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Tears
Kinds of Tears Terms modified by Tears Selected AbstractsCase Report of Cardiac Arrest, Abdominal Compartment Syndrome, and Thoracic Aortic Injury with Endovascular Repair of Thoracic Aortic TearJOURNAL OF CARDIAC SURGERY, Issue 4 2007Randy M. Stevens M.D. Currently, endografts are not FDA-approved for treating thoracic aortic injury (TAI). We report a case of TAI who presented in hemorrhagic shock and preoperative cardiac arrest who was successfully treated with large volume resuscitation, closed chest cardiac massage, exploratory laparotomy, and thoracic endografting. [source] Distinguishing Between Damage to Clothing as a Result of Normal Wear and Tear or as a Result of Deliberate Damage: A Sexual Assault Case StudyJOURNAL OF FORENSIC SCIENCES, Issue 2 2009Dyan J. Daly Ph.D. Abstract:, This paper focuses on bra damage, specifically damage observed in hook and eye fasteners that are generally located at the backstraps of bras. We describe bra design including the method by which hook and eye fasteners are generally constructed. We assess bra damage in two situations where the damage observed was unexpected given the case scenarios. These were: (i) the complainant of an alleged rape attributed damage to her bra hooks to force during a struggle and (ii) the complainant had earlier manipulated her bra hooks in an incident not related to her complaint. Steriomicroscopy and reconstruction experimentation were necessarily used to assess the bra damage. A systematic approach to damage analysis was employed by the forensic practitioners to correctly identify damage as being a result of mechanical manipulation and therefore as falsified. This paper suggests that more examples of falsified damage should be documented. [source] Urinary Bladder Herniation through a Vaginal Tear in a Rottweiller with DystociaJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 3 2000DACVECC, Deborah C. Mandell VMD Summary A four-year old female Rottweiler presented with a 34-hour history of dystocia. Physical examination revealed a purple-black, fluid-filled sac protruding from vulva and suspended by a similar colored stalk. Digital vaginal examination indicated that the stalk of tissue extended up into the cervix and beyond. Due to the grossly necrotic appearance, the stalk of tissue was ligated, and the sac was removed. Three puppies were delivered vaginally, but a subsequent caesarian section was required due to uterine inertia likely secondary to exhaustion. Three more live puppies were delivered via the c-section. Further abdominal exploration revealed a tear in the left vaginal wall, one ligated ureter, and the second ureter free at its distal end and leaking urine into the abdomen. The surgical findings indicated that the bladder, ureters, and urethra had herniated through the vaginal tear and prolapsed through the vulva. [source] Sonography of the rotator cuff in painful shoulders performed without knowledge of clinical information: Results from 58 sonographic examinations with surgical correlationJOURNAL OF CLINICAL ULTRASOUND, Issue 1 2007Stefan Moosmayer MD Abstract Purpose. To assess the value of sonography as an isolated diagnostic test for the detection and quantification of rotator cuff tears. Methods. Preoperative sonographic examination was performed on 58 shoulders. Key biases on sonographic interpretation such as history-taking, physical examination, or concurrent imaging examinations were excluded by way of blinding. Tears of the rotator cuff were the positive findings of interest. Assessment of tear size and localization was done sonographically, and the results were compared with operative findings. Results. All 24 full-thickness tears observed at surgery had been diagnosed correctly via sonography. In 19 of 20 cases with an intact rotator cuff, preoperative sonography was negative. Thirteen of 14 partial-thickness tears were not detected via sonography; 1 was misinterpreted as a full-thickness tear. Location of the tears relative to the rotator cuff tendons was described correctly in 21 of 25 cases. For tear size measurement, the 95% range of agreement was less than ±1 cm. Conclusions. Blinded sonographic examination is effective in the detection and quantification of full-thickness tears of the rotator cuff but lacks sensitivity in the detection of partial-thickness tears. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound 2007 [source] Cytokines, matrix metalloproteases, angiogenic and growth factors in tears of normal subjects and vernal keratoconjunctivitis patientsALLERGY, Issue 5 2009A. Leonardi Background:, To detect the presence of multiple mediators and growth factors in tears of vernal keratoconjunctivitis (VKC) patients with active disease using stationary phase antibody arrays. Methods:, Tears were collected from 12 normal subjects (CT) and 24 active VKC patients. Tears were centrifuged and successively probed using three microwell plate arrays specific for: (i) cytokines: interleukin (IL)-2, IL-4, IL-5, IL-8, IL-10, IL-12, IL-13, interferon-, and tumour necrosis factor-,; (ii) growth factors: basic fibroblast growth factor (bFGF), platelet-derived growth factor, thrombopoietin, angiopoietin-2, vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), keratocyte growth factor, tissue inhibitor of metalloprotease (TIMP)-1 and heparin-binding epithelial growth factor (HB-EGF) and (iii) matrix metalloprotease (MMP)-1, MMP-2, MMP-3, MMP-8, MMP-9, MMP-10, MMP-13, TIMP-1 and TIMP-2. Results:, Interleukin-8 signals were detected in all CT and highly detected in all VKC samples. The Th2-type cytokines, IL-4, IL-5 and IL-10 were detected only in tears of VKC patients. Signals for bFGF, HB-EGF, VEGF and HGF were detected in 41,87% of VKC samples and in few CT samples. Only TIMP-1 and TIMP-2 were found in all normal and patient tear samples, whereas MMP-1, MMP-2, MMP-3, MMP-9 and MMP-10 were highly present in all VKC samples. Conclusions:, Stationary phase antibody array methodology was useful for the screening of various cytokines, growth factors and MMPs in tears. These analyses identified in tears of VKC patients previously unreported factors including MMP-3 and MMP-10 and multiple proteases, growth factors and cytokines, which may all play an important role in the pathogenesis of conjunctival inflammation. [source] Ultrasound assessment of large joint amyloidosis in haemodialysisNEPHROLOGY, Issue 1-2 2000Marc Lanteri SUMMARY: Dialysis-related amyloidosis (DRA), associated with beta-2 microglobulin deposition, is a common cause of morbidity in patients with renal failure undergoing chronic dialysis. The non-invasive diagnosis of DRA in its early stages is difficult. High resolution ultrasound (US) was used to examine the shoulder, hip and knee joints of 25 chronic haemodialysis patients, and features distinctive of DRA were determined. Distinctive US features were associated with increased total duration of dialysis (15 ± 5 vs 4 ± 2 years), carpal tunnel syndrome (9/10 cases) and shoulder joint discomfort (19 vs three joints). These features include altered rotator cuff echogenicity (hyperechoic and hypoechoic areas; 20/48 joints), hypoechoic material in the biceps sheath (16/48), erosions of bone (15/48) and reduced biceps tendon fibril echogenicity (12/48). These changes are unique in the experience of the current authors, but histological proof that they are definitely the result of DRA has not yet been possible. Tears of the rotator cuff tendons (14/50) were not consistently associated with symptoms (7/14). Tendon thickness was also increased (as has been described previously). The hip capsule thickness was increased in patients with signs of DRA in the shoulder, but no specific changes in texture were seen. Asymptomatic knee joint effusions were present in 40/50 joints (80%). These features detectable on high resolution US allow the non-invasive early detection of DRA and are useful in the diagnosis and management of this condition. [source] Monica's Tears: Augustine on Words and SpeechNEW BLACKFRIARS, Issue 980 2002Janet Martin Soskice First page of article [source] Proteomic analysis of rabbit tear fluid: Defensin levels after an experimental corneal wound are correlated to wound closurePROTEINS: STRUCTURE, FUNCTION AND BIOINFORMATICS, Issue 17 2007Lei Zhou Abstract The cornea is the major refracting optical element of the eye and therefore critical for forming a retinal image. The exposed surface of the eye is protected from pathogens by the innate immune system whose components include defensins, naturally occurring peptides with antimicrobial properties, and the physical barrier formed by the outer epithelial layer of the cornea. The proteomic approach has revealed that tear levels of defensins are correlated with the course of healing of an experimental corneal wound. Tears were collected from New Zealand White rabbits prior to (day 0) and daily for 5 days (days 1,5) following a standard unilateral 6,mm diameter corneal epithelial abrasion. Tear protein profiles obtained from wounded and contra-lateral control eyes were compared using SELDI ProteinChip technology. Peptides and proteins of interest were purified by RP-HPLC and characterized by nanoESI-MS/MS. Mass spectra of tears on post-wound day 1, revealed 13,peaks whose level decreased and five that increased. During wound healing the tear protein profile correlated with wound closure. An important finding was that the levels of rabbit defensins (NP-1 and NP-2), which were elevated after wounding returned to normal levels by the time the corneal abrasion healed. Relative quantification of NP-2 in tear fluid prior to (day 0) and after corneal wounding (days 1, 3) was determined using iTRAQ technology. A corneal wound eliminates the barrier function of innate immunity and puts the cornea at risk from microbial attack until the epithelial cells restore the surface barrier. The increased availability of defensins in the tears during healing suggests that these peptides could protect the cornea from microbial attack during a period of increased vulnerability. [source] Jacob's Tears: The Priestly Work of Reconciliation.THE HEYTHROP JOURNAL, Issue 6 2009By Mary Douglas No abstract is available for this article. [source] Propagation of Tears in Pericardium From Young Bulls: Influence of the SutureARTIFICIAL ORGANS, Issue 3 2010José María García Páez Abstract The tearing of the collagen fibers of biological materials utilized in implants or bioprostheses is an important, and sometimes early cause of the failure of these devices. We studied the force necessary to propagate a tear in a biomaterial, pericardium from young bulls, and the influence of the suture. An Elmendorf pendulum capable of measuring the force necessary to tear a given length of tissue was employed. We analyzed 112 trials (70%) that proved valid after achieving the homogeneity of the samples according to their thickness, thus making the results comparable. Mean forces ranging between 19.87 and 150 N were required to propagate tears measuring from 0.25 to 2.0 cm. In the samples with a 1-cm-long suture, sewn using an edge-to-edge technique, the propagation of the tear required a mean force of 15.75 N when the suture was made of nylon and 28.73 N when Prolene was utilized. When these results were compared with the mean recorded in an unsutured control series (56.76 N), the loss of resistance was significant in both sutured series (P = 0.000 and P = 0.011, respectively). Finally, the equation that relates the force (y) with the length of the tear made in unsutured tissue (x) was also obtained: y = 58.14 + 9.62x2 (R2 = 0.924). The force necessary to produce a microtear, thus estimated, can be utilized as a parameter for comparison. [source] Muscle strain injuries of the hindlimb in eight horses: diagnostic imaging, management and outcomesAUSTRALIAN VETERINARY JOURNAL, Issue 8 2010EA Walmsley Objective To describe the clinical presentation, ultrasound findings, management and outcome in horses with muscle tear injuries of the hindlimbs. Design Retrospective case series Procedure Medical records of eight horses were reviewed and information on signalment, history, presenting complaint, physical examination findings and further diagnostic tests were recorded. Diagnosis of muscle injury was determined by the presence of abnormal ultrasound findings, compared with the contralateral limb, and, when required, nuclear scintigraphy. Follow-up information was obtained via telephone interviews with owners, trainers and referring veterinarians. Results Muscle tears causing lameness were identified in the middle gluteal (3), semitendinosus (1), semimembranosus (2) and gracilis (2) muscles. Tears were classified by ultrasound imaging as partial (6) or complete (2). The degree of lameness did not appear to be indicative of the extent of injury or of completion of healing. Long-term follow-up was available for seven horses and the outcome was favourable in six cases. Conclusions and clinical relevance Ultrasonography is useful in the diagnosis and assessment of moderate to severe muscle strain injuries. The prognosis appears to be favourable in most cases, although recurrence of injury and lameness can delay the return to athletic activity and an inferior outcome with persistent gait abnormality may occur. [source] Modulation of tear film protein secretion with phosphodiesterase inhibitorsCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2000Victoria Evans BOptom ABSTRACT A double-blind randomized clinical study was conducted to determine whether nicardipine hydrochloride was a useful treatment for dry eye. We examined its effect on the tear film, ocular surface and ocular comfort. Nicardipine hydrochloride, 3-isobutyl-1-methylxanthine and pilocarpine hydrochloride were dissolved in an artificial tear vehicle and applied topically to one eye of 12 subjects on separate days. Ocular physiology, ocular comfort and tear volume were assessed. The trial was repeated with nicardipine in an aqueous gel vehicle. Tears were collected and assessed for protein concentration and protein profile, using electrophoresis and mass spectrometry. Nicardipine induced conjunctival redness and symptoms of dryness and irritation. There was no change in total tear protein concentration or volume. An increase in a 68 kDa protein was observed, this was probably due to conjunctival vessel dilation and leakage of albumin. The adverse symptomatology and increased conjunctival redness experienced with nicardipine make it an undesirable treatment for dry eye. [source] The Risk of Intra-abdominal Injuries in Pediatric Patients with Stable Blunt Abdominal Trauma and Negative Abdominal Computed TomographyACADEMIC EMERGENCY MEDICINE, Issue 5 2010Jeffrey Hom MD Abstract Objectives:, This review examines the prevalence of intra-abdominal injuries (IAI) and the negative predictive value (NPV) of an abdominal computed tomography (CT) in children who present with blunt abdominal trauma. Methods:, MEDLINE, EMBASE, and Cochrane Library databases were searched. Studies were selected if they enrolled children with blunt abdominal trauma from the emergency department (ED) with significant mechanism of injury requiring an abdominal CT. The primary outcome measure was the rate of IAI in patients with negative initial abdominal CT. The secondary outcome measure was the number of laparotomies, angiographic embolizations, or repeat abdominal CTs in those with negative initial abdominal CTs. Results:, Three studies met the inclusion criteria, comprising a total of 2,596 patients. The overall rate of IAI after a negative abdominal CT was 0.19% (95% confidence interval [CI] = 0.08% to 0.44%). The overall NPV of abdominal CT was 99.8% (95% CI = 99.6% to 99.9%). There were five patients (0.19%, 95% CI = 0.08% to 0.45%) who required additional intervention despite their initial negative CTs: one therapeutic laparotomy for bowel rupture, one diagnostic laparotomy for mesenteric hematoma and serosal tear, and three repeat abdominal CTs (one splenic and two renal injuries). None of the patients in the latter group required surgery or blood transfusion. Conclusions:, The rate of IAI after blunt abdominal trauma with negative CT in children is low. Abdominal CT has a high NPV. The review shows that it might be safe to discharge a stable child home after a negative abdominal CT. ACADEMIC EMERGENCY MEDICINE 2010; 17:469,475 © 2010 by the Society for Academic Emergency Medicine [source] Workers in the New Economy: Transformation as Border CrossingETHOS, Issue 1 2006Valerie Walkerdine In this article, I seek to make an intervention in debates between psycho-logical and postmodern anthropology by engaging with the theme of border crossing. I argue that the theme of the border is one that fundamentally instantiates a separation between interior and exterior with respect to subjectivity, itself a funda-mental transformation and a painful and difficult border. This is related to a Cartesian distinction critiqued in this article. How the distinction between interior and exterior may be transcended is discussed in relation to examples of transformation from the crossing of class borders to the production and regulation of workers in a globalized and neoliberal economy. I begin with reference to postwar transformations of class with its anxious borders and go on to think about changes in the labor market and how these demand huge transformations that tear apart communities, destroy work-places, and sunder the sense of safety and stability that those gave. Advanced liberalism or neoliberalism brings with it a speeding up of the transformations of liberalism in which subjects are constantly invoked as self-contained, with a trans-portable self that must be produced through the developmental processes of personality and rationality. This self must be carried like a snail carries a shell. It must be coherent yet mutable, fixed yet multiple and flexible. But this view of the subject covers over the many connections that make subjectivity possible. I conclude by ask-ing what it would mean to rethink this issue of the production of safe spaces beyond an essentialist psychological conception of only one mother child space, separated from the social world, as having the power to produce feelings of safety? I end the article with an argument for a relational approach to subjectivity and sociality. [subjectivity, relationality, neoliberalism, workers, class] [source] Cemental tear: a case reportINTERNATIONAL ENDODONTIC JOURNAL, Issue 1 2006M. L. Stewart Abstract Aim, To report a case of a cemental tear. Summary, A case is reported of a patient with a history of trauma, root canal treatment and retreatment procedures to eliminate recurring sinus tracts. An exploratory surgery, extraction, and biopsy resulted in a diagnosis of cemental tear. Key learning points, ,,The detachment of a fragment of cementum is described as a cemental tear. ,,Cemental tears have been reported in the periodontal literature associated with localized, rapid periodontal breakdown. Common causative factors are aging and traumatic occlusion but the exact aetiology is unknown. ,,Trauma may be considered as a potential aetiologic factor for cemental tears in addition to occlusal traumatism and aging. [source] Risk of perineal damage is not a reason to discourage a sitting birthing position: a secondary analysisINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 5 2010A. De Jonge Summary Aim:, To examine the association between semi-sitting and sitting position at the time of birth and perineal damage amongst low-risk women in primary care. Background:, Evidence on the association between birthing positions and perineal trauma is not conclusive. Most studies did not distinguish between positions during the second stage of labour and position at the time of birth. Therefore, although birthing positions do not seem to affect the overall perineal trauma rate, an increase in trauma with upright position for birthing cannot be ruled out. Methods:, Secondary analysis was performed on data from a large trial. This trial was conducted amongst primary care midwifery practices in the Netherlands. A total of 1646 women were included who had a spontaneous, vaginal delivery. Perineal outcomes were compared between women in recumbent, semi-sitting and sitting position. Logistic regression analysis was used to examine the effects of these positions after controlling for other factors. Findings:, No significant differences were found in intact perineum rates between the position groups. Women in sitting position were less likely to have an episiotomy and more likely to have a perineal tear than women in recumbent position. After controlling for other factors, the odds ratios (OR) were 0.29 [95% confidence interval (CI): 0.16,0.54] and 1.83 (95% CI: 1.22,2.73) respectively. Women in semi-sitting position were more likely to have a labial tear than women in recumbent position (OR: 1.43, 95% CI: 1.00,2.04). Conclusion:, A semi-sitting or sitting birthing position does not need to be discouraged to prevent perineal damage. Women should be encouraged to use positions that are most comfortable to them. [source] Wool peptide derivatives for hand careINTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 1 2008C. Barba Hands experience much greater wear and tear during normal daily routines compared with most other parts of the body, and thereby demand specific needs from cosmetics targeted at hand care. Keratin proteins are the major structural component of the outer layers of the skin. In this work a novel keratin fraction from wool, which has high cystine content present in the S-sulphonated form, has been developed to target hand care applications. In vivo long-term studies were performed to evaluate the water-holding capacity and elasticity of hand skin following topical application of keratins. Moreover, protection of healthy skin against detergent-induced dermatitis was evaluated after topical application of the keratin-active formulation. Significant results in the measured biophysical parameters were found, which indicated an improvement in the skin's water-holding capacity, hydration, and elasticity for volunteers with dry skin as a result of the keratin peptide treatment. Results also indicated that the keratin peptide treatment can prevent some of the damaging effects associated with surfactant exposure. [source] Sonographic diagnosis of acute injuries of the ulnar collateral ligament of the metacarpophalangeal joint of the thumbJOURNAL OF CLINICAL ULTRASOUND, Issue 2 2007Takaaki Shinohara Abstract Purpose. To evaluate the significance of the ultrasonographic appearance of the aponeurosis for deciding the best treatment for ulnar collateral ligament (UCL) injuries of the thumb metacarpophalangeal joint. Methods. Fourteen patients (11 men, 3 women; mean age, 41 years; range, 15,66 years) who had an acute UCL tear were included. All patients were examined by ultrasonography (US) with a 7.5-MHz transducer and subsequently underwent surgery. The ultrasonographic findings were compared to the intraoperative findings. Results. UCL injuries were classified into two types by US according to the appearance of aponeurosis and its spatial relationship with the UCL: the intra-aponeurosis type (5 patients) and the extra-aponeurosis type (9 patients). In the 5 patients with intra-aponeurosis, ultrasonographic findings were well consistent with intraoperative findings. In contrast, extra-aponeurosis cases contained two different pathologies: of the 9 patients, 7 had so-called ,Stener lesions', one showed folding of a ruptured capsule, and one showed a ruptured aponeurosis. Conclusions. Because US is highly reliable in differentiating intra-aponeurosis from extra-aponeurosis types of injuries, the aponeurosis is a more reliable reference than Stener lesion for treatment decision by US. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound, 2007. [source] Sonography of the rotator cuff in painful shoulders performed without knowledge of clinical information: Results from 58 sonographic examinations with surgical correlationJOURNAL OF CLINICAL ULTRASOUND, Issue 1 2007Stefan Moosmayer MD Abstract Purpose. To assess the value of sonography as an isolated diagnostic test for the detection and quantification of rotator cuff tears. Methods. Preoperative sonographic examination was performed on 58 shoulders. Key biases on sonographic interpretation such as history-taking, physical examination, or concurrent imaging examinations were excluded by way of blinding. Tears of the rotator cuff were the positive findings of interest. Assessment of tear size and localization was done sonographically, and the results were compared with operative findings. Results. All 24 full-thickness tears observed at surgery had been diagnosed correctly via sonography. In 19 of 20 cases with an intact rotator cuff, preoperative sonography was negative. Thirteen of 14 partial-thickness tears were not detected via sonography; 1 was misinterpreted as a full-thickness tear. Location of the tears relative to the rotator cuff tendons was described correctly in 21 of 25 cases. For tear size measurement, the 95% range of agreement was less than ±1 cm. Conclusions. Blinded sonographic examination is effective in the detection and quantification of full-thickness tears of the rotator cuff but lacks sensitivity in the detection of partial-thickness tears. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound 2007 [source] Sonography of the shoulder after arthrography (arthrosonography): Preliminary resultsJOURNAL OF CLINICAL ULTRASOUND, Issue 1 2002Hak Soo Lee MD Abstract Purpose The purpose of this study was to verify whether arthrosonography improves diagnostic accuracy in diseases of the shoulder and provides additional information for therapeutic planning, compared with conventional sonography. Methods We prospectively studied 113 consecutive patients with chronic shoulder pain. Sonography was performed before and after arthrography, with the radiologist blinded to the results of arthrography. When a rotator cuff tear was detected sonographically, its type, location, and size were recorded; we also evaluated any changes in the subacromial-subdeltoid bursa and any abnormalities in the biceps tendon sheath. The diagnostic accuracy of conventional sonography and arthrosonography was compared with that of arthrography for rotator cuff tear. Changes in the subacromial-subdeltoid bursa and biceps tendon sheath seen on conventional sonography were also compared with those seen on arthrosonography. Results The sensitivity and specificity of conventional sonography in the diagnosis of rotator cuff tear were 86% (25/29) and 95% (80/84), respectively; for arthrosonography, the values were 97% (28/29) and 95% (80/84), respectively. The differences in sensitivity and specificity for the 2 sonographic techniques were not statistically significant (p > 0.05). The accuracy in localizing the tear was also not significantly different between the 2 sonographic techniques. Synovial proliferation was more easily detected with arthrosonography than it was with conventional sonography in the subacromial-subdeltoid bursa (p < 0.01) and in the biceps tendon sheath (p < 0.0001). Conclusions Our preliminary results suggest that although arthrosonography was not superior to conventional sonography in the diagnosis of rotator cuff tears, it may provide a better assessment of the size of tears and additional information about synovial proliferation in the subacromial-subdeltoid bursa and the biceps tendon sheath. © 2002 John Wiley & Sons, Inc. J Clin Ultrasound 30:23,32, 2002. [source] Perineal-Vaginal Injuries in Children: Accident or Abuse?JOURNAL OF FORENSIC SCIENCES, Issue 4 2010Claudia Liuzzi M.D. Abstract:, A large number of conditions have been mistaken for abuse. Differentiating accidental injuries from inflicted injuries is important in the management of injured children. In this work, the authors describe two cases of accidental perineal-vaginal injury in children. In case 1, a 4-year-old girl suffered a vaginal tear caused by violent stretching during play; in case 2, a 3-year-old girl had minor lacerations of labia minora and majora. The intervention of a multi-specialist team including a forensic pathologist and forensic psychiatrist was the key factor in being able to exclude abuse by third parties in the described cases.. This leads to the appropriate recommendations to be adopted in the forensic medicine setting. [source] Medial meniscus posterior root attachment injury and degeneration: MRI findingsJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 4 2006AO Jones Summary The posterior root attachment of the medial meniscus is readily identifiable on MRI. Unless specifically reviewed, injuries involving this structure may be overlooked. Significant meniscal root pathology may cause functional incompetence of the meniscus, with consequent early onset cartilage degeneration and osteoarthritis. This review article emphasizes the importance of positive identification of an intact meniscal root and illustrates the known association of meniscal root injury or tear with medial extrusion of the medial meniscus by greater than 3 mm beyond the joint margin. [source] Perineal Trauma and Postpartum Perineal Morbidity in Asian and Non-Asian Primiparous Women Giving Birth in AustraliaJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 4 2008Hannah Dahlen ABSTRACT Objectives: To describe the postpartum perineal morbidity of primiparous women who had a vaginal birth and compare outcomes between Asian and non-Asian women in the first 2 days following the birth and at 6 and 12 weeks postpartum. Design: Data from a randomized clinical trial of a perineal management technique (perineal warm packs) were used to address the study objective. Setting: Two maternity hospitals in Sydney, Australia. Participants: Primiparous women who had a vaginal birth in the trial were included (n=697). One third of the women were identified as "Asian." Results: Compared with non-Asian women, Asian women were significantly more likely to have an episiotomy; require perineal suturing; sustain a third- or fourth-degree perineal tear; and report their perineal pain as being moderate to severe on day 1 following the birth. Asian women were less likely to give birth in an upright position or to resume sexual intercourse by 6 or 12 weeks following the birth. Conclusion: More research is needed into methods that could reduce the high rates of perineal trauma experienced by Asian women, and midwives need to be able to offer appropriate support for Asian women. [source] Expression of interleukin-1,, cyclooxygenase-2, and prostaglandin E2 in a rotator cuff tear in rabbitsJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 1 2007Hiroshi Koshima Abstract We investigated the specific factors related to shoulder pain due to a rotator cuff tear using a model in rabbits. A rotator cuff tear was surgically created, and the expression of interleukin-1, (IL-1,), prostaglandin E2 (PGE2), and cyclooxygenase-2 (COX-2) was analyzed. In the supernatant of the tissue culture of the torn tendon, IL-1, production was detected. The amount of IL-1, was highest 1 day after injury, and then decreased gradually to 21 days. PGE2, the mediator of pain and the product of COX-2, was also detected in the supernatant of the tissue culture. The production of PGE2 significantly increased to 7 days after injury, and then decreased to 21 days. RT-PCR analysis confirmed the mRNA expression of IL-1, and COX-2 in the torn tendon. Immunohistochemical study demonstrated that cells in the tendon stump were immunopositive for IL-1, and COX-2. Furthermore, in the affected joint, articular chondrocytes in the remote area from the tear expressed COX-2 strongly. When the rotator cuff is torn, IL-1, is produced in the torn tendon, and stimulates the expression of COX-2 in not only the torn tendon but also in articular chondrocytes. The COX-2 then produces PGE2, which would mediate shoulder pain. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:92,97, 2007 [source] A pathomechanical concept explains muscle loss and fatty muscular changes following surgical tendon releaseJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2004Dominik C. Meyer Abstract Following tendon tear, the musculo-tendinous unit retracts permanently, looses muscle fibre volume and is infiltrated with fat. This is currently considered to be an unexplained degenerative process. In a sheep model of chronic tendon tear with delayed tendon repair (35 weeks after tendon release), we studied the nature of these muscle changes in eight experimental animals. At sacrifice (75 weeks after tendon release) the muscle had retracted by 1.7±0.5 cm (9% of entire length, P < 0.0001), the pennation angle had increased from 22±2.5° to 50±11° (P < 0.0001) and the mean muscle fibre length had shortened from 32±3 to 16±5 mm (50%, P < 0.0001). In electron and light microscopy, we found essentially normal muscle fibres with an unaltered fibre diameter and myofibrillar structure, while interstitial fat and fibrous tissue had increased from 3.9% to 45.9% (P < 0.0001) of the muscle volume. Geometric modelling showed that the increase of the pennation angle separates the muscle fibre bundles mechanically like limbs of a parallelogram. Infiltrating fat cells fill the created space between the reoriented muscle fibres which may be quantitatively calculated without affecting the structural properties of the muscle cells. Fatty infiltration is therefore not seen as a degenerative process but a necessary rearrangement of the tissue after macroarchitectural changes caused by musculo-tendinous retraction. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source] Tendon-defect and muscle-unloaded models for relating a rotator cuff tear to glenohumeral stabilityJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 6 2000Horng-Chaung Hsu Rotator cuff tear and glenohumeral instability are closely related. Any tear may disturb muscle force generation due to pain inhibition. In addition, a full-thickness tear may foster instability by removing a structural element constraining the joint. It was hypothesized that the loss of both dynamic force and static constraint with a rotator cuff tear will affect glenohumeral stability. In a tendon-defect model, dynamic and static elements of the joint were sacrificed. In a muscle-unloaded model, only the dynamic element was removed. The location and size of the defect were also investigated. The effect on instability of a small tendon defect was less than that of muscle unloading, implying that a patient with a small tear would have less instability than a patient with weak or nonfunctioning supraspinatus and infraspinatus muscles. On the other hand, with a larger tear the defect had a greater effect than muscle-unloading because sectioning of the glenohumeral and coracohumeral ligaments was included in the model. Clinically, such a defect in the front is critical for anterior stability because it might insult the important anterior capsule ligamentous complex. Orthopaedic surgeons should pay attention, therefore, to the effect of possible associated lesions of static constraints based on the size and location of the tear in addition to the dynamic stabilizer. [source] Diaphragmatic hernia in horses: 44 cases (1986,2006)JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 4 2009Samantha K. Hart BVMS (Hons) Abstract Objectives , To present a case series of horses diagnosed with diaphragmatic hernia, and to determine the significance of (1) historical information, examination findings, and laboratory data; and (2) exploratory laparotomy or necropsy findings on short- and long-term outcome. Setting , University Referral Hospital. Design , Retrospective study. Animals , Forty-four horses/foals admitted between 1986 and 2006 with a diagnosis of diaphragmatic hernia made either at exploratory laparotomy or necropsy. Interventions , None. Measurements and Main Results , Information from the medical records included history, clinical examination findings at presentation, and findings of exploratory laparotomy or necropsy. Logistic regression or the Fisher exact test was used to determine factors associated with survival. Outcome was defined as survival to discharge (short-term survival), and long-term survival was defined as horses alive at least 1-year post surgery. Of the 44 horses, 18 died or were euthanized before surgery. Twenty-six were taken to surgery, 17 were euthanized. Nine horses recovered from anesthesia, 7 of which survived to hospital discharge. Of these, 5 were alive at long-term follow-up. Survival was significantly associated with the age of the horse (,2 y old) at presentation, presence of normal peritoneal fluid at presentation, amount of compromised viscera at surgery (<50% small intestine), and the size (<10 cm) and location (ventral) of the diaphragmatic tear. Conclusion , This study confirms that size and location of the lesion do play a significant role in prognosis. And, although the prognosis for horses with diaphragmatic hernia is poor, if horses have operable lesions there is a fair prognosis for long-term survival. [source] Hemorrhagic bile pleuritis and peritonitis secondary to traumatic common bile duct rupture, diaphragmatic tear, and rupture of the spleen in a dogJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 6 2008Gordon D. Peddle VMD Abstract Objective, To describe the diagnosis and successful treatment of bile pleuritis and peritonitis secondary to traumatic rupture of the common bile duct and a diaphragmatic tear in a young dog. Case Summary, A 1-year-old German Shepherd dog was referred for evaluation of vomiting and icterus 4 days after being hit by a car. Thoracic radiographs, thoracic and abdominal ultrasonographic examinations, thoraco- and abdominocentesis, and positive contrast celiogram indicated hemorrhagic pleuritis and peritonitis, left dorsal diaphragmatic tear, and rupture and infarct of the spleen. Surgical exploration of the abdomen confirmed these findings in addition to a circumferential tear of the common bile duct, leading to a diagnosis of hemorrhagic bile pleuritis and peritonitis. Aerobic and anaerobic bacterial culture of the abdominal fluid yielded no growth. Surgical correction of the traumatic injuries was achieved via common bile duct anastomosis, cholecystojejunostomy, repair of the diaphragm, and splenectomy. The dog developed postoperative signs consistent with aspiration pneumonia but was successfully treated and discharged from the hospital. Clinical signs and laboratory abnormalities resolved and the dog was alive and healthy 8 months after discharge. New or Unique Information Provided, Bile pleuritis is rare in dogs and cats and is usually associated with penetrating, not blunt, abdominal trauma. Multiple organ injury in cases of traumatic bile duct rupture is uncommon; in this dog, rupture of the common bile duct was accompanied by rupture of the diaphragm and spleen. [source] Urinary Bladder Herniation through a Vaginal Tear in a Rottweiller with DystociaJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 3 2000DACVECC, Deborah C. Mandell VMD Summary A four-year old female Rottweiler presented with a 34-hour history of dystocia. Physical examination revealed a purple-black, fluid-filled sac protruding from vulva and suspended by a similar colored stalk. Digital vaginal examination indicated that the stalk of tissue extended up into the cervix and beyond. Due to the grossly necrotic appearance, the stalk of tissue was ligated, and the sac was removed. Three puppies were delivered vaginally, but a subsequent caesarian section was required due to uterine inertia likely secondary to exhaustion. Three more live puppies were delivered via the c-section. Further abdominal exploration revealed a tear in the left vaginal wall, one ligated ureter, and the second ureter free at its distal end and leaking urine into the abdomen. The surgical findings indicated that the bladder, ureters, and urethra had herniated through the vaginal tear and prolapsed through the vulva. [source] Measuring Knowledge Stocks: A Process of Creative DestructionKYKLOS INTERNATIONAL REVIEW OF SOCIAL SCIENCES, Issue 3 2005Jürgen Bitzer Summary This paper proposes a new method for constructing R&D capital stocks developed to avoid the common assumption of a constant rate of knowledge depreciation, which implies wear and tear of knowledge. The method models the development of R&D capital stocks as a process of creative destruction linking the depreciation of knowledge to the emergence of new knowledge. A first empirical assessment of the new method , measuring the influence of R&D capital stocks on production in the manufacturing sectors of 12 OECD countries , produces plausible and robust results. [source] | ||||||||||||||||||||||||||||||||||||||||