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Sample records for unilateral zmc fractures

  1. Three-Dimensional Analysis of Zygomatic-Maxillary Complex Fracture Patterns

    PubMed Central

    Pau, Candace Y.; Barrera, Jose E.; Kwon, Jaehwan; Most, Sam P.

    2010-01-01

    Zygomatic-maxillary (ZMC) complex fractures are a common consequence of facial trauma. In this retrospective study, we present a novel method of ZMC fracture pattern analysis, utilizing three-dimensional visualization of computed tomography (CT) images to record displacement of the malar eminence in a three-dimensional coordinate plane. The pattern of fracture was then correlated with treatment outcome. Facial CT scans were obtained from 29 patients with unilateral ZMC fractures and 30 subjects without fractures and analyzed. Briefly, displacement of the malar eminence (ME) on the fractured side was measured in medial-lateral (x), superior-inferior (y), and anterior-posterior (z) dimensions, as well as Euclidean distance, by comparison to ME location on the unfractured side. Baseline natural variance in asymmetry was accounted for by comparing ME location on the left and right sides in subjects without fractures. Patients who required open reduction and internal fixation (ORIF) to repair the ZMC fracture alone had significantly greater cumulative ME displacements than patients who did not require ORIF (p = 0.02). Additionally, patients with a high fracture score of 3, 4, or 5 (assigned based on severity displacement in each dimension) had significantly higher rates of ORIF than patients with a low fracture score of 0, 1, or 2 (p = 0.05). Severe displacement in one or more dimensions was associated with higher rates of ORIF than seen in patients with only neutral or mild displacements in all dimensions (p = 0.05). Severe x displacement was most strongly correlated with surgical intervention (p = 0.02). Overall, orbital floor repair was less strongly associated with most displacement measures than ZMC repair alone; however, patients requiring orbital floor repair had greater Euclidean ME displacements than patients who did not require orbital floor repair (p = 0.02). Fracture severity, as determined by multiple parameters in this novel evaluation

  2. Unilateral Mydriasis After Mandibular Fracture Fixation Surgery

    PubMed Central

    Nesioonpour, Sholeh; Khiabani, Kazem; Hassanijirdehi, Marzieh

    2014-01-01

    Introduction: Unilateral mydriasis is a seriously significant finding in neurologic examinations indicating life-threatening conditions such as cerebral vascular injuries. Case Presentation: A 24 year old woman with mandibular trauma was referred to our center after five days for a reduction of the right mandibular angle fracture. The patient had no history of any loss of consciousness after the accident. Her physical examination showed no abnormalities, except those related to her mandibular fracture. The laboratory results were normal as well. At 8:30 am a general anesthesia was induced. The patient’s eyes were kept shut throughout the surgical procedure. The operation included an intraoral open reduction and fixation using two miniplates without any complications. After the operation, it was noticed that the left eye was completely dilated with no reaction to light, while the right eye was normal. The management and outcomes in this patient were described in the present case report. Conclusions: Evaluating the size of the patient’s pupils before, during and after the operation, careful history, consult, CT scan and MRI would help to diagnosis. Although no probable cause was found to explain the transient mydriasis in our patient. PMID:24829881

  3. Unilateral Adolescent Pes Planus After a Bimalleolar Ankle Fracture: A Case Report.

    PubMed

    Phillips, Staton L; Williams, Daniel; Jeyaseelan, Luckshmana; Bryce, Elaine; Alyas, Faisal; Vemulapalli, Krishna

    2016-01-01

    We present the case of a 14-year-old female who presented with unilateral pes planus 30 months after a bimalleolar ankle fracture dislocation. At surgery, the tibialis posterior tendon was encased in fracture callus within the syndesmosis and required reconstruction using flexor digitorum longus transfer. Dislocation of the tibialis posterior tendon and entrapment within the tibiofibular syndesmosis has been previously reported. To our knowledge, this is the first case report tibialis posterior tendon syndesmotic entrapment presenting with unilateral pes planus. PMID:25648274

  4. Unilateral versus bilateral balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures.

    PubMed

    Chen, Hua; Tang, Peifu; Zhao, Yanpeng; Gao, Yuan; Wang, Yan

    2014-09-01

    Bilateral and unilateral approaches are the main methods for balloon kyphoplasty. However, controversy exists about which leads to superior outcomes. The goal of this study was to compare the clinical effects and safety of unilateral vs bilateral balloon kyphoplasty for osteoporotic vertebral compression fractures. Five databases (PubMed, Cochrane Library, EMBASE, Web of Science, and Chinese Biomedical Database) were searched without language, publication, or date restrictions. Randomized controlled trials involving a total of 876 patients and comparing the efficacy of unilateral vs bilateral balloon kyphoplasty for osteoporotic vertebral compression fractures were identified. Meta-analysis revealed no significant differences in visual analog scale pain score up to 2-year follow-up (mean difference at 1 week, 0.17 [95% confidence interval (CI), -0.11 to 0.44]; mean difference at 1 year, 0.01 [95% CI, -0.29 to 0.32]; mean difference at 2 years, 0.28 [95% CI, -0.13 to 0.70]), Oswestry Disability Index pain score up to 1-year follow-up (mean difference at 1 week, 1.28 [95% CI, -2.62 to 5.17]; mean difference at 1 year, 1.87 (95% CI, -5.33 to 9.06]), anterior and middle vertebral height (mean difference anterior, -0.13 [95% CI, -0.32 to 0.06]; mean difference middle, -0.16 [95% CI, -0.36 to 0.03]), or kyphotic angle (mean difference, -0.02 [95% CI, -0.65 to 0.61]); however, the unilateral approach resulted in a shorter operative time (mean difference, -19.33 [95% CI, -4.42 to -14.24]), smaller amount of cement injected (mean difference, -2.07 [95% CI, -2.42 to -1.71]), and lower risk of cement leakage (mean difference, 0.47 [95% CI, 0.24-0.92]) than the bilateral approach. The unilateral approach resulted in pain relief and vertebral height and kyphotic angle restoration comparable with that of bilateral kyphoplasty. The unilateral approach should be considered an effective option for the treatment of osteoporotic vertebral compression fractures. PMID:25350627

  5. Unilateral versus bilateral balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures.

    PubMed

    Chen, Hua; Tang, Peifu; Zhao, Yanpeng; Gao, Yuan; Wang, Yan

    2014-09-01

    Bilateral and unilateral approaches are the main methods for balloon kyphoplasty. However, controversy exists about which leads to superior outcomes. The goal of this study was to compare the clinical effects and safety of unilateral vs bilateral balloon kyphoplasty for osteoporotic vertebral compression fractures. Five databases (PubMed, Cochrane Library, EMBASE, Web of Science, and Chinese Biomedical Database) were searched without language, publication, or date restrictions. Randomized controlled trials involving a total of 876 patients and comparing the efficacy of unilateral vs bilateral balloon kyphoplasty for osteoporotic vertebral compression fractures were identified. Meta-analysis revealed no significant differences in visual analog scale pain score up to 2-year follow-up (mean difference at 1 week, 0.17 [95% confidence interval (CI), -0.11 to 0.44]; mean difference at 1 year, 0.01 [95% CI, -0.29 to 0.32]; mean difference at 2 years, 0.28 [95% CI, -0.13 to 0.70]), Oswestry Disability Index pain score up to 1-year follow-up (mean difference at 1 week, 1.28 [95% CI, -2.62 to 5.17]; mean difference at 1 year, 1.87 (95% CI, -5.33 to 9.06]), anterior and middle vertebral height (mean difference anterior, -0.13 [95% CI, -0.32 to 0.06]; mean difference middle, -0.16 [95% CI, -0.36 to 0.03]), or kyphotic angle (mean difference, -0.02 [95% CI, -0.65 to 0.61]); however, the unilateral approach resulted in a shorter operative time (mean difference, -19.33 [95% CI, -4.42 to -14.24]), smaller amount of cement injected (mean difference, -2.07 [95% CI, -2.42 to -1.71]), and lower risk of cement leakage (mean difference, 0.47 [95% CI, 0.24-0.92]) than the bilateral approach. The unilateral approach resulted in pain relief and vertebral height and kyphotic angle restoration comparable with that of bilateral kyphoplasty. The unilateral approach should be considered an effective option for the treatment of osteoporotic vertebral compression fractures.

  6. The biomechanical advantages of bilateral lumbo-iliac fixation in unilateral comminuted sacral fractures without sacroiliac screw safe channel

    PubMed Central

    Song, Wenhao; Zhou, Dongsheng; He, Yu

    2016-01-01

    Abstract Background: The aim of this study was to compare the biomechanical characteristics between bilateral and unilateral lumbo-iliac fixation in unilateral comminuted sacral fractures (USF) by finite element analysis. Methods: A 3-dimensional finite element model of unilateral sacral fractures was simulated. Three kinds of implants were instrumented into the model, including the unilateral lumbopelvic fixation (ULF), bilateral lumbopelvic fixation (BLF), and unilateral iliac fixation with bilateral lumbar pedicle screws (UBF). Loads of compression and rotation were distributed to the superior endplate of L3. To evaluate the biomechanical properties, the construct stiffness, the micromotion of the fractures, the stress distribution of implants, and the balance of hemilumbar vertebra are recorded and analyzed. Results: The highest construct stiffness was provided by BLF. In BLF model, the displacement between iliums was only 0.009 mm (compressional) and 0.001 mm (rotational), which was less than that under normal condition (0.02 mm). The maximum von Misses stress of implants appeared on the UBF. By using unilateral fixation, the L4 endured obvious imbalance on bilateral hemivertebra. A marked difference was exposed in BLF and UBF models, and the equilibrium of stress and activity was shown. Conclusion: From the finite element view, the stability of ULF is insufficient to reconstruct the posterior pelvic ring. Furthermore, the unilateral fixation may lead to imbalance of lumbar vertebra and pelvis. On the contrary, the BLF can provide satisfied stability and lumbar balance. PMID:27749563

  7. Unilateral versus bilateral percutaneous kyphoplasty for osteoporotic vertebral compression fractures: A systematic review and meta-analysis of RCTs.

    PubMed

    Feng, Hui; Huang, Peng; Zhang, Xuesong; Zheng, Guoquan; Wang, Yan

    2015-11-01

    The purpose of this research was to compare the efficacy and safety of unilateral versus bilateral PKP for osteoporotic vertebral compression fractures (OVCFs). Six databases (Cochrane, PubMed, MEDLINE, EMBASE, SinoMed, and CNKI) were searched without language restrictions. Twelve randomized controlled trials involving a total of 1,030 patients were identified. The results indicate that unilateral PKP had a better degree of pain relief (visual analog scale) than bilateral PKP (p = 0.04; 95%CI = -0.36 to -0.00) with short-term follow-up (within 4 weeks) after operation. The radiological outcome assessment with short-term follow-up after operation indicates bilateral PKP had a better degree of anterior vertebral height restoration (p = 0.03; 95%CI = -2.58 to -0.14). Operation time and cement dosage were less for unilateral PKP (p < 0.05). There were no differences in complications such as cement leakage and adjacent vertebral fractures between two approaches (p = 0.06 and p = 0.97, respectively). Life quality assessment (SF-36) indicates unilateral PKP had a better result of bodily pain relief (p < 0.05; 95%CI = 3.93 to 7.48) and general health benefit (p < 0.05; 95%CI = 0.02 to 2.93) with short-term follow-up after operation. We suggest that a unilateral PKP is advantageous. PMID:26123667

  8. Unilateral versus bilateral percutaneous kyphoplasty for osteoporotic vertebral compression fractures: A systematic review and meta-analysis of RCTs.

    PubMed

    Feng, Hui; Huang, Peng; Zhang, Xuesong; Zheng, Guoquan; Wang, Yan

    2015-11-01

    The purpose of this research was to compare the efficacy and safety of unilateral versus bilateral PKP for osteoporotic vertebral compression fractures (OVCFs). Six databases (Cochrane, PubMed, MEDLINE, EMBASE, SinoMed, and CNKI) were searched without language restrictions. Twelve randomized controlled trials involving a total of 1,030 patients were identified. The results indicate that unilateral PKP had a better degree of pain relief (visual analog scale) than bilateral PKP (p = 0.04; 95%CI = -0.36 to -0.00) with short-term follow-up (within 4 weeks) after operation. The radiological outcome assessment with short-term follow-up after operation indicates bilateral PKP had a better degree of anterior vertebral height restoration (p = 0.03; 95%CI = -2.58 to -0.14). Operation time and cement dosage were less for unilateral PKP (p < 0.05). There were no differences in complications such as cement leakage and adjacent vertebral fractures between two approaches (p = 0.06 and p = 0.97, respectively). Life quality assessment (SF-36) indicates unilateral PKP had a better result of bodily pain relief (p < 0.05; 95%CI = 3.93 to 7.48) and general health benefit (p < 0.05; 95%CI = 0.02 to 2.93) with short-term follow-up after operation. We suggest that a unilateral PKP is advantageous.

  9. Monte Carlo Modeling of Diffuse Scattering from Single Crystals: The Program ZMC

    SciTech Connect

    Goossens, D.J.; Heerdegen, A.P.; Chan, E.J.; Welberry, T.R.

    2012-04-30

    Diffuse scattering probes the local ordering in a crystal, whereas Bragg peaks are descriptive of the average long-range ordering. The population of local configurations can be explored by modeling the three-dimensional distribution of diffuse scattering. Local configurations are not constrained by the average crystallographic symmetry, so one way of modeling diffuse scattering is by modeling a disordered (short-range-ordered) structure and then calculating its diffuse scattering. The structure must contain enough unit cells to give a statistically valid model of the populations of local configurations, and so requirements for a program to model this ordering are very different from programs that model average crystal structures (used to fit the Bragg diffraction). ZMC is a program that has been developed to model diffuse scattering, particularly from molecular crystals. The strategies used to tackle the problem and the way in which they are implemented will be discussed.

  10. Evaluation of the Mandibular Function, after Nonsurgical Treatment of Unilateral Subcondylar Fracture: A 1-Year Follow-Up Study.

    PubMed

    K M, Sudheesh; Desai, Rajendra; K Sn, Siva Bharani; S, Subhalakshmi

    2016-09-01

    There are no clearly defined guidelines for when an open or closed treatment is indicated for treatment of mandibular condylar fractures. The aim of the study is to analyze the mandibular function after nonsurgical treatment of unilateral subcondylar fractures, in a prospective study. A prospective study was conducted on 30 patients with unilateral mandibular subcondylar fracture undergoing nonsurgical treatment. Clinical and radiographic examinations were done prior to treatment and at 12-month follow-up. Pain, perceived occlusion, mouth opening, protrusion, and horizontal movements of the mandible were evaluated by clinical examination. Radiologic evaluation was done using Panoramic and Reverse Towne's radiographs. At 12-month follow-up, there was minimal pain in the temporomandibular joint region, there was an improvement in the perceived occlusion, and mouth opening did not reduce. There was insignificant absolute difference between left and right lateral mandibular movements. The amount of increase in the protrusion of mandible was insignificant. On radiographic evaluation, the degree of coronal and sagittal displacement was insignificant at follow-up. Mean ramus height pretreatment and 12 months posttreatment were 0.98 ± 0.50 and 0.87 ± 0.47, respectively. Based on this study, patients had adequate mandibular function and minimal pain after nonsurgical treatment. Unilateral subcondylar fractures of the mandible can be treated nonsurgically in patients with minimal occlusal discrepancies, adequate mouth opening, minimal displacement of condyle, and minimal ramus height shortening. PMID:27516838

  11. Conservative Approach to Unilateral Condylar Fracture in a Growing Patient: A 2.5-Year Follow Up

    PubMed Central

    Tuna, Elif Bahar; Dündar, Aysun; Çankaya, Abdülkadir Burak; Gençay, Koray

    2012-01-01

    Condylar fractures in children are especially important because of the risk of a mandibular growth-center being affected in the condylar head, which can lead to growth retardation and facial asymmetry. The purpose of this article is to follow up the two and half year clinical and radiological evaluation of the conservative treatment of a 10 year-old patient, who had a unilateral green-stick type fracture. The patient presented with painful facial swelling localized over the left condylar region, limited mouth-opening and mandibular deviation to the left. Panoramic radiography and computed tomography confirmed the diagnosis of incomplete fracture on the left condyle with one side of the bone fractured and the other bent. Closed reduction was chosen to allow for initial fibrous union of the fracture segments and remodeling with a normal functional stimulus. A non-rigid mandibular splint was applied in order to remove the direct pressure on the fracture side of the mandible. Clinical and radiologic examination after 30 months revealed uneventful healing with reduction of the condylar head and remodeling of the condylar process following conservative treatment. PMID:22276078

  12. Synthetic Metallochaperone ZMC1 Rescues Mutant p53 Conformation by Transporting Zinc into Cells as an Ionophore

    PubMed Central

    Blanden, Adam R.; Yu, Xin; Wolfe, Aaron J.; Gilleran, John A.; Augeri, David J.; O’Dell, Ryan S.; Olson, Eric C.; Kimball, S. David; Emge, Thomas J.; Movileanu, Liviu; Carpizo, Darren R.

    2015-01-01

    p53 is a Zn2+-dependent tumor suppressor inactivated in >50% of human cancers. The most common mutation, R175H, inactivates p53 by reducing its affinity for the essential zinc ion, leaving the mutant protein unable to bind the metal in the low [Zn2+]free environment of the cell. The exploratory cancer drug zinc metallochaperone-1 (ZMC1) was previously demonstrated to reactivate this and other Zn2+-binding mutants by binding Zn2+ and buffering it to a level such that Zn2+ can repopulate the defective binding site, but how it accomplishes this in the context of living cells and organisms is unclear. In this study, we demonstrated that ZMC1 increases intracellular [Zn2+]free by functioning as a Zn2+ ionophore, binding Zn2+ in the extracellular environment, diffusing across the plasma membrane, and releasing it intracellularly. It raises intracellular [Zn2+]free in cancer (TOV112D) and noncancer human embryonic kidney cell line 293 to 15.8 and 18.1 nM, respectively, with half-times of 2–3 minutes. These [Zn2+]free levels are predicted to result in ∼90% saturation of p53-R175H, thus accounting for its observed reactivation. This mechanism is supported by the X-ray crystal structure of the [Zn(ZMC1)2] complex, which demonstrates structural and chemical features consistent with those of known metal ionophores. These findings provide a physical mechanism linking zinc metallochaperone-1 in both in vitro and in vivo activities and define the remaining critical parameter necessary for developing synthetic metallochaperones for clinical use. PMID:25710967

  13. Unilateral posterior vertebral column resection for severe thoracolumbar kyphotic deformity caused by old compressive vertebrae fracture: a technical improvement.

    PubMed

    Wang, Hui; Zhang, Di; Sun, Ya-Peng; Ma, Lei; Ding, Wen-Yuan; Shen, Yong; Zhang, Ying-Ze

    2015-01-01

    Severe thoracolumbar kyphotic deformity caused by old compressive vertebrae fracture remains a big challenge for spine surgeons. When symptoms related to significant deformities cannot be adequately managed conservatively, posterior vertebral column resection (PVCR) is required, but with long operating time and severe blood loss. We develop a UPVCR technique, which is done through a unilateral approach instead of a bilateral approach, vertebral body resection advancing to cross the midline in an abrasive way from an extreme oblique orientation enable the resection of most contralateral vertebral body. In the present study, the effects of UPVCR for severe thoracolumbar kyphotic deformity were investigated. We did find that satisfactory correction of sagittal deformity, functional improvement and pain relief can be achieved by UPVCR, and it has the advantage of shortening surgery time, reducing blood loss and incidence of nerve root impingement over PVCR.

  14. Multiple Cerebral Infarctions due to Unilateral Traumatic Vertebral Artery Dissection after Cervical Fractures

    PubMed Central

    Yoon, Sang-Youl; Hwang, Jeong-Hyun; Hwang, Sung-Kyoo

    2016-01-01

    We report a case of multiple symptomatic cerebral infarctions from a traumatic vertebral artery dissection (VAD) after cervical fractures. A 73-year-old man was admitted with stuporous mentality and left hemiparesis after a motor-vehicle accident. A brain computed tomography (CT) scan at admission showed a traumatic subarachnoid hemorrhage on the left parietal lobe. A cervical CT scan showed left lateral mass fractures on C2, C5, and C6, involving the transverse foramen. Cervical spine magnetic resonance imaging (MRI) revealed loss of signal void on the left vertebral artery. Neck CT angiography showed left VAD starting at the C5 level. Brain MRI revealed acute, multiple cerebral infarctions involving the pons, midbrain, thalamus, corpus callosum, and parietal and frontal lobes on diffusion weighted images. The patient was treated conservatively at the intensive care unit in the acute stage to prevent extent of stroke. Aspirin was started for antiplatelet therapy in the chronic stage. The possibility of symptomatic cerebral infarctions due to traumatic VAD following cervical fracture should be considered. PMID:27182500

  15. Multiple Cerebral Infarctions due to Unilateral Traumatic Vertebral Artery Dissection after Cervical Fractures.

    PubMed

    Yoon, Sang-Youl; Park, Seong-Hyun; Hwang, Jeong-Hyun; Hwang, Sung-Kyoo

    2016-04-01

    We report a case of multiple symptomatic cerebral infarctions from a traumatic vertebral artery dissection (VAD) after cervical fractures. A 73-year-old man was admitted with stuporous mentality and left hemiparesis after a motor-vehicle accident. A brain computed tomography (CT) scan at admission showed a traumatic subarachnoid hemorrhage on the left parietal lobe. A cervical CT scan showed left lateral mass fractures on C2, C5, and C6, involving the transverse foramen. Cervical spine magnetic resonance imaging (MRI) revealed loss of signal void on the left vertebral artery. Neck CT angiography showed left VAD starting at the C5 level. Brain MRI revealed acute, multiple cerebral infarctions involving the pons, midbrain, thalamus, corpus callosum, and parietal and frontal lobes on diffusion weighted images. The patient was treated conservatively at the intensive care unit in the acute stage to prevent extent of stroke. Aspirin was started for antiplatelet therapy in the chronic stage. The possibility of symptomatic cerebral infarctions due to traumatic VAD following cervical fracture should be considered. PMID:27182500

  16. Monocular blindness developing 7 days after repair of zygomaticomaxillary complex fracture. A clinical report.

    PubMed

    Buckley, S B; McAnear, J T; Dolwick, M F; Aragon, S B

    1985-07-01

    Blindness following zygomaticomaxillary complex (ZMC) fracture and surgical repair is an unfortunate and uncommon complication. A review of the literature reveals fewer than 25 cases of monocular blindness resulting from zygomaticomaxillary fracture or repair. The case presented here is that of a man who was assaulted with a baseball bat and suffered a mildly displaced ZMC fracture. On admission, the patient had light perception only in his left eye. During his convalescence, vision in his left eye gradually improved to the point of allowing him to read a newspaper without difficulty. Then, 9 days after the injury (7 days after surgical repair), the patient awoke with complete blindness of the left eye. The possible mechanisms for such loss of vision are discussed.

  17. Unilateral perseveration.

    PubMed

    Acosta, Lealani Mae Y; Goodman, Ira J; Heilman, Kenneth M

    2013-12-01

    The brain's action-intentional ("when") programming system helps to control when to and when not to initiate an action, when to persist at an action, and when to terminate an action. Motor perseveration is a failure to terminate an action. This disengagement disorder most often results from dysfunction of the executive frontal-subcortical networks that control the action-intentional programming system. Reports of unilateral perseveration are unusual. Here we describe a patient with a form of progressive supranuclear palsy (PSP) who exhibited continuous right-hand motor perseveration. This 68-year-old right-handed man had impaired walking and vertical gaze, consistent with PSP. He often repeated words, and on many motor tasks he showed continuous perseveration of his right but not his left hand. Unilateral motor perseveration may be a sign of PSP, the corticobasal syndrome, or a subtype of these disorders. Future studies of patients with both disorders should use tasks that assess for asymmetric hand perseveration. The mechanism of the unilateral perseveration must also be determined. Bilateral perseveration is found most often in patients with unilateral right frontal-subcortical (basal ganglia) or insula dysfunction. Because patients with PSP or corticobasal syndrome have callosal degeneration, their unilateral perseveration might result from a callosal disconnection of the right frontal lobe from the left hemisphere's premotor and motor as well as speech areas. PMID:24366105

  18. Fractures

    PubMed Central

    Hall, Michael C.

    1963-01-01

    Recent studies on the epidemiology and repair of fractures are reviewed. The type and severity of the fracture bears a relation to the age, sex and occupation of the patient. Bone tissue after fracture shows a process of inflammation and repair common to all members of the connective tissue family, but it repairs with specific tissue. Cartilage forms when the oxygen supply is outgrown. After a fracture, the vascular bed enlarges. The major blood supply to healing tissue is from medullary vessels and destruction of them will cause necrosis of the inner two-thirds of the cortex. Callus rapidly mineralizes, but full mineralization is achieved slowly; increased mineral metabolism lasts several years after fracture. PMID:13952119

  19. Fractures

    MedlinePlus

    ... commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the ...

  20. Heritable unilateral clinical anophthalmia.

    PubMed

    Griepentrog, Gregory J; Lucarelli, Mark J

    2004-03-01

    We examined a newborn child with unilateral right-sided clinical anophthalmos born to a mother with unilateral left-sided anophthalmos. Although rare, isolated nonsyndromic heritable unilateral anophthalmia and microphthalmia have been reported in the literature. We briefly review the genetics of such anomalies and discuss the importance of a full clinical genetics evaluation. Treatment of this patient's anophthalmic socket consists of progressive conformer expansion to be followed by placement of a self-inflating polymer expander.

  1. Isolated bilateral fractures of zygomatic arches: report of a case.

    PubMed

    Ho, V

    1994-12-01

    Isolated unilateral fractures of the zygomatic arch are uncommon. Isolated bilateral fractures of the zygomatic arches are even more rare. Indeed a search of the literature failed to find any previous report of this fracture pattern.

  2. Active unilateral condylar hyperplasia.

    PubMed

    Luz, J G; de Rezende, J R; de Araújo, V C; Chilvarquer, I

    1994-01-01

    Two cases of active unilateral condylar hyperplasia which were treated with condylectomy alone are presented. The first case was an adult form and the other a juvenile form. Both were classified as active by using 99Tc bone scintigraphy. Clinical and radiographic features of both cases conformed to the hemimandibular hypertrophy type. Satisfactory facial symmetry and dental occlusion were achieved. Histopathological data confirmed the activity of the articular cartilage layers. PMID:8181091

  3. Transient ipsilateral mydriasis during correction of left blowout fracture.

    PubMed

    Lee, Ju-Min; Kim, Cheul-Hong; Kim, Uk-Kyu; Chung, In-Kyo

    2014-03-01

    Mydriasis, either bilateral or unilateral, seldom occurs during reconstruction of periorbital fracture. Anisocoria, a unilateral mydriasis, requires more urgent assessment than bilateral mydriasis does. Pharmacologic agents, local anesthetic infiltration, as well as direct or indirect oculomotor nerve damage are possible causes of unilateral mydriasis. Few cases have been reported about intraoperative temporary ipsilateral mydriasis during correction of blowout fracture. We have experienced an unusual case of anisocoria and report the case with literature reviews.

  4. Isolated unilateral rupture of the alar ligament.

    PubMed

    Wong, Sui-To; Ernest, Kimberly; Fan, Grace; Zovickian, John; Pang, Dachling

    2014-05-01

    Only 6 cases of isolated unilateral rupture of the alar ligament have been previously reported. The authors report a new case and review the literature, morbid anatomy, and pathogenesis of this rare injury. The patient in their case, a 9-year-old girl, fell head first from a height of 5 feet off the ground. She presented with neck pain, a leftward head tilt, and severe limitation of right rotation, extension, and right lateral flexion of the neck. Plain radiographs and CT revealed no fracture but a shift of the dens toward the right lateral mass of C-1. Magnetic resonance imaging of the cervical spine showed signal hyperintensity within the left dens-atlas space on both T1- and T2-weighted sequences and interruption of the expected dark signal representing the left alar ligament, suggestive of its rupture. After 12 weeks of immobilization in a Guilford brace, MRI showed lessened dens deviation, and the patient attained full and painless neck motion. Including the patient in this case, the 7 patients with this injury were between 5 and 21 years old, sustained the injury in traffic accidents or falls, presented with marked neck pain, and were treated with external immobilization. All patients had good clinical outcome. The mechanism of injury is hyperflexion with rotation. Isolated unilateral alar ligament rupture is a diagnosis made by excluding associated fracture, dislocation, or disruption of other major ligamentous structures in the craniovertebral junction. CT and MRI are essential in establishing the diagnosis. External immobilization is adequate treatment.

  5. Chronic unilateral vestibular loss.

    PubMed

    Kerber, K A

    2016-01-01

    Chronic unilateral vestibular loss is a condition defined by the presence of reduced function of the peripheral vestibular system on one side, which has generally persisted for 3 or more months. The deficit is demonstrated by a reduction of the vestibular-ocular reflex either at the bedside or on laboratory testing. Though some patients with chronic vestibular loss have disabling symptoms, others are asymptomatic. Causes include a viral/postviral disorder, Menière's disease, structural lesions, ischemia, and trauma. Any other systemic or genetic disorder would be expected to involve both sides at some point. PMID:27638074

  6. Unilateral cerebellar aplasia.

    PubMed

    Boltshauser, E; Steinlin, M; Martin, E; Deonna, T

    1996-02-01

    We describe three children with unilateral cerebellar aplasia (UCA). Deliveries at term and neonatal periods were uneventful. Pregnancy was normal in one and complicated by mild bleeding (in second and fourth month respectively) in two instances. Presenting signs were delayed motor development with marked contralateral torticollis (n = 1), hemiplegia (n = 1) and unusual head nodding (n = 1). Neuroradiological investigations revealed complete aplasia (n = 1) and subtotal aplasia (n = 2) of one cerebellar hemisphere with only a residual wing-like structure below the tentorium. There was contralateral underdevelopment of the brainstem. The infant with hemiplegic cerebral palsy had an additional supratentorial periventricular parenchymal defect, contralateral to the cerebellar hypoplasia. In view of literature reports, describing similar neuroradiological or neuropathological findings in asymptomatic individuals, it is doubtful whether UCA is responsible for our patient's problems. In our cases UCA has presumably resulted from a prenatal destructive lesion, possibly an infarct, but the timing and exact nature are unknown. PMID:8677027

  7. Unilateral anhidrosis: A rare complication of thoracic epidural analgesia.

    PubMed

    Gulbahar, Gultekin; Gundogdu, Ahmet Gokhan; Alkan, Güzide; Baysalman, Hatice Baran; Kaplan, Tevfik

    2016-02-01

    Management of pain following thoracotomy is an important issue for the control of early morbidity. We herein present the case of a patient who was referred to our hospital after a fall from a height. Right-sided multiple rib fractures, hemopneumothorax, and diaphragmatic rupture were detected. Thoracic epidural catheterization was performed for pain management just before thoracotomy. The patient developed unilateral anhidrosis postoperatively. We discuss this rare complication of thoracic epidural analgesia with a review of relevant literature.

  8. Nose fracture

    MedlinePlus

    Fracture of the nose; Broken nose; Nasal fracture; Nasal bone fracture; Nasal septal fracture ... A fractured nose is the most common fracture of the face. It ... with other fractures of the face. Sometimes a blunt injury can ...

  9. Repair of Bovine and Equine Mandibular Fractures

    PubMed Central

    Murch, K. M.

    1980-01-01

    Clinical findings, surgical repair and postsurgical care of a unilateral fracture of the mandible of a bull and of a bilateral mandibular fracture in a horse are described. Compression plating limited the pain suffered by the animals and resulted in a quick return to function of the mandibles. ImagesFigure 1.Figure 1.Figure 3.Figure 4.Figure 5.Figure 6. PMID:7363268

  10. Delayed Facial Nerve Palsy After Open Reduction of an Isolated Zygomaticomaxillary Complex Fracture.

    PubMed

    Manosalva, Rodolfo E; Dyckman, Damian; Melzer, Jonathan M

    2016-06-01

    Facial nerve paralysis is a devastating complication which can occur after a variety of otolaryngic procedures, including facial trauma repair. The frontal and marginal branches are most often placed at risk. However, facial nerve paralysis is not typically described as a risk in most uncomplicated facial trauma repairs of the zygomaticomaxillary complex (ZMC). In particular, buccal branch injury has not been described in a delayed setting following repair of the ZMC. The authors present a patient of delayed buccal branch paralysis following a simple ZMC repair which has not been previously reported.The diagnosis, clinical course, and management strategies for delayed facial nerve paralysis in the setting of a ZMC repair are discussed. This rare complication after facial trauma repair should be discussed with patients as a possible complication. PMID:27213738

  11. Managing advanced unilateral pseudoexfoliative glaucoma.

    PubMed

    Marques, André

    2014-01-01

    The only proven therapy for glaucoma is intraocular pressure (IOP) reduction, which can be accomplished by different means. Each should be properly discussed with patients in order to best preserve visual function and quality of life. We report a case of unilateral pseudoexfoliative glaucoma, treated for years with triple topical IOP-lowering drugs. The patient presented with advanced optic neuropathy and important ocular side effects secondary to the treatment. Having discussed his options and prognosis, laser trabeculoplasty was performed while maintaining the remaining therapy considering the advanced stage of glaucoma. His IOP was effectively reduced and no progression was noted after 1-year follow-up. Although medical therapy is the mainstream in glaucoma management, its side effects should not be ignored, especially in unilateral cases. Surgery might have been a better solution, but we chose to perform laser trabeculoplasty, an effective and safer alternative, considering the unlikely but serious risk of the "wipe-out phenomenon" in this case. PMID:24850557

  12. Primary unilateral cleft lip repair

    PubMed Central

    Adenwalla, H. S.; Narayanan, P. V.

    2009-01-01

    The unilateral cleft lip is a complex deformity. Surgical correction has evolved from a straight repair through triangular and quadrilateral repairs to the Rotation Advancement Technique of Millard. The latter is the technique followed at our centre for all unilateral cleft lip patients. We operate on these at five to six months of age, do not use pre-surgical orthodontics, and follow a protocol to produce a notch-free vermillion. This is easy to follow even for trainees. We also perform closed alar dissection and extensive primary septoplasty in all these patients. This has improved the overall result and has no long-term deleterious effect on the growth of the nose or of the maxilla. Other refinements have been used for prevention of a high-riding nostril, and correction of the vestibular web. PMID:19884683

  13. Managing advanced unilateral pseudoexfoliative glaucoma.

    PubMed

    Marques, André

    2014-01-01

    The only proven therapy for glaucoma is intraocular pressure (IOP) reduction, which can be accomplished by different means. Each should be properly discussed with patients in order to best preserve visual function and quality of life. We report a case of unilateral pseudoexfoliative glaucoma, treated for years with triple topical IOP-lowering drugs. The patient presented with advanced optic neuropathy and important ocular side effects secondary to the treatment. Having discussed his options and prognosis, laser trabeculoplasty was performed while maintaining the remaining therapy considering the advanced stage of glaucoma. His IOP was effectively reduced and no progression was noted after 1-year follow-up. Although medical therapy is the mainstream in glaucoma management, its side effects should not be ignored, especially in unilateral cases. Surgery might have been a better solution, but we chose to perform laser trabeculoplasty, an effective and safer alternative, considering the unlikely but serious risk of the "wipe-out phenomenon" in this case.

  14. Pulfrich's phenomenon in unilateral cataract

    PubMed Central

    Scotcher, S.; Laidlaw, D; Canning, C.; Weal, M.; Harrad, R.

    1997-01-01

    AIMS—To determine whether unilateral cataract causes a pathological Pulfrich's phenomenon.
METHODS—29 subjects with unilateral cataract and contralateral pseudophakia were assessed on their ability to perceive the Pulfrich phenomenon. Using a computer generated pendulum image, and graded neutral density filters, a series of forced choice trials were performed in which the subject was required to describe the direction of any apparent pendulum rotation. A pathological Pulfrich effect was said to occur when apparent rotation was perceived in the presence of a zero strength neutral density filter. The size of any pathological Pulfrich effect which was present was quantified by neutralising the perceived pendulum rotation with neutral density filters of varying strength placed before the better seeing eye.
RESULTS—20 out of 29 subjects were able to perceive apparent pendulum rotation when uniocular filtering was performed. In the group (n=12) which was tested both before and after cataract extraction with intraocular lens implantation, a statistically significant pathological Pulfrich effect was demonstrated preoperatively, compared with a group of normal control subjects. This effect was abolished after cataract extraction (p=0.009). The median size of the effect was equivalent to a 0.25 log unit neutral density filter over the non-cataractous eye. The subjects who were unable to perceive the Pulfrich phenomenon at all had a significantly greater difference in the visual acuity of each eye (p=0.045) and significantly worse stereoacuity than those who were able to perceive the effect (p=0.002).
CONCLUSIONS—Unilateral cataract can cause a pathological Pulfrich phenomenon. This finding may explain why some patients with unilateral cataract complain of visual symptoms that are not easily accounted for in terms of visual acuity, contrast sensitivity, or stereoacuity.

 PMID:9497463

  15. Unilateral mandibular condylectomy in lambs.

    PubMed

    Miyamoto, H; Matsuura, H; Jones, R H; Kurita, K; Goss, A N

    2001-08-01

    The purpose of this experimental study was to investigate the degree of regeneration of the mandibular condyle after unilateral condylectomy in 10-week-old lambs. The lambs were killed three months after the operation, and the joints examined radiologically and histologically. Scoring systems were used to assess the radiological changes and histological regeneration of the condyle. All joints showed regeneration of the condylar head postoperatively. The maximum degree of regeneration occurred on the medial side rather than the central or lateral areas. There was a significant correlation among the medial, central, and lateral planes (P<0.05). The reformed articular cartilage was irregular and thin (P<0.01), and the disc was thick in the central plane (P<0.01) compared with the control joints. The temporal bone was normal. This study shows that unilateral condylectomy in the growing period results in some condylar regeneration particularly on the medial side and reformation of some irregular and thin articular cartilage. PMID:11437430

  16. Discoid lupus erythematosus presenting as unilateral blepharitis.

    PubMed

    Au, Leon

    2006-01-01

    A 39-year-old man presented with a 4-month history of unilateral blepharitis that did not respond to conventional treatment. Punch biopsy confirmed the diagnosis of discoid lupus erythematosus. Unilateral blepharitis as the only presenting sign of discoid lupus erythematosus is uncommon but should be considered in the differential diagnosis in patients with asymmetric blepharitis.

  17. A Case of Unilateral Ashy Dermatosis

    PubMed Central

    Chun, Ji-Sung; Hong, Soon-Kwan; Seo, Jong-Keun; Lee, Deborah; Sung, Ho-Suk

    2009-01-01

    Ashy dermatosis, also known as erythema dyschromicum perstans, is a peculiar, slowly progressive, idiopathic dermal melanosis. In most cases, slate gray- to lead-colored patches are symmetrically distributed over the body. Ashy dermatosis with a unilateral distribution is rare. We report a case of unilateral ashy dermatosis in a 27-year-old Korean man. PMID:20523842

  18. Acute unilateral facial nerve palsy.

    PubMed

    Yeong, Siew Swan; Tassone, Peter

    2011-05-01

    Mrs PS, 78 years of age, presented with acute left-sided otalgia, ear swelling and subsequent unilateral facial paralysis (Figure 1). She denied any otorrhoea or hearing loss. Past medical history relevant to the presenting complaint included: * Bell palsy diagnosed 20 years ago with no residual effect * biopsy confirmed benign parotid lump (diagnosed 3 years previously). Histopathology revealed a pleomorphic adenoma. Mrs PS declined surgical intervention at the time * chicken pox as a child * normal fasting blood glucose 1 month previously and no known immune compromise. Examination revealed yellow crusts and small vesicles on the external acoustic meatus (Figure 2). A 10 mm well defined firm and nontender nodule was palpable at the ramus of the mandible.

  19. 48 CFR 30.603-2 - Unilateral and desirable changes.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... changes. 30.603-2 Section 30.603-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Unilateral and desirable changes. (a) Unilateral changes. (1) The contractor may unilaterally change its... the aggregate, as a result of the unilateral change. (2) Prior to making any contract price or...

  20. Posterior interbody fusion using a diagonal cage with unilateral transpedicular screw fixation for lumbar stenosis.

    PubMed

    Zhao, Jian; Zhang, Feng; Chen, Xiaoqing; Yao, Yu

    2011-03-01

    Few reports have described the combined use of unilateral pedicle screw fixation and interbody fusion for lumbar stenosis. We retrospectively reviewed 79 patients with lumbar stenosis. The rationale and effectiveness of unilateral pedicle screw fixation were studied from biomechanical and clinical perspectives, aiming to reduce stiffness of the implant. All patients were operated with posterior interbody fusion using a diagonal cage in combination with unilateral transpedicular screw fixation and had reached the 3-year follow-up interval after operation. The mean operating time was 115 minutes (range=95-150 min) and the mean estimated blood loss was 150 mL (range=100-200 mL). The mean duration of hospital stay was 10 days (range=7-15 days). Clinical outcomes were assessed prior to surgery and reassessed at intervals using Denis' pain and work scales. Fusion status was determined from X-rays and CT scans. At the final follow-up, the clinical results were satisfactory and patients showed significantly improved scores (p<0.01) either on the pain or the work scale. Successful fusion was achieved in all patients. There were no new postoperative radiculopathies, or instances of malpositioned or fractured hardware. Posterior interbody fusion using a diagonal cage with unilateral transpedicular fixation is an effective treatment for decompressive surgery for lumbar stenosis.

  1. A novel technique of unilateral percutaneous kyphoplasty achieves effective biomechanical strength and reduces radiation exposure

    PubMed Central

    Zhuang, Yan; Yang, Lei; Li, Haijun; Ren, Yajun; Cao, Xiaojian

    2016-01-01

    Purpose: To develop a novel technique of percutaneous kyphoplasty (PKP) with effective biomechanical strength and lower radiation exposure. Methods: Thirty fresh lumbar vertebrae isolated from six hogs were decalcified and compressed to induce osteoporotic vertebral compression fractures. Kyphoplasty was performed using three different techniques (ten for each group): conventional unilateral approach (group A), conventional bilateral approach (group B) and novel unilateral approach (group C). Biomechanical indexes including Yield load and stiffness were tested before and after kyphoplasty. The anterior height of each vertebral body (AHVB) was measured before compression, after compression and after kyphoplasty. Frequency of C-arm use and volume of bone cement were also recorded in the process. Results: Compared with group A, our novel technique in group C can significantly improve the recovery of AHVB after compression fractures. However, there was no statistical difference between group B and group C. Values of Yield load in both group B and group C were statistically higher than that in group A, however, no significant difference was found between group B and C. Statistical results of stiffness were similar to Yield load. Regarding volume of bone cement and radiation exposure, the novel technique in group C needed more bone cement and fluoroscopy use than in group A but less than in group B. Conclusions: This novel device makes unilateral kyphoplasty feasible, safe and effective. In the premise of guaranteed biomechanical strength, the new technique significantly reduces risk of radiation exposure in kyphoplasty. PMID:27158403

  2. Elbow Fractures

    MedlinePlus

    ... and held together with pins and wires or plates and screws. Fractures of the distal humerus (see ... doctor. These fractures usually require surgical repair with plates and/or screw, unless they are stable. SIGNS ...

  3. Causative factors in unilateral giant papillary conjunctivitis.

    PubMed

    Palmisano, P C; Ehlers, W H; Donshik, P C

    1993-04-01

    Giant papillary conjunctivitis (GPC) is usually a bilateral disease. However, in a small number of cases, GPC can be manifested as a unilateral, or a markedly asymmetrical disease in patients wearing bilateral contact lenses. We reviewed the clinical records of 148 patients with GPC to determine the incidence of unilateral GPC and its causative factors. Specifically, charts were reviewed for data on refractive error, keratometry, lens fit, lens care, lens replacement, and the presence or absence of associated ocular abnormalities (dry eyes, blepharitis, previous injury, or surgery). Fourteen patients with unilateral or markedly asymmetrical disease were identified. Overall, no statistically significant difference was found in lens care, refractive error, or keratometric measurements in the affected and unaffected eyes. While not statistically significant, infrequent lens replacement appears to be an important factor in the development of unilateral GPC. Three patients had a history of wearing an older lens in the GPC eye. Two patients were found with unilateral meibomian gland dysfunction involving the affected eye, and one patient had undergone surgery on the affected eye. No causative factor was identified in eight cases.

  4. Facial fractures.

    PubMed Central

    Carr, M. M.; Freiberg, A.; Martin, R. D.

    1994-01-01

    Emergency room physicians frequently see facial fractures that can have serious consequences for patients if mismanaged. This article reviews the signs, symptoms, imaging techniques, and general modes of treatment of common facial fractures. It focuses on fractures of the mandible, zygomaticomaxillary region, orbital floor, and nose. Images p520-a p522-a PMID:8199509

  5. Unilateral pulmonary edema following acute subglottic edema.

    PubMed

    Morisaki, H; Ochiai, R; Takeda, J; Nagano, M

    1990-01-01

    Presented here is a case of unilateral pulmonary edema following acute subglottic edema after removal of an endotracheal tube. A 3-year-old boy, diagnosed as having nondiphtheric croup and pectus excavatum deformity, was scheduled for repair of a cleft lip. No complication occurred during the operation. After removal of the endotracheal tube, he showed dyspnea and cyanosis and was later found to have acute subglottic edema. After reintubation of the trachea, frothy pink fluid was discharged from the tube, and chest roentgenogram showed a right-sided alveolar infiltrate. Many factors may cause unilateral pulmonary edema, but it is suggested that acute subglottic edema and unilateral bronchial fragility strongly affected this episode.

  6. A unique case of unilateral synophthalmia.

    PubMed

    Proia, Alan D

    2011-01-01

    Developmental anomalies resulting in a single eye (cyclopia) or fusion of the eyes (synophthalmia) are rare. Examples of unilateral synophthalmia-in which there are 1 normal and 2 fused eyes from 3 anlagen in 2 orbits, 1 lateral proboscis, and 3 optic nerves-are even more rare. Herein, I report a unique fetus with unilateral synophthalmia that was not associated with a lateral proboscis but instead had an extra cerebral hemisphere. I postulate that the unilateral synophthalmia, accessory cerebral hemisphere, and minor structural abnormalities in the skull base were the result of failure in separating a monozygous twin, a situation similar to that postulated as the cause of fetus in fetu. PMID:20528261

  7. Unilateral hyperhydrosis in Pourfour du Petit syndrome.

    PubMed

    Kara, Murat; Dikmen, Erkan; Akarsu, Cengiz; Birol, Ahu

    2004-08-01

    Upper limp hyperhydrosis is an idiopathic disease with bilateral involvement. However, Pourfour du Petit syndrome, the opposite of Horner syndrome, may result in unilateral upper limb hyperhydrosis. It occurs following hyperactivity of the sympathetic cervical chain as a consequence of irritation secondary to trauma. We report herein two cases with Pourfour du Petit syndrome showing unilateral upper limb hyperhydrosis. The patients presented with right-sided mydriasis and ipsilateral hemifacial hyperhydrosis. The onset of disease was followed by a trauma in both patients. They underwent upper thoracic sympathectomy with favorable outcome. A history of an antecedent trauma in patients with unilateral upper limb hyperhydrosis and anisocoria may imply a possible diagnosis of Pourfour du Petit syndrome. PMID:15296919

  8. Case report: unilateral mydriasis following nasal cautery.

    PubMed

    Koo Ng, Nigel K F; Calder, Nick

    2010-12-01

    We report a case of unilateral mydriasis following nasal electrocautery presumed to be the result of retrograde flow of adrenaline and/or xylometazoline hydrochloride (Otrivine) through the nasolacrimal duct into the eye. We review the literature and highlight the importance of correct interpretation of finding a dilated pupil post-operatively. To our knowledge. we report the first such case involving xylometazoline hydrochloride and also following nasal electrocautery. Unilateral mydriasis is alarming after nasal surgery but must be interpreted with caution. During minimally invasive procedures it is likely to be due to the effects of topical medication to the nose rather than surgical trauma. PMID:21158576

  9. Unilateral Isolated Proximal Femoral Focal Deficiency

    PubMed Central

    Doğer, Emek; Köpük, Şule Y.; Çakıroğlu, Yiğit; Çakır, Özgür; Yücesoy, Gülseren

    2013-01-01

    Objective. To discuss a patient with a prenatal diagnosis of unilateral isolated femoral focal deficiency. Case. Antenatal diagnosis of unilateral isolated femoral focal deficiency was made at 20 weeks of gestation. The length of left femur was shorter than the right, and fetal femur length was below the fifth percentile. Proximal femoral focal deficiency was diagnosed. After delivery, the diagnosis was confirmed with skeletal radiographs and magnetic resonance imaging. In prenatal ultrasonographic examination, the early recognition and exclusion of skeletal dysplasias is important; moreover, treatment plans should be initiated, and valuable information should be provided to the family. PMID:23984135

  10. Asymmetric and Unilateral Hearing Loss in Children

    PubMed Central

    Vila, Peter; Lieu, Judith E. C.

    2015-01-01

    Asymmetric and unilateral hearing losses in children have traditionally been underappreciated, but health care practitioners are now beginning to understand their effect on development and the underlying pathophysiologic mechanisms. The common wisdom among medical and educational professionals has been that at least one normal hearing or near-normal hearing ear was sufficient for typical speech and language development in children. The objective of this review is to illustrate to the non-otolaryngologist the consequences of asymmetric and unilateral hearing loss in children on developmental and educational outcomes. In the process, etiology, detection, and management are discussed. Lastly, implications for further research are considered. PMID:26004144

  11. Unilateral acrokeratoelastoidosis--second reported case.

    PubMed

    Klekowski, Nicole; Shwayder, Tor

    2011-01-01

    Acrokeratoelastoidosis (AKE) is a rare disease that manifests as wartlike papules along the dorsal palmar junction. It is characterized by orthohyperkeratosis in the horny layer and elastorrhexis in the reticular dermis. Both sporadic and familial cases following autosomal dominant inheritance have been reported. Currently, no effective treatments exist for AKE, which can have a significant cosmetic impact. Here we present the second reported case of unilateral AKE in a 5-year-old African American girl and hypothesize that the mechanism for the unilateral nature of AKE in this patient is genetic mosaicism.

  12. Metatarsal fractures.

    PubMed

    Rammelt, Stefan; Heineck, Jan; Zwipp, Hans

    2004-09-01

    Metatarsal fractures are relatively common and if malunited, a frequent source of pain and disability. Nondisplaced fractures and fractures of the second to fourth metatarsal with displacement in the horizontal plane can be treated conservatively with protected weight bearing in a cast shoe for 4-6 weeks. In most displaced fractures, closed reduction can be achieved but maintenance of the reduction needs internal fixation. Percutaneous pinning is suitable for most fractures of the lesser metatarsals. Fractures with joint involvement and multiple fragments frequently require open reduction and plate fixation. Transverse fractures at the metaphyseal-diaphyseal junction of the fifth metatarsal ("Jones fractures") require an individualized approach tailored to the level of activity and time to union. Avulsion fractures of the fifth metatarsal bone are treated by open reduction and tension-band wiring or screw fixation if displaced more than 2 mm or with more that 30% of the joint involved. The metatarsals are the most common site of stress fractures, most of which are treated nonoperatively. Symptomatic posttraumatic deformities need adequate correction, in most cases by osteotomy across the former fracture site.

  13. Unilateral asterixis associated with a mesencephalic syndrome.

    PubMed

    Tarsy, D; Lieberman, B; Chirico-Post, J; Benson, F

    1977-07-01

    Unilateral asterixis due to a focal brain lesion is a rare occurrence. Acute asterixis restricted to the left upper extremity appeared in a patient in association with signs of acute midbrain dysfunction, without changes in mental status or in the EEG, and in the absence of metabolic or toxic disturbance. Electromyography disclosed features typical of asterixis due to metabolic causes.

  14. Unilateral vestibular loss impairs external space representation.

    PubMed

    Borel, Liliane; Redon-Zouiteni, Christine; Cauvin, Pierre; Dumitrescu, Michel; Devèze, Arnaud; Magnan, Jacques; Péruch, Patrick

    2014-01-01

    The vestibular system is responsible for a wide range of postural and oculomotor functions and maintains an internal, updated representation of the position and movement of the head in space. In this study, we assessed whether unilateral vestibular loss affects external space representation. Patients with Menière's disease and healthy participants were instructed to point to memorized targets in near (peripersonal) and far (extrapersonal) spaces in the absence or presence of a visual background. These individuals were also required to estimate their body pointing direction. Menière's disease patients were tested before unilateral vestibular neurotomy and during the recovery period (one week and one month after the operation), and healthy participants were tested at similar times. Unilateral vestibular loss impaired the representation of both the external space and the body pointing direction: in the dark, the configuration of perceived targets was shifted toward the lesioned side and compressed toward the contralesioned hemifield, with higher pointing error in the near space. Performance varied according to the time elapsed after neurotomy: deficits were stronger during the early stages, while gradual compensation occurred subsequently. These findings provide the first demonstration of the critical role of vestibular signals in the representation of external space and of body pointing direction in the early stages after unilateral vestibular loss.

  15. Unilateral Vestibular Loss Impairs External Space Representation

    PubMed Central

    Borel, Liliane; Redon-Zouiteni, Christine; Cauvin, Pierre; Dumitrescu, Michel; Devèze, Arnaud; Magnan, Jacques; Péruch, Patrick

    2014-01-01

    The vestibular system is responsible for a wide range of postural and oculomotor functions and maintains an internal, updated representation of the position and movement of the head in space. In this study, we assessed whether unilateral vestibular loss affects external space representation. Patients with Menière's disease and healthy participants were instructed to point to memorized targets in near (peripersonal) and far (extrapersonal) spaces in the absence or presence of a visual background. These individuals were also required to estimate their body pointing direction. Menière's disease patients were tested before unilateral vestibular neurotomy and during the recovery period (one week and one month after the operation), and healthy participants were tested at similar times. Unilateral vestibular loss impaired the representation of both the external space and the body pointing direction: in the dark, the configuration of perceived targets was shifted toward the lesioned side and compressed toward the contralesioned hemifield, with higher pointing error in the near space. Performance varied according to the time elapsed after neurotomy: deficits were stronger during the early stages, while gradual compensation occurred subsequently. These findings provide the first demonstration of the critical role of vestibular signals in the representation of external space and of body pointing direction in the early stages after unilateral vestibular loss. PMID:24523916

  16. Microanatomic features of unilateral condylar hyperplasia.

    PubMed

    Luz, J G; de Rezende, J R; Jaeger, R G; de Araújo, V C

    1994-01-01

    Microanatomic features of unilateral condylar hyperplasia (UCH) are described. The articular surface exhibited clefts with surrounding elevations, and globules varying 0.5-2 microns in diameter. The articular zone presented giant coiled fibers, and the proliferative zone was composed of small round cells. The findings suggest that degenerative changes occur in UCH, both in adult and juvenile forms. PMID:8000234

  17. Condylar hyperplasia following unilateral temporomandibular joint replacement.

    PubMed

    Machon, V; Levorova, J; Hirjak, D; Foltan, R

    2015-06-01

    Total joint replacement of the temporomandibular joint (TJR) can be associated with intraoperative and postoperative complications. We report herein the occurrence of a postoperative open bite malocclusion, the result of condylar hyperplasia affecting the non-operated joint at 1 year after unilateral total joint replacement. PMID:25662429

  18. Modification of unilateral otolith responses following spaceflight.

    PubMed

    Clarke, Andrew H; Schönfeld, Uwe

    2015-12-01

    The aim of the study was to resolve the issue of spaceflight-induced, adaptive modification of the otolith system by measuring unilateral otolith responses in a pre- versus post-flight design. The study represents the first comprehensive approach to examining unilateral otolith function following space flight. Ten astronauts participated in unilateral otolith function tests three times preflight and up to four times after Shuttle flights from landing day through the subsequent 10 days. During unilateral centrifugation, utricular function was examined by the perceptual changes reflected by the subjective visual vertical (SVV) and the otolith-mediated ocular counter-roll, designated as utriculo-ocular response (UOR). Unilateral saccular reflexes were recorded by measurement of collic vestibular evoked myogenic potentials (cVEMP). The findings demonstrate a general increase in interlabyrinth asymmetry of otolith responses on landing day relative to preflight baseline, with subsequent reversal in asymmetry within 2-3 days. Recovery to baseline levels was achieved within 10 days. This fluctuation in asymmetry was consistent for the utricle tests (SVV and UOR) while apparently stronger for SVV. A similar asymmetry was observed during cVEMP testing. In addition, the results provide initial evidence of a dominant labyrinth. The findings require reconsideration of the otolith asymmetry hypothesis; in general, on landing day, the response from one labyrinth was equivalent to preflight values, while the other showed considerable discrepancy. The finding that one otolith response can return to one-g level within hours after re-entry while the other takes considerably longer demonstrates the importance of considering the otolith response as a result of both peripheral and associated central neural processing.

  19. Modification of unilateral otolith responses following spaceflight.

    PubMed

    Clarke, Andrew H; Schönfeld, Uwe

    2015-12-01

    The aim of the study was to resolve the issue of spaceflight-induced, adaptive modification of the otolith system by measuring unilateral otolith responses in a pre- versus post-flight design. The study represents the first comprehensive approach to examining unilateral otolith function following space flight. Ten astronauts participated in unilateral otolith function tests three times preflight and up to four times after Shuttle flights from landing day through the subsequent 10 days. During unilateral centrifugation, utricular function was examined by the perceptual changes reflected by the subjective visual vertical (SVV) and the otolith-mediated ocular counter-roll, designated as utriculo-ocular response (UOR). Unilateral saccular reflexes were recorded by measurement of collic vestibular evoked myogenic potentials (cVEMP). The findings demonstrate a general increase in interlabyrinth asymmetry of otolith responses on landing day relative to preflight baseline, with subsequent reversal in asymmetry within 2-3 days. Recovery to baseline levels was achieved within 10 days. This fluctuation in asymmetry was consistent for the utricle tests (SVV and UOR) while apparently stronger for SVV. A similar asymmetry was observed during cVEMP testing. In addition, the results provide initial evidence of a dominant labyrinth. The findings require reconsideration of the otolith asymmetry hypothesis; in general, on landing day, the response from one labyrinth was equivalent to preflight values, while the other showed considerable discrepancy. The finding that one otolith response can return to one-g level within hours after re-entry while the other takes considerably longer demonstrates the importance of considering the otolith response as a result of both peripheral and associated central neural processing. PMID:26358122

  20. Rapidly fluctuating anosmia: A clinical sign for unilateral smell impairment.

    PubMed

    Negoias, Simona; Friedrich, Hergen; Caversaccio, Marco D; Landis, Basile N

    2016-02-01

    Reports about fluctuating olfactory deficits are rare, as are reports of unilateral olfactory loss. We present a case of unilateral anosmia with contralateral normosmia, presenting as rapidly fluctuating anosmia. The olfactory fluctuation occurred in sync with the average nasal cycle duration. Examination after nasal decongestion, formal smell testing, and imaging revealed unilateral, left-sided anosmia of sinonasal cause, with right-sided normosmia. We hypothesize that the nasal cycle induced transient anosmia when blocking the normosmic side. Fluctuating olfactory deficits might hide a unilateral olfactory loss and require additional unilateral testing and thorough workup.

  1. Fatigue Fractures

    PubMed Central

    Morris, James M.

    1968-01-01

    Fatigue (or stress) fracture of bone in military recruits has been recognized for many years. Most often it is a metatarsal bone that is involved but the tarsal bones, calcaneus, tibia, fibula, femur, and pelvis are occasionally affected. Reports of such fractures in the ribs, ulna and vertebral bodies may be found in the literature. In recent years, there has been increasing awareness of the occurrence of fatigue fractures in the civilian population. Weekend sportsmen, athletes in an early phase of training, and persons engaged in unaccustomed, repetitive, vigorous activity are potential victims of such a fracture. The signs and symptoms, roentgenographic findings, treatment and etiology of fatigue fractures are dealt with in this presentation. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6. PMID:5652745

  2. [Unilateral nasal obstruction in children: Pai syndrome].

    PubMed

    Zanetta, Adrián; Cuestas, Giselle; Oviedo, Maricruz; Tiscorni, Carlos

    2011-10-01

    Unilateral obstruction of the nasal cavity in children is mainly caused by the introduction of foreign bodies further stated with rhinorrhea and fetid odor. Less commonly, it can be traumatic, neoplastic, due to congenital malformation or iatrogenic. Symptoms of congenital intranasal mass may present at birth, or go unnoticed and be a finding in a routine pediatric examination. Patient evaluation should include imaging studies to guide the diagnosis and rule out intracranial extension. A syndrome associated with congenital nasal tumor should be suspected when other abnormalities are present. Pai syndrome is a rare genetic disorder. Its manifestations are craniofacial being congenital nasal polyp his main marker. We present a patient with unilateral nasal respiratory failure secondary to congenital nasal lipoma, with craniofacial anomalies belonging to Pai syndrome. Nasal obstruction was successfully surgically resolved. PMID:22042063

  3. Unilateral Punctate Keratitis Secondary to Wallenberg Syndrome

    PubMed Central

    Boto, Ana; Del Hierro, Almudena; Capote, Maria; Noval, Susana; Garcia, Amanda; Santiago, Susana

    2014-01-01

    We studied three patients who developed left unilateral punctate keratitis after suffering left-sided Wallenberg Syndrome. A complex evolution occurred in two of them. In all cases, neurophysiological studies showed damage in the trigeminal sensory component at the bulbar level. Corneal involvement secondary to Wallenberg syndrome is a rare cause of unilateral superficial punctate keratitis. The loss of corneal sensitivity caused by trigeminal neuropathy leads to epithelial erosions that are frequently unobserved by the patient, resulting in a high risk of corneal-ulcer development with the possibility of superinfection. Neurophysiological studies can help to locate the anatomical level of damage at the ophthalmic branch of the trigeminal nerve, confirming the suspected etiology of stroke, and demonstrating that prior vascular involvement coincides with the location of trigeminal nerve damage. In some of these patients, oculofacial pain is a distinctive feature. PMID:24882965

  4. A Very Rare Presentation of Multiple Myeloma: Unilateral Raccoon Eye.

    PubMed

    Varım, Ceyhun; Ergenc, Hasan; Uyanık, Mehmet Sevki; Kaya, Tezcan; Nalbant, Ahmet; Karacaer, Cengiz; Sunu, Cenk; Tamer, Ali

    2015-09-15

    Multiple myeloma (MM), the second most common hematological malignancy, is caused by the accumulation of monoclonal plasma cells in bone marrow. It accounts for 10-15% of deaths from hematological malignancies and approximately 2% of deaths from cancer. The median age at presentation is 70 years old. The diagnosis is incidental in 30% of cases. MM is often discovered through routine blood screening with a large gap between the total protein and the albumin levels. Two thirds of patients complain of bone pain, especially lower back pain. MM could be diagnosed after a pathologic fracture occurs in one third of patients. Presentation with symptoms related to hyperviscosity, hypercalcemia and bleeding tendency could also be observed. A rare presentation of MM is peri-orbital ecchymotic lesion (raccoon eye). Here, we report a 64 years old, male patient presented with unilateral raccoon eye and high erythrocyte sedimentation rate (ESR) to internal medicine outpatient. The patient was referred to hematology outpatient and was diagnosed with multiple myeloma. PMID:27275266

  5. Unilateral phrenic nerve lesion in Lyme neuroborreliosis

    PubMed Central

    2013-01-01

    Background Among a variety of more common differential diagnoses, the aetiology of acute respiratory failure includes Lyme neuroborreliosis. Case presentation We report an 87-years old huntsman with unilateral phrenic nerve palsy as a consequence of Lyme neuroborreliosis. Conclusion Although Lyme neuroborreliosis is a rare cause of diaphragmatic weakness, it should be considered in the differential workup because of its potentially treatable nature. PMID:23327473

  6. Unilateral musical hallucinations and all that jazz.

    PubMed

    Couper, J

    1994-09-01

    A 78-year-old hearing-impaired woman who presented to hospital with a stroke and a subsequent epileptic seizure later developed unilateral musical hallucinations in her better hearing (right) ear. She was found to have a left-sided temporal epileptic focus and the music ceased after a second anti-convulsant was introduced. Comments are made on unusual features of the hallucination and its probable causation.

  7. Functioning unilateral adrenocortical carcinoma in a dog.

    PubMed

    Gójska-Zygner, Olga; Lechowski, Roman; Zygner, Wojciech

    2012-06-01

    An 11-year-old, 24-kg, intact female Siberian husky dog in anestrus had a 2-month history of polyuria and polydipsia. The dog had signs of mineralocorticoid excess such as hypertension and hypokalemia refractory to potassium supplementation. Abdominal ultrasound revealed an irregular mass in the left adrenal gland. The ACTH stimulation test for aldosterone concentration did not reveal hyperaldosteronism. Unilateral adrenalectomy was performed and histopathology identified adrenal cortical carcinoma. All clinical signs of mineralocorticoid excess ceased after surgery.

  8. Fracture Management

    MedlinePlus

    ... to hold the fracture in the correct position. • Fiberglass casting is lighter and stronger and the exterior ... with your physician if this occurs. • When a fiberglass cast is used in conjunction with a GORE- ...

  9. Lisfranc fractures.

    PubMed

    Wright, Amanda; Gerhart, Ann E

    2009-01-01

    Injuries of the tarsometatarsal, or Lisfranc, joint are rarely seen. Lisfranc fractures and fracture dislocations are among the most frequently misdiagnosed foot injuries in the emergency department. A misdiagnosed injury may have severe consequences including chronic pain and loss of foot biomechanics. Evaluation of a foot injury should include a high level of suspicion of a Lisfranc injury, and a thorough work-up is needed for correct diagnosis.

  10. Fractures of the articular processes of the cervical spine

    SciTech Connect

    Woodring, J.H.; Goldstein, S.J.

    1982-08-01

    Fractures of the articular processes occurred in 16 (20.8%) of 77 patients with cervical spine fractures as demonstrated by multidirectional tomography. Plain films demonstrated the fractures in only two patients. Acute cervical radiculopathy occurred in five of the patients with articular process fractures (superior process, two cases; inferior process, three cases). Persistent neck pain occurred in one other patient without radiculopathy. Three patients suffered spinal cord damage at the time of injury, which was not the result of the articular process fracture itself. In the other seven cases, no definite sequelae occurred. However, disruption of the facet joint may predispose to early degenerative joint disease and chronic pain; unilateral or bilateral facet dislocation was present in five patients. In patients with cervical trauma who develop cervical radiculopathy, tomography should be performed to evaluate the articular processes.

  11. Bridging plate osteosynthesis of humeral shaft fractures.

    PubMed

    Livani, Bruno; Belangero, William Dias

    2004-06-01

    This study was approved by the Ethics Committee of the Faculty of Medical Sciences and developed during November 2000 and July 2001 in the Orthopedic and Traumatology Department of UNICAMP. There were 15 patients, 11 males, age between 14 and 66 years. All fractures were unilateral. Of the 15 patients eight were polytraumatised, two of them had open fractures. The others had an isolated fracture of the humerus, of which one was open. None of the patients had previous lesions of the radial nerve, but in two patients there was a lesion of the brachial plexus. All of the patients underwent a bridging plate osteosynthesis of the humeral shaft fractures using only two small incisions proximal and distal to the fracture site. We used broad or narrow D.C.P. plates for large fragments mostly with 12 holes, fixed with two or three screws at each end. All cases united with an average time of 8-12 weeks, with the exception of one case with a grade III open fracture and a brachial plexus lesion on the same side. We had no major complications. All patients recovered good function of the limb without significant residual deformity. PMID:15135278

  12. Some remarks on unilateral matrix equations

    SciTech Connect

    Cerchiai, Bianca L.; Zumino, Bruno

    2001-02-01

    We briefly review the results of our paper LBNL-46775: We study certain solutions of left-unilateral matrix equations. These are algebraic equations where the coefficients and the unknown are square matrices of the same order, or, more abstractly, elements of an associative, but possibly noncommutative algebra, and all coefficients are on the left. Recently such equations have appeared in a discussion of generalized Born-Infeld theories. In particular, two equations, their perturbative solutions and the relation between them are studied, applying a unified approach based on the generalized Bezout theorem for matrix polynomials.

  13. [Unilateral hip arthrosis: expression of joint haemochromatosis].

    PubMed

    Prieto Zancudo, C; Villán Villán, Y F; Tascón Guerra, M F

    2012-10-01

    Hereditary haemochromatosis is the most common genetic disorder in the Caucasian population, with an estimated prevalence of 1/200-1/400 (homozygous) and 1/8-1/10 in carriers (heterozygous). The transmission is recessive and linked to HLA. The clinical expression of disease appears only in homozygous and will depend on the time of diagnosis and the degree of organ involvement. The clinical case presented below describes the process of differential diagnosis made in a young patient with unilateral coxarthrosis and clinical suspicion of hemochromatosis. Early diagnosis of hereditary hemochromatosis in primary care can reduce morbidity and mortality of this disease by detecting homozygous at younger ages.

  14. Regenerate Healing Outcomes in Unilateral Mandibular Distraction Osteogenesis Using Quantitative Histomorphometry

    PubMed Central

    Schwarz, Daniel A.; Arman, Krikor G.; Kakwan, Mehreen S.; Jamali, Ameen M.; Elmeligy, Ayman A.; Buchman, Steven R.

    2015-01-01

    Background The authors’ goal was to ascertain regenerate bone-healing metrics using quantitative histomorphometry at a single consolidation period. Methods Rats underwent either mandibular distraction osteogenesis (n=7) or partially reduced fractures (n=7); their contralateral mandibles were used as controls (n=11). External fixators were secured and unilateral osteotomies performed, followed by either mandibular distraction osteogenesis (4 days’ latency, then 0.3 mm every 12 hours for 8 days; 5.1 mm) or partially reduced fractures (fixed immediately postoperatively; 2.1 mm); both groups underwent 4 weeks of consolidation. After tissue processing, bone volume/tissue volume ratio, osteoid volume/tissue volume ratio, and osteocyte count per high-power field were analyzed by means of quantitative histomorphometry. Results Contralateral mandibles had statistically greater bone volume/tissue volume ratio and osteocyte count per high-power field compared with both mandibular distraction osteogenesis and partially reduced fractures by almost 50 percent, whereas osteoid volume/tissue volume ratio was statistically greater in both mandibular distraction osteogenesis specimens and partially reduced fractures compared with contralateral mandibles. No statistical difference in bone volume/tissue volume ratio, osteoid volume/tissue volume ratio, or osteocyte count per high-power field was found between mandibular distraction osteogenesis specimens and partially reduced fractures. Conclusions The authors’ findings demonstrate significantly decreased bone quantity and maturity in mandibular distraction osteogenesis specimens and partially reduced fractures compared with contralateral mandibles using the clinically analogous protocols. If these results are extrapolated clinically, treatment strategies may require modification to ensure reliable, predictable, and improved outcomes. PMID:20463629

  15. Disrupted functional brain connectome in unilateral sudden sensorineural hearing loss.

    PubMed

    Xu, Haibo; Fan, Wenliang; Zhao, Xueyan; Li, Jing; Zhang, Wenjuan; Lei, Ping; Liu, Yuan; Wang, Haha; Cheng, Huamao; Shi, Hong

    2016-05-01

    Sudden sensorineural hearing loss (SSNHL) is generally defined as sensorineural hearing loss of 30 dB or greater over at least three contiguous audiometric frequencies and within a three-day period. This hearing loss is usually unilateral and can be associated with tinnitus and vertigo. The pathogenesis of unilateral sudden sensorineural hearing loss is still unknown, and the alterations in the functional connectivity are suspected to involve one possible pathogenesis. Despite scarce findings with respect to alterations in brain functional networks in unilateral sudden sensorineural hearing loss, the alterations of the whole brain functional connectome and whether these alterations were already in existence in the acute period remains unknown. The aim of this study was to investigate the alterations of brain functional connectome in two large samples of unilateral sudden sensorineural hearing loss patients and to investigate the correlation between unilateral sudden sensorineural hearing loss characteristics and changes in the functional network properties. Pure tone audiometry was performed to assess hearing ability. Abnormal changes in the peripheral auditory system were examined using conventional magnetic resonance imaging. The graph theoretical network analysis method was used to detect brain connectome alterations in unilateral sudden sensorineural hearing loss. Compared with the control groups, both groups of unilateral SSNHL patients exhibited a significantly increased clustering coefficient, global efficiency, and local efficiency but a significantly decreased characteristic path length. In addition, the primary increased nodal strength (e.g., nodal betweenness, hubs) was observed in several regions primarily, including the limbic and paralimbic systems, and in the auditory network brain areas. These findings suggest that the alteration of network organization already exists in unilateral sudden sensorineural hearing loss patients within the acute period

  16. Disrupted functional brain connectome in unilateral sudden sensorineural hearing loss.

    PubMed

    Xu, Haibo; Fan, Wenliang; Zhao, Xueyan; Li, Jing; Zhang, Wenjuan; Lei, Ping; Liu, Yuan; Wang, Haha; Cheng, Huamao; Shi, Hong

    2016-05-01

    Sudden sensorineural hearing loss (SSNHL) is generally defined as sensorineural hearing loss of 30 dB or greater over at least three contiguous audiometric frequencies and within a three-day period. This hearing loss is usually unilateral and can be associated with tinnitus and vertigo. The pathogenesis of unilateral sudden sensorineural hearing loss is still unknown, and the alterations in the functional connectivity are suspected to involve one possible pathogenesis. Despite scarce findings with respect to alterations in brain functional networks in unilateral sudden sensorineural hearing loss, the alterations of the whole brain functional connectome and whether these alterations were already in existence in the acute period remains unknown. The aim of this study was to investigate the alterations of brain functional connectome in two large samples of unilateral sudden sensorineural hearing loss patients and to investigate the correlation between unilateral sudden sensorineural hearing loss characteristics and changes in the functional network properties. Pure tone audiometry was performed to assess hearing ability. Abnormal changes in the peripheral auditory system were examined using conventional magnetic resonance imaging. The graph theoretical network analysis method was used to detect brain connectome alterations in unilateral sudden sensorineural hearing loss. Compared with the control groups, both groups of unilateral SSNHL patients exhibited a significantly increased clustering coefficient, global efficiency, and local efficiency but a significantly decreased characteristic path length. In addition, the primary increased nodal strength (e.g., nodal betweenness, hubs) was observed in several regions primarily, including the limbic and paralimbic systems, and in the auditory network brain areas. These findings suggest that the alteration of network organization already exists in unilateral sudden sensorineural hearing loss patients within the acute period

  17. Unilateral and bilateral nasal resistances: a supplement.

    PubMed

    Naito, K; Cole, P; Humphrey, D

    1990-06-01

    Three hundred and thirty-four measurements of bilateral and unilateral nasal resistance (at delta P 1.0 cm H2O and by time averaging) in 233 adults were carried out by posterior rhinomanometry with a head-out body plethysmograph. Total nasal resistances, calculated by the equation of Ohm's Law for parallel resistors from measured unilateral resistances, were compared with measured total nasal resistances. The time averaged total nasal resistances calculated by use of Ohm's Law for parallel resistors were closer to direct measurements than resistances at delta P 1.0 cm H2O calculated from the same equation. We attempted to fit calculated total nasal resistance with direct measurements by modification of the equation of Ohm's Law for parallel resistors to T = 0.96[R x L/(R + L)]0.92 in the time averaged nasal resistance and T = 1.07[R x L/(R + L)]0.77 in resistance at delta P 1.0 cm H2O (T: total nasal resistance, R: nasal resistance on the right side, L: nasal resistance on the left side). Calculated total nasal resistances from the above equations agreed closely with direct measurements.

  18. Molecular Karyotype of Sporadic Unilateral Retinoblastoma Tumors

    PubMed Central

    Ganguly, Arupa; Nichols, Kim E.; Grant, Gregory; Rappaport, Eric; Shields, Carol

    2009-01-01

    Background Retinoblastoma (RB) is a childhood ocular malignancy associated with mutations in RB1, a tumor susceptibility gene. Inactivation of both copies of the RB1 gene in a retinal cell is followed by the sequential acquisition of additional genetic changes that define the course to tumor formation. Methods To identify the genetic events that cooperate with loss of the RB1 gene function, we performed a whole genome sampling assay (WGSA) based on SNP genotyping. We used DNA isolated from 25 sporadic, unilateral RB tumors and matched blood samples. Results Genomic profiles were analyzed to identify regions of loss of heterozygosity (LOH) and/or amplification. Two major subclasses of RB tumors were defined by the presence (n=18) or absence (n=7) of LOH of chromosome 13. LOH in most cases was due to copy neutral events caused by mitotic recombination and mitotic non-disjunction. Tumors harbored novel regions of amplification at 1q44, 3p25, 11q14, 11q25, 14q23, 15q21, 16p13, 17p11.2, 19q13, and 20q13 while regions of loss included 6q22, 7q21and 21q2. Conclusion WGSA-based analysis of unilateral RB tumors revealed novel regions as significant. These minimum critical regions that are lost or amplified are expected to harbor genes that aid the process of tumorigenesis. PMID:19491728

  19. Diaphragm mechanics in dogs with unilateral emphysema.

    PubMed Central

    Hubmayr, R D; Farkas, G A; Tao, H Y; Sieck, G C; Margulies, S S

    1993-01-01

    We studied dogs with unilateral papain-induced emphysema to answer two questions: (1) Do emphysema lung-apposed hemidiaphragm (DiE) and normal lung-apposed hemidiaphragm (DiN) have equal capacities for lowering lung surface pressure? and (2) Are side-to-side differences in intrathoracic pressure the result of unequal force outputs by DiE and DiN or are they caused by differences in their mechanical efficiency as pressure generators? After the airways of the emphysematous and normal lungs were intubated with a dual lumen endotracheal tube, both phrenic nerves were maximally stimulated at rates between 1 and 50 Hz and the changes in airway occlusion pressure (delta PaoE,N) and diaphragm length (sonomicrometry) were recorded. In all animals, delta PaoN exceeded delta PaoE. Differences in pressure ranged from 1.2 +/- 0.6 cm H2O during a twitch to 6.0 +/- 2.9 cm H2O during a 50-Hz tetanus. Midcostal bundles of DiE shortened less than corresponding bundles of DiN, but both reached the same active length relative to their optimal lengths, which were measured in vitro. There was no significant difference in fiber type distribution, fiber cross-sectional area, or maximal isometric tetanic tensions among midcostal regions of DiE and DiN. We conclude that unilateral hyperinflation impairs the mechanical efficiency of the apposing hemidiaphragm as a pressure generator. PMID:8473503

  20. Hypertropia in unilateral isolated abducens palsy

    PubMed Central

    Pihlblad, Matthew S.; Demer, Joseph L.

    2014-01-01

    Purpose To evaluate the incidence and features of hypertropia in abducens nerve palsy. Methods The records of consecutive patients with unilateral, isolated, previously unoperated abducens nerve palsy were reviewed for binocular alignment on cover testing, Krimsky measurement, or Hess screen testing. Patients with associated cranial nerve palsy (including bilateral abducens palsies), orbital disease, myasthenia gravis, Horner syndrome, hemiplegia, cerebellar signs, arteritis, or previous strabismus surgery were excluded. Control subjects underwent complete examination to confirm normality. Results A total of 79 patients were included (40 males; mean age 49.2 years). Hypertropia in lateral or central gazes was present in 15 of 79 cases (19%) on alternate cover or Krimsky testing, in 32 of 56 cases (57%) on Hess screen testing, and absent in all 30 normal controls. Of cases with hypertropia, the mean of the greatest hypertropia in lateral or central gaze on was 5.0Δ ± 2.3Δ (standard deviation; range, 1Δ–8Δ) routine clinical examination, and 5.8Δ ± 4.2Δ (range, 2Δ–24Δ) on Hess screen testing. Of 39 cases with partial abducens palsy evaluated by Hess screen testing, the ipsilesional eye was hypertropic in 24 (61%) and hypotropic in 15 cases (39%). Conclusions Small-angle hypertropia is common in isolated, unilateral abducens and does not necessarily imply existence of multiple cranial neuropathies or skew deviation. PMID:24924275

  1. Clinical verification of a unilateral otolith test

    NASA Astrophysics Data System (ADS)

    Wetzig, J.; Hofstetter-Degen, K.; Maurer, J.; von Baumgarten, R. J.

    In a previous study 13 we reported promising results for a new test to differentiate in vivo unilateral otolith functions. That study pointed to a need for further validation on known pathological cases. In this presentation we will detail the results gathered on a group of clinically verified vestibular defectives (verum) and a normal (control) group. The subjects in the verum group were former patients of the ENT clinic of the university hospital. These subjects had usually suffered from neurinoma of the VIIth cranial nerve or inner ear infections. All had required surgical intervention including removal of the vestibular system. The patients were contacted usually two or more years postoperatively. A group of students from the pre- and clinical phase of medical training served as control. Both groups were subjected to standardized clinical tests. These tests served to reconfirm the intra- or postoperative diagnosis of unilateral vestibular loss in the verum group. In the control group they had to establish the normalcy of the responses of the vestibular system. Both groups then underwent testing on our exccentric rotary chair in the manner described before 13. Preliminary results of the trials indicate that this test may indeed for the first time offer a chance to look at isolated otolith apparati in vivo.

  2. Language development after unilateral brain injury.

    PubMed

    Feldman, H M; Holland, A L; Kemp, S S; Janosky, J E

    1992-01-01

    This longitudinal study describes the growth of syntactic abilities and vocabulary size in nine children with unilateral antepartum or perinatal brain injury. Five children with left hemisphere damage (LHD) and four with right hemisphere damage (RHD), ages 15 to 48 months, were evaluated on three or more occasions. Language samples generated from parent-child interaction were transcribed, coded, and analyzed using the Child Language Data Exchange System. Individual growth trajectories were constructed by graphing three dependent variables--MLU, scores on the Index of Productive Syntax (IPSYN), and number of different words--as a function of the child's age. One subject remained in a prelinguistic stage throughout the study. Simple linear functions best described the growth of MLU, IPSYN scores, and vocabulary in the other eight children. The slopes of the individual growth trajectories, the graphic representations of rates of progress, were comparable in the eight children. Seven children showed developmental delays in initial word use and five in the onset of multiword utterances. However, by age 24 months, four children with LHD and two children with RHD had syntactic capabilities comparable to those of children without brain injuries. The developmental patterns suggested that both cerebral hemispheres may play critical roles in the very earliest stages of language acquisition. Some unilateral lesions caused little discernible effect on language outcome in the toddler-preschool years after the initial developmental delays. PMID:1547471

  3. Galeazzi fracture.

    PubMed

    Atesok, Kivanc I; Jupiter, Jesse B; Weiss, Arnold-Peter C

    2011-10-01

    Galeazzi fracture is a fracture of the radial diaphysis with disruption at the distal radioulnar joint (DRUJ). Typically, the mechanism of injury is forceful axial loading and torsion of the forearm. Diagnosis is established on radiographic evaluation. Underdiagnosis is common because disruption of the ligamentous restraints of the DRUJ may be overlooked. Nonsurgical management with anatomic reduction and immobilization in a long-arm cast has been successful in children. In adults, nonsurgical treatment typically fails because of deforming forces acting on the distal radius and DRUJ. Open reduction and internal fixation is the preferred surgical option. Anatomic reduction and rigid fixation should be followed by intraoperative assessment of the DRUJ. Further intraoperative interventions are based on the reducibility and postreduction stability of the DRUJ. Misdiagnosis or inadequate management of Galeazzi fracture may result in disabling complications, such as DRUJ instability, malunion, limited forearm range of motion, chronic wrist pain, and osteoarthritis.

  4. Pediatric Thighbone (Femur) Fracture

    MedlinePlus

    ... fractures in infants under 1 year old is child abuse. Child abuse is also a leading cause of thighbone fracture ... contact sports • Being in a motor vehicle accident • Child abuse Types of Femur Fractures (Classification) Femur fractures vary ...

  5. Unilateral asterixis: motor integrative dysfunction in focal vascular disease.

    PubMed

    Massey, E W; Goodman, J C; Stewart, C; Brannon, W L

    1979-08-01

    In three patients we found unilateral asterixis in limbs contralateral to a discrete lesion adjacent to the internal capsule. Etiology was vascular in each, with no metabolic or toxic disturbance. Unilateral asterixis bespeaks focal disease arising from lesions in the thalamus or internal capsule and is a sign of motor integrative dysfunction.

  6. Leg stiffness: comparison between unilateral and bilateral hopping tasks.

    PubMed

    Brauner, Torsten; Sterzing, Thorsten; Wulf, Mathias; Horstmann, Thomas

    2014-02-01

    Leg stiffness is a predictor of athletic performance and injury and typically evaluated during bilateral hopping. The contribution of each limb to bilateral leg stiffness, however, is not well understood. This study investigated leg stiffness during unilateral and bilateral hopping to address the following research questions: (1) does the magnitude and variability of leg stiffness differ between dominant and non-dominant legs? (2) Does unilateral leg stiffness differ from bilateral leg stiffness? and (3) Is bilateral leg stiffness determined by unilateral leg stiffness? Thirty-two physically active males performed repeated hopping tests on a force platform for each of the three conditions: bilateral hopping, unilateral hopping on the dominant leg, and unilateral hopping on the non-dominant leg. Leg stiffness was estimated as the ratio of the peak vertical force and the maximum displacement using a simple 1-D mass-spring model. Neither the magnitude nor variability of leg stiffness differed between dominant and non-dominant limbs. Unilateral leg stiffness was 24% lower than bilateral stiffness and showed less variability between consecutive hops and subjects. Unilateral leg stiffness explained 76% of the variance in bilateral leg stiffness. We conclude that leg stiffness estimates during unilateral hopping are preferable for intervention studies because of their low variability. PMID:24290613

  7. Reproducibility of Tactile Assessments for Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Auld, Megan Louise; Ware, Robert S.; Boyd, Roslyn Nancy; Moseley, G. Lorimer; Johnston, Leanne Marie

    2012-01-01

    A systematic review identified tactile assessments used in children with cerebral palsy (CP), but their reproducibility is unknown. Sixteen children with unilateral CP and 31 typically developing children (TDC) were assessed 2-4 weeks apart. Test-retest percent agreements within one point for children with unilateral CP (and TDC) were…

  8. Management of malunited mandibular condylar fractures.

    PubMed

    Rubens, B C; Stoelinga, P J; Weaver, T J; Blijdorp, P A

    1990-02-01

    The non-surgical treatment of mandibular condylar fractures, may occasionally result in articular imbalance and temporomandibular joint dysfunction. This may be attributed to condylar head displacement and resorption, resulting in a shortened vertical ramus and lost posterior vertical facial height. Restoring the vertical ramus height is essential in the treatment of such dysfunction, and may be accomplished by unilateral, or bilateral ramus osteotomies. Four examples of patients treated with mandibular ramus osteotomies to restore vertical ramus height, with subsequent improvement in occlusal balance and function are presented. The use of the sagittal split mandibular osteotomy and the external vertical ramus osteotomy, stabilized with small osseous plates, and monocortical screws, is discussed.

  9. Arcuate Fractures

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site]

    In the upper left corner of this VIS image are a series of fractures. Where the fractures are exposed on the surface it is impossible to tell the plane of the fracture; however where the fractures are visible in the cliff wall it is possible to see that the fractures dip to the north. This image shows part of the caldera of Tharsis Tholus.

    Image information: VIS instrument. Latitude 1.7, Longitude 176.5 East (183.5 West). 19 meter/pixel resolution.

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

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

  10. Unilateral condylar hyperplasia: a treatment strategy.

    PubMed

    Ferreira, Sabrina; da Silva Fabris, André Luis; Ferreira, Gabriel Ramalho; Faverani, Leonardo Perez; Francisconi, Giovanna Barbosa; Souza, Francisley Avila; Garcia, Idelmo Rangel

    2014-05-01

    Condylar hyperplasia (CH) is a pathologic condition that causes overdevelopment of the condylar head and neck as well as the mandible. Slowly progressive unilateral enlargement of the head and the neck of the condyle causes crossbite malocclusion, facial asymmetry, and shifting of the midpoint of the chin to the unaffected side. The etiology and the pathogenesis of CH remain uncertain. The diagnosis is made by clinical and radiologic examinations and bone scintigraph. A difference in uptake of 10% or more between condyles is regarded as indicative of CH, and the affected condyles had a relative uptake of 55% or more. When the diagnosis of active CH is established, the treatment consists of removal of the growth center by a partial condylectomy. The authors present the case of a 46-year-old male patient with right active type II CH or hemimandibular hyperplasia who underwent a high condylectomy. PMID:24820728

  11. Speed of information processing after unilateral stroke.

    PubMed

    Gerritsen, Marleen J J; Berg, Ina J; Deelman, Betto G; Visser-Keizer, Annemarie C; Meyboom-de Jong, Betty

    2003-02-01

    Speed of information processing in the subacute stage after stroke was studied in 88 first ever, unilateral, ischemic stroke patients. The patient group included 42 right and 46 left hemisphere patients. Seventy-one control subjects were also examined. Four reaction time tasks with different levels of complexity were used: two visuomotor, and two semantic categorisation tasks. The results showed that stroke causes a decrease in decision making speed, but that the effect is different for right and left hemisphere patients. The right hemisphere group were slower than the control group on all reaction time tasks, and slower than the left hemisphere patients on the visuomotor tasks. The left hemisphere patients were slower than the healthy controls, only on the most complex tasks, the categorisation tasks. PMID:12607167

  12. Isolated unilateral idiopathic transient hypoglossal nerve palsy

    PubMed Central

    Ahmed, Syed Viqar; Akram, Muhammad Saqub

    2014-01-01

    A 52-year-old Caucasian man presented with sudden onset of difficulty in moving his tongue to the left with preceding left-sided headache with no neck pain. Earlier, he had self-limiting chest infection without rashes or tonsillar enlargement. His medical and surgical history was unremarkable with no recent trauma. Oral examination revealed difficulty in protruding his tongue to the left with muscle bulk loss and fasciculation on the same side, suggesting left hypoglossal nerve palsy. Examination of the rest of the cranial nerves and nervous system was normal. The patient's oropharyngeal and laryngeal examination was unremarkable with no cervical lymphadenopathy. He had normal laboratory investigations and cerebrospinal fluid examination. Extensive imaging of the head, neck and chest failed to reveal any pathology. Further review by an otorhinologist and rheumatologist ruled out any other underlying pathology. He made a good recovery without treatment. English literature search revealed very few cases of idiopathic, transient, unilateral hypoglossal nerve palsy. PMID:24969070

  13. Spontaneous Idiopathic Unilateral Adrenal Haemorrhage (SIAH).

    PubMed

    Naqvi, Syed Ali; Zaman, Shamas; Ahmed, Irfan

    2015-04-01

    Spontaneous Idiopathic Adrenal Haemorrhage (SIAH) is an unusual surgical emergency which can present with life threatening massive retroperitoneal bleeding. Most of the cases reported in the literature are associated with use of anticoagulation or underlying adrenal pathology such as tumors or cysts. Since this clinical entity is uncommon and clinical presentation is very indistinct, the diagnosis can be easily missed and can be challenging for the treating physicians. Nevertheless a raised clinical suspicion coupled with advances in radiological imaging have considerably improved the detection of SIAH in recent times. We report an unusual case of a 20 years old healthy female student who presented to our hospital with sudden onset of abdominal pain and shock. She was diagnosed as a case of massive spontaneous idiopathic unilateral adrenal haemorrhage, unaccompanied by any hematologic disorder, trauma or underlying pathology. Although patient was hemodynamically unstable at presentation, she was resuscitated promptly, investigated appropriately, hence recovered uneventfully with conservative management alone.

  14. An interesting radiological picture of post traumatic TMJ ankylosis due to sagittal condylar fracture

    PubMed Central

    Kumar L.K., Surej; Manuel, Suvy; Kurien, Nikhil M.; Khalam, Sherin A.; P. Menon, Varun

    2015-01-01

    Introduction In a condylar fracture whether to intervene or to go for conservative management still remains a dilemma. Studies and hypothesis suggests that it's medially dislocated condylar fracture segment that is more likely to ankylose, moreover no consensus have been put forth as to whether to remove the medially displaced fracture segment. Presentation of case The current article describes a case of unilateral temporomandibular joint (TMJ) ankylosis, which resulted as a sequlae from conservative management of a bilateral condylar fracture of which, the ankylosed side had a sagittal fracture of condyle. In our case the post trauma CT shows the lateral segment abutting with the arch and that the area has become ankylotic in a span of 2 years. Here we report a case of posttraumatic unilateral TMJ ankylosis resulting from closed reduction of a bilateral condylar fracture with interesting radiological findings. Discussion We have tried to discuss a rather interesting radiological picture of posttraumatic TMJ ankylosis which resulted as a sequlae from conservative management of a bilateral condylar fracture. Conclusion The dilemma for a clinician as to whether to intervene in a condylar fracture or to go for conservative management still remains at large. As in this case the medial fracture segment was intact and the lateral segment was resulting in ankylosis. PMID:25985295

  15. Unilateral pupillary dilatation following septoplasty: cause for concern?

    PubMed

    Shakeel, Muhammad; Trinidade, Aaron; Khan, Imran; Johnston, Graham; Hussain, Akhtar

    2013-07-01

    We report and explain unilateral pupillary dilatation following routine septoplasty and trimming of inferior turbinates. The unilateral pupillary dilatation was caused by inadvertent instillation of sympathomimetic, (xylometazoline hydrochloride) in the eye during preparation for nasal surgery. The effect was short-lived and the patient made a full recovery. Unilateral pupillary dilatation after sinonasal surgery can be alarming due to the possibility of injury to the globe and intracranial haemorrhage but can also be explained by the mydriatic effect of the sympathomimetic nasal drops and sprays used to decongest the nose. Such possibility should be borne in mind and would help to explain and reduce the anxiety and avoid unnecessary investigations. PMID:23823962

  16. Auditory sustained attention is a marker of unilateral spatial neglect.

    PubMed

    Robertson, I H; Manly, T; Beschin, N; Daini, R; Haeske-Dewick, H; Hömberg, V; Jehkonen, M; Pizzamiglio, G; Shiel, A; Weber, E

    1997-12-01

    The relationships between performance on a non-spatially-lateralized measure of sustained attention and spatial bias on tests sensitive to unilateral neglect were considered in a group of 44 patients with right hemisphere lesions following stroke. As predicted from earlier studies showing a strong association between unilateral spatial neglect and sustained attention, performance on a brief and monotonous tone-counting measure formed a significant predictor of spatial bias across a variety of measures of unilateral visual neglect. This study provides further evidence for a very close link between two attentional systems hitherto regarded as being quite separate, namely a spatial attention system implicated in unilateral neglect and a sustained attention system. A close connection between these two systems was predicted by Posner, who argued that the right hemisphere-dominant sustained attention system provides a strong modulatory influence on the functioning of the lateralized posterior attention system.

  17. Unilateral phrenic nerve paralysis from cutting down a Christmas tree.

    PubMed

    Tiede, R H; Hover, J R; Davies, S F

    1994-11-01

    Stretch injury to the phrenic nerve is an unusual cause of unilateral diaphragmatic paralysis. In this case the injury occurred while the patient was lying on the ground and cutting down a Christmas tree with a hand saw.

  18. Influence of unilateral weight on bilateral cyclograms

    NASA Astrophysics Data System (ADS)

    Pellicer Costa, Juan José; Dusza, Jacek J.

    2014-11-01

    The paper presents the results of gait parameters as a function of unilateral weight. The object of the research was a woman walking on a stationary surface and carrying in his hand weights from 0 to 15 kg. Her movement was recorded by 6 cameras recording the location of 34 markers placed at appropriate points in the body. 3D reconstruction was performed for each of the reflecting markers. Tested signals were changes in the value the joint angles of ankle, knee and hip. On the basis of about 6 cycles of movement of each load, a model for the average gait cycle was developed. The result of the experiments are graphs of changes the joint angles as a function of time, bilateral cyclograms, synchronized bilateral cyclograms and regression lines. The conclusion of the study is to determine how one-sided load affects gait asymmetry. Simple and easy to interpret method of presentation of results were also shown. Studies were conducted using VICON system.

  19. Auditory localization by subjects with unilateral tinnitus.

    PubMed

    Hyvärinen, Petteri; Mendonça, Catarina; Santala, Olli; Pulkki, Ville; Aarnisalo, Antti A

    2016-05-01

    Tinnitus is associated with changes in neural activity. How such alterations impact the localization ability of subjects with tinnitus remains largely unexplored. In this study, subjects with self-reported unilateral tinnitus were compared to subjects with matching hearing loss at high frequencies and to normal-hearing subjects in horizontal and vertical plane localization tasks. Subjects were asked to localize a pink noise source either alone or over background noise. Results showed some degree of difference between subjects with tinnitus and subjects with normal hearing in horizontal plane localization, which was exacerbated by background noise. However, this difference could be explained by different hearing sensitivities between groups. In vertical plane localization there was no difference between groups in the binaural listening condition, but in monaural listening the tinnitus group localized significantly worse with the tinnitus ear. This effect remained when accounting for differences in hearing sensitivity. It is concluded that tinnitus may degrade auditory localization ability, but this effect is for the most part due to the associated levels of hearing loss. More detailed studies are needed to fully disentangle the effects of hearing loss and tinnitus. PMID:27250123

  20. Unilateral condylar hyperplasia: A case report and review of literature

    PubMed Central

    Bharathi, Saravana C.; Senthilnathan, S.; Kumar, Lokesh D.; Mohan, Anand C. S.; Taranath, M.

    2014-01-01

    Condylar hyperplasia is (CH) an uncommon malformation of the mandible involving change in size and morphology of the condylar neck and head. CH is an anomaly that usually occurs unilaterally and equally affects in both men and women. Hyperplasia of the condyle ‘differentiated into hemimandibular hyperplasia, hemimandibular elongation and CH. Here, we are presenting a case of 17-year-old male patient with unilateral CH and its review of the literature. PMID:24818099

  1. Grip Force Coordination during Bimanual Tasks in Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Islam, Mominul; Gordon, Andrew M.; Skold, Annika; Forssberg, Hans; Eliasson, Ann-Christin

    2011-01-01

    Aim: The aim of the study was to investigate coordination of fingertip forces during an asymmetrical bimanual task in children with unilateral cerebral palsy (CP). Method: Twelve participants (six males, six females; mean age 14y 4mo, SD 3.3y; range 9-20y;) with unilateral CP (eight right-sided, four left-sided) and 15 age-matched typically…

  2. Unilateral condylar hyperplasia: A case report and review of literature.

    PubMed

    Bharathi, Saravana C; Senthilnathan, S; Kumar, Lokesh D; Mohan, Anand C S; Taranath, M

    2014-01-01

    Condylar hyperplasia is (CH) an uncommon malformation of the mandible involving change in size and morphology of the condylar neck and head. CH is an anomaly that usually occurs unilaterally and equally affects in both men and women. Hyperplasia of the condyle 'differentiated into hemimandibular hyperplasia, hemimandibular elongation and CH. Here, we are presenting a case of 17-year-old male patient with unilateral CH and its review of the literature. PMID:24818099

  3. [Cause and treatment of unilateral vocal cord paralysis].

    PubMed

    Xu, Dongyue; Li, Keyong

    2016-03-01

    Unilateral vocal cord paralysis(UVCP) is defined as affected side vocal cord emerges immobility or motion weakening and abnormal tension due to unilateral intrinsic laryngeal muscles suffering from disorder about motor nerve. The patients usually present with hoarse voice, disability of high pitch, cough, aspiration, or a combination of these symptoms. There are increasing therapeutics researches and case analyses regarding UVCP in recent years. Thus this review summarized the progression about its causes and treatment methods. PMID:27382698

  4. Prolonged adrenal insufficiency after unilateral adrenalectomy for Cushing's Syndrome.

    PubMed

    Kulshreshtha, Bindu; Arora, Arpita; Aggarwal, Anshita; Bhardwaj, Minakshi

    2015-01-01

    The contralateral healthy adrenal in patients undergoing unilateral adrenalectomy for Cushing's is known to be suppressed temporarily and forms the basis of peri and postoperative steroids. We present four cases of Cushing's who had prolonged adrenal insufficiency with continued requirement for steroids for periods ranging 1-4 years after unilateral adrenalectomy for Cushing's. We further review literature regarding the recovery of the hypothalamo pituitary adrenal axis postsurgery in patients with Cushing's syndrome.

  5. Hypertension and unilateral vascular occlusion. Diagnosis and surgical intervention.

    PubMed

    Viol, G W; Smith, E K; Keane, P M

    1978-08-01

    Four hypertensive patients with unilateral atheromatous renal arterial occlusion have been studied. Each showed elevation of renal venous activity on the side of the vascular occlusion relative to the opposite side. Three of the patients underwent nephrectomy with amelioration of their hypertension. It is concluded that surgical treatment is valid therapy in patients with atheromatous unilateral renal vascular occlusion and ipsilateral elevation of renal venous renin activity. PMID:695147

  6. Cyclotorsion in unilateral and bilateral superior oblique paresis.

    PubMed

    Kraft, S P; O'Reilly, C; Quigley, P L; Allan, K; Eustis, H S

    1993-01-01

    We studied excyclotorsion prospectively in 12 non-strabismic normal patients, 24 patients with unilateral superior oblique paresis (SOP), and 14 patients with bilateral SOP to determine which test and position, and what amount of torsion best discriminates between bilateral and unilateral SOP. For each patient, we measured torsion at near in primary position and in 20 degrees downgaze, using both the double Maddox rod (DMR) and Bagolini lens (BL) tests. We calculated the average of three measurements for each test in each position and the differences in mean excyclotorsion between downgaze and primary position for each patient for each test. To discriminate between unilateral SOP and normal, and bilateral and unilateral SOP patients, the best test and position combination was the DMR in downgaze (P = .0001). The probability of a torsion measurement indicating a unilateral SOP rather than a normal value was 95% at 6 degrees of excyclotorsion; of bilateral rather than unilateral SOP, 90% at 20 degrees. The range in the three torsion readings within patients with either DMR or BL in either position varied up to 7 degrees.

  7. Radial head fracture - aftercare

    MedlinePlus

    Elbow fracture - radial head - aftercare ... to 2 weeks. If you have a small fracture and your bones did not move around much, ... to see a bone doctor (orthopedic surgeon). Some fractures require surgery to: Insert pins and plates to ...

  8. Fractured Surface

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site] Context image for PIA03084 Fractured Surface

    These fractures and graben are part of Gordii Fossae, a large region that has undergone stresses which have cracked the surface.

    Image information: VIS instrument. Latitude 16.6S, Longitude 234.3E. 18 meter/pixel resolution.

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

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

  9. Multiwell fracturing experiments. [Nitrogen foam fracture treatment

    SciTech Connect

    Warpinski, N.

    1985-01-01

    The objective of the Multiwell fracturing experiments is to test and develop the technology for the efficient stimulation of tight, lenticular gas sands. This requires basic understanding of: (1) fracture behavior and geometry in this complex lithologic environment, and (2) subsequent production into the created fracture. The intricate interplay of the hydraulic fracture with the lens geometry, the internal reservoir characteristics (fractures, reservoir breaks, etc.), the in situ stresses, and the mechanical defects (fracture, bedding, etc.) need to be defined in order to develop a successful stimulation program. The stimulation phase of the Multiwell Experiment is concerned with: (1) determining important rock/reservoir properties that influence or control fracture geometry and behavior, (2) designing fracture treatments to achieve a desired size and objectives, and (3) conducting post-treatment analyses to evaluate the effectiveness of the treatment. Background statement, project description, results and evaluation of future plans are presented. 5 refs., 2 figs., 2 tabs.

  10. Acute unilateral loss of vestibular function.

    PubMed

    Fetter, M

    2016-01-01

    Sudden unilateral loss of vestibular function is the most severe condition that can occur in the vestibular system. The clinical syndrome is caused by the physiologic properties of the vestibulo-ocular reflex (VOR) arc. In the normal situation, the two peripheral vestibular end organs are connected to a functional unit in coplanar pairs of semicircular canals working in a push-pull mode. "Push-pull" mode means that, when one side is excited, the other side is inhibited, and vice versa due to two mechanisms. First, first-order vestibular afferents are bipolar cells. They have a tonic firing rate that is modulated up or down depending on the direction of rotation. Second, via inhibitory neural connections of second-order vestibular neurons between the vestibular nuclei (vestibular commissural system), the excited side inhibits further the contralateral side. The neural signals are encoded as the difference of the change in firing rate of the vestibular neurons modulating the tonic firing rate on both sides in opposite directions (one side up, the contralateral side down). When the head is not moving, the two peripheral vestibular end organs generate a resting firing rate, which is exactly equal on both sides. When the head is rotated, for example, to the right, the right-sided first-order vestibular afferents increase their discharge rate and the left-sided ones decrease their firing rate. This leads to increase in firing rate of also the type I second-order vestibular neurons in the vestibular nuclei, which synapse with inhibitory type II neurons on the contralateral side, further decreasing the firing rate in the second-order vestibular neurons in the contralateral vestibular nucleus. When the direction of head rotation is reversed, the behavior of the type I neurons on the two sides of the head is reversed. The same relation exists between the coplanar vertical canal afferents on the two sides of the head. When there is unilateral damage to the end organ or the

  11. The impacts of Unilateral Stratospheric Geoengineering

    NASA Astrophysics Data System (ADS)

    Jones, A.; Haywood, J. M.; Bellouin, N.; Stephenson, D.

    2013-12-01

    Stratospheric geoengineering proposals have been suggested on the premise that the cooling impacts of volcanic eruptions could be deliberately mimicked to offset the impacts of increased greenhouse gas concentrations in the future by counterbalance global warming. Here, we examine both the impacts of hemispherically asymmetric volcanoes in the observational record and the impact of prolonged deliberate injection of stratospheric aerosol into either the northern or southern hemisphere stratosphere or into both hemispheres equally to assess the impacts on Sahelian rainfall and agriculture (Haywood et al., 2013). While the frequency of volcanic eruptions during the past 100 years is too sparse for definitive attribution, there is a suggestion that volcanic eruptions that preferentially load the northern hemisphere are the harbinger of Sahelian drought. Simulations are then performed with the HadGEM2 couple atmospheric-ocean model to assess the impacts of these volcanic eruptions and deliberate unilateral stratospheric geoengineering. Figure 1 shows the impacts of the geoengineering simulations which show that stratospheric injection into the northern hemisphere induces a severe and prolonged Sahelian drought with undoubted detrimental consequences for the local population. Conversely injection into the southern hemisphere causes a significant greening of the Sahel with vegetation productivity enhanced by over 100%. On the face of it, this suggests potential advocacy of injection into the southern hemisphere: we will investigate potential other side-effects from such a strategy...... Haywood, J.M., A. Jones, N. Bellouin, and D.B. Stephenson, Asymmetric forcing from stratospheric aerosols impacts Sahelian drought, Nature Climate Change, Vol 3, No 7, 660-665, doi: 10.1038/NCLIMATE1857, 2013.

  12. Ultrasound biomicroscopy in patients with unilateral pseudoexfoliation

    PubMed Central

    Ünsal, Erkan; Eltutar, Kadir; Muftuoglu, Ilkay; Akcetin, Tulay Alpar; Acar, Yıldız

    2015-01-01

    AIM To compare the anterior segment morphology evaluated using ultrasound biomicroscopy (UBM) in patients with clinical pseudoexfoliation syndrome (XFS) in one eye and no clinical XFS in the fellow eye. METHODS Thirty patients with unilateral XFS were included in the study. All patients underwent evaluation of their anterior segment using UBM with and without dilatation with 1% cyclopentolate. The anterior chamber depth (ACD), lens thickness (LT), anterior chamber angle (ACA), ciliary body thickness (CBT), scleral thickness (ST), trabeculae -ciliary processes distance (T-CPD), and iris-ciliary processes distance (I-CPD) were measured using UBM scans. All results between the eyes with clinical XFS and their fellow eyes without clinical XFS were then compared. RESULTS Before dilatation the eyes with XFS (4.350±0.531 mm) were found to have a significantly thicker lens (P=0.002) than the eyes without XFS (4.238±0.540 mm). In addition after dilatation, the eyes with XFS (4.310±0.500 mm) were found to have a significantly thicker lens than the eyes without XFS (4.160±0.480 mm) (P=0.019). The average ACD, for the group with XFS, comparing pre-dilatation (2.616±0.349 mm) and post-dilatation measurements (2.714±0.413) was found to be statistically increased (P=0.014). The average ACD, comparing pre-dilatation to post-dilatation measurements in patients without XFS (2.680±0.360), (2.720±0.500) was found to be statistically unchanged (P=0.450). DISCUSSION Crystalline lenses tended to be thicker in the eyes with clinical pseudoexfoliation than their fellow eyes without pseudoexfoliation. PMID:26309875

  13. Fracture healing in protease-activated receptor-2 deficient mice.

    PubMed

    O'Neill, Kevin R; Stutz, Christopher M; Mignemi, Nicholas A; Cole, Heather; Murry, Matthew R; Nyman, Jeffry S; Hamm, Heidi; Schoenecker, Jonathan G

    2012-08-01

    Protease-activated receptor-2 (PAR-2) provides an important link between extracellular proteases and the cellular initiation of inflammatory responses. The effect of PAR-2 on fracture healing is unknown. This study investigates the in vivo effect of PAR-2 deletion on fracture healing by assessing differences between wild-type (PAR-2(+/+)) and knock-out (PAR-2(-/-)) mice. Unilateral mid-shaft femur fractures were created in 34 PAR-2(+/+) and 28 PAR-2(-/-) mice after intramedullary fixation. Histologic assessments were made at 1, 2, and 4 weeks post-fracture (wpf), and radiographic (plain radiographs, micro-computed tomography (µCT)) and biomechanical (torsion testing) assessments were made at 7 and 10 wpf. Both the fractured and un-fractured contralateral femur specimens were evaluated. Polar moment of inertia (pMOI), tissue mineral density (TMD), bone volume fraction (BV/TV) were determined from µCT images, and callus diameter was determined from plain radiographs. Statistically significant differences in callus morphology as assessed by µCT were found between PAR-2(-/-) and PAR-2(+/+) mice at both 7 and 10 wpf. However, no significant histologic, plain radiographic, or biomechanical differences were found between the genotypes. The loss of PAR-2 was found to alter callus morphology as assessed by µCT but was not found to otherwise effect fracture healing in young mice.

  14. The clinical application and efficacy of percutaneous kyphoplasty via unilateral pedicular approach guided by CT image measurement

    PubMed Central

    Zhai, Weifeng; Jia, Yongwei; Wang, Jianjie; Cheng, Liming

    2015-01-01

    This study aimed to investigate the clinical application and efficacy of percutaneous kyphoplasty via unilateral pedicular approach with the reference of preoperative CT image data. 73 cases (a total of 112 vertebrae) with thoracic and lumbar osteoporotic vertebral compression fractures (OVCF) received in our department were collected in this study and underwent percutaneous kyphoplasty via unilateral pedicular approach directed by CT image measurement with the operative time and fluoroscopic times recorded. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to assess the pain status and functional activity before and after operation and at the last follow-up, while X-ray and CT image were used to measure the height of the injured spinal middle column and kyphotic Cobb angle before and after operation. 73 cases (112 vertebrae) underwent percutaneous kyphoplasty successfully. Cement leakage occurred in 7 cases without obvious neurological symptoms, and they were followed up for 10 to 60 months with the average of 23 months; adjacent vertebral refractures occurred in 3 cases during the follow-up, and their symptoms were relieved after the second surgery. There was significant difference in the height of the injured spinal middle column and kyphotic Cobb angle before and after operation (P<0.05); there was significant difference in preoperative and postoperative VAS score and ODI values (P<0.05). Postoperative CT image data showed that puncture paths of the 110 vertebrae were consistent with preoperative ones sketched using the CT image, and the consistent rate of preoperative and postoperative measurement data was 98%. All patients could ambulate with brace within 2 days after operation without serious complications. In conclusion, percutaneous kyphoplasty via unilateral pedicular approach guided by preoperative CT image data is effective in treatment of osteoporotic vertebral compression fractures, and it is convenient and safe with high

  15. Proximal fifth metatarsal fractures.

    PubMed

    Ramponi, Denise R

    2013-01-01

    The most common fracture of the foot is a fracture of the proximal fifth metatarsal. In general, there are 3 types of fractures involving the proximal fifth metatarsal area, including a proximal diaphyseal stress fracture, a Jones fracture, and an avulsion fracture of the tuberosity. Some fractures of the fifth metatarsal heal without difficulty, whereas some have the potential for nonunion or delayed healing. Each fracture has some variation in the anatomical location on the fifth metatarsal, the mechanism of injury, the radiographic findings, and the treatment plan. Avulsion fractures of the tuberosity often heal without difficulty, yet fractures distal to the area of insertion of the peroneus brevis tendon are prone to nonunion and delayed healing (). Differential diagnosis of a fifth metatarsal midfoot injury includes ankle sprains, midfoot sprains, plantar facial ruptures, peroneus tendon ruptures, and other foot fractures.

  16. A new biomechanical model for evaluation of fixation systems of maxillofacial fractures.

    PubMed

    Ji, Baohui; Wang, Chun; Song, Fumin; Chen, Mengshi; Wang, Hang

    2012-07-01

    The aim of this study was to develop a new type of biomechanical model for biomechanical researches of maxillofacial fractures and then evaluate it. Twenty synthetic polyurethane maxillary and mandibular models were used to simulate the mandible and maxilla. Springs were used to represent the forces of masseter, medial pterygoid, temporalis, and lateral pterygoid muscles acting on the models. Four masticatory conditions, namely clenching in the intercuspal position (ICP), incisal clenching (INC), left unilateral molar clenching (L-MOL, contralateral side of fracture) and right unilateral molar clenching (R-MOL, fracture side) were simulated. The strain on a miniplates placed across a simulated fracture was measured using strain gauges attached to the plate surface. During INC and L-MOL, the strain on the miniplates confirmed the findings of Champy. The upper miniplate was subjected to tension force and the lower miniplate to compression. When the bite point moved to the fracture, the tension-compression zone reversed, with the upper miniplate relatively compressed and the lower miniplate tension. During ICP, the tension-compression zone changed again, with both miniplates tension. In conclusion, we have successfully developed a model which is much closer to physiological conditions than models used previously. It is reliable and useful for biomechanical tests of mandibular fractures. Models including soft tissue need developing to further understand fracture healing biomechanics.

  17. Uniextrapedicular kyphoplasty for the treatment of thoracic osteoporotic vertebral fractures.

    PubMed

    Ge, Zhaohui; Ma, Rong; Chen, Zhen; Zhang, Huiyong; Ding, Huiqiang; Liang, Siming; Suo, Zhigang

    2013-08-01

    Osteoporotic vertebral compression fractures are common and cause pain and disability. Most osteoporotic vertebral compression fractures occur in the lower thoracic and thoracolumbar spine. Percutaneous balloon kyphoplasty through a transpedicular approach is a classic procedure performed to treat osteoporotic vertebral compression fractures. However, due to the slender morphology of the pedicles, small pedicle size, and the angular severity of thoracic kyphosis, performing kyphoplasty in middle and high thoracic levels is technically challenging. The purpose of this retrospective study was to evaluate the clinical outcomes of single-balloon kyphoplasty for the treatment of thoracic osteoporotic vertebral compression fractures via an extrapedicular approach. Between July 2004 and May 2008, thirty-eight patients with thoracic osteoporotic vertebral compression fractures underwent percutaneous kyphoplasty via a unilateral extrapedicular approach. Average patient age was 60.3 years. Symptomatic levels ranged from T4 to T12. All affected vertebrae were identified via physical examination, magnetic resonance imaging, and radiographs. Pain relief, vertebral height restoration, and kyphosis correction were compared pre- and postoperatively using the visual analog scale and radiographs. The operation was successful in all patients. Average injected bone cement volume was 3.2±1.4 mL. Mean follow-up was 9.5 months. Visual analog scale pain score improved in 36 of 38 patients postoperatively. Mean visual analog scale pain score was 8.92±0.682 preoperatively and 2.40±0.31 postoperatively and remained at 2.80±0.34 until last follow-up. Mean middle body height correction ratio was 50.9%±34.6%. No lateral wedging was found in the coronal alignment of the treated vertebrae. Three (7.9%) patients sustained cement extravasation with no adverse events. Kyphoplasty through a unilateral extrapedicular approach can achieve convergent and proper cement filling in the affected

  18. Fractures of the forefoot.

    PubMed

    Mandracchia, Vincent J; Mandi, Denise M; Toney, Patris A; Halligan, Jennifer B; Nickles, W Ashton

    2006-04-01

    Fractures of the forefoot are common injuries of various causes. Although not crippling, forefoot fractures can be debilitating if they go undiagnosed or are mistreated. Whenever patients complain of foot pain with ambulation or difficulty ambulating, radiographs should be taken as part of a standard routine to assess for bony pathology. This article discusses the classification and treatment of metatarsal fractures, digital and sesamoid fractures, and open fractures about the forefoot.

  19. Unilateral buckling of elastically restrained rectangular mild steel plates

    NASA Astrophysics Data System (ADS)

    Smith, S. T.; Bradford, M. A.; Oehlers, D. J.

    This paper considers the elastic unilateral buckling of rectangular mild steel plates that are restrained elastically and subjected to bending and axial actions. A variational formulation of the Ritz method using linear combinations of harmonic functions for the buckling deformations is used to establish an eigenproblem to determine the plate local buckling coefficients. The motivation for the study is the retrofit of reinforced concrete beams by gluing and then bolting steel plates to the sides of the beam. Such plates, when acting compositely with the concrete beam, are subjected to predominantly bending and axial actions which may cause unilateral local buckling. Whereas the bolts provide complete restraint against buckling at discrete points, the glue may also inhibit local buckling between these nodal points since it acts as a continuous elastic restraint. The influence of the glue stiffness, support conditions and plate proportions on the unilateral buckling of such plates are assessed.

  20. Surgical removal of fragmented coronoid processes and fractured anconeal process in an older dog with evidence of severe degenerative joint disease.

    PubMed

    Flo, G L

    1998-12-15

    A 10-year-old Labrador Retriever was admitted because of severe unilateral (left) forelimb lameness of 6 weeks' duration. Computerized tomography revealed bilateral fragmented coronoid processes (FCP) and unilateral fracture of the anconeal process. Surgery on the left elbow to remove the loose anconeal process and FCP resolved the severe lameness and improved the dog's overall activity, compared with that of the preceding 2 years. Unstable FCP can develop late in life, and a degenerative anconeal process may fracture. Surgical removal of loose fragments in a severely arthritic joint may be beneficial. PMID:9861974

  1. Bilateral Neck Femur Fracture Following a Generalized Seizure- A Rare Case Report

    PubMed Central

    M Shah, Harshad; Grover, Amit; Gadi, Daksh; Sudarshan, K

    2014-01-01

    Hip fractures are one of the most common injuries which present to an orthopaedic surgeon. Most of these cases are unilateral .Bilateral simultaneous femur neck fracture is a rare occurrence. We report a case of a bilateral neck femur fracture in a 30 year male following a generalized tonic clonic seizure in view of its rarity and also to increase the awareness of such rare injuries. The patient was operated within 3 hours. At 5 months, the patient had good radiological and functional outcome. During a convulsion, there is a powerful and forceful contraction of muscles which may lead to fracture or dislocation. The incidence of fractures following a convulsion is 1.1%. A delay in diagnosis can lead to complications like avascular necrosis, osteoarthritis, non union, functional disability and legal consequences. All orthopaedic surgeons and emergency physicians should be aware of such uncommon injuries to ensure early diagnosis and treatment. PMID:25692154

  2. Bilateral neck femur fracture following a generalized seizure- a rare case report.

    PubMed

    M Shah, Harshad; Grover, Amit; Gadi, Daksh; Sudarshan, K

    2014-10-01

    Hip fractures are one of the most common injuries which present to an orthopaedic surgeon. Most of these cases are unilateral .Bilateral simultaneous femur neck fracture is a rare occurrence. We report a case of a bilateral neck femur fracture in a 30 year male following a generalized tonic clonic seizure in view of its rarity and also to increase the awareness of such rare injuries. The patient was operated within 3 hours. At 5 months, the patient had good radiological and functional outcome. During a convulsion, there is a powerful and forceful contraction of muscles which may lead to fracture or dislocation. The incidence of fractures following a convulsion is 1.1%. A delay in diagnosis can lead to complications like avascular necrosis, osteoarthritis, non union, functional disability and legal consequences. All orthopaedic surgeons and emergency physicians should be aware of such uncommon injuries to ensure early diagnosis and treatment. PMID:25692154

  3. Cerebral potentials preceding unilateral and simultaneous bilateral finger movements.

    PubMed

    Kristeva, R; Keller, E; Deecke, L; Kornhuber, H H

    1979-08-01

    Cerebral potentials preceding voluntary bilateral simultaneous finger movements were investigated in 19 right-handed young adult subjects, and were compared with unilateral right-sided finger m n the same experiment. With bilateral movements, the Bereitschaftspotential (BP) was not symmetrical or larger over the dominant hemisphere, but surprisingly, it was larger over the minor hemisphere. The BP averaged -3.66 microV (S.D. 1.96) over the left precentral region and -4.82 microV (S.D. 3.73) over the right precentral region in this condition. The difference was significant at 2P less than 0.01. This difference was pronounced in precentral leads but very small and almost missing in parietal leads. The pre-motion positivity (PMP) was well developed and even larger with bilateral than with unilateral (right-sides) movements. At the vertex it averaged +1.33 microV (S.D.4.16) with bilateral movements and only +0.15 microV (S.D. 1.42) with right-sided unilateral movements (2P less than 0.05). With bilateral movements the PMP could be observed in any record, but with unilateral movements it was missing at the left precentral lead, in accordance with previous publications (Deecke et al. 1969, 1976). The motor potential (MP), measured in a bipolar record from left and right precentral leads, was larger with unilateral (-1.25 microV, S.D. 1.33) than with bilateral movements (-0.36 microV, S.D. 0.92). Onset time differences of the BP preceding unilateral and bilateral movements were very small. However, there was a tendency towards earlier onset with unilateral than with bilateral movements (1031 msec, S.D. 358, as compared with 951 msec, S.D. 305). The averaged EMG revealed differences in movement onset. Muscular contraction tended to be earlier in the right than in the left m. flexor indicis in our right-handed subjects, on the average by 16 msec (S.D. 15). With unilateral right-sided movements, the left m. flexor indicis was not silent but showed an abortive mirror activity

  4. Cold shivering activity after unilateral destruction of the vestibular apparatus

    NASA Technical Reports Server (NTRS)

    Kuzmina, G. I.

    1980-01-01

    The bioelectric activity of muscles (flexors and extensors of the forelimbs and hindlimbs) during cold shivering after unilateral destruction of the vestibular apparatus. It was found, that unilateral delabyrinthing produces bilateral facilitation of cold shivering in the flexor extremities more pronounced on the ipsilateral side. In the extensor muscles there was an absence of bioelectric activity both before and after delabyrinthing. Enhancement of cold shivering in the flexor extremities following intervention was evidently conditioned by removal of the inhibiting effect of the vestibulary apparatus on the function of special centers.

  5. Unilateral Crystalline Vitreoretinopathy: A Rare Entity Associated with Intraocular Inflammation

    PubMed Central

    Harshey, Kaustubh B.; Srinivasan, Karthik; Rengappa, Ramakrishnan; Ramasamy, Kim

    2015-01-01

    A 31-year-old Indian male presented with floaters and diminution of vision in the right eye. Ocular examination showed features of old anterior uveitis with posterior subcapsular cataract and fine, refractile crystals in the vitreous cavity and on the retinal surface. A thorough workup for all known causes of crystalline retinopathy was inconclusive. Unilateral crystalline retinopathy has been sparingly reported. This is the first report of unilateral, crystalline vitreoretinopathy in the absence of any demonstrable and known cause for intraocular crystals. PMID:26688764

  6. Unilateral Crystalline Vitreoretinopathy: A Rare Entity Associated with Intraocular Inflammation.

    PubMed

    Harshey, Kaustubh B; Srinivasan, Karthik; Rengappa, Ramakrishnan; Ramasamy, Kim

    2015-01-01

    A 31-year-old Indian male presented with floaters and diminution of vision in the right eye. Ocular examination showed features of old anterior uveitis with posterior subcapsular cataract and fine, refractile crystals in the vitreous cavity and on the retinal surface. A thorough workup for all known causes of crystalline retinopathy was inconclusive. Unilateral crystalline retinopathy has been sparingly reported. This is the first report of unilateral, crystalline vitreoretinopathy in the absence of any demonstrable and known cause for intraocular crystals. PMID:26688764

  7. [Schizophrenic syndromes and efficacy of unilateral electroconvulsive therapy].

    PubMed

    Kornetov, A N; Samokhvalov, V P; Ovsiankin, M I

    1985-01-01

    The authors compared the efficacy of unilateral electroconvulsive therapy in schizophrenia in relation to the leading syndrome and the place of electrode application. In controlling the affective and catatonic syndromes the best effect was achieved when the electrodes were applied to the non-dominant hemisphere. In delirious, hallucinatory-delirious and hallucinatory syndromes, the maximal effect was achieved by the application of electrodes to the dominant hemisphere. The relationship between the effect of local electroconvulsive therapy and the semiotics of the syndromes allows making the most rational use of unilateral electroconvulsive therapy in the differential treatment of schizophrenia.

  8. Fractures of angle of mandible – A retrospective study

    PubMed Central

    Singh, Sourav; Fry, Ramesh R.; Joshi, Ajit; Sharma, Geeta; Singh, Smita

    2012-01-01

    Aims This retrospective study was done to evaluate the efficacy of single miniplate osteosynthesis at superior border of angle of mandible. Material and methods In this study 50 patients were treated by single miniplate osteosynthesis according to Champy's principle. Bite force generated was used as a parameter for judging the efficacy of internal fixation. In this article we present our experience over the years in the management of the fractures of angle of mandible based on this model. Results Most patients were of 21–30 yrs of age with unilateral angle fracture of mandible except one patient who had isolated bilateral angle fracture. The patients were treated successfully according to Champy's principle of osteosynthesis. There was a progressive improvement in the bite force generated after osteosynthesis. Conclusions The angle of the mandible is an anatomically weak and an area susceptible to fracture. The presence of an impacted or partially erupted third molar tooth further weakens it. Angle of mandible is the most common site for fracture however, bilateral angle fracture is very rare and uncommon. Osteosynthesis according to Champy's model led to an early functional improvement as demonstrated by the bite force generated. PMID:25737858

  9. Paratrooper's Ankle Fracture: Posterior Malleolar Fracture

    PubMed Central

    Young, Ki Won; Cho, Jae Ho; Kim, Hyung Seuk; Cho, Hun Ki; Lee, Kyung Tai

    2015-01-01

    Background We assessed the frequency and types of ankle fractures that frequently occur during parachute landings of special operation unit personnel and analyzed the causes. Methods Fifty-six members of the special force brigade of the military who had sustained ankle fractures during parachute landings between January 2005 and April 2010 were retrospectively analyzed. The injury sites and fracture sites were identified and the fracture types were categorized by the Lauge-Hansen and Weber classifications. Follow-up surveys were performed with respect to the American Orthopedic Foot and Ankle Society ankle-hindfoot score, patient satisfaction, and return to preinjury activity. Results The patients were all males with a mean age of 23.6 years. There were 28 right and 28 left ankle fractures. Twenty-two patients had simple fractures and 34 patients had comminuted fractures. The average number of injury and fractures sites per person was 2.07 (116 injuries including a syndesmosis injury and a deltoid injury) and 1.75 (98 fracture sites), respectively. Twenty-three cases (41.07%) were accompanied by posterior malleolar fractures. Fifty-five patients underwent surgery; of these, 30 had plate internal fixations. Weber type A, B, and C fractures were found in 4, 38, and 14 cases, respectively. Based on the Lauge-Hansen classification, supination-external rotation injuries were found in 20 cases, supination-adduction injuries in 22 cases, pronation-external rotation injuries in 11 cases, tibiofibular fractures in 2 cases, and simple medial malleolar fractures in 2 cases. The mean follow-up period was 23.8 months, and the average follow-up American Orthopedic Foot and Ankle Society ankle-hindfoot score was 85.42. Forty-five patients (80.36%) reported excellent or good satisfaction with the outcome. Conclusions Posterior malleolar fractures occurred in 41.07% of ankle fractures sustained in parachute landings. Because most of the ankle fractures in parachute injuries were

  10. [Fractures of the forefoot].

    PubMed

    Richter, M

    2011-10-01

    Fractures of the forefoot are common and comprise approximately two thirds of all foot fractures. Forefoot fractures are caused by direct impact or the effect of indirect force. The forces exerted can range from repetitive minor load (stress fractures) to massive destructive forces (complex trauma). The clinical course in forefoot fractures is typically more favourable than in fractures of the mid- and hindfoot. The incidence of complications like infection or pseudarthrosis is low. Exceptions are rare fractures of the proximal shaft of the fifth metatarsal and the sesamoids with higher pseudarthrosis rates. Malunited metatarsal fractures can cause painful conditions that should even be treated operatively. Differences in structure and function of the different forefoot areas and specific fracture types require an adapted management of these special injuries.

  11. Epidemiology of fragility fractures.

    PubMed

    Friedman, Susan M; Mendelson, Daniel Ari

    2014-05-01

    As the world population of older adults-in particular those over age 85-increases, the incidence of fragility fractures will also increase. It is predicted that the worldwide incidence of hip fractures will grow to 6.3 million yearly by 2050. Fractures result in significant financial and personal costs. Older adults who sustain fractures are at risk for functional decline and mortality, both as a function of fractures and their complications and of the frailty of the patients who sustain fractures. Identifying individuals at high risk provides an opportunity for both primary and secondary prevention.

  12. Unilateral nevoid acanthosis nigricans: Uncommon variant of a common disease

    PubMed Central

    Das, Anupam; Bhattacharya, Sabari; Kumar, Piyush; Gayen, Tirthankar; Roy, Kunal; Das, Nilay K.; Gharami, Ramesh C.

    2014-01-01

    Acanthosis nigricans (AN) is a fairly common dermatosis characterized by hyperpigmented velvety plaques, having a predilection for the intertriginous areas. We herein present a case of unilateral nevoid acanthosis nigricans over the left lateral chest, in an adult male. The rarity of documentation of this entity in the world literature prompted us to report the case. PMID:25506563

  13. Unilateral Pulmonary Agenesis and Gastric Duplication Cyst: A Rare Association

    PubMed Central

    Skokic, Fahrija; Hotic, Nesad; Husaric, Edin; Radoja, Gordana; Muratovic, Selma; Dedic, Nermina

    2013-01-01

    Lung agenesis and gastric duplication cysts are both rare congenital anomalies. Gastric duplication cysts can present with nausea, vomiting, hematemesis, or vague abdominal pain. Unilateral pulmonary agenesis can present with respiratory distress which usually occurs due to retention of bronchial secretions and inflammations. We report the unique case of right pulmonary agenesis associated with gastric duplication cyst. PMID:23844300

  14. Management of Young Children with Unilateral Hearing Loss

    ERIC Educational Resources Information Center

    McKay, Sarah

    2006-01-01

    Children with unilateral hearing loss (UHL) are at risk for academic, speech and language and social-emotional difficulties. To date, most of the evidence documented in the literature has been obtained from school-age children, most of whom were diagnosed with UHL after enrollment in school. Following the widespread institution of universal…

  15. Bimanual Force Coordination in Children with Spastic Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Smits-Engelsman, B. C. M.; Klingels, K.; Feys, H.

    2011-01-01

    In this study bimanual grip-force coordination was quantified using a novel "Gripper" system that records grip forces produced while holding a lower and upper unit, in combination with the lift force necessary to separate these units. Children with unilateral cerebral palsy (CP) (aged 5-14 years, n = 12) were compared to age matched typically…

  16. Axial length in unilateral idiopathic central serous chorioretinopathy

    PubMed Central

    Moon, Hoseok; Lee, Dae Yeong; Nam, Dong Heun

    2016-01-01

    AIM To evaluate the axial length (AXL) in unilateral idiopathic central serous chorioretinopathy (CSC). METHODS This retrospective case-control study was comprised of a consecutive case series of 35 patients with acute unilateral idiopathic CSC, and age- and sex-matched 50 control eyes. AXL of both eyes of unilateral CSC patients and the control eyes were investigated. AXL was measured by ultrasonic biometry, and the adjusted AXL was calculated for CSC eyes as measured AXL plus differences of foveal thickness between CSC and normal fellow eyes in millimeters. The main outcome measures were comparison of AXL between CSC, fellow and control eyes. RESULTS The mean age of 35 CSC patients was 45.5y, and 31 males were included. The adjusted AXL of CSC eyes was 23.52 mm, and the AXL of fellow eyes was 23.46 mm, and of control eyes 23.94 mm. The AXL of both CSC and fellow eyes were significantly shorter than control eyes (CSC vs control, P=0.044; fellow vs control, P=0.026). There was no statistically significant difference in AXL between CSC and fellow eyes. CONCLUSION In unilateral idiopathic CSC, the AXL of CSC and fellow eyes are shorter than that of control eyes. Short AXL may be related with choroidal circulation abnormality in CSC. PMID:27275428

  17. IQ Decline Following Early Unilateral Brain Injury: A Longitudinal Study

    ERIC Educational Resources Information Center

    Levine, Susan C.; Kraus, Ruth; Alexander, Erin; Suriyakham, Linda Whealton; Huttenlocher, Peter R.

    2005-01-01

    We examine whether children with early unilateral brain injury show an IQ decline over the course of development. Fifteen brain injured children were administered an IQ test once before age 7 and again several years later. Post-7 IQ scores were significantly lower than pre-7 IQ scores. In addition, pre-7 IQ scores were lower for children with…

  18. Reproducibility of tactile assessments for children with unilateral cerebral palsy.

    PubMed

    Auld, Megan Louise; Ware, Robert S; Boyd, Roslyn Nancy; Moseley, G Lorimer; Johnston, Leanne Marie

    2012-05-01

    A systematic review identified tactile assessments used in children with cerebral palsy (CP), but their reproducibility is unknown. Sixteen children with unilateral CP and 31 typically developing children (TDC) were assessed 2-4 weeks apart. Test-retest percent agreements within one point for children with unilateral CP (and TDC) were Semmes-Weinstein monofilaments: 75% (90%); single-point localization: 69% (97%); static two-point discrimination: 93% (97%); and moving two-point discrimination: 87% (97%). Test-retest reliability for registration and unilateral spatial tactile perception tests was high in children with CP (intraclass correlation coefficient [ICC] = 0.79-0.96). Two tests demonstrated a learning effect for children with CP, double simultaneous and tactile texture perception. Stereognosis had a ceiling effect for TDC (ICC = 0) and variability for children with CP (% exact agreement = 47%-50%). The Semmes-Weinstein monofilaments, single-point localization, and both static and moving two-point discrimination are recommended for use in practice and research. Although recommended to provide a comprehensive assessment, the measures of double simultaneous, stereognosis, and tactile texture perception may not be responsive to change over time in children with unilateral CP.

  19. Reimbursing Parents for Unilateral Placements in Private Special Education Schools.

    ERIC Educational Resources Information Center

    Goldberg, Steven S.

    1986-01-01

    In Burlington School Committee v. Department of Education, Commonwealth of Massachusetts, the U.S. Supreme Court held that the law does not bar parents from making unilateral placements, but they may be reimbursed only if the private educational program is eventually approved through the appeal set forth in the law. (Author/CL)

  20. Coupling of FM Systems to Individuals with Unilateral Hearing Loss.

    ERIC Educational Resources Information Center

    Kopun, Judy G.; And Others

    1992-01-01

    This study examined the attenuation characteristics of 5 Frequency Modulation system sound delivery options for 25 adults and children (ages 5-13). Degree of ear canal occlusion was a major factor in degree of attenuation. For children with unilateral hearing impairments, the most acoustically appropriate option was the tube-fitting. (Author/JDD)

  1. Bilateral cerebellar activation in unilaterally challenged essential tremor.

    PubMed

    Broersma, Marja; van der Stouwe, Anna M M; Buijink, Arthur W G; de Jong, Bauke M; Groot, Paul F C; Speelman, Johannes D; Tijssen, Marina A J; van Rootselaar, Anne-Fleur; Maurits, Natasha M

    2016-01-01

    •We added EMG as an index of tremor intensity to fMRI to study essential tremor.•Block- and tremor-related activations during a unilateral motor task were separated.•Block-related activations were found in the classical motor network.•Tremor-related activations were found in bilateral cerebellar lobules V, VI and VIII.

  2. Unilateral multiple benign mixed tumors of the parotid gland.

    PubMed

    Behnke, E E

    1982-11-01

    Multiple tumors of a single salivary gland in an unoperated-on patient are rare; only five have previously been reported in the world literature. The author reports the sixth case of multiple, benign mixed tumors of a unilateral parotid gland in a 61-year-old woman, discusses its management, and reviews the literature.

  3. Marcus Gunn pupil in a possible case of unilateral retinitis pigmentosa.

    PubMed

    Brill, T F

    1979-04-01

    A possible case of unilateral retinitis pigmentosa (RP) is reviewed. The electrodiagnostic and clinical findings are discussed, with perspective given to alternative diagnoses. A review of the literature is included to show the controversy which clouds a positive diagnosis of unilateral RP. A co-existing Marcus Gunn pupil is defined and discussed in relation to unilateral RP-like processes.

  4. Circling behavior following unilateral kainic acid injections into rat striatum.

    PubMed

    Taylor, R J; Reavill, C; Jenner, P; Marsden, C D

    1981-12-01

    Unilateral injection of kainic acid (2.5-25 nmol) into rat anterior caudate putamen induced dose-related circling behaviour. Kainic acid (10 nmol) consistently caused initial weak ipsiversive circling lasting 1 h followed by prolonged strong contraversive rotation lasting in excess of 10 h. Unilateral intrastriatal administration of L-glutamic acid, or of monosodium L-glutamate, to normal rats, or administration of monosodium L-glutamate to rats with extensive decortication, did not induce circling behaviour. The simultaneous unilateral injection of monosodium L-glutamate (1 mumol) with kainic acid (10 nmol) did not modify circling behaviour induced by kainic acid. However, extensive decortication greatly reduced circling induced by unilateral intrastriatal kainic acid (10 nmol), and effect not reversed by the simultaneous administration of monosodium L-glutamate (1 mumol). Unilateral 6-hydroxydopamine lesions of the left nigrostriatal pathway abolished the initial ipsiversive rotation and potentiated the subsequent contraversive rotation for up to 4 h after intrastriatal injection of kainic acid (10 nmol). Peripheral administration of haloperidol (1 mg/kg i.p.) also abolished initial ipsiversive rotation and decreased the subsequent contraversive rotation. Electro-coagulation of the ipsilateral strio-nigral pathway prolonged the initial ipsiversive rotation produced by kainic acid, but markedly attenuated contraversive rotation. These findings suggest that circling induced by intrastriatal administration of kainic acid depends on intact corticostriate pathways, but it cannot be reproduced or modified by intrastriatal administration of glutamate. Kainic acid circling appears to be mediated via strio-nigral pathways, and to be modulated by dopaminergic function. PMID:7333356

  5. Presurgical nasoalveolar moulding in unilateral cleft lip and palate

    PubMed Central

    Zuhaib, Mohammed; Bonanthaya, Krishnamurthy; Parmar, Renu; Shetty, Pritham N.; Sharma, Pradeep

    2016-01-01

    Context: Presurgical nasoalveolar moulding (PNAM) is a non-surgical method of reshaping the cleft lip, alveolus, palate and the nose to minimize the severity of the cleft deformity, before primary cheiloplastyand palatoplasty. In this context, PNAM proves to be an invaluable asset in the management of unilateral cleft lip and palate. Aims: The study was conducted to evaluate the efficacy of PNAM in the management of unilateral cleft lip and palate with the following objectives: (1) To assess and compare the degree of reduction in the size of cleft palate and alveolus (pre-PNAM and post-PNAM). (2) To evaluate and compare the improvement in columellar length and correction of columellar deviation (pre-PNAM and post-PNAM). (3) To assess the changes in the position of the alar base and the alar cartilages. Settings and Design: Prospective study. Subjects and Methods: A prospective study consisting of, which included 20 patients with complete unilateral cleft lip and palate was conducted. The age at the start of PNAM treatment of the infants ranged from 2 to 44 days of age reporting to our institute between December 2011 and August 2013. All the patients underwent PNAM therapy before primary cheiloplasty at 6 months of age; clinical parameters were assessed pre- and post-therapy using photographs and dental study models of the maxilla. Statistical Analysis Used: Student's t-test for paired comparisons. Results: Results of the study showed a promising reduction in the cleft size before the surgery, significant improvement in nasal symmetry, including the columellar length on the cleft side. Conclusions: PNAM is a valuable adjunct to our surgical armamentarium in dealing with the challenges of primary closure of unilateral cleft lip and palate thereby enhancing the overall surgical outcome. The advantages of this method include the simplicity of the procedure and improving the quality of surgical repair, particularly in obtaining tension free muscle closure in unilateral

  6. Outcomes After Unilateral Uterine Artery Embolization: A Retrospective Review

    SciTech Connect

    Bratby, M. J.; Hussain, F. F.; Walker, W. J.

    2008-03-15

    Purpose. Bilateral uterine artery embolization (UAE) is considered necessary to provide effective treatment for symptomatic uterine fibroids. Occasionally, only unilateral embolization is performed, and this study evaluates these outcomes. Materials and Methods. As part of a prospective observational study of more than 1600 patients treated with UAE since 1996, there have been 48 patients in whom unilateral embolization has been performed. This study retrospectively reviews clinical response as assessed by our standard questionnaire and radiological response assessed by either magnetic resonance imaging or ultrasound. Results. Two principal groups emerged: the largest, where only the dominant unilateral arterial supply was electively embolized (30 patients); and the second, where there was technical failure to catheterize the second uterine artery as a result of anatomical constraints (12 patients). Favorable clinical response with a reduction in menorrhagia at 1 year was seen in 85.7% (18/21) of those patients with a dominant arterial supply to the fibroid(s). In contrast, in those patients where there was technical failure to embolize one uterine artery, there was a high rate of clinical failure requiring further intervention in 58.3% (7/12). Comparison of the technical failure group with the dominant uterine artery group demonstrated a statistically significant (Fisher's exact test) difference in the proportion of patients with evidence of persistent fibroid vascularity (p < 0.001) and requiring repeat intervention (p < 0.01). Conclusion. We conclude that unilateral UAE can achieve a positive clinical result in the group of patients where there is a dominant unilateral artery supplying the fibroid(s), in contrast to the poor results seen following technical failure.

  7. Infant skull fracture (image)

    MedlinePlus

    Skull fractures may occur with head injuries. Although the skull is both tough and resilient and provides excellent ... or blow can result in fracture of the skull and may be accompanied by injury to the ...

  8. Nasal fracture (image)

    MedlinePlus

    A nasal fracture is a break in the bone over the ridge of the nose. It usually results from a blunt ... and is one of the most common facial fracture. Symptoms of a broken nose include pain, blood ...

  9. Metatarsal stress fractures - aftercare

    MedlinePlus

    The metatarsal bones are the long bones in your foot that connect your ankle to your toes. A stress fracture is a break in the bone that happens with repeated injury or stress. Stress fractures are caused ...

  10. Fractures in anisotropic media

    NASA Astrophysics Data System (ADS)

    Shao, Siyi

    Rocks may be composed of layers and contain fracture sets that cause the hydraulic, mechanical and seismic properties of a rock to be anisotropic. Coexisting fractures and layers in rock give rise to competing mechanisms of anisotropy. For example: (1) at low fracture stiffness, apparent shear-wave anisotropy induced by matrix layering can be masked or enhanced by the presence of a fracture, depending on the fracture orientation with respect to layering, and (2) compressional-wave guided modes generated by parallel fractures can also mask the presence of matrix layerings for particular fracture orientations and fracture specific stiffness. This report focuses on two anisotropic sources that are widely encountered in rock engineering: fractures (mechanical discontinuity) and matrix layering (impedance discontinuity), by investigating: (1) matrix property characterization, i.e., to determine elastic constants in anisotropic solids, (2) interface wave behavior in single-fractured anisotropic media, (3) compressional wave guided modes in parallel-fractured anisotropic media (single fracture orientation) and (4) the elastic response of orthogonal fracture networks. Elastic constants of a medium are required to understand and quantify wave propagation in anisotropic media but are affected by fractures and matrix properties. Experimental observations and analytical analysis demonstrate that behaviors of both fracture interface waves and compressional-wave guided modes for fractures in anisotropic media, are affected by fracture specific stiffness (controlled by external stresses), signal frequency and relative orientation between layerings in the matrix and fractures. A fractured layered medium exhibits: (1) fracture-dominated anisotropy when the fractures are weakly coupled; (2) isotropic behavior when fractures delay waves that are usually fast in a layered medium; and (3) matrix-dominated anisotropy when the fractures are closed and no longer delay the signal. The

  11. Displaced patella fractures.

    PubMed

    Della Rocca, Gregory J

    2013-10-01

    Displaced patella fractures often result in disruption of the extensor mechanism of the knee. An intact extensor mechanism is a requirement for unassisted gait. Therefore, operative treatment of the displaced patella fracture is generally recommended. The evaluation of the patella fracture patient includes examination of extensor mechanism integrity. Operative management of patella fractures normally includes open reduction with internal fixation, although partial patellectomy is occasionally performed, with advancement of quadriceps tendon or patellar ligament to the fracture bed. Open reduction with internal fixation has historically been performed utilizing anterior tension band wiring, although comminution of the fracture occasionally makes this fixation construct inadequate. Supplementation or replacement of the tension band wire construct with interfragmentary screws, cerclage wire or suture, and/or plate-and-screw constructs may add to the stability of the fixation construct. Arthrosis of the patellofemoral joint is very common after healing of patella fractures, and substantial functional deficits may persist long after fracture healing has occurred.

  12. Hydraulic fracture design optimization

    SciTech Connect

    Lee, Tae-Soo; Advani, S.H.

    1992-01-01

    This research and development investigation, sponsored by US DOE and the oil and gas industry, extends previously developed hydraulic fracture geometry models and applied energy related characteristic time concepts towards the optimal design and control of hydraulic fracture geometries. The primary objective of this program is to develop rational criteria, by examining the associated energy rate components during the hydraulic fracture evolution, for the formulation of stimulation treatment design along with real-time fracture configuration interpretation and control.

  13. Hydraulic fracture design optimization

    SciTech Connect

    Lee, Tae-Soo; Advani, S.H.

    1992-06-01

    This research and development investigation, sponsored by US DOE and the oil and gas industry, extends previously developed hydraulic fracture geometry models and applied energy related characteristic time concepts towards the optimal design and control of hydraulic fracture geometries. The primary objective of this program is to develop rational criteria, by examining the associated energy rate components during the hydraulic fracture evolution, for the formulation of stimulation treatment design along with real-time fracture configuration interpretation and control.

  14. Clavicle fractures: individualizing treatment for fracture type.

    PubMed

    Housner, Jeffrey A; Kuhn, John E

    2003-12-01

    Clavicle fractures are common injuries in both children and adults. In most cases, the diagnosis can be made readily from the patient's history and physical examination. X-rays are helpful to confirm the diagnosis, to assess the severity of the fracture, and to follow interval healing. Most fractures are treated nonoperatively, and surgical intervention is typically reserved for unstable distal clavicle fractures. Nonoperative options involve either a sling-and-swathe or figure-of-eight splint. Return-to-play decisions should be individualized based on the age of the patient, location and severity of the fracture, degree of clinical and radiographic healing, and the sport in which the athlete will be participating.

  15. Treatment of fractures of the tibial and/or fibular malleoli in 30 cats.

    PubMed

    Roch, S P; Störk, C K; Gemmill, T J; Downes, C; Pink, J; McKee, W M

    2009-08-01

    Five cats were treated for a fracture of the medial malleolus, 10 for a fracture of the lateral malleolus and 15 for fractures of both malleoli. Open reduction and internal fixation with Kirschner wires (K-wires) with or without a tension band wire was applied to 26 of the fractures. Unilateral-uniplanar or bilateral-uniplanar transarticular external skeletal fixators were applied to provide coaptation in 19 cases and appeared to be well tolerated. In 24 cases fracture healing was assessed radiographically between four and eight weeks after treatment. In seven cases fracture healing was good, in 12 cases it was reasonable, in four cases it was poor and in one case with two fractures healing was poor in one and reasonable in the other. The 12 fractures treated by open reduction and internal fixation with K-wires and a tension band wire all showed evidence of good or reasonable healing. The nine fractures treated by open reduction and internal fixation with K-wires without a tension band wire showed evidence of good or reasonable healing in six cases and poor healing in three cases. Complications occurred in nine of the cats and included persistent talocrural instability, soft tissue necrosis, implant migration and external fixator pin breakage. Twenty-one of the cats were followed up by telephone questionnaire for between 5.5 and 84 months; the owner satisfaction was excellent in 17 cases, good in two cases, moderate in one case and poor in one case. PMID:19666914

  16. Osteoporotic vertebral fractures redux.

    PubMed

    Lentle, B C; Gordon, P; Ward, L

    2008-02-01

    Osteoporosis remains an important cause of morbidity and mortality especially in the elderly. This fact is largely due to fractures of the proximal femur and spine. As recently recognized, vertebral fractures are as much a threat to health and longevity as fractures of the proximal femur. In recent decades, the development of tools to evaluate fracture risk as well as medications to treat osteoporosis has altered the management of people who are at fracture risk. At the same time identification and management procedures concerning spinal fracturing are not very clear. Besides there is not even clear consensus about what exactly constitutes a vertebral fracture, particularly those of minor degree. While height loss is a simple and valuable tool to detect vertebral fractures, it is neither sensitive nor specific enough to replace radiographs. Some 65% of fractures cause no symptoms. Often vertebral fractures are misdiagnosed, especially if they have occurred silently and if the opportunity for diagnosis arises fortuitously. It is to the patient's benefit that radiologists report and physicians identify vertebral fractures evident on a chest or other radiograph, no matter how incidental to the immediate clinical indication for the examination. Technological evolution now allows dual-energy x-ray absorptiometry machines to be used to take spine images while doing a densitometry. The images are adequate, even if not of high radiographic quality, and, more important, the patient undergoes a smaller radiation dose than with conventional spinal radiographs. Such technology may promote fracture recognition. The recognition of vertebral fractures, as well as the prevention and treatment of further fractures, will likely do much to reduce both the burden of osteoporosis-related morbidity and mortality, as well as fracture-related costs to healthcare systems.

  17. Proximal humerus fractures.

    PubMed

    Price, Matthew C; Horn, Pamela L; Latshaw, James C

    2013-01-01

    Proximal humerus fractures are among the most common fractures associated with osteoporosis. With an aging population, incidence of these fractures will only increase. The proximal humerus not only forms the lateral portion of the shoulder articulation but also has significant associations with musculoskeletal and neurovascular structures. As a result, fractures of the proximal humerus can significantly impact not only the function of the shoulder joint, but the health and function of the entire upper extremity as well. Understanding of these fractures, the management options, and associated nursing care, can help reduce morbidity rate and improve functional outcomes.

  18. Talus fractures: surgical principles.

    PubMed

    Rush, Shannon M; Jennings, Meagan; Hamilton, Graham A

    2009-01-01

    Surgical treatment of talus fractures can challenge even the most skilled foot and ankle surgeon. Complicated fracture patterns combined with joint dislocation of variable degrees require accurate assessment, sound understanding of principles of fracture care, and broad command of internal fixation techniques needed for successful surgical care. Elimination of unnecessary soft tissue dissection, a low threshold for surgical reduction, liberal use of malleolar osteotomy to expose body fracture, and detailed attention to fracture reduction and joint alignment are critical to the success of treatment. Even with the best surgical care complications are common and seem to correlate with injury severity and open injuries. PMID:19121756

  19. Epidemiology of clavicle fractures.

    PubMed

    Postacchini, Franco; Gumina, Stefano; De Santis, Pierfrancesco; Albo, Francesco

    2002-01-01

    An epidemiologic study of 535 isolated clavicle fractures treated in a hospital of a large metropolis during an 11-year period was performed. Data regarding patient's age and sex, side involved, mechanism of injury, and season in which the fracture occurred were obtained from the clinical records. Radiographic classification was performed with the Allman system. Clavicle fractures represented 2.6% of all fractures and 44% of those in the shoulder girdle. Most patients were men (68%), and the left side was involved in 61% of cases. Fractures of the middle third of the clavicle, which were the most common (81%), were displaced in 48% of cases and comminuted in 19%. Fractures of the medial third were the least common (2%). The prevalence of midclavicular fractures was found to decrease progressively with age, starting from the first decade of life when they represented 88.2% of all clavicle fractures and were undisplaced in 55.5% of cases. In adults, the incidence of displaced fractures, independent of location, was higher than that of undisplaced fractures. Traffic accidents were the most common cause of the injury. In the period under study, the incidence of fractures showed no significant change over time and no seasonal variation. PMID:12378163

  20. Subsurface fracture spacing

    SciTech Connect

    Lorenz, J.C. ); Hill, R.E. )

    1991-01-01

    This study was undertaken in order to document and analyze the unique set of data on subsurface fracture characteristics, especially spacing, provided by the US Department of Energy's Slant Hole Completion Test well (SHCT-1) in the Piceance Basin, Colorado. Two hundred thirty-six (236) ft (71.9 m) of slant core and 115 ft (35.1 m) of horizontal core show irregular, but remarkably close, spacings for 72 natural fractures cored in sandstone reservoirs of the Mesaverde Group. Over 4200 ft (1280 m) of vertical core (containing 275 fractures) from the vertical Multiwell Experiment wells at the same location provide valuable information on fracture orientation, termination, and height, but only data from the SHCT-1 core allow calculations of relative fracture spacing. Within the 162-ft (49-m) thick zone of overlapping core from the vertical and deviated wellbores, only one fracture is present in vertical core whereas 52 fractures occur in the equivalent SHCT-1 core. The irregular distribution of regional-type fractures in these heterogeneous reservoirs suggests that measurements of average fracture spacing'' are of questionable value as direct input parameters into reservoir engineering models. Rather, deviated core provides data on the relative degree of fracturing, and confirms that cross fractures can be rare in the subsurface. 13 refs., 11 figs.

  1. Atraumatic sternum fracture

    PubMed Central

    Abrahamsen, Sebastian Ørskov; Madsen, Christina Friis

    2014-01-01

    The spine, pelvic bones and long bones of the lower extremities are common sites for insufficiency fractures. Cases of sternum insufficiency fractures have rarely been reported among elderly patients. Insufficiency fractures tend to occur in bones with decreased mechanical strength especially among elderly patients, in postmenopausal women and patients with underlying diseases. We describe a case of spontaneous sternum insufficiency fracture in a healthy man, with no known risk factors to fracture, or previous history of fractures. Sternum insufficiency fracture is a rare cause of chest pain. This case serves to remind the emergency physician to remain vigilant for other non-cardiac, non-pulmonary and non-traumatic causes of chest pain, especially among patients with known risk factors such as osteoporosis, chronic obstructive pulmonary disease, rheumatoid arthritis, systemic lupus erythematosus and patients on long-term steroid treatment. If diagnosed correctly, these patients can be discharged and treated as outpatients as this case emphasises. PMID:25326566

  2. [Fractures of carpal bones].

    PubMed

    Lögters, T; Windolf, J

    2016-10-01

    Fractures of the carpal bones are uncommon. On standard radiographs fractures are often not recognized and a computed tomography (CT) scan is the diagnostic method of choice. The aim of treatment is to restore pain-free and full functioning of the hand. A distinction is made between stable and unstable carpal fractures. Stable non-displaced fractures can be treated conservatively. Unstable and displaced fractures have an increased risk of arthritis and non-union and should be stabilized by screws or k‑wires. If treated adequately, fractures of the carpal bones have a good prognosis. Unstable and dislocated fractures have an increased risk for non-union. The subsequent development of carpal collapse with arthrosis is a severe consequence of non-union, which has a heterogeneous prognosis.

  3. Posterior malleolus fracture.

    PubMed

    Irwin, Todd A; Lien, John; Kadakia, Anish R

    2013-01-01

    Posterior malleolus fractures are a common component of ankle fractures. The morphology is variable; these fractures range from small posterolateral avulsion injuries to large displaced fracture fragments. The integrity of the posterior malleolus and its ligamentous attachment is important for tibiotalar load transfer, posterior talar stability, and rotatory ankle stability. Fixation of posterior malleolus fractures in the setting of rotational ankle injuries has certain benefits, such as restoring articular congruity and rotatory ankle stability, as well as preventing posterior talar translation, but current indications are unclear. Fragment size as a percentage of the anteroposterior dimension of the articular surface is often cited as an indication for fixation, although several factors may contribute to the decision, such as articular impaction, comminution, and syndesmotic stability. Outcome studies show that, in patients with ankle fractures, the presence of a posterior malleolus fracture negatively affects prognosis. Notable variability is evident in surgeon practice. PMID:23281469

  4. Unilateral absence of pulmonary artery associated with contralateral lung cancer

    PubMed Central

    Zhang, Liang-Ze; Ma, Wei-Guo; He, Jie

    2016-01-01

    Unilateral absence of a pulmonary artery (UAPA) is a rare congenital cardiac malformation that is often associated with other cardiovascular deformities. Surgical repair of this rare condition is usually performed only on the abnormal lung. The occurrence of lung cancer in association with UAPA is even rarer and clinical experience is very limited. This report aims to describe a case of unilateral absence of right pulmonary artery that was complicated by primary carcinoma of the contralateral lung. A left lower lobectomy was performed despite the absence of the right pulmonary artery and repeated decreases in the arterial oxygen saturation (SaO2) were encountered intraoperatively. The current case provides insights into the operative tolerability and the foreseeable ominous prognosis after excision of the normal lung in patients with UAPA and highlights the importance of the clinical awareness of this potentially lethal congenital anomaly in light of its extreme rarity, which may facilitate better diagnosis and treatment of such patients.

  5. Unilateral Loss of Spontaneous Venous Pulsations in an Astronaut

    NASA Technical Reports Server (NTRS)

    Mader, Thomas H.; Gibson, C. Robert; Lee, Andrew G.; Patel, Nimesh; Hart, Steven; Pettit, Donald R.

    2014-01-01

    Spontaneous venous pulsations seen on the optic nerve head (optic disc) are presumed to be caused by fluctuations in the pressure gradient between the intraocular and retrolaminar venous systems. The disappearance of previously documented spontaneous venous pulsations is a well-recognized clinical sign usually associated with a rise in intracranial pressure and a concomitant bilateral elevation of pressure in the subarachnoid space surrounding the optic nerves. In this correspondence we report the unilateral loss of spontaneous venous pulsations in an astronaut 5 months into a long duration space flight. We documented a normal lumbar puncture opening pressure 8 days post mission. The spontaneous venous pulsations were also documented to be absent 21 months following return to Earth.. We hypothesize that these changes may have resulted from a chronic unilateral rise in optic nerve sheath pressure caused by a microgravity-induced optic nerve sheath compartment syndrome.

  6. Framework Surgery for Treatment of Unilateral Vocal Fold Paralysis

    PubMed Central

    Daniero, James J.; Garrett, C. Gaelyn; Francis, David O.

    2014-01-01

    Laryngeal framework surgery is the current gold standard treatment for unilateral vocal fold paralysis. It provides a permanent solution to glottic insufficiency caused by injury to the recurrent laryngeal nerve. Various modifications to the original Isshiki type I laryngoplasty procedure have been described to improve voice and swallowing outcomes. The success of this procedure is highly dependent on the experience of the surgeon as it epitomizes the intersection of art and science in the field. The following article reviews the evidence, controversies, and complications related to laryngoplasty for unilateral vocal fold paralysis. It also provides a detailed analysis of how and when arytenoid-positioning procedures should be considered, and summarizes the literature on postoperative outcomes. PMID:24883239

  7. Unilateral Stance Strategies of Athletes With ACL Deficiency

    PubMed Central

    Di Stasi, Stephanie L.; Hartigan, Erin H.; Snyder-Mackler, Lynn

    2013-01-01

    Aberrant movement strategies are characteristic of ACL-deficient athletes with recurrent knee instability (non-copers), and may instigate premature or accelerate joint degradation. Biomechanical evaluation of kinematic changes over time may elucidate noncopers’ responses to neuromuscular intervention and ACL reconstruction (ACLR). Forty noncopers were randomized into a perturbation group or a strength training only group. We evaluated the effects of perturbation training, and then gender on knee angle and tibial position during a unilateral standing task before and after ACLR. No statistically significant interactions were found. Before surgery, the strength training only group demonstrated knee angle asymmetry, but 6 months after ACLR, both groups presented with similar knee flexion between limbs. Aberrant and asymmetrical tibial position was found only in females following injury and ACLR. Neither treatment group showed distinct unilateral standing strategies following intervention; however, males and female noncopers appear to respond uniquely to physical therapy and surgery. PMID:22983931

  8. Case report of unilateral eosinophilic fasciitis in a Vietnamese woman.

    PubMed

    Daniel, Rodney S; Brown, Alan N

    2009-02-01

    Symmetric skin thickening of the limbs with deep fascial inflammation is the hallmark of eosinophilic fasciitis. We describe a woman who presented with unilateral progressive skin thickening. Examination of a full-thickness skin biopsy revealed an inflammatory process and fascial changes consistent with eosinophilic fasciitis. In contrast to other scleroderma mimics, eosinophilic fasciitis generally responds rapidly to glucocorticoid therapy. It is possible that unilateral eosinophilic fasciitis is under-recognized and can easily be misdiagnosed as another scleroderma variant if a full-thickness biopsy is not reviewed by a dermatopathologist. Recognition of this subtype of eosinophilic fasciitis is important given the profound differences in prognosis of eosinophilic fasciitis and other scleroderma variants.

  9. Congenital Unilateral Deafness Affects Cerebral Organization of Reading

    PubMed Central

    Adorni, Roberta; Manfredi, Mirella; Proverbio, Alice Mado

    2013-01-01

    It is known that early sensory deprivation modifies brain functional structure and connectivity. The aim of the present study was to investigate the neuro-functional organization of reading in a patient with profound congenital unilateral deafness. Using event-related potentials (ERPs), we compared cortical networks supporting the processing of written words in patient RA (completely deaf in the right ear since birth) and in a group of control volunteers. We found that congenital unilateral hearing deprivation modifies neural mechanisms of word reading. Indeed, while written word processing was left-lateralized in controls, we found a strong right lateralization of the fusiform and inferior occipital gyri activation in RA. This finding goes in the same direction of recent proposals that the ventral occipito-temporal activity in word reading seem to lateralize to the same hemisphere as the one involved in spoken language processing. PMID:24961430

  10. Solving the Beam Bending Problem with an Unilateral Winkler Foundation

    NASA Astrophysics Data System (ADS)

    Machalová, Jitka; Netuka, Horymír

    2011-09-01

    Our work is going to deal with the bending of a beam resting on an unilateral elastic foundation and develops further the ideas from the article [5]. In some cases the beam has fixed connection with the foundation. Such problems are linear. However there are applications where the beam is not connected with the foundation. This so-called unilateral case represents an interesting nonlinear problem and cannot be solved by easy means. We propose here first a new formulation of this problem which is based upon the idea of a decomposition. This way we can convert the usual variational formulation of our problem to a saddle-point formulation. In the second part of this paper we will deal with a numerical solution using the finite element method. The system of equations for the saddle point is nonlinear and nondifferentiable. It can be handled by the transformation to a complementarity problem which is solved by the nonsmooth Newton method.

  11. Unilateral sensorineural hearing loss: analysis of 200 consecutive cases.

    PubMed

    Kumar, A; Maudelonde, C; Mafee, M

    1986-01-01

    The spectrum of diseases diagnosed and the protocol used in the investigation of 200 consecutive patients with unilateral sensorineural hearing loss (SNHL) is presented. The diagnostic tests found most useful in defining the site of the lesion were a combination of a well-masked pure tone audiogram, speech discrimination score (SDS), acoustic reflex test (ART), and a vestibular evaluation using photoelectric nystagmography (PENG) and the Torok Monothermal Differential Caloric Test. With this protocol, the site of the lesion was correctly defined in 94% of patients with unilateral progressive SNHL. Laboratory and radiological studies confirmed a variety of lesions other than acoustic tumors. It is, therefore, felt that the primary objective of investigations should be to define the site of the lesion rather than aim to diagnose a specific disease entity.

  12. Harlequin syndrome: the sudden onset of unilateral flushing and sweating.

    PubMed Central

    Lance, J W; Drummond, P D; Gandevia, S C; Morris, J G

    1988-01-01

    Facial flushing and sweating were investigated in five patients who complained of the sudden onset of unilateral facial flushing in hot weather or when exercising vigorously. One patient probably suffered a brainstem infarct at the time that the unilateral flush was first noticed, and was left with a subtle Horner's syndrome on the side opposite to the flush. The other four had no other neurological symptoms and no ocular signs of Horner's syndrome. Thermal and emotional flushing and sweating were found to be impaired on the non-flushing side of the forehead in all five patients whereas gustatory sweating and flushing were increased on that side in four of the five patients, a combination of signs indicating a deficit of the second sympathetic neuron at the level of the third thoracic segment. CT and MRI of this area failed to disclose a structural lesion but latency from stimulation of the motor cortex and thoracic spinal cord to the third intercostal muscle was delayed on the non-flushing side in one patient. The complaint of unilateral flushing and sweating was abolished in one patient by ipsilateral stellate ganglionectomy. The unilateral facial flushing and sweating induced by heat in all five patients was thus a normal or excessive response by an intact sympathetic pathway, the other side failing to respond because of a sympathetic deficit. The onset in the four cases of peripheral origin followed strenuous exertion, which suggested that an anterior radicular artery may have become occluded at the third thoracic segment during torsion of the thoracic spine. Images PMID:3155385

  13. Effect of unilateral condylectomy on the sheep temporomandibular joint.

    PubMed

    Miyamoto, K; Vickers, R; Ishimaru, J I; Ogi, N; Kurita, K; Goss, A N

    1999-10-01

    Unilateral condylectomy was performed on five young adult sheep. The animals were killed at three months and both joints and the excised condyles were examined macroscopically and histologically. All five showed pronounced regeneration of the condylar head on the operated side. The articular surface was fibrous and fused to the disc. Four of the five opposite joints showed medial remodelling. Young sheep have a higher regenerative capability than human adults of equivalent age, and similar reactions to those of children. PMID:10577756

  14. Magnetic Vestibular Stimulation in Subjects with Unilateral Labyrinthine Disorders

    PubMed Central

    Ward, Bryan K.; Roberts, Dale C.; Della Santina, Charles C.; Carey, John P.; Zee, David S.

    2014-01-01

    We recently discovered that static magnetic fields from high-strength MRI machines induce nystagmus in all normal humans, and that a magneto-hydrodynamic Lorentz force, derived from ionic currents in the endolymph and pushing on the cupula, best explains this effect. Individuals with no labyrinthine function have no nystagmus. The influence of magnetic vestibular stimulation (MVS) in individuals with unilateral deficits in labyrinthine function is unknown and may provide insight into the mechanism of MVS. These individuals should experience MVS, but with a different pattern of nystagmus consistent with their unilateral deficit in labyrinthine function. We recorded eye movements in the static magnetic field of a 7 T MRI machine in nine individuals with unilateral labyrinthine hypofunction, as determined by head impulse testing and vestibular-evoked myogenic potentials (VEMP). Eye movements were recorded using infrared video-oculography. Static head positions were varied in pitch with the body supine, and slow-phase eye velocity (SPV) was assessed. All subjects exhibited predominantly horizontal nystagmus after entering the magnet head-first, lying supine. The SPV direction reversed when entering feet-first. Pitching chin-to-chest caused subjects to reach a null point for horizontal SPV. Right unilateral vestibular hypofunction (UVH) subjects developed slow-phase-up nystagmus and left UVH subjects, slow-phase-down nystagmus. Vertical and torsional components were consistent with superior semicircular canal excitation or inhibition, respectively, of the intact ear. These findings provide compelling support for the hypothesis that MVS is a result of a Lorentz force and suggest that the function of individual structures within the labyrinth can be assessed with MVS. As a novel method of comfortable and sustained labyrinthine stimulation, MVS can provide new insights into vestibular physiology and pathophysiology. PMID:24659983

  15. Silent intravascular lymphoma initially manifesting as a unilateral adrenal incidentaloma.

    PubMed

    Takahashi, Yoshiko; Iida, Keiji; Hino, Yasuhisa; Ohara, Takeshi; Kurahashi, Toshifumi; Tashiro, Takashi; Chihara, Kazuo

    2012-01-01

    Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of malignant lymphoma. Although the involvement of adrenal glands in IVLBCL is often observed, primary adrenal IVLBCL is rare. Most reported cases of adrenal IVLBCL showed bilateral lesions resulting in rapidly progressive adrenal failure and poor prognosis. Here, we report a case of slowly progressive primary adrenal IVLBCL manifesting initially with unilateral adrenal incidentaloma. This case is a silent IVLBCL and shows that the enlargement of both adrenal glands can be followed.

  16. Unilateral asterixis due to a lesion of the ventrolateral thalamus.

    PubMed Central

    Stell, R; Davis, S; Carroll, W M

    1994-01-01

    A case of unilateral asterixis in a man with a focal ischaemic lesion of the contralateral ventral thalamus is presented. Atypically, the movements were present at rest and had a pattern of activation that resulted in an initial misdiagnosis of epilepsia partialis continua. This case emphasises the importance of electromyographic analysis in establishing the correct diagnosis of involuntary movements before starting specific treatment. Images PMID:8021693

  17. Unilateral asterixis due to a lesion of the ventrolateral thalamus.

    PubMed Central

    Stell, R; Davis, S; Carroll, W M

    1994-01-01

    A case of unilateral asterixis in a man with a focal ischaemic lesion of the contralateral ventral thalamus is presented. Atypically, the movements were present at rest and had a pattern of activation that resulted in an initial misdiagnosis of epilepsia partialis continua. This case emphasises the importance of electromyographic analysis in establishing the correct diagnosis of involuntary movements before starting specific treatment. Images PMID:8301291

  18. Presurgical nasoalveolar molding in unilateral cleft lip and palate

    PubMed Central

    Hegde, Rahul J.; Kharkar, Viraj R.; Kamath, Shamika

    2015-01-01

    Unilateral cleft lip and palate (UCLP) patients have an esthetic and functional compromise of the middle third of the face and nasal structures. To improve the esthetic result of lip repair, the concept of presurgical nasoalveolar molding (PNAM) was brought into conception. PNAM is an easy and passive method of bringing the alveolus and lips together by redirecting the forces of natural growth. This case report documents a 2-year follow-up of PNAM in UCLP. PMID:26681868

  19. Acute Contralateral Radiculopathy after Unilateral Transforaminal Lumbar Interbody Fusion

    PubMed Central

    Jang, Kyoung-Min; Kim, Young-Baeg; Park, Yong-Sook; Nam, Taek-Kyun; Lee, Young-Seok

    2015-01-01

    Objective Cases of contralateral radiculopathy after a transforaminal lumbar interbody fusion with a single cage (unilateral TLIF) had been reported, but the phenomenon has not been explained satisfactorily. The purpose of this study was to determine its incidence, causes, and risk factors. Methods We did retrospective study with 546 patients who underwent a unilateral TLIF, and used CT and MRI to study the causes of contralateral radicular symptoms that appeared within a week postoperatively. Clinical and radiological results were compared by dividing the patients into the symptomatic group and asymptomatic group. Results Contralateral symptoms occurred in 32 (5.9%) of the patients underwent unilateral TLIF. The most common cause of contralateral symptoms was a contralateral foraminal stenosis in 22 (68.8%), screw malposition in 4 (12.5%), newly developed herniated nucleus pulposus in 3 (9.3%), hematoma in 1 (3.1%), and unknown origin in 2 patients (6.3%). 16 (50.0%) of the 32 patients received revision surgery. There was no difference in visual analogue scale and Oswestry disability index between the two groups at discharge. Both preoperative and postoperative contralateral foraminal areas were significantly smaller, and postoperative segmental angle was significantly greater in the symptomatic group comparing to those of the asymptomatic group (p<0.05). Conclusion The incidence rate is not likely to be small (5.9%). If unilateral TLIF is performed for cases when preoperative contralateral foraminal stenosis already exists or when a large restoration of segmental lordosis is required, the probability of developing contralateral radiculopathy is increased and caution from the surgeon is needed. PMID:26587189

  20. Antiphospholipid Antibody Syndrome Presenting with Unilateral Adrenal Hemmorhage.

    PubMed

    Ullah, Kifayat; Butt, Ghias; Neopane, Sippy; Arshi, Shahana

    2016-06-01

    The antiphospholipid antibody syndrome presents with vascular thrombosis which involve both arterial and venous systems. The clinical presentation of antiphospholipid antibody syndrome includes obstetric complications leading to recurrent abortions, presence of circulating antibodies against phospholipids, and multi-organ thromboembolisms. We report a case of a patient who presented with unilateral adrenal hemorrhage and subsequently found to have antiphospholipid antibody syndrome and lupus nephritis. PMID:27376219

  1. Early surgical treatment in unilateral coronoid hyperplasia and facial asymmetry.

    PubMed

    Galiè, Manlio; Consorti, Giuseppe; Tieghi, Riccardo; Denes, Stefano Andrea; Fainardi, Enrico; Schmid, Judith Louisa; Neuschl, Matthias; Clauser, Luigi

    2010-01-01

    Unilateral coronoid hyperplasia is a rare condition in the pediatric age. It may be an unrecognized cause of restricted mouth opening in children.The limited jaw movement is due to the enlargement of the coronoid process of the mandible that impinges on the zygomatic arch during mouth opening. This pathologic condition is still unknown and often misdiagnosed.Although in the past the term osteochondroma has been used to describe most of the unilateral and a few of the bilateral cases, there is no histologic evidence that the process has a neoplastic origin.Microscopic examination of the removed coronoid process has revealed hyperplastic compact bone covered with a thin layer of normal cartilage.There are multiple causes of mandibular hypomobility, each of them associated with different anatomic structures and etiologies, and a large number of cases, mostly bilateral, are idiopathic in nature.Several theories of pathogenesis have been proposed: temporomandibular joint dysfunctions, mandibular hypomobility, temporalis hyperactivity, hormonal stimulus, persistent cartilage growth center, genetic inheritance, and family factors.Unilateral coronoid hyperplasia is usually due to a trauma or a pathologic condition and is associated with facial asymmetry, being more frequently seen in women with histologic chondromatous or neoplastic changes. A thorough clinical history should include information about the onset and progression of pain and other subjective symptoms.In this study, we present a case of unilateral hyperplasia of the coronoid process in a 3 year-old female who, to the best of our knowledge, is the youngest patient so far reported with such anomaly.Our findings support the recommendation that early surgical treatment and aggressive postoperative physical therapy should be taken into account to allow for recovery of morphology and growth function in children.

  2. Unilateral parotid gland involvement with synchronous multiple Basal cell adenomas.

    PubMed

    Ozcan, Cengiz; Apa, Duygu Düsmez; Vayisoglu, Yusuf; Görür, Kemal

    2007-11-01

    Basal cell adenoma (BCA) is a rare benign epithelial tumor of the salivary gland. BCA is seen most frequently in the parotid gland and less commonly in the submandibular gland and minor glands of the upper lips, oral cavity, and hard palate. Salivary gland tumors are observed as single tumors in one salivary gland. Double or multiple tumors of the salivary gland tumors are unusual and metachronous or bilateral salivary gland tumors are more observed than synchronous or unilateral tumors. The most commonly seen multiple tumor unilaterally or bilaterally is the Warthin's tumor. A 65-year-old woman with a painful, slowly enlarging mass in front of the left ear, which was present for 6 months, was evaluated. Physical examination revealed two solid and well-delineated masses in the preauricular region, which were 1.5 x 1 cm in diameter and in the tail of the parotid gland, which is 2.5 x 2 cm in diameter. Excision of the superficial lobe of the parotid gland was performed. The macroscopic examination of the specimen showed the two discrete nodular masses. Histologic examination of the two nodular solid lesions was reported as BCA. Multiple synchronous nonmembranous-type BCAs of the unilateral parotid gland is a rare entity. More extensive excision of the parotid gland tumor, careful macroscopic perioperative examination of the surgical specimen, and histologic evaluation of all surgical specimens might be necessary for reducing revision operations and surgical complications.

  3. [Fracture endoprosthesis of distal humerus fractures].

    PubMed

    Müller, L P; Wegmann, K; Burkhart, K J

    2013-08-01

    The treatment of choice for fractures of the distal humerus is double plate osteosynthesis. Due to anatomical preshaped angle stable plates the primary stability and management of soft tissues has been improved. However, osteoporotic comminuted fractures in the elderly are often not amenable to stable osteosynthesis and total elbow arthroplasty has been established as an alternative therapy. Although complication rates have been reduced, complications of total elbow arthroplasty are still much more frequent than in total hip replacement. Furthermore, patients are advised not to exceed a weight bearing of 5 kg. Therefore, the indications for elbow arthroplasty must be evaluated very strictly and should be reserved for comminuted distal humeral fractures in the elderly with poor bone quality that are not amenable to stable osteosynthesis or for simple fractures in cases of preexisting symptomatic osteoarthritis. This article introduces and discusses modern concepts of elbow arthroplasty, such as modular convertible prosthesis systems, hemiarthroplasty and radial head replacement in total elbow arthroplasty.

  4. Fracture corridors in carbonates

    NASA Astrophysics Data System (ADS)

    Chatelée, Sébastien; Lamarche, Juliette; Gauthier, Bertrand D. M.

    2015-04-01

    Among fractures, Fracture Corridors (FC) are anomalous structures made of highly persistent fracture clusters having a strong effect on multi-phase fluid flow in the subsurface. While mechanical and geological conditions for diffuse fracture systems are well constrained, FC genetic conditions remain a matter of questioning. FC can be localized in larger structures such as folds and fault zones but recent studies suggest that a large amount of fractures and FC also arise as distributed in the host rock and formed in tabular layers during burial with early rock mechanical differentiation. In addition, while the mechanical stratigraphy is of prime importance for fracture stratigraphy, it is still unknown which factor prevails on FC genesis among the local versus regional stress-state, the host rock mechanical stratigraphy or the sedimentary facies. We present a study of fractures in a 400×300 m wide quarry (Calvisson, SE France) dug in homogeneous marly limestones of Hauterivian age. The quarry exhibits diffuse fractures as well as 16 FC. The aim of this study is to reveal the genetics factor for FC development, their global geometry and internal morphologic variations, but also to clear the impact of fracture corridors on diffuse fracture. For that, we measured >2500 fractures (strike, dip, spacing, filling, aperture, etc.) and studied microstructures in 80 thin sections. We calculated fracture density and acquired LiDAR data with >90 million points with a resolution of 4 to 15mm. Diffuse fractures are organized as two perpendicular sets, a main set NE-SW-trending and minor set NW-SE-trending. The FC have the same trend, but the NW-SE trend prevail on the NE-SW one. The LiDAR acquisition allows to visualize the 3D lateral continuity with corridors with a minimal extension of 30m. We distinguish 4 internal morphologic types in FC, depending on fracture morphology, occurrence of breccia and number of zones. The types may occur in a single FC with a lateral transition

  5. Stress fractures in athletes.

    PubMed

    Fredericson, Michael; Jennings, Fabio; Beaulieu, Christopher; Matheson, Gordon O

    2006-10-01

    A stress fracture is a partial or complete bone fracture that results from repeated application of stress lower than the stress required to fracture the bone in a single loading. Otherwise healthy athletes, especially runners, sustain stress injuries or fractures. Prevention or early intervention is the preferable treatment. However, it is difficult to predict injury because runners vary with regard to biomechanical predisposition, training methods, and other factors such as diet, muscle strength, and flexibility. Stress fractures account for 0.7% to 20% of all sports medicine clinic injuries. Track-and-field athletes have the highest incidence of stress fractures compared with other athletes. Stress fractures of the tibia, metatarsals, and fibula are the most frequently reported sites. The sites of stress fractures vary from sport to sport (eg, among track athletes, stress fractures of the navicular, tibia, and metatarsal are common; in distance runners, it is the tibia and fibula; in dancers, the metatarsals). In the military, the calcaneus and metatarsals were the most commonly cited injuries, especially in new recruits, owing to the sudden increase in running and marching without adequate preparation. However, newer studies from the military show the incidence and distribution of stress fractures to be similar to those found in sports clinics. Fractures of the upper extremities are relatively rare, although most studies have focused only on lower-extremity injuries. The ulna is the upper-extremity bone injured most frequently. Imaging plays a key role in the diagnosis and management of stress injuries. Plain radiography is useful when positive, but generally has low sensitivity. Radionuclide bone scanning is highly sensitive, but lacks specificity and the ability to directly visualize fracture lines. In this article, we focus on magnetic resonance imaging, which provides highly sensitive and specific evaluation for bone marrow edema, periosteal reaction as well

  6. Natural fracturing, by depth

    NASA Astrophysics Data System (ADS)

    Hooker, John; Laubach, Stephen

    2013-04-01

    Natural opening-mode fractures commonly fall upon a spectrum whose end-members are veins, which have wide ranges of sizes and are mostly or thoroughly cemented, and joints, which have little opening displacement and little or no cement. The vein end-member is common in metamorphic rocks, whose high temperature and pressure of formation place them outside typical reservoir settings; conversely, many uncemented joints likely form near the surface and so too have limited relevance to subsurface exploration. Sampling of cores retrieved from tight-gas sandstone reservoirs suggest that it is intermediate fractures, not true joints or veins, that provide natural porosity and permeability. Such fractures have abundant pore space among fracture-bridging cements, which may hold fractures open despite varying states of stress through time. Thus the more sophisticated our understanding of the processes that form veins and joints, i.e., how natural fracturing varies by depth, the better our ability to predict intermediate fractures. Systematic differences between veins and joints, in terms of size-scaling and lateral and stratigraphic spatial arrangement, have been explained in the literature by the mechanical effects of sedimentary layering, which likely exert more control over fracture patterns at shallower depths. Thus stratabound joints commonly have narrow size ranges and regular spacing; non-stratabound veins have a wide range of sizes and spacings. However, new fieldwork and careful literature review suggest that the effects of mechanical layering are only half the story. Although atypical, veins may be highly stratabound and yet spatially clustered; non-stratabound fractures may nonetheless feature narrow size ranges. These anomalous fracture arrangements are better explained by the presence of precipitating cements during fracture opening than by mechanical layering. Cement is thought to be highly important for fracture permeability, but potential effects of

  7. Multiple noncontiguous spine fractures.

    PubMed

    Henderson, R L; Reid, D C; Saboe, L A

    1991-02-01

    The data from a prospective study of 508 spine injuries were reviewed to determine the incidence of multiple noncontiguous spine fractures. All patients were examined at admission and at 1 and 2 years postinjury. This series identified 77 (15.2%) multilevel fractures. Motor vehicle accidents were the primary cause of these fractures. The incidence of neurologic injury was not significantly different between multiple noncontiguous and single fractures. Failure to use seat belts and ejection from the vehicle were the main factors associated with multiple noncontiguous spine injuries. Seven major fracture patterns were identified, which accounted for 60% of these injuries. The prognosis for multilevel spine fractures was not significantly worse that that for single-level injuries. PMID:2011766

  8. Finite element analysis of three commonly used external fixation devices for treating Type III pilon fractures.

    PubMed

    Ramlee, Muhammad Hanif; Kadir, Mohammed Rafiq Abdul; Murali, Malliga Raman; Kamarul, Tunku

    2014-10-01

    Pilon fractures are commonly caused by high energy trauma and can result in long-term immobilization of patients. The use of an external fixator i.e. the (1) Delta, (2) Mitkovic or (3) Unilateral frame for treating type III pilon fractures is generally recommended by many experts owing to the stability provided by these constructs. This allows this type of fracture to heal quickly whilst permitting early mobilization. However, the stability of one fixator over the other has not been previously demonstrated. This study was conducted to determine the biomechanical stability of these external fixators in type III pilon fractures using finite element modelling. Three-dimensional models of the tibia, fibula, talus, calcaneus, navicular, cuboid, three cuneiforms and five metatarsal bones were reconstructed from previously obtained CT datasets. Bones were assigned with isotropic material properties, while the cartilage was assigned as hyperelastic springs with Mooney-Rivlin properties. Axial loads of 350 N and 70 N were applied at the tibia to simulate the stance and the swing phase of a gait cycle. To prevent rigid body motion, the calcaneus and metatarsals were fixed distally in all degrees of freedom. The results indicate that the model with the Delta frame produced the lowest relative micromovement (0.03 mm) compared to the Mitkovic (0.05 mm) and Unilateral (0.42 mm) fixators during the stance phase. The highest stress concentrations were found at the pin of the Unilateral external fixator (509.2 MPa) compared to the Mitkovic (286.0 MPa) and the Delta (266.7 MPa) frames. In conclusion, the Delta external fixator was found to be the most stable external fixator for treating type III pilon fractures.

  9. [Femoral neck fracture].

    PubMed

    Gierer, P; Mittlmeier, T

    2015-03-01

    The incidence of femoral neck fractures increases exponentially with rising age. Young patients are rarely affected but when they are it is mostly due to high energy accidents, whereas older patients suffer from femoral neck fractures by low energy trauma due to osteoporotic changes of the bone mineral density. Treatment options have not essentially changed over the last few years. Non-operative treatment may be a choice in non-dislocated and impacted fractures. Due to the high risk of secondary fracture displacement prophylactic screw osteosynthesis is recommended even in Garden type I fractures. Osteosynthetic fracture stabilization with cannulated screws or angle stable sliding screws, is usually applied in non-displaced fractures and fractures in younger patients. Older patients need rapid mobilization after surgery; therefore, total hip arthroplasty and hemiarthroplasty are commonly used with a low incidence of secondary complications. In addition to sufficient operative treatment a guideline conform osteoprosis therapy should be initiated for the prophylaxis of further fractures and patients should undertake a suitable rehabilitation.

  10. Pathological fractures in children

    PubMed Central

    De Mattos, C. B. R.; Binitie, O.; Dormans, J. P.

    2012-01-01

    Pathological fractures in children can occur as a result of a variety of conditions, ranging from metabolic diseases and infection to tumours. Fractures through benign and malignant bone tumours should be recognised and managed appropriately by the treating orthopaedic surgeon. The most common benign bone tumours that cause pathological fractures in children are unicameral bone cysts, aneurysmal bone cysts, non-ossifying fibromas and fibrous dysplasia. Although pathological fractures through a primary bone malignancy are rare, these should be recognised quickly in order to achieve better outcomes. A thorough history, physical examination and review of plain radiographs are crucial to determine the cause and guide treatment. In most benign cases the fracture will heal and the lesion can be addressed at the time of the fracture, or after the fracture is healed. A step-wise and multidisciplinary approach is necessary in caring for paediatric patients with malignancies. Pathological fractures do not have to be treated by amputation; these fractures can heal and limb salvage can be performed when indicated. PMID:23610658

  11. Fracture detection logging tool

    DOEpatents

    Benzing, William M.

    1992-06-09

    A method and apparatus by which fractured rock formations are identified and their orientation may be determined includes two orthogonal motion sensors which are used in conjunction with a downhole orbital vibrator. The downhole vibrator includes a device for orienting the sensors. The output of the sensors is displayed as a lissajou figure. The shape of the figure changes when a subsurface fracture is encountered in the borehole. The apparatus and method identifies fractures rock formations and enables the azimuthal orientation of the fractures to be determined.

  12. Natural fracture systems studies

    SciTech Connect

    Lorenz, J.C.; Warpinski, N.R.

    1992-09-01

    The objectives of this program are (1) to develop a basinal-analysis methodology for natural fracture exploration and exploitation, and (2) to determine the important characteristics of natural fracture systems for use in completion, stimulation, and production operations. Natural-fracture basinal analysis begins with studies of fractures in outcrop, core and logs in order to determine the type of fracturing and the relationship of the fractures to the lithologic environment. Of particular interest are the regional fracture systems that are pervasive in western US tight sand basins. A Methodology for applying this analysis is being developed, with the goal of providing a structure for rationally characterizing natural fracture systems basin-wide. Such basin-wide characterizations can then be expanded and supplemented locally, at sites where production may be favorable. Initial application of this analysis is to the Piceance basin where there is a wealth of data from the Multiwell Experiment (MWX), DOE cooperative wells, and other basin studies conducted by Sandia, CER Corporation, and the USGS (Lorenz and Finley, 1989, Lorenz et aI., 1989, and Spencer and Keighin, 1984). Such a basinal approach has been capable of explaining the fracture characteristics found throughout the southern part of the Piceance basin and along the Grand Hogback.

  13. Unilateral Radiotherapy for the Treatment of Tonsil Cancer

    SciTech Connect

    Chronowski, Gregory M.; Garden, Adam S.; Morrison, William H.; Frank, Steven J.; Schwartz, David L.; Shah, Shalin J.; Beadle, Beth M.; Gunn, G. Brandon; Kupferman, Michael E.; Ang, Kian K.; Rosenthal, David I.

    2012-05-01

    Purpose: To assess, through a retrospective review, clinical outcomes of patients with squamous cell carcinoma of the tonsil treated at the M. D. Anderson Cancer Center with unilateral radiotherapy techniques that irradiate the involved tonsil region and ipsilateral neck only. Methods and Materials: Of 901 patients with newly diagnosed squamous cell carcinoma of the tonsil treated with radiotherapy at our institution, we identified 102 that were treated using unilateral radiotherapy techniques. All patients had their primary site of disease restricted to the tonsillar fossa or anterior pillar, with <1 cm involvement of the soft palate. Patients had TX (n = 17 patients), T1 (n = 52), or T2 (n = 33) disease, with Nx (n = 3), N0 (n = 33), N1 (n = 23), N2a (n = 21), or N2b (n = 22) neck disease. Results: Sixty-one patients (60%) underwent diagnostic tonsillectomy before radiotherapy. Twenty-seven patients (26%) underwent excision of a cervical lymph node or neck dissection before radiotherapy. Median follow-up for surviving patients was 38 months. Locoregional control at the primary site and ipsilateral neck was 100%. Two patients experienced contralateral nodal recurrence (2%). The 5-year overall survival and disease-free survival rates were 95% and 96%, respectively. The 5-year freedom from contralateral nodal recurrence rate was 96%. Nine patients required feeding tubes during therapy. Of the 2 patients with contralateral recurrence, 1 experienced an isolated neck recurrence and was salvaged with contralateral neck dissection only and remains alive and free of disease. The other patient presented with a contralateral base of tongue tumor and involved cervical lymph node, which may have represented a second primary tumor, and died of disease. Conclusions: Unilateral radiotherapy for patients with TX-T2, N0-N2b primary tonsil carcinoma results in high rates of disease control, with low rates of contralateral nodal failure and a low incidence of acute toxicity

  14. Torsional optokinetic nystagmus after unilateral vestibular loss: asymmetry and compensation.

    PubMed

    Lopez, Christophe; Borel, Liliane; Magnan, Jacques; Lacour, Michel

    2005-07-01

    The aim of this study was to analyse torsional optokinetic nystagmus (tOKN) in 17 patients with Menière's disease before and after (1 week, 1 month and 3 months) a curative unilateral vestibular neurotomy (UVN). The tOKN was investigated during optokinetic stimulations around the line of sight directed towards either the lesioned or the healthy side, at various constant angular velocities. Dynamic properties of tOKN and static ocular cyclotorsion were analysed using videonystagmography. Patients' performances were compared with those of 10 healthy subjects. The results indicate that, in the acute stage after UVN, patients exhibited drastic impairment of tOKN velocity that depended on the direction of stimulation: tOKN velocity increased for ipsilesional stimulations and decreased for contralesional stimulations. These changes were responsible for a dramatic tOKN asymmetry, with ipsilesional directional preponderance of torsional slow-phase eye velocity. The changes were associated with static ocular cyclotorsion towards the operated side. Despite progressive compensation of tOKN deficits over time, tOKN velocity still differed from that recorded preoperatively, and tOKN asymmetry remained uncompensated 3 months after UVN. A static ocular cyclotorsion remained up to 3 months after lesion. These results are the first description of tOKN deficits and recovery after unilateral vestibular loss. They show that vestibular cues contribute to gaze stabilization during optokinetic stimulation around the line of sight. They also strongly suggest that tOKN impairment could be part of the long-term asymmetrical functions reported after unilateral loss of vestibular functions. PMID:15917290

  15. Pneumothorax complicating isolated clavicle fracture.

    PubMed

    Hani, Redouane; Ennaciri, Badr; Jeddi, Idriss; El Bardouni, Ahmed; Mahfoud, Mustapha; Berrada, Mohamed Saleh

    2015-01-01

    Isolated clavicle fractures are among the commonest of traumatic fractures in the emergency department. Complications of isolated clavicle fractures are rare. Pneumothorax has been described as a complication of a fractured clavicle only rarely in English literature. In all the reported cases, the pneumothorax was treated by a thoracostomy and the clavicle fracture was treated conservatively. In our case, the pneumothorax required a chest drain insertion and the clavicle fracture was treated surgically with good result.

  16. A case of unilateral keloid after bilateral breast reduction

    PubMed Central

    Devalia, Haresh; Mansfield, Lucy; Minakaran, Neda; Banerjee, Dibyesh

    2008-01-01

    Keloid scar is a manifestation of abnormal wound healing in predisposed individuals. Many treatment modalities have been tried with varying degrees of success. Radiotherapy is one such modality that is widely recognised. We present a case report and literature review based on a patient who developed unilateral keloid scarring following bilateral breast reduction surgery. Some 4 years previously, she had undergone breast conserving surgery followed by adjuvant radiotherapy for breast cancer. After her breast reduction surgery, she developed keloid scarring on the non-irradiated breast only. This case highlights a possible 'preventative' effect of radiotherapy in keloid formation. PMID:18294403

  17. Unilateral adaptation of the human angular vestibulo-ocular reflex.

    PubMed

    Migliaccio, Americo A; Schubert, Michael C

    2013-02-01

    A recent study showed that the angular vestibulo-ocular reflex (VOR) can be better adaptively increased using an incremental retinal image velocity error signal compared with a conventional constant large velocity-gain demand (×2). This finding has important implications for vestibular rehabilitation that seeks to improve the VOR response after injury. However, a large portion of vestibular patients have unilateral vestibular hypofunction, and training that raises their VOR response during rotations to both the ipsilesional and contralesional side is not usually ideal. We sought to determine if the vestibular response to one side could selectively be increased without affecting the contralateral response. We tested nine subjects with normal vestibular function. Using the scleral search coil and head impulse techniques, we measured the active and passive VOR gain (eye velocity / head velocity) before and after unilateral incremental VOR adaptation training, consisting of self-generated (active) head impulses, which lasted ≈ 15 min. The head impulses consisted of rapid, horizontal head rotations with peak-amplitude 15°, peak-velocity 150°/s and peak-acceleration 3,000°/s(2). The VOR gain towards the adapting side increased after training from 0.92 ± 0.18 to 1.11 ± 0.22 (+22.7 ± 20.2 %) during active head impulses and from 0.91 ± 0.15 to 1.01 ± 0.17 (+11.3 ± 7.5 %) during passive head impulses. During active impulses, the VOR gain towards the non-adapting side also increased by ≈ 8 %, though this increase was ≈ 70 % less than to the adapting side. A similar increase did not occur during passive impulses. This study shows that unilateral vestibular adaptation is possible in humans with a normal VOR; unilateral incremental VOR adaptation may have a role in vestibular rehabilitation. The increase in passive VOR gain after active head impulse adaptation suggests that the training effect is robust.

  18. Unilateral frontal lobectomy can produce strategy application disorder.

    PubMed Central

    Goldstein, L H; Bernard, S; Fenwick, P B; Burgess, P W; McNeil, J

    1993-01-01

    Following a 5 cm left frontal lobectomy for the removal of a mixed astrocytoma-oligodendroglioma, a 51 year old right handed man showed a marked dissociation between his performance on standard neuropsychological tests and his everyday behaviour. In contrast to his intact neuropsychological test performance, he was impaired on a test of "strategy application" which requires goal articulation, plan specification, self-monitoring, and evaluation of outcomes, as well as the establishment of mental "markers" to trigger specific behaviour. Strategy application disorder can therefore be produced by a unilateral circumscribed frontal lobe lesions. Images PMID:8459244

  19. Graves' disease presenting as unilateral anterior ischaemic optic neuropathy.

    PubMed

    Monigari, Naresh; Deshpande, Anirudda; Nalabothu, Murali; Rao, Shilpa

    2014-03-19

    We report a case of a 28-year-old man who presented with 1-day history of sudden diminution of vision in the right eye. Examination showed unilateral exophthalmos with restricted eyeball movement on upward gaze in the right eye. MRI of the orbit showed no evidence of compression of the optic nerve on the right side. Visual-evoked potential showed prolonged P100 in the right eye. Fundus examination revealed swollen optic disc and para papillary nerve fibre layer splinter haemorrhages with corresponding altitudinal field defect on perimetry suggestive of anterior ischaemic optic neuropathy.

  20. Unilateral rubral tremors in Wilson's disease treated with dimercaprol

    PubMed Central

    Chakor, Rahul T.; Bharote, Haresh; Eklare, Nishikant; Tamboli, Khansabegum

    2015-01-01

    Tremors are reported as the most frequent neurological manifestation of Wilson's disease (WD) in some series. Postural tremors, rest tremors, action tremors and wing-beating (rubral) tremors are the different types of tremors seen in WD. We report a patient of WD with unilateral rubral tremors refractory to 1-year therapy with Penicillamine and anti-tremor medications. The tremors decreased considerably after adding chelation therapy with dimercaprol. Combination of Penicillamine and dimercaprol is an effective decoppering measure in rubral tremors of WD. PMID:25745328

  1. Severe amnesia following a unilateral temporal lobe stroke.

    PubMed

    Grewal, Raji P

    2003-01-01

    A 60 year old right-handed man developed severe amnesia following a left medial temporal stroke as documented by cerebral MRI, MRA and SPECT scans. Neuropsychological evaluation 13 weeks after the stroke showed a profound retrograde amnesia characterised by memory loss for public facts and events over the previous four decades. In addition, autobiographical memory showed selective loss of personal episodic memory with relative preservation of personal semantic memory. The development of this degree of amnesia with these features following a unilateral temporal lobe lesion is unusual. The possible neuroanatomical mechanisms underlying the amnesia and how they relate to current theories of memory loss are discussed. PMID:12464535

  2. Unilateral sudden hearing loss: a rare symptom of Moyamoya disease.

    PubMed

    Gül, Fatih; Berçin, Sami; Müderris, Togay; Yalçıner, Gökhan; Ünal, Özkan; Kırış, Muzaffer

    2016-01-01

    A 38-year-old female patient experienced a sudden onset of unilateral sensorineural hearing loss due to Moyamoya disease. A detailed summary of audiological and neurological findings indicated that the sudden hearing loss might be due to Moyamoya disease resulting in occlusion of posterior and middle cerebral arteries. Intravenous prednisolone and trimetazidine dihydrochloride may improve hearing thresholds and speech understanding. To our knowledge, this is the first article in the literature reporting a case of sudden hearing loss as the first manifestation of Moyamoya disease in a young adult.

  3. MRI and unilateral NMR study of reindeer skin tanning processes.

    PubMed

    Zhu, Lizheng; Del Federico, Eleonora; Ilott, Andrew J; Klokkernes, Torunn; Kehlet, Cindie; Jerschow, Alexej

    2015-04-01

    The study of arctic or subarctic indigenous skin clothing material, known for its design and ability to keep the body warm, provides information about the tanning materials and techniques. The study also provides clues about the culture that created it, since tanning processes are often specific to certain indigenous groups. Untreated skin samples and samples treated with willow (Salix sp) bark extract and cod liver oil are compared in this study using both MRI and unilateral NMR techniques. The two types of samples show different proton spatial distributions and different relaxation times, which may also provide information about the tanning technique and aging behavior.

  4. MRI and unilateral NMR study of reindeer skin tanning processes.

    PubMed

    Zhu, Lizheng; Del Federico, Eleonora; Ilott, Andrew J; Klokkernes, Torunn; Kehlet, Cindie; Jerschow, Alexej

    2015-04-01

    The study of arctic or subarctic indigenous skin clothing material, known for its design and ability to keep the body warm, provides information about the tanning materials and techniques. The study also provides clues about the culture that created it, since tanning processes are often specific to certain indigenous groups. Untreated skin samples and samples treated with willow (Salix sp) bark extract and cod liver oil are compared in this study using both MRI and unilateral NMR techniques. The two types of samples show different proton spatial distributions and different relaxation times, which may also provide information about the tanning technique and aging behavior. PMID:25719858

  5. Unilateral coronal craniosynostosis in Abraham Lincoln and his family.

    PubMed

    Fishman, Ronald S

    2010-09-01

    Premature closure of one coronal skull suture produces a characteristic arching or relative elevation of the superior orbital rim on the involved side. This sign is associated with facial asymmetry, and both signs are usually the most conspicuous features in patients with mild unilateral coronal craniosynostosis. Photographs suggest that at least 9 individuals over 5 generations of the Abraham Lincoln family had premature closure of 1 coronal suture. In 8 males, there was involvement of the left side; in 1 female, there was involvement of the right side.

  6. Osteosynthesis of fragility fractures.

    PubMed

    Tarantino, Umberto; Iundusi, Riccardo; Lecce, Domenico; Tempesta, Valerio; Perrone, Fabio Luigi; Rao, Cecilia; Cerocchi, Irene; Gasbarra, Elena

    2011-04-01

    The deepening knowledge about bone pathophysiology, together with the development of less invasive bone implants, fitted for the treatment of fragility fractures, the continuous advances in the creation of osteoconductive and osteoinductive biomaterials, the availability of bone active agents, capable of modulating fracture healing, actually represent the orthopaedic "weapons" to improve the surgical outcome and quality of life in patients with osteoporosis.

  7. TIBIAL SHAFT FRACTURES

    PubMed Central

    Kojima, Kodi Edson; Ferreira, Ramon Venzon

    2015-01-01

    The long-bone fractures occur most frequently in the tibial shaft. Adequate treatment of such fractures avoids consolidation failure, skewed consolidation and reoperation. To classify these fractures, the AO/OTA classification method is still used, but it is worthwhile getting to know the Ellis classification method, which also includes assessment of soft-tissue injuries. There is often an association with compartmental syndrome, and early diagnosis can be achieved through evaluating clinical parameters and constant clinical monitoring. Once the diagnosis has been made, fasciotomy should be performed. It is always difficult to assess consolidation, but the RUST method may help in this. Radiography is assessed in two projections, and points are scored for the presence of the fracture line and a visible bone callus. Today, the dogma of six hours for cleaning the exposed fracture is under discussion. It is considered that an early start to intravenous antibiotic therapy and the lesion severity are very important. The question of early or late closure of the lesion in an exposed fracture has gone through several phases: sometimes early closure has been indicated and sometimes late closure. Currently, whenever possible, early closure of the lesion is recommended, since this diminishes the risk of infection. Milling of the canal when the intramedullary nail is introduced is still a controversial subject. Despite strong personal positions in favor of milling, studies have shown that there may be some advantage in relation to closed fractures, but not in exposed fractures. PMID:27026999

  8. Transphyseal Distal Humerus Fracture.

    PubMed

    Abzug, Joshua; Ho, Christine Ann; Ritzman, Todd F; Brighton, Brian

    2016-01-01

    Transphyseal distal humerus fractures typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small height. Prompt and accurate diagnosis of a transphyseal distal humerus fracture is crucial for a successful outcome. Recognizing that the forearm is not aligned with the humerus on plain radiographs may aid in the diagnosis of a transphyseal distal humerus fracture. Surgical management is most commonly performed with the aid of an arthrogram. Closed reduction and percutaneous pinning techniques similar to those used for supracondylar humerus fractures are employed. Cubitus varus caused by a malunion, osteonecrosis of the medial condyle, or growth arrest is the most common complication encountered in the treatment of transphyseal distal humerus fractures. A corrective lateral closing wedge osteotomy can be performed to restore a nearly normal carrying angle.

  9. Diplopia following midfacial fractures.

    PubMed

    al-Qurainy, I A; Stassen, L F; Dutton, G N; Moos, K F; el-Attar, A

    1991-10-01

    Over a period of 2 years, 363 patients who had sustained a total of 438 midfacial fractures due to blunt trauma received a full ophthalmological examination within 1 week of injury. Of these, 72 patients (19.8%) developed diplopia. Diplopia was most common following road traffic accidents (31%) and least common with simple falls (10%). Blow-out fractures of the orbit led to double vision in 58% of cases. Eighty two percent of patients recovered from diplopia within 6 months of injury; only 1 patient required squint surgery for double vision. The principal risk factors for diplopia comprise road traffic accidents, blow-out fractures and comminuted malar fractures. Early surgical reconstruction of midfacial fractures with conservative management of concomitant motility disorders has, in our series, resulted in very few patients having diplopia in the long term. PMID:1742259

  10. Role of platelet-rich plasma in acceleration of bone fracture healing.

    PubMed

    Simman, Richard; Hoffmann, Andrea; Bohinc, R Jordan; Peterson, Wylan C; Russ, Andrew J

    2008-09-01

    Platelet-rich plasma (PRP) is a common therapy for acceleration of maxillofacial and spinal fusion bone-graft healing. This study analyzes the therapeutic role of PRP during long-bone fracture healing evaluated Lewis rats. Following creation of unilateral open femur fractures, either 500 microL thrombin-activated PRP (PRP treated group) or 500 microL saline (control group) were applied once to the fracture site. Fracture healing was analyzed after 1 and 4 weeks. Following 4 weeks of fracture healing, radiographic analysis demonstrated higher callus to cortex width ratio (P < 0.05) in the PRP group (PRP: 1.65 +/- 0.06; control: 1.48 +/- 0.05). Three-point load bearing showed increased bone strength following PRP treatment (PRP: 60.85 +/- 6.06 Newton, control: 47.66 +/- 5.49 Newton). Fracture histology showed enhanced bone formation in the PRP group. Immunohistochemistry and Western-blotting demonstrated healing-associated changes in transforming growth factor (TGF)-beta1 and bone morphogenetic protein (BMP)-2. Our results suggest that PRP accelerates bone fracture healing of rat femurs via modulation of TGF-beta1 and BMP-2 growth factor expression.

  11. Routine removal of the plate after surgical treatment for mandibular angle fracture with a third molar in relation to the fracture line

    PubMed Central

    Yamamoto, Kazuhiko; Matsusue, Yumiko; Horita, Satoshi; Murakami, Kazuhiro; Sugiura, Tsutomu; Kirita, Tadaaki

    2015-01-01

    Purpose: The purpose was to analyze the clinical course of surgically treated mandibular angle fractures from the viewpoint of routine removal of the plate because these fractures are associated with high rates of complications and plate removal. Subjects and Methods: The subjects were 40 patients with unilateral mandibular angle fracture, which was intraorally reduced and principally fixed with a single miniplate on the external oblique ridge. The third molar in relation to the fracture line was extracted in seven patients during the surgery. Clinical course was evaluated in terms of removal of the plate, preservation of the third molar and complications. Results: One patient showed a wound infection postoperatively, and two patients developed pericoronitis during the follow-up. These were managed with medication and local irrigation. One patient with a preserved third molar did not make a required visit and was lost from the follow-up. Removal of the plates was performed in 39 patients after confirmation of good fracture healing, mostly within a year. Twenty-four of 32 preserved third molars were simultaneously extracted. These procedures were generally performed under local anesthesia on an outpatient basis, and they did not cause any complications. Conclusions: Routine removal of the plate after surgical treatment for mandibular angle fractures, simultaneously with extraction of the third molar if indicated, may be beneficial to avoid complications related to the plate and the third molar later in life. PMID:26389039

  12. Altered Contralateral Auditory Cortical Morphology in Unilateral Sudden Sensorineural Hearing Loss

    PubMed Central

    Fan, Wenliang; Zhang, Wenjuan; Li, Jing; Zhao, Xueyan; Mella, Grace; Lei, Ping; Liu, Yuan; Wang, Haha; Cheng, Huamao; Shi, Hong; Xu, Haibo

    2015-01-01

    Objective: To investigate the cerebral gray matter volume alterations in unilateral sudden sensorineural hearing loss patients within the acute period by the voxel-based morphometry method, and to determine if hearing impairment is associated with regional gray matter alterations in unilateral sudden sensorineural hearing loss patients. Study Design: Prospective case study. Setting: Tertiary class A teaching hospital. Patients: Thirty-nine patients with left-side unilateral sudden sensorineural hearing loss and 47 patients with right-side unilateral sudden sensorineural hearing loss. Intervention: Diagnostic. Main Outcome Measure: To compare the regional gray matter of unilateral sudden sensorineural hearing loss patients and healthy control participants. Results: Compared with control groups, patients with left side unilateral sudden sensorineural hearing loss had significant gray matter reductions in the right middle temporal gyrus and right superior temporal gyrus, whereas patients with right side unilateral sudden sensorineural hearing loss showed gray matter decreases in the left superior temporal gyrus and left middle temporal gyrus. A significant negative correlation with the duration of the sudden sensorineural hearing loss (R = −0.427, p = 0.012 for left-side unilateral SSNHL and R = −0.412, p = 0.013 for right-side unilateral SSNHL) was also found in these brain areas. There was no region with increased gray matter found in both groups of unilateral sudden sensorineural hearing loss patients. Conclusions: This study confirms that detectable decreased contralateral auditory cortical morphological changes have occurred in unilateral SSNHL patients within the acute period by voxel-based morphometry methods. The gray matter volumes of these brain areas also perform a negative correlation with the duration of the disease, which suggests a gradual brain structural impairment after the progression of the disease. PMID:26595717

  13. The Computerized Table Setting Test for Detecting Unilateral Neglect

    PubMed Central

    Ye, Byoung Seok; Lee, Hye Sun; Chang, Hyuk-Jae; Song, Dongbeom; Kim, Young Dae; Heo, Ji Hoe; Nam, Hyo Suk

    2016-01-01

    Background Patients with unilateral neglect fail to respond normally to stimuli on the left side. To facilitate the evaluation of unilateral spatial neglect, we developed a new application that runs on a tablet device and investigated its feasibility in stroke patients. Methods We made the computerized table setting test (CTST) to run on the tablet computer. Forty acute ischemic stroke patients (20 patients with right hemispheric infarction with neglect, 10 patients with right hemispheric infarction without neglect, and 10 patients with left hemispheric infarction) and 10 healthy controls were prospectively enrolled to validate the CTST. The test requires subjects to set a table by dragging 12 dishes located below the table on the tablet screen. The horizontal deviation of the 12 dishes from the midline of the table, the selection tendency measured by the sequence of the dish selection, and the elapsed time for table setting were calculated automatically. Results Parameters measured by the CTST were correlated with the results of conventional neglect tests. The horizontal deviation was significantly higher in patients with right hemispheric infarction with neglect compared with the other groups. The selection tendency and elapsed time also were significantly different in patients with right hemispheric infarction with neglect compared with the left hemispheric infarction and control groups, but were similar to those with right hemispheric infarction without neglect. Conclusions The CTST is feasible to administer and comparable with conventional neglect tests. This new application may be useful for the initial diagnosis and follow-up of neglect patients. PMID:26771512

  14. [Surgical Therapy of Acquired Unilateral Diaphragmatic Paralysis: Indication and Results].

    PubMed

    Wiesemann, S; Haager, B; Passlick, B

    2016-09-01

    Unilateral elevation of the diaphragm may be due to various causes and requires further elucidation when the aetiology is unknown. Elevation of the diaphragm is often caused by diaphragmatic paralysis, either due to damage to the phrenic nerve or to the phrenic muscle. Patients typically complain of increased respiratory distress when lying down, bending or swimming. Basic diagnostic testing consists of a chest X-ray, as well as spirometry and computer tomography of the neck and chest. In many cases, no cause can be identified for the diaphragmatic paralysis. In symptomatic patients, diaphragm plication leads to fixation and thus to a reduction in the paradoxal respiratory movement of the paralysed diaphragm. In a large majority of studies, this results in significant and lasting improvement in vital capacity and respiratory distress. Spontaneous recovery of diaphragm paralysis is possible, even after several months, so a waiting period of at least 6 months should elapse before diaphragmatic plication is performed, if the clinical situation allows. The procedure can be performed minimally invasively, with low morbidity and mortality. When cutting the phrenic nerve, a nerve suture is recommended, if possible, or otherwise diaphragm plication during the procedure, especially in the case of pneumonectomy. This review provides an overview of the causes, pathophysiology, symptoms, diagnosis, therapy and results of diaphragmatic plication in acquired, unilateral diaphragmatic paralysis in adults, and suggests an algorithm for diagnostic testing and therapy. PMID:27607888

  15. Diffuse unilateral subacute neuroretinitis in the United Kingdom.

    PubMed

    Oueghlani, Evelyne; O'Sullivan, Eoin; Pavesio, Carlos E

    2010-10-01

    We describe the first two cases of diffuse unilateral subacute neuroretinitis (DUSN) in the UK successfully treated with albendazole. Two patients are described who presented with unilateral reduction in vision, with clusters of yellow-white retinal lesions fading and reappearing in new locations of the fundus over a period of weeks. Based on the clinical picture, the diagnosis of DUSN was made, even though no subretinal worm could be found. Both patients were treated with albendazole 400 mg daily for 30 days. After 4 weeks the vision in the affected eye improved to 6/9 in each patient and the retinal lesions resolved completely. Over a follow-up period of 28 months and 13 months respectively, there was no recurrence of any lesion and the vision was maintained. DUSN is a sight-threatening disease and the preservation of vision relies on early diagnosis and treatment. Laser photocoagulation of the worm is the treatment of choice, but this was not possible in either case, as no worm could be found; however, oral albendazole proved to be a safe and effective alternative treatment. PMID:20336350

  16. Mensuration data in infant eyes with unilateral congenital cataracts.

    PubMed

    Moore, B D

    1987-03-01

    The purpose of this study was to determine the size and shape of infant eyes having a unilateral congenital cataract. Fourteen infants presenting consecutively with a unilateral congenital cataract were studied. Ages ranged from 1.3 to 6 months (mean 3.7 months). Corneal curvature ranged from 43.00 to 49.50 D (mean 45.6 D). Refractive error at the corneal plane ranged from +23.50 to +34.00 D (mean +28.07 D). The axial length ranged from 16.49 to 20.09 mm (mean 18.41 mm). Microcornea was found in eight infants. There was rapid growth in eye size from normal neonatal dimensions. No significant relation was found among the following: corneal curvature and age; refractive error and age; axial length and age or presence of microcornea; and corneal curvature and refractive error. Corneal vault may be an important factor in fitting contact lenses to aphakic infants. Contact lenses for infants should be designed based on the dimensions of the infant eye.

  17. Unilateral peripheral neuropathic pain: The role of neurodiagnostic skin biopsy.

    PubMed

    Buonocore, Michelangelo

    2014-02-16

    According to the current definition of neuropathic pain ("pain arising as a direct consequence of a lesion or disease affecting the somatosensory system"), the demonstration of a lesion or disease involving the somatosensory system is mandatory for the diagnosis of definite neuropathic pain. Although several methods are currently available for this aim, none is suitable for every type of disease (or lesion). Neurodiagnostic skin biopsy (NSB) is a relatively new technique for the diagnosis of peripheral nerve lesions. It is an objective method, completely independent from the patient's complaining, based on immunohistochemical staining techniques that allow measurement of the density of the epidermal nerve fibers, currently considered the free nerve endings of small diameter (A-delta and C) afferent fibers. NSB has the important property of being used to investigate the skin, allowing obtaining a diagnosis of small fiber axonal neuropathy of peripheral nerves supplying every body part covered by skin. This feature appears to be very important, particularly in cases of unilateral nerve lesions, because it allows going beyond the possibilities of neurophysiological tests which are available only for a limited number of peripheral nerves. All these characteristics make NSB a precious instrument for the diagnosis of peripheral unilateral neuropathic pain.

  18. Multiple Unilateral Vestibular Schwannomas: Segmental NF2 or Sporadic Occurrence?

    PubMed Central

    Carlson, Matthew L.; Gompel, Jamie J. Van

    2016-01-01

    Objective To report a case of a patient presenting with two separate unilateral vestibular schwannomas (VSs) without other stigmata of neurofibromatosis type 2 (NF2). Study Design This article discusses a case report and review of the literature. Setting Tertiary academic referral center. Participants A 41-year-old female was referred for evaluation of a left-sided 1.8-cm cerebellopontine angle tumor centered on the porus acusticus and a separate ipsilateral 3-mm intracanalicular tumor appearing to arise from the superior vestibular nerve. The patient denied a family history of NF2. Neurotologic examination was unremarkable and close review of magnetic resonance imaging did not find any other stigmata of NF2. Results The patient underwent left-sided retrosigmoid craniotomy with gross total resection of both tumors. Final pathology confirmed benign schwannoma. The INI1/SMARCB1 staining pattern did not suggest NF2 or schwannomatosis. Conclusions This is only the third report of a case with multiple unilateral VSs occurring in a patient without other features of NF2. Herein, the authors review the two other reports and discuss potential mechanisms for this rare phenomenon. PMID:27354931

  19. Functional unilateral posterior crossbite effects on mastication movements using axiography.

    PubMed

    Salioni, Marco Antonio Canada; Pellizoni, Silmara Elena Papa; Guimarães, Antonio Sérgio; Juliano, Yara; Alonso, Luís Garcia

    2005-05-01

    This prospective study investigated the influence of functional unilateral posterior crossbite on mastication movements. The study group included 16 patients (nine girls and seven boys) with functional unilateral posterior crossbite involving three or more posterior teeth. A control group comprised 15 individuals (nine girls and six boys) with normal occlusion and the mean age of both groups was 9.17 years. The mandibular masticatory movements were registered, using computer axiography, for 30 seconds during chewing to determine the preference side of chewing. The patterns of the first, third, and fifth chewing cycles were compared with the preference side to establish whether they would predict the chewing preference side. The extent of the maximal lateral and vertical displacements of the mandible during chewing were compared between study and control groups. This study found that overall the left side was the preferred mastication side in 43.7% of individuals in the study and 46.7% in the control group. There was no relationship between the side of the crossbite and the masticatory preference side (Mc Nemar test, P = .5). No correlation was present between the patterns of chewing movements in the first, third, or fifth cycles. Both study and control groups showed similar maximal lateral and vertical mandible displacement.

  20. Biomechanical evaluation of four different posterior screw and rod fixation techniques for the treatment of the odontoid fractures

    PubMed Central

    Li, Lei; Liu, Wen-Fei; Jiang, Hong-Kun; Li, Yun-Peng

    2015-01-01

    Problems that screw cannot be inserted may occur in screw-rod fixation techniques such as Harms technique. We compared the biomechanical stability imparted to the C-2 vertebrae by four designed posterior screw and rod fixation techniques for the management of odontoid fractures. A three-dimensional finite element model of the odontoid fracture was established by subtracting several unit structures from the normal model from a healthy male volunteer. 4 different fixation techniques, shown as follows: ① C-1 lateral mass and C-2 pedicle screw fixation (Harms technique); ② C-1 lateral mass and unilateral C-2 pedicle screw fixation combined with ipsilateral laminar screw fixation; ③ Unilateral C-1lateral mass combined with ipsilateral C-1 posterior arch, and C-2 pedicle screw fixation; and ④ Unilateral C1 lateral mass screw connected with bilateral C2 pedicle screw fixation was performed on the odontoid fracture model. The model was validated for axial rotation, flexion, extension, lateral bending, and tension for 1.5 Nm. Changes in motion in flexion-extension, lateral bending, and axial rotation were calculated. The finite element model of the odontoid fracture was established in this paper. All of the four screw-rod techniques significantly decreased motion in flexion-extension, lateral bending, and axial rotation, as compared with the destabilized odontoid fracture complex (P<0.05). There was no statistically significant difference in stability among the four screw techniques. We concluded that the first three fixation techniques are recommended to be used as surgical intervention for odontoid fracture, while the last can be used as supplementary for the former three methods. PMID:26309508

  1. Metatarsal shaft fractures and fractures of the proximal fifth metatarsal.

    PubMed

    Fetzer, Gary B; Wright, Rick W

    2006-01-01

    Metatarsal fractures represent a relatively common injury, especially in athletes. The pertinent anatomy, evaluation, diagnosis, classification, and treatment of acute and chronic (stress) metatarsal shaft fractures are discussed. Fractures of the proximal fifth metatarsal, which are unique and important injuries, are also discussed. Treatment remains relatively straightforward for the traumatic metatarsal injury, whereas traditional stress fractures typically heal with decreased activity. The problematic proximal fifth metatarsal fracture (Jones fracture) frequently requires surgical intervention in patients who want to avoid non-weight-bearing cast immobilization. The authors' current treatment for this fracture includes the option of intramedullary fixation versus cast immobilization.

  2. Bilateral Facial Paralysis Caused by Temporal Bone Fracture: A Case Report

    PubMed Central

    Ghiasi, Samad; Banaei, Mehdi

    2016-01-01

    Introduction Although bilateral facial nerve palsy is a rare condition, its etiology is more detectable than the unilateral type. A temporal bone fracture is one cause of bilateral facial nerve palsy, contributing in 3% of the cases. Case Presentation Here, we report the case of a 35-year-old man complaining of bilateral incomplete eye closure, two weeks after a closed head injury caused by a motor vehicle accident. Conclusions The high resolution computed tomography findings revealed a bilateral temporal bone fracture line, which extended to the fallopian canal. With regard to treatment, near complete recovery was obvious after two weeks of treatment with oral corticosteroids. Overall, bilateral facial palsy is hard to diagnose; therefore, clinical suspicion and the early detection of facial nerve injuries is necessary for good nerve recovery in temporal bone fractures. PMID:27679786

  3. Bilateral Facial Paralysis Caused by Temporal Bone Fracture: A Case Report

    PubMed Central

    Ghiasi, Samad; Banaei, Mehdi

    2016-01-01

    Introduction Although bilateral facial nerve palsy is a rare condition, its etiology is more detectable than the unilateral type. A temporal bone fracture is one cause of bilateral facial nerve palsy, contributing in 3% of the cases. Case Presentation Here, we report the case of a 35-year-old man complaining of bilateral incomplete eye closure, two weeks after a closed head injury caused by a motor vehicle accident. Conclusions The high resolution computed tomography findings revealed a bilateral temporal bone fracture line, which extended to the fallopian canal. With regard to treatment, near complete recovery was obvious after two weeks of treatment with oral corticosteroids. Overall, bilateral facial palsy is hard to diagnose; therefore, clinical suspicion and the early detection of facial nerve injuries is necessary for good nerve recovery in temporal bone fractures.

  4. Periprosthetic patellar fractures.

    PubMed

    Adigweme, Obinna O; Sassoon, Adam A; Langford, Joshua; Haidukewych, George J

    2013-10-01

    Periprosthetic patellar fractures represent a spectrum of injuries to a patient with a total knee arthroplasty. They range in severity from an inconsequential injury, which does not compromise function, to a severely debilitating injury that may require advanced reconstructive measures. This article will outline the epidemiology and risk factors associated with periprosthetic patellar fractures. Treatment options as they relate to injury mechanism, fracture severity, patellar component stability, and remaining bone stock will also be discussed. Finally, a review of the current literature regarding the results of treatment will be presented.

  5. Unilateral Nipple Eczema in Children: Report of Five Cases and Literature Review.

    PubMed

    Jenkins, David; Cooper, Susan M; McPherson, Tess

    2015-01-01

    Bilateral nipple eczema on the background of atopy is not an uncommon problem and is a minor criterion in some diagnostic systems for atopic dermatitis (AD), but unilateral atopic nipple eczema is underrecognized and often causes clinical concern. We present the first case series of children with unilateral atopic nipple eczema and discuss the clinical aspects of this unusual distribution.

  6. Neuromagnetic fields accompanying unilateral and bilateral voluntary movements: topography and analysis of cortical sources.

    PubMed

    Kristeva, R; Cheyne, D; Deecke, L

    1991-08-01

    Movement-related magnetic fields (MRMFs) accompanying left and right unilateral and bilateral finger flexions were studied in 6 right-handed subjects. Six different MRMF components occurring prior to, and during both unilateral and bilateral movements are described: a slow pre-movement readiness field (RF, 1-0.5 sec prior to movement onset); a motor field (MF) starting shortly before EMG onset; 3 separate "movement-evoked" fields following EMG onset (MEFI at 100 msec; MEFII at 225 msec; and MEFIII at 320 msec); and a "post-movement" field (PMF) following the movement itself. The bilateral topography of the RF and MF for both unilateral and bilateral movements suggested bilateral generators for both conditions. Least-squares fitting of equivalent current dipole sources also indicated bilateral sources for MF prior to both unilateral and bilateral movements with significantly greater strength of contralateral sources in the case of unilateral movements. Differences in pre-movement field patterns for left versus right unilateral movements indicated possible cerebral dominance effects as well. A single current dipole in the contralateral sensorimotor cortex could account for the MEFI for unilateral movements and bilateral sensorimotor sources for bilateral movements. Other MRMF components following EMG onset indicated similar sources in sensorimotor cortex related to sensory feedback or internal monitoring of the movement. The results are discussed with respect to the possible generators active in sensorimotor cortex during unilateral and bilateral movement preparation and execution and their significance for the study of cortical organization of voluntary movement.

  7. Preliminary speech recognition results after cochlear implantation in patients with unilateral hearing loss: a case series

    PubMed Central

    2011-01-01

    Introduction Cochlear implants known to provide support in individuals with bilateral hearing loss may also be of great benefit for individuals with unilateral hearing loss. This case report demonstrates the positive effects of cochlear implantation on speech understanding in noise conditions in patients with unilateral hearing loss and normal hearing on the contralateral side. To the best of our knowledge, the data presented here are from the first few cases to receive a cochlear implant for unilateral hearing loss. Case presentation Four Caucasian German men, two aged 48 and the others aged 51 and 57 years old, with post-lingual unilateral hearing loss and normal hearing on the contralateral side were implanted with a cochlear implant. All our patients were members of the German army. Before and after implantation, they were given a battery of speech tests in different hearing conditions to assess the effect of unilateral cochlear implantation on speech understanding in noise conditions. Test results showed that all patients benefited from unilateral cochlear implantation, particularly in terms of speech understanding in noise conditions. Conclusions Unilateral cochlear implantation might be a successful treatment method for patients with unilateral hearing loss not benefiting from alternative treatment options. The results of this case report open up the field of cochlear implantation for expanded criteria and new areas of research. PMID:21810235

  8. A Magnetoencephalographic Study of Sensorimotor Activity Differences during Unilateral and Bilateral Forearm Movements

    ERIC Educational Resources Information Center

    Nakagawa, Kei

    2010-01-01

    This study compared activation of the sensorimotor area using magnetoencephalography after unilateral and bilateral movements. Thirteen healthy individuals and a patient with mild hemiplegia performed unilateral and bilateral forearm pronation movements. Among healthy participants, there were no significant differences in motor-evoked field during…

  9. Children with Mild Bilateral and Unilateral Hearing Loss: Parents' Reflections on Experiences and Outcomes

    ERIC Educational Resources Information Center

    Fitzpatrick, Elizabeth; Grandpierre, Viviane; Durieux-Smith, Andrée; Gaboury, Isabelle; Coyle, Doug; Na, Eunjung; Sallam, Nusaiba

    2016-01-01

    Children with mild bilateral and unilateral hearing loss are now commonly identified early through newborn hearing screening initiatives. There remains considerable uncertainty about how to support parents and about which services to provide for children with mild bilateral and unilateral hearing loss. The goal of this study was to learn about…

  10. A case of strictly unilateral migraine without aura transformed in an episodic hemicrania continua.

    PubMed

    Terlizzi, Rossana; Cevoli, Sabina; Nicodemo, Marianna; Pierangeli, Giulia; Grimaldi, Daniela; Cortelli, Pietro

    2011-02-01

    According to the diagnostic criteria of International Headache Society classification, hemicrania continua is a strictly unilateral continuous headache of moderate intensity with painful exacerbations associated with ipsilateral autonomic signs without pain-free periods. We report a case of a 42-year-old woman suffered of a remitting form of hemicrania continua evolved from a strictly unilateral migraine without aura.

  11. Bilateral Input Protects the Cortex from Unilaterally-Driven Reorganization in Children Who Are Deaf

    ERIC Educational Resources Information Center

    Gordon, Karen A.; Wong, Daniel D. E.; Papsin, Blake C.

    2013-01-01

    Unilateral hearing in childhood restricts input along the bilateral auditory pathways, possibly causing permanent reorganization. In this study we asked: (i) do the auditory pathways develop abnormally in children who are bilaterally deaf and hear with a unilateral cochlear implant? and (ii) can such differences be reversed by restoring input to…

  12. Doctor, I am sweating on just one side of my body: unilateral hyperhidrosis associated with mesothelioma.

    PubMed

    Waran, Eswaran

    2016-05-01

    Unilateral hyperhidrosis is rare and should prompt a thorough review for potentially serious underlying etiologies. Available treatments for unilateral hyperhidrosis secondary to mesothelioma are limited and its presence as a symptom usually signifies advanced disease and a poor prognosis. PMID:27190625

  13. Early Swept-Source Optical Coherence Tomography Angiography Findings in Unilateral Acute Idiopathic Maculopathy.

    PubMed

    Nicolo, Massimo; Rosa, Raffaella; Musetti, Donatella; Musolino, Maria; Traverso, Carlo Enrico

    2016-02-01

    Unilateral acute idiopathic maculopathy (UAIM) is a rare disorder presenting in young people with an acute onset of unilateral central visual loss often associated with a prodromal flu-like illness. The authors present the early anatomical findings of a 35-year-old man clinically diagnosed with UAIM using swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography.

  14. Determinants of Autobiographical Memory in Patients with Unilateral Temporal Lobe Epilepsy or Excisions

    ERIC Educational Resources Information Center

    St-Laurent, Marie; Moscovitch, Morris; Levine, Brian; McAndrews, Mary Pat

    2009-01-01

    Patients with unilateral temporal lobe epilepsy from hippocampal origin and patients with unilateral surgical excision of an epileptic focus located in the medial temporal lobe were compared to healthy controls on a version of the Autobiographical Interview (AI) adapted to assess memory for event-specific and generic personal episodes. For both…

  15. Longitudinal Development of Hand Function in Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Holmefur, Marie; Krumlinde-Sundholm, Lena; Bergstrom, Jakob; Eliasson, Ann-Christin

    2010-01-01

    Aim: The aim of this study was to describe how the usefulness of the hemiplegic hand develops in children with unilateral cerebral palsy (CP) aged between 18 months and 8 years. Method: A prospective longitudinal study of 43 children (22 males, 21 females) with unilateral CP was conducted. Inclusion age was 18 months to 5 years 4 months (mean 2y…

  16. Motor Learning of a Bimanual Task in Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Hung, Ya-Ching; Gordon, Andrew M.

    2013-01-01

    Children with unilateral cerebral palsy (CP) have been shown to improve their motor performance with sufficient practice. However, little is known about how they learn goal-oriented tasks. In the current study, 21 children with unilateral CP (age 4-10 years old) and 21 age-matched typically developed children (TDC) practiced a simple bimanual…

  17. Song Recognition by Young Children with Cochlear Implants: Comparison between Unilateral, Bilateral, and Bimodal Users

    ERIC Educational Resources Information Center

    Bartov, Tamar; Most, Tova

    2014-01-01

    Purpose: To examine song identification by preschoolers with normal hearing (NH) versus preschoolers with cochlear implants (CIs). Method: Participants included 45 children ages 3;8-7;3 (years;months): 12 with NH and 33 with CIs, including 10 with unilateral CI, 14 with bilateral CIs, and 9 bimodal users (CI-HA) with unilateral CI and…

  18. Surgery for scapula process fractures

    PubMed Central

    Anavian, Jack; Wijdicks, Coen A; Schroder, Lisa K; Vang, Sandy

    2009-01-01

    Background Generally, scapula process fractures (coracoid and acromion) have been treated nonoperatively with favorable outcome, with the exception of widely displaced fractures. Very little has been published, however, regarding the operative management of such fractures and the literature that is available involves very few patients. Our hypothesis was that operative treatment of displaced acromion and coracoid fractures is a safe and effective treatment that yields favorable surgical results. Methods We reviewed 26 consecutive patients (27 fractures) treated between 1998 and 2007. Operative indications for these process fractures included either a painful nonunion, a concomitant ipsilateral operative scapula fracture, ≥ 1 cm of displacement on X-ray, or a multiple disruption of the superior shoulder suspensory complex. All patients were followed until they were asymptomatic, displayed radiographic fracture union, and had recovered full motion with no pain. Patients and results 21 males and 5 females, mean age 36 (18–67) years, were included in the study. 18 patients had more than one indication for surgery. Of the 27 fractures, there were 13 acromion fractures and 14 coracoid fractures. 1 patient was treated for both a coracoid and an acromion fracture. Fracture patterns for the acromion included 6 acromion base fractures and 7 fractures distal to the base. Coracoid fracture patterns included 11 coracoid base fractures and 3 fractures distal to the base. Mean follow-up was 11 (2–42) months. All fractures united and all patients had recovered full motion with no pain at the time of final follow-up. 3 patients underwent removal of hardware due to irritation from hardware components that were too prominent. There were no other complications. Interpretation While most acromion and coracoid fractures can be treated nonoperatively with satisfactory results, operative management may be indicated for displaced fractures and double lesions of the superior shoulder

  19. Mechanical Coal-Face Fracturer

    NASA Technical Reports Server (NTRS)

    Collins, E. R., Jr.

    1984-01-01

    Radial points on proposed drill bit take advantage of natural fracture planes of coal. Radial fracture points retracted during drilling and impacted by piston to fracture coal once drilling halts. Group of bits attached to array of pneumatic drivers to fracture large areas of coal face.

  20. Unilateral cross bite treated by corticotomy-assisted expansion: two case reports

    PubMed Central

    2010-01-01

    Background True unilateral posterior crossbite in adults is a challenging malocclusion to treat. Conventional expansion methods are expected to have some shortcomings. The aim of this paper is to introduce a new technique for treating unilateral posterior crossbite in adults, namely, corticotomy-assisted expansion (CAE) applied on two adult patients: one with a true unilateral crossbite and the other with an asymmetrical bilateral crossbite, both treated via modified corticotomy techniques and fixed orthodontic appliances. Methods Two cases with asymmetric maxillary constriction were treated using CAE. Results In both cases, effective asymmetrical expansion was achieved using CAE, and functional occlusion was established as well. Conclusions Unilateral CAE presents an effective and reliable technique to treat true unilateral crossbite. PMID:20482859

  1. Asymptomatic Unilateral Hyperlucent Lung in a Prospective Kidney Donor.

    PubMed

    Lunia, Prajay; Karkhanis, Vinaya; Joshi, J M

    2015-09-01

    A 50 year old lady, prospective kidney donor was referred to our department for opinion in view of abnormal clinical findings during preoperative evaluation. She was asymptomatic from respiratory point of view. Her vital parameters were normal and on auscultation found to have decreased breath sounds and fine crackles throughout left hemithorax. Chest x-ray (CXR) showed left sided hyperlucency with small hilum (Figure 1). High resolution computed tomography (HRCT) showed scattered areas of bronchiectasis with associated air trapping throughout left lung with small left pulmonary artery (Figure 2). Sputum for acid fast bacilli (AFB) was negative. Spirometry showed moderate obstructive abnormality with forced expiratory volume in one second (FEV1) - 51% predicted, forced vital capacity (FVC) - 60% and FEV1/FVC - 76% with no bronchodilator reversibility. On post bronchodilator study there was paradoxical fall in FEV1/FVC to 72% consistent with small airway disease. Arterial blood gas analysis was normal. Technetium (Tc) 99m MAA lung perfusion scan (Figure3) showed normal perfusion of right lung contributing 75.4% of relative function and left lung contributing only 24.6%. Diagnosis of Swyer-James-MacLeod syndrome (SJMS) probably due to a childhood viral infection was made. Operative complications in such cases like difficult weaning and extubation, post-operative respiratory infections, collapse and respiratory failure are likely. However, our patient had an uneventful operative and post-operative course. SJMS is characterized by unilateral hyperlucency of a part of or the entire lung which was first described in 1953 by Swyer and James and later in 1954 by Macleod.1,2 It is considered to be an acquired disease as a result of post-infectious obliterative bronchiolitis. Productive cough, shortness of breath and sometimes hemoptysis are presenting symptoms. Some patients are asymptomatic and not diagnosed until they are adults.3 Radiologically it presents as predominant

  2. Unilateral Herpes Zoster Ophthalmicus Results in Bilateral Corneal Nerve Alteration

    PubMed Central

    Hamrah, Pedram; Cruzat, Andrea; Dastjerdi, Mohammad H.; Prüss, Harald; Zheng, Lixin; Shahatit, Bashar M.; Bayhan, Hasan A.; Dana, Reza; Pavan-Langston, Deborah

    2013-01-01

    Purpose Herpes zoster ophthalmicus (HZO), thought to be a unilateral disease, results in loss of corneal sensation, leading to neurotrophic keratopathy. This study aimed to analyze bilateral corneal nerve changes in patients with HZO by in vivo confocal microscopy (IVCM) and their correlation with corneal sensation as a measure of nerve function. Design Prospective, cross-sectional, controlled, single-center study. Participants Twenty-seven eyes with the diagnosis of HZO and their contralateral clinically unaffected eyes were studied and compared with normal controls (n = 15). Methods In vivo confocal microscopy (Confoscan 4; Nidek Technologies, Gamagori, Japan) and corneal esthesiometry (Cochet-Bonnet; Luneau Ophthalmologie, Chartres, France) of the central cornea were performed bilaterally in all patients and controls. Patients were grouped into normal (>5.5 cm), mild (>2.5–5.5 cm), and severe (<2.5 cm) loss of sensation. Main Outcome Measures Changes in corneal nerve density, total nerve number, main nerve trunks, branching, and tortuosity were evaluated after IVCM and were correlated to corneal sensation, disease duration, and number of recurrences. Results Eyes with herpes zoster ophthalmicus had a significant (P<0.001) decrease in total nerve length (595.8±358.1 vs. 2258.4±989.0 μm/frame), total number of nerves (5.4±2.8 vs. 13.1±3.8), number of main nerve trunks (2.3±1.1 vs. 4.7±1.2), and number of nerve branches (3.2±2.3 vs. 8.4±3.7) as compared with controls. In the contralateral clinically unaffected eyes, total nerve length (1053.1±441.4 μm/frame), total number of nerves (8.3±2.9), and main nerve trunks (3.1±1.0) also were decreased significantly as compared with controls (P<0.01). Reduced nerve density, total nerve count, main trunks, and tortuosity was correlated significantly with corneal sensation across all subgroups (P<0.001). Conclusions Patients with unilateral HZO demonstrated a profound and significant bilateral loss of the

  3. Ankle fracture - aftercare

    MedlinePlus

    ... that surgery can allow faster and more reliable healing. In children, the fracture involves the part of ... will use a special walking boot as the healing progresses. You will need to learn: How to ...

  4. Fracture Characterization of Meteorites

    NASA Astrophysics Data System (ADS)

    Bryson, K. L.; Agrawal, P.; Ostrowski, D. R.; Sears, D. W. G.

    2015-07-01

    NASA ARC has been tasked with understanding the behavior of ~100m asteroids entering the atmosphere and quantifying the impact hazard. As part of this task, we report the initial results of a survey of the fracture properties of meteorites.

  5. Geothermal Ultrasonic Fracture Imager

    SciTech Connect

    Patterson, Doug; Leggett, Jim

    2013-07-29

    The Geothermal Ultrasonic Fracture Imager project has a goal to develop a wireline ultrasonic imager that is capable of operating in temperatures up to 300°C (572°F) and depths up to 10 km (32,808 ft). This will address one of the critical needs in any EGS development of understanding the hydraulic flow paths in the reservoir. The ultrasonic imaging is well known in the oil and gas industry as one of the best methods for fracture evaluation; providing both high resolution and complete azimuthal coverage of the borehole. This enables fracture detection and characterization, both natural and induced, providing information as to their location, dip direction and dip magnitude. All of these factors are critical to fully understand the fracture system to enable the optimization of the thermal drainage through injectors and producers in a geothermal resource.

  6. Management of condylar fractures.

    PubMed

    Montazem, André H; Anastassov, George

    2009-03-01

    Management of condylar fractures remains a source of ongoing controversy. While it appears that many condylar fractures can be managed nonsurgically, recognition of cases that require surgical intervention and selection of an appropriate procedure are paramount to success in treating these injuries. There are a variety of special considerations that are peculiar to the condylar region. This article discusses anatomic considerations, classification of condylar fractures, indications for surgery, treatment options, and complications. The goals of treatment include restoration of function and esthetics. Careful consideration and attention to the principles of fracture management, and the role of the condyle as an articulating unit and growth center, must be taken into account for the successful management of these injuries.

  7. Etiology of zygomatic fractures.

    PubMed

    Cotter, C J; Ogunbowale, A; Beirne, C

    2005-01-01

    We report on the etiology of zygomatic fractures in an Irish population. More than half of these injuries are related to interpersonal assault. Treatment of these injuries places a considerable burden on the health service. PMID:16445148

  8. Sprains, Strains and Fractures

    MedlinePlus

    ... are useful for finding soft issue injuries (including torn ligaments) and stress fractures. Treatment will depend on ... weeks. Professional athletes may undergo surgery to repair torn ligaments. Oral anti-inflammatory medication, such as ibuprofen, ...

  9. Lisfranc (Midfoot) Fractures

    MedlinePlus

    ... broken or ligaments that support the midfoot are torn. The severity of the injury can vary from ... bones are broken (fractured) or the ligaments are torn (ruptured). Injuries can vary, from a simple injury ...

  10. Clavicle Fracture (Broken Collarbone)

    MedlinePlus

    ... place and the fragments are severely out of alignment. A large bump over the fracture site may ... bone fragments are first repositioned into their normal alignment, and then held in place with special screws ...

  11. Hay balers' fractures.

    PubMed

    Mayba, I I

    1984-03-01

    Two cases of fractures of the sternum and T12 vertebra are presented, which appear to be a characteristic combination of injuries to farmers when hay bales fall on them. The mechanism of injury proposed is a severe forward flexion, producing vertebral collapse at the dorsolumbar junction, and fracture of the sternum from direct trauma against the steering wheel. These fractures should always be suspected in persons injured while baling hay. It is proposed to call this complex of injuries hay balers' fractures. Preventive measures suggested are: operator caution when hay bales are lifted; addition of locks to the loader forks; increasing the size of the loader, or placing a screen or cage over the operators to keep hay bales from falling on them.

  12. Adult orbital trapdoor fracture.

    PubMed

    Kum, Clarissa; McCulley, Timothy J; Yoon, Michael K; Hwang, Thomas N

    2009-01-01

    Trapdoor fractures occur almost exclusively in the pediatric population. The authors describe an adult with an entrapped inferior rectus muscle sheath in a trapdoor fracture. A 37-year-old man presented with persistent diplopia 3 weeks after blunt right orbital trauma. The only abnormal findings on clinical examination were limited vertical ductions. No bony defect or displacement was evident on CT. However, several small pockets of air were visible adjacent to the inferior rectus muscle. On surgical exploration, a linear nondisplaced orbital floor fracture was confirmed, and the entrapped inferior rectus muscle was released. One month postoperatively, extraocular motility had improved with no diplopia in primary or reading positions. This case demonstrates that trapdoor fractures can occur in adults and should be considered when suggestive findings are encountered. Clinicians should be aware of this because timely diagnosis and treatment might achieve more favorable outcomes.

  13. Hay balers' fractures.

    PubMed

    Mayba, I I

    1984-03-01

    Two cases of fractures of the sternum and T12 vertebra are presented, which appear to be a characteristic combination of injuries to farmers when hay bales fall on them. The mechanism of injury proposed is a severe forward flexion, producing vertebral collapse at the dorsolumbar junction, and fracture of the sternum from direct trauma against the steering wheel. These fractures should always be suspected in persons injured while baling hay. It is proposed to call this complex of injuries hay balers' fractures. Preventive measures suggested are: operator caution when hay bales are lifted; addition of locks to the loader forks; increasing the size of the loader, or placing a screen or cage over the operators to keep hay bales from falling on them. PMID:6708148

  14. Relative permeability through fractures

    SciTech Connect

    Diomampo, Gracel, P.

    2001-08-01

    The mechanism of two-phase flow through fractures is of importance in understanding many geologic processes. Currently, two-phase flow through fractures is still poorly understood. In this study, nitrogen-water experiments were done on both smooth and rough parallel plates to determine the governing flow mechanism for fractures and the appropriate methodology for data analysis. The experiments were done using a glass plate to allow visualization of flow. Digital video recording allowed instantaneous measurement of pressure, flow rate and saturation. Saturation was computed using image analysis techniques. The experiments showed that gas and liquid phases flow through fractures in nonuniform separate channels. The localized channels change with time as each phase path undergoes continues breaking and reforming due to invasion of the other phase. The stability of the phase paths is dependent on liquid and gas flow rate ratio. This mechanism holds true for over a range of saturation for both smooth and rough fractures. In imbibition for rough-walled fractures, another mechanism similar to wave-like flow in pipes was also observed. The data from the experiments were analyzed using Darcy's law and using the concept of friction factor and equivalent Reynold's number for two-phase flow. For both smooth- and rough-walled fractures a clear relationship between relative permeability and saturation was seen. The calculated relative permeability curves follow Corey-type behavior and can be modeled using Honarpour expressions. The sum of the relative permeabilities is not equal one, indicating phase interference. The equivalent homogeneous single-phase approach did not give satisfactory representation of flow through fractures. The graphs of experimentally derived friction factor with the modified Reynolds number do not reveal a distinctive linear relationship.

  15. Interlaminar fracture of composites

    NASA Technical Reports Server (NTRS)

    Obrien, T. K.

    1984-01-01

    Fracture mechanics has been found to be a useful tool for understanding composite delamination. Analyses for calculating strain energy release rates associated with delamination growth have been developed. These analyses successfully characterized delamination onset and growth for particular sources of delamination. Low velocity impact has been found to be the most severe source of composite delamination. A variety of test methods for measuring interlaminar fracture toughness are being developed to identify new composite materials with enhanced delamination resistance.

  16. Treatment of Thoracolumbar Fracture

    PubMed Central

    Kim, Byung-Guk; Shin, Dong-Eun

    2015-01-01

    The most common fractures of the spine are associated with the thoracolumbar junction. The goals of treatment of thoracolumbar fracture are leading to early mobilization and rehabilitation by restoring mechanical stability of fracture and inducing neurologic recovery, thereby enabling patients to return to the workplace. However, it is still debatable about the treatment methods. Neurologic injury should be identified by thorough physical examination for motor and sensory nerve system in order to determine the appropriate treatment. The mechanical stability of fracture also should be evaluated by plain radiographs and computed tomography. In some cases, magnetic resonance imaging is required to evaluate soft tissue injury involving neurologic structure or posterior ligament complex. Based on these physical examinations and imaging studies, fracture stability is evaluated and it is determined whether to use the conservative or operative treatment. The development of instruments have led to more interests on the operative treatment which saves mobile segments without fusion and on instrumentation through minimal invasive approach in recent years. It is still controversial for the use of these treatments because there have not been verified evidences yet. However, the morbidity of patients can be decreased and good clinical and radiologic outcomes can be achieved if the recent operative treatments are used carefully considering the fracture pattern and the injury severity. PMID:25705347

  17. FRACTURING FLUID CHARACTERIZATION FACILITY

    SciTech Connect

    Subhash Shah

    2000-08-01

    Hydraulic fracturing technology has been successfully applied for well stimulation of low and high permeability reservoirs for numerous years. Treatment optimization and improved economics have always been the key to the success and it is more so when the reservoirs under consideration are marginal. Fluids are widely used for the stimulation of wells. The Fracturing Fluid Characterization Facility (FFCF) has been established to provide the accurate prediction of the behavior of complex fracturing fluids under downhole conditions. The primary focus of the facility is to provide valuable insight into the various mechanisms that govern the flow of fracturing fluids and slurries through hydraulically created fractures. During the time between September 30, 1992, and March 31, 2000, the research efforts were devoted to the areas of fluid rheology, proppant transport, proppant flowback, dynamic fluid loss, perforation pressure losses, and frictional pressure losses. In this regard, a unique above-the-ground fracture simulator was designed and constructed at the FFCF, labeled ''The High Pressure Simulator'' (HPS). The FFCF is now available to industry for characterizing and understanding the behavior of complex fluid systems. To better reflect and encompass the broad spectrum of the petroleum industry, the FFCF now operates under a new name of ''The Well Construction Technology Center'' (WCTC). This report documents the summary of the activities performed during 1992-2000 at the FFCF.

  18. Fracture toughness of graphene.

    PubMed

    Zhang, Peng; Ma, Lulu; Fan, Feifei; Zeng, Zhi; Peng, Cheng; Loya, Phillip E; Liu, Zheng; Gong, Yongji; Zhang, Jiangnan; Zhang, Xingxiang; Ajayan, Pulickel M; Zhu, Ting; Lou, Jun

    2014-04-29

    Perfect graphene is believed to be the strongest material. However, the useful strength of large-area graphene with engineering relevance is usually determined by its fracture toughness, rather than the intrinsic strength that governs a uniform breaking of atomic bonds in perfect graphene. To date, the fracture toughness of graphene has not been measured. Here we report an in situ tensile testing of suspended graphene using a nanomechanical device in a scanning electron microscope. During tensile loading, the pre-cracked graphene sample fractures in a brittle manner with sharp edges, at a breaking stress substantially lower than the intrinsic strength of graphene. Our combined experiment and modelling verify the applicability of the classic Griffith theory of brittle fracture to graphene. The fracture toughness of graphene is measured as the critical stress intensity factor of and the equivalent critical strain energy release rate of 15.9 J m(-2). Our work quantifies the essential fracture properties of graphene and provides mechanistic insights into the mechanical failure of graphene.

  19. Subduction of fracture zones

    NASA Astrophysics Data System (ADS)

    Constantin Manea, Vlad; Gerya, Taras; Manea, Marina; Zhu, Guizhi; Leeman, William

    2013-04-01

    Since Wilson proposed in 1965 the existence of a new class of faults on the ocean floor, namely transform faults, the geodynamic effects and importance of fracture zone subduction is still little studied. It is known that oceanic plates are characterized by numerous fracture zones, and some of them have the potential to transport into subduction zones large volumes of water-rich serpentinite, providing a fertile water source for magma generated in subduction-related arc volcanoes. In most previous geodynamic studies, subducting plates are considered to be homogeneous, and there is no clear indication how the subduction of a fracture zone influences the melting pattern in the mantle wedge and the slab-derived fluids distribution in the subarc mantle. Here we show that subduction of serpentinized fracture zones plays a significant role in distribution of melt and fluids in the mantle wedge above the slab. Using high-resolution tree-dimensional coupled petrological-termomechanical simulations of subduction, we show that fluids, including melts and water, vary dramatically in the region where a serpentinized fracture zone enters into subduction. Our models show that substantial hydration and partial melting tend to concentrate where fracture zones are being subducted, creating favorable conditions for partially molten hydrous plumes to develop. These results are consistent with the along-arc variability in magma source compositions and processes in several regions, as the Aleutian Arc, the Cascades, the Southern Mexican Volcanic Arc, and the Andean Southern Volcanic Zone.

  20. Unilateral ophthalmoplegia secondary to anterior clinoid process mucocele.

    PubMed

    Forer, Boaz; Hui, Ng Yuk; Sethi, Dharmbir Singh

    2010-12-01

    A 50-year-old Chinese man presented with rapidly progressive unilateral ophthalmoplegia and then an ipsilateral afferent pupil defect. CT and MRI revealed a mass centered in the anterior clinoid process causing bone destruction and showing high T1 and T2 signal intensity indicative of mucosal protein secretion. These imaging features suggested a mucocele, which may have resulted from sequestration of a clinoidal extension of the sphenoid sinus. The sphenoid sinus was opened via an image-guided endoscopic approach, and the lesion incised. There were no complications. The ophthalmoplegia and afferent pupil defect had completely resolved within 1 week of surgery. This is the eighth reported case of anterior clinoidal mucocele, a rare cause of ophthalmoplegia or optic neuropathy. Advances in endoscopic instrumentation, navigation systems, and intraoperative imaging have reduced the operative risk and made the endoscopic approach a feasible and safer alternative to open surgery for this condition.

  1. Unusual unilateral presentation of pachydermodactyly: a case report.

    PubMed

    Ulusoy, Hasan; Tas, Nevsun Pihtili; Akgol, Gurkan; Gulkesen, Arif; Kamanli, Ayhan

    2012-06-01

    Pachydermodactyly is a rare digital fibromatosis characterized by asymptomatic fusiform soft-tissue swellings of the proximal interphalangeal joints of the hands. It usually affects healthy adolescent males with a negative family history. As a rule, clinical presentation of the disease is bilateral and symmetrical enlargement of the joints. So it can be misdiagnosed with inflammatory rheumatic diseases, especially with juvenile chronic arthritis. A prompt clinical diagnosis of the disease would prevent inappropriate treatment with immunosuppressive agents or steroids and unnecessary expensive diagnostic procedures such as biopsy or magnetic resonance imaging. Once diagnosed, patients should be advised in order to avoid repetitive traumas of the hands, rubbing and cracking of the fingers, obsessive-compulsive use of computer and video games. The joint outcome is always benign. Here, we report a case of pachydermodactyly differs from the typical clinical picture of pachydermodactyly in the unilateral distribution of the lesions.

  2. Apparatus for unilateral generation of a homogeneous magnetic field

    DOEpatents

    Fukushima, Eiichi; Rath, Alan R.; Roeder, Stephen B. W.

    1988-01-01

    An apparatus for unilaterally producing a substantially homogeneous magnetic field. The apparatus includes two circular electromagnet coils, a small coil and a large coil, which are coaxial with one another and which are separated by a distance equal to one-half the difference in the radius of the two coils. By appropriate selection of electrical currents, which are passed through the coil in opposite directions, a region of homogeneous magnetic field is formed. This region is centered on the common axis of the two coils, at a point on the axis which is at a distance from the small coil equal to one-half the radius of the small coil, and which is on the opposite side of the small coil from the large coil. The apparatus has particular application in the field of diagnostic medical NMR and other NMR applications.

  3. Apparatus for unilateral generation of a homogeneous magnetic field

    DOEpatents

    Fukushima, E.; Rath, A.R.; Roeder, S.B.W.

    1984-05-01

    An apparatus for unilaterally producing a substantially homogeneous magnetic field. The apparatus includes two circular electromagnet coils, a small coil and a large coil, which are coaxial with one another and which are separated by a distance equal to one-half the difference in the radius of the two coils. By appropriate selection of electrical currents, which are passed through the coils in opposite directions, a region of homogeneous magnetic field is formed. This region is centered on the common axis of the two coils, at a point on the axis which is at a distance from the small coil equal to one-half the radius of the small coil, and which is on the opposite side of the small coil from the large coil. The apparatus has particular application in the field of diagnostic medical NMR and other NMR applications.

  4. Point localisation in patients with unilateral brain damage.

    PubMed Central

    Tartaglione, A; Benton, A L; Cocito, L; Bino, G; Favale, E

    1981-01-01

    The ability to reproduce the position of points in a plane was examined by a copying test in a control group and in unilaterally brain damaged patients. The procedure was designed to minimise the influence of visual field defects and of spatial hemi-inattention on performance. Accuracy of of localisation and direction of errors were studied in each half of the plane. Analysis showed a greater impairment of localisation ability in the patients with right hemisphere disease; however, the performance of both hemispheric groups was characterised by a reduction of accuracy in half of the plane contralateral to the side of the lesion. Both hemispheric groups showed an abnormal direction of errors in the left half of the plane, but the two groups presented a different pattern of errors. PMID:7310411

  5. Unilateral and bilateral laparoscopic ovariectomy of mares by electrocautery.

    PubMed

    Smith, L J; Mair, T S

    2008-09-01

    Twelve horses underwent standing laparoscopic ovariectomy using electrocoagulation and fine dissection as the only means of achieving haemostasis of the severed ovarian pedicle. Four mares had bilateral ovariectomy performed as a treatment for aggressive behaviour thought to be associated with the oestrous cycle. Eight mares had unilateral ovariectomy performed for removal of a granulosa thecal cell tumour (GCT). Electrocoagulation provided an effective means of haemostasis in both normal and pathological ovaries. Only one case (removal of a GCT) had mild haemorrhage following electrocoagulation, necessitating the need for the application of endoscopic clips to achieve haemostasis. Six of the horses developed minor wound complications (none of them requiring any additional treatment). Long-term follow-up information showed complete resolution of abnormal behaviour in all eight horses with GCTs, but in one of the four horses with normal ovaries the aggressive behaviour had not been completely resolved. PMID:18776175

  6. Unusual unilateral presentation of pachydermodactyly: a case report.

    PubMed

    Ulusoy, Hasan; Tas, Nevsun Pihtili; Akgol, Gurkan; Gulkesen, Arif; Kamanli, Ayhan

    2012-06-01

    Pachydermodactyly is a rare digital fibromatosis characterized by asymptomatic fusiform soft-tissue swellings of the proximal interphalangeal joints of the hands. It usually affects healthy adolescent males with a negative family history. As a rule, clinical presentation of the disease is bilateral and symmetrical enlargement of the joints. So it can be misdiagnosed with inflammatory rheumatic diseases, especially with juvenile chronic arthritis. A prompt clinical diagnosis of the disease would prevent inappropriate treatment with immunosuppressive agents or steroids and unnecessary expensive diagnostic procedures such as biopsy or magnetic resonance imaging. Once diagnosed, patients should be advised in order to avoid repetitive traumas of the hands, rubbing and cracking of the fingers, obsessive-compulsive use of computer and video games. The joint outcome is always benign. Here, we report a case of pachydermodactyly differs from the typical clinical picture of pachydermodactyly in the unilateral distribution of the lesions. PMID:21442169

  7. Adaptations to unilateral lower limb suspension in humans

    NASA Technical Reports Server (NTRS)

    Dudley, Gary A.; Duvoisin, Marc R.; Adams, Gregory R.; Meyer, Ronald A.; Belew, Anne H.; Buchanan, Paul

    1992-01-01

    The effect of unilateral lower limb suspension (ULLS) on neuromuscular function in humans is analyzed. All ambulatory activity on crutches was performed by eight subjects for 6 weeks who wear a shoe with a 10 cm sole on the right foot to unweight the left lower limb. Results show that average muscle cross sectional area (CSA) of the left knee extensor (KE) decreased 16 percent whereas the KE of the nonsuspended right limb showed no changes. Maximal integrated electromyography of vastus lateralis and overall mean power frequency of gastrocnemius medialis and soleus for submaximal isometric actions were both decreased post-ULLS. It is concluded that six weeks of ULLS induces adaptations in the neuromuscular system of humans which are comparable to those induced by bed rest and spaceflight.

  8. Unilateral ophthalmoplegia secondary to anterior clinoid process mucocele.

    PubMed

    Forer, Boaz; Hui, Ng Yuk; Sethi, Dharmbir Singh

    2010-12-01

    A 50-year-old Chinese man presented with rapidly progressive unilateral ophthalmoplegia and then an ipsilateral afferent pupil defect. CT and MRI revealed a mass centered in the anterior clinoid process causing bone destruction and showing high T1 and T2 signal intensity indicative of mucosal protein secretion. These imaging features suggested a mucocele, which may have resulted from sequestration of a clinoidal extension of the sphenoid sinus. The sphenoid sinus was opened via an image-guided endoscopic approach, and the lesion incised. There were no complications. The ophthalmoplegia and afferent pupil defect had completely resolved within 1 week of surgery. This is the eighth reported case of anterior clinoidal mucocele, a rare cause of ophthalmoplegia or optic neuropathy. Advances in endoscopic instrumentation, navigation systems, and intraoperative imaging have reduced the operative risk and made the endoscopic approach a feasible and safer alternative to open surgery for this condition. PMID:20881616

  9. Severe unilateral corneal melting after uneventful phacoemulsification cataract surgery.

    PubMed

    Praidou, Anna; Brazitikos, Periklis; Dastiridou, Anna; Androudi, Sofia

    2013-01-01

    We present a rare case of severe unilateral corneal melt after uneventful phacoemulsification. A 38-year-old woman presented one week after uneventful phacoemulsification cataract surgery complaining of pain and blurred vision in her operated eye. Our differential diagnosis included peripheral ulcerative keratitis, Mooren's ulcer and herpetic keratitis. The patient was started on oral acyclovir and topical steroids. An extensive blood work-up was done to rule out autoimmune diseases. Purified protein derivative test demonstrated 15 mm of erythema. Because the clinical picture was progressing, the patient was started on triple anti-tuberculosis therapy. Despite treatment, the patient was complaining of excruciating eye pain that was relieved only with intramuscular prednisone injections. The corneal melt healed after approximately three months without any other intervention, leaving a 90 per cent thickness loss in its central area. Idiopathic corneal melt after uneventful phacoemulsification is a rare complication, which must be managed in a multidirectional treatment approach to prevent devastating corneal perforation.

  10. Unilateral sagittal split mandibular ramus osteotomy: indications and geometry.

    PubMed

    Beukes, Jacques; Reyneke, Johan P; Damstra, Janalt

    2016-02-01

    Small mandibular asymmetries may be corrected by unilateral sagittal split ramus osteotomy (USSO). This study had two objectives: first to define the geometric changes in the mandibular condyle and the lower incisor teeth that result from the rotation of the major segment (n=26), and secondly to examine in a clinical study the temporomandibular joints (TMJ) of 23 patients after correction of mandibular asymmetry by USSO to find out if there were any long-term adverse effects. Small mandibular asymmetries (<5mm) can be corrected by USSO. Secondary anteroposterior changes as a result of setback or advancement on the operated side should be taken into account during the planning of treatment. The small rotational changes of the condyle did not adversely affect the TMJ. PMID:26774360

  11. Early cavernous sinus thrombosis following unilateral pansinusitis in a child.

    PubMed

    Mallick, Ajay; Pathak, Som Dutt; Shankar, Sandeep; Sati, Alok

    2015-01-01

    Cavernous sinus thrombosis (CST) is a life-threatening entity with a high rate of mortality and lifelong morbidity. A strong clinical suspicion of the complication, early radiological detection and institution of timely, aggressive treatment are required to prevent permanent neurological disability. We present a 12-year-old girl with bilateral CST following unilateral pansinusitis. Clinical symptoms of headache and retro-orbital pain out of proportion to clinical signs on presentation prompted a suspicion of something beyond sinusitis and raised the clinical suspicion of cavernous sinus involvement. In spite of institution of an early medical treatment, she progressed to develop bilateral cranial nerve paresis. However, with the persistence of antibiotics and anticoagulation therapy, she was successfully managed with no residual neurological sequelae. The aim of this presentation is to highlight the grave consequences of cavernous sinus involvement following infections of paranasal sinus and the rare complete recovery from disability in this case. PMID:25917067

  12. Micronucleus formation causes perpetual unilateral chromosome inheritance in mouse embryos.

    PubMed

    Vázquez-Diez, Cayetana; Yamagata, Kazuo; Trivedi, Shardul; Haverfield, Jenna; FitzHarris, Greg

    2016-01-19

    Chromosome segregation defects in cancer cells lead to encapsulation of chromosomes in micronuclei (MN), small nucleus-like structures within which dangerous DNA rearrangements termed chromothripsis can occur. Here we uncover a strikingly different consequence of MN formation in preimplantation development. We find that chromosomes from within MN become damaged and fail to support a functional kinetochore. MN are therefore not segregated, but are instead inherited by one of the two daughter cells. We find that the same MN can be inherited several times without rejoining the principal nucleus and without altering the kinetics of cell divisions. MN motion is passive, resulting in an even distribution of MN across the first two cell lineages. We propose that perpetual unilateral MN inheritance constitutes an unexpected mode of chromosome missegregation, which could contribute to the high frequency of aneuploid cells in mammalian embryos, but simultaneously may serve to insulate the early embryonic genome from chromothripsis. PMID:26729872

  13. Disorders of sex development presenting as unilateral cryptorchidism.

    PubMed

    Østergren, Peter; Juul, Anders; Azawi, Nessn H

    2013-10-01

    Disorders of sex development (DSD) present in different forms but, in most cases, with visible anomalies of the external genitalia. The diagnosis of DSD can have a vast impact on an individual; in addition to concerns about fertility and a higher risk of neoplasia, it may have severe psychosocial impact on the patient. This report presents two apparently healthy cases referred for operation because of unilateral undescended testis. In these two patients, uterine remnants were found during the operation, and underlying DSD conditions were unexpectedly diagnosed. One patient had a 45,X/46,XY mosaic karyotype, while the second patient had persistent müllerian duct syndrome, probably due to an anti-müllerian hormone receptor defect. Both conditions are extremely rare, but the findings reinforce that DSD should be considered in patients with cryptorchidism, especially if other clinical signs are present.

  14. Micronucleus formation causes perpetual unilateral chromosome inheritance in mouse embryos.

    PubMed

    Vázquez-Diez, Cayetana; Yamagata, Kazuo; Trivedi, Shardul; Haverfield, Jenna; FitzHarris, Greg

    2016-01-19

    Chromosome segregation defects in cancer cells lead to encapsulation of chromosomes in micronuclei (MN), small nucleus-like structures within which dangerous DNA rearrangements termed chromothripsis can occur. Here we uncover a strikingly different consequence of MN formation in preimplantation development. We find that chromosomes from within MN become damaged and fail to support a functional kinetochore. MN are therefore not segregated, but are instead inherited by one of the two daughter cells. We find that the same MN can be inherited several times without rejoining the principal nucleus and without altering the kinetics of cell divisions. MN motion is passive, resulting in an even distribution of MN across the first two cell lineages. We propose that perpetual unilateral MN inheritance constitutes an unexpected mode of chromosome missegregation, which could contribute to the high frequency of aneuploid cells in mammalian embryos, but simultaneously may serve to insulate the early embryonic genome from chromothripsis.

  15. Phonetic features by babies with unilateral cleft lip and palate.

    PubMed

    O'Gara, M M; Logemann, J A; Rademaker, A W

    1994-11-01

    Twenty-three babies with nonsyndromic unilateral cleft lip and palate were audiotaped at regular intervals from 5 to 35 months of age. Narrow phonetic transcription of their comfort-state vocalizations and word approximations was accomplished to describe phonetic development over time and according to the nonrandomized age of palatoplasty. The babies that had earlier palatal repair produced significantly higher percentages of oral stops after 12 months of age than babies with similar clefts that had later palatal repair. No significant differences are evident, however, according to age of palatoplasty, for mean frequency use of oral fricatives up to 3 years of age. For all 23 babies, regardless of the age of palatoplasty intervention, time is an even stronger variable than age of palatoplasty for development of palatal, alveolar and velar place features, oral stops, and oral fricatives.

  16. Unilateral ureteral obstruction secondary to rupture of liver echinococcal cyst.

    PubMed

    Shapira, O M; Simon, D; Rothstein, H; Mor, E; Pfeffermann, R

    1992-12-01

    We report a case of ureteral obstruction by reactive retroperitoneal fibrosis secondary to rupture of a liver echinococcal cyst after minimal blunt flank trauma. The patient presented initially with a cyst-cutaneous fistula and was treated with mebendazole, since surgery was refused. Unilateral ureteral obstruction due to reactive dense retroperitoneal fibrosis developed 2 years later, which presumably was initiated by intense inflammatory reaction to the cyst content. Diagnosis was established by excretory urography, ultrasonography and computerized tomography, and was histologically confirmed. Hydronephrosis and hydroureter resolved following ureterolysis. This complication is anticipated to be encountered more frequently with the use of the new potent anthelmintic agents, which may successfully prevent daughter cyst formation but fail to abolish reactive retroperitonitis.

  17. Overexpanded viscous supersonic jet interacting with a unilateral barrier

    NASA Astrophysics Data System (ADS)

    Dobrynin, B. M.; Maslennikov, V. G.; Sakharov, V. A.; Serova, E. V.

    1986-07-01

    The interaction of a two-dimensional supersonic jet with a unilateral barrier parallel to the flow symmetry plane was studied to account for effects due to gas viscosity and backgound-gas ejection from the region into which the jet expands. In the present experiments, the incident shock wave was reflected at the end of a shock tube equipped with a nozzle. The jet emerged into a pressure chamber 6 cu m in volume and the environmental pressure ratio of the flow in the quasi-stationary phase remained constant. The light source was an OGM-20 laser operating in the giant-pulse mode. Due to background-gas ejection, the gas density in the vicinity of the barrier is much less than on the unconfined side of the jet. The resulting flow is characterized by two distinct environmental pressure ratios: the flow is underexpanded near the barrier, while on the other side it is overexpanded.

  18. Isolated Unilateral Ptosis due to Paramedian Midbrain Infarction.

    PubMed

    Sugawara, Eriko; Nakamura, Haruko; Endo, Masanao; Tanaka, Fumiaki; Takahashi, Tatsuya

    2015-05-01

    A 59-year-old man who had hypertension, dyslipidemia, diabetes mellitus, and left eye glaucoma developed sudden vertigo and left ptosis; he did not notice diplopia. He visited our hospital on day 3 after onset and neurologic examination showed left ptosis. His left visual acuity was counting fingers, and the light reflex was sluggish owing to glaucoma. Pupil sizes were equal, and eye movements and the lower lid were unremarkable. Magnetic resonance images revealed an acute infarction of the left paramedian midbrain. We considered that selective damage to the oculomotor fascicles innervating the left levator palpebrae superioris caused ipsilateral ptosis. As the fascicles for this ocular muscle run in the small area adjacent to those for the medial rectus, inferior rectus and superior rectus muscles, this is an extremely rare case of midbrain infarction presenting with isolated unilateral ptosis.

  19. Thalamic astasia: inability to stand after unilateral thalamic lesions.

    PubMed

    Masdeu, J C; Gorelick, P B

    1988-06-01

    Inability to stand in the absence of motor weakness or marked sensory loss is usually considered to reflect midline cerebellar disease. However, the 15 patients reported here had astasia related to unilateral thalamic lesions, documented by autopsy and computed tomography in 2 patients and by computed tomography in 13. The lesions, including infarction (6), hemorrhage (7), and tumor (2), involved primarily the superoposterolateral portion of the thalamus, but spared the rubral region. Alert, with normal or near-normal strength on isometric muscle testing and a variable degree of sensory loss, the patients could not stand and 7 of them could not sit up unassisted. They fell backwards or toward the side contralateral to the lesion. They appeared to have a deficit of overlearned motor activity of an axial and postural nature. In the vascular cases, the deficit improved in a few days or weeks. However, these patients had a tendency to sustain falls during the rehabilitation period.

  20. [Skull fracture or accessory suture in a child?].

    PubMed

    Burkhard, Katrin; Lange, Lena M; Plenzig, Stefanie; Verhoff, Marcel A; Kölzer, Sarah C

    2016-01-01

    Differentiation between accessory sutures and fractures in the skull of an infant can be difficult. Apart from the regular sutures there is a multitude of variations that may be mistaken for a fracture line. Such variations include for instance the intraparietal suture between the two ossification centers of the parietal bone or the mendosal suture between the supraoccipital and interparietal bone of the occipital squama. The presented case refers to an approximately 20-month-old female child. During autopsy, a discontinuity in the right paramedian posterior cranial fossa parallel to the internal occipital crest with connection to the foramen magnum was observed. The macroscopic findings suggested a fracture line because of its course. However, neither a hemorrhage in the soft tissue nor callus formation was discernible. The discontinuity was preserved with the adjacent parts of the occipital bone for further histological examination. In the report of a cranial CT, which was carried out five days before the child's death, an accessory suture paramedially in the right posterior cranial fossa was described. When the clinical CT records were re-evaluated, a similar discontinuity at the corresponding position on the other side was detected, though of noticeably shorter length. Additionally, the preserved occipital bone fragment including the discontinuity was histologically processed. In the radiological literature, precise (radiological) criteria for differential diagnosis are indicated. A zigzag pattern with sclerotic borders and a bilateral and fairly symmetric occurrence indicate a suture, whereas a sharp lucency with non-sclerotic edges and a unilateral occurrence indicate a fracture. Taking all the findings into account, the depicted discontinuity was regarded as an accessory suture. This case demonstrates that differentiation between a fracture and an accessory suture may be difficult in the autopsy of a child and underlines the importance of a postmortem CT

  1. Complex reinnervation pattern after unilateral renal denervation in rats.

    PubMed

    Rodionova, Kristina; Fiedler, Christian; Guenther, Franziska; Grouzmann, Eric; Neuhuber, Winfried; Fischer, Michael J M; Ott, Christian; Linz, Peter; Freisinger, Wolfgang; Heinlein, Sonja; Schmidt, Stephanie T; Schmieder, Roland E; Amann, Kerstin; Scrogin, Karie; Veelken, Roland; Ditting, Tilmann

    2016-05-01

    Renal denervation (DNX) is a treatment for resistant arterial hypertension. Efferent sympathetic nerves regrow, but reinnervation by renal afferent nerves has only recently been shown in the renal pelvis of rats after unilateral DNX. We examined intrarenal perivascular afferent and sympathetic efferent nerves after unilateral surgical DNX. Tyrosine hydroxylase (TH), CGRP, and smooth muscle actin were identified in kidney sections from 12 Sprague-Dawley rats, to distinguish afferents, efferents, and vasculature. DNX kidneys and nondenervated kidneys were examined 1, 4, and 12 wk after DNX. Tissue levels of CGRP and norepinephrine (NE) were measured with ELISA and mass spectrometry, respectively. DNX decreased TH and CGRP labeling by 90% and 95%, respectively (P < 0.05) within 1 wk. After 12 wk TH and CGRP labeling returned to baseline with a shift toward afferent innervation (P < 0.05). Nondenervated kidneys showed a doubling of both labels within 12 wk (P < 0.05). CGRP content decreased by 72% [3.2 ± 0.3 vs. 0.9 ± 0.2 ng/gkidney; P < 0.05] and NA by 78% [1.1 ± 0.1 vs. 0.2 ± 0.1 pmol/mgkidney; P < 0.05] 1 wk after DNX. After 12 wk, CGRP, but not NE, content in DNX kidneys was fully recovered, with no changes in the nondenervated kidneys. The use of phenol in the DNX procedure did not influence this result. We found morphological reinnervation and transmitter recovery of afferents within 12 wk after DNX. Despite morphological evidence of sympathetic regrowth, NE content did not fully recover. These results suggest a long-term net surplus of afferent influence on the DNX kidney may be contributing to the blood pressure lowering effect of DNX. PMID:26911463

  2. Emotional Perception of Music in Children with Unilateral Cochlear Implants

    PubMed Central

    Shirvani, Sareh; Jafari, Zahra; Sheibanizadeh, Abdolreza; Motasaddi Zarandy, Masoud; Jalaie, Shohre

    2014-01-01

    Introduction: Cochlear implantation (CI) improves language skills among children with hearing loss. However, children with CIs still fall short of fulfilling some other needs, including musical perception. This is often attributed to the biological, technological, and acoustic limitations of CIs. Emotions play a key role in the understanding and enjoyment of music. The present study aimed to investigate the emotional perception of music in children with bilaterally severe-to-profound hearing loss and unilateral CIs. Materials and Methods: Twenty-five children with congenital severe-to-profound hearing loss and unilateral CIs and 30 children with normal hearing participated in the study. The children’s emotional perceptions of music, as defined by Peretz (1998), were measured. Children were instructed to indicate happy or sad feelings fostered in them by the music by pointing to pictures of faces showing these emotions. Results: Children with CI obtained significantly lower scores than children with normal hearing, for both happy and sad items of music as well as in overall test scores (P<0.001). Furthermore, both in CI group (P=0.49) and the control one (P<0.001), the happy items were more often recognized correctly than the sad items. Conclusion: Hearing-impaired children with CIs had poorer emotional perception of music than their normal peers. Due to the importance of music in the development of language, cognitive and social interaction skills, aural rehabilitation programs for children with CIs should focus particularly on music. Furthermore, it is essential to enhance the quality of musical perception by improving the quality of implant prostheses. PMID:25320700

  3. Sudden death from pelvic hemorrhage after bilateral central fracture dislocations of the hip due to an epileptic seizure.

    PubMed

    Hughes, C A; O'Briain, D S

    2000-12-01

    Fracture and dislocation of major joints may be caused by the forceful tonic muscular contractions of seizure activity. A 77-year-old man who was found dead in bed with no sign of external trauma had bilateral central fracture dislocations of the femoral head through the acetabular floor with fatal pelvic hemorrhage and extensive pulmonary fat and bone marrow embolism. He had epilepsy, but the last seizure was 6 years earlier, and he had long discontinued medication. The fractures were attributed to a new unwitnessed seizure. This is the twentieth case of central fracture dislocation of the hip since 1970, when better anesthesia eliminated convulsive therapy-induced fractures. The authors review these 20 cases. Seizures followed inflammation, infarction or neoplasia of the brain, eclampsia, metabolic or iatrogenic causes, or epilepsy (6 cases, 2 of which had no prior seizures for 5 years). There were 11 men (mean age, 64 years) and 9 women (mean age, 47 years). Fractures were unilateral in 13 and bilateral in 7. Additional fractures (in vertebrae, shoulders, or femur) were present in eight. Only eight had prior bone disease. Local symptoms led to diagnosis in most, but two were identified incidentally on imaging. The current patient was the only one to die suddenly, but six other patients presented with shock and three died (one of whom had injuries that led to a suspicion of manslaughter). Central fracture-dislocation of the hip is a rare and little known consequence of seizures, with strong potential for misdiagnosis and lethal complications.

  4. Value of Measuring Bone Microarchitecture in Fracture Discrimination in Older Women with Recent Hip Fracture: A Case-control Study with HR-pQCT

    PubMed Central

    Zhu, Tracy Y.; Hung, Vivian W. Y.; Cheung, Wing-Hoi; Cheng, Jack C. Y.; Qin, Ling; Leung, Kwok-Sui

    2016-01-01

    We aimed to determine whether loss of volumetric bone mineral density (vBMD) and deterioration of microarchitecture imaged by high-resolution peripheral quantitative computed tomography at the distal radius/tibia provided additional information in fracture discrimination in postmenopausal women with recent hip fracture. This case-control study involved 24 postmenopausal Chinese women with unilateral femoral neck fracture (average [SD] age: 79.6[5.6]) and 24 age-matched women without any history of fracture. Each SD decrease in T-score at femoral neck (FN) was associated with a higher fracture risk (odds ratio: 6.905, p = 0.001). At the distal radius, fracture women had significantly lower total vBMD (−17.5%), fewer (−20.3%) and more unevenly spaced (81.4%) trabeculae, and thinner cortices (−14.0%) (all p < 0.05). At the distal tibia, vBMD was on average −4.7% (cortical) to −25.4% (total) lower, trabecular microarchitecture was on average −19.8% (number) to 102% (inhomogeneity) inferior, cortices were thinner (−21.1%) and more porous (18.2%) (all p < 0.05). Adding parameters of vBMD and microarchitecture in multivariate models did not offer additional discriminative capacity of fracture status compared with using T-score at FN. In old postmenopausal women with already excessive loss of bone mass, measuring bone microarchitecture may provide limited added value to improve identification of risk of femoral neck fracture. PMID:27670149

  5. Why are rare traits unilaterally expressed?: trait frequency and unilateral expression for cranial nonmetric traits in humans.

    PubMed

    Hallgrímsson, Benedikt; Donnabháin, Barra O; Blom, Deborah E; Lozada, Maria C; Willmore, Katherine T

    2005-09-01

    Based on an analysis of nonmetric trait databases from several large skeletal series in Northern Europe and South America, representing 27 bilateral traits, we report a predictable relationship between the frequency of nonmetric traits and the probability that they are expressed bilaterally. In a wider sampling of traits and populations, this study thus confirms the findings of an earlier study by Ossenberg ([1981] Am. J. Phys. Anthropol. 54:471-479), which reported the same relationship for two mandibular traits. This trend was previously explained by extending the multifactorial threshold model for discontinuous traits to incorporate either separate thresholds for unilateral or bilateral expression, or by a fuzzy threshold in which the probability of bilateral expression increases away from the median threshold value. We show that the trend is produced under the standard multifactorial threshold model for discontinuous traits simply if the within-individual or developmental instability variance remains relatively constant across the range of liability. Under this assumption, the number of individuals in which one side but not the other is pushed over the threshold for trait formation will be a larger proportion of the number of individuals expressing the trait when the trait frequency is low. As trait frequency increases, the significance of within-individual variance as a determinant of trait formation decreases relative to the genetic and among-individual environmental variance. These results have implications for interpreting nonmetric trait data as well as for understanding the prevalence of unilateral vs. bilateral expression of a wide variety of discontinuous traits, including dysmorphologies in humans.

  6. Comparison of weight changes following unilateral and staged bilateral STN DBS for advanced PD

    PubMed Central

    Lee, Eric M; Kurundkar, Ashish; Cutter, Gary R; Huang, He; Guthrie, Barton L; Watts, Ray L; Walker, Harrison C

    2011-01-01

    Unilateral and bilateral subthalamic nucleus deep brain stimulation (STN DBS) in Parkinson's disease (PD) result in weight gain in the initial postoperative months, but little is known about the changes in weight following unilateral and staged bilateral STN DBS over longer time intervals. A case–control comparison evaluated weight changes over 2 years in 43 consecutive unilateral STN DBS patients, among whom 25 elected to undergo staged bilateral STN DBS, and 21 age-matched and disease severity matched PD controls without DBS. Regression analyses incorporating age, gender, and baseline weight in case or control were conducted to assess weight changes 2 years after the initial unilateral surgery. Unilateral STN DBS and staged bilateral STN DBS patients gained 3.9 ± 2.0 kg and 5.6 ± 2.1 kg versus their preoperative baseline weight (P < 0.001, respectively) while PD controls without DBS lost 0.8 ± 1.1 kg. Although bilateral STN DBS patients gained 1.7 kg more than unilateral STN DBS patients at 2 years, this difference was not statistically significant (P = 0.885). Although there was a trend toward greater weight gain in staged bilateral STN DBS patients versus unilateral patients, we found no evidence for an equivalent or synergistic increase in body weight following placement of the second DBS electrode. PMID:22398977

  7. Micro-computed tomography assessment of the progression of fracture healing in mice.

    PubMed

    O'Neill, Kevin R; Stutz, Christopher M; Mignemi, Nicholas A; Burns, Michael C; Murry, Matthew R; Nyman, Jeffry S; Schoenecker, Jonathan G

    2012-06-01

    The mouse fracture model is ideal for research into the pathways of healing because of the availability of genetic and transgenic mice and the ability to create cell-specific genetic mutations. While biomechanical tests and histology are available to assess callus integrity and tissue differentiation, respectively, micro-computed tomography (μCT) analysis has increasingly been utilized in fracture studies because it is non-destructive and provides descriptions of the structural and compositional properties of the callus. However, the dynamic changes of μCT properties that occur during healing are not well defined. Thus, the purpose of this study was to determine which μCT properties change with the progression of fracture repair and converge to values similar to unfractured bone in the mouse femur fracture model. A unilateral femur fracture was performed in C57BL/6 mice and intramedullary fixation performed. Fractured and un-fractured contralateral specimens were harvested from groups of mice between 2 and 12 weeks post-fracture. Parameters describing callus based on μCT were obtained, including polar moment of inertia (J), bending moment of inertia (I), total volume (TV), tissue mineral density (TMD), total bone volume fraction (BV/TV), and volumetric bone mineral density (vBMD). For comparison, plain radiographs were used to measure the callus diameter (D) and area (A); and biomechanical properties were evaluated using either three-point bending or torsion. The μCT parameters J, I, TV, and TMD converged toward their respective values of the un-fractured femurs over time, although significant differences existed between the two sides at every time point evaluated (p<0.05). Radiograph measurement D changed with repair progression in similar manner to TV. In contrast, BV/TV and BMD increased and decreased over time with statistical differences between callus and un-fractured bone occurring sporadically. Similarly, none of the biomechanical properties were found

  8. Action planning in typically and atypically developing children (unilateral cerebral palsy).

    PubMed

    Crajé, Céline; Aarts, Pauline; Nijhuis-van der Sanden, Maria; Steenbergen, Bert

    2010-01-01

    In the present study, we investigated the development of action planning in children with unilateral Cerebral Palsy (CP, aged 3-6 years, n=24) and an age matched control group. To investigate action planning, participants performed a sequential movement task. They had to grasp an object (a wooden play sword) and place the sword in a hole in a wooden block. Our main dependent variable was the grip type that participants used, i.e., did they adapt their initial grip choice such that they would reach a comfortable posture at the end of the action? This end-state comfort effect has been abundantly shown in research on action planning, and is taken as evidence for anticipatory planning. The first aim of the study was to investigate the development of action planning in the unilateral CP group and the control group. Our hypothesis was that action planning improves with age in the control group, but not in the unilateral CP group. The results showed that planning was impaired in the unilateral CP group compared with the control group. Consistent with our hypothesis, we found an age effect in the control group, but not in the unilateral CP group. In the control group 5 and 6 years olds showed more anticipatory planning compared with the 3 and 4 years olds. The second aim of this study was to examine whether an intervention for children with unilateral CP (i.e., constrained induced movement therapy combined with bimanual training) affected action planning. The children with unilateral CP were therefore measured on the experimental task before and after an 8-week intervention period. The results showed that planning improved after the intervention. This finding suggests that action planning ability in young children with unilateral CP may be sensitive to improvement. These findings are discussed within the context of typical and atypical development of action planning and further guidelines for intervention in children with unilateral CP are given. PMID:20451346

  9. Thrower's fracture of the humerus.

    PubMed

    Miller, Andrew; Dodson, Christopher C; Ilyas, Asif M

    2014-10-01

    Thrower's fractures are spiral fractures of the humerus caused by forceful throwing of a ball. Although these fractures have been cited in the literature, little research exists regarding the significance of stress fractures and fatigue injuries that may precede these injuries. This article presents 3 cases of middle-aged recreational baseball pitchers who sustained mid to distal third spiral humerus fractures, reviews the biomechanics of a thrower's fracture, and provides a detailed review of the literature to help better understand this condition and guide treatment.

  10. Pelvic Insufficiency Fractures

    PubMed Central

    O’Connor, Timothy J.

    2014-01-01

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

  11. Frontal bone fractures.

    PubMed

    Marinheiro, Bruno Henrique; de Medeiros, Eduardo Henrique Pantosso; Sverzut, Cássio Edvard; Trivellato, Alexandre Elias

    2014-11-01

    The aim of this retrospective study was to evaluate the epidemiology, treatment, and complications of frontal bone fractures associated, or not, with other facial fractures. This evaluation also sought to minimize the influence of the surgeon's skills and the preference for any rigid internal fixation system. The files from 3758 patients who attended the Oral and Maxillofacial Surgery Department of the School of Dentistry of Ribeirao Preto, University of Sao Paulo, from March 2004 to November 2011 and presented with facial trauma were scanned, and 52 files were chosen for the review. Eleven (21.15%) of these patients had pure fractures of the frontal bone, and trauma incidence was more prevalent in men (92.3%), whites (61.53%), and adults (50%). Despite the use of helmets at the moment of the trauma, motorcycle crashes were the most common etiological factor (32.69%). Fracture of the anterior wall of the frontal sinus with displacement was the main injury observed (54.9%), and the most common treatment was internal fixation with a plate and screws (45.09%). Postoperative complications were observed in 35.29% of the cases. The therapy applied was effective in handling this type of fracture, and the success rate was comparable to that reported in other published studies. PMID:25377971

  12. Fracture-Flow-Enhanced Solute Diffusion into Fractured Rock

    SciTech Connect

    Wu, Yu-Shu; Ye, Ming; Sudicky, E.A.

    2007-12-15

    We propose a new conceptual model of fracture-flow-enhanced matrix diffusion, which correlates with fracture-flow velocity, i.e., matrix diffusion enhancement induced by rapid fluid flow within fractures. According to the boundary-layer or film theory, fracture flow enhanced matrix diffusion may dominate mass-transfer processes at fracture-matrix interfaces, because rapid flow along fractures results in large velocity and concentration gradients at and near fracture-matrix interfaces, enhancing matrix diffusion at matrix surfaces. In this paper, we present a new formulation of the conceptual model for enhanced fracture-matrix diffusion, and its implementation is discussed using existing analytical solutions and numerical models. In addition, we use the enhanced matrix diffusion concept to analyze laboratory experimental results from nonreactive and reactive tracer breakthrough tests, in an effort to validate the new conceptual model.

  13. Fracture Genesis and Fracture Filling In Hydrate Systems

    NASA Astrophysics Data System (ADS)

    Daigle, H.; Dugan, B.

    2009-12-01

    Steady-state models of coupled flow through fractures and porous media predict that millions of years are required to accumulate the very high hydrate saturation (>50%) necessary to form hydraulic fractures by fluid pressure buildup; however, once a fracture system is formed, it will fill with hydrate in roughly 15 kyr. This modeling is a first step towards understanding heterogeneous, fracture-hosted methane hydrate deposits that have been observed in marine hydrate systems worldwide. In fine-grained sediments, methane hydrate is frequently observed in pores as well as in veins and fractures. One possible explanation is hydrate forms in pores and fluid pressure increases until fractures form. Fluid then flows through the fractures and forms hydrate-filled fractures. To study this, we ran 1-D numerical simulations with a prescribed flow rate of methane-charged fluid through a porous medium. As hydrate forms, pores are occluded and permeability is reduced, causing an increase in fluid pressure to maintain the constant flow rate. We assume that hydraulic fractures form when the fluid pressure reaches 90% of the overburden stress. Simulations of Blake Ridge (offshore South Carolina) indicate that fractures occur after 7.4 million years with a hydrate saturation (Sh) of 95% at the base of the methane hydrate stability zone (MHSZ). Simulations of Keathley Canyon (Gulf of Mexico) achieve the fracture criterion after 7.9 million years with Sh = 54% at the base of the MHSZ. Once fractures are formed they fill with hydrate after 15,000 years. Our results indicate that the time scale of pressure buildup assuming present-day fluxes is very long, and that lower-permeability sediments require lower hydrate saturations to reach the fracture criterion. However, once fractures form, they are filled with hydrate rapidly. This suggests that fractures may provide short-term migration pathways between higher-permeability layers, but also that additional research is needed to constrain

  14. Estimating fracture geometry in the naturally fractured Antrim Shale

    SciTech Connect

    Hopkins, C.W.; Frantz, J.H. Jr.; Hill, D.G.

    1995-12-31

    The Antrim Shale of the Michigan Basin has been an active gas play with over 3,500 wells drilled over the last 5 years. There is substantial evidence that the Antrim must be fracture stimulated to be economical and that two-stage treatments provide the best results. However, due to the shallow depths (500-2300 ft) and naturally fractured nature of the Antrim, fracture geometry is complex, and determination of optimal fracture treatments is not straight forward. Because historical field comparisons did not provide insight on the optimal fracture treatments, the Gas Research Institute (GRI) instituted a field-based project for the specific purpose of evaluating the geometry of hydraulic fractures in the Antrim. Open- and cased-hole tests were performed on two separate Antrim wells - a shallow producer (600 {+-} ft) and a deep producer (1550 {+-} ft). Open-hole testing and data collection consisted of in-situ stress and mechanical property testing with Halliburton`s THE{trademark} Tool (9 tests) and a detailed suite of geophysical logs including dipole sonic logs and natural fracture detection logs. Cased-hole testing consisted of pre- and post-fracture injection/falloff tests, minifracture treatments, multiple isotope tracer and tracer logs, and treating pressure and production data analysis. The shallow depths, low in-situ stresses, and extremely fractured nature of the Antrim probably results in the preferential opening of existing fractures instead of the creation of new fracture planes. As a result, the creation of multiple fractures and severe near wellbore tortuosity is likely. Therefore, the natural fractures are responsible for increased leakoff and will greatly impact created fracture geometry. The results also suggest that creating long propped hydraulic fractures in the Antrim is not likely due to the creation of multiple fractures.

  15. Treatment of Clavicle Fractures

    PubMed Central

    Paladini, P; Pellegrini, A; Merolla, G; Campi, F; Porcellini, G

    2012-01-01

    Summary Clavicle fractures are very common injuries in adults (2–5%) and children (10–15%) (1) and represent the 44–66% of all shoulder fractures (2). Despite the high frequency the choice of proper treatment is still a challenge for the orthopedic surgeon. With this review we wants to focus the attention on the basic epidemiology, anatomy, classification, evaluation and management of surgical treatments in relationship with the gravity of injuries. Both conservative and surgical management are possible, and surgeons must choose the most appropriate management modality according to the biologic age, functional demands, and type of lesion. We performed a review of the English literature thought PubMed to produce an evidence-based review of current concept and management of clavicle fracture. We finished taking a comparison with our survey in order to underline our direct experience. PMID:23905044

  16. Pediatric foot fractures.

    PubMed

    Ribbans, William J; Natarajan, Ramanathan; Alavala, Sairam

    2005-03-01

    Fractures of the foot in children usually have a good prognosis and generally are treated nonoperatively. Displaced fractures of the talus and calcaneus and tarsometatarsal dislocations are rare in children and their outcome is generally good in the younger child. Older adolescents with these injuries need treatment similar to how an adult would be treated for the same injury in order to achieve a good result. Foot fractures in children may pose a diagnostic challenge particularly in the absence of obvious radiographic changes. Repeated clinical examination and judicious use of imaging techniques such as isotope bone scans and magnetic resonance imaging are needed to establish a diagnosis. Knowledge of the anatomy and significance of accessory bones of the foot and disorders of the growing foot skeleton are helpful in managing injuries of child's foot. In this study, we review common injuries of a child's foot and include a discussion on differential diagnosis.

  17. DEM Particle Fracture Model

    SciTech Connect

    Zhang, Boning; Herbold, Eric B.; Homel, Michael A.; Regueiro, Richard A.

    2015-12-01

    An adaptive particle fracture model in poly-ellipsoidal Discrete Element Method is developed. The poly-ellipsoidal particle will break into several sub-poly-ellipsoids by Hoek-Brown fracture criterion based on continuum stress and the maximum tensile stress in contacts. Also Weibull theory is introduced to consider the statistics and size effects on particle strength. Finally, high strain-rate split Hopkinson pressure bar experiment of silica sand is simulated using this newly developed model. Comparisons with experiments show that our particle fracture model can capture the mechanical behavior of this experiment very well, both in stress-strain response and particle size redistribution. The effects of density and packings o the samples are also studied in numerical examples.

  18. Fracture of the cuboid.

    PubMed

    Borrelli, Joseph; De, Sayan; VanPelt, Michael

    2012-07-01

    Cuboid fracture accounts for a minority of all foot fractures in adults and often is indicative of a multiply injured foot. Understanding the normal anatomy and function of the cuboid and its relation to foot biomechanics is necessary for appropriate management. Clinical evaluation includes history, physical examination, and thorough assessment of the skin and soft tissues. Plain radiographs and CT are helpful in preoperative planning. Cuboid fractures may be managed either nonsurgically (splinting or casting) or surgically (closed reduction and external fixation or open reduction and internal fixation). Careful handling of the soft tissues is important, as is restoration of articular congruity, lateral column length, and a stable midfoot. Postoperative care consists of prolonged immobilization followed by 3 months of progressive weight bearing. Published reports of long-term outcomes and functional postoperative assessments are lacking. PMID:22751166

  19. Fracking, fracture, and permeability

    NASA Astrophysics Data System (ADS)

    Turcotte, D. L.; Norris, J.; Rundle, J. B.

    2013-12-01

    Injections of large volumes of water into tight shale reservoirs allows the extraction of oil and gas not previously accessible. This large volume 'super' fracking induces damage that allows the oil and/or gas to flow to an extraction well. The purpose of this paper is to provide a model for understanding super fracking. We assume that water is injected from a small spherical cavity into a homogeneous elastic medium. The high pressure of the injected water generates hoop stresses that reactivate natural fractures in the tight shales. These fractures migrate outward as water is added creating a spherical shell of damaged rock. The porosity associated with these fractures is equal to the water volume injected. We obtain an analytic expression for this volume. We apply our model to a typical tight shale reservoir and show that the predicted water volumes are in good agreement with the volumes used in super fracking.

  20. Semiautomatic fracture zone tracking

    NASA Astrophysics Data System (ADS)

    Wessel, Paul; Matthews, Kara J.; Müller, R. Dietmar; Mazzoni, Aline; Whittaker, Joanne M.; Myhill, Robert; Chandler, Michael T.

    2015-07-01

    Oceanic fracture zone traces are widely used in studies of seafloor morphology and plate kinematics. Satellite altimetry missions have resulted in high-resolution gravity maps in which all major fracture zones and other tectonic fabric can be identified, and numerous scientists have digitized such lineaments. We have initiated a community effort to maintain low-cost infrastructure that allows seafloor fabric lineaments to be stored, accessed, and updated. A key improvement over past efforts is our processing software (released as a GMT5 supplement) that allows for semiautomatic corrections to previously digitized fracture zone traces given improved gridded data sets. Here we report on our seafloor fabric processing tools, which complement our database of seafloor fabric lineations, magnetic anomaly identifications, and plate kinematic models.

  1. Talar neck fractures.

    PubMed

    Berlet, G C; Lee, T H; Massa, E G

    2001-01-01

    Clinical management of talar neck fractures is complex and fraught with complications. As Gaius Julius Caesar stated: "The die is cast"; often the outcome of a talar neck fracture is determined at the time of injury. The authors believe, however, that better results can be achieved by following some simple guidelines. The authors advocate prompt and precise anatomic surgical reduction, preferring the medial approach with secondary anterolateral approach. Preservation of blood supply can be achieved by a thorough understanding of vascular pathways and efforts to stay within appropriate surgical intervals. The authors advocate bone grafting of medial neck comminution (if present) to prevent varus malalignment and rigid internal fixation to allow for joint mobilization postoperatively. These guidelines may seem simple, but when dealing with the complexity of talar neck fractures, the foot and ankle surgeon needs to focus and rely on easily grasped concepts to reduce poor outcomes. PMID:11465133

  2. Clinical experience in treatment of diffuse unilateral subretinal neuroretinitis

    PubMed Central

    Relhan, Nidhi; Pathengay, Avinash; Raval, Vishal; Nayak, Sameera; Choudhury, Himadri; Flynn, Harry W

    2015-01-01

    Purpose To describe the clinical features, management, and outcomes of patients with diffuse unilateral subacute neuroretinitis (DUSN). Methods A noncomparative, consecutive analysis of case series from two tertiary care campuses of LV Prasad Eye Institute, India, between January 2011 and April 2014 was performed. Medical records of the patients presenting with DUSN (early or late stage) were reviewed. Results The current study included 13 patients. The majority (10/13, 76.92%) of the patients were aged 20 years or less. All patients had unilateral eye involvement. Visual acuity at presentation was 20/200 or worse in 9/13 (69.23%) patients. A delay in diagnosis occurred in 6/13 patients, and initial diagnosis in these patients included retinitis pigmentosa (4 patients) and posterior uveitis (2 patients). Clinical features included early presentation (prominent vitritis, localized retinitis, and vasculitis) in 7/13 (53.85%) patients and late presentation (attenuation of vessels, retinal pigment epithelium atrophic changes, and optic atrophy) in 6/13 (46.15%) patients. Worm could not be identified in any of the cases. All the patients received laser photocoagulation of retina and oral albendazole treatment for a period of 30 days. With treatment, visual acuity improved in seven patients (six early stage, one late stage) and remained unchanged in six patients. Mean follow-up period was 8.69 months (range, 1–21 months). The mean central foveal thickness in the affected eye, done by optical coherence tomography, during the late stage of the disease was 188.20±40 µm (range, 111–242 µm), which was significantly thinner than the fellow eye, 238.70±36.90 µm (range, 186–319 µm), P=0.008. Conclusion DUSN is a serious vision threatening disease, which may progress to profound vision loss in the later stage of the disease. Visualization of subretinal worm is usually not possible. Treatment with high-dose albendazole therapy and laser photocoagulation may alter the

  3. Kinematic analysis of locomotion in unilateral vestibular neurectomized cats.

    PubMed

    Lacour, M; Sun, J; Harlay, F

    1997-01-01

    The vestibular syndrome following unilateral lesion of the vestibular system and the subsequent behavioral compensation over time have been well documented in many species. However, the locomotor pattern changes and the behavioral strategies used to preserve balance have still not been described. This study was aimed at quantitatively describing posturolocomotor behavior in cats tested before and after unilateral vestibular neurectomy (UVN) by the rotating beam test, which provides locomotor tasks of various difficulty. The position of head, neck, and trunk and the trajectory of the forelimbs and hindlimbs were recorded in 5 cats by 3D motion analysis. Step length and frequency walking velocity, and body height were computed. Results showed that normal cats adapted their locomotor patterns to the speed of beam rotation by increasing step length and/or frequency, that is, by increasing walking velocity, but without drastically changing their body posture. By contrast, UVN cats typically lowered their body centers of gravity and modified their locomotor patterns according to the locomotor task. Mean walking velocity was decreased in the low range of beam rotation as a result of smaller step length and lower frequency, and it was increased in the high range by opposite effects on these step cycle parameters. Modifications of the locomotor parameters were a function of the direction of beam rotation, showing significant reduction of step length, frequency, and velocity in the low range of counterclockwise compared to clockwise beam rotation, that is, during rotations toward the lesioned side. Phase plane plots of foot linear velocity with respect to foot linear displacement along the horizontal longitudinal axis displayed two different limit cycles, adapted to easy (low range of beam rotation) and more difficult (high range of rotation) walking conditions, in the normal cat. These dynamic profiles of the trajectories of the limbs during the step cycle were not greatly

  4. [Supracondylar fractures in children].

    PubMed

    Petrov, N; Gucev, S; Kirkov, Lj; Dajljevik, S; Ruso, B

    1982-01-01

    In the Department of Pediatric surgery, during the last ten years, 190 patients with supracondylar fractures (second and third degree, according to Bauman's classification) have been treated. The operation was performed in only 5% of all hospitalized cases. There were only one patient with neurological and vascular complications in the early stage, but without any complications in the late stage. The presented cases showed a high percentage of flexion type of fractures. The conservative treatment by a reposition has given the most satisfactory results.

  5. Complications of mandibular fractures.

    PubMed

    Zweig, Barry E

    2009-03-01

    Before any definitive treatment of mandibular fractures, the patient needs to be evaluated for more potentially life-threatening injuries. Complications can and do occur with treatment of mandibular fractures and can occur during any of the phases of treatment. The development of an accurate diagnosis and appropriate treatment plan is vital in achieving optimal success and decreasing complications. Knowledge of the anatomy and the principles of bone healing is also an important factor in preventing complications. To limit long-term untoward effects, complications should be recognized early and the appropriate treatment should be started before a minor complication becomes a complex one that is more difficult to manage.

  6. Fractured Petroleum Reservoirs

    SciTech Connect

    Firoozabadi, Dr. Abbas

    2000-01-18

    In this report the results of experiments of water injection in fractured porous media comprising a number of water-wet matrix blocks are reported for the first time. The blocks experience an advancing fracture-water level (FWL). Immersion-type experiments are performed for comparison; the dominant recovery mechanism changed from co-current to counter-current imbibition when the boundary conditions changed from advancing FWL to immersion-type. Single block experiments of co-current and counter-current imbibition was performed and co-current imbibition leads to more efficient recovery was found.

  7. Pediatric Orbital Fractures

    PubMed Central

    Oppenheimer, Adam J.; Monson, Laura A.; Buchman, Steven R.

    2013-01-01

    It is wise to recall the dictum “children are not small adults” when managing pediatric orbital fractures. In a child, the craniofacial skeleton undergoes significant changes in size, shape, and proportion as it grows into maturity. Accordingly, the craniomaxillofacial surgeon must select an appropriate treatment strategy that considers both the nature of the injury and the child's stage of growth. The following review will discuss the management of pediatric orbital fractures, with an emphasis on clinically oriented anatomy and development. PMID:24436730

  8. Bone fracture repair - series (image)

    MedlinePlus

    The three main treatment options for bone fractures are: Casting Open reduction, and internal fixation- this involves a surgery to repair the fracture-frequently, metal rods, screws or plates are used to repair the ...

  9. Fracture After Total Hip Replacement

    MedlinePlus

    ... er Total Hip Replacement cont. • Dislocation • Limb length inequality • Poor fracture healing • Repeat fracture • Lack of in- ... Surgeons (AAOS). To learn more about your orthopaedic health, please visit orthoinfo.org. Page ( 5 ) AAOS does ...

  10. Distal Radius Fracture (Broken Wrist)

    MedlinePlus

    ... choice depends on many factors, such as the nature of the fracture, your age and activity level, ... causing the cast to loosen. Depending on the nature of the fracture, your doctor may closely monitor ...

  11. 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.

  12. Vertebroplasty for Spine Fracture Pain

    MedlinePlus

    MENU Return to Web version Vertebroplasty for Spine Fracture Pain Vertebroplasty for Spine Fracture Pain More than 40 million people in the United States have osteoporosis (a decrease in the amount ...

  13. Correlation of Hip Fracture with Other Fracture Types: Toward a Rational Composite Hip Fracture Endpoint

    PubMed Central

    Colón-Emeric, Cathleen; Pieper, Carl F.; Grubber, Janet; Van Scoyoc, Lynn; Schnell, Merritt L; Van Houtven, Courtney Harold; Pearson, Megan; Lafleur, Joanne; Lyles, Kenneth W.; Adler, Robert A.

    2016-01-01

    Purpose With ethical requirements to the enrollment of lower risk subjects, osteoporosis trials are underpowered to detect reduction in hip fractures. Different skeletal sites have different levels of fracture risk and response to treatment. We sought to identify fracture sites which cluster with hip fracture at higher than expected frequency; if these sites respond to treatment similarly, then a composite fracture endpoint could provide a better estimate of hip fracture reduction. Methods Cohort study using Veterans Affairs and Medicare administrative data. Male Veterans (n=5,036,536) aged 50-99 years receiving VA primary care between1999-2009 were included. Fractures were ascertained using ICD9 and CPT codes and classified by skeletal site. Pearson correlation coefficients, logistic regression and kappa statistics, were used to describe the correlation between each fracture type and hip fracture within individuals, without regards to the timing of the events. Results 595,579 (11.8%) men suffered 1 or more fractures and 179,597 (3.6%) suffered 2 or more fractures during the time under study. Of those with one or more fractures, rib was the most common site (29%), followed by spine (22%), hip (21%) and femur (20%). The fracture types most highly correlated with hip fracture were pelvic/acetabular (Pearson correlation coefficient 0.25, p<0.0001), femur (0.15, p<0.0001), and shoulder (0.11, p<0.0001). Conclusions Pelvic, acetabular, femur, and shoulder fractures cluster with hip fractures within individuals at greater than expected frequency. If we observe similar treatment risk reductions within that cluster, subsequent trials could consider use of a composite endpoint to better estimate hip fracture risk. PMID:26151123

  14. Osteoporotic Hip and Spine Fractures

    PubMed Central

    Hill, Brian W.

    2014-01-01

    Hip and spine fractures represent just a portion of the burden of osteoporosis; however, these fractures require treatment and often represent a major change in lifestyle for the patient and their family. The orthopedic surgeon plays a crucial role, not only in the treatment of these injuries but also providing guidance in prevention of future osteoporotic fractures. This review provides a brief epidemiology of the fractures, details the surgical techniques, and outlines the current treatment guidelines for orthopedic surgeons. PMID:26246944

  15. Clinical consequences of vertebral fractures.

    PubMed

    Ross, P D

    1997-08-18

    People with vertebral fractures have greater pain, disability, and healthcare utilization, on average, than those without fractures. Most studies of acute pain and disability have been limited to patients with clinically diagnosed fractures (a subset of all symptomatic patients), representing about one third of all patients with fractures identified radiographically. Acute symptoms vary widely. Some patients experience intolerable pain that can be completely debilitating for several weeks or months, whereas about half of all patients with radiographically identified fractures report having had no symptoms. The reasons for this variability are unknown. Chronic pain and disability among patients with vertebral fractures are significantly greater on average than among people without fractures, even after adjusting for comorbid conditions that are common among the elderly. Similar to acute symptoms, chronic symptoms vary widely and often persist for at least several years. The risk of pain and disability increases progressively with the number and severity of vertebral deformities: the risk is multiplied several times with each additional fracture. On average, physical function is impaired among people with vertebral fractures, whether or not they currently report back pain. Declines in physical function and changes in appearance contribute to social isolation and loss of self-esteem, impairing quality of life. The cumulative impact of vertebral fractures on quality of life may rival that of hip fractures because hip fractures are less frequent and occur later in life. As many as 40% of symptomatic vertebral fractures are initially misdiagnosed, signaling a need for greater awareness among physicians and patients. Prevention of initial vertebral fractures should be actively encouraged; even if the initial fracture is asymptomatic, it indicates a greatly increased risk of subsequent fractures, pain, and physical impairment. PMID:9302895

  16. Talar fractures: three case studies.

    PubMed

    Jimenez, A L; Morgan, J H

    2001-09-01

    Three case studies of fractures are presented that demonstrate the potential morbidity that these injuries can cause as well as the acceptable outcomes if treated appropriately. Two of the cases are talar fracture dislocations; the third is an osteochondral fracture of the talus. The importance of early treatment with open reduction and internal fixation is demonstrated. Success following surgical intervention in a nonhealed osteochondral fracture of the talus is also demonstrated.

  17. Numerical Modeling of Fracture Propagation in Naturally Fractured Formations

    NASA Astrophysics Data System (ADS)

    Wang, W.; Prodanovic, M.; Olson, J. E.; Schultz, R.

    2015-12-01

    Hydraulic fracturing consists of injecting fluid at high pressure and high flowrate to the wellbore for the purpose of enhancing production by generating a complex fracture network. Both tensile failure and shear failure occur during the hydraulic fracturing treatment. The shear event can be caused by slip on existing weak planes such as faults or natural fractures. From core observation, partially cemented and fully cemented opening mode natural fractures, often with considerable thickness are widely present. Hydraulic fractures can propagate either within the natural fracture (tensile failure) or along the interface between the natural fracture and the rock matrix (tensile/shear failure), depending on the relative strength of cement and rock matrix materials, the bonding strength of interface, as well as the presence of any heterogeneities. In this study, we evaluate the fracture propagation both experimentally and numerically. We embed one or multiple inclusions of different mechanical properties within synthetic hydrostone samples in order to mimic cemented natural fractures and rock. A semi-circular bending test is performed for each set of properties. A finite element model built with ABAQUS is used to mimic the semi-circular bending test and study the fracture propagation path, as well as the matrix-inclusion bonding interface status. Mechanical properties required for the numerical model are measured experimentally. The results indicate that the match between experiment and modeling fracture path are extremely sensitive to the chosen interface (bonding) model and related parameters. The semi-circular bending test is dry and easily conducted, providing a good platform for validating numerical approaches. A validated numerical model will enable us to add pressurized fluid within the crack and simulate hydraulic fracture-natural fracture interaction in the reservoir conditions, ultimately providing insights into the extent of the fracture network.

  18. Contingent negative variation indicates phasic arousal for externally cued unilateral eye blink in human subjects.

    PubMed

    Strenge, H; Kropp, P; Hoffmeister, J; Verri, A; Galli, C; Gerber, W D

    1999-04-30

    The contingent negative variation (CNV) as a slow cortical potential was used to investigate cortical processing of externally cued, voluntary unilateral eye blink. Probands blinked as a response within a modified two-stimulus reaction time paradigm. Reaction time and amplitudes of CNV were determined. The activity of the orbicularis oculi muscles (OO) was registered by surface electromyography (EMG). Probands who performed unilateral eye blinks with accurately inhibiting contralateral OO activity showed a significantly higher negativity of the early CNV component compared with the bilateral eye blink condition. This effect was confined to the beginning of unilateral blinking performance. It is suggested that the unilateral eye blink is a challenging motor task, initially requiring an increased cortically driven arousal and attention as revealed by increased early CNV components. PMID:10336183

  19. Temporomandibular joint ankylosis caused by condylar fractures: a retrospective analysis of cases at an urban teaching hospital in Nigeria.

    PubMed

    Anyanechi, C E

    2015-08-01

    Mandibular condylar fractures are common presentations to hospitals across the globe and remain the most important cause of temporomandibular joint (TMJ) ankylosis. This study aimed to analyze cases of mandibular condylar fracture complicated by TMJ ankylosis after treatment. A 16-year retrospective analysis was performed at the dental and maxillofacial surgery clinic of the study institution; patient data were collected from the hospital records and entered into a pro-forma questionnaire. It was found that 56/3596 (1.6%) fractures resulted in TMJ ankylosis. The age of patients with ankylosis ranged from 12 to 47 years. The age (P=0.03) and gender (P=0.01) distributions were significant, with most cases of ankylosis occurring in those aged 11-30 years (n=43/56, 76.8%). Fractures complicated by ankylosis were intracapsular (n=22/56, 39.3%) and extracapsular (n=34/56, 60.7%). Ankylosis increased significantly with the increase in time lag between injury and fracture treatment (P=0.001). Ankylosis was associated with concomitant mandibular (85.7%) and middle third (66.1%) fractures. Treatment methods were not significantly related to ankylosis (P=0.32). All cases of ankylosis were unilateral, and complete (n=36, 64.3%) and incomplete ankylosis (n=20, 35.7%) were diagnosed clinically. The incorporation of computed tomography scans and rigid internal fixation in the management of condylar fractures will reduce ankylosis.

  20. Associations of Anisometropia with Unilateral Amblyopia, Interocular Acuity Difference and Stereoacuity in Preschoolers

    PubMed Central

    Ying, Gui-shuang; Huang, Jiayan; Maguire, Maureen; Quinn, Graham; Kulp, Marjean Taylor; Ciner, Elise; Cyert, Lynn; Orel-Bixler, Deborah

    2012-01-01

    Purpose To evaluate the relation of anisometropia with unilateral amblyopia, interocular acuity difference (IAD) and stereoacuity, among Head Start preschoolers, using both clinical notation and vector notation analyses. Design Multicenter, cross-sectional study. Participants 3- to 5-year-old participants in the Vision In Preschoolers (VIP) Study (N=4040). Methods Secondary analysis of VIP data from participants who had comprehensive eye examinations including monocular visual acuity (VA) testing, stereoacuity testing, and cycloplegic refraction. VA was retested with full cycloplegic correction when retest criteria were met. Unilateral amblyopia was defined as IAD ≥2 lines in logarithm of the Minimum Angle of Resolution (logMAR). Anisometropia was defined as ≥0.25 D (diopter) difference in spherical equivalent (SE) or in cylinder power, and also two approaches using power vector notation. The percentage with unilateral amblyopia, mean IAD, and mean stereoacuity were compared between anisometropic and isometropic children. Main Outcomes Measures The percentage with unilateral amblyopia, mean IAD, and mean stereoacuity. Results Compared with isometropic children, anisometropic children had a higher percentage of unilateral amblyopia (8% vs. 2%), larger mean IAD (0.07 vs. 0.05 logMAR) and worse mean stereoacuity (145 vs.117 arc sec) (all p<0.0001). Larger amounts of anisometropia were associated with higher percentages of unilateral amblyopia, larger IAD, and worse stereoacuity (trend p<0.001). Percentage of unilateral amblyopia was significantly increased with spherical equivalent (SE) anisometropia >0.5 D, cylindrical anisometropia >0.25 D, the vertical/horizontal meridian (J0) or oblique meridian (J45) >0.125 D, or vector dioptric distance (VDD) >0.35 D (all p<0.001). VDD had higher ability in detecting unilateral amblyopia than cylinder, SE, J0 and J45 (p<0.001). Conclusions The presence of and amount of anisometropia were associated with the presence of

  1. Isolated Bilateral Mandibular Angle Fractures: An Extensive Literature Review of the Rare Clinical Phenomenon with Presentation of a Classical Clinical Model

    PubMed Central

    Elavenil, P.; Mohanavalli, S.; Sasikala, B.; Prasanna, R. Ashok; Krishnakumar, Raja V. B.

    2014-01-01

    Bilateral angle fractures are a rare clinical phenomenon in contrast to the incidence of unilateral angle fractures. However, the rarity has garnered less attention in spite of the uniqueness of fracture pattern and distinctive biomechanics. This article is a detailed review on the etiology, clinical presentation, and management of bilateral angle fractures with the presentation of an interesting case. The bilateral angle fracture reported is a untreated, malunited fracture representing an ideal clinical model to study its biomechanics. The clinical features were anterior open bite, increased facial height, and temporomandibular joint tenderness. The management included osteotomy at the malunion and miniplate osteosynthesis. Bilateral angle fracture presents mandible in three independent fragments (left angle, right angle, and intermediate corpus), each with strong muscles acting in different vectors. This makes the fracture vulnerable to severe displacing forces and unfavorable to achieve the optimal reduction, stability, and healing. This necessitates comprehension of the biomechanical forces involved to avoid malunion following fixation. The article details the complex biomechanics of mandibular angle and its clinical implications in the rare event of bilateral angle fractures. It describes the necessity for a systematic approach and ideal osteosynthesis principles to achieve maximal treatment outcomes and minimal complications. PMID:26000089

  2. A Novel Two-Step Technique for Retrieving Fractured Peripherally Inserted Central Catheter Segments Migrating into the Heart or the Pulmonary Artery

    PubMed Central

    Peng, Juan; Zhang, Xiao-Ming; Xu, Hao; Miao, Nan-Dong; Ren, Yong-Jun; Liu, Kang; Min, Xu-Li; Yang, Ke; Yang, Shi; Yang, Cheng

    2016-01-01

    Objective. To report the experience of a percutaneous technique for retrieving fractured peripherally inserted central catheter (PICC) segments migrating into the heart or the pulmonary artery. Method. From April 2013 to July 2015, we performed percutaneous retrieval of fractured PICC segments migrating into the heart or the pulmonary artery in five cancer patients who had undergone chemotherapy via PICC. The fractures were diagnosed with chest plain radiography. The patients included three cases of breast cancer, one case of rectal cancer, and one case of lower limb Ewing's tumor. The fractures were retained in the vessels of the patients for 1 to 3 days. All the fractures were retrieved by using a novel two-step technique in the digital subtraction angiography (DSA) suite. This two-step technique involves inserting a pigtail catheter to the heart or the pulmonary artery to grasp the fractured catheter fragment and bring it to the lower segment of the inferior vena cava, followed by grasping and removing the catheter fragment with a retrieval loop system of the vena cava filter retrieval set. Result. The fractured PICC segments were removed successfully in all five patients via unilateral (four patients) or bilateral (one patient) femoral vein access. No complications occurred during the interventional procedure. Conclusion. Percutaneous retrieval can be a safe, convenient, and minimally invasive method for the removal of fractured PICC segments. The technique reported in this paper will be applicable for the retrieval of fractured PICC segments and other catheter fragments migrating into the heart or the pulmonary artery.

  3. Management of osteoporotic vertebral fractures

    PubMed Central

    Dionyssiotis, Yannis

    2010-01-01

    Osteoporotic vertebral fractures are associated with considerable reduction of quality of life, morbidity, and mortality. The management of patients with vertebral fractures should include treatment for osteoporosis and measures to reduce pain and improve mobility. This article provides information for management and rehabilitation of vertebral fractures based on clinical experience and literature. PMID:20689689

  4. Hearing and music in unilateral spatial neglect neuro-rehabilitation

    PubMed Central

    Guilbert, Alma; Sylvain Clément; Moroni, Christine

    2014-01-01

    Unilateral spatial neglect (USN) is an attention deficit in the contralesional side of space which occurs after a cerebral stroke, mainly located in the right hemisphere. USN patients are disabled in all daily activities. USN is an important negative prognostic factor of functional recovery and of socio-professional reinsertion. Thus, patient rehabilitation is a major challenge. As this deficit has been described in many sensory modalities (including hearing), many sensory and poly-sensory rehabilitation methods have been proposed to USN patients. They are mainly based on visual, tactile modalities and on motor abilities. However, these methods appear to be quite task-specific and difficult to transfer to functional activities. Very few studies have focused on the hearing modality and even fewer studies have been conducted in music as a way of improving spatial attention. Therefore, more research on such retraining needs is neccessary in order to make reliable conclusions on its efficiency in long-term rehabilitation. Nevertheless, some evidence suggests that music could be a promising tool to enhance spatial attention and to rehabilitate USN patients. In fact, music is a material closely linked to space, involving common anatomical and functional networks. The present paper aims firstly at briefly reviewing the different procedures of sensory retraining proposed in USN, including auditory retraining, and their limits. Secondly, it aims to present the recent scientific evidence that makes music a good candidate for USN patients’ neuro-rehabilitation. PMID:25566165

  5. Hearing and music in unilateral spatial neglect neuro-rehabilitation.

    PubMed

    Guilbert, Alma; Sylvain Clément; Moroni, Christine

    2014-01-01

    Unilateral spatial neglect (USN) is an attention deficit in the contralesional side of space which occurs after a cerebral stroke, mainly located in the right hemisphere. USN patients are disabled in all daily activities. USN is an important negative prognostic factor of functional recovery and of socio-professional reinsertion. Thus, patient rehabilitation is a major challenge. As this deficit has been described in many sensory modalities (including hearing), many sensory and poly-sensory rehabilitation methods have been proposed to USN patients. They are mainly based on visual, tactile modalities and on motor abilities. However, these methods appear to be quite task-specific and difficult to transfer to functional activities. Very few studies have focused on the hearing modality and even fewer studies have been conducted in music as a way of improving spatial attention. Therefore, more research on such retraining needs is neccessary in order to make reliable conclusions on its efficiency in long-term rehabilitation. Nevertheless, some evidence suggests that music could be a promising tool to enhance spatial attention and to rehabilitate USN patients. In fact, music is a material closely linked to space, involving common anatomical and functional networks. The present paper aims firstly at briefly reviewing the different procedures of sensory retraining proposed in USN, including auditory retraining, and their limits. Secondly, it aims to present the recent scientific evidence that makes music a good candidate for USN patients' neuro-rehabilitation. PMID:25566165

  6. Hearing and music in unilateral spatial neglect neuro-rehabilitation.

    PubMed

    Guilbert, Alma; Sylvain Clément; Moroni, Christine

    2014-01-01

    Unilateral spatial neglect (USN) is an attention deficit in the contralesional side of space which occurs after a cerebral stroke, mainly located in the right hemisphere. USN patients are disabled in all daily activities. USN is an important negative prognostic factor of functional recovery and of socio-professional reinsertion. Thus, patient rehabilitation is a major challenge. As this deficit has been described in many sensory modalities (including hearing), many sensory and poly-sensory rehabilitation methods have been proposed to USN patients. They are mainly based on visual, tactile modalities and on motor abilities. However, these methods appear to be quite task-specific and difficult to transfer to functional activities. Very few studies have focused on the hearing modality and even fewer studies have been conducted in music as a way of improving spatial attention. Therefore, more research on such retraining needs is neccessary in order to make reliable conclusions on its efficiency in long-term rehabilitation. Nevertheless, some evidence suggests that music could be a promising tool to enhance spatial attention and to rehabilitate USN patients. In fact, music is a material closely linked to space, involving common anatomical and functional networks. The present paper aims firstly at briefly reviewing the different procedures of sensory retraining proposed in USN, including auditory retraining, and their limits. Secondly, it aims to present the recent scientific evidence that makes music a good candidate for USN patients' neuro-rehabilitation.

  7. Unilateral germinomas involving the basal ganglia and thalamus.

    PubMed

    Kobayashi, T; Kageyama, N; Kida, Y; Yoshida, J; Shibuya, N; Okamura, K

    1981-07-01

    Clinical characteristics of six cases of germinoma involving a unilateral basal ganglion and thalamus are summarized. The incidence was estimated as 10% of all intracranial germinomas. The average age at the onset was 10.5 years. The sex incidence showed a male dominance. The clinical course was slowly progressive, and the average duration between onset and diagnosis was 2 years 5 months. Common symptoms and signs were hemiparesis in all cases, fever of unknown origin and eye symptoms in most, mental deterioration and psychiatric signs in three, and convulsions, pubertas praecox, and diabetes insipidus in two. Signs of increased intracranial pressure were found in only two cases in the later state of the disease. Early diagnosis is difficult because of nonspecific symptomatology and slow progression. Carotid angiography and pneumoencephalography showed abnormal findings compatible with basal ganglia and thalamic tumors, but not specific to germinoma. Ipsilateral cortical atrophy and ventricular dilatation might be significant findings. Radioisotope scanning was useful. Computerized tomography scans were the best method of detecting the location and nature of this tumor, and repeat scans showed response to radiation therapy. PMID:7241216

  8. Effects of unilateral selective hypergravity stimulation on gait

    NASA Astrophysics Data System (ADS)

    Lazerges, M.; Bessou, P.

    The purpose of this work is to analyse the neural mechanisms of human motor perturbations induced by dynamic changes in gravity. A unilateral selective hypergravity stimulation (USHS) was produced by stretching an elastic band between the right shoulder and foot. The consequences of the extensor muscle tone change due to the positioning (increased muscular loading) and to its removal (decreased muscular loading) by the elastic band were observed on motor gait skill. Gait spatio-temporal parameters (horizontal displacement of both feet) and lower limb functional length variations (efficiency of flexion and extension movements of the lower limbs) were measured. The latter measure was performed using a device specially designed for that purpose. The main results were: (1) during and after USHS, gait perturbations appeared on the left—the body side not directly stimulated, (2) just after the end of USHS, perturbations were present on the right (homolateral) side evidencing a post treatment effect which caused a decrease in functional shortening of the lower limb during extension and an increase of functional shortening of the lower limb during stance (opposite in sense to the modification observed during swing). Such results afford evidence that, in addition to vestibular receptors, the mechanoreceptors of extensor muscles are involved in determining the changes in motor skills observed at the beginning and at the end of space flights.

  9. Unilateral lower limb suspension: From subject selection to "omic" responses.

    PubMed

    Tesch, Per A; Lundberg, Tommy R; Fernandez-Gonzalo, Rodrigo

    2016-05-15

    The unilateral lower limb suspension (ULLS) method was developed, introduced, and validated in the quest for a simple, effective, and highly reliable human analog to study the consequences of spaceflight on muscle size and function. Because withdrawal of weight bearing for no more than 2-3 days is sufficient to inflict disturbances in protein metabolism of postural muscles, it is imperative ULLS serves as a very powerful method to manifest skeletal muscle adaptations similar to those experienced in 0 g. Thus the rate of global muscle loss appears rather constant over the first 2 mo, amounting to about 2-3% per week. At the microscopic level, these changes are accompanied by a corresponding decrease in individual muscle fiber size. ULLS alters metabolism favoring more carbohydrate over fat substrate utilization. Altogether, these changes result in impaired work and endurance capacity of muscles being subjected to ULLS. Maximal voluntary force decreases out of proportion to the muscle loss, suggesting motor control is modified. Past reviews offer near exhaustive information on ULLS-induced responses with regard to the above changes. Hence, the current brief review describes more broadly the evolution of the ULLS model, from issues of subject recruitment and compliance control, to recent advances unraveling molecular mechanisms facilitating unloading-induced muscle wasting. Such knowledge is critical in designing future studies aimed at exploring and developing exercise countermeasures or other means to combat the debilitating effects on muscle experienced by astronauts during long-haul missions in Orbit. PMID:26846557

  10. Gait recovery pattern of unilateral lower limb amputees during rehabilitation.

    PubMed

    Baker, P A; Hewison, S R

    1990-08-01

    The aim of this study was to determine the rate at which gait recovery as measured by temporal distance factors (velocity and symmetry) occurs in unilateral lower limb amputees. A microcomputer foot switch system was used to record the gait patterns of twenty subjects, mean age 65.1 years. The initial measurement was taken when the subject was capable of walking 6 metres with an interim prosthesis within the parallel bars. The patient sample as a whole was analyzed and subjects were further divided into four groups, depending on ambulatory aid required at discharge. Group A, n = 3 used no aid, Group B, n = 5 used a single stick, Group C, n = 6 used 2 single sticks and Group D, n = 5 required frames. A one way analysis of variance (F = 4.55, p = 0.02) showed a significant difference between the Groups, (A and D, B and D, C and D). The major velocity increase occurs within the first 30 days of the gait training programme. Overall about 55% increase in velocity can be expected within the first fifteen day period followed by an additional 30% between days 15-30. A moderately strong correlation (r = 0.78) was found between initial and discharge velocity. The correlation between initial and discharge symmetry was weaker (r = 0.50). PMID:2235305

  11. Unilateral, recurrent exudative retinal detachment in association with pansinusitis

    PubMed Central

    Osman Saatci, Ali; Ozbek Soylemezoglu, Zeynep; Barut Selver, Ozlem; Cenk Ecevit, M.; Ada, Emel

    2012-01-01

    Aim: To report a patient with unilateral exudative retinal detachment due to pansinusitis. Methods: Case report. Results: A 65-year-old woman with a two-month history of blurred vision, red eye and lid swelling in her left eye was referred to us. Her best-corrected visual acuity was 20/20 in the right eye and 20/200 in the left. Conjunctival vessels were engorged in the OS. Funduscopy revealed a 360° exudative detachment in OS and computerized tomography (CT) imaging revealed pansinusitis. Systemic antibiotic treatment was employed and exudative detachment regressed. However, exudative detachment remitted as soon as antibiotic treatment ceased. Finally she underwent sinus surgery and decompression of the orbita. Her visual acuity improved to 20/100 just two days after the surgery, stabilized at 20/30 and no further recurrences occured during the follow-up of 10 months. Conclusion: Since exudative retinal detachment usually accompanies systemic inflammatory or neoplastic diseases, systemic screening and collaboration with other disciplines are mandatory. To the best of our knowledge, this is the first report of a case that developed exudative retinal detachment due to pansinusitis and only recovered after decompression surgery.

  12. Unilateral Condylar Hyperplasia: A 3-Dimensional Quantification of Asymmetry

    PubMed Central

    Maal, Thomas J. J.; Bergé, Stefaan J.; Becking, Alfred G.

    2013-01-01

    Purpose Objective quantifications of facial asymmetry in patients with Unilateral Condylar Hyperplasia (UCH) have not yet been described in literature. The aim of this study was to objectively quantify soft-tissue asymmetry in patients with UCH and to compare the findings with a control group using a new method. Material and Methods Thirty 3D photographs of patients diagnosed with UCH were compared with 30 3D photographs of healthy controls. As UCH presents particularly in the mandible, a new method was used to isolate the lower part of the face to evaluate asymmetry of this part separately. The new method was validated by two observers using 3D photographs of five patients and five controls. Results A significant difference (0.79 mm) between patients and controls whole face asymmetry was found. Intra- and inter-observer differences of 0.011 mm (−0.034–0.011) and 0.017 mm (−0.007–0.042) respectively were found. These differences are irrelevant in clinical practice. Conclusion After objective quantification, a significant difference was identified in soft-tissue asymmetry between patients with UCH and controls. The method used to isolate mandibular asymmetry was found to be valid and a suitable tool to evaluate facial asymmetry. PMID:23544063

  13. Unilateral oculomotor nerve palsy: unusual sign of hydrocephalus.

    PubMed

    Cultrera, F; D'Andrea, M; Battaglia, R; Chieregato, A

    2009-06-01

    We report an unusual case of hydrocephalus in which unilateral oculomotor nerve paralysis was the predominant sign. Misinterpretation of such an atypical clinical sign may lead to inappropriate therapy. We outline the role of intracranial pressure monitoring as an adjunctive diagnostic tool and we suggest a presumptive mechanism to explain the correlation between enlarged ventricles and 3(rd) nerve dysfunction. A 16-year-old boy presented with a complete left oculomotor nerve palsy associated with imaging findings of dilated ventricles and Dandy-Walker variant cystic malformation. Monitoring of intracranial pressure through a ventricular catheter was undertaken. In the first phase (no cerebrospinal fluid drainage [CSF] drainage) mean intracranial pressure (ICP) values were >0 mmHg. A second phase (with progressively longer CSF draining) further defined the diagnosis. A ventriculo-peritoneal shunt was then placed and the nerve function returned to normal within few days. Third cranial nerve dysfunction as a predominant sign of hydrocephalus is very rare and may raise doubts as to the real significance of the imaging findings of enlarged ventricles. In this ground, ICP monitoring is a safe and helpful diagnostic tool that can afford a more accurate evaluation and proper treatment. The supposed mechanism of 3(rd) nerve dysfunction was bending/stretching of the nerve. PMID:19546847

  14. Gray-matter atrophy after chronic complete unilateral vestibular deafferentation.

    PubMed

    Hüfner, Katharina; Stephan, Thomas; Hamilton, Derek A; Kalla, Roger; Glasauer, Stefan; Strupp, Michael; Brandt, Thomas

    2009-05-01

    It has been shown in blind patients that the abolition of sensory input can lead to changes in white- and cortical gray-matter volumes. Here the white- and gray-matter changes found with whole brain voxel-based morphometry in 16 patients with complete chronic unilateral vestibular deafferentation (UVD) due to vestibular schwannoma removal several years prior are reported on. Subtle deficits in spatial memory and navigation were previously shown in patients with right UVD. Images of the brains of right-UVD patients were flipped, standard preprocessing steps were performed, and the data were modulated. Patients showed a gray-matter volume reduction in the cerebellum due to schwannoma removal, in the supramarginal gyrus ipsilateral to the lesion, as well as in the postcentral and superior temporal gyrus, areas involved in the vestibular cortical network, and in the motion-sensitive area MT/V5. There was no correlation with behavioral navigational abilities. No gray-matter atrophy was found in the insular cortical vestibular region or the hippocampus, both of which receive bilateral vestibular projections. The thalamus and tegmentum of the mesencephalon showed gray-matter reduction on the opposite side; this was possibly due to reduced auditory input, which is known to cross at this level. In comparison to healthy controls, no regional increases in gray-matter volume were seen. No white-matter changes were detected at the selected threshold.

  15. Primate translational vestibuloocular reflexes. IV. Changes after unilateral labyrinthectomy

    NASA Technical Reports Server (NTRS)

    Angelaki, D. E.; Newlands, S. D.; Dickman, J. D.

    2000-01-01

    The effects of unilateral labyrinthectomy on the properties of the translational vestibuloocular reflexes (trVORs) were investigated in rhesus monkeys trained to fixate near targets. Translational motion stimuli consisted of either steady-state lateral and fore-aft sinusoidal oscillations or short-lasting transient displacements. During small-amplitude, steady-state sinusoidal lateral oscillations, a small decrease in the horizontal trVOR sensitivity and its dependence on viewing distance was observed during the first week after labyrinthectomy. These deficits gradually recovered over time. In addition, the vertical response component increased, causing a tilt of the eye velocity vector toward the lesioned side. During large, transient lateral displacements, the deficits were larger and longer lasting. Responses after labyrinthectomy were asymmetric, with eye velocity during movements toward the side of the lesion being more compromised. The most profound effect of the lesions was observed during fore-aft motion. Whereas responses were kinematically appropriate for fixation away from the side of the lesion (e.g., to the left after right labyrinthectomy), horizontal responses were anticompensatory during fixation at targets located ipsilateral to the side of the lesion (e.g., for targets to the right after right labyrinthectomy). This deficit showed little recovery during the 3-mo post-labyrinthectomy testing period. These results suggest that inputs from both labyrinths are important for the proper function of the trVORs, although the details of how bilateral signals are processed and integrated remain unknown.

  16. Motor Response Deficits of Unilateral Neglect: Assessment, Therapy, and Neuroanatomy.

    PubMed

    Saevarsson, Styrmir

    2013-04-16

    The clinical impact of the motor deficits of unilateral neglect is indisputable. The diagnosis criteria are confusing and complicated, and assessment has been extended and modified gradually during the last few decades, which has led to inconsistency and confusion. Many different attempts have been made to overcome various assessment shortcomings. In this article, different examinations of previous studies and analyses are discussed in a systematic and critical way. Research databases were used to identify 254 reports, including 26 different empirical studies on motor neglect and 44 studies on premotor neglect. Most of the studies address the gross neuroanatomical location of lesions. The main findings indicate that frontal lesions are more common in motor neglect than in premotor neglect, and parietal lesions are more common in premotor neglect than in motor neglect. Few studies have evaluated therapeutic programs for the motor deficits of neglect. Unfortunately, most studies suffer from various diagnostic problems that result in inconsistent and controversial findings. Different assessment issues need to be addressed systematically in future studies in light of current findings to increase our understanding and awareness of these important neuropsychological motor deficits. Implications of and possible solutions to the current assessment shortcomings are discussed.

  17. Alterations in gray matter volume due to unilateral hearing loss

    PubMed Central

    Wang, Xingchao; Xu, Pengfei; Li, Peng; Wang, Zhenmin; Zhao, Fu; Gao, Zhixian; Xu, Lei; Luo, Yue-jia; Fan, Jin; Liu, Pinan

    2016-01-01

    Although extensive research on neural plasticity resulting from hearing deprivation has been conducted, the direct influence of compromised audition on the auditory cortex and the potential impact of long durations of incomplete sensory stimulation on the adult cortex are still not fully understood. In this study, using voxel-based morphometry, we evaluated gray matter (GM) volume changes that may be associated with reduced hearing ability and the duration of hearing impairment in 42 unilateral hearing loss (UHL) patients with acoustic neuromas compared to 24 normal controls. We found significant GM volume increases in the somatosensory and motor systems and GM volume decreases in the auditory (i.e., Heschl’s gyrus) and visual systems (i.e., the calcarine cortex) in UHL patients. The GM volume decreases in the primary auditory cortex (i.e., superior temporal gyrus and Heschl’s gyrus) correlated with reduced hearing ability. Meanwhile, the GM volume decreases in structures involving high-level cognitive control functions (i.e., dorsolateral prefrontal cortex and anterior cingulate cortex) correlated positively with hearing loss duration. Our findings demonstrated that the severity and duration of UHL may contribute to the dissociated morphology of auditory and high-level neural structures, providing insight into the brain’s plasticity related to chronic, persistent partial sensory loss. PMID:27174521

  18. [Unilateral idiopathic gingival fibromatosis--a case report].

    PubMed

    Łazarz-Bartyzel, Katarzyna; Gawron, Katarzyna; Darczuk, Dagmara; Chomyszyn-Gajewska, Maria

    2016-01-01

    Gingival fibromatosis is a painless gingival overgrowth. It may result in difficulties with proper dental hygiene keeping, mastication and occlusion. Herein, a case of a 10-year-old patient was described. The patient reported to the Department of Periodontology and Oral Medicine of the Jagiellonian University Medical College in Krakow due to the problems with permanent teeth eruption (23-26), chewing and dental hygiene maintaining. Based on medical history, clinical examination, diagnostic tests and histopathological study of gingival tissue biopsies the patient was diagnosed with unilateral idiopathic gingival fibromatosis. After oral cavity hygienization, patient un- derwent dental surgery procedures by gingivectomy and gingivoplasty. The follow-up examination 2 and 6 months post operation showed un- eventful healing, proper tooth eruption, improved oral hygiene and chewing function. Twelve months post surgery no recurrence was noted. Due to the etiological diversity of gingival lesions occurring as an overgrowth, accurate medical history, clinical examination, laboratory tests and histopathological study are needed. Accurate diagnos- tics is crucial mainly to exclude he- matological and oncological diseases. Gingivectomy being the "gold method" of gingival fibromatosis treatment was effective and sufficient to cure the case presented in this article. PMID:27526431

  19. Changes in contralateral protein metabolism following unilateral sciatic nerve section

    SciTech Connect

    Menendez, J.A.; Cubas, S.C.

    1990-03-01

    Changes in nerve biochemistry, anatomy, and function following injuries to the contralateral nerve have been repeatedly reported, though their significance is unknown. The most likely mechanisms for their development are either substances carried by axoplasmic flow or electrically transmitted signals. This study analyzes which mechanism underlies the development of a contralateral change in protein metabolism. The incorporation of labelled amino acids (AA) into proteins of both sciatic nerves was assessed by liquid scintillation after an unilateral section. AA were offered locally for 30 min to the distal stump of the sectioned nerves and at homologous levels of the intact contralateral nerves. At various times, from 1 to 24 h, both sciatic nerves were removed and the proteins extracted with trichloroacetic acid (TCA). An increase in incorporation was found in both nerves 14-24 h after section. No difference existed between sectioned and intact nerves, which is consistent with the contralateral effect. Lidocaine, but not colchicine, when applied previously to the nerves midway between the sectioning site and the spinal cord, inhibited the contralateral increase in AA incorporation. It is concluded that electrical signals, crossing through the spinal cord, are responsible for the development of the contralateral effect. Both the nature of the proteins and the significance of the contralateral effect are matters for speculation.

  20. Rehabilitation and neuroplasticity in children with unilateral cerebral palsy.

    PubMed

    Reid, Lee B; Rose, Stephen E; Boyd, Roslyn N

    2015-07-01

    Cerebral palsy is a childhood-onset, lifelong neurological disorder that primarily impairs motor function. Unilateral cerebral palsy (UCP), which impairs use of one hand and perturbs bimanual co-ordination, is the most common form of the condition. The main contemporary upper limb rehabilitation strategies for UCP are constraint-induced movement therapy and bimanual intensive therapy. In this Review, we outline the factors that are crucial to the success of motor rehabilitation in children with UCP, including the dose of training, the relevance of training to daily life, the suitability of training to the age and goals of the child, and the ability of the child to maintain close attention to the tasks. Emerging evidence suggests that the first 2 years of life are a critical period during which interventions for UCP could be more effective than in later life. Abnormal brain organization in UCP, and the effects of development on rehabilitation, must also be understood to develop new effective interventions. Therefore, we also consider neuroimaging methods that can provide insight into the neurobiology of UCP and how the condition responds to existing therapies. We discuss how these methods could shape future rehabilitative strategies based on the neurobiology of UCP and the therapy-induced changes seen in the brain. PMID:26077839

  1. Comparison of effects of the bisphosphonate alendronate versus the RANKL inhibitor denosumab on murine fracture healing.

    PubMed

    Gerstenfeld, Louis C; Sacks, Daniel J; Pelis, Megan; Mason, Zachary D; Graves, Dana T; Barrero, Mauricio; Ominsky, Michael S; Kostenuik, Paul J; Morgan, Elise F; Einhorn, Thomas A

    2009-02-01

    The role of osteoclast-mediated resorption during fracture healing was assessed. The impact of two osteoclast inhibitors with different mechanisms of action, alendronate (ALN) and denosumab (DMAB), were examined during fracture healing. Male human RANKL knock-in mice that express a chimeric (human/murine) form of RANKL received unilateral transverse femur fractures. Mice were treated biweekly with ALN 0.1 mg/kg, DMAB 10 mg/kg, or PBS (control) 0.1 ml until death at 21 and 42 days after fracture. Treatment efficacy assessed by serum levels of TRACP 5b showed almost a complete elimination of TRACP 5b levels in the DMAB-treated animals but only approximately 25% reduction of serum levels in the ALN-treated mice. Mechanical testing showed that fractured femurs from both ALN and DMAB groups had significantly increased mechanical properties at day 42 compared with controls. muCT analysis showed that callus tissues from DMAB-treated mice had significantly greater percent bone volume and BMD than did both control and ALN-treated tissues at both 21 and 42 days, whereas ALN-treated bones only had greater percent bone volume and BMC than control at 42 days. Qualitative histological analysis showed that the 21-and 42-day ALN and DMAB groups had greater amounts of unresorbed cartilage or mineralized cartilage matrix compared with the controls, whereas unresorbed cartilage could still be seen in the DMAB groups at 42 days after fracture. Although ALN and DMAB delayed the removal of cartilage and the remodeling of the fracture callus, this did not diminish the mechanical integrity of the healing fractures in mice receiving these treatments. In contrast, strength and stiffness were enhanced in these treatment groups compared with control bones.

  2. Endoscopic repair of unilateral choanal atresia with the KTP laser: a one stage procedure.

    PubMed

    Tzifa, K T; Skinner, D W

    2001-04-01

    This paper, describes the endoscopic repair of unilateral choanal atresia with the KTP laser, a one-stage procedure, with no requirement for stenting. Three patients are presented with unilateral choanal atresia, aged six, nine and 38-years-old. The procedure combines the excellent endoscopic visualization, with the good haemostatic and penetrating properties of the KTP laser. Follow up was between 12 months and four years with all choanae remaining patent, no dilatation was required. No surgical complications were noted.

  3. Unilateral condylar hyperplasia combined with synovial chondromatosis of the temporomandibular joint. Report of a case.

    PubMed

    de Bont, L G; Blankestijn, J; Panders, A K; Vermey, A

    1985-02-01

    A case of unilateral condylar hyperplasia combined with synovial chondromatosis of the temporomandibular joint (TMJ) is presented. Clinical and radiographic findings were consistent with an active unilateral hyperplasia. A high condylectomy was performed. During the operation numerous cartilaginous particles discharged from the TMJ and so it became clear that the patient was also suffering from chondromatosis. Both conditions were confirmed by histological examination. PMID:3856622

  4. Orthodontic management of a borderline case with ectopic maxillary canine by unilateral premolar extractions

    PubMed Central

    Gaur, Aditi; Maheshwari, Sandhya; Verma, Sanjeev Kumar; Mohd. Tariq

    2016-01-01

    Management of orthodontic cases often requires extraction of permanent teeth. The decision making regarding extractions depends upon the arch length tooth material discrepancies, the growth pattern, general profile, and arch asymmetries. Unique orthodontic problems may command special treatment lines to be taken. The present report describes a case with unilateral buccally blocked out canine and bilateral posterior crossbite, for which unilateral premolar extractions were performed achieve esthetic and functionally stable occlusion. PMID:27041913

  5. Assessment of head tilt in young children with unilateral posterior crossbite by video recording.

    PubMed

    Bevilaqua-Grossi, Débora; Chaves, Thaís Cristina; Lovato, Margarete; de Oliveira, Anamaria Siriani; Regalo, Simone Cecílio Hallak

    2008-01-01

    14 children with unilateral posterior crossbites (PCB) participated in this study and 14 children with Angle's class I occlusion. Body posture analysis was made by a video recording technique. The results showed greater tilt in the angles of head tilt in PCB children when compared to neutral occlusion children. We also observed that head tilt followed the side of crossbite. Such results suggest that unilateral PCB could be related to the development of head tilt on the same side of the crossbite.

  6. Fragility fractures of the pelvis: should they be fixed?

    PubMed

    Rommens, P M; Dietz, S-O; Ossendorf, C; Pairon, P; Wagner, D; Hofmann, A

    2015-01-01

    Due to the aging population, there is an increasing number of fragility fractures of the pelvis (FFP). They are the result of low energy trauma. The bone breaks but the ligaments remain intact. Immobilizing pain at the pubic region or at the sacrum is the main symptom. Conventional radiographs reveal pubic rami fractures, but lesions of the dorsal pelvis are hardly visible and easily overlooked. CT of the pelvis with multiplanar reconstructions show the real extension of the lesion. Most patients have a history of osteoporosis or other fragility fractures. The new classification distinguishes between four categories of different and increasing instability. FFP Type I are anterior lesions only, FFP Type II are non-displaced posterior lesions, FFP Type III are displaced unilateral posterior lesions and FFP Type IV are displaced bilateral posterior lesions. Subgroups discriminate between the localization of the dorsal instability. FFP Type I lesions are treated non-operatively. FFP Type II lesions are fixed in a percutaneous procedure when a trial of conservative treatment was not successful. FFP Type III lesions are treated with open reduction and internal fixation (ORIF). FFP Type IV lesions are treated with bilateral ORIF or with a bridging osteosynthesis. Iliosacral screw osteosynthesis is widely used, but has an elevated risk of screw loosening due to diminished bine mineral density. Transsacral bar osteosynthesis enable interfragmentary compression and does not have this danger of loosening. Bridging plate osteosynthesis is used as an additional fixation to iliosacral screw osteosynthesis. Lumbopelvic fixation is restricted to highly unstable lumbopelvic dissociations. More studies are needed to find the optimal treatment for each type of instability. Key words: pelvis, fragility fracture, diagnosis, classification, treatment.

  7. Injection through fractures

    SciTech Connect

    Johns, R.A.

    1987-05-01

    Tracer tests are conducted in geothermal reservoirs as an aid in forecasting thermal breakthrough of reinjection water. To interpret tracer tests, mathematical models have been developed based on the various transport mechanisms in these highly fractured reservoirs. These tracer flow models have been applied to interpret field tests. The resulting matches between the model and field data were excellent and the model parameters were used to estimate reservoir properties. However, model fitting is an indirect process and the model's ability to estimate reservoir properties cannot be judged solely on the quality of the match between field data and model predictions. The model's accuracy in determining reservoir characteristics must be independently verified in a closely controlled environment. In this study, the closely controlled laboratory environment was chosen to test the validity and accuracy of tracer flow models developed specifically for flow in fractured rocks. The laboratory tracer tests were performed by flowing potassium iodide (KI) through artificially fractured core samples. The tracer test results were then analyzed with several models to determine which best fit the measured data. A Matrix Diffusion model was found to provide the best match of the tracer experiments. The core properties, as estimated by the Matrix Diffusion model parameters generated from the indirect matching process, were then determined. These calculated core parameters were compared to the measured core properties and were found to be in agreement. This verifies the use of the Matrix Diffusion flow model in estimating fracture widths from tracer tests.

  8. Hip fracture surgery

    MedlinePlus

    ... thigh bone. The thigh bone is called the femur. It is part of the hip joint. Hip pain is a related topic. ... to 4 hours. If you have an intertrochanteric fracture (the area below the femur neck), your surgeon will use a special metal ...

  9. Femur fracture repair - discharge

    MedlinePlus

    ... surgery, your surgeon will make a cut to open your fracture. Your surgeon will then use special metal devices to hold your bones in place while they heal. These devices are called ... is open reduction and internal fixation (ORIF). In the most ...

  10. Fracture design modelling

    SciTech Connect

    Crichlow, H.B.; Crichlow, H.B.

    1980-02-07

    A design tool is discussed whereby the various components that enter the design process of a hydraulic fracturing job are combined to provide a realistic appraisal of a stimulation job in the field. An interactive computer model is used to solve the problem numerically to obtain the effects of various parameters on the overall behavior of the system.

  11. Infiltration into Fractured Bedrock

    SciTech Connect

    Salve, Rohit; Ghezzehei, Teamrat A.; Jones, Robert

    2007-09-01

    One potential consequence of global climate change and rapid changes in land use is an increased risk of flooding. Proper understanding of floodwater infiltration thus becomes a crucial component of our preparedness to meet the environmental challenges of projected climate change. In this paper, we present the results of a long-term infiltration experiment performed on fractured ash flow tuff. Water was released from a 3 x 4 m{sup 2} infiltration plot (divided into 12 square subplots) with a head of {approx}0.04 m, over a period of {approx}800 days. This experiment revealed peculiar infiltration patterns not amenable to current infiltration models, which were originally developed for infiltration into soils over a short duration. In particular, we observed that in part of the infiltration plot, the infiltration rate abruptly increased a few weeks into the infiltration tests. We suggest that these anomalies result from increases in fracture permeability during infiltration, which may be caused by swelling of clay fillings and/or erosion of infill debris. Interaction of the infiltration water with subsurface natural cavities (lithophysal cavities) could also contribute to such anomalies. This paper provides a conceptual model that partly describes the observed infiltration patterns in fractured rock and highlights some of the pitfalls associated with direct extension of soil infiltration models to fractured rock over a long period.

  12. Statistical Physics of Fracture

    SciTech Connect

    Alava, Mikko; Nukala, Phani K; Zapperi, Stefano

    2006-05-01

    Disorder and long-range interactions are two of the key components that make material failure an interesting playfield for the application of statistical mechanics. The cornerstone in this respect has been lattice models of the fracture in which a network of elastic beams, bonds, or electrical fuses with random failure thresholds are subject to an increasing external load. These models describe on a qualitative level the failure processes of real, brittle, or quasi-brittle materials. This has been particularly important in solving the classical engineering problems of material strength: the size dependence of maximum stress and its sample-to-sample statistical fluctuations. At the same time, lattice models pose many new fundamental questions in statistical physics, such as the relation between fracture and phase transitions. Experimental results point out to the existence of an intriguing crackling noise in the acoustic emission and of self-affine fractals in the crack surface morphology. Recent advances in computer power have enabled considerable progress in the understanding of such models. Among these partly still controversial issues, are the scaling and size-effects in material strength and accumulated damage, the statistics of avalanches or bursts of microfailures, and the morphology of the crack surface. Here we present an overview of the results obtained with lattice models for fracture, highlighting the relations with statistical physics theories and more conventional fracture mechanics approaches.

  13. Bipartite patella fracture.

    PubMed

    Canizares, George H; Selesnick, F Harlan

    2003-02-01

    Bipartite patella fracture is an uncommon injury that has rarely been described in the literature. It can be quite debilitating in the competitive athlete and is often overlooked by the treating physician. A bone scan can be helpful in confirming the diagnosis, and appropriate treatment often results in a successful outcome.

  14. Dorsal radiocarpal fracture dislocation.

    PubMed

    Tanzer, T L; Horne, J G

    1980-11-01

    A case of a rare radiocarpal fracture dislocation in a 17-year-old girl, with persisting loss of radiocarpal joint space following reduction under hematoma block, is described. The wrist joint was exposed, and two osteochondral fragments were rotated 90 degrees and secured with 2.7-mm AO screws. Satisfactory healing followed 3 months postinjury.

  15. Fractures in Tharsis Tholus

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site]

    In the upper left corner of this VIS image are a series of fractures. Where the fractures are exposed on the surface it is impossible to tell the plane of the fracture; however where the fractures are visible in the cliff wall it is possible to see that the fractures dip to the north. This image shows part of the caldera of Tharsis Tholus.

    Image information: VIS instrument. Latitude 13.5, Longitude 268.9 East (91.1 West). 19 meter/pixel resolution.

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

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

  16. Entablature: fracture types and mechanisms

    NASA Astrophysics Data System (ADS)

    Forbes, A. E. S.; Blake, S.; Tuffen, H.

    2014-05-01

    Entablature is the term used to describe zones or tiers of irregular jointing in basaltic lava flows. It is thought to form when water from rivers dammed by the lava inundates the lava flow surface, and during lava-meltwater interaction in subglacial settings. A number of different fracture types are described in entablature outcrops from the Búrfell lava and older lava flows in Þjórsárdalur, southwest Iceland. These are: striae-bearing, column-bounding fractures and pseudopillow fracture systems that themselves consist of two different fracture types—master fractures with dimpled surface textures and subsidiary fractures with curved striae. The interaction of pseudopillow fracture systems and columnar jointing in the entablature produces the chevron fracture patterns that are commonly observed in entablature. Cube-jointing is a more densely fractured version of entablature, which likely forms when more coolant enters the hot lava. The entablature tiers display closely spaced striae and dendritic crystal shapes which indicate rapid cooling. Master fracture surfaces show a thin band with an evolved composition at the fracture surface; mineral textures in this band also show evidence of quenching of this material. This is interpreted as gas-driven filter pressing of late-stage residual melt that is drawn into an area of low pressure immediately preceding or during master fracture formation by ductile extensional fracture of hot, partially crystallised lava. This melt is then quenched by an influx of water and/or steam when the master fracture fully opens. Our findings suggest that master fractures are the main conduit for coolant entering the lava flow during entablature formation.

  17. Chondrocyte BMP2 signaling plays an essential role in bone fracture healing

    PubMed Central

    Mi, Meng; Jin, Hongting; Wang, Baoli; Yukata, Kiminori; Sheu, Tzong-jen; Ke, Qiao Han; Tong, Peijian; Im, Hee-Jeong; Xiao, Guozhi; Chen, Di

    2012-01-01

    The specific role of endogenous Bmp2 gene in chondrocytes and in osteoblasts in fracture healing was investigated by generation and analysis of chondrocyte- and osteoblast-specific Bmp2 conditional knockout (cKO) mice. The unilateral open transverse tibial fractures were created in these Bmp2 cKO mice. Bone fracture callus samples were collected and analyzed by X-ray, micro-CT, histology analyses, biomechanical testing and gene expression assays. The results demonstrated that the lack of Bmp2 expression in chondrocytes leads to a prolonged cartilage callus formation and a delayed osteogenesis initiation and progression into mineralization phase with lower biomechanical properties. In contrast, when the Bmp2 gene was deleted in osteoblasts, the mice showed no significant difference in the fracture healing process compared to control mice. These findings suggest that endogenous BMP2 expression in chondrocytes may play an essential role in cartilage callus maturation at an early stage of fracture healing. Our studies may provide important information for clinical application of BMP2. PMID:23107765

  18. [Pathogenesis of atypical femoral fracture].

    PubMed

    Iwata, Ken; Mashiba, Tasuku

    2016-01-01

    We demonstrated microdamage accumulation in the fracture sites in the patients of subtrochanteric atypical femoral fracture with long term bisphosphonate therapy and of incomplete shaft fracture of lateral femoral bowing without bisphosphonate therapy. Based on these findings, pathogenesis of atypical femoral fracture is revealed stress fracture caused by accumulation of microdamages between distal to the lesser trochanter and proximal to the supracondylar flare in the femur in association with severely suppressed bone turnover and/or abnormal lower limb alignment, that causes stress concentration on the lateral side cortex of the femur. PMID:26728533

  19. Tibial Stress Fractures in Athletes.

    PubMed

    Feldman, John J; Bowman, Eric N; Phillips, Barry B; Weinlein, John C

    2016-10-01

    Tibial stress fractures are common in the athlete. There are various causes of these fractures, the most common being a sudden increase in training intensity. Most of these injuries are treated conservatively; however, some may require operative intervention. Intervention is mostly dictated by location of the fracture and failure of conservative treatment. There are several surgical options available to the treating surgeon, each with advantages and disadvantages. The physician must understand the nature of the fracture and the likelihood for it to heal in a timely manner in order to best treat these fractures in this patient subset. PMID:27637660

  20. Biomechanical Concepts for Fracture Fixation.

    PubMed

    Bottlang, Michael; Schemitsch, Christine E; Nauth, Aaron; Routt, Milton; Egol, Kenneth A; Cook, Gillian E; Schemitsch, Emil H

    2015-12-01

    Application of the correct fixation construct is critical for fracture healing and long-term stability; however, it is a complex issue with numerous significant factors. This review describes a number of common fracture types and evaluates their currently available fracture fixation constructs. In the setting of complex elbow instability, stable fixation or radial head replacement with an appropriately sized implant in conjunction with ligamentous repair is required to restore stability. For unstable sacral fractures with vertical or multiplanar instabilities, "standard" iliosacral screw fixation is not sufficient. Periprosthetic femur fractures, in particular Vancouver B1 fractures, have increased stability when using 90/90 fixation versus a single locking plate. Far cortical locking combines the concept of dynamization with locked plating to achieve superior healing of a distal femur fracture. Finally, there is no ideal construct for syndesmotic fracture stabilization; however, these fractures should be fixed using a device that allows for sufficient motion in the syndesmosis. In general, orthopaedic surgeons should select a fracture fixation construct that restores stability and promotes healing at the fracture site, while reducing the potential for fixation failure.

  1. Linear elastic fracture mechanics primer

    NASA Technical Reports Server (NTRS)

    Wilson, Christopher D.

    1992-01-01

    This primer is intended to remove the blackbox perception of fracture mechanics computer software by structural engineers. The fundamental concepts of linear elastic fracture mechanics are presented with emphasis on the practical application of fracture mechanics to real problems. Numerous rules of thumb are provided. Recommended texts for additional reading, and a discussion of the significance of fracture mechanics in structural design are given. Griffith's criterion for crack extension, Irwin's elastic stress field near the crack tip, and the influence of small-scale plasticity are discussed. Common stress intensities factor solutions and methods for determining them are included. Fracture toughness and subcritical crack growth are discussed. The application of fracture mechanics to damage tolerance and fracture control is discussed. Several example problems and a practice set of problems are given.

  2. Hydraulic fracture propagation modeling and data-based fracture identification

    NASA Astrophysics Data System (ADS)

    Zhou, Jing

    Successful shale gas and tight oil production is enabled by the engineering innovation of horizontal drilling and hydraulic fracturing. Hydraulically induced fractures will most likely deviate from the bi-wing planar pattern and generate complex fracture networks due to mechanical interactions and reservoir heterogeneity, both of which render the conventional fracture simulators insufficient to characterize the fractured reservoir. Moreover, in reservoirs with ultra-low permeability, the natural fractures are widely distributed, which will result in hydraulic fractures branching and merging at the interface and consequently lead to the creation of more complex fracture networks. Thus, developing a reliable hydraulic fracturing simulator, including both mechanical interaction and fluid flow, is critical in maximizing hydrocarbon recovery and optimizing fracture/well design and completion strategy in multistage horizontal wells. A novel fully coupled reservoir flow and geomechanics model based on the dual-lattice system is developed to simulate multiple nonplanar fractures' propagation in both homogeneous and heterogeneous reservoirs with or without pre-existing natural fractures. Initiation, growth, and coalescence of the microcracks will lead to the generation of macroscopic fractures, which is explicitly mimicked by failure and removal of bonds between particles from the discrete element network. This physics-based modeling approach leads to realistic fracture patterns without using the empirical rock failure and fracture propagation criteria required in conventional continuum methods. Based on this model, a sensitivity study is performed to investigate the effects of perforation spacing, in-situ stress anisotropy, rock properties (Young's modulus, Poisson's ratio, and compressive strength), fluid properties, and natural fracture properties on hydraulic fracture propagation. In addition, since reservoirs are buried thousands of feet below the surface, the

  3. Outcome of humeral shaft fractures treated by functional cast brace

    PubMed Central

    Pal, Jitendra Nath; Biswas, Prahas; Roy, Avik; Hazra, Sunit; Mahato, Somnath

    2015-01-01

    Background: Functional brace application for isolated humeral shaft fracture persistently yields good results. Nonunion though uncommon involves usually the proximal third shaft fractures. Instead of polyethylene bivalve functional brace four plaster sleeves wrapped and molded with little more proximal extension expected to prevent nonunion of proximal third fractures. Periodic compressibility of the cast is likely to yield a better result. This can be applied on the 1st day of the presentation as an outpatient basis. Comprehensive objective scoring system befitting for fracture humeral shaft is a need. Materials and Methods: Sixty six (male = 40, female = 26) unilateral humeral shaft fractures of mean age 34.4 years (range 11–75 years) involving 38 left and 28 right hands were included in this study during April 2008 to December 2012. Fractures involved proximal (n = 18), mid (n = 35) and distal (n = 13) of humerus. Transverse, oblique, comminuted and spiral orientations in 18, 35 and 13 patients respectively. One had segmental fracture and three had a pathological fracture with cystic bone lesion. Mechanisms of injuries as identified in this study were road traffic accidents 57.6% (n = 38), fall 37.9% (n = 25). 12.1% (n = 8) had radial nerve palsy 7.6% (n = 5) had Type I open fracture. Four plaster strips of 12 layers and 5–7.5 cm broad depending on the girth of arm were prepared. Arm was then wrapped with single layer compressed cotton. Lateral and medial strips were applied and then after molding anterior and posterior strips were applied in such a way that permits full elbow range of motion and partial abduction of the shoulder. Care was taken to prevent adherence of one strip with other except in the proximal end. Limb was then put in loose collar and cuff sling intermittently allowing active motion of the elbow ROM and pendular movement of the shoulder. Weekly tightening of the cast by fresh layers of bandage over the existing cast brace continued

  4. Fracture mechanics validity limits

    NASA Technical Reports Server (NTRS)

    Lambert, Dennis M.; Ernst, Hugo A.

    1994-01-01

    Fracture behavior is characteristics of a dramatic loss of strength compared to elastic deformation behavior. Fracture parameters have been developed and exhibit a range within which each is valid for predicting growth. Each is limited by the assumptions made in its development: all are defined within a specific context. For example, the stress intensity parameters, K, and the crack driving force, G, are derived using an assumption of linear elasticity. To use K or G, the zone of plasticity must be small as compared to the physical dimensions of the object being loaded. This insures an elastic response, and in this context, K and G will work well. Rice's J-integral has been used beyond the limits imposed on K and G. J requires an assumption of nonlinear elasticity, which is not characteristic of real material behavior, but is thought to be a reasonable approximation if unloading is kept to a minimum. As well, the constraint cannot change dramatically (typically, the crack extension is limited to ten-percent of the initial remaining ligament length). Rice, et al investigated the properties required of J-type parameters, J(sub x), and showed that the time rate, dJ(sub x)/dt, must not be a function of the crack extension rate, da/dt. Ernst devised the modified-J parameter, J(sub M), that meets this criterion. J(sub M) correlates fracture data to much higher crack growth than does J. Ultimately, a limit of the validity of J(sub M) is anticipated, and this has been estimated to be at a crack extension of about 40-percent of the initial remaining ligament length. None of the various parameters can be expected to describe fracture in an environment of gross plasticity, in which case the process is better described by deformation parameters, e.g., stress and strain. In the current study, various schemes to identify the onset of the plasticity-dominated behavior, i.e., the end of fracture mechanics validity, are presented. Each validity limit parameter is developed in

  5. Comparison of ventilation and voice outcomes between unilateral laryngeal pacing and unilateral cordotomy for the treatment of bilateral vocal fold paralysis

    PubMed Central

    Li, Yike; Pearce, Elizabeth C.; Mainthia, Rajshri; Athavale, Sanjay M.; Dang, Jennifer; Ashmead, Daniel H; Garrett, C. Gaelyn; Rousseau, Bernard; Billante, Cheryl R.; Zealear, David L.

    2013-01-01

    Background/Aims Rehabilitation of the bilaterally paralyzed human larynx remains a complex clinical problem. Conventional treatment generally involves surgical enlargement of the compromised airway, but often with resultant dysphonia and risk of aspiration. In this retrospective study, we compared one such treatment, posterior cordotomy, against unilateral laryngeal pacing: reanimation of vocal fold opening by functional electrical stimulation of the posterior cricoarytenoid muscle. Methods Post-operative peak inspiratory flow (PIF) values and overall voice grade ratings were compared between the two surgical groups, and pre and post-operative PIF were compared within the pacing group. Results There were five patients in the unilateral pacing group and 12 patients in the unilateral cordotomy group. Within the pacing group, post-operative PIF values were significantly improved from pre-operative PIF values (p=0.04) without significant effect on voice (grade) (p=0.62). Within the pacing group, the mean post-operative PIF value was significantly higher than that in the cordotomy group (p=0.05). Also, the mean post-operative overall voice grade values in the pacing group were significantly lower (better) than that of cordotomy group (p=0.03). Conclusion Unilateral pacing appears to be an effective and superior treatment to posterior cordotomy with respect to post-operative ventilation and voice outcome measures. PMID:23736349

  6. Glucocorticoids improve acute dizziness symptoms following acute unilateral vestibulopathy.

    PubMed

    Batuecas-Caletrío, Angel; Yañez-Gonzalez, Raquel; Sanchez-Blanco, Carmen; Pérez, Pedro Blanco; González-Sanchez, Enrique; Sanchez, Luis Alberto Guardado; Kaski, Diego

    2015-11-01

    Acute unilateral vestibulopathy (AUV) is characterized by acute vertigo, nausea, and imbalance without neurological deficits or auditory symptomatology. Here, we explore the effect of glucocorticoid treatment on the degree of canal paresis in patients with AUV, and critically, establish its relationship with dizziness symptom recovery. We recruited consecutive patients who were retrospectively assigned to one of the two groups according to whether they received glucocorticoid treatment (n = 32) or not (n = 44). All patients underwent pure-tone audiometry, bithermal caloric testing, MRI brain imaging, and were asked to complete a dizziness handicap inventory on admission to hospital and just prior to hospital discharge. In the treatment group, the canal paresis at discharge was significantly lower than in the control group (mean ± SD % 38.04 ± 21.57 versus 82.79 ± 21.51, p < 0.001). We also observed a significant reduction in the intensity of nystagmus in patients receiving glucocorticoid treatment compared to the non-treatment group (p = 0.03). DHI test score was significantly lower at discharge in the treatment group (mean ± SD % 23.15 ± 12.40 versus 64.07 ± 12.87, p < 0.001), as was the length of hospital stay (2.18 ± 1.5 days versus 3.6 ± 1.7 days, p = 0.002). Glucocorticoid treatment leads to acute symptomatic improvement, with a reduced hospital stay and reduction in the intensity of acute nystagmus. Our findings suggest that glucocorticoids may accelerate vestibular compensation via a restoration of peripheral vestibular function, and therefore has important clinical implications for the treatment of AUV. PMID:26459091

  7. The Unilateral, Self-Deregulation of AT&T

    NASA Astrophysics Data System (ADS)

    Maloff, Joel H.

    1990-01-01

    The provision of telecommunications products and services in the United States has been dominated by AT&T and the Bell System for more than one hundred years. From the early days of telephones, it was clear that some framework of logic was required to provide "universal" telephone services to the vast majority of American citizens. The concept was known as "natural monopoly", and for the most part, has served us well. We are all aware of statements concerning absolute power corrupting absolutely, and AT&T has not been immune to this law of human nature. Several times during the past century, action has been required by the Federal Government to regulate and constrain AT&T and the Bell System from anti-competitive and predatory actions. These have been called consent decrees, Computer Inquiry II, Computer Inquiry III, and the Modified Final Judgment. The regulations and constraints imposed upon AT&T, with good reason, are now becoming eroded. The perception of a more highly competitive marketplace capable of accommodating an unrestrained AT&T, the impact of uncoordinated national and regional government policies, and unilateral actions by AT&T themselves are bringing us to the edge of an abyss. There are substantial reasons to believe that AT&T will use its considerable might to eliminate its competitors, once free to do so. Must we be doomed to repeat history with still another antitrust case against AT&T some years from now? Logic demands that we learn from the past, and that telecommunications policies be based upon that knowledge.

  8. Unilateral microfibrillar abnormalities in a case of asymmetric Marfan syndrome.

    PubMed Central

    Godfrey, M; Olson, S; Burgio, R G; Martini, A; Valli, M; Cetta, G; Hori, H; Hollister, D W

    1990-01-01

    The Marfan syndrome is a dominantly inherited connective-tissue disorder characterized by ocular, cardiovascular, and musculoskeletal abnormalities. Although the underlying biochemical and molecular defect(s) of this pleiotropic disease is currently unknown, we have consistently observed apparent diminished content of elastin-associated microfibrillar fibers accumulating in skin, or produced by cultured fibroblasts, from patients with the Marfan syndrome and have documented the cosegregation of these immunofluorescent abnormalities of microfibrillar fibers with the Marfan syndrome phenotype in family studies. Recently, an unusual patient has been described with unilateral phenotypic features of the Marfan syndrome, providing an unique opportunity to compare microfibrillar fibers and other connective-tissue components between the affected and nonaffected sides. In the present report, we demonstrate striking differences in apparent content of microfibrillar fibers, as determined by indirect immunofluorescence of skin and fibroblast cultures, that are revealed when multiple homologous samples derived from different sides of the patient's body are compared. In contrast, no differences in apparent content of type III collagen or in the biosynthesis and apparent structure of types I and III (pro)collagens were found. HLA types and chromosome heteromorphisms were identical in fibroblasts from both sides of the body, eliminating the formal possibility of chimerism and suggesting that a postzygotic mutation accounts for the asymmetric manifestation of the Marfan syndrome in this patient. The observation of striking decreases in microfibrillar fibers on the affected side of the body provides further evidence that abnormalities of this component of the elastic fiber system may be central to the pathogenesis and possibly the etiology of the Marfan syndrome. Images Figure 5 Figure 4 Figure 1 Figure 2 Figure 3 Figure 6 PMID:2180285

  9. Characteristics of the perception for unilateral facial nerve palsy.

    PubMed

    Mun, Sue Jean; Park, Kyung Tae; Kim, Yoonjoong; Park, Joo Hyun; Kim, Young Ho

    2015-11-01

    Patients with facial nerve palsy (FNP) are actually evaluated by other people rather than doctors or the patients themselves. This study was performed to investigate the characteristics of the perception of unilateral FNP in Korean people. A questionnaire using photographs of four patients with four different grades (House-Brackmann) of FNP was given to two hundred people with no FNP. Subjects of each gender, ranging from 20 to 69 years of age, participated. The questionnaire, showing facial expressions of resting, smiling, whistling, eye closing, and frowning, consisted of questions concerning the identification and the involved side of FNP, the unnatural areas of the face, and the unnaturalness of the facial expressions. The overall identification rate of FNP was 75.0%. The identification rate increased according to the increase in the grade of the patient's FNP (p < .001). The overall detection rate of the involved side was 54.5%, and that rate decreased with increasing subject age (p < .001). The area of the most unnatural facial expression was reported to be the mouth, followed by the eyes and cheeks. The most unnatural facial expression was also reported to be smiling, followed by eye closing and whistling. There was no difference in the identification rate of FNP according to education level. However, the overall detection rate of the involved side was higher in the high-education group (p < .001). The detection rate for the involved side of FNP was lower than the rate of identification of FNP and was significantly low in the middle-aged/elderly and low-education level groups.

  10. Visuomotor adaptation is impaired in patients with unilateral neglect.

    PubMed

    Aimola, Lina; Rogers, Gillian; Kerkhoff, Georg; Smith, Daniel T; Schenk, Thomas

    2012-05-01

    Patients with unilateral neglect tend to ignore sensory information from their contralesional hemispace. Many symptoms of neglect can be reduced by exposing patients to rightward-shifting prism goggles. It was noted that the effects on neglect symptoms last for at least two hours. This seems surprising in light of the fact that the after-effect of prism adaptation in healthy subjects lasts only for a few trials. To account for this discrepancy Michel et al. (2003) referred to anecdotal observations which suggested that neglect patients show little awareness of prism-induced spatial errors. They argued that this lack of awareness might interfere with more conscious attempts to compensate for the prism goggles (called strategic control) and thereby enhance the effects of more implicit corrective mechanisms (called spatial realignment) leading to more pronounced and longer-lasting after-effects. We examined this hypothesis in a group of neglect patients, patients with right-hemispheric lesions but no neglect and a group of healthy age-matched controls. Our findings confirm that strategic control mechanisms are impaired in neglect patients. However, their after-effects seem neither reduced nor pathologically increased, thereby suggesting that the two mechanisms of prism adaptation, namely strategic control and spatial realignment are quite independent of each other. Furthermore we found that these deficits are quite specific for neglect since other patients with right-hemisphere lesions but no neglect are not impaired in this task. We discuss the implications of our findings for our understanding of visual neglect, prism adaptation and the perception and action model. PMID:21964198

  11. Bilateral cerebellar activation in unilaterally challenged essential tremor

    PubMed Central

    Broersma, Marja; van der Stouwe, Anna M.M.; Buijink, Arthur W.G.; de Jong, Bauke M.; Groot, Paul F.C.; Speelman, Johannes D.; Tijssen, Marina A.J.; van Rootselaar, Anne-Fleur; Maurits, Natasha M.

    2015-01-01

    Background Essential tremor (ET) is one of the most common hyperkinetic movement disorders. Previous research into the pathophysiology of ET suggested underlying cerebellar abnormalities. Objective In this study, we added electromyography as an index of tremor intensity to functional Magnetic Resonance Imaging (EMG-fMRI) to study a group of ET patients selected according to strict criteria to achieve maximal homogeneity. With this approach we expected to improve upon the localization of the bilateral cerebellar abnormalities found in earlier fMRI studies. Methods We included 21 propranolol sensitive patients, who were not using other tremor medication, with a definite diagnosis of ET defined by the Tremor Investigation Group. Simultaneous EMG-fMRI recordings were performed while patients were off tremor medication. Patients performed unilateral right hand and arm extension, inducing tremor, alternated with relaxation (rest). Twenty-one healthy, age- and sex-matched participants mimicked tremor during right arm extension. EMG power variability at the individual tremor frequency as a measure of tremor intensity variability was used as a regressor, mathematically independent of the block regressor, in the general linear model used for fMRI analysis, to find specific tremor-related activations. Results Block-related activations were found in the classical upper-limb motor network, both for ET patients and healthy participants in motor, premotor and supplementary motor areas. In ET patients, we found tremor-related activations bilaterally in the cerebellum: in left lobules V, VI, VIIb and IX and in right lobules V, VI, VIIIa and b, and in the brainstem. In healthy controls we found simulated tremor-related activations in right cerebellar lobule V. Conclusions Our results expand on previous findings of bilateral cerebellar involvement in ET. We have identified specific areas in the bilateral somatomotor regions of the cerebellum: lobules V, VI and VIII. PMID:26909321

  12. Aggravated Cardiac Remodeling post Aortocaval Fistula in Unilateral Nephrectomized Rats

    PubMed Central

    Gu, Ye; Zou, Wusong; Zhang, Mingjing; Zhu, Pengfei; Hu, Shao

    2015-01-01

    Background Aortocaval fistula (AV) in rat is a unique model of volume-overload congestive heart failure and cardiac hypertrophy. Living donor kidney transplantation is regarded as beneficial to allograft recipients and not particularly detrimental to the donors. Impact of AV on animals with mild renal dysfunction is not fully understood. In this study, we explored the effects of AV in unilateral nephrectomized (UNX) rats. Methods Adult male Sprague-Dawley (SD) rats were divided into Sham (n = 10), UNX (right kidney remove, n = 10), AV (AV established between the levels of renal arteries and iliac bifurcation, n = 18) and UNX+AV (AV at one week after UNX, n = 22), respectively. Renal outcome was measured by glomerular filtration rate, effective renal plasma flow, fractional excretion of sodium, albuminuria, plasma creatinine, and cystatin C. Focal glomerulosclerosis (FGS) incidence was evaluated by renal histology. Cardiac function was measured by echocardiography and hemodynamic measurements. Results UNX alone induced compensatory left kidney enlargement, increased plasma creatinine and cystatin C levels, and slightly reduced glomerular filtration rate and increased FGS. AV induced significant cardiac enlargement and hypertrophy and reduced cardiac function and increased FGS, these changes were aggravated in UNX+AV rats. Conclusions Although UNX only induces minor renal dysfunction, additional chronic volume overload placement during the adaptation phase of the remaining kidney is associated with aggravated cardiac dysfunction and remodeling in UNX rats, suggesting special medical care is required for UNX or congenital monokidney subjects in case of chronic volume overload as in the case of pregnancy and hyperthyroidism to prevent further adverse cardiorenal events in these individuals. PMID:26252578

  13. Traumatic Testicular Dislocation Associated with Lateral Compression Pelvic Ring Injury and T-Shaped Acetabulum Fracture

    PubMed Central

    Wang, Mike; Yeon-Kim, Chang; Tomaszewski, Paul; Leslie, Michael P.

    2016-01-01

    We report a case of a unilateral testicular dislocation to the superficial inguinal region associated with a lateral compression type pelvic ring injury (OTA classification 61-C3.3a2, b2, c3) and left T-shaped acetabulum fracture (OTA classification 62-B2) in a 44-year-old male who was in a motorcycle accident. The testicular dislocation was noted during the emergency department primary survey, and its location and viability were verified with ultrasound. The testicle was isolated during surgical stabilization of the left acetabulum through a Pfannenstiel incision and modified-Stoppa approach and returned through the inguinal canal to the scrotum. In follow-up, the patient did not suffer urologic or sexual dysfunction. All motorcycle collision patients presenting with pelvic ring injuries or acetabulum fractures should be worked up for possible testicular dislocation with a scrotal exam. Advanced imaging and a urologic consult may be necessary to detect and treat these injuries.

  14. Vertebral fracture classification

    NASA Astrophysics Data System (ADS)

    de Bruijne, Marleen; Pettersen, Paola C.; Tankó, László B.; Nielsen, Mads

    2007-03-01

    A novel method for classification and quantification of vertebral fractures from X-ray images is presented. Using pairwise conditional shape models trained on a set of healthy spines, the most likely unfractured shape is estimated for each of the vertebrae in the image. The difference between the true shape and the reconstructed normal shape is an indicator for the shape abnormality. A statistical classification scheme with the two shapes as features is applied to detect, classify, and grade various types of deformities. In contrast with the current (semi-)quantitative grading strategies this method takes the full shape into account, it uses a patient-specific reference by combining population-based information on biological variation in vertebra shape and vertebra interrelations, and it provides a continuous measure of deformity. Good agreement with manual classification and grading is demonstrated on 204 lateral spine radiographs with in total 89 fractures.

  15. Fracture in Electronics

    NASA Astrophysics Data System (ADS)

    Plumbridge, William J.

    Although the World’s largest industrial sector, Electronics has received relatively little attention with regard to mechanical failure of its equipment. Design strategies against fracture are advanced for applications, such as aerospace, automotive, pressure vessel and engine applications. So a fundamental question arises as to the extent to which these can be applied to Electronics. The paper describes the special characteristics of electronics equipment in service, and outlines common modes of failure, with emphasis on thermomechanical fatigue. The particular challenge of size is considered when behaviour determined from conventional bulk samples is no longer representative of actual components. Two case studies are presented that illustrate the special nature of electronics. It is suggested that as miniaturisation continues, fracture will become a major cause of failure.

  16. HUMERAL SHAFT FRACTURES

    PubMed Central

    Benegas, Eduardo; Ferreira Neto, Arnaldo Amado; Neto, Raul Bolliger; Santis Prada, Flavia de; Malavolta, Eduardo Angeli; Marchitto, Gustavo Oliveira

    2015-01-01

    Humeral shaft fractures (HSFs) represent 3% of the fractures of the locomotor apparatus, and the middle third of the shaft is the section most affected. In the majority of cases, it is treated using nonsurgical methods, but surgical indications in HSF cases are increasingly being adopted. The diversity of opinions makes it difficult to reach a consensus regarding the types of osteosynthesis, surgical technique and quantity and quality of synthesis materials that should be used. It would appear that specialists are far from reaching a consensus regarding the best method for surgical treatment of HSFs. We believe that less invasive methods, which favor relative stability, are the most appropriate methods, since the most feared complications are less frequent. PMID:27019833

  17. Unilateral Subthalamic Nucleus Stimulation Has a Measurable Ipsilateral Effect on Rigidity And Bradykinesia in Parkinson Disease

    PubMed Central

    Tabbal, Samer D.; Ushe, Mwiza; Mink, Jonathan W.; Revilla, Fredy J.; Wernle, Angie R.; Hong, Minna; Karimi, Morvarid; Perlmutter, Joel S.

    2008-01-01

    Background Bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves motor function in Parkinson disease (PD). However, little is known about the quantitative effects on motor behavior of unilateral STN DBS. Methods In 52 PD subjects with STN DBS, we quantified in a double-blinded manner rigidity (n= 42), bradykinesia (n= 38), and gait speed (n= 45). Subjects were tested in four DBS conditions: both on, left on, right on and both off. A force transducer was used to measure rigidity across the elbow, and gyroscopes were used to measure angular velocity of hand rotations for bradykinesia. About half of the subjects were rated using the Unified Parkinson Disease Rating Scale (part III) motor scores for arm rigidity and repetitive hand rotation simultaneously during the kinematic measurements. Subjects were timed walking 25 feet. Results All subjects had significant improvement with bilateral STN DBS. Contralateral, ipsilateral and bilateral stimulation significantly reduced rigidity and bradykinesia. Bilateral stimulation improved rigidity more than unilateral stimulation of either side, but there was no significant difference between ipsilateral and contralateral stimulation. Although bilateral stimulation also increased hand rotation velocity more than unilateral stimulation of either side, contralateral stimulation increased hand rotation significantly more than ipsilateral stimulation. All stimulation conditions improved walking time but bilateral stimulation provided the greatest improvement. Conclusions Unilateral STN DBS decreased rigidity and bradykinesia contralaterally as well ipsilaterally. As expected, bilateral DBS improved gait more than unilateral DBS. These findings suggest that unilateral STN DBS alters pathways that affect rigidity and bradykinesia bilaterally but do not support the clinical use of unilateral STN DBS since bilateral DBS clearly provides greater benefit. PMID:18329019

  18. Phase Field Fracture Mechanics.

    SciTech Connect

    Robertson, Brett Anthony

    2015-11-01

    For this assignment, a newer technique of fracture mechanics using a phase field approach, will be examined and compared with experimental data for a bend test and a tension test. The software being used is Sierra Solid Mechanics, an implicit/explicit finite element code developed at Sandia National Labs in Albuquerque, New Mexico. The bend test experimental data was also obtained at Sandia Labs while the tension test data was found in a report online from Purdue University.

  19. Melt fracture revisited

    SciTech Connect

    Greenberg, J. M.

    2003-07-16

    In a previous paper the author and Demay advanced a model to explain the melt fracture instability observed when molten linear polymer melts are extruded in a capillary rheometer operating under the controlled condition that the inlet flow rate was held constant. The model postulated that the melts were a slightly compressible viscous fluid and allowed for slipping of the melt at the wall. The novel feature of that model was the use of an empirical switch law which governed the amount of wall slip. The model successfully accounted for the oscillatory behavior of the exit flow rate, typically referred to as the melt fracture instability, but did not simultaneously yield the fine scale spatial oscillations in the melt typically referred to as shark skin. In this note a new model is advanced which simultaneously explains the melt fracture instability and shark skin phenomena. The model postulates that the polymer is a slightly compressible linearly viscous fluid but assumes no slip boundary conditions at the capillary wall. In simple shear the shear stress {tau}and strain rate d are assumed to be related by d = F{tau} where F ranges between F{sub 2} and F{sub 1} > F{sub 2}. A strain rate dependent yield function is introduced and this function governs whether F evolves towards F{sub 2} or F{sub 1}. This model accounts for the empirical observation that at high shears polymers align and slide more easily than at low shears and explains both the melt fracture and shark skin phenomena.

  20. Maxillofacial fracture repairs.

    PubMed

    Legendre, Loïc

    2005-07-01

    Oral trauma remains a common presentation in a small animal practice. Most fractures are the result of vehicular accidents. Among other causes are falls, kicks, gunshots wounds, and encounters with various hard objects ranging from baseball bats and golf clubs to horse hooves and car doors. Next in popularity are dog fights, especially when a large dog and a small dog are involved, and fights with other animals. With cats, falls from various heights are responsible for a large percentage of presentations.

  1. Fractured Craters on Ganymede

    NASA Technical Reports Server (NTRS)

    1997-01-01

    Two highly fractured craters are visible in this high resolution image of Jupiter's moon, Ganymede. NASA's Galileo spacecraft imaged this region as it passed Ganymede during its second orbit through the Jovian system. North is to the top of the picture and the sun illuminates the surface from the southeast. The two craters in the center of the image lie in the ancient dark terrain of Marius Regio, at 40 degrees latitude and 201 degrees longitude, at the border of a region of bright grooved terrain known as Byblus Sulcus (the eastern portion of which is visible on the left of this image). Pervasive fracturing has occurred in this area that has completely disrupted these craters and destroyed their southern and western walls. Such intense fracturing has occurred over much of Ganymede's surface and has commonly destroyed older features. The image covers an area approximately 26 kilometers (16 miles) by 18 kilometers (11 miles) across at a resolution of 86 meters (287 feet) per picture element. The image was taken on September 6, 1996 by the solid state imaging (CCD) system on NASA's Galileo spacecraft.

    The Jet Propulsion Laboratory, Pasadena, CA manages the Galileo mission for NASA's Office of Space Science, Washington, DC. JPL is an operating division of California Institute of Technology (Caltech).

    This image and other images and data received from Galileo are posted on the World Wide Web, on the Galileo mission home page at URL http://galileo.jpl.nasa.gov.

  2. Controversial Issues in Kyphoplasty and Vertebroplasty in Osteoporotic Vertebral Fractures

    PubMed Central

    Papanastassiou, Ioannis D.; Filis, Andreas; Gerochristou, Maria A.; Vrionis, Frank D.

    2014-01-01

    Kyphoplasty (KP) and vertebroplasty (VP) have been successfully employed for many years for the treatment of osteoporotic vertebral fractures. The purpose of this review is to resolve the controversial issues raised by the two randomized trials that claimed no difference between VP and SHAM procedure. In particular we compare nonsurgical management (NSM) and KP and VP, in terms of clinical parameters (pain, disability, quality of life, and new fractures), cost-effectiveness, radiological variables (kyphosis correction and vertebral height restoration), and VP versus KP for cement extravasation and complications profile. Cement types and optimal filling are analyzed and technological innovations are presented. Finally unipedicular/bipedicular techniques are compared. Conclusion. VP and KP are superior to NSM in clinical and radiological parameters and probably more cost-effective. KP is superior to VP in sagittal balance improvement and cement leaking. Complications are rare but serious adverse events have been described, so caution should be exerted. Unilateral procedures should be pursued whenever feasible. Upcoming randomized trials (CEEP, OSTEO-6, STIC-2, and VERTOS IV) will provide the missing link. PMID:24724106

  3. Opportunistic Identification of Vertebral Fractures.

    PubMed

    Adams, Judith E

    2016-01-01

    Vertebral fractures are powerful predictors of future fracture, so, their identification is important to ensure that patients are commenced on appropriate bone protective or bone-enhancing therapy. Risk factors (e.g., low bone mineral density and increasing age) and symptoms (back pain, loss of height) may herald the presence of vertebral fractures, which are usually confirmed by performing spinal radiographs or, increasingly, using vertebral fracture assessment with dual-energy X-ray absorptiometry scanners. However, a large number (30% or more) of vertebral fractures are asymptomatic and do not come to clinical attention. There is, therefore, scope for opportunistic (fortuitous) identification of vertebral fractures from various imaging modalities (radiographs, computed tomography, magnetic resonance imaging, and radionuclide scans) performed for other clinical indications and which include the spine in the field of view, with midline sagittal reformatted images from computed tomography having the greatest potential for such opportunistic detection. Numerous studies confirm this potential for identification but consistently find underreporting of vertebral fractures. So, a valuable opportunity to improve the management of patients at increased risk of future fracture is being squandered. Educational training programs for all clinicians and constant reiteration, stressing the importance of the accurate and clear reporting of vertebral fractures ("you only see what you look for"), can improve the situation, and automated computer-aided diagnostic tools also show promise to solve the problem of this underreporting of vertebral fractures.

  4. Opportunistic Identification of Vertebral Fractures.

    PubMed

    Adams, Judith E

    2016-01-01

    Vertebral fractures are powerful predictors of future fracture, so, their identification is important to ensure that patients are commenced on appropriate bone protective or bone-enhancing therapy. Risk factors (e.g., low bone mineral density and increasing age) and symptoms (back pain, loss of height) may herald the presence of vertebral fractures, which are usually confirmed by performing spinal radiographs or, increasingly, using vertebral fracture assessment with dual-energy X-ray absorptiometry scanners. However, a large number (30% or more) of vertebral fractures are asymptomatic and do not come to clinical attention. There is, therefore, scope for opportunistic (fortuitous) identification of vertebral fractures from various imaging modalities (radiographs, computed tomography, magnetic resonance imaging, and radionuclide scans) performed for other clinical indications and which include the spine in the field of view, with midline sagittal reformatted images from computed tomography having the greatest potential for such opportunistic detection. Numerous studies confirm this potential for identification but consistently find underreporting of vertebral fractures. So, a valuable opportunity to improve the management of patients at increased risk of future fracture is being squandered. Educational training programs for all clinicians and constant reiteration, stressing the importance of the accurate and clear reporting of vertebral fractures ("you only see what you look for"), can improve the situation, and automated computer-aided diagnostic tools also show promise to solve the problem of this underreporting of vertebral fractures. PMID:26412139

  5. Fractures of the cervical spine

    PubMed Central

    Marcon, Raphael Martus; Cristante, Alexandre Fogaça; Teixeira, William Jacobsen; Narasaki, Douglas Kenji; Oliveira, Reginaldo Perilo; de Barros Filho, Tarcísio Eloy Pessoa

    2013-01-01

    OBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative. PMID:24270959

  6. Procedure for estimating fracture energy from fracture surface roughness

    DOEpatents

    Williford, Ralph E.

    1989-01-01

    The fracture energy of a material is determined by first measuring the length of a profile of a section through a fractured surface of the material taken on a plane perpendicular to the mean plane of that surface, then determining the fractal dimensionality of the surface. From this, the yield strength of the material, and the Young's Modulus of that material, the fracture energy is calculated.

  7. Evaluation of five fracture models in Taylor impact fracture

    NASA Astrophysics Data System (ADS)

    Zhang, Wei; Xiao, Xin-Ke; Wei, Gang; Guo, Zitao

    2012-03-01

    Taylor impact test presented in a previous study on a commercial high strength and super hard aluminum alloy 7A04-T6 are numerically evaluated using the finite element code ABAQUS/Explicit. In the present study, the influence of fracture criterion in numerical simulations of the deformation and fracture behavior of Taylor rod has been studied. Included in the paper are a modified version of Johnson-Cook, the Cockcroft-Latham(C-L), the constant fracture strain, the maximum shear stress and the maximum principle stress fracture models. Model constants for each criterion are calibrated from material tests. The modified version of Johnson-Cook fracture criterion with the stress triaxiality cut off idea is found to give good prediction of the Taylor impact fracture behavior. However, this study will also show that the C-L fracture criterion where only one simple material test is required for calibration is found to give reasonable predictions. Unfortunately, the other three criteria are not able to repeat the experimentally obtained fracture behavior. The study indicates that the stress triaxiality cut off idea is necessary to predict the Taylor impact fracture.

  8. Evaluation of Five Fracture Models in Taylor Impact Fracture

    NASA Astrophysics Data System (ADS)

    Zhang, Wei; Xiao, Xinke; Wei, Gang; Guo, Zitao

    2011-06-01

    Taylor impact test presented in a previous study on a commercial high strength and super hard aluminum alloy 7A04-T6 are numerically evaluated using the finite element code ABAQUS/Explicit. In the present study, the influence of fracture criterion in numerical simulations of the deformation and fracture behavior of Taylor rod has been studied. Included in the paper are a modified version of Johnson-Cook, the Cockcroft-Latham(C-L), the constant fracture strain, the maximum shear stress and the maximum principle stress fracture models. Model constants for each criterion are calibrated from material tests. The modified version of Johnson-Cook fracture criterion with the stress triaxiality cut off idea is found to give good prediction of the Taylor impact fracture behavior. However, this study will also show that the C-L fracture criterion where only one simple material test is required for calibration, is found to give reasonable predictions. Unfortunately, the other three criteria are not able to repeat the experimentally obtained fracture behavior. The study indicates that the stress triaxiality cut off idea is necessary to predict the Taylor impact fracture. The National Natural Science Foundation of China (No.: 11072072).

  9. FRACTURED PETROLEUM RESERVOIRS

    SciTech Connect

    Abbas Firoozabadi

    1999-06-11

    The four chapters that are described in this report cover a variety of subjects that not only give insight into the understanding of multiphase flow in fractured porous media, but they provide also major contribution towards the understanding of flow processes with in-situ phase formation. In the following, a summary of all the chapters will be provided. Chapter I addresses issues related to water injection in water-wet fractured porous media. There are two parts in this chapter. Part I covers extensive set of measurements for water injection in water-wet fractured porous media. Both single matrix block and multiple matrix blocks tests are covered. There are two major findings from these experiments: (1) co-current imbibition can be more efficient than counter-current imbibition due to lower residual oil saturation and higher oil mobility, and (2) tight fractured porous media can be more efficient than a permeable porous media when subjected to water injection. These findings are directly related to the type of tests one can perform in the laboratory and to decide on the fate of water injection in fractured reservoirs. Part II of Chapter I presents modeling of water injection in water-wet fractured media by modifying the Buckley-Leverett Theory. A major element of the new model is the multiplication of the transfer flux by the fractured saturation with a power of 1/2. This simple model can account for both co-current and counter-current imbibition and computationally it is very efficient. It can be orders of magnitude faster than a conventional dual-porosity model. Part II also presents the results of water injection tests in very tight rocks of some 0.01 md permeability. Oil recovery from water imbibition tests from such at tight rock can be as high as 25 percent. Chapter II discusses solution gas-drive for cold production from heavy-oil reservoirs. The impetus for this work is the study of new gas phase formation from in-situ process which can be significantly

  10. Closed reduction of displaced or dislocated mandibular condyle fractures in children using threaded Kirschner wire and external rubber traction.

    PubMed

    Kim, J H; Nam, D H

    2015-10-01

    Most surgeons agree that closed treatment provides the best results for condylar fractures in children. Nevertheless, treatment of the paediatric mandibular condyle fracture that is severely displaced or dislocated is controversial. The purpose of this study was to investigate the long-term clinical and radiological outcomes following the treatment of displaced or dislocated condylar fractures in children using threaded Kirschner wire and external rubber traction. This procedure can strengthen the advantage of closed reduction and make up for the shortcomings of open reduction. From March 1, 2005 to December 25, 2011, 11 children aged between 4 and 12 years with displaced or dislocated mandibular condyle fractures were treated using threaded Kirschner wire and external rubber traction under portable C-arm fluoroscopy. All patients had unilateral displaced or dislocated condylar fractures. The follow-up period ranged from 24 to 42 months (mean 29.3 months). Normal occlusion and pain-free function of the temporomandibular joint, without deviation or limitation of jaw opening, was achieved in all patients. This closed reduction technique in displaced or dislocated condylar fractures in children offers a reliable solution in preventing the unfavourable sequelae of closed treatment and the open technique, such as altered morphology, functional disturbances, and facial nerve damage.

  11. Forced in-plane vibration of a thick ring on a unilateral elastic foundation

    NASA Astrophysics Data System (ADS)

    Wang, Chunjian; Ayalew, Beshah; Rhyne, Timothy; Cron, Steve; Dailliez, Benoit

    2016-10-01

    Most existing studies of a deformable ring on elastic foundation rely on the assumption of a linear foundation. These assumptions are insufficient in cases where the foundation may have a unilateral stiffness that vanishes in compression or tension such as in non-pneumatic tires and bushing bearings. This paper analyzes the in-plane dynamics of such a thick ring on a unilateral elastic foundation, specifically, on a two-parameter unilateral elastic foundation, where the stiffness of the foundation is treated as linear in the circumferential direction but unilateral (i.e. collapsible or tensionless) in the radial direction. The thick ring is modeled as an orthotropic and extensible circular Timoshenko beam. An arbitrarily distributed time-varying in-plane force is considered as the excitation. The Equations of Motion are explicitly derived and a solution method is proposed that uses an implicit Newmark scheme for the time domain solution and an iterative compensation approach to determine the unilateral zone of the foundation at each time step. The dynamic axle force transmission is also analyzed. Illustrative forced vibration responses obtained from the proposed model and solution method are compared with those obtained from a finite element model.

  12. Descending pathways from activated locus coeruleus/subcoeruleus following unilateral hindpaw inflammation in the rat.

    PubMed

    Maeda, Masako; Tsuruoka, Masayoshi; Hayashi, Bunsho; Nagasawa, Ikuko; Inoue, Tomio

    2009-03-16

    We have previously shown that the descending pathways from the locus coeruleus (LC)/subcoeruleus (SC) to the spinal cord are activated during peripheral inflammation, and that activation of this coeruleospinal system decreases development of hyperalgesia. Anatomical evidence suggests that the descending modulation system from the LC/SC should be active bilaterally during inflammation when the LC/SC either ipsilateral or contralateral to the site of inflammation is activated. In the present study, the development of hyperalgesia following the induction of unilateral hindpaw inflammation was compared between rats with either bilateral or unilateral lesions of the LC/SC and rats with a sham operation. Four hours after carrageenan injection, in the inflamed paw, paw withdrawal latencies (PWLs) to thermal stimuli of the bilateral LC/SC-lesioned rats were significantly shorter than those of the unilateral LC/SC-lesioned and the sham-operated rats, whereas the decreased PWLs of the unilateral LC/SC-lesioned rats were equivalent to those of the sham-operated rats. A difference in PWL between the bilateral and the unilateral LC/SC-lesioned rats was not observed in the contralateral non-inflamed paw. The result suggests that in the LC/SC both ipsilateral and contralateral to the inflamed paw, only neurons which project to the dorsal horn ipsilateral to the inflamed paw were activated following peripheral inflammation.

  13. Isolated Unilateral Tongue Atrophy: A Possible Late Complication of Juxta Cephalic Radiation Therapy

    PubMed Central

    Alqahtani, Saeed A.; Agha, Caroline; Rothstein, Ted

    2016-01-01

    Patient: Male, 51 Final Diagnosis: Radiation therapy induced unilateral tongue atrophy Symptoms: — Medication: — Clinical Procedure: EMG Specialty: Neurology Objective: Rare disease Background: Isolated unilateral hypoglossal nerve injury is extremely rare. It may be caused by radiation therapy targeting neoplasms of the cephalic region. Case Report: A 51-year-old man with synovial sarcoma of the left upper arm status post extensive radiation therapy in 1980 presented in late 2014 with gradual onset of speech difficulty and difficulty moving his tongue for a couple of weeks. Neurological examination revealed isolated left-sided unilateral tongue atrophy. Postradiation residual extensive cicatrix with erythema over the whole left upper extremity extending to the neck on the affected side was noticed. On head magnetic resonance imaging (MRI) before and after administration of gadolinium, he was found to have asymmetrically fatty striations, atrophy, and fibrosis in the left tongue consistent with radiation toxicity. The patient’s tongue weakness persisted without improvement. Conclusions: The diagnosis of unilateral hypoglossal nerve injury is usually difficult. Detailed neurological examinations and thorough investigations including head MRI are very helpful. Previous exposure to radiation therapy is a potential cause of hypoglossal nerve injury. To our knowledge, this is the first case report that presents isolated unilateral tongue atrophy as a late complication of juxta cephalic radiation therapy. PMID:27458010

  14. Melatonin protects kidney against apoptosis induced by acute unilateral ureteral obstruction in rats

    PubMed Central

    Badem, Hüseyin; Cakmak, Muzaffer; Yilmaz, Hakki; Kosem, Bahadir; Karatas, Omer Faruk; Bayrak, Reyhan; Cimentepe, Ersin

    2016-01-01

    Introduction To investigate whether there was a protective effect of melatonin on apoptotic mechanisms after an acute unilateral obstruction of the kidney. Material and methods A total of 25 rats consisting of five groups were used in the study, designated as follows: Group 1: control, Group 2: sham, Group 3: unilateral ureteral obstruction treated with only saline, Group 4: unilateral ureteral obstruction treated with melatonin immediately, and Group 5: unilateral obstruction treated with melatonin one day after obstruction. Melatonin was administered as a 10 mg/kg dose intraperitoneally. The kidneys were evaluated according to the apoptotic index and Ki-67 scores. Results Comparison of all obstruction groups (Group 3, 4, and 5), revealed that the apoptotic index was significantly higher in Groups 1 and 2. Despite melatonin reduced apoptotic mechanisms in Groups 4 and 5, there was no significant difference between Groups 4 and 5 in terms of the reduction of apoptosis. However, the reduction of apoptosis in the melatonin treated group did not decrease to the level of Groups 1 and 2. Conclusions Despite melatonin administration, which significantly reduces the apoptotic index occurring after acute unilateral ureteral obstruction, the present study did not observe a return to normal renal histology in the obstruction groups. PMID:27551563

  15. Unilateral and bilateral ECT: a study of memory disturbance and relief from depression

    PubMed Central

    Cronin, D.; Bodley, P.; Potts, L.; Mather, Marcia D.; Gardner, R. K.; Tobin, Jean C.

    1970-01-01

    Fifty-one endogenous and reactive female depressives were given a course of either unilateral non-dominant, unilateral dominant, or bilateral ECT. Visual and verbal memory tests and confusion ratings were administered at frequent intervals during the treatment course. Pre-and post-treatment assessments of depression were made. Comparisons of the therapeutic effect of six and of eight ECTs were studied separately. One month after the last ECT the patients were again assessed on the memory and the depression tests. The results of the memory tests indicate that unilateral non-dominant ECT produced least memory disturbance (particularly of a verbal kind) and also less immediate confusion within 40 minutes of each ECT. This observation applies more to the reactive than the endogenous group. Comparisons of the depression tests reveal that unilateral non-dominant ECT is as effective in relieving depression as bilateral ECT, though progress may be less rapid. The observation holds true only for the reactive depressives. Endogenous depressives benefit more from bilateral ECT. Caution is advised against the administration of unilateral dominant ECT, since this group does not respond to treatment as well as the other two groups. Degree of improvement as a whole does not appear to be related to the degree of confusion experienced. The implications of these findings are discussed. PMID:5478954

  16. Complex Fluids and Hydraulic Fracturing.

    PubMed

    Barbati, Alexander C; Desroches, Jean; Robisson, Agathe; McKinley, Gareth H

    2016-06-01

    Nearly 70 years old, hydraulic fracturing is a core technique for stimulating hydrocarbon production in a majority of oil and gas reservoirs. Complex fluids are implemented in nearly every step of the fracturing process, most significantly to generate and sustain fractures and transport and distribute proppant particles during and following fluid injection. An extremely wide range of complex fluids are used: naturally occurring polysaccharide and synthetic polymer solutions, aqueous physical and chemical gels, organic gels, micellar surfactant solutions, emulsions, and foams. These fluids are loaded over a wide range of concentrations with particles of varying sizes and aspect ratios and are subjected to extreme mechanical and environmental conditions. We describe the settings of hydraulic fracturing (framed by geology), fracturing mechanics and physics, and the critical role that non-Newtonian fluid dynamics and complex fluids play in the hydraulic fracturing process. PMID:27070765

  17. [Distal humerus fractures in children].

    PubMed

    Schneidmueller, D; Boettger, M; Laurer, H; Gutsfeld, P; Bühren, V

    2013-11-01

    Fractures of the distal humerus belong to the most common injuries of the upper arm in childhood. Most frequently occurring is the supracondylar fracture of the distal humerus. In these cases and in the second most common epicondylar fractures, the metaphysis is affected and these fractures are therefore extra-articular. They have to be distinguished from articular fractures regarding therapy and prognosis. The growth potential of the distal epiphysis is very limited as is the possibility of spontaneous correction so that major dislocations should not be left uncorrected. Unstable and especially dislocated articular fractures must be anatomically reconstructed employing various osteosynthetic techniques, mostly combined with immobilization. Insufficient reconstruction, growth disturbance and non-union can result in axial deformities, such as cubitus valgus and varus, restriction of motion, pain and nerve palsy.

  18. Fracture healing: mechanisms and interventions

    PubMed Central

    Einhorn, Thomas A.; Gerstenfeld, Louis C.

    2015-01-01

    Fractures are the most common large-organ, traumatic injuries to humans. The repair of bone fractures is a postnatal regenerative process that recapitulates many of the ontological events of embryonic skeletal development. Although fracture repair usually restores the damaged skeletal organ to its pre-injury cellular composition, structure and biomechanical function, about 10% of fractures will not heal normally. This article reviews the developmental progression of fracture healing at the tissue, cellular and molecular levels. Innate and adaptive immune processes are discussed as a component of the injury response, as are environmental factors, such as the extent of injury to the bone and surrounding tissue, fixation and the contribution of vascular tissues. We also present strategies for fracture treatment that have been tested in animal models and in clinical trials or case series. The biophysical and biological basis of the molecular actions of various therapeutic approaches, including recombinant human bone morphogenetic proteins and parathyroid hormone therapy, are also discussed. PMID:25266456

  19. Complex Fluids and Hydraulic Fracturing.

    PubMed

    Barbati, Alexander C; Desroches, Jean; Robisson, Agathe; McKinley, Gareth H

    2016-06-01

    Nearly 70 years old, hydraulic fracturing is a core technique for stimulating hydrocarbon production in a majority of oil and gas reservoirs. Complex fluids are implemented in nearly every step of the fracturing process, most significantly to generate and sustain fractures and transport and distribute proppant particles during and following fluid injection. An extremely wide range of complex fluids are used: naturally occurring polysaccharide and synthetic polymer solutions, aqueous physical and chemical gels, organic gels, micellar surfactant solutions, emulsions, and foams. These fluids are loaded over a wide range of concentrations with particles of varying sizes and aspect ratios and are subjected to extreme mechanical and environmental conditions. We describe the settings of hydraulic fracturing (framed by geology), fracturing mechanics and physics, and the critical role that non-Newtonian fluid dynamics and complex fluids play in the hydraulic fracturing process.

  20. Unusual presentation of a femoral stress fracture

    PubMed Central

    Ejnisman, Leandro; Wajnsztejn, Andre; Queiroz, Roberto Dantas; Ejnisman, Benno

    2013-01-01

    Stress fractures are common injuries in sports medicine. Among these fractures, femoral neck stress fractures frequently have a benign course, especially when it happens in the medial aspect of the neck. This case report describes a stress fracture of the medial aspect of the femoral neck that developed a complete fracture and underwent surgical fixation. PMID:23283621

  1. Seismic determination of saturation in fractured reservoirs

    USGS Publications Warehouse

    Brown, R.L.; Wiggins, M.L.; Gupta, A.

    2002-01-01

    Detecting the saturation of a fractured reservoir using shear waves is possible when the fractures have a geometry that induces a component of movement perpendicular to the fractures. When such geometry is present, vertically traveling shear waves can be used to examine the saturation of the fractured reservoir. Tilted, corrugated, and saw-tooth fracture models are potential examples.

  2. Nonunion of fifth metatarsal fractures.

    PubMed

    Solan, Matthew; Davies, Mark

    2014-09-01

    Metatarsal fractures are those most frequently encountered in the foot. More than half of these are of the 5th metatarsal. The incidence is increasing, along with the activity levels of the general population. Fractures of the 5th metatarsal require careful evaluation and classification to ensure selection of the optimum treatment plan. Distal fractures rarely require fixation, even when displacement is wide. Cases of established nonunion or refracture require fixation.

  3. Insufficiency fractures of the sacrum

    SciTech Connect

    Cooper, K.L.; Beabout, J.W.; Swee, R.G.

    1985-07-01

    Insufficiency stress fractures may occur in the sacrum after radiation therapy or secondary to postmenopausal or steroid-induced osteoporosis. These fractures are often either overlooked or confused both clinically and radiographically with metastatic disease. Findings on plain films and conventional tomograms are often subtle. Radionuclide bone scans show a characteristic distribution of increased uptake. Computed tomography is the definitive technique for demonstrating the fractures.

  4. Method for fracturing subterranean formations

    SciTech Connect

    Almond, S. W.; Conway, M. W.

    1985-11-19

    The present invention relates to a thermally stable crosslinked gel fracturing fluid for use in the treatment of subterranean formations penetrated by a well bore. The fracturing fluid comprises an aqueous liquid, a gelling agent comprising a selected modified cellulose ether, a crosslinking agent and any additional additives that may be present. The fracturing fluid is thermally stable under shear at temperatures in excess of about 200/sup 0/ F.

  5. Coupled Fracture and Flow in Shale in Hydraulic Fracturing

    NASA Astrophysics Data System (ADS)

    Carey, J. W.; Mori, H.; Viswanathan, H.

    2014-12-01

    Production of hydrocarbon from shale requires creation and maintenance of fracture permeability in an otherwise impermeable shale matrix. In this study, we use a combination of triaxial coreflood experiments and x-ray tomography characterization to investigate the fracture-permeability behavior of Utica shale at in situ reservoir conditions (25-50 oC and 35-120 bars). Initially impermeable shale core was placed between flat anvils (compression) or between split anvils (pure shear) and loaded until failure in the triaxial device. Permeability was monitored continuously during this process. Significant deformation (>1%) was required to generate a transmissive fracture system. Permeability generally peaked at the point of a distinct failure event and then dropped by a factor of 2-6 when the system returned to hydrostatic failure. Permeability was very small in compression experiments (< 1 mD), possibly because of limited fracture connectivity through the anvils. In pure share experiments, shale with bedding planes perpendicular to shear loading developed complex fracture networks with narrow apertures and peak permeability of 30 mD. Shale with bedding planes parallel to shear loading developed simple fractures with large apertures and a peak permeability as high as 1 D. Fracture systems held at static conditions for periods of several hours showed little change in effective permeability at hydrostatic conditions as high as 140 bars. However, permeability of fractured systems was a function of hydrostatic pressure, declining in a pseudo-linear, exponential fashion as pressure increased. We also observed that permeability decreased with increasing fluid flow rate indicating that flow did not follow Darcy's Law, possibly due to non-laminar flow conditions, and conformed to Forscheimer's law. The coupled deformation and flow behavior of Utica shale, particularly the large deformation required to initiate flow, indicates the probable importance of activation of existing

  6. Fracture Control in Engineering Structures

    NASA Astrophysics Data System (ADS)

    Weatherly, G. C.

    1980-07-01

    The three-day meeting "Fracture Control in Engineering Structures" was held at the 1979 C.I.M. Annual Conference of Metallurgists in Sudbury, Ontario, August 19-21, 1979. The meeting was organized by the Materials Engineering Section of C.I.M. and the Canadian Fracture Research Committee (CFRC), a non-profit organization and the national arm of the International Congress on Fracture. The objectives of CFRC are to promote research and conferences in Canada on the Strength & Fracture of Materials. To this end, CFRC holds (sometimes jointly) conferences every year.

  7. Postpartal sacral fracture without osteoporosis.

    PubMed

    Rousière, M; Kahan, A; Job-Deslandre, C

    2001-02-01

    Stress fractures of the sacrum during pregnancy or the postpartum seem uncommon. We report a new case of nontrauma-related postpartal sacral fracture. Only four similar cases have been reported to date. The patient was 36 years of age and her fracture was diagnosed four weeks after her first delivery. Vitamin D levels were low, but there was no osteomalacia. Other standard laboratory tests were normal, as were absorptiometry measurements at the lumbar spine and femur. Rheumatologists should consider sacral fracture in pregnant or nursing patients with buttock pain. Magnetic resonance imaging is the diagnostic investigation of choice.

  8. Acute tibial tubercle avulsion fractures.

    PubMed

    McKoy, Brodie E; Stanitski, Carl L

    2003-07-01

    Acute tibial tubercle avulsion fractures are uncommon, and these injuries typically occur in mature-appearing adolescent boys involved in jumping sports, particularly basketball. The developmental anatomy of the tibial tuberosity and the changes surrounding normal physiologic epiphysiodesis render this structure susceptible to acute avulsion fractures. Possible associated injuries include patellar and quadriceps avulsions, collateral and cruciate ligament tears, and meniscal damage. The treatment of this injury is based on the amount of displacement and associated injuries. Nondisplaced fractures are treated nonoperatively with cast immobilization. Displaced fractures require open reduction and internal fixation. Even in Type III injuries, the outcome is usually excellent.

  9. Peritonsillar abscess: risk of disease in the remaining tonsil after unilateral tonsillectomy à chaud.

    PubMed

    Sørensen, J A; Godballe, C; Andersen, N H; Jørgensen, K

    1991-06-01

    The occurrence of disease in the remaining tonsil after unilateral tonsillectomy à chaud in the treatment of peritonsillar abscess, was studied in 536 patients. No patient had a history of previous severe tonsillitis at the time of the unilateral tonsillectomy, 6.1 per cent of the patients were readmitted for surgery of the remaining tonsil during the follow-up period. Ninety-seven per cent of these patients were younger than 30 years of age. Previous investigations have shown increasing frequency by age of pharyngitis after bilateral tonsillectomy. We suggest bilateral tonsillectomy in all cases of patients younger than 30 years old who suffer from peritonsillar abscess irrespective of previous tonsillar disease. Patients older than 30 should be treated with unilateral ablation, unless there is a clear indication for bilateral tonsillectomy. PMID:2072012

  10. [Peritonsillar abscess. Occurrence of disease requiring surgery in the remaining tonsil after unilateral tonsillectomy à chaud].

    PubMed

    Godballe, C; Sørensen, J A; Andersen, N H; Jørgensen, K E

    1991-09-23

    The occurrence of disease requiring surgery of the remaining tonsil after unilateral tonsillectomy à chaud in the treatment of peritonsillar abscess was studied in 536 patients. None of the patients histories of previous severe tonsillitis at the time of the unilateral had tonsillectomy. 9.3% of the patients under 30 years of age were readmitted for surgery on the remaining tonsil during the follow up period. Only 0.5% of the patients over 30 years were readmitted. Previous investigations have shown increasing frequency of pharyngitis after bilateral tonsillectomy. The present authors suggest bilateral tonsillectomy in all patients under 30 years of age who suffer from peritonsillar abscess irrespectively of previous tonsillar disease. In patients over 30 years, unilateral ablation is recommended unless clear indication for bilateral tonsillectomy are present. PMID:1949288

  11. Regeneration of the mandibular condyle after unilateral condylectomy and myotomy of the masseter in lambs.

    PubMed

    Miyamoto, H; Matsuura, H; Singh, J; Goss, A N

    2002-04-01

    We investigated the degree of regeneration of the mandibular condyle after unilateral condylectomy and myotomy of the masseter in growing lambs. Four 10-week-old lambs had unilateral condylectomy and myotomy of the superficial layer of the masseter on the right side, and were killed 3 months later. The joints were examined radiologically and histologically. All joints showed poor regeneration of the condylar head. In the medial plane there was partial condylar and articular cartilage reformation, but in the lateral plane there was neither condylar nor cartilaginous reformation. The articular cartilage of the temporal bone was thicker in the medial plane and the disc was thicker in the central plane, than in unoperated joints. We conclude that unilateral condylectomy and myotomy of the masseter in the growing period results in poor regeneration of the condyle. PMID:12180201

  12. Surgical treatment for irreducible pediatric subaxial cervical unilateral facet dislocation: case report.

    PubMed

    Qu, Wei; Hao, Dingjun; Wu, Qining; Song, Zongrang; Liu, Jijun

    2016-05-01

    Unilateral facet dislocation at the subaxial cervical spine (C3-7) in children younger than 8 years of age is rare. The authors describe a surgical approach for irreducible subaxial cervical unilateral facet dislocation (SCUFD) at C3-4 in a 5-year-old boy and present a literature review. A dorsal unilateral approach was applied, and a biodegradable plate was used for postreduction fixation without fusion after failed conservative treatment. There was complete resolution of symptoms and restored cervical stability. Two years after surgery, the patient had recovered range of motion in C3-4. In selected cases of cervical spine injury in young children, a biodegradable plate can maintain reduction until healing occurs, obviate the need to remove an implant, and recover the motion of the injured segment. PMID:26722755

  13. Unilateral spectral and temporal compression reduces binaural fusion for normal hearing listeners with cochlear implant simulations.

    PubMed

    Aronoff, Justin M; Shayman, Corey; Prasad, Akila; Suneel, Deepa; Stelmach, Julia

    2015-02-01

    Patients with single sided deafness have recently begun receiving cochlear implants in their deaf ear. These patients gain a significant benefit from having a cochlear implant. However, despite this benefit, they are considerably slower to develop binaural abilities such as summation compared to bilateral cochlear implant patients. This suggests that these patients have difficulty fusing electric and acoustic signals. Although this may reflect inherent differences between electric and acoustic stimulation, it may also reflect properties of the processor and fitting system, which result in spectral and temporal compression. To examine the possibility that unilateral spectral and temporal compression can adversely affect binaural fusion, this study tested normal hearing listeners' binaural fusion through the use of vocoded speech with unilateral spectral and temporal compression. The results indicate that unilateral spectral and temporal compression can each hinder binaural fusion and thus may adversely affect binaural abilities in patients with single sided deafness who use a cochlear implant in their deaf ear. PMID:25549574

  14. Meta-analysis of functional outcome in Parkinson patients treated with unilateral pallidotomy.

    PubMed

    Ahmad, S O; Mu, K; Scott, S A

    2001-10-26

    Parkinson's disease (PD) profoundly affects activities of daily living (ADL) and quality of human life. Although unilateral pallidotomy has become a common surgical treatment for persons with advanced PD, functional outcome data from previous reports have failed to uniformly support this procedure. In the present investigation, results from 12 studies meeting specific inclusion criteria were subjected to meta-analysis. Only reports featuring unilateral pallidotomy as the exclusive surgery, a sample size of at least five patients, explicit assessment of ADL, and sufficient quantitative data were subjected to analysis. Type of research design was not a factor in the selection process. The results of our analysis suggest that unilateral pallidotomy successfully enhances functional outcome in patients with clinically advanced PD. PMID:11602333

  15. Functional effects of unilateral open-angle glaucoma on the primary and extrastriate visual cortex.

    PubMed

    Borges, Victor M; Danesh-Meyer, Helen V; Black, Joanna M; Thompson, Benjamin

    2015-01-01

    The purpose of this study was to use functional magnetic resonance imaging (fMRI) to investigate the response of the visual cortex to unilateral primary open-angle glaucoma (POAG). Specifically, we assessed whether regions of V1 and V2 with lost input from the glaucomatous eye had a greater response to input from the nonaffected fellow eye. Nine participants with unilateral POAG causing paracentral visual field defects and four controls participated in the study. We found no evidence for an increased response to the fellow eye in glaucoma-affected regions of the visual cortex; however, in agreement with previous studies, there was a pronounced, retinotopically localized reduction of activation in both the primary (V1) and extrastriate visual cortex (V2), when participants viewed through their glaucomatous eye. Our results suggest a remarkable level of stability within the adult primary and extrastriate visual cortex in response to unilateral neurodegeneration of the optic nerve. PMID:26575195

  16. Bilateral segmental aplasia with unilateral uterine horn torsion in a Pomeranian bitch.

    PubMed

    Nakamura, Kensuke; Yamasaki, Masahiro; Osaki, Tomohiro; Ohta, Hiroshi; Sasaki, Noboru; Aoshima, Keisuke; Kimura, Takashi; Takiguchi, Mitsuyoshi

    2012-01-01

    Bilateral segmental aplasia of the uterine horns with unilateral pyometra and uterine horn torsion were diagnosed in a Pomeranian bitch that presented with chronic abdominal distension and an acute onset of anorexia and lethargy. Because radiographic and ultrasonographic findings revealed the presence of markedly enlarged bilateral uterine horns filled with fluid in the caudal abdomen, a tentative diagnosis of either pyometra or hydrometra with uterine horn torsion was made. Exploratory laparotomy showed bilateral, segmentally distended uterine horns with unilateral uterine horn torsion. Ovariohysterectomy was performed, and bilateral segmental aplasia of the uterine horns with the development of unilateral uterine horn torsion was diagnosed histopathologically. To the authors' knowledge, this is the first report of uterine horn torsion in conjunction with segmental aplasia of the uterine horn in a bitch. PMID:22843825

  17. Causation of Permanent Unilateral and Mild Bilateral Hearing Loss in Children

    PubMed Central

    Tharpe, Anne Marie; Sladen, Douglas P.

    2008-01-01

    Children with permanent unilateral or mild bilateral hearing loss have been a focus of concern by audiologists, educators, and physicians for at least 2 decades. These children are known to be at risk for psychoeducational difficulties. However, despite this concern, little has been learned about the causative factors of these hearing losses and how those factors might be contributing to child development. This review of known causes of permanent unilateral and mild bilateral hearing loss in children is meant to draw attention to the importance of the search for etiologic factors. That is, the identification of the hearing loss should not signal the end of the diagnostic process but, rather, the beginning of a search for causation. With the combined efforts of audiologists, otolaryngologists, pediatricians, geneticists, and other medical professionals, we may enhance our understanding of the primary causes of unilateral and mild bilateral hearing loss and, perhaps, create links between causative factors and psychosocial and psychoeducational outcomes. PMID:18270175

  18. Hyperventilation-induced nystagmus in vestibular schwannoma and unilateral sensorineural hearing loss.

    PubMed

    Mandalà, Marco; Giannuzzi, Annalisa; Astore, Serena; Trabalzini, Franco; Nuti, Daniele

    2013-07-01

    We evaluated the incidence and characteristics of hyperventilation-induced nystagmus (HVN) in 49 patients with gadolinium-enhanced magnetic resonance imaging evidence of vestibular schwannoma and 53 patients with idiopathic unilateral sensorineural hearing loss and normal radiological findings. The sensitivity and specificity of the hyperventilation test were compared with other audio-vestibular diagnostic tests (bedside examination of eye movements, caloric test, auditory brainstem responses) in the two groups of patients. The hyperventilation test scored the highest diagnostic efficiency (sensitivity 65.3 %; specificity 98.1 %) of the four tests in the differential diagnosis of vestibular schwannoma and idiopathic unilateral sensorineural hearing loss. Small tumors with a normal caloric response or caloric paresis were associated with ipsilateral HVN and larger tumors and severe caloric deficits with contralateral HVN. These results confirm that the hyperventilation test is a useful diagnostic test for predicting vestibular schwannoma in patients with unilateral sensorineural hearing loss.

  19. A case of generalized auditory agnosia with unilateral subcortical brain lesion.

    PubMed

    Suh, Hyee; Shin, Yong-Il; Kim, Soo Yeon; Kim, Sook Hee; Chang, Jae Hyeok; Shin, Yong Beom; Ko, Hyun-Yoon

    2012-12-01

    The mechanisms and functional anatomy underlying the early stages of speech perception are still not well understood. Auditory agnosia is a deficit of auditory object processing defined as a disability to recognize spoken languages and/or nonverbal environmental sounds and music despite adequate hearing while spontaneous speech, reading and writing are preserved. Usually, either the bilateral or unilateral temporal lobe, especially the transverse gyral lesions, are responsible for auditory agnosia. Subcortical lesions without cortical damage rarely causes auditory agnosia. We present a 73-year-old right-handed male with generalized auditory agnosia caused by a unilateral subcortical lesion. He was not able to repeat or dictate but to perform fluent and comprehensible speech. He could understand and read written words and phrases. His auditory brainstem evoked potential and audiometry were intact. This case suggested that the subcortical lesion involving unilateral acoustic radiation could cause generalized auditory agnosia.

  20. EVALUTION OF UNILATERAL ELECTRO-CONVULSIVE THERAPY (A double blind study).

    PubMed

    Chatterjee, S B; Mohammed, E

    1980-04-01

    A double blind study of one hundred twenty patients ( ninety schizophrenics and thirty depressives )-who were divided equally into three groups, who received either (a) bilateral ECT or (b) unilateral application of electrodes on non-dominant hemisphere or (c) unilateral on dominant hemisphere was conducted. The three groups were compared regarding efficacy of the therapy, effects on memory, speed of recovery from each shock session and lastly changes in the electro-encephalogram.It was found that all the three techniques were more or less equal in therapeutic efficacy. There was no significant difference between them in the speed of recovery, nor in the EEG changes. Only difference was that in the field of memory, unilateral non-dominant group showed significant improvement in the 'immediate verbal recall' component of memory in particular. Results have been discussed in view of the current literature on the subject.

  1. [Rehabilitation after periprosthetic fractures].

    PubMed

    Schmitt-Sody, M; Valle, C

    2016-03-01

    Periprosthetic fractures of the upper and lower extremities not only represent a challenge for surgeons but also for the rehabilitation team. The sometimes multimorbid patients have often undergone several surgical operations and need special planning and cooperation between an interdisciplinary team in order to achieve the best possible functional result and social reintegration. A structured rehabilitation planning after surgical treatment is a prerequisite for the patient to return to life as normal as possible. The aim is always rapid mobilization to achieve independence in activities of daily living. Special attention should be paid to postoperative immobilization and weight bearing. PMID:26923872

  2. Permeability damage to natural fractures caused by fracturing fluid polymers

    SciTech Connect

    Gall, B.L.; Sattler, A.R.; Maloney, D.R.; Raible, C.J.

    1988-04-01

    Formation damage studies using artificially fractured, low-permeability sandstone cores indicate that viscosified fracturing fluids can severely restrict gas flow through these types of narrow fractures. These studies were performed in support of the Department of Energy's Multiwell Experiment (MWX). Extensive geological and production evaluations at the MWX site indicate that the presence of a natural fracture system is largely responsible for unstimulated gas production. The laboratory formation damage studies were designed to examine changes in cracked core permeability to gas caused by fracturing fluid residues introduced into such narrow fractures during fluid leakoff. Polysaccharide polymers caused significant reduction (up to 95%) to gas flow through cracked cores. Polymer fracturing fluid gels used in this study included hydroxypropyl guar, hydroxyethyl cellulose, and xanthan gum. In contrast, polyacrylamide gels caused little or no reduction in gas flow through cracked cores after liquid cleanup. Other components of fracturing fluids (surfactants, breakers, etc.) caused less damage to gas flows. Other factors affecting gas flow through cracked cores were investigated, including the effects of net confining stress and non-Darcy flow parameters. Results are related to some of the problems observed during the stimulation program conducted for the MWX. 24 refs., 4 figs., 7 tabs.

  3. Unilateral pediatric "do not attempt resuscitation" orders: the pros, the cons, and a proposed approach.

    PubMed

    Mercurio, Mark R; Murray, Peter D; Gross, Ian

    2014-02-01

    A unilateral do not attempt resuscitation (DNAR) order is written by a physician without permission or assent from the patient or the patient's surrogate decision-maker. Potential justifications for the use of DNAR orders in pediatrics include the belief that attempted resuscitation offers no benefit to the patient or that the burdens would far outweigh the potential benefits. Another consideration is the patient's right to mercy, not to be made to undergo potentially painful interventions very unlikely to benefit the patient, and the physician's parallel obligation not to perform such interventions. Unilateral DNAR orders might be motivated in part by the moral distress caregivers sometimes experience when feeling forced by parents to participate in interventions that they believe are useless or cruel. Furthermore, some physicians believe that making these decisions without parental approval could spare parents needless additional emotional pain or a sense of guilt from making such a decision, particularly when imminent death is unavoidable. There are, however, several risks inherent in unilateral DNAR orders, such as overestimating one's ability to prognosticate or giving undue weight to the physician's values over those of parents, particularly with regard to predicted disability and quality of life. The law on the question of unilateral DNAR varies among states, and readers are encouraged to learn the law where they practice. Arguments in favor of, and opposed to, the use of unilateral DNAR orders are presented. In some settings, particularly when death is imminent regardless of whether resuscitation is attempted, unilateral DNAR orders should be viewed as an ethically permissible approach.

  4. Etiology and clinical characteristics of symptomatic unilateral maxillary sinusitis: A review of 174 cases.

    PubMed

    Troeltzsch, Matthias; Pache, Christoph; Troeltzsch, Markus; Kaeppler, Gabriele; Ehrenfeld, Michael; Otto, Sven; Probst, Florian

    2015-10-01

    The purpose of the study was to analyze the causative pathology associated with symptomatic unilateral maxillary sinusitis requiring surgical treatment. A retrospective review of all patients that have been treated surgically for unilateral symptomatic maxillary sinusitis between 2006 and 2013 at a single institution was performed. Demographic, anamnesis, clinical, radiological, microbiological and histological data were gathered and analyzed. The patients were allocated into groups depending on the underlying cause of the disease. Descriptive and inferential statistics were computed (level of significance: p ≤ 0.05). The study sample was composed of 174 patients (72 female; 102 male) with a mean age of 52.7 years (SD 16.9). Most cases (130; 75%) were triggered by odontogenic pathology following dentoalveolar surgical interventions (83/130 patients; 64%). Other etiological factors for odontogenic unilateral sinusitis were periapical (23/130 cases; 18%) and periodontal pathology (13/130 cases; 10%). Rhinogenic factors for sinusitis were detected in 13 patients (7.5%) and dental implant-associated unilateral maxillary sinusitis was diagnosed in nine patients (5.2%). Four patients (2.3%) had undergone previous sinus augmentation surgery. A leading cause for the sinus infection could not be identified in 18 patients (10%) who all had a history of midfacial surgery. Medication-related osteonecrosis of the jaw (8) and squamous cell carcinoma (2) were incidental findings. There were no differences in the clinical appearance of the disease with respect to its etiology. Odontogenic causes for maxillary sinusitis must be considered especially in unilateral cases. Maxillary dental implants may induce symptomatic unilateral maxillary sinusitis. PMID:26319958

  5. Effects on contralateral muscles after unilateral electrical muscle stimulation and exercise.

    PubMed

    Song, Yafeng; Forsgren, Sture; Yu, Jiguo; Lorentzon, Ronny; Stål, Per S

    2012-01-01

    It is well established that unilateral exercise can produce contralateral effects. However, it is unclear whether unilateral exercise that leads to muscle injury and inflammation also affects the homologous contralateral muscles. To test the hypothesis that unilateral muscle injury causes contralateral muscle changes, an experimental rabbit model with unilateral muscle overuse caused by a combination of electrical muscle stimulation and exercise (EMS/E) was used. The soleus and gastrocnemius muscles of both exercised and non-exercised legs were analyzed with enzyme- and immunohistochemical methods after 1, 3 and 6 weeks of repeated EMS/E. After 1 w of unilateral EMS/E there were structural muscle changes such as increased variability in fiber size, fiber splitting, internal myonuclei, necrotic fibers, expression of developmental MyHCs, fibrosis and inflammation in the exercised soleus muscle. Only limited changes were found in the exercised gastrocnemius muscle and in both non-exercised contralateral muscles. After 3 w of EMS/E, muscle fiber changes, presence of developmental MyHCs, inflammation, fibrosis and affections of nerve axons and AChE production were observed bilaterally in both the soleus and gastrocnemius muscles. At 6 w of EMS/E, the severity of these changes significantly increased in the soleus muscles and infiltration of fat was observed bilaterally in both the soleus and the gastrocnemius muscles. The affections of the muscles were in all three experimental groups restricted to focal regions of the muscle samples. We conclude that repetitive unilateral muscle overuse caused by EMS/E overtime leads to both degenerative and regenerative tissue changes and myositis not only in the exercised muscles, but also in the homologous non-exercised muscles of the contralateral leg. Although the mechanism behind the contralateral changes is unclear, we suggest that the nervous system is involved in the cross-transfer effects.

  6. Etiology and clinical characteristics of symptomatic unilateral maxillary sinusitis: A review of 174 cases.

    PubMed

    Troeltzsch, Matthias; Pache, Christoph; Troeltzsch, Markus; Kaeppler, Gabriele; Ehrenfeld, Michael; Otto, Sven; Probst, Florian

    2015-10-01

    The purpose of the study was to analyze the causative pathology associated with symptomatic unilateral maxillary sinusitis requiring surgical treatment. A retrospective review of all patients that have been treated surgically for unilateral symptomatic maxillary sinusitis between 2006 and 2013 at a single institution was performed. Demographic, anamnesis, clinical, radiological, microbiological and histological data were gathered and analyzed. The patients were allocated into groups depending on the underlying cause of the disease. Descriptive and inferential statistics were computed (level of significance: p ≤ 0.05). The study sample was composed of 174 patients (72 female; 102 male) with a mean age of 52.7 years (SD 16.9). Most cases (130; 75%) were triggered by odontogenic pathology following dentoalveolar surgical interventions (83/130 patients; 64%). Other etiological factors for odontogenic unilateral sinusitis were periapical (23/130 cases; 18%) and periodontal pathology (13/130 cases; 10%). Rhinogenic factors for sinusitis were detected in 13 patients (7.5%) and dental implant-associated unilateral maxillary sinusitis was diagnosed in nine patients (5.2%). Four patients (2.3%) had undergone previous sinus augmentation surgery. A leading cause for the sinus infection could not be identified in 18 patients (10%) who all had a history of midfacial surgery. Medication-related osteonecrosis of the jaw (8) and squamous cell carcinoma (2) were incidental findings. There were no differences in the clinical appearance of the disease with respect to its etiology. Odontogenic causes for maxillary sinusitis must be considered especially in unilateral cases. Maxillary dental implants may induce symptomatic unilateral maxillary sinusitis.

  7. Gravity-Driven Hydraulic Fractures

    NASA Astrophysics Data System (ADS)

    Germanovich, L. N.; Garagash, D.; Murdoch, L. C.; Robinowitz, M.

    2014-12-01

    This study is motived by a new method for disposing of nuclear waste by injecting it as a dense slurry into a hydraulic fracture that grows downward to great enough depth to permanently isolate the waste. Disposing of nuclear waste using gravity-driven hydraulic fractures is mechanically similar to the upward growth of dikes filled with low density magma. A fundamental question in both applications is how the injected fluid controls the propagation dynamics and fracture geometry (depth and breadth) in three dimensions. Analog experiments in gelatin [e.g., Heimpel and Olson, 1994; Taisne and Tait, 2009] show that fracture breadth (the short horizontal dimension) remains nearly stationary when the process in the fracture "head" (where breadth is controlled) is dominated by solid toughness, whereas viscous fluid dissipation is dominant in the fracture tail. We model propagation of the resulting gravity-driven (buoyant or sinking), finger-like fracture of stationary breadth with slowly varying opening along the crack length. The elastic response to fluid loading in a horizontal cross-section is local and can be treated similar to the classical Perkins-Kern-Nordgren (PKN) model of hydraulic fracturing. The propagation condition for a finger-like crack is based on balancing the global energy release rate due to a unit crack extension with the rock fracture toughness. It allows us to relate the net fluid pressure at the tip to the fracture breadth and rock toughness. Unlike the PKN fracture, where breadth is known a priori, the final breadth of a finger-like fracture is a result of processes in the fracture head. Because the head is much more open than the tail, viscous pressure drop in the head can be neglected leading to a 3D analog of Weertman's hydrostatic pulse. This requires relaxing the local elasticity assumption of the PKN model in the fracture head. As a result, we resolve the breadth, and then match the viscosity-dominated tail with the 3-D, toughness

  8. Comparison of two-transsacral-screw fixation versus triangular osteosynthesis for transforaminal sacral fractures.

    PubMed

    Min, Kyong S; Zamorano, David P; Wahba, George M; Garcia, Ivan; Bhatia, Nitin; Lee, Thay Q

    2014-09-01

    Transforaminal pelvic fractures are high-energy injuries that are translationally and rotationally unstable. This study compared the biomechanical stability of triangular osteosynthesis vs 2-transsacral-screw fixation in the repair of a transforaminal pelvic fracture model. A transforaminal fracture model was created in 10 cadaveric lumbopelvic specimens. Five of the specimens were stabilized with triangular osteosynthesis, which consisted of unilateral L5-to-ilium lumbopelvic fixation and ipsilateral iliosacral screw fixation. The remaining 5 were stabilized with a 2-transsacral-screw fixation technique that consisted of 2 transsacral screws inserted across S1. All specimens were loaded cyclically and then loaded to failure. Translation and rotation were measured using the MicroScribe 3D digitizing system (Revware Inc, Raleigh, North Carolina). The 2-transsacral-screw group showed significantly greater stiffness than the triangular osteosynthesis group (2-transsacral-screw group, 248.7 N/mm [standard deviation, 73.9]; triangular osteosynthesis group, 125.0 N/mm [standard deviation, 66.9]; P=.02); however, ultimate load and rotational stiffness were not statistically significant. Compared with triangular osteosynthesis fixation, the use of 2 transsacral screws provides a comparable biomechanical stability profile in both translation and rotation. This newly revised 2-transsacral-screw construct offers the traumatologist an alternative method of repair for vertical shear fractures that provides biplanar stability. It also offers the advantage of percutaneous placement in either the prone or supine position.

  9. Long-term results of early condylar fracture correction: case report.

    PubMed

    Farronato, Giampietro; Grillo, Maria Elena; Giannini, Lucia; Farronato, Davide; Maspero, Cinzia

    2009-06-01

    Condylar fractures in childhood occur frequently, often with minimal pain and discomfort and therefore the diagnosis is not made at the time of injury. Management may be surgical or non-surgical. Non-surgical therapy in children is the method of choice if the condyle can translate normally. In fact, there is an excellent chance of regeneration and continued normal development after fracture in growing patients. The purpose of this article is to describe the long-term clinical and radiological evaluation of a conservatively treated unilateral condylar fracture, a result of trauma, in a 6-year-old patient. In addition, she presented a congenitally missing lower incisor ipsilateral to the fracture and a class II malocclusion. She was treated with functional jaw orthopedics using a splint and an activator and subsequent orthodontic treatment with fixed appliances [J Orofac Orthop5 (2002) 429]. The remodeling process of the condylar head and neck is clearly observed in the panoramic radiographs of the 12-year follow-up records presented. PMID:19239483

  10. Mechanical Models of Bed-Perpendicular Fractures in Layered Rocks Subjected to Extensional Strain

    NASA Astrophysics Data System (ADS)

    Sanz, P.; Pollard, D. D.; Borja, R. I.

    2010-12-01

    Natural fractures (joints) enhance permeability and therefore are important for the economical production of low-permeability hydrocarbon reservoirs and aquifers. In this work we investigate the formation of bed-perpendicular joints during extension in a stiff brittle layer surrounded by thick softer layers. The quasi-static finite element models consist of three elasto-plastic layers with frictional bedding interfaces and the middle layer contains layer-perpendicular fractures that can accommodate opening at the bedding surface accompanied by interface sliding. The upper and lower boundaries are subject to normal tractions appropriate for the depth of burial. Lateral boundaries are displaced horizontally to represent the extensional tectonic regime. We use an interface model that captures the most important mechanical features during sliding of bedding interfaces and opening of joints: unilateral contact, elastic and plastic relative deformation, tensile strength, cohesion, frictional sliding, and non-associative plastic flow. The constitutive law extends the Coulomb slip criterion to the tensile regime to capture opening of fractures in a quasi-brittle manner. The finite element implementation employs a penalty scheme to impose the contact constraints along the interfaces. The numerical simulations show the effects of mechanical properties of layers and interfaces in the development and spacing of bed-perpendicular joints. We evaluate the concepts of fracture saturation and sequential infilling, and the relationship between joint spacing and layer thickness in the context of the new modeling capabilities.

  11. PERPENDICULAR DOUBLE-PLATE FIXATION WITH LOCKING SYSTEM FOR ACROMION PEDICLE FRACTURE

    PubMed Central

    Zhu, Junkun; Pan, Zhijun; Zheng, Rongzong; Lan, Shuhua

    2016-01-01

    Objective : To describe the surgical technique and preliminary clinical outcomes in a series of open reduction internal fixation of basal acromion process fractures applying a double-plating technique. Methods : Nine consecutive patients, mean age 33.4 years old (range, 23-61 years old) with unilateral acromion fracture (Type 3 AO/OTA) with more than 1cm displacement who underwent fixation utilizing a locked double-plating technique, were evaluated on average at 7.8 months (range, 3-15 months) for outcomes related to pain, shoulder function, and surgical complications. Results : Eight patients recovered with complete radiographic union and favorable shoulder function. One case failed to be fully evaluated for more than 3 months follow-up. The overall scores of Constant, Shoulder Pain and Disability Index (SPADI) and DASH for the eight patients reviewed were 91.9± 6.31, 3.11± 3.79 and 5.2± 6.35, respectively. No post-operative infection or surgical hardware irritation was identified at final follow-up of these eight patients. Conclusion : While more evidence is needed to justify its advantages over traditional implants, perpendicular double-plate with a locking system may be indicated for acromion pedicle fracture treatment, since it performed well for fracture healing and joint function rehabilitation. Level of Evidence IV, Therapeutic Study. PMID:26981047

  12. Spontaneous fractures in the differential diagnosis of fractures in children.

    PubMed

    Torwalt, Carla R; Balachandra, A Thambirajah; Youngson, Carol; de Nanassy, Joseph

    2002-11-01

    A four-year-old male with cerebral palsy and spasticity, as a result of a non-accidental head injury sustained when he was two years old, died of pneumonia. Postmortem full body X-rays revealed fractures of varying ages of the left humerus and both femora, tibiae, and fibulae. This led to a thorough investigation of the case by the Office of the Chief Medical Examiner. Child abuse, accidents, metabolic bone disorders, other primary or secondary diseases of the bones, and pathological fractures were ruled out. The final diagnosis was spontaneous fractures secondary to osteopenia. The term spontaneous fractures is used to define fractures that occur without any known external cause, especially in cerebral palsy patients with spasticity.

  13. Pseudopathologic fracture of the femoral neck

    SciTech Connect

    Pope, T.L. Jr.; Keats, T.E.; Goldner, R.; Stelling, C.B.; Logan, M.

    1981-11-01

    We have seen two cases of traumatic subcapital fractures of the femoral neck which resembled pathologic fractures on plain radiography. We have named this entity pseudopathologic fracture of the femoral neck and offer suggestions for why it occurs.

  14. Closed reduction of a fractured bone

    MedlinePlus

    Fracture reduction - closed ... pain medicine you receive. There may be new fractures that occur with the reduction. If the reduction ... BD, Jupiter JBl, Krettek C, Anderson PA. Closed fracture management. In: Browner BD, Jupiter JB, Krettek C, ...

  15. Traumatic cervical spine fractures in the adult.

    PubMed

    Copley, Phillip; Tilliridou, Vicky; Jamjoom, Aimun

    2016-09-01

    This article reviews fractures of the cervical spine, highlighting the pertinent goals of initial management, the indications for different imaging modalities and the different fracture patterns. Basic principles of management of these different fracture patterns are outlined. PMID:27640656

  16. Unilateral asterixis, thalamic astasia and vertical one and half syndrome in a unilateral posterior thalamo-subthalamic paramedian infarct: An interesting case report.

    PubMed

    Ramakrishnan, Subasree; Narayanaswamy, Veera Rajkumar

    2013-04-01

    A 42-year-old young lady presented with acute onset of dizziness, drooping of left eye with binocular diplopia and inability to walk unassisted. She had past history of uncontrolled diabetes mellitus and hypertension. On examination, she had left fascicular type of third nerve palsy, vertical one and half syndrome (VOHS), left internuclear ophthalmoplegia and skew deviation with ipsilesional hypertropia. She also had thalamic astasia and right unilateral asterixis. Her MRI revealed T2 and Flair hyper intense signal changes with restricted diffusion in the left thalamus, subthalamus and left midbrain. MR Angiography was normal. Thalamic-subthalamic paramedian territory infarct is relatively uncommon. It can present with oculomotor abnormalities including vertical one and half syndrome, skew deviation, thalamic astasia and asterixis. This case is reported for the rarity of the presenting clinical findings in unilateral thalamo-mesencephalic infarcts.

  17. Definitive Management of Open Tibia Fractures Using Limb Reconstruction System

    PubMed Central

    Patil, Mahantesh Yellangouda; Gupta, Srinath Myadam; Agarwal, Saumya; Chandarana, Vishal

    2016-01-01

    Introduction Open fractures are treated as surgical emergency and early administration of intravenous antibiotic coupled with early irrigation and debridement decreases the infection rate dramatically. Limb Reconstruction System (LRS) is a unilateral rail system which consists of Shanz pins, rail rods and sliding clamps. It is specifically designed to enable the surgeon to perform simple and effective surgery as it offers rigid fixation of fracture fragments, allowing early weight bearing and reduces economic burden. Aim To determine the efficacy of Limb Reconstruction System for treatment of compound tibia fractures. Materials and Methods A prospective study was carried out where in 54 cases out of 412 compound tibia fractures having Modified Gustilo Anderson Type IIIA and IIIB with a mean age of 42±5 years were treated using LRS over a period of 26 months. Limb reconstruction system was used in acute docking mode or with corticotomy and bone transport was done depending upon the bone loss. The soft tissue condition was assessed and split thickness skin grafting and flap repairs were done as per the need. Clinical and radiological assessment was done at every follow-up. Bony and functional assessment was done by Association for the Study and Application of the Methods of Illizarov (ASAMI) criteria. Results Among 54 patients, bony results as per ASAMI score were excellent in 36, good in 14, fair in 2 and poor in 2 patients. Functional results were excellent in 43, good in 7, fair in 4 patients. The average fracture union time was 8 months. Post-surgery patient satisfaction was excellent since fixation allowed weight bearing immediately. Average hospital stay was 7 days and financial burden was reduced by 40% as compared to multi staged surgery. The average time of return to work was 20 days. Conclusion LRS is an easy, simple and definitive surgical procedure that allows immediate full weight bearing walking. It reduces hospital stay, is cost effective with

  18. Unilateral, Linear Blue Rubber Bleb Nevus Syndrome (Bean's syndrome): An Unfamiliar Presentation: First Case from India

    PubMed Central

    Sancheti, Karan; Podder, Indrashis; Das, Anupam; Choudhury, Sourav; Chandra, Somodyuti; Gharami, Ramesh Chandra

    2015-01-01

    Blue rubber bleb nevus syndrome (BRBNS) also called Bean's syndrome is a rare disorder characterized by multiple cutaneous venous malformations in association with visceral lesions, most commonly affecting the gastrointestinal tract. We report here, a 21-year-old woman patient, who presented with unilateral, blaschkoid distribution of cutaneous venous malformations along with blue rubber bleb nevus and recurrent episodes of hematochezia due to vascular lesions in the sigmoid colon; likely to be a case of BRBNS. The unusual unilateral, blaschkoid distribution of BRBNS prompted this present report. PMID:26677281

  19. Data on galvanic-evoked head movements in healthy and unilaterally labyrinthectomized rats.

    PubMed

    Shaabani, Moslem; Lotfi, Yones; Karimian, Seyed Morteza; Rahgozar, Mehdi; Hooshmandi, Mehdi

    2016-12-01

    In this dataset, we analyzed galvanic-evoked head movements (GEHMs) in the spatial planes of yaw, and roll in normal and unilaterally labyrinthectomized (UL) Wistar rats. The rats were assigned in 4 groups of 10: control, sham, right-UL and left-UL. Bilateral galvanic vestibular stimulation (GVS) was presented by our "ring-shaped electrode" design (see "Short-term galvanic vestibular stimulation promotes functional recovery and neurogenesis in unilaterally labyrinthectomized rats" (M. Shaabani et al., 2016) [1]). Required data were collected through video recording of GEHMs followed by image processing and statistical analysis. PMID:27672673

  20. EEG DELTA BAND SPECTRAL POWER: DIFFERNECES BETWEEN UNILATERAL AND BILATERAL ECT SEIZURES

    PubMed Central

    Dutt, D.Narayana; Mahapatra, P.K.; Gangadhar, B.N.; Sadasivan, P.K.; Janakiramaiah, N.; Subbakrishna, D.K.; Rao, K.M. Jyoti

    1997-01-01

    EEG was recorded from right and left frontal leads during bilateral (n=11) and unilateral (n=l4) ECTs. The seizure EEG was analyzed using East Fourier ′Transform and the spectral power oj the Delta (1-4 Hz) band was computed. The spectral power on both sides was similar in the bilateral ECT. Unilateral ECT produced asymmetry in the early - (first 8 seconds after stimulus offset) and mid - (17-32 seconds after the stimulus offset) siezure phases; the spectral power was lower on the unstimulated hemisphere. Studies to elucidate the relevance of EEG delta band of the seizure to therapeutic potency of ECT are suggested. PMID:21584046

  1. Earth horizontal axis rotational responses in patients with unilateral peripheral vestibular deficits

    NASA Technical Reports Server (NTRS)

    Furman, Joseph M. R.; Kamerer, Donald B.; Wall, Conrad, III

    1989-01-01

    The vestibulo-ocular reflex (VOR) of five patients with surgically confirmed unilateral peripheral vestibular lesions is evaluated. Testing used both earth vertical axis (EVA) and earth horizontal axis (EHA) yaw rotation. Results indicated that the patients had short VOR time constants, asymmetric responses to both EVA and EHA rotation, and normal EHA modulation components. These findings suggest that unilateral peripheral vestibular loss causes a shortened VOR time constant even with the addition of dynamic otolithic stimulation and causes an asymmetry in semicircular canal-ocular reflexes and one aspect of otolith-ocular reflexes.

  2. Simple and Efficient Technique for Correction of Unilateral Scissor Bite Using Straight Wire

    PubMed Central

    Dolas, Siddhesh Gajanan; Chitko, Shrikant Shrinivas; Kerudi, Veerendra Virupaxappa; Bonde, Prasad Vasudeo

    2016-01-01

    Unilateral scissor bite is a relatively rare malocclusion. However, its correction is often difficult and a challenge for the clinician. This article presents simple and efficient technique for the correction of severe unilateral scissor bite in a 14 year old boy, using 0.020 S.S. A. J. Wilcock wire (premium plus) out of the spool, with minimal adjustments and placed in mandibular arch. After about six weeks time, good amount of correction was seen in the lower arch and the lower molar had been relieved of scissor bite. PMID:27231682

  3. Uterus didelphys with unilateral obstructed hemivagina and haematocolpos with ipsilateral renal agenesis - a case report.

    PubMed

    Chowdhury, S; Ara, R; Begum, S A; Chowdhury, S B; Hussain, M A; Mirza, T T

    2015-01-01

    Mullerian anomalies are a relatively uncommon occurrence with implication for adolescents and adults as they may result in specific gynaecologic, fertility and obstetrical issues. Uterus didelphys with blind hemivagina and ipsilateral renal agenesis is a rare congenital anomaly. Patient may be asymptomatic and unaware of having double uterus or may present with severe dysmenorrhoea or dyspareunia or a palpable mass due to unilateral haematocolpos. We report a case of 12 year old girl with this condition who was diagnosed as uterus didelphys with unilateral haematocolpos with ipsilateral renal agenesis on the basis of clinical association, physical examination and sonography and intravenous urogram.

  4. Ocular Lyme borreliosis as a rare presentation of unilateral vision loss.

    PubMed

    Patterson-Fortin, Jeffrey; Kohli, Anita; Suarez, Maria J; Miller, P Elliott

    2016-04-25

    Ocular Lyme borreliosis is a rare manifestation of Lyme disease. We describe a case of an 80-year-old woman who presented with a 1-month history of unilateral painless central vision loss. Based on a temporal artery biopsy, she was initially diagnosed with giant cell arteritis and treated with a 3-day course of high-dose intravenous steroids. A more detailed history uncovered multiple previous treatments for Lyme disease and residence in an endemic Lyme area. The patient was subsequently diagnosed with ocular Lyme borreliosis and treated with intravenous antibiotics. After 5 weeks of treatment, unilateral vision loss did not progress and optic disc oedema resolved.

  5. Thoracolumbar Spine Fractures in the Geriatric Fracture Center

    PubMed Central

    Folbert, E. C.; Kraai, M.; Smit, R. S.; Hegeman, J. H.; van der Velde, D.

    2014-01-01

    Introduction: Thoracolumbar spine fractures are common osteoporotic fractures among elderly patients. Several studies suggest that these fractures can be treated successfully with a nonoperative management. The aim of this study is to evaluate the conservative treatment of elderly patients with a vertebral fracture. Methods: This study is a retrospective cohort study, which included all patients with an age of 65 years and older, who were diagnosed with a vertebral fracture and where therefore admitted to the Geriatric Fracture Center over a period of 2 years. Primary outcome was the level of functioning 6 weeks and 3 months after admission. Results: We included 106 patients with 143 vertebral fractures, of which 61 patients were evaluated after 3 months. In our population, 53% of the patients had a fracture involving both middle and anterior columns. The majority of the patients functioned sufficiently 6 weeks and 3 months after admission. Analysis showed that age <80 years is an independent predictor of a sufficient level of functioning after 6 weeks. Discussion: The nonoperative treatment of elderly patients with a vertebral fracture leads to a sufficient level of functioning 6 weeks and 3 months after admission. In our population, only age <80 years is an independent predictor for a sufficient level of functioning 6 weeks after admission. The level of functioning at 6 weeks predicts the level of functioning 3 months after admission. On comparison, the level of functioning after early ambulation is equal to the level of functioning after immobilization. Where immobilization may lead to complications, early ambulation was not associated with new complications or neurological damage. Based on these advantages, the treatment of elderly patients with a fracture involving both middle and anterior columns may be altered from immobilization to mobilization in the future. PMID:25360330

  6. Rock fracture processes in chemically reactive environments

    NASA Astrophysics Data System (ADS)

    Eichhubl, P.

    2015-12-01

    Rock fracture is traditionally viewed as a brittle process involving damage nucleation and growth in a zone ahead of a larger fracture, resulting in fracture propagation once a threshold loading stress is exceeded. It is now increasingly recognized that coupled chemical-mechanical processes influence fracture growth in wide range of subsurface conditions that include igneous, metamorphic, and geothermal systems, and diagenetically reactive sedimentary systems with possible applications to hydrocarbon extraction and CO2 sequestration. Fracture processes aided or driven by chemical change can affect the onset of fracture, fracture shape and branching characteristics, and fracture network geometry, thus influencing mechanical strength and flow properties of rock systems. We are investigating two fundamental modes of chemical-mechanical interactions associated with fracture growth: 1. Fracture propagation may be aided by chemical dissolution or hydration reactions at the fracture tip allowing fracture propagation under subcritical stress loading conditions. We are evaluating effects of environmental conditions on critical (fracture toughness KIc) and subcritical (subcritical index) fracture properties using double torsion fracture mechanics tests on shale and sandstone. Depending on rock composition, the presence of reactive aqueous fluids can increase or decrease KIc and/or subcritical index. 2. Fracture may be concurrent with distributed dissolution-precipitation reactions in the hostrock beyond the immediate vicinity of the fracture tip. Reconstructing the fracture opening history recorded in crack-seal fracture cement of deeply buried sandstone we find that fracture length growth and fracture opening can be decoupled, with a phase of initial length growth followed by a phase of dominant fracture opening. This suggests that mechanical crack-tip failure processes, possibly aided by chemical crack-tip weakening, and distributed

  7. Fracture detection and mapping

    SciTech Connect

    Goldstein, N.E.; Iovenitti, J.L.

    1986-03-01

    Because the costs of drilling, completing, and testing a well can be extremely high, it is important to develop better tools and methods for locating high permeability zones prior to drilling, and to develop better tools and methods for identifying and characterizing major fracture zones during the drilling and well testing stages. At the recommendation of the LBL Industry Review Panel on Geothermal Reservoir Technology, we organized and convened a one-day workshop this past July to discuss various aspects of DOE's current and planned activities in fracture detection, to review the geothermal industry's near-term and long-term research needs, to determine the priority of those needs, to disseminate to industry the status of research in progress, and to discuss the possibility of future joint research between industry and DOE. In this paper we present a brief overview of the workshop from the perspective of those who participated in it and provided us with written comments to a questionnaire that was distributed.

  8. Fracture Detection and Mapping

    SciTech Connect

    Goldstein, Norman E.; Iovenitti, Joseph L.

    1986-01-21

    Because the costs of drilling, completing, and testing a well can be extremely high, it is important to develop better tools and methods for locating high permeability zones prior to drilling, and to develop better tools and methods for identifying and characterizing major fracture zones during the drilling and well testing stages. At the recommendation of the LBL Industry Review Panel on Geothermal Reservoir Technology, we organized and convened a one-day workshop this past July to discuss various aspects of DOE's current and planned activities in fracture detection, to review the geothermal industry's near-term and long-term research needs, to determine the priority of those needs, to disseminate to industry the status of research in progress, and to discuss the possibility of future joint research between industry and DOE. In this paper we present a brief overview of the workshop from the perspective of those who participated in it and provided us with written comments to a questionnaire that was distributed.

  9. Acute effects of unilateral sectioning the superior ovarian nerve of rats with unilateral ovariectomy on ovarian hormones (progesterone, testosterone and estradiol) levels vary during the estrous cycle

    PubMed Central

    2011-01-01

    The present study analyzed the participation of the left and right superior ovarian nerves (SON) in regulating progesterone, testosterone, and estradiol serum levels in unilaterally ovariectomized rats on each day of the estrous cycle. For this purpose, ovarian hormone concentrations in serum were measured in animals with either sham-surgery, unilateral ovariectomy (ULO), unilateral sectioning of the SON, or sectioning of the SON innervation of the in situ ovary in rats with ULO. This investigation results show that the right and left ovaries have different capacities to maintain normal hormone levels, that such capacity varies during the estrous cycle, and that it depends on the integrity of the SON innervation. In rats with only one ovary, the effects of ovarian denervation on hormone levels varied according to which ovary remained in situ, the specific hormone, and the day of the estrous cycle when treatment was performed. Present results support the idea that the ovaries send and receive neural information that is processed in the central nervous system and we propose that this information participates in controlling the secretion of gonadotropins related to the regulation of ovarian functions. PMID:21414235

  10. Fracture toughness of anisotropic graphites

    SciTech Connect

    Kennedy, C.R.; Kehne, M.T.

    1985-01-01

    Fracture toughness measurements have been made at 0, 30, 45, 60, and 90/sup 0/ from the extrusion axis on a reasonably anisotropic graphite, grade AGOT. It was found that the fracture toughness did not vary appreciably with orientation. An observed variation in strength was found to be the result of defect orientation.

  11. Management of pediatric mandible fractures.

    PubMed

    Goth, Stephen; Sawatari, Yoh; Peleg, Michael

    2012-01-01

    The pediatric mandible fracture is a rare occurrence when compared with the number of mandible fractures that occur within the adult population. Although the clinician who manages facial fractures may never encounter a pediatric mandible fracture, it is a unique injury that warrants a comprehensive discussion. Because of the unique anatomy, dentition, and growth of the pediatric patient, the management of a pediatric mandible fracture requires true diligence with a variance in treatment ranging from soft diet to open reduction and internal fixation. In addition to the variability in treatment, any trauma to the face of a child requires additional management factors including child abuse issues and long-term sequelae involving skeletal growth, which may affect facial symmetry and occlusion. The following is a review of the incidence, relevant anatomy, clinical and radiographic examination, and treatment modalities for specific fracture types of the pediatric mandible based on the clinical experience at the University of Miami/Jackson Memorial Hospital Oral and Maxillofacial Surgery program. In addition, a review of the literature regarding the management of the pediatric mandible fracture was performed to offer a more comprehensive overview of this unique subset of facial fractures. PMID:22337373

  12. Effect of unilateral, bilateral, and combined plyometric training on explosive and endurance performance of young soccer players.

    PubMed

    Ramírez-Campillo, Rodrigo; Burgos, Carlos H; Henríquez-Olguín, Carlos; Andrade, David C; Martínez, Cristian; Álvarez, Cristian; Castro-Sepúlveda, Mauricio; Marques, Mário C; Izquierdo, Mikel

    2015-05-01

    The aim of the study was to compare the effects of bilateral, unilateral, or combined bilateral and unilateral plyometric training (PT) on muscle power output, endurance, and balance performance adaptations in young soccer players. Four groups of young soccer players (age 11.4 ± 2.2 years) were divided into control group (CG; n = 14), bilateral group (BG; n = 12), unilateral group (UG; n = 16), and bilateral + unilateral group (B + UG; n = 12). Players were measured in unilateral and bilateral countermovement jump with arms, 5 multiple bounds test, 20-cm drop jump reactive strength index, maximal kicking velocity, sprint and agility test time, endurance, and balance performance. The PT was applied during 6 weeks, 2 sessions per week, for a total of 2,160 jumps. After intervention, all PT groups showed a statistically significant (p ≤ 0.05) change in all performance measures, with no statistically significant differences between treatments. Among the 21 performance measures, the B + UG showed a significantly (p ≤ 0.05) higher performance change in 13 of them vs. the CG, whereas the UG and BG showed only 6 and 3, respectively. The current study showed that bilateral, unilateral, and combined bilateral and unilateral PT ensured significant improvement in several muscular power and endurance performance measures in young soccer players. However, the combination of unilateral and bilateral drills seems more advantageous to induce superior performance improvements.

  13. Hand Function in Relation to Brain Lesions and Corticomotor-Projection Pattern in Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Holmstrom, Linda; Vollmer, Brigitte; Tedroff, Kristina; Islam, Mominul; Persson, Jonas Ke; Kits, Annika; Forssberg, Hans; Eliasson, Ann-Christin

    2010-01-01

    Aim: To investigate relationships between hand function, brain lesions, and corticomotor projections in children with unilateral cerebral palsy (CP). Method: The study included 17 children (nine males, eight females; mean age 11.4 [SD 2.4] range 7-16y), with unilateral CP at Gross Motor Function Classification System level I and Manual Ability…

  14. Visual Field Function in School-Aged Children with Spastic Unilateral Cerebral Palsy Related to Different Patterns of Brain Damage

    ERIC Educational Resources Information Center

    Jacobson, Lena; Rydberg, Agneta; Eliasson, Ann-Christin; Kits, Annika; Flodmark, Olof

    2010-01-01

    Aim: To relate visual field function to brain morphology in children with unilateral cerebral palsy (CP). Method: Visual field function was assessed using the confrontation technique and Goldmann perimetry in 29 children (15 males, 14 females; age range 7-17y, median age 11y) with unilateral CP classified at Gross Motor Function Classification…

  15. Test-Free Fracture Toughness

    NASA Technical Reports Server (NTRS)

    Minnetyan, Levon; Chamis, Christos C. (Technical Monitor)

    2003-01-01

    Computational simulation results can give the prediction of damage growth and progression and fracture toughness of composite structures. The experimental data from literature provide environmental effects on the fracture behavior of metallic or fiber composite structures. However, the traditional experimental methods to analyze the influence of the imposed conditions are expensive and time consuming. This research used the CODSTRAN code to model the temperature effects, scaling effects and the loading effects of fiberbraided composite specimens with and without fiber-optic sensors on the damage initiation and energy release rates. The load-displacement relationship and fracture toughness assessment approach is compared with the test results from literature and it is verified that the computational simulation, with the use of established material modeling and finite element modules, adequately tracks the changes of fracture toughness and subsequent fracture propagation for any fiberbraided composite structure due to the change of fiber orientations, presence of large diameter optical fibers, and any loading conditions.

  16. Atypical fractures, a biased perspective.

    PubMed

    Aspenberg, Per

    2016-01-01

    When stress fractures started to show up in the femurs of elderly ladies, it was soon evident that bisphosphonate use lay behind, and the absolute risk increase due to bisphosphonate use was reasonably well estimated already in 2008. Thereafter followed a period of confusion: the term atypical fracture was introduced, with a definition so vague that the true stress fractures tended to disappear in a cloud of ambiguity. This cast doubt on the association with bisphosphonates. The association was then re-established by large epidemiological studies based on radiographic adjudication. Atypical fractures are largely caused by bisphosphonates. With a correct indication, bisphosphonates prevent many more fractures than they cause, at least during the first years of use. With an incorrect indication they are likely to cause more harm than good. PMID:26768286

  17. Distal clavicle fractures in children☆

    PubMed Central

    Labronici, Pedro José; da Silva, Ricardo Rodrigues; Franco, Marcos Vinícius Viana; Labronici, Gustavo José; Pires, Robinson Esteves Santos; Franco, José Sergio

    2015-01-01

    Objective To analyze fractures of the distal clavicle region in pediatric patients. Methods Ten patients between the ages of five to eleven years (mean of 7.3 years) were observed. Nine patients were treated conservatively and one surgically. All the fractures were classified using the Nenopoulos classification system. Results All the fractures consolidated without complications. Conservative treatment was used for nine patients, of whom three were in group IIIB, three IIb, two IIa and one IV. The only patient who was treated surgically was a female patient of eleven years of age with a group IV fracture. Conclusion The treatment indication for distal fractures of the clavicle in children should be based on the patient's age and the displacement of the fragments. PMID:26962489

  18. Fractures of the Radial Head.

    PubMed

    Burkhart, Klaus Josef; Wegmann, Kilian; Müller, Lars P; Gohlke, Frank E

    2015-11-01

    Radial head fractures are the most common fractures around the elbow. Because they are often accompanied by ligamentous injuries, we recommend considering them to be osteoligamentous injuries rather than simple fractures, even in undisplaced or minimally displaced fractures. Surgeons should always suspect and actively exclude concomitant ligament tears. The incidence of these associated injuries increases with greater severity of the radial head fracture. However, the standard Mason classification system does not adequately address this problem, and all attempts to establish a new classification system that provides concise treatment algorithms have failed. This article discusses the current treatment options and the current controversies in nonsurgical therapy, open reduction and internal fixation (ORIF) and radial head replacement. PMID:26498543

  19. Acute tibial tubercle avulsion fractures.

    PubMed

    Mosier, Susan M; Stanitski, Carl L

    2004-01-01

    A retrospective analysis of 18 patients with 19 acute tibial tubercle avulsion fractures was performed. Mean age at injury was 13 years 8 months. Mean follow-up time was 2 years 8 months. A group of four preadolescent patients ages 9 to 12 years at injury was identified. Participation in athletics, particularly basketball, resulted in 77% of fractures. There were one type IA, three type IB, two type IIA, six type IIB, two type IIIA, four type IIIB, and one type IV fractures. Fifteen fractures were treated with open reduction and internal fixation and four by closed reduction and cylinder cast immobilization. Three cases (15.7%) of extensor mechanism disruption were noted, two patellar tendon avulsions and one quadriceps avulsion. Final outcome was good in all patients regardless of fracture type or treatment. There were no complications.

  20. Pulmonary embolism following ankle fractures treated without an operation - an analysis using National Health Service data.

    PubMed

    Jameson, Simon S; Rankin, Kenneth S; Desira, Nicola L; James, Philip; Muller, Scott D; Reed, Mike R; Rangan, Amar

    2014-08-01

    The majority of ankle fractures are stable and can be treated without an operation, most commonly with cast immobilisation. Based on concerns regarding the risk of a venous thromboembolic event (VTE) while immobilised, there is currently debate as to whether these patients should receive VTE prophylaxis for the duration of treatment. Rates of pulmonary embolism (PE) in this patient group are unknown. This retrospective cohort study was designed to identify patients treated without an operation for ankle fracture and determine the occurrence of PE and inpatient mortality within 90 days of injury using the English National Health Service administrative databases. Logistic regression models were used to assess the influence of age, gender and Charlson co-morbidity score on these outcomes. We identified 14777 adult patients over a 54-month period (April 2007-September 2011) that met our linkage and inclusion criteria (isolated, unilateral closed ankle fracture that did not require hospitalisation). Mean age was 46.4 years (range 18-99) and the majority had a Charlson 0 score (97.7%). There were 32 (0.22%) PEs within 90 days of the fracture (including in one patient who subsequently died). After adjustment, Charlson score of ≥1 was associated with a greater risk of PE (Odds ratio = 11.97, p < 0.001) compared to Charlson 0. Risk for these patients was 2.08%. In total, fifteen patients (0.11%) died in hospital within 90 days. Pulmonary embolism is rare following ankle fractures treated without an operation. Patients with multiple co-morbidities are at a higher risk. Based on this evidence, an ankle fracture treated without an operation does not appear to be an indication for routine VTE prophylaxis.

  1. Chronic unilateral locked facet joint with spinal cord injury in a 26-month-old child: A case report

    PubMed Central

    Wu, Ai-Min; Wang, Xiang-Yang; Luo, Peng; Xu, Hua-Zi; Chi, Yong-Long

    2015-01-01

    Objectives This study presents the successful posterior surgical reduction and fusion on a 26-month-old child with chronic unilateral locked facet joint and spinal cord injury (SCI). Methods A 26-month-old child with chronic unilateral locked facet joint and SCI treated by posterior surgical reduction and fusion. Plaster external fixation was applied and rehabilitation exercise was trained post-operatively. Results Chronic unilateral locked facet joint was reduced successfully and bone fusion of C4/5 was achieved 3 months after surgery. The function of both lower limbs was improved 1 year after surgery, aided with physical rehabilitation. Conclusion Unilateral locked facet joint in pediatric population is rare. Few clinical experiences were found in the literature. Non-surgical treatment has advantages of not being invasive and is preferred for acute patients; however, it may not be suitable for chronic unilateral locked facet joint with SCI, in which surgical intervention is needed. PMID:24673578

  2. External fixator configurations in tibia fractures: 1D optimization and 3D analysis comparison.

    PubMed

    Roseiro, Luis M; Neto, M Augusta; Amaro, Ana; Leal, Rogerio P; Samarra, Miguel C

    2014-01-01

    The use of external fixation devices in orthopedic surgery is very common in open tibial fractures. A properly applied fixator may improve the healing process while one improperly applied might delay the healing process. The several external fixator systems used in clinical today, can be categorized into uniplanar-unilateral, uniplanar-bilateral, biplanar and multiplanar. The stability on the fracture focus and, therefore, the fracture healing process, is related with the type of external fixator configuration that is selected. The aim of this study is to discuss the principles for the successful application of unilateral-uniplanar external fixation, the assembly of its components, for the case of a transverse fractures using computational models. In this context, the fixation stiffness characteristics are evaluated using a simplified 1D finite element model for the tibia and external fixator. The beams are modeled with realistic cross-sectional geometry and material properties instead of a simplified model. The VABS (the Variational Asymptotic Beam Section analysis) methodology is used to compute the cross-sectional model for the generalized Timoshenko model, which was embedded in the finite element solver FEAP. The use of Timoshenko beam theory allows accounting for several kinds of loads, including torsion moments. Optimal design is performed with respect to the assembly of fixator components using a genetic algorithm. The optimization procedure is based on the evaluation of an objective function, which is dependent on the displacement at the fracture focus. The initial and optimal results are compared by performing a 3D analysis, for which different three-dimensional finite element models are created. The geometrical model of a tibia is created on the basis of data acquired by CAT scan, made for a healthy tibia of a 22 year old male. The 3D comparison of the 1D optimal results show a clear improvement on the objective function for the several load cases and

  3. Relative Permeability of Fractured Rock

    SciTech Connect

    Mark D. Habana

    2002-06-30

    Contemporary understanding of multiphase flow through fractures is limited. Different studies using synthetic fractures and various fluids have yielded different relative permeability-saturation relations. This study aimed to extend the understanding of multiphase flow by conducting nitrogen-water relative permeability experiments on a naturally-fractured rock from The Geysers geothermal field. The steady-state approach was used. However, steady state was achieved only at the endpoint saturations. Several difficulties were encountered that are attributed to phase interference and changes in fracture aperture and surface roughness, along with fracture propagation/initiation. Absolute permeabilities were determined using nitrogen and water. The permeability values obtained change with the number of load cycles. Determining the absolute permeability of a core is especially important in a fractured rock. The rock may change as asperities are destroyed and fractures propagate or st rain harden as the net stresses vary. Pressure spikes occurred in water a solute permeability experiments. Conceptual models of an elastic fracture network can explain the pressure spike behavior. At the endpoint saturations the water relative permeabilities obtained are much less than the nitrogen gas relative permeabilities. Saturations were determined by weighing and by resistivity calculations. The resistivity-saturation relationship developed for the core gave saturation values that differ by 5% from the value determined by weighing. Further work is required to complete the relative permeability curve. The steady-state experimental approach encountered difficulties due to phase interference and fracture change. Steady state may not be reached until an impractical length of time. Thus, unsteady-state methods should be pursued. In unsteady-state experiments the challenge will be in quantifying rock fracture change in addition to fluid flow changes.

  4. Broken ribs: paleopathological analysis of costal fractures in the human identified skeletal collection from the Museu Bocage, Lisbon, Portugal (late 19th to middle 20th centuries).

    PubMed

    Matos, Vítor

    2009-09-01

    Although rarely reported in the anthropological literature, rib fractures are commonly found during the analysis of human skeletal remains of past and modern populations. This lack of published data precludes comparison between studies and restricts an accurate understanding either of the mechanisms involved in thoracic injuries or their impact on past societies. The present study aimed: 1) to report rib fracture prevalence in 197 individuals, 109 males, and 88 females, with ages at death ranging from 13 to 88 years old, from the Human Identified Skeletal Collection, Museu Bocage, Portugal (late 19th-middle 20th centuries); 2) to test the hypothesis that a higher prevalence of rib stress fractures existed in the 133 individuals who died from respiratory diseases, in a period before antibiotics. The macroscopic analysis revealed 23.9% (n = 47) of individuals with broken ribs. 2.6% (n = 124) out of 4,726 ribs observed were affected. Males presented more rib fractures, and a significantly higher prevalence was noted for older individuals. Fractures were more frequently unilateral (n = 34), left sided (n = 19) and mainly located on the shaft of ribs from the middle thoracic wall. Nineteen individuals presented adjacent fractured ribs. Individuals who died from pulmonary diseases were not preferentially affected. However, a higher mean rate of fractures was found in those who died from pneumonia, a scenario still common nowadays. Since rib involvement in chest wall injury and its related outcomes are important issues both for paleopathology and forensic anthropology, further investigations are warranted.

  5. Effect of long-term unilateral activity on bone mineral density of female junior tennis players.

    PubMed

    Haapasalo, H; Kannus, P; Sievänen, H; Pasanen, M; Uusi-Rasi, K; Heinonen, A; Oja, P; Vuori, I

    1998-02-01

    High peak bone mass in early adulthood is an important protective factor against osteoporotic fractures in later life, but little is known about the effects of exercise on growing bone. The purpose of this cross-sectional study was to determine at which state of maturity (Tanner stage), the areal bone mineral density (BMD) differences between the playing and nonplaying arms of junior tennis players become obvious, and to clarify in each developmental stage which training and background variables, if any, could explain the interindividual differences in bones' response to mechanical loading. Ninety-one 7- to 17-year-old female tennis players and 58 healthy female controls were measured. In each Tanner stage, differences in BMD in playing and nonplaying (dominant and nondominant) arms (proximal humerus, humeral shaft, and distal radius) and BMD of the lumbar spine and nondominant distal radius were compared between the controls and players. Within each Tanner stage of players, the associations between training and background variables and BMD differences were analyzed with Spearman rank correlation coefficients. In players, BMD differences between the playing and nonplaying arms were significant (P < 0.05- < 0.001) in all Tanner stages, with the mean difference ranging from 1.6 to 15.7%. In controls, these dominant-to-nondominant arm differences were clearly smaller (ranging from -0.2 to 4.6%), but significant at some measured sites. In comparison with the relative side-to-side arm differences between the players and controls (i.e., examination of the training effect), the mean difference was not obvious and significant until the adolescent growth spurt (i.e., the girls in Tanner stage III with a mean age of 12.6 years). In the lumbar spine, significant BMD differences between players and controls were not found until Tanner stage IV (mean age 13.5 years; 8.7%, P < 0.05) and V (mean age 15.5 years; 12.4%, P < 0.05). In a nonloaded site of the skeleton (nondominant

  6. The incidence of fragility fractures in Italy.

    PubMed

    Ratti, Chiara; Vulcano, Ettore; La Barbera, Giuseppe; Canton, Gianluca; Murena, Luigi; Cherubino, Paolo

    2013-10-01

    Osteoporosis can significantly impact on the risk of developing a fracture. Thus, fragility fractures represent a challenge for health professionals and decision makers of the twenty-first century. The aim of this work is to review the literature concerning osteoporotic fractures in Italy in terms of incidence, rate of hospitalization, relative risk of a new fragility fracture, and costs for the national health system. It was estimated that the costs of treating proximal femur fragility fractures in 2002 summed up to 1 billion Euros. The number of fragility fractures in Italy was calculated as follows: 91.494 hip fractures, 61.009 clinical vertebral fractures, 57.401 humeral fragility fractures, and 94.045 forearm/wrist fragility fractures. The incidence of fragility fractures in Italy is very high, and osteoporosis is the leading cause of morbidity in the Italian population. PMID:24046040

  7. Verbal Competence in Narrative Retelling in 5-Year-Olds with Unilateral Cleft Lip and Palate

    ERIC Educational Resources Information Center

    Klintö, Kristina; Salameh, Eva-Kristina; Lohmander, Anette

    2015-01-01

    Background: Research regarding expressive language performance in children born with cleft palate is sparse. The relationship between articulation/phonology and expressive language skills also needs to be further explored. Aims: To investigate verbal competence in narrative retelling in 5-year-old children born with unilateral cleft lip and palate…

  8. Action Planning in Typically and Atypically Developing Children (Unilateral Cerebral Palsy)

    ERIC Educational Resources Information Center

    Craje, Celine; Aarts, Pauline; Nijhuis-van der Sanden, Maria; Steenbergen, Bert

    2010-01-01

    In the present study, we investigated the development of action planning in children with unilateral Cerebral Palsy (CP, aged 3-6 years, n = 24) and an age matched control group. To investigate action planning, participants performed a sequential movement task. They had to grasp an object (a wooden play sword) and place the sword in a hole in a…

  9. Comparison of the Electromyographic Activation Level and Unilateral Selectivity of Erector Spinae during Different Selected Movements

    ERIC Educational Resources Information Center

    Guo, Lan-Yuen; Wang, Yu-Lin; Huang, Yu-Han; Yang, Chich-Haung; Hou, Yi-You; Harn, Hans I-Chen; You, Yu-Lin

    2012-01-01

    For patients with scoliosis, core stabilization exercises may be beneficial in improving muscle strength and trunk dynamic control. However, few studies have examined whether the erector spinae (ES) activation status during unilateral spinal extensor strengthening meets the guideline for patients with spinal scoliosis. To determine ES activation…

  10. Mechanisms of Gait Asymmetry Due to Push-Off Deficiency in Unilateral Amputees.

    PubMed

    Adamczyk, Peter Gabriel; Kuo, Arthur D

    2015-09-01

    Unilateral lower-limb amputees exhibit asymmetry in many gait features, such as ground force, step time, step length, and joint mechanics. Although these asymmetries result from weak prosthetic-side push-off, there is no proven mechanistic explanation of how that impairment propagates to the rest of the body. We used a simple dynamic walking model to explore possible consequences of a unilateral impairment similar to that of a transtibial amputee. The model compensates for reduced push-off work from one leg by performing more work elsewhere, for example during the middle of stance by either or both legs. The model predicts several gait abnormalities, including slower forward velocity of the body center-of-mass during intact-side stance, greater energy dissipation in the intact side, and more positive work overall. We tested these predictions with data from unilateral transtibial amputees (N = 11) and nonamputee control subjects (N = 10) walking on an instrumented treadmill. We observed several predicted asymmetries, including forward velocity during stance phases and energy dissipation from the two limbs, as well as greater work overall. Secondary adaptations, such as to reduce discomfort, may exacerbate asymmetry, but these simple principles suggest that some asymmetry may be unavoidable in cases of unilateral limb loss.

  11. A unilateral twin extrauterine pregnancy occurring in a solitary fallopian tube: therapeutic choices.

    PubMed

    Awwad, J T; ElHajj, M; Usta, I; Nassar, A; Awwad, S T; Khalil, A

    2002-01-01

    A unilateral twin tubal pregnancy occurring in a solitary fallopian tube is presented. The gynecological history was notable for a previous extrauterine pregnancy in the contralateral fallopian tube and reconstructive surgery to the ipsilateral one. Radical total salpingectomy was performed. The rationale for this management is discussed and different therapeutic alternatives presented.

  12. Transient right-to-left shunting through a patent foramen ovale secondary to unilateral diaphragmatic paralysis.

    PubMed Central

    Cordero, P. J.; Morales, P.; Mora, V.; Cebrian, J.; Vallterra, J.; Gudin, J.; Benlloch, E.; Marco, V.

    1994-01-01

    A 57 year old patient presented with unilateral diaphragmatic paralysis and severe hypoxaemia secondary to transient right-to-left interatrial shunting through a patent foramen ovale. The final diagnosis was made because of the initial detection of a shunt while the patient was breathing 100% oxygen. Images PMID:7940438

  13. Amplification Considerations for Children With Minimal or Mild Bilateral Hearing Loss and Unilateral Hearing Loss

    PubMed Central

    McKay, Sarah; Gravel, Judith S.; Tharpe, Anne Marie

    2008-01-01

    Children with minimal or mild bilateral hearing loss and unilateral hearing loss are at higher risk for academic, speech-language, and social-emotional difficulties than their normal hearing peers. The choice to fit infants with moderate or greater degrees of bilateral hearing loss has been standard practice for most clinicians, but for those with minimal or mild bilateral hearing loss or unilateral hearing loss, the fitting of hearing technology must be based on limited data. Evidence does not yet exist to support all the management decisions that an audiologist must make upon identifying an infant with minimal or mild bilateral hearing loss or unilateral hearing loss. It is not yet known which children are at the greatest risk for educational problems nor is it known if the provision of early amplification in this population will help a child avoid later difficulties. Some of these considerations and current hearing technology options for children with minimal or mild bilateral hearing loss or unilateral hearing loss are reviewed in this article. PMID:18270178

  14. 36 CFR 223.235 - Unilateral delay, suspension, or modification of contracts, permits, or other instruments...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Unilateral delay, suspension, or modification of contracts, permits, or other instruments authorizing the sale of special forest products. 223.235 Section 223.235 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT...

  15. 36 CFR 223.235 - Unilateral delay, suspension, or modification of contracts, permits, or other instruments...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Unilateral delay, suspension, or modification of contracts, permits, or other instruments authorizing the sale of special forest products. 223.235 Section 223.235 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT...

  16. 36 CFR 223.235 - Unilateral delay, suspension, or modification of contracts, permits, or other instruments...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Unilateral delay, suspension, or modification of contracts, permits, or other instruments authorizing the sale of special forest products. 223.235 Section 223.235 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT...

  17. 36 CFR 223.235 - Unilateral delay, suspension, or modification of contracts, permits, or other instruments...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 2 2013-07-01 2013-07-01 false Unilateral delay, suspension, or modification of contracts, permits, or other instruments authorizing the sale of special forest products. 223.235 Section 223.235 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT...

  18. 36 CFR 223.235 - Unilateral delay, suspension, or modification of contracts, permits, or other instruments...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 2 2012-07-01 2012-07-01 false Unilateral delay, suspension, or modification of contracts, permits, or other instruments authorizing the sale of special forest products. 223.235 Section 223.235 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT...

  19. Topographical memory impairments after unilateral lesions of the anterior thalamus and contralateral inferotemporal cortex.

    PubMed

    Ridley, R M; Baker, H F; Mills, D A; Green, M E; Cummings, R M

    2004-01-01

    Monkeys with crossed unilateral excitotoxic lesions of the anterior thalamus and unilateral inferotemporal cortex ablation were severely impaired at learning two tasks which required the integration of information about the appearance of objects and their positions in space. The lesioned monkeys were also impaired at learning a spatial task and a task which required the integration of information about the appearance of objects and the background on which the objects were situated. Monkeys with only one of the unilateral lesions were not impaired and previous work has shown that monkeys with bilateral lesions of the anterior thalamus were not impaired on these tasks. These results indicate that the whole of the inferotemporal cortex-anterior thalamic circuit, which passes via the hippocampus, fornix, mamillary bodies and mamillothalamic tract, is essential for the topographical analysis of information about specific objects in different positions in space. Together with previous work, the results show that a unilateral lesion may affect cognition in the presence of other brain damage when an equivalent bilateral lesion alone does not. The tasks required the slow acquisition of information into long term memory and therefore assessed semantic knowledge although other research has shown impairment on topographical processing within working or episodic memory following lesions of the hippocampal-diencephalic circuit. It is argued that the hippocampal-diencephalic circuit does not have a role in a specific form of memory such as episodic memory but rather is involved in topographical analysis of the environment in perception and across all types of declarative memory.

  20. TRPV1 channel-mediated bilateral allodynia induced by unilateral masseter muscle inflammation in rats

    PubMed Central

    2013-01-01

    Pain in masticatory muscles is among the most prominent symptoms of temperomandibular disorders (TMDs) that have diverse and complex etiology. A common complaint of TMD is that unilateral pain of craniofacial muscle can cause a widespread of bilateral pain sensation, although the underlying mechanism remains unknown. To investigate whether unilateral inflammation of masseter muscle can cause a bilateral allodynia, we generated masseter muscle inflammation induced by unilateral injection of complete Freund’s adjuvant (CFA) in rats, and measured the bilateral head withdrawal threshold at different time points using a von Frey anesthesiometer. After behavioral assessment, both right and left trigeminal ganglia (TRG) were dissected and examined for histopathology and transient receptor potential vanilloid 1 (TRPV1) mRNA expression using quantitative real-time PCR analysis. A significant increase in TRPV1 mRNA expression occurred in TRG ipsilateral to CFA injected masseter muscle, whereas no significant alteration in TRPV1 occurred in the contralateral TRG. Interestingly, central injection of TRPV1 antagonist 5-iodoresiniferatoxin into the hippocampus significantly attenuated the head withdrawal response of both CFA injected and non-CFA injected contralateral masseter muscle. Our findings show that unilateral inflammation of masseter muscle is capable of inducing bilateral allodynia in rats. Upregulation of TRPV1 at the TRG level is due to nociception caused by inflammation, whereas contralateral nocifensive behavior in masticatory muscle nociception is likely mediated by central TRPV1, pointing to the involvement of altered information processing in higher centers. PMID:24377488

  1. Isolated Unilateral Tongue Atrophy: A Possible Late Complication of Juxta Cephalic Radiation Therapy.

    PubMed

    Alqahtani, Saeed A; Agha, Caroline; Rothstein, Ted

    2016-01-01

    BACKGROUND Isolated unilateral hypoglossal nerve injury is extremely rare. It may be caused by radiation therapy targeting neoplasms of the cephalic region. CASE REPORT A 51-year-old man with synovial sarcoma of the left upper arm status post extensive radiation therapy in 1980 presented in late 2014 with gradual onset of speech difficulty and difficulty moving his tongue for a couple of weeks. Neurological examination revealed isolated left-sided unilateral tongue atrophy. Postradiation residual extensive cicatrix with erythema over the whole left upper extremity extending to the neck on the affected side was noticed. On head magnetic resonance imaging (MRI) before and after administration of gadolinium, he was found to have asymmetrically fatty striations, atrophy, and fibrosis in the left tongue consistent with radiation toxicity. The patient's tongue weakness persisted without improvement. CONCLUSIONS The diagnosis of unilateral hypoglossal nerve injury is usually difficult. Detailed neurological examinations and thorough investigations including head MRI are very helpful. Previous exposure to radiation therapy is a potential cause of hypoglossal nerve injury. To our knowledge, this is the first case report that presents isolated unilateral tongue atrophy as a late complication of juxta cephalic radiation therapy. PMID:27458010

  2. Unilateral cochlear implantation in children with a potentially useable contralateral ear.

    PubMed

    Sadadcharam, M; Warner, L; Henderson, L; Brown, N; Bruce, I A

    2016-04-01

    Increasingly, children are considered for a unilateral CI, even if the contralateral ear falls outside current audiological guidelines, especially if they are not considered to be reaching their educational potential. The primary aim was to investigate the benefit of unilateral CI in children currently outside UK [National Institute for Health and Care Excellence Technology Appraisal Guidance. 2009. Cochlear implants for children and adults with severe to profound deafness. NICE technology appraisal guidance [TAG166]. Available January 29, 2016 from http://www.nice.org.uk/ta166 ] audiological guidelines in the contralateral ear. The secondary aim was to measure compliance. A retrospective case review with standard demographic data was performed. Forty-seven children were identified as having received a unilateral CI with the contralateral ear falling outside of current UK audiological criteria. These children were allocated to two groups; with hearing between 50 and 70 dB, and 70 and 90 dB at 2 and 4 kHz in the contralateral ear, respectively. Categories of auditory performance (CAP) were assessed. Pre- and post-operative CAP scores demonstrated a statistically significant improvement in auditory perception. We would suggest that assessing candidacy in individual ears and subsequent unilateral CI, has given these children a benefit they may not otherwise have acquired if they only had bilateral hearing aid.

  3. [Antegrade unilateral perfusion of the brain through the brachiocephalic trunk in operations on the aortic arch].

    PubMed

    Kozlov, B N; Panfilov, D S; Kuznetsov, M S; Ponomarenko, I V; Nasrashvili, G G; Shipulin, V M

    2016-01-01

    Presented herein is a technique of unilateral antegrade perfusion of the brain in operations on the aortic arch. The method makes it possible to perform both systemic artificial circulation and adequate physiological perfusion of the brain, promoting minimization of the number of neurological complications. PMID:27100557

  4. The Course and Outcome of Unilateral Intracranial Arteriopathy in 79 Children with Ischaemic Stroke

    ERIC Educational Resources Information Center

    Braun, K. P. J.; Bulder, M. M. M.; Chabrier, S.; Kirkham, F. J.; Uiterwaal, C. S. P.; Tardieu, M.; Sebire, G.

    2009-01-01

    Arteriopathies are the commonest cause of arterial ischaemic stroke (AIS) in children. Repeated vascular imaging in children with AIS demonstrated the existence of a "transient cerebral arteriopathy" (TCA), characterized by lenticulostriate infarction due to non-progressive unilateral arterial disease affecting the supraclinoid internal carotid…

  5. Unilateral cleft lip and palate: Simultaneous early repair of the nose, anterior palate and lip

    PubMed Central

    Laberge, Louise Caouette

    2007-01-01

    Unilateral cleft lip and palate is a defect involving the lip, nose and maxilla. These structures are inter-related, and simultaneous early correction of all the aspects of the defect is necessary to obtain a satisfactory result that will be maintained with growth. The surgical technique combining various procedures is presented and compared with previously published reports. PMID:19554125

  6. 12 CFR 950.11 - Capital stock requirements; unilateral redemption of excess stock.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Capital stock requirements; unilateral redemption of excess stock. 950.11 Section 950.11 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK ASSETS AND OFF-BALANCE SHEET ITEMS ADVANCES Advances to Members § 950.11 Capital...

  7. Look over There! Unilateral Gaze Increases Geographical Memory of the 50 United States

    ERIC Educational Resources Information Center

    Propper, Ruth E.; Brunye, Tad T.; Christman, Stephen D.; Januszewskia, Ashley

    2012-01-01

    Based on their specialized processing abilities, the left and right hemispheres of the brain may not contribute equally to recall of general world knowledge. US college students recalled the verbal names and spatial locations of the 50 US states while sustaining leftward or rightward unilateral gaze, a procedure that selectively activates the…

  8. Reliability of a Unilateral Horizontal Leg Power Test to Assess Stretch Load Tolerance

    ERIC Educational Resources Information Center

    Simpson, Rhianna Parker; Cronin, John

    2006-01-01

    Drop jumping has previously been used to measure fast stretch shorten cycle (SSC) ability and stretch load tolerance. To the knowledge of these authors a test does not exist to achieve this in the horizontal direction. The purpose of this study therefore was to estimate the reliability of a new unilateral horizontal leg power test to assess these…

  9. Unilateral oculomotor nerve palsy as an initial presentation of bilateral chronic subdural hematoma: case report.

    PubMed

    Matsuda, Ryosuke; Hironaka, Yasuo; Kawai, Hisashi; Park, Young-Su; Taoka, Toshiaki; Nakase, Hiroyuki

    2013-01-01

    Isolated oculomotor nerve palsy is well known as a symptom of microvascular infarction and intracranial aneurysm, but unilateral oculomotor nerve palsy as an initial manifestation of chronic subdural hematoma (CSDH) is a rare clinical condition. We report a rare case of an 84-year-old woman with bilateral CSDH who presented with unilateral oculomotor nerve palsy as the initial symptom. The patient, who had a medical history of minor head injury 3 weeks prior, presented with left ptosis, diplopia, and vomiting. She had taken an antiplatelet drug for lacunar cerebral infarction. Computed tomography (CT) of the head showed bilateral CSDH with a slight midline shift to the left side. She underwent an urgent evacuation through bilateral frontal burr holes. Magnetic resonance angiography (MRA) after evacuation revealed no intracranial aneurysms, but constructive interference in steady-state (CISS) magnetic resonance imaging (MRI) revealed that the left posterior cerebral artery (PCA) ran much more anteriorly and inferiorly compared with the right PCA and the left oculomotor nerve passed very closely between the left PCA and the left superior cerebellar artery (SCA). There is the possibility that the strong compression to the left uncus, the left PCA, and the left SCA due to the bilateral CSDH resulted in left oculomotor nerve palsy with an initial manifestation without unconsciousness. Unilateral oculomotor nerve palsy as an initial presentation caused by bilateral CSDH without unconsciousness is a rare clinical condition, but this situation is very important as a differential diagnosis of unilateral oculomotor nerve palsy.

  10. Language-specific dysgraphia in Korean patients with right brain stroke: influence of unilateral spatial neglect.

    PubMed

    Jang, Dae-Hyun; Kim, Min-Wook; Park, Kyoung Ha; Lee, Jae Woo

    2015-03-01

    The purpose of the present study was to investigate the relationship between Korean language-specific dysgraphia and unilateral spatial neglect in 31 right brain stroke patients. All patients were tested for writing errors in spontaneous writing, dictation, and copying tests. The dysgraphia was classified into visuospatial omission, visuospatial destruction, syllabic tilting, stroke omission, stroke addition, and stroke tilting. Twenty-three (77.4%) of the 31 patients made dysgraphia and 18 (58.1%) demonstrated unilateral spatial neglect. The visuospatial omission was the most common dysgraphia followed by stroke addition and omission errors. The highest number of errors was made in the copying and the least was in the spontaneous writing test. Patients with unilateral spatial neglect made a significantly higher number of dysgraphia in the copying test than those without. We identified specific dysgraphia features such as a right side space omission and a vertical stroke addition in Korean right brain stroke patients. In conclusion, unilateral spatial neglect influences copy writing system of Korean language in patients with right brain stroke. PMID:25729257

  11. Levels of Processing with Free and Cued Recall and Unilateral Temporal Lobe Epilepsy

    ERIC Educational Resources Information Center

    Lespinet-Najib, Veronique; N'Kaoua, Bernard; Sauzeon, Helene; Bresson, Christel; Rougier, Alain; Claverie, Bernard

    2004-01-01

    This study investigates the role of the temporal lobes in levels-of-processing tasks (phonetic and semantic encoding) according to the nature of recall tasks (free and cued recall). These tasks were administered to 48 patients with unilateral temporal epilepsy (right ''RTLE''=24; left ''LTLE''=24) and a normal group (n=24). The results indicated…

  12. Single-Sided Deafness Leads to Unilateral Aural Preference within an Early Sensitive Period

    ERIC Educational Resources Information Center

    Kral, Andrej; Hubka, Peter; Heid, Silvia; Tillein, Jochen

    2013-01-01

    Unilateral deafness has a high incidence in children. In addition to children who are born without hearing in one ear, children with bilateral deafness are frequently equipped only with one cochlear implant, leaving the other ear deaf. The present study investigates the effects of such single-sided deafness during development in the congenitally…

  13. Gaze Behaviour during Interception in Children with Spastic Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    van Kampen, P. M.; Ledebt, A.; Smorenburg, A. R. P.; Vermeulen, R. J.; Kelder, M. E.; van der Kamp, J.; Savelsbergh, G. J. P.

    2012-01-01

    Anticipatory gaze behaviour during interceptive movements was investigated in children with Spastic Unilateral Cerebral Palsy (SUCP), and related to the side of the intracerebral lesion. Five children with lesions of the right hemisphere (RHL) and five children with lesions of the left hemisphere (LHL) had to walk towards and intercept a ball that…

  14. [Acute unilateral deafness and contralateral hearing loss following inguinal hernia repair under controlled anesthesia].

    PubMed

    Constantinidis, J; Mertzlufft, F; Steinhart, H

    1999-10-01

    Acute hearing loss following non-otologic surgery and general anesthesia is a rare occurrence. Deafness following anesthesia has more commonly been associated with spinal anesthesia or cardiopulmonary bypass surgical procedures. We present a case with unilateral cochlear dysfunction and sensorineural hearing loss after inguinal hernia operation. The literature is reviewed and the mechanisms causing hearing loss during anesthesia are discussed.

  15. Unilateral canine crossbite correction in adults using the Invisalign method: a case report.

    PubMed

    Giancotti, Aldo; Mampieri, Gianluca

    2012-01-01

    The aim of this paper is to present and debate the treatment of a unilateral canine crossbite using clear aligners (Invisalign). The possibility of combining partial fixed appliances with removable elastics to optimize the final outcome is also described. The advantages of protected movement, due to the presence of the aligners, to jump the occlusion during crossbite correction is also highlighted.

  16. Language-specific dysgraphia in Korean patients with right brain stroke: influence of unilateral spatial neglect.

    PubMed

    Jang, Dae-Hyun; Kim, Min-Wook; Park, Kyoung Ha; Lee, Jae Woo

    2015-03-01

    The purpose of the present study was to investigate the relationship between Korean language-specific dysgraphia and unilateral spatial neglect in 31 right brain stroke patients. All patients were tested for writing errors in spontaneous writing, dictation, and copying tests. The dysgraphia was classified into visuospatial omission, visuospatial destruction, syllabic tilting, stroke omission, stroke addition, and stroke tilting. Twenty-three (77.4%) of the 31 patients made dysgraphia and 18 (58.1%) demonstrated unilateral spatial neglect. The visuospatial omission was the most common dysgraphia followed by stroke addition and omission errors. The highest number of errors was made in the copying and the least was in the spontaneous writing test. Patients with unilateral spatial neglect made a significantly higher number of dysgraphia in the copying test than those without. We identified specific dysgraphia features such as a right side space omission and a vertical stroke addition in Korean right brain stroke patients. In conclusion, unilateral spatial neglect influences copy writing system of Korean language in patients with right brain stroke.

  17. Mechanisms of Gait Asymmetry Due to Push-off Deficiency in Unilateral Amputees

    PubMed Central

    Adamczyk, Peter Gabriel; Kuo, Arthur D.

    2015-01-01

    Unilateral lower-limb amputees exhibit asymmetry in many gait features, such as ground force, step time, step length, and joint mechanics. Although these asymmetries result from weak prosthetic-side push-off, there is no proven mechanistic explanation of how that impairment propagates to the rest of the body. We used a simple dynamic walking model to explore possible consequences of a unilateral impairment similar to that of a transtibial amputee. The model compensates for reduced push-off work from one leg by performing more work elsewhere, for example during the middle of stance by either or both legs. The model predicts several gait abnormalities, including slower forward velocity of the body center-of-mass (COM) during intact-side stance, greater energy dissipation in the intact side, and more positive work overall. We tested these predictions with data from unilateral transtibial amputees (N = 11) and non-amputee control subjects (N = 10) walking on an instrumented treadmill. We observed several predicted asymmetries, including forward velocity during stance phases and energy dissipation from the two limbs, as well as greater work overall. Secondary adaptations, such as to reduce discomfort, may exacerbate asymmetry, but these simple principles suggest that some asymmetry may be unavoidable in cases of unilateral limb loss. PMID:25222950

  18. [Tumors of different histological type in unilateral salivary glands: a case report].

    PubMed

    Zhao, Da-Min; He, Hua-Wei; Liu, Mei-Yan; He, Zhi-Xiu

    2010-12-01

    Tumors of synchronous benign and malignant in unilateral salivary glands have rarely been reported. A case of 21-year-old girl who was diagnosed as synchronously adenoid cystic carcinoma of the left parotid and pleomorphic adenoma of the left submandibular gland. The classification, clinic pathology, diagnosis, possible mechanism were discussed based on similar literatures.

  19. Mode 2 fracture mechanics

    NASA Technical Reports Server (NTRS)

    Buzzard, Robert J.; Ghosn, Louis

    1988-01-01

    Current development of high-performance rolling element bearings for aircraft engines (up to 3 million DN, where DN is the product of shaft diameter in millimeters and speed in revolutions per minute) has aroused concern about fatigue crack growth in the inner bearing race that leads to catastrophic failure of the bearing and the engine. A failure sequence was postulated by Srawley, and an analytical program was undertaken to simulate fatigue crack propagation in the inner raceway of such a bearing. A fatigue specimen was developed at NASA by which fatigue data may be obtained relative to the cracking problems. The specimen may be used to obtain either mode 2 data alone or a combination of mixed-mode (1 and 2) data as well and was calibrated in this regard. Mixed-mode fracture data for M-50 bearing steel are presented, and a method for performing reversed-loading tests is described.

  20. Cerberus Fossae Fractures

    NASA Technical Reports Server (NTRS)

    2003-01-01

    [figure removed for brevity, see original site]

    Released 29 October 2003

    The fractured surface of the Cerberus region southeast of the Elysium volcanoes provides an impressive example of the powerful tectonic forces that have shaped the region. Both the smooth lava plains and the mountains that poke through the lava are subject to the extensional forces that rip open the landscape. The fractures are radial to the Elysium complex, suggesting a relationship to the volcanic processes that have built it.

    Image information: VIS instrument. Latitude 8.6, Longitude 160.6 East (199.4 West). 19 meter/pixel resolution.

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

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