu, Hairong; Zhang, Jianbin

2016-12-12

The relationship between baliao points and pelvis floor diseases was explored based on the ancient literature review on these acupoints' targeted diseases. It is considered that baliao points are applied to treat various pelvis floor diseases and symptoms of different systems. Each point has similar function but with unique feature. Shangliao (BL 31) is mainly used to treat gynecologic diseases;Ciliao (BL 32) and Zhongliao (BL 33),urologic system and reproductive system diseases;Zhongliao (BL 33) and Xialiao (BL 34),reproductive system and anorectal system diseases.

Thermoluminescent chip detector for in vivo dosimetry in pelvis and head & neck cancer treatment.

PubMed

Leal, Marcela A; Viegas, Claudio; Viamonte, Alfredo; Campos, Anna; Braz, Delson; Clivland, Paul

2010-01-01

Our aim is to show the TL dosimetry as a confident QA method for radiotherapy treatments. Before in vivo entrance dose measurements using TLD-100 chips, ECLIPSE TPS-simulated treatments for a Rando anthropomorphic phantom, two for pelvis and one head & neck. In Vivo measurements results with (60)Co beam remained within +/-5% limits. Results for 6 and 15 MV are in conclusion. This is a National Cancer Institute/RJ/Brazil study under the 13.111-IAEA Coordinated Research Project. Copyright 2010. Published by Elsevier Ltd.

Lesions in mink (Mustela vison) infected with giant kidney worm (Dioctophyma renale).

PubMed

Mace, T F

1976-01-01

Adult Dioctophyma renale occupied the enlarged renal pelvis of the right kidney of naturally infected mink. Lesions in the kidney parenchyma consisted of connective tissue proliferation in the interstitial tissue, tubular atrophy and fibrosis, and periglomerular fibrosis. The luminal surface of the renal pelvis wall was formed of numerous papillae covered with transitional epithelium. The nematodes in the lumen were bathed in an albuminous fluid containing red blood cells, epithelial cells and D. renale eggs. The left (uninfected) kidney was 60% larger than the left kidney of normal mink.

Aircraft Crash Survival Design Guide. Volume 2. Aircraft Design Crash Impact Conditions and Human Tolerance

DTIC Science & Technology

1989-12-01

abdomen and against the lower margin of the rib cagc This movement of the lap belt allows the pelvis to move forward under thc ’.p belt, causing severe...because of the asymmetry of the abdomen. 100 80 - 60 U. 0 40LETSRC 0 M RIGHT STRUCK./ 0 L -- L. . 0 50 100 150 200 250 TTI (MAX RIB) FIGURE 22...mathematical development: 0 The 24 vertebral bodies, the head, and the pelvis are rigid bodies constrained to move in the midsagittal plane. a Each rigid

Functional movement impairment in dancers: An assessment and treatment approach utilizing the Biomechanical Asymmetry Corrector (BAC) to restore normal mechanics of the spine and pelvis.

PubMed

Keller, K; West, J C

1995-01-01

Musculoskeletal injuries to the spine and pelvis are common in dancers. These injuries are associated with mechanical dysfunctions that impair spinal adaptation to the movement demands of the art form. This article introduces the biomechanical asymmetry corrector (BAC), a dynamic assessment and treatment tool, designed to restore normal spinal mechanics and functional movement patterns in dancers. A discussion of lumbo-pelvic mechanics and dance injury provides a theoretical context for describing exercises on the BAC.

Veliparib, Cisplatin, and Gemcitabine Hydrochloride in Treating Patients With Advanced Biliary, Pancreatic, Urothelial, or Non-Small Cell Lung Cancer

ClinicalTrials.gov

2013-07-01

Advanced Adult Primary Liver Cancer; Localized Unresectable Adult Primary Liver Cancer; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage III Bladder Cancer; Stage III Pancreatic Cancer; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IV Bladder Cancer; Stage IV Non-small Cell Lung Cancer; Stage IV Pancreatic Cancer; Transitional Cell Carcinoma of the Bladder; Unresectable Extrahepatic Bile Duct Cancer; Unresectable Gallbladder Cancer

Correlative CT and anatomic study of the sciatic nerve

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

Pech, P.; Haughton, V.

1985-05-01

Sciatica can be caused by numerous processes affecting the sciatic nerve or its components within the pelvis including tumors, infectious diseases, aneurysms, fractures, and endometriosis. The CT diagnosis of these causes of sciatica has not been emphasized. This study identified the course and appearance of the normal sciatic nerve in the pelvis by correlating CT and anatomic slices in cadavers. For purposes of discussion, the sciatic nerve complex is conveniently divided into three parts: presacral, muscular, and ischial. Each part is illustrated here by two cryosections with corresponding CT images.

The influence of early or delayed provision of ankle-foot orthoses on pelvis, hip and knee kinematics in patients with sub-acute stroke: A randomized controlled trial.

PubMed

Nikamp, Corien D M; van der Palen, Job; Hermens, Hermie J; Rietman, Johan S; Buurke, Jaap H

2018-06-01

Compensatory pelvis, hip- and knee movements are reported after stroke to overcome insufficient foot-clearance. Ankle-foot orthoses (AFOs) are often used to improve foot-clearance, but the optimal timing of AFO-provision post-stroke is unknown. Early AFO-provision to prevent foot-drop might decrease the development of compensatory movements, but it is unknown whether timing of AFO-provision affects post-stroke kinematics. 1) To compare the effect of AFO-provision at two different points in time (early versus delayed) on frontal pelvis and hip, and sagittal hip and knee kinematics in patients with sub-acute stroke. Effects were assessed after 26 weeks; 2) To study whether possible changes in kinematics or walking speed during the 26-weeks follow-up period differed between both groups. An explorative randomized controlled trial was performed, including unilateral hemiparetic patients maximal six weeks post-stroke with indication for AFO-use. Subjects were randomly assigned to AFO-provision early (at inclusion) or delayed (eight weeks later). 3D gait-analysis with and without AFO was performed in randomized order. Measurements were performed in study-week 1, 9, 17 and 26. Twenty-six subjects (15 early, 11 delayed) were analyzed. After 26 weeks, no differences in kinematics were found between both groups for any of the joint angles, both for the without and with AFO-condition. Changes in kinematics during the 26-weeks follow-up period did not differ between both groups for any of the joint angles during walking without AFO. Significant differences in changes in walking speed during the 26-weeks follow-up were found (p = 0.034), corresponding to the first eight weeks after AFO-provision. Results indicate that early or delayed AFO-use post-stroke does not influence pelvis, hip and knee movements after 26 weeks, despite that AFO-use properly corrected drop-foot. AFOs should be provided to improve drop-foot post-stroke, but not with the intention to influence development of compensatory patterns around pelvis and hip. Copyright © 2018 Elsevier B.V. All rights reserved.

Comparison of conventional versus three-dimensional ultrasound in fetal renal pelvis measurement and their potential prediction of neonatal uropathies.

PubMed

Duin, L K; Nijhuis, J G; Scherjon, S A; Vossen, M; Willekes, C

2016-01-01

To establish a threshold value for fetal renal pelvis dilatation measured by automatic volume calculation (SonoAVC) in the third trimester of pregnancy to predict neonatal uropathies, and to compare these results with conventional antero-posterior (AP) measurement, fetal kidney 3D volume and renal parenchymal thickness. In a prospective cohort study, 125 fetuses with renal pelvis AP diameter of ≥5 mm both at 20 weeks of gestation and in the third trimester, underwent an additional 3D volume measurement of the fetal kidney in the third trimester. Receiver operating characteristic (ROC) curves for establishing threshold values for fetal renal pelvis volume, AP measurement, fetal kidney volume and renal parenchymal thickness to predict neonatal uropathies were analyzed. Also, sensitivity, specificity, area under the curve (AUC) and likelihood ratios were calculated. A cut-off point of 1.58 cm³ was identified in the third trimester of pregnancy (AUC 0.865 (95% CI 0.789-0.940), sensitivity 76.3%, specificity 87.4%, LR+ 6.06, LR- 0.27) for measurements with SonoAVC. A cut-off value of 11.5 mm was established in the third trimester of pregnancy (AUC 0.828 (95% CI 0.737-0.918), sensitivity 71.1%, specificity 85.1%, LR+ 4.77, LR- 0.34) for the conventional AP measurement. A cut-off point for fetal kidney volume was calculated at 13.29 cm³ (AUC 0.769 (95% CI 0.657-0.881), sensitivity 71%, specificity 66%, LR+ 2.09, LR- 0.44). For renal parenchymal thickness, a cut-off point of 8.4 mm was established (AUC 0.216 (95% CI 0.117-0.315), sensitivity 31.6%, specificity 32.6%, LR+ 0.47, LR- 2.10). This study demonstrates that 3D fetal renal pelvis volume measurements and AP measurements both have a good and comparable diagnostic performance, fetal renal volume a fair accuracy and renal parenchymal thickness a poor accuracy in predicting postnatal renal outcome.

Personalized Assessment of kV Cone Beam Computed Tomography Doses in Image-guided Radiotherapy of Pediatric Cancer Patients

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

Zhang Yibao; Yan Yulong; Nath, Ravinder

2012-08-01

Purpose: To develop a quantitative method for the estimation of kV cone beam computed tomography (kVCBCT) doses in pediatric patients undergoing image-guided radiotherapy. Methods and Materials: Forty-two children were retrospectively analyzed in subgroups of different scanned regions: one group in the head-and-neck and the other group in the pelvis. Critical structures in planning CT images were delineated on an Eclipse treatment planning system before being converted into CT phantoms for Monte Carlo simulations. A benchmarked EGS4 Monte Carlo code was used to calculate three-dimensional dose distributions of kVCBCT scans with full-fan high-quality head or half-fan pelvis protocols predefined by themore » manufacturer. Based on planning CT images and structures exported in DICOM RT format, occipital-frontal circumferences (OFC) were calculated for head-and-neck patients using DICOMan software. Similarly, hip circumferences (HIP) were acquired for the pelvic group. Correlations between mean organ doses and age, weight, OFC, and HIP values were analyzed with SigmaPlot software suite, where regression performances were analyzed with relative dose differences (RDD) and coefficients of determination (R{sup 2}). Results: kVCBCT-contributed mean doses to all critical structures decreased monotonically with studied parameters, with a steeper decrease in the pelvis than in the head. Empirical functions have been developed for a dose estimation of the major organs at risk in the head and pelvis, respectively. If evaluated with physical parameters other than age, a mean RDD of up to 7.9% was observed for all the structures in our population of 42 patients. Conclusions: kVCBCT doses are highly correlated with patient size. According to this study, weight can be used as a primary index for dose assessment in both head and pelvis scans, while OFC and HIP may serve as secondary indices for dose estimation in corresponding regions. With the proposed empirical functions, it is possible to perform an individualized quantitative dose assessment of kVCBCT scans.« less

Effects of volitional spine stabilization on lifting task in recurrent low back pain population.

PubMed

Haddas, Ram; Yang, James; Lieberman, Isador

2016-09-01

To examine the influence of volitional preemptive abdominal contraction (VPAC) and recurrent low back pain (rLBP) on trunk mechanics and neuromuscular control during a symmetric lifting task. A 2 × 2 crossover mixed design was used to examine the effects of VPAC and group. Thirty-seven healthy individuals and 32 rLBP individuals performed symmetric box lifting trials with and without VPAC to a 1-m height table 3D trunk, pelvis, and hip joint angle and electromyographic magnitude variables were obtained. Selected variables were analyzed using ANOVA. The VPAC induced differences in joint kinematics and muscle activity in rLBP and healthy subjects during symmetric lifting. A significant two-way interaction effect was observed for the semitendinosus activity. The VPAC increased external oblique muscle activity, reduced erector spinae and multifidus muscles activity, and induced greater trunk flexion angle, greater trunk side flexion angle, and greater hip flexion angle, and decreased pelvis obliquity angle in both groups. In addition, the rLBP subjects presented with a reduced external oblique and gluteus maximus muscle activity, greater erector spinae and multifidus muscles activity, and greater pelvis posterior tilt angle. Our results provide evidence that a VPAC strategy performed during symmetric lifting may potentially reduce exposure to biomechanical factors that can contribute to lumbar spine injury. The hamstring muscles may play an important role in achieving pelvic balance during the lifting maneuver. Incorporating the VPAC during dynamic stressful activities appears to help improve sensorimotor control and facilitate positioning of the lower extremities and the pelvis, while protecting the lumbar spine.

Kinematics of the Pelvis, Torso, and Lower Limb During Obstacle Negotiation While Under Temporal Constraints.

PubMed

Christensen, Jesse C; Wilson, Christopher R; Merryweather, Andrew S; Foreman, K Bo

2017-04-01

Biomechanics of unobstructed locomotion consists of synchronized complex movements of the pelvis, torso, and lower limbs. These movement patterns become more complex as individuals encounter obstacles or negotiate uneven terrain. To date, limited research has explored how specifically the pelvis, torso, and lower limb segments relate to obstacle negotiation of varying sized objects combined with temporal constraints to perform the task. Understanding pelvis and adjoining segment movements during object negotiation will provide necessary information in identifying abnormal mechanics and potential fall risk characteristics in balance compromised patient populations. In this prospective cohort study, we aimed to compare pelvic, torso, and lower limb kinematics during unobstructed locomotion with obstacle negotiation of varying heights. Ten healthy young adults (7 females and 3 males, mean age 28.4 ± 4.1 years, mean body mass index 22.5 ± 3.6 kg/m 2 ) enrolled in this study. Analysis of within-subject differences revealed a significant increase in sagittal (posterior tilt) and frontal (ipsilateral hike) plane pelvic angular displacement and higher sagittal plane posterior torso lean angular displacement with increased obstacle height. Furthermore, both sagittal plane hip and knee maximum joint flexion were significantly higher with increasing heights of the obstacles during negotiation. These data provide insight on segment mechanics within a non-mobility-impaired population; therefore, providing a baseline to understand the kinematic demands necessary for safe and effective gait in mobility-compromised populations. Anat Rec, 300:732-738, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Developmental evidence for obstetric adaptation of the human female pelvis.

PubMed

Huseynov, Alik; Zollikofer, Christoph P E; Coudyzer, Walter; Gascho, Dominic; Kellenberger, Christian; Hinzpeter, Ricarda; Ponce de León, Marcia S

2016-05-10

The bony pelvis of adult humans exhibits marked sexual dimorphism, which is traditionally interpreted in the framework of the "obstetrical dilemma" hypothesis: Giving birth to large-brained/large-bodied babies requires a wide pelvis, whereas efficient bipedal locomotion requires a narrow pelvis. This hypothesis has been challenged recently on biomechanical, metabolic, and biocultural grounds, so that it remains unclear which factors are responsible for sex-specific differences in adult pelvic morphology. Here we address this issue from a developmental perspective. We use methods of biomedical imaging and geometric morphometrics to analyze changes in pelvic morphology from late fetal stages to adulthood in a known-age/known-sex forensic/clinical sample. Results show that, until puberty, female and male pelves exhibit only moderate sexual dimorphism and follow largely similar developmental trajectories. With the onset of puberty, however, the female trajectory diverges substantially from the common course, resulting in rapid expansion of obstetrically relevant pelvic dimensions up to the age of 25-30 y. From 40 y onward females resume a mode of pelvic development similar to males, resulting in significant reduction of obstetric dimensions. This complex developmental trajectory is likely linked to the pubertal rise and premenopausal fall of estradiol levels and results in the obstetrically most adequate pelvic morphology during the time of maximum female fertility. The evidence that hormones mediate female pelvic development and morphology supports the view that solutions of the obstetrical dilemma depend not only on selection and adaptation but also on developmental plasticity as a response to ecological/nutritional factors during a female's lifetime.

Reference data on muscle volumes of healthy human pelvis and lower extremity muscles: an in vivo magnetic resonance imaging feasibility study.

PubMed

Lube, Juliane; Cotofana, Sebastian; Bechmann, Ingo; Milani, Thomas L; Özkurtul, Orkun; Sakai, Tatsuo; Steinke, Hanno; Hammer, Niels

2016-01-01

Muscle volumes are of crucial interest when attempting to analyze individual physical performance and disease- or age-related alterations in muscle morphology. However, very little reference data are available in the literature on pelvis and lower extremity muscle volumes originating from healthy and young individuals. Furthermore, it is of interest if representative muscle volumes, covering large anatomical regions, can be obtained using magnetic resonance imaging (MRI) in a setting similar to the clinical routine. Our objective was therefore to provide encompassing, bilateral, 3-T MRI-based datasets on muscle volumes of the pelvis and the lower limb muscles. T1-weighted 3-T MRI records were obtained bilaterally from six young and healthy participants. Three-dimensional volumes were compiled from 28 muscles and muscle groups of each participant before the muscle volumes were computed. Muscle volumes were obtained from 28 muscles and muscle groups of the pelvis and lower extremity. Volumes were larger in male than in female participants. Volumes of the dominant and non-dominant sides were similar in both genders. The obtained results were in line with volumetric data obtained from smaller anatomical areas, thus extending the available datasets. This study provides an encompassing and feasible approach to obtain data on the muscle volumes of pelvic and limb muscles of healthy, young, and physically active individuals. The respective data form a basis to determine effects of therapeutic approaches, progression of diseases, or technical applications like automated segmentation algorithms applied to different populations.

Patient characteristics associated with differences in radiation exposure from pediatric abdomen-pelvis CT scans: a quantile regression analysis.

PubMed

Cooper, Jennifer N; Lodwick, Daniel L; Adler, Brent; Lee, Choonsik; Minneci, Peter C; Deans, Katherine J

2017-06-01

Computed tomography (CT) is a widely used diagnostic tool in pediatric medicine. However, due to concerns regarding radiation exposure, it is essential to identify patient characteristics associated with higher radiation burden from CT imaging, in order to more effectively target efforts towards dose reduction. Our objective was to identify the effects of various demographic and clinical patient characteristics on radiation exposure from single abdomen/pelvis CT scans in children. CT scans performed at our institution between January 2013 and August 2015 in patients under 16 years of age were processed using a software tool that estimates patient-specific organ and effective doses and merges these estimates with data from the electronic health record and billing record. Quantile regression models at the 50th, 75th, and 90th percentiles were used to estimate the effects of patients' demographic and clinical characteristics on effective dose. 2390 abdomen/pelvis CT scans (median effective dose 1.52mSv) were included. Of all characteristics examined, only older age, female gender, higher BMI, and whether the scan was a multiphase exam or an exam that required repeating for movement were significant predictors of higher effective dose at each quantile examined (all p<0.05). The effects of obesity and multiphase or repeat scanning on effective dose were magnified in higher dose scans. Older age, female gender, obesity, and multiphase or repeat scanning are all associated with increased effective dose from abdomen/pelvis CT. Targeted efforts to reduce dose from abdominal CT in these groups should be undertaken. Copyright © 2017 Elsevier Ltd. All rights reserved.

Influence of Surgical Approach on Pelvic Lift in Hip Arthroplasty During Cup Insertion.

PubMed

Brodt, Steffen; Windisch, Christoph; Krakow, Linda; Nowack, Dimitri; Matziolis, Georg

2017-07-01

The position of the acetabular cup is a major factor in the long-term outcome of total hip arthroplasty (THA). Malpositioning of the acetabular cup frequently has been reported with the use of a minimally invasive implantation technique. It remains unclear whether the limited visibility or the increased retractor traction and thus tilting of the pelvis during cup implantation is the cause. This study investigated the influence of iatrogenically related pelvic lift using an anterolateral minimally invasive THA technique. In a group of 30 consecutive patients who underwent THA via a minimally invasive anterolateral approach, iatrogenic lifting of the pelvis was measured with a smartphone using a 3-axis accelerometer and compared with patients in a historical age- and sex-matched control group who underwent THA using a transgluteal approach. Postoperatively, the inclination and anteversion of the cup was determined on pelvic radiographs. In the anterolateral group, the pelvis was lifted by a maximum of 6.3° and by an average of 3.9° when the acetabular cup was impacted; no difference was noted compared with the transgluteal group. In contrast, the cups in the anterolateral group showed significantly increased inclination and reduced anteversion. In both techniques, the iatrogenic tilting of the pelvis at the time of cup implantation occurred to a comparable extent. Therefore, the significant differences in postoperative radiographs cannot be attributed to increased retractor traction on exposure of the acetabulum, which means that the limited visibility must be responsible. [Orthopedics. 2017; 40(4):e589-e593.]. Copyright 2017, SLACK Incorporated.

The role of obesity, biomechanical constitution of the pelvis and contact joint stress in progression of hip osteoarthritis.

PubMed

Recnik, G; Kralj-Iglic, V; Iglic, A; Antolic, V; Kramberger, S; Rigler, I; Pompe, B; Vengust, R

2009-07-01

The aim of our study was to explore whether earlier hip arthroplasty for idiopathic osteoarthritis (OA) might be explained by enlarged contact stress in the hip joint, and to what amount can that be attributed to obesity and biomechanical constitution of the pelvis. Fifty subjects were selected from a list of consecutive recipients of hip endoprosthesis due to idiopathic OA; standard pelvic radiographs made years prior to surgery were the main selection criteria. For 65 hips resultant hip force and peak contact hip stress normalized to the body weight (R/Wb and p(max)/Wb) were determined from the radiographs with the HIPSTRESS method. Body weight and body mass index (BMI) were obtained with an interview. Regression analysis was used to correlate parameters of obesity (body weight, BMI), biomechanical constitution of the pelvis (R/Wb, p(max)/Wb) and mechanical loading within the hip joint (R, p(max)) with age at hip arthroplasty. Younger age at hip arthroplasty was associated with higher body weight (P=0.009), higher peak contact hip stress normalized to the body weight - p(max)/Wb (P=0.019), higher resultant hip force -R (P=0.027) and larger peak contact hip stress - p(max) (P<0.001), but not with BMI (P=0.121) or R/Wb (P=0.614). Our results suggest that enlarged contact stress (p(max)) plays an important role in rapid progression of hip OA with both obesity (increased body weight) and unfavorable biomechanical constitution of the pelvis (greater p(max)/Wb) contributing.

Developmental evidence for obstetric adaptation of the human female pelvis

PubMed Central

Huseynov, Alik; Zollikofer, Christoph P. E.; Coudyzer, Walter; Gascho, Dominic; Kellenberger, Christian; Hinzpeter, Ricarda; Ponce de León, Marcia S.

2016-01-01

The bony pelvis of adult humans exhibits marked sexual dimorphism, which is traditionally interpreted in the framework of the “obstetrical dilemma” hypothesis: Giving birth to large-brained/large-bodied babies requires a wide pelvis, whereas efficient bipedal locomotion requires a narrow pelvis. This hypothesis has been challenged recently on biomechanical, metabolic, and biocultural grounds, so that it remains unclear which factors are responsible for sex-specific differences in adult pelvic morphology. Here we address this issue from a developmental perspective. We use methods of biomedical imaging and geometric morphometrics to analyze changes in pelvic morphology from late fetal stages to adulthood in a known-age/known-sex forensic/clinical sample. Results show that, until puberty, female and male pelves exhibit only moderate sexual dimorphism and follow largely similar developmental trajectories. With the onset of puberty, however, the female trajectory diverges substantially from the common course, resulting in rapid expansion of obstetrically relevant pelvic dimensions up to the age of 25–30 y. From 40 y onward females resume a mode of pelvic development similar to males, resulting in significant reduction of obstetric dimensions. This complex developmental trajectory is likely linked to the pubertal rise and premenopausal fall of estradiol levels and results in the obstetrically most adequate pelvic morphology during the time of maximum female fertility. The evidence that hormones mediate female pelvic development and morphology supports the view that solutions of the obstetrical dilemma depend not only on selection and adaptation but also on developmental plasticity as a response to ecological/nutritional factors during a female’s lifetime. PMID:27114515

Surgical technique for balancing posterior spinal fusions to the pelvis using the T square of Tolo.

PubMed

Andras, Lindsay; Yamaguchi, Kent T; Skaggs, David L; Tolo, Vernon T

2012-12-01

Correcting pelvic obliquity and improving sitting balance in neuromuscular scoliosis often requires fixation to the pelvis. We describe the use of a T square instrument to assist intraoperatively in evaluating the alignment of these curves and achieving balance in the coronal plane. The T square instrument was constructed with a vertical limb perpendicular to 2 horizontal limbs in a T formation. At the conclusion of the instrumentation and preliminary reduction maneuvers, the T square was positioned with the horizontal limbs parallel to the pelvis and the vertical limb in line with the central sacral line. If the spine and pelvis were well balanced, fluoroscopic images demonstrated that the superior aspect of the vertical limb of the T square was crossing the vertebral body of T1. If this was not shown, then some combination of compression, distraction, or a change in the contouring of the rods was performed until this balance was achieved. In this series, we describe case examples in which the T square has been successfully used to aid in achieving balance in the coronal plane. This technique helps to overcome the challenges with positioning and imaging often encountered in managing these long, rigid curves. The T square is a useful adjunct in balancing posterior spinal fusions and evaluating the correction of pelvic obliquity in cases of neuromuscular scoliosis. This novel, yet simple, T square technique can be used for any method of posterior spinal fusion with lumbopelvic fixation to assist in the intraoperative evaluation and achievement of balance in the coronal plane and has become routine at our institution. IV.

CNS sites activated by renal pelvic epithelial sodium channels (ENaCs) in response to hypertonic saline in awake rats.

PubMed

Goodwill, Vanessa S; Terrill, Christopher; Hopewood, Ian; Loewy, Arthur D; Knuepfer, Mark M

2017-05-01

In some patients, renal nerve denervation has been reported to be an effective treatment for essential hypertension. Considerable evidence suggests that afferent renal nerves (ARN) and sodium balance play important roles in the development and maintenance of high blood pressure. ARN are sensitive to sodium concentrations in the renal pelvis. To better understand the role of ARN, we infused isotonic or hypertonic NaCl (308 or 500mOsm) into the left renal pelvis of conscious rats for two 2hours while recording arterial pressure and heart rate. Subsequently, brain tissue was analyzed for immunohistochemical detection of the protein Fos, a marker for neuronal activation. Fos-immunoreactive neurons were identified in numerous sites in the forebrain and brainstem. These areas included the nucleus tractus solitarius (NTS), the lateral parabrachial nucleus, the paraventricular nucleus of the hypothalamus (PVH) and the supraoptic nucleus (SON). The most effective stimulus was 500mOsm NaCl. Activation of these sites was attenuated or prevented by administration of benzamil (1μM) or amiloride (10μM) into the renal pelvis concomitantly with hypertonic saline. In anesthetized rats, infusion of hypertonic saline but not isotonic saline into the renal pelvis elevated ARN activity and this increase was attenuated by simultaneous infusion of benzamil or amiloride. We propose that renal pelvic epithelial sodium channels (ENaCs) play a role in activation of ARN and, via central visceral afferent circuits, this system modulates fluid volume and peripheral blood pressure. These pathways may contribute to the development of hypertension. Copyright © 2016 Elsevier B.V. All rights reserved.

Position of the quadriceps actuator influences knee loads during simulated squat testing.

PubMed

Hast, Michael W; Piazza, Stephen J

2018-05-17

The "Oxford Rig" cadaveric simulator permits researchers and clinicians to study knee mechanics during a simulated squatting motion. The motion of the lower limb in the Oxford Rig is typically controlled by a single actuator that applies tension to the quadriceps tendon. The location of the quadriceps actuator, however, has differed across published descriptions of the Oxford Rig. Actuators have been placed on the femur and pelvis, and on "grounded" locations external to the specimen, but the consequences of this placement for knee kinematics and kinetics are unknown. The purpose of this study was to examine these effects using a validated computational musculoskeletal model. When the actuator was placed on the femur or pelvis, forces realistically increased with knee flexion, with quadriceps and patellofemoral contact forces exceeding 2000 N and 3000 N, respectively, at 100° flexion. When the actuator was grounded, however, forces were substantially reduced and did not monotonically increase with flexion. Articular joint contact forces were not strongly influenced by changing the location of the actuator from the femur to the pelvis, with small RMS differences in quadriceps forces (48.2 N), patellofemoral forces (83.6 N), and tibiofemoral forces (58.9 N) between these conditions. The location of the actuator did not substantially affect knee kinematics. The results of this study suggest that the quadriceps actuator of the Oxford Rig should be attached to either the femur or the pelvis when the goal is to make realistic estimates of quadriceps forces and articular contact forces within the knee joint. Copyright © 2018 Elsevier Ltd. All rights reserved.

Comparison of different morphological parameters with duration of obstruction created experimentally in unilateral upper ureters: an animal model.

PubMed

Panda, Shasanka Shekhar; Bajpai, Minu; Mallick, Saumyaranjan; Sharma, Mehar C

2014-01-01

The objective of the following study is to determine and to compare the different morphological parameters with duration of obstruction created experimentally in unilateral upper ureters of rats. Unilateral upper ureteric obstruction was created in 60 adult Wistar rats that were reversed after predetermined intervals. Rats were sacrificed and ipsilateral kidneys were subjected for analysis of morphological parameters such as renal height, cranio-caudal diameter, antero-posterior diameter, lateral diameter, volume of the pelvis and average cortical thickness: Renal height. Renal height and cranio-caudal diameter of renal pelvis after ipsilateral upper ureteric obstruction started rising as early as 7 days of creating obstruction and were affected earlier than antero-posterior and lateral diameter and also were reversed earlier than other parameters after reversal of obstruction. Renal cortical thickness and volume of the pelvis were affected after prolonged obstruction (> 3 weeks) and were the late parameters to be reversed after reversal of obstruction. Cranio-caudal diameter and renal height were the early morphological parameters to be affected and reversed after reversal of obstruction in experimentally created ipsilateral upper ureteric obstruction.

Covariation between human pelvis shape, stature, and head size alleviates the obstetric dilemma

PubMed Central

Fischer, Barbara; Mitteroecker, Philipp

2015-01-01

Compared with other primates, childbirth is remarkably difficult in humans because the head of a human neonate is large relative to the birth-relevant dimensions of the maternal pelvis. It seems puzzling that females have not evolved wider pelvises despite the high maternal mortality and morbidity risk connected to childbirth. Despite this seeming lack of change in average pelvic morphology, we show that humans have evolved a complex link between pelvis shape, stature, and head circumference that was not recognized before. The identified covariance patterns contribute to ameliorate the “obstetric dilemma.” Females with a large head, who are likely to give birth to neonates with a large head, possess birth canals that are shaped to better accommodate large-headed neonates. Short females with an increased risk of cephalopelvic mismatch possess a rounder inlet, which is beneficial for obstetrics. We suggest that these covariances have evolved by the strong correlational selection resulting from childbirth. Although males are not subject to obstetric selection, they also show part of these association patterns, indicating a genetic–developmental origin of integration. PMID:25902498

Physiological asymmetry of trunk ranging and pelvis motility: an anatomo-functional study in 80 healthy subjects.

PubMed

Macchi, Claudio; Biricolti, Claudia; Cappelli, Lorenza; Galli, Francesca; Molino-Lova, Raffaele; Cecchi, Francesca; Corigliano, Alvaro; Miniati, Benedetta; Conti, Andrea A; Gulisano, Massimo; Catini, Claudio; Gensini, Gian Franco

2002-01-01

A key feature in physiotherapeutic treatment of patients with motion disturbances is the appropriate ranging of the trunk and pelvis motility. Eighty subjects randomly selected and free from known pathology of the muscular-skeletal and/or of the neurological system classed into four groups according to the age and the sex have been assessed, by using a new, simple and easy administrable tool. Our results demonstrate that the new measurement tool showed a very low intra- and inter-observer variability, that healthy subjects showed a more adduced and elevated right scapula if compared to the contralateral one and, as regard as the pelvic motion, a broader joint excursion in passive motion compared with active motion in the overall group, a broader joint excursion in young subjects compared with elderly ones, and a broader joint excursion in female subjects compared with males subjects. In conclusion our study allowed to identify a range of physiological asymmetry and pelvis motility. Such a range of physiological asymmetry might be useful as a reference for the physiotherapists.

Locomotor Adaptation to an Asymmetric Force on the Human Pelvis Directed Along the Right Leg.

PubMed

Vashista, Vineet; Martelli, Dario; Agrawal, Sunil

2015-09-11

In this work, we study locomotor adaptation in healthy adults when an asymmetric force vector is applied to the pelvis directed along the right leg. A cable-driven Active Tethered Pelvic Assist Device (A-TPAD) is used to apply an external force on the pelvis, specific to a subject's gait pattern. The force vector is intended to provide external weight bearing during walking and modify the durations of limb supports. The motivation is to use this paradigm to improve weight bearing and stance phase symmetry in individuals with hemiparesis. An experiment with nine healthy subjects was conducted. The results show significant changes in the gait kinematics and kinetics while the healthy subjects developed temporal and spatial asymmetry in gait pattern in response to the applied force vector. This was followed by aftereffects once the applied force vector was removed. The adaptation to the applied force resulted in asymmetry in stance phase timing and lower limb muscle activity. We believe this paradigm, when extended to individuals with hemiparesis, can show improvements in weight bearing capability with positive effects on gait symmetry and walking speed.

Cabozantinib-s-malate and Nivolumab With or Without Ipilimumab in Treating Patients With Metastatic Genitourinary Tumors

ClinicalTrials.gov

2018-04-02

Clear Cell Renal Cell Carcinoma; Metastatic Malignant Neoplasm in the Bone; Metastatic Penile Carcinoma; Renal Pelvis Urothelial Carcinoma; Squamous Cell Carcinoma of the Penis; Stage III Bladder Adenocarcinoma AJCC v6 and v7; Stage III Bladder Squamous Cell Carcinoma AJCC v6 and v7; Stage III Bladder Urothelial Carcinoma AJCC v6 and v7; Stage III Penile Cancer AJCC v7; Stage III Renal Cell Cancer AJCC v7; Stage III Renal Pelvis Cancer AJCC v7; Stage III Ureter Cancer AJCC v7; Stage III Urethral Cancer AJCC v7; Stage IIIa Penile Cancer AJCC v7; Stage IIIb Penile Cancer AJCC v7; Stage IV Bladder Adenocarcinoma AJCC v7; Stage IV Bladder Squamous Cell Carcinoma AJCC v7; Stage IV Bladder Urothelial Carcinoma AJCC v7; Stage IV Penile Cancer AJCC v7; Stage IV Renal Cell Cancer AJCC v7; Stage IV Renal Pelvis Cancer AJCC v7; Stage IV Ureter Cancer AJCC v7; Stage IV Urethral Cancer AJCC v7; Ureter Urothelial Carcinoma; Urethral Urothelial Carcinoma

Covariation between human pelvis shape, stature, and head size alleviates the obstetric dilemma.

PubMed

Fischer, Barbara; Mitteroecker, Philipp

2015-05-05

Compared with other primates, childbirth is remarkably difficult in humans because the head of a human neonate is large relative to the birth-relevant dimensions of the maternal pelvis. It seems puzzling that females have not evolved wider pelvises despite the high maternal mortality and morbidity risk connected to childbirth. Despite this seeming lack of change in average pelvic morphology, we show that humans have evolved a complex link between pelvis shape, stature, and head circumference that was not recognized before. The identified covariance patterns contribute to ameliorate the "obstetric dilemma." Females with a large head, who are likely to give birth to neonates with a large head, possess birth canals that are shaped to better accommodate large-headed neonates. Short females with an increased risk of cephalopelvic mismatch possess a rounder inlet, which is beneficial for obstetrics. We suggest that these covariances have evolved by the strong correlational selection resulting from childbirth. Although males are not subject to obstetric selection, they also show part of these association patterns, indicating a genetic-developmental origin of integration.

Struma Ovarii in Pregnancy: An Uncommon Cause of Hyperthyroidism.

PubMed

Merza, Zayd; White, Duncan; Khanem, Noor

2015-08-01

A 28-year-old woman presented with weight loss and tiredness. Investigations revealed hyperthyroidism. She was commenced on treatment and later became pregnant. Her thyroid levels remained raised, and she later underwent an elective cesarean delivery and ovarian cystectomy. Only a partial cystectomy was achieved, and histopathology examination revealed struma ovarii. An isotope uptake scan ((123)I) including her pelvis revealed low uptake in the thyroid gland and an area of high uptake in her pelvis. The cyst was subsequently removed, and within days, her thyroid hormone levels dropped. This case illustrates the importance of considering uncommon causes of hyperthyroidism.

Use of computed tomography abdomen and pelvis for investigation of febrile neutropenia in adult haematology patients.

PubMed

Lim, H Y; Ashby, M; Williams, B; Grigg, A

2016-11-01

We retrospectively evaluated the use of computed tomography abdomen and pelvis (CTAP) in febrile neutropenic autologous stem cell transplant (ASCT) and acute myeloid leukaemia (AML) patients. CTAP was more common in ASCT patients (59%) compared with AML (31%; P  < 0.001). Although abnormal findings were reported in 51%, only 10% resulted in therapy change (addition of anaerobic antibiotic/bowel rest), which would have otherwise been instituted based on clinical grounds. CTAP in these patients rarely provide useful information unsuspected clinically. © 2016 Royal Australasian College of Physicians.

Effects of balance ability and handgrip height on kinematics of the gait, torso, and pelvis in elderly women using a four-wheeled walker.

PubMed

Choi, Hyuk-Jae; Ko, Chang-Yong; Kang, Sungjae; Ryu, Jeicheong; Mun, Museong; Jeon, Hye-Seon

2015-02-01

Numerous elderly individuals use the four-wheeled walker (FWW) as a gait-assistive device. The walker's handgrip height is important for correct use. However, few clinical studies have investigated the biomechanical effects of the FWW's handgrip height on balance. Therefore, the present study assessed kinematic features of the gait, torso and pelvis during use of the FWW at two levels of handgrip height (48% vs 55% of the subject's height) while assessing balance in older adults. A total of 20 older adults were allocated into two groups according to the Berg Balance Scale (BBS): good balance (GB; BBS≥46) versus poor balance (PB; BBS<45). Participants walked with the FWW at 48% or 55% handgrip height for 10 m. Our study showed that the double-support period and stance phase significantly increased at 55% handgrip height, but the swing phase significantly decreased in the GB group. In the PB group, velocity and stride length significantly increased at 55% handgrip height. Tilt angle of the torso in the GB group was significantly lower at 55% than at 48% handgrip height, but no differences were observed in the PB group. In the pelvis, initial contact and toe-off angles of tilt were lower in the GB group at 55% handgrip height, but no differences were observed in the PB group. These results showed that kinematic features of the gait, torso, and pelvis in older adults using the FWW might be dependent on the handgrip height of the FWW and the patient's balance. Additionally, greater than 48% of the body height might be appropriate for older adults with poor balance. © 2014 Japan Geriatrics Society.

Pelvic dimorphism in relation to body size and body size dimorphism in humans.

PubMed

Kurki, Helen K

2011-12-01

Many mammalian species display sexual dimorphism in the pelvis, where females possess larger dimensions of the obstetric (pelvic) canal than males. This is contrary to the general pattern of body size dimorphism, where males are larger than females. Pelvic dimorphism is often attributed to selection relating to parturition, or as a developmental consequence of secondary sexual differentiation (different allometric growth trajectories of each sex). Among anthropoid primates, species with higher body size dimorphism have higher pelvic dimorphism (in converse directions), which is consistent with an explanation of differential growth trajectories for pelvic dimorphism. This study investigates whether the pattern holds intraspecifically in humans by asking: Do human populations with high body size dimorphism also display high pelvic dimorphism? Previous research demonstrated that in some small-bodied populations, relative pelvic canal size can be larger than in large-bodied populations, while others have suggested that larger-bodied human populations display greater body size dimorphism. Eleven human skeletal samples (total N: male = 229, female = 208) were utilized, representing a range of body sizes and geographical regions. Skeletal measurements of the pelvis and femur were collected and indices of sexual dimorphism for the pelvis and femur were calculated for each sample [ln(M/F)]. Linear regression was used to examine the relationships between indices of pelvic and femoral size dimorphism, and between pelvic dimorphism and female femoral size. Contrary to expectations, the results suggest that pelvic dimorphism in humans is generally not correlated with body size dimorphism or female body size. These results indicate that divergent patterns of dimorphism exist for the pelvis and body size in humans. Implications for the evaluation of the evolution of pelvic dimorphism and rotational childbirth in Homo are considered. Copyright © 2011 Elsevier Ltd. All rights reserved.

A novel combined hemipelvic endoprosthesis for peri-acetabular tumours involving sacroiliac joint: a finite element study.

PubMed

Wang, Bo; Sun, Peidong; Xie, Xianbiao; Wu, Weidong; Tu, Jian; Ouyang, Jun; Shen, Jingnan

2015-11-01

Our aim was to introduce a novel combined hemipelvic endoprosthesis for pelvic reconstruction after Enneking type I/II/IV resection and to evaluate the biomechanical properties of the endoprosthesis using finite element analysis. A three-dimensional finite element model of the postoperative pelvis was developed based on computed tomography (CT) images of the patient with the best post-operative limb function. A force of 400 N was applied along the longitudinal axis of the normal and post-operative pelvis for two positions: standing on two feet and sitting. Stress-distribution analysis was performed in both positions, and results were compared. Prosthesis improvements were simulated by intervertebral fusion and extra screw fixation. In the normal pelvis, stress distributions were mostly concentrated on the superior area of the acetabulum, arcuate line, sacroiliac joint and sacral midline in both static conditions, and peak stresses of 1.52 MPa and 4.53 MPa were observed at the superior area of the greater sciatic notch and ischial tuberosity, respectively. For the reconstructed hemipelvis, stress distributions were concentrated on the connecting rods of the acetabular component and the proximal segment of the pedicle rods, and peak stresses of 252 MPa and 213 MPa were observed on the proximal pedicle rods of the fourth lumbar vertebra for standing and sitting, respectively. Interbody fusion of the fourth and fifth lumbar vertebrae and extra screw fixation to the sacrum decreased the peak stresses by 33.0 % and 18.3 % while standing and by 10.8 % and 6.6 % while sitting. Reconstruction with combined hemipelvic endoprosthesis after types I/II/IV resection of the pelvis fulfilled physiological and biomechanical demands of the hemipelvis and yielded good biomechanical characteristics.

Patient-specific dose estimation for pediatric abdomen-pelvis CT

NASA Astrophysics Data System (ADS)

Li, Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Frush, Donald P.

2009-02-01

The purpose of this study is to develop a method for estimating patient-specific dose from abdomen-pelvis CT examinations and to investigate dose variation across patients in the same weight group. Our study consisted of seven pediatric patients in the same weight/protocol group, for whom full-body computer models were previously created based on the patients' CT data obtained for clinical indications. Organ and effective dose of these patients from an abdomen-pelvis scan protocol (LightSpeed VCT scanner, 120-kVp, 85-90 mA, 0.4-s gantry rotation period, 1.375-pitch, 40-mm beam collimation, and small body scan field-of-view) was calculated using a Monte Carlo program previously developed and validated for the same CT system. The seven patients had effective dose of 2.4-2.8 mSv, corresponding to normalized effective dose of 6.6-8.3 mSv/100mAs (coefficient of variation: 7.6%). Dose variations across the patients were small for large organs in the scan coverage (mean: 6.6%; range: 4.9%-9.2%), larger for small organs in the scan coverage (mean: 10.3%; range: 1.4%-15.6%), and the largest for organs partially or completely outside the scan coverage (mean: 14.8%; range: 5.7%-27.7%). Normalized effective dose correlated strongly with body weight (correlation coefficient: r = -0.94). Normalized dose to the kidney and the adrenal gland correlated strongly with mid-liver equivalent diameter (kidney: r = -0.97; adrenal glands: r = -0.98). Normalized dose to the small intestine correlated strongly with mid-intestine equivalent diameter (r = -0.97). These strong correlations suggest that patient-specific dose may be estimated for any other child in the same size group who undergoes the abdomen-pelvis scan.

Antero-posterior (AP) pelvis x-ray imaging on a trolley: Impact of trolley design, mattress design and radiographer practice on image quality and radiation dose.

PubMed

Tugwell, J R; England, A; Hogg, P

2017-08-01

Physical and technical differences exist between imaging on an x-ray tabletop and imaging on a trolley. This study evaluates how trolley imaging impacts image quality and radiation dose for an antero-posterior (AP) pelvis projection whilst subsequently exploring means of optimising this imaging examination. An anthropomorphic pelvis phantom was imaged on a commercially available trolley under various conditions. Variables explored included two mattresses, two image receptor holder positions, three source to image distances (SIDs) and four mAs values. Image quality was evaluated using relative visual grading analysis with the reference image acquired on the x-ray tabletop. Contrast to noise ratio (CNR) was calculated. Effective dose was established using Monte Carlo simulation. Optimisation scores were derived as a figure of merit by dividing effective dose with visual image quality scores. Visual image quality reduced significantly (p < 0.05) whilst effective dose increased significantly (p < 0.05) for images acquired on the trolley using identical acquisition parameters to the reference image. The trolley image with the highest optimisation score was acquired using 130 cm SID, 20 mAs, the standard mattress and platform not elevated. A difference of 12.8 mm was found between the image with the lowest and highest magnification factor (18%). The acquisition parameters used for AP pelvis on the x-ray tabletop are not transferable to trolley imaging and should be modified accordingly to compensate for the differences that exist. Exposure charts should be developed for trolley imaging to ensure optimal image quality at lowest possible dose. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Global geometric morphometric analyses of the human pelvis reveal substantial neutral population history effects, even across sexes.

PubMed

Betti, Lia; von Cramon-Taubadel, Noreen; Manica, Andrea; Lycett, Stephen J

2013-01-01

Recent applications of population genetic models to human craniodental traits have revealed a strong neutral component to patterns of global variation. However, little work has been undertaken to determine whether neutral processes might also be influencing the postcranium, perhaps due to substantial evidence for selection and plastic environmental responses in these regions. Recent work has provided evidence for neutral effects in the pelvis, but has been limited in regard to shape data (small numbers of linear measurements) and restricted only to males. Here, we use geometric morphometric methods to examine population variation in the human os coxae (pelvic bone) in both males and females. Neutrality is examined via apportionment of variance patterns and fit to an Out-of-Africa serial founder effect model, which is known to structure neutral genetic patterns. Moreover, we compare males and females directly, and the true versus false pelvis, in order to examine potential obstetrical effects. Our results indicate evidence for substantial neutral population history effects on pelvic shape variation. They also reveal evidence for the effect of obstetrical constraints, but these affect males and females to equivalent extents. Our results do not deny an important role for selection in regard to specific aspects of human pelvic variation, especially in terms of features associated with body size and proportions. However, our analyses demonstrate that at a global level, the shape of the os coxae reveals substantial evidence for neutral variation. Our analyses thus indicate that population variation in the human pelvis might be used to address important questions concerning population history, just as the human cranium has done.

Development of upper body coordination during sitting in typically developing infants

PubMed Central

KYVELIDOU, ANASTASIA; STUBERG, WAYNE A.; HARBOURNE, REGINA T.; DEFFEYES, JOAN E.; BLANKE, DANIEL; STERGIOU, NICHOLAS

2009-01-01

Pediatric Research Articles Ahead of Print contains articles in unedited manuscript form that have been peer-reviewed and accepted for publication. As a service to our readers, we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting and review of the resulting proof before it is published in its final definitive form. Please note that during the production process errors may be discovered, which could affect the content, and all legal disclaimers that apply to the journal pertain. Our goal was to determine how the actions of the thorax and the pelvis are organized and coordinated to achieve independent sitting posture in typically developing infants. The participants were ten typically developing infants that were evaluated longitudinally from first onset of sitting until sitting independence. Each infant underwent nine testing sessions. The first session included motor evaluation with the Peabody test. The other eight sessions occurred over a period of four months where sitting behavior was evaluated by angular kinematics of the thorax and the pelvis. A physical therapist evaluated sitting behavior in each session and categorized it according to five stages. The phasing relationship of the thorax and the pelvis was calculated and evaluated longitudinally using a one-way ANOVA. With development, the infants progressed from an in-phase (moving in the same direction) to an out-of-phase (moving in an opposite direction) coordinative relationship between the thorax and the pelvis segments. This change was significant for both the sagittal and frontal planes of motion. Clinically, this relationship is important because it provides a method to quantify infant sitting postural development, and can be used to assess efficacy of early interventions for pediatric populations with developmental motor delays. PMID:19190546

[Efficacy of antiseptics in the prevention of post-operative infections of the proximal femur, hip and pelvis regions in orthopedic pediatric patients. Analysis of the first results].

PubMed

Kokavec, M; Fristáková, M

2008-04-01

In orthopedics an infected operative wound always presents a serious complication that, apart from many adverse effects on the patient, increases the costs of therapy. The aim of this study was to analyze the effectiveness of antiseptic agents in the prevention of postoperative complications associated with surgery on the proximal femur, hip and pelvis in children. This prospective randomized study included 162 patients with the following diagnoses: cerebral palsy, developmental hip dysplasia, Perthes' disease, epiphyseolysis of the femoral head, and tumors. A total of 182 surgical procedures were carried out on soft and bone tissues in the proximal femur, hip and pelvis regions. The patients were allocated to two groups according to the intra-operative conditions used. Group 1, including 89 patients, was treated with 3.5 % solution of betadine before final closing of the wound and group 2, comprising 73 patients, received no betadine irrigation during the intraoperative period. The other operative and post-operative conditions provided for the patients were identical; surgery was carried out in one operating theatre without laminar air flow. The average follow-up was 7.8 months (range, 2-14 months). No infected operative wound was observed in group 1, and two superficial wound infections were recorded in group 2. The first results of our study suggest the need of prophylactic intra-operative irrigation of wounds in the hip and pelvis region. Irrigation with a diluted betadine solution is indicated in accord with the risk factors of the patient's diagnosis and the site of surgery, and also when the operative time is longer, there is insufficient protection with single-use surgical toweling, laminar air flow is present in the operating theatre or for other reasons.

Congenital ureteropelvic junction obstruction: physiopathology, decoupling of tout court pelvic dilatation-obstruction semantic connection, biomarkers to predict renal damage evolution.

PubMed

Alberti, C

2012-02-01

The widespread use of fetal ultrasonography results in a frequent antenatally observation of hydronephrosis, ureteropelvic junction obstruction (UPJO) accounting for the greatest fraction of congenital obstructive nephropathy. UPJO may be considered, in most cases, as a functional obstructive condition, depending on defective fetal smooth muscle/nerve development at this level, with lack of peristaltic wave propagation--aperistaltic segment--and, therefore, poor urine ejection from the renal pelvis into the ureter. The UPJO-related physiopathologic events are, at first, the compliant dilatation of renal pelvis that, acting as hydraulic buffer, protects the renal parenchyma from the rising intrapelvic pressure-related potential damages, and, subsequently, beyond such phase of dynamic balance, the tubular cell stretch-stress induced by increased intratubular pressure and following parenchymal inflammatory lesions: inflammatory infiltrates, fibroblast proliferation, activation of myofibroblasts, tubulo-interstitial fibrosis. Reactive oxygen species (ROS), nitric oxide (NO), several chemo- and cytokines, growth factors, prostaglandins and eicosanoids, angiotensin-II are the main pathogenetic mediators of the obstructive nephropathy. Apoptosis of tubular cells is the major cause of the tubular atrophy, together with epithelial-mesenchymal transdifferentiation. Some criticisms on tout court semantic renal pelvis dilatation-obstruction connection have been raised considering that the renal pelvis expansion isn't, in any case, linked to an ostructive condition, as it may be verified by diuretic (furosemide) renogram together with scintiscan-based evaluation of differential renal function. In this regard, rather than repetitive invasive nuclear procedures that expose the children to ionizing radiations, an intriguing noninvasive strategy, based on the evaluation of urinary biomarkers and urinary proteome, can define the UPJO-related possible progress of parenchymal lesions, thus predicting which patients must require an obstruction correcting surgery and in which patients, instead, the hydronephrosis will spontaneously resolve.

Modelling resonances of the standing body exposed to vertical whole-body vibration: Effects of posture

NASA Astrophysics Data System (ADS)

Subashi, G. H. M. J.; Matsumoto, Y.; Griffin, M. J.

2008-10-01

Lumped parameter mathematical models representing anatomical parts of the human body have been developed to represent body motions associated with resonances of the vertical apparent mass and the fore-and-aft cross-axis apparent mass of the human body standing in five different postures: 'upright', 'lordotic', 'anterior lean', 'knees bent', and 'knees more bent'. The inertial and geometric parameters of the models were determined from published anthropometric data. Stiffness and damping parameters were obtained by comparing model responses with experimental data obtained previously. The principal resonance of the vertical apparent mass, and the first peak in the fore-and-aft cross-axis apparent mass, of the standing body in an upright posture (at 5-6 Hz) corresponded to vertical motion of the viscera in phase with the vertical motion of the entire body due to deformation of the tissues at the soles of the feet, with pitch motion of the pelvis out of phase with pitch motion of the upper body above the pelvis. Upward motion of the body was in phase with the forward pitch motion of the pelvis. Changing the posture of the upper body had minor effects on the mode associated with the principal resonances of the apparent mass and cross-axis apparent mass, but the mode changed significantly with bending of the legs. In legs-bent postures, the principal resonance (at about 3 Hz) was attributed to bending of the legs coupled with pitch motion of the pelvis in phase with pitch motion of the upper body. In this mode, extension of the legs was in phase with the forward pitch motion of the upper body and the upward vertical motion of the viscera.

Cesarean section indications and anthropometric parameters in Rwandan nulliparae: preliminary results from a longitudinal survey.

PubMed

Kakoma, Jean-Baptiste

2016-01-01

Maternal anthropometric parameters as risk factors for cesarean section have always been a matter of interest and concern for obstetricians. Some of these parameters have been shown to be predictors of dystocia. This study aims at showing the relationship between cesarean section indications and anthropometric parameters sizes in Rwandan nulliparae for the purpose of comparison and appropriate recommendations. A cross-sectional and analytical study was made on data collected from 32 operated patients among 152 nulliparae with singleton pregnancy at term and vertex presentation. Concerned anthropometric parameters were height, weight and six pelvic distances. Fisher exact and Student's tests were used to compare observed proportions and mean values, respectively. Findings were as follows: 1) the overall cesarean section rate was 21.05%; 2) acute fetal distress (31.3 %), generally contracted pelvis (28.1 %), and engagement failure (25%) were the most frequent indications of cesarean section; 3) all patients ≤ 145 cm tall were operated on for general pelvis contraction whose proportion was significantly higher in them than in the others (p < 0.01); 4) more than half of pelvis contraction cases were observed in patients weighing ≤ 50 kg, but the difference with other weight categories was not significant; 5) considered external pelvic diameters but the Biiliac Diameter displayed average measurements smaller in clinically contracted pelvis than in other CS indications. External pelvimetry associated with specific other anthropometric parameters could be helpful in the screening of generally contracted pelves, and consequently pregnancies at high risk of cephalopelvic disproportion in nulliparous women, particularly in developing countries with limited resources. Further investigations are requested to deal with this topic in depth.

The relationship of body mass index and abdominal fat on the radiation dose received during routine computed tomographic imaging of the abdomen and pelvis.

PubMed

Chan, Victoria O; McDermott, Shaunagh; Buckley, Orla; Allen, Sonya; Casey, Michael; O'Laoide, Risteard; Torreggiani, William C

2012-11-01

To determine the relationship of increasing body mass index (BMI) and abdominal fat on the effective dose acquired from computed tomography (CT) abdomen and pelvis scans. Over 6 months, dose-length product and total milliamp-seconds (mAs) from routine CT abdomen and pelvis scans of 100 patients were recorded. The scans were performed on a 64-slice CT scanner by using an automatic exposure control system. Effective dose (mSv) based on dose-length product, BMI, periumbilical fat thickness, and intra-abdominal fat were documented for each patient. BMI, periumbilical fat thickness, and intra-abdominal fat were compared with effective dose. Thirty-nine men and 61 women were included in the study (mean age, 56.3 years). The mean BMI was 26.2 kg/m(2). The mean effective dose was 10.3 mSv. The mean periumbilical fat thickness was 2.4 cm. Sixty-five patients had a small amount of intra-abdominal fat, and 35 had a large amount of intra-abdominal fat. The effective dose increased with increasing BMI (P < .001) and increasing amounts of intra-abdominal fat (P < .001). For every kilogram of weight, there is a 0.13 mSv increase in effective dose, which is equal to 6.5 chest radiographs per CT examination. For an increase in BMI by 5 kg/m(2), there is a 1.95 mSv increase in effective dose, which is equal to 97.5 chest radiographs per CT examination. Increasing BMI and abdominal fat significantly increases the effective dose received from CT abdomen and pelvis scans. Copyright © 2012 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

The segmentation of bones in pelvic CT images based on extraction of key frames.

PubMed

Yu, Hui; Wang, Haijun; Shi, Yao; Xu, Ke; Yu, Xuyao; Cao, Yuzhen

2018-05-22

Bone segmentation is important in computed tomography (CT) imaging of the pelvis, which assists physicians in the early diagnosis of pelvic injury, in planning operations, and in evaluating the effects of surgical treatment. This study developed a new algorithm for the accurate, fast, and efficient segmentation of the pelvis. The proposed method consists of two main parts: the extraction of key frames and the segmentation of pelvic CT images. Key frames were extracted based on pixel difference, mutual information and normalized correlation coefficient. In the pelvis segmentation phase, skeleton extraction from CT images and a marker-based watershed algorithm were combined to segment the pelvis. To meet the requirements of clinical application, physician's judgment is needed. Therefore the proposed methodology is semi-automated. In this paper, 5 sets of CT data were used to test the overlapping area, and 15 CT images were used to determine the average deviation distance. The average overlapping area of the 5 sets was greater than 94%, and the minimum average deviation distance was approximately 0.58 pixels. In addition, the key frame extraction efficiency and the running time of the proposed method were evaluated on 20 sets of CT data. For each set, approximately 13% of the images were selected as key frames, and the average processing time was approximately 2 min (the time for manual marking was not included). The proposed method is able to achieve accurate, fast, and efficient segmentation of pelvic CT image sequences. Segmentation results not only provide an important reference for early diagnosis and decisions regarding surgical procedures, they also offer more accurate data for medical image registration, recognition and 3D reconstruction.

Running Technique is an Important Component of Running Economy and Performance

PubMed Central

FOLLAND, JONATHAN P.; ALLEN, SAM J.; BLACK, MATTHEW I.; HANDSAKER, JOSEPH C.; FORRESTER, STEPHANIE E.

2017-01-01

ABSTRACT Despite an intuitive relationship between technique and both running economy (RE) and performance, and the diverse techniques used by runners to achieve forward locomotion, the objective importance of overall technique and the key components therein remain to be elucidated. Purpose This study aimed to determine the relationship between individual and combined kinematic measures of technique with both RE and performance. Methods Ninety-seven endurance runners (47 females) of diverse competitive standards performed a discontinuous protocol of incremental treadmill running (4-min stages, 1-km·h−1 increments). Measurements included three-dimensional full-body kinematics, respiratory gases to determine energy cost, and velocity of lactate turn point. Five categories of kinematic measures (vertical oscillation, braking, posture, stride parameters, and lower limb angles) and locomotory energy cost (LEc) were averaged across 10–12 km·h−1 (the highest common velocity < velocity of lactate turn point). Performance was measured as season's best (SB) time converted to a sex-specific z-score. Results Numerous kinematic variables were correlated with RE and performance (LEc, 19 variables; SB time, 11 variables). Regression analysis found three variables (pelvis vertical oscillation during ground contact normalized to height, minimum knee joint angle during ground contact, and minimum horizontal pelvis velocity) explained 39% of LEc variability. In addition, four variables (minimum horizontal pelvis velocity, shank touchdown angle, duty factor, and trunk forward lean) combined to explain 31% of the variability in performance (SB time). Conclusions This study provides novel and robust evidence that technique explains a substantial proportion of the variance in RE and performance. We recommend that runners and coaches are attentive to specific aspects of stride parameters and lower limb angles in part to optimize pelvis movement, and ultimately enhance performance. PMID:28263283

[Abnormal growth of spine in patients with adolescent idiopathic thoracic scoliosis].

PubMed

Bao, Hongda; Liu, Zhen; Qiu, Yong; Zhu, Feng; Zhu, Zezhang; Zhang, Wen

2014-05-01

To investigate if the growth patterns of the spine and pelvis are consistent in adolescent idiopathic scoliosis (AIS) patients with single thoracic curves. Forty-eight thoracic adolescent idiopathic scoliosis (T-AIS) female patients and 48 healthy age-matched adolescents were recruited consecutively between December 2011 and October 2012. Radiographic parameters including height of spine (HOS), length of spine (LOS), height of thoracic spine (HOT), length of thoracic spine (LOT), height of pelvis (HOP), width of pelvis (WOP) and width of thorax (WOT) were measured on the long-cassette posteroanterior standing radiographs. In addition, ratios including HOS/HOP, LOS/HOP, HOT/HOP, LOT/HOP, LOS/LOT, WOT/WOP were also calculated. Independent t-test was performed to compare the radiographic parameters and ratios between the two groups. Compared to the age-matched healthy adolescents, T-AIS patients had a significantly higher LOS and LOT (t = -2.364 and -1.495, P = 0.020 and 0.043) and smaller HOS and HOT (t = 2.060 and 3.359, P = 0.042 and 0.001). Yet, all of HOP, WOP and WOT showed no significant difference between T-AIS patients and healthy adolescents. Similarly, LOS/HOP and LOT/HOP were significantly higher in T-AIS patients as may be expected with an average LOS/HOP of 2.26 ± 0.14 in normal controls.In addition, LOS/LOT in normal controls had a trend of increase with age which was different from the stable LOS/LOT in T-AIS patients, indicating an increased growth of thoracic vertebra compared to lumbar vertebra. Compared to the age-matched healthy adolescents, T-AIS patients have an abnormal growth characteristics with longer spine. The growth of pelvis and thorax show no significant differences between T-AIS patients and healthy adolescents.

Transatlantic Comparison of CT Radiation Doses in the Era of Radiation Dose-Tracking Software.

PubMed

Parakh, Anushri; Euler, Andre; Szucs-Farkas, Zsolt; Schindera, Sebastian T

2017-12-01

The purpose of this study is to compare diagnostic reference levels from a local European CT dose registry, using radiation-tracking software from a large patient sample, with preexisting European and North American diagnostic reference levels. Data (n = 43,761 CT scans obtained over the course of 2 years) for the European local CT dose registry were obtained from eight CT scanners at six institutions. Means, medians, and interquartile ranges of volumetric CT dose index (CTDI vol ), dose-length product (DLP), size-specific dose estimate, and effective dose values for CT examinations of the head, paranasal sinuses, thorax, pulmonary angiogram, abdomen-pelvis, renal-colic, thorax-abdomen-pelvis, and thoracoabdominal angiogram were obtained using radiation-tracking software. Metrics from this registry were compared with diagnostic reference levels from Canada and California (published in 2015), the American College of Radiology (ACR) dose index registry (2015), and national diagnostic reference levels from local CT dose registries in Switzerland (2010), the United Kingdom (2011), and Portugal (2015). Our local registry had a lower 75th percentile CTDI vol for all protocols than did the individual internationally sourced data. Compared with our study, the ACR dose index registry had higher 75th percentile CTDI vol values by 55% for head, 240% for thorax, 28% for abdomen-pelvis, 42% for thorax-abdomen-pelvis, 128% for pulmonary angiogram, 138% for renal-colic, and 58% for paranasal sinus studies. Our local registry had lower diagnostic reference level values than did existing European and North American diagnostic reference levels. Automated radiation-tracking software could be used to establish and update existing diagnostic reference levels because they are capable of analyzing large datasets meaningfully.

Treatment of aneurysmal bone cysts of the pelvis and sacrum.

PubMed

Papagelopoulos, P J; Choudhury, S N; Frassica, F J; Bond, J R; Unni, K K; Sim, F H

2001-11-01

Aneurysmal bone cysts are benign, non-neoplastic, highly vascular bone lesions. The purpose of this study was to describe the prevalence, the clinical presentation, and the recurrence rate of aneurysmal bone cysts of the pelvis and sacrum and to examine the diagnostic and therapeutic options and prognosis for patients with this condition. Forty consecutive patients with an aneurysmal bone cyst of the pelvis and/or sacrum were treated from 1921 to 1996. Their medical records and radiographic and imaging studies were reviewed, and histological sections from the cysts were examined. Seventeen lesions were iliosacral, sixteen were acetabular, and seven were ischiopubic. Seven involved the hip joint, and two involved the sacroiliac joint. All twelve sacral lesions extended to more than one sacral segment and were associated with neurological signs and symptoms. Destructive acetabular lesions were associated with pathological fracture in five patients and with medial migration of the femoral head, hip subluxation, and hip dislocation in one patient each. The mean duration of follow-up was thirteen years (range, three to fifty-three years). Thirty-five patients who were initially treated for a primary lesion had surgical treatment (twenty-one had excision-curettage and fourteen had intralesional excision); two patients also had adjuvant radiation therapy. Of the thirty-five patients, five (14%) had a local recurrence noted less than eighteen months after the operation. Of five patients initially treated for a recurrent lesion, one had a local recurrence. At the latest follow-up examination, all forty patients were disease-free and twenty-eight (70%) were asymptomatic. There were two deep infections. Aneurysmal bone cysts of the pelvis and sacrum are usually aggressive lesions associated with substantial bone destruction, pathological fractures, and local recurrence. Current management recommendations include preoperative selective arterial embolization, excision-curettage, and bone-grafting.

Computed tomography landmark-based semi-automated mesh morphing and mapping techniques: generation of patient specific models of the human pelvis without segmentation.

PubMed

Salo, Zoryana; Beek, Maarten; Wright, David; Whyne, Cari Marisa

2015-04-13

Current methods for the development of pelvic finite element (FE) models generally are based upon specimen specific computed tomography (CT) data. This approach has traditionally required segmentation of CT data sets, which is time consuming and necessitates high levels of user intervention due to the complex pelvic anatomy. The purpose of this research was to develop and assess CT landmark-based semi-automated mesh morphing and mapping techniques to aid the generation and mechanical analysis of specimen-specific FE models of the pelvis without the need for segmentation. A specimen-specific pelvic FE model (source) was created using traditional segmentation methods and morphed onto a CT scan of a different (target) pelvis using a landmark-based method. The morphed model was then refined through mesh mapping by moving the nodes to the bone boundary. A second target model was created using traditional segmentation techniques. CT intensity based material properties were assigned to the morphed/mapped model and to the traditionally segmented target models. Models were analyzed to evaluate their geometric concurrency and strain patterns. Strains generated in a double-leg stance configuration were compared to experimental strain gauge data generated from the same target cadaver pelvis. CT landmark-based morphing and mapping techniques were efficiently applied to create a geometrically multifaceted specimen-specific pelvic FE model, which was similar to the traditionally segmented target model and better replicated the experimental strain results (R(2)=0.873). This study has shown that mesh morphing and mapping represents an efficient validated approach for pelvic FE model generation without the need for segmentation. Copyright © 2015 Elsevier Ltd. All rights reserved.

How Did the Pelvis and Vertebral Column Become a Functional Unit during the Transition from Occasional to Permanent Bipedalism?

PubMed

Tardieu, Christine; Hasegawa, Kazuhiro; Haeusler, Martin

2017-05-01

The functional linkage between pelvis and spine remained long hidden to science. Here, we recount the history of research that led in 1992 to the discovery of the "angle of sacral incidence" by the team of G. Duval-Beaupère. This angle, formed between a ray from the hip joint center to the superior sacral surface and the perpendicular to the sacral surface, was later called pelvic incidence. Specific to each individual, pelvic incidence is tightly correlated with the degree of lumbar lordosis. It is each individual's "signature" for an efficient sagittal balance since it represents the sum of two positional parameters, sacral slope and pelvic tilt. The simultaneous experimental determination of the trunk line of gravity permitted Duval-Beaupère's team to elucidate the conditions of an efficient sagittal balance of the trunk on the lower limbs. We present an in vivo EOS study of eight spino-pelvic parameters describing the sagittal balance in 131 adults. We observe a chain of correlations between the six angular parameters and discuss the functional significance of these results. We show that pelvic incidence increases and lumbar lordosis develops when the infant learns to walk, leading to a correlation between these parameters. This process of association between pelvis and spine might have acquired a solid genetic basis during hominid evolution by natural selection acting on both pelvis and spine. We suggest that this process of functional integration was only possible in the context of bipedal locomotion becoming permanent and stereotyped, expressed by a relatively invariant, periodic walking cycle. Anat Rec, 300:912-931, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

The influence of simulated transversus abdominis muscle force on sacroiliac joint flexibility during asymmetric moment application to the pelvis.

PubMed

Gnat, Rafael; Spoor, Kees; Pool-Goudzwaard, Annelies

2015-10-01

The role of so-called local muscle system in motor control of the lower back and pelvis is a subject of ongoing debate. Prevailing beliefs in stabilizing function of this system were recently challenged. This study investigated the impact of in vitro simulated force of transversely oriented fibres of the transversus abdominis muscle (a part of the local system) on flexibility of the sacroiliac joint during asymmetric moment application to the pelvis. In 8 embalmed specimens an incremental moment was applied in the sagittal plane to one innominate with respect to the fixed contralateral innominate. Ranges of motion of the sacroiliac joint were recorded using the Vicon Motion Capture System. Load-deformation curves were plotted and flexibility of the sacroiliac joint was calculated separately for anterior and posterior rotations of the innominate, with and without simulated muscle force. Flexibility of the sacroiliac joint was significantly bigger during anterior rotation of the innominate, as compared to posterior rotation (Anova P<0.05). After application of simulated force of transversus abdominis, flexibility of the joint did not change both during anterior and posterior rotations of the innominate. A lack of a stiffening effect of simulated transversus abdominis force on the sacroiliac joint was demonstrated. Earlier hypotheses suggesting a stiffening influence of this muscle on the pelvis cannot be confirmed. Consistent with previous findings smaller flexibility of the joint recorded during posterior rotation of the innominate may be of clinical importance for physio- and manual therapists. However, major limitations of the study should be acknowledged: in vitro conditions and simulation of only solitary muscle force. Copyright © 2015 Elsevier Ltd. All rights reserved.

Global Geometric Morphometric Analyses of the Human Pelvis Reveal Substantial Neutral Population History Effects, Even across Sexes

PubMed Central

Betti, Lia; von Cramon-Taubadel, Noreen; Manica, Andrea; Lycett, Stephen J.

2013-01-01

Recent applications of population genetic models to human craniodental traits have revealed a strong neutral component to patterns of global variation. However, little work has been undertaken to determine whether neutral processes might also be influencing the postcranium, perhaps due to substantial evidence for selection and plastic environmental responses in these regions. Recent work has provided evidence for neutral effects in the pelvis, but has been limited in regard to shape data (small numbers of linear measurements) and restricted only to males. Here, we use geometric morphometric methods to examine population variation in the human os coxae (pelvic bone) in both males and females. Neutrality is examined via apportionment of variance patterns and fit to an Out-of-Africa serial founder effect model, which is known to structure neutral genetic patterns. Moreover, we compare males and females directly, and the true versus false pelvis, in order to examine potential obstetrical effects. Our results indicate evidence for substantial neutral population history effects on pelvic shape variation. They also reveal evidence for the effect of obstetrical constraints, but these affect males and females to equivalent extents. Our results do not deny an important role for selection in regard to specific aspects of human pelvic variation, especially in terms of features associated with body size and proportions. However, our analyses demonstrate that at a global level, the shape of the os coxae reveals substantial evidence for neutral variation. Our analyses thus indicate that population variation in the human pelvis might be used to address important questions concerning population history, just as the human cranium has done. PMID:23409086

Anatomical study of the pelvis in patients with adolescent idiopathic scoliosis

PubMed Central

Qiu, Xu-Sheng; Zhang, Jun-Jie; Yang, Shang-Wen; Lv, Feng; Wang, Zhi-Wei; Chiew, Jonathan; Ma, Wei-Wei; Qiu, Yong

2012-01-01

Standing posterior–anterior (PA) radiographs from our clinical practice show that the concave and convex ilia are not always symmetrical in patients with adolescent idiopathic scoliosis (AIS). Transverse pelvic rotation may explain this observation, or pelvic asymmetry may be responsible. The present study investigated pelvic symmetry by examining the volume and linear measurements of the two hipbones in patients with AIS. Forty-two female patients with AIS were recruited for the study. Standing PA radiographs (covering the thoracic and lumbar spinal regions and the entire pelvis), CT scans and 3D reconstructions of the pelvis were obtained for all subjects. The concave/convex ratio of the inferior ilium at the sacroiliac joint medially (SI) and the anterior superior iliac spine laterally (ASIS) were measured on PA radiographs. Hipbone volumes and several distortion and abduction parameters were measured by post-processing software. The concave/convex ratio of SI–ASIS on PA radiographs was 0.97, which was significantly < 1 (P < 0.001). The concave and convex hipbone volumes were comparable in patients with AIS. The hipbone volumes were 257.3 ± 43.5 cm3 and 256.9 ± 42.6 cm3 at the concave and convex sides, respectively (P > 0.05). Furthermore, all distortion and abduction parameters were comparable between the convex and concave sides. Therefore, the present study showed that there was no pelvic asymmetry in patients with AIS, although the concave/convex ratio of SI–ASIS on PA radiographs was significantly < 1. The clinical phenomenon of asymmetrical concave and convex ilia in patients with AIS in preoperative standing PA radiographs may be caused by transverse pelvic rotation, but it is not due to developmental asymmetry or distortion of the pelvis. PMID:22133294

Anatomical study of the pelvis in patients with adolescent idiopathic scoliosis.

PubMed

Qiu, Xu-Sheng; Zhang, Jun-Jie; Yang, Shang-Wen; Lv, Feng; Wang, Zhi-Wei; Chiew, Jonathan; Ma, Wei-Wei; Qiu, Yong

2012-02-01

Standing posterior-anterior (PA) radiographs from our clinical practice show that the concave and convex ilia are not always symmetrical in patients with adolescent idiopathic scoliosis (AIS). Transverse pelvic rotation may explain this observation, or pelvic asymmetry may be responsible. The present study investigated pelvic symmetry by examining the volume and linear measurements of the two hipbones in patients with AIS. Forty-two female patients with AIS were recruited for the study. Standing PA radiographs (covering the thoracic and lumbar spinal regions and the entire pelvis), CT scans and 3D reconstructions of the pelvis were obtained for all subjects. The concave/convex ratio of the inferior ilium at the sacroiliac joint medially (SI) and the anterior superior iliac spine laterally (ASIS) were measured on PA radiographs. Hipbone volumes and several distortion and abduction parameters were measured by post-processing software. The concave/convex ratio of SI-ASIS on PA radiographs was 0.97, which was significantly < 1 (P < 0.001). The concave and convex hipbone volumes were comparable in patients with AIS. The hipbone volumes were 257.3 ± 43.5 cm(3) and 256.9 ± 42.6 cm(3) at the concave and convex sides, respectively (P > 0.05). Furthermore, all distortion and abduction parameters were comparable between the convex and concave sides. Therefore, the present study showed that there was no pelvic asymmetry in patients with AIS, although the concave/convex ratio of SI-ASIS on PA radiographs was significantly < 1. The clinical phenomenon of asymmetrical concave and convex ilia in patients with AIS in preoperative standing PA radiographs may be caused by transverse pelvic rotation, but it is not due to developmental asymmetry or distortion of the pelvis. © 2011 The Authors. Journal of Anatomy © 2011 Anatomical Society.

Long-term changes in body proportions since 1983 to 2010 in children and adolescents from Kraków (Poland).

PubMed

Woronkowicz, Agnieszka; Kryst, Łukasz; Kowal, Małgorzata; Brudecki, Janusz; Sobiecki, Jan

The aim of the study was to assess changes in body proportions and the rate of growth in boys and girls from the population of Kraków (Poland) in the years 1983-2010. The children and adolescents analyzed in this study were included in three cross-sectional surveys conducted in Kraków in 1983, 2000 and 2010. The sample sizes were the following: 3,214 boys and 3,250 girls in 1983, 2,381 boys and 2,096 girls in 2000, 1,889 boys and 1,989 girls in 2010. The comparison of selected features and indices were made: subischial leg length, biacromial width, biiliac width, reciprocal ponderal index, skelic index, pelvi-acromial index, shoulder-height ratio, pelvis-height ratio. To analyze the rate of growth the modeling functions of Preece-Baines (PB1) were used. Over the analyzed period, the children and adolescents from Kraków showed a positive secular trend for all the analyzed traits, especially consistent in the width of the pelvis and shoulders. The acceleration of development was reflected in the earlier pubertal spurt in the studied lengths and widths. The changes in body proportions showed a tendency to more slender body proportions in children between 3 and 8 years of age in girls and after puberty, and the relative shortening of the lower limbs. In the group of boys, there was a distinct widening of hips and pelvis, more pronounced than in height. In girls, similar changes were noted only until the period of puberty, and throughout the entire duration of ontogeny for the shoulders-height ratio.

Review of techniques for monitoring the healing fracture of bones for implementation in an internally fixated pelvis.

PubMed

Wong, Lydia Chwang Yuh; Chiu, Wing Kong; Russ, Matthias; Liew, Susan

2012-03-01

Sacral fractures from high-impact trauma often cause instability in the pelvic ring structure. Treatment is by internal fixation which clamps the fractured edges together to promote healing. Healing could take up to 12 weeks whereby patients are bedridden to avoid hindrances to the fracture from movement or weight bearing activities. Immobility can lead to muscle degradation and longer periods of rehabilitation. The ability to determine the time at which the fracture is stable enough to allow partial weight-bearing is important to reduce hospitalisation time. This review looks into different techniques used for monitoring the fracture healing of bones which could lead to possible methods for in situ and non-invasive assessment of healing fracture in a fixated pelvis. Traditional techniques being used include radiology and CT scans but were found to be unreliable at times and very subjective in addition to being non in situ. Strain gauges have proven to be very effective for accurate assessment of fracture healing as well as stability for long bones with external fixators but may not be suitable for an internally fixated pelvis. Ultrasound provides in situ monitoring of stiffness recovery but only assesses local fracture sites close to the skin surface and has only been tested on long bones. Vibration analysis can detect non-uniform healing due to its assessment of the overall structure but may suffer from low signal-to-noise ratio due to damping. Impedance techniques have been used to assess properties of non-long bones but recent studies have only been conducted on non-biological materials and more research needs to be done before it can be applicable for monitoring healing in the fixated pelvis. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

Acute Management of the Traumatically Injured Pelvis.

PubMed

Skitch, Steven; Engels, Paul T

2018-02-01

Severe pelvic trauma is a challenging condition. The pelvis can create multifocal hemorrhage that is not easily compressible nor managed by traditional surgical methods such as tying off a blood vessel or removing an organ. Its treatment often requires reapproximation of bony structures, damage control resuscitation, assessment for associated injuries, and triage of investigations, as well as multimodality hemorrhage control (external fixation, preperitoneal packing, angioembolization, REBOA [resuscitative endovascular balloon occlusion of the aorta]) by multidisciplinary trauma specialists (general surgeons, orthopedic surgeons, endovascular surgeons/interventional radiologists). This article explores this complex clinical problem and provides a practical approach to its management. Copyright © 2017 Elsevier Inc. All rights reserved.

[Case report of rare co-occurrence of renal cell carcinoma and crossed renal dystopia (L-shaped kidney)].

PubMed

Bakov, V N; Los, M S

2017-10-01

L-shaped kidney refers to a rare anomaly of the relative kidney positioning. Due to low prevalence, the literature on the co-occurrence of this anomaly with malignancy is lacking. And, if the diagnosis of a renal anomaly does not present difficulties, if a tumor is detected in such a kidney, even MSCT does not always help differentiate a pelvic tumor from a tumor of the renal parenchyma spreading to the pelvicalyceal system. This has important implications for choosing an appropriate surgical strategy. A feature of the presented clinical observation is the co-occurrence of the rare anomaly of kidney position and locally advanced renal cell carcinoma spreading to the renal pelvis. Due to the massive spread of the tumor, an organ-sparing surgery was not feasible. Due to the suspicion of tumor spread to the renal pelvis, the patient underwent nephrureterectomy of the L-shaped kidney. Introduction to renoprival state with transfer to chronic hemodialysis became the only option to maintain homeostasis and extend the patients life. Histological examination revealed clear cell renal cell carcinoma with invasion of the pelvis and renal capsule, with no clear demarcation between the fused kidneys.

Xanthogranulomatous Salpingooophoritis: The Youngest Documented Case Report

PubMed Central

Tanwar, Harshawardhan; Joshi, Avinash; Wagaskar, Vinayak; Kini, Siddharth; Bachhav, Manoj

2015-01-01

Background. Xanthogranulomatous inflammation is an uncommon affection of the female genital tract. The youngest case reported of xanthogranulomatous salpingooophoritis in literature was by Shilpa et al. in 2013 in an eighteen-year-old female. Case Report. We report a case of 2-year-old female child with right-sided xanthogranulomatous salpingooophoritis presented as mass in abdomen. This is a case report of the youngest documented case of xanthogranulomatous salpingooophoritis in literature. As per abdominal examination, there was generalized distention of abdomen and a mass was palpable which was arising out of pelvis more on the right side. The ultrasonography (USG) abdomen and pelvis revealed a thick-walled mass measuring 9.2 cm × 6.0 cm × 7.6 cm in pelvis. We did right salpingooophorectomy of the patient. On histopathology, the diagnosis of xanthogranulomatous salpingooophoritis was confirmed. Conclusion. Clinical presentation, radiological appearance, and gross features of xanthogranulomatous lesions of ovary can mimic neoplastic lesions and lead to misdiagnosis. Though, it is very rare in pediatric age group, xanthogranulomatous salpingooophoritis as one of the differential diagnoses should be kept in mind while dealing with tuboovarian masses in this age group. PMID:26114000

A Lower Limb-Pelvis Finite Element Model with 3D Active Muscles.

PubMed

Mo, Fuhao; Li, Fan; Behr, Michel; Xiao, Zhi; Zhang, Guanjun; Du, Xianping

2018-01-01

A lower limb-pelvis finite element (FE) model with active three-dimensional (3D) muscles was developed in this study for biomechanical analysis of human body. The model geometry was mainly reconstructed from a male volunteer close to the anthropometry of a 50th percentile Chinese male. Tissue materials and structural features were established based on the literature and new implemented experimental tests. In particular, the muscle was modeled with a combination of truss and hexahedral elements to define its passive and active properties as well as to follow the detailed anatomy structure. Both passive and active properties of the model were validated against the experiments of Post-Mortem Human Surrogate (PMHS) and volunteers, respectively. The model was then used to simulate driver's emergency braking during frontal crashes and investigate Knee-Thigh-Hip (KTH) injury mechanisms and tolerances of the human body. A significant force and bending moment variance was noted for the driver's femur due to the effects of active muscle forces during emergency braking. In summary, the present lower limb-pelvis model can be applied in various research fields to support expensive and complex physical tests or corresponding device design.

Anatomical landmark asymmetry assessment in the lumbar spine and pelvis: a review of reliability.

PubMed

Stovall, Bradley Alan; Kumar, Shrawan

2010-01-01

The purpose of this article is to review current research investigating the reliability of bony anatomical landmark positional asymmetry assessment in the lumbar spine and pelvis, to determine the agreement on findings between authors, and to explore future directions in the area to address the significant issues. The databases MEDLINE, CINAHL, AMED, MANTIS, Academic Search Complete, and Web of Knowledge were searched. A total of 23 articles were identified and reviewed, 10 of which met the inclusion criteria. For these 10 articles, the average interexaminer reliability for bony anatomical landmark positional asymmetry assessment was slightly above chance for all landmarks except medial malleolus, which had fair reliability. Interexaminer reliability on average was less than intraexaminer reliability (anterior superior iliac spine, k = 0.128/0.414; posterior superior iliac spine, k = 0.092/0.371). All interexaminer reliability averages were below values of clinical significance. From the current literature review, bony anatomical landmark positional asymmetry assessment in the lumbar spine and pelvis has not been demonstrated to be a reliable assessment method. However, there are unexplored factors that, after standardization, may improve reliability and further the understanding of musculoskeletal palpatory examination.

Developing a cumulative anatomic scoring system for military perineal and pelvic blast injuries.

PubMed

Mossadegh, Somayyeh; Midwinter, M; Parker, P

2013-03-01

Improvised explosive device (IED) yields in Afghanistan have increased resulting in more proximal injuries. The injury severity score (ISS) is an anatomic aggregate score of the three most severely injured anatomical areas but does not accurately predict severity in IED related pelvi-perineal trauma patients. A scoring system based on abbreviated injury score (AIS) was developed to reflect the severity of these injuries in order to better understand risk factors, develop a tool for future audit and improve performance. Using standard AIS descriptors, injury scales were constructed for the pelvis (1, minor to 6, maximal). The perineum was divided into anterior and posterior zones as relevant to injury patterns and blast direction with each soft tissue structure being allocated a score from its own severity scale. A cumulative score, from 1 to 36 for soft tissue, or a maximum of 42 if a pelvic fracture was involved, was created for all structures injured in the anterior and posterior zones. Using this new scoring system, 77% of patients survived with a pelvi-perineal trauma score (PPTS) below 5. There was a significant increase in mortality, number of pelvic fractures and amputations with increase in score when comparing the first group (score 1-5) to the second group (score 6-10). For scores between 6 and 16 survival was 42% and 22% for scores between 17 and 21. In our cohort of 62 survivors, 1 patient with an IED related pelvi-perineal injury had a 'theoretically un-survivable' maximal ISS of 75 and survived, whereas there were no survivors with a PPTS greater than 22 but this group had no-one with an ISS of 75 suggesting ISS is not an accurate reflection of the true severity of pelvi-perineal blast injury. This scoring system is the initial part of a more complex logistic regression model that will contribute towards a unique trauma scoring system to aid surgical teams in predicting fluid requirements and operative timelines. In austere environments, it may also help to prevent futile resuscitations. Better correlation between measurement of severity and outcome would aid performance improvement monitoring. In the longer term it will also allow benchmarking of current survival rates and comparisons in the future.

Feature selection for elderly faller classification based on wearable sensors.

PubMed

Howcroft, Jennifer; Kofman, Jonathan; Lemaire, Edward D

2017-05-30

Wearable sensors can be used to derive numerous gait pattern features for elderly fall risk and faller classification; however, an appropriate feature set is required to avoid high computational costs and the inclusion of irrelevant features. The objectives of this study were to identify and evaluate smaller feature sets for faller classification from large feature sets derived from wearable accelerometer and pressure-sensing insole gait data. A convenience sample of 100 older adults (75.5 ± 6.7 years; 76 non-fallers, 24 fallers based on 6 month retrospective fall occurrence) walked 7.62 m while wearing pressure-sensing insoles and tri-axial accelerometers at the head, pelvis, left and right shanks. Feature selection was performed using correlation-based feature selection (CFS), fast correlation based filter (FCBF), and Relief-F algorithms. Faller classification was performed using multi-layer perceptron neural network, naïve Bayesian, and support vector machine classifiers, with 75:25 single stratified holdout and repeated random sampling. The best performing model was a support vector machine with 78% accuracy, 26% sensitivity, 95% specificity, 0.36 F1 score, and 0.31 MCC and one posterior pelvis accelerometer input feature (left acceleration standard deviation). The second best model achieved better sensitivity (44%) and used a support vector machine with 74% accuracy, 83% specificity, 0.44 F1 score, and 0.29 MCC. This model had ten input features: maximum, mean and standard deviation posterior acceleration; maximum, mean and standard deviation anterior acceleration; mean superior acceleration; and three impulse features. The best multi-sensor model sensitivity (56%) was achieved using posterior pelvis and both shank accelerometers and a naïve Bayesian classifier. The best single-sensor model sensitivity (41%) was achieved using the posterior pelvis accelerometer and a naïve Bayesian classifier. Feature selection provided models with smaller feature sets and improved faller classification compared to faller classification without feature selection. CFS and FCBF provided the best feature subset (one posterior pelvis accelerometer feature) for faller classification. However, better sensitivity was achieved by the second best model based on a Relief-F feature subset with three pressure-sensing insole features and seven head accelerometer features. Feature selection should be considered as an important step in faller classification using wearable sensors.

3D video-based deformation measurement of the pelvis bone under dynamic cyclic loading

PubMed Central

2011-01-01

Background Dynamic three-dimensional (3D) deformation of the pelvic bones is a crucial factor in the successful design and longevity of complex orthopaedic oncological implants. The current solutions are often not very promising for the patient; thus it would be interesting to measure the dynamic 3D-deformation of the whole pelvic bone in order to get a more realistic dataset for a better implant design. Therefore we hypothesis if it would be possible to combine a material testing machine with a 3D video motion capturing system, used in clinical gait analysis, to measure the sub millimetre deformation of a whole pelvis specimen. Method A pelvis specimen was placed in a standing position on a material testing machine. Passive reflective markers, traceable by the 3D video motion capturing system, were fixed to the bony surface of the pelvis specimen. While applying a dynamic sinusoidal load the 3D-movement of the markers was recorded by the cameras and afterwards the 3D-deformation of the pelvis specimen was computed. The accuracy of the 3D-movement of the markers was verified with 3D-displacement curve with a step function using a manual driven 3D micro-motion-stage. Results The resulting accuracy of the measurement system depended on the number of cameras tracking a marker. The noise level for a marker seen by two cameras was during the stationary phase of the calibration procedure ± 0.036 mm, and ± 0.022 mm if tracked by 6 cameras. The detectable 3D-movement performed by the 3D-micro-motion-stage was smaller than the noise level of the 3D-video motion capturing system. Therefore the limiting factor of the setup was the noise level, which resulted in a measurement accuracy for the dynamic test setup of ± 0.036 mm. Conclusion This 3D test setup opens new possibilities in dynamic testing of wide range materials, like anatomical specimens, biomaterials, and its combinations. The resulting 3D-deformation dataset can be used for a better estimation of material characteristics of the underlying structures. This is an important factor in a reliable biomechanical modelling and simulation as well as in a successful design of complex implants. PMID:21762533

MO-H-19A-01: FEATURED PRESENTATION - Treatment Planning Tool for Radiotherapy with Very High-Energy Electron Beams

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

Bazalova, M; Qu, B; Palma, B

2014-06-15

Purpose: To develop a tool for treatment planning optimization for fast radiotherapy delivered with very high-energy electron beams (VHEE) and to compare VHEE plans to state-of-the-art plans for challenging pelvis and H'N cases. Methods: Treatment planning for radiotherapy delivered with VHEE scanning pencil beams was performed by integrating EGSnrc Monte Carlo (MC) dose calculations with spot scanning optimization run in a research version of RayStation. A Matlab GUI for MC beamlet generation was developed, in which treatment parameters such as the pencil beam size and spacing, energy and number of beams can be selected. Treatment planning study for H'N andmore » pelvis cases was performed and the effect of treatment parameters on the delivered dose distributions was evaluated and compared to the clinical treatment plans. The pelvis case with a 691cm3 PTV was treated with 2-arc 15MV VMAT and the H'N case with four PTVs with total volume of 531cm3 was treated with 4-arc 6MV VMAT. Results: Most studied VHEE plans outperformed VMAT plans. The best pelvis 80MeV VHEE plan with 25 beams resulted in 12% body dose sparing and 8% sparing to the bowel and right femur compared to the VMAT plan. The 100MeV plan was superior to the 150MeV plan. Mixing 100 and 150MeV improved dose sparing to the bladder by 7% compared to either plan. Plans with 16 and 36 beams did not significantly affect the dose distributions compared to 25 beam plans. The best H'N 100MeV VHEE plan decreased mean doses to the brainstem, chiasm, and both globes by 10-42% compared to the VMAT plan. Conclusion: The pelvis and H'N cases suggested that sixteen 100MeV beams might be sufficient specifications of a novel VHEE treatment machine. However, optimum machine parameters will be determined with the presented VHEE treatment-planning tool for a large number of clinical cases. BW Loo and P Maxim received research support from RaySearch Laboratories. E Hynning and B Hardemark are employees of RaySearch Laboratories.« less

Vertical head and pelvic movement symmetry at the trot in dogs with induced supporting limb lameness.

PubMed

Gómez Álvarez, C B; Gustås, P; Bergh, A; Rhodin, M

2017-11-01

Compensatory limb loading has been studied in lame dogs; however, little is known about how these compensations relate to motion of the head and pelvis, assessment of which is an important component of lameness examinations. The aim of this study was to describe the patterns of vertical head and pelvic motion symmetry at the trot in dogs with induced supporting limb lameness in the forelimbs or hind limbs. Ten sound dogs were trotted on a treadmill before and after temporary induction of moderate lameness (grade 2/5) in each limb. Reflective markers were located on the head, pelvis and right forelimb, and kinematic data were captured with a motion capture system. Upper body symmetry parameters were calculated, including differences in the highest (HDmax) and in the lowest (HDmin) positions of the head, and in the highest (PDmax) and in the lowest (PDmin) positions of the mid-pelvis, with a value of zero indicating symmetry. The head was lowered more during the sound limb stance phase and lowered less during the lame limb stance phase in supporting forelimb lameness (HDmin: 4.6mm in dogs when sound, -18.3mm when left limb lameness was induced and 20.5mm when right limb lameness was induced). The mid-pelvis was lowered more during the sound limb stance phase and lowered and lifted less during the lame limb stance phase in supporting hind limb lameness (PDmin: 1mm in dogs when sound, -10.1mm in left limb lameness and 8.4mm in right limb lameness). The hip of the lame side, measured at the level of the greater trochanter, had an increased downwards displacement during the lame limb swing phase (-21mm in left hind limb lameness, P=0.005; 23.4mm in right hind limb lameness, P=0.007). Asymmetry in the lowering of the head or mid-pelvis is a more sensitive indicator of supporting forelimb and hind limb lameness, respectively, than asymmetry in the raising of the head. Increased displacement of the hip ('hip drop' of the lame side during its swing phase) is a good indicator of hind limb lameness in dogs. Copyright © 2017. Published by Elsevier Ltd.

Pelvic Rotation and Lower Extremity Motion with Two Different Front Foot Directions in the Tennis Backhand Groundstroke

PubMed Central

Iwamoto, Sayumi; Fukubayashi, Toru; Hume, Patria

2013-01-01

When a tennis player steps forward to hit a backhand groundstroke in closed stance, modifying the direction of the front foot relative to the net may reduce the risk of ankle injury and increase performance. This study evaluated the relationship between pelvic rotation and lower extremity movement during the backhand groundstroke when players stepped with toes parallel to the net (Level) or with toes pointed towards the net (Net). High school competitive tennis players (eleven males and seven females, 16.8 ± 0.8 years, all right- handed) performed tennis court tests comprising five maximum speed directional runs to the court intersection line to hit an imaginary ball with forehand or backhand swings. The final backhand groundstroke for each player at the backcourt baseline was analyzed. Pelvic rotation and lower extremity motion were quantified using 3D video analysis from frontal and sagittal plane camera views reconstructed to 3D using DLT methods. Plantar flexion of ankle and supination of the front foot were displayed for both Net and Level groups during the late phase of the front foot step. The timings of the peak pelvis rotational velocity and peak pelvis rotational acceleration showed different pattern for Net and Level groups. The peak timing of the pelvis rotational velocity of the Level group occurred during the late phase of the step, suggesting an increase in the risk of inversion ankle sprain and a decrease in stroke power compared to the Net group. Key Points Regarding the movement of the forefoot, the Net group and the Level group showed a pattern of supination-pronation-supination during the front stepping foot contact phase (FSFCP). However, the Level group showed only supination of various degrees during FSFCP. For the Net group, the maximum angular velocity of pelvis occurred in the early phase of FSFCP before impact; however, for the Level group, the maximum angular velocity of pelvis occurred in the latter phase of FSFCP after impact. The Level group players showed a potentially higher risk of inversion ankle sprain during the latter stage of FSFCP as pelvic rotation reached maximum angular velocity. The Net group may have a more effective kinetic chain during backhand groundstrokes, which ultimately enhances performance. PMID:24149814

Differences in Lower Extremity and Trunk Kinematics between Single Leg Squat and Step Down Tasks

PubMed Central

Lewis, Cara L.; Foch, Eric; Luko, Marc M.; Loverro, Kari L.; Khuu, Anne

2015-01-01

The single leg squat and single leg step down are two commonly used functional tasks to assess movement patterns. It is unknown how kinematics compare between these tasks. The purpose of this study was to identify kinematic differences in the lower extremity, pelvis and trunk between the single leg squat and the step down. Fourteen healthy individuals participated in this research and performed the functional tasks while kinematic data were collected for the trunk, pelvis, and lower extremities using a motion capture system. For the single leg squat task, the participant was instructed to squat as low as possible. For the step down task, the participant was instructed to stand on top of a box, slowly lower him/herself until the non-stance heel touched the ground, and return to standing. This was done from two different heights (16cm and 24cm). The kinematics were evaluated at peak knee flexion as well as at 60° of knee flexion. Pearson correlation coefficients (r) between the angles at those two time points were also calculated to better understand the relationship between each task. The tasks resulted in kinematics differences at the knee, hip, pelvis, and trunk at both time points. The single leg squat was performed with less hip adduction (p ≤ 0.003), but more hip external rotation and knee abduction (p ≤ 0.030), than the step down tasks at 60° of knee flexion. These differences were maintained at peak knee flexion except hip external rotation was only significant in the 24cm step down task (p ≤ 0.029). While there were multiple differences between the two step heights at peak knee flexion, the only difference at 60° of knee flexion was in trunk flexion (p < 0.001). Angles at the knee and hip had a moderate to excellent correlation (r = 0.51–0.98), but less consistently so at the pelvis and trunk (r = 0.21–0.96). The differences in movement patterns between the single leg squat and the step down should be considered when selecting a single leg task for evaluation or treatment. The high correlation of knee and hip angles between the three tasks indicates that similar information about knee and hip kinematics was gained from each of these tasks, while pelvis and trunk angles were less well predicted. PMID:25955321

[Analysis of normal pelvis morphometry of modern Chinese southern Han female and its correlation with age].

PubMed

Liu, Ping; Yu, Yan-Hong; Chen, Chun-Lin; Tang, Yi-Xin; Wang, Li; Mao, Dong-Rui; Xu, Yi-Kai; Chen, Lan

2013-07-01

To analyze the normal pelvis morphometry of Chinese southern Han female and its correlation with age. From August 2009 to September 2011, 289 Han nationality females who received pelvis CT scan at Nanfang Hospital of Southern Medical University were eligible for the study. Their mean age was 43.5 years, with normal body development and no pelvic abnormality. The patients were divided into 3 age groups: 25 to 40 (n = 109), 41 to 50 (n = 115), and >50 years (n = 65). After constructing a three-dimensional digital model of the pelvis, the following parameters were measured, including transverse inlet diameter, posterior sagittal diameter of pelvic inlet, sagittal inlet, diagonal conjugate, biischial diameter, posterior sagittal diameter of midpelvis, sagittal midpelvic diameter, intertuberous distance, posterior sagittal diameter of outlet, angle of pubic arch, sagittal outlet, penal height, sacrum length and sacrum curvature. The relationship between all parameters and age was analyzed. (1) The posterior sagittal diameters of pelvic inlet of the 25 to 40 age group, 41 to 50 age group, >50 years age group were (53 ± 8), (51 ± 7), (48 ± 6) mm. The sagittal inlet of the three groups were (122 ± 8), (120 ± 9), (114 ± 8) mm. And the diagonal conjugate of the three groups were (135 ± 10), (132 ± 9), (127 ± 9) mm. All had significant differences among the three groups (P < 0.01) . (2) The posterior sagittal diameter of midpelvis of the three groups were (43 ± 6), (44 ± 6), (43 ± 7) mm, and the sagittal midpelvic diameter of the three groups were (119 ± 8), (120 ± 8), (119 ± 7) mm, with no significant difference among the three groups (P > 0.05). (3) The intertuberous distance of the three groups were (122 ± 11), (121 ± 10), (117 ± 11) mm, and the posterior sagittal diameter of outlet of the three groups were (56 ± 9), (58 ± 8), (57 ± 9) mm. There was no significant difference among the three groups (P > 0.05) .(4) Penal height of three groups were (31 ± 3), (33 ± 3), (34 ± 3) mm, there was with significant differences (P < 0.01) .(5) Pearson correlation analysis showed that penal height was positively correlated with age (r = 0.331, P < 0.05), while sagittal inlet, posterior sagittal diameter of inlet, diagonal conjugate, intertuberous distance, angle of pubic arch, sacrum length and sacrum curvature were negatively correlated with age (r = -0.120 to -0.343, P < 0.05). The shape of the pelvic inlet of Chinese southern Han female changed from sagittal elliptic into transverse elliptic form, and the posterior part of pelvic inlet became larger.Sacral concavity was increased and the pelvis became deeper. Mid pelvis and the pelvic outlet was almost unchanged, and showed no correlation with age.

[Evolution of the pelvis and hip throughout history: from primates to modern man].

PubMed

Lapègue, F; Jirari, M; Sethoum, S; Faruch, M; Barcelo, C; Moskovitch, G; Ponsot, A; Rabat, M-C; Labarre, D; Vial, J; Chiavassa, H; Baunin, C; Railhac, J-J; Sans, N

2011-06-01

The evolution to a bipedal mode of locomotion was accompanied by a verticalization of the spine and a modification in the shape of the pelvis: horizontal curvature and sagittal rotation. Phylogenesis meets ontogenesis: flat bones in fetuses similar to the monkey, australopithecus features at birth and "human-like" features by 7 or 8years of age. These anatomical modifications explain the characteristics of human bipedalism: stable, economical, with hip and knee extension in the standing position with little lateral motion. Some pathologies induce a regression to a more archaic mode of bipedal locomotion. Copyright © 2011 Elsevier Masson SAS and Éditions françaises de radiologie. All rights reserved.

Rectus sheath haematoma: a serious complication of a commonly administered drug.

PubMed

Parkinson, Fran; Khalid, Usman; Woolgar, Justin

2013-04-10

Ten days after an above knee amputation, this 62-year-old woman became acutely anaemic (haemoglobin drop of 10.4 to 6.2). Clinically, she had no obvious source of bleeding; however, on examination, her abdomen was slightly distended and she was tender over the suprapubic area. A CT scan of her abdomen and pelvis was arranged which showed a large haematoma (17 × 11 cm) arising from the anterior abdominal wall from the deep aspect of the left rectus abdominus, extending across the midline to the right rectus abdominus and deep into the pelvis. This may have been spontaneous or may have been due to direct injury when injecting subcutaneous heparin.

Giant multilocular cystadenoma of the prostate: a rare cause of huge cystic pelvic mass.

PubMed

Olgun, Deniz Cebi; Onal, Bulent; Mihmanli, Ismail; Kantarci, Fatih; Durak, Haydar; Demir, Hale; Cetinel, Bulent

2012-03-01

Giant multilocular prostatic cystadenoma is a rare benign tumor that evolves from the prostate gland. Obstructive voiding symptoms occur in all reported cases. These lesions do not invade adjacent structures. Preoperative radiologic evaluation can define the benign nature of the lesion. Here we report a case of large cystic lesions identified by magnetic resonance imaging and sonographic findings that caused an extensive mass effect in the pelvis. When retrovesical, huge cystic lesions fill the pelvis completely in young men, with high levels of serum prostate-specific antigen, giant multilocular prostatic cystadenoma should be considered as a differential diagnosis. To our knowledge, this is the youngest case of prostatic cystadenoma reported in the literature.

Rectus sheath haematoma: a serious complication of a commonly administered drug

PubMed Central

Parkinson, Fran; Khalid, Usman; Woolgar, Justin

2013-01-01

Ten days after an above knee amputation, this 62-year-old woman became acutely anaemic (haemoglobin drop of 10.4 to 6.2). Clinically, she had no obvious source of bleeding; however, on examination, her abdomen was slightly distended and she was tender over the suprapubic area. A CT scan of her abdomen and pelvis was arranged which showed a large haematoma (17×11 cm) arising from the anterior abdominal wall from the deep aspect of the left rectus abdominus, extending across the midline to the right rectus abdominus and deep into the pelvis. This may have been spontaneous or may have been due to direct injury when injecting subcutaneous heparin. PMID:23580671

Blood loss in the space of Retzius and pelvis with tension-free vaginal tape and trans-obturator tape procedures.

PubMed

Huffaker, R Keith; Copas, Pleas

2006-11-01

The purpose of this study was to evaluate the space of Retzius and pelvis for hematoma formation and blood loss following placement of tension-free vaginal tapes (TVT) and transobturator tapes (TOT). 25 women were examined with ultrasonography on post-operative days one, two, three, four or five. One patient underwent TVT while the other 24 underwent TOT. Additional procedures were performed on most patients. No hematomas or collections of free fluid were identified post-operatively. TVT and TOT procedures are relatively safe procedures. We encountered no vascular complications in this small series of patients. Review of literature has yielded reports of infrequent complications.

In vivo relationship between pelvis motion and deep fascia displacement of the medial gastrocnemius: anatomical and functional implications.

PubMed

Cruz-Montecinos, Carlos; González Blanche, Alberto; López Sánchez, David; Cerda, Mauricio; Sanzana-Cuche, Rodolfo; Cuesta-Vargas, Antonio

2015-11-01

Different authors have modelled myofascial tissue connectivity over a distance using cadaveric models, but in vivo models are scarce. The aim of this study was to evaluate the relationship between pelvic motion and deep fascia displacement in the medial gastrocnemius (MG). Deep fascia displacement of the MG was evaluated through automatic tracking with an ultrasound. Angular variation of the pelvis was determined by 2D kinematic analysis. The average maximum fascia displacement and pelvic motion were 1.501 ± 0.78 mm and 6.55 ± 2.47 °, respectively. The result of a simple linear regression between fascia displacement and pelvic motion for three task executions by 17 individuals was r = 0.791 (P < 0.001). Moreover, hamstring flexibility was related to a lower anterior tilt of the pelvis (r = 0.544, P < 0.024) and a lower deep fascia displacement of the MG (r = 0.449, P < 0.042). These results support the concept of myofascial tissue connectivity over a distance in an in vivo model, reinforce the functional concept of force transmission through synergistic muscle groups, and grant new perspectives for the role of fasciae in restricting movement in remote zones. © 2015 Anatomical Society.

In vivo relationship between pelvis motion and deep fascia displacement of the medial gastrocnemius: anatomical and functional implications

PubMed Central

Cruz-Montecinos, Carlos; González Blanche, Alberto; López Sánchez, David; Cerda, Mauricio; Sanzana-Cuche, Rodolfo; Cuesta-Vargas, Antonio

2015-01-01

Different authors have modelled myofascial tissue connectivity over a distance using cadaveric models, but in vivo models are scarce. The aim of this study was to evaluate the relationship between pelvic motion and deep fascia displacement in the medial gastrocnemius (MG). Deep fascia displacement of the MG was evaluated through automatic tracking with an ultrasound. Angular variation of the pelvis was determined by 2D kinematic analysis. The average maximum fascia displacement and pelvic motion were 1.501 ± 0.78 mm and 6.55 ± 2.47 °, respectively. The result of a simple linear regression between fascia displacement and pelvic motion for three task executions by 17 individuals was r = 0.791 (P < 0.001). Moreover, hamstring flexibility was related to a lower anterior tilt of the pelvis (r = 0.544, P < 0.024) and a lower deep fascia displacement of the MG (r = 0.449, P < 0.042). These results support the concept of myofascial tissue connectivity over a distance in an in vivo model, reinforce the functional concept of force transmission through synergistic muscle groups, and grant new perspectives for the role of fasciae in restricting movement in remote zones. PMID:26467242

Between Scylla and Charybdis: renegotiating resolution of the ‘obstetric dilemma’ in response to ecological change

PubMed Central

Wells, Jonathan C. K.

2015-01-01

Hominin evolution saw the emergence of two traits—bipedality and encephalization—that are fundamentally linked because the fetal head must pass through the maternal pelvis at birth, a scenario termed the ‘obstetric dilemma’. While adaptive explanations for bipedality and large brains address adult phenotype, it is brain and pelvic growth that are subject to the obstetric dilemma. Many contemporary populations experience substantial maternal and perinatal morbidity/mortality from obstructed labour, yet there is increasing recognition that the obstetric dilemma is not fixed and is affected by ecological change. Ecological trends may affect growth of the pelvis and offspring brain to different extents, while the two traits also differ by a generation in the timing of their exposure. Two key questions arise: how can the fit between the maternal pelvis and the offspring brain be ‘renegotiated’ as the environment changes, and what nutritional signals regulate this process? I argue that the potential for maternal size to change across generations precludes birthweight being under strong genetic influence. Instead, fetal growth tracks maternal phenotype, which buffers short-term ecological perturbations. Nevertheless, rapid changes in nutritional supply between generations can generate antagonistic influences on maternal and offspring traits, increasing the risk of obstructed labour. PMID:25602071

Classifying Hydroceles of the Pelvis and Groin: An Overview of Etiology, Secondary Complications, Evaluation, and Management

PubMed Central

Dagur, Gautam; Gandhi, Jason; Suh, Yiji; Weissbart, Steven; Sheynkin, Yefim R.; Smith, Noel L.; Joshi, Gargi; Khan, Sardar Ali

2017-01-01

Introduction A hydrocele is defined as the pathological buildup of serous fluid in the pelvis and groin due to various etiologies such as diseases or trauma. It has distinct clinical manifestations, particularly discomfort and psychosocial distress. Understanding the anatomy, embryology, and physiology associated with hydrocele formation is crucial to understand its onset and progression. Materials and Methods A MEDLINE® search was conducted using keywords for the relevant classification of hydrocele and its etiology, complications, sexual barriers, evaluation, and management. Results Appropriately classifying the hydrocele as primary, secondary communicating, secondary noncommunicating, microbe-induced, inflammatory, iatrogenic, trauma-induced, tumor-induced, canal of Nuck, congenital, and giant is important for identifying the underlying etiology. Often this process is overlooked when the classification or etiology is too rare. A focused evaluation is important for this, so that timely management can be provided. We comprehensively review the classifications, etiology, and secondary complications of hydrocele. Pitfalls of current diagnostic techniques are explored along with recommended methods for accurate diagnosis and current treatment options. Conclusion Due to the range of classifications and etiologies of hydrocele in the pelvis and groin, a deliberate differential diagnosis is essential to avoiding imminent life-threatening complications as well as providing the appropriate treatment. PMID:28559772

Comparison of clinical and functional outcome between surgical treatment and carbon ion radiotherapy for pelvic chondrosarcoma.

PubMed

Outani, Hidetatsu; Hamada, Kenichiro; Imura, Yoshinori; Oshima, Kazuya; Sotobori, Tsukasa; Demizu, Yusuke; Kakunaga, Shigeki; Joyama, Susumu; Imai, Reiko; Okimoto, Tomoaki; Naka, Norifumi; Kudawara, Ikuo; Ueda, Takafumi; Araki, Nobuhito; Kamada, Tadashi; Yoshikawa, Hideki

2016-02-01

As there are no reports of studies in patients with pelvic chondrosarcoma treated with carbon ion radiotherapy (CIRT), the aim of this study was to evaluate the applicability of CIRT for patients with chondrosarcoma of the pelvis. The medical records of 31 patients with chondrosarcoma of the pelvis treated either by surgical resection or by CIRT between 1983 and 2014 were reviewed. There were 22 males and 9 females with a median age of 43 years (range 16-77 years). The median duration of follow-up was 66 months (range 5-289 months). Twenty-four patients underwent surgery, and 7 patients received CIRT (70.4 GyE in 16 fractions over 4 weeks). The overall local recurrence rate was 32 %, and the estimated overall 5- and 10-year survival rates were 72 and 57 %, respectively. The mean Musculoskeletal Tumor Society functional score was 59 %. The treatment procedures (surgery or CIRT) did not affect overall survival (P = 0.347). However, the patients who underwent surgery had impaired function compared with those who received CIRT (P = 0.03). Although more patients need to be monitored to assess the clinical and functional outcomes of CIRT for patients with chondrosarcoma of the pelvis, this treatment might offer an acceptable alternative.

Hallux valgus surgery affects kinematic parameters during gait

PubMed Central

Klugarova, J.; Janura, M.; Svoboda, Z.; Sos, Z.; Stergiou, N.; Klugar, M.

2017-01-01

Background The aim of our study was to compare spatiotemporal parameters and lower limb and pelvis kinematics during the walking in patients with hallux valgus before and after surgery and in relation to a control group. Methods Seventeen females with hallux valgus, who underwent first metatarsal osteotomy, constituted our experimental group. The control group consisted of thirteen females. Kinematic data during walking were obtained using the Vicon MX system. Findings Our results showed that hallux valgus before surgery affects spatiotemporal parameters and lower limb and pelvis kinematics during walking. Hallux valgus surgery further increased the differences that were present before surgery. Specifically after hallux valgus surgery, the walking speed decreased even more (p=0.09, η2= 0.19) while step time increased (p=0.002, η2=0.44) on both legs. The maximum ankle plantar flexion of the operated leg during toe off decreased to a greater extend (p=0.03, η2=0.26). The asymmetry in the hip and the pelvis movements in the frontal plane (present preoperatively) persisted after surgery. Interpretation Hallux valgus is not an isolated problem of the first ray, which could be just surgically addressed by correcting the foot’s alignment. It is a long-term progressive malfunction of the foot affecting the entire kinematic chain of the lower extremity. PMID:27792950

Kinematic comparison of the preferred and non-preferred foot punt kick.

PubMed

Ball, Kevin A

2011-11-01

Kicking with the non-preferred leg is important in Australian Football and becoming important in the rugby codes. The aim of this study was to examine differences between preferred and non-preferred leg kicking in the drop punt kick. Seventeen elite Australian Football players performed kicks with the preferred and non-preferred leg. Optotrak Certus collected kinematic data of the kick leg and pelvis (200 Hz) from kick leg toe-off until ball contact. Foot speed, knee and shank angular velocity at ball contact, and pelvis range of motion were significantly larger for the preferred leg (P < 0.05). In contrast, hip and thigh angular velocity at ball contact and hip range of motion were significantly larger for the non-preferred leg. This indicates different movement patterns, with preferred-leg kicks making greater use of the pelvis, knee, and shank while non-preferred leg kicks rely relatively more on the hip and thigh (P < 0.05). Reasons for this difference might be due to locking degrees of freedom or sub-optimal sequencing in the non-preferred leg. The thigh-knee continuum identified by Ball ( 2008 ) was also evident in this study. Findings have implications for training non-preferred leg kicking for performance and injury prevention.

Walking stability and sensorimotor function in older people with diabetic peripheral neuropathy.

PubMed

Menz, Hylton B; Lord, Stephen R; St George, Rebecca; Fitzpatrick, Richard C

2004-02-01

To evaluate, in older people with diabetic peripheral neuropathy (DPN) and in age-matched controls, acceleration patterns of the head and pelvis when walking to determine the effect of lower-limb sensory loss on walking stability. Case-control study. Falls and balance laboratory in Australia. Thirty persons with diabetes mellitus (age range, 55-91 y) and 30 age-matched controls. Acceleration patterns of the head and pelvis were measured while participants walked on a level surface and an irregular walkway. Participants also underwent tests of vision, sensation, strength, reaction time, and balance. Temporospatial gait parameters and variables derived from acceleration signals. Participants with DPN had reduced walking speed, cadence, and step length, and less rhythmic acceleration patterns at the head and pelvis compared with controls. These differences were particularly evident when participants walked on the irregular surface. Participants with DPN also had impaired peripheral sensation, reaction time, and balance. Older people with DPN have an impaired ability to stabilize their body when walking on irregular surfaces, even if they adopt a more conservative gait pattern. These results provide further insights into the role of peripheral sensory input in the control of gait stability, and suggest possible mechanisms underlying the increased risk of falling in older people with diabetic neuropathy.

Treatment of pyonephrosis with a subcutaneous ureteral bypass device in four cats.

PubMed

Cray, Megan; Berent, Allyson C; Weisse, Chick W; Bagley, Demetrius

2018-03-15

CASE DESCRIPTION 4 cats were examined because of ureteral obstruction. CLINICAL FINDINGS Clinical and clinicopathologic abnormalities were nonspecific and included anorexia, lethargy, weight loss, anemia, leukocytosis, neutrophilia, lymphopenia, and azotemia. A diagnosis of pyonephrosis was made in all cats. The presence of bacteriuria was confirmed by means of urinalysis in 2 cats, bacterial culture of a urine sample obtained by means of preoperative cystocentesis in 2 cats, and bacterial culture of samples obtained from the renal pelvis intraoperatively in 3 cats. Ureteral obstruction was caused by a urolith in 3 cats; ureteral stricture associated with a circumcaval ureter was identified in 1 cat. TREATMENT AND OUTCOME All 4 cats underwent renal pelvis lavage and placement of a subcutaneous ureteral bypass (SUB) device for treatment of obstructive pyonephrosis. Postoperatively, the cystostomy tube became occluded with purulent material in 1 cat, requiring exchange. The procedure was successful in relieving the obstruction and pyonephrosis in all cats. Three of 4 cats had documented resolution of urinary tract infection. One cat had persistent bacteriuria without clinical signs 1 month after SUB device placement. CLINICAL RELEVANCE Results of this small series suggested that renal pelvis lavage with placement of an SUB device may be a treatment option for cats with obstructive pyonephrosis.

Between Scylla and Charybdis: renegotiating resolution of the 'obstetric dilemma' in response to ecological change.

PubMed

Wells, Jonathan C K

2015-03-05

Hominin evolution saw the emergence of two traits-bipedality and encephalization-that are fundamentally linked because the fetal head must pass through the maternal pelvis at birth, a scenario termed the 'obstetric dilemma'. While adaptive explanations for bipedality and large brains address adult phenotype, it is brain and pelvic growth that are subject to the obstetric dilemma. Many contemporary populations experience substantial maternal and perinatal morbidity/mortality from obstructed labour, yet there is increasing recognition that the obstetric dilemma is not fixed and is affected by ecological change. Ecological trends may affect growth of the pelvis and offspring brain to different extents, while the two traits also differ by a generation in the timing of their exposure. Two key questions arise: how can the fit between the maternal pelvis and the offspring brain be 'renegotiated' as the environment changes, and what nutritional signals regulate this process? I argue that the potential for maternal size to change across generations precludes birthweight being under strong genetic influence. Instead, fetal growth tracks maternal phenotype, which buffers short-term ecological perturbations. Nevertheless, rapid changes in nutritional supply between generations can generate antagonistic influences on maternal and offspring traits, increasing the risk of obstructed labour. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Human Evolution: The Real Cause for Birth Palsy

PubMed Central

Sreekanth, R; Thomas, BP

2015-01-01

ABSTRACT Objective: Birth palsy, otherwise known as obstetric brachial plexus paralysis (OBPP), is a closed stretch injury to the brachial plexus of nerves during the birth process resulting in varying degree of paralysis and contractures of the upper limb. The study aimed to find out the susceptibility of humans and small-bodied primates to birth palsy. Method: A comparative study on parturition in modern humans, hominoids, hominids, small-bodied primates and great apes was done to determine if changes in the female pelvis and neonatal head and shoulder during human evolution is the real cause for OBPP. Results: During evolution, the morphology of the female pelvis and birth canal changed into a narrow and twisted one and also the size of the fetal head increased. Thus, the narrow and twisted pelvis of the mother, and the relatively large head and broad shoulders of the newborn has made the birthing process of modern human and small bodied primates a precarious fine-tuned act with a very narrow margin for error. This has necessitated proper obstetric care to reduce or even at times obviate the incidence of birth injuries like OBPP. Conclusion: Human evolution has made human babies susceptible to birth palsy and thus is the real cause of birth palsy. PMID:26624599

The Radiograph of the Pelvis as a Window to Skeletal Dysplasias.

PubMed

Gajarajulu, Vijayalakshmi; Natarajan, Balakrishnan; Muralinath, S

2016-06-01

Skeletal dysplasias are disorders of bone formation. There are many dysplasias that have been identified and studied over the years and long lists of radiological features have been documented; it is not possible to remember all of them, most of which are common to more than one dysplasia. This article is about a practical approach to the radiological diagnosis of skeletal dysplasias by viewing only a few radiographs rather than the entire skeletal survey. The radiographs that are to be studied are AP view of the pelvis, dorsolumbar spine- AP and lateral view and both hands PA view, in that order. The skull lateral view and both knees AP view are sometimes required. The authors advice to set out with the pelvis that provides information of not only the pelvic bones but also parts of the lumbar spine and the upper ends of the femur including their epiphyses, metaphyses and a part of the diaphyses. Sometimes the diagnosis is reached with only this one radiograph, as in achondroplasia or it may indicate a group like mucopolysaccharidoses which can be sorted out with radiographs of the spine and hands or the upper part of the femur can provide a cue to epiphyseal and metaphyseal dysplasias. Gamuts and atlases can be consulted for the rare dysplasias.

Walking patterns of hip arthroplasty patients: some observations on the medio-lateral excursions of the trunk.

PubMed

Vogt, L; Brettmann, K; Pfeifer, K; Banzer, W

2003-04-08

This study examined the angular gait kinematics of the trunk and the pelvis in the frontal plane and their amount of side-to-side asymmetry in patients after total hip replacement arthroplasty. The angular gait kinematics of 12 male hip arthroplasty patients (53-70 years) were compared to ten age-matched and ten young (24-35 years) male control subjects. Average step times and medio-lateral oscillation amplitudes of the pelvic and thoracic recordings were calculated for each step. Between successive steps the asymmetry ratio was computed and the mean angle around which the side-to-side oscillations occurred was compared to the angle in a symmetrical standing trial. ANOVA indicated no significant side differences in relative step cycle durations. Patients and senior controls had significantly (p<0.01) less pelvis side-to-side displacements than the younger controls. No significant between-group differences could be detected for the average asymmetry ratio. However, during walking the patients showed a significantly (p<0.01) increased lateral thorax and pelvis deviation. Hip replacement patients' thoracic and pelvic position is characterized by a lateral shift throughout the gait cycle, while left and right symmetry of angular movements amplitudes remain at about the same value of unimpaired subjects.

Ruptured renal arteriovenous malformation successfully treated by catheter embolization: a case report.

PubMed

Takeuchi, Nobuhiro; Nomura, Yusuke

2014-01-09

Renal arteriovenous fistula (RAVF) is a comparatively rare malformation. Here, we report a case of ruptured RAVF that was successfully treated by catheter embolization. An 89-year-old female was transferred to our institution with massive gross hematuria in March 2011. Plain abdominal computed tomography (CT) revealed dilated left renal pelvis with high-density contents. Hematoma was suspected. Subsequent plain abdominal magnetic resonance imaging revealed left hydronephrosis and blood retention in the dilated left renal pelvis. No renal or ureteral cancer was evident. Hematuria was conservatively treated using hemostatic agents but hematuria persisted. Repeated urinary cytology revealed no malignant cells. On day 9, the patient went into septic and/or hemorrhagic shock. Fluid and catecholamine infusion, blood transfusion, and antibacterial drugs were rapidly initiated, and the patient's general condition gradually improved. Contrast-enhanced abdominal CT revealed marked expansion of the hematoma in the renal pelvis and microaneurysms in the segmental arteries of the left kidney. Inflammation improved, and a left double-J stent was inserted. Selective renal angiography revealed RAVF with microaneurysms in the left segmental arteries; therefore, catheter embolization using metallic coils was performed, which resolved hematuria. We report a case of ruptured renal arteriovenous malformation, which was successfully treated by catheter embolization.

Traumatic lesions of the posterior urethra.

PubMed

Velarde-Ramos, L; Gómez-Illanes, R; Campos-Juanatey, F; Portillo-Martín, J A

2016-11-01

The posterior urethral lesions are associated with pelvis fractures in 5-10% of cases. The posterior urethra is attached to the pelvis bone by puboprostatic ligaments and the perineal membrane, which explains why disruption of the pelvic ring can injure the urethra at this level. To identify suspected cases of posterior urethral trauma and to perform the diagnosis and its immediate or deferred management. Search in PubMed of articles related to traumatic posterior urethral lesions, written in English or Spanish. We reviewed the relevant publications including literature reviews and chapters from books related to the topic. With patients with pelvis fractures, we must always rule out posterior urethral lesions. The diagnostic examination of choice is retrograde urethrography, which, along with the severity of the condition, will determine the management in the acute phase and whether the treatment will be performed immediately or deferred. Early diagnosis and proper acute management decrease the associated complications, such as strictures, urinary incontinence and erectile dysfunction. Despite the classical association between posterior urethral lesions and pelvic fractures, the management of those lesions (whether immediate or deferred) remains controversial. Thanks to the growing interest in urethral disease, there are an increasing number of studies that help us achieve better management of these lesions. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Skill transfer, affordances and dexterity in different climbing environments.

PubMed

Seifert, L; Wattebled, L; L'hermette, M; Bideault, G; Herault, R; Davids, K

2013-12-01

This study explored how skills in one region of a perceptual-motor landscape of performance, created in part by previous experience in rock climbing, can shape those that emerge in another region (ice climbing). Ten novices in rock climbing and five intermediate rock climbers were observed climbing an icefall. Locations of right and left ice tools and crampons were videotaped from a frontal camera. Inter-individual variability of upper and lower limb couplings and types of action regarding icefall properties were assessed by cluster hierarchical analysis, distinguishing three clusters. Pelvis vertical displacement, duration and number of pelvis pauses were also analyzed. Experienced rock climbers were grouped in the same cluster and showed the highest range and variability of limb angular locations and coordination patterns, the highest vertical displacement and the shortest pelvis plateaux durations. Non-fluent climbers (clusters 2 and 3) showed low range and variability of limb angular locations and coordination patterns. In particular, climbers of cluster 3 exhibited the lowest vertical displacement, the longest plateaux durations and the greatest ratio between tool swinging and definitive anchorage. Our results exemplified the positive influence of skills in rock climbing on ice climbing performance, facilitated by the detection of affordances from environmental properties. Copyright © 2013 Elsevier B.V. All rights reserved.

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 - ...

FDG-PET/CT Limited to the Thorax and Upper Abdomen for Staging and Management of Lung Cancer.

PubMed

Arens, Anne I J; Postema, Jan W A; Schreurs, Wendy M J; Lafeber, Albert; Hendrickx, Baudewijn W; Oyen, Wim J G; Vogel, Wouter V

2016-01-01

This study evaluates the diagnostic accuracy of [F-18]-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) of the chest/upper abdomen compared to the generally performed scan from head to upper thighs, for staging and management of (suspected) lung cancer in patients with no history of malignancy or complaints outside the thorax. FDG-PET/CT scans of 1059 patients with suspected or recently proven lung cancer, with no history of malignancy or complaints outside the thorax, were analysed in a retrospective multi-centre trial. Suspect FDG-avid lesions in the chest and upper abdomen, the head and neck area above the shoulder line and in the abdomen and pelvis below the caudal tip of the liver were noted. The impact of lesions detected in the head and neck area and abdomen and pelvis on additional diagnostic procedures, staging and treatment decisions was evaluated. The head and neck area revealed additional suspect lesions in 7.2%, and the abdomen and pelvis in 15.8% of patients. Imaging of the head and neck area and the abdomen and pelvic area showed additional lesions in 19.5%, inducing additional diagnostic procedures in 7.8%. This resulted in discovery of additional lesions considered malignant in 10.7%, changing patient management for lung cancer in 1.2%. In (suspected) lung cancer, PET/CT limited to the chest and upper abdomen resulted in correct staging in 98.7% of patients, which led to the identical management as full field of view PET in 98.8% of patients. High value of FDG-PET/CT for staging and correct patient management is already achieved with chest and upper abdomen. Findings in head and neck area and abdomen and pelvis generally induce investigations with limited or no impact on staging and treatment of NSCLC, and can be interpreted accordingly.

SU-G-IeP3-04: Effective Dose Measurements in Fast Kvp Switch Dual Energy Computed Tomography

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

Raudabaugh, J; Moore, B; Nguyen, G

2016-06-15

Purpose: The objective of this study was two-fold: (a) to test a new approach to approximating organ dose by using the effective energy of the combined 80kV/140kV beam in dual-energy (DE) computed tomography (CT), and (b) to derive the effective dose (ED) in the abdomen-pelvis protocol in DECT. Methods: A commercial dual energy CT scanner was employed using a fast-kV switch abdomen/pelvis protocol alternating between 80 kV and 140 kV. MOSFET detectors were used for organ dose measurements. First, an experimental validation of the dose equivalency between MOSFET and ion chamber (as a gold standard) was performed using a CTDImore » phantom. Second, the ED of DECT scans was measured using MOSFET detectors and an anthropomorphic phantom. For ED calculations, an abdomen/pelvis scan was used using ICRP 103 tissue weighting factors; ED was also computed using the AAPM Dose Length Product (DLP) method and compared to the MOSFET value. Results: The effective energy was determined as 42.9 kV under the combined beam from half-value layer (HVL) measurement. ED for the dual-energy scan was calculated as 16.49 ± 0.04 mSv by the MOSFET method and 14.62 mSv by the DLP method. Conclusion: Tissue dose in the center of the CTDI body phantom was 1.71 ± 0.01 cGy (ion chamber) and 1.71 ± 0.06 (MOSFET) respectively; this validated the use of effective energy method for organ dose estimation. ED from the abdomen-pelvis scan was calculated as 16.49 ± 0.04 mSv by MOSFET and 14.62 mSv by the DLP method; this suggests that the DLP method provides a reasonable approximation to the ED.« less

Fertility and Pregnancy Outcome After Abdominal Irradiation That Included or Excluded the Pelvis in Childhood Tumor Survivors

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

Sudour, Helene, E-mail: h.sudour@hotmail.f; Chastagner, Pascal; Claude, Line

Purpose: To evaluate fertility after abdominal and/or pelvic irradiation in long-term female survivors. Methods and Materials: Puberty and pregnancy outcome were analyzed in female survivors of childhood cancer (aged <18 years) treated with abdominal and/or pelvic radiotherapy (RT) at one of two French centers (Nancy and Lyon) between 1975 and 2004. Data were obtained from medical records and questionnaires sent to the women. Results: A total of 84 patients who had received abdominal and/or pelvic RT during childhood and were alive and aged more than 18 years at the time of the study made up the study population. Of themore » 57 female survivors treated with abdominal RT that excluded the pelvis, 52 (91%) progressed normally through puberty and 23 (40%) had at least one recorded pregnancy. Of the 27 patients treated with pelvic RT, only 10 (37%) progressed normally through puberty and 5 (19%) had at least one recorded pregnancy. Twenty-two women (seventeen of whom were treated with pelvic RT) had certain subfertility. A total of 50 births occurred in 28 women, with one baby dying at birth; one miscarriage also occurred. There was a high prevalence of prematurity and low birth weight but not of congenital malformations. Conclusions: Fertility can be preserved in patients who undergo abdominal RT that excludes the pelvis, taking into account the other treatments (e.g., chemotherapy with alkylating agents) are taken into account. When RT includes the pelvis, fertility is frequently impaired and women can have difficulty conceiving. Nevertheless, pregnancies can occur in some of these women. The most important factor that endangers a successful pregnancy after RT is the total dose received by the ovaries and uterus. This radiation dose has to be systematically recorded to improve our ability to follow up patients.« less

Patient-specific geometrical modeling of orthopedic structures with high efficiency and accuracy for finite element modeling and 3D printing.

PubMed

Huang, Huajun; Xiang, Chunling; Zeng, Canjun; Ouyang, Hanbin; Wong, Kelvin Kian Loong; Huang, Wenhua

2015-12-01

We improved the geometrical modeling procedure for fast and accurate reconstruction of orthopedic structures. This procedure consists of medical image segmentation, three-dimensional geometrical reconstruction, and assignment of material properties. The patient-specific orthopedic structures reconstructed by this improved procedure can be used in the virtual surgical planning, 3D printing of real orthopedic structures and finite element analysis. A conventional modeling consists of: image segmentation, geometrical reconstruction, mesh generation, and assignment of material properties. The present study modified the conventional method to enhance software operating procedures. Patient's CT images of different bones were acquired and subsequently reconstructed to give models. The reconstruction procedures were three-dimensional image segmentation, modification of the edge length and quantity of meshes, and the assignment of material properties according to the intensity of gravy value. We compared the performance of our procedures to the conventional procedures modeling in terms of software operating time, success rate and mesh quality. Our proposed framework has the following improvements in the geometrical modeling: (1) processing time: (femur: 87.16 ± 5.90 %; pelvis: 80.16 ± 7.67 %; thoracic vertebra: 17.81 ± 4.36 %; P < 0.05); (2) least volume reduction (femur: 0.26 ± 0.06 %; pelvis: 0.70 ± 0.47, thoracic vertebra: 3.70 ± 1.75 %; P < 0.01) and (3) mesh quality in terms of aspect ratio (femur: 8.00 ± 7.38 %; pelvis: 17.70 ± 9.82 %; thoracic vertebra: 13.93 ± 9.79 %; P < 0.05) and maximum angle (femur: 4.90 ± 5.28 %; pelvis: 17.20 ± 19.29 %; thoracic vertebra: 3.86 ± 3.82 %; P < 0.05). Our proposed patient-specific geometrical modeling requires less operating time and workload, but the orthopedic structures were generated at a higher rate of success as compared with the conventional method. It is expected to benefit the surgical planning of orthopedic structures with less operating time and high accuracy of modeling.

Application of syntactic methods of pattern recognition for data mining and knowledge discovery in medicine

NASA Astrophysics Data System (ADS)

Ogiela, Marek R.; Tadeusiewicz, Ryszard

2000-04-01

This paper presents and discusses possibilities of application of selected algorithms belonging to the group of syntactic methods of patten recognition used to analyze and extract features of shapes and to diagnose morphological lesions seen on selected medical images. This method is particularly useful for specialist morphological analysis of shapes of selected organs of abdominal cavity conducted to diagnose disease symptoms occurring in the main pancreatic ducts, upper segments of ureters and renal pelvis. Analysis of the correct morphology of these organs is possible with the application of the sequential and tree method belonging to the group of syntactic methods of pattern recognition. The objective of this analysis is to support early diagnosis of disease lesions, mainly characteristic for carcinoma and pancreatitis, based on examinations of ERCP images and a diagnosis of morphological lesions in ureters as well as renal pelvis based on an analysis of urograms. In the analysis of ERCP images the main objective is to recognize morphological lesions in pancreas ducts characteristic for carcinoma and chronic pancreatitis, while in the case of kidney radiogram analysis the aim is to diagnose local irregularities of ureter lumen and to examine the morphology of renal pelvis and renal calyxes. Diagnosing the above mentioned lesion has been conducted with the use of syntactic methods of pattern recognition, in particular the languages of description of features of shapes and context-free sequential attributed grammars. These methods allow to recognize and describe in a very efficient way the aforementioned lesions on images obtained as a result of initial image processing of width diagrams of the examined structures. Additionally, in order to support the analysis of the correct structure of renal pelvis a method using the tree grammar for syntactic pattern recognition to define its correct morphological shapes has been presented.

A finite element model of a six-year-old child for simulating pedestrian accidents.

PubMed

Meng, Yunzhu; Pak, Wansoo; Guleyupoglu, Berkan; Koya, Bharath; Gayzik, F Scott; Untaroiu, Costin D

2017-01-01

Child pedestrian protection deserves more attention in vehicle safety design since they are the most vulnerable road users who face the highest mortality rate. Pediatric Finite Element (FE) models could be used to simulate and understand the pedestrian injury mechanisms during crashes in order to mitigate them. Thus, the objective of the study was to develop a computationally efficient (simplified) six-year-old (6YO-PS) pedestrian FE model and validate it based on the latest published pediatric data. The 6YO-PS FE model was developed by morphing the existing GHBMC adult pedestrian model. Retrospective scan data were used to locally adjust the geometry as needed for accuracy. Component test simulations focused only the lower extremities and pelvis, which are the first body regions impacted during pedestrian accidents. Three-point bending test simulations were performed on the femur and tibia with adult material properties and then updated using child material properties. Pelvis impact and knee bending tests were also simulated. Finally, a series of pediatric Car-to-Pedestrian Collision (CPC) were simulated with pre-impact velocities ranging from 20km/h up to 60km/h. The bone models assigned pediatric material properties showed lower stiffness and a good match in terms of fracture force to the test data (less than 6% error). The pelvis impact force predicted by the child model showed a similar trend with test data. The whole pedestrian model was stable during CPC simulations and predicted common pedestrian injuries. Overall, the 6YO-PS FE model developed in this study showed good biofidelity at component level (lower extremity and pelvis) and stability in CPC simulations. While more validations would improve it, the current model could be used to investigate the lower limb injury mechanisms and in the prediction of the impact parameters as specified in regulatory testing protocols. Copyright © 2016 Elsevier Ltd. All rights reserved.

Stapler access and visibility in the deep pelvis: A comparative human cadaver study between a computerized right angle linear cutter versus a curved cutting stapler

PubMed Central

2011-01-01

Purpose Distal rectal stapling is often challenging because of limited space and visibility. We compared two stapling devices in the distal rectum in a cadaver study: the iDrive™ right angle linear cutter (RALC) (Covidien, New Haven, CT) and the CONTOUR® curved cutter (CC) (Ethicon Endo-Surgery, Cincinnati, OH). Methods Twelve male cadavers underwent pelvic dissection by 4 surgeons. After rectal mobilization as in a total mesorectal excision, the staplers were applied to the rectum as deep as possible in both the coronal and sagittal positions. The distance from the pelvic floor was measured for each application. A questionnaire rated the visibility and access of the stapling devices. Measurements were taken between pelvic landmarks to see what anatomic factors hinder the placement of a distal rectal stapler. Results The median (range) distance of the stapler from the pelvic floor in the coronal position for the RALC was 1.0 cm (0-4.0) vs. 2.0 cm (0-5.0) for the CC, p = 0.003. In the sagittal position, the median distance was 1.6 cm (0-3.5) for the RALC and 3.3 cm (0-5.0) for the CC, p < 0.0001. The RALC scored better than the CC in respect to: 1. interference by the symphysis pubis, 2. number of stapler readjustments, 3. ease of placement in the pelvis, 4. impediment of visibility, 5. ability to hold and retain tissue, 6. visibility rating, and 7. access in the pelvis. A shorter distance between the tip of the coccyx and the pubic symphysis correlated with a longer distance of the stapler from the pelvic floor (p = 0.002). Conclusions The RALC is superior to the CC in terms of access, visibility, and ease of placement in the deep pelvis. This could provide important clinical benefit to both patient and surgeon during difficult rectal surgery. PMID:21871120

[PELVIS/SACRAL syndrome with livedoid haemangioma and amniotic band].

PubMed

Bourrat, E; Lemarchand-Venencie, F; Jacquemont, M-L; El Ghoneimi, A; Wassef, M; Leger, J; Morel, P

2008-12-01

PELVIS or SACRAL syndrome denotes the association of local haemangioma and malformation in the pelvic region. In this paper, we report a case noteworthy on account of the initially livedoid appearance of the haemangioma as well as associated amniotic banding of an upper limb. A newborn male infant underwent left colostomy on the day of birth due to anal imperforation and anomalies of the external genital organs with sexual ambiguity. Examination of the skin and appendages revealed poorly delineated hypopigmentation in the sacrolumbar region and a fibrous groove around the right arm characteristic of amniotic band syndrome. Sacrolumbar and pelvic MRI scans revealed deviation towards the left of the last three sacral vertebrae with no medullary anomalies. Retrograde cystography showed a recto-uretral fistula. Progression of the infant's condition was marked by the appearance during the first month of a flat, violaceous, angiomatous, livedoid lesion in the middle of the buttocks and the perineum and a linear lesion on the rear aspect of the right lower limb. The skin biopsy of this lesion revealed a single capillary lobule at the dermal-hypodermal junction of non-specific appearance but with marked Glut1 expression by endothelial cells highly evocative of infantile haemangioma. Segmented haemangiomas are commonly associated with extracutaneous abnormalities. By analogy with PHACE syndrome, defined as association of segmented facial haemangioma with cerebral, ocular and cardio-aortic abnormalities, PELVIS/SACRAL syndrome denotes the association of segmented haemangioma of the loins (sacrolumbar region, buttocks or perineum=napkin haemangioma) with spinal dysraphia affecting the sacrolumbar spine, the terminal medullary cone, the genitourinary organs and the anal region to different degrees. Diagnosis of haemangioma associated with PELVIS/SACRAL syndrome may be delayed or complicated due to the macular, telangiectasic or livedoid appearance commonly seen. To our knowledge, there have been no reports to date of an association of amniotic banding with haemangioma or perineal dysraphia.

The effects of low-repetition and light-load power training on bone mineral density in postmenopausal women with sarcopenia: a pilot study.

PubMed

Hamaguchi, Kanako; Kurihara, Toshiyuki; Fujimoto, Masahiro; Iemitsu, Motoyuki; Sato, Koji; Hamaoka, Takafumi; Sanada, Kiyoshi

2017-05-02

Age-related reduction in bone mineral density (BMD) is generally accelerated in women after menopause, and could be even more pronounced in individuals with sarcopenia. Light-load power training with a low number of repetitions would increase BMD, significantly reducing bone loss in individuals at risk of osteoporosis. This study investigated the effects of low-repetition, light-load power training on BMD in Japanese postmenopausal women with sarcopenia. The training group (n = 7) followed a progressive power training protocol that increased the load with a weighted vest, for two sessions per week, over the course of 6 weeks. The training exercise comprised five kinds of exercises (squats, front lunges, side lunges, calf raises, and toe raises), and each exercise contained eight sets of three repetitions with a 15-s rest between each set. The control group (n = 8) did not undergo any training intervention. We measured BMD, muscle strength, and anthropometric data. Within-group changes in pelvis BMD and knee extensor strength were significantly greater in the training group than the control group (p = 0.029 and 0.030 for pelvis BMD and knee extensor strength, respectively). After low-repetition, light-load power training, we noted improvements in pelvis BMD (1.6%) and knee extensor strength (15.5%). No significant within- or between-group differences were observed for anthropometric data or forearm BMD. Six weeks of low-repetition, light-load power training improved pelvis BMD and knee extensor strength in postmenopausal women with sarcopenia. Since this training program does not require high-load exercise and is therefore easily implementable as daily exercise, it could be an effective form of exercise for sedentary adults at risk for osteoporosis who are fearful of heavy loads and/or training that could cause fatigue. This trial was registered with the University Hospital Medical Information Network on 31 October 2016 ( UMIN000024651 ).

Automatic exposure control calibration and optimisation for abdomen, pelvis and lumbar spine imaging with an Agfa computed radiography system.

PubMed

Moore, C S; Wood, T J; Avery, G; Balcam, S; Needler, L; Joshi, H; Saunderson, J R; Beavis, A W

2016-11-07

The use of three physical image quality metrics, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and mean effective noise equivalent quanta (eNEQ m ) have recently been examined by our group for their appropriateness in the calibration of an automatic exposure control (AEC) device for chest radiography with an Agfa computed radiography (CR) imaging system. This study uses the same methodology but investigates AEC calibration for abdomen, pelvis and spine CR imaging. AEC calibration curves were derived using a simple uniform phantom (equivalent to 20 cm water) to ensure each metric was held constant across the tube voltage range. Each curve was assessed for its clinical appropriateness by generating computer simulated abdomen, pelvis and spine images (created from real patient CT datasets) with appropriate detector air kermas for each tube voltage, and grading these against reference images which were reconstructed at detector air kermas correct for the constant detector dose indicator (DDI) curve currently programmed into the AEC device. All simulated images contained clinically realistic projected anatomy and were scored by experienced image evaluators. Constant DDI and CNR curves did not provide optimized performance but constant eNEQ m and SNR did, with the latter being the preferred calibration metric given that it is easier to measure in practice. This result was consistent with the previous investigation for chest imaging with AEC devices. Medical physicists may therefore use a simple and easily accessible uniform water equivalent phantom to measure the SNR image quality metric described here when calibrating AEC devices for abdomen, pelvis and spine imaging with Agfa CR systems, in the confidence that clinical image quality will be sufficient for the required clinical task. However, to ensure appropriate levels of detector air kerma the advice of expert image evaluators must be sought.

Tumor resection at the pelvis using three-dimensional planning and patient-specific instruments: a case series.

PubMed

Jentzsch, Thorsten; Vlachopoulos, Lazaros; Fürnstahl, Philipp; Müller, Daniel A; Fuchs, Bruno

2016-09-21

Sarcomas are associated with a relatively high local recurrence rate of around 30 % in the pelvis. Inadequate surgical margins are the most important reason. However, obtaining adequate margins is particularly difficult in this anatomically demanding region. Recently, three-dimensional (3-D) planning, printed models, and patient-specific instruments (PSI) with cutting blocks have been introduced to improve the precision during surgical tumor resection. This case series illustrates these modern 3-D tools in pelvic tumor surgery. The first consecutive patients with 3-D-planned tumor resection around the pelvis were included in this retrospective study at a University Hospital in 2015. Detailed information about the clinical presentation, imaging techniques, preoperative planning, intraoperative surgical procedures, and postoperative evaluation is provided for each case. The primary outcome was tumor-free resection margins as assessed by a postoperative computed tomography (CT) scan of the specimen. The secondary outcomes were precision of preoperative planning and complications. Four patients with pelvic sarcomas were included in this study. The mean follow-up was 7.8 (range, 6.0-9.0) months. The combined use of preoperative planning with 3-D techniques, 3-D-printed models, and PSI for osteotomies led to higher precision (maximal (max) error of 0.4 centimeters (cm)) than conventional 3-D planning and freehand osteotomies (max error of 2.8 cm). Tumor-free margins were obtained where measurable (n = 3; margins were not assessable in a patient with curettage). Two insufficiency fractures were noted postoperatively. Three-dimensional planning as well as the intraoperative use of 3-D-printed models and PSI are valuable for complex sarcoma resection at the pelvis. Three-dimensionally printed models of the patient anatomy may help visualization and precision. PSI with cutting blocks help perform very precise osteotomies for adequate resection margins.

Whole-pelvis, 'mini-pelvis,' or prostate-only external beam radiotherapy after neoadjuvant and concurrent hormonal therapy in patients treated in Radiation Therapy Oncology Group 9413 trial

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

Roach, Mack; De Silvio, Michelle; Valicenti, Richard

2006-11-01

Purpose: Radiation Therapy Oncology Group (RTOG) 9413 trial demonstrated a better progression-free survival (PFS) with whole-pelvis (WP) radiotherapy (RT) compared with prostate-only (PO) RT. This secondary analysis was undertaken to determine whether 'mini-pelvis' (MP; defined as {>=}10 x 11 cm but <11 x 11 cm) RT resulted in progression-free survival (PFS) comparable to that of WP RT. To avoid a timing bias, this analysis was limited to patients receiving neoadjuvant and concurrent hormonal therapy (N and CHT) in Arms 1 and 2 of the study. Methods and Materials: Eligible patients had a risk of lymph node (LN) involvement >15%. Neoadjuvantmore » and concurrent hormonal therapy (N and CHT) was administered 2 months before and during RT for 4 months. From April 1, 1995, to June 1, 1999, a group of 325 patients were randomized to WP RT + N and CHT and another group of 324 patients were randomized to receive PO RT + N and CHT. Patients randomized to PO RT were dichotomized by median field size (10 x 11 cm), with the larger field considered an 'MP' field and the smaller a PO field. Results: The median PFS was 5.2, 3.7, and 2.9 years for WP, MP, and PO fields, respectively (p = 0.02). The 7-year PFS was 40%, 35%, and 27% for patients treated to WP, MP, and PO fields, respectively. There was no association between field size and late Grade 3+ genitourinary toxicity but late Grade 3+ gastrointestinal RT complications correlated with increasing field size. Conclusions: This subset analysis demonstrates that RT field size has a major impact on PFS, and the findings support comprehensive nodal treatment in patients with a risk of LN involvement of >15%.« less

Potassium and ANO1/TMEM16A chloride channel profiles distinguish atypical and typical smooth muscle cells from interstitial cells in the mouse renal pelvis

PubMed Central

Iqbal, Javed; Tonta, Mary A; Mitsui, Retsu; Li, Qun; Kett, Michelle; Li, Jinhua; Parkington, Helena C; Hashitani, Hikaru; Lang, Richard J

2012-01-01

BACKGROUND AND PURPOSE Although atypical smooth muscle cells (SMCs) in the proximal renal pelvis are thought to generate the pacemaker signals that drive pyeloureteric peristalsis, their location and electrical properties remain obscure. EXPERIMENTAL APPROACH Standard patch clamp, intracellular microelectrode and immunohistochemistry techniques were used. To unequivocally identify SMCs, transgenic mice with enhanced yellow fluorescent protein (eYFP) expressed in cells containing α-smooth muscle actin (α-SMA) were sometimes used. KEY RESULTS Atypical SMCs were distinguished from typical SMCs by the absence of both a transient 4-aminopyridine-sensitive K+ current (IKA) and spontaneous transient outward currents (STOCs) upon the opening of large-conductance Ca2+-activated K+ (BK) channels. Many typical SMCs displayed a slowly activating, slowly decaying Cl- current blocked by niflumic acid (NFA). Immunostaining for KV4.3 and ANO1/ TMEM16A Cl- channel subunits co-localized with α-SMA immunoreactive product predominately in the distal renal pelvis. Atypical SMCs fired spontaneous inward currents that were either selective for Cl- and blocked by NFA, or cation-selective and blocked by La3+. α-SMA- interstitial cells (ICs) were distinguished by the presence of a Xe991-sensitive KV7 current, BK channel STOCs and Cl- selective, NFA-sensitive spontaneous transient inward currents (STICs). Intense ANO1/ TMEM16A and KV7.5 immunostaining was present in Kit-α-SMA- ICs in the suburothelial and adventitial regions of the renal pelvis. CONCLUSIONS AND IMPLICATIONS We conclude that KV4.3+α-SMA+ SMCs are typical SMCs that facilitate muscle wall contraction, that ANO1/ TMEM16A and KV7.5 immunoreactivity may be selective markers of Kit- ICs and that atypical SMCs which discharge spontaneous inward currents are the pelviureteric pacemakers. PMID:22014103

SU-F-T-522: Dosimetric Study of Junction Dose in Double Isocenter Flatten and Flatten Filter Free IMRT and VMAT Plan Delivery

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

Samuvel, K; Yadav, G; Bhushan, M

2016-06-15

Purpose: To quantify the dosimetric accuracy of junction dose in double isocenter flattened and flatten filter free(FFF) intensity modulated radiation therapy(IMRT) and volumetric modulated arc therapy(VMAT) plan delivery using pelvis phantom. Methods: Five large field pelvis patients were selected for this study. Double isocenter IMRT and VMAT treatment plans were generated in Eclipse Treatment planning System (V.11.0) using 6MV FB and FFF beams. For all the plans same distance 17.0cm was kept between one isocenter to another isocenter. IMRT Plans were made with 7 coplanar fields and VMAT plans were made with full double arcs. Dose calculation was performed usingmore » AAA algorithms with dose grid size of 0.25 cm. Verification plans were calculated on Scanditronix Wellhofer pelvis slab phantom. Measurement point was selected and calculated, where two isocenter plan fields are overlapping, this measurement point was kept at distance 8.5cm from both isocenter. The plans were delivered using Varian TrueBeamTM machine on pelvis slab phantom. Point dose measurements was carried out using CC13 ion chamber volume of 0.13cm3. Results: The measured junction point dose are compared with TPS calculated dose. The mean difference observed was 4.5%, 6.0%, 4.0% and 7.0% for IMRT-FB,IMRT-FFF, VMAT-FB and VMAT-FFF respectively. The measured dose results shows closer agreement with calculated dose in Flatten beam planning in both IMRT and VMAT, whereas in FFF beam plan dose difference are more compared with flatten beam plan. Conclusion: Dosimetry accuracy of Large Field junction dose difference was found less in Flatten beam compared with FFF beam plan delivery. Even though more dosimetric studies are required to analyse junction dose for FFF beam planning using multiple point dose measurements and fluence map verification in field junction area.« less

Automatic exposure control calibration and optimisation for abdomen, pelvis and lumbar spine imaging with an Agfa computed radiography system

NASA Astrophysics Data System (ADS)

Moore, C. S.; Wood, T. J.; Avery, G.; Balcam, S.; Needler, L.; Joshi, H.; Saunderson, J. R.; Beavis, A. W.

2016-11-01

The use of three physical image quality metrics, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and mean effective noise equivalent quanta (eNEQm) have recently been examined by our group for their appropriateness in the calibration of an automatic exposure control (AEC) device for chest radiography with an Agfa computed radiography (CR) imaging system. This study uses the same methodology but investigates AEC calibration for abdomen, pelvis and spine CR imaging. AEC calibration curves were derived using a simple uniform phantom (equivalent to 20 cm water) to ensure each metric was held constant across the tube voltage range. Each curve was assessed for its clinical appropriateness by generating computer simulated abdomen, pelvis and spine images (created from real patient CT datasets) with appropriate detector air kermas for each tube voltage, and grading these against reference images which were reconstructed at detector air kermas correct for the constant detector dose indicator (DDI) curve currently programmed into the AEC device. All simulated images contained clinically realistic projected anatomy and were scored by experienced image evaluators. Constant DDI and CNR curves did not provide optimized performance but constant eNEQm and SNR did, with the latter being the preferred calibration metric given that it is easier to measure in practice. This result was consistent with the previous investigation for chest imaging with AEC devices. Medical physicists may therefore use a simple and easily accessible uniform water equivalent phantom to measure the SNR image quality metric described here when calibrating AEC devices for abdomen, pelvis and spine imaging with Agfa CR systems, in the confidence that clinical image quality will be sufficient for the required clinical task. However, to ensure appropriate levels of detector air kerma the advice of expert image evaluators must be sought.

Posterior locked lateral compression injury of the pelvis in geriatric patients: an infrequent and specific variant of the fragility fracture of pelvis.

PubMed

Lee, Se-Won; Kim, Weon-Yoo; Koh, Sung-Jun; Kim, Young-Yul

2017-09-01

Posterior locked lateral compression injury (PLLCI) of the pelvic ring is an infrequent variant of lateral compression injury, a condition described in only eight reported cases since 2000. Lateral compression injury usually results from high-energy trauma and is characterized by locking between the medially translated fractured ilium and the anterior border of the sacrum, regardless of whether the fractured ilium involves the sacroiliac joint. However, in our experience, lateral compression injury can also result from low-energy trauma as a manifestation of pelvic fragility fracture. The aim of the present study was to describe this rare form of PLLCI in a case series of geriatric patients. A retrospective analysis of consecutive patients with pelvic ring injuries who were admitted to our hospital from January 2008 to April 2015 identified seven geriatric patients (1 male and 6 females; median age 81 years) with a form of PLLCI. All injuries were due to falls from a standing position onto the ground. All seven cases demonstrated characteristics of a locking fractured ilium over the anterior border of the sacrum on axial computed tomography images, but were not detected on plain radiographs. All underwent follow-up at 1 year or later with improved mean visual analogue scale scores (range 0-3). Regarding Koval walking ability scores, patients who underwent pelvic brim plating with anterior external fixation were more likely to regain their pre-injury walking ability than patients who only underwent anterior external fixation or conservative treatment. Geriatric patients can experience PLCCIs of the pelvis due to low-energy trauma. These fractures have different characteristics from those associated with severe injuries due to high-energy trauma, and they comprise an infrequent form of Rommens fragility fracture of the pelvis (type IIIa). In these cases, appropriate surgical management that includes sacroiliac plating combined with anterior external fixation can yield good outcomes.

Single-source chest-abdomen-pelvis cancer staging on a third generation dual-source CT system: comparison of automated tube potential selection to second generation dual-source CT.

PubMed

Park, Clara; Gruber-Rouh, Tatjana; Leithner, Doris; Zierden, Amelie; Albrecht, Mortiz H; Wichmann, Julian L; Bodelle, Boris; Elsabaie, Mohamed; Scholtz, Jan-Erik; Kaup, Moritz; Vogl, Thomas J; Beeres, Martin

2016-10-10

Evaluation of latest generation automated attenuation-based tube potential selection (ATPS) impact on image quality and radiation dose in contrast-enhanced chest-abdomen-pelvis computed tomography examinations for gynaecologic cancer staging. This IRB approved single-centre, observer-blinded retrospective study with a waiver for informed consent included a total of 100 patients with contrast-enhanced chest-abdomen-pelvis CT for gynaecologic cancer staging. All patients were examined with activated ATPS for adaption of tube voltage to body habitus. 50 patients were scanned on a third-generation dual-source CT (DSCT), and another 50 patients on a second-generation DSCT. Predefined image quality setting remained stable between both groups at 120 kV and a current of 210 Reference mAs. Subjective image quality assessment was performed by two blinded readers independently. Attenuation and image noise were measured in several anatomic structures. Signal-to-noise ratio (SNR) was calculated. For the evaluation of radiation exposure, CT dose index (CTDI vol ) values were compared. Diagnostic image quality was obtained in all patients. The median CTDI vol (6.1 mGy, range 3.9-22 mGy) was 40 % lower when using the algorithm compared with the previous ATCM protocol (median 10.2 mGy · cm, range 5.8-22.8 mGy). A reduction in potential to 90 kV occurred in 19 cases, a reduction to 100 kV in 23 patients and a reduction to 110 kV in 3 patients of our experimental cohort. These patients received significantly lower radiation exposure compared to the former used protocol. Latest generation automated ATPS on third-generation DSCT provides good diagnostic image quality in chest-abdomen-pelvis CT while average radiation dose is reduced by 40 % compared to former ATPS protocol on second-generation DSCT.

[A clinical study of associated bladder tumor in patients with renal pelvic and ureteral tumor].

PubMed

Sugano, O; Shouji, N; Horigome, T; Uchi, K; Katou, H

1995-08-01

We investigated the incidence of associated bladder tumor and prognosis in 101 cases with a pathological diagnosis of transitional cell carcinoma, selected from those with renal pelvic and ureteral tumor whom we had encountered over the 18 years between April 1976 and March 1993. Among these 101 cases, the incidence of associated bladder tumor was noted in 42 (41.6%), 23 (22.8%) with coexistence and 19 (18.8%) with subsequence. As for the primary site of renal pelvis and ureter, the coexistence was 15.4% and subsequence 20.5% in renal pelvis, and the coexistence was 24.6% and subsequence 19.3% in ureter, and the coexistence was 60.0% and subsequence 0.0% in both renal pelvis and ureter. The incidence of coexistent bladder tumor was high in both renal pelvis and ureter, but no significant difference was noted. As for the stage, the incidence of coexistence was high in T1, while subsequence was high in T2, but no significant difference was noted. As for the grade, the incidence of coexistence was high in G2, but no significant difference was noted. The 5 year survival rate was 58.2% in those without, 54.2% with coexistence, and 82.5% with subsequent bladder tumor, with a significant difference (p < 0.05) between the last two groups. The interval of subsequent bladder tumor ranged from 4 to 164 months (mean 27.7 months), with the incidence within 2 years being approximately 70.0%. It was found that the renal pelvic and ureteral tumors are frequently associated bladder tumor while associated bladder tumor dose not appear to have an ill effect on the prognosis. Therefore it is necessary that patients with renal pelvic and ureteral tumor be observed closely for 5 years, especially for the initial 2 years.

Pelvic Incidence and Acetabular Version in Slipped Capital Femoral Epiphysis.

PubMed

Gebhart, Jeremy J; Bohl, Michael S; Weinberg, Douglas S; Cooperman, Daniel R; Liu, Raymond W

2015-09-01

The etiology of slipped capital femoral epiphysis (SCFE) is multifactorial, but the role of sagittal balance of the pelvis as a contributing factor to its development has not been well studied. Our primary purpose was to determine whether a smaller pelvic incidence (PI), a position-independent anatomic parameter that regulates pelvic orientation, could be a factor that increases shear stress in the epiphyseal growth plate and potentially contributes to the development of SCFE. We also set out to determine whether acetabular retroversion was associated with SCFE. We obtained 14 cadaveric pelvi from the Hamann-Todd Osteological Collection whose femurs showed evidence of post-SCFE deformity. Two hundred age-matched, sex-matched, and race-matched pelvi were used as controls. PI and acetabular version were measured using standardized lateral photographs and goniometers, respectively. T tests were performed to evaluate for differences in measured parameters between groups. The mean PI was 40.6±6.1 degrees for SCFE specimens and 47.4±9.9 degrees for normal specimens (P=0.01). The mean version of SCFE and normal acetabula was 15±7 and 17±6 degrees, respectively (P=0.39). There was also no significant difference in version between SCFE acetabula and the contralateral, uninvolved acetabular of the same specimen (15±7 vs. 17±8 degrees, P=0.33). Specimens with SCFE deformity demonstrated a smaller PI than a large cohort of normal control specimens. We found no significant difference between acetabular version of specimens with and without SCFE deformity. Contralateral or unaffected acetabuli of SCFE specimens were not more retroverted than the affected side of the same specimen. Sagittal balance of the pelvis, and particularly decreased PI, may play an important role in the development of SCFE. The influence of mechanical factors beyond the hip joint in the development of SCFE should be considered by clinicians.

How is sagittal balance acquired during bipedal gait acquisition? Comparison of neonatal and adult pelves in three dimensions. Evolutionary implications.

PubMed

Tardieu, Christine; Bonneau, Noémie; Hecquet, Jérôme; Boulay, Christophe; Marty, Catherine; Legaye, Jean; Duval-Beaupère, Geneviève

2013-08-01

We compare adult and intact neonatal pelves, using a pelvic sagittal variable, the angle of sacral incidence, which presents significant correlations with vertebral curvature in adults and plays an important role in sagittal balance of the trunk on the lower limbs. Since the lumbar curvature develops in the child in association with gait acquisition, we expect a change in this angle during growth which could contribute to the acquisition of sagittal balance. To understand the mechanisms underlying the sagittal balance in the evolution of human bipedalism, we also measure the angle of incidence of hominid fossils. Fourty-seven landmarks were digitized on 50 adult and 19 intact neonatal pelves. We used a three-dimensional model of the pelvis (DE-VISU program) which calculates the angle of sacral incidence and related functional variables. Cross-sectional data from newborns and adults show that the angle of sacral incidence increases and becomes negatively correlated with the sacro-acetabular distance. During ontogeny the sacrum becomes curved, tends to sink down between the iliac blades as a wedge and moves backward in the sagittal plane relative to the acetabula, thus contributing to the backwards displacement of the center of gravity of the trunk. A chain of correlations links the degree of the sacral slope and of the angle of incidence, which is tightly linked with the lumbar lordosis. We sketch a model showing the coordinated changes occurring in the pelvis and vertebral column during the acquisition of bipedalism in infancy. In the australopithecine pelves, Sts 14 and AL 288-1, and in the Homo erectus Gona pelvis the angle of sacral incidence reaches the mean values of humans. Discussing the incomplete pelves of Ardipithecus ramidus, Australopithecus sediba and the Nariokotome Boy, we suggest how the functional linkage between pelvis and spine, observed in humans, could have emerged during hominid evolution. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Prophylactic osteotomy of pelvis in dysplastic acetabulum.].

PubMed

Richtr, M; Sosna, A

1998-01-01

Acetabular dysplasia and anatomical changes of pelvis accompanied with gracility of iliac bone pose a problem for a reliable fixation of acetabular component. In extreme cases the bone stock is not sufficient to accommodate the smallest size of the cup. Sometimes even reaming of the bed down to lamina interna is not sufficient for an adequate covering of the implant. Consequently, weakening of the bottom of acetabulum may be not only one of the causes of the failure of the implant but it makes difficult also the following revision surgeries. Therefore in acetabular dysplasia the authors recommend acetabuloplasty of the bottom of acetabulum preserving its original thickness including inner cortex. They recommend to perform osteotomy of the full thickness of the medial wall of acetabulum and move the massive bone graft created in this way farther into pelvis. At the same time they take care to preserve blood supply of the bone graft by retaining corticoperiostal bridge by means of osteoclasia. The suggested procedure allows full coverage of the implant by iliac bone and at the same time preserves a firm support of acetabular fossa. The original thickness of the medial wall of acetabulum is considered by authors as a significant antimigration barrier. In the period 1991 -1994 the authors used this method at Ist Orthopaedic Clinic of 1st Medical Faculty, Charles University in Prague in total in 16 patients. In all of them after 6 months the bone graft was fully absorbed. Remodelling of the bone graft occurred 1 to 2 years after the surgery and after that the thickness of the graft remained the same. Neither any change of the structure nor reduction of the thickness of the graft was found between 3rd and 4th year after the surgery. The nature of trabecular remodelling of the bone graft corresponds to the transfer of forces in loading the graft by acetabular cup. Key words: acetabuloplasty, osteotomy of the medial wall of acetabulum, osteotomy of pelvis, THR, acetabular dysplasia.

Automatic detection of patient identification and positioning errors in radiation therapy treatment using 3-dimensional setup images.

PubMed

Jani, Shyam S; Low, Daniel A; Lamb, James M

2015-01-01

To develop an automated system that detects patient identification and positioning errors between 3-dimensional computed tomography (CT) and kilovoltage CT planning images. Planning kilovoltage CT images were collected for head and neck (H&N), pelvis, and spine treatments with corresponding 3-dimensional cone beam CT and megavoltage CT setup images from TrueBeam and TomoTherapy units, respectively. Patient identification errors were simulated by registering setup and planning images from different patients. For positioning errors, setup and planning images were misaligned by 1 to 5 cm in the 6 anatomical directions for H&N and pelvis patients. Spinal misalignments were simulated by misaligning to adjacent vertebral bodies. Image pairs were assessed using commonly used image similarity metrics as well as custom-designed metrics. Linear discriminant analysis classification models were trained and tested on the imaging datasets, and misclassification error (MCE), sensitivity, and specificity parameters were estimated using 10-fold cross-validation. For patient identification, our workflow produced MCE estimates of 0.66%, 1.67%, and 0% for H&N, pelvis, and spine TomoTherapy images, respectively. Sensitivity and specificity ranged from 97.5% to 100%. MCEs of 3.5%, 2.3%, and 2.1% were obtained for TrueBeam images of the above sites, respectively, with sensitivity and specificity estimates between 95.4% and 97.7%. MCEs for 1-cm H&N/pelvis misalignments were 1.3%/5.1% and 9.1%/8.6% for TomoTherapy and TrueBeam images, respectively. Two-centimeter MCE estimates were 0.4%/1.6% and 3.1/3.2%, respectively. MCEs for vertebral body misalignments were 4.8% and 3.6% for TomoTherapy and TrueBeam images, respectively. Patient identification and gross misalignment errors can be robustly and automatically detected using 3-dimensional setup images of different energies across 3 commonly treated anatomical sites. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

The influence of passenger car front shape on pedestrian injury risk observed from German in-depth accident data.

PubMed

Li, Guibing; Lyons, Mathew; Wang, Bingyu; Yang, Jikuang; Otte, Dietmar; Simms, Ciaran

2017-04-01

Quantified relationships between passenger car front shape and pedestrian injury risk derived from accident data are sparse, especially considering the significant recent changes in car front design. The purpose of this paper is therefore to investigate the detailed effects of passenger car front shape on injury risk to a pedestrian's head, thorax, pelvis and leg in the event of a vehicle pedestrian impact. Firstly, an accident sample of 594 pedestrian cases captured during 2000-2015 from the German In-Depth Accident Study (GIDAS) database was employed. Multicollinearity diagnostic statistics were then used to detect multicollinearity between the predictors. Following this, logistic regression was applied to quantify the effects of passenger car front shape on injury risks while controlling for impact speed and pedestrian age. Results indicate that the bumper lower depth (BLD), bumper lower height (BLH), bumper upper height (BUH) and normalised bumper lower/upper height (NBLH/NBUH) are statistically significant for AIS2+ leg injury risk. The normalised bonnet leading edge height (NBLEH) has a statistically significant influence on AIS2+ femur/pelvis injury occurrence. The passenger car front shape did not show statistical significance for AIS3+ thorax and head injuries. The impact speed and pedestrian age are generally significant factors influencing AIS2+ leg and pelvis injuries, and AIS3+ thorax and head injuries. However, when head impacts are fixed on the central windscreen region both pedestrian age and impact speed are not statistically significant for AIS3+ head injury. For quantified effects, when controlling for speed, age and BUH, an average 7% and 6% increase in AIS2+ leg injury odds was observed for every 1cm increase in BLD and BLH respectively; 1cm increase in BUH results in a 7% decrease in AIS2+ leg injury odds when the BLD or BLH are fixed respectively (again controlling for impact speed and pedestrian age); the average AIS2+ femur/pelvis injury odds increase by 74% for a 10% increase in NBLEH. These findings suggest that passenger car bumpers should support the lower leg with a low and flat lower bumper and even contact up to the femur area with a high upper bumper which extends above the knee to protect the pedestrian's leg. A low passenger car bonnet leading edge helps to reduce femur/pelvis injury risk. The passenger car front shape parameters are less influential than impact speed and pedestrian age for pedestrian injury risk. Copyright © 2017 Elsevier Ltd. All rights reserved.

Ultrasonographic reproductive tract measures and pelvis measures as predictors of pregnancy failure and anestrus in restricted bred beef heifers.

PubMed

Holm, Dietmar E; Nielen, Mirjam; Jorritsma, Ruurd; Irons, Peter C; Thompson, Peter N

2016-02-01

Previous reports have shown that reproductive tract score (RTS) can predict reproduction outcomes in seasonally bred beef heifers, although the accuracy can vary. Some ultrasonographic measures of the female reproductive tract and pelvis area have also been associated with reproductive outcome in young heifers. The objectives of this study were to determine which transrectal ultrasound or pelvis measures taken at a single examination are independent predictors of reproductive failure and whether the RTS system can be optimized with this information. In this observational study, year-old beef heifers (n = 488) in 2 birth cohorts were followed from just before the first breeding until confirmation of pregnancy. A single pre-breeding examination included body condition score, RTS, ultrasound measures of the reproductive tract (length and diameter of the left and right ovaries, presence and diameter of a CL, largest follicle diameter and left uterus horn diameter) and transverse and vertical diameters of the pelvis. Additional farm records including dam parity, sire, birth weight and birth date, weaning weight, weaning date, prebreeding body weight, AI dates, and semen used were available. Breeding consisted of 50 days of AI, followed 5 to 7 days later by a 42-day bull breeding period. Pregnancy failure was defined as the failure to become pregnant after the AI and bull breeding periods, while anestrus was defined as the failure to be detected in estrus during the 50-day AI period. From the prebreeding data and farm records, independent predictors of pregnancy failure and anestrus were identified using stepwise reduction in multiple logistic regression models. Age at the onset of breeding was the only consistent independent predictor of pregnancy failure and anestrus in both cohorts of this study (P < 0.05). Body condition score, uterus horn diameter, absence of a CL, largest follicle of less than 13 mm, and pelvis area (PA) were the prebreeding examination variables that remained in prognostic models (P < 0.1). Combining either the model based on the 3 remaining ultrasound measures or RTS with PA provided more accurate prognostic models for pregnancy failure and anestrus than using RTS alone (P < 0.05). It is concluded that ultrasound measures have prognostic value for pregnancy failure in restricted bred yearling heifers as a result of their association with anestrus, and that smaller PA has additional prognostic value for poorly performing heifers. Copyright © 2016 Elsevier Inc. All rights reserved.

Spontaneous rupture of the renal pelvis presenting as an urinoma in locally advanced rectal cancer

PubMed Central

Garg, Pankaj Kumar; Mohanty, Debajyoti; Rathi, Vinita; Jain, Bhupendra Kumar

2014-01-01

A 29-year-old gentleman underwent a transverse colostomy for intestinal obstruction caused by advanced rectal carcinoma. On the 5th postoperative day, the patient developed a painful swelling on the right side of the abdomen. The contrast enhanced computed tomography of the abdomen revealed a right sided hydronephrosis, a large rent in the renal pelvis, and a large retroperitoneal fluid collection on the right side. Percutaneous nephrostomy and pigtail catheter drainage of the urinoma led to resolution of abdominal swelling. Development of a urinoma as a consequence of rectal carcinoma is highly unusual. Prompt imaging for confirmation of diagnosis, decompression of the renal pelvicalyceal system, and drainage of the urinoma limits morbidity. PMID:24749123

Case-control study of arsenic in drinking water and kidney cancer in uniquely exposed Northern Chile.

PubMed

Ferreccio, Catterina; Smith, Allan H; Durán, Viviana; Barlaro, Teresa; Benítez, Hugo; Valdés, Rodrigo; Aguirre, Juan José; Moore, Lee E; Acevedo, Johanna; Vásquez, María Isabel; Pérez, Liliana; Yuan, Yan; Liaw, Jane; Cantor, Kenneth P; Steinmaus, Craig

2013-09-01

Millions of people worldwide are exposed to arsenic in drinking water. The International Agency for Research on Cancer has concluded that ingested arsenic causes lung, bladder, and skin cancer. However, a similar conclusion was not made for kidney cancer because of a lack of research with individual data on exposure and dose-response. With its unusual geology, high exposures, and good information on past arsenic water concentrations, northern Chile is one of the best places in the world to investigate the carcinogenicity of arsenic. We performed a case-control study in 2007-2010 of 122 kidney cancer cases and 640 population-based controls with individual data on exposure and potential confounders. Cases included 76 renal cell, 24 transitional cell renal pelvis and ureter, and 22 other kidney cancers. For renal pelvis and ureter cancers, the adjusted odds ratios by average arsenic intakes of <400, 400-1,000, and >1,000 µg/day (median water concentrations of 60, 300, and 860 µg/L) were 1.00, 5.71 (95% confidence interval: 1.65, 19.82), and 11.09 (95% confidence interval: 3.60, 34.16) (Ptrend < 0.001), respectively. Odds ratios were not elevated for renal cell cancer. With these new findings, including evidence of dose-response, we believe there is now sufficient evidence in humans that drinking-water arsenic causes renal pelvis and ureter cancer.

Role of Minimally Invasive Surgery in the Reoperative Abdomen or Pelvis

PubMed Central

Feigel, Amanda; Sylla, Patricia

2016-01-01

Laparoscopy has become widely accepted as the preferred surgical approach in the management of benign and malignant colorectal diseases. Once considered a relative contraindication in patients with prior abdominal surgery (PAS), as surgeons have continued to gain expertise in advanced laparoscopy, minimally invasive approaches have been increasingly incorporated in the reoperative abdomen and pelvis. Although earlier studies have described conversion rates, most contemporary series evaluating the impact of PAS in laparoscopic colorectal resection have reported equivalent conversion and morbidity rates between reoperative and non-reoperative cases, and series evaluating the impact of laparoscopy in reoperative cases have demonstrated improved short-term outcomes with laparoscopy. The data overall highlight the importance of case selection, careful preoperative preparation and planning, and the critical role of surgeons' expertise in advanced laparoscopic techniques. Challenges to the widespread adoption of minimally invasive techniques in reoperative colorectal cases include the longer learning curve and longer operative time. However, with the steady increase in adoption of minimally invasive techniques worldwide, minimally invasive surgery (MIS) is likely to continue to be applied in the management of increasingly complex reoperative colorectal cases in an effort to improve patient outcomes. In the hands of experienced MIS surgeons and in carefully selected cases, laparoscopy is both safe and efficacious for reoperative procedures in the abdomen and pelvis, with measurable short-term benefits. PMID:28642675

Changes of pelvis control with subacute stroke: A comparison of body-weight- support treadmill training coupled virtual reality system and over-ground training.

PubMed

Mao, Yurong; Chen, Peiming; Li, Lifang; Li, Le; Huang, Dongfeng

2015-01-01

Gait recovery is very important to stroke survivors to regain their independence in activity of daily life. This study aimed to investigate the effects of virtual reality (VR) coupled body weight support treadmill training (BWSTT) on pelvic control at the early stage of stroke. Kinematic and kinetic changes of pelvic motion were evaluated by a 3D gait analysis system and were compared to the results from over-ground walking training. Twenty-four patients having unilateral hemiplegia with subacute stroke were recruited to a VR coupled BWSTT group (n= 12) and a conventional therapy (CT) group (n= 12). Both of the groups received training of 20-40 min/day, 5 days/week, for 3 weeks. The results showed the tilt of pelvis in sagittal plane improved significantly (P= 0.038) after treatment in the BWSTT+VR group, in terms of decreased amplitude of anterior peak (mean, from 10.99° to 6.25°), while there were no significant differences in the control group. The findings suggested that VR coupled BWSTT gait training could decrease anterior tilt of pelvis in early hemiparetic persons following a modest intervention dose, and the training may have advantages over conventional over-ground gait training and can assist the therapists in correcting abnormal gait pattern of stroke survivors.

Stress fracture of the pelvis and lower limbs including atypical femoral fractures-a review.

PubMed

Tins, Bernhard J; Garton, Mark; Cassar-Pullicino, Victor N; Tyrrell, Prudencia N M; Lalam, Radhesh; Singh, Jaspreet

2015-02-01

Stress fractures, that is fatigue and insufficiency fractures, of the pelvis and lower limb come in many guises. Most doctors are familiar with typical sacral, tibial or metatarsal stress fractures. However, even common and typical presentations can pose diagnostic difficulties especially early after the onset of clinical symptoms. This article reviews the aetiology and pathophysiology of stress fractures and their reflection in the imaging appearances. The role of varying imaging modalities is laid out and typical findings are demonstrated. Emphasis is given to sometimes less well-appreciated fractures, which might be missed and can have devastating consequences for longer term patient outcomes. In particular, atypical femoral shaft fractures and their relationship to bisphosphonates are discussed. Migrating bone marrow oedema syndrome, transient osteoporosis and spontaneous osteonecrosis are reviewed as manifestations of stress fractures. Radiotherapy-related stress fractures are examined in more detail. An overview of typical sites of stress fractures in the pelvis and lower limbs and their particular clinical relevance concludes this review. Teaching Points • Stress fractures indicate bone fatigue or insufficiency or a combination of these. • Radiographic visibility of stress fractures is delayed by 2 to 3 weeks. • MRI is the most sensitive and specific modality for stress fractures. • Stress fractures are often multiple; the underlying cause should be evaluated. • Infratrochanteric lateral femoral fractures suggest an atypical femoral fracture (AFF); endocrinologist referral is advisable.

Relationship between Physical Impairments and Movement Patterns During Gait in Patients With End-stage Hip Osteoarthritis

PubMed Central

Zeni, Joseph; Pozzi, Federico; Abujaber, Sumayah; Miller, Laura

2014-01-01

Patients with hip osteoarthritis demonstrate limited range of motion, muscle weakness and altered biomechanics; however, few studies have evaluated the relationships between physical impairments and movement asymmetries. The purpose of this study was to identify the physical impairments related to movement abnormalities in patients awaiting total hip arthroplasty. We hypothesized that muscle weakness and pain would be related to greater movement asymmetries. Fifty-six subjects who were awaiting total hip arthroplasty were enrolled. Pain was assessed using a 0 to 10 scale, range of motion was assessed with the Harris Hip Score and isometric hip abductor strength was tested using a hand-held dynamometer. Trunk, pelvis and hip angles and moments in the frontal and sagittal planes were measured during walking using three dimensional motion analysis. During gait, subjects had 3.49 degrees less peak hip flexion and 8.82 degrees less extension angles (p<0.001) and had 0.03 Nm/k*m less hip abduction moment on the affected side (p=0.043). Weaker hip muscles were related to greater pelvis (r=−0.291) and trunk (r=−0.332) rotations in the frontal plane. These findings suggest that hip weakness drives abnormal movement patterns at the pelvis and trunk in patients with hip osteoarthritis to a greater degree than hip pain. PMID:25492583

A Wider Pelvis Does Not Increase Locomotor Cost in Humans, with Implications for the Evolution of Childbirth

PubMed Central

Warrener, Anna G.; Lewton, Kristi L.; Pontzer, Herman; Lieberman, Daniel E.

2015-01-01

The shape of the human female pelvis is thought to reflect an evolutionary trade-off between two competing demands: a pelvis wide enough to permit the birth of large-brained infants, and narrow enough for efficient bipedal locomotion. This trade-off, known as the obstetrical dilemma, is invoked to explain the relative difficulty of human childbirth and differences in locomotor performance between men and women. The basis for the obstetrical dilemma is a standard static biomechanical model that predicts wider pelves in females increase the metabolic cost of locomotion by decreasing the effective mechanical advantage of the hip abductor muscles for pelvic stabilization during the single-leg support phase of walking and running, requiring these muscles to produce more force. Here we experimentally test this model against a more accurate dynamic model of hip abductor mechanics in men and women. The results show that pelvic width does not predict hip abductor mechanics or locomotor cost in either women or men, and that women and men are equally efficient at both walking and running. Since a wider birth canal does not increase a woman’s locomotor cost, and because selection for successful birthing must be strong, other factors affecting maternal pelvic and fetal size should be investigated in order to help explain the prevalence of birth complications caused by a neonate too large to fit through the birth canal. PMID:25760381

Position of pelvis in the 3rd month of life predicts further motor development.

PubMed

Gajewska, Ewa; Sobieska, Magdalena; Moczko, Jerzy

2018-06-01

The aim of the study is to select elements of motor skills assessed at 3 months that provide the best predictive properties for motor development at 9 months. In all children a physiotherapeutic assessment of the quantitative and qualitative development at the age of 3 months was performed in the prone and supine positions, which was presented in previous papers as the quantitative and qualitative assessment sheet of motor development. The neurological examination at the age of 9 months was based on the Denver Development Screening Test II and the evaluation of reflexes, muscle tone (hypotony and hypertony), and symmetry. The particular elements of motor performance assessment were shown to have distinct predictive value for further motor development (as assessed at 9 months), and the pelvis position was the strongest predictive element. Irrespective of the symptomatic and anamnestic factors the inappropriate motor performance may already be detected in the 3rd month of life and is predictive for further motor development. The assessment of the motor performance should be performed in both supine and prone positions. The proper position of pelvis summarizes the proper positioning of the whole spine and ensures proper further motor development. To our knowledge, the presented motor development assessment sheet allows the earliest prediction of motor disturbances. Copyright © 2018 Elsevier B.V. All rights reserved.

Automatic 3D kidney segmentation based on shape constrained GC-OAAM

NASA Astrophysics Data System (ADS)

Chen, Xinjian; Summers, Ronald M.; Yao, Jianhua

2011-03-01

The kidney can be classified into three main tissue types: renal cortex, renal medulla and renal pelvis (or collecting system). Dysfunction of different renal tissue types may cause different kidney diseases. Therefore, accurate and efficient segmentation of kidney into different tissue types plays a very important role in clinical research. In this paper, we propose an automatic 3D kidney segmentation method which segments the kidney into the three different tissue types: renal cortex, medulla and pelvis. The proposed method synergistically combines active appearance model (AAM), live wire (LW) and graph cut (GC) methods, GC-OAAM for short. Our method consists of two main steps. First, a pseudo 3D segmentation method is employed for kidney initialization in which the segmentation is performed slice-by-slice via a multi-object oriented active appearance model (OAAM) method. An improved iterative model refinement algorithm is proposed for the AAM optimization, which synergistically combines the AAM and LW method. Multi-object strategy is applied to help the object initialization. The 3D model constraints are applied to the initialization result. Second, the object shape information generated from the initialization step is integrated into the GC cost computation. A multi-label GC method is used to segment the kidney into cortex, medulla and pelvis. The proposed method was tested on 19 clinical arterial phase CT data sets. The preliminary results showed the feasibility and efficiency of the proposed method.

Kidney stones

MedlinePlus Videos and Cool Tools

... kidneys, ureters, bladder and urethra. Within each kidney, urine flows from the outer cortex to the inner ... The renal pelvis is the funnel through which urine exits the kidney and enters the ureter. As ...

Ultrasound -- Pelvis

MedlinePlus Videos and Cool Tools

... the transducer for analysis. top of page Additional Information and Resources RTAnswers.org Radiation Therapy for Gynecologic ... Send us your feedback Did you find the information you were looking for? Yes No Please type ...

Sacroiliitis

MedlinePlus

... an inflammation of one or both of your sacroiliac joints — situated where your lower spine and pelvis ... climbing Running Taking large strides Causes Causes for sacroiliac joint dysfunction include: Traumatic injury. A sudden impact, ...

Peristalsis

MedlinePlus

... JE, ed. Guyton and Hall Textbook of Medical Physiology . 13th ed. Philadelphia, PA: Elsevier; 2016:chap 63. ... Saunders; 2016:chap 43. Weiss RM, Martin DT. Physiology and pharmacology of the renal pelvis and ureter. ...

Abdominal CT scan

MedlinePlus

Computed tomography scan - abdomen; CT scan - abdomen; CT abdomen and pelvis ... An abdominal CT scan makes detailed pictures of the structures inside your belly very quickly. This test may be used to look ...

Frequent or urgent urination

MedlinePlus

Urgent urination; Urinary frequency or urgency; Urgency-frequency syndrome; Overactive bladder (OAB) syndrome; Urge syndrome ... Medicines such as water pills (diuretics) Overactive bladder syndrome Radiation therapy to the pelvis, which is used ...

[Ultrasound semiotics in recurrent ovarian cancer after optimal cytoreductive surgery].

PubMed

Baklanova, N S; Kolomiets, L A; Frolova, I G; Viatkina, N V; Krasil'nikov, S É

2014-01-01

Features of ultrasound picture of morphologically verified recurrence of ovarian cancer in 21 patients are presented, who received combined treatment including cytoreductive surgery in the form of hysterectomy with oophorectomy, resection of the greater omentum and 6 courses of chemotherapy CAP for ovarian cancer stage III (FIGO). In all patients cytoreductive surgery was optimal--without residual tumor. Recurrence of the disease was detected in 12-48 months in 80.9% of the cases. Three variants of recurrence was revealed by ultrasonography: isolated peritoneal dissemination, in 14.2% of the cases, which was mainly detected during the first 12 months; single entities in the projection of the small pelvis (61.9%) and mixed form (local lesions of small pelvis and peritoneal dissemination) in 23.8% of the cases.

Pudendal nerve neuromodulation with neurophysiology guidance: a potential treatment option for refractory chronic pelvi-perineal pain.

PubMed

Carmel, Maude; Lebel, Michel; Tu, Le Mai

2010-05-01

Refractory chronic pelvi-perineal pain (RCPPP) is a challenging entity that has devastating consequences for patient's quality of life. Many etiologies have been proposed including pudendal neuralgia. Multiple treatment options are used but the reported results are sub-optimal and temporary. In this article, we present the technique of pudendal nerve neuromodulation with neurophysiology guidance as a treatment option for RCPPP. This technique is a two-step procedure that includes electrode implantation under neurophysiology guidance followed by the implantation of a permanent generator after a successful trial period. We report the cases of three women who underwent this procedure as a last-resort treatment option. After 2 years of follow-up, their symptoms are still significantly improved. No major complication occurred.

A Transperineal Approach to Hysterectomy of a Retained Didelphic Uterine Horn.

PubMed

Mullen, Mary M; Kuroki, Lindsay M; Hunt, Steven R; Ratkowski, Kristy L; Mutch, David G

2017-09-01

Gynecologic surgeries are performed through abdominal, vaginal, laparoscopic, or robot-assisted laparoscopic routes. However, if the pelvis is not accessible by one of these routes, there are no published reports to guide pelvic surgeons. A 34-year-old conjoined twin status postseparation with uterine didelphys and absence of her left colon and sacrum underwent hemihysterectomy, at which time her müllerian anomaly was unknown. She re-presented with vaginal bleeding and pain eventually attributed to a retained uterine horn. Conservative management failed. Given dense adhesions, traditional approaches to hysterectomy were not successful. She underwent a transperineal hemisupracervical hysterectomy. We propose a novel approach to the pelvis to guide surgeons when traditional approaches are not feasible. We also describe an instance of a retained uterine didelphys horn.

[One-stage operation for pelvis and acetabular fractures combined with Morel-Lavallée injury by internal fixation associated with vacuum sealing drainage].

PubMed

Wei, Dan; Wang, Yue; Yuan, Jiabin; Tang, Xiaoming; Zhang, Bin; Lu, Bing; Tan, Bo

2014-01-01

To investigate the methods and effectiveness of one-stage operation for pelvis and acetabular fractures combined with Morel-Lavallée injury by internal fixation associated with vacuum sealing drainage (VSD). Between June 2008 and October 2012, 15 cases of pelvis and acetabular fractures combined with Morel-Lavallée injury were treated. There were 5 males and 10 females, aged from 18 to 67 years (mean, 36.8 years). Fractures were caused by traffic accident in 11 cases and crashing injury of heavy object in 4 cases. The time from injury to hospitalization was 3 hours to 9 days (mean, 5.4 days). Morel-Lavallée injury located in the above posterior superior iliac spine in 4 cases, greater trochanter in 7 cases, and anterior proximal thigh in 4 cases. In 10 cases complicated by pelvic fracture, there were 1 case of anteroposterior compression type, 3 cases of lateral compression type, 5 cases of vertical shear type, and 1 case of compound injury type; in 5 cases complicated by acetabular fracture, there were 1 case of transverse fracture, 1 case of posterior wall and posterior column fracture, 1 case of transverse acetabulum plus posterior wall fracture, and 2 cases of both columns fracture. Open reduction and internal fixation were used to treat pelvic and acetabular fractures, and VSD to treat Morel-Lavallée injury. When the drainage volume was less than 20 mL/d, interrupted wound suture or free skin grafting was performed. The hospitalization time was 16-31 days (mean, 20.8 days). Thirteen cases were followed up 4-16 months (mean, 7.8 months). The healing time of Morel-Lavallée injury was 16-36 days after operation (mean, 21.3 days). All the wounds had primary healing, and no infection occurred. The X-ray films showed that all fractures healed, with a mean healing time of 13.6 weeks (range, 11-18 weeks). At 6.5 months after operation, according to Majeed function scoring system in 8 cases of pelvic fracture, the results were excellent in 5 cases, good in 2 cases, and fair in 1 case; according to Harris hip scoring in 4 cases of acetabular fracture, the results were excellent in 2 cases, good in 1 case, and fair in 1 case. To pelvis-acetabular fractures combined with Morel-Lavallée injury, internal fixation treatment for fracture and VSD for Morel-Lavallée injury not only can cure merge Morel-Lavallée injury effectively, but also can guarantee the operation timing and incision safty of the pelvis-acetabular fractures.

Shortness of Breath

MedlinePlus

... with blood clots in the legs or pelvis (deep venous thrombosis), debilitating medical conditions, immobility, or inherited ... it hard for a person to take a deep breath, which usually results in retention of carbon ...

Pheochromocytoma and Paraganglioma: Overview

MedlinePlus

... Family Lodge Children's Inn Frequently Asked Questions Overview Pheochromocytoma Pheochromocytoma is a rare endocrine tumor originating in ... abdomen, or pelvis. Who Should Be Examined for Pheochromocytoma? Patients with very difficult-to-control hypertension Patients ...

Nabothian cyst

MedlinePlus

... Procedures for Primary Care . 3rd ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 135. Dolan MS, Hill C, ... FA, eds. Comprehensive Gynecology . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 18. Hertzberg BS, Middleton WD. Pelvis ...

[MR Imaging of the pelvis in the diagnosis of the endometrium in breast cancer patients in tamoxifen therapy].

PubMed

Hauth, E; Libera, H; Kimmig, R; Forsting, M

2006-03-01

The purpose of the study was to determine the value of MR imaging of the pelvis in the diagnostic work-up of the endometrium in breast cancer patients in tamoxifen therapy. MR imaging of the pelvis was performed on 24 patients (mean: 62 years, range: 51 - 74 years) and 30 healthy women (mean: 65 years, range: 51 - 73 years). The volume of the uterus and cervix and the maximal thickness of the endometrium, junctional zone and myometrium of the uterus were determined and compared to the confidence interval of the parameters in healthy women. The Mann-Whitney U-test was used to identify differences in the volume of the uterus and cervix and in the thickness of the uterine wall layers in both groups. A comparison of the volume of the uterus and cervix and the thickness of the uterine wall layers in the two groups yielded no significant differences. The volume of the uterus and cervix showed no statistical differences between the two groups. The maximal height of the endometrium in the patient group showed a mean of 0.6 cm (range: 0.1 - 2.2 cm), and a mean of 0.4 cm (range: 0.1 - 1.2 cm) in the group of healthy women. The differences were not statistically significant. In all healthy women the endometrium showed homogeneous signal intensity in the sagittal T2-weighted images. In 12 of the 24 breast cancer patients, the endometrium showed inhomogeneous signal intensity. In 9 of 12 patients with an inhomogeneous endometrium with a thickness equal to or greater than 0.6 cm, histopathology confirmed polyps. In 3 patients endometrium hyperplasia was found. In one patient histopathology revealed a polyp and an endometrium carcinoma in stage T1 a N0. The endometrium carcinoma was not able to be seen via MR imaging. MR imaging might be helpful in the diagnosis of endometrium pathologies during tamoxifen therapy. Therefore, MR imaging of the pelvis could be used as a diagnostic tool in the follow-up diagnosis of the endometrium in breast cancer patients in tamoxifen therapy.

Kinematics of the human pelvis following open book injury.

PubMed

Hefzy, M S; Ebraheim, N; Mekhail, A; Caruntu, D; Lin, H; Yeasting, R

2003-05-01

The objective of this study is to determine the three dimensional kinematics of the human pelvis including both sacroiliac joints following a simulated open book injury induced on cadavers by applying anterior-posterior compressive loads to the pelvis. An electromagnetic digitizing and motion tracking system was utilized to measure the morphology of the pelvis and the relative movements of its bones during this simulated open book fracture. The screw displacement axis method was used to describe the relative motion between the sacrum and each hipbone. Morphologically, it was found that the articular surfaces forming the sacroiliac joints could be approximated with planar surfaces directed from proximal and lateral to distal and medial and from posteromedial to anterolateral. The kinematic data obtained from this study indicate that there is a direct correlation between the opening of the symphysis pubis and the opening of the sacroiliac joint (SIJ) during open book injury. This suggests that the extent of injury of the SIJ maybe estimated from the degree of opening of the symphysis pubis as demonstrated on anteroposterior (A-P) x-rays. The results obtained from this study also indicate that the motion of the hipbone with respect to the sacrum on the side of the sacroiliac joint opening is almost a pure rotation, which translates clinically on the A-P x-rays as pure opening of the SIJ without vertical displacement. The average axis of rotation was found to be almost parallel to the SIJ planar articular surface. Furthermore, the pubic bone on the side of SIJ opening was found to displace inferiorly and posteriorly. One can thus conclude that in open book pelvic injuries, the pubic bone on the side of injury displaces inferiorly on the outlet projection x-rays with no vertical displacement of the SIJ. This is important since the initial assessment of the open book injury in the emergency room includes outlet projection x-rays. From this study, the relative vertical positions of the pubic bones on these x-rays can help the surgeon in differentiating open book fracture injury from other pelvic injuries.

SU-E-I-29: Care KV: Dose It Influence Radiation Dose in Non-Contrast Examination of CT Abdomen/pelvis?

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

Zhang, J; Ganesh, H; Weir, V

Purpose: CARE kV is a tool that automatically recommends optimal kV setting for individual patient for specific CT examination. The use of CARE kV depends on topogram and the user-selected contrast behavior. CARE kV is expected to reduce radiation dose while improving image quality. However, this may work only for certain groups of patients and/or certain CT examinations. This study is to investigate the effects of CARE kV on radiation dose of non-contrast examination of CT abdomen/pelvis. Methods: Radiation dose (CTDIvol and DLP) from patients who underwent abdomen/pelvis non-contrast examination with and without CARE kV were retrospectively reviewed. All patientsmore » were scanned in the same scanner (Siemens Somatom AS64). To mitigate any possible influences due to technologists’ unfamiliarity with the CARE kV, the data with CARE kV were retrieved 1.5 years after the start of CARE kV usage. T-test was used for significant difference in radiation dose. Results: Volume CTDIs and DLPs from 18 patients before and 24 patients after the use of CARE kV were obtained in a duration of one month. There is a slight increase in both average CTDIvol and average DLP with CARE kV compared to those without CARE kV (25.52 mGy vs. 22.65 mGy for CTDIvol; 1265.81 mGy-cm vs. 1199.19 mGy-cm). Statistically there was no significant difference. Without CARE kV, 140 kV was used in 9 of 18 patients, while with CARE KV, 140 kV was used in 15 of 24 patients. 80kV was not used in either group. Conclusion: The use of CARE kV may save time for protocol optimization and minimize variability among technologists. Radiation dose reduction was not observed in non-contrast examinations of CT abdomen/pelvis. This was partially because our CT protocols were tailored according to patient size before CARE kV and partially because of large size patients.« less

SU-E-J-167: Improvement of Time-Ordered Four Dimensional Cone-Beam CT; Image Mosaicing with Real and Virtual Projections

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

Nakano, M; Kida, S; Masutani, Y

2014-06-01

Purpose: In the previous study, we developed time-ordered fourdimensional (4D) cone-beam CT (CBCT) technique to visualize nonperiodic organ motion, such as peristaltic motion of gastrointestinal organs and adjacent area, using half-scan reconstruction method. One important obstacle was that truncation of projection was caused by asymmetric location of flat-panel detector (FPD) in order to cover whole abdomen or pelvis in one rotation. In this study, we propose image mosaicing to extend projection data to make possible to reconstruct full field-of-view (FOV) image using half-scan reconstruction. Methods: The projections of prostate cancer patients were acquired using the X-ray Volume Imaging system (XVI,more » version 4.5) on Synergy linear accelerator system (Elekta, UK). The XVI system has three options of FOV, S, M and L, and M FOV was chosen for pelvic CBCT acquisition, with a FPD panel 11.5 cm offset. The method to produce extended projections consists of three main steps: First, normal three-dimensional (3D) reconstruction which contains whole pelvis was implemented using real projections. Second, virtual projections were produced by reprojection process of the reconstructed 3D image. Third, real and virtual projections in each angle were combined into one extended mosaic projection. Then, 4D CBCT images were reconstructed using our inhouse reconstruction software based on Feldkamp, Davis and Kress algorithm. The angular range of each reconstruction phase in the 4D reconstruction was 180 degrees, and the range moved as time progressed. Results: Projection data were successfully extended without discontinuous boundary between real and virtual projections. Using mosaic projections, 4D CBCT image sets were reconstructed without artifacts caused by the truncation, and thus, whole pelvis was clearly visible. Conclusion: The present method provides extended projections which contain whole pelvis. The presented reconstruction method also enables time-ordered 4D CBCT reconstruction of organs with non-periodic motion with full FOV without projection-truncation artifacts. This work was partly supported by the JSPS Core-to-Core Program(No. 23003). This work was partly supported by JSPS KAKENHI 24234567.« less

SU-E-T-261: Development of An Automated System to Detect Patient Identification and Positioning Errors Prior to Radiotherapy Treatment

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

Jani, S; Low, D; Lamb, J

2015-06-15

Purpose: To develop a system that can automatically detect patient identification and positioning errors using 3D computed tomography (CT) setup images and kilovoltage CT (kVCT) planning images. Methods: Planning kVCT images were collected for head-and-neck (H&N), pelvis, and spine treatments with corresponding 3D cone-beam CT (CBCT) and megavoltage CT (MVCT) setup images from TrueBeam and TomoTherapy units, respectively. Patient identification errors were simulated by registering setup and planning images from different patients. Positioning errors were simulated by misaligning the setup image by 1cm to 5cm in the six anatomical directions for H&N and pelvis patients. Misalignments for spine treatments weremore » simulated by registering the setup image to adjacent vertebral bodies on the planning kVCT. A body contour of the setup image was used as an initial mask for image comparison. Images were pre-processed by image filtering and air voxel thresholding, and image pairs were assessed using commonly-used image similarity metrics as well as custom -designed metrics. A linear discriminant analysis classifier was trained and tested on the datasets, and misclassification error (MCE), sensitivity, and specificity estimates were generated using 10-fold cross validation. Results: Our workflow produced MCE estimates of 0.7%, 1.7%, and 0% for H&N, pelvis, and spine TomoTherapy images, respectively. Sensitivities and specificities ranged from 98.0% to 100%. MCEs of 3.5%, 2.3%, and 2.1% were obtained for TrueBeam images of the above sites, respectively, with sensitivity and specificity estimates between 96.2% and 98.4%. MCEs for 1cm H&N/pelvis misalignments were 1.3/5.1% and 9.1/8.6% for TomoTherapy and TrueBeam images, respectively. 2cm MCE estimates were 0.4%/1.6% and 3.1/3.2%, respectively. Vertebral misalignment MCEs were 4.8% and 4.9% for TomoTherapy and TrueBeam images, respectively. Conclusion: Patient identification and gross misalignment errors can be robustly and automatically detected using 3D setup images of two imaging modalities across three commonly-treated anatomical sites.« less

Geometric validation of MV topograms for patient localization on TomoTherapy

NASA Astrophysics Data System (ADS)

Blanco Kiely, Janid P.; White, Benjamin M.; Low, Daniel A.; Qi, Sharon X.

2016-01-01

Our goal was to geometrically validate the use of mega-voltage orthogonal scout images (MV topograms) as a fast and low-dose alternative to mega-voltage computed tomography (MVCT) for daily patient localization on the TomoTherapy system. To achieve this, anthropomorphic head and pelvis phantoms were imaged on a 16-slice kilo-voltage computed tomography (kVCT) scanner to synthesize kilo-voltage digitally reconstructed topograms (kV-DRT) in the Tomotherapy detector geometry. MV topograms were generated for couch speeds of 1-4 cm s-1 in 1 cm s-1 increments with static gantry angles in the anterior-posterior and left-lateral directions. Phantoms were rigidly translated in the anterior-posterior (AP), superior-inferior (SI), and lateral (LAT) directions to simulate potential setup errors. Image quality improvement was demonstrated by estimating the noise level in the unenhanced and enhanced MV topograms using a principle component analysis-based noise level estimation algorithm. Average noise levels for the head phantom were reduced by 2.53 HU (AP) and 0.18 HU (LAT). The pelvis phantom exhibited average noise level reduction of 1.98 HU (AP) and 0.48 HU (LAT). Mattes Mutual Information rigid registration was used to register enhanced MV topograms with corresponding kV-DRT. Registration results were compared to the known rigid displacements, which assessed the MV topogram localization’s sensitivity to daily positioning errors. Reduced noise levels in the MV topograms enhanced the registration results so that registration errors were  <1 mm. The unenhanced head MV topograms had discrepancies  <2.1 mm and the pelvis topograms had discrepancies  <2.7 mm. Result were found to be consistent regardless of couch speed. In total, 64.7% of the head phantom MV topograms and 60.0% of the pelvis phantom MV topograms exactly measured the phantom offsets. These consistencies demonstrated the potential for daily patient positioning using MV topogram pairs in the context bony-anatomy based procedures such as total marrow irradiation, total body irradiation, and cranial spinal irradiation.

Multi-institutional Quantitative Evaluation and Clinical Validation of Smart Probabilistic Image Contouring Engine (SPICE) Autosegmentation of Target Structures and Normal Tissues on Computer Tomography Images in the Head and Neck, Thorax, Liver, and Male Pelvis Areas

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

Zhu, Mingyao; Bzdusek, Karl; Brink, Carsten

2013-11-15

Purpose: Clinical validation and quantitative evaluation of computed tomography (CT) image autosegmentation using Smart Probabilistic Image Contouring Engine (SPICE). Methods and Materials: CT images of 125 treated patients (32 head and neck [HN], 40 thorax, 23 liver, and 30 prostate) in 7 independent institutions were autosegmented using SPICE and computational times were recorded. The number of structures autocontoured were 25 for the HN, 7 for the thorax, 3 for the liver, and 6 for the male pelvis regions. Using the clinical contours as reference, autocontours of 22 selected structures were quantitatively evaluated using Dice Similarity Coefficient (DSC) and Mean Slice-wisemore » Hausdorff Distance (MSHD). All 40 autocontours were evaluated by a radiation oncologist from the institution that treated the patients. Results: The mean computational times to autosegment all the structures using SPICE were 3.1 to 11.1 minutes per patient. For the HN region, the mean DSC was >0.70 for all evaluated structures, and the MSHD ranged from 3.2 to 10.0 mm. For the thorax region, the mean DSC was 0.95 for the lungs and 0.90 for the heart, and the MSHD ranged from 2.8 to 12.8 mm. For the liver region, the mean DSC was >0.92 for all structures, and the MSHD ranged from 5.2 to 15.9 mm. For the male pelvis region, the mean DSC was >0.76 for all structures, and the MSHD ranged from 4.8 to 10.5 mm. Out of the 40 autocontoured structures reviews by experts, 25 were scored useful as autocontoured or with minor edits for at least 90% of the patients and 33 were scored useful autocontoured or with minor edits for at least 80% of the patients. Conclusions: Compared with manual contouring, autosegmentation using SPICE for the HN, thorax, liver, and male pelvis regions is efficient and shows significant promise for clinical utility.« less

Skin dose differences between intensity-modulated radiation therapy and volumetric-modulated arc therapy and between boost and integrated treatment regimens for treating head and neck and other cancer sites in patients

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

Penoncello, Gregory P.; Ding, George X., E-mail: george.ding@vanderbilt.edu

The purpose of this study was (1) to evaluate dose to skin between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) treatment techniques for target sites in the head and neck, pelvis, and brain and (2) to determine if the treatment dose and fractionation regimen affect the skin dose between traditional sequential boost and integrated boost regimens for patients with head and neck cancer. A total of 19 patients and 48 plans were evaluated. The Eclipse (v11) treatment planning system was used to plan therapy in 9 patients with head and neck cancer, 5 patients with prostate cancer, andmore » 5 patients with brain cancer with VMAT and static-field IMRT. The mean skin dose and the maximum dose to a contiguous volume of 2 cm{sup 3} for head and neck plans and brain plans and a contiguous volume of 5 cm{sup 3} for pelvis plans were compared for each treatment technique. Of the 9 patients with head and neck cancer, 3 underwent an integrated boost regimen. One integrated boost plan was replanned with IMRT and VMAT using a traditional boost regimen. For target sites located in the head and neck, VMAT reduced the mean dose and contiguous hot spot most noticeably in the shoulder region by 5.6% and 5.4%, respectively. When using an integrated boost regimen, the contiguous hot spot skin dose in the shoulder was larger on average than a traditional boost pattern by 26.5% and the mean skin dose was larger by 1.7%. VMAT techniques largely decrease the contiguous hot spot in the skin in the pelvis by an average of 36% compared with IMRT. For the same target coverage, VMAT can reduce the skin dose in all the regions of the body, but more noticeably in the shoulders in patients with head and neck and pelvis cancer. We also found that using integrated boost regimens in patients with head and neck cancer leads to higher shoulder skin doses compared with traditional boost regimens.« less

TU-AB-BRA-03: Atlas-Based Algorithms with Local Registration-Goodness Weighting for MRI-Driven Electron Density Mapping

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

Farjam, R; Tyagi, N; Veeraraghavan, H

Purpose: To develop image-analysis algorithms to synthesize CT with accurate electron densities for MR-only radiotherapy of head & neck (H&N) and pelvis anatomies. Methods: CT and 3T-MRI (Philips, mDixon sequence) scans were randomly selected from a pool of H&N (n=11) and pelvis (n=12) anatomies to form an atlas. All MRIs were pre-processed to eliminate scanner and patient-induced intensity inhomogeneities and standardize their intensity histograms. CT and MRI for each patient were then co-registered to construct CT-MRI atlases. For more accurate CT-MR fusion, bone intensities in CT were suppressed to improve the similarity between CT and MRI. For a new patient,more » all CT-MRI atlases are deformed onto the new patients’ MRI initially. A newly-developed generalized registration error (GRE) metric was then calculated as a measure of local registration accuracy. The synthetic CT value at each point is a 1/GRE-weighted average of CTs from all CT-MR atlases. For evaluation, the mean absolute error (MAE) between the original and synthetic CT (generated in a leave-one-out scheme) was computed. The planning dose from the original and synthetic CT was also compared. Results: For H&N patients, MAE was 67±9, 114±22, and 116±9 HU over the entire-CT, air and bone regions, respectively. For pelvis anatomy, MAE was 47±5 and 146±14 for the entire and bone regions. In comparison with MIRADA medical, an FDA-approved registration tool, we found that our proposed registration strategy reduces MAE by ∼30% and ∼50% over the entire and bone regions, respectively. GRE-weighted strategy further lowers MAE by ∼15% to ∼40%. Our primary dose calculation also showed highly consistent results between the original and synthetic CT. Conclusion: We’ve developed a novel image-analysis technique to synthesize CT for H&N and pelvis anatomies. Our proposed image fusion strategy and GRE metric help generate more accurate synthetic CT using locally more similar atlases (Support: Philips Healthcare). The research is supported by Philips HealthCare.« less

How Is Pelvic Pain Diagnosed?

MedlinePlus

... NICHD Research Information Find a Study More Information Pharmacology Condition Information NICHD Research Information Find a Study ... button to look inside the pelvis 4 Pelvic MRI (magnetic resonance imaging) scan, an imaging test that ...

Burkitt lymphoma

MedlinePlus

The health care provider will perform a physical exam. Tests include: Bone marrow biopsy Chest x-ray CT scan of the chest, abdomen, and pelvis Complete blood count (CBC) Examination of the spinal fluid Lymph node biopsy PET scan

Neuroblastoma—Health Professional Version

Cancer.gov

Neuroblastoma is a disease in which malignant cells form in the neuroblasts of the adrenal glands and paraspinal nerve tissue from the neck to the pelvis. Find evidence-based information on neuroblastoma treatment, screening, research, and genetics.

Femoral nerve dysfunction

MedlinePlus

... in the groin Diabetes or other causes of peripheral neuropathy Internal bleeding in the pelvis or belly area ( ... Editorial team. Leg Injuries and Disorders Read more Peripheral Nerve Disorders Read more NIH MedlinePlus Magazine Read more A. ...

Cancer in Patients With Gabapentin (GPRD)

ClinicalTrials.gov

2017-06-06

Pain, Neuropathic; Epilepsy; Renal Pelvis Cancer; Pancreatic Cancer; Breast Cancer; Nervous System Cancer; Chronic Pancreatitis; Stomach Cancer; Renal Cell Carcinoma; Diabetes; Bladder Cancer; Bone and Joint Cancer; Penis Cancer; Anal Cancer; Cancer; Renal Cancer

Renal Cysts

MedlinePlus

... inside the renal cysts. Your doctor may use ultrasound imaging to monitor renal cysts for any changes over ... Related Articles and Media Ultrasound - Abdomen Children's (Pediatric) Ultrasound - Abdomen Magnetic Resonance Imaging (MRI) - Body Ultrasound - Pelvis Children's (Pediatric) Nuclear Medicine ...

A functional-anatomical approach to the spine-pelvis mechanism: interaction between the biceps femoris muscle and the sacrotuberous ligament.

PubMed

van Wingerden, J P; Vleeming, A; Snijders, C J; Stoeckart, R

1993-10-01

Summary. Sacroiliac joint dysfunction is often overlooked as a possible cause of low back pain. This is due to the use of reductionistic anatomical models. From a kinematic point of view, topographic anatomical models are generally inadequate since they categorize pelvis, lower vertebral column and legs as distinct entities. This functional-anatomical study focuses on the question whether anatomical connections between the biceps femoris muscle and the sacrotuberous ligament are kinematically useful. Forces applied to the tendon of the biceps femoris muscle, simulating biceps femoris muscle force, were shown to influence sacrotuberous ligament tension. Since sacrotuberous ligament tension influences sacroiliac joint kinematics, hamstring training could influence the sacroiliac joint and thus low back kinematics. The clinical implications with respect to 'short' hamstrings, pelvic instability and walking are discussed.

Acetabular inclination and anteversion in infants using 3D MR imaging.

PubMed

Falliner, A; Muhle, C; Brossmann, J

2002-03-01

To establish if 3D MR imaging could be used for measurements of acetabular inclination and anteversion in infants specimens. 3D MR data of 3 pelvic preparations of 6-week- to 10-month-old infant specimens was gathered. MR imaging in transaxial and frontal planes was carried out to measure the acetabular inclination and anteversion: a method to determine the MR planes for measurements is described. It was oriented on anatomical landmarks of the pelvis and therefore allowed adjustment of the frontal and transaxial planes, independent of the pelvis position. The mean acetabular inclination angle was 48 degrees, and the mean acetabular anteversion was 23 degrees. Because of the low number of cases the results can only be assessed as a tendency, but MR imaging seems to be suitable for measurements of acetabular inclination and anteversion.

Pelvic and lower extremity injuries in Homer's Iliad: a review of the literature.

PubMed

Galanakos, Spyridon P; Bot, Arjan G J; Macheras, George A

2015-01-01

The Iliad, composed approximately in the middle of the eighth century bc, constitutes the leading and oldest known example of heroic epic. The Homeric epic presents the conflicts that took place during the last year of the 10-year lasting Trojan War, offering a realistic description of battle wounds. We studied the text of The Iliad in ancient Greek and in the translations in modern Greek and English and searched for all recorded injuries to the pelvis and lower extremities. A total of 16 traumatic injuries of pelvis and lower extremities were described, including 7 fatal wounds, while in 9 cases, the outcome was unknown.The Iliad remains the oldest record of Greek medicine and a unique source of surgical history. To study the vividly reported events is a great experience, particularly for a surgeon.

Hemipelvectomy images of loss caused by war

PubMed Central

Salamon, Tal; Kassis, Shokrey; Lerner, Alexander

2014-01-01

As we treat our 230th patient from the Syrian conflict, the pathology we see is more debilitating and the humanitarian needs of the wounded have become even more obvious. This case presents some graphic images of the realities of war. Care in the most advanced units cannot restore broken limbs, let alone broken lives. We present a case of a young war-injured man, who suffered severe crush injury to the pelvis and lower limb, arriving at our medical facility after a delay of hours. The lower limb was shattered from the pelvis down (essentially a traumatic hemipelvectomy). His life had been saved in Syria by ligation of the femoral vessels in an unknown facility by an unknown medical team. On arrival in a centre in Israel for definitive care of an unsalvageable leg, formal hemipelvectomy was performed. PMID:25008336

Demonstration of pelvic anatomy by modified midline transection that maintains intact internal pelvic organs.

PubMed

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 of the bony pelvis but leaves the internal organs intact. The authors propose a modified technique that combines advantages of both classical dissections. This novel approach involves dividing the pubic symphysis and sacrum in the median plane after shifting all internal organs to one side. The hemipelvis without internal organs is immediately available for further dissection of the lower limb. The hemipelvis with intact internal organs is ideal for showing the complex spatial relationships of the pelvic organs and vessels relative to the intact pelvic floor.

Hip joint center localisation: A biomechanical application to hip arthroplasty population

PubMed Central

Bouffard, Vicky; Begon, Mickael; Champagne, Annick; Farhadnia, Payam; Vendittoli, Pascal-André; Lavigne, Martin; Prince, François

2012-01-01

AIM: To determine hip joint center (HJC) location on hip arthroplasty population comparing predictive and functional approaches with radiographic measurements. METHODS: The distance between the HJC and the mid-pelvis was calculated and compared between the three approaches. The localisation error between the predictive and functional approach was compared using the radiographic measurements as the reference. The operated leg was compared to the non-operated leg. RESULTS: A significant difference was found for the distance between the HJC and the mid-pelvis when comparing the predictive and functional method. The functional method leads to fewer errors. A statistical difference was found for the localization error between the predictive and functional method. The functional method is twice more precise. CONCLUSION: Although being more individualized, the functional method improves HJC localization and should be used in three-dimensional gait analysis. PMID:22919569

Principles of three-dimensional printing and clinical applications within the abdomen and pelvis.

PubMed

Bastawrous, Sarah; Wake, Nicole; Levin, Dmitry; Ripley, Beth

2018-04-04

Improvements in technology and reduction in costs have led to widespread interest in three-dimensional (3D) printing. 3D-printed anatomical models contribute to personalized medicine, surgical planning, and education across medical specialties, and these models are rapidly changing the landscape of clinical practice. A physical object that can be held in one's hands allows for significant advantages over standard two-dimensional (2D) or even 3D computer-based virtual models. Radiologists have the potential to play a significant role as consultants and educators across all specialties by providing 3D-printed models that enhance clinical care. This article reviews the basics of 3D printing, including how models are created from imaging data, clinical applications of 3D printing within the abdomen and pelvis, implications for education and training, limitations, and future directions.

The Biomechanical and Energetic Advantages of a Mediolaterally Wide Pelvis in Women.

PubMed

Wall-Scheffler, Cara M; Myers, Marcella J

2017-04-01

Here, we argue that two key shifts in thinking are required to more clearly understand the selection pressures shaping pelvis evolution in female hominins: (1) the primary locomotor mode of female hominins was loaded walking in the company of others, and (2) the periodic gait of human walking is most effectively explained as a biomechanically controlled process related to heel-strike collisions that is tuned for economy and stability by properly-timed motor inputs (a model called dynamic walking). In the light of these two frameworks, the evidence supports differences between female and male upper-pelvic morphology being the result of the unique reproductive role of female hominins, which involved moderately paced, loaded walking in groups. Anat Rec, 300:764-775, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Injuries to the urethra and urinary bladder associated with fractures of the pelvis.

PubMed

Morehouse, D D

1988-03-01

The posterior urethra or urinary bladder may be injured in patients who sustain fractures of the bony pelvis. It is important to assess the urethra radiologically by retrograde urethrography before introducing a urethral catheter to avoid missing a urethral injury or causing further damage. The author's approach to the immediate management of urethral injury is suprapubic cystostomy. The urethra may be repaired later after other injuries have healed. With this approach the incidence of permanent impotence and incontinence will be low and the stricture cure rate high. If the urethra has not been injured, a catheter is introduced and cystography performed to rule out bladder injuries. If the bladder is ruptured, the area is explored, the perivesical space drained and urinary drainage is provided by either a suprapubic cystostomy or a urethral catheter.

Radiation therapy in primary carcinoma of the vagina

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

Reddy, S.; Lee, M.S.; Graham, J.E.

1987-01-01

A retrospective analysis of 32 patients with carcinoma of the vagina treated with curative radiotherapy between 1965 and 1981 is presented. Squamous cell carcinoma was the most common histologic type, found in 78% of the patients. Patients were staged according to the FIGO system. Stage I and II disease was found in 8 and 18 patients, respectively. Six patients had either Stage III or IV disease. The absolute survival rate was 100% for Stage I and 72% for Stage II patients. The pattern of failure was analyzed. All patients who failed had done so within 14 months of completion ofmore » treatment. Treatment failure in the pelvis occurred only in 16% of the patients with early disease (Stages I and II) while 81% of the patients with late stage had failed in the pelvis.« less

Expression of MLH1 and MSH2 in urothelial carcinoma of the renal pelvis.

PubMed

Ehsani, Laleh; Osunkoya, Adeboye O

2014-09-01

In this study, we investigated microsatellite instability in urothelial carcinoma of the renal pelvis by lack of immunohistochemical staining for MLH1 and MSH2. The study included 44 cases of urothelial carcinoma of the renal pelvis obtained from radical nephroureterectomy specimens at our institution. We evaluated the loss of nuclear immunohistochemical staining of MLH1 and MSH2. Eight of 44 (18 %) patients had negative MLH1 expression and 25/44 (57 %) patients had negative MSH2 expression. Six of 8 (75 %) patients with negative MLH1 expression were male and 2/8 (25 %) patients were female. Nineteen of 25 (75 %) patients with negative MSH2 expression were male, and 6/25 (24 %) patients were female. Seven of 8 (88 %) cases with negative MLH1 expression were high-grade urothelial carcinoma, and 21/25 (84 %) cases with negative MSH2 expression were high-grade urothelial carcinoma. Twenty-one of 44 (48 %) cases had an inverted growth pattern, of which 3/21 (14 %) cases had negative MLH1 expression and 14/21 (67 %) cases had negative MSH2 expression. Our study showed that microsatellite instability based on negative expression of MLH1 and MSH2 was more common in male patients with high-grade urothelial carcinoma. There is a strong correlation between inverted growth pattern and negative MSH2 expression. Microsatellite instability testing should be performed in patients with upper urinary tract carcinoma and may have prognostic value.

Pathological gait in children with Legg-Calvé-Perthes disease and proposal for gait modification to decrease the hip joint loading.

PubMed

Svehlík, Martin; Kraus, Tanja; Steinwender, Gerhard; Zwick, Ernst B; Linhart, Wolfgang E

2012-06-01

Legg-Calvé-Perthes disease (LCP) severely limits the range of hip motion and hinders a normal gait. Loading of the hip joint is a major consideration in LCP treatment. The aim of this study was to evaluate gait patterns in LCP and identify gait modifications to decrease the load on the affected hip. Forty children with unilateral LCP were divided into three groups based on the time base integral of the hip abductor moments during single stance on the affected side acquired during instrumented 3D gait analysis. X-rays of the affected hip were classified according to Herring and Catterall. Children in the "unloading" group spontaneously adopted a Duchenne-like gait with pelvis elevation, hip abduction and external rotation during single support phase. The "normal-loading" group showed pelvis elevation with a neutral hip position in the frontal plane. In the "overloading" group the pelvis dropped to the swinging limb at the beginning of stance accompanied by prolonged hip adduction. The time base integral of the hip abductor moments during single stance correlated positively with the X-ray classifications of Herring and Catterall, hip abduction angle and age. Older children preferred to walk in hip adduction during single stance, had more impaired hips and tended to overload them. The hip overloading pattern should be avoided in children with LCP. Gait training to unload the hip might become an integral component of conservative treatment in children with LCP.

Pelvic orientation for total hip arthroplasty in lateral decubitus: can it be accurately measured?

PubMed

Sykes, Alice M; Hill, Janet C; Orr, John F; Gill, Harinderjit S; Salazar, Jose J; Humphreys, Lee D; Beverland, David E

2016-05-16

During total hip arthroplasty (THA), accurately predicting acetabular cup orientation remains a key challenge, in great part because of uncertainty about pelvic orientation. This pilot study aimed to develop and validate a technique to measure pelvic orientation; establish its accuracy in the location of anatomical landmarks and subsequently; investigate if limb movement during a simulated surgical procedure alters pelvic orientation. The developed technique measured 3-D orientation of an isolated Sawbone pelvis, it was then implemented to measure pelvic orientation in lateral decubitus with post-THA patients (n = 20) using a motion capture system. Orientation of the isolated Sawbone pelvis was accurately measured, demonstrated by high correlations with angular data from a coordinate measurement machine; R-squared values close to 1 for all pelvic axes. When applied to volunteer subjects, largest movements occurred about the longitudinal pelvic axis; internal and external pelvic rotation. Rotations about the anteroposterior axis, which directly affect inclination angles, showed >75% of participants had movement within ±5° of neutral, 0°. The technique accurately measured orientation of the isolated bony pelvis. This was not the case in a simulated theatre environment. Soft tissue landmarks were difficult to palpate repeatedly. These findings have direct clinical relevance, landmark registration in lateral decubitus is a potential source of error, contributing here to large ranges in measured movement. Surgeons must be aware that present techniques using bony landmarks to reference pelvic orientation for cup implantation, both computer-based and mechanical, may not be sufficiently accurate.

[Clinical results of percutaneous pyeloplasty for ureteropelvic junction obstruction: 5 years follow-up].

PubMed

Nishio, S; Hamada, S; Nabeshima, S; Yokoyama, M; Takeuchi, M; Takeda, H

1994-11-01

We performed percutaneous endopyeloplasty on 20 patients between February, 1988 and July, 1993. Eighteen patients had primary and two had secondary ureteropelvic junction (UPJ) obstructions. There were 15 female and 5 male patients, whose ages ranged from 14 to 77, with an average of 43.6. The length of the follow-up after pyeloplasty ranged from 4 to 69 months with an average of 28.7 months. Among the 20 patients, there were 4 high insertion type cases, a bifid renal pelvis in one case and one case combined with a renal stone. Incisions were made with a hook-shaped cold knife and Ono's transpelvic extraureteral approach was used in most patients. Catheters were placed at the upper and the lower of renal pelvis in the patient with a bifid renal pelvis. In the case with a renal stone, pyeloplasty was successively performed after percutaneous nephrolithotomy in a single session. An endopyelotomy stent (14 Fr) was indwelled for 6 weeks in all patients except one. All patients had a low grade fever and abdominal pain for a few days after their operations, but there were no major complications. In nineteen patients (95%), the symptoms improved and their obstructive patterns disappeared or improved during follow-up. Complete ureteral stricture was found in one case at the removal of the stent and open pyeloplasty was performed. Percutaneous endopyeloplasty is a safe and useful technique, but further evaluation and/or better techniques are needed for avoiding recurrence of obstruction.

Determination of effective doses in image-guided radiation therapy system

NASA Astrophysics Data System (ADS)

Pyone, Y. Y.; Suriyapee, S.; Sanghangthum, T.; Oonsiri, S.; Tawonwong, T.

2016-03-01

The organ and effective doses in image-guided radiotherapy system are determined in this study. For 2D imaging, incident air kerma (Ki) was measured by 6cc ionization chamber with Accu-Pro dosimeter. The entrance surface air kerma (ESAK) was calculated by multiplying Ki with backscatter factor. The effective dose was calculated by multiplying ESAK with conversion coefficient. For 3D imaging, computed tomography/cone-beam dose index (CTDI/CBDI) measurements were performed by using 100mm pencil ionization chamber with Accu-Pro dosimeter. The dose index in air and in CTDI phantom from planning CT and cone- beam CT were measured. Then, effective dose was calculated by ImPACT software. The effective doses from 2D conventional simulator for anteroposterior and lateral projections were 01 and 0.02mSv for head, 0.15 and 0.16mSv for thorax, 0.22 and 0.21mSv for pelvis, respectively. The effective doses from 3D, planning CT and CBCT, were 3.3 and 0.1mSv for head, 13 and 2.4mSv for thorax and 7.2 and 4.9mSv for pelvis, respectively. Based on 30 fractions of treatment course, total effective dose (3D CT, 2D setup verification and 6 times CBCT) of head, thorax and pelvis were 3.93, 27.71 and 37.03mSv, respectively. Therefore, IGRT should be administered with significant parameters to reduce the dose.

Functional asymmetry of gait in children and youth with low-grade scoliosis.

PubMed

Nowotny-Czupryna, Olga; Nowotny, Janusz; Brzek, Anna; Czupryna, Krzysztof

2006-04-28

Background. Compensation for abnormal alignment of body parts in scoliosis may occur above or below the pelvis. This manifests as dislocation of body parts or changes in the angular composition of the lower limbs. Compensation for unbalanced body arrangement through changes in pelvic tilt and lower limb joints are typically reflected in the gait pattern of the person with scoliosis. The aim of our research was to determine whether and how improper body arrangement in the frontal plane is reflected in the gait pattern of children and youth with lower degree scolioses. Material and method. Children and youth with scolioses of varying grade were examined. In addition to photogrammetric body posture examination, three-dimensional gait analysis was performed during particular gait phases. For each examined child the results of this analysis were compared to the posture parameters. Results. Varying signs of gait asymmetry were observed in the whole group of children and youth with scoliosis. The symptoms were connected with both general gait attributes (unisommetry and unisochrony) and further gait markers. The most obvious changes were observed in pelvis rotation during the swing phase and excessive pelvis elevation during the mid-stance phase. These deviations did not correlate significantly with the results of the static examination. Conclusions. The gait asymmetries observed in children and youth with low-grade scoliosis are non-specific, and probably depend on the individual capabilities of each person to compensate for deficiencies.

Primary Report of Totally Tubeless Percutaneous Nephrolithotomy Despite Pelvi-calyceal Perforations.

PubMed

Aghamir, Seyed Mohammad Kazem; Salavati, Alborz; Hamidi, Morteza; FallahNejad, Asghar

2017-07-02

Nephrostomy tube insertion and/or a ureteral stent placement is advised when pelvi-calyceal perforations are encountered during percutaneous nephrolithotomy (PNL) nevertheless totally tubeless PNL is a possible exit strategy in percutaneous renal surgery therefore case series on the short term clinical outcomes of noninvasive management of iatrogenic pelvicalyceal perforations encountered during PNL is presented. During retrospective analysis of 1271 PNL procedures, 25 incidents of accidental ureteral catheter/ jj stent dislodgement during first 24 post-operative hours were identified in patient who had pelvi calyceal perforations and had no nephrostomy tube (tubeless). Thirteen patients could not be re-stented nor a nephrostomytube could have been placed for them mainly due to patient refusal or comorbid conditions. The main outcome was rate of successful noninvasive management. Eighteen Patients bearing mucosal tears (grade I trauma) or visible peri-pelvic fat (grade II) successfully recovered without need for ureteral stenting or nephrostomy (72.0%). In seven (28.0%) cases of extension of the perforation into the peri-pelvic fat (grade III), either nephrostomy insertion or JJ stenting was needed for resolution of fever and urinoma. The major limitation was the necessity to exclude patients and manage them in the standard fashion according to clinical guidelines. Iatrogenic perforations of the collecting system are quite diverse in terms of severity that result in different natural histories and not all might need urinary diversion via nephrostomy or ureteral stenting.Low grade perforations may be successfully managed in totally tubeless fashion nevertheless further prospective investigations seem warranted.

Usefulness of Ultrasonography and Cortical Transit Time to Differentiate Nonobstructive From Obstructive Dilatation in the Management of Prenatally Detected Pelvic Ureteric Junction Like Obstruction.

PubMed

Sharma, Gyanendra; Sharma, Anshu

2017-12-01

To differentiate a nonobstructive dilatation from an obstructive dilatation in prenatally detected presumed pelvi-ureteric junction obstruction so that intervention can be planned before irreversible damage can occur to the renal unit. From January 2012 to December 2016, all patients with prenatally detected or asymptomatic incidentally detected presumed pelvi-ureteric junction obstruction were evaluated by ultrasonography and renogram. The anteroposterior diameter of the renal pelvis was measured in supine and prone position. Presence of calyceal dilatation in prone position was noted. They were categorized into obstructed, nonobstructed, and equivocal groups based on sonography findings. The differential renal function and the cortical transit time (CTT) was calculated and compared with the sonography groups. Of the 98 patients, 72 were in the obstructed, 18 were in the nonobstructed, and 8 were in the equivocal category. All except 1 in the nonobstructed category had a function of >40% with CTT of <3 minutes. Seventy patients in the obstructed category had a CTT of >3 minutes, whereas 61 had function <40% on initial evaluation. Eleven patients in the obstructed category with an initial function of >40% had CTT of >3 minutes. All of them showed increasing hydronephrosis and deterioration of function during follow-up, necessitating pyeloplasty. All patients in the equivocal group had function >40% and CTT <3 minutes. Ultrasonography along with CTT can help to differentiate nonobstructive from obstructive dilatation. Copyright © 2017 Elsevier Inc. All rights reserved.

Concomitant management of renal calculi and pelvi-ureteric junction obstruction with robotic laparoscopic surgery.

PubMed

Atug, Fatih; Castle, Erik P; Burgess, Scott V; Thomas, Raju

2005-12-01

To present technical recommendations for robotic-assisted laparoscopic pyeloplasty (RALP) and stone extraction, as patients with kidney stones proximal to a pelvi-ureteric junction obstruction (PUJO) present a technical challenge, and have traditionally been managed with open surgery or percutaneous antegrade endopyelotomy. From November 2002 to April 2005, 55 patients had RALP for PUJO; eight of these had concomitant renal calculi. Stone burden and location were assessed with a preoperative radiological examination. Before completing the PUJO repair, one robot working arm (cephalad one) was temporarily undocked to allow passage of a flexible nephroscope into the renal pelvis and collecting systems under direct vision. Stones were extracted with graspers or basket catheters and removed via the port. The surgical-assistant port in the subxiphoid area was used to introduce laparoscopic suction and other instruments. The Anderson-Hynes dismembered pyeloplasty was the preferred reconstructive technique in all patients. Operations were completed robotically with no conversions to open surgery. All patients were rendered stone-free, confirmed by imaging, and there were no intraoperative or delayed complications during a mean (range) follow-up of 12.3 (4-22) months. The mean operative time was 275.8 min, 61.7 min longer than in patients who did not have concomitant stone removal. Concurrent stone extraction and PUJO repair can be successful with RALP. Operative times are longer than in patients with isolated PUJO repair, but this is to be expected as there is an additional procedure.

Development and validation of a visual grading scale for assessing image quality of AP pelvis radiographic images.

PubMed

Mraity, Hussien A A B; England, Andrew; Cassidy, Simon; Eachus, Peter; Dominguez, Alejandro; Hogg, Peter

2016-01-01

The aim of this article was to apply psychometric theory to develop and validate a visual grading scale for assessing the visual perception of digital image quality anteroposterior (AP) pelvis. Psychometric theory was used to guide scale development. Seven phantom and seven cadaver images of visually and objectively predetermined quality were used to help assess scale reliability and validity. 151 volunteers scored phantom images, and 184 volunteers scored cadaver images. Factor analysis and Cronbach's alpha were used to assess scale validity and reliability. A 24-item scale was produced. Aggregated mean volunteer scores for each image correlated with the rank order of the visually and objectively predetermined image qualities. Scale items had good interitem correlation (≥0.2) and high factor loadings (≥0.3). Cronbach's alpha (reliability) revealed that the scale has acceptable levels of internal reliability for both phantom and cadaver images (α = 0.8 and 0.9, respectively). Factor analysis suggested that the scale is multidimensional (assessing multiple quality themes). This study represents the first full development and validation of a visual image quality scale using psychometric theory. It is likely that this scale will have clinical, training and research applications. This article presents data to create and validate visual grading scales for radiographic examinations. The visual grading scale, for AP pelvis examinations, can act as a validated tool for future research, teaching and clinical evaluations of image quality.

Development and validation of a visual grading scale for assessing image quality of AP pelvis radiographic images

PubMed Central

England, Andrew; Cassidy, Simon; Eachus, Peter; Dominguez, Alejandro; Hogg, Peter

2016-01-01

Objective: The aim of this article was to apply psychometric theory to develop and validate a visual grading scale for assessing the visual perception of digital image quality anteroposterior (AP) pelvis. Methods: Psychometric theory was used to guide scale development. Seven phantom and seven cadaver images of visually and objectively predetermined quality were used to help assess scale reliability and validity. 151 volunteers scored phantom images, and 184 volunteers scored cadaver images. Factor analysis and Cronbach's alpha were used to assess scale validity and reliability. Results: A 24-item scale was produced. Aggregated mean volunteer scores for each image correlated with the rank order of the visually and objectively predetermined image qualities. Scale items had good interitem correlation (≥0.2) and high factor loadings (≥0.3). Cronbach's alpha (reliability) revealed that the scale has acceptable levels of internal reliability for both phantom and cadaver images (α = 0.8 and 0.9, respectively). Factor analysis suggested that the scale is multidimensional (assessing multiple quality themes). Conclusion: This study represents the first full development and validation of a visual image quality scale using psychometric theory. It is likely that this scale will have clinical, training and research applications. Advances in knowledge: This article presents data to create and validate visual grading scales for radiographic examinations. The visual grading scale, for AP pelvis examinations, can act as a validated tool for future research, teaching and clinical evaluations of image quality. PMID:26943836

Chronic Pelvic Pain in Women

MedlinePlus

... enlarged veins in the pelvis have no associated pain. Psychological factors. Depression, chronic stress or a history of sexual or physical abuse may increase your risk of chronic pelvic pain. Emotional distress makes pain worse, and living with ...

Power of Your Pancreas: Keep Your Digestive Juices Flowing

MedlinePlus

... Issues Subscribe February 2017 Print this issue The Power of Your Pancreas Keep Your Digestive Juices Flowing ... your entire digestive system working properly. Related Stories Power to the Pelvis Battling a Bulging Hernia Keeping ...

Menopause

MedlinePlus

... and pelvis. Practice slow, deep breathing whenever a hot flash begins. Try taking 6 breaths a minute. Try yoga, tai chi, or meditation. Other tips: Dress lightly and in layers. Keep having sex. Use water-based lubricants or a vaginal moisturizer ...

Power to the Pelvis: Strengthening Your Pelvic Floor Muscles

MedlinePlus

... to Anyone Battling a Bulging Hernia Keeping Your Gut in Check The Power of Your Pancreas Wise ... Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network. Am J Obstet ...

Nerve supply to the pelvis (image)

MedlinePlus

The nerves that branch off the central nervous system (CNS) provide messages to the muscles and organs for normal ... be compromised. In multiple sclerosis, the demyelinization of nerve cells may lead to bowel incontinence, bladder problems ...

Ultrasound: Pelvis (For Parents)

MedlinePlus

... the computer screen. A technician (sonographer) trained in ultrasound imaging will spread a clear, warm gel on the ... specially trained in reading and interpreting X-ray, ultrasound, and other imaging studies) will interpret the ultrasound results and then ...

Cervix

MedlinePlus

... 2016:chap 44. Ellenson LH, Pirog EC. The female genital tract. In: Kumar V, Abbas AK, Aster JC, eds. Robbins and Cotran Pathologic Basis of Disease . 9th ed. Philadelphia, ... of the female pelvis. In: Wein AJ, Kavoussi LR, Partin AW, ...

21 CFR 884.4530 - Obstetric-gynecologic specialized manual instrument.

Code of Federal Regulations, 2010 CFR

2010-04-01

... measure the diameter and capacity of the pelvis. (17) A nonmetal vaginal speculum is a nonmetal instrument used to expose the interior of the vagina. (18) A fiberoptic nonmetal vaginal speculum is a nonmetal...

Becker muscular dystrophy

MedlinePlus

The health care provider will do a nervous system (neurological) and muscle exam. A careful medical history is also important, ... the legs and pelvis, then moves to the muscles of the shoulders, ... respiratory system Tests that may be done include: CPK blood ...

Abscess - abdomen or pelvis

MedlinePlus

... risk for an abdominal abscess if you have: Trauma Perforated ulcer disease Surgery in your belly area Weakened immune system Germs may pass through your blood to an organ in your belly. Sometimes, no reason can be found for an abscess.

Better Check Your Bowels: Screening for Colon and Rectal Cancer

MedlinePlus

... the Pelvis Battling a Bulging Hernia Keeping Your Gut in Check The Power of Your Pancreas Wise ... will give me the results, and when? Links Gut Check Colon and Rectal Cancer NIHSeniorHealth: Colorectal Cance ...

Battling a Bulging Hernia: Don't Ignore Your Groin Pain

MedlinePlus

... Related Stories Power to the Pelvis Keeping Your Gut in Check The Power of Your Pancreas Better ... Maintain a healthy body weight. Links Keeping Your Gut in Check: Healthy Options to Stay on Tract ...

Multiple Primary and Histology Coding Rules - SEER

Cancer.gov

Download the coding manual and training resources for cases diagnosed from 2007 to 2017. Sites included are lung, breast, colon, melanoma of the skin, head and neck, kidney, renal pelvis/ureter/bladder, benign brain, and malignant brain.

Guillain-Barre syndrome

MedlinePlus

... the body's defense (immune) system mistakenly attacks part of the nervous system. This leads to nerve inflammation that causes muscle ... Nerve supply to the pelvis Brain and nervous system References Katirji B. Disorders of peripheral nerves. In: Daroff RB, Jankovic J, Mazziotta ...

Back Injuries

MedlinePlus

... to your pelvis. Back injuries can result from sports injuries, work around the house or in the garden, or a sudden jolt such as a car accident. The lower back is the most common site of back injuries and back pain. Common ...

Position Between Trunk and Pelvis During Gait Depending on the Gross Motor Function Classification System.

PubMed

Sanz-Mengibar, Jose Manuel; Altschuck, Natalie; Sanchez-de-Muniain, Paloma; Bauer, Christian; Santonja-Medina, Fernando

2017-04-01

To understand whether there is a trunk postural control threshold in the sagittal plane for the transition between the Gross Motor Function Classification System (GMFCS) levels measured with 3-dimensional gait analysis. Kinematics from 97 children with spastic bilateral cerebral palsy from spine angles according to Plug-In Gait model (Vicon) were plotted relative to their GMFCS level. Only average and minimum values of the lumbar spine segment correlated with GMFCS levels. Maximal values at loading response correlated independently with age at all functional levels. Average and minimum values were significant when analyzing age in combination with GMFCS level. There are specific postural control patterns in the average and minimum values for the position between trunk and pelvis in the sagittal plane during gait, for the transition among GMFCS I-III levels. Higher classifications of gross motor skills correlate with more extended spine angles.

Arteriovenous malformations of the uterus.

PubMed

Cura, M; Martinez, N; Cura, A; Dalsaso, T J; Elmerhi, F

2009-09-01

Arterial venous malformations (AVM) of the uterus are uncommon entities and should be considered in patients who present with profuse genital bleeding. There are two types of uterine AVM: acquired and congenital. Acquired uterine AVMs are conformed by communications between the uterine arteries and the myometrial veins, and are caused by an iatrogenic event or a pathological condition. Congenital AVMs are the result of abnormal development of primitive vessels that result in connections between pelvic arteries and veins in the uterus without an interconnecting capillary bed. Ultrasonography is a noninvasive diagnostic method able to demonstrate and characterize AVMs of the uterus. AVM in the pelvis may be noted incidentally by computed tomography (CT) of the pelvis, and magnetic resonance imaging (MRI) is frequently used to confirm and further characterize the sonographic findings of uterine AVM. Catheter angiography and embolization are very effective in defining the vascular anatomy and treating uterine vascular abnormalities.

Motor imagery modality in expert dancers: an investigation of hip and pelvis kinematics in demi-plié and sauté.

PubMed

Coker, Elizabeth; McIsaac, Tara L; Nilsen, Dawn

2015-06-01

Elite dancers often engage in mental practice during training, but little is known about the effects of discrete, repetitive motor imagery on dance movement performance. This study compared the effects of two motor imagery modalities, third-person visual imagery and kinesthetic imagery, on hip and pelvis kinematics during two technical dance movements, plié and sauté. Twenty-four female dancers (mean age: 26.04; mean years of training: 19.63) were randomly assigned to a type of imagery practice: visual imagery (VI), kinesthetic imagery (KI), or a mental arithmetic task control condition (MAT). No statistically significant effects of imagery group or task type were found for external hip rotation, sagittal pelvic excursion, or a ratio relating hip to pelvic movement, suggesting that imagery practice did not affect either temporal or kinematic characteristics of the plié or sauté.

Peritoneal Metastases from Gastrointestinal Cancer.

PubMed

Sugarbaker, Paul H

2018-06-08

Peritoneal metastases may occur from a majority of cancers that occur within the abdomen or pelvis. When cancer spread to the peritoneal surfaces is documented, a decision regarding palliation vs. an aggressive approach using cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy must be made. The perioperative chemotherapy may be hyperthermic intraperitoneal chemotherapy (HIPEC) administered in the operating room or early postoperative intraperitoneal chemotherapy (EPIC) administered in the first 4 or 5 postoperative days. This decision is dependent on a well-defined group of prognostic indicators. In addition to treatment, the clinical and pathologic features of a primary cancer can be used to select perioperative treatments that may prevent cancer cells within the abdomen and pelvis from progressing to established peritoneal metastases. In some clinical situations with appendiceal and colorectal cancers, the clinical or histopathologic features may indicate that second-look surgery plus perioperative chemotherapy should occur. Peritoneal metastases should always be considered for treatment or prevention.

Evolution of the human hip. Part 1: the osseous framework

PubMed Central

Hogervorst, Tom; Vereecke, Evie E.

2014-01-01

Extensive osseous adaptations of the lumbar spine, pelvis, hip and femur characterize the emergence of the human bipedal gait with its ‘double extension’ of the lumbar spine and hip. To accommodate lumbar lordosis, the pelvis was ‘compacted’, becoming wider and shorter, as compared with the non-human apes. The hip joint acquired a much more extended position, which can be seen in a broader evolutionary context of verticalization of limbs. When loaded in a predominantly vertical position, the femur can be built lighter and longer than when it is loaded more horizontally because bending moments are smaller. Extension of the hip joint together with elongation of the femur increases effective leg length, and hence stride length, which improves energy efficiency. At the hip joint itself, the shift of the hip’s default working range to a more extended position influences concavity at the head–neck junction and femoral neck anteversion. PMID:27011802

Evolution of the human hip. Part 1: the osseous framework.

PubMed

Hogervorst, Tom; Vereecke, Evie E

2014-10-01

Extensive osseous adaptations of the lumbar spine, pelvis, hip and femur characterize the emergence of the human bipedal gait with its 'double extension' of the lumbar spine and hip. To accommodate lumbar lordosis, the pelvis was 'compacted', becoming wider and shorter, as compared with the non-human apes. The hip joint acquired a much more extended position, which can be seen in a broader evolutionary context of verticalization of limbs. When loaded in a predominantly vertical position, the femur can be built lighter and longer than when it is loaded more horizontally because bending moments are smaller. Extension of the hip joint together with elongation of the femur increases effective leg length, and hence stride length, which improves energy efficiency. At the hip joint itself, the shift of the hip's default working range to a more extended position influences concavity at the head-neck junction and femoral neck anteversion.

Low impact weight-bearing exercise in an upright posture achieves greater lumbopelvic stability than overground walking.

PubMed

Gibbon, K C; Debuse, D; Caplan, N

2013-10-01

The aim of this study was to determine the kinematic differences between movements on a new exercise device (EX) that promotes a stable trunk over a moving, unstable base of support, and overground walking (OW). Sixteen male participants performed EX and OW trials while their movements were tracked using a 3D motion capture system. Trunk and pelvis range of motion (ROM) were similar between EX and OW in the sagittal and frontal planes, and reduced for EX in the transverse plane. The pelvis was tilted anteriorly, on average, by about 16° in EX compared to OW. Hip and knee ROM were reduced in EX compared to OW. The exercise device appears to promote similar or reduced lumbopelvic motion, compared to walking, which could contribute to more tonic activity of the local lumbopelvic musculature. Copyright © 2013 Elsevier Ltd. All rights reserved.

A novel missense mutation, p.(R102W) in WNT7A causes Al-Awadi Raas-Rothschild syndrome in a fetus.

PubMed

Mutlu, Mehmet Burak; Cetinkaya, Arda; Koc, Nermin; Ceylaner, Gulay; Erguner, Bekir; Aydın, Hatip; Karaman, Selin; Demirci, Oya; Goksu, Kamber; Karaman, Ali

2016-11-01

Al-Awadi-Raas-Rothschild syndrome (AARRS) is a rare autosomal recessive disorder which consists of severe malformations of the upper and lower limbs, abnormal genitalia and underdeveloped pelvis. Here, we present a fetus with severe limbs defects, including bilateral humeroradial synostosis, bilateral oligodactyly in hands, underdeveloped pelvis, short femora and tibiae, absence of fibulae, severely small feet, and absence of uterus. An autosomal recessively inherited novel mutation in WNT7A found in the fetus, c.304C > T, affects an evolutionarily well-conserved amino acid, causing the p.(R102W) missense change at protein level. The findings presented in this fetus are compatible with diagnosis of AARRS, expanding the mutational spectrum of limb malformations arising from defects in WNT7A. Crown Copyright © 2016. Published by Elsevier Masson SAS. All rights reserved.

Musculoskeletal Geometry, Muscle Architecture and Functional Specialisations of the Mouse Hindlimb.

PubMed

Charles, James P; Cappellari, Ornella; Spence, Andrew J; Hutchinson, John R; Wells, Dominic J

2016-01-01

Mice are one of the most commonly used laboratory animals, with an extensive array of disease models in existence, including for many neuromuscular diseases. The hindlimb is of particular interest due to several close muscle analogues/homologues to humans and other species. A detailed anatomical study describing the adult morphology is lacking, however. This study describes in detail the musculoskeletal geometry and skeletal muscle architecture of the mouse hindlimb and pelvis, determining the extent to which the muscles are adapted for their function, as inferred from their architecture. Using I2KI enhanced microCT scanning and digital segmentation, it was possible to identify 39 distinct muscles of the hindlimb and pelvis belonging to nine functional groups. The architecture of each of these muscles was determined through microdissections, revealing strong architectural specialisations between the functional groups. The hip extensors and hip adductors showed significantly stronger adaptations towards high contraction velocities and joint control relative to the distal functional groups, which exhibited larger physiological cross sectional areas and longer tendons, adaptations for high force output and elastic energy savings. These results suggest that a proximo-distal gradient in muscle architecture exists in the mouse hindlimb. Such a gradient has been purported to function in aiding locomotor stability and efficiency. The data presented here will be especially valuable to any research with a focus on the architecture or gross anatomy of the mouse hindlimb and pelvis musculature, but also of use to anyone interested in the functional significance of muscle design in relation to quadrupedal locomotion.

The geometrical precision of virtual bone models derived from clinical computed tomography data for forensic anthropology.

PubMed

Colman, Kerri L; Dobbe, Johannes G G; Stull, Kyra E; Ruijter, Jan M; Oostra, Roelof-Jan; van Rijn, Rick R; van der Merwe, Alie E; de Boer, Hans H; Streekstra, Geert J

2017-07-01

Almost all European countries lack contemporary skeletal collections for the development and validation of forensic anthropological methods. Furthermore, legal, ethical and practical considerations hinder the development of skeletal collections. A virtual skeletal database derived from clinical computed tomography (CT) scans provides a potential solution. However, clinical CT scans are typically generated with varying settings. This study investigates the effects of image segmentation and varying imaging conditions on the precision of virtual modelled pelves. An adult human cadaver was scanned using varying imaging conditions, such as scanner type and standard patient scanning protocol, slice thickness and exposure level. The pelvis was segmented from the various CT images resulting in virtually modelled pelves. The precision of the virtual modelling was determined per polygon mesh point. The fraction of mesh points resulting in point-to-point distance variations of 2 mm or less (95% confidence interval (CI)) was reported. Colour mapping was used to visualise modelling variability. At almost all (>97%) locations across the pelvis, the point-to-point distance variation is less than 2 mm (CI = 95%). In >91% of the locations, the point-to-point distance variation was less than 1 mm (CI = 95%). This indicates that the geometric variability of the virtual pelvis as a result of segmentation and imaging conditions rarely exceeds the generally accepted linear error of 2 mm. Colour mapping shows that areas with large variability are predominantly joint surfaces. Therefore, results indicate that segmented bone elements from patient-derived CT scans are a sufficiently precise source for creating a virtual skeletal database.

Urothelial signet-ring cell carcinoma of the renal pelvis with collagenous spherulosis: a case report.

PubMed

Hes, Ondrej; Curík, Romuald; Mainer, Karel; Michal, Michal

2005-10-01

We present a unique case of urothelial carcinoma of the right renal pelvis. It occurred in a 58-year-old woman. The tumor was located in the renal pelvis with extension into the adjacent renal medulla and cortex. Two years after surgical excision the patient is free of recurrence and metastasis. The tumor was well demarcated, without capsule, firm, solid, and whitish on the cut surface. It was 3x4 cm in largest diameter and without signs of necroses and hemorrhages. The tumor did not infiltrate the ureter. Histologically the predominant pattern of the tumor was adenocarcinomatous differentiation, and only very rare foci of urothelial carcinoma composed of typical transitional cells were found. No signs of intestinal type of metaplasia and adenocarcinoma, changes similar to the cystitis cystica or cystitis glandularis, were found in the tumor or in its vicinity. Most of the tumor looked like solid nests composed of cells with intracytoplasmic lumens. The resulting appearance was that of typical signet-ring cell change. These solid nests were usually surrounded by columnar epithelium, which in many areas formed papillary structures. A very striking feature was formation of collagen spherules. Small collagen spherules were often surrounded by a layer of the neoplastic cells so that collagenous rosettes were formed. In some areas these collagenous spherules clustered together so that they formed areas of collagenous spherulosis. The collagen in the spherules reacted positively with collagen IV. Ultrastructurally these spherules were formed by basal membrane-like material. Intracytoplasmic lumens of the signet-ring cell change were endowed by slender microvilli at ultrastructural level.

Ultrastructural organization of the hamster renal pelvis.

PubMed

Lacy, E R; Schmidt-Nielsen, B

1979-08-01

The renal pelvis of the hamster has been studied by light microscopy (epoxy resin sections), transmission electron microscopy, and morphometric analysis of electron micrographs. Three morphologically distinct epithelia line the pelvis, and each covers a different zone of the kidney. A thin epithelium covering the outer medulla (OM) consists of two cell types: (1) granular cells are most numerous and have apically positioned granules which stain intensely with toluidine blue, are membrane-bound, and contain a fine particulate matter that stains light grey to black in electron micrographs. (2) Basal cells do not have granules, are confined to the basal lamina region, and do not reach the mucosal epithelial surface. The inner medulla (IM) is covered by a pelvic epithelium morphologically similar to collecting duct epithelium of IM. Some cells in this portion of the pelvic epithelium (IM) stain intensely dark with toluidine blue, osmium tetroxide, lead, and uranyl acetate. Transitional epithelium, which separates cortex (C) from pelvic urine, has an asymmetric luminal plasma membrane and discoid vesicles, each of which is similar to those previously observed in mammalian ureter and urinary bladder epithelia. Based on morphological comparisons with other epithelia, the IM and OM pelvic epithelia would appear permeable to solutes and/or water, while the transitional epithelium covering the C appears relatively impermeable. It would also appear that the exchange of solutes and water between pelvic urine and OM would involve capillaries, primarily, since morphometric analysis showed that both fenestrated and continuous capillaries of the OM were extremely abundant (greater than 60% of OM pelvic surface area) just under the thin pelvic epithelium.

The urogenital-hypogastric sheath: an anatomical observation on the relationship between the inferomedial extension of renal fascia and the hypogastric nerves.

PubMed

Yang, X F; Luo, G H; Ding, Z H; Li, G X; Chen, X W; Zhong, S Z

2014-11-01

The study aimed to perform an anatomical observation on the inferomedial extension of the renal fascia (RF) to the pelvis and explore its relationship with the hypogastric nerves (HGNs). Gross anatomy was performed on 12 formalin-fixed and 12 fresh cadavers. Sectional anatomy was performed on four formalin-fixed cadavers. Different from the traditional concept, both the anterior and posterior RF included the outer and inner layer with different inferomedial extensions. The multiple layers of RF extended downward to form a sandwich-like and compound fascia sheath with potential and expandable spaces which was named as "the urogenital-hypogastric sheath." Below the level of the origin of the inferior mesenteric artery, the bilateral urogenital-hypogastric sheath communicated with the counterpart in front of the great vessels in the midline and the superior hypogastric plexus ran into the urogenital-hypogastric sheath which carried the HGNs, ureters, and genital vessels downward to their terminations in the pelvis. In the retrorectal space, the urogenital-hypogastric sheath surrounded the fascia propria of the rectum posterolaterally as a layer of coat containing HGNs. The multiple layers of RF with different extensions are the anatomical basis of the formation of the urogenital-hypogastric sheath. As a special fascial structure in the retroperitoneal space and the pelvis, emphasis on its formation and morphology may be helpful for not only unifying the controversies about the relationship between the pelvic fascia and HGNs but also improving the intraoperative preservation of the HGNs by dissecting in the correct surgical plane.

Improved access and visibility during stapling of the ultra-low rectum: a comparative human cadaver study between two curved staplers

PubMed Central

2012-01-01

Background The purpose of this study was to compare in human cadavers the applicability of a commonly used stapling device, the CONTOUR® curved cutter (CC) (Ethicon Endo-Surgery, Cincinnati, OH) to a newly released, curved stapler, the Endo GIA™ Radial Reload with Tri-Staple™ Technology (RR) (Covidien, New Haven, CT) Methods Four experienced surgeons performed deep pelvic dissection with total mesorectal excision (TME) of the rectum in twelve randomized male cadavers. Both stapling devices were applied to the ultra-low rectum in coronal and sagittal configurations. Extensive measurements were recorded of anatomic landmarks for each cadaver pelvis along with various aspects of access, visibility, and ease of placement for each device. Results The RR reached significantly lower into the pelvis in both the coronal and sagittal positions compared to the CC. The median distance from the pelvic floor was 1.0 cm compared to 2.0 cm in the coronal position, and 1.0 cm versus 3.3 cm placed sagitally, p < 0.0001. Surgeons gave a higher visibility rating with less visual impediment in the sagittal plane using the RR Stapler. Impediment of visibility occurred in only 10% (5/48) of RR applications in the coronal position, compared to a rate of 48% (23/48) using the CC, p = 0.0002. Conclusions The RR device performed significantly better when compared to the CC stapler in regards to placing the stapler further into the deep pelvis and closer to the pelvic floor, while causing less obstructing of visualization. PMID:23148602

Carcinosarcoma of the upper urinary tract with an aggressive angiosarcoma component.

PubMed

Cuadra-Urteaga, José Luis; Font, Albert; Tapia, Gustavo; Areal, Juan; Taron, Miquel

2016-01-01

Carcinosarcomas (CS) are biphasic tumors with malignant epithelial and mesenchymal elements. The sarcomatoid elements of CS can include chondrosarcoma, malignant fibrous histiocytoma, osteosarcoma, leiomyosarcoma, fibrosarcoma, or liposarcoma. CS of the upper urinary tract are extremely rare but are associated with a poor prognosis. We report a case of a 44-year-old man with a localized right renal pelvis mass treated with a right nephroureterectomy. The pathological examination showed a high-grade urothelial carcinoma of the renal pelvis, stage III (pT3aNxM0). A few days later, he developed lower back pain, hematuria, cough with hemoptoic sputum and progressive dyspnea. Radiological explorations showed multiple bilateral lung nodules and a retroperitoneal mass. A CT-guided biopsy of the retroperitoneal mass revealed a high-grade angiosarcoma. A review of the nephrectomy specimen showed a microscopic focus of angiosarcoma in the urothelial carcinoma. Therefore, the initial diagnosis was changed to CS of the renal pelvis with an angiosarcoma component. The patient developed progressive respiratory failure and died 8 weeks after surgery. An autopsy revealed a large retroperitoneal mass with metastatic nodules to the abdominal wall, diaphragm, small intestine, liver, spleen, and lung. All lesions were angiosarcoma, with no evidence of urothelial carcinoma. This is the first case reported of a patient with CS of the upper urinary tract with an angiosarcoma component with a very aggressive course that caused the immediate appearance of multiple angiosarcoma metastases. We also describe the clinical and molecular characteristics of CS, which will help to contribute to a better understanding of this type of tumor.

Carcinosarcoma of the upper urinary tract with an aggressive angiosarcoma component

PubMed Central

Cuadra-Urteaga, José Luis; Font, Albert; Tapia, Gustavo; Areal, Juan; Taron, Miquel

2016-01-01

ABSTRACT Carcinosarcomas (CS) are biphasic tumors with malignant epithelial and mesenchymal elements. The sarcomatoid elements of CS can include chondrosarcoma, malignant fibrous histiocytoma, osteosarcoma, leiomyosarcoma, fibrosarcoma, or liposarcoma. CS of the upper urinary tract are extremely rare but are associated with a poor prognosis. We report a case of a 44-year-old man with a localized right renal pelvis mass treated with a right nephroureterectomy. The pathological examination showed a high-grade urothelial carcinoma of the renal pelvis, stage III (pT3aNxM0). A few days later, he developed lower back pain, hematuria, cough with hemoptoic sputum and progressive dyspnea. Radiological explorations showed multiple bilateral lung nodules and a retroperitoneal mass. A CT-guided biopsy of the retroperitoneal mass revealed a high-grade angiosarcoma. A review of the nephrectomy specimen showed a microscopic focus of angiosarcoma in the urothelial carcinoma. Therefore, the initial diagnosis was changed to CS of the renal pelvis with an angiosarcoma component. The patient developed progressive respiratory failure and died 8 weeks after surgery. An autopsy revealed a large retroperitoneal mass with metastatic nodules to the abdominal wall, diaphragm, small intestine, liver, spleen, and lung. All lesions were angiosarcoma, with no evidence of urothelial carcinoma. This is the first case reported of a patient with CS of the upper urinary tract with an angiosarcoma component with a very aggressive course that caused the immediate appearance of multiple angiosarcoma metastases. We also describe the clinical and molecular characteristics of CS, which will help to contribute to a better understanding of this type of tumor. PMID:26891233

Computed tomographic pelvimetry in English bulldogs.

PubMed

Dobak, Tetyda P; Voorhout, George; Vernooij, Johannes C M; Boroffka, Susanne A E B

2018-05-31

English bulldogs have been reported to have a high incidence of dystocia and caesarean section is often performed electively in this breed. A narrow pelvic canal is the major maternal factor contributing to obstructive dystocia. The objective of this cross-sectional study was to assess the pelvic dimensions of 40 clinically healthy English bulldogs using computed tomography pelvimetry. A control group consisting of 30 non-brachycephalic dogs that underwent pelvic computed tomography was retrospectively collected from the patient archive system. Univariate analysis of variance was used to compare computed tomography pelvimetry of both groups and the effects of weight and gender on the measurements. In addition, ratios were obtained to address pelvic shape differences. A significantly (P = 0.00) smaller pelvic size was found in English bulldogs compared to the control group for all computed tomography measurements: width and length of the pelvis, pelvic inlet and caudal pelvic aperture. The pelvic conformation was significantly different between the groups, English bulldogs had an overall shorter pelvis and pelvic canal and a narrower pelvic outlet. Weight had a significant effect on all measurements whereas gender that only had a significant effect on some (4/11) pelvic dimensions. Our findings prove that English bulldogs have a generally reduced pelvic size as well as a shorter pelvis and narrower pelvic outlet when compared to non-brachycephalic breeds. We suggest that some of our measurements may serve as a baseline for pelvic dimensions in English bulldogs and may be useful for future studies on dystocia in this breed. Copyright © 2018 Elsevier Inc. All rights reserved.

Accounting for patient size in the optimization of dose and image quality of pelvis cone beam CT protocols on the Varian OBI system.

PubMed

Wood, Tim J; Moore, Craig S; Horsfield, Carl J; Saunderson, John R; Beavis, Andrew W

2015-01-01

The purpose of this study was to develop size-based radiotherapy kilovoltage cone beam CT (CBCT) protocols for the pelvis. Image noise was measured in an elliptical phantom of varying size for a range of exposure factors. Based on a previously defined "small pelvis" reference patient and CBCT protocol, appropriate exposure factors for small, medium, large and extra-large patients were derived which approximate the image noise behaviour observed on a Philips CT scanner (Philips Medical Systems, Best, Netherlands) with automatic exposure control (AEC). Selection criteria, based on maximum tube current-time product per rotation selected during the radiotherapy treatment planning scan, were derived based on an audit of patient size. It has been demonstrated that 110 kVp yields acceptable image noise for reduced patient dose in pelvic CBCT scans of small, medium and large patients, when compared with manufacturer's default settings (125 kVp). Conversely, extra-large patients require increased exposure factors to give acceptable images. 57% of patients in the local population now receive much lower radiation doses, whereas 13% require higher doses (but now yield acceptable images). The implementation of size-based exposure protocols has significantly reduced radiation dose to the majority of patients with no negative impact on image quality. Increased doses are required on the largest patients to give adequate image quality. The development of size-based CBCT protocols that use the planning CT scan (with AEC) to determine which protocol is appropriate ensures adequate image quality whilst minimizing patient radiation dose.