Uterus didelphys with obstructedhemivagina and ipsilateral renal agenesis is a rare entity, sometimes referred to as Herlyn-Werner-Wunderlich syndrome (HWW). It usually presents after menarche with progressive pelvic pain, sometimes with regular menses, and a palpable mass due to hemihaematocolpos. The diagnosis is generally made only if the suspicion of this genitourinary syndrome is raised. To highlight the imaging diagnostic clues in this rare condition. We report on 11 adolescents with this condition. Sonography mostly allowed the correct diagnosis by showing uterovaginal duplication, haematocolpos or haematometrocolpos, and the absence of the ipsilateral kidney. MRI provided more detailed information regarding uterine morphology, the continuity with each vaginal channel (obstructed and nonobstructed), and the bloody nature of the contents. Early and accurate diagnosis of this syndrome is important so that adequate and ...
Small bowel obstructions can be distinguished into more simple and closed loop obstructions. The latter is a more severe condition which is often complicated by strangulation with vascular impairment, edema and intramural and mesenteric hemorrhage. Consequent arterial insufficiency rapidly leads to ischemia, infarction and necrosis. The radiologist plays a role in the early recognition of the closed loop obstruction and of any sign of strangulation. The role of CT in the diagnosis and workup of patients with suspected intestinal occlusion has been analyzed in the literature with reported 63% sensitivity, 78% specificity and 66% accuracy. CT is also capable of revealing the causes of occlusion in 73-95% of cases. The above CT signs allow to identify closed loop obstruction and also small bowel strangulation, thus supplying a valuable contribution to diagnosis and accurate ...
Objective: To explore the interventional method to treat biliary recurrent jaundice after T tube drainage in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods: 7 biliary metallic stents were placed in 7 patients with recurrent jaundice after T-tube drainage in cholangiocarcinoma cases. Results: Stent placement was once successful in all 7 cases with successful rate of 100%. For all cases, TBIL, ALT, GTP and AKP values 7 days postoperatively were significantly lower than that of preoperation together with subsidence of jaundice satisfactorily for 100% after the treatment. Conclusions: Percutaneous placement of biliary metallic stents was effective economic, minimal invasive and safe for palliation of biliary recurrent jaundice after T tube drainage in cholangiocarcinoma-induced obstructive jaundice
In cases of obstructive colorectal cancer (CRC), preoperative diagnosis of the proximal lesion is often difficult when the primary lesion impedes the passage of the endoscope. The aim of this study was to evaluate the usefulness of fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) in such cases. A total of 52 obstructive CRC patients who underwent preoperative FDG-PET and subsequent surgical resection were retrospectively reviewed. The correlation between characteristics of the proximal lesion and FDG-PET findings was analyzed statistically. There was a significant correlation between the proximal lesion size and the maximum standardized uptake value (P=0.00016). Abnormal FDG accumulation in the proximal colon indicated the existence of proximal cancer or adenoma with a sensitivity of 50% and a specificity of 100%. There was a significant difference in the distribution of tumor size ...
Objective: To investigate the inserting technique of biliary double stents in treating hilar cholangiocarcinoma. Methods: 6 patients with hilar cholangiocarcinoma (Bismuth IV) were treated by percutaneous transhepatic insertion of biliary stents. Double stents were inserted in each patient. Different inserting methods were adopted according to the branch angles formed by left and right hepatic ducts. Results: The jaundice of all patients alleviated or disappeared obviously after stent implantation. The average difference between post-and pre-operation in the serum total bilirubin level was (104 #+-# 29) #mu#mol/L (P<0.01). Stent obstruction was found in 2 cases after 4 and 6 months respectively. Conclusion: Double stents implantation is effective for the treatment of hilar cholangiocarcinoma. Beware of the angulation between main hepatic duct and adopting different inserting methods. (authors)
To evaluate the efficacy of newly designed covered and non-covered coated colorectal stents for colonic decompression. Twenty-six patients, (15 palliative cases and 11 preoperative) underwent treatment for the relief of colorectal obstruction using metallic stents positioned under fluoroscopic guidance. In 24 of the 26, primary colorectal carcinoma was diagnosed, and in the remaining two, recurrent colorectal carcinoma. Twenty-one patients were randomly selected to receive either a type A or type B stent; for the remaining five, type C was used. Type A, an uncovered nitinol wire stent, was lightly coated to ensure structural integrity. Type B (flare type) and C (shoulder type) stents were polyurethane covered and their diameter was 24 and 26mm, respectively. The rates of technical success, clinical success, and complications were analyzed using the chi-square test, and to analyse the mean period of patency, the Kaplan-Meier method was used. ...
Objective: To explore the interventional treatment for biliary re-stenosis after metallic stents placement in patients due to cholangiocarcinoma and evaluate its therapeutic effect. Methods: Percutaneous metallic stents placement or combined with continuously infusion arterial chemotherapeutic and chemotherapeutic embolization were performed in 12 patients with biliary re-stenosis using 12 metallic stents. Results: Once stent placement was 100% successful in all 12 cases, TBIL, ALT, GTP and AKP values 7 days postoperatively were significantly lower than that in preoperation. Jaundice was reduced satisfactorily in 12 patients. 3 patients were undergone continuously arterial chemotherapeutics infusion and chemotherapeutic embolization 4 weeks after stents placement. Conclusions: Percutaneous replacement of biliary metallic stents was effective and safe for palliation of malignant biliary re-stenosis and would be much better when combined with continuously arterial ...
Recurrent tumour after radical pancreaticoduodenectomy may cause obstruction of the small bowel loop draining the liver. Roux-loop obstruction presents a particular therapeutic challenge, since the...Full Text Available
BackgroundCystinuria is the most common inherited cause of urinary tract stones in children. It can lead to obstructive uropathy, which is a major cause of renal...Full Text Available
Central airway obstruction (CAO) is a serious presentation of lung cancer and associated chest diseases. It presents a real challenge to the anesthesiologist because usually the patient admitted to...Full Text Available
Ischemic bowel disease is a rare disorder whose incidence is increasing as the mean age of the population increases. Diagnosis by clinical, laboratory and radiologic means is often difficult, and delay in definitive therapy results in substantial morbidity and mortality. A series of 26 consecutive patients, with proved acute superior mesenteric ischemia, was retrospectively reviewed: the authors reports the diagnostic methods performed preoperatively, the site and the cause of infarction and the time passed between the first radiograph and surgery. Plain abdominal radiographs were performed in 25 of 26 patients, screening abdominal US in 23 cases and CT in 19 cases. All radiological examinations were retrospectively reviewed by the three authors, independently, to recognize the different signs of infarction. On plain abdominal films, the findings warranting a presumptive diagnosis of bowel infarction were air-fluid levels (84% of cases), dilated bowel loops (48%), ...
BackgroundThe purpose of our investigation was to compare a digital templating system to conventional templating techniques when preoperatively planning for total hip arthroplasty.MethodsWe...Full Text Available
During organogenesis, net growth of tissues is determined by a balance between proliferation, hypertrophy, and apoptotic death. Human fetal bladder outflow obstruction is a major cause of end-stage...Full Text Available
Introduction:Chronic obstructive pulmonary disease (COPD) is a major public health problem. It imparts a substantial economic burden on individuals and society. Acute exacerbations...Full Text Available
Partial bladder outlet obstruction (PBOO) induces remodeling of urinary bladder smooth muscle (detrusor). We demonstrate an increase in bladder wall mass, muscle bundle size, and a threefold increase...Full Text Available
The authors’ objective was to analyze the impact of respiratory impairment on the risk of physical functional limitations among adults with chronic obstructive pulmonary disease (COPD)....Full Text Available
The purpose of this paper was to inform the reader that prolonged upper airway obstruction after posterior cervical spine surgery is a possible complication for patients with metastatic tumor of upper...Full Text Available
AIM: To evaluate the efficacy of self expandable metallic stents (SEMS) in patients with malignant esophageal obstruction and fistulas.METHODS: SEMS were implanted in the presence of fluoroscopic...Full Text Available
A bladder neck obstruction was suspected after ultrasound investigation at 16 weeks' gestation. Evaluation of protein content in the amniotic fluid, fetal ascites, and fluid from the overdistended bladder...Full Text Available
1. In normal rats and rats with bladder hypertrophy secondary to outflow obstruction, undergoing continuous cytometry, we examined the responses to the selective alpha 1-adrenoceptor antagonist doxazosin...Full Text Available
Objective:The aim of this study was to investigate the effects of obstructive sleep apnea (OSA) on procedural and declarative memory encoding in the evening prior to sleep, on memory...Full Text Available
This paper reviews 165 cases of lower urinary obstruction in infancy. The commonest lesions were posterior urethral valves (91) and ectopic ureterocele (34), stenosis or atresia of the urethra (8),...Full Text Available
Objectives To understand the perspectives of people with severe chronic obstructive pulmonary disease (COPD) as their illness progresses, and of their informal and professional carers,...Full Text Available
We investigated the pathophysiological mechanism by proteomic approach as a possible tool to detect the marker proteins to develop lower urinary tract symptoms following bladder outlet obstruction (BOO)....Full Text Available
Vesical diverticula frequently result from bladder outlet obstructions. However, giant vesical diverticula which cause acute abdomen or intestinal obstruction are very rare. Our review of the English...Full Text Available
BackgroundPlaster ingestion forming gastric bezoar is a strange way to attempt suicide and this method has not yet been reported. It may lead to a mechanical obstruction of the gut,...Full Text Available
Biliary obstructions are rarely caused by a foreign body and have received sparse attention. We present an unusual case with pruritis and abdominal pain caused by impacted full length surgical gauze...Full Text Available
Progressive obstructive lung disease is a characteristic component of cystic fibrosis (CF). It is the pulmonary manifestations, including obstruction and endobronchial infection, which directly contribute...Full Text Available
Normal urinary bladder function requires contraction and relaxation of the detrusor smooth muscle (DSM). The DSM undergoes compensatory hypertrophy in response to partial bladder outlet obstruction...Full Text Available
1. To explore mechanisms of urinary obstruction in benign prostatic hyperplasia (BPH), the features of contraction and relaxation in human hyperplastic and non-hyperplastic (control) prostatic tissues...Full Text Available
AIM: To find out whether a newly designed big cup nitinol stent is suitable for treatment of patients with gastric outlet obstruction resulting from gastric cancer.METHODS: The new stent is composed...Full Text Available
The aim of the paper is to review the role of interventional radiology in the management of hemodialysis vascular access and complications in renal transplantation. The evaluation of patients with hemodialysis vascular access is complex. It includes the radiology/ultrasound (US) evaluation of the peripheral veins of the upper extremities with venous mapping and the evaluation of the central vein prior to the access placement and radiological detection and treatment of the stenosis and thrombosis in misfunctional dialysis fistulas. Preoperative screening enables the identification of a suitable vessel to create a hemodynamically-sound dialysis fistula. Clinical and radiological detection of the hemodynamically significant stenosis or occlusion demands fistulography and endovascular treatment. Endovascular prophylactic dilatation of stenosis greater than 50% with associated clinical abnormalities such as flow-rate reduction is warranted to prolong access patency. The ...
Eight patients with primary hyperparathyroidism were examined preoperative to locate the affected parathyroid glands. The localisation was done with technetium 99m and thallium 201. This new method seems to be of great value to locate preoperative the affected parathyroid glands. (R.B.).
This paper deals with the indications for prostatectomy; the differential diagnosis of the symptomatology of bladder neck obstruction; and the factors influencing the choice of operation....Full Text Available
Abstract Introduction: The obstructed, infected kidney is a urological emergency. It has been accepted that the management of infected hydronephrosis secondary to ureteric stones is through prompt decompression of the collecting system. However, the optimal method of decompression has yet to be established. Materials and Methods: A PubMed and Medline search was performed of all English-language articles from 1960 using key words ?sepsis,?? ?urosepsis,?? ?obstruction,?? ?obstructive pyelonephritis,?? ?pyonephrosis,?? ?infection and hydronephrosis?? ?decompression,?? ?stent,?? ?nephrostomy,?? and ?management.?? The Cochrane database and National Institute for Clinical Effectiveness guidelines were searched using the terms ?sepsis,?? ?urosepsis,?? ?stent,?? ?nephrostomy,?? or ?obstruction.?? ...
To evaluate the feasibility and clinical effectiveness of using a polyurethane-covered expandable nitinol stent in the palliative treatment of malignant duodenal obstruction. Under fluoroscopic guidance, a polyurethane-covered expandable nitinol stent was placed in 12 consecutive patients with malignant duodenal obstructions. All presented with severe nausea and recurrent vomiting. The underlying causes of obstruction were duodenal carcinoma (n=4), pancreatic carcinoma (n=4), gall bladder carcinoma (n=2), distal CBD carcinoma (n=1), and uterine cervical carcinoma (n=1). The sites of obstruction were part I (n=1), part II (n=8), and III (n=3). Due to pre-existing jaundice, eight patients with part II obstructions underwent biliary decompression prior to stent placement. An introducer sheath with a 6-mm outer diameter and stents 16 mm in diameter were employed, and to place the stent, ...
We consider an admissible fibration $\\pi:X\\to\\mathbb{P}^1$ over a curve over a number field, of which the generic fiber $X_\\eta$ is geometrically rationally connected. We suppose that there exists a generalized Hilbertian subset $\\textsf{Hil}$ of $\\mathbb{P}^1$, such that the Brauer-Manin obstruction is the only obstruction to the Hasse principle (resp. to the weak approximation) for $X_\\theta(\\theta\\in \\textsf{Hil}).$ We prove that the Brauer-Manin obstruction is the only obstruction to the Hasse principle (resp. to the strong approximation) for zero-cycles of degree 1 on $X$ in the following cases: $(B_1)$ the index of the generic fibre $X_\\eta$ is equal to 1; $(B_2)$ all fibers are geometrically integral. Then, we obtain some similar results for certain fibrations over $\\mathbb{P}^n$. As a consequence, we obtain the following result: let $X$ be a smooth projective geometrically rationally ...
Background/Aim:To assess the prognostic indicators preoperatively presenting and influencing the mortality rate following esophagectomy for esophageal cancer.Full Text Available
The paper investigates computerized tomography capabilities in showing vascular complications secondary to intestinal obstruction and for assessing the site and cause of obstruction. [Italian] Scopo del lavoro e' lo studio dell'uso della tomografia computerizzata nel riconoscimento di complicanze vascolari secondarie ad occlusione intestinale e della presenza, della natura e della sede dell'ostacolo alla canalizzazione intestinale.
We introduce a cohomological obstruction to solving the constant scalar curvature K\\"ahler (cscK) equation twisted by a semipositive form, appearing in works of Fine and Song-Tian. Geometrically this gives an obstruction for a manifold to be the base of a holomorphic submersion carrying a cscK metric in certain ``adiabatic'' classes. In turn this produces many new examples of general type threefolds with classes which do not admit a cscK representative. When the twist vanishes our obstruction extends the slope stability of Ross-Thomas to effective divisors on a K\\"ahler manifold. Thus we find examples of non-projective slope unstable manifolds.
The extent (density and diameter) of the native (preexisting) collateral circulation in healthy tissues and the capacity of collaterals to enlarge/remodel in obstructive arterial disease are important...Full Text Available
BackgroundLymphangioleiomyomatosis (LAM) is a rare lung disease characterised by progressive airflow obstruction. No effective medical treatment is available but therapy with sirolimus...Full Text Available
PurposeUltrasonically measured intravesical prostatic protrusion may be a promising noninvasive method of assessing bladder outlet obstruction. Previous investigations...Full Text Available
BackgroundThe aim of this report was to describe duodenal obstruction caused by a rubber foreign body in a cow.Case PresentationThe clinical, biochemical...Full Text Available
Cystic dilatation of Cowper's gland ducts (Cowper's syringocele) is uncommon in children and is frequently asymptomatic, but it may cause urinary infection, haematuria, dysuria, and obstructive voiding...Full Text Available
BackgroundAlthough self-expandable metal stent (SEMS) insertion is widely used for relief of malignant colorectal obstructions, the immediate technical and clinical failure rates of SEMSs and the associated risk factors remain largely unknown. ObjectiveTo identify rates and factors predictive of technical and clinical failure of SEMSs when their use is attempted for the decompression of malignant colorectal obstruction. DesignRetrospective chart review. SettingA tertiary-care academic medical center in South Korea. PatientsThis study involved a total of 412 patients with malignant colorectal obstruction in whom SEMS insertion was attempted. InterventionPlacement of colonic SEMSs. Main Outcome MeasurementsTechnical success and immediate and long-term clinical success rates. ResultsTechnical...
A case of acute urinary retention due to a vesical leiomyoma is described. This is an unusual presentation and the treatment is discussed.ImagesFull Text Available
Purpose:To report the preoperative best-corrected visual acuity (BCVA) and foveal thickness (FT) values that lead to a postoperative decimal BCVA of ≥1.0 after surgical removal...Full Text Available
We wanted to evaluate the usefulness of a new type of a complex expandable nitinol stent that was designed to reduce the stent's propensity to migration during the treatment of malignant gastroduodenal obstructions. Two types of expandable nitinol stent were constructed by weaving a single thread of 0.2mm nitinol wire in a tubular configuration: an uncovered stent 18mm in diameter and a covered stent 16mm in diameter. Both ends of the covered stent were fabricated by coaxially inserting the covered stent into the tubular uncovered stent and then attaching the two stents together with using nylon monofilament. Under fluoroscopic guidance, the stent was placed in 29 consecutive patients (20 men and 9 women, mean age: 65 years) who were suffering with malignant gastric outlet obstruction (n=20), duodenal obstruction (n=6) or combined obstruction (n=3). Clinical improvement was assessed by ...
In this study, we investigated the effects of bladder outlet obstruction (BOO) on the expression and function of large conductance (BK) and small conductance (SK) Ca2+-activated K+...Full Text Available
Inferior vena cava (IVC) obstruction is a well-described clinical entity. Most IVC obstructions from malignant neoplasms are a direct result of tumor compression [Oviedo J, Cerda S. Vascular invasion by hepatocellular carcinoma. Arch Pathol Lab Med 2001;125: 454-5; Furui S, Sawada S, et al. Gianturco stent placement in malignant caval obstruction: analysis of factors for predicting the outcome. Radiology 1995;195:147-52; Fletcher WS, Lakin PC, et al. Results of treatment of inferior vena cava syndrome with expandable metallic stents. Arch Surg 1998;133:935-8]. The symptoms of IVC obstruction include progressive ascites, scrotal edema and lower body edema. These constellations of symptoms are described as IVC syndrome and are devastating to a patient with end-stage cancer. We describe a palliative therapy utilizing Luminexx nitinol self-expanding stents to treat intracaval hepatoma thrombus ...
To illustrate frequently encountered anatomic variations on PNS computed tomography(CT) and to assess their clinical significance. CT findings of 1523 patients, who underwent PNS CT with no history of sinus surgery, were reviewed, and prevalence of each anatomic variation and its relationship with mucociliary clearance pathway was evaluated. Two categories of anatomic variations were encountered. The first group included variations of the turbinates, such as concha bullosa(28.6%), paradoxical middle turbinate(31.5%), of the uncinate process, such as medially bent or folded(36.3%), laterally bent(3.7%) or uncinate bulla(0.5%), of the ethmoidal sinus, such as Haller's cell(28.2%), large agger nasi cell(9.6%) or large ethmoidal bulla(23.5%) and nasal septal deviation(24.1%), which might cause obstruction of mucociliary clearance pathway and thus give rise to secondary obstructive sinusitis. The second group included Onodi cell(1.4%) and ...
To illustrate frequently encountered anatomic variations on PNS computed tomography(CT) and to assess their clinical significance. CT findings of 1523 patients, who underwent PNS CT with no history of sinus surgery, were reviewed, and prevalence of each anatomic variation and its relationship with mucociliary clearance pathway was evaluated. Two categories of anatomic variations were encountered. The first group included variations of the turbinates, such as concha bullosa(28.6%), paradoxical middle turbinate(31.5%), of the uncinate process, such as medially bent or folded(36.3%), laterally bent(3.7%) or uncinate bulla(0.5%), of the ethmoidal sinus, such as Haller's cell(28.2%), large agger nasi cell(9.6%) or large ethmoidal bulla(23.5%) and nasal septal deviation(24.1%), which might cause obstruction of mucociliary clearance pathway and thus give rise to secondary obstructive sinusitis. The second group included Onodi cell(1.4%) and medial ...
Purpose Video-assisted thoracic surgery (VATS) has recently been adopted for complicated anatomical lung resections. During these thoracoscopic procedures, surgeons view the operative field on a two-dimensional (2-D) video monitor and cannot palpate the organ directly, thus frequently encountering anatomical difficulties. This study aimed to estimate the usefulness of preoperative three-dimensional (3-D) imaging of thoracic organs. Methods We compared the preoperative 64-row three-dimensional multidetector computed tomography (3DMDCT) findings of lung cancer-affected thoracic organs to the operative findings. Results In comparison to the operative findings, the branches of pulmonary arteries, veins, and bronchi were well defined in the 3D-MDCT images of 27 patients. Conclusion 3D-MDCT imag...
AIM: The purpose of the study was to evaluate the percutaneous use of the new nitinol SMARTeR stents in patients with biliary obstruction. MATERIALS AND METHODS: Four stents were placed in three patients percutaneously under ultrasound and fluoroscopic guidance. RESULTS: The deployment of the stents was successful in all three patients. All stents maintained their patency and position after short-term follow-up. CONCLUSION: The nitinol SMARTeR stent is useful in the management of patients with biliary obstruction although accurate placement across the ampulla was found to be technically more difficult than with the Wallstent. Larger, long-term follow-up studies are required to evaluate the long-term patency of these new devices.
A 65-year-old woman who was diagnosed as having psoitis by CT findings, which disclosed non-symmetrical dilation of the psoas muscle and gaseous image. Pus from the psoas muscle seen at surgery corresponded to CT findings. Preoperative CT examination was useful in the establishment of diagnosis. (Namekawa, K.).
Neurofibromatosis type I (NF1) is one of the most common inheritable disorders and is associated with an increased risk of gastrointestinal stromal tumours (GISTs). However, the predominant location...Full Text Available
Objective. Cervical cancer patients who had an abandoned radical hysterectomy were evaluated for preoperative clinical predictors, complication rates, and outcomes. Study...Full Text Available
Objectives:Cachexia is common in pancreatic cancer and may have an influence on longterm survival but few studies have investigated this in patients with operable tumours. Therefore,...Full Text Available
AimsThe aims of the study were to study the effect of pre-operative treatment on the expression of tumour-related proteins and to correlate the expression of these...Full Text Available
Patients treated with bleomycin are at risk of developing the acute adult respiratory distress syndrome post-operatively. In a prospective study of 12 patients who had received bleomycin preoperatively...Full Text Available
In a consecutive series of 26 patients (10 men and 16 women) undergoing abdominoperineal resection of the rectum, cystometry and pressure-flow-EMG measurements were made preoperatively and three and...Full Text Available
PurposeTaxanes have effects on angiogenesis causing difficulties in separating biologic effects of chemotherapy from those due to angiogenesis inhibitors. This randomized...Full Text Available
Objective:The identification of biological markers in order to assess different aspects of COPD is an area of growing interest. The objective of this study was to investigate whether...Full Text Available
This article addresses the connection of cogeneration plants to the utility system. The article provides examples for use in illustrating the problems that must be overcome and the solution chosen. These illustrations include high voltage utility connection, multiple connections to the utility at one location, and dealing with losses and obstructions.
Background:Tobacco smoking is the most important risk factor for chronic obstructive pulmonary disease (COPD) development. Inhaled cigarette smoke can induce tumor necrosis factor-α...Full Text Available
IntroductionSevere obstructive sleep apnea has been associated with sexual dysfunction; however, it is unclear whether milder forms of sleep disturbances might also...Full Text Available
Acoustic pharyngometry is a relatively new noninvasive method that quantifies geometrically complexed pharyngeal dimensions. Our study aimed to investigate the predictability and usefulness of acoustic...Full Text Available
Polyp originating within a concha bullosa is uncommon; we report only the third such case in the English literature. A 45-year-old man presented with nasal obstruction and headache. Examination of the...Full Text Available
Epithelial-mesenchymal transition (EMT) has emerged in recent years as an important process in the development of organ fibrosis in many human diseases. Our previous experience in a nonhuman primate...Full Text Available
The goal of this study was to evaluate the clinical and urodynamic features in Korean men with lower urinary tract symptoms (LUTS) and to determine non-invasive parameters for predicting bladder outlet...Full Text Available
Breath analysis is a powerful noninvasive technique for the diagnosis and monitoring of respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD). Nitric oxide...Full Text Available
Study Objectives:To evaluate the value of mouth opening during sleep for predicting surgical outcomes after uvulopalatopharyngoplasty (UPPP).Methods:Retrospectively,...Full Text Available
Four infants with obstructive hydrocephalus caused by space occupying third ventricle and mesencephalic cysts are reported. Despite immediate shunt insertion in all patients, there was either lack of...Full Text Available
Concha bullosa is a common anatomic variation of the middle turbinate; however, sinusitis secondary to the concha bullosa is rare. A 52-yr-old woman presented with nasal obstruction and posterior nasal...Full Text Available
OBJECTIVE: To evaluate the effect of fetal tracheal occlusion on sodium and chloride concentrations in amniotic and tracheal fluid. SUMMARY BACKGROUND DATA: Intrauterine tracheal occlusion has been...Full Text Available
BackgroundWith the increasing interest with botulinum toxin – A (BTX-A) application in the lower urinary tract, we investigated the BTX-A effects on the canine prostate and...Full Text Available
We report a case of symptomatic intraurethral prostatic cyst in a 42-yr-old man without clinical evidence of benign prostatic hyperplasia. The intraurethral cyst makes it unique from the all previously...Full Text Available
We describe two cases of septic arthritis occurring in association with lower urinary tract infection in elderly men. In both cases the organism isolated from both the joint and the urine was Staphylococcus...Full Text Available
Functional imaging of the pharynx used to be the domain of cineradiography, CT and ultrafast CT. The development of modern MRI techniques led to new access to functional disorders of the pharynx. The aim of this study was to implement a new MRI technique to examine oropharyngeal obstructive mechanisms in patients with obstructive sleep apnea (OSA). Sixteen patients suffering from OSA and 6 healthy volunteers were examined on a 1.5 T whole-body imager ('Vision', Siemens, Erlangen Medical Engineering, Germany) using a circular polarized head coil. Imaging was performed with 2D flash sequences in midsagittal and axial planes. Patients and volunteers were asked to breathe normally through the nose and to simulate snoring and the Mueller maneuver during magnetic resonance imaging (MRI). Prior to MRI, all patients underwent an ear, nose and throat (ENT) examination, functional fiberoptic nasopharyngoscopy and polysomnography. A temporal resolution of ...
Epignathus is an extremely rare oropharyngeal teratoma that commonly arises from the palate, leading to a high mortality (80–100%) due to airway obstruction in the neonatal period. We present...Full Text Available
ObjectivesWe examined the expression of Rho Kinase (ROK) isoforms in young and old rabbit’s detrusor smooth muscles (SM) during the progression of short term...Full Text Available
AbstractA 6-month-old female alpaca was presented for stranguria. Based on the history, physical examination findings, and radiographic studies, the alpaca was diagnosed with bladder...Full Text Available
In 29 patients with urinary obstruction due to prostatic enlargement, medium-fill water cystometry was performed before prostatectomy and again 3 months after. A high incidence of detrusor hyperreflexia...Full Text Available
To investigate the problems of the Hanaro stent (Solco Intermed, Seoul, Korea) when used in the palliative treatment of patients with inoperable malignant biliary obstruction. Between January 2000 and May 2001, the treatment of 46 patients with malignant biliary obstruction involved percutaneous placement of the Hanaro stent. Five patients encountered problems during removal of the stent's introduction system. The causes of obstruction were pancreatic carcinoma (n=2), cholangiocarcinoma (n=2), and gastric carcinoma with biliary invasion (n=1). In one patient, percutaneous transhepatic cholangiography and stent insertion were performed as a one-step procedure, while the others underwent conventional percutaneous transhepatic biliary drainage for at least two days prior to stent insertion. A self-expandable Hanaro stent, 8-10 mm in deameter and 50-100 mm in lengh, and made from a strand of nitinol wire, was used in ...
We wanted to determine the technical and clinical efficacy of placing a self-expandable PTFE-covered nitinol stent for the management of inoperable malignant biliary obstruction. Thirty six patients with inoperable malignant biliary obstructions were treated by placement of self-expandable PTFE-covered nitinol stents (S and G Biotech Corporation, Seongnam, Korea). Clinical evaluation was done with assessment of the serum bilirubin and alkaline phosphatase levels, which were measured before and after stent placement within 1 week, at 1 month and at 3 months. The patient survival rate and stent patency rate were calculated with performing Kaplan-Meier survival analysis. Successful stent placement was achieved in all the patients without procedure-related complication. Pancreatitis as an early complication occurred in two cases. The serum bilirubin and alkaline phosphatase levels were significantly decreased after the procedure. During the ...
Purpose: To evaluate the significance of preoperative localization of abnormal parathyroid glands to the surgical outcome in patients with primary hyperparathyroidism. Material and Methods: Thirty-nine patients with primary hyperparathyroidism were studied preoperatively with US (39 patients), CT (30 patients) and MR imaging (18 patients). The overall diagnostic accuracy for US was 87%, CT 66% and MR 94%. In patients with a single parathyroid adenoma US was the most cost-effective localization technique with a detection rate of 96%. CT had a lower detection rate (78%) but was of particular value for fairly large ectopic adenomas in the root of the neck. MR imaging was a good confirmatory test (93%). In patients with multiple gland disease (primary hyperplasia and multiple adenomas), no single localization study alone was sufficient. Combination of all 3 studies, however, alerted the physician to the presence of disease in more than one gland in ...
The anatomical patterns of anorectal malformations have so far been studied according to the principles which inspire Pena's technique for the surgical treatment of anorectal anomalies. Thus, the diagnostic study of anorectal malformation has by the authors been considered a work of classification, but of identification. Among the diagnostic procedures in use in author's Institute, preoperative CT of pelvis is performed to assess the presence and to define the development of muscular sphincteric structure towards prognostic evaluation of continence, the major long-term goal. Seven patients, aged 1-30 months, with anorectal anomalies were studied with preoperative CT of the pelvis. CT scans showed well-developed sphinteric muscles in 3 patients (2 with recto-ureteral and 1 with recto-vestibular fistulas), poorly-developed muscular structure in 3 patients (with recto-vaginal, cloacal and prostatic fistulas), absence of muscular structure in 1 ...
Purpose: To determine the value of MRI in the preoperative evaluation of chronic paranasal sinusitis and to compare the results with CT and intraoperative findings. Method/Materials: 42 patients with clinical signs of chronic paranasal sinusitis underwent MRI after CT evaluation on one day, with subsequent functional endoscopic sinus surgery on the next day. Coronary CT was obtained with 5-mm slices and table-feed in the prone position, while MRI was performed in the supine position with coronary T_2-TSE+pd and coronary and transverse HASTE, each with 5-mm slice thickness. Aquisition time in MRI was less than 8 minutes. Two radiologists reviewed the CT and MRI scans for signs of sinusitis and detection of anatomical landmarks. The results were correlated with the intraoperative findings. Results: MRI offered no artifacts of dental work and showed more often high quality pictures than CT. CT and MRI demonstrated a good correlation in the detection of mucosal ...
The purpose of this study was to assess the efficacy of MRM in providing preoperative locoregional information on patients with breast cancer. MRI was performed on 62 female breast cancer patients. A 1.5 T MR-system was used to acquire fat-suppressed T{sub 1}WI, T{sub 2}WI and dynamic-contrast-enhanced images with an SPGR pulse sequence. The extent of the cancer measured with MRM was confirmed histologically in all patients. The size obtained from MRM correlated well with the size obtained histologically, including intraductal spread of cancer (R: 0.853). As for shape, the round/oval type evident from MRM correlated more accurately (R: 0.934) than the ill-defined type associated with a linear and/or clumped enhanced area (R:0.744). The difference between the size obtained from MRM and the size obtained histologically, including IDS, was less than 15 mm in the majority of patients (93.5%). MRM accurately reveals the extent of cancer, including IDS, and is effective ...
Computed tomography (CT) of the neck and mediastinum was performed in 16 patients with renal osteodystrophy. Thirty out of 34 excised parathyroid glands weighing more than 500mg were diagnosed preoperatively (88.2%). Scintigraphy of the neck with _2_0_1TlCl and sup(99m)TcOsub(4-) was also performed in 15 patients. The introduction of subtraction method with a mini-computor in the scintigraphy has remarkably improved the visualization rate of parathyroid glands. Ultrasonic echography (US) of the neck which is able to obtain not only transverse butalso longitudinal imaging was done in 7 patients. It has about same detection rate of the glands with CT. The visualization of enlarged parathyroid glands is valuable not only for localization but also for undeniable evidence of hyperparathyroidism. Also, repeated follow-up examination can determine the effectiveness of conservative treatment. (author).
Hilar cholangiocarcinoma is associated with a dismal prognosis; however, curative resection may offer a chance of cure. Various factors should be considered in the surgical planning for curative resection. These factors include extent of bile duct involvement, relationship between portal vein and tumor involvement, diffuse hepato duodenal ligament infiltration, vascular invasion, lymph node metastasis, peritoneal seeding, and hepatic volume. Using high-quality volume data from multidetector-row computed tomography (MDCT) and adequate postprocessing images, radiologists can provide various types of information, imperative for curative resection of a hilar cholangiocarcinoma. This review illustrates the role of MDCT in the preoperative workup of hilar cholangiocarcinoma.
Atrial fibrillation (AF) is common after coronary artery bypass grafting (CABG) and increases the morbidity and cost. Amiodarone reduces AF after CABG. Ranolazine, an antianginal agent, also prolongs atrial refractoriness and inhibits after depolarizations and triggered activity; effects that could decrease AF after CABG. The present study compared amiodarone versus ranolazine for the prevention of AF after CABG. A retrospective cohort study of patients undergoing CABG at Aspirus Hospital from June 2008 to April 2010. The patients received either amiodarone (400 mg preoperatively followed by 200 mg twice daily for 10 to 14 days) or ranolazine (1,500 mg preoperatively followed by 1,000 mg twice daily for 10 to 14 days). The primary end point was any identified AF after CABG. A total of 393 ...
Objective: To evaluate the feasibility and clinical application of two stents insertion via single tract for treatment of hepatic hilar cholangiocarcinoma. Methods: Eighteen patients with hepatic hilar cholangiocarcinoma who had left and right bile duct obstruction were treated with stents insertion via right bile duct puncturing routeway. These two stents were implanted between right and left bile duct, and between right bile duct and common bile duct. Results: Eighteen patients obtained successful two stents placement by right bile duct puncturing tract and succeeded with internal drainage for all biliary tree jaundice subsided distinctly. Conclusions: The technique of two stents insertion via single tract could predigest interventional drainage procedure of high bile duct obstruction, reduce operation trauma, shorten handling time and possess promising application value
Conclusions. There are gender differences when it comes to the risk factors for sleep apnea. Large tonsils, a high tongue and a wide uvula are risk factors for sleep apnea in men, while large tonsils and a retrognathic mandible are risk factors in women. Upper airway abnormalities including mandibular retrognathia are, however, unable to predict sleep apnea among snorers being investigated for suspected sleep apnea. Objectives. To identify gender-specific risk factors for obstructive sleep apnea and the diagnostic performance from physical upper airway examinations among snoring men and women investigated because of suspected sleep apnea. Patients and methods. The dimensions of the uvula, tonsils, velopharynx and tongue, and nasal septal deviation, mandibular position, neck circumference, ...
Objectives The optimal timing of pyeloplasty for children diagnosed with ureteropelvic junction obstruction (UPJO) after workup for antenatal hydronephrosis is disputed. We sought to examine the potential costs and clinical outcomes of treatment protocols featuring different indications for pediatric pyeloplasty using Markov models. Methods Cost and outcomes analysis using Markov modeling was performed for three treatment algorithms: medical management, immediate pyeloplasty (during the first year of life), and pyeloplasty after no improvement on imaging. The costs were determined from the perspective of the medical institution. The variables tracked during Markov model simulation included age at resolution of UPJO, the proportion of patients with worsened hydronephrosis, the number of pye...
The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas will be described in this paper. The pre- and postoperative imaging of the temporal bone was performed with HRCT and MRI. HRCT and MRI were performed in the axial and coronal plane. MRI was done with T2 weighted and T1 weighted sequences both before and after the intravenous application of contrast material. All imaging findings were confirmed clinically or surgically. The preoperative cholesteatoma-caused complications depicted by HRCT included bony erosions of the ossicles, scutum, facial canal in the middle ear, tympanic walls including the tegmen tympani, and of the labyrinth. The preoperative cholesteatoma-caused complications depicted by MRI included signs indicative for labyrinthitis, and brain abscess. Postoperative HRCT ...
Cerebral blood flow (CBF) and cerebrovascular reserve capacity (CRC) were measured by stable xenon computerized tomography (Xe-CT) and acetazolamide test in 15 patients with cerebrovascular disease before and after extracranial-intracranial (EC-IC) bypass surgery for minor stroke, reversible ischemic neurological deficit or transient ischemic attack. All had angiographically shown occlusive lesions of the major arterial trunk. In the present series, global analysis showed that the bypass did not increase the resting rCBF, but did increase the rCRC. We divided the patients into four groups according to the preoperative resting rCBF and rCRC. All 3 patients with normal resting rCBF and reduced rCRC showed postoperative improvement of rCRC. Of 6 patients with reduced CBF and reduced CRC, three had postoperative increase in resting CBF and four had increased CRC. One of two patients with reduced CBF and normal CRC showed only an increase in CRC. We propose that reduced ...
Cardiac tumours may display diverse symptoms through potential involvement of any structure of the heart. We describe a case of a highly malignant thymoma with involvement of different cardiac structures with important haemodynamic compromise. With the high sensitivity of transthoracic echocardiography for detection of intracardiac masses, computed tomography and magnetic resonance add essential structural preoperative information on the tumour and surrounding tissue as vessels, pleura, lung and mediastinum.
The accurate staging of rectal carcinoma is very important for treatment planning. The histological data obtained from surgical specimens of 22 patients with rectal carcinoma were compared with pre-and postoperative endorectal US findings and with preoperative CT results. According to an adapted version of Astler and Coller classification, the different degrees of tumor spread into the rectal wall were represented as follows: stage A: 1 patient; stage B1: 5 patients; stage B2: 6 patients; stage C1: 1 patient; stage C2: 8 patients and stage D: 1 patient. Preoperative staging, based on the overall results of CT and US, was in agreement with histology in 19 of 22 cases. Individual analysis of US and CT results, in comparison with histological data, showed US staging accuracy to be 77.3% (17/22 patients). US accuracy in demonstrating tumor spread into the rectal wall (stages A, B1, C1) was 100% (7/7 patients); US was 70% accurate in lymph node ...
Intravenous digital subtraction angiography using Fuji computed radiography system (FCR-DSA) was used to evaluate 57 preoperative patients with clinical manifestations of peripheral vascular disease of lower extremity. With its high contrast resolution and good special resolution, image of FCR-DSA could offer optimal information of vascular abnormality in lower extremity distal to midfoot for the diagnosis and the choice of management.
Intravenous digital subtraction angiography using Fuji computed radiography system (FCR-DSA) was used to evaluate 57 preoperative patients with clinical manifestations of peripheral vascular disease of lower extremity. With its high contrast resolution and good special resolution, image of FCR-DSA could offer optimal information of vascular abnormality in lower extremity distal to midfoot for the diagnosis and the choice of management. (orig.).
Different sized ROIs within the femoral head and different modes of calculation were used in (/sup 99m/Tc)MDP scintimetry after femoral neck fracture. In preoperative scintimetry, correction for increased trochanteric uptake gave the best discrimination, whereas in postoperative scintimetry the direct ratio fractured/intact femoral head was superior. The change in ROI size had little influence.
Computer tomography used in the diagnosis of tumours is described in the light of particularly great diagnostic difficulties in children. Computer tomography was applied in 12 cases. A high diagnostic value of this method was demonstrated, which makes possible a more accurate diagnosis of the position of the tumour, its size, and expanding tendency. The possibility of estimating healthy tissues and organs, and those with pathological changes on the basis of differences in their density with a detection threshold at 0.5% density difference facilitates not infrequently preoperative diagnosis raising the value of the method.
This report contains data collected on a monthly basis over the period April, 1973 - April, 1975 for dustfall particulates, sodium and chloride and SO2 levels obtained from 12 monitoring sites near the Chalk Point Generating Station operated by PEPCO and ...
1. The effects on micturition of RP 67,580, a selective NK1 receptor antagonist, and SR 48,968, a highly, potent antagonist at NK2 receptor sites, given intrathecally (i.t.) or intra-arterially (i.a.)...Full Text Available
To find out the sonographic findings that are useful to differentiate hepatic abscess from peripheral cholangiocarcinoma. Twenty-two hepatic abscesses and 22 peripheral cholangiocarcinomas which had been confirmed histologically were included in this study. Objective points were echo characteristics of the lesion, internal septation, presence of peripheral low echoic rim, demarcation from normal liver(well or poorly defined), posterior enhancement, multiplicity, dilatation of bile duct(obstructive or non-obstructive), intrahepatic duct stone, pleural effusion, and intra-abdominal fluid collection. Echo characteristics of the lesion were classified in-to four types. Type I; Predominantly echogenic with hypoechoic portion, type II; Echogenic without hypoechoic portion, type III; Predominantly hypoechoic with echogenic portion, type IV; Hypoechoic without echogenic portion. 1)Nine abscesses and 2 peripheral cholangiocarcinomas were type ...
Peritoneal calcification, which can lead to intestinal obstruction and potentially lethal hemoperitoneum, is a rare complication of continuous ambulatory peritoneal dialysis. We describe a case in which extensive peritoneal calcification had arisen for this reason. Although the patient was asymptomatic, extensive calcification was present on the parietal and visceral peritoneum, including the hepatic and splenic surface. (author)
The value of biliary scintigraphy was studied in 180 patients with suspected biliary tract disease. Most of the patients were investigated additionally by conventional techniques such as cholecystography, cholangiography and ultrasonography. It is concluded that biliary scintigraphy is a simple and safe technique for visualization of the biliary tract. It is particularly useful in the evaluation of acute cholecystitis, in patients with iodine sensitivity obstructive from nonobstructive jaundice.
The purpose of the paper is to investigate whether high-resolution CT (HRCT) can detect the subjects with massive emphysematous destruction in a group of patients with severe chronic obstructive pulmonary disease (COPD) and therefor be of help in selecting the candidates to surgical lung volume reduction. Have been examined 40 former smokers with severe COPD (FEV_1#<=#40% of the predicted value, with no major improvement after inhalation of bronchodilators). The emphysema extent score was significantly correlated with the hematocrit value and Tiffeneau index (p<2) in all the 40 patients. The severity of bronchial obstruction was the same in bronchitis and dyspnoeic patients. The subject with chronic bronchitis had milder emphysema (mean extent 35% versus 47% in the dyspnoeic subjects) and a higher frequency of bronchial involvement. A decrease in FEV_1 was significantly correlated with emphysema extent (p<1) in dyspnoeic, but not in ...
In 10 cases of femoral neck fracture treated with prosthetic replacement, the preoperative sup(99m)Tc-MDP scintigraphs were investigated and then compared with each histological findings of the extracted femoral head. The appearances of the scintigraphs were classified into following 3 patterns; increased activity pattern of sup(99m)Tc-MDP uptake in the overall femoral head (type I) in 4 cases, deficient activity pattern at the lateral side correspond to weight-bearing area (type II) in 2 cases and considerably deficient activity pattern in the whole femoral head (type III) in remaining 4 cases. Histological examination of the extracted femoral heads revealed the narrow part of ischemic necrosis in type I. However type II showed extensive necrosis in the portion of deficient activity by scintigraphs and in type III, the femoral heads except articular cartilage were entirely necrotic. This classification of sup(99m)Tc-MDP scintigraphy is correlated with the degree ...
Nine infants (six boys, three girls) with anorectal anomalies were examined in the immediate newborn period, prior to corrective surgery, with MRI. Three high, one intermediate and five low anomalies were found at MRI - one patient with a `low` lesion was subsequently found at surgery 2 months later to have a high anorectal anomaly. This infant had passed meconium per urethram soon after the MRI study, prompting the need for a protective colostomy and stressing the importance of a thorough clinical examination of babies with anorectal malformations. The MRI results and findings at surgery were in agreement in all other patients (n=8). Hydronephrosis was evident in two and renal agenesis in one patient. Sacrococcygeal hypoplasia was found in two and two hemivertebrae in one infant. No spinal cord lesion was identified. One fistula was evident on MRI but four were later found at surgery. Uniformly hyperintense T1 signal meconium was seen in all nine newborns, allowing for easy ...
PurposeTo evaluate the efficacy of photorefractive keratectomy (PRK) for residual refractive error after penetrating keratoplasty (PKP) for keratoconus. SettingPrivate ophthalmic clinic. DesignCase series. MethodConsecutive patients who had PRK augmented with topical mitomycin-C (MMC) after PKP for keratoconus were retrospectively reviewed. Patients were divided into a a low cylinder group (refractive cylinder 6.00 D). Visual acuity, refraction, and keratometry were analyzed preoperatively and 1, 3, 6, and 12 months postoperatively. ResultsThe study comprised 47 eyes (41 patients). The spherical equivalent (SE) decreased from -4.24 D +- 3.23 (SD) preoperatively to -0.71 +- 1.03 D 12 months postoperatively in the low cylinder group and from -4.19 +- 3.54 D to -2.45 +- 3.42 D, respectively, ...
To investigate the usefulness of a newly developed magnetic resonance (MR) image-guided surgical robotic system for minimally invasive laparoscopic surgery. The system consists of MR image guidance [interactive scan control (ISC) imaging, three-dimensional (3-D) navigation, and preoperative planning], an MR-compatible operating table, and an MR-compatible master-slave surgical manipulator that can enter the MR gantry. Using this system, we performed in vivo experiments with MR image-guided laparoscopic puncture on three pigs. We used a mimic tumor made of agarose gel and with a diameter of approximately 2 cm. All procedures were successfully performed. The operator only advanced the probe along the guidance device of the manipulator, which was adjusted on the basis of the preoperative plan, and punctured the target while maintaining the operative field using robotic forceps. The position of the probe was monitored continuously with 3-D ...
Purpose: Small suspicious breast lesions that are only visible at MR imaging were preoperatively marked with a hook wire under MR-guidance to allow the removal of the lesion with tissue-sparing surgery. Method: In all patients the suspicious lesions were marked preoperatively under MR guidance with a hook wire using a commercially available stereotactic device. Interventions were performed with MR guidance on a 1.0 T and on a 1.5 T system. Results: In 19 patients 22 lesions were localized. One lesion was missed and removed in a second procedure. The mean duration for localization was 66{+-}20 min (range 38-119 min). In two patients two lesions were localized. The mean deviation of the wire tip to the lesion was 2,0{+-}2,6 mm. In this series, 6 of 22 lesions were malignant. The mean diameter of the lesion was 7.6{+-}2.6 mm (range 3-14 mm). Conclusion: Suspicious breast lesions detectable only in MR imaging can be accurately localized with a hook ...
The value of CT in respect of preoperative determination of tumour status and of tumour classification was studied using 127 histologically identified ovarial tumours as basis in a blind study via mutual image classification by the two participating institutes. The medium accuracy of diagnosis was 82%, but the results were found to be greatly dependent on tumour histology. Quotas of more than 90% were obtained in case of functional cysts, cystomas, cystadeno-carcinomas and dermoids, whereas classification was less successful with the other types of tumours such as germ cell tumours, tumours of the sexually differentiated stroma, metastases and tubo-ovarial abscesses.
The purpose of this paper is to describe a technique of forced surgical rotation of the mandible used in skeletal Class II patients with deep bite and prominent chin. Posterior occlusal composite onlays combined with preoperative orthodontic treatment without anterior intrusion increase the posterior rotational component of the surgical mandibular advancement, when removed during operation. This manoeuvre allows for the surgical closure of the posterior open bite, while anteriorly the deep bite is opened. This technique avoids bimaxillary rotation surgery with dorsal impaction in mild to moderate cases. In any case, a chin setback osteotomy with compromised aesthetics can be avoided.
Thirty-seven patients with histologic proof of cholangiocarcinoma at the confluence were examined by computed tomography (CT) to determine whether this examination is of value in the assessment of these patients for surgery and whether there are any features specific to this type of tumor. Thirty-two patients showed intrahepatic duct dilatation; six of these showed dilatation of ducts in one lobe only. Eighteen patients had intrahepatic low-attenuation areas, while eight had a mass lesion in the porta hepatis. The results of this study show that CT provides useful anatomic information preoperatively but that the appearances are nonspecific. Lobar atrophy is highly suggestive of hilar cholangiocarcinoma, either of long-standing or with unilateral portal venous involvement.
In order to stress the role of computed tomography (CT) in the evaluation of benign spinal osteoblastoma, the authors examined by CT 10 patients with surgically and histologically proved osteoblastomas of the spine. Basing on surgical and histopathological findings CT proved to be a very important method for attesting the presence of the tumors (usually showed by radiographic examination), and specially for their staging and follow-up. CT in fact showed the real extent of the tumor into the spinal canal and towards the paraspinal soft tissues, and allowed the aerly detection of post surgical relapses. The authors conclude that CT is a primary diagnostic modality for preoperative planning and follow-up of benign osteoblastoma.
Two patients with femoral neck fractures, one displaced and one undisplaced, are presented. Preoperative intravital staining with tetracycline and Tc-MDP scintimetry both showed intact femoral head circulation while Tc-MDP-scintimetry 1 week after operation showed pronounced circulatory deficiency. Sr/sup 85/-scintimetry performed at the same time was inconclusive. Segmental collapse was observed radiographically, 8 and 12 months postoperatively. The major vascular injury resulting in avascularity most probably occured during the procedure of osteosynthesis, and Tc-MDP-scintimetry was found suitable for early postoperative recognition of avascular necrosis in both fractures.
Two patients with femoral neck fractures, one displaced and one undisplaced, are presented. Preoperative intravital staining with tetracycline and Tc-MDP scintimetry both showed intact femoral head circulation while Tc-MDP-scintimetry 1 week after operation showed pronounced circulatory deficiency. SR"8"5-scintimetry performed at the same time was inconclusive. Segmental collapse was observed radiographically, 8 and 12 months postoperatively. The major vascular injury resulting in avascularity most probably occured during the procedure of osteosynthesis, and Tc-MDP-scintimetry was found suitable for early postoperative recognition of avascular necrosis in both fractures. (author).
Lung transplantation has become an accepted option for many patients with end-stage pulmonary diseases. Anesthesia and surgery following lung transplantation may be required for various diseases that may affect both systemic organs and the transplanted graft. When a patient with a lung transplant undergoes surgery, there is the potential for interference with lung function, depending on the type of intervention and its anatomical site. Accurate preoperative evaluation, an understanding of the physiology of the transplanted lung, proper airway instrumentation, individualized management of intraoperative ventilation, and fluid balance are essential for a positive perioperative outcome.
Sufficient passing sight distance is an important control for two-lane rural highway design to minimize the possibility of a head-on collision between passing and opposing vehicles. Traditionally, passing zones are marked by checking passing sight distance that is potentially restricted by static sight obstructions. Such obstructions include crest curves, overpasses, and lateral objects along highways. This paper proposes a new concept of dynamic sight-distance assessment, which involves restricted passing sight distances due to the impeding vehicles that are traveling in the same direction. Using a finite-element model, the dynamic passing sight-distance problem was evaluated, and the writers analyzed the relationships between the available passing sight distance and other factors such as the horizontal curve radius, impeding vehicle dimensions, and a driver s following distance. It was found that the impeding vehicles may cause substantially ...
Gallstone is a common disease with a 10% prevalence in the United States and Western Europe. However, it is only symptomatic in 20-30% of patients, with biliary pain "colic" being the most common symptom. Complications of asymptomatic gallstone disease are generally rare, with an incidence of <1 %/yr. The most common complications of gallstone disease are acute cholecystitis, acute pancreatitis, ascending cholangitis, and gangrenous gallbladder. Less frequent complications include Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. Mirizzi syndrome and cholecystocholedochal fistula are two manifestations of the same process that starts with impaction of a gallstone in the gallbladder neck that results in obstruction of the bile duct, causing jaundice. The gallstone may erode into the bile duct, causing cholecystocholedochal fistula. Gallstone ileus refers to small bowel obstruction resulting from the impaction of one or ...
Problems and solutions in the diagnosis and operative treatment were clarified by retrospective evaluation of cases of intramedullary tumor in which MRI and surgery had been performed. The subjects were 16 patients (21-75 years old, mean age: 45 years) whose tumor was surgically removed between 1991 and 1998. MRI was performed preoperatively, and T1-weighted images, T2-weighted images, and enhanced images were obtained. Angiography was also performed in some cases. The histological diagnosis based on the MRI findings before surgery were compared with the pathological diagnosis after the operation. In 9/16 cases (56%), the preoperative histological diagnosis based on the MR images was the same as the pathological diagnosis after the operation. In 8 of the 11 cases (73%) whose images showed clear tumor margins and well shaped the tumor, the tumors were completely removed. The concordance rate between the pathological diagnosis during and after ...
Our aim was to investigate the diagnostic reliability of multidetector-row computed tomography (MDCT) for preoperative assessment of local tumoral spread in hilar cholangiocarcinoma. Thirteen of 30 consecutive patients with hilar cholangiocarcinoma who underwent surgery, excluding 17 patients who underwent biliary drainage or preoperative portal embolization, were retrospectively evaluated. Using MDCT systems of 4 detector rows or 16 detector rows, plain and dynamic contrast-enhanced images of three phases were obtained. Extent of tumor spread and lymph node metastasis were assessed with MDCT and compared with histopathological findings. The Bismuth-Corlette classification of hilar cholangiocarcinoma with MDCT were type I, 1 patient; type IIIa, 3 patients; type IIIb, 4 patients; and type IV, 5 patients; those with histopathological findings were type I, 1 patient; type IIIa, 2 patients; type IIIb, 4 patients; and type IV, 6 patients. One ...
Objective was to assess the accuracy of a single versus combined use of ultrasound (US) or computed tomography (CT) in the localization of diseased parathyroid glands. Forty-one patients with hyper-parathyroidism treated surgically between January 2000 to December 2005 at Jordan University Hospital, Amman, Jordan were included in this study. Preoperative ultrasonographic and CT findings were reviewed and compared to the intraoperative and pathologic diagnosis of diseased parathyroid glands. The mean age of patients was 46 years (range 16-70; 15 males and 26 females). Parathyroid adenoma was confirmed in 33 patients and hyperplasia of the parathyroid glands in 8 patients. Preoperative evaluation was carried out in 32 patients (CT scan) and in 23 patients (US). In 18 cases, the diagnosis of parathyroid disease was based on CT findings alone and in 9 patients the diagnosis was based on a single US finding. Combined CT and US evaluation was carried ...
Stream invertebrates that feed on leaf litter are intimately tied to the nature and timing of the litter input. These invertebrates are called shredders; they consume streamside, riparian litter that has become trapped in the stream channel. This plant litter accumulates at the leading edge of obstructions in the current and settles out in pools, alcoves, and other depositional zones. Given the extensive literature that has accumulated over the last 20 years, researchers can now develop a general, testable model that relates riparian plant communities to the stream shredders, which depend upon litter derived from those communities.
Primary B-cell lymphoma of thymus is uncommon. We describe the case of a 23-year-old woman with a history of shortness of breath and distended neck veins of 1-month duration. A chest roentgenogram and computed tomographic chest scan of the showed a large anterior mediastinal mass. Tru-cut biopsy revealed primary B-cell lymphoma of thymus. She underwent chemotherapy with no symptomatic improvement. Post-chemotherapy computed tomographic scan of the chest showed no appreciable reduction in tumor size. Surgical excision was carried out with excellent results.
Dyspnea is the most distressing symptom experienced by those suffering from advanced stages of chronic obstructive pulmonary disease (COPD). Activity-related dyspnea in COPD is multifactorial but is associated with increased central neural drive, impaired dynamic respiratory mechanics and abnormal respiratory muscle function. Each of these components can potentially be targeted for pharmacotherapy. Recent advances in the pharmacotherapy of COPD include the development of new long-acting bronchodilators which, when combined, provide sustained improvements in dyspnea. Additionally, novel applications of older therapies such as opiates, furosemide, helium-oxygen, and statins show early promise as dyspnea-relieving interventions in COPD. Effective pharmacological manipulation of the affective ...
Objective: To evaluate the effect of PTBD in treating malignant biliary obstruction caused by hilar cholangiocarcinoma. Methods: We retrospectively analyzed the data of 103 patients(M:62,F:41)with malignant obstructive jaundice caused by hilar cholangiocarcinoma. After taking percutaneous transhepatic cholangiography, metallic stent or plastic external catheter or external-internal catheter for drainage was deployed and then followed up was undertaken with clinical and radiographic evaluation and laboratory. examination. Results: All patients went though PTBD successfully (100%). According to Bismuth classification, all 103 cases consisted of I type(N=30), II type (N=30), III type (N=26) and IV type (N=17). Thirty-nine cases were placed with 47 stents and 64 eases with drainage tubes. 4 cases installed two stems for bilateral drainage, 2 cases installed two stents because of long segmental strictures with stent in stent, 1 case was placed with ...
Phytoplankton community was investigated in the cage culture area of Daya Bay during a diurnal cycle. Two rainfalls occurred during the course of the experiment and decreased the surface seawater salinity in the aquaculture area. A total of 38 species were identified, of which the dominant species included Pseudo-nitzschia spp. and Skeletonema costatum. Water stratification obstructed the vertical migration of dinoflagellates. Statistical analysis indicated that Synechococcus showed negative relationship with silicate and ammonia, which indicated that Synechococcus adapted to grow at oligotrophic environment. Phytoplankton community structure implied the risk of Pseudo-nitzschia spp. blooms in the aquaculture area of Daya Bay.
The heavy crude fraction processing is performed under very high vacuum to minimize thermal cracking which cause coke deposition and damage the equipment. The current tendency is to process heavier oil leading to higher process temperatures and consequently to greater fouling. This situation demands better knowledge fouling process by carbonization. This problem is pronounced in the residual gasoil region of a vacuum distillation unit because it obstructs the recirculation circuits and the spray system with serious environmental and economics implications. This paper review the main correlated published work related to coke generation and fouling and presents a discussion about the works. (author)
In response to a request from the International Chemical Workers Union, Akron, Ohio, an investigation was made into possible hazardous working conditions at two American Smelting and Refining Company (SIC-1031) zinc mines (New Market and Young) in Mascot, Tennessee. Specifically, exposures to asbestos (1332214), silica (14808607), and diesel emissions were determined. At both mines overexposures were found to nitrogen-dioxide (10102440) (NO2) and coal-tar pitch volatiles. Twenty-four percent of the NO2 measurements taken were above the NIOSH recommended ceiling of 1 part per million (ppm), but none exceeded the Mine Safety and Health Administration's (MSHA) ceiling of 5ppm. Exposure to diesel particulates ranged from 0.24 to 1.06mg/cu m. None of the 52 respirable dust samples collected exceeded the calculated MSHA limits for free silica exposure. A medical evaluation was offered and 83 of the 400 current employees and one retired employee participated. Seven underground ...
Each disease affecting the bile ducts tends to produce characteristic pattern of biliary dilatation: recurrent pyogenic cholangitis causes dilatation and straightening of the larger (central) intrahepatic ducts: clonorchiasis causes dilatation of the smaller (peripheral) intrahepatic ducts; and carcinoma along the extrahepatic ducts causes (proportional) dilatation and tortuosity of both larger and smaller intrahepatic ducts. To evaluate the specificity of the pattern and morphology of the dilated biliary tree on CT scans (CT characterization) three independent radiologists who were unifamiliar with the cases were asked to classify 62 CT scans in patients with obstructive jaundice. The case population consisted of 14 cases with recurrent pyogenic cholangitis, 18 cases with clonorchiasis and 30 cases with carcinoma along the extrahepatic ducts, which were intermixed randomly. Classification was made only on the basis of CT characterization: those scans showing ...
Each disease affecting the bile ducts tends to produce characteristic pattern of biliary dilatation: recurrent pyogenic cholangitis causes dilatation and straightening of the larger (central) intrahepatic ducts: clonorchiasis causes dilatation of the smaller (peripheral) intrahepatic ducts; and carcinoma along the extrahepatic ducts causes (proportional) dilatation and tortuosity of both larger and smaller intrahepatic ducts. To evaluate the specificity of the pattern and morphology of the dilated biliary tree on CT scans (CT characterization) three independent radiologists who were unifamiliar with the cases were asked to classify 62 CT scans in patients with obstructive jaundice. The case population consisted of 14 cases with recurrent pyogenic cholangitis, 18 cases with clonorchiasis and 30 cases with carcinoma along the extrahepatic ducts, which were intermixed randomly. Classification was made only on the basis of CT characterization: those scans showing ...
Purpose of this work is to investigate the role of Helical CT and the usefulness of three-dimensional (3D) imaging for pre-operative planning and follow-up of reconstructive maxillofacial surgery with alloplastic material in neoplastic disease involving this region. From 1996 to 1999 eleven patients were examined with Helical CT and 3D images for planning of maxillofacial plastic and reconstructive surgery for advanced cancer of this anatomically complex region. A 3D-modulated titanium mesh (100%) or micro nets was used to rebuild the anterior surface of maxillary bone and the orbital floor. The mesh was cut to the appropriate size and shape and curved where necessary. Within the residual sinusal cavity a siliconed filling was used surmounting an acrylic prosthesis with dental arch to rebuild the palate. A rehydrated bovine pericardium was affixed and moduled on the borders in two cases only. Three-dimensionally reconstructed CT images were obtained ...
Image subtraction techniques, in conjunction with [75Se]selenomethionine (75Se) scintigraphy, have recently been suggested to be a potentially valuable tool for localization of parathyroid abnormalities. With use of these techniques, we prospectively studied 15 patients scheduled for parathyroid operations. Postoperatively, all were normocalcemic. Anterior scintiscans of the neck were divided into quadrants, and regions of enhanced uptake were assigned to one or more quadrants. On this basis, by chance alone a minimum of 25% of single-gland enlargements would be assigned to the correct quadrant of the neck. We found that by use of 75Se scanning only 8 of 22 abnormal glands (36%) were assigned to the quadrant of the neck in which they were found intraoperatively. In no case was a clearly visualized focus of parathyroid activity encountered. These results do not justify the continued use of 75Se scintigraphy with or without image subtraction in the preoperative ...
Lobar emphysema is an uncommon cause of respiratory distress in infancy. Congenital heart disease is seen in about 20% of the patients with infantile (congenital) lobar emphysema. We described six infants with lobar emphysema. In three of them a congenital heart disease was demonstrated by cardiac catheterization and cineangiography; two had a tetralogy of Fallot with right aortic arch and the third infant a ventricular septal defect. The pulmonary angiography showed stretching of the arteries with very poor filling of the peripheral arteries and a characteristic smaller pulmonary vein in the affected lobe. In all the six patients the pulmonary artery pressure was normal. All the patients underwent lobectomy with good results. We feel that a preoperative cardiac catheterization and cineangiography is of value in this very sick group of infants. (orig.).
The use of magnetic resonance imaging for diagnosis and the preoperative staging of renal cell carconoma was evaluated in 79 patients with 88 tumors. Gradient-echo and spin-echo images before and after intravenous administration of Gadolinium DTPA were compared with the results of computed tomography (CT) and histologic staging. The two imaging techniques had comparable results: T-stage was predicted correctly with CT in 78%.4% and with MRI in 84.0% of the cases, while the N-stage was accurately assessed in 81.8% and 79.5%, respectively. MRI had some advantages in diagnosing perirental tumor spread and in excluding an infiltration beyond Gerota's fascia. Therefore, MRI is a true alternative to CT for staging large renal cell carcinomas and especially for patients with contraindications for iodinated contrast agents. (orig.).
The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas will be described in this paper. The pre- and postoperative imaging of the temporal bone was performed with HRCT and MRI. HRCT and MRI were performed in the axial and coronal plane. MRI was done with T2 weighted and T1 weighted sequences both before and after the intravenous application of contrast material. All imaging findings were confirmed clinically or surgically. The preoperative cholesteatoma-caused complications depicted by HRCT included bony erosions of the ossicles, scutum, facial canal in the middle ear, tympanic walls including the tegmen tympani, and of the labyrinth. The preoperative cholesteatoma-caused complications depicted by MRI included signs indicative for labyrinthitis, and brain abscess. Postoperative HRCT ...
The surgical management of osteoradionecrosis of the temporal bone has met with limited success because of the difficulty in accurate assessment of the viability of nonnecrotic bone intraoperatively. Failure to resect all nonviable bone results in recurrence of a necrotic focus. With the use of hyperbaric oxygen therapy to stabilize marginal bone and oral tetracycline to label viable bone preoperatively, removal of all nonviable bone can be accomplished. Postoperatively, a second course of hyperbaric therapy enhances wound healing, thus assuring a successful outcome. This article details a successful systematic approach that was developed to resect a necrotic focus in the temporal bone of a 10-year-old boy who had undergone a full course of radiotherapy for treatment of a rhabdomyosarcoma.
The prospective study includes 25 patients without pathology of the femoral head for the evaluation of the normal femoral head perfusion. In addition 34 patients with femoral head necrosis underwent i.a. DSA preoperatively before pedicled pelvic bone grafting. 15 patients after pelvic bone graft operation and 7 patients with medial femoral head fracture were also examined via superselective DSA. In cases with femoral head necrosis a rarefaction or interruption of the rami nutricii proximales, or an occlusion of the medial circumflex femoral artery were observed. Patients with medial femoral neck fracture showed an interruption of the rami nutricii proximales of the femoral head. Postoperative DSA - after pedicled pelvic bone graft - revealed a regular arterial graft perfusion in 82%. (orig.).
RIFLE criteria have been used to determine the incidence of acute kidney dysfunction (AKD) after orthotopic liver transplantation (OLT). However, no studies have focused on the incidence of AKD after OLT in patients with normal pre-OLT kidney functions. Using the RIFLE criteria, we determined the incidence and risk factors for AKD after OLT in patients with normal pre-OLT kidney function. We retrospectively analyzed the records of 112 patients who underwent OLT from January 2000 to February 2009 with normal prior kidney function. We investigated three levels of renal dysfunction outlined in the RIFLE criteria: risk (R); injury (I); and failure (F). Preoperative, intraoperative, and postoperative variables were collected. AKD occurred in 64 (57%) OLTs with risk, injury, and failure frequenc...
Abstract Aim- Conventional outcomes such as survival, tumour recurrence and complication rates after surgery for rectal cancer have been rigorously assessed, but the importance of maintaining quality of life (QOL) after surgery for rectal cancer has received less attention. The aim of the current study was to analyse QOL and the occurrence of pelvic dysfunction after the surgical treatment of rectal cancer. Method- Between May 2005 and May 2008, 150 patients with rectal cancer underwent abdominoperineal resection (APR) or anterior resection (AR). Seventy-four answered two preoperative questionnaires. At a follow up of 1-year, 65 were alive without sign of recurrence and answered the same questionnaires: (a) validated RAND 36-item health survey QOL questionnaire; and (b) self-administered d...
Objectives: Intra-operative cisplatin-based intra-peritoneal chemotherapy (IPC) may alter renal function in patients with advanced ovarian cancer. The aim of this study was to describe postoperative alteration of renal function after cisplatin-based IPC and to identify risk factors for moderate to severe acute renal failure. Study design: This prospective observational study was carried out on 77 consecutive patients who underwent cisplatin-based IPC procedures, with (n=23) or without (n=54) intra-peritoneal epinephrine, for advanced ovarian cancer. Postoperative renal function was assessed using serial serum creatinine measurements and was based on serum creatinine changes from pre-operative values, according to the risk, injury, failure, loss, end-stage kidney disease (RIFLE) classificat...
Purpose. To compare erectile function (EF) recovery of patients treated by early penile rehabilitation therapy (PRT) with sildenafil and with control group. Method. Forty men treated by bilateral nerve sparing radical prostatectomy (NSRP) and with a normal pre-operative EF were enrolled. Fourteen days after surgery, they were randomised to a flexible-dose sildenafil group and to a control group. The International Index of Erectile Function (IIEF) questionnaire was completed before surgery and at 3, 6, 12 and 24 weeks after NSRP. Results. In the group treated, the mean IIEF score before surgery was 26.2 and 14.1, 16.2, 22.5 and 25.2 at 3, 6, 12 and 24 weeks after NSRP, respectively. In the control group, the respective scores were 26.5 and 12.4, 15.8, 15.3 and 17.4. There was a significant ...
The optimal management of men with very favorable clinicopathological factors who develop biochemical recurrence (BCR) after radical prostatectomy (RP) has not been previously reported. Both local and systemic recurrences are unlikely in this cohort. This study examines their management and outcomes. Between October 2000 to March 2010, 1627 men underwent open RP by a single surgeon. In all, 448 (27.5%) met the following criteria for extremely low risk disease: preoperative PSA level <10?ng?ml?1, clinical stage T1c/T2a, Gleason score ?6, estimated cancer volume in the surgical specimen ?5% and no evidence for positive surgical margin. Undetectable PSA was defined as ?0.04?ng?ml?1. BCR was defined as PSA ?0.2?ng?ml...
Abstract Background. Complementary and alternative medicine (CAM) use is common among breast cancer patients. Several CAM therapies may have negative side effects or interact with conventional therapies. We studied biologically based CAM use with and without vitamins/minerals in relation to patient and tumor characteristics as well as treatment in an ongoing prospective cohort of 855 primary breast cancer patients. Methods. Patients from two hospitals in southern Sweden were included. Pre-operative and follow-up questionnaires containing questions on food intake, lifestyle, and concomitant medications, including natural remedies, were completed up to five years postoperatively. Clinical information was obtained from clinical records and tumor characteristics from pathology reports. Results...
We evaluated in this study the value of preoperative examinations of anal atresia with an optimised MRI strategie. 13 patients with anorectal anomalies, most of them younger than one year, underwent an MRI examination of the pelvis. 10 of these patients were operated afterwards. Compared with the situs shown by the operation the results of the MRI examination were very exact in all cases in respect of the level of atresia and the development of the striateed muscle complex. Fistulas could be completely described in most cases. MRI demonstrated additional lesions in some patients which were of great importance for planning the further treatment of the patients. As a consequence MRI can give valid information on anal atresia for planning the operative treatment. (orig.).
Background: High satisfaction rates have been reported after autologous breast reconstruction. Yet, most mastectomy patients receive implant reconstructions (ImBR). Independent and active decision makers have shown mainly to choose for autologous reconstructions, such as the Deep inferior epigastric perforator (DIEP) flap (DiepBR). To further explore the decision making to opt for either ImBR or DiepBR, we investigated patient knowledge, informational resources used, effect of plastic surgeons' advice, coping style and personal independence. Methods: A total of 153 women, who were planned for DiepBR or ImBR preoperatively, completed a study-specific and standardised validated psychological questionnaire. Analyses were aimed at information-seeking behaviour, personal independence and coping...
PurposeThe purpose of this study was to determine the relationship between the changes of soft and hard tissues after modified anterior segmental osteotomy on the maxilla and mandible and to evaluate unintended facial changes using cephalometric and photometric analyses.Materials and MethodsThe subjects included 29 women and 1 man (22 to 50 years of age) who were diagnosed as bialveolar or bimaxillary protrusion and underwent modified anterior segmental osteotomy on the maxilla and mandible. Lateral cephalograms and lateral and frontal photographs taken preoperatively and postoperatively were analyzed.ResultsThere was a significant change in all soft and hard tissue parameters except the labiomental angle. The ratio of upper lip to maxillary incisor retraction was 0.67:1 and the ratio of l...
Background: While waiting for surgery, patients often exhibit fear and anxiety. Music is thought to be an alternative to medication to relieve anxiety. However, due to concerns about infection control, devices other than headphones may be considered for this purpose. Objectives: The purpose of this study was to determine the anxiety-relieving effect of broadcast versus headphone music playing for patients awaiting surgery. Design: A randomized controlled clinical study. Setting: The waiting area of an operating theater of a metropolitan teach hospital in Taiwan. Participants: Alert adult with age between 20 and 65 years old waiting for surgery without premedications. Methods: A total of 167 patients were randomly assigned to the headphone, broadcast and control groups. Both the headphone a...
Background: Superficial inferior epigastric artery (SIEA) flap has a great advantage over other flaps of the area, that is, readily non-existent donor-site problems. The main reason why the SIEA flap has never been extensively used in breast reconstruction is the small diameter and variable anatomy of its donor artery. This study presents a possibility of enlarging the SIEA diameter using the delay-phenomenon mechanism. Methods: A prospective clinical study of 26 patients was undertaken. Prior to surgery, ultrasound examinations were performed, measuring the diameter of SIEA and the velocity of blood flow in SIEA. The ipsilateral deep inferior epigastric artery (DIEA) was then ligated in all patients who had a measurable SIEA preoperatively. Two weeks later, measurements were repeated. The...
Integrated Leakage Rate Test (ILRT) of containment system plays a very important role in safety of a Nuclear Power Plant. Containment system constitutes the last physical barrier to release of radioactivity from the core and is called upon to mitigate the consequences of not only accidents within the design basis, but also some of the highly unlikely severe accidents. Hence, leak tightness of containment becomes uttermost priority for the safety of plant personnel and public. The containment and associated ESFs are tested before the first criticality and there after periodically during service. The pre-operational integrated leakage rate is carried out at LOCA based design pressure, at periodic test pressure and at some intermediate pressure points to assess the leakage characteristics. This paper summarizes the various requirements and activities relevant to the ILRT of the Indian Pressurized Heavy Water Reactor (PHWR) containment system. (author)
Abstract Purpose: To compare the safety and efficiency of conventional monopolar, plasmakinetic and holmium laser transurethral resection of bladder tumor (CM-TURBT, PK-TURBT and HoL-TURBT) while managing primary non-muscle invasive bladder cancer. Patients and Methods: From 2005 to 2009, 173 patients with primary non-muscle invasive bladder cancer underwent endoscopic surgery. Among them, 51 patients underwent CM-TURBT, 58 patients underwent PK-TURBT, and 64 patients underwent HoL-TURBT. All patients were divided into three risk groups (low, intermediate, and high) based on the European Association of Urology guidelines and prognostic factors of recurrence. Clinical data, included preoperative, operative, and postoperative management and follow-up, were recorded. Results: Patient demograp...
Contrast agent-enhanced CT scans in nine male patients with histologically proved benign lymphoepithelial lesions of the perotid gland were reviewed. All scans showed cystic-appearing masses with peripheral rim enhancement corresponding to the macroscopic appearance of the lesion. Five patients were seropositive for human immunodeficiency virus (HIV) infection or had infections seen in acquired immunodeficiency syndrome. Three patients were members of high-risk groups. Only one patient had symptoms of the SICCA syndrome. Once a rare cause of parotid gland enlargement, benign lymphoepithelial lesions have recently been seen with increasing frequency in patients with HIV infection. Although the CT appearance is not pathognomic, correlation results of aspiration cytology and with clinical history can lead to a preoperative diagnosis of a benign lymphoepithelial lesion.
Background Adrenal incidentaloma remains a diagnostic challenge. Despite well-established management guidelines, the long-term results of following these guidelines are unknown. We sought to determine how accurately these guidelines identify functioning incidentalomas and how often these guidelines result in adrenalectomy for benign tumors. Methods We catalogued adrenal incidentalomas from a retrospective review of 500 consecutive adrenalectomies at a single institution. The outcome measures studied were patient demographics, preoperative biochemical analysis, imaging characteristics, tumor size, type of operation performed, and postoperative histologic diagnosis. Results Eighty-one of the 500 adrenalectomies performed were for incidentalomas. Size was the only significant characteristic t...
A prospective comparative study with pathology was performed to assess the clinical value of Computed Tomography (CT) and endoscopic ultrasound (EUS) for nodal staging in lung cancer. A total of 329 nodal stations were dissected or sampled and 755 lymph nodes were examined at histology. On a pre-station basis, CT had greater sensitivity (74%) than EUS (56%), but EUS was more specific (83% versus 93%). The accuracy rates of the two techniques were similar. In conclusion, endoscopic ultrasound should be part of a routine preoperative diagnostic approach to non-small-cell lung cancer., because of its high specificity. Results can be improved when EUS and CT are combined., which suggests that these imaging modalities should be used together in selected patients for the noninvasive staging of non-small-cell lung cancer to identify local lymphatic spread.
Background There is some evidence that a patient?s pre-operative condition influences short-term and long-term post-operative outcomes. The aim of the present study is to compare the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and modified Glasgow prognostic score (mGPS) models in the prediction of post-operative outcome, both short term and long term, in patients undergoing resection of oesophago-gastric cancer. Patients and Methods Patients who underwent curative resection for oesophago-gastric cancer from January 2005 to May 2009 and who had data to score the POSSUM, P-POSSUM, O-POSSUM and mGPS models were included in the study. Observed morbidity and mortality rates were compared with predicted outcome in different risk groups. Bot...
Abstract An increase in chronic disease prevalence is contributing to health care cost growth and decreased quality of life in industrialized nations worldwide. Inadequate management of chronic diseases is a leading cause of hospitalizations and, thus, avoidable expenditures. In this study, we evaluated the impact of nurse-delivered care calls, the primary intervention of a proactive chronic care management (CCM) program, in a population aged 65 and older in Germany. In this analysis, hospital admission rates were evaluated among program enrollees who were diagnosed with diabetes, heart failure, coronary heart disease, or chronic obstructive pulmonary disease. The Intervention group comprised those members who participated in care calls (n?=?13,486), whereas the Comparison group included e...
In recent years, slightly acid formulas for cosmetics which remove follicular infundibulum obstruction of the hair follicle, have been devised. Therefore, few acne patients experience a problem with cosmetics use. On the other hand, cosmetics use differs from person to person. Thus, an investigation of actual conditions of cosmetics use was done among acne patients. Compared with healthy people, acne patients used more facial wash products more. It has been understood that treatment and skincare instruction are important for the improvement and prevention of acne. We examined skin physiology function and patient's QOL by using a skin care product for women for two months with skincare instruction from a dermatologist for 31 female patients this time. As a result, it was able to be confirme...
The incidence of hilar cholangiocarcinoma is very rare worldwide. Radical resection is the only prognostic factor for long survival in patients with hilar cholangiocarcinoma. Postoperative radiation therapy can improve local control and survival rates for patients with palliative resection, but it remains controversial in patients with radical resection. Biliary drainage can effectively release bile duct obstruction for the majority of patients with locally advanced disease, and may even prolong survival when combined with radiation therapy. Radiation therapy includes extrernal beam therapy alone, external beam therapy with intraluminal brachytheapy and new radiation technique, such as three dimentional conformal therapy and intensity modulated radiation therapy. The propective randomized clinical study is needed for further investigation in the role of combined modality therapy especially for hilar cholangiocarcinoma. (authors)
Functional imaging of the pharynx used to be the domain of cineradiography, CT and ultrafast CT. The development of modern MRI techniques led to new access to functional disorders of the pharynx. The aim of this study was to implement a new MRI technique to examine oropharyngeal obstructive mechanisms in patients with obstructive sleep apnea (OSA). Sixteen patients suffering from OSA and 6 healthy volunteers were examined on a 1.5 T whole-body imager (`Vision`, Siemens, Erlangen Medical Engineering, Germany) using a circular polarized head coil. Imaging was performed with 2D flash sequences in midsagittal and axial planes. Patients and volunteers were asked to breathe normally through the nose and to simulate snoring and the Mueller maneuver during magnetic resonance imaging (MRI). Prior to MRI, all patients underwent an ear, nose and throat (ENT) examination, functional fiberoptic nasopharyngoscopy and polysomnography. A temporal resolution of ...
Abstract Background: Obstructive sleep apnea (OSA), a highly prevalent condition, is independently associated with increased risks of developing type 2 diabetes mellitus (T2D) and metabolic syndrome. It is unclear, however, if the severity of OSA has any impact on glycemic control among patients with T2D. We therefore aimed to determine the independent association between OSA severity and glycosylated hemoglobin (HbA1c) in patients with T2D. Methods: This was an observational cross-sectional study of 52 consecutive patients attending the diabetes obesity clinic between January 2008 to February 2010 with risk factors for sleep apnea and who underwent polysomnography study. Clinical, demographic, and lifestyle data were recorded using a questionnaire. Results: Prevalence of OSA in this clini...
Summary Objective To evaluate the cost-effectiveness of an educational outreach intervention to improve primary respiratory care by South African nurses. Methods Cost-effectiveness analysis alongside a pragmatic cluster randomised controlled trial, with individual patient data. The intervention, the Practical Approach to Lung Health in South Africa (PALSA), comprised educational outreach based on syndromic clinical practice guidelines for tuberculosis, asthma, chronic obstructive pulmonary disease, pneumonia and other respiratory diseases. The study included 1999 patients aged 15 or over with cough or difficult breathing, attending 40 primary care clinics staffed by nurses in the Free State province. They were interviewed at first presentation, and 1856 (93%) were interviewed 3 months late...
ALLEYNE G., HANCOCK C. & HUGHES P. (2011) Chronic and non-communicable diseases: a critical challenge for nurses globally. International Nursing Review58, 328-331 Background:- Chronic and non-communicable diseases (NCDs) are a growing and enormous challenge that faces countries across the world. Low- and middle-income countries are disproportionately affected. Contributory factors:- Three risk factors - tobacco use, poor diet (including excessive alcohol intake) and lack of physical activity - contribute to four major chronic diseases - cardiovascular, chronic obstructive pulmonary disease, diabetes and some cancers, which are responsible for over 50% of deaths worldwide. Potential solutions:- International governmental and non-governmental agencies are becoming increasingly concerned and ...
Parathyroid imaging based on the principle of differential uptakes of Tc-99m and T1-201 in the anterior neck to localize parathyroid (PT) disease has been reported with widely varying results. To evaluate the usefulness of this method, we have performed PT imaging on 47 patients prior to exploratory surgery for PT disease. Using pinhole collimation and digital acquisition, a 50k count image of the thyroid was obtained 20 minutes after injection of 1mCi99m Tc-pertechnetate. Then a lmCi dose of Tl-201 chloride was injected and a series of images acquired for 30 minutes at 30 sec/image. Raw data was spatially filtered and normalized by summing sufficient T1-201 images to equal the Tc-99m image scale of maximum cts/pixel. Image subtraction (Tl-Tc) gave the final PT image. Of 10 pts who had previous neck exploration, all had PT pathology accurately localized by preoperative scanning (7=single adenoma, 2=single hyperplastic gland, 1=two hyperplastic glands). In two ...
Developed under the PN II Project 71-009 - MONA, the pre-operational monitoring program of the LIL waste disposal site presented in this paper covers the main elements requested for a continuous improvement of site characterization and safety assessment, as well as for the set up of the baseline data requested for the future operational and post-operational monitoring and surveillance. These elements are: vadose and saturated zones hydrogeology, surface erosion, meteorology and radionuclides content in waters, soil and biota. Pairs of TDR (Time Domain Reflectometry) and pressure sensors, coupled with a meteorological station have been installed on site for the continuously measurement of the water content and matric potential changes due to the climate variations. The data will be used to follow the water balance, the pores water velocity and to calculate the infiltration rate. A new set of erosion rates experimentally determined by Pinhole test on surface soil ...
Tc-MDP 10mCi was intravenously given preoperatively to 20 patients with primary bone tumors and 1 with a metastatic bone tumor. Preoperative and postoperative scintigraphs of resected tumor and scintigraphs of sliced tumor were compared. Tissue fragments were collected from the sliced tumor, and RI measured to compare concentration rates at different areas. Histological investigations were also done. Localization of Tc-MDP was increased at sites of tumorous bone formation, of reactive bone formation at tumor edges, and of cartilage calcification, with little concentration at tumor cells or necrotic tissue. VX/sub 2/ carcinoma was transplanted into the rabbit tibia, Tc-MDP was intravenously injected when bone destruction was radiologically evident, and investigations were done as in the clinical cases. In experimental bone tumor, increased uptake localization of Tc-MDP was much the same as in clinical cases. Tetracycline was given to the rabbit ...
To compare the accuracy of MR imaging using an endorectal-pelvic and a pelvic phased-array coil for preoperative local staging of rectal carcinoma. To determine preoperative staging, 38 patients with rectal carcinoma underwent MR imaging. All patients were examined with both an endorectal-pelvic and a pelvic phased-array coil. All underwent surgery and staging was pathologically confirmed. Two radiologists blinded to pathologic stage analyzed perirectal invasion and perirectal node metastasis, and scored according to a four-point scale. Radiologic and pathologic findings were correlated. Receiver operating characteristic (ROC) analysis of Wilcoxon statistic (W values) was used to compare diagnostic accuracy between the two different MR methods. Interobserver variation was measured using {kappa} statistics. For perirectal invasion, T1WI endorectal-pelvic phased-array coil images (reader 1:0. 854, reader 2:0.818) showed higher W values than ...
The treatment of bony, osteochondral, and ligamentous injuries of the tibio-talar requires precise preoperative planning by radiological investigation. This is essential to a correct understanding of the underlying pathology and will allow a proper classification of the injury, which is the basis of treatment. Conventional radiography using anteroposterior and lateral X-rays with comparative views of the noninjured side and, if necessary, rotated spot views and tomography are of high value especially in osteochondral fractures of the talus. Intraoperative control images in both planes after osteosynthesis are mandatory. For evaluation of the postoperative course and severity of arthrosis formation, the classification system of Bargon has proved its worth. In addition, tomography of the tibio-talar joint in two planes is useful especially in tibial pilon fractures, some malleolar fractures, and peripheral talar fractures. In talar fracture dislocations with ...
Accurate diagnosis of local invasion of hilar cholangiocarcinomas is challenging due to their small size and the anatomic complexity of the hepatic hilar region. On the other hand, the correct diagnosis of local invasion is essential for assuring the possibility of curative surgery. The purpose of this study was to evaluate the feasibility of four-channel multidetector-row computed tomography (MDCT) in the assessment of vascular and bile duct involvement, by which we could obtain useful information for the surgical management of hilar cholangiocarcinoma. The subjects were 18 patients for whom the extent of tumor invasion was surgically and pathologically confirmed. All patients underwent preoperative multiphasic CT scanning by MDCT. Arterial and portal dominant phases were acquired using a detector configuration of 1.25 mm x 4 mm, and both axial and multiplanar reconstructed images were interpreted. Longitudinal extension was evaluated up to second-order branches. ...
We wanted to determine the technical and clinical efficacy of using a PTFE-covered self-expandable nitinol stent for the palliative treatment of malignant biliary obstruction. Thirty-seven patients with common bile duct strictures caused by malignant disease were treated by placing a total of 37 nitinol PTFE stents. These stents were covered with PTFE with the exception of the last 5 mm at each end; the stent had an unconstrained diameter of 10 mm and a total length of 50 80 mm. The patient survival rate and stent patency rate were calculated by performing Kaplan-Meier survival analysis. The bilirubin, serum amylase and lipase levels before and after stent placement were measured and then compared using a Wilcoxon signed-rank test. The average follow-up duration was 27.9 weeks (range: 2 81 weeks). Placement was successful in all cases. Seventy-six percent of the patients (28/37) experienced adequate palliative drainage for the remainder of their lives. There were ...
Purpose: To determine the value of MRI in the preoperative evaluation of chronic paranasal sinusitis and to compare the results with CT and intraoperative findings. Method/Materials: 42 patients with clinical signs of chronic paranasal sinusitis underwent MRI after CT evaluation on one day, with subsequent functional endoscopic sinus surgery on the next day. Coronary CT was obtained with 5-mm slices and table-feed in the prone position, while MRI was performed in the supine position with coronary T{sub 2}-TSE+pd and coronary and transverse HASTE, each with 5-mm slice thickness. Aquisition time in MRI was less than 8 minutes. Two radiologists reviewed the CT and MRI scans for signs of sinusitis and detection of anatomical landmarks. The results were correlated with the intraoperative findings. Results: MRI offered no artifacts of dental work and showed more often high quality pictures than CT. CT and MRI demonstrated a good correlation in the detection of mucosal ...
Xeroradiography (XR) was retrospectively compared with a newly developed computed radiography (FCR) for diagnostic availability for breast cancer. FCR provides with the image processed by a computer. Subjects were 65 breast cancer patients for XR and 51 for FCR. Both methods were performed preoperatively. No significant difference was observed in distribution of age between the two groups but the average tumor size in XR group was larger than that in FCR group. Tumor shadow appeared in 44 of 65 xeromammograms (67.7%) and in 34 of 51 computed radiograms (66.7%). Microcalcification was detected in 27 of 65 xeromammograms (41.5%) and in 21 of 51 computed radiograms (41.2%). Consequently, diagnosis of breast cancer could be achieved in 47 of 65 patients (72.3%, established: 39, suspective: 8) through XR and in 41 of 51 (80.4%, established: 33, suspected: 8) through FCR. Thus FCR is thought to be more useful for breast cancer because it not only offers good diagnostic ...
Xeroradiography (XR) was retrospectively compared with a newly developed computed radiography (FCR) for diagnostic availability for breast cancer. FCR provides with the image processed by a computer. Subjects were 65 breast cancer patients for XR and 51 for FCR. Both methods were performed preoperatively. No significant difference was observed in distribution of age between the two groups but the average tumor size in XR group was larger than that in FCR group. Tumor shadow appeared in 44 of 65 xeromammograms (67.7%) and in 34 of 51 computed radiograms (66.7%). Microcalcification was detected in 27 of 65 xeromammograms (41.5%) and in 21 of 51 computed radiograms (41.2%). Consequently, diagnosis of breast cancer could be achieved in 47 of 65 patients (72.3%, established: 39, suspective: 8) through XR and in 41 of 51 (80.4%, established: 33, suspected: 8) through FCR. Thus FCR is thought to be more useful for breast cancer because it not only offers good diagnostic ...
Abstract. Purpose: To determine whether vitrectomy with 25-gauge instruments contributes to better postoperative visual recovery after macular hole (MH) surgery. Methods: The medical records for 46 consecutive eyes operated for MH by a single surgeon were retrospectively examined. Vitrectomy had been performed with a 25-gauge instrument in 23 eyes (25-G group) and with a 20-gauge instrument in 23 eyes (20-G group). Postoperative visual acuity (VA) in logMAR (logarithm of the minimum angle of resolution) units after 1 week and 1, 3, 6, 9 and 12 months, operating time, and volume of intraocular irrigating fluid were compared between the two groups. Results: Mean preoperative logMAR VA was 0.72 in the 25-G group and 0.68 in the 20-G group (p = 0.282, unpaired t-test). One week after surgery, ...
Objective was to present our 8 year experience in the prevention of the obturator nerve reflex during transurethral resection of bladder tumors. This study was performed in Ataturk University Hospital between 1999 and 2007. We retrospectively reviewed the records of 89 patients with inferolateral bladder tumors, who underwent transurethral resection under epidural or general anesthesia and requested obturator nerve reflex inhibition. Epidural anesthesia was administered to 57 patients, while the remaining 32 patients underwent general anesthesia via mask; and succinylcholine was administered prior to resection. Of the 57 patients received epidural anesthesia, 18 were diagnosed as inferolateral bladder tumors during endoscopy and had to undergo general anesthesia. Obturator nerve block was attempted preoperatively in 39 patients. However, a nerve identification failure, hematoma and 4 obturator nerve reflex events, despite the block, were observed and these patients ...
In IO cases of femoral neck fracture treated with prosthetic replacement, the preopera tive sup(99m)Tc-MDP scintigraphs were investigated and then compared with each histological findings of the extracted femoral head. The appearances of the scintigraphs were classified into following 3 patterns; increased activity pattern of sup(99m)Tc-MDP uptake in the overall femoral head (type I) in 4 cases, deficient activity pattern at the lateral side correspond to weight-bearing area (type II) in 2 cases and considerably deficient activity pattern in the whole femoral head (type III) in remaining 4 cases. Histological examination of the extracted femoral heads revealed the narrow part of ischemic necrosis in type I. However type II showed extensive necrosis in the portion of deficient activity by scintigraphs and in type III, the femoral heads except articular cartilage were entirely necrotic. This classification of sup(99m)Tc-MDP scintigraphy is correlated with the degree of femoral head ...
Quantitative bone scintigraphy was performed in 24 patients with prostatic carcinoma before orchiectomy and up to one to four years after operation. The gamma camera count rate was recorded over the lower thoracic and all lumbar vertebrae 4 h after injection of [sup 99m]Tc-MDP. Twelve patients has normal bone scintigrams throughout the study. They showed from two years after operation a slight increase in count rate values compared with the preoperative values, probability due to hormonal changes after orchiectomy and to age-related alterations in skeletal metabolism. Twelve patients had abnormal bone scintigrams. They showed as a response to treatment the flare phenomenon with an increase in count rate over the abnormal vertebrae when measured two weeks after operation followed by a decrease after two months. The lowest count rate values were obtained between six months and one year after operation. Thereafter the count rate seemed to remain on the same level. An ...
Quantitative bone scintigraphy was performed in 24 patients with prostatic carcinoma before orchiectomy and up to one to four years after operation. The gamma camera count rate was recorded over the lower thoracic and all lumbar vertebrae 4 h after injection of "9"9"mTc-MDP. Twelve patients has normal bone scintigrams throughout the study. They showed from two years after operation a slight increase in count rate values compared with the preoperative values, probability due to hormonal changes after orchiectomy and to age-related alterations in skeletal metabolism. Twelve patients had abnormal bone scintigrams. They showed as a response to treatment the flare phenomenon with an increase in count rate over the abnormal vertebrae when measured two weeks after operation followed by a decrease after two months. The lowest count rate values were obtained between six months and one year after operation. Thereafter the count rate seemed to remain on the same level. An ...
The PSDE/SAT-2 multimission satellite designed to offer a flight opportunity to different experimental communication payloads and verify the feasibility of advanced space technologies is described. It was conceived for expriment in the framework of the European DRS (Data Relay Satellite) program thus providing intersatellite and interorbit communication links, but also experimental and preoperative services. Payloads include optical communication single access payload (LSA); S-Band single access payload; S-Band multiple access payload; land mobile experimental payload; navigation payload; 40/50 GHz communication payload; and millimeter wave propagation payload. The orbital slot and interference analysis identified a limited number of orbital positions for the mission interleaved between Eutelsat satellites (i.e., 14 deg 30 min E and 17 deg 30 min E). A coordination is required in Ku-Band with Eutelsat satellites and in Ka-Band with ITALSAT (Italy) and TOR-12 (USSR) ...
Sonography, subtraction scintigraphy, computed tomography and MRI were compared in 100 patients who had surgery 105 times for hyperparathyroidism (HPT). Surgical and pathological data were available for all operations. A total of 105 MR, 77 CT, 84 sonograms and 70 subtraction scintigrams were performed. The ability of the imaging modalities, individually and in combination, to detect HPT, histology, size, concomitant thyroid disease and location of the diseased glands has been evaluated. For primary HPT, sensitivity ranged from 68% for MRI to 40% for scintigraphy but was much lower for tertiary HPT with all modalities. The ability to identify diseased glands was strongly size dependent for all methods. If patients had had previous neck surgery, the most sensitive methods were MRI and scintigraphy and this also held true for patients with concomitant thyroid disease and ectopically located glands. The findings presented suggest that while sonography may be the only imaging examination ...
The primary aim was to evaluate delayed contrast-enhanced MRI in depicting perineural spread of hilar cholangiocarcinoma (CCC) and consequently to determine the capability of MRI/MRCP for staging CCC. Fifteen patients that underwent MRI/MRCP and surgical treatment were retrospectively included. Two radiologists evaluated MR images to assess delayed periductal enhancement, extent of bile duct stenosis, liver parenchymal and vascular involvement and presence of liver atrophy. An agreement between delayed enhancement of the bile duct walls and perineural neoplastic spread showed a very good correlation factor (0.93). The overall accuracy in detecting biliary neoplastic invasion was higher for delayed T1-weighted images (93.3%) than for the MRCP images (80%), and T1-delayed image increased the MR accuracy in assessing the neoplastic resectability (p < 0.05). MRI correctly predicted vascular involvement in 73% and liver involvement in 80% of the cases. The number of overall correctly ...
Ectopically located parathyroid adenomas may be difficult to find during initial neck exploration. They account for over 70 percent of missed adenomas found at reexploration. Preoperative localization of parathyroid adenomas would reduce unnecessary dissection and possibly reduce the number of negative results of initial neck exploration. Before reoperative parathyroid surgery is performed, some means of localization is mandatory to detect ectopic adenomas in the neck and mediastinum. Computed tomography and ultrasonography cannot effectively evaluate the mediastinum. Angiography and venous parathyroid hormone sampling are invasive, costly, and tedious to perform. We have shown that thallium-201 will accurately localize ectopic parathyroid adenomas. All 10 adenomas found in positions not immediately adjacent to the thyroid gland were detected by thallium-201 scintigraphy. One was a mediastinal adenoma resected with a median sternotomy. Our results suggest that ...
We report a patient who developed occlusion of the intracranial major arteries induced by radiation therapy for craniopharyngioma. The patient, a 9-year-old boy, presented with deterioration of vision, nausea and vomiting. He underwent a right ventriculo-peritoneal shunt operation, and the tumor was partially removed. Postoperatively, he received focal radiation therapy with total of 60 Gy. Preoperative cerebral angiography, cerebral vessels had no sigh of occlusive lesion or stenosis. One year after irradiation, he started to have repeated cerebral ischemic attacks. But no regrowth of the tumor was detected on CT scans. Two years and 8 months after irradiation, he suddenly had right hemiparesis. Cerebral angiography revealed severe stenosis of the right anterior cerebral artery (precommunicating segment), middle cerebral artery (horizontal portion) and terminal portion of the right carotid artery. Left carotid angiography showed complete occlusion of the terminal ...
We report a patient who developed occlusion of the intracranial major arteries induced by radiation therapy for craniopharyngioma. The patient, a 9-year-old boy, presented with deterioration of vision, nausea and vomiting. He underwent a right ventriculo-peritoneal shunt operation, and the tumor was partially removed. Postoperatively, he received focal radiation therapy with total of 60 Gy. Preoperative cerebral angiography, cerebral vessels had no sigh of occlusive lesion or stenosis. One year after irradiation, he started to have repeated cerebral ischemic attacks. But no regrowth of the tumor was detected on CT scans. Two years and 8 months after irradiation, he suddenly had right hemiparesis. Cerebral angiography revealed severe stenosis of the right anterior cerebral artery (precommunicating segment), middle cerebral artery (horizontal portion) and terminal portion of the right carotid artery. Left carotid angiography showed complete occlusion of the terminal ...
The purpose of this study was to determine the feasibility of virtual endoscopy, named as ''virtual CT laparoscopy'', in the hepatobiliary system prior to laparoscopic cholecystectomy. We applied this technique to 28 patients suspected of having biliary disease. These images were compared and analyzed qualitatively based on visualization of the structures critical to operative cholangiography and surgical findings. Twenty-four patients, who underwent laparoscopic cholecystectomy, were evaluated as follows: the common bile duct and the hepatic duct were adequately visualized in 23 (96%) of the 24 patients, the cystic duct in 21 (88%), the gallbladder opacification in 20 (83%), the liver inferior surface in 20 (83%). Four patients had anatomic variations detected virtual CT laparoscopy and were proven by operative cholangiography and surgical findings. We emphasize that our new technique may contribute to the laparoscopy during surgery as the aid of ...
Premature fusion of multiple cranial sutures has been associated with increased intracranial pressure and the potential for mental impairment. Isolated craniosynostosis, however, is considered a benign condition primarily reconstructed for aesthetic purposes. A comparative analysis, to assess the differences between pre- and post operatory cerebral perfusion of patients who underwent surgery for simple cranisynostosis, was performed using single positron emission computed tomography ''SPECT'' Images. Cerebral blood flow studies were performed using "9"9"mTc-HMPAO SPECT in children with simple cranisynotoses. The subjects were 8 children with craniosynostosis (age, 2 months-9 years). Preoperative revealed regional hypovascularity in the cerebral hemisphere in 5 cases (62%). In 6 patients the cerebral blood flow normalized or increased after craniofacial reconstruction. We demonstrated the presence of regional hypovascularity in the cerebral hemisphere of simple ...
Two cases of primary Ewing's sarcoma of the rib are reported, in which radiation therapy was quite effective. Case 1 was an 18-year-old female who had had an operation and radiation therapy for Ewing's sarcoma of the left 7th rib. She was referred to our hospital after a recurrent tumor was found. Radiation therapy (tumor dose 46.2 Gy) and chemotherapy were given. The tumor disappeared and there has been no relapse for 1 year and 3 months after the treatment. Case 2 was a 2-year-old-infant. Radiation therapy (tumor dose 74 Gy) was given for primary Ewing's sarcoma of the left 6th rib. The tumor became small and was successfully removed at operation. There has been no relapse or distant metastasis for 8 months following the operation. We emphasize the importance of multidisciplinary treatment in case 1 and the usefulness of preoperative radiotherapy in case 2. (author).
Dynamic quantitative bone scintigraphy was performed on 31 men with prostatic carcinoma before orchiectomy as well as 2 weeks, 2 and 6 months postoperatively. After injection of technetium methylene diphosphonate Tc 99m ("9"9"mTc-MDP) the count rate was recorded as serial images over the lower thoracic and all the lumbar vertebrae from 1 to 240 min post-injection. Thirteen men had normal bone scintigrams with no changes in "9"9"mTc-MDP content at the four different investigation times. Eighteen men had skeletal metastases. Throughout the study half of the abnormal vertebrae in these patients showed an abnormal count rate after only 6 min post-injection. After 1 h it was possible in almost all abnormal vertebrae to predict abnormal bone uptake. In response to therapy a 'flare phenomenon' with an increase in count rate was seen 2 weeks after orchiectomy followed by a decrease 2 months postoperatively in most of the abnormal vertebrae. The count rate decreased even below the ...
Described is the diagnosis for the cancer extension of cholangiocarcinoma by various imaging techniques and processes to support the current surgical procedure based on preoperative biliary drainage. The cancer tends to locally extend horizontally and/or vertically and its diagnosis is important for surgical indication. For the indication, multi-detector raw CT (MDCT) and MR cholangio-pancreatography (MRCP) are useful and particularly, the former can give multi-phase (arterial, portal and delayed) images to reconstruct multiplanar (MPR) and CT angiographic 3D images, which have made the previous invasive examinations like angiography and percutaneous transportal contrasting unnecessary. MDCT and MRCP can almost complete the diagnosis of the extension. The operative procedure is decided dependently on the site of the lesion, and of which diagnosis, whether it is hepatic hilar/on upper bile duct or middle/lower ductal, is different. MDCT-MPR and MRCP are virtually ...
Purpose: To evaluate contrast-enhanced CT scan in the diagnosis of intrahepatic cholangiocarcinoma by correlating the CT appearance with pathologic specimens. Materials and methods: Twenty-eight patients with pathologically proven intrahepatic cholangiocarcinoma were examined. Unenhanced abdominal CT study were performed in 28 patients; conventional contrast-enhanced CT in 27 patients. Enhanced CT scan including fast injection, fast scan and delayed scan at the largest section of the lesion was done in 7 patients. Contiguous 10 mm CT scans of the surgical specimens were also obtained in 8 patients. The preoperative and specimen CT scans in these 8 patients were compared with the corresponding pathological sections. A total of 103 areas of the pathological sections was compared with the CT appearances. Results: All lesions contained areas of delayed contrast enhancement and/or no enhancement on CT examinations. The areas of delayed contrast enhancement corresponded ...
We evaluated robotically assisted laparoscopic adrenalectomy (RLA) in a prospective study of 100 consecutive patients (60 women and 40 men) undergoing unilateral adrenalectomy at the University Hospital. The median age was 59 (24?82) years and BMI 27.6 (17.1?40.9) kg/m2. Preoperative diagnoses were Conn?s syndrome 30%, pheochromocytoma 23%, Cushing syndrome 27% and non-functional tumor 20%. The median tumor size was 53 (10?106) mm. The majority of the 7% of the patients who were converted to open surgery were in the early phase after the introduction of the technique. The BMI of the patients who were converted to open surgery was significantly higher, 31.5 (range 25.3?37.8) compared to, 27.5 (range 17.1?40.9) in patients without conversion (P?=?0.047). The median weight of the tumor was 51...
The purpose of this study was to evaluate the usefulness of a multifunctional gastrointestinal coil catheter for stent placement in 98 patients with colorectal strictures. The catheter was used in 98 consecutive patients for stent placement in the rectum (n = 24), recto-sigmoid (n = 13), sigmoid (n = 38), descending (n = 6), transverse (n = 11), splenic flexure (n = 3), hepatic flexure (n = 2), and ascending (n = 1) colon. The catheter was made of a stainless steel coil (1.3 mm in inner diameter), a 0.4-mm nitinol wire, a polyolefin tube, and a hemostasis valve. Usefulness of the catheter was evaluated depending on whether the catheter could pass a stricture over a guide wire and whether measurement of the stricture length was possible. The passage of the catheter over a guide wire beyond the stricture was technically successful and well tolerated in 93 (94.9%) of 98 patients. In the failed five patients, it was not possible to negotiate the guide wire due to presence of nearly ...
SummaryStudy Objectives: To compare the effect of noninvasive mechanical ventilation (NIV) in severely acidotic with mildly acidotic patients with acute hypercapnic chronic obstructive lung disease (COPD).Design: Comparison of NIV in consecutively enrolled patients with acute hypercapnic COPD with mild (pH 7.25-7.35) or severe (pHPaCO2, duration of NIV treatment, length of stay in hospital and survival.Results (meadian (IQR)): Twenty-nine patients had 36 episodes of acute hypercapnic respiratory failure: Seventeen with pHPaCO2 improve (12 (6-34) vs 12 (4-28)h, respectively, Formula Not Shown ), with similar duration of NIV treatment (60 (35-96) vs 68 (36-48)h, respectively, Formula Not Shown ) and hospital length of stay (8 (7-18) vs 9 (5-17) days, respectively, Formula Not Shown ). Overal...
Vertical thin film evaporators have been used to concentrate and dry solutions because their rotating swing blades prevent scale from being deposited on the heated surfaces. Powdering capacity of the vertical thin film evaporator was examined experimentally for drying applications of radioactive liquid waste generated from nuclear power plants. As a result, it was found that the powdering capacity increased with the blade rotation, changing significantly in the low ratational region and scarcely in the high rotational region. The powdering capacity in the high rotational region was restricted by the lack of heat flux which was theoretically evaluated for the concentrating process. As the critical factor in the low rotational region was not clear, a visual test apparatus was made to observe flow patterns in the evaporator, and a powdering model was obtained. This model showed that powdering process was obstructed when the liquid film lost its fluidity at high ...
Vertical thin film evaporators have been used to concentrate and dry solutions because their rotating swing blades prevent scale from being deposited on the heated surfaces. Powdering capacity of the vertical thin film evaporator was examined experimentally for drying applications of radioactive liquid waste generated from nuclear power plants. As a result, it was found that the powdering capacity increased with the blade rotation, changing significantly in the low ratational region and scarcely in the high rotational region. The powdering capacity in the high rotational region was restricted by the lack of heat flux which was theoretically evaluated for the concentrating process. As the critical factor in the low rotational region was not clear, a visual test apparatus was made to observe flow patterns in the evaporator, and a powdering model was obtained. This model showed that powdering process was obstructed when the liquid film lost its fluidity at high ...
The mortality in undrained abdominal abscesses is high with a mortality rate ranging between 45 and 100%. The outcome in abdominal abscesses, however, has improved due to advances in image guided percutaneous interventional techniques. The main indications for the catheter drainage include treatment or palliation of sepsis associated with an infected fluid collection, and alleviation of the symptoms that may be caused by fluid collections by virtue of their size, like pancreatic pseudocele or lymphocele. The single liver abscesses may be drained with ultrasound guidance only, whereas the multiple abscesses usually require computed tomography (CT) guidance and placement of multiple catheters. The pancreatic abscesses are generally drained routinely and urgently. Non-infected pancreatic pseudocysts may be simply observed unless they are symptomatic or cause problems such as pain or obstruction of the biliary or the gastrointestinal tract. Percutaneous routes that ...
Objective: Traditional nasolacrimal duct stenting possesses some shortcoming including difficulty of pulling ball head guide wire from the nasal cavity with turbinate hypertrophy and nasal septal deviation. The new method of nose-oral tube track establishment can overcome the forementioned and increase the successful rate. Methods: 5 F catheter and arterial sheath were modified to be nasolacrimal duct stent delivery device respectively. Antegrade dacryocystography was taken firstly to display the obstructed site and followed by the modified protocol of inserting the guide wire through nasolacrimal duct and nasal cavity, and establishing the stent delivery track for retrograde stent placement. Results: 5 epiphora patients with failure implantation by traditional method were all succeeded through the modified stenting (100%). During 6-mouth follow-up, no serious complications and reocclusion occurred. Conclusion: The establishment of eye-nose-mouth-nose of external ...
Hepatobiliary scintigraphy is the only non-invasive technique providing real-time assessment of hepatocytes function and bile progression from the liver to the intestine; for this reason it is of great importance in the study of jaundice and many other disorders of the liver and the biliary tract in children. Ultrasonography is the initial method of evaluating the intra- and extrahepatic bile ducts dilatation: the differential diagnosis between biliary atresia and neonatal hepatitis cannot however be done without hepatobiliary scintigraphy. Cystic fibrosis patients also require hepatobiliary scintigraphy; liver and biliary tract disease can really occur independently of the underlying disease severity and the presence of steatorrhoea. Hepatobiliary imaging in children who have undergone liver transplantation is of major importance; it can assess vascularity, parenchymal function biliary drainage, possible presence of a bile leak and obstruction; it has very good ...
INTRODUCTION: Fatigue is a prominent symptom in chronic obstructive pulmonary disease (COPD) and it has distinctive features; however, there is a need for a robust scale to measure fatigue in COPD. METHODS: At baseline, 122 patients with COPD (forced expiratory volume in 1 s (FEV(1)) 52%, women 38%, mean age 66 years) completed a pilot fatigue scale covering a pool of 57 items and underwent a range of tests, including indicators of mood and a short general fatigue questionnaire. All patients responded to the 57-item scale and it was readministered to a subset of 30 patients. The pilot scale was first subjected to constructive validated shortening steps and then to a principal components analysis. RESULTS: The Manchester COPD fatigue scale (MCFS) consists of 27 items, loading into three dimensions: physical, cognitive and psychosocial fatigue. Internal consistency (Cronbach's alpha = 0.97) and test-retest repeatability (r = 0.97, por=16 scores in the Center for ...
Continuous ambulatory peritoneal dialysis (CAPD) is a generally well-tolerated treatment. However, some patients exhibit such complications as to prevent the continuation of treatment. Peritonitis is the major problem, but the continuation of treatment may also be undermined by different complications, such as peritoneal leakage, hernia, catheter malfunctioning, and scrotal-penile edema; a careful investigation of the patient is always needed in such cases. From November 1985 to February 1990, we examined 20 patients, who had presented with different types of complications in the course of dialysis. Peritoneography demonstrated 3 cases of abdominal hernias, 2 cases of patency of the peritoneal-vaginal duct, and 2 cases of catheter obstruction. Peritoneal CT allowed the identification of leakage in 3 patients, while the combined use of the two techniques showed adhesions or pathologic peritoneal recesses in 7 cases. In 3 patients normal patterns were observed. ...
The centre of the symmetric group algebra $\\mathbb{C}[\\mathfrak{S}_n]$ has been used successfully for studying important problems in enumerative combinatorics. These include maps in orientable surfaces and ramified covers of the sphere by curves of genus $g$, for example. However, the combinatorics of some equally important $\\mathfrak{S}_n$-factorization problems forces $k$ elements in $\\{1,...,n\\}$ to be distinguished. Examples of such problems include the star factorization problem, for which $k=1,$ and the enumeration of 2-cell embeddings of dipoles with two distinguished edges \\cite{VisentinWieler:2007} associated with Berenstein-Maldacena-Nastase operators in Yang-Mills theory \\cite{ConstableFreedmanHeadrick:2002}, for which $k=2.$ Although distinguishing these elements obstructs the use of central methods, these problems may be encoded algebraically in the centralizer of $\\mathbb{C}[\\mathfrak{S}_n]$ with respect to the subgroup $\\mathfrak{S}_{n-k}.$ ...
The paper investigates the functional endoscopic sinus surgery with the Messer-linger's technique which treats benign or inflammatory diseases of paranasal sinuses resistant to medical therapy. The goal of this type of surgery is to open the obstructed sinus ostia and restore normal aeration and mucociliary clearance. The computerized tomography permits an accurate assessment of extension and results of functional endoscopic sinus surgery. [Italian] L'articolo discute l'uso della tecnica di Messerklinger nella chirurgia funzionale endoscopica dei seni paranasali per il trattamento delle malattie benigne e delle infiammazioni croniche. Essa disostruisce gli osti sinusali ripristinando la normale areazione e la pulizia mucociliare. La tomografia computerizzata consente di valutare l'estensione e i risultati del trattamento chirurgico funzionale, soprattutto nel caso di insuccesso terapeutico, rilevando malattia nasosinusale ...
Objective: To evaluate the clinical efficacy of multiple stents placement in the management of hilar cholangiocarcinoma, especially in the complex cases of which the hepatic ducts are invaded. Methods: Forty-five consecutive patients with hilar cholangiocarcinoma were treated with percutaneous transhepatic placement of two or three self-expandable metallic endoprostheses. The cause of hilar obstructions in these patients were all cholangiocarcinoma, including Bismuth classification type II (n 12), IIIa (n 17), IIIb (n 10), and IV (n 6). Two or 3 stents were placed in the configuration of T, Y or X over the strictures. Results: Stent placement with 2 or 3 endoprostheses was successful in all patients. All patients showed significant decrease in serum bilirubin level. The mortality rate within 30 days of stent placement was 2.2% (1/45). The mean survival and stent patency times were 215.3 d (26- 516 d) and 181.5 d (26-473 d), respectively. Conclusion: Deploying of ...
CT is the most accurate method to detect pulmonary emphysema in vivo. They compared prospectively two different methods for emphysema quantitation in 5 normal volunteers and 20 consecutive patients with chronic obstructive pulmonary disease (COPD). All subjects were submitted to function tests and HRCT; three scans were acquired at preselected levels during inspiration. The type and extent of pulmonary emphysema were defined by two independent observers under blind conditions. Disagreements were subsequently settled by consent. All subjects were also examined with expiratory spiral CT using a density mask program, at two different cut-off levels (-850,-900 HU). Visual score and expiratory spiral density mask values (-850 HU) were significantly correlated (r = 0.86), but the visual extent of emphysema was always higher than shown by expiratory spiral CT. The emphysema extent assessed with both CT methods correlated with the function result of expiratory airflow ...
CT is the most accurate method to detect pulmonary emphysema in vivo. They compared prospectively two different methods for emphysema quantitation in 5 normal volunteers and 20 consecutive patients with chronic obstructive pulmonary disease (COPD). All subjects were submitted to function tests and HRCT; three scans were acquired at preselected levels during inspiration. The type and extent of pulmonary emphysema were defined by two independent observers under blind conditions. Disagreements were subsequently settled by consent. All subjects were also examined with expiratory spiral CT using a density mask program, at two different cut-off levels (-850,-900 HU). Visual score and expiratory spiral density mask values (-850 HU) were significantly correlated (r = 0.86), but the visual extent of emphysema was always higher than shown by expiratory spiral CT. The emphysema extent assessed with both CT methods correlated with the function result of expiratory airflow ...
Purpose: Budd-Chiari syndrome is a fairly uncommon disease in Europe. This often leads to its late diagnosis. The syndrome is characterised by portal hypertension and splanchnic congestion due to obstruction of hepatic venous outflow. This paper describes the treatment of three patients with Budd-Chiari syndrome by interventional therapeutic techniques and discusses alternative treatment modalities. Patients and Methods: The first patient presented with veno-occlusive disease and was treated by the placement of a transjugular intrahepatic portosystemic stentshunt. The second patient showed an occlusion of the major hepatic veins. After percutaneous recanalisation, a stent was placed in the right hepatic vein which remained patent. The third patient had a membranous obstruction of the right hepatic vein which was treated by percutaneous balloon dilatation. Results: In all patients the clinical symptoms resolved completely after treatment and no ...
In this issue it has been investigated the yield of Helical CT in the study of lung vessels, the incidence of the angiogram sign and its actual value. July 1997 to December 1998, were studied 30 cases of pulmonary collapse of different origin. It was found 15 cases of passive collapse (10 from pleural effusion, 2 from diaphragmatic compression, 2 from traumatic pneumothorax, and 1 from isthmic aortic aneurysm), 12 cases of obstructive collapse (9 from bronchogenic carcinoma, 1 from mucoid obstruction, 1 from ilar lymphadenopathy, and 1 from mediastinal cancer), 2 cases of adhesive collapse and 1 case of round atelectasis. All the examinations were performed with the Helical technique during nonionic iodinated contrast agent injection (bolus, 300-350 mg/mL); it was used an automatic injector set at 2-3 mL/s. It was studied the images for the angiogram sign, that is hyperdense bands, usually longer than 2 cm, through the collapsed lung, which ...
Analyzing various SBLOCA with high pressure safety injection (HPSI) at VVER-440/213, we met a surprising phenomenon - a 'natural' circulation post SG heat transfer reversal. This is not usual, because normal natural circulation (NC) in primary circuit is connected with positive heat transfer at SG. If there is reverse heat transfer at SG (as soon as the break enthalpy outflow is sufficient for removal of reactor decay heat), it should obstruct any natural circulation. The question was, what is the driving force of this 'non-standard natural circulation'. After all we revealed that force - it is the density difference between the colder water in reactor downcomer (cold water from HPSI) and warmer water in inner reactor (lower plenum, core, upper plenum). This phenomenon could be confusing for operating personal, because there would be an opposite temperature difference at the loop than by normal natural circulation (under ...
Analyzing various SBLOCA with high pressure safety injection (HPSI) at VVER-440/213, we met a surprising phenomenon - a 'natural' circulation post SG heat transfer reversal. This is not usual, because normal natural circulation (NC) in primary circuit is connected with positive heat transfer at SG. If there is reverse heat transfer at SG (as soon as the break enthalpy outflow is sufficient for removal of reactor decay heat), it should obstruct any natural circulation. The question was, what is the driving force of this 'non-standard natural circulation'. After all we revealed that force - it is the density difference between the colder water in reactor downcomer (cold water from HPSI) and warmer water in inner reactor (lower plenum, core, upper plenum). This phenomenon could be confusing for operating personal, because there would be an opposite temperature difference at the loop than by normal natural circulation (under non-standard NC conditions water is heated ...
Purpose: The results of therapy in 288 men with pathologic Stage C prostate cancer who underwent radical retropubic prostatectomy (RRP) were analyzed to determine the effects of adjuvant therapy. Methods and Materials: Twenty-seven of the 288 patients received preoperative neoadjuvant hormonal therapy (leuprolide acetate). Postoperatively, 60 patients received adjuvant radiotherapy (RT) to the prostate bed. Follow-up ranged from 3 to 83 months (median = 32 months). Freedom from failure (FFF) was defined as maintaining a serum PSA level of #<=# 0.3 ng/ml. Results: The FFF was 61% at 3 years and 45% at 5 years for the entire group. The FFF following RRP plus RT was 75% at 3 years and 57% at 5 years as compared to 56% at 3 years and 40% at 5 years for RRP without RT (p = 0.049). The FFF following RRP plus neoadjuvant hormonal therapy was 58% at 3 years and 40% at 5 years as compared to 60% at 3 years and 45% at 5 years following RRP without hormonal therapy (p = ...
Objective: To compare the therapeutic effect of unilateral biliary duct drainage with bilateral biliary duct drainage in the treatment of Bismuth-Corlette II-IV type hilar cholangiocarcinoma in order to provide rational and proper clinical options. Methods: Biliary duct drainage was performed in 80 patients with hilar cholangiocarcinoma. The patients were divided into unilateral drainage group (n = 52) and bilateral drainage group (n = 28). The clinical data and the therapeutic results of the two groups were retrospectively analyzed and compared. Results The two groups were quite comparable in the patient's age, sex, clinical type, drainage way, preoperative total and direct bilirubin level, white blood cell, total protein and albumin, etc. After the treatment, the mean reduction value of the total bilirubin and direct bilirubin was 82.73 #mu#mol/L and 31.71#mu#mol/L respectively in unilateral drainage group, and was 80.28 #mu#mol/L and 50.89#mu#mol/L respectively ...
In this study, we investigated the effects of one- and two-staged orchiopexy on testicular volume and serum testosterone levels in cases with high, abdominally localized, bilateral nonpalpable testes. Between March 1996 and April 2001, orchiopexy was performed on 46 testes in 23 patients with bilateral nonpalpable testes. In 15 of the 23 patients, a two-stage Fowler-Stephens orchiopexy was performed, and in 8 of the 23 patients, a one-stage laparoscopic orchiopexy was performed. For one patient who lacked both testes, bilateral prosthetic testes were inserted. The patients' ages were between 20 and 23 years (average, 21 years). In the first stage of the two-stage orchiopexy, the spermatic artery was ligated laparoscopically. Six months later, open surgery orchiopexy was performed. Patients were followed for 2 to 16 months (average, 10 months) and were evaluated for testicular atrophy, serum testosterone levels, and complications. In all the patients, the ...
Objective: To evaluate the diagnostic value of 64 multidetector-row CT angiography for internal carotid artery (ICA) stenosis and the application in the follow-up of carotid endarterectomy and percutaneous transluminal stenting. Methods: Forty transient ischemic attack (TIA) patients with interpretable CTA and DSA of the cervical carotid arteries were selected from May 2005 to December 2005. This yielded a total of 80 vessels. The CTA curved planar reformations (CPR) and DSA images referenced to the distal cervical internal carotid were graded by two senior neuroradiologists blindly, according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) guidelines. The paired-t test was used to verify the statistical significant difference between pre-operating and post-operating of carotid endarterectomy or percutaneous transluminal stenting in measuring the vascular diameter and area of cross section using CTA. Results: When the 70% stenosis was used ...
Purpose: Treatment results and the pattern of relapse were evaluated in the multimodal treatment of Ewing's sarcomas of the chest wall. Methods and Materials: In a retrospective analysis, 114 patients with non-metastatic Ewing's sarcoma of the chest wall were evaluated. They were treated in the CESS 81, CESS 86, or EICESS 92 studies between January 1981 and December 1993. The treatment consisted of polychemotherapy (VACA, VAIA, or EVAIA) and local therapy, either surgery alone (14 patients), radiotherapy alone (28 patients) or a combination of both (71 patients). The median follow-up was 46.6 months (range 5-170). A relapse analysis for all patients with local or combined relapses was performed. Results: Overall survival was 60% after 5 years, event-free survival was 50%. Thirty-seven patients had a systemic relapse (32.4%), 11 patients had a local relapse alone (9.6%), and 3 patients had a combined local and systemic relapse (2.6%). The risk to relapse locally after 5 years was 0% ...
Quantitative bone scintigraphy was performed in patients with prostatic carcinoma before orchiectomy as well as two weeks, two and six months after operation. The count rate was recorded as serial gamma camera images over the lower thoracic and all lumbar vertebrae from 1 to 240 min and at 24 h after injection of "9"9"Tc"m-MDP. In almost all abnormal vertebrae an increased count rate was observed within one hour after injection. Most of the vertebrae which were considered normal at 4 h after injection, but had an increased 24h/4h ratio developed into abnormal vertebrae later in the study. The patients with normal bone scintigrams showed no change in "9"9Tc"m-MDP uptake during the study. The reproducibility of quantitative bone scintigraphy was found to be #+-# 7% (1 SD). In response to therapy, most of the patients with abnormal bone scintigrams showed an increase in count rate two weeks after operation followed by a decrease to the pre-operative level after two ...
The bone scans of 33 patients (pts) with recent subcapital fractures (fx) of the femur were evaluated prospectively to determine their value in predicting femoral head visability. Each of the 33 pts (ll men, 22 women, age range 30-92) had a pre-operative bone scan within 72 hrs of the fx (23 pts within 24 hrs). Anterior and posterior planar views of both hips and pinhole views (50% of pts) were obtained 2 hrs after administration of Tc-99m HDP. The femoral head was classified as perfused if it showed the same activity as the opposite normal side or if it showed only slightly decreased activity. Femoral heads showing absent activity were classified as nonperfused. Overall, 20 of the 33 pts showed a photopenic femoral head on the side of the fx. Only 2 pts showed increased activity at hte site of the fx. Internal fixation of the fx was performed in 23 pts, 12 of whom had one or more follow-up scans. Five of these 12 pts showed absent femoral head activity on their ...
BACKGROUND AND CASE STUDY: Surgical fires are rare but preventable. During facial surgery for a 68-year-old man, a fire broke out, resulting in first- and second-degree burns after a nasal cannula ignited in an oxygen-rich environment because of improper draping and tenting. DISCUSSION: Operating room (OR) fires can be prevented if any component of the "fire triangle"-fuels, ignition sources, and oxidizers-is reduced or eliminated. The use of supplemental oxygen in the OR via nasal cannulae, nebulizers, and oxygen cylinders must always considered a potential source of fire. Deficits in knowledge among the surgical team with respect to the prevention and management of surgical fires were apparent. A plan was put into place to improve fire safety education, entailing an educational program that is included in intern and resident orientation. Surgical fire safety training was also put into place for anesthesia and surgical faculty. The anesthesia preoperative ...
Already, MR Imaging is superior in diagnostic imaging of joints in many cases; however, there have been recent developments, which are the subjects of this paper. With gradient-echo sequences acquired in 3D technique, it is possible to produce high-resolution images of joints in acceptable scantime, because gradient-echo sequences are less time-consuming than convential SE sequences. With the acquisition of two echoes, phase difference between water and fat protons have to be considered. 3D Imaging is capable of displaying complex pathology in a superior way, which should be useful in preoperative planning. Tissue contrast is altered by fat saturation or magnetization transfer in order to achieve better conspicuity of lesions. Although diagnostic value of some of these options is not yet clear and further clinical studies are needed, they are a promising possibility for improving MR Imaging of the joints. (orig.) [Deutsch] In der Gelenkdiagnostik gibt es einige ...
Background: EGFR (epidermal growth factor receptor) and VEGF (vascular endothelial growth factor) inhibitors confer clinical benefit in metastatic colorectal cancer when combined with chemotherapy. An emerging strategy to improve outcomes in rectal cancer is to integrate biologically active, targeted agents as triple therapy into chemoradiation protocols. Material and methods: cetuximab and bevacizumab have now been incorporated into phase I-II studies of preoperative chemoradiation therapy (CRT) for rectal cancer. The rationale of these combinations, early efficacy and toxicity data, and possible molecular predictors for tumor response are reviewed. Computerized bibliographic searches of Pubmed were supplemented with hand searches of reference lists and abstracts of ASCO and ASTRO meetings. Results: the combination of cetuximab and CRT can be safely applied without dose compromises of the respective treatment components. Disappointingly low rates of pathologic ...
In cooperation with NRPB, the specifications of the mainframe COSYMA version 95/1 and the PC COSYMA version 2.0 were prepared and the corresponding modifications implemented. Important improvements are dose-rate dependent models for deterministic health effects, the time dependent efficiency of stable iodine tablets, the extension of data bases for the inclusion of activation products, and supplementary evaluation programs. PC COSYMA has been completed by an economics module, further options in the ingestion pathways, and a graphics package for presenting assessment results. COSYMA has been applied for probabilistic dose assessments within paramter studies and special investigations of EPR concepts. RODOS, the real-time on-line decision support system for nuclear emergency management, has been further developed with the aim of the first pilot version 2.0 for pre-operational application in the second half of 1995. At present, some 20 institutes in the EU, 8 ...
(Materials and Methods) (I) VX/sub 2/ carcinoma was transplanted to the rabbit tibia, sup(99m)Tc-MDP was intravenously injected when bone destruction was radiologically seen. Preoperative scintigraphs, postoperative one of the resected tibia and fibra and scintigraphs of sliced tumor were compared with each other. Tissue fragments were collected from the sliced tumor, and RI was measured to compare concentration rates at different parts together with histological investigations. (II) Tetracycline was given to the rabbit of Experiment (I) to compare with the concentration of sup(99m)Tc-MDP. (III) Microautoradiography method was done on the experimental animals for investigation of the concentration of sup(99m)Tc-MDP. (Results) (I) Localization of sup(99m)Tc-MDP was increased at the sites of tumorous bone formation, of reactive bone formation at tumor edges, and of cartilage calcification, with little concentration at tumor cells or necrotic tissue. (II) Deposition ...
Objective: To assess dynamic MRI with Gd-DTPA enhancement for evaluating inflammatory changes in the subacromial bursa. Design and patients: We detected the signal intensity changes in dynamic MRI of the subacromial bursa, and confirmed these macroscopically by arthroscopy and histologically. The signal intensity was measured using built-in software, and the enhancement ratio (E ratio) was calculated from dynamic MR images. In addition, as a parameter of the rate of the increase in the signal intensity from 0 to 80 s, the mean increase per second in the E ratio was obtained as the coefficient of enhancement (CE). The correlation was studied of the E ratio and CE with the arthroscopic findings (redness, villous formation, thickening and adhesion), and of the E ratio and CE with the histological findings (capillary proliferation, papillary hyperplasia, fibrosis and inflammatory cell infiltration) of the subacromial bursa. Of patients with shoulder pain, this study included those with ...
Purpose: Extrahepatic cholangiocarcinoma is a rare malignancy. Despite radical resection, survival remains poor, with high rates of local and distant failure. To clarify the role of radiotherapy with chemotherapy, we performed a retrospective analysis of resected patients who had undergone chemoradiotherapy. Methods and Materials: A total of 45 patients (13 with proximal and 32 with distal disease) underwent resection plus radiotherapy (median dose, 50.4 Gy). All but 1 patient received concurrent fluoropyrimidine-based chemotherapy. The median follow-up was 30 months for all patients and 40 months for survivors. Results: Of the 45 patients, 33 underwent adjuvant radiotherapy, and 12 were treated neoadjuvantly. The 5-year actuarial overall survival, disease-free survival, metastasis-free survival, and locoregional control rates were 33%, 37%, 42%, and 78%, respectively. The median survival was 34 months. No patient died perioperatively. Patient age #<=#60 years and perineural ...
Cholangiocarcinoma is synonymous with bile duct carcinoma, and can originate in a small intrahepatic bile duct (peripheral type), a major intrahepatic duct including the hepatic hills, an extrahepatic duct, or near the papilla of Vater (central type). In a sense bile duct carcinoma of the peripheral type is cholangiocarcinoma of the liver; it has the same gross configuration as hepatocellular carcinoma, resulting in difficulty to differentiate on the CT. The authors studied CT findings of 14 cases of pathologically proven peripheral type cholangiocarcinoma of the liver during the last 4 years. The results were as follows: 1. Of 14 cases, 8 were female and 6 were male, and the age ranged from 5th to 7th decades. 2. Preoperative clinical diagnosis were as follows: hepatoma 8 cases, abscess 5 cases and metastasis 1 case in order of frequency. 3. Diagnosis were confirmed by hepatic lobectomy in 7 cases, wedge resection in 5 cases and needle biopsy in 2 case. 4. ...
Differentiated thyroid cancer (DTC) has variable degree of F-18 FDG avidity. The purpose of this study was to evaluate the relationship between F-18 FDG uptake and pathological or immunohistochemical features of DTC. DTC patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included in the study. Maximum standardized uptake values (SUVmax) of primary tumor were calculated. If the primary tumor showed no perceptibly increased F-18 FDG uptake, region of interest was drawn based on finding of CT portion of the PET/CT images. Pathological and immunohistochemical markers such as presence of lymph node (LN) metastasis and underlying thyroiditis, tumor size, Ki-67 labeling index, expressions of EGFR, COX-2, and Galectin-3 were evaluated. Total of 106 patients was included (102 papillary carcinomas, 4 follicular carcinomas). The mean SUVmax of the large tumors (above 1 cm) was significantly higher than the mean SUVmax of small (equal to or less ...
(1) To determine the accuracy of computed tomography (CT) in the evaluation of ligament tear and avulsion in patients with tibial plateau fracture. (2) To evaluate whether the presence or severity of fracture gap and articular depression can predict meniscal injury. A fellowship-trained musculoskeletal radiologist retrospectively reviewed knee CT and MRI examinations of 41 consecutive patients presenting to a level 1 trauma center with tibial plateau fractures. Fracture gap, articular depression, ligament tear and footprint avulsions were assessed on CT examinations. The MRI studies were examined for osseous and soft tissue injuries, including meniscal tear, meniscal displacement, ligament tear, and ligament avulsion. CT demonstrated torn ligaments with 80% sensitivity and 98% specificity. Only 2% of ligaments deemed intact on careful CT evaluation had partial or complete tears on MRI. Although the degree of fracture gap and articular depression was significantly greater in patients ...
The accuracy is investigated of both lymphangiography and CT in detecting lymph nodes metastases in 59 patients evaluated preoperatively and subsequently submitted to surgery with selective/systemic pelvic and paraaortic lymphadenectomy. CT accuracy was also investigated in 46 patients with a clinically suspected relapse of ovarian cancer (verified by means of clinical and/or CT follow-up in 36 patients, by laparotomy in 7, by fine-needle biopsy in 1 and by necroscopy in the last 2). In the first group (previously untreated patients) the overall results in the pelvis were, respectively, for lymphangiography and CT: 94.9% vs 89.8% accuracy, 86.6% vs 60% sensitivity, 97.7% vs 100% specificity, and 92.8% vs 100%, 95.5% vs 88% positive and negative predictive values. In the paraaortic region the results were: 89.1% vs 86.5% accuracy, 73.3% vs 66.6% sensitivity, 100% specificity for both techniques, 100% positive predictive value, and 84.6% vs 81.5% negative predictive ...
The thermal performance of an automotive radiator plays an important role in the performance of an automobile's cooling system and all other associated systems. For a number of years, this component has been given little attention with very little changing in its manufacturing cost, operation and geometry. As opposed to the old tubular heat exchanger configurations used in automotive radiators, plate heat exchangers currently form the backbone of today's process industry with their advanced performance reaching levels the designers of tubular heat exchangers can only dream of. The aluminium roll-bonding technique widely used in manufacturing the cooling compartments for domestic refrigeration units is one of the cheapest methods for heat exchanger manufacturing. Using this technique, it is possible to manufacture a wide range of heat exchanger configurations that can help augment heat transfer whilst reducing pressure drops. CFD results obtained for a patterned plate ...
Three studies of electrochemical current distribution have been performed using potential-theory models and the boundary-element method (BEM). (1) The steady-state behavior of cells with nonuniform current density over a passivating anode is investigated. Current distributions calculated for a test cell, using the measured kinetic behavior of nickel in acid-nickel-sulfate solution, are compared to estimates from earlier models. Although current-density profiles determined by weight loss on a segmented rotating cylinder agreed satisfactorily with model calculations, the measured length of the passive zone exceeds the theoretical value. The model's applicability to anodic protection is demonstrated for a stainless-steel sulfuric-acid holding tank. (2) A model is established to describe the effects of attached bubbles on the potential drop at gas-evolving electrodes including: (1) ohmic obstruction within the electrolyte; (2) area masking on the electrode ...
The feasibility of self-expanding nitinol stents for treatment of infragenicular arteries following unsuccessful balloon angioplasty was assessed. Options for lower limb percutaneous revascularization are limited, especially for complex vessel obstruction. Depending on the lesion and the experience of the interventionalist, the failure rate of balloon angioplasty (PTA) ranges between 10 and 40%. Until recently, no self-expanding stent for the use in the infragenicular arteries was available. This is the first report of the results for 18 consecutive patients who received 4F sheath compatible self-expanding nitinol stents following unsuccessful PTA or early restenosis. Twenty-four stents were implanted in 21 lesions for various indications residual stenosis >50% due to heavy calcification, flow-limiting dissection, occluding thrombus resistant to thrombolyis, thrombaspiration, and PTA, and early restenosis after previous PTA. Stent implantation was feasible ...
During the past 10 years, five infants with Kasabach-Merritt syndrome (K-M) receiving radiation therapy were reported. We investigated whether radiation therapy for K-M was useful and what the unfavorable factors of K-M were. During the past 10 years, we have treated five infants with K-M. The syndrome occurred at ages ranging from birth to 4 months. The incidence of female to male ratio was 3:2. Among 5 cases, the site of hemangioma was as follows; shoulder, anterior chest wall, lower abdominal wall, face and neck and inguinal site. All 5 cases received medication to control the coagulopathy including prednisone and blood transfusion at first. Because the platelet count and the bleeding tendency did not improve in any case, these cases received radiation therapy. Total dose ranged from 5 to 10 Gy and fraction-size ranged from 0.5 to 1.75 Gy. Irradiation session was 2 or 3 times per week. In 5 cases, 4 cases showed cure of bleeding tendency and disappearance of tumor, and survived. In ...
This study examined whether cognitive behavioural therapy (CBT) could prevent the development or worsening of panic-spectrum psychopathology and anxiety symptoms in chronic obstructive pulmonary disease (COPD). 41 patients with COPD, who had undergone pulmonary rehabilitation, were randomised to either a four-session CBT intervention condition (n = 21) or a routine care condition (n = 20). Assessments were at baseline, post-intervention, and at 6-, 12- and 18-month follow-ups. Primary outcomes were the rates of panic attacks, panic disorder and anxiety symptoms. Secondary outcomes were depressive symptoms, catastrophic cognitions about breathing difficulties, disease-specific quality of life and hospital admission rates. There were no significant differences between the groups on outcome measures at baseline. By the 18-month follow-up assessment, 12 (60%) routine care group participants had experienced at least one panic attack in the previous 6 months, with two ...
Forty-one patients with uncomplicated gall stone disease were laparoscopied with the object of cholecystectomy. The procedure was accomplished in 36 patients, but the operation had to be transformed to a conventional open operation in five: Fibrosis made dissection of the gall bladder hazardous in four and bleeding during the procedure made immediate laparotomy necessary in one patient, whose postoperative course was uneventful. The median operating time was 100 minutes, range was 60-250 minutes. The only operative complication was bleeding from a trocar puncture hole on the first postoperative day which stopped spontaneously in one patient. Eighteen were sent home on the first postoperative day and 12 patients on the second day. Peroperative cholangiography was performed employing the Olsen-Reddick cholangiography forceps. We have designed a special catheter, which greatly facilitates the procedure. The procedure was accomplished in 27 of 32 planned cases. Two patients had common bile ...
Experimental investigations were performed to assess the effects of different shaped obstructions on flame propagation in a rectangular confinement, 235 mm in height, with a 1000 x 950mm cross section and a large top-venting area of 1000 x 320mm. Four different single obstacles were used: rectangular, cylindrical, triangular, and square cross-sections with blockage ratios of 5 and 10%. Temporally resolved flame front images were recorded by a high-speed video camera to investigate the interaction between a propagating flame and the obstacle. The local flame displacement speeds and their probability density functions (pdfs) were obtained for the different obstacles. Before the freely propagating flame impinges on the obstacle, the flame propagation speed remains close to the laminar burning velocity, regardless of the obstacles used. As the propagating flame impinges on the obstacle, the local propagation speed increases due to the expansion of the burnt gas and the ...
Cervix cancer is the most common female cancer in Korea. In spite of their relatively local invasive tendency, still 44% of patient will develop recurrent cancer This result suggests that more aggressive local treatment may increase the cure rate but increased complication risk also cannot be avoidable. Various institutions proposed different treatment regimen, but recommended dose were about 4500 cGy for whole pelvis and 8000 cGy at point A, even though they agreed that those doses may not be satisfactory for control of bulky disease. 96 cases of invasive cervical cancer, treated with postoperative or primary radiation therapy were analyzed to determine the complication rate and prognostic factor in our treatment regimen which is 500-1000 cGy higher than other institution. Mean follow up duration was 21 months. Symptomatic patients including mild but persistent abdominal discomfort was 46%, but only 1 patient (1%) had operative treatment because of incomplete ...
The adequacy of the nasopharyngeal airway has been found to be related to craniofacial development. Obstruction of the airway by adenoid tissue, nasal septal deviation or abnormal morphology of the area is associated with characteristic changes in craniofacial morphology such as long anterior face height, facial retrognathism, and a steep inclination of mandibular plane often with a high vaulted palate and crossbite. Some studies have shown the changes to be reversible after adenoidectomy which improves nasal airway patency and a control mechanism for facial growth has been proposed to account for the relationships between airway adequacy, craniofacial morphology and craniocervical postural relationships. It is therefore important to be able to measure nasal respiratory resistance so that the effect of operative procedures in the area such as rapid maxillary expansion (RME) can be determined. Nasal respiratory resistance (NRR) is a measure of airway adequacy. It ...
Hystreosalpingogram of 375 patients with infertility were reviewed with reference to radiological feature of each pathology and a comparative study of hysterosalpingography and laparoscopy in 36 patients was presented. This results were as follows;1. In 375 cases of infertility, 191 cases (50.9%) were primary infertility and 181 cases (49.1%) were secondary infertility. 2. The peak age distribution was 26 to 30 year old group in 211 cases (56.3%), and the peak duration of infertility was less than 3 years in 256 cases (68.3%). 3. Abnormal uterine findings were 115 cases (30.7%) and there were 73 cases of filling defects, 13 cases of irregularity, 12 cases of uterine flexion, 11 cases of congenital anomaly, and 9 cases of hypoplasia among them. 4. Abnormal tubal findings were 196 cases (52.3%) and there were 103 cases of simple obstruction, 69 cases of hydrosalpinx, and 50 cases of peritubal adhesion among them. 5. Intravasation of contrast media was noted in 42 ...
This is a slide-based oral presentation given to the COG/IAEA: Fifth technical committee meeting on 'Exchange of operating experience of pressurized heavy water reactors' held in Mangalia, Romania on 7-10 September 1998. Since energization of Wolsung Unit 3 station service transformer on July 12, 1996 a line of initial test program was conducted as follows: 1. ILRT/SIT; 2. Pre-operational and Hot Functional testing with a Light Water and without Fuel in Systems; 3. Load D_2O in Moderator System; 4. Initial fuel loading; 5. Load D_2O in PHT System; 6. Hot Functional Testing with Heavy Water and Fuel in Systems; 7. Criticality and Low Power Physics Testing; 8. Power Ascension Test and, then finally, phase-D test; the plant acceptance test was accomplished after having a Mini-Overhaul to prepare for Commercial Operation. These documents contain not only both overall introduction of commissioning and the first TBN rolling and Synchronization test performed in Hot ...
Purpose: To evaluate the effect of low-dose radiation therapy and surgery on local control in patients with Ewing's Sarcoma. Materials and Methods: Between 1979 and 1995 24 patients (ages 4-47) with Ewing's sarcoma were treated with combined modality therapy that included multi agent chemotherapy, surgical resection, and radiation therapy. Twelve patients had metastatic disease at the time of presentation (pleura = 3, lung = 5, bone 4). Tumor location was central in 16 and peripheral in 8. Multi agent chemotherapy consisted of vincristine/actinomycin D/cyclophosphamide/doxorubicin in 19. The same agents with the addition of ifosfamide and etoposide were given in 5. The extent of resection was considered to be radical in 14 and of the 16 patients who received preoperative chemotherapy, 5 were found to have a pathologic complete response. All patients with lung metastases at diagnosis received whole-lung irradiation to 1400 cGy in 10 fractions. Radiation therapy to ...
Clinical studies have proved the effectiveness of local ablading methods in pations with non-resectable liver metastases of a colorectal carcinoma. RF ablation and LITT are a potentially curative therapy option and an alternative to systemic chemotherapy; the latter is carried out primarily for reducing tumour size with the goal of secondary resectability. The number of R0-sesectable metastases can be enhanced by a combined therapy of surgery and local ablading methods, e.g. by preoperative, intraoperative or postoperative ablasion of further non-resectable tumours during surgery. Systemic chemotherapy combined with surgery as an adjuvant method is not recommended unless in cases of non-abladable tumour recidivation. Currently, systemic chemotherapy is used as a neo-adjuvant therapy for tumour size reduction with the goal of secondary resectability or, in case of inoperability, local ablation. (orig.) [German] Abladierende Verfahren. Klinische Studien belegen die ...
Materials and methods: 12 patients with 22 coronary bypass grafts underwent intraoperative flow quantification using the transit time ultrasound method. These values were compared to postoperative MR phase shift measurements. Flow measurements were performed preoperatively in 28 coronary arteries of 20 patients. For flow measurement, we used a velocity-encoded k-space segmented gradient echo sequence with a temporal resolution of 110 or 125 ms, respectively. 6-8 pase shift images could be acquired during one cardiac cycle. Results: There was a significant correlation between intraoperative and flow measurements using velocity-encoded MR imaging (r=0.76, p<0.0001, t-test). Flow volumes determined by MR imaging were systematically larger than those determined by the transit time ultrasound method. Mean flow in coronary arteries was reduced in severely stenosed vessels (>70%) compared to normal vessels. Intra- and interobserver variability were 10.5 and ...
Scour around offshore structures is well known. It is caused by the strong eddy formation at the base of the structures protruding from the sea bottom. The strong vortices result in an amplified effective shear stress working on the sea bottom surface adjacent to the structure. When the surrounding sea bottom is lowered the scour protection will end up being a cap on a small hill and when the slopes are getting too steep the scour protection will roll or slide down the sides. It will loose its cohesion and therefore its integrity. This will take place irrespective of the type of scour protection material and the type of scour protection. This report describes scour protections, which can deal with this particular problem. Such a scour protection must be able to sustain the following loads: Be able to follow the lowering of the seabed on its way down; Be resistant to edge scour (scour around the perimeter of the scour protection). The installation of scour protection is not ...
The data center in this study had a total floor area of 3,024 square feet (ft{sup 2}) with one-foot raised-floors. It was a rack lab with 147 racks, and was located in a 96,000 ft{sup 2} multi-story office building in San Jose, California. Since the data center was used only for testing equipment, it was not configured as a critical facility in terms of electrical and cooling supply. It did not have a dedicated chiller system but was served by the main building chiller plant and make-up air system. Additionally it was served by only a single electrical supply with no provision for backup power in the event of a power outage. The Data Center operated on a 24 hour per day, year-round cycle, and users had full-hour access to the data center facility. The study found that data center computer load accounted for 15% of the overall building electrical load, while the total power consumption attributable to the data center including allocated cooling load and lighting was 22% of the total ...
The integrity of the RPV head and reactor internals was assessed by means of fluid-structural analyses using a coupled method to evaluate the water hammer phenomenon arising from high burnup fuel failure under RIA conditions. The fluid viscosity effect on the water column burst as well as the complex three-dimensional flow paths caused by a core shroud and standpipes were considered in this study. The three analysis scenarios were designed to investigate the above mentioned influential factors separately. In the first scenario, a two-dimensional axisymmetric reactor vessel model without any reactor internals was modeled to assess the influence of the fluid dynamics in the NSC RIA regulatory evaluation. This model has an actual RPV geometry and can be simply separated from other influential factors in order to concentrate only on investigation of the fluid viscosity effect. In the second scenario, a two-dimensional axisymmetric reactor vessel model with major reactor internals, such as ...
Purpose: Liposarcoma is the most common soft tissue sarcoma in adults. The purpose of the study was to correlate MR imaging features with the four ICD subclasses. Methods: 28 patients with liposarcoma were examined preoperatively on a 1.0 T MRI system, using spin echo sequences, gradient echo imaging and STIR sequences. In all patients, classification of the liposarcomas was made by histologic diagnosis (ICD-10-M-classification). Results: Well differentiated liposarcomas (9 patients) showed a number of MRI features consistent with lipoma (well defined mass high signal intensity (SI) on T{sub 1} images, low signal on T{sub 2} images, no or only little signal increase of tumour tissue after contrast material application, no necrosis). Not well differentiated liposarcomas (myxoid 14 patients, pleomorphic three patients, round cell two patients) revealed the largest part of the mass to be of low SI on T{sub 1}-weighted images. Only scattered fatty islands and septa (9 ...
Objective: To evaluate the treatment of malignant biliary stenoses and occlusions using a new stent. Methods: In a prospective study, 25 patients with malignant obstructive jaundice were treated with SMART stents. The handling and the quality of stent expansion were documented. Stent function was assessed 2-4 days after intervention by cholangiography and laboratory tests. A follow-up was performed three months, after stent placement. Results: All lesions were treated successfully, with a total of 35 stents implanted. In 14 patients a further balloon dilatation was performed after stent placement (8-10 mm diameter/40-80 mm length). The mean serum bilirubin level decreased significantly from 11.6 mg/dl to 4.6 mg/dl after intervention (p<0.05). The follow-up showed a mean serum bilirubin level at 4.0 mg/dl. In 4 cases (16%) a further intervention (PTCD or stent) was performed. Six patients died due to tumor progression. The stents proved to be patent in 79% ...
This document - IAEA Safeguards: Implementation Blueprint of Commercial Satellite Imagery - constitutes the second report from SSC Satellitbild giving a structured view and solid guidelines on how to proceed with a conceivable implementation of satellite imagery to support Safeguards activities of the Agency. This Phase 2 report presents a large number of concrete recommendations regarding suggested management issues, work organisation, imagery purchasing and team building. The study has also resulted in several lists of actions and preliminary project plans with GANT schedules concerning training, hardware and software, as well as for the initial pilot studies. In both the Phase 1 and Phase 2 studies it is confirmed that the proposed concept of a relatively small Imagery Unit using high-resolution data will be a sound and feasible undertaking. Such a unit capable of performing advanced image processing as a tool for various safeguard tasks will give the Agency an effective instrument ...
Purpose of this work is to evaluate the effectiveness and role of CT in blunt diaphragmatic injuries by reviewing our 8-year experience. It is reviewed the preoperative CT findings of 35 patients with surgically confirmed diaphragmatic rupture. Surgical repair was performed in the acute setting (within 12 hours of trauma) in 22 cases, and late (8 months-5 years) in 13 cases. Twenty-eight patients (80%) were examined with conventional CT and 7 (20%) with Helical CT. Of the 13 patients examined long after trauma, the left hemi diaphragm was ruptured in 12 cases (with visceral herniation in 4), and the right hemi diaphragm in 1, with no herniation. The diaphragmatic rent was found in the dome (15 cases, 43%), muscolotendinous junction (11 cases, 31%), muscular portion (8 cases, 23%), and at the muscular attachments on the ribs (1 case, 3%). As for the site of diaphragmatic injury, CT never depicted the diaphragmatic rent in the dome and at the muscolotendinous ...
The aim of this work is to provide a comprehensive and consistent description of the complexity of laws regulating the field of biotechnology, mainly focusing on the definition of items to be patented, which is one of the most important and also controversial issues within the new 98/44/EC set of rules. As biotechnology is a specialist and multidisciplinary field, it has begun by giving a general description of the field, outlining the grounds for the new rules, and then thoroughly examined and evaluated previous national and international laws especially with regard to patenting. This was followed by an evaluation of what can be patented according to the new instructions by systematically assessing the section defining items to be patented in the field of biotechnology. It is used to be a matter of opinion whether biotechnological material was to be considered a discovery or an invention, the former being impatentable according to patenting laws. The new law pays particular attention ...
...and it's really a pleasure to ...you and ...and for ...was shelled and then doses of pleasure for me to ...and my director general ...? and journal article ? ...but and yeah well that's um ? ...and ...and what could be achieved ? what might be the consequences ...? and ...and ...and ...and ...and ...structural because and ...over and hopefully is also serve the purpose to get ...principles and ...and ...and ...how to use them and future ...and and that ...and purposes and that's very important ...you and ...and ...and in the future ? and yeah ...true and ...and ...just and and and and and the order of nuclear physics a ...useful and ...too much ? and ...portable comes from and ...and ...and ...and ...no more ? how to knowledge and the and ...and ...and and keep ever seen all of all ? ...and ...and ...and what you're ...and ...and ...and you and ...and ...and ...and so when you keep that and and ...and ...? and ...and ...and ...the problems and the other side ? ...door and a ...and ...