Ankle joint pressure changes in a pes cavovarus model: supramalleolar valgus osteotomy versus lateralizing calcaneal osteotomy

BACKGROUND: A fixed cavovarus foot deformity can be associated with anteromedial ankle arthrosis due to elevated medial joint contact stresses. Supramalleolar valgus osteotomies (SMOT) and lateralizing calcaneal osteotomies (LCOT) are commonly used to treat symptoms by redistributing joint contact forces. In a cavovarus model, the effects of SMOT and LCOT on the lateralization of the center of force (COF) and reduction of the peak pressure in the ankle joint were compared. METHODS: A previously published cavovarus model with fixed hindfoot varus was simulated in 10 cadaver specimens. Closing wedge supramalleolar valgus osteotomies 3 cm above the ankle joint level (6 and 11 degrees) and lateral sliding calcaneal osteotomies (5 and 10 mm displacement) were analyzed at 300 N axial static load (half body weight). The COF migration and peak pressure decrease in the ankle were recorded using high-resolution TekScan pressure sensors. RESULTS: A significant lateral COF shift was observed for each osteotomy: 2.1 mm for the 6 degrees (P = .014) and 2.3 mm for the 11 degrees SMOT (P = .010). The 5 mm LCOT led to a lateral shift of 2.0 mm (P = .042) and the 10 mm LCOT to a shift of 3.0 mm (P = .006). Comparing the different osteotomies among themselves no significant differences were recorded. No significant anteroposterior COF shift was seen. A significant peak pressure reduction was recorded for each osteotomy: The SMOT led to a reduction of 29% (P = .033) for the 6 degrees and 47% (P = .003) for the 11 degrees osteotomy, and the LCOT to a reduction of 41% (P = .003) for the 5 mm and 49% (P = .002) for the 10 mm osteotomy. Similar to the COF lateralization no significant differences between the osteotomies were seen. CONCLUSION: LCOT and SMOT significantly reduced anteromedial ankle joint contact stresses in this cavovarus model. The unloading effects of both osteotomies were equivalent. More correction did not lead to significantly more lateralization of the COF or more reduction of peak pressure but a trend was seen. CLINICAL RELEVANCE: In patients with fixed cavovarus feet, both SMOT and LCOT provided equally good redistribution of elevated ankle joint contact forces. Increasing the amount of displacement did not seem to equally improve the joint pressures. The site of osteotomy could therefore be chosen on the basis of surgeon's preference, simplicity, or local factors in case of more complex reconstructions.

Métodos numéricos y estadísticos de caracterización de uniones tubulares soldadas para su aplicación en modelos de elementos finitos de estructuras de vehículos

El análisis de estructuras mediante modelos de elementos finitos representa una de las metodologías más utilizadas y aceptadas en la industria moderna. Para el análisis de estructuras tubulares de grandes dimensiones similares a las sobrestructuras de autobuses y autocares, los elementos de tipo viga son comúnmente utilizados y recomendados debido a que permiten obtener resultados satisfactorios con recursos computacionales reducidos. No obstante, los elementos de tipo viga presentan importante desventaja ya que las uniones modeladas presentan un comportamiento infinitamente rígido, esto determina un comportamiento mas rígido en las estructuras modeladas lo que se traduce en fuentes de error para las simulaciones estructurales (hasta un 60%). Mediante el modelado de uniones tubulares utilizando elementos de tipo área o volumen, se pueden obtener modelos más realistas, ya que las características topológicas de la unión propiamente dicha pueden ser reproducidas con un mayor nivel de detalle. Evitándose de esta manera los inconvenientes de los elementos de tipo viga. A pesar de esto, la modelización de estructuras tubulares de grandes dimensiones con elementos de tipo área o volumen representa una alternativa poco atractiva debido a la complejidad del proceso de modelados y al gran número de elementos resultantes lo que implica la necesidad de grandes recursos computacionales. El principal objetivo del trabajo de investigación presentado, fue el de obtener un nuevo tipo de elemento capaz de proporcionar estimaciones más exactas en el comportamiento de las uniones modeladas, al mismo tiempo manteniendo la simplicidad del procesos de modelado propio de los elementos de tipo viga regular. Con el fin de alcanzar los objetivos planteados, fueron realizadas diferentes metodologías e investigaciones. En base a las investigaciones realizadas, se obtuvo un modelo de unión viga alternativa en el cual se introdujeron un total seis elementos elásticos al nivel de la unión mediante los cuales es posible adaptar el comportamiento local de la misma. Adicionalmente, para la estimación de las rigideces correspondientes a los elementos elásticos se desarrollaron dos metodologías, una primera basada en la caracterización del comportamiento estático de uniones simples y una segunda basada en la caracterización del comportamiento dinámico a través de análisis modales. Las mejoras obtenidas mediante la implementación del modelo de unión alternativa fueron analizadas mediante simulaciones y validación experimental en una estructura tubular compleja representativa de sobrestructuras de autobuses y autocares. En base a los análisis comparativos realizados con la uniones simples modeladas y los experimentos de validación, se determinó que las uniones modeladas con elementos de tipo viga son entre un 5-60% más rígidas que uniones equivalentes modeladas con elementos área o volumen. También se determinó que las uniones área y volumen modeladas son entre un 5 a un 10% mas rígidas en comparación a uniones reales fabricadas. En los análisis realizados en la estructura tubular compleja, se obtuvieron mejoras importantes mediante la implementación del modelo de unión alternativa, las estimaciones del modelo viga se mejoraron desde un 49% hasta aproximadamente un 14%. ABSTRACT The analysis of structures with finite elements models represents one of the most utilized an accepted technique in the modern industry. For the analysis of large tubular structures similar to buses and coaches upper structures, beam type elements are utilized and recommended due to the fact that these elements provide satisfactory results at relatively reduced computational performances. However, the beam type elements have a main disadvantage determined by the fact that the modeled joints have an infinite rigid behavior, this shortcoming determines a stiffer behavior of the modeled structures which translates into error sources for the structural simulations (up to 60%). By modeling tubular junctions with shell and volume elements, more realistic models can be obtained, because the topological characteristics of the junction at the joint level can be reproduced more accurately. This way, the shortcoming that the beam type elements present can be solved. Despite this fact, modeling large tubular structures with shell or volume type elements represents an unattractive alternative due to the complexity of the modeling process and the large number of elements that result which imply the necessity of vast computational performances. The main objective of the research presented in this thesis was to develop a new beam type element that would be able to provide more accurate estimations for the local behavior of the modeled junctions at the same time maintaining the simplicity of the modeling process the regular beam type elements have. In order to reach the established objectives of the research activities, a series of different methodologies and investigations have been necessary. From these investigations an alternative beam T-junction model was obtained, in which a total of six elastic elements at the joint level were introduced, the elastic elements allowed us to adapt the local behavior of the modeled junctions. Additionally, for the estimation of the stiffness values corresponding to the elastic elements two methodologies were developed, one based on the T-junction’s static behavior and a second one based on the T-junction’s dynamic behavior by means of modal analysis. The improvements achieved throughout the implementation of this alternative T-junction model were analyzed though mechanical validation in a complex tubular structures that had a representative configuration for buses and coaches upper structures. From the comparative analyses of the finite element modeled T-junctions and mechanical experimental analysis, was determined that the beam type modeled T-junctions have a stiffer behavior compared to equivalent shell and volume modeled T-junctions with average differences ranging from 5-60% based on the profile configurations. It was also determined that the shell and volume models have a stiffer behavior compared to real T-junctions varying from 5 to 10% depending on the profile configurations. Based on the analysis of the complex tubular structure, significant improvements were obtained by the implementation of the alternative beam T-junction model, the model estimations were improved from a 49% to approximately 14%.

O Emprego Conjunto das Operações de Informação no Brasil como forma de fogo não cinético nas Operações Conjuntas.

O atual ambiente operacional, tem sentido profundas mudanças, fruto especialmente, da evolução tecnológica global, fazendo com que a tomada de decisão dependa ainda mais dos sistemas de informação. Para fazer face a esta realidade têm sido atualizadas e desenvolvidas conceções doutrinárias, onde se incluem as Operações de Informação, com o intuito de dar resposta aos desafios vindouros. Sendo o objeto de estudo deste trabalho as Operações de Informação, analisamos essa temática à luz da doutrina da Organização do Tratado do Atlântico Norte (OTAN) e do Exército Brasileiro, com vista a determinar contributos que possibilitem a sua conceção de emprego no Brasil a nível conjunto. Após tratada, sistematizada e analisada a informação recolhida, constatamos que a OTAN utiliza instrumentos de poder de maneira abrangente e tem conduzido as Operações de Informação para maximizar os efeitos produzidos no ambiente da informação, como uma função integradora de capacidades. O Exército Brasileiro possui doutrina consubstanciada de emprego tático das Operações de Informação. Assim sendo, esta investigação permitiu concluir que o estudo das Operações de Informação, através de contributos do Exército Brasileiro e da OTAN abre caminhos para o estabelecimento inicial de uma conceção doutrinária para o Brasil a nível conjunto. Abstract: The current operating environment, it makes sense profound changes, especially fruit, the global technological evolution, making decision making depends further information systems. To address this reality has been updated and developed doctrinal conceptions, which includes the Information Operations, in order to meet the challenges ahead. As the object of study of this work the Information Operations, we analyzed this issue in the light of the doctrine of the North Atlantic Treaty Organization (NATO) and the Brazilian Army, to determine contributions to enable your use of design in Brazil at the joint level. After treated, systemized and analyzed the information collected, we found that NATO uses power tools in a comprehensive manner and has led the Information Operations to maximize the effects in the information environment as an integrating function capabilities. The Brazilian Army has embodied the doctrine of tactical employment of Information Operations. Therefore, this investigation has concluded that the study of Information Operations through contributions of the Brazilian Army and NATO open paths for the initial establishment of a doctrinal design for Brazil at the joint level.

On-axis joint transform correlation based on a four-level power spectrum

We propose a method to obtain a single centered correlation with use of a joint transform correlator. We analyze the required setup to carry out the whole process optically, and we also present experimental results.

Effects of thresholding level variation in fringe binarization of multiobject joint transform correlation

It is possible to improve the fringe binarization method of joint transform correlation by choosing a suitable threshold level.

Carlisle joint station, and approaches from north, south, east, & west, including Saint Nicholas level crossing and Crown street junction : instructions to signalmen, drivers, guards, breaksmen, & others.

Mode of access: Internet.

Gonadal Hormones Modulate The Responsiveness To Local β-blocker-induced Antinociception In The Temporomandibular Joint Of Male And Female Rats.

We have previously demonstrated that blockade of β-adrenoreceptors (β-AR) located in the temporomandibular joint (TMJ) of rats suppresses formalin-induced TMJ nociceptive behaviour in both male and female rats, but female rats are more responsive. In this study, we investigated whether gonadal hormones modulate the responsiveness to local β-blocker-induced antinociception in the TMJ of rats. Co-administration of each of the selective β1 (atenolol), β2 (ICI 118.551) and β3 (SR59230A)-AR antagonists with equi-nociceptive concentrations of formalin in the TMJ of intact, gonadectomized and hormone-treated gonadectomized male and female rats. Atenolol, ICI 118.551 and SR59230A significantly reduced formalin-induced TMJ nociception in a dose response fashion in all groups tested. However, a lower dose of each β-AR antagonist was sufficient to significantly reduce nociceptive responses in gonadectomized but not in intact and testosterone-treated gonadectomized male rats. In the female groups, a lower dose of β1 -AR antagonist was sufficient to significantly reduce nociceptive responses in gonadectomized but not in intact or gonadectomized rats treated with progesterone or a high dose of oestradiol; a lower dose of β2 -AR antagonist was sufficient to significantly reduce nociceptive responses in gonadectomized but not in intact and gonadectomized rats treated with low or high dose of oestradiol. Gonadal hormones may reduce the responsiveness to local β-blocker-induced antinociception in the TMJ of male and female rats. However, their effect depends upon their plasma level, the subtype of β-AR and the dose of β-blockers used.

Effects of Laser on the Synovial Fluid in the Inflammatory Process of the Knee Joint of the Rabbit

Objective: The purpose of this study was to evaluate the effects of low-level laser (LLL) energy on the clinical signs of inflammation and the cellular composition of synovial fluid (SF) in the inflamed knee of the rabbit. Background Data: There are few findings related to the effects of LLL on SF in inflammatory processes and there is little knowledge about the optimal parameters for reducing joint inflammation. Materials and Methods: Inflammation in the right knee of 36 rabbits was induced by intracapsular injection (0.2 mL) of Terebinthina commun (Tc). The animals were randomly assigned to three groups: acute experimental group (AEG), chronic experimental group (CEG), and control group (CG), which only received Tc. Each group was divided in two subgroups of six animals each. The AEG and CEG groups began to receive laser treatment 2 and 5 d after the induction of inflammation, respectively. Laser irradiation at a wavelength of 830 nm, power output of 77 mW, and power density of 27.5 W/cm(2) was applied daily for 7 d for either 0.12 sec or 0.32 sec, resulting in doses of 3.4 J/cm(2) and 8 J/cm(2), respectively. Body mass, joint perimeter, joint temperature, and the morphology of the SF were analyzed. Results: There was no statistically significant differences between groups in the body mass, joint perimeter, and SF morphology. Conclusion: Laser irradiation with the selected parameters produced only a few subtle differences in the inflammatory signs and the SF. The lack of effects may have been due to the short irradiation time.

THE SUMMATION OF VOLUNTARY AND ELECTRICAL ELICITED STIMULUS INCREASES JOINT TORQUE?

The aim of this study is to analyze the effect of neuromuscular electrical stimulation (NMES) on myoelectrical activity and on joint torque during isometric plantar flexion contraction. Ten healthy young adult subjects participate in this study. The electrodes for NMES are placed along posterior thigh along ciatic nerve trajectory. It is measured the myoelectrical activity and the isometric torque generated by ankle plantar flexion with an isokinetic dynamometer. The conditions of isometric contractions are maximum isometric voluntary contraction (MIVC), NMES, and association of both (MIVC+NMES). The results show lower torque during NMES and larger SOL activity compare to the others. Besides, in order to keep the same objective task (to produce the same level of torque), neuromuscular adaptations are necessary on the common drive.

Joint forces and torques when walking in shallow water

This study reports for the first time an estimation of the internal net joint forces and torques on adults` lower limbs and pelvis when walking in shallow water, taking into account the drag forces generated by the movement of their bodies in the water and the equivalent data when they walk on land. A force plate and a video camera were used to perform a two-dimensional gait analysis at the sagittal plane of 10 healthy young adults walking at comfortable speeds on land and in water at a chest-high level. We estimated the drag force on each body segment and the joint forces and torques at the ankle, knee, and hip of the right side of their bodies using inverse dynamics. The observed subjects` apparent weight in water was about 35% of their weight on land and they were about 2.7 times slower when walking in water. When the subjects walked in water compared with walking on land, there were no differences in the angular displacements but there was a significant reduction in the joint torques which was related to the water`s depth. The greatest reduction was observed for the ankle and then the knee and no reduction was observed for the hip. All joint powers were significantly reduced in water. The compressive and shear joint forces were on average about three times lower during walking in water than on land. These quantitative results substantiate the use of water as a safe environment for practicing low-impact exercises, particularly walking. (C) 2011 Elsevier Ltd. All rights reserved.

Country risk, national cultural differences between partners and survival of international joint ventures in Brazil

This article aims to identify the main and interaction effects of two country-level variables, namely national distance and country risk, on the survival of international joint ventures in emerging markets. Research hypotheses predicting the negative impact of national distance and country risk on survival of international joint ventures are formulated in this article. These research hypotheses are examined in a sample of 234 international joint ventures formed in Brazil between 1973 and 2004. These international joint ventures were subjected to an event history analysis over a period of time ranging from 1973 to 2006. The empirical results show that large national cultural differences between local and foreign partners increase the instability of international joint ventures, whereas the survival of these alliances does not seem to be affected either by the economic and political uncertainty of Brazil. Furthermore, the national distance between local and foreign partners has effects on survival that are variable according to the life cycle of international joint ventures. (C) 2007 Elsevier Ltd. All rights reserved.

ARTHROSCOPIC TREATMENT OF ACUTE ACROMIOCLAVICULAR JOINT DISLOCATION USING SUTURE ANCHORS

Objective: To present the clinical and radiographic results of a case series of patients with acute acromioclavicular dislocation (MD) treated by arthroscopic coracoclavicular fixation with suture anchors. Method: Twenty patients with AAD with less than 30 days since the injury were submitted to a coracoclavicular stabilization procedure using 2 suture anchors placed at the base of the coracoid process. Each suture anchor was connected to 2 strands of No.2 nonabsorbable-braided sutures, which were passed through the holes drilled in the clavicle and tied to the upper surface of the clavicle. The coracoclavicular distance was measured and compared to the opposite side using radiographic evaluation. Constant and UCLA scores were used to determine clinical and functional evaluation after 6 months. Results: Of the initial twenty cases, six were submitted to a new surgical procedure and were excluded from the study. Of the fourteen patients remaining, only two maintained the initial reduction, while the remainder presented some degree of reduction loss. The Constant and UCLA score averages were 94.79 (82-100) and 32.64 (26-35) respectively. Conclusion: The technique had a high incidence of reduction loss after 6 months of follow up. The clinical and functional evaluation was satisfactory, with a high average score. Level of Evidence: Level III, retrospective study.

Evaluation of the prognostic significance of serum galectin-3 in American Joint Committee on Cancer stage III and stage IV melanoma patients

Galectin-3 (Gal-3) is a member of the P-galactoside-binding lectins family and has been implicated in angiogenesis, tumor invasion, and metastatic process in vitro and in vivo. As we showed recently that advanced melanoma patients presented high serum level of Gal-3, we investigated the association of this protein with the outcome of melanoma patients. Whether this protein could be a biomarker has riot been assessed, and we compared the prognostic value of serum Gal-3 in multivariate analysis with lactate dehydrogenase, C-reactive protein and S100B. We conclude that Gal-3 could be of prognostic value in melanoma patients; more precisely, this protein has a strong independent prognostic signification with a cut-off value of 10 ng/ml. After these data, we believe that serum Gal-3 measurement can have an important role in the follow-up and management of advanced American Joint Commission on Cancer stage III and stage IV melanoma patients. Further studies will uncover whether Gal-3 will be able to open new therapeutic perspectives. Melanoma Res 19:316-320 (C) 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Histopathology of the Hematopoietic Bone Marrow in the Temporomandibular Joint of Rats Subjected to Undernutrition and to Mandibular Condyle Fracture

Undernutrition can cause important functional and morphological alterations in the hematopoietic bone marrow (HBM). Degeneration of the HBM in malnourished individuals has been observed in the long bones, but none has been described in the cranial bones. Mandibular condyle fracture can lead to determine nutritional effects due to the high catabolism needed for the bone healing added to the difficulties of mastication. The aim of this study is to describe the histological aspect of HBM in the fractured mandibular condyle and in the temporal bone of malnourished rats. Thirty adult rats suffered unilateral mandibular condyle fracture and were divided into well-nourished (FG) and malnourished (MG) groups. In the MG the animals received a hypoproteic diet during the experiment. Histological sections of the temporomandibular joint were stained to visualize and quantify the HBM in this region at 24h, and 7, 15, 30, and 90 days post-fracture. At 24 hours, FG and MG showed hypocellularity and ischemic degeneration in the mandibular condyle and in the temporal bone. At 7 days, FG exhibited high cellularity in comparison with MG in the condyle; the temporal bone of both groups presented hypocellularity and degeneration. At 30 and 90 days, FG exhibited similar characteristics to those of the control; MG maintained the degeneration level mainly in the temporal bone. Malnutrition prejudices the regeneration of the HBM during a fracture healing in the temporomandibular joint. This fact contributes to a complete modification of the bone structure as well as to an impairment of the healing process.