scholarly journals A PROSPECTIVE ANALYSIS OF GUSTILLO-ANDERSON OPEN TYPE II AND TYPE III TIBIAL DIAPHYSEAL FRACTURES OF AO TYPE 42C1 AND 42C2; THAT WERE SURGICALLY INTERVENED UPON.

2021 ◽  
pp. 1-8
Author(s):  
Umale Rushikesh Hari ◽  
R K Guhan ◽  
Janhavi Thanigaivelu ◽  
Venkatachalam. K
Keyword(s):  
Tibial Fracture ◽  
Tibial Fractures ◽  
Soft Tissue Coverage ◽  
Type Ii ◽  
Open Type ◽  
Type Iii ◽  
Bone Trauma ◽  
Diaphyseal Fractures ◽  
The Mean ◽  
Poor Outcomes

Introduction: Segmental tibial fracture is characterized, as a distinguished kind of fracture type. They are portrayed by at least, two distinctive fracture lines, with a totally separate, inter-calary osseous section, either with intact cortical tubular or as a comminuted segment. AO type 42 C1 and C2 fractures of the tibia are generally, brought about by a high- velocity RTA. They have a high “taux de” of complications. AO type 42 C1 and C2 tibial fractures are considered, as a discrete clinico-surgical bone trauma and are in deep contrast, with the other variants of tibial fractures. Aim: To analyze the functional outcome of Gustillo- Anderson open type II and type III Tibial Diaphyseal fractures of AO Type 42C1 and 42C2; that were surgically intervened upon. Materials and Methods: 62 adult patients in the age bracket of 26-55 years having Gustillo-Anderson open type II and type III Tibial Diaphyseal fractures of AO Type 42C1 and 42C2, were surgically intervened in the form of reamed IMIL nailing. Results: We achieved 62.36% Excellent, 13.98% Good, 15.05% Fair and 4.84% Poor outcomes calculated by the mean of mean scores of Johner AND Wruhs Criteria, Modified Knee Society Score, Yokoyama Criteria scores. Conclusion: This study concludes that Gustillo- Anderson open type II and type III Tibial Diaphyseal fractures of AO Type 42C1 and 42C2 can be managed satisfactorily with IMIL nailing without the need of external fixator application, provided appropriate soft tissue coverage is given at the appropriate time.

scholarly journals Types of Lens Structure in Intumescent Cataract

2018 ◽  
Vol 15 (2S) ◽  
pp. 153-159
Author(s):  
E. S. Pirogova ◽  
O. L. Fabrikantov ◽  
S. I. Nikolashin
Keyword(s):  
Irrigation System ◽  
Anterior Segment ◽  
Type I ◽  
Type Ii ◽  
Large White ◽  
Type Iii ◽  
Associated Diseases ◽  
Type Iv ◽  
The Mean ◽  
Anatomical Parameters

Purpose: to study the structure of the swelling lens, the dependence of its anatomical parameters on the nucleus sizes and density, patients’ age.Patients and methods. 52 patients with intumescent mature cataract were examined. All patients underwent phacoemulsification with a two-stage continuous circular capsulorhexis. After the 2–2.5 mm capsulorhexis had been created, the liquid lenticular masses were removed from the anterior and posterior lens compartment with the aspiration/irrigation system. Visually we determined the size of the nucleus, its color and density according to Buratto’s classification.Results. When performing this work 4 types of the swelling lens structure were revealed. Type I — a small emerging white nucleus with large amount of liquid lenticular masses in the anterior and posterior lens compartment, II degree of density according to Buratto’s classification. The mean age was 49.09 ± 3.19 years old. The related ophthalmic diseases accounted for 36.4%. Type II — a large white nucleus with the presence of liquefied lenticular masses in the anterior and posterior lens compartment. III degree of density according to Buratto’s classification. The mean age was 71.00 ± 1.92 years old. Associated diseases — 84.6%. Type III — a large brown nucleus with the presence of liquefied lenticular masses in the anterior and posterior lens compartment. IV degree of density according to Buratto’s classification. The mean age was 75.84 ± 1.46 years old. Associated diseases — 100%. Type IV — a small, very dense, brown nucleus with liquid lenticular masses. V degree of density according to Buratto’s classification. The mean age was 77.33 ± 2.49 years old. Associated diseases — 100%.Conclusion. 4 types of lens structure in intumescent cataract were described depending on the nucleus size, density, the amount of the lenticular masses. By means of UBM method, it was shown that intumescent cataract is accompanied with the alterations of the ocular anterior segment parameters, which depend on the type of lens structure. It was revealed that the types of swelling lens structure are directly connected to the patients’ age: mean age of patients with type I — 49.09 ± 3.19 years old, with type II — 71.00 ± 1.92, with type III — 75.84 ± 1.46, with type IV — 77.33 ± 2.49 years old. 

scholarly journals Failed Dermal Allograft Procedures for Irreparable Rotator Cuff Tears Can Still Improve Pain and Function: The “Biologic Tuberoplasty Effect”

2019 ◽  
Vol 7 (8) ◽  
pp. 232596711986343 ◽  
Author(s):  
Raffy Mirzayan ◽  
Michael A. Stone ◽  
Michael Batech ◽  
Daniel C. Acevedo ◽  
Anshuman Singh
Keyword(s):  
Rotator Cuff ◽  
Clinical Improvement ◽  
Rotator Cuff Tears ◽  
Type I ◽  
Type Ii ◽  
Bone Contact ◽  
Type Iii ◽  
Goutallier Classification ◽  
Functional Scores ◽  
The Mean

Background:Acellular dermal matrices (ADMs) have been used in the treatment of shoulders with massive rotator cuff tears (MRCTs). Despite clinical improvement, correlation of clinical findings with ADM integrity on imaging has not been investigated.Hypothesis:The pain in shoulders with MRCTs is partially due to bone-to-bone contact between the tuberosity and acromion. Coverage of the tuberosity with an intact graft or a graft that is torn in a way that the tuberosity remains covered will act as an interpositional tissue, preventing bone-to-bone contact and leading to clinical improvement.Study Design:Case series; Level of evidence, 4.Methods:Between 2006 and 2016, a total of 25 shoulders with MRCTs underwent a procedure with an ADM. Pre- and postoperative visual analog scale (VAS) results, American Shoulder and Elbow Surgeons (ASES) score, Hamada grade, and Goutallier classification were reviewed. A postoperative magnetic resonance imaging (MRI) was obtained in 22 (88%) shoulders. The status of the graft was divided into the following categories: type I, intact graft; type II, graft tear with tuberosity covered; and type III, graft tear with tuberosity uncovered (bare).Results:The mean patient age was 61 years (range, 49-73 years), and the mean follow-up was 25.6 months (range, 10-80 months). Mean length from surgery to postoperative MRI was 13.9 months (range, 6-80 months). The graft was torn in 59% (13/22 shoulders). Significant improvements were found in VAS and ASES scores (7 vs 0.7 and 32.6 vs 91.2, respectively; P < .01) for type I grafts and in VAS and ASES scores (8.1 vs 1.3 and 26.3 vs 84.6, respectively; P < .01) for type II grafts. No difference was found in postoperative VAS and ASES (0.7 vs 1.3 and 91.2 vs 84.6, respectively; P = .8) between type I and type II grafts. No improvement was seen in VAS (7.3 vs 5.7; P = .2) or ASES (30.6 vs 37.2; P = .5) for type III grafts.Conclusion:MRI appearance of the graft has a significant impact on functional outcomes. Patients with an intact graft or a graft tear leaving the tuberosity covered have lower pain and higher functional scores than those in whom the torn graft leaves the tuberosity uncovered.

scholarly journals Infectious Complications of Open Type III Tibial Fractures among Combat Casualties

2007 ◽  
Vol 45 (4) ◽  
pp. 409-415 ◽  
Author(s):  
E. N. Johnson ◽  
T. C. Burns ◽  
R. A. Hayda ◽  
D. R. Hospenthal ◽  
C. K. Murray
Keyword(s):  
Infectious Complications ◽  
Tibial Fractures ◽  
Open Type ◽  
Type Iii ◽  
Combat Casualties

scholarly journals Role of Bishop–Koop Procedure for Jejunal and Proximal Ileal Atresia

2020 ◽  
Vol 8 (4) ◽  
pp. 31
Author(s):  
Anand Pandey ◽  
Gurmeet Singh ◽  
Gaurav Shandilya ◽  
Archika Gupta ◽  
Jiledar Rawat ◽  
...  
Keyword(s):  
Complication Rate ◽  
Adverse Outcomes ◽  
Proximal Segment ◽  
Type Ii ◽  
Ileal Atresia ◽  
Type Iii ◽  
Jejunoileal Atresia ◽  
Operation Techniques ◽  
The Mean ◽  
Medical University

Background: This study was undertaken to review the Bishop–Koop procedure as a treatment option with a grossly dilated proximal segment in jejunal and proximal ileal atresia.Materials and Methods: This was a retrospective cohort study conducted from January 2012 to June 2018 in the Department of Pediatric Surgery at King George's Medical University, Lucknow, India. The outcome, complication rate, and the follow-up study for postoperative adverse outcomes were assessed.Results: Thirty-two neonates underwent Bishop–Koop procedure. The mean age at presentation was 4.37  2.3 days. The male (n=22) to female (n=10) ratio was 2.2:1. Sixteeen had jejunal (type II-9, type III- 7), and 16 (type II-6, type III-10) had proximal ileal atresia. The mean duration of the hospital stay was 13.03  5.7 days. Oral feeds were initiated by the 7th postoperative day. In our study, the complication rate was 31.25% (n=10) and mortality rate was 37.5% (n=12).Conclusions: Bishop–Koop procedure appears to be a technically efficient method in desperate cases of jejunoileal atresia with a grossly dilated proximal segment, although more extensive studies may be needed to compare Bishop–Koop procedure and other operation techniques.

The development of lampbrush chromosome-type transcription in the early diplotene oocytes of Xenopus laevis: an electron-microscope analysis

1980 ◽  
Vol 44 (1) ◽  
pp. 87-101
Author(s):  
R.S. Hill ◽  
H.C. Macgregor
Keyword(s):  
Linear Regression ◽  
Xenopus Laevis ◽  
Linear Regression Analysis ◽  
Transcription Unit ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Significant Difference ◽  
Germinal Vesicles ◽  
The Mean

Oocytes of Xenopus laevis in pachytene and early diplotene of meiosis have been studied using the Miller spreading technique. Transcription first appears in germinal vesicles 25–40 micrometers in diameter, when the oocyte is in early diplotene. Transcription at this stage consists of arrays of short RNP transcripts, irregularly distributed along the DNP axis. Linear regression analysis has shown that many of these arrays are transcription units (Type I) with the transcripts having a common point of origin. The lengths of these early transcription units (mean = 7.06 +/− 5.06 micrometers), calculated from the linear regression data, are comparable to the lengths of transcription units from later stages, including Dumont stage 3. The polymerase granules of Type I transcription units are widely and irregularly spaced, having a mean spacing of 505 +/− 748 nm. More advanced transcription units (Type II, mean length = 8.72 +/− 3.77 micrometer) are usually found in the same chromosome set as the Type I units. Type II transcription units have closer and more regularly spaced polymerase granules than Type I transcription units (mean spacing = 92 +/− 49 nm). Both Type I and II transcription units have comparatively short RNP transcripts, the mean values for the slopes of their regression lines being 0.1336 and 0.1440 respectively. By the time the germinal vesicles are about 50–60 micrometers in diameter the transcription units have a quite different morphology (Type III). The lengths of the Type III transcription units are comparable to the Type I and II units, the mean length being 6.34 +/− 4.03 micrometers. The spacing of the polymerase granules in the Type III units is closer and more regular than the earlier stages (70 +/− 40 nm). Another significant difference between Type III and Types I and II transcription units is a decrease in the foreshortening of the Type III RNP transcripts. The mean slope of the regression lines for Type III transcription units is 0.2439. The morphological appearance of the Type III transcription unit is virtually identical to that of the transcription units from Dumont stage 3 oocytes, both with respect to the length and the spacing of the polymerase granules. However, the transcripts in Type III transcription units are still more foreshortened than those of Dumont stage 3 oocytes, having mean regression slopes of 0.4728. From the data obtained in the present study, it has been concluded that the pattern of lampbrush-type transcription is virtually fully established by the time most germinal vesicles are about 50 micrometers in diameter.

Functional outcomes of tympanoplasty surgery

2016 ◽  
Vol 70 (6) ◽  
pp. 12-19 ◽  
Author(s):  
Izabela Matuszewska ◽  
Paweł Burduk ◽  
Wojciech Kaźmierczak ◽  
Joanna Janiak-Kiszka
Keyword(s):  
Functional Outcomes ◽  
Pure Tone Audiometry ◽  
Type I ◽  
Type Ii ◽  
Hearing Improvement ◽  
Type Iii ◽  
Type Iv ◽  
Ossicular Replacement ◽  
The Mean ◽  
Replacement Prosthesis

Objective: We reviewed functional outcomes of tympanoplasty. Study design: The results of tympanoplastic surgery are changing in time. We present late treatment outcomes among different types of tympanoplasty. Methods: Eighty-six patients who underwent tympanoplasty were enrolled in the study. The results of pure tone audiometry performed 7 days before, then at 3 months, 1 year, and 3 years after the surgery were assessed. Type II tympanoplasty involved implantation of a partial ossicular replacement prosthesis and type III tympanoplasty involved reconstruction with a total ossicular replacement prosthesis and the use of autogenous homogenous material. Statistical analysis was performed. Results: With all four types of tympanoplasty, hearing improvement was achieved at 3 months and 1 year after surgery based on the magnitude of the mean ABG reduction (p<0.001). In patients who underwent type I, type III, and type IV tympanoplasty, the ABG reduction at 3 years after surgery was maintained at the level reported at 3 months and 1 year after surgery (p<0.001). In patients who underwent type II tympanoplasty, however, the mean ABG value was increased at all tested frequencies (p<0.05). The mean ABG values reported 3 years after type II and type III tympanoplasty were similar. Conclusions: Based on the results over time, hearing improvement seems to be less durable after reconstruction with the partial ossicular replacement prosthesis procedure compared to the total ossicular replacement prosthesis procedure.

scholarly journals Use of the AFX Stent Graft in Patients with Extremely Narrow Aortic Bifurcation: A Multicenter Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
M. U. Wagenhäuser ◽  
N. Floros ◽  
E. Nikitina ◽  
J. Mulorz ◽  
K. M. Balzer ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Patient Outcomes ◽  
Stent Graft ◽  
Patient Survival ◽  
Type Ii ◽  
Aortic Bifurcation ◽  
Type Iii ◽  
Kaplan Meier ◽  
The Mean

Introduction. This study analyzed the patient outcomes following endovascular aortic aneurysm repair (EVAR) for infrarenal aortic pathologies with very narrow aortic bifurcations using the AFX stent graft. Methods. The data was retrieved from the archived medical records of 35 patients treated for abdominal aortic aneurysm (AAA) (48.6%) or penetrating aortic ulcer (PAU) (51.4%) with very narrow aortic bifurcation between January 2013 and May 2020. Patient survival, freedom from endoleak (EL), and limb occlusion were estimated applying the Kaplan–Meier method. Results. The mean follow-up time was 20.4 ± 22.8 months. The mean aortic bifurcation diameter was 15.8 ± 2.2   mm . Technical success was 100%, and no procedure-related deaths occurred. Two type II ELs occurred within 30-day follow-up. We observed one common iliac artery stenosis at four months and one type III EL at 54 months in the same patient, both of which required re-intervention. Overall patient survival was 95 ± 5 % (AAA: 100%; PAU: 89 ± 10 % ), freedom from limb occlusion was 94 ± 5 % (AAA: 91 ± 9 % ; PAU: 100%), freedom from type II EL was 94 ± 4 % (AAA: 88 ± 8 % ; PAU: 100%), and freedom from EL type III was 83 ± 15 % (AAA: 80 ± 18 % ; PAU: 100%) at the end of the follow-up period. Conclusions. Very narrow aortic bifurcations may predispose patients to procedure-related complications following EVAR. Our results suggest a safe use of the AFX stent graft in such scenarios. The overall short- and long-term procedure-related patient outcomes are satisfying albeit they may seem superior for PAU when compared to AAA.

scholarly journals THE GLENOID NOTCH AND ITS CLINICAL IMPLICATIONS. La muesca glenoidea y sus implicaciones clínicas.

2017 ◽  
Vol 9 (1) ◽  
pp. 11-17 ◽  
Author(s):  
Abduelmenem Alashkham ◽  
Abdulrahman Alraddadi ◽  
Roger Soames
Keyword(s):  
Multivariate Analysis ◽  
Shoulder Dislocation ◽  
Glenohumeral Joint ◽  
Clinical Implications ◽  
Type I ◽  
Type Ii ◽  
Glenoid Fossa ◽  
Type Iii ◽  
The Mean ◽  
Las Mujeres

A notch is often observed on the anterosuperior aspect of the glenoid fossa, however its association with gender remains unexplored. The aims of this study were to: (i) investigate the incidence and type of glenoid notch, and (ii) its association with gender, age and side. A total of 140 shoulders from 30 male and 40 female cadavers were examined. All muscles and blood vessels surrounding the glenohumeral joint, as well as the fibrous capsule, were removed to expose the glenoid fossa: the presence of a notch was classified as type I (mild), type II (moderate) or type III (severe). The mean age of specimens was 81.5 years (±9.8 years). A type III notch was the most commonly observed (32 male, 21 female specimens), followed by type I (14 male, 34 female specimens) and finally type II (14 male, 25 female specimens). Multivariate analysis showed that the type of glenoid notch was significantly associated with gender (?2 (2, n=140) = 11.088, p = 0.004). Females are significantly more likely to have a type I or II glenoid notch, while males are significantly more likely to have a type III notch. This difference could explain the higher incidence of shoulder dislocation in males compared to females.  A menudo se observa una muesca en el lado anterosuperior de la fosa glenoidea, sin embargo su relación con el sexo sigue siendo inexplorada. Los objetivos de este estudio fueron: (i) investigar la incidencia y el tipo de muesca glenoidea, y (ii) su relación con el sexo, la edad y el lado en el que se observa. Se examinaron un total de 140 hombros de entre 30 cadáveres masculinos y 40 femeninos. Todos los músculos y vasos sanguíneos que rodean la articulación glenohumeral, así como la cápsula fibrosa, fueron retirados para permitir el acceso a la fosa glenoidea: la presencia de la muesca fue clasificada como tipo I (leve), tipo II (moderado) o tipo III (grave). La edad media de los especímenes examinados fue de 81,5 años (± 9,8 años). La muesca de tipo III fue la más comúnmente observada (32 varones, 21 hembras), seguida por la muesca de tipo I (14 varones, 34 hembras) y finalmente seguida de la de tipo II (14 varones, 25 hembras). El análisis multivariado mostró que el tipo de muesca glenoidea está significativamente relacionado con el sexo (?2 (2, n = 140) = 11.088, p = 0.004). Las mujeres son significativamente más propensas a presentar una muesca glenoidea de tipo I o II, mientras que los varones son significativamente más propensos a presentar una muesca de tipo III. Esta diferencia podría explicar la mayor incidencia de luxación de hombro que se produce en los varones en comparación con la que se produce en las mujeres. 

Effort and the Forced Expiratory Volume in One Second (FEV1)

1970 ◽  
Vol 39 (6) ◽  
pp. 747-755 ◽  
Author(s):  
J. R. Kemm ◽  
P. L. Kamburoff
Keyword(s):  
Healthy Subjects ◽  
Forced Expiratory Volume ◽  
The Body ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Significant Difference ◽  
Maximum Effort ◽  
The Mean ◽  
The Relationship

1. The relationship between volumes expired and the maximum intrathoracic pressures developed within the first second of expiration was examined in a group of healthy subjects and patients with airways obstruction who exhaled with varying degrees of effort. 2. The body plethysmographic method was used to ensure that expirations started from total lung capacity. 3. Three different types of volume-effort curves could be distinguished: Type I; in this the volume expired increased with greater effort. Type II; after a phase in which the volume expired increased with effort, a plateau was reached after which increasing effort made no difference to the volume expired. Type III; this resembles Type II except that instead of a plateau being established at maximum expired volume, increasing effort resulted in diminishing expired volume. Correction for the degree of compression of the intrathoracic gas failed to account for this phenomenon. Type III curves were found in healthy subjects as well as in patients. 4. In most cases the maximum Forced Expiratory Volume in 1 s (FEV1) was not found to coincide with the maximum oesophageal pressure (Poes), nor was there a significant difference between the mean and the maximum FEV1 produced with an effort greater than 75% of maximum. 5. Blowing ‘half as hard’ is an unnatural procedure; all subjects tend to blow nearly as hard as possible or very gently. In the latter case, the resulting FEV1 tracing is easily recognizable as technically unsatisfactory. 6. We conclude that for practical purposes, measurements of FEV1 depend for their reliability upon ensuring that they are started from full inspiration; insistence upon maximum effort is less important because FEV1 is independent of effort for the greater part of the effort range.

scholarly journals Functional Outcome of Open Tibial Fracture Using Illizarov Apparatus

2021 ◽  
pp. 62-65
Author(s):  
Abhishek Choukse
Keyword(s):  
Soft Tissue ◽  
Functional Outcome ◽  
Tibial Fracture ◽  
Tibial Fractures ◽  
Wound Complications ◽  
Soft Tissue Coverage ◽  
Hybrid Technique ◽  
Open Tibial Fracture ◽  
Ring Fixator ◽  
Ilizarov Ring Fixator

The better treatment for tibial fractures are very vague and difficult. Since the tibia is covered by soft tissue coverage fixing of plate becomes very difficult as it creates wound complications, mainly in case of severe fractures.In this study of 20 cases of open communited fractures of tibia with the Ilizarov ring fixator hybrid technique was used, it was found that this technique has a major advantages in treatment and management of the tibial fracture.

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