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Sample records for progressive atlanto-axial subluxation

  1. Atlanto-axial subluxation: a case report

    PubMed Central

    Thurlow, Robert D

    1988-01-01

    One of the causes of death in rheumatoid patients is cord compression following atlanto-axial subluxation. Dislocations in the cervical spine are common with patients who have rheumatoid arthritis. Anterior subluxation occurs in up to 35%, followed by vertical subluxation in 22.2%, lateral subluxation in 20.6% and rarely posterior subluxation. A case report is presented to illustrate such a complication. ImagesFigure 1Figure 2Figure 3Figure 4

  2. Atlanto-axial subluxation after pyogenic spondylitis of the atlanto-occipital joint.

    PubMed

    Tsunoda, Kazuhiko; Iizuka, Haku; Sorimachi, Yasunori; Ara, Tsuyoshi; Nishinome, Masahiro; Takechi, Yasuhiko; Takagishi, Kenji

    2011-07-01

    This report presents a case of atlanto-axial subluxation after treatment of pyogenic spondylitis of the atlanto-occipital joint. A 60-year-old male had 1-month history of neck pain with fever. Magnetic resonance imaging showed inflammation around the odontoid process. Intravenous antibiotic therapy was administrated immediately. After 6 weeks, CRP had returned almost to normal. After 4 months, laboratory data was still normal, but the patient experienced increasing neck pain. Lateral cervical radiography in the neutral position showed instability between C1 and C2. Computed tomography showed a bony union of the atlanto-occipital joint and severe destruction of the atlanto-axial joint on the left side. Transarticular screw fixation for the atlanto-axial joint was performed. A lateral cervical radiograph in the neutral position after surgery showed a solid bony union. Neck pain improved following surgery. We speculate that spondylitis of the atlanto-occipital joint induced a loosening of the transverse ligament and articulation of the atlanto-axial joint. A bony fusion of the atlanto-occipital joint after antibiotic treatment resolved the pyogenic inflammation concentrated stress to the damaged atlanto-axial joint, resulting in further damage. The atlanto-axial instability was finally managed by the insertion of a transarticular screw.

  3. Congenital laxity of the transverse atlantal ligament producing atlanto-axial subluxation: a case report

    PubMed Central

    Mick, Timothy J

    1988-01-01

    An anterior atlanto-dental interspace (ADI) of greater than 3mm in an adult indicates atlanto-axial subluxation (AAS) and instability. A number of pathological processes are known to cause AAS. Trauma, specifically injuries with a component of hyperflexion, may produce sprain or avulsion of the transverse atlantal ligament (TAL). More often, however, the odontoid process will fracture before the tough TAL ruptures, so that isolated rupture of the ligament is generally considered to be rare. Inflammatory arthritis or infection may erode and weaken or destroy this ligament. Focal or global congenital conditions are also associated with TAL laxity or agenesis and subsequent AAS. Congenital laxity of the TAL is a diagnosis of exclusion which may be made only after a comprehensive search for other causes of AAS. ImagesFigure 1Figure 2Figure 3

  4. Ganglion cyst arising from the composite occipito-atlanto-axial joint cavity in a cat.

    PubMed

    Aikawa, T; Sadahiro, S; Nishimura, M; Miyazaki, Y; Shibata, M

    2014-01-01

    A four-year-old, female spayed Domestic Longhaired cat was referred for evaluation with a two month history of initial inability to jump progressing to ambulatory tetraparesis. Magnetic resonance imaging studies demonstrated a cystic lesion arising from the composite occipito-atlanto-axial joint cavity and extending to the region of the occipital bone and the axis. The lesion surrounded the spinal canal, causing moderate dorsal spinal cord compression at the atlanto-occipital joint. A dynamic myelographic study demonstrated attenuation of the dorsal contrast column at the atlanto-occipital joint when the cervical spine was positioned in extension. Partial excision of the cyst capsule by a ventral approach resulted in long-term (64 months) resolution of clinical signs. Histological evaluation was consistent with a ganglion cyst. An intra-spinal ganglion cyst arising from the composite occipito-atlanto-axial joint cavity may be considered as an uncommon differential diagnosis for cats with cervical myelopathy.

  5. Posterior atlanto-axial arthrodesis for fixation of odontoid nonunions.

    PubMed

    Platzer, Patrick; Vécsei, Vilmos; Thalhammer, Gerhild; Oberleitner, Gerhard; Schurz, Mark; Gaebler, Christian

    2008-03-15

    A retrospective case series. To determine the clinical and radiographic long-term results after posterior atlanto-axial arthrodesis of odontoid nonunions. Nonunion of odontoid fractures is a relatively common and dreaded complication after surgical and nonoperative treatment of these injuries. Although there might be a significant rate, which require surgical stabilization due to atlanto-axial instability, only few publications have covered this issue and presented reliable long-term results. We retrospectively analyzed the clinical and radiographic records of 9 (4 women and 5 men) patients with an average age of 68 (42-78) years at the time of injury who had undergone posterior atlanto-axial arthrodesis for surgical treatment of odontoid nonunions between 1988 and 2004. For posterior atlanto-axial arthrodesis, we performed either C1-C2 transarticular screw fixation, or posterior wiring and bone grafting, or a combination of these 2 techniques. Eight patients achieved a satisfactory clinical outcome and returned to their preinjury activity level. The Smiley-Webster scale showed an overall functional outcome score of 2.2, which was 0.9 points superior to the outcome score before surgery. Neurologic deficits after operative treatment of the odontoid nonunion were evaluated in 2 patients. In all the other patients with primary neurologic deficits or delayed neurologic sequelae we saw a full recovery. Solid bony fusion of the cervical arthrodesis was achieved in all of the patients. Failures of reduction or fixation were noted in 2 patients, but no reoperations were necessary. In summary, we had a satisfactory outcome after surgical treatment of odontoid nonunions in patients with atlanto-axial instability and severe motion pain at the cervical spine. With a bony union rate of 100% and a noticeable improvement of clinical results and neurologic function, posterior atlanto-axial arthrodesis seems to be an appropriate option for nonunited odontoid fractures that require

  6. Atlanto-axial malformation in an adult Quarter horse gelding.

    PubMed

    Cole, Robert; Taintor, Jennifer; Hanson, Reid

    2017-09-01

    An adult gelding was evaluated for bilateral intermittent forelimb lameness of approximately 2 years duration. The horse was found to have grade 2/5 upper motor neuron-general proprioception ataxia with no cranial nerve deficits. During radiographic and gross necropsy examinations a novel atlanto-axial malformation of possible congenital etiology was found.

  7. [Atlanto-axial dislocation associated with os odontoideum. Reduction and fixation with sublaminar wires in Cl and pedicle screws in C2. Case report].

    PubMed

    Martínez-Flórez, P; Chillón-Medina, D; Escosa-Bage, M; Manzanares-Soler, R

    2004-12-01

    This report describes a case of atlanto-axial dislocation associated with os odontoideum. This 18-year-old male had a traumatic episode when he was 2 years old. As a result he suffered progressive chronic myelopathy on the verge of death. For the reduction and fixation of the atlanto-axial dislocation, sublaminar wires have been used anchored to C1 and to screws placed in the pedicles of C2. The authors present a surgical technique that has not been previously described.

  8. Atlanto Axial Rotatory Dislocation in Adults: A Rare Complication of an Epileptic Seizure—Case Report

    PubMed Central

    TARANTINO, Roberto; DONNARUMMA, Pasquale; MAROTTA, Nicola; MISSORI, Paolo; VIOZZI, Ilaria; LANDI, Alessandro; DELFINI, Roberto

    2014-01-01

    Atlanto Axial Rotatory Dislocations (AARDs) are a heterogeneous group of post-traumatic pathologies typical of the pediatric age, and rare in adults. We describe the case of a 34-year-old woman, developing Atlanto Axial Rotatory Fixation (AARF) after a generalized tonic-clonic epileptic seizure, an extremely rare traumatic cause never described in literature. AARF was detected only 1 month after the accident and nonsurgical treatment was attempted at the beginning. The patient underwent surgery only 2 months after the accident. The best treatment should be conservative reduction within 1 month; when it is not possible, it is advisable to perform surgery as soon as possible. C1–C2 fixation with Harm's technique is the gold standard for fixed luxations. Delay of treatment makes intraoperative reduction more difficult and increase the establishment of the chronic permanent change of neck muscles and ligaments. PMID:24201098

  9. Odontoid pannus formation in a patient with ankylosing spondylitis causing atlanto-axial instability.

    PubMed

    Rajak, Rizwan; Wardle, Phil; Rhys-Dillon, Ceril; Martin, James C

    2012-02-25

    Ankylosing spondylitis is one of the commonest inflammatory diseases of the axial skeleton and can be complicated by atlanto-axial instability. This serious and likely underestimated complication can be easily overlooked. However, there are clear features which can help alert suspicion to initiate the appropriate investigations with imaging that is very effective at diagnosing and assessing this complication. The authors report an unusual case where odontoid pannus formation, akin to that seen in rheumatoid arthritis, was the underlying cause.

  10. Atlanto-axial dislocation complicating a type II odontoid fracture. Reduction and final fixation.

    PubMed

    Riouallon, G; Pascal-Moussellard, H

    2014-05-01

    A case of traumatic posterolateral C1-C2 dislocation associated with odontoid fracture is reported. This is a rare case of traumatic posterolateral C1-C2 dislocation associated with odontoid fracture. Its management is discussed. A traumatic dislocation of atlanto-axial joint associated with an odontoid fracture remains a rare injury. No case of posterior dislocation has been reported so far in the literature with this type of management. The case is of a 25 year-old-man with a primary atlanto-axial posterolateral dislocation associated with a type II displaced odontoid fracture without any neurological complication. The patient underwent gentle traction during 24 hours with a halo frame. An incomplete reduction was achieved. Two days later, a complete reduction was obtained thanks to a preoperative manual traction maintained by a Mayfield (R) modified skull clamp. Anterior C1-C2 fixation was performed according to Vaccaro's technique. The patient wore a cervical collar and underwent physiotherapy during three months. To our best knowledge, this case represents the first traumatic atlanto-axial dislocation associated with an odontoid fracture which was treated through retropaharyngeal approach. This had been rendered possible thanks to the final reduction maneuver in extension.

  11. A geometrical model of vertical translation and alar ligament tension in atlanto-axial rotation.

    PubMed

    Boszczyk, B M; Littlewood, A P; Putz, R

    2012-08-01

    While allowing the greatest range of axial rotation of the entire spine with 40° to each side, gradual restraint at the extremes of motion by the alar ligaments is of vital importance. In order for the ligaments to facilitate a gradual transition from the neutral to the elastic zone, a complex interaction of axial rotation and vertical translation via the biconvex articular surfaces is essential. The aim of this investigation is to establish a geometrical model of the intricate interaction of the alar ligaments and vertical translatory motion of C1/C2 in axial rotation. Bilateral alar ligaments including the odontoid process and condylar bony entheses were removed from six adult cadavers aged 65-89 years within 48 h of death. All specimens were judged to be free of abnormalities with the exception of non-specific degenerative changes. Dimensions of the odontoid process and alar ligaments were measured. Graphical multiplanar reconstruction of atlanto-axial rotation was done in the transverse and frontal planes for the neutral position and for rotation to 40° with vertical translation of 3 mm. The necessary fibre elongation of the alar ligaments in the setting with and without vertical translation of the atlas was calculated. The mean diameter of the odontoid process in the sagittal plane was 10.6 mm (SD 1.1). The longest fibre length was measured from the posterior border of the odontoid enthesis to the posterior border of the condylar enthesis with an average of 13.2 mm (SD 2.5) and the shortest between the lateral (anterior) border odontoid enthesis and the anterior condylar enthesis with an average of 8.2 mm (SD 2.2). In graphical multiplanar reconstruction of atlanto-axial rotation to 40° without vertical translation of C1/C2, theoretical alar fibre elongation reaches 27.1% for the longest fibres, which is incompatible with the collagenous structure of the alar ligaments. Allowing 3 mm caudal translation of C1 on C2 at 40° rotation, as facilitated by the

  12. Atlanto-axial malformation and instability in dogs with pituitary dwarfism due to an LHX3 mutation.

    PubMed

    Voorbij, A M W Y; Meij, B P; van Bruggen, L W L; Grinwis, G C M; Stassen, Q E M; Kooistra, H S

    2015-01-01

    Canine pituitary dwarfism or combined pituitary hormone deficiency (CPHD) in shepherd dogs is associated with an LHX3 mutation and can lead to a wide range of clinical manifestations. Some dogs with CPHD have neurological signs that are localized to the cervical spine. In human CPHD, caused by an LHX3 mutation, anatomical abnormalities in the atlanto-axial (C1-C2) joint have been described. To evaluate the presence of atlanto-axial malformations in dogs with pituitary dwarfism associated with an LHX3 mutation and to investigate the degree of similarity between the atlanto-axial anomalies found in canine and human CPHD patients with an LHX3 mutation. Three client-owned Czechoslovakian wolfdogs and 1 client-owned German shepherd dog, previously diagnosed with pituitary dwarfism caused by an LHX3 mutation, with neurological signs indicating a cervical spinal disorder. Radiography, computed tomography, and magnetic resonance imaging of the cranial neck and skull, necropsy, and histology. Diagnostic imaging identified abnormal positioning of the dens axis and incomplete ossification of the suture lines between the ossification centers of the atlas with concurrent atlanto-axial instability and dynamic compression of the spinal cord by the dens axis. The malformations and aberrant motion at C1-C2 were confirmed at necropsy and histology. The atlanto-axial abnormalities of the dwarf dogs resemble those encountered in human CPHD patients with an LHX3 mutation. These findings suggest an association between the LHX3 mutation in dogs with CPHD and atlanto-axial malformations. Consequently, pituitary dwarfs should be monitored closely for neurological signs. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of American College of Veterinary Internal Medicine.

  13. [One-stage operative treatment of atlanto-axial instability with stenosis of lower cervical level of spinal canal].

    PubMed

    Liu, H; Yang, Z; Chen, T

    1998-09-01

    To cure patients suffering from atlanto-axial instability following old fracture of odontoid process concomitant with stenosis of lower end of cervical spinal canal, a new operative method was designed. It included atlanto-axial fusion by Gallie technique and resection of right half of the laminae of C3-C7 spine at one stage. A female of 63 years old was treated. She was admitted with neck pain and numbness of the upper and lower limbs. A history of neck injury was noted in enquiry. In physical examination showed the sensation of pain of the upper limbs was decreased and the muscle power of the upper and lower limbs ranged from III degree to IV degree. The X-ray film and MRI suggested that there was instability of the atlanto-axial joint with stenosis of 4th-6th cervical spinal canal. The operation was satisfactory. After operation, the patient was followed up for 11 months. The physical examination indicated that sensation of the upper limbs had recovered to normal and the muscle power of the upper limbs reached IV degree and that the lower limbs reached V degree and X-ray showed bony fusion of the atlanto-axial joint. The conclusions were: 1. The stability of atlanto-axial joint was reconstructed with expanding of the spinal canal at the same time. 2. The duration, risk and cost of the therapy were reduced, and maintenance of the stability of the cervical spine throughout whole period of treatment was recommended.

  14. Hydrocephalus Caused by Fat Embolism: A Rare Complication of Atlanto-Axial Fixation for Odontoid Fractures.

    PubMed

    Wang, Chun-Hao; Chang, Peng-Yuan; Wu, Jau-Ching; Tu, Tsung-Hsi; Wu, Ching-Lan; Huang, Wen-Cheng; Cheng, Henrich

    2016-06-01

    Odontoid fracture is not uncommon and surgical treatment that uses posterior screw/rod fixation is an acceptable option. This is the first report of delayed hydrocephalus due to subarachnoid fat migration as a complication of posterior atlanto-axial (AA) fixation. A 27-year-old man underwent posterior C1 lateral mass and C2 pedicle screw fixation for a recent Anderson-D'Alonzo type 2 odontoid fracture. Autologous bone graft was wired for onlay fusion. The surgery was smooth, except that there was an incidental durotomy intraoperatively. The patient had significant relief of his neck pain, although computed tomography (CT) demonstrated a medial breach of the left C1 screw postoperation; however, he gradually developed headache and dizziness after discharge. Five weeks after operation, magnetic resonance imaging demonstrated a large pseudo-meningocele at the surgical site, which was managed conservatively. Nine weeks after the AA fixation, the patient was sent to the emergency department for altered consciousness. A brain CT demonstrated hydrocephalus and multiple fat emboli in the subarachnoid and intraventricular space. A ventriculoperitoneal shunt was inserted to manage the hydrocephalus and pseudo-meningocele. The patient recovered well and was followed up to 13 months after operation. To date, this was the first report of delayed hydrocephalus caused by fat embolism after AA fixation surgery. Incidental durotomy in posterior AA fixation may predispose the patient to a serious complication of fat-cerebrospinal fluid embolism and subsequent hydrocephalus. There should be a heightened awareness for such a complication. Both CT and magnetic resonance imaging are useful for the diagnosis of subarachnoid fat droplets. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Atlanto-Axial Instability in People with Down’s Syndrome and its Impact on the Ability to Perform Sports Activities – A Review

    PubMed Central

    Myśliwiec, Andrzej; Posłuszny, Adam; Saulicz, Edward; Doroniewicz, Iwona; Linek, Paweł; Wolny, Tomasz; Knapik, Andrzej; Rottermund, Jerzy; Żmijewski, Piotr; Cieszczyk, Paweł

    2015-01-01

    Atlanto-axial instability (AAI) is a developmental anomaly often occurring in persons with Down’s syndrome (DS). According to various reports, AAI affects from 6.8 to 27% of the population with DS. The aim of this review was to illustrate the issue of AAI with regard to the progressively changing state of scientific knowledge. The extended distance between the rear surface of the frontal arcus of the C1 cervical vertebra and the anterior surface of C2 cervical vertebra dens (anterior atlanto-odontoid distance, AAOD) indicates the occurrence of AAI and is detectable through X-ray examination. Hypoplasia of the C2 dens, also detectable through X-ray examination, is another suggested risk factor for AAI. According to current data, the methodology of taking measurements is inconsistent, which leads to errors in interpretation. As research focusing on AAI was progressing, new data emerged from other studies on persons with DS, suggesting that neurological symptoms in persons with DS that indicated the occurrence of spinal cord compression were an important factor in medical imaging detection of AAI. One of the main arguments supporting this thesis is that in isolated cases spinal cord (SC) damage was noted during screening examinations conducted on a large population of subjects. Moreover, cases in which the neurological symptoms indicate spinal cord compression existed long before the occurrence of the actual damage also remain of significant importance. Therefore, it is necessary to promote neurological studies on persons with DS to enable early diagnosis of spinal cord compression and, at the same time, reduce the use of medical imaging in cases of neurological symptoms. PMID:26834869

  16. The treatment of refractory atlanto-axial rotatory fixation using a halo vest: results of a case series involving seven children.

    PubMed

    Tauchi, R; Imagama, S; Kanemura, T; Yoshihara, H; Sato, K; Deguchi, M; Kamiya, M; Ishiguro, N

    2011-08-01

    We reviewed seven children with torticollis due to refractory atlanto-axial rotatory fixation who were treated in a halo vest. Pre-operative three-dimensional CT and sagittal CT imaging showed deformity of the superior articular process of C2 in all patients. The mean duration of halo vest treatment was 67 days (46 to 91). The mean follow-up was 34 months (8 to 73); at the latest review six patients demonstrated remodelling of the deformed articular process. The other child, who had a more severe deformity, required C1-2 fusion. We suggest that patients with atlanto-axial rotatory fixation who do not respond to conservative treatment and who have deformity of the superior articular process of C2 should undergo manipulative reduction and halo-vest fixation for two to three months to induce remodelling of the deformed superior articular process before C1-2 fusion is considered.

  17. Dynamic response of the occipito-atlanto-axial (C0-C1-C2) complex in right axial rotation.

    PubMed

    Chang, H; Gilbertson, L G; Goel, V K; Winterbottom, J M; Clark, C R; Patwardhan, A

    1992-05-01

    The torque-angular deformation in right axial rotation until failure of the ligamentous occipito-atlanto-axial complex subjected to variable loading rate (dynamic) axial torque was characterized using a biaxial MTS system. A special fixture and gear box that permitted right axial rotation of the specimen until failure without imposing any additional constraints were used to obtain the data. The specimens were divided into three groups and tested until failure at three different dynamic loading rates: 50, 100, and 400 degrees/s. A previous study by the authors provided data for quasi-static (4 degrees/s) loading conditions. The torque versus rotation curves can be divided into two straight regions and two transition zones. The plots clearly indicated that at loading rates higher than 4 degrees/s, the specimens became stiffer in the region of steadily increasing resistance prior to failure. The increase in stiffness was maximum at 100 degrees/s. The stiffness decreased somewhat at 400 degrees/s in comparison with 100 degrees/s, but this decrease was not significant. The resulting torque-right axial rotation curves were also examined to estimate the magnitude of maximum resistance (torque) and the corresponding angular rotation value. The average maximum resistance torque increased from 13.6 Nm at 4 degrees/s to 27.8 Nm at 100 degrees/s. The corresponding right angular rotation data (65-78 degrees), however, did not show any significant variation with loading rate. Posttest dissection of the specimens indicated that the type of injury observed was related to the rate of axial loading imposed on a specimen during testing.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. The influence of age, anthropometrics and range of motion on the morphometry of the synovial folds of the lateral atlanto-axial joints: a pilot study.

    PubMed

    Webb, Alexandra; Darekar, Angela; Rassoulian, Hamid

    2011-04-01

    The purpose of this study was to investigate the effect of age, anthropometrics and cervical range of motion upon synovial fold volume. Ten healthy female subjects aged 20-40 years were included in the study. Age, height, body mass, dimensions of the head and neck and cervical range of motion of each subject were measured. Magnetic resonance (MR) images of the cervical spine were acquired; the volume of the ventral and dorsal synovial folds of the right and the left lateral atlanto-axial joints was measured using seed growing and thresholding methods. Using Spearman's correlation coefficient, it was determined that there was no correlation between synovial fold volume and age. Synovial fold volume was positively correlated with subject height and neck length but negatively correlated with body mass, body mass index and the circumference of the head and neck. The relationship between synovial fold volume and range of cervical motion varied with the plane of movement. The ability to image the synovial folds of the lateral atlanto-axial joints using MR imaging to determine their normal morphology provides the basis for investigating synovial fold pathology in patients with neck pain and headache.

  19. Anatomical evaluation of the groove for the vertebral artery in the axis vertebrae for atlanto-axial transarticular screw fixation technique.

    PubMed

    Kazan, S; Yildirim, F; Sindel, M; Tuncer, R

    2000-01-01

    Anatomical measurements were studied on 40 dry axis vertebrae to determine the suitability of the groove for the vertebral artery for atlanto-axial transarticular screw fixation technique. We measured 13 parameters including three angular and 10 linear dimensions related to the groove of the vertebral artery, pedicle, and pars interarticularis and evaluated 80 measurements for each parameter. All measurements were done after placing a Kischner guide wire through the pedicle. We found that differences between measurements on the left and right sides of each vertebra were nonsignificant. In spite of the variability in measurements such as height, width, and median angle of the pedicle, the decline angle for instrumentation, the depth of the groove for the vertebral artery, and the internal height of the pars interarticularis, all of these had good symmetry. However, there were statistically significant differences between the sides in measurements for both the width (P=0.05) and the angle (P<0.02) of the pedicle allowing instrumentation and they did not show good symmetry. The risk of vertebral artery injury was found to be 22.5% per specimen, or 16.25% per screw inserted because the internal height of the pars interarticularis at point of fixation was atlanto-axial transarticular screw fixation is to be performed.

  20. Subluxation: dogma or science?

    PubMed Central

    Keating, Joseph C; Charlton, Keith H; Grod, Jaroslaw P; Perle, Stephen M; Sikorski, David; Winterstein, James F

    2005-01-01

    Subluxation syndrome is a legitimate, potentially testable, theoretical construct for which there is little experimental evidence. Acceptable as hypothesis, the widespread assertion of the clinical meaningfulness of this notion brings ridicule from the scientific and health care communities and confusion within the chiropractic profession. We believe that an evidence-orientation among chiropractors requires that we distinguish between subluxation dogma vs. subluxation as the potential focus of clinical research. We lament efforts to generate unity within the profession through consensus statements concerning subluxation dogma, and believe that cultural authority will continue to elude us so long as we assert dogma as though it were validated clinical theory. PMID:16092955

  1. Risk Factors for the Development and Progression of Atlantoaxial Subluxation in Surgically Treated Rheumatoid Arthritis Patients, Considering the Time Interval between Rheumatoid Arthritis Diagnosis and Surgery

    PubMed Central

    Na, Min-Kyun; Bak, Koang-Hum; Yi, Hyeong-Joong; Ryu, Je Il; Han, Myung-Hoon

    2016-01-01

    Objective Rheumatoid arthritis (RA) is a systemic disease that can affect the cervical spine, especially the atlantoaxial region. The present study evaluated the risk factors for atlantoaxial subluxation (AAS) development and progression in patients who have undergone surgical treatment. Methods We retrospectively analyzed the data of 62 patients with RA and surgically treated AAS between 2002 and 2015. Additionally, we identified 62 patients as controls using propensity score matching of sex and age among 12667 RA patients from a rheumatology registry between 2007 and 2015. We extracted patient data, including sex, age at diagnosis, age at surgery, disease duration, radiographic hand joint changes, and history of methotrexate use, and laboratory data, including presence of rheumatoid factor and the C-reactive protein (CRP) level. Results The mean patient age at diagnosis was 38.0 years. The mean time interval between RA diagnosis and AAS surgery was 13.6±7.0 years. The risk factors for surgically treated AAS development were the serum CRP level (p=0.005) and radiographic hand joint erosion (p=0.009). The risk factors for AAS progression were a short time interval between RA diagnosis and radiographic hand joint erosion (p<0.001) and young age at RA diagnosis (p=0.04). Conclusion The CRP level at RA diagnosis and a short time interval between RA diagnosis and radiographic hand joint erosion might be risk factors for surgically treated AAS development in RA patients. Additionally, a short time interval between RA diagnosis and radiographic hand joint erosion and young age at RA diagnosis might be risk factors for AAS progression. PMID:27847572

  2. Changes in articular cartilage in experimentally induced patellar subluxation

    PubMed Central

    Ryu, J.; Saito, S.; Yamamoto, K.

    1997-01-01

    OBJECTIVES—Patellar subluxation was experimentally induced in young rabbits and the resulting cartilaginous changes were observed over a prolonged period of time to determine histological changes in the subluxated patellar cartilage.
METHODS—The tibial tuberosity in 12 week old rabbits was laterally displaced and fixed to the tibia with wire to induce lateral patellar subluxation. Pathological changes in patellar cartilage were examined for 120 weeks after surgery using computed tomography and stereoscopic microscopy.
RESULTS—Eight weeks after surgery, changes in articular cartilage consisting of horizontal splitting of the matrix were observed in the intermediate zone and were presumed to have been caused by shearing stress applied to the patellar cartilage. The cartilaginous changes caused by patellar subluxation progressed very little over the 120 weeks. Very few rabbits presented with osteoarthritic changes in the patellofemoral joint, most probably because the stress resulting from the malalignment of the patellofemoral joint was mild enough to permit recovery.
CONCLUSION—The mild, non-progressive pathological changes, in particular, basal degeneration, induced in this experiment in patellar cartilage were quite similar to the changes in articular cartilage seen in human chondromalacia patellae.

 PMID:9462171

  3. Conservative treatment of patellofemoral subluxation.

    PubMed

    Henry, J H

    1989-04-01

    As pointed out in the preface of this book, patellofemoral subluxation is probably the most common knee problem seen in many orthopedists' offices today. Whereas the other authors have emphasized the anatomy and diagnosis, this article should serve as a dry but basic instruction on the exercise program that has been used in our clinic. We have had a success rate with this program of approximately 80 per cent. Certainly not all of the 20 per cent that fail require surgery. The classic exercises are quadricep sets, straight leg raises, hip abductors, hip adductors, hip flexors, and hamstring stretches, which have endured the test of time. The prevention of flexion extension activity, such as running the stadium stairs in order to strengthen the quadriceps of the patient with patellofemoral subluxation should be emphasized. Complications of conservative treatment, such as low back pain, iliopsoas tendinitis, and muscle soreness and the treatment of these is described. Finally, the importance of stretching the hamstring muscles is a cornerstone in the treatment of patellofemoral problems. Likewise, a tight IT band can put abnormal stress on the lateral aspect of the patella. In this article I have tried to point out our approach to conservative treatment of patellofemoral subluxation.

  4. Subluxation of the hip joint after internal fixation of a trochanteric fracture.

    PubMed

    Kaneko, Kazuo; Murotani, Rentaroh; Mogami, Atsuhiko; Okahara, Hitoshi; Ohbayashi, Osamu; Iwase, Hideaki; Fujita, Hidemine; Kurosawa, Hisashi

    2004-02-01

    The authors report an unusual case of hip subluxation after internal fixation without associated sepsis. We report one recently treated case in which a 75-year-old female experienced subluxation of her hip joint after open reduction and internal fixation for a trochanteric fracture. In this paper, we describe a case of progressive, spontaneous subluxation of the hip joint over several weeks. Most previously reported cases are associated with cerebral palsy. This entity has not been reported previously. Our patient was treated by hemi-arthroplasty and repair of the disrupted capsule, and achieved a good long-term functional result. The cause of this particular condition is discussed.

  5. Subluxation and semantics: a corpus linguistics study.

    PubMed

    Budgell, Brian

    2016-06-01

    The purpose of this study was to analyze the curriculum of one chiropractic college in order to discover if there were any implicit consensus definitions of the term subluxation. Using the software WordSmith Tools, the corpus of an undergraduate chiropractic curriculum was analyzed by reviewing collocated terms and through discourse analysis of text blocks containing words based on the root 'sublux.' It was possible to identify 3 distinct concepts which were each referred to as 'subluxation:' i) an acute or instantaneous injurious event; ii) a clinical syndrome which manifested post-injury; iii) a physical lesion, i.e. an anatomical or physiological derangement which in most instances acted as a pain generator. In fact, coherent implicit definitions of subluxation exist and may enjoy broad but subconscious acceptance. However, confusion likely arises from failure to distinguish which concept an author or speaker is referring to when they employ the term subluxation.

  6. Medial Patella Subluxation: Diagnosis and Treatment

    PubMed Central

    McCarthy, Mark A.; Bollier, Mathew J.

    2015-01-01

    Medial patella subluxation is a disabling condition typically associated with previous patellofemoral instability surgery. Patients often describe achy pain with painful popping episodes. They often report that the patella shifts laterally, which occurs as the medial subluxed patella dramatically shifts into the trochlear groove during early knee flexion. Physical examination is diagnostic with a positive medial subluxation test. Nonoperative treatment, such as focused physical therapy and patellofemoral stabilizing brace, is often unsuccessful. Primary surgical options include lateral retinacular repair/imbrication or lateral reconstruction. Prevention is key to avoid medial patella subluxation. When considering patellofemoral surgery, important factors include appropriate lateral release indications, consideration of lateral retinacular lengthening vs release, correct MPFL graft placement and tension, and avoiding excessive medialization during tubercle transfer. This review article will analyze patient symptoms, diagnostic exam findings and appropriate treatment options, as well as pearls to avoid this painful clinical entity. PMID:26361441

  7. Successful conservative treatment of rheumatoid subaxial subluxation resulting in improvement of myelopathy, reduction of subluxation, and stabilisation of the cervical spine. A report of two cases

    PubMed Central

    Oostveen, J.; van de Laar, M. A F J; Geelen, J.; de Graaff, R.

    1999-01-01

    OBJECTIVE—To report the efficacy of conservative treatment with cervical traction and immobilisation with a Halo vest, in two consecutive rheumatoid arthritis patients with progressive cervical myelopathy caused by subaxial subluxation.
METHODS—Description of neurological symptoms and signs and findings in plain radiography (PR) and magnetic resonance imaging (MRI) of the cervical spine before and after treatment of the subaxial subluxation by traction and immobilisation with a Halo vest during four months.
RESULTS—During four months of traction and immobilisation neurological examination showed a considerable improvement of the signs and symptoms of cervical myelopathy. Afterwards PR and MRI of the cervical spine showed reduction of the subaxial subluxation. Eventually firm stabilisation was obtained in both patients without surgery of the cervical spine.
CONCLUSION—Cervical traction and immobilisation with a Halo vest can be considered as an independent conservative treatment in rheumatoid arthritis patients with cervical myelopathy caused by subaxial subluxation.

 Keywords: rheumatoid arthrits; rheumatoid subaxial subluxation PMID:10343530

  8. When does subluxation of the first carpometacarpal joint cause swan-neck deformity of the thumb in rheumatoid arthritis: a 20-year follow-up study.

    PubMed

    Belt, E; Kaarela, K; Lehtinen, J; Kautiainen, H; Kauppi, M; Lehto, M U

    1998-01-01

    The aim of our study was to assess the incidence of subluxation of the first carpometacarpal joint (CMC I) and to evaluate which degree of subluxation produces swan-neck deformity of the thumb in rheumatoid arthritis (RA) occurring over 20 years. The hands of 83 rheumatoid factor (RF)-positive RA patients with recent (< or = 6 months) arthritis were evaluated radiographically at onset and at 1, 3, 8 and 15 years; 68 patients were evaluated at 20 years from entry. Subluxation was assessed in millimetres and compared with the MCP-I angle measurement to evaluate the thumb deformity. A statistical end-point analysis was performed between two different grades of subluxation. Subluxation of 2-3 mm was non-specific and only one third of these thumbs showed swan-neck deformity. At the end-point, subluxation of > or = 4mm was present in 17% of the thumbs, 81% of which had the swan-neck deformity; only five thumbs did not show this deformity, but presented deformed and unstable MCP I and interphalangeal joints. The frequency of swan-neck deformity was highly significantly (p < 0.0001) increased in the thumbs with severe CMC I subluxation (> or = 4 mm) compared with lesser subluxation (< 4 mm). When subluxation of the CMC I exceeds 4 mm, the swan-neck deformity of the thumb is a common consequence. This deformity is often progressive, and the hand function of such patients should be followed up carefully, both clinically and radiographically.

  9. Subluxation and semantics: a corpus linguistics study

    PubMed Central

    Budgell, Brian

    2016-01-01

    Introduction: The purpose of this study was to analyze the curriculum of one chiropractic college in order to discover if there were any implicit consensus definitions of the term subluxation. Methods: Using the software WordSmith Tools, the corpus of an undergraduate chiropractic curriculum was analyzed by reviewing collocated terms and through discourse analysis of text blocks containing words based on the root ‘sublux.’ Results: It was possible to identify 3 distinct concepts which were each referred to as ‘subluxation:’ i) an acute or instantaneous injurious event; ii) a clinical syndrome which manifested post-injury; iii) a physical lesion, i.e. an anatomical or physiological derangement which in most instances acted as a pain generator. Conclusions: In fact, coherent implicit definitions of subluxation exist and may enjoy broad but subconscious acceptance. However, confusion likely arises from failure to distinguish which concept an author or speaker is referring to when they employ the term subluxation. PMID:27385839

  10. Intraocular lens subluxation in marfan syndrome.

    PubMed

    Rodrigo, Bolaños-Jiménez; Paulina, López-Lizárraga E; Francesc, March de R; Eduardo, Telich-Tarriba J; Alejandro, Navas

    2014-01-01

    Ectopia lentis (EL) is a major criteria for the diagnosis of Marfan syndrome, it may vary from an asymptomatic mild displacement to a significant subluxation that places the equator of the lens in the pupillary axis. The purpose of this work is to present the case of a patient with Marfan syndrome who received treatment for subluxation at our institution. A 51-year-old female diagnosed with Marfan syndrome presented to the emergency department with bilateral eye redness, foreign body sensation and crusting around the eyes on awakening. She had the following history of cardiac and ophthalmologic complications, including: 1. Lens subluxation 2. High myopia 3. Aortic root dilation, 4. Mitral valve prolapse and 5. Tricuspid insufficiency. The ophthalmological management of Marfan patients is challenging and periodical follow-up is needed. Surgical versus conservative management is controversial, each case needs to be evaluated individually to analyze the risks and benefits of the procedures.

  11. Intraocular Lens Subluxation in Marfan Syndrome

    PubMed Central

    Rodrigo, Bolaños-Jiménez; Paulina, López-Lizárraga E; Francesc, March de R; Eduardo, Telich-Tarriba J; Alejandro, Navas

    2014-01-01

    Purpose : Ectopia lentis (EL) is a major criteria for the diagnosis of Marfan syndrome, it may vary from an asymptomatic mild displacement to a significant subluxation that places the equator of the lens in the pupillary axis. The purpose of this work is to present the case of a patient with Marfan syndrome who received treatment for subluxation at our institution. Case Report : A 51-year-old female diagnosed with Marfan syndrome presented to the emergency department with bilateral eye redness, foreign body sensation and crusting around the eyes on awakening. She had the following history of cardiac and ophthalmologic complications, including: 1. Lens subluxation 2. High myopia 3. Aortic root dilation, 4. Mitral valve prolapse and 5. Tricuspid insufficiency. Conclusion : The ophthalmological management of Marfan patients is challenging and periodical follow-up is needed. Surgical versus conservative management is controversial, each case needs to be evaluated individually to analyze the risks and benefits of the procedures. PMID:25279020

  12. Epidemiology of traumatic lenticular subluxation in India.

    PubMed

    Khokhar, Sudarshan; Agrawal, Saurabh; Gupta, Shikha; Gogia, Varun; Agarwal, Tushar

    2014-04-01

    To study the epidemiological and clinical profile of patients with traumatic subluxated lenses at a tertiary care center in India. Ours was a non-comparative descriptive case series. Evaluation of 71 eyes of 71 consecutive patients presenting to the lens clinic over a period of 2 years with traumatic lenticular subluxation was done. Demographic and clinical profile of patients was acquired, followed by a biomicroscopic examination of the cornea, anterior chamber, iris, lens, angles, zonules, anterior vitreous and fundus. Most of the patients were adolescents and belonged to lower socioeconomic status. The mean time lag before presenting was 33.6 months (range 5 days to 40 years) and mean visual acuity in the affected eyes was 1.67 + 0.56 logMAR. Blunt trauma (63/71) was nine times more common than penetrating trauma in the etiology of manifest subluxation. Injury while playing accounted for the highest rate of injury; sports-related injury with a gulli danda or a cricket bat and ball were the most common mode of blunt trauma while bow and arrow injury was the commonest cause of injury in the penetrating trauma subgroup. Cataract was the most frequent ocular association (53.5 %). All eyes had broken zonules and most presented with inferior subluxation (46 %). Traumatic lenticular subluxation, a unilateral cause of zonulolysis usually occurs while playing with a gulli danda, bow and arrow, or cricket bat and ball in Northern India. It is a major cause of severe visual loss and a modification in risk factors is mandatory to decrease ocular morbidity from trauma.

  13. A review of canine atlantoaxial joint subluxation.

    PubMed

    Stalin, C; Gutierrez-Quintana, R; Faller, K; Guevar, J; Yeamans, C; Penderis, J

    2015-01-01

    Atlantoaxial subluxation was first reported in dogs nearly fifty years ago. Since that time a better understanding of the aetiologies predisposing to joint laxity and instability has been achieved. Surgeons however are still trying to address the problems associated with stabilizing this joint which by nature is often required in small juvenile dogs. This review describes the various techniques used, discussing the associated benefits and complications thereby allowing the clinician to make an informed decision on the best treatment for the individual patient.

  14. Subaxial subluxation after atlantoaxial transarticular screw fixation in rheumatoid patients.

    PubMed

    Ito, Hiromu; Neo, Masashi; Sakamoto, Takeshi; Fujibayashi, Shunsuke; Yoshitomi, Hiroyuki; Nakamura, Takashi

    2009-06-01

    The most common cervical abnormality associated with rheumatoid arthritis (RA) is atlantoaxial subluxation, and atlantoaxial transarticular screw fixation has proved to be one of the most reliable, stable fixation techniques for treating atlantoaxial subluxation. Following C1-C2 fixation, however, subaxial subluxation reportedly can bring about neurological deterioration and require secondary operative interventions. Rheumatoid patients appear to have a higher risk, but there has been no systematic comparison between rheumatoid and non-rheumatoid patients. Contributing radiological factors to the subluxation have also not been evaluated. The objective of this study was to evaluate subaxial subluxation after atlantoaxial transarticular screw fixation in patients with and without RA and to find contributing factors. Forty-three patients who submitted to atlantoaxial transarticular screw fixation without any concomitant operation were followed up for more than 1 year. Subaxial subluxation and related radiological factors were evaluated by functional X-ray measurements. Statistical analyses showed that aggravations of subluxation of 2.5 mm or greater were more likely to occur in RA patients than in non-RA patients over an average of 4.2 years of follow-up, and postoperative subluxation occurred in the anterior direction in the upper cervical spine. X-ray evaluations revealed that such patients had a significantly smaller postoperative C2-C7 angle, and that the postoperative AA angle correlated negatively with this. Furthermore, anterior subluxation aggravation was significantly correlated with the perioperative atlantoaxial and C2-C7 angle changes, and these two changes were strongly correlated to each other. In conclusion, after atlantoaxial transarticular screw fixation, rheumatoid patients have a greater risk of developing subaxial subluxations. The increase of the atlantoaxial angel at the operation can lead to a decrease in the C2-C7 angle, followed by anterior

  15. Interchondral subluxation or "clicking rib syndrome".

    PubMed

    Abrahams, P

    1976-08-01

    A case history of the interchondral subluxation syndrome is presented, the anatomy as related to the symptoms discussed and the literature of this so-called "clicking-rib syndrome" reviewed. Unfortunately, this syndrome is not widely recognized but it is hoped that this article will bring it to the attention of those most likely to encounter it-the primary-care physician-and so save numerous unnecessary investigations and consultations. Once one is aware of its existence, the condition is easily diagnosed by careful history and examination alone.

  16. Glenohumeral subluxation in hemiplegia: An overview.

    PubMed

    Paci, Matteo; Nannetti, Luca; Rinaldi, Lucio A

    2005-01-01

    This review summarizes the recent advances in glenohumeral subluxation (GHS) in hemiplegic patients and analyzes the reliability and validity of clinical evaluation and the effectiveness of different treatment approaches. GHS, a common complication of stroke, can be considered an important risk factor for shoulder pain and other problems. GHS is a complex phenomenon, and its pathomechanics are not yet fully understood. Radiographic measurements are considered the best method of quantifying GHS. Clinical evaluation can be useful as screening assessment. Functional electrical stimulation and strapping are effective in an acute stage of hemiplegia; some types of slings have been shown to be effective and may be used together with other strategies.

  17. Pediatric Chiropractic Care: The Subluxation Question And Referral Risk.

    PubMed

    Homola, Samuel

    2016-02-01

    Chiropractors commonly treat children for a variety of ailments by manipulating the spine to correct a 'vertebral subluxation' or a 'vertebral subluxation complex' alleged to be a cause of disease. Such treatment might begin soon after a child is born. Both major American chiropractic associations - the International Chiropractic Association and the American Chiropractic Association - support chiropractic care for children, which includes subluxation correction as a treatment or preventive measure. I do not know of any credible evidence to support chiropractic subluxation theory. Any attempt to manipulate the immature, cartilaginous spine of a neonate or a small child to correct a putative chiropractic subluxation should be regarded as dangerous and unnecessary. Referral of a child to a chiropractor for such treatment should not be considered lest a bad outcome harms the child or leads to a charge of negligence or malpractice.

  18. Acquired Chiari malformation secondary to atlantoaxial vertical subluxation in a patient with rheumatoid arthritis combined with atlanto-occipital assimilation.

    PubMed

    Kimura, Yuiko; Seichi, Atsushi; Gomi, Akira; Kojima, Masahiro; Inoue, Hirokazu; Kimura, Atsushi

    2012-01-01

    A 65-year-old woman with a history of rheumatoid arthritis presented with a rare case of acquired Chiari malformation secondary to atlantoaxial vertical subluxation, associated with congenital atlanto-occipital assimilation. Syringomyelia and tetraparesis improved immediately after posterior fossa decompression and simultaneous occipito-cervical junction fusion. The progression of acquired Chiari malformation is not well known. We concluded that coexisting assimilation accelerated crowded foramen magnum following atlantoaxial vertical subluxation and induced acquired Chiari malformation over the course of a few years.

  19. Traumatic atlantoaxial rotatory subluxation in an adolescent: a case report

    PubMed Central

    2012-01-01

    Introduction Atlantoaxial rotatory subluxation is rarely caused by trauma in adults. Usually, the treatment of choice is traction using Halo/Gardner-Wells fixation devices for up to six weeks. Case presentation We present the case of a 19-year-old Caucasian woman with traumatic atlantoaxial subluxation. Early reduction three hours after trauma and immobilization using only a soft collar were performed and yielded very good clinical results. Conclusion In the adult population, atlantoaxial subluxation is a rare condition but is severe if untreated. Early treatment implies a non-surgical approach and a good outcome. Conservative treatment is the recommended first step for this condition. PMID:22269577

  20. PHYSICAL THERAPY INTERVENTION FOR MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION AFTER REPEATED LATERAL PATELLAR SUBLUXATION/DISLOCATION

    PubMed Central

    Mooney, Brianne; Vitale, Ashley; Apergis, Demitra; Wirth, Stephen; Grossman, Mark G.

    2016-01-01

    ABSTRACT Background The incidence of patellar subluxation or dislocation has been documented up to 43/100,000 with females more prevalent then males. There are many contributing factors involving the hip, knee, and ankle that lead to patellar subluxation. A patellar position of lateral tilt with lateral glide may indicate weakness of the vastus medialis oblique (VMO) and adductors, increased tightness in the iliotibial band, and overpowering of the vastus lateralis. Patella alta can predispose an individual to lateral dislocation due to the patella placement outside of the femoral trochlear groove with a disadvantage of boney stability. Other factors that may cause the patella to laterally sublux or dislocate during a functional activity or sporting activity include a position of femoral external rotation, tibial internal rotation, and excessive contraction of the vastus lateralis. The medial patellofemoral ligament (MPFL) aids in the prevention of a lateral patellar subluxation or dislocation. In cases where there is recurrent subluxation/dislocation and Magnetic Resonance Imaging confirms a MPFL tear, a reconstruction may be the treatment of choice. Purpose The purpose of this case series is to describe the post-surgical physical therapy management of MPFL reconstructions, outcomes using the Modified Cincinnati Knee Outcome Measure (MCKOM) and to propose staged physical therapy interventions for this pathology in the form of a treatment progression. Methods Post-operative management data and outcomes were retrospectively collected using a detailed chart review methodology from seven subjects who underwent MPFL reconstruction. Findings The Modified Cincinnati Knee Outcome Measure (MCKOM) was analyzed for each participant in four sections that were most important to the return and maintenance of participation in sport. At follow-up the mean scores for the seven subjects in Section 3 (instability) was 19.3/20, Section 4 (overall activity level) was 17.3/20, Section

  1. Cervical cyst of the ligamentum flavum and C7-T1 subluxation: case report.

    PubMed

    Gazzeri, Roberto; Galarza, Marcelo; Gorgoglione, Leonardo; Bisceglia, Michele; D'Angelo, Vincenzo

    2005-10-01

    A patient with progressive gait disturbance resulting from a cyst of the cervical ligamentum flavum associated with C7-T1 listhesis is reported. Surgical removal of the cyst improved the patient's myelopathy. Intraspinal degenerative cysts are preferentially located in the lumbar region:unusual is the cervical localization. Differential diagnosis includes ligamentum flavum cyst, synovial and ganglion cysts. Association between degenerative intraspinal cysts and listhesis is discussed. To our knowledge, this is the first case of cyst of the ligamentum flavum associated with cervical subluxation.

  2. Intracapsular lensectomy and sulcus intraocular lens fixation in dogs with primary lens luxation or subluxation.

    PubMed

    Stuhr, Charles M; Schilke, Hillary K; Forte, Christina

    2009-01-01

    To evaluate the postoperative results of lensectomy and sulcus intraocular lens fixation (SIOLF) via an ab interno approach in dogs with progressive lens subluxation or early luxation. Retrospective study. Twenty eyes from 19 dogs presented to the Animal Eye Clinic for lens luxation or subluxation between 1999 and 2006. Medical records were reviewed to evaluate preoperative lens position, vision status, intraocular pressure (IOP), and whether surgery was performed on an emergent or elective nature. Lensectomy and SIOLF were performed and postoperative status including vision, glaucoma, and retinal detachment was assessed. Average age was 8.6 years (range 4-14 years) and 55% (11/20) were terriers. Patients were followed a mean of 29.2 months (range 1-92 months) after surgery. Retinal detachment or secondary glaucoma was observed in 1 of 20 (5%) and 5 of 20 (20%) eyes, respectively, with 1 of 20 (5%) exhibiting both. Mean preoperative IOP was 16 mmHg and preoperative lens position was equally divided between luxated and subluxated lenses. Surgery was performed more frequently as an elective procedure (18/20; 90%) due to normalized IOP vs. an emergency procedure (2/20; 10%). Vision was retained in 70% (14/20) of eyes with a mean time to vision loss of 41 months in the remaining eyes due to glaucoma, retinal detachment, or retinal degeneration. Complications of glaucoma and retinal detachment after SIOLF in this study were less when compared with previously reported incidence rates in the literature for lensectomy alone which may reflect improved patient selection.

  3. Pigment dispersion syndrome associated with spontaneous subluxation of crystalline lens

    PubMed Central

    Veerwal, Vikas; Goyal, Jawahar Lal; Jain, Parul; Arora, Ritu

    2017-01-01

    Pigment dispersion syndrome (PDS) is an ocular condition characterized by a dispersion of iris pigment throughout the eye. This pigment is deposited in a characteristic manner on the corneal endothelium as Krukenberg's spindle, anterior surface of the iris, in the trabecular meshwork, on the lens and zonule and occasionally on the anterior hyaloid face. Even with deposition of pigment on zonular fibers, no zonular weakness, or zonular dehiscence has been reported in these cases. We report a unique case of PDS with bilateral spontaneous subluxation of crystalline lens. With characteristic findings of pigment distribution in both his eyes, the patient had concave iris configuration with heavily pigmented trabecular meshwork confirming the diagnosis of PDS. The patient had bilateral 180° temporal subluxation of crystalline lens in both his eyes. The usual cause of lens subluxation such as Marfan's Syndrome and Ehler's Danlos Syndrome was ruled out. The patient underwent right eye followed by left eye intracapsular cataract extraction with ab-interno technique with postoperative best-corrected visual acuity (BCVA) of 6/9 in both eyes. Spontaneous subluxation of crystalline lens in isolated PDS is not known to occur and has been reported by means of this case. We recommend a thorough assessment of zonular status in all cases of PDS. PMID:28298869

  4. Translation of Hecker's 1922 "the occipital-atlanto-axial ligament system": A study in comparative anatomy.

    PubMed

    Oakes, Peter C; Sardi, Juan Pablo; Iwanaga, Joe; Topale, Nitsa; Oskouian, Rod J; Tubbs, R Shane

    2017-04-01

    In 1922, Paul Hecker, a French physician and Head of Anatomy at the Medical College of Strasbourg, published a sentinel thesis on the ligaments of the craniocervical junction based on a study of comparative anatomy. Unfortunately, this dissertation has been lost to history and until now, was unavailable in the English language. Herein, we present a translation of Hecker's work with an update in its nomenclature, which with modern imaging capabilities of the craniocervical junction is germane and timely. Clin. Anat. 30:322-329, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  5. Biomechanics of the Atlanto-Occiptal and Atlanto-Axial Joints’ Lesions,

    DTIC Science & Technology

    1979-05-04

    lordosis , the principal acting forces are the following ones: the P2 force representing the head weight; the P1 force representing the neck muscle; and... lordosis is directed toward outside from the central axis of the vertebra’s trunk, and it can be considered according to two constituents: the P0 one...conditions of the physiological lordosis of the average degree at the C=5-100 angle, the tension force of the atlas transverse ligament (designated as R

  6. Biomechanics of Atlanto-Occipital and Atlanto-Axial Joint Injuries,

    DTIC Science & Technology

    1982-11-12

    conditions, after physiological lordosis is taken into account, the main acting forces are: the weight of the head--force P21 the force of the muscles...position, the force Pv’ because of physiological lordosis , is directed away from the cen- tral axis of the vertebral shafts and can be considered using two...and the equivalent tension force in the transverse ligament of the atlas--R. We found out that under intermediate degree of physiological lordosis

  7. Atlanto-axial langerhans cell histiocytosis in a child presented as torticollis

    PubMed Central

    Tfifha, Miniar; Gaha, Mehdi; Mama, Nadia; Yacoubi, Mohamed Taher; Abroug, Saoussen; Jemni, Hela

    2017-01-01

    Langerhans cell histiocytosis (LCH) is a rare condition mostly seen in children and adolescents. Eosinophilic granuloma (EG) is one of its three clinical entities and is considered as a benign osteolytic lesion. Many reports of patients with spine histiocytosis are well documented in the literature but it is not the case of atlantoaxial localization. We report here a new observation of atlantoaxial LCH in a 4-year-old boy revealed by persistent torticollis. He was successfully treated with systemic chemotherapy and surgery. Inter-body fusion packed by autologous iliac bone was performed with resolution of his symptoms. It is known that conservative treatment is usually sufficient and surgery should be reserved for major neurologic defects in spine EG. In atlantoaxial lesion, surgical treatment should be frequently considered. PMID:28868307

  8. Unilateral facet subluxations: an example of a missed post-traumatic unilateral facet subluxation — a case report

    PubMed Central

    Tuling, Jeffrey R; Hsu, William H

    1999-01-01

    Unilateral facet injuries occur in 4-16% of patients with cervical spine injuries, (of which unilateral facet subluxations occur as a subgroup in this population). These injuries arise in motor vehicle accidents because of flexion-distraction forces, or flexion of an already rotated head. Due to the common presentation of a lack of neurological signs and symptoms, delayed diagnosis of unilateral facet subluxations are common. As a result, it is imperative that the proper diagnosis is made so that patient care can be made more effective with ultimately less sequelae. For the clinician, diagnosis can be aided by the use of radiographic analysis. Adequate radiographic analysis is an important tool to accurately assess whiplash associated disorders. Radiographic findings of facet subluxations are subtle on routine views. Utilizing oblique views, the diagnoses are usually evident. Therefore, oblique views are very useful in the clinical setting. This case report will describe a 29-year-old female with a missed unilateral facet subluxation, radiographic findings and characteristics, and the clinical utility of oblique views in patients suffering from whiplash associated disorders. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6

  9. Bilateral C1 laminar hooks combined with C2 pedicle screw fixation in the treatment of atlantoaxial subluxation after Grisel syndrome.

    PubMed

    Morales, Luis C; Alvarado, Fernando; Corredor, José A; Rodríguez, Andrés

    2016-12-01

    Many etiologies can lead to atlantoaxial subluxaion. In Grisel syndrome (GS), this subluxation occurs spontaneously after inflammatory processes of the head and neck. Diagnosis is typically based on clinical history and a strong suspicion of this syndrome. Nonsurgical treatment most often resolves the symptoms; however, in some cases surgical treatment is necessary to repair the subluxation. Various surgical techniques and instrumentation systems have been used to treat atlantoaxial subluxation, although there is no consensus regarding the best treatment method for the pediatric population. To describe a case of atlantoaxial subluxation in a child with GS treated surgically with an alternative construct. This is a case report and literature review. Our case study involves a 5-year-old girl with a 6-month history of unresolved Fielding type II atlantoaxial subluxation caused by GS. Despite conservative treatment, the patient's symptoms continued to progress. After two failed closed reduction attempts, open reduction and C1-C2 fusion were performed with atlas laminar hook and axis pedicle polyaxial screws. A literature review of the surgical treatment of GS was also performed. After surgery, the patient exhibited full clinical and functional recovery with complete resolution of symptoms. At the 36-month follow-up examination, there was continual evidence of satisfactory reduction and fusion. No complications were observed. Upon completion of the literature review, eight GS cases were found to have been treated surgically with the minimum patient age being 9 years. Conservative management of GS is the most common and effective treatment; however, a few surgical cases have been reported in the literature with good results. Satisfactory clinical results and fusion at 36 months post surgery were seen in a pediatric patient with atlantoaxial subluxation and instability using atlas laminar hook and axis pedicle polyaxial screws. Copyright © 2016 Elsevier Inc. All rights

  10. Patellar Subluxation With Early-Phase Synovial Chondromatosis of the Knee.

    PubMed

    Bashaireh, Khaldoon M

    2016-01-01

    Primary synovial chondromatosis is a rare, benign, monoarticular disease process that affects the synovial membrane of the joint, the synovial sheath, or the bursa around the joint. The etiology is unknown, but it has been associated with trauma in some cases. Although it is a benign lesion, if left untreated, it may lead to early secondary osteoarthritis of the joint. The knee joint is affected in 50% to 65% of cases, followed by the elbow and the hip. This article reports a 30-year-old active woman who presented to the author's clinic with a large infrapatellar mass that caused lateral subluxation of the patella, swelling, and episodic pain with crepitations 14 months after direct trauma to the knee. Clinical examination, magnetic resonance imaging, and arthroscopy revealed a large infrapatellar mass causing lateral subluxation of the patella with no loose bodies. Hoffa's disease, para-articular osteochondroma, and early-phase synovial chondromatosis were considered in the differential diagnosis. The histopathologic and clinical features were consistent with early synovial chondromatosis. The patient underwent local excision of the mass through a medial parapatellar arthrotomy. At 5 years of follow-up, she had no recurrence of the lesion or progression of the disease. Early diagnosis of synovial chondromatosis with local excision offers a reliable cure. However, long-term follow-up is advised because of the high recurrence rates as well as the risk of metaplastic transformation.

  11. Medial subluxation of the patella without previous lateral retinacular release.

    PubMed

    Richman, N M; Scheller, A D

    1998-07-01

    This case presented a 17-year-old patient with persistent complaints localized to the right patellofemoral joint. Clinical examination demonstrated increased medial translation of the patella on manual stress. In contrast to previous published reports on medial patellar subluxation, this patient had not undergone prior lateral retinacular release. Arthroscopic examination documented medial tracking of the patella as well as excess medial translation. Imbrication of the patient's lateral patellar retinaculum centralized patella tracking and diminished medial translation on stress testing as observed arthroscopically and clinically. This case illustrates that medial patellar subluxation is a subtle problem that may be overlooked in the patient presenting with patellofemoral complaints and should be included in the differential diagnosis.

  12. Pediatric cerebellar infarction caused by atlantoaxial subluxation--case report.

    PubMed

    Miyata, I; Imaoka, T; Masaoka, T; Nishiura, T; Ishimitsu, H

    1994-04-01

    An 11-year-old girl developed cerebellar infarction presenting as a posterior fossa mass lesion after stretching and flexing her neck. Cerebral angiography demonstrated irregular narrowing of the right vertebral artery at the C2 level and x-rays of the upper cervical spine showed atlantoaxial subluxation with os odontoideum. She underwent surgical decompression with removal of infarcted tissue. The cerebellar infarction probably resulted from occlusion of the vertebral artery, followed by brain swelling due to recanalization.

  13. Outcome of iris fixation of subluxated intraocular lenses.

    PubMed

    Michaeli, Adi; Soiberman, Uri; Loewenstein, Anat

    2012-09-01

    The aim of this study was to evaluate the efficacy of iris fixation of subluxated intraocular lenses (IOLs). A retrospective study of 44 consecutive cases of subluxated IOLs that underwent iris fixation of the IOL. Demographic information, data regarding surgery, and follow-up were retrieved from patient files. All eyes were operated on in a similar fashion by the same anterior segment surgeon (A.M.) utilizing the McCannel suture technique and/or the Siepser slipknot technique. The main outcome measures were visual acuity improvement, surgically induced astigmatism, and assessment of complications. Ten eyes had a documented complication during primary cataract extraction. Pseudoexfoliation was present in 11 eyes (25 %). History of ocular trauma and high myopia were present in six eyes (each). Excluding eyes with macular disease and very low visual acuity, visual acuity improved from 0.4 (± 0.05) logMAR to 0.24 (± 0.05) logMAR (p = 0.047). Eyes with low pre-operative astigmatism did not worsen post-operatively (R square linear = 0.8, p < 0.01). Pupil ovalization was a major aesthetic complication (21 of 44 eyes). Major hemorrhagic complications were uncommon. One patient developed intermediate uveitis 1 year after IOL fixation. In this study of 44 eyes, iris fixation was proven to be a an effective method for treating subluxated IOLs.

  14. Spinal cord compression following traditional confinement massage.

    PubMed

    Sahathevan, R; Tan, H J; Abdullah, Suhail; Shahizon, A M M; Hamidon, B B; Raymond, A A

    2011-12-01

    We describe a case of tetraparesis in a 33-year-old woman following neck manipulation performed by a traditional confinement mid-wife. An MRI of the cervical spine revealed a fracture of the second cervical vertebra with atlanto-axial subluxation that resulted in cord compression.

  15. Not your typical torticollis: a case of atlantoaxial rotatory subluxation

    PubMed Central

    Hussain, Kosar; Mohamad Abdo, Motea; AlNajjar, Firas Jaafar Kareem; Abbo, Michael

    2014-01-01

    A 9-year-old boy was pushed while carrying a heavy backpack. He had no fall or direct trauma to his neck. After a few hours from the incident, he presented with neck pain and torticollis. However, somewhat atypical for torticollis, he was not able to rotate his face to the neutral position. There were no neurological deficits. Concerned by his inability to rotate his neck, the clinician suggested CT of the upper cervical spine, which demonstrated rotary subluxation of the atlantoaxial junction. The patient was taken to the operating theatre. Reduction was performed under general anaesthesia. He did well and was back to school in the following days. PMID:24667946

  16. Not your typical torticollis: a case of atlantoaxial rotatory subluxation.

    PubMed

    Hussain, Kosar; Abdo, Motea Mohamad; AlNajjar, Firas Jaafar Kareem; Abbo, Michael

    2014-03-25

    A 9-year-old boy was pushed while carrying a heavy backpack. He had no fall or direct trauma to his neck. After a few hours from the incident, he presented with neck pain and torticollis. However, somewhat atypical for torticollis, he was not able to rotate his face to the neutral position. There were no neurological deficits. Concerned by his inability to rotate his neck, the clinician suggested CT of the upper cervical spine, which demonstrated rotary subluxation of the atlantoaxial junction. The patient was taken to the operating theatre. Reduction was performed under general anaesthesia. He did well and was back to school in the following days.

  17. Feasibility and Complications between Phacoemulsification and Manual Small Incision Surgery in Subluxated Cataract

    PubMed Central

    Goel, Ruchi; Kamal, Saurabh; Kumar, Sushil; Kishore, Jugal; Malik, K. P. S.; Angmo Bodh, Sonam; Bansal, Smriti; Singh, Madhu

    2012-01-01

    Purpose. To compare the feasibility of cataract surgery with implantation of endocapsular supporting devices and intraocular lens (IOL) in subluxated cataract in phacoemulsification and manual small incision cataract surgery (MSICS). Design. Prospective randomized intervention case series consisting of 60 eyes with visually significant subluxated cataract. Method. The patients were randomly distributed between the two groups equally. The main outcome measure was implantation of in-the-bag IOL, requirement of additional procedure and complications, if any. Results. Capsular bag retention in subluxated lenses is possible in 90% cases in phacoemulsification versus 76.67% cases in MSICS (P = 0.16). Both groups, achieved similar best corrected visual acuity (P = 0.73), although additional procedures, intraoperative, and postoperative complications were more common in MSICS. Conclusions. Achieving intact capsulorhexis and nuclear rotation in MSICS may be difficult in cases with large nucleus size and severe subluxation, but subluxated cataracts can be effectively managed by both phacoemuslification and MSICS. PMID:22523646

  18. Accuracy of long head of the biceps subluxation as a predictor for subscapularis tears.

    PubMed

    Shi, Lewis L; Mullen, Martin G; Freehill, Michael T; Lin, Albert; Warner, Jon J P; Higgins, Laurence D

    2015-04-01

    The aim of this study is to understand the relation between long head of the biceps tendon (LHBT) subluxation and full-thickness tears of the subscapularis. Magnetic resonance imaging (MRI) scans of 94 patients undergoing shoulder arthroscopy were evaluated preoperatively for the presence or absence of LHBT subluxation. Intraoperative pathology of the biceps and subscapularis tendons was recorded. The diagnostic accuracy of LHBT subluxation on preoperative MRI in determining full-thickness subscapularis tendon tears was calculated. Of the 94 patients in this study, 26 were diagnosed with LHBT subluxation preoperatively. Of these 26 patients, 9 were confirmed to have full-thickness tears of the subscapularis tendon (Lafosse grade 2 or higher). Of the remaining 68 patients who did not appear to have LHBT subluxation preoperatively, 2 were confirmed to have full-thickness tears of the subscapularis tendon. Thus LHBT subluxation on MRI as a predictor for full-thickness subscapularis tears had a sensitivity of 82%, specificity of 80%, positive predictive value of 35%, and negative predictive value of 97%. LHBT subluxation was directly correlated with the severity of the subscapularis tendon tear (P < .001). The diagnostic value of subluxation of the LHBT, as seen on an axial MRI scan, lies primarily in its negative predictive value. If the LHBT is not subluxated, it is unlikely that a full-thickness tear of the subscapularis tendon is present. Surgeons should be cautious about relying on biceps subluxation as a primary diagnostic tool in predicting subscapularis tears. Level IV, study of diagnostic test. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  19. Modified technique of endocapsular lens aspiration for severely subluxated lenses.

    PubMed

    Khokhar, S; Aron, N; Yadav, N; Pillay, G; Agarwal, E

    2017-08-11

    PurposeSeverely subluxated crystalline lenses pose a difficult situation to anterior segment surgeons and can only be managed surgically by removal of the lens as well as the capsular bag. Several techniques have been described in literature for the management of such cases. We describe a modified technique of endocapsular lens aspiration by the limbal route for lens extraction through small incisions on the cornea.Patients and methodsThirty-two eyes of 16 consecutive patients with severely subluxated crystalline lenses were recruited in the study. All eyes underwent a modified technique of lens aspiration within the capsular bag using a single instrument, vitrectomy cutter, and irrigation cannula, followed by sacrificing of the capsular bag. The patients were either left aphakic or implanted with an open loop anterior chamber intraocular lens (ACIOL Kelman Multiflex) and prospectively followed up for a period of 3 months.ResultsThe mean age of the patients was 9 years 3 months±3 years (range 5-15 yrs). All eyes underwent complete lens aspiration within the capsular bag with no dislocation of the lens matter. ACIOL was inserted in 22 eyes (68.7%) and 10 eyes (31.2%) were left aphakic. All the surgeries were uneventful. The mean best corrected visual acuity (BCVA) at 3 months post surgery was 0.47±0.11 logMAR which was significantly better than pre-operative BCVA (P=0.001). The percentage endothelial cell loss at 3 months was 7.1%. There was no evidence of glaucoma, corneal decompensation, or retinal detachment. The astigmatism which increased from 1.45D±086 preoperatively to 3.76D±2.02 1 week post-operatively due to sutures reduced to 1.97D±0.81 post suture removal at 3 months.ConclusionThe modified technique of endocapsular lens aspiration proves to be a simple and effective method of removal of the lens-capsular bag complex in severely subluxated lenses.Eye advance online publication, 11 August 2017; doi:10.1038/eye.2017.160.

  20. [The problem of amblyopia in subluxated lenses (author's transl)].

    PubMed

    Schulz, E

    1980-01-01

    A re-evaluation of the incidence and development of amblyopia was carried out in 27 patients with a history of lens subluxation at pre-school age. Due to insufficiently accurate histories and the heterogeneous composition of the material it is impossible to make any valid statement regarding the critical phase of development of deprivation amblyopia. However, it appears that "form-deprivation" amblyopia may regress spontaneously up to early school age following hygienization of the optic media and if optimal spectacles or contact lenses are worn. In individual cases it has been shown that unilateral amblyopias can and should be treated (pleoptics) following hygienization of the optic media. Therefore, early surgical treatment should be considered in such cases, above all in view of the fact that complications are rare.

  1. FRACTURE PROPAGATION PROPENSITY OF CERAMIC LINERS DURING IMPINGEMENT-SUBLUXATION

    PubMed Central

    Elkins, Jacob M.; Pedersen, Douglas R.; Callaghan, John J.; Brown, Thomas D.

    2011-01-01

    Although improvements in materials engineering have greatly reduced fracture rates in ceramic femoral heads, concerns still exist for liners. Ceramics are vulnerable fracture due to impact, and from stress concentrations (point and line loading) such as those associated with impingement-subluxation. Thus, ceramic cup fracture propensity is presumably very sensitive to surgical cup positioning. A novel fracture mechanics finite element formulation was developed to identify cup orientations most susceptible to liner fracture propagation, for several impingement-prone patient maneuvers. Other factors being equal, increased cup inclination and increased anteversion were found to elevate fracture risk. Squatting, stooping and leaning shoe-tie maneuvers were associated with highest fracture risk. These results suggest that fracture risk can be reduced by surgeons’ decreasing cup abduction and by patients’ avoiding of specific activities. PMID:21855277

  2. Occult lens subluxation related to laser peripheral iridotomy

    PubMed Central

    Hu, Rongrong; Wang, Xiaoyu; Wang, Yang; Sun, Yang

    2017-01-01

    Abstract Rationale: Laser peripheral iridotomy (LPI) is commonly performed as a primary treatment for acute primary angle closure glaucoma after administration of anti-glaucoma medications or for prevention of this condition. Minor complications may occur following LPI and most of them do not have deleterious consequences. We report a rare case of lens subluxation that has a possible relationship with LPI treatment. Patient concerns: A 54-year-old female patient was initially referred for surgical treatment of medication-uncontrollable angle closure glaucoma in her left eye. The patient had undergone Neodymium:YAG LPI at an outside hospital 2 months prior to the presentation due to an episode of elevated intraocular pressure (IOP). About 5 days after the LPI, she had spontaneous blurred vision, redness, and pain in the left eye. Her IOP was found to re-rise and was not controlled well even with maximum tolerated anti-glaucoma medications during the following 2 months. On slit-lamp examination, the significant shallowing of both peripheral and central anterior chamber was noted in the left eye. Ultrasound biomicroscopy examination revealed the lens tilting towards the iris and the inferior zonular dehiscence corresponding to the iridotomy site. Diagnoses: Lens subluxation secondary to LPI treatment in the left eye. Interventions: Phacoemulsification combined with in-the-bag intraocular lens implantation was performed in the left eye. The zonular weakness corresponding to the iridotomy site was further confirmed during surgery. Outcomes: The patient's IOP remained stable in the first postoperative 3 months without additional anti-glaucoma medications. Lessons: Laser peripheral iridotomy may cause structural zonular damage, and ophthalmologists should be aware of this potential complication and proceed with caution. PMID:28272229

  3. Ultrasound of Extensor Carpi Ulnaris Tendon Subluxation in a Tennis Player.

    PubMed

    Spicer, Paul J; Romesberg, Amanda; Kamineni, Srinath; Beaman, Francesca D

    2016-06-01

    Wrist pain is common among competitive tennis players. Subluxation of the extensor carpi ulnaris (ECU) tendon has gained recognition as a cause of ulnar-side wrist pain in athletes. In tennis, the wrist is forcibly flexed, supinated, and ulnar deviated. These repetitive motions stress the ECU tendon stabilizers allowing tendon subluxation from the ulnar groove, especially in cases of anatomic variations such as a shallow groove. We present the presurgical and postsurgical imaging findings of recurrent ECU tendon subluxation in an elite tennis player.

  4. Atlantoaxial Subluxation due to an Os Odontoideum in an Achondroplastic Adult: Report of a Case and Review of the Literature

    PubMed Central

    Rahimizadeh, Abolfazl; Soufiani, Housain F.; Hassani, Valiolah; Rahimizadeh, Ava

    2015-01-01

    The authors report the first example of an adult achondroplastic dwarf with progressive quadriparesis secondary to atlantoaxial subluxation as a consequence of an os odontoideum. Actually, craniocervical region is a frequent site of compression and myelopathy in achondroplasia particularly in children as a result of small foramen magnum and hypertrophied opisthion. Moreover, very rarely in achondroplastic patients, coexistence of atlantoaxial instability as the sequel of os odontoideum can result in further compression of the already compromised cervicomedullary neural tissues, the scenario that has been reported only in five achondroplastic children. Herein, a 39-year-old achondroplastic male suffering such an extremely rare combination is presented. With C1-C2 screw rod instrumentation, atlas arch laminectomy, limited suboccipital craniectomy, and release of dural fibrous bands, reduction, decompression, and stabilization could be achieved properly resulting in steady but progressive recovery. PMID:26693369

  5. Planned posterior assisted levitation in severe subluxated cataract: Surgical technique and clinical results

    PubMed Central

    Lifshitz, Tova; Levy, Jaime; Kratz, Assaf; Belfair, Nadav; Tsumi, Erez

    2012-01-01

    We report the surgical technique and outcome of planned posterior assisted levitation (P-PAL) in four cases of subluxated cataract. P-PAL was planned as the preferred approach in all cases. A spatula was inserted via the pars plana, the whole lens was lifted to the anterior chamber and then removed through a scleral tunnel incision. Anterior chamber intraocular lenses were implanted in all cases. All four eyes had severe subluxation of the crystalline lenses with marked phacodonesis. Two eyes had history of blunt trauma, and the other two eyes had severe pseudoexfoliation with spontaneous lens subluxation. Follow-up ranged from 1 to 2 years in three cases. The postoperative visual acuity was 20/80 or better. No intraoperative complications were observed. In conclusion, the P-PAL technique was successfully performed during cataract surgery in four eyes with severe subluxated cataracts. There were no complications over the long-term follow-up. PMID:23202402

  6. Planned posterior assisted levitation in severe subluxated cataract: surgical technique and clinical results.

    PubMed

    Lifshitz, Tova; Levy, Jaime; Kratz, Assaf; Belfair, Nadav; Tsumi, Erez

    2012-01-01

    We report the surgical technique and outcome of planned posterior assisted levitation (P-PAL) in four cases of subluxated cataract. P-PAL was planned as the preferred approach in all cases. A spatula was inserted via the pars plana, the whole lens was lifted to the anterior chamber and then removed through a scleral tunnel incision. Anterior chamber intraocular lenses were implanted in all cases. All four eyes had severe subluxation of the crystalline lenses with marked phacodonesis. Two eyes had history of blunt trauma, and the other two eyes had severe pseudoexfoliation with spontaneous lens subluxation. Follow-up ranged from 1 to 2 years in three cases. The postoperative visual acuity was 20/80 or better. No intraoperative complications were observed. In conclusion, the P-PAL technique was successfully performed during cataract surgery in four eyes with severe subluxated cataracts. There were no complications over the long-term follow-up.

  7. Congenital Anomaly of the Atlas Misdiagnosed as Posterior Arch Fracture of the Atlas and Atlantoaxial Subluxation

    PubMed Central

    Park, Yung; Kim, Seong Min; Lee, Yun Tae; Yoo, Ju Hyung; Oh, Hyun Chul; Sung, Seung Yong; Yoon, Han Kook; Chang, Jee-Hoon; Jung, Jeung-Yeul

    2014-01-01

    Partial or complete absence of the posterior arch of the atlas is a well-documented anomaly but a relatively rare condition. This condition is usually asymptomatic so most are diagnosed incidentally. There have been a few documented cases of congenital defects of the posterior arch of the atlas combined with atlantoaxial subluxation. We report a very rare case of congenital anomaly of the atlas combined with atlantoaxial subluxation, that can be misdiagnosed as posterior arch fracture. PMID:24605195

  8. The risk factors associated with subluxation of the distal interphalangeal joint in mallet fracture.

    PubMed

    Kim, J K; Kim, D J

    2015-01-01

    Surgical fixation is recommended when a mallet fracture involves more than one-third of the articular surface of the distal phalanx. This recommendation originates from the idea that involvement of more than one-third of the base of the distal phalanx causes subluxation of the distal interphalangeal (DIP) joint. Eighty-six fingers of 85 patients with a mallet fracture involving more than one-third of the articular surface of the distal phalanx were enrolled in this study. Patients were allocated on the basis of subluxation of the DIP joint into a group with no subluxation or a group with subluxation. These two groups were compared with respect to age, sex, fracture size, fracture displacement, time to finger immobilizer application, and initial extensor lag of the DIP joint. Backward stepwise multiple logistic regression analysis was performed to identify the risk factors of DIP joint subluxation, and receiver operating curve analysis was used to calculate the optimal cut-off point for the risk factors. Half of our patients with a mallet fracture involving > one-third of the articular surface of the distal phalanx showed subluxation of the DIP joint. A significant intergroup difference was found for fracture size and time to application of a finger immobilizer, but no significant difference was observed for other parameters. The risk factors of DIP joint subluxation were fracture size and time to application of finger immobilizer. The optimal cut-off values for the development of DIP joint subluxation were 48% for the fracture size and 12.5 days for time to finger immobilizer application. © The Author(s) 2014.

  9. Postinfective skin contracture: a rare cause of fifth metatarsophalangeal joint subluxation

    PubMed Central

    Prakash, Jatin; Mehtani, Anil

    2014-01-01

    Dislocation or subluxation of the metatarsophalangeal joint (MTP) is common and usually follows a traumatic event. Non-traumatic causes usually include inflammatory arthritis (rheumatoid arthritis), connective tissue disorders, crowded shoewear or flexor digitorum longus tendon contracture. We present a very unusual case of subluxation of the fifth MTP joint following a postboil skin contracture. The case was treated with the release of contracture by Z-plasty. It resulted in concentric reduction of the joint and normal skin healing. PMID:25199201

  10. Osteochondral humeral head fracture after posterior shoulder subluxation: A case report

    PubMed Central

    Fandridis, Emmanouil; Stavropoulos, Spiros; Dimou, Leonidas; Spyridonos, Sarantis

    2014-01-01

    Traumatic posterior shoulder subluxations are rare entities which require clinical suspicion upon presentation. Although literature presents many sequels of posterior shoulder subluxations, we have not come across any shearing type osteochondral fracture in the literature. In this case report we present diagnosis, treatment and follow-up results of this rare fracture in a 26-year-old male following a fall from a motorcycle. PMID:25114417

  11. Retro-Odontoid Pseudotumor without Atlantoaxial Subluxation or Rheumatic Arthritis

    PubMed Central

    Yu, Seung Han; Choi, Hyuk Jin; Cho, Won Ho; Cha, Seung Heon

    2016-01-01

    We present a case of retro-odontoid pseudotumor (ROP) without rheumatoid arthritis (RA) or atlantoaxial subluxation (AAS). A 76-year-old woman presented with paresthesia and weakness of both lower and upper extremities. She had no laboratory or physical findings of RA. Dynamic X-ray showed no AAS and magnetic resonance imaging (MRI) showed a retro-odontoid mass compressing the spinal cord. Transdural mass debulking and biopsy were performed via minimal left suboccipital craniectomy and C1 hemilaminectomy. Two months after surgery, her symptoms were aggravated. Follow-up MRI visualized mass re-growth and spinal cord compression due to the mass and AAS. Posterior C1-2 fixation was performed without further decompression. Twelve months after posterior fixation, no symptoms were apparent and follow-up MRI showed complete resolution of the ROP with C1-2 bony fusion. The ROP with C1-2 instability might be completely resolved only C1-2 fusion without decompression. Furthermore, we speculated that osteoarthritis of C1-2 itself causes a partial tear or degradation of the transverse ligament, that induced formation of ROP. PMID:27857933

  12. The Effect of Subluxation of Articulating Antibiotic Spacers on Bone Defects and Degree of Constraint in Revision Knee Arthroplasty.

    PubMed

    Lau, Adrian C K; Howard, James L; Macdonald, Steven J; Teeter, Matthew G; Lanting, Brent A

    2016-01-01

    This study investigated whether subluxation of articulating antibiotic spacers is associated with the bone defects found and constraint required when re-implanting the knee arthroplasty components. Staged revisions for infections of primary total knee arthroplasties between 2004 and 2012 were examined. Radiographic sagittal and coronal subluxations of 72 knees were measured prior to second stage revision. Coronal subluxation was found to be associated with increased requirement for constrained knee systems (P<0.035). Sagittal subluxation was associated with greater tibia bone defects (P<0.037). Careful surgical technique and monitoring of articulating spacers should be done to avoid subluxation after stage 1 revision. If subluxation of the articulating spacer is present, constrained revision knee systems as well as augments should be available at time of re-implantation.

  13. Lens Subluxation after Plasmin and SF6 Injections in Rabbit Eyes

    PubMed Central

    Wu, Wei-Chi; Liu, Chi-Hsien; Wang, Nan-Kai; Chen, Kwan-Jen; Chen, Tun-Lu; Hwang, Yih-Shiou; Liao, Pei-Ju; Li, Lien-Min; Lai, Chi-Chun

    2014-01-01

    Purpose To investigate the rate of lens subluxation following plasmin and/or SF6 injections in eyes, and whether a subsequent elevated level of vascular endothelial growth factor (VEGF) and vitreous tap would aggravate subluxation. Methods Four groups of rabbits were used. Group 1 received an intravitreal injection (IVI) of plasmin and SF6 in the right eye; group 2 received an IVI of plasmin in the right eye; group 3 received an IVI of SF6 in the right eye; and group 4 received an IVI of balanced salt solution in the right eye. After treatment, IVIs of VEGF were given and vitreous tap was performed three times, followed by clinical observation of lens subluxation and scanning electronic microscope evaluation of the zonular fibers. Results After IVIs of plasmin and SF6, and VEGF and vitreous tap had been performed one to three times, lens subluxation was noted in 0%, 43%, 71%, 71%, and 86% of the eyes in group 1. After IVIs of plasmin, VEGF, and vitreous tap had been performed one to three times, lens subluxation was noted in 11%, 22%, 44%, 44%, and 67% of the eyes in group 2. The eyes in group 3 and 4 did not show signs of lens subluxation after VEGF IVIs and vitreous tap. Histology confirmed zonular fiber damage in the eyes treated with plasmin. Conclusions The incidence of lens subluxation increased following plasmin injections in the eyes, and this was aggravated by the subsequent high VEGF level in the eyes and vitreous tapping. Zonular fibers were disrupted following plasmin treatment. These effects should be kept in mind when using plasmin enzymes in patients with vitreoretinal abnormalities. PMID:25397749

  14. Atlanto-axial approach for cervical myelography in a Thoroughbred horse with complete fusion of the atlanto-occipital bones

    PubMed Central

    Aleman, Monica; Dimock, Abigail N.; Wisner, Erik R.; Prutton, Jamie W.; Madigan, John E.

    2014-01-01

    A 2-year-old Thoroughbred gelding with clinical signs localized to the first 6 spinal cord segments (C1 to C6) had complete fusion of the atlanto-occipital bones which precluded performing a routine myelogram. An ultrasound-assisted myelogram at the intervertebral space between the atlas and axis was successfully done and identified a marked extradural compressive myelopathy at the level of the atlas and axis, and axis and third cervical vertebrae. PMID:25392550

  15. Atlanto-axial approach for cervical myelography in a Thoroughbred horse with complete fusion of the atlanto-occipital bones.

    PubMed

    Aleman, Monica; Dimock, Abigail N; Wisner, Erik R; Prutton, Jamie W; Madigan, John E

    2014-11-01

    A 2-year-old Thoroughbred gelding with clinical signs localized to the first 6 spinal cord segments (C1 to C6) had complete fusion of the atlanto-occipital bones which precluded performing a routine myelogram. An ultrasound-assisted myelogram at the intervertebral space between the atlas and axis was successfully done and identified a marked extradural compressive myelopathy at the level of the atlas and axis, and axis and third cervical vertebrae.

  16. Posterior-assisted levitation: outcomes in the retrieval of nuclear fragments and subluxated intraocular lenses.

    PubMed

    Por, Yong Ming; Chee, Soon-Phaik

    2006-12-01

    To report the outcomes of posterior-assisted levitation (PAL) to retrieve nuclear fragments and subluxated intraocular lenses (IOLs). Singapore National Eye Centre, Singapore, Singapore. In a retrospective series, the case notes of consecutive surgeries performed by a single surgeon between 1999 and 2006 were reviewed. Posterior-assisted levitation was performed for intraoperative posterior capsule rupture with nucleus-IOL dislocation or for late subluxation of posterior chamber intraocular lenses (PC IOLs). This was accomplished by the pars plana insertion of a needle followed by levitation of the subluxated object. Ophthalmic viscosurgical device injection was not used as an adjunct for levitation. Fourteen patients with PAL were followed for a mean of 18.71 months (range 1 to 79 months). There were 3 cases of dropped nucleus/nuclear fragments, 1 case of intraoperative subluxated PC IOL, and 10 cases of late subluxated PC IOLs. Complications included 1 case of retinal detachment occurring 20 months after PAL and 1 case of cystoid macular edema in a patient with previous anterior uveitis. Best corrected visual acuity was 20/40 or better in all except 3 patients (1 retinal detachment, 1 corneal edema/scarring, 1 unspecified). Posterior-assisted levitation provided an effective, relatively noninvasive means of levitating nuclear fragments and PC IOLs with few complications.

  17. Static and dynamic components of the chiropractic subluxation complex: a literature review.

    PubMed

    Dishman, R W

    1988-04-01

    Intervertebral dysfunction refers to a biomechanical fault which is abnormal in both its dynamic and static components. A subluxation may be considered as being fixated and also slightly malpositioned in one or more axes of rotation. Subluxation may be considered as one component of a complex or syndrome of intervertebral dyskinesia, dysarthrosis or dysfunction. The biochemical and histological components explain some of the pain mechanisms, tissue changes and residual effects of acute and chronic intervertebral fixation and the need for repeated spinal manipulations and prolonged care. Interexaminer reliability studies indicate that a standard method of motion palpation is quite feasible and accurate. X-ray evidence of dyskinesia shows promise as a means of documenting subluxation fixations.

  18. Prediction of motor outcome by shoulder subluxation at early stage of stroke

    PubMed Central

    Jang, Sung Ho; Yi, Ji Hyun; Chang, Chul Hoon; Jung, Young Jin; Kim, Seong Ho; Lee, Jun; Seo, Jeong Pyo

    2016-01-01

    Abstract We attempted to determine whether shoulder subluxation at the early stage of stroke can predict motor outcome in relation to the corticospinal tract (CST) state on diffusion tensor tractography. Fifty-nine stroke patients with severe hemiparesis were recruited. The patients were classified according to the distance of shoulder subluxation (group A: ≥2 cm, group B: <2 cm) and the affected CST on diffusion tensor tractography at the first evaluation (CST type A—the CST was discontinued at the stroke lesion; CST type B—the integrity of the CST was preserved). Motor function of the patients was evaluated twice (first: beginning of rehabilitation—24.1 ± 16.6 days; second: discharge after first rehabilitation—58.5 ± 24.1 days) using the Medical Research Council score, Motricity Index, and Modified Brunnstrom Classification. Regarding the improvement of the Medical Research Council for the finger extensor and upper Motricity Index, the order in terms of better recovery was as follows: group B–type B, group A–type B, group B–type A, and group A–type A (P < 0.05). The distance of shoulder subluxation showed significant correlation with improvement of the finger extensor (moderate negative correlation, r = −0.37) and improvement of the Modified Brunnstrom Classification (weak negative correlation, r = −0.29) (P < 0.05). The presence of shoulder subluxation at the early stage of stroke can be a predictor of motor outcome of the affected upper extremity and the degree of shoulder subluxation can be a predictor of the motor function of the affected hand. Therefore, our results suggest that shoulder subluxation in relation to the affected CST state at the early stage of stroke can be a prognostic factor for motor outcome. PMID:27512873

  19. Prediction of motor outcome by shoulder subluxation at early stage of stroke.

    PubMed

    Jang, Sung Ho; Yi, Ji Hyun; Chang, Chul Hoon; Jung, Young Jin; Kim, Seong Ho; Lee, Jun; Seo, Jeong Pyo

    2016-08-01

    We attempted to determine whether shoulder subluxation at the early stage of stroke can predict motor outcome in relation to the corticospinal tract (CST) state on diffusion tensor tractography.Fifty-nine stroke patients with severe hemiparesis were recruited. The patients were classified according to the distance of shoulder subluxation (group A: ≥2 cm, group B: <2 cm) and the affected CST on diffusion tensor tractography at the first evaluation (CST type A-the CST was discontinued at the stroke lesion; CST type B-the integrity of the CST was preserved). Motor function of the patients was evaluated twice (first: beginning of rehabilitation-24.1 ± 16.6 days; second: discharge after first rehabilitation-58.5 ± 24.1 days) using the Medical Research Council score, Motricity Index, and Modified Brunnstrom Classification.Regarding the improvement of the Medical Research Council for the finger extensor and upper Motricity Index, the order in terms of better recovery was as follows: group B-type B, group A-type B, group B-type A, and group A-type A (P < 0.05). The distance of shoulder subluxation showed significant correlation with improvement of the finger extensor (moderate negative correlation, r = -0.37) and improvement of the Modified Brunnstrom Classification (weak negative correlation, r = -0.29) (P < 0.05).The presence of shoulder subluxation at the early stage of stroke can be a predictor of motor outcome of the affected upper extremity and the degree of shoulder subluxation can be a predictor of the motor function of the affected hand. Therefore, our results suggest that shoulder subluxation in relation to the affected CST state at the early stage of stroke can be a prognostic factor for motor outcome.

  20. Current and future interventions for glenohumeral subluxation in hemiplegia secondary to stroke.

    PubMed

    Stolzenberg, David; Siu, Gilbert; Cruz, Ernesto

    2012-01-01

    Poststroke shoulder pain is a common issue and can be caused by glenohumeral subluxation. This entity hinders function and quality of life and is caused by changes in tone and loss of fi ne control of the shoulder joints' supporting structures after a stroke. Current treatments are limited in number and effectiveness and have significant problems and limitations to their use. Furthermore, prior to percutaneous implantable neuromuscular electrical stimulation, there was no evidence for any treatment to provide relief for chronic hemiplegic shoulder pain from glenohumeral subluxation. This clinical review provides a comprehensive review of the anatomy, pathogenesis, clinical features, management, and clinical efficacy of current treatment modalities.

  1. Thoracolumbar kyphoscoliosis with unilateral subluxation of the spine and postoperative lumbar spondylolisthesis in Hunter syndrome.

    PubMed

    Roberts, Simon B; Tsirikos, Athanasios I

    2016-03-01

    Surgical correction for kyphoscoliosis is increasingly being performed for patients with mucopolysaccharidosis (MPS). Reported case series have predominantly included patients with Type I (Hurler) and Type IV (Morquio) MPS. To their knowledge, the authors describe the first case report of surgical management of thoracolumbar kyphoscoliosis in Hunter syndrome (MPS Type II) and the rare occurrence of lumbar spondylolisthesis following surgical stabilization. A 12-year-old boy with Hunter syndrome presented with severe thoracolumbar kyphoscoliosis and no associated symptoms. Spinal radiographs demonstrated kyphosis of 48° (T11-L3) and scoliosis of 22° (T11-L3) with an anteriorly hypoplastic L-1 vertebra. The deformity progressed to kyphosis of 60° and scoliosis of 42° prior to surgical intervention. Spinal CT scans identified left T12-L1 facet subluxation, causing anterior rotatory displacement of the spine proximal to L-1 and bilateral L-5 isthmic spondylolysis with no spondylolisthesis. A combined single-stage anterior and posterior instrumented spinal arthrodesis from T-9 to L-4 was performed. Kyphosis and scoliosis were corrected to 4° and 0°, respectively. Prolonged ventilator support and nasogastric feedings were required for 3 months postoperatively. At 2.5 years following surgery, the patient was asymptomatic, mobilizing independently, and had achieved a solid spinal fusion. However, he had also developed a Grade II spondylolisthesis at L4-5; this was managed nonoperatively in the absence of symptoms or further deterioration of the spondylolisthesis to the 3.5-year postoperative follow-up visit. Satisfactory correction of thoracolumbar kyphoscoliosis in Hunter syndrome can be achieved by combined anterior/posterior instrumented arthrodesis. The risk of developing deformity or instability in motion segments adjacent to an instrumented fusion may be greater in patients with MPS related to the underlying connective tissue disorder.

  2. Passive Rotation Range of Motion and Shoulder Subluxation: A Comparative Study

    PubMed Central

    Stanish, William; Kozey, Cheryl

    2009-01-01

    Background Conflicting reports of range of motion (ROM) findings exist related to shoulder instability. Knowledge of range of motion findings among individuals with shoulder subluxation may aid in diagnosis and facilitate appropriate management. Purpose The purpose of this study was to compare passive rotation ROM and determine if a symptom-provoking activity alters ROM between patients with shoulder subluxations and healthy controls. Methods Seventeen symptomatic patients with shoulder subluxations and 14 healthy controls between the ages of 18 and 35 years were recruited. Lateral and medial rotation ROM measures were taken using a universal goniometer. Symptoms were assessed using a 10cm visual analog scale (VAS). Each group performed a symptom-provoking activity, and VAS and ROM measures were repeated. Results A two-factor analysis of variance with repeated measures on pre/post activity demonstrated lower medial rotation measures for the instability group, but no differences for lateral rotation or total range (p < 0.05). A “warm-up” effect was noted, with greater ROM found in each group post activity, with a greater increase noted among controls. Analysis of the ratio of lateral rotation to medial rotation ROM found a significantly greater ratio in the instability group. VAS pain scores were greater in the instability group. Conclusion Shoulder subluxation is not necessarily associated with increased rotation ROM, therefore total ROM findings should not be used to screen for instability. Imbalances in rotation ROM may be associated with symptomatic shoulder instability and may have implications for treatment. PMID:21509102

  3. Pilot study of a robotic protocol to treat shoulder subluxation in patients with chronic stroke

    PubMed Central

    2013-01-01

    Background Shoulder subluxation is a frequent complication of motor impairment after stroke, leading to soft tissue damage, stretching of the joint capsule, rotator cuff injury, and in some cases pain, thus limiting use of the affected extremity beyond weakness. In this pilot study, we determined whether robotic treatment of chronic shoulder subluxation can lead to functional improvement and whether any improvement was robust. Methods 18 patients with chronic stroke (3.9 ± 2.9 years from acute stroke), completed 6 weeks of robotic training using the linear shoulder robot. Training was performed 3 times per week on alternate days. Each session consisted of 3 sets of 320 repetitions of the affected arm, and the robotic protocol alternated between training vertical arm movements, shoulder flexion and extension, in an anti-gravity plane, and training horizontal arm movements, scapular protraction and retraction, in a gravity eliminated plane. Results Training with the linear robot improved shoulder stability, motor power, and resulted in improved functional outcomes that were robust 3 months after training. Conclusion In this uncontrolled pilot study, the robotic protocol effectively treated shoulder subluxation in chronic stroke patients. Treatment of subluxation can lead to improved functional use of the affected arm, likely by increasing motor power in the trained muscles. PMID:23914834

  4. Radial ridge excision for symptomatic volar tendon subluxation following de Quervain's release.

    PubMed

    Collins, Evan D

    2014-09-01

    Traditional surgical release to address de Quervain's stenosing tenosynovitis can lead to the rare complication of volar tendon subluxation. This study presents a surgical procedure, which entails excision of the radial ridge as an alternative treatment to relieve pain associated with symptomatic volar tendon subluxation following de Quervain's release. The procedure was performed on 6 patients complaining of painful volar tendon subluxation of abductor pollicis longus (APL) and extensor pollicis brevis (EPB), following a first dorsal compartment release and postoperative splinting. We opened the same incision sharply, with direct view of the tendons of the first dorsal compartment. The wrist was ranged through extension and flexion, and volar subluxation of the APL and EPB over the prominent radial ridge was confirmed. The bony portion of the radial ridge was excised and filed smooth. The periosteal flap is advanced over the ridge and sutured into place. The APL and EPB tendons were released from dorsal retractors. All patients reported relief upon follow-up. Excision of this ridge removes the obtrusive friction to the APL and EPB tendons, allowing them to glide painlessly over the radial styloid.

  5. Siepser slipknot for McCannel iris-suture fixation of subluxated intraocular lenses.

    PubMed

    Chang, David F

    2004-06-01

    In 8 cases that presented with symptomatic posterior chamber IOL subluxation, a McCannel polypropylene (Prolene) suture was used with the Siepser slipknot technique to successfully refixate the IOLs to the iris. There were no intraoperative complications, and a round pupil was preserved in all cases.

  6. Pilot study of a robotic protocol to treat shoulder subluxation in patients with chronic stroke.

    PubMed

    Dohle, Carolin I; Rykman, Avrielle; Chang, Johanna; Volpe, Bruce T

    2013-08-05

    Shoulder subluxation is a frequent complication of motor impairment after stroke, leading to soft tissue damage, stretching of the joint capsule, rotator cuff injury, and in some cases pain, thus limiting use of the affected extremity beyond weakness. In this pilot study, we determined whether robotic treatment of chronic shoulder subluxation can lead to functional improvement and whether any improvement was robust. 18 patients with chronic stroke (3.9 ± 2.9 years from acute stroke), completed 6 weeks of robotic training using the linear shoulder robot. Training was performed 3 times per week on alternate days. Each session consisted of 3 sets of 320 repetitions of the affected arm, and the robotic protocol alternated between training vertical arm movements, shoulder flexion and extension, in an anti-gravity plane, and training horizontal arm movements, scapular protraction and retraction, in a gravity eliminated plane. Training with the linear robot improved shoulder stability, motor power, and resulted in improved functional outcomes that were robust 3 months after training. In this uncontrolled pilot study, the robotic protocol effectively treated shoulder subluxation in chronic stroke patients. Treatment of subluxation can lead to improved functional use of the affected arm, likely by increasing motor power in the trained muscles.

  7. Long-term clinical and radiographic follow up of subluxated and intruded maxillary primary anterior teeth.

    PubMed

    Qassem, Aya; Martins, Nathália da Motta; da Costa, Vanessa Polina Pereira; Torriani, Dione Dias; Pappen, Fernanda Geraldo

    2015-02-01

    This study aimed to determine the kinds of sequelae resulting from intrusive luxation and subluxative injuries in primary anterior teeth as well as the timing of such sequelae. In this longitudinal retrospective study, data were collected from dental records and radiographs of patients with traumatic dental injury (TDI) treated at the Centre for the Study and Treatment of Dental Trauma in Primary Dentition (Pelotas, RS, Brazil). Fifty-two children, with seventy intruded teeth, and 76 children, with 99 subluxated teeth, met the inclusion criteria. Sequelae, such as crown discoloration, fistula, pulp canal obliteration (PCO), inflammatory root resorption (IRR), and internal root resorption, were investigated. The data on the sequelae were distributed into eight follow-up periods: 0-30 days, 31-90 days, 91-180 days, 181-365 days, 1-2 years, 2-3 years, 3-4 years, and >4 years. The sample comprised 99 subluxation cases and 70 intruded teeth. Crown discoloration was the most prevalent sequelae. Among the subluxated teeth, <50% of IRR, fistula, crown discoloration, and PCO occurred within 180 days after TDI; however, the sequelae were also diagnosed after longer periods. Majority of sequelae of intrusion were diagnosed within the 181-365 days and 1-2 years periods but were also observed after more than 4 years of follow up. For both intrusion and subluxation, trauma sequelae were diagnosed even after the 3-4 years of follow-up. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. [Unusual presentation of juvenile idiopathic arthritis and autoimmune hepatitis].

    PubMed

    Moreno Prieto, M; Carbonero Celis, M J; Cuadrado Caballero, M C

    2015-01-01

    The coexistence of autoimmune hepatitis and juvenile idiopathic arthritis is very rare. This is the case of an 18 month old female patient whose first sign of disease was torticollis due to an underlying atlanto-axial subluxation. Three months later, bilateral knee arthritis developed and she was diagnosed with Juvenile Idiopathic Arthritis. Throughout the disease a persistent elevation of liver enzymes was noted, combined with positive antinuclear antibodies and hypergammaglobulinemia, reaching the diagnosis of concomitant autoimmune hepatitis.

  9. Subluxation of the shoulder joint in stroke patients and the influence of selected factors on the incidence of instability.

    PubMed

    Pop, Teresa

    2013-06-28

    The aim of the study was to evaluate the incidence of shoulder subluxation in stroke patients and the impact of rehabilitation and presence/absence of fluid in the subhumeral and subdeltoid bursae on the occurrence of instability. The study group was composed of 182 patients after stroke, with 108 men and 74 women. 156 of the patients had suffered an ischemic stroke whereas 26 had experienced a hemorrhagic stroke; 90 patients had right-sided paresis and 92 left-sided paresis. The study variables were evaluated by performing, on two occasions, an ultrasound examination of the shoulder and an assessment of upper limb functional capacity using the Brunnström scale. 182 patients of the study group participated in an exercise programme according tothe PNF concept. There was no subluxation of the shoulder on the healthy side, while on the paretic side, subluxation occurred in 25.3% of the patients. Bursal fluid was seen more frequently on the paretic side (12.6%). A statistically significant reduction of the subluxation and bursal fluid was achieved after the rehabilitation. Subluxation occurred more frequently in patients with a known presence of fluid in the bursae and in those with poorer functional capacity of the upper limb. 1. The clinical symptoms of stroke are the cause of subluxation in the shoulder joint. 2. Subluxation occurs more frequently in patients with a known presence of fluid in the subhumeral and subdeltoid bursae and in patients with reduced functional capacity. 3. The reduction of subluxation and bursal fluid was influenced by the exercise program and improved functional capacity.

  10. Atlantoaxial Rotatory Subluxation after Removal of a Ventriculoperitoneal Shunt in the Supine-Lateral Position.

    PubMed

    Hashide, Shusei; Aihara, Yasuo; Nagahara, Ayumi; Mitsuyama, Tetsuryu; Okada, Yoshikazu

    2015-01-01

    Atlantoaxial rotatory subluxation (AARS) is an uncommon disease with a greater prevalence in children than adults. So far there has only been one report of AARS after surgery related to ventriculoperitoneal (VP) shunting. We present a new case of AARS closed reduction treatment after VP shunt removal in an 8-year-old girl with wound pain on the back of her head and torticollis after surgery. Her head was rotated in the spine-lateral position during surgery. The diagnosis of AARS was established by 3D-computed tomography. The rotatory subluxation was cured after cervical traction therapy. The successful closed reduction was the consequence of early detection and conservative treatment, which are important constituents in the management of AARS. © 2015 S. Karger AG, Basel.

  11. Proximal tibiofibular subluxation relationship to lateral knee pain: a review of proximal tibiofibular joint pathologies.

    PubMed

    Semonian, R H; Denlinger, P M; Duggan, R J

    1995-05-01

    Proximal tibiofibular subluxation is the symptomatic hypermobility of the proximal tibiofibular joint. Pain along the lateral aspect of the knee must be carefully evaluated as the anatomy and biomechanics of this region are very complex. Anatomical variants of the proximal tibiofibular joint may be key to understanding the pathomechanics and, thus, treatment of this joint. The "horizontal" proximal tibiofibular joint has a higher degree of mobility, while the "oblique" joint is relatively immobile to rotational forces on the fibula. Increased fibular external rotation will result in injury to the anterior capsule and ligaments of the proximal tibiofibular joint causing common complaints of "popping" and lateral knee pain. Treatment of proximal tibiofibular subluxation will involve modifications of a patient's activity level and training programs, utilization of a supportive strap, lower leg strengthening, and modifications in the lower kinetic chain biomechanics.

  12. Investigation into the heredity of congenital lateral patellar (sub)luxation in the Shetland pony.

    PubMed

    Hermans, W A; Kersjes, A W; van der Mey, G J; Dik, K J

    1987-01-01

    A breeding experiment was carried out in a group of Shetland ponies in order to investigate the heredity of congenital lateral patellar (sub)luxation. A breeding herd was established and consisted of stallions and mares acquired at different times. Some were free from, and others were affected by lateral patellar (sub)luxation in either one or both femoropatellar joints. Over a period of 20 years, 49 foals were born from different mating combinations. Some offspring were free from the defect and others showed the abnormality. Though the number of foals bred during the experiment is rather small, there is sufficient evidence to suggest a monogenic autosomal recessive hereditary transmission of the defect.

  13. Eye Popping Disease: Common Characteristics and Management of Spontaneous Globe Subluxation.

    PubMed

    Jones, Scott T; Ho, Son T; Maleki, Babak; Valenzuela, Alejandra A

    2012-01-01

    The objective of this study was to describe the clinical features, predisposing factors, and management of 8 new cases of spontaneous globe subluxation (SGS) and provide a review of the relevant literature. Patient demographics, clinical presentations, investigations, management, complications, and outcomes were measured. This was a retrospective, case-note analysis of 8 patients with SGS and a major review of the English-language literature. Eight new cases of spontaneous globe subluxation were identified with varying clinical manifestations and treatments. Literature review has shown less than 50 cases. Space-occupying lesions such as thyroid eye disease, shallow orbits, and floppy eyelids were major contributors to predisposition to SGS. Orbital congestion, shallow orbits, and floppy eyelids can all play a role in predisposing patients to SGS. Successful surgical management of SGS, when required, should be tailored to the individual patient profile for best results.

  14. Asymptomatic moyamoya syndrome, atlantoaxial subluxation and basal ganglia calcification in a child with Down syndrome.

    PubMed

    Lee, Kyung Yeon; Lee, Kun-Soo; Weon, Young Cheol

    2013-12-01

    Down syndrome, the most common chromosomal abnormality, may be associated with various neurologic complications such as moyamoya syndrome, cervical spinal cord compression due to atlantoaxial subluxation, and basal ganglia damage, as well as epileptic seizures and stroke. Many cases of Down syndrome accompanied by isolated neurologic manifestations have been reported in children; however, Down syndrome with multiple neurologic conditions is rare. Here, we have reported a case of Down syndrome in a 10-year-old girl who presented with asymptomatic moyamoya syndrome, atlantoaxial subluxation with spinal cord compression, and basal ganglia calcification. To the best of our knowledge, this is the first report of Down syndrome, in a child, which was accompanied by these 3 neurologic complications simultaneously. As seen in this case, patients with Down syndrome may have neurologic conditions without any obvious neurologic symptoms; hence, patients with Down syndrome should be carefully examined for the presence of neurologic conditions.

  15. Combined intra-articular and extra-articular reconstructions for anterior tibial subluxation.

    PubMed

    Zarins, B

    1985-04-01

    This article describes several procedures that combine intra-articular techniques with extra-articular techniques to stabilize the knee with anterior tibial subluxation. The procedures detailed are reconstruction using the semitendinosus tendon and the iliotibial tract; tenodesis using a strip of iliotibial tract combined with intra-articular reconstruction of the anterior cruciate ligament with the central third of the patellar tendon; "mini-reconstruction"; and a procedure utilizing a vascularized patellar tendon graft plus "dynamic" augmentation.

  16. Sonographic detection of inferior subluxation in post-stroke hemiplegic shoulders.

    PubMed

    Idowu, Bukunmi M; Ayoola, Oluwagbemiga O; Adetiloye, Victor A; Komolafe, Morenikeji A; Afolabi, Babalola I

    2017-06-01

    To evaluate the usefulness of ultrasonographic acromion-greater tuberosity distance measurement and Shoulder ratio in detecting post-stroke inferior shoulder subluxation. Forty-five hemiplegic stroke patients and 45 controls underwent shoulder sonography to measure their acromion-greater tuberosity distance. Side-to-side acromion-greater tuberosity distance differences and Shoulder ratios were derived from the acromion-greater tuberosity distance values. The long head of biceps tendon, subscapularis tendon, supraspinatus tendon, and the infraspinatus tendon were also evaluated to exclude full thickness tendon tears. Data were analyzed using the Statistical Package for Social Sciences version 20.0 for windows. Normality of data distribution was checked using the Kolmogorov-Smirnov test. Mann-Whitney U test and Chi-square tests were utilized. Hemiplegic and control shoulders' acromion-greater tuberosity distance values were 2.8 ± 0.6 cm and 2.4 ± 0.4 cm, respectively (p = 0.001). Hemiplegic and control shoulder ratios were 1.3 ± 0.3 and 1.1 ± 0.1, respectively; p < 0.001. Point biserial correlation showed that the presence of subluxation correlated moderately with higher shoulder ratios in all the hemiplegics (rpb = 0.520; p < 0.001). Our results suggest that acromion-greater tuberosity distance measurement is useful for detecting inferior shoulder subluxation. Shoulder ratio may be of complementary or supplemental value to acromion-greater tuberosity distance difference.

  17. Microscopic evaluation of induced tooth movement after subluxation trauma: an experimental study in rats

    PubMed Central

    Busato, Mauro Carlos Agner; Pereira, Alex Luiz Pozzobon; Sonoda, Celso Koogi; Cuoghi, Osmar Aparecido; de Mendonça, Marcos Rogério

    2014-01-01

    Objective The objective of this study was to assess the histological alterations that occurred in the periodontal area of rat molars submitted to induced tooth movement (ITM) right after an intentional trauma (subluxation). Methods Forty adult male Wistar rats (Rattus norvegicus albinus) were selected. The animals were divided into eight groups (n = 5), according to the combination of variables: Group 1 - control (neither trauma nor ITM); Group 2 - ITM; Groups 3, 4, 5 and 6 - dentoalveolar trauma groups corresponding, respectively, to 1, 3, 8 and 10 days after trauma; Groups 7 and 8 - the animals' molars were subjected to a 900 cN impact and, one and three days after the trauma event, tooth movement was induced. The rats' maxillary first molars were mesially moved during seven days with a closed coil (50 cN). After the experimental period of each group, the animals were sacrificed by anesthetic overdose and the right maxillas were removed and processed for histological analysis under light microscopy. Results In the animals of group 3, 4, 5 and 6, the histological alterations were not very significant. Consequently, the effect of induced tooth movement right after a subluxation event (groups 7 and 8) was very similar to those described for Group 2. Conclusion There was no difference in the quality of periodontal repair when ITM was applied to teeth that had suffered a subluxation trauma. PMID:24713565

  18. Ultrasonographic measurement of shoulder subluxation in patients with post-stroke hemiplegia.

    PubMed

    Park, Gi-Young; Kim, Jong-Min; Sohn, Sung-Il; Shin, Im-Hee; Lee, Michael Y

    2007-09-01

    To evaluate the ultrasonographic measurement of shoulder subluxation in patients with post-stroke hemiplegia. Prospective, single blind study. A total of 41 patients with post-stroke hemiplegia were included (24 men and 17 women, mean age 56 years (standard deviation 11), age range 34-78 years). Clinical evaluation of the affected shoulder was assessed using the Motricity Index scores and the Modified Ashworth Scale. Two ultrasonographic measurements were taken to check intra-rater reliability. The shoulder subluxation ratio was determined as the ratio of the radiographic vertical and horizontal distance, and the ultrasonographic lateral and anterior distances in the affected shoulder divided by that in the unaffected shoulder. Intraclass correlation coefficients of the repeated ultrasonographic lateral/anterior distance measurements in the unaffected and affected shoulders were 0.979/0.969 and 0.950/0.947, respectively. Ultrasonographic lateral/anterior distance ratios were negatively correlated with Motricity Index scores of the affected shoulder abduction (r = -0.490, p < 0.001/ r = -0.671, p < 0.001). Ultrasonographic anterior distance ratio was negatively correlated with Modified Ashworth Scale score of the affected shoulder (r = -0.374, p < 0.05). However, there was no correlation between radiographic distance ratios and clinical evaluation scores. We strongly recommend ultrasonography as a diagnostic tool to measure the degree of shoulder subluxation in patients with post-stroke hemiplegia.

  19. Microscopic evaluation of induced tooth movement after subluxation trauma: an experimental study in rats.

    PubMed

    Busato, Mauro Carlos Agner; Pereira, Alex Luiz Pozzobon; Sonoda, Celso Koogi; Cuoghi, Osmar Aparecido; de Mendonça, Marcos Rogério

    2014-01-01

    The objective of this study was to assess the histological alterations that occurred in the periodontal area of rat molars submitted to induced tooth movement (ITM) right after an intentional trauma (subluxation). Forty adult male Wistar rats (Rattus norvegicus albinus) were selected. The animals were divided into eight groups (n=5), according to the combination of variables: Group 1--control (neither trauma nor ITM); Group 2--ITM; Groups 3, 4, 5 and 6--dentoalveolar trauma groups corresponding, respectively, to 1, 3, 8 and 10 days after trauma; Groups 7 and 8 - the animals' molars were subjected to a 900 cN impact and, one and three days after the trauma event, tooth movement was induced. The rats' maxillary first molars were mesially moved during seven days with a closed coil (50 cN). After the experimental period of each group, the animals were sacrificed by anesthetic overdose and the right maxillas were removed and processed for histological analysis under light microscopy. In the animals of group 3, 4, 5 and 6, the histological alterations were not very significant. Consequently, the effect of induced tooth movement right after a subluxation event (groups 7 and 8) was very similar to those described for Group 2. There was no difference in the quality of periodontal repair when ITM was applied to teeth that had suffered a subluxation trauma.

  20. Hinged-Knee External Fixator Used to Reduce and Maintain Subacute Tibiofemoral Coronal Subluxation.

    PubMed

    Geiger, Erik J; Arzeno, Alexander H; Medvecky, Michael J

    Dislocation of the knee is a rare phenomenon that is becoming increasingly recognized with the expansion of its definition to include knees presenting with multiligament compromise. Hinged external fixators are now considered a viable supplementary treatment option in the management of acute ligament repair or reconstruction but their use in the management of subacute or chronic tibiofemoral dislocations or subluxations is less well defined. We report a case of a hinged-knee external fixator used to facilitate and maintain reduction of a chronic coronal tibial subluxation that presented after repair of an acute knee dislocation with lateral ligament injury secondary to a motor vehicle accident. At 5-year follow-up, the patient treated with hinged external fixation had a stable joint, was able to tolerate regular aerobic exercise, was minimally symptomatic, and did not require more extensive ligament reconstruction. Although there are reports on postoperative use of hinged external fixation to maintain the reduction of chronic or subacute knee dislocations in the sagittal plane after cruciate ligament repair, there are no reports on management of subacute tibiofemoral subluxation in the coronal plane.

  1. Gait analysis in low lumbar myelomeningocele patients with unilateral hip dislocation or subluxation.

    PubMed

    Gabrieli, Ana Paula T; Vankoski, Stephen J; Dias, Luciano S; Milani, Carlo; Lourenco, Alexandre; Filho, Jose Laredo; Novak, Robert

    2003-01-01

    The surgical indications for the treatment of unilateral hip dislocations or subluxations in patients with low lumbar myelomeningocele remain highly debatable. This study examines the influence of unilateral hip dislocation or subluxation on the gait of these patients using three-dimensional gait analysis. Twenty patients with a diagnosis of low lumbar myelomeningocele underwent three-dimensional gait analysis. All patients were community ambulators with solid ankle-foot orthoses and crutches who presented with unilateral hip dislocation or subluxation and no scoliosis. The patients were divided in two groups. Group 1 comprised 10 patients who demonstrated either no evidence of hip flexion or adduction contractures or symmetric hip contractures. Group 2 comprised 10 patients with unilateral hip flexion and/or adduction contractures. Pelvic and hip kinematics were assessed to determine the symmetry of motion between the involved and the noninvolved side during walking. Seven patients from group 1 walked with a symmetric gait pattern; only two patients from group 2 walked with a symmetric pattern. Gait symmetry corresponded to the absence of hip contractures or bilateral symmetrical hip contractures and had no relation to the presence of hip dislocation. The authors concluded that reduction of the hip is unnecessary.

  2. [Innominate osteotomy in the treatment of subluxation of hip in adult].

    PubMed

    Hu, C; Luo, Y; Xi, G

    1998-07-01

    The symptomatic subluxation of hip is not uncommon in adults, and several kinds of surgical options are available. Twenty-six patients (26 hips) suffering from residual symptomatic subluxation of the hip were treated with innominate osteotomy during 1985 to 1991. The patients were followed-up for 4 to 9 years. The ages of the patients ranged from 22 to 38 years with an average of 26 years and 6 months. The duration of symptoms ranged from 3 to 6 years with an average of 3 years and 5 months. The pertinent prior diseases were the congenital dislocation of hip in 12 cases, Perthes disease in 10 cases, and in the remaining 4 cases, the causes were not identified. The indications for operative intervention were that presence of a reasonable articular cartilaginous space, a reasonable range of motion preserved and particularly a reasnable joint congruity must exist. A new method of re-alignment of the acetabulum was used to placing the ipsilateral foot on the contralateral thigh. The result was evaluated by the symptoms, the function of the hip and the radiographic findings. According to these criteria, the excellent results were obtained in 11 cases and the good result in 15 cases. It was suggested that the innominate osteotomy were also suitable for the treatment of residual symptomatic subluxation of hip in carefully selected adults and the new method of re-alignment of acetabulum was simple and effective.

  3. Cervical Fracture/Subluxation in a Patient with a Prior C2-Sacrum Fusion: Case Report and Review of Literature.

    PubMed

    Chen, Yi-Ren; Chan, Alvin Y; Kumar, Kevin K; Veeravagu, Anand

    2016-11-22

    Traumatic injury to an adjacent segment of a previously fused spine is a rare complication of scoliosis surgery. The adjacent spinal segments may be more vulnerable to traumatic fracture or dislocation due to increased strain. We present a patient with prior C2 to sacrum fusion who suffered a C2 fracture/dislocation after falling. A 52-year-old female with a previous C2 to the sacrum fusion for idiopathic scoliosis presented with severe and progressively worsening neck pain after multiple falls. Imaging showed anterior displacement of the C2 vertebral body, fracture of C2, and anterior subluxation of the C1-2 complex on C3. The patient underwent posterior occiput to cervical fusion and reduction of the C1-C2 complex. Our case describes a potential complication of long-segment fusion. Adjacent segments may be more prone to fracture-dislocation because of increased intradiscal pressure and strain. Clinicians should have a high suspicion of fractures in patients with prior spinal fusions in the setting of trauma.

  4. Cervical Fracture/Subluxation in a Patient with a Prior C2-Sacrum Fusion: Case Report and Review of Literature

    PubMed Central

    Chen, Yi-Ren; Kumar, Kevin K; Veeravagu, Anand

    2016-01-01

    Traumatic injury to an adjacent segment of a previously fused spine is a rare complication of scoliosis surgery. The adjacent spinal segments may be more vulnerable to traumatic fracture or dislocation due to increased strain. We present a patient with prior C2 to sacrum fusion who suffered a C2 fracture/dislocation after falling. A 52-year-old female with a previous C2 to the sacrum fusion for idiopathic scoliosis presented with severe and progressively worsening neck pain after multiple falls. Imaging showed anterior displacement of the C2 vertebral body, fracture of C2, and anterior subluxation of the C1-2 complex on C3. The patient underwent posterior occiput to cervical fusion and reduction of the C1-C2 complex. Our case describes a potential complication of long-segment fusion. Adjacent segments may be more prone to fracture-dislocation because of increased intradiscal pressure and strain. Clinicians should have a high suspicion of fractures in patients with prior spinal fusions in the setting of trauma. PMID:28018758

  5. Outcomes of the biceps suspension procedure for painful inferior glenohumeral subluxation in hemiplegic patients.

    PubMed

    Namdari, Surena; Keenan, Mary Ann

    2010-11-03

    Patients with upper motor neuron injury can develop painful inferior glenohumeral subluxation with functional impairment. If the pain is relieved by manual reduction of the subluxation, this pain is considered mechanical in nature and potentially amenable to surgical treatment to maintain this reduction. The purpose of this study was to report our outcomes with use of the biceps suspension procedure to achieve shoulder joint reduction and pain relief in hemiplegic patients. This retrospective case series of eleven consecutive hemiplegic patients with painful glenohumeral subluxation underwent surgical reduction with a biceps suspension procedure. Seven patients had, in addition, extra-articular tenotomies to treat coexisting muscular contractures. Pain, physical examination findings, and radiographs were evaluated before and after surgery. Patient satisfaction with the outcome of the surgery was determined as well. The mean duration of the patient follow-up was 3.2 years (range, 2.0 to 5.8 years). The average patient age was 46.9 years (range, eighteen to eighty-one years). Ten of the patients were female. All patients had pain with passive shoulder motion preoperatively, but only one patient had such pain postoperatively (p < 0.001). At the time of follow-up after the surgery, the mean score for pain on a visual analog scale was 1.45 (range, 0 to 5), with all patients noting a decrease in pain. Ten patients noted that deformity was also decreased at the time of follow-up. All patients had a sulcus sign on physical examination preoperatively, but only three had such a sign postoperatively (p < 0.001). The seven patients who had undergone shoulder tenotomies had significant improvements in shoulder extension (p = 0.009), forward elevation (p = 0.030), abduction (p = 0.040), and external rotation (p = 0.043) postoperatively. Ten patients were satisfied with the outcome of the surgery. Preoperative radiographs demonstrated inferior subluxation of the humeral head at

  6. Interest in the glenoid hull method for analyzing humeral subluxation in primary glenohumeral osteoarthritis.

    PubMed

    Bouacida, Soufyane; Gauci, Marc-Olivier; Coulet, Bertrand; Lazerges, Cyril; Cyteval, Catherine; Boileau, Pascal; Chammas, Michel

    2017-07-01

    Posterior humeral subluxation is the main cause of failure of total shoulder arthroplasty. We aimed to compare humeral head subluxation in various reference planes and to search for a correlation with retroversion, inclination, and glenoid wear. We included 109 computed tomography scans of primary glenohumeral osteoarthritis and 97 of shoulder problems unrelated to shoulder osteoarthritis (controls); all computed tomography scans were reconstructed in the anatomic scapular plane and the glenoid hull plane that we defined. In both planes, we measured retroversion, inclination, glenohumeral offset (Walch index), and scapulohumeral offset. Retroversion in the scapular plane (Friedman method) was lower than that in the glenoid hull plane for controls and for arthritic shoulders. The threshold of scapulohumeral subluxation was 60% and 65% in the scapular plane and glenoid hull plane, respectively. The mean upward inclination was lower in the scapular plane (Churchill method) than in the glenoid hull plane (Maurer method). In the glenoid hull plane, 35% of type A2 glenoids showed glenohumeral offset greater than 75%, with mean retroversion of 25.6° ± 6° as compared with 7.5° ± 7.2° for the "centered" type A2 glenoids (P < .0001) and an upward inclination of -1.4° ± 8° and 6.3° ± 7° (P = .03), respectively. The correlation between retroversion and scapulohumeral offset was r = 0.64 in the glenoid hull plane and r = 0.59 in the scapular plane (P < .05). Measurement in the glenoid hull plane may be more accurate than in the scapular plane. Thus, the glenoid hull method allows for better understanding type B3 of the modified Walch classification. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  7. TREATMENT OF ANTERIOR SHOULDER SUBLUXATION USING THE MULLIGAN CONCEPT AND REFLEX NEUROMUSCULAR STABILIZATION: A CASE REPORT

    PubMed Central

    Baker, Russell T.; Nasypany, Alan; Reordan, Don

    2017-01-01

    Background and Purpose Shoulder instability, a common issue among athletes who engage in contact sports, may lead to recurrent subluxations, or partial dislocations of the shoulder. Young athletic patients generally respond poorly to the nonsurgical treatments for shoulder instability that are commonly utilized. The purpose of this case report is to describe the effects of the treatment guided by the Mulligan Concept (MC) coupled with reflex neuromuscular stabilization (RNS) also known as reactive neuromuscular training (RNT), on an adolescent football player with glenohumeral joint (GHJ) instability who sustained a traumatic anterior subluxation. Case Description The MC shoulder Mobilization with Movement (MWM) and RNS were applied in the treatment of an anterior shoulder subluxation injury sustained by a competitive adolescent football player. The Numeric Pain Rating Scale (NPRS), the Disability in the Physically Active (DPA) scale, the Patient specific Functional Scale (PSFS) and the Shoulder Pain and Disability Index (SPADI), were administered in order to identify patient-reported outcomes. Outcomes The shoulder MWM and RNS provided immediate relief of all of the patient's pain and increased ROM after the first treatment. The use of the coupled treatments resulted in a resolution of pain, an increase in range of motion (ROM) and improvement in perceived stability. A minimal clinically important difference (MCID) was reported on the NPRS and minimal detectable changes (MDC) were reported on the NRS and PSFS, after the first treatment. Equally important, MCIDs were reported on the DPA scale and SPADI scale over the course of treatment. Discussion In this case report, the MC shoulder MWM, coupled with RNS, was an effective treatment for this patient and provided a short time to resolution (6 treatments; 19 days) compared to other descriptions of recovery in the literature. Clinicians treating patients who display anterior shoulder instability can consider this as

  8. TREATMENT OF ANTERIOR SHOULDER SUBLUXATION USING THE MULLIGAN CONCEPT AND REFLEX NEUROMUSCULAR STABILIZATION: A CASE REPORT.

    PubMed

    Hudson, Robinetta A; Baker, Russell T; Nasypany, Alan; Reordan, Don

    2017-02-01

    Shoulder instability, a common issue among athletes who engage in contact sports, may lead to recurrent subluxations, or partial dislocations of the shoulder. Young athletic patients generally respond poorly to the nonsurgical treatments for shoulder instability that are commonly utilized. The purpose of this case report is to describe the effects of the treatment guided by the Mulligan Concept (MC) coupled with reflex neuromuscular stabilization (RNS) also known as reactive neuromuscular training (RNT), on an adolescent football player with glenohumeral joint (GHJ) instability who sustained a traumatic anterior subluxation. The MC shoulder Mobilization with Movement (MWM) and RNS were applied in the treatment of an anterior shoulder subluxation injury sustained by a competitive adolescent football player. The Numeric Pain Rating Scale (NPRS), the Disability in the Physically Active (DPA) scale, the Patient specific Functional Scale (PSFS) and the Shoulder Pain and Disability Index (SPADI), were administered in order to identify patient-reported outcomes. The shoulder MWM and RNS provided immediate relief of all of the patient's pain and increased ROM after the first treatment. The use of the coupled treatments resulted in a resolution of pain, an increase in range of motion (ROM) and improvement in perceived stability. A minimal clinically important difference (MCID) was reported on the NPRS and minimal detectable changes (MDC) were reported on the NRS and PSFS, after the first treatment. Equally important, MCIDs were reported on the DPA scale and SPADI scale over the course of treatment. In this case report, the MC shoulder MWM, coupled with RNS, was an effective treatment for this patient and provided a short time to resolution (6 treatments; 19 days) compared to other descriptions of recovery in the literature. Clinicians treating patients who display anterior shoulder instability can consider this as a viable treatment option. Even though current literature

  9. Grisel’s syndrome: a rare complication following adenoidectomy

    PubMed Central

    Bocciolini, C; Dall’Olio, D; Cunsolo, E; Cavazzuti, PP; Laudadio, P

    2005-01-01

    Summary Grisel’s syndrome, defined as subluxation of the atlanto-axial joint, not associated with trauma or bone disease, is found primarily in children. There are few references to this syndrome in the ENT literature but it may occur in association with any condition that results in hyperaemia and pathological relaxation of the transverse ligament of the atlanto-axial joint. Several common otolaryngeal conditions have been associated with the syndrome: pharyngitis, adenotonsillitis, tonsillar abscess, cervical abscess, and otitis media. Moreover, the syndrome has been observed after numerous otolaryngologic procedures such as tonsillectomy, adenoidectomy and mastoidectomy. Non-traumatic subluxation of the atlanto-axial joint should be suspected in cases of persistent neck pain and stiffness. X-rays and computed tomography scans of the cervical spine can confirm the diagnosis. Early management, consisting of cervical immobilization and medical treatment, is considered the key factor for a satisfactory outcome. Inappropriate treatment may result in a permanent and painful neck deformity that may even require surgical fusion. Neurological complications have been reported in the literature, with outcome ranging from mild paresthesia, clonus, to quadriplegia or acute respiratory failure and death. The case is described of an 8-year-old boy who developed Grisel’s syndrome following adenoidectomy. The pathogenesis, classification, diagnosis, and treatment of this condition are discussed. PMID:16482983

  10. Surgical Management of a Patient with Anterior Megalophthalmos, Lens Subluxation, and a High Risk of Retinal Detachment

    PubMed Central

    Guixeres Esteve, María Carmen; Pardo Saiz, Augusto Octavio; Martínez-Costa, Lucía; González-Ocampo Dorta, Samuel; Sanz Solana, Pedro

    2017-01-01

    The early development of lens opacities and lens subluxation are the most common causes of vision loss in patients with anterior megalophthalmos (AM). Cataract surgery in such patients is challenging, however, because of anatomical abnormalities. Intraocular lens dislocation is the most common postoperative complication. Patients with AM also seem to be affected by a type of vitreoretinopathy that predisposes them to retinal detachment. We here present the case of a 36-year-old man with bilateral AM misdiagnosed as simple megalocornea. He had a history of amaurosis in the right eye due to retinal detachment. He presented with vision loss in the left eye due to lens subluxation. Following the removal of the subluxated lens, it was deemed necessary to perform a vitrectomy in order to prevent retinal detachment. Seven months after surgery, an Artisan® Aphakia iris-claw lens was implanted in the anterior chamber. Fifteen months of follow-up data are provided. PMID:28203198

  11. Vertebral subluxation during three-column osteotomy in surgical correction of adult spine deformity: incidence, risk factors, and complications.

    PubMed

    Qiao, Jun; Xiao, Lingyan; Sun, Xu; Shi, Benlong; Liu, Zhen; Xu, Leilei; Zhu, Zezhang; Qian, Bangping; Qiu, Yong

    2017-08-24

    To investigate incidence, risk factors, and complications of vertebral subluxation (VS) during three-column osteotomy in surgical correction of adult spine deformity. Adult spine deformity patients who underwent three-column osteotomies including VCR, PSO, and other modified types from March 2000 to December 2014 in our center were retrospectively reviewed. The following parameters were measured pre- and postoperatively: Cobb angle of main curve, global kyphosis, sagittal vertical axis, and kyphosis flexibility. Radiographic parameters between groups (VCR vs. PSO and subluxation vs. non-subluxation) were compared. 171 ASD patients were recruited, 18 of which (10.5%) developed sagittal vertebral subluxation at the osteotomy site. 5 of 18 patients (27.8%) developed neurological complications after surgery. For these five patients, two patients got partial recovery, and three got complete recovery at 2-year follow-up. 116 patients underwent PSO, 12 of which (10.3%) developed sagittal vertebral subluxation. In 55 patients receiving VCR, 6 (10.9%) developed sagittal vertebral subluxation. No significant difference was noted between the two groups (P > 0.05). The mean age of VS group was larger than that of non-VS group (46.2 vs. 34.2, P < 0.05). VS group had less kyphosis flexibility (11 vs. 23%, P < 0.05). More patients in VS group had preoperative sagittal VS as compared to non-VS group (77.8 vs. 20.9%, P < 0.05). VS group had more neurological complications than non-VS group (25 vs. 5.4%, P < 0.05). VS occurred in one-tenth of patients receiving three-column osteotomies, one-fourth of which would develop neurological deficits. Older age, rigid kyphosis, and the pre-existence of VS were risk factors for developing VS.

  12. Measurement of rehabilitation in thumb MP joint subluxation due to rheumatoid arthritis.

    PubMed

    Kitano, Keisuke; Tsujiuchi, Nobutaka; Ito, Akihito; Tokunaga, Daisaku; Kubo, Toshikazu; Nakamura, Satoru

    2014-01-01

    As treatment for subluxation due to rheumatoid arthritis (RA), rehabilitation by hand therapy is one option, but the number of therapist is not sufficient. Therefore, a device for rehabilitation of thumb metacarpophalangeal (MP) joint subluxation has been developed. To improve the device, it is necessary to measure in close proximity to the actual rehabilitation. Therefore, the authors tried to measure two kinds of rehabilitation by using motion capture and a contact force sensor. To measure rehabilitation movements, three markers were attached to the metacarpal bone, six markers were attached to each side of the interphalangeal (IP) joint, MP joint and proximal phalanx of the right thumb of the subjects, and a finger model was created by these markers. Further, three markers were placed on the left index of the therapist, and force direction was calculated by these markers. Measurement was conducted on healthy subjects, Rehabilitation was performed by the person who is not a therapist, but received the guidance of the doctor who is coauthor. As a result, the authors could measure rehabilitation by hand therapy, force, point of action and displacement. The results suggest that rehabilitation with traction twice as efficient as that without traction. Furthermore, it was found that rehabilitation is possible with calculated force, and the force is reproducible by the actuator in the device.

  13. Clinical predictors and radiological reliability in atlantoaxial subluxation in Down's syndrome.

    PubMed Central

    Selby, K A; Newton, R W; Gupta, S; Hunt, L

    1991-01-01

    Clinical signs and symptoms that might predict atlantoaxial subluxation were studied prospectively in 135 of 180 children with Down's syndrome aged 6-14 years who form the Hester Adrian Research Centre cohort. Lateral radiographs of the cervical spine were taken in flexed, extended, and neutral positions, and the percentage of abnormalities in each view was 14, 10, and 10%, respectively. Gait was the only significant clinical predictor. The relative risk of having an abnormal neck radiograph with an abnormal gait was 2.91 (95% confidence interval (CI) 1 to 8). The sensitivity was 50% and the specificity 81%. Nineteen children had repeat radiographs to assess the reliability of radiological diagnosis. Six had abnormalities; five of 19 (26%) had an abnormality on the first radiograph, and four of 19 (21%) had an abnormality on a second radiograph, but only three (15%) had an abnormality on both occasions in any view (95% CI 0 to 25). We conclude that radiographs of the cervical spine are unreliable at identifying atlantoaxial subluxation in children with Down's syndrome, and we failed to identify any reliable clinical predictor. PMID:1830735

  14. Multiple subluxations and comminuted fracture of the cervical spine in a sheep.

    PubMed

    Lin, C-C; Chen, K-S; Lin, Y-L; Chan, J P-W

    2015-01-01

    A 5-month-old, 13.5 kg, female Corriedale sheep was referred to the Veterinary Medicine Teaching Hospital, with a history of traumatic injury of the cervical spine followed by non-ambulatoric tetraparesis that occurred 2 weeks before being admitted to the hospital. At admission, malalignment of the cervical spine with the cranial part of the neck deviating to the right was noted. Neurological examinations identified the absence of postural reactions in both forelimbs, mildly decreased spinal reflexes, and normal reaction to pain perception tests. Radiography revealed malalignment of the cervical vertebrae with subluxations at C1-C2 and C2-C3, and a comminuted fracture of the caudal aspect of C2. The sheep was euthanized due to a presumed poor prognosis. Necropsy and histopathological findings confirmed injuries of the cervical spine from C1 to C3, which were consistent with the clinical finding of tetraparesis in this case. This paper presents a rare case of multiple subluxations of the cervical spine caused by blunt force trauma in a young sheep. These results highlight the importance of an astute clinical diagnosis for such an acute cervical spine trauma and the need for prompt surgical correction for similar cases in the future.

  15. Microperforation prolotherapy: a novel method for successful nonsurgical treatment of atraumatic spontaneous anterior sternoclavicular subluxation, with an illustrative case.

    PubMed

    Stein, Alvin; McAleer, Scott; Hinz, Marty

    2011-01-01

    Surgical repair of an atraumatic spontaneous anterior subluxation of the sternoclavicular joint (herein referred to as the "SCJ") is often associated with poor outcome expectations. With traditional treatment, successful conservative therapy usually incorporates major lifestyle alterations. This manuscript discusses a novel approach known as "microperforation prolotherapy". To illustrate the technique, the care of a patient who benefitted from this treatment is reviewed. To present a novel form of treatment with an illustrative case that demonstrates the potential efficacy of microperforation prolotherapy of the SCJ. A novel approach to treatment of bilateral subluxation of the sternoclavicular joint with microperforation prolotherapy is discussed. The clinical course of a 21-year-old male with bilateral subluxation of the SCJ, which seriously hampered the patient's athletic and daily living activities, is used as a backdrop to the discussion. Following microperforation prolotherapy, the instability of the SCJ was replaced by full stability, complete range of motion, and the opportunity to engage in all of the athletic endeavors previously pursued. There is no scar or other cosmetic defect resulting from the treatment received. Anterior sternoclavicular joint subluxation has a poor record of complete recovery with surgical procedures or conservative measures with regard to providing restoration of full lifestyle function. This manuscript documents a novel microperforation prolotherapy treatment that induced healing and restored full stability to the ligament structures responsible for the condition in a completely safe and effective fashion, allowing the patient to resume full lifestyle activities without restriction. The exceptional response to treatment noted here is encouragement for further studies.

  16. Case Report of a Traumatic Atlantoaxial Rotatory Subluxation with Bilateral Locked Cervical Facets: Management, Treatment, and Outcome

    PubMed Central

    Hawi, Nael; Alfke, Dirk; Liodakis, Emmanouil; Omar, Mohamed; Krettek, Christian; Müller, Christian Walter; Meller, Rupert

    2016-01-01

    The aim was to report a rare case of isolated traumatic atlantoaxial rotatory subluxation without ligamentous injury. Management consisted of analgesia, sedation, and application of a halo skull traction device. After removing halo skull traction, full reduction and recovery were achieved without instability. PMID:27190664

  17. [Surgical treatment for third-grade fracture of the dens of the second cervical vertebra with transdental posterior subluxation].

    PubMed

    Dzukaev, D N; Dreval', O N; Sidorenko, V V; Siviakov, A A; Khoreva, N E

    2007-01-01

    The paper describes a case of successful treatment in a patient with third-grade fracture of the dens of the second cervical vertebra with transdental posterior subluxation. According to the treatment policy chosen, posterior upper cervical spine stabilization and anterior upper spinal cord decompression that was supplemented by anterior cervical spondylodesis were performed in the early period.

  18. Evaluation of Publicly Available Documents to Trace Chiropractic Technique Systems That Advocate Radiography for Subluxation Analysis: A Proposed Genealogy

    PubMed Central

    Young, Kenneth J.

    2014-01-01

    Objective The purpose of this study was to evaluate publicly available information of chiropractic technique systems that advocate radiography for subluxation detection to identify links between chiropractic technique systems and to describe claims made of the health effects of the osseous misalignment component of the chiropractic subluxation and radiographic paradigms. Methods The Internet and publicly available documents were searched for information representing chiropractic technique systems that advocate radiography for subluxation detection. Key phrases including chiropractic, x-ray, radiography, and technique were identified from a Google search between April 2013 and March 2014. Phrases in Web sites and public documents were examined for any information about origins and potential links between these techniques, including the type of connection to BJ Palmer, who was the first chiropractor to advocate radiography for subluxation detection. Quotes were gathered to identify claims of health effects from osseous misalignment (subluxation) and paradigms of radiography. Techniques were grouped by region of the spine and how they could be traced back to B.J Palmer. A genealogy model and summary table of information on each technique were created. Patterns in year of origination and radiographic paradigms were noted, and percentages were calculated on elements of the techniques’ characteristics in comparison to the entire group. Results Twenty-three techniques were identified on the Internet: 6 full spine, 17 upper cervical, and 2 techniques generating other lineage. Most of the upper cervical techniques (14/16) traced their origins to a time when the Palmer School was teaching upper cervical technique, and all the full spine techniques (6/6) originated before or after this phase. All the technique systems’ documents attributed broad health effects to their methods. Many (21/23) of the techniques used spinal realignment on radiographs as one of their outcome

  19. Conservative treatment of an acute traumatic extensor carpi ulnaris tendon subluxation in a collegiate basketball player: a case report.

    PubMed

    Patterson, Steve M; Picconatto, William J; Alexander, Julie A; Johnson, Rachel L

    2011-01-01

    To present the case of an acute traumatic extensor carpi ulnaris (ECU) subluxation in a National Collegiate Athletic Association Division II female basketball player. The ECU tendon is stabilized in the ulnar groove by a subsheath located inferior to the extensor retinaculum. The subsheath can be injured with forced supination, ulnar deviation, and wrist flexion, resulting in the ECU tendon subluxing in the palmar and ulnar directions during wrist circumduction. Several methods of intervention exist, but controversy remains on how to best treat this condition. Distal ulnar fracture, ulnar collateral ligament sprain, triangular fibrocartilage complex lesion, lunotriquetral instability, distal radioulnar joint injury, pisotriquetral joint injury, ECU tendinopathy or subluxation. The wrist was placed in a short-arm cast in slight extension and radial deviation for 4 weeks. At that time, the patient was still able to actively sublux the ECU tendon, so a long-arm cast was applied with the wrist in slight extension, radial deviation, and pronation for an additional 4 weeks. The ECU tendon was then found to be stable. She wore a rigid wrist brace for 3 more weeks while she pursued rehabilitation. At the final follow-up appointment, the ECU tendon remained stable, and the wrist was asymptomatic. Subluxations of the ECU are rare. If the patient does not improve with conservative measures, surgical intervention is warranted to repair the sixth dorsal compartment. A long-arm cast with the elbow flexed to 90° and the wrist in approximately 30° of extension, radial deviation, and pronation was appropriate treatment for this type of injury.

  20. Atlantoaxial rotatory subluxation as a cause of torticollis in a 5-year-old girl.

    PubMed

    Bagouri, Elmunzar; Deshmukh, Sandeep; Lakshmanan, Palaniappan

    2014-05-15

    Many patients present to the emergency department complaining of a sore or stiff neck and lateral flexion of the neck with contralateral rotation. Under the pressure of the breaching time and busy shifts some of the patients are discharged to the care of their general practitioners without adequate investigations. While most of the cases are due to benign causes, torticollis can be due to many congenital and acquired pathologies, some of which may need further investigation and urgent management. Atlantoaxial subluxation (AAS), tumours of the base of the skull and infections are among these causes. Delayed diagnosis may lead to worsening neurology and complicate the management. We report a case of a 5-year-old girl who presented to our fracture clinic with a fractured clavicle and torticollis; her subsequent investigations confirmed the diagnosis of AAS. Our patient responded to non-operative treatment and improved with no neurological complications.

  1. Nonacute Treatment of Elbow Fracture with Persistent Ulnohumeral Dislocation or Subluxation.

    PubMed

    Chen, Neal C; Jupiter, Jesse B; Steinmann, Scott P; Ring, David

    2014-08-06

    ➤ There are patterns of traumatic elbow instability that help a surgeon to anticipate which structures are injured.➤ Patients treated for persistent subluxation or dislocation of the elbow more than two weeks after injury regain less motion and experience more adverse events.➤ The primary goal of treatment is stable reduction of the ulnohumeral joint and functional elbow motion.➤ Motion and pain are affected by contracture and scarring of the soft tissues, malalignment of the joint, fracture malunion, damage to the articular surface, and ulnar neuropathy.➤ Biomechanical and clinical studies support treatment with radial head arthroplasty and/or coronoid reconstruction for patients who have osseous insufficiency.

  2. Chondromalacia induced by patellar subluxation: morphological and morphometrical aspects in rabbits.

    PubMed

    Sant'Anna, M M S; Apfel, M I R

    2002-01-01

    The purpose of this study was to describe morphologically and quantify the changes of the articular cartilage in chondromalacia, concerning both the chondrocytes and extracellular matrix. Eight rabbits were submitted daily to patellar subluxation, causing chondromalacia after two weeks. The knee fragments obtained were processed by the standard methods. These experimental conditions caused degenerative alterations of the articular cartilage, varying from a slight decrease of proteoglycans, to fibrillations, clefts, and horizontal splitting. The results showed a significantly increase number of chondrocytes (p < 0,000139), although smaller in size (p < 0,000109). The immobilization for 2 weeks and the intermittent passive daily motion afterwards for a period of 2 weeks, was effective to cause patellar chrondomalacia in rabbits.

  3. A Case of Delayed Myelopathy Caused by Atlantoaxial Subluxation without Fracture.

    PubMed

    Takamatsu, Ryo; Takahashi, Hiroshi; Yokoyama, Yuichiro; Terajima, Fumiaki; Inoue, Yasuhiro; Fukutake, Katsunori; Wada, Akihito

    2013-01-01

    We report a case of delayed myelopathy caused by atlantoaxial subluxation without fracture. The patient was a 38-year-old male who became aware of weakness in extremities. The patient had a history of hitting his head severely while diving into a swimming pool at the age of 14 years old. At that time, cervical spine plain X-ray images showed no fracture, and the cervical pain disappeared after use of a collar for several weeks. At his first visit to our department, X-ray images showed an unstable atlantoaxial joint. After surgery, weakness of the extremities gradually improved. At 6 months after surgery, bone union was completed and the symptoms disappeared. This case shows that atlantoaxial ligament injuries are difficult to diagnose and may easily be missed. A high level of suspicion is important in such cases, since neurological compromise or deterioration may occur many years after the injury.

  4. Mandibular subluxation for distal internal carotid artery exposure in edentulous patients.

    PubMed

    Jaspers, Gijs W; Witjes, Max J; van den Dungen, Jan J; Reintsema, Harry; Zeebregts, Clark J

    2009-12-01

    Four patients with high internal carotid artery (ICA) occlusive disease were indicated for surgical endarterectomy and needed additional exposure besides regular head rotation and extension. When indicated, in our clinic this is usually achieved by mandibular subluxation with interdental wiring. Due to dental wear and periodontal disease, all 4 patients were edentulous. As a consequence, the technique of interdental wiring could not be used. In this technical note we will explain a method for interarch fixation with the use of two ipsilateral monocortical miniscrews and wiring, and the use of patients' pre-existing mandibular implants and provisional overdenture. This method gives rise to an additional exposure of 15 to 20 mm of the ICA.

  5. Single suture iris-to-capsulorhexis fixation for in-the-bag intraocular lens subluxation.

    PubMed

    Siegel, Michael J; Condon, Garry P

    2015-11-01

    We present a simplified modification to a technique for early or mild in-the-bag subluxation that avoids conjunctival and scleral incisions and minimizes intraocular manipulation. While the capsulorhexis edge is grasped with an intraocular forceps to stabilize the IOL-capsular bag complex, a 10-0 polypropylene suture on a long curved needle is used to secure the fibrotic superior capsulorhexis edge to the midperipheral iris at 12 o'clock using a combination of a modified McCannel suture and a Siepser sliding knot. Dr. Condon receives speaker and consultant fees from Alcon Surgical, Inc., Allergan, Inc., and Microsurgical Technology. Although the Microsurgical Technology Condon snare instrument is named after him, Dr. Condon reports no patents, fees, or payments related to it. Dr. Siegel has no financial or proprietary interest in any material or method mentioned. Copyright © 2015. Published by Elsevier Inc.

  6. Congenital Spondylolytic Spondylolisthesis of C2 Vertebra Associated With Atlanto-Axial Dislocation, Chiari Type I Malformation, and Anomalous Vertebral Artery: Case Report With Review Literature.

    PubMed

    Sardhara, Jayesh; Pavaman, Sindgikar; Das, Kuntal; Srivastava, Arun; Mehrotra, Anant; Behari, Sanjay

    2016-11-01

    Congenital spondylolytic spondylolisthesis of C2 vertebra resulting from deficient posterior element of the axis is rarely described in the literature. We describe a unique case of agenesis of posterior elements of C2 with craniovertebral junction anomalies consisting of osseous, vascular, and soft tissue anomalies. A 26-year-old man presented with symptoms of upper cervical myelopathy of 12 months' duration. A computed tomography scan of the cervical spine including the craniovertebral junction revealed spondylolisthesis of C2 over C3, atlantoaxial dislocation, occipitalization of the atlas, hypoplasia of the odontoid, and cleft posterior C1 arch. Additionally, the axis vertebra was found devoid of its posterior elements except bilaterally rudimentary pedicles. Magnetic resonance imaging revealed tonsilar herniation, suggesting associated Chiari type I malformation. CT angiogram of the vertebral arteries displayed persistent bilateral first intersegmental arteries crossing the posterior aspect of the C1/2 facet joint. This patient underwent foramen magnum decompression, C3 laminectomy with occipito-C3/C4 posterior fusion using screw and rod to maintain the cervical alignment and stability. We report this rare constellation of congenital craniovertebral junction anomaly and review the relevant literature. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Active and passive characteristics of muscle tone and their relationship to models of subluxation/joint dysfunction

    PubMed Central

    Knutson, Gary A.; Owens, Edward F.

    2003-01-01

    The relationship of muscles to the causes and effects of the pathophysiologic entity referred to as chiropractic subluxation or joint dysfunction is critical. Part I of this paper reviewed the complexities of skeletal muscle in regards to anatomy, active and passive tone, detection of muscle tone, neurophysiology, and how muscle function fits into a variety of subluxation/joint dysfunction models. The concluding part of the review culminates in a hypothesis to describe and explain varying degrees of muscle tone that may be encountered clinically. It is hoped that knowledge of the differing levels of muscle tone and their causes will help the clinician to better determine the underlying cause of a neuromusculoskeletal problem allowing application of necessary and proper intervention.

  8. Active and passive characteristics of muscle tone and their relationship to models of subluxation/joint dysfunction

    PubMed Central

    Knutson, Gary A; Owens, Edward F

    2003-01-01

    The relationship of muscles to the causes and effects of the pathophysiologic entity referred to as chiropractic subluxation or joint dysfunction is critical. Part I of this paper reviews complexities of skeletal muscle in regards to anatomy, active and passive tone, detection of muscle tone, neurophysiology, and how muscle function fits into a variety of subluxation/joint dysfunction models. The review culminates in Part II with a hypothesis to describe and explain varying degrees of muscle tone that may be encountered clinically. It is hoped that knowledge of the differing levels of muscle tone and their causes will help the clinician to better determine the underlying cause of a neuro-musculoskeletal problem allowing application of necessary and proper intervention. Imagesp179-a

  9. Vertebral rotatory subluxation in degenerative scoliosis: facet joint tropism is related.

    PubMed

    Bao, Hongda; Zhu, Feng; Liu, Zhen; Bentley, Mark; Mao, Saihu; Zhu, Zezhang; Ding, Yitao; Qiu, Yong

    2014-12-15

    A cross-sectional study. To identify facet tropism as one of the possible risk factors leading to vertebral rotatory subluxation (VRS). VRS has been considered as one of the prognostic factors for degenerative scoliosis. Although several risk factors of VRS, including age and Cobb angle, have been investigated, few studies exist that have evaluated the correlation between VRS and anatomical structures of the vertebral column. This retrospective study recruited 23 patients diagnosed with degenerative lumbar scoliosis with VRS and 20 patients with degenerative scoliosis without VRS. The lateral translation on coronal radiographs was measured and 5 mm was used as the cutoff value to define rotatory subluxation. Computed tomographic scans for facet joints were made for all lumbar levels. The difference between right and left facet angles was recorded as ΔFA. Facet tropism was defined as a difference between the bilateral facet angles of more than 10°. In this study, VRS was most commonly found at the L3-L4 level (49%) and, with decreasing frequency at L2-L3 (24%), L4-L5 (20%), and L1-L2 (7%). On the convex side of the main curve, face joints at levels with VRS were more coronally oriented compared with those at levels without VRS (41.64° ± 11.65° vs. 36.30° ± 10.99°, P = 0.034). ΔFA was also significantly different between levels with and without VRS (P = 0.005). A strong correlation was found between ΔFA and lateral translation, with a coefficient of 0.33 (P < 0.001). In addition, ΔFA and a larger Cobb angle were found to be significantly associated with VRS based on binary regression analysis, with an odds ratio of 4.68 and 2.14, respectively. Facet tropism was more significantly observed at levels with VRS. On the convex side of the main curve, facet joints at levels with VRS were more coronally oriented. A larger Cobb angle and severe facet tropism in degenerative scoliosis should be considered to be related to VRS.

  10. The Elmslie-Trillat procedure for recurrent subluxation of the patella. One to five year follow-up.

    PubMed

    Conti, C; Berruto, M; Bianchi, M

    1992-01-01

    Thirty-four patients who had undergone the Elmslie-Trillat procedure from 1985 to 1989 were examined in order to evaluate the effectiveness of this operation in the treatment of recurrent subluxation of the patella. The result of an increased Q angle accompanied by patella alta, femoral sulcus dysplasia, or vastus medialus obliquus dysplasia was also studied. Only those patients with recurrent subluxation of the patella took part in this study; cases of habitual or permanent dislocation, potential instability, traumatic dislocation, and degenerative arthritis were excluded. The patients were reviewed both clinically and radiographically, and the A.R.P.E.G.E. scoring system was used to evaluate the results. The follow-up period ranged from 1 year to 5 years and 4 months, with an average of 3 years. The overall results were excellent or good in 77% of the cases, as was the subjective knee stability rating in 87% of the cases and the pain rating in 82% of the cases. Recurrence of the subluxation was observed in only one instance. The results were not significantly different when the groups of patients with patella alta and type 1 femoral sulcus dysplasia were considered separately. The results were also excellent in the patients who underwent the Elmslie-Trillat procedure with reconstruction of the vastus medialis obliquus. In conclusion, surgical realignment of the anterior tibial tubercle confirmed its reliability in the treatment of recurrent subluxation of the patella. In cases of patella alta, the authors recommend lowering the anterior tibial tubercle only when the Insall-Burstein index is greater than 1.3. Femoral sulcus-plasty should be performed in cases of type 3 sulcus dysplasia.

  11. Analysis and Adjustment of Vertebral Subluxation as a Separate and Distinct Identity for the Chiropractic Profession: A Commentary.

    PubMed

    Hart, John

    2016-12-01

    The purpose of this paper is to discuss various statements related to chiropractic identity from(1) D. D. Palmer(2); selected chiropractic organizations, associations, and colleges; and(3) attitudes and perceptions of chiropractic from chiropractic students, practitioners, and patients. For comparison purposes, identity statements and perceptions from the various chiropractic associations and colleges, as well as from students and patients, were explored. Identity statements for chiropractic were searched in various sources such as Palmer's 1910 textbook, recent literature on viewpoints from chiropractic students and practitioners, and websites for chiropractic colleges and organizations. Palmer taught that the chiropractor's focus was on vertebral subluxation. Today, a number of chiropractic colleges and organizations continue to include the vertebral subluxation model in their instruction, with a majority of students and practitioners subscribing to the model. Conversely, a number of other colleges and organizations portray chiropractic as being essentially about the treatment of back and neck pain, which is what patients associate with chiropractic. However, settling on any particular identity for the chiropractic profession will likely be met with resistance by some, given the plethora of opinions among chiropractic professionals as to what the identity of the chiropractic profession should be. Common ground between the different factions within the chiropractic profession might be found in a unifying expression such as "functional neurology." When a profession's identity is not clear with respect to its area of interest and mission, then the public may be less inclined to seek its services. Identifying the chiropractic profession with a focus on vertebral subluxation would give the profession uniqueness not duplicated by other health care professions and, therefore, might legitimatize the existence of chiropractic as a health care profession. An identity

  12. Microperforation prolotherapy: a novel method for successful nonsurgical treatment of atraumatic spontaneous anterior sternoclavicular subluxation, with an illustrative case

    PubMed Central

    Stein, Alvin; McAleer, Scott; Hinz, Marty

    2011-01-01

    Background Surgical repair of an atraumatic spontaneous anterior subluxation of the sternoclavicular joint (herein referred to as the “SCJ”) is often associated with poor outcome expectations. With traditional treatment, successful conservative therapy usually incorporates major lifestyle alterations. This manuscript discusses a novel approach known as “microperforation prolotherapy”. To illustrate the technique, the care of a patient who benefitted from this treatment is reviewed. Purpose To present a novel form of treatment with an illustrative case that demonstrates the potential efficacy of microperforation prolotherapy of the SCJ. Patient and methods A novel approach to treatment of bilateral subluxation of the sternoclavicular joint with microperforation prolotherapy is discussed. The clinical course of a 21-year-old male with bilateral subluxation of the SCJ, which seriously hampered the patient’s athletic and daily living activities, is used as a backdrop to the discussion. Results Following microperforation prolotherapy, the instability of the SCJ was replaced by full stability, complete range of motion, and the opportunity to engage in all of the athletic endeavors previously pursued. There is no scar or other cosmetic defect resulting from the treatment received. Conclusion Anterior sternoclavicular joint subluxation has a poor record of complete recovery with surgical procedures or conservative measures with regard to providing restoration of full lifestyle function. This manuscript documents a novel microperforation prolotherapy treatment that induced healing and restored full stability to the ligament structures responsible for the condition in a completely safe and effective fashion, allowing the patient to resume full lifestyle activities without restriction. The exceptional response to treatment noted here is encouragement for further studies. PMID:24198570

  13. Radiological assessment of irreducible posterolateral knee subluxation after dislocation due to interposition of the vastus medialis: a case report.

    PubMed

    Paulin, Emilie; Boudabbous, Sana; Nicodème, Jean-Damien; Arditi, Daniel; Becker, Christoph

    2015-06-01

    Knee dislocation is a serious and relatively uncommon traumatism that every emergency room is supposed to diagnose and treat rapidly. Most of the time these dislocations reduce spontaneously or with closed reduction. If a subluxation persists, an incarceration of soft tissue in the joint must be suspected. Irreducible knee subluxations after dislocation are rare entities better described in the orthopaedic than in the radiological literature. However, the initial radiological assessment is an important tool to obtain the correct diagnosis, to detect neurovascular complications, and to plan the most suitable treatment. In cases of delayed diagnosis, the functional prognosis of the joint and even the limb may be seriously compromised primarily because of vascular lesions. Thereby, vascular imaging is essential in cases of dislocation of the knee, and we will discuss the role of angiography and the more recent use of computed tomography angiography or magnetic resonance angiography. Our patient presented with an irreducible knee subluxation due to interposition of the vastus medialis, and we will review the classical clinical presentation and 'do not miss' imaging findings on conventional radiography, computed tomography angiography, and magnetic resonance imaging. Finally, we will also report the classical imaging pathway indicated in knee dislocation, with a special emphasis on the irreducible form.

  14. Spontaneous Reduction of a Chronic Radial Head Subluxation after open Reduction and Percutaneous Pin Fixation of a Radial Neck Fracture: A Case Report and Review of the Literature

    PubMed Central

    Illingworth, Kenneth David; Thompson, Kirk; Lovell, Matthew; McGinty, Jasmin

    2013-01-01

    Background Fractures of the radial neck in children have shown to account for 5-10% of traumatic elbow injuries in the pediatric population. Chronic dislocation of the radial head with concomitant fracture has been shown to result in progressive deformity and unacceptable loss of motion. Methods In this case report, we describe a patient who sustained a type 2 radial neck fracture with 100% displacement. The patient’s clinical and surgical management will be discussed and a review of the literature is provided as it relates to this particular case. Results The patient underwent open reduction and percutaneous pin fixation of her displaced, dislocated left radial neck fracture in the operating room after multiple failed attempts at closed reduction due to interposition of the annular ligament. Three months after her operation radiographs revealed a well-healed radial neck with no signs of avascular necrosis with an anterior dislocation of her radial head, which was a new finding from her previous radiographs. Fourteen months after her initial injury and operation, radiographs taken at this visit revealed a radial neck fracture that was completely remodeled and had spontaneous relocated and was now aligned with the capitellum without any reduction attempt. Conclusion Closed reduction of displaced radial neck fractures may be unsuccessful and open reduction may be warranted. Excess callus formation post-operatively may have resulted in the radial head subluxation; however there was spontaneous reduction with conservative treatment without a reduction attempt, most likely related to remodeling of the excel callus formation. PMID:24027488

  15. One-step fixation of atlantoaxial rotatory subluxation: technical note and report of three cases.

    PubMed

    Dahdaleh, Nader S; Dlouhy, Brian J; Menezes, Arnold H

    2013-12-01

    To describe a successful one-step intraoperative reduction of atlantoaxial rotatory subluxation (AARS) using neuromuscular blockade and intraoperative traction. While the patient was undergoing continuous somatosensory evoked potential monitoring, crown halo traction was applied under general anesthesia. A muscle relaxant was administered, and an intraoperative computed tomography scan was performed using the O-arm Surgical Imaging System in the supine position verifying adequate reduction. The patient was placed in the prone position, and a repeat image was obtained verifying persistent reduction in the position that the patient would undergo dorsal fixation. Occipitocervical fixation was then performed. This technique was performed successfully in three pediatric patients with chronic AARS. There were no complications related to the procedure. Intraoperative traction and neuromuscular blockade achieved a one-step reduction before fixation for subacute and chronic irreducible AARS. This one-step reduction obviates preoperative traction, which is often inconvenient and not tolerated by pediatric patients. Successful reduction is also demonstrated in detail intraoperatively with three-dimensional imaging. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. The effect of electrical stimulation in combination with Bobath techniques in the prevention of shoulder subluxation in acute stroke patients.

    PubMed

    Fil, Ayla; Armutlu, Kadriye; Atay, Ahmet Ozgur; Kerimoglu, Ulku; Elibol, Bulent

    2011-01-01

    To examine the efficiency of electrical stimulation in combination with Bobath techniques in the prevention of inferior and anterior shoulder subluxation in acute stroke patients. A prospective randomized controlled trial. Intensive care unit and inpatient clinics of neurology in a university hospital. Forty-eight patients with acute stroke, divided equally into control and study groups. Subjects in both groups were treated in accordance with the Bobath concept during the early hospitalization period. In addition to Bobath techniques, electrical stimulation was also applied to the supraspinatus muscle, mid and posterior portions of the deltoid muscle of patients in the study group. Two radiological methods were used to measure the horizontal, vertical and total asymmetry and vertical distance values of the shoulder joint. Motor functions of the arm were evaluated with the Motor Assessment Scale. The hospitalization period was 12.62 ± 2.24 days for the control group and 11.66 ± 1.88 days for the study group. Shoulder subluxation occurred in 9 (37.5%) subjects in the control group, whereas it was not observed in the study group. All shoulder joint displacement values were higher in the control group than in the study group (horizontal asymmetry P = 0.0001, vertical asymmetry P = 0.0001, total asymmetry P = 0.0001, vertical range P = 0.002). Application of electrical stimulation combined with the Bobath approach proved to be efficient in preventing inferior and anterior shoulder subluxation in the acute stages of stroke.

  17. General anaesthesia in an adult patient with Morquio syndrom with emphasis on airway issues.

    PubMed

    Kadic, Lajla; Driessen, Jacques J

    2012-05-01

    Patients with Morquio syndrome possess a number of characteristics which may complicate an anaesthetic procedure. The most important is that a deposition of mucopolysaccharides in the soft tissues of the oro-pharynx distorts the airway, making the airway management difficult, while the atlanto-axial instability puts these patients at risk of subluxation and quadriparesis. As the endotracheal intubation in Morquio syndrome patients may be difficult or even impossible, we recommend the technique of awake fiberoptic intubation to be considered. Our approach to awake fiberoptic intubation in an adult patient is described in this case report.

  18. Pupil block glaucoma after neodymium:YAG capsulotomy in a patient with a partially subluxated posterior chamber intraocular lens.

    PubMed

    Kersey, James P; McMullan, Tristan F W; Broadway, David C

    2005-07-01

    A 73-year-old-woman presented following neodymium:YAG capsulotomy for posterior capsular opacification with acute glaucoma. Previous cataract surgery had left her with a subluxated lens. Cornea edema obscured detail of the anterior chamber, but the edge of the lens could be seen clearly within the pupillary space. This produced a diagnostic dilemma because no obvious cause for pupil block could be seen. She failed to respond to medical therapy and had a laser iridotomy, following which her symptoms resolved. We believe this case demonstrates the importance of a laser iridotomy to exclude pupil block glaucoma when adequate visualization of the pupillary space is obscured.

  19. Effect of anteromedial and posterolateral anterior cruciate ligament bundles on resisting medial and lateral tibiofemoral compartment subluxations.

    PubMed

    Gardner, Eric J; Noyes, Frank R; Jetter, Andrew W; Grood, Edward S; Harms, Samuel P; Levy, Martin S

    2015-05-01

    This study analyzed the interaction of the anteromedial and posterolateral portions of the anterior cruciate ligament (ACL) in resisting medial and lateral tibiofemoral compartment subluxations under multiple loading conditions. By use of a 6-df robotic simulator, 10 human cadaveric knees were tested in 3 states: intact ACL, partial ACL (loss of either the anteromedial bundle [AMB] or posterolateral bundle [PLB]), and deficient ACL. The testing profile involved anterior-posterior translation and internal-external rotation, as well as 3 pivot-shift loading conditions with varying internal rotation torque (1- or 5-Nm) and coupled anterior force (35- or 100-N). Digitization of anatomic landmarks provided tibiofemoral compartment translations and centers of tibial rotation. During pivot-shift testing (100-N anterior force, 1-Nm internal rotation torque, and 7-Nm valgus), the lateral and medial compartment anterior translation increased by a mean of 2.5 ± 0.8 mm (P = .016) and 3.4 ± 2.0 mm (P = .001), respectively, on AMB sectioning and 1.3 ± 0.9 mm (P = .329) and 0.6 ± 0.7 mm (P = .544), respectively, on PLB sectioning. Higher internal rotation torque (5 Nm v 1 Nm) on pivot-shift testing reduced central and medial anterior translation after ACL sectioning. There was no change in internal rotation on AMB or PLB sectioning. During the Lachman test (100-N), AMB and PLB sectioning increased central translation by 3.6 ± 1.6 mm (P = .001) and 0.7 ± 0.6 mm (P = .498), respectively. Both ACL bundles function synergistically in resisting medial and lateral compartment subluxations on the Lachman and pivot-shift tests. The AMB provided more restraint to anterior tibial translation during both tests as compared with the PLB. PLB sectioning produced no statistically significant change in anterior translation on the Lachman or pivot-shift test. Neither bundle contributed to resisting internal rotation. An ACL graft designed to duplicate the AMB would theoretically

  20. Effectiveness of external rotation immobilization in highly active young men with traumatic primary anterior shoulder dislocation or subluxation.

    PubMed

    Tanaka, Yoshitaka; Okamura, Kenji; Imai, Tomohito

    2010-09-07

    We treated 15 highly active young men (16 shoulders) with traumatic primary anterior shoulder dislocation or subluxation using 3-week external rotation immobilization. Fourteen patients (14 shoulders) were members of the Self-Defense Force and the other patient (2 shoulders) was a high school student who played club-level rugby. Average patient age at the time of the primary injury was 21.3 years (range, 17-26 years). Magnetic resonance imaging (MRI) was performed on 14 of 16 shoulders after the 3-week external rotation immobilization and showed that the anteroinferior labrum was reduced on the glenoid rim in 11 shoulders but remained medially displaced on the glenoid neck in 3 shoulders. Five shoulders, including these 3 shoulders, underwent arthroscopic Bankart repair after 3-week external rotation immobilization. Eleven shoulders continued nonoperative treatment after the immobilization. Four of 11 shoulders had no recurrence of symptoms for >2 years, and these patients were able to return to their preinjury activities. However, 7 shoulders experienced recurrence within 2 years. We concluded that external rotation immobilization may not be as effective as mentioned previously in highly active young men with primary traumatic anterior shoulder dislocation or subluxation. Whether a patient has instability symptom recurrence after external rotation immobilization depends on more than the fact that the anteroinferior labrum is not reduced on MRI. Copyright 2010, SLACK Incorporated.

  1. Effect of biological agents on cervical spine lesions in rheumatoid arthritis.

    PubMed

    Kaito, Takashi; Hosono, Noboru; Ohshima, Shirou; Ohwaki, Hajime; Takenaka, Shota; Fujiwara, Hiroyasu; Makino, Takahiro; Yonenobu, Kazuo

    2012-09-15

    A retrospective cohort analysis. To determine the effect of biological agents (BAs) on the development and progression of cervical spine lesions and identify predictors of lesion progression. The introduction of BAs has facilitated advances in the treatment of rheumatoid arthritis (RA). BAs reduce disease activity and limit structural joint damage. However, the effect of BAs on cervical spine lesions remains unclear. Thirty-eight subjects who received more than 2 years of continuous BA treatment were enrolled. The mean x-ray interval was 4.4 years. RA activity was evaluated by disease activity score (DAS)-C reactive protein (CRP) and matrix metalloproteinase (MMP)-3. Radiographical definitions of cervical lesions were atlanto-dental interval (ADI) more than 3 mm for atlanto-axial subluxation (AAS), Ranawat value less than 13 mm for vertical subluxation (VS), and anterior or posterior listhesis more than 2 mm for subaxial subluxation (SS). Definitions of radiographical progression were an increase of ADI more than 2 mm for AAS, a decrease of both Ranawat and Redlund-Johnell values more than 2 mm for VS, and an increase of listhesis more than 2 mm for SS. RA activity responded dramatically to BA therapy (DAS-CRP from 4.3 to 2.3, P < 0.01; MMP-3 from 207.9 ng/mL to 105.6 ng/mL, P < 0.01). Baseline radiographical evaluation showed no pre-existing cervical spine lesions in 12 cases, AAS in 15 cases, and VS in 11 cases. Radiological progression was found in 1 (8%) patient in the no lesion group, 12 patients (80%) in the AAS group, and 9 patients (80%) in the VS group. The incidence of progression was significantly lower in the no lesion group compared with the other groups. Multivariate regression analysis showed that the presence of pre-existing cervical lesions was the single greatest predictor of progression. BAs prevented the development of de novo cervical spine lesions in patients with RA, but failed to inhibit progression of pre-existing RA lesions.

  2. Familial subluxation of the metacarpophalangeal and proximal interphalangeal joints of the little finger in two consecutive siblings: the "serpentine little finger".

    PubMed

    Jenyo, M S; Nzeh, D A

    1990-01-01

    Two consecutive siblings, both males, presented with congenital curly little finger ('serpentine finger') caused by subluxations at the metacarpo-phalangeal and the proximal interphalangeal joints. Literature on this phenomenon is scant, and to the best of the authors' knowledge it is probably a new entity. A theory of the possible aetiology is presented.

  3. Effects of Brain-Computer Interface-controlled Functional Electrical Stimulation Training on Shoulder Subluxation for Patients with Stroke: A Randomized Controlled Trial.

    PubMed

    Jang, Yun Young; Kim, Tae Hoon; Lee, Byoung Hee

    2016-06-01

    The purpose of this study was to investigate the effects of brain-computer interface (BCI)-controlled functional electrical stimulation (FES) training on shoulder subluxation of patients with stroke. Twenty subjects were randomly divided into two groups: the BCI-FES group (n = 10) and the FES group (n = 10). Patients in the BCI-FES group were administered conventional therapy with the BCI-FES on the shoulder subluxation area of the paretic upper extremity, five times per week during 6 weeks, while the FES group received conventional therapy with FES only. All patients were assessed for shoulder subluxation (vertical distance, VD; horizontal distance, HD), pain (visual analogue scale, VAS) and the Manual Function Test (MFT) at the time of recruitment to the study and after 6 weeks of the intervention. The BCI-FES group demonstrated significant improvements in VD, HD, VAS and MFT after the intervention period, while the FES group demonstrated significant improvements in HD, VAS and MFT. There were also significant differences in the VD and two items (shoulder flexion and abduction) of the MFT between the two groups. The results of this study suggest that BCI-FES training may be effective in improving shoulder subluxation of patients with stroke by facilitating motor recovery. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Otitis interna, media, and externa with destruction of the left tympanic bulla and subluxation and septic arthritis of the left temporomandibular joint in an alpaca (Vicugna pacos)

    PubMed Central

    Galvan, Noe; Middleton, John R.; Cook, Cristi; Britt, Lisa G.; Kuroki, Keiichi

    2013-01-01

    A 1.5-year-old, 37.7 kg, female alpaca was evaluated for a 2-week history of weight loss, left ear droop, and deviation of the rostral mandible to the right. Antemortem radiography and postmortem examination revealed otitis interna, media, and externa, destruction of the left tympanic bulla, and subluxation and septic arthritis of the left temporomandibular joint. PMID:23997267

  5. The epidemiology of 1345 shoulder dislocations and subluxations in French Rugby Union players: a five-season prospective study from 2008 to 2013.

    PubMed

    Bohu, Yoann; Klouche, Shahnaz; Lefevre, Nicolas; Peyrin, Jean-Claude; Dusfour, Bernard; Hager, Jean-Philippe; Ribaut, Aurélie; Herman, Serge

    2015-12-01

    An understanding of the epidemiology of shoulder dislocation/subluxation in rugby union players could help develop targeted prevention programmes and treatment. We performed a multiyear epidemiological survey of shoulder dislocation/subluxation in a large cohort of rugby players. A descriptive epidemiological study was performed prospectively for five playing seasons (2008-2013) in all players licensed in the French Rugby Union. Rugby players were categorised into five groups by age. The player and the team physician reported the injury to the club insurance company if it occurred during training or a match. The goals of the study were to define the rate, type and causes of shoulder dislocation/subluxation. 88,044 injuries were reported, including 1345 (1.5%) episodes of dislocation/subluxation in 1317 men and 28 women, mean age 22.5±5.9 years. About 10/10,000 men and 5/10,000 women reported an episode of shoulder dislocation/subluxation per season, including 83/10,000 senior professionals, 17/10,000 senior amateurs, 21/10,000 juniors, 12/10,000 cadets and <1/10,000 rugby school players. Shoulder dislocation/subluxation was significantly more frequent in senior and junior players (p<0.001). Injuries mainly occurred during a match (66%) in the middle of the season (44%). The most frequent playing position was forwards (56%) and the main mechanism was tackling (69%). When reported, the history of recurrence was found in 66% of injured players, fractures in 22% and acromioclavicular injury in 6.7%. Nerve injury was associated with shoulder dislocation in 6% of cases. Senior professionals and junior male forward rugby players with a history of shoulder dislocation/subluxation should receive special attention from sports medicine professionals and orthopaedic surgeons. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma

    PubMed Central

    Wang, Rui; Bi, Chun-Chao; Lei, Chun-Ling; Sun, Wen-Tao; Wang, Shan-Shan; Dong, Xiao-Juan

    2014-01-01

    AIM To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL) implantation. METHODS Non-comparative retrospective observational case series. Participants: 30 cases (30 eyes) of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi'an No.4 Hospital from 2007 to 2011. According to the different situations of lens subluxation/dislocation, various surgical procedures were performed such as crystalline lens phacoemulsification, crystalline lens phacoemulsification combined anterior vitrectomy, intracapsular cataract extraction combined anterior vitrectomy, lensectomy combined anterior vitrectomy though peripheral transparent cornea incision, pars plana lensectomy combined pars plana vitrectomy, and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy. And whether to implement trabeculectomy depended on the different situations of secondary glaucoma. The posterior chamber intraocular lenses (PC-IOLs) were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present. Main outcome measures: visual acuity, intraocular pressure, the situation of intraocular lens and complications after the operations. RESULTS The follow-up time was 11-36mo (21.4±7.13). Postoperative visual acuity of all eyes were improved; 28 cases maintained IOP below 21 mm Hg; 2 cases had slightly IOL subluxation, 4 cases had slightly tilted lens optical area; 1 case had postoperative choroidal detachment; 4 cases had postoperative corneal edema more than 1wk, but eventually recovered transparent; 2 cases had mild postoperative vitreous hemorrhage, and absorbed 4wk later. There was no postoperative retinal detachment, IOL dislocation, and

  7. Scleral fixation of a subluxated intraocular lens-capsular bag complex through a fibrotic continuous curvilinear capsulorhexis.

    PubMed

    Gimbel, Howard V; Brucks, Matthew; Dardzhikova, Albena A; Camoriano, Gerardo D

    2011-04-01

    Several strategies have been devised to manage in-the-bag intraocular lens (IOL) subluxation. We describe a method of fixating the IOL-capsular bag complex to the sclera using the fibrotic ring that develops around the continuous curvilinear capsulorhexis (CCC). Two, preferably 3, double-armed 10-0 polypropylene sutures are passed around the fibrotic CCC rim of the capsule and out the Hoffman scleral pockets and then tied in the scleral tunnels to center the IOL-bag complex. This technique provides an alternative approach to repositioning and fixating the IOL-bag complex that is especially useful in cases in which removal and replacement of the IOL would be difficult. It also provides more than 2-point fixation to achieve perfect IOL centration. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  8. Radial Head Subluxation: Factors Associated with Its Recurrence and Radiographic Evaluation in a Tertiary Pediatric Emergency Department.

    PubMed

    Wong, Kei; Troncoso, Alex B; Calello, Diane P; Salo, David; Fiesseler, Fred

    2016-12-01

    Radial head subluxation (RHS) is a common complaint seen in the pediatric emergency department in children ages 6 months to 4 years. Classically, injury occurs due to axial traction on the arm, but this mechanism is not universal. Some patients will have recurrent RHS; some may undergo x-ray (XR) evaluation for alternative diagnosis. To determine factors associated with recurrences and radiographic evaluations in RHS. A retrospective study with inclusion criteria: under 10 years of age with discharge diagnosis "nursemaid," "radial head," or "subluxation." We examined factors associated with RHS recurrences, circumstances when radiographic evaluations performed, physician's training background (pediatric vs. general emergency medicine), mechanisms of injury, and demographic factors including age, gender, and arm involved. In 246 visits, median age was 27 months (interquartile range 16.1), with females comprising 55.7% (n = 137), and left-sided predominance (52%, n = 130). Mechanisms of injury were classified as "pull" (65.9%, n = 162), "non-pull" (15.9%, n = 39), and "unknown" (18.3%, n = 45). Eighteen patients with recurring RHS were more likely to be male (p = 0.008). In 61 visits where radiography was performed, patients were older (p = 0.03), with a higher frequency seen in non-pull and unknown mechanism (p = 0.0001). No significant difference was found in frequency of radiographs obtained in regard to physician training (p = 0.4660). RHS can result from a myriad of mechanisms. We found that recurrence was more likely in male patients. Factors associated with radiographic evaluation included atypical mechanism, older age, and unclear history, regardless of physician training background. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Proximal junctional vertebral fracture-subluxation after adult spine deformity surgery. Does vertebral augmentation avoid this complication? A case report

    PubMed Central

    2012-01-01

    Background To report to the orthopedic community a case of vertebral fracture and adjacent vertebral subluxation through the upper instrumented vertebra after thoracolumbar fusion with augmentation of the cranial level. Methods This report reviewed the patient`s medical record, her imaging studies and related literature. The possible factors contributing to this fracture are hypothesized. Results A 70-year-old woman underwent decompressive surgery and posterolateral fusion for adult lumbar scoliosis. We used pedicular screws from T10 to S1 and iliac screw at the right side, augmented with cement at T10, T11, L1, L5 and S1; and prophylactic vertebroplasty at T9 to avoid the "topping-off syndrome". Thirty days after discharge, without recognizable inciting trauma, the patient complained of pain in the lower thoracic area. The exam revealed overall neurological deficit below the level of fracture. CT scan and MRI demonstrated a T10 vertebral collapse and T9 vertebral subluxation with morphologic features of flexion-distraction fracture through the upper edge of the screw. At this point, the authors performed posterior decompression at T9 to T10 and extended posterolateral arthrodesis from T2 to T10. To our knowledge, this is an unreported fracture. Conclusions Augmentation of the cranial level in a long thoracolumbar fusion has been developed to avoid the junctional kyphosis and compression fractures at that level. We alert the orthopedic community that this augmentation may lead to further and more severe fractures, although this opinion requires investigation for confirmation. PMID:22947422

  10. Traumatic subaxial cervical facet subluxation and dislocation: epidemiology, radiographic analyses, and risk factors for spinal cord injury.

    PubMed

    Quarrington, Ryan D; Jones, Claire F; Tcherveniakov, Petar; Clark, Jillian M; Sandler, Simon J I; Lee, Yu Chao; Torabiardakani, Shabnam; Costi, John J; Freeman, Brian J C

    2017-07-21

    .5%). Younger adults were over-represented among motor-vehicle accidents, whereas falls contributed to a majority of DFIs sustained by older adults. Greater vertebral translation, together with lower facet apposition, distinguished facet dislocation from subluxation. Dislocation, bilateral facet injury, reduced Glasgow Coma Scale, spinal canal occlusion, and spinal cord compression were predictive of neurologic deficit. Radiographic measurements demonstrated at least a "moderate" agreement (ICC>0.4), with most demonstrating an "almost perfect" reproducibility. This large-scale cohort investigation of DFIs in the cervical spine describes radiographic features that distinguish facet dislocation from subluxation, and associates highly reproducible anatomical and clinical indices to the occurrence of concomitant SCI. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Chronic C1-C2 Rotatory Subluxation Reduced by C1 Lateral Mass Screws and C2 Translaminar Screws: A Case Report.

    PubMed

    Lavelle, William F; Palomino, Kathryn; Badve, Siddharth A; Albanese, Stephen A

    C1-C2 rotatory subluxation can result from a variety or etiologies. Pediatric patients are particularly susceptible to C1-C2 rotatory subluxation. If left untreated the condition is termed an atlantoaxial rotatory fixation (AARF) and chronic neck pain and deformity can result. Patients failing conservative treatment or those with recurrent or chronic rotatory subluxation may require halo treatment or surgical intervention. This illustrative case report is about a patient with chronic C1-C2 AARF who was treated with C1 lateral mass screws and C2 translaminar screws, a treatment that has not been addressed by this technique in a pediatric population. This is a retrospective case review. After an unsuccessful attempt at reduction, an 11-year-old girl underwent surgery to treat her C1-C2 AARF. Through an all posterior approach, screws were placed bilaterally into the C1 lateral masses followed by the placement of C2 translaminar screws bilaterally. A small amount of distraction was applied through the screw construct to open up the C1-C2 articulation and the AARF was open reduced and fused. A detailed postoperative computed tomographic scan focused on the occiput C1-C2 joint confirmed the anatomical reduction of the joint complex. The patient had cosmetically pleasing relief of her torticollis and was doing well at 60 months after surgery. Level IV.

  12. Subluxation of the Cricoarytenoid Joint After External Laryngeal Trauma: A Rare Case and Review of the Literature.

    PubMed

    Friedlander, Eviatar; Pascual, Paula Martínez; Da Costa Belisario, Julia; Serafini, Daniel Poletti

    2017-03-01

    Cricoarytenoid joint subluxation is rare condition. There are <200 cases reported in the English literature. The most frequent cause of this condition is a traumatic tracheal intubation which account for approximately 80 % of all cases. The most common symptoms are dysphonia and pain of the anterior region of the neck which appear after upper airway manipulation or cervical trauma. In this report we present a well-documented case of a 31 year old male that was referred to the outpatient clinic because of acute dysphonia and pain that appeared immediately after receiving a blow of a soccer ball. Diagnosis was suspected after patient reported the acute onset of symptoms after the traumatic event along with findings in flexible fiberoptic laryngoscopy and videostroboscopy. A CT scan of the larynx was done where the injury of the left cricoarytenoid joint was seen. The patient was informed of the condition and was given the option of surgical reduction or speech therapy. Speech therapy was done for 3 month and the patient was satisfied with the result, although the anatomical abnormality persisted. We reviewed the literature and we discuss the diagnosis process and possible treatment options.

  13. Cervical pedicle screw fixation in traumatic cervical subluxation after laminectomy using the pedicle axis view technique under fluoroscopy.

    PubMed

    Machino, Masaaki; Yukawa, Yasutsugu; Ito, Keigo; Nakashima, Hiroaki; Kanbara, Shunsuke; Morita, Daigo; Kato, Fumihiko

    2012-10-10

    Cervical pedicle screw (CPS) fixation has recently been performed in patients in need of cervical reconstruction. We report the case of a 50-year-old man who was operated for traumatic cervical vertebra subluxation using CPS fixation, in whom laminectomy had been performed in the past. We performed CPS fixation using the pedicle axis view technique under fluoroscopy. The four pedicle screws were accurately inserted within the pedicles without perforating the bone cortex of the pedicles. A navigation system is useful for cervical spine surgery because it enables a surgeon to perform relatively safe and accurate surgery during transpedicular screw fixation. However, attachment of the stereotactic reference arc to the spinous process is impossible, and the application of a navigation system is limited in cases in which laminectomy has been performed in the past. We have been using the pedicle axis view technique under fluoroscopy and have found that if we take care of the entry point accurately, we can safely insert the pedicle screw in cases with fewer landmarks.

  14. Lap-tray and triangular sling are no more effective than a hemi-sling in preventing shoulder subluxation in those at risk early after stroke: a randomized trial.

    PubMed

    Ada, Louise; Foongchomcheay, Anchalee; Langhammer, Birgitta; Preston, Elisabeth; Stanton, Rosalyn; Robinson, John; Paul, Serene; Canning, Colleen

    2017-02-01

    Shoulder subluxation is a common secondary impairment of the upper limb following stroke. A range of supportive devices are used in rehabilitation to prevent shoulder subluxation, including hemi-slings and firm supports, such as arm troughs, however, there is little evidence regarding their efficacy. To determine whether a modified lap-tray during sitting and a triangular sling during standing is more effective than a hemi-sling in preventing shoulder subluxation, pain, contracture and upper limb activity limitation after stroke. A prospective, randomized trial with concealed allocation, assessor blinding and intention-to-treat analysis. Three inpatient rehabilitation units in Australia and Norway. Forty-six acute stroke survivors within 3 weeks of stroke who were at risk of subluxation. The experimental group used a modified lap-tray while sitting and a triangular sling while standing to support the affected arm for four weeks. The control group used a hemi-sling while sitting and standing. The primary outcome was amount of shoulder subluxation on X-ray. Secondary outcomes were upper limb activity, pain and contracture. There was no significant difference between groups in terms of shoulder subluxation (MD -3 mm, 95% CI -8 to 3). There was a trend for the experimental group to develop less pain at rest (MD -0.7 out of 10, 95% CI -2.2 to 0.8) and during shoulder external rotation (MD -1.7 out of 10, 95% CI -3.7 to 0.3) and a trend towards having less contracture of shoulder external rotation (MD -10 deg, 95% CI -22 to 2). There was no significant difference between groups in terms of other contractures and activity of the upper limb. A lap-tray during sitting combined with a triangular sling during standing is no more effective than a hemi-sling in preventing subluxation, pain, contracture and activity limitation in acute stroke survivors at risk of shoulder subluxation. The use of a lap-tray during sitting and triangular sling during standing is not indicated as

  15. Effects of implant design parameters on fluid convection, potentiating third-body debris ingress into the bearing surface during THA impingement/subluxation.

    PubMed

    Lundberg, Hannah J; Pedersen, Douglas R; Baer, Thomas E; Muste, Marian; Callaghan, John J; Brown, Thomas D

    2007-01-01

    Aseptic loosening from polyethylene wear debris is the leading cause of failure for metal-on-polyethylene total hip implants. Third-body debris ingress to the bearing space results in femoral head roughening and acceleration of polyethylene wear. How third-body particles manage to enter the bearing space between the closely conforming articulating surfaces of the joint is not well understood. We hypothesize that one such mechanism is from convective fluid transport during subluxation of the total hip joint. To test this hypothesis, a three-dimensional (3D) computational fluid dynamics (CFD) model was developed and validated, to quantify fluid ingress into the bearing space during a leg-cross subluxation event. The results indicated that extra-articular joint fluid could be drawn nearly to the pole of the cup with even very small separations of the femoral head (<0.60mm). Debris suspended near the equator of the cup at the site of maximum fluid velocity just before the subluxation began could be transported to within 11 degrees from the cup pole. Larger head diameters resulted in increased fluid velocity at all sites around the entrance to the gap compared to smaller head sizes, with fluid velocity being greatest along the anterosuperolateral cup edge, for all head sizes. Fluid pathlines indicated that suspended debris would reach similar angular positions in the bearing space regardless of head size. Increased inset of the femoral head into the acetabular cup resulted both in higher fluid velocity and in transport of third-body debris further into the bearing space.

  16. Surgical treatment of scapulohumeral subluxation in an alpaca (Vicugna pacos) using osteotomy of the acromion, open reduction and extracapsular tension sutures.

    PubMed

    Kofler, J; Eberspächer, E; Fischl, K; Vidoni, B

    2016-05-01

    A 3.3-year-old male alpaca, weighing 60 kg was referred for investigation of a severe left forelimb lameness of 4 weeks duration. A scapulohumeral subluxation had been diagnosed radiographically by the referring veterinarian. Based on clinical, ultrasonographic and radiographic findings the diagnosis of cranio-lateral subluxation of the left humeral head was confirmed. In addition, a full thickness lesion (approximately 1×1 cm) of the articular cartilage on the caudomedial aspect of the humeral head was diagnosed by arthroscopy. Treatment included open reduction with internal fixation. Severe muscle contraction and local tissue fibrosis around the scapulohumeral joint (SHJ) required osteotomy of the acromion 3 cm proximal to the distal acromial edge, to allow adequate access. Internal stabilisation was achieved by placing tension band sutures between one cortical screw in the scapular neck and two cortical screws, with washers, craniolaterally on the greater tubercle of the humerus. Post-surgery, a carpal flexion sling was applied with the carpus maintained in 70° flexion for 4 weeks to avoid postoperative weight-bearing. An exercise programme was started 8 days after surgery and continued for 12 weeks. The alpaca had an uneventful postsurgical recovery and showed no lameness after 8 weeks. The long-term outcome was excellent; 21 months after surgery the alpaca was sound and the range of movement of the left SHJ was equal to the right SHJ. Even in this chronic case of subluxation of the SHJ of 4 weeks duration, surgical treatment using osteotomy of the acromion, open reduction and internal fixation with extracapsular scapulohumeral tension sutures resulted in an excellent long-term outcome in this alpaca, despite the presence of a cartilage lesion.

  17. Effects of Implant Design Parameters on Fluid Convection, Potentiating 3rd Body Debris Ingress into the Bearing Surface during THA Impingement/Subluxation

    PubMed Central

    Lundberg, Hannah J.; Pedersen, Douglas R.; Baer, Thomas E.; Muste, Marian; Callaghan, John J.; Brown, Thomas D.

    2007-01-01

    Aseptic loosening from polyethylene wear debris is the leading cause of failure for metal-on-polyethylene total hip implants. Third body debris ingress to the bearing space results in femoral head roughening and acceleration of polyethylene wear. How third body particles manage to enter the bearing space between the closely conforming articulating surfaces of the joint is not well understood. We hypothesize that one such mechanism is from convective fluid transport during subluxation of the total hip joint. To test this hypothesis, a three-dimensional computational fluid dynamics model was developed and validated, to quantify fluid ingress into the bearing space during a leg-cross subluxation event. The results indicated that extra-articular joint fluid could be drawn nearly to the pole of the cup with even very small separations of the femoral head (<0.60 mm). Debris suspended near the equator of the cup at the site of maximum fluid velocity just before the subluxation began could be transported to within 11° from the cup pole. Larger head diameters resulted in increased fluid velocity at all sites around the entrance to the gap compared to smaller head sizes, with fluid velocity being greatest along the anterosuperolateral cup edge, for all head sizes. Fluid pathlines indicated that suspended debris would reach similar angular positions in the bearing space regardless of head size. Increased inset of the femoral head into the acetabular cup resulted both in higher fluid velocity and in transport of third body debris further into the bearing space. PMID:17400230

  18. Posterior fixation for atlantoaxial subluxation in a case with complex anomaly of persistent first intersegmental artery and assimilation in the C1 vertebra.

    PubMed

    Umebayashi, Daisuke; Hara, Masahito; Nakajima, Yasuhiro; Nishimura, Yusuke; Wakabayashi, Toshihiko

    2013-01-01

    We report a very rare case of atlantoaxial subluxation (AAS) with persistent first intersegmental artery (PFIA) and assimilation in the atlas (C1) vertebra. This case demonstrates the difficulty of deciding on a surgical strategy for complex anomalies. A 63-year-old man presented with gait disturbance, neck pain, and severe dysesthesia in his left arm. Past history included a whiplash injury. Dynamic X-ray studies demonstrated an irreducible AAS and assimilation of C1. This subluxation was slightly deteriorated in an extended position. A three-dimensional computed tomography angiography (3DCTA) indicated that the PFIA was located on the left side. We performed a C1 posterior arch resection and C1 lateral mass-axis pedicle screw (C1LM-C2PS) fixation using the modified technique of skewering the occipital condyle and C1 lateral mass. The patient had no postoperative morbidity and his symptoms disappeared immediately after operation. Complex anomalies cause difficulty in determining surgical strategy although several surgical methods for simple craniovertebral junction anomaly have been reported. To avoid significant morbidities associated with vertebral artery injury, surgical strategies for these complex conditions are discussed. The modified technique of a C1 lateral mass screw penetrating the occipital condyle is a viable treatment option.

  19. Cadaveric study of movement of an unstable atlanto-axial (C1/C2) cervical segment during laryngoscopy and intubation using the Airtraq(®) , Macintosh and McCoy laryngoscopes.

    PubMed

    McCahon, R A; Evans, D A; Kerslake, R W; McClelland, S H; Hardman, J G; Norris, A M

    2015-04-01

    Concern that laryngoscopy and intubation might create or exacerbate a spinal cord injury has generated extensive research into cervical spinal movement during laryngoscopy. We performed a randomised trial on six cadavers, using three different laryngoscopes, before and after creating a type-2 odontoid peg fracture. Our primary outcome measure was the change in the space available for the spinal cord at the C1/2 segment measured by cinefluoroscopy. Tracheal intubation was performed using a minimal view of the glottis, a bougie, and manual in-line stabilisation. In a cadaveric model of type-2 odontoid fracture, the space available for the cord was preserved in maximum flexion and extension, and changed little on laryngoscopy and intubation.

  20. Biceps tendinitis and subluxation.

    PubMed

    Patton, W C; McCluskey, G M

    2001-07-01

    Since the 17th century, the long head of the biceps tendon as a source of shoulder pain and its functional significance has been a source of debate. Although the term tendinitis is commonly used, overuse tendon injuries infrequently demonstrate inflammatory cells; instead, degenerative changes resulting from the failure of self-repair usually are found. Bicipital tendinitis or bicipital tenosynovitis is most often secondary to impingement beneath the coracoacromical arch. Primary bicipital tendinitis and tendinitis secondary to instability are possible, however. Through a careful history, physical examination, and appropriate imaging studies, the clinician can establish the diagnosis of disorders of the biceps tendon Arthroscopic evaluation greatly improves the diagnosis and treatment of biceps tendon and related shoulder pathology. Although the exact functional role of the biceps tendon remains incompletely defined, a growing body of evidence supports its role as a stabilizer of the glenohumeral joint. This stabilizing function should be incorporated into the treatment of biceps tendon disorders. Routine tenodesis has been replaced by a more individualized approach, taking into consideration physiologic age, activity level, expectations, and exact shoulder pathology present. New repair techniques are under development, and preservation of the biceps-labral complex is now preferred when possible.

  1. Damaged ligaments at the craniocervical junction presenting as an extradural tumour: a differential diagnosis in the elderly.

    PubMed Central

    Crockard, H A; Sett, P; Geddes, J F; Stevens, J M; Kendall, B E; Pringle, J A

    1991-01-01

    An extradural mass at the craniocervical junction causing progressive neurological disability in five elderly patients is described. The lesion, which might be confused with a meningioma or other tumour, is composed of amorphous degenerate fibrocartilaginous material and could be due to degeneration of the ligaments responsible for atlanto-axial stability. Recognition of the condition early is important as the patient's clinical condition will deteriorate without decompression. Anterior transoral removal is relatively simple, unlike surgery for tumours in the area, and will not destabilise the craniovertebral junction. It is likely that a proportion of these lesions are undetected, misdiagnosed or untreated to the detriment of the patient. Images PMID:1955901

  2. [Treatment of subluxation and dislocation of the patella in the child. Elmslie technic with movable soft tissue pedicle (8 year review)].

    PubMed

    Grammont, P M; Latune, D; Lammaire, I P

    1985-09-01

    The Elmslie method using a soft-tissue strip aims at realigning the extensor mechanism in the same way as the Elmslie-Trillat operation in adults. We feel that the main cause of dislocation or subluxation of the patella is to be found in incorrect alignment of this mechanism. We feel that the Q angle should especially be correct with regard to knee stability during rotation. This angle should not be neutralized or even inverted. In young, growing patients, as compared to adults, excess stress on the medial side due to medial displacement of the tuberosity will be compensated for by increasing valgus of the knee joint. Analysis of the potential risks involved in this pretuberosity operation led us to the conclusion that there is no risk of early epiphysiodesis or bony recurvation, and no risk of patella baja or osteochondrosis of the tuberosity. The functional results are so far very satisfactory (13 of 17 reexamined cases continue to be involved in sports or have taken up sports); this is particularly rewarding if we consider that the operation is not technically demanding and may even be undergone by ambulatory patients.

  3. Arthroscopic repair of anterosuperior (supraspinatus/subscapularis) rotator cuff tears: a prospective cohort with 2- to 4-year follow-up. Classification of biceps subluxation/instability.

    PubMed

    Bennett, William F

    2003-01-01

    The purpose of this study was to evaluate the outcome of patients who underwent arthroscopic repair of anterosuperior rotator cuff tears. The null hypothesis, that there was no difference between preoperative scores and postoperative scores, was tested statistically. A cohort study. The preoperative and postoperative status of patients with anterosuperior rotator cuff tears was analyzed using the Constant score, American Shoulder and Elbow Society Index (ASES Index), a visual analog pain scale (VAS), a single question of percent function compared with the opposite unaffected extremity, and a single question reflecting satisfaction, "would you undergo the surgery and the postoperative rehabilitation to achieve the result you have today." There were also 2 groups compared: 1 that had a "tac" used for repair of the subscapularis tendon, and the other that used a "tie" technique for subscapularis repair. All supraspinatus tendon tears were complete and were repaired using a soft-tissue fixation device. There was a statistically significant difference for all outcome measures except for the objective Constant score of the tie group, P =.58. Follow-up was 2 to 4 years. There were no differences based on sex or type of fixation device used for repair of the subscapularis tendon. There were no reruptures, clinically. The arthroscopic repair of anterosuperior rotator cuff tears provides reliable expectation for improvement in function, decreases in pain, decreases in clinical findings of biceps subluxation and inflammation, improvement in shoulder scores, and the improvement of clinical findings of subscapularis insufficiency.

  4. Practice-based randomized controlled-comparison clinical trial of chiropractic adjustments and brief massage treatment at sites of subluxation in subjects with essential hypertension: pilot study.

    PubMed

    Plaugher, Gregory; Long, Cynthia R; Alcantara, Joel; Silveus, Alyssa D; Wood, Herbert; Lotun, Kapildeo; Menke, J Michael; Meeker, William C; Rowe, Stephen H

    2002-05-01

    To determine the feasibility of conducting a randomized clinical trial in the private practice setting examining short- and long-term effects of chiropractic adjustments for subjects with essential hypertension compared with a brief soft tissue massage, as well as a nontreatment control group. Randomized controlled-comparison trial with 3 parallel groups. Private practice outpatient chiropractic clinic. Twenty-three subjects, aged 24 to 50 years with systolic or diastolic essential hypertension. Two months of full-spine chiropractic care (ie, Gonstead) consisting primarily of specific-contact, short-lever-arm adjustments delivered at motion segments exhibiting signs of subluxation. The massage group had a brief effleurage procedure delivered at localized regions of the spine believed to be exhibiting signs of subluxation. The nontreatment control group rested alone for a period of approximately 5 minutes in an adjustment room. Cost per enrolled subject, as well as systolic and diastolic blood pressure (BP) measured with a random-0 sphygmomanometer and patient reported health status (SF-36). Pilot study outcome measures also included an assessment of cooperation of subjects to randomization procedures and drop-out rates, recruitment effectiveness, analysis of temporal stability of BPs at the beginning of care, and the effects of inclusion/exclusion criteria on the subject pool. Thirty subjects enrolled, yielding a cost of $161 per enrolled subject. One subject was later determined to be ineligible, and 6 others dropped out. In both the chiropractic and massage therapy groups, all subjects were classified as either overweight or obese; in the control group there were only 2 classified as such. SF-36 profiles for the groups were similar to that of a normal population. The mean change in diastolic BP was -4 (95% confidence interval [CI]: -8.6, 0.5) in the chiropractic care group, 0.5 (95% CI: -3.5, 4.5) in the brief massage treatment group, and -4.9 (95% CI: -9.7, -0

  5. The Norberg angle is not an accurate predictor of canine hip conformation based on the distraction index and the dorsolateral subluxation score.

    PubMed

    Gaspar, Ana R; Hayes, Galina; Ginja, Catarina; Ginja, Mário M; Todhunter, Rory J

    2016-12-01

    Canine hip dysplasia (CHD) is a common complex trait characterized by abnormal hip joint development. Hip joint laxity, an early characteristic of CHD, results in degeneration of the joint due to mechanical trauma, which is a clinical problem mostly in medium to large breed dogs. Clinical signs include pain, decreased activity and lameness. A retrospective, multi-center, cross sectional study of 437 dogs was performed to determine if a Norberg angle (NA) ≥105° accurately predicts a non-dysplastic hip based on a distraction index (DI) cut-off of ≤0.3 or a dorsolateral subluxation (DLS) score cut-off of ≥55%. The predictive capacity of the NA against a DI ≤0.3 or a DLS score ≥55% was assessed using area under the receiver operator characteristic (ROC) curve analysis. The ROC curve of NA for the prediction of a DI ≤0.3 was 0.59 (95% CI=0.50-0.69) and for the prediction of DLS score ≥55% was 0.69 (95% CI=0.63-0.75). Optimizing the specificity of the NA to ≥80% for prediction of a DI ≤0.3 and a DLS score ≥55% gave a cut-point for the NA of ≥112° and 108.7°, respectively. In conclusion, at the cut-point of 105°, the NA is not an accurate measurement to score normal or abnormal hips, based on the DI or DLS score. Application of screening methods for CHD based on hip laxity, such as the DI or the DLS score, would help to remove additional dysplastic dogs from the breeding pool or the NA criterion should be higher when selecting unaffected dogs for breeding.

  6. Patella malalignment, pain and patellofemoral progression: The Health ABC Study

    PubMed Central

    Hunter, DJ; Zhang, YQ; Niu, JB; Felson, DT; Kwoh, K; Newman, A; Kritchevsky, S; Harris, T; Carbone, L; Nevitt, M

    2007-01-01

    Objective Patellofemoral (PF) joint OA is strongly correlated with lower extremity disability and knee pain. Risk factors for pain and structural progression in patellofemoral OA are poorly understood. Our objective was to determine the association between patella malalignment and its relation to pain severity, and PF OA disease progression. Methods We conducted an analysis of data from the Health ABC knee OA study. Health ABC is a community based, multi-center cohort study of 3,075 Caucasian and Black men and women aged 70–79 at enrollment. Weight bearing skyline knee x-rays were obtained in a subset (595) of subjects, with and without knee pain, at year 2 and year 5 (mean follow-up 36 months). Films were read paired, and patellofemoral osteophytes (OST) and narrowing (JSN) were scored on a 0–3 scale using the OARSI atlas. We defined progression of PF OA as any increase in JSN score. 3 measures of patella malalignment were made: sulcus angle; patella tilt angle; and patella subluxation medially or laterally (bisect offset). Knee symptoms were assessed using a knee specific WOMAC knee pain subscale. We assessed the relationship between baseline patella malalignment and pain severity (linear regression for WOMAC) and compartment specific PF OA progression (logistic regression for dichotomous outcomes). We classified continuous measures of patella alignment into quartile groups. We performed multivariable adjusted logistic regression models, including age, gender and BMI to assess the relation of baseline patella alignment to the occurrence of PF JSN progression using generalized estimating equations. Results The subjects had a mean age 73.6 (SD 2.9), BMI 28.8 (SD 4.9), 40.3% male, and 46% were Black. Medial displacement of the patella predisposed to medial JSN progression; odds for each quartile 1, 1.2, 1.2, 2.2 (p for trend=0.03), whilst protecting from lateral JSN progression; odds for each quartile 1, 0.7, 0.6, 0.4 (p for trend=0.0004). Increasing patella

  7. Central nervous system and cervical spine abnormalities in Apert syndrome.

    PubMed

    Breik, Omar; Mahindu, Antony; Moore, Mark H; Molloy, Cindy J; Santoreneos, Stephen; David, David J

    2016-05-01

    Apert syndrome characterized by acrocephalosyndactyly is a rare autosomal dominant congenital malformation with a prevalence of 1/65,000 births. With an extensive range of phenotypic and developmental manifestations, its management requires a multidisciplinary approach. A variety of craniofacial, central nervous system (CNS), and cervical spine abnormalities have been reported in these patients. This study aimed to determine the incidence of these CNS abnormalities in our case series. Retrospective review of Australian Craniofacial Unit (ACFU) database for Apert patients was performed. Data collected that included demographics, place of origin, age at presentation, imaging performed, and images were reviewed and recorded. Where available, developmental data was also recorded. Ninety-four patients seen and managed at the ACFU had their CNS and cervical spine abnormalities documented. The main CNS abnormalities were prominent convolutional markings (67 %), ventriculomegaly (48 %), crowded foramen magnum (36 %), deficient septum pellucidum (13 %), and corpus callosum agenesis in 11 %. Major C-spine findings were present in 50.8 % of patients and included fusion of posterior elements of C5/C6 (50 %) and C3/4 (27 %). Multilevel fusion was seen in 20 %. Other abnormalities were C1 spina bifida occulta (7 %) and atlanto-axial subluxation (7 %). Multiple CNS and cervical spine (c-spine) abnormalities are common in Apert syndrome. The significance of these abnormalities remains largely unknown. Further research is needed to better understand the impact of these findings on growth, development, and treatment outcomes.

  8. Hypoplastic occipital condyle and third occipital condyle: review of their dysembryology.

    PubMed

    Tubbs, R Shane; Lingo, Patrick Ryan; Mortazavi, Martin M; Cohen-Gadol, Aaron A

    2013-11-01

    Disruption or embryologic derailment of the normal bony architecture of the craniovertebral junction (CVJ) may result in symptoms. As studies of the embryology and pathology of hypoplasia of the occipital condyles and third occipital condyles are lacking in the literature, the present review was performed. Standard search engines were accessed and queried for publications regarding hypoplastic occipital condyles and third occipital condyles. The literature supports the notion that occipital condyle hypoplasia and a third occipital condyle are due to malformation or persistence of the proatlas, respectively. The Pax-1 gene is most likely involved in this process. Clinically, condylar hypoplasia may narrow the foramen magnum and lead to lateral medullary compression. Additionally, this maldevelopment can result in transient vertebral artery compression secondary to posterior subluxation of the occiput. Third occipital condyles have been associated with cervical canal stenosis, hypoplasia of the dens, transverse ligament laxity, and atlanto-axial instability causing acute and chronic spinal cord compression. Treatment goals are focused on craniovertebral stability. A better understanding of the embryology and pathology related to CVJ anomalies is useful to the clinician treating patients presenting with these entities.

  9. Successful antibiotic treatment for subdural empyema and seizure due to methicillin-resistant Staphylococcus aureus as a complication of halo orthosis usage: a case report.

    PubMed

    Hioki, Akira; Miyamoto, Kei; Inoue, Toshiyuki; Hosoe, Hideo; Shinoda, Jun; Iwama, Toru; Shimizu, Katsuji

    2012-11-01

    Halo orthosis is used for cervical spine fixation after spinal surgery or injury. Although superficial infection at pin sites occurs frequently, intracranial development of infection, including brain abscesses, is very rare. We experienced subdural empyema due to methicillin-resistant Staphylococcus aureus (MRSA) caused by intracranial penetration of halo pins. A 38-year-old woman with a 4-year history of rheumatoid arthritis experienced severe myelopathy due to atlanto-axial dislocation and vertical subluxation. Reduction and immobilization using a halo vest resulted in neurologic improvement; she later underwent occipital bone to C2 fusion using posterior instrumentation. Three months after halo orthosis fixation, she complained of a headache, experienced a generalized tonic-clonic seizure, and became unconscious for 10 min. Computed tomography revealed pneumoencephalus, and Gd-enhanced magnetic resonance imaging revealed edema, enhancement of the overlying dura in the left partial lobe, and subdural and subarachnoidal empyema. Following removal of the halo vest, there was a purulent discharge from the left-posterior pin site. Culture of the discharge was positive for MRSA. The patient was treated with intravenous vancomycin for 2 weeks, followed by cefozopran hydrochloride for 4 weeks. Her symptoms improved, and additional surgery was not required. At latest follow-up, 10 years after the seizure, she is neurologically stable without any recurrence of the infection.

  10. Pulmonary, renal and neurological comorbidities in patients with ankylosing spondylitis; implications for clinical practice.

    PubMed

    Mercieca, Cecilia; van der Horst-Bruinsma, Irene E; Borg, Andrew A

    2014-08-01

    Ankylosing spondylitis (AS) is associated with several comorbidities which contribute significantly to morbidity and mortality and add to the complexity of management. In addition to the well known extra-articular manifestations and increased cardiovascular risk, several pulmonary, renal, and neurological complications which have been associated with AS deserve equal attention. Whereas a clear link has been established for some manifestations, the evidence for other associations is less clear. Interstitial lung disease, apical fibrosis, secondary infection, and ventilatory restriction from reduced chest wall movement are well known pulmonary complications; more recently an association with sleep apnoea has been suggested. Renal amyloidosis and IgA nephropathy remain a treatment challenge which may respond to anti-TNF therapy. Atlanto axial subluxation and vertebral fractures can result in serious neurological complications and are notoriously difficult to diagnose unless a high level of suspicion is maintained. Despite several reports linking AS with demyelination a true link remains to be proved. This review discusses the prevalence, pathophysiology, and management of pulmonary, renal, and neurological complications, and implications for clinical practice.

  11. Upper cervical instability associated with rheumatoid arthritis: what to 'know' and what to 'do'.

    PubMed

    Slater, Helen; Briggs, Andrew M; Fary, Robyn E; Chan, Madelynn

    2013-12-01

    This case report describes a patient who presented with cervical spinal pain and headaches associated with atlanto-axial subluxation (AAS) secondary to rheumatoid arthritis (RA). For physiotherapists, especially less experienced clinicians, the significant risks associated with using manual assessment and treatment techniques in such a patient require careful consideration right at the start of a consultation. The focus of the case is therefore on the recognition of AAS in this patient with RA, highlighting the clinical findings that alert clinicians to this possibility and explaining the requisite knowledge and skills required to safely and effectively manage this patient. The use of screening tools to help clinicians identify possible RA in its pre-diagnosis stage and the clinical signs and symptoms that raise the index of suspicion for AAS, are discussed. The relevant contraindications and precautions associated with manual treatments directed at the upper cervical spine, and which may have potentially serious negative consequences, including quadriplegia and mortality, are addressed. Finally, the implications for the use of manual assessment and treatment of patients with RA and co-morbid AAS are addressed.

  12. Incontinence in Intellectual Disability: An Under Recognized Cause

    PubMed Central

    Sagayaraj, Benjamin; V.T.T., Rajan; Kumar, Radha

    2015-01-01

    Many children with Down syndrome may develop urinary incontinence during adolescence or nearing adulthood. Most often low mental ability, behavioural issues, urinary tract infection, hypothyroidism, atlanto-axial subluxation or sexual abuse may be suspected to be the reason. We report a case of Down syndrome with tethered cord syndrome (TCS) and Lipoma of Filum terminale with Cauda equina in normal position, as a cause of bowel and bladder incontinence. The need for operating with Cauda Equina in normal position is debated. But a conscious decision was taken to operate and the incontinence improved markedly which was documented by using a standardized questionnaire (King’s questionnaire) and thereby making a difference in the child’s life. A literature search did not result in any case of Down syndrome with tethered cord syndrome and secondary incontinence as presentation. Considering the possibility of TCS as a cause of incontinence, often neglected even in normal children, careful evaluation and correction of such problems will make a difference in the life of many intellectually disabled children. Incontinence should not be casually attributed to intellectual disability without ruling out other causes. PMID:26500975

  13. Grisel's syndrome, a rare cause of anomalous head posture in children: a case report.

    PubMed

    Allegrini, Davide; Autelitano, Alessandro; Nocerino, Elisabetta; Fogagnolo, Paolo; De Cillà, Stefano; Rossetti, Luca

    2016-03-01

    Anomalous head posture (AHP) or torticollis is a relatively common condition in children. Torticollis is not a diagnosis, but it is a sign of underlying disease. Grisel's syndrome (GS) is a rare condition of uncertain etiology characterized by a nontraumatic atlanto-axial subluxation (AAS), secondary to an infection in the head and neck region. It has not been considered, in ophthalmological papers, as a possible cause of AHP. A case of AAS secondary to an otitis media is studied. The children showed neck pain, head tilt, and reduction in neck mobility. The patient had complete remission with antibiotic and anti-inflammatory therapy and muscle relaxants. Signs of GS should always be taken into account during ophthalmological examination (recent history of upper airway infections and/or head and neck surgeries associated to a new onset of sudden, painful AHP with normal ocular exam). In such cases it is necessary to require quick execution of radiological examinations (computer tomography and/or nuclear magnetic resonance), which are essential to confirm the diagnosis. GS is a multidisciplinary disease. We underline the importance of an accurate orthoptic and ophthalmological examination. Indeed, early detection and diagnosis are fundamental to achieve proper management, avoid neurological complications and lead to a good prognosis.

  14. EDITORIAL: Catalysing progress Catalysing progress

    NASA Astrophysics Data System (ADS)

    Demming, Anna

    2010-01-01

    Examples of the merits of blue-sky research in the history of science are legion. The invention of the laser, celebrating its 50th anniversary this year, is an excellent example. When it was invented it was considered to be 'a solution waiting for a problem', and yet the level to which it has now infiltrated our day-to-day technological landscape speaks volumes. At the same time it is also true to say that the direction of research is also at times rightly influenced by the needs and concerns of the general public. Over recent years, growing concerns about the environment have had a noticeable effect on research in nanotechnology, motivating work on a range of topics from green nanomaterial synthesis [1] to high-efficiency solar cells [2] and hydrogen storage [3]. The impact of the world's energy consumption on the welfare of the planet is now an enduring and well founded concern. In the face of an instinctive reluctance to curtail habits of comfort and convenience and the appendages of culture and consumerism, research into renewable and more efficient energy sources seem an encouraging approach to alleviating an impending energy crisis. Fuel cells present one alternative to traditional combustion cells that have huge benefits in terms of the efficiency of energy conversion and the limited harmful emissions. In last week's issue of Nanotechnology, Chuan-Jian Zhong and colleagues at the State University of New York at Binghamton in the USA presented an overview of research on nanostructured catalysts in fuel cells [4]. The topical review includes insights into the interactions between nanoparticles and between nanoparticles and their substrate as well as control over the composition and nanostructure of catalysts. The review also serves to highlight how the flourishing of nanotechnology research has heralded great progress in the exploitation of catalysts with nanostructures ingeniously controlled to maximize surface area and optimize energetics for synthesis

  15. Primary Progressive Aphasia

    MedlinePlus

    Primary progressive aphasia Overview By Mayo Clinic Staff Primary progressive aphasia (uh-FAY-zhuh) is a rare nervous system (neurological) syndrome ... your ability to communicate. People with primary progressive aphasia can have trouble expressing their thoughts and understanding ...

  16. Management of the subluxated crystalline lens.

    PubMed

    Hoffman, Richard S; Snyder, Michael E; Devgan, Uday; Allen, Quentin B; Yeoh, Ronald; Braga-Mele, Rosa

    2013-12-01

    The surgical management of ectopia lentis presents the ophthalmic surgeon with numerous challenges and options. From the clinical evaluation to the surgical approach, ectopia lentis patients require additional methodologies, techniques, and devices to ensure the best possible outcome. The continued refinement of surgical techniques and adjunctive prosthetic devices has led to incremental improvements in the ability to achieve successful in-the-bag placement and centration of intraocular lenses while reducing complications. A thorough understanding of the challenges inherent in ectopia lentis cases and the management of intraoperative complications will ensure that surgeons approaching the correction of these eyes will achieve the best possible surgical results.

  17. Progressive valgus angulation of the ankle secondary to loss of fibular congruity treated with medial tibial hemiepiphysiodesis and fibular reconstruction.

    PubMed

    Lesiak, Alex C; Esposito, Paul W

    2014-06-01

    The fibula is an important stabilizer of the lateral ankle. Discontinuity of the fibular shaft can lead to progressive pain and shortening of the fibula, ultimately causing loss of lateral support to the ankle. Two children, who sustained segmental bone loss of the shaft of the fibula, developed progressive symptomatic valgus of the ankle with widening of the mortice and lateral subluxation of the talus. Both patients were treated with fibular plating and grafting with tricalcium sulfate with acute reconstitution of fibular length. Distal medial tibial hemiepiphysiodesis was simultaneously performed. One patient required revision plating and grafting 14 months after the index surgery because of plate failure. The valgus angulation and the widened medial mortice were corrected in the ankles of both patients, who returned to full activities. The patients were followed to maturity; the correction has been maintained, and they remain asymptomatic. The technique used in these cases can correct valgus angulation secondary to loss of fibular congruity rather than only halting progression of the deformity.

  18. Arithmetic Progressions on Conics.

    PubMed

    Ciss, Abdoul Aziz; Moody, Dustin

    2017-01-01

    In this paper, we look at long arithmetic progressions on conics. By an arithmetic progression on a curve, we mean the existence of rational points on the curve whose x-coordinates are in arithmetic progression. We revisit arithmetic progressions on the unit circle, constructing 3-term progressions of points in the first quadrant containing an arbitrary rational point on the unit circle. We also provide infinite families of three term progressions on the unit hyperbola, as well as conics ax(2) + cy(2) = 1 containing arithmetic progressions as long as 8 terms.

  19. Reconstructing Progressive Education

    ERIC Educational Resources Information Center

    Kaplan, Andy

    2013-01-01

    The work of Colonel Francis W. Parker, the man whom Dewey called "the father of progressive education," provides a starting point for reconstructing the loose ambiguities of progressive education into a coherent social and educational philosophy. Although progressives have claimed their approach is more humane and sensitive to children, we need…

  20. Progressive dysembryoplastic neuroepithelial tumour.

    PubMed

    Alexander, Hamish; Tannenburg, Anthony; Walker, David G; Coyne, Terry

    2015-01-01

    Dysembryoplastic neuroepithelial tumour (DNET) is a benign tumour characterised by cortical location and presentation with drug resistant partial seizures in children. Recently the potential for malignant transformation has been reported, however progression without malignant transformation remains rare. We report a case of clinical and radiologic progression of a DNET in a girl 10 years after initial biopsy.

  1. Rapidly Progressive Dementia

    PubMed Central

    Geschwind, Michael D.; Shu, Huidy; Haman, Aissa; Sejvar, James J.; Miller, Bruce L.

    2009-01-01

    In contrast with more common dementing conditions that typically develop over years, rapidly progressive dementias can develop subacutely over months, weeks, or even days and be quickly fatal. Because many rapidly progressive dementias are treatable, it is paramount to evaluate and diagnose these patients quickly. This review summarizes recent advances in the understanding of the major categories of RPD and outlines efficient approaches to the diagnosis of the various neurodegenerative, toxic-metabolic, infectious, autoimmune, neoplastic, and other conditions that may progress rapidly. PMID:18668637

  2. Waste management progress report

    SciTech Connect

    1997-06-01

    During the Cold War era, when DOE and its predecessor agencies produced nuclear weapons and components, and conducted nuclear research, a variety of wastes were generated (both radioactive and hazardous). DOE now has the task of managing these wastes so that they are not a threat to human health and the environment. This document is the Waste Management Progress Report for the U.S. Department of Energy dated June 1997. This progress report contains a radioactive and hazardous waste inventory and waste management program mission, a section describing progress toward mission completion, mid-year 1997 accomplishments, and the future outlook for waste management.

  3. Rapidly progressive Alzheimer disease.

    PubMed

    Schmidt, Christian; Wolff, Martin; Weitz, Michael; Bartlau, Thomas; Korth, Carsten; Zerr, Inga

    2011-09-01

    Different rates of progression have been observed among patients with Alzheimer disease. Risk factors that accelerate deterioration have been identified and some are being discussed, such as genetics, comorbidity, and the early appearance of Alzheimer disease motor signs. Progressive forms of Alzheimer disease have been reported with rapid cognitive decline and disease duration of only a few years. This short review aims to provide an overview of the current knowledge of rapidly progressive Alzheimer disease. Furthermore, we suggest that rapid, in this context, should be defined as a Mini-Mental State Examination score decrease of 6 points per year.

  4. Progress Resupply Vehicle approach

    NASA Image and Video Library

    2012-01-27

    ISS030-E-050883 (27 Jan. 2012) --- Russian cosmonaut Anton Shkaplerov (bottom), Expedition 30 flight engineer, monitors data at the manual TORU docking system controls in the Zvezda Service Module of the International Space Station during approach and docking operations of the unpiloted ISS Progress 46 resupply vehicle. Progress 46 docked automatically to the Pirs Docking Compartment via the Kurs automated rendezvous system at 7:00 p.m. (EST) on Jan. 27, 2012. NASA astronaut Dan Burbank, commander, looks on. Russian cosmonaut Anatoly Ivanishin (bottom background), flight engineer, photographs the approach of the Progress from a Zvezda window.

  5. Progress Resupply Vehicle approach

    NASA Image and Video Library

    2012-01-27

    ISS030-E-050885 (27 Jan. 2012) --- Russian cosmonauts Anton Shkaplerov (bottom) and Oleg Kononenko (center), both Expedition 30 flight engineers, monitor data at the manual TORU docking system controls in the Zvezda Service Module of the International Space Station during approach and docking operations of the unpiloted ISS Progress 46 resupply vehicle. Progress 46 docked automatically to the Pirs Docking Compartment via the Kurs automated rendezvous system at 7:00 p.m. (EST) on Jan. 27, 2012. NASA astronaut Dan Burbank, commander, looks on. Russian cosmonaut Anatoly Ivanishin (bottom background), flight engineer, photographs the approach of the Progress from a Zvezda window.

  6. Progress Resupply Vehicle approach

    NASA Image and Video Library

    2012-01-27

    ISS030-E-050884 (27 Jan. 2012) --- Russian cosmonaut Anton Shkaplerov (bottom), Expedition 30 flight engineer, monitors data at the manual TORU docking system controls in the Zvezda Service Module of the International Space Station during approach and docking operations of the unpiloted ISS Progress 46 resupply vehicle. Progress 46 docked automatically to the Pirs Docking Compartment via the Kurs automated rendezvous system at 7:00 p.m. (EST) on Jan. 27, 2012. NASA astronaut Dan Burbank, commander, looks on. Russian cosmonaut Anatoly Ivanishin (bottom background), flight engineer, photographs the approach of the Progress from a Zvezda window.

  7. Progressive Supranuclear Palsy

    MedlinePlus

    ... Education » Fact Sheets Progressive Supranuclear Palsy Fact Sheet Table of Contents (click to jump to sections) What ... Information Page NINDS Epilepsy Information Page NINDS Familial Periodic Paralyses Information Page NINDS Farber's Disease Information Page ...

  8. Reporting Continuous Progress

    ERIC Educational Resources Information Center

    DeMott, Richard M.; Fistler, Ronald

    1973-01-01

    Described is the approach to evaluating student progress in the Iowa Braille and Sight Saving School which is based upon observable behaviors in all subject areas from kindergarten through grade 12. (MC)

  9. Progressive hemifacial atrophy

    PubMed Central

    Sande, Abhijeet; Risbud, Mukund; Kshar, Avinash; Paranjpe, Arati Oka

    2013-01-01

    Progressive hemifacial atrophy, also known as Parry-Romberg Syndrome, is an uncommon degenerative and poorly understood condition. It is characterized by a slow and progressive but self-limited atrophy affecting one side of the face. The incidence and the cause of this alteration are unknown. A cerebral disturbance of fat metabolism has been proposed as a primary cause. Possible factors that are involved in the pathogenesis include trauma, viral infections, heredity, endocrine disturbances and auto-immunity. The most common complications that appear in association to this disorder are: trigeminal neuralgia, facial paresthesia, severe headache and epilepsy. Characteristically, the atrophy progresses slowly for several years and, it becomes stable. The objective of this work is, through the presentation of a clinical case, to accomplish a literature review concerning general characteristics, etiology, physiopathology and treatment of progressive hemifacial atrophy. PMID:23878573

  10. Teaching "The Pilgrim's Progress"

    ERIC Educational Resources Information Center

    Batson, E. Beatrice

    1973-01-01

    The Pilgrim's Progress, apart from its hortatory religious nature, has imaginative, creative power to command the attention of English teachers at the college level and is discussed in terms of the classroom. (Editor)

  11. Progressive Supranuclear Palsy

    MedlinePlus

    Progressive supranuclear palsy (PSP) is a rare brain disease. It affects brain cells that control the movement of your eyes. This leads to ... speech, vision and swallowing problems. Doctors sometimes confuse PSP with Parkinson's disease or Alzheimer's disease. PSP has ...

  12. Immunotherapy Slows TNBC Progression.

    PubMed

    2015-06-01

    The experimental monoclonal antibody MPDL3280A extended progression-free survival and produced durable responses in some patients with triple-negative breast cancer, according to preliminary results from a phase I trial.

  13. Orion Progress - Spring 2010

    NASA Image and Video Library

    NASA and contractor teams are designing, building and testing the next generation human spacecraft Orion. Progress on Orion is highlighted by employees working on the project, along with video of t...

  14. Progress for the Paralyzed

    MedlinePlus

    ... this page please turn Javascript on. Feature: NIBIB Robotics Progress for the Paralyzed Past Issues / Spring 2013 ... Paralyzed —The expanding options for paralyzed individuals include: robotic arms spinal cord stimulation improved prosthetic limbs restored ...

  15. Progressive supranuclear palsy.

    PubMed

    Kent, Anna

    Progressive supranuclear palsy (PSP), or Steele-Richardson-Olszewski syndrome, is a rare, progressive neurodegenerative condition with cognitive and motor involvement. Diagnosis can be challenging as some people do not display the classic symptoms of the condition and there are no specific investigations to confirm diagnosis. Timely discussions and access to symptom management and palliative care services need to be provided from diagnosis throughout the disease trajectory to ensure holistic care of people with PSP.

  16. Progress Resupply Vehicle approach

    NASA Image and Video Library

    2012-01-28

    ISS030-E-050932 (27 Jan. 2012) --- Russian cosmonaut Anton Shkaplerov (left), Expedition 30 flight engineer, monitors data at the manual TORU docking system controls in the Zvezda Service Module of the International Space Station during approach and docking operations of the unpiloted ISS Progress 46 resupply vehicle. Progress 46 docked automatically to the Pirs Docking Compartment via the Kurs automated rendezvous system at 7:00 p.m. (EST) on Jan. 27, 2012. NASA astronaut Dan Burbank, commander, looks on.

  17. [Progressive visual agnosia].

    PubMed

    Sugimoto, Azusa; Futamura, Akinori; Kawamura, Mitsuru

    2011-10-01

    Progressive visual agnosia was discovered in the 20th century following the discovery of classical non-progressive visual agnosia. In contrast to the classical type, which is caused by cerebral vascular disease or traumatic injury, progressive visual agnosia is a symptom of neurological degeneration. The condition of progressive visual loss, including visual agnosia, and posterior cerebral atrophy was named posterior cortical atrophy (PCA) by Benson et al. (1988). Progressive visual agnosia is also observed in semantic dementia (SD) and other degenerative diseases, but there is a difference in the subtype of visual agnosia associated with these diseases. Lissauer (1890) classified visual agnosia into apperceptive and associative types, and it in most cases, PCA is associated with the apperceptive type. However, SD patients exhibit symptoms of associative visual agnosia before changing to those of semantic memory disorder. Insights into progressive visual agnosia have helped us understand the visual system and discover how we "perceive" the outer world neuronally, with regard to consciousness. Although PCA is a type of atypical dementia, its diagnosis is important to enable patients to live better lives with appropriate functional support.

  18. Progressive multiple sclerosis

    PubMed Central

    Ontaneda, Daniel; Fox, Robert J.

    2015-01-01

    Purpose to Review To highlight the pathological features and clinical aspects of progressive multiple sclerosis (PMS). To highlight results of clinical trial experience to date and review ongoing clinical trials and perspective new treatment options. Explain the challenges of clinical trial design in PMS. Recent Findings MS has been identified as a chronic immune mediated disease, and the progressive phase of the disease appears to have significant neurodegenerative mechanisms. The classification of the course of PMS has been re-organized into categories of active vs. inactive inflammatory disease and the presence vs. absence of gradual disease progression. This differentiation allows clearer conceptualization of PMS and possibly even more efficient recruitment of PMS subjects into clinical trials. Clinical trial experience to date in PMS has been negative with anti-inflammatory medications used in relapsing MS. Simvastatin was recently tested in a phase II trial and showed a 43% reduction on annualized atrophy progression in secondary progressive MS. Ongoing PMS trials are currently being conducted with the phosphodiesterase inhibitor ibudilast, S1P modulator siponimod, and anti-B-cell therapy ocrelizumab. Several efforts for development of outcome measures in PMS are ongoing. Summary PMS represents a significant challenge, as the pathogenesis of the disease is not well understood, no validated outcome metrics have been established, and clinical trial experience to date has been disappointing. Advances in the understanding of the disease and lessons learned in previous clinical trials are paving the way for successful development of disease modifying agents for this disease. PMID:25887766

  19. Progressive supranuclear palsy: progression and survival.

    PubMed

    Arena, Julieta E; Weigand, Stephen D; Whitwell, Jennifer L; Hassan, Anhar; Eggers, Scott D; Höglinger, Günter U; Litvan, Irene; Josephs, Keith A

    2016-02-01

    Progressive supranuclear palsy (PSP) is a progressive neurodegenerative disorder characterized by postural instability and falls, vertical supranuclear gaze palsy, parkinsonism with poor levodopa response, pseudobulbar palsy, and frontal release signs. The natural history of the disease has been previously described. However, the time frame of appearance of clinical milestones and how these symptoms may relate to survival in PSP are unknown. The primary objective was to determine the prevalence of symptoms at different stages of PSP and to estimate the time of appearance of clinical symptoms characteristic of the disease. Second, we determined the association between clinical symptoms and survival. We prospectively studied 35 PSP patients during assessments scheduled every 6 months for up to 2 years. We estimated symptoms prevalence and the association between symptoms and survival. The median age of onset was 65.9 years (IQR 60.6-70.0), and the median time from onset to first assessment was 3.0 years (IQR 2.4-3.9). The most commonly reported symptoms at baseline were: motor (100%) followed by cognitive/behavioral (89%), systemic and bulbar (80%), and sleep disturbances (60%). Slowness of movement, falls, neck stiffness and difficulty looking up/down had high prevalence from baseline, while balance and gait impairment were less common at baseline but increased in prevalence over time. The presence of sleep disturbances, and possibly hallucinations, was associated with increased death risk. Improved recognition of the clinical spectrum and milestones of PSP advances knowledge of the disease, helps earlier diagnosis, and allows prognostic predictions.

  20. Pesticide reregistration progress report

    SciTech Connect

    Not Available

    1993-01-01

    The report is produced by the Special Review and Reregistration Division (SRRD), Office of Pesticide Programs, U.S. Environmental Protection Agency (EPA), on progress towards pesticide reregistration as mandated under 1988 amendments to the Federal Insecticide, Fungicide, and Rodenticide Act. The report shows the status of reregistration through the first quarter of the 1993 fiscal year. SRRD is in the process of re-evaluating the format and information in the Progress Report, as a result of the October 1992 Customer Survey sent to the recipients of the report. Results of the survey will be incorporated in the April 1993 issue of the report.

  1. Progress Resupply Vehicle approach

    NASA Image and Video Library

    2012-01-28

    ISS030-E-050933 (27 Jan. 2012) --- Russian cosmonauts Anton Shkaplerov (left) and Oleg Kononenko (partially obscured), both Expedition 30 flight engineers, monitor data at the manual TORU docking system controls in the Zvezda Service Module of the International Space Station during approach and docking operations of the unpiloted ISS Progress 46 resupply vehicle. Progress 46 docked automatically to the Pirs Docking Compartment via the Kurs automated rendezvous system at 7:00 p.m. (EST) on Jan. 27, 2012. NASA astronaut Dan Burbank (partially out of frame at right), commander, looks on.

  2. Progress 54 Spacecraft

    NASA Image and Video Library

    2014-02-05

    ISS038-E-042668 (5 Feb. 2014) --- An unpiloted ISS Progress resupply vehicle approaches the International Space Station, carrying 2.8 tons of food, fuel and supplies for the Expedition 38 crew members. The Progress 54 spacecraft launched from the Baikonur Cosmodrome in Kazakhstan at 11:23 a.m. (10:23 p.m. Baikonur time) and completed its four-orbit trek at 5:22 p.m. (EST) when it docked automatically to the station's Pirs docking compartment.

  3. Progress 54 Spacecraft

    NASA Image and Video Library

    2014-02-05

    ISS038-E-042674 (5 Feb. 2014) --- An unpiloted ISS Progress resupply vehicle approaches the International Space Station, carrying 2.8 tons of food, fuel and supplies for the Expedition 38 crew members. The Progress 54 spacecraft launched from the Baikonur Cosmodrome in Kazakhstan at 11:23 a.m. (10:23 p.m. Baikonur time) and completed its four-orbit trek at 5:22 p.m. (EST) when it docked automatically to the station's Pirs docking compartment.

  4. Progress 54 Spacecraft

    NASA Image and Video Library

    2014-02-05

    ISS038-E-042675 (5 Feb. 2014) --- An unpiloted ISS Progress resupply vehicle approaches the International Space Station, carrying 2.8 tons of food, fuel and supplies for the Expedition 38 crew members. The Progress 54 spacecraft launched from the Baikonur Cosmodrome in Kazakhstan at 11:23 a.m. (10:23 p.m. Baikonur time) and completed its four-orbit trek at 5:22 p.m. (EST) when it docked automatically to the station's Pirs docking compartment.

  5. Progress 54 Spacecraft

    NASA Image and Video Library

    2014-02-05

    ISS038-E-042680 (5 Feb. 2014) --- An unpiloted ISS Progress resupply vehicle approaches the International Space Station, carrying 2.8 tons of food, fuel and supplies for the Expedition 38 crew members. The Progress 54 spacecraft launched from the Baikonur Cosmodrome in Kazakhstan at 11:23 a.m. (10:23 p.m. Baikonur time) and completed its four-orbit trek at 5:22 p.m. (EST) when it docked automatically to the station's Pirs docking compartment.

  6. ISS Progress 24 Rollout

    NASA Image and Video Library

    2007-01-16

    JSC2007-E-03081 (16 Jan. 2007) --- Roll-out of the Progress 24 vehicle occurred on schedule at 7:00 a.m., Jan. 16, 2007 at the Baikonur Cosmodrome, Kazakhstan. The vehicle was in the vertical and hard-down at the pad by 9:30 a.m. The gantry towers were placed around the vehicle shortly thereafter. Progress is targeted for launch on Jan. 18, 2007 for a two-day trip to the International Space Station carrying 2 1/2 tons of food, fuel and supplies for the Expedition 14 crew. Photo Credit: NASA

  7. ISS Progress 24 Rollout

    NASA Image and Video Library

    2007-01-16

    JSC2007-E-03084 (16 Jan. 2007) --- Roll-out of the Progress 24 vehicle occurred on schedule at 7:00 a.m., Jan. 16, 2007 at the Baikonur Cosmodrome, Kazakhstan. The vehicle was in the vertical and hard-down at the pad by 9:30 a.m. The gantry towers were placed around the vehicle shortly thereafter. Progress is targeted for launch on Jan. 18, 2007 for a two-day trip to the International Space Station carrying 2 1/2 tons of food, fuel and supplies for the Expedition 14 crew. Photo Credit: NASA

  8. ISS Progress 24 Rollout

    NASA Image and Video Library

    2007-01-16

    JSC2007-E-03083 (16 Jan. 2007) --- Roll-out of the Progress 24 vehicle occurred on schedule at 7:00 a.m., Jan. 16, 2007 at the Baikonur Cosmodrome, Kazakhstan. The vehicle was in the vertical and hard-down at the pad by 9:30 a.m. The gantry towers were placed around the vehicle shortly thereafter. Progress is targeted for launch on Jan. 18, 2007 for a two-day trip to the International Space Station carrying 2 1/2 tons of food, fuel and supplies for the Expedition 14 crew. Photo Credit: NASA

  9. ISS Progress 24 Rollout

    NASA Image and Video Library

    2007-01-16

    JSC2007-E-03080 (16 Jan. 2007) --- Roll-out of the Progress 24 vehicle occurred on schedule at 7:00 a.m., Jan. 16, 2007 at the Baikonur Cosmodrome, Kazakhstan. The vehicle was in the vertical and hard-down at the pad by 9:30 a.m. The gantry towers were placed around the vehicle shortly thereafter. Progress is targeted for launch on Jan. 18, 2007 for a two-day trip to the International Space Station carrying 2 1/2 tons of food, fuel and supplies for the Expedition 14 crew. Photo Credit: NASA

  10. ISS Progress 24 Rollout

    NASA Image and Video Library

    2007-01-16

    JSC2007-E-03082 (16 Jan. 2007) --- Roll-out of the Progress 24 vehicle occurred on schedule at 7:00 a.m., Jan. 16, 2007 at the Baikonur Cosmodrome, Kazakhstan. The vehicle was in the vertical and hard-down at the pad by 9:30 a.m. The gantry towers were placed around the vehicle shortly thereafter. Progress is targeted for launch on Jan. 18, 2007 for a two-day trip to the International Space Station carrying 2 1/2 tons of food, fuel and supplies for the Expedition 14 crew. Photo Credit: NASA

  11. [Progress on transgenic mosquitoes].

    PubMed

    Yang, Pin

    2011-04-30

    The genetically modified mosquitoes have been developed aiming to control mosquito-borne diseases by either reducing population sizes or replacing existing populations with vectors unable to transmit the disease. introduces some progress on the generation of transgenic mosquitoes and their fitness in wild population. This paper

  12. Basic Measures of Progress.

    ERIC Educational Resources Information Center

    Calkins, Julia; Ling, Thomson; Moore, Eric; Halle, Tamara; Hair, Beth; Moore, Kris; Zaslow, Marty

    This document provides a compilation of measures of progress toward school readiness and three contributing conditions as used in several local, state, and national surveys. The report begins with a legend listing the surveys examined, their acronyms, and contact information. The remainder of the report, in tabular format, lists measures of…

  13. MCNP Progress & Performance Improvements

    SciTech Connect

    Brown, Forrest B.; Bull, Jeffrey S.; Rising, Michael Evan

    2015-04-14

    Twenty-eight slides give information about the work of the US DOE/NNSA Nuclear Criticality Safety Program on MCNP6 under the following headings: MCNP6.1.1 Release, with ENDF/B-VII.1; Verification/Validation; User Support & Training; Performance Improvements; and Work in Progress. Whisper methodology will be incorporated into the code, and run speed should be increased.

  14. Mystery in Progress.

    ERIC Educational Resources Information Center

    Hall, Kristen

    1989-01-01

    Describes "Mystery in Progress," a traveling exhibit which traces the development of Predynastic Egypt. The exhibit provides a time line for Predynastic Egypt, depicts the history of the Hierakonpolis expedition, documents the formation of Egypt's first centralized nation state, and summarizes the emergence of a unified Egypt. (LS)

  15. Progress in physiological optics.

    PubMed

    Boynton, R M

    1967-08-01

    A survey is made of the current state of physiological optics, broadly defined as equated with visual science. After a survey of some historical and definitional matters, recent progress in a number of areas is critically reviewed. Finally, seven examples of important recent discoveries in physiological optics are given.

  16. Music and Progressive Education.

    ERIC Educational Resources Information Center

    Zinar, Ruth

    1984-01-01

    John Dewey believed that man can only learn about the world through experience. He included music as part of his "core curriculum," in which children learned by doing. This progressive education emphasized self-expression and individual fulfillment, but did not mean the abandonment of knowledge and techniques in teaching music. (CS)

  17. Response: Progress Takes Time.

    ERIC Educational Resources Information Center

    Rist, Marilee C.

    1984-01-01

    Although declining enrollment and administrative seniority have hampered efforts to eliminate sex discrimination in employment practices in three Long Island, New York, school systems (Commack, Smithtown, and Bay Shore), progress is being made. Because of the Reagan administration's lack of support for affirmative action, however, litigation…

  18. Learning Progressions & Climate Change

    ERIC Educational Resources Information Center

    Parker, Joyce M.; de los Santos, Elizabeth X.; Anderson, Charles W.

    2015-01-01

    Our society is currently having serious debates about sources of energy and global climate change. But do students (and the public) have the requisite knowledge to engage these issues as informed citizenry? The learning-progression research summarized here indicates that only 10% of high school students typically have a level of understanding…

  19. Opportunities and progress.

    PubMed

    Litchfield, John H

    2014-01-01

    In this review, I cover my professional experiences in food science and technology and related areas of applied and industrial microbiology over the span of my career. It emphasizes opportunities and technological problems that I encountered together with my progress in follow-up development of products and processes.

  20. Mystery in Progress.

    ERIC Educational Resources Information Center

    Hall, Kristen

    1989-01-01

    Describes "Mystery in Progress," a traveling exhibit which traces the development of Predynastic Egypt. The exhibit provides a time line for Predynastic Egypt, depicts the history of the Hierakonpolis expedition, documents the formation of Egypt's first centralized nation state, and summarizes the emergence of a unified Egypt. (LS)

  1. 1992 PVUSA progress report

    SciTech Connect

    Ellyn, W.

    1992-12-31

    Photovoltaics for Utility Scale Applications (PVUSA) is a national public-private partnership that is assessing and demonstrating the viability of utility-scale photovoltaic (PV) electric generating systems. This report updates the progress of the PVUSA project, reviews the status and performance of the various PV installations during 1992, and summarizes key accomplishments and conclusions from work to date.

  2. Progress and promise.

    PubMed

    Kamphaus, Randy W

    2012-12-01

    This editorial introduces the current issue of the journal School Psychology Quarterly (SPQ).There has been an impressive and promising progress of school psychology science has been reflected in every issue of SPQ, including the current one. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  3. Learning Progressions & Climate Change

    ERIC Educational Resources Information Center

    Parker, Joyce M.; de los Santos, Elizabeth X.; Anderson, Charles W.

    2015-01-01

    Our society is currently having serious debates about sources of energy and global climate change. But do students (and the public) have the requisite knowledge to engage these issues as informed citizenry? The learning-progression research summarized here indicates that only 10% of high school students typically have a level of understanding…

  4. Assessing Pupils' Progress

    ERIC Educational Resources Information Center

    Ollerton, Mike

    2010-01-01

    In this article, the author explores what Assessing Pupils' Progress (APP) is about. He contends that the predilection for testing is a catastrophe as far as the teaching and learning of mathematics is concerned; it is an outcome of the drive for collecting so-called "data" on pupils. What those people, who should know better, either choose to…

  5. Progressive Response Surfaces

    NASA Technical Reports Server (NTRS)

    Romero, V. J.; Swiler, L. P.

    2004-01-01

    Response surface functions are often used as simple and inexpensive replacements for computationally expensive computer models that simulate the behavior of a complex system over some parameter space. Progressive response surfaces are ones that are built up progressively as global information is added from new sample points in the parameter space. As the response surfaces are globally upgraded based on new information, heuristic indications of the convergence of the response surface approximation to the exact (fitted) function can be inferred. Sampling points can be incrementally added in a structured fashion, or in an unstructured fashion. Whatever the approach, at least in early stages of sampling it is usually desirable to sample the entire parameter space uniformly. At later stages of sampling, depending on the nature of the quantity being resolved, it may be desirable to continue sampling uniformly over the entire parameter space (Progressive response surfaces), or to switch to a focusing/economizing strategy of preferentially sampling certain regions of the parameter space based on information gained in early stages of sampling (Adaptive response surfaces). Here we consider Progressive response surfaces where a balanced indication of global response over the parameter space is desired.We use a variant of Moving Least Squares to fit and interpolate structured and unstructured point sets over the parameter space. On a 2-D test problem we compare response surface accuracy for three incremental sampling methods: Progressive Lattice Sampling; Simple-Random Monte Carlo; and Halton Quasi-Monte-Carlo sequences. We are ultimately after a system for constructing efficiently upgradable response surface approximations with reliable error estimates.

  6. The Progressive Era.

    PubMed

    Chambers, David W

    2005-01-01

    The American College of Dentists was founded in 1920 for the purpose of encouraging young dentists to continue study and to apply science to their practices. This ideal emerged in the Progressive Era, which lasted roughly from 1895 to 1920. The animating spirit of this period was that the human condition could be improved and that the way to achieve this was through science and the use of experts working together. The Progressive Era saw inventions, such as automobiles and airplanes, telephone and radio, that required mass production and brought people together. It also spawned many political and legislative innovations that we now take for granted. Among these are the Food and Drug Administration, the Department of Commerce, and the Federal Trade Commission. Workers' compensation and other social protections were introduced, as were city commissions; the income tax; women's suffrage; and initiative, referendum, and recall. Medicine, for the first time, became an effective way to treat disease as it developed a scientific foundation.

  7. Current progress in pharmacogenetics

    PubMed Central

    Blakey, John D; Hall, Ian P

    2011-01-01

    The study of genetic variation has the potential to aid understanding of the mechanisms underlying the observed inter-individual variation in drug response and by which idiosyncratic adverse effects occur. In this review, we outline current progress in pharmacogenetics using examples to highlight both mechanisms of influence of polymorphisms and research strategies for their detection. In the final sections we discuss contemporary challenges for both researchers and clinicians. PMID:21235621

  8. Progress in Scientific Visualization

    SciTech Connect

    Max, N

    2004-11-15

    Visualization of observed data or simulation output is important to science and engineering. I have been particularly interested in visualizing 3-D structures, and report here my personal impressions on progress in the last 20 years in visualizing molecules, scalar fields, and vector fields and their associated flows. I have tried to keep the survey and list of references manageable, so apologize to those authors whose techniques I have not mentioned, or have described without a reference citation.

  9. Xenon Feed System Progress

    DTIC Science & Technology

    2006-01-01

    From - To) 13-06-2006 Technical Paper 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER F04611-00-C-0055 Xenon Feed System Progress (Preprint) 5b. GRANT...propulsion xenon feed system for a flight technology demonstration program. Major accomplishments include: 1) Utilization of the Moog...successfully fed xenon to a 200 watt Hall Effect Thruster in a Technology Demonstration Program. The feed system has demonstrated throttling of xenon

  10. [Progress in optical imaging].

    PubMed

    Bremer, C; Ntziachristos, V; Mahmood, U; Tung, C H; Weissleder, R

    2001-02-01

    Different optical imaging technologies have significantly progressed over the last years. Besides advances in imaging techniques and image reconstruction, new "smart" optical contrast agents have been developed which can be used to detect molecular targets (such as endogenous enzymes) in vivo. The combination of novel imaging technologies coupled with smart agents bears great diagnostic potential both clinically and experimentally. This overview outlines the basic principles of optical imaging and summarizes the current state of the art.

  11. ISABELLE: a progress report

    SciTech Connect

    Hahn, H

    1980-01-01

    This paper discusses the ISABELLE project, which has the objective of constructing a high-energy proton colliding beam facility at Brookhaven National Laboratory. The major technical features of the intersecting storage accelerators with their projected performance are described. Application of over 1000 superconducting magnets in the two rings represents the salient characteristic of the machine. The status of the entire project, the technical progress made so far, and difficulties encountered are reviewed.

  12. COSMIC monthly progress report

    NASA Technical Reports Server (NTRS)

    1994-01-01

    Activities of the Computer Software Management and Information Center (COSMIC) are summarized for the month of January 1994. Tables showing the current inventory of programs available from COSMIC are presented and program processing and evaluation activities are discussed. Marketing and customer service activities in this period are presented as is the progress report of NASTRAN maintenance and support. Tables of disseminations and budget summary conclude the report.

  13. Progress In Holographic Cinematography

    NASA Astrophysics Data System (ADS)

    Smigielski, P.; Fagot, H.; Albe, F.

    1986-06-01

    Two important progresses were achieved for the first time: 1) recording of single exposure cineholograms of living bodies on a 126-mm film, at a frequency of 25 holograms per second. Limitations of 3-D movies by holography are described. 2) recording of double-exposure cineholograms of reflecting objects, a loudspeaker membrane and the vertex cranii of a bald-headed man. These experiments show the interest of interferometric cineholography for industrial applications.

  14. Primary Progressive Speech Abulia.

    PubMed

    Milano, Nicholas J; Heilman, Kenneth M

    2015-01-01

    Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by progressive language impairment. The three variants of PPA include the nonfluent/agrammatic, semantic, and logopenic types. The goal of this report is to describe two patients with a loss of speech initiation that was associated with bilateral medial frontal atrophy. Two patients with progressive speech deficits were evaluated and their examinations revealed a paucity of spontaneous speech; however their naming, repetition, reading, and writing were all normal. The patients had no evidence of agrammatism or apraxia of speech but did have impaired speech fluency. In addition to impaired production of propositional spontaneous speech, these patients had impaired production of automatic speech (e.g., reciting the Lord's Prayer) and singing. Structural brain imaging revealed bilateral medial frontal atrophy in both patients. These patients' language deficits are consistent with a PPA, but they are in the pattern of a dynamic aphasia. Whereas the signs-symptoms of dynamic aphasia have been previously described, to our knowledge these are the first cases associated with predominantly bilateral medial frontal atrophy that impaired both propositional and automatic speech. Thus, this profile may represent a new variant of PPA.

  15. Progressive contour models

    NASA Astrophysics Data System (ADS)

    Lin, Remin; Lin, Wei-Chung; Chen, Chin-Tu

    1995-08-01

    A progressive contour model is developed based on the idea of deforming the contour from an initial shape as a source of prior knowledge by minimizing a defined contour energy to extract a desired contour from images. This model differs from active contour models (or snakes) in that the internal component of the contour energy is used to impose the smoothness constraints not on the shape of the contour but on the displacements of deformation, and the external component of the contour energy is used to locate the correspondence for the contour through a specified local correspondence mapping. A sequence of deformations is determined by repeatedly deforming and updating the initial contour. It is shown that the contour deformed by this sequence will smoothly and progressively approach a well-defined contour. Finite- element methods, multigrid algorithms, and unconstrained optimization methods are employed to implement this model. This approach offers several attractive advantages including a good convergence rate, the adaptation of the smoothness constraints and the adoption of a globally convergent algorithm. Experiments are conducted on real images to evaluate the performance of a progressive contour program, and a computational complexity in the order of O (lnN) is verified.

  16. Topiramate in migraine progression.

    PubMed

    Ruiz, Luigi; Ferrandi, Delfina

    2009-12-01

    Increasing evidence shows that migraine, typically considered as an episodic disease, is a chronic and, in some patients, progressive disorder. Among neuromodulators used for migraine prevention, topiramate has a high level of evidence-based efficacy. Through its wide range of mechanisms of action topiramate increases the activation threshold resulting in neuronal stabilization and thereby reducing cortical neurons hyperexcitability, which is believed to be an important electrophysiological feature underlying the pathogenesis of epilepsy and migraine. Recent studies show that migraineurs have subclinical structural brain changes and persistent alteration of pain perception, in some cases correlated with the duration of the disease and the frequency of attacks that might play a role in the transformation of episodic migraine to chronic forms. An early and prolonged preventive treatment might reduce the risk of such transformation. Recent evidence suggests that topiramate, by reducing migraine frequency and use of acute medication, may prevent the negative progression of migraine. Furthermore, two recently completed multicenter, randomised, placebo-controlled trials have shown that treatment with topiramate 100 mg/day is effective and well tolerated in patients already progressed to chronic migraine and difficult to treat conditions associated with medication-overuse. Topiramate seems to be a preventive treatment, which might be able to act at different levels of the migraine cycle: reduction of frequency in episodic migraine, prevention, and treatment of chronic migraine.

  17. Post Kalman progress

    NASA Technical Reports Server (NTRS)

    Sonnabend, David

    1995-01-01

    In a paper here last year, an idea was put forward that much greater performance could be obtained from an observer, relative to a Kalman filter if more general performance indices were adopted, and the full power spectra of all the noises were employed. The considerable progress since then is reported here. Included are an extension of the theory to regulators, direct calculation of the theory's fundamental quantities - the noise effect integrals - for several theoretical spectra, and direct derivations of the Riccati equations of LQG (Linear-Quadratic-Gaussian) and Kalman theory yielding new insights.

  18. MEIC Design Progress

    SciTech Connect

    Zhang, Y; Douglas, D; Hutton, A; Krafft, G A; Li, R; Lin, F; Morozov, V S; Nissen, E W; Pilat, F C; Satogata, T; Tennant, C; Terzic, B; Yunn, C; Barber, D P; Filatov, Y; Hyde, C; Kondratenko, A M; Manikonda, S L; Ostroumov, P N; Sullivan, M K

    2012-07-01

    This paper will report the recent progress in the conceptual design of MEIC, a high luminosity medium energy polarized ring-ring electron-ion collider at Jefferson lab. The topics and achievements that will be covered are design of the ion large booster and the ERL-circulator-ring-based electron cooling facility, optimization of chromatic corrections and dynamic aperture studies, schemes and tracking simulations of lepton and ion polarization in the figure-8 collider ring, and the beam-beam and electron cooling simulations. A proposal of a test facility for the MEIC electron cooler will also be discussed.

  19. Soyuz and Progress

    NASA Image and Video Library

    2014-05-30

    ISS040-E-006230 (30 May 2014) --- Two Russian spacecraft docked to the International Space Station are featured in this image photographed by an Expedition 40 crew member from inside the International Space Station?s Cupola. The Soyuz 39 (TMA-13M) spacecraft, docked to the Rassvet Mini-Research Module 1 (MRM1), is visible in the foreground. The Progress 55 resupply vehicle, docked to the Pirs Docking Compartment, is visible in the background. A blue and white part of Earth and the blackness of space provide the backdrop for the scene.

  20. [Progress in eyeglass optics].

    PubMed

    Köppen, W

    1995-08-01

    In this article product developments for ophthalmic lenses are discussed: new materials, designs and coatings. High-index plastic substrates allow to offer corrections which are simultaneously light and thin and for the first time there are high performant plastic photochromic lenses. Head and eye movements with latest generation's progressives are very similar to natural vision behaviour. Special aspheric designs have been developed for comfortable vision for near and intermediate distances. Finally there are new coatings which protect the high quality surfaces of plastic lenses distinctly longer than before.

  1. Progress in computational physics

    NASA Technical Reports Server (NTRS)

    Turkel, E.

    1983-01-01

    Recent progress in computational methods for time dependent fluid dynamics is presented. The emphasis is on advances applicable to large scale systems with the connection between the numerics and the physics of the code stressed. All aspects of a working code are discussed including such topics as initialization, boundary conditions, grid generation in addition to algorithmic advances. One sometimes uses a time dependent method as an iteration procedure to reach a steady state solution. Work in accelerating the convergence to the steady state is also surveyed.

  2. Progressive image denoising.

    PubMed

    Knaus, Claude; Zwicker, Matthias

    2014-07-01

    Image denoising continues to be an active research topic. Although state-of-the-art denoising methods are numerically impressive and approch theoretical limits, they suffer from visible artifacts.While they produce acceptable results for natural images, human eyes are less forgiving when viewing synthetic images. At the same time, current methods are becoming more complex, making analysis, and implementation difficult. We propose image denoising as a simple physical process, which progressively reduces noise by deterministic annealing. The results of our implementation are numerically and visually excellent. We further demonstrate that our method is particularly suited for synthetic images. Finally, we offer a new perspective on image denoising using robust estimators.

  3. Progress 39 Supply Vehicle

    NASA Image and Video Library

    2011-02-20

    ISS026-E-028490 (20 Feb. 2011) --- Backdropped by a blue and white part of Earth, the unpiloted ISS Progress 39 supply vehicle appears to be very small as it departs from the International Space Station at 8:12 a.m. (EST) on Feb. 20, 2011. At 11:12 a.m., the deorbit burn braked the trash-loaded cargo ship into its re-entry trajectory over the Pacific Ocean, where it was burned up in Earth’s atmosphere.

  4. Annual Progress Report.

    DTIC Science & Technology

    1981-10-20

    AD-AIO6 983 ILLINOIS UNIV AT URBANA COORDINATEO SCIENCE LAB F/0 12/1 ANNUAL PROGRESS REPOMT ,(U1 OCT 81 H V POOR NOOOII-81-K-O014 UNCLASSIFIED T-111...34 University of Illinois at Urbana -Chaimpaign Urbana , Illinois 61801 I ~~ ~ ~ ~ I I7 CONROLINOFIC______NDADDES Office of Naval Research - Octe--mm...Unclassified Approved for public release; dis tribu tion ’anlimi ted. 17. DISTRIBUTION STATEMENT (of the aboeet onfored a Weak 20. 1# Offrmoaw Repeol

  5. HSX progress report

    SciTech Connect

    Not Available

    1994-05-01

    Brief statements on the progress of the design and construction of the HSX experiment are reported. Topics covered include the modular and auxiliary coil systems, the coil support structure, vacuum vessel, the ECH system, the magnet power supply and site. The proposed budget for Year 2 (August 1, 1994 through July 31, 1995) is presented. The effects of a flat funding profile (based on Year 2 budget level of $1137K) on out-years and the HSX project schedule are discussed. The stretching out of the program to accommodate the reduced funding profile should result in only a slight delay in HSX operations.

  6. PROGRESS ON STELLA EXPERIMENT.

    SciTech Connect

    KIMURA,W.D.; CAMPBELL,L.P.; GOTTSCHALK,S.C.; QUIMBY,D.C.; ROBINSON,K.E.; STEINHAUER,L.C.; BABZIEN,M.; BEN-ZVI,I.; GALLARDO,J.C.; KUSCHE,K.P.; POGORELSKY,I.V.; SKARITKA,J.; VAN STEENBERGEN,A.; YAKIMENKO,V.; CLINE,D.B.; HE,P.; LIU,Y.; FIORITO,R.B.; PANTELL,R.H.; RULE,D.W.; SANDWEISS,J.

    1999-03-01

    Progress is reported on the Staged Electron Laser Acceleration (STELLA) experiment, which has been assembled on the BNL Accelerator Test Facility (ATF). The primary goal of STELLA is to demonstrate staging of the laser acceleration process by using the BNL inverse free electron laser (IFEL) as a prebuncher, which generates {approx} 1-{micro}m long microbunches, and accelerating these microbunches using an inverse Cerenkov acceleration (ICA) stage. Experimental runs are underway to recommission the IFEL and ICA systems separately, and reestablish the: microbunching process. Staging will then be examined by running both the IFEL and ICA systems together.

  7. Tumour progression and metastasis

    PubMed Central

    Arvelo, Francisco; Sojo, Felipe; Cotte, Carlos

    2016-01-01

    The two biological mechanisms that determine types of malignancy are infiltration and metastasis, for which tumour microenvironment plays a key role in developing and establishing the morphology, growth and invasiveness of a malignancy. The microenvironment is formed by complex tissue containing the extracellular matrix, tumour and non-tumour cells, a signalling network of cytokines, chemokines, growth factors, and proteases that control autocrine and paracrine communication among individual cells, facilitating tumour progression. During the development of the primary tumour, the tumour stroma and continuous genetic changes within the cells makes it possible for them to migrate, having to count on a pre-metastatic niche receptor that allows the tumour’s survival and distant growth. These niches are induced by factors produced by the primary tumour; if it is eradicated, the active niches become responsible for activating the latent disseminated cells. Due to the importance of these mechanisms, the strategies that develop tumour cells during tumour progression and the way in which the microenvironment influences the formation of metastasis are reviewed. It also suggests that the metastatic niche can be an ideal target for new treatments that make controlling metastasis possible. PMID:26913068

  8. Progressive supranuclear palsy.

    PubMed

    Golbe, Lawrence I

    2014-04-01

    Progressive supranuclear palsy is a disorder of tau protein aggregation. Its clinical spectrum is now known to be wider than originally described, with a phenotype resembling Parkinson disease accounting for a third of cases. However, at least half of the patients with PSP exhibit the classic bradykinesia with disproportionate postural instability, erect posture with nuchal rigidity, frontal behavioral and cognitive changes, vertical gaze palsy, and other disabling brainstem deficits. Nonmendelian genetic risk factors exist, but PSP is almost entirely sporadic, with a prevalence of five to six persons per 100,000, mean onset age of 63, and median survival of 7 years. Clinical diagnostic criteria with excellent specificity and a clinical rating scale sensitive to progression are available. Diagnosis remains clinical, although magnetic resonance imaging and cerebrospinal fluid measures are showing promise as early-stage screening tools. Multiple candidate neuroprotective medications have proven ineffective to date. Treatment remains supportive, although coenzyme Q-10 has shown preliminary symptomatic efficacy and levodopa may provide transient, modest benefit.

  9. Rapidly Progressive Dementia

    PubMed Central

    Geschwind, Michael D.

    2016-01-01

    Purpose of Review This article presents a practical and informative approach to the evaluation of a patient with a rapidly progressive dementia (RPD). Recent Findings Prion diseases are the prototypical causes of RPD, but reversible causes of RPD might mimic prion disease and should always be considered in a differential diagnosis. Aside from prion diseases, the most common causes of RPD are atypical presentations of other neurodegenerative disorders, curable disorders including autoimmune encephalopathies, as well as some infections, and neoplasms. Numerous recent case reports suggest dural arterial venous fistulas sometimes cause RPDs. Summary RPDs, in which patients typically develop dementia over weeks to months, require an alternative differential than the slowly progressive dementias that occur over a few years. Because of their rapid decline, patients with RPDs necessitate urgent evaluation and often require an extensive workup, typically with multiple tests being sent or performed concurrently. Jakob-Creutzfeldt disease, perhaps the prototypical RPD, is often the first diagnosis many neurologists consider when treating a patient with rapid cognitive decline. Many conditions other than prion disease, however, including numerous reversible or curable conditions, can present as an RPD. This chapter discusses some of the major etiologies for RPDs and offers an algorithm for diagnosis. PMID:27042906

  10. Progress in computational toxicology.

    PubMed

    Ekins, Sean

    2014-01-01

    Computational methods have been widely applied to toxicology across pharmaceutical, consumer product and environmental fields over the past decade. Progress in computational toxicology is now reviewed. A literature review was performed on computational models for hepatotoxicity (e.g. for drug-induced liver injury (DILI)), cardiotoxicity, renal toxicity and genotoxicity. In addition various publications have been highlighted that use machine learning methods. Several computational toxicology model datasets from past publications were used to compare Bayesian and Support Vector Machine (SVM) learning methods. The increasing amounts of data for defined toxicology endpoints have enabled machine learning models that have been increasingly used for predictions. It is shown that across many different models Bayesian and SVM perform similarly based on cross validation data. Considerable progress has been made in computational toxicology in a decade in both model development and availability of larger scale or 'big data' models. The future efforts in toxicology data generation will likely provide us with hundreds of thousands of compounds that are readily accessible for machine learning models. These models will cover relevant chemistry space for pharmaceutical, consumer product and environmental applications. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Tumour progression and metastasis.

    PubMed

    Arvelo, Francisco; Sojo, Felipe; Cotte, Carlos

    2016-01-01

    The two biological mechanisms that determine types of malignancy are infiltration and metastasis, for which tumour microenvironment plays a key role in developing and establishing the morphology, growth and invasiveness of a malignancy. The microenvironment is formed by complex tissue containing the extracellular matrix, tumour and non-tumour cells, a signalling network of cytokines, chemokines, growth factors, and proteases that control autocrine and paracrine communication among individual cells, facilitating tumour progression. During the development of the primary tumour, the tumour stroma and continuous genetic changes within the cells makes it possible for them to migrate, having to count on a pre-metastatic niche receptor that allows the tumour's survival and distant growth. These niches are induced by factors produced by the primary tumour; if it is eradicated, the active niches become responsible for activating the latent disseminated cells. Due to the importance of these mechanisms, the strategies that develop tumour cells during tumour progression and the way in which the microenvironment influences the formation of metastasis are reviewed. It also suggests that the metastatic niche can be an ideal target for new treatments that make controlling metastasis possible.

  12. [Progressive facial hemiatrophy].

    PubMed

    Naumbaev, A N; Sharipov, A Sh; Iakhontov, B V

    1991-01-01

    The authors describe a case of progressive facial hemiatrophy in a woman aged 26 years, coming from the Isfarin region of Tadzhikistan. The patient views herself as being ill for 14 years, since the moment of an epileptic attack with tonic and clonic convulsions. Approximately at the same time she noted a small dry ulcer on the left on the vertex. The ulcer slowly increased, followed by skin atrophy. The disease progressed for 4 to 5 years. At present to the left there are folds in the form of scars on the face. The skin is thinned, united with the bones in the frontal and parietal areas, the subcutaneous fat is atrophic. The lips and nose at the left are subatrophic. Negligible enophthalmos, hemiatrophy of the tongue at the left. Alopecia. A certain deterioration of memory and reduction of the critical attitude are recorded. The patient is in a state of euphoria. Left-sided anosmia. The left auricular floor is subatrophic, hearing is almost lacking. Diffuse elevation of the tendinous reflexes of the limbs on the left side. X-ray signs of osteoporosis of the bones of the cranial vault on the left.

  13. Conceptions of Progress: How Is Progress Perceived? Mainstream versus Alternative Conceptions of Progress

    ERIC Educational Resources Information Center

    Itay, Anat

    2009-01-01

    Progress is a powerful political concept, encompassing different and sometimes contradictory conceptions. This paper examines the results of a survey on progress conducted at the OECD World Forum entitled "Measuring and Fostering the Progress of Societies" held in Istanbul in June 2007. First, a distinction is drawn between the two approaches to…

  14. Conceptions of Progress: How Is Progress Perceived? Mainstream versus Alternative Conceptions of Progress

    ERIC Educational Resources Information Center

    Itay, Anat

    2009-01-01

    Progress is a powerful political concept, encompassing different and sometimes contradictory conceptions. This paper examines the results of a survey on progress conducted at the OECD World Forum entitled "Measuring and Fostering the Progress of Societies" held in Istanbul in June 2007. First, a distinction is drawn between the two approaches to…

  15. 1992 PVUSA progress report

    SciTech Connect

    1992-12-31

    Photovoltaics for Utility Scale Applications (PVUSA) is a national public-private partnership that is assessing and demonstrating the viability of utility-scale photovoltaic (PV) electric generating systems. This report updates the progress of the PVUSA project, reviews the status and performance of the various PV installations during 1992, and summarizes key accomplishments and conclusions from work to date. Fall PV module costs and rising environmental pressures could make PV a significant source of large-scale power within the next decade. However, utility acceptance of this technology requires knowledge of PV operational characteristics in a utility system and confidence in predicting PV performance, reliability, and economics. PVUSA consists of two types of demonstrations: Emerging Module Technologies (EMTs), which are unproven but promising state-of-the-art PV technologies in 20-kW (nominal) arrays; and Utility Scale (US) systems, which represent more mature PV technologies in 200- to 500-kW (nominal) turnkey systems.

  16. Sphingosylphosphorylcholine in cancer progress

    PubMed Central

    Yue, Hong-Wei; Jing, Qing-Chuan; Liu, Ping-Ping; Liu, Jing; Li, Wen-Jing; Zhao, Jing

    2015-01-01

    Sphingosylphosphorylcholine (SPC) is a naturally occurring bioactive sphingolipid in blood plasma, metabolizing from the hydrolysis of the membrane sphingolipid. It has been shown to exert multifunctional role in cell physiological regulation either as an intracellular second messenger or as an extracellular agent through G protein coupled receptors (GPCRs). Because of elevated levels of SPC in malicious ascites of patients with cancer, the role of SPC in tumor progression has prompted wide interest. The factor was reported to affect the proliferation and/or migration of many cancer cells, including pancreatic cancer cells, epithelial ovarian carcinoma cells, rat C6 glioma cells, neuroblastoma cells, melanoma cells, and human leukemia cells. This review covers current knowledge of the role of SPC in tumor. PMID:26550104

  17. Progress in prokaryotic transcriptomics.

    PubMed

    Filiatrault, Melanie J

    2011-10-01

    Genome-wide expression studies transformed the field of transcriptomics and made it feasible to study global gene expression in extraordinary detail. These new methods have revealed an enhanced view of the transcriptional landscape and have yielded many biological insights. It is increasingly clear that the prokaryotic transcriptome is much more complex than once thought. Recent advances in microbial transcriptome analyses are highlighted in this review. Areas of progress include the development of optimized techniques that minimize the abundance of ribosomal RNAs in RNA samples as well as the development of novel methods to create transcriptome libraries. Advances such as these have led to a new emphasis in areas such as metatranscriptomics and single cell gene expression studies. Published by Elsevier Ltd.

  18. Progress in Induction Linacs

    SciTech Connect

    Caporaso, G J

    2000-09-27

    This presentation will be a broad survey of progress in induction technology over the past four years. Much work has been done on accelerators for hydrodynamic test radiography and other applications. Solid-state pulsers have been developed which can provide unprecedented flexibility and precision in pulse format and accelerating voltage for both ion and electron induction machines. Induction linacs can now be built which can operate with MHz repetition rates. Solid-state technology has also made possible the development of fast kickers for precision control of high current beams. New insulator technology has been developed which will improve conventional induction linacs in addition to enabling a new class of high gradient induction linacs.

  19. Progressive Band Selection

    NASA Technical Reports Server (NTRS)

    Fisher, Kevin; Chang, Chein-I

    2009-01-01

    Progressive band selection (PBS) reduces spectral redundancy without significant loss of information, thereby reducing hyperspectral image data volume and processing time. Used onboard a spacecraft, it can also reduce image downlink time. PBS prioritizes an image's spectral bands according to priority scores that measure their significance to a specific application. Then it uses one of three methods to select an appropriate number of the most useful bands. Key challenges for PBS include selecting an appropriate criterion to generate band priority scores, and determining how many bands should be retained in the reduced image. The image's Virtual Dimensionality (VD), once computed, is a reasonable estimate of the latter. We describe the major design details of PBS and test PBS in a land classification experiment.

  20. BRIF and CARIF progress

    NASA Astrophysics Data System (ADS)

    Liu, WeiPing; Li, ZhiHong; Bai, XiXiang; Wang, YouBao; Guo, Bing; Peng, ChaoHua; Yang, Yi; Su, Jun; Cui, BaoQun; Zhou, ShuHua; Zhu, ShengYun; Xia, HaiHong; Guan, XiaLing; Zeng, Sheng; Zhang, HuanQiao; Chen, YongShou; Tang, HongQing; Huang, Li; Feng, BeiYuan

    2011-08-01

    China Institute of Atomic Energy (CIAE) is currently constructing Beijing rare ion beam facility (BRIF) and is proposing China advanced rare ion beam facility (CARIF). This paper is aiming at introducing the progress of BRIF project and the conceptual design CARIF. The ISOL type facility BRIF under construction is composed of a 100 MeV 300 μA proton cyclotron, an ISOL with mass resolution of 20000, and a super-conducting LINAC of 2 MeV/q, and will be commissioned in 2013. CARIF facility proposed is planned to use both ISOL and PF techniques. It is based on a China advanced research reactor CARR that was critical, with ISOL separation of fission fragment, post acceleration to 150 MeV/u, and fragmentation of neutron-rich fission fragment beam like 132Sn. Such unique combination will allow CARIF to deliver beam intensity better than the best world facilities by more than one order of magnitude.

  1. Progress Towards International Repositories

    SciTech Connect

    McCombie, C.; Chapman, N.

    2002-02-27

    The nuclear fuel cycle is designed to be very international, with some specialist activities (e.g. fuel fabrication, reprocessing, etc.) being confined to a few countries. Nevertheless, political and public opposition has in the past been faced by proposals to internationalise the back-end of the cycle, in particular waste disposal. Attitudes, however, have been changing recently and there is now more acceptance of the general concept of shared repositories and of specific proposals such as that of Pangea. However, as for national facilities, progress towards implementation of shared repositories will be gradual. Moreover, the best vehicle for promoting the concept may not be a commercial type of organization. Consequently the Pangea project team are currently establishing a widely based Association for this purpose.

  2. Progress and Potential

    PubMed Central

    Haspel, Richard L.; Olsen, Randall J.; Berry, Anna; Hill, Charles E.; Pfeifer, John D.; Schrijver, Iris; Kaul, Karen L.

    2014-01-01

    Context Genomic medicine is revolutionizing patient care. Physicians in areas as diverse as oncology, obstetrics, and infectious disease have begun using next-generation sequencing assays as standard diagnostic tools. Objective To review the role of pathologists in genomic testing as well as current educational programs and future training needs in genomic pathology. Data Sources Published literature as well as personal experience based on committee membership and genomic pathology curricular design. Conclusion Pathologists, as the directors of the clinical laboratories, must be prepared to integrate genomic testing into their practice. The pathology community has made significant progress in genomics-related education. A continued coordinated and proactive effort will ensure a future vital role for pathologists in the evolving health care system and also the best possible patient care. PMID:24678680

  3. Progressing batch hydrolysis process

    DOEpatents

    Wright, J.D.

    1985-01-10

    A progressive batch hydrolysis process is disclosed for producing sugar from a lignocellulosic feedstock. It comprises passing a stream of dilute acid serially through a plurality of percolation hydrolysis reactors charged with feed stock, at a flow rate, temperature and pressure sufficient to substantially convert all the cellulose component of the feed stock to glucose. The cooled dilute acid stream containing glucose, after exiting the last percolation hydrolysis reactor, serially fed through a plurality of pre-hydrolysis percolation reactors, charged with said feedstock, at a flow rate, temperature and pressure sufficient to substantially convert all the hemicellulose component of said feedstock to glucose. The dilute acid stream containing glucose is cooled after it exits the last prehydrolysis reactor.

  4. Progressing batch hydrolysis process

    DOEpatents

    Wright, John D.

    1986-01-01

    A progressive batch hydrolysis process for producing sugar from a lignocellulosic feedstock, comprising passing a stream of dilute acid serially through a plurality of percolation hydrolysis reactors charged with said feedstock, at a flow rate, temperature and pressure sufficient to substantially convert all the cellulose component of the feedstock to glucose; cooling said dilute acid stream containing glucose, after exiting the last percolation hydrolysis reactor, then feeding said dilute acid stream serially through a plurality of prehydrolysis percolation reactors, charged with said feedstock, at a flow rate, temperature and pressure sufficient to substantially convert all the hemicellulose component of said feedstock to glucose; and cooling the dilute acid stream containing glucose after it exits the last prehydrolysis reactor.

  5. Progressive familial intrahepatic cholestasis.

    PubMed

    Srivastava, Anshu

    2014-03-01

    Progressive familial intrahepatic cholestasis (PFIC) is a group of rare disorders which are caused by defect in bile secretion and present with intrahepatic cholestasis, usually in infancy and childhood. These are autosomal recessive in inheritance. The estimated incidence is about 1 per 50,000 to 1 per 100,000 births, although exact prevalence is not known. These diseases affect both the genders equally and have been reported from all geographical areas. Based on clinical presentation, laboratory findings, liver histology and genetic defect, these are broadly divided into three types-PFIC type 1, PFIC type 2 and PFIC type 3. The defect is in ATP8B1 gene encoding the FIC1 protein, ABCB 11 gene encoding BSEP protein and ABCB4 gene encoding MDR3 protein in PFIC1, 2 and 3 respectively. The basic defect is impaired bile salt secretion in PFIC1/2 whereas in PFIC3, it is reduced biliary phospholipid secretion. The main clinical presentation is in the form of cholestatic jaundice and pruritus. Serum gamma glutamyl transpeptidase (GGT) is normal in patients with PFIC1/2 while it is raised in patients with PFIC3. Treatment includes nutritional support (adequate calories, supplementation of fat soluble vitamins and medium chain triglycerides) and use of medications to relieve pruritus as initial therapy followed by biliary diversion procedures in selected patients. Ultimately liver transplantation is needed in most patients as they develop progressive liver fibrosis, cirrhosis and end stage liver disease. Due to the high risk of developing liver tumors in PFIC2 patients, monitoring is recommended from infancy. Mutation targeted pharmacotherapy, gene therapy and hepatocyte transplantation are being explored as future therapeutic options.

  6. Progressive Familial Intrahepatic Cholestasis

    PubMed Central

    Srivastava, Anshu

    2013-01-01

    Progressive familial intrahepatic cholestasis (PFIC) is a group of rare disorders which are caused by defect in bile secretion and present with intrahepatic cholestasis, usually in infancy and childhood. These are autosomal recessive in inheritance. The estimated incidence is about 1 per 50,000 to 1 per 100,000 births, although exact prevalence is not known. These diseases affect both the genders equally and have been reported from all geographical areas. Based on clinical presentation, laboratory findings, liver histology and genetic defect, these are broadly divided into three types—PFIC type 1, PFIC type 2 and PFIC type 3. The defect is in ATP8B1 gene encoding the FIC1 protein, ABCB 11 gene encoding BSEP protein and ABCB4 gene encoding MDR3 protein in PFIC1, 2 and 3 respectively. The basic defect is impaired bile salt secretion in PFIC1/2 whereas in PFIC3, it is reduced biliary phospholipid secretion. The main clinical presentation is in the form of cholestatic jaundice and pruritus. Serum gamma glutamyl transpeptidase (GGT) is normal in patients with PFIC1/2 while it is raised in patients with PFIC3. Treatment includes nutritional support (adequate calories, supplementation of fat soluble vitamins and medium chain triglycerides) and use of medications to relieve pruritus as initial therapy followed by biliary diversion procedures in selected patients. Ultimately liver transplantation is needed in most patients as they develop progressive liver fibrosis, cirrhosis and end stage liver disease. Due to the high risk of developing liver tumors in PFIC2 patients, monitoring is recommended from infancy. Mutation targeted pharmacotherapy, gene therapy and hepatocyte transplantation are being explored as future therapeutic options. PMID:25755532

  7. Progress 28 supply vehicle docking

    NASA Image and Video Library

    2008-02-07

    ISS016-E-027827 (7 Feb. 2008) --- An unpiloted Progress supply vehicle approaches the International Space Station. Progress 28 resupply craft launched at 7:03 a.m. (CST) on Feb. 5, 2008 from the Baikonur Cosmodrome in Kazakhstan to deliver more than 2.5 tons of food, fuel, oxygen and other supplies to the Expedition 16 crewmembers onboard the station. Progress automatically docked to the Pirs Docking Compartment at 8:30 a.m. (CST) on Feb. 7.

  8. Progress 28 supply vehicle approach

    NASA Image and Video Library

    2008-02-07

    ISS016-E-027820 (7 Feb. 2008) --- An unpiloted Progress supply vehicle approaches the International Space Station. Progress 28 resupply craft launched at 7:03 a.m. (CST) on Feb. 5, 2008 from the Baikonur Cosmodrome in Kazakhstan to deliver more than 2.5 tons of food, fuel, oxygen and other supplies to the Expedition 16 crewmembers onboard the station. Progress automatically docked to the Pirs Docking Compartment at 8:30 a.m. (CST) on Feb. 7.

  9. Progressive familial intrahepatic cholestasis.

    PubMed

    Jacquemin, Emmanuel

    2012-09-01

    Progressive familial intrahepatic cholestasis (PFIC) refers to a heterogeneous group of autosomal-recessive disorders of childhood that disrupt bile formation and present with cholestasis of hepatocellular origin. The exact prevalence remains unknown, but the estimated incidence varies between 1/50,000 and 1/100,000 births. Three types of PFIC have been identified and associated with mutations in hepatocellular transport-system genes involved in bile formation. PFIC1 and PFIC2 usually appear in the first months of life, whereas onset of PFIC3 may arise later in infancy, in childhood or even during young adulthood. The main clinical manifestations include cholestasis, pruritus and jaundice. PFIC patients usually develop fibrosis and end-stage liver disease before adulthood. Serum gamma-glutamyltransferase (GGT) activity is normal in PFIC1 and PFIC2 patients, but is elevated in PFIC3 patients. Both PFIC1 and PFIC2 are caused by impaired bile salt secretion due to defects in ATP8B1 encoding the FIC1 protein and in ABCB11 encoding bile salt export pump (BSEP) protein, respectively. Defects in ABCB4, encoding multidrug resistance 3 protein (MDR3), impair biliary phospholipid secretion, resulting in PFIC3. Diagnosis is based on clinical manifestations, liver ultrasonography, cholangiography and liver histology, as well as on specific tests to exclude other causes of childhood cholestasis. MDR3 and BSEP liver immunostaining, and analysis of biliary lipid composition should help to select PFIC candidates for whom genotyping could be proposed to confirm the diagnosis. Antenatal diagnosis may be proposed for affected families in which a mutation has been identified. Ursodeoxycholic acid (UDCA) therapy should be initiated in all patients to prevent liver damage. In some PFIC1 and PFIC2 patients, biliary diversion may also relieve pruritus and slow disease progression. However, most PFIC patients are ultimately candidates for liver transplantation. Monitoring of liver tumors

  10. Progressive familial intrahepatic cholestasis.

    PubMed

    Davit-Spraul, Anne; Gonzales, Emmanuel; Baussan, Christiane; Jacquemin, Emmanuel

    2009-01-08

    Progressive familial intrahepatic cholestasis (PFIC) refers to heterogeneous group of autosomal recessive disorders of childhood that disrupt bile formation and present with cholestasis of hepatocellular origin. The exact prevalence remains unknown, but the estimated incidence varies between 1/50,000 and 1/100,000 births. Three types of PFIC have been identified and related to mutations in hepatocellular transport system genes involved in bile formation. PFIC1 and PFIC2 usually appear in the first months of life, whereas onset of PFIC3 may also occur later in infancy, in childhood or even during young adulthood. Main clinical manifestations include cholestasis, pruritus and jaundice. PFIC patients usually develop fibrosis and end-stage liver disease before adulthood. Serum gamma-glutamyltransferase (GGT) activity is normal in PFIC1 and PFIC2 patients, but is elevated in PFIC3 patients. Both PFIC1 and PFIC2 are caused by impaired bile salt secretion due respectively to defects in ATP8B1 encoding the FIC1 protein, and in ABCB11 encoding the bile salt export pump protein (BSEP). Defects in ABCB4, encoding the multi-drug resistant 3 protein (MDR3), impair biliary phospholipid secretion resulting in PFIC3. Diagnosis is based on clinical manifestations, liver ultrasonography, cholangiography and liver histology, as well as on specific tests for excluding other causes of childhood cholestasis. MDR3 and BSEP liver immunostaining, and analysis of biliary lipid composition should help to select PFIC candidates in whom genotyping could be proposed to confirm the diagnosis. Antenatal diagnosis can be proposed for affected families in which a mutation has been identified. Ursodeoxycholic acid (UDCA) therapy should be initiated in all patients to prevent liver damage. In some PFIC1 or PFIC2 patients, biliary diversion can also relieve pruritus and slow disease progression. However, most PFIC patients are ultimately candidates for liver transplantation. Monitoring of

  11. Dynamically prioritized progressive transmission

    NASA Astrophysics Data System (ADS)

    Blanford, Ronald

    1992-04-01

    Retrieval of image data from a centralized database may be subject to bandwidth limitations, whether due to a low-bandwidth communications link or to contention from simultaneous accesses over a high-bandwidth link. Progressive transmission can alleviate this problem by encoding image data so that any prefix of the data stream approximates the complete image at a coarse level of resolution. The longer the prefix, the finer the resolution. In many cases, as little at 1 percent of the image data may be sufficient to decide whether to discard the image, to permit the retrieval to continue, or to restrict retrieval to a subsection of the image. Our approach treats resolution not as a fixed attribute of the image, but rather as a resource which may be allocated to portions of the image at the direction of a user-specified priority function. The default priority function minimizes error by allocating more resolution to regions of high variance. The user may also point to regions of interest requesting priority transmission. More advanced target recognition strategies may be incorporated at the user's discretion. Multispectral imagery is supported. The user engineering implications are profounded. There is immediate response to a query that might otherwise take minutes to complete. The data is transmitted in small increments so that no single user dominates the communications bandwidth. The user-directed improvement means that bandwidth is focused on interesting information. The user may continue working with the first coarse approximations while further image data is still arriving. The algorithm has been implemented in C on Sun, Silicon Graphics, and NeXT workstations, and in Lisp on a Symbolics. Transmission speeds reach as high as 60,000 baud using a Sparc or 68040 processor when storing data to memory; somewhat less if also updating a graphical display. The memory requirements are roughly five bytes per image pixel. Both computational and memory costs may be reduced

  12. Using Learning Progressions to Monitor Progress across Grades

    ERIC Educational Resources Information Center

    Hess, Karin K.

    2010-01-01

    Learning progressions (LPs)--descriptive continuums of how students develop and demonstrate more sophisticated understanding over time--have become an increasingly important tool in today's science classrooms. Here the author discusses some of the research behind learning progressions and presents The Science Inquiry Profile for PreK-4. This is a…

  13. Progress in Ultrafast Photonics

    NASA Astrophysics Data System (ADS)

    Kamiya, Takeshi; Tsuchiya, Masahiro

    2005-08-01

    Recent progress in ultrafast photonics is reviewed with special emphasis on the research and development activities in Japanese research institutions in the field of optical communication and related measurement technologies. After summarizing the physical natures of ultrashort optical pulses, selected topics are reviewed on such as (1) ultrahigh-bit-rate optical communication employing the combination of optical time division multiplexing (OTDM) and wavelength division multiplexing (WDM), (2) optical components for ultrafast photonics with emphasis on all optical switches including semiconductor optical amplifiers, cascaded second order frequency converters, semiconductor saturable absorber switches, organic dye saturable absorber switches and bistable semiconductor lasers, (3) microwave photonics, emphasizing millimeter-wave/photonic communication technologies, and (4) high-speed optical measurements featuring both compact femtosecond pulse source development and rf magnetic field imaging. Some comments on the future prospect of ultrafast photonics are also given. It is concluded that in order to bring the powerful and versatile capability of ultrafast photonics into the real world, further collaboration between photonics specialists and production engineers/information specialists is strongly desired.

  14. IPY Progress and Prospects

    NASA Astrophysics Data System (ADS)

    Carlson, D.

    2008-12-01

    We can summarize the IPY goals as: (a) make major advances in polar knowledge and understanding; (b) leave a legacy of new or enhanced observational systems, facilities and infrastructure; (c) excite a new generation of polar scientists and engineers, and (d) elicit exceptional interest and participation from polar residents, schoolchildren, the general public, and decision-makers, worldwide. This talk reports on the progress and prospects in each of those areas from an overall international view; separate talks will describe details of future researcher and the IPY outreach efforts. To achieve major advances in knowledge, IPY has entrained the intellectual resources of thousands of scientists, many more than expected, often from 'non- polar' nations, and representing an unprecedented breadth of scientific specialties; integration of those efforts across disciplines to achieve integrated system-level understanding remains a substantial challenge. Many national and international organizations prepare plans to sustain new and improved observational systems, but clear outcomes and the necessary resources remain elusive. International outreach networks gradually build breadth and strength, largely through IPY Polar Science Days and other internationally- coordinated IPY events. A new Association of Polar Early Career Scientists (APECS) devotes talent and energy to shaping the future of polar research. These activities and networks may, with time and with continued international coordination, achieve an exceptional level of interest and participation. In all areas, much work remains.

  15. PVUSA progress report, 1991

    SciTech Connect

    Ellyn, W.; Jennings, C.

    1991-12-31

    Photovoltaics for Utility Scale Applications (PVUSA) is a national public-private partnership that is assessing and demonstrating the viability of utility-scale photovoltaic (PV) electric generating systems. PVUSA participants include Pacific Gas & Electric (PG&E), the US Department of Energy (DOE), the Electric Power Research Institute (EPRI), the California Energy Commission (CEC), and eight utilities and other agencies. This report updates the progress of the PVUSA project, reviews the status and performance of the various PV installations during 1991, and summarizes key findings and conclusions from work to date. PVUSA offers utilities hands-on experience needed to evaluate and utilize maturing PV technology. The project also provides manufacturers a test bed for their products, encourages technology improvement and cost reductions in PV modules and other system components, and establishes communication channels between utilities and the PV industry. The project consists of two types of demonstrations: Emerging Module Technology (EMT) arrays, which are unproven but promising state-of-the-art PV technologies in 20-kW (nominal) arrays; and Utility Scale (US) systems, which represent more mature PV technologies in 200- to 500-kW turnkey systems.

  16. W7-X Progress

    SciTech Connect

    Gasparotto, M.; Erckmann, V.; Gardebrecht, W.; Rummel, Th.; Schauer, F.; Wanner, M.; Wegener, L.

    2005-04-15

    The WENDELSTEIN 7-X stellarator (W7-X) is the next step device in the stellarator line of IPP and is presently under construction at the Greifswald branch institute. The experiment aims at demonstrating the steady state capability of a stellarator machine at reactor relevant parameters. An important feature of W7-X is the high geometrical accuracy of the magnetic configuration which implies tight tolerances in the construction and assembly phases. The magnetic system consists of 50 non planar and 20 planar superconducting coils. Critical components are the coil support elements connecting the coil to the central mechanical structure and the inter-coil elements connecting the coils one to the other. Efficient thermal insulation of the superconducting coils is achieved by high vacuum and multi-layer insulation. The plasma vessel is composed of 10 half-modules welded together during the assembly phase. A 10 MW ECRH system with CW-capability operation at 140 GHz is required to meet the scientific objective of W7-X.The paper will report the recent progress on W7-X with particular emphasis on the components where high technology solutions have been applied.

  17. Progressive myoclonic epilepsies

    PubMed Central

    Michelucci, Roberto; Canafoglia, Laura; Striano, Pasquale; Gambardella, Antonio; Magaudda, Adriana; Tinuper, Paolo; La Neve, Angela; Ferlazzo, Edoardo; Gobbi, Giuseppe; Giallonardo, Anna Teresa; Capovilla, Giuseppe; Visani, Elisa; Panzica, Ferruccio; Avanzini, Giuliano; Tassinari, Carlo Alberto; Bianchi, Amedeo; Zara, Federico

    2014-01-01

    Objective: To define the clinical spectrum and etiology of progressive myoclonic epilepsies (PMEs) in Italy using a database developed by the Genetics Commission of the Italian League against Epilepsy. Methods: We collected clinical and laboratory data from patients referred to 25 Italian epilepsy centers regardless of whether a positive causative factor was identified. PMEs of undetermined origins were grouped using 2-step cluster analysis. Results: We collected clinical data from 204 patients, including 77 with a diagnosis of Unverricht-Lundborg disease and 37 with a diagnosis of Lafora body disease; 31 patients had PMEs due to rarer genetic causes, mainly neuronal ceroid lipofuscinoses. Two more patients had celiac disease. Despite extensive investigation, we found no definitive etiology for 57 patients. Cluster analysis indicated that these patients could be grouped into 2 clusters defined by age at disease onset, age at myoclonus onset, previous psychomotor delay, seizure characteristics, photosensitivity, associated signs other than those included in the cardinal definition of PME, and pathologic MRI findings. Conclusions: Information concerning the distribution of different genetic causes of PMEs may provide a framework for an updated diagnostic workup. Phenotypes of the patients with PME of undetermined cause varied widely. The presence of separate clusters suggests that novel forms of PME are yet to be clinically and genetically characterized. PMID:24384641

  18. Progressive familial intrahepatic cholestasis.

    PubMed

    Jacquemin, E

    1999-06-01

    Progressive familial intrahepatic cholestasis (PFIC), also known as Byler disease, is an inherited disorder of childhood in which cholestasis of hepatocellular origin often presents in the neonatal period and leads to death from liver failure before adolescence. The pattern of appearance of affected children within families is consistent with autosomal recessive inheritance. Several studies have provided support for the heterogeneity of this clinical entity suggesting the existence of different types due to different disorders affecting the hepatocyte and related to defects of bile acid secretion or bile acid metabolism. Recent molecular and genetic studies have identified genes responsible for three types of PFIC and have shown that PFIC was related to mutations in hepatocellular transport system genes involved in bile formation. These findings now provide specific diagnostic tools for the investigation of children with PFIC and should allow prenatal diagnosis in the future. Genotype-phenotype correlations performed in patients treated with ursodeoxycholic acid or biliary diversion should allow those PFIC patients who could benefit from these therapies to be precisely identified. In the future, other therapies, such as cell and gene therapies, might be considered and could also represent an alternative to liver transplantation.

  19. Progressive familial intrahepatic cholestasis.

    PubMed

    Cavestro, Giulia Martina; Frulloni, Luca; Cerati, Elena; Ribeiro, Luciana Andrea; Corrente, Vincenzo; Sianesi, Mario; Franzè, Angelo; Di Mario, Francesco

    2002-01-01

    Progressive familial intrahepatic cholestasis (PFIC) is a heterogeneous group of autosomal recessive childhood cholestasis of hepatocellular origin. PFIC 1, also known as Byler disease, was first described in Amish kindred. It is characterized by cholestasis often arising in the neonatal period and it leads to death due to liver failure. PFIC 1, like Benign Recurrent Intrahepatic Cholestasis (BRIC) which is the benign form of the same disease, recognizes mutations in the ATP8B1 gene. PFIC 2 disease is clinically similar to PFIC 1 but it has a different gene mutation causing a defect in the Bile Salt Export Pump (BSEP), exclusively expressed in the liver and involved in the canalicular secretion of bile acids. PFIC 3 usually appears later in life and it has a higher risk of portal hypertension, gastrointestinal bleeding and liver failure. This particular form of disease (the only one with high serum values of g-glutamil transpeptidase), is associated to a genetic defect in the class III multidrug resistance protein (MDR). External biliary diversion and ursodeoxycholic acid therapy, should be considered as the initial therapy in these patients, even if liver transplantation still seems to be the only solution for most patients.

  20. Annual Technical Progress Report

    SciTech Connect

    Ayman I. Hawari

    2002-10-02

    This report describes the results generated during phase 1 of this project. During this phase, the main tools that are used to compute the thermal neutron scattering kernels for graphite, beryllium, beryllium oxide, zirconium hydride, light water, polyethylene were implemented and tested. This includes a modified NJOY/LEAPR code system, the GASKET code, and the ab initio condensed matter codes VASP and PHONON. Thermal neutron scattering kernels were generated for graphite, beryllium, beryllium oxide. In the case of graphite, new phonon spectra were examined. The first is a spectrum based on experiments performed at Oak Ridge National Laboratory in the early seventies, and the second is generated using the ab initio methods. In the case of beryllium, and beryllium oxide, a synthetic approach for generating the phonon spectra was implemented. In addition, significant progress was made on an experiment to benchmark the graphite scattering kernels was made. The simulations of this experiment show that differences on the order of a few percent, in Pu-239 detector responses, can be expected due to the use of different scattering kernels. (B204) NOT A FINAL REPORT

  1. Progress in neuromorphic photonics

    NASA Astrophysics Data System (ADS)

    Ferreira de Lima, Thomas; Shastri, Bhavin J.; Tait, Alexander N.; Nahmias, Mitchell A.; Prucnal, Paul R.

    2017-03-01

    As society's appetite for information continues to grow, so does our need to process this information with increasing speed and versatility. Many believe that the one-size-fits-all solution of digital electronics is becoming a limiting factor in certain areas such as data links, cognitive radio, and ultrafast control. Analog photonic devices have found relatively simple signal processing niches where electronics can no longer provide sufficient speed and reconfigurability. Recently, the landscape for commercially manufacturable photonic chips has been changing rapidly and now promises to achieve economies of scale previously enjoyed solely by microelectronics. By bridging the mathematical prowess of artificial neural networks to the underlying physics of optoelectronic devices, neuromorphic photonics could breach new domains of information processing demanding significant complexity, low cost, and unmatched speed. In this article, we review the progress in neuromorphic photonics, focusing on photonic integrated devices. The challenges and design rules for optoelectronic instantiation of artificial neurons are presented. The proposed photonic architecture revolves around the processing network node composed of two parts: a nonlinear element and a network interface. We then survey excitable lasers in the recent literature as candidates for the nonlinear node and microring-resonator weight banks as the network interface. Finally, we compare metrics between neuromorphic electronics and neuromorphic photonics and discuss potential applications.

  2. Technical progress report

    SciTech Connect

    1996-10-01

    This report summarizes experimental and theoretical work in basic nuclear physics carried out between October 1, 1995, the closing of our last Progress Report, and September 30, 1996 at the Nuclear Physics Laboratory of the University of Colorado, Boulder, under contracts DE-FG03-93ER-40774 and DE-FG03-95ER-40913 with the United States Department of Energy. The experimental contract supports broadly-based experimental research in intermediate energy nuclear physics. This report includes results from studies of Elementary Systems involving the study of the structure of the nucleon via polarized high-energy positron scattering (the HERMES experiment) and lower energy pion scattering from both polarized and unpolarized nucleon targets. Results from pion- and kaon-induced reactions in a variety of nuclear systems are reported under the section heading Meson Reactions; the impact of these and other results on understanding the nucleus is presented in the Nuclear Structure section. In addition, new results from scattering of high-energy electrons (from CEBAF/TJNAF) and pions (from KEK) from a broad range of nuclei are reported in the section on Incoherent Reactions. Finally, the development and performance of detectors produced by the laboratory are described in the section titled Instrumentation.

  3. 1993 PVUSA progress report

    SciTech Connect

    1993-12-31

    Photovoltaics for Utility Scale Applications (PVUSA) is a national public-private partnership that is assessing and demonstrating the viability of utility-scale photovoltaic (PV) electric generation systems and recent developments in module technology. This report updates the progress of the PVUSA project, review the status and performance of all PV installations during 1993, and summarizes key accomplishments and conclusions for the year. The PVUSA project has five objectives designed to narrow the gap between a large utility industry that is unfamiliar with PV, and a small PV industry that is aware of a potentially large utility market but unfamiliar with how to meet its requirements. The objectives are: to evaluate the performance, reliability, and cost of promising PV modules and balance-of-system (BOS) components side-by-side at a single location; to assess PV system operation and maintenance (O and M) in a utility setting; to compare PV technologies in diverse geographic areas; to provide US utilities with hands-on experience in designing, procuring, and operating PV systems; and to document and disseminate knowledge gained from the project.

  4. Progress of AMOLED technology

    NASA Astrophysics Data System (ADS)

    Park, Joon Young

    2005-01-01

    We report the technical progress of AMOLED at Samsung SDI, comparing with other technologies. We introduce the voltage-compensational TFT circuit structure to improve the brightness uniformity of AMOLED, which is based on the low temperature poly-silicon. We have developed not only small molecule emitters (phosphorescence and fluorescence) but also polymeric emitters. From red and green phosphors, we achieved longer lifetime and higher efficiency than fluorophors. With the shadow mask patterning and the bottom-emission structure, 20,000-hour lifetime of QCIF device and the power consumption less than 150 mW at 100 cd/m2 (30% on condition) were obtained. In the case of the top-emission structure, we could get high efficiency also by maximizing the light out-coupling efficiency and enhance the color purity to the level of the NTSC. We have developed another patterning technology, "LITI: Laser Induced Thermal Imaging" and fabricated 17-inch full color AMOLED, which is the largest AMOLED based on the low temperature poly-Silicon.

  5. Quarterly Progress Report

    SciTech Connect

    David Gray; Glen Tomlinson

    1998-11-12

    The Federal Energy Technology Center (FETC) at Pittsburgh contracted with the MJTRE Corporation to perform Research Guidance Studies that will assist the Center and other relevant offices in the Department of Energy in evaluating and prioritizing research in the areas of coal and natural gas conversion. MITRE was reorganized in December 1995, which resulted in the formation of Mitretek Systems Inc. Mitretek has been performing this work on MITRE's behalf awaiting completion of contract novation to Mitretek. The contract was novated in February 1998 to Mitretek Systems. The overall objectives of this contract are to provide support to DOE in the following areas: (1) technical and economic analyses of current and future coal-based energy conversion technologies and other similar emerging technologies such as coal-waste coprocessing, natural gas conversion, and biomass conversion technologies for the production of fuels, chemicals and electric power,(2) monitor progress in these technologies with respect to technical, economic, and environmental impact (including climate change), (3) conduct specific and generic project economic and technical feasibility studies based on these technologies, (4) identify long-range R&D areas that have the greatest potential for process improvements, and (5) investigate optimum configurations and associated costs for production of high quality energy products via refining and their performance in end-use applications.

  6. Nuclear chemistry progress report

    SciTech Connect

    Viola, V.E.; Kwiatkowski, K.

    1993-08-01

    This is the annual progress report for the Indiana University nuclear chemistry program for the 1992/1993 year. Accomplishments include the construction, testing, and initial experimental runs of the Indiana Silicon Sphere (ISiS) 4{pi} charged particle detector. ISiS is designed to study energy dissipation and multifragmentation phenomena in light-ion-induced nuclear reactions at medium-to-high energies. Its second test run was to examine 3.6 GeV {sup 3}He beam reactions at Laboratoire National Saturne (LNS) in Saclay. The development and deployment of this system has occupied a great deal of the groups effort this reporting period. Additional work includes: calculations of isotopic IMF yields in the {sup 4}He + {sup 116,124}Sn reaction; cross sections for A = 6 - 30 fragments from the {sup 4}He + {sup 28}Si reaction at 117 and 198 MeV; charging effects of passivated silicon detectors; neck emission of intermediate-mass fragments in the fission of hot heavy nuclei.

  7. Treatment of congenital aniridia associated with subluxated infantile cataract.

    PubMed

    Jusufovic, Vahid; Cabric, Emir; Popovic-Beganovic, Allen; Musanovic, Zlatko; Zvornicanin, Jasmin

    2014-01-01

    A 5 year old boy was presented at Eye clinic University clinical center Tuzla with congenital aniridia in both eyes. Clinical examination revealed visual acuity of 0.08 without correction in right and 0.7 with -5.0 Dsph and -1.0 Dcyl Axx 109 degrees in left eye. Opthalmologic examination showed bilateral aniridia associated with moderate cataract in the right and incipient cataract in the left eye. In the right eye, zonular weakness with incipient capsular displacement and esotropia of delta6 degrees, were noted. The patient underwent phacoemulsification, implantation of capsular tension ring and Artificial Iris implant in the capsular bag. Phacoemulsification went uneventful and early postoperative recovery was successful with no signs of aniridia-associated keratopathy development and normal values of intra ocular pressure. Patient was not motivated for operation of the left eye and it was corrected with soft contact lens. Six month after the operation visual acuity in the right eye improved to 0.9 with +1.25 Dsph and maintained stable in left eye, with complete elimination of esotropia and signs of binocular vision restoration. Small incision cataract extraction with IOL and Artificial Iris implantation in one procedure can be used to correct congenital aniridia and cataract with significant visual function improvement.

  8. Treatment of congenital aniridia associated with subluxated infantile cataract.

    PubMed

    Jusufovic, Vahid; Cabric, Emir; Popovic-Beganovic, Allen; Musanovic, Zlatko; Zvornicanin, Jasmin

    2014-06-01

    A 5 year old boy was presented at Eye clinic University clinical center Tuzla with congenital aniridia in both eyes. Clinical examination revealed visual acuity of 0,08 without correction in right and 0.7 with -5.0 Dsph and -1.0 Dcyl Axx 109° in left eye. Opthalmologic examination showed bilateral aniridia associated with moderate cataract in the right and incipient cataract in the left eye. In the right eye, zonular weakness with incipient capsular displacement and esotropia of Δ6º, were noted. The patient underwent phacoemulsification, implantation of capsular tension ring and Artificial Iris implant in the capsular bag. Phacoemulsification went uneventful and early postoperative recovery was successful with no signs of aniridia-associated keratopathy development and normal values of intra ocular pressure. Patient was not motivated for operation of the left eye and it was corrected with soft contact lens. Six month after the operation visual acuity in the right eye improved to 0.9 with +1.25Dsph and maintained stable in left eye, with complete elimination of esotropia and signs of binocular vision restoration. Small incision cataract extraction with IOL and Artificial Iris implantation in one procedure can be used to correct congenital aniridia and cataract with significant visual function improvement.

  9. Subtle lisfranc subluxation: results of operative and nonoperative treatment.

    PubMed

    Crates, John M; Barber, F Alan; Sanders, Eric J

    2015-01-01

    Subtle Lisfranc instability is typically a low-energy, twisting, axial-loading injury. The present study evaluated the operative treatment of subtle Lisfranc injuries after nonoperative failure. The data from consecutive patients with subtle Lisfranc instabilities were reviewed. Those in whom initial nonoperative treatment had failed underwent surgery. The American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score was obtained initially, after nonoperative treatment, and, for those in whom nonoperative treatment had failed, after operative treatment. Of 36 patients enrolled, 16 (44.44%) were successfully treated nonoperatively, and 20 (55.56%) required surgery after nonoperative treatment had failed. Of those treated operatively, 9 (45%) were stabilized with dual screws and 11 (55%) with dual suture buttons. The mean follow-up period was 36 ± 12.2 months. The AOFAS scores significantly improved from the pre- to final post-treatment values. The overall mean pretreatment AOFAS score (62.8 ± 8.84) was significantly lower statistically than the mean overall post-treatment AOFAS score (91.3 ± 8.34; p < .0001). The mean AOFAS score before nonoperative treatment (61.9 ± 9.5) improved to a mean AOFAS score of 75.3 ± 15.8 after nonoperative treatment (p = .0029). The mean preoperative AOFAS score (63.5 ± 8.46) improved to a postoperative AOFAS score of 92.3 ± 8.43 (p < .0001). The mean AOFAS score before nonoperative treatment (61.9 ± 9.5) was not significantly different statistically from the mean preoperative AOFAS score (63.5 ± 8.46; p = .62). The mean AOFAS score after nonoperative treatment (75.3 ± 15.8) was lower than the mean postoperative AOFAS score (92.3 ± 8.43; p < .0001). Of the 9 feet stabilized with dual screws, 7 (77.78%) required screw removal during the observation period. Subtle Lisfranc injuries failing nonoperative treatment were successfully stabilized using either a dual screw or suture button technique. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Radiologic comparison of erosive polyarthritis with prominent interphalangeal involvement

    SciTech Connect

    Gold, R.H.; Bassett, L.W.; Theros, E.G.

    1982-05-01

    Psoriatic arthritis, Reiter's disease, and multicentric reticulohistiocytosis may manifest prominent interphalangeal joint and cutaneous involvement. All three disorders may also affect the sacroiliac joints and spine. Despite these similarities, there are basic radiologic differences enabling distinction between the three disorders. Erosive osteoarthritis must also be considered in the differential diagnosis of interphalangeal erosive arthritis. Psoriatic erosions are characteristically ill defined, often bilaterally asymmetrical, usually unaccompanied by significant osteoporosis, and frequently associated with florid proliferation of subperiosteal new bone. An unilateral polyarticular pattern, which often occurs in a single ray, is the most prevalent of several patterns of involvement. Reiter's disease exhibits many clinical and radiologic similarities to psoriatic arthritis, but in the former there tends to be selective involvement of the joints of the lower limbs and particularly the feet, with relative sparing of the hands and wrists, while in the latter the joints of the upper and lower limbs tend to be involved to an equal extent. Multicentric reticulohistiocytosis (MR). Lesions predominate in skin and synovium and result in sharply circumscribed, rapidly progressive, strikingly bilaterally symmetrical erosions spreading from joint margins to articular surfaces. Most or all of the diarthrodial joints may be affected, but interphalangeal joint predominance and early and severe atlanto-axial involvement are characteristic. Erosive osteoarthritis is characterized by interphalangeal subchondral erosions, accompanying periosteal new bone that is more subtle than that of psoriatic arthritis, and interphalangeal bony ankylosis that occurs with the same frequency as that of psoriatic arthritis.

  11. Dysspondyloenchondromatosis (DSC) associated with COL2A1 mutation: Clinical and radiological overlap with spondyloepimetaphyseal dysplasia-Strudwick type (SEMD-S).

    PubMed

    Merrick, Blair; Calder, Alistair; Wakeling, Emma

    2015-12-01

    Dysspondyloenchondromatosis (DSC) is a rare skeletal dysplasia characterized by enchondroma-like lesions and anisospondyly. The former leads to discrepancies in limb length, and the latter, to progressive kyphoscoliosis. Two recent cases have highlighted the genetic heterogeneity of DSC, one demonstrating the presence and, the other, the absence of a COL2A1 mutation. This may have important clinical implications, for example, screening for complications including atlanto-axial instability associated with type II collagenopathies, as well as long-term patient management. We report on a case with radiographic features of DSC with overlap into the type II collagenopathy spondyloepimetaphyseal dysplasia, Strudwick type, who was found to carry a novel heterozygous mutation in the COL2A1 gene. Testing for COL2A1 mutations should be performed in all patients with radiological features of DSC. Further research is needed to identify the underlying molecular cause in cases where no COL2A1 mutation is identified. © 2015 Wiley Periodicals, Inc.

  12. The Thermochronologist's Progress

    NASA Astrophysics Data System (ADS)

    Zeitler, P. K.

    2011-12-01

    We owe our current understanding of thermochronology less to a series of revolutionary insights than to a somewhat uneven intellectual pilgrimage that over fifty years has progressed in fits and starts. Though hampered at times by overenthusiasm, oversimplification, and misunderstandings, on balance the field advanced thanks to a blend of curiosity-driven research, tool-building motivated by new ideas about Earth science, and improvements in technology. But now that we've exploited most radiogenic systems and the major minerals that host them, and now that our models can devour CPU time along with the best of them, are we done? Have we reached peak thermochron? The answer of course is no, and papers in this session will demonstrate what new technologies and techniques might have to offer in the coming years. However, I will argue that the discipline as a whole has matured to a point where if thermochronology is to remain a mainstream tool as opposed to a weekend sport, we need to get serious about several challenges. The most fundamental challenge is that current geodynamic models (and even more complex models we can envision coding) have outpaced our meagre stockpile of kinetic calibrations, our understanding of detailed isotope systematics, and our ability to generate data with sufficient throughput. These issues will not be addressed adequately through the business-as-usual approach that brought us to our current knowledge, and some community effort will probably be needed to coordinate the hard work that will be required. But any serious attempt to answer important questions with accurate thermal histories that have low and well-defined uncertainties will require that we actually know the kinetics for the specific samples we are analyzing, that we fully understand scatter in the data, that we work with the large sample numbers that are required for some problems like landscape evolution, and that inversion tools fully explore the important aspects of both the

  13. Progress in Helioseismic Holography

    NASA Astrophysics Data System (ADS)

    Braun, D. C.

    2001-05-01

    Local Helioseismology uses acoustic waves to probe small-scale structures in the solar interior down to a spatial resolution imposed by wave diffraction. Although its practitioners, including this author, may sometimes employ measurements of the acoustic wave field made over a local area of the Sun's surface to examine its shallow layers, local helioseismology generally has a much broader utility. For example, some applications of helioseismic holography (and other local diagnostics) require global acoustic modes, observed over large portions of the surface, to produce diffraction-limited images of the far side or deep interior of the Sun. In this review, I will summarize recent progress achieved in seismic holography in collaboration with C. Lindsey (SPRC). With P. Scherrer and the SOI-MDI team at Stanford, we have helped to realize a daily synoptic monitor of far-side activity using medium-resolution MDI images obtained within 24 hours of their acquisition by the SOHO spacecraft. In addition, we have laid out the basic theoretical groundwork for the application of computational seismic holography to the deep solar interior to image the tachocline and underlying radiative core of the Sun. Taking advantage of the substantial depth sensitivity of horizontal-flow diagnostics, we have recently adapted our holographic software to test the basic techniques on the shallow subphotospheres of active regions. The utility of both ground- and space-based instruments is usually enhanced by their combination and comparison. I will present the results of holographic analyses of simultaneous GONG+ prototype and SOI-MDI observations of a large flare-producing active region. The general similarity of the helioseismic images from both instruments is noteworthy. This demonstrates the feasibility of increasing the temporal and spatial coverage available to local analyses by combining SOHO data with that obtained from the GONG+ network. We gratefully acknowledge recent support from the

  14. Benchtop Energetics Progress

    NASA Astrophysics Data System (ADS)

    Fajardo, Mario

    2011-06-01

    We have constructed an apparatus for investigating the reactive chemical dynamics of mg-scale energetic materials samples. We seek to advance the understanding of the reaction kinetics of energetic materials, and of the chemical influences on energetic materials sensitivity. We employ direct laser irradiation, and indirect laser-driven shock, techniques to initiate thin-film explosive samples contained in a high-vacuum chamber. Expansion of the reacting flow into vacuum quenches the chemistry and preserves reaction intermediates for interrogation via time-of-flight mass spectrometry (TOFMS). By rastering the sample coupon through the fixed laser beam focus, we generate hundreds of repetitive energetic events in a few minutes. A detonation wave passing through an organic explosive, such as pentaerythritol tetranitrate (PETN, C5H4N4O12) , is remarkably efficient in converting the solid explosive into final thermodynamically-stable gaseous products (e . g . N2, CO2, H2O...). Termination of a detonation at an explosive-to-vacuum interface produces an expanding pulse of hyperthermal molecular species, with leading-edge velocities ~10 km/s. In contrast, deflagration (subsonic combustion) of PETN in vacuum produces mostly reaction intermediates, such as NO and NO2, with much slower molecular velocities; consistent with expansion-quenched thermal decomposition of PETN. We propose to exploit these differences in product chemical identities and molecular species velocities to provide a chemically-based diagnostic for distinguishing between detonation and deflagration events. In this talk we also report recent progress towards the quantitative detection of hyperthermal neutral species produced by direct laser ablation of aluminum metal and of organic energetic materials, as a step towards demonstrating the ability to discriminate slow reaction intermediates from fast thermodynamically-stable final products. Work done in collaboration with Emily Fossum, Christopher Molek, and

  15. The Progress of Nations, 1999.

    ERIC Educational Resources Information Center

    United Nations Children's Fund, New York, NY.

    This report summarizes the latest available statistics on international progress on children's well-being. Each of the report's sections contains a commentary, related statistics, and a discussion on progress and disparity in the section's particular area. Following a foreword by United Nations Secretary-General Kofi A. Annan, the sections of the…

  16. The Progress of Nations, 2000.

    ERIC Educational Resources Information Center

    United Nations Children's Fund, New York, NY.

    This report summarizes the latest available statistics on international progress on children's well-being. Each section of the report contains a commentary, related statistics, and a discussion on progress and disparity in the section's particular area. Following a foreword by United Nations Secretary-General Kofi A. Annan, the sections of the…

  17. Progress in NASA Rotorcraft Propulsion

    NASA Technical Reports Server (NTRS)

    DellaCorte, Christopher; Johnson, Susan M.

    2008-01-01

    This presentation reviews recent progress made under NASA s Subsonic Rotary Wing (SRW) propulsion research activities. Advances in engines, drive systems and optimized propulsion systems are discussed. Progress in wide operability compressors, modeling of variable geometry turbine performance, foil gas bearings and multi-speed transmissions are presented.

  18. The Progress of Nations, 1999.

    ERIC Educational Resources Information Center

    United Nations Children's Fund, New York, NY.

    This report summarizes the latest available statistics on international progress on children's well-being. Each of the report's sections contains a commentary, related statistics, and a discussion on progress and disparity in the section's particular area. Following a foreword by United Nations Secretary-General Kofi A. Annan, the sections of the…

  19. Enquiry into Student Progress 1968.

    ERIC Educational Resources Information Center

    Her Majestys Stationery Office, London (England).

    This report is the result of a study made to establish the extent of success and failure in degree courses and the reasons for failure. The material is presented in a series of tables that approach the subject from the following points of view: (1) progress of undergraduate students in universities by subject group; (2) progress of undergraduate…

  20. The Progress of Nations, 2000.

    ERIC Educational Resources Information Center

    United Nations Children's Fund, New York, NY.

    This report summarizes the latest available statistics on international progress on children's well-being. Each section of the report contains a commentary, related statistics, and a discussion on progress and disparity in the section's particular area. Following a foreword by United Nations Secretary-General Kofi A. Annan, the sections of the…

  1. Understanding nuclei: progress and challenges

    SciTech Connect

    Dean, D. J.

    2008-04-17

    Nuclear theory today aims for a comprehensive theoretical framework that can describe all nuclei. I discuss recent progress in this pursuit and the associated challenges as we move forward, paying particular attention to progress in the applications of coupled-cluster theory to the challenges.

  2. [Changes in the cranio-cervical junction in Down's syndrome].

    PubMed

    Amato, C; Moschini, M; Cioni, M; Bianco, M

    1990-01-01

    Twenty-eight subjects with Down syndrome, 9-29 years old, were examined for instability of the cervical spine at the atlanto-axial and atlanto-occipital joints. This region was studied by evaluating the atlanto-odontoid space and the basilar line both in neutral position and during functional movements. Two patients (7.2%) presented atlanto-axial anomalies, while 3 patients (10.7%) showed atlanto-occipital instability. Clinical goniometric measurements demonstrated specific and significant improvement in the extension movement of Down patients, when compared to the control group.

  3. Scientific progress: Knowledge versus understanding.

    PubMed

    Dellsén, Finnur

    2016-04-01

    What is scientific progress? On Alexander Bird's epistemic account of scientific progress, an episode in science is progressive precisely when there is more scientific knowledge at the end of the episode than at the beginning. Using Bird's epistemic account as a foil, this paper develops an alternative understanding-based account on which an episode in science is progressive precisely when scientists grasp how to correctly explain or predict more aspects of the world at the end of the episode than at the beginning. This account is shown to be superior to the epistemic account by examining cases in which knowledge and understanding come apart. In these cases, it is argued that scientific progress matches increases in scientific understanding rather than accumulations of knowledge. In addition, considerations having to do with minimalist idealizations, pragmatic virtues, and epistemic value all favor this understanding-based account over its epistemic counterpart.

  4. [Recent progress in mycobacteriology].

    PubMed

    Okada, Masaji; Kobayashi, Kazuo

    2007-10-01

    Mycobacterium tuberculosis is one of the most successful bacterial parasites of humans, infecting over one-third of the population of the world as latent infection without clinical manifestations. Over 8.8 million new cases and nearly 2 million deaths by tuberculosis (TB) occur annually. TB poses a significant health threat to the world population. The goal of this symposium is to open new avenues for combating tuberculosis. The speakers have presented their data and provided control strategies against tuberculosis and pulmonary disease due to M. avium complex (MAC) from aspects of molecular epidemiology, pathogenesis, serodiagnosis, new anti-TB drugs, and vaccine development. Drs. Maeda and Murase have reported that the 12-locus VNTR analysis is very useful for molecular epidemiology of M. tuberculosis strains isolated in Japan better than IS6110-RFLP and suggested that the analysis is powerful tool for the molecular epidemiology. Drs. Matsumoto and Kobayashi have discovered a protein, mycobacterial DNA-binding protein 1 (MDPl), overproduced in dormant M. tuberculosis that plays key roles in latent/ persistent infection, disease progression, and host protection. They have concluded that MDP1 may be a possible target for anti-tuberculosis drugs and vaccines. Drs. Kitada and Maekura have developed serodiagnosis of MAC disease based on enzyme immunoassay (EIA) by detecting anti-glycopeptidolipid (GPL) antibody in sera of human patients. GPL is specific for MAC. The EIA is a simple, rapid and accurate measure with high sensitivity and specificity. The levels of antibody also reflect disease activity. A large-scale clinical multicenter study is currently in progress. Dr. Makoto Matsumoto has discovered an innovative new anti-TB drug, OPC-67683 that is a derivative of nitroimidazole compounds. OPC-67683 inhibited mycolic acid synthesis and exerted potent antimycobacterial activity, including multidrug-resistant M. tuberculosis. Multidrug therapy using OPC-67683 could

  5. PATHWAYS OF MEDICAL PROGRESS.

    PubMed

    Wiggers, C J

    1940-01-12

    During the three decades that have passed, medical science has ascended to a high plateau of achievement. The climb has involved several pathways; among them: (1) the physiological approach toward disease as experiments which nature performs on organisms, (2) the more intelligent interpretation of the functional reactions of the body in disease in accordance with latest discoveries in physiology, (3) the supplementation of observable phenomena through use of laboratory instruments, (4) the assumption of active investigation both on patients and experimental animals by clinicians themselves, (5) the shuttling of problems between clinical and experimental laboratories and (6) correlated research in clinical and physiological departments. As we look down from the heights we have reached, we have reason to be pleased with our progress; but when we look ahead we become aware that there are still high mountain ranges to be climbed. We realize that their ascent can not be accomplished by employing merely the methods, equipment and strategy that have proved successful so far; we must improve the application of principles that are old and well established, and evolve others that are new. Above all, we from laboratories and clinics must join hands to help each other climb; and through correlated team-work overcome the great obstacles that jealous nature places in our way. I have ventured to suggest a few directions which such mutual help may take. They include (1) means by which new fundamental discoveries can be utilized more quickly by clinicians and practitioners of medicine; (2) plans by which younger clinical investigators can be given approximately the same opportunity for training in research technique as their colleagues entering experimental sciences; (3) pleas that the shuttling of problems between hospitals and laboratories of fundamental science may continue in order that the ultimate significance of clinical results may be better understood and that the

  6. Targeting ECM Disrupts Cancer Progression

    PubMed Central

    Venning, Freja A.; Wullkopf, Lena; Erler, Janine T.

    2015-01-01

    Metastatic complications are responsible for more than 90% of cancer-related deaths. The progression from an isolated tumor to disseminated metastatic disease is a multistep process, with each step involving intricate cross talk between the cancer cells and their non-cellular surroundings, the extracellular matrix (ECM). Many ECM proteins are significantly deregulated during the progression of cancer, causing both biochemical and biomechanical changes that together promote the metastatic cascade. In this review, the influence of several ECM proteins on these multiple steps of cancer spread is summarized. In addition, we highlight the promising (pre-)clinical data showing benefits of targeting these ECM macromolecules to prevent cancer progression. PMID:26539408

  7. Progress 28 supply vehicle approach

    NASA Image and Video Library

    2008-02-07

    ISS016-E-027761 (7 Feb. 2008) --- Backdropped by a colorful Earth, an unpiloted Progress supply vehicle approaches the International Space Station. Progress 28 resupply craft launched at 7:03 a.m. (CST) on Feb. 5, 2008 from the Baikonur Cosmodrome in Kazakhstan to deliver more than 2.5 tons of food, fuel, oxygen and other supplies to the Expedition 16 crewmembers onboard the station. Progress automatically docked to the Pirs Docking Compartment at 8:30 a.m. (CST) on Feb. 7.

  8. Progress 24 resupply approaches ISS

    NASA Image and Video Library

    2007-01-20

    ISS014-E-12434 (19 Jan. 2007) --- Backdropped by a blue and white Earth, an unpiloted Progress supply vehicle approaches the International Space Station. The Progress 24 resupply craft launched at 8:12 p.m. (CST) on Jan. 17, 2007 from the Baikonur Cosmodrome in Kazakhstan to deliver 2.5 tons of food, fuel, oxygen and other supplies to the Expedition 14 crewmembers onboard the station. Progress automatically docked to the Pirs Docking Compartment at 8:59 p.m. (CST) on Jan. 19 as the spacecraft and the station flew approximately 220 miles above a point near the South Atlantic off the southeast coast of Uruguay.

  9. Progress 28 supply vehicle approach

    NASA Image and Video Library

    2008-02-07

    ISS016-E-027742 (7 Feb. 2008) --- Backdropped by a blue and white Earth, an unpiloted Progress supply vehicle approaches the International Space Station. Progress 28 resupply craft launched at 7:03 a.m. (CST) on Feb. 5, 2008 from the Baikonur Cosmodrome in Kazakhstan to deliver more than 2.5 tons of food, fuel, oxygen and other supplies to the Expedition 16 crewmembers onboard the station. Progress automatically docked to the Pirs Docking Compartment at 8:30 a.m. (CST) on Feb. 7.

  10. Progress 24 resupply approaches ISS

    NASA Image and Video Library

    2007-01-20

    ISS014-E-12364 (19 Jan. 2007) --- Backdropped by a blue Earth, an unpiloted Progress supply vehicle approaches the International Space Station. The Progress 24 resupply craft launched at 8:12 p.m. (CST) on Jan. 17, 2007 from the Baikonur Cosmodrome in Kazakhstan to deliver 2.5 tons of food, fuel, oxygen and other supplies to the Expedition 14 crewmembers onboard the station. Progress automatically docked to the Pirs Docking Compartment at 8:59 p.m. (CST) on Jan. 19 as the spacecraft and the station flew approximately 220 miles above a point near the South Atlantic off the southeast coast of Uruguay.

  11. Progress 28 supply vehicle approach

    NASA Image and Video Library

    2008-02-07

    ISS016-E-027798 (7 Feb. 2008) --- Backdropped by a blue and white Earth, an unpiloted Progress supply vehicle (seen as a tiny object just left of center) approaches the International Space Station. Progress 28 resupply craft launched at 7:03 a.m. (CST) on Feb. 5, 2008 from the Baikonur Cosmodrome in Kazakhstan to deliver more than 2.5 tons of food, fuel, oxygen and other supplies to the Expedition 16 crewmembers onboard the station. Progress automatically docked to the Pirs Docking Compartment at 8:30 a.m. (CST) on Feb. 7.

  12. Progress 28 supply vehicle approach

    NASA Image and Video Library

    2008-02-07

    ISS016-E-027815 (7 Feb. 2008) --- Backdropped by a colorful Earth, an unpiloted Progress supply vehicle approaches the International Space Station. Progress 28 resupply craft launched at 7:03 a.m. (CST) on Feb. 5, 2008 from the Baikonur Cosmodrome in Kazakhstan to deliver more than 2.5 tons of food, fuel, oxygen and other supplies to the Expedition 16 crewmembers onboard the station. Progress automatically docked to the Pirs Docking Compartment at 8:30 a.m. (CST) on Feb. 7.

  13. Federal Facility Agreement progress report

    SciTech Connect

    Not Available

    1993-10-01

    The (SRS) Federal Facility Agreement (FFA) was made effective by the US. Environmental Protection Agency Region IV (EPA) on August 16, 1993. To meet the reporting requirements in Section XXV of the Agreement, the FFA Progress Report was developed. The FFA Progress Report is the first of a series of quarterly progress reports to be prepared by the SRS. As such this report describes the information and action taken to September 30, 1993 on the SRS units identified for investigation and remediation in the Agreement. This includes; rubble pits, runoff basins, retention basin, seepage basin, burning pits, H-Area Tank 16, and spill areas.

  14. Progress 12P approaching ISS

    NASA Image and Video Library

    2003-08-31

    ISS007-E-13814 (30 August 2003) --- Backdropped by a blue and white Earth, an unpiloted Progress supply vehicle approaches the International Space Station (ISS). The Progress 12 resupply craft, which launched from the Baikonur Cosmodrome in Kazakhstan at 8:48 p.m. (CDT) on August 28, 2003, carried nearly three tons of food, fuel, water, supplies and scientific gear for the Expedition 7 crew aboard the Station. The Progress linked up with the Station at 10:40 p.m. (CDT) on August 30, 2003 as the two spacecraft were flying over Central Asia at an altitude of 240 statute miles.

  15. Progress 12P approaching ISS

    NASA Image and Video Library

    2003-08-31

    ISS007-E-13808 (30 August 2003) --- Backdropped by Earth’s horizon, an unpiloted Progress supply vehicle approaches the International Space Station (ISS). The Progress 12 resupply craft, which launched from the Baikonur Cosmodrome in Kazakhstan at 8:48 p.m. (CDT) on August 28, 2003, carried nearly three tons of food, fuel, water, supplies and scientific gear for the Expedition 7 crew aboard the Station. The Progress linked up with the Station at 10:40 p.m. (CDT) on August 30, 2003 as the two spacecraft were flying over Central Asia at an altitude of 240 statute miles.

  16. Progress 12P approaching ISS

    NASA Image and Video Library

    2003-08-31

    ISS007-E-13811 (30 August 2003) --- Backdropped by a blue and white Earth, an unpiloted Progress supply vehicle approaches the International Space Station (ISS). The Progress 12 resupply craft, which launched from the Baikonur Cosmodrome in Kazakhstan at 8:48 p.m. (CDT) on August 28, 2003, carried nearly three tons of food, fuel, water, supplies and scientific gear for the Expedition 7 crew aboard the Station. The Progress linked up with the Station at 10:40 p.m. (CDT) on August 30, 2003 as the two spacecraft were flying over Central Asia at an altitude of 240 statute miles.

  17. Targeting ECM Disrupts Cancer Progression.

    PubMed

    Venning, Freja A; Wullkopf, Lena; Erler, Janine T

    2015-01-01

    Metastatic complications are responsible for more than 90% of cancer-related deaths. The progression from an isolated tumor to disseminated metastatic disease is a multistep process, with each step involving intricate cross talk between the cancer cells and their non-cellular surroundings, the extracellular matrix (ECM). Many ECM proteins are significantly deregulated during the progression of cancer, causing both biochemical and biomechanical changes that together promote the metastatic cascade. In this review, the influence of several ECM proteins on these multiple steps of cancer spread is summarized. In addition, we highlight the promising (pre-)clinical data showing benefits of targeting these ECM macromolecules to prevent cancer progression.

  18. [Domestic violence: any progress?].

    PubMed

    Henrion, Roger

    2014-01-01

    Since the publication of the French national survey of violence against women in 2000, the fight against domestic violence has made steady progress. Knowledge of the phenomenon has significantly improved. A nationwide study of murders and manslaughters perpetrated by one partner of a couple against the other has been published annually since 2006. In 2012, domestic violence resulted in the deaths of 314 persons: 166 women, 31 men, 25 children, 9 collateral victims, 14 rivals, and two former spouses killed by their ex-fathers in law. In addition, 67 perpetrators committed suicide (51 men and3 women). The number of victims fluctuates from year to year but has remained fairly stable since 2006 (n=168). Legislation has improved significantly: eight new laws have been passed since 2004, all designed to protect women and to ensure that violent men are restrained and treated. New measures to inform and protect women have been implemented and others have been improved, such as the anonymous helpline (phone no 3919, "domestic violence information"). An inter-ministerial committee on the protection of women from violence and the prevention of human trafficking (MIPROF) was created on 3 January 2013. A website entitled "Stop violence against women " (Stop violences faites aux femmes) is now available. The "Imminent Danger" mobile phone system, designed to alert police if a suspected or known perpetrator breaches restraint conditions, will be extended to the entire country from January 2014. Referees charged with coordinating comprehensive long-tern care of women victims have been deployed at the county level. Information centers on the rights of women and families (CIDFF) now form a local nationwide network. Routine interviews with a midwife during the fourth month of pregnancy, focusing on the woman's emotional, economic and social conditions, have been implemented in 21 % of maternity units and should gradually be generalized. The authorities who have enforced the law have

  19. Arsenic | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  20. Prevention | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  1. Home | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  2. Preventing Breast Cancer: Making Progress

    MedlinePlus

    ... Navigation Bar Home Current Issue Past Issues Preventing Breast Cancer: Making Progress Past Issues / Fall 2006 Table of ... 000 women will have been diagnosed with invasive breast cancer, and nearly 41,000 women will die from ...

  3. Acknowledgements | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  4. Sunburn | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  5. Survival | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  6. Incidence | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  7. Cadmium | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  8. Diagnosis | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  9. Treatment | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  10. Benzene | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  11. Radon | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  12. Nitrate | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  13. Mortality | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  14. Weight | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  15. Introduction | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  16. Mortality | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  17. Acknowledgements | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  18. Survival | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  19. Rapidly Progressing Alzheimer's: Something Else?

    MedlinePlus

    ... Something else? My mother has been diagnosed with Alzheimer's disease, but she seems to be declining rapidly. Doesn' ... Answers from Jonathan Graff-Radford, M.D. Yes, Alzheimer's disease usually worsens slowly. But its speed of progression ...

  20. Benzene | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  1. Progress of the Productive Ward.

    PubMed

    Robert, Glenn

    The progress of the Productive Ward programme has been variable. This article outlines a study that investigated the experience of implementing the programme in different hospitals and the lessons that can be learnt.

  2. Progresses in proton radioactivity studies

    SciTech Connect

    Ferreira, L. S.; Maglione, E.

    2016-07-07

    In the present talk, we will discuss recent progresses in the theoretical study of proton radioactivity and their impact on the present understanding of nuclear structure at the extremes of proton stability.

  3. Atlantic Richfield Monthly Progress Reports

    EPA Pesticide Factsheets

    Last three monthly progress reports submitted by Atlantic Richfield Company on cleanup activities at the Silver Bow Creek/Butte Area Superfund Site, as required by the Butte Priority Soils UAO, Docket No. CERCLA 08-2011-0011.

  4. Teaching Styles and Pupil Progress

    ERIC Educational Resources Information Center

    Rogers, Vincent; Baron, Joan

    1977-01-01

    Critically analyzes Neville Bennett's book "Teaching Styles and Pupil Progress," which found that formal teaching styles are more closely associated with student achievement in "basic skills" than are informal styles. (IRT)

  5. Public Attitudes to Technological Progress.

    ERIC Educational Resources Information Center

    Marshall, Eliot

    1979-01-01

    Discusses the probable changes in public attitudes toward science and technology as a result of the engineering accidents of 1979. Results of national polls conducted to identify public confidence in technological progress are included. (HM)

  6. Progress 53P after Undocking

    NASA Image and Video Library

    2014-04-23

    ISS039-E-014672 (23 April 2014) --- The unpiloted Progress 53 cargo ship undocks from the aft port of the Zvezda service module at 3:58 a.m. (CDT) on April 23 and begins its relative separation from the International Space Station for tests on its upgraded Kurs automated rendezvous system that were delayed from last November. The Russian resupply vehicle will move to a distance of some 300 miles from the complex before it begins to phase back in, testing the Kurs-NA rendezvous hardware and its associated software. The enhanced Kurs system will be incorporated into future Progress vehicles to reduce weight by eliminating several navigational antennas, thus enabling the Progress to carry additional supplies to the station. The Progress is scheduled to redock to Zvezda around 7:15 a.m. (CDT) April 25.

  7. Progress 53P after Undocking

    NASA Image and Video Library

    2014-04-23

    ISS039-E-016869 (23 April 2014) --- The unpiloted Progress 53 cargo ship undocks from the aft port of the Zvezda service module at 3:58 a.m. (CDT) on April 23 and begins its relative separation from the International Space Station for tests on its upgraded Kurs automated rendezvous system that were delayed from last November. The Russian resupply vehicle will move to a distance of some 300 miles from the complex before it begins to phase back in, testing the Kurs-NA rendezvous hardware and its associated software. The enhanced Kurs system will be incorporated into future Progress vehicles to reduce weight by eliminating several navigational antennas, thus enabling the Progress to carry additional supplies to the station. The Progress is scheduled to redock to Zvezda around 7:15 a.m. (CDT) April 25.

  8. Public Attitudes to Technological Progress.

    ERIC Educational Resources Information Center

    Marshall, Eliot

    1979-01-01

    Discusses the probable changes in public attitudes toward science and technology as a result of the engineering accidents of 1979. Results of national polls conducted to identify public confidence in technological progress are included. (HM)

  9. Annual Progress report - General Task

    SciTech Connect

    Wesnousky, S.G.

    1993-09-30

    This report provides a summary of progress for the project {open_quotes}Evaluation of the Geologic Relations and Seismotectonic Stability of the Yucca Mountain Area, Nevada Nuclear Waste Site Investigation (NNWSI).{close_quotes} A similar report was previously provided for the period of 1 October 1991 to 30 September 1992. The report initially covers the activities of the General Task and is followed by sections that describe the progress of the other ongoing tasks.

  10. Monomelic amyotrophy with late progression.

    PubMed

    Rowin, J; Meriggioli, M N; Cochran, E J

    2001-04-01

    Monomelic amyotrophy is a sporadic juvenile-onset disease that presents with gradual onset of weakness and atrophy in the hand muscles unilaterally. Generally, this disease is considered a 'benign' and non-progressive motor neuron disease, which stabilizes within five years of onset. We discuss a case that illustrates that monomelic amyotrophy may rarely exhibit late clinical progression to the lower extremities after a prolonged period of disease stability.

  11. Expedition 15 Progress 26 Launch

    NASA Image and Video Library

    2007-08-02

    JSC2007-E-41113(2 Aug. 2007) --- The ISS Progress 26 launched Aug. 2 from the Baikonur Cosmodrome in Kazakhstan on time at 12:33:46 pm (CDT) and 11:33:46 pm, Baikonur time. Ascent was nominal and by the book. Once in orbit, the Progress separated from the third stage of the booster and all appendages and antennas were deployed on time. Photo Credit: NASA/Mark Bowman

  12. Scientific progress as increasing verisimilitude.

    PubMed

    Niiniluoto, Ilkka

    2014-06-01

    According to the foundationalist picture, shared by many rationalists and positivist empiricists, science makes cognitive progress by accumulating justified truths. Fallibilists, who point out that complete certainty cannot be achieved in empirical science, can still argue that even successions of false theories may progress toward the truth. This proposal was supported by Karl Popper with his notion of truthlikeness or verisimilitude. Popper's own technical definition failed, but the idea that scientific progress means increasing truthlikeness can be expressed by defining degrees of truthlikeness in terms of similarities between states of affairs. This paper defends the verisimilitude approach against Alexander Bird who argues that the "semantic" definition (in terms of truth or truthlikeness alone) is not sufficient to define progress, but the "epistemic" definition referring to justification and knowledge is more adequate. Here Bird ignores the crucial distinction between real progress and estimated progress, explicated by the difference between absolute (and usually unknown) degrees of truthlikeness and their evidence-relative expected values. Further, it is argued that Bird's idea of returning to the cumulative model of growth requires an implausible trick of transforming past false theories into true ones.

  13. Genetics Home Reference: Lafora progressive myoclonus epilepsy

    MedlinePlus

    ... Conditions Lafora progressive myoclonus epilepsy Lafora progressive myoclonus epilepsy Enable Javascript to view the expand/collapse boxes. ... Open All Close All Description Lafora progressive myoclonus epilepsy is a brain disorder characterized by recurrent seizures ( ...

  14. Defining secondary progressive multiple sclerosis.

    PubMed

    Lorscheider, Johannes; Buzzard, Katherine; Jokubaitis, Vilija; Spelman, Tim; Havrdova, Eva; Horakova, Dana; Trojano, Maria; Izquierdo, Guillermo; Girard, Marc; Duquette, Pierre; Prat, Alexandre; Lugaresi, Alessandra; Grand'Maison, François; Grammond, Pierre; Hupperts, Raymond; Alroughani, Raed; Sola, Patrizia; Boz, Cavit; Pucci, Eugenio; Lechner-Scott, Jeanette; Bergamaschi, Roberto; Oreja-Guevara, Celia; Iuliano, Gerardo; Van Pesch, Vincent; Granella, Franco; Ramo-Tello, Cristina; Spitaleri, Daniele; Petersen, Thor; Slee, Mark; Verheul, Freek; Ampapa, Radek; Amato, Maria Pia; McCombe, Pamela; Vucic, Steve; Sánchez Menoyo, José Luis; Cristiano, Edgardo; Barnett, Michael H; Hodgkinson, Suzanne; Olascoaga, Javier; Saladino, Maria Laura; Gray, Orla; Shaw, Cameron; Moore, Fraser; Butzkueven, Helmut; Kalincik, Tomas

    2016-09-01

    A number of studies have been conducted with the onset of secondary progressive multiple sclerosis as an inclusion criterion or an outcome of interest. However, a standardized objective definition of secondary progressive multiple sclerosis has been lacking. The aim of this work was to evaluate the accuracy and feasibility of an objective definition for secondary progressive multiple sclerosis, to enable comparability of future research studies. Using MSBase, a large, prospectively acquired, global cohort study, we analysed the accuracy of 576 data-derived onset definitions for secondary progressive multiple sclerosis and first compared these to a consensus opinion of three neurologists. All definitions were then evaluated against 5-year disease outcomes post-assignment of secondary progressive multiple sclerosis: sustained disability, subsequent sustained progression, positive disability trajectory, and accumulation of severe disability. The five best performing definitions were further investigated for their timeliness and overall disability burden. A total of 17 356 patients were analysed. The best definition included a 3-strata progression magnitude in the absence of a relapse, confirmed after 3 months within the leading Functional System and required an Expanded Disability Status Scale step ≥4 and pyramidal score ≥2. It reached an accuracy of 87% compared to the consensus diagnosis. Seventy-eight per cent of the identified patients showed a positive disability trajectory and 70% reached significant disability after 5 years. The time until half of all patients were diagnosed was 32.6 years (95% confidence interval 32-33.6) after disease onset compared with the physicians' diagnosis at 36 (35-39) years. The identified patients experienced a greater disease burden [median annualized area under the disability-time curve 4.7 (quartiles 3.6, 6.0)] versus non-progressive patients [1.8 (1.2, 1.9)]. This objective definition of secondary progressive multiple

  15. Clinical management of progressive myopia

    PubMed Central

    Aller, T A

    2014-01-01

    Myopia has been increasing in prevalence throughout the world, reaching over 90% in some East Asian populations. There is increasing evidence that whereas genetics clearly have an important role, the type of visual environment to which one is exposed to likely influences the onset, progression, and cessation of myopia. Consequently, attempts to either modify the environment or to reduce the exposure of the eye to various environmental stimuli to eye growth through the use of various optical devices are well under way at research centers around the globe. The most promising of current treatments include low-percentage atropine, bifocal soft contact lenses, orthokeratology, and multifocal spectacles. These methods are discussed briefly and are then categorized in terms of their expected degree of myopia progression control. A clinical strategy is presented for selecting the most effective treatment for the appropriate type of patient at the optimal stage of refractive development to achieve the maximum control of myopia progression. PMID:24357844

  16. Progress 24 resupply approaches ISS

    NASA Image and Video Library

    2007-01-20

    ISS014-E-12361 (19 Jan. 2007) --- Backdropped by a sprinkling of small clouds over a blue Earth, an unpiloted Progress supply vehicle approaches the International Space Station. The Progress 24 resupply craft launched at 8:12 p.m. (CST) on Jan. 17, 2007 from the Baikonur Cosmodrome in Kazakhstan to deliver 2.5 tons of food, fuel, oxygen and other supplies to the Expedition 14 crewmembers onboard the station. Progress automatically docked to the Pirs Docking Compartment at 8:59 p.m. (CST) on Jan. 19 as the spacecraft and the station flew approximately 220 miles above a point near the South Atlantic off the southeast coast of Uruguay.

  17. Progress 12P approaching ISS

    NASA Image and Video Library

    2003-08-31

    ISS007-E-13791 (30 August 2003) --- This close-up view of an unpiloted Progress supply vehicle was taken by one of the crewmembers onboard the International Space Station (ISS) as it approached the aft docking port (out of frame) on the Zvezda Service Module. The Progress 12 resupply craft, which launched from the Baikonur Cosmodrome in Kazakhstan at 8:48 p.m. (CDT) on August 28, 2003, carried nearly three tons of food, fuel, water, supplies and scientific gear for the Expedition 7 crew aboard the Station. The Progress linked up with the Station at 10:40 p.m. (CDT) on August 30, 2003 as the two spacecraft were flying over Central Asia at an altitude of 240 statute miles.

  18. Progress 12P approaching ISS

    NASA Image and Video Library

    2003-08-31

    ISS007-E-13803 (30 August 2003) --- Backdropped by the blackness of space, an unpiloted Progress supply vehicle approaches the aft docking port (out of frame) on the Zvezda Service Module on the International Space Station (ISS). The Progress 12 resupply craft, which launched from the Baikonur Cosmodrome in Kazakhstan at 8:48 p.m. (CDT) on August 28, 2003, carried nearly three tons of food, fuel, water, supplies and scientific gear for the Expedition 7 crew aboard the Station. The Progress linked up with the Station at 10:40 p.m. (CDT) on August 30, 2003 as the two spacecraft were flying over Central Asia at an altitude of 240 statute miles.

  19. Progress 12P approaching ISS

    NASA Image and Video Library

    2003-08-31

    ISS007-E-13799 (30 August 2003) --- This close-up view of an unpiloted Progress supply vehicle was taken by one of the crewmembers onboard the International Space Station (ISS) as it approached the aft docking port (out of frame) on the Zvezda Service Module. The Progress 12 resupply craft, which launched from the Baikonur Cosmodrome in Kazakhstan at 8:48 p.m. (CDT) on August 28, 2003, carried nearly three tons of food, fuel, water, supplies and scientific gear for the Expedition 7 crew aboard the Station. The Progress linked up with the Station at 10:40 p.m. (CDT) on August 30, 2003 as the two spacecraft were flying over Central Asia at an altitude of 240 statute miles.

  20. Optics of progressive addition lenses.

    PubMed

    Sheedy, J E; Buri, M; Bailey, I L; Azus, J; Borish, I M

    1987-02-01

    The optical characteristics of the major progressive addition lenses were measured using an automated lensometer with a specially designed lens holder to simulate eye rotation. Measurements were made every 3 degrees (about 1.5 mm) and graphs of isospherical equivalent lines and isocylinder lines were developed. Generally the near zone of these lenses is narrower and lower than in bifocal or trifocal lenses. Distinct differences exist between the various progressive lenses. The width of the near zone, rate of power progression, amount of unwanted cylinder (level with the distance center), and clarity of the distance zone are compared for the various lenses. The optical measurements demonstrate an apparent trade-off between the size of the cylinder-free area of the lens and the amount of the cylinder.

  1. Longitudinal study of keratoconus progression.

    PubMed

    Li, Xiaohui; Yang, Huiying; Rabinowitz, Yaron S

    2007-10-01

    To determine if differences in topographic progression between unaffected keratoconus relatives and normal controls can predict factors associated with the development of keratoconus in a longitudinal study. We recruited 369 unaffected keratoconus relatives and 119 normal controls in Los Angeles. Both eyes of subjects were examined at baseline clinically and by quantitative videokeratography and at a period ranging from 1 year to 8 years. Progression to keratoconus was evaluated by quantitative videokeratography variables. Unaffected relatives had higher Central K (CK), I-S and KISA values and were younger than normal controls (CK: 44.70 vs 44.01, P<0.01; I-S: 0.76 vs 0.58, P<0.01, KISA: 29.97 vs 23.89, P=0.02; age: 34.8 vs 41.0, P<0.01) at baseline. All three indices significantly increased with age, and CK and KISA values were associated with a positive family history for keratoconus (P<0.001 for CK and P=0.05 for KISA), however, the two groups were not statistically different in progression of keratoconus. After grouping unaffected relatives as high risk (age< or = 30 or Central K > or = 47.2 and I-S> or =1.2 or KISA> or = 60) and low risk (age>30 and Central K<47.2 and I-S<1.2 and KISA< 60), relatives in the high risk group had a greater increase in CK and I-S values than those in the low risk group (CK: P=0.009; I-S: P<0.001), which indicated that there were significantly different rates of progression between two groups. Unaffected relatives had higher videokeratography indices than normal controls, but overall they did not progress to keratoconus quicker than normal controls. However, relatives in the high risk group may have a greater risk of progression to keratoconus.

  2. Longitudinal study of keratoconus progression

    PubMed Central

    Li, Xiaohui; Yang, Huiying; Rabinowitz, Yaron S.

    2013-01-01

    To determine if differences in topographic progression between unaffected keratoconus relatives and normal controls can predict factors associated with the development of keratoconus in a longitudinal study. We recruited 369 unaffected keratoconus relatives and 119 normal controls in Los Angeles. Both eyes of subjects were examined at baseline clinically and by quantitative videokeratography and at a period ranging from 1 year to 8 years. Progression to keratoconus was evaluated by quantitative videokeratography variables. Unaffected relatives had higher Central K (CK), I-S and KISA values and were younger than normal controls (CK: 44.70 vs 44.01, P<0.01; I-S: 0.76 vs 0.58, P<0.01, KISA: 29.97 vs 23.89, P=0.02; age: 34.8 vs 41.0, P<0.01) at baseline. All three indices significantly increased with age, and CK and KISA values were associated with a positive family history for keratoconus (P<0.001 for CK and P=0.05 for KISA), however, the two groups were not statistically different in progression of keratoconus. After grouped unaffected relatives as the high risk (age<=30 or Central K>=47.2 or I-S >=1.2 or KISA>=60) and the low risk (age>30 and Central K<47.2 and I-S <1.2 and KISA<60), relatives in the high risk group had a greater increase in CK and I-S values than those in the low risk group (CK: p=0.009; I-S: p<0.001), which indicated that there were significantly different rates of progression between two groups. Unaffected relatives had higher videokeratography indices than normal controls, but overall they did not progress to keratoconus quicker than normal controls. However, relatives in a high risk group may have a greater risk of progression to keratoconus. PMID:17681291

  3. Thematic Progression in a Cardiologist's Text: Context, Frames and Progression.

    ERIC Educational Resources Information Center

    Salter, Robert T.

    Thematic progression (TP) is examined in the text of a communication between a cardiologist and a general practitioner concerning a patient, offering a clinical diagnosis of the patient's condition. Analysis of the discourse looks at the field, tenor, and mode of the communication as a context for TP. The methods of analysis are first described,…

  4. [Can we accept medical progress without progress in ethics?].

    PubMed

    Benaroyo, Lazare

    2013-01-01

    Since the mid 20th century progress in biomedical science has been punctuated by the emergence of bioethics which has fashioned the moral framework of its application to both research and clinical practice. Can we, however, consider the advent of bioethics as a form of progress marking the advances made in biomedical science with an adequate ethical stamp? The argument put forward in this chapter is based on the observation that, far from being a mark of progess, the development of bioethics runs the risk of favouring, like modern science, a dissolution of the links that unite ethics and medicine, and so of depriving the latter of the humanist dimensions that underlie the responsibilities that fall to it. Faced with this possible pitfall, this contribution proposes to envisage as a figure of moral progress, consubstantial with the development of biomedical science, an ethical approach conceived as a means of social intervention which takes the first steps towards an ethics of responsibility integrating the bioethical perspective within a hermeneutic and deliberative approach. By the yardstick of a prudential approach, it would pay particular attention to the diverse sources of normativity in medical acts. It is suggested that this ethical approach is a source of progress insofar as it constitutes an indispensable attitude of watchfulness, which biomedical science can lean on as it advances, with a view to ensuring that the fundamental link uniting ethics and medicine is maintained.

  5. Measuring Progressions: Assessment Structures Underlying a Learning Progression

    ERIC Educational Resources Information Center

    Wilson, Mark

    2009-01-01

    This article describes some of the underlying conceptualizations that have gone into the work of the BEAR Center in the development of learning progressions. The core of all of these developments has been the construct map, which is the first building block in the BEAR Assessment System (BAS). After introducing the concept of a learning…

  6. Superfund progress. Aficionado's version. Progress as of September 30, 1992

    SciTech Connect

    Not Available

    1993-01-01

    The issue of Superfund Progress Aficionado's Version provides facts and figures as of September 30, 1992, for NPL site distribution, emergency removals, preliminary assessments/site inspections/the NPL, remedial investigations/feasibility studies/RODs, remedial action, and enforcement.

  7. Recent progress on intrinsic charm

    NASA Astrophysics Data System (ADS)

    Hobbs, T. J.

    2017-03-01

    Over the past ˜10 years, the topic of the nucleon's nonperturbative or intrinsic charm (IC) content has enjoyed something of a renaissance, largely motivated by theoretical developments involving quark modelers and PDF-fitters. In this talk I will briefly describe the importance of intrinsic charm to various issues in high-energy phenomenology, and survey recent progress in constraining its overall normalization and contribution to the momentum sum rule of the nucleon. I end with the conclusion that progress on the side of calculation has now placed the onus on experiment to unambiguously resolve the proton's intrinsic charm component.

  8. Biogas Opportunities Roadmap Progress Report

    SciTech Connect

    None, None

    2015-12-01

    In support of the Obama Administration's Climate Action Plan, the U.S. Department of Energy, the U.S. Environmental Protection Agency, and U.S. Department of Agriculture jointly released the Biogas Opportunities Roadmap Progress Report, updating the federal government's progress to reduce methane emissions through biogas systems since the Biogas Opportunities Roadmap was completed by the three agencies in July 2014. The report highlights actions taken, outlines challenges and opportunities, and identifies next steps to the growth of a robust biogas industry.

  9. Progression of choroid plexus papilloma.

    PubMed

    Dhillon, Rana S; Wang, Yi Yuen; McKelvie, Penny A; O'Brien, Brendan

    2013-12-01

    Choroid plexus papillomas are rare neoplasms that arise from choroid plexus epithelium. The World Health Organization classification describes three histological grades. Grade I is choroid plexus papilloma, grade II is atypical choroid plexus papilloma and grade III is choroid plexus carcinoma. Progression between grades is rare but documented. We present two adult cases, a 53-year-old female and a 70-year-old male, who demonstrated clear interval histological progression from grade I choroid plexus papilloma to higher grades. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Docking Mechanism on Progress 52

    NASA Image and Video Library

    2014-02-03

    ISS038-E-041175 (3 Feb. 2014) --- This close-up view shows the docking mechanism of the unpiloted Russian ISS Progress 52 resupply ship as it undocks from the International Space Station's Pirs Docking Compartment at 11:21 a.m. (EST) on Feb. 3, 2014. The Progress backed away to a safe distance from the orbital complex to begin several days of tests to study thermal effects of space on its attitude control system. Filled with trash and other unneeded items, the Russian resupply ship will be commanded to re-enter Earth's atmosphere Feb. 11 and disintegrate harmlessly over the Pacific Ocean.

  11. After Progress Resupply Vehicle Docking

    NASA Image and Video Library

    2012-01-28

    ISS030-E-050949 (27 Jan. 2012) --- NASA astronaut Dan Burbank (right), Expedition 30 commander; Russian cosmonauts Anton Shkaplerov (bottom), Oleg Kononenko (center) and Anatoly Ivanishin (left background); and European Space Agency astronaut Andre Kuipers, all flight engineers, take a moment for a photo in the Zvezda Service Module of the International Space Station following the successful docking of the unpiloted ISS Progress 46 resupply vehicle. Progress 46 docked automatically to the Pirs Docking Compartment via the Kurs automated rendezvous system at 7:00 p.m. (EST) on Jan. 27, 2012.

  12. After Progress Resupply Vehicle Docking

    NASA Image and Video Library

    2012-01-28

    ISS030-E-050946 (27 Jan. 2012) --- NASA astronaut Dan Burbank (right), Expedition 30 commander; Russian cosmonauts Anton Shkaplerov (bottom), Oleg Kononenko (center) and Anatoly Ivanishin (left background); and European Space Agency astronaut Andre Kuipers, all flight engineers, take a moment for a photo in the Zvezda Service Module of the International Space Station following the successful docking of the unpiloted ISS Progress 46 resupply vehicle. Progress 46 docked automatically to the Pirs Docking Compartment via the Kurs automated rendezvous system at 7:00 p.m. (EST) on Jan. 27, 2012.

  13. Kurs antenna on the Progress

    NASA Image and Video Library

    2006-11-23

    ISS014-E-07953 (22 Nov. 2006) ---This photo shows the position of the KURS antennae on 23 Progress as seen by spacewalkers Michael Lopez-Alegria and Mikhail Tyurin during Russian EVA 17 on Nov. 22. During docking of the Progress to the International Space Station on Oct. 26, 2006, flight controllers were unable to confirm if the antenna had retracted as commanded. On the right-hand side of the photo, there is a visible clearance between the antennae's satellite dish and handrail 2745 on the ISS Service Module.

  14. Progress 23 supply vehicle approach

    NASA Image and Video Library

    2006-10-26

    ISS014-E-06544 (26 Oct. 2006) --- Backdropped by a blue and white Earth, an unpiloted Progress supply vehicle approaches the International Space Station. Progress docked to the aft port of the Zvezda Service Module at 9:29 a.m. (CDT) on Oct. 26. The spacecraft used the automated Kurs system to dock at the aft port of the Zvezda service module. Expedition 14 flight engineer Mikhail Tyurin stood by at the manual Toru docking system controls, but the automated system functioned as designed and manual intervention was not needed.

  15. Progress Report NORSAR Phase 3

    DTIC Science & Technology

    1975-04-11

    1 A I)-A 010 5 86 PROGRriSS REPORT NORSAR PHASE 3 K . /\\ . B c r t c u s s e n Royal Norwegian Council for Scientific and...NORSAR ROYAl NORWEGIAN COUNCIL FOR SCIENTIFIC AND INDUSTRIAL RESEARCH <o<: 00 10’ o H O < F 8606-74-C-0049 PROGRESS REPORT - NORSAR PHASE 3 1...Report NORSAR Phase 3 1st Quarter 1975 5 TYPE OE REPORT « PERIOD COVERED Progress Report 1st Quarter 1975 6 PERFORMING ORG

  16. Shuttle Risk Progression by Flight

    NASA Technical Reports Server (NTRS)

    Hamlin, Teri; Kahn, Joe; Thigpen, Eric; Zhu, Tony; Lo, Yohon

    2011-01-01

    Understanding the early mission risk and progression of risk as a vehicle gains insights through flight is important: . a) To the Shuttle Program to understand the impact of re-designs and operational changes on risk. . b) To new programs to understand reliability growth and first flight risk. . Estimation of Shuttle Risk Progression by flight: . a) Uses Shuttle Probabilistic Risk Assessment (SPRA) and current knowledge to calculate early vehicle risk. . b) Shows impact of major Shuttle upgrades. . c) Can be used to understand first flight risk for new programs.

  17. Assessment of Child Progress. Monograph Number 2.

    ERIC Educational Resources Information Center

    Danaher, Joan, Ed.

    Four author-contributed papers examine issues in assessing child progress in early childhood special education. D. Bricker and S. Gumerlock present "A Three-Level Strategy" which features analysis of daily or weekly progress, analysis of progress toward long- and short-term objectives, and analysis of progress toward program goals. C. Dunst…

  18. Significant Ideas and Progressive Change

    ERIC Educational Resources Information Center

    Morgan, Gwen; Mitchell, Anne

    2012-01-01

    Ideas are not one-time "Eureka" moments, but are parts of concepts progressing forward. Sometimes years pass before ideas are implemented. They then resurface, connect with other ideas, and move policies ahead. Meanwhile, the idea remains alive in the field, influencing decisions and goals. Ideas build on one another when implemented. The field of…

  19. Continuous Progress Program Inservice Materials.

    ERIC Educational Resources Information Center

    Chicago Board of Education, IL.

    The Continuous Progress Program of the Board of Education for the City of Chicago focuses on the improvement of education for the individual child and the upgrading of educational practices and techniques. The philosophy of the program is based on the individualized rate of teaching and learning of the pupil. Its planning and organization is…

  20. Progressive transmission and compression images

    NASA Technical Reports Server (NTRS)

    Kiely, A. B.

    1996-01-01

    We describe an image data compression strategy featuring progressive transmission. The method exploits subband coding and arithmetic coding for compression. We analyze the Laplacian probability density, which closely approximates the statistics of individual subbands, to determine a strategy for ordering the compressed subband data in a way that improves rate-distortion performance. Results are presented for a test image.

  1. Mapping Arizona's Educational Progress, 2008

    ERIC Educational Resources Information Center

    US Department of Education, 2008

    2008-01-01

    Every day, we learn what works so students can make greater progress. Six years after No Child Left Behind's passage--and midway to the nation's goal of having students on grade level or better in reading and math by 2014--we have collected more data than ever before about the academic performance of our students and schools. This information…

  2. Blue Origin Facility - Construction Progress

    NASA Image and Video Library

    2017-03-21

    Construction is progressing on Blue Origin's 750,000-square-foot facility being built at Exploration Park on NASA Kennedy Space Center property in Florida. Blue Origin will use the factory to manufacture its two-stage super-heavy-lift New Glenn launch vehicle and launch the vehicles from Space Launch Complex 46 at Cape Canaveral Air Force Station.

  3. Progress in semiconductor drift detectors

    SciTech Connect

    Rehak, P.; Walton, J.; Gatti, E.; Longoni, A.; Sanpietro, M.; Kemmer, J.; Dietl, H.; Holl, P.; Klanner, R.; Lutz, G.

    1985-01-01

    Progress in testing semiconductor drift detectors is reported. Generally better position and energy resolutions were obtained than resolutions published previously. The improvement is mostly due to new electronics better matched to different detectors. It is shown that semiconductor drift detectors are becoming versatile and reliable detectors for position and energy measurements.

  4. HARVARD PROJECT PHYSICS PROGRESS REPORT.

    ERIC Educational Resources Information Center

    Harvard Univ., Cambridge, MA.

    THIS REPORT OF HARVARD PROJECT PHYSICS PRESENTS DRAFTS OF THREE SPEECHES DELIVERED TO THE AMERICAN ASSOCIATION OF PHYSICS TEACHERS (AAPT) MEETING, FEBRUARY, 1967. THE ADDRESS BY GERALD HOLTON DEALS WITH THE AIMS AND PROGRESS OF THE PROJECT. DISCUSSED ARE (1) PROJECT PARTICIPANTS, (2) AIMS AND CONTENT, (3) THE NEW EMPHASIS, (4) SURVEY OF COURSE…

  5. Progress in pulsed power fusion

    SciTech Connect

    Quintenz, J.P.; Adams, R.G.; Bailey, J.E.

    1996-07-01

    Pulsed power offers and efficient, high energy, economical source of x-rays for inertial confinement fusion (ICF) research. We are pursuing two main approaches to ICF driven with pulsed power accelerators: intense light ion beams and z-pinches. This paper describes recent progress in each approach and plans for future development.

  6. Measuring research progress in photovoltaics

    NASA Technical Reports Server (NTRS)

    Jackson, B.; Mcguire, P.

    1986-01-01

    The role and some results of the project analysis and integration function in the Flat-plate Solar Array (FSA) Project are presented. Activities included supporting the decision-making process, preparation of plans for project direction, setting goals for project activities, measuring progress within the project, and the development and maintenance of analytical models.

  7. Continuous Progress and Nongraded Schools.

    ERIC Educational Resources Information Center

    Cox, June

    1983-01-01

    Four schools offering a continuous progress or nongraded approach to pacing for gifted students are reviewed: the Plano (TX) Independent School District, The University of Pittsburgh Laboratory School, the Chesapeake (VA) Demonstration School, and the University of California at Los Angeles Elementary School. (CL)

  8. Phillips with stowage from Progress

    NASA Image and Video Library

    2005-06-19

    ISS011-E-09200 (19 June 2005) --- Astronaut John L. Phillips, Expedition 11 NASA space station science officer and flight engineer, holds small packages of supplies and fruit in the Zvezda Service Module of the International Space Station, which he un-stowed from the docked Progress 18 supply vehicle.

  9. Grassroots Excellence: Problems and Progress.

    ERIC Educational Resources Information Center

    Hansen, Kenneth H.

    The educational "excellence" movement is hindered by inconsistencies between goals and action and by difficulties in translating national and state goals into local policy; nonetheless, progress has occurred. Examples of "voodoo excellence," in which proposed policies will likely work against their stated objectives, are…

  10. Solar Energy: Progress and Promise.

    ERIC Educational Resources Information Center

    Council on Environmental Quality, Washington, DC.

    This report discusses many of the economic and policy questions related to the widespread introduction of solar power, presents recent progress in developing solar technologies and advancing their economic feasibility, and reviews some recommendations that have been made for achieving the early introduction and sustained application of solar…

  11. Mapping Colorado's Educational Progress, 2008

    ERIC Educational Resources Information Center

    US Department of Education, 2008

    2008-01-01

    Every day, we learn what works so students can make greater progress. Six years after No Child Left Behind's passage--and midway to the nation's goal of having students on grade level or better in reading and math by 2014--we have collected more data than ever before about the academic performance of our students and schools. This information…

  12. Progress with Student Teacher Placements

    ERIC Educational Resources Information Center

    Her Majesty's Inspectorate of Education, 2006

    2006-01-01

    This is a report on the progress that has been made since HMIE published "Student Teacher Placements within Initial Teacher Education" in October 2005 in response to a request by the Minister for Education and Young People. The report was based on extensive fieldwork and consultation over session 2004/2005, activity which itself…

  13. Katrina's progress with learning mathematics.

    PubMed

    McConnochie, Jan; Sneath, Greg

    2007-07-01

    Katrina is 10 years old and has Down syndrome. She is making good progress with learning and numbers and mathematics. We describe how Katrina has learned number concepts and arithmetic skills over several years. We highlight the influence of early learning habits, visual supports, motivation and practice, and the uses made of different number teaching schemes.

  14. Assessing Pupils' Progress in Science

    ERIC Educational Resources Information Center

    Slade, Peter

    2009-01-01

    Good assessment practice is a fundamental part of good teaching and learning. It puts learners at the heart of the process, helping them to recognise achievement and make progress, and enables teachers to shape and adapt their teaching to individual needs and aspirations. Over the past year, the Qualifications and Curriculum Authority (QCA) has…

  15. Progress Update: Stack Project Complete

    SciTech Connect

    Cody, Tom

    2010-01-01

    Progress update from the Savannah River Site. The 75 foot 293 F Stack, built for plutonium production, was cut down to size in order to prevent injury or release of toxic material if the structure were to collapse due to harsh weather.

  16. Myopia: attempts to arrest progression

    PubMed Central

    Saw, S M; Gazzard, G; Au Eong, K-G; Tan, D T H

    2002-01-01

    Previous studies have evaluated the efficacy of several interventions to decrease the progression of myopia. These include devices that alter the perception of the visual environment and pharmacological treatments. There is no conclusive evidence thus far that alteration of the pattern of spectacle wear, bifocals, ocular hypotensives, or contact lenses retards the progression of myopia. Several randomised clinical trials have demonstrated that the rate of progression of myopia is lower in children given atropine eye drops than those given placebo. However, atropine is associated with short term side effects such as photophobia and possible long term adverse events including light induced retinal damage and cataract formation. Other more selective antimuscarinic agents such as pirenzipine are presently being evaluated. Further well conducted randomised clinical trials with large sample sizes and adequate follow up designed to evaluate treatments to retard the progression of myopia should be conducted, since the identification of an effective intervention may have a greater public health impact on the burden and morbidity from myopia than the few treatments currently available. PMID:12386095

  17. The Future of Progressive Education

    ERIC Educational Resources Information Center

    Hayes, William

    2008-01-01

    What David J. Ferrero has called "the Hundred Year's War between "progressives" and "traditionalists"" continues unabated in the twenty-first century. Undoubtedly, current initiatives in public education favor those who support traditional approaches, yet many critics believe inflexible state tests are restricting…

  18. Continuous Progress and Nongraded Schools.

    ERIC Educational Resources Information Center

    Cox, June

    1983-01-01

    Four schools offering a continuous progress or nongraded approach to pacing for gifted students are reviewed: the Plano (TX) Independent School District, The University of Pittsburgh Laboratory School, the Chesapeake (VA) Demonstration School, and the University of California at Los Angeles Elementary School. (CL)

  19. Progressive Paraparesis after CABG Surgery

    PubMed Central

    Shadvar, Kamran; Eslampoor, Yashar

    2013-01-01

    CABG is one of the most common cardiac surgeries all over the world. Similar to other surgeries, it may be associated with some undesirable complications including neurologic complications which might cause morbidity and mortality after surgery. We will describe a case of Progressive Paraparesis after CABG Surgery and review its etiology, diagnosis and management. PMID:24251008

  20. Baltimore Community Schools: Promise & Progress

    ERIC Educational Resources Information Center

    Durham, Rachel E.; Connolly, Faith

    2016-01-01

    This report documents the interim progress of the Baltimore Community School (CommSch) strategy by examining outcomes for the 2014-15 school year. Results show that CommSch parents more often reported being connected with community resources by school staff compared to parents at other schools. They also were more likely to report that school…

  1. Minority Student Progress Report, 1991.

    ERIC Educational Resources Information Center

    Diaz, Porfirio R.; Luan, Jing

    This report offers a consolidated systemwide analysis of key issues and recommendations for improvement of minority recruitment and retention at Arizona State Universities and an evaluation of progress toward achieving Arizona Board of Regents (ABOR) approved recruitment and graduation goals. A description of ABOR system goals notes three goals:…

  2. Significant Ideas and Progressive Change

    ERIC Educational Resources Information Center

    Morgan, Gwen; Mitchell, Anne

    2012-01-01

    Ideas are not one-time "Eureka" moments, but are parts of concepts progressing forward. Sometimes years pass before ideas are implemented. They then resurface, connect with other ideas, and move policies ahead. Meanwhile, the idea remains alive in the field, influencing decisions and goals. Ideas build on one another when implemented. The field of…

  3. Research progress in advanced melanoma.

    PubMed

    Luo, Cong; Shen, Jiayu

    2017-07-01

    Melanoma is a malignant tumor with high rate of metastasis and poor prognosis. How melanoma develops and how to treat it will continue to be a hot topic. This review briefly summarizes the mechanism of melanoma development and the latest progress in its treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Minority Student Progress Report, 1991.

    ERIC Educational Resources Information Center

    Diaz, Porfirio R.; Luan, Jing

    This report offers a consolidated systemwide analysis of key issues and recommendations for improvement of minority recruitment and retention at Arizona State Universities and an evaluation of progress toward achieving Arizona Board of Regents (ABOR) approved recruitment and graduation goals. A description of ABOR system goals notes three goals:…

  5. [Eugenics: progress or backward movement?].

    PubMed

    González de Cancino, Emilssen

    2007-01-01

    Throughout this article there is a critical analysis of how genetics presents a dilemma for "human progress". So much so, that the legal world aims to create unequivocal norms and guarantees in relation with eugenics in order to avoid attempting against human dignity. The document makes the reader reflect on the ethical problems that eugenics can entail.

  6. Progress Update: Stack Project Complete

    ScienceCinema

    Cody, Tom

    2016-07-12

    Progress update from the Savannah River Site. The 75 foot 293 F Stack, built for plutonium production, was cut down to size in order to prevent injury or release of toxic material if the structure were to collapse due to harsh weather.

  7. Canadian ERTS program progress report

    NASA Technical Reports Server (NTRS)

    Morley, L. W.; Mcquillan, A. K.

    1974-01-01

    Progress of the Canadian ERTS program is provided along with statistics on the production and role of ERTS images both from the CCRS in Ottawa and from the Prince Albert Saskatchewan satellite station. The types of products, difficulties of production and some of the main applications in Canada are discussed.

  8. Progress?

    NASA Astrophysics Data System (ADS)

    Scientists who were once protected by the hammer and sickle are now being bludgeoned with them, according to a report published in November by the American Association for the Advancement of Science (AAAS). Thousands of scientists, professors, and science teachers who had been affiliated with the communist regimes of Central and Eastern European nations are being purged from academic institutions under the premise of righting a perceived historical wrong.More than 3,000 scientists in Bulgaria, as well as 884 university professors and 10,000 teachers in the German state of Saxony, have lost their jobs in the past 5 years. Nearly 6% of all Czech faculty members also have been fired. The purges—which are more reminiscent of the communist past than of a democratic future—are the result of government-sanctioned programs to weed out public employees who may have received their positions due to their Communist affiliation.

  9. Geothermal Progress Monitor report No. 8. Progress report

    SciTech Connect

    Not Available

    1983-11-01

    Geothermal Progress Monitor (GPM) Report Number 8 presents information concerning ongoing technology transfer activities and the mechanisms used to support these activities within geothermal R and D programs. A state-by-state review of major geothermal development activities for the reporting period 1 February 1983 through 31 July 1983 is provided. Recent drilling and exploration efforts and the current status of geothermal electric power plant development in the United States are summarized.

  10. Geothermal Progress Monitor report No. 5. Progress report, June 1981

    SciTech Connect

    Not Available

    1981-01-01

    Updated information is presented on activities and progress in the areas of electric power plants, direct heat applications, deep well drilling, leasing of federal lands, legislative and regulatory actions, research and development, and others. Special attention is given in this report to 1980 highlights, particularly in the areas of electric and direct heat uses, drilling, and the Federal lands leasing program. This report also includes a summary of the DOE FY 1982 geothermal budget request to Congress.

  11. Staphylococcal infection of the odontoid peg.

    PubMed Central

    Keogh, S.; Crockard, A.

    1992-01-01

    An epidural abscess secondary to osteomyelitis of the odontoid peg produced a sudden left-sided weakness. Appropriate antibiotics, transoral evacuation of the pus and subsequent posterior atlanto-axial fusion were associated with a full recovery. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:1561192

  12. Cultural Neuroscience: Progress and Promise

    PubMed Central

    Chiao, Joan Y.; Cheon, Bobby K.; Pornpattanangkul, Narun; Mrazek, Alissa J.; Blizinsky, Katherine D.

    2013-01-01

    The nature and origin of human diversity has been a source of intellectual curiosity since the beginning of human history. Contemporary advances in cultural and biological sciences provide unique opportunities for the emerging field of cultural neuroscience. Research in cultural neuroscience examines how cultural and genetic diversity shape the human mind, brain and behavior across multiple time scales: situation, ontogeny and phylogeny. Recent progress in cultural neuroscience provides novel theoretical frameworks for understanding the complex interaction of environmental, cultural and genetic factors in the production of adaptive human behavior. Here, we provide a brief history of cultural neuroscience, theoretical and methodological advances, as well as empirical evidence of the promise of and progress in the field. Implications of this research for population health disparities and public policy are discussed. PMID:23914126

  13. Damage Progression in Bolted Composites

    NASA Technical Reports Server (NTRS)

    Minnetyan, Levon; Chamis, Christos; Gotsis, Pascal K.

    1998-01-01

    Structural durability,damage tolerance,and progressive fracture characteristics of bolted graphite/epoxy composite laminates are evaluated via computational simulation. Constituent material properties and stress and strain limits are scaled up to the structure level to evaluate the overall damage and fracture propagation for bolted composites. Single and double bolted composite specimens with various widths and bolt spacings are evaluated. The effect of bolt spacing is investigated with regard to the structural durability of a bolted joint. Damage initiation, growth, accumulation, and propagation to fracture are included in the simulations. Results show the damage progression sequence and structural fracture resistance during different degradation stages. A procedure is outlined for the use of computational simulation data in the assessment of damage tolerance, determination of sensitive parameters affecting fracture, and interpretation of experimental results with insight for design decisions.

  14. Damage Progression in Bolted Composites

    NASA Technical Reports Server (NTRS)

    Minnetyan, Levon; Chamis, Christos C.; Gotsis, Pascal K.

    1998-01-01

    Structural durability, damage tolerance, and progressive fracture characteristics of bolted graphite/epoxy composite laminates are evaluated via computational simulation. Constituent material properties and stress and strain limits are scaled up to the structure level to evaluate the overall damage and fracture propagation for bolted composites. Single and double bolted composite specimens with various widths and bolt spacings are evaluated. The effect of bolt spacing is investigated with regard to the structural durability of a bolted joint. Damage initiation, growth, accumulation, and propagation to fracture are included in the simulations. Results show the damage progression sequence and structural fracture resistance during different degradation stages. A procedure is outlined for the use of computational simulation data in the assessment of damage tolerance, determination of sensitive parameters affecting fracture, and interpretation of experimental results with insight for design decisions.

  15. Recent Progress in Terahertz Metasurfaces

    NASA Astrophysics Data System (ADS)

    Al-Naib, Ibraheem; Withayachumnankul, Withawat

    2017-09-01

    In the past decade, the concept of metasurfaces has gradually dominated the field of metamaterials owing to their fascinating optical properties and simple planar geometries. At terahertz frequencies, the concept has been driven further by the availability of advanced micro-fabrication technologies that deliver sub-micron accuracy, well below the terahertz wavelengths. Furthermore, terahertz spectrometers with high dynamic range and amplitude and phase sensitivity provide valuable information for the study of metasurfaces in general. In this paper, we review recent progress in terahertz metasurfaces mainly in the last 5 years. The first part covers nonuniform metasurfaces that perform beamforming in reflection and transmission. In addition, we briefly overview four different methodologies that can be utilized in realizing high-quality-factor metasurfaces. We also describe two recent approaches to tuning the frequency response of terahertz metasurfaces using graphene as an active medium. Finally, we provide a brief summary and outlook for future developments in this rapidly progressing field.

  16. Progress of MICE RFCC Module

    SciTech Connect

    Li, D.; Bowring, D.; DeMello, A.; Gourlay, S.; Green, M.; Li, N.; Niinikoski, T.; Pan, H.; Prestemon, S.; Virostek, S.; Zisman, M.; Bross, A.; Carcagno, R.; Kashikhin, V.; Sylvester, C.; Chen, A. B.; Guo, Bin; Li, Liyi; Xu, Fengyu; Cao, Y.; Sun, S.; Wang, Li; Yin, Lixin; Luo, Tianhuan; Summers, Don; Smith, B.; Radovinsky, A.; Zhukovsky, A.; Kaplan, D.

    2012-05-20

    Recent progress on the design and fabrication of the RFCC (RF and superconducting Coupling Coil) module for the international MICE (Muon Ionization Cooling Experiment) are reported. The MICE ionization cooling channel has two RFCC modules, each having four 201- MHz normal conducting RF cavities surrounded by one superconducting coupling coil (solenoid) magnet. The magnet is designed to be cooled by three cryocoolers. Fabrication of the RF cavities is complete; preparation for the cavity electro-polishing, low power RF measurements, and tuning are in progress at Lawrence Berkeley National Laboratory (LBNL). Fabrication of the cold mass of the first coupling coil magnet has been completed in China and the cold mass arrived at LBNL in late 2011. Preparations for testing the cold mass are currently under way at Fermilab. Plans for the RFCC module assembly and integration are being developed and are described.

  17. Progress on alternative energy resources

    NASA Astrophysics Data System (ADS)

    Couch, H. T.

    1982-03-01

    Progress in the year 1981 toward the development of energy systems suitable for replacing petroleum products combustion and growing in use to fulfill a near term expansion in energy use is reviewed. Coal is noted to be a potentially heavy pollution source, and the presence of environmentally acceptable methods of use such as fluidized-bed combustion and gasification and liquefaction reached the prototype stage in 1981, MHD power generation was achieved in two U.S. plants, with severe corrosion problems remaining unsolved for the electrodes. Solar flat plate collectors sales amounted to 20 million sq ft in 1981, and solar thermal electric conversion systems with central receivers neared completion. Solar cells are progressing toward DOE goals of $.70/peak W by 1986, while wind energy conversion sales were 2000 machines in 1981, and the industry is regarded as maturing. Finally, geothermal, OTEC, and fusion systems are reviewed.

  18. Kurs antenna on the Progress

    NASA Image and Video Library

    2007-02-22

    ISS014-E-14451 (22 Feb. 2007) --- A close-up view of the Kurs antenna on the Progress vehicle docked to the International Space Station's Zvezda Service Module was photographed during a session of extravehicular activity (EVA) on Feb. 22, 2007. During the 6-hour, 18-minute spacewalk, astronaut Michael E. Lopez-Alegria (out of frame), Expedition 14 commander and NASA space station science officer; and cosmonaut Mikhail Tyurin (out of frame), flight engineer representing Russia's Federal Space Agency, were able to retract the stuck antenna which did not properly retract when the Progress docked to the station on Oct. 26, 2006. Moving the antenna was necessary to ensure it would not interfere with the undocking scheduled in April.

  19. Recent Progress in Terahertz Metasurfaces

    NASA Astrophysics Data System (ADS)

    Al-Naib, Ibraheem; Withayachumnankul, Withawat

    2017-03-01

    In the past decade, the concept of metasurfaces has gradually dominated the field of metamaterials owing to their fascinating optical properties and simple planar geometries. At terahertz frequencies, the concept has been driven further by the availability of advanced micro-fabrication technologies that deliver sub-micron accuracy, well below the terahertz wavelengths. Furthermore, terahertz spectrometers with high dynamic range and amplitude and phase sensitivity provide valuable information for the study of metasurfaces in general. In this paper, we review recent progress in terahertz metasurfaces mainly in the last 5 years. The first part covers nonuniform metasurfaces that perform beamforming in reflection and transmission. In addition, we briefly overview four different methodologies that can be utilized in realizing high-quality-factor metasurfaces. We also describe two recent approaches to tuning the frequency response of terahertz metasurfaces using graphene as an active medium. Finally, we provide a brief summary and outlook for future developments in this rapidly progressing field.

  20. Progress Toward National Aeronautics Goals

    NASA Technical Reports Server (NTRS)

    Russo, Carlo J.; Sehra, Arun K.

    1999-01-01

    NASA has made definitive progress towards achieving several bold U.S. goals in aeronautics related to air breathing engines. The advanced technologies developed towards these goals span applications from general aviation to large subsonic and supersonic aircraft. The proof of successful technology development is demonstrated through successful technology transfer to U.S. industry and projected fleet impact. Specific examples of progress are discussed that quantifies the achievement towards these goals. In addition, a more detailed vision for NASA aeronautics is defined and key strategic issues are explored which invite international and national debate and involvement especially in reduced environmental impact for subsonic and supersonic aircraft, dramatic new capabilities in general aviation engines, and reduced development cycle time and costs.

  1. Progress in Heavy Ion Fusion

    SciTech Connect

    Herrmannsfeldt, W.B.

    1988-09-01

    The progress of the field of Heavy Ion Fusion has been documented in the proceedings of the series of International Symposia that, in recent years, have occurred every second year. The latest of these conferences was hosted by Gesellshaft fuer Schwerionenforshung (GSI) in Darmstadt, West Germany, June 28-30, 1988. For this report, a few highlights from the conference are selected, stressing experimental progress and prospects for future advances. A little extra time is devoted to report on the developments at the Lawrence Berkeley Laboratory (LBL) which is the center for most of the HIFAR program. The Director of the HIFAR program at LBL is Denis Keefe, who presented the HIF report at the last two of the meetings in this series, and in whose place the author is appearing now. 4 refs., 1 fig.

  2. Revolution and progress in medicine.

    PubMed

    Goodwin, William

    2015-02-01

    This paper adapts Kuhn's conceptual framework to developmental episodes in the theory and practice of medicine. Previous attempts to understand the reception of Ignaz Semmelweis's work on puerperal fever in Kuhnian terms are used as a starting point. The author identifies some limitations of these attempts and proposes a new way of understanding the core Kuhnian notions of "paradigm," "progress," and "revolution" in the context of a socially embedded technoscience such as medicine.

  3. PROGRESS IN ACUTE MYELOID LEUKEMIA

    PubMed Central

    Kadia, Tapan M.; Ravandi, Farhad; O’Brien, Susan; Cortes, Jorge; Kantarjian, Hagop M.

    2014-01-01

    Significant progress has been made in the treatment of acute myeloid leukemia (AML). Steady gains in clinical research and a renaissance of genomics in leukemia have led to improved outcomes. The recognition of tremendous heterogeneity in AML has allowed individualized treatments of specific disease entities within the context of patient age, cytogenetics, and mutational analysis. The following is a comprehensive review of the current state of AML therapy and a roadmap of our approach to these distinct disease entities. PMID:25441110

  4. Recent progress of quantum annealing

    SciTech Connect

    Suzuki, Sei

    2015-03-10

    We review the recent progress of quantum annealing. Quantum annealing was proposed as a method to solve generic optimization problems. Recently a Canadian company has drawn a great deal of attention, as it has commercialized a quantum computer based on quantum annealing. Although the performance of quantum annealing is not sufficiently understood, it is likely that quantum annealing will be a practical method both on a conventional computer and on a quantum computer.

  5. Ongoing Progress in Spacecraft Controls

    NASA Technical Reports Server (NTRS)

    Ghosh, Dave (Editor)

    1992-01-01

    This publication is a collection of papers presented at the Mars Mission Research Center workshop on Ongoing Progress in Spacecraft Controls. The technical program addressed additional Mars mission control problems that currently exist in robotic missions in addition to human missions. Topics include control systems design in the presence of large time delays, fuel-optimal propulsive control, and adaptive control to handle a variety of unknown conditions.

  6. Progress in Microbial Carotenoids Production.

    PubMed

    Saini, Ramesh Kumar; Keum, Young-Soo

    2017-03-01

    Carotenoids are versatile isoprenoids pigments, play a vital role in the cellular system, starting from antioxidant to gene regulation. Carotenoids are widely used in food, nutraceuticals, and cosmetics owing to their vitamin A, antioxidant and anticancer activities. The demand of carotenoids in various sectors has triggered the research to explore a commercially viable and environmentally friendly production. This article presents a short review of progress in carotenoids production from microbial platforms.

  7. Visual Analytics Technology Transition Progress

    SciTech Connect

    Scholtz, Jean; Cook, Kristin A.; Whiting, Mark A.; Lemon, Douglas K.; Greenblatt, Howard

    2009-09-23

    The authors provide a description of the transition process for visual analytic tools and contrast this with the transition process for more traditional software tools. This paper takes this into account and describes a user-oriented approach to technology transition including a discussion of key factors that should be considered and adapted to each situation. The progress made in transitioning visual analytic tools in the past five years is described and the challenges that remain are enumerated.

  8. Gammasphere software development. Progress report

    SciTech Connect

    Piercey, R.B.

    1993-05-01

    Activities of the nuclear physics group are described. Progress was made in organizing the Gammasphere Software Working Group, establishing a nuclear computing facility, participating in software development at Lawrence Berkeley, developing a common data file format, and adapting the ORNL UPAK software to run at Gammasphere. A universal histogram object was developed that defines a file format and provides for an objective-oriented programming model. An automated liquid nitrogen fill system was developed for Gammasphere (110 Ge detectors comprise the sphere).

  9. Gammasphere software development. Progress report

    SciTech Connect

    Piercey, R.B.

    1994-01-01

    This report describes the activities of the nuclear physics group at Mississippi State University which were performed during 1993. Significant progress has been made in the focus areas: chairing the Gammasphere Software Working Group (SWG); assisting with the porting and enhancement of the ORNL UPAK histogramming software package; and developing standard formats for Gammasphere data products. In addition, they have established a new public ftp archive to distribute software and software development tools and information.

  10. Progress in NTHMP Hazard Assessment

    USGS Publications Warehouse

    Gonzalez, F.I.; Titov, V.V.; Mofjeld, H.O.; Venturato, A.J.; Simmons, R.S.; Hansen, R.; Combellick, R.; Eisner, R.K.; Hoirup, D.F.; Yanagi, B.S.; Yong, S.; Darienzo, M.; Priest, G.R.; Crawford, G.L.; Walsh, T.J.

    2005-01-01

    The Hazard Assessment component of the U.S. National Tsunami Hazard Mitigation Program has completed 22 modeling efforts covering 113 coastal communities with an estimated population of 1.2 million residents that are at risk. Twenty-three evacuation maps have also been completed. Important improvements in organizational structure have been made with the addition of two State geotechnical agency representatives to Steering Group membership, and progress has been made on other improvements suggested by program reviewers. ?? Springer 2005.

  11. Global Trends: Paradox of Progress

    DTIC Science & Technology

    2017-01-01

    down more jobs into automated components. Skyrocketing investment in AI, surging sales of industrial and service robotics, and cloud -based platforms...glacial melt, air quality degradation, changes in cloud 22 GLOBAL TRENDS: PARADOX OF PROGRESS -2 0 2 4 6 2050 21002000 Degrees Celsius Projected...such as injecting aerosols in the stratosphere, chemically brightening marine clouds , and installing space-mirrors in orbit. Other approaches focus

  12. Dietary Patterns and CKD Progression.

    PubMed

    Banerjee, Tanushree; Liu, Yang; Crews, Deidra C

    2016-01-01

    Chronic kidney disease (CKD) patients and their clinicians seek ways to mitigate the risk of CKD progression and its associated complications. Emerging data suggest that dietary modifications may be beneficial adjuvant approaches to reducing the risk of adverse CKD outcomes. This review focuses on several different dietary patterns, including the Dietary Approaches to Stop Hypertension and Mediterranean diets, and their kidney health benefits. We discuss how healthful dietary patterns are lower in dietary acid load and how improving diet quality may slow the progression of CKD. We also discuss some barriers that may impede socially disadvantaged individuals from following healthful diets. Dietary patterns low in dietary acid load might slow the progression of CKD. Current evidence suggests that a reduction in dietary acid load could be beneficial in patients with CKD, but the supremacy of any particular diet is yet to be established. Additional randomized controlled dietary interventions among CKD patients are needed to inform evidence-based recommendations, which can be tailored to an individual's preferences and ability to access healthful foods. © 2016 S. Karger AG, Basel.

  13. Mathematical models of diabetes progression.

    PubMed

    De Gaetano, Andrea; Hardy, Thomas; Beck, Benoit; Abu-Raddad, Eyas; Palumbo, Pasquale; Bue-Valleskey, Juliana; Pørksen, Niels

    2008-12-01

    Few attempts have been made to model mathematically the progression of type 2 diabetes. A realistic representation of the long-term physiological adaptation to developing insulin resistance is necessary for effectively designing clinical trials and evaluating diabetes prevention or disease modification therapies. Writing a good model for diabetes progression is difficult because the long time span of the disease makes experimental verification of modeling hypotheses extremely awkward. In this context, it is of primary importance that the assumptions underlying the model equations properly reflect established physiology and that the mathematical formulation of the model give rise only to physically plausible behavior of the solutions. In the present work, a model of the pancreatic islet compensation is formulated, its physiological assumptions are presented, some fundamental qualitative characteristics of its solutions are established, the numerical values assigned to its parameters are extensively discussed (also with reference to available cross-sectional epidemiologic data), and its performance over the span of a lifetime is simulated under various conditions, including worsening insulin resistance and primary replication defects. The differences with respect to two previously proposed models of diabetes progression are highlighted, and therefore, the model is proposed as a realistic, robust description of the evolution of the compensation of the glucose-insulin system in healthy and diabetic individuals. Model simulations can be run from the authors' web page.

  14. Information Loss from Technological Progress

    NASA Astrophysics Data System (ADS)

    Townsend, P. D.

    2014-12-01

    Progress in electronics and optics offers faster computers, and rapid communication via the internet that is matched by ever larger and evolving storage systems. Instinctively one assumes that this must be totally beneficial. However advances in software and storage media are progressing in ways which are frequently incompatible with earlier systems and the economics and commercial pressures rarely guarantee total compatibility with earlier systems. Instead, the industries actively choose to force the users to purchase new systems and software. Thus we are moving forward with new technological variants that may have access to only the most recent systems and we will have lost earlier alternatives. The reality is that increased processing speed and storage capacity are matched by an equally rapid decline in the access and survival lifetime of older information. This pattern is not limited to modern electronic systems but is evident throughout history from writing on stone and clay tablets to papyrus and paper. It is equally evident in image systems from painting, through film, to magnetic tapes and digital cameras. In sound recording we have variously progressed from wax discs to vinyl, magnetic tape and CD formats. In each case the need for better definition and greater capacity has forced the earlier systems into oblivion. Indeed proposed interactive music systems could similarly relegate music CDs to specialist collections. The article will track some of the examples and discuss the consequences as well as noting that this information loss is further compounded by developments in language and changes in cultural views of different societies.

  15. Progress in the Equal Rights Struggle

    ERIC Educational Resources Information Center

    Lewis, Alfred Baker

    1976-01-01

    Notes that by using their democratic political process Negroes have made good progress in various areas and can make more progress. Apathy and skepticism regarding politics have no foundation in fact. (Author/AM)

  16. Fluor Hanford Project Focused Progress at Hanford

    SciTech Connect

    HANSON, R.D.

    2000-02-01

    Fluor Hanford is making significant progress in accelerating cleanup at the Hanford site. This progress consistently aligns with a new strategic vision established by the U.S. Department of Energy's Richland Operations Office (RL).

  17. Satisfactory Academic Progress: Who Cares and Why?

    ERIC Educational Resources Information Center

    Blakey, William A.

    1985-01-01

    The author states that postsecondary institutions must implement their own minimum academic progress requirements to avoid a potentially punitive legislative requirement. Various General Accounting Office reports concerned with student progress statistics are quoted. (CT)

  18. Chronic spinal cord injury treated with transplanted autologous bone marrow-derived mesenchymal stem cells tracked by magnetic resonance imaging: a case report.

    PubMed

    Chotivichit, Areesak; Ruangchainikom, Monchai; Chiewvit, Pipat; Wongkajornsilp, Adisak; Sujirattanawimol, Kittipong

    2015-04-09

    Intrathecal transplantation is a minimally invasive method for the delivery of stem cells, however, whether the cells migrate from the lumbar to the injured cervical spinal cord has not been proved in humans. We describe an attempt to track bone marrow-derived mesenchymal stem cells in a patient with a chronic cervical spinal cord injury. A 33-year-old Thai man who sustained an incomplete spinal cord injury from the atlanto-axial subluxation was enrolled into a pilot study aiming to track bone marrow-derived mesenchymal stem cells, labeled with superparamagnetic iron oxide nanoparticles, from intrathecal transplantation in chronic cervical spinal cord injury. He had been dependent on respiratory support since 2005. There had been no improvement in his neurological function for the past 54 months. Bone marrow-derived mesenchymal stem cells were retrieved from his iliac crest and repopulated to the target number. One half of the total cells were labeled with superparamagnetic iron oxide nanoparticles before transplantation to the intrathecal space between L4 and L5. Magnetic resonance imaging studies were performed immediately after the transplantation and at 48 hours, two weeks, one month and seven months after the transplantation. His magnetic resonance imaging scan performed immediately after the transplantation showed hyposignal intensity of paramagnetic substance tagged stem cells in the subarachnoid space at the lumbar spine area. This phenomenon was observed at the surface around his cervical spinal cord at 48 hours. A focal hyposignal intensity of tagged bone marrow-derived stem cells was detected at his cervical spinal cord with magnetic resonance imaging at 48 hours, which faded after two weeks, and then disappeared after one month. No clinical improvement of the neurological function had occurred at the end of this study. However, at 48 hours after the transplantation, he presented with a fever, headache, myalgia and worsening of his motor function (by one

  19. Cochlear implantation for progressive hearing loss

    PubMed Central

    Gray, R; Jones, S; Court, I

    2003-01-01

    This paper shows that a subgroup of congenitally deaf children exists, who, having made good progress with conventional hearing aids, suffer a sudden or progressive hearing deterioration which arrests the speech development. Sixty children have been implanted in the Cambridge Programme, half for meningitis or other acquired losses and half for congenital prelingual deafness. Six of this latter group were congenital but progressive; their progress, deterioration, and improvement after implantation are summarised. PMID:12876170

  20. Progression of HIV in haemophilia.

    PubMed

    Ragni, M V

    1998-07-01

    The recent elucidation of the life cycle and dynamics of the human immunodeficiency virus (HIV) and technological advances in development of the HIV RNA PCR assay for sensitive detection of viral load have revolutionized the diagnosis, management, and treatment of HIV infection. Beginning with initial infection, there is unremitting, high-level viral replication that persists throughout the course of HIV infection. The measure of the amount of virus present in plasma, HIV viral load, is the single most important predictor of HIV progression, the best indicator of immune system decline, and the best guide for initiating and monitoring antiviral treatment. Further, HIV viral load has become the new yardstick against which other markers, including CD4 number, age, chemokine receptor mutations, cytotoxic T-cell responses, and neutralizing antibody titers are assessed. For individuals with haemophilia, additional 'markers' may have significant impact on the outcome of HIV disease. Chronic factor concentrate treatment has led to transfusion-associated hepatitis, co-infection with hepatitis C (HCV), and chronic liver disease. The latter may become accelerated with HIV progression and may lead to hepatotoxicity with antiviral drug therapy. Chronic factor concentrate treatment has also been associated with immunosuppression, including both B- and T-cell immune defects. In HIV(+) haemophilic men, this immune deficit has led to lower CD4 counts with HIV progression and poorer CD4 response to antiviral drugs than in gay men. The underlying haemophilic bleeding tendency may result in significant haemorrhage with HIV-associated immune thrombocytopenia and with protease inhibitor antiretroviral therapy. Although AIDS is the leading cause of death in this group, the reduction in the size of the haemophilia population over the next two centuries is estimated to be small, and survival should improve as better antiviral therapeutics are identified.

  1. Gleason Grade Progression Is Uncommon

    PubMed Central

    Penney, Kathryn L.; Stampfer, Meir J.; Jahn, Jaquelyn L; Sinnott, Jennifer A.; Flavin, Richard; Rider, Jennifer R.; Finn, Stephen; Giovannucci, Edward; Sesso, Howard D.; Loda, Massimo; Mucci, Lorelei A.; Fiorentino, Michelangelo

    2013-01-01

    Gleason grade is universally used for pathologic scoring the differentiation of prostate cancer. However, it is unknown whether prostate tumors arise well-differentiated and then progress to less differentiated forms or if Gleason grade is an early and largely unchanging feature. Prostate Specific Antigen (PSA) screening has reduced the proportion of tumors diagnosed at advanced stage, which allows assessment of this question on a population level. If Gleason grade progresses as stage does, one would expect a similar reduction in high grade tumors. We studied 1,207 Physicians’ Health Study and Health Professionals Follow-up Study participants diagnosed with prostate cancer 1982–2004 and treated with prostatectomy. We compared the distribution of grade and clinical stage across the pre-PSA and PSA screening eras. We re-reviewed grade using the ISUP 2005 revised criteria. The proportion of advanced stage tumors dropped more than six-fold, from the earliest period (12/1982–1/1993), 19.9% stage ≥T3, to the latest (5/2000–12/2004), 3% stage T3, none T4. The proportion of Gleason score ≥8 decreased substantially less, from 25.3% to 17.6%. A significant interaction between stage and diagnosis date predicting grade (p=0.04) suggests the relationship between grade and stage varies by time period. As the dramatic shift in stage since the introduction of PSA screening was accompanied by a more modest shift in Gleason grade, these findings suggest grade may be established early in tumor pathogenesis. This has implications for the understanding of tumor progression and prognosis, and may help patients diagnosed with lower grade disease feel more comfortable choosing active surveillance. PMID:23946472

  2. Towards a Learning Progression of Energy

    ERIC Educational Resources Information Center

    Neumann, Knut; Viering, Tobias; Boone, William J.; Fischer, Hans E.

    2013-01-01

    This article presents an empirical study on an initial learning progression of energy, a concept of central importance to the understanding of science. Learning progressions have been suggested as one vehicle to support the systematic and successful teaching of core science concepts. Ideally, a learning progression will provide teachers with a…

  3. Towards a Learning Progression of Energy

    ERIC Educational Resources Information Center

    Neumann, Knut; Viering, Tobias; Boone, William J.; Fischer, Hans E.

    2013-01-01

    This article presents an empirical study on an initial learning progression of energy, a concept of central importance to the understanding of science. Learning progressions have been suggested as one vehicle to support the systematic and successful teaching of core science concepts. Ideally, a learning progression will provide teachers with a…

  4. 40 CFR 35.6650 - Progress reports.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... STATE AND LOCAL ASSISTANCE Cooperative Agreements and Superfund State Contracts for Superfund Response Actions Reports Required Under A Cooperative Agreement § 35.6650 Progress reports. (a) Reporting frequency. The recipient must submit progress reports as specified in the Cooperative Agreement. Progress...

  5. Progressive Education and the "Indian New Deal".

    ERIC Educational Resources Information Center

    Reyhner, Jon

    This paper examines the progressive education movement and its effect on American Indian education. Progressive education became popular during the late 19th century during the period when American Indian children were being enrolled in Bureau of Indian Affairs (BIA) schools. John Dewey, who is considered the father of progressive education,…

  6. 2016 Nebraska Higher Education Progress Report

    ERIC Educational Resources Information Center

    Nebraska's Coordinating Commission for Postsecondary Education, 2016

    2016-01-01

    The 2016 Nebraska Higher Education Progress Report is the 12th annual progress report designed to provide the Nebraska Legislature with comparative statistics to monitor and evaluate progress toward achieving three key priorities for Nebraska's postsecondary education system. These priorities were developed by the 2003 LR 174 Higher Education Task…

  7. Recent progress in tidal modeling

    NASA Technical Reports Server (NTRS)

    Vial, F.; Forbes, J. M.

    1989-01-01

    Recent contributions to tidal theory during the last five years are reviewed. Specific areas where recent progress has occurred include: the action of mean wind and dissipation on tides, interactions of other waves with tides, the use of TGCM in tidal studies. Furthermore, attention is put on the nonlinear interaction between semidiurnal and diurnal tides. Finally, more realistic thermal excitation and background wind and temperature models have been developed in the past few years. This has led to new month-to-month numerical simulations of the semidiurnal tide. Some results using these models are presented and compared with ATMAP tidal climatologies.

  8. Progress toward hydrogen peroxide micropulsion

    SciTech Connect

    Whitehead, J C; Dittman, M D; Ledebuhr, A G

    1999-07-08

    A new self-pressurizing propulsion system has liquid thrusters and gas jet attitude control without heavy gas storage vessels. A pump boosts the pressure of a small fraction of the hydrogen peroxide, so that reacted propellant can controllably pressurize its own source tank. The warm decomposition gas also powers the pump and is supplied to the attitude control jets. The system has been incorporated into a prototype microsatellite for terrestrial maneuvering tests. Additional progress includes preliminary testing of a bipropellant thruster, and storage of unstabilized hydrogen peroxide in small sealed tanks.

  9. Progress of the LASSO experiment

    NASA Technical Reports Server (NTRS)

    Serene, B. E. H.

    1981-01-01

    The LASSO (Later Synchronisation from Stationary Orbit) experiment, designed to demonstrate the feasibility of achieving time synchronization between remote atomic clocks with an accuracy of one nanosecond or better by using laser techniques for the first time is described. The experiment uses groundbased laser stations and the SIRIO-2 geostationary satellite to be launched towards the end of 1981. The qualification of the LASSO on-board equipment is discussed with a brief description of the electrical and optical test equipment used. The progress of the operational organization is included.

  10. Interventions in progressive supranuclear palsy.

    PubMed

    Koros, Christos; Stamelou, Maria

    2016-01-01

    Progressive supranuclear palsy (PSP) an atypical parkinsonian with a common phenotype comprising early falls, the characteristic slowing of vertical saccades and a frontal syndrome with marked apathy (Richardson's syndrome). Currently, no effective symptomatic or neuroprotective treatment is available for PSP. Current medical have a limited role in PSP. Novel experimental treatments include davunetide or tideglusib, both inhibitors of glycogen synthase kinase-3 (GSK-3) that failed to improve the clinical outcome of PSP patients in two recent studies. Future interventions aiming at tau dysfunction and passive or active immunization are ongoing or underway.

  11. Theory investigation progress of DMAZ

    NASA Astrophysics Data System (ADS)

    Xie, Hui; Mu, Xiaogang; Zhang, Yue; Wang, Xuanjun

    2017-05-01

    The recent progress in the theoretical study of N, N-dimethyl-2-azidoethylamine (DMAZ), a new type of azide fuel, is summarized. Thermodynamic Properties (such as Enthalpy-of-Formation, Enthalpy-of-Vaporization, and Enthalpy-of-Sublimation), conformers, Spectrums, the Henry's constant, ignition delay et al. are studied by Density Functional Theory (DFT). It is proved that DMAZ has good performance with a density impulse 2.499 Ns/m3, and has a good application prospect in replacing the traditional hydrazine propellant methyl-hydrazine (MMH).

  12. [Research Progress on Forensic Entomotoxicology].

    PubMed

    Liu, Zhi-jiang; Zhai, Xian-dun; Guan, Ling; Mo, Yao-nan

    2015-06-01

    Forensic entomotoxicology is a branch of forensic medicine, which applies entomology, toxicology and other related studies to solve the poisoning cases. It has an obvious advantage in the investigation on poisoning death. Based on the expounding definition and research of entomotoxicology, this paper reviews research progress and application value in some aspects of forensic medicine, such as the effects of drugs/toxins on the growth and development of sarcosaphagous insects and the qualitative and quantitative analysis of the drugs/toxins in the poisoned body tissue.

  13. Progress in breast cancer: overview.

    PubMed

    Arteaga, Carlos L

    2013-12-01

    This edition of CCR Focus titled Research in Breast Cancer: Frontiers in Genomics, Biology, and Clinical Investigation reviews six topics that cover areas of translational research of high impact in breast cancer. These topics represent areas of breast cancer research where significant progress has occurred but also where very important challenges remain. The papers in this CCR Focus section are contributed by experts in the respective areas of investigation. Herein, key aspects of these contributions and the research directions they propose are reviewed. ©2013 AACR.

  14. Genetic progression of malignant melanoma.

    PubMed

    Tímár, J; Vizkeleti, L; Doma, V; Barbai, T; Rásó, E

    2016-03-01

    Malignant melanoma of the skin is the most aggressive human cancer given that a primary tumor a few millimeters in diameter frequently has full metastatic competence. In view of that, revealing the genetic background of this potential may also help to better understand tumor dissemination in general. Genomic analyses have established the molecular classification of melanoma based on the most frequent driver oncogenic mutations (BRAF, NRAS, KIT) and have also revealed a long list of rare events, including mutations and amplifications as well as genetic microheterogeneity. At the moment, it is unclear whether any of these rare events have role in the metastasis initiation process since the major drivers do not have such a role. During lymphatic and hematogenous dissemination, the clonal selection process is evidently reflected by differences in oncogenic drivers in the metastases versus the primary tumor. Clonal selection is also evident during lymphatic progression, though the genetic background of this immunoselection is less clear. Genomic analyses of metastases identified further genetic alterations, some of which may correspond to metastasis maintenance genes. The natural genetic progression of melanoma can be modified by targeted (BRAF or MEK inhibitor) or immunotherapies. Some of the rare events in primary tumors may result in primary resistance, while further new genetic lesions develop during the acquired resistance to both targeted and immunotherapies. Only a few genetic lesions of the primary tumor are constant during natural or therapy-modulated progression. EGFR4 and NMDAR2 mutations, MITF and MET amplifications and PTEN loss can be considered as metastasis drivers. Furthermore, BRAF and MITF amplifications as well as PTEN loss are also responsible for resistance to targeted therapies, whereas NRAS mutation is the only founder genetic lesion showing any association with sensitivity to immunotherapies. Unfortunately, there are hardly any data on the

  15. Progress re-supply ship

    NASA Image and Video Library

    2010-01-14

    ISS01-324-002 (18 November 2000) --- A Progress supply ship linked up to the orbiting International Space Station (ISS) at 3:48 GMT, November 18, bringing Expedition 1 commander William M. Shepherd, pilot Yuri P. Gidzenko and flight engineer Sergei K. Krikalev two tons of food, clothing, hardware and holiday gifts from their families. The photograph was taken with a 35mm camera and the film was later handed over to the STS-97 crew members for return to Earth and subsequent processing.

  16. Progress Report NORSAR Phase 3

    DTIC Science & Technology

    1974-10-11

    PHASE 3 1 July - 30 September 1974 1 AUTHOR’«; Prepared by K.A. Berteussen 9 PERFORMING ORGANIZATION NAME AND ADDRESS NTNF...30 June 1975 F08606-74-C-0049 Norwegian Seismic Array (NORSAR) Phase 3 $900 000.— II October 1974 1 July - 30 September 197 4 Nils Maräs, (02)71...Hi.»,«—, Hl .1 ii.li in im. UM;!..». .1.1 „IM I,„LWII ■Mtffll^ A D/A-00 2 25 2 PROGRESS REPORT NORSAR PHASE

  17. Recent Progress in SERS Biosensing

    PubMed Central

    Bantz, Kyle C.; Meyer, Audrey F.; Wittenberg, Nathan J.; Im, Hyungsoon; Kurtuluş, Özge; Lee, Si Hoon; Lindquist, Nathan C.

    2011-01-01

    This perspective gives an overview of recent developments in surface-enhanced Raman scattering (SERS) for biosensing. We focus this review on SERS papers published in the last 10 years and to specific applications of detecting biological analytes. Both intrinsic and extrinsic SERS biosensing schemes have been employed to detect and identify small molecules, nucleic acids, lipids, peptides, and proteins, as well as for in vivo and cellular sensing. Current SERS substrate technologies along with a series of advancements in surface chemistry, sample preparation, intrinsic/extrinsic signal transduction schemes, and tip-enhanced Raman spectroscopy are discussed. The progress covered herein shows great promise for widespread adoption of SERS biosensing. PMID:21509385

  18. [Research progress on wetland ecotourism].

    PubMed

    Wang, Li-Long; Lu, Lin

    2009-06-01

    Wetland is rich in biodiversity and cultural diversity, possessing higher tourism value and environmental education and community participation functions. Wetland ecotourism reflects the sustainable development of tourism economy and wetland protection, having received great concern from governments and scholars at home and abroad. This paper summarized the related theories and practices, discussed the research advances in wetland ecotourism from the aspects of significance, progress, contents, methods and results, and pointed out the important research fields in the future, aimed to accelerate the development of wetland ecotourism research and to provide reference about the resources exploitation, environment protection, and scientific administration of wetland and related scenic areas.

  19. Statistical variation in progressive scrambling

    NASA Astrophysics Data System (ADS)

    Clark, Robert D.; Fox, Peter C.

    2004-07-01

    The two methods most often used to evaluate the robustness and predictivity of partial least squares (PLS) models are cross-validation and response randomization. Both methods may be overly optimistic for data sets that contain redundant observations, however. The kinds of perturbation analysis widely used for evaluating model stability in the context of ordinary least squares regression are only applicable when the descriptors are independent of each other and errors are independent and normally distributed; neither assumption holds for QSAR in general and for PLS in particular. Progressive scrambling is a novel, non-parametric approach to perturbing models in the response space in a way that does not disturb the underlying covariance structure of the data. Here, we introduce adjustments for two of the characteristic values produced by a progressive scrambling analysis - the deprecated predictivity (Q_s^{ast^2}) and standard error of prediction (SDEP s * ) - that correct for the effect of introduced perturbation. We also explore the statistical behavior of the adjusted values (Q_0^{ast^2} and SDEP 0 * ) and the sensitivity to perturbation (d q 2/d r yy ' 2). It is shown that the three statistics are all robust for stable PLS models, in terms of the stochastic component of their determination and of their variation due to sampling effects involved in training set selection.

  20. Progressive Fracture of Composite Structures

    NASA Technical Reports Server (NTRS)

    Minnetyan, Levon

    2001-01-01

    This report includes the results of a research in which the COmposite Durability STRuctural ANalysis (CODSTRAN) computational simulation capabilities were augmented and applied to various structures for demonstration of the new features and verification. The first chapter of this report provides an introduction to the computational simulation or virtual laboratory approach for the assessment of damage and fracture progression characteristics in composite structures. The second chapter outlines the details of the overall methodology used, including the failure criteria and the incremental/iterative loading procedure with the definitions of damage, fracture, and equilibrium states. The subsequent chapters each contain an augmented feature of the code and/or demonstration examples. All but one of the presented examples contains laminated composite structures with various fiber/matrix constituents. For each structure simulated, damage initiation and progression mechanisms are identified and the structural damage tolerance is quantified at various degradation stages. Many chapters contain the simulation of defective and defect free structures to evaluate the effects of existing defects on structural durability.

  1. Progress towards understanding baryon resonances

    SciTech Connect

    Crede, Volker; Roberts, Winston

    2013-07-01

    The composite nature of baryons manifests itself in the existence of a rich spectrum of excited states, in particular in the important mass region 1?2 GeV for the light-flavoured baryons. The properties of these resonances can be identified by systematic investigations using electromagnetic and strong probes, primarily with beams of electrons, photons, and pions. After decades of research, the fundamental degrees of freedom underlying the baryon excitation spectrum are still poorly understood. The search for hitherto undiscovered but predicted resonances continues at many laboratories around the world. Recent results from photo- and electroproduction experiments provide intriguing indications for new states and shed light on the structure of some of the known nucleon excitations. The continuing study of available data sets with consideration of new observables and improved analysis tools have also called into question some of the earlier findings in baryon spectroscopy. Other breakthrough measurements have been performed in the heavy-baryon sector, which has seen a fruitful period in recent years, in particular at the B factories and the Tevatron. First results from the large hadron collider indicate rapid progress in the field of bottom baryons. In this review, we discuss the recent experimental progress and give an overview of theoretical approaches.

  2. MITRE progress report No. 2

    SciTech Connect

    Not Available

    1980-09-23

    This progress report documents the major accomplishments on the two remaining SEAS tasks for the period of July 10 to August 8, 1980. The tasks are SEAS scenario runs, and SEAS management, documentation, maintenance and support. The scenario run work in this month period consisted of the completion of the TASE 6 scenario on the reference system, development of an ARMS baseline scenario and a run of the NEP2 scenario. The SEAS management, documentation, maintenance and support task continued at about a five person level during this period. A list of all the SEAS change requests that have been completed under this contract (since the procedures begin in March 1980) is contained in Table 1. Approximately forty additional change requests have been proposed. Some of these have been approved by the change control board and are in progress. Work has continued on several documents and some have been published. In addition to the ARMS design briefing on August 8, MITRE participated in two other design briefings during this month report period. These are the July 14 briefing on the guidance document and the July 23 briefing on the TECNET/MOBIL 1 Comparison and on the Graphics Preprocessor Design.

  3. [Growth and nonlinearity]. Progress report

    SciTech Connect

    Savit, R.

    1993-12-31

    The research centered on the physics of growth. One particular focus was the spiral patterns seen in excitable media, such as the chemical reaction of Belousov and Zhabatinskii, and the aggregation of the slime mold, Dictyostelium Discoideum. Another area of interest is the statistical roughness of the growth front itself. For example, when growing thin films, the roughness of the surface is very important for the ultimate quality of the film. Besides its direct technological relevance, this problem is intimately connected to many fundamental problems in statistical physics. In addition work was done in the related area of statistical properties of flux-flow motion in superconductors. Substantial progress was also made on techniques and applications of the analysis of complex systems. Methods of time series analysis were generalized to the analysis of complex spatio-temporal patterns. In the examples studied most, turbulence and electroencephalograms, the spatio-temporal patterns are very complex and fleeting, and can easily be misken for random noise. Nevertheless, substantial progress was made in developing and applying methods to these systems that indicate the presence of nonrandom time-varying spatial patterns.

  4. Progressive Pseudorheumatoid Dysplasia or JIA?

    PubMed Central

    2017-01-01

    Progressive pseudorheumatoid dysplasia (PPD) or spondyloepiphyseal dysplasia tarda with progressive arthropathy (SEDT-PA) is a rare arthropathy of childhood involving the axial skeleton as well as small peripheral joints. A 10-year-old boy was referred by a general practitioner with pain and deformity in the fingers of hands and limping gait. There was no joint synovitis although the finger joints were bulky on examination with mild flexion deformity. Patient had exaggerated kyphosis and lumbar lordosis with pigeon chest and restricted hip joint movements. Anteroposterior X-rays of the hip joints revealed widened and flattened epiphyses of the femoral heads with narrow and irregular joint spaces. Hand X-rays revealed periarticular osteopenia, significant narrowing of the joint spaces of proximal interphalangeal, and distal interphalangeal joints, together with osseous enlargement of the basis of metacarpal bones and phalanges. Spinal X-rays revealed generalized platyspondyly and anterior beaking of vertebral bodies. There was a clear mega os trigonum in his feet images. All blood investigations were normal with no evidence of inflammation and thyroid hormone levels were normal. The diagnosis of PPD was favored by imaging studies and normal inflammatory markers and the patient was treated with physiotherapy, family counseling, and anti-inflammatory medications. PMID:28316857

  5. Progress in BazookaSPECT.

    PubMed

    Miller, Brian W; Barber, H Bradford; Furenlid, Lars R; Moore, Stephen K; Barrett, Harrison H

    2009-01-01

    Recent progress on a high-resolution, photon-counting gamma-ray and x-ray imager called BazookaSPECT is presented. BazookaSPECT is an example of a new class of scintillation detectors based on integrating detectors such as CCD(charge-coupled device) or CMOS(complementary metal-oxide semiconductor) sensors. BazookaSPECT is unique in that it makes use of a scintillator in close proximity to a microchannel plate-based image intensifier for up-front optical amplification of scintillation light. We discuss progress made in bringing about compact BazookaSPECT modules and in real-time processing of event data using graphics processing units (GPUs). These advances are being implemented in the design of a high-resolution rodent brain imager called FastSPECT III. A key benefit of up-front optical gain is that any CCD/CMOS sensor can now be utilized for photon counting. We discuss the benefits and feasibility of using CMOS sensors as photon-counting detectors for digital radiography, with application in mammography and computed tomography (CT). We present as an appendix a formal method for comparing various photon-counting integrating detectors using objective statistical criteria.

  6. Progress in BazookaSPECT

    PubMed Central

    Miller, Brian W.; Barber, H. Bradford; Furenlid, Lars R.; Moore, Stephen K.; Barrett, Harrison H.

    2010-01-01

    Recent progress on a high-resolution, photon-counting gamma-ray and x-ray imager called BazookaSPECT is presented. BazookaSPECT is an example of a new class of scintillation detectors based on integrating detectors such as CCD(charge-coupled device) or CMOS(complementary metal-oxide semiconductor) sensors. BazookaSPECT is unique in that it makes use of a scintillator in close proximity to a microchannel plate-based image intensifier for up-front optical amplification of scintillation light. We discuss progress made in bringing about compact BazookaSPECT modules and in real-time processing of event data using graphics processing units (GPUs). These advances are being implemented in the design of a high-resolution rodent brain imager called FastSPECT III. A key benefit of up-front optical gain is that any CCD/CMOS sensor can now be utilized for photon counting. We discuss the benefits and feasibility of using CMOS sensors as photon-counting detectors for digital radiography, with application in mammography and computed tomography (CT). We present as an appendix a formal method for comparing various photon-counting integrating detectors using objective statistical criteria. PMID:21297897

  7. Slug Expression during Melanoma Progression

    PubMed Central

    Shirley, Stephanie H.; Greene, Victoria R.; Duncan, Lyn M.; Torres Cabala, Carlos A.; Grimm, Elizabeth A.; Kusewitt, Donna F.

    2012-01-01

    Slug (Snai2), a member of the Snail family of zinc finger transcription factors, plays a role in the epithelial-to-mesenchymal transformation (EMT) that occurs during melanocyte emigration from the neural crest. A role for Slug in the EMT-like loss of cell adhesion and increased cell motility exhibited during melanoma progression has also been proposed. Our immunohistochemical studies of melanoma arrays, however, revealed that Slug expression was actually higher in nevi than in primary or metastatic melanomas. Moreover, Slug expression in melanomas was not associated with decreased expression of E-cadherin, the canonical Slug target in EMT. Comparisons of endogenous Slug and E-cadherin expression in cultured normal human melanocytes and melanoma cell lines supported our immunohistochemical findings. Expression of exogenous Slug in melanocytes and melanoma cells in vitro, however, suppressed E-cadherin expression, enhanced N-cadherin expression, and stimulated cell migration and invasion. Interestingly, both in tumors and cultured cell lines, there was a clear relationship between expression of Slug and MITF, a transcription factor known to regulate Slug expression during development. Taken together, our findings suggest that Slug expression during melanomagenesis is highest early in the process and that persistent Slug expression is not required for melanoma progression. The precise role of Slug in melanomagenesis remains to be elucidated and may be related to its interactions with other drivers of EMT, such as Snail. PMID:22503751

  8. Progress on DCLL Blanket Concept

    SciTech Connect

    Wong, Clement; Abdou, M.; Katoh, Yutai; Kurtz, Richard J.; Lumsdaine, A.; Marriott, Edward P.; Merrill, Brad; Morley, Neil; Pint, Bruce A.; Sawan, M.; Smolentsev, S.; Williams, Brian; Willms, Scott; Youssef, M.

    2013-09-01

    Under the US Fusion Nuclear Science and Technology Development program, we have selected the Dual Coolant Lead Lithium concept (DCLL) as a reference blanket, which has the potential to be a high performance DEMO blanket design with a projected thermal efficiency of >40%. Reduced activation ferritic/martensitic (RAF/M) steel is used as the structural material. The self-cooled breeder PbLi is circulated for power conversion and for tritium breeding. A SiC-based flow channel insert (FCI) is used as a means for magnetohydrodynamic pressure drop reduction from the circulating liquid PbLi and as a thermal insulator to separate the high-temperature PbLi (~700°C) from the helium-cooled RAF/M steel structure. We are making progress on related R&D needs to address critical Fusion Nuclear Science and Facility (FNSF) and DEMO blanket development issues. When performing the function as the Interface Coordinator for the DCLL blanket concept, we had been developing the mechanical design and performing neutronics, structural and thermal hydraulics analyses of the DCLL TBM module. We had estimated the necessary ancillary equipment that will be needed at the ITER site and a detailed safety impact report has been prepared. This provided additional understanding of the DCLL blanket concept in preparation for the FNSF and DEMO. This paper will be a summary report on the progress of the DCLL TBM design and R&Ds for the DCLL blanket concept.

  9. [Progress of bone graft substitute].

    PubMed

    Zhang, Yongguang; Wang, Zhiqiang

    2008-10-01

    To sum up the recent progress of common bone graft substitute and to forecast the possible directions for further research. Recent original articles about investigation and application for bone graft substitute were extensively reviewed. Several common bone graft substitutes were selected and expounded in different categories. Bone graft was an essential treatment in order to provide structural support, fill bone cavity and promote bone defect healing. The gold standard for bone graft was autograft which is subject to many restrictions. In recent years, the research and development of bone graft substitute have received public attention. A very great progress has been made in the research and application of allograft bones, synthetic bones and engineered bones, and some research results have been put into use for real products. There still exist many problems in present bone graft substitutes. Combining various biomaterials and using the specific processing technology to develop a biomaterial which has the similar mechanical and chemical properties and physical structures to autograft so as to promote bone defect healing is the direction for future research.

  10. Green Chemistry: Progress and Barriers

    NASA Astrophysics Data System (ADS)

    Green, Sarah A.

    2016-10-01

    Green chemistry can advance both the health of the environment and the primary objectives of the chemical enterprise: to understand the behavior of chemical substances and to use that knowledge to make useful substances. We expect chemical research and manufacturing to be done in a manner that preserves the health and safety of workers; green chemistry extends that expectation to encompass the health and safety of the planet. While green chemistry may currently be treated as an independent branch of research, it should, like safety, eventually become integral to all chemistry activities. While enormous progress has been made in shifting from "brown" to green chemistry, much more effort is needed to effect a sustainable economy. Implementation of new, greener paradigms in chemistry is slow because of lack of knowledge, ends-justify-the-means thinking, systems inertia, and lack of financial or policy incentives.

  11. CERN ELENA project progress report

    NASA Astrophysics Data System (ADS)

    Bartmann, Wolfgang; Belochitskii, Pavel; Breuker, Horst; Butin, François; Carli, C.; Eriksson, Tommy; Oelert, Walter; Maury, Stephan; Pasinelli, Sergio; Tranquille, Gerard

    2015-05-01

    The Extra Low Energy Antiproton ring (ELENA) is a CERN project aiming at constructing a 30 m circumference synchrotron to further decelerate antiprotons from the Antiproton Decelerator (AD) from 5.3 MeV to 100 keV. The additional deceleration complemented by an electron cooler to reduce emittances will allow the existing AD experiments to increase substantially their antiproton capture efficiencies and render new experiments possible. The ELENA design is now well advanced and the project has entered the construction stage, in particular for what concerns the infrastructure. Installation of the machine components is foreseen during the second half of 2015 and beginning of 2016 followed by ring commissioning until the end of 2016. New electrostatic transfer lines to the experiments will be installed and commissioned during the first half of 2017 followed by the first physics operation with AD/ELENA end of 2017. Main ELENA related infrastructure progresses as well as the status of the project are reported.

  12. [Progress in dedifferentiated fat cells].

    PubMed

    Cheng, Feifei; Yang, Zhi; Qian, Cheng

    2014-10-01

    When mature adipocytes are subjected to an in vitro dedifferentiation strategy referred to as ceiling culture, these mature adipocytes can revert to dedifferentiated fat (DFAT) cells. DFAT cells have many advantages compared with adipose-derived stem cells (ASCs) and bone marrow mesenchymal stem cells (BMSCs). For example, DFAT cells are homogeneous and could be obtained from donors regardless of their age. Furthermore, DFAT cells also have the same multi-lineage potentials and low immunogenicity as ASCs. As an excellent source of seed cells for tissue engineering and stem cell transplantation, DFAT cells have better prospects in the treatment of many clinical diseases, such as bone defects, neurological diseases, ischemic heart disease and kidney disease. It is necessary to make more intensive studies of DFAT cells. This article summarizes progresses in the immunological characteristics, differentiation ability and potential clinical applications of DFAT cells.

  13. Recent progress in henipavirus research.

    PubMed

    Halpin, Kim; Mungall, Bruce A

    2007-09-01

    Following the discovery of two new paramyxoviruses in the 1990s, much effort has been placed on rapidly finding the reservoir hosts, characterising the genomes, identifying the viral receptors and formulating potential vaccines and therapeutic options for these viruses, Hendra and Nipah viruses caused zoonotic disease on a scale not seen before with other paramyxoviruses. Nipah virus particularly caused high morbidity and mortality in humans and high morbidity in pig populations in the first outbreak in Malaysia. Both viruses continue to pose a threat with sporadic outbreaks continuing into the 21st century. Experimental and surveillance studies identified that pteropus bats are the reservoir hosts. Research continues in an attempt to understand events that precipitated spillover of these viruses. Discovered on the cusp of the molecular technology revolution, much progress has been made in understanding these new viruses. This review endeavours to capture the depth and breadth of these recent advances.

  14. Progress in optical parametric oscillators

    NASA Technical Reports Server (NTRS)

    Fan, Y. X.; Byer, R. L.

    1984-01-01

    It is pointed out that tunable coherent sources are very useful for many applications, including spectroscopy, chemistry, combustion diagnostics, and remote sensing. Compared with other tunable sources, optical parametric oscillators (OPO) offer the potential advantage of a wide wavelength operating range, which extends from 0.2 micron to 25 microns. The current status of OPO is examined, taking into account mainly advances made during the last decade. Attention is given to early LiNbO3 parametric oscillators, problems which have prevented wide use of parametric oscillators, the demonstration of OPO's using urea and AgGaS2, progress related to picosecond OPO's, a breakthrough in nanosecond parametric oscillators, the first demonstration of a waveguide and fiber parametric amplification and generation, the importance of chalcopyrite crystals, and theoretical work performed with the aim to understand the factors affecting the parametric oscillator performance.

  15. Gene therapy: progress and predictions.

    PubMed

    Collins, Mary; Thrasher, Adrian

    2015-12-22

    The first clinical gene delivery, which involved insertion of a marker gene into lymphocytes from cancer patients, was published 25 years ago. In this review, we describe progress since then in gene therapy. Patients with some inherited single-gene defects can now be treated with their own bone marrow stem cells that have been engineered with a viral vector carrying the missing gene. Patients with inherited retinopathies and haemophilia B can also be treated by local or systemic injection of viral vectors. There are also a number of promising gene therapy approaches for cancer and infectious disease. We predict that the next 25 years will see improvements in safety, efficacy and manufacture of gene delivery vectors and introduction of gene-editing technologies to the clinic. Gene delivery may also prove a cost-effective method for the delivery of biological medicines. © 2015 The Authors.

  16. Artificial sensory organs: latest progress.

    PubMed

    Nakamura, Tatsuo; Inada, Yuji; Shigeno, Keiji

    2017-09-21

    This study introduces the latest progress on the study of artificial sensory organs, with a special emphasis on the clinical results of artificial nerves and the concept of in situ tissue engineering. Peripheral nerves have a strong potential for regeneration. An artificial nerve uses this potential to recover a damaged peripheral nerve. The polyglycolic acid collagen tube (PGA-C tube) is a bio-absorbable tube stuffed with collagen of multi-chamber structure that consists of thin collagen films. The clinical application of the PGA-C tube began in 2002 in Japan. The number of PGA-C tubes used is now beyond 300, and satisfactory results have been reported on peripheral nerve repairs. This PGA-C tube is also effective for patients suffering from neuropathic pain.

  17. Progressive Fracture of Composite Structures

    NASA Technical Reports Server (NTRS)

    Chamis, Christos C.; Minnetyan, Levon

    2008-01-01

    A new approach is described for evaluating fracture in composite structures. This approach is independent of classical fracture mechanics parameters like fracture toughness. It relies on computational simulation and is programmed in a stand-alone integrated computer code. It is multiscale, multifunctional because it includes composite mechanics for the composite behavior and finite element analysis for predicting the structural response. It contains seven modules; layered composite mechanics (micro, macro, laminate), finite element, updating scheme, local fracture, global fracture, stress based failure modes, and fracture progression. The computer code is called CODSTRAN (Composite Durability Structural ANalysis). It is used in the present paper to evaluate the global fracture of four composite shell problems and one composite built-up structure. Results show that the composite shells and the built-up composite structure global fracture are enhanced when internal pressure is combined with shear loads.

  18. Progress on the Cluster Mission

    NASA Technical Reports Server (NTRS)

    Kivelson, Margaret; Khurana, Krishan; Acuna, Mario (Technical Monitor)

    2002-01-01

    Prof M. G. Kivelson and Dr. K. K. Khurana (UCLA (University of California, Los Angeles)) are co-investigators on the Cluster Magnetometer Consortium (CMC) that provided the fluxgate magnetometers and associated mission support for the Cluster Mission. The CMC designated UCLA as the site with primary responsibility for the inter-calibration of data from the four spacecraft and the production of fully corrected data critical to achieving the mission objectives. UCLA will also participate in the analysis and interpretation of the data. The UCLA group here reports its excellent progress in developing fully intra-calibrated data for large portions of the mission and an excellent start in developing inter-calibrated data for selected time intervals, especially extended intervals in August, 2001 on which a workshop held at ESTEC in March, 2002 focused. In addition, some scientific investigations were initiated and results were reported at meetings.

  19. Hidden progress: broadband plasmonic invisibility.

    PubMed

    Renger, Jan; Kadic, Muamer; Dupont, Guillaume; Aćimović, Srdjan S; Guenneau, Sébastien; Quidant, Romain; Enoch, Stefan

    2010-07-19

    One of the key challenges in current research into electromagnetic cloaking is to achieve invisibility at optical frequencies and over an extended bandwidth. There has been significant progress towards this using the idea of cloaking by sweeping under the carpet of Li and Pendry. Here, we show that we can harness surface plasmon polaritons at a metal surface structured with a dielectric material to obtain a unique control of their propagation. We exploit this control to demonstrate both theoretically and experimentally cloaking over an unprecedented bandwidth (650-900 nm). Our non-resonant plasmonic metamaterial is designed using transformational optics extended to plasmonics and allows a curved reflector to mimic a flat mirror. Our theoretical predictions are validated by experiments mapping the surface light intensity at a wavelength of 800 nm.

  20. Research Progress on Vertebrobasilar Dolichoectasia

    PubMed Central

    Yuan, Yong-Jie; Xu, Kan; Luo, Qi; Yu, Jin-Lu

    2014-01-01

    Vertebrobasilar dolichoectasia (VBD) is a rare disease characterized by significant expansion, elongation, and tortuosity of the vertebrobasilar arteries. Current data regarding VBD are very limited. Here we systematically review VBD incidence, etiology, characteristics, clinical manifestations, treatment strategies, and prognosis. The exact incidence rate of VBD remains unclear, but is estimated to be 1.3% of the population. The occurrence of VBD is thought to be due to the cooperation of multiple factors, including congenital factors, infections and immune status, and degenerative diseases. The VBD clinical manifestations are complex with ischemic stroke as the most common, followed by progressive compression of cranial nerves and the brain stem, cerebral hemorrhage, and hydrocephalus. Treatment of VBD remains difficult. Currently, there are no precise and effective treatments, and available treatments mainly target the complications of VBD. With the development of stent technology, however, it may become an effective treatment for VBD. PMID:25136259

  1. Recent progress in planetary balloons

    NASA Astrophysics Data System (ADS)

    Kerzhanovich, Viktor V.; Cutts, James A.

    2001-08-01

    In the last 15 years several balloon mission cencepts have been proposed for Mars and Venus, one of them - Russian-French Mars Aerostat - was extensively developed in 1988-1995 but was terminated before completion. It became clear that a number of critical technologies still needed to be developed prior to committing a costly space mission. In recent years significant progress has been made in two critical fields: aerial deployment and inflation of thin-film balloons for specific planetary applications, and in the development of envelope design for stratospheric applications. This paper describes requirements, proposed concepts, critical elements and trade-offs in planetary balloon missions as well as current results of some of JPL balloon programs.

  2. International Study Group Progress Report

    SciTech Connect

    Raubenheimer, Tor O

    2000-07-18

    The focus of the ISG work was on advancing the accelerator design and supporting technologies. This is a complex process which involves a close interaction between theoretical analysis of the collider design and R and D progress on hardware components. The sequence of efforts took place roughly in the following order: (1) Optimization of the collider parameters and definition of system and subsystem requirements, (2) Identification of design strategies and options, and (3) Development of specific technologies to achieve these requirements. Development and testing of the required components, and R and D on manufacturing techniques have been important activities of the ISG. Experiments at the major test facilities such as the ATF at KEK and ASSET at SLAC have also played a significant role in the ISG studies.

  3. European Archaeomagnetism: Progress and Problems

    NASA Astrophysics Data System (ADS)

    Evans, M. E.; Hoye, G.

    2009-05-01

    Much progress has been made since the seminal work of Giuseppe Folgheraiter (1856-1913) in the late 19th century. So much so that recent advances now make it possible to draw up complete isogonic and isoclinic maps for Europe and adjacent areas spanning the last three millennia (Pavon-Carrasco et al., 2009). Results based on multiple independent studies, with high precision and good age control are crucial and should be recognized as "anchor points" (e.g. Pompeii). On the other hand, the nagging problem of outliers persists. Among the possible causes are magnetic refraction, physical distortion, and inadequate chronological control. Some examples, drawn from our own investigations over the last 30 years, will be discussed in detail. These include previously unpublished data from a detailed study (more than 100 samples) of a kiln in southern Italy, and an apparently good (but aberrant) archaeodirection from a kiln in southern Spain.

  4. Stepwise Progression of Embryonic Patterning.

    PubMed

    Sandler, Jeremy E; Stathopoulos, Angelike

    2016-07-01

    It is long established that the graded distribution of Dorsal transcription factor influences spatial domains of gene expression along the dorsoventral (DV) axis of Drosophila melanogaster embryos. However, the more recent realization that Dorsal levels also change with time raises the question of whether these dynamics are instructive. An overview of DV axis patterning is provided, focusing on new insights identified through quantitative analysis of temporal changes in Dorsal target gene expression from one nuclear cycle to the next ('steps'). Possible roles for the stepwise progression of this patterning program are discussed including (i) tight temporal regulation of signaling pathway activation, (ii) control of gene expression cohorts, and (iii) ensuring the irreversibility of the patterning and cell fate specification process. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Stepwise progression of embryonic patterning

    PubMed Central

    Sandler, Jeremy; Stathopoulos, Angelike

    2016-01-01

    It is long established that the graded distribution of Dorsal transcription factor influences spatial domains of gene expression along the dorsoventral axis of Drosophila melanogaster embryos. However, the more recent realization that Dorsal levels also change in time raises the question of whether these dynamics are instructive. Here, an overview of dorsoventral axis patterning is provided focusing on new insights identified through quantitative analysis of temporal changes in Dorsal target gene expression from one nuclear cycle to the next (‘steps’). Possible roles for the step-wise progression of this patterning program are discussed including (i) tight, temporal regulation of signaling pathway activation, (ii) control of gene expression cohorts, and (iii) to ensure irreversibility of the patterning and cell fate specification process. PMID:27230753

  6. EUV progress toward HVM readiness

    NASA Astrophysics Data System (ADS)

    Turkot, Britt; Carson, Steven L.; Lio, Anna; Liang, Ted; Phillips, Mark; McCool, Brian; Stenehjem, Eric; Crimmins, Tim; Zhang, Guojing; Sivakumar, Sam

    2016-03-01

    This past year has witnessed a sharp increase in EUV lithography progress spanning production tools, source and infrastructure to better position the technology for HVM readiness. While the exposure source remains the largest contributor to downtime and availability, significant strides in demonstrated source power have bolstered confidence in the viability of EUVL for insertion into HVM production. The ongoing development of an EUV pellicle solution alleviates industry concern about one significant source of line-yield risk. In addition to continued expected improvements in EUV source power and availability, the ability to deliver predictable yield remains an ultimate gate to HVM insertion. Ensuring predictable yield requires significant emphasis on reticles. This includes continued pellicle development to enable the readiness and supply of a robust pellicle solution in advance of 250W source power, as well as improvements in mask blank defectivity and techniques to detect and mitigate reticle blank and pattern defects.

  7. Environmental tester development. Progress report

    SciTech Connect

    Tressler, R.E.

    1998-08-01

    The primary objective is to further develop the environmental tensometer toward commercialization by making key technical refinements, improving the controlling and data-logging software, and testing the system in a potential customer`s laboratory. Progress has been made in Tasks 1 (completed), Task 2 (one half completed), Task 4 (one half completed) of the original work plan. In this report a detailed description of the work completed on the second prototype is explained in detail. A second prototype of the Environmental Tester, a device capable of tensile tests of fibers in controlled environments and at high temperatures, has been designed and is currently being fabricated. The first prototype includes six integrated systems; the testing system, the furnace system, the vacuum system, the mass flow control system, and the computer data acquisition and control (CDAC) system.

  8. Progress towards a dengue vaccine.

    PubMed

    Webster, Daniel P; Farrar, Jeremy; Rowland-Jones, Sarah

    2009-11-01

    The spread of dengue virus throughout the tropics represents a major, rapidly growing public health problem with an estimated 2.5 billion people at risk of dengue fever and the life-threatening disease, severe dengue. A safe and effective vaccine for dengue is urgently needed. The pathogenesis of severe dengue results from a complex interaction between the virus, the host, and, at least in part, immune-mediated mechanisms. Vaccine development has been slowed by fears that immunisation might predispose individuals to the severe form of dengue infection. A pipeline of candidate vaccines now exists, including live attenuated, inactivated, chimeric, DNA, and viral-vector vaccines, some of which are at the stage of clinical testing. In this Review, we present what is understood about dengue pathogenesis and its implications for vaccine design, the progress that is being made in the development of a vaccine, and the future challenges.

  9. Progress toward single cell metabolomics

    PubMed Central

    Rubakhin, Stanislav S.; Lanni, Eric J.; Sweedler, Jonathan V.

    2012-01-01

    The metabolome refers to the entire set of small molecules, or metabolites, within a biological sample. These molecules are involved in many fundamental intracellular functions and reflect the cell’s physiological condition. The ability to detect and identify metabolites and determine and monitor their amounts at the single cell level enables an exciting range of studies of biological variation and functional heterogeneity between cells, even within a presumably homogenous cell population. Significant progress has been made in the development and application of bioanalytical tools for single cell metabolomics based on mass spectrometry, microfluidics, and capillary separations. Remarkable improvements in the sensitivity, specificity, and throughput of these approaches enable investigation of multiple metabolites simultaneously in a range of individual cell samples. PMID:23246232

  10. Treatment of Primary Progressive Aphasia

    PubMed Central

    Tippett, Donna C.; Hillis, Argye E.; Tsapkini, Kyrana

    2015-01-01

    Primary progressive aphasia (PPA) is a neurodegenerative disease that primarily affects language functions and often begins in the fifth or sixth decade of life. The devastating effects on work and home life call for the investigation of treatment alternatives. In this paper, we present a review of the literature on treatment approaches for this neurodegenerative disease. We also present new data from two intervention studies we have conducted, a behavioral one and a neuromodulatory one using transcranial direct current stimulation (tDCS) combined with written production intervention. We show that speech-language intervention improves language outcomes in individuals with PPA; and especially in the short term, tDCS augments generalization and maintenance of positive language outcomes. We also outline current issues and challenges in intervention approaches in PPA. PMID:26062526

  11. Decomposable Mandrel Project. Progress report

    SciTech Connect

    Letts, S.A.; Fearon, E.; Allison, L.; Buckley, S.; Saculla, M.; Cook, R.

    1995-05-08

    We report on our progress in developing a new technology to produce both Nova and NIF scale capsules using a depolymerizable mandrel. In this technique we use poly({alpha}-methylstyrene) (PAMS) beads or shells as mandrels which are overcoated with plasma polymer. The poly({alpha}-methylstyrene) mandrel is then thermally depolymerized to gas phase monomer which diffuses away through the more thermally stable plasma polymer coating, leaving a hollow shell. Since our last report we have concentrated on characterization of the final shell. Starting with PAMS bead mandrels leads to distorted pyrolyzed shells because of thermally induced creep of the CH coating. We found that plasma polymer coatings on hollow shell mandrels shrink isotropically during pyrolysis and maintain sphericity. We are now concentrating our efforts on the use of microencapsulated shells to prepare targets with buried diagnostic layers or inner wall surface texture.

  12. PROGRESSIVE OSSIFYING FIBRODYSPLASIA: CASE REPORT

    PubMed Central

    Romani, Fabiana; de Menezes Karam, Simone

    2015-01-01

    Progressive ossifying fibrodysplasia is a rare genetic disease that affects one individual in every two million births. Its main consequence is heterotopic ossification, i.e. formation of additional bone in abnormal locations. It is an autosomal dominant disease, usually caused by a new mutation in the ACVR1 receptor gene, which is in the signaling pathway for bone morphogenic protein. This abnormality is not related to gender, ethnicity or consanguinity. The present study reports the case of A.C., a 17-year-old girl. Her clinical investigation began at the age of four years, but she was only diagnosed with FOP at the age of 15 years, after being evaluated by several specialists in different centers. The patient has two siblings, but her family history did not reveal any similar cases. PMID:27047836

  13. Probabilistic progressive buckling of trusses

    NASA Technical Reports Server (NTRS)

    Pai, Shantaram S.; Chamis, Christos C.

    1991-01-01

    A three-bay, space, cantilever truss is probabilistically evaluated to describe progressive buckling and truss collapse in view of the numerous uncertainties associated with the structural, material, and load variables (primitive variables) that describe the truss. Initially, the truss is deterministically analyzed for member forces, and member(s) in which the axial force exceeds the Euler buckling load are identified. These member(s) are then discretized with several intermediate nodes and a probabilistic buckling analysis is performed on the truss to obtain its probabilistic buckling loads and respective mode shapes. Furthermore, sensitivities associated with the uncertainties in the primitive variables are investigated, margin of safety values for the truss are determined, and truss end node displacements are noted. These steps are repeated by sequentially removing the buckled member(s) until onset of truss collapse is reached. Results show that this procedure yields an optimum truss configuration for a given loading and for a specified reliability.

  14. Probabilistic progressive buckling of trusses

    NASA Technical Reports Server (NTRS)

    Pai, Shantaram S.; Chamis, Christos C.

    1994-01-01

    A three-bay, space, cantilever truss is probabilistically evaluated to describe progressive buckling and truss collapse in view of the numerous uncertainties associated with the structural, material, and load variables that describe the truss. Initially, the truss is deterministically analyzed for member forces, and members in which the axial force exceeds the Euler buckling load are identified. These members are then discretized with several intermediate nodes, and a probabilistic buckling analysis is performed on the truss to obtain its probabilistic buckling loads and the respective mode shapes. Furthermore, sensitivities associated with the uncertainties in the primitive variables are investigated, margin of safety values for the truss are determined, and truss end node displacements are noted. These steps are repeated by sequentially removing buckled members until onset of truss collapse is reached. Results show that this procedure yields an optimum truss configuration for a given loading and for a specified reliability.

  15. [Progressive supranuclear palsy: what's new?].

    PubMed

    Levy, Richard

    2011-06-01

    Progressive supranuclear palsy (PSP) has been described as a clinical syndrome characterized by an impairment of voluntary control of gaze (supranuclear palsy), postural and gait instability, and behavioral and cognitive deficits including a frontal syndrome and psychic retardation. However, in the recent years, at least four other clinical forms of PSP have been recognized: PSP-Parkinsonism, "pure akinesia with gait freezing", PSP with cortico-basal syndrome, and PSP with speech apraxia. PSP-Parkinsonism mimics the signs and symptoms of idiopathic Parkinson's disease, including a significant reactivity to levodopa. "Pure akinesia with gait freezing" is characterized by a difficulty of self-initiation of motor programs, usually walking program. PSP with cortico-basal syndrome mimics cortico-basal degeneration (CBD) in that unilateral or asymmetric limb dystonia and apraxia are prominent signs. PSP with speech apraxia is an isolated syndrome of progressive anarthria. All these clinical syndromes are due to brain accumulation of phosphorylated tau protein. The differences in clinical expression within the framework of PSP can be explained by the differences in the topographical distribution of the lesions. PSP is considered as a primary tau disease ("tauopathy") such as CBD and some forms of fronto-temporal lobar degeneration. At the level of neuropathology, the pattern of tau abnormal inclusions differentiates PSP from other tau diseases, but some overlaps are reported. Moreover, several of the clinical forms of PSP partially or fully overlap with the other tauopathies. As a whole, the emergence of new clinical forms of PSP challenges the nosology of tauopathies and our understanding of these diseases.

  16. Progress towards diesel combustion modeling

    SciTech Connect

    Rutland, C.J.; Ayoub, N.; Han, Z.

    1995-12-31

    Progress on the development and validation of a CFD model for diesel engine combustion and flow is described. A modified version of the KIVA code is used for the computations, with improved submodels for liquid breakup, drop distortion and drag, spray/wall impingement with rebounding, sliding and breaking-up drops, wall heat transfer with unsteadiness and compressibility, multistep kinetics ignition and laminar-turbulent characteristic time combustion models, Zeldovich NOx formation, and soot formation with Nagle Strickland-Constable oxidation. The code also considers piston-cylinder-liner crevice flows and allows computations of the intake flow process in the realistic engine geometry with two moving intake valves. Significant progress has been made using a modified RNG {kappa}-{var_epsilon} turbulence model, and a multicomponent fuel vaporization model and a flamelet combustion model have been implemented. Model validation experiments have been performed using a single-cylinder heavy duty truck engine that features state-of-the-art high pressure electronic fuel injection and emissions instrumentation. In addition to cylinder pressure, heat release, and emissions measurements, new combustion visualization experiments have also been performed using an endoscope system that takes the place of one of the exhaust valves. Modifications to the engine geometry for optical access were minimal, thus ensuring that the results represent the actual engine. The intake flow CFD modeling results show that the details of the intake flow process influence the engine performance. Comparisons with the measured engine cylinder pressure, heat release, soot and NOx emission data, and the combustion visualization flame images show that the CFD model results are generally in good agreement with the experiments. In particular, the model is able to correctly predict the soot-NOx trade-off trend as a function of injection timing. 44 refs., 21 figs., 6 tabs.

  17. Genetics of Progressive Supranuclear Palsy.

    PubMed

    Im, Sun Young; Kim, Young Eun; Kim, Yun Joong

    2015-09-01

    Progressive supranuclear palsy (PSP) is a neurodegenerative syndrome that is clinically characterized by progressive postural instability, supranuclear gaze palsy, parkinsonism and cognitive decline. Pathologically, diagnosis of PSP is based on characteristic features, such as neurofibrillary tangles, neutrophil threads, tau-positive astrocytes and their processes in basal ganglia and brainstem, and the accumulation of 4 repeat tau protein. PSP is generally recognized as a sporadic disorder; however, understanding of genetic background of PSP has been expanding rapidly. Here we review relevant publications to outline the genetics of PSP. Although only small number of familial PSP cases have been reported, the recognition of familial PSP has been increasing. In some familial cases of clinically probable PSP, PSP pathologies were confirmed based on NINDS neuropathological diagnostic criteria. Several mutations in MAPT, the gene that causes a form of familial frontotemporal lobar degeneration with tauopathy, have been identified in both sporadic and familial PSP cases. The H1 haplotype of MAPT is a risk haplotype for PSP, and within H1, a sub-haplotype (H1c) is associated with PSP. A recent genome-wide association study on autopsyproven PSP revealed additional PSP risk alleles in STX6 and EIF2AK3. Several heredodegenerative parkinsonian disorders are referred to as PSP-look-alikes because their clinical phenotype, but not their pathology, mimics PSP. Due to the fast development of genomics and bioinformatics, more genetic factors related to PSP are expected to be discovered. Undoubtedly, these studies will provide a better understanding of the pathogenesis of PSP and clues for developing therapeutic strategies.

  18. World progress toward fusion energy

    NASA Astrophysics Data System (ADS)

    Clarke, J. F.

    1989-09-01

    This paper will describe the progress in fusion science and technology from a world perspective. The paper will cover the current technical status, including the understanding of fusion's economic, environmental, and safety characteristics. Fusion experiments are approaching the energy breakeven condition. An energy gain (Q) of 30 percent has been achieved in magnetic confinement experiments. In addition, temperatures required for an ignited plasma (Ti = 32 KeV) and energy confinements (about 75 percent of that required for ignition) have been achieved in separate experiments. Two major facilities have started the experimental campaign to extend these results and achieve or exceed Q = 1 plasma conditions by 1990. Inertial confinement fusion experiments are also approaching thermonuclear conditions and have achieved a compression factor 100-200 times liquid D-T. Because of this progress, the emphasis in fusion research is turning toward questions of engineering feasibility. Leaders of the major fusion R and D programs in the European Community (EC), Japan, the United States, and the U.S.S.R. have agreed on the major steps that are needed to reach the point at which a practical fusion system can be designed. The United States is preparing for an experiment to address the last unexplored scientific issue, the physics of an ignited plasma, during the late 1990's. The EC, Japan, U.S.S.R., and the United States have joined together under the auspices of the International Atomic Energy Agency (IAEA) to jointly design and prepare the validating R&D for an international facility, the International Thermonuclear Experimental Reactor (ITER), to address all the remaining scientific issues and to explore the engineering technology of fusion around the turn of the century.

  19. Genetics of Progressive Supranuclear Palsy

    PubMed Central

    Im, Sun Young; Kim, Young Eun; Kim, Yun Joong

    2015-01-01

    Progressive supranuclear palsy (PSP) is a neurodegenerative syndrome that is clinically characterized by progressive postural instability, supranuclear gaze palsy, parkinsonism and cognitive decline. Pathologically, diagnosis of PSP is based on characteristic features, such as neurofibrillary tangles, neutrophil threads, tau-positive astrocytes and their processes in basal ganglia and brainstem, and the accumulation of 4 repeat tau protein. PSP is generally recognized as a sporadic disorder; however, understanding of genetic background of PSP has been expanding rapidly. Here we review relevant publications to outline the genetics of PSP. Although only small number of familial PSP cases have been reported, the recognition of familial PSP has been increasing. In some familial cases of clinically probable PSP, PSP pathologies were confirmed based on NINDS neuropathological diagnostic criteria. Several mutations in MAPT, the gene that causes a form of familial frontotemporal lobar degeneration with tauopathy, have been identified in both sporadic and familial PSP cases. The H1 haplotype of MAPT is a risk haplotype for PSP, and within H1, a sub-haplotype (H1c) is associated with PSP. A recent genome-wide association study on autopsyproven PSP revealed additional PSP risk alleles in STX6 and EIF2AK3. Several heredodegenerative parkinsonian disorders are referred to as PSP-look-alikes because their clinical phenotype, but not their pathology, mimics PSP. Due to the fast development of genomics and bioinformatics, more genetic factors related to PSP are expected to be discovered. Undoubtedly, these studies will provide a better understanding of the pathogenesis of PSP and clues for developing therapeutic strategies. PMID:26413239

  20. Patterns of progression, treatment of progressive disease and post-progression survival in the New EPOC study

    PubMed Central

    Pugh, Siân A; Bowers, Megan; Ball, Alexandre; Falk, Stephen; Finch-Jones, Meg; Valle, Juan W; O'Reilly, Derek A; Siriwardena, Ajith K; Hornbuckle, Joanne; Rees, Myrddin; Rees, Charlotte; Iveson, Tim; Hickish, Tamas; Maishman, Tom; Stanton, Louise; Dixon, Elizabeth; Corkhill, Andrea; Radford, Mike; Garden, O James; Cunningham, David; Maughan, Tim S; Bridgewater, John A; Primrose, John N

    2016-01-01

    Background: The addition of cetuximab (CTX) to perioperative chemotherapy (CT) for operable colorectal liver metastases resulted in a shorter progression-free survival. Details of disease progression are described to further inform the primary study outcome. Methods: A total of 257 KRAS wild-type patients were randomised to CT alone or CT with CTX. Data regarding sites and treatment of progressive disease were obtained for the 109 (CT n=48, CT and CTX n=61) patients with progressive disease at the cut-off date for analysis of November 2012. Results: The liver was the most frequent site of progression (CT 67% (32/48); CT and CTX 66% (40/61)). A higher proportion of patients in the CT and group had multiple sites of progressive disease (CT 8%, 4/48; CT and CTX 23%, 14/61 P=0.04). Further treatment for progressive disease is known for 84 patients of whom 69 received further CT, most frequently irinotecan based. Twenty-two patients, 11 in each arm, received CTX as a further line agent. Conclusions: Both the distribution of progressive disease and further treatment are as expected for such a cohort. The pattern of disease progression seen is consistent with failure of systemic micrometastatic disease control rather than failure of local disease control following liver surgery. PMID:27434036