342 research outputs found

    Distal posterior tibial artery perforator flaps for the management of calcaneal and Achilles tendon injuries in diabetic and non-diabetic patients

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    Management of Achilles tendon and heel area defects is a common challenge for the reconstructive surgeon due to the lack of soft tissue availability in that region. In this article, we present our experience in covering these defects by using the distal perforator propeller flaps based on the posterior tibial artery. Perforator flaps are based on cutaneous, small diameter vessels that originate from a main pedicle and perforate the fascia or muscle to reach the skin. Their development has followed the understanding of the blood supply from a source artery to the skin. Six patients (five males and one female) underwent reconstruction by using the posterior tibial artery distal perforator flap for covering defects in the distal Achilles tendon region in patients with and without diabetes mellitus. Postoperative complications included a hypertrophic scar formation in one patient, partial marginal flap necrosis in another patient, and a wound infection in a third patient. All wounds were eventually healed by the last postoperative visit. In conclusion, perforator flaps based on the distal posterior tibial artery may be a reliable option for the coverage of small to moderate size defects of the Achilles tendon and heel area regions

    Particle shape dependence in 2D granular media

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    Particle shape is a key to the space-filling and strength properties of granular matter. We consider a shape parameter η\eta describing the degree of distortion from a perfectly spherical shape. Encompassing most specific shape characteristics such as elongation, angularity and nonconvexity, η\eta is a low-order but generic parameter that we used in a numerical benchmark test for a systematic investigation of shape-dependence in sheared granular packings composed of particles of different shapes. We find that the shear strength is an increasing function of η\eta with nearly the same trend for all shapes, the differences appearing thus to be of second order compared to η\eta. We also observe a nontrivial behavior of packing fraction which, for all our simulated shapes, increases with η\eta from the random close packing fraction for disks, reaches a peak considerably higher than that for disks, and subsequently declines as η\eta is further increased. These findings suggest that a low-order description of particle shape accounts for the principal trends of packing fraction and shear strength. Hence, the effect of second-order shape parameters may be investigated by considering different shapes at the same level of η\eta.Comment: 5 pages, 8 figure

    Diffusion of 18 elements implanted into thermally grown SiO2

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    Diffusion data are presented for 18 elements implanted in SiO2 layers thermally grown on silicon and annealed at temperatures ranging from 300 to 1000degreesC. Most species studied, (e.g., Be, B, Al, Sc, Ti, V, Zn, Ga, and Mo), showed negligible diffusion over the examined temperature range. In general, this study has shown that the diffusivity of dopants or impurities in SiO2 is significantly smaller than that in silicon. However we also observed that several elements (e.g., Rb and In) have a higher diffusivity in SiO2 than in Si. Because Ga and In are both used as sources for focused ion beam analyses, the lack of Ga diffusion and the movement of In in SiO2 is of interest

    Dealing Automatically with Exceptions by Introducing Specificity in ASP

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    Answer Set Programming (ASP), via normal logic programs, is known as a suitable framework for default reasoning since it offers both a valid formal model and operational systems. However, in front of a real world knowledge representation problem, it is not easy to represent information in this framework. That is why the present article proposed to deal with this issue by generating in an automatic way the suitable normal logic program from a compact representation of the information. This is done by using a method, based on specificity, that has been developed for default logic and which is adapted here to ASP both in theoretical and practical points of view

    A Comparative Neuroanatomical Study of the Red Nucleus of the Cat, Macaque and Human

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    BACKGROUND:The human red nucleus (Nr) is comparatively less well-studied than that of cats or monkeys. Given the functional importance of reticular and midbrain structures in control of movement and locomotion as well as from an evolutionary perspective, we investigated the nature and extent of any differences in Nr projections to the olivary complex in quadrupedal and bipedal species. Using neuroanatomical tract-tracing techniques we developed a "neural sheet" hypothesis allowing us to propose how rubro-olivary relations differ among the three species. METHODS AND FINDINGS:Wheat germ agglutinin-horseradish peroxidase staining supports findings that the cat's nucleus accessories medialis of Bechtrew (NB) projects mainly to the lateral bend of the principal olive. We clarified boundaries among nucleus of Darkschewitsch (ND), NB and parvicellular red nucleus (pNr) of the cat's neural sheet. The macaque's ND-medial accessory olivary projection is rostro-caudally organized and the dorsomedial and ventrolateral parts of the macaque's pNr may project to the principal olive's rostral and caudal dorsal lamella; in cat it projects as well to pNr. Myelin- and Nissl-stained sections show that a well-developed dorsomedial part of the human Nr consists of densely packed cells, deriving small myelinated fibers that continue into the medial central tegmental tract. CONCLUSIONS:Based on these findings we suggest there are distinct bipedal-quadrupedal differences for Nr projections to the olivary complex. We propose the Nr of cats and monkeys comprise the ND, NB and pNr in a zonal sheet-like structure, retaining clear nuclear boundaries and an isolated, well-developed mNr. The human NB may be distinguished from its more specialised ND (ND lies alongside a well-developed pNr) in the human central gray. Phylogenetically, the NB may have been translocated into a roll-shaped Nr in the reticular formation, the dorsomedial portion of which might correspond to the cat's and monkey's NB

    Prevalent vertebral fractures among children initiating glucocorticoid therapy for the treatment of rheumatic disorders

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    Objective. Vertebral fractures are an under-recognized problem in children with inflammatory disorders. We studied spine health among 134 children (87 girls) with rheumatic conditions (median age 10 years) within 30 days of initiating glucocorticoid therapy. Methods. Children were categorized as follows: juvenile dermatomyositis (n = 30), juvenile idiopathic arthritis (n = 28), systemic lupus erythematosus and related conditions (n = 26), systemic arthritis (n = 22), systemic vasculitis (n = 16), and other conditions (n = 12). Thoracolumbar spine radiograph and dual x-ray absorptiometry for lumbar spine (L-spine) areal bone mineral density (BMD) were performed within 30 days of glucocorticoid initiation. Genant semiquantitative grading was used for vertebral morphometry. Second metacarpal morphometry was carried out on a hand radiograph. Clinical factors including disease and physical activity, calcium and vitamin D intake, cumulative glucocorticoid dose, underlying diagnosis, L-spine BMD Z score, and back pain were analyzed for association with vertebral fracture. Results. Thirteen vertebral fractures were noted in 9 children (7%). Of these, 6 patients had a single vertebral fracture and 3 had 2-3 fractures. Fractures were clustered in the mid-thoracic region (69%). Three vertebral fractures (23%) were moderate (grade 2); the others were mild (grade 1). For the entire cohort, mean ± SD L-spine BMD Z score was significantly different from zero (-0.55 ± 1.2, P \u3c 0.001) despite a mean height Z score that was similar to the healthy average (0.02 ± 1.0, P = 0.825). Back pain was highly associated with increased odds for fracture (odds ratio 10.6 [95% confidence interval 2.1-53.8], P = 0.004). Conclusion. In pediatric rheumatic conditions, vertebral fractures can be present prior to prolonged glucocorticoid exposure. © 2010, American College of Rheumatology
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