854 resultados para Resurfacing Cartilage
Resumo:
Based upon the success the Iowa Department of Transportation has had using thin bonded, low slump, dense portland cement concrete on bridge decks for rehabilitation, it was decided to pursue research in the area of bonded portland cement concrete resurfacing of pavements. Since that time, in an effort to reduce costs, research was conducted into eliminating the grouting operation. On this project a non-grouted overlay was used to modernize an existing urban street. This research project is located in the City of Oskaloosa on 11th Avenue from South M Street to South Market Street. Construction of the project went well and the non-grouted overlay has performed very well to date.
Resumo:
The major problem with durability of asphalt cement concrete (ACC) overlays to rehabilitate jointed portland cement concrete (PCC) pavement comes from reflective cracking. The objective of this research was to evaluate the effectiveness of Glasgrid in regard to preventing reflection cracking. Glasgrid is a glass fiber mesh with 1/2 inch by 1 inch openings (Figure 1). Each strand is composed of many small glass fibers. After the grid is formed, it is coated with a polymer modified asphalt cement. In 1986, four experimental Glasgrid test sections were incorporated into Polk County project IR-35-2(191)67--12-77 on Interstate 35 from IA 5 to the west 1-80 interchange on the west edge of Des Moines, Single and double layers of Glasgrid were placed over transverse cracks and joints of the existing PCC pavement. The Glasgrid was placed on the PCC pavement for one section and between lifts of the ACC resurfacing on the other three sections. The four Glasgrid sections were compared to two sections without Glasgrid for four years. The sections were reviewed annually to determine how many cracks or joints had reflected through the resurfacing. Glasgrid placed on the PCC pavement was more effective at preventing reflection cracking than Glasgrid between lifts of AC resurfacing. In general, Glasgrid yielded a small reduction or retardation in the amount of reflection cracking, but not sufficient to justify additional expense for the use of Glasgrid.
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Iowa has been using low slump concrete for repair and surfacing of deteriorated bridge decks on a routine basis since the mid 1960'2. More than 150 bridges have been resurfaced by this method with good results. A study was initiated in 1973 to evaluate 15 bridges resurfaced with low slump concrete, and one bridge resurfaced with latex modified concrete. The evaluation includes an assessment of concrete physical properties, chloride penetration rates, concrete consolidation, and riding qualities of the finished bridge deck. Results indicate that the overall properties of these two types of concrete are quite similar and have resulted in a contractor option concerning which system shall be used on bridge deck repair/resurfacing projects.
Resumo:
Reflective cracking of asphalt resurfacing has been a concern for a long time. Years ago wire mesh was used to control widening cracks. More recently it has been fabrics or fiberglass. In 1986, part of the proposed fabric was deleted from projects in different parts of Iowa with various histories and designs. These projects were monitored in 1988, 1989, 1990 and 1992 with only the thin (3 inch) overlays on newly widened pavements showing a significantly greater percentage of cracks in the areas where the fabric was deleted.
Resumo:
In 1975, Kossuth County had 492 miles of asphalt pavements, sixty percent of which were between l5 and 20 years old. Many of these roadways were in need of rehabilitation. Normally, asphaltic resurfacing would be the procedure for correcting the pavement deterioration. There are areas within the state of Iowa which do not have Class I aggregate readily available for asphalt cement concrete paving. Kossuth County is one of those areas. The problem is typified by this project. Limestone aggregate to be incorporated into the asphalt resurfacing had to be hauled 53 miles from the quarry to the plant site. The cost of hauling good quality aggregate coupled with the increasing cost of asphalt cement encouraged Kossuth County to investigate the possibility of asphaltic pavement recycling. Another problem, possibly unique to Kossuth County, was the way the original roadways had been constructed. A good clay soil was present under 3 to 4 feet of poorer soil. In order to obtain this good clay soil for subbase construction, the roadway ditches were excavated 1 to 3 feet into the clay soil layer. The resultant roadway tops were several feet above the surrounding farm land and generally less than 26 feet wide. To bring the existing roadway up to current minimum design width, there were two choices: One was to widen the roadway by truck hauling soil and constructing new 4 to 6 foot shoulders. The cost of widening by this method averaged $36,000 per mile in 1975. The other choice was to remove the old pavement and widen the roadway by lowering the grade line. The desire to provide wider paved roadways gave Kossuth County the additional incentive needed to proceed with a pavement recycling project.
Resumo:
Construction of the interstate highway system began in 1956. This U.S. network of highway consists of more than 41,000 miles with 790 miles in Iowa. There have been many benefits of the controlled access roadway, but probably the most significant is the improved safety for the motorist. In Iowa, we have always endeavored to utilize quality locally available materials in our construction using the most economical or cost effective methods. Obviously when the effort is to build a cost effective system, there will be some portions of the network that will not perform as well as expected. In the design of our interstate, the main consideration for base construction under the pavement was structural capacity. The material was dense graded with the aim of supporting the pavement and distributing the load as it is transferred to the underlying grade. The drainage characteristic of the base was apparently not given adequate consideration. On jointed portland cement concrete (pcc) pavement, the water that is trapped immediately beneath the pavement causes severe problems. The traffic causes rapid movement of the water resulting in the hydraulic pressures or "pumping" (movement and redeposit of base fine material) resulting in faulting between individual slabs. Recognizing the need for maintaining this large national highway network, the Federal Highway Administration has initiated a funding program for resurfacing, restoration and rehabilitation (3R). Many miles of the system are more than 20 years old and in need of major maintenance. This new 3R Program necessitated a complete inventory of the Iowa interstate system to establish priorities and to identify those sections in need of immediate remedial treatments.
Resumo:
One of the main problems of bridge maintenance in Iowa is the spalling and scaling of the decks. This problem stems from the continued use of deicing salts during the winter months. Since bridges will frost or freeze more often than roadways, the use of deicing salts on bridges is more frequent. The salt which is spread onto the bridge dissolves in water and permeates into the concrete deck. When the salt reaches the depth of the reinforcing steel and the concentration at that depth reaches the threshold concentration for corrosion (1.5 lbs./yd. 3 ), the steel will begin to oxidize. The oxidizing steel must then expand within the concrete. This expansion eventually forces undersurface fractures and spalls in the concrete. The spalling increases maintenance problems on bridges and in some cases has forced resurfacing after only a few years of service. There are two possible solutions to this problem. One solution is discontinuing the use of salts as the deicing agent on bridges and the other is preventing the salt from reaching or attacking the reinforcing steel. This report deals with one method which stops the salt from reaching the reinforcing steel. The method utilizes a waterproof membrane on the surface of a bridge deck. The waterproof membrane stops the water-salt solution from entering the concrete so the salt cannot reach the reinforcing steel.
Resumo:
OBJECTIVES: To assess the long-term outcome, safety, and efficacy of partial cricotracheal resection (PCTR) for subglottic stenosis in a group of children and infants weighing less than 10 kg at the time of the surgery. STUDY DESIGN: Historical cohort study. SETTING: Academic tertiary medical center. SUBJECTS AND METHODS: Thirty-six children weighing less than 10 kg at the time of the surgery were compared to a group of 65 children who weighed more than 10 kg. The Kaplan Meier method and Cox regression were carried out to detect differences in decannulation time and rates and to examine the influence of various parameters (i.e., comorbidities, type of surgery, and complications requiring revision surgery) at the time of decannulation. Evaluation of the long-term outcome was based on questionnaires assessing breathing, voice, and swallowing. RESULTS: Decannulation rate was 92 percent (33/36) for the group of children weighing less than 10 kg. No significant differences were found between the two body weight groups with respect to the aforementioned covariates. The median follow-up period was nine years (range, 1-23 yrs). Questionnaire responses revealed completely normal breathing and swallowing in 72 percent and 90 percent of the children, respectively. Seventy-one percent of the patients considered their voice to be rough or weak. CONCLUSION: PCTR in infants and children weighing less than 10 kg is a safe and efficient technique with similar long-term results when compared to results seen in older and heavier children.
Resumo:
The Iowa Department of Transportation has overlaid 446 bridge decks with low slump dense concrete from 1964 through October 1978. The overall performance of these decks has been satisfactory. Nineteen bridges that were resurfaced with either low slump dense concrete (LSDC) or latex-modified concrete were analyzed for chloride content, electrical corrosion potential, delaminations or debonding, and deck surface condition. The resurfacing ages of these bridges range from 5 to 13 years. None of the bridges showed any evidence of surface distress and the chloride penetration into the resurfacing concrete is relatively low. There are delaminations in the original decks below the resurfacing on the majority of bridges examined. The delaminations are concluded to be caused by either (A) reinforcing steel corrosion, (B) not removing all delaminated concrete prior to placing the resurfacing concrete, or (C) creating an incipient fracture in the top surf ace of the original deck through the use of scarification equipment. The active corrosion of the reinforcing steel is predominately in the gutter line on the majority of bridges evaluated. Recommendations for future deck repairs include removal of concrete to the top layer of reinforcing steel in areas where an electrical corrosion potential of -0.35V or more is detected, providing more positive methods of locating delaminated concrete, and treating the curb and gutter line to reduce the potential damage from salt water.
Resumo:
As of December 31, 1970 there were 57,270 miles of Local Secondary roads and 32,958 miles of Farm to Market roads in the Iowa secondary road system. The Local Secondary system carried a traffic load of 2,714,180 daily vehicle miles, accounting for 32% of all traffic in the secondary system. For all Local Secondary roads having some form of surfacing, 98% were surfaced with gravel or crushed stone. During the 1970 construction year 335 miles of surfaced roads were constructed in the Local Secondary system with 78% being surfaced with gravel or crushed stone. The total maintenance expenditure for all secondary roads in Iowa during 1970 amounted to $40,086,091. Of this, 42%, or $17,020,332, was spent for aggregate replacement on existing gravel or crushed stone roads with an additional 31% ($12,604,456) being spent on maintenance other than resurfacing. This amounts to 73% of the total maintenance budget and are the largest two maintenance expenditure items out of a list of 10 ranging from bridges to drainage assessments. The next largest item was 7%, for maintenance of existing flexible bases. Three concurrent phases of study were included in this project: (1) laboratory screenings studies of various additives thought to have potential for long-lasting dust palliation, soil additive strength, durability, and additive retention potential; (2) test road construction using those additives that indicated promise for performance-serviceability usage; and (3) observations and tests of constructed sections for evaluation of the additive's contribution to performance and serviceability as well as the relationship to initial costs.
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Cartilage-hair hypoplasia (CHH) is a pleiotropic disease caused by recessive mutations in the RMRP gene that result in a wide spectrum of manifestations including short stature, sparse hair, metaphyseal dysplasia, anemia, immune deficiency, and increased incidence of cancer. Molecular diagnosis of CHH has implications for management, prognosis, follow-up, and genetic counseling of affected patients and their families. We report 20 novel mutations in 36 patients with CHH and describe the associated phenotypic spectrum. Given the high mutational heterogeneity (62 mutations reported to date), the high frequency of variations in the region (eight single nucleotide polymorphisms in and around RMRP), and the fact that RMRP is not translated into protein, prediction of mutation pathogenicity is difficult. We addressed this issue by a comparative genomic approach and aligned the genomic sequences of RMRP gene in the entire class of mammals. We found that putative pathogenic mutations are located in highly conserved nucleotides, whereas polymorphisms are located in non-conserved positions. We conclude that the abundance of variations in this small gene is remarkable and at odds with its high conservation through species; it is unclear whether these variations are caused by a high local mutation rate, a failure of repair mechanisms, or a relaxed selective pressure. The marked diversity of mutations in RMRP and the low homozygosity rate in our patient population indicate that CHH is more common than previously estimated, but may go unrecognized because of its variable clinical presentation. Thus, RMRP molecular testing may be indicated in individuals with isolated metaphyseal dysplasia, anemia, or immune dysregulation.
Resumo:
OBJECTIVES: To delineate the various factors contributing to failure or delay in decannulation after partial cricotracheal resection (PCTR) in children. STUDY DESIGN: Case series. SETTING: Academic tertiary medical center. SUBJECTS AND METHODS: A retrospective case review of 100 children who underwent PCTR between 1978 and 2008 for severe subglottic stenosis using an ongoing database. RESULTS: Ninety of 100 (90%) patients were decannulated. Six patients needed secondary tracheostomy. The results of the preoperative evaluation showed grade II stenosis in four patients, grade III in 64 patients, and grade IV in 32 patients. The overall decannulation rate was 100 percent in grade II, 95 percent in grade III, and 78 percent in grade IV stenosis. Fourteen (14%) patients required revision open surgery. The most common cause of revision surgery was posterior glottic stenosis. Partial anastomotic dehiscence was seen in four patients. Delayed decannulation (>1 year) occurred in nine patients. Overall mortality rate in the whole series was 6 percent. No deaths were directly related to the surgery. No iatrogenic recurrent laryngeal nerve injury was present in the entire series. CONCLUSION: Comorbidities and associated syndromes should be addressed before PCTR is planned to improve the final postoperative outcome in terms of decannulation. Perioperative morbidity due to anastomotic dehiscence, to a certain extent, can be avoided by intraoperative judgment in the selection of double-stage surgery when more than five tracheal rings need to be resected. Subglottic stenosis with glottic involvement continues to pose a difficult challenge to pediatric otolaryngologists, often necessitating revision procedures.
Resumo:
PURPOSE OF REVIEW: The article reviews recent significant advances and current applications of the temporoparietal fascia flap (TPFF) in head and neck surgery. RECENT FINDINGS: The recent literature describes a wide span of new applications of the TPFF in many areas. Significant developments and refinements in the reconstruction of orbitomaxillary composite defects and orbital exenteration cavities are reported. The TPFF combined with alloplastic framework is gaining in importance in external ear reconstruction. Innovative prefabricated skin or soft-tissue grafts based on the TPFF are used to restore facial contour or in the reconstruction of complex facial defects. The free TPFF finds a role in laryngotracheal reconstruction as a vascular carrier to support cartilage grafts. SUMMARY: Owing to its reliability and unequalled structural properties, the TPFF still plays a central role in facial reconstruction. Future investigation will likely incorporate the free TPFF as a vascular carrier of bioengineered tissues, such as cartilage and mucosa, for various head and neck indications.
Resumo:
Bone morphogenetic protein (BMP)-2 and transforming growth factor (TGF)-beta1 are multifunctional cytokines both proposed as stimulants for cartilage repair. Thus it is crucial to closely examine and compare their effects on the expression of key markers of the chondrocyte phenotype, at the gene and protein level. In this study, the expression of alpha 10 and alpha 11 integrin subunits and the IIA/IIB spliced forms of type II procollagen have been monitored for the first time in parallel in the same in vitro model of mouse chondrocyte dedifferentiation/redifferentiation. We demonstrated that TGF-beta1 stimulates the expression of the non-chondrogenic form of type II procollagen, IIA isoform, and of a marker of mesenchymal tissues, i.e. the alpha 11 integrin subunit. On the contrary, BMP-2 stimulates the cartilage-specific form of type II procollagen, IIB isoform, and a specific marker of chondrocytes, i.e. the alpha 10 integrin subunit. Collectively, our results demonstrate that BMP-2 has a better capability than TGF-beta1 to stimulate chondrocyte redifferentiation and reveal that the relative expressions of type IIB to type IIA procollagens and alpha 10 to alpha 11 integrin subunits are good markers to define the differentiation state of chondrocytes. In addition, adenoviral expression of Smad6, an inhibitor of BMP canonical Smad signaling, did not affect expression of total type II procollagen or the ratio of type IIA and type IIB isoforms in mouse chondrocytes exposed to BMP-2. This result strongly suggests that signaling pathways other than Smad proteins are involved in the effect of BMP-2 on type II procollagen expression.
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The so-called "enchondromatoses" are skeletal disorders defined by the presence of ectopic cartilaginous tissue within bone tissue. The clinical and radiographic features of the different enchondromatoses are distinct, and grouping them does not reflect a common pathogenesis but simply a similar radiographic appearance and thus the need for a differential diagnosis. Recent advances in the understanding of their molecular and cellular bases confirm the heterogeneous nature of the different enchondromatoses. Some, like Ollier disease, Maffucci disease, metaphyseal chondromatosis with hydroxyglutaric aciduria, and metachondromatosis are produced by a dysregulation of chondrocyte proliferation, while others (such as spondyloenchondrodysplasia or dysspondyloenchondromatosis) are caused by defects in structure or metabolism of cartilage or bone matrix. In other forms (e.g., the dominantly inherited genochondromatoses), the basic defect remains to be determined. The classification, proposed by Spranger and associates in 1978 and tentatively revised twice, was based on the radiographic appearance, the anatomic sites involved, and the mode of inheritance. The new classification proposed here integrates the molecular genetic advances and delineates phenotypic families based on the molecular defects. Reference radiographs are provided to help in the diagnosis of the well-defined forms. In spite of advances, many cases remain difficult to diagnose and classify, implying that more variants remain to be defined at both the clinical and molecular levels. © 2012 Wiley Periodicals, Inc.