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Sample records for abandoned radical hysterectomy

  1. Classical radical hysterectomy and nerve-sparing radical hysterectomy in the treatment of cervical cancer

    Marcin Makowski; Marek Nowak; Marian Szpakowski; Jacek Władziński; Anna Serwach-Nowińska; Łukasz Janas; Jacek R. Wilczyński

    2014-01-01

    Aim of the study: To compare Piver III radical hysterectomy (RH) with nerve-sparing radical hysterectomy (NSRH) for cervical cancer patients in terms of postoperative physiology of pelvic autonomic nerves and perioperative complications. Material and methods : Seventy-three consecutive patients with invasive cervical cancer underwent RH (53 cases) or NSRH (20 cases) from 2001 to 2012 at the Department of Gynecology and Gynecologic Oncology of Polish Mother’s Memorial Hospital – Research...

  2. Classical radical hysterectomy and nerve-sparing radical hysterectomy in the treatment of cervical cancer

    Marcin Makowski

    2014-06-01

    Full Text Available Aim of the study: To compare Piver III radical hysterectomy (RH with nerve-sparing radical hysterectomy (NSRH for cervical cancer patients in terms of postoperative physiology of pelvic autonomic nerves and perioperative complications. Material and methods : Seventy-three consecutive patients with invasive cervical cancer underwent RH (53 cases or NSRH (20 cases from 2001 to 2012 at the Department of Gynecology and Gynecologic Oncology of Polish Mother’s Memorial Hospital – Research Institute in Łódź. Results : Compared with patients treated with RH, patients who underwent NSRH presented no significant difference in terms of operative time (146 vs. 143 minutes, p > 0.05, blood loss and hospital stay (9.2 vs. 7.5 days, p > 0.05. A positive surgical margin was found in 6 cases of RH. No serious surgical complications were found in the NSRH group, while there were 4 cases in the RH group. Conclusions : Nerve-sparing radical hysterectomy is safe and feasible surgical management for cervical cancer patients, which should improve the physiology of the pelvic autonomic nerve system postoperatively. The technique is relatively new and its oncologic efficiency has not been fully established yet, moreover it requires sophisticated anatomical knowledge and high operative skills.

  3. Radical Hysterectomy and Total Abdominal Vaginectomy for Primary Vaginal Cancer.

    Ozgul, Nejat; Basaran, Derman; Boyraz, Gokhan; Salman, Coskun; Yuce, Kunter

    2016-03-01

    The aim of this surgical video is to demonstrate en bloc radical removal of uterus and vagina in a patient with clinical early-stage vaginal cancer. Surgical treatment was offered to our patient for clinical early-stage primary vaginal cancer. An en bloc radical hysterectomy, systematic pelvic lymphadenectomy, and total abdominal vaginectomy were performed. Postoperative adjuvant radiation or chemotherapy was not recommended for completely resected pathologic stage I disease with no lymph node involvement and negative surgical margins. Radical surgery can be a treatment option for selected patients with primary vaginal cancer. PMID:26825828

  4. Laparoscopic pelvic anatomy of nerve-sparing radical hysterectomy.

    Park, Nae Yoon; Cho, Young Lae; Park, Il Soo; Lee, Yoon Soon

    2010-03-01

    Many reports regarding nerve-sparing radical hysterectomy have been published. However, most reports have been based on systematic descriptions via laparotomy or cadaver dissection. The aim of this work was to describe the pelvic anatomy of nerve-sparing radical hysterectomy via laparoscopy, with specific focus on the inferior hypogastric plexus. This study is based on 125 patients with FIGO stage IB cervical cancer who had undergone laparoscopic nerve-sparing radical hysterectomies since 1999. The inferior hypogastric plexus was demonstrated via laparoscopy and was comprised of afferent fibers from the sacral root (S2, S3, and S4), sacral sympathetic ganglion, and hypogastric nerve, and efferent fibers forming its vesical, uterovaginal, and rectal branches. During the dissection of the posterior leaf of the vesicouterine ligament, various vesical veins were identified. If the cut edge of an inferior vesical vein was pulled medially with upward traction, the vesical branches of the inferior hypogastric plexus were exposed and these were divided into medial and lateral branches. The magnified view of laparoscopy made it possible to dissect nerves and vessels meticulously and to secure a clear resection margin during the dissection of the deep part of the cardinal ligament, uterosacral ligament, and posterior leaf of the vesicouterine ligament. PMID:20108355

  5. Urological complications after radical hysterectomy: Incidence rates and predisposing factors

    Likić-Lađević Ivana

    2007-01-01

    Full Text Available Bacground/Aim. Radical hysterectomy is a surgical approach for stage Ib and IIa of cervical cancer. The incidence of intraoperative injuries of the bladder during radical hysterectomy ranges from 0.4-3.7%. The ureter can be crushed, caught in sutures, transsected, obstructed by angulation, or ischemic by the stippling or periureteric fascia. Vesicovaginal and ureterovaginal fistuls are reported to develop in 0.9-2% of patients after radical abdominal hysterectomy. Fistulas usually become manifested or visible at speculum examination within 14 days following the surgery. The aim of this study was to establish the incidence and predisposing factor of urological complications after radical hysterectomy. Methods. The study included a total of 536 patients with invasive stage Ib to IIb cancer of the cervix uteri who had underwent radical hysterectomy. The special elements considered were: the patient’s age; the International Federation of Ginecology and Obstetrics (FIGO stage after pathohistology; duration of operation; the result of preoperative laboratory tests for diabetes, anemia, hypoproteinemia, or disorders of liver or kidney function; ASA status; postoperative surgical infection. Results. The average age of the patients with complications was 48.68 years. All patients with intraoperative ureteric and bladder injuries had statisticaly significant higher stage of disease and operation lasted more than in others without injury. We noticed 1.3% ureteral injuries and 1.49% bladder injuries, more than 50% of the patients with a previously mentioned injuries were operated on more than 3 hours. We found 2.61% vesicovaginal and 2.43% ureterovaginal fistuls. A total of 50% of the patients with bladder injury and vesicovaginal fistuls and 70% of the patients with ureterovaginal fistuls had diabetes mellitus. Postoperative infection of surgical site is a very important factor for the development of fistule. Half of the patients with vesicovaginal

  6. Hysterectomy

    ... such as wound infection, bleeding, blood clots, and nerve and tissue damage, than vaginal or laparoscopic hysterectomy. ... hysterectomy, you still may need pelvic exams and cervical cancer screening. Glossary Adhesions: Scarring that binds together ...

  7. Can radical parametrectomy be omitted inoccult cervical cancer afterextrafascial hysterectomy?

    Huai-WuLu,; JingLi,; Yun-YunLiu,; Chang-HaoLiu,; Guo-CaiXu,; Ling-LingXie,; Miao-FangWu; Zhong-QiuLin

    2015-01-01

    Background:Occult invasive cervical cancer discovered after simple hysterectomy is not common, radical parame‑trectomy (RP) is a preferred option for young women. However, the morbidity of RP was high. The aim of our study is to assess the incidence of parametrial involvement in patients who underwent radical parametrectomy for occult cervical cancer or radical hysterectomy for early‑stage cervical cancer and to suggest an algorithm for the triage of patients with occult cervical cancer to avoid RP. Methods:A total of 13 patients with occult cervical cancer who had undergone RP with an upper vaginectomy and pelvic lymphadenectomy were included in this retrospective study. Data on the clinicopathologic characteristics of the cases were collected. The published literature was also reviewed, and low risk factors for parametrial involvement in early‑stage cervical cancer were analyzed. Results:Of the 13 patients, 9 had a stage IB1 lesion, and 4 had a stage IA2 lesion. There were four patients with grade 1 disease, seven with grade 2 disease, and two with grade 3 disease. The median age of the entire patients was 41years. The most common indication for extrafascial hysterectomy was cervical intraepithelial neoplasia 3. Three patients had visible lesions measuring 10–30mm, in diameter and ten patients had cervical stromal invasions with depths ranging from 4 to 9mm; only one patient had more than 50% stromal invasion, and four patients had lymph‑vascular space invasion (LVSI). Perioperative complications included intraoperative bowel injury, blood transfusion, vesico‑vaginal ifstula, and ileus (1 case for each). Postoperative pathologic examination results did not show residual disease or parametrial involvement. One patient with positive lymph nodes received concurrent radiation therapy. Only one patient experienced recurrence. Conclusions:Perioperative complications following RP were common, whereas the incidence of parametrial involve‑ment was very low

  8. Learning curve analysis of laparoscopic radical hysterectomy for gynecologic oncologists without open counterpart experience

    Kong, Tae-Wook; Chang, Suk-Joon; Paek, Jiheum; Park, Hyogyeong; Kang, Seong Woo; Ryu, Hee-Sug

    2015-01-01

    Objective To evaluate the learning curve of laparoscopic radical hysterectomy (LRH) for gynecologic oncologists who underwent residency- and fellowship-training on laparoscopic surgery without previous experience in performing abdominal radical hysterectomy (ARH). Methods We retrospectively reviewed 84 patients with FIGO (International Federation of Gynecology and Obstetrics) stage IB cervical cancer who underwent LRH (Piver type III) between April 2006 and March 2014. The patients were divid...

  9. Radical hysterectomy with adjuvant radiotherapy versus radical radiotherapy for FIGO stage IIB cervical cancer

    The goal of this study was to compare treatment outcomes for Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical carcinoma patients receiving radical surgery followed by adjuvant postoperative radiotherapy versus radical radiotherapy. Medical records of FIGO stage IIB cervical cancer patients treated between July 2008 and December 2011 were retrospectively reviewed. A total of 148 patients underwent radical hysterectomy with pelvic lymph node dissection followed by adjuvant radiotherapy (surgery-based group). These patients were compared with 290 patients that received radical radiotherapy alone (RT-based group). Recurrence rates, progression-free survival (PFS), overall survival (OS), local control rates, and treatment-related complications were compared for these two groups. Similar rates of recurrence (16.89% vs. 12.41%, p = 0.200), PFS (log-rank, p = 0.211), OS (log-rank, p = 0.347), and local control rates (log-rank, p = 0.668) were observed for the surgery-based group and the RT-based group, respectively. Moreover, the incidence of acute grade 3–4 gastrointestinal reactions and late grade 3–4 lower limb lymphedema were significantly higher for the surgery-based group versus the RT-based group. Cox multivariate analyses found no significant difference in survival outcome between the two groups, and tumor diameter and histopathology were identified as significant prognostic factors for OS. Radical radiotherapy was associated with fewer treatment-related complications and achieved comparable survival outcomes for patients with FIGO stage IIB cervical cancer compared to radical hysterectomy followed by postoperative radiotherapy

  10. Application of da Vinci® Robot in simple or radical hysterectomy: Tips and tricks

    Iavazzo, Christos; Gkegkes, Ioannis D.

    2016-01-01

    The first robotic simple hysterectomy was performed more than 10 years ago. These days, robotic-assisted hysterectomy is accepted as an alternative surgical approach and is applied both in benign and malignant surgical entities. The two important points that should be taken into account to optimize postoperative outcomes in the early period of a surgeon’s training are how to achieve optimal oncological and functional results. Overcoming any technical challenge, as with any innovative surgical method, leads to an improved surgical operation timewise as well as for patients’ safety. The standardization of the technique and recognition of critical anatomical landmarks are essential for optimal oncological and clinical outcomes on both simple and radical robotic-assisted hysterectomy. Based on our experience, our intention is to present user-friendly tips and tricks to optimize the application of a da Vinci® robot in simple or radical hysterectomies. PMID:27403078

  11. Multivariate prognostic analysis of adenocarcinoma of the uterine cervix treated with radical hysterectomy and systematic lymphadenectomy

    KATO, TATSUYA; Watari, Hidemichi; Takeda, Mahito; Hosaka, Masayoshi; Mitamura, Takashi; Kobayashi, Noriko; Sudo, Satoko; Kaneuchi, Masanori; Kudo, Masataka; Sakuragi, Noriaki

    2013-01-01

    Objective The aim of this study was to investigate the prognostic factors and treatment outcome of patients with adenocarcinoma of the uterine cervix who underwent radical hysterectomy with systematic lymphadenectomy. Methods A total of 130 patients with stage IB to IIB cervical adenocarcinoma treated with hysterectomy and systematic lymphadenectomy from 1982 to 2005 were retrospectively analyzed. Clinicopathological data including age, stage, tumor size, the number of positive node sites, ly...

  12. Early-stage cervical carcinoma, radical hysterectomy, and sexual function. A longitudinal study

    Jensen, Pernille T; Groenvold, Mogens; Klee, Marianne C;

    2004-01-01

    BACKGROUND: Limited knowledge exists concerning the impact of radical hysterectomy (RH) alone on the sexual function of patients with early-stage cervical carcinoma. The authors investigated the longitudinal course of self-reported sexual function after RH. METHODS: The current study was comprise...

  13. Adjuvant postoperative radiation therapy following simple hysterectomy and radical hysterectomy in stage IB cancer of the cervix: Analysis of risk factors and patterns of failure

    Between 1969 and 1980, 242 cases of stage IB cancer of the cervix were referred to the department of radiation oncology for curative radiation therapy. In 186 cases treatment was with radiation therapy alone. In 56 cases treatment included adjuvant postoperative radiation therapy; a minimum follow-up of 5 years has been carried out in this group. In 17 cases radiation therapy followed a simple hysterectomy for an unexpected stage IB cancer of the cervix. In 39 cases radiation therapy was given after a radical hysterectomy for stage IB cancer of the cervix because of positive margins and/or positive pelvic lymph nodes

  14. Self-assessment of morbidity following radical hysterectomy for cervical cancer.

    Butler-Manuel, S A; Summerville, K; Ford, A; Blake, P; Riley, A J; Sultan, A H; Monga, A K; Stanton, S L; Shepherd, J H; Barton, D P

    1999-03-01

    The aim of this study was to assess the magnitude of the morbidity following radical surgery for early stage cervical cancer. We performed a retrospective survey of all women who had undergone a radical hysterectomy and lymphadenectomy between the months of July 1995 and December 1996 inclusive at either the Royal Marsden or St George's Hospital (n =38), using a detailed questionnaire on bladder, ano-rectal and sexual function, both before and after treatment. Sixteen women (44.4%) received adjuvant radiotherapy. The mean interval between surgery and inquiry was 16.4% months (range 8-25 months). The mean age at the time of surgery was 40.5 years. Thirty-six out of 38 women contacted responded (94.7%). Overall 33 women (91.7%) reported new bladder, ano-rectal or sexual symptoms. Complaints of urinary incontinence, particularly of urge incontinence, and of voiding difficulties increased significantly after surgery (P sex lives, 54.8% thought that their sex life was worse after treatment, and 12.9% of women had ceased sexual activity altogether. Of women of childbearing age 53.8% felt adversely affected by their loss of fertility. Bladder, ano-rectal and sexual symptoms are very common following radical hysterectomy for cervical cancer, with adverse effect on quality of life, and persist into the second year after treatment. PMID:15512265

  15. Complications after radiotherapy and radical hysterectomy in early-stage cervical carcinoma

    Gerdin, E. [Univ. Hospital, Dept. of Obstetrics and Gynecology, and Gynecologic Oncology, Uppsala (Sweden); Cnattingius, S. [Univ. Hospital, Dept. of Social Medicine, Uppsala (Sweden); Johnson, P. [Univ. Hospital, Dept. of Obstetrics and Gynecology, Uppsala (Sweden)

    1995-08-01

    Objective: To evaluate the overall complications, major as well as minor, in patients treated for early-stage cervical carcinoma as related to treatment parameters. Methods: In this retrospective study, 167 consecutive patients with early-stage cervical carcinoma treated with preoperative radiotherapy and radical hysterectomy were investigated. Clinical data were collected from the medical files. Results: Transient or permanent complications appeared in up to half of all patients. Seven percent exhibited intraoperative complications and 35% suffered from early postoperative urinary tract problems; most frequently urinary tract infection. After one year, the urinary tract complications dominated; voidance difficulties and incontinence being most common. Gastrointestinal complications occurred in 15% of patients. Lymphedema appeared during the first year in 21% of the patients but several of the mild or moderate cases improved after the first year. The relative risk of lymphedema was increased with shorter duration of surgery, extensive preoperative irradiation to the bladder and after external postoperative irradiation. Some form of late sequelae remained in every fifth patient, and every fourth patient, aged 23-44 years, periodically suffered from vasomotor symptoms despite estrogen replacement therapy. Conclusion: The complications after radiotherapy and radical hysterectomy in early stage cervical carcinoma suggest that attempts should be made to evaluate effective treatments designed to minimize risk to the patients. (au) 29 refs.

  16. The anatomical basis and prevention of neurogenic voiding dysfunction following radical hysterectomy.

    Tong, X K; Huo, R J

    1991-01-01

    The disorder of neurogenic dysfunction is one of the most important complications of radical hysterectomy. In order to prevent this potential complication, the authors have studied the composition and layers of the pelvic paravisceral structures. The nerve branching and distribution of the pelvic plexus of 12 adult female cadavers were analyzed. From lateral to medial the pelvic paravisceral structure is made up of three layers. The lateral layer is the pelvic visceral fascia, the middle, a vascular layer, and the medial one, a nervous one which consists of the pelvic plexus and subsidiary plexuses. The pelvic plexus and subsidiary plexuses are laid closely to the lateral walls of pelvic organs. The ischial spine was taken as the central point and two perpendicular lines penetrating through the ischial spine were used as the longitudinal axis and transverse axis. According to these landmarks, the pelvic plexus could be divided into three parts: behind the longitudinal axis are the roots of the pelvic plexus, near the longitudinal axis is the uterovaginal plexus, and in front of the longitudinal axis are the branches distributed to bladder and urethra. The pelvic plexus and the uterosacral and cardinal ligaments are closely related. The pelvic and subsidiary plexuses can be damaged in radical hysterectomy and voiding dysfunction may then develop. Some anatomic bases are provided to explain and hopefully prevent this from happening. PMID:1925917

  17. Radical Hysterectomy

    ... with grief and loss Rebuilding self-esteem Good communication: The key to building a successful sexual relationship Overcoming anxiety about sex Rekindling sexual interest Sexual activity with your partner ...

  18. Adjuvant radiotherapy after radical hysterectomy of the cervical cancer. Prognostic factors and complications

    Chatani, Masashi; Nose, Takayuki; Masaki, Norie [Osaka Univ. Medical School (Japan). Dept. of Radiation Therapy; Inoue, Toshihiko [Osaka Univ. Medical School (Japan). Dept. of Radiation Oncology

    1998-10-01

    Aim: To investigate prognostic factors and complications after radical hysterectomy followed by postoperative radiotherapy for carcinoma of the uterine cervix. Patients and Methods: One hundred twenty-eight patients with T1b-2b carcinoma of the uterine cervix following radical hysterectomy with bilateral pelvic lymphadenectomy and postoperative radiation therapy were reviewed. Pathologic and treatment variables were assessed by multivariate analysis for local recurrence, distant metastases and cause specific survival. Results: The number of positive nodes (PN) in the pelvis was the strongest predictor of pelvic recurrence and distant metastases. These 2 failure patterns independently affect the cause specific survival. The 5-year cumulative local and distant failure were PN(0): 2% and 12%, PN(1-2): 23% and 25%, PN(2<): 32% and 57%, respectively (p=0.0029 and p=0.0051). The 5-year cause specific survival rates were PN(0): 90%, PN(1-2): 59% and PN(2<): 42% (p=0.0001). The most common complication was lymphedema of the foot experienced by one-half of the patients (5-year: 42%, 10-year: 49%). Conclusion: These results suggest that patients with pathologic T1b-T2b cervix cancer with pelvic lymph node metastases are at high risk of recurrence or metastases after radical hysterectomy with pelvic lymphadenectomy and postoperative irradiation. (orig.) [Deutsch] Ziel: Untersuchung der prognostischen Faktoren und Komplikationen der adjuvanten Radiotherapie nach radikaler Hysterektomie bei Patienten mit Zervixkarzinom. Patienten und Methoden: In dieser Studie wurden 128 Patientinnen mit Zervixkarzinom untersucht, bei denen die pathologische Untersuchung nach radikaler Hysterektomie mit gleichzeitiger bilateraler pelvischer Lymphadenektomie und postoperativer Radiotherapie die Klassifikation als T1b-T2b-Karzinome ergab. Dabei wurden pathologische und therapeutische Parameter auf der behandelten Seite mit Hilfe der Multivarianzanalyse auf lokale Rezidive und Fernmetastasen

  19. Clinical efficacy and safety of paclitaxel plus carboplatin as neoadjuvant chemotherapy prior to radical hysterectomy and pelvic lymphadenectomy for Stage IB2-IIB cervical cancer

    Yang, Lu; Guo, Jianfeng; Shen, Yi; Cai, Jing; Xiong, Zhoufang; Dong, Weihong; Min, Jie; Wang, Zehua

    2015-01-01

    Objective: To assess the efficacy and toxicity of the combination of paclitaxel plus carboplatin as neoadjuvant chemotherapy (NACT) for locally advanced cervical cancer (LACC) prior to radical hysterectomy and pelvic lymphadenectomy. Methods: We reviewed patients with cervical cancer of the International Federation of Gynecology and Obstetrics (FIGO) stage IB2-IIB who underwent neoadjuvant chemotherapy (NACT) with paclitaxel plus carboplatin followed by radical hysterectomy (NACT group) or on...

  20. Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy

    Fiorica, J.V.; Roberts, W.S.; Greenberg, H.; Hoffman, M.S.; LaPolla, J.P.; Cavanagh, D. (Univ.ersity of South Florida College of Medicine, Tampa (USA))

    1990-03-01

    Morbidity and survival patterns were reviewed in 50 patients who underwent radical hysterectomy, pelvic lymphadenectomy, and adjuvant postoperative pelvic radiotherapy for invasive cervical cancer. Ninety percent of the patients were FIGO stage IB, and 10% were clinical stage IIA or IIB. Indications for adjuvant radiotherapy included pelvic lymph node metastasis, large volume, deep stromal penetration, lower uterine segment involvement, or capillary space involvement. Seventy-two percent of the patients had multiple high-risk factors. An average of 4700 cGy of whole-pelvis radiotherapy was administered. Ten percent of the patients suffered major gastrointestinal complications, 14% minor gastrointestinal morbidity, 12% minor genitourinary complications, one patient a lymphocyst, and one patient lymphedema. Of the five patients with major gastrointestinal morbidity, all occurred within 12 months of treatment. Three patients required intestinal bypass surgery for distal ileal obstructions and all are currently doing well and free of disease. All of the patients who developed recurrent disease had multiple, high-risk factors. The median time of recurrence was 12 months. All patients recurred within the radiated field. Actuarial survival was 90% and disease-free survival 87% at 70 months. It is our opinion that the morbidity of postoperative pelvic radiotherapy is acceptable, and benefit may be gained in such a high-risk patient population.

  1. Influence of margin status and radiation on recurrence after radical hysterectomy in Stage IB cervical cancer

    Purpose: To examine the relationship between margin status and local recurrence (LR) or any recurrence after radical hysterectomy (RH) in women treated with or without radiotherapy (RT) for Stage IB cervical carcinoma. Methods and Materials: This study included 284 patients after RH with assessable margins between 1980 and 2000. Each margin was scored as negative (≥1 cm), close (>0 and <1 cm), or positive. The outcomes measured were any recurrence, LR, and relapse-free survival. Results: The crude rate for any recurrence was 11%, 20%, and 38% for patients with negative, close, and positive margins, respectively. The crude rate for LR was 10%, 11%, and 38%, respectively. Postoperative RT decreased the rate of LR from 10% to 0% for negative, 17% to 0% for close, and 50% to 25% for positive margins. The significant predictors of decreased relapse-free survival on univariate analysis were the depth of tumor invasion (hazard ratio [HR] 2.14/cm increase, p = 0.007), positive margins (HR 3.92, p = 0.02), tumor size (HR 1.3/cm increase, p = 0.02), lymphovascular invasion (HR 2.19, p = 0.03), and margin status (HR 0.002/increasing millimeter from cancer for those with close margins, p = 0.03). Long-term side effects occurred in 8% after RH and 19% after RH and RT. Conclusion: The use of postoperative RT may decrease the risk of LR in patients with close paracervical margins. Patients with other adverse prognostic factors and close margins may also benefit from the use of postoperative RT. However, RT after RH may increase the risk of long-term side effects

  2. Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer

    From 1971 through 1984, 320 women underwent radical hysterectomy as primary therapy of stage IB and IIA cervical cancer. Two hundred forty-eight patients (78%) were treated with surgery alone and 72 patients (22%) received adjuvant postoperative external-beam radiotherapy. Presence of lymph node metastasis, large lesion (greater than 4 cm in diameter), histologic grade, race (noncaucasian), and age (greater than 40 years) were significant poor prognostic factors for the entire group of patients. Patients treated with surgery alone had a better disease-free survival than those who received combination therapy (P less than 0.001). However, patients receiving adjuvant radiation therapy had a higher incidence of lymphatic metastases, tumor involvement of the surgical margin, and large cervical lesions. Adjuvant pelvic radiation therapy did not improve the survival of patients with unilateral nodal metastases or those who had a large cervical lesion with free surgical margins and the absence of nodal involvement. Radiation therapy appears to reduce the incidence of pelvic recurrences. Unfortunately, 84% of patients who developed recurrent tumor after combination therapy had a component of distant failure. The incidence of severe gastrointestinal or genitourinary tract complications was not different in the two treatment groups. However, the incidence of lymphedema was increased in patients who received adjuvant radiation therapy. Although adjuvant radiation therapy appears to be tolerated without a significant increase in serious complications, the extent to which it may improve local control rates and survival in high-risk patients appears to be limited. In view of the high incidence of distant metastases in high-risk patients, consideration should be given to adjuvant systemic chemotherapy in addition to radiation therapy

  3. Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer

    Soisson, A.P.; Soper, J.T.; Clarke-Pearson, D.L.; Berchuck, A.; Montana, G.; Creasman, W.T. (Duke Univ. Medical Center, Durham, NC (USA))

    1990-06-01

    From 1971 through 1984, 320 women underwent radical hysterectomy as primary therapy of stage IB and IIA cervical cancer. Two hundred forty-eight patients (78%) were treated with surgery alone and 72 patients (22%) received adjuvant postoperative external-beam radiotherapy. Presence of lymph node metastasis, large lesion (greater than 4 cm in diameter), histologic grade, race (noncaucasian), and age (greater than 40 years) were significant poor prognostic factors for the entire group of patients. Patients treated with surgery alone had a better disease-free survival than those who received combination therapy (P less than 0.001). However, patients receiving adjuvant radiation therapy had a higher incidence of lymphatic metastases, tumor involvement of the surgical margin, and large cervical lesions. Adjuvant pelvic radiation therapy did not improve the survival of patients with unilateral nodal metastases or those who had a large cervical lesion with free surgical margins and the absence of nodal involvement. Radiation therapy appears to reduce the incidence of pelvic recurrences. Unfortunately, 84% of patients who developed recurrent tumor after combination therapy had a component of distant failure. The incidence of severe gastrointestinal or genitourinary tract complications was not different in the two treatment groups. However, the incidence of lymphedema was increased in patients who received adjuvant radiation therapy. Although adjuvant radiation therapy appears to be tolerated without a significant increase in serious complications, the extent to which it may improve local control rates and survival in high-risk patients appears to be limited. In view of the high incidence of distant metastases in high-risk patients, consideration should be given to adjuvant systemic chemotherapy in addition to radiation therapy.

  4. Variability of bladder dysfunction in post radical hysterectomy effect of pelvic autonomic nerve preservation with/without postoperative radiation therapy

    The objective of this study was to demonstrate an improved method for radical hysterectomy procedures to prevent post-operative variable bladder dysfunction. This study presents the results of a Urodynamic Study performed in subjects who underwent radical hysterectomy to clarify the efficacy of the new surgical method. Participants in this study consisted of 40 Stage 1B cervical cancer patients. These 40 participants were divided into two categories. The control group, consisting of 21 patients, underwent surgery by the established procedure. The experimental group was treated by our improved surgical method for retaining pelvic autonomic nerve function after radical hysterectomy. The groups were further divided into those who received radiation therapy and those who did not require radiation therapy. Two UDS (Urodynamic Study) methods were chosen to estimate bladder function; cystometry and uroflowmetry. The cystometry measurement parameters indicate bladder pliancy at the point of maximum desire to void. The uroflowmetry measurement parameters indicate the time required from post-surgical dysfunctional urinary flow pattern to the recovery of a normal pattern. Initial cystometry and uroflowmetry measurements were established pre-operatively. Further measurements were taken 1, 3, 6, 12, and 24 months post-operation. Four groups were divided as indicated in the methods section above. The non-radiated group who underwent our improved surgical method showed significantly better quality of improvement in cystometry measurements compared to those treated by the established method on measurements obtained 24 months post-operatively. Even the group requiring post-op radiation showed significantly better results at the 1 and 24 month points. At the 24 month point, the group receiving radiation therapy showed the lowest level of pliancy improvement, indicating a tendency for a longer recovery time than this study allowed. Irrespective of radiation therapy, the groups

  5. Risk model in stage IB1-IIB cervical cancer with positive node after radical hysterectomy

    Chen Z

    2016-05-01

    Full Text Available Zhilan Chen,1,2,* Kecheng Huang,1,* Zhiyong Lu,1,3 Song Deng,1,4 Jiaqiang Xiong,1 Jia Huang,1 Xiong Li,5 Fangxu Tang,1 Zhihao Wang,6 Haiying Sun,1 Lin Wang,1 Shasha Zhou,1 Xiaoli Wang,1 Yao Jia,1 Ting Hu,1 Juan Gui,7 Dongyi Wan,1 Ding Ma,1 Shuang Li,1 Shixuan Wang11Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Techonology, Wuhan, 2Department of Obstetrics and Gynecology, Wuhan General Hospital of Guangzhou Military Command, Wuhan, 3Hubei Key Laboratory of Embryonic Stem Cell Research, Tai-He Hospital, Hubei University of Medicine, Shiyan, Hubei, 4Department of Obstetrics and Gynecology, University Hospital of Hubei University for Nationalities, Enshi, Hubei, 5Department of Obstetrics and Gynecology, Wuhan Central Hospital, Wuhan, 6Department of Pathology and Pathophysiology, Key Laboratory of Ministry of Education of China for Neurological Disorders, Huazhong University of Science and Techonology, Wuhan, 7Department of Obstetrics and Gynecology, Renmin Hospital, Wuhan University, Wuhan, People’s Republic of China*These authors contributed equally to this workAbstract: The purpose of this study was to identify risk factors in patients with surgically treated node-positive IB1-IIB cervical cancer and to establish a risk model for disease-free survival (DFS and overall survival (OS. A total of 170 patients who underwent radical hysterectomy and bilateral pelvic lymphadenectomy as primary treatment for node-positive International Federation of Gynaecology and Obstetrics (FIGO stage IB1-IIB cervical cancer from January 2002 to December 2008 were retrospectively analyzed. Five published risk models were evaluated in this population. The variables, including common iliac lymph node metastasis and parametrial invasion, were independent predictors of outcome in a multivariate analysis using a Cox regression model. Three distinct prognostic groups (low, intermediate, and high risk

  6. Management of low-risk early-stage cervical cancer: Should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care?

    Ramirez, Pedro T.; Pareja, Rene; Rendón, Gabriel J.; Millan, Carlos; Frumovitz, Michael; Schmeler, Kathleen M.

    2013-01-01

    The standard treatment for women with early-stage cervical cancer (IA2-IB1) remains radical hysterectomy with pelvic lymphadenectomy. In select patients interested in future fertility, the option of radical trachelectomy with pelvic lymphadenectomy is also considered a viable option. The possibility of less radical surgery may be appropriate not only for patients desiring to preserve fertility but also for all patients with low-risk early-stage cervical cancer. Recently, a number of studies h...

  7. Description of preoperative risk factors and postoperative complications of radical hysterectomy in patients of Hospital Dr. Rafael Angel Calderon Guardia: period 2000-2006

    Preoperative risk factors and postoperative complications were determined in patients with radical hysterectomy in gynecologic oncology service of Hospital Rafael Angel Calderon Guardia in 2000-2006. Radical hysterectomy Piver type II and III was carried out among women in the gynecology service. The information derived from the qualitative variables were analyzed using frequency distributions and percentages. The most common preoperative comorbidity has been hypertension, the most frequently encountered complication has been urinary incontinence. Postoperative complications have been located in a period less than three months.

  8. Sentinel lymph node identification in patients with early stage cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy

    李斌; 章文华; 刘琳; 吴令英; 张蓉; 李宁

    2004-01-01

    Background In general, sentinel lymph node (SLN) can reflect the whole state of the entire drainage area. The present study evaluated the clinical significance of sentinel lymph node identification in the treatment of early stage cervical cancer.Methods Twenty-eight patients with early stage (Ia-Iia) cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy were included in this study. At two locations 8 hours before operation, 0.4 ml 37 Mbq technicium-99 labeled dextran was injected intracervically. After that, preoperative lymphoscintigraphy was performed to detect SLNs. During the operation, lymph nodes were detected ex vivo by a γ-counter to identify SLNs. The samples of SLNs and non-SLNs were used for pathological examination separately and compared with the final results. Results SLNs were identified in 27 of 28 (96.4%) patients. A total of 123 SLNs were identified from 814 nodes. Six patients had altogether 11 positive lymph nodes, which were all SLNs. No patient had false-negative sentinel node. Conclusion SLNs can successfully predict the lymphatic metastasis in patients with cervical cancer. The clinical validity of this technique should be evaluated prospectively.

  9. Adjuvant chemoradiation after laparoscopically assisted radical vaginal hysterectomy (LARVH) in patients with cervical cancer. Oncologic outcome and morbidity

    Gruen, Arne; Musik, Thabea; Stromberger, Carmen; Budach, Volker; Marnitz, Simone [Charite Univ. Medicine Berlin, Campus Virchow-Klinikum, Berlin (Germany). Dept. of Radiooncology; Koehler, Christhardt; Schneider, Achim [Charite Univ. Medicine Berlin, Campus Mitte- und Benjamim Franklin, Berlin (Germany). Dept. of Gynaecology; Fueller, Juergen; Wendt, Thomas [Jena Univ. Hospital (Germany). Dept. of Radiooncology

    2011-06-15

    Compared to laparotomic surgery, laparoscopically assisted radical vaginal hysterectomy (LARVH) offers decreased blood loss during surgery and faster convalescence of the patient postoperatively, while at the same time delivering similar oncologic results. However, there is no data on outcome and toxicity of LARVH followed by (chemo)radiation. A total of 55 patients (range 28-78 years) with cervical cancer on FIGO stages IB1-IIIA (Tables 1 and 2) with risk factors were submitted to either external beam radiotherapy alone [EBRT, n = 8 (14%), including paraaortic irradiation, n = 4 (2.2%); EBRT and brachytherapy (BT), n = 33 (60%); BT alone, n = 14 (25.5%)] or chemoradiation after LARVH. At a median follow-up of 4.4 years, the 5-year disease-free survival (DFS) was 81.8% with 84.5% overall survival (OS). Acute grade 3 side effects were seen in 4 patients. These were mainly gastrointestinal (GI) and genitourinary (GU) symptoms. Grade 4 side effects were not observed. With similar oncologic outcome data and mostly mild side effects, LARVH followed by (chemo)radiation is a valid alternative in the treatment of cervical cancer patients. (orig.)

  10. Adjuvant chemoradiation after laparoscopically assisted radical vaginal hysterectomy (LARVH) in patients with cervical cancer. Oncologic outcome and morbidity

    Compared to laparotomic surgery, laparoscopically assisted radical vaginal hysterectomy (LARVH) offers decreased blood loss during surgery and faster convalescence of the patient postoperatively, while at the same time delivering similar oncologic results. However, there is no data on outcome and toxicity of LARVH followed by (chemo)radiation. A total of 55 patients (range 28-78 years) with cervical cancer on FIGO stages IB1-IIIA (Tables 1 and 2) with risk factors were submitted to either external beam radiotherapy alone [EBRT, n = 8 (14%), including paraaortic irradiation, n = 4 (2.2%); EBRT and brachytherapy (BT), n = 33 (60%); BT alone, n = 14 (25.5%)] or chemoradiation after LARVH. At a median follow-up of 4.4 years, the 5-year disease-free survival (DFS) was 81.8% with 84.5% overall survival (OS). Acute grade 3 side effects were seen in 4 patients. These were mainly gastrointestinal (GI) and genitourinary (GU) symptoms. Grade 4 side effects were not observed. With similar oncologic outcome data and mostly mild side effects, LARVH followed by (chemo)radiation is a valid alternative in the treatment of cervical cancer patients. (orig.)

  11. Brachytherapy versus radical hysterectomy after external beam chemoradiation: a non-randomized matched comparison in IB2-IIB cervical cancer patients

    Flores Vladimir

    2009-02-01

    Full Text Available Abstract Background A current paradigm in the treatment of cervical cancer with radiation therapy is that intracavitary brachytherapy is an essential component of radical treatment. This is a matched retrospective comparison of the results of treatment in patients treated with external beam chemoradiation (EBRT-CT and radical hysterectomy versus those treated with identical chemoradiation followed by brachytherapy. Methods In this non-randomized comparison EBRT-CT protocol was the same in both groups of 40 patients. In the standard treated patients, EBRT-CT was followed by one or two intracavitary Cesium (low-dose rate applications within 2 weeks of finishing external radiation to reach a point A dose of at least 85 Gy. In the surgically treated patients, radical hysterectomy with bilateral pelvic lymph node dissection and para-aortic lymph node sampling were performed within 7 weeks after EBRT-CT. Response, toxicity and survival were evaluated. Results A total of 80 patients were analyzed. The patients receiving EBRT-CT and surgery were matched with the standard treated cases. There were no differences in the clinicopathological characteristics between groups or in the delivery of EBRT-CT. The pattern of acute and late toxicity differed. Standard treated patients had more chronic proctitis while the surgically treated had acute complications of surgery and hydronephrosis. At a maximum follow-up of 60 months, median follow-up 26 (2–31 and 22 (3–27 months for the surgery and standard therapy respectively, eight patients per group have recurred and died. The progression free and overall survival are the same in both groups. Conclusion The results of this study suggest that radical hysterectomy can be used after EBRT-CT without compromising survival in FIGO stage IB2-IIB cervical cancer patients in settings were brachytherapy is not available. A randomized study is needed to uncover the value of surgery after EBRT-CT.

  12. Clinical Behaviors and Outcomes for Adenocarcinoma or Adenosquamous Carcinoma of Cervix Treated by Radical Hysterectomy and Adjuvant Radiotherapy or Chemoradiotherapy

    Huang, Yi-Ting; Wang, Chun-Chieh; Tsai, Chien-Sheng [Department of Radiation Oncology, Chang Gung Memorial Hospital, Lin-Kou, Chang Gung University, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Science, Chang Gung University, Taoyuan, Taiwan (China); Lai, Chyong-Huey; Chang, Ting-Chang; Chou, Hung-Hsueh [Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Lin-Kou, Chang Gung University, Taoyuan, Taiwan (China); Lee, Steve P. [Department of Radiation Oncology, University of California, Los Angeles School of Medicine, Los Angeles, CA (United States); Hong, Ji-Hong, E-mail: jihong@adm.cgmh.org.tw [Department of Radiation Oncology, Chang Gung Memorial Hospital, Lin-Kou, Chang Gung University, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Science, Chang Gung University, Taoyuan, Taiwan (China)

    2012-10-01

    Purpose: To compare clinical behaviors and treatment outcomes between patients with squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) of the cervix treated with radical hysterectomy (RH) and adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). Methods and Materials: A total of 318 Stage IB-IIB cervical cancer patients, 202 (63.5%) with SCC and 116 (36.5%) with AC/ASC, treated by RH and adjuvant RT/CCRT, were included. The indications for RT/CCRT were deep stromal invasion, positive resection margin, parametrial invasion, or lymph node (LN) metastasis. Postoperative CCRT was administered in 65 SCC patients (32%) and 80 AC/ASC patients (69%). Patients with presence of parametrial invasion or LN metastasis were stratified into a high-risk group, and the rest into an intermediate-risk group. The patterns of failure and factors influencing survival were evaluated. Results: The treatment failed in 39 SCC patients (19.3%) and 39 AC/ASC patients (33.6%). The 5-year relapse-free survival rates for SCC and AC/ASC patients were 83.4% and 66.5%, respectively (p = 0.000). Distant metastasis was the major failure pattern in both groups. After multivariate analysis, prognostic factors for local recurrence included younger age, parametrial invasion, AC/ASC histology, and positive resection margin; for distant recurrence they included parametrial invasion, LN metastasis, and AC/ASC histology. Compared with SCC patients, those with AC/ASC had higher local relapse rates for the intermediate-risk group but a higher distant metastasis rate for the high-risk group. Postoperative CCRT tended to improve survival for intermediate-risk but not for high-risk AC/ASC patients. Conclusions: Adenocarcinoma/adenosquamous carcinoma is an independent prognostic factor for cervical cancer patients treated by RH and postoperative RT. Concurrent chemoradiotherapy could improve survival for intermediate-risk, but not necessarily high-risk, AC/ASC patients.

  13. Clinical Behaviors and Outcomes for Adenocarcinoma or Adenosquamous Carcinoma of Cervix Treated by Radical Hysterectomy and Adjuvant Radiotherapy or Chemoradiotherapy

    Purpose: To compare clinical behaviors and treatment outcomes between patients with squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) of the cervix treated with radical hysterectomy (RH) and adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). Methods and Materials: A total of 318 Stage IB–IIB cervical cancer patients, 202 (63.5%) with SCC and 116 (36.5%) with AC/ASC, treated by RH and adjuvant RT/CCRT, were included. The indications for RT/CCRT were deep stromal invasion, positive resection margin, parametrial invasion, or lymph node (LN) metastasis. Postoperative CCRT was administered in 65 SCC patients (32%) and 80 AC/ASC patients (69%). Patients with presence of parametrial invasion or LN metastasis were stratified into a high-risk group, and the rest into an intermediate-risk group. The patterns of failure and factors influencing survival were evaluated. Results: The treatment failed in 39 SCC patients (19.3%) and 39 AC/ASC patients (33.6%). The 5-year relapse-free survival rates for SCC and AC/ASC patients were 83.4% and 66.5%, respectively (p = 0.000). Distant metastasis was the major failure pattern in both groups. After multivariate analysis, prognostic factors for local recurrence included younger age, parametrial invasion, AC/ASC histology, and positive resection margin; for distant recurrence they included parametrial invasion, LN metastasis, and AC/ASC histology. Compared with SCC patients, those with AC/ASC had higher local relapse rates for the intermediate-risk group but a higher distant metastasis rate for the high-risk group. Postoperative CCRT tended to improve survival for intermediate-risk but not for high-risk AC/ASC patients. Conclusions: Adenocarcinoma/adenosquamous carcinoma is an independent prognostic factor for cervical cancer patients treated by RH and postoperative RT. Concurrent chemoradiotherapy could improve survival for intermediate-risk, but not necessarily high-risk, AC/ASC patients.

  14. Radical hysterectomy in surgical treatment of invasive cervical cancer at the Department of gynecology and obstetrics in Novi Sad in the period 1993-2013.

    Đurđević Srđan

    2015-01-01

    Full Text Available Introduction. During the period from 1993 - 2013, 175 women with invasive cervical cancer underwent radical hysterectomy sec. Wertheim-Meigs at the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad. Indications for radical hysterectomy comprise histopathologically confirmed invasive cervical cancer in stages I B 1 - II B according to the International Federation of Gynecology and Obstetrics. Material and Methods. Stage of the disease or extent of the disease spread to the adjacent structures was assessed in accordance with the International Federation of Gynecology and Obstetrics staging system from 2009. Exclusion criteria were all other stages of this disease: I A and stages higher than II B, as well as the absence of definite histological confirmation of the cervical cancer (primary endometrial or vaginal cancer which infiltrates the uterine cervix. Prior the operation, the following had to be done: the imaging of pelvis and abdomen, chest X-ray in two directions, electrocardiography, internist and anesthesiological examination. Results. The patients’ age ranged from 24-79 years (x : 46 years, and the operation duration was 120-300 minutes (x : 210 min.. Stage I B 1 was found in 64.6% of operated patients, 14.8% of the patients were in stage I B 2, 9.1% were in stage II A and 11.4 % were in stage II B. Blood loss during the operation ranged from 50-800 ml (on average 300 ml, and the number of removed lymph nodes per operation was 14-75 (x : 32. Intraoperative and postoperative complications developed in 6.8% of and 17.7% of patients, respectively. Recurrence was reported in 22 (12.5% patients, most often in paraaortic lymph nodes (3.4% and parametria (2.8%, while the overall 5-year survival rate was 87% until 2008. Concluision. Wertheim-Meigs radical hysterectomy is a basic surgical technique for the treatment of initial stages of invasive cervical cancer.

  15. Clinical efficacy and safety of paclitaxel plus carboplatin as neoadjuvant chemotherapy prior to radical hysterectomy and pelvic lymphadenectomy for Stage IB2-IIB cervical cancer

    Yang, Lu; Guo, Jianfeng; Shen, Yi; Cai, Jing; Xiong, Zhoufang; Dong, Weihong; Min, Jie; Wang, Zehua

    2015-01-01

    Objective: To assess the efficacy and toxicity of the combination of paclitaxel plus carboplatin as neoadjuvant chemotherapy (NACT) for locally advanced cervical cancer (LACC) prior to radical hysterectomy and pelvic lymphadenectomy. Methods: We reviewed patients with cervical cancer of the International Federation of Gynecology and Obstetrics (FIGO) stage IB2-IIB who underwent neoadjuvant chemotherapy (NACT) with paclitaxel plus carboplatin followed by radical hysterectomy (NACT group) or only received primary radical surgery (PRS group) in our hospital between Jan 2007 and Jan 2012. Toxicity, NACT response, surgery pathological factors and survival data were collected and analyzed. Results: In the NACT group, the overall response rate was 71.3% (82/115). Eighteen (15.7%) patients achieved complete remission. Well differentiated tumors showed a more favorable response to NACT (P=0.011). Myelosuppression was the most common adverse effect (51.7%) and serious adverse effects were rare (3.4%). The median follow-up period was 44 months (range, 6-75). The NACT responders had significantly longer OS and PFS when compared to the non-NACT responders and patients in the PRS group. Conclusion: Patients with LACC can benefit from neoadjuvant chemotherapy with paclitaxel plus carboplatin when they have response to the chemotherapeutic agents. PMID:26550314

  16. Therapeutic comparison of uterine artery chemoembolization with internal iliac anterior trunk arterial chemotherapy performed before radical hysterectomy in patients with stages I b2-II a cervical cancer

    Objective: To compare the short-term and long-term therapeutic response of uterine artery chemoembolization with internal iliac anterior trunk arterial chemotherapy performed before radical hysterectomy in patients with stages I b2-II a cervical cancer. Methods: One hundred and fifty-one patients with stages I b2-II a cervical cancer were treated with preoperative intra-arterial chemotherapy before radical hysterectomy was carried out. Patients in study group (n = 113) received uterine artery chemoembolization (UACE), while patients control group(n = 38) received internal iliac anterior trunk arterial chemotherapy. Radical hysterectomy was carried out in all patients within 2-4 weeks after UACE or chemotherapy. The tumor size was measured before and after the procedure,and the survival rate at 2 and 5 years after treatment was calculated. Results: The mean maximum diameter of the tumors was (4.58 ± 0.37) cm before interventional therapy, and it was (2.11 ± 0.24) cm in two weeks after interventional therapy. The complete response rate of study group and control group was 31.9% and 21.1% respectively. The total effective rate of study group and control group was 94.7% (107/113) and 76.3% (29/38) respectively. The effective rate of study group two weeks after therapy was significantly higher than that of control group. No surgical margin infiltration was observed in both groups. Pathological findings in study group included vascular invasion around surgical margin (n = 3), parametrial invasion (n = 5) and pelvic lymph node metastasis (n = 6), while in control group vascular invasion around surgical margin, parametrial invasion and pelvic lymph node metastasis were found in one, two and one cases respectively. The two-year and five-year survival rate in study group were 80.9% (68/84) and 73.4% (47/64) respectively, while the two-year and five-year survival rate in control group were 81.3% (26/32) and 75.0% (18/24) respectively. No significant difference in survival

  17. Chemoradiation With Paclitaxel and Carboplatin in High-Risk Cervical Cancer Patients After Radical Hysterectomy: A Korean Gynecologic Oncology Group Study

    Lee, Taek Sang [Department of Obstetrics and Gynecology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of); Kang, Soon Beom, E-mail: tslee70@gmail.com [Department of Obstetrics and Gynecology, Konkuk University Medical Center, Seoul (Korea, Republic of); Kim, Young Tak [Department of Obstetrics and Gynecology, Asan Medical Center, Seoul (Korea, Republic of); Park, Byung Joo [Department of Preventive Medicine, Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Yong Man [Department of Obstetrics and Gynecology, Asan Medical Center, Seoul (Korea, Republic of); Lee, Jong Min [Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of); Kim, Seok Mo [Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju (Korea, Republic of); Kim, Young Tae [Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Jae Hoon [Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Seoul (Korea, Republic of); Kim, Kyung Tai [Department of Obstetrics and Gynecology, Hanyang University Medical Center, Seoul (Korea, Republic of)

    2013-06-01

    Purpose: To evaluate the efficacy and toxicity of concurrent chemoradiation with paclitaxel and carboplatin in patients with high-risk cervical cancer. Methods and Materials: Patients after radical hysterectomy for cervical cancer, with at least 1 high-risk characteristic, were administered paclitaxel 135 mg/m{sup 2}, carboplatin area under the curve = 5 every 3 weeks for 3 cycles concomitant with radiation therapy as adjuvant treatment. Results: This prospective study enrolled 71 consecutive patients. Sixty-six patients (93%) completed the planned treatment. The majority of grade 3/4 neutropenia or nonhematologic toxicities were usually self-limited. Diarrhea grades 3/4 were observed in 4 patients (5.6%). One patient developed anaphylactic shock after infusion of paclitaxel. With a median follow-up of 57 months, recurrences occurred in 16 patients. Multivariable analysis indicated that common iliac lymph node involvement is an independent risk factor for disease recurrence (odds ratio 13.48; 95% confidence interval 2.93-62.03). In the intent-to-treat population (n=71), the estimated 5-year disease-free survival and overall survival rates were 77.3% and 80.3% respectively. In the per-protocol population (n=62), disease-free survival was 78.9% and overall survival was 83.9%. Conclusions: Concurrent chemoradiation with paclitaxel/carboplatin is well tolerated and seems to be effective for patients who undergo radical hysterectomy. Therefore, a prospective, randomized controlled study should be designed to evaluate efficacy of this approach for patients with high-risk cervical cancer.

  18. Longer waiting times for early stage cervical cancer patients undergoing radical hysterectomy are associated with diminished long-term overall survival

    Nanthamongkolkul, Kulisara

    2015-01-01

    Objective The aim of this study was to evaluate the impact of surgical waiting time on clinical outcome in early stage cervical cancer. Methods The cohort consisted of 441 patients diagnosed with stages IA2-IB1cervical cancer who underwent radical hysterectomy and pelvic node dissection. The patients were divided into two groups based on surgical waiting time. The associations between waiting time and other potential prognostic factors with clinical outcome were evaluated. Results The median surgical waiting time was 43 days. Deep stromal invasion (hazard ratio [HR], 2.5; 95% confidence interval [CI], 1.4 to 4.6; p=0.003) and lymph node metastasis (HR, 2.9; 95% CI, 1.3 to 6.7; p=0.026) were identified as independent prognostic factors for recurrence-free survival while no prognostic significance of surgical waiting time was found (p=0.677). On multivariate analysis of overall survival (OS), only deep stromal invasion (HR, 2.6; 95% CI, 1.3 to 5.0; p=0.009) and lymph node metastasis (HR, 3.6; 95% CI, 1.5 to 8.6; p=0.009) were identified as independent prognostic factors for OS. Although OS showed no significant difference between short (≤8 weeks) and long (>8 weeks) waiting times, multivariate analysis of OS with time-varying effects revealed that a waiting time longer than 8 weeks was associated with poorer long-term survival (after 5 years; HR, 3.4; 95% CI, 1.3 to 9.2; p=0.021). Conclusion A longer surgical waiting time was associated with diminished long-term OS of early stage cervical cancer patients. PMID:26404122

  19. Randomized phase III trial of radiotherapy or chemoradiotherapy with topotecan and cisplatin in intermediate-risk cervical cancer patients after radical hysterectomy

    . Concurrent chemoradiotherapy with topotecan and cisplatin showed severe hematologic toxicity in intermediate-risk cervical cancer patients after radical hysterectomy. Thus, the study was closed ahead of schedule. ClinicalTrials.gov Identifier: https://www.clinicaltrials.gov/ct2/show/NCT01418859?term

  20. 早期宫颈癌(Ⅰb-Ⅱa期)预后相关因素的回顾性分析%Clinical outcome following radical hysterectomy and pelvic lymphadenectomy for early-stage cervical cancer

    Hongbo Wang; Suhui Wu; Zehua Wang

    2008-01-01

    Objective: To estimate the impact of parametrial infiltration and lymph node metastasis on clinical outcome in women with early-stage cervical cancer following radical hysterectomy and pelvic lymphadenectomy. Methods: Clinical re-cords and pathologic slides of 532 patients with early-stage cervical cancer (330 Ib and 202 Ila) treated with radical hyster-ectomy and pelvic lymphadenectomy were reviewed. The study group comprised 520 patients with squamous cell carcinoma and 12 patients with adenocarcinoma of the cervix. Median follow-up time was 67 months. The association among the various histopathologic predictors of outcome was determined with analysis. The influence of the predictors on outcome was exam-ined with log rank survival methods and the Cox regression model. Results: FIGO stage, histologic type, tumor size, depth of invasion, parametrial infiltration, lymph node metastasis, and remote metastasis were identified as significantly biologically relevant and therefore were included as candidate predictors in multivariate analysis. In particular, parametrial infiltration and lymph node metastasis were found to be simultaneous predictors of death on multivariate analysis (P < 0.05). After controlling for these two factors, the other variables considered were not statistically significant up to a two-way interaction. Conclusion: Presence of parametrial infiltration and/or lymph node metastasis in women with early-stage cervical cancer is an indepen-dent poor prognostic factor. In addition, the relatively poor survival of women with more than one lymph nodes identified with cancer cells.

  1. 腹腔镜宫颈癌根治术中腹膜阴道延长术的应用%The application of vaginal extension with peritoneum in the laparoscopic radical hysterectomy

    杨尚武; 王小婕; 梦灵; 仲勇; 李莉芳; 黄浩

    2013-01-01

    Objective To explore the value of vaginal extension with peritoneum in the laparoscopic radical hysterectomy with the preservation of pelvic autonomic nerve .Methods Seven cases with cervical carcinoma at the stage of the Ⅰb-Ⅱa had the laparoscopic radical hysterectomy with the preservation of pelvic autonomic nerve and the operation of vaginal extension with peritoneum at the same time.Post-operative vaginal length and sexual life status of the patients were studied .Results The length of vagina 3 months after the operation was 8 to 11cm, with the average length of 8.8 ±2.2cm.No obvious side effect on sex life was found after the surgery . Conclusion It is feasible and advisable that the patients with cervical carcinoma have vaginal extension with peritoneum to ensure their life quality while they have laparoscopic radical hysterectomy with the preservation of the pelvic autonomic nerve .%目的探讨腹膜阴道延长术在腹腔镜下保留盆腔自主神经广泛子宫切除术中的价值。方法对7例Ⅰb~Ⅱa宫颈癌患者在行保留盆腔自主神经广泛性子宫切除术的同时行腹膜阴道延长术,研究患者术后阴道长度、性生活的情况。结果术后3个月测量阴道长度为8~11cm,平均长度为8.8±2.2cm。性生活质量术后与术前相比无明显影响。结论宫颈癌患者在行腹腔镜下保留盆腔自主神经的同时,采用腹膜进行阴道延长是可行的,保证了患者术后的生活质量,值得推广。

  2. Current Issues with Hysterectomy.

    Barker, Matthew A

    2016-09-01

    Hysterectomy is one of the most common gynecologic surgeries. Early adoption of surgical advancements in hysterectomies has raised concerns over safety, quality, and costs. The risk of potential leiomyosarcoma in women undergoing minimally invasive hysterectomy led the US Food and Drug Administration to discourage the use of electronic power morcellator. Minimally invasive hysterectomies have increased substantially despite lack of data supporting its use over other forms of hysterectomy and increased costs. Health care reform is incentivizing providers to improve quality, improve safety, and decrease costs through standardized outcomes and process measures. PMID:27521886

  3. Chronic pain after hysterectomy

    Brandsborg, B; Nikolajsen, L; Kehlet, Henrik;

    2008-01-01

    BACKGROUND: Chronic pain is a well-known adverse effect of surgery, but the risk of chronic pain after gynaecological surgery is less established. METHOD: This review summarizes studies on chronic pain following hysterectomy. The underlying mechanisms and risk factors for the development of chronic...... post-hysterectomy pain are discussed. RESULTS AND CONCLUSION: Chronic pain is reported by 5-32% of women after hysterectomy. A guideline is proposed for future prospective studies. Udgivelsesdato: 2008-Mar...

  4. [Peripartal hysterectomy - review].

    Pálová, E; Borovsky, M

    2012-06-01

    Peripartal hysterectomy is one of the life - threatening procedures needed to be performed in an urgent situation. Women at highest risk of peripartal hysterectomy are multiparas, women who had a caesarian delivery in either previous or present pregnancy or women who had an abnormal placentation. This report presents the basic issues and brief review of the major indications of peripartal hysterectomy. It also compares the effectiveness of the selected types of operation. PMID:22779724

  5. 腹腔镜下宫颈癌根治术32例临床分析%Clinical Analysis of 32 Cases of Laparoscopic Radical Hysterectomy for Cervical Cancer

    倪琴; 米鑫; 张风格

    2015-01-01

    Objective:To explore the clinical efficacy of laparoscopic radical hysterectomy in the treatment of cervical cancer.Method:A retrospective chart review identified stageⅠa2 toⅡa cervical cancer patients who underwent laparoscopic radical hysterectomy and pelvic lymph node dissection and abdominal aorta lymph node dissection from January 2011 to November 2014,the treatment effect was observed.Result:All the 32 cases were successfully treated by laparoscopic surgery,no one turned to undergo laparotomy.The mean operative time was (240.06±31.99)min.The average intraoperative blood loss was (245.31±102.45)ml.The average pelvic lymph node resected and abdominal aorta lymph node resected were (23.41±1.72) and (4.13±0.94).Postoperative anal exhaust time was (42.63±5.98)h,and bladder function recovery time was (16.78±4.72)d.One case complicated with external iliac vein injury.All cases of vaginal stump and cutting edge were negative.Seven cases received supplementary postoperative radiotherapy and chemotherapy.32 cases followed up 1 to 48 months postoperatively no recurrence.Conclusion:Laparoscopic radical hysterectomy for cervical cancer is safe and feasible,and has satisfactory result,but the surgeon must have skilled operation technique and treatment experience of operation complication.%目的:探讨腹腔镜下宫颈癌根治术的临床疗效。方法:回顾性分析笔者所在医院32例Ⅰa2~Ⅱa期宫颈癌患者腹腔镜下广泛子宫切除术及盆腔淋巴结和腹主动脉旁淋巴结清扫术的临床资料,观察腹腔镜手术治疗效果。结果:32例患者手术均成功,无一例中转开腹。手术时间(240.06±31.99)min,术中出血量(245.31±102.45)ml,切除盆腔淋巴结(23.41±1.72)枚,切除腹主动脉旁淋巴结(4.13±0.94)枚,术后肛门排气时间(42.63±5.98)h,膀胱功能恢复时间(16.78±4.72)d;1例髂外静脉损伤;所有病例断端及阴道切缘均阴性,术后7例补充放疗、化疗。32

  6. Sentinel node detection with 99mTc phytate alone is satisfactory for cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy

    If the sentinel-lymph-node (SLN) concept is valid in cervical cancer, most patients could avoid pelvic lymphadenectomy when absence of metastasis is intraoperatively confirmed in the SLN. We assessed feasibility and accuracy of SLN detection using 99mTc phytate in patients with cervical cancer. Eighty-two women with stage Ia-IIb cervical cancer enrolled in this study. All underwent hysterectomy or trachelectomy with accompanying total pelvic lymphadenectomy. On the day before surgery, we injected fluid containing 99mTc-labeled phytate subepithelially into four cervical quadrants outside the tumor. Intraoperatively, SLNs were identified as radioactive ''hot nodes'' by gamma probe. Systematic bilateral pelvic lymphadenectomy was performed after the hot node sampling to evaluate the predictive ability of hot nodes. A total of 157 lymph nodes were detected as SLNs in 72 of 82 patients. SLN detection rate was 88%. Detection rate was 95% for the subgroups of patients with stage Ia-Ib1 disease and smaller tumor size (≤3 cm in maximal diameter). Lymph node metastasis was found in 15 patients. In 3 of them, no SLNs were detected. In the remaining 12 patients, each ipsilateral SLN contained metastasis when the pelvic lymph nodes contained metastases. Sensitivity was 100%, the false negative rate was 0%, and the negative predictive value of SLN was 100%. We conclude SLN detection using 99mTc-labeled phytate is satisfactory to assess pelvic nodes in patients with early cervical cancer; if validated with other research, it should be incorporated into clinical practice. (author)

  7. "STUDY OF CONCURRENT CISPLATIN AND EXTERNAL RADIOTHERAPY PRIOR TO RADICAL HYSTERECTOMY AND LYMPHADENECTOMY IN PATIENTS WITH STAGE IB-IIB CERVICAL CANCER"

    M. Modares Gilani

    2004-06-01

    Full Text Available The purpose of this study was to describe the feasibility of a combined preoperative chemoradiation program Ib-IIa, bulky and suspicious IIb by radical surgery in patients with stage Ib-IIb cervical cancer. From September 1999 to April 2002, 30 patients with carcinoma of the cervix were treated with preoperative external beam radiotherapy of 45 Gy in 5 weeks. Patients received concurrent continuous infusion of cisplatin 50 mg/m2 for one day in week during 5 weeks of radiation. Radical surgery was performed 4-6 weeks after completion of the preoperative treatment. Toxicity with chemoradiation was usually mild. Two patients developed vesicovaginal fistula, and four developed long-term hydronephrosis that needed ureteral stenting. Clinical response was observed in 100% of the patients (23.7% complete response. The analysis of the surgical specimens revealed complete pathological response in 43.3% of the cases and partial pathological response in 56.7%. The degree of pathological response was not predictable by the degree of clinical response. Thirty months disease-free survival and overall survival were 66.3% and 77.31%, respectively. Patients with complete and partial pathological response were not significantly different in terms of disease-free survival (p= 0.08 and overall survival (p= 0.3. Cisplatin in preoperative chemoradiation is effective and usually welltolerated in bulky cervical cancer and parametrial invasion, inducing a high rate of clinical and pathological complete responses. When this therapy is followed by radical surgery, disease-free and overall survival rates are higher. The latter may be possible only through extensive surgical resection with a parallel increase in complication rates.

  8. Emergency peripartum hysterectomy

    Jakobsson, Maija; Tapper, Anna-Maija; Colmorn, Lotte Berdiin;

    2015-01-01

    OBJECTIVE: To assess the prevalence and risk factors of emergency peripartum hysterectomy. DESIGN: Nordic collaborative study. POPULATION: 605 362 deliveries across the five Nordic countries. METHODS: We collected data prospectively from patients undergoing emergency peripartum hysterectomy within...... 7 days of delivery from medical birth registers and hospital discharge registers. Control populations consisted of all other women delivering on the same units during the same time period. MAIN OUTCOME MEASURES: Emergency peripartum hysterectomy rate. RESULTS: The total number of emergency.......7%), uterine rupture (n = 31, 14.7%), other bleeding disorders (n = 12, 5.7%), and other indications (n = 8, 3.8%). The delivery mode was cesarean section in nearly 80% of cases. Previous cesarean section was reported in 45% of women. Both preterm and post-term birth increased the risk for emergency peripartum...

  9. Emergency peripartum hysterectomy

    Mehmet Sıddık Evsen

    2009-03-01

    Full Text Available The aim of the present study was to determine the incidence, indications and maternal characteristics of emergency peripartum hysterectomy (EPH.Medical records belong to 49 patients, that undergone EPH at Diyarbakır Gynecology and Obstetrics Hospital, between September 2005 and August 2008 were retrospectively reviewed. During three years, from 63463 deliveries, hysterectomy was performed to 49 patients (0.77/1000 due to obstetrical hemorrhage. Indications for EPH were uterine atony (49.6%, uterine rupture (42.9% and placenta accreata (8.2%. The mean age of patients was 34.6±5.7 years, and mean gravida was 5.5±2.4. Subtotal hysterectomy was performed to 31 (63.3% patients and total hysterectomy to 18 (36.7% of them. Bilateral hypogastric artery ligation was performed to 8 (16.3% and unilateral ooferectomy to 7 (14.3%. Two of our patients died secondary to uncontrolled uterine bleeding.In conclusion, uterine atony and uterine rupture were the most frequent causes of EPH. Emergent and appropriate management of these patients is the most important life saving procedure.

  10. Total versus subtotal hysterectomy

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Anna Birthe; Gluud, Christian; Ottesen, Bent S; Tabor, Ann

    2005-01-01

    The aim of this study was to compare total and subtotal abdominal hysterectomy for benign indications, with regard to urinary incontinence, postoperative complications, quality of life (SF-36), constipation, prolapse, satisfaction with sexual life, and pelvic pain at 1-year postoperative. Eighty...

  11. Radicals

    Jahn, Ullrich; Cornils, B.

    Weinheim: Wiley-VCH, 2013 - (Cornils, B.; Herrmann, W.; Wong, C.; Zanthoff, H.), s. 1897-1898 ISBN 978-3-527-33307-3 Institutional support: RVO:61388963 Keywords : radicals * enzymatic catalysis * coenzyme B12 * ribonucleotide reductase * mutases Subject RIV: CC - Organic Chemistry

  12. Salpingectomy as standard at hysterectomy?

    Guldberg, Rikke; Wehberg, Sonja; Skovlund, Charlotte Wessel; Mogensen, Ole; Lidegaard, Ojvind

    2013-01-01

    To assess if the risk of first-time salpingectomy was affected by prior hysterectomy with retained fallopian tubes and by prior sterilisation.......To assess if the risk of first-time salpingectomy was affected by prior hysterectomy with retained fallopian tubes and by prior sterilisation....

  13. Laparoscopic Radical Trachelectomy

    Rendón, Gabriel J.; Ramirez, Pedro T.; Frumovitz, Michael; Schmeler, Kathleen M.; Pareja, Rene

    2012-01-01

    Introduction: The standard treatment for patients with early-stage cervical cancer has been radical hysterectomy. However, for women interested in future fertility, radical trachelectomy is now considered a safe and feasible option. The use of minimally invasive surgical techniques to perform this procedure has recently been reported. Case Description: We report the first case of a laparoscopic radical trachelectomy performed in a developing country. The patient is a nulligravid, 30-y-old fem...

  14. Sexuality after total vs. subtotal hysterectomy

    Zobbe, Vibeke Bahn; Gimbel, Helga Margrethe Elisabeth; Andersen, Birthe Margrethe;

    2004-01-01

    The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies.......The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies....

  15. Preoperative teaching and hysterectomy outcomes.

    Oetker-Black, Sharon L; Jones, Susan; Estok, Patricia; Ryan, Marian; Gale, Nancy; Parker, Carla

    2003-06-01

    This study used a theoretical model to determine whether an efficacy-enhancing teaching protocol was effective in improving immediate postoperative behaviors and selected short- and long-term health outcomes in women who underwent abdominal hysterectomies. The model used was the self-efficacy theory of Albert Bandura, PhD. One hundred eight patients in a 486-bed teaching hospital in the Midwest who underwent hysterectomies participated. The participation rate was 85%, and the attrition rate was 17% during the six-month study. The major finding was that participants in the efficacy-enhancing teaching group ambulated significantly longer than participants in the usual care group. This is an important finding because the most prevalent postoperative complications after hysterectomy are atelectasis, pneumonia, paralytic ileus, and deep vein thrombosis, and postoperative ambulation has been shown to decrease or prevent all of these complications. This finding could affect the overall health status of women undergoing hysterectomies. PMID:12817743

  16. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... abdominal hysterectomy? Well the vaginal hysterectomy has some limitations. It is somewhat of a blind procedure, as we know, with limited exposure. Inherent with that may be some fear ...

  17. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... taking all that into account, taking experience and skill, for most of us, the abdominal hysterectomy is ... You’ll basically converting that into a two-step procedure, a myomectomy first, and then a hysterectomy. ...

  18. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... as follows: I’ll begin with some historical information regarding hysterectomy, and then we’ll show a ... perform the hysterectomy procedure; however I believe the information that we present and discuss tonight will be ...

  19. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... discuss an innovative approach to do a hysterectomy. It’s called the “minilap hysterectomy.” I’m very excited ... settle for large incisions and prolonged recoveries when it comes time to have your hysterectomy. With that, ...

  20. Peripartum hysterectomy: an evolving picture.

    Turner, Michael J

    2012-02-01

    Peripartum hysterectomy (PH) is one of the obstetric catastrophes. Evidence is emerging that the role of PH in modern obstetrics is evolving. Improving management of postpartum hemorrhage and newer surgical techniques should decrease PH for uterine atony. Rising levels of repeat elective cesarean deliveries should decrease PH following uterine scar rupture in labor. Increasing cesarean rates, however, have led to an increase in the number of PHs for morbidly adherent placenta. In the case of uterine atony or rupture where PH is required, a subtotal PH is often sufficient. In the case of pathological placental localization involving the cervix, however, a total hysterectomy is required. Furthermore, the involvement of other pelvic structures may prospectively make the diagnosis difficult and the surgery challenging. If resources permit, PH for pathological placental localization merits a multidisciplinary approach. Despite advances in clinical practice, it is likely that peripartum hysterectomy will be more challenging for obstetricians in the future.

  1. The decline of hysterectomy for benign disease.

    Horgan, R P

    2012-01-31

    Hysterectomy is one of the most common gynaecological surgical procedures performed but there appears to be a decline in the performance of this procedure in Ireland in recent times. We set out to establish the extent of the decline of hysterectomy and to explore possible explanations. Data for hysterectomy for benign disease from Ireland was obtained from the Hospital In-Patient Enquiry Scheme (HIPE) section of the Economic and Social Research Institute for the years 1999 to 2006. The total number of hysterectomies performed for benign disease showed a consistent decline during this time. There was a 36% reduction in the number of abdominal hysterectomy procedures performed.

  2. Total Vaginal NOTES Hysterectomy: A New Approach to Hysterectomy.

    Baekelandt, Jan

    2015-01-01

    The aim of this study was to demonstrate the feasibility of a total hysterectomy performed entirely by transvaginal natural orifice transluminal endoscopic surgery (vNOTES). Conventional, reusable laparoscopic instruments were used, inserted through an inexpensive, self-constructed single-port device. Ten total vaginal NOTES hysterectomies (TVNHs) were performed by a single surgeon. The self-constructed single-port device was made by assembling a surgical glove, a wound protector or modified laryngeal mask airway, 1 reusable 10-mm trocar, and 4 reusable 5-mm trocars. This gloveport was inserted into the vagina to create a pneumovagina. The conventional steps of a vaginal hysterectomy were followed, but performed endoscopically with standard reusable endoscopic instruments. The patient and perioperative data were analyzed. No conversion to standard laparoscopy or laparotomy was necessary in any of the 10 patients who underwent a TVNH. Mean operation time was 97 min (range: 60-120); mean drop in hemoglobin level was 1.5 g/dL (range: 0.5-2.4). There were no operative complications, and postoperative pain scores were very low. This first report on a small number of patients demonstrates that TVNH is possible. By incorporating the advantages of endoscopic surgery, TVNH broadens the indications for vaginal hysterectomy and helps overcome its limitations. At the same time, the NOTES approach avoids abdominal wall wounds and trocar-related complications. TVNH is feasible, even when performed with reusable, conventional laparoscopic instruments. This frugally innovative technique also enables surgeons to perform hysterectomies by vNOTES in low resource settings. PMID:26009278

  3. HYSTERECTOMY ………. WHY?

    Swati

    2014-08-01

    Full Text Available OBJECTIVE: This study was designed to identify various factors affecting women’s decision to undergo hysterectomy, to know the reasons for preference of hysterectomy over medical and surgical conservative management and observe occurrence of various uterine pathologies in relation to age. METHODS: A prospective observational study of 600 patients who underwent hysterectomy for various etiologies by different routes at Sola Civil Hospital, Ahmedabad over a period of 1 year (from jan-13 to Dec 13 was carried out. RESULT: percentage of patients undergoing hysterectomy in prolapse and adenomyosis group patients are 100% and 96.29% In DUB 64.39% and the fibroid group 68.10-% patients preferred hysterectomy as a first line of treatment. CONCLUSION: DUB was recognized as the most common indication for hysterectomy amongst reproductive age women whereas prolapse was the commonest indication in women over 50 years of age. A considerable number of patients with PID preferred medical management Patients with DUB and fibroid preferred conservative surgical and medical management before finally opting for hysterectomy but more than 64% patients in both group opted hysterectomy as first-line treatment.. Cost of medical management and affection of quality of life were identified as major reasons for diverting to permanent cure (hysterectomy in DUB patients. Belief of uterus as a vestigial organ after completion of childbearing was reason for hysterectomy in PID and prolapse patients.

  4. Total Laparoscopic Hysterectomy Compared with Abdominal Hysterectomy; Clinical Outcomes

    Cem Celik

    2013-10-01

    Full Text Available Aim: The purpose of this study was to confirm the positive intraoperative and postoperative outcomes of total laparoscopic hysterectomy (TLH and total abdominal hysterectomy (TAH. Material and Method: We presented surgical procedures performed at Namik Kemal University Faculty of Medicine, Department of Obstetrics and Gynecology between September 2010 and December 2012, 47 patients who underwent TLH and 30 patients who underwent TAH  were included in the present study. Results: Operating time in TLH group was significantly longer than in the TAH group (202.56±61.53 vs 138.06±40.52 min. There were no significant differences between the two groups regarding complications, conversion to laparotomy, intraoperative bleeding. We observed no differences in reoperation and transfusion rates between the two groups. Duration of hospital stay was statistically shorter in TLH group compared to the TAH group (3.93±0.70 vs 5.26±1.63 day. Discussion: Laparoscopic hysterectomy, compared to laparotomy regarding equal outcomes and lower perioperative morbidity, improvement of quality of life, shorter hospital stay and faster return to activity.

  5. Abandoned vehicles

    Relations with the Host States Service

    2004-01-01

    The services in charge of managing the CERN site have recently noted an increase in the number of abandoned vehicles. This poses a risk from the point of view of safety and security and, on the eve of several important events in honour of CERN's fiftieth anniversary, is detrimental to the Organization's image. Owners of vehicles that have been left immobile for some time on the CERN site, including on the external car park by the flags, are therefore invited to contact the Reception and Access Control Service (service-parking-longterm@cern.ch) before 1st October 2004 and, where appropriate, move their vehicle to a designated long-term parking area. After this date, any vehicle whose owner has failed to respond to this request and which is without a number plate, has been stationary for several weeks or is out of service, may be impounded at the owner's risk and expense. Relations with the Host States Service Tel. 72848

  6. Lower urinary tract symptoms after subtotal versus total abdominal hysterectomy

    Andersen, Lea Laird; Møller, Lars Mikael Alling; Gimbel, Helga

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: Lower urinary tract symptoms (LUTS) are common after hysterectomy and increase after menopause. We aimed to compare subtotal with total abdominal hysterectomy regarding LUTS, including urinary incontinence (UI) subtypes, 14 years after hysterectomy. Main results from ...

  7. Total laparoscopic hysterectomy versus vaginal hysterectomy: a retrospective study

    Jayashree S.

    2015-10-01

    Full Text Available Background: Total laparoscopic hysterectomy (TLH is now emerging as a safe procedure even in patients suitable for vaginal hysterectomy (VH due to its advantages like better visualisation, less post-operative pain and shorter hospital stay. This study was done to compare the duration of surgery, intra-operative and postoperative complications, hospital stay and post-operative analgesia requirement in TLH and VH. Methods: A retrospective study of women undergoing TLH and VH between June 2013 and September 2014 in JSS Hospital, Mysore was done. Patients with suspected genital malignancy and uterine prolapse were excluded. Baseline characteristics like age, BMI, parity, indication for hysterectomy, uterine size and previous pelvic surgeries were noted. Intra-operative and post-operative parameters like duration of surgery, complications, post-operative analgesic dosage and hospital stay were compared between the two surgeries and the results were analysed using Chi square test and independent t test. Results: The mean time taken to perform TLH was significantly longer, i.e. 113.46 minutes compared with VH, i.e. 61.18 minutes ( p <0.0001. But the duration of stay in the hospital was shorter for the women undergoing TLH, mean duration being 3.74 days as opposed to 5.85 days in women undergoing VH (p<0.0001. Also, women undergoing VH required more analgesic doses (mean 1.79 than those undergoing TLH (mean 1.36. When we studied the rate of complications in both the groups, we found no statistically significant difference. Conclusions: TLH was as safe as VH and had advantages like shorter hospital stay and reduced analgesia dose. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1499-1504

  8. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... t know if I feel comfortable doing that.” Well I believe our presentation will be different. I’m confident that after this evening ... this? Why do OB-GYNs prefer abdominal hysterectomy? Well the vaginal hysterectomy ... Inherent with that may be some fear that will have some injury to ...

  9. 腹腔镜下广泛全子宫及盆腹腔淋巴结切除手术6例泌尿系损伤临床分析%Clinical analysis on 6 cases of urinary system injury in peritoneoscope radical hysterectomy and abdomi-nopelvic cavity lymph node excision

    陶玲; 于春霞; 李霞; 周琦

    2015-01-01

    目的:探讨我科腹腔镜广泛全子宫及盆腔淋巴结切除手术中泌尿系损伤的发生情况、处理方式以及预防的方法。方法:回顾性分析5年间我科腹腔镜广泛全子宫+盆腔淋巴结切除手术中发生泌尿系损伤患者的临床资料、疾病类型、盆腔情况、损伤、诊治情况及预后。结果:385例妇科腹腔镜手术中,共发生泌尿系损伤6例,发生率为1.56%,其中膀胱损伤2例,输尿管损伤4例。5例均有盆腔粘连,4例有盆腹腔手术史,1例合并盆腔子宫内膜异位症,2例子宫均有增大(6~10周)。2例膀胱损伤及 2例输尿管损伤均在术中发现。另 2例输尿管损伤于术后发现,其中 1例为术后复习录制手术视频时发现;1例为术后第5天行静脉肾盂造影确诊。2例膀胱损伤术中发现者均行腹腔镜下膀胱修补术。2例术中发现输尿管损伤者在术中行腹腔镜下输尿管吻合术+支架置入术及膀胱镜下输尿管支架置入术。2例术后发现者其中 1例行腹腔镜输尿管修补术及支架置入术,1例在膀胱镜下行输尿管支架置入术,预后均较好。结论:妇科腹腔镜手术泌尿系损伤是妇科腹腔镜手术少见而严重的并发症,如果注意预防损伤常可避免。术前须仔细评估患者的病情,应严格掌握腹腔镜手术指征,术中应仔细操作,术中术后尽早发现膀胱或输尿管损伤,尽可能采取及时、有效的方式减少损害。%Objectives:To discuss the occurrence rate,causes,treatment and prevention methods of urina-ry system injury in peritoneoscope radical hysterectomy and abdominopelvic cavity lymph node excision.Methods:A retrospective analysis on the clinical material,disease type,pelvic cavity condition,damage,diagnosis and treat-ment condition and prognosis of the patients suffering from urinary system injury in peritoneoscope radical hysterecto-my and abdominopelvic cavity lymph

  10. Clinicopathological review of gynaecological hysterectomies local experience

    share clinicopathological spectrum of hysterectomies performed at CMH Rawalpindi. Study Design: A cross sectional descriptive study. Place and duration of the study : This study was carried out at Obstetrics and Gynaecology department CMH Rawalpindi, from October 2010 to June 2012. Material and Methods: Total of 54 patients who underwent hysterectomy were selected for the study. Detailed history and examination of the patient pre and post-operatively were carried out to observe the indications and complications of hysterectomy. Results: In total 54 hysterectomies were carried out; all of which with the exception of one were total abdominal. The patients who underwent hysterectomies were in the 4th decade of life. The most common (48%) indication of hysterectomy in our study was found to be menstrual irregularities like menorrheagia, irregular vaginal bleeding, DUB and post-menopausal bleeding give frequently of complication as well. Delayed wound healing was the most common complaint (7%). Histopathology carried out on the uterine specimen showed adenomyosis 17(31%) being the most common finding. Conclusion: Abdominal hysterectomies carried out in our setup are most commonly done for menstrual irregularities and complication rate is low. (author)

  11. Depression Following Hysterectomy and the Influencing Factors

    Bahri, Narjes; Tohidinik, Hamid Reza; Fathi Najafi, Tahereh; Larki, Mona; Amini, Thoraya; Askari Sartavosi, Zahra

    2016-01-01

    Background Hysterectomy is one of the most common gynecological surgeries performed worldwide. However, women undergoing this surgery often experience negative emotional reactions. Objectives This study was done with the aim of investigating the relationship between hysterectomy and postoperative depression, three months after the procedure. Materials and Methods This longitudinal study was conducted in the province of Khorasan-Razavi in Iran, using multistage sampling. At first, three cities were selected from the province by cluster sampling; then, five hospitals were randomly selected from these cities. The participants included 53 women who were hysterectomy candidates in one of the five selected hospitals. The participants’ demographics and hysterectomy procedure information were entered into two separate questionnaires, and the Beck depression inventory (BDI) was employed to measure their severity of depression before and three months after the surgery. The statistical package for the social sciences (SPSS) version 16 was used for the statistical analysis, and a P value of < 0.05 was considered to be statistically significant. Results The means and standard deviations of the participants’ depression scores before and three months after their hysterectomies were 13.01 ± 10.1 and 11.02 ± 10.3, respectively. Although the mean score of depression decreased three months after the hysterectomy, the difference was not statistically significant. However, a significant relationship was found between the satisfaction with the outcome of the hysterectomy and the postoperative depression score (P = 0.04). Conclusions In this study, undergoing a hysterectomy did not show a relationship with postoperative depression three months after the surgery. Moreover, the only factor related to depression following a hysterectomy was satisfaction with the surgery. PMID:27066267

  12. Hysterectomy

    ... in the pelvic area). You may still get pregnant after myolysis. Treatments to shrink fibroids without surgery. These treatments include uterine artery embolization (UAE) and magnetic resonance (MR)-guided focused ultrasound (MR[f]US). UAE puts ...

  13. Abandoned Shipwreck Act

    National Oceanic and Atmospheric Administration, Department of Commerce — The Abandoned Shipwreck Act of 1987 (ASA) affirms the authority of state governments to claim ownership to, protect, and manage abandoned shipwrecks on state...

  14. Guam Abandoned Vessel Inventory

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Guam. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  15. Florida Abandoned Vessel Inventory

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Florida. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  16. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... this evening you will feel very encouraged to offer the minilap hysterectomy to your patients, and if ... that’s what you want to be able to offer your patients. You can offer them something that ...

  17. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available Expanding Patient Options: Minilaparotomy for Hysterectomy Covidien Energy Based Devices Concord, California May 26, 2010 Welcome to this OR ... a procedure that is very cost effective and patient friendly. Our agenda tonight is as follows: I’ ...

  18. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... is large; that’s not something we want as far to enter into. We are very comfortable as ... not things that are new to us as far as doing abdominal hysterectomy, C-sections, myomectomies, multiple ...

  19. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... know that all the patients in this particular analysis had supercervical hysterectomies. So back to that slide, ... patient recovery. I would say that, again, statistical analysis tells us that we’re not comfortable doing ...

  20. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... This is something that I can do.” Many times I would have attended conferences and seminars where ... large incisions and prolonged recoveries when it comes time to have your hysterectomy. With that, let me ...

  1. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... hysterectomy summer of 2009, and it was my doctor that recommended the surgery. I had this procedure ... that’s gone. My expectations were really high. My doctor, Dr. Fillmore, said it was going to be ...

  2. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... recently issued an opinion to the OB-GYN community. They state that the vaginal hysterectomy is the ... this conflict out there in the OB-GYN community. The American College of OB-GYN wishes that ...

  3. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... taking all that into account, taking experience and skill, for most of us, the abdominal hysterectomy is ... approach. If you do not have vaginal surgery skills, again, this is not -- that’s not something you ...

  4. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... 600,000 procedures being performed annually. By the age of 60, one in three women will have ... hysterectomy (INAUDIBLE) myomectomy, adnexal masses, pretty common standard age. Most people going through this procedures are in ...

  5. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... By the age of 60, one in three women will have had a hysterectomy. The American College ... Alexis O, please make sure you get the right retractor. It will make all the difference in ...

  6. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... be resolved. I believe we can achieve ACOG’s goals by using the familiar abdominal hysterectomy, and using ... sealing device that can help us achieve these goals an also use what we’ve learned from ...

  7. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available Expanding Patient Options: Minilaparotomy for Hysterectomy Covidien Energy Based Devices Concord, California May 26, 2010 Welcome to this OR Live program presented by Covidien energy-based devices. Good evening, and thank ...

  8. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... is as follows: I’ll begin with some historical information regarding hysterectomy, and then we’ll show ... if feasibly possible. It does have the best historical data in terms of outcome and patient recovery. ...

  9. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... Illinois. I practice with North Shore University Health Systems at Highland Park Hospital. I’m joined tonight ... as follows: I’ll begin with some historical information regarding hysterectomy, and then we’ll show a ...

  10. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... to be a question of asking, what’s the comparison of this procedure with other hysterectomies? In my ... an approach because it has many benefits. In comparison to the laparoscopy, I do a lot of ...

  11. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... majority of our hysterectomies as an abdominal procedure, meaning with sort of the larger abdominal incision. In ... less blood loss and a quicker recovery. We should also recognize that there have been technological advances ...

  12. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... women will have had a hysterectomy. The American College of OB-GYN recently issued an opinion to ... something new. About 20 years ago, the American College of OB-GYN or ACOG issued a similar ...

  13. Women's Hysterectomy Experiences and Decision-Making

    Uskul, Ayse K.; Ahmad, Farah; Leyland, Nicholas A.; Stewart, Donna E.

    2003-01-01

    The goal of the study was to examine women's experiences with gynaecologic symptoms and how they decided to undergo hysterectomy. For this purpose, twenty-nine women were interviewed in hospital within three days of undergoing hysterectomy. The interviews elicited information about the nature of the problem that caused the women to seek medical help, actions taken to solve their problem, their relationship with their gynaecologist, information seeking patterns and decision-making about hyster...

  14. Diagnostic Neglect Regarding Ureter Ligation After Hysterectomy

    BİLGE, Yaşar

    2007-01-01

    Complications following cesarean and hysterectomy operations can occur, one of which is ureter ligation. Aims: Urological injuries that occur during hysterectomy are rare but important causes of morbidity. It was aimed to investigate in this case report whether there was any evidence to support malpractice in Court. Case Report: The patient was a woman in her 343 week of pregnancy with familial Mediterranean fever (FMF) and nephrotic syndrome with renal amyloidosis. Preterm operational di...

  15. Laparoscopic hysterectomy in the treatment of endometrial cancer: NCI experience

    The standard treatment for women with endometrial cancer is total abdominal hysterectomy and pelvic lymphadenectomy for surgical staging. Total laparoscopic radical hysterectomy (TLH) is an alternative approach providing surgical and patient related advantages to laparoscopy. Methods: Twenty female patients with early stage endometrial cancer were operated upon by TLH and pelvic lymphadenectomy, aiming to assess the safety and efficacy of TLH. Results: The mean operative time was 296.8 min conversion to laparotomy was done in one patient due to bleeding from the uterine vessels. The mean blood loss was 517.5 cc. The uterus was removed transvaginally in 18 patients (90%) and via a small Pfannenstiel incision in two patients (10%). The mean number of pelvic lymph nodes retrieval was 21.2. Postoperative bleeding occurred in one patient (5%) which necessitated exploration. One patient (5%) suffered a pulmonary embolism. Four patients (20%) developed pyrexia, and one patient (5%) suffered from a chest infection. One patient (5%) had wound infection. The mean hospital stay was 4.5 days (range 3-10). Conclusion: TLH with pelvic lymphadenectomy is a safe and effective approach in the treatment of early endometrial carcinoma.

  16. Morbidity and mortality associated with obstetric hysterectomy

    Background: Obstetric hysterectomy still complicates a substantial number of pregnancies in third world countries and is a significant cause of obstetric morbidity and mortality. This study was carried out to evaluate in our setup the frequency of obstetric hysterectomy, its indication, risk factors, complication, morbidity, mortality and avoidable factors. Methods: A descriptive study of all patients who under went obstetric hysterectomy was conducted from May 1, 2004 to October 31, 2005 at Gynaecology and Obstetric Unit-II, III of Liaquat University of Medical and Health Science Hospital, Hyderabad. After collecting the data on pre-designed proforma the data was fed to SPSS in the form of frequency distribution tables and percentages were calculated. Statistical analysis of data was performed by using Chi-square test. The level of significance was taken as p<0.05. Results: During the study time period there were total 6495 deliveries and 41 cases of obstetric hysterectomy were identified, giving a frequency of 0.63% or 1 in 158 deliveries. Most of patients were from rural areas (82.92%), un-booked 73.17%), uneducated (95%), lower socio economical class (92.69%), 25-29 years age (48.78%) multiparae (56.10%), have to travel a distance of <100 km to reach hospital and referred late (51%) by health care providers (doctors). Majority of hysterectomies were performed due to ruptured uteri (51.21%). There were 5 maternal and 26 perinatal deaths; all were due to severity of conditions necessitating hysterectomy. Conclusion: Incidence of obstetric hysterectomy in our woman is very high. The reason being many avoidable factors such as high parity, inadequate maternity and family planning services, lack of proper referral system, un-booked status, mismanaged labour, illiteracy on the part of woman herself, family and health care providers are not taken care of during pregnancy, labour and puerperium. (author)

  17. Laparoscopic hysterectomy with morcellation versus abdominal hysterectomy for presumed fibroids in premenopausal women: a decision analysis

    SIEDHOFF, Matthew T.; WHEELER, Stephanie B.; RUTSTEIN, Sarah E.; GELLER, Elizabeth J.; DOLL, Kemi M.; WU, Jennifer M.; CLARKE-PEARSON, Daniel L.

    2016-01-01

    Objective To model outcomes in laparoscopic hysterectomy with morcellation compared to abdominal hysterectomy for the presumed fibroid uterus, examining short-and long-term complications, as well as mortality. Study Design A decision tree was constructed to compare outcomes for a hypothetical cohort of 100,000 premenopausal women undergoing hysterectomy for presumed fibroids over a 5-year time horizon. Parameter and quality of life utility estimates were determined from published literature for postoperative complications, leiomyosarcoma incidence, death related to leiomyomsarcoma, and procedure-related death. Results The decision analysis predicted fewer overall deaths with laparoscopic hysterectomy compared to abdominal hysterectomy (98 vs. 103 per 100,000). While there were more deaths from leiomyosarcoma following laparoscopic hysterectomy (86 vs. 71 per 100,000), there were more hysterectomy-related deaths with abdominal hysterectomy (32 vs. 12 per 100,000). The laparoscopic group had lower rates of transfusion (2,400 vs. 4,700 per 100,000), wound infection (1,500 vs 6,300 per 100,000), venous thromboembolism (690 vs. 840 per 100,000) and incisional hernia (710 vs. 8,800 per 100,000), but a higher rate of vaginal cuff dehiscence (640 vs. 290 per 100,000). Laparoscopic hysterectomy resulted in more quality-adjusted life years (499,171 vs. 490,711 over five years). Conclusion The risk of leiomyosarcoma morcellation is balanced by procedure-related complications associated with laparotomy, including death. This analysis provides patients and surgeons with estimates of risk and benefit, upon which patient-centered decisions can be made. PMID:25817518

  18. Endoluminal release of ureteral ligature after hysterectomy.

    Wang, Chih-Jen; Lin, Victor Chia-Hsiang; Huang, Ching-Yu

    2016-01-01

    Iatrogenic ureteral injury is a well-recognized complication of abdominal total hysterectomy. We report a case of a 57-year-old female who underwent abdominal total hysterectomy for a uterine myoma and experienced severe right flank pain postoperatively. The imaging study displayed an obstruction of the right distal ureter. Under ureteroscopy, an extraluminal ligature was released with a holmium:yttrium-aluminum-garnet laser. The stenotic segment was immediately relieved. Two months later, the intravenous urogram illustrated patency of the distal ureter with regression of right hydronephrosis. There was no recurrent hydronephrosis during 1 year of follow-up. PMID:25241286

  19. Low adherence to cervical cancer screening after subtotal hysterectomy

    Andersen, Lea Laird; Møller, Lars Mikael Alling; Gimbel, Helga Margrethe

    2015-01-01

    INTRODUCTION: A reason for not recommending subtotal hysterectomy is the risk of cervical pathology. We aimed to evaluate cervical cancer screening and to describe cervical pathology after subtotal and total hysterectomy for benign indications. METHODS: Data regarding adherence to screening.......7% were not screened. We found a minimum of one abnormal test in 28 (10.8%) after subtotal hysterectomy and one after total hysterectomy. No cervical cancers were found. CONCLUSIONS: Adherence to cervical cancer screening after subtotal hysterectomy in a Danish population is suboptimal and some patients...... have unnecessary tests performed after total hysterectomy. Clarification of the use of cervical/vaginal smears after hysterectomy is needed to identify women at risk of cervical dysplasia or cancer. FUNDING: Research Foundation of Region Zealand, University of Southern Denmark, Nykøbing Falster...

  20. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... to us as far as doing abdominal hysterectomy, C-sections, myomectomies, multiple other procedures. This is the ... standard if you use Alexis O retractors in C-sections, and they’re self-retaining. The good ...

  1. Abandoning wells working group

    NONE

    1997-03-01

    The primary objective of this working group is to identify major technical, regulatory, and environmental issues that are relevant to the abandonment of offshore wellbores. Once the issues have been identified, the working group also has the objective of making recommendations or providing potential solutions for consideration. Areas for process improvement will be identified and {open_quotes}best practices{close_quotes} will be discussed and compared to {open_quotes}minimum standards.{close_quotes} The working group will primarily focus on wellbore abandonment in the Gulf of Mexico. However, workshop participants are encouraged to discuss international issues which may be relevant to wellbore abandonment practices in the Gulf of Mexico. The Abandoning Wells Group has identified several major areas for discussion that have concerns related to both operators and service companies performing wellbore abandonments in the Gulf of Mexico. The following broad topics were selected for the agenda: (1) MMS minimum requirements and state regulations. (2) Co-existence of best practices, new technology, and P & A economics. (3) Liability and environmental issues relating to wellbore abandonment.

  2. A STUDY OF PSYCHIATRIC ASPECTS OF HYSTERECTOMY

    Vyas, J.N.; R. S. Rathore; P.Sharma; Singhal, A.K.

    1989-01-01

    SUMMARY Thirty women patients who were hysterectomized for non-malignant pathologies were compared with thirty comparable patients who underwent other gynaecological operations. Each patient was subjected to semistructured psychiatric interview, standardised Hindi version of G.H.Q., Hindi version of PEN, I.P.I.S. and BDRI. The diagnosis was made according to I.C.D. - 9. It was observed that patients undergoing hysterectomy do suffer significantly higher psychiatric morbidity (60%), had higher...

  3. HYSTERECTOMY: CHANGING TRENDS IN A TERTIARY CARE CENTER

    Abha; Smrity; Anchala

    2015-01-01

    BACKGROUND: Hysterectomy is the most common gynec operation worldwide. It leads to significant morbidity and mortality hence there must be justifiable indication before procedure is undertaken. There is a lack of comprehensive data and too much variability from place to place, even in India. OBJECTIVE: To analyze the changing trends in hysterectomy in past 6 years. METHOD: A retrospective study of all women undergoing hysterectomy that were done in Dr. B.R.A.M. Hospital, Medic...

  4. Analysis of a Standardized Technique for Laparoscopic Cuff Closure following 1924 Total Laparoscopic Hysterectomies.

    O'Hanlan, Katherine A; Emeney, Pamela L; Peters, Alfred; Sten, Margaret S; McCutcheon, Stacey P; Struck, Danielle M; Hoang, Joseph K

    2016-01-01

    Objective. To review the vaginal cuff complications from a large series of total laparoscopic hysterectomies in which the laparoscopic culdotomy closure was highly standardized. Methods. Retrospective cohort study (Canadian Task Force Classification II-3) of consecutive total and radical laparoscopic hysterectomy patients with all culdotomy closures performed laparoscopically was conducted using three guidelines: placement of all sutures 5 mm deep from the vaginal edge with a 5 mm interval, incorporation of the uterosacral ligaments with the pubocervical fascia at each angle, and, whenever possible, suturing the bladder peritoneum over the vaginal cuff edge utilizing two suture types of comparable tensile strength. Four outcomes are reviewed: dehiscence, bleeding, infection, and adhesions. Results. Of 1924 patients undergoing total laparoscopic hysterectomy, 44 patients (2.29%) experienced a vaginal cuff complication, with 19 (0.99%) requiring reoperation. Five patients (0.26%) had dehiscence after sexual penetration on days 30-83, with 3 requiring reoperation. Thirteen patients (0.68%) developed bleeding, with 9 (0.47%) requiring reoperation. Twenty-three (1.20%) patients developed infections, with 4 (0.21%) requiring reoperation. Three patients (0.16%) developed obstructive small bowel adhesions to the cuff requiring laparoscopic lysis. Conclusion. A running 5 mm deep × 5 mm apart culdotomy closure that incorporates the uterosacral ligaments with the pubocervical fascia, with reperitonealization when possible, appears to be associated with few postoperative vaginal cuff complications. PMID:27579179

  5. Puerto Rico Abandoned Vessel Inventory

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Puerto Rico. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  6. American Samoa Abandoned Vessel Inventory

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for American Samoa. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  7. Hawaii Abandoned Vessel Inventory, Lanai

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Lanai. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  8. Hawaii Abandoned Vessel Inventory, Oahu

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Oahu, Hawaii. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  9. CNMI Abandoned Vessel Inventory, Rota

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Rota. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  10. Hawaii Abandoned Vessel Inventory, Molokai

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Molokai, Hawaii. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of...

  11. CNMI Abandoned Vessel Inventory, Saipan

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Saipan. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  12. CNMI Abandoned Vessel Inventory, Tinian

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Tinian. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  13. Hawaii Abandoned Vessel Inventory, Kauai

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Kauai. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  14. Hawaii Abandoned Vessel Inventory, Maui

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Maui. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  15. Establishment of a national Danish hysterectomy database: preliminary report on the first 13,425 hysterectomies

    Hansen, Charlotte T; Møller, Charlotte; Daugbjerg, Signe;

    2008-01-01

    2%, the rate of bleeding complications from 8 to 6%, the reoperation rate from 5 to 4%, and the readmission rate from 7 to 5%. CONCLUSIONS: Clinical performance indicators, audit meetings and nationwide collaboration are useful in monitoring and improving outcome after hysterectomy on a national...

  16. A new approach to simplify surgical colpotomy in laparoscopic hysterectomy

    Van den Haak, L.; Rhemrev, J.P.; Bikkendaal, M.D.; Luteijn, A.C.; Van den Dobbelsteen, J.J.; Driessen, S.R.; Jansen, F.W.

    2016-01-01

    New surgical techniques and technology have simplified laparoscopic hysterectomy and have enhanced the safety of this procedure. However, the surgical colpotomy step has not been addressed. This study evaluates the surgical colpotomy step in laparoscopic hysterectomy with respect to difficulty and d

  17. 42 CFR 50.207 - Sterilization by hysterectomy.

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Sterilization by hysterectomy. 50.207 Section 50... GENERAL APPLICABILITY Sterilization of Persons in Federally Assisted Family Planning Projects § 50.207 Sterilization by hysterectomy. (a) Programs or projects to which this subpart applies shall not perform...

  18. 42 CFR 441.255 - Sterilization by hysterectomy.

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Sterilization by hysterectomy. 441.255 Section 441.255 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Sterilizations § 441.255 Sterilization by hysterectomy. (a) FFP is not available in expenditures for...

  19. Total abdominal hysterectomy versus minimal-invasive hysterectomy: a systemic review and meta-analysis

    INTRODUCTION. At the present time three types of hysterectomies are used: the vaginal hysterectomy and the minimal-invasive hysterectomy (MIH). The objective of present research was to compare the MIH and the total abdominal hysterectomy (TAH) in women presenting with benign uterine diseases. METHODS. A systemic review was made and a meta-analysis from the following databases: MEDLINE, EBSCO HOST AND The Cochrane Central Register of Controlled Trials. Only the controlled and randomized studies were selected. The data of all studies were combined and also the relative risk (RR) with a 95% CI was used with the Mantel-Haenszel method as an effect measure for dichotomy variables. For the analysis of continuing variables the mean difference was used. In all the comparisons performed the results were obtained with the fix effect and randomized forms. RESULTS. A total of 53 transoperative complications were registered in the MIH hysterectomy versus 17 in the TAH group (RR: 1,78; 95% CI: 1,04-3.05). Postoperative complications evolved in a similar way in both groups without significant differences from the statistical point of view. The blood losses, the hospital stay and the patient's reincorporation to usual and work activities were lesser in the laparoscopy group; however, the operative time is higher when it is compared with TAH (mean difference: 37,36; 95% CI: 34,36-39,93). CONCLUSIONS. Both techniques have advantages and disadvantages. The indication of MIH must to be individualized according to the clinical situation of each patient and these not to be performed in those centers without a properly trained surgical staff and with experience in advanced minimal invasive surgery. (author)

  20. Are hysterectomies necessary? Racial-ethnic differences in women's attitudes.

    Dillaway, Heather E

    2016-01-01

    There is a dearth of comparative information about how women from diverse social locations think about, talk about, and experience the various types of reproductive aging. In this article I analyze racial-ethnic differences in attitudes toward surgically induced menopause (hysterectomy) utilizing data from an interview study of 130 menopausal women. African American women in this study were more suspect of doctors' initial offers of hysterectomies than European American women, with the former group of interviewees still fearing a legacy of racial-ethnic discrimination within medical institutions. Only after seeking a second opinion or finding a trustworthy doctor did African American women feel comfortable accepting a hysterectomy. European American interviewees were not as wary as their African American counterparts and sometimes reported wishing for a hysterectomy. I argue that attitudes toward hysterectomy must be contextualized within women's experiences of racial-ethnic oppression and privilege to be fully understood. PMID:27045199

  1. Effect of socioeconomic position on patient outcome after hysterectomy

    Daugbjerg, Signe B; Cesaroni, Giulia; Ottesen, Bent;

    2014-01-01

    OBJECTIVE: To investigate the association between socioeconomic position (assessed by education, employment and income) and complications following hysterectomy and assess the role of lifestyle, co-morbidity and clinical conditions on the relationship. DESIGN: Register-based cohort study. SETTING...... AND POPULATION: The study included nearly all Danish women (n = 22 150) registered with a benign elective hysterectomy in the Danish Hysterectomy Database in 2004-2008. METHODS: Data were analyzed using logistic regression models estimating the odds ratio with 95% confidence intervals. MAIN OUTCOME...... MEASURES: Complications following hysterectomy. RESULTS: Seventeen percent of the women experienced complications in relation to the hysterectomy. Women with less than high school education and unemployed women had higher odds of infection, complications and readmission than women with more than high...

  2. Surgeon volume and outcomes in benign hysterectomy.

    Doll, Kemi M; Milad, Magdy P; Gossett, Dana R

    2013-01-01

    Annual surgeon case volume has been linked to patient outcome in a variety of surgical fields, although limited data focus on gynecologic surgery performed by general gynecologists. Herein we review the literature addressing the associations between intraoperative injury, postoperative morbidity, and resource use among surgeons performing a low vs high volume of hysterectomies. Although study design and populations differ, individual and composite morbidity outcomes consistently favored high-volume surgeons. Given the growing emphasis on competency-based evaluation in surgery, gynecology departments may soon consider volume requirements a component of privileging. PMID:23622760

  3. Emergency peripartum hysterectomy: Incidence, indications, risk factors and outcome

    Lovina S.M. Machado

    2011-01-01

    Full Text Available Background: Peripartum hysterectomy is a major operation and is invariably performed in the presence of life threatening hemorrhage during or immediately after abdominal or vaginal deliveries. Material and Methods: A Medline search was conducted to review the recent relevant articles in English literature on emergency peripartum hysterectomy. The incidence, indications, risk factors and outcome of emergency peripartum hysterectomy were reviewed. Results: The incidence of emergency peripartum hysterectomy ranged from 0.24 to 8.7 per 1000 deliveries. Emergency peripartum hysterectomy was found to be more common following cesarean section than vaginal deliveries. The predominant indication for emergency peripartum hysterectomy was abnormal placentation (placenta previa/accreta which was noted in 45 to 73.3%, uterine atony in 20.6 to 43% and uterine rupture in 11.4 to 45.5 %. The risk factors included previous cesarean section, scarred uterus, multiparity, older age group. The maternal morbidity ranged from 26.5 to 31.5% and the mortality from 0 to 12.5% with a mean of 4.8%. The decision of performing total or subtotal hysterectomy was influenced by the patient′s condition. Conclusion: Emergency peripartum hysterectomy is a most demanding obstetric surgery performed in very trying circumstances of life threatening hemorrhage. The indication for emergency peripartum hysterectomy in recent years has changed from traditional uterine atony to abnormal placentation. Antenatal anticipation of the risk factors, involvement of an experienced obstetrician at an early stage of management and a prompt hysterectomy after adequate resuscitation would go a long way in reducing morbidity and mortality.

  4. The Effect of Abdominal Radical Trachelectomy on Ovarian Reserve: Serial Changes in Serum Anti-Müllerian Hormone Levels

    Miho Muraji, Tamotsu Sudo, Shinichi Iwasaki, Sayaka Ueno, Senn Wakahashi, Satoshi Yamaguchi, Kiyoshi Fujiwara, Ryuichiro Nishimura

    2012-01-01

    Full Text Available Aim: To evaluate the effect of abdominal radical trachelectomy on ovarian reserve and compare it with abdominal radical hysterectomy and a control group that did not have surgery.Method: We enrolled eighteen women who had abdominal radical trachelectomy with pelvic lymphadenectomy and sixteen patients who had abdominal radical hysterectomy for this study. Ten thousand one hundred eighty-six women were also included as a control group for comparison. The Mann-Whitney U test was used for comparison of patient characteristics and comparison of serum anti-Müllerian hormone levels between the three groups.Results: Serum anti-Müllerian hormone levels in patients with abdominal radical trachelectomy were significantly higher than those of patients with abdominal radical hysterectomy (P<0.05. Serum anti-Müllerian hormone levels in the abdominal radical hysterectomy group were significantly lower than those in the control group (P=0.02, with no significant difference between the abdominal radical trachelectomy and control groups. These data indicated that abdominal radical trachelectomy did not affect ovarian function with respect to ovarian reserve and the response to ovarian stimulation.Conclusions: Serum anti-Müllerian hormone levels could be useful as a marker of ovarian reserve after abdominal radical trachelectomy. It is important to avoid postoperative complications causing a reduction in ovarian function to accomplish fertility-sparing surgery.

  5. HYSTERECTOMY: CHANGING TRENDS IN A TERTIARY CARE CENTER

    Abha

    2015-11-01

    Full Text Available BACKGROUND: Hysterectomy is the most common gynec operation worldwide. It leads to significant morbidity and mortality hence there must be justifiable indication before procedure is undertaken. There is a lack of comprehensive data and too much variability from place to place, even in India. OBJECTIVE: To analyze the changing trends in hysterectomy in past 6 years. METHOD: A retrospective study of all women undergoing hysterectomy that were done in Dr. B.R.A.M. Hospital, Medical College, Raipur for 6yrs from 2009 to 2014. RESULTS: A total of 1032 hysterectomies were done during the study period. Most common age group was from 41-50 years. The commonest indication was symptomatic fibroid (33.52%. Vaginal and abdominal hysterectomy were done equally. A declining trend of incidence of hysterectomy was observed over the years from 14.9 to 9.61 per 1000 women per year, which is significant (p value- 0.008. CONCLUSION: This study shows changing scenario of hysterectomy in terms of age, oophorectomy and rate. A shift towards minimal invasive techniques is also evident

  6. Complications of vaginal hysterectomy - (Analysis of 1105 cases

    Bhattacharya Menna

    1978-01-01

    Full Text Available Eleven hundred and five cases of vaginal hysterectomy are analysed and their complications discussed. More than 90% of the patients were between the ages of 31 to 60 years. The common indications for hysterectomy were prolapse (51% and dysfunctional uterine bleeding (34.9%. In four cases abdominal approach was necessary to complete the operation. The overall incidence of major complications was 4% and the corrected mortality rate was 0.18%. The complications of vaginal hysterec-tomy by other authors are discussed.

  7. Gender and power: the Irish hysterectomy scandal.

    McCarthy, Joan; Murphy, Sharon; Loughrey, Mark

    2008-09-01

    In April 2004 the Irish Government commissioned Judge Maureen Harding Clark to compile a report to ascertain the rate of caesarean hysterectomies at Our Lady of Lourdes Hospital in Drogheda, Republic of Ireland. The report came about as a result of complaints by midwives into questionable practices that were mainly (but not solely) attributed to one particular obstetrician. In this article we examine the findings of this Report through a feminist lens in order to explore what a feminist reading of the Report and the events that led to the inquiry will bring to light. We consider how sex and gender feature in the Lourdes case, draw attention to the deeply gendered asymmetries of power and privilege that existed between the men and women at the centre of this inquiry, and explore the impact such asymmetries had on this particular situation. PMID:18687818

  8. Single-incision total laparoscopic hysterectomy

    Sinha Rakesh

    2011-01-01

    Full Text Available Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. Ongoing refinement of the surgical technique and instrumentation is likely to expand its role in gynecologic surgery in the future. We perform single-incision total laparoscopic hysterectomy using three ports in the single transumbilical incision.

  9. Pelvic organ prolapse (POP) surgery among Danish women hysterectomized for benign conditions: age at hysterectomy, age at subsequent POP operation, and risk of POP after hysterectomy

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent;

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to describe the incidence of pelvic organ prolapse (POP) surgery after hysterectomy from 1977 to 2009, the time interval from hysterectomy to POP surgery, and age characteristics of women undergoing POP surgery after hysterectomy and to...

  10. Frequency of adenomyosis in hysterectomy specimens performed for benign indications

    Çakmak, Bülent; özsoy, zeki; nacar, mehmet; aysal, tülay; hısım, yeliz; Demirtürk, Fazlı

    2012-01-01

    Objective: The aim of this study is to determine the frequency of adenomyosis in hysterectomy specimens performed for benign indications. Methods: Adenomyosis frequency was retrospectively evaluated hystopathologically in hysterectomy specimens performed for benign indications on 149 patients between January 2009 and January 2012 in Gaziosmanpaşa University Medical School, Obstetric and Gynecology Clinic. Results: Adenomyosis frequency was determined as 11.7% (17) of 149 patients received f...

  11. Histopathological Analysis of 422 Nononcological Hysterectomies in a University Hospital

    Seda Ates

    2016-04-01

    Full Text Available Aim: The aim of the study was to evaluate the surgical indications, routes of surgery and the correlation between preoperative diagnosis and histopathological examination of hysterectomy specimens. Material and Method: Medical records and histopathological findings were reviewed and analyzed retrospectively, in 422 consecutive women who underwent hysterectomy over a two-year period from 2011 to 2014. Those with confirmed malignancy before operation were excluded. Cohen kappa statistics were used to measure agreement between preoperative clinical and postoperative histopathological diagnosis which was found to be fair with %u043A value being 0.4. Results: The mean age of our patients was 51.5 ± 8 years. The abdominal route was used in 378 cases (85.5%, the vaginal route in 55 patients (12.4% and the laparoscopic-assisted vaginal hysterectomy in 9 cases (2%. Abnormal uterine bleeding (28.9 % was the most common indication for hysterectomy. The histopathology of the endometrium prior to hysterectomy was reported in 75% of the cases and the most common finding was a secretory or proliferative endometrium. Leiomyomatous uterus was the most frequently encountered pathology (43.7% followed by coexistence of leiomyoma and adenomyosis (17.4% in hysterectomy specimens. Hysterectomy specimens may be unremarkable histopathologically, most of which are vaginal hysterectomies done for uterine prolapsed (kappa=0,407. Discussion: The correlation between the preoperative clinical and the pathological diagnosis were poor in cases with abdominal pain, abnormal uterine bleeding and fibroids. But there was a high correlation in cases with adnexial mass.

  12. The prevelance of adenomyosis at hysterectomy and associated factors

    Şentürk, Mehmet Baki; BUDAK, Mehmet Şükrü; Çakmak, Yusuf; DURUKAN, Ömer Birol; Polat, Mesut

    2015-01-01

    Objective: Adenomyosis is a entity characterized by the presence of endometrial glands and stroma embedded within the myometrium without apparent contact with the endo-myometrial junction. As the diagnosis of adenomyosis is based on histological examination, the condition is best described in women at the time of hysterectomy.Material and Methods: We evaluated results of 109 hysterectomized patients retrospectively. Age, parity, menopausal status and indication of hysterectomy were compared b...

  13. The effect of hysterectomy on ano-rectal physiology.

    Kelly, J L

    2012-02-03

    Hysterectomy is associated with severe constipation in a subgroup of patients, and an adverse effect on colonic motility has been described in the literature. The onset of irritable bowel syndrome and urinary bladder dysfunction has also been reported after hysterectomy. In this prospective study, we investigated the effect of simple hysterectomy on ano-rectal physiology and bowel function. Thirty consecutive patients were assessed before and 16 weeks after operation. An abdominal hysterectomy was performed in 16 patients, and a vaginal procedure was performed in 14. The parameters measured included the mean resting, and maximal forced voluntary contraction anal pressures, the recto-anal inhibitory reflex, and rectal sensation to distension. In 8 patients, the terminal motor latency of the pudendal nerve was assessed bilaterally. Pre-operatively, 8 patients were constipated. This improved following hysterectomy in 4, worsened in 2, and was unchanged in 2. Symptomatology did not correlate with changes in manometry. Although, the mean resting pressure was reduced after hysterectomy (57 mmHg-53 mmHg, P = 0.0541), the maximal forced voluntary contraction pressure was significantly decreased (115 mmHg-105 mmHg, P = 0.029). This effect was more pronounced in those with five or more previous vaginal deliveries (P = 0.0244, n = 9). There was no significant change in the number of patients with an intact ano-rectal inhibitory reflex after hysterectomy. There was no change in rectal sensation to distension, and the right and left pudendal nerve terminal motor latencies were unaltered at follow-up. Our results demonstrate that hysterectomy causes a decrease in the maximal forced voluntary contraction and pressure, and this appears to be due to a large decrease in a small group of patients with previous multiple vaginal deliveries.

  14. Emergency peripartum hysterectomy in a tertiary hospital in southern Nigeria

    Abasiattai, Aniekan Monday; Umoiyoho, Aniefiok Jackson; Utuk, Ntiense Maurice; Inyang-Etoh, Emmanuel Columba; Asuquo, Otobong Peter

    2013-01-01

    Introduction Emergency peripartum hysterectomy, a maker of severe maternal morbidity and near miss mortality is an inevitable surgical intervention to save a woman's life when uncontrollable obstetric haemorrhage complicates delivery. This study was conducted in order to determine the incidence, types, indications and maternal complications of emergency peripartum hysterectomy at the University of Uyo Teaching Hospital, Uyo, Nigeria. Methods The case records of all women who underwent emergen...

  15. Total laparoscopic hysterectomy via suture and ligation technique

    Kang, Hye Won; Lee, Ji Won; Ho Yeon KIM; Kim, Bo Wook; Moon, Chong Soo

    2016-01-01

    Objective The term 'total laparoscopic hysterectomy (TLH) with classical suture method' refers to a surgical procedure performed using only sutures and ligations with intracorporeal or extracorporeal ties, without using any laser or electronic cauterization devices during laparoscopic surgery as in total abdominal hysterectomy. However, the method is not as widely used as electric coagulation equipment for TLH because further advances in technology and surgical technique are required and oper...

  16. Cervical removal at hysterectomy for benign disease. Risks and benefits.

    Hasson, H M

    1993-10-01

    An assessment of the risks and benefits of total and subtotal hysterectomy for benign disease was performed using the published literature, including a MEDLINE search, on all studies dealing with hysterectomy and related topics from 1946 to 1992. The shift from subtotal to total hysterectomy occurred before cytologic screening was accepted. Currently, SIL is diagnosed by cytology, evaluated by colposcopy and treated preferentially with cone biopsy. Prophylactic removal of the cervix does not eliminate the risk of cancer: it may shift the risk to the vaginal epithelium. The cervix has a role in sexual arousal and orgasm, probably due to stimulation of the Frankenhauser uterovaginal plexus. Bladder and bowel dysfunction following total hysterectomy may be related to loss of nerve ganglia closely associated with the cervix. Increased operative and postoperative morbidity, vaginal shortening, vault prolapse, abnormal cuff granulations and oviductal prolapse are other disadvantages of total hysterectomy. The cervix is not a useless organ and should not be removed during hysterectomy without a proper indication. PMID:8263867

  17. Fallopian tube prolapse after hysterectomy: a systematic review.

    Lobna Ouldamer

    Full Text Available BACKGROUND: Prolapse of the fallopian tube into the vaginal vault is a rarely reported complication that may occur after hysterectomy. Clinicians can miss the diagnosis of this disregarded complication when dealing with post-hysterectomy vaginal bleeding. OBJECTIVES: We performed a systematic review in order to describe the clinical presentation, therapeutic management and outcome of fallopian tube prolapse occurring after hysterectomy. SEARCH STRATEGY: A systematic search of MEDLINE and EMBASE references from January 1980 to December 2010 was performed. We included articles that reported cases of fallopian tube prolapse after hysterectomy. Data from eligible studies were independently extracted onto standardized forms by two reviewers. RESULTS: Twenty-eight articles including 51 cases of fallopian tube prolapse after hysterectomy were included in this systematic review. Clinical presentations included abdominal pain, dyspareunia, post- coital bleeding, and/or vaginal discharge. Two cases were asymptomatic and diagnosed at routine checkup. The surgical management reported comprised partial or total salpingectomy, with vaginal repair in some cases combined with oophorectomy using different approaches (vaginal approach, combined vaginal-laparoscopic approach, laparoscopic approach, or laparotomy. Six patients were initially treated by silver nitrate application without success. CONCLUSIONS: This systematic review provided a precise summary of the clinical characteristics and treatment of patients presenting with fallopian tube prolapse following hysterectomy published in the past 30 years. We anticipate that these results will help inform current investigations and treatment.

  18. Abandoned vehicles REMINDER

    Relations with the Host States Service

    2004-01-01

    The services in charge of managing the CERN site have recently noted an increase in the number of abandoned vehicles. This poses a risk from the point of view of safety and security and, on the eve of several important events in honour of CERN's fiftieth anniversary, is detrimental to the Organization's image. Owners of vehicles that have been left immobile for some time on the CERN site, including on the external car park by the flags, are therefore invited to contact the Reception and Access Control Service (service-parking-longterm@cern.ch) before 1st October 2004 and, where appropriate, move their vehicle to a designated long-term parking area. After this date, any vehicle whose owner has failed to respond to this request and which is without a number plate, has been stationary for several weeks or is out of service, may be impounded at the owner's risk and expense. Relations with the Host States Service Tel. 72848

  19. Abandonned vehicles - REMINDER

    Relations with the Host States Service

    2004-01-01

    The services in charge of managing the CERN site have recently noted an increase in the number of abandoned vehicles. This poses a risk from the point of view of safety and security and, on the eve of several important events in honour of CERN's fiftieth anniversary, is detrimental to the Organization's image. Owners of vehicles that have been left immobile for some time on the CERN site, including on the external car park by the flags, are therefore invited to contact the Reception and Access Control Service (service-parking-longterm@cern.ch) before 1st October 2004 and, where appropriate, move their vehicle to a designated long-term parking area. After this date, any vehicle whose owner has failed to respond to this request and which is without a number plate, has been stationary for several weeks or is out of service, may be impounded at the owner's risk and expense. Relations with the Host States Service Tel. 72848

  20. Abandoned vehicles - Reminder

    Relations with the Host States Service

    2004-01-01

    The services in charge of managing the CERN site have recently noted an increase in the number of abandoned vehicles. This poses a risk from the point of view of safety and security and, on the eve of several important events in honour of CERN's fiftieth anniversary, is detrimental to the Organization's image. Owners of vehicles that have been left immobile for some time on the CERN site, including on the external car park by the flags, are therefore invited to contact the Reception and Access Control Service (service-parking-longterm@cern.ch) before 1st October 2004 and, where appropriate, move their vehicle to a designated long-term parking area. After this date, any vehicle whose owner has failed to respond to this request and which is without a number plate, has been stationary for several weeks or is out of service, may be impounded at the owner's risk and expense. Relations with the Host States Service Tel. 72848

  1. Clinicohistopathological correlation of hysterectomy in rural India: an observational study

    Kumud Gupta

    2015-04-01

    Full Text Available Background: Hysterectomy - abdominal or vaginal or laparoscopic assisted, hysterectomy is the most commonly performed elective major gynaecological surgery. Rate of hysterectomy has varied between 6.1 and 8.6/1000 women of all ages. The abdominal removal of the uterus is called and lsquo;total abdominal hysterectomy' while the removal of the uterus by the vaginal route is termed as and lsquo;vaginal hysterectomy'. The supracervical removal of the uterus is termed as and lsquo;subtotal hysterectomy'. As compared to a higher frequency of hysterectomy (10-20% in other countries, a lower rate (4-6% has been reported in India. Methods: The study was conducted in the department of obstetrics and gynaecology National Institute of Medical Sciences (NIMS, Jaipur in 2013-2014. 100 patients were undergoing hysterectomy. The patients were diagnosed on the basis of history, clinical examination and ultrasonography report. Results: In our study, maximum number of clinical diagnosis made, were of DUB (with PID and Prolapse which was 35%. This was followed by leiomyoma i.e. 29%, clinically 29 cases were diagnosed of which 24 were histopathologically proven. Adenomyosis (10%, clinically 10 cases were identified but there were 15 cases histopathologically, this can be due to different clinical presentation. Clinically diagnosed cases of carcinoma endometrium and cervical erosions were 1% and 2% respectively. Overall sensitivity for clinical diagnosis in our study was 52%. The most common histopathological finding was leiomyoma (24%, followed by adenomyosis (15% and chronic cervicitis (15%. Other pathologies include combined adenomyosis and leiomyoma (6%, benign ovarian cyst in four cases. Normal histopathological report was obtained in 32 cases. Maximum correlation (100% was found with cancer cervix, cancer ovary and cancer endometrium. Conclusions: Hysterectomy still remains the widely used modality in developing as well as developed countries. Every

  2. Experience with irrigation analgesia after abdominal hysterectomy

    R. V. Garyaev

    2014-07-01

    Full Text Available A prospective randomized clinical trial was performed in 100 patients who underwent abdominal hysterectomy under endotracheal anesthesia based on sevoflurane and fentanyl. Intraoperatively, ketorolac 30 mg was administered intramuscularly after induction of anesthesia and paracetamol 1 g was injected intravenously 30–40 minutes prior to surgical termination in a control group (n = 25. For postoperative anal- gesia, promedol, tramadol, and ketorolac were used intramuscularly and paracetamol was given intravenously. Three study groups (n = 2 in each differed from the control group in that during wound suturing a multiperforated catheter was placed above the peritoneum over a length of 15 cm, through which a 10-ml bolus of 0.75 % ropivacaine was first administered, followed by continuous infusion of 0.2 % ropivacaine at a rate of 8 ml/hour for 36 hours. In one irrigation group, ketorolac 30 mg was injected intramuscularly t.i.d. for 2 days; in another group, the agent was added to a ropivacaine solution calculated with reference to 180 mg for 2 days; in the third group, ketoprofen 100 mg instead of ketorolac was used b.i.d. for 2 days. Pain level (by digital rating scale, 0–10 and the need for analgesics were measured. There was no sta- tistical significant difference in the level of pain and the need for analgesics between the wound irrigation and control groups.

  3. Early Feeding After a Total Abdominal Hysterectomy

    Mary Flesher

    2009-02-01

    Full Text Available Background: Oral fluids and food are traditionally introduced slowly after total abdominal hysterectomy (TAH. This descriptive study examined the effect and tolerance of early oral intake following this surgery. Methods: A retrospective chart review was conducted on 164 patients who had been on a clinical pathway following TAH. Comparisons in initiation of fluids and foods, and gastrointestinal effects were made between the early fed group (n=82 and the traditionally fed group (n=82. Results: Both groups had the similar gastrointestinal symptoms postoperatively, but the early fed group had an earlier bowel movement. The early fed group had a statistically significant shorter length of stay. Similar usage of anti-nausea medication and pain medication usage was noted between the two groups, except for a lower usage of Tylenol #3 (acetaminophen with codeine in the early fed group. Conclusions: This study found that early feeding could be tolerated well in TAH patients, with statistically significant improvements in usage of some pain medication and length of stay were noted in the early fed group.

  4. Analysis of 46 Hysterectomies Performed for Obstetric Indications

    Mahmut Erdemoğlu

    2006-01-01

    Full Text Available We analyzed retrospectively 52 cases of emergency peripartum hysterectomy that were performed at our clinic from January 1998 to December 2004. Fifty two patients of emergency peripartum hysterectomy were identified amoung 11098 deliveries.The mean age was 32.66±6.74, gravida 7.09±3.37, parity 6.12±3.11 , gestational weeks. 84.61% patients were underwent subtotal hysterectomy. The emergency peripartum hysterectomy was done 51.92% of the cases during cesarean section or later. The indications of hysterectomy were identified as (55.76% uterine atony, uterine rupture (15.38%, pelviperitonitis and acute abdomen (9.61%, anormal placentation (15.38%, uterine myoma (1.92%, and cervical cancer (1.92% respectively. The overall (23.07% patients developed disseminated intravascular coagulopathy (DIC, two cases had ureter injury,one case had bladder injury. Bilateral hypogastric artery ligation were performed in 30.76% of the patients and relaparatomy was performed in 5 (9.61% patients due to the intraabdominal hemorrhage. Maternal mortality occured in four cases.

  5. Extrafascial hysterectomy in IB2 cervical cancer after radio chemotherapy

    Aim: To evaluate overall and disease free survival in cervical cancer IB2 patients with concomitant chemoradiotherapy and posterior extrafascial hysterectomy treatment. Methods: Between July 2005 to December 2009, a total of 31 eligible patients with IB2 cervical cancer were treated with chemoradiotherapy and posterior hysterectomy in the Carlos Van Buren Hospital Oncology Unit. Radiotherapy consisted in external pelvic radiation and a utero-vaginal brachytherapy with low rate doses to get preoperatory doses between 70 and 75 Gy to the A point and a concomitant Cisplatin based chemotherapy. After this treatment, the patients received extrafascial hysterectomy 4 to 6 weeks completed chemoradiotherapy. Results: The mean age was 41 ± 8 years. 81% of the patients had an spinocelular carcinoma. The extrafascial hysterectomy was made between 4 to 6 weeks post-radiation in 85% of the patients. 79% and 13% of the patients received 5 and 4 chemotherapy cycles respectively. The median follow up was 38 months. The 5 years overall survival and disease free survival estimates were 86% and 79% respectively. There was a significant difference between subgroups of patients with and without macroscopic residual disease in the operatory specimen (p<0.001). Conclusion: Our survival is similar to published results with the same treatment. The presence of macroscopic residual disease in the hysterectomy specimen could be a factor of prognostic value

  6. Mirena as an alternative to hysterectomy in cases of Dub

    Introduction: Dysfunctional uterine bleeding is the leading cause of hysterectomy due to conventional treatment failure. Levonorgestrel releasing intra uterine device (Mirena) is found to solve this issue by better control of bleeding and thus reducing hysterectomy rate. Objective: To measure the efficacy of Mirena as compared to OCP's in control of DUB and to deter-mine that it is an alternative to hysterectomy. Study Design: It was an interventional (experimental) type of study. Setting: Department of Obstetrics and gynecology Unit 11 Lady Willingdon Hospital, Lahore. Duration with Dates: In a total of 60 patients presenting with DUB in out patient department from 7th April 2004 to 31st December 2005. Subjects and Methods: In a total of 60 patients selected were randomly allocated to Group A and B to receive Mirena and OCP's respectively. Both groups were followed at 6 months and 1 year of treatment. Main outcome measures were patient satisfaction with current treatment and their decision to continue or opt for hysterectomy. 80.7% women receiving Mirena were satisfied with their treatment, while only 30% in the OCP's group (p-value < 0.05) at the end of study. 7.69% was the discontinuation rate of treatment in Mirena group while it was 50% in the control group (p-value < 0.05). Conclusion: Mirena is a better option in the treatment of DUB and it can prove to be an alternative to hysterectomy, while we want a more conservative type of treatment. (author)

  7. Transformation of Abandonment

    Krag, Mo Michelsen Stochholm

    2015-01-01

    interventions are of such a radical manner it will not be possible to re-establish the former function of the building. The aim of the actions is to develop and test full-scale transformation prototypes in varying rural village environments. Interaction with local people and their response to the prototypes can...... be seen as real life peer reviewing and is considered an important impact indicator and supplement to the physical interventions. The prototypes vary in achievement and in timeframe. The geographical area for the actions is Thisted Municipality, Denmark, ideal due to its many identified small...

  8. The indication for hysterectomy as a risk factor for subsequent pelvic organ prolapse repair

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent;

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to investigate whether the indication for hysterectomy was itself a risk factor for subsequent pelvic organ prolapse (POP) in Danish women who underwent hysterectomy from 1977 to 2009. METHODS: Data from 154,882 women who underwent hysterectomy...

  9. Water pollution from abandoned mines

    Iversen, E.; Johannessen, M.

    1987-01-01

    The report provides a country-wide overview of abandoned pyrite mines where operations have been fairly extensive. The water pollution situation is assessed on the basis of reported investigations, inspections and chemical analyses from the individual areas. In cases where larger watercourses (Orkla, Gaula), and the upper stretch of the Glåma are affected the situation appears to be adequately described. However abandoned mine areas may also cause local pollution problems, and here documentat...

  10. Global epidemiology of hysterectomy: possible impact on gynecological cancer rates

    Hammer, Anne; Rositch, Anne; Kahlert, Johnny Abildgaard; Blaakær, Jan; Gravitt, Patti; Søgaard, Mette

    2015-01-01

    Despite the fact that hysterectomy is the most common surgical procedure worldwide in gynecology, national reporting of the incidence rate of gynecological cancers rarely removes the proportion no longer at risk of the disease from the population-at-risk-denominator (ie. women who have had a...... hysterectomy). The incidence rate of gynecological cancers is thus likely underestimated. Since hysterectomy, as well as oophorectomy, incidence varies across countries, age, and over time, meaningful comparison of gynecological cancer incidence rates may be compromised. Without accurate estimates of...... gynecological cancer incidence rates, performed via removing the proportion of hysterectomized or oophorectomized women from the population-at-risk-denominator, the impact of prevention strategies may be masked or misinterpreted. Furthermore, since national cervical cancer screening guidelines are at least in...

  11. NON - D ESCENT VAGINAL HYSTERECTOMY ANALYSIS OF 120 CASES

    Pradeep

    2015-08-01

    Full Text Available OBJECTIVE: To evaluate the role of non - descent vaginal hysterectomy in advancing gynaecological practice and to study the safety and feasibility of performing vaginal hysterectomy for non - prolapsed uterus as primary route in benign gynaecological condition . METHODS: A prospective study of 120 cases was conducted at the department of obstetrics and g ynaecology of PES institute of medical sciences and research from January 2012 to December 2014 120 patients planned for hysterectomy for a wide range of benign indications like fibroid uterus, AUB, adenomyosis were chosen for non - descent vaginal hysterect omy. Data regarding age, parity, uterine size, and estimated blood loss, length of operation, intra - operative and post - operative complications and hospital stay were recorded. RESULTS: A total of 120 cases were selected for non - descent vaginal hysterectomy . Among them 113(94.16% cases successfully underwent non - descent vaginal hysterectomy. Majority were aged 40 - 45 years (53.33% with 8 nullipara and 21primipara. Commonest indication was fibroid (58% and largest uterine size was 16 weeks. Different morc ellation techniques were used in more than 10weeks sized uterus. Adnexal surgeries were performed in 11 cases without much difficulty. In uncomplicated cases average blood loss was 200 ml and operating time was 60minutes. Most of the patients were discharg ed by 4 th post - operative day, 7 patients were converted to abdominal route due to various difficulties, 3 patients had bladder injury and 1 patient was subjected to laparotomy due to hemoperitoneum post operatively. CONCLUSION: Proper training and proper c ase selection can lead a gynecologist to consider the vaginal approach as the standard route for hysterectomy and good patient compliance

  12. Hysterectomy with ovarian conservation: effect on bone mineral density

    Full text: There are conflicting data on the long-term effects of hysterectomy with ovarian conservation on bone mineral density (BMD). Accordingly, we performed a cross-sectional study on 58 women with premenopausal hysterectomy and ovarian conservation (group 1) and 59 women with natural menopause (group 2). No subjects had disorders or medications known to interfere with bone metabolism. Patients underwent bone densitometry of the lumbar spine and hip using a Norland XR-36. By chi-squared and one-way ANOVA, there were no differences in age: 55.4± 11.0 y (1)v 57.6± 9.8 y (2); exercise, alcohol or smoking consumption, family history of osteoporosis, height: 1.61 ± 0.08m (1) v 1.61 ± 0.08m (2); weight 67.7 ± 11.3kg (1) v 68.3 kg ± 12.5 kg (2); body mass index: 30.95 (1 ) v 26.26 (2). Lumbar spine BMD was also similar for the two groups [0.95 ± 0.18g/cm2 (1) v 0.94± 0.21 g/cm2 (2)]. However, hysterectomy patients had a significantly lower hip BMD: 0.63 ± 0.16 g/cm2 v 0.76 ± 0.18 g/cm2 (p>0.001). Multivariate logistic regression showed that spine BMD was influenced by age, family history, height and weight (R2 = 0.37), but not prior hysterectomy. Hip BMD was related to age, hysterectomy, smoking and weight (R2 = o 45). We conclude that prior hysterectomy with ovarian conservation has an adverse effect on hip but not spine BMD

  13. Robotic Trachelectomy After Supracervical Hysterectomy for Benign Gynecologic Disease

    Aoun, Joelle; Hanna, Rabbie; Papalekas, Eleni; Schiff, Lauren; Theoharis, Evan; Eisenstein, David

    2016-01-01

    Background and Objectives: A renewed interest in the supra cervical approach to hysterectomy has created a cohort of patients with a retained cervix at risk of persistent symptoms requiring a subsequent trachelectomy. The objective of this study was to evaluate the efficacy of robotic trachelectomy after a previous supracervical hysterectomy. Methods: This is a retrospective chart review of women who had robotic trachelectomy after supracervical hysterectomy for benign gynecologic disease from January 2009 through October 2014. Results: Eleven patients underwent robotic trachelectomy for benign conditions during the observed period. Prior supracervical hysterectomy had been performed for pelvic pain (8/11, 73%), abnormal uterine bleeding (7/11, 64%), and dysmenorrhea (5/11, 45%). In 10 of 11 patients, the symptoms leading to robotic trachelectomy were the same as those leading to supracervical hysterectomy. The time from hysterectomy to recurrence of symptoms ranged from 0.5 to 26 months (median, 6), whereas the time interval from previous surgery to robotic trachelectomy ranged from 1 to 57 months (median, 26). Mean age and body mass index at robotic trachelectomy were 42 ± 5.4 years and 32 ± 6.1 kg/m2. Mean length of surgery was 218 ± 88 minutes (range, 100–405). There was 1 major postoperative complication involving bladder perforation and subsequent vesicovaginal fistula (VVF). Endometriosis was seen in 27% of pathologic specimens and cervicitis in another 27%; 45% showed normal tissue histology. In 6 (55%) cases, symptoms leading to trachelectomy resolved completely after surgery, and the other 5 (45%) patients reported a significant improvement. Conclusions: Although trachelectomy can be a challenging surgery, our experience suggests that the robotic approach may be a valuable means of achieving safe and reproducible outcomes. PMID:27493470

  14. Abdominal versus vaginal hysterectomy in non-descent cases

    Kavitha Gayak

    2015-04-01

    Full Text Available Background: Hysterectomy is the most frequently performed elective major operation in gynaecology by vaginal and abdominal route. Gynaecologic surgeons worldwide said that two are not competitive procedures but each one has its own place in the operative armamentarium. Present study is done to comparative risks of complications in abdominal route versus vaginal route of hysterectomy in intra operative and post-operative periods. Methods: It's a retrospective study was done from Dec 2013 - Dec 2014 for a period of one year in 82 women who had undergone hysterectomy, divided as group A with abdominal hysterectomies (44 cases and group B with vaginal hysterectomies (38. Information on the indications, operative procedures, and complications were noted and analyzed. Results: Intra-operative blood loss, mean operating time was more in group A than in group B. The mean duration of surgery in group B was 76 +/- 12 min and that of group B was 101 +/- 14 min. The mean blood loss was also more in case of group A than that of group B (219 ml vs. 172 ml. Bladder injury occurred in 1 case in group B (3% and in 3 cases in group B (7%. Ureter injury occurred in 1 (2% case in group A. Postoperative fever (20% and 8%, UTI (13% and 11% and wound infection (10%, 0%. Only one patient underwent relaparotomy for internal bleeding via abdominal route was more common in group A as compared to group B. Only one patient underwent re-laparotomy for internal bleeding via abdominal route. Conclusions: Study results conclude that patients requiring hysterectomy for benign non prolapse cases be offered the option of vaginal route which is quicker recovery, early mobilization, shorter hospitalization, less operative and post-operative morbidity, more economical and effective. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 419-423

  15. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... entire piece. We’re going to use the technology of LigaSure, which has radically changed our ability ... so we’re going to need to use technology to help us, and that technology with the ...

  16. ASYMPTOMATIC MISSING INTRAUTERINE CONTRACEPTIVE DEVICE FOUND INCIDENTALLY DURING VAGINAL HYSTERECTOMY

    Reena

    2015-06-01

    Full Text Available Incidence of missing IUCD iy is 0.5% - 2%. U s ually the cause is either expulsion or perforation of uterus. Sometimes the perforated IUCD remains asymptomatic for years together and found incidentally later on. We hereby presenting a case of 55 yrs female presenting with prolapsed uterus , planned for vaginal hysterectomy. During vaginal hysterectomy asymptomatic missing IUCD was detected which was found on the anterior surface of body of uterus with omentum adherent to it. KEY WORDS: M issing Cu T , IUCD , O mentum , P erforation .

  17. The Essential Elements of a Robotic-Assisted Laparoscopic Hysterectomy.

    Simpson, Khara M; Advincula, Arnold P

    2016-09-01

    Robotic-assisted laparoscopic hysterectomies are being performed at higher rates since the da Vinci Surgical System (Intuitive Surgical, Inc, Sunnyvale, CA, USA) received US Food and Drug Administration approval in 2005 for gynecologic procedures. Despite the technological advancements over traditional laparoscopy, a discrepancy exists between what the literature states and what the benefits are as seen through the eyes of the end-user. There remains a significant learning curve in the adoption of safe and efficient robotic skills. The authors present important considerations when choosing to perform a robotic hysterectomy and a step-by-step technique. The literature on perioperative outcomes is also reviewed. PMID:27521880

  18. Radical surgery in septic abortion.

    Chatterjee, P; Ghosh, M; Ghosh, S

    1979-08-01

    At R.G. Kar Medical College Hospital, Calcutta, 10 cases of septic abortion from 1975-1977 were studied. Hysterectomies were preformed on 4 cases due to emergency situations including traumatised uterine fundus and perforated cervix, and on 6 cases after conservative treatment. Upon performing laparotomy in 9 cases, a uterine rent was detected; in 1 case there was a perforation in the posterior wall of the cervix, and in 5 cases mechanical obstructions due to internal adhesions to the uterine rent were found. 4 patients died primarily because of the patients seeking help too late. It is suggested that under high risk circumstances, laparotomy is advantageous to conservative medical management since bowel injuries and mechanical obstructions can only be detected by laparotomy. Radical surgery, however, should be undertaken before the patients general condition deteriorates to the point that the patient cannot tolerate surgical intervention. PMID:12336028

  19. Risk factors associated with emergency peripartum hysterectomy

    Jin Rong; Guo Yuna; Chen Yan

    2014-01-01

    Background Use of an emergency peripartum hysterectomy (EPH) as a lifesaving measure to manage intractable postpartum hemorrhage (PPH) appears to be increasing recently around the world,and the indications for EPH have changed.The object of this study is to identify risk factors associated with EPH.Methods We conducted a case-control study of 21 patients who underwent EPH because of intractable PPH between January 1,2005 and June 30,2013,at the International Peace Maternity and Child Health Hospital Shanghai Jiao Tong University,School of Medicine (IPMCH).The parametric t-test,chi-square tests and Logistic regression models were used for analysis to identify the risk factors.The results were considered statistically significant when P<0.05.Results There were 89 178 deliveries during the study period.Twenty-one women had an EPH,with an incidence of 24 per 100 000 deliveries.The loss of blood during postpartum hemorrhage of the EPH group was (5 060.7±3 032.6)ml,and that of the control group was (2 040.8±723.5) ml.There was a significant difference of PHH between the EHP group and the control group (P=0.001).Independent risk factors for EPH from a logistic regression model were:disseminated intravascular coagulation (DIC) (OR:9.9,95% CI 2.8-34,P=0.003),previous cesarean section (OR:5.27;95% CI:1.48-17.9,P=0.009),placenta previa (OR:6.9; 95% CI 1.6-2.9,P=0.008),the loss of PPH (OR:1.001; 95% CI 1.001-1.002,P=0.002),placenta accreta (OR:68; 95% CI 10-456,P=0.004),the use of tocolytic agents prenatally (OR:6.55,95%CI 1.34-32.1,P=0.049),and fetal macrosomia (OR:6.9,95% CI 1.25-38,P=0.049).Conclusion Significant risk factors of EPH are DIC,placenta previa,PPH,previous cesarean delivery,and placenta accrete,the use of tocolytic agents prenatally,and fetal macrosomia.

  20. Review article: late post-hysterectomy ectopic pregnancy.

    Saad Aldin, Ehab; Saadeh, Joanna; Ghulmiyyah, Labib; Hitti, Eveline

    2012-06-01

    Ectopic pregnancy after hysterectomy is a rare but potentially life-threatening condition requiring prompt diagnosis to prevent the increased mortality associated with rupture. Twenty-seven cases of late post-hysterectomy ectopic pregnancy reported in the English literature since 1918 were reviewed and analysed for presenting symptoms, missed diagnosis rate at initial presentation, location of ectopic and rupture rate at diagnosis. The presenting symptoms were found to be non-specific. The diagnosis in this population is twice more likely to be missed than in women with intact uteri. The rupture rate is 63%, compared with 37% in women with intact uteri. The majority of late post-hysterectomy ectopic pregnancies (62%) were located in the fallopian tubes. Because of the potential risk of mortality, emergency physicians should always consider the possibility of ectopic pregnancy in childbearing women whose surgical history includes hysterectomy without oophorectomy. Evaluation of abdominal pain in this population should include a pregnancy test to ensure prompt diagnosis when the possibility of pregnancy exists clinically. PMID:22672163

  1. Nonmalignant Sequelae of Unconfined Morcellation at Laparoscopic Hysterectomy or Myomectomy.

    Tulandi, Togas; Leung, Annie; Jan, Noran

    2016-01-01

    The objective of this study was to evaluate nonmalignant sequelae of unconfined morcellation at hysterectomy and myomectomy. We performed a systematic review following the PRISMA statement key words of "morcellation, uterine leiomyoma, uterine fibroid, laparoscopic myomectomy, laparoscopic total hysterectomy, and laparoscopic supracervical hysterectomy" and their combination. Fifty-one articles met the inclusion criteria: 11 articles were related to endometriosis, adenomyosis, and endometrial hyperplasia; 30 articles parasitic myoma; and 9 disseminated peritoneal leiomyomatosis (DPL) and 1 DPL and endometriosis. We found that laparoscopic hysterectomy or myomectomy with unconfined morcellation is associated with the risk of iatrogenic endometriosis (1.4%), adenomyosis (0.57%), parasitic myoma (0.9%), and rarely DPL. Our study showed that benign sequelae of uterine or myoma morcellation could be found in up to 1% of cases. This is much higher than the prevalence of uterine sarcoma after morcellation. Benign conditions have less consequences than malignancy, yet they are more common and might require another operation. Accordingly, if morcellation is required, confined morcellation should be considered. PMID:26802909

  2. Millipede succession in abandoned fields

    Tajovský, Karel

    2000-01-01

    Roč. 43, - (2000), s. 361-370. ISSN 0015-9301 R&D Projects: GA ČR GA526/97/0631 Institutional research plan: CEZ:AV0Z6066911 Keywords : Millipedes * abandoned field * fallow Subject RIV: EH - Ecology, Behaviour

  3. US Virgin Islands Abandoned Vessel Inventory

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for US Virgin Islands. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of...

  4. Hawaii Abandoned Vessel Inventory, Maro Reef, NWHI

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Maro Reef, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of...

  5. Hawaii Abandoned Vessel Inventory, Hawaii Island

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Hawaii Island. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  6. Hawaii Abandoned Vessel Inventory, Midway Island, NWHI

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Midway Island, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of...

  7. Hawaii Abandoned Vessel Inventory, Kure, NWHI

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Kure, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  8. Hawaii Abandoned Vessel Inventory, Lisianski Island, NWHI

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Lisianski Island, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction...

  9. Ovarian function and ovarian blood supply following premenopausal abdominal hysterectomy

    Abdelrazak, Khaled M.; Elbiaa, Assem A.M.; Farghali, Mohamed M.; Essam, Amr; Zhurabekova, Gulmira

    2015-01-01

    Introduction The issue of conserving the ovaries at hysterectomy in premenopausal women with benign gynecologic disease has been the subject of considerable controversy. Some clinicians prefer prophylactic oophorectomy in premenopausal women during hysterectomy to prevent future development of malignant changes in conserved ovaries. Other clinicians prefer to conserve apparently normal ovaries, because bilateral oophorectomy in premenopausal women results in an abrupt imbalance, sudden onset of menopausal symptoms, decreased libido, increased cardiovascular risk and osteoporosis. Material and methods Two hundred and twenty multipara women (who had completed their families), with benign uterine pathology were included in this prospective study for abdominal hysterectomy with bilateral ovarian preservation. Pre-operative vaginal ultrasound, Doppler studies, diagnostic hysteroscopy and endometrial biopsy were done followed by laboratory studies including Anti-mullerian hormone (AMH), follicle stimulating hormone (FSH) and estradiol for all studied women. Doppler studies, AMH, FSH and estradiol were repeated 6 and 12 months post-operative for assessment of the ovarian function and ovarian blood supply after hysterectomy. Results Pre-operative AMH, FSH and estradiol of the studied women were statistically insignificant compared to AMH, FSH and estradiol 6 and 12 months post-operative. Twelve months post-operative right and left ovarian volumes (6.92 ± 0.18 and 6.85 ± 0.19 cm3, respectively) were significantly larger than pre-operative right and left ovarian volumes (6.19 ± 0.22 and 5.86 ± 0.23 cm3, respectively), and, 12 months post-operative right and left ovarian pulsatility indices (2.92 ± 0.15 and 2.96 ± 0.16 cm/s, respectively) were significantly lower than pre-operative right and left ovarian pulsatility indices (3.45 ± 0.19 and 3.36 ± 0.2 cm/s, respectively). Eight (3.6%) cases of the studied women developed an ovarian cyst 6 months after hysterectomy, 3

  10. Who abandons embryos after IVF?

    Walsh, A P H

    2010-04-01

    This investigation describes features of in vitro fertilisation (IVF) patients who never returned to claim their embryos following cryopreservation. Frozen embryo data were reviewed to establish communication patterns between patient and clinic; embryos were considered abandoned when 1) an IVF patient with frozen embryo\\/s stored at our facility failed to make contact with our clinic for > 2 yrs and 2) the patient could not be located after a multi-modal outreach effort was undertaken. For these patients, telephone numbers had been disconnected and no forwarding address was available. Patient, spouse and emergency family contact\\/s all escaped detection efforts despite an exhaustive public database search including death records and Internet directory portals. From 3244 IVF cycles completed from 2000 to 2008, > or = 1 embryo was frozen in 1159 cases (35.7%). Those without correspondence for > 2 yrs accounted for 292 (25.2%) patients with frozen embryos; 281 were contacted by methods including registered (signature involving abandoned embryos did not differ substantially from other patients. The goal of having a baby was achieved by 10\\/11 patients either by spontaneous conception, adoption or IVF. One patient moved away with conception status unconfirmed. The overall rate of embryo abandonment was 11\\/1159 (< 1%) in this IVF population. Pre-IVF counselling minimises, but does not totally eliminate, the problem of abandoned embryos. As the number of abandoned embryos from IVF accumulates, their fate urgently requires clarification. We propose that clinicians develop a policy consistent with relevant Irish Constitutional provisions to address this medical dilemma.

  11. Objective comparison of subtotal vs. total abdominal hysterectomy regarding pelvic organ prolapse and urinary incontinence

    Andersen, Lea L; Alling Møller, Lars M; Gimbel, Helga M

    2015-01-01

    OBJECTIVE: To compare subtotal and total abdominal hysterectomy regarding objective assessment of pelvic organ prolapse, urinary incontinence and voiding function 14 years after hysterectomy for benign diseases. STUDY DESIGN: Long-term follow-up of a randomized clinical trial of subtotal vs. total......, total: 100), the PFDI-20 questionnaire was answered by 140 (46.1%) (subtotal: 68, total: 72). We found no difference between subtotal and total abdominal hysterectomy in the PFDI-20 scores or regarding objectively assessed urinary incontinence or pelvic organ prolapse. In the subtotal hysterectomy group...... (443ml) (P=0.0147) according to the voiding diary. CONCLUSION: Subtotal and total abdominal hysterectomy are comparable regarding long-term objective pelvic organ prolapse and urinary incontinence. The subtotal hysterectomy group had a higher Qmax and voided volume....

  12. Postpartum Prolapsed Leiomyoma with Uterine Inversion Managed by Vaginal Hysterectomy

    Kelly L. Pieh-Holder

    2014-01-01

    Full Text Available Background. Uterine inversion is a rare, but life threatening, obstetrical emergency which occurs when the uterine fundus collapses into the endometrial cavity. Various conservative and surgical therapies have been outlined in the literature for the management of uterine inversions. Case. We present a case of a chronic, recurrent uterine inversion, which was diagnosed following spontaneous vaginal delivery and recurred seven weeks later. The uterine inversion was likely due to a leiomyoma. This late-presenting, chronic, recurring uterine inversion was treated with a vaginal hysterectomy. Conclusion. Uterine inversions can occur in both acute and chronic phases. Persistent vaginal bleeding with the appearance of a prolapsing fibroid should prompt further investigation for uterine inversion and may require surgical therapy. A vaginal hysterectomy may be an appropriate management option in select populations and may be considered in women who do not desire to maintain reproductive function.

  13. Safe vaginal uterine morcellation following total laparoscopic hysterectomy.

    Günthert, Andreas R; Christmann, Corina; Kostov, Plamen; Mueller, Michael D

    2015-04-01

    The minimally invasive approach for hysterectomy with proven benefits and lower morbidity has become the gold standard, even in women with large uterine masses. Most women with a malignant condition present with abnormal vaginal bleeding and/or suspicious imaging such that few are diagnosed by final histopathology after surgery. However, if a malignancy is not diagnosed preoperatively, intraabdominal morcellation for uterus extraction has an increased risk for potential tumor spread and peritoneal metastases, especially in cases of unexpected leiomyosarcoma. We describe a simple method to wrap the uterus in a contained environment with a plastic bag through the posterior vaginal fornix prior to conventional coring morcellation for vaginal extraction in total laparoscopic hysterectomy. We further describe our experience with a risk stratification and treatment algorithm to implement this procedure in daily routine. A video and an illustrating sketch demonstrate the simplicity and safety of the procedure. PMID:25460836

  14. Lower urinary tract symptoms after total and subtotal hysterectomy

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Birthe Jakobsen; Sørensen, Helle Christina; Toftager-Larsen, Kim; Sidenius, Katrine; Møller, Nini; Madsen, Ellen Merete; Vejtorp, Mogens; Clausen, Helle; Rosgaard, Annie; Villumsen, John; Gluud, Christian; Ottesen, Bent S; Tabor, Ann

    2005-01-01

    The aim of this Danish multicenter trial was to compare the proportion of women with lower urinary tract symptoms after total abdominal hysterectomy (TAH) and subtotal abdominal hysterectomy (SAH) for benign uterine disorders. A total of 319 women were randomized to TAH (n = 158) or SAH (n = 161......). Women were followed up for 1 year by strict data collection procedures, including postal questionnaires. Results were analyzed by intention-to-treat analyses. Urinary incontinence was found less often among TAH women than among SAH women. This was due to a larger reduction of the number of women with...... stress and urinary incontinence in the TAH group. No other differences were found between the two operation methods. The number of women with urinary incontinence and frequency was reduced from study entry for follow-up, while double/triple voiding was increased. Incontinent women had significantly lower...

  15. Clinical study of emergency peripartum hysterectomy for postpartum hemorrhage

    Amudha S.

    2016-04-01

    Conclusions: PPH is unpredictable in onset, duration and etiology and it remains a major life threatening complication of any delivery. The most common causes of hemorrhage in these women are placental abnormalities and uterine atony. When conservative treatment is not feasible or has failed, prompt peripartum hysterectomy is performed failing which the delay would contribute to the maternal morbidity and mortality. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1171-1173

  16. Influence of alcohol intake on postoperative morbidity after hysterectomy

    Felding, C; Jensen, L M; Tønnesen, H

    1992-01-01

    Postoperative morbidity after hysterectomy was prospectively studied in 229 consecutive patients in our departments. The incidence of alcohol abuse (greater than 60 gm of alcohol daily) and social drinking (between 25 and 60 gm of alcohol daily) was 6.5% for each. When compared with the social...... drinkers and the control group, the alcohol abuse group had significantly more complications (80% vs 27% and 80% vs 13%, respectively)....

  17. Bursectomy at radical gastrectomy

    Cuneyt; Kayaalp

    2015-01-01

    Radical gastrectomy with extended lymph node dissec tion and prophylactic resection of the omentum, peri toneum over the posterior lesser sac, pancreas and/o spleen was advocated at the beginning of the 1960 s in Japan. In time, prophylactic routine resections of the pancreas and/or spleen were abandoned because of the high incidence of postoperative complications. However omentectomy and bursectomy continued to be standard parts of traditional radical gastrectomy. The bursaomentalis was thought to be a natural barrier against invasion of cancer cells into the posterior part of the stomach. The theoretical rationale for bursectomy was to reduce the risk of peritoneal recurrences by eliminating the peritoneum over the lesser sac, which might include free cancer cells or micrometastases. Over time, the indication for bursectomy was gradually reduced to only patients with posterior gastric wall tumors penetrating the serosa. Despite its theoretical advantages, its benefit for recurrence or survival has not been proven yet. The possible reasons for this inconsistency are discussed in this review. In conclusion, the value of bursectomy in the treatment of gastric cancer is still under debate and large-scale randomized studies are necessary. Until clear evidence of patient benefit is obtained, its routine use cannot be recommended.

  18. EMERGENCY PERIPARTUM HYSTERECTOMY AT A TERTIARY CARE HOSPITAL IN KASHMIR VALLEY

    Sameena

    2015-01-01

    Full Text Available OBJECTIVE: To determine the incidence , indications , maternal and perinatal outcome of emergency peripartum hysterectomy. METHOD: A prospective observational study of all patients who underwent peripartum hysterectomy was conducted from June 2011 to November 2012 in the Department of Obstetrics and Gynecology , Lalla Ded Hospital , an associated hospital of Government Medical College , Srinagar , Kashmir. Data , specifically on the incidence of emergency peripartum hysterectomy , the total number of deliveries , the maternal parameters , the indications of peripartum hysterectomy and associated maternal morbidity and mortality were recorded on a proforma. RESULTS: There were 87 cases of peripartum hysterectom y ( 75 caesarean hysterectomies , 86.2% and 12 postpartum hysterectomies , 13.8% , making an incidence of 2.56/1000 deliveries. Most of the patients were para 3 , 32 ( 36.8% , were mostly in age group of 35 - 39 years 38 ( 43.7% and belonged to rural areas . Overa ll , the most common indication for emergency peripartum hysterectomy was morbidly adherent placenta with placenta previa 39( 44.8% followed by uterine rupture 24 ( 27.6 % , uterine atony 13 (14.9% and accidental haemorrhage 6 (6.9%. In 38 (43.7% patients total abdominal hysterectomy was performed while 49 (56.3% patients required subtotal hysterectomy. There were 9 (10.3% maternal and 40 (46% perinatal deaths; all were due to severity of conditions necessitating hysterectomy. CONCLUSION: Emergency perip artum hysterectomy is potentially a lifesaving procedure associated with significant maternal morbidity and mortality. Morbidly adherent placenta with placenta previa was the commonest indication for emergency peripartum hysterectomy. Previous scar , multip arity and abnormal placentation were the significant risk factors.

  19. Analysis of Risk Factors for Post-Hysterectomy Vaginal Vault Prolapse

    Mahmut Kuntay kuntay Kokanali

    2015-03-01

    Conclusions: Vault prolapse after hysterectomy is a relatively rare complication. Elderly age, obesity, chronic obstructive lung diseases, prior genital prolapse sugery, vaginal hysterectomy, genital prolapse as indication of hysterectomy and the number of vaginal delivery and #8805;2 increase vault prolapse risk. Identification of these risk factors is important to prevent this complication. [Cukurova Med J 2015; 40(1.000: 63-71

  20. Obstetric Hysterectomy: Retrospective analytical study at P D U Medical College, Rajkot

    Parmar, Prakash; Goswami, K. D.; Dudhrejiya, Kavita M; Jain, Mahima

    2014-01-01

    Objective: To find out indications of obstetrics hysterectomy, related complications and associated maternal morbidity and mortality.Methods:  A Retrospective Analytical Study was performed at Dept of obs & gynec P D U Medical College, Rajkot over a period of 3 yrs during 2011-2013.Evaluation of Maternal age, parity, SE status, booking status, obstetric risk factors, duration of hospital stay, indications of hysterectomy, type of hysterectomy, intra-op and post-operative complications, bl...

  1. EM ERGENCY PERIPARTUM HYSTERECTOMY: A FIVE YEAR STUDY

    Saritha

    2015-10-01

    Full Text Available Emergency peripartum hysterectomy is performed as a life saving measure in uncontrolled PPH. OBJECTIVES: T o examine incidence, risk factors, indications, outcome and complications of emergency peripartum hysterectomy in a teaching hospital. METHODS: A 5 ye ar prospective study conducted between January 2010 to December 2014. Demographic data, detailed history, clinical examination and relevant investigations obtained. RESULTS: The incidence of EPH in present study was 0.6 per 1000 deliveries. Most of these p atients were young, mean age of 22.67 years, para 1 and 2, 84.21% were unbooked with no antenatal visits and delivered outside. Rupture of uterus was the commonest indication (42.10% for EPH, followed by uterine atony (26.32% and abnormal placentation (2 6.32%. Both total or subtotal hysterectomy were performed as a life saving measure after conservative measures failed. Maternal mortality in this study was 15.79%. Other complications noted were febrile illness, anaemia, coagulopathy, renal failure, wound infection. CONCLUSION: EPH performed for uncontrolled PPH is associated with significant mortality and morbidity. Its incidence can be reduced by regular antenatal check - ups, early detection and referral of high risk patients and updating knowledge and skill of doctors working in peripheral centres.

  2. Localized Detection of Abandoned Luggage

    Jing-Ying Chang

    2010-01-01

    Full Text Available Abandoned luggage represents a potential threat to public safety. Identifying objects as luggage, identifying the owners of such objects, and identifying whether owners have left luggage behind are the three main problems requiring solution. This paper proposes two techniques which are “foreground-mask sampling” to detect luggage with arbitrary appearance and “selective tracking” to locate and to track owners based solely on looking only at the neighborhood of the luggage. Experimental results demonstrate that once an owner abandons luggage and leaves the scene, the alarm fires within few seconds. The average processing speed of the approach is 17.37 frames per second, which is sufficient for real world applications.

  3. Legal aspects of abandoned facilities

    This paper outlines the basic regulatory requirements needed to identify radioactive material licensee owners/operators. Basic actions that must be taken once a radioactive material site is abandoned are also listed. Two such actions in Texas are briefly described. Civil suits requesting penalties, injunctive relief for decontamination, and recovery of response costs pursuant to the Texas regulatory acts have been filed against the potentially responsible parties

  4. Brent Spar abandonment - impact hypothesis

    This report describes the predicted fate of the Brent Spar storage and offloading platform following its proposed deep sea abandonment. Based on the characteristics of the Brent Spar and the contents of the buoy this ''Impact Hypothesis'' uses currently available knowledge of the North East Atlantic deep sea environment. Three scenarios based on possible outcomes are considered, incllcuding the release of metals into the water following corrosion of the structure. (UK)

  5. Long-term cancer risk after hysterectomy on benign indications: Population-based cohort study.

    Altman, Daniel; Yin, Li; Falconer, Henrik

    2016-06-01

    Hysterectomy on benign indications is associated with an increased risk for adverse health effects. However, little is known about the association between hysterectomy and subsequent cancer occurrence later in life. The purpose of this study was to assess the effect of hysterectomy on the incidence of cancer. In this population-based cohort study, we used data on 111,595 hysterectomized and 537,9843 nonhysterectomized women from nationwide Swedish Health Care registers including the Inpatient Register, the Cancer Register and the Cause of Death Register between 1973 and 2009. Hysterectomy with or without concomitant bilateral salpingo-ophorectomy (BSO) performed on benign indications was considered as exposure and incidence of primary cancers was used as outcome measure. Rare primary cancers (cancer was observed for women with previous hysterectomy and for those with hysterectomy and concurrent BSO (HR 0.93, 95% CI 0.91-0.95 and HR 0.92, 95% CI 0.87-0.96, respectively). Compared to nonhysterectomized women, significant risks were observed for thyroid cancer (HR 1.76, 95% CI 1.45-2.14). For both hysterectomy and hysterectomy with BSO, an association with brain cancer was observed (HR 1.48, 95% CI 1.32-1.65 and HR 1.45, 95% CI 1.15-1.83, respectively). Hysterectomy, with or without BSO, was not associated with breast, lung or gastrointestinal cancer. We conclude that hysterectomy on benign indications is associated with an increased risk for thyroid and brain cancer later in life. Further research efforts are needed to identify patient groups at risk of malignancy following hysterectomy. PMID:26800386

  6. Comparative study of abdominal, vaginal and laparoscopic assisted vaginal hysterectomies with special reference to immediate sequel, late sequel and complications

    Pujitha Devi Suraneni

    2016-02-01

    Conclusions: Preference for laparoscopic assisted vaginal hysterectomy or vaginal hysterectomy depends on expertise of doctor and selections of patients. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 402-406

  7. Radical Evil

    Carlos Manrique

    2007-12-01

    Full Text Available There is an aporia in Kant’s analysis of evil: he defines radical evilas an invisible disposition of the will, but he also demands an inferential connection between visible evil actions and this invisible disposition. This inference,however, undermines the radical invisibility of radical evil according to Kant’s own definition of the latter. Noting how this invisibility of moral worth is a distinctive feature of Kant’s approach to the moral problem, the paper then asks why, in the Groundwork, he nonetheless forecloses a question about evil that seems to be consistent with this approach. It is argued that to account for this aporia and this foreclosure, one has to interrogate the way in which the category of religion orients Kant’s incipient philosophy of history in Die Religion.

  8. Port-site metastasis following robotic-assisted radical hysterectomy for squamous cell cervical cancer

    Bolles, Olivia; Borowsky, Mark

    2011-01-01

    ► Port-site metastases can occur following treatment for cervical cancer. ► Port-site metastases can occur following robotic assisted laparoscopic surgery. ► The pathogenesis of port-site metastases is poorly understood.

  9. Age at hysterectomy as a predictor for subsequent pelvic organ prolapse repair

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent;

    2016-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to investigate the association between patient age at the time of hysterectomy and subsequent pelvic organ prolapse (POP) surgery. METHODS: We gathered data on all benign hysterectomies and POP surgeries performed in Denmark on Danish women...

  10. The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy.

    Carney, John

    2008-12-01

    Patients undergoing total abdominal hysterectomy suffer significant postoperative pain. The transversus abdominis plane (TAP) block is a recently described approach to providing analgesia to the anterior abdominal wall. We evaluated the analgesic efficacy of the TAP block in patients undergoing total abdominal hysterectomy via a transverse lower abdominal wall incision, in a randomized, controlled, double-blind clinical trial.

  11. Multiple factors drive regional agricultural abandonment.

    Osawa, Takeshi; Kohyama, Kazunori; Mitsuhashi, Hiromune

    2016-01-15

    An understanding of land-use change and its drivers in agroecosystems is important when developing adaptations to future environmental and socioeconomic pressures. Agricultural abandonment occurs worldwide with multiple potentially positive and negative consequences; however, the main factors causing agricultural abandonment in a country i.e., at the macro scale, have not been identified. We hypothesized that socio-environmental factors driving agricultural abandonment could be summarized comprehensively into two, namely "natural" and "social", and the relative importance of these differs among regions. To test this postulate, we analyzed the factors currently leading to agricultural abandonment considering ten natural environment variables (e.g., temperature) and five social variables (e.g., number of farmers) using the random forest machine learning method after dividing Japan into eight regions. Our results showed that agricultural abandonment was driven by various socio-environmental factors, and the main factors leading to agricultural abandonment differed among regions, especially in Hokkaido in northern Japan. Hokkaido has a relatively large area of concentrated farmland, and abandonment might have resulted from the effectiveness of cultivation under specific climate factors, whereas the other regions have relatively small areas of farmland with many elderly part-time farmers. In such regions, abandonment might have been caused by the decreasing numbers of potential farmers. Thus, two different drivers of agricultural abandonment were found: inefficient cultivation and decreasing numbers of farmers. Therefore, agricultural abandonment cannot be prevented by adopting a single method or policy. Agricultural abandonment is a significant problem not only for food production but also for several ecosystem services. Governments and decision-makers should develop effective strategies to prevent further abandonment to ensure sustainable future management of agro

  12. Cost-analysis of robotic-assisted laparoscopic hysterectomy versus total abdominal hysterectomy for women with endometrial cancer and atypical complex hyperplasia

    Herling, Suzanne Forsyth; Palle, Connie; Møller, Ann M;

    2016-01-01

    AND METHODS: This cost analysis was based on two cohorts: women treated with robotic-assisted laparoscopic hysterectomy (n = 202) or with total abdominal hysterectomy (n = 158) at Copenhagen University Hospital, Herlev, Denmark. We conducted an activity-based cost analysis including consumables and healthcare......INTRODUCTION: The aim of this study was to analyse the hospital cost of treatment with robotic-assisted laparoscopic hysterectomy and total abdominal hysterectomy for women with endometrial cancer or atypical complex hyperplasia and to identify differences in resource use and cost. MATERIAL...... professionals' salaries. As cost-drivers we included severe complications, duration of surgery, anesthesia and stay at the post-anesthetic care unit, as well as number of hospital bed-days. Ordinary least-squares regression was used to explore the cost variation. The primary outcome was cost difference...

  13. Physiological FDG uptake in the ovaries after hysterectomy

    It is known that focal 18F-fluorodeoxyglucose (FDG) uptake is physiologically seen in the ovaries and uterus of premenopausal women in correlation with the menstrual cycle, which may cause false-positive diagnoses on the images of FDG positron emission tomography (PET). The objective of this study was to clarify whether women of reproductive age after hysterectomy whose ovaries were preserved, also showed physiological ovarian FDG uptake. We reviewed 26 women after hysterectomy (age 51.1±5.0 years), who underwent annual cancer screening, including FDG-PET and pelvic magnetic resonance (MR) imaging, three times. Seven women (age 45.9±5.8 years, range 34-52 years) had at least one ovary, showing changes in its appearance including the size and number of follicles on MR images each year, which suggested that the ovary was functioning. Four of the seven women showed focal FDG uptake (standardized uptake value 4.2±1.1) that corresponded to the normal ovaries on five PET examinations. Another group of 19 women (age 53.1±3.1 years, range 47-59 years) who had small ovaries without changes on MR images each year did not show FDG uptake in the ovaries. Physiological FDG uptake observed in the ovaries of women of reproductive age even after hysterectomy is reasonably common. As it is not easy to determine the hormonal cycle in these women, it is essential to correlate focal FDG uptake in the pelvis with anatomical and morphological findings on MR images to avoid false-positive diagnoses. (author)

  14. Hysterectomy as a Management Option for Morbidly Adherent Placenta

    Objective: To determine the outcome of interval (delayed) hysterectomy as compared to cesarean (immediate) hysterectomy in cases of placental invasion in previous cesarean sections. Study Design: Comparative study. Place and Duration of Study: Department of Obstetrics and Gynecology, Unit II, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from January 2008 to June 2011. Methodology: The study subjects included 28 women with history of previous cesarean section who had low lying as well as morbidly adherent placenta (MAP) of variable degree. Patients were classified into two groups (group A and B) according to whether cesarean or interval hysterectomy was needed at time of delivery. Demographic data, obstetrical risk factors such as parity and number of previous cesarean sections were compared as well as radiological and histopathological findings, and details of the management. Chi-square, Fisher's exact and t-tests were used to compare proportions and mean values. Results: The frequency of MAP in previous cesarean sections turned out to be 1.83/1000 (28/15,340) deliveries. Mean maternal age (26.54 vs. 29.13 years, p=0.05), mean gestational age (33.8 vs. 36 weeks, p=0.05), estimated blood loss (2615.38 vs. 1506.6 mL, p=0.001), volume of blood transfused (9.76 vs. 2.9 pints, p=0.001) and the duration of hospital stay (10.69 vs. 32.86 days, p=0.001) differed significantly between group A and group B. One maternal death occurred in each group. Eight patients had other complications in group A compared to 3 patients in group B. Three neonatal deaths occurred in group A compared to nil in group B. Conclusion: The frequency of morbidly adherent placenta was 1.83/1000 deliveries. The management and outcome differed markedly according to emergency and scheduled antenatal diagnosis. Counselling and antenatal radiological screening can reduce the high morbidity and mortality associated with it. (author)

  15. Optimization of subarachanoid block by oral pregabalin for hysterectomy

    Monica Kohli

    2011-01-01

    Full Text Available Background: 80% of patients undergoing surgical procedures experience postoperative pain 1 and requires adequate pain relief. Nowadays drugs like COX2 inhibitors and calcium channel modulators (Pregabalin and Gabapentin are been increasingly used for postoperative pain management effectively. We conducted this study to find whether preoperative pregabalin has any effect in postoperative analgesic requirement in patients undergoing hysterectomy under spinal anaesthesia. Patients & Methods: This randomized, double-blind, placebo-controlled trial was conducted in 150 patients undergoing hysterectomy under spinal anaesthesia, divided in three groups - Group I (PO - Control group, Group II (P150 received 150 mg pregabalin and Group III (P300 received 300 mg pregabalin. We used VAS for anxiety, Ramsay sedation scale and VAS for patient satisfaction regarding pain relief. Results: There was significant reduction in anxiety in groups P (150 and P (300 than placebo group P (0 during intraoperative and postoperative period than preoperative period. There was significant sedation seen in groups P (150 and P (300 than placebo group P (0. First rescue analgesia in group P (300 was202.42±6.77 and in group P (150 was176.38±4.80on average, group P (0 was131.38±5.15. Dizziness was 44.44% in group P (300, 36.11% in group P (150, and 19.44% in group P (0. Patient satisfaction was better in P (300 group than other two groups. Conclusions: Pregabalin being an oral drug which would be easy for the patients to take and also its prolongation of the neuraxial block helps in immediate postoperative analgesia and further reduction of other parentral analgesics. Pregabalin 150mg would be the optimal preemptive dose for hysterectomy under spinal anaesthesia.

  16. Radical Geography

    H. Hataminezhad

    2012-07-01

    Full Text Available Interdisciplinary sciences emerging and specialization were result of historical conditions. Lack of common and grand theories have caused social sciences such as Geography disintegrated to many courses. The Geography science has been divided two main courses, Physical and Human through the time. Every one used another similar science in theoretical principles and methodologies for their domain development and strengthening of their bases. The Human Geography was influenced by Anthropology during nineteenth century and was affected by nineteenth century and dawn twentieth century by Sociology and from mid twentieth century until present time by Biological sciences, Psychology, Political economics and social theories. Radical Geography was one of the Human Geography branches that was influenced by Political economics and left ideology. Radical Geography emphasizes on investigation about quality of life in different spaces and attempts to change socio-economic and spatial relationships, therefore critical Geography is one of its similar approaches.

  17. THE ROLE OF HYSTERECTOMY IN THE THERAPY OF GESTATIONAL TROPHOBLASTIC TUMOR

    2000-01-01

    Objective.To evaluate the role of hysterectomy for patients with gestational trophoblastic tumor.Methods.We retrospectively analyzed 68 cases of gestational trophoblastic neoplasia treated by hysterectomy from 1985~1997 at PUMC hospital. Thirty-eight cases were diagnosed of choriocarcinoma and 30 were invasive mole.Results.Twenty-three elder patients who didn't desire to preserve fertility were selected for hysterectomy after shorter courses of chemotherapy, 22 of them had a complete remission(95.6%), the total aver-age courses of chemotherapy was 4.2. Of twenty-seven chemorefractory cases who were suspected of a refractory isolated lesion in the uterus, delayed hysterectomy as an adjunct to chemotherapy was performed, 20 of them got a complete remission(74.1%), the total average courses of chemotherapy were 9.4. Emergency hysterectomy is indicated in 18 patients with uterine perforation or life-threatening hemorrhage, 17 cases had a complete remission(94.4%), the total average courses of chemotherapy were 7.6.Conclusion.Although the development of effective chemotherapy has resulted in improved survival of patients with gestational trophoblastic tumor, hysterectomy remains an important adjuncts in the treatment of a selected subset of patients; in order to operate more completely and prevent recurrence, it's better to perform extended hysterectomy for the indicated patients.

  18. An audit of indications and complications associated with elective hysterectomy at SVMCH and RC, Ariyur, Pondicherry

    Nidhi Bansal, Hiremath PB, Meenal C, Vishnu Prasad

    2013-04-01

    Full Text Available Background: Hysterectomy is the most common gynaecological surgery performed worldwide Menorrhagia secondary to uterine fibroids and abnormal menstrual bleeding are the two most common indications for hysterectomy. An important factor impacting on the incidence of complications of hysterectomy, apart from the indication for surgery, is the surgical approach. Most surgeons perform up to 80% of procedures by the abdominal route. The incidence of LAVH performed for benign lesions has progressively increased in recent years. Methods : Surgical indications and details, histological findings, and postoperative course were reviewed and analysed for 340 patients who underwent hysterectomy in 2011 and 2012.Results : In our study, fibroid uterus (27.9 % was the leading indication for performing hysterectomies followed by a DUB (22.9% and uterovaginal prolapse (UVP-21.8%. During the study period (2011-2012, most hysterectomies were performed abdominally (54.4%. Overall post operative complications including major and minor, are significantly higher in the abdominal surgery group as compared to the vaginal and laparoscopic group ( p value= 0.001 . Conclusion: We need to ensure that trainees acquire competency in performing hysterectomies vaginally, which is clearly safer than the abdominal approach.

  19. Histopathological Distribution of Ovarian Masses Occurring After Hysterectomy: A Five-Year Assay in Iranian Patients

    Lalooei

    2016-01-01

    Full Text Available Background Ovarian cancer, the third most important genital cancer and fifth cause of cancer-related death in women, is diagnosed at terminal stages in 70% of cases. Therefore, it is imperative to know the possible risk factors associated with ovarian cancer. Only a few studies have discussed the histopathological features of ovarian masses occurring after hysterectomy. Objectives The study aimed to investigate the five-year prevalence and histopathological distribution of ovarian masses after hysterectomy in Iranian patients and to determine the need for prophylactic salpingo-oophorectomy. Patients and Methods This descriptive cross-sectional study enrolled all patients with ovarian masses and a history of hysterectomy for benign conditions who were visiting the gynecology clinic of Baqiyatallah Hospital, Tehran, between May 2009 and May 2014. Demographic information, pathological features of ovarian masses, family history, the time between hysterectomy and ovarian mass surgery, and method of hysterectomy were recorded in a predesigned checklist. The level of tumor markers such as CA125 and alpha-fetoprotein (α-FP were measured. Results Of the 1052 patients with ovarian masses, 45patients (mean age, 53.11 ± 9.56 years who had undergone abdominal hysterectomy underwent analysis. The study participants had a mean age of 47.92 ± 1.58 years at the time of hysterectomy. The mean time interval between hysterectomy and diagnosis of ovarian mass was 5.38 ± 4.15 years. Based on pathological reports, serous cystadenoma was the most frequent (43.2% pathological diagnosis, followed by mucinous cystadenoma (17.5%. Conclusions A majority of ovarian masses, especially those diagnosed within a short duration after hysterectomy, are benign. Iranian patients with such ovarian masses when asymptomatic and associated with negative tumor markers could be followed up, and prophylactic oophorectomy may not be necessary.

  20. Roaming Radicals

    Bowman, Joel M.; Shepler, Benjamin C.

    2011-05-01

    Roaming is a recently verified unusual pathway to molecular products from unimolecular dissociation of an energized molecule. Here we present the evidence for this pathway for H2CO and CH3CHO. Theoretical analysis shows that this path visits the plateau region of the potential energy surface near dissociation to radical products. It is not clear whether roaming is a distinct isolated pathway, in addition to the conventional one via the well-known molecular saddle-point transition state. Evidence is presented to suggest that the two pathways may originate from a single, but highly complicated, dividing surface. Other examples of unusual reaction dynamics are also reviewed.

  1. Advantages of nerve-sparing intrastromal total abdominal hysterectomy

    Samimi D

    2013-01-01

    Full Text Available Daryoosh Samimi,1 Afdal Allam,2 Robert Devereaux,2 William Han,2 Mark Monroe21Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 2Department of Obstetrics and Gynecology, Fountain Valley Regional Hospital, Fountain Valley, CA, USABackground: The purpose of the prospective study was to evaluate the effect of the nerve-sparing intrastromal abdominal hysterectomy bilateral salpingo-oophorectomy (ISTAH-BSO on intraoperative, and postoperative complications namely blood loss and length of hospital stay.Methods: Forty female patients were allocated by a block randomization method into a study group and a control group. The study group consisted of 20 patients who underwent ISTAH-BSO over a 2-year period. The control group included 20 patients who underwent conventional hysterectomy by the same surgeon during the same time frame. Both groups were followed for outcomes of interest, which included length of hospital stay, blood loss, and surgical complications. The participants in both groups were as similar as possible with respect to all known or unknown factors that might affect the study outcome.Results: Postoperative hemoglobin levels were higher in the study group (blood loss 1.0 g/dL versus 1.4 g/dL in control group. Average hospital stay was significantly shorter in the study group (2.7 days versus 3.15 days in the control group, P = 0.028. No significant complications such as urinary fistula, vaginal vault prolapse, blood transfusion, or postoperative infections were identified in the study group.Conclusion: The nerve-sparing ISTAH-BSO procedure described in this study has the potential to reduce length of hospital stay after abdominal hysterectomy by reducing blood loss and postoperative complications. Follow-up observations suggest that urinary function and sexual satisfaction are also preserved. Since this research, 175 cases have been performed, with an average of 5 years of

  2. Laparoscopic Assisted Vaginal Hysterectomy, Setting Up a Service at a Peripheral Teaching Hospital

    Jim Tsaltas; Gab Kovacs; Jenny Dennis; Amanda Pratt

    1996-01-01

    The establishment of a laparoscopically assisted hysterectomy program at Box Hill Hospital is described. The first eight cases have been reviewed and recommendations are made to other gynaecology units who wish to establish a minimally invasive gynaecological surgery unit.

  3. Is Previous Tubal Ligation a Risk Factor for Hysterectomy because of Abnormal Uterine Bleeding?

    Sanam Moradan

    2012-07-01

    Full Text Available Objectives: Post tubal ligation syndrome (PTLS is a term used to describe a variety of post tubal ligation side effects or symptoms. These include increased menstrual bleeding and hysterectomy. Whether or not post tubal syndrome is a real entity, it has been a subject of controversy in the medical literature for decades. Numerous studies have reported conflicting conclusions about these symptoms. In this study the incidence of hysterectomy for bleeding disorders among sterilized women was compared with the incidence of hysterectomy for bleeding disorders among non-sterilized female population of the same age.Methods: This study was carried out on 160 women, 38-52 years, who underwent hysterectomy in Amir University Hospital, Semnan, Iran, from September 2008 to September 2011. After gathering of data from medical records, in this study, the incidence of hysterectomy for bleeding disorders among sterilized women was compared with the incidence of hysterectomy for bleeding disorders among nonsterilized female population for the same age.Results: The mean age of the study group was 44/4±5/7 and the mean age of the control group was 45/2±5/3, (p=0.424.The mean parity of the study group was 3/8±1/8 and the mean parity of the control group was 3/5±1/4, (p=0.220. So, in regard to age and parity, two groups were matched. Hysterectomies were performed for 160 cases and abnormal uterine bleeding was the cause of hysterectomy in 67 cases. Among 67 cases, 19 cases (37.3% had previous tubal sterilization + hysterectomy (study group and 48 cases (44% were not undergoing tubal sterilization but had hysterectomy for abnormal bleeding causes (control group. Statistical analyses showed that there were not significant differences between two groups, (RR=0.85; 95% CI: 0.56-1.28; p=0.418.Conclusion: The result of this study showed that previous tubal sterilization is not a risk factor for undergoing hysterectomy because of abnormal uterine bleeding.

  4. Single-Port Access Laparoscopy-Assisted Vaginal Hysterectomy: Our Initial Experiences with 100 Cases

    Yun-Sang Oh; Ji-No Park; Jin Choi; Kwang-Sik Shin; Young-Sam Choi; Tae-Eel Rhee

    2012-01-01

    Objectives. To present our initial experiences with laparoscopically assisted vaginal hysterectomy performed using homemade transumbilical single-port system. Materials and Methods. We reviewed the medical records of one hundred patients who underwent single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH). SPA-LAVH was performed with homemade single port system and conventional rigid laparoscopic instruments. Results. All procedures were successfully completed through th...

  5. Adenomyosis among samples from hysterectomy due to abnormal uterine bleeding in Ahwaz, southern Iran

    Maryam Dehghani Mobarakeh; Ahmadreza Maghsudi; Iran Rashidi

    2012-01-01

    Introduction: Adenomyosis is one of the most common, yet underdiagnosed, underlying causes of abnormal uterine bleeding (AUB). We aimed to evaluate the prevalence of adenomyosis among subjects who underwent hysterectomy due to AUB. Materials and Methods: We studied the pathological specimens from 100 cases of AUB who underwent hysterectomy and were referred to Jundishapur University of Medical Sciences, Ahwaz (Iran) from 2007 to 2010. All specimens were reviewed by the same pathologist. ...

  6. Mood Symptoms After Natural Menopause and Hysterectomy With and Without Bilateral Oophorectomy Among Women in Midlife

    Gibson, Carolyn J.; Joffe, Hadine; Bromberger, Joyce T.; Thurston, Rebecca C.; Lewis, Tené T.; Khalil, Naila; Matthews, Karen A.

    2012-01-01

    Objective To examine whether mood symptoms increased more for women in the years after hysterectomy with or without bilateral oophorectomy relative to natural menopause. Methods Using data from the Study of Women’s Health Across the Nation (n=1,970), depression and anxiety symptoms were assessed annually for up to 10 years with the Center for Epidemiological Studies Depression Index and four anxiety questions, respectively. Piecewise hierarchical growth models were used to relate natural menopause, hysterectomy with ovarian conservation, and hysterectomy with bilateral oophorectomy to trajectories of mood symptoms before and after the final menstrual period or surgery. Covariates included educational attainment, race, menopausal status, age the year prior to final menstrual period or surgery, and time-varying body mass index, self-rated health, hormone therapy, and antidepressant use. Results By the 10th annual visit, 1,793 (90.9%) women reached natural menopause, 76 (3.9%) reported hysterectomy with ovarian conservation, and 101 (5.2%) reported hysterectomy with bilateral oophorectomy. For all women, depressive and anxiety symptoms decreased in the years after final menstrual period or surgery. These trajectories did not significantly differ by hysterectomy or oophorectomy status. The Center for Epidemiological Studies Depression Index means were .72 standard deviations lower, and anxiety symptoms .67 standard deviations lower, five years after final menstrual period or surgery. Conclusion In this study, mood symptoms continued to improve after the final menstrual period or hysterectomy for all women. Women who undergo a hysterectomy with or without bilateral oophorectomy in midlife do not experience more negative mood symptoms in the years after surgery. PMID:22525904

  7. Patient and Staff (doctors and nurses) Experiences of Abdominal Hysterectomy in Accelerated Recovery Programme

    Wagner, Lis; Carlslund, Anne Mette; Møller, Charlotte;

    2004-01-01

    Introduction: The accelerated recovery programme (ARP) is becoming commonplace in surgical specialties and has also been introduced to hysterectomy patients. Diagnostic, prognostic and other clinical indicators are well described. The aim of this article is to relay knowledge about the ARP, throu...... for purposes of information relay and dialogue between staff and patients/family members. A nursing care ambulatory unit is recommended to support with information for women prior to and following hysterectomy in the ARP....

  8. Hysterectomy and Bilateral Salpingoovariectomy in a Transsexual Subject without Visible Scaring

    Anna Myriam Perrone; Maria Cristina Scifo; Valentina Martelli; Paolo Casadio; Paolo Giovanni Morselli; Giuseppe Pelusi; Maria Cristina Meriggiola

    2010-01-01

    Objective. To report on the use of laparoendoscopic single-site surgery (LESS) for the management of total hysterectomy (TH) with bilateral salpingoovariectomy (BSO) in a subject affected by gender identity disorder. Design. Case report. Setting. University Hospital. Patient(s). A 27-year-old affected by Gender Identity Disorder underwent a hysterectomy and BSO as part of surgical sex reassignment. Intervention(s). Laparoendoscopic single-site surgery access for TH and BSO. Main Outcome Measu...

  9. Mini laparotomy versus conventional laparotomy for abdominal hysterectomy: A comparative study

    Sharma Jai

    2004-05-01

    Full Text Available BACKGROUND: Less traumatizing measures for hysterectomies are searched for to improve the recovery from surgery. AIM: Comparison of minilaparotomy abdominal hysterectomy with conventional abdominal hysterectomy in respect to per-operative and post-operative outcome and complications. SETTING AND DESIGN: In a medical college hospital patients undergoing abdominal hysterectomy were enrolled. It was a concomitant comparative study. METHODS AND MATERIAL: We are presenting our comparative data of 100 cases of minilaparotomy abdominal hysterectomy (group I, incision =< 6 cm performed over last 4 years from January 1998 to December 2002 and comparing the outcome with 99 cases of abdominal hysterectomy (group II, incision > 6 cm done by traditional method over the same duration. STATISTICAL ANALYSIS USED: Chi-square and Fischer test with significance of p value being taken at 0.05 were used for categorical data, while student′s t test was used for continuous data. RESULTS: Mean age and parity of patients were similar in the two groups. Incision was transverse in 100% cases in-group I and 22.2% cases in-group II. Estimated blood loss was significantly higher (354 ml in group II in contrast to group I (240 ml. Blood transfusion was also required more commonly (22.2% in-group II than in-group I (9%. Mean operative time was significantly more in-group II (90 minutes than in group I (41 minutes. Mean hospital stay, day of mobility, starting oral diet and days of injectable analgesics required were higher in group II than in group I. Major complications were rare in both the groups, but minor complications were significantly higher in group II (40.4% than in group I (26%. CONCLUSION: Minilaparotomy abdominal hysterectomy appears to be an attractive alternative to traditional abdominal hysterectomy with fewer complications.

  10. Chronic plasma cell endometritis in hysterectomy specimens of HIV-infected women: a retrospective analysis.

    Kerr-Layton, J A; Stamm, C. A.; Peterson, L. S.; McGregor, J A

    1998-01-01

    OBJECTIVE: Abnormal uterine bleeding is a common and troublesome problem in human immunodeficiency virus (HIV)-infected women. We sought to evaluate endometrial pathology among HIV-infected women requiring hysterectomy to explore if endometritis may be common among these patients. METHODS: We performed a retrospective analysis of uterine pathology specimens obtained from HIV-infected and control patients requiring hysterectomy in two urban hospitals between 1988 and 1997 matched for age, surg...

  11. Chronic Plasma Cell Endometritis in Hysterectomy Specimens of HIV-Infected Women: A Retrospective Analysis

    Kerr-Layton, J A; Stamm, C. A.; Peterson, L. S.; McGregor, J A

    1998-01-01

    Objective: Abnormal uterine bleeding is a common and troublesome problem in human immunodeficiency virus (HIV)-infected women. We sought to evaluate endometrial pathology among HIVinfected women requiring hysterectomy to explore if endometritis may be common among these patients.Methods: We performed a retrospective analysis of uterine pathology specimens obtained from HIV-infected and control patients requiring hysterectomy in two urban hospitals between 1988 and 1997 matched for age, surgic...

  12. Continued distress among abandoned dogs in Fukushima.

    Nagasawa, Miho; Mogi, Kazutaka; Kikusui, Takefumi

    2012-01-01

    In Fukushima, Japan, a prolonged refugee situation caused by a major nuclear incident after the earthquake of March 11, 2011 has led to the unintentional abandonment of many pets. We received stray or abandoned dogs from rescue centers in Fukushima Prefecture. During re-socialization training and health care, we accessed the behavioral characteristics and the urine cortisol level of each dog and compared them with those of other abandoned dogs not involved in this earthquake. The dogs from Fukushima showed significantly lower aggression toward unfamiliar people, trainability, and attachment to their caretakers; also, urine cortisol levels in the dogs from Fukushima were 5-10-fold higher than those in abandoned dogs from another area of Japan. These results suggested that the dogs from Fukushima suffered through an extremely stressful crisis. PMID:23061007

  13. Coal Mines, Abandoned - AML Inventory Sites 201601

    NSGIC GIS Inventory (aka Ramona) — This data set portrays the approximate location of Abandoned Mine Land Problem Areas containing public health, safety, and public welfare problems created by past...

  14. Coal Mines, Abandoned - AML Polygons Feature

    NSGIC GIS Inventory (aka Ramona) — This data set portrays the approximate location of Abandoned Mine Land Problem Areas containing public health, safety, and public welfare problems created by past...

  15. Coal Mines, Abandoned - AML Points Feature

    NSGIC GIS Inventory (aka Ramona) — This data set portrays the approximate location of Abandoned Mine Land Problem Areas containing public health, safety, and public welfare problems created by past...

  16. Landscape reconstruction planning of abandoned quarries

    Zhou, Linjia; 周麟佳

    2015-01-01

    Zhejiang, with a rich resource of stone, has a long history of stone extraction, where scatter thousands of traditional quarries and as a result many abandoned ones are left, which is challenged economically, ecologically and socially. On account of the soil erosion, security risks and degradation of ecosystem, reusing of the large number of abandoned quarries located in the city or the suburbs have become an important topic on sustainable development in China in resent years. These a...

  17. The rail abandonment process: A southern perspective

    One factor in evaluating the desirability of rail transport for high-level radioactive wastes or spent fuels is the frequency, or lack thereof, with which railroad and railroad lines have been, and are, abandoned. If DOE makes a decision to use the rail option and a line is subsequently abandoned, the choice results in increased cost, time delays and possibly safety problems: Information is therefore needed prior to the decision-making process to evaluate the desirability of the rail shipping option. One result of the abandonments mentioned herein, as well as other later abandonments, is the creation of a US rail system undergoing an evolutionary process in the 1980s as far-reaching as the changes that occurred when the industry was in its infancy a century and-a-half ago. The purpose of this paper is to examine the factors leading to some of these changes by tracing the historical development of the rail abandonment process, with particular emphasis on the rise of regional railroads, their problems in the modern era and current trends in rail abandonments as well as their effects on the southeastern United States

  18. Pain and other symptom severity in women with fibromyalgia and a previous hysterectomy

    Vincent A

    2011-10-01

    Full Text Available Ann Vincent1, Mary O Whipple1, Connie A Luedtke2, Terry H Oh3, Richa Sood1, Robin L Smith1, Aminah Jatoi4 1Department of Medicine, 2Department of Nursing, 3Department of Physical Medicine and Rehabilitation, 4Department of Oncology, Mayo Clinic, Rochester, MN, USA Objective: Fibromyalgia is a troubling disease characterized by chronic pain. This study explored whether pain and other fibromyalgia symptoms are worse among women who had undergone a hysterectomy with or without an oophorectomy versus those who had not. Methods: Consecutive women who were seen at the Fibromyalgia Treatment Program at a tertiary medical center between 2001 and 2004 and who completed the Fibromyalgia Impact Questionnaire (FIQ and Short Form-36 Health Survey (SF-36 at initial evaluation were included in this study. Results: A total of 813 women were included; 328 had had a hysterectomy. Total FIQ scores from women who had had a hysterectomy were higher (worse symptoms than those who had not (58.1 vs 56.4, P = 0.002. FIQ subscale scores of pain (P = 0.003, fatigue (P = 0.030, stiffness (P = 0.035, and depression (P = 0.008 were also worse in women who had had a hysterectomy. Similar to the FIQ, SF-36 physical component scores were worse in women who had had a hysterectomy (P = 0.045. Conclusion: Pain and other fibromyalgia symptom severity was worse in women who had had a hysterectomy with or without an oophorectomy. Keywords: fibromyalgia, hysterectomy, oophorectomy, symptom severity, surgical menopause

  19. Hysterectomy at a Canadian tertiary care facility: results of a one year retrospective review

    Gorwill R Hugh

    2004-11-01

    Full Text Available Abstract Background The purpose of this study was to investigate the indications for and approach to hysterectomy at Kingston General Hospital (KGH, a teaching hospital affiliated with Queen's University at Kingston, Ontario. In particular, in light of current literature and government standards suggesting the superiority of vaginal versus abdominal approaches and a high number of concurrent oophorectomies, the aim was to examine the circumstances in which concurrent oophorectomies were performed and to compare abdominal and vaginal hysterectomy outcomes. Methods A retrospective chart audit of 372 consecutive hysterectomies performed in 2001 was completed. Data regarding patient characteristics, process of care and outcomes were collected. Data were analyzed using descriptive statistics, t-tests and linear and logistic regression. Results Average age was 48.5 years, mean body mass index (BMI was 28.6, the mean length of stay (LOS was 5.2 days using an abdominal approach and 3.0 days using a vaginal approach without laparoscopy. 14% of hysterectomies were performed vaginally, 5.9% were laparoscopically assisted vaginal hysterectomies and the rest were abdominal hysterectomies. The most common indication was dysfunctional or abnormal uterine bleeding (37%. The average age of those that had an oophorectomy (removal of both ovaries was 50.8 years versus 44.3 years for those that did not (p Conclusions A significant reduction in LOS was found using the vaginal approach. Both the patient and the health care system may benefit from the tendency towards an increased use of vaginal hysterectomies. The audit process demonstrated the usefulness of an on-going review mechanism to examine trends associated with common surgical procedures.

  20. NON–DESCENT VAGINAL HYSTERECTOMY FOR BENIGN GYNAECOLOGICAL DISEASE – A PROSPECTIVE STUDY

    Thulasi

    2016-04-01

    Full Text Available OBJECTIVE To assess safety and feasibility of non-descent vaginal hysterectomy for benign gynaecological disease. METHODS A prospective study was conducted at the Department of Obstetrics and Gynaecology of P K Das Institute of Medical Sciences from January 2013 to December 2013. An effort was made to perform hysterectomies vaginally in women with benign or premalignant conditions in the absence of prolapse. A suspected adnexal pathology, endometriosis, immobility of uterus, uterus size more than 16 weeks was excluded from the study. Vaginal hysterectomy was done in usual manner. In bigger size uterus, morcellation techniques like bisection, debulking, coring, myomectomy, or combination of these were used to remove the uterus. Data regarding age, parity, uterine size, estimated blood loss, length of operation, intraoperative and postoperative complications and hospital stay were recorded. RESULTS A total of 100 cases were selected for non-descent vaginal hysterectomy. Among them, 97 cases successfully underwent nondescent vaginal hysterectomy. Majority of the patients (55% were in age group 40-45 yrs. Four patients were nulligravida and eight patients had previous LSCS. Uterine size was ≤ 12 weeks in 84 cases and > 12-16 weeks in 16 cases. Commonest indication was leiomyoma of uterus (43%. Mean duration of surgery was 70±20.5 minutes. Mean blood loss was 150±65 mL. Reasons for failure to perform NDVH was difficulty in opening pouch of Douglas in two cases because of adhesions and in one case there was difficulty in reaching the fundal myoma which prevented the uterine descent. Intra–operatively, one case had bladder injury (1% that had previous 2 LSCS. Postoperatively, complications were minimal which included postoperative fever (11%, UTI (8% and vaginal cuff infection was (4%. Mean hospital stay was 3.5 days. CONCLUSION Vaginal hysterectomy is safe, feasible in most of the women requiring hysterectomy for benign conditions with less

  1. [Radical trachelectomy -- surgery for preserving woman's fertility in patients with invasive cervical cancer].

    Kostov, I; Vasilev, N; Nacheva, A; Lazarov, I

    2013-01-01

    For the past 15 years gynecological oncologists have been seeking ways to preserve woman's fertility when treating invasive cervical cancer. Many cases of cervical cancer are diagnosed in young woman who wish to preserve their fertility. As more women are delaying childbearing, fertility preservation has become an important consideration. The standard surgical treatment for stage IA2-IB1 cervical cancer is a radical hysterectomy and bilateral pelvic lymphadenectomy. This surgery includes removal of the uterus and cervix, radical resection of the parametrial tissue and upper vagina, and complete pelvic lymphadenectomy. Obviously, the standard treatment does not allow future childbearing. For some women with small localized invasive cervical cancers, there is hope for pregnancy after treatment. Radical trachelectomy is a fertility-sparing surgical approach developed in France in 1994 by Dr. Daniel Dargent for the treatment of early invasive cervical cancer. The radical trachelectomy operation has been described and performed abdominally, assisted vaginally by laparoscopy and robotically. PMID:24505637

  2. Effects of Weather Variability on Crop Abandonment

    Kelvin Mulungu

    2015-03-01

    Full Text Available In Zambia, every year some parts of the maize fields are abandoned post-planting. Reasons for this are not clearly known. In this paper, we examine the influence of soil and climatic factors on crop abandonment using a six-year (2007–2012 panel data by modeling the planted-to-harvested ratio (a good indicator of crop abandonment using a fractional and linear approach. Therefore, for the first time, our study appropriately (as supported by the model specification tests that favour fractional probit over linear models the fractional nature of crop abandonment. Regression results, which are not very different between the two specifications, indicate that, more than anything, high rainfall immediately after planting and inadequate fertilizer are the leading determinants of crop abandonment. In the agro-ecological region where dry planting takes place, low temperature during planting months negatively affects the harvested area. The results have implications on the sustainability of farming systems in the face of a changing climate.

  3. History of abandoned infants in Greece

    Maria Athanasopoulou

    2010-01-01

    Full Text Available It is since mythology to classical ages in Greece, since Medieval Ages to the end of the 19th century in Smyrna and in Athens, that history indicates the abandonment of the infants as a phenomenon always existing. A time flashback and the research of the phenomenon through the historic examples contribute unequivocally to the remonstrance of the social facts in each era.Aim: The aim of this study was to critically review all the historical data and the evidence from the international and Greek literature and to explore the factors that are accountable for to the infant’s abandonment and especially in Greece.Method: A critical literature search was performed using of MEDLINE and CINAHL (1990-2008 databases. The literature review referred to historical data related to the care of the abandoned infants since ancient Greek times.Conclusion: The literature review leads to the conclusion that the detection of the historical sources combines a “mosaic” which reflects the multiple needs of the Greek society, with target to encounter the infant abandonment. The ways used each time in order the phenomenon to be faced, not rarely were doubted. Still they stand as the salutary solutions for the abandoned infants and they are explained and established through the social background of each era and through the needs serviced each time.

  4. Changing trends in peripartum hysterectomy over the last 4 decades.

    Flood, Karen M

    2012-02-01

    OBJECTIVE: The purpose of this study was to identify changing trends in peripartum hysterectomy (PH) in a single large obstetric population over the last 40 years. STUDY DESIGN: A retrospective cohort study was performed from 1966-2005 of patients who had PH in any of the 3 Dublin obstetric hospitals. Cases were identified, and details were obtained from the combined patient databases of each hospital. RESULTS: There were 872,379 deliveries during the study period, among which 358 women underwent PH (0.4\\/1000 deliveries). In a comparison of the study decades 1966-1975 with 1996-2005, PH decreased from 0.9 per 1000 deliveries to 0.2 of 1000 deliveries. Although the overall cesarean delivery rate has increased from 6-19% during these 2 decades, the percentage of PH that occurs in the setting of a previous cesarean delivery has increased from 27-57% (P < .00001). Indications for PH have changed significantly in this time period, with "uterine rupture" as the indication for PH decreasing from 40.5-9.3% (P < .0001) and placenta accreta as the indication increasing significantly from 5.4-46.5% (P < .00001). CONCLUSION: PH has decreased over the last 4 decades. However, alongside the rising cesarean delivery rate, there has been a marked increase in the incidence of placenta accreta.

  5. Pattern and frequency of uterine pathologies among hysterectomy specimens in rural part of northern India: a retrospective secondary data analysis

    Vineet Chaturvedi

    2014-03-01

    Full Text Available Background: Hysterectomy is the most commonly performed gynecological surgery throughout the world.  Over the last several years reported cases of hysterectomy was increasing in numbers. However, similar studies from Etawah district with high prevalence of hysterectomy are lacking. Therefore, we have conducted this study to identify the pattern of pathologies identified in hysterectomy specimen and to correlate the pathological findings with the age group of the patient along with frequency of benign, malignant pathologies identified. Material and method:  This   study was conducted on 870 hysterectomy specimen who reported to pathology department .They were compared in terms of age of the patients and pathology of hysterectomy specimens. Result: Out of the hysterectomy specimens, pathological findings were seen in 850 hysterectomies.  Most common lesion was   leiomyoma (22.47% followed by Adenomyosis (21.76% ,Endometrial hyperplasia (14.00 %, ovarian cyst (9.29%, Endometrial atrophy (8.70%, Endometritis (7.76 %, Endo cervical polyp (5.64, Carcinoma intra epithelial neoplasm (3.52%, Endometrial polyp (3.17%, Carcinoma cervix (1.17%, Carcinoma ovary (1.05%, Benign ovarian tumor (0.58%,Carcinoma endometrium(0.35%, Myometritis (0.35%, Chorio carcinoma (0.11% The most common age group was (40-49 years. Conclusion:  Our data suggest that leiomyoma was the most common pathology seen in hysterectomy .The common age group for hysterectomy was (40 -49 years. Benign pathologies are more frequent in hysterectomy than malignant. Histopathology is mandatory for ensuring diagnosis and thus management, in particular of malignant disease.         

  6. Infanticide and illegal infant abandonment in Malaysia.

    Razali, Salmi; Kirkman, Maggie; Ahmad, S Hassan; Fisher, Jane

    2014-10-01

    Infant abandonment and infanticide are poorly understood in Malaysia. The information available in the public arena comes predominantly from anecdotal sources. The aim of this study was to describe the prevalence and characteristics of infanticide and illegal infant abandonment in Malaysia and to estimate annual rates for the most recent decade. Summaries of data about infanticide and illegal infant abandonment were gathered from police records; the annual number of live births was ascertained from the national registry. The estimated inferred infanticide rates for Malaysia were compared with the infanticide rates among countries of very high, high, medium, and low rankings on the Human Development, Gender Inequality, and Gini indices. From 1999 to 2011, 1,069 cases of illegal infant abandonment were recorded and 1,147 people were arrested as suspected perpetrators. The estimated inferred infanticide rate fluctuated between 4.82 and 9.11 per 100,000 live births, a moderate rate relative to the infanticide rates of other countries. There are substantial missing data, with details undocumented for about 78-87% of cases and suspected perpetrators. Of the documented cases, it appeared that more boys than girls were victims and that suspected perpetrators were predominantly Malays who were women, usually mothers of the victim; the possibility of arrest bias must be acknowledged. Economic and social inequality, particularly gender inequality, might contribute to the phenomena of infanticide and abandonment. Strategies to reduce rates of infanticide and illegal infant abandonment in Malaysia will require strengthening of the surveillance system and attention to the gender-based inequalities that underpin human development. PMID:25048164

  7. Obstetric hysterectomy, still a life saving tool in modern day obstetrics: a five year study

    Neetu Singh

    2014-06-01

    Results: During the study period, 105 emergency obstetric hysterectomies were performed giving an incidence of 0.54% .The incidence of hysterectomy following vaginal delivery was 0.54% and that of caesarean hysterectomy was 2.08%. It was most common in the age group 26-35 years (66.66% and in women of parity 3-4 (71.42%.Rupture uterus was the most common indication accounting for 59.04% cases followed by Atonic PPH (18.09%. Febrile illness and wound infection were the two most common co-morbidities. Maternal mortality was 5.71%. Conclusions: Emergency obstetric hysterectomy is potentially a life saving procedure which every obstetrician must be familiar with in cases of catastrophic rupture uterus and intractable haemorrhage. With the help of prostaglandins, modern policies of active management of labor, timely performance of caesarean section, internal iliac artery ligation, compression sutures etc. obstetric hysterectomy should be made a more rare procedure. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 540-543

  8. Histopathological Study of Hysterectomy Operations in A University Clinic in Tehran From 2005 to 2009

    Mahmoud Khaniki

    2011-06-01

    Full Text Available Objective: We intended to determine causes and histological pattern of hysterectomies in an Iranianpopulation.Materials and methods: Archived reports of pathology department of a university hospital dated March2005 to March 2009 were retrospectively reviewed. Age, chief complaint, type of operation includingabdominal, vaginal and subtotal hysterectomy, the indication of the operation and the pathology of thespecimen were retrieved from the records.Results: The average rate of hysterectomy was 219 per year. The average age of the patients was49.6±11.3. About 40% of cases aged 45-54 years. The main chief compliant was abnormal uterinebleeding (62.2%. The leading preoperative indication for hysterectomy operations were uterineleiomyoma (24.8% and then abnormal uterine bleeding and abdominal/pelvic mass. The most frequentpathologic findings were leiomyoma (22.0% and adenomyosis (12.1%. In 11.8% of hysterectomyspecimens no pathologic lesion was found.Conclusion: The hysterectomy is rather common in Iran with age dependent pattern of indications andcorresponding pathologies.

  9. A Marked Increase in Obstetric Hysterectomy for Placenta Accreta

    Xiao-Yu Pan; Yu-Ping Wang; Zheng Zheng; Yan Tian; Ying-Ying Hu; Su-Hui Han

    2015-01-01

    Background:Obstetric hysterectomy (OH) as a lifesaving measure to manage uncontrolled uterine hemorrhage appears to be increasing recently.The objective of this study was to determine the etiology and changing trends of OH and to identify those at particular risk of OH to enhance the early involvement of multidisciplinary intensive care.Methods:A retrospective study was carried out in patients who had OH in China-Japan Friendship Hospital from 2004 to 2014.Maternal characteristics,preoperative evaluation,operative reports,and prenatal outcomes were studied in detail.Results:There were 19 cases of OH among a total of 18,838 deliveries.Comparing the study periods between 2004-2010 and 2011-2014,OH increased from 0.8/1000 (10/12,890) to 1.5/1000 (9/5948).Indications for OH have changed significantly during this study period with uterine atony decreasing from 50.0% (5/10) to 11.1% (1/9) (P < 0.05),and placenta accreta as the indication for OH has increased significantly from 20.0% (2/10) to 77.8% (7/9) (P < 0.05).Ultrasonography and magnetic resonance imaging (MRI) have been used to make an exact antepartum diagnosis of placenta accreta.A multidisciplinary management led to improved outcomes for patients with placenta accreta.Conclusion:As the multiple cesarean delivery rates have risen,there has been a dramatic increase in OH for placenta accreta.An advance antenatal diagnosis of ultrasonography,and MRI,and a multidisciplinary teamwork can maximize patients' safety and outcome.

  10. Hysterectomy and Bilateral Salpingoovariectomy in a Transsexual Subject without Visible Scaring

    Anna Myriam Perrone

    2010-01-01

    Full Text Available Objective. To report on the use of laparoendoscopic single-site surgery (LESS for the management of total hysterectomy (TH with bilateral salpingoovariectomy (BSO in a subject affected by gender identity disorder. Design. Case report. Setting. University Hospital. Patient(s. A 27-year-old affected by Gender Identity Disorder underwent a hysterectomy and BSO as part of surgical sex reassignment. Intervention(s. Laparoendoscopic single-site surgery access for TH and BSO. Main Outcome Measure(s. The procedure was performed without incident. The trocar placement was easy and safe, without inadvertent port removal. No vascular or visceral injuries, loss of pneumoperitoneum, or intraoperative port site bleeding occurred. Result(s. A detailed description of the technique of a single-site surgery for management of hysterectomy and BSO. Conclusion. Our case presents the first report of single-site surgery for surgical treatment of subjects affected by GID.

  11. Role of non-descent vaginal hysterectomy in previous cesarean section scar women

    Naina Kumar

    2015-06-01

    Results: Total ten cases were selected for NDVH with history of one, two/ three cesarean sections. All successfully underwent NDVH, except one in which bladder injury occurred which was repaired at same time from below. Five patients had previous one Lower Segment Cesarean Section (LSCS, four had two LSCS and one had three LSCS. Commonest indication was leiomyoma of uterus followed by abnormal uterine bleeding. Mean duration of surgery was 50 +/- 20.5 min. Mean blood loss was 150 +/- 65 ml. Post-operative complications were minimal with no scar, patient mobility, resumption of daily activities was fast. Mean hospital stay was 4-5 days. Conclusions: Vaginal hysterectomy appears to be safe, cost effective alternative to abdominal hysterectomy in women with previous cesarean section scar requiring hysterectomy for benign conditions with fewer complications, shorter hospital stay. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 785-789

  12. Hysterectomy and its impact on the calculated incidence of cervical cancer and screening coverage in Denmark

    Lam, Janni Uyen Hoa; Lynge, Elsebeth; Njor, Sisse Helle;

    2015-01-01

    BACKGROUND: The incidence rates of cervical cancer and the coverage in cervical cancer screening are usually reported by including in the denominator all women from the general population. However, after hysterectomy women are not at risk anymore of developing cervical cancer. Therefore, it makes...... sense to determine the indicators also for the true at-risk populations. We described the frequency of total hysterectomy in Denmark and its impact on the calculated incidence of cervical cancer and the screening coverage. MATERIAL AND METHODS: With data from five Danish population-based registries......, the incidence rate of cervical cancer and the screening coverage for women aged 23-64 years on 31 December 2010 were calculated with and without adjustments for hysterectomies undertaken for reasons other than cervical cancer. They were calculated as the number of cases divided by 1) the total number of woman...

  13. Soil microbial community of abandoned sand fields

    Elhottová, Dana; Szili-Kovács, T.; Tříska, Jan

    2002-01-01

    Roč. 47, č. 4 (2002), s. 435-440. ISSN 0015-5632 R&D Projects: GA ČR GA526/99/P033 Grant ostatní: OTKA(HU) T25739 Institutional research plan: CEZ:AV0Z6066911 Keywords : microbial community * abandoned fields Subject RIV: EH - Ecology, Behaviour Impact factor: 0.979, year: 2002

  14. 18 CFR 157.216 - Abandonment.

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Abandonment. 157.216 Section 157.216 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT... firm contract; or (2) A facility that did or could now qualify for automatic authorization as...

  15. Hawaii Abandoned Vessel Inventory, French Frigate Shoals, NWHI

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for French Frigate Shoals. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction...

  16. Development of database on circular abandoned channel in Japan

    To develop a method for estimating late Quaternary uplift rates of inland mountainous terrains where fluvial terraces are poorly developed, we focused on 'circular abandoned channels', formed by meander cut-offs or river capture of an incised meandering river. We studied about 1,000 circular abandoned channels distributed throughout the Islands of Japan, and developed GIS database on circular abandoned channel in Japan. This database contains formation process, relative heights, degree of dissection and bedrocks of circular abandoned channels. Circular abandoned channels are distributed in inland mountainous terrains, where late Quaternary uplift rates are unknown, and indicate different relative heights along the same river. Relative heights tend to correlate with degree of dissection of the circular abandoned channels, which may indicate that degree of dissection correlate with ages of abandonment of circular abandoned channels. A CD-ROM is attached as an appendix. (J.P.N.)

  17. Hawaii Abandoned Vessel Inventory, Pearl & Hermes Atoll, NWHI

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for , Pearl & Hermes, Atoll, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical...

  18. Quarries - QUARRIES_ABANDONED_IN: Abandoned Quarries in Indiana (Indiana Geological Survey, Point Shapefile)

    NSGIC GIS Inventory (aka Ramona) — QUARRIES_ABANDONED_IN was derived from a comma-delimited text file named "QUALOC.TXT" contained on the following CD-ROM publication: Hasenmueller, W.A., and Ault,...

  19. Nurses' Attitudes and Knowledge of Their Roles in Newborn Abandonment

    Cesario, Sandra K.

    2003-01-01

    The practice of abandoning newborns shortly after birth has always existed. Occurring in primitive and contemporary societies, the motivations for newborn abandonment are varied and dependent upon the social norms of a specific geographic region at a given point in time. Because the desire to abandon an infant has had no support system in American society, such unwanted infants have been abandoned in a manner leading to their deaths. In response, many states have passed safe-haven legislation...

  20. Working Models about Mother-Child Relationships in Abandoned Children.

    Garcia-Torres, Belen; Guerrero, Pilar Garcia-Calvo

    2000-01-01

    Sixty abandoned and 36 non-abandoned school-aged children were told six short stories about mother-child relationships. Abandoned children showed less positive affect attribution to the mother, more compliant behavior in the child, and more justification of the mother when her behaviors were unfair. (Contains references.) (Author/CR)

  1. 30 CFR 256.56 - Lease-specific abandonment accounts.

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Lease-specific abandonment accounts. 256.56... OF SULPHUR OR OIL AND GAS IN THE OUTER CONTINENTAL SHELF Bonding § 256.56 Lease-specific abandonment accounts. (a) The Regional Director may authorize you to establish a lease-specific abandonment account...

  2. Radical prostatectomy - discharge

    ... prostatectomy - discharge; Laparoscopic radical prostatectomy - discharge; LRP - discharge; Robotic-assisted laparoscopic prostatectomy - discharge ; RALP - discharge; Pelvic lymphadenectomy - ...

  3. Can We Be Less Radical with Surgery for Early Cervical Cancer?

    Macdonald, Madeleine C; Tidy, John A

    2016-03-01

    Although a rare cancer in the developed world due to the success of cervical screening programmes, cervical cancer remains one of the most common cancers diagnosed in women under the age of 35 years old. Radical hysterectomy and more recently radical trachelectomy have been highly effective in curing the majority of women with early stage disease. Many, however, are left with long-term 'survivorship' issues including bowel, bladder and sexual dysfunction. In view of these chronic co-morbidities, many clinicians now consider whether a less radical approach to surgery may be an option for some women. This review focuses on the current evidence for the safety of conservative surgery for early stage cervical cancer with regard to cure rates in comparison to standard management, as well as any improvement in short and long-term morbidity associated with a more conservative approach. PMID:26838586

  4. Free radical inactivation of trypsin

    Reactivities of free radical oxidants, radical OH, Br2-anion radical and Cl3COO radical and a reductant, CO2-anion radical, with trypsin and reactive protein components were determined by pulse radiolysis of aqueous solutions at pH 7, 200C. Highly reactive free radicals, radical OH, Br2-anion radical and CO2-anion radical, react with trypsin at diffusion controlled rates. Moderately reactive trichloroperoxy radical, k(Cl3COO radical + trypsin) preferentially oxidizes histidine residues. The efficiency of inactivation of trypsin by free radicals is inversely proportional to their reactivity. The yields of inactivation of trypsin by radical OH, Br2-anion radical and CO2-anion radical are low, G(inactivation) = 0.6-0.8, which corresponds to ∼ 10% of the initially produced radicals. In contrast, Cl3COO radical inactivates trypsin with ∼ 50% efficiency, i.e. G(inactivation) = 3.2. (author)

  5. Perioperative use of etoricoxib reduces pain and opioid side-effects after total abdominal hysterectomy

    Viscusi, Eugene R; Frenkl, Tara L; Hartrick, Craig T;

    2012-01-01

    -blind, placebo-controlled, randomized clinical trial, we evaluated postoperative pain following total abdominal hysterectomy over 5 days in patients receiving placebo or etoricoxib administered 90 min prior to surgery and continuing postoperatively. Patients were randomly assigned to receive either placebo (n...

  6. Emergency peripartum hysterectomy in a tertiary hospital in Upper Egypt: six years analysis

    Ahmed M. Abbas

    2016-04-01

    Conclusions: The incidence of EPH in Upper Egypt is high. Uterine atony is the major indication for EPH in our hospital. Late referral and delayed decisions to perform hysterectomy contributes in the high mortality rate. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 953-958

  7. Prophylactic antibiotics for hysterectomy and cesarean section: amoxicillin-clavulanic acid versus cefazolin

    Jyoti Malik

    2016-04-01

    Conclusions: Broad spectrum amoxicillin-clavulanic acid was not superior to cefazolin in prevention of post-operative infection when given as prophylaxis in hysterectomy and elective cesarean section. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 980-983

  8. Prediction of peripartum hysterectomy and end organ dysfunction in major obstetric haemorrhage.

    O'Brien, D

    2010-12-01

    The aims of this study are to determine the incidence and aetiology of major obstetric haemorrhage (MOH) in our population, to examine the success rates of medical and surgical interventions and to identify risk factors for peripartum hysterectomy and end organ dysfunction (EOD).

  9. Single-port access laparoscopic hysterectomy: a new dimension of minimally invasive surgery.

    Liliana, Mereu; Alessandro, Pontis; Giada, Carri; Luca, Mencaglia

    2011-01-01

    The fundamental idea is to have all of the laparoscopic working ports entering the abdominal wall through the same incision. Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus and reduces morbidity of minimally invasive surgery. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. This review summarizes the history of SPAL hysterectomy (single-port access laparoscopy), and emphasizes nomenclature, surgical technique, instrumentation, and perioperative outcomes. Specific gynecological applications of single-port hysterectomy to date are summarized. Using the PubMed database, the English-language literature was reviewed for the past 40 years. Keyword searches included scarless, scar free, single-port/trocar/incision, single-port access laparoscopic hysterectomy. Within the bibliography of selected references, additional sources were retrieved. The purpose of the present article was to review the development and current status of SPAL hysterectomy and highlight important advances associated with this innovative approach. PMID:22442528

  10. Peripartum hysterectomy in the first decade of the 21st century.

    Tadesse, W

    2012-02-01

    We reviewed the role of peripartum hysterectomy (PH) in the first decade of the 21st century. The study was confined to women who delivered a baby weighing 500 g or more between 2000 and 2009, and who required a hysterectomy within 72 h of delivery for obstetric reasons. Individual case records were reviewed. There were 19 cases of PH in 78,961 deliveries giving an incidence of 1 in 4,156 (0.02%). Of the 19 cases, 95% were delivered by caesarean section and 89% had one or more prior sections. The indications were placental bed pathology (79%), uterine atony (16%) and uterine trauma (5%). Of the 19 hysterectomies, 16 (84%) were total and a gynaecological oncologist was involved in nine (56%) of these cases. There were no maternal or fetal deaths, but a mother required an average blood transfusion of 10 units. The overall rate of PH was remarkably low compared with other studies but it is likely to increase in the future because of the strong association between increasing caesarean section rates and placental bed pathology. The potential involvement of the cervix and other pelvic structures by placental pathology means that PH in the future will be more challenging, and the hysterectomy will need to be total rather than subtotal.

  11. A six year review of hysterectomy for benign gynaecological conditions at the Federal Medical Centre, Owerri

    Duke A. Onyeabochukwu

    2014-04-01

    Conclusions: Hysterectomy for benign gynaecological conditions is relatively common and safe in our centre, but there is need for improvement on the high post-operative morbidity rate. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 352-356

  12. Multi-institute survey on actual conditions of urologic management for severe bladder dysfunction after hysterectomy

    We conducted a multi-institute survey on the conditions related to urologic management of severe voiding dysfunction after hysterectomy for uterine cancer with or without postoperative irradiation. Our first study population was a group of adult female patients currently managed by urologists, using clean intermittent catheterization (CIC). Of the 287 patients in this group, 99 (34%) had suffered from uterine cancer. Of these patients, 94 underwent hysterectomy for this disease; 44 and 30 were treated with or without postoperative radiation, respectively, while postoperative irradiation status was unknown for 20. Median follow-up after surgery was 21 (0.2-52) years and median interval from operation to the introduction of CIC was 4.0 (0-49) years. CIC tended to be introduced later for patients with postoperative radiation than those without it. Seventy-four patients, who required invasive urologic interventions other than CIC for voiding dysfunction after hysterectomy, are the second study population. Most of these (82%) had received postoperative irradiation. Continuous Foley catheter placement was the most frequent procedure. Long-term follow-up and urologic management for voiding dysfunction is required for patients undergoing hysterectomy. (author)

  13. Inflammatory response in patients undergoing uterine artery embolization as compared to patients undergoing conventional hysterectomy

    Brøchner, A C; Mygil, B; Elle, B;

    2009-01-01

    BACKGROUND: Uterine fibroids are benign tumors seen in 20-40% of women of childbearing age, and these fibroids are usually treated by hysterectomy. During the last decade, embolization of the uterine arteries with polyvinyl alcohol microparticles has become an alternative treatment. PURPOSE: To...

  14. Explosives remain preferred methods for platform abandonment

    Economics and safety concerns indicate that methods involving explosives remain the most practical and cost-effective means for abandoning oil and gas structures in the Gulf of Mexico. A decade has passed since 51 dead sea turtles, many endangered Kemp's Ridleys, washed ashore on the Texas coast shortly after explosives helped remove several offshore platforms. Although no relationship between the explosions and the dead turtles was ever established, in response to widespread public concern, the US Minerals Management Service (MMS) and National Marine Fisheries Service (NMFS) implemented regulations limiting the size and timing of explosive charges. Also, more importantly, they required that operators pay for observers to survey waters surrounding platforms scheduled for removal for 48 hr before any detonations. If observers spot sea turtles or marine mammals within the danger zone, the platform abandonment is delayed until the turtles leave or are removed. However, concern about the effects of explosives on marine life remains

  15. Effects of institutional changes on land use: agricultural land abandonment during the transition from state-command to market-driven economies in post-Soviet Eastern Europe

    Prishchepov, Alexander V.; Radeloff, Volker C.; Baumann, Matthias; Kuemmerle, Tobias; Müller, Daniel

    2012-06-01

    Institutional settings play a key role in shaping land cover and land use. Our goal was to understand the effects of institutional changes on agricultural land abandonment in different countries of Eastern Europe and the former Soviet Union after the collapse of socialism. We studied ˜273 800 km2 (eight Landsat footprints) within one agro-ecological zone stretching across Poland, Belarus, Latvia, Lithuania and European Russia. Multi-seasonal Landsat TM/ETM + satellite images centered on 1990 (the end of socialism) and 2000 (one decade after the end of socialism) were used to classify agricultural land abandonment using support vector machines. The results revealed marked differences in the abandonment rates between countries. The highest rates of land abandonment were observed in Latvia (42% of all agricultural land in 1990 was abandoned by 2000), followed by Russia (31%), Lithuania (28%), Poland (14%) and Belarus (13%). Cross-border comparisons revealed striking differences; for example, in the Belarus-Russia cross-border area there was a great difference between the rates of abandonment of the two countries (10% versus 47% of abandonment). Our results highlight the importance of institutions and policies for land-use trajectories and demonstrate that radically different combinations of institutional change of strong institutions during the transition can reduce the rate of agricultural land abandonment (e.g., in Belarus and in Poland). Inversely, our results demonstrate higher abandonment rates for countries where the institutions that regulate land use changed and where the institutions took more time to establish (e.g., Latvia, Lithuania and Russia). Better knowledge regarding the effects of such broad-scale change is essential for understanding land-use change and for designing effective land-use policies. This information is particularly relevant for Northern Eurasia, where rapid land-use change offers vast opportunities for carbon balance and biodiversity

  16. Effects of institutional changes on land use: agricultural land abandonment during the transition from state-command to market-driven economies in post-Soviet Eastern Europe

    Institutional settings play a key role in shaping land cover and land use. Our goal was to understand the effects of institutional changes on agricultural land abandonment in different countries of Eastern Europe and the former Soviet Union after the collapse of socialism. We studied ∼273 800 km2 (eight Landsat footprints) within one agro-ecological zone stretching across Poland, Belarus, Latvia, Lithuania and European Russia. Multi-seasonal Landsat TM/ETM + satellite images centered on 1990 (the end of socialism) and 2000 (one decade after the end of socialism) were used to classify agricultural land abandonment using support vector machines. The results revealed marked differences in the abandonment rates between countries. The highest rates of land abandonment were observed in Latvia (42% of all agricultural land in 1990 was abandoned by 2000), followed by Russia (31%), Lithuania (28%), Poland (14%) and Belarus (13%). Cross-border comparisons revealed striking differences; for example, in the Belarus–Russia cross-border area there was a great difference between the rates of abandonment of the two countries (10% versus 47% of abandonment). Our results highlight the importance of institutions and policies for land-use trajectories and demonstrate that radically different combinations of institutional change of strong institutions during the transition can reduce the rate of agricultural land abandonment (e.g., in Belarus and in Poland). Inversely, our results demonstrate higher abandonment rates for countries where the institutions that regulate land use changed and where the institutions took more time to establish (e.g., Latvia, Lithuania and Russia). Better knowledge regarding the effects of such broad-scale change is essential for understanding land-use change and for designing effective land-use policies. This information is particularly relevant for Northern Eurasia, where rapid land-use change offers vast opportunities for carbon balance and

  17. Detecting abandoned objects using interacting multiple models

    Becker, Stefan; Münch, David; Kieritz, Hilke; Hübner, Wolfgang; Arens, Michael

    2015-10-01

    In recent years, the wide use of video surveillance systems has caused an enormous increase in the amount of data that has to be stored, monitored, and processed. As a consequence, it is crucial to support human operators with automated surveillance applications. Towards this end an intelligent video analysis module for real-time alerting in case of abandoned objects in public spaces is proposed. The overall processing pipeline consists of two major parts. First, person motion is modeled using an Interacting Multiple Model (IMM) filter. The IMM filter estimates the state of a person according to a finite-state, discrete-time Markov chain. Second, the location of persons that stay at a fixed position defines a region of interest, in which a nonparametric background model with dynamic per-pixel state variables identifies abandoned objects. In case of a detected abandoned object, an alarm event is triggered. The effectiveness of the proposed system is evaluated on the PETS 2006 dataset and the i-Lids dataset, both reflecting prototypical surveillance scenarios.

  18. Radical theory of rings

    Gardner, JW

    2003-01-01

    Radical Theory of Rings distills the most noteworthy present-day theoretical topics, gives a unified account of the classical structure theorems for rings, and deepens understanding of key aspects of ring theory via ring and radical constructions. Assimilating radical theory's evolution in the decades since the last major work on rings and radicals was published, the authors deal with some distinctive features of the radical theory of nonassociative rings, associative rings with involution, and near-rings. Written in clear algebraic terms by globally acknowledged authorities, the presentation

  19. Radiation Therapy Results of Invasive Cervical Carcinoma Found After Inappropriate Hysterectomy

    Choi, Doo Ho; Kim, Eun Seog; Nam, Kae Hyun; Huh, Seung Jae [Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    1996-09-15

    Purpose : Hysterectomy without lymph node dissection was considered an inadequate treatment method for invasive uterine cervix cancer. Usually the procedure was performed inadvertently on patients who were thought to have benign or premalignant conditions preoperatively. We analysed radiotherapy results of such patients to evaluate survival rates, failure patterns and prognostic factors according to various conditions. Methods and Materials : Sixty one patients undergoing hysterectomy in the presence of invasive cervical carcinoma were reviewed retrospectively. Preoperative diagnosis were carcioma in situ (38 cases), severe dysplasia(2), myoma(6), uterine bleeding (4), uterine prolapse (2), and early invasive cervix cancer (10) (One patient had myoma and carcinoma in situ coincidently). Patients received postoperative megavoltage radiotherapy form August 1985 to December 1993, and minimum follow-up period was 24 months. Eight patients reveived ICR only, 6 patients ICR and external radiation, and 47 patients received external radiation therapy only. Results : Overall 5-year survival rate and relapse-free survival rate were 83.8%, 86.9% respectively. For patients with retrospective stage IA, IB, IIB (gross residual after surgery), and vaginal cuff recurrence were 90.9%, 88.8%, 38.4%, and 100% respectively. There were 8 cases of treatment failure, most of them (5/8) were in patients with gross residual disease, other patients were full thickness involvement of cervix wall (2/8) except one. Patients with early vaginal cuff recurrence and microinvasive cervical cncer (stage IA) had no treatment related failure. Prognostic factors affecting survival by univariate analysis were status of residual disease, tumor histology and retrospective stage. Conclusion : Adjuvant radiotherapy appeared to be effective treatment method for patients with presumed stage IA, IB and early local recurrent disease after inadvertent hysterectomy. Survivals for patients with gross disease

  20. Pattern of mental ill health morbidities following hysterectomy for benign gynaecological disorders among Nigerian women

    Morhason-Bello Imran O

    2009-07-01

    Full Text Available Abstract Objective to compare the pre and post hysterectomy mental ill health (MIH status and also, to determine whether there is any association with the surgical indication. Methodology An observational study, conducted among women scheduled for hysterectomy at the University College Hospital, Ibadan from January till June 2005. The MIH morbidities were assessed using a validated general health questionnaire (GHQ before and after the surgery by trained research assistant. The score of 4 and above was used as the cut off. Cross tabulations were performed to detect any association and also to compare pre and post hysterectomy mental health status. The level of statistical significance was set at P Results Of the 50 women recruited, 45 participated in the study. The age range of the participants was 35 to 63 years with a mean of 48.6 (SD = 0.6 years. Anxiety related disorder was present in 20 (44.4%, and depression in 3 (6.7% before hysterectomy. Post surgery, there was significant increase in those with anxiety by 6.8% and a reduction in the proportion of depressive illness by 2.3%. Uterine fibroid as a preoperative diagnosis, had significant association among those with anxiety related disorder (68.4% and depression (10.5%. Conclusion This study suggests that mental ill health may complicates hysterectomy for benign uterine pathology among Nigerian women, and that anxiety related disorders increases after operation with the highest proportion in those with clinical diagnosis of Uterine Fibroid. We recommend adequate preoperative counseling using properly trained psychologists when affordable to minimize these morbidities.

  1. Anti-hemorrhagic effect of prophylactic tranexamic acid in benign hysterectomy - a double-blinded randomized placebo-controlled trial

    Fink Topsøe, Märte; Bergholt, Thomas; Ravn, Pernille;

    2016-01-01

    to benign hysterectomy is still missing. OBJECTIVE: To investigate the anti-hemorrhagic effect of prophylactic tranexamic acid in elective benign hysterectomy. STUDY DESIGN: A double-blinded randomized placebo-controlled trial was conducted at four Gynecological departments in Denmark from April 2013...... in 2004, 8% of all women in Denmark undergoing benign hysterectomy experienced a bleeding complication. Tranexamic acid is an anti-fibrinolytic agent that has shown to effectively reduce bleeding complications within other surgical and medical areas. However, knowledge on the drugs effect in relation...... to October 2014. A total of 332 women undergoing benign abdominal, laparoscopic or vaginal hysterectomy were included in the trial, and randomized to either 1 g of intravenous tranexamic acid or placebo at start of surgery. Chi-test and Student T-test statistical analyses were applied. RESULTS: The...

  2. Preoperative radium therapy and radical hysterectomy in the treatment of cervical cancer stage IB, IIA, and initial IIB

    Patients with IB, IIa and in initial IIb cervical cancer were randomized for combined therapy, consisting of one or two radium insertion followed by Wertheim Meigs operation performed 40 days later. We look for the early and late complications of the treatment, residual cancer after radiotherapy and survival without recurrence. The project begin in 1965 and ended in 1986. All the operations were done by one of the investigators and 116 patients were analysed. The age ranged from 21 to 75 years with an average of 4.18 years. During the operations 31 (26.72%) patients needed 1.500 cc or greater amount of blood transfusion and we have 3 iliac veins lesions. Managing the ureters, we do our best to leave the posterior fascia as intact as possible. Post operative complications ranged from minor (fever, localised pelvic infections, temporary popliteal nerve paralysis) to evisceration (3 patients) deep venous thrombosis (3 patients) and two early urinary fistulas. Late complications were seen in patients submitted to sequential teletherapy irradiation. One uretrovaginal fistula occurred 10 month after treatment, another one, 7 years later and the third one 24 years later. One patient develop hydronefrosis and enterocolite after 7.000 rads of teletherapy and another one rectovaginal fistula 13 years after initial therapy. The shortening of the vagina making impossible the intercourse was seen in 7 patients. By the histological examination, the cervix was sterilized in 73.3 % of the patients. Residual cancer was found according the original size of the tumour and the stage of the disease. Studying different combinations between the existence of residual cervical cancer with positive or negative limphnodes and making a correlation with survival, we found the critical points is to have positive cervix and [positive lymphonodes. The five years survival (life table methodology) for stage 1 lesion was 96%; stage II, 67%. At ten years survival was slighted different. With positive lymphnodes the survival was 47.38%. We believe the combined therapy has an important place in the treatment of cervical cancer stage I,IIA and initial IB. (author)

  3. Integrated interventions for improving negative emotions and stress reactions of young women receiving total hysterectomy.

    Wang, Fen; Li, Chun-Bo; Li, Shenghua; Li, Quan

    2014-01-01

    50% of women had obvious abnormal emotions before hysterectomy and hysterectomy can cause strong mental stress reaction. This study was to investigate the impact of psychological health education based integrated interventions on the preoperative negative emotions and stress of patients younger than 45 years receiving total hysterectomy. Forty patients undergoing total hysterectomy were randomly divided into psychological intervention (PI) group and control group (n=20 per group). Patients in PI received peri-operative psychological intervention (supportive psychotherapy, health education, individual depth psychotherapy, family and society supportive care, education on anesthesia and surgery etc.); Interventions were not used in control group. Hamilton Anxiety Scale and Hamilton Depression Rating Scale were used to evaluate patients in two groups on admission (T1) and before surgery (T2; after interventions in PI group). Serum levels of cortisol and IL-6 were detected at T1, T2 and the second day after surgery (T3). Results showed that 1) Patients had obvious anxiety and depression symptoms before and after total hysterectomy. For patients in PI group, the Hamilton Anxiety Scale (HAMA) score decreased from 14.4±5.9 to 9.1±4.2 and the Hamilton Depressing Scale (HAMD) score from 17.8±3.5 to 9.4±6.8 after interventions; 2) In PI group, the serum cortisol was 13.4±3.9 μg/dl at T2 and 14.2±4.8 μg/dl at T3 which were significantly lower than that at T1 (16.6±4.0 μg/dl) and that in the control group at T2 (13.4±3.9/15.5±4.3 μg/dl, t=2.10, P<0.05). Thus, preoperative integrated intervention based on psychological health education can improve peri-operative negative emotions and psychological stress in young patients undergoing hysterectomy. PMID:24482729

  4. Comparison of ramosetron's and ondansetron's preventive anti-emetic effects in highly susceptible patients undergoing abdominal hysterectomy

    Lee, Jae-Woo; Park, Hye Jin; Choi, Juyoun; Park, So Jin; Kang, Hyoseok; Kim, Eu-Gene

    2011-01-01

    Background This study compared the preventive effects of ramosetron and ondansetron on postoperative nausea and vomiting (PONV) in highly susceptible patients undergoing abdominal hysterectomy. Methods In a prospective, randomized, double-blinded study, a total of 120 highly susceptible women (nonsmokers, those receiving opioid-based IV patient-controlled analgesia [PCA]) undergoing abdominal hysterectomy were included in the study. Patients were divided into 2 groups and each group received ...

  5. Emergency peripartum hysterectomy- a study in tertiary care centre and medical college in Hubli, North Karnataka, India

    Sahaja Kittur; Swetha D.

    2016-01-01

    Background: Post-partum haemorrhage is a significant cause of maternal mortality and morbidity. The objective of the study was to evaluate the incidence, predisposing factors and associated complications and outcome of emergency peripartum hysterectomy. Methods: It is a prospective analysis of emergency peripartum hysterectomy conducted at tertiary care centre at Karnataka Institute of Medical Sciences, Hubli, Karnataka, India between June 2013 to December 2015. Age, parity, traumatic o...

  6. Impact of stress coping capacity on recovery from abdominal hysterectomy in a fast-track programme: a prospective longitudinal study

    Kjölhede, Preben; Borendal Wodlin, Ninnie; Nilsson, Lena; Fredrikson, Mats; Wijma, Klaas

    2012-01-01

    Objective To evaluate the effect of stress coping capacity in combination with mode of anaesthesia on postoperative recovery in fast-track abdominal hysterectomy. Design Prospective longitudinal study. Setting Five hospitals in the south-east of Sweden. Population A cohort of 162 women undergoing fast-track abdominal hysterectomy for benign conditions. Methods Self-administered questionnaires, the Stress Coping Inventory (SCI) and the Swedish Postoperative Symptom Questionnaire (SPSQ), and cl...

  7. Abandonment: Technological, organisational and environmental challenges

    The paper deals with the abandonment of offshore wells. Decommissioning of offshore installations is a complex multi-disciplined issue, which raises a number of technical, organisational and environmental challenges. The success of a planned decommissioning operation depends on the development of a clear understanding of the complex blend of drivers which control the decommissioning process and their inter-relationship. Due to the complexity of the inter-relationship between the primary drivers one cannot separate the technological, organisational and environmental issues raised by the decommissioning of offshore installations. The optimal solution will be a compromise between all the decommissioning drivers mentioned in this paper. 5 figs., 3 tabs

  8. Phase-in, abandonment, and cost disallowances

    The major regulatory challenge to the electric utility industry appears to be coming from the financial side with its bookkeeping and financial reporting requirements. The author describes the accounting procedures and problems associated with straightforward phase-in rate treatment, abandonment, excess capacity, cost allowances, etc. She concludes that the available options to the Financial Accounting Standards Board are to adopt either the proposed exposure draft or a modification of the draft, to drop the proposed draft of amendments to Statement No. 71, or issue a whole new exposure draft

  9. Mercury distribution in an abandoned metallurgical plant

    Millán R.; Sierra M. J.; Schmid T.; Carrasco Gil S.; Sánchez Ledesma D. M.; Díaz Puent F. J.

    2013-01-01

    The aim of the work is to evaluate the spatial distribution of Hg in the soil-plant system within an area where intense activity of Hg was dominant over a long period. An abandoned metallurgical plant from the 17th-18th centuries was chosen as the study area. It is situated in Almadenejos within the Almadén mining district (Spain) that constitutes the largest and most unusual concentration of mercury in the world and has provided a third of the entire world production of mercury (Hg). Nowaday...

  10. Should executive stock options be abandoned?

    Choe, Chongwoo; Yin, Xiangkang

    2006-01-01

    Recent corporate scandals around the world have led many to single out executive stock options as one of the main culprits. More corporations are abandoning stock options and reverting to restricted stock. This paper argues that such a change is not entirely justifiable. We first provide a critical review of the pros and cons of executive stock options. We then compare option-based contracts with stock-based contracts using a simple principal-agent model with moral-hazard. In a general enviro...

  11. Laparoscopic radical cystectomy

    Fergany, Amr

    2012-01-01

    Objective Laparoscopic radical cystectomy (LRC) has emerged as a minimally invasive alternative to open radical cystectomy (ORC). This review focuses on patient selection criteria, technical aspects and postoperative outcomes of LRC. Methods Material for the review was obtained by a PubMed search over the last 10 years, using the keywords ‘laparoscopic radical cystectomy’ and ‘laparoscopic bladder cancer’ in human subjects. Results Twenty-two publications selected for relevance and content we...

  12. Setting plug & abandonment barriers with minimum removal of tubulars

    Nessa, Jon Olav

    2012-01-01

    The useful life of an offshore well is determined by the reserves which it contacts, the pressure support within the reservoir and the continued integrity of the wellbore. When a well has reached the end of its lifetime, plugging operations have to be conducted before permanent abandonment. Conventional Plug and Abandonment (P&A) operations will often require removing a section of the casing in order to create cross sectional barriers for well abandonment. Recently developed and field test...

  13. Sexuality and Body Image After Uterine Artery Embolization and Hysterectomy in the Treatment of Uterine Fibroids: A Randomized Comparison

    In this paper the effect of uterine artery embolization (UAE) on sexual functioning and body image is investigated in a randomized comparison to hysterectomy for symptomatic uterine fibroids. The EMbolization versus hysterectoMY (EMMY) trial is a randomized controlled study, conducted at 28 Dutch hospitals. Patients were allocated hysterectomy (n = 89) or UAE (n 88). Two validated questionnaires (the Sexual Activity Questionnaire [SAQ] and the Body Image Scale [BIS]) were completed by all patients at baseline, 6 weeks, and 6, 12, 18, and 24 months after treatment. Repeated measurements on SAQ scores revealed no differences between the groups. There was a trend toward improved sexual function in both groups at 2 years, although this failed to reach statistical significance except for the dimensions discomfort and habit in the UAE arm. Overall quality of sexual life deteriorated in a minority of cases at all time points, with no significant differences between the groups (at 24 months: UAE, 29.3%, versus hysterectomy, 23.5%; p = 0.32). At 24 months the BIS score had improved in both groups compared to baseline, but the change was only significant in the UAE group (p = 0.009). In conclusion, at 24 months no differences in sexuality and body image were observed between the UAE and the hysterectomy group. On average, both after UAE and hysterectomy sexual functioning and body image scores improved, but significantly so only after UAE

  14. Schoenberg and the Radical Economies of Harmonielehre

    Murray Dineen

    2009-06-01

    Full Text Available This article examines Schoenberg’s Harmonielehre as a text shaped by the influence of Central European science and politics. In accord with a severely economical approach to his subject, Schoenberg’s critique of figured bass and chorale harmonization is compared with Ernst Mach’s writings on scientific method. In support of this comparison, the article addresses the role played in Schoenberg’s political development by the Leftist editor and organizer, David J. Bach, one of Schoenberg’s closest childhood friends and a student of Mach. The comparison between Schoenberg and Mach, then, is drawn not only in terms of scientific method but also in light of the radical politics of the Austrian Left at the time, a politics for which both Mach and Schoenberg held sympathies. It should not be overlooked that later, however, they ceased to acknowledge these sympathies explicitly, and Schoenberg would appear to have abandoned them entirely.

  15. Emergency Peripartum Hysterectomies at a District General Hospital in United Kingdom: 10-Year Review of Practice

    J. Chester

    2016-01-01

    Full Text Available Peripartum haemorrhage is an obstetric emergency which requires effective and timely management. A retrospective analysis was conducted at a single centre district hospital, over a 10-year period to describe factors that would lead to a peripartum hysterectomy. We sought to establish intraoperative and postoperative risks and review outcomes and complications associated with the procedure. A total of 29 cases (incidence 0.8 per 1000 were reviewed over 2001–2011. The mean parity was 1.8 and the mean maternal age was 33 years. Uterine atony was the most common indication for hysterectomy (12/29 followed by placenta praevia and accreta (4/29 and 5/29 cases, resp.. The commonest postoperative complications were sepsis and paralytic ileus. EPH most commonly occurs due to uterine atony but remains difficult to predict. Hospitals should continue to have robust systems and the necessary resources available to perform EPH where clinically indicated.

  16. Early postoperative mortality following hysterectomy. A Danish population based study, 1977-1981

    Loft, Anne; Andersen, T F; Brønnum-Hansen, Henrik; Roepstorff, Carsten; Madsen, Mette

    1991-01-01

    The main objective of this cohort study was to analyse the early postoperative mortality after 'simple' hysterectomy for benign indications and to compare it with that of a randomly selected reference group of women matched for age. Registry data covering the entire Danish female population were...... used. Included in the study were all patients operated in the period 1977-1981. Patients were only included if no cancer was diagnosed and if no major co-surgery was performed (29,192 patients). Cancer patients were also excluded in the reference group (16,182 women). Mortality was studied according to...... characteristics of patients, their residential area, the surgical approach and operating hospital. Overall 47 patients died within 30 days of admission for hysterectomy (overall mortality 16.1 per 10,000). Only seven deaths were expected on the basis of the population sample, and adjusted for age, the relative...

  17. Acute Colonic Pseudo-Obstruction (Ogilvie's Syndrome) Following Total Laparoscopic Hysterectomy.

    Cebola, Monique; Eddy, Eliza; Davis, Suzanne; Chin-Lenn, Laura

    2015-01-01

    Rapid identification of acute colonic pseudo-obstruction (ACPO), or Ogilvie's syndrome, is paramount in the management of this condition, which, if unresolved, can progress to bowel ischemia and perforation with significant morbidity and mortality. We present the first case report, to our knowledge, of ACPO following total laparoscopic hysterectomy. We describe the presentation and management of ACPO in a patient who underwent uncomplicated total laparoscopic hysterectomy to treat menorrhagia and dysmenorrhea after declining conservative treatment. Following initial conservative management, the patient rapidly deteriorated and required laparotomy for clinically suspected cecal ischemia. Cecal resection, colonic decompression, and end ileostomy formation were performed. A brief review of the current literature is presented with respect to the case report. PMID:26164536

  18. Utility of endometrial sampling prior to risk-reducing hysterectomy in a patient with Lynch syndrome

    Frey, Melissa K; David-West, Gizelka; Mittal, Khushbakhat R; Muggia, Franco M; Pothuri, Bhavana

    2016-01-01

    Occult endometrial cancer is occasionally discovered in women with Lynch syndrome undergoing risk-reducing hysterectomy. The case presented here demonstrates that preoperative endometrial sampling can help detect these occult cancers; however, there are currently no recommendations for this preoperative intervention. A 50-year-old woman with Lynch syndrome underwent endometrial sampling prior to planned risk-reducing hysterectomy and bilateral salpingo-oophorectomy. The endometrial biopsy demonstrated a serous endometrial cancer. The patient was counselled regarding the diagnosis and revised operative plan, which now included staging, prior to surgery. Although the prevalence of occult endometrial cancer at the time of risk-reducing surgery in women with Lynch syndrome remains unknown, preoperative endometrial sampling may allow for improved patient counselling and surgical planning in this population, and can help avoid a subsequent surgery for staging. PMID:26823682

  19. Transversus abdominis plane (TAP) block after robot-assisted laparoscopic hysterectomy

    Torup, H; Bøgeskov, M; Hansen, E G;

    2015-01-01

    on top of paracetamol and ibuprofen or diclofenac. For the first 24 post-operative hours, we monitored PCA morphine consumption and pain scores with visual analogue scale (VAS) at rest and while coughing. Post-operative nausea and number of vomits (PONV) were recorded. RESULTS: Sixty-five patients......BACKGROUND: Transversus abdominis plane (TAP) block is widely used as a part of pain management after various abdominal surgeries. We evaluated the effect of TAP block as an add-on to the routine analgesic regimen in patients undergoing robot-assisted laparoscopic hysterectomy. METHODS: In a...... and Nonsteroidal anti-inflammatory drugs (NSAID) treatment, had no effect on morphine consumption, VAS pain scores, or frequency of nausea and vomiting after robot-assisted laparoscopic hysterectomy compared with paracetamol and NSAID alone....

  20. LigaSure versus Conventional Suture Ligature for Vaginal Hysterectomy: a Randomized Controlled Trial

    Mohamed Abd Elzaher, a, b, Ashraf Moawad, a, c and Hanaa Abu-Ria

    2011-01-01

    Introduction: Vaginal hysterectomy is considered to be the method of choice for removal of the uterus. Of particular concern for the vaginal surgeon is the ability to access, visualize, and legate structures while maintaining adequate hemostasis. Surgical hemostasis can be secured by a variety of methods, including mechanical means (sutures) or vessel coagulation (diathermy). Electro-surgical vessel sealing (LigaSure) is a new hemostatic system based on the combination of pressure and bipolar...

  1. Hysterectomy and laparoscopic staging of endometrial cancer. Initial experience of 11 cases

    The objective of this work is to describe the results obtained in performing laparoscopy for endometrial cancer in the Gynecologic Oncologic and Endoscopic service in the Pereira Rossell Hospital. A descriptive study included 11 patients programmed for laparoscopic hysterectomy in a period of 12 months between March 2011 and March 2012. The main variables considereded are: age, admission diagnosis, surgical history, body weight, operative time, blood loss, intraoperative complications, length of hospital stay and postoperative course

  2. Transvaginal Laparoscopic Appendectomy Simultaneously with Vaginal Hysterectomy: Initial Experience of 10 Cases

    Tian, Yu; Wu, Shuo-Dong; Chen, Ying-Han; Wang, Dan-Bo

    2014-01-01

    Background Natural orifice transluminal endoscopic surgery (NOTES) involves the introduction of instruments through a natural orifice into the peritoneal cavity to perform surgical interventions. The vagina is the most widely used approach to NOTES. We report the utilization of the vaginal opening at the time of vaginal hysterectomy as a natural orifice for laparoscopic appendectomy. Material/Methods We reviewed cases of 10 patients with chronic appendicitis who underwent transvaginal laparos...

  3. Adenomyosis: Epidemiology, Risk Factors, Clinical Phenotype and Surgical and Interventional Alternatives to Hysterectomy

    Taran, F. A.; Stewart, E. A.; Brucker, S.

    2013-01-01

    Adenomyosis is an important clinical challenge in gynecology and healthcare economics; in its fully developed form, hysterectomy is often used to treat it in premenopausal and perimenopausal women. Symptoms of adenomyosis typically include menorrhagia, pelvic pain and dysmenorrhea. Moreover, adenomyosis and leiomyomas commonly coexist in the same uterus, and differentiating the symptoms for each pathological process can be problematic. Although it has been recognized for ove...

  4. Development of Transvaginal Uterus Amputation Device for Laparoscopic Hysterectomies in Gynecologic Surgeries

    Serkan DİKİCİ

    2015-01-01

    Full Text Available Hysterectomy, that is removal of uterus, is one of the most common major operations in gynecologic surgeries. Laparoscopy technique is preferred in hysterectomy because of its advantages such as lower intra-operative blood loss, decreased surrounding tissue/organ damage, less operating time, lower postoperative infection and frequency of fever, shorter duration of hospitalization and post-operative returning time to normal activity. During total laparoscopic hysterectomy, first uterine vessels and ligaments are cauterized respectively, and then cervicovaginal connections are cauterized and coagulated to remove uterus completely. Uterine manipulators are used during laparoscopy to maximize the endoscopic vision of surgeons by moving related organs. However, conventional uterine manipulators have important drawbacks particularly to move uterus in three dimensions and to show cervicovaginal landmark during laparoscopic circular cauterization and amputation of the uterine cervix. A new transvaginal uterine manipulator may overcome these two important drawbacks of these currently available devices. For this reason, a3D scanned technique was used to get uterus sizes and computer aided design software is used in designing of the new manipulator and then 3D printer was used in prototyping. Special light emitting diodes (LEDs were mounted on the cervical cap of the manipulator to guide light beams from inside of cervicovaginal tissue to abdominal cavity to facilitate the visualization of tissue landmarks. Moreover, performances of different caps and LED systems will be evaluated. Furthermore, after integration of self-cutting and self-suturing mechanisms into our system, final prototype will be produced by using titanium which is biologically and mechanically appropriate. Therefore, aim of this study was to design and produce a new uterine manipulator with three dimensional movements, LED illumination, self-cutting and self-suturing systems to facilitate

  5. Analgesic effect of ultrasound-guided transversus abdominis plane block after total abdominal hysterectomy

    Røjskjaer, Jesper O; Gade, Erik; Kiel, Louise B;

    2015-01-01

    OBJECTIVE: To assess the effect of bilateral ultrasound-guided transversus abdominis plane block with ropivacaine compared with placebo as part of a multimodal analgesic regimen. DESIGN: A randomized, double-blind, placebo-controlled trial following the CONSORT criteria. SETTING: Hvidovre...... ultrasound-guided transversus abdominis plane block in women undergoing total abdominal hysterectomy. As part of a multimodal regimen the transversus abdominis plane block showed some effect on pain scores at rest only in the early postoperative period....

  6. Emergency peripartum hysterectomy: a retrospective study at a tertiary care hospital

    Ranjana Patil; Anupama Dave

    2016-01-01

    Background: The main objective is to study the incidence, demographic profile, indications and feto-maternal outcome associated with emergency peripartum hysterectomy (EPH). Methods: We conducted a retrospective, observational study over a period of 5 years; from January 2011 to December 2015.We studied 81 patients who underwent EPH for various indications in Department of Obstetrics and Gynaecology, MGM Medical College, Indore. Results: The rate of EPH in present study was 1.46 per 1...

  7. A prospective study of risk factors for pain persisting 4 months after hysterectomy

    Brandsborg, Birgitte; Dueholm, Margit; Nikolajsen, Lone;

    2009-01-01

    OBJECTIVES: Chronic pain after hysterectomy is reported by 5% to 32% of women, but it is unknown whether the pain is a result of surgery or can be attributable to other factors such as preoperative and postoperative pain, physical, and psychosocial status. The aim of this prospective study was...... most often related to preoperative factors and acute postoperative pain. The relative contribution of surgery itself is small....

  8. Profound bilateral visual loss after hysterectomy indicated for severe postpartum haemorrhage

    Ostri, Christoffer; Zibrandtsen, Nathalie; Larsen, Michael;

    2014-01-01

    We present a case of a patient with bilateral posterior ischaemic optic neuropathy in the previously unreported setting of hysterectomy indicated for severe postpartum haemorrhage. The diagnosis was based on clinical and paraclinical examinations, including MRI of the head, electroretinography (ERG....... The diagnosis of perioperative posterior ischaemic optic neuropathy is mostly a clinical diagnosis. However, MRI plays a major role in excluding other causes of visual loss, and VEP, ERG and OCT are valuable supplemental diagnostic tools....

  9. Effect of preoperative flupirtine on postoperative morphine sparing in patients undergoing total abdominal hysterectomy

    Thapa, D; Ahuja, V; C Dass; S Gombar; Huria, A.

    2016-01-01

    Background: Flupirtine is a unique non-opioid, centrally acting analgesic with muscle relaxant properties. So far no study has evaluated, use of preoperative flupirtine on postoperative morphine sparing effect in patients undergoing total abdominal hysterectomy (TAH). Materials and Methods: We performed a prospective, controlled, and randomized study in 50 female patients of American Society of Anesthesiologists physical status I-II, aged between 30 and 60 years scheduled for TAH under ge...

  10. Minimally invasive vaginal hysterectomy using bipolar vessel sealing: preliminary experience with 500 cases.

    Ghirardini, G; Mohamed, M; Bartolamasi, A; Malmusi, S; Dalla Vecchia, E; Algeri, I; Zanni, A; Renzi, A; Cavicchioni, O; Braconi, A; Pazzoni, F; Alboni, C

    2013-01-01

    The objective of our study was to evaluate surgical outcome of minimally invasive vaginal hysterectomy (MIVH), using the bipolar vessel sealing system (BVSS; BiClamp®). The design was a retrospective analysis (Canadian Task-force Classification II-3). The setting was a secondary care hospital. Records of patients who underwent vaginal hysterectomy for benign indications in our centre between November 2005 and March 2011 were reviewed. The demographic patients' data, indications for surgery, patient history with regard to previous surgery, duration of surgery, blood loss (postoperative hemoglobin drop '∆Hb'), perioperative complications, and length of inpatient stay were collected from the medical records. The intervention was vaginal hysterectomy using BVSS (BiClamp®). Results showed that the mean duration of surgery was 48.9 ± 15.3 min (95% CI, 49.2-52.5). The mean duration of hospital stay was 3.2 ± 1.2 days (95% CI, 2.8-3.2). The mean ∆Hb was 1.4 ± 1.8 g/dl. Overall, conversion to laparotomy was required in three cases (0.6%). Only one haemoperitoneum occurred (0.2%) and this is the only case who required blood transfusion. The main indication for VH was uterine prolapse in 52.0% (n = 260) of cases; uterine fibroids in 37.4% (n = 187); adenomyosis uteri in 4.2% (n = 21); cervical dysplasia in 22 patients (4.4%) and in 2% (n = 10) of patients, endometrial hyperplasia and other pathologies were the indications for VH. It was concluded that electrosurgical bipolar vessel sealing by (BiClamp®) can provide a safe and feasible alternative to sutures in vaginal hysterectomy, resulting in reduced operative time and blood loss, with acceptable surgical outcomes. PMID:23259887

  11. Emergency peripartum hysterectomy, physical and mental consequences: a 6-year study

    Denisa-Oana Bălălău; Romina Marina Sima; Nicolae Bacalbașa; Liana Pleș; Anca Daniela Stănescu

    2016-01-01

    Emergency peripartum hysterectomy (EPH) is performed for massive postpartum hemorrhage following a cesarean delivery or vaginal delivery, in order to save the patient’s life. The current study was performed on a sample of 13.162 patients, which underwent cesarean or vaginal delivery during a period of 6 years, from 2010 to 2015, in Bucur Maternity Hospital. There were two subsequential groups consisting in: 6593 patients with cesarean operations and 6569 patients with vaginal delivery. In 12 ...

  12. Emergency peripartum hysterectomy, physical and mental consequences: a 6-year study

    Denisa-Oana Bălălău

    2016-04-01

    Full Text Available Emergency peripartum hysterectomy (EPH is performed for massive postpartum hemorrhage following a cesarean delivery or vaginal delivery, in order to save the patient’s life. The current study was performed on a sample of 13.162 patients, which underwent cesarean or vaginal delivery during a period of 6 years, from 2010 to 2015, in Bucur Maternity Hospital. There were two subsequential groups consisting in: 6593 patients with cesarean operations and 6569 patients with vaginal delivery. In 12 cases occurred one or more of the risk factors that lead to EPH, divided equally across the two groups above. The main two types of surgery are a more frequent subtotal hysterectomy, which is the preferred type of EPH as it takes less time and is associated with fewer complications, and a total hysterectomy. The majority of procedures were performed at patients over 35 years old (9 of 12, with a median age of 31,16 (ranging from 21 to 44 years old. The most important risk factor present across the lot was multiparity (11 from 12, with cicatricial uterus being the second one (4 of 12. ICU median time was 4,5 days (ranging from 3 to 15 days, with a median blood transfusion necessity of around 2,4 I.U per patient. There were no mother or newborn reported deaths, neither PTSD following EPH.EPH is a procedure performed as last-resort, life-saving surgery, leaving no time for mental preparation of the patients. This may predispose to negative psychological outcomes, especially because they are not part of decision-making process due to the emergency character of hysterectomy.

  13. The impact of nonclinical factors on practice variations: the case of hysterectomies.

    Geller, S E; Burns, L R; Brailer, D J

    1996-01-01

    OBJECTIVE: This study investigates the role of nonclinical factors (physician characteristics) in explaining variations in hysterectomy practice patterns. DATA SOURCES AND STUDY SETTING: Patient discharge data are obtained from the Arizona state discharge database for the years 1989-1991. Physician data are obtained from the Arizona State Medical Association. The analyses are based on 36,104 cases performed by 339 physicians in 43 hospitals. STUDY DESIGN: This article measures the impact of p...

  14. Physiology of free radicals

    Stevanović Jelka

    2011-01-01

    Full Text Available Free radicals imply that every atom, molecule, ion, group of atoms, or molecules with one or several non-paired electrons in outer orbital. Among these are: nitrogenoxide (NO•, superoxide-anion-radical (O2•-, hydroxyl radical (OH•, peroxyl radical (ROO•, alcoxyl radical (RO• and hydroperoxyl radical (HO2•. However, reactive oxygen species also include components without non-paired electrons in outer orbital (so-called reactive non-radical agents, such as: singlet oxygen (1O2, peroxynitrite (ONOO-, hydrogen-peroxide (H2O2, hypochloric acid (eg. HOCl and ozone (O3. High concentrations of free radicals lead to the development of oxidative stress which is a precondition for numerous pathological effects. However, low and moderate concentrations of these matter, which occur quite normally during cell metabolic activity, play multiple significant roles in many reactions. Some of these are: regulation of signal pathways within the cell and between cells, the role of chemoattractors and leukocyte activators, the role in phagocytosis, participation in maintaining, changes in the position and shape of the cell, assisting the cell during adaption and recovery from damage (e.g.caused by physical effort, the role in normal cell growth, programmed cell death (apoptosis and cell ageing, in the synthesis of essential biological compounds and energy production, as well as the contribution to the regulation of the vascular tone, actually, tissue vascularization.

  15. Frequency of endometrial carcinoma in histopathology of hysterectomy specimen in Hyderabad

    This study was conducted to find the frequency of endometrial carcinoma in histopathology specimens in Hyderabad. All hysterectomy specimens received in the histopathology departments of Isra University Hyderabad and Liaquat University of Medical and Health Sciences Hyderabad during the period of January 2005 to December 2006 were collected. A randomized study of 100 cases undergoing hysterectomy was carried out. Maximum number of women who underwent hysterectomy was in the age group of 25-75 years. Two proformas were designed to get the clinical information and gross and histopathological findings. Specimens were preserved in 10% formalin and thorough naked eye examination was done. Representative blocks were taken and processed for paraffin embedding. Out of 100 cases, endometrial carcinoma was found in 07 (7%) cases. Mean age of the patient was 43.06 +- 7.34 years while the mean age of endometrial carcinoma was 50.71+-9.32 years. Abnormal menstrual flow was the most common complaint. Most of the cases (N= 06) were present in group B that is above the age of 40 years. Furthermore out of these 07 diagnosed cases, 06 cases were present in multiparous women while only one case was found in nulliparous woman. Frequency of endometrial carcinoma is 7% in women of Hyderabad. It is more common above the age of 40 years and in multiparous and grand multiparous women. (author)

  16. Immediate versus delayed hysterectomy for endometrial carcinoma: surgical morbidity and hospital stay

    A retrospective review presented is of the intraoperative complications, postoperative morbidity, and length of hospitalization in 138 patients with stage I endometrial carcinoma treated at Yale-New Haven Hospital from January 1, 1977 to December 31, 1981. One group (stage IA, grade 1) was treated with surgery alone; two groups were treated with preoperative intracavitary radium, followed with either an immediate or a delayed hysterectomy. The three groups were comparable in age, weight, and major preoperative medical problems. The mean estimated blood loss during surgery and transfusion requirements during hospitalization were similar for all three groups. The duration of the surgery in the immediate group was longer than the other two groups. The occurrence of febrile morbidity and major postoperative complications in the three groups was similar, except for bacteriuria, which was significantly more common in the immediate group. The length of the postoperative hospitalization was the same for each group; however, the delayed group as compared with the immediate group had a total hospitalization of two days longer. Hence, in the current study, immediate hysterectomy did not significantly increase the surgical or postoperative morbidity rate, compared with delayed hysterectomy. The single hospital stay in the former treatment group represented cost containment

  17. Unexpected premalignant gynecological lesions in women undergoing vaginal hysterectomy for utero-vaginal prolapse

    Assem A.M. Elbiaa

    2015-09-01

    Full Text Available Aim of the study was to estimate the incidence of unexpected premalignant gynecological lesions in women undergoing vaginal hysterectomy for utero-vaginal prolapse. Material and methods : Eighty women with asymptomatic utero-vaginal prolapse were included in this prospective study for vaginal hysterectomy after preoperative preparation and after written informed consent. Women included in this study were screened preoperatively by high vaginal swab, Pap smear, endometrial biopsy and trans-vaginal ultrasound. Surgically removed uteri and ovaries were sent for histopathological examination. Results of histopathological examination as gold standard were compared with conventional gynecological screening methods. Results : Histopathological examination of surgically removed uteri and ovaries after vaginal hysterectomy for uterovaginal prolapse showed abnormal findings in 61.25% (49/80 of studied cases (10 chronic cervicitis; 20 cervical intra-epithelial neoplasia-1 [CIN-1]; 5 CIN-2; 2 CIN-3; 10 simple endometrial hyperplasia without atypia and 2 simple serous ovarian cyst. Also, histopathological examination showed premalignant changes in 33.75% (27/80 of studied cases (20 CIN-1; 5 CIN-2 and 2 CIN-3, which mean 50% sensitivity of pre-operative Pap smear to detect premalignant cervical changes. Conclusions : Asymptomatic women with utero-vaginal prolapse may have associated premalignant lesions which may not be detected by conventional screening methods, and this should be explained preoperatively for women undergoing surgery, especially if conservative management was considered.

  18. Robotic Compartment-Based Radical Surgery in Early-Stage Cervical Cancer

    Toptas, Tayfun; Uysal, Aysel; Ureyen, Isin; Erol, Onur; Simsek, Tayup

    2016-01-01

    A radical hysterectomy with pelvic lymphadenectomy is the recommended treatment option in patients with early-stage cervical cancer. Although various classifications were developed in order to define the resection margins of this operation, no clear standardization could be achieved both in the nomenclature and in the extent of the surgery. Total mesometrial resection (TMMR) is a novel procedure which aims to remove all components of the compartment formed by Müllerian duct in which female reproductive organs develop. TMMR differs from the conventional radical hysterectomy techniques in that its surgical philosophy, terminology, and partly resection borders are different. In this paper, a TMMR with therapeutic pelvic lymphadenectomy operation that we performed for the first time with robot-assisted laparoscopic (robotic) approach in an early-stage cervical cancer patient was presented. This procedure has already been described in open surgery by Michael Höckel and translated to the robotic surgery by Rainer Kimmig. Our report is the second paper, to our knowledge, to present the initial experience regarding robotic TMMR in the English literature. PMID:27195167

  19. Incidence and Treatment Abandonment in Teen And Young Adult Cancers

    Prakash Chitalkar

    2016-03-01

    Results- On analyzing data of three years ,hematolymphoid malignancy(28% cases are the most common cases seen followed by Breast (10% and head and neck (10%,cervix(6%,CNS(5% ,Bone( 4%. 38% TYA cancer patients abandoned treatment . Telephonic tracking, financial support, counseling of whole family are methods employed in reducing abandonment. [Natl J Med Res 2016; 6(1.000: 77-79

  20. Variation in NHS utilisation of vault smear tests in women post-hysterectomy: A study, using routinely collected datasets

    Wilson Sue

    2008-03-01

    Full Text Available Abstract Background 20% of women living in the UK have a hysterectomy during their lifetime, levels are higher in the USA, making it one of the most commonly performed major surgical procedures. Understanding of the indications for hysterectomy and of the rationale for follow-up of women post hysterectomy is currently limited. Guidelines concerning follow-up by means of vaginal vault cytology tests exist but these are not based on 'gold standard' evidence. Furthermore, the extent to which current practice reflects these guidelines is unclear. This study aims to determine the factors associated with variability in hysterectomy rates and subsequent follow-up after surgery by use of the vaginal vault smear cytology test. Methods/Design All women resident in the West Midlands region, of the United Kingdom, who had a hysterectomy operation between 1st April 2002 and 30th March 2003 will be identified from the Hospital Episodes Statistics database which also contains proxy data on deprivation status, derived from postcode and self declared ethnicity. These data will be linked to regional cervical screening records for each woman and histopathology laboratory records from the relevant hospitals. Study objectives are to describe: Indications for the hysterectomy operation, histology at hysterectomy, subsequent follow-up by use or non-use of vaginal vault cytology tests and variation between histological groups. Additionally the data will be categorised according to a woman's cytology screening history prior to surgery (i.e. always normal, borderline, resolved abnormalities, CIN etc and these different groups compared. Variations in these outcomes according to age, deprivation and ethnic group will also be examined. Analysis will be undertaken using SPSS. Discussion This study will clarify patterns of current practice in one large English region and determine whether this practice reflects existing guidelines. The study will also strengthen the evidence

  1. A 12-year cavern abandonment test

    Brouard B.

    2010-06-01

    Full Text Available In 1997-1998, an abandonment test was performed in a 950-m deep, 8000-m3 salt cavern operated by GDF SUEZ at Etrez, France. In this relatively small brine-filled cavern, which had been kept idle for 15 years before the test, thermal equilibrium was reached. A special system was designed to monitor leaks, which proved to be exceedingly small. In these conditions, brine permeation and cavern creep closure are the only factors to play significant roles in pressure evolution. This test strongly suggested that obtaining an equilibrium pressure such that the effects of these two factors were exactly equal would be reached in the long term. Four years later, pressure monitoring in the closed cavern resumed. Pressure evolution during the 2002-2009 period confirmed that cavern brine pressure will remain constant and significantly smaller than geostatic pressure in the long term, precluding any risk of fracturing and brine seepage to the overburden layers.

  2. Heavy metals biogeochemistry in abandoned mining areas

    Favas P. J. C.

    2013-04-01

    Full Text Available Plants growing on the abandoned Portuguese mines, highly contaminated with W, Sn, As, Cd, Cu, Zn and Pb, have been studied for their biogeochemical indication/prospecting and mine restoration potential. The results of analysis show that the species best suited for biogeochemical indicating are: aerial tissues of Halimium umbellatum (L. Spach, for As and W; leaves of Erica arborea L. for Bi, Sn, W and mostly Pb; stems of Erica arborea L. for Pb; needles of Pinus pinaster Aiton and aerial tissues of Pteridium aquilinum (L. Kuhn for W; and leaves of Quercus faginea Lam. for Sn. The aquatic plant studied (Ranunculus peltatus Schrank can be used to decrease the heavy metals, and arsenic amounts into the aquatic environment affected by acid mine drainages.

  3. THE ESTIMATION OF DIMENSION AND FACTORS OF SCHOOL ABANDON

    Andreea Iluzia IACOB

    2011-12-01

    Full Text Available During the transition period, in Romania, the dimension of school abandon had risen. The main goals of the study are: to estimate the school abandon rate by each educational level in Romania, to identify the factors which affect school abandon on urban and rural areas and at development regions level; to analyze the causes of earlier school abandon. In the same time, the analysis had also followed the temporal component, by including in the database the last decade statistical information. The school abandon was measured as the difference between the numbers of pupils/students found at the end of the school year and the same category enrolled at the beginning of the same year.

  4. Preliminary characterization of abandoned septic tank systems. Volume 1

    This report documents the activities and findings of the Phase I Preliminary Characterization of Abandoned Septic Tank Systems. The purpose of the preliminary characterization activity was to investigate the Tiger Team abandoned septic systems (tanks and associated leachfields) for the purpose of identifying waste streams for closure at a later date. The work performed was not to fully characterize or remediate the sites. The abandoned systems potentially received wastes or effluent from buildings which could have discharged non-domestic, petroleum hydrocarbons, hazardous, radioactive and/or mixed wastes. A total of 20 sites were investigated for the preliminary characterization of identified abandoned septic systems. Of the 20 sites, 19 were located and characterized through samples collected from each tank(s) and, where applicable, associated leachfields. The abandoned septic tank systems are located in Areas 5, 12, 15, 25, and 26 on the Nevada Test Site

  5. Abandoning pipelines working group regulatory issues

    NONE

    1997-03-01

    The history of hydrocarbon development in Louisiana and off its coast is one of the interdependence of technological innovation, entrepreneurial risk-taking, resource management, judicial decisions, legislation, marketing, employee good will, infrastructure and support services, coupled with favorable geologic structures that made early exploration and development relatively easy. Mariners sailing off the coast of Louisiana and Texas in the 1600`s recorded one of the earliest known natural oil seeps. They shrugged it off as unimportant, as there was no market for the substance they witnessed. The seepage, however, provided a tiny clue to the vast storehouse of hydrocarbons trapped in the earth`s crust extending from the uplands, through Louisiana`s swamps and marshes, and into the subaqueous habitats of the Gulf of Mexico-the world`s ninth largest body of water. In all cases, each move into a new geographic province required considerable change in operation philosophy and in the science supporting the exploration and development activity. As technology changed, or was developed to meet the industry`s needs, new frontiers were explored. However, with time-as is the case with any nonrenewable resource-fields and wells lost their productive life. They had to be abandoned. In fact, the Minerals Management Service suggests that within the next 10 years the offshore industry will remove 150 platforms per year, or nearly half of the current number of production units. The industry will be asked to dispose of nearly one unit every 2.4 days. If this is the case, abandonment issues are going to continue to surface.

  6. Radical chemistry of artemisinin

    Denisov, Evgenii T; Solodova, S L; Denisova, Taisa G [Institute of Problems of Chemical Physics, Russian Academy of Sciences, Chernogolovka, Moscow Region (Russian Federation)

    2010-12-29

    The review summarizes physicochemical characteristics of the natural sesquiterpene peroxide artemisinin. The kinetic schemes of transformations of artemisinin radicals under anaerobic conditions are presented and analyzed. The sequence of radical reactions of artemisinin in the presence of oxygen is considered in detail. Special emphasis is given to the intramolecular chain oxidation resulting in the transformation of artemisinin into polyatomic hydroperoxide. The kinetic characteristics of elementary reaction steps involving alkyl, alkoxyl, and peroxyl radicals generated from artemisinin are discussed. The results of testing of artemisinin and its derivatives for the antimalarial activity and the scheme of the biochemical synthesis of artemisinin in nature are considered.

  7. Negative attitudes and affect do not predict elective hysterectomy: A prospective analysis from the Study of Women's Health Across the Nation

    Gibson, Carolyn J.; Bromberger, Joyce T.; Weiss, Gerson E.; Thurston, Rebecca C.; Sowers, MaryFran; Matthews, Karen A.

    2010-01-01

    Objective Cross-sectional studies suggest an association between hysterectomy and negative affect. Using prospective data, we examined the associations of negative affect, attitudes toward aging and menopause, premenstrual symptoms and vasomotor symptoms with elective hysterectomy in midlife. Methods Data were from the Study of Women's Health Across the Nation, a multi-site community-based prospective cohort study of the menopausal transition (n=2,818). Annually reported hysterectomy at visits 2-9 was verified with medical records when available (71%). Anxiety, perceived stress, depressive symptoms, attitudes toward aging and menopause, vasomotor symptoms, and premenstrual symptoms were assessed at baseline using standardized questions. Cox proportional hazards models were used to relate these variables to subsequent elective hysterectomy. Covariates included demographic variables, menstrual bleeding problems, body mass index, hormone levels, and self-rated health, also assessed at baseline. Results Elective hysterectomy was reported by 6% of participants (n=168) over an 8-year period. Women with hysterectomy were not higher in negative affect or negative attitudes toward aging and menopause compared to women without hysterectomy. Vasomotor symptoms (HR 1.44, 95% CI 1.03-2.01, p=.03) and positive attitudes toward aging and menopause (HR 1.74, 95% CI 1.04-2.93) at baseline predicted hysterectomy over the 8-year period, controlling for menstrual bleeding problems, site, race/ethnicity, follicle stimulating hormone, age, education, body mass index, and self-rated health. Menstrual bleeding problems at baseline were the strongest predictor of hysterectomy (HR 4.30, 95% CI 2.05-9.05). Conclusions In this prospective examination, negative affect and attitudes were not associated with subsequent hysterectomy. Menstrual bleeding problems were the major determinant of elective hysterectomy. PMID:21228728

  8. Radical cystectomy in eldery

    Bančević Vladimir; Aleksić Predrag; Milović Novak; Spasić Aleksandar; Kovačević Božidar; Toševski Perica; Čampara Zoran; Milošević Radovan; Cerović Snežana

    2015-01-01

    Background/Aim. Radical cystectomy is the method of choice for the treatment of muscle invasive bladder cancer. This major surgery is associated with many complications, especially in older patients. The aim of this study was to analyze preoperative comorbidity, and intraoperative and postoperative complicatons in patients older than 75 years. Methods. This clinical, retrospective study included 46 patients over 75 years, who underwent radical cystectomy. I...

  9. Radical trachelectomy: a fertility-sparing option for early invasive cervical cancer.

    Mejia-Gomez, Javier; Feigenberg, Tomer; Feigenber, Tomer; Arbel-Alon, Sagit; Kogan, Liron; Benshushan, Abraham

    2012-05-01

    For the past 15 years gynecological oncologists have been seeking ways to preserve woman's fertility when treating invasive cervical cancer. For some women with small localized invasive cervical cancers, there is now hope for pregnancy after treatment. Many cases of cervical cancer are diagnosed in young woman who wish to preserve their fertility. As more women are delaying childbearing, fertility preservation has become an important consideration. The standard surgical treatment for stage IA2-IB1 cervical cancer is a radical hysterectomy and bilateral pelvic lymphadenectomy. This surgery includes removal of the uterus and cervix, radical resection of the parametrial tissue and upper vagina, and complete pelvic lymphadenectomy. Obviously, the standard treatment does not allow future childbearing. Radical trachelectomy is a fertility-sparing surgical approach developed in France in 1994 by Dr. Daniel Dargent for the treatment of early invasive cervical cancer. Young women wishing to bear children in the future may be candidates for fertility-preservation options. The radical trachelectomy operation has been described and performed abdominally, assisted vaginally by laparoscopy and robotically. In this review we discuss the selection criteria for radical trachelectomy, the various possible techniques for the operation, the oncological and obstetric outcomes, and common complications. PMID:22799068

  10. Transfer Out Patient Not Abandon The Patient

    Deepak Gupta

    2015-12-01

    Full Text Available Physician-patient relationship is unique in some aspects and not-so-unique in other aspects when compared to other human interactions. Until-unless for the sake of health promotional activities, this relationship is almost always conceived in the times of human sufferings and consequently culminated when those sufferings have subsided as well as sought out happiness has ensued/been achieved. However, not all physician-patient relationships follow the normal course and/or meet the natural ends. These abnormal relationships are not inconsequential in terms of numbers and/or their effects (short-term and long term on both patients and physicians. Every country has its own baggage in the wake of why, how and what about these abnormal ends to physician-patient relationships; however, the most common causes are the patients’ inability to pay their medical bills, the conflicting goals of physicians and their patients in regards to patients’ sufferings’ management and finally the behavioral issues (patients’ and/or physicians’ interfering these relationships. Irrespective of any cause, the physicians should never forget that the patient can always discharge their physicians and discontinue their relationship with their physicians without any reason (until unless the physicians deem those patients either incapable/non-consentable to do so and/or potential threat to their own personal safety or other people’s safety. Contrarily, physicians can also discharge patients from their care but cannot abandon these patients (1-3 which mean that physicians have to ensure their discharged patients either are referred to or have sought another physician within appropriate time frame post-relationship-discontinuation. Each country has their own medico-legal liabilities that vary in terms of penalties imposed; however, irrespective of the feared legal concerns, the physicians should not forget that ethical essence of medicine is the art of healing that

  11. Stability analysis of abandoned drift for alternative utilization

    Kim, Bo-Hyun; Yoo, In-Kol; Kim, Moon-Seob; Kim, Ryang-Hee [Korea Resources Corp., Seoul(Korea); Yang, Hyung-Sik [Chonnam National University, Kwangju(Korea); Lee, Hi-Keun [Seoul National University, Seoul(Korea); Kim, Jae-Dong [Kangwon National University, Chuncheon(Korea)

    2000-04-30

    This study was performed to find the way that is alternative utilization of the drift that had been abandoned by coal industry promotion. To determine whether abandoned drift would be maintained without supports or not, the safety inspection that consists of drift survey, laboratory tests, rock mass classification and numerical analysis was performed. According to the result, there were discontinuity sets those had unfavorable orientation to the drift and rock mass around the drift had generally poor condition. So, it would be much difficult that abandoned drift is maintained without supports. (author). 15 refs., 8 tabs., 7 figs.

  12. Pharma TARP: A Troubled Asset Relief Program for Novel, Abandoned Projects in the Pharmaceutical Industry

    Tamas Bartfai

    2011-01-01

    Full Text Available Within days of each other, Pfizer, Merck, and GlaxoSmithKline announced that they will focus on a few therapeutic areas only and abandon others entirely. Pfizer alone will close well over a hundred drug development projects that have reached two-thirds of the way to launch. The programs are deemed to be too risky and not lucrative enough for Big Pharma in the current climate. Society has a real need for the drugs that are no longer going to be developed for, among others, drug-resistant epilepsy, neuropathic and cancer pain, type-2 diabetes, obesity, and schizophrenia. The authors propose a radical response by the U.S. government and the National Institutes of Health to rescue these abandoned projects, and to continue selected programs for drug approval by the U.S. Food and Drug Administration and the European Medicines Agency. The investment required is small compared to the Troubled Asset Relief Program bank bail out, but the return on investment in financial terms and in satisfying societal needs makes this proposal attractive.

  13. Free Radical Reactions in Food.

    Taub, Irwin A.

    1984-01-01

    Discusses reactions of free radicals that determine the chemistry of many fresh, processed, and stored foods. Focuses on reactions involving ascorbic acid, myoglobin, and palmitate radicals as representative radicals derived from a vitamin, metallo-protein, and saturated lipid. Basic concepts related to free radical structure, formation, and…

  14. Comparison between bipolar vessel sealer (LigaSure vessel sealer and harmonic scalpel in total laparoscopic hysterectomy

    Vandana Bansal

    2014-08-01

    Full Text Available Background: The aim of the present study was to compare the use of bipolar Vessel Sealer with Harmonic Scalpel (HS during total laparoscopic hysterectomy with respect to estimated blood loss and related postoperative complications. Methods: A retrospective study was conducted in the Jeevan Jyoti hospital and Guru Gobind Singh Memorial Vanadana Women's hospital, Allahabad, U.P., India. Two forty two patients were enrolled who underwent total laparoscopic hysterectomy and were randomized into two homogenous groups: bipolar vessel sealer and harmonic scalpel. Results: Estimated blood loss was significantly less in bipolar vessel sealer when compared with harmonic scalpel. No significant difference was observed in postoperative complications. Conclusions: The bipolar vessel sealer is a reliable and safe tool for reducing intraoperative blood loss in patients undergoing total laparoscopic hysterectomy. More randomized studies need to be done to confirm the advantages of this technique. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 1006-1009

  15. Uterine compression suture technique in the management of severe postpartum haemorrhage as an alternative to hysterectomy

    Stanojević Dušan

    2009-01-01

    Full Text Available Introduction. One of the most dramatic conditions in obstetrics is definitely bleeding from the uterus which fails to compress. This condition is known as postpartum atony. When such a condition is diagnosed, the obstetrician has a choice of several conservative methods to stimulate the uterus to contract and several surgical methods to stop the bleeding. The most extreme measure used to save the patient's life and stop the bleeding is hysterectomy. This surgery is characterized by high morbidity, primarily by the loss of woman's fertility. In order to avoid hysterectomy, several authors have introduced the compressive uterine suture technique into gynaecological practice. Objective. The aim of the paper is to demonstrate the technique of applying compressive uterine suture after delivery to stop excessive bleeding, and to present results obtained by this technique. Methods. The paper explains the technique of applying compressive suture to the atonic uterus in cases when all other procedures to stop excessive bleeding after delivery fail. Since uterine atony is the main reason for excessive and uncontrollable bleeding after childbirth, the need to perform such surgery is rather common. Authors demonstrate the technique of applying four compressive sutures which prevent uterus dilation and thus stop the bleeding. Results. Compressive suture technique was used by the authors eight times, seven of which during caesarean section and one after spontaneous delivery. All patients had normal postpartum period and normal involution of the uterus. Conclusion. Although this surgery requires a skilful and experienced obstetrician, the authors find it rather easy to perform and it is suggested to be applied in all cases of uterine atony when excessive bleeding cannot be stopped by other any other method except hysterectomy. This surgical procedure saves the uterus and facilitates quick and easy patient's recovery.

  16. Risk factors for urinary retention after vaginal hysterectomy for pelvic organ prolapse

    Chong, Chul; Kim, Hye Sung; Suh, Dong Hoon

    2016-01-01

    Objective To evaluate the risk factors for postoperative urinary retention in women who underwent vaginal hysterectomy for symptomatic pelvic organ prolapse. Methods The medical records of 221 women who underwent vaginal hysterectomy with anterior and posterior colporrhapy were reviewed. Urinary retention after catheter removal was defined as the presence of at least one of the following three conditions: 1) failure of first voiding trial necessitating catheterization, 2) first residual urine volume after self-voiding ≥150 mL, and 3) Foley catheter re-insertion. Results Urinary retention occurred in 60 women (27.1%). Multivariate and receiver operating characteristic curve analysis revealed that age (>63 years) and early postoperative day of catheter removal (day 1) was independent predictor for postoperative urinary retention. The incidence of urinary retention was significantly higher in women who removed indwelling catheter at day 1 (35.2%) than those at day 2 (12.0%, P=0.024), or day 3 (21.3%, P=0.044), but was similar to those at day 4 (25.0%, P=0.420). In women ≤63 years, urinary retention rate was not associated with the time of catheter removal after surgery; however, in women >63 years, the rate was significantly higher in day 1 removal group than day 2 to 4 removal group. Conclusion Age and postoperative day of catheter removal appear to be associated with postoperative urinary retention in women undergoing vaginal hysterectomy for pelvic organ prolapse. Keeping urinary catheter in situ at least for one day after vaginal prolapse surgery could be recommended, especially, in women older than 63 years. PMID:27004205

  17. Outcome analysis of salvage radiotherapy for occult cervical cancer found after simple hysterectomy

    The objective was to analyze the outcomes of the patients, who received salvage radiotherapy for incidentally discovered cervical cancer following simple hysterectomy, and to identify the influence of intracavitary radiotherapy on treatment outcomes. Data from 117 patients with occult cervical cancer who underwent simple hysterectomy followed by salvage radiotherapy from September 1979 to November 2010 were collected. All the patients received external beam radiotherapy with (n=45) or without (n=72) intracavitary radiotherapy. Local control, disease-free survival, overall survival and treatment-related toxicity were investigated. The median follow-up time was 75 months. The 5- and 10-year local control/disease-free survival/overall survival rates were 93/87/87% and 90/84/83%, respectively. Among 98 patients who had no residual disease and negative resection margin on surgical specimens, 32 (33%) received intracavitary radiotherapy and 66 (67%) did not. There were no differences in patient and tumor characteristics between patients treated with and without intracavitary radiotherapy. The 5-year local control rate for the non-intracavitary radiotherapy group was 93 versus 94% for the intracavitary radiotherapy group (P=0.564); the disease-free survival rate was 88 versus 94% (P=0.894); the overall survival rate was 95 versus 85% (P=0.106), respectively. Among all patients, there were 5% of Grade 3 or higher late toxicities. Patients with occult invasive cervical cancer discovered following simple hysterectomy could be treated safely and effectively with salvage radiotherapy. For patients with no residual disease and negative resection margin, intracavitary radiotherapy could be omitted. (author)

  18. Postoperative Nausea and Vomiting: Palonosetron with Dexamethasone vs. Ondansetron with Dexamethasone in Laparoscopic Hysterectomies

    Anish N. G. Sharma

    2015-07-01

    Full Text Available Objectives: Postoperative nausea and vomiting (PONV is the most common complication seen following laparoscopic surgery. Our study sought to evaluate the efficacy of the newer drug palonosetron with that of ondansetron, in combination with dexamethasone, for PONV in patients undergoing laparoscopic hysterectomies. Methods: A total of 90 patients, aged between 30–50 years old, posted for elective laparoscopic hysterectomies under general anesthesia belonging to the American Society of Anesthesiologist (ASA physical status I and II were included in the study. Patients were randomly divided into one of two groups (n=45. Before induction, patients in the first group (group I received 0.075mg palonosetron with 8mg dexamethasone and patients in the second group (group II received 4mg ondansetron with 8mg dexamethasone. Postoperatively, any incidences of early or delayed vomiting, requirement of rescue antiemetic, and side effects were recorded. Patient’s hemodynamics were also monitored. Statistical analysis was done using Student’s t-test, chi-square test, and Fisher’s exact test. Results: Preoperative, intraoperative, and postoperative heart rate, mean arterial pressure, peripheral capillary oxygen saturation were statistically not significant (p>0.050 in either group. In group II, eight patients had nausea in the first two hours and three patients had nausea in the two to six-hour postoperative period. In group I, three patients experienced nausea in the first six hours period. Eight patients in group II had vomited in the first two-hour period compared to one patient in group I (p=0.013. The requirement of rescue antiemetic was greater in group II than group I (20% vs. 4%. No side effects of antiemetic use were observed in either group. Conclusion: The combination of palonosetron with dexamethasone is more effective in treating early, delayed, and long term PONV compared to ondansetron with dexamethasone in patients undergoing

  19. Emergency Peripartum Hysterectomy: A Multicenter Study of Incidence, Indications and Outcomes in Southwestern Nigeria.

    Akintayo, A A; Olagbuji, B N; Aderoba, A K; Akadiri, O; Olofinbiyi, B A; Bakare, B

    2016-06-01

    Objective To determine the incidence, indications and outcomes of emergency peripartum hysterectomy (EPH) in three tertiary institutions in south-west Nigeria between January, 2010 and December , 2013. Methods A retrospective review of all cases of EPH over a 4 year period was done. EPH was defined as hysterectomy performed at the time of delivery or within 24 h of delivery for uncontrollable postpartum bleeding not responsive to conservative measures. Relevant information was extracted from the hospital records and operation notes. Statistical analysis was done using SPSS software version 17.0. Statistical significance was set at p < 0.05. Results There were 102 EPHs performed among 39,738 deliveries within the study period, giving a rate of 2.6 per thousand deliveries. Indications were uterine rupture (44.1 %), uterine atony (37.3 %), morbidly adherent placenta (17.6 %) and extension of caesarean section incision involving the uterine arteries (1 %). Subtotal hysterectomy was performed in most cases (67.6 %).Maternal case fatality rate was 11.8 % and perinatal mortality rate was 55.9 %. Blood transfusion, severe postoperative anaemia, wound sepsis, febrile morbidity and acute kidney injury were common morbidities associated with the procedure. Following multivariate logistic regression, the unbooked status [odds-ratio 95 % CI = 12.80 (1.22-133.97) p = 0.03] was the only variable that significantly predicted maternal death. Conclusion The incidence of EPH from our study is high. Much more needs to be done in maternal health services, particularly provision of quality obstetric care to reduce the rates of EPH and the associated high maternal and perinatal morbidity and mortality. PMID:26961244

  20. Histopathology findings in patients presenting with menorrhagia: A study of 100 hysterectomy specimen

    Nilima G Sawke

    2015-01-01

    Full Text Available Background: Menorrhagia, by definition, is heavy cyclical blood loss in excess of 80 ml/month of menstrual period lasting longer than 7 days. There are many possible causes of heavy menstrual bleeding which include hormonal imbalance, fibroids, miscarriage or ectopic pregnancy, nonhormonal intrauterine device, adenomyosis, pelvic inflammatory disease, and rarely uterine, ovarian, or cervical cancer. Treatment depends on the causes of the menorrhagia. Hysterectomy is one of the several surgical procedures as definitive treatment. Objective: To determine the histopathologic spectrum of lesions associated with menorrhagia in different age groups. Study Design: This prospective descriptive study was conducted at the Department of Pathology, People′s College of Medical Sciences and Research Centre, Bhopal. During the study period, 100 hysterectomy specimens were taken which were performed for the treatment of menorrhagia. Patients with menorrhagia in the age group of 30-50 years were selected after detailed history and fulfilling the inclusion criteria. Result: In our study, it was observed that maximum number of cases were in the age group of 41-50 years (n = 35 followed by the age group of 31-40 (n = 30. Out of 100 cases, 31% cases (n = 31 showed adenomyosis followed by leiomyomas 25% (n = 25, endometrial hyperplasia 23% (n = 23, and endometrial polyp 4% (n = 4. 11% cases (n = 11 showed dual pathology consisting of both adenomyosis and endometrial hyperplasia and 6% cases (n = 6 of leiomyoma with adenomyosis. Conclusion: Uterine adenomyosis and leiomyoma are the most common benign conditions found in hysterectomy specimens with peak incidence at 31-50 years. Patients having menorrhagia above 40 years should be screened for any endometrial pathology. Histopathology is mandatory for confirming diagnosis and the key to effective therapy and optimal outcome.

  1. A randomized controlled trial to compare pregabalin with gabapentin for postoperative pain in abdominal hysterectomy

    Anju Ghai

    2011-01-01

    Full Text Available Background: Pregabalin is a potent ligand for alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system, which exhibits potent anticonvulsant, analgesic and anxiolytic activity. The pharmacological activity of pregabalin is similar to that of gabapentin and shows possible advantages. Although it shows analgesic efficacy against neuropathic pain, very limited evidence supports its postoperative analgesic efficacy. We investigated its analgesic efficacy in patients experiencing acute pain after abdominal hysterectomy and compared it with gabapentin and placebo. Methods: A randomized, double-blind, placebo-controlled study was conducted in 90 women undergoing abdominal hysterectomy who were anaesthetized in a standardized fashion. Patients received 300 mg pregabalin, 900 mg gabapentin or placebo, 1-2 hours prior to surgery. Postoperative analgesia was administered at visual analogue scale (VAS ≥3. The primary outcome was analgesic consumption over 24 hours and patients were followed for pain scores, time to rescue analgesia and side effects as secondary outcomes. Results: The diclofenac consumption was statistically significant between pregabalin and control groups, and gabapentin and control groups; however, pregabalin and gabapentin groups were comparable. Moreover, the consumption of tramadol was statistically significant among all the groups. Patients in pregabalin and gabapentin groups had lower pain scores in the initial hour of recovery. However, pain scores were subsequently similar in all the groups. Time to first request for analgesia was longer in pregabalin group followed by gabapentin and control groups. Conclusion: A single dose of 300 mg pregabalin given 1-2 hours prior to surgery is superior to 900 mg gabapentin and placebo after abdominal hysterectomy. Both the drugs are better than placebo.

  2. Mercury distribution in an abandoned metallurgical plant

    Millán R.

    2013-04-01

    Full Text Available The aim of the work is to evaluate the spatial distribution of Hg in the soil-plant system within an area where intense activity of Hg was dominant over a long period. An abandoned metallurgical plant from the 17th-18th centuries was chosen as the study area. It is situated in Almadenejos within the Almadén mining district (Spain that constitutes the largest and most unusual concentration of mercury in the world and has provided a third of the entire world production of mercury (Hg. Nowadays, this study area is covered with cinnabar mine tailings and village habitants use it for livestock. The area has elevated Hg concentrations of natural origin and from human activities. Soil parameters are similar throughout the study area; however, data reveal high variability in total and available Hg concentrations in soils, making it difficult to establish a tendency. Marrubium vulgare L.has been studied due to its high presence in the field plot, and there is no evidence of phenological toxicity. Furthermore, in spite of elevated Hg concentrations, a good biological activity is tested in the soil samples. All these characteristics, spatial variation, high Hg concentration, good biological activity, enhance the peculiarity of the study area for studies involving Hg.

  3. Transmural penetration of sigmoid colon and rectum by retained surgical sponge after hysterectomy.

    Shin, Woo Young; Im, Chan Hyuk; Choi, Sun Keun; Choe, Yun-Mee; Kim, Kyung Rae

    2016-03-14

    Gossypiboma is a surgical sponge that is retained in the body after the operation. A 39-year-old female presented with vague lower abdominal pain, fever, and rectal discharge 15 mo after hysterectomy. The sponge remaining in the abdomen had no radiopaque marker. Therefore a series of radiographic evaluations was fruitless. The surgical sponge was found in the rectosigmoid colon on colonoscopy. The sponge penetrated the sigmoid colon and rectum transmurally, forming an opening on both sides. The patient underwent low anterior resection and was discharged without postoperative complications. PMID:26973401

  4. Anaesthetic management of a patient with Liddle's syndrome for emergency caesarean hysterectomy.

    Hayes, N E

    2012-02-01

    We describe the anaesthetic management of a patient with Liddle\\'s syndrome during caesarean section and emergency hysterectomy for placenta accreta associated with significant intrapartum haemorrhage. Liddle\\'s syndrome is a rare autosomal dominant disorder characterised by early onset arterial hypertension and hypokalaemic metabolic alkalosis. Additional issues were the presence of short stature, limb hypertonicity and preeclampsia. Initial management with a low-dose combined spinal-epidural technique was subsequently converted to general anaesthesia due to patient discomfort. The management of Liddle\\'s syndrome in the setting of neuraxial and general anaesthesia in a patient undergoing caesarean section is discussed.

  5. Anaesthetic management of a patient with Liddle's syndrome for emergency caesarean hysterectomy.

    Hayes, N E

    2011-04-01

    We describe the anaesthetic management of a patient with Liddle\\'s syndrome during caesarean section and emergency hysterectomy for placenta accreta associated with significant intrapartum haemorrhage. Liddle\\'s syndrome is a rare autosomal dominant disorder characterised by early onset arterial hypertension and hypokalaemic metabolic alkalosis. Additional issues were the presence of short stature, limb hypertonicity and preeclampsia. Initial management with a low-dose combined spinal-epidural technique was subsequently converted to general anaesthesia due to patient discomfort. The management of Liddle\\'s syndrome in the setting of neuraxial and general anaesthesia in a patient undergoing caesarean section is discussed.

  6. Complications after hysterectomy. A Danish population based study 1978-1983

    Andersen, T F; Loft, A; Brønnum-Hansen, Henrik;

    1993-01-01

    all the complications which occurred during hospital admission from the time of surgery up to six years from that point. Within 30 days of hysterectomy 2.6% of the patients had been diagnosed in hospitals as having complications according to our definition. The corresponding figures at 90 days and two...... years after the operation were 3.7% and 9.4%. The most frequently observed complications were post operative wound infections and bleeding, each affecting about 2% of all operated women. Logistic regression and Cox regression were used to identify prognostic indicators of readmission with complications...

  7. URETER INJURY PRESENTIN G AS ASCITES AFTER HYSTERECTOMY: A CASE REPORT

    Venugopalan

    2015-04-01

    Full Text Available Urinary bladder injury or injury to ureter is a recognized complication of lower abdominal surgery and it is the most common organ injured during gynecological procedures. We report here, history of a 48 year old female developing ascites and respiratory distress on 3 rd postoperative day of abdominal hysterectomy for fibroid ut e rus. Ultrasound guided abdominal tap showed urine. Computed tomography of abdomen revealed double ureter and injury to one of the left ureters. It was re implanted and bladder site repaired throug h emergency lap a rotomy. The key to the diagnosis of ureter injury is awareness of this clinical entity.

  8. 7 CFR 97.104 - Application or certificate abandoned.

    2010-01-01

    ... 97.104 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY... abandoned certificates shall be published in the Official Journal, indicating that the variety has...

  9. Abandoned mines at Little Pend Oreille National Wildlife Refuge

    US Fish and Wildlife Service, Department of the Interior — The objectives of the study were: 1 Determine whether abandoned mines on LPO were impacting aquatic biota, 2 Determine whether mines were safety or liability...

  10. Gangs, Terrorism, and Radicalization

    Scott Decker

    2011-01-01

    Full Text Available What can street gangs tell us about radicalization and extremist groups? At first glance, these two groups seem to push the boundaries of comparison. In this article, we examine the important similarities and differences across criminal, deviant, and extremist groups. Drawing from research on street gangs, this article explores issues such as levels of explanation,organizational structure, group process, and the increasingly important role of technology and the Internet in the context of radicalization. There are points of convergence across these groups, but it is important to understand the differences between these groups. This review finds little evidence to support the contention that American street gangs are becoming increasingly radicalized. This conclusion is based largely on organizational differences between gangs and terror groups.

  11. Sexuality Following Radical Prostatectomy

    Fode, Mikkel; Serefoglu, Ege C; Albersen, Maarten;

    2016-01-01

    INTRODUCTION: Radical prostatectomies can result in urinary incontinence and sexual dysfunction. Traditionally, these issues have been studied separately, and the sexual problem that has received the most focus has been erectile dysfunction. AIM: To summarize the literature on sexually related side...... effects and their consequences after radical prostatectomy and focus on the occurrence and management of problems beyond erectile dysfunction. METHODS: The literature on sexuality after radical prostatectomy was reviewed through a Medline search. Original research using quantitative and qualitative...... methodologies was considered. Priority was given to studies exploring aspects of sexuality other than erectile function. MAIN OUTCOME MEASURES: The prevalence, predictive factors, and management of post-prostatectomy sexual problems beyond erectile dysfunction. RESULTS: Most patients will develop urinary...

  12. Identification of Risks Pertaining to Abandoned Housing Projects in Malaysia

    Hamzah Abdul-Rahman; Chen Wang; Nur Hamizah Ariffin

    2015-01-01

    Housing industry is one of the most dynamic, risky, and challenging industries. In Malaysia, this industry has a poor reputation for managing risks, with many major projects failing to be completed within the allotted time. Due to the inherent risks involved in construction projects, it is essential to recognize the risks that cause problems associated with abandoned housing projects. Therefore, this study aims to identify the risks that contribute to issues of abandoned housing projects and ...

  13. Brent spar experience haunts N. Sea platform abandonments

    This paper reviews the environmental conflicts that oil and gas industry officials have recently encountered in their attempts to abandon offshore platforms. It reviews the various governmental policies which are in effect in the North Sea area and the effect these policies have had on removal or deepsea disposal of these facilities. It provides a prospectus of soon to be abandoned facilities in the North Sea countries and a summary of removal operations in recent history

  14. Investigation on Health Effects of an Abandoned Metal Mine

    Kim, Soyeon; Kwon, Ho-Jang; Cheong, Hae-Kwan; Choi, Kyungho; Jang, Jae-Yeon; Jeong, Woo-Chul; Kim, Dae-Seon; Yu, Seungdo; Kim, Young-Wook; Lee, Kwang-Young; Yang, Seoung-Oh; Jhung, Ik Jae; Yang, Won-Ho; Hong, Yun-Chul

    2008-01-01

    To investigate potential health risks associated with exposure to metals from an abandoned metal mine, the authors studied people living near an abandoned mine (n=102) and control groups (n=149). Levels of cadmium, copper, arsenic, lead, and zinc were measured in the air, soil, drinking water, and agricultural products. To assess individual exposure, biomarkers of each metal in blood and urine were measured. β2-microglobulin, α1-microglobulin, and N-acetyl-beta-glucosaminidase and bone minera...

  15. Determinants of the exclusive breastfeeding abandonment: psychosocial factors

    Mariana Campos Martins Machado; Karine Franklin Assis; Fabiana de Cássia Carvalho Oliveira; Andréia Queiroz Ribeiro; Raquel Maria Amaral Araújo; Alexandre Faisal Cury; Silvia Eloiza Priore; Sylvia do Carmo Castro Franceschini

    2014-01-01

    OBJECTIVE To assess the determinants of exclusive breastfeeding abandonment. METHODS Longitudinal study based on a birth cohort in Viçosa, MG, Southeastern Brazil. In 2011/2012, 168 new mothers accessing the public health network were followed. Three interviews, at 30, 60, and 120 days postpartum, with the new mothers were conducted. Exclusive breastfeeding abandonment was analyzed in the first, second, and fourth months after childbirth. The Edinburgh Postnatal Depression Scale was applied...

  16. Homegrown religious radicalization

    Khawaja, Iram

    and their families. Existing literature and ways of thinking about the social psychological process of radicalization will be reviewed, such as social identity theory and transformative learning theory, and a theoretical framework based on a focus on belonging, recognition and the sense of community......It has been reported that a growing number of youngsters from Western Europe are engaging in conflicts motivated by religious and political conflicts in the Middle East. This paper aims at exploring the reasons behind this seemingly religious radicalization from the point of view of the youngsters...

  17. Adenomyosis among samples from hysterectomy due to abnormal uterine bleeding in Ahwaz, southern Iran

    Maryam Dehghani Mobarakeh

    2012-01-01

    Full Text Available Introduction: Adenomyosis is one of the most common, yet underdiagnosed, underlying causes of abnormal uterine bleeding (AUB. We aimed to evaluate the prevalence of adenomyosis among subjects who underwent hysterectomy due to AUB. Materials and Methods: We studied the pathological specimens from 100 cases of AUB who underwent hysterectomy and were referred to Jundishapur University of Medical Sciences, Ahwaz (Iran from 2007 to 2010. All specimens were reviewed by the same pathologist. Results: Pathological findings included adenomyosis 21%, leiomyoma 30%, adenomyosis and leiomyoma 21%, adenomyosis and other pathological causes 7%, and other pathological causes 21%. The overall prevalence of adenomyosis was 49%. Mean age of the patients was 46.9 ± 7.8 years and the highest frequency of adenomyosis was observed in the age group 30-60 years. Conclusions: Overall prevalence of adenomyosis in the population with AUB (49% that we studied was higher than that in the reports from other populations. Occurrence of isolated adenomyosis in those aged less than 30 years was rare, and adenomyosis was usually accompanied by other lesions.

  18. Body mass and risk of complications after hysterectomy on benign indications

    Osler, Merete; Daugbjerg, Signe; Frederiksen, Birgitte Lidegaard; Ottesen, Bent

    2011-01-01

    BACKGROUND: This study examines BMI in relation to risk of complications after hysterectomy on benign indications, and explores whether any associations vary by route of surgery. METHODS: In this cohort study, we included data on health and lifestyle collected prospectively for all hysterectomy...... infection [OR = 1.47 (1.23-1.77)]. The risk of all bleeding complications [OR = 1.48 (1.28-1.82)] and re-operation [OR = 1.66 (1.26-2.17)] were also increased among women with a BMI <20. This U-shaped relation between BMI and bleeding, and the association between high BMI and infections were only seen for...... referrals for benign indications in Denmark from 2004 to 2009. Logistic regression was used to investigate relationship between BMI and complications reported at surgery or during the first 30 days after surgery. RESULTS; Of the 20 353 women with complete data, 6.0% had a BMI <20 kg/m(2), 31.9% with BMI...

  19. THE BENEFITS OF IVP AND BARIUM ENEMA IN PATIENTS UNDERGOING HYSTERECTOMY FOR BENIGN CONDITIONS

    Heshmatollah Azhar

    1995-06-01

    Full Text Available A review of500 cases was undertaken in order to identify which patients undergoing hrsterectomy for benign disease weresubjected topreoperative intravenous pyelogram (lVP and/ or barium enema (BE, and what abnormalities couldbe anticipatedbythese procedures as a surgical screen."nOver 80% ofthe cases reviewed underwent trans-ahdominal hysteredomy, and the remainder hadvaginal hysterectomy. Close to one-third of the patients were admitted with the diagnosis offibroid; and one-sixth with uterine prolapse. Miscellaneous benign conditions included adnexal masses, ovarian cysts, and dysfunctional uterine bleeding. Twentytwo patients (4.4% had IVP preoperatively, while eight patienls (1.6% were given both lIP and barium enema prior to hysterectomy. Over three-fourth ofthe 22 patients revealed normal IVP, while one-half who had received both IVP and/or BE had an unremarkable roentgenogram interpretation. None of the subiects who had unusual findings in either group were ofclinical significance on the pathology report Post-operative coursefor the patients was also quite unremarkable. This review indicates that when benign disease is clear-cut and hysteredomy is indicated there is no needfor IVP and barium enema.

  20. Histerectomias: estudo retrospectivo de 554 casos Hysterectomies: a retrospective study of 554 cases

    Eddie Fernando Cândido Murta

    2000-10-01

    Full Text Available OBJETIVO: A histerectomia é uma operação muito realizada, entretanto há poucos trabalhos na literatura nacional sobre suas indicações, técnica e complicações. O objetivo deste trabalho é avaliar estes procedimentos realizados na Disciplina de Ginecologia e Obstetrícia da Faculdade de Medicina do Triângulo Mineiro. MÉTODO: Estudo retrospectivo de 470 histerectomias abdominais e 84 vaginais foi conduzido analisando as indicações, tempo de cirurgia e internação, tipo de incisão e morbidez. RESULTADOS: As principais indicações foram o mioma uterino e o prolapso uterino para as histerectomias abdominais e vaginais, respectivamente. As complicações intra-operatórias aconteceram em 3,4% e as pós-operatórias em 2,4% do total de casos. Nenhuma diferença estatística foi encontrada no número de complicações em relação ao tipo de incisão (vertical ou transversal. O tempo de cirurgia e o de hospitalização foram estatisticamente maiores nas incisões verticais. A hemorragia foi a mais freqüente complicação intra-operatória e a infecção da incisão operatória foi a mais freqüente no pós-operatório. CONCLUSÕES: A histerectomia é um procedimento de baixo risco, no entanto, a realização de revisões sobre indicações e complicações, e a pesquisa de melhores técnicas cirúrgicas são necessárias para torná-la cada vez mais segura.OBJECTIVE: Hysterectomy is a frequently performed surgery, but national literature gives limited information regarding indications, technique and complications. The aim of this study is to evaluate our results with this operation performed by the Discipline of Gynecology and Obstetrics of the Faculty of Medicine of "Triângulo Mineiro". METHODS: A retrospective study of 470 abdominal and 84 vaginal hysterectomies was conducted in which the indications, operation time, abdominal approach, hospitalization time, and morbidity were analyzed. RESULTS: Uterine myoma and uterine prolapse

  1. Violent Radicalization in Europe

    Dalgaard-Nielsen, Anja

    2010-01-01

    When, why, and how do people living in a democracy become radicalized to the point of being willing to use or directly support the use of terrorist violence against fellow citizens? This question has been at the center of academic and public debate over the past years as terrorist attacks...

  2. Radical School Reform.

    Gross, Beatrice, Ed.; Gross, Ronald, Ed.

    This book provides a comprehensive examination of the nature of the school crisis and the ways in which radical thinkers and educators are dealing with it. Excerpts from the writings of Jonathan Kozol, John Holt, Kenneth Clark, and others are concerned with the realities of education in ghettos and suburbs. Paul Goodman, Marshall McLuhan, Sylvia…

  3. Radically enhanced molecular recognition

    Trabolsi, Ali

    2009-12-17

    The tendency for viologen radical cations to dimerize has been harnessed to establish a recognition motif based on their ability to form extremely strong inclusion complexes with cyclobis(paraquat-p-phenylene) in its diradical dicationic redox state. This previously unreported complex involving three bipyridinium cation radicals increases the versatility of host-guest chemistry, extending its practice beyond the traditional reliance on neutral and charged guests and hosts. In particular, transporting the concept of radical dimerization into the field of mechanically interlocked molecules introduces a higher level of control within molecular switches and machines. Herein, we report that bistable and tristable [2]rotaxanes can be switched by altering electrochemical potentials. In a tristable [2]rotaxane composed of a cyclobis(paraquat-p-phenylene) ring and a dumbbell with tetrathiafulvalene, dioxynaphthalene and bipyridinium recognition sites, the position of the ring can be switched. On oxidation, it moves from the tetrathiafulvalene to the dioxynaphthalene, and on reduction, to the bipyridinium radical cation, provided the ring is also reduced simultaneously to the diradical dication. © 2010 Macmillan Publishers Limited. All rights reserved.

  4. On Radical Feminism

    翟良锴

    2015-01-01

    <正>All men are created equal.For centuries,human have been struggling for their rights.Women,as a special social force,are fighting vigorously for their equal rights with men.According to an introduction to feminism,there are three main types of feminism:socialist,reformist and radical(Feminism 101).In order

  5. Radical Financial Innovation

    Robert J. Shiller

    2004-01-01

    Radical financial innovation is the development of new institutions and methods that permit risk management to be extended far beyond its former realm, covering important new classes of risks. This paper compares past such innovation with potential future innovation, looking at the process that produced past success and the possibilities for future financial innovation.

  6. OH radicals in the troposphere

    OH radicals are radicals which determine the photochemistry of the troposphere. The reactivity of OH radicals to organic substances is one of the fundamental criteria for the evaluation of abiotic decomposition. Details are given about the photochemical formation and reaction of OH radicals, the decomposition reactions of organic compounds in the gaseous phase, the determination of the specific rates of OH radical decomposition reactions, measuring methods for the determination of OH radical concentrations in the troposphere, selected results, OH concentration distributions obtained from model calculations, and the influence of trace gases on OH concentrations. A summary, conclusions, and research proposals are attached. (orig./BBR)

  7. Railroad Lines - RAIL_SYSTEM_ACTIVE_ABANDONED_INDOT_IN: Active and Abandoned Rail System in Indiana, 2005 (Indiana Department of Transportation, 1:1200, Line Shapefile)

    NSGIC GIS Inventory (aka Ramona) — RAIL_SYSTEM_ACTIVE_ABANDONED_INDOT_IN is a line shapefile that contains all active and abandoned rail lines in Indiana, provided by personnel of Indiana Department...

  8. Total laparoscopic hysterectomy versus abdominal hysterectomy in the treatment of patients with early stage endometrial cancer: A randomized multi center study

    Bergsma-Kadijk Johanna A

    2009-01-01

    Full Text Available Abstract Background Traditionally standard treatment for patients with early stage endometrial cancer (EC is total abdominal hysterectomy and bilateral salpingo oophorectomy (TAH+BSO with or without lymph node dissection through a vertical midline incision. While TAH is an accepted effective treatment, it is highly invasive, visibly scarring and associated with morbidity. An alternative treatment is the same operation by laparoscopy. Though in several studies total laparoscopic hysterectomy (TLH+ BSO seems a safe and feasible alternative approach in early stage endometrial cancer patients, there are no randomized data available yet. Furthermore, a randomized controlled trial with surgeons trained in laparoscopy is warranted in order to implement this technique in a safe manner. The aim of this study is to compare the treatment related morbidity, cost-effectiveness and quality of life in early stage endometrial cancer patients treated by laparoscopy versus the standard open approach. Methods A multi centre randomized clinical phase 3 trial, including 5 university hospitals and 15 regional hospitals in the Netherlands. Only gynecologists trained in performing a TLH are allowed to participate. Inclusion criteria: Patients with a clinical stage I endometrioid adenocarcinoma or complex atypical hyperplasia are randomized in a 2:1 allocation to receive TLH or TAH. The main outcome measure is the rate of major complications, as assessed by an independent clinical review board. In total, 275 patients are required to have 80% power at α-0.05 to detect a significant difference of 15% complication rate. Secondary outcome measures are 1 costs and cost-effectiveness, 2 minor complications, and 3 quality of life. All data from this multi center study are reported using case record forms. Data regarding quality of life, pain, body Image, sexuality and additional homecare are assessed with self reported questionnaires. Discussion A randomized multi center

  9. Free radical transfer in polymers

    For the present study of free-radical transfer in polymers pulse radiolysis and product studies have been carried out in aqueous solutions using thus far only the water-soluble polymers polyacrylic acid, polymethacrylic acid and polyvinyl alcohol. When OH radicals, generated in the radiolysis of N2O-saturated aqueous solutions, react with polymers the lifetime of the polymer radical thus created very much depends on the number of radicals per polymer chain. When there are a large number of radicals per chain their bimolecular decay may be faster than the corresponding (diffusion controlled) decay of monomeric radicals, but when the macromolecule contains only few or even just one radical their lifetime is considerably prolonged. Highly charged polymers such as polyacrylic acid at high pH attain a rod-like conformation which again favors a long lifetime of the radicals. Under such conditions, radical transfer reactions can occur. For example, in polyacrylic acid OH radicals generate two kinds of radicals side by side. The radical in β-position to the carboxylate group converts into the thermodynamically more stable α-radicals by an H-transfer reaction as can be followed by spectrophotometry. Besides radical transfer reactions β-fragmentation reactions occur causing chain scission. Such reactions can be followed in a pulse radiolysis experiment by conductometry, because counter ions are released upon chain scission. Such a process is especially effective in the case of polymethacrylic acid, where it results in a chain depolymerization. An intramolecular H-abstraction is also observed in the γ-radiolysis of polyacrylic acid with the corresponding peroxyl radicals. This causes a chain reaction to occur. The resulting hydroperoxides are unstable and decarboxylate given rise to acetylacetone-like products. In polyvinyl alcohol the peroxyl radicals in α-position to the alcohol function undergo HO2-elimination. This prevents a scission of the polymer chain in the

  10. Absent organs—Present selves: Exploring embodiment and gender identity in young Norwegian women's accounts of hysterectomy

    Kari Nyheim Solbrække

    2015-04-01

    Full Text Available In this paper, we explore how younger women in Norway construct their embodiment and sense of self after hysterectomy. To do this, we conducted in-depth interviews with eight ethnic Norwegian women aged between 25 and 43 who had undergone hysterectomy. In line with a broad phenomenological approach to illness, the study was designed to explore the trajectories of the women's illness with a specific focus on concrete human experience and identity claims from a subjective point of view. In analysing the stories, we encountered feelings of suffering due to the loss of the uterus as well as profound side-effects, such as menopause. However, we also found evidence of relief from being treated for heavy bleeding and serious illness. In order to accentuate the individual voices in these illness stories, we chose a case-oriented analysis in line with Radley and Chamberlain (2001 and Riessman (2008. From this, two main seemingly contradictory storylines stood out: They have removed what made me a woman versus Without a uterus, I feel more like a woman. We also identified heteronormativity as an unstated issue in both these storylines and in the research data as a whole. Acknowledging diversity in the way women experience hysterectomy is important for a better understanding of the ways in which hysterectomy may affect women as humans as well as for developing more cultural competent healthcare services for this group.

  11. The role of interventional radiology in reducing haemorrhage and hysterectomy following caesarean section for morbidly adherent placenta

    Aim: To report experience of prophylactic occlusion balloon catheters (POBCs) in both internal iliac arteries before caesarean section, with or without embolization, to preserve the uterus and reduce haemorrhage. Methods and materials: Twenty-seven women diagnosed with morbidly adherent placenta (MAP) and with suspected placenta percreta underwent POBC placement before caesarean section. The balloons were inflated immediately after delivery of the baby. The patients' case notes were reviewed retrospectively for histological grading of MAP, blood loss, transfusion, requirement of uterine artery embolization (UAE), or hysterectomy, radiation dose, and infant or maternal morbidity and mortality. Results: MAP was confirmed histologically as percreta in 17, accreta in eight, and increta in two women. Mean blood loss was 1.92 l (range 0.5–12 l). Postpartum haemorrhage (PPH) occurred in nine patients. Eight were referred for UAE, which was successful in six. Immediate peri-partum hysterectomy was performed in one patient. Three women in total required hysterectomy, two after recurrent haemorrhage after UAE. No foetal morbidity or mortality occurred. No maternal mortality occurred. There was one case of iliac artery thrombosis, which resolved with conservative therapy. Conclusion: POBC, with or without UAE, contributes to reduction of blood loss and preservation of the uterus in women with MAP. - Highlights: • Management of morbidly adherent placenta requires a multidisciplinary team approach. • Prophylactic occlusion balloon catheters reduce blood loss and help avoid hysterectomy. • Protocols ensure correct management of placenta percreta patients and minimise risk

  12. Timing of heparin prophylaxis and bleeding complications in hysterectomy a nationwide prospective cohort study of 9,949 Danish women

    Hansen, Charlotte T; Kehlet, Henrik; Møller, Charlotte;

    2008-01-01

    's experience, route and type of hysterectomy and additional surgery, and stratification on assistant's experience, peri-operative pain prophylaxis with NSAID and daily use of Acetyl Salicylic Acid (ASA)/NSAID. RESULTS: 9,051 women (92%) received thromboprophylaxis with heparin, initiated pre-operatively in 48...

  13. The effect of menopause and hysterectomy on systemic vascular endothelial growth factor in women undergoing surgery for breast cancer

    Vascular endothelial growth factor (VEGF) is a potent angiogenic cytokine produced physiologically by the uterus. Pathological secretion by tumours promotes growth and metastasis. High circulating VEGF levels potentially have a deleterious effect on breast cancer by promoting disease progression. The aims of this study were to investigate circulating VEGF levels in breast cancer patients and assess the effect of menopause or hysterectomy on systemic VEGF. Patients undergoing primary surgery for breast cancer and controls matched for age, menopausal and hysterectomy status were prospectively recruited. Serum VEGF, FSH, LH, estrogen, progesterone and platelet levels were measured. Serum VEGF was corrected for platelet load (sVEGFp) to provide a biologically relevant measurement of circulating VEGF. SVEGFp levels were analyzed with respect to tumor characteristics, menopausal status and hysterectomy status. Two hundred women were included in the study; 89 breast cancer patients and 111 controls. SVEGFp levels were significantly higher in breast cancer patients compared to controls (p = 0.0001), but were not associated with clinico-pathological tumor characteristics. Systemic VEGF levels reduced significantly in the breast cancer patients following tumor excision (p = 0.018). The highest systemic VEGF levels were observed in postmenopausal breast cancer patients. Postmenopausal women who had had a previous hysterectomy had significantly higher VEGF levels than those with an intact postmenopausal uterus (p = 0.001). This study identifies an intact postmenopausal uterus as a potential means of reducing circulating levels of VEGF which could confer a protective effect against breast cancer metastatic potential

  14. Interval Between Hysterectomy and Start of Radiation Treatment Is Predictive of Recurrence in Patients With Endometrial Carcinoma

    Purpose: Adjuvant radiation therapy (RT) has been shown to improve local control in patients with endometrial carcinoma. We analyzed the impact of the time interval between hysterectomy and RT initiation in patients with endometrial carcinoma. Methods and Materials: In this institutional review board-approved study, we identified 308 patients with endometrial carcinoma who received adjuvant RT after hysterectomy. All patients had undergone hysterectomy, oophorectomy, and pelvic and para-aortic lymph node evaluation from 1988 to 2010. Patients' demographics, pathologic features, and treatments were compared. The time interval between hysterectomy and the start of RT was calculated. The effects of time interval on recurrence-free (RFS), disease-specific (DSS), and overall survival (OS) were calculated. Following univariate analysis, multivariate modeling was performed. Results: The median age and follow-up for the study cohort was 65 years and 72 months, respectively. Eighty-five percent of the patients had endometrioid carcinoma. RT was delivered with high-dose-rate brachytherapy alone (29%), pelvic RT alone (20%), or both (51%). Median time interval to start RT was 42 days (range, 21-130 days). A total of 269 patients (74%) started their RT <9 weeks after undergoing hysterectomy (group 1) and 26% started ≥9 weeks after surgery (group 2). There were a total of 43 recurrences. Tumor recurrence was significantly associated with treatment delay of ≥9 weeks, with 5-year RFS of 90% for group 1 compared to only 39% for group 2 (P<.001). On multivariate analysis, RT delay of ≥9 weeks (P<.001), presence of lymphovascular space involvement (P=.001), and higher International Federation of Gynecology and Obstetrics grade (P=.012) were independent predictors of recurrence. In addition, RT delay of ≥9 weeks was an independent significant predictor for worse DSS and OS (P=.001 and P=.01, respectively). Conclusions: Delay in administering adjuvant RT after

  15. Interval Between Hysterectomy and Start of Radiation Treatment Is Predictive of Recurrence in Patients With Endometrial Carcinoma

    Cattaneo, Richard [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States); Hanna, Rabbie K. [Division of Gynecologic Oncology, Department of Women' s Health Services, Henry Ford Hospital, Detroit, Michigan (United States); Jacobsen, Gordon [Public Health Science, Henry Ford Hospital, Detroit, Michigan (United States); Elshaikh, Mohamed A., E-mail: melshai1@hfhs.org [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States)

    2014-03-15

    Purpose: Adjuvant radiation therapy (RT) has been shown to improve local control in patients with endometrial carcinoma. We analyzed the impact of the time interval between hysterectomy and RT initiation in patients with endometrial carcinoma. Methods and Materials: In this institutional review board-approved study, we identified 308 patients with endometrial carcinoma who received adjuvant RT after hysterectomy. All patients had undergone hysterectomy, oophorectomy, and pelvic and para-aortic lymph node evaluation from 1988 to 2010. Patients' demographics, pathologic features, and treatments were compared. The time interval between hysterectomy and the start of RT was calculated. The effects of time interval on recurrence-free (RFS), disease-specific (DSS), and overall survival (OS) were calculated. Following univariate analysis, multivariate modeling was performed. Results: The median age and follow-up for the study cohort was 65 years and 72 months, respectively. Eighty-five percent of the patients had endometrioid carcinoma. RT was delivered with high-dose-rate brachytherapy alone (29%), pelvic RT alone (20%), or both (51%). Median time interval to start RT was 42 days (range, 21-130 days). A total of 269 patients (74%) started their RT <9 weeks after undergoing hysterectomy (group 1) and 26% started ≥9 weeks after surgery (group 2). There were a total of 43 recurrences. Tumor recurrence was significantly associated with treatment delay of ≥9 weeks, with 5-year RFS of 90% for group 1 compared to only 39% for group 2 (P<.001). On multivariate analysis, RT delay of ≥9 weeks (P<.001), presence of lymphovascular space involvement (P=.001), and higher International Federation of Gynecology and Obstetrics grade (P=.012) were independent predictors of recurrence. In addition, RT delay of ≥9 weeks was an independent significant predictor for worse DSS and OS (P=.001 and P=.01, respectively). Conclusions: Delay in administering adjuvant RT after

  16. Who Says There Is No Life after Abandonment? A Grounded Theory on the Coping of Abandoned Filipino Elderly in Nursing Homes

    de Guzman, Allan B.; Lacorte, Jeremy C.; Lacsamana, Andrea Keith G.; Lagac, Mark Lawrence M.; Laguador, Jobel M.; Lapid, Jazminn Jessica R.; Lee, Lyndcie Miriele C.

    2012-01-01

    Cases of abandoned elderly are increasing worldwide. By and large, this group struggles with the sudden change in living arrangement as well as abandonment by their families. Consequently, many elderly are forced into living in nursing homes for the remainder of their lives. Abandonment among these elderly negatively affects how they view…

  17. LigaSure versus Conventional Suture Ligature for Vaginal Hysterectomy: a Randomized Controlled Trial

    Mohamed Abd Elzaher, a, b, Ashraf Moawad, a, c and Hanaa Abu-Ria

    2011-07-01

    Full Text Available Introduction: Vaginal hysterectomy is considered to be the method of choice for removal of the uterus. Of particular concern for the vaginal surgeon is the ability to access, visualize, and legate structures while maintaining adequate hemostasis. Surgical hemostasis can be secured by a variety of methods, including mechanical means (sutures or vessel coagulation (diathermy. Electro-surgical vessel sealing (LigaSure is a new hemostatic system based on the combination of pressure and bipolar electrical energy and is able to seal vessels up to 7 mm in diameter. Objective: To assess the safety and efficacy of using the LigaSure vessel sealing system for securing the pedicles during vaginal hysterectomy in comparison with the conventional method of securing the pedicles by suture ligation. Design: Prospective randomized controlled trial. Setting: Obstetrics and Gynecology departments (Al-Kharj University Hospital- KSA, Enjab Hospital - UAE and Gulf Medical College and Research Centre- UAE. Methods: 80 patients undergoing vaginal hysterectomy for benign conditions were randomized to either LigaSure group (n=40 or Suture group (n=40. Main outcome measures: The primary outcome measures were the operative time and blood loss while the secondary outcome measures were the hospital stay and intra- and post-operative complications. Results: Patients in the LigaSure group had a significantly reduced operating time (37.1 ± 8.9 min vs. 63.8 ± 10.9 min; P < 0.001, operative blood loss (125.5 ± 33.2 mL vs. 264.6 ± 70.4 mL; P < 0.001, requirement of surgical sutures(1.2 ± 0.4 units vs. 8.2 ± 0.4 units; p < 0.001, pain status (2.0 ± 0.6 vs. 3.7 ± 0.7; P < 0.001, and hospital stay (30.3 ± 2.5 h vs. 45.7 ±10.5 h; P < 0.001 compared to the control group. The overall complication rate in the study was 10 % (8/80, and did not differ between patients of the LigaSure and control group. Conclusion: The use of LigaSure device can reduce operative time. It allows

  18. Adnexectomy Versus Ovarian Conservation During Total Hysterectomy for Benign Conditions. A Difficult Dilemma

    Ion Păun

    2014-09-01

    Full Text Available Introduction: Bilateral adnexectomy is a surgical procedure that is frequently associated with total hysterectomy performed for benign uterine conditions. Given the relatively wide range of indications for the aforementioned type of salpingo-ooforectomy which in it self is not devoid of potential risks the patients' and physicians' decision-making should take into account several parameters (most helpful to individualize treatment such as published ratio of removal versus conservation of uterine adnexae, patients' age, pre/postmenopausal status at the time of surgery, relevant family and personal history including current use of hormonal replacement therapy. Material and Method: This retrospective cohort study was conducted among 457 women aged 18 years or older who underwent abdominal total hysterectomies for benign uterine conditions between 2000 and 2011. The study patients were stratified by age for better characterization and according to recent publications. Results: Uni- or bilateral oophorectomy was performed in 50% of the subgroup of hysterectomized women younger than 35 years old whereas in the other half of the same age category of patients the uterine adnexas were conserved. Among the study patients aged between 35 and 45 years in 50.5% of the cases the unilateral type of oophorectomy was undertaken while for the other 49.5% of women the bilateral adnexectomy was the rule. Finally, in all patients older than age 45 years the bilateral salpingo-oophorectomy was the procedure of choice. Moreover, out of the 55 study patients in which at least one ovary was preserved, 30.9% of cases underwent the removal of the remaining adnexa when affected de novo by malignant (n=3 or benign (n=14 pathology. Last but not least, in order to reduce both cancer risks and early menopause hazards, our analysis based on recent literature attempted to identify patient characteristics (relevant factors associated with or without bilateral oophorectomy at the

  19. Combined spinal and general anesthesia is better than general anesthesia alone for laparoscopic hysterectomy

    Poonam S Ghodki

    2014-01-01

    Full Text Available Context: Spinal anesthesia (SA was combined with general anesthesia (GA for achieving hemodynamic stability in laparoscopic hysterectomy. Aims: The aim of our study was to evaluate the impact of SA combined with GA in maintaining hemodynamic stability in laparoscopic hysterectomy. The secondary outcomes studied were requirement of inhaled anesthetics, vasodilators, and recovery profile. Settings and Design: We conducted a prospective, randomized study in ASAI/II patients posted for laparoscopic hysterectomy, who were willing to participate in the study. Materials and Methods: Patients were randomly assigned to receive SA with GA (group SGA or plain GA (group GA. Group SGA received 10 mg bupivacaine (heavy for SA. GA was administered using conventional balanced technique. Maintenance was carried out with nitrous oxide, oxygen, and isoflurane. Comparison of hemodynamic parameters was carried out during creation of pneumoperitoneum and thereafter. Total isoflurane requirement, need of vasodilators, recovery profile, and regression of SA were studied. Statistical analysis used: Descriptive statistics in the form of mean, standard deviation, frequency, and percentages were calculated for interval and categorical variables, respectively. One-way analysis of variance (ANOVA was applied for noting significant difference between the two groups, with chi-square tests for categorical variables and post-hoc Bonferroni test for interval variables. Comparison of heart rate (HR, mean arterial pressure (MAP, SPO2, and etCO2 was done with Student′s t-test or Mann-Whitney test, wherever applicable. Results: Patients in group SGA maintained stable and acceptable MAP values throughout pneumoperitoneum. The difference as compared to group GA was statistically significant (P < 0.01. Group GA showed additional requirement of metoprolol (53.33% and higher concentration of isoflurane (P < 0.001 to combat the increased MAP. Recovery was early and quick in group SGA as

  20. Seasonal energy storage using bioenergy production from abandoned croplands

    Bioenergy has the unique potential to provide a dispatchable and carbon-negative component to renewable energy portfolios. However, the sustainability, spatial distribution, and capacity for bioenergy are critically dependent on highly uncertain land-use impacts of biomass agriculture. Biomass cultivation on abandoned agriculture lands is thought to reduce land-use impacts relative to biomass production on currently used croplands. While coarse global estimates of abandoned agriculture lands have been used for large-scale bioenergy assessments, more practical technological and policy applications will require regional, high-resolution information on land availability. Here, we present US county-level estimates of the magnitude and distribution of abandoned cropland and potential bioenergy production on this land using remote sensing data, agriculture inventories, and land-use modeling. These abandoned land estimates are 61% larger than previous estimates for the US, mainly due to the coarse resolution of data applied in previous studies. We apply the land availability results to consider the capacity of biomass electricity to meet the seasonal energy storage requirement in a national energy system that is dominated by wind and solar electricity production. Bioenergy from abandoned croplands can supply most of the seasonal storage needs for a range of energy production scenarios, regions, and biomass yield estimates. These data provide the basis for further down-scaling using models of spatially gridded land-use areas as well as a range of applications for the exploration of bioenergy sustainability. (letter)

  1. Blasting as a method for abandoned mine land reclamation

    Blasting methods have been proposed for reclaiming abandoned underground coal mine sites having unstable conditions. The objective of blasting is twofold: the permanent stabilization of an area by the collapse of underground workings to prevent any future subsidence, and the use of blasting to close existing sinkholes. This paper presents the results of two research projects funded by the Bureau of Mines Abandoned Mine Land Research Program to investigate the feasibility of blasting to assist in the reclamation of shallow abandoned coal mine sites. Blasting tests were conducted at Beulah, North Dakota and at Scobey, Montana, involving different configurations. The first test was a 10-acre site where blasting was used to collapse regular room and pillar panels for which good mine layout information was available. The second test involved a one acre site containing very irregular workings for which there was little available information. Finally, blasting techniques were used to close 13 individual vertical openings. The depths to the coal seams were 60 feet or less at all sites. When blasting for Abandoned Mine Land Reclamation, material must be cast downward into the abandoned developments or laterally into the sinkhole. Designs based on cratering concepts and spherical charges worked well. The blasting techniques successfully collapsed and stabilized the test areas. Cost of reclamation for the two test sites are presented. Data from blast vibration monitoring are presented because control of vibrations is of concern when mitigation efforts are conducted near homes

  2. Abandoned pastoral settlements provide concentrations of resources for savanna birds

    Söderström, Bo; Reid, Robin S.

    2010-03-01

    Knowledge is poor of how fertilization affects birds in grasslands. We investigated the impact on birds of abandoned pastoral settlements that historically received very high levels of livestock dung. A total of 28 abandoned settlements and 74 landscape controls - in Koyake Group Ranch and Maasai Mara National Reserve in Kenya - were surveyed for birds during the wet and/or dry season. Our results showed that bird species richness and total abundance increased within 200 m of abandoned pastoral settlements, particularly during the dry season when foraging resources on the savanna are limited. The high concentrations of nutrients inside abandoned settlements favoured the abundance of Diptera and Coleoptera, as shown by invertebrate surveys performed during the dry season on a subset of 32 sites. Both total numbers and dry biomass of these two invertebrate orders were higher on abandoned settlements in comparison with the surrounding landscape. We conclude that higher fertilization levels cause a temporal and spatial redistribution of birds on the savanna. Livestock fertilization and bird abundance are probably linked through an increase in abundance of invertebrate food upon which birds feed in an opportunistic fashion.

  3. How to find abandoned oil and gas wells

    Johnston, K.H.; Carroll, H.B.; Heemstra, R.J.; Armstrong, F.E.

    1973-01-01

    This guide was written to furnish the coal industry with a description of techniques, instruments, and clues on how to find abandoned oil and gas wells that have penetrated coal seams. The report includes specific information on searching techniques currently in use by several coal mining companies, gas-transmission companies, and waterflood operators, as well as information on State agencies responsible for the enforcement of laws and the preservation and distribution of data pertaining to the drilling, development, and abandonment of oil and gas wells. Comparative tests were performed with several commercial electronic metal detectors to determine the feasibility of using them to aid in the search for abandoned wells and to determine the instrument most suited for that particular use. The role of methane detectors to locate abandoned wells is described, including a case history. Tests were made to develop an efficient procedure to follow in systematically searching an area for metallic clues or hydrocarbon evidence to abandoned wells. The guide describes, in detail, a search sequence, including the collection of basic data, preparation of the selected area, and the physical search. Methods are given for evaluating the results. (auth)

  4. Toward Radicalizing Community Service Learning

    Sheffield, Eric C.

    2015-01-01

    This article advocates a radicalized theoretical construction of community service learning. To accomplish this radicalization, I initially take up a discussion of traditional understandings of CSL rooted in pragmatic/progressive thought. I then suggest that this traditional structural foundation can be radicalized by incorporating Deborah…

  5. Oligorotaxane Radicals under Orders

    WANG, YUPING; Frasconi, Marco; Liu, Wei-Guang; Sun, Junling; Wu, Yilei; Nassar, Majed S.; Botros, Youssry Y.; Goddard, William A.; Wasielewski, Michael R.; Stoddart, J. Fraser

    2016-01-01

    A strategy for creating foldameric oligorotaxanes composed of only positively charged components is reported. Threadlike components—namely oligoviologens—in which different numbers of 4,4′-bipyridinium (BIPY2+) subunits are linked by p-xylylene bridges, are shown to be capable of being threaded by cyclobis(paraquat-p-phenylene) (CBPQT4+) rings following the introduction of radical-pairing interactions under reducing conditions. UV/vis/NIR spectroscopic and electrochemical investigations sugge...

  6. Oligorotaxane Radicals under Orders

    WANG, YUPING; Frasconi, Marco; Liu, Wei-Guang; Sun, Junling; Wu, Yilei; Nassar, Majed S.; Botros, Youssry Y.; Goddard, William A.; Wasielewski, Michael R.; Stoddart, J. Fraser

    2016-01-01

    A strategy for creating foldameric oligorotaxanes composed of only positively charged components is reported. Threadlike components—namely oligoviologens—in which different numbers of 4,4′-bipyridinium (BIPY^(2+)) subunits are linked by p-xylylene bridges, are shown to be capable of being threaded by cyclobis(paraquat-p-phenylene) (CBPQT^(4+)) rings following the introduction of radical-pairing interactions under reducing conditions. UV/vis/NIR spectroscopic and electrochemical investigations...

  7. Investigation of abandoned surface settling ponds

    One of the problems that may appear during the ground reclamation of surface settling ponds of underground mines is enhanced radon exhalation from bottom sediments. This problem becomes more important when the concentration of radium isotopes in sediments is enhanced due to the discharge of radium-bearing waters into the pond. For investigations, special radon accumulation chambers have been designed and constructed. The concentration of radon in these chambers can be measured with the application of Lucas cells or activated charcoal detectors. In the latter method, radon is extracted from charcoal into a liquid scintillator and the sample is measured in a liquid scintillation spectrometer. Therefore the lower limit of detection (LLD) of the second method is as low as 0.1 mBq·m-2s-1, while the LLD for Lucas cells is 1.5 mBq·m-2s-1. The above-mentioned methods for the measurement of radon exhalation have been applied to investigations of a surface settling pond of one Polish coal mine, abandoned and emptied at the beginning of 2002. An agreement between the mine management and the local authority was to make the ground reclamation of the pond. A thick layer of sediments with an enhanced concentration of radium isotopes covers the bottom of the pond. The maximum concentration of radium isotopes in these sediments is as high as 2000 Bq/kg for 226Ra and up to 4000 Bq/kg for 228Ra. Two years after the complete release of brines from the pond, bottom sediments are still soaked with water. Therefore, measurements of radon in soil gas were not possible. On the other hand, in some parts of the pond investigations of radon exhalation coefficient were done. The preliminary results of measurements, conducted in 2002, showed that radon exhalation rates in specific parts of the pond were higher than the highest values of radon exhalation from the ground in the Upper Silesia region. Values of exhalation coefficient up to 200 mBq·m-2s-1 were found. It must be pointed out that

  8. Assessment of environmental implications of abandoned oil and gas wells

    A detailed study was made of the potential for abandoned oil and gas wells in the Lower Tuscaloosa sand of Mississippi and Louisiana to act as conduits for movement of saline water from the Lower Tuscaloosa into underground sources of drinking water (USDW's). Finite-difference numerical modeling determined the extent that water might be forced from the Lower Tuscaloosa sand into a USDW as a result of injection into the Lower Tuscaloosa. Within the range of conditions modeled, water from the Lower Tuscaloosa never traveled into a USDW. On the basis of the modeling, the authors concluded that it is unlikely that abandoned oil and gas wells in the Lower Tuscaloosa would serve as conduits for water movement from the trend into a USDW. The procedures developed in this study should be readily applicable to analysis of the potential for abandoned wells to act as pathways for contaminant flow into USDW's in other oil and gas producing areas of the country

  9. Laparoscopic hysterectomy with bilateral orchidectomy for Persistent Mullerian duct syndrome with seminoma testes: Case report

    Senthilnathan Palanisamy

    2015-01-01

    Full Text Available Persistent Mullerian duct syndrome (PMDS is one of the three rare intersex disorders caused by defective anti-mullerian hormone or its receptor, characterized by undescended testes with presence of underdeveloped derivatives of mullerian duct in genetically male infant or adult with normal external genitals and virilization. This population will essentially have normal, 46(XY, phenotype. We hereby present a case of PMDS, presented with incarcerated left inguinal hernia associated with cryptorchidism and seminoma of right testes. Patient underwent laparoscopic hernia repair with bilateral orchidectomy and hysterectomy with uneventful postoperative recovery. Here we highlight the importance of minimal access approach for this scenario in terms of better visualization, less blood loss, combining multiple procedures along with early return to work and excellent cosmetic outcome.

  10. Iatrogenic Lower Extremity Subcutaneous Emphysema after Prolonged Robotic-Assisted Hysterectomy

    Monica Hagan Vetter

    2015-01-01

    Full Text Available Subcutaneous emphysema is a known complication of carbon dioxide insufflation, an essential component of laparoscopy. The literature contains reports of hypercarbia, pneumothorax, or pneumomediastinum. However, isolated lower extremity subcutaneous emphysema remains a seldom-reported complication. We report a case of unilateral lower extremity subcutaneous emphysema following robotic-assisted hysterectomy, bilateral salpingooophorectomy, staging, and anterior/posterior colporrhaphy for carcinosarcoma and vaginal prolapse. On postoperative day 1, the patient developed tender crepitus and bruising of her right ankle. Radiography confirmed presence of subcutaneous air. Vital signs and laboratory findings were unremarkable. Her symptoms spontaneously improved over time, and she was discharged in good condition on day 2. In stable patients with postoperative extremity swelling or pain with crepitus on exam, the diagnosis of iatrogenic subcutaneous emphysema must be considered.

  11. The value of random biopsies, omentectomy, and hysterectomy in operations for borderline ovarian tumors

    Kristensen, Gitte Schultz; Schledermann, Doris; Mogensen, Ole;

    2014-01-01

    OBJECTIVE: Borderline ovarian tumors (BOTs) are treated surgically like malignant ovarian tumors with hysterectomy, salpingectomy, omentectomy, and multiple random peritoneal biopsies in addition to removal of the ovaries. It is, however, unknown how often removal of macroscopically normal-appearing...... Hospital from 2007 to 2011 were eligible for this study. Data were extracted from electronic records. Intraoperative assessment of tumor spread (macroscopic disease) and the microscopic evaluation of removed tissues were the main outcome measures. RESULTS: The study included 75 patients, 59 (78.7%) in...... surgeon's identification of macroscopic tumor spread to the contralateral ovary and the peritoneum had a sensitivity of 88% and 69.2% and a specificity of 90.2% and 92.5%, respectively. The macroscopic assessment of the uterine surface, the omentum, and the pelvic and para-aortal lymph nodes was not a...

  12. Metastatic low-grade endometrial stromal sarcoma of the sigmoid colon three years after hysterectomy

    Yuki Asada; Hajime Isomoto; Fumitaka Akama; Noriko Nomura; Chun-Yang Wen; Haruhiko Nakao; Ikuo Murata; Kan Toriyama; Shigeru Kohno

    2005-01-01

    A 49-year-old woman, who had undergone hysterectomy for low-grade endometrial stromal sarcoma (ESS) 3 years ago, presented with a 2-wk history of lower abdominal pain. Barium enema and sigmoidoscopy disclosed a polypoid submucosal tumor. Histopathologic features of biopsy specimens from the lesion were similar to those of the resected uterine ESS. Under the diagnosis of metastatic ESS of the sigmoid colon, sigmoidectomy was performed. Microscopic examination demonstrated dense proliferation of spindle cells with little nuclear atypia, which were sometimes arranged in whorled pattern around abundant arterioles. Mitotic count is below 1 in 10 highpower fields. Immunohi-stochemically, the neoplastic cells were strongly positive for vimentin, estrogen receptor and progesterone receptor but negative for α-smooth muscle actin, S-100 protein and CD34. Thus, a final diagnosis of low-grade ESS metastasis to the sigmoid colon was made.Her postoperative course was uneventful and hormonal therapy with progestational agents is entertained.

  13. Combined epidural-spinal opioid-free anaesthesia and analgesia for hysterectomy

    Callesen, T; Schouenborg, Lars Øland; Nielsen, D; Guldager, H; Kehlet, H

    1999-01-01

    Postoperative nausea and vomiting (PONV) are major problems after gynaecological surgery. We studied 40 patients undergoing total abdominal hysterectomy, allocated randomly to receive opioid-free epidural-spinal anaesthesia or general anaesthesia with continuous epidural bupivacaine 15 mg h-1 or...... continuous bupivacaine 10 mg h-1 with epidural morphine 0.2 mg h-1, respectively, for postoperative analgesia. Nausea, vomiting, pain and bowel function were scored on 4-point scales for 3 days. Patients undergoing general anaesthesia had significantly higher nausea and vomiting scores (P < 0.01) but...... significantly lower pain scores during rest (P < 0.05) and mobilization (P < 0.01). More patients undergoing general anaesthesia received antiemetics (13 vs five; P < 0.05), but fewer received supplementary opioids on the ward (eight vs 16; P < 0.05). We conclude that opioid-free epidural-spinal anaesthesia for...

  14. Comparison between Preoperative Rectal Diclofenac Plus Paracetamol and Diclofenac Alone for PostoperativePain of Hysterectomy.

    Saghar Samimi Sede

    2014-09-01

    Full Text Available To detect whether the preoperative combined administration of rectal diclofenac and paracetamol is superior to placebo or rectal diclofenac alone for pain after abdominal hysterectomy.Ninety female patients (American Society of Anesthesiologists (ASA physical status I-II, scheduled for abdominal hysterectomy were recruited to this double blind trial and were randomized to receive one of three modalities before surgery: rectal combination of diclofenac and paracetamol, rectal diclofenac alone or rectal placebo alone which were given as a suppository one hour prior to surgery. The primary outcomes were visual analogue pain scores measured at 0, 0.5, 2, 4, 8, 16 and 24 hours after surgery and the time of first administration and also total amount of morphine used in the first 24 hour after surgery. A 10 cm visual analog scale (VAS was used to assess pain intensity at rest.In patients receiving the combination of diclofenac and paracetamol total dose of morphine used in the first 24 hour after surgery was significantly lower (13.9 ± 2.7 mg compared to diclofenac group (16.8± 2.8 mg and placebo group (20.1 ± 3.6 mg (p<0.05. VAS pain score was significantly lower in combination group compared to other groups all time during first 24 hours (p<0.05. There had been a significant difference between combination group and the two other groups in terms of the first request of morphine (p<0.05.According to our study Patients who receive the rectal diclofenac-paracetamol combination experience significantly a lower pain scale in the first 24 hour after surgery compared with patients receiving diclofenac or placebo alone. Their need to supplementary analgesic is significantly later and lower compared to placebo and diclofenac alone.

  15. ENERGY TRANSPORT AND POTENTIAL OF AN ABANDONED MINE

    BÉLA ILLÉS; JÁNOS ZSUGA; ANIKÓ TÓTH

    2012-01-01

    In the „70s an important copper ore mine was implemented in Recsk, Northern Hungary. Unfortunately as soon as the use of the roadways were finished the activities were suspended, because the decreasing price of the copper on the international market. The mine then was abandoned the roadways and the shafts were flooded by mine water. The abandoned mine has a substantial geothermal potential. The terrestrial heat flow is anomalously high: 0.108 W/m2, the temperature is 59.5 0C at the lower leve...

  16. Mapping abandoned agriculture with multi-temporal MODIS satellite data

    Alcantara, Camilo; Kuemmerle, Tobias; Prishchepov, Alexander;

    2012-01-01

    agriculture was widespread. Input data included Normalized Difference Vegetation Index (NDVI) and reflectance bands (NASA Global MODIS Terra and Aqua 16-Day Vegetation Indices for the years 2003 through 2008, ~250-m resolution), as well as phenology metrics calculated with TIMESAT. The data were classified...... with Support Vector Machines (SVM). Training data were derived from several Landsat classifications of agricultural abandonment in the study area. A validation was conducted based on independently collected data. Our results showed that it is possible to map abandoned agriculture for large areas from MODIS...

  17. Observational evaluation of preoperative, intraoperative, and postoperative characteristics in 117 Brazilian women without uterine prolapse undergoing vaginal hysterectomy

    Osako MT

    2012-09-01

    Full Text Available Claudio Sergio Batista,1 Takasi Osako,2 Eliana Mara Clemente,2 Fernanda Carvalhido Antonio Batista,3 Maurício Takeshi Janiques Osako41Department of Gynecology and Obstetrics of Faculty of Medicine of Petropolis, Petropolis, Rio de Janeiro, Brazil; 2Gynecology and Obstetrics, Casa Providencia Hospital, Petropolis, Rio de Janeiro, Brazil; 3School of Medicine of Technical Educational Foundation Souza Marques, Rio de Janeiro, Brazil; 4School of Medicine of University Gama Filho, Rio de Janeiro, BrazilBackground: Despite the introduction of minimally invasive approaches for various benign uterine problems, hysterectomy is often still performed abdominally, but the vaginal route should be used whenever possible. The aim of this study was to identify the preoperative, intraoperative, and postoperative characteristics of women undergoing vaginal hysterectomy in the absence of uterine prolapse.Methods: A prospective, descriptive, quantitative, noncomparative study was conducted in 117 women between August 2009 and February 2011 in Petropolis, Rio de Janeiro, Brazil. The women included had a uterine indication for hysterectomy, their surgeries were performed by the same team, and they were followed up for 12 months. An adapted Pelvic Organ Prolapse Quantification system was used to check for uterine prolapse.Results: The age range of the women was 33–59 years, uterine volume was 300–900 mL, and 73.50% has undergone prior cesarean section. The main indication for hysterectomy was uterine myoma (64.95%, with a surgery time of 30–60 minutes in 55 (59.82% and 19 (15.98% cases, respectively. Uterine volume reduction was performed in 41 (35.05% cases, salpingectomy was the most common associated surgery (81.19%, and anesthesia was subdural (68.37%. Common intraoperative complications included bladder lesions (8.54%, with conversion to the abdominal route being necessary in one case (1.28%, and the most common postoperative complication being vaginal

  18. A radical publishing collective: the Journal of Radical Librarianship

    Simon Barron

    2015-01-01

    The Journal of Radical Librarianship is a new open-access journal publishing scholarly work in the field of radical librarianship. The focus on critical approaches to librarianship and anti-marketisation of information is reflected not only in our subject matter but in our publishing model, our licensing model, and our organisational practices. We hope to foster open and engaging discussions about radical approaches to librarianship and information studies.

  19. Abandoning uranium mining in Germany. Rehabilitation of the Wismut site

    After the unification of Germany in 1989, the Government decided to abandon uranium mining in two lands of the former Eastern Germany, in Saxonia and Thuringia. The closing of the mines and the reclamation and rehabilitation of the site cost more than 10 billion USD. The rehabilitation of the Wismut site is described in detail. (R.P.)

  20. 78 FR 9803 - Tennessee Abandoned Mine Land Program

    2013-02-12

    ... Program; Part 879, Management and Disposition of Lands and Water; Part 882, Reclamation on Private Land..., Management, and Disposition of Lands and Water. This section is also in conformity with the Tennessee Code... program in full, effective October 1, 1984. See 49 FR 38874. Abandoned Mine Lands Program (Title...

  1. Oligorotaxane Radicals under Orders.

    Wang, Yuping; Frasconi, Marco; Liu, Wei-Guang; Sun, Junling; Wu, Yilei; Nassar, Majed S; Botros, Youssry Y; Goddard, William A; Wasielewski, Michael R; Stoddart, J Fraser

    2016-02-24

    A strategy for creating foldameric oligorotaxanes composed of only positively charged components is reported. Threadlike components-namely oligoviologens-in which different numbers of 4,4'-bipyridinium (BIPY(2+)) subunits are linked by p-xylylene bridges, are shown to be capable of being threaded by cyclobis(paraquat-p-phenylene) (CBPQT(4+)) rings following the introduction of radical-pairing interactions under reducing conditions. UV/vis/NIR spectroscopic and electrochemical investigations suggest that the reduced oligopseudorotaxanes fold into highly ordered secondary structures as a result of the formation of BIPY(•+) radical cation pairs. Furthermore, by installing bulky stoppers at each end of the oligopseudorotaxanes by means of Cu-free alkyne-azide cycloadditions, their analogous oligorotaxanes, which retain the same stoichiometries as their progenitors, can be prepared. Solution-state studies of the oligorotaxanes indicate that their mechanically interlocked structures lead to the enforced interactions between the dumbbell and ring components, allowing them to fold (contract) in their reduced states and unfold (expand) in their fully oxidized states as a result of Coulombic repulsions. This electrochemically controlled reversible folding and unfolding process, during which the oligorotaxanes experience length contractions and expansions, is reminiscent of the mechanisms of actuation associated with muscle fibers. PMID:27163033

  2. Into the Woods Again: Three Recent Young Adult Novels of Parental Abandonment.

    Munde, Gail

    1997-01-01

    Takes a look at three recent young adult novels that are stories of children abandoned by their parents, and shows how each retains the essential features of the Hansel and Gretel folktale, a prototype of abandonment stories. (SR)

  3. America's Tolerance for French Radicalism

    Wolin, Richard

    2008-01-01

    The publication of Francois Cusset's "French Theory" raises a series of fascinating questions concerning the trans-Atlantic transmission and circulation of ideas. Most important, it impels everyone to inquire why for a time French thought managed to flourish in American universities while French intellectuals rapidly abandoned the entire paradigm.…

  4. Determinants of the exclusive breastfeeding abandonment: psychosocial factors

    Mariana Campos Martins Machado

    2014-12-01

    Full Text Available OBJECTIVE To assess the determinants of exclusive breastfeeding abandonment. METHODS Longitudinal study based on a birth cohort in Viçosa, MG, Southeastern Brazil. In 2011/2012, 168 new mothers accessing the public health network were followed. Three interviews, at 30, 60, and 120 days postpartum, with the new mothers were conducted. Exclusive breastfeeding abandonment was analyzed in the first, second, and fourth months after childbirth. The Edinburgh Postnatal Depression Scale was applied to identify depressive symptoms in the first and second meetings, with a score of ≥ 12 considered as the cutoff point. Socioeconomic, demographic, and obstetric variables were investigated, along with emotional conditions and the new mothers’ social network during pregnancy and the postpartum period. RESULTS The prevalence of exclusive breastfeeding abandonment at 30, 60, and 120 days postpartum was 53.6% (n = 90, 47.6% (n = 80, and 69.6% (n = 117, respectively, and its incidence in the fourth month compared with the first was 48.7%. Depressive symptoms and traumatic delivery were associated with exclusive breastfeeding abandonment in the second month after childbirth. In the fourth month, the following variables were significant: lower maternal education levels, lack of homeownership, returning to work, not receiving guidance on breastfeeding in the postpartum period, mother’s negative reaction to the news of pregnancy, and not receiving assistance from their partners for infant care. CONCLUSIONS Psychosocial and sociodemographic factors were strong predictors of early exclusive breastfeeding abandonment. Therefore, it is necessary to identify and provide early treatment to nursing mothers with depressive symptoms, decreasing the associated morbidity and promoting greater duration of exclusive breastfeeding. Support from health professionals, as well as that received at home and at work, can assist in this process.

  5. Abandonment, Ecological Assembly and Public Health Risks in Counter-Urbanizing Cities

    Alexandra Gulachenski; Ghersi, Bruno M.; Amy E. Lesen; Michael J Blum

    2016-01-01

    Urban landscapes can be transformed by widespread abandonment from population and economic decline. Ecological assembly, sometimes referred to as “greening”, following abandonment can yield valuable ecosystem services, but also can pose a risk to public health. Abandonment can elevate zoonotic vector-borne disease risk by favoring the hyperabundance of commensal pests and pathogen vectors. Though greater biodiversity in abandoned areas can potentially dilute vector-borne pathogen transmission...

  6. Robot-Assisted Laparoscopic Hysterectomy,Gonadal Biopsy, and Orchiopexies in an Infant with Persistent Mullerian Duct Syndrome

    Wu, Jonathan A.; Hsieh, Michael H.

    2013-01-01

    An infant born with hypospadias and no palpable gonads was diagnosed with persistent mullerian duct syndrome (PMDS) based on history, physical examination, laboratory testing, and radiologic imaging. A robot-assisted laparoscopic hysterectomy, right gonadal biopsy, and bilateral orchiopexies were performed without incident. Final pathology confirmed the diagnosis of PMDS. To our knowledge, this is only the second report of PMDS managed through a robot-assisted laparoscopic approach.

  7. The Abandonment of an Active Lifestyle Within University Students: Reasons for Abandonment and Expectations of Re-Engagement

    Manuel Gómez-López

    2011-08-01

    Full Text Available The objective of this research is to analyse in detail the barriers that make university students abandon the practice of physical activity and adopt a sedentary lifestyle. In order to do so, a questionnaire on the analysis of sports habits and lifestyles was administered to 795 students who stated not having done any physical and/or sports activity for at least one year at the moment of the field-work. A factorial, descriptive and correlation analysis was carried out. The results reveal that university students abandon a healthy lifestyle mainly due to external barriers particularly because of lack of time. On the one hand, women appear to be the ones who, to a great extent, adopt a sedentary lifestyle. On the other hand, men are the ones who refer more to abandoning the practice of physical activity due to internal barriers. The majority of the university students gave up practicing sport before entering university alluding to external barriers as their reason for the abandonment. A greater part of the sedentary university students expressing that they will be active in the future, left the practice of sport due to internal barriers.

  8. Histopathological correlation of adenomyosis and leiomyoma in hysterectomy specimens as the cause of abnormal uterine bleeding in women in different age groups in the Kumaon region: A retroprospective study

    Rizvi, Ghazala; Pandey, Harishankar; Pant, Hema; Chufal, Sanjay Singh; Pant, Prabhat

    2013-01-01

    Objective: To study adenomyosis and leiomyoma as the cause of Abnormal Uterine Bleeding AUB in hysterectomy specimens. Study Method: A descriptive study was carried out on 184 hysterectomy specimens of patients with AUB during the period of Jan 2010 to Dec 2011. Data including age, parity, symptoms and clinical indication for hysterectomy was collected for the study. The specimens were processed routinely and stained with hematoxylin and eosin stain and examined microscopically. Results: Wome...

  9. Shot to Death: The Fate of Abandoned Places in the Hands of Artists

    Nezaket Tekin

    2015-08-01

    Full Text Available This essay discusses the use of abandoned places by photographers. I review this subject from a perspective of remembering and forgetting. Giving examples of artists, especially photographer’s works whose subjects are abandoned places in Izmir and Detroit, I interpret photographs of abandoned places in the context of hauntology and ghost-metaphors.

  10. 76 FR 12222 - Wisconsin Central, Ltd.-Abandonment Exemption-in Marathon County, WI

    2011-03-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Surface Transportation Board Wisconsin Central, Ltd.--Abandonment Exemption--in Marathon County, WI... ] Abandonments to abandon 1.14 miles of rail line between mileposts 17.50 and 18.64, in Weston, Marathon...

  11. Radical cystectomy in eldery

    Bančević Vladimir

    2015-01-01

    Full Text Available Background/Aim. Radical cystectomy is the method of choice for the treatment of muscle invasive bladder cancer. This major surgery is associated with many complications, especially in older patients. The aim of this study was to analyze preoperative comorbidity, and intraoperative and postoperative complicatons in patients older than 75 years. Methods. This clinical, retrospective study included 46 patients over 75 years, who underwent radical cystectomy. Indications for surgery, and complications during and after the surgery were followed up. Results. Preoperatively, anemia caused by hematuria was registered in 76% of the patients. In 52% of the patients urine derivation was performed by ileal conduit, in 35% by ureterocutaneostomy and in 13% orthotopic ileal neobladder was created. The average duration of surgery was 190 (120-300 min. A total of 76% of the patients were treated by blood supstitution intraoperatively, average 630 (310-1230 mL. Concerning pathological stage of transitional cell carcinoma of urinary bladder, 26% of the patients had T2, 4% T3a, 52% T3b, and 14% T4a stage. In one case, planocellular carcinoma was diagnosed by patohistological examination, and in 2 cases prostate carcinoma was incidentally found. The average duration of hospitalization was 16 (8-35 days. Conclusion. The main reason for cystectomy in patients over 70 and 80 years was gross hematuria caused by bladder cancer, with consecutive anemia which could not be solved using endoscopic treatment or blood supstitution. As expected, a prolonged stay in hospital after cystectomy, and a higher rate of complications were recorded in this population.

  12. Community members’ responses to the elective hysterectomy of an intellectually disabled girl

    Carol Hamilton

    2011-06-01

    Full Text Available Abstract The United Nations Convention on the Rights of People with Disabilities (2007 guarantees all intellectually disabled women the right to full bodily integrity. However, non-therapeutic sterilisations continue to be proposed as a means of managing the support needs of some members of this group. The opinions of community members, and whether men and women's views differ in relation to this topic, are rarely canvassed. Yet these views are significant as what constitutes acceptable social practice is ultimately set and contested at community level. This article reviews comments posted by male and female contributors to a BBC Have Your Say website about a mother's request for a hysterectomy for her 'severely disabled' daughter. Comments suggest the majority of posters endorse the request, however a marked difference by gender in reasons for support is evident. Gender differences are also noted in remarks about the social implications of requests of this kind and in the gender of contributors who thought this topic to be unsuitable for discussion in public forum. The difficulty some posters had with comments made from a rights-based advocacy position is briefly discussed as are possible limitations involved in using rights when debating the issue of non-therapeutic sterilisation. Keywords: intellectual disability, sterilisation, gender, community, rights

  13. A rare case of arteriovenous malformation following hysterectomy in a case of choriocarcinoma

    Suchitra R

    2015-10-01

    Full Text Available A uterine arteriovenous malformation (AVM is a rare cause of uterine bleeding. It may have varied presentations ranging from being completely asymptomatic; to features of congestive heart failure, to vaginal bleeding which may at times life be threatening. Clinical findings in such cases are often un-reliable; requiring a high index of suspicion to make the diagnosis. We report a case of a 46-year-old lady who presented with heavy vaginal bleeding. She has undergone hysterectomy with a histopathology of choriocarcinoma one and half months back. She has received chemotherapy and 8 fractions of radiotherapy for the same. AVM was diagnosed following a CT angiogram and was managed by embolization. We also discuss in brief about this uncommon but serious condition which the radiologist/gynaecologist may encounter in their practice. AV Malformation is a rare but potentially life-threatening cause of vaginal bleeding which must be kept in the differential diagnosis of sudden and massive vaginal bleeding. It requires a high index of clinical suspicion. Despite its rarity, early recognition of an AVM is imperative to enable timely diagnosis and intervention. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1561-1564

  14. Total laparoscopic hysterectomy in cases of very large uteri: a retrospective comparative study.

    Fiaccavento, Andrea; Landi, Stefano; Barbieri, Fabrizio; Zaccoletti, Riccardo; Tricolore, Carlo; Ceccaroni, Marcello; Pomini, Paola; Bruni, Francesco; Soriano, David; Stepniewska, Ania; Selvaggi, Luigi; Zanolla, Luisa; Minelli, Luca

    2007-01-01

    In this review, we assessed the feasibility of total laparoscopic hysterectomy (TLH) in cases of very large uteri weighting more than 500 grams. We compared surgical outcomes and short term follow-up in 149 patients with the uterus weighing less than 350 g (group A: 40-350 g) and 100 patients with the uterus weighing more than 500 g (group B: 500-1550 g). We discovered no statistical difference between the 2 groups in terms of intraoperative complications (group A: 0%; group B: 2%) and postoperative stay (group A: 3.05 +/- 1.89 days; group B: 3.2 +/- 1.28 days). There were statistically significant differences between the 2 groups in terms of operative time (group A: 101.3 +/- 34.3 min; group B: 149.1 +/- 57.2 min.; p <.0001) and postoperative hospital stay length (group A: 2.8 +/- 0.7 days; group B: 3.5 +/- 1.7 days; p <.0001). No major complications occurred in either group. Postoperative minor complications were more frequent in group B (group A: 8.7%; group B: 18%; p = .03). Median time to well-being was comparable in both groups. In conclusion, TLH is a feasible surgical technique also in cases of very large uteri. An increase in operative time, intraoperative blood loss, hospital stay length, and postoperative minor complications can be expected as the uterine weight increases. PMID:17848315

  15. Infusion of hypertonic saline before elective hysterectomy: effects on cytokines and stress hormones

    Kølsen-Petersen, Jens Aage; Bendtzen, Klaus; Tønnesen, Else Kirstine

    2008-01-01

    BACKGROUND: Infusion of hypertonic saline provides early haemodynamic benefits and may affect the immune system. It is unknown if infusion of hypertonic saline affects plasma cytokines and stress hormones after surgery. METHODS: Sixty-two women undergoing abdominal hysterectomy were randomized in a...... double-blind study to infusion of NaCl 7.5% (HS), NaCl 0.9% (NS4), both 4 ml kg(-1), or NaCl 0.9% 32 ml kg(-1) (NS32) over 20 min. Blood was collected at baseline, 1, 4, and 24 h after surgery (n=34) for the determination of interleukin (IL)-1beta, IL-6, IL-8, IL-10, IL-12, IL-1ra, and tumour necrosis...... factor-alpha. Serum cortisol and vasopressin were measured at these time points and 48 h after operation. Epinephrine and norepinephrine (n=26) were quantified at baseline, after infusion, 25 min after incision, 1, and 4 h after surgery. Finally, C-reactive protein was measured at baseline, 24, and 48 h...

  16. Studies of radiation-produced radicals and radical ions

    The radiolytic oxidation of anti-5-methylbicyclo[2.1.0]pentane gives the 1-methylcyclopentene radical cation as the sole rearrangement product H migration whereas oxidation of its syn isomer results in the highly selective formation of the 3-methylcyclopentene radical cation by methyl group migration. Since exactly the same stereoselectivity of olefin formation was observed in corresponding PET (photosensitized electron transfer) studies in the liquid phase, it is concluded that the rearrangement in this case also occurs through the intermediacy of radical cations. Clearly, the radical cation rearrangement must occur very rapidly (10-8--10-9s) under liquid-phase conditions at room temperature to compete with back electron transfer, and therefore the hydrogen (or methyl) migration is a fast process under these conditions. An intramolecular cycloaddition reaction was demonstrated in the radical cation rearrangement of 4-vinylcyclohexene to bicyclo[3.2.1]oct-2-ene. ESR studies show that the radiolytic oxidation of quadricyclane in Freon matrices under conditions of high substrate dilution leads to the bicyclo[3.2.0]hepta-2,6-diene radical cation as well as the previously reported norbornadiene radical cation, the former species predominating at sufficiently low concentrations

  17. A Critique of Block on Abortion and Child Abandonment

    Jakub Bożydar Wiśniewski

    2010-05-01

    Full Text Available The present paper offers a critique of Block on the issues of abortion and child abandonment. Block regards aborting a fetus or abandoning a child as an instance of exercising one’s libertarian right of expelling trespassers from one’s private property. I argue that the above reasoning is flawed due to the lack of the appreciation of the fact that if one voluntarily initiates the causal chain which leads to someone else ending up on his property, the latter person cannot be considered a trespasser. Furthermore, in the light of the above observation, any direct effects resulting from that person’s eviction should be considered the responsibility of the property’s owner. All of this follows from the simple logical fact that in all links of the causal chain under consideration the owner is the ultimate causal agent.

  18. Abandoned coal mine tunnels: Future heating/power Supply centers

    Luo Pingjia; Chen Ning

    2011-01-01

    We have studied three plans for re-use of the abandoned mine roadway tunnels as an energy center.These are the thermostat plan,the thermal accumulator plan,and the CAES plan.Calculations show that the thermostat plan can provide over 15,000 m2 of building air-conditioning/heating load for each kilometer of roadway,but electric power is needed to run the system.Numerical research proved that the accumulation of hot water in the roadway for seasonal heating purposes (a temperature swing from 90 to 54 ℃) is a viable possibility.The CAES plan proposes using the discarded coal mine tunnel as a peaking power station with an energy storage density over 7000 kJ/m3.It can be concluded that presently abandoned coal mines could be reformed into future energy centers for a city.

  19. The problem of abandoned uranium tailings in northern Saskatchewan

    Two Saskatchewan tailings sites, Lorado and Gunnar, covering approximately 89 ha., were abandoned in the early 1960s leaving untreated tailings in lakes and depressions. This report reviews the literature on environmental conditions in abandoned uranium tailings and available managmenet and mitigation options, and identifies research requirements essential for proper treatment of these two sites. The recommended management plan includes isolation of the exposed tailings area from surface waters, stabilization of the exposed tailings surfaces, diversion of runoff around tailings, treatment of overflow water before release, and implementation of an environmental monitoring program. Revegetation appears to be a promising stabilization measure, but research is needed into propagation methods of appropriate native species. Studies of the existing geological and hydrological conditions at both sites, detailed characterization of the wastes, field testing of different surface treatment methods, and nutrient cycling investigations are also needed

  20. Abandoned mine shafts and levels in the British coalfields

    Davies, Christopher S.

    1988-07-01

    Industrial dereliction is a concern to all societies. In the United Kingdom the British government is trying to make its abandoned coalfields more attractive to new industry through a combination of land reclamation and job incentive programs. The most ambitious of these projects occurs in the South Wales Coalfield, which records 200 years of land defilement and the highest unemployment amplitudes in mainland Britain. In returning this area to a semblance of its previous state, problems arise over how best to fill and cap the many derelict pit shafts and abandoned shallow mines that riddle this region. This analysis reports on the methods of treatment used to achieve this end, along with the procedures used to minimize ground subsidence, water pollution, noxious gas emission, and the potential for physical injury. These environmental controls have application to the United States and Western Europe, where pockets of industrial blight are also symptomatic of a troubled local economy.

  1. Abandoned Highway Sections: an Opportunity for Requalification Landscape Projects

    Lucia Moretti

    2014-12-01

    Full Text Available With technology constantly improving, modern highways can nowadays be built through terrains where construction used to be either technically infeasible or too costly. While this results in faster connections and shorter commuting times, it leaves the abandoned historic routes behind without any use. This workshop was aimed at developing solutions for the requalification of abandoned highway sections, focusing on the example of the Autostrada del Sole which bypasses the little town of Vado, Bologna. A concept of converting the section into a Sole Park - a park which offers both relaxation and amusement elements - was developed in order to attract visitors from the neighboring villages and the high-speed highway. Within this context, potential locations for lookouts were identified, giving stunning vistas of the Tuscan-Emilian landscape.

  2. Television method of controlling stowing of abandoned workings

    Zimny, W.

    1978-01-01

    This method describes a method of monitoring stowing of an underground abandoned working by means of a television camera lowered through a drillhole from the surface. The method was used in Poland for the first time in the period from 1974 to 1976. The camera had been previously used to check the technical state of underground sewage systems. The sAV 18 camera can be lowered to a maximum depth of 400 m, it is explosion proof and can be used under conditions of explosion hazard. A scheme of the equipment is given. A method of determining size of old workings using the camera (with light source) is explained. Examples of photos made by the camera (on videotape) of the abandoned working being stowed with a sand-water mixture through a drillhole from the surface are also given. (In Polish)

  3. The Consequences of Chronic Stereotype Threat: Domain Disidentification and Abandonment

    Woodcock, Anna; Hernandez, Paul R.; Estrada, Mica; Schultz, P. Wesley

    2012-01-01

    Stereotype threat impairs performance across many domains. Despite a wealth of research, the long-term consequences of chronic stereotype threat have received little empirical attention. Beyond the immediate impact on performance, the experience of chronic stereotype threat is hypothesized to lead to domain disidentification and eventual domain abandonment. Stereotype threat is 1 explanation why African Americans and Hispanic/Latino(a)s “leak” from each juncture of the academic scientific pip...

  4. Should High-Frequency Ventilation in the Adult Be Abandoned?

    Nguyen, Albert P; Schmidt, Ulrich H; MacIntyre, Neil R

    2016-06-01

    High-frequency oscillatory ventilation (HFOV) can improve ventilation-perfusion matching without excessive alveolar tidal stretching or collapse-reopening phenomenon. This is an attractive feature in the ventilation of patients with ARDS. However, two recent large multi-center trials of HFOV failed to show benefits in this patient population. The following review addresses whether, in view of these trails, HFOV should be abandoned in the adult population? PMID:27235314

  5. "I no longer believe": did Freud abandon the seduction theory?

    Ahbel-Rappe, Karin

    2006-01-01

    Recent accounts of the seduction theory and the question of its abandonment have emphasized the continuity of Freud's work before and after the seduction theory, claiming that Freud did not abandon his concern with the event of seduction but rather came to appreciate that an understanding of fantasy was also essential. This claim is challenged. It is shown that Freud did abandon the passionate concerns of his seduction theory for the most part; that he left behind his early interest in reconstructing unconscious infantile incest and focused instead on later, conscious seduction; that he at times clearly reduced apparent paternal incest to fantasy; that he turned away from the phenomenology of incest he had begun to develop; and that he theoretically nullified the value of the difference between real and fantasied seduction. It is also shown that, contrary to a persistent concern in psychoanalytic history, attention to actual seduction need not detract from the essential psychoanalytic concern with fantasy and infantile sexuality. Thinking about incest specifically illuminates the capacity for fantasizing, the core of the Freudian psyche. In this way the intuition of the seduction theory that there is something of distinctive psychoanalytic significance about incest finds support. PMID:16602351

  6. Identification of Risks Pertaining to Abandoned Housing Projects in Malaysia

    Hamzah Abdul-Rahman

    2015-01-01

    Full Text Available Housing industry is one of the most dynamic, risky, and challenging industries. In Malaysia, this industry has a poor reputation for managing risks, with many major projects failing to be completed within the allotted time. Due to the inherent risks involved in construction projects, it is essential to recognize the risks that cause problems associated with abandoned housing projects. Therefore, this study aims to identify the risks that contribute to issues of abandoned housing projects and to propose mitigation strategies. The methodologies used in this study are combination of qualitative and quantitative methods of literature review, questionnaire survey, and interview. The results show that many risks are involved in housing project, including risks related to environmental impacts, construction, politics, law, management, finance, materials, and economy, of which the probability of risks from unexpected ground condition, project delays, bureaucracy, contractual disputes between developer and landlord, weakness in management by inexperience developer, and financial crisis is very high. It was also found that all relevant parties involved in housing industry are required to have extensive cooperation in advance and should perform systematic risk management strategies in order to mitigate the risks leading to problems associated with abandoned housing projects.

  7. Secondary Forests from Agricultural Abandonment in Amazonia 2000-2009

    Morton, Douglas

    2010-01-01

    Ongoing negotiations to include reducing emissions from tropical deforestation and forest degradation (REDD+) in a post-Kyoto climate agreement highlight the critical role of satellite data for accurate and transparent accounting of forest cover changes. In addition to deforestation and degradation, knowledge of secondary forest dynamics is essential for full carbon accounting under REDD+. Land abandonment to secondary forests also frames one of the key tradeoffs for agricultural production in tropical forest countries-whether to incentivize secondary forest growth (for carbon sequestration and biodiversity conservation) or low-carbon expansion of agriculture or biofuels production in areas of secondary forests. We examined patterns of land abandonment to secondary forest across the arc of deforestation in Brazil and Bolivia using time series of annual Landsat and MODIS data from 2000-2009. Rates of land abandonment to secondary forest during 2002-2006 were less than 5% of deforestation rates in these years. Small areas of new secondary forest were scattered across the entire arc of deforestation, rather than concentrated in any specific region of the basin. Taken together, our analysis of the satellite data record emphasizes the difficulties of addressing the pool of new secondary forests in the context of REDD+ in Amazonia. Due to the small total area of secondary forests, land sparing through agricultural intensification will be an important element of efforts to reduce deforestation rates under REDD+ while improving agricultural productivity in Amazonia.

  8. Traditional olive orchards on sloping land: sustainability or abandonment?

    Duarte, Filomena; Jones, Nádia; Fleskens, Luuk

    2008-11-01

    Traditional olive orchards account for a large share of the area under olives in the EU, particularly in marginal areas, like those analysed in the OLIVERO project. In general, traditional olive growing can be described as a low-intensity production system, associated with old (sometimes very old) trees, grown at a low density, giving small yields and receiving low inputs of labour and materials. Though such systems are environmentally sustainable, their economic viability has become an issue, since EU policies favour more intensive and competitive systems. Orchards that have not been intensified seem to be threatened by the recent reform of the EU olive and olive oil policy, as income support has been decoupled from production. The main purpose of this paper is to identify the present constraints to traditional olive growing, and to recommend some private and public interventions to prevent its abandonment. During the OLIVERO project, traditional olive production systems were identified and described in five target areas (Trás-os-Montes--Portugal, Cordoba and Granada/Jaen--Spain, Basilicata/Salerno--Italy, and West Crete--Greece). The causes and consequences of abandonment are discussed, based on the analysis of the costs and returns, which revealed that these systems are barely economically sustainable. Their viability is only assured if reduced opportunity costs for family labour are accepted, and the olive growing is part-time. Based on these results, recommendations are made to prevent the abandonment of traditional olive growing and to preserve its environmental benefits. PMID:17923250

  9. Cost-Effectiveness of Global Endometrial Ablation vs. Hysterectomy for Treatment of Abnormal Uterine Bleeding: US Commercial and Medicaid Payer Perspectives

    Lenhart, Gregory M.; Bonafede, Machaon M.; Lukes, Andrea S.; Laughlin-Tommaso, Shannon K.

    2015-01-01

    Abstract Cost-effectiveness modeling studies of global endometrial ablation (GEA) for treatment of abnormal uterine bleeding (AUB) from a US perspective are lacking. The objective of this study was to model the cost-effectiveness of GEA vs. hysterectomy for treatment of AUB in the United States from both commercial and Medicaid payer perspectives. The study team developed a 1-, 3-, and 5-year semi-Markov decision-analytic model to simulate 2 hypothetical patient cohorts of women with AUB—1 treated with GEA and the other with hysterectomy. Clinical and economic data (including treatment patterns, health care resource utilization, direct costs, and productivity costs) came from analyses of commercial and Medicaid claims databases. Analysis results show that cost savings with simultaneous reduction in treatment complications and fewer days lost from work are achieved with GEA versus hysterectomy over almost all time horizons and under both the commercial payer and Medicaid perspectives. Cost-effectiveness metrics also favor GEA over hysterectomy from both the commercial payer and Medicaid payer perspectives—evidence strongly supporting the clinical-economic value about GEA versus hysterectomy. Results will interest clinicians, health care payers, and self-insured employers striving for cost-effective AUB treatments. (Population Health Management 2015;18:373–382) PMID:25714906

  10. Radical production in biological systems

    This paper describes our effort to develop a metric for radiation exposure that is more fundamental than adsorbed dose and upon which a metric for exposure to chemicals could be based. This metric is based on the production of radicals by the two agents. Radicals produced by radiation in biological systems commonly assumed to be the same as those produced in water despite the presence of a variety of complex molecules. This may explain why the extensive efforts to describe the relationship between energy deposition (track structure) and molecular damage to DNA, based on the spectrum of radicals produced, have not been successful in explaining simple biological effects such as cell killing. Current models assume that DNA and its basic elements are immersed in water-like media and only model the production and diffusion of water-based radicals and their interaction with DNA structures; these models lack the cross sections associated with each macro-component of DNA and only treat water-based radicals. It has been found that such models are not realistic because DNA is not immersed in pure water. A computer code capable of simulating electron tracks, low-energy electrons, energy deposition in small molecules, and radical production and diffusion in water like media has been developed. This code is still in at a primitive stage and development is continuing. It is being used to study radical production by radiation, and radical diffusion and interactions in simple molecular systems following their production. We are extending the code to radical production by chemicals to complement our PBPK modeling efforts. It therefore has been developed primarily for use with radionuclides that are in biological materials, and not for radiation fields

  11. Guest Editorial: Processes of Radicalization and De-Radicalization

    Donatella Della Porta

    2012-05-01

    Full Text Available The study of radicalization and de-radicalization, understood as processes leading towards the increased or decreased use of political violence, is central to the question of how political violence emerges, how it can be prevented, and how it can be contained. The focus section of this issue of the International Journal of Conflict and Violence addresses radicalization and de-radicalization, seeking to develop a more comprehensive understanding of the processes, dynamics, and mechanisms involved and taking an interdisciplinary approach to overcome the fragmentation into separate disciplines and focus areas. Contributions by Pénélope Larzillière, Felix Heiduk, Bill Kissane, Hank Johnston, Christian Davenport and Cyanne Loyle, Veronique Dudouet, and Lasse Lindekilde address repressive settings, legitimacy, institutional aspects, organizational outcomes, and dynamics in Europe, Asia, Africa, and North and South America.

  12. Radical Surgery for Endometriosis: Analysis of Quality of Life and Surgical Procedure

    De la Hera-Lazaro, Cristina M.; Muñoz-González, Jose L.; Perez, Reyes Oliver; Vellido-Cotelo, Rocío; Díez-Álvarez, Alvaro; Muñoz-Hernando, Leticia; Alvarez-Conejo, Carmen; Jiménez-López, Jesús S.

    2016-01-01

    OBJECTIVE The main aim of this study is to determine the improvement in quality of life in patients who have undergone radical surgery because of severe endometriosis. PATIENTS AND METHODS This nonrandomized interventional study (quasi experimental) was carried out between January 2009 and September 2014. A total of 46 patients with diagnosis of severe endometriosis were included. Radical surgery, including hysterectomy, was performed. Acting as their own control group, the patients were asked to fill in a validated questionnaire of quality of life [Endometriosis Health Profile-5 (EHP-5)] and a visual analog scale of pain at the moment of the preoperative visit (one month prior to surgery) and six months after the surgery. RESULTS Radical surgery for endometriosis was performed in 46 patients at our center over the period of six years. Among the patients, 73.9% of them had undergone previous surgery for endometriosis. In 82.6% of cases, a complete laparoscopic resection was carried out. Gastrointestinal tract resection was performed in 21.7%, and urinary tract resection was necessary in 8.7%. The mean age of the patients was 38.6 years. The rate of complications was 30.4%. Six months after the surgery, all items of the EHP-5 questionnaire had a lower score, which means an improvement in all aspects of quality of life related to endometriosis. The difference obtained between the scores before and after the surgery was statistically significant. The mean visual analog scale score before the surgery was 8.5, whereas it decreased to 1.4 after the surgery (P < 0.001). CONCLUSION Performing a radical surgery is a difficult decision to make; however, it can provide optimal results in terms of improvement of quality of life and, therefore, should be considered when conservative therapy fails. PMID:26966396

  13. Comparison of the short-term and long-term outcomes of laparoscopic hysterectomies and of abdominal hysterectomies: a case study of 4,895 patients in the Guangxi Zhuang Autonomous Region, China

    He, Hongying; Yang, Zhijun; Zeng, Dingyuan; Fan, Jiangtao; Hu, Xiaoxia; Ye, Yuan; Bai, Hua; Jiang, Yanming; Lin, Zhong; Lei, Zhiying; Li, Xinlin; Li, Lian; Gan, Jinghua; Lan, Ying; Tang, Xiongzhi; Wang, Danxia; Jiang, Junsong; Wu, Xiaoyan; Li, Meiying; Ren, Xiaoqing; Yang, Xiaomin; Liu, Mei; Wang, Qinmei; Jiang, Fuyan; Li, Li

    2016-01-01

    Background: To evaluate the short-term and long-term outcomes after laparoscopic hysterectomy (LH) compared with abdominal hysterectomy (AH) in case of benign gynecological disease. Methods: A multi-center cohort retrospective comparative study of population among 4,895 hysterectomies (3,539 LH vs.1,356 AH) between 2007 and 2013 was involved. Operative time (OT), estimated blood loss (EBL), intra-operative and post-operative complications, passing flatus; days with indwelling catheter, questionnaires covering pelvic floor functions and sexual functions were assessed. Results: The EBL (174.1±157.4 vs. 263.1±183.2 cc, LH and AH groups, respectively), passing flatus (38.7±14.1 vs. 48.1±13.2 hours), days with indwelling catheter (1.5±0.6 vs. 2.2±0.8 days), use of analgesics (6.5% vs. 73.1%), intra-operative complication rate (2.4% vs. 4.1%), post-operative complication rate (2.3% vs. 5.7%), post-operative constipation (12.1% vs. 24.6%), mild and serious stress urinary incontinence (SUI) post-operative (PSexual Functioning Index (FSFI) total score <26.55 post-operative (P<0.001) of the LH group were significantly less than those of AH group. There were no significant differences in OT (106.5±34.5 vs. 106.2±40.3 min) between the two groups. Conclusions: LH is a safe and efficient operation for improving patients?long-term quality of life (QoL), and LH is a cost-effectiveness procedure for treating benign gynecological disease. LH is superior to AH due to reduced EBL, reduced post-operative pain and earlier passing flatus. PMID:27199516

  14. The effect of Landsat ETM/ETM+ image acquisition dates on the detection of agricultural land abandonment in Eastern Europe

    Prishchepov, Alexander; Prishchepov, Alexander V.; Radeloff, Volker C.;

    2012-01-01

    seasons for a pre-abandonment-time I (1989) and post-abandonment-time II (1999/2000). Using a factorial experiment, we tested how the classification accuracy and spatial patterns of classified abandonment changed over all possible 49 image-date combinations when mapping both "abandoned arable land...... for the classification, the seasons captured also mattered, and the importance of specific seasonal image dates varied between the pre- and post-abandonment dates. For "abandoned arable land" it was important to have at least one "Spring" or "Summer" image for pre-abandonment and as many images as possible for post...

  15. Redox Properties of Free Radicals.

    Neta, P.

    1981-01-01

    Describes pulse radiolysis as a useful means in studing one-electron redox potentials. This method allows the production of radicals and the determination of their concentration and rates of reaction. (CS)

  16. Decidual transformation in adenomyosis during pregnancy as an indication for hysterectomy

    Jovanović Božidar

    2009-01-01

    Full Text Available Introduction. Incidence of adenomyosis is estimated on 20% in all of extracted uteruses. Clinically, it usually exists asymptomatically, but could be followed with dysmenorrhoea, menorrhagia and pelvic pain. One third of patients with adenomyosis are sterile, however in other two thirds, conception and pregnancy could have normal development, with delivery without complications. One of possible complications related to adenomyosis is rupture of uterus during delivery. Case report. A pregnant woman at the end of the 10th lunar month of pregnancy, showed minimal labour contractions, following amnion rupture and the delivery was terminated by section ceasar. Subtotal hysterectomy was performed because of concominant profuse bleeding. Myometrium was occupied with decidual cells in trabecular arrangement, among which elongated endometrial glands were placed. Surrounding muscle fascicles showed atrophic, apoptic, and occasionally necrotic changes. Myometrial stroma was edematous, and infiltrated with mesenchymal cells, as well as with adipose cells, which were extending toward serosa. Discussion. The patient had been receiving treatment, for a long period, because of sterility without clear etiological factor. A small number of similar cases ends with complications. Here, it is evident that abundant decidual transformation of stromal cells in adenomiosis leads to atrophy and necrosis of muscle cells. Teh reduction of uterine muscle mass causes atony and threating rupture, through separation of muscle cells, and therefore the absence of their synchronized contractions. Conclusion. Atony of uterine muscle could be caused by decidual transformation in adenomyosal fields, atrophy of muscle fascicles, edema of the stroma, mesenchymal transformation, and fibrosis. This leads to a decrease in myometrial contractions, and prolonged postpartal bleeding.

  17. Vaginal Motion and Bladder and Rectal Volumes During Pelvic Intensity-Modulated Radiation Therapy After Hysterectomy

    Purpose: To evaluate variations in bladder and rectal volume and the position of the vaginal vault during a 5-week course of pelvic intensity-modulated radiation therapy (IMRT) after hysterectomy. Methods and Materials: Twenty-four patients were instructed how to fill their bladders before simulation and treatment. These patients underwent computed tomography simulations with full and empty bladders and then underwent rescanning twice weekly during IMRT; patients were asked to have full bladder for treatment. Bladder and rectal volumes and the positions of vaginal fiducial markers were determined, and changes in volume and position were calculated. Results: The mean full and empty bladder volumes at simulation were 480 cc (range, 122–1,052) and 155 cc (range, 49–371), respectively. Bladder volumes varied widely during IMRT: the median difference between the maximum and minimum volumes was 247 cc (range, 96–585). Variations in rectal volume during IMRT were less pronounced. For the 16 patients with vaginal fiducial markers in place throughout IMRT, the median maximum movement of the markers during IMRT was 0.59 cm in the right–left direction (range, 0–0.9), 1.46 cm in the anterior–posterior direction (range, 0.8–2.79), and 1.2 cm in the superior–inferior direction (range, 0.6–2.1). Large variations in rectal or bladder volume frequently correlated with significant displacement of the vaginal apex. Conclusion: Although treatment with a full bladder is usually preferred because of greater sparing of small bowel, our data demonstrate that even with detailed instruction, patients are unable to maintain consistent bladder filling. Variations in organ position during IMRT can result in marked changes in the position of the target volume and the volume of small bowel exposed to high doses of radiation.

  18. Radical polymerization of monoethyl itaconate

    Katsikas Lynne; Nišević Nataša; Ignjatović Milka; Adamović Vladimir; Đakov Tatjana A.; Popović Ivanka G.

    2003-01-01

    The radical polymerization of monoethyl itaconate (MEI) was investigated in bulk and in solution at 60°C using a,a'-azobisisobutyronitrile as initiator. It was established that the obtained polymer poly(monoethyl itaconate) was insoluble in its monomer, implying that the bulk polymerization of MEI was a precipitation polymerization. The polymerization kinetics of MEI were discussed and compared to the polymerization kinetics of structurally similar alkyl itaconates. The homogeneous radical po...

  19. Ecoporn, Irrationalities and Radical Environmentalism

    Măntescu, Liviu

    2016-01-01

    This study explores the ‘irrationalities’ of deep ecology activism in the context of radical environmentalism by using the empirical example of ecoporn. Fuck For Forest is an environmental Non-Governmental Organisation which undertakes fund-raising for re-forestation and forest protection by means of pornography. Following twelve months of ethnographic fieldwork, this study presents first research results on a radical environmental project which does not promote democratic and established pro...

  20. Surgical and Pathologic Outcomes of Fertility-Sparing Radical Abdominal Trachelectomy for FIGO Stage IB1 Cervical Cancer

    Abu-Rustum, Nadeem R.; Neubauer, Nikki; Sonoda, Yukio; Park, Kay J.; Gemignani, Mary; Alektiar, Kaled M.; Tew, William; Leitao, Mario M.; Chi, Dennis S.; Barakat, Richard R.

    2016-01-01

    Objectives To describe the surgical and pathologic findings of fertility-sparing radical abdominal trachelectomy using a standardized surgical technique, and report the rate of post-trachelectomy adjuvant therapy that results in permanent sterility Methods A prospectively maintained database of all patients with FIGO stage IB1 cervical cancer admitted to the operating room for planned fertility-sparing radical abdominal trachelectomy was analyzed. Sentinel node mapping was performed via cervical injection of Technetium and blue dye. Results Between 6/2005 and 5/2008, 22 consecutive patients with FIGO stage IB1 cervical cancer underwent laparotomy for planned fertility-sparing radical abdominal trachelectomy. Median age was 33 years (range 23–43). Histology included 13 (59%) with adenocarcinoma and 9 (41%) with squamous carcinoma. Lymph-vascular invasion was seen in 9 (41%) cases. Only 3 (14%) needed immediate completion radical hysterectomy due to intraoperative findings (2 for positive nodes, 1 for positive endocervical margin). Median number of nodes evaluated was 23 (range 11–44); and 6 (27%) patients had positive pelvic nodes on final pathology – all received postoperative chemoradiation. Sixteen (73%) patients agreed to participate in sentinel node mapping which yielded a detection rate of 100%, sensitivity of 83%, specificity of 100% and false negative rate of 17%. Eighteen of 19 (95%) patients who completed trachelectomy had a cerclage placed, and 9/22 (41%) patients had no residual cervical carcinoma on final pathology. Median time in the operating room was 298 minutes (range 180–425). Median estimated blood loss was 250 ml (range 50–700), and median hospital stay was 4 days (range 3–6). No recurrences were noted at the time of this report. Conclusions Cervical adenocarcinoma and lymph-vascular invasion are common features of patients selected for radical abdominal trachelectomy. The majority of patients can undergo the operation successfully

  1. Emergency peripartum hysterectomy- a study in tertiary care centre and medical college in Hubli, North Karnataka, India

    Sahaja Kittur

    2016-04-01

    Conclusions: Hysterectomy is a lifesaving procedure to control postpartum hemorrhage, but is associated with significant maternal morbidity and mortality. Uterine atony, uterine ruptures, also due to prior caesarean delivery, placenta previa were identified as risk factors. The incidence in this part of Karnataka was found to be significantly high due to referral cases from neighboring 5 government district hospitals. Hence only proper awareness, timely referral and correction of anemia are the key factors to be addressed to this part of the state. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1097-1101

  2. Adjuvant simultaneous radiochemotherapy following radical hysterectomy for patients with cervical cancers in high-risk situation. Results of a pilot study

    Background: The most important factors for prognosis of cervical cancers are age and histological criteria such as the tumor size, the involvement of lymph nodes, lympho-vascular space involvement as well as microvessel involvement and poor tumor differentiation (grading 3). Here we present the results of concomitant chemo-radiation at high-risk situation of patients with cervical cancer after surgery. Patients and Methods: The study comprised 34 patients with median age of 40 years (26-63 years) after Wertheim surgical technique for cervical cancer at the FIGO Stages IB (n = 19) and IIB (n = 15). All patients were treated between November 1995 and June 1999 by a schedule of concomitant chemoradiation. The indication for this treatment was given by the positive histological proof of lymph node metastasis, microvessel or lympho-vascular space involvement as well as a G3 grading. The chemo-therapy was given in week 1 and 5 (day 1-5 and day 29-33). The dosage of cisplatin was 20 mg/m2/d on every day and 5-FU was given as a 120-h infusion with 600 mg/m2/d. The external beam radiotherapy was applied to the pelvis with 1.8 Gy per fraction up to 50.4-54 Gy. In two patients the paraaortal region was irradiated too because of the involvement of these lymph nodes. Results: The median observation time was 48 months (3-68 months). 30 patients are alive (88%) in complete response. Four patients died. The mean survival was 61 ± 3 months. We have seen only slight acute toxicities of grade 1 and 2. Three patients suffered from a grade 3 diarrhea and three patients developed a grade 3 leukopenia. In seven patients we found a secondary lymphedema as a late toxicity. Conclusion: The concomitant chemoradiation containing cisplatin in high-risk situation for cervical cancer after surgery improves the outcome and survival in these patients. (orig.)

  3. Patterns and drivers of post-socialist farmland abandonment in Western Ukraine

    Baumann, Matthias; Kuemmerle, Tobias; Elbakidze, Marine;

    2011-01-01

    Farmland abandonment restructures rural landscapes in many regions worldwide in response to gradual industrialization and urbanization. In contrast, the political breakdown in Eastern Europe and the former Soviet Union triggered rapid and widespread farmland abandonment, but the spatial patterns of...... substantial spatial variation in abandonment rates. However, many of our a priori hypotheses about the direction of variable influence were rejected. Most importantly, abandonment rates were higher in the plains and lower in marginal areas. The growing importance of subsistence farming in the transition...... period, as well as off-farm income and remittances likely explain these patterns. The breakdown of socialism appears to have resulted in fundamentally different abandonment patterns in the Western Ukraine, where abandonment was a result of the institutional and economic shock, compared to those in Europe...

  4. The games radicals play : special issue on free radicals and radical ions

    Walton, John C; Ffrancon Williams

    2015-01-01

    Chemistry and Physics have aptly been described as “most excellent children of Intellect and Art” [1]. Both these “children” engage with many playthings, and molecules rank as one of their first favorites, especially radicals, which are amongst the most lively and exciting. Checking out radicals dancing to the music of entropy round their potential energy ballrooms is surely both entertaining and enlightening. Radicals’ old favorite convolutions are noteworthy, but the new styles, modes and a...

  5. Koritnjak: Abandoned rural settlement in the beginning of 2002.

    Martinović Marija

    2004-01-01

    Full Text Available Under non-adequate conditions of social relation to rural area after Second world war, modern development of rural settlements of Serbia has a lot of rural problems. A certain number of rural settlements, after negative general development at the end of XX and in the beginning of XXI century have been in demographical mean disappeared. With this paper, in the example of Koritnjak, is showed the genesis and evolution of settlement which is abandoned in the beginning of 2002, after continuous decrease of total population and non-positive demographical and total development.

  6. Brent Spar abandonment - Best Practicable Environmental Option (BPEO) assessment

    Possible methods of abandoning or re-using the Brent Spar storage and tanker offloading facility following its decommissioning in 1991 are discussed. The report assesses six of the thirteen possible methods, including horizontal dismantling and onshore disposal, vertical dismantling and onshore disposal, in-field disposal, deep water disposal, refurbishment and re-use, and continued maintenance, in order to determine the Best Practicable Environmental Option (BPEO). The BPEO covers technical feasibility risks to health and safety of the work force, environmental impacts, public acceptability and costs. (UK)

  7. Measures of Vegetation Restoration in Abandoned Mined Lands

    2008-01-01

    By 2004, the occupied and disturbed land area had reached 3.393 million ha by mining, of which forest land took 532 000 ha; In addition, mining also caused 3.721 million -5.316 million ha of degraded forests and woodlands. The impact of mining on environment is multi-fold and deep. Thus it is necessary and significant to approach effective methods to speed up vegetation restoration in abandoned mined lands. Phytoremediation is a relatively new technology (in the lastest decade) and the numbers of plant spec...

  8. Direct measurements of methane emissions from abandoned oil and gas wells in Pennsylvania

    Kang, Mary; Kanno, Cynthia M.; Reid, Matthew C.; Zhang, Xin; Mauzerall, Denise L.; Celia, Michael A.; Chen, Yuheng; Onstott, Tullis C.

    2014-01-01

    Recent studies indicate that greenhouse gas emission inventories are likely missing methane emission sources. We conducted the first methane emission measurements from abandoned oil and gas wells and found substantial emissions, particularly from high-emitting abandoned wells. These emissions are not currently considered in any emissions inventory. We scaled methane emissions from our direct measurements of abandoned wells in Pennsylvania and calculate that they represent 4–7% of current tota...

  9. Abandonment Fears in Persons with Alzheimer's at Adult Day Care Centers

    Judkins, Wayne A

    1999-01-01

    In my research, I examined abandonment fears in persons with Alzheimerâ s disease at the Salem Veterans Affairs adult day care center. I observed fifty hours at the center, and conducted open-ended interviews with two of the participants and their respective caregivers. These two participants (Ellen and Opel) at the center expressed abandonment fears much more frequently than any of the other participants. I found that most of the time, these two women would express their abandonment f...

  10. Crystalline bipyridinium radical complexes and uses thereof

    Fahrenbach, Albert C.; Barnes, Jonathan C.; Li, Hao; Stoddart, J. Fraser; Basuray, Ashish Neil; Sampath, Srinivasan

    2015-09-01

    Described herein are methods of generating 4,4'-bipyridinium radical cations (BIPY.sup..cndot.+), and methods for utilizing the radical-radical interactions between two or more BIPY.sup..cndot.+ radical cations that ensue for the creation of novel materials for applications in nanotechnology. Synthetic methodologies, crystallographic engineering techniques, methods of physical characterization, and end uses are described.

  11. Crystalline bipyridinium radical complexes and uses thereof

    Fahrenbach, Albert C.; Barnes, Jonathan C.; Li, Hao; Stoddart, J. Fraser; Basuray, Ashish Neil; Sampath, Srinivasan

    2015-09-01

    Described herein are methods of generating 4,4'-bipyridinium radical cations (BIPY.sup..cndot.+), and methods for utilizing the radical-radical interactions between two or more BIPY.sup..cndot.+ radical cations that ensue for the creation of novel materials for applications in nanotechnology. Synthetic methodologies, crystallographic engineering techniques, methods of physical characterization, and end uses are described.

  12. Soil erosion as a consequence of wildfires on recently abandoned citrus orchards in eastern Spain

    A. Cerdà; F. A. González-Peñaloza; Burguet, M.; P. Pereira

    2013-01-01

    Fire is a natural factor in the evolution of Earth ecosystems. Due to land abandonment wildfire are widespread in Mediterranean Type Ecosystems, which contribute to increase the soil erosion rates. Fire is also found in recently abandoned citrus orchards due to the quick vegetation recovery and the dry biomass found after 2 years of abandonment. Rainfall simulation experiments (1 hour at 45 mm h-1 in a plot of 0.25 m2) show that although land abandonment on irrigated citrus orchards reduces t...

  13. Fiscal year 1996 well plugging and abandonment program Y-12 Plant, Oak Ridge, Tennessee

    NONE

    1997-04-01

    This report is a synopsis of the progress of the well plugging and abandonment program at the Oak Ridge Y-12 Plant, Oak Ridge, Tennessee, from August 1995 through August 1996. A total of 27 wells, piezometers, and borings were plugged and abandoned during the period of time covered in this report. All wells and borings were plugged and abandoned in accordance with the Monitoring Well Plugging and Abandonment Plan for the U.S. Department of Energy, Y-12 Plant, Oak Ridge, Tennessee (HSW, Inc. 1991).

  14. Peroxy radical partitioning during the AMMA radical intercomparison exercise

    M. D. Andrés-Hernández

    2010-11-01

    Full Text Available Peroxy radicals were measured onboard two scientific aircrafts during the AMMA (African Monsoon Multidisciplinary Analysis campaign in summer 2006. This paper reports results from the flight on 16 August 2006 during which measurements of HO2 by laser induced fluorescence spectroscopy at low pressure (LIF-FAGE and total peroxy radicals (RO2* = HO2+ΣRO2, R = organic chain by two similar instruments based on the peroxy radical chemical amplification (PeRCA technique were subject of a blind intercomparison. The German DLR-Falcon and the British FAAM-BAe-146 flew wing tip to wing tip for about 30 min making concurrent measurements on 2 horizontal level runs at 697 and 485 hPa over the same geographical area in Burkina Faso. A full set of supporting measurements comprising photolysis frequencies, and relevant trace gases like CO, NO, NO2, NOy, O3 and a wider range of VOCs were collected simultaneously.

    Results are discussed on the basis of the characteristics and limitations of the different instruments used. Generally, no data bias are identified and the RO2* data available agree quite reasonably within the instrumental errors. The [RO2*]/[HO2] ratios, which vary between 1:1 and 3:1, as well as the peroxy radical variability, concur with variations in photolysis rates and in other potential radical precursors. Model results provide additional information about dominant radical formation and loss processes.

  15. Peroxy radical partitioning during the AMMA radical intercomparison exercise

    M. D. Andrés-Hernández

    2010-04-01

    Full Text Available Peroxy radicals were measured onboard two scientific aircrafts during the AMMA (African Monsoon Multidisciplinary Analysis campaign in summer 2006. This paper reports results from the flight on 16 August 2006 during which measurements of HO2 by laser induced fluorescence spectroscopy at low pressure (LIF-FAGE and total peroxy radicals (RO2*=HO2+ΣRO2, R= organic chain by two similar instruments based on the peroxy radical chemical amplification (PerCA technique were subject of a blind intercomparison. The German DLR-Falcon and the British FAAM-BAe-146 flew wing tip to wing tip for about 30 min making concurrent measurements on 2 horizontal level runs at 697 and 485 hPa over the same geographical area in Burkina Faso. A full set of supporting measurements comprising photolysis frequencies, and relevant trace gases like CO, NO, NO2, NOy, O3 and a wider range of VOCs were collected simultaneously.

    Results are discussed on the basis of the characteristics and limitations of the different instruments used. Generally, no data bias are identified and the RO2* data available agree quite reasonably within the instrumental errors. The [RO2*]/[HO2] ratios, which vary between 1:1 and 3:1, as well as the peroxy radical variability, concur with variations in photolysis rates and in other potential radical precursors. Model results provide additional information about dominant radical formation and loss processes.

  16. Standard Electrode Potentials Involving Radicals in Aqueous Solution: Inorganic Radicals

    Armstrong, David A.; Huie, Robert E.; Koppenol, Willem H.; Lymar, Sergei V.; Merenyi, Gabor; Neta, Pedatsur; Ruscic, Branko; Stanbury, David M.; Steenken, Steen; Wardman, Peter

    2015-12-01

    Recommendations are made for standard potentials involving select inorganic radicals in aqueous solution at 25 °C. These recommendations are based on a critical and thorough literature review and also by performing derivations from various literature reports. The recommended data are summarized in tables of standard potentials, Gibbs energies of formation, radical pKa’s, and hemicolligation equilibrium constants. In all cases, current best estimates of the uncertainties are provided. An extensive set of Data Sheets is appended that provide original literature references, summarize the experimental results, and describe the decisions and procedures leading to each of the recommendations

  17. Radical-Enhanced Chinese Character Embedding

    Sun, Yaming; Lin, Lei; Tang, Duyu; Yang, Nan; Ji, Zhenzhou; Wang, Xiaolong

    2014-01-01

    We present a method to leverage radical for learning Chinese character embedding. Radical is a semantic and phonetic component of Chinese character. It plays an important role as characters with the same radical usually have similar semantic meaning and grammatical usage. However, existing Chinese processing algorithms typically regard word or character as the basic unit but ignore the crucial radical information. In this paper, we fill this gap by leveraging radical for learning continuous r...

  18. The Abandonment of an Active Lifestyle Within University Students: Reasons for Abandonment and Expectations of Re-Engagement

    Manuel Gómez-López; Antonio Granero-Gallegos; Antonio Baena-Extremera

    2011-01-01

    The objective of this research is to analyse in detail the barriers that make university students abandon the practice of physical activity and adopt a sedentary lifestyle. In order to do so, a questionnaire on the analysis of sports habits and lifestyles was administered to 795 students who stated not having done any physical and/or sports activity for at least one year at the moment of the field-work. A factorial, descriptive and correlation analysis was carried out. The results reveal that...

  19. COMPARATIVE STUDY OF EPIDURAL ROPIVACAINE WITH DEXMEDETOMIDINE, ROPIVACAINE WITH CLONIDINE AND ROPIVACAINE ALONE FOR PERIOPERATIVE ANALGESIA IN ABDOMINAL HYSTERECTOMY

    Satheedev

    2015-11-01

    Full Text Available Regional anesthesia is widely used for abdominal hysterectomies. It is divided into spinal and epidural anaesthesia. Epidural anesthesia has got the advantage of extending the period of anesthesia to post-operative analgesia. We can use various pharmacological agents as adjuvants, which prolong the duration of action of local anesthetics. They include opiods, alpha 2 agonists like clonidine and dexmedetomidine. In this we studied the efficacy of local anesthetic agent – ropivacaine alone, ropivacaine with clonidine and ropivacaine with dexmedetomidine for epidural block. Present study showed that Epidural Dexmedetomidine and clonidine have synergistic action in combination with epidural ropivacaine resulting in smooth and prolonged postoperative analgesia and sedation. Group RD (Ropivacaine and Dexmedetomidine had significant difference in comparison of postoperative block characteristics, such as time of two segment regression, time to Bromage scale 1, time of regression to S1 dermatome and time of first epidural top up than group RC and R. (Ropivacaine with clonidine and Ropivacaine alone. Thus epidural dexmedetomidine is a better neuraxial adjuvant in combination with epidural ropivacaine in producing prolonged analgesia and better sedation for abdominal hysterectomy

  20. Conservative management of postmenopausal woman with prolonged use of the dislocated intrauterine device which was also unnoticed while hysterectomy

    Mustafa Gazi Ucar

    2015-10-01

    Full Text Available The objectives of this study are to identify and compare the treatment options of woman with uterine perforation caused by intrauterine device (IUD. A 74-years-old woman presented with irritable voiding symptoms and a dislocated IUD into the peritoneal cavity was discovered incidentally during radiologic imaging. While a Lippes loop IUD had been inserted 35 years previously, she had a history of hysterectomy 10 years after an IUD insertion. Not only the patient had forgotten the presence of the IUD, but also it was unnoticed during hysterectomy. Patient has remained asymptomatic for over the 25 years, with the prolonged use of dislocated IUD. The patient managed conservatively and no need for surgical intervention. Once a gynaecologist is faced with the dilemma of whether it is necessary to remove a dislocated IUD or not, patients should undergo an individualized management, balancing both risks and benefits of surgical intervention. Asymptomatic elderly patients with comorbidities may benefit from conservative management with close monitoring. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1565-1567

  1. Characterization and effectiveness of remining abandoned coal mines in Pennsylvania

    Under an approved remining program, mine operators can remine abandoned coal mines without assuming legal responsibility for treatment of the previously degraded water, as long as the discharging waters are not further degraded and other regulatory requirements are satisfied. A US Bureau of Mines review of 105 remining permits in Pennsylvania indicates that remining results in substantial reclamation of abandoned mine lands, utilization of significant quantities of coal, and reduction of contaminant loads (acidity and iron) from degraded mine drainage discharges. Normality tests performed on the water quality and flow data indicate generally nonnormal distributions and extreme right-skewness tending toward lower values. The water quality of underground coal mines was observed to be more highly degraded in terms of acidity, iron, and sulfate than that of surface coal mines. The optimum baseline sampling scenario is 12 months in duration at a frequency of one sample per month. Analysis of water quality and flow rates before and after remining indicates that a majority of the mines exhibited either no change or a significant decrease in pollution rate because of remining. The discharge flow rate was the dominant controlling factor when the post-remining contaminant load was significantly better or worse than the baseline (pre-mining) load

  2. The Oedipus complex revisited: Oedipus abandoned, Oedipus adopted.

    Quinodoz, D

    1999-02-01

    The author considers that the Oedipus of Sophocles' drama, who kills his biological father and marries his biological mother, is an illustration of the failure to work through the complex named after him. She draws attention to the contrast between the obscurity that surrounds the hero's adoptive parents and the notoriety of their biological counterparts arguing that the former are equally important in the universal oedipal fantasy. In her view the fact that Oedipus has two sets of parents--abandoning and adopting respectively--is significant in that the resulting dichotomisation of the parental imago enables him seemingly to avoid a conflict of ambivalence in relation to a single object. The author further contends that the plague of Thebes represents the symptomatic return of repressed or disavowed aggression. Three clinical examples reveal the parental imago's division to be an unconscious defence against oedipal anxieties and the sense of solitude vis-à-vis the intimacy of the parental couple. The working through of the Oedipus complex is stated to require the synthesis of love and hate and of the abandoning and adoptive aspects of the parents whereby the formerly sadistic superego becomes protective. The author also argues that a useful distinction can be made between splitting and dichotomisation. PMID:10216814

  3. EFFECT OF DEXMEDETOMIDINE ADDED TO SPINAL BUPIVACAINE FOR TOTAL ABDOMINAL HYSTERECTOMY

    Vinod

    2014-09-01

    Full Text Available BACKGROUND: Various adjuvants are being used with local anaesthetics in spinal anaesthesia for prolongation of intraoperative and post-operative analgesia. Dexmedetomidine, a highly selective α2 adrenergic agonist is a new neuroaxial adjuvant gaining popularity. AIMS: To evaluate the onset and duration of sensory and motor block, hemodynamic effect, post-operative analgesia and adverse effects of dexmedetomidine given intrathecally with hyperbaric 0.5% bupivacaine. METHODOLOGY: A study was carried out in 30 adult female patients aged 18-55 yrs of ASA grade I and II in each group scheduled for Total abdominal hysterectomy under spinal anaesthesia. Group B received 2.5ml of 0.5% hyperbaric bupivacaine with 0.5ml of normal saline. Group D received 2.5ml of 0.5% hyperbaric bupivacaine with 10µg of dexmedetomidine in 0.5ml of normal saline. The onset time to reach peak sensory and motor level, regression time of sensory and motor block, rescue analgesia, hemodynamic changes and side effects were recorded. STATISTICAL ANALYSIS USED: Data obtained were tabulated and analyzed using statistical package for social science (SPSS 16.0 evaluation version to calculate the sample size. Descriptive data are presented as Mean ± SD and Continuous data are analyzed by unpaired’t’ test. P<0.05 was considered statistically significant. RESULTS: Patients in dexmedetomidine group (group D had a significantly longer sensory and motor block than patients in bupivacaine group (group B. The mean time of sensory regression to S1 was (323 ± 31 min in group D and (191 ± 15min in group B. The regression time of motor block to reach Bromage 0 was (314 ± 30 min in group D and (163 ± 15 min in group B. The time to rescue analgesia was significantly longer in group D (383 ± 38 min as compared to group B (228.6 ± 15 min. CONCLUSION: Intrathecal dexmedetomidine as adjuvant to spinal bupivacaine is associated with prolonged sensory and motor block, hemodynamic stability

  4. Post-Soviet cropland abandonment and carbon sequestration in European Russia, Ukraine, and Belarus

    Schierhorn, Florian; Müller, Daniel; Beringer, Tim; Prishchepov, Alexander V.; Kuemmerle, Tobias; Balmann, Alfons

    2013-12-01

    Widespread cropland abandonment occurred after the collapse of socialism across the former Soviet Union, but the rates and spatial patterns of abandoned lands are not well known. As a result, the potential of this region to contribute to global food production and estimates of the carbon sink developing on currently idle lands are highly uncertain. We developed a spatial allocation model that distributes yearly and subnational sown area statistics to the most agriculturally suitable plots. This approach resulted in new, high-resolution (1 km2) annual time series of cropland and abandoned lands in European Russia, Ukraine, and Belarus from 1990 to 2009. A quantitative validation of the cropland map confirms the reliability of this data set, especially for the most important agricultural areas of the study region. Overall, we found a total of 87 Mha of cropland and 31 Mha of abandoned cropland in European Russia, Ukraine, and Belarus combined, suggesting that abandonment has been severely underestimated in the past. The abandonment rates were highest in European Russia. Feeding our new map data set into the dynamic vegetation model LPJmL revealed that cropland abandonment resulted in a net carbon sink of 470 TgC for 1990 to 2009. Carbon sequestration was generally slow in the early years after abandonment, but carbon uptake increased significantly after approximately 10 years. Recultivation of older abandoned lands would be associated with high carbon emissions and lead to substantial amounts of carbon not being sequestered in vegetation formations currently developing on idle croplands. Our spatially and temporally explicit cropland abandonment data improve the estimation of trade-offs involved in reclaiming abandoned croplands and thus in increasing agricultural production in this globally important agricultural region.

  5. Laparoscopic radical and partial cystectomy

    Challacombe Ben

    2005-01-01

    Full Text Available Radical cystectomy remains the standard treatment for muscle invasive organ confined bladder carcinoma. Laparoscopic radical cystoprostatectomy (LRC is an advanced laparoscopic procedure that places significant demands on the patient and the surgeon alike. It is a prolonged procedure which includes several technical steps and requires highly developed laparoscopic skills including intra-corporeal suturing. Here we review the development of the technique, the indications, complications and outcomes. We also examine the potential benefits of robotic-assisted LRC and explore the indications and technique of laparoscopic partial cystectomy.

  6. Radical democratic politics and feminism

    Martínez Labrin, Soledad

    2006-05-01

    Full Text Available In the article I present a reflection around the radical democratic project proposed by Chantal Mouffe and Ernesto Laclau. Specifically, I examine the application of the project in the context of the “new social movements” and especially, of feminist movement. I state the need of drawing attention to universalism and essentialism as the main obstacles to generate a collective proposal without margins. Nevertheless, doubts remind about the possibility of building up a feminism tailored by the radical democratic project, in a stage in which the political action of such a movement is characterized by categories that are closed and crystallized

  7. Quantification of a radical beam source for methyl radicals

    A radical beam source for methyl radicals (CH3) was characterized applying ionization-threshold mass spectrometry. The beam source is based on thermal dissociation of methane (CH4) or azomethane (N2(CH3)2) in a heated tungsten capillary. A flux of (3±1)x1013 cm-2 s-1 CH3 radicals is produced using methane as precursor gas and a capillary temperature of 1650 K. Alternatively, a flux of (3±1)x1014 cm-2 s-1 CH3 is produced using azomethane as precursor gas and a capillary temperature of 1150 K. The dominant production of methyl from the precursor methane occurs due to reaction 2 CH4+M→2 CH3+H2+M at the hot tungsten surface. The dominant production of methyl from azomethane occurs due to the reaction N2(CH3)2→2 CH3+N2. Besides methyl radicals, only stable molecules contribute to the emitted flux; within the detection limit, no atomic hydrogen is observed. From the comparison of ionization-threshold mass spectrometry and standard mass spectrometry, it is concluded that the cracking pattern of methane varies with the methane gas temperature. This is explained by the vibrational assisted dissociation of methane

  8. Prevalence and burden of adenomyosis in hysterectomy specimens for benign abnormal uterine bleeding in a tertiary care institute in Pondicherry, India

    Vijaya Koothan

    2016-04-01

    Conclusions: Adenomyosis was diagnosed in 119 (55.66 % of the benign AUB specimens. Adenomyosis is a frequent cause for failed conservative management culminating in hysterectomy, posing risk to health related quality of life of women with a bearing on emotional, physical, psychosocial, economic issues and family life. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1119-1123

  9. A randomized trial of prophylactic uterosacral ligament suspension at the time of hysterectomy for Prevention of Vaginal Vault Prolapse (PULS): design and methods.

    Alperin, Marianna; Weinstein, Milena; Kivnick, Seth; Duong, Thinh H; Menefee, Shawn

    2013-07-01

    The primary aim of this randomized trial is to evaluate whether a standardized uterosacral ligament suspension colpopexy (USLSC), added to a planned hysterectomy for an indication other than pelvic organ prolapse (POP), decreases the rate of subsequent vaginal vault prolapse in women without preoperative symptomatic POP. Secondary aims include comparison of perioperative complications, urinary, bowel and sexual functions between subjects with and without concomitant USLSC. If shown to be beneficial, the cost-effectiveness of prophylactic USLSC at the time of hysterectomy will be evaluated. This trial will be performed at 4 centers across the United States. The data will be analyzed by the data-coordinating center of the Southern California Kaiser Permanente. Standardized questionnaires and objective measurements will be obtained. The patients and providers performing assessments are masked to treatment assignment. The primary outcome, defined as absence of POP at/distal to the hymen on Pelvic Organ Prolapse Quantitative examination, will be determined 12 months post-operatively. Secondary outcomes include: no prolapse symptoms by questionnaires, and no treatment for POP besides the prophylactic study intervention. Additional follow-up occurs annually for a total of 5 years. Accrual is projected to take 3 years. Given cost and morbidity of surgical repair of post-hysterectomy prolapse, preventive strategies are of outmost importance. The risks and benefits of prophylactic USLSC have never been studied prospectively. This trial is designed to determine if USLSC is an appropriate clinical adjunct at the time of hysterectomy, with subsequent reduction of symptomatic POP. PMID:23587538

  10. Incidental placenta increta at the time of prophylactic hysterectomy for Lynch syndrome: Insights into individualized decision-making and surgical timing

    Nielsen, Tara A.; David, Stephanie N.; Desouki, Mohamed M; Crispens, Marta A.; Dineo Khabele

    2015-01-01

    Highlights • Increta in a prophylactic hysterectomy specimen for Lynch syndrome is rare. • Individualizing risk-reducing procedures after childbearing is important. • Shared decision making should include the timing of prophylactic surgery. • Minimizing surgical risks in the postpartum period should be discussed.

  11. Age at Menarche, Level of Education, Parity and the Risk of Hysterectomy: A Systematic Review and Meta-Analyses of Population-Based Observational Studies.

    Louise F Wilson

    Full Text Available Although rates have declined, hysterectomy is still a frequent gynaecological procedure. To date, there has been no systematic quantification of the relationships between early/mid-life exposures and hysterectomy. We performed a systematic review and meta-analyses to quantify the associations between age at menarche, education level, parity and hysterectomy.Eligible studies were identified by searches in PubMed and Embase through March 2015. Study-specific estimates were summarised using random effects meta-analysis. Heterogeneity was explored using sub-group analysis and meta-regression.Thirty-two study populations were identified for inclusion in at least one meta-analysis. Each year older at menarche was associated with lower risk of hysterectomy-summary hazard ratio 0.86 (95% confidence interval: 0.78, 0.95; I2 = 0%; summary odds ratio 0.88 (95% confidence interval: 0.82, 0.94; I2 = 61%. Low education levels conferred a higher risk of hysterectomy in the lowest versus highest level meta-analysis (summary hazard ratio 1.87 (95% confidence interval: 1.25, 2.80; I2 = 86%, summary odds ratio 1.51 (95% confidence interval: 1.35, 1.69; I2 = 90% and dose-response meta-analysis (summary odds ratio 1.17 (95% confidence interval: 1.12, 1.23; I2 = 85% per each level lower of education. Sub-group analysis showed that the birth cohort category of study participants, the reference category used for level of education, the year the included article was published, quality of the study (as assessed by the authors and control for the key variables accounted for the high heterogeneity between studies in the education level meta-analyses. In the meta-analyses of studies of parity and hysterectomy the results were not statistically significant.The present meta-analyses suggest that the early life factors of age at menarche and lower education level are associated with hysterectomy, although this evidence should be interpreted with some caution due to variance

  12. 剖宫产子宫切除术相关情况分析%The Analysis of Cesarean Hysterectomy during Caesarean Section

    李湛

    2014-01-01

    Objective To investigate the related factors of cesarean hysterectomy during caesarean section. Methods From January 2003 to December 2012,a total of 14 601 women had delivery at department of obstetrical and gynecology in Bei-jing Chaoyang Hospital,among whom 7 178 momen received cesarean section,13 cases received cesarean hysterectomy during cesarean section,the general information,postpartum blood lossing,postoperative complications,and prognosis of mother and infant were analyzed retrospectively. Results Among 7 178 momen who received cesarean section during past 10 years,there were totally 13 cases who received cesarean hysterectomy,the incidence was 0. 18% ,10 cases received total hysterectomy,3 cases received subtotal hysterectomy. The indications of operation include placental factor(9 cases),hemorrhage and dissemi-nated intravascular coagulation(3 cases),and uterine atony(1 case). The postpartum hemorrhage was 600 to 12 600 ml(av-erage 3 800 ml). The postpartum hemorrhage,post - operative hospitalization duration,the proportion of cases with postopera-tive complications,and the proportion of cases who were transferred to ICU after operation of cases whose quantity of blood lossing≤1 500 ml when making the hysterectomy decision were significantly less than those of cases whose quantity of blood lossing >1 500 ml when making the hysterectomy decision(P 1500 ml 者产后出血量、术后住院日减少,术后并发症发生率及转 ICU 比例降低(P <0.05)。2例产妇分别于孕20周及孕24周因瘢痕子宫胎盘因素大量出血急诊行剖宫产术终止妊娠,其余11例进入围生期。13例产妇均治愈出院;11例围生儿中,早产儿7例,胎死宫内2例,新生儿重度窒息1例家属放弃抢救后死亡,轻度窒息1例。结论剖宫产子宫切除术胎盘因素是主要手术指征,剖宫产术中各种止血措施无效时应及时切除子宫。

  13. Why do leaf-tying caterpillars abandon their leaf ties?

    Michelle Sliwinski

    2013-09-01

    Full Text Available Leaf-tying caterpillars act as ecosystem engineers by building shelters between overlapping leaves, which are inhabited by other arthropods. Leaf-tiers have been observed to leave their ties and create new shelters (and thus additional microhabitats, but the ecological factors affecting shelter fidelity are poorly known. For this study, we explored the effects of resource limitation and occupant density on shelter fidelity and assessed the consequences of shelter abandonment. We first quantified the area of leaf material required for a caterpillar to fully develop for two of the most common leaf-tiers that feed on white oak, Quercus alba. On average, Psilocorsis spp. caterpillars consumed 21.65 ± 0.67 cm2 leaf material to complete development. We also measured the area of natural leaf ties found in a Maryland forest, to determine the distribution of resources available to caterpillars in situ. Of 158 natural leaf ties examined, 47% were too small to sustain an average Psilocorsis spp. caterpillar for the entirety of its development. We also manipulated caterpillar densities within experimental ties on potted trees to determine the effects of cohabitants on the likelihood of a caterpillar to leave its tie. We placed 1, 2, or 4 caterpillars in ties of a standard size and monitored the caterpillars twice daily to track their movement. In ties with more than one occupant, caterpillars showed a significantly greater propensity to leave their tie, and left sooner and at a faster rate than those in ties as single occupants. To understand the consequences of leaf tie abandonment, we observed caterpillars searching a tree for a site to build a shelter in the field. This is a risky behavior, as 17% of the caterpillars observed died while searching for a shelter site. Caterpillars that successfully built a shelter traveled 110 ± 20 cm and took 28 ± 7 min to find a suitable site to build a shelter. In conclusion, leaf-tying caterpillars must frequently

  14. Technical standardization of oil well abandonment: a review of current standards and technologies

    Suzart, J. Walter P.; Pessoa, Laudemar; Paiva, Maria [Halliburton Energy Services (HES), Duncan, OK (United States)

    2008-07-01

    The objective of this study is to provide a new methodology for well abandonment. This practice is becoming more and more important because of the increasing number of production fields being abandoned. We strongly recommend a study of cement slurries properties for specific use in temporary and permanent abandonment plugs based on the estimation of the cement slurry hardened when placed in the well. By using specific additives, it is possible to achieve very stable slurries. For example, when permeability is reduced, formation fluid migration can be blocked and chemical reactions between the fluid and the slurry may be inhibited. With this objective, we present a laboratory investigation model and an example of slurry testing recommendation. During the abandonment operation, all records of the well characteristics should be maintained to include the reason for the abandonment, and location of fresh water, brine, and hydrocarbon zones that may exist. This documentation will also allow the analysis of solutions for the problems that originally caused the abandonment of the well. This data could be important for future use by environmental protection commissions to reopen or to drill an adjacent well. Given the high price of oil, it may now be economically feasible to reopen the well, if the reason for abandonment was low productivity. This way, a critical analysis of the current conditions of well and field abandonment in the country is presented. Based on this information, a review of the current standards is suggested. (author)

  15. 19 CFR 19.9 - General order, abandoned, and seized merchandise.

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false General order, abandoned, and seized merchandise... Provisions § 19.9 General order, abandoned, and seized merchandise. (a) Acceptance of merchandise. The... Customs-authorized permit to transfer or in-bond entry) is responsible for preparing a Customs Form...

  16. 78 FR 57681 - Norfolk Southern Railway Company-Abandonment Exemption-in Polk County, Iowa

    2013-09-19

    ... Surface Transportation Board Norfolk Southern Railway Company--Abandonment Exemption--in Polk County, Iowa Norfolk Southern Railway Company (NSR) has filed a verified notice of exemption under 49 CFR part 1152... effects, if any, of the abandonment on the environment and historic resources. OEA will issue...

  17. 78 FR 48931 - Norfolk Southern Railway Company-Abandonment Exemption-in Lucas County, Ohio

    2013-08-12

    ... Surface Transportation Board Norfolk Southern Railway Company--Abandonment Exemption--in Lucas County, Ohio Norfolk Southern Railway Company (NSR) has filed a verified notice of exemption under 49 CFR pt... any, of the abandonment on the environment and historic resources. OEA will issue an...

  18. 76 FR 36617 - Union Pacific Railroad Company-Abandonment Exemption-in Freeborn County, MN

    2011-06-22

    ... Surface Transportation Board Union Pacific Railroad Company--Abandonment Exemption--in Freeborn County, MN Union Pacific Railroad Company (UP) filed a verified notice of exemption under 49 CFR part 1152 subpart... addresses the effects, if any, of the abandonment on the environment and historic resources. OEA will...

  19. 78 FR 11733 - Norfolk Southern Railway Company-Abandonment Exemption-in Calhoun County, AL

    2013-02-19

    ... Surface Transportation Board Norfolk Southern Railway Company--Abandonment Exemption--in Calhoun County, AL Norfolk Southern Railway Company (NSR) has filed a verified notice of exemption under 49 CFR pt... and historic report that addresses the effects, if any, of the abandonment on the environment...

  20. 78 FR 79726 - Norfolk Southern Railway Company-Abandonment Exemption-in Gaston County, NC

    2013-12-31

    ... Surface Transportation Board Norfolk Southern Railway Company--Abandonment Exemption--in Gaston County, NC Norfolk Southern Railway Company (NSR) has filed a verified notice of exemption under 49 CFR part 1152... report that addresses the effects, if any, of the abandonment on the environment and historic...

  1. 78 FR 21494 - Union Pacific Railroad Company-Abandonment Exemption-in Washington County, Idaho

    2013-04-10

    ... Surface Transportation Board Union Pacific Railroad Company--Abandonment Exemption--in Washington County, Idaho Union Pacific Railroad Company (UP) has filed a verified notice of exemption under 49 C.F.R. pt... effects, if any, of the abandonment on the environment and historic resources. OEA will issue...

  2. 78 FR 44190 - Union Pacific Railroad Company-Abandonment Exemption-in Miami County, KS

    2013-07-23

    ... Surface Transportation Board Union Pacific Railroad Company--Abandonment Exemption--in Miami County, KS Union Pacific Railroad Company (UP) has filed a verified notice of exemption under 49 CFR part 1152... abandonment on the environment and historic resources. OEA will issue an environmental assessment (EA) by...

  3. Impacts of Land Abandonment on Vegetation: Successional Pathways in European Habitats

    Prévosto, B.; Kuiters, A.T.; Bernhardt-Römermann, M.; Dölle, M.; Schmidt, W.; Hoffmann, M.; Uytvanck, Van J.; Bohner, A.; Kreiner, D.; Stadler, J.; Klotz, S.; Brandl, R.

    2011-01-01

    Changes in traditional agricultural systems in Europe in recent decades have led to widespread abandonment and colonization of various habitats by shrubs and trees. We combined several vegetation databases to test whether patterns of changes in plant diversity after land abandonment in different hab

  4. 40 CFR 144.62 - Cost estimate for plugging and abandonment.

    2010-07-01

    ... Oil and Gas Field Equipment Cost Index. The inflation factor is the result of dividing the latest... abandonment. 144.62 Section 144.62 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER... Waste Injection Wells § 144.62 Cost estimate for plugging and abandonment. (a) The owner or...

  5. 78 FR 5244 - BNSF Railway Company-Abandonment Exemption-in Fulton County, IL

    2013-01-24

    ... TRANSPORTATION Surface Transportation Board BNSF Railway Company--Abandonment Exemption--in Fulton County, IL BNSF Railway Company (BNSF) has filed a verified notice of exemption under 49 CFR pt. 1152 subpart F... any, of the abandonment on the environment and historic resources. OEA will issue an...

  6. 78 FR 14622 - BNSF Railway Company-Abandonment Exemption-in Cook County, Ill.

    2013-03-06

    ... Surface Transportation Board BNSF Railway Company--Abandonment Exemption--in Cook County, Ill. BNSF Railway Company (BNSF) has filed a verified notice of exemption under 49 CFR part 1152 subpart F-Exempt... the effects, if any, of the abandonment on the environment and historic resources. OEA will issue...

  7. 75 FR 65049 - Union Pacific Railroad Company-Abandonment Exemption-in Pulaski County, AR

    2010-10-21

    ... Surface Transportation Board Union Pacific Railroad Company--Abandonment Exemption--in Pulaski County, AR Union Pacific Railroad Company (UP) filed a verified notice of exemption under 49 CFR part 1152 subpart... any, of the abandonment on the environment and historic resources. OEA will issue an...

  8. 78 FR 49603 - Norfolk Southern Railway Company-Abandonment Exemption-in Marengo County, Ala

    2013-08-14

    ... Surface Transportation Board Norfolk Southern Railway Company--Abandonment Exemption--in Marengo County, Ala Norfolk Southern Railway Company (NSR) has filed a verified notice of exemption under 49 CFR part... any, of the abandonment on the environment and historic resources. OEA will issue an...

  9. 77 FR 59451 - Pickens Railway Company-Abandonment Exemption-in Pickens County, SC

    2012-09-27

    ... Surface Transportation Board Pickens Railway Company--Abandonment Exemption--in Pickens County, SC Pickens Railway Company (Pickens) has filed a verified notice of exemption under 49 CFR part 1152 subpart F... the effects, if any, of the abandonment on the environment and historic resources. OEA will issue...

  10. 76 FR 72241 - BNSF Railway Company-Abandonment Exemption-in Cass County, ND

    2011-11-22

    ... Surface Transportation Board BNSF Railway Company--Abandonment Exemption--in Cass County, ND BNSF Railway Company (BNSF) has filed a verified notice of exemption under 49 CFR pt. 1152 subpart F--Exempt... and historic report that addresses the effects, if any, of the abandonment on the environment...

  11. An exploratory analysis of land abandonment drivers in areas prone to desertification

    Kosmas, C.; Kairis, O.; Karavitis, C.; Hessel, R.; Ritsema, C.J.

    2015-01-01

    The abandonment of land is a global problemwith environmental and socioeconomic implications. An approach to assess the relationship between land abandonment and a large set of indicators was illustrated in the present study by using data collected in the framework of the European Union DESIRE resea

  12. 30 CFR 902.20 - Approval of Alaska abandoned mine land reclamation plan.

    2010-07-01

    ... available at: (a) Department of Natural Resources, Division of Mining and Water Management, 3601 C Street... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Approval of Alaska abandoned mine land... § 902.20 Approval of Alaska abandoned mine land reclamation plan. The Alaska Reclamation Plan,...

  13. Inhomogeneous CTMC Model of a Call Center with Balking and Abandonment

    Burak, Maciej Rafal

    2015-01-01

    This paper considers a nonstationary multiserver queuing model with abandonment and balking for inbound call centers. We present a continuous time Markov chain (CTMC) model which captures the important characteristics of an inbound call center and obtain a numerical solution for its transient state probabilities using uniformization method with steady-state detection. Keywords: call center, transient, Markov processes, numerical methods, uniformization, abandonment, balking

  14. Detecting Social Polarization and Radicalization

    Qureshi, Pir Abdul Rasool; Memon, Nasrullah; Wiil, Uffe Kock;

    2011-01-01

    This paper proposes a novel system to detect social polarization and to estimate the chances of violent radicalization associated with it. The required processes for such a system are indicated; it is also analyzed how existing technologies can be integrated into the proposed system to fulfill the...

  15. Exploring the Theories of Radicalization

    Maskaliūnaitė Asta

    2015-12-01

    Full Text Available After the London bombings in July 2005, the concern of terrorism scholars and policy makers has turned to “home-grown” terrorism and potential for political violence from within the states. “Radicalization” became a new buzz word. This article follows a number of reviews of the literature on radicalization and offers another angle for looking at this research. First, it discusses the term “radicalization” and suggests the use of the following definition of radicalization as a process by which a person adopts belief systems which justify the use of violence to effect social change and comes to actively support as well as employ violent means for political purposes. Next, it proposes to see the theories of radicalization focusing on the individual and the two dimensions of his/her motivation: whether that motivation is internal or external and whether it is due to personal choice or either internal (due to some psychological traits or external compulsion. Though not all theories fall neatly within these categories, they make it possible to make comparisons of contributions from a variety of different areas thus reflecting on the interdisciplinary nature of the study of terrorism in general and radicalization as a part of it.

  16. Kinetics of nitroxyl radical reactions

    Absolute rate-constants for the reaction of the nitroxyl free radicals TAN and TMPN with radiation-chemically-formed radicals and ions have been determined. k(TAN + X) (in M-1 sec-1) = 4.0 x 109 (for X =OH), 2.9 x 1010(esub(aq)-), 8.0 x 109 (H), 7.2 x 108 (CH2OH), 4.0 x 108 (CH3CHOH), 4.3 x 108 ((CH3)2COH), 2.8 x 108 (CH2(CH3)2COH), 5.9 x 107 (glucose radical), 4.0 x 108 (c-C5H9), and k(TMPN + X) = 3.4 x 109 (OH), 7.8 x 109 (esub(aq)-), 4.9 x 109 (H), 4.4 x 108 (CH2OH), 4.9 x 108 (CH3CHOH), 3.6 x 108 ((CH3)2COH), 1.5 x 108 (CH2(CH3)2COH), 4.9 x 107 (glucose radical), 4.3 x 108 (c-C5H9). Direct measurements by means of a pulse-radiolysis conductivity technique were based on the formation and destruction of charged species in these reactions within certain pH ranges. It is indicated that the radiosensitizing nitroxyles undergo both redox and addition reactions. (author)

  17. Reaction between protein radicals and other biomolecules

    Østdal, Henrik; Davies, Michael Jonathan; Andersen, Henrik J

    2002-01-01

    The present study investigates the reactivity of bovine serum albumin (BSA) radicals towards different biomolecules (urate, linoleic acid, and a polypeptide, poly(Glu-Ala-Tyr)). The BSA radical was formed at room temperature through a direct protein-to-protein radical transfer from H(2)O(2....... Subsequent analysis showed a decrease in the concentration of urate upon reaction with the BSA radical, while the BSA radical in the presence of poly(Glu-Ala-Tyr) resulted in increased formation of the characteristic protein oxidation product, dityrosine. Reaction between the BSA radical and a linoleic acid...

  18. Reclamation of abandoned underground mines in the United Kingdom

    Since 1980, the Derelict Land Grant program has supported reclamation of abandoned mines in the United Kingdom. The stabilization of large-scale limestone mines in the West Midlands has stimulated the development of new methods of bulk infilling using waste materials as thick pastes. Colliery spoil rock paste develops strengths of 10 to 20 kPa to support roof falls and prevent crown hole collapse. Pulverized fuel ash rock paste develops strengths over 1 MPa where lateral support to pillars is required. Smaller scale mine workings in the West Midlands and elsewhere have been stabilized using conventional grouting techniques, hydraulic and pneumatic stowing, foamed-concrete infill, bulk excavation with controlled backfill, and structural support using bolts, mesh, and shotcrete

  19. Long-term ecological behaviour of abandoned uranium mill tailings

    Semi-aquatic and terrestrial areas on abandoned or inactive uranium mill tailings in Ontario were studied in order to identify the growth characteristics of the naturally invading species dominating these areas. Semi-aquatic areas of tailings sites have been invaded by cattails. These species formed wetland communities which varied in size, but all were essentially monocultures of Typha latifolia, T. angustifolia, or of the hybrids T. glauca. Sedges, Scripus cyperinus (wool-grass) and Phragmites australis (reed-grass), were found in transition zones between the cattail stand and the dry section of the tailings site. The expansion of the cattail stands appeared to be controlled by the hydrological conditions on the site, rather than the chemical characteristics of the tailings

  20. Should fine needle aspiration cytology in breast assessment be abandoned?

    Litherland, Janet C

    2002-02-01

    Fine needle aspiration cytology (FNAC) has been used extensively in the U.K. for the diagnosis of breast lesions over the past 15 years. More recently, large gauge needle biopsy has been used to address many of the problems which have been encountered with fine needle aspiration. This paper reviews the evolution of the use of these procedures and the advantages and disadvantages of each. In considering whether to abandon the use of fine needle aspiration cytology in breast assessment, each individual unit should make a decision based upon their own audited results. However, even if FNAC is retained, it is important to be able to complement cytological diagnosis with core biopsy as there are indisputable advantages, e.g. in the diagnosis of mammographically detected microcalcification. As always, a multi-disciplinary approach is ultimately essential for effective patient management. Litherland, J.C. (2002)

  1. Should fine needle aspiration cytology in breast assessment be abandoned?

    Litherland, Janet C

    2002-02-01

    Fine needle aspiration cytology (FNAC) has been used extensively in the U.K. for the diagnosis of breast lesions over the past 15 years. More recently, large gauge needle biopsy has been used to address many of the problems which have been encountered with fine needle aspiration. This paper reviews the evolution of the use of these procedures and the advantages and disadvantages of each. In considering whether to abandon the use of fine needle aspiration cytology in breast assessment, each individual unit should make a decision based upon their own audited results. However, even if FNAC is retained, it is important to be able to complement cytological diagnosis with core biopsy as there are indisputable advantages, e.g. in the diagnosis of mammographically detected microcalcification. As always, a multi-disciplinary approach is ultimately essential for effective patient management. PMID:11977938

  2. Childhood lead poisoning: the promise and abandonment of primary prevention.

    Needleman, H L

    1998-12-01

    In 1991, the Public Health Service published the Strategic Plan for the Elimination of Childhood Lead Poisoning. This document marked a fundamental shift in federal policy from finding and treating lead-poisoned children to authentic primary prevention. It spelled out a 15-year strategy to achieve this goal and provided a cost-benefit analysis showing that the monetized benefits far exceeded the costs of abatement. A strong national effort to eliminate the disease developed. Now, 7 years after publication of the plan, primary prevention of lead exposure has been abandoned. This article examines the role of some prevailing attitudes and institutions in derailing the effort. Some institutions--the lead industry, real estate interests, and insurance interests--behaved as anticipated. Others, including private pediatricians, the American Academy of Pediatrics, some federal agencies, and a public interest group ostensibly dedicated to eliminating lead poisoning, also played an unexpected part in derailing the plan. PMID:9842392

  3. Radioactive pollution investigation and disposal of abandoned uranium mines in Jiangsu province

    The environment influence of five abandoned uranium mines in Jiangsu province from 1950s to 1960s is introduced. By monitoring air absorbed dose rate of external exposure γ radiation, it is found that the pollution scope of No.1 abandoned uranium mine is the biggest in five abandoned uranium mines. The No. 2 and No. 3 mine areas has achieved the limit use after they were desposed. The radioactivity and the gamma nuclein in solid samples(slag, soil, silt) and liquid samples (the surface water, the well water)of No. 1 abandoned uranium mine were further analyzed and measured, the measured values are higher. The pollution of abandoned uranium mines still exists and diffuses after 30 years. According to the monitoring results and the analysis of pollution present situation, suggestions and measures are proposed for the pollution control. (authors)

  4. GROWING NIPA PALM FOR RESTORATION OF ABANDONED SHRIMP PONDS

    Noparat Bamroongrugsa; Chorthip Purintavarakul

    2006-01-01

    Rapid increase in the production of marine shrimps in the coastal zone has resulted in large - scale conversion of mangrove forests to shrimp ponds. Productions of the shrimps in some regions have been unstable. Consequently, a number of ponds are left idle. Restoring environmental conditions within the pond site by planting a suitable mangrove species considered an option. The experiment herein was carried out to explore the effect of planting methods on growth of Nipa palm in abandoned shrimp ponds in the Southern Thailand. Economically, coastal villagers in this area earn their income from the palm in several ways, the most importantly in Nipa sugar production. Most seedlings were planted on top of furrows were constructed in the pond to avoid flooding, except for some seedlings which were planted in the pond base where additional pond sludge were slightly filled up to compare their growth rates. The results showed that planting seedlings with attached rhizomes had the best growth rate and without seedling death at 14 months after planting. At this stage, however, the height of seedlings grown from the fallen fruits was similar to those growth from bare rooted seedlings (70 cm tall). Also, seedling mortality was not observed when growth from fallen fruits whereas about6% mortality was experienced by the bare rooted ones. Among the bare rooted seedling treatments, however no significant differences in growth rates were found when applying the soil with chemical fertilizers or farm manure or liming with CaCO3. In addition, it was found that seedling growth measured at 40 months after planting for those growths in pond base was almost 100% greater than those grown on the furrows. Therefore, this finding may be applied for the restoration of abandoned shrimp ponds by growing Nipa palm.

  5. Restoration of abandoned mine lands through cooperative coal resource evaluations

    The public reclamation cost of reclaiming all of Pennsylvania's abandoned mine lands is estimated at $15 billion. Drainage from abandoned mines poses another $5 billion water pollution clean-up problem. Although it is unlikely that public reclamation alone could ever tackle these problems, much can be done to alleviate the nuisances through the remining of previously mined areas to recover remaining reserves, restore the land and improve water quality in the same process. Remining of priority areas is encouraged through a new Pennsylvania policy which provides incentives to mining companies. One incentive, initiated under Pennsylvania's comprehensive mine reclamation strategy, is to identify and geologically map reminable coal resources in selected watersheds, and then to expedite mine permitting in these watersheds. At present, two such priority watersheds, Little Toby Creek in Elk County and Tangascootak Creek in Clinton County, are the focus of geologic map compilation based on recent quadrangle mapping, or new, directed, geologic mapping, including new research core drilling to establish the geologic stratigraphic framework. In order to maximize environmental benefits the comprehensive mine reclamation strategy identifies watersheds which are affected by acid mine drainage (AMD), but that are reasonably capable of restoration, if sufficient coal reserves remain. Pennsylvania's geochemical quality database of rock overburden, in combination with detailed coal resource mapping by the Pennsylvania Geological Survey, and the cooperation of coal companies and leaseholders, is being used by the Department of Environmental Protection (DEP) to identify and design remining projects which will not only allow the recovery of coal resources, but will also improve the water quality through a variety of innovative mining techniques

  6. Abandoned Rice Fields Make Streams Go Dry in Upland Landscapes

    Jayawickreme, D.

    2015-12-01

    In South Asia, new economic realities are driving many rural rice farmers out of agriculture. With increasing neglect, abandonment, and rising conversions of centuries old rice fields into other uses, ecological and environmental consequences of these transitions are becoming progressively clear. Field observations in Sri Lanka's central highlands suggest that small shifts in rice to non-rice land uses in headwater watersheds can have a domino effect on the productivity and viability of rice fields and other ecological systems downstream by inflicting groundwater recharge reductions, lowering groundwater yields, and causing other hydrological changes. Preliminary analysis shows that although rice itself is a very water intensive crop, the presence of rain-fed upland rice-fields is hugely beneficial to the watersheds they reside. In particular, water benefits of rice appear to be derived from ponded conditions (3-5 inches of standing water) in which rice is grown, and the contribution rice fields makes to enhance water retention and storage capacity of their watersheds during the monsoon season that coincide with the cropping season. In the absence of well managed rice-fields, hilly upland landscapes produce more runoff and retain little rainwater during the wet season. Furthermore, after centuries of intensive use, much of South Asia's rice fields are nutrient poor and minimally productive without fertilizer applications and other interventions. Consequently, when abandoned, soil erosion and other impacts that affect aquatic ecosystems and watershed health also emerge. Despite these multiple concerns however, little research is currently done to better understand the environmental significance of rice cultivations that are a dominant land-use in many South Asian landscapes. The aim of this presentation is to stir interest among the scientific community to engage more broadly in rice, water, and environmental change research in the face of new economic realities in

  7. Alternative utilization of underground spaces with abandoned mine openings

    Chung, So Keul; Cho, Won Jai; Han, Kong Chang; Choi, Sung Oong [Korea Institute of Geology Mining and Materials, Taejon (Korea)

    1998-12-01

    Utilization of the openings of the abandoned mines could be planned by the principal parameters such as location and geotechnical impact. The local governments have not only to lead the each stage of the utilization project from the very beginning of conceptual design up to the construction stage, but also to promote the project for the development of public purpose. The possible tentative candidates for the utilization of the abandoned mine openings which are supported by the local governments could be summarized as follows. a. The Gahak mine of Kwangmyung, Kyunggi: The mine caverns which have been served as the storage of the pickled fishes, could be reexcavated by taking into consideration the geotechnical parameters for the public use such as: 1) Training center for the youth, 2) Fermentation and storehouse of marine products, 3) Sightseeing resort, 4) Sports and leisure complex, 5) Underground parking lot, 6) Underground shopping mall and chilled room storage, 7) Library, concert hall and museum. b. Hamtae mine of Taebaek, Kangwon: The Hambaek main haulage way and its shaft should be investigated in detail in order to find out a possible use as the underground challenging park of the coal mining operation. c. Mines of Boryung and Hongsung, Chungnam: Lots of mine caverns have been used as the storehouse for the pickled shrimp. However, they have to be promoted to a large scale industries. d. Imgok mine of Kwangju and Palbong mine of Jeongeup, Chunbuk: Mine caverns which have been used as the storehouse of pickles, need a detailed investigation for alternative promotion. e. Yongho mine of Pusan Dalsung mine of Taegu: Both of the mines are located near metropolitan communities. Reconstruction of the old mine caverns of the Yongho mine is highly recommended for a public use. The caverns of the Dalsung mine could be utilized as the storage facilities. Detailed geotechnical survey and sit investigation could be suggested to design the recommended facilities for both

  8. Comparison of the effect of laparoscopic hysterectomy and abdominal hysterectomy on ovarian function%腹腔镜与开腹全子宫切除术对女性卵巢功能影响的比较

    姜琦; 朱福梅

    2014-01-01

    目的:探讨腹腔镜下与开腹全子宫切除术对中青年女性卵巢功能的影响。方法选择60例未绝经的子宫良性疾病并需行子宫切除术的中青年患者,随机分为腹腔镜组和开腹组,每组各30例,比较两组患者围手术期指标、性激素水平及围绝经期综合征情况。结果腹腔镜组术中出血量、术后肛门排气时间均显著少于开腹组,差异有统计学意义( t值分别为4.27和3.11,P<0.05);术后6个月,两组患者卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、孕酮(P)水平相比,差异均无统计学意义(t值分别为0.69、0.95、0.67、-0.33,均P>0.05);术后12个月两组患者FSH、LH、E2、P水平差异也均无统计学意义(t值分别为0.88、-0.21、1.65、0.20,均P>0.05);两组患者术后围绝经期综合征发生率比较差异无统计学意义(χ2=0.10,P>0.05)。结论腹腔镜子宫切除术具有对机体创伤小、术后恢复快的优点,与传统子宫切除术相比不会增加对卵巢功能的损伤。%Objective To investigate the effect of laparoscopic hysterectomy ( LH) and abdominal hysterectomy ( AH) on ovarian function of young and middle-aged women.Methods Totally 60 young and middle-aged premenopausal patients with benign uterine disease were going to undergo hysterectomy .They were randomly divided into LH group and AH group with 30 cases in each .The perioperative indexes , sexual hormone level and perimenopausal syndrome were compared between two groups .Results The blood loss and postoperative flatus in LH group were significantly less than AH group , and the differences were significant (t value was 4.27 and 3.11, respectively, both P0.05).There were not significant differences in the serum levels of FSH , LH, E2 and P in 12 months after surgery ( t value was 0.88, -0.21, 1.65 and 0.20, respectively, all P >0.05 ).The incidence of

  9. From Radical Translation to Radical Interpretation and Back

    António Zilhão

    2003-12-01

    Full Text Available Both Quine and Davidson put forth programs of empirical semantics satisfying the conditions that characterize the so-called “standpoint of interpretation.” Quine’s less ambitious program of radical translation rests upon two buttresses: causality and empathy. Davidson’s more ambitious program of radical interpretation replaces causality with truth and empathy with rationality. Although the replacement of causality with intersubjective truth seems to me to be a fully justified move, I nevertheless contend that it is more realistic to develop the work of interpretation drawing upon Quine’s less ambitious requirement of empathy than upon Davidson’s view of human agency as rational agency. In order to substantiate this contention, I present an argument to the effect that Davidson’s characterization of human agency as rational is not compatible with his other requirement that truth should pro-vide the essential link connecting speech with environment and action.

  10. The Experience of Robotic-Assisted Laparoscopic Hysterectomy for Women Treated for Early-Stage Endometrial Cancer

    Herling, Suzanne Forsyth; Palle, Connie; Moeller, Ann M;

    2016-01-01

    -assisted laparoscopic hysterectomy. METHODS: Semistructured interviews were carried out with 12 women, and interview data were analyzed by qualitative content analysis. RESULTS: Four overarching themes emerged: "surgery was a piece of cake," "recovering physically after surgery," "going from being off guard to being on...... in the robotic technique and recovered quickly physically, they lacked information about what went on in the operation theatre and about their new anatomy. IMPLICATIONS FOR PRACTICE: Patient education about the normal postoperative course in regard to vaginal bleeding, bowel function, and level of...... physical activity is needed. Individualized information about anatomical changes after surgery is warranted, preferably using anatomical drawings. Potentially, the women could benefit from attending a nursing clinic during the first postoperative months....

  11. Pregabalin and dexamethasone in combination with paracetamol for postoperative pain control after abdominal hysterectomy. A randomized clinical trial

    Rasmussen, M L; Dierking, G; Lech, K;

    2008-01-01

    BACKGROUND: Multimodal analgesia may be important for optimal postoperative pain treatment and facilitation of early mobilization and recovery. We investigated the analgesic effect of pregabalin and dexamethasone in combination with paracetamol after abdominal hysterectomy. METHODS: One hundred and...... sixteen patients were randomly assigned to either group A (paracetamol+placebo x 2), group B (paracetamol+pregabalin+placebo) or group C (paracetamol+pregabalin+dexamethasone). According to randomization and preoperatively, patients received paracetamol 1000 mg, pregabalin 300 mg, dexamethasone 8 mg or...... placebo. General anaesthesia was performed. Postoperative pain treatment was paracetamol 1000 mg x 4 and patient-controlled intravenous morphine, 2.5 mg bolus. Nausea was treated with ondansetron. Morphine consumption, pain score (visual analogue scale) at rest and during mobilization, nausea, sedation...

  12. A case of AML with preceding hypoplastic stage after oophoro-hysterectomy and 60Co-irradiation

    A case of AML (preceded by a hypoplastic stage) which developed after oophoro-hysterectomy and 60Co-irradiation is presented, and related literature concerning irradiation-induced leukemia and the early diagnosis of leukemia and/or preleukemia are discussed. The patient, a 47 year old female had had surgery and irradiation with a subsequent normachromic anemia necessitating transfusions 11 years prior to her presenting herself at our hospital because of anemia. Her pancytopenic peripheral blood picture combined with a relatively hypererythroid marron led to a diagnosis of atypical hypoplastic anemia. Two years after this she suddenly developed a high fever, general fatigue and a severe anemia. Hematological studies revealed acute myeloblastic leukemia. A combination therapy consisting of DM, 6MP, prednisolon and blood transfusions was given with no effect and 3 months after the onset, the patient died of asphyxia resulting from gross hemoptysis. Autopsy revealed pulmonary hemorrhage secondary to the leukemia. (J. Evans)

  13. The effect of Reiki on pain and anxiety in women with abdominal hysterectomies: a quasi-experimental pilot study.

    Vitale, Anne T; O'Connor, Priscilla C

    2006-01-01

    The purpose of this pilot study was to compare reports of pain and levels of state anxiety in 2 groups of women after abdominal hysterectomy. A quasi-experimental design was used in which the experimental group (n = 10) received traditional nursing care plus three 30-minute sessions of Reiki, while the control group (n = 12) received traditional nursing care. The results indicated that the experimental group reported less pain and requested fewer analgesics than the control group. Also, the experimental group reported less state anxiety than the control group on discharge at 72 hours postoperation. The authors recommend replication of this study with a similar population, such as women who require nonemergency cesarian section deliveries. PMID:17099413

  14. Electron attachment to fluorocarbon radicals

    Shuman, Nicholas

    2014-10-01

    Most plasma environments contain populations of short-lived species such as radicals, the chemistry of which can have significant effects on the overall chemistry of the system. However, few experimental measurements of the kinetics of electron attachment to radicals exist due to the inherent difficulties of working with transient species. Calculations from first principles have been attempted, but are arduous and, because electron attachment is so sensitive to the specifics of the potential surface, their accuracy has not been established. Electron attachment to small fluorocarbon radicals is particularly important, as the data are needed for predictive modeling of plasma etching of semiconductor materials, a key process in the industrial fabrication of microelectronics. We have recently developed a novel flowing afterglow technique to measure several types of otherwise difficult to study plasma processes, including thermal electron attachment to radicals. Variable Electron and Neutral Density Attachment Mass Spectrometry (VENDAMS) exploits dissociative electron attachment in a weakly ionized plasma as a radical source. Here, we apply VENDAMS to a series of halofluorocarbon precursors in order to measure the kinetics of thermal electron attachment to fluorocarbon radicals. Results are presented for CF2, CF3, C2F5,C2F3,1-C3F7, 2-C3F7, and C3F5 from 300 K to 900 K. Both the magnitude and the temperature dependences of rate coefficients as well as product branching between associative and dissociative attachment are highly system specific; however, thermal attachment to all species is inefficient, never exceeding 5% of the collision rate. The data are analyzed using a recently developed kinetic modeling approach, which uses extended Vogt-Wannier theory as a starting point, accounts for dynamic effects such as coupling between the electron and nuclear motions through empirically validated functional forms, and finally uses statistical theory to determine the fate of

  15. Radical carbonylations using a continuous microflow system

    Takahide Fukuyama

    2009-07-01

    Full Text Available Radical-based carbonylation reactions of alkyl halides were conducted in a microflow reactor under pressurized carbon monoxide gas. Good to excellent yields of carbonylated products were obtained via radical formylation, carbonylative cyclization and three-component coupling reactions, using tributyltin hydride or TTMSS as a radical mediator.

  16. EPR spin trapping of protein radicals

    Davies, Michael Jonathan; Hawkins, Clare L

    2004-01-01

    Electron paramagnetic resonance (EPR) spin trapping was originally developed to aid the detection of low-molecular-mass radicals formed in chemical systems. It has subsequently found widespread use in biology and medicine for the direct detection of radical species formed during oxidative stress...... selected examples of radical formation on proteins....

  17. Histerectomia vaginal: o laparoscópico é necessário? Vaginal hysterectomy: is the laparoscope necessary?

    Octacílio Figueiredo Netto

    1998-10-01

    pode ser realizada na grande maioria dos casos.Purpose: the laparoscope can be used to convert an abdominal into a vaginal hysterectomy when there are contraindications for the vaginal approach, and not as a substitute for simple vaginal hysterectomy. The purpose of the present study is to discuss the role of laparoscopy in vaginal hysterectomy. Methods: between February 1995 and September 1998, 400 patients were considered candidates for vaginal hysterectomy.Exclusion criteria included uterine prolapse, adnexal tumor and uterine immobility. The Heaney technique was used, and different morcellation procedures were employed for the removal of enlarged uteri. Results: the mean age and parity was 46.9 years and 3.2 deliveries, respectively. Twenty-nine patients (7.2% were nulliparous, and 104 (26.0% had never delivered vaginally. Three hundred and three patients (75.7% had a history of previous pelvic surgery, the most common being cesarean section (48.7%. The most frequent indication was leiomyoma (61.2%, and the mean uterine volume was 239.9 cm³ (30-1228 cm³. Vaginal hysterectomy was successfully performed in 396 patients (99.0%, and 73 surgeries (18.2% were done by residents. The mean operative time was 45 min. Diagnostic/operative laparoscopy was performed in 16 patients (4.0%. Intraoperative complications included 6 cystotomies (1.5% and one rectal laceration (0.2%. There were four conversions (1.0% to the abdominal route. Postoperative complications occurred in 24 patients (6.0%. Two hundred and eighty-one patients (70.2% were discharged 24 h after surgery. Conclusions: the laparoscope does not seem to be necessary in cases were the uterus is mobile and there is no adnexal tumor. The main role of the laparoscope may be to increase the awareness of gynecologists to the possibility of a simple vaginal hysterectomy in the majority of cases.

  18. Free radicals and Dupuytren's contracture.

    Murrell, G. A.; Francis, M. J.; Bromley, L.

    1987-01-01

    The concentration of substrate expressed as hypoxanthine capable of reacting with xanthine oxidase to release superoxide free radicals (O2-) was measured in control and Dupuytren's contracture palmar fascia. In Dupuytren's contracture palmar fascia the concentration of hypoxanthine was six times that of control and was greatest in "nodular" areas. Xanthine oxidase activity was also detected in Dupuytren's contracture palmar fascia. These results suggest a greater potential for hypoxanthine-xa...

  19. Microbial Nitrogen-Cycle Gene Abundance in Soil of Cropland Abandoned for Different Periods

    Huhe; Borjigin, Shinchilelt; Buhebaoyin; Wu, Yanpei; Li, Minquan; Cheng, Yunxiang

    2016-01-01

    In Inner Mongolia, steppe grasslands face desertification or degradation because of human overuse and abandonment after inappropriate agricultural management. The soils in these abandoned croplands exist in heterogeneous environments characterized by widely fluctuating microbial growth. Quantitative polymerase chain reaction analysis of microbial genes encoding proteins involved in the nitrogen cycle was used to study Azotobacter species, nitrifiers, and denitrifiers in the soils from steppe grasslands and croplands abandoned for 2, 6, and 26 years. Except for nitrifying archaea and nitrous oxide-reducing bacteria, the relative genotypic abundance of microbial communities involved in nitrogen metabolism differed by approximately 2- to 10-fold between abandoned cropland and steppe grassland soils. Although nitrogen-cycle gene abundances varied with abandonment time, the abundance patterns of nitrogen-cycle genes separated distinctly into abandoned cropland versus light-grazing steppe grassland, despite the lack of any cultivation for over a quarter-century. Plant biomass and plant diversity exerted a significant effect on the abundance of microbial communities that mediate the nitrogen cycle (P bacteria that mediate the nitrogen cycle in recently abandoned croplands. PMID:27140199

  20. Abandonment terraced hillside and answer of the fire system: some results from Mediterranean old fields

    The abandonment of agricultural lands promotes temporal changes both in soil characteristics (i.e., increasing organic matter and other quality indicators) and in plant community (i.e., changing its composition and structure, and increasing the fuel load). As a consequence, we can expect differences in the resilience to fire as succession progresses. The aim of this work is to analyse the capacity of an ecosystem to return to pre-fire conditions as a function of the stage of abandonment of old agricultural lands. The study was carried out in the north of Alicante province (E Spain). In long-term abandoned lands, post-fire modulated plant response, which in turn determined soil crusting, runoff and erosion dynamics. In recently-abandoned lands, the plant community seemed less dependent on ratio to recover. Results show a large increase in soil surface crusting in the short term after the fire and it remained high at medium term in long-abandoned lands colonised by pine forest. Fire scarcely modified runoff and erosion in recently-abandoned lands whereas in forest lands the post-fire values increased by some orders of magnitude and remained highly dependent on rain characteristics in the short and medium term after the fire. The results obtained show evidence of increased vulnerability to fire in long-abandoned lands colonised by pine forests. (Author) 4 refs.