Magnetic resonance diagnosis of posterior horn tears of the lateral meniscus using a thin axial plane: the zip sign--a preliminary study.

OBJECTIVE: The "zip" sign is a newly described form of meniscal tear progressing from the distal insertion of menisco-femoral ligaments (MFLs) through the lateral meniscal wall; the tear occurs during anterior cruciate ligament (ACL) rupture. The purpose of this study was to evaluate the zip sign on knee MRI within the context of ACL injuries. METHODS: From a series of 261 MR examinations for acute knee injury, we selected 97 patients with both MR and arthroscopic data for a retrospective blinded review. The zip sign was defined on axial thin MR sections as a straight line from the distal insertion of MFLs in association with five sagittal images lateral to the posterior cruciate ligament (PCL) where the MFLs were identified. Sensitivity and specificity in detecting lateral meniscal tears before and after having defined the zip sign were calculated. RESULTS: Sensitivity in detecting the tears of the posterior horn of the lateral meniscus (PHLM) reached 87.5% (CI 0.68-0.97) after zip sign criteria were defined. The zip sign has excellent inter-observer agreement, К>0.90. CONCLUSION: The zip sign indicates a lesion at the insertion site of MFLs into the PHLM on thin axial images associated with sagittal MR sections that may improve MR sensitivity in detecting PHLM tears.

Wastewater disinfection by low-pressure UV and ozone: a design approach based on water quality.

Disinfection processes are known to be very sensitive to wastewater quality. This paper discusses the parameters that impact the UV light (UV) and ozone disinfection processes and the related mechanisms based on literature review. Low-pressure UV and ozone technologies were investigated on effluents that covered a wide range of water quality. The results are given in terms of design doses required to meet three major disinfection standards. Both processes were found eligible for the majority of effluents tested. Although cost-effectiveness is usually considered more favourable to UV, the ozone alternative should be examined in cases such as the disinfection of low-quality effluents or large treatment plants. Ozonation was also found capable of meeting the stringent Title 22 standard with no coagulation at a dose of 10 mg/l.