Search results for: anterior segment OCT

Authors: Ananya Hazare, Ranjit Kamble

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Introduction: Patients with Cleft lip and palate (CL/P) can present with a maxillary retrution after cleft repair. Anterior Maxillary distraction osteogenesis (AMD) is a technique that provides simultaneous skeletal advancement and expansion of the soft tissues related to an anterior segment of the maxilla. This case presented is a case of AMD. The advantage of this technique is that the occlusion in the posterior segment can be maintained, and only the segment in cross bite is advanced for correction of the midfacial deficiency. The other alternative treatment is anterior movement by a Lefort 1 osteotomy. When a Lefort 1 osteotomy is compared with the Distraction osteogenesis or AMD, the disadvantages of the Le Fort 1 include a higher risk of morbidity, requirement of fixation, relapse tendency and unexpected changes in the nasal form. These complications were eliminated by AMD technique. This was followed by placement of the implant in the bone formed after AMD. Hence complete surgical, orthodontic and prosthodontics rehabilitation of the patient was done by an interdisciplinary approach. Methods: Patient presented with repaired UCL/P of the right side with midfacial retrusion. Intro-oral examination revealed a good occlusion in the posterior arch and anterior Crossbite from canine to canine. Patient's both maxillary lateral incisors were missing. The lower arch was well aligned with all teeth present. The study models when scored according to GOSLON yardstick received a score of 4. After pre-surgical orthodontic phase was completed an intraoral distractor was fabricated by modification of HYRAX expansion screw. After surgery, low subapical osteotomy cuts were placed and the distractor was fixed. The latency period of 5 days was observed after which the distraction was started. Distraction was done at a rate of 1 mm/day with a rhythm of 0.5mm in morning and 0.5mm in the evening. The total distraction of 12 mm was done. After a consolidation period, the distractor was removed, and retention by a removable partial denture was given. Radiographic examination confirmed mature bone formation in the distracted segment. Implants were placed and allowed to osseointegrate for approximately 4 months and were then loaded with abutments. Results: Total distraction done was 12mm and after relapse it was 8mm. After consolidation phase the radiographic examination revealed a B2 quality of bone according to the Misch's classification and sufficient height from the maxillary sinus. These findings were indicative for placement of implants in the distracted bone formed in premolar region. Implants were placed and after radiographic evidence of osseointegration was seen they were loaded with abutments. Thus resulting in a complete rehabilitation of a cleft patient by an interdisciplinary approach. Conclusion: Anterior maxillary distraction can be used as an alternative method instead of complete distraction osteogenesis or Lefort 1 advancement of maxilla in cases where the advancement needed is minimum. Use of HYRAX expansion screw modified as intra-oral distractor can be used in such cases, which significantly reduces the cost of treatment, as expensive distractors are not used. This technique is very useful and efficient in countries like India where the patient cannot afford expensive treatment options.

Keywords: cleft lip and palate, distraction osteogenesis, anterior maxillary distraction, orthodontics and dentofacial orthopaedics, hyrax expansion screw modification

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Authors: Shinta Stri Ayuda Nur Setyaningsih

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Anterior uveitis is often triggered by viral infections such as herpes simplex virus (HSV) and cytomegalovirus (CMV). This study aims to provide an overview of the demographic and clinical characteristics of patients with anterior uveitis caused by CMV and HSV infection at PMN Cicendo Eye Hospital Bandung. This study used a retrospective observational method. Data were collected from the medical records of patients who visited the PMN Infection and Immunology Polyclinic at Cicendo Eye Hospital between February and July 2023. The results showed that anterior uveitis associated with HSV and CMV viruses often occurs in the elderly and more in women. The most common clinical symptoms are red eyes and decreased visual acuity, with a gradual onset of symptoms. Complications that often arise are cataracts and glaucoma. This study provides a deeper understanding of anterior uveitis caused by infection with HSV and CMV viruses.

Keywords: uveitis anterior, cytomegavirus, herpes simplex virus type I ELISA

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Authors: Sayyed Mostafa Ahmadi, Neda Raeesi

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Background and Objectives: Cervical spondylosis is a common problem that affects the adult spine and is the most common cause of radiculopathy and myelopathy in older patients. Anterior discectomy and fusion is a well-known technique in degenerative cervical disc disease. However, one of the late undesirable complications is adjacent disc degeneration, which affects about 91% of patients in ten years. Many factors can be effective in causing this complication, but some are still debatable. Discovering these risk factors and eliminating them can improve the quality of life. Methods: This is a retrospective cohort study. All patients who underwent anterior discectomy and fusion surgery in the neurosurgery ward of Imam Khomeini Hospital between 2013 and 2016 were evaluated. Their demographic information was collected. All patients were visited and examined for radiculopathy, myelopathy, and muscular force. At the same visit, all patients were asked to have a facelift, and neck profile, as well as a neck MRI(General Tesla 3). Preoperative graphs were used to measure the diameter of the cervical canal(Pavlov ratio) and to evaluate sagittal alignment(Cobb Angle). Preoperative MRI of patients was reviewed for anterior and posterior longitudinal ligament calcification. Result: In this study, 57 patients were studied. The mean age of patients was 50.63 years, and 49.1% were male. Only 3.5% of patients had anterior and posterior longitudinal ligament calcification. Symptomatic ASD was observed in 26.6%. The X-rays and MRIs showed evidence of 80.7% radiological ASD. Among patients who underwent one-level surgery, 20% had symptomatic ASD, but among patients who underwent two-level surgery, the rate of ASD was 50%.In other words, the higher the number of surfaces that are operated and fused, the higher the probability of symptomatic ASD(P-value <0.05). The X-rays and MRIs showed 80.7% of radiological ASD. Among patients who underwent surgery at one level, 78% had radiological ASD, and this number was 92% among patients who underwent two-level surgery(P-value> 0.05). Demographic variables such as age, sex, height, weight, and BMI did not have a significant effect on the incidence of radiological ASD(P-value> 0.05), but sex and height were two influential factors on symptomatic ASD(P-value <0.05). Other related variables such as family history, smoking and exercise also have no significant effect(P-value> 0.05). Radiographic variables such as Pavlov ratio and sagittal alignment were also unaffected by the incidence of radiological and symptomatic ASD(P-value> 0.05). The number of surgical surfaces and the incidence of anterior and posterior longitudinal ligament calcification before surgery also had no statistically significant effect(P-value> 0.05). In the study of the ability of the neck to move in different directions, none of these variables are statistically significant in the two groups with radiological and symptomatic ASD and the non-affected group(P-value> 0.05). Conclusion: According to the findings of this study, this disease is considered to be a multifactorial disease. The incidence of radiological ASD is much higher than symptomatic ASD (80.7% vs. 26.3%) and sex, height and number of fused surfaces are the only factors influencing the incidence of symptomatic ASD and no variable influences radiological ASD.

Keywords: risk factors, anterior neck disectomy and fusion, adjucent segment degeneration, complication

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Authors: Mohamed Salah El-Din Mahmoud, Ahmed Hamed, Asmaa Anwar Mohamed

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Purpose: To study the tear film parameters, total corneal thickness (CT), corneal epithelial thickness and, corneal power in Juvenile systemic lupus erythematosus (JSLE) patients compared to age-matched controls using anterior segment optical coherence tomography (AS-OCT). Methods: This was a cross-sectional study. Study participants were divided into 2 groups: Group A: 75 eyes of JSLE patients, Group B: 75 eyes of healthy controls. Tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus area (TMA) were the lower tear meniscus parameters that were measured. The corneal power, CT, and epithelial thickness were all determined automatically. Results: In the JSLE group, the range of age was 10 to 15 years while the control group was 11 to 16 years. TMH, TMA, and TMD were 527.7±46.8, 0.059±0.015 and 343.3±59.9 respectively in JSLE group while 525.4±44.6, 0.058±0.011 and 340.6±58.0 respectively in control group without significant difference (p-value<0.001). The corneal power was 43.3±0.55 in the JSLE while 43.2±0.54 in the control group without significant difference (p-value= 0.407). CT was 551.1±13.5 in JSLE group while 551.2±15.3 in control group without significant difference (p-value= 0.982). Epithelial thickness was 52.66±1.35 in the JSLE group while 52.60±1.36 in the control group without significant difference (p-value= 0.765). Conclusion: We demonstrated no significant difference in tear meniscus dimensions, CT, epithelial thickness, and corneal power in the JSLE patients compared to age-matched controls using AS-OCT.

Keywords: tear film, ASOCT, JSLE, pachymetry, corneal thickness

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Authors: Min Jee Lee, Young Sun Park, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Jae Ho Lee, Yoon Seon Lee, Kyung Soo Lim, Won Young Kim

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Background: Acute myocardial infarction (AMI) concomitant with acute aortic syndrome (AAS) is rare but prompt recognition of concomitant AAS is crucial, especially in patients with ST-segment elevation myocardial infarction (STEMI) because misdiagnosis with early thrombolytic or anticoagulant treatment may result in catastrophic consequences. Objectives: This study investigated the clinical features of patients of STEMI concomitant with AAS that may lead to the diagnostic clue. Method: Between 1 January 2010 and 31 December 2014, 22 patients who were the initial diagnosis of acute coronary syndrome (AMI and unstable angina) and AAS (aortic dissection, intramural hematoma and ruptured thoracic aneurysm) in our emergency department were reviewed. Among these, we excluded 10 patients who were transferred from other hospital and 4 patients with non-STEMI, leaving a total of 8 patients of STEMI concomitant with AAS for analysis. Result: The mean age of study patients was 57.5±16.31 years and five patients were Standford type A and three patients were type B aortic dissection. Six patients had ST-segment elevation in anterior leads and two patients had in inferior leads. Most of the patients had acute onset, severe chest pain but no patients had dissecting nature chest pain. Serum troponin I was elevated in three patients but all patients had D-dimer elevation. Aortic regurgitation or regional wall motion abnormality was founded in four patients. However, widened mediastinum was seen in all study patients. Conclusion: When patients with STEMI have elevated D-dimer and widened mediastinum, concomitant AAS may have to be suspected.

Keywords: aortic dissection, myocardial infarction, ST-segment, d-dimer

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Authors: Fumihiko Isada, Yuriko Isada

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The aim of this research is to clarify the difference by industry segment or product characteristics as regards organisation management for an open innovation to raise R&D performance. In particular, the trait of the pharmaceutical industry is defined in comparison with IT component industry segment. In considering open innovation, both inter-organisational relation and the management in an organisation are important issues. As methodology, a questionnaire was conducted. In conclusion, suitable organisation management according to the difference in industry segment or product characteristics became clear.

Keywords: empirical study, industry segment, open innovation, product-development organisation pattern

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Authors: Barbara Torres Rives

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Uveitis. Non-infectious anterior uveitis is a polygenic inflammatory eye disease, and it is suggested that mediated processes by the immune system (autoimmune or not) are the main mechanisms proposed in the pathogenesis of this type of uveitis. A relationship between infectious processes, digestive disorders, and a dysbiosis of the microbiome was recently described. In addition, alterations in the immune response associated with the initiation and progression of the disease have been described. Objective: The aim of this study was to identify factors related to the immune system associated with complicated non-infectious anterior uveitis. Methods: A cross-sectional observational analytical study was carried out. The universe consisted of all patients attending the ocular inflammation service of the Cuban Institute of Ophthalmology Ramón Pando Ferrer. The sample consisted of 213 patients diagnosed with non-infectious anterior uveitis. Results: Of the 213 patients with non-infectious anterior uveitis, the development of ophthalmologic complications predominated 56.3% (p=0.0094). In patients with complications was more frequent the presence of human leukocyte antigen-B27 allele (49.2%) (p<0.0001), decreased immunoglobulin G (24.2%, p=0.0124), increased immunoglobulin A (14.2%, p=0.0024), history of recurrent sepsis (59.2%, p=0.0018), recurrent respiratory infections (44.2%, p=0.0003), digestive alterations (40%, p=0.0013) and spondyloarthropathies (30%, p=0.0314). By logistic regression, it was observed that, for each completed year, the elevated risk for developing complicated non-infectious anterior uveitis in human leukocyte antigen-B27 allele positive patients (OR: 4.22, p=0.000), Conclusions: The control of recurrent sepsis at mucosal level and immunomodulation could prevent complications in non-infectious anterior uveitis. Therefore, the microbiome becomes the target of treatment and prevention of complications in non-infectious anterior uveitis.

Keywords: non-infectious anterior uveitis, immune system disorders, recurrent mucosal infections, microbiome

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Authors: Amir H. Bayat, Mohammad R. Alipour, Saeed Khamneh

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As the respiration via nose is important physiologically, many studies have been done about nasal breathing that switches to oronasal breathing during exercise. The aim of this study was to assess the role of anterior nasal resistance as one of the effective factors on this switching. Twelve young, healthy, non-athletic and non-smoker male volunteers with normal BMI were selected after physical examination and participated in exercise protocol, including measurement of the ventilation, work load and oronasal switching point (OSP) during exercise, and anterior rhinomanometry at rest. The protocol was an incremental exercise with 25 watt increase in work load per minute up to OSP occurrence. There was a significant negative correlation between resting total anterior nasal resistance with OSP, work load and ventilation (p<0.05, r= -0.709). Resting total anterior nasal resistance can be considered as an important factor on OSP occurrence. So, the reducing the resistance of nasal passage may increase nasal respiration tolerance for longer time during exercise.

Keywords: anterior nasal resistance, exercise, OSP, ventilation, work load

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Authors: P. Panwalkar, K. Veravalli, M. Tofighi, A. Mofidi

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Introduction: Anterior femoral perforation or distal anterior nail position is a known complication of femoral nailing specifically in pertrochantric fractures fixed with cephalomedullary nail. This has been attributed to wrong entry point for the femoral nail, nail with large radius of curvature or malreduced fracture. Left alone anterior perforation of femur or abutment of nail on anterior femur will result in pain and risk stress riser at distal femur and periprosthetic fracture. There have been multiple techniques described to avert or correct this problem ranging from using different nail, entry point change, poller screw to deflect the nail position, use of shorter nail or use of curved guidewire or change of nail to ensure a nail with large radius of curvature Methods: We present this technique which we have used in order to centralise the femoral nail either when the nail has been put anteriorly or when the guide wire has been inserted too anteriorly prior to the insertion of the nail. This technique requires the use of femoral reduction spool from the nailing set. This technique was used by eight trainees of different level of experience under supervision. Results: This technique was easily reproducible without any learning curve without a need for opening of fracture site or change in the entry point with three different femoral nailing sets in twenty-five cases. The process took less than 10 minutes even when revising a malpositioned femoral nail. Conclusion: Our technique of using femoral reduction spool is easily reproducible and repeatable technique for avoidance of non-centralised femoral nail insertion and distal anterior perforation of femoral nail.

Keywords: femoral fracture, nailing, malposition, surgery

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Authors: Reza Hedayati, Meysam Jahanbakhshi

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The typical airplane stabilizer structures consist of two main similar segments (outer and inner parts), one of them a little larger than the other. In this study, bird impact on four different spots of the stabilizer structure: (a) between two ribs of smaller segment, (b) between two ribs of larger segment, (c) on the rib connecting the two segments, and (d) on a middle rib of the smaller segment, is investigated and their results are compared by means of energy absorption, displacement, and bird’s mass diagrams as well as visible damage induced on the stabilizer structure.

Keywords: airplane, bird strike, LS-DYNA, stabilizer

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Authors: A. B. Robert, Adam Pramadia, Calvin Andika

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The main purpose of this study is to explore consumer loyalty characteristic of mobile phone category in Indonesia. Second, this research attempts to identify consumer segment and to explore their profile in each segment as the basis of marketing strategy formulation. This study used some tools of multivariate analysis such as discriminant analysis and cluster analysis. Discriminate analysis used to discriminate consumer loyal and not loyal by using particular variables. Cluster analysis used to reveal various segment in mobile phone category. In addition to having better customer understanding in each segment, this study used descriptive analysis and cross tab analysis in each segment defined by cluster analysis. This study expected several findings. First, consumer can be divided into two large group of loyal versus not loyal by set of variables. Second, this study identifies customer segment in mobile phone category. Third, exploring customer profile in each segment that has been identified. This study answer a call for additional empirical research into different product categories. Therefore, a replication research is advisable. By knowing the customer loyalty characteristic, and deep analysis of their consumption behavior and profile for each segment, this study is very advisable for high impact marketing strategy development. This study contributes body of knowledge by adding empirical study of consumer loyalty, segmentation analysis in mobile phone category by multiple brand analysis.

Keywords: customer loyalty, segmentation, marketing strategy, discriminant analysis, cluster analysis, mobile phone

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Authors: Norhanim Nordin, Rosnah Shamsudin, Azrina Azlan, Mohammad Effendy Ya’acob

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An environmental friendly approach for disposal of voluminous durian husk waste could be implemented by substituting them into various valuable commodities, such as healthcare and biofuel products. Thus, the study of composition value in each segment of durian husk was very crucial to determine the suitable proportions of nutrients that need to be added and mixed in the product. A total of 12 ‘Durian Kampung’ fruits from Sg Ruan, Pahang were selected and each fruit husk was divided into four segments and labelled as P-L (thin neck area of white inner husk), P-B (thick bottom area of white inner husk), H (green and thorny outer husk) and W (whole combination of P-B and H). Four experiments have been carried out to determine the dry matter, moisture, ash and crude fibre content. The results show that the H segment has the highest dry matter content (30.47%), while the P-B segment has the highest percentage in moisture (81.83%) and ash (6.95%) content. It was calculated that the ash content of the P-B segment has a higher rate of moisture level which causes the ash content to increase about 2.89% from the P-L segment. These data have proven that each segment of durian husk has a significant difference in terms of composition value, which might be useful information to fully utilize every part of the durian husk in the future.

Keywords: durian husk, crude fibre content, dry matter content, moisture content

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Authors: K. Matušínská, H. Starzyczná, M. Stoklasa

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The paper deals with behaviour of the segment 50+ in the financial market in the Czech Republic. This segment could be said as the strong market power and it can be a crucial business potential for financial business units. The main defined objective of this paper is analysis of the customers´ behaviour of the segment 50-60 years in the financial market in the Czech Republic and proposal making of the suitable marketing approach to satisfy their demands in the area of product, price, distribution and marketing communication policy. This paper is based on data from one part of primary marketing research. Paper determinates the basic problem areas as well as definition of financial services marketing, defining the primary research problem, hypothesis and primary research methodology. Finally suitable marketing approach to selected sub-segment at age of 50-60 years is proposed according to marketing research findings.

Keywords: population aging in the Czech Republic, segment 50-60 years, financial services marketing, marketing research, marketing approach

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Authors: K. Matušínská, H. Starzyczná, M. Stoklasa

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The paper deals with finding and describing of the effective marketing communication forms relating to the segment 50+ in the financial market in the Czech Republic. The segment 50+ can be seen as a great marketing potential in the future but unfortunately the Czech financial institutions haven´t still reacted enough to this fact and they haven´t prepared appropriate marketing programs for this customers´ segment. Demographic aging is a fundamental characteristic of the current European population evolution but the perspective of further population aging is more noticeable in the Czech Republic. This paper is based on data from one part of primary marketing research. Paper determinates the basic problem areas as well as definition of marketing communication in the financial market, defining the primary research problem, hypothesis and primary research methodology. Finally suitable marketing communication approach to selected sub-segment at age of 50-60 years is proposed according to marketing research findings.

Keywords: population aging in the Czech Republic, segment 50+, financial services, marketing communication, marketing research, marketing communication approach

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Authors: Chang Soo Chon, Cheol Woong Ko, Han Sung Kim

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The aim of this study is to develop an anterior lumbar interbody fusion (ALIF) PEEK cage suitable for Korean people. In this study, CT images were obtained from Korean male (173cm, 71kg) and 3D Korean lumbar models were reconstructed based on the CT images to investigate anatomical characteristics. Major design parameters of anterior lumbar interbody fusion (ALIF) PEEK Cage were selected using the morphological measurement information of the Korean Lumbar models. Through finite element analysis and mechanical tests, the developed ALIF PEEK Cage prototype was compared with the Fidji Cage (Zimmer.Inc, USA) and it was found that the ALIF prototype showed similar and/or superior mechanical performance compared to the FidJi Cage. Also, clinical validation for the ALIF PEEK Cage prototype was carried out to check predictable troubles in surgical operations. Finally, it is considered that the convenience and stability of the prototype was clinically verified.

Keywords: inter-body anterior fusion, ALIF cage, PEEK, Korean lumbar, CT image, animal test

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Authors: Halimah Al Hifzi, Waseem Al-Talalwah, Shorok Al Dorazi, Hassan Al Mousa, Zainab Al-Hashim, Roger Soames

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The obturator artery is one branches of anterior division of the internal iliac artery. It passes on the lateral wall of pelvis to escape into thigh region via obturator foremen. Based on previous research studies, it found to be extremely variable in origin and course. It may arise from internal or external iliac artery. The current study includes 82 dissected specimens to investigate the origin of the obturator artery and explain the clinical importance. The obturator artery arises from the internal iliac artery in 75% either from its anterior or posterior division in 46.9% or 25% respectively. Further, it arises neither from the anterior nor posterior division of the internal iliac artery but it arises between them in 3.1%. In 25%, the obturator artery arises from the external iliac artery. In case of aneurysmectomy of posterior division, carries a high risk of insufficient of vascular supply for demand structures such as proximal adductors attachment and hip joint. Therefore, vascular surgeons have to pay attention to the posterior division being an origin of the obturator artery beside its usual three classical branches: superior gluteal, iliolumbar and lateral sacral arteries. Further, the obturator artery arising from the external iliac system is in great dangerous of laceration in case of anterior pelvic fracture. Therefore, it may lead to haemorrhagic shock threatening life.

Keywords: obturator artery, external iliac, internal iliac artery, anterior division, posterior division, superior gluteal, iliolumbar and lateral sacral, pubic fracture, aneurysm, shock

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Authors: Waseem Al Talalwah, Shorok Ali Al Dorazi, Roger Soames

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The inferior gluteal artery is a largest branch of the anterior division of internal iliac artery. It escapes from the pelvic cavity through the greater sciatic foramen below the lower edge of piriformis. In gluteal region, it provides several muscular branches to gluteal maximus and articular branch to hip joint. Further, it provides sciatic branch to sciatic nerve. Present study explores the origin of the inferior gluteal artery of 41 cadavers in Centre for Anatomy and Human Identification, University of Dundee, UK. It arose directly from the anterior division of internal iliac artery in 39% and 45.7% indirectly as with the internal pudendal artery. Further, it arose indirectly from anterior division with internal pudendal and obturator arteries in 1.5% referred as obturatogluteopudendal trunk in 1.5%. Therefore, it arose from the anterior division of the internal iliac artery in 86.2%. However, it found to be as a branch of the posterior division of internal iliac artery in 7.7% which is either a direct branch in 6.2% as or indirect branch (as from the sciatic artery) in 1.5%. It neither arose from anterior or posterior division in 1.5% as from gluteopudendal trunk arising from the internal iliac artery bifurcation site. In few cases, the inferior gluteal artery found to be congenital absence in 4.6% which is compensated by the persistent sciatic artery. Therefore, radiologists have to aware of the origin variability of the inferior gluteal artery to alert surgeons. Knowing the origin of the inferior gluteal artery may help the surgeons to avoid iatrogenic sciatic neuropathy or gluteal claudication due to prolonged ligation in pelvic procedures such as removing prostate or of uterine fibroid.

Keywords: inferior gluteal artery, internal pudendal, sciatic nerve, sciatic artery, gluteal claudication, sciatic neuopathy

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Authors: Marwan Ahmed Swileh, Amal Hussein Abuaffan

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Objective: This study aimed to explore the existence of golden proportion (GP) between the widths of maxillary anterior teeth and golden standard (GS) for width to height ratio of maxillary central incisor in individuals with attractive and non-attractive smiles. Materials and methods: A total of 82 females were recruited and divided into 2 groups: attractive smile (n= 41) and non-attractive smile (n= 41). Frontal photographs were taken, scanned, and saved on a personal computer. The apparent mesiodistal width of each anterior tooth was measured. The data were analyzed using the appropriate statistical tests at p-value < 0.05. Results: Frequency of GP was very low among the total sample, and most proportions were higher than GP. No significant differences were found between both groups in relation to central-to-lateral ratio while significant differences were found in relation to canine-to-lateral ratio. Similarly, most proportions of width to height ratio were higher than GS. Difference between groups was significant for left side and for both sides (p < 0.05) but was not for right side (p > 0.05). Conclusion: Frequency of golden proportion was very low among the study population. Smile attractiveness is not related that much to the proportions between the teeth.

Keywords: golden proportion, golden standard, attractive smile, esthetic, anterior teeth

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Authors: S. Houssaini, L. Bahi

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The motorway segment between Tangier and Oued R’mel has experienced, since the beginning of building works, significant instability and landslides linked to a number of geological, hydrogeological and geothermic factors affecting the different formations. The landslides observed are not fully understood, despite many studies conducted on this segment. This study aims at producing new methods to better explain the phenomena behind the landslides, taking into account the geotechnical and geothermic contexts. This analysis builds up on previous studies and geotechnical data collected in the field. The final body of data collected shall be processed through the Plaxis software for a better and customizable view of the landslide problems in the area, which will help to find solutions and stabilize land in the area.

Keywords: landslides, modeling, risk, stabilization

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Authors: Luna Sequier, Florian Forelli, Maude Traulle, Amaury Vandebrouck, Pascal Duffiet, Louis Ratte, Jean Mazeas

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The study's objective is to compare the muscular activity of the flexor knee muscle in patients who underwent an anterior cruciate ligament reconstruction with hamstring autograft and the individuals who have not undergone surgery. Methods: The participants were divided into two groups: a healthy group and an experimental group who had undergone an anterior cruciate ligament reconstruction with a hamstring graft. All participants had to perform a knee flexion strength test on an isokinetic dynamometer. The medial Gastrocnemius, lateral Gastrocnemius, Biceps femoris, and medial Hamstring muscle activity were measured during this test. Each group’s mean muscle activity was tested with statistical analysis, and a muscle activity ratio of gastrocnemius and hamstring muscles was calculated Results: The results showed a significant difference in activity of the medial gastrocnemius (p = 0,004901), the biceps femoris (p = 5,394.10-6), and the semitendinosus muscles (p = 1,822.10-6), with a higher Biceps femoris and Semitendinosus activity for the experimental group. It is however noticeable that inter-subject differences were important. Conclusion: This study has shown a difference in the gastrocnemius and hamstring muscle activity between patients who underwent an anterior cruciate ligament reconstruction surgery and healthy participants. With further results, this could show a modification of muscle activity patterns after surgery which could lead to compensatory behaviors at a return to sport and eventually explain a higher injury risk for our patients.

Keywords: anterior cruciate ligament, electromyography, muscle activity, physiotherapy

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Authors: Mohammad Ghandehari Motlagh

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Purpose: Comparing anterior chamber depth (ACD) measured with Orbscan II and Pentacam HR compared with the Smith method results. Methods: Smith method (1979) is a reliable method of measuring ACD only with help of slit lamp. In this study 102 phakic eyes as PRK candidates were imaged with both OrbScan and Pentacam and finally ACD was measured thru Smith method with slit lamp. ACD measured with Smith method was presumed as the gold standard and was compared with ACD of the 2 imaging devices. Contraindication cases for PRK and pseudophakic eyes have been excluded from the study. Results: Mean age of the patients was 35.2 ±14.8 yrs/old including 56 M(54.9%)and 46 F(45.09%).Acceptable correlation of ACD measured thru Smith method with Orbscan and Pentacam are R=0.958 and R=0.942 respectively and so Orbscan results can be used in procedures relying on ACD. Conclusion: ACDs measured with OrbScan is more precise than Pentacam and so can be more useful in some surgery procedures relying ACD results such as phakic IOLs and in cycloplegia contraindications.

Keywords: orbscan, pentacam, anterior chamber depth, slit lamp

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Authors: M. H. Ahmadi, A. Mortazavi, H. Zarei

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Several authors have described the main mechanism of formation of cracks in the segment lining during the construction of tunnels with tunnel boring machines. A comprehensive analysis of segmental lining joints may help to guarantee a safe construction during Tunneling and serviceable stages. The most frequent types of segment damage are caused by a condition of uneven segment matching due to contact deficiencies. This paper investigated the interaction mechanism of precast concrete lining joints in tunnels. The Discrete Element Method (DEM) was used to analyze a typical segmental lining model consisting of six segment rings. In the analyses, typical segmental lining design parameters of the Ghomrood water conveyance tunnel, Iran were employed in the study. In the conducted analysis, the worst-case scenario of loading faced during the boring of Ghomrood tunnel was considered. This was associated with the existence of a crushed zone dipping at 75 degree at the location of the key segment. In the analysis, moreover, the effect of changes in horizontal stress ratio on the loads on the segment was assessed. The boundary condition associated with K (ratio of the horizontal to the vertical stress) values of 0.5, 1, 1.5 and 2 were applied to the model and separate analysis was conducted for each case. Important parameters such as stress, moments, and displacements were measured at joint locations and the surrounding rock. Accordingly, the segment joint interactions were assessed and analyzed. Moreover, rock mass properties of the Ghomrood in Ghom were adopted. In this study, the load acting on segments joints are included a crushed zone stratum force that intersect tunnel with 75 slopes in the location of the key segment, gravity force of segments and earth pressures. A numerical investigation was used for different coefficients of stress concentration of 0.5, 1, 1.5, 2 and different geological conditions of saturated crushed zone under the critical scenario. The numerical results also demonstrate that maximum bending moments in longitudinal joints occurred for crushed zone with the weaken strengths (Sandstone). Besides that, increasing the load in segment-stratum interfaces affected radial stress in longitudinal joints and finally the opening of joints occurred.

Keywords: joint, interface, segment, contact

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Authors: Waseem Al Talalwah, Shorok Al Dorazi, Roger Soames

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The inferior gluteal artery is a prominent branch of the anterior trunk of internal iliac artery. It escapes from the pelvic cavity through the greater sciatic foramen below the lower edge of piriformis. In gluteal region, it provides several muscular branches to gluteal maximus and articular branch to hip joint. Further, it provides sciatic branch to sciatic nerve. Current study investigates the origin of the inferior gluteal artery of 41 cadavers in Centre for Anatomy and Human Identification, University of Dundee, UK. It arose from the anterior trunk in 37.5% independently and 45.7% dependently as with the internal pudendal artery. Therefore, it arose from the anterior trunk in 83.2%. However, it found to be as a branch of the posterior trunk of internal iliac artery in 7.7% which is either a direct branch in 6.2% as or indirect branch in 1.5%. Beside the inferior gluteal artery arose with internal pudendal artery as from GPT of anterior division in 45.7%, it arose from the GPT arising from the internal iliac artery bifurcation site in 1.5%. Further, the inferior gluteal artery arose from the trunk with internal pudendal and obturator arteries in 1.5% referred as obturatogluteopudendal trunk. Occasionally, it arose from the sciatic artery in 1.5%. In few cases, the inferior gluteal artery found to be congenital absence in 4.6% which is compensated by the persistent sciatic artery. Therefore, radiologists have to aware of the origin variability of the inferior gluteal artery to alert surgeons. Knowing the origin of the inferior gluteal artery may help the surgeons to avoid iatrogenic sciatic neuropathy in pelvic procedures such as removing prostate or of uterine fibroid. Further, it may also prevent avascular necrosis of femur neck as well as gluteal claudication.

Keywords: inferior gluteal artery, internal iliac artery, sciatic neuropathy, gluteal claudication

Procedia PDF Downloads 319

Authors: Sharadha G., Suresh Kanakkanavar

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Background: Placenta previa is a condition characterized by partial or complete implantation of the placenta in the lower uterine segment. It is one of the main causes of vaginal bleeding in the third trimester and a significant cause of maternal and perinatal morbidity and mortality. Materials and Methods: This is an observational study involving 130 patients diagnosed with placenta previa and satisfying inclusion criteria. The demographic data, clinical, surgical, and treatment, along with maternal and neonatal outcome parameters, were noted in proforma. Results: The incidence of placenta previa among scarred uterus was 1.32%, and in unscarred uterus was 0.67%. The mean age of the study population was 27.12±4.426years. High parity, high abortion rate, multigravida status, and less gestational age at delivery were commonly seen in scarred uterus compared to unscarred uterus. Complete placenta previa, anterior placental position, and adherent placenta were significantly associated with a scarred uterus compared to an unscarred uterus. The rate of caesarean hysterectomy was higher in the scarred uterus, along with statistical association to previous lower-segment caesarean sections. Intraoperative procedures like uterine artery ligation, bakri balloon insertion, and iliac artery ligation were higher in the scarred group. The maternal intensive care unit admission rate was higher in the scarred group and also showed its statistical association with previous lower segment caesarean section. Neonatal outcomes in terms of pre-term birth, still birth, neonatal intensive care unit admission, and neonatal death, though higher in the scarred group, did not differ statistically among the groups. Conclusion: Advancing maternal age, multiparity, prior uterine surgeries, and abortions are independent risk factors for placenta previa. Maternal morbidity is higher in the scarred uterus group compared to the unscarred group. Neonatal outcomes did not differ statistically among the groups. This knowledge would help the obstetricians to take measures to reduce the incidence of placenta previa and scarred uterus which would improve the fetomaternal outcome of placenta previa.

Keywords: placenta previa, scarred uterus, unscarred uterus, adherent placenta

Procedia PDF Downloads 18

Authors: Yuri Seu, Hyun Jin Park, Jin Seo Park, Yong-Suk Moon, HongtaeKim, Mi-Sun Hur

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The present case report describes bifid ureters arising directly from the separate calyces and renal pelvis of the kidney. It was a single common ureter leading away from the bladder, which was separated into incompletely duplicated ureters near the level of the anterior superior iliac supine. These two branches then entered the left kidney through their own courses. Each ureter traveled anterior and posterior to the renal vein, respectively. These two ureters formed a Y-shaped pattern. One ureter coursed anterior to the renal vein with shorter length, and it terminated at the renal pelvis that was divided into major calices in approximately lower two thirds of the kidney. The other ureter coursed posterior to the renal vein with longer length, terminating at approximately the upper third of the kidney. The renal calices in the upper third of the kidney were directly connected to the posterior ureter, whereas the other major calices in the lower two thirds of the kidney formed the renal pelvis connecting to the anterior ureter. Thus, convergence of the major calices was separated according to the terminations of two ureters. These anomalous ureters were traced to the calices of the kidney, thereby providing a reference of a rare variation of the ureter. The bifid ureters arising from the separate calyces and renal pelvis should be considered by radiologists when evaluating images and diagnosing possible complications of these anomalies.

Keywords: bifid ureters, kidney, major calices, renal pelvis

Procedia PDF Downloads 54

Authors: Mohammad Alobaidy, David Nicoll, Tracey Wilkinson

Abstract:

Background: Many patients suffer postoperative knee stability after total knee arthroplasty (joint replacement) involving posterior cruciate ligament (PCL) sacrificing or retaining, but is not clear whether the meniscofemoral ligaments (MFLs) are retained during these procedures; their function in terms of knee stability is not well established in the literature. Purpose: Macroscopic, detailed, morphometric investigation of the anterior and posterior MFLs of the knee joint was undertaken to assist understanding of knee stability after total knee arthroplasty and ligament reconstruction. Methods: Dissection of eighty Thiel embalmed knees from 19 male and 21 female cadavers was conducted, mean age 77 (range 47-99 years). The origin and insertion of the anterior and posterior MFLs were measured using high accuracy, calibrated, digital Vernier calipers at 0.01mm. Results: The means were: anterior meniscofemoral ligament (aMFL) length 28.4 ± 2.7mm; posterior meniscofemoral ligament (pMFL) length 29 ± 3.7mm; aMFL femoral width 6.4 ± 1.7mm, mid-distance ligament width 4 ± 1.1mm, meniscal ligament width 3.9 ± 1.2mm; pMFL femoral width 5.6 ± 1.5mm, mid-distance ligament width 4.1 ± 1.1mm, meniscal ligament width 4.1 ± 1.3mm. Some of the male measurements were larger than female, with significant differences in the length of the aMFL femoral length p<0.01 and pMFL femoral length p<0.007, and width of the pMFL mid-distance p<0.04. Conclusion: This study may help explore the role of the meniscofemoral ligaments in knee stability after total knee arthroplasty with a posterior cruciate ligament retaining prosthesis. Anatomical information for Thiel embalmed knees may aid orthopaedic surgeons in ligament reconstruction.

Keywords: anterior and posterior meniscofemoral ligaments, morphometric analysis, Thiel embalmed knees, knee arthroplasty

Procedia PDF Downloads 329

Authors: Amerah Alsalem

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Aim: Laminate veneers are restorations which are envisioned to correct existing abnormalities, esthetic deficiencies, and discolorations. Laminate veneer restorations may be processed in two different ways: direct or indirect. Materials and methods: Direct composite laminate veneers require minimal preparation compared to indirect composite veneers, cost less and are easier to repair, so are useful in young patients. However, composites can have inherent limitations such as shrinkage, limited toughness; color instability and susceptibility to wear that reduce the lifespan of the restoration and cause postoperative complications. Every new material or method introduced to the field of dentistry aims to achieve esthetics and successful dental treatments with minimal invasiveness. Therefore, direct laminate veneer restorations have been developed for advanced esthetic problems of anterior teeth. Tooth discolorations, rotated teeth, coronal fractures, congenital or acquired malformations, diastemas, discolored restorations, palatally positioned teeth, the absence of lateral incisors, abrasions and erosions are the main indications for direct laminate veneer restorations. Result: Direct veneers, as esthetic procedures, have become treatment alternatives for patients with esthetic problems of anterior teeth in recent years. The cost, social and time factors have to be considered. Although ceramic laminate veneer restorations have some advantages like color stability and high resistance against abrasion, they have also some disadvantages, including high cost and long chair time. Moreover, they have some problems such as the necessity of an additional adhesive cement. Conclusion: Although there are still some disadvantages, especially discolorations and fragility, with the development of new composite resins, direct laminate veneer restorations can be a treatment option for patients with esthetic problems of anterior teeth, when applied judiciously with good patient hygiene motivation.

Keywords: direct, veneers, composite, anterior

Procedia PDF Downloads 251

Authors: Paulus Maulana

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Forensic identification is to help investigators determine a person's identity. Personal identification is often a problem in civil and criminal cases. Orthodontists like all other dental professionals can play a major role by maintaining lateral cephalogram and thus providing important or vital information or can clues to the legal authorities in order to help them in their search. Radiographic lateral cephalometry is a measurement method which focused on the anatomical points of human lateral skull. Sex determination is one of the most important aspects of the personal identification in forensic. Lateral cephalogram is a valuable tool in identification of sex as reveal morphological details of the skull on single radiograph. This present study evaluates the role of lateral cephalogram in identification of sex that parameters of lateral cephalogram are linear measurement and angle measurement. The linear measurements are N-S ( Anterior cranial length), Sna-Snp (Palatal plane length), Me-Go (menton-gonion), N-Sna ( Midfacial anterior height ), Sna-Me (Lower anterior face height), Co-Gn (total mandibular length). The angle measurements are SNA, SNB, ANB, Gonial, Interincical, and facial.

Keywords: lateral cephalometry, cephalogram, sex, forensic, parameter

Procedia PDF Downloads 169

Authors: Imran Badshah

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This paper study the impact of Un-signalized pedestrian on traffic flow at Stationary Bottleneck. The Highway Capacity Manual (HCM) analyze the methodology of level of service for Urban street segment but it does not include the impact of un-signalized pedestrian crossing at stationary bottleneck. The un-signalized pedestrian crossing in urban road segment causes conflict between vehicles and pedestrians. As a result, the average time taken by vehicle to travel along a road segment increased. The speed of vehicle and the level of service decreases as the running time of a segment increased. To analyze the delay, we need to determine the pedestrian speed while crossing the road at a stationary bottleneck. The objective of this research is to determine the speed of pedestrian and its impact on traffic flow at stationary bottleneck. In addition, the result of this study should be incorporated in the Urban Street Analysis Chapter of HCM.

Keywords: stationary bottleneck, traffic flow, pedestrian speed, HCM

Procedia PDF Downloads 47

Authors: Mirzashahi Babak, Mansouri Pejman, Najafi Arvin, Farzan Mahmoud

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Introduction: There are several surgical treatment choices for cervical spondylotic myelopathy (CSM). The aim of this study is to evaluate clinical outcomes and surgical complications in patients with cervical disk degeneration (CDD) undergoing either anterior cervical discectomy with or without fusion or cervical laminectomy and fusion. Methods: This prospective case series study included 45 consecutive patients with cervical spondylotic myelopathy between January 2010 and November 2014. There were 28 males and 17 females, with a mean age of 47 (range 37-68) years. The mean clinical follow-up was 14 months (range 3-24 months). The Neck Disability Index (NDI), visual analog scale (VAS) neck and arm pain, Short Form-36 (SF-36) were used as the functional outcome measurements. All of the complications in our patients were recorded. Results: In our study group, 26 patients underwent only one or two level anterior cervical discectomy. Ten patients underwent anterior cervical discectomy and fusion (ACDF) and nine cases underwent posterior laminectomy and fusion. We have found a statistically significant improvement between mean preoperative (29, range 19-43) and postoperative (7, range 0-12) NDI scores following surgery (P < 0.05). Also, there was a statistically significant difference between pre and post-operative VAS and SF-36 score (p < 0.05). There was a 7% overall complication rate (n = 3). The only complication in our patients was surgical site cellulitis which has been managed with oral antibiotic therapy. Conclusion: Both anterior cervical discectomy with or without fusion or posterior laminectomy and fusion are safe and efficacious treatment options for the management of CSM. The clinical outcomes seem to be fairly reproducible.

Keywords: cervical, myelopathy, discectomy, fusion, laminectomy

Procedia PDF Downloads 317