bluuebunny/crossref_metadata_2025 huggingface dataset:
Some Effects of Moisture Migration and Persistence in Building Materials
Authors: Shuman EC
Published: March 2009

While mass transfer of moisture with air, as infiltration and exfiltration, is now a concern in building performance, when these correctable errors are minimized, migration of moisture by the laws of physics will still occur. The tendency is to presume that moisture migrates in straight lines, as flow perpendicularly through thin materials. However, migration will occur in all materials or constructions in any direction that vapor pressures dictate, including migration laterally in sheet materials if interstitial paths exist. As example, lateral migration through felts was demonstrated by use of tritiated water vapor as a tracer. Strips of felts immersed in water for 100 days did expand across the fibers, as expected, but they shrank in the longitudinal direction. Uncoated felts responded promptly to changes in relative humidity, but coated felts, with their partially protected fibers, persisted to expand for a while even after the exposure relative humidity had been decreased. Felts even at sub-zero temperature expanded and contracted with changes in relative humidity induced by silica gel and by ice. Field examples of moisture migration and persistence are given, and attention is called to overlooked freezing induced by radiative cooling to the sky at night that decreases surface temperatures as much as 5.5°C (10°F) even at freezing temperatures.
Roof/Wall Seals in Buildings
Authors: Riedel RG
Published: March 2009

Investigation of construction details reveals that seals are virtually nonexistent at the junction of roofs and walls in commercial and school buildings of both past and current construction. Buildings with roof overhangs have greater problems than those with parapets or nonoverhanging designs. Various wall systems are utilized in conjunction with various roof systems, each reasonably serviceable in themselves, but the junction of two is badly neglected by designers and builders. Infiltration and exfiltration of hot and cold air at these junctions leads to the loss of large amounts of energy. Calculations of R-values are seriously in error due to lack of wind seals. Infiltration of rain water and the condensation that can form can appear to be roof and wall leaks. Methods are described to overcome this problem both in new and existing buildings, but primarily, the need to recognize and cope with the problem is described.
Coordination of Performance Standards on Moisture Control in Buildings
Authors: Hans GE
Published: March 2009

Changing and expanding uses of consensus standards favor their organization in the format of clusters composed of concise specific documents covering different aspects of a broad subject. A framework for a cluster format on the control of water-induced damage in building constructions has been developed, and is hereby proposed for adoption.

The framework defines distinctions among design strategies, construction requirements, material properties, and test methods to be covered by separate but interrelated documents. It permits easy identification of inadequate coverage in specific areas. It allows separation between condensation and surface water control strategies and technologies. It also provides an opportunity for redefinition of the critical applicable technical terms and effective coordination with other related documents.

Clustered consensus standards are better protected against untimely obsolescence than those written in a comprehensive format.
Moisture Control in Building Wall Retrofit
Authors: Trechsel HR , Achenbach PR , Launey SJ
Published: March 2009

For the Residential Conservation Service Program (RCS), the Department of Energy (DOE) in 1979 promulgated standard practices for the installation of various energy conservation retrofit measures, including insulation. Various standard provisions and recommendations exist for moisture control in insulated walls of new constructions. These provisions in general require a vapor retarder on the warm side of walls and ceilings in all but the warmest climate areas. To apply these existing requirements to retrofit applications of insulation would be burdensome and costly. Since field experiences did not indicate conclusively that moisture problems in insulated walls can be prevented by the application of vapor retarders, nor that the absence of vapor retarders necessarily leads to moisture damage in insulated walls, DOE, with the assistance of the National Bureau of Standards (NBS) and outside consultants, developed new standard provisions specifically designed for retrofit wall installations. For roofs, the vapor retarder and attic ventilation requirements contained in the Housing and Urban Development (HUD) Minimum Property Standards (MPS) and the American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE) Guidelines were adopted unchanged. This paper thus deals with exterior wall retrofit.

The provisions were developed based on the premise that the relative humidity of the interior air is a good indicator of the potential for moisture condensation in walls. The RCS provisions stipulate a vapor retarder only in high-moisture rooms of houses in ASHRAE condensation Zone 1, but such rooms also require the sealing of cracks on the interior face of exterior walls to prevent moist indoor air from penetrating into the wall cavity. In addition, the standards recommend the same provisions in Zone 2. Finally, the provisions identify houses by size, occupancy rate, and other parameters for which additional precautions may be justified.
Air Leakage, Ventilation, and Moisture Control in Buildings
Authors: Handegord GO
Published: March 2009

Air leakage through the building envelope traditionally has been regarded as an acceptable means of ventilation, although it is a major cause of condensation problems in buildings and can be a contributing factor to rain penetration. Recent concern for energy conservation, promoting the need for air tightness, is still clouded by the notion that some leakage must be provided and that the primary effort must be toward quantifying the resultant energy loss.

This paper discusses the possible effects of wind, stack effect, vents, and fans on air leakage, and the influence of air leakage openings and their location on the pattern of air flow through buildings. The possible extent and location of condensation in relation to these patterns is considered, as well as methods of controlling moisture entry and removal of accumulated moisture. Effort toward the development of construction details, techniques, and standards to ensure air tightness in buildings and building components is advocated as the primary means of achieving energy conservation through improved building performance and extended service life.
Absorption Coefficient of NaF by Attenuated Total Reflection Spectroscopy
Authors: Burdick DL
Published: March 2009

Attenuated total reflection (ATR) spectroscopy has been employed to measure the absorption coefficient of NaF films from the visible to 3 µm. A 1-mm-thick ZnSe ATR plate (50-mm long) was coated on two sides with NaF (0.55- and 0.57-µm-thick films). By coating half the width of the ATR plate, “sample-in/sample-out” measurements could be performed to reduce substrate effects. The spectra reveal a strong water band in NaF peaking at 2.95 µm with a peak absorption coefficient at 165 cm-1 relative to the substrate. Scattering effects are noted at shorter wavelengths, and it is estimated that 7 Å of water are adsorbed onto the bare ATR plate.
Piezo-Optic Coefficients of Some Neodymium Doped Laser Glasses and Single Crystals of CaF2, BaF2 and SrF2
Authors: Waxler RM , Feldman A , Horowitz D
Published: March 2009

The piezo-birefringence coefficients of one neodymium doped phosphate laser glass and three neodymium doped fluorophosphate laser glasses have been measured at 0.6328 µm and 1.15 µm. All of the piezo-optic constants have been obtained for two of the glasses. The piezo-optic coefficients, q11, q12 and q44, of CaF2, BaF2, and SrF2 have been measured at 0.6328 µm, 1.15 µm, and 3.39 µm. The coefficients were obtained by interferometric and polarimetric techniques.
Laser Induced Damage in Fluoride Glasses: A Status Report
Authors: Stokowski SE , Milam D , Weber MJ
Published: March 2009

Bulk and surface damage thresholds of fluorophosphate and fluoroberyllate glasses have been measured for 1-ns 1064-nm laser pulses. For crystal-free samples, threshold values for fluoride glasses are comparable to those measured in optical quality fused silica and borosilicate glasses. However, for many samples investigated the presence of solid inclusions results in low damage thresholds. Some examples of solid inclusions are shown and discussed. Surface damage thresholds in FK-51 fluorophosphate glass are uniformly high and exhibit an approximate square root dependence on pulse duration in the range of 0.1–1.0 ns.
1064—NM Laser Damage Thresholds of Polished Glass Surfaces as a Function of Pulse Duration and Surface Roughness
Authors: Milam D
Published: March 2009

Laser damage thresholds were measured for four polished glass surfaces, using linearly polarized 1064-nm pulses with durations of 0.17 ns, 1.0 ns, 1.6 ns, and 3.2 ns. Thresholds scaled approximately as the square root of pulse duration, but were insensitive to variations in surface roughness when the roughness was <25 Å rms. Careful cleaning increased the damage threshold at 3.2 ns by removing parti culates.
Ultraviolet Damage Resistance of Laser Coatings
Authors: Newnam BE , Gill DH
Published: March 2009

The damage resistance of several thin-film materials used in ultraviolet laser optics was measured at 266 nm and 355 nm. The coatings included single, quarter-wave (QW) layers of NaF, LaF3, MgF2, Tho2, AI2O3, HfO2, ZrO2, Y2O3 and SiO2, plus multilayer reflectors composed of some of these materials. The substrates were uv-grade fused silica. Single-shot thresholds were obtained with 22-ns and 27-ns (FWHM) pulses at 266 and 355 nm, respectively. One of the samples had previously been tested using 20-ps pulses, providing a pulsewidth comparison.
TEM Investigation of Effects of a Barrier Layer on Damage to 1.064µ AR Coatings
Authors: Carniglia CK , Apfel JH , Carrier GB , Milam D
Published: March 2009

Silica/titania 4 layer AR coatings on BK-7 glass, with and without a half-wave silica barrier layer, have been damaged at 1.064µ by 150 ps laser pulses. The damage sites have been examined by TEM replica techniques at a magnification of 70,000. The size of the damage sites appears to be “quantized.” Most sites consist of a 1µ nucleus which leads to a 3µ crater in a fully developed site. The mechanical properties of the films appear to play a role in the morphology of the damage sites. The titania layers seem to fracture while the silica layers seem to melt or tear. A series of micrographs of near threshold damage sites shows the development of the sites from a rupture which appears to occur at or near the substrate surface. Evidence of heating in the substrate is also present, although it is difficult to pinpoint the exact starting point of the damage mechanism.
New Coating Materials for IR Laser Optical Components
Authors: Pastor RC , Harrington JA , Gorre LE , Chew RK
Published: March 2009

Six materials (LaF3, PrF3, CeF3, BiF3, KGaF4, and BiI3) were prepared and optical evaluated for use as thin film coating materials at 3.8 and 9.27 µm.
Graded Index Coatings of Cubic Thallium Iodide (TLI) and Lead Fluoride (PbF 2)
Authors: Moravec TJ , Skogman RA
Published: March 2009

We present a new technique for producing graded index films from alternating very thin layers of two materials. During deposition the thickness of the layers is adjusted so that the resulting average index matches the index of the profile for that total thickness. This method shows great promise for making films with any desired complicated index profile in a very straightforward manner. Results are presented for graded index AR films near 10µm made from TℓI and PbF 2. The lO.µm absorption of these films was similar to that of discrete, multilayer AR films composed of the same materials.
Fatigue Mechanisms
Authors: Fong JT
Published: March 2009

Description

Deals with direct observations of different physical characteristics; dislocation level; clip bands; striations, voids and micro cracks, time dependent damage; and the basic concepts of quantitative microscopy.
Fracture Mechanics Applied to Brittle Materials
Authors: Freiman SW
Published: March 2009

Description

This publication provides guidelines for choosing a particular test technique. 14 papers provide a basis for future experiments to establish parameters for determination of accurate values of toughness and crack velocity.
Corrosion and Degradation of Implant Materials
Authors: Syrett BC , Acharya A
Published: March 2009

Description

Contains 22 papers ranging from degradation of ceramic and polymeric materials to corrosion of dental and orthopedic implant alloys.
Effluent and Evironmental Radiation Surveillance
Authors: Kelly JJ
Published: March 2009

Description

A review of methodologies used, data and interpretations obtained from, and the monitoring of effluents from and environments surrounding nuclear facilities. Specifically addresses techniques used in measuring the radioactive effluent from facilities using nuclear materials and the monitoring of the environment in order to determine the impact of these materials on man and the environment.
Fracture Mechanics
Authors: Paris PC
Published: March 2009

Description

33 papers describe the developments in research as well as applications. Prediction methods, elastic-plastic analysis, J-Integral approach, and many other techniques are included.
Crack Arrest Methodology and Applications
Authors: Hahn GT , Kanninen MF
Published: March 2009

Description

22 papers address emerging crack arrest test methods and reflect the substantial progress made during the past 2-1/2 years. The test procedures presented document cooperative evaluation that includes investigations from 11 foreign countries.
Zirconium in the Nuclear Industry
Authors: Franklin DG
Published: March 2009

Description

This publication provides information on the performance of zirconium and zirconium alloy components in nuclear application. Nuclear physicists have discovered that some materials -- zirconium, for example, provide much better neutron economy than conventional materials such as stainless steels.
Fire Risk Assessment
Authors: Castino GT , Harmathy TZ
Published: March 2009

Description

The papers presented in this publication provide an updated review of techniques, methods, and analytical approaches for quantitatively assessing the risks associated with unwanted fires, and at the same time identifying qualitative and subjective public perceptions of fire assessment, which establish acceptable levels of risk.
Mechanical Testing for Deformation Model Development
Authors: Rohde RW , Swearengen JC
Published: March 2009

Description

This publication of 24 technical papers that utilize an interdisciplinary approach to deformation modeling by providing a vehicle for increased communication between analytical mechanics and materials science disciplines. The contents of STP 765 encompass three major subject areas: Implication of Experimental Techniques, Phenomenological Modeling and Applications, and Microstructural Evolution and Derived Models.
Selected Sensory Methods: Problems and Approaches to Measuring Hedonics
Authors: Kuznicki JT , Johnson RA , Rutkiewic AF
Published: March 2009

Description

STP 773 is a presentation of methodologies currently in use in measuring pleasurable and annoying human sensory experiences, a field known as hedonics. A keynote paper provides background and an overview of remarkable sensory sensitivities and other features found at all levels of development in nature.
Extending Aggregate Resources
Authors: Hotaling WW
Published: March 2009

Description

This publication addresses better utilization of what is available to extend aggregate resources. Several papers contained this volume look into supplementing the supply with another resource. Other papers discuss extending aggregate initially, stabilizing aggregate mixtures, and in general upgrading individual aggregate particles.
Masonry: Materials, Properties, and Performance
Authors: Borchelt JG
Published: March 2009

Description

This publication contains information of interest to persons specifying and designing masonry construction. It provides current research on masonry units, mortar and grout and their components, and masonry assemblages. The majority of the papers contained in this book deal with the performance of the assemblage of masonry units and mortar.
Integral abutment bridge hysteresis model for long prediction
Authors: Pugasap K. , Laman J. A.
Published: March 2009

A numerical prediction methodology utilising hysteresis models was developed to enable long-term response prediction of integral abutment (IA) bridges. Long-term IA bridge behaviour prediction is important due to the nonlinear response of this bridge type, resulting in cumulatively increasing deformations over repeated annual temperature cycles. In order to limit computational demand for long-term simulations, a numerical model condensation technique was performed. Although the condensed model is intended to be simple, the complexity of inelastic IA bridge behaviour and time-dependent effects is fully captured for accurate prediction. The condensed model predicted response is compared with measured responses from field monitoring of three IA bridges in Pennsylvania, as well as predicted responses from two- and three-dimensional (2D and 3D) finite-element (FE) models. Abutment longitudinal displacement is used as a basis for comparison among models, as pile and girder stresses are directly related to this measure. Predicted long-term responses over a 100-year simulation period based on the condensed model and complex 2D FE model are presented and compared. The results indicate that the condensed model is an accurate and efficient alternative to more complex 2D and 3D FE models for predicting the long-term response of IA bridges.
Numerical modelling of braided streams in unsteady flow
Authors: Takebayashi H. , Okabe T.
Published: March 2009

Braided streams with vegetation growth under unsteady water supply conditions were reproduced using horizontal two-dimensional bed deformation numerical analysis. The effects of both vegetation and the unsteady characteristics of the water supply on the dynamic characteristics of braided streams are investigated. The mechanisms of stream lengthening and the decrease in the number of streams under unsteady flow conditions are discussed. To avoid complete transitions of bed configurations during a flood, tested hydraulic conditions were restricted to those with short-period hydrographs. The results show that wavelengths of submerged bars under unsteady water supply conditions are shorter than those under steady conditions. The results further suggest that both sediment deposition at higher locations and the formation of islands primarily cause stream lengthening under unsteady flow conditions. The wavelength of submerged bars was not a primary cause. Sediment is deposited in smaller channels during floods; the bed at riffles is eroded during low flows. These phenomena force water to flow into larger streams. Consequently, the number of streams decreases under unsteady flow conditions. Furthermore, the presence of vegetation enhances sediment deposition at higher locations and this contributes to a decrease in the number of streams under the condition that vegetation on islands is not completely washed away by floods.
Chemical Composition and Antimicrobial Properties of Piper ovatum Vahl
Authors: Silva Daniel Rodrigues , Endo Eliana Harue , Filho Benedito Prado Dias , Nakamura Celso Vataru , Svidzinski Terezinha Inez Estivaleti , De Souza Amanda , Young Maria Claudia M. , Ueda-Nakamura Tânia , Cortez Diógenes Aparício Garcia
Published: March 2009

The chemical composition of the essential oil obtained from the leaves of Piper ovatum Vahl by hydrodistillation was analyzed by GC–MS. The main constituents found were δ-amorphene (16.5 %), cis-muurola-4(14),5-diene (14.29 %) and γ-muurolene (13.26%). The crude extracts and isolated compounds were screened for their antimicrobial activity. Hydroalcoholic extracts of different parts of Piper ovatum Vahl, essential oil and amides isolated from leaves were tested against Gram-positive and Gram-negative bacteria and Candida species. All extracts and amides were active against Bacillus subtilis and Candida tropicalis, including clinical strains. Essential oil was active against C. tropicalis. These amides showed an inhibitory effect on the adherence of C. tropicalis ATCC 28707 on cover glasses at 10 μg/mL, but did not show morphological alterations at the tested concentrations. Amides were identified as piperovatine and piperlonguminine, and showed MIC values of 15.6 and 31.2 μg/mL to B. subtilis and 3.9 μg/mL to C. tropicalis, and low toxic effects to Vero cells and macrophages.
Analysis of an Integrated Clinical Decision Support System in Nursing Home Clinical Information Systems
Authors: Alexander Gregory L.
Published: March 2009

This descriptive study evaluated a clinical decision support system (CDSS) in three nursing homes. The CDSS included alerts for decline in condition, improvement in condition, constipation, dehydration, loss of skin integrity, weight loss, and weight gain. Frequencies of alerts and their triggers were counted, and Spearman’s rank correlations were determined between active alert frequency and number of secondary diagnoses. The most frequent alerts were for dehydration and improvement in condition. One significant positive correlation existed between number of secondary diagnoses and weight gain alert frequencies in residents with cerebral vascular accident. Health care leaders face challenges constructing an implementation strategy that addresses usability, ensures accuracy, and guides users to critical information about residents.
Policy Recommendations on the Prevention of Violence in Long-Term Care Facilities
Authors: Robinson Karen M. , Tappen Ruth M.
Published: March 2009

Violence in long-term care facilities is not well understood and remains unaddressed by policy makers and administrators. Underlying factors contributing to violence are discussed and preventive strategies are offered as potential solutions to reduce aggressive behavior. Knowledge of the incidence of violence and the conditions and factors contributing to violence can help nurses protect both staff and residents and achieve better resident outcomes. Potential solutions and policy recommendations for the prevention of violence, including improvement of staffing in long-term care facilities, are offered.
Roles and Responsibilities of Health Care Agents: Views of Patients and Agents
Authors: Tesfa Asrat , Kaplan Karen Orloff , Meyer Mary L. , Coachman Denise M.
Published: March 2009

Two qualitative methods were used to explore, from the perspectives of both patients and agents, the roles and responsibilities of health care agents related to making end-of-life decisions. Results of the individual interviews revealed that both patients and agents did not have a clear understanding of the role, responsibility, and legal authority of health care agents. The results of the focus group of former agents indicated that when assuming the role, some agents had both knowledge and experience in making end-of-life decisions, whereas others had little understanding of their role. Former agents discussed serious communication difficulties they had encountered with health care professionals when making life-and-death decisions.
Use of Videophones for Distant Caregiving: An Enriching Experience for Families and Residents in Long-Term Care
Authors: Demiris George , Parker Oliver Debra R. , Hensel Brian , Dickey Geraldine , Rantz Marilyn , Skubic Marjorie
Published: March 2009

The objective of this study was to explore the role of videophone technology in enhancing the distant care-giving experience of and communication between residents of a long-term care facility and their family members. Ten participants—4 residents of an independent retirement facility and 6 family members—were recruited. A videophone was installed in each resident’s apartment, and another was mailed to the remote family member. Participants were asked to conduct a videocall at least once per week for 3 months. Exit interviews assessed general impressions of videophone communication, the relationship between residents and family members, stress, burden, and isolation. Participants were enthusiastic and emphasized a sense of closeness, the inclusion of the resident in family interactions, and reduced feelings of guilt and isolation as key benefits. New models of care are needed to challenge the existing paradigm, which often excludes distant caregivers from the care process. Technology can facilitate this process by bridging geographic distance.
Atrial Fibrillation Among Older Adults: Pathophysiology, Symptoms, and Treatment
Authors: Hardin Sonya R. , Steele James R.
Published: March 2009

Atrial fibrillation is the most common arrhythmia among older adults. Valvular heart disease, dilated cardiomyopathy, aortic stenosis, hypertension, coronary artery disease, pericarditis, thyrotoxicosis, pulmonary disease, cardiac surgery, alcohol excess, and alcohol withdrawal are associated with atrial fibrillation. Nurses caring for older adults need to understand the condition’s pathophysiology, signs and symptoms, diagnostic data and treatment protocols, and adherence issues to prevent the formation of emboli in chronic atrial fibrillation and to understand treatment of this common arrhythmia. This article presents an individual example of an elderly man exhibiting a new onset of atrial fibrillation and the interventions required to manage the associated complications. Atrial fibrillation places patients at risk for stroke from a thromboembolism; thus, pharmacological and nonpharmocological care strategies for managing patients with atrial fibrillation are discussed.
Surviving the Storms: Emergency Preparedness in Texas Nursing Facilities and Assisted Living Facilities
Authors: Castro Carmen , Persson Diane , Bergstrom Nancy , Cron Stanley
Published: March 2009

This study assesses the preparedness of long-term care facilities in Texas responding to Hurricanes Katrina and Rita. A 41-item questionnaire was mailed to facilities; the response rate was 42%. Among responding facilities, 4,513 residents were evacuated, and 6% of respondents reported resident death. Financial losses were reported by 8% of nursing facilities and 45% of assisted living facilities due to transportation and staff overtime. Respondents indicated the need for improved disaster preparedness training, better coordination, and transportation. Changes in policy and practice will lead to better trained staff who will provide the care residents need for improved health outcomes during future public health disasters.
CNAs’ Experiences in the Nursing Home: “It’s in My Soul”
Authors: Carpenter Jacque , Thompson Sarah A.
Published: March 2009

Issues affecting CNAs’ ability to do the job can affect resident care quality. The purpose of this study was to explore the meaning of CNAs’ experiences in the nursing home. A naturalistic design using qualitative methods guided data collection and analysis. Data were analyzed using qualitative content analysis. Four themes emerged: Transitioning Between Two Worlds, Responding to the Call, Living the Job, and Transcending the Job. The challenge is to create strategies that identify CNAs’ passion for the job, support their ability to balance daily tasks with relationships, and value their knowledge and contributions to the care team.
Having a Voice and Being Heard: Nursing Home Residents and In-House Advocacy
Authors: Walent Ronald J. , Kayser-Jones Jeanie
Published: March 2009

As part of an ethnographic study exploring what it means for nursing home residents to “do well,” we examined patterns of advocacy on which they relied to have an effective voice. The purposive sample included 17 older, long-stay residents from a for-profit chain nursing home and a large public skilled nursing facility. Data collection included in-depth interviews, participant observation, and document review. Depending on personal history, health status, and facility context, participants relied on family and friends, trusted staff, fellow residents, or themselves as advocates. Although residents varied in their abilities and willingness to express concerns, a program matching staff advocates with residents at the chain nursing home fostered participants’ sense that they were heard and their needs addressed. Attending to patterns of advocacy and the effect of the nursing home environment on resident communication are essential for individualizing care and promoting systems to ensure residents have a voice and are heard.
Physical and Psychosocial Correlates of Fear of Falling Among Older Adults in Assisted Living Facilities
Authors: Sharaf Amira Y. , Ibrahim Hanaa S.
Published: March 2009

Fear of falling is the most common reported fear among older adults. Nevertheless, little is known about whom among this population develops fear of falling and why. This study aims to identify physical and psychosocial correlates of fear of falling among older adults in assisted living facilities. Data were collected from interviews with 208 residents using measures of fear of falling, physical and social functioning, depression, and state and trait anxiety. Results revealed that 48.6% of the participants had moderate to severe concern about falling. Stepwise multiple linear regression analysis revealed that use of a walking device, depression, balance impairment, trait anxiety, female gender, and a previous history of a fall or falls were independent factors associated with fear of falling. It is suggested that improving physical fitness and balance control and increasing one’s self-efficacy and sense of control over the environment can decrease these sources of fear among older adults.
Abnormal Band of Lateral Meniscus
Authors: Giordano Brian , Goldblatt John
Published: March 2009

This article describes a case of an “abnormal band” of the lateral meniscus, extending from the posterior horn of the true lateral meniscus to its antero-mid portion, observed during arthroscopy in a 45-year-old white man of Bosnian descent. The periphery of the aberrant lateral meniscus was freely mobile, and not connected to the underlying true lateral meniscus. Preoperative physical examination findings were consistent with medial-sided meniscal pathology only; however, evidence of an anomalous lateral meniscus was seen with magnetic resonance imaging. This anatomical pattern is rare and has been reported in the literature only once, in a report of 2 Asian patients. This article illustrates an anatomical variant of the lateral meniscus in a non-Asian patient with a clinical presentation that has not been previously described. In addition to the case report, the article presents a comprehensive review of the existing body of literature on anomalous lateral meniscus patterns. We believe that the definitions of the types of aberrant meniscus can be clarified to establish improved accuracy in reporting.
Extensor Deficiency: First Cause of Childhood Flexible Flat Foot
Authors: Vittore Donato , Patella Vittorio , Petrera Massimo , Caizzi Gianni , Ranieri Maurizio , Putignano Piero , Spinarelli Antonio
Published: March 2009

Childhood flexible flat foot is the most common paramorphism of the lower limb. The cause is not a bony malformation of the foot but a functional deficiency of the anatomic structures supporting the plantar arch. These structures, working as active tie rods (the tibialis anterior and posterior muscles) or passive factors of support (flexor hallucis longus and flexor digitorum longus muscles) act together to maintain the plantar arch. Their deficiency is responsible for childhood flexible flat foot, characterized by a flattening of the plantar arch and calcaneus pronation (heel valgus) and manifested in the characteristic “duck walking” in children. Hypothesizing poor extensor activity of the tibialis anterior, extensor digitorum longus, and extensor hallucis longus muscles during the heel contact phase of the gait cycle, we began a preliminary study to evaluate, through superficial electromyography (sEMG), the activation of muscle groups involved in the pathogenesis of childhood flexible flat foot, in particular the tibialis anterior and extensor hallucis longus muscles, to plan a rehabilitative program addressing the strengthening of insufficient muscles. The therapeutic program should also include the use of a medial elastic push orthosis. Data obtained by sEMG highlight a reduced activation of muscles related to the grade of flat foot, emphasizing the concept that a reduced activation of extensor muscles may be involved in determining flexible flat foot.
Ocular Infections Due to Anaerobic Bacteria in Children
Authors: Brook Itzhak
Published: March 2009

The recent increased recovery of anaerobic bacteria from children has led to greater appreciation of the role these organisms play in pediatric infections at all body sites, including the eye. In studies that employed adequate methods for recovery of anaerobes, they were isolated from approximately one-third of the children with conjunctivitis, half of the time in pure culture. The predominant recovered anaerobes were Clostridium spp., gram-negative anaerobic bacilli, and Peptostreptococcus spp. Anaerobic bacteria were also recovered from patients who wore contact lenses and developed conjunctivitis, and were reported in cases of keratitis. The most frequently recovered anaerobes were Propionibacterium spp., Peptostreptococcus spp., Clostridium spp., Prevotella spp., and Fusobacterium spp. The most frequently recovered anaerobes from dacryocystitis were Peptostreptococcus spp., Propionibacterium spp., Prevotella spp., and Fusobacterium spp. This review describes the microbiology, diagnosis, and management of ocular infections due to anaerobic bacteria in children.
The Frequency of Ocular Abnormalities in Inpatient Pediatric Ophthalmology Consultations
Authors: Hasan S. Jafar , Yen Kimberly G. , Parghi Chirag R. , Castanes Maria S. , Edmond Jane C.
Published: March 2009

Objective:
To determine the frequency, type, and results of pediatric ophthalmology service consultations at a tertiary care children’s hospital and to offer advice as to the timing of the initial consultation based on the patient’s diagnosis and likelihood of ocular disease.

Method:
A retrospective evaluation of inpatient ophthalmology consultations from September 1, 2003, to August 31, 2004, at Texas Children’s Hospital was conducted. Patients were identified using the Current Procedural Terminology listing of billing codes for various levels of service for new initial inpatient consultations.

Results:
During the 1-year period, 445 new inpatient consultations were requested from the pediatric ophthalmology service, primarily to rule out ophthalmic problems or manifestations (55.9%) and to evaluate ocular complaints or ocular abnormalities as noted by the primary team (44.1%). Of the 445 patients, 215 (48.3%) were found to have ocular abnormalities and 230 (51.7%) had no ocular abnormalities at the time of initial consultation.

Conclusion:
Patients with ocular signs or symptoms of disease should receive urgent ophthalmic consultation. Consideration should be given to the usefulness of urgent consultations in patients suspected of having fungemia, sepsis, and headache.
Rhabdomyoma of the Orbit
Authors: Li Yong-ping , Nie Li , Zhang Wen-xin , Lin Jian-xian , Yang Hua-sheng , Feng Guan-guang
Published: March 2009

The authors describe a rare case of orbital rhabdomyoma in a 3-year-old girl who presented with progressive proptosis of the left eye. An axial computed tomographic scan of the left orbit demonstrated an irregular retrobulbar mass. The tumor was resected locally from the lateral wall of the orbit and the resected specimens were diagnosed as orbital rhabdomyoma. The authors review the literature and discuss the diagnostic implications and treatment strategies.
The Use of Levodopa in the Treatment of Bilateral Amblyopia Secondary to Uncorrected High Hypermetropia
Authors: Abrams Michael S.
Published: March 2009

The standard treatment of bilateral amblyopia secondary to uncorrected high bilateral hypermetropia has been spectacles and time. The patient described here failed to show adequate improvement in visual acuity after 18 months of standard treatment. Visual acuity improved dramatically when the patient began taking levodopa, dropped precipitously when the medication was discontinued, and returned quickly to post-treatment levels when levodopa was restarted. Visual acuity remained stable when the medication was slowly tapered and discontinued. This report suggests that dopamine may play a role in the pathophysiology of bilateral amblyopia secondary to uncorrected high bilateral hypermetropia.
Ocular Complications of Eyebrow Piercing
Authors: Carelli Roberta , Fimiani Francesco , Iovine Antonello , Vassallo Patrizia , Magli Adriano
Published: March 2009

Piercing, a type of body art, is increasing in popularity among young people. Two patients presented with complications a few days after having an eyebrow piercing. The first had posterior cellulitis and the second had anterior cellulitis. In both cases, symptoms decreased after 1 week of therapy with antibiotics and cortisone.
Excyclotorsion in Congenital Fibrosis of Extraocular Muscles
Authors: Pandey Pramod Kumar , Shroff Daraius , Kaur Navjot , Garg Deepali , Sahu Atul
Published: March 2009

The authors report marked bilateral excyclotorsion contributing to loss of binocularity and leading to ipsilateral head tilt in a patient with congenital fibrosis of the extraocular muscles type 1. Neuroimaging revealed bilateral hypoplastic superior recti and levator palpebrae superioris muscles. Postoperatively, head tilt was relieved and excyclotorsion was reduced. Assessment of torsion may influence surgical strategies and outcome in patients with congenital fibrosis of the extraocular muscles.
Orbital Rhabdomyosarcoma Masquerading as a Mucocele
Authors: Lazaridou Marie-Noëlle , Nabili Shahriar , Lavy Timothy
Published: March 2009

The authors describe a case of orbital rhabdomyosarcoma masquerading as a lacrimal mucocele in a newborn infant. Rhabdomyosarcoma is one of the few life-threatening diseases that an ophthalmologist may be the first to diagnose. This case highlights the importance of close monitoring of such presentations in the newborn.
A Rare Association of Familial Exudative Vitreoretinopathy and Turner’s Syndrome
Authors: Mandal Subrata , Venkatesh Pradeep , Wadha Neeraj , Vohra Rajpal , Garg Satpal
Published: March 2009

A 6-year-old girl presented with left divergent strabismus that had been noticed by her parents. She was known to have Turner’s syndrome. On examination, she had tractional retinal detachment in the left eye and a temporal avascular area with neovascularization at the junction with the vascular area. Clinical features were characteristic of familial exudative vitreoretinopathy. This case is a rare and, to the authors’ knowledge, the first reported association of familial exudative vitreoretinopathy and Turner’s syndrome.
Ocular Findings in a Child With Multiple Endocrine Neoplasia Type 2b
Authors: Sahin Afsun , Yildirim Nilgun
Published: March 2009

A 16-year-old girl was admitted with severe bilateral conjunctival hyperemia and stinging lasting for more than 1 year. Slit-lamp biomicroscopic examination revealed extremely thickened corneal nerves and multiple small plexiform subconjunctival neuromas. Both eyes had thickened upper and lower eyelids and a neuroma was found on the left upper conjunctival lid margin. On physical examination, a 2 × 3 cm nodule was detected within the thyroid gland. Medullary thyroid carcinoma was diagnosed by fine needle aspiration biopsy and thyroidectomy ensued. Further investigation with abdominal computed tomography revealed a pheochromocytoma (3 × 4.5 × 2 cm) of the right adrenal gland, which was removed surgically. Ophthalmologists must remember multiple endocrine neoplasia 2b in the presence of greatly thickened corneal nerves and subconjunctival neuroma because this may be the first sign of the disease. Early diagnosis and prophylactic thyroidectomy may be life saving.
What’s Your Diagnosis?
Authors: Tatham Andrew , Walton David S.
Published: March 2009

Visual acuities and color vision were normal in a 16-year-old boy. Electrodiagnostic testing revealed a normal electroretinogram but an abnormal electro-olfactogram ratio.
Parry–Romberg Syndrome Presenting With Recurrent Exotropia and Torticollis
Authors: Kee Changwon , Hwang Jeong-Min
Published: March 2009

Parry–Romberg syndrome, or progressive facial hemiatrophy, is a unilateral, slowly progressive atrophy that affects skin, subcutaneous tissues, muscles, and bones. The authors describe an 8-year-old girl with Parry–Romberg syndrome, amblyopia, recurrent exotropia, and torticollis, and stress that the association between this syndrome and amblyopia, recurrent exotropia, and torticollis should be recognized.
Retinoblastoma and Hirschsprung Disease With a 13q14 to 22 Deletion
Authors: Zaborowski Anthony G. , Kruse Carl-Heinz , Kavonic Shelagh , Pegoraro Rosemary J.
Published: March 2009

Hirschsprung disease, bilateral retinoblastoma, and craniofacial dysmorphism with an interstitial deletion of chromosome 13 is a rare gene deletion syndrome that has twice before been described in white children. The authors present the third report of such a case in a South African child of Indian-Asian descent.
Panuveitis Associated With Granuloma Annulare in a Child
Authors: Arekapudi Smitha , Whitfield Katherine , Morrison David
Published: March 2009

A 5-year-old child developed panuveitis with choroidal lesions. Topical steroid medications were insufficient to control the inflammation long term. Granuloma annulare was subsequently diagnosed in association with the uveitis. Systemic immunosuppression with methotrexate was eventually required to control the skin lesions and uveitis. Uveitis associated with granuloma annulare may present with choroidal lesions and panuveitis in children.
[J Pediatr Ophthalmol Strabismus 2009;46:45–46.]
Role of the Equator in the Early Overcorrection of Intermittent Exotropia
Authors: Cho Yoonae A. , Kim Seung-Hyun
Published: March 2009

Purpose:

To determine the cause of consecutive esotropia on the basis of the relationship between the location of the equator and a new insertional site of the recessed lateral rectus muscle in cases of intermittent exotropia.

Methods:

Ninety-two patients with intermittent exotropia, all of whom underwent recessions of both lateral rectus muscles (5 to 8 mm), were included. The distances from the limbus to the equator (LE distance) and from the equator to the new insertion of the recessed lateral rectus muscle (EIN distance) were calculated using the following formula: (LE = axial length·π/4 – corneal diameter/2). Overcorrection was defined as esophoria in excess of 5 prism diopters, and all patients were followed up for at least 3 months after surgery.

Results:

In all patients, the mean LE distance was 12.7 mm in the right eye and 12.6 mm in the left eye. The mean EIN distance in the successfully corrected patients was −0.82 mm in the right eye and −0.95 mm in the left eye. A negative distance value indicates a new insertion anterior to the equator. Overcorrection was detected in 15 patients (16.3%), whose mean EIN distances were −0.93 mm in the right eye and −0.78 mm in the left eye. No significant differences were determined to exist between the corrected and overcorrected patients with regard to the affected eye (
P
> .05).

Conclusions:

Overcorrection of intermittent exotropia did not appear to be related to the location of new insertions of the lateral rectus muscle of up to 8 mm of recession. This may indicate the redistributing of relatively more innervational inputs to the medial rectus muscle after the completion of lateral rectus recession in consecutive esotropia.

[J Pediatr Ophthalmol Strabismus 2009;46:30–34.]
Fluorescein and Indocyanine Green Angiographic Findings in Progressive Hemifacial Atrophy
Authors: Kawazoe Mariko , Hirata Akira , Okinami Satoshi
Published: March 2009

A 20-year-old man who had progressive hemifacial atrophy was examined using fluorescein and indocyanine green angiography. The fundus showed sectional chorioretinal atrophy. Fluorescein angiography showed window defects without leakage. Indocyanine green angiography revealed narrow choroidal vessels with hypofluorescence.
[J Pediatr Ophthalmol Strabismus 2009;46:56–58.]
Congenital Axial High Myopia Detected by Prenatal Ultrasound
Authors: Kim Min Jung , Lee Jeong Heon , Lee Dong Wook , Kweon Eui Yong , Ahn Min
Published: March 2009

High-resolution prenatal ultrasound can allow for early detection and monitoring of many fetal anomalies, including those involving the globe and orbit. The authors present a case of congenital axial high myopia that was diagnosed at 33 gestational weeks and monitored by prenatal ultrasonography. Some systemic abnormalities that can be associated with congenital high myopia are reviewed. High ammetropias, anisometropia, and either axial myopia or axial hyperopia can be detected in utero and give this early detection a greater chance of treating and reversing the devastating effects of amblyopia.
[J Pediatr Ophthalmol Strabismus 2009;46:50–53.]
Abnormal Ocular Electrophysiology in Sjögren–Larsson Syndrome
Authors: Sharma Pankaj , Chaudhuri Zia , Raina Usha K. , Ghosh Basudeb , Sethi Sumita
Published: March 2009

Two siblings who were born out of consanguineous marriage in an Indian family and had typical clinical manifestations of Sjögren–Larsson syndrome were found to have normal electroretinogram and abnormal visual evoked potential results. Abnormal visual evoked potential results along with the presence of distinctive foveal and parafoveal deposits, which could have a prognostic bearing on the visual acuity of the patients, emphasize the importance of a complete ophthalmological and electrophysiological evaluation in all patients with Sjögren–Larsson syndrome.
[J Pediatr Ophthalmol Strabismus 2009;46:42–44.]
Wound Leakage and Hypotony After 25-Gauge Sutureless Vitrectomy: Factors Affecting Postoperative Intraocular Pressure
Authors: Byeon Suk Ho , Lew Young Ju , Kim Min , Kwon Oh W.
Published: March 2009

Background and Objective:
To investigate the factors related to postoperative hypotony after 25-gauge sutureless vitrectomy.

Patients and Methods:
Of 109 consecutive eyes undergoing sutureless vitrectomy, 95 fluid-filled eyes were randomly assigned to three groups according to the order of infusion cannula removal. In group 1 (30 eyes), the infusion was removed first. In group 2 (32 eyes), the infusion was removed after another cannula. In group 3 (33 eyes), the infusion was removed last. Intraocular pressure (IOP) was measured on pre-operative day 1 and postoperative days 1, 7, and 30.

Results:
Mean age was 58.9 ± 11.6 years (range: 18 to 80 years). Among each factor (including order of infusion removal, age, sex, axial length, preoperative IOP, previous vitrectomy, indications for vitrectomy and lens status), only age was significantly correlated with IOP on postoperative day 1 (P = .019). In 13 eyes in which hypotony persisted through postoperative day 2 (IOP ≤ 5 mm Hg), the age of the patients was significantly younger than those who did not experience persisting hypotony (P = .006).

Conclusion:
Younger patients were more likely to experience early postoperative hypotony.