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Purpose: To evaluate the association of acromial morphology and subacromial impingement. Methods: Bilateral shoulder computed tomography was performed in 138 patients who received shoulder arthroscopy. Measured parameters included: acromial tilt (AT), modified acromial tilt (mAT), acromial slope (AS), acromiohumeral interval (AHI), lateral acromial angle (LAA), acromial index (AI), critical shoulder angle (CSA), acromial anterior protrusion (AAP), and acromial inferior protrusion (AIP). Acromial morphological characteristics were compared between groups. Side-to-side differences were assessed between affected and non-affected shoulders. Intra- and inter-observer agreements for each parameter were calculated. Results: AT (25.90 vs. 29.41°), mAT (18.88 vs. 22.64°), and AHI (5.46 vs. 6.47 mm) were significantly smaller in impinged patients. The impingement group demonstrated significantly larger AI (63.50 vs. 59.84%), CSA (31.78 vs. 28.74°), AAP (7.13 vs. 5.32 mm), and AIP (5.51 vs. 4.04 mm). Regarding side-to-side comparison, the acromial morphology was significantly different between the affected and non-affected shoulders in impinged patients, while the difference was slight and insignificant in control patients. All, except AS and LAA, measured parameters demonstrated good intra- and inter-observer agreements. Conclusions: Three-dimensional reconstructed CT scan is a reliable method to measure shoulder morphology. The acromial morphological variation is related with sub acromial impingement, however, the causal relationship of them should be further explored. [ABSTRACT FROM AUTHOR]

Analysis of the slipstream development around the high-speed trains in tunnels would provide references for assessing the transient gust loads on trackside workers and trackside furniture in tunnels. This paper focuses on the computational analysis of the slipstream caused by high-speed trains passing through double-track tunnels with a cross-sectional area of 100 m2. Three-dimensional unsteady compressible Reynolds-averaged Navier-Stokes equations and a realizable k-ε turbulence model were used to describe the airflow characteristics around a high-speed train in the tunnel. The moving boundary problem was treated using the sliding mesh technology. Three cases were simulated in this paper, including two tunnel lengths and two different configurations of the train. The train speed in these three cases was 250 km/h. The accuracy of the numerical method was validated by the experimental data from full-scale tests, and reasonable consistency was obtained. The results show that the flow field around the high-speed trains can be divided into three distinct regions: the region in front of the train nose, the annular region and the wake region. The slipstream development along the two sides of train is not in balance and offsets to the narrow side in the double-track tunnels. Due to the piston effect, the slipstream has a larger peak value in the tunnel than in open air. The tunnel length, train length and length ratio affect the slipstream velocities; in particular, the velocities increase with longer trains. Moreover, the propagation of pressure waves also induces the slipstream fluctuations: substantial velocity fluctuations mainly occur in front of the train, and weaken with the decrease in amplitude of the pressure wave. [ABSTRACT FROM AUTHOR]

Objective: To evaluate clinical characteristics and present surgical outcomes of PT caused by sigmoid sinus wall dehiscence (SSWD) Methods: This study retrospectively reviewed 34 patients with PT who were diagnosed with SSWD in our institution between December 2008 and July 2013. Among them, 27 patients underwent sigmoid sinus wall reconstruction (surgery group) and 7 patients refused surgery (non-surgery group). Preoperative data were obtained from the patients’ medical records. All patients were followed up regularly for at least 25 months. Preoperative and postoperative computed tomography angiography (CTA) images were compared. Student’s t-tests were used to compare age, body mass index (BMI) and preoperative Tinnitus Handicap Inventory (THI) scores between the surgery and the non-surgery groups and to compare pre- and follow-up THI scores. Results: There was no significant difference in age, body mass index, or preoperative THI scores between groups. Following surgery, 14 patients had complete resolution, 5 had partial resolution, 7 experienced no change and PT was aggravated in 1 patient. The difference between preoperative and postoperative THI scores was significant. No severe complications were found postoperatively. Comparison of the preoperative and postoperative CTA images revealed that remnant unrepaired dehiscences were the cause of unsatisfactory outcomes following surgery. In the non-surgery group, PT remained largely unchanged. Conclusions: Sigmoid sinus wall reconstruction is an effective and safe treatment for PT caused by SSWD. It is imperative that all regions of the dehiscence are sufficiently exposed and resurfaced during surgery. [ABSTRACT FROM AUTHOR]