Anatomic foveal reconstruction of the triangular fibrocartilage complex with a tendon graft

An acute injury to the triangular fibrocartilage complex (TFCC) with avulsion of the foveal attachment can produce distal radioulnar joint (DRUJ) instability. The avulsed TFCC is translated distally so the footprint will be bathed in synovial fluid from the DRUJ and will become covered in synovitis. If the TFCC fails to heal to the footprint, then persistent instability can occur. The authors describe a surgical technique indicated for the treatment of persistent instability of the DRUJ due to foveal detachment of the TFCC. The procedure utilizes a loop of palmaris longus tendon graft passed through the ulnar aspect of the TFCC and into an osseous tunnel in the distal ulna to reconstruct the foveal attachment. This technique provides stability of the distal ulna to the radius and carpus. We recommend this procedure for chronic instability of the DRUJ due to TFCC avulsion, but recommend that suture repair remain the treatment of choice for acute instability. An arthroscopic assessment includes the trampoline test, hook test, and reverse hook test. DRUJ ballottement under arthroscopic vision details the direction of instability, the functional tear pattern, and unmasks concealed tears. If the reverse hook test demonstrates a functional instability between the TFCC and the radius, then a foveal reconstruction is contraindicated, and a reconstruction that stabilizes the radial and ulnar aspects of the TFCC is required. The foveal reconstruction technique has the advantage of providing a robust anatomically based reconstruction of the TFCC to the fovea, which stabilizes the DRUJ and the ulnocarpal sag.

2D-3D Reconstruction-Based Planning of Total Hip Arthroplasty

This chapter proposed a personalized X-ray reconstruction-based planning and post-operative treatment evaluation framework called iJoint for advancing modern Total Hip Arthroplasty (THA). Based on a mobile X-ray image calibration phantom and a unique 2D-3D reconstruction technique, iJoint can generate patient-specific models of hip joint by non-rigidly matching statistical shape models to the X-ray radiographs. Such a reconstruction enables a true 3D planning and treatment evaluation of hip arthroplasty from just 2D X-ray radiographs whose acquisition is part of the standard diagnostic and treatment loop. As part of the system, a 3D model-based planning environment provides surgeons with hip arthroplasty related parameters such as implant type, size, position, offset and leg length equalization. With this newly developed system, we are able to provide true 3D solutions for computer assisted planning of THA using only 2D X-ray radiographs, which is not only innovative but also cost-effective.

Reconstruction of Chronic Foveal TFCC Tears with an Autologous Tendon Graft

Background A triangular fibrocartilage complex (TFCC) injury can produce distal radioulnar joint (DRUJ) instability. If the foveal attachment is avulsed, it translates distally. The footprint is separated from its origin and will become covered in synovitis, preventing healing. The authors describe a surgical technique for the treatment of instability of the DRUJ due to chronic foveal detachment of the TFCC. Technique The procedure utilizes a loop of autologous palmaris longus tendon graft passed through the ulnar aspect of the TFCC and through an osseous tunnel in the distal ulna to reconstruct the fovel attachment. Patients and Methods We report on nine patients with a mean age of 42. Median follow-up was 13 months. Results The median pain scores measured were reduced from 8 to 3 postoperatively, and all had a stable DRUJ. Conclusions This technique provides stability of the distal ulna to the radius and carpus, with potential for biologic healing through osseous integration. It is a robust, anatomically based reconstruction of the TFCC to the fovea that stabilizes the DRUJ and the ulnar-carpal sag.

Report of the Joint Select Committee to Inquire into the Condition of Affairs in the Late Insurrectionary States /

John Scott, Chairman. Report presented by L.P. Poland.

Transforming Iraq's economy : hearing before the Joint Economic Committee, Congress of the United States, One Hundred Eighth Congress, first session, June 11, 2003.

Shipping list no.: 2004-0090-P.

Exploiting sensitivity of nonorthogonal joint diagonalisation as a security mechanism in steganography

We have recently proposed the framework of independent blind source separation as an advantageous approach to steganography. Amongst the several characteristics noted was a sensitivity to message reconstruction due to small perturbations in the sources. This characteristic is not common in most other approaches to steganography. In this paper we discuss how this sensitivity relates the joint diagonalisation inside the independent component approach, and reliance on exact knowledge of secret information, and how it can be used as an additional and inherent security mechanism against malicious attack to discovery of the hidden messages. The paper therefore provides an enhanced mechanism that can be used for e-document forensic analysis and can be applied to different dimensionality digital data media. In this paper we use a low dimensional example of biomedical time series as might occur in the electronic patient health record, where protection of the private patient information is paramount.

Disruption prediction at JET [Joint European Torus]

The sudden loss of the plasma magnetic confinement, known as disruption, is one of the major issue in a nuclear fusion machine as JET (Joint European Torus), Disruptions pose very serious problems to the safety of the machine. The energy stored in the plasma is released to the machine structure in few milliseconds resulting in forces that at JET reach several Mega Newtons. The problem is even more severe in the nuclear fusion power station where the forces are in the order of one hundred Mega Newtons. The events that occur during a disruption are still not well understood even if some mechanisms that can lead to a disruption have been identified and can be used to predict them. Unfortunately it is always a combination of these events that generates a disruption and therefore it is not possible to use simple algorithms to predict it. This thesis analyses the possibility of using neural network algorithms to predict plasma disruptions in real time. This involves the determination of plasma parameters every few milliseconds. A plasma boundary reconstruction algorithm, XLOC, has been developed in collaboration with Dr. D. Ollrien and Dr. J. Ellis capable of determining the plasma wall/distance every 2 milliseconds. The XLOC output has been used to develop a multilayer perceptron network to determine plasma parameters as ?i and q? with which a machine operational space has been experimentally defined. If the limits of this operational space are breached the disruption probability increases considerably. Another approach for prediction disruptions is to use neural network classification methods to define the JET operational space. Two methods have been studied. The first method uses a multilayer perceptron network with softmax activation function for the output layer. This method can be used for classifying the input patterns in various classes. In this case the plasma input patterns have been divided between disrupting and safe patterns, giving the possibility of assigning a disruption probability to every plasma input pattern. The second method determines the novelty of an input pattern by calculating the probability density distribution of successful plasma patterns that have been run at JET. The density distribution is represented as a mixture distribution, and its parameters arc determined using the Expectation-Maximisation method. If the dataset, used to determine the distribution parameters, covers sufficiently well the machine operational space. Then, the patterns flagged as novel can be regarded as patterns belonging to a disrupting plasma. Together with these methods, a network has been designed to predict the vertical forces, that a disruption can cause, in order to avoid that too dangerous plasma configurations are run. This network can be run before the pulse using the pre-programmed plasma configuration or on line becoming a tool that allows to stop dangerous plasma configuration. All these methods have been implemented in real time on a dual Pentium Pro based machine. The Disruption Prediction and Prevention System has shown that internal plasma parameters can be determined on-line with a good accuracy. Also the disruption detection algorithms showed promising results considering the fact that JET is an experimental machine where always new plasma configurations are tested trying to improve its performances.

Reconstruction of graded groupoids from graded Steinberg algebras

We show how to reconstruct a graded ample Hausdorff groupoid with topologically principal neutrally-graded component from the ring structure of its graded Steinberg algebra over any commutative integral domain with 1, together with the embedding of the canonical abelian subring of functions supported on the unit space. We deduce that diagonal-preserving ring isomorphism of Leavitt path algebras implies $C^*$-isomorphism of $C^*$-algebras for graphs $E$ and $F$ in which every cycle has an exit. This is a joint work with Joan Bosa, Roozbeh Hazrat and Aidan Sims.

Neuromuscular deficits after peripheral joint injury: a neurophysiological hypothesis

In addition to biomechanical disturbances, peripheral joint injuries (PJIs) can also result in chronic neuromuscular alterations due in part to loss of mechanoreceptor-mediated afferent feedback. An emerging perspective is that PJI should be viewed as a neurophysiological dysfunction, not simply a local injury. Neurophysiological and neuroimaging studies have provided some evidence for central nervous system (CNS) reorganization at both the cortical and spinal levels after PJI. The novel hypothesis proposed is that CNS reorganization is the underlying mechanism for persisting neuromuscular deficits after injury, particularly muscle weakness. There is a lack of direct evidence to support this hypothesis, but future studies utilizing force-matching tasks with superimposed transcranial magnetic stimulation may be help clarify this notion.