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Sample records for abdomen clinical background

  1. Acute abdomen. Clinical background and demands on imaging

    International Nuclear Information System (INIS)

    Graeb, C.; Jauch, K.W.; Reiser, M.; Graser, A.

    2010-01-01

    The term ''acute abdomen'' does not describe a specific disease entity but is more a critical clinical state which incorporates very heterogeneous clinical presentations. The prognosis of any disease depends on the time frame from the onset of symptoms to the initiation of a specific therapy. For this reason there are special expectations by clinicians regarding the diagnostic assessment provided by radiology which is expected to deliver an immediate diagnosis supporting further therapeutic decisions. Along with the patient's clinical history, physical examination and blood tests, radiological diagnostics are essential for enabling a specific treatment. From a surgical point of view the radiologist is expected to help in differentiating between cases with indications for emergency surgery and cases eligible for elective surgery or conservative treatment. (orig.) [de

  2. Acute abdomen. Clinical background and demands on imaging; Akutes Abdomen. Klinische Begriffsbestimmung und Anforderungen an die Bildgebung

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    Graeb, C.; Jauch, K.W. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Klinik und Poliklinik fuer Chirurgie, Muenchen (Germany); Reiser, M.; Graser, A. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany)

    2010-03-15

    The term ''acute abdomen'' does not describe a specific disease entity but is more a critical clinical state which incorporates very heterogeneous clinical presentations. The prognosis of any disease depends on the time frame from the onset of symptoms to the initiation of a specific therapy. For this reason there are special expectations by clinicians regarding the diagnostic assessment provided by radiology which is expected to deliver an immediate diagnosis supporting further therapeutic decisions. Along with the patient's clinical history, physical examination and blood tests, radiological diagnostics are essential for enabling a specific treatment. From a surgical point of view the radiologist is expected to help in differentiating between cases with indications for emergency surgery and cases eligible for elective surgery or conservative treatment. (orig.) [German] Der Begriff ''akutes Abdomen'' stellt keine eigenstaendige Erkrankung dar, sondern beschreibt einen kritischen klinischen Zustand, unter dessen Oberbegriff sich die unterschiedlichsten Krankheitsbilder subsumieren lassen. Das Zeitintervall zwischen dem Auftreten der ersten Symptome bis zur Einleitung einer gezielten Therapie ist fuer die Prognose der Patienten der entscheidende Faktor. Aus diesem Grund bestehen besondere Anforderungen an die bildgebende Diagnostik, die dazu beitragen soll, innerhalb kuerzester Zeit eine moeglichst genaue Diagnose zu stellen. Neben Anamnese, klinischer Untersuchung und Labordiagnostik stellt die radiologische Untersuchung einen wesentlichen Baustein vor der Therapieeinleitung dar. Aus chirurgischer Sicht muessen Krankheitsbilder, die eine sofortige Notfalloperation erforderlich machen, von Erkrankungen differenziert werden, die eine elektive Chirurgie oder ein konservatives Vorgehen indizieren. (orig.)

  3. A CLINICAL STUDY ON BLUNT INJURY ABDOMEN

    Directory of Open Access Journals (Sweden)

    G. Kishore Babu

    2016-10-01

    Full Text Available BACKGROUND Abdominal trauma continues to account for a large number of trauma-related injuries and deaths. Motor vehicle accidents and urban violence, respectively, are the leading causes of blunt and penetrating trauma to this area of the body. Unnecessary deaths and complications can be minimized by improved resuscitation, evaluation and treatment. The new techniques and diagnostic tools available are important in the management of abdominal trauma. These improved methods, however, still depend on experience and clinical judgment for application and determination of the best care for the injured patient. The aim of the study is to 1. Analyse the incidence, clinical characteristics, diagnosis, indications for laparotomy, therapeutic methods and morbidity & mortality rates. 2. To study nature of blunt abdominal trauma. 3. To assess patient for surgical intervention and to avoid negative laparotomy. 4. To assess morbidity rate in different organs injury. 5. To evaluate modalities of treatment, complications and prognosis. MATERIALS AND METHODS This study is a prospective study on 97 patients with Blunt injuries to the abdomen admitted in S.V.R.R.G.G. Hospital, Tirupati during October 2013-15. Inclusion Criteria Patients > 13 years, with Blunt injury to abdomen either by RTA, fall, object contact, assault giving written informed consent. Exclusion Criteria Patients <13 yrs. Blunt injuries due to blasts, patients with severe cardiothoracic and head injuries who are hemodynamically unstable. CONCLUSION Blunt Trauma to abdomen is on rise due to excessive use of motor vehicles. It poses a therapeutic and diagnostic dilemma for the attending surgeon due to wide range of clinical manifestations ranging from no early physical findings to progression to shock. So, the Trauma surgeon should rely on his physical findings in association with use of modalities like x-ray abdomen, USG abdomen and abdominal paracentesis. Hollow viscus perforations are

  4. Causes and Clinical Outcomes in Neonates with Acute Abdomen ...

    African Journals Online (AJOL)

    Causes and Clinical Outcomes in Neonates with Acute Abdomen Requiring Surgery at ... Neonatal surgery is challenging, particularly in the emergency setting whereby ... Other causes included peritonitis (6.9%) and abdominal wall defects (4.7%). ... accounting for 13 cases (30.2%) and mortality was 34.9 % ( 15 neonates).

  5. Results of emergency management of acute abdomen in adults based on clinical assessment and basic imaging investigations: are advanced imaging techniques always necessary for successful treatment?

    OpenAIRE

    Sangram Karandikar

    2016-01-01

    Background: The term acute abdomen refers to signs and symptoms of abdominal pain and tenderness, a clinical presentation that may require emergency surgical treatment. Patients suffering from both, surgical as well as medical diseases may present with acute abdomen. The main objectives of the study are to identify common causes of acute abdomen, to assess the need for urgent surgical intervention in these patients and to evaluate role of basic diagnostic techniques and need of advanced imagi...

  6. Radiological diagnostics of abdomen and thorax. Image interpretation considering anatomical landmarks and clinical symptoms; Radiologische Diagnostik Abdomen und Thorax. Bildinterpretation unter Beruecksichtigung anatomischer Landmarken und klinischer Symptome

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    Krombach, Gabriele A. [Universitaetsklinikum Giessen (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Mahnken, Andreas H. (ed.) [Universitaetsklinikum Marburg (Germany). Diagnostische und Interventionelle Radiologie

    2015-07-01

    The book on radiological diagnostics of abdomen and thorax - image interpretation considering anatomical landmarks and clinical symptoms - includes three chapters: (1) imaging of different parts of the body: thorax and abdomen. (II) Thorax: head and neck; mediastinum; heard and pericardium; large vessels; lungs and pleura; mamma. (III) Abdomen: liver; gall bladder and biliary tract; pancreas; gastrointestinal tract; spleen and lymphatic system; adrenal glands; kidneys and urinary tract; female pelvis; male pelvis.

  7. Acute abdomen. Akutes Abdomen

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    Beger, H.G.; Kern, E. (eds.)

    1987-01-01

    The book first presents the anatomy and physiology of the abdomen and continues with chapters discussing clinical and laboratory aspects and a suitable order of diagnostic examinations with reference to the acute processes, explaining the diagnostic tools: ultrasonography, radiography including angiography and CT, tapping techniques and endoscopy together with their basic principles, examination techniques, and diagnosis. One chapter presents a complete survey of the processes involving the entire abdomen - as e.g. peritonitis, ileus, abdominal trauma, intraperitoneal hemorrage. This chapter profoundly discusses the diagnostics and therapies including emergency measures and surgery. Problems requiring consultation among varous specialists, in internal medicine, gynecology, urology, or pediatrics, are discussed in great detail. Information for the anesthetist is given for cases of emergency. More than one third of the book is devoted to organ-specific information, dicussing the pathogenesis, diagnostics, and therapy of the oesophagus, stomach, large and small intestine, bile ducts, pankreas, liver, spleen, and the abdominal vessels and the abdominal wall. (orig.) With 153 figs., 90 tabs.

  8. The Clinical anatomy of the physical examination of the abdomen: A comprehensive review.

    Science.gov (United States)

    Bilal, Muhammad; Voin, Vlad; Topale, Nitsa; Iwanaga, Joe; Loukas, Marios; Tubbs, R Shane

    2017-04-01

    Physical examination of the abdomen is an essential skill. Knowledge of its clinical anatomy and application is vital for making diagnoses. Misinterpretation of anatomy during examination can have serious consequences. This review addresses understanding of the anatomy, methodology, and complications of abdominal physical examination. It includes particular reference to modern technology and investigations. Physical examination is performed for diagnostic purposes. However, the art of physical examination is declining as more and more clinicians rely on newer technology. This can have regrettable consequences: negligence, waste of time and resources, and deterioration of clinical skills. With a sound knowledge of clinical anatomy, and realization of the importance of physical examination of the abdomen, clinician, and patients alike can benefit. Clin. Anat. 30:352-356, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  9. Clinical course of Crohn's disease first diagnosed at surgery for acute abdomen.

    Science.gov (United States)

    Latella, G; Cocco, A; Angelucci, E; Viscido, A; Bacci, S; Necozione, S; Caprilli, R

    2009-04-01

    The severity of clinical activity of Crohn's disease is high during the first year after diagnosis and decreases thereafter. Approximately 50% of patients require steroids and immunosuppressants and 75% need surgery during their lifetime. The clinical course of patients with Crohn's disease first diagnosed at surgery has never been investigated. To assess the clinical course of Crohn's disease first diagnosed at surgery for acute abdomen and to evaluate the need for medical and surgical treatment in this subset of patients. Hospital clinical records of 490 consecutive Crohn's disease patients were reviewed. Patients were classified according to the Vienna criteria. Sex, extraintestinal manifestations, family history of inflammatory bowel diseases, appendectomy, smoking habit and medical/surgical treatments performed during the follow-up period were assessed. Kaplan-Meier survival method and Cox proportional hazards regression model. Of the 490 Crohn's disease patients, 115 had diagnosis of Crohn's disease at surgery for acute abdomen (Group A) and 375 by conventional clinical, radiological, endoscopic and histologic criteria (Group B). Patients in Group A showed a low risk of further surgery (Log Rank test pacute abdomen showed a low risk for reintervention and less use of steroids and immunosuppressants during follow-up than those not operated upon at diagnosis. Early surgery may represent a valid approach in the initial management of patients with Crohn's disease, at least in the subset of patients with ileal and complicated disease.

  10. Acute abdomen

    Directory of Open Access Journals (Sweden)

    Wig J

    1978-01-01

    Full Text Available 550 cases of acute abdomen have been analysed in detail includ-ing their clinical presentation and operative findings. Males are more frequently affected than females in a ratio of 3: 1. More than 45% of patients presented after 48 hours of onset of symptoms. Intestinal obstruction was the commonest cause of acute abdomen (47.6%. External hernia was responsible for 26% of cases of intestinal obstruction. Perforated peptic ulcer was the commonest cause of peritonitis in the present series (31.7% while incidence of biliary peritonitis was only 2.4%.. The clinical accuracy rate was 87%. The mortality in operated cases was high (10% while the over-all mortality rate was 7.5%.

  11. Does analgesia affect the diagnostic process in acute abdomen? a randomized clinical trial

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    Khashayar P.

    2008-03-01

    Full Text Available Background: About one-forth of the patients admitted to the emergency department complain of acute abdominal pain. According to surgical records, most surgeons believe that pain relief for these patients may interfere with the clinical examinations and the final diagnoses. As a result, analgesics are withheld in patients with acute abdominal pain until the determination of a definite diagnosis and suitable management plan. The purpose of this study was to evaluate the effect of analgesics on the evaluation course and treatment in acute abdomen.Methods: Two hundred patients at a surgical emergency department with acute abdominal pain were enrolled in this prospective study and randomly divided into two groups at the time of admission. The case group consisted of 98 patients who received intravenous analgesia immediately after admission. The other 102 patients in the control group did not receive analgesia until a definite diagnosis was made. Diagnostic and therapeutic procedures were similar between the two groups. The primary and final diagnoses, and the time intervals between the admission and definite diagnosis, and that between admission and surgery were gathered and analyzed.Results: The mean time to definitive diagnosis was 1.7 and 2.04 hours in the case and control groups, respectively. There was no statistically significant relationship between analgesic use and gender, age, time to definite diagnosis, or accuracy of the diagnosis. In fact, the time required to achieve a definite diagnosis and the time between admission and surgery were less in the group that had received analgesics. Conclusions: In spite of the fact that analgesics remove the very symptoms that brings patients to the emergency room, appropriate use of analgesics does not reduce diagnostic efficiency for patients with acute abdominal pain.

  12. The abdomen

    International Nuclear Information System (INIS)

    Baumgartner, B.R.

    1987-01-01

    Radiographic evaluation of the abdomen is obtained less often than that of the chest with the postoperative or critically ill patient. Because of the limitations in mobility with these patients, the studies are usually made with a portable radiographic unit and often require considerable assistance from the intensive care unit (ICU) staff. The technologist must use considerable care in obtaining these studies; optimal radiographic technique and careful patient positioning should result in a satisfactory radiograph so that the study will not have to be repeated. If a ''supine abdomen'' film is requested, the technologist will center the film to include the diaphragm; with a ''kidney-ureter-bladder'' film, the pelvis will be included and the diaphragm may not be seen. It is important to have as much clinical information as possible before interpreting any radiographs of the critically ill patient

  13. Techniques, clinical applications and limitations of 3D reconstruction in CT of the abdomen

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    Maher, Michael M.; Kalra, Mannudeep K.; Sahani, Dushyant V.; Perumpillichira, James J.; Rizzo, Stephania; Saini, Sanjay; Mueller, Peter R. [Massachusetts General Hospital and Harvard Medical School, Boston (United States)

    2004-03-15

    Enhanced z-axis coverage with thin overlapping slices in breath-hold acquisitions with multidetector CT (MDCT) has considerably enhanced the quality of multiplanar 3D reconstruction. This pictorial essay describes the improvements in 3D reconstruction and technical aspects of 3D reconstruction and rendering techniques available for abdominal imaging. Clinical applications of 3D imaging in abdomen including liver, pancreaticobiliary system, urinary and gastrointestinal tracts and imaging before and after transplantation are discussed. In addition, this article briefly discusses the disadvantages of this-slice acquisitions including increasing numbers of transverse images, which must be reviewed by the radiologist.

  14. Techniques, clinical applications and limitations of 3D reconstruction in CT of the abdomen

    International Nuclear Information System (INIS)

    Maher, Michael M.; Kalra, Mannudeep K.; Sahani, Dushyant V.; Perumpillichira, James J.; Rizzo, Stephania; Saini, Sanjay; Mueller, Peter R.

    2004-01-01

    Enhanced z-axis coverage with thin overlapping slices in breath-hold acquisitions with multidetector CT (MDCT) has considerably enhanced the quality of multiplanar 3D reconstruction. This pictorial essay describes the improvements in 3D reconstruction and technical aspects of 3D reconstruction and rendering techniques available for abdominal imaging. Clinical applications of 3D imaging in abdomen including liver, pancreaticobiliary system, urinary and gastrointestinal tracts and imaging before and after transplantation are discussed. In addition, this article briefly discusses the disadvantages of this-slice acquisitions including increasing numbers of transverse images, which must be reviewed by the radiologist

  15. Principles of three-dimensional printing and clinical applications within the abdomen and pelvis.

    Science.gov (United States)

    Bastawrous, Sarah; Wake, Nicole; Levin, Dmitry; Ripley, Beth

    2018-04-04

    Improvements in technology and reduction in costs have led to widespread interest in three-dimensional (3D) printing. 3D-printed anatomical models contribute to personalized medicine, surgical planning, and education across medical specialties, and these models are rapidly changing the landscape of clinical practice. A physical object that can be held in one's hands allows for significant advantages over standard two-dimensional (2D) or even 3D computer-based virtual models. Radiologists have the potential to play a significant role as consultants and educators across all specialties by providing 3D-printed models that enhance clinical care. This article reviews the basics of 3D printing, including how models are created from imaging data, clinical applications of 3D printing within the abdomen and pelvis, implications for education and training, limitations, and future directions.

  16. Clinical validation of a dose reduction study in paediatric abdomen MSCT scanning

    International Nuclear Information System (INIS)

    Ciccarone, A.; Fonda, C.; Zatelli, Giovanna; Mazzocchi, S.

    2008-01-01

    Full text: In our previous work an individual dose adaptation in abdomen of paediatric patients has been showed at the Meyer children hospital of Florence. For each kV really feasible in our MSCT scanner, a table of mAs versus abdomen thickness and width ratio has been developed only on the basis of water cylinder phantoms. The choice of the water arise by the fact that in pediatric patient the quantity of water inside the body is major than that of adult. In this way a reduction dose has showed with respect to the ordinary paediatric scanning protocol in use before and the same image quality has been preserved in the case of an optimized CT scanning technique of a standard adult patient of height 175 cm and weight 70 kg. However these results were only theoretical because relied on water phantoms. Now this work concerns the clinical validation of our dose reduction study on phantoms. So 50 examinations were acquired with the dose reduction scanning technique and scored randomly, without knowing weight and height of patient by three radiologists. These scores were compared with that of other 50 abdomen examination before dose reduction study. The scores refers to the noise perceived by radiologist and to the diagnostic quality of radiograph. As last, a score on the low contrast tissue separation between muscle and fat and a score on visibility of structure therein have been asked to the radiologists. The same work has concerned the abdomen examinations with iodine contrast medium. In this study the score of each radiographs has been catalogued in four range of age, 0 - 1; 1 - 3; 3 - 8; 8 - 13 years. Aligned rank and Wilcoxon's signed rank tests were used for statistical analyses. The table of modulating mAs with respect to the size of patient obtained with only water phantom study has been revised so that none reduced detection in low-visibility structures like fat or muscle or liver was evident. Nevertheless a reduction in CTDI of 30 % has been reached in our new

  17. Acute abdomen

    International Nuclear Information System (INIS)

    Beger, H.G.; Kern, E.

    1987-01-01

    The book first presents the anatomy and physiology of the abdomen and continues with chapters discussing clinical and laboratory aspects and a suitable order of diagnostic examinations with reference to the acute processes, explaining the diagnostic tools: ultrasonography, radiography including angiography and CT, tapping techniques and endoscopy together with their basic principles, examination techniques, and diagnosis. One chapter presents a complete survey of the processes involving the entire abdomen - as e.g. peritonitis, ileus, abdominal trauma, intraperitoneal hemorrage. This chapter profoundly discusses the diagnostics and therapies including emergency measures and surgery. Problems requiring consultation among varous specialists, in internal medicine, gynecology, urology, or pediatrics, are discussed in great detail. Information for the anesthetist is given for cases of emergency. More than one third of the book is devoted to organ-specific information, dicussing the pathogenesis, diagnostics, and therapy of the oesophagus, stomach, large and small intestine, bile ducts, pankreas, liver, spleen, and the abdominal vessels and the abdominal wall. (orig.) With 153 figs., 90 tabs [de

  18. Management of the open abdomen: clinical recommendations for the trauma/acute care surgeon and general surgeon.

    Science.gov (United States)

    Fernández, Luis G

    2016-09-01

    Traditionally, the surgical approach to managing abdominal injuries was to assess the extent of trauma, repair any damage and close the abdomen in one definitive procedure rather than leave the abdomen open. With advances in medicine, damage control surgery using temporary abdominal closure methods is being used to manage the open abdomen (OA) when closure is not possible. Although OA management is often observed in traumatic injuries, the extension of damage control surgery concepts, in conjunction with OA, for the management of the septic patient requires that the general surgeon who is faced with these challenges has a comprehensive knowledge of this complex subject. The purpose of this article is to provide guidance to the acute care and general surgeon on the use of OA negative pressure therapy (OA-NPT; ABTHERA™ Open Abdomen Negative Pressure Therapy System, KCI, an ACELITY Company, San Antonio, TX) for OA management. A literature review of published evidence, clinical recommendations on managing the OA and a case study demonstrating OA management using OA-NPT have been included. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  19. Improving the diagnosis of acute appendicitis in children with atypical clinical findings using the technetium-99m hexamethylpropylene amine oxime-labelled white-blood-cell abdomen scan

    International Nuclear Information System (INIS)

    Yan Dahchin; Shiau Yuchien; Wang Jhijoung; Ho Shungtai; Kao Chiahung

    2002-01-01

    Heading AbstractBackground. Diagnosing acute appendicitis in children with equivocal signs and symptoms may be difficult. The usual approach is hospital observation and frequent re-examination. However, many surgeons are reluctant to delay surgery because of the risk of perforation and a negative laparotomy.Objective. To assess and compare the value of the technetium-99m hexamethylpropylene amine oxime ( 99m Tc-HMPAO)-labelled white-blood-cell (WBC) abdomen scan in the diagnosis of acute appendicitis in children with atypical clinical presentation.Patients and methods. Fifty children with acute right lower quadrant abdominal pain and possible acute appendicitis, but atypical findings were included. After IV injection of 99m Tc-HMPAO-labelled WBCs, serial anterior abdomen scans were obtained using a gamma camera.Results. Thirty-three children underwent surgery, while 17 children were managed conservatively and were followed up for at least 1 month. Four children had false-positive results and one child had a false-negative scan result. The overall sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the scan to diagnose acute appendicitis in children with atypical findings was 96.7, 80.0, 90.0, 87.8 and 94.1%, respectively.Conclusions. The 99m Tc-HMPAO WBC abdomen scan is a potential tool for diagnosing acute appendicitis in children with atypical clinical findings. The high sensitivity and negative predictive value allows early discharge from the emergency department to avoid costly observation in hospital and potentially unnecessary surgery in those patients with negative scans. (orig.)

  20. Bilateral ovarian teratoma presenting with a clinical picture of acute abdomen

    Directory of Open Access Journals (Sweden)

    Massimiliano Rocchietti March

    2012-12-01

    Full Text Available We describe the case of a 30-year-old patient with bilateral mature cystic teratoma (MCT of the ovaries. The patient had been complaining of mild abdominal pain for several months that had suddenly become severe. Early diagnosis at the emergency room was acute appendicitis, but definitive diagnosis was bilateral ovarian teratoma. We therefore recommend considering ovarian teratomas in the differential diagnosis of acute abdomen in young women in an emergency care setting.

  1. Plain X-ray diagnosis of the acute abdomen: A surgical handbook with notes on clinical presentation and differential diagnosis

    International Nuclear Information System (INIS)

    Gough, M.H.; Gear, M.W.; Daar, A.S.

    1985-01-01

    Taken in conjunction with a history and clinical examination, the plain X-ray film may provide invaluable help in reaching or confirming a diagnosis in the patient with an acute abdomen. Designed for the casualty officer or trainee surgeon, this clinical handbook is a practical guide to the interpretation of the plain abdominal X-ray. The format of the first edition has been retained, providing typical examples of X-rays of the conditions which present as abdominal emergencies. Each X-ray is accompanied by a legend in four sections: the characteristic radiological signs demonstrated in the film; the differential diagnosis suggested by the X-ray; the presenting signs and symptoms of the condition under discussion; and a list of possible clinical differential diagnoses

  2. [CLINICAL BACKGROUND ANALYSIS ABOUT TRANSURETHRAL ELECTROCOAGULATION].

    Science.gov (United States)

    Katsui, Masahiro; Kikuchi, Eiji; Yazawa, Satoshi; Hagiwara, Masayuki; Morita, Shinya; Shinoda, Kazunobu; Kosaka, Takeo; Mizuno, Ryuichi; Shinojima, Toshiaki; Asanuma, Hiroshi; Miyajima, Akira; Oya, Mototsugu

    2015-10-01

    Transurethral electrocoagulation (TUC) is a rare event but occurs in a constant manner with various causes or disorders and reduces patient quality of life. So far there have been no reports focusing on the details of TUC. We focused on the clinical background and related causes in cases of TUC in our institution. We identified 76 cases (65 patients) who underwent TUC at Keio University Hospital between April 2001 and March 2011. We focused on patient background, especially with respect to the primary disease, treatment modality, use of antiplatelet or anticoagulant agent, timing of TUC, type of electrosurgical device, and the incidence of transfusion. The primary disease for TUC included bladder tumor (BT) in 31 cases, benign prostate hyperplasia (BPH) in 13, prostate cancer (PCa) in 13, idiopathic bladder bleeding in 4, periarteritis nodosa in 3, uterine cervical cancer in 3, and others in 9. TUC after transurethral resection (TUR) was found in 38 cases, including transurethral resection of bladder tumor (TURBT) in 26 of 31 BT cases and transurethral resection of prostate (TURP) in 12 of 13 BPH cases. After TURBT, TUC was performed before removal of a urethral catheter in 7 cases, and after removal of a urethral catheter in 19 cases. With regard to TUC associated with TURP, the average estimated prostate volume in TUC cases before removal of the urethral catheter was 66.2 ml, which was significantly larger than that in TUC cases after removal of the urethral catheter (46.1 ml, p = 0.045). TUC after the radiation therapy was observed in 21 cases, and the average time from the radiation therapy to TUC was 3.4 years (7 months-10 years). TUC was caused by multiple causes or disorders, and 75% of our TUC was associated with BT, BPH or PCa. TUC associated with TURBT frequently occurred within 1 week after TURBT but was still observed after 1 month following the operation. All TUC associated with TURP occurred within 3 weeks after operation. The average period from

  3. Dose reduction with adaptive statistical iterative reconstruction for paediatric CT: phantom study and clinical experience on chest and abdomen CT.

    Science.gov (United States)

    Gay, F; Pavia, Y; Pierrat, N; Lasalle, S; Neuenschwander, S; Brisse, H J

    2014-01-01

    To assess the benefit and limits of iterative reconstruction of paediatric chest and abdominal computed tomography (CT). The study compared adaptive statistical iterative reconstruction (ASIR) with filtered back projection (FBP) on 64-channel MDCT. A phantom study was first performed using variable tube potential, tube current and ASIR settings. The assessed image quality indices were the signal-to-noise ratio (SNR), the noise power spectrum, low contrast detectability (LCD) and spatial resolution. A clinical retrospective study of 26 children (M:F = 14/12, mean age: 4 years, range: 1-9 years) was secondarily performed allowing comparison of 18 chest and 14 abdominal CT pairs, one with a routine CT dose and FBP reconstruction, and the other with 30 % lower dose and 40 % ASIR reconstruction. Two radiologists independently compared the images for overall image quality, noise, sharpness and artefacts, and measured image noise. The phantom study demonstrated a significant increase in SNR without impairment of the LCD or spatial resolution, except for tube current values below 30-50 mA. On clinical images, no significant difference was observed between FBP and reduced dose ASIR images. Iterative reconstruction allows at least 30 % dose reduction in paediatric chest and abdominal CT, without impairment of image quality. • Iterative reconstruction helps lower radiation exposure levels in children undergoing CT. • Adaptive statistical iterative reconstruction (ASIR) significantly increases SNR without impairing spatial resolution. • For abdomen and chest CT, ASIR allows at least a 30 % dose reduction.

  4. Role of ultrasonography in the evaluation of children with acute abdomen in the emergency set-up

    Directory of Open Access Journals (Sweden)

    Aviral

    2005-01-01

    Full Text Available Background: Acute abdomen in children has been aptly described as Pandora′s box. Unlike computerized tomography (CT scan, ultrasonography (USG has no radiation hazard and the present study analyses the diagnostic yield of the USG in acute abdomen in children. Materials and Methods: Between September 2001 to October 2003, 75 patients with acute abdomen underwent clinical examination, routine biochemical tests, erect X-ray abdomen, USG and CT scan. Laparotomy and histological examination established final diagnosis. Results: The accuracy of correct diagnosis was 60%, 66.6%, 64%, 98.7% with clinical examination alone, USG alone, clinical examination combined with conventional radiography, and clinical evaluation combined with conventional radiography and USG respectively. USG helped to prevent unnecessary laparotomy in 16.3% of patients. Conclusions: USG is good investigative modality in the management of acute abdomen in children.

  5. Aromatherapy Massage on the Abdomen for Alleviating Menstrual Pain in High School Girls: A Preliminary Controlled Clinical Study

    Science.gov (United States)

    Hur, Myung-Haeng; Lee, Myeong Soo; Seong, Ka-Yeon; Lee, Mi-Kyoung

    2012-01-01

    This study investigated the alleviating effects of aromatherapy massage and acetaminophen on menstrual pain in Korean high school girls. Subjects were divided into two groups: the aromatherapy massage (treatment) group (n = 32) and the acetaminophen (control) group (n = 23). Aromatherapy massage was performed on subjects in the treatment group. The abdomen was massaged once using clary sage, marjoram, cinnamon, ginger, and geranium in a base of almond oil. The level of menstrual pain was assessed using a visual analogue scale at baseline and twenty-four hours afterward. The reduction of menstrual pain was significantly higher in the aromatherapy group than in the acetaminophen group. Using multiple regression, aromatherapy massage was found to be more highly associated with reduction in the level of menstrual pain than acetaminophen. These finding suggest that aromatherapy massage may be an effective treatment for menstrual pain in high school girls. However, it could not be verified whether the positive effects derived from the aromatherapy, the massage, or both. Further rigorous studies should be conducted using more objective measures. PMID:21949670

  6. The Practice Guidelines for Primary Care of Acute Abdomen 2015.

    Science.gov (United States)

    Mayumi, Toshihiko; Yoshida, Masahiro; Tazuma, Susumu; Furukawa, Akira; Nishii, Osamu; Shigematsu, Kunihiro; Azuhata, Takeo; Itakura, Atsuo; Kamei, Seiji; Kondo, Hiroshi; Maeda, Shigenobu; Mihara, Hiroshi; Mizooka, Masafumi; Nishidate, Toshihiko; Obara, Hideaki; Sato, Norio; Takayama, Yuichi; Tsujikawa, Tomoyuki; Fujii, Tomoyuki; Miyata, Tetsuro; Maruyama, Izumi; Honda, Hiroshi; Hirata, Koichi

    2016-01-01

    Since acute abdomen requires accurate diagnosis and treatment within a particular time limit to prevent mortality, the Japanese Society for Abdominal Emergency Medicine in collaboration with four other medical societies launched the Practice Guidelines for Primary Care of Acute Abdomen that were the first English guidelines in the world for the management of acute abdomen. Here we provide the highlights of these guidelines [all clinical questions (CQs) and recommendations are shown in supplementary information]. A systematic and comprehensive evaluation of the evidence for epidemiology, diagnosis, differential diagnosis, and primary treatment for acute abdomen was performed to develop the Practice Guidelines for Primary Care of Acute Abdomen 2015. Because many types of pathophysiological events underlie acute abdomen, these guidelines cover the primary care of adult patients with nontraumatic acute abdomen. A total of 108 questions based on 9 subject areas were used to compile 113 recommendations. The subject areas included definition, epidemiology, history taking, physical examination, laboratory test, imaging studies, differential diagnosis, initial treatment, and education. Japanese medical circumstances were considered for grading the recommendations to assure useful information. The two-step methods for the initial management of acute abdomen were proposed. Early use of transfusion and analgesia, particularly intravenous acetaminophen, were recommended. The Practice Guidelines for Primary Care of Acute Abdomen 2015 have been prepared as the first evidence-based guidelines for the management of acute abdomen. We hope that these guidelines contribute to clinical practice and improve the primary care and prognosis of patients with acute abdomen.

  7. Clinical evaluation of digital radiography based on a large-area cesium iodide-amorphous silicon flat-panel detector compared with screen-film radiography for skeletal system and abdomen

    International Nuclear Information System (INIS)

    Okamura, Terue; Tanaka, Saori; Koyama, Koichi; Norihumi, Nishida; Daikokuya, Hideo; Matsuoka, Toshiyuki; Yamada, Ryusaku; Kishimoto, Kenji; Hatagawa, Masakatsu; Kudoh, Hiroaki

    2002-01-01

    The aim of this clinical study was to compare the image quality of digital radiography using the new digital Bucky system based on a flat-panel detector with that of a conventional screen-film system for the skeletal structure and the abdomen. Fifty patients were examined using digital radiography with a flat-panel detector and screen-film systems, 25 for the skeletal structures and 25 for the abdomen. Six radiologists judged each paired image acquired under the same exposure parameters concerning three observation items for the bone and six items for the abdomen. Digital radiographic images for the bone were evaluated to be similar to screen-film images at the mean of 42.2%, to be superior at 50.2%, and to be inferior at 7.6%. Digital radiographic images for the abdomen were judged to be similar to screen-film images at the mean of 43.4%, superior at 52.4%, and inferior at 4.2%; thus, digital radiographic images were estimated to be either similar as or superior to screen-film images at over 92% for the bone and abdomen. On the statistical analysis, digital radiographic images were also judged to be preferred significantly in the most items for the bone and abdomen. In conclusion, the image quality of digital radiography with a flat-panel detector was superior to that of a screen-film system under the same exposure parameters, suggesting that dose reduction is possible with digital radiography. (orig.)

  8. Dose reduction with adaptive statistical iterative reconstruction for paediatric CT: phantom study and clinical experience on chest and abdomen CT

    Energy Technology Data Exchange (ETDEWEB)

    Gay, F.; Lasalle, S.; Neuenschwander, S.; Brisse, H.J. [Institut Curie, Imaging Department, Paris (France); Pavia, Y.; Pierrat, N. [Institut Curie, Medical Physics Department, Paris (France)

    2014-01-15

    To assess the benefit and limits of iterative reconstruction of paediatric chest and abdominal computed tomography (CT). The study compared adaptive statistical iterative reconstruction (ASIR) with filtered back projection (FBP) on 64-channel MDCT. A phantom study was first performed using variable tube potential, tube current and ASIR settings. The assessed image quality indices were the signal-to-noise ratio (SNR), the noise power spectrum, low contrast detectability (LCD) and spatial resolution. A clinical retrospective study of 26 children (M:F = 14/12, mean age: 4 years, range: 1-9 years) was secondarily performed allowing comparison of 18 chest and 14 abdominal CT pairs, one with a routine CT dose and FBP reconstruction, and the other with 30 % lower dose and 40 % ASIR reconstruction. Two radiologists independently compared the images for overall image quality, noise, sharpness and artefacts, and measured image noise. The phantom study demonstrated a significant increase in SNR without impairment of the LCD or spatial resolution, except for tube current values below 30-50 mA. On clinical images, no significant difference was observed between FBP and reduced dose ASIR images. Iterative reconstruction allows at least 30 % dose reduction in paediatric chest and abdominal CT, without impairment of image quality. (orig.)

  9. Dose reduction with adaptive statistical iterative reconstruction for paediatric CT: phantom study and clinical experience on chest and abdomen CT

    International Nuclear Information System (INIS)

    Gay, F.; Lasalle, S.; Neuenschwander, S.; Brisse, H.J.; Pavia, Y.; Pierrat, N.

    2014-01-01

    To assess the benefit and limits of iterative reconstruction of paediatric chest and abdominal computed tomography (CT). The study compared adaptive statistical iterative reconstruction (ASIR) with filtered back projection (FBP) on 64-channel MDCT. A phantom study was first performed using variable tube potential, tube current and ASIR settings. The assessed image quality indices were the signal-to-noise ratio (SNR), the noise power spectrum, low contrast detectability (LCD) and spatial resolution. A clinical retrospective study of 26 children (M:F = 14/12, mean age: 4 years, range: 1-9 years) was secondarily performed allowing comparison of 18 chest and 14 abdominal CT pairs, one with a routine CT dose and FBP reconstruction, and the other with 30 % lower dose and 40 % ASIR reconstruction. Two radiologists independently compared the images for overall image quality, noise, sharpness and artefacts, and measured image noise. The phantom study demonstrated a significant increase in SNR without impairment of the LCD or spatial resolution, except for tube current values below 30-50 mA. On clinical images, no significant difference was observed between FBP and reduced dose ASIR images. Iterative reconstruction allows at least 30 % dose reduction in paediatric chest and abdominal CT, without impairment of image quality. (orig.)

  10. Analysis of Clinical and Dosimetric Factors Associated With Change in Renal Function in Patients With Gastrointestinal Malignancies After Chemoradiation to the Abdomen

    International Nuclear Information System (INIS)

    May, Kilian Salerno; Khushalani, Nikhil I.; Chandrasekhar, Rameela; Wilding, Gregory E.; Iyer, Renuka V.; Ma, Wen W.; Flaherty, Leayn; Russo, Richard C. C.; Fakih, Marwan; Kuvshinoff, Boris W.; Gibbs, John F.; Javle, Milind M.; Yang, Gary Y.

    2010-01-01

    Purpose: To analyze clinical and dosimetric factors associated with change in renal function in patients with gastrointestinal malignancies after chemoradiation to the abdomen. Methods and Materials: A retrospective review of 164 patients with gastrointestinal malignancies treated between 2002 and 2007 was conducted to evaluate change in renal function after concurrent chemotherapy and three-dimensional conformal abdominal radiotherapy (RT). Laboratory and biochemical endpoints were determined before RT and after RT at 6-month intervals. Factors assessed included smoking, diabetes, hypertension, blood urea nitrogen, creatinine, creatinine clearance (CrCl), chemotherapy, and dose-volume parameters. Renal toxicity was assessed by decrease in CrCl and scored using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer late radiation morbidity scoring schema. Results: Of 164 patients, 63 had clinical and dosimetric data available. Median follow-up was 17.5 months. Creatinine clearance declined from 98.46 mL/min before RT to 74.20 mL/min one year after chemoradiation (p 10 ), and mean kidney dose were significantly associated with development of Grade ≥2 renal complications at 1 year after chemoradiation (p = 0.0025, 0.0170, and 0.0095, respectively). Conclusions: We observed correlation between pre-RT CrCl, V 10 , and mean kidney dose and decline in CrCl 1 year after chemoradiation. These observations can assist in treatment planning and renal dose constraints in patients receiving chemotherapy and abdominal RT and may help identify patients at increased risk for renal complications.

  11. Analysis of clinical and dosimetric factors associated with change in renal function in patients with gastrointestinal malignancies after chemoradiation to the abdomen.

    Science.gov (United States)

    May, Kilian Salerno; Khushalani, Nikhil I; Chandrasekhar, Rameela; Wilding, Gregory E; Iyer, Renuka V; Ma, Wen W; Flaherty, Leayn; Russo, Richard C; Fakih, Marwan; Kuvshinoff, Boris W; Gibbs, John F; Javle, Milind M; Yang, Gary Y

    2010-03-15

    To analyze clinical and dosimetric factors associated with change in renal function in patients with gastrointestinal malignancies after chemoradiation to the abdomen. A retrospective review of 164 patients with gastrointestinal malignancies treated between 2002 and 2007 was conducted to evaluate change in renal function after concurrent chemotherapy and three-dimensional conformal abdominal radiotherapy (RT). Laboratory and biochemical endpoints were determined before RT and after RT at 6-month intervals. Factors assessed included smoking, diabetes, hypertension, blood urea nitrogen, creatinine, creatinine clearance (CrCl), chemotherapy, and dose-volume parameters. Renal toxicity was assessed by decrease in CrCl and scored using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer late radiation morbidity scoring schema. Of 164 patients, 63 had clinical and dosimetric data available. Median follow-up was 17.5 months. Creatinine clearance declined from 98.46 mL/min before RT to 74.20 mL/min one year after chemoradiation (p kidney dose were significantly associated with development of Grade > or =2 renal complications at 1 year after chemoradiation (p = 0.0025, 0.0170, and 0.0095, respectively). We observed correlation between pre-RT CrCl, V(10), and mean kidney dose and decline in CrCl 1 year after chemoradiation. These observations can assist in treatment planning and renal dose constraints in patients receiving chemotherapy and abdominal RT and may help identify patients at increased risk for renal complications. Published by Elsevier Inc.

  12. Obstructive acute abdomen: reviewing important points

    International Nuclear Information System (INIS)

    Francisco, Marina Celli; Abud, Thiago Giansante; Reibscheid, Samuel; Szejnfeld, Jacob; Lederman, Henrique Manoel; Colleone Neto, Ramiro

    2008-01-01

    The obstructive acute abdomen is a common presentation, for which safe and effective management depends on a fast and accurate diagnosis. Conventional radiograph remains the first choice among the imaging exams because of its availability, low cost and the possibility to be done serially to follow the patient's clinical progression. The ultrasonography does not require ionizing radiation. It is a dynamic and in realtime exam. Computed tomography is used increasingly due to the provision of essential diagnostic information not apparent from radiographs, such as the confirmation of the obstruction, degree and place of the occlusion, presence of ischemia as well as the causes of the obstruction. Magnetic resonance imaging has presented great technological advances and it may play a role in the future of obstructive acute abdomen diagnosis. The objective of this pictorial essay is to review the different imaging techniques used on diagnosing obstructive acute abdomen. (author)

  13. The use of computer tomography of the abdomen in differentiating post-transplant complications in patients with renal grafts using a study of clinical cases

    International Nuclear Information System (INIS)

    Borowiak, H.; Glowacki, J.; Pieta, M.; Sraga, W.; Trzeszkowska-Rotkegel, S.; Jackowska, Z.; Myga-Porosilo, J.; Legaszewski, T.; Skrzelewski, S.; Zywiec, J.

    2006-01-01

    The aim of the study was to describe the diagnostic efficiency of computer tomography in the differentiation of urgent complications after renal transplants. The most common situation which needs to be explained using imaging diagnostics is acute abdominal pain in patients with renal grafts shortly after the operation (within a few weeks) in conditions of emergency. Most of the examinations were performed without contrast enhancement to avoid possible nephrotoxicity of the contrast media following the transplantology rule. The difference in the efficiency of the two methods with or without i.v. infusion contrast is emphasized. Thirty-two CT's of 22 patients with complications after renal transplants were analyzed by comparing their clinical data. The images were compared with regard to size, parenchymal density, and homogeneity of the renal graft. Furthermore, contrast enhancement homogeneity with preservation of the cortical-medullar differentiation, width of the excretory system and the ureter, and presence of circumgraft fluid collection with a designation of its density and periorbital specify (lymphocele, abscess, or hematoma) were also considered. When possible, the lumen of the renal vessels and the state of vessel anastomosis were recorded (CT angiography and some good-quality contrast examination). Also, other pathologies in the examined region were considered as a potential cause of the acute pain (e.g. multiplanar reconstruction was performed to obtain proper images of the lumbal spine). CT of the abdomen explained clinical problems in 21 of the 22 patients (95%). Most examinations showed that the fluid collections were lymphocele, mainly small and without compression of adjoining structures, which are considered normal after transplants. Large fluid collections requiring decompression were found in 6 patients (including 2 hematoma and 1 with abscess). Causes unrelated to renal graft were found in 4 cases. Computer tomography, although it is not included

  14. Practice Guidelines for Primary Care of Acute Abdomen 2015.

    Science.gov (United States)

    Mayumi, Toshihiko; Yoshida, Masahiro; Tazuma, Susumu; Furukawa, Akira; Nishii, Osamu; Shigematsu, Kunihiro; Azuhata, Takeo; Itakura, Atsuo; Kamei, Seiji; Kondo, Hiroshi; Maeda, Shigenobu; Mihara, Hiroshi; Mizooka, Masafumi; Nishidate, Toshihiko; Obara, Hideaki; Sato, Norio; Takayama, Yuichi; Tsujikawa, Tomoyuki; Fujii, Tomoyuki; Miyata, Tetsuro; Maruyama, Izumi; Honda, Hiroshi; Hirata, Koichi

    2016-01-01

    Since acute abdomen requires accurate diagnosis and treatment within a particular time limit to prevent mortality, the Japanese Society for Abdominal Emergency Medicine, in collaboration with four other medical societies, launched the Practice Guidelines for Primary Care of Acute Abdomen that were the first English guidelines in the world for the management of acute abdomen. Here we provide the highlights of these guidelines (all clinical questions and recommendations were shown in supplementary information). A systematic and comprehensive evaluation of the evidence for epidemiology, diagnosis, differential diagnosis, and primary treatment for acute abdomen was performed to develop the Practice Guidelines for Primary Care of Acute Abdomen 2015. Because many types of pathophysiological events underlie acute abdomen, these guidelines cover the primary care of adult patients with nontraumatic acute abdomen. A total of 108 questions based on nine subject areas were used to compile 113 recommendations. The subject areas included definition, epidemiology, history taking, physical examination, laboratory test, imaging studies, differential diagnosis, initial treatment, and education. Japanese medical circumstances were considered for grading the recommendations to assure useful information. The two-step methods for the initial management of acute abdomen were proposed. Early use of transfusion and analgesia, particularly intravenous acetaminophen, were recommended. The Practice Guidelines for Primary Care of Acute Abdomen 2015 have been prepared as the first evidence-based guidelines for the management of acute abdomen. We hope that these guidelines contribute to clinical practice and improve the primary care and prognosis of patients with acute abdomen. © 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  15. [Diagnostic laparoscopy in acute abdomen].

    Science.gov (United States)

    Keller, R; Kleemann, M; Hildebrand, P; Roblick, U J; Bruch, H-P

    2006-11-01

    Acute abdomen is not a disease in itself but a description of a complex of symptoms combined with severe abdominal pain developed within a time frame of less than 24 h. All strategies for the management of acute abdomen underline the need for an interdisciplinary approach to diagnosis and therapy. This requires focused and intelligent use of efficient diagnostic procedures. Diagnostic laparoscopy may be a key to solving the diagnostic dilemma of unspecific acute abdomen. Furthermore, it allows not only direct inspection of the abdominal cavity but also surgical intervention, if needed. In particular the rate of negative laparotomies can be reduced.

  16. Attach importance to intervention therapy of acute abdomen

    International Nuclear Information System (INIS)

    Li Xuan

    2006-01-01

    Acute abdomen means a set of clinical emergency with acute abdominalgia as the primary characteristic symptom of onset, including others as the acute onset, quick symptom changes, severe illness, and oftenly need surgical treatment; therefore, acute abdomen ought to be designated within surgery domain. As interventional therapy is extensively applied in clinical medicine, now a days many victims of acute abdomen, especially those with ambiguous clinical diagnosis requiring an initial invasive examination (angiography, PTC, etc), should be referred to interventional therapy before taking an item of invasive measures. This new concept management has achieved good clinical curative effect and become one of the remarkable achievements in acute abdomen therapeutics. Such predominance finds proper expression in the following two aspects: (1) The evolution of contemporary medical iconography has made it possible to duly and accurately diagnose acute abdomen, and thus created a diagnostic predominance for us-interventionalists; (2) Intervention therapy is featured with its unique minimal invasion and massive effectiveness, and thus provides high leading edge than conventional surgical operation. The authors believe that intervention management ought to become the first-choice for treating the above mentioned acute abdomen. (authors)

  17. Typhoid fever with severe abdominal pain: diagnosis and clinical findings using abdomen ultrasonogram, hematology-cell analysis and the Widal test.

    Science.gov (United States)

    Arjunan, Maripandi; Al-Salamah, Ali A

    2010-10-04

    A six-year-old boy with high-grade fever and abdominal pain in the epigastric region was examined with ultrasonogram of the abdomen. Hematology-cell analysis, serology (Widal test), urine analysis, and blood cultures were also performed. The ultrasonogram was helpful for the identification of multiple organ involvement with Salmonella typhi. The results revealed mild hepatosplenomegaly, minimal ascitis, and mesenteric lympoadenopathy. Hematological analysis showed a white blood count of 6,300 cells mL-1; a red blood cell count of 4.54 million/cu mm. The erythrocyte sedimentation rate (ESR) was 24 mm/1 hr; hemoglobin level of 11.5 g/dl; and a platelet count of 206,000 cells/mL. The patient's serum was agglutinated with lipopolysaccharide (TO), the titre value was 1:320 dilution, and flagellar antigen (TH) titre was 1:640. The patient was diagnosed with typhoid fever. Ceftriaxone was given intravenously for five days and the patient fully recovered.

  18. Clinical and Diagnostic Features of Bronchial Asthma in Children on the Background of Latent Food Allergy

    Directory of Open Access Journals (Sweden)

    V.M. Levytskyi

    2015-09-01

    Full Text Available Based on clinical and paraclinical examination of 112 children with bronchial asthma, there were studied the features of its course against the background of food allergy. It was found that only a set of clinical and paraclinical signs is the most important for the diagnosis of bronchial asthma in children on the background of latent food allergy.

  19. Abdomen X-Ray (Radiography)

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z X-ray (Radiography) - Abdomen Abdominal x-ray uses a very small ... of an abdominal x-ray? What is abdominal x-ray? An x-ray (radiograph) is a noninvasive medical ...

  20. Acute Abdomen in Diabetic Patients – Analysis of Complications and Mortality

    Directory of Open Access Journals (Sweden)

    Dejeu Dănuț

    2014-12-01

    Full Text Available Background and Aims. We aimed to analyze the complications and mortality of acute abdomen cases in diabetic patients compared to non-diabetic patients. Materials and Method. This observational, retrospective, cohort study was conducted between 2008 - 2011, on a total of 4021 cases with acute abdomen admitted to the Surgical Ward I of the Clinical County Emergency Hospital Oradea. Of these, 488 were diabetic patients and 3533 non-diabetics. Results. Women represented the majority in both groups (62.24% respectively 58.40%. Entero-mesenteric infarction and acute pancreatitis were more common in diabetic patients compared to non-diabetics. Peritonitis was more frequent in non-diabetics, with statistically significant difference (p = 0.0003. In diabetic patients the postoperative morbidity was 36.27%, significantly higher than in non-diabetic patients (14.43%. The mortality was significantly higher in diabetic patients than in nondiabetics (9.84% vs. 5.38%. Average length of stay in Surgical Ward I is 3.8 days. For non-diabetic patients, mean hospitalization for acute abdomen was 5.1 days, and for diabetics 7.8 days. Conclusions. This study showed important differences between diabetics and non-diabetic patients in the clinical evolution, complications, mortality and length of hospitalization.

  1. Torsion of a Wandering Spleen Presenting as Acute Abdomen

    International Nuclear Information System (INIS)

    Chauhan, Narvir Singh; Kumar, Satish

    2016-01-01

    Wandering spleen is a rare condition which if uncorrected, can result in torsion and infarction. Clinical presentation of a wandering spleen can vary from asymptomatic abdominal mass to acute abdominal pain. Radiological investigations play a pivotal role in diagnosis as the clinical diagnosis is usually impossible. We present a case of wandering spleen with torsion and complete infarction that occurred in a 32-year-old multiparous female. The diagnosis was established preoperatively on colour Doppler and CT of the abdomen with subsequent confirmation on surgery. Wandering spleen is a rare clinical condition which can present as acute abdomen. An increased awareness of this entity together with the timely use of ultrasound and CT of the abdomen can play an important role in preoperative diagnosis and surgical management

  2. Electrical burns of the abdomen.

    Science.gov (United States)

    Srivastava, Rakesh Kumar; Kumar, Ritesh

    2013-09-01

    A 35-year-old male farmer came in contact with 11,000 volts high tension electric wire and sustained full thickness burn wounds over scapula, upper limb and anterior abdominal wall along with perforation of the intestine. Patient was initially managed conservatively in general surgery ward and was referred to us after 3 days with necrosis of the burned skin and muscles over the shoulder and abdomen. Patient was initially managed conservatively and then thorough debridement of the necrotic skin over the left shoulder and upper arm was done and the area was split skin grafted. Patient developed enterocutaneous fistula, which healed over a period of 8 weeks. The granulating wound over the abdomen was also skin grafted and patient was discharged after 18 days. About 4 months, after the discharge patient presented with ventral hernia. Repair of ventral hernia by synthetic mesh application and reconstruction of the abdominal wall with a free tensor fascia lata flap was done over the mesh, but the flap failed. Then after debridement two random pattern transposition skin flaps, one from the right upper and another from the left lower abdomen were transposed over the abdominal wound and donor area was skin grafted. Patient was discharged after 17 days.

  3. Electrical burns of the abdomen

    Directory of Open Access Journals (Sweden)

    Rakesh Kumar Srivastava

    2013-01-01

    Full Text Available A 35-year-old male farmer came in contact with 11,000 volts high tension electric wire and sustained full thickness burn wounds over scapula, upper limb and anterior abdominal wall along with perforation of the intestine. Patient was initially managed conservatively in general surgery ward and was referred to us after 3 days with necrosis of the burned skin and muscles over the shoulder and abdomen. Patient was initially managed conservatively and then thorough debridement of the necrotic skin over the left shoulder and upper arm was done and the area was split skin grafted. Patient developed enterocutaneous fistula, which healed over a period of 8 weeks. The granulating wound over the abdomen was also skin grafted and patient was discharged after 18 days. About 4 months, after the discharge patient presented with ventral hernia. Repair of ventral hernia by synthetic mesh application and reconstruction of the abdominal wall with a free tensor fascia lata flap was done over the mesh, but the flap failed. Then after debridement two random pattern transposition skin flaps, one from the right upper and another from the left lower abdomen were transposed over the abdominal wound and donor area was skin grafted. Patient was discharged after 17 days.

  4. Surgical Tips in Frozen Abdomen Management: Application of Coliseum Technique.

    Science.gov (United States)

    Kyriazanos, Ioannis D; Manatakis, Dimitrios K; Stamos, Nikolaos; Stoidis, Christos

    2015-01-01

    Wound dehiscence is a serious postoperative complication, with an incidence of 0.5-3% after primary closure of a laparotomy incision, and represents an acute mechanical failure of wound healing. Relatively recently the concept of "intentional open abdomen" was described and both clinical entities share common pathophysiological and clinical pathways ("postoperative open abdominal wall"). Although early reconstruction is the target, a significant proportion of patients will develop adhesions between abdominal viscera and the anterolateral abdominal wall, a condition widely recognized as "frozen abdomen," where delayed wound closure appears as the only realistic alternative. We report our experience with a patient who presented with frozen abdomen after wound dehiscence due to surgical site infection and application of the "Coliseum technique" for its definitive surgical management. This novel technique represents an innovative alternative to abdominal exploration, for cases of "malignant" frozen abdomen due to peritoneal carcinomatosis. Lifting the edges of the surgical wound upwards and suspending them under traction by threads from a retractor positioned above the abdomen facilitates approach to the peritoneal cavity, optimizes exposure of intra-abdominal organs, and prevents operative injury to the innervation and blood supply of abdominal wall musculature, a crucial step for subsequent hernia repair.

  5. Magnetic resonance imaging of the abdomen

    International Nuclear Information System (INIS)

    Kulkarni, M.V.

    1986-01-01

    MRI of the abdomen currently competes with CT and ultrasonography as an imaging technique for abdominal pathology. Although ultrasonography has certain advantages, such as real-time scanning, the major comparison is to be made between MR and CT. CT has slightly superior spatial resolution and minimal motion artifacts, and enables the use of contrast agents in bowel. MR, on the other hand, has improved capabilities in contrasting soft tissues and providing multiplanar imaging. The greatest advantage of CT is the experience that the medical community has gained with it over the last decade. Further development in technology and improvement in the clinical experience with MR will be important in determining its future role in abdominal imaging. Large series of clinical trials are required for further experience. Chemical spectroscopy with proton and possibly other nuclei may improve diagnostic specificity. Paramagnetic contrast agents for bowel specification would certainly improve imaging quality. Thus, MR will play a significant role in abdominal imaging in the future

  6. MRI of the fetal abdomen; MRT des fetalen Abdomens

    Energy Technology Data Exchange (ETDEWEB)

    Hoermann, M.; Brugger, P.C.; Witzani, L.; Prayer, D. [Medizinische Universitaet Wien (Austria). Universitaetsklinik fuer Radiodiagnostik

    2006-02-15

    Magnetic resonance imaging (MRI) is an important diagnostic component for central nervous system and thoracic diseases during fetal development. Although ultrasound remains the method of choice for observing the fetus during pregnancy, fetal MRI is being increasingly used as an additional technique for the accurate diagnosis of abdominal diseases. Recent publications confirm the value of MRI in the diagnosis of fetal gastrointestinal tract and urogenital system diseases. The following report provides an overview of MRI-examination techniques for the most frequent diseases of the abdomen. (orig.) [German] Die MRT ist ein wichtiger Bestandteil zur Diagnostik des zentralen Nervensystems und thorakaler Erkrankungen in der fetalen Entwicklung. Wenngleich der Ultraschall die Methode der Wahl zur Ueberwachung des Feten in der Schwangerschaft bleibt, bekommt die fetale MRT als zusaetzliche Untersuchungstechnik zur akkuraten Diagnostik abdomineller Erkrankungen immer groessere Bedeutung. Die neueren Publikationen bestaetigen v. a. den Stellenwert der MRT in der Diagnose von Erkrankungen des fetalen Gastrointestinaltrakts und des Urogenitalsystems. Im Folgenden soll ein Ueberblick ueber die MR-Untersuchungstechnik der haeufigsten Erkrankungen des Abdomens gegeben werden. (orig.)

  7. MRI of the fetal abdomen

    International Nuclear Information System (INIS)

    Hoermann, M.; Brugger, P.C.; Witzani, L.; Prayer, D.

    2006-01-01

    Magnetic resonance imaging (MRI) is an important diagnostic component for central nervous system and thoracic diseases during fetal development. Although ultrasound remains the method of choice for observing the fetus during pregnancy, fetal MRI is being increasingly used as an additional technique for the accurate diagnosis of abdominal diseases. Recent publications confirm the value of MRI in the diagnosis of fetal gastrointestinal tract and urogenital system diseases. The following report provides an overview of MRI-examination techniques for the most frequent diseases of the abdomen. (orig.) [de

  8. Elephantiasis nostras verrucosa on the legs and abdomen with morbid obesity in an Indian lady.

    Science.gov (United States)

    Sarma, Podila S; Ghorpade, Ashok

    2008-12-15

    Elephantiasis nostras verrucosa (ENV) of the legs and abdomen in a morbidly obese woman with multiple medical problems is reported. The diagnosis was suggested by the classical clinical features and confirmed by histopathology. The patient succumbed due to her multisystem diseases. Elephantiasis nostras verrucosa involving the abdomen is uncommon and has been reported only five times in the past.

  9. Evaluation of image quality and radiation dose using gold nanoparticles and other clinical contrast agents in dual-energy Computed Tomography (CT): CT abdomen phantom

    Science.gov (United States)

    Zukhi, J.; Yusob, D.; Tajuddin, A. A.; Vuanghao, L.; Zainon, R.

    2017-05-01

    The aim of this study was to evaluate the image quality and radiation dose using commercial gold nanoparticles and clinical contrast agents in dual-energy Computed Tomography (CT). Five polymethyl methacrylate (PMMA) tubes were used in this study, where four tubes were filled with different contrast agents (barium, iodine, gadolinium, and gold nanoparticles). The fifth tube was filled with water. Two optically stimulated luminescence dosimeters (OSLD) were placed in each tube to measure the radiation dose. The tubes were placed in a fabricated adult abdominal phantom of 32 cm in diameter using PMMA. The phantom was scanned using a DECT at low energy (80 kV) and high energy (140 kV) with different pitches (0.6 mm and 1.0 mm) and different slice thickness (3.0 mm and 5.0 mm). The tube current was applied automatically using automatic exposure control (AEC) and tube current modulation recommended by the manufacturer (CARE Dose 4D, Siemens, Germany). The contrast-to-noise ratio (CNR) of each contrast agent was analyzed using Weasis software. Gold nanoparticles has highest atomic number (Z = 79) than barium (Z = 56), iodine (Z = 53) and gadolinium (Z = 64). The CNR value of each contrast agent increases when the slice thickness increases. The radiation dose obtained from this study decreases when the pitch increases. The optimal imaging parameters for gold nanoparticles and other clinical contrast agents is obtained at pitch value of 1.0 mm and slice thickness of 5.0 mm. Low noise and low radiation dose obtained at these imaging parameters. The optimal imaging parameters obtained in this study can be applied in multiple contrast agents imaging.

  10. Evaluation of image quality and radiation dose using gold nanoparticles and other clinical contrast agents in dual-energy Computed Tomography (CT): CT abdomen phantom

    International Nuclear Information System (INIS)

    Zukhi, J; Yusob, D; Vuanghao, L; Zainon, R; Tajuddin, A A

    2017-01-01

    The aim of this study was to evaluate the image quality and radiation dose using commercial gold nanoparticles and clinical contrast agents in dual-energy Computed Tomography (CT). Five polymethyl methacrylate (PMMA) tubes were used in this study, where four tubes were filled with different contrast agents (barium, iodine, gadolinium, and gold nanoparticles). The fifth tube was filled with water. Two optically stimulated luminescence dosimeters (OSLD) were placed in each tube to measure the radiation dose. The tubes were placed in a fabricated adult abdominal phantom of 32 cm in diameter using PMMA. The phantom was scanned using a DECT at low energy (80 kV) and high energy (140 kV) with different pitches (0.6 mm and 1.0 mm) and different slice thickness (3.0 mm and 5.0 mm). The tube current was applied automatically using automatic exposure control (AEC) and tube current modulation recommended by the manufacturer (CARE Dose 4D, Siemens, Germany). The contrast-to-noise ratio (CNR) of each contrast agent was analyzed using Weasis software. Gold nanoparticles has highest atomic number (Z = 79) than barium (Z = 56), iodine (Z = 53) and gadolinium (Z = 64). The CNR value of each contrast agent increases when the slice thickness increases. The radiation dose obtained from this study decreases when the pitch increases. The optimal imaging parameters for gold nanoparticles and other clinical contrast agents is obtained at pitch value of 1.0 mm and slice thickness of 5.0 mm. Low noise and low radiation dose obtained at these imaging parameters. The optimal imaging parameters obtained in this study can be applied in multiple contrast agents imaging. (paper)

  11. Laparoscopy in the acute abdomen.

    Science.gov (United States)

    Navez, Benoit; Navez, Julie

    2014-02-01

    Laparoscopy has become a routine procedure in the management of acute abdominal disease and can be considered both an excellent therapeutic and additional diagnostic tool in selected cases. However, a high level of expertise in laparoscopic and emergency surgery is required. Hemodynamic instability, huge abdominal distension, fecal peritonitis and perforated cancer are relative contraindications for the laparoscopic approach. In recent years, abdominal emergencies have increasingly been managed successfully by laparoscopy. In acute appendicitis, acute cholecystitis and perforated peptic ulcer, randomized controlled trials have proven that the laparoscopic approach is as safe and as effective as open surgery, with fewer complications and a quicker postoperative recovery. Other indications such as blunt and penetrating trauma to the abdomen, small bowel occlusion and perforated diverticular disease are under debate, indicating that more randomized controlled trials comparing laparoscopic and open surgery are still necessary. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. A randomised clinical trial of routine versus selective CT imaging in acute abdomen: Impact of patient age on treatment costs and hospital resource use

    Energy Technology Data Exchange (ETDEWEB)

    Lehtimäki, Tiina T., E-mail: tiina.lehtimaki@kuh.fi [Department of Clinical Radiology, Kuopio University Hospital, Puijonlaaksontie 2, FI-70210, Kuopio (Finland); Valtonen, Hannu, E-mail: hannu.valtonen@uef.fi [University of Eastern Finland, Department of Health and Social Management, Yliopistonranta 1, FI-70211 Kuopio (Finland); Miettinen, Pekka, E-mail: pekka.miettinen@satucon.fi [Department of Gastrointestinal Surgery, Kuopio University Hospital, Puijonlaaksontie 2, FI-70210 Kuopio (Finland); Juvonen, Petri, E-mail: petri.juvonen@kuh.fi [Department of Gastrointestinal Surgery, Kuopio University Hospital, Puijonlaaksontie 2, FI-70210 Kuopio (Finland); Paajanen, Hannu, E-mail: hannu.paajanen@kuh.fi [Department of Gastrointestinal Surgery, Kuopio University Hospital, Puijonlaaksontie 2, FI-70210 Kuopio (Finland); University of Eastern Finland, Department of Clinical Medicine, Unit of Surgery, Yliopistonranta 1, FI-70211 Kuopio (Finland); Vanninen, Ritva, E-mail: ritva.vanninen@kuh.fi [Department of Clinical Radiology, Kuopio University Hospital, Puijonlaaksontie 2, FI-70210, Kuopio (Finland); University of Eastern Finland, Department of Clinical Medicine, Unit of Radiology, Yliopistonranta 1, FI-70211 Kuopio (Finland)

    2017-02-15

    Objectives: To evaluate the impact of patient age on hospital resource use and treatment costs of acute abdominal pain (AAP). Materials and methods: A total of 300 adult patients with AAP were randomised to either computed tomography (CT, n = 150) or selective imaging practice (SIP, n = 150) groups. Final analysis included 254 patients, 143 (42 patients ≥65 years) in the CT and 111 (32 patients ≥65 years) in the SIP group. All CT group patients underwent abdominal CT whereas in the SIP group, imaging was based on the clinical assessment. For each patient, the hospital length of stay (LOS), the numbers and costs of diagnostic and treatment procedures arising from AAP were calculated and registered. The incremental cost-effectiveness ratio (ICER) and bootstrapped cost-effectiveness acceptability curve (CEAC) were estimated for routine CT. Results: Treatment costs, imaging costs and LOS increased in conjunction with aging in both study groups, and were generally higher in the CT group compared to the SIP group. In the SIP group, CT was undertaken in 34% (27/79) of the <65 year olds but in 59% (19/32) of the older patients (≥65 years) (p = 0.02). The proportion of patients with non-specific abdominal pain was significantly lower in patients ≥65 years than in their younger counterparts (p = 0.04). In the routine CT group, the ICER of obtaining a specific diagnosis was 1682 € for patients <65 years and 1055 € for patients ≥65 years. According to CEAC estimation, routine CT for every patient with AAP has a 95% probability of being cost-effective if society is willing to pay 14087 € for an additional specific diagnosis for patients <65 years but only 4204 € in those ≥65 years. Conclusion: Treatment costs of AAP increase in parallel with aging, and the costs are generally higher with routine CT compared to selective imaging. The probability of obtaining a specific diagnosis of AAP increases with aging. If obtaining a specific diagnosis is deemed crucial

  13. Surgical evaluation of acute abdomen in pregnancy

    International Nuclear Information System (INIS)

    Kovarova, P.

    2013-01-01

    Acute abdomen in pregnancy is a disease with a low incidence. The purpose of this work was therefore to create a review of current recommended practice in diagnostics and surgical solution. I also mention surgically relevant physiological and pathological changes specific to pregnancy, differential diagnostics of acute abdomen in pregnancy and impact of the disease and its treatment on the fetus. (author)

  14. VALIDITY OF PARACENTESIS IN DIAGNOSING BLUNT TRAUMA ABDOMEN

    Directory of Open Access Journals (Sweden)

    Fahad Bin Abdul Majeed

    2017-03-01

    Full Text Available BACKGROUND Blunt abdominal trauma is a common case that comes to an emergency department and it is the most easily missed diagnosis resulting in catastrophic consequences. Delay in diagnosing a case is due to the nonspecific character of the symptoms with which it presents. Clinical signs that could be elicited in blunt trauma abdomen are equally nonspecific. Thus, to avoid delay and save the life of the patient, a doctor has to depend on various investigations to rule out blunt trauma abdomen. The modalities which help include paracentesis, diagnostic peritoneal lavage, Focused Abdominal Sonography for Trauma (FAST and ContrastEnhanced Computed Tomography (CECT. To choose the right investigation for the right patient helps in saving precious lives. Validity of each investigation, availability, condition of the patient are the main points to look into before deciding on the right investigative modality. Paracentesis is the simplest investigation that could be done in emergency department and also at the site of accident to triage the patient. Paracentesis has low sensitivity to detect blunt trauma. FAST is a better investigation with higher validity rates than paracentesis. This study aims to validate paracentesis, which is the simplest and commonest investigation used to identify blunt abdominal trauma. MATERIALS AND METHODS In this study, 106 patients who fulfilled the inclusion and exclusion criteria were followed up by detailed history, clinical examination, paracentesis and FAST to identify blunt abdominal trauma and then compared with a gold standard investigation, which was assigned as CECT for haemodynamically stable patients and laparotomy for haemodynamically unstable patients. Commonest organs injured in blunt trauma and their management was noted. Patients were followed up till discharge or death. Subsequently, the data were compiled using excel sheet and evaluated using tables and charts. RESULTS Paracentesis is found to have a

  15. How to deal with an open abdomen?

    LENUS (Irish Health Repository)

    De Waele, Jan J

    2015-01-01

    Appropriate open abdomen treatment is one of the key elements in the management of patients who require decompressive laparotomy or in whom the abdomen is left open prophylactically. Apart from fluid control and protection from external injury, fluid evacuation and facilitation of early closure are now the goals of open abdomen treatment. Abdominal negative pressure therapy has emerged as the most appropriate method to reach these goals. Especially when combined with strategies that allow progressive approximation of the fascial edges, high closure rates can be obtained. Intra-abdominal pressure measurement can be used to guide the surgical strategy and continued attention to intra-abdominal hypertension is necessary. This paper reviews recent advances as well as identifying the remaining challenges in patients requiring open abdomen treatment. The new classification system of the open abdomen is an important tool to use when comparing the efficacy of different strategies, as well as different systems of temporary abdominal closure.

  16. [The historical background and present development of evidence-based healthcare and clinical nursing].

    Science.gov (United States)

    Tsai, Jung-Mei

    2014-12-01

    Evidence-based healthcare (EBHC) emphasizes the integration of the best research evidence with patient values, specialist suggestions, and clinical circumstances during the process of clinical decision-making. EBHC is a recognized core competency in modern healthcare. Nursing is a professional discipline of empirical science that thrives in an environment marked by advances in knowledge and technology in medicine as well as in nursing. Clinical nurses must elevate their skills and professional qualifications, provide efficient and quality health services, and promote their proficiency in EBHC. The Institute of Medicine in the United States indicates that evidence-based research results often fail to disseminate efficiently to clinical decision makers. This problem highlights the importance of better promoting the evidence-based healthcare fundamentals and competencies to frontline clinical nurses. This article describes the historical background and present development of evidence-based healthcare from the perspective of modern clinical nursing in light of the importance of evidence-based healthcare in clinical nursing; describes the factors associated with evidence-based healthcare promotion; and suggests strategies and policies that may improve the promotion and application of EBHC in clinical settings. The authors hope that this paper provides a reference for efforts to improve clinical nursing in the realms of EBHC training, promotion, and application.

  17. Acute abdomen. Diagnostic radiology according to principal signs

    International Nuclear Information System (INIS)

    Krestin, G.P.

    1994-01-01

    The acute abdomen is a frequent and very often dangerous syndrome which requires sophisticated diagnostic evaluation. A decisive factor determining the following case history is efficient and exact diagnosis, calling for experienced clinical and diagnostic experts for efficient application of available methods, and correct interpretation of findings. The book offers: 1. Practice-oriented diagnostic strategies, based on 13 principal signs and constellations derived from clinical experience, presented in each chapter as a combination of - suitable differential diagnostic procedures and methods,- exhaustive description of the clinical signs and diagnostic findings specific of the various symptoms,- algorithmic presentations. 2. A special chapter on the pediatric acute abdomen. 3. The most important findings shown in more than 250 original pictures. 4. A graphical design and presentation of the information which permits quick access to the important content. (orig./CB) [de

  18. Clinically speaking: A communication skills program for students from non-English speaking backgrounds.

    Science.gov (United States)

    Miguel, Caroline San; Rogan, Fran; Kilstoff, Kathleen; Brown, Di

    2006-09-01

    This paper reports on the design, delivery and evaluation of an innovative oral communication skills program for first year students in a Bachelor of Nursing degree at an Australian university. This program was introduced in 2004 to meet the needs of first year undergraduate students from non-English speaking backgrounds who had experienced difficulties with spoken English while on clinical placement. The program consisted of early identification of students in need of communication development, a series of classes incorporated into the degree program to address students' needs, followed by a clinical placement block. This paper describes the structure of the program, discusses some of the major problems encountered by students in the clinical setting and presents some of the teaching strategies used to address these problems. Evaluations of the program suggest that students' communication skills and confidence improved, resulting in a more positive clinical experience for the majority of students.

  19. Comparison of two interpolative background subtraction methods using phantom and clinical data

    International Nuclear Information System (INIS)

    Houston, A.S.; Sampson, W.F.D.

    1989-01-01

    Two interpolative background subtraction methods used in scintigraphy are tested using both phantom and clinical data. Cauchy integral subtraction was found to be relatively free of artefacts but required more computing time than bilinear interpolation. Both methods may be used with reasonable confidence for the quantification of relative measurements such as left ventricular ejection fraction and myocardial perfusion index but should be avoided if at all possible in the quantification of absolute measurements such as glomerular filtration rate. (author)

  20. Neuroendocrine tumors of the abdomen; Neuroendokrine Tumoren des Abdomens

    Energy Technology Data Exchange (ETDEWEB)

    Juchems, M. [Klinikum Konstanz, Diagnostische und Interventionelle Radiologie, Konstanz (Germany)

    2018-01-15

    Gastroenteropancreatic neuroendocrine neoplasia (GEP-NEN) are a heterogeneous group of complex tumors, which is often difficult to classify due to heterogeneity and varying locations. Ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and positron-emission tomography computed tomography (PET/CT) are available for the localization of NEN as well as for the staging. In particular, nuclear medical examination methods with somatostatin analogues are of great importance since radioactively labeled receptor ligands make tumors visible with high sensitivity. CT and MRT have high detection rates for GEP-NEN and have been further improved by developments such as diffusion weighted imaging. The nuclear medical methods, however, are superior in detection, especially in gastrointestinal NEN It is important for the radiologist to become acquainted with the NEN as they can occur ubiquitously in the abdomen and should be identified as such. Since GEP-NEN are predominantly hypervascularized, a biphasic examination technique is obligatory for contrast-enhanced cross-sectional imaging. PET/CT with somatostatin analogs should be used for further diagnosis. (orig.) [German] Gastroenteropankreatische neuroendokrine Neoplasien (GEP-NEN) sind eine heterogene Gruppe komplexer Tumoren, deren Einteilung aufgrund der Heterogenitaet und unterschiedlichen Lokalisation haeufig schwerfaellt. Fuer die Lokalisation der NEN sowie zur Ausbreitungsdiagnostik und Metastasensuche stehen Ultraschalldiagnostik, Computertomographie (CT), Magnetresonanztomographie (MRT) und die Positronenemissionstomographie-Computertomographie (PET-CT) zur Verfuegung. Insbesondere nuklearmedizinische Untersuchungsmethoden mit Somatostatinanaloga sind von hoher Wertigkeit, da sie ueber radioaktiv markierte Rezeptoliganden Tumoren mit hoher Sensitivitaet sichtbar machen. CT und MRT haben hohe Detektionsraten bei den GEP-NEN und konnten durch Weiterentwicklungen, wie Diffusionsbildgebung, weiter

  1. Clinical usefulness of the thickness of preperitoneal and subcutaneous fat layer in the abdomen estimated by ultrasonography for diagnosing abdominal obesity in each type of impaired glucose tolerance in man.

    Science.gov (United States)

    Soyama, Akiko; Nishikawa, Tetsuo; Ishizuka, Toshiharu; Ito, Hiroko; Saito, Jun; Yagi, Kazuo; Saito, Yasushi

    2005-04-01

    For this study we enrolled 1,615 males who were admitted to our hospital for a general health check-up. Plasma glucose (PG) and insulin were measured during 75 g OGTT, and abdominal obesity was assessed by ultrasonography in all subjects. We divided them into several groups: normal glucose tolerance (NGT), high-normal glucose tolerance (h-NGT) who showed >10.0 nmol/l at 1 hr PG among those with NGT, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG + IGT, and DM, according to the results of 75 g OGTT. The aim of the present study was to clarify the clinical characteristics of pre-diabetic disorders relating to metabolic syndrome by comparing various parameters including body mass index (BMI), blood levels of various lipids and abdominal wall fat index (AFI) calculated from the thickness of preperitoneal (Pmax) and subcutaneous (Smin) fat layer in the abdomen estimated by ultrasonography with insulin sensitivity determined by homeostatic model assessment (HOMA-IR) in each type of abnormal glucose regulation as classified by PG changes in 75 g OGTT. We also investigated the relationship between insulin secretion capability and insulin sensitivity to delineate the characteristics of each type of abnormal glucose regulation, and compared the area under the insulin curve (AUCins) and the time axis, and the ability of early insulin secretion by glucose loading (insulinogenic index: I.I.) in each type of abnormal glucose regulation. There was a significant positive correlation between HOMA-IR and Smin or Pmax, suggesting that Smin and Pmax may reflect insulin sensitivity. Abdominal obesity, which was diagnosed from the data of AFI, was present in the h-NGT and IFG + IGT groups, suggesting that those groups belong to the clinical entity of metabolic syndrome. HOMA-IR was higher in IFG than in IGT, although I.I. was reduced and AUCins was increased in IFG as well as in IGT. h-NGT demonstrated a slightly lower I.I. and higher AUCins, compared with IGT

  2. Acute abdomen: An unusual presentation of disseminated Penicillium marneffei infection

    Directory of Open Access Journals (Sweden)

    George I

    2008-01-01

    Full Text Available Varied clinical presentations of Penicillium marneffei , an opportunistic pathogen in HIV disease has been rarely described in literature. We report a patient with advanced AIDS who presented to us with prolonged fever and had features of an acute abdomen. On radiologic imaging he had features of intestinal obstruction and mesenteric lymphadenitis. A diagnosis was made possible by endoscopic biopsies of the small bowel and bone marrow culture which grew P . Marneffei . He was treated with intravenous amphotericin for 2 weeks followed by oral itraconazole. This case is reported for its rarity and unusual presentation and to sensitise clinicians and microbiologists to consider this as an aetiology in patients with advanced HIV/AIDS who present with acute abdomen, more so in patients from a distinct geographic region - South-East Asia

  3. Acute abdomen: an unusual presentation of disseminated Penicillium marneffei infection.

    Science.gov (United States)

    George, I A; Sudarsanam, T D; Pulimood, A B; Mathews, M S

    2008-01-01

    Varied clinical presentations of Penicillium marneffei, an opportunistic pathogen in HIV disease has been rarely described in literature. We report a patient with advanced AIDS who presented to us with prolonged fever and had features of an acute abdomen. On radiologic imaging he had features of intestinal obstruction and mesenteric lymphadenitis. A diagnosis was made possible by endoscopic biopsies of the small bowel and bone marrow culture which grew P. Marneffei. He was treated with intravenous amphotericin for 2 weeks followed by oral itraconazole. This case is reported for its rarity and unusual presentation and to sensitise clinicians and microbiologists to consider this as an aetiology in patients with advanced HIV/AIDS who present with acute abdomen, more so in patients from a distinct geographic region--South-East Asia.

  4. MO-B-BRB-01: 3D Dosimetry in the Clinic: Background and Motivation

    International Nuclear Information System (INIS)

    Schreiner, L.

    2016-01-01

    Full three-dimensional (3D) dosimetry using volumetric chemical dosimeters probed by 3D imaging systems has long been a promising technique for the radiation therapy clinic, since it provides a unique methodology for dose measurements in the volume irradiated using complex conformal delivery techniques such as IMRT and VMAT. To date true 3D dosimetry is still not widely practiced in the community; it has been confined to centres of specialized expertise especially for quality assurance or commissioning roles where other dosimetry techniques are difficult to implement. The potential for improved clinical applicability has been advanced considerably in the last decade by the development of improved 3D dosimeters (e.g., radiochromic plastics, radiochromic gel dosimeters and normoxic polymer gel systems) and by improved readout protocols using optical computed tomography or magnetic resonance imaging. In this session, established users of some current 3D chemical dosimeters will briefly review the current status of 3D dosimetry, describe several dosimeters and their appropriate imaging for dose readout, present workflow procedures required for good dosimetry, and analyze some limitations for applications in select settings. We will review the application of 3D dosimetry to various clinical situations describing how 3D approaches can complement other dose delivery validation approaches already available in the clinic. The applications presented will be selected to inform attendees of the unique features provided by full 3D techniques. Learning Objectives: L. John Schreiner: Background and Motivation Understand recent developments enabling clinically practical 3D dosimetry, Appreciate 3D dosimetry workflow and dosimetry procedures, and Observe select examples from the clinic. Sofie Ceberg: Application to dynamic radiotherapy Observe full dosimetry under dynamic radiotherapy during respiratory motion, and Understand how the measurement of high resolution dose data in an

  5. MO-B-BRB-01: 3D Dosimetry in the Clinic: Background and Motivation

    Energy Technology Data Exchange (ETDEWEB)

    Schreiner, L. [Cancer Center of Southeastern Ontario (Canada)

    2016-06-15

    Full three-dimensional (3D) dosimetry using volumetric chemical dosimeters probed by 3D imaging systems has long been a promising technique for the radiation therapy clinic, since it provides a unique methodology for dose measurements in the volume irradiated using complex conformal delivery techniques such as IMRT and VMAT. To date true 3D dosimetry is still not widely practiced in the community; it has been confined to centres of specialized expertise especially for quality assurance or commissioning roles where other dosimetry techniques are difficult to implement. The potential for improved clinical applicability has been advanced considerably in the last decade by the development of improved 3D dosimeters (e.g., radiochromic plastics, radiochromic gel dosimeters and normoxic polymer gel systems) and by improved readout protocols using optical computed tomography or magnetic resonance imaging. In this session, established users of some current 3D chemical dosimeters will briefly review the current status of 3D dosimetry, describe several dosimeters and their appropriate imaging for dose readout, present workflow procedures required for good dosimetry, and analyze some limitations for applications in select settings. We will review the application of 3D dosimetry to various clinical situations describing how 3D approaches can complement other dose delivery validation approaches already available in the clinic. The applications presented will be selected to inform attendees of the unique features provided by full 3D techniques. Learning Objectives: L. John Schreiner: Background and Motivation Understand recent developments enabling clinically practical 3D dosimetry, Appreciate 3D dosimetry workflow and dosimetry procedures, and Observe select examples from the clinic. Sofie Ceberg: Application to dynamic radiotherapy Observe full dosimetry under dynamic radiotherapy during respiratory motion, and Understand how the measurement of high resolution dose data in an

  6. Dengue Haemorrhagic Fever presenting as Acute Abdomen

    OpenAIRE

    Al-Araimi, Hanaa; Al-Jabri, Amal; Mehmoud, Arshad; Al-Abri, Seif

    2011-01-01

    We describe a case of a 38 year-old Sri Lankan female who was referred to the surgeon on call with a picture of acute abdomen. She presented with a three-day history of fever, headache, abdominal pain and diarrhoea; however, the physical examination was not consistent with acute abdomen. Her platelet count was 22 ×109/L. A diagnosis of dengue haemorrhagic fever (DHF) was made and dengue serology was positive. Dengue epidemics have been associated with a variety of gastrointestinal symptoms an...

  7. Differential diagnosis of the acute abdomen. Pt. 4. Acute abdomen in children; Differenzialdiagnose des akuten Abdomens. T. 4. Akutes Abdomen im Kindesalter

    Energy Technology Data Exchange (ETDEWEB)

    Staatz, Gundula [Universitaetsklinikum Mainz (Germany). Sektion Kinderradiologie; Schneider, Karl [Klinikum der Univ. Muenchen (Germany). Abt. Radiologie

    2010-06-15

    The diagnostic work-up of adults with acute abdominal pain has changed significantly within the last decade and computed tomography is often used as the first imaging modality of choice. In pediatric patients with an acute abdomen, ultrasound and abdominal X-rays remain the first line procedures. Because of the radiation risk, computed tomography is only recommended in selected cases and when strongly indicated. This review is the fourth and final part within a series of reviews dealing with the diagnostic strategy in the work-up of patients with an acute abdomen. (orig.)

  8. Diffusion weighted imaging (DWI) in the abdomen

    International Nuclear Information System (INIS)

    Collaku, A.

    2013-01-01

    Full text: Introduction: The use of diffusion weighted images when performing abdomen MRI has been increased during the last years; achieving high quality images for a short period of time remains still a challenge. Learning points: We present a literature review together with our experience in optimizing the DW imaging in the abdomen, focused on creating high density ADC maps and handling the uncooperative patients. Discussion: The factors that influence the image quality are discussed as well. Conclusion: The factors that influence the image quality are discussed as well

  9. Intestinal tuberculosis presenting as acute abdomen

    International Nuclear Information System (INIS)

    Khan, M.A.; Majeed, F.A.; Ahmed, M.; Khan, M.N.

    2012-01-01

    Objectives: To study the outcome of intestinal tuberculosis presenting as acute abdomen. Study design: Descriptive Study. Place and Duration: Bolan Medical Complex Hospital (BMC) Quetta and Combined Military Hospital (CMH) Quetta from Nov 2003 to Nov 2005 from Bolan Medical Complex and from Nov 2005 to Nov 2006 in CMH Quetta. Material and Method: Thirty seven patients of acute abdomen presenting with intestinal obstruction were admitted; 28 from emergency department and 9 from out patient department. Twenty seven patients were from BMC and 10 from CMH Quetta. Patients were diagnosed as having abdominal tuberculosis on the basis of operative findings and histopathological reports. Results: Out of 37 patients presenting with acute abdomen due to intestinal obstruction, 54% were male and 46% were female with M: F ratio of 1: 1.2. Age of the patient ranged from 20 to 50 years, with maximum frequency between 30 to 40 years. Abdominal pain was the commonest presenting feature in all patients followed by constipation in 81.1% patients. Peritonism was seen in 27% patients. Different operative procedures performed were adhesionolysis 65.8%, segmental resection 7.9%, right hemicolectomy 10.5%, stricturoplasty 7.9% and ileostomy 1.3%. Mesenteric lymph node biopsy 40.8%. Conclusion: Intestinal tuberculosis is still a very important surgical problem in our country presenting as acute abdomen. A suspicion must always be kept during laparotomy and adequate tissue histopathology should supplement the diagnosis. (author)

  10. Emergency management of acute abdomen in children.

    Science.gov (United States)

    Balachandran, Binesh; Singhi, Sunit; Lal, Sadhna

    2013-03-01

    Acute abdomen can be defined as a medical emergency in which there is sudden and severe pain in abdomen with accompanying signs and symptoms that focus on an abdominal involvement. It accounts for about 8 % of all children attending the emergency department. The goal of emergency management is to identify and treat any life-threatening medical or surgical disease condition and relief from pain. In mild cases often the cause is gastritis or gastroenteritis, colic, constipation, pharyngo-tonsilitis, viral syndromes or acute febrile illnesses. The common surgical causes are malrotation and Volvulus (in early infancy), intussusception, acute appendicitis, and typhoid and ischemic enteritis with perforation. Lower lobe pneumonia, diabetic ketoacidosis and acute porphyria should be considered in patients with moderate-severe pain with little localizing findings in abdomen. The approach to management in ED should include, in order of priority, a rapid cardiopulmonary assessment to ensure hemodynamic stability, focused history and examination, surgical consult and radiologic examination to exclude life threatening surgical conditions, pain relief and specific diagnosis. In a sick patient the initial steps include rapid IV access and normal saline 20 ml/kg (in the presence of shock/hypovolemia), adequate analgesia, nothing per oral/IV fluids, Ryle's tube aspiration and surgical consultation. An ultrasound abdomen is the first investigation in almost all cases with moderate and severe pain with localizing abdominal findings. In patients with significant abdominal trauma or features of pancreatitis, a Contrast enhanced computerized tomography (CECT) abdomen will be a better initial modality. Continuous monitoring and repeated physical examinations should be done in all cases. Specific management varies according to the specific etiology.

  11. Malignant schwannoma of the abdomen

    International Nuclear Information System (INIS)

    Kraemer, S.C.; Kolokythas, O.; Aschoff, A.J.; Merkle, E.

    1996-01-01

    A 63 year-old female patient presented herself because of abdominal distension, without being able to report specific complaints. Clinical examination found a well palpable, elastic and engorged abdominal tumour approximately of the size of a football. Conventional imaging of the small intestine according to Sellink with subsequent delayed film revealed in the first instance a displacement of intestinal loops and of the colon frame, with no signs of an onstruction. A similar diagnosis resulted from intraarterial angiography of the abdominal vessels, showing a displacement of the truncus coeliacus, and the A. mesenterica superior. There were no signs of vascular occlusions or pathologic tumour vessels. Surgery revealed a tumour of about 10 kg, with pathologic vascular connection and a broad area of contact to neighbouring intestinal loops. Control CT performed one year after surgery revealed newly developed, multiple, nodular formations, their structure and contrast signs being similar to those of the primary tumour. (orig./VHE) [de

  12. MR venography of the abdomen

    International Nuclear Information System (INIS)

    Alfke, H.; Ishaque, N.; Froelich, J.J.; Klose, K.J.

    1998-01-01

    Purpose: To evaluate the image quality of magnetic resonance venography (MRV) of pelvic and abdominal veins. Methods: A retrospective analysis of all MRV between 1993 and 1996 was conducted. A 2D-FLASH-TOF without breath hold and with arterial presaturation was used. All venous segments have been assessed for the quality of visualisation and an overall image quality was determined. 43% of our patients h[ malignant disease and phlebothrombosis h[ alre[y been diagnosed in 64%. Results: 126 examinations and 1696 venous segments were analysed. The overall quality of the examinations was good, however one examination was non diagnostic because of motion artefacts. Vessels along the vertical axis were good visualised in over 90%. Most important reasons for insufficient visualisation were breathing, motion and metal artefacts as well as compression and displacement of veins due to tumour disease. Conclusions: Magnetic resonance venography without breath hold TOF-technique is practical and robust for routine clinical applications. (orig.) [de

  13. Guillain-Barre Syndrome Presenting as Acute Abdomen

    Directory of Open Access Journals (Sweden)

    Faruk incecik

    2015-09-01

    Full Text Available Guillain-Barr and eacute; syndrome (GBS is the most common cause of acute flaccid paralysis in childhood. Symmetric weakness, headache, respiratory symptom, neuropathic pain, muscle pain, paresthesia, and facial palsy were the most common clinical presentations. We report 13-year-old boy with GBS who presented with acute abdominal pain. This is the first report, to our knowledge, first presented of acute abdomen of a pediatric patient with GBS. [Cukurova Med J 2015; 40(3.000: 601-603

  14. MELAS syndrome presenting as an acute surgical abdomen.

    Science.gov (United States)

    Dindyal, S; Mistry, K; Angamuthu, N; Smith, G; Hilton, D; Arumugam, P; Mathew, J

    2014-01-01

    MELAS (mitochondrial cytopathy, encephalomyopathy, lactic acidosis and stroke-like episodes) is a syndrome in which signs and symptoms of gastrointestinal disease are uncommon if not rare. We describe the case of a young woman who presented as an acute surgical emergency, diagnosed as toxic megacolon necessitating an emergency total colectomy. MELAS syndrome was suspected postoperatively owing to persistent lactic acidosis and neurological symptoms. The diagnosis was later confirmed with histological and genetic studies. This case highlights the difficulties in diagnosing MELAS because of its unpredictable presentation and clinical course. We therefore recommend a high index of suspicion in cases of an acute surgical abdomen with additional neurological features or raised lactate.

  15. Children with language problems in a speech and hearing clinic : Background variables and extent of language problems

    NARCIS (Netherlands)

    Keegstra, A.L.; Knijff, W.A.; Post, W.J.; Goorhuis-Brouwer, S.M.

    Objective: Analysis of a clinical population referred for language analysis in terms of background variables and extent of language problems. Design: Descriptive study. Materials and methods: Children referred to a speech and hearing clinic because of assumed language problems were analyzed with

  16. Mechanistic background and clinical applications of indocyanine green fluorescence imaging of hepatocellular carcinoma.

    Science.gov (United States)

    Ishizawa, Takeaki; Masuda, Koichi; Urano, Yasuteru; Kawaguchi, Yoshikuni; Satou, Shouichi; Kaneko, Junichi; Hasegawa, Kiyoshi; Shibahara, Junji; Fukayama, Masashi; Tsuji, Shingo; Midorikawa, Yutaka; Aburatani, Hiroyuki; Kokudo, Norihiro

    2014-02-01

    Although clinical applications of intraoperative fluorescence imaging of liver cancer using indocyanine green (ICG) have begun, the mechanistic background of ICG accumulation in the cancerous tissues remains unclear. In 170 patients with hepatocellular carcinoma cells (HCC), the liver surfaces and resected specimens were intraoperatively examined by using a near-infrared fluorescence imaging system after preoperative administration of ICG (0.5 mg/kg i.v.). Microscopic examinations, gene expression profile analysis, and immunohistochemical staining were performed for HCCs, which showed ICG fluorescence in the cancerous tissues (cancerous-type fluorescence), and HCCs showed fluorescence only in the surrounding non-cancerous liver parenchyma (rim-type fluorescence). ICG fluorescence imaging enabled identification of 273 of 276 (99%) HCCs in the resected specimens. HCCs showed that cancerous-type fluorescence was associated with higher cancer cell differentiation as compared with rim-type HCCs (P Fluorescence microscopy identified the presence of ICG in the canalicular side of the cancer cell cytoplasm, and pseudoglands of the HCCs showed a cancerous-type fluorescence pattern. The ratio of the gene and protein expression levels in the cancerous to non-cancerous tissues for Na(+)/taurocholate cotransporting polypeptide (NTCP) and organic anion-transporting polypeptide 8 (OATP8), which are associated with portal uptake of ICG by hepatocytes that tended to be higher in the HCCs that showed cancerous-type fluorescence than in those that showed rim-type fluorescence. Preserved portal uptake of ICG in differentiated HCC cells by NTCP and OATP8 with concomitant biliary excretion disorders causes accumulation of ICG in the cancerous tissues after preoperative intravenous administration. This enables highly sensitive identification of HCC by intraoperative ICG fluorescence imaging.

  17. 49 CFR 572.19 - Lumbar spine, abdomen and pelvis.

    Science.gov (United States)

    2010-10-01

    ...-Year-Old Child § 572.19 Lumbar spine, abdomen and pelvis. (a) The lumbar spine, abdomen, and pelvis... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine, abdomen and pelvis. 572.19 Section..., the lumbar spine assembly shall flex by an amount that permits the rigid thoracic spine to rotate from...

  18. CT arteriography of the upper abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Hasuo, K; Matsuura, K; Baba, H; Numaguchi, Y; Komaki, S [Kyushu Univ., Fukuoka (Japan). Faculty of Medicine

    1980-04-01

    The technique of CT arteriography was introduced, and CT images of the upper abdomen were explained. Very clear enhancement of parenchyma and vessels (especially portal vein) of the object organs could be obtained by CT arteriography of the upper abdomen, anatomical structures of organs were identified more easily by CT arteriography than by conventional CT, and the amount of information obtained was increased by using CT arteriography. However, the indication of CT arteriography must be limited, because of its complexity that CT arteriography is performed after angiography and involves the invasion of patients' bodies. As described in many reports, CT arteriography is useful for malignant tumors of the liver, and it is worthwhile, especially when surgery for hepatocellular carcinoma is considered. CT arteriography for organs except the liver has not been discussed sufficiently. Therefore, an application of this method for other organs must be decided after consideration of the balance of the amount of information obtained by CT arteriography with invasion to patients.

  19. A RETROSPECTIVE STUDY ON BLUNT INJURY ABDOMEN

    OpenAIRE

    Kopperundevi; Jagadeesan; Kiruthiga

    2016-01-01

    Blunt injury abdomen is the leading cause of morbidity and mortality in all age groups. Blunt trauma differs from penetrating trauma as different organs are characteristically injured by compression from blunt straining. A total of 53 cases of blunt trauma were studied in this study for the period of 1 year. In this study, commonest cause for blunt abdominal trauma was road traffic accident. The maximum incidence was noted in 20-40 middle age group of which 90% male patients were ...

  20. Damage control surgery by keeping the abdomen open during pregnancy: favorable outcome, a case report

    Directory of Open Access Journals (Sweden)

    Marty François

    2009-09-01

    Full Text Available Abstract Background Acute abdomen in advanced pregnancy is one of the most challenging surgical situations. In life-threatening situations, despite optimal management, foetus distress and preterm delivery may occur. Although laparostomy is a useful treatment of abdominal sepsis, its successful management has not been reported previously in pregnant women. Case 30-year-old woman at 23 week of pregnancy was investigated for non-specific abdominal pain. Surgical exploration revealed extensive ischemic bowel necrosis. Multiple segmental resections were performed and abdomen was left open with vacuum assisted dressing, maintained for 48 hours. At the third surgical look the continuity was restored and abdominal wall closed. The foetal condition stayed unperturbed under pharmacologic tocolysis. Pregnancy was carried to full term delivery. Conclusion Open abdomen strategy can be successfully applied in pregnant woman.

  1. Gross anatomy of superficial fascia and future localised fat deposit areas of the abdomen in foetus

    Directory of Open Access Journals (Sweden)

    Pramod Kumar

    2013-01-01

    Full Text Available Background: The development and popularity of body contouring procedures such as liposuction and abdominoplasty has renewed interest in the anatomy of the superficial fascia and subcutaneous fat deposits of the abdomen. The study of anatomy of fascia and fetal adipose tissue was proposed as it may be of value in understanding the possible programing of prevention of obesity. Objectives: The present study was undertaken to understand the gross anatomy of superficial fascia of abdomen and to study the gross anatomy of future localized fat deposits (LFDs area of abdomen in fetus. Materials and Methods: Four fetus (two male & two female of four month of intrauterine life were dissected. Attachments & layers of superficial fascia and future subcutaneous fat deposit area of upper and lower abdomen were noted. Results: Superficial fascia of the abdomen was multi layered in mid line and number of layers reduced laterally as in adult. The future abdominal LFD (localized fat deposits area in fetus shows brownish-white blubbary tissue without well-defined adult fat lobules. Conclusion: The attachment and gross anatomy of superficial fascia of the fetus was similar to that in adults. The future LFD areas showed brownish white blubbary tissue with ill-defined fat lobules.

  2. Acute abdomen due to primary omental torsion: case report.

    Science.gov (United States)

    Tsironis, Apostolos; Zikos, Nikolaos; Bali, Christina; Pappas-Gogos, George; Koulas, Spiridon; Katsamakis, Nikolaos

    2013-01-01

    Primary torsion of the greater omentum is an uncommon cause of acute abdominal pain that mainly affects adults in their fourth or fifth decade. It was first described by Eitel in 1899. Since then, more than 300 cases have been reported in the published literature. Clinical presentation and imaging findings are often of limited value in the diagnosis of primary omental torsion (POT). The patients usually undergo laparotomy for "acute appendicitis" or acute abdomen of poorly defined origin. To provide a detailed description of this rare cause of acute abdomen. We report a case of POT in a woman of reproductive age and discuss contemporary methods in diagnosis and management of the condition. Nowadays, laparoscopy is a safe and effective approach for the diagnosis and management of POT, with the advantages of reduced postoperative pain and hospital stay. Conservative management has also been advocated by some authors in selected patients with a preoperative diagnosis of POT based on computed tomography findings. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Background Complex angiographic lesions and clinic presentation in unstable angina. A prospective study

    International Nuclear Information System (INIS)

    LLuberas, R.; Mallo, D.; Pouso, J.; Artucio, C.; Korytnicki; Argon, L.; Besada, E.; Tavella, N.

    2002-01-01

    Background Complex angiography lesions and intracoronary thrombus have been identified in unstable angina.Braunwalds categorization has been accepted in the last years.Identifying severe clinical classes class III (angina at rest during the last 48 hours), class C (angina postinfarction) and class c (angina with maximum therapeutic). The main objective of this study was to determine independent associations of Braunwalds classes III, C and c: complex lesions, intracoronary thrombus, total occlusion and distal flux TIMI<3 of the responsible vessel. The secondary objectives were to analyze the angiographic features of the lesion and the responsible vessel. Aprospective study of 300 patients with diagnosed unstable angina, clustered according to Braunwalds clinis classification was done. The angiographic evaluation was performed identifying the responsible lesion and the presence of the complex lesion, intracoronary thrombus, total occlusion and distal flux TIMI<3 of the responsible vessel. A univariate analysis and a multivariate model of binary logistic regression were used. In the 300 patient population, 22 patients with normal coronaries(7.3%) were identified. The responsible lesion was identified in 243 out of the remaining 278 patients (87,4%). Class III was significantly associated with the complex lesion (OR=2.74, IC95%=1,27-5,9) and intracoronary thrombus (OR=2,82 IC95=1,2-6,6). Class C was significantly associated with intracoronary thrombus (OR=3.9),IC95%=1.53-10,0).Class III was and independent predictor for the presence of the complex lesion(OR=1.98, IC 95%=1,01-3,87) and intracoronary thrombus (OR=2,47 IC95%=1,14-5,37). Class C was and independent predictor for the complex lesion (OR=5,05,IC95%=2.25-11,3), infracoronary thrombus (OR=8,04, IC 95%=3,49-18,0), total occlusion (OR=6,49, IC95%=2,67-15,7) and distal flux TIMI<3(OR=3,96,IC 95%=1,87-8,4) There was no significant association between classes III, C and c and the responsible vessel, localization of

  4. Differential diagnosis of the acute abdomen. Pt. 4. Acute abdomen in children

    International Nuclear Information System (INIS)

    Staatz, Gundula; Schneider, Karl

    2010-01-01

    The diagnostic work-up of adults with acute abdominal pain has changed significantly within the last decade and computed tomography is often used as the first imaging modality of choice. In pediatric patients with an acute abdomen, ultrasound and abdominal X-rays remain the first line procedures. Because of the radiation risk, computed tomography is only recommended in selected cases and when strongly indicated. This review is the fourth and final part within a series of reviews dealing with the diagnostic strategy in the work-up of patients with an acute abdomen. (orig.)

  5. Abdominal compartment syndrome and open abdomen management with negative pressure devices.

    Science.gov (United States)

    Surace, Alessandra; Ferrarese, Alessia; Marola, Silvia; Cumbo, Jacopo; Valentina, Gentile; Borello, Alessandro; Solej, Mario; Martino, Valter; Nano, Mario

    2015-01-01

    Abdominal compartment syndrome (ACS) is defined as an increase of intra-abdominal pressure (IAH) to values higher than 20 mmHg, associated with reduced perfusion and organ dysfunction. There is a classification of open abdomen which stratifies patients according to the natural history of improvement or clinical deterioration. The aim of treatment is to maintain the open abdomen at the lowest level and to prevent progression to a more complex level. Surgical treatment essentially consists in abdominal decompression by leaving the abdomen open. Analysis of the literature shows that negative pressure increases the rate of primary fascial closure; entero-cutaneous fistulas are seen in a minority of cases, without seeming consequence of the application of the dressing. Open abdomen management consists of three treatment stages: acute (24-48 hours), intermediate (from 48 hours to 10 days) and late or reconstruction (from 10 days to the final closure). It's important to recognize patients at risk of IAH and the first signs of ACS and intervene early with abdominal decompression if this will establish itself. Management of the open abdomen is now facilitated by negative pressure devices, which positively affect the morbidity and mortality of patients with ACS.

  6. Pharmacokinetics of a new subcutaneous diclofenac formulation administered to three body sites: quadriceps, gluteus, and abdomen.

    Science.gov (United States)

    Salomone, Salvatore; Piazza, Cateno; Vitale, Daniela Cristina; Cardì, Francesco; Gugliotta, Barbara; Drago, Filippo

    2014-02-01

    To assess the relative bioavailability of a new subcutaneous (SC) diclofenac hydroxypropyl b-cyclodextrin (HPbCD) formulation administered to three body sites: quadriceps, gluteus, and abdomen. This was a pilot, single-dose, randomized, three-way crossover relative bioavailability study. A total of 12 healthy subjects received a single SC injection of diclofenac HPbCD 50 mg/1 mL in the quadriceps, gluteus, or abdomen. The AUC was comparable after SC diclofenac HPbCD in the quadriceps, gluteus, and abdomen. The Cmax was comparable after SC administration in the quadriceps or abdomen, and ~ 17% higher in the gluteus. The absorption was rapid (30 minutes) after administration of the treatment at any site. The treatment was well tolerated. The relative bioavailability of SC diclofenac HPbCD was comparable when administered to the quadriceps, gluteus, and abdomen. The new diclofenac formulation can therefore be administered subcutaneously to any of these sites without clinically significant differences. A further adequately powered study would be necessary to reveal any differences among injection sites in terms of peak plasma concentration.

  7. Obstructive acute abdomen: reviewing important points; Abdome agudo obstrutivo: revisando pontos fundamentais

    Energy Technology Data Exchange (ETDEWEB)

    Francisco, Marina Celli; Abud, Thiago Giansante; Reibscheid, Samuel; Szejnfeld, Jacob; Lederman, Henrique Manoel [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: nana_celli@hotmail.com; Neves, Felipe Trentin [Hospital Ipiranga, Sao Paulo, SP (Brazil); Colleone Neto, Ramiro [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil)

    2008-07-01

    The obstructive acute abdomen is a common presentation, for which safe and effective management depends on a fast and accurate diagnosis. Conventional radiograph remains the first choice among the imaging exams because of its availability, low cost and the possibility to be done serially to follow the patient's clinical progression. The ultrasonography does not require ionizing radiation. It is a dynamic and in realtime exam. Computed tomography is used increasingly due to the provision of essential diagnostic information not apparent from radiographs, such as the confirmation of the obstruction, degree and place of the occlusion, presence of ischemia as well as the causes of the obstruction. Magnetic resonance imaging has presented great technological advances and it may play a role in the future of obstructive acute abdomen diagnosis. The objective of this pictorial essay is to review the different imaging techniques used on diagnosing obstructive acute abdomen. (author)

  8. Improving abdomen tumor low-dose CT images using a fast dictionary learning based processing

    International Nuclear Information System (INIS)

    Chen Yang; Shi Luyao; Shu Huazhong; Luo Limin; Coatrieux, Jean-Louis; Yin Xindao; Toumoulin, Christine

    2013-01-01

    In abdomen computed tomography (CT), repeated radiation exposures are often inevitable for cancer patients who receive surgery or radiotherapy guided by CT images. Low-dose scans should thus be considered in order to avoid the harm of accumulative x-ray radiation. This work is aimed at improving abdomen tumor CT images from low-dose scans by using a fast dictionary learning (DL) based processing. Stemming from sparse representation theory, the proposed patch-based DL approach allows effective suppression of both mottled noise and streak artifacts. The experiments carried out on clinical data show that the proposed method brings encouraging improvements in abdomen low-dose CT images with tumors. (paper)

  9. Update on the management of non-obstetric acute abdomen in pregnant patients.

    Science.gov (United States)

    Barber-Millet, Sebastián; Bueno Lledó, José; Granero Castro, Pablo; Gómez Gavara, Immaculada; Ballester Pla, Neus; García Domínguez, Rafael

    2016-05-01

    Acute abdomen is a rare entity in the pregnant patient, with an incidence of one in 500-635 patients. Its appearance requires a quick response and an early diagnosis to treat the underlying disease and prevent maternal and fetal morbidity. Imaging tests are essential, due to clinical and laboratory masking in this subgroup. Appendicitis and complicated biliary pathology are the most frequent causes of non-obstetric acute abdomen in the pregnant patient. The decision to operate, the timing, and the surgical approach are essential for a correct management of this pathology. The aim of this paper is to perform a review and update on the diagnosis and treatment of non-obstetric acute abdomen in pregnancy. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 1, Pathological Background and Clinical Implications

    International Nuclear Information System (INIS)

    Sun, Fei; Crisóstomo, Verónica; Báez-Díaz, Claudia; Sánchez, Francisco M.

    2016-01-01

    Pathological features of benign prostatic hyperplasia (BPH) dictate various responses to prostatic artery embolization (PAE). Typically, BPH originates in the transition zone and periurethral region, where should be considered the primary target area in PAE procedures. Given that histological heterogeneity of components in hyperplasia nodules, epithelial or stromal, identifying the more responsive nodules to PAE will have clinical implications. Since some lower urinary tract symptoms (LUTS) in patients with BPH are usually related to bladder outlet obstruction-induced changes in bladder function rather than to outflow obstruction directly, proper selection of candidate patients prior to PAE is of great clinical importance. BPH is a typical chronic progressive condition, suggesting PAE could aim not only to relieve LUTS but also to delay or prevent the clinical progression. Awareness of the pathological background of BPH is essential for interventional radiologists to improve clinical outcomes and develop new treatment strategies in clinical practice of PAE

  11. Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 1, Pathological Background and Clinical Implications.

    Science.gov (United States)

    Sun, Fei; Crisóstomo, Verónica; Báez-Díaz, Claudia; Sánchez, Francisco M

    2016-01-01

    Pathological features of benign prostatic hyperplasia (BPH) dictate various responses to prostatic artery embolization (PAE). Typically, BPH originates in the transition zone and periurethral region, where should be considered the primary target area in PAE procedures. Given that histological heterogeneity of components in hyperplasia nodules, epithelial or stromal, identifying the more responsive nodules to PAE will have clinical implications. Since some lower urinary tract symptoms (LUTS) in patients with BPH are usually related to bladder outlet obstruction-induced changes in bladder function rather than to outflow obstruction directly, proper selection of candidate patients prior to PAE is of great clinical importance. BPH is a typical chronic progressive condition, suggesting PAE could aim not only to relieve LUTS but also to delay or prevent the clinical progression. Awareness of the pathological background of BPH is essential for interventional radiologists to improve clinical outcomes and develop new treatment strategies in clinical practice of PAE.

  12. Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 1, Pathological Background and Clinical Implications

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Fei, E-mail: feisun@ccmijesususon.com; Crisóstomo, Verónica, E-mail: crisosto@ccmijesususon.com; Báez-Díaz, Claudia, E-mail: cbaez@ccmijesususon.com; Sánchez, Francisco M., E-mail: msanchez@ccmijesususon.com [Jesús Usón Minimally Invasive Surgery Centre (Spain)

    2016-01-15

    Pathological features of benign prostatic hyperplasia (BPH) dictate various responses to prostatic artery embolization (PAE). Typically, BPH originates in the transition zone and periurethral region, where should be considered the primary target area in PAE procedures. Given that histological heterogeneity of components in hyperplasia nodules, epithelial or stromal, identifying the more responsive nodules to PAE will have clinical implications. Since some lower urinary tract symptoms (LUTS) in patients with BPH are usually related to bladder outlet obstruction-induced changes in bladder function rather than to outflow obstruction directly, proper selection of candidate patients prior to PAE is of great clinical importance. BPH is a typical chronic progressive condition, suggesting PAE could aim not only to relieve LUTS but also to delay or prevent the clinical progression. Awareness of the pathological background of BPH is essential for interventional radiologists to improve clinical outcomes and develop new treatment strategies in clinical practice of PAE.

  13. The Myth of the Nuclear Family: Historical Background and Clinical Implications.

    Science.gov (United States)

    Uzoka, Azubike Felix

    1979-01-01

    Research reviewed indicates that the concept of the nuclear family is inadequate and misleading for an understanding of family dynamics or a guide for therapeutic intervention. Nonetheless, clinical practitioners and psychological theorists foster the nuclear myth. A new approach to the study of human relationships is needed. (Author/GC)

  14. Non-traumatic rhabdomyolysis: Background, laboratory features, and acute clinical management.

    Science.gov (United States)

    Cervellin, Gianfranco; Comelli, Ivan; Benatti, Mario; Sanchis-Gomar, Fabian; Bassi, Antonella; Lippi, Giuseppe

    2017-08-01

    Rhabdomyolysis is a relatively rare condition, but its clinical consequences are frequently dramatic in terms of both morbidity and mortality. Although no consensus has been reached so far about the precise definition of this condition, the term rhabdomyolysis describes a rapid breakdown of striated, or skeletal, muscle. It is hence characterized by the rupture and necrosis of muscle fibers, resulting in release of cell degradation products and intracellular elements within the bloodstream and extracellular space. Notably, the percentage of patients with rhabdomyolysis who develop acute kidney injury, the most dramatic consequence, varies from 13% to over 50% according to both the cause and the clinical and organizational setting where they are diagnosed. Despite direct muscle injury (i.e., traumatic rhabdomyolysis) remains the most common cause, additional causes, frequently overlapping, include hypoxic, physical, chemical or biological factors. The conventional triad of symptoms includes muscle pain, weakness and dark urine. The laboratory diagnosis is essentially based on the measurement of biomarkers of muscle injury, being creatine kinase (CK) the biochemical "gold standard" for diagnosis, and myoglobin the "gold standard" for prognostication, especially in patients with non-traumatic rhabdomyolysis. The essential clinical management in the emergency department is based on a targeted intervention to manage the underlying cause, combined with infusion of fluids and eventually sodium bicarbonate. We will present and discuss in this article the pathophysiological and clinical features of non-traumatic rhabdomyolysis, focusing specifically on Emergency Department (ED) management. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  15. Automatically pairing measured findings across narrative abdomen CT reports.

    Science.gov (United States)

    Sevenster, Merlijn; Bozeman, Jeffrey; Cowhy, Andrea; Trost, William

    2013-01-01

    Radiological measurements are one of the key variables in widely adopted guidelines (WHO, RECIST) that standardize and objectivize response assessment in oncology care. Measurements are typically described in free-text, narrative radiology reports. We present a natural language processing pipeline that extracts measurements from radiology reports and pairs them with extracted measurements from prior reports of the same clinical finding, e.g., lymph node or mass. A ground truth was created by manually pairing measurements in the abdomen CT reports of 50 patients. A Random Forest classifier trained on 15 features achieved superior results in an end-to-end evaluation of the pipeline on the extraction and pairing task: precision 0.910, recall 0.878, F-measure 0.894, AUC 0.988. Representing the narrative content in terms of UMLS concepts did not improve results. Applications of the proposed technology include data mining, advanced search and workflow support for healthcare professionals managing radiological measurements.

  16. Antipsychotic drug treatment for patients with schizophrenia: theoretical background, clinical considerations and patients preferences

    DEFF Research Database (Denmark)

    Nielsen, René Ernst; Nielsen, Jimmi

    2009-01-01

      The cornerstone in treatment of psychosis is antipsychotic drugs. Treatment options have increased over the years; newer antipsychotic drugs with a proposed efficacy regarding negative and cognitive symptoms, but also a shift in side-effects from neurological side-effects to metabolic side......-effects have arisen as the new challenge. The basis of successful pharmacological treatment is a fundamental understanding of the mechanisms of action, the desired effects and side-effects of antipsychotic drugs, a good relationship with the patient and a thorough monitoring of the patient before and during...... treatment. The clinically relevant aspects of antipsychotic drug treatment are reviewed; mechanism of antipsychotic drug action, clinical considerations in treatment, switching antipsychotic drugs, polypharmacy, safety and patient preference.  ...

  17. Ethical and social significance of microdose clinical trial. Background of guidance draw-up

    International Nuclear Information System (INIS)

    Kurihara, Chieko

    2008-01-01

    Microdose clinical trial (MCT) aims to elucidate only the mass balance (pharmacokinetics, PK) in human of a new drug candidate compound before the first Phase I trial and is going to be approved by the authority MHLW in Japan. In MCT, the compound is administered in human in an extremely small amount (microdose) that is unexpected to exert its pharmacological effect ( 14 C) labeled compound is administered, LC/MS/MS with non-isotopic compound and positron emission tomography (PET) with compound labeled by positron emitter like 11 C, 13 N, etc. Under promotions by support and demand of related scientific societies and corporations in Japan as well as by ICH agreement, MHLW has defined MCT as one of clinical trials linked with GMP standard of drug candidate for clinical trials, with concept for assessment of internal radiation exposure, and with consistency with handling of radioisotopes, because of ethical consideration for volunteers to be enrolled. MCT can expectedly improve the cost- and time-effectiveness of new drug development, which ultimately leads to earlier supply of superior medicines. (R.T.)

  18. Background on Establishing a Working Group to Create Home Clinical Cases for Education.

    Science.gov (United States)

    Yoshitake, Taketo

    2017-01-01

    In Japan there are concerns that there will be a surge in social insurance costs such as medical and nursing care expenses as a result of the baby boom generation reaching the late stages of old age (75 years old and beyond) around 2025 ("The 2025 Problem"). In 2012, the "Outline on Social Insurance and Tax Reform" was approved by the Japanese cabinet and government, including "construction of regional comprehensive care". To promote participation in home medical care by pharmacists, this article presents the roles demanded of pharmacists in regional comprehensive care from the standpoint of physicians, and the discussion of case studies bridging the gap from knowledge learned in lectures to practical applications. In the field of medical education, "The 2023 Problem", regarding standards of education on a global level, caused medical schools across Japan to scramble for curriculum reform, specifically in the demand for increased time spent in clinical training and the expansion of community-based medical education. The current state of community-based medical education will be reviewed. In light of these developments, "the working group to create home clinical cases for education" was developed by clinical pharmacists in the field and university faculty members at Daiichi University of Pharmacy.

  19. MR imaging of the abdomen in pregnancy

    International Nuclear Information System (INIS)

    Klasen, J.; Antoch, G.; Blondin, D.

    2011-01-01

    Sonography is still the method of choice for imaging diseases in pregnant women. The changed physiognomy of the women increases the known limitations of sonography while the advantages of MRI (large field of view, excellent soft-tissue contrast, sensitive diagnosis of edema) are not affected. The available sequences allow the differentiation of various pathologies. Most of these can frequently be visualized without intravenous administration of contrast material. Although the significance of techniques like DWI and ASL has not yet been explored, initial descriptions are promising and MR imaging in pregnancy will be increasingly important in the future. Therefore, knowledge of the most frequent diseases in pregnancy and their image appearance is relevant to radiologists. The advantages of MRI in comparison to sonography and its important role in imaging pathologies of the acute abdomen in pregnancy are illustrated and discussed. (orig.)

  20. Imaging findings of Castleman disease of the abdomen and pelvis

    International Nuclear Information System (INIS)

    Zhou Liangping; Wang Peihua; Peng Weijun; Yang Wentao; Zhang Bei; Guan Yubao; Zhou Kangrong

    2006-01-01

    Objective: The purpose of this work was to analysis the most suggestive imaging findings of Castleman disease in the abdomen and pelvis and to improve the recognition of this rare disease. Methods: Ten patients with pathologically proved Castleman disease in the abdomen (n=9) and pelvis (n=1) were included in this study. Patients were 18-56 yeas old (mean=40); 7 were men and 3 women. Imaging findings (CT and MRI, n=4; only CT, n=4; only MRI, n=2) were retrospectively reviewed and correlated with clinical and pathologic findings. Results: The lesions were divided into localized (n=9) and disseminated (n=1) group. The pathologic subtypes of all 9 cases of localized disease were hyaline vascular type. Imaging findings showed a single large mass in six and a single dominant mass with small satellite nodules in three. On plain CT images, the lesions manifested as homogeneous soft masses, which is isoattenuating to muscle. After intravenous injection of contrast media, most of the masses enhanced sharply (5/7) with the attenuation similar to large arteries at arterial phase and delay scans. On MR imaging, the lesions also were homogenous and had isointense or slightly low signal intensity compared with that of muscle on T 1 weighted images and high signal intensity on T 2 weighted images, and showed contrast enhancement in a similar pattern to contrast enhanced CT. After intravenous injection of contrast media, areas of central lower radial attenuation in the mass were noted in 4 cases of large masses ( > 5 cm) and proved to be fibrotic component pathologically. The pathologic subtypes of 1 cases of disseminated disease was plasma cell type. Imaging findings showed several well-defined nodules lied in the retroperitoneal zone that enhanced sharply with the attenuation similar to large arteries after intravenous injection of contrast media. Conclusion: Imaging findings of Castleman disease in the abdomen and pelvis are closely associated with its pathology. The most

  1. Spontaneous Spleen Rupture in a Teenager: An Uncommon Cause of Acute Abdomen

    Directory of Open Access Journals (Sweden)

    Verroiotou Maria

    2013-01-01

    Full Text Available Spontaneous spleen rupture is a rare complication of infectious diseases and it can become a potentially life-threatening condition if not diagnosed in time. A 17-year-old Greek female presented to the ER due to acute abdominal pain, mainly of the left upper quadrant. She had no recent report of trauma. The patient was pale, her blood pressure was 90/70 mmHg, and her pulse was 120 b/min. Clinical examination of the abdomen revealed muscle contraction and resistance. The patient was submitted to an ultrasound of the upper abdomen and to a CT scanning of the abdomen that revealed an extended intraperitoneal hemorrhage due to spleen rupture. Due to the patient’s hemodynamic instability, she was taken to the operation room and splenectomy was performed. Following a series of laboratory examinations, the patient was diagnosed to be positive for current cytomegalovirus infection. The postoperative course was uneventful, and in a two year follow-up the patient is symptom-free. Spontaneous spleen rupture due to Cytomegalovirus infection is a rare clinical entity, described in few case reports in the world literature and should always be taken into consideration in differential diagnosis of acute abdomen, especially in adolescents with no recent report of trauma.

  2. WE-D-207-01: Background and Clinical Implementation of a Screening Program

    International Nuclear Information System (INIS)

    Aberle, D.

    2015-01-01

    In the United States, Lung Cancer is responsible for more cancer deaths than the next four cancers combined. In addition, the 5 year survival rate for lung cancer patients has not improved over the past 40 to 50 years. To combat this deadly disease, in 2002 the National Cancer Institute launched a very large Randomized Control Trial called the National Lung Screening Trial (NLST). This trial would randomize subjects who had substantial risk of lung cancer (due to age and smoking history) into either a Chest X-ray arm or a low dose CT arm. In November 2010, the National Cancer Institute announced that the NLST had demonstrated 20% fewer lung cancer deaths among those who were screened with low-dose CT than with chest X-ray. In December 2013, the US Preventive Services Task Force recommended the use of Lung Cancer Screening using low dose CT and a little over a year later (Feb. 2015), CMS announced that Medicare would also cover Lung Cancer Screening using low dose CT. Thus private and public insurers are required to provide Lung Cancer Screening programs using CT to the appropriate population(s). The purpose of this Symposium is to inform medical physicists and prepare them to support the implementation of Lung Screening programs. This Symposium will focus on the clinical aspects of lung cancer screening, requirements of a screening registry for systematically capturing and tracking screening patients and results (such as required Medicare data elements) as well as the role of the medical physicist in screening programs, including the development of low dose CT screening protocols. Learning Objectives: To understand the clinical basis and clinical components of a lung cancer screening program, including eligibility criteria and other requirements. To understand the data collection requirements, workflow, and informatics infrastructure needed to support the tracking and reporting components of a screening program. To understand the role of the medical physicist in

  3. Underdiagnosis of Vertebral Collapse on Routine Multidetector Computed Tomography Scan of the Abdomen

    International Nuclear Information System (INIS)

    Obaid, H.; Husamaldin, Z.; Bhatt, R.

    2008-01-01

    Background: Vertebral fractures are commonly associated with osteoporosis and have significant morbidity and mortality rates. Osteoporotic vertebral fractures are presently considered as a treatable and preventable condition, and early detection is vital for further management. The evaluation of vertebral compression on multidetector computed tomography (MDCT) scans of the abdomen has, to our knowledge, not been reported before. Purpose: To assess the prevalence of vertebral collapse on routine abdominal CT scans, and to evaluate the usefulness of the multiplanar reconstruction (MPR) capability of MDCT scans in accurately identifying vertebral abnormalities such as vertebral collapse, spondylolisthesis, and retrolisthesis. Material and Methods: A retrospective review of 307 MDCT scans of the abdomen was carried out at a university teaching hospital. Identifiable patient information was anonymized for data protection. All images were reviewed on a picture archiving and communications system (PACS) using sagittal MPR and bone window for the assessment of the vertebrae. Data were collected from the Computerized Radiology Information System (CRIS). Results: Vertebral collapse was seen in 42 (13.6%) of the 307 patients undergoing routine MDCT of the abdomen. Multilevel and single-level collapses were seen in 24 and 18 patients, respectively. Spondylolisthesis was identified in 5.5% (n=17), and retrolisthesis was seen in 0.6% (n=2). All patients with vertebral fracture were older than 50 years. Women were more commonly affected than men. Conclusion: A significant number of patients with vertebral collapse were diagnosed using MPR on MDCT routine scans of the abdomen

  4. The Managed Ventricular pacing versus VVI 40 Pacing (MVP) Trial: clinical background, rationale, design, and implementation.

    Science.gov (United States)

    Sweeney, Michael O; Ellenbogen, Kenneth A; Miller, Elaine Hogan; Sherfesee, Lou; Sheldon, Todd; Whellan, David

    2006-12-01

    Implantable cardioverter defibrillators (ICDs) reduce mortality among appropriately selected patients who have had or are at risk for life-threatening ventricular arrhythmia. Right ventricular apical (RVA) pacing has been implicated in worsening heart failure and death. The optimal pacemaker mode for bradycardia support while minimizing unnecessary and potentially harmful RVA pacing has not been determined. The Managed Ventricular pacing vs. VVI 40 Pacing Trial (MVP) is a prospective, multicenter, randomized, single-blind, parallel, controlled clinical trial designed to establish whether atrial-based dual-chamber managed ventricular pacing mode (MVP) is equivalent or superior to back-up only ventricular pacing (VVI 40) among patients with standard indications for ICD therapy and no indication for bradycardia pacing. The MVP Trial is designed with 80% power to detect a 10% reduction in the primary endpoint of new or worsening heart failure or all-cause mortality in the MVP-treated group. Approximately 1,000 patients at 80 centers in the United States, Canada, Western Europe, and Israel will be randomized to MVP or VVI 40 pacing after successful implantation of a dual-chamber ICD. Heart failure therapies will be optimized in accordance with evidence-based guidelines. Prespecified secondary endpoints will include ventricular arrhythmias, atrial fibrillation, new indication for bradycardia pacing, health-related quality of life, and cost effectiveness. Enrollment began in October 2004 and concluded in April 2006. The study will be terminated upon recommendation of the Data Monitoring Committee or when the last patient enrolled and surviving has reached a minimum 2 years of follow-up. The MVP Trial will meet the clinical need for carefully designed prospective studies to define the benefits of atrial-based dual-chamber minimal ventricular pacing versus single-chamber ventricular pacing in conventional ICD patients.

  5. Clinical MR mammography. Impact of hormonal status on background enhancement and diagnostic accuracy

    International Nuclear Information System (INIS)

    Baltzer, Pascal Andreas Thomas; Dietzel, M.; Burmeister, H.; Pfleiderer, S.O.; Kaiser, W.A.; Vag, T.; Gajda, M.; Camara, O.

    2011-01-01

    Purpose: Hormonal stimulation can induce background enhancement (BE) in MR mammography (MRM). This fact has been assumed to decrease the accuracy of MRM. Consequently, this report investigates: 1. The prevalence of BE in postmenopausal vs. premenopausal women in correlation to hormonal cycle phase (CP). 2. The impact of hormonal status (HS) and BE on diagnostic accuracy. Materials and Methods: Consecutive patients over 22 months with complete HS information (week of CP or postmenopausal) were included in this prospective investigation. Exclusion criteria were any hormonal therapy, hysterectomy as well as cancer proven by biopsy. The standard of reference was histopathology. All MRM scans were acquired using the same protocol (1.5 T, dynamic T 1w GRE after 0.1 mmol/kg bw Gd-DTPA i. v.). Two radiologists rated all examinations in consensus according to BI-RADS. BE was defined as: 0 = missing, 1 = moderate, 2 = distinct. Results: 224 patients (150 postmenopausal, 74 premenopausal, 45 in the second week of CP) were included in this study (83 benign and 141 malignant findings). BE was more frequent in premenopausal women (p = 0.006), but did not differ between CP (p = 0.460). Neither HS nor BE had a significant impact on the diagnostic parameters of MRM (p ≥ 0.375). However, regarding BE, the relative number of false positive (FP) findings was highest (5 / 10; 50 %) in the distinct BE group. Regarding HS, 17 % more FP findings were observed in premenopausal women examined outside the second week of CP. Conclusion: In premenopausal women, HS leads to increased BE of breast tissue, independent of CP. Distinct BE and less pronounced, non-optimal CP may lead to an increased number of false positive findings. (orig.)

  6. Clinical MR mammography. Impact of hormonal status on background enhancement and diagnostic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Baltzer, Pascal Andreas Thomas; Dietzel, M.; Burmeister, H.; Pfleiderer, S.O.; Kaiser, W.A. [Jena Univ. (Germany). Inst. of Diagnostic and Interventional Radiology; Vag, T. [Klinikum Rechts der Isar (Germany). Dept. of Radiology; Gajda, M. [Jena Univ. (Germany). Inst. of Pathology; Camara, O. [Jena Univ. (Germany). Clinic of Gynaecology

    2011-05-15

    Purpose: Hormonal stimulation can induce background enhancement (BE) in MR mammography (MRM). This fact has been assumed to decrease the accuracy of MRM. Consequently, this report investigates: 1. The prevalence of BE in postmenopausal vs. premenopausal women in correlation to hormonal cycle phase (CP). 2. The impact of hormonal status (HS) and BE on diagnostic accuracy. Materials and Methods: Consecutive patients over 22 months with complete HS information (week of CP or postmenopausal) were included in this prospective investigation. Exclusion criteria were any hormonal therapy, hysterectomy as well as cancer proven by biopsy. The standard of reference was histopathology. All MRM scans were acquired using the same protocol (1.5 T, dynamic T 1w GRE after 0.1 mmol/kg bw Gd-DTPA i. v.). Two radiologists rated all examinations in consensus according to BI-RADS. BE was defined as: 0 = missing, 1 = moderate, 2 = distinct. Results: 224 patients (150 postmenopausal, 74 premenopausal, 45 in the second week of CP) were included in this study (83 benign and 141 malignant findings). BE was more frequent in premenopausal women (p = 0.006), but did not differ between CP (p = 0.460). Neither HS nor BE had a significant impact on the diagnostic parameters of MRM (p {>=} 0.375). However, regarding BE, the relative number of false positive (FP) findings was highest (5 / 10; 50 %) in the distinct BE group. Regarding HS, 17 % more FP findings were observed in premenopausal women examined outside the second week of CP. Conclusion: In premenopausal women, HS leads to increased BE of breast tissue, independent of CP. Distinct BE and less pronounced, non-optimal CP may lead to an increased number of false positive findings. (orig.)

  7. Abdomen agudo quirúrgico en el anciano

    Directory of Open Access Journals (Sweden)

    Jesús M Valdés Jiménez

    2002-04-01

    Full Text Available Se presenta un estudio descriptivo retrospectivo de 156 enfermos mayores de 65 años, con diagnóstico de abdomen agudo quirúrgico (AAQ, operados en el Hospital Clinicoquirúrgico «Manuel Fajardo» e ingresados en la Unidad de Cuidados Intermedios Polivalente, durante el trienio comprendido entre 1995 y 1998. Las causas más frecuentes del síndrome fueron la oclusión intestinal (58,9 %, la colecistitis aguda (13,5 % y la úlcera péptica gastroduodenal perforada (10,9 %. Las enfermedades asociadas de mayor prevalencia eran la cardiopatía isquémica (62,2 % y la hipertensión arterial (48,7 %. La mortalidad aumentó con el avance de la edad, y alcanzó el 70,4 % en los mayores de 85 años. Entre las complicaciones predominaron la infección de la herida quirúrgica (12,8 % y la bronconeumonía (5,8 %. La principal causa de muerte fue la sepsis (10,3 %A descriptive and retrospective study of 156 patients over 65 with diagnosis of acute surgical abdomen (ASA that were operated on at "Manuel Fajardo" Clinical and Surgical Hospital and admitted at the Polyvalent Intermediate Care Unit, from 1995 to 1998, was conducted. The most common causes of the syndrome were intestinal occlusion (58.9 %, acute cholecystitis (13.5 % and the gastroduodenal perforated peptic ulcer (10.9 %. The associated diseases of highest prevalence were ischemic heart disease (62.2 % and arterial hypertension (48.7 %. Mortality increased with age and amounted to 70.4 % in patients over 85. The infection of the surgical wound (12.8 % and bronchopneumonia (5.8% prevailed among the complications. Sepsis (10.3 % was the main cause of death

  8. Unusual causes of acute abdomen in a Nigerian hospital ...

    African Journals Online (AJOL)

    Acute abdomen is the most common abdominal emergency associated with high morbidity and mortality in General surgical practice. Over a 7-year period, a study of unusual causes of acute abdomen was undertaken, with the aim of identifying these causes and outcome of operative management. Eleven cases were ...

  9. Evaluation of amylase and lipase levels in blunt trauma abdomen patients

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    Subodh Kumar

    2012-01-01

    Full Text Available Background: There are studies to prove the role of amylase and lipase estimation as a screening diagnostic tool to detect diseases apart from acute pancreatitis. However, there is sparse literature on the role of serum and urine amylase, lipase levels, etc to help predict the specific intra-abdominal injury after blunt trauma abdomen (BTA. Aim: To elucidate the significance of elevation in the levels of amylase and lipase in serum and urine samples as reliable parameters for accurate diagnosis and management of blunt trauma to the abdomen. Materials and Methods: A prospective analysis was done on the trauma patients admitted in Jai Prakash Narayan Apex Trauma Center, AIIMS, with blunt abdomen trauma injuries over a period of six months. Blood and urine samples were collected on days 1, 3, and 5 of admission for the estimation of amylase and lipase, liver function tests, serum bicarbonates, urine routine microscopy for red blood cells, and complete hemogram. Clinical details such as time elapsed from injury to admission, type of injury, trauma score, and hypotension were noted. Patients were divided into groups according to the single or multiple organs injured and according to their hospital outcome (dead/discharged. Wilcoxon′s Rank sum or Kruskal-Wallis tests were used to compare median values in two/three groups. Data analysis was performed using STATA 11.0 statistical software. Results: A total of 55 patients with median age 26 (range, 6-80 years, were enrolled in the study. Of these, 80% were males. Surgery was required for 20% of the patients. Out of 55 patients, 42 had isolated single organ injury [liver or spleen or gastrointestinal tract (GIT or kidney]. Patients with pancreatic injury were excluded. In patients who suffered liver injuries, urine lipase levels on day 1, urine lipase/amylase ratio along with aspartate aminotransferase (AST, alanine aminotransferase (ALT, and alkaline phosphatase (ALP on days 1, 3, and 5, were found to

  10. Advanced practice registered nurses and physician assistants in sleep centers and clinics: a survey of current roles and educational background.

    Science.gov (United States)

    Colvin, Loretta; Cartwright, Ann; Collop, Nancy; Freedman, Neil; McLeod, Don; Weaver, Terri E; Rogers, Ann E

    2014-05-15

    To survey Advanced Practice Registered Nurse (APRN) and Physician Assistant (PA) utilization, roles and educational background within the field of sleep medicine. Electronic surveys distributed to American Academy of Sleep Medicine (AASM) member centers and APRNs and PAs working within sleep centers and clinics. Approximately 40% of responding AASM sleep centers reported utilizing APRNs or PAs in predominantly clinical roles. Of the APRNs and PAs surveyed, 95% reported responsibilities in sleep disordered breathing and more than 50% in insomnia and movement disorders. Most APRNs and PAs were prepared at the graduate level (89%), with sleep-specific education primarily through "on the job" training (86%). All APRNs surveyed were Nurse Practitioners (NPs), with approximately double the number of NPs compared to PAs. APRNs and PAs were reported in sleep centers at proportions similar to national estimates of NPs and PAs in physicians' offices. They report predominantly clinical roles, involving common sleep disorders. Given current predictions that the outpatient healthcare structure will change and the number of APRNs and PAs will increase, understanding the role and utilization of these professionals is necessary to plan for the future care of patients with sleep disorders. Surveyed APRNs and PAs reported a significant deficiency in formal and standardized sleep-specific education. Efforts to provide formal and standardized educational opportunities for APRNs and PAs that focus on their clinical roles within sleep centers could help fill a current educational gap.

  11. The Effects of Music Intervention on Background Pain and Anxiety in Burn Patients: Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Najafi Ghezeljeh, Tahereh; Mohades Ardebili, Fatimah; Rafii, Forough; Haghani, Hamid

    2016-01-01

    This study aimed to investigate the effect of music on the background pain, anxiety, and relaxation levels in burn patients. In this pretest-posttest randomized controlled clinical trial, 100 hospitalized burn patients were selected through convenience sampling. Subjects randomly assigned to music and control groups. Data related to demographic and clinical characteristics, analgesics, and physiologic measures were collected by researcher-made tools. Visual analog scale was used to determine pain, anxiety, and relaxation levels before and after the intervention in 3 consecutive days. Patients' preferred music was offered once a day for 3 days. The control group only received routine care. Data were analyzed using SPSS-PC (V. 20.0). According to paired t-test, there were significant differences between mean scores of pain (P < .001), anxiety (P < .001), and relaxation (P < .001) levels before and after intervention in music group. Independent t-test indicated a significant difference between the mean scores of changes in pain, anxiety, and relaxation levels before and after intervention in music and control groups (P < .001). No differences were detected in the mean scores of physiologic measures between groups before and after music intervention. Music is an inexpensive, appropriate, and safe intervention for applying to burn patients with background pain and anxiety at rest. To produce more effective comfort for patients, it is necessary to compare different types and time lengths of music intervention to find the best approach.

  12. A STUDY OF POST-SURGICAL COMPLICATIONS IN ACUTE ABDOMEN CONDITIONS

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    Bhooma Reddy Muthyala

    2016-09-01

    Full Text Available BACKGROUND The most common causes of the acute abdomen are acute appendicitis which may be perforated, typhoid ileal perforation, acute intestinal obstruction, gastroduodenal perforations, nonspecific abdominal pain, abdominal injuries, and acute cholecystitis. A summary of all the acute complications taken together will be the fact that all are associated with post-surgical complications. A sincere effort has been made to study the post-operative complications that a surgeon encounters while treating the acute abdomen cases. This study is intended to help the practising surgeons who deal with such complications. It also is intended to help the doctors who practice to identify such complications and thus refer the patients for immediate intervention. METHODS This study was conducted in the Department of General Surgery, Government Medical College, Nizamabad, Telangana. This study was done from June 2013 to May 2016. One hundred sixty patients who were admitted in the hospital after surgery for acute abdominal conditions were considered for the study. Thorough clinical examination was conducted and the complications that were encountered were noted and the complications were treated as per the need of the hour. The complications faced by the treating surgeon in each and every entity that was discussed earlier was duly noted and statistical analysis was conducted. All the statistical analysis was done using the latest SPSS software 2015 (California. RESULT In our study, the mean age of the study population was found to be 29.8 years. That means the majority of the patients who turn up in the Department of Emergency is young and generally in the third decade of life. In Acute Intestinal Obstruction and blunt abdominal injuries, significance of mortality is high (p<0.05. CONCLUSION The study was successful in proving that abdominal injuries are the main factors of causing morbidity and mortality in the younger generation. The surgical mode of

  13. Role of inflammatory markers as predictors of laparotomy in patients presenting with acute abdomen.

    Science.gov (United States)

    Dias, Brendan H; Rozario, Anthony P; Olakkengil, Santosh A

    2015-10-01

    There is a need for an ideal indicator of surgery in patients presenting with acute abdomen. Several markers have been analysed, but the search still continues as none have proven effective. This study aimed to analyse and compare the predictive value of plasma procalcitonin (PCT) strip test in patients presenting with acute abdomen and identify a useful cut-off value to differentiate patients that would benefit with surgery from those that require conservative management. A prospective study was conducted in the department of general surgery from June 2012 to June 2013. Plasma PCT was estimated by the semi-quantitative strip test. The levels of plasma PCT and other routinely used markers of inflammation were analysed and compared. Of the total of 58 patients, 44 patients (76%) were men with a mean age of 45 years. Forty patients required emergency surgical intervention. A plasma PCT value of >0.5 ng/mL at admission was 80% sensitive and 100% specific for predicting need for antibiotics in patients with acute abdomen that were managed conservatively. The mean plasma PCT value in the patients undergoing surgery (5.0-10.0 ng/mL) was significantly more than in those managed conservatively (0.5-2.0 ng/mL). Using receiver operating characteristic (ROC) curves a cut-off for plasma PCT of >5.0 ng/mL was 75% sensitive and 100% specific for considering surgical intervention in patients presenting with acute abdomen. Plasma PCT (value >5 ng/mL) could be used as an adjunct to clinical examination to predict requirement of surgery in patients presenting with acute abdomen. © 2015 Royal Australasian College of Surgeons.

  14. Normal sonographic anatomy of the abdomen of coatis (Nasua nasua Linnaeus 1766).

    Science.gov (United States)

    Ribeiro, Rejane G; Costa, Ana Paula A; Bragato, Nathália; Fonseca, Angela M; Duque, Juan C M; Prado, Tales D; Silva, Andrea C R; Borges, Naida C

    2013-06-23

    The use of ultrasound in veterinary medicine is widespread as a diagnostic supplement in the clinical routine of small animals, but there are few reports in wild animals. The objective of this study was to describe the anatomy, topography and abdominal sonographic features of coatis. The urinary bladder wall measured 0.11 ± 0.03 cm. The symmetrical kidneys were in the left and right cranial quadrant of the abdomen and the cortical, medullary and renal pelvis regions were recognized and in all sections. The medullary rim sign was visualized in the left kidney of two coatis. The liver had homogeneous texture and was in the cranial abdomen under the rib cage. The gallbladder, rounded and filled with anechoic content was visualized in all coatis, to the right of the midline. The spleen was identified in the left cranial abdomen following the greater curvature of the stomach. The parenchyma was homogeneous and hyperechogenic compared to the liver and kidney cortex. The stomach was in the cranial abdomen, limited cranially by the liver and caudo-laterally by the spleen. The left adrenal glands of five coatis were seen in the cranial pole of the left kidney showing hypoechogenic parenchyma without distinction of cortex and medulla. The pancreas was visualized in only two coatis. The left ovary (0.92 cm x 0.56 cm) was visualized on a single coati in the caudal pole of the kidney. The uterus, right adrenal, right ovary and intestines were not visualized. Ultrasound examination of the abdomen of coatis may be accomplished by following the recommendations for dogs and cats. It is possible to evaluate the anatomical and topographical relationships of the abdominal organs together with the knowledge of the peculiarities of parenchymal echogenicity and echotexture of the viscera.

  15. Role of computed tomography of abdomen in difficult to diagnose typhoid fever: a case series.

    Science.gov (United States)

    Hafeez, Wajid; Rajalakshmi, S; Sripriya, S; Madhu Bashini, M

    2018-04-01

    Background and Aim Diagnosis of typhoid is challenging when blood cultures fail to isolate Salmonella species. We report our experience with interpreting computed tomography (CT) abdomen findings in a case series of typhoid fever. Methods The case series consisted of patients who had a CT abdomen done as part of their investigations and a final diagnosis of typhoid fever. The CT films were reviewed and findings evaluated for distinctive features. Results During 2011-2017, 11 patients met the inclusion criteria. Indication for CT was pyrexia of unknown origin in the majority of patients. Review of CT films revealed mesenteric lymphadenopathy (100%), terminal ileum thickening (85%), hepatosplenomegaly (45%), retroperitoneal lymphadenopathy (18%) and ascites (9%). Conclusions Enhancing discrete mesenteric lymphadenopathy and terminal ileum thickening are non-specific findings noted in typhoid fever. Absence of matted necrotic nodes and peritoneal thickening rule out tuberculosis and raise suspicion of typhoid fever in endemic regions.

  16. The role of US examination in the management of acute abdomen.

    Science.gov (United States)

    Mazzei, Maria Antonietta; Guerrini, Susanna; Cioffi Squitieri, Nevada; Cagini, Lucio; Macarini, Luca; Coppolino, Francesco; Giganti, Melchiore; Volterrani, Luca

    2013-07-15

    Acute abdomen is a medical emergency, in which there is sudden and severe pain in abdomen of recent onset with accompanying signs and symptoms that focus on an abdominal involvement. It can represent a wide spectrum of conditions, ranging from a benign and self-limiting disease to a surgical emergency. Nevertheless, only one quarter of patients who have previously been classified with an acute abdomen actually receive surgical treatment, so the clinical dilemma is if the patients need surgical treatment or not and, furthermore, in which cases the surgical option needs to be urgently adopted. Due to this reason a thorough and logical approach to the diagnosis of abdominal pain is necessary. Some Authors assert that the location of pain is a useful starting point and will guide a further evaluation. However some causes are more frequent in the paediatric population (like appendicitis or adenomesenteritis) or are strictly related to the gender (i.e. gynaechologic causes). It is also important to consider special populations such as the elderly or oncologic patients, who may present with atypical symptoms of a disease. These considerations also reflect a different diagnostic approach. Today, surely the integrated imaging, and in particular the use of multidetector Computed Tomography (MDCT) has revolutionised the clinical approach to this condition, simplyfing the diagnosis but burdening the radiologists with the problems related to the clinical management. However although CT emerging as a modality of choice for evaluation of the acute abdomen, ultrasonography (US) remains the primary imaging technique in the majority of cases, especially in young and female patients, when the limitation of the radiation exposure should be mandatory, limiting the use of CT in cases of nondiagnostic US and in all cases where there is a discrepancy between the clinical symptoms and negative imaging at US.

  17. Acute abdomen: An unusual presentation of disseminated Penicillium marneffei infection

    OpenAIRE

    George I; Sudarsanam T; Pulimood A; Mathews M

    2008-01-01

    Varied clinical presentations of Penicillium marneffei , an opportunistic pathogen in HIV disease has been rarely described in literature. We report a patient with advanced AIDS who presented to us with prolonged fever and had features of an acute abdomen. On radiologic imaging he had features of intestinal obstruction and mesenteric lymphadenitis. A diagnosis was made possible by endoscopic biopsies of the small bowel and bone marrow culture which grew P . Marneffei . He was treated with ...

  18. Noncommunicating isolated enteric duplication cyst in the abdomen ...

    African Journals Online (AJOL)

    ... Surgery 2013, 9:124–126. Keywords: abdomen, children, duplication, isolated, noncommunicating. Department of Pediatric Surgery, Seoul National University College of Medicine, .... M Abdominal pain, anorexia, fever. Ileum. Respiratory.

  19. Parenteral nutrition including polyamine under experimental irradiation of the abdomen

    International Nuclear Information System (INIS)

    Moroz, B.B.; Fedorovskij, L.L.; Lyashchenko, Yu.N.

    1982-01-01

    White rats-males were used in experiments. Irradiation dose of abdomen area is 13.5 Gy (1400 R). Parenteral nutrition using aminoacid preparation of polyamine affects favourably during radiation damage resulted from local irradiation of abdomen area. This was manifested in weakening of gastroenteric syndrom, reduction of 3.5 day death of animals and increase of their 30 day survival rate, intensification of recovery processes in small intestine, decrease of cell devastation in bone marrow

  20. Clinical background and its relation to results of percutaneous needle biopsy of suspected bone metastasis under guidance with CT fluoroscopy

    International Nuclear Information System (INIS)

    Aoki, Jun; Koyama, Yoshinori; Morita, Hideo; Takahashi, Ayako; Nakajima, Takahito; Yagi, Akiko; Arai, Kiyokazu; Shinozaki, Tetsuya; Watanabe, Hideomi

    2005-01-01

    The purpose of this study was to investigate the clinical background of needle biopsy of suspected bone metastasis under guidance with CT fluoroscopy. During a 3-year period (from April 2000 to March 2003), 103 needle biopsies on 101 lesions of 90 patients were performed for pathological evaluation of suspected bone metastasis. The clinical course of these patients prior to biopsy and its relation to the biopsy results were retrospectively reviewed. Sixty-two patients (69% of total cases) were referred for biopsy from orthopedic surgeons, and 51 of these patients consulted orthopedic surgeons on the initial presentation. Malignancy was pathologically proved in 47 (76%) of the 62 orthopedic patients, and in 19 (68%) of the 28 patients referred from other clinicians. Thirteen (21%) of the orthopedic patients had a history of malignancy, while 22 (78%) of the non-orthopedic patients were cancer patients. Metastasis was pathologically proved in 23 (66%) of the 35 patients with a history of malignancy, while malignancy was pathologically proved in 43 (78%) of the 55 patients without known malignancy. Diagnostic accuracy of the needle bone biopsy was 96%, and its complication rate was 0.7%. In the era of CT fluoroscopy, needle biopsy for suspected bone metastasis was most frequently requested for the patients who consulted orthopedic surgeons for the occurrence of local bone pain as the initial symptom of unknown malignancy. Frequency of malignancy proved by the biopsy in those patients was as high as that in the cancer patients referred from other clinicians. (author)

  1. Survey of young patients with polio and a foreign background at a Swedish post-polio outpatient clinic.

    Science.gov (United States)

    Werhagen, Lars; Borg, Kristian

    2016-10-01

    Nowadays, polio survivors aged under 60 years are non-native Swedes which pose new aspects and challenges to a post-polio outpatient clinic. To analyze the medical data, walking aids, occupational, and family situation in non-native polio survivors aged less than 60 years at a Swedish post-polio outpatient clinic. Retrospective data analysis. Data were retrieved from medical records at the post-polio outpatient clinic. Actual age, age at acute polio infection, walking capacity, pain, concomitant diseases, working and family situation, and ethnical origin were analyzed. Data are presented in numbers and percentage. 153 patients were included. Mean age was 45 (17-60) years, and mean age at acute polio infection was 2 (0-12) years. Paresis of the lower extremities was the most common disability. 10 % were wheelchair dependent. Pain occurred in 70 % with a mean intensity of 55 measured with the visual analog scale. Hypertension was the most common concomitant disease. Half of the polio survivors were working at least part time, and roughly half were singles. Data were comparable with data earlier published in Swedish native polio survivors. Non-native polio survivors aged under 60 years showed similarities in age at acute polio infection, paresis, prevalence, and intensity of pain when compared with native Swedish polio survivors. They were, however, younger, and were less often working and married/cohabitants than native Swedish polio survivors. The results of this study underline the importance of social and vocational rehabilitation tailoring rehabilitation suitable for polio survivors with a foreign background.

  2. The clinical meaning of oxaluria in chronic obstructive pulmonary disease patients with comorbid chronic pyelonephritis on the background of urolithiasis.

    Directory of Open Access Journals (Sweden)

    O. S. Khukhlina

    2017-06-01

    Full Text Available Aim. To study clinical peculiarities of chronic obstructive pulmonary disease in patients with comorbid chronic pyelonephritis on the background of urolithiasis with oxaluria. Materials and methods. 60 patients were included into the study and divided into 3 groups. Study groups: I-st group - 18 patients with isolated course of chronic pyelonephritis (CP and urolithiasis (U of oxalic and mixed genesis, II-nd group - 19 patients with chronic obstructive pulmonary disease (COPD, study group III - 23 patients with COPD, CP and U of oxalic genesis. Additional control group consisted of 20 practically healthy individuals (PHI of corresponding age and gender. Laboratory and clinical examination of the patients was conducted. Spectrophotometry with polarization of biologic material was performed. Statistical analysis was done in Primer of Biostatistics, Origin 8.0. Results. Systemic inflammation in patients with COPD and comorbid CP with oxaluria form the syndrome of mutual burdening. This fact was proved by inverse correlation between oxalate salts in sputum (15,5±1,0 mg/24h and reduction of forced expiratory volume in 1 second (FEV1 in group III. This result was in 2,1 lower than in PHI (r = -0,53,р<0,05. Conclusions. Taking into account data of the anamnesis, patients with COPD, comorbid CP and urolithiasis with oxaluria, had more severe course of COPD than patients with isolated COPD. This can be explained by the oxalic acid crystals deposition in bronchial wall. Stated above clinical characteristics are the features of respiratory oxalosis that needs special treatment.

  3. Splenic rupture following idiopathic rupture of the urinary bladder presenting as acute abdomen

    Directory of Open Access Journals (Sweden)

    Jurisic D

    2007-01-01

    Full Text Available Idiopathic rupture of the urinary bladder is an uncommon condition and represents less than 1% of all bladder rupture cases. In most of the cases the main etiological factor was heavy alcohol ingestion. A combined injury of the spleen and bladder is a very rare condition that is almost often associated with trauma and foreign bodies. In this paper we present the extremely rare clinical course of acute abdomen caused by a combined spontaneous intraperitoneal injury; spontaneous rupture of the urinary bladder and spleen. According to our opinion, spontaneous bladder rupture caused by bladder distension due to alcohol ingestion led to urinary ascites and abdominal distension. Finally, repeated minor abdominal blunt trauma during everyday life, to a moderately distended abdomen caused a spontaneous splenic rupture in the patient with abnormal coagulation studies.

  4. A Rare Cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception.

    Science.gov (United States)

    Sertkaya, Mehmet; Emre, Arif; Pircanoglu, Eyüp Mehmet; Yazar, Fatih Mehmet; Tepe, Murat; Cengiz, Emrah; Isler, Ali; Vicdan, Halit

    2016-01-01

    Intussusception in adults is very rarely seen, and this cause acute abdomen. A computed tomography (CT) scan, clinical suspicion, history, and a physical examination are important for the diagnosis. We present two cases of colonic intussusceptions induced by lipoma. The cases had similar locations, diagnoses, and management. Both lipomas were located close to the cecum in the ascending colon, and a right segmental colon resection was performed in both cases. The follow-up of both cases was uneventful. Although benign lesions can cause colonic intussusception, the high incidence of malignancy in colonic lesions should always be considered. Therefore, oncologic surgical procedures should be applied. The definitive diagnosis can be made by histopathology. Sertkaya M, Emre A, Pircanoglu EM, Yazar FM, Tepe M, Cengiz E, Isler A, Vicdan H. A Rare cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception. Euroasian J Hepato-Gastroenterol 2016;6(2):179-182.

  5. Lymphangioma of the jejunal mesentery and jejunal polyps presenting as an acute abdomen in a teenager.

    Science.gov (United States)

    Jayasundara, Jasb; Perera, E; Chandu de Silva, M V; Pathirana, A A

    2017-03-01

    Cystic lymphangioma of the small bowel mesentery is a rare clinical entity, especially after childhood. Medical literature reveals a limited number of such cases presenting as acute abdomen due to bowel obstruction, small bowel volvulus and bleeding into the tumour. We present the management experience of an 18-year-old woman who presented with rapid onset diffuse peritonism and raised inflammatory markers. Computed tomography showed a mass in the small bowel mesentery with suspicion of segmental bowel ischaemia. Emergency laparotomy revealed a mass in the mid-jejunal mesentery close to the bowel wall with no bowel ischaemia. The patient made an uncomplicated recovery after segmental bowel resection and end-to-end anastomosis. Histology confirmed the mass as a cystic lymphangioma involving the jejunal mesentery and two small jejunal polyps. Lymphangioma could be considered in the differential diagnosis of an acute abdomen in a young adult when the presentation is atypical.

  6. Dose estimation in CT exams of the abdomen based on values of DLP

    International Nuclear Information System (INIS)

    Kikuti, C.F.; Medeiros, R.B.; Salvadori, P.S.; Costa, D.M.C; D'lppolito, G.

    2013-01-01

    One of the challenges of multidetector computerized tomography is to minimize the risk of ionizing radiation using optimized protocols since higher doses are necessary to obtain high image quality. It was also noted that, due to the geometry in image acquisition using MDCT becomes necessary to estimate dose values consistent with the hypothesis clinically and with the specificities of the tomographic equipment. The aim of this study was to estimate the doses in abdomen exams from the data recorded on the MDCT console and dimensions obtained from DICOM images of patients undergoing different clinical protocols. Were collected, from the image DICOM of 101 exams, values of the dose length product (DLP) provided by Philips Health Care - Brilliance 64 equipment console, in order to relate them with the dose values obtained by means of thermoluminescent dosimeters ( TLD ) of CasSo 4 :Mn placed on the surface of a cylindrical simulator abdomen acrylic manufactured under the technical - operational conditions for a typical abdomen exam. From the data obtained, it was possible to find a factor of 1.16 ( 5 % ) indicating that the DLP values Brilliance 64 console underestimate the doses and this should be used with correction factor to estimate the total dose of the patient. (author)

  7. Initial clinical experience with spiral CT angiography in the abdomen

    International Nuclear Information System (INIS)

    Gaa, J.; Stehling, M.K.; Costello, P.

    1993-01-01

    The latest developments in modern CT instruments, offering scanning times of a second, opened up new possibilities in CT imaging in combination with the spiral technique. The data set normally taken with single-breath-hold technique is free of respiratory artefacts and thus is a good basis for accurate 3D image reconstruction. Spiral CTA allows a non-invasive 3D imaging of various blood vessels. Patients with abdominal aortic aneurysms of aorto-iliac bypass can be examined as outpatients within 15 minutes. (orig.) [de

  8. A Clinical Skills Instruction Program: The Acute Abdomen.

    Science.gov (United States)

    Laube, Douglas W.; And Others

    1982-01-01

    An effective evaluation of the acutely ill female implies a thorough examination that integrates skills representing three learning domains. This process should include: a thorough medical history, a physical examination, good patient-physician rapport, and development of an efficacious management plan. A University of Iowa simulation approach is…

  9. 49 CFR 572.75 - Lumbar spine, abdomen, and pelvis assembly and test procedure.

    Science.gov (United States)

    2010-10-01

    ...) ANTHROPOMORPHIC TEST DEVICES 6-Year-Old Child § 572.75 Lumbar spine, abdomen, and pelvis assembly and test procedure. (a) Lumbar spine, abdomen, and pelvis assembly. The lumbar spine, abdomen, and pelvis consist of... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine, abdomen, and pelvis assembly and...

  10. Analysis of the clinical backgrounds of patients who developed respiratory acidosis under high-flow oxygen therapy during emergency transport.

    Science.gov (United States)

    Ogino, Hirokazu; Nishimura, Naoki; Yamano, Yasuhiko; Ishikawa, Genta; Tomishima, Yutaka; Jinta, Torahiko; Takahashi, Osamu; Chohnabayashi, Naohiko

    2016-01-01

    High-flow oxygen is often administered to patients during emergency transport and can sometimes cause respiratory acidosis with disturbed consciousness, thereby necessitating mechanical ventilation. Although oxygen titration in chronic obstructive pulmonary disease patients during emergency transport reduces mortality rates, the clinical risk factors for respiratory acidosis in emergency settings are not fully understood. Therefore, we analyzed the clinical backgrounds of patients who developed respiratory acidosis during pre-hospital transport. This was a retrospective study of patients who arrived at our hospital by emergency transport in 2010 who received high-flow oxygen while in transit. Respiratory acidosis was defined by the following arterial blood gas readings: pH, ≤7.35; PaCO 2 , ≥45 mmHg; and HCO 3 - , ≥24 mmol/L. The risk factors were identified using multivariable logistic regression analysis. In 765 study patients, 66 patients showed respiratory acidosis. The following risk factors for respiratory acidosis were identified: age, ≥65 years (odds ratio [OR] 1.4; 95% confidence interval [CI], 0.7-2.8); transportation time, ≥10 min (OR 2.0; 95% CI, 1.1-3.7); three digits on the Japan Coma Scale (OR 3.1; 95% CI, 1.7-5.8); percutaneous oxygen saturation, ≤90% (OR 1.6; 95% CI, 0.8-3.0); tuberculosis (OR 4.5; 95% CI, 1.4-15.1); asthma (OR 1.8; 95% CI, 0.6-5.3); pneumonia (OR 1.5; 95% CI, 0.7-3.1); and lung cancer (OR 3.9; 95% CI, 1.5-10.1). These underlying diseases as risk factors included both comorbid diseases and past medical conditions. The factors identified may contribute to the development of respiratory acidosis. Further studies on preventing respiratory acidosis will improve the quality of emergency medical care.

  11. Portable abdomen radiography. Moving to thickness-based protocols

    International Nuclear Information System (INIS)

    Sanchez, Adrian A.; Reiser, Ingrid; Baxter, Tina; Zhang, Yue; Finkle, Joshua H.; Lu, Zheng Feng; Feinstein, Kate A.

    2018-01-01

    Default pediatric protocols on many digital radiography systems are configured based on patient age. However, age does not adequately characterize patient size, which is the principal determinant of proper imaging technique. Use of default pediatric protocols by inexperienced technologists can result in patient overexposure, inadequate image quality, or repeated examinations. To ensure diagnostic image quality at a well-managed patient radiation exposure by transitioning to thickness-based protocols for pediatric portable abdomen radiography. We aggregated patient thickness data, milliamperes (mAs), kilovoltage peak (kVp), exposure index (EI), source-to-detector distance, and grid use for all portable abdomen radiographs performed in our pediatric hospital in a database with a combination of automated and manual data collection techniques. We then analyzed the database and used it as the basis to construct thickness-based protocols with consistent image quality across varying patient thicknesses, as determined by the EI. Retrospective analysis of pediatric portable exams performed at our adult-focused hospitals demonstrated substantial variability in EI relative to our pediatric hospital. Data collection at our pediatric hospital over 4 months accumulated roughly 800 portable abdomen exams, which we used to develop a thickness-based technique chart. Through automated retrieval of data in our systems' digital radiography exposure logs and recording of patient abdomen thickness, we successfully developed thickness-based techniques for portable abdomen radiography. (orig.)

  12. Portable abdomen radiography. Moving to thickness-based protocols

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez, Adrian A.; Reiser, Ingrid; Baxter, Tina; Zhang, Yue; Finkle, Joshua H.; Lu, Zheng Feng; Feinstein, Kate A. [University of Chicago Medical Center, Department of Radiology, Chicago, IL (United States)

    2018-02-15

    Default pediatric protocols on many digital radiography systems are configured based on patient age. However, age does not adequately characterize patient size, which is the principal determinant of proper imaging technique. Use of default pediatric protocols by inexperienced technologists can result in patient overexposure, inadequate image quality, or repeated examinations. To ensure diagnostic image quality at a well-managed patient radiation exposure by transitioning to thickness-based protocols for pediatric portable abdomen radiography. We aggregated patient thickness data, milliamperes (mAs), kilovoltage peak (kVp), exposure index (EI), source-to-detector distance, and grid use for all portable abdomen radiographs performed in our pediatric hospital in a database with a combination of automated and manual data collection techniques. We then analyzed the database and used it as the basis to construct thickness-based protocols with consistent image quality across varying patient thicknesses, as determined by the EI. Retrospective analysis of pediatric portable exams performed at our adult-focused hospitals demonstrated substantial variability in EI relative to our pediatric hospital. Data collection at our pediatric hospital over 4 months accumulated roughly 800 portable abdomen exams, which we used to develop a thickness-based technique chart. Through automated retrieval of data in our systems' digital radiography exposure logs and recording of patient abdomen thickness, we successfully developed thickness-based techniques for portable abdomen radiography. (orig.)

  13. Prevention of Incisional Hernias after Open Abdomen Treatment

    Directory of Open Access Journals (Sweden)

    Frederik Berrevoet

    2018-02-01

    Full Text Available Management of a patient with an open abdomen is difficult, and the primary closure of the fascial edges is essential to obtain the best patient outcome, regardless of the initial etiology of the open abdomen. The use of temporary abdominal closure devices is nowadays the gold standard to have the highest closure rates with mesh-mediated fascial traction as the proposed standard of care. However, the incidence of incisional hernias, although much more controlled than when leaving an abdomen open, is high and reaches up to 65%. As shown for other high-risk patient subgroups, such as obese patients, patients with an abdominal aneurysm, and patients with former -ostomy sites, the prevention of incisional hernias might be key to further optimize patient outcomes after open abdomen treatment. In this overview, current available modalities to decrease the incidence of incisional hernia are discussed. Most of these preventive options have been shown effective in giant ventral hernia repair and might work effectively in this patient cohort with open abdomen as well.

  14. Lincosamide resistance is less frequent in Denmark in Staphylococcus pseudintermedius from first-time canine superficial pyoderma compared with skin isolates from clinical samples with unknown clinical background.

    Science.gov (United States)

    Larsen, Rikke; Boysen, Lene; Berg, June; Guardabassi, Luca; Damborg, Peter

    2015-06-01

    Antimicrobial resistance may be overestimated in bacterial isolates from clinical samples because veterinarians often submit samples in cases of treatment failure or recurrent cases, which are more frequently associated with resistant strains. To assess to what extent the prevalence of antimicrobial resistance in Staphylococcus pseudintermedius isolated from first-time superficial pyoderma differs from canine skin isolates from clinical samples with unknown clinical background. Two study groups were enrolled in Denmark between March 2012 and October 2013: 57 dogs with first-time superficial pyoderma and no prior antimicrobial treatment (Group A); and 289 different dogs for which skin specimens were submitted for culture during the study (Group B). One S. pseudintermedius isolate from each dog was confirmed by MALDI-TOF mass spectrometry and tested for antimicrobial susceptibility by broth microdilution. Resistance levels in the two groups were compared by Fisher's exact test. Clindamycin resistance was less frequent in Group A (14%) than in Group B (27%) (P = 0.02). Similar trends were observed for amoxicillin-clavulanic acid (1.8 versus 4.8%), chloramphenicol (8.8 versus 14.5%), enrofloxacin (1.8 versus 3.5%), oxacillin (1.8 versus 4.8%) and trimethoprim/sulfamethoxazole (3.5 versus 5.9%). Oxacillin resistance was significantly associated with resistance to six of seven non-β-lactams. The prevalence of lincosamide resistance is markedly influenced by patients' clinical and antimicrobial treatment history. To limit selection of multidrug-resistant bacteria, lincosamides are appropriate empirical choices for treatment of first-time superficial pyoderma even though resistance is not infrequent. Culture and susceptibility testing are, however, recommended for all pyoderma patients. © 2015 ESVD and ACVD.

  15. Factors that affect the accuracy in the precise radiotherapy for abdomen tumors

    International Nuclear Information System (INIS)

    Yang Tieming; Ju Yongjian

    2008-01-01

    The precise radiotherapy has been widely used in the clinics. But there are many factors that affect the accuracy in the course of implementation. Finally the effect of radiotherapy is affected. These factors are reviewed. And the previous research data about the abdomen tumors is summed up. Also how the accuracy was affected by the respiratory movement, positioning, position fixed technology, weight, retraction and motion of the tumor and the situation of surrounding organs will be analyzed. At last, how to avoid these errors in clinics will be discussed. (authors)

  16. Estimation of breast dose and cancer risk in chest and abdomen CT procedures

    International Nuclear Information System (INIS)

    Eltahir, Suha Abubaker Ali

    2013-05-01

    The use of CT in medical diagnosis delivers radiation doses to patents that are higher than those from other radiological procedures. Lack of optimized protocols be an additional source of increased dose in developing countries. The aims of this study are first, to measure patient doses during CT chest and abdomen procedures, second, to estimate the radiation dose to the breast, and third to quantify the radiation risks during the procedures. Patient doses from two common CT examinations were obtained from four hospitals in Khartoum.The patient doses were estimated using measurement of CT dose indexes (CTDI), exposure-related parameters, and the IMPACT spreadsheet based on NRPB conversion factors. A large variation of mean organ doses among hospitals was observed for similar CT examinations. These variations largely originated from different CT scanning protocols used in different hospitals and scanner type. The largest range was found for CT of the chest, for which the dose varied from 2.3 to 47 (average 24.7) mSv and for abdomen CT, it was 1.6 to 18.8 (average 10.2) mSv. Radiation dose to the breast ranged from 1.6 to 32.9 mSv for the chest and 1.1 to 13.2 mSv for the abdomen. The radiation risk per procedure was high. The obtained values were mostly higher than the values of organ doses reported from the other studies. It was concluded that current clinical chest and abdomen protocols result in variable radiation doses to the breast. The magnitude of exposure may have implications for imaging strategies.(Author)

  17. Differential diagnosis of the acute abdomen. Pt. 2

    International Nuclear Information System (INIS)

    Wiesner, Walter; Kirchhoff, Timm D.; Opherk, Jan Patrick

    2009-01-01

    The imaging of the acute abdomen has undergone fundamental changes in the recent past. The diagnostic strategy requires an up-date since ultrasound and computed-tomography have replaced classic radiography in cases of acute lower abdominal pain as well. The present contribution is the second of four reviews on this issue and focuses on the acute lower quadrant pain while part three will depict diffuse acute abdominal pain and, finally, the diagnostic strategy of the acute abdomen in childhood will be described in part four. (orig.)

  18. Diffusion-weighted magnetic resonance imaging of the abdomen; Diffusionsgewichtete Magnetresonanztomographie des Abdomens

    Energy Technology Data Exchange (ETDEWEB)

    Schmid-Tannwald, C.; Reiser, M.F.; Zech, C.J. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany)

    2011-03-15

    Diffusion-weighted magnetic resonance imaging (DW-MRI) provides qualitative and quantitative information of tissue cellularity and the integrity of cellular membranes. Since DW-MRI can be performed without ionizing radiation exposure and contrast media application, DW-MRI is a particularly attractive tool for patients with allergies for gadolinium-based contrast agents or renal failure. Recent technical developments have made DW-MRI a robust and feasible technique for abdominal imaging. DW-MRI provides information on the detection and characterization of focal liver lesions and can also visualize treatment effects and early changes in chronic liver disease. In addition DW-MRI is a promising tool for the detection of inflammatory changes in patients with Crohn's disease. (orig.) [German] Die diffusionsgewichtete (DW-)MRT ermoeglicht die Erfassung qualitativer und quantitativer Informationen bzgl. der Gewebezellularitaet und Membranintegritaet. Die DW-MRT ist insbesondere bei Patienten mit einer Allergie gegen gadoliniumhaltige Kontrastmittel oder eingeschraenkter Nierenfunktion attraktiv, da ihr Einsatz nicht mit Strahlenexposition oder Kontrastmittelgabe verbunden ist. Durch technische Weiterentwicklungen ist die robuste Anwendung der DW-MRI in der Bildgebung des Abdomens seit einiger Zeit moeglich geworden. In der Leberdiagnostik lassen sich Zusatzinformationen zur Detektion und Charakterisierung von Leberlaesionen gewinnen, aber auch Therapieerfolge dokumentieren und fruehe chronische Leberveraenderungen visualisieren. Neben ihrer Rolle bei hepatologischen und onkologischen Fragestellungen erscheint der Einsatz der DW-MRT zudem bei entzuendlichen Fragestellungen wie dem Morbus Crohn sehr viel versprechend. (orig.)

  19. Analysis of the clinical backgrounds of patients who developed respiratory acidosis under high‐flow oxygen therapy during emergency transport

    Science.gov (United States)

    Ogino, Hirokazu; Yamano, Yasuhiko; Ishikawa, Genta; Tomishima, Yutaka; Jinta, Torahiko; Takahashi, Osamu; Chohnabayashi, Naohiko

    2015-01-01

    Aim High‐flow oxygen is often administered to patients during emergency transport and can sometimes cause respiratory acidosis with disturbed consciousness, thereby necessitating mechanical ventilation. Although oxygen titration in chronic obstructive pulmonary disease patients during emergency transport reduces mortality rates, the clinical risk factors for respiratory acidosis in emergency settings are not fully understood. Therefore, we analyzed the clinical backgrounds of patients who developed respiratory acidosis during pre‐hospital transport. Methods This was a retrospective study of patients who arrived at our hospital by emergency transport in 2010 who received high‐flow oxygen while in transit. Respiratory acidosis was defined by the following arterial blood gas readings: pH, ≤7.35; PaCO 2, ≥45 mmHg; and HCO 3 −, ≥24 mmol/L. The risk factors were identified using multivariable logistic regression analysis. Results In 765 study patients, 66 patients showed respiratory acidosis. The following risk factors for respiratory acidosis were identified: age, ≥65 years (odds ratio [OR] 1.4; 95% confidence interval [CI], 0.7–2.8); transportation time, ≥10 min (OR 2.0; 95% CI, 1.1–3.7); three digits on the Japan Coma Scale (OR 3.1; 95% CI, 1.7–5.8); percutaneous oxygen saturation, ≤90% (OR 1.6; 95% CI, 0.8–3.0); tuberculosis (OR 4.5; 95% CI, 1.4–15.1); asthma (OR 1.8; 95% CI, 0.6–5.3); pneumonia (OR 1.5; 95% CI, 0.7–3.1); and lung cancer (OR 3.9; 95% CI, 1.5–10.1). These underlying diseases as risk factors included both comorbid diseases and past medical conditions. Conclusions The factors identified may contribute to the development of respiratory acidosis. Further studies on preventing respiratory acidosis will improve the quality of emergency medical care. PMID:29123744

  20. 'You find yourself.' Perceptions of nursing students from non-English speaking backgrounds of the effect of an intensive language support program on their oral clinical communication skills.

    Science.gov (United States)

    Rogan, Fran; San Miguel, Caroline; Brown, Di; Kilstoff, Kathleen

    2006-10-01

    Nurses of ethnically diverse backgrounds are essential in providing multicultural populations in western societies with culturally and linguistically competent health care. However, many nurses from non-English speaking backgrounds (NESB) are at high risk of failure in university programs particularly during clinical placements. Few studies investigate the clinical experiences of students from NESB and strategies to support their learning. This study describes perceptions of fifteen undergraduate nursing students from NESB about their first clinical placement in an Australian university program and the effect of a language support program on their oral clinical communication skills. Three categories arose: *Wanting to belong but feeling excluded; *Wanting to learn how to...; and *You find yourself. While many students find clinical placement challenging, it appeared difficult for students in this study as language and cultural adjustments required some modification of their usual ways of thinking and communicating, often without coping strategies available to other students.

  1. Huge Mesenteric Lymphangioma – A Rare Cause of Acute Abdomen

    African Journals Online (AJOL)

    Lymphangiomas are benign congenital masses which occur most commonly in head and neck of children and incidence of mesenteric lymphangiomas is very rare. We report such a case of huge mesenteric lymphangioma in a 20 year old male who presented to us with acute abdomen. Pre-operative diagnosis is difficult ...

  2. Surgically treated acute abdomen at Gondar University Hospital ...

    African Journals Online (AJOL)

    Conclusion: This study has shown what the commonest symptoms of acute abdomen are and that the outcome of emergency laparotomy may be affected by different factors. Some of these factors were duration of illness, age, presence of peritonitis, Haematocrit level and complication detection time. Since the management ...

  3. Chilaiditi's syndrome as an acute abdomen | Jambo | Port Harcourt ...

    African Journals Online (AJOL)

    The interposed loop of bowel reduced spontaneously following conservative management. Conclusion: As Chilaiditi syndrome is a rare disease entity, a high index of suspicion is required to make an accurate diagnosis. It should be considered as one of the differential diagnoses of an acute abdomen. Keywords: Acute ...

  4. Nutritional management of a patient with an open abdomen

    African Journals Online (AJOL)

    2014-08-14

    Aug 14, 2014 ... Keywords: nutritional, management, open abdomen. Introduction ... lower than required energy intake (25 kCal/kg), and increasing it to target over the ..... Trauma and surgery lead to an intense inflammatory response and possible ... state, characterised by muscle breakdown, acute protein malnutrition ...

  5. Septic Arthritis of The Hip Joint presenting as Acute Abdomen ...

    African Journals Online (AJOL)

    These cases illustrate the maxim that any painful movement of the hip joint with associated unexplained fever should raise suspicion of septic arthritis. The close relationship of the hip joint to the pelvis sometimes confuses hip diseases with pelvic pathologies. Key Words: Septic arthritis, acute abdomen, pathological ...

  6. Analysis of the computed tomography in the acute abdomen

    International Nuclear Information System (INIS)

    Hochhegger, Bruno; Moraes, Everton; Haygert, Carlos Jesus Pereira; Antunes, Paulo Sergio Pase; Gazzoni, Fernando; Lopes, Luis Felipe Dias

    2007-01-01

    Introduction: This study tends to test the capacity of the computed tomography in assist in the diagnosis and the approach of the acute abdomen. Material and method: This is a longitudinal and prospective study, in which were analyzed the patients with the diagnosis of acute abdomen. There were obtained 105 cases of acute abdomen and after the application of the exclusions criteria were included 28 patients in the study. Results: Computed tomography changed the diagnostic hypothesis of the physicians in 50% of the cases (p 0.05), where 78.57% of the patients had surgical indication before computed tomography and 67.86% after computed tomography (p = 0.0546). The index of accurate diagnosis of computed tomography, when compared to the anatomopathologic examination and the final diagnosis, was observed in 82.14% of the cases (p = 0.013). When the analysis was done dividing the patients in surgical and nonsurgical group, were obtained an accuracy of 89.28% (p 0.0001). The difference of 7.2 days of hospitalization (p = 0.003) was obtained compared with the mean of the acute abdomen without use the computed tomography. Conclusion: The computed tomography is correlative with the anatomopathology and has great accuracy in the surgical indication, associated with the capacity of increase the confident index of the physicians, reduces the hospitalization time, reduces the number of surgeries and is cost-effective. (author)

  7. Burst abdomen in pregnancy: A proposed management algorithm ...

    African Journals Online (AJOL)

    Management of the burst abdomen is complex due to the co-morbidities associated with it. When coupled with intraabdominal sepsis and pregnancy, it becomes even more difficult due to the ethical issues that have to be considered when managing both mother and child. Due to the paucity of literature on this subject, ...

  8. Treatment of the complex abdomen and acute intestinal failure

    NARCIS (Netherlands)

    de Vries, F.E.E.

    2018-01-01

    Management of the complex abdomen and acute intestinal failure (IF) is challenging and requires specialized multidisciplinary treatment. Due to the small numbers and heterogeneity of the patient group high-quality evidence for some of the research questions is probably unachievable. Nevertheless,

  9. Gossypiboma of the Abdomen and Pelvis; A Recurring Error

    African Journals Online (AJOL)

    Moi Hospital, Voi, Kenya. Correspondence to: Dr. Gilbert Maranya, P.O Box 91066-80103 Mombasa, Kenya. Email: gilbertmaranya@gmail.com. CASE SERIES. Abstract. Introduction: Gossypiboma is a retained surgical sponge commonly in the abdomen and pelvis. Risk factors include emergency and prolonged surgery.

  10. Impalement Injury to the Abdomen: Report of a Case

    African Journals Online (AJOL)

    2017-10-26

    Oct 26, 2017 ... is even more demanding in environments where health-care personnel, facilities for emergency care, and communications infrastructure are absent or poorly funded and equipped. The primary objective of ... palm tree and got impaled through his lower abdomen on a sharp, freshly cut branch of a tree.

  11. Role of Ultrasonography in Acute Abdomen

    International Nuclear Information System (INIS)

    An, Ji Hyun; Lee, Yeon Hee; Kim, Tae Hoon; Yu, Pil Mun; Choi, Young Hi; Kim, Sang Joon; Kim, Seung Cheul; Cho, Jeong Hee; Jung, Jae Un

    1996-01-01

    Authors analyzed the distribution of diseases and compared ultrasonographic conclusions with confirmed diagnoses of emergency abdominal ultrasonographies in acute abdominal conditions. We evaluated the role of emergency abdominal ultrasonography especially in the decision of emergency operation. In one hundred and forty five patients, emergent abdominal ultrasonography was performed within on admission. We compared the sonographic conclusion with postoperative pathology and analyzed the diagnoses of medically treated diseases. Twenty-eight patients under vent surgery and 117 patients were treated conservatively. Among the surgically treated patients, 19 patients (70.4%) were correctly diagnosed by preoperative ultrasonography.These included acute appendicitis (N = 8), acute cholecystitis (n = 7), ovarian cyst torsion (n = 2), and liver abscess (n = 1). Correct preoperative diagnosis was not made in 9 patients, including acute appendicitis (n = 4),peritonitis due to bowel perforation (n = 2), ectopic pregnancy (n = 1), colonic diverticulitis (n = 1 ) and pelvic inflammatory disease (n = 1 ). Clinical follow up was possible in 50 patients among the non-operative patient group, and the clinical diagnoses were chronic liver disease (n = 14), acute pyelonephritis (n = 10), and biliary stone (n = 10). Emergent ultrasonography plays an important role in acute abdominal conditions by supporting the differential diagnosis of medical and surgical disease

  12. Role of Ultrasonography in Acute Abdomen

    Energy Technology Data Exchange (ETDEWEB)

    An, Ji Hyun; Lee, Yeon Hee; Kim, Tae Hoon; Yu, Pil Mun; Choi, Young Hi; Kim, Sang Joon; Kim, Seung Cheul; Cho, Jeong Hee [Dankook University College of Medicine, Cheonan (Korea, Republic of); Jung, Jae Un [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1996-12-15

    Authors analyzed the distribution of diseases and compared ultrasonographic conclusions with confirmed diagnoses of emergency abdominal ultrasonographies in acute abdominal conditions. We evaluated the role of emergency abdominal ultrasonography especially in the decision of emergency operation. In one hundred and forty five patients, emergent abdominal ultrasonography was performed within on admission. We compared the sonographic conclusion with postoperative pathology and analyzed the diagnoses of medically treated diseases. Twenty-eight patients underwent surgery and 117 patients were treated conservatively. Among the surgically treated patients, 19 patients (70.4%) were correctly diagnosed by preoperative ultrasonography.These included acute appendicitis (N = 8), acute cholecystitis (n = 7), ovarian cyst torsion (n = 2), and liver abscess (n = 1). Correct preoperative diagnosis was not made in 9 patients, including acute appendicitis (n = 4), peritonitis due to bowel perforation (n = 2), ectopic pregnancy (n = 1), colonic diverticulitis (n = 1) and pelvic inflammatory disease (n = 1). Clinical follow up was possible in 50 patients among the non-operative patient group, and the clinical diagnoses were chronic liver disease (n = 14), acute pyelonephritis (n = 10), and biliary stone (n = 10). Emergent ultrasonography plays an important role in acute abdominal conditions by supporting the differential diagnosis of medical and surgical disease

  13. MRI of the abdomen – how we do it?

    International Nuclear Information System (INIS)

    Zlatanov, Y.; Penkov, M.

    2013-01-01

    Full text: Introduction: Currently MR tomography in comparison with multidetector CT plays a subordinate role in the diagnostic and imaging algorithm in the study of abdomen organs. However, technical innovation occurring in magnetic resonance imaging, allow us to obtain images with high resolution at an acceptable duration of the study. Moreover assessment of the condition of the biliary system can be optimized through the use of MR cysto- pancreatography that allows non-invasive assessment of pancreatic biliary system, and the use of MR angiography, which visualized in the abdominal vessels. What you will learn: methods for approach to patient for abdominal examination; the advantages and disadvantages of different MR sequences in imaging of organs and structures in the abdomen; the advantages and disadvantages of different types MR cysto- pancreatography for the purpose of magnetic resonance tomography in patients with diseases in the abdomen. Discussion: MR is used for diseases of the organs in the abdomen especially for diagnosis and staging of neoplastic processes, to differentiate between tumors and inflammatory processes, and in the characterization of the cystic lesion. MRI scan has three main tasks in the assessment of the conditions of the organs in the abdomen: should provide a definitive diagnosis in patients with inconclusive data on abdominal ultrasound or CT scan for any pathological process , must allow proper staging of malignancies in order to preoperative assessment of the state of patient and sometimes non-resectability of the tumor formations due to their advancing, should characterize cystic lesions whose frequency increases in the conduct of routine or diagnostic CT studies. Conclusion: As a result of rapid technological progress current protocols for MR examinations of the abdomen are very different from those used 10 years ago. Most sequences can be performed during one or more breath-hold cycle and 3D sequences with thin consecutive

  14. Computed tomography of the traumatized abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Young Woon; Baik, Seung Kug; Lee, Jong Yul; Choi, Han Yong; Kim, Bong Ki [Wallace Memotial Baptist Hospital, Pusan (Korea, Republic of)

    1989-02-15

    Forty-seven patients with abdominal and retroperitoneal injuries were examined by computed tomography(CT). We analyzed the results of 47 patients who were confirmed of abdominal injuries by operation, clinical follow up, and repeated radiologic examinations. 1. the type of trauma was blunt in 38 patients (81%) and penerating in 9 patients (19%) 2. There were 14 splenic, 11 renal, 9 hepatic, 6 retroperitoneal, 4 pancreatic, and 3 alimentary tract injuries. 3. The patients who had been treated by conservative management were 23.4% (surgical treatment,76.6%). 4. The six ratio was 4.9 : 1.0 (male ; female). 5. CT has major advantage over plain radiography, radionuclide imaging, and angiography in assessment of trauma-induced injuries.

  15. Computed tomography of the traumatized abdomen

    International Nuclear Information System (INIS)

    Yoon, Young Woon; Baik, Seung Kug; Lee, Jong Yul; Choi, Han Yong; Kim, Bong Ki

    1989-01-01

    Forty-seven patients with abdominal and retroperitoneal injuries were examined by computed tomography(CT). We analyzed the results of 47 patients who were confirmed of abdominal injuries by operation, clinical follow up, and repeated radiologic examinations. 1. the type of trauma was blunt in 38 patients (81%) and penerating in 9 patients (19%) 2. There were 14 splenic, 11 renal, 9 hepatic, 6 retroperitoneal, 4 pancreatic, and 3 alimentary tract injuries. 3. The patients who had been treated by conservative management were 23.4% (surgical treatment,76.6%). 4. The six ratio was 4.9 : 1.0 (male ; female). 5. CT has major advantage over plain radiography, radionuclide imaging, and angiography in assessment of trauma-induced injuries

  16. Sci-Fri AM: MRI and Diagnostic Imaging - 02: Quality Improvement: Diagnostic Reference Levels for Interior Health CT exams – L-Spine, Chest/Abdomen/pelvis, Abdomen/Pelvis, Head

    International Nuclear Information System (INIS)

    Bjarnason, Thorarin

    2016-01-01

    Diagnostic Reference Levels are used to optimize patient dose and image quality in the clinical setting. It is assumed that the majority of exams are of diagnostic quality, or the radiologists would request protocol adjustments. By investigating the dose indicator distributions from all scanners, the upper DRL can be set to the 75th percentile of the distribution and a lower DRL can be set to the 10th percentile. Scanners using doses consistently outside the upper/lower DRL range can be adjusted accordingly. 11 CT scanners, all contributing to the American College of Radiology Dose Index Registry (ACR DIR) were used in this study. Dose indicator data were compiled from the ACR DIR data and local DRLs established. Scanners with median doses outside the upper/lower DRL were followed-up with. Using effective dose and exam volumes, collective dose was determined before and after protocol adjustments to evaluate the effect of this quality improvement effort. The quality initiative is complete for L-spine and Chest/Abdomen/Pelvis exams and only initial surveys were completed for Head and Abdomen/Pelvis examsg. Median Scanner Dose reductions were 8.8 and 4.9 % for L-spine and Chest/Abdomen/Pelvis exams, respectively, resulting with collective dose reductions of 0.7 and 3.2 person•Sv/yr. Follow-up is ongoing for Abdomen/Pelvis and Head exams.

  17. Sci-Fri AM: MRI and Diagnostic Imaging - 02: Quality Improvement: Diagnostic Reference Levels for Interior Health CT exams – L-Spine, Chest/Abdomen/pelvis, Abdomen/Pelvis, Head

    Energy Technology Data Exchange (ETDEWEB)

    Bjarnason, Thorarin [Diagnostic Imaging / Interior Health, Mathematics, Statistics, Physics & Computer Science / UBCO (Canada); Radiology / UBC (Canada)

    2016-08-15

    Diagnostic Reference Levels are used to optimize patient dose and image quality in the clinical setting. It is assumed that the majority of exams are of diagnostic quality, or the radiologists would request protocol adjustments. By investigating the dose indicator distributions from all scanners, the upper DRL can be set to the 75th percentile of the distribution and a lower DRL can be set to the 10th percentile. Scanners using doses consistently outside the upper/lower DRL range can be adjusted accordingly. 11 CT scanners, all contributing to the American College of Radiology Dose Index Registry (ACR DIR) were used in this study. Dose indicator data were compiled from the ACR DIR data and local DRLs established. Scanners with median doses outside the upper/lower DRL were followed-up with. Using effective dose and exam volumes, collective dose was determined before and after protocol adjustments to evaluate the effect of this quality improvement effort. The quality initiative is complete for L-spine and Chest/Abdomen/Pelvis exams and only initial surveys were completed for Head and Abdomen/Pelvis examsg. Median Scanner Dose reductions were 8.8 and 4.9 % for L-spine and Chest/Abdomen/Pelvis exams, respectively, resulting with collective dose reductions of 0.7 and 3.2 person•Sv/yr. Follow-up is ongoing for Abdomen/Pelvis and Head exams.

  18. Usefulness of the helical CT in gastro intestinally caused acute abdomen

    International Nuclear Information System (INIS)

    Cruz, R. A. de la; Martel, J.; Albillos, J. C.; Oliver, J. M.; Lopez, J.; Trapero, M. A.

    2000-01-01

    At present, there is a vivid debate on the role of the Helical CT (HCT) in the acute abdomen, principally on the usefulness of the non contrast HCT. We aim to present the most common semiological findings and the differential diagnoses, and to give a short description of the indications and protocols, according to the existing literature and to our experience with HCT during the last three years. We believe that the generalization of the use of HCT in emergencies avoid unnecessary surgery and shorten observation times on many occasions, with clear benefits in the clinical management of the patients. (Author) 30 refs

  19. A Rare Case of Acute Abdomen: Perforation Secondary to Intramural Hematoma at Rectosigmoid Region

    Directory of Open Access Journals (Sweden)

    Orhan Yagmurkaya

    2013-06-01

    Full Text Available Intramural hematoma is a clinical situation which is secondary to anticoagulant therapy. In this study, a chronic atrial fibrilation patient taking anticoagulant, had perforation at rectosigmoid region which was secondary to intramural hematoma, is presented. Our case was a eighty-three-year-old male presented with acute abdomen at emergency room. In computerized tomography, intraabdominal free air and hematoma at rectosigmoid region were seen. Due to these, the decision of immidiate exploration was made. This should be noted that intramural hematoma can emerge in patientd on anticoagulant theraphy without trauma. Additionally, it shold be considered that intramural hematoma can lead to lethal complication such as perforation.

  20. Comparison of Outcomes between Early Fascial Closure and Delayed Abdominal Closure in Patients with Open Abdomen: A Systematic Review and Meta-Analysis

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    Yu Chen

    2014-01-01

    Full Text Available Up to the present, the optimal time to close an open abdomen remains controversial. This study was designed to evaluate whether early fascial abdominal closure had advantages over delayed approach for open abdomen populations. Medline, Embase, and Cochrane Library were searched until April 2013. Search terms included “open abdomen,” “abdominal compartment syndrome,” “laparostomy,” “celiotomy,” “abdominal closure,” “primary,” “delayed,” “permanent,” “fascial closure,” and “definitive closure.” Open abdomen was defined as “fail to close abdominal fascia after a laparotomy.” Mortality, complications, and length of stay were compared between early and delayed fascial closure. In total, 3125 patients were included for final analysis, and 1942 (62% patients successfully achieved early fascial closure. Vacuum assisted fascial closure had no impact on pooled fascial closure rate. Compared with delayed abdominal closure, early fascial closure significantly reduced mortality (12.3% versus 24.8%, RR, 0.53, P<0.0001 and complication incidence (RR, 0.68, P<0.0001. The mean interval from open abdomen to definitive closure ranged from 2.2 to 14.6 days in early fascial closure groups, but from 32.5 to 300 days in delayed closure groups. This study confirmed clinical advantages of early fascial closure over delayed approach in treatment of patients with open abdomen.

  1. AN ANALYSIS ON HOLLOW VISCERAL INJURY AND ITS MANAGEMENT FOLLOWING BLUNT TRAUMA ABDOMEN AT A TERTIARY HEALTHCARE CENTRE

    Directory of Open Access Journals (Sweden)

    Niranjan Sahoo

    2017-10-01

    Full Text Available BACKGROUND Trauma is “the neglected disease of modern developing nations.” Hollow viscous injury following blunt trauma to abdomen is not common. The incidence of hollow viscous injuries following abdominal trauma varies from 2 to 15%. The following study was conducted at Department of General Surgery, MKCG Medical College and Hospital, Berhampur, a tertiary care hospital. MATERIALS AND METHODS All the patients admitted to MKCG Medical College and Hospital, Berhampur, with history of blunt trauma to abdomen were examined carefully. Those patients with symptoms and signs suggestive of visceral injury were identified and subjected to xray chest and abdomen erect view and ultrasound abdomen/CT scan. Those with features of pneumoperitoneum are subjected to laparotomy and treated according to location of perforation. Duration of study was from January 2016 to July 2017. RESULTS This study included people of different age groups from 13 to 65 years. Majority of the patients were men (83.5% and most common mode was found to be road traffic accident (69.6%. Most of the patients injured were young and belonged to earning group (81.44%. Most common viscera injured was ileum (37.85% Most common type of injury encountered in our study was isolated perforation and the common surgical procedure was primary closure. CONCLUSION In cases of polytrauma, blunt abdominal trauma contributes significantly to morbidity and mortality. Both the sexes were affected with a male preponderance. The most common mode of blunt trauma was found to be Road Traffic Accident (RTA. Adequate knowledge regarding suspecting intra-abdominal injuries and timely management at tertiary care centre can definitely bring a marked difference in the prognosis of polytrauma patients with history of blunt trauma to abdomen.

  2. Pattern and presentation of acute abdomen in a Nigerian teaching hospital.

    Science.gov (United States)

    Agboola, John Owoade; Olatoke, Samuel Adegboyega; Rahman, Ganiyu Abebisi

    2014-05-01

    Abdominal pain of sudden onset is the hallmark of most non-traumatic emergency surgical presentations. This presents a scenario of urgency to the young surgeon who has to determine which of a myriad of disease conditions the patient is presenting with. Such a physician has to rely on experience and a sound knowledge of the local aetiological spectrum in making a clinical diagnosis. To determine the epidemiology and aetiological spectrum of diseases presenting as acute abdomen in the adult population at the hospital surgical emergency unit. Two hundred and seventy-six patients presenting at the University of Ilorin Teaching Hospital emergency unit and managed by the general surgeons between 1(st) of May 2009 and 30(th) of April 2010 were recruited and followed-up throughout the period of admission. The biodata and clinical information inclusive of diagnosis, investigations, treatment modality and outcome were entered in a structured questioner. Standardised treatment was given to all patients and difficulties encountered in their management were also noted. The data collected was evaluated using SPSS16. Acute abdomen constituted 9.6% of total surgical emergency admissions with patients aged 16-45 years constituting 78.3%. The commonest cause of acute abdomen was appendicitis (30.3%) followed by intestinal obstruction (27.9%), perforated typhoid ileitis 14.9% and peptic ulcer disease (7.6%), respectively. The result from the study is similar to what has been reported in other tropical settings with inflammatory lesions being the major problem. There is also a rising incidence of post-operative adhesions and gradual decline in incidence of obstructed hernia.

  3. Vacuum-assisted closure of the open abdomen in a resource-limited ...

    African Journals Online (AJOL)

    Vacuum-assisted closure of the open abdomen in a resource-limited setting. ... Massive delays in presentation of patients with acute abdomen are common. Closure at initial laparotomy is not possible in many cases ... with an open abdomen. The management of these patients is particularly labour intensive for nursing staff.

  4. [Anesthesiological management of patients with an acute abdomen].

    Science.gov (United States)

    Sakka, Samir G; Wappler, Frank

    2008-11-01

    Patients with an acute abdomen present with marked deterioration in physiological and pathophysiological conditions, which make general anesthesia to a challenging but also potentially dangerous procedure. A broad and fundamental knowledge of the pathophysiologically involved mechanisms of cardiovascular functions during anesthesia and appropriate anesthesiological approach are crucial for a successful peri-operative management. The anesthesiologist's goal is to perform adequate anesthesia while maintaining cardiovascular stability. Monitoring and management of acid-base-status as well as cardiovascular functions are required to maintain sufficient tissue oxygenation during anesthesia. The postoperative anesthesiological management may also crucially influence the further course and therefore should be considered in the anesthesiological planning. Finally, adequate pain management in all these patients is an important and not to underestimate part in the treatment. This article gives an overview on the major aspects in the different fields in the anesthesiological management of patients with an acute abdomen.

  5. Diagnostics of vascular diseases as a cause for acute abdomen

    International Nuclear Information System (INIS)

    Juchems, M.S.; Aschoff, A.J.

    2010-01-01

    Vascular pathologies are rare causes of an acute abdomen. If the cause is a vascular disease a rapid diagnosis is desired as vascular pathologies are associated with high mortality. A differentiation must be made between arterial and venous diseases. An occlusion of the superior mesenteric artery is the most common reason for acute mesenteric ischemia but intra-abdominal arterial bleeding is also of great importance. Venous pathologies include thrombotic occlusion of the portal vein, the mesenteric vein and the vena cava. Multi-detector computed tomography (MDCT) is predestined for the diagnostics of vascular diseases of the abdomen. Using multiphasic contrast protocols enables reliable imaging of the arterial and venous vessel tree and detection of disorders with high sensitivity and specificity. Although conventional angiography has been almost completely replaced by MDCT as a diagnostic tool, it is still of high importance for minimally invasive interventions, for example in the management of gastrointestinal bleeding. (orig.) [de

  6. Multi-detector computed tomography of acute abdomen

    International Nuclear Information System (INIS)

    Leschka, Sebastian; Alkadhi, Hatem; Wildermuth, Simon; Marincek, Borut; University Hospital of Zurich

    2005-01-01

    Acute abdominal pain is one of the most common causes for referrals to the emergency department. The sudden onset of severe abdominal pain characterising the ''acute abdomen'' requires rapid and accurate identification of a potentially life-threatening abdominal pathology to provide a timely referral to the appropriate physician. While the physical examination and laboratory investigations are often non-specific, computed tomography (CT) has evolved as the first-line imaging modality in patients with an acute abdomen. Because the new multi-detector CT (MDCT) scanner generations provide increased speed, greater volume coverage and thinner slices, the acceptance of CT for abdominal imaging has increased rapidly. The goal of this article is to discuss the role of MDCT in the diagnostic work-up of acute abdominal pain. (orig.)

  7. Infected Congenital Epicardial Cyst Presenting as Acute Abdomen.

    Science.gov (United States)

    Dribin, Timothy; Files, Matthew D; Rudzinski, Erin R; Kaplan, Ron; Stone, Kimberly P

    2016-12-01

    A previously healthy 3-year-old boy presented to the emergency department with abdominal pain, fever, and emesis. Laboratory and radiologic evaluation for causes of acute abdomen were negative; however, review of the abdominal x-ray demonstrated cardiomegaly with the subsequent diagnosis of pericardial cyst by echocardiogram and computed tomography. The patient underwent surgical decompression and attempted removal of the cystic structure revealing that the cyst originated from the epicardium. His abdominal pain and fever resolved postoperatively and he completed a 3-week course of ceftriaxone for treatment of Propionibacterium acnes infected congenital epicardial cyst. Emergency department physicians must maintain a broad differential in patients with symptoms of acute abdomen to prevent complications from serious cardiac or pulmonary diseases that present with symptoms of referred abdominal pain.

  8. FAST ultrasound in abdomen closed trauma: literature review

    International Nuclear Information System (INIS)

    Perez Chacon, Cristian Alonso

    2010-01-01

    The management of polytraumatized patients has been important to know the scope and limitations of ultrasonography resources. A literature review was performed on FAST ultrasound in closed trauma in the abdomen. FAST (focused assessment with sonography for trauma) has been a study performed on the patient who has suffered both abdominal and thoracic trauma to determine the presence or absence of free fluid in these body cavities. The use is directed to locate intraabdominal drugs that may lead to bleeding and endanger the patient's life. Different techniques existent are recommended to use the original FAST as has been the extended FAST. In the United States the three diagnostic techniques generally have been: diagnostic peritoneal lavage, computed tomography (CT) of the abdomen and ultrasonography for the evaluation of patients with trauma abdominal; each of them have had their own advantages and disadvantages to study [es

  9. Anti-VEGF strategies - from antibodies to tyrosine kinase inhibitors: background and clinical development in human cancer.

    LENUS (Irish Health Repository)

    Korpanty, Grzegorz

    2012-01-01

    Tumour angiogenesis (formation of new blood vessels supporting tumour growth and metastasis) is a result of complex interactions between the tumour and the surrounding microenvironment. Targeting tumours with anti-angiogenic therapy remains an exciting area of preclinical and clinical studies. Although many significant advances have been achieved and the clinical use of anti-angiogenic drugs is now well recognized in many solid malignancies, these therapies fall short of their anticipated clinical benefits and leave many unanswered questions like exact mechanism of action, patients\\' selection and monitoring response to anti-angiogenic drugs. Tumour angiogenesis is controlled by complex signaling cascades and ongoing research into molecular mechanisms of tumour angiogenesis not only helps to understand its basic mechanisms but hopefully will identify new therapeutic targets. In 2012, both monoclonal antibodies and small molecule tyrosine kinase inhibitors remain the two major clinically useful therapeutic options that interfere with tumour angiogenesis in many solid malignancies.

  10. Acute Abdomen: A Rare Presentation of Lung Cancer Metastasis

    OpenAIRE

    Guérin, E.; Gilbert, O.; Dequanter, D.

    2009-01-01

    Surgical emergencies caused by bowel metastases from carcinoma of the lung are very rare. We describe two cases of symptomatic gastrointestinal metastatic small cell carcinoma: the first one concerns a 69-year-old man with an acute abdomen and the second is a 72-year-old man complaining of a gastric ulcer symptoms. We also discuss the current management and the prognosis of these patients.

  11. Development of a finite element model of the human abdomen.

    Science.gov (United States)

    Lee, J B; Yang, K H

    2001-11-01

    Currently, three-dimensional finite element models of the human body have been developed for frequently injured anatomical regions such as the brain, chest, extremities and pelvis. While a few models of the human body include the abdomen, these models have tended to oversimplify the complexity of the abdominal region. As the first step in understanding abdominal injuries via numerical methods, a 3D finite element model of a 50(th) percentile male human abdomen (WSUHAM) has been developed and validated against experimental data obtained from two sets of side impact tests and a series of frontal impact tests. The model includes a detailed representation of the liver, spleen, kidneys, spine, skin and major blood vessels. Hollow organs, such as the esophagus, stomach, small and large intestines, gallbladder, bile ducts, ureters, rectum and adrenal glands are grouped into three bodybags in order to provide realistic inertial properties and to maintain the position of the solid organs in their appropriate locations. Using direct connections, the model was joined superiorly to a partial model of the human thorax, and inferiorly to models of the human pelvis and the lower extremities that have been previously developed. Material properties for various tissues of the abdomen were derived from the literature. Data obtained in a series of cadaveric pendulum impact tests conducted at Wayne State University (WSU), a series of lateral drop tests conducted at Association Peugeot-Renault (APR) and a series of cadaveric lower abdomen frontal impact tests conducted at WSU were used to validate the model. Results predicted by the model match these experimental data for various impact speeds, impactor masses and drop heights. Further study is still needed in order to fully validate WSUHAM before it can be used to assess various impact loading conditions associated with vehicular crashes.

  12. Acute abdomen caused by ingested chicken wishbone: a case report

    OpenAIRE

    Hoxha, Faton T; Hashani, Shemsedin I; Komoni, Driton S; Gashi-Luci, Lumturije H; Kurshumliu, Fisnik I; Hashimi, Medita SH; Krasniqi, Avdyl S

    2009-01-01

    Introduction An ingested foreign body often passes the gastrointestinal tract without any complications. Foreign bodies, such as dentures, fish bones, chicken bones, and toothpicks, have been known to cause perforation of the GI tract. Case presentation We are presenting a case of a fifty-year-old male with acute abdomen; diffuse fibro purulent peritonitis, i.e. ileum perforation, caused by accidentally ingesting a chicken wishbone. He was treated surgically with ileum resection, and temporar...

  13. A role of abdomen in butterfly's flapping flight

    Science.gov (United States)

    Jayakumar, Jeeva; Senda, Kei; Yokoyama, Naoto

    2017-11-01

    Butterfly's forward flight with periodic flapping motion is longitudinally unstable, and control of the thoracic pitching angle is essential to stabilize the flight. This study aims to comprehend roles which the abdominal motion play in the pitching stability of butterfly's flapping flight by using a two-dimensional model. The control of the thoracic pitching angle by the abdominal motion is an underactuated problem because of the limit on the abdominal angle. The control input of the thorax-abdomen joint torque is obtained by the hierarchical sliding mode control in this study. Numerical simulations reveal that the control by the abdominal motion provides short-term pitching stabilization in the butterfly's flight. Moreover, the control input due to a large thorax-abdomen joint torque can counteract a quite large perturbation, and can return the pitching attitude to the periodic trajectory with a short recovery time. These observations are consistent with biologists' view that living butterflies use their abdomens as rudders. On the other hand, the abdominal control mostly fails in long-term pitching stabilization, because it cannot directly alter the aerodynamic forces. The control for the long-term pitching stabilization will also be discussed.

  14. Swordfish bill injury involving abdomen and vertebral column: case report and review

    Directory of Open Access Journals (Sweden)

    Drossos Charalambos

    2010-10-01

    Full Text Available Abstract Background Penetrating injuries of the abdomen and spinal canal that involve organic material of animal origin are extremely rare and derive from domestic and wild animal attacks or fish attacks. Case presentation In this case report we present the unique, as far as the literature is concerned, unprovoked woman's injury to the abdomen by a swordfish. There are only four cases of swordfish attacks on humans in the literature - one resulted to thoracic trauma, two to head trauma and one to knee trauma, one of which was fatal - none of which were unprovoked. Three victims were professional or amateur fishermen whereas in the last reported case the victim was a bather as in our case. Our case is the only case where organic debris of animal's origin remained in the spinal canal after penetrating trauma. Conclusions Although much has been written about the management of penetrating abdominal and spinal cord trauma, controversy remains about the optimal management. Moreover, there is little experience in the management of patients with such spinal injuries, due to the fact that such cases are extremely rare. In this report we focus on the patient's treatment with regard to abdominal and spinal trauma and present a review of the literature.

  15. Non Obstetric Causes and Presentation of Acute Abdomen among the Pregnant Women.

    Science.gov (United States)

    Haque, Monoarul; Kamal, Farah; Chowdhury, Shahanaz; Uzzaman, Monir; Aziz, Itrat

    2014-09-01

    To identify the non-obstetric causes and presentation of acute abdomen among pregnant women. This was a cross sectional hospital-based study among 128 pregnant women by face to face interview using a semi-structured questionnaire. This study was conducted at the Gynecology & Obstetric Ward of 250 Bed General Hospital, Noakhali, Bangladesh, from January to August 2013. Data were analyzed by a software package used for statistical analysis (SPSS) version 11.5 (SPSS, Inc., Chicago, IL, USA). Mean age of participants was 25±4 years. Our findings showed that 81% were Muslim, 67% were lower middle income group, as well as 47% completed primary level of education. The results revealed that 28% had biliary ascariasis, 24% had peptic ulcer disease and 10% had lower urinary tract infection. We also found that 6% had acute pyelonephritis, 6% had acute gastroenteritis, 6% had acute cholecystitis, 6% had acute appendicitis, 2% had acute pancreatitis, 3% had choledocolithiasis, 2% had ovarian solid mass, 2% had twisted ovarian cyst, 4% had renal colic, and 1% had renal calculus. In non-obstetrical presentation of acute abdomen, the study found that 84% of respondents complained their pain lasting more than 24 hours. Besides, half of respondents felt pain in epigastrium and right hypochondrium. Cramping, prickling and aching type of pain were more, while 66% suffered from continuous pain. Our results also showed that 73% did not explain any aggravating factor and relieving factor, and the rest said food, fasting state and position change aggravated pain as well as relieved pain. The study concludes that precise diagnosis of the acute abdomen in pregnant women by continual updating of abdominal assessment knowledge, and clinical skills is necessary in the management of abdominal pain in obstetric settings.

  16. Illness Perception and Clinical Treatment Experiences in Patients with M. Maroteaux-Lamy (Mucopolysaccharidosis Type VI) and a Turkish Migration Background in Germany

    Science.gov (United States)

    Dilger, Hansjörg; Leissner, Linn; Bosanska, Lenka; Lampe, Christina; Plöckinger, Ursula

    2013-01-01

    Introduction Mucopolysaccharidosis VI (MPS VI) is an inherited lysosomal storage disease caused by a mutation of the gene for arylsulfatase B (ASB). Of the thirty-one patients registered in Germany, almost fifty percent have a Turkish migration background. MPS VI is treated by enzyme replacement therapy (ERT), which is time-consuming and expensive. Methods This interdisciplinary study explored the illness perceptions and clinical treatment experiences among ten MPS VI patients with a Turkish migration background in two centers for metabolic diseases (Berlin and Mainz, Germany). The clinical treatment situation was observed and semi-structured interviews were conducted with patients and health care personnel, in addition to participatory observation in four patients' everyday environments in Berlin. The data from the interviews, patient records, and personal field notes were encoded, cross-related, and analyzed. Results Patients' acknowledgement of the disease and coping strategies are influenced predominantly by the perception of their individual health status and the handling of the disease within their family. Patients' willingness to cooperate with treatment strategies is further modified by their knowledge of the disease and the relationships with their health care providers. In this analysis, cultural factors turned out to be marginally relevant. Conclusion As with other chronic and debilitating diseases, effective treatment strategies have to reach beyond delivering medication. Health care providers need to strengthen the support for patients with a migration background. In this regard, they should respect the patients' cultural and social background and their personal perception of the disease and the therapy. Yet structural and social aspects (clinical setting, family and educational background) may be more crucial here than “cultural barriers.” PMID:23826140

  17. Prostheses size dependency of the mechanical response of the herniated human abdomen.

    Science.gov (United States)

    Simón-Allué, R; Hernández-Gascón, B; Lèoty, L; Bellón, J M; Peña, E; Calvo, B

    2016-12-01

    Hernia repairs still exhibit clinical complications, i.e. recurrence, discomfort and pain and mesh features are thought to be highly influent. The aim of this study is to evaluate the impact of the defect size and mesh type in an herniated abdominal wall using numerical models. To do so, we have started from a FE model based on a real human abdomen geometry obtained by MRI, where we have provoked an incisional hernia of three different sizes. The surgical procedure was simulated by covering the hernia with a prostheses, and three surgical meshes with distinct mechanical properties were used for the hernia repair: an isotropic heavy-weight mesh (Surgipro @ ), a slightly anisotropic light-weight mesh (Optilene @ ) and a highly anisotropic medium-weight mesh (Infinit @ ). The mechanical response of the wall to a high intraabdominal pressure (corresponding to a coughing motion) was analyzed here. Our findings suggest that the anisotropy of the mesh becomes more relevant with the increase of the defect size. Additionally, according to our results Optilene @ showed the closest deformation to the natural distensibility of the abdomen while Infinit @ should be carefully used due to its excessive compliance.

  18. Anatomic atlas for computed tomography in the mesaticephalic dog: caudal abdomen and pelvis

    International Nuclear Information System (INIS)

    Smallwood, J.E.; George, T. II.

    1993-01-01

    The purpose of this study was to produce a comprehensive anatomic atlas of CT anatomy of the dog for use by veterinary radiologists, clinicians, and surgeons. Whole-body CT images of two mature beagle dogs were made with the dogs supported in sternal recumbency and using a slice thickness of 13 mm. At the end of the CT session, each dog was euthanized, and while carefully maintaining the same position, the body was frozen. The body was then sectioned at 13-mm intervals, with the cuts matched as closely as possible to the CT slices. The frozen sections were cleaned, photographed, and radiographed using xeroradiography. Each CT image was studied and compared with its corresponding xeroradiograph and anatomic section to assist in the accurate identification of specific structures. Clinically relevant anatomic structures were identified and labeled in the three corresponding photographs (CT image, xeroradiograph, and anatomic section). In previous papers, the head and neck, and the thorax and cranial abdomen of the mesaticephalic (beagle) dog were presented. In this paper, the caudal part of the abdomen and pelvis of the bitch and male dog are presented

  19. Difficult airway management with bonfils fiberscope in case of emergency: acute abdomen with ileus.

    Science.gov (United States)

    Maldini, Branka; Novotny, Zdenko; Letica-Brnadić, Renata; Brkljacić, Ana; Bartolek, Dubravka

    2012-09-01

    This clinical report describes an emergency case of a 49-year-old man, ASA E III status, with clinical symptoms of acute abdomen and ileus, who was scheduled for urgent surgery. Predictors of difficult intubation (Mallampati test Class III, short thyro-mental (management decided on one attempt of Bonfils fiberoptic intubation as primary intervention and urgent tracheotomy, if needed, as secondary intervention. Immediately after assuming supine position on the operating table, the patient lost consciousness and cardiac arrest developed. Successful intubation with oxygenation was followed by cardiopulmonary resuscitation. Upon stabilization of the patient's vital functions, urgent surgery was performed. In the emergency case presented, we succeeded quickly to secure the airway with Bonfils fiberoptic intubation, which allowed for appropriate oxygenation and starting resuscitation. The high risk of the possible aspiration was avoided by timely provision of airway in the experienced anesthetist's hands.

  20. [Abdomen specific bioelectrical impedance analysis (BIA) methods for evaluation of abdominal fat distribution].

    Science.gov (United States)

    Ida, Midori; Hirata, Masakazu; Hosoda, Kiminori; Nakao, Kazuwa

    2013-02-01

    Two novel bioelectrical impedance analysis (BIA) methods have been developed recently for evaluation of intra-abdominal fat accumulation. Both methods use electrodes that are placed on abdominal wall and allow evaluation of intra-abdominal fat area (IAFA) easily without radiation exposure. Of these, "abdominal BIA" method measures impedance distribution along abdominal anterior-posterior axis, and IAFA by BIA method(BIA-IAFA) is calculated from waist circumference and the voltage occurring at the flank. Dual BIA method measures impedance of trunk and body surface at the abdominal level and calculates BIA-IAFA from transverse and antero-posterior diameters of the abdomen and the impedance of trunk and abdominal surface. BIA-IAFA by these two BIA methods correlated well with IAFA measured by abdominal CT (CT-IAFA) with correlatipn coefficient of 0.88 (n = 91, p abdominal adiposity in clinical study and routine clinical practice of metabolic syndrome and obesity.

  1. SPLENIC INFARCTION: an intriguing and important cause of pain abdomen in high altitude

    Directory of Open Access Journals (Sweden)

    P. K. Hota

    2015-01-01

    Full Text Available Background: Patients with Sickle cell trait (SCT are usually asymptomatic. They are usually unaware of their condition unless they have a family history. There are specific situations, where these people suffer from the effects of sickle cell trait. Splenic syndrome at high altitude is one of the specific problems. It is usually seen after a patient with SCT has been inducted to high altitude like in case of mountaineers and military personnel deployed in high altitude warfare. Pain abdomen due to splenic infarction in individuals with SCT is one of the manifestations. These patients, if diagnosed in time, they can be spared from unnecessary surgical interventions. We present herewith our experience of splenic infarction due to SCT in high altitude and their management.

  2. CLINICAL AND LABORATORY ASPECTS OF CHRONIC HEPATITIS B ON THE BACKGROUND OF REFRACTORY ANEMIA OF INFLAMMATION IN CHILDREN OF UZBEKISTAN

    Directory of Open Access Journals (Sweden)

    F. I. Inoyatova

    2017-01-01

    Full Text Available A total of 75 children with chronic hepatitis B (ChHB with a refractory variant of anemia of inflammation (AV course were examined, the pathogenetic manifestation of which was the development of iron overload syndrome (IOS. It was revealed that against the background of an increase in the severity of the IOS, the incidence of progressive forms of the disease with persistent prevalence of asthenovegetative, hemorrhagic syndromes and severe hepatosplenomegaly increased. At the same time, the leading biochemical syndromes were the presence of cytolysis with prolonged hyperfermentemia, endotoxemia and mesenchymal inflammatory syndrome. A directly proportional dependence of the hepcidin-25 peptide level on the degree of expression of the IOS, the higher the presentation of the IOS, the higher the level of suppression of peptide expression in hepatocytes. Diagnostically significant tests of severe forms of IOS in ChHB in children are the presence of hemosiderin in the urine and an increase in the level of sIL-6R in the serum.  

  3. Roentogenologic diagnosis of an acute abdomen in children

    Energy Technology Data Exchange (ETDEWEB)

    Oka, Makio; Chiba, Nobuyuki; Miyagi, Tetsuo (Kanagawa Children' s Medical Center, Yokohama (Japan))

    1983-05-01

    An acute abdomen is one of the main topics among emergency practice for children. We have experienced about 300 acute abdomen cases per year at our Children's Hospital since 1970. Radiological technologists provide a 24-hour emergency service using special knowledge and techniques in our radiological investigation. In the noenatal period esophageal atresia should be diagnosed by plain up-right film with a coiled-up rubber tube, and a contrast examination is contraindicated to prevent severe aspiration pneumonia. In the cases with intestinal atresia, the contrast examination is not necessary again, because the findings of plain film such as the distribution of air-filled intestinal loops, dilated bowel with air-fluid level gives us enough information for the diagnosis of these congenital anomalies. On the contrary, barium enema is useful and harmless for the neonatal age group. It is practical for diagnosing Hirschsprung's disease, midgut malrotation with volvulus, ileal and colonic atresia and necrotizing enterocolitis. An imperforate anus should be classified into the high and low type in the neonatal period to define the treatment. Invertogram is an only way for the differentiation of a baby without external fistula, and we have established the technique for this. The level is diagnosed by the relationship between the gas-filled rectal pouch and ischiac bone. In the infant group intussusception is the most common and urgent acute abdomen. We use a special device to fix the bady, dilute the barium with warm saline (to avoid water intoxication), limit the water pressure to within one meter, and avoid abdominal manipulation and longtime exposure. The successful reduction rate that our team has obtained is almost 85%.

  4. Roentogenologic diagnosis of an acute abdomen in children

    International Nuclear Information System (INIS)

    Oka, Makio; Chiba, Nobuyuki; Miyagi, Tetsuo

    1983-01-01

    An acute abdomen is one of the main topics among emergency practice for children. We have experiencing about 300 acute abdomen cases per year at our Children's Hospital since 1970. We radiological technologists provide a 24-hour emergency service using special knowledge and techniques in our radiological investigation. In the noenatal period esophageal atresia should be diagnosed by plain up-right film with a coiled-up rubber tube, and a contrast examination is contraindicated to prevent severe aspiration pneumonia. In the cases with intestinal atresia, the contrast examination is not necessary again, because the findings of plain film such as the distribution of air-filled intestinal loops, dilated bowel with air-fluid level gives us enough information for the diagnosis of these congenital anomalies. On the contrary, barium enema is useful and harmless for the neonatal age group. It is practical for diagnosing Hirschsprung's disease, midgut malrotation with volvulus, ileal and colonic atresia and necrotizing enterocolitis. An imperforate anus should be classified into the high and low type in the neonatal period to define the treatment. Invertogram is an only way for the differentiation of a baby without external fistula, and we have established the technique for this. The level is diagnosed by the relationship between the gas-filled rectal pouch and ischiac bone. In the infant group intussusception is the most common and urgent acute abdomen. We use a special device to fix the bady, dilute the barium with warm saline (to avoid water intoxication), limit the water pressure to within one meter, and avoid abdominal manipulation and longtime exposure. The successful reduction rate that our team has obtained is almost 85 %. (author)

  5. Hernia interna de Quain como causa de abdomen agudo

    OpenAIRE

    García-Oria, M.; Muñoz de la Fuente, A.; Peraza Casajús, J.M.; Bodega Quiroga, I.; Martínez Pozuelo, A.; Serrano Muñoz, A

    2012-01-01

    Presentamos el caso de una paciente de 47 años de edad que consulta en urgencias por un cuadro de 8 horas de evolución, de dolor abdominal continuo y difuso, acompañado de vómitos alimentarios al inicio y biliosos después. La paciente presenta estabilidad hemodinámica permaneciendo afebril. El hemiabdomen inferior presenta signos de irritación peritoneal. En los análisis destaca la presencia de neutrofilia y leucocitosis, la radiología simple de abdomen es compatible con suboclusión de intest...

  6. Background Material

    DEFF Research Database (Denmark)

    Zandersen, Marianne; Hyytiäinen, Kari; Saraiva, Sofia

    This document serves as a background material to the BONUS Pilot Scenario Workshop, which aims to develop harmonised regional storylines of socio-ecological futures in the Baltic Sea region in a collaborative effort together with other BONUS projects and stakeholders.......This document serves as a background material to the BONUS Pilot Scenario Workshop, which aims to develop harmonised regional storylines of socio-ecological futures in the Baltic Sea region in a collaborative effort together with other BONUS projects and stakeholders....

  7. Some clinical and laboratory parameters of hemorrhagic fever with renal failure syndrome against the background correction of hyperhomocysteinemia

    Directory of Open Access Journals (Sweden)

    G. R. Syrtlanova

    2013-01-01

    Full Text Available The aim of the research was to curry out correction of hyperhomocysteinemia in patients with hemorrhagic fever with renal failure syndrome (HFRS and evaluate some clinical and laboratory parameters. The results of examining 91 men patients with HFRS at the age of 18 till 50 years old are presented. The vitamin complex «Angiovit» was used for hyperhomocysteinemia correction. The correction of hyperhomocysteinemia using the vitamin complex in all the three considered forms (mid, severs, complicated there are statistically significant decreases of homocysteine, the duration of oliguric stage and the concentration of creatinine in oliguric and diuretic stages in patients with HFRS compared with the group of patients having the generally basically therapy.

  8. Diagnostics of vascular diseases as a cause for acute abdomen; Diagnostik vaskulaerer Erkrankungen als Ursache fuer das akute Abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Juchems, M.S. [Universitaetsklinikum Ulm, Klinik fuer Diagnostische und Interventionelle Radiologie, Ulm (Germany); Aschoff, A.J. [Klinikum Kempten-Oberallgaeu, Abteilung fuer Radiologie, Kempten (Germany)

    2010-03-15

    Vascular pathologies are rare causes of an acute abdomen. If the cause is a vascular disease a rapid diagnosis is desired as vascular pathologies are associated with high mortality. A differentiation must be made between arterial and venous diseases. An occlusion of the superior mesenteric artery is the most common reason for acute mesenteric ischemia but intra-abdominal arterial bleeding is also of great importance. Venous pathologies include thrombotic occlusion of the portal vein, the mesenteric vein and the vena cava. Multi-detector computed tomography (MDCT) is predestined for the diagnostics of vascular diseases of the abdomen. Using multiphasic contrast protocols enables reliable imaging of the arterial and venous vessel tree and detection of disorders with high sensitivity and specificity. Although conventional angiography has been almost completely replaced by MDCT as a diagnostic tool, it is still of high importance for minimally invasive interventions, for example in the management of gastrointestinal bleeding. (orig.) [German] Vaskulaere Pathologien sind seltene Ursachen fuer den klinischen Zustand eines akuten Abdomens. Liegt eine vaskulaere Erkrankung vor, ist jedoch aufgrund der hohen Mortalitaet eine zuegige Diagnostik von grosser Wichtigkeit. Bei den Erkrankungen der abdominellen Gefaesse sind arterielle von venoesen Ursachen zu unterscheiden. Ein Verschluss der A. mesenterica superior ist die haeufigste Ursache fuer die akute Mesenterialischaemie, daneben sind Blutungen in den abdominellen Gefaessprovinzen des arteriellen Gefaessbaums von Bedeutung. Venoese Pathologien betreffen thrombotische Verschluesse der Pfortader, der V. mesenterica und der V. cava. Die Multidetektor-CT (MDCT) ist zur Diagnostik vaskulaerer Erkrankungen des Abdominalraums praedestiniert. Mit mehrphasigen Untersuchungsprotokollen gelingt es, den arteriellen und venoesen Gefaessbaum zuverlaessig darzustellen und Erkrankungen mit hoher Sensitivitaet und Spezifitaet zu

  9. Extra-skeletal Ewing's sarcoma resembling acute abdomen. Case report.

    Science.gov (United States)

    Valdivia Gómez, Gilberto Guzmán; Soto Guerrero, María Teresa; Cedillo de la Cruz, María Isabel

    2010-01-01

    Extraosseous Ewing's sarcoma is a rare tumor of neuroectodermal origin. It presents mainly in the soft tissue of the extremities and thorax. Histologically, it is similar to Ewing's sarcoma of the bone. We present the case of a male who arrived at the emergency room with acute abdomen, leucocytosis and imaging techniques (abdominal ultrasound and computed tomography) suggestive of complicated diverticular disease. He was treated with emergency surgery. Intraoperative findings were an unsuspected tumor (20 x 15 x 15 cm). Treatment consisted of extirpation of the tumor, separating it from the adjacent viscera and followed by chemotherapy based on epirubicin, cyclophosphamide and vincristine for six cycles. Because the control abdominal CT demonstrated tumor activity in the retroperitoneum adjacent to the ascending colon and cecum, further resection was decided upon. In a review of the literature, no previous reports of extraosseous Ewing's sarcoma were found presenting as acute abdomen. Due to the rarity of this tumor, only case reports or series have been found in the literature without randomized or comparative studies. Surgery was the cornerstone of treatment, without reports of preoperative chemotherapy. If the patient's condition permits, percutaneous needle biopsy is mandatory to obtain optimum treatment as well as to improve prognosis.

  10. Background radiation

    International Nuclear Information System (INIS)

    Arnott, D.

    1985-01-01

    The effects of background radiation, whether natural or caused by man's activities, are discussed. The known biological effects of radiation in causing cancers or genetic mutations are explained. The statement that there is a threshold below which there is no risk is examined critically. (U.K.)

  11. [The acute (surgical) abdomen - epidemiology, diagnosis and general principles of management].

    Science.gov (United States)

    Grundmann, R T; Petersen, M; Lippert, H; Meyer, F

    2010-06-01

    This review comments on epidemiology, diagnosis and general principles of surgical management in patients with acute abdomen. DEFINITION AND EPIDEMIOLOGY: The most common cause of acute abdominal pain is non-specific abdominal pain (24 - 44.3 % of the study populations), followed by acute appendicitis (15.9 - 28.1 %), acute biliary disease (2.9 - 9.7 %) and bowel obstruction or diverticulitits in elderly patients. Acute appendicitis represents the cause of surgical intervention in two-thirds of the children with acute abdomen. A standardised physical examination combined with ultrasonography (US) represents the initial investigation in patients with acute abdominal pain. Due to the risk associated with radiation and due to the costs, a selective use of CT imaging is recommended. The work-flow given in this paper restricts the use of CT imaging to less than 50 % of patients with acute abdominal pain. Diagnostic laparoscopy should be considered in patients without a specific diagnosis after appropriate imaging and as an alternative to active clinical observation which is the current practice in patients with non-specific abdominal pain. Acute small bowel obstruction has previously been considered as a relative contraindication for laparoscopic management, but it has been shown in the meantime that laparoscopic treatment is an elegant tool for the management of simple band small bowel obstruction. Bedside diagnostic laparoscopy is recommended in intensive care unit (ICU) patients with acute abdomen or sepsis of unknown origin, in suspicion of acute cholecystitis, diffuse gut hypoperfusion and mesenteric ischaemia or in refractory lactic acidosis, especially after cardiac surgery. Early administration of analgesia to patients with acute abdominal pain in the emergency department will reduce the patient's discomfort without impairing clinically important diagnostic accuracy and is recommended on the basis of some prospective randomised trials. However, the impact on

  12. Rare cause of acute surgical abdomen with free intraperitoneal air: Spontaneous perforated pyometra. A report of 2 cases.

    Science.gov (United States)

    Lim, Siew Fung; Lee, Song Liang; Chiow, Adrian Kah Heng; Foo, Chek Siang; Wong, Andrew Siang Yih; Tan, Su-Ming

    2012-01-01

    The acute abdomen accounts for up to 40% of all emergency surgical hospital admissions and a large proportion are secondary to gastrointestinal perforation. Studies have shown the superiority of the abdominal CT over upright chest radiographs in demonstrating free intraperitoneal air. Spontaneous perforated pyometra is a rare cause of the surgical acute abdomen with free intraperitoneal air. Only 38 cases have been reported worldwide. We report 2 cases of spontaneously perforated pyometra in our hospital's general surgery department. Both underwent exploratory laparotomy: one had a total hysterectomy and bilateral salpingo-oophorectomy, while the other had an evacuation of the uterine cavity, primary repair of uterine perforation and a peritoneal washout. A literature search was conducted and all reported cases reviewed in order to describe the clinical presentations and management of the condition. Of the 40 cases to date, including 2 of our cases, the most common presenting symptoms were abdominal pain (97.5%), fever (37.5%) and vomiting (25.0%). The main indication for exploratory laparotomy was pneumoperitoneum (97.5%). Pyometra is an unusual but serious condition in elderly women presenting with an acute abdomen. A high index of suspicion is needed to make the appropriate diagnosis.

  13. Impact of quality control radiation doses received by patients undergoing abdomen x-ray examination in ten hospitals

    International Nuclear Information System (INIS)

    Aghahadi, B.; Zhang, Z.; Zareh, S.; Sarkar, S.; Tayebi, P. S.

    2006-01-01

    The X-ray machines used for radiodiagnosis should meet certain quality assurance programmes. These are necessary to have good quality radiographs at reasonably low exposure to patients. Materials and Methods: Dose reduction methods in abdomen X-ray examination were carried out in 10 hospitals in Tehran. This paper presents the work, which was implemented on 200 patients and evaluated using the entrance skin dose in the Anterior-Posterior abdomen projection measured directly at the center of the X-ray field. In addition, the machine room, and dark room parameters, as well as work practices and repeat rates were studied. Results: The quality control parameters and the entrance skin dose were evaluated utilizing an anthropologic phantom to define the optimal exposure condition at all hospitals before and after quality control . Results show that after using the quality control parameters and optimization of the exposure conditions, the mean of mAs and entrance skin dose can be decreased by 62% and 65% respectively. Conclusion: The quality of the radiographs generally increased. The reported method is easily implemented in any clinical situation where optimization of abdomen radiography is necessary

  14. Usefulness of CT in the diagnosis and management of acute abdomen

    International Nuclear Information System (INIS)

    Suzuki, Takuya; Matsumoto, Junichi; Funakubo, Masakatsu; Yamashita, Hirotaka; Ehara, Norishige; Minowa, Yoshiyuki; Nakajima, Yasuo

    2010-01-01

    We prospectively evaluated the usefulness of computed tomography (CT) in the diagnosis and management of acute abdomen. Ninety-four patients with acute abdomen were enrolled. We compared the final diagnosis and management CT diagnosis and management. Then, we evaluated how many of the CT examinations were useful and the degree to which they were useful. In more than 90% of cases, CT was very useful for the diagnosis and management of acute abdomen. (author)

  15. Intussusceptions as acute abdomen caused by Burkitt lymphoma: a case report

    OpenAIRE

    Hoxha, Faton T; Hashani, Shemsedin I; Krasniqi, Avdyl S; Kurshumliu, Fisnik I; Komoni, Driton S; Hasimja, Shpresa M; Maxhuni, Mehmet

    2009-01-01

    Introduction Burkitt's lymphoma is a highly malignant, aggressive and rapidly growing B-cell neoplasm, which has low long-term survival rates. The abdomen is the most frequent onset site of non endemic Burkitt's lymphoma. Symptoms are often misleading and make diagnosis difficult. Ileum intussusception as acute abdomen caused by Burkitt lymphoma is rare. Case presentation We are presenting a case of a 16 year-old male with acute abdomen, which three weeks prior initially has been surgically t...

  16. Severe acute abdomen caused by symptomatic Meckel's diverticulum in three children with trisomy 18.

    Science.gov (United States)

    Hayashi, Anri; Kumada, Tomohiro; Furukawa, Oki; Nozaki, Fumihito; Hiejima, Ikuko; Shibata, Minoru; Kusunoki, Takashi; Fujii, Tatsuya

    2015-10-01

    Meckel's diverticulum (MD) is the most prevalent congenital anomaly of the gastrointestinal tract and often presents a diagnostic challenge. Patients with trisomy 18 frequently have MD, but the poor prognosis and lack of consensus regarding management for neonates has meant that precise information on the clinical manifestations in infants and children with MD is lacking. We describe the cases of three children with trisomy 18 who developed symptomatic MD. Intussusception was diagnosed in Patient 1, intestinal volvulus in Patient 2, and gastrointestinal bleeding in Patient 3. All three patients underwent surgical treatment and only the Patient 1 died due to pulmonary hypertensive crisis. The other two patients experienced no further episodes of abdominal symptoms. In patients with trisomy 18, although consideration of postoperative complications and prognosis after surgical treatment is necessary, symptomatic MD should carry a high index of suspicion in patients presenting with acute abdomen. © 2015 Wiley Periodicals, Inc.

  17. Non-traumatic acute abdomen in the adult: a critical review of imaging modalities

    International Nuclear Information System (INIS)

    Buitrago-Tellez, C.; Boos, S.; Heinemann, F.; Wenz, W.

    1992-01-01

    Two different series collected at the University Hospital of Freiburg are presented as a basis for the critical appraisal of available imaging tests and their correlation with anatomic pain sites. The first series comprises 284 patients of non-traumatic acute abdomen admitted to the emergency department during 1990. The radiological approach revealed an increased use of immediate ultrasound (58%) followed by plain film radiography (53%), contrast studies (15%), and computed tomography (9.8%). Five groups of entities were identified according to the diagnostic imaging procedure prior to surgery. In a second series, the clinical presentation, the distribution and the efficacy of imaging studies for the confirmation of acute mesenteric ischemia were evaluated in 55 patients over a period of 14 years. A reduced mortality rate emphasizes the value of early and agressive diagnosis and angiographic management. (orig.)

  18. An Extremely Rare Case of Lower Urinary Tract Symptoms: Floating Benign Mesenchymal Mass in Abdomen

    Directory of Open Access Journals (Sweden)

    Bulent Kati

    2017-01-01

    Full Text Available A 48-year-old man admitted to the urology outpatient clinic with major symptoms of right-side pain and intermittent lower urinary tract symptoms (LUTSs such as low urine flow rate, dysuria, and frequency. Uroflowmetry showed low urine flow, and laboratory tests revealed no pathology. Ultrasound (US showed a 7 cm calcific mass above the bladder and a kidney cyst with a diameter of 5.3 cm in the upper pole of the right kidney. Enhanced computed tomography confirmed the US findings. Laparoscopic transperitoneal renal cyst decortication was performed. There was no sign of additional tumors. An independent mass in the abdomen was diagnosed, and the mass was removed. Based on the pathology, the diagnosis was a benign mesenchymal calcific mass. This is the first report of LUTSs due to a free benign mesenchymal mass in the published literature.

  19. The value of the abdominal radiograph in the assessment of the acute abdomen- work in progress

    International Nuclear Information System (INIS)

    Verma, R.; Kew, J.; Davies, R.P.

    2002-01-01

    Full text: The value of the abdominal radiograph in the assessment of the acute abdomen was evaluated for those patients who also had abdominal ultrasound and/or CT. The value of each modality in patient management is reviewed. Retrospective review of 52 consecutive patients presented to a tertiary hospital emergency department with acute abdominal pain who underwent abdominal radiographs (AXR) and abdominal ultrasound (US) and / or computed tomography (CT) within 24 hours of presentation was undertaken. There were 37 males and 15 females. The mean age was 53 years (range 18-95y). Abdominal radiographs were reviewed by two radiologists.Two patients had two separate admissions one week apart. There were 35 normal abdominal radiographs. 19 studies showed clinically relevant abnormalities. Of the normal group, 14 out of 21 patients had abnormal findings on CT and 8 out of 16 had abnormal US examinations. Of the 19 patients with abnormal AXR, 17 out of 19 patients had abnormal CT and 2 out of 5 had abnormal ultrasound examinations. There were 5 cases where both CT scan and US was performed. The positive and negative predictive value for AXR vs CT scan was 89% and 33% respectively and for AXR vs US scan was 40% and 50% respectively. For patients with normal AXR and abnormal CT, there was only one case (a non calcified abdominal aortic aneurysm) which might have required immediate surgical intervention. The preliminary results suggest that the abnormal radiograph is sensitive in the detection of relevant abnormalities in the acute abdomen in the context of appropriate clinical selection. Both CT and ultrasound provide additional diagnostic accuracy for some indications.A further 50 patients are being reviewed and the combined results will be presented. Copyright (2002) Blackwell Science Pty Ltd

  20. Ovarian vein thrombosis mimicking acute abdomen: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Arkadopoulos Nikolaos

    2011-12-01

    Full Text Available Abstract Background Ovarian vein thrombosis (OVT is a rare, but serious condition that affects mostly postpartum women. A high index of suspicion is required in order to diagnose this unusual cause of abdominal pain. Case presentation A 19-year-old woman at three days postpartum was admitted to our hospital because of severe right lower quandrant abdominal pain and fever 38.5'C. Physical examination revealed an acutely ill patient and right lower quadrant tenderness with positive rebound and Giordano signs. The patient underwent appendectomy which proved to be negative for acute appendicitis. Postoperatively fever and pain persisted and abdominal CT-scan with intravenous contrast agent demonstrated a thrombosed right ovarian vein. The patient was initiated on low-molecular weight heparin (LMWH and antibiotic treatment and a month later a new abdominal CT-scan showed a patent right ovarian vein. Discussion Pathophysiologically, OVT is explained by Virchow's triad, because pregnancy is associated with a hypercoagulable state, venous stasis due to compression of the inferior vena cava by the uterus and endothelial trauma during delivery or from local inflammation. Common symptoms and signs of OVT include lower abdomen or flank pain, fever and leukocytosis usually within the first ten days after delivery. The reported incidence of OVT ranges 0,05-0,18% of pregnancies and in most cases the right ovarian vein is the one affected. Anticoagulation and antibiotics is the mainstay of treatment of OVT. Complications of OVT include sepsis, extension of the thrombus to the inferior vena cava and renal veins, and pulmonary embolism. The incidence of pulmonary embolism is reported to be 13.2% and represents the main source of mortality due to OVT. Conclusions OVT is a rare condition, usually in the postpartum period. A high index of suspicion is required for the prompt diagnosis and management especially in cases that mimic acute abdomen.

  1. IDIOPATHIC OMENTAL INFARCTION : A RARE CAUSE OF ACUTE PAIN ABDOMEN

    Directory of Open Access Journals (Sweden)

    Narendra Nath

    2015-02-01

    Full Text Available Omental torsion leading on to omental infarction is an unusual cause of acute abdominal pain in adults. Often the condition mimics common causes of acute abdomen like acute cholecystitis, acute appendicitis or acute pancreatitis. A review of literature reveals that this enigmatic condition has been managed both non - operatively and by surgery in the past. We report the case of a 46 - year - old man who presented with a 4 - day history of severe right - sided abdominal pain mimicking acute cholecystitis. Abdominal CT scan revealed a right upper quadrant mass with a whirl - like appearance, suspicious for omental infarction. He was started on conservative management with analgesics and antibiotics. He improved symptomatically and was discharged

  2. Intraoperative radiation in the canine para-aortic abdomen

    International Nuclear Information System (INIS)

    Hoopes, P.J.; Gillette, E.L.

    1984-01-01

    Twenty adult beagle dogs received intraoperatively delivered 6 MeV electrons to the para-aortic abdomen and bladder. The dogs were equally divided into 4 dose groups receiving 22 Gy, 30 Gy, 38.5 Gy and 47 Gy. The 5 cm x 8 cm radiation field included a variable portion of the left kidney, the left ureter, the abdominal aorta and vena cava, the base of the bladder and the left sciatic and femoral nerves. The lesions observed were fibroelastic proliferation of the aortic intima, severe renal atrophy and fibrosis, ureteral stenosis, bladder fibrosis and demyelinating peripheral neuropathies. Histologic, morphometric and dose response analyses are compared with responses of dogs receiving more conventional fractionated doses to a total of 60 Gy, 70 Gy or 80 Gy x-ray in 6 weeks

  3. Open abdomen and VAC® in severe diffuse peritonitis.

    Science.gov (United States)

    Mutafchiyski, Ventsislav M; Popivanov, G I; Kjossev, K T; Chipeva, S

    2016-02-01

    Currently, the open abdomen technique is the widely recognised method for treatment of life-threatening trauma, intra-abdominal sepsis, abdominal compartment syndrome and wound dehiscence. The techniques for temporary closure using negative pressure have gained increasing popularity. Although negative pressure wound therapy has been proved as an effective method in trauma, the results in diffuse peritonitis are contradictory. Overall, 108 patients with diffuse peritonitis and open abdomen were prospectively enrolled from January 2006 to December 2013--69 treated with mesh-foil laparostomy without negative pressure and 49 with vacuum-assisted closure (VAC(®)) The primary endpoints were the rate of primary fascial closure and mortality. The secondary outcomes were the rate of complications--enteroatmospheric fistulas, intra-abdominal abscesses, wound infection and necrotising fasciitis, intensive care unit (ICU) and overall hospital stay. VAC was associated with higher overall (73% vs 53%) and late primary fascial closure rates (31% vs 7%), lower rates of necrotising fasciitis (2% vs 15%, p=0.012), intra-abdominal abscesses (10% vs 20%), enteroatmospheric fistulas (8% vs 19%), overall mortality (31% vs 53%, pVAC in comparison to the temporary abdominal closure without negative pressure in the cases with severe diffuse peritonitis. However, to a large extent, our results might be attributed to the combination of VAC with dynamic fascial closure. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Drug-related disorders and the criminal and clinical background of the prison population of São Paulo State, Brazil.

    Directory of Open Access Journals (Sweden)

    Maíra Mendes dos Santos

    Full Text Available OBJECTIVE: To analyze the association between drug (DAD and alcohol (AAD abuse and dependency and criminal and clinical background by gender of prisoners in São Paulo, Brazil. METHOD: Cross-sectional study, random sample stratified by administrative district, from which prisons and prisoners were selected via random, multistage sampling. Psychiatric diagnoses were made with the CIDI 2.1. Lifetime prevalence and 95% CI were calculated and adjusted via analysis of complex samples. Multinomial logistic regression analysis was carried out with four categories of dependent variables: presence AAD; presence DAD; presence of another mental disorder; no mental disorders. For female alcohol and drug abuse and dependency (ADAD were combined into a single category. RESULTS: The sample was composed by 1809 interviewed prisoners (1192 men and 617 women. Prevalence of DAD and AAD was 25.2% and 15.6%, respectively, among female prisoners, and 26.5% and 18.5% among males. Male prisoners with DAD were more likely to have a criminal record as an adolescent (OR 2.17, to be a repeat offender (OR 2.85, and to have committed a property crime (OR 2.18. Prisoners with AAD were repeat offenders (OR 2.18. Among female prisoners, ADAD was associated with repeat offenses (OR 3.39, a criminal record as an adolescent (OR 9.24, a clinical or infectious condition (OR 5.09, another health problem (OR 3.04, and violent crime (OR 2.5. CONCLUSION: The study confirmed an association between drug-use disorders and the criminal and clinical background in the study population. Prisoners with such disorders were more likely to be repeat offenders and to have a criminal record as adolescents. Among female prisoners disorders were also associated with violent crime and health problems, while among males they were associated with property crime. These patterns in clinical and criminal backgrounds illustrate the need for social rehabilitation programs and specific medical treatment for

  5. Small bowel obstruction in the virgin abdomen: time to challenge surgical dogma with evidence.

    Science.gov (United States)

    Ng, Yvonne Ying-Ru; Ngu, James Chi-Yong; Wong, Andrew Siang-Yih

    2018-01-01

    Although adhesions account for more than 70% of small bowel obstruction (SBO), they are thought to be less likely aetiologies in patients without previous abdominal surgery. Expedient surgery has historically been advocated as prudent management in these patients. Emerging evidence appears to challenge such a dogmatic approach. A retrospective analysis was performed in all SBO patients with a virgin abdomen admitted between January 2012 and August 2014. Patients with obstruction secondary to abdominal wall hernias were excluded. Patient demographics, clinical presentation, management strategy and pathology involved were reviewed. A total of 72 patients were included in the study. The majority of patients were males (66.7%), with a median age of 58 years (range: 23-101). Abdominal pain (97%) and vomiting (86%) were the most common presentations while abdominal distention (60%) and constipation (25%) were reported less frequently. Adhesions accounted for the underlying cause in 44 (62%) patients. Other aetiologies included gallstone ileus (n = 5), phytobezoar (n = 5), intussusception (n = 4), internal herniation (n = 4), newly diagnosed small bowel tumour (n = 3), mesenteric volvulus (n = 3), stricture (n = 3) and Meckel's diverticulum (n = 1). Twenty-nine (40%) patients were successfully managed conservatively while the remaining 43 (60%) underwent surgery. The intraoperative findings were in concordance with the preoperative computed tomography scan in 76% of cases. Adhesions remain prevalent despite the absence of previous abdominal surgery. Non-operative management is feasible for SBO in a virgin abdomen. Computed tomography scan can be a useful adjunct in discerning patients who may be treated non-operatively by elucidating the underlying cause of obstruction. © 2016 Royal Australasian College of Surgeons.

  6. Utility of screening computed tomography of chest, abdomen and pelvis in patients after heart transplantation

    International Nuclear Information System (INIS)

    Dasari, Tarun W.; Pavlovic-Surjancev, Biljana; Dusek, Linda; Patel, Nilamkumar; Heroux, Alain L.

    2011-01-01

    Introduction: Malignancy is a late cause of mortality in heart transplant recipients. It is unknown if screening computed tomography scan would lead to early detection of such malignancies or serious vascular anomalies post heart transplantation. Methods: This is a single center observational study of patients undergoing surveillance computed tomography of chest, abdomen and pelvis atleast 5 years after transplantation. Abnormal findings, included pulmonary nodules, lymphadenopathy and intra-thoracic and intra-abdominal masses and vascular anomalies such as abdominal aortic aneurysm. The clinical follow up of each of these major abnormal findings is summarized. Results: A total of 63 patients underwent computed tomography scan of chest, abdomen and pelvis at least 5 years after transplantation. Of these, 54 (86%) were male and 9 (14%) were female. Mean age was 52 ± 9.2 years. Computed tomography revealed 1 lung cancer (squamous cell) only. Non specific pulmonary nodules were seen in 6 patients (9.5%). The most common incidental finding was abdominal aortic aneurysms (N = 6 (9.5%)), which necessitated follow up computed tomography (N = 5) or surgery (N = 1). Mean time to detection of abdominal aortic aneurysms from transplantation was 14.6 ± 4.2 years. Mean age at the time of detection of abdominal aortic aneurysms was 74.5 ± 3.2 years. Conclusion: Screening computed tomography scan in patients 5 years from transplantation revealed only one malignancy but lead to increased detection of abdominal aortic aneurysms. Thus the utility is low in terms of detection of malignancy. Based on this study we do not recommend routine computed tomography post heart transplantation.

  7. Ferric ammonium citrate as a positive bowel contrast agent for MR imaging of the upper abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Kivelitz, D.; Taupitz, M.; Hamm, B. [Universitaetsklinikum Charite, Berlin (Germany). Inst. fuer Radiologie; Gehl, H.B. [Medizinische Univ. Luebeck (Germany). Inst. fuer Radiologie; Heuck, A. [Muenchen Univ. (Germany). Radiologische Klinik; Krahe, T. [Koeln Univ. (Germany). Inst. fuer Radiologische Diagnostik; Lodemann, K.P. [Bracco-Byk Gulden GmbH, Konstanz (Germany)

    1999-07-01

    Purpose: To evaluate the safety and diagnostic efficacy of two different doses of ferric ammonium citrate as a paramagnetic oral contrast agent for MR imaging of the upper abdomen. Material and methods: Ninety-nine adult patients referred for MR imaging for a known or suspected upper abdominal pathology were included in this randomized multicenter double-blind clinical trial. Imaging was performed with spin-echo (T1- and T2-weighted) and gradient-echo (T1-weighted) techniques before and after administration of either 1200 mg or 2400 mg of ferric ammonium citrate dissolved in 600 ml of water. Safety analysis included monitoring of vital signs, assessment of adverse events, and laboratory testing. Efficacy with regard to organ distension, contrast distribution, bowel enhancement and delineation of adjacent structures was graded qualitatively. Results: No serious adverse events were reported for either of the two concentrations. A total of 31 minor side effects were noted, of which significantly more occurred in the higher dose group (p<0.01). The diagnostic confidence in defining or excluding disease was graded as better after contrast administration for 48% of all images. Marked or moderate enhancement of the upper gastrointestinal tract was achieved at both doses in 69.5% of cases with no evident difference between the two doses. The higher dose tended to show better results in terms of the contrast assessment parameters. Conclusion: Ferric ammonium citrate is a safe and effective oral contrast agent for MR imaging of the upper abdomen at two different dose levels. The higher dose showed a tendency toward better imaging results while the lower dose caused significantly fewer side effects. Therefore, the 1200 mg dose can be recommended in view of the risk-to-benefit ratio. (orig.)

  8. Non-traumatic causes and the management of the open abdomen.

    Science.gov (United States)

    Mentula, P

    2011-04-01

    The open abdomen is increasingly used for the treatment and prevention of abdominal compartment syndrome. The leading non-traumatic conditions that may cause abdominal compartment syndrome requiring surgical decompression include secondary peritonitis, ruptured abdominal aortic aneurysm and severe acute pancreatitis. Patients may also end up with the open abdomen when the laparotomy wound cannot be closed without tension because of excessive visceral swelling. Also, surgical complications such as laparotomy wound dehiscence, may require temporary abdominal closure techniques. In critically ill surgical patients and in situations when second-look laparotomy is mandatory the open abdomen can be utilized in a preventive manner like in damage control trauma surgery. Underlying disease and the indication for the open abdomen significantly contributes to outcome of patient with open abdomen. Non-traumatic aetiology of the open abdomen is associated with lower likelihood of primary fascial closure and higher rate of open abdomen related complications compared with traumatic aetiology. A number of temporal abdominal closure techniques have been described. Ideally, temporal abdominal closure technique should prevent the development of recurrent abdominal compartment syndrome and facilitate later primary fascia closure with low complication rate. Although fascial closure rate varies between techniques, there are few evidence-based data to support one technique over another. However, recent evolution of temporary abdominal closure techniques have decreased the number of patients with frozen abdomen and reduced the need for planned hernia management. Highest fascial closure rates have been achieved with vacuum-assisted closure systems and systems that provide continuous fascial traction.

  9. The role of open abdomen in non-trauma patient: WSES Consensus Paper

    NARCIS (Netherlands)

    Coccolini, Federico; Montori, Giulia; Ceresoli, Marco; Catena, Fausto; Moore, Ernest E.; Ivatury, Rao; Biffl, Walter; Peitzman, Andrew; Coimbra, Raul; Rizoli, Sandro; Kluger, Yoram; Abu-Zidan, Fikri M.; Sartelli, Massimo; de Moya, Marc; Velmahos, George; Fraga, Gustavo Pereira; Pereira, Bruno M.; Leppaniemi, Ari; Boermeester, Marja A.; Kirkpatrick, Andrew W.; Maier, Ron; Bala, Miklosh; Sakakushev, Boris; Khokha, Vladimir; Malbrain, Manu; Agnoletti, Vanni; Martin-Loeches, Ignacio; Sugrue, Michael; Di Saverio, Salomone; Griffiths, Ewen; Soreide, Kjetil; Mazuski, John E.; May, Addison K.; Montravers, Philippe; Melotti, Rita Maria; Pisano, Michele; Salvetti, Francesco; Marchesi, Gianmariano; Valetti, Tino M.; Scalea, Thomas; Chiara, Osvaldo; Kashuk, Jeffry L.; Ansaloni, Luca

    2017-01-01

    The open abdomen (OA) is defined as intentional decision to leave the fascial edges of the abdomen un-approximated after laparotomy (laparostomy). The abdominal contents are potentially exposed and therefore must be protected with a temporary coverage, which is referred to as temporal abdominal

  10. Acute Abdomen in Pediatric Patients Admitted to the Pediatric Emergency Department

    Directory of Open Access Journals (Sweden)

    Yu-Ching Tseng

    2008-08-01

    Conclusion: The etiology of acute abdomen varied depending on the age of the patient. Acute appendicitis was the most common cause of acute abdomen in children older than 1 year of age, followed by traumatic injury. Abdominal CT scanning was a useful diagnostic imaging modality in patients with both traumatic and non-traumatic abdominal pain.

  11. Ecchymosis and/or haematoma formation after prophylactic administration of subcutaneous enoxaparin in the abdomen or arm of the critically ill patient.

    Science.gov (United States)

    Jareño-Collado, R; Sánchez-Sánchez, M M; Fraile-Gamo, M P; García-Crespo, N; Barba-Aragón, S; Bermejo-García, H; Sánchez-Izquierdo, R; Sánchez-Muñoz, E I; López-López, A; Arias-Rivera, S

    Ecchymosis and/or haematoma are the most common adverse events after subcutaneous administration of low molecular weight heparin. There is no strong recommendation as to the puncture site. To evaluate the adverse events, ecchymosis and/or haematoma after the administration of prophylactic subcutaneous enoxaparin in the abdomen vs the arm in the critically ill patient. A randomised, two-arm clinical trial (injection in the abdomen vs the arm), performed between July 2014 and January 2017, in an 18-bed, polyvalent intensive care unit. Patients receiving prophylactic enoxaparin, admitted >72h, with no liver or haematological disorders, a body mass index (BMI) >18.5, not pregnant, of legal age and with no skin lesions which would impede assessment were included. We excluded patients who died or who were transferred to another hospital before completing the evaluation. We gathered demographic and clinical variables, and the onset of ecchymosis and/or haematomas at the injection site after 12, 24, 48 and 72hours. A descriptive analysis was undertaken, with group comparison and logistic regression. The study was approved by the ethics committee with the signed consent of patients/families. 301 cases (11 excluded): 149 were injected in the abdomen vs 141 in the arm. There were no significant differences in demographic and clinical variables, BMI, enoxaparin dose or antiplatelet administration [ecchymosis, abdomen vs arm, n(%): 66(44) vs 72(51), P=.25] [haematoma abdomen vs arm, n(%): 9(6) vs 14(10), P=.2]. Statistical significance was found in the size of the haematomas after 72h: [area of haematoma (mm 2 ) abdomen vs arm, median (IQR): 2(1-5.25) vs 20(5.25-156), P=.027]. In our patient cohort, prophylactic subcutaneous enoxaparin administered in the abdomen causes fewer haematomas after 72hours, than when administered in the arm. The incidence rate of ecchymosis and haematoma was lower than the published incidence in critically ill patients, although patients receiving

  12. International consensus conference on open abdomen in trauma.

    Science.gov (United States)

    Chiara, Osvaldo; Cimbanassi, Stefania; Biffl, Walter; Leppaniemi, Ari; Henry, Sharon; Scalea, Thomas M; Catena, Fausto; Ansaloni, Luca; Chieregato, Arturo; de Blasio, Elvio; Gambale, Giorgio; Gordini, Giovanni; Nardi, Guiseppe; Paldalino, Pietro; Gossetti, Francesco; Dionigi, Paolo; Noschese, Giuseppe; Tugnoli, Gregorio; Ribaldi, Sergio; Sgardello, Sebastian; Magnone, Stefano; Rausei, Stefano; Mariani, Anna; Mengoli, Francesca; di Saverio, Salomone; Castriconi, Maurizio; Coccolini, Federico; Negreanu, Joseph; Razzi, Salvatore; Coniglio, Carlo; Morelli, Francesco; Buonanno, Maurizio; Lippi, Monica; Trotta, Liliana; Volpi, Annalisa; Fattori, Luca; Zago, Mauro; de Rai, Paolo; Sammartano, Fabrizio; Manfredi, Roberto; Cingolani, Emiliano

    2016-01-01

    A part of damage-control laparotomy is to leave the fascial edges and the skin open to avoid abdominal compartment syndrome and allow further explorations. This condition, known as open abdomen (OA), although effective, is associated with severe complications. Our aim was to develop evidence-based recommendations to define indications for OA, techniques for temporary abdominal closure, management of enteric fistulas, and methods of definitive wall closure. The literature from 1990 to 2014 was systematically screened according to PRISMA [Preferred Reporting Items for Systematic Reviews and Meta-analyses] protocol. Seventy-six articles were reviewed by a panel of experts to assign grade of recommendations (GoR) and level of evidence (LoE) using the GRADE [Grading of Recommendations Assessment, Development, and Evaluation] system, and an international consensus conference was held. OA in trauma is indicated at the end of damage-control laparotomy, in the presence of visceral swelling, for a second look in vascular injuries or gross contamination, in the case of abdominal wall loss, and if medical treatment of abdominal compartment syndrome has failed (GoR B, LoE II). Negative-pressure wound therapy is the recommended temporary abdominal closure technique to drain peritoneal fluid, improve nursing, and prevent fascial retraction (GoR B, LoE I). Lack of OA closure within 8 days (GoR C, LoE II), bowel injuries, high-volume replacement, and use of polypropylene mesh over the bowel (GoR C, LoE I) are risk factors for frozen abdomen and fistula formation. Negative-pressure wound therapy allows to isolate the fistula and protect the surrounding tissues from spillage until granulation (GoR C, LoE II). Correction of fistula is performed after 6 months to 12 months. Definitive closure of OA has to be obtained early (GoR C, LoE I) with direct suture, traction devices, component separation with or without mesh. Biologic meshes are an option for wall reinforcement if bacterial

  13. Sonographic findings of ovarian hemorrhage presenting acute abdomen

    International Nuclear Information System (INIS)

    Sun, Joo Sung; Lee, Eun Ju; Kang, Hae Jin; Suh, Jung Ho

    2000-01-01

    To obtain the characteristic sonographic findings of ovarian hemorrhage and investigate the usefulness of ultrasonography in the diagnosis. Forty-nine cases presenting acute abdomen diagnosed as ovarian hemorrhage by ultrasonography or surgicopathological confirmation. We observed the size and margin of the ovary, size, pattern, shape, wall and internal echogenecity of the masses and the amount of hemoperitoneum. We also performed a color Doppler study to evaluate the blood flow pattern and resistive index (RI). The age of patients were between 21-41. Most symptoms occurred from days 14 to 30 of her menstrual cycle and were presented for less than 24 hours. Twenty patients had a history of intercourse shortly before the onset of the symptom. Thirty two cases involved the right ovary while the other 17 cases involved the left. All patients had a negative urine or serum hCG test except for 4 pregnant women. The size of the ovary was measured as mean 5.1 cm and marginal irregularly was noted in 36 cases. Mixed echoic solid masses were observed in 6 cases and variable echogenecity of cystic masses were seen in 43 cases. Maximal diameter of adnexal masses were measured as mean 3.95 cm. Internal echogenecity of cystic masses appeared as mainly heterogeneous (21). Twenty two cystic masses had a thick irregular wall and 17 had a thin smooth wall. Hypoechoic rim like halo surrounding was noted in 17 cystic masses. 17 cases seemed to have a small amount of hemoperitoneum, a moderate amount in 22 cases and a large amount in 9 cases. The blood flow pattern of cystic masses showed a rim (29) and spotty (8) pattern in the color Doppler study. Measured RI was 0.41 (mean). Fertile women with the complaint of acute abdominal pain, who has the laboratory data of negative hCG test, ultrasonographic findings of enlargement of ovary with irregular margin, heterogeneous echoic cystic mass, peripheral halo surrounding the mass, hemoperitoneum and low resistance index of peripheral blood

  14. [Successful treatment of hyperthyroidism simulating acute abdomen and psychosis].

    Science.gov (United States)

    Kósa, D; Patakfalvi, A; Györi, L

    1992-07-19

    A 49 years old female patient entered the surgical department because of epigastric and ileocoecal pains with the symptoms of acute abdomen. A surgical intervention was performed because of supposed appendicitis, but it was not verified. During the surgical observation the patient was confused and negativistic so she was transferred to the psychiatric department. Because of loss of 20 kg weight, high blood sedimentation and anaemia she was sent to our department with the suspicion of an organic disease. A moderate exophthalmos, glittering eyes and Graefe's sign was noted, therefore hyperthyroidism was diagnosed, which was proved by Kocher's blood picture, low serum cholesterol, extremely high T3 and T4 level, and iodine storage diagram. The antithyreotic treatment resulted a dramatic improvement in the extremely serious moreover hopeless case and after a long-term treatment the patient became symptom-free without complaints. Later because of regression of hyperthyreoidism and the growing nodular goitre the patient was treated on two occasions with radioactive iodine. At present the patient is in remission.

  15. Abdomen and spinal cord segmentation with augmented active shape models.

    Science.gov (United States)

    Xu, Zhoubing; Conrad, Benjamin N; Baucom, Rebeccah B; Smith, Seth A; Poulose, Benjamin K; Landman, Bennett A

    2016-07-01

    Active shape models (ASMs) have been widely used for extracting human anatomies in medical images given their capability for shape regularization of topology preservation. However, sensitivity to model initialization and local correspondence search often undermines their performances, especially around highly variable contexts in computed-tomography (CT) and magnetic resonance (MR) images. In this study, we propose an augmented ASM (AASM) by integrating the multiatlas label fusion (MALF) and level set (LS) techniques into the traditional ASM framework. Using AASM, landmark updates are optimized globally via a region-based LS evolution applied on the probability map generated from MALF. This augmentation effectively extends the searching range of correspondent landmarks while reducing sensitivity to the image contexts and improves the segmentation robustness. We propose the AASM framework as a two-dimensional segmentation technique targeting structures with one axis of regularity. We apply AASM approach to abdomen CT and spinal cord (SC) MR segmentation challenges. On 20 CT scans, the AASM segmentation of the whole abdominal wall enables the subcutaneous/visceral fat measurement, with high correlation to the measurement derived from manual segmentation. On 28 3T MR scans, AASM yields better performances than other state-of-the-art approaches in segmenting white/gray matter in SC.

  16. Magnetic resonance imaging of the abdomen and pelvis

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    Magnetic resonance imaging (MRI) of the abdomen presents greater inherent difficulties than other anatomic regions. However, new techniques now allow imaging comparable in quality to computed tomography (CT). Magnetic resonance imaging offers the advantages of greater tissue contrast, multiplanar imaging, and lack of ionizing radiation or risk of toxic reactions from iodinated contrast media. Its use remains limited by high cost, limited availability, lack of a bowel contrast agent, and long imaging time, which some patients cannot tolerate. In many areas of abdominal imaging, MRI is now comparable to CT, but because of the greater availability and lesser cost, CT remains the procedure of choice. Magnetic resonance imaging is more accurate for staging neoplasms of the liver, adrenal glands, kidneys, bladder, prostate, uterus, and cervix and may aid in diagnosis of hepatic, adrenal, and uterine masses. In selected patients, especially those in whom CT is inconclusive or those who cannot tolerate iodinated contrast material, MRI can provide valuable information. Development of faster scanning techniques and MRI contrast agents and wider availability will probably increase the usefulness of abdominal MRI. At this time, MRI complements other abdominal imaging procedures. In a small number of patients, however, it can provide unique information in a virtually risk-free manner

  17. Fetal demise by umbilical cord around abdomen and stricture.

    Science.gov (United States)

    Tan, Shun-Jen; Chen, Chi-Huang; Wu, Gwo-Jang; Chen, Wei-Hwa; Chang, Cheng-Chang

    2010-01-01

    Umbilical cord abnormalities are accepted as conditions associated with intrauterine fetal demise (IUFD), and umbilical cord stricture is most frequently encountered. In addition, although cord entanglement with multiple loops rarely increases the perinatal mortality, it is associated with a significant increase in variable kind of morbidity such as growth restriction. We describe a 27-year-old woman, with a missed abortion history at about 10 weeks' gestation in her first pregnancy, who presented to our outpatient department at 34 4/7 weeks of gestation due to decreased fetal activity during the preceding week. No fetal heart activity and blood flow had been detected by ultrasonography and pulsed-wave Doppler. A demised fetus with umbilical cord stricture and three loops around abdomen was delivered and was weighted 1,830 g that was below the tenth percentile for the gestational age. Either umbilical cord stricture or entanglement around the body can affect the development of the fetus and even be lethal. The former might play a more important role in this case. Their etiology and the sequence of the events are still undetermined, and additional evaluation such as autopsy and further research may be needed. In addition, counsel and frequent fetal surveillance should be done in patients with previous IUFD attributed to cord stricture during next pregnancy because of undetermined risk of recurrence.

  18. Durable efficacy of enfuvirtide over 48 weeks in heavily treatment-experienced HIV-1-infected patients in the T-20 versus optimized background regimen only 1 and 2 clinical trials

    NARCIS (Netherlands)

    Nelson, Mark; Arastéh, Keikawus; Clotet, Bonaventura; Cooper, David A.; Henry, Keith; Katlama, Christine; Lalezari, Jacob P.; Lazzarin, Adriano; Montaner, Julio S. G.; O'Hearn, Mary; Piliero, Peter J.; Reynes, Jacques; Trottier, Benoit; Walmsley, Sharon L.; Cohen, Calvin; Eron, Joseph J.; Kuritzkes, Daniel R.; Lange, Joep; Stellbrink, Hans-Jürgen; Delfraissy, Jean-François; Buss, Neil E.; Donatacci, Lucille; Wat, Cynthia; Smiley, Lynn; Wilkinson, Martin; Valentine, Adeline; Guimaraes, Denise; DeMasi, Ralph; Chung, Jain; Salgo, Miklos P.

    2005-01-01

    The T-20 Versus Optimized Background Regimen Only (TORO) 1 and TORO 2 clinical trials are open-label, controlled, parallel-group, phase 3 studies comparing enfuvirtide plus an optimized background (OB) of antiretrovirals (n = 661) with OB alone (n = 334) in treatment-experienced HIV-1-infected

  19. Perforated duodenal ulcer -a rare cause of acute abdomen in pregnancy.

    Science.gov (United States)

    Goel, Bharti; Rani, Jyotsna; Huria, Anju; Gupta, Pratiksha; Dalal, Usha

    2014-09-01

    Acute abdomen during pregnancy is a medico-surgical emergency demanding concerted, synchronized specialties approach of obstetrician, surgeon and gastroenterologist. Duodenal perforation is one of the rarer causes of acute abdomen in pregnancy. Here, we report a case of duodenal perforation with peritonitis in third trimester of pregnancy requiring surgical management. Our aim of reporting this case is to stress the physicians to keep the differential of duodenal perforation also in mind while dealing with cases of acute abdomen in pregnancy and to proceed with multidisciplinary approach for better feto-maternal outcome.

  20. Whole abdomen irradiation in epithelial ovarian cancer - state of the art

    International Nuclear Information System (INIS)

    Gocheva, L.

    2009-01-01

    Epithelial ovarian cancer (OC) as a malignancy which poses multiple challenges has led to growing attention and concern during recent years. The not very noteworthy treatment results achieved during the last three decades with contemporary chemotherapeutic schemes have led to the need for research and development of new therapeutic approaches, as well as to a resurgence of interest in radiotherapy (RT) as part of a combined modality approach and as salvage therapy for patients with small volume persistent disease after primary cytoreductive surgery and chemotherapy. This article reviews the state of the art of whole abdomen irradiation (WAI) (excluding the moving strip field technique) as part of the complex treatment of epithelial OC. The prognostic factors and risk groups of epithelial OC are discussed as indicators for WAI, giving in detail the applied treatment modalities, fractionation and total doses. Toxicity and second primary malignancies following WAI are analyzed. The clinical experience accumulated during the last decades, as adjuvant, consolidative, salvage and palliative WAI in combined treatment of epithelial OC, is presented. Current issues in the radiotherapeutic management are discussed along with ideas for future clinical research directions. (author)

  1. Jejunal Diverticulosis Presented with Acute Abdomen and Diverticulitis Complication: A Case Report

    International Nuclear Information System (INIS)

    Fidan, Nurdan; Mermi, Esra Ummuhan; Acay, Mehtap Beker; Murat, Muammer; Zobaci, Ethem

    2015-01-01

    Jejunal diverticulosis is a rare, usually asymptomatic disease. Its incidence increases with age. If symptomatic, diverticulosis may cause life-threatening acute complications such as diverticulitis, perforation, intestinal hemorrhage and obstruction. In this report, we aimed to present a 67-year-old male patient with jejunal diverticulitis accompanying with abdominal pain and vomiting. A 67-year-old male patient complaining of epigastric pain for a week and nausea and fever for a day presented to our emergency department. Ultrasonographic examination in our clinic revealed diverticulum-like images with thickened walls adjacent to the small intestine loops, and increase in the echogenicity of the surrounding mesenteric fat tissue. Contrast-enhanced abdominal computed tomography showed multiple diverticula, thickened walls with showing contrast enhancement and adjacent jejunum in the left middle quadrant, increased density of the surrounding mesenteric fat tissue, and mesenteric lymph nodes. The patient was hospitalized by general surgery department with the diagnosis of jejunal diverticulitis. Conservative intravenous fluid administration and antibiotic therapy were initiated. Clinical symptoms regressed and the patient was discharged from hospital after 2 weeks. In cases of diverticulitis it should be kept in mind that in patients with advanced age and pain in the left quadrant of the abdomen, diverticular disease causing mortality and morbidity does not always originate from the colon but might also originate from the jejunum

  2. The role of the computerized axial tomography(CT) of the abdomen and pelvis in follow-up studies for the follicular lymphoma patients

    International Nuclear Information System (INIS)

    Oh, Y.K.; Ha, C.S.; McLaughlin, P.; Cabanillas, F.; Hess, M.A.; Cox, J. D.

    1997-01-01

    Purpose/Objective: A large proportion of patients with stage I, II or III follicular lymphoma remains free of recurrence for a long period of time after a complete response(CR) to the initial treatment. The yield of the costly follow-up tests, especially the CT of the abdomen and pelvis, for this indolent lymphoma has not been systematically studied. Materials and Methods: A total of 328 patients with previously untreated stage I, II or III follicular lymphoma were treated at our institution between 1978 and 1994. Two hundred fifty seven patients achieved CR to treatments: seventy eight of them relapsed. Their median age was 55 years. Their stages were; I-15, II-28, III-35. Their treatments were; radiation therapy-15, chemotherapy-12, combined modality with radiation and chemotherapy-51. The medical records of these 78 patients were reviewed in detail to analyze the yield of the CT of the abdomen and pelvis in detecting the recurrence relative to history/physical exam(H/PE), complete blood count(CBC), serum chemistry, chest roentgenogram(CXR), and KUB to visualize the residual lymphangiogram dye(KUB/LAG). A positive study was defined as one which led to or was abnormal at the time of the diagnosis of recurrence. Results: The median follow-up period was 101 months. Patients were usually followed in the clinic every 3 to 6 months for the initial 5 years and then yearly thereafter. The number of the positive studies per total number of follow-up studies performed in the period between CR and recurrence were; H/PE-55/568, CBC-1/534, serum chemistry-5/517, CXR-6/488, KUB/LAG-13/190, CT of abdomen-29/259, CT of pelvis-19/242. Eleven relapses were detected only by CT of abdomen and pelvis. Conclusion: Fourteen percent ((11(78))) of the relapses were detected solely by CT of the abdomen and pelvis. This implies 4.3 % ((11(257))) of the patients who achieved CR benefited from the CT of the abdomen and pelvis for recurrence detection. The yield of the routine use of the CT

  3. Acute abdomen in a patient with Mayer-Rokitansky-Kuster-Hauser syndrome

    Directory of Open Access Journals (Sweden)

    Petrić Aleksandra

    2008-01-01

    Full Text Available Background. Mayer-Rokitansky-Kuster-Hauser (MRKH syndrome is a malformation of female genital tract (incidence 1 in 4000 female newborn children. It appears as a result of a disorder in the development of Millerian cannals. Etiology is unknown. Syndrome MRKH is the most frequent cause of primary amenorrhoea (90%. Patients with MRKH have a normal female phenotype, with normal pubic hairness and thelarche, and female karyotype (46XX followed by primary amenorrhoea. Hormonal status corresponds to healthy women, where the appearance of ovarian tumors and tumors on rudiment parts of uterus is possible. Case report. We presented a case of acute abdomen in a patient with previously not diagnosed MRKH. The diagnosis was done during the operation. Small pelvis and an abdominal part were filled with torquated tumor lump, where ovaries, oviducts, uterus or something resembling rudiment of uterus were not recognized through careful examination. Furthemore, the patient had a short, dead-end vagina. Tumorectomy was done and hystopathological finding showed the presence of vascular leiomyoma. Conclusion. The diagnosis of complex syndromes, such as MRKH, can, despite modern diagnostics, be absent for non-medical and psycho-social reasons. We can expect ovarian and uterine pathology on hypoplastic structures in these patients, as well as in healthy women. Vascular leiomyoma in the patients with MRKH was not found in the available literature.

  4. Evaluation of amylase and lipase levels in blunt trauma abdomen patients.

    Science.gov (United States)

    Kumar, Subodh; Sagar, Sushma; Subramanian, Arulselvi; Albert, Venencia; Pandey, Ravindra Mohan; Kapoor, Nitika

    2012-04-01

    There are studies to prove the role of amylase and lipase estimation as a screening diagnostic tool to detect diseases apart from acute pancreatitis. However, there is sparse literature on the role of serum and urine amylase, lipase levels, etc to help predict the specific intra-abdominal injury after blunt trauma abdomen (BTA). To elucidate the significance of elevation in the levels of amylase and lipase in serum and urine samples as reliable parameters for accurate diagnosis and management of blunt trauma to the abdomen. A prospective analysis was done on the trauma patients admitted in Jai Prakash Narayan Apex Trauma Center, AIIMS, with blunt abdomen trauma injuries over a period of six months. Blood and urine samples were collected on days 1, 3, and 5 of admission for the estimation of amylase and lipase, liver function tests, serum bicarbonates, urine routine microscopy for red blood cells, and complete hemogram. Clinical details such as time elapsed from injury to admission, type of injury, trauma score, and hypotension were noted. Patients were divided into groups according to the single or multiple organs injured and according to their hospital outcome (dead/discharged). Wilcoxon's Rank sum or Kruskal-Wallis tests were used to compare median values in two/three groups. Data analysis was performed using STATA 11.0 statistical software. A total of 55 patients with median age 26 (range, 6-80) years, were enrolled in the study. Of these, 80% were males. Surgery was required for 20% of the patients. Out of 55 patients, 42 had isolated single organ injury [liver or spleen or gastrointestinal tract (GIT) or kidney]. Patients with pancreatic injury were excluded. In patients who suffered liver injuries, urine lipase levels on day 1, urine lipase/amylase ratio along with aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) on days 1, 3, and 5, were found to be significant. Day 1 serum amylase, AST, ALT, hemoglobin, and

  5. Frequency, Pattern and Management of Acute Abdomen in Dengue Fever in Karachi, Pakistan

    Directory of Open Access Journals (Sweden)

    Muhammad Shamim

    2010-07-01

    Conclusion: Early diagnosis and prompt conservative management of dengue acute abdomen is necessary to avoid mortality and emergency surgery-related morbidity. However, if needed, surgery can be performed with acceptable morbidity.

  6. Diseases of the hepatobiliary system as a cause of acute abdomen; Erkrankungen des hepatobiliaeren Systems als Ursache des akuten Abdomens

    Energy Technology Data Exchange (ETDEWEB)

    Schima, W.; Eisenhuber-Stadler, E. [Krankenhaus Goettlicher Heiland, Abteilung fuer Radiologie und bildgebende Diagnostik, Wien (Austria); Koelblinger, C.; Kulinna-Cosentini, C.; Ba-Ssalamah, A. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2010-03-15

    Diseases of the liver and biliary system are common causes of acute abdominal pain and gallstone disease predisposes to cholecystitis and cholangiolithiasis. Sonography is the method of choice for the assessment of cholecystitis, whereas magnetic resonance cholangiopancreaticography (MRCP) is the standard technique to detect stones in the common bile duct. Multi-detector computed tomography (MDCT) is ideal for detection of associated complications, including abscess formation and gall stone ileus. Pyogenic, amebic and fungal liver abscesses are reliably diagnosed with MDCT which can also be used for interventional radiologic therapy of liver abscesses by percutaneous aspiration or drainage procedures. The second most common cause of liver rupture after blunt trauma is spontaneous rupture of hypervascular liver tumors (i.e., HCC, adenoma, angiosarcoma) and due to medical procedures. Multi-phase contrast-enhanced MDCT can reliably detect active bleeding to guide further therapy in these cases. (orig.) [German] Die Cholezystitis ist eine der haeufigsten Ursachen fuer ein akutes Abdomen. Waehrend die Sonographie die Methode der Wahl zum Nachweis einer Cholezystolithiasis und Cholezystitis ist, steht bei der Entwicklung von Komplikationen die Multidetektorcomputertomographie (MDCT) diagnostisch im Vordergrund. Die Magnetresonanzcholangiopankreatikographie (MRCP) hat einen hohen Stellenwert bei der Abklaerung der Cholangiolithiasis, v. a. bei der Differenzialdiagnose zu anderen Ursachen einer Cholestase. Die Diagnose bakterieller, Amoeben- oder fungaler Leberabszesse kann mittels Sonographie oder MDCT rasch gestellt werden, wobei diese Methoden auch fuer die interventionelle radiologische Therapie von Leberabszessen (Punktion oder Drainage) gut geeignet sind. Die mehrphasige, kontrastmittelverstaerkte MDCT ist die Methode der Wahl fuer den Nachweis von Leberinfarkten oder -rupturen, da bei diesen Erkrankungen bzw. Verletzungsfolgen die Darstellung der

  7. Frequency, Pattern and Management of Acute Abdomen in Dengue Fever in Karachi, Pakistan

    OpenAIRE

    Muhammad Shamim

    2010-01-01

    This study aimed to determine the frequency, pattern and management of acute abdomen in patients with dengue fever. Methods: This descriptive case series is a prospective analysis of acute abdomen in dengue fever that was performed at three secondary care hospitals in Karachi, Pakistan from June 1, 2005 to December 31, 2008. The inclusion criterion was all patients with confirmed diagnosis of dengue fever. Patients with incomplete laboratory, ultrasound or histopathology data were excluded...

  8. Varicella Zoster Infection: A Rare Cause of Abdominal Pain Mimicking Acute Abdomen

    OpenAIRE

    Olmez, Deniz; Boz, Alper; Erkan, Nazif

    2009-01-01

    Varicella zoster is an acute viral infection that results from reactivation of a latent varicella zoster virus. It usually occurs in adult population and immune compromised patients. It rarely occurs in healthy children. Here we present a 14 years old male with varicella zoster that had abdominal pain mimicking acute abdomen to alert others who are consulted for the differentiation of acute abdomen and others who may be consulted for pain management. Keywords Varicella zoster; Abdominal pain

  9. Open Abdomen Therapy with Vacuum and Mesh Mediated Fascial Traction After Aortic Repair: an International Multicentre Study.

    Science.gov (United States)

    Acosta, Stefan; Seternes, Arne; Venermo, Maarit; Vikatmaa, Leena; Sörelius, Karl; Wanhainen, Anders; Svensson, Mats; Djavani, Khatereh; Björck, Martin

    2017-12-01

    Open abdomen therapy may be necessary to prevent or treat abdominal compartment syndrome (ACS). The aim of the study was to analyse the primary delayed fascial closure (PDFC) rate and complications after open abdomen therapy with vacuum and mesh mediated fascial traction (VACM) after aortic repair and to compare outcomes between those treated with open abdomen after primary versus secondary operation. This was a retrospective cohort, multicentre study in Sweden, Finland, and Norway, including consecutive patients treated with open abdomen and VACM after aortic repair at six vascular centres in 2006-2015. The primary endpoint was PDFC rate. Among 191 patients, 155 were men. The median age was 71 years (IQR 66-76). Ruptured abdominal aortic aneurysm (RAAA) occurred in 69.1%. Endovascular/hybrid and open repairs were performed in 49 and 142 patients, respectively. The indications for open abdomen were inability to close the abdomen (62%) at primary operation and ACS (80%) at secondary operation. Duration of open abdomen was 11 days (IQR 7-16) in 157 patients alive at open abdomen termination. The PDFC rate was 91.8%. Open abdomen initiated at primary (N=103), compared with secondary operation (N=88), was associated with less severe initial open abdomen status (p=.006), less intestinal ischaemia (p=.002), shorter duration of open abdomen (p=.007), and less renal replacement therapy (RRT, popen abdomen initiated at primary versus secondary operation. VACM was associated with a high PDFC rate after prolonged open abdomen therapy following aortic repair. Patient outcomes seemed better when open abdomen was initiated at primary, compared with secondary operation but a selection effect is possible. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  10. Ileum perforation due to accidental chicken bone ingestion a rare cause of the acute abdomen

    Directory of Open Access Journals (Sweden)

    Doklestić Krstina S.

    2012-03-01

    Full Text Available Ingestion of foreign bodies is not an uncommon occurrence, but most of them will pass through the gastrointestinal tract without consequences. Complication such as perforation is rare. We present a case of small bowel perforation secondary to the accidental ingestion of a chicken bone. The patient presented with abdominal pain, constipation and vomiting. Clinical examination confirmed generalized abdominal tenderness and rebound tenderness. Abdominal radiography showed multiple dilated loops of small bowel, and abdominal ultrasound (US showed inflammatory changes on small bowel loops, with free fluid and fluid collection around intestinal loops. The patient underwent an emergency laparotomy. Intra operative findings revealed diffuse fibro purulent peritonitis with abscess between central small bowels loops. At about 60 cm from Bauchini valve we found a perforation of ileum at the anti-mesenteric site caused by a sharp chicken wishbone. The patient was treated with resection of the ileum segment (10 cm and primary end-to-end anastomosis. Even that intestinal perforation by a foreign body is rare, physicians should consider possibility of intestinal perforation by a foreign body in the differential diagnosis of acute abdomen in patients presenting with abdominal pain.

  11. Radiotherapy of ovarian epithelial cancer by total orthogonal field irradiation of the abdomen

    International Nuclear Information System (INIS)

    Delouche, G.; Valinta, D.; Bachelot, F.

    1981-01-01

    Isotopic intraperitoneal curietherapy by 32 P is the simplest method for irradiating the peritoneum, but it has only limited indications. This irradiation has usually to be given by the percutaneous route, but because of the size of the region to be irradiated it raises delicate problems poorly resolved by the traditional methods applied. For this reason, a particular method is suggested including, among other characteristics: 4 orthogonal fields; 2 sessions daily, irradiating one part of the abdomen in the morning and the other part in the afternoon; spreading of the doses in confirmity with current specifications; and modulation of the total dose as a function of the maximum size of the tumoral remnants. Abdominal radiotherapy is currently the method of choice in cases where lesions are in their early stages, in so far as chemotherapy, much more restrictive for the patient, has not yet demonstrated its long-term efficacy. A controlled clinical study is necessary in order to determine the most effective method [fr

  12. Meckel's Diverticulitis as a Cause of an Acute Abdomen in the Second Trimester of Pregnancy: Laparoscopic Management.

    Science.gov (United States)

    Pandeva, Ivilina; Kumar, Sumit; Alvi, Atif; Nosib, Hema

    2015-01-01

    Introduction. Meckel's diverticulitis is an extremely rare cause of an acute abdomen in pregnancy. Its clinical presentation tends to be rather unusual and therefore commonly delaying diagnosis. The surgical method of exploration can be either by laparoscopy or through an open incision. Case Report. We report a case of a 34-year-old, P1 with previous Caesarean section, who presented at 20 weeks with worsening right-sided abdominal pain, distention, and peritonism. Ultrasound scan showed an area of a possibly thickened loop of bowel inconsistent with an appendicitis. The findings at laparoscopy were purulent fluid in the pelvis, a congested appendix, and inflamed Meckel's diverticulum. An appendectomy and excision of the diverticulum was performed using stapler technique. Discussion. Meckel's diverticulitis in pregnancy can have nonspecific presentation and poses difficulties for preoperative diagnosis. Delay in diagnosis and management poses significant maternal and fetal risks. The use of laparoscopy if the gestational age and uterine size permit its use allows a thorough exploration of the abdominal cavity and management of rarer and unexpected pathology. Laparoscopic management of acute abdomen in the midtrimester of pregnancy has been found to be safe and effective.

  13. Meckel’s Diverticulitis as a Cause of an Acute Abdomen in the Second Trimester of Pregnancy: Laparoscopic Management

    Directory of Open Access Journals (Sweden)

    Ivilina Pandeva

    2015-01-01

    Full Text Available Introduction. Meckel’s diverticulitis is an extremely rare cause of an acute abdomen in pregnancy. Its clinical presentation tends to be rather unusual and therefore commonly delaying diagnosis. The surgical method of exploration can be either by laparoscopy or through an open incision. Case Report. We report a case of a 34-year-old, P1 with previous Caesarean section, who presented at 20 weeks with worsening right-sided abdominal pain, distention, and peritonism. Ultrasound scan showed an area of a possibly thickened loop of bowel inconsistent with an appendicitis. The findings at laparoscopy were purulent fluid in the pelvis, a congested appendix, and inflamed Meckel’s diverticulum. An appendectomy and excision of the diverticulum was performed using stapler technique. Discussion. Meckel’s diverticulitis in pregnancy can have nonspecific presentation and poses difficulties for preoperative diagnosis. Delay in diagnosis and management poses significant maternal and fetal risks. The use of laparoscopy if the gestational age and uterine size permit its use allows a thorough exploration of the abdominal cavity and management of rarer and unexpected pathology. Laparoscopic management of acute abdomen in the midtrimester of pregnancy has been found to be safe and effective.

  14. Dose estimation in CT exams of the abdomen based on values of DLP; Estimativa da dose em exames de tomografia de abdome com base nos valores de DLP

    Energy Technology Data Exchange (ETDEWEB)

    Kikuti, C.F.; Medeiros, R.B.; Salvadori, P.S.; Costa, D.M.C; D' lppolito, G., E-mail: kikuticf@gmail.com, E-mail: rbitelli2011@gmail.com [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Coordenadoria de Fisica e Higiene das Radiacoes. Departamento de Diagnostico por Imagem

    2013-10-01

    One of the challenges of multidetector computerized tomography is to minimize the risk of ionizing radiation using optimized protocols since higher doses are necessary to obtain high image quality. It was also noted that, due to the geometry in image acquisition using MDCT becomes necessary to estimate dose values consistent with the hypothesis clinically and with the specificities of the tomographic equipment. The aim of this study was to estimate the doses in abdomen exams from the data recorded on the MDCT console and dimensions obtained from DICOM images of patients undergoing different clinical protocols. Were collected, from the image DICOM of 101 exams, values of the dose length product (DLP) provided by Philips Health Care - Brilliance 64 equipment console, in order to relate them with the dose values obtained by means of thermoluminescent dosimeters ( TLD ) of CasSo{sub 4}:Mn placed on the surface of a cylindrical simulator abdomen acrylic manufactured under the technical - operational conditions for a typical abdomen exam. From the data obtained, it was possible to find a factor of 1.16 ( 5 % ) indicating that the DLP values Brilliance 64 console underestimate the doses and this should be used with correction factor to estimate the total dose of the patient. (author)

  15. Open abdomen management of intra-abdominal infections: analysis of a twenty-year experience.

    Science.gov (United States)

    Rausei, Stefano; Dionigi, Gianlorenzo; Boni, Luigi; Rovera, Francesca; Minoja, Giulio; Cuffari, Salvatore; Dionigi, Renzo

    2014-06-01

    No conclusive results on the efficacy and timing of open abdomen (OA) are available, particularly in the setting of intra-abdominal infections. We analyzed outcomes and risk factors retrospectively in a large series of patients managed with an OA during the past 20 y in an effort to clarify this issue. We reviewed the records of 133 patients who underwent treatment with an OA, considering factors related to patient, disease, medical management, and surgical treatment. The end points of the bi-variable analysis were 1-y mortality, calculated from the time of an initial OA procedure, and definitive fascial closure. Most patients (112/133) managed with an OA had one of several types of peritonitis. Many patients had severe clinical conditions (mean Acute Physiology and Chronic Health Evaluation [APACHE] II score was almost 9 points for the study population). With regard to surgical management, the mean (+SD) number of abdominal revisions was 5.9+9.3 during a mean duration of treatment with an OA of 14.3+11.6 d. The overall mortality in the study was 26% (35/133). Bi-variable analysis revealed factors associated with overall mortality to be age, renal and respiratory co-morbidities, edema on an initial chest radiograph, blood pressure, blood glucose and creatinine concentrations; and APACHE II score. The rate of definitive fascial closure was 75% (100/133). Factors associated negatively with fascial closure were respiratory co-morbidity, edema on a first chest radiograph, post-operative mesenteric ischemia as an indication for OA, blood glucose and creatinine concentrations, and duration of an OA. Patients' pre-operative clinical status influences strongly their response to surgical treatment. The management of OA does not affect adversely the survival of patients with intra-abdominal infections, but factors related to the management of OA (duration of OA) seem to affect the possibility of definitive fascial closure.

  16. Acute abdomen in pregnancy requiring surgical management: a 20-case series.

    Science.gov (United States)

    Unal, Aysun; Sayharman, Sema Etiz; Ozel, Leyla; Unal, Ethem; Aka, Nurettin; Titiz, Izzet; Kose, Gultekin

    2011-11-01

    The obstetrician often has a difficult task in diagnosing and managing the acute abdomen in pregnancy. A reluctance to operate during pregnancy adds unnecessary delay, which may increase morbidity for both mother and fetus. In this study, we present our experience in pregnant patients with acute abdomen. Pregnant patients with acute abdomen requiring surgical exploration were enrolled from 2007 to 2010. Demographics, gestational age, symptoms, fetal loss, preterm delivery, imaging studies, operative results, postoperative complications and histopathologic evaluations were recorded. Ultrasound (US) and magnetic resonance (MR) imaging studies were evaluated. Data analyses were performed with Microsoft Excel and statistical evaluations were done by using Student's t-test. There were 20 patients with a mean age of 32 years. The rate of emergency surgery was seen to be significantly higher in the second trimester (pacute abdomen (30% and 15%, respectively). All patients tolerated surgery well, and postoperative complications included wound infection, 10%, preterm labor, 5%, and prolonged paralytic ileus, 5%. One patient died from advanced gastric carcinoma and the only fetal death was seen in this case. Prompt diagnosis and appropriate therapy are crucial in pregnant with acute abdomen. The use of US may be limited and CT is not desirable due to fetal irradiation. MR has thus become increasingly popular in the evaluation of such patients. Adhesive small bowel obstruction should be kept in mind as an important etiology. Copyright © 2011. Published by Elsevier Ireland Ltd.

  17. Non Obstetric Acute Abdomen in Pregnancy – An Experience from Kashmir

    Directory of Open Access Journals (Sweden)

    Ajaz Ahmad Rather

    2013-11-01

    Full Text Available Objectives: The objective of this study was to study the profile of pregnant patients who were managed by general surgical unit of a referral hospital in Kashmir valley for non obstetric causes of acute abdomen over a period of seven years. Methods: The study was done retrospectively after acquiring data from databank related to pregnant patients managed for acute abdomen over a period of seven years (from January 2006 to December 2012 in the general surgical department of the medical college of SK Institute of Medical Sciences, Srinagar, Kashmir. Results: 49 non obstetric acute abdomen were managed in pregnant females over a period of seven years. 23 (46.9% patients reported with a delay of more than 12 hours and 34 (69.4% cases underwent surgical interventions. Appendicitis was the commonest cause of acute abdomen and Ultrasonography was the only imaging modality utilized. Only 3 cases had preterm labor. Conclusions: Acute abdomen in pregnant females should be assessed with high level of suspicion .Delay in presentation and intervention leads to adverse outcomes.

  18. Abscess of urachal remnants presenting with acute abdomen: a case series

    Directory of Open Access Journals (Sweden)

    Tazi Fadl

    2012-07-01

    one, with a good follow-up result. Case presentation 3: A 22-year-old Arab-Berber man, with no relevant past medical history, presented to our emergency department because of suspected acute surgical abdomen. Physical examination revealed umbilical discharge with erythema and a tender umbilical mass. Abdominal ultrasonography and computed tomography scan confirmed the diagnosis of infected urachal sinus. Initial management was intravenous antibiotics associated with a percutaneous drainage with a good post-operative result, but a few days later, he was readmitted with the same complaint and the decision was made for surgical treatment consisting of excision of the infected urachal sinus. The clinical course was uneventful. Histological examination did not reveal any signs of malignancy. Conclusions We describe our clinical observations and an analysis of the existing literature to present the various clinical, radiological, pathological and therapeutic aspects of an abscess of urachal remnants. To the best of our knowledge, this manuscript is an original case report because this atypical presentation is rarely reported in the literature and only a few cases have been described.

  19. Temporary Closure of the Open Abdomen: A Systematic Review on Delayed Primary Fascial Closure in Patients with an Open Abdomen

    NARCIS (Netherlands)

    Boele van Hensbroek, Pieter; Wind, Jan; Dijkgraaf, Marcel G. W.; Busch, Olivier R. C.; Goslings, J. Carel

    2009-01-01

    Background This study was designed to systematically review the literature to assess which temporary abdominal closure (TAC) technique is associated with the highest delayed primary fascial closure (FC) rate. In some cases of abdominal trauma or infection, edema or packing precludes fascial closure

  20. Síndrome de abdomen en ciruela pasa y dextrocardia, asociación infrecuente

    Directory of Open Access Journals (Sweden)

    Hermann Silva

    2015-01-01

    Full Text Available Se describe un neonato con Síndrome de abdomen en ciruela pasa, de sexo masculino, nacido de 36 semanas de gestación y pesó 3 650 g al nacer. El examen clínico mostró un neonato con un abdomen globuloso, con redundancia de la piel que huelga a los costados rebosantes, la palpación del abdomen no descubre la tonalidad muscular. No se palpa visceromegalia y hay presencia normal de ruidos hidroaéreos. El examen físico del tórax y cardiovascular fueron aparentemente normales. Normocéfalo y facies no peculiar. La radiografía de tórax muestra dextrocardía. La ecografía renal mostró dilatación pielocalicial. Revela además criptorquidia bilateral.

  1. Acute abdomen and ascites as presenting features of autosomal dominant polycystic kidney disease.

    Science.gov (United States)

    Chaudhary, Sanjay; Qian, Qi

    2012-12-27

    We describe a patient with sudden onset of abdominal pain and ascites, leading to the diagnosis of autosomal dominant polycystic kidney disease (ADPKD). Her presentation was consistent with acute liver cyst rupture as the cause of her acute illness. A review of literature on polycystic liver disease in patients with ADPKD and current management strategies are presented. This case alerts physicians that ADPKD could occasionally present as an acute abdomen; cyst rupture related to ADPKD may be considered in the differential diagnoses of acute abdomen.

  2. Mesenteric defect with internal herniation in the pediatric emergency department: an unusual presentation of acute abdomen.

    Science.gov (United States)

    Hu, Mei-Hua; Huang, Go-Shine; Chen, Jeng-Chang; Wu, Chang-Teng

    2014-04-01

    Internal herniation is a rare cause of intestinal obstruction, especially in the emergency department. We report a child with acute abdomen resulting from transmesenteric internal herniation of the small bowel. Radiographic findings revealed gaseous distension of the bowel loops in the upper abdominal area with a paucity of gas in the lower abdomen. Operative finding showed gangrenous small bowel due to mesenteric defect with an internal herniation. The gangrenous bowel was resected and the patient was discharged with an uneventful outcome. We emphasize that early recognition of internal herniation warrants further evaluation and appropriate management. Copyright © 2012. Published by Elsevier B.V.

  3. Calculations on the dose decreasing and image quality improving effects of an abdomen dodger

    International Nuclear Information System (INIS)

    Koblinger, L.

    1974-07-01

    A Monte Carlo computer program is performed to study the effects of an abdomen dodger. For this study the inhomogeneous Snyder phantom is assumed to be irradiated by an X-ray tube operated at 80 kV. By the use of a dodger which compensates the varying thickness of the body the exposure distribution on the photoreceptor can be made more uniform and the absorbed dose decreases. As different patients have different dimensions, the results presented here cannot be applied for any given abdomen examination, but can be used as average values, characteristic for an average examination, thus applicable in the estimations for the total population. (K.A.)

  4. Well differentiated papillary mesothelioma of abdomen- a rare case with diagnostic dilemma.

    Science.gov (United States)

    Saha, Aniruddha; Mandal, Palash Kumar; Manna, Anupam; Khan, Kalyan; Pal, Subrata

    2018-01-01

    Well-differentiated papillary mesothelioma is a rare tumor occurring predominantly in the peritoneum of young women, a few with history of asbestos exposure. A 28-year-old woman presented with ascites and pain abdomen. Ultrasonography and computed tomography scan of the abdomen revealed a mass in the retroperitoneum measuring 15 cm × 12 cm. Histopathological examination along with immunohistochemistry (IHC) confirmed it to be a papillary mesothelioma in the peritoneum. It is difficult to differentiate from more common malignant mesothelioma and papillary adenocarcinoma, which also have poorer prognosis. The difficulty can be resolved by clinico-radiological correlation along with histopathological examination and IHC.

  5. Acute Abdomen Secondary to a Spontaneous Perforation of the Biliary Tract, a Rare Complication of Choledocholithiasis

    Directory of Open Access Journals (Sweden)

    G.A. Gómez-Torres

    Full Text Available Introduction: The spontaneous perforation of the biliary tract (SPBT is an extremely rare cause of peritonitis, which was first described by Freeland in 1982, to date only around 70 cases have been reported. Here we present a case of spontaneous perforation of the biliary tract, in a patient with choledocholithiasis, which was treated with ultrasound-guided drainage and ERCP. Case report: A 51-year-old male was admitted to the emergency room for 15-day evolution jaundice, localized pain in the right flank and hypochondrium of 3 days. He had a history of cholecystectomy 15 years ago and 4 episodes of cholangitis, the last one in 2015. A magnetic resonance imaging (MRI was performed, that showed evidence of choledocholithiasis, in addition to a possible biliary leakage. The patient was treated with ultrasound-guided drainage and ERCP successfully. Discussion: Spontaneous perforation of the biliary tract is a disease entity in which wall of the extrahepatic or intrahepatic duct is perforated without any traumatic or iatrogenic injury. The clinical presentation varies from nonspecific abdominal pain to biliary peritonitis, in most of the cases forming bilomas. Universal management involves decompression of the biliary tree and repair of the leak site. Conclusion: The spontaneous perforation of the biliary tract is a disease that represents a diagnostic challenge. The treatment in the patients with SPBT is not well established and has to be individualized for each case, depending on the history of the patient, the site of perforation, the time of evolution, the suspicion of infection, and the patient status. Keywords: Acute abdomen, Spontaneous perforation biliary tract, Biloma, Complication choledocholithiasis, Case report

  6. Acute abdomen from gossypiboma: Our Case series and review of ...

    African Journals Online (AJOL)

    maurice asuquo

    complaint of progressive abdominal pain/ distension of three weeks duration, vomiting /constipation of five ... man in painful distress, afebrile, dehydrated and pale. Chest was clinically clear. Abdominal examination revealed two ... pain and distension following an emergency. Caesarian section due to prolonged labour. She.

  7. Motion based Segmentation of Chest and Abdomen Region of Neonates

    NARCIS (Netherlands)

    Venkitaraman, A.; Makkapati, V.V.

    2015-01-01

    Respiration rate (RR) is one of the important vital signs used for clinical monitoring of neonates in intensive care units. Due to thefragile skin of the neonates, it is preferable to have monitoring systems with minimal contact with the neonate. Recently, several methods have been proposed for

  8. Critique of Sew it Up! A Western Trauma Association Multi-Institutional Study of Enteric Injury Management in the Postinjury Open Abdomen

    Directory of Open Access Journals (Sweden)

    Nuri Abdurraheim

    2013-03-01

    Full Text Available Background: Use of damage control surgery techniques has reduced mortality in critically injured patients but at the cost of the open abdomen. With the option of delayed definitive management of enteric injuries, the question of intestinal repair/anastomosis or definitive stoma creation has been posed with no clear consensus. The purpose of this study was to determine outcomes on the basis of management of enteric injuries in patients relegated to the postinjury open abdomen.Methods: Patients requiring an open abdomen after trauma from January 1, 2002 to December 31, 2007 were reviewed. Type of bowel repair was categorized as immediate repair, immediate anastomosis, delayed anastomosis, stoma and a combination. Logistic regression was used to determine independent effect of risk factors on leak development.Results: During the 6-year study period, 204 patients suffered enteric injuries and were managed with an open abdomen. The majority was men (77% sustaining blunt trauma (66% with a mean age of 37.1 years±1.2 years and median Injury Severity Score of 27 (interquartile range=20-41. Injury patterns included 81 (40% small bowel, 37 (18% colonic, and 86 (42% combined injuries. Enteric injuries were managed with immediate repair (58, immediate anastomosis (15, delayed anastomosis (96, stoma (10, and a combination (22; three patients died before definitive repair. Sixty-one patients suffered intra-abdominal complications: 35 (17% abscesses, 15 (7% leaks, and 11 (5% enterocutaneous fistulas. The majority of patients with leaks had a delayed anastomosis; one patient had a right colon repair. Leak rate increased as one progresses toward the left colon (small bowel anastomoses, 3% leak rate; right colon, 3%; transverse colon, 20%; left colon, 45%. There were no differences in emergency department physiology, injury severity, transfusions, crystalloids, or demographic characteristics between patients with and without leak. Leak cases had higher 12-hour

  9. A Rare Cause of Acute Abdomen: Idiopathic Isolated Cecal Necrosis

    Directory of Open Access Journals (Sweden)

    Ender Özer

    2015-03-01

    Full Text Available Idiopathic isolated cecal necrosis is a clinical problem characterized by right-sided inferior abdominal pain. It is rarely seen, develops due to decreased blood flow to the colon and, imitates acute appendicitis. Its clinical signs are similar to many illnesses causing sensitivity in the right inferior quadrant and, the diagnosis is generally determined during surgery. An 86-year-old male patient presented with the complaints of abdominal pain, trichiniasis, nausea and vomiting. Surgical intervention was decided when physical examination and laboratory results were taken into consideration. After diagnostic laparoscopy, right hemicolectomy was performed because of cecal necrosis. While the mortality and morbidity rates for ischemic bowel disease are high, prognosis for early diagnosed patients with isolated cecal necrosis is better, provided that timely surgical treatment is decided.

  10. Critical Structure for Telescopic Movement of Honey bee (Insecta: Apidae) Abdomen: Folded Intersegmental Membrane.

    Science.gov (United States)

    Zhao, Jieliang; Yan, Shaoze; Wu, Jianing

    2016-01-01

    The folded intersegmental membrane is a structure that interconnects two adjacent abdominal segments; this structure is distributed in the segments of the honey bee abdomen. The morphology of the folded intersegmental membrane has already been documented. However, the ultrastructure of the intersegmental membrane and its assistive role in the telescopic movements of the honey bee abdomen are poorly understood. To explore the morphology and ultrastructure of the folded intersegmental membrane in the honey bee abdomen, frozen sections were analyzed under a scanning electron microscope. The intersegmental membrane between two adjacent terga has a Z-S configuration that greatly influences the daily physical activities of the honey bee abdomen. The dorsal intersegmental membrane is 2 times thicker than the ventral one, leading to asymmetric abdominal motion. Honey bee abdominal movements were recorded using a high-speed camera and through phase-contrast computed tomography. These movements conformed to the structural features of the folded intersegmental membrane. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America.

  11. Placenta percreta causing acute abdomen in the second trimester of pregnancy

    International Nuclear Information System (INIS)

    Hussain, M.; Bhutta, S. Z.; Sarwar, S.

    2004-01-01

    Two cases of acute abdomen due to haemoperitoneum caused by placenta percreta in the second trimester are presented. Both had a history of previous lower segment caesarean section, a factor well-known to predispose the condition. How- ever, the rarity of the condition, presenting in mid pregnancy makes diagnosis and management difficult. Optimum ways of management are discussed. (author)

  12. Frequency, pattern and management of acute abdomen in dengue fever in Karachi, Pakistan.

    Science.gov (United States)

    Shamim, Muhammad

    2010-07-01

    This study aimed to determine the frequency, pattern and management of acute abdomen in patients with dengue fever. This descriptive case series is a prospective analysis of acute abdomen in dengue fever that was performed at three secondary care hospitals in Karachi, Pakistan from June 1, 2005 to December 31, 2008. The inclusion criterion was all patients with confirmed diagnosis of dengue fever. Patients with incomplete laboratory, ultrasound or histopathology data were excluded. Among 357 patients with dengue fever, 43 (12.04%) had acute abdomen. There were 15 men and 28 women, with a median age of 29 years. These included 26 cases of acute cholecystitis, 7 cases of acute appendicitis, 7 cases of nonspecific peritonitis, and 3 cases of acute pancreatitis. Dengue hemorrhagic fever/shock syndrome was found in acute pancreatitis, and two of these patients died. Emergency surgery was required in eight patients (5 appendectomy and 3 open cholecystectomy). Substantial transfusion of blood and its components was required in eight patients who underwent emergency surgery. Early diagnosis and prompt conservative management of dengue acute abdomen is necessary to avoid mortality and emergency surgery-related morbidity. However, if needed, surgery can be performed with acceptable morbidity. Copyright © 2010 Asian Surgical Association. Published by Elsevier B.V. All rights reserved.

  13. 505 Effective Medicated Abdomen Wrapper Best External Care for Lingering Diseases Unconventional Product for Vigorous Health

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    505 Effective Medicated Abdomen Wrapper,a national patent product(patent num-ber 90202386.1),together with its serial products,has filled in the gaps in the field ofChina’s medical science and health care products.The development of the product wasbrought into line with the State Spark Programme by the State Commission for Science

  14. Neoplastic and other pathologic effects of fractionated fast neutrons or photons on the thorax and anterior abdomen of beagles

    International Nuclear Information System (INIS)

    Zook, B.C.; Bradley, E.W.; Casarett, G.W.; Rogers, C.C.

    1986-01-01

    Thirty-nine adult male beagle dogs received either fast-neutron or photon irradiation to the right hemithorax and right rostral abdomen. Twenty-four dogs (six per group) received fast neutrons (15 MeV) to total doses of 1000, 1500, 2250, or 3375 cGy in four fractions per week for six weeks. Fifteen dogs received 3000, 4500, or 6750 cGy of photons in an identical fractionation pattern. One photon-irradiated dog and 13 neutron-irradiated dogs died or were euthanatized because of hepatic and gastrointestinal disturbances 47 to 708 days after irradiation; 20 dogs died of other causes. These 34 dogs were necropsied and have been studied microscopically; the remaining five dogs are still alive seven years after irradiation. Neutron-induced lesions included hemorrhage, necrosis, fibrosis, and atrophy of the heart, liver, pancreas, pylorus, duodenum, and kidney. All lesions were associated with degenerative and occlusive vascular changes including coronary arteriosclerosis. The relative biological effectiveness (RBE) of fast neutrons, assessed by clinical signs and by gross and microscopic pathology, is between 3 and 4.5 for pancreas, ∼4.5 for heart, pylorus, duodenum, and kidney, and greater than 6.75 for liver. Ten malignancies and two benign tumors developed in the irradiated field of six of 12 neutron-exposed dogs that survived over one year after irradiation. Two malignancies and one benign tumor arose in three of 12 photon-exposed dogs surviving over one year postirradiation. Only one neoplasm developed in the same field in 11 nonirradiated controls or in 62 dogs irradiated at sites other than the thorax or abdomen. The neutron RBE for neoplasia is approximately 6.75. 85 refs., 8 figs., 3 tabs

  15. Damage control surgery and open abdomen in trauma patients with exsanguinating bleeding.

    Science.gov (United States)

    Mutafchiĭski, V; Popivanov, G

    2014-01-01

    Acute coagulopathy with exsanguinating bleeding occurs in 2-5% of all trauma cases carrying mortality rate near 100% after conventional management. In the last few decades, the development of damage control surgery (DCS) in combination with the technique of open abdomen led to significantly improved survival among these patients. A descriptive study based on a retrospective analysis of 12 consecutive blast victims with exsanguinating bleeding underwent DCS and open abdomen management. All patients were soldiers injured during their deployment in Iraq and Afghanistan during 2002-2007, treated by our deployed surgical teams. Vacuum Assisted Closure (V.A.C., KCI) and vacuum pack (VP) was used for a temporary closure of abdomen. A cumulative analysis of all relevant series used these methods during the period 2000-2013 was performed. DCS was applied in 12 of 114 consecutive blast victims (10.5%) with survival rate 66.7% (8/12). Eleven had open abdomen with temporary closure with V.A.C. in 6 and VP in 5. Four patients died before the definitive closure (36.4%). The survivors (n = 8) were with a mean age 28.5 years, suffered from a critical trauma with a mean Injury Severity Score 35.5. V.A.C was used in 4 of them, VP in 3. Primary closure of abdomen was achieved in 6 (85.7%) within 3.5 days and mean 1.3 dressing changes. Due to ACS, the abdomen was closed through skin suture only and a creation of planned ventral hernia in 1 patient treated with VP (1/7, 14.3%). Wound infection was observed in 1 case (14.3%). Despite the small sample size, our series clearly demonstrate the benefits of DCS and open abdomen in trauma patients with exsangiunating bleeding. The survival rate is highly dependent on the rapid implementation of DCS in properly selected patients. V.A.C. and VP provide a high rate of primary fascial closure in trauma.

  16. Detection of Hyperechoic Inflammatory Fatty Tissue during Transabdominal Ultrasonography: Diagnostic Role in Acute Abdomen

    International Nuclear Information System (INIS)

    Park, Seong Jin; Lee, Hae Kyung; Yi, Bum Ha; Kim, Hyun Cheol

    2005-01-01

    To assess the incidence and diagnostic role of hyperechoic inflammatory fatty tissue (HIFT) in transabdominal ultrasonography (TAUS) for acute abdomen. With TAUS, we examined 98 consecutive patients (68 women, 30 men: mean age, 32 years: age range, 4-84 years) having acute abdominal pain. We examined the abdomen and pelvis by TAUS to determine the cause of acute abdomen, to check for the presence of HIFT, and to investigate whether it was easier and earlier to find the main cause and HIFT presence. We also prospectively evaluated the shape, distribution, and diagnostic role of HIFT. Final diagnoses consisted of 47 cases of acute appendicitis, 14 of enterocolitis, 13 of PID, 7 of gynecological hemoperitoneum, 5 of colonic diverticulitis, 3 of ovarian torsion, 2 of colon perforation, 2 of only presence of non-specific HIFT, 1 of mesenteric lymphadenitis, and 4 of normal. HIFT were seen in 67 patients (68.4%), including 44/47(93.6%) of acute appendicitis, 2/14(14.3%) of enterocolitis, 11/13(84.6%) of PID, 0/7 of hemoperitoneum, 5/5 of colonic diverticulitis, 0/3 of ovarian torsion, 2/2 of colon perforation, and 1/1 mesenteric lymphadenitis. HIFT were detected earlier than the main cause in 17/44 of acute appendicitis, 6/11 of PID, and 4/5 of colonic diverticulitis. In acute appendicitis, the shape of HIFT appeared as fat thickening along the mesoappendix in 12/44, fat thickening along the mesoappendix and the opposite side in 13/44, fat encircled appendix in 6/44, fatty mass wrapping abscess in 10/44, and diffuse intraperitoneal fat thickening in 3/44. In PID, HIFT appeared as a single fatty mass in the pelvis and lower abdomen in 6/11, wrapping pelvic abscess in 2/11, and multiple fatty masses scattered in abdomen and pelvis in 3/11. In colonic diverticulitis, all 5 cases appeared as hyperechoic hemispheric mass covering the inflamed diverticulum. HIFT are a usual US finding in patients with acute abdomen, particularly on abdominal and pelvic inflammatory conditions

  17. Application of Optical Measurement Techniques During Stages of Pregnancy: Use of Phantom High Speed Cameras for Digital Image Correlation (D.I.C.) During Baby Kicking and Abdomen Movements

    Science.gov (United States)

    Gradl, Paul

    2016-01-01

    Paired images were collected using a projected pattern instead of standard painting of the speckle pattern on her abdomen. High Speed cameras were post triggered after movements felt. Data was collected at 120 fps -limited due to 60hz frequency of projector. To ensure that kicks and movement data was real a background test was conducted with no baby movement (to correct for breathing and body motion).

  18. Doses in pediatric patients undergoing chest and abdomen CT examinations. Preliminary results

    International Nuclear Information System (INIS)

    Jornada, Tiago S.; Silva, Teogenes A. da

    2011-01-01

    Computed tomography (CT) is a non-invasive method of image production that imparts significant doses to a patient, it is expected that pediatric CT examinations will increase the risk of induced cancer in children. In this study the effective doses in a five year-old child submitted to chest or abdomen CT scans were assessed for comparison purposes. The CTEXPO computed program was used with data from routine protocols of a 0 to 13 year-old children in two public hospitals in Belo Horizonte. Hospital A used a Siemens Dual-Slice unit with 80 kV, 41 mA and pitch 2 for chest or abdomen; hospital B used a Multislice GE unit with 120 kV, 45 mA and pitch 1 for chest and 120 kV, 55 mA. and pitch 1 for abdomen. Results of effective doses in a five year-old child were 1.7 and 1.0 mSv in hospital A and 9.1 and 7.2 mSv in hospital B, for chest and abdomen, respectively. Results were compared to the reference effective doses of 7.2 and 5.0 mSv for chest and abdomen respectively that were derived from the air kerma length product values given in ICRP publication 87. Results of hospital A showed that low dose exposures also can be achieved in CT scans of children. Results showed that even a hospital with a modern facility (hospital B) can provided doses higher than reference values if protocols are not adjusted for children. Preliminary results suggested that there is a room for optimizing children exposure submitted to CT scans. (author)

  19. Clinical Features and Genetic Background of the Periodic Fever Syndrome with Aphthous Stomatitis, Pharyngitis, and Adenitis: A Single Center Longitudinal Study of 81 Patients

    Directory of Open Access Journals (Sweden)

    Daša Perko

    2015-01-01

    Full Text Available PFAPA syndrome is the most common autoinflammatory disorder in childhood with unknown etiology. The aim of our study was clinical evaluation of PFAPA patients from a single tertiary care center and to determine whether variations of AIM2, MEFV, NLRP3, and MVK genes are involved in PFAPA pathogenesis. Clinical and laboratory data of consecutive patients with PFAPA syndrome followed up at the University Children’s Hospital, Ljubljana, were collected from 2008 to 2014. All four genes were PCR amplified and directly sequenced. Eighty-one patients fulfilled criteria for PFAPA syndrome, 50 (63% boys and 31 (37% girls, with mean age at disease onset of 2.1 ± 1.5 years. Adenitis, pharyngitis, and aphthae were present in 94%, 98%, and 56%, respectively. Family history of recurrent fevers in childhood was positive in 78%. Nineteen variants were found in 17/62 (27% patients, 4 different variants in NLRP3 gene in 13 patients, and 6 different variants in MEFV gene in 5 patients, and 2 patients had 2 different variants. No variants of clinical significance were found in MVK and AIM2 genes. Our data suggest that PFAPA could be the result of multiple low-penetrant variants in different genes in combination with epigenetic and environmental factors leading to uniform clinical picture.

  20. MANAGEMENT OF SPLENIC INJURY AFTER BLUNT INJURY TO ABDOMEN

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    J. Bharath Prakash Reddy

    2016-07-01

    Full Text Available BACKGROUND The spleen is an important organ in the body’s immune system. It is the most frequently injured organ in blunt abdominal trauma. 1 Over the past several decades, diagnosis and management of splenic trauma has been evolved. The conservative, operative approach has been challenged by several reports of successful non-operative management aided by the power of modern diagnostic imaging. The aim of our prospective study was to compare non-operative management with surgery for cases of splenic injury. METHODS We conducted a prospective study of patients admitted with blunt splenic injury to our regional hospital over a three-year period (2012-2015. Haemodynamic status upon admission, FAST examination, computed tomography 2 grade of splenic tear, presence and severity of associated injuries have been taken into account to determine the treatment of choice. Therapeutic options were classified into non-operative and splenectomy. RESULTS Over a 3-year period, 24 patients were admitted with blunt splenic injury. Sixteen patients were managed operatively and eight patients non-operatively. 3,4 Non-operative management failed in one patient due to continued bleeding. The majority of grades I, II, and III splenic injuries were managed non-operatively and grades IV and V were managed operatively. Blood transfusion requirement was significantly higher among the operative group, but the operative group had a significantly longer hospital stay. Among those managed non-operatively (median age 24.5 years, a number of patients were followed up with CT scans with significant radiation exposure and unknown longterm consequences. CONCLUSION In our experience, NOM is the treatment of choice for grade I, II and III blunt splenic injuries. Splenectomy was the chosen technique in patients who met exclusion criteria for NOM, as well as for patients with grade IV and V injury.

  1. Use of a furosemide drip does not improve earlier primary fascial closure in the open abdomen

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    Leland H Webb

    2012-01-01

    Full Text Available Background: The furosemide drip (FD, in addition to improving volume overload respiratory failure, has been used to decrease fluid in attempts to decrease intra-abdominal and abdominal wall volumes to facilitate fascial closure. The purpose of this study is to evaluate the FD and the associated rate of primary fascial closure following trauma damage control laparotomy (DCL. Materials and Methods: From January 2004 to September 2008, a retrospective review from a single institution Trauma Registry of the American College of Surgeons dataset was performed. All DCLs greater than 24 h who had a length of stay for 3 or more days were identified. The study group (FD+ and control group (FD- were compared. Demographic data including age, sex, probability of survival, red blood cell transfusions, initial lactate, and mortality were collected. Primary outcomes included primary fascial closure and primary fascial closure within 7 days. Secondary outcomes included total ventilator days and LOS. Results: A total of 139 patients met inclusion criteria: 25 FD+ and 114 FD-. The 25 FD+ patients received the drug at a median 4 days post DCL. Demographic differences between the groups were not significantly different, except that initial lactate was higher for FD- (1.7 vs 4.0; P=0.03. No differences were noted between groups regarding successful primary fascial closure (FD+ 68.4% vs FD- 64.0%; P=0.669, or closure within 7 days (FD+13.2% vs FD- 28.0%; P=0.066 of original DCL. FD+ patients suffered more open abdomen days (4 [2-7] vs 2 [1-4]; P=0.001. FD+ did not demonstrate an association with primary fascial closure [Odds ratio (OR 1.5, 95% confidence interval (CI 0.260-8.307; P=0.663]. FD+ patients had more ventilator days and longer Intensive Care Unit (ICU/hospital LOS (P<0.01. Conclusion: FD use may remove excess volume; however, forced diuresis with an FD is not associated with an increased rate of primary closure after DCL. Further studies are warranted to

  2. PECULIARITIES OF THE CLINICAL COURSE OF NON-ALCOHOLIC STEATOHEPATITIS AGAINST THE BACKGROUND OF THE CHRONIC KIDNEY DISEASE OF THE I-III STAGE WITH SECONDARY ARTERIAL HYPERTENSION.

    Science.gov (United States)

    Hukhlina, O; Antoniv, A; Dudka, I; Dudka, T; Mandryk, O

    2017-09-01

    The article addresses the theoretical generalization of the clinical study of non-alcoholic steatohepatitis peculiarities in comorbidity with obesity and chronic kidney disease of the І-ІІІ stage, characterized by higher frequency and intensity of clinical and biochemical syndromes, the manifestation of which is likely to increase the occurrence of secondary arterial hypertension (portal hypertension syndromes, cholestasis, mesenchymal inflammation). Comorbid course of non-alcoholic steatohepatitis with chronic kidney disease is characterized by higher degree of liver steatosis compared to the patients with only non-alcoholic steatohepatitis (p<0.05), and a higher diagnostic threshold of the hepatorenal index values, which correlates with the Steato-test index (p<0.001) with strong interdependence.

  3. Acute abdomen in children due to extra-abdominal causes.

    Science.gov (United States)

    Tsalkidis, Aggelos; Gardikis, Stefanos; Cassimos, Dimitrios; Kambouri, Katerina; Tsalkidou, Evanthia; Deftereos, Savas; Chatzimichael, Athanasios

    2008-06-01

    Acute abdominal pain in children is a common cause for referral to the emergency room and for subsequent hospitalization to pediatric medical or surgical departments. There are rare occasions when the abdominal pain is derived from extra-abdominal organs or systems. The aim of the present study was to establish the most common extra-abdominal causes of acute abdominal pain. The notes of all children (1 month-14 years of age) examined for acute abdominal pain in the Accident and Emergency (A&E) Department of Alexandroupolis District University Hospital in January 2001-December 2005 were analyzed retrospectively. Demographic data, clinical signs and symptoms, and laboratory findings were recorded, as well as the final diagnosis and outcome. Of a total number of 28 124 children who were brought to the A&E department, in 1731 the main complaint was acute abdominal pain. In 51 children their symptoms had an extra-abdominal cause, the most frequent being pneumonia (n = 15), tonsillitis (n = 10), otitis media (n = 9), and acute leukemia (n = 5). Both abdominal and extra-abdominal causes should be considered by a pediatrician who is confronted with a child with acute abdominal pain.

  4. [Clinical usefulness of the combined empirical therapy with flomoxef and fosfomycin for intractable respiratory tract infections. With a background of increasing MRSA incidence].

    Science.gov (United States)

    Shimada, K; Kudoh, S; Hayashi, I; Shishido, H; Fukuchi, Y; Suzuki, H; Oritsu, M; Nakada, K; Sano, Y; Goto, H

    1994-10-01

    We conducted a multicenter trial to determine the clinical usefulness of the combined therapy with flomoxef (FMOX) and fosfomycin (FOM) (FF therapy) as an empirical therapy in the treatment of intractable respiratory tract infections, because FF therapy has clinically been proved to be very useful for the treatment of severe infections including MRSA infections. The overall efficacy rate of FF therapy was 69.2%. The efficacy rate for "pneumonia/lung abscess," which occupy the largest portions of respiratory tract infections, was 70.0%, showing a statistically significant difference from the efficacy rate for FMOX alone (56.7%) found in a previous study (P = 0.09 by chi-squared test). Although MRSA was eradicated in only 3 cases (37.5%) including superinfection cases, of 8 patients, from whom MRSA had been isolated as causative organisms, none of our patients were superinfected with MRSA. Thus it has been concluded that FF therapy is clinically very useful when used as an empirical therapy in the treatment of respiratory tract infections.

  5. Managed ventricular pacing vs. conventional dual-chamber pacing for elective replacements: the PreFER MVP study: clinical background, rationale, and design.

    Science.gov (United States)

    Quesada, Aurelio; Botto, Gianluca; Erdogan, Ali; Kozak, Milan; Lercher, Peter; Nielsen, Jens Cosedis; Piot, Olivier; Ricci, Renato; Weiss, Christian; Becker, Daniel; Wetzels, Gwenn; De Roy, Luc

    2008-03-01

    Several clinical studies have shown that, in patients with intact atrioventricular (AV) conduction, unnecessary chronic right ventricular (RV) pacing can be detrimental. The managed ventricular pacing (MVP) algorithm is designed to give preference to spontaneous AV conduction, thus minimizing RV pacing. The clinical outcomes of MVP are being studied in several ongoing trials in patients undergoing a first device implantation, but it is unknown to what extent MVP is beneficial in patients with a history of ventricular pacing. The purpose of the Prefer for Elective Replacement MVP (PreFER MVP) study is to assess the superiority of the MVP algorithm to conventional pacemaker and implantable cardioverter-defibrillator programming in terms of freedom from hospitalization for cardiovascular causes in a population of patients exposed to long periods of ventricular pacing. PreFER MVP is a prospective, 1:1 parallel, randomized (MVP ON/MVP OFF), single-blinded multi-centre trial. The study population consists of patients with more than 40% ventricular pacing documented with their previous device. Approximately, 600 patients will be randomized and followed for at least 24 months. The primary endpoint comprises cardiovascular hospitalization. The PreFER MVP trial is the first large prospective randomized clinical trial evaluating the effect of MVP in patients with a history of RV pacing.

  6. The Appropriateness of the Length of Insulin Needles Based on Determination of Skin and Subcutaneous Fat Thickness in the Abdomen and Upper Arm in Patients with Type 2 Diabetes

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    Kang Hee Sim

    2014-04-01

    Full Text Available BackgroundLonger needle and complicated insulin injection technique such as injecting at a 45-degree angle and making skinfolds may decrease patient compliance to insulin injection therapy. In this light, shorter insulin needles have been recently developed. However, it is necessary to ascertain that such shorter needles are appropriate for Korean patients with diabetes as well.MethodsFirst, the diverse demographic and diabetic features of 156 Korean adults with diabetes were collected by a questionnaire and a device unit of body fat measurement. The skin and subcutaneous fat thicknesses of each subject were measured by Ultrasound device with a 7- to 12-MHz probe. Data were analyzed using analysis of variance and multiple linear regression.ResultsThe mean skin thickness was 2.29±0.37 mm in the abdomen and 2.00±0.34 mm in the upper arms, and the mean subcutaneous fat thickness was to 10.15±6.54 mm in the abdomen and 5.50±2.68 mm in the upper arms. Our analysis showed that the factors affecting the skin thickness of the abdomen and upper arms were gender and body mass index (BMI, whereas the factors influencing the subcutaneous fat thickness in the abdomen were gender and BMI, and the factors influencing the subcutaneous fat thickness in the upper arms were gender, BMI, and age. Insulin fluids may not appear to be intradermally injected into the abdomen and upper arms at any needle lengths. The risk of intramuscular injection is likely to increase with longer insulin needles and lower BMI.ConclusionIt is recommended to fully inform the patients about the lengths of needles for insulin injections. As for the recommended needle length, the findings of this study indicate that needles as short as 4 mm are sufficient to deliver insulin for Korean patients with diabetes.

  7. Nutritional and clinical aspects of parenteral nutrition in pigs irradiated on the abdomen with supralethal doses

    International Nuclear Information System (INIS)

    Daburon, F.; Duee, P.H.

    1976-01-01

    Nutritional balances of nitrogen and minerals (sodium, potassium, calcium, phosphorus) were established in 10 pigs receiving a continuous parenteral nutrition supplying a daily amount of 1500ml containing 1500kcal and 2.2-5.4g of protein, and in addition, 2 liters of water per day. The balances were recorded for 5 days in the animals used as controls and for 9 days in those irradiated with 1000 rd in the median plane. This dose represents the inferior limit for appearence of the gastrointestinal syndrome in this species. The irradiated subjects seemed to be able to use a relatively high supply of energy and protein. Water and nitrogen balances were easy to obtain with respect to sodium, potassium and calcium, whereas the deficiency in phosphorus was difficult to compensate for through the intravenous route only

  8. Early clinical experience in CT scanning of the abdomen using a third generation scanner

    International Nuclear Information System (INIS)

    Love, L.; Churchill, R.J.; Reynes, C.J.; Marsan, R.E.

    1979-01-01

    Five-second scanning offers an improvement over second generation scanners. There is no need for glucagon administration since there is virtually no objectionable artifact secondary to motion. Scans with the Photrax 4000 show resolution of structures such as gallbladder wall and renal fascia routinely. The anatomic structures visualized are more clearly identified than on second generation scans. Representative normal and pathological anatomy will be shown. (orig.) 891 MG/orig. 892 MB [de

  9. Comparison of image quality and radiation dose between combined automatic tube current modulation and fixed tube current technique in CT of abdomen and pelvis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sanghee (Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan Univ. School of Medicine (Korea, Republic of)); Yoon, Sang-Wook; Yoo, Seung-Min; Kim, Kyoung Ah; Kim, Sang Heum; Lee, Jong Tae (Dept. of Diagnostic Radiology, CHA Bundang Medical Center, CHA Univ. (Korea, Republic of)), email: jansons@cha.ac.kr; Ji, Young Geon (Preventive Medicine, CHA Bundang Medical Center, CHA Univ. (Korea, Republic of))

    2011-12-15

    Background. Tube current is an important determinant of radiation dose and image quality in X-ray-based examination. The combined automatic tube current modulation technique (ATCM) enables automatic adjustment of the tube current in various planes (x-y and z) based on the size and attenuation of the body area scanned. Purpose. To compare image quality and radiation dose of the ATCM with those of a fixed tube current technique (FTC) in CT of the abdomen and pelvis performed with a 16-slice multidetector row CT. Material and Methods. We reviewed 100 patients in whom initial and follow-up CT of the abdomen and pelvis were performed with FTC and ATCM. All acquisition parameters were identical in both techniques except for tube current. We recorded objective image noise in liver parenchyma, subjective image noise and diagnostic acceptability by using a five-point scale, radiation dose, and body mass index (BMI, kg/m2). Data were analyzed with parametric and non-parametric statistical tests. Results. There was no significant difference in image noise and diagnostic acceptability between two techniques. All subjects had acceptable subjective image noise in both techniques. The significant reduction in radiation dose (45.25% reduction) was noted with combined ATCM (P < 0.001). There was a significant linear statistical correlation between BMI and dose reduction (r = -0.78, P < 0.05). Conclusion. The ATCM for CT of the abdomen and pelvis substantially reduced radiation dose while maintaining diagnostic image quality. Patients with lower BMI showed more reduction in radiation dose

  10. Laparostomy management using the ABThera™ open abdomen negative pressure therapy system in a grade IV open abdomen secondary to acute pancreatitis.

    Science.gov (United States)

    Fitzgerald, James E F; Gupta, Shradha; Masterson, Sarah; Sigurdsson, Helgi H

    2013-04-01

    Wound control in laparostomy for the treatment of intra-abdominal hypertension remains challenging and numerous techniques have been described. We report the first UK experience with a new commercially available device specifically designed to facilitate management of the open abdomen. A 44-year-old gentleman presented with a 3-day history of constant severe epigastric pain and associated vomiting. Amylase was markedly elevated and he was admitted for supportive management of pancreatitis, with subsequent transfer to intensive care due to severe systemic inflammatory syndrome. The patient decompensated, developing intra-abdominal hypertension with renal and respiratory failure. This was successfully managed by performing a laparostomy and using an ABThera™ Open Abdomen Negative Pressure Therapy System (KCI, San Antonio, TX). We describe its use to facilitate wound control, including enteroatmospheric fistula, allowing granulation and eventual restoration of gastrointestinal continuity 383-days after admission. We found the ABThera™ System proved to be a useful treatment adjunct, protecting intra-abdominal contents while removing large volumes of exudate and infected material from within the abdominal cavity. Complex cases such as this remain infrequent and this article provides a summary of our experience, including a review of indications for laparostomy and the underlying basic science in this difficult area. © 2012 The Authors. International Wound Journal © 2012 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

  11. Towards the optimisation of acoustic fields for ablative therapies of tumours in the upper abdomen

    International Nuclear Information System (INIS)

    Gélat, P; Ter Haar, G; Saffari, N

    2013-01-01

    The efficacy of high intensity focused ultrasound (HIFU) for the non-invasive treatment of cancer has been demonstrated for a range of different cancers including those of the liver, kidney, prostate and breast. As a non-invasive focused therapy, HIFU offers considerable advantages over other techniques such as chemotherapy and surgical resection, in terms of its non-invasiveness and low risk of harmful side effects. There is, however, a number of significant challenges which currently hinder its widespread clinical application. One of these challenges is the need to transmit sufficient energy through the ribcage to induce tissue necrosis at the required foci whilst minimising the formation of side lobes and sparing healthy tissue. Ribs both absorb and reflect ultrasound strongly. As such, a common side effect of focusing ultrasound in regions located behind the rib cage is the overheating of bone and surrounding tissue, which can lead to skin burns. Successful treatment of a patient with tumours in the upper abdomen therefore requires a thorough understanding of the way acoustic and thermal energy are deposited. This is likely to rely on a treatment planning procedure in which optimal source velocity distributions are obtained so as to maximise a dose quantity at the treatment sites, whilst ensuring that this quantity does not exceed a specified threshold at other field locations, particularly on the surface of the ribs. Previously, a boundary element approach based on a Generalised Minimal Residual (GMRES) implementation of the Burton-Miller formulation was developed to predict the field of a multi-element HIFU array scattered by human ribs, the topology of which was obtained from CT scan data [1]. This work describes the reformulation of the boundary element equations as a least-squares minimisation problem with non-linear constraints. The methodology was subsequently tested at an excitation frequency of 100 kHz on a spherical multi-element array in the presence

  12. Towards the optimisation of acoustic fields for ablative therapies of tumours in the upper abdomen

    Science.gov (United States)

    Gélat, P.; ter Haar, G.; Saffari, N.

    2013-08-01

    The efficacy of high intensity focused ultrasound (HIFU) for the non-invasive treatment of cancer has been demonstrated for a range of different cancers including those of the liver, kidney, prostate and breast. As a non-invasive focused therapy, HIFU offers considerable advantages over other techniques such as chemotherapy and surgical resection, in terms of its non-invasiveness and low risk of harmful side effects. There is, however, a number of significant challenges which currently hinder its widespread clinical application. One of these challenges is the need to transmit sufficient energy through the ribcage to induce tissue necrosis at the required foci whilst minimising the formation of side lobes and sparing healthy tissue. Ribs both absorb and reflect ultrasound strongly. As such, a common side effect of focusing ultrasound in regions located behind the rib cage is the overheating of bone and surrounding tissue, which can lead to skin burns. Successful treatment of a patient with tumours in the upper abdomen therefore requires a thorough understanding of the way acoustic and thermal energy are deposited. This is likely to rely on a treatment planning procedure in which optimal source velocity distributions are obtained so as to maximise a dose quantity at the treatment sites, whilst ensuring that this quantity does not exceed a specified threshold at other field locations, particularly on the surface of the ribs. Previously, a boundary element approach based on a Generalised Minimal Residual (GMRES) implementation of the Burton-Miller formulation was developed to predict the field of a multi-element HIFU array scattered by human ribs, the topology of which was obtained from CT scan data [1]. This work describes the reformulation of the boundary element equations as a least-squares minimisation problem with non-linear constraints. The methodology was subsequently tested at an excitation frequency of 100 kHz on a spherical multi-element array in the presence

  13. The optimization of acoustic fields for ablative therapies of tumours in the upper abdomen

    Science.gov (United States)

    Gélat, P.; ter Haar, G.; Saffari, N.

    2012-12-01

    High intensity focused ultrasound (HIFU) enables highly localized, non-invasive tissue ablation and its efficacy has been demonstrated in the treatment of a range of cancers, including those of the kidney, prostate and breast. HIFU offers the ability to treat deep-seated tumours locally, and potentially bears fewer side effects than more invasive treatment modalities such as resection, chemotherapy and ionizing radiation. There remains however a number of significant challenges which currently hinder its widespread clinical application. One of these challenges is the need to transmit sufficient energy through the ribcage to ablate tissue at the required foci whilst minimizing the formation of side lobes and sparing healthy tissue. Ribs both absorb and reflect ultrasound strongly. This sometimes results in overheating of bone and overlying tissue during treatment, leading to skin burns. Successful treatment of a patient with tumours in the upper abdomen therefore requires a thorough understanding of the way acoustic and thermal energy is deposited. Previously, a boundary element approach based on a Generalized Minimal Residual (GMRES) implementation of the Burton-Miller formulation was developed to predict the field of a multi-element HIFU array scattered by human ribs, the topology of which was obtained from CT scan data (Gélat et al 2011 Phys. Med. Biol. 56 5553-81). The present paper describes the reformulation of the boundary element equations as a least-squares minimization problem with nonlinear constraints. The methodology has subsequently been tested at an excitation frequency of 1 MHz on a spherical multi-element array in the presence of ribs. A single array-rib geometry was investigated on which a 50% reduction in the maximum acoustic pressure magnitude on the surface of the ribs was achieved with only a 4% reduction in the peak focal pressure compared to the spherical focusing case. This method was then compared with a binarized apodization approach

  14. A Study of Physicochemical Properties of Subcutaneous Fat of the Abdomen and its Implication in Abdominal Obesity.

    Science.gov (United States)

    Pandey, Arvind Kumar; Kumar, Pramod; Kodavoor, Srinivas Aithal; Kotian, Sushma Rama; Yathdaka, Sudhakar Narahari; Nayak, Dayanand; Souza, Anne D; Souza, Antony Sylvan D

    2016-05-01

    The lower abdominal obesity is more resistant to absorption as compared to that of upper abdomen. Differences in the physicochemical properties of the subcutaneous fat of the upper and lower abdomen may be responsible for this variation. There is paucity of the scientific literature on the physicochemical properties of the subcutaneous fat of abdomen. The present study was undertaken to create a database of physicochemical properties of abdominal subcutaneous fat. The samples of subcutaneous fat from upper and lower abdomen were collected from 40 fresh autopsied bodies (males 33, females 7). The samples were prepared for physicochemical analysis using organic and inorganic solvents. Various physicochemical properties of the fat samples analysed were surface tension, viscosity, specific gravity, specific conductivity, iodine value and thermal properties. Data was analysed by paired and independent sample t-tests. There was a statistically significant difference in all the physicochemical parameters between males and females except surface tension (organic) and surface tension (inorganic) of upper abdominal fat, and surface tension (organic) of lower abdominal fat. In males, viscosity of upper abdominal fat was more compared to that of lower abdomen (both organic and inorganic) unlike the specific conductivity that was higher for the lower abdominal fat as compared to that of the upper abdomen. In females there were statistically significant higher values of surface tension (inorganic) and specific gravity (organic) of the upper abdomen fat as compared to that of lower abdomen. The initial and final weight loss of the lower abdominal fat as indicated by Thermo Gravimetric Analysis was significantly more in males than in female. The difference in the physicochemical properties of subcutaneous fat between upper and lower abdomen and between males and females could be responsible for the variant behaviour of subcutaneous abdominal fat towards resorption.

  15. Accessory spleen presenting as acute abdomen: A case report and operative management

    Directory of Open Access Journals (Sweden)

    A. Landmann

    2016-09-01

    Full Text Available Accessory spleens are found in 10–30% of patients and are asymptomatic. Rarely, torsion of an accessory spleen can cause abdominal pain and acute abdomen. We present the case of an 8-year-old girl who arrives to the emergency room with left upper quadrant abdominal pain. CT scan revealed a non-enhancing soft tissue mass and multiple small splenules. Laparoscopy revealed a torsed accessory spleen and malrotation. Accessory spleen is a common congenital anomaly that is frequently asymptomatic. Rarely, an accessory spleen may become torsed around its vascular pedicle resulting in severe abdominal pain. Treatment is surgical resection. Torsion of accessory splenic tissue is a rare cause of acute abdomen in pediatric patients.

  16. Definitive identification of magnetite nanoparticles in the abdomen of the honeybee Apis mellifera

    Energy Technology Data Exchange (ETDEWEB)

    Desoil, M [Biological Physics Department, University of Mons-Hainaut (Belgium); Gillis, P [Biological Physics Department, University of Mons-Hainaut (Belgium); Gossuin, Y [Biological Physics Department, University of Mons-Hainaut (Belgium); Pankhurst, Q A [London Centre for Nanotechnology, University College London, London WC1E 7HN (United Kingdom); Hautot, D [London Centre for Nanotechnology, University College London, London WC1E 7HN (United Kingdom); Institute for Science and Technology in Medicine, Keele University, Thornburrow Drive, Hartshill, Stoke-en-Trent, ST4 7QB (United Kingdom)

    2005-01-01

    The biogenic magnetic properties of the honeybee Apis mellifera were investigated with a view to understanding the bee's physiological response to magnetic fields. The magnetisations of bee abdomens on one hand, and heads and thoraxes on the other hand, were measured separately as functions of temperature and field. Both the antiferromagnetic responses of the ferrihydrite cores of the iron storage protein ferritin, and the ferrimagnetic responses of nanoscale magnetite (Fe{sub 3}O{sub 4}) particles, were observed. Relatively large magnetite particles (ca. 30 nm or more), capable of retaining a remanent magnetisation at room temperature, were found in the abdomens, but were absent in the heads and thoraxes. In both samples, more than 98% of the iron atoms were due to ferritin.

  17. Mechanical response of the herniated human abdomen to the placement of different prostheses.

    Science.gov (United States)

    Hernández-Gascón, Belén; Peña, Estefanía; Grasa, Jorge; Pascual, Gemma; Bellón, Juan M; Calvo, Begoña

    2013-05-01

    This paper describes a method designed to model the repaired herniated human abdomen just after surgery and examine its static mechanical response to the maximum intra-abdominal pressure provoked by a physiological movement (standing cough). The model is based on the real geometry of the human abdomen bearing a large incisional hernia with several anatomical structures differentiated by MRI. To analyze the outcome of hernia repair, the surgical procedure was simulated by modeling a prosthesis placed over the hernia. Three surgical meshes with different mechanical properties were considered: an isotropic heavy-weight mesh (Surgipro®), a slightly anisotropic light-weight mesh (Optilene®), and a highly anisotropic medium-weight mesh (Infinit®). Our findings confirm that anisotropic implants need to be positioned such that the most compliant axis of the mesh coincides with the craneo-caudal direction of the body.

  18. Entrance doses during lateral lumbar spine and antero-posterior abdomen examinations: generator waveform dependence

    International Nuclear Information System (INIS)

    Morrison, G.D.; Underwood, A.C.

    1995-01-01

    In North Trent, UK, an entrance dose survey of lateral lumbar spine and antero-posterior (AP) abdomen examinations has been carried out in 17 radiology departments. The survey comprised 294 lateral lumbar spine and 322 AP abdomen entrance dose measurements. The mean entrance doses were found to be approximately half of the relevant national reference entrance dose levels of 30 mGy and 10 mGy, respectively. The effect of generator waveform on entrance dose was studied by separating the generators into two types: ''pulsating potential'' (PP) generators and ''constant potential'' (CP) generators for each examination. PP generators comprised 23% of the total number of examinations. The mean entrance dose and radiographic exposure factors from CP generators were found to be significantly lower than those from PP generators. The use of CP type generators, together with low attenuation components can significantly reduce patient entrance doses for these examinations. (author)

  19. Definitive identification of magnetite nanoparticles in the abdomen of the honeybee Apis mellifera

    Science.gov (United States)

    Desoil, M.; Gillis, P.; Gossuin, Y.; Pankhurst, Q. A.; Hautot, D.

    2005-01-01

    The biogenic magnetic properties of the honeybee Apis mellifera were investigated with a view to understanding the bee's physiological response to magnetic fields. The magnetisations of bee abdomens on one hand, and heads and thoraxes on the other hand, were measured separately as functions of temperature and field. Both the antiferromagnetic responses of the ferrihydrite cores of the iron storage protein ferritin, and the ferrimagnetic responses of nanoscale magnetite (Fe3O4) particles, were observed. Relatively large magnetite particles (ca. 30 nm or more), capable of retaining a remanent magnetisation at room temperature, were found in the abdomens, but were absent in the heads and thoraxes. In both samples, more than 98% of the iron atoms were due to ferritin.

  20. Definitive identification of magnetite nanoparticles in the abdomen of the honeybee Apis mellifera

    International Nuclear Information System (INIS)

    Desoil, M; Gillis, P; Gossuin, Y; Pankhurst, Q A; Hautot, D

    2005-01-01

    The biogenic magnetic properties of the honeybee Apis mellifera were investigated with a view to understanding the bee's physiological response to magnetic fields. The magnetisations of bee abdomens on one hand, and heads and thoraxes on the other hand, were measured separately as functions of temperature and field. Both the antiferromagnetic responses of the ferrihydrite cores of the iron storage protein ferritin, and the ferrimagnetic responses of nanoscale magnetite (Fe 3 O 4 ) particles, were observed. Relatively large magnetite particles (ca. 30 nm or more), capable of retaining a remanent magnetisation at room temperature, were found in the abdomens, but were absent in the heads and thoraxes. In both samples, more than 98% of the iron atoms were due to ferritin

  1. Acute Abdomen Due to Uncontrolled Use of Warfarin: Spontaneous Intra-abdominal

    Directory of Open Access Journals (Sweden)

    Fatih Dal

    2017-12-01

    Full Text Available Warfarin is an oral anticoagulant, which is commonly used in the treatment and prophylaxis of thromboembolic conditions. Bleeding is the primary adverse effect associated with warfarin. The majority of warfarin-related bleedings are spontaneous minor hemorrhages occurring in the subcutaneous or intramuscular tissues and can be treated by decreasing the dose of oral anticoagulants. However, although rare, it is possible to encounter spontaneous major bleedings with increased risk of mortality. Conservative approach is the preferred initial therapy for hemodynamically stable patients with major intra-abdominal hemorrhages that we define as the intermediate group patients. Nevertheless, surgery is required for hemodynamically unstable patients with acute abdominal pain in cases of ongoing active hemorrhage, generalized peritonitis, obstruction, acute abdomen, intestinal ischemia, and perforation. In this article, we present a rare case of acute abdomen and spontaneous intra-abdominal hemorrhage resulting from uncontrolled use of warfarin and a new classification requirement.

  2. Analysis of the computed tomography in the acute abdomen; Analise da tomografia computadorizada no abdome agudo

    Energy Technology Data Exchange (ETDEWEB)

    Hochhegger, Bruno [Complexo Hospitalar Santa Casa de Porto Alegre, RS (Brazil); Moraes, Everton [Universidade Federal de Santa Maria (UFSM), RS (Brazil); Haygert, Carlos Jesus Pereira; Antunes, Paulo Sergio Pase [Hospital Universitario de Santa Maria, RS (Brazil); Gazzoni, Fernando [Pontificia Universidade Catolica de Porto Alegre (PUC-RS), Porto Alegre, RS (Brazil). Hospital Sao Lucas; Andrade, Rubens Gabriel Feijo [Fundacao Universitaria de Cardiologia de Porto Alegre, RS (Brazil). Inst. de Cardiologia; Bueno, Leticia Rossi [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil); Lopes, Luis Felipe Dias [Universidade Federal de Santa Maria (UFSM), RS (Brazil). Dept. de Estatistica]. E-mail: brunorgs@pop.com.br

    2007-07-01

    Introduction: This study tends to test the capacity of the computed tomography in assist in the diagnosis and the approach of the acute abdomen. Material and method: This is a longitudinal and prospective study, in which were analyzed the patients with the diagnosis of acute abdomen. There were obtained 105 cases of acute abdomen and after the application of the exclusions criteria were included 28 patients in the study. Results: Computed tomography changed the diagnostic hypothesis of the physicians in 50% of the cases (p < 0.05), and the confidence index in 85.71% of the cases (p 0.014). Computed tomography also altered the management in 46.43% of the cases (p > 0.05), where 78.57% of the patients had surgical indication before computed tomography and 67.86% after computed tomography (p = 0.0546). The index of accurate diagnosis of computed tomography, when compared to the anatomopathologic examination and the final diagnosis, was observed in 82.14% of the cases (p = 0.013). When the analysis was done dividing the patients in surgical and nonsurgical group, were obtained an accuracy of 89.28% (p 0.0001). The difference of 7.2 days of hospitalization (p = 0.003) was obtained compared with the mean of the acute abdomen without use the computed tomography. Conclusion: The computed tomography is correlative with the anatomopathology and has great accuracy in the surgical indication, associated with the capacity of increase the confident index of the physicians, reduces the hospitalization time, reduces the number of surgeries and is cost-effective. (author)

  3. Peritoneal cavity lavage reduces the presence of mitochondrial damage associated molecular patterns in open abdomen patients.

    Science.gov (United States)

    Martinez-Quinones, Patricia A; McCarthy, Cameron G; Mentzer, Caleb J; Wenceslau, Camilla F; Holsten, Steven B; Webb, R Clinton; O'Malley, Keith

    2017-12-01

    Mitochondrial damage-associated molecular patterns (mtDAMPs), such as mitochondrial DNA and N-formylated peptides, are endogenous molecules released from tissue after traumatic injury. mtDAMPs are potent activators of the innate immune system. They have similarities with bacteria, which allow mtDAMPs to interact with the same pattern recognition receptors and mediate the development of systemic inflammatory response syndrome (SIRS). Current recommendations for management of an open abdomen include returning to the operating room every 48 hours for peritoneal cavity lavage until definitive procedure. These patients are often critically ill and develop SIRS. We hypothesized that mitochondrial DAMPs are present in the peritoneal cavity fluid in this setting, and that they accumulate in the interval between washouts. We conducted a prospective pilot study of critically ill adult patients undergoing open abdomen management in the surgical and trauma intensive care units. Peritoneal fluid was collected daily from 10 open abdomen patients. Specimens were analyzed via quantitative polymerase chain reaction (qPCR) for mitochondrial DNA (mtDNA), via enzyme immunoassay for DNAse activity and via Western blot analysis for the ND6 subunit of the NADH: ubiquinone oxidoreductase, an N-formylated peptide. We observed a reduction in the expression of ND6 the day after lavage of the peritoneal cavity, that was statistically different from the days with no lavage (% change in ND6 expression, postoperative from washout: -50 ± 11 vs. no washout day, 42 ± 9; p abdomen. It is possible that increased frequency of peritoneal cavity lavage may lead to decreased systemic absorption of mtDAMPs, thereby reducing the risk of SIRS. Prospective study, Case Series, Level V.

  4. Acute abdomen and ascites as presenting features of autosomal dominant polycystic kidney disease

    OpenAIRE

    Chaudhary, Sanjay; Qian, Qi

    2012-01-01

    We describe a patient with sudden onset of abdominal pain and ascites, leading to the diagnosis of autosomal dominant polycystic kidney disease (ADPKD). Her presentation was consistent with acute liver cyst rupture as the cause of her acute illness. A review of literature on polycystic liver disease in patients with ADPKD and current management strategies are presented. This case alerts physicians that ADPKD could occasionally present as an acute abdomen; cyst rupture related to ADPKD may be ...

  5. Role of Definitive Radiation Therapy in Carcinoma of Unknown Primary in the Abdomen and Pelvis

    International Nuclear Information System (INIS)

    Kelly, Patrick; Das, Prajnan; Varadhachary, Gauri R.; Fontanilla, Hiral P.; Krishnan, Sunil; Delclos, Marc E.; Jhingran, Anuja; Eifel, Patricia J.; Crane, Christopher H.

    2012-01-01

    Objectives: Carcinoma of unknown primary (CUP) in the abdomen and pelvis is a heterogeneous group of cancers with no standard treatment. Considered by many to be incurable, these patients are often treated with chemotherapy alone. In this study, we determined the effectiveness of radiation therapy in combination with chemotherapy in patients with CUP in the abdomen and pelvis. Patients and Methods: Medical records were reviewed for 37 patients with CUP treated with radiation therapy for disease located in the soft tissues and/or nodal basins of the abdomen and pelvis at University of Texas M.D. Anderson Cancer between 2002 and 2009. All patients underwent chemotherapy, either before or concurrent with radiation therapy. Patients were selected for radiation therapy on the basis of histologic type, disease extent, and prior therapy response. Twenty patients underwent definitive radiation therapy (defined as radiation therapy targeting all known disease sites with at least 45 Gy) and 17 patients underwent palliative radiation therapy. Only 6 patients had surgical resection of their disease. Patient and treatment characteristics were extracted and the endpoints of local disease control, progression-free survival (PFS), overall survival (OS), and treatment-related toxicity incidence were analyzed. Results: The 2-year PFS and OS rates for the entire cohort were 32% and 57%, respectively. However, in patients treated with definitive radiation therapy, the rates were 48% and 76%, and 7 patients lived more than 3 years after treatment with no evidence of disease progression. Nevertheless, radiation-associated toxicity was significant in this cohort, as 40% experienced Grade 2 or higher late toxicities. Conclusions: The use of definitive radiation therapy should be considered in selected patients with CUP in the soft tissues or nodal basins of the abdomen and pelvis.

  6. Necrotizing myofasciitis: an atypical cause of ''acute abdomen'' in an immunocompromised child

    International Nuclear Information System (INIS)

    Donnelly, L.F.; Frush, D.P.; O'Hara, S.M.; Bisset, G.S. III

    1998-01-01

    We report the case of an immunocompromised 15-year-old boy who presented with symptoms mimicking an ''acute abdomen'' related to necrotizing myofasciitis of the anterior abdominal wall. CT demonstrated the abdominal wall process as the cause of the patient's symptoms and sonographically guided aspiration confirmed the diagnosis. Despite prompt diagnosis and aggressive surgical debridement, the infection continued to progress and the patient died within 24 h of presentation. (orig.)

  7. Blunt liver injury with intact ribs under impacts on the abdomen: a biomechanical investigation.

    Directory of Open Access Journals (Sweden)

    Yu Shao

    Full Text Available Abdominal trauma accounts for nearly 20% of all severe traffic injuries and can often result from intentional physical violence, from which blunt liver injury is regarded as the most common result and is associated with a high mortality rate. Liver injury may be caused by a direct impact with a certain velocity and energy on the abdomen, which may result in a lacerated liver by penetration of fractured ribs. However, liver ruptures without rib cage fractures were found in autopsies in a series of cases. All the victims sustained punches on the abdomen by fist. Many studies have been dedicated to determining the mechanism underlying hepatic injury following abdominal trauma, but most have been empirical. The actual process and biomechanism of liver injury induced by blunt impact on the abdomen, especially with intact ribs remained, are still inexhaustive. In order to investigate this, finite element methods and numerical simulation technology were used. A finite element human torso model was developed from high resolution CT data. The model consists of geometrically-detailed liver and rib cage models and simplified models of soft tissues, thoracic and abdominal organs. Then, the torso model was used in simulations in which the right hypochondrium was punched by a fist from the frontal, lateral, and rear directions, and in each direction with several impact velocities. Overall, the results showed that liver rupture was primarily caused by a direct strike of the ribs induced by blunt impact to the abdomen. Among three impact directions, a lateral impact was most likely to cause liver injury with a minimum punch speed of 5 m/s (the momentum was about 2.447 kg.m/s. Liver injuries could occur in isolation and were not accompanied by rib fractures due to different material characteristics and injury tolerance.

  8. Intrarectal negative pressure system in the management of open abdomen with colorectal fistula: A case report☆

    Science.gov (United States)

    Yetişir, Fahri; Salman, A. Ebru; Mamedov, Ruslan; Aksoy, Mustafa; Yalcin, Abdussamet; Kayaalp, Cüneyt

    2014-01-01

    INTRODUCTION To present the management of open abdomen with colorectal fistula by application of intrarectal negative pressure system (NPS) in addition to abdominal NPS. PRESENTATION OF CASE Twenty-year old man had a history of injuries by a close-range gunshot to the abdomen eight days ago and he had been treated by bowel repairs, resections, jejunal anastomosis and Hartman's procedure. He was referred to our center after deterioration, evisceration with open abdomen and enteric fistula in septic shock. There were edematous, fibrinous bowels and large multiple fistulas from the edematous rectal stump. APACHE II, Mannheim Peritoneal Index and Björck scores were 18, 33 and 3, respectively (expected mortality 100%). After intensive care for 5 days, he was treated by abdominal and intrarectal NPS. NPS repeated for 5 times and the fistula was recovered on day 18 completely. Fascial closure was facilitated with a dynamic abdominal closure system (ABRA) and he was discharged on day 33 uneventfully. There was no herniation and any other problem after 12 months follow-up. DISCUSSION Management of fistula in OA can be extremely challenging. Floating stoma, fistula VAC, nipple VAC, ring and silo VAC, fistula intubation systems are used for isolation of the enteric effluent from OA. Several biologic dressings such as acellular dermal matrix, pedicled flaps have been used to seal the fistula opening with various success. Resection of the involved enteric loop and a new anastomosis of the intestine is very hard and rarely possible. In all of these reports, usually patients are left to heal with a giant hernia. In contrast to this, there is no hernia in our case during one year follow up period. CONCLUSION Combination of intra and extra luminal negative pressure systems and ABRA is a safe and successful method to manage open abdomen with colorectal fistula. PMID:24584042

  9. Intrarectal negative pressure system in the management of open abdomen with colorectal fistula: A case report.

    Science.gov (United States)

    Yetişir, Fahri; Salman, A Ebru; Mamedov, Ruslan; Aksoy, Mustafa; Yalcin, Abdussamet; Kayaalp, Cüneyt

    2014-01-01

    To present the management of open abdomen with colorectal fistula by application of intrarectal negative pressure system (NPS) in addition to abdominal NPS. Twenty-year old man had a history of injuries by a close-range gunshot to the abdomen eight days ago and he had been treated by bowel repairs, resections, jejunal anastomosis and Hartman's procedure. He was referred to our center after deterioration, evisceration with open abdomen and enteric fistula in septic shock. There were edematous, fibrinous bowels and large multiple fistulas from the edematous rectal stump. APACHE II, Mannheim Peritoneal Index and Björck scores were 18, 33 and 3, respectively (expected mortality 100%). After intensive care for 5 days, he was treated by abdominal and intrarectal NPS. NPS repeated for 5 times and the fistula was recovered on day 18 completely. Fascial closure was facilitated with a dynamic abdominal closure system (ABRA) and he was discharged on day 33 uneventfully. There was no herniation and any other problem after 12 months follow-up. Management of fistula in OA can be extremely challenging. Floating stoma, fistula VAC, nipple VAC, ring and silo VAC, fistula intubation systems are used for isolation of the enteric effluent from OA. Several biologic dressings such as acellular dermal matrix, pedicled flaps have been used to seal the fistula opening with various success. Resection of the involved enteric loop and a new anastomosis of the intestine is very hard and rarely possible. In all of these reports, usually patients are left to heal with a giant hernia. In contrast to this, there is no hernia in our case during one year follow up period. Combination of intra and extra luminal negative pressure systems and ABRA is a safe and successful method to manage open abdomen with colorectal fistula. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. [Diverticulosis of the colon end its complications under the mask of emergency surgical abdomen--10 years experience].

    Science.gov (United States)

    Jaramov, N; Sokolov, M; Angelov, K; Toshev, S; Petrov, B

    2009-01-01

    estimating the prevalence of colonic diverticulosis and its complications studied at the clinic for 10-years period as well as the approaches for its operative treatment and analysis of the subsequent results. CASES AND APPROACHES: During the period 1998-2008 56 patients were hospitalized (31 women and 25 men) at the Surgical department of the University hospital "Alexandrovska". They had different forms of colonic diverticulosis. The average age of the patients was 66.7. The retrospective analysis divides the patients into three clinical groups: 1st group--peritonitis and pericolic abscess caused by diverticulosis--present in 49 patients. 2nd group--chronic non-specific inflammatory infiltrate and fistula--present in 5 patients. 3rd group--severe haemorrhage and anaemic syndrome--present in 2 patients Mortality-rate is 12.5% (7 patients). 10 patients with complications were registered--5 with suppuration of the surgical wound and 5 with pneumonia and pleural effusion. Colonic diverticulosis is a disease of great surgical interest because of its complicated forms requiring conventional or surgical treatment. Various forms of peritonitis which are part of the emergency surgical abdomen domain are relatively frequent complication of the gastrointestinal (in particular of the colon) diverticulosis. They are difficult to diagnose in the pre-operative period and its not easy to take a decision about the particular operative approach. All that is related with the relatively high morbidity and mortality.

  11. Honey bees (Apis mellifera ligustica) swing abdomen to dissipate residual flying energy landing on a wall

    Science.gov (United States)

    Zhao, Jieliang; Huang, He; Yan, Shaoze

    2017-03-01

    Whether for insects or for aircrafts, landing is one of the indispensable links in the verification of airworthiness safety. The mechanisms by which insects achieve a fast and stable landing remain unclear. An intriguing example is provided by honeybees (Apis mellifera ligustica), which use the swinging motion of their abdomen to dissipate residual flying energy and to achieve a smooth, stable, and quick landing. By using a high-speed camera, we observed that touchdown is initiated by honeybees extending their front legs or antennae and then landing softly on a wall. After touchdown, they swing the rest of their bodies until all flying energy is dissipated. We suggested a simplified model with mass-spring dampers for the body of the honeybee and revealed the mechanism of flying energy transfer and dissipation in detail. Results demonstrate that body translation and abdomen swinging help honeybees dissipate residual flying energy and orchestrate smooth landings. The initial kinetic energy of flying is transformed into the kinetic energy of the abdomen's rotary movement. Then, the kinetic energy of rotary movement is converted into thermal energy during the swinging cycle. This strategy provides more insight into the mechanism of insect flying, which further inspires better design on aerial vehicle with better landing performance.

  12. MREIT conductivity imaging of the postmortem canine abdomen using CoReHA

    International Nuclear Information System (INIS)

    Jeon, Kiwan; Lee, Chang-Ock; Minhas, Atul S; Kim, Young Tae; Jeong, Woo Chul; Kim, Hyung Joong; Woo, Eung Je; Kang, Byeong Teck; Park, Hee Myung; Seo, Jin Keun

    2009-01-01

    Magnetic resonance electrical impedance tomography (MREIT) is a new bio-imaging modality providing cross-sectional conductivity images from measurements of internal magnetic flux densities produced by externally injected currents. Recent experimental results of postmortem and in vivo imaging of the canine brain demonstrated its feasibility by showing conductivity images with meaningful contrast among different brain tissues. MREIT image reconstructions involve a series of data processing steps such as k-space data handling, phase unwrapping, image segmentation, meshing, modelling, finite element computation, denoising and so on. To facilitate experimental studies, we need a software tool that automates these data processing steps. In this paper, we summarize such an MREIT software package called CoReHA (conductivity reconstructor using harmonic algorithms). Performing imaging experiments of the postmortem canine abdomen, we demonstrate how CoReHA can be utilized in MREIT. The abdomen with a relatively large field of view and various organs imposes new technical challenges when it is chosen as an imaging domain. Summarizing a few improvements in the experimental MREIT technique, we report our first conductivity images of the postmortem canine abdomen. Illustrating reconstructed conductivity images, we discuss how they discern different organs including the kidney, spleen, stomach and small intestine. We elaborate, as an example, that conductivity images of the kidney show clear contrast among cortex, internal medulla, renal pelvis and urethra. We end this paper with a brief discussion on future work using different animal models

  13. Delayed rupture of thoracic aorta aneurysm following a kick to the abdomen.

    Science.gov (United States)

    Oliva, Antonio; De Giorgio, Fabio; Partemi, Sara; Pascali, Vincenzo L; Carbone, Arnaldo

    2009-03-01

    Several theories have been proposed to explain the Blunt Traumatic Aortic Rupture (BTAR) because different mechanical forces act on the aorta, at anatomically susceptible sites, including shearing, torsion and stretching, but the origin, transduction and relative importance of these forces remain uncertain. We report a case of a 74-year-old man injured by a kick to the abdomen. After 2 days he felt chest pain paroxysm and weakness in his left leg. The patient was admitted to an emergency care department where he experienced sudden and severe hemodynamic deterioration, dying rapidly. The autopsy, performed 3 days later, showed haemorragic infarction of hypogastric subcutaneous tissues and revealed an extended dissecting aneurysm of the thoracic aorta with following haemopericardium. In our case we considered that a low energy compression to the abdomen, in presence of underlying atherosclerosis, caused aortic dissection rather than rupture and then the 48h time span after the traumatic event and the cardiac tamponade was enough to complete the aortic retrograde dissection. We finally emphasise the importance of the careful surveillance of any trauma close to the abdomen in view of initially unpredictable, as well as eventful injuries. The finding of early signs of neointima formation in thoracoabdominal portions of aortic dissection strongly supported our interpretation. The forensic interest of this case is correlated to the voluntary character of the inflicted injury. The culprit was thus charged with manslaughter.

  14. Diagnostic Algorithm in the Management of Acute Febrile Abdomen in Patients with Autosomal Dominant Polycystic Kidney Disease.

    Directory of Open Access Journals (Sweden)

    Marie Neuville

    Full Text Available Acute febrile abdomen represents a diagnostic challenge in patients with autosomal dominant polycystic kidney disease (ADPKD. Although criteria have been proposed for cyst infection (CyI and hemorrhage (CyH, there is a lack of comparative assessments. Furthermore, distinguishing cystic from non-cystic complications remains problematic.ADPKD patients presenting with abdominal pain and/or fever between 01/2005 and 06/2015 were retrospectively identified in a systematic computerized billing database. CyH was defined as spontaneous intracystic density above 50 Hounsfield units on computed tomography (CT. CyI was definite if confirmed by cyst puncture, and probable if 4 criteria were met: 3-day fever, loin/liver tenderness, C-reactive protein (CRP plasma levels >50mg/L and no CT evidence for CyH. Other episodes were grouped as inflammation of unknown origin (IUO.Among a cohort of 173 ADPKD patients, 101 presented with 205 episodes of abdominal pain (n = 172 and/or fever (n = 33. 20 patients experienced 30 CyH, whereas 16 presented 23 episodes of definite (n = 11 or probable (n = 12 CyI. 35 IUO were observed in 31 patients. Clinically, fever was observed in 7% vs. 100% vs. 66% of CyH, CyI and IUO, respectively. Biologically, CRP cut-off at 70 mg/dl showed 92% sensitivity and 81% specificity in CyI diagnosis. Urine or blood cultures remained sterile in >90% of CyH, but were contributive in 53.4% of CyI and IUO, with a 74.2% prevalence for E. coli. Radiologically, ultrasounds, CT and magnetic resonance diagnosed CyI in 2.6%, 20% and 16.7% of cases, respectively. 18F-FDG positron-emission tomography (PET/CT was done within a median period of 7 days post antibiotics, and significantly changed patient management in 71.4%.This retrospective single-center series underscores the usefulness of clinical-fever-and biological-CRP-parameters, but emphasizes the limitations of bacteriological and radiological investigations in cases of acute febrile abdomen in

  15. Diagnostic Algorithm in the Management of Acute Febrile Abdomen in Patients with Autosomal Dominant Polycystic Kidney Disease.

    Science.gov (United States)

    Neuville, Marie; Hustinx, Roland; Jacques, Jessica; Krzesinski, Jean-Marie; Jouret, François

    2016-01-01

    Acute febrile abdomen represents a diagnostic challenge in patients with autosomal dominant polycystic kidney disease (ADPKD). Although criteria have been proposed for cyst infection (CyI) and hemorrhage (CyH), there is a lack of comparative assessments. Furthermore, distinguishing cystic from non-cystic complications remains problematic. ADPKD patients presenting with abdominal pain and/or fever between 01/2005 and 06/2015 were retrospectively identified in a systematic computerized billing database. CyH was defined as spontaneous intracystic density above 50 Hounsfield units on computed tomography (CT). CyI was definite if confirmed by cyst puncture, and probable if 4 criteria were met: 3-day fever, loin/liver tenderness, C-reactive protein (CRP) plasma levels >50mg/L and no CT evidence for CyH. Other episodes were grouped as inflammation of unknown origin (IUO). Among a cohort of 173 ADPKD patients, 101 presented with 205 episodes of abdominal pain (n = 172) and/or fever (n = 33). 20 patients experienced 30 CyH, whereas 16 presented 23 episodes of definite (n = 11) or probable (n = 12) CyI. 35 IUO were observed in 31 patients. Clinically, fever was observed in 7% vs. 100% vs. 66% of CyH, CyI and IUO, respectively. Biologically, CRP cut-off at 70 mg/dl showed 92% sensitivity and 81% specificity in CyI diagnosis. Urine or blood cultures remained sterile in >90% of CyH, but were contributive in 53.4% of CyI and IUO, with a 74.2% prevalence for E. coli. Radiologically, ultrasounds, CT and magnetic resonance diagnosed CyI in 2.6%, 20% and 16.7% of cases, respectively. 18F-FDG positron-emission tomography (PET)/CT was done within a median period of 7 days post antibiotics, and significantly changed patient management in 71.4%. This retrospective single-center series underscores the usefulness of clinical-fever-and biological-CRP-parameters, but emphasizes the limitations of bacteriological and radiological investigations in cases of acute febrile abdomen in ADPKD

  16. Abdomen - swollen

    Science.gov (United States)

    ... of a serious medical problem) Gas in the intestines from eating foods that are high in fiber (such as fruits and vegetables) Irritable bowel syndrome Lactose intolerance Ovarian cyst Partial bowel blockage Pregnancy ...

  17. Background sources at PEP

    International Nuclear Information System (INIS)

    Lynch, H.; Schwitters, R.F.; Toner, W.T.

    1988-01-01

    Important sources of background for PEP experiments are studied. Background particles originate from high-energy electrons and positrons which have been lost from stable orbits, γ-rays emitted by the primary beams through bremsstrahlung in the residual gas, and synchrotron radiation x-rays. The effect of these processes on the beam lifetime are calculated and estimates of background rates at the interaction region are given. Recommendations for the PEP design, aimed at minimizing background are presented. 7 figs., 4 tabs

  18. Open abdomen procedure in managing abdominal compartment syndrome in a child with severe fungal peritonitis and sepsis after gastric perforation

    Directory of Open Access Journals (Sweden)

    Wei Lai

    2016-04-01

    Full Text Available Abdominal compartment syndrome with increased abdominal pressure resulted in multi-organ dysfunctions can be lethal in children. The open abdomen procedure intentionally leaves the abdominal cavity open in patients with severe abdominal sepsis and abdominal compartment syndrome by temporarily relieving the abdominal pressure. We reported our experience of open abdomen procedure in successfully treating a 4-year old boy with abdominal compartment syndrome caused by severe fungal peritonitis and sepsis after gastric perforation.

  19. Cosmic Microwave Background Timeline

    Science.gov (United States)

    Cosmic Microwave Background Timeline 1934 : Richard Tolman shows that blackbody radiation in an will have a blackbody cosmic microwave background with temperature about 5 K 1955: Tigran Shmaonov anisotropy in the cosmic microwave background, this strongly supports the big bang model with gravitational

  20. SU-E-P-08: Establishment of Local Diagnostic Reference Levels of Routine Abdomen Exam in Computed Tomography According to Body Weight

    International Nuclear Information System (INIS)

    Wang, H; Wang, Y; Weng, H

    2015-01-01

    Purpose: The national diagnostic reference levels (NDRLs) is an efficient, concise and powerful standard for optimizing radiation protection of a patient. However, for each hospital the dose-reducing potential of focusing on establishment of local DRLs (LDRLs). A lot of study reported that Computed tomography exam contributed majority radiation dose in different medical modalities, therefore, routine abdomen CT exam was choose in initial pilot study in our study. Besides the mAs of routine abdomen CT exam was decided automatic exposure control by linear attenuation is relate to body shape of patient. In this study we would like to establish the local diagnostic reference levels of routine abdomen exam in computed tomography according to body weight of patient. Methods and Materials: There are two clinical CT scanners (a Toshiba Aquilion and a Siemens Sensation) were performed in this study. For CT examinations the basic recommended dosimetric quantity is the Computed Tomography Dose Index (CTDI). The patient sample involved 82 adult patients of both sexes and divided into three groups by their body weight (50–60 kg, 60–70 kg, 70–80 kg).Carried out the routine abdomen examinations, and all exposure parameters have been collected and the corresponding CTDIv and DLP values have been determined. The average values were compared with the European DRLs. Results: The majority of patients (75%) were between 50–70 Kg of body weight, the numbers of patient in each group of weight were 40–50:7; 50–60:29; 60–70:33; 70–80:13. The LDRLs in each group were 10.81mGy, 14.46mGy, 20.27mGy and 21.04mGy, respectively. The DLP were 477mGy, 630mGy, 887mGy and 959mGy, respectively. No matter which group the LDRLs were lower than European DRLs. Conclusions: We would like to state that this was a pioneer work in local hospital in Chiayi. We hope that this may lead the way to further developments in Taiwan

  1. SU-E-P-08: Establishment of Local Diagnostic Reference Levels of Routine Abdomen Exam in Computed Tomography According to Body Weight

    Energy Technology Data Exchange (ETDEWEB)

    Wang, H; Wang, Y; Weng, H [Chiayi Chang Gung Memorial Hospital of The C.G.M.F, Puzi City, Chiayi County, Taiwan (China)

    2015-06-15

    Purpose: The national diagnostic reference levels (NDRLs) is an efficient, concise and powerful standard for optimizing radiation protection of a patient. However, for each hospital the dose-reducing potential of focusing on establishment of local DRLs (LDRLs). A lot of study reported that Computed tomography exam contributed majority radiation dose in different medical modalities, therefore, routine abdomen CT exam was choose in initial pilot study in our study. Besides the mAs of routine abdomen CT exam was decided automatic exposure control by linear attenuation is relate to body shape of patient. In this study we would like to establish the local diagnostic reference levels of routine abdomen exam in computed tomography according to body weight of patient. Methods and Materials: There are two clinical CT scanners (a Toshiba Aquilion and a Siemens Sensation) were performed in this study. For CT examinations the basic recommended dosimetric quantity is the Computed Tomography Dose Index (CTDI). The patient sample involved 82 adult patients of both sexes and divided into three groups by their body weight (50–60 kg, 60–70 kg, 70–80 kg).Carried out the routine abdomen examinations, and all exposure parameters have been collected and the corresponding CTDIv and DLP values have been determined. The average values were compared with the European DRLs. Results: The majority of patients (75%) were between 50–70 Kg of body weight, the numbers of patient in each group of weight were 40–50:7; 50–60:29; 60–70:33; 70–80:13. The LDRLs in each group were 10.81mGy, 14.46mGy, 20.27mGy and 21.04mGy, respectively. The DLP were 477mGy, 630mGy, 887mGy and 959mGy, respectively. No matter which group the LDRLs were lower than European DRLs. Conclusions: We would like to state that this was a pioneer work in local hospital in Chiayi. We hope that this may lead the way to further developments in Taiwan.

  2. Synthesis of a posterior indicator protein in normal embryos and double abdomens of Smittia sp. (Chironomidae, Diptera).

    Science.gov (United States)

    Jäckle, H; Kalthoff, K

    1980-01-01

    In embryos of the chironomid midge Smittia, synthesis of a posterior indicator protein designated PI1 (Mr approximately 50,000; pI approximately 5.5) forecasts development of an abdomen as opposed to head and thorax. The protein is synthesized several hours before germ anlage formation. In normal embryos at early blastoderm stages, synthesis of PI1 is restricted to posterior embryonic fragments but not to pole cells. In "double-abdomen" embryos, a mirror-image duplication of the abdomen is formed by cells that would otherwise develop into head and thorax. Embryos were programmed for double-abdomen development by UV irradiation of the anterior pole, and half of them were reprogrammed for normal development by subsequent exposure to visible light (photoreversal). Correspondingly, PI1 was synthesized in anterior fragments of UV-irradiated embryos but not after photoreversal. In a control experiment, UV irradiation of the posterior pole caused neither double-abdomen formation nor PI1 synthesis in anterior fragments. The identity of PI1 formed in anterior fragments of prospective double abdomens with the protein found in posterior fragments was revealed by two-dimensional gel electrophoresis and limited proteolysis. Suppression of PI1 synthesis in anterior fragments of normal embryos is ascribed to the activity of cytoplasmic ribonucleoprotein particles thought to act as anterior determinants. Images PMID:6935679

  3. Respiratory-Gated MRgHIFU in Upper Abdomen Using an MR-Compatible In-Bore Digital Camera

    Directory of Open Access Journals (Sweden)

    Vincent Auboiroux

    2014-01-01

    Full Text Available Objective. To demonstrate the technical feasibility and the potential interest of using a digital optical camera inside the MR magnet bore for monitoring the breathing cycle and subsequently gating the PRFS MR thermometry, MR-ARFI measurement, and MRgHIFU sonication in the upper abdomen. Materials and Methods. A digital camera was reengineered to remove its magnetic parts and was further equipped with a 7 m long USB cable. The system was electromagnetically shielded and operated inside the bore of a closed 3T clinical scanner. Suitable triggers were generated based on real-time motion analysis of the images produced by the camera (resolution 640×480 pixels, 30 fps. Respiratory-gated MR-ARFI prepared MRgHIFU ablation was performed in the kidney and liver of two sheep in vivo, under general anaesthesia and ventilator-driven forced breathing. Results. The optical device demonstrated very good MR compatibility. The current setup permitted the acquisition of motion artefact-free and high resolution MR 2D ARFI and multiplanar interleaved PRFS thermometry (average SNR 30 in liver and 56 in kidney. Microscopic histology indicated precise focal lesions with sharply delineated margins following the respiratory-gated HIFU sonications. Conclusion. The proof-of-concept for respiratory motion management in MRgHIFU using an in-bore digital camera has been validated in vivo.

  4. Acute abdomen due to ovarian congestion: a fallopian tube accompanied by a paratubal cyst, coiling tightly round the ovary.

    Science.gov (United States)

    Kaido, Yoshitaka; Kikuchi, Akihiko; Kanasugi, Tomonobu; Fukushima, Akimune; Sugiyama, Toru

    2013-01-01

    We experienced an unreported rare case with an adnexal mass causing severe acute abdomen during pregnancy. A 30-year-old Japanese pregnant woman was transported to our hospital for her right lower abdominal pain at 30 weeks of gestation. Magnetic resonance imaging and ultrasound demonstrated a cyst measuring 3-4 cm in diameter adjacent to the right ovary, and a parovarian cyst was considered to be the most probable diagnosis. We strongly suspected torsion of the ovarian pedicle or fallopian tube in conjunction with her clinical symptoms. Laparotomy revealed that the elongated right fallopian tube accompanied by a paratubal cyst was coiling tightly 2.5 times round the right ovary, causing apparent congestion and enlargement of the right ovary. Soon after we released the congested right ovary from the coiling of the fallopian tube, the congestion subsided. The postoperative course was favorable, and pregnancy and delivery were uneventful. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

  5. Spinal cord stimulation: Background and clinical application

    DEFF Research Database (Denmark)

    Meier, Kaare

    2014-01-01

    a number of contacts capable of delivering a weak electrical current to the spinal cord, evoking a feeling of peripheral paresthesia. With correct indication and if implanted by an experienced implanter, success rates generally are in the range of about 50–75%. Common indications include complex regional...

  6. Delayed pneumothorax after stab wound to thorax and upper abdomen: Truth or myth?

    Science.gov (United States)

    Zehtabchi, Shahriar; Morley, Eric J; Sajed, Dana; Greenberg, Oded; Sinert, Richard

    2009-01-01

    Stab wounds to the thorax and upper abdomen have the potential to cause pneumothorax (PTX). When a CXR (CXR) obtained during initial resuscitation is negative, a second CXR (CXR-2) is commonly performed with the goal of identifying delayed PTX. To assess the diagnostic yield of the CXR-2 in identifying delayed PTX. Prospective observational study of patients (age >or=13 years) with stab wounds to the thorax (chest/back) and upper abdomen with suspected PTX, in a level 1 trauma centre. Patients were included if they had a negative initial CXR followed by a repeat CXR 3-6h after the initial one. patients who died, were transferred out of the ED, or received chest tubes before the second CXR. The outcome of interest was delayed PTX. All CXR were read by an attending radiologist. To test the inter-observer agreement, another blinded radiologist reviewed 20% of CXR. Continuous data is presented as mean+/-standard deviation and categorical data as percentages with 95% confidence interval (CI). Kappa statistics were used to measure the inter-observer agreement between radiologists. Between January 2003 and December 2006 a total of 185 patients qualified for the enrollment (mean age: 28+/-10 years, age range: 13-65, 94% male). Only 2 patients (1.1%, 95% CI, 0.4- 4.1%) had PTX on the CXR-2. Both patients received chest tubes. The inter-observer agreement for radiology reports was high (kappa: 0.79). Occurrence of delayed PTX in patients with stab wounds to the thorax and upper abdomen and negative triage CXR is rare.

  7. Effective dose conversion coefficients for X-ray radiographs of the chest and the abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Lima, F.R.A. [Centro regional de Ciencias Nucleares, CRCN/CNEN, Rua Conego Barata, 999, Tamarineira, Recife, PE (Brazil); Kramer, R.; Vieira, J.W.; Khoury, H.J. [Departamento de Energia Nuclear, DEN/UFPE, Cidade Universitaria, Recife, PE (Brazil)]. E-mail: falima@cnen.gov.br

    2004-07-01

    The recently developed MAX (Male Adult voXel) and the FAXht (Female Adult voXel) head and trunk phantoms have been used to calculate organ and tissue equivalent dose conversion coefficients for X-ray radiographs of the chest and the abdomen as a function of source and field parameters, like voltage, filtration, field size, focus-to-skin distance, etc. Based on the equivalent doses to twenty three organs and tissues at risk, the effective dose has been determined and compared with corresponding data for others phantoms. The influence of different radiation transport codes, different tissue compositions and different human anatomies have been investigated separately. (Author)

  8. Comparison of CT and anatomic pathological findings of the abdomen in HIV infection

    International Nuclear Information System (INIS)

    Tosch, U.; Witt, H.; Jautzke, G.; Ruf, B.

    1990-01-01

    In a retrospective study the results of abdominal computed tomography (CT) from 48 patients, who died of the complications of HIV infection, were compared with those obtained at autopsy. The CT diagnosis was confirmed at autopsy in 39 cases (81.3%). In nine patients CT results did not correlate with the postmortal findings. This was caused by lack of cooperation, cachexia and the time between the last CT study and the death of the patients. Nevertheless, CT with its standardised imaging planes is an important method for diagnosing and monitoring HIV-related diseases of the abdomen. (orig.) [de

  9. Effective dose conversion coefficients for X-ray radiographs of the chest and the abdomen

    International Nuclear Information System (INIS)

    Lima, F.R.A.; Kramer, R.; Vieira, J.W.; Khoury, H.J.

    2004-01-01

    The recently developed MAX (Male Adult voXel) and the FAXht (Female Adult voXel) head and trunk phantoms have been used to calculate organ and tissue equivalent dose conversion coefficients for X-ray radiographs of the chest and the abdomen as a function of source and field parameters, like voltage, filtration, field size, focus-to-skin distance, etc. Based on the equivalent doses to twenty three organs and tissues at risk, the effective dose has been determined and compared with corresponding data for others phantoms. The influence of different radiation transport codes, different tissue compositions and different human anatomies have been investigated separately. (Author)

  10. Abdomen agudo ocasionado por apendicitis aguda de probable origen tuberculoso. Informe de un caso

    OpenAIRE

    Montiel-Jarquín, Álvaro José; Alvarado-Ortega, Iván; Romero-Figueroa, María del Socorro; Rodríguez-Pérez, Fabiola; Rodríguez-Lima, Felipe; Loria-Castellanos, Jorge

    2017-01-01

    RESUMEN Antecedentes: la apendicitis aguda tuberculosa es una enfermedad rara, constituye de 0,001 % a 0,01 % de las formas clínicas de tuberculosis. Se presenta un caso de apendicitis aguda probablemente tuberculosa como causa de abdomen agudo quirúrgico. Caso clínico: hombre de 29 años con cuadro de dolor abdominal leve a moderado que se intensificó y localizó en el hemiabdomen derecho, claudicación, febrícula, vómito, mal estado general, leucocitosis de 11 300/µL y neutrofilia de 91 %....

  11. Optimal background matching camouflage.

    Science.gov (United States)

    Michalis, Constantine; Scott-Samuel, Nicholas E; Gibson, David P; Cuthill, Innes C

    2017-07-12

    Background matching is the most familiar and widespread camouflage strategy: avoiding detection by having a similar colour and pattern to the background. Optimizing background matching is straightforward in a homogeneous environment, or when the habitat has very distinct sub-types and there is divergent selection leading to polymorphism. However, most backgrounds have continuous variation in colour and texture, so what is the best solution? Not all samples of the background are likely to be equally inconspicuous, and laboratory experiments on birds and humans support this view. Theory suggests that the most probable background sample (in the statistical sense), at the size of the prey, would, on average, be the most cryptic. We present an analysis, based on realistic assumptions about low-level vision, that estimates the distribution of background colours and visual textures, and predicts the best camouflage. We present data from a field experiment that tests and supports our predictions, using artificial moth-like targets under bird predation. Additionally, we present analogous data for humans, under tightly controlled viewing conditions, searching for targets on a computer screen. These data show that, in the absence of predator learning, the best single camouflage pattern for heterogeneous backgrounds is the most probable sample. © 2017 The Authors.

  12. [Efficacy of intestinal splinting in hostile abdomen secondary to postoperative flanges in pediatric patients].

    Science.gov (United States)

    Bracho-Blanchet, Eduardo; Langarica-Bulos, Mónica; Dávila-Pérez, Roberto; Fernández-Portilla, Emilio; Zalles-Vidal, Cristian; Nieto-Zermeño, Jaime

    2016-10-01

    Objetivo: Mostrar la eficacia de la FI para prolongar el tiempo libre de oclusión intestinal quirúrgica en niños con abdomen hostil secundario a bridas posquirúrgicas. Método: Análisis retrospectivo de FI por abdomen hostil de 2000 a 2011 y su seguimiento a largo plazo. Comparamos el tiempo libre de oclusión quirúrgica antes y después de la FI. Resultados: Se incluyeron 20 FI en 19 pacientes. Predominaron las causas congénitas, la mediana de edad en la cirugía fue de 6 meses, todos tenían cirugías previas con mediana de tres, y dos de ellas fueron por oclusión intestinal previa. La férula se quitó a los 28 días (mediana). Con un seguimiento de 1-183 meses, hubo una recurrencia de oclusión quirúrgica. El tiempo libre de oclusión quirúrgica posferulización fue significativamente mayor que el preferulización mediante la prueba de Wilcoxon, con un valor Z = -3.594; p = el tiempo libre de oclusión quirúrgica.

  13. Prophylaxis of radiotherapy induced diarrhea after irradiation of the pelvis or the abdomen

    International Nuclear Information System (INIS)

    Hombrink, J.; Voss, A.C.; Froehlich, D.; Glatzel, M.; Krauss, A.; Glaser, F.H.

    1995-01-01

    Radiotherapy induced diarrhea and convulsive pain are severe side-effects of irradiation of the pelvis and the abdomen leading often to an interruption of the treatment. Up to now these side-effects were only treated symptomatically, prophylactic therapies are not known. During the years 1992 and 1993 174 patients who obtained radiotherapy in the pelvis or the abdomen because of different malignancies were observed referring to the diarrhea-prophylactic effect of Smectite (=Skilpin R ). 80 patients received Smectite at the beginning of radiotherapy, 94 patients of the controlgroup were treated with motility modifying drugs when diarrhea appeared. The following parameters were compared: Frequency, consistence and incontinence of stool, tenesmus and the onset of diarrhea. 67,0% (n=63) of the patients in the controlgroup developed diarrhea, whereas in the pretreated Smectite-group only 37,5% of the cases (n=30) developed diarrhea. The first appearance of diarrhea was at day 17 in the pretreated group and averagely at day 11 in the controlgroup. 44% of the patients in the controlgroup suffered from tenesmus versus 25% in the Smectite-group. In comparison to the symptomatic treatment of radiation enteritis the prophylactic application of Smectite is able to reduce the diarrhea from the beginning of raditherapy or at least to reduce the pathological frequency of stool and therefore to increase the quality of life. (orig.) [de

  14. Gd-DTPA: a bowel contrast agent for magnetic resonance imaging of the abdomen

    International Nuclear Information System (INIS)

    Vlahos, L.; Gouliamos, A.; Clauss, W.; Kalovidouris, A.; Hadjiioannou, A.; Athanasopoulou, A.; Trakadas, S.; Papavasiliou, C.

    1992-01-01

    Forty patients with suspected pathology in the abdomen and pelvis have been investigated with MRI before and after administration of Gd-DTPA as an oral or rectal solution. The findings are analysed with respect to: (a) filling of the GI tract; (b) contrast in the region of interest, surrounding fat and vessels; (c) diagnostic yield in comparison to non-enhanced MRI and contrast CT. At a concentration of 1 mmol/l Gd-DTPA provided consistent positive contrast in the stomach and bowel in all cases. In 57.5% of cases we achieved complete filling of the GI tract. The opacification in the region of interest was good or satisfactory in 90% of cases. The diagnostic value of contrast MRI was better in 93% of cases than the non-enhanced MRI of the abdomen. In comparison with contrast CT, the contrast MRI was better or of the same value in 92% of cases. Despite the disadvantage of poor fat-to-bowel contrast (35% of cases were classified as poor), it is concluded that Gd-DTPA-enhanced MRI provides good delineation of organs adjacent to the bowel so this contrast agent has potential for a future role in abdominal MRI. (orig.)

  15. Gd-DTPA: a bowel contrast agent for magnetic resonance imaging of the abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Vlahos, L. [Dept. of Radiology, Univ. of Athens, Areteion Hospital (Greece); Gouliamos, A. [Dept. of Radiology, Univ. of Athens, Areteion Hospital (Greece); Clauss, W. [Schering A. G., Berlin (Germany); Kalovidouris, A. [Dept. of Radiology, Univ. of Athens, Areteion Hospital (Greece); Hadjiioannou, A. [Dept. of Radiology, Univ. of Athens, Areteion Hospital (Greece); Athanasopoulou, A. [Dept. of Radiology, Univ. of Athens, Areteion Hospital (Greece); Trakadas, S. [Dept. of Radiology, Univ. of Athens, Areteion Hospital (Greece); Papavasiliou, C. [Dept. of Radiology, Univ. of Athens, Areteion Hospital (Greece)

    1992-08-01

    Forty patients with suspected pathology in the abdomen and pelvis have been investigated with MRI before and after administration of Gd-DTPA as an oral or rectal solution. The findings are analysed with respect to: (a) filling of the GI tract; (b) contrast in the region of interest, surrounding fat and vessels; (c) diagnostic yield in comparison to non-enhanced MRI and contrast CT. At a concentration of 1 mmol/l Gd-DTPA provided consistent positive contrast in the stomach and bowel in all cases. In 57.5% of cases we achieved complete filling of the GI tract. The opacification in the region of interest was good or satisfactory in 90% of cases. The diagnostic value of contrast MRI was better in 93% of cases than the non-enhanced MRI of the abdomen. In comparison with contrast CT, the contrast MRI was better or of the same value in 92% of cases. Despite the disadvantage of poor fat-to-bowel contrast (35% of cases were classified as poor), it is concluded that Gd-DTPA-enhanced MRI provides good delineation of organs adjacent to the bowel so this contrast agent has potential for a future role in abdominal MRI. (orig.)

  16. Relationship of the Cold-Heat Sensation of the Limbs and Abdomen with Physiological Biomarkers

    Directory of Open Access Journals (Sweden)

    Duong Duc Pham

    2016-01-01

    Full Text Available The present study explored the relationship between the regional Cold-Heat sensation, the key indicator of the Cold-Heat patterns in traditional East Asian medicine (TEAM, and various biomarkers in Korean population. 734 apparently healthy volunteers aged 20 years and older were enrolled. Three scale self-report questions on the general thermal feel in hands, legs, and abdomen were examined. We found that 65% of women tended to perceive their body, particularly their hands and legs, to be cold, versus 25% of men. Energy expenditure and temperature load at resting state were lower in women, independently of body mass index (BMI. Those with warm hands and warm legs had a 0.74 and 0.52 kg/m2 higher BMI than those with cold hands and cold legs, respectively, regardless of age, gender, and body weight. Norepinephrine was higher, whereas the dynamic changes in glucose and insulin during an oral glucose tolerance test were lower in those with cold extremities, particularly hands. No consistent differences in biomarkers were found for the abdominal dimension. These results suggest that gender, BMI, the sympathetic nervous system, and glucose metabolism are potential determinants of the Cold-Heat sensation in the hands and legs, but not the abdomen.

  17. Diffusion-weighted MR imaging of the abdomen with pulse triggering

    International Nuclear Information System (INIS)

    Muertz, P.; Pauleit, D.; Traeber, F.; Kreft, B.P.; Schild, H.H.

    2000-01-01

    Purpose: The aim of this work was to reduce the influence of motion on diffusion-weighted MR images of the abdomen by pulse triggering of single-shot sequences. Methods: Five healthy volunteers were examined both without and with finger pulse-triggering of a diffusion-weighted single-shot echo planar MR imaging sequence at 1.5 T. Series of diffusion-weighted images were acquired at different phases of the cardiac cycle by varying the time delay between finger pulse and sequence acquisition. The measurements were repeated three times. The diffusion weighted images were analysed by measuring the signal intensities and by determining the ADC values within the spleen, kidney and liver. Results: The magnitude of motion artifacts on diffusion weighted images shows a strong dependence on the trigger delay. The optimum trigger delay is found to be between 500 and 600 ms. For these values the abdominal organs appear homogeneous on all diffusion weighted images and the strongest signal intensities are detected. At optimum triggering the accuracy of the apparent diffusion coefficients is up to 10 times better than without triggering. Moreover, the standard deviation of the repeated measurements is smaller than 12% for all volunteers and for all organs. Without triggering the standard deviation is larger by a factor of 4 on average. Conclusion: Pulse triggering of single-shot sequences leads to significant reduction of motion related artifacts on diffusion weighted images of the abdomen and provides more accurate and reproducible ADC values. (orig.) [de

  18. Evaluation of body simulator for chest and abdomen in digital X-ray equipment

    International Nuclear Information System (INIS)

    Soares, Sidney S.; Cardoso, Gabriela P.; Oliveira, Giovanni Antônio P.; Batista, Adriana S.M.; Pereira, Esther Lorrayne M.

    2017-01-01

    The use of body simulators to control the quality of X-ray images is a practice that guarantees the control of essential parameters for diagnosis by the technique. The evolution of the equipment, between the analogue, digital computerized radiology (CR) and direct radiography (DR), requires evaluation of the equivalence in grayscale, of simulators, for an adjustment according to the specific technology of obtaining the image. In this sense, the present work presents the evaluation of a body simulator with regard to the representation of mean values of signal, noise and contrast obtained in chest radiographs and panoramic of the abdomen. For the thorax the cardiac region was considered as simulation target and for the abdomen simulation of the liver and small intestine. We used a retrospective study of images obtained with X-ray equipment - CR system, in which the images were studied using the ImageJ program, generating a data catalog. These were subsequently compared with those obtained experimentally using gel filled polymer body simulator. For the validation of the simulator, it was observed the gel equivalence of filling of the polymer box required to reach the image parameters of the cataloged radiographs. The results are discussed as to the physical principles of radiation interaction with biological and equivalent tissues

  19. Relationship of the Cold-Heat Sensation of the Limbs and Abdomen with Physiological Biomarkers.

    Science.gov (United States)

    Pham, Duong Duc; Lee, JeongHoon; Kim, GaYul; Song, JiYeon; Kim, JiEun; Leem, Chae Hun

    2016-01-01

    The present study explored the relationship between the regional Cold-Heat sensation, the key indicator of the Cold-Heat patterns in traditional East Asian medicine (TEAM), and various biomarkers in Korean population. 734 apparently healthy volunteers aged 20 years and older were enrolled. Three scale self-report questions on the general thermal feel in hands, legs, and abdomen were examined. We found that 65% of women tended to perceive their body, particularly their hands and legs, to be cold, versus 25% of men. Energy expenditure and temperature load at resting state were lower in women, independently of body mass index (BMI). Those with warm hands and warm legs had a 0.74 and 0.52 kg/m 2 higher BMI than those with cold hands and cold legs, respectively, regardless of age, gender, and body weight. Norepinephrine was higher, whereas the dynamic changes in glucose and insulin during an oral glucose tolerance test were lower in those with cold extremities, particularly hands. No consistent differences in biomarkers were found for the abdominal dimension. These results suggest that gender, BMI, the sympathetic nervous system, and glucose metabolism are potential determinants of the Cold-Heat sensation in the hands and legs, but not the abdomen.

  20. Abdomen disease diagnosis in CT images using flexiscale curvelet transform and improved genetic algorithm.

    Science.gov (United States)

    Sethi, Gaurav; Saini, B S

    2015-12-01

    This paper presents an abdomen disease diagnostic system based on the flexi-scale curvelet transform, which uses different optimal scales for extracting features from computed tomography (CT) images. To optimize the scale of the flexi-scale curvelet transform, we propose an improved genetic algorithm. The conventional genetic algorithm assumes that fit parents will likely produce the healthiest offspring that leads to the least fit parents accumulating at the bottom of the population, reducing the fitness of subsequent populations and delaying the optimal solution search. In our improved genetic algorithm, combining the chromosomes of a low-fitness and a high-fitness individual increases the probability of producing high-fitness offspring. Thereby, all of the least fit parent chromosomes are combined with high fit parent to produce offspring for the next population. In this way, the leftover weak chromosomes cannot damage the fitness of subsequent populations. To further facilitate the search for the optimal solution, our improved genetic algorithm adopts modified elitism. The proposed method was applied to 120 CT abdominal images; 30 images each of normal subjects, cysts, tumors and stones. The features extracted by the flexi-scale curvelet transform were more discriminative than conventional methods, demonstrating the potential of our method as a diagnostic tool for abdomen diseases.

  1. Ruptured Granulosa Cell Tumor of the Ovary as a Cause of Acute Abdomen in Postmenopausal Woman

    Directory of Open Access Journals (Sweden)

    Tufan Oge

    2012-01-01

    Full Text Available Acute abdomen with hemoperitoneum is a very rare entity in postmenopausal women due to gynecologic conditions. A 54-year-old, postmenopausal woman was brought to emergency department with severe abdominal pain. Physical examination revealed acute abdomen findings with 15 cm pelvic mass on the right adnexal region. Immediate exploratory laparotomy was performed. During laparotomy 1000 cc of bloodstained fluid, ruptured and actively bleeding large mass arising from right ovary was observed. Right salpingo-oopherectomy was performed in emergency conditions, and pathology report revealed an adult type of granulosa cell tumor. After this result, staging surgery was performed and patient was diagnosed as granulosa cell tumor stage 1 c. Cisplatin, etoposide, and bleomycin chemotherapy was given. Clinicians should be aware of granulosa cell tumors which may occur at any age and prone to rupture. Frozen section will be helpful in order to avoid incomplete surgeries especially in postmenopausal women presented with intra-abdominal bleeding.

  2. Cosmic microwave background radiation

    International Nuclear Information System (INIS)

    Wilson, R.W.

    1979-01-01

    The 20-ft horn-reflector antenna at Bell Laboratories is discussed in detail with emphasis on the 7.35 cm radiometer. The circumstances leading to the detection of the cosmic microwave background radiation are explored

  3. Zambia Country Background Report

    DEFF Research Database (Denmark)

    Hampwaye, Godfrey; Jeppesen, Søren; Kragelund, Peter

    This paper provides background data and general information for the Zambia studies focusing on local food processing sub­‐sector; and the local suppliers to the mines as part of the SAFIC project (Successful African Firms and Institutional Change).......This paper provides background data and general information for the Zambia studies focusing on local food processing sub­‐sector; and the local suppliers to the mines as part of the SAFIC project (Successful African Firms and Institutional Change)....

  4. Acute abdomen due to ovarian congestion caused by coiling of the fallopian tube accompanied by paratubal cyst around the utero-ovarian ligament.

    Science.gov (United States)

    Kim, Juyoung; Park, Daehyun; Han, Won Bo; Jeong, Hyangjin; Park, Youngse

    2014-07-01

    Torsion of uterine adnexa is an important cause of acute abdominal pain in females. The main organ which can cause torsion is the ovaries, but torsions of the fallopian tube, subserosal myoma, paratubal cyst, and even the uterine body have been reported. The incidence of isolated fallopian tubal torsion is very rare. Even more rarely, it can coil around nearby organs such as the utero-ovarian ligament, showing similar clinical manifestations with those of adnexal torsion. We experienced an extremely rare case of acute abdomen induced by ovarian congestion triggered by the fallopian tube accompanying a paratubal cyst coiling around the utero-ovarian ligament. The right paratubal cyst was misinterpreted as being part of a cystic component of the left ovary on preoperative sonographic examination, and the coiling of the right fallopian tube accompanying the paratubal cyst was misdiagnosed as torsion of the right ovary. We report this rare case with a brief literature review.

  5. Laparoscopic management of ovarian dysgerminoma presenting with acute abdomen caused by adnexal torsion in a 17-year-old girl.

    Science.gov (United States)

    Takeda, Akihiro; Mori, Masahiko; Sakai, Kotaro; Mitsui, Takashi; Nakamura, Hiromi

    2009-02-01

    Ovarian dysgerminoma cases very rarely present with acute abdomen due to adnexal torsion and the successful laparoscopic management of such a case has not been reported previously. A 17-year-old sexually inactive high school girl presenting with acute abdomen was referred to our emergency department. Transabdominal ultrasonography showed the presence of homogeneous tumor in the lower abdomen. Emergency laparoscopic surgery was performed and left ovarian tumor with adnexal torsion was identified. Left salpingo-oophorectomy was performed carefully to avoid damaging the tumor capsule and the excised tissue was removed after retrieval in an endobag. The histopathological diagnosis was pure ovarian dysgerminoma. The postoperative course was uneventful. Laparoscopic management with careful postoperative follow-up to monitor recurrence could be a treatment option in a young girl with dysgerminoma, if the disease condition is detected in the early stage.

  6. Evaluation of the usefulness of computed tomography on diagnosis and management of acute abdomen

    International Nuclear Information System (INIS)

    Sakai, Takehiro; Yagihashi, Nobuo; Osawa, Tadaharu; Harada, Osamu; Ito, Hiroyuki

    2007-01-01

    We evaluated the usefulness of computed tomography (CT) in diagnosing and managing acute abdomen. Subjects were 91 patients admitted complaining of acute abdominal pain and divided into two groups-those undergoing CT within 24 hours of admission (emergency CT group, n=70), those without CT (Non-CT group, n=21). The emergency CT group was subdivided into those with bowel obstruction (bowel obstruction group, n=29), those with acute appendicitis and other diseases necessitating differential diagnosis (appendicitis group, n=36), those with perforation of the digestive tract (perforation group, n=4), and other disease (n=1). We evaluated the accuracy of admission diagnosis retrospectively in each group. The final diagnosis of the bowel obstruction group was adhesive bowel obstruction in 16, colon cancer in 5, external hernia in 3 and other in 5. That in the appendicitis group was acute appendicitis in 25, colonic diverticulitis in 3, pelvic inflammatory disease in 3, ovarian hemorrhage in 2 and other in 5. The origin of perforation in the perforation group was upper digestive tract in 2 and lower digestive tract in 2. The sensitivity, specificity and accuracy of admission diagnosis in the emergency CT group was 91.1, 100 and 91.4%, respectively. The accuracy of admission diagnosis was 96.5% in the bowel obstruction group, 88.9% in the appendicitis group and 75.9% in the perforation group. Patients who could not be diagnosed precisely consisted of 6 patients in the emergency CT group. Those who could not be diagnosed precisely included 3 with pericecal abscess, 1 with acute appendicitis, 1 with stercoral perforation of the sigmoid colon and 1 with impacted bezoar in the small intestine. Evaluated retrospectively, 4 patients were able to be diagnosed by CT on admission. In diagnosis of acute abdomen, CT was useful in differential diagnosis of bowel obstruction and acute appendicitis, detection of fine free air, and determine of perforated sites. Emergency CT was thus

  7. Accuracy and precision of flash glucose monitoring sensors inserted into the abdomen and upper thigh compared with the upper arm.

    Science.gov (United States)

    Charleer, Sara; Mathieu, Chantal; Nobels, Frank; Gillard, Pieter

    2018-06-01

    Nowadays, most Belgian patients with type 1 diabetes use flash glucose monitoring (FreeStyle Libre [FSL]; Abbott Diabetes Care, Alameda, California) to check their glucose values, but some patients find the sensor on the upper arm too visible. The aim of the present study was to compare the accuracy and precision of FSL sensors when placed on different sites. A total of 23 adults with type 1 diabetes used three FSL sensors simultaneously for 14 days on the upper arm, abdomen and upper thigh. FSL measurements were compared with capillary blood glucose (BG) measurements obtained with a built-in FSL BG meter. The aggregated mean absolute relative difference was 11.8 ± 12.0%, 18.5 ± 18.4% and 12.3 ± 13.8% for the arm, abdomen (P = .002 vs arm) and thigh (P = .5 vs arm), respectively. Results of Clarke error grid analysis for the arm and thigh were similar (zone A: 84.9% vs 84.5%; P = .6), while less accuracy was seen for the abdomen (zone A: 69.4%; P = .01). Apart from the first day, the accuracy of FSL sensors on the arm and thigh was more stable across the 14-day wear duration than accuracy of sensors on the abdomen, which deteriorated mainly during week 2 (P < .0005). The aggregated precision absolute relative difference was markedly lower for the arm/thigh (10.9 ± 11.9%) compared with the arm/abdomen (20.9 ± 22.8%; P = .002). Our results indicate that the accuracy and precision of FSL sensors placed on the upper thigh are similar to the upper arm, whereas the abdomen performed unacceptably poorly. © 2018 John Wiley & Sons Ltd.

  8. A Case Involving Needles in the Medulla Oblongata, Cervical Spinal Cord, and Abdomen.

    Science.gov (United States)

    Zhang, Hao-Yu; Li, Da; Wu, Zhen; Zhang, Li-Wei; Zhang, Jun-Ting

    2014-10-01

    It is extremely rare to encounter intracranial foreign bodies caused by penetrating injuries other than gunshot wounds or low-velocity wounds. We present a case describing a 5-year-old girl with metallic foreign bodies in the medulla oblongata, cervical spinal cord, and abdomen. The foreign bodies may have been there and remained silent for several years until the patient developed nausea and vomiting that persisted for 3 months. A craniotomy and a laparotomy were performed after a thorough discussion. Five pieces of metallic foreign bodies were removed, and the patient had a good outcome. Despite the precarious location of the needles in the medulla oblongata and cervical spinal cord, this rare case supports the use of surgery to remove the foreign bodies.

  9. Scanning and contrast enhancement protocols for multi-slice CT in evaluation of the upper abdomen

    International Nuclear Information System (INIS)

    Awai, Kazuo; Onishi, Hiromitsu; Takada, Koichi; Yamaguchi, Yasuo; Eguchi, Nobuko; Hiraishi, Kumiko; Hori, Shinichi

    2000-01-01

    The advent of multi-slice CT is one of the quantum leaps in computed tomography since the introduction of helical CT. Multi-slice CT can rapidly scan a large longitudinal (z-axis) volume with high longitudinal resolution and low image artifacts. The rapid volume coverage speed of multi-slice CT can increase the difficulty in optimizing the delay time between the beginning of contrast material injection and the acquisition of images and we need accurate knowledge about optimal temporal window for adequate contrast enhancement. High z-axis resolution of multi-slice can improve the quality of three-dimensional images and MPR images and we must select adequate slice thickness and slice intervals in each case. We discuss basic considerations for adequate contrast enhancement and scanning protocols by multi-slice CT scanner in the upper abdomen. (author)

  10. Delayed diagnosis of a heterotopic pregnancy as a cause of acute abdomen: A case report

    Directory of Open Access Journals (Sweden)

    Fatma Turkan Ayan

    2013-09-01

    Full Text Available Introduction: Heterotopic pregnancy is a life threating condition of intrauterine and extrauterine gestations which occur at the same time. We report a delayed diagnosed case of heterotopic pregnancy. Case: A 31 year-old primigravida was referred to our Emergency Gynaecology Service complicated by acute abdomen. She had been treated with clomiphene citrate and on admission intrauterine a missed abortus of about 8 weeks complicated by a large subchorionic hematoma was detected. Emergency laparotomy was performed because of diffuse intra-abdominal haemorrhage. A right-sided ectopic focus was recognized and excised, and dilatation - curettage was performed. Coclusion: Delay in diagnosing the condition can be fatal to both the mother and the intrauterine fetus. [J Contemp Med 2013; 3(3.000: 207-208

  11. Gadolinium-DTPA as an oral contrast medium for MR tomography of the abdomen

    International Nuclear Information System (INIS)

    Krahe, T.; Doelken, W.; Lackner, K.; Houselog, M.

    1990-01-01

    150 MR examinations of the upper abdomen were carried out after the oral administration of 5 ml/kg body weight of a gadolinium DTPA formulation (1.0 mmol/l, 15 g/l manitol), with reference to the delineation of the pancreas, the liver and intra-abdominal fat. For comparison, 100 MR examinations without oral opacification of the G.I. tract were evaluated. Contrast administration resulted in a signal-intensive demonstration of the G.I tract for all measurement sequences. The intraluminal contrast improved the distinction between normal and abnormal structures, T 1 and T 2 sequences and the demonstration of fat on T 2 -weighted series. T 1 -weighted series showed the best diagnostic results. In 25% there was meteorism and diarrhoea within 24 hours of the administration of the oral contrast. (orig.) [de

  12. Whole-abdomen radiotherapy for non-Hodgkin's lymphoma using twice-daily fractionation

    International Nuclear Information System (INIS)

    Liauw, Stanley L.; Yeh, Alexander M.; Morris, Christopher G.; Olivier, Kenneth R.; Mendenhall, Nancy Price

    2006-01-01

    Purpose: To report the tolerability and efficacy of twice-daily whole-abdomen irradiation (WAI) for non-Hodgkin's lymphoma (NHL). Methods and Materials: Of 123 patients treated for NHL with WAI, 37% received previous chemotherapy, 28% received WAI as part of comprehensive lymphatic irradiation (CLI), and 32% received WAI for palliation. The median dose to the whole abdomen was 25.0 Gy, followed by a median tumor boost of 9.8 Gy in 58 patients. Fractionation was 1.0 Gy once daily (54%) or 0.8 Gy twice daily (46%). Blood counts were measured weekly. Results: At a median follow-up of 4.3 years, local control was 72% and overall survival was 55% at 5 years. Median time of WAI was 42 days for once-daily treatment and 32 days for twice-daily treatment. Patients receiving twice-daily WAI did not have a significantly higher rate of acute side effects (e.g., nausea, diarrhea, platelet or red blood cell toxicity). Overall, acute thrombocytopenia was the most frequent side effect of treatment; 24 of 96 patients (25%) with available hematologic data had Grade 3+ toxicity. There was no acute Grade 3 gastrointestinal toxicity and no late small bowel obstruction. Multiple regression indicated that patients with four or less involved sites and disease size ≤6 cm had improved local control and overall survival. Conclusions: Twice-daily WAI using 0.8 Gy/fraction does not appear to have any greater toxicity compared with once-daily treatment using 1 Gy/fraction. Small doses per fraction (0.8-1 Gy/fx) are effective, tolerated well in the acute setting, and associated with a low rate of late toxicity

  13. Efficient organ localization using multi-label convolutional neural networks in thorax-abdomen CT scans

    Science.gov (United States)

    Efrain Humpire-Mamani, Gabriel; Arindra Adiyoso Setio, Arnaud; van Ginneken, Bram; Jacobs, Colin

    2018-04-01

    Automatic localization of organs and other structures in medical images is an important preprocessing step that can improve and speed up other algorithms such as organ segmentation, lesion detection, and registration. This work presents an efficient method for simultaneous localization of multiple structures in 3D thorax-abdomen CT scans. Our approach predicts the location of multiple structures using a single multi-label convolutional neural network for each orthogonal view. Each network takes extra slices around the current slice as input to provide extra context. A sigmoid layer is used to perform multi-label classification. The output of the three networks is subsequently combined to compute a 3D bounding box for each structure. We used our approach to locate 11 structures of interest. The neural network was trained and evaluated on a large set of 1884 thorax-abdomen CT scans from patients undergoing oncological workup. Reference bounding boxes were annotated by human observers. The performance of our method was evaluated by computing the wall distance to the reference bounding boxes. The bounding boxes annotated by the first human observer were used as the reference standard for the test set. Using the best configuration, we obtained an average wall distance of 3.20~+/-~7.33 mm in the test set. The second human observer achieved 1.23~+/-~3.39 mm. For all structures, the results were better than those reported in previously published studies. In conclusion, we proposed an efficient method for the accurate localization of multiple organs. Our method uses multiple slices as input to provide more context around the slice under analysis, and we have shown that this improves performance. This method can easily be adapted to handle more organs.

  14. The deceased organ donor with an "open abdomen": proceed with caution.

    Science.gov (United States)

    Watkins, A C; Vedula, G V; Horan, J; Dellicarpini, K; Pak, S-W; Daly, T; Samstein, B; Kato, T; Emond, J C; Guarrera, J V

    2012-06-01

    In solid organ transplantation, the disparity between donor supply and patients awaiting transplant continues to increase. The organ shortage has led to relaxation of historic contraindications to organ donation. A large percentage of deceased organ donors have been subjected to traumatic injuries, which can often result in intervention that leads to abdominal packing and intensive care unit resuscitation. The donor with this "open abdomen" (OA) presents a situation in which the risk of organ utilization is difficult to quantify. There exists a concern for the potential of a higher risk for both bacterial and fungal infections, including multidrug-resistant (MDR) pathogens because of the prevalence of antibiotic use and critical illness in this population. No recommendations have been established for utilization of organs from these OA donors, because data are limited. Herein, we report a case of a 21-year-old donor who had sustained a gunshot wound to his abdomen, resulting in a damage-control laparotomy and abdominal packing. The donor subsequently suffered brain death, and the family consented to organ donation. A multiorgan procurement was performed with respective transplantation of the procured organs (heart, liver, and both kidneys) into 4 separate recipients. Peritoneal swab cultures performed at the time of organ recovery grew out MDR Pseudomonas aeruginosa on the day after procurement, subsequently followed by positive blood and sputum cultures as well. All 4 transplant recipients subsequently developed infections with MDR P. aeruginosa, which appeared to be donor-derived with similar resistance patterns. Appropriate antibiotic coverage was initiated in all of the patients. Although 2 of the recipients died, mortality did not appear to be clearly associated with the donor-derived infections. This case illustrates the potential infectious risk associated with organs from donors with an OA, and suggests that aggressive surveillance for occult infections

  15. The natural radiation background

    International Nuclear Information System (INIS)

    Duggleby, J.C.

    1982-01-01

    The components of the natural background radiation and their variations are described. Cosmic radiation is a major contributor to the external dose to the human body whilst naturally-occurring radionuclides of primordial and cosmogenic origin contribute to both the external and internal doses, with the primordial radionuclides being the major contributor in both cases. Man has continually modified the radiation dose to which he has been subjected. The two traditional methods of measuring background radiation, ionisation chamber measurements and scintillation counting, are looked at and the prospect of using thermoluminescent dosimetry is considered

  16. Effects of background radiation

    International Nuclear Information System (INIS)

    Knox, E.G.; Stewart, A.M.; Gilman, E.A.; Kneale, G.W.

    1987-01-01

    The primary objective of this investigation is to measure the relationship between exposure to different levels of background gamma radiation in different parts of the country, and different Relative Risks for leukaemias and cancers in children. The investigation is linked to an earlier analysis of the effects of prenatal medical x-rays upon leukaemia and cancer risk; the prior hypothesis on which the background-study was based, is derived from the earlier results. In a third analysis, the authors attempted to measure varying potency of medical x-rays delivered at different stages of gestation and the results supply a link between the other two estimates. (author)

  17. The cosmic microwave background

    International Nuclear Information System (INIS)

    Silk, J.

    1991-01-01

    Recent limits on spectral distortions and angular anisotropies in the cosmic microwave background are reviewed. The various backgrounds are described, and the theoretical implications are assessed. Constraints on inflationary cosmology dominated by cold dark matter (CDM) and on open cosmological models dominated by baryonic dark matter (BDM), with, respectively, primordial random phase scale-invariant curvature fluctuations or non-gaussian isocurvature fluctuations are described. More exotic theories are addressed, and I conclude with the 'bottom line': what theories expect experimentalists to be measuring within the next two to three years without having to abandon their most cherished theorists. (orig.)

  18. The Cosmic Background Explorer

    Science.gov (United States)

    Gulkis, Samuel; Lubin, Philip M.; Meyer, Stephan S.; Silverberg, Robert F.

    1990-01-01

    The Cosmic Background Explorer (CBE), NASA's cosmological satellite which will observe a radiative relic of the big bang, is discussed. The major questions connected to the big bang theory which may be clarified using the CBE are reviewed. The satellite instruments and experiments are described, including the Differential Microwave Radiometer, which measures the difference between microwave radiation emitted from two points on the sky, the Far-Infrared Absolute Spectrophotometer, which compares the spectrum of radiation from the sky at wavelengths from 100 microns to one cm with that from an internal blackbody, and the Diffuse Infrared Background Experiment, which searches for the radiation from the earliest generation of stars.

  19. Thermal background noise limitations

    Science.gov (United States)

    Gulkis, S.

    1982-01-01

    Modern detection systems are increasingly limited in sensitivity by the background thermal photons which enter the receiving system. Expressions for the fluctuations of detected thermal radiation are derived. Incoherent and heterodyne detection processes are considered. References to the subject of photon detection statistics are given.

  20. Berkeley Low Background Facility

    International Nuclear Information System (INIS)

    Thomas, K. J.; Norman, E. B.; Smith, A. R.; Poon, A. W. P.; Chan, Y. D.; Lesko, K. T.

    2015-01-01

    The Berkeley Low Background Facility (BLBF) at Lawrence Berkeley National Laboratory (LBNL) in Berkeley, California provides low background gamma spectroscopy services to a wide array of experiments and projects. The analysis of samples takes place within two unique facilities; locally within a carefully-constructed, low background laboratory on the surface at LBNL and at the Sanford Underground Research Facility (SURF) in Lead, SD. These facilities provide a variety of gamma spectroscopy services to low background experiments primarily in the form of passive material screening for primordial radioisotopes (U, Th, K) or common cosmogenic/anthropogenic products; active screening via neutron activation analysis for U,Th, and K as well as a variety of stable isotopes; and neutron flux/beam characterization measurements through the use of monitors. A general overview of the facilities, services, and sensitivities will be presented. Recent activities and upgrades will also be described including an overview of the recently installed counting system at SURF (recently relocated from Oroville, CA in 2014), the installation of a second underground counting station at SURF in 2015, and future plans. The BLBF is open to any users for counting services or collaboration on a wide variety of experiments and projects

  1. Discrimination and anatomical mapping of PET-positive lesions: comparison of CT attenuation-corrected PET images with coregistered MR and CT images in the abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Kuhn, Felix P.; Crook, David W.; Mader, Caecilia E.; Appenzeller, Philippe; Schulthess, G.K. von; Schmid, Daniel T. [University Hospital Zurich, Department of Medical Radiology, Zurich (Switzerland)

    2013-01-15

    PET/MR has the potential to become a powerful tool in clinical oncological imaging. The purpose of this prospective study was to evaluate the performance of a single T1-weighted (T1w) fat-suppressed unenhanced MR pulse sequence of the abdomen in comparison with unenhanced low-dose CT images to characterize PET-positive lesions. A total of 100 oncological patients underwent sequential whole-body {sup 18}F-FDG PET with CT-based attenuation correction (AC), 40 mAs low-dose CT and two-point Dixon-based T1w 3D MRI of the abdomen in a trimodality PET/CT-MR system. PET-positive lesions were assessed by CT and MRI with regard to their anatomical location, conspicuity and additional relevant information for characterization. From among 66 patients with at least one PET-positive lesion, 147 lesions were evaluated. No significant difference between MRI and CT was found regarding anatomical lesion localization. The MR pulse sequence used performed significantly better than CT regarding conspicuity of liver lesions (p < 0.001, Wilcoxon signed ranks test), whereas no difference was noted for extrahepatic lesions. For overall lesion characterization, MRI was considered superior to CT in 40 % of lesions, equal to CT in 49 %, and inferior to CT in 11 %. Fast Dixon-based T1w MRI outperformed low-dose CT in terms of conspicuity and characterization of PET-positive liver lesions and performed similarly in extrahepatic tumour manifestations. Hence, under the assumption that the technical issue of MR AC for whole-body PET examinations is solved, in abdominal PET/MR imaging the replacement of low-dose CT by a single Dixon-based MR pulse sequence for anatomical lesion correlation appears to be valid and robust. (orig.)

  2. Discrimination and anatomical mapping of PET-positive lesions: comparison of CT attenuation-corrected PET images with coregistered MR and CT images in the abdomen

    International Nuclear Information System (INIS)

    Kuhn, Felix P.; Crook, David W.; Mader, Caecilia E.; Appenzeller, Philippe; Schulthess, G.K. von; Schmid, Daniel T.

    2013-01-01

    PET/MR has the potential to become a powerful tool in clinical oncological imaging. The purpose of this prospective study was to evaluate the performance of a single T1-weighted (T1w) fat-suppressed unenhanced MR pulse sequence of the abdomen in comparison with unenhanced low-dose CT images to characterize PET-positive lesions. A total of 100 oncological patients underwent sequential whole-body 18 F-FDG PET with CT-based attenuation correction (AC), 40 mAs low-dose CT and two-point Dixon-based T1w 3D MRI of the abdomen in a trimodality PET/CT-MR system. PET-positive lesions were assessed by CT and MRI with regard to their anatomical location, conspicuity and additional relevant information for characterization. From among 66 patients with at least one PET-positive lesion, 147 lesions were evaluated. No significant difference between MRI and CT was found regarding anatomical lesion localization. The MR pulse sequence used performed significantly better than CT regarding conspicuity of liver lesions (p < 0.001, Wilcoxon signed ranks test), whereas no difference was noted for extrahepatic lesions. For overall lesion characterization, MRI was considered superior to CT in 40 % of lesions, equal to CT in 49 %, and inferior to CT in 11 %. Fast Dixon-based T1w MRI outperformed low-dose CT in terms of conspicuity and characterization of PET-positive liver lesions and performed similarly in extrahepatic tumour manifestations. Hence, under the assumption that the technical issue of MR AC for whole-body PET examinations is solved, in abdominal PET/MR imaging the replacement of low-dose CT by a single Dixon-based MR pulse sequence for anatomical lesion correlation appears to be valid and robust. (orig.)

  3. The Cosmic Microwave Background

    Directory of Open Access Journals (Sweden)

    Jones Aled

    1998-01-01

    Full Text Available We present a brief review of current theory and observations of the cosmic microwave background (CMB. New predictions for cosmological defect theories and an overview of the inflationary theory are discussed. Recent results from various observations of the anisotropies of the microwave background are described and a summary of the proposed experiments is presented. A new analysis technique based on Bayesian statistics that can be used to reconstruct the underlying sky fluctuations is summarised. Current CMB data is used to set some preliminary constraints on the values of fundamental cosmological parameters $Omega$ and $H_circ$ using the maximum likelihood technique. In addition, secondary anisotropies due to the Sunyaev-Zel'dovich effect are described.

  4. Incidence of seed migration to the chest, abdomen, and pelvis after transperineal interstitial prostate brachytherapy with loose 125I seeds

    International Nuclear Information System (INIS)

    Sugawara, Akitomo; Shigematsu, Naoyuki; Nakashima, Jun; Kunieda, Etsuo; Nagata, Hirohiko; Mizuno, Ryuichi; Seki, Satoshi; Shiraishi, Yutaka; Kouta, Ryuichi; Oya, Mototsugu

    2011-01-01

    The aim was to determine the incidence of seed migration not only to the chest, but also to the abdomen and pelvis after transperineal interstitial prostate brachytherapy with loose 125 I seeds. We reviewed the records of 267 patients who underwent prostate brachytherapy with loose 125 I seeds. After seed implantation, orthogonal chest radiographs, an abdominal radiograph, and a pelvic radiograph were undertaken routinely to document the occurrence and sites of seed migration. The incidence of seed migration to the chest, abdomen, and pelvis was calculated. All patients who had seed migration to the abdomen and pelvis subsequently underwent a computed tomography scan to identify the exact location of the migrated seeds. Postimplant dosimetric analysis was undertaken, and dosimetric results were compared between patients with and without seed migration. A total of 19,236 seeds were implanted in 267 patients. Overall, 91 of 19,236 (0.47%) seeds migrated in 66 of 267 (24.7%) patients. Sixty-nine (0.36%) seeds migrated to the chest in 54 (20.2%) patients. Seven (0.036%) seeds migrated to the abdomen in six (2.2%) patients. Fifteen (0.078%) seeds migrated to the pelvis in 15 (5.6%) patients. Seed migration occurred predominantly within two weeks after seed implantation. None of the 66 patients had symptoms related to the migrated seeds. Postimplant prostate D90 was not significantly different between patients with and without seed migration. We showed the incidence of seed migration to the chest, abdomen and pelvis. Seed migration did not have a significant effect on postimplant prostate D90

  5. Independent predictors of enteric fistula and abdominal sepsis after damage control laparotomy: results from the prospective AAST Open Abdomen registry.

    Science.gov (United States)

    Bradley, Matthew J; Dubose, Joseph J; Scalea, Thomas M; Holcomb, John B; Shrestha, Binod; Okoye, Obi; Inaba, Kenji; Bee, Tiffany K; Fabian, Timothy C; Whelan, James F; Ivatury, Rao R

    2013-10-01

    Enterocutaneous fistula (ECF), enteroatmospheric fistula (EAF), and intra-abdominal sepsis/abscess (IAS) are major challenges for surgeons caring for patients undergoing damage control laparotomy after trauma. To determine independent predictors of ECF, EAF, or IAS in patients undergoing damage control laparotomy after trauma, using the AAST Open Abdomen Registry. The AAST Open Abdomen registry of patients with an open abdomen following damage control laparotomy was used to identify patients who developed ECF, EAF, or IAS and to compare these patients with those without these complications. Univariate analyses were performed to compare these groups of patients. Variables from univariate analyses differing at P IAS. Fourteen level I trauma centers. A total of 517 patients with an open abdomen following damage control laparotomy. Complication of ECF, EAF, or IAS. More patients in the ECF/EAF/IAS group than in the group without these complications underwent bowel resection (63 of 111 patients [57%] vs 133 of 406 patients [33%]; P 48 hours after surgery, the ECF/EAF/IAS group received more colloids (P IAS group underwent almost twice as many abdominal reexplorations as did the group without these complications (mean [SD] number, 4.1 [4.1] vs 2.2 [3.4]; P IAS were a large bowel resection (adjusted odds ratio [AOR], 3.56 [95% CI, 1.88-6.76]; P 48 hours of between 5 and 10 L (AOR, 2.11 [95% CI, 1.15-3.88]; P = .02) or more than 10 L (AOR, 1.93 [95% CI, 1.04-3.57]; P = .04), and an increasing number of reexplorations (AOR, 1.14 [95% CI, 1.06-1.21]; P IAS in patients with an open abdomen after damage control laparotomy.

  6. Multidendritic sensory neurons in the adult Drosophila abdomen: origins, dendritic morphology, and segment- and age-dependent programmed cell death

    Directory of Open Access Journals (Sweden)

    Sugimura Kaoru

    2009-10-01

    Full Text Available Abstract Background For the establishment of functional neural circuits that support a wide range of animal behaviors, initial circuits formed in early development have to be reorganized. One way to achieve this is local remodeling of the circuitry hardwiring. To genetically investigate the underlying mechanisms of this remodeling, one model system employs a major group of Drosophila multidendritic sensory neurons - the dendritic arborization (da neurons - which exhibit dramatic dendritic pruning and subsequent growth during metamorphosis. The 15 da neurons are identified in each larval abdominal hemisegment and are classified into four categories - classes I to IV - in order of increasing size of their receptive fields and/or arbor complexity at the mature larval stage. Our knowledge regarding the anatomy and developmental basis of adult da neurons is still fragmentary. Results We identified multidendritic neurons in the adult Drosophila abdomen, visualized the dendritic arbors of the individual neurons, and traced the origins of those cells back to the larval stage. There were six da neurons in abdominal hemisegment 3 or 4 (A3/4 of the pharate adult and the adult just after eclosion, five of which were persistent larval da neurons. We quantitatively analyzed dendritic arbors of three of the six adult neurons and examined expression in the pharate adult of key transcription factors that result in the larval class-selective dendritic morphologies. The 'baseline design' of A3/4 in the adult was further modified in a segment-dependent and age-dependent manner. One of our notable findings is that a larval class I neuron, ddaE, completed dendritic remodeling in A2 to A4 and then underwent caspase-dependent cell death within 1 week after eclosion, while homologous neurons in A5 and in more posterior segments degenerated at pupal stages. Another finding is that the dendritic arbor of a class IV neuron, v'ada, was immediately reshaped during post

  7. Comparison of virtual unenhanced CT images of the abdomen under different iodine flow rates.

    Science.gov (United States)

    Li, Yongrui; Li, Ye; Jackson, Alan; Li, Xiaodong; Huang, Ning; Guo, Chunjie; Zhang, Huimao

    2017-01-01

    To assess the effect of varying iodine flow rate (IFR) and iodine concentration on the quality of virtual unenhanced (VUE) images of the abdomen obtained with dual-energy CT. 94 subjects underwent unenhanced and triphasic contrast-enhanced CT scan of the abdomen, including arterial phase, portal venous phase, and delayed phase using dual-energy CT. Patients were randomized into 4 groups with different IFRs or iodine concentrations. VUE images were generated at 70 keV. The CT values, image noise, SNR and CNR of aorta, portal vein, liver, liver lesion, pancreatic parenchyma, spleen, erector spinae, and retroperitoneal fat were recorded. Dose-length product and effective dose for an examination with and without plain phase scan were calculated to assess the potential dose savings. Two radiologists independently assessed subjective image quality using a five-point scale. The Kolmogorov-Smirnov test was used first to test for normal distribution. Where data conformed to a normal distribution, analysis of variance was used to compare mean HU values, image noise, SNRs and CNRs for the 4 image sets. Where data distribution was not normal, a nonparametric test (Kruskal-Wallis test followed by stepwise step-down comparisons) was used. The significance level for all tests was 0.01 (two-sided) to allow for type 2 errors due to multiple testing. The CT numbers (HU) of VUE images showed no significant differences between the 4 groups (p > 0.05) or between different phases within the same group (p > 0.05). VUE images had equal or higher SNR and CNR than true unenhanced images. VUE images received equal or lower subjective image quality scores than unenhanced images but were of acceptable quality for diagnostic use. Calculated dose-length product and estimated dose showed that the use of VUE images in place of unenhanced images would be associated with a dose saving of 25%. VUE images can replace conventional unenhanced images. VUE images are not affected by varying iodine

  8. Study of dosimetric quantities and image quality in pediatric examinations of chest and abdomen computed tomography

    International Nuclear Information System (INIS)

    Jornada, Tiago da Silva

    2013-01-01

    This work had the objective to achieve the knowledge of the dosimetric quantities related to chest and abdomen computed tomography (CT) examinations of pediatric patients, in Belo Horizonte city. The reason of this work is based on the fact that the probability of health detriment in children, which it may be caused by radiation, is higher than in adults. Besides, although in many countries the knowledge and control of patient doses is a normal procedure, this safety culture does not exist in Brazil. Another objective of this work was to compare the dosimetric quantity values with the Diagnostic Reference Levels (DRLs); when it was needed, an optimization process was applied and the quality of the diagnostic image obtained with the optimized technical parameters was analyzed. This study was carried out in five hospitals, where the weighted air kerma index (Cw), the volumetric air kerma index (Cvol), the air kerma - length product (PKL,CT), the Effective Dose (E) and the Normalized Effective Dose (En) were determined; three methods were adopted for measurements: the ionization chamber inside a chest pediatric phantom, radiochromic films and the CT-EXPO software. The optimization process was applied to a single hospital through variations in the current (mA) and voltage (kV) of the x-ray tube for the protocols used for abdomen CT examinations. The analysis of the quality of the diagnostic image was done by Normal Distribution and ROC analysis; spatial resolution analysis was used through MTF determination and the noise level was judged in terms quantitative and qualitative. Results of the dosimetric quantities showed that they significantly differed between single-slice and multi-slice tomography units, but their values were always below the recommended DRLs. The optimized values of the dosimetric quantities obtained after the optimization process showed that it was possible to reduce the radiation exposure of pediatric patient without losing the image quality

  9. Family Background and Entrepreneurship

    DEFF Research Database (Denmark)

    Lindquist, Matthew J.; Sol, Joeri; Van Praag, Mirjam

    Vast amounts of money are currently being spent on policies aimed at promoting entrepreneurship. The success of such policies, however, rests in part on the assumption that individuals are not ‘born entrepreneurs’. In this paper, we assess the importance of family background and neighborhood...... effects as determinants of entrepreneurship. We start by estimating sibling correlations in entrepreneurship. We find that between 20 and 50 percent of the variance in different entrepreneurial outcomes is explained by factors that siblings share. The average is 28 percent. Allowing for differential...... entrepreneurship does play a large role, as do shared genes....

  10. Malaysia; Background Paper

    OpenAIRE

    International Monetary Fund

    1996-01-01

    This Background Paper on Malaysia examines developments and trends in the labor market since the mid-1980s. The paper describes the changes in the employment structure and the labor force. It reviews wages and productivity trends and their effects on unit labor cost. The paper highlights that Malaysia’s rapid growth, sustained since 1987, has had a major impact on the labor market. The paper outlines the major policy measures to address the labor constraints. It also analyzes Malaysia’s recen...

  11. Fine focal spot size improves image quality in computed tomography abdomen and pelvis

    Energy Technology Data Exchange (ETDEWEB)

    Goh, Yin P.; Low, Keat; Kuganesan, Ahilan [Monash Health, Diagnostic Imaging Department, 246, Clayton Road, Clayton, Victoria (Australia); Lau, Kenneth K. [Monash Health, Diagnostic Imaging Department, 246, Clayton Road, Clayton, Victoria (Australia); Monash University, Department of Medicine, Faculty of Medicine, Nursing and Health Sciences, Victoria (Australia); Buchan, Kevin [Philips Healthcare, Clinical Science, PO Box 312, Mont Albert, Victoria (Australia); Oh, Lawrence Chia Wei [Flinders Medical Centre, Division of Medical Imaging, Bedford Park South (Australia); Huynh, Minh [Swinburne University, Department of Statistics, Data Science and Epidemiology, School of Health Sciences, Faculty of Health, Arts and Design, Hawthorn (Australia)

    2016-12-15

    To compare the image quality between fine focal spot size (FFSS) and standard focal spot size (SFSS) in computed tomography of the abdomen and pelvis (CTAP) This retrospective review included all consecutive adult patients undergoing contrast-enhanced CTAP between June and September 2014. Two blinded radiologists assessed the margin clarity of the abdominal viscera and the detected lesions using a five-point grading scale. Cohen's kappa test was used to examine the inter-observer reliability between the two reviewers for organ margin clarity. Mann-Whitney U testing was utilised to assess the statistical difference of the organ and lesion margin clarity. 100 consecutive CTAPs were recruited. 52 CTAPs were examined with SFSS of 1.1 x 1.2 mm and 48 CTAPs were examined with FFSS of 0.6 x 0.7 mm. Results showed that there was substantial agreement for organ margin clarity (mean κ = 0.759, p < 0.001) among the reviewers. FFSS produces images with clearer organ margins (U = 76194.0, p < 0.001, r = 0.523) and clearer lesion margins (U = 239, p = 0.052, r = 0.269). FFSS CTAP improves image quality in terms of better organ and lesion margin clarity. Fine focus CT scanning is a novel technique that may be applied in routine CTAP imaging. (orig.)

  12. A Rare Cause of Acute Abdomen: Urinary Bladder Rupture due to Foley Catheter

    Directory of Open Access Journals (Sweden)

    Ömer Engin

    2013-07-01

    Full Text Available Urinary bladder rupture is usually found due to blunt or penetrating traumas and iatrogenic injuries, and spontaneous intraperitoneal perforation is very rare. 57 years old male patient was consulted to general surgery department due to abdominal pain, nausia-vomiting and fever. He had Diabetes Mellitus, Multiple Sclerosis, Leriche Syndrome and operation for benign prostatic hypertrophy 5 years ago on his medical history which the case catheterised him urinary bladder himself frequently in nonsterile conditions. He did not care about sterility. On physical examination, suprapubic defence and rebound was noted more prominently on right lower quadrant. He was taken to operating room with the diagnosis of acute abdomen. On exploration, infection was seen on all layers of the whole urinary bladder, abscess formation and necrosis causing a microperforation which is detected by methylene blue was also present. Intraabdominal abscess drainage, cystostomy and primary suturing of the urinary bladder was performed. Patient died due to sepsis at the 9.th post operative day.

  13. INTRA-ABDOMINAL INFECTION AND ACUTE ABDOMEN-EPIDEMIOLOGY, DIAGNOSIS AND GENERAL PRINCIPLES OF SURGICAL MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Jovanović Dušan

    2015-03-01

    Full Text Available Intra-abdominal infections are multifactorial and present an complex inflammatory response of the peritoneum to microorganisms followed by exudation in the abdominal cavity and systemic response Despite advances in management and critical care of patients with acute generalized peritonitis due to hollow viscus perforation, prognosis is still very poor, with high mortality rate. Early detection and adequate treatment is essential to minimize complications in the patient with acute abdomen. Prognostic evaluation of complicated IAI by modern scoring systems is important to assess the severity and the prognosis of the disease. Control of the septic source can be achieved either by nonoperative or operative means. Nonoperative interventional procedures include percutaneous drainages of abscesses. The management of primary peritonitis is non-surgical and antibiotic- treatment. The management of secondary peritonitis include surgery to control the source of infection, removal of toxins, bacteria, and necrotic tissue, antibiotic therapy, supportive therapy and nutrition. "Source control" is sine qua non of success and adequate surgical procedure involves closure or resection of any openings into the gastrointestinal tract, resection of inflamed tissue and drainage of all abdominal and pelivic collections.

  14. Treatments and other prognostic factors in the management of the open abdomen: A systematic review.

    Science.gov (United States)

    Cristaudo, Adam T; Jennings, Scott B; Hitos, Kerry; Gunnarsson, Ronny; DeCosta, Alan

    2017-02-01

    The open abdomen (OA) is an important approach for managing intra-abdominal catastrophes and continues to be the standard of care. Despite this, challenges remain with it associated with a high incidence of complications and poor outcomes. The objective of this article is to perform a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify prognostic factors in OA patients in regard to definitive fascial closure (DFC), mortality and intra-abdominal complications. An electronic database search was conducted involving Medline, Excerpta Medica, Central Register of Controlled Trials, Cumulative Index to Nursing, and Allied Health Literature and Clinicaltrials.gov. All studies that described prognostic factors in regard to the above outcomes in OA patients were eligible for inclusion. Data collected were synthesized by each outcome of interest and assessed for methodological quality. Thirty-one studies were included in the final synthesis. Enteral nutrition, organ dysfunction, local and systemic infection, number of reexplorations, worsening Injury Severity Score, and the development of a fistula appeared to significantly delay DFC. Age and Adult Physiology And Chronic Health Evaluation version II score were predictors for in-hospital mortality. Failed DFC, large bowel resection and >5 to 10 L of intravenous fluids in 5 to 10 and >10 L of intravenous fluids in management of OA patients will avoid prolonged treatment and facilitate early DFC. Future research should focus on the development of a prognostic model. Systematic review, level III.

  15. Improved regression models for ventilation estimation based on chest and abdomen movements

    International Nuclear Information System (INIS)

    Liu, Shaopeng; Gao, Robert; He, Qingbo; Staudenmayer, John; Freedson, Patty

    2012-01-01

    Non-invasive estimation of minute ventilation is important for quantifying the intensity of physical activity of individuals. In this paper, several improved regression models are presented, based on the measurement of chest and abdomen movements from sensor belts worn by subjects (n = 50) engaged in 14 types of physical activity. Five linear models involving a combination of 11 features were developed, and the effects of different model training approaches and window sizes for computing the features were investigated. The performance of the models was evaluated using experimental data collected during the physical activity protocol. The predicted minute ventilation was compared to the criterion ventilation measured using a bidirectional digital volume transducer housed in a respiratory gas exchange system. The results indicate that the inclusion of breathing frequency and the use of percentile points instead of interdecile ranges over a 60 s window size reduced error by about 43%, when applied to the classical two-degrees-of-freedom model. The mean percentage error of the minute ventilation estimated for all the activities was below 7.5%, verifying reasonably good performance of the models and the applicability of the wearable sensing system for minute ventilation estimation during physical activity. (paper)

  16. An Experience of an Individual With a Chronic Wound in an Open Abdomen: A Grounded Theory.

    Science.gov (United States)

    Fuentes-Ramírez, Alejandra

    2017-06-01

    The open abdomen (OA) surgical technique has become an option for treating complex abdominal injuries; however, complications leading to late closure conditions might arise. In these cases the wound must be left open, which greatly impacts the patient's life. The author aims to describe the experiences of individuals with a chronic OA wound. Qualitative design using grounded theory was utilized. This study was carried out with a group of 28 adults who were treated with OA technique and whose wound had remained open for more than a month in duration and only received outpatient wound care. Data were collected through open interviews and examined under continuous comparison. The average age of the respondents was 45 years, and their wound, treated with OA due to severe abdominal infection, remained open between 2 months and 8 years. An emergent theory was developed to describe how people facing this experience undergo a process of 4 stages: 1) finding an OA wound upon waking, 2) feeling desperate about the healing process and the limitations involved, 3) regaining control of their life, and 4) taking advantage of their second chance at life with an OA wound. This study provides insight for nurses and other health care professionals into the experiences of patients with a chronic OA wound and proposes an emerging theory based on the conceptualization of these experiences.

  17. Multidetector CT of blunt traumatic venous injuries in the chest, abdomen, and pelvis.

    Science.gov (United States)

    Holly, Brian P; Steenburg, Scott D

    2011-01-01

    Venous injuries as a result of blunt trauma are rare. Even though current protocols for multidetector computed tomography (CT) of patients with trauma are designed to evaluate primarily the solid organs and arteries, blunt venous injuries may nevertheless be identified, or at least suspected, on the basis of the multidetector CT findings. Venous injuries are associated with high morbidity and mortality rates. Diagnosis of a possible venous injury is crucial because the physical findings of a venous injury are nonspecific and may be absent. This article aims to make the radiologist aware of various venous injuries caused by blunt trauma and to provide helpful hints to aid in the identification of venous injuries. Multidetector CT technology, in combination with interactive manipulation of the raw dataset, can be useful in the creation of multiplanar reconstructed images and in the identification of a venous injury caused by blunt trauma. Familiarity with direct and indirect signs of venous injuries, as well as with examples of blunt traumatic venous injuries in the chest, abdomen, and pelvis, will help in the diagnosis of these injuries.

  18. The open abdomen and temporary abdominal closure systems--historical evolution and systematic review.

    Science.gov (United States)

    Quyn, A J; Johnston, C; Hall, D; Chambers, A; Arapova, N; Ogston, S; Amin, A I

    2012-08-01

    Several techniques for temporary abdominal closure have been developed. We systematically review the literature on temporary abdominal closure to ascertain whether the method can be tailored to the indication. Medline, Embase, the Cochrane Central Register of Controlled Trials and relevant meeting abstracts until December 2009 were searched using the following headings: open abdomen, laparostomy, VAC (vacuum assisted closure), TNP (topical negative pressure), fascial closure, temporary abdominal closure, fascial dehiscence and deep wound dehiscence. The data were analysed by closure technique and aetiology. The primary end-points included delayed fascial closure and in-hospital mortality. The secondary end-points were intra-abdominal complications. The search identified 106 papers for inclusion. The techniques described were VAC (38 series), mesh/sheet (30 series), packing (15 series), Wittmann patch (eight series), Bogotá bag (six series), dynamic retention sutures (three series), zipper (15 series), skin only and locking device (one series each). The highest facial closure rates were seen with the Wittmann patch (78%), dynamic retention sutures (71%) and VAC (61%). Temporary abdominal closure has evolved from simple packing to VAC based systems. In the absence of sepsis Wittmann patch and VAC offered the best outcome. In its presence VAC had the highest delayed primary closure and the lowest mortality rates. However, due to data heterogeneity only limited conclusions can be drawn from this analysis. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

  19. Childhood motocross truncal injuries: high-velocity, focal force to the chest and abdomen

    Science.gov (United States)

    Kennedy, Raelene D; Potter, D Dean; Osborn, John B; Zietlow, Scott; Zarroug, Abdalla E; Moir, Christopher R; Ishitani, Michael B; McIntosh, Amy

    2012-01-01

    Objectives To review the need for operative intervention and critical care services for motocross truncal injuries in children. Design cohort Retrospective review of patients identified via the hospital trauma registry. Setting Our Level 1 Pediatric Trauma Center serves five motocross tracks. These patients require frequent medical care for injuries. Participants All patients ≤17 years of age with truncal injuries sustained during motocross activities, between 2000 and 2011, were identified through the trauma registry. Primary and secondary outcome measures Operative intervention, intensive care unit (ICU) admission, length of stay, morbidity and demographics were reviewed. Results Motocross injured 162 children. Thirty (18.5%) were thoracic or abdominal injuries. Operative intervention was required in eight (27%) patients. Mean injury severity score (ISS) was 11.8. ICU admission was required in 50% and average hospital length of stay was 4.1 days. The most common injuries include pulmonary contusion, pneumothorax, spleen and liver lacerations. 13% of subjects suffered truncal injury from motocross on more than one occasion. Conclusions Paediatric motocross-related truncal injuries are significant. Surgical intervention is required in 27% of patients. The lower ISS incurred from motocross combined with high surgical and ICU admission rates suggests focal high-impact injuries to the chest and abdomen. Despite significant injury, 13% of motocross patients suffer recurrent injuries. Parents and children need injury prevention education. PMID:23166134

  20. First identification of nanoparticles on thorax, abdomen and wings of the worker bee Apis dorsata Fabricius

    Directory of Open Access Journals (Sweden)

    Bhattacharyya Atanu

    2016-06-01

    Full Text Available The presence of nanoparticles on the body of the honeybee Apis dorsata Fabricius, was investigated for the first time to better understand the bee’s behaviour. These have been observed by using Scanning Electron Microscopy (SEM, Transmission Electron Microscopy (TEM and confirmed by Atomic Force Microscopy (AFM. Our study clearly denotes that the Indian rock honey bee Apis dorsata possess calcium silicate and calcium phosphate nanoparticles on its body surface of 5-50 nm in diameter. In particular, the nanoparticles on the abdomen and thorax of A. dorsata have an average diameter of about 10 nanometers and they are smaller than those found on wings of the same bees which are about 20 nanometers. The nanoparticles found are different of the ones previously observed on honey bees or other insects. The origin and role of these natural nanoparticles on the body of the Indian rock bee need to be to be further investigated; more research in the subject might raise important aspects in relation to the conservation of these unique pollinators.

  1. Evaluation of the usefulness and validity of imaging diagnosis for acute abdomen

    International Nuclear Information System (INIS)

    Sakai, Takehiro; Sudo, Yasuhiro

    2007-01-01

    We retrospectively evaluated the usefulness and validity of imaging diagnosis for acute abdomens. Sixty-one patients who had complained of acute abdominal pain upon hospital admittance were and divided into four groups according to the diagnostic imaging modalities that were used: X-ray alone (X-P group, n=11), ultrasonography (US group, n=12), computed tomography (CT group, n=14), and both ultrasonography and CT (US/CT group, n=24). The diagnosis made at the time of admission was also evaluated, and the patients were divided into three groups and analyzed statistically: bowel obstructions (bowel obstruction group, n=20), acute appendicitis or other diseases necessitating a differential diagnosis (appendicitis group, n=35), and perforations of the digestive tract (perforation group, n=6). X-ray and CT examinations were useful for making a diagnosis in the bowel obstruction and perforation groups. Ultrasonography was regarded as important in the appendicitis group. The accuracy of the diagnosis made upon admission was 95.0% in the bowel obstruction group, 88.6 % in the appendicitis group, and 100 % in the perforation group. Although a prospective evaluation is necessary, CT appears to be useful for diagnosing bowel obstructions and perforations of the digestive tract. Although ultrasonography is useful for diagnosing acute appendicitis, CT is recommended in patients in whom a differential diagnosis is difficult to obtain. (author)

  2. Giant Inflammatory Fibroid Polyp of the Hepatic Flexure of Colon Presenting with an Acute Abdomen

    Directory of Open Access Journals (Sweden)

    Ashish Lal Shrestha

    2016-01-01

    Full Text Available Background. Inflammatory Fibroid Polyp (IFP of the colon is an exceedingly rare condition. Since 1952 till now only 32 cases have been reported worldwide of which only 5 were giant (>4 cm polyps mostly found in the caecum (15 cases with only 3 in the descending colon. Case Presentation. A 36-year-old female with no previous illness presented to the emergency unit with an acute onset pain over the right hypochondrium for 3 days associated with intermittent fever and anorexia. As she had evidence of localized peritonitis she underwent a diagnostic laparoscopy and subsequently an exploratory laparotomy. A mass measuring 8 × 7 × 5 cm arising from the hepatic flexure of colon was noted. Right hemicolectomy with ileotransverse anastomosis was performed. The mass was subsequently reported to be IFP. Conclusion. IFP is a very rare condition with clinical presentation depending upon its size and location. Definitive diagnosis is possible with histopathological examination of tissue aided by immunohistochemical studies. Surgical resection has been the most common method of treatment especially for large and giant colonic IFPs owing to challenges in terms of diagnosis and technical difficulties associated with endoscopic methods.

  3. Backgrounded but not peripheral

    DEFF Research Database (Denmark)

    Hovmark, Henrik

    2013-01-01

    .e. the schema enters into apparently contradictory constructions of the informants’ local home-base and, possibly, of their identity (cf. Hovmark, 2010). Second, I discuss the status and role of the specific linguistic category in question, i.e. the directional adverbs. On the one hand we claim that the DDAs......In this paper I pay a closer look at the use of the CENTRE-PERIPHERY schema in context. I address two specific issues: first, I show how the CENTRE-PERIPHERY schema, encoded in the DDAs, enters into discourses that conceptualize and characterize a local community as both CENTRE and PERIPHERY, i......; furthermore, the DDAs are backgrounded in discourse. Is it reasonable to claim, rather boldly, that “the informants express their identity in the use of the directional adverb ud ‘out’ etc.”? In the course of this article, however, I suggest that the DDAs in question do contribute to the socio...

  4. OCRWM Backgrounder, January 1987

    International Nuclear Information System (INIS)

    1987-01-01

    The Nuclear Waste Policy Act of 1982 (NWPA) assigns to the US Department of Energy (DOE) responsibility for developing a system to safely and economically transport spent nuclear fuel and high-level radioactive waste from various storage sites to geologic repositories or other facilities that constitute elements of the waste management program. This transportation system will evolve from technologies and capabilities already developed. Shipments of spent fuel to a monitored retrievable storage (MRS) facility could begin as early as 1996 if Congress authorizes its construction. Shipments of spent fuel to a geologic repository are scheduled to begin in 1998. The backgrounder provides an overview of DOE's cask development program. Transportation casks are a major element in the DOE nuclear waste transportation system because they are the primary protection against any potential radiation exposure to the public and transportation workers in the event an accident occurs

  5. Monitored background radiometer

    International Nuclear Information System (INIS)

    Ruel, C.

    1988-01-01

    A monitored background radiometer is described comprising: a thermally conductive housing; low conductivity support means mounted on the housing; a sensing plate mounted on the low conductivity support means and spaced from the housing so as to be thermally insulated from the housing and having an outwardly facing first surface; the sensing plate being disposed relative to the housing to receive direct electromagnetic radiation from sources exterior to the radiometer upon the first surface only; means for controllably heating the sensing plate; first temperature sensitive means to measure the temperature of the housing; and second temperature sensitive means to measure the temperature of the sensing plate, so that the heat flux at the sensing plate may be determined from the temperatures of the housing and sensing plate after calibration of the radiometer by measuring the temperatures of the housing and sensing plate while controllably heating the sensing plate

  6. Simulated Online Adaptive Magnetic Resonance–Guided Stereotactic Body Radiation Therapy for the Treatment of Oligometastatic Disease of the Abdomen and Central Thorax: Characterization of Potential Advantages

    Energy Technology Data Exchange (ETDEWEB)

    Henke, Lauren; Kashani, Rojano; Yang, Deshan; Zhao, Tianyu; Green, Olga; Olsen, Lindsey; Rodriguez, Vivian; Wooten, H. Omar; Li, H. Harold; Hu, Yanle; Bradley, Jeffrey; Robinson, Clifford; Parikh, Parag; Michalski, Jeff; Mutic, Sasa [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Olsen, Jeffrey R., E-mail: Jeffrey.R.Olsen@ucdenver.edu [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)

    2016-12-01

    Purpose: To characterize potential advantages of online-adaptive magnetic resonance (MR)-guided stereotactic body radiation therapy (SBRT) to treat oligometastatic disease of the non-liver abdomen and central thorax. Methods and Materials: Ten patients treated with RT for unresectable primary or oligometastatic disease of the non-liver abdomen (n=5) or central thorax (n=5) underwent imaging throughout treatment on a clinical MR image guided RT system. The SBRT plans were created on the basis of tumor/organ at risk (OAR) anatomy at initial computed tomography simulation (P{sub I}), and simulated adaptive plans were created on the basis of observed MR image set tumor/OAR “anatomy of the day” (P{sub A}). Each P{sub A} was planned under workflow constraints to simulate online-adaptive RT. Prescribed dose was 50 Gy/5 fractions, with goal coverage of 95% planning target volume (PTV) by 95% of the prescription, subject to hard OAR constraints. The P{sub I} was applied to each MR dataset and compared with P{sub A} to evaluate changes in dose delivered to tumor/OARs, with dose escalation when possible. Results: Hard OAR constraints were met for all P{sub Is} based on anatomy from initial computed tomography simulation, and all P{sub As} based on anatomy from each daily MR image set. Application of the P{sub I} to anatomy of the day caused OAR constraint violation in 19 of 30 cases. Adaptive planning increased PTV coverage in 21 of 30 cases, including 14 cases in which hard OAR constraints were violated by the nonadaptive plan. For 9 P{sub A} cases, decreased PTV coverage was required to meet hard OAR constraints that would have been violated in a nonadaptive setting. Conclusions: Online-adaptive MRI-guided SBRT may allow PTV dose escalation and/or simultaneous OAR sparing compared with nonadaptive SBRT. A prospective clinical trial is underway at our institution to evaluate clinical outcomes of this technique.

  7. Advantages and disadvantages of using non-coplanar techniques in radiotherapy of the abdomen formed 3D; Ventajas e inconvenientes del uso de tecnicas con coplanares en radiaoterpia 3D conformada de abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Urena Llinares, A.; Castro Ramirez, I.; Iborra Oquendo, M. A; Quinones Rodriguez, L. A.; Angulo Pain, E.

    2011-07-01

    3D Radiotherapy locations abdomen, especially in pancreas and stomach cancers is often extremely difficult if we are to meet the dose constraints to organs at risk due to proximity and many of these (liver, kidneys, intestines, lungs, bone. ..). Of these, the most critical are the kidneys, which also present values of tolerance, in most cases difficult to meet. This is done in our hospital are using non-coplanar techniques performing well both as coating PTV dose to both kidneys.

  8. Background dose subtraction in personnel dosimetry

    International Nuclear Information System (INIS)

    Picazo, T.; Llorca, N.; Alabau, J.

    1997-01-01

    In this paper it is proposed to consider the mode of the frequency distribution of the low dose dosemeters from each clinic that uses X rays as the background environmental dose that should be subtracted from the personnel dosimetry to evaluate the doses due to practice. The problems and advantages of this indirect method to estimate the environmental background dose are discussed. The results for 60 towns are presented. (author)

  9. Low background infrared (LBIR) facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Low background infrared (LBIR) facility was originally designed to calibrate user supplied blackbody sources and to characterize low-background IR detectors and...

  10. Hanford Site background: Part 1, Soil background for nonradioactive analytes

    International Nuclear Information System (INIS)

    1993-04-01

    Volume two contains the following appendices: Description of soil sampling sites; sampling narrative; raw data soil background; background data analysis; sitewide background soil sampling plan; and use of soil background data for the detection of contamination at waste management unit on the Hanford Site

  11. Unusual cause of acute abdomen in a child--torsion of greater omentum: report of two cases.

    Science.gov (United States)

    Pogorelić, Zenon; Katić, Josip; Gudelj, Karla; Mrklić, Ivana; Vilović, Katarina; Perko, Zdravko

    2015-08-01

    Torsion of the omentum is twisting along its long axis and a rare cause of acute abdomen. Depending on associated conditions, it is classified as primary and secondary. It may mimic different pathologies presenting as acute abdomen, most common of them being acute appendicitis. Current choice for management of omental torsion is laparoscopic surgery. We present two cases of omental torsion of two boys who presented with abdominal pain, nausea and vomiting and underwent emergency laparoscopy. Omental torsion is very rare, and its diagnosis is usually made only after surgery. At laparoscopy, omental torsion is suspected when the appendix is normal and the symptoms and findings of torsion are present. Laparoscopy is a safe and effective approach for the diagnosis and management of omental torsion, with the advantages of reduced postoperative pain and hospital stay. © The Author(s) 2015.

  12. Can vacuum-assisted closure and instillation therapy (VAC-Instill therapy) play a role in the treatment of the infected open abdomen?

    Science.gov (United States)

    D'Hondt, M; D'Haeninck, A; Dedrye, L; Penninckx, F; Aerts, R

    2011-03-01

    Severe superimposed infection during open abdomen treatment with development of intra-abdominal sepsis is a challenging complication associated with high mortality rates. We report our experience with VAC-Instill therapy (KCI, San Antonio, USA) used for treatment of an infected open abdomen following pancreatic surgery. A literature search revealed no analogous case reports using VAC-Instill therapy for treatment of an infected laparostomy. The encouraging result of the case presented seems to indicate that VAC-Instill therapy could be used as adjunctive treatment in the management of the infected open abdomen when traditional therapy fails to control the infection.

  13. Accuracy of Focused Assessment with Sonography for Trauma (FAST) in Blunt Trauma Abdomen-A Prospective Study.

    Science.gov (United States)

    Kumar, Subodh; Bansal, Virinder Kumar; Muduly, Dillip Kumar; Sharma, Pawan; Misra, Mahesh C; Chumber, Sunil; Singh, Saraman; Bhardwaj, D N

    2015-12-01

    Focused assessment with sonography for trauma (FAST) is a limited ultrasound examination, primarily aimed at the identification of the presence of free intraperitoneal or pericardial fluid. In the context of blunt trauma abdomen (BTA), free fluid is usually due to hemorrhage, bowel contents, or both; contributes towards the timely diagnosis of potentially life-threatening hemorrhage; and is a decision-making tool to help determine the need for further evaluation or operative intervention. Fifty patients with blunt trauma abdomen were evaluated prospectively with FAST. The findings of FAST were compared with contrast-enhanced computed tomography (CECT), laparotomy, and autopsy. Any free fluid in the abdomen was presumed to be hemoperitoneum. Sonographic findings of intra-abdominal free fluid were confirmed by CECT, laparotomy, or autopsy wherever indicated. In comparing with CECT scan, FAST had a sensitivity, specificity, and accuracy of 77.27, 100, and 79.16 %, respectively, in the detection of free fluid. When compared with surgical findings, it had a sensitivity, specificity, and accuracy of 94.44, 50, and 90 %, respectively. The sensitivity of FAST was 75 % in determining free fluid in patients who died when compared with autopsy findings. Overall sensitivity, specificity, and accuracy of FAST were 80.43, 75 and 80 %, respectively, for the detection of free fluid in the abdomen. From this study, we can safely conclude that FAST is a rapid, reliable, and feasible investigation in patients with BTA, and it can be performed easily, safely, and quickly in the emergency room with a reasonable sensitivity, specificity, and accuracy. It helps in the initial triage of patients for assessing the need for urgent surgery.

  14. Advantages and disadvantages of using non-coplanar techniques in radiotherapy of the abdomen formed 3D

    International Nuclear Information System (INIS)

    Urena Llinares, A.; Castro Ramirez, I.; Iborra Oquendo, M. A; Quinones Rodriguez, L. A.; Angulo Pain, E.

    2011-01-01

    3D Radiotherapy locations abdomen, especially in pancreas and stomach cancers is often extremely difficult if we are to meet the dose constraints to organs at risk due to proximity and many of these (liver, kidneys, intestines, lungs, bone. ..). Of these, the most critical are the kidneys, which also present values of tolerance, in most cases difficult to meet. This is done in our hospital are using non-coplanar techniques performing well both as coating PTV dose to both kidneys.

  15. Attainment of dosimetric pediatrics grandeur to computed tomography examinations of the abdomen

    International Nuclear Information System (INIS)

    Jormada, Tiago S.

    2013-01-01

    Currently, 10% of all computerized tomography exams (CT) are made in pediatric patients. In developed countries, the practice of obtaining the dosimetric quantities (weighted index dose C w , index air kerma volumetric C vol product kerma-length P KL , CT ) and effective dose (E) in pediatric CT scans is common. In Brazil, data like these are practically nonexistent. The goal of this work is to obtain the dosimetric quantities and the dose effective in pediatric CT scans, and study its application in the optimization process. The study took place in a thermographs' Toshiba Asteion Single-Slice and a GE Brightsped's multi-slice where measurements were made with type pencil ionization chamber and a trunk's phantom of PMMA with diameter of 16 cm. In single-slice CT scanner, the results obtained for the C vol , P KL , CT and E were 18.73 mGy, 15.61 mGy and 6.87 mSv mGy.cm 343.51, respectively, whereas in multi-slice CT scanner the results were 18.81 mGy, 20.07 mGy, 441.64 mGy.cm and 8,83 mSv. There was no significant difference between the values of C w obtained already in the values of the Cvol, P KL , CT and E dose the differences between the results were quite significant. Comparing the C w and P KL , CT and with the values recommended by UCRP 87 (25 mGy for C vol and 360 mGy.cm for P KL , CT in pediatric CT scans of the abdomen), the two scanners were below reference levels for C w and not require an start on process of optimization. (author)

  16. A rare cause of acute abdomen at a young patient: aorta and superior mesenteric artery dissection

    International Nuclear Information System (INIS)

    Kara, K.; Bozlar, U.; Guler, A.; Tasar, M.

    2012-01-01

    Full text: Introduction: Aortic emergencies are some of the most important causes of sudden death. Acute mesenteric ischemia has a low incidence about one in 1000 patients acutely admitted to a hospital but a high mortality rate of about 70%. In aortic dissection, only 3-5% of cases are found to be complicated by a superior mesentery artery (SMA) occlusion Objectives and tasks: The aim of the presentation is to demonstrate the computed tomography (CT) angiography findings of the dissection at aorta and SMA which is a rare cause of acute abdomen at a young patient. Materials and methods: A 22-year-old patient was admitted to emergency department suffering from severe abdominal pain, nausea and vomiting. Physical examination revealed abdominal tenderness. CT angiography was performed for the possible diagnosis like acute appendicitis and mesenteric ischemia. Formation of the intimal flap at the abdominal aorta and high grade narrowed celiac trunk at the origin that is in the true lumen were seen. Formation of the intimal flap at the aorta was extending through the SMA and SMA was filling both from true and false lumen. The same flap formation was narrowing the lumen of proximal SMA extensively. It was continued to the central part of SMA and a thrombus was detected at that level in the false lumen. Conclusion: Although patients at the younger age group, dissection should be considered in the differential diagnosis of acute abdominal pain. CT angiography is a rapid, noninvasive and effective method to detect vascular pathology, to asses the prevalence and to help treatment planning

  17. Can ultrasound abdomen help in early diagnosis of diabetes mellitus? an observational study

    International Nuclear Information System (INIS)

    Anwar, J.; Aamir, M.O.; Imdad, Z.U.H.

    2015-01-01

    Diabetes mellitus is a common disease. Similarly, ultrasound findings of fatty change and renal crystals are commonly seen on ultrasound. In the personal observation of the main author over the past so many years it was noticed that Diabetes Mellitus, Fatty liver and renal crystals all sit well together. This study tries to establish a relationship between diabetes mellitus renal echogenic foci and fatty liver. This study is first of its kind, as nobody has ever before investigated an association between the renal echogenic foci and fatty liver in relation to diabetes mellitus. Methods: This cross-sectional, observational study was conducted at Radiology Department Combined Military Hospital, Kohat From 2nd June 2013 to 30th May 2014. Three hundred patients were collected on the basis of having fatty liver and renal echogenic foci on ultrasound and three hundred more patients were collected who had no fatty liver or renal echogenic foci on ultrasound. Their labs were done for diabetes mellitus. Results: The patients having renal echogenic foci together with fatty liver had 83% positive rate of being diabetics, while patients with no fatty liver and no echogenic foci on ultrasonography had only 0.6% Positive rate of being diabetics. Conclusion: Our results provided the first demonstration of an association between renal echogenic foci together with fatty liver with the diabetes mellitus. Thus ultrasound examination of abdomen can be helpful in its early diagnosis if we make a protocol of doing fasting and random blood sugars in all those patients who have positive renal echogenic foci and fatty liver on their ultrasound examination. (author)

  18. Radiation doses of patients undergoing abdomen, pelvis and lumbar spine x-ray examinations in Nigeria

    International Nuclear Information System (INIS)

    Ogundare, F.O.; Uche, C.Z.; Balogun, F.A.

    2003-01-01

    Full text: Thermoluminescence dosemeters (TLD) have been used to measure the entrance surface doses (ESD) of patients undergoing diagnostic x-ray examinations in Pelvis, Abdomen and Lumbar Spine in Nigeria. A total of 4 randomly selected public hospitals and 240 patients were included in this investigation. Age of the patients used is from 45 years and above. Mean, median, first and third quartiles of ESDs are reported. The results showed that in most cases, for each of the examinations, the mean ESDs are higher than the published reference doses and their corresponding values from other countries. Nevertheless the ESD of each of the patients fall within the ranges of ESDs that have been reported from other countries as quoted by UNSCEAR. The distribution of the ESDs was also found to be negatively skewed. This suggests that radiographic departments need to review their radiographic practices in order to bring their doses to optimum levels. Effective doses were also calculated from the ESD values. The importance of good regulatory activities and trained personnel is stressed in this work It is therefore suggested that further dose reduction program, while still having in focus ways of optimizing the various radiological parameters in order for patient to receive least dose and the radiologist having an acceptable image, should include emphasis on good regulatory control and use of well-trained personnel. Apart from the fact that the data provided in this work will be useful for the formulation of national guidance levels, it also provides patient dosimetry information on healthcare level IV countries

  19. Note on bouncing backgrounds

    Science.gov (United States)

    de Haro, Jaume; Pan, Supriya

    2018-05-01

    The theory of inflation is one of the fundamental and revolutionary developments of modern cosmology that became able to explain many issues of the early Universe in the context of the standard cosmological model (SCM). However, the initial singularity of the Universe, where physics is indefinite, is still obscure in the combined SCM +inflation scenario. An alternative to SCM +inflation without the initial singularity is thus always welcome, and bouncing cosmology is an attempt at that. The current work is thus motivated to investigate the bouncing solutions in modified gravity theories when the background universe is described by the spatially flat Friedmann-Lemaître-Robertson-Walker (FLRW) geometry. We show that the simplest way to obtain the bouncing cosmologies in such spacetime is to consider some kind of Lagrangian whose gravitational sector depends only on the square of the Hubble parameter of the FLRW universe. For these modified Lagrangians, the corresponding Friedmann equation, a constraint in the dynamics of the Universe, depicts a curve in the phase space (H ,ρ ), where H is the Hubble parameter and ρ is the energy density of the Universe. As a consequence, a bouncing cosmology is obtained when this curve is closed and crosses the axis H =0 at least twice, and whose simplest particular example is the ellipse depicting the well-known holonomy corrected Friedmann equation in loop quantum cosmology (LQC). Sometimes, a crucial point in such theories is the appearance of the Ostrogradski instability at the perturbative level; however, fortunately enough, in the present work, as long as the linear level of perturbations is concerned, this instability does not appear, although it may appear at the higher order of perturbations.

  20. ABDOMINAL TRAUMA- CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Vanaja Ratnakumari Billa

    2017-08-01

    Full Text Available BACKGROUND In the recent times there has been increased incidence of abdominal trauma cases due to several causes. Quick and prompt intervention is needed to decrease the mortality of the patients. So we conducted a study to assess the cause and the management of abdominal trauma cases in our institution. The aim of this study was to know the incidence of blunt and penetrating injuries and their causes, age and sex incidence, importance of various investigations, mode of treatment offered and post-operative complications. To study the cause of death and evolve better management. MATERIALS AND METHODS The present study comprises of patients admitted to and operated in various surgical units in the Department of Surgery at Government General Hospital, attached to Guntur Medical College Guntur, from August 2014 to October 2016. RESULTS Increase incidence seen in age group 20-29 years (30%. Male predominance 77.5%. Mechanism of injury–road traffic accidents 65%. Isolated organ injury–colon and rectum 40%. Other associated injuries–chest injuries with rib fractures 7.5%. Complications–wound infection 17.5%. Duration of hospital stay 8–14 days. Bowel injury management–closure of perforation 84.6%. Resection anastomosis 15.38%. CONCLUSION Thorough clinical examination, diagnostic paracentesis, plain X-ray erect abdomen and ultrasound proved to be very helpful in the diagnosis of intra-abdominal injuries. Spleen is the commonest organ involved in blunt trauma and colon is the commonly injured organ in penetrating abdominal trauma, many patients have associated extremity and axial skeleton injuries. With advances in diagnosis and intensive care technologies, most patients of solid visceral injuries with hemodynamic stability can be managed conservatively. Surgical site infection is the most common complication following surgery. The mortality is high; reason might be patient reaching the hospital late, high incidence of postoperative septic

  1. Sew it up! A Western Trauma Association multi-institutional study of enteric injury management in the postinjury open abdomen.

    Science.gov (United States)

    Burlew, Clay Cothren; Moore, Ernest E; Cuschieri, Joseph; Jurkovich, Gregory J; Codner, Panna; Crowell, Kody; Nirula, Ram; Haan, James; Rowell, Susan E; Kato, Catherine M; MacNew, Heather; Ochsner, M Gage; Harrison, Paul B; Fusco, Cynthia; Sauaia, Angela; Kaups, Krista L

    2011-02-01

    Use of damage control surgery techniques has reduced mortality in critically injured patients but at the cost of the open abdomen. With the option of delayed definitive management of enteric injuries, the question of intestinal repair/anastomosis or definitive stoma creation has been posed with no clear consensus. The purpose of this study was to determine outcomes on the basis of management of enteric injuries in patients relegated to the postinjury open abdomen. Patients requiring an open abdomen after trauma from January 1, 2002 to December 31, 2007 were reviewed. Type of bowel repair was categorized as immediate repair, immediate anastomosis, delayed anastomosis, stoma and a combination. Logistic regression was used to determine independent effect of risk factors on leak development. During the 6-year study period, 204 patients suffered enteric injuries and were managed with an open abdomen. The majority was men (77%) sustaining blunt trauma (66%) with a mean age of 37.1 years±1.2 years and median Injury Severity Score of 27 (interquartile range=20-41). Injury patterns included 81 (40%) small bowel, 37 (18%) colonic, and 86 (42%) combined injuries. Enteric injuries were managed with immediate repair (58), immediate anastomosis (15), delayed anastomosis (96), stoma (10), and a combination (22); three patients died before definitive repair. Sixty-one patients suffered intra-abdominal complications: 35 (17%) abscesses, 15 (7%) leaks, and 11 (5%) enterocutaneous fistulas. The majority of patients with leaks had a delayed anastomosis; one patient had a right colon repair. Leak rate increased as one progresses toward the left colon (small bowel anastomoses, 3% leak rate; right colon, 3%; transverse colon, 20%; left colon, 45%). There were no differences in emergency department physiology, injury severity, transfusions, crystalloids, or demographic characteristics between patients with and without leak. Leak cases had higher 12-hour heart rate (148 vs. 125, p=0

  2. The Qatar Biobank: background and methods.

    Science.gov (United States)

    Al Kuwari, Hanan; Al Thani, Asma; Al Marri, Ajayeb; Al Kaabi, Abdulla; Abderrahim, Hadi; Afifi, Nahla; Qafoud, Fatima; Chan, Queenie; Tzoulaki, Ioanna; Downey, Paul; Ward, Heather; Murphy, Neil; Riboli, Elio; Elliott, Paul

    2015-12-03

    The Qatar Biobank aims to collect extensive lifestyle, clinical, and biological information from up to 60,000 men and women Qatari nationals and long-term residents (individuals living in the country for ≥15 years) aged ≥18 years (approximately one-fifth of all Qatari citizens), to follow up these same individuals over the long term to record any subsequent disease, and hence to study the causes and progression of disease, and disease burden, in the Qatari population. Between the 11(th)-December-2012 and 20(th)-February-2014, 1209 participants were recruited into the pilot study of the Qatar Biobank. At recruitment, extensive phenotype information was collected from each participant, including information/measurements of socio-demographic factors, prevalent health conditions, diet, lifestyle, anthropometry, body composition, bone health, cognitive function, grip strength, retinal imaging, total body dual energy X-ray absorptiometry, and measurements of cardiovascular and respiratory function. Blood, urine, and saliva were collected and stored for future research use. A panel of 66 clinical biomarkers was routinely measured on fresh blood samples in all participants. Rates of recruitment are to be progressively increased in the coming period and the recruitment base widened to achieve a cohort of consented individuals broadly representative of the eligible Qatari population. In addition, it is planned to add additional measures in sub-samples of the cohort, including Magnetic Resonance Imaging (MRI) of the brain, heart and abdomen. The mean time for collection of the extensive phenotypic information and biological samples from each participant at the baseline recruitment visit was 179 min. The 1209 pilot study participants (506 men and 703 women) were aged between 28-80 years (median 39 years); 899 (74.4%) were Qatari nationals and 310 (25.6%) were long-term residents. Approximately two-thirds of pilot participants were educated to graduate level or above. The

  3. Effective dose evaluation of head and abdomen CT exams in adult patients at the Instituto de Radiologia of Faculdade de Medicina of University of Sao Paulo, SP, Brazil

    International Nuclear Information System (INIS)

    Nersissian, Denise Y.; Scolastici, Eric F.; Doro, Renato B.; Furquim, Tania A.C.

    2013-01-01

    This paper presents an estimate of the effective dose from CTDI vol for exams of skull and abdomen in adult patients. Thereafter, measurements were taken of CTDI using an ionization chamber type pencil (Radcal Corportation, model 10 x 5 - 3CT) and cylindrical phantom of PMMA equivalent to regions of the skull (diameter = 16 cm) and abdomen (diameter = 32 cm). The results of effective dose for abdomen varied between 7,3 and 12,1 mSv and for skull between 1,4 and 5,0 mSv. Comparing with the literature data, for abdomen exams between 5 and 7 mSV and skull exams between 1 and 2 mSv, it is shown that it is possible to optimize these protocols, aiming to reduce the doses to patients

  4. Radiation risk assessment in neonatal radiographic examinations of the chest and abdomen: a clinical and Monte Carlo dosimetry study

    International Nuclear Information System (INIS)

    Makri, T; Yakoumakis, E; Papadopoulou, D; Gialousis, G; Theodoropoulos, V; Sandilos, P; Georgiou, E

    2006-01-01

    Seeking to assess the radiation risk associated with radiological examinations in neonatal intensive care units, thermo-luminescence dosimetry was used for the measurement of entrance surface dose (ESD) in 44 AP chest and 28 AP combined chest-abdominal exposures of a sample of 60 neonates. The mean values of ESD were found to be equal to 44 ± 16 μGy and 43 ± 19 μGy, respectively. The MCNP-4C2 code with a mathematical phantom simulating a neonate and appropriate x-ray energy spectra were employed for the simulation of the AP chest and AP combined chest-abdominal exposures. Equivalent organ dose per unit ESD and energy imparted per unit ESD calculations are presented in tabular form. Combined with ESD measurements, these calculations yield an effective dose of 10.2 ± 3.7 μSv, regardless of sex, and an imparted energy of 18.5 ± 6.7 μJ for the chest radiograph. The corresponding results for the combined chest-abdominal examination are 14.7 ± 7.6 μSv (males)/17.2 ± 7.6 μSv (females) and 29.7 ± 13.2 μJ. The calculated total risk per radiograph was low, ranging between 1.7 and 2.9 per million neonates, per film, and being slightly higher for females. Results of this study are in good agreement with previous studies, especially in view of the diversity met in the calculation methods

  5. Radiation risk assessment in neonatal radiographic examinations of the chest and abdomen: a clinical and Monte Carlo dosimetry study

    Science.gov (United States)

    Makri, T.; Yakoumakis, E.; Papadopoulou, D.; Gialousis, G.; Theodoropoulos, V.; Sandilos, P.; Georgiou, E.

    2006-10-01

    Seeking to assess the radiation risk associated with radiological examinations in neonatal intensive care units, thermo-luminescence dosimetry was used for the measurement of entrance surface dose (ESD) in 44 AP chest and 28 AP combined chest-abdominal exposures of a sample of 60 neonates. The mean values of ESD were found to be equal to 44 ± 16 µGy and 43 ± 19 µGy, respectively. The MCNP-4C2 code with a mathematical phantom simulating a neonate and appropriate x-ray energy spectra were employed for the simulation of the AP chest and AP combined chest-abdominal exposures. Equivalent organ dose per unit ESD and energy imparted per unit ESD calculations are presented in tabular form. Combined with ESD measurements, these calculations yield an effective dose of 10.2 ± 3.7 µSv, regardless of sex, and an imparted energy of 18.5 ± 6.7 µJ for the chest radiograph. The corresponding results for the combined chest-abdominal examination are 14.7 ± 7.6 µSv (males)/17.2 ± 7.6 µSv (females) and 29.7 ± 13.2 µJ. The calculated total risk per radiograph was low, ranging between 1.7 and 2.9 per million neonates, per film, and being slightly higher for females. Results of this study are in good agreement with previous studies, especially in view of the diversity met in the calculation methods.

  6. Executive Summary - Historical background

    International Nuclear Information System (INIS)

    2005-01-01

    matter physics experiments at the High Flux Reactor of The Laue Langevin Institute and the ISIS spallation source at Rutherford-Appleton. Recently, we very actively entered the ICARUS neutrino collaboration and were invited to the PIERRE AUGER collaboration which will search for the highest energies in the Universe. Having close ties with CERN we are very actively engaged in CROSS-GRID, a large computer network project. To better understand the historical background of the INP development, it is necessary to add a few comments on financing of science in Poland. During the 70's and the 80's, research was financed through the so-called Central Research Projects for Science and Technical Development. The advantage of this system was that state-allocated research funds were divided only by a few representatives of the scientific community, which allowed realistic allocation of money to a small number of projects. After 1989 we were able to purchase commercially available equipment, which led to the closure of our large and very experienced electronic workshop. We also considerably reduced our well equipped mechanical shop. During the 90's the reduced state financing of science was accompanied by a newly established Committee of Scientific Research which led to the creation of a system of small research projects. This precluded the development of more ambitious research projects and led to the dispersion of equipment among many smaller laboratories and universities. A large research establishment, such as our Institute, could not develop properly under such conditions. In all, between 1989 and 2004 we reduced our personnel from about 800 to 470 and our infrastructure became seriously undercapitalised. However, with energetic search for research funds, from European rather than national research programs, we hope to improve and modernize our laboratories and their infrastructure in the coming years

  7. Temporary abdominal closure in the critically ill patients with an open abdomen.

    Directory of Open Access Journals (Sweden)

    Ghodratollah Maddah

    2014-05-01

    Full Text Available The emergent abdominal surgeries from either of traumatic or non traumatic causes can result in situations in which the abdominal wall cannot initially be closed. Many techniques have been reported for temporary coverage of the exposed viscera, but the result of various techniques remains unclear. During 94 months, 19 critically ill patients whit an open abdomen underwent surgery using plastic bags (Bogotá bag. The study population comprised of 11 (57.9% male and 8 (42.1% female with an average age of 32.26+14.8 years. The main indications for temporary abdominal coverage were as follows: planned reoperation in 11 (57.9% patients, subjective judgment that the fascia closure is too tight in 6 (31.6% patient's damage control surgery in one patient (5.3% and development of abdominal compartment surgery in one patient (5.3%. Surgical conditions requiring temporary abdominal closure was severe post operative peritonitis in 9 (47.4% patients, post operative intestinal fistula in 4 (21.1% patients, post traumatic intra abdominal bleeding in 3 (15.8% patients and intestinal obstructions in 3 (15.8% patients. Length of hospitalization was 45+23.25 days and the mean total number of laparotomies was 6.2+3.75 times per patient. Three bowel fistulas occurred due to a missed injury at the time of initial operation that was discovered during changing the plastic sheet. They were unrelated to coverage technique. All of them were treated by repair of the defect and serosal patch by adjacent bowel loop. Only one (10.0% patient underwent definitive closure within 6 months of initial operation. The remaining survivor has declined to have hernia repaired. There were 4 (%21.1 early postoperative deaths that were not related to the abdominal coverage technique. Also, there were 5 (26.3% late deaths that were due to dissemination of malignancy with a mean survival time of 20.8+13 (range 2-54 months. Currently 10 patients (52.6% are alive at a follow up of 45 (range 1

  8. Optimization of recommendations for abdomen computerized tomography based on reconstruction filters, voltage and tube current

    International Nuclear Information System (INIS)

    Silveira, Vinicius da Costa

    2015-01-01

    The use of computed tomography has increased significantly over the past decades. In Brazil the use increased more than twofold from 2008 to 2014, in the meantime the abdomen procedures have tripled. The high frequency of this procedure combined by the increasing collective radiation dose in medical exposures, has resulted development tools to maximize the benefit in CT images. This work aimed to establish protocols optimized in abdominal CT through acquisitions parameters and reconstructions techniques based on filters kernels. A sample of patients undergoing abdominal CT in a diagnostic center of Rio de Janeiro was assessed. Had been collected patients information and acquisitions parameters. The phantoms CT image acquisitions were performed by using different voltage values by adjusting the tube current (mAs) to obtain the same value from CTDI vol patients with normal BMI. Afterwards, the CTDIvol values were reduced by 30%, 50% and 60%. All images were reconstructed with low-contrast filters (A) and standard filters (B). The CTDIvol values for patients with normal BMI were 7% higher than in patients with underweight BMI and 30%, 50% and 60% lower than the overweight, obese I and III patients, respectively. The evaluations of image quality showed that variation of the current (mA) and the reconstruction filters did not affect the Hounsfield values. When the contrast-to-noise ratio (CNR) was normalized to CTDIvol, the protocols acquired with 60% reduction of CTDIvol with 140 kV and 80 kV showed CNR 6% lower than the routine. Modifications of the acquisition parameters did not affect spatial resolution, but the post-processing with B filters reduced the spatial frequency by 16%. With reduced the dose of 30%, lesions in the spleen had the CNR higher than 10% routine protocols with 140 kV acquired and post-processed to filter A. The image post-processing with a filter A with a 80kV voltage provided CNR values equal to the routine for the liver lesions with a 30

  9. Tomografia computadorizada sem contraste intravenoso no abdome agudo: quando e por que usar When and why use unenhanced computed tomography in patients with acute abdomen

    Directory of Open Access Journals (Sweden)

    Edison de Oliveira Freire Filho

    2006-02-01

    Full Text Available A tomografia computadorizada sem contraste intravenoso tem sido freqüentemente proposta na avaliação inicial de pacientes com suspeita de abdome agudo, ocupando o espaço de outros métodos diagnósticos. Os autores apresentam uma revisão bibliográfica dos principais aspectos e eficácia da tomografia computadorizada sem contraste intravenoso no diagnóstico de apendicite aguda, cólica nefrética, diverticulite, pancreatite aguda, apendicite epiplóica, pneumoperitônio e obstrução intestinal. Discutem quais as vantagens e limitações desta técnica de exame, bem como seus aspectos práticos.The use of unenhanced computed tomography has been frequently recommended for the initial assessment of patients with clinical suspicion of acute abdomen instead of other diagnostic methods. The authors present a review of the literature on the main aspects, advantages, limitations and efficacy of unenhanced computed tomography for the diagnosis of acute appendicitis, renal colic, diverticulitis, acute pancreatitis, primary epiploic appendicitis, pneumoperitoneum and small bowel obstruction. The advantages and limitations of this technique are also discussed.

  10. Surgical abdomen in patients with nephrotic syndrome: complexities of differential diagnostics. 2 case reports

    OpenAIRE

    Nogaibayeva, A.; Moldakhmetova, S.; Tuganbekova, S.; Krivoruchko, N.

    2014-01-01

    INTROduCTIONANdAIMS: Differential-diagnostic search is very important at the stage of abdominal nephrotic crisis for determination of therapy tactics; as the probability of development of acute surgical pathology is very high, due to connection of infectious complications on a background of the basic pathology and immunosupression. We report 2 patients with acute onset of abdominal pain on a background of severe nephrotic syndrome (NS). METHOdS: Case 1: 20-years old man with bioptic diagnosis...

  11. Scientific background of the project

    International Nuclear Information System (INIS)

    Christofidis, I.

    1997-01-01

    The main objective of the proposed project is the development of radioimmunometric assay(s) for the determination of free and total PSA in serum samples from normal and pathological individuals (BPH, PCa). This will be achieved by: A. Selection of appropriate antibody pairs (capture and labelled antibody) for determination of total PSA (free and complex) and for determination of free PSA. From bibliography we have already spotted some antibody pairs. B. Radiolabelling of antibodies. Several labelling and purification procedures will be followed in order to obtain the required analytical sensitivity and dynamic range of the assays. Special attention will be given to the affinity constant as well as to the stability of the radiolabelled molecules. C. Development of protocols for immobilisation of capture antibodies. We will use several solid support formats (plastic tubes, beads and magnetizable particles). Direct adsorption or covalent binding will be used. Immunoadsorption through immobilised second antibody will be also tested in order to decrease the preparation cost of the solid phase reagents. D. Preparation of standards of suitable purity levels. We will test different PSA-free matrices (Bovine serum, buffer solutions etc.) in order to select the most appropriate among them in terms of low background determination and low reagents cost. E. Optimisation of the immunoassays conditions for the free PSA and total PSA (e.g. assay buffers, incubation time, temperature, one or two step procedure, washings). F. Optimisation and standardisation of assay protocols for kit production. G. Production of kits for distribution in clinical laboratories in Greece for comparison with commercial kits. H. Evaluation of the developed assays in real clinical conditions using well characterised human serum samples. This will be performed in co-operation with the Hellenic Society for Tumor Markers, and other anticancer institutions and hospital clinicians of long standing relation

  12. Background noise levels in Europe

    OpenAIRE

    Gjestland, Truls

    2008-01-01

    - This report gives a brief overview of typical background noise levels in Europe, and suggests a procedure for the prediction of background noise levels based on population density. A proposal for the production of background noise maps for Europe is included.

  13. Radiographic image quality and dose at thorax, abdomen and skull of patients at HC-FMB-UNESP

    International Nuclear Information System (INIS)

    Alvarez, Matheus; Giacomini, Guilherme; Bacchim Neto, Fernando A.; Alves, Allan F.F.; Velo, Alexandre F.; Miranda, Jose R.A.; Pina, Diana R. de

    2013-01-01

    ICRP 103 specifies reference dose levels to be used during radiographic exams. Usually, the radiographer qualitative determines the best radiographic technique (kV and mAs) in order to obtain better image quality with the lowest dose. The objective of this study was to evaluate the doses used in examination of the chest, abdomen and skull in patients of different physical sizes, and infer about the amount of dose required to maintain acceptable radiological contrast in patients of different physical sizes. Techniques used by experienced radiographers of HC-FMB-UNESP for examinations of the chest (PA), abdomen (AP) and skull (AP) for patients of different thickness (small, medium and thick body) were obtained. Dose measurements were performed referring to all kV/mAs combinations. PMMA phantoms were placed below the ionization chamber. The Signal Difference Noise Ratio (SDNR) of the images of the phantoms were calculated from an area of contrast and a region of normal tissue. The Figure of Merit (FoM) was calculated for each of the exam modality. Measured FoM decreased according to the thickness of the chest and abdomen, indicating the need to increase the dose level to maintain the same level of image contrast. Patients thicker usually end up getting more than twice the dose of lean patients. Required image quality levels for correct diagnosis should be obtained using dose levels as low as reasonably practicable examination. These factors highlight the need for a program of quality assurance and effective dose studies in actual service. (author)

  14. SPET/CT image co-registration in the abdomen with a simple and cost-effective tool

    International Nuclear Information System (INIS)

    Foerster, Gregor J.; Laumann, Christina; Nickel, Otmar; Bartenstein, Peter; Kann, Peter; Rieker, Olaf

    2003-01-01

    Fusion of morphology and function has been shown to improve diagnostic accuracy in many clinical circumstances. Taking this into account, a number of instruments combining computed tomography (CT) with positron emission tomography (PET) or single-photon emission tomography (SPET) are appearing on the market. The aim of this study was to evaluate a simple and cost-effective approach to generate fusion images of similar quality. For the evaluation of the proposed approach, patients with neuroendocrine abdominal tumours with liver metastases were chosen, since the exact superimposition in the abdomen is more difficult than in other regions. Five hours following the injection of 110 MBq 111 In-DTPA-octreotide, patients were fixed in a vacuum cushion (MED-TEC, Vac-Loc) and investigated with helical CT in a mid-inspiration position (n=14). Directly following the CT, a SPET study (SPET1) of the abdominal region was performed without changing the position of the patient. A second SPET study (SPET2), 24 h p.i., was acquired after repositioning the patient in his or her individually moulded vacuum cushion. A total of nine markers suitable for imaging with CT and SPET were fixed on the cushion. Datasets were fused by means of internal landmarks (e.g. metastases or margin of abdominal organs) or by the external markers. Image fusion using external markers was fast and easy to handle compared with the use of internal landmarks. Using this technique, all lesions detectable by SPET (n=28) appeared exactly superpositioned on the respective CT morphology by visual inspection. Image fusion of CT/SPET1 and CT/SPET2 showed a mean deviation of the external markers that in the former case was smaller than the voxel size of 4.67 mm: 4.17±0.61 (CT/SPET1; ±SD) and 5.52±1.56 mm (CT/SPET2), respectively. Using internal landmarks, the mean deviation of the chosen landmarks was 6.47±1.37 and 7.78±1.21 mm. Vector subtraction of corresponding anatomical points of the CT and the re

  15. Variation in the quality of CT images of the upper abdomen when CT automatic exposure control is employed

    International Nuclear Information System (INIS)

    Aizawa, Isao; Muramatsu, Yoshihisa; Nomura, Keiichi; Shimizu, Fuminori

    2010-01-01

    The aim of this study was to analyze the reason for variation of image quality in the upper abdomen CT with the use of CT-automatic exposure control (AEC). The CT investigated was 3D modulation in the 16 multi detector row CT (MDCT) and lung cancer screening CT (LSCT) phantom was used to simulate the patient. When there was a phase difference, an image noise increase of around 15% at the maximum was accepted. It is concluded that the major reason for variation in image quality is respiratory motion and the importance of respiration control must be recognized. (author)

  16. Blunt-tip coaxial introducer: a revisited tool for difficult CT-guided biopsy in the chest and abdomen.

    Science.gov (United States)

    de Bazelaire, Cedric; Farges, Cecile; Mathieu, Olivier; Zagdanski, Anne-Marie; Bourrier, Pierre; Frija, Jacques; de Kerviler, Eric

    2009-08-01

    We describe a coaxial introducer provided with an additional blunt-tip stylet that allows safe access to difficult-to-reach lymph nodes in the chest, abdomen, and pelvis under CT control. Once the thoracic, abdominal, or pelvic wall is crossed by the introducer fitted with the sharp-tip stylet, the blunt-tip stylet replaces the sharp stylet for further progression in the fat toward the target. The soft-tip stylet carries a smaller risk of inadvertent perforation displacing vital structures.

  17. PMHS impact response in 3 m/s and 8 m/s nearside impacts with abdomen offset.

    Science.gov (United States)

    Miller, Carl S; Madura, Nathaniel H; Schneider, Lawrence W; Klinich, Kathleen D; Reed, Matthew P; Rupp, Jonathan D

    2013-11-01

    Lateral impact tests were performed using seven male post-mortem human subjects (PMHS) to characterize the force-deflection response of contacted body regions, including the lower abdomen. All tests were performed using a dual-sled, side-impact test facility. A segmented impactor was mounted on a sled that was pneumatically accelerated into a second, initially stationary sled on which a subject was seated facing perpendicular to the direction of impact. Positions of impactor segments were adjusted for each subject so that forces applied to different anatomic regions, including thorax, abdomen, greater trochanter, iliac wing, and thigh, could be independently measured on each PMHS. The impactor contact surfaces were located in the same vertical plane, except that the abdomen plate was offset 5.1 cm towards the subject. The masses of the sleds and the force- deflection characteristics of the energy-absorbing interface material between the sleds were set to provide the impactor sled with a velocity profile that matched the average driver door velocity history produced in a series of side NCAP tests. Impactor padding was also selected so that average ATD pelvis and thorax responses from the same series of side NCAP tests were reproduced when the ATD used in these tests was impacted using the average door-velocity history. Each subject was first impacted on one side of the body using an initial impactor speed of 3 m/s. If a post-test CT scan and strain-gage data revealed two or fewer non-displaced rib fractures, then the PMHS was impacted on the contralateral side of the body at a speed of 8 m/s or 10 m/s. The results of tests in the 3 m/s and 8 m/s conditions were used to develop force-deflection response corridors for the abdomen, force history response corridors for the pelvis (iliac wing and greater trochanter), the midthigh, and the thorax. Response corridors for the lateral acceleration of the pelvis were also developed. Future work will compare side impact ATD

  18. Applying the PCXMC software for dose assessment in patients submitted to abdomen and pelvis X-ray examinations

    International Nuclear Information System (INIS)

    Oliveira, V.L.S.; Silva, T.A. da

    2009-01-01

    The PCXMC R computational methodology was applied as a evaluation tool of the organ doses in patients submitted to different X-ray conventional diagnoses examinations. Simulations were made based in x-ray parameters and exposure geometry of three patient of same age group in an Emergency Hospital of the metropolitan area of Belo Horizonte city. Contributions to the effective dose from critical organs were evaluated and analyzed in terms of patient height and weight for the examinations of abdomen and pelvis. (author)

  19. Función del diafragma durante la colocación de cargas sobre el abdomen en sujetos normales

    Directory of Open Access Journals (Sweden)

    Sergio G. Monteiro

    2012-04-01

    Full Text Available Los efectos de las cargas en el abdomen con el objeto de producir entrenamiento del diafragma, no han sido suficientemente evaluados. Estudiamos la función del diafragma durante la colocación de cargas sobre el abdomen y con cambios en el patrón respiratorio. Se estudiaron 6 voluntarios normales. Se obtuvo flujo en la boca, presión gástrica (Pga, presión esofágica (Pes, movimiento torácico (TX y abdominal (AB, presión inspiratoria máxima (PImax y presión transdiafragmática media (Pdi y máxima (Pdimax. Se calculó la relación Pdi/Pdimax y el índice tensión-tiempo del diafragma (TTdi. Etapas: patrón normal (PN, patrón abdominal (PA y carga de 1, 2, 4 y 6 kg con PN y PA. El PA fue facilitado por las cargas sobre el abdomen. Solo con 6 kg (PN y PA la Pga a capacidad residual funcional aumentó significativamente (p 0.001. La Pdi siguió a las variaciones de la Pga y aumentó con todos los PA (p < 0.001. Con PA y carga el índice TTdi alcanzó un valor de 0.05 ± 0.02 (p < 0.001. Las cargas no aumentaron este índice más de lo que hizo el PA solo. Nuestros hallazgos sugieren que las cargas sobre el abdomen aumentan la propiocepción relacionada con los movimientos respiratorios y descenso del diafragma. Las cargas producen cambios leves en la mecánica del diafragma (en sujetos normales, 1/3 de la carga necesaria para desarrollar fatiga. En sujetos normales estos cambios parecen ser insuficientes para producir entrenamiento de los músculos respiratorios.

  20. Backgrounder

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC CRDI

    Center for Mountain Ecosystem Studies, Kunming Institute of Botany of the Chinese Academy of Sciences, China: $1,526,000 to inform effective water governance in the Asian highlands of China, Nepal, and Pakistan. • Ashoka Trust for Research in Ecology and the Environment (ATREE), India: $1,499,300 for research on ...

  1. BACKGROUNDER

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC CRDI

    demographic trends, socio-economic development pathways, and strong ... knowledge and experience, and encourage innovation. ... choices, and will work with stakeholders in government, business, civil society, and regional economic.

  2. Backgrounder

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC CRDI

    Safe and Inclusive Cities: ... improving urban environments and public spaces might have on reducing the city's high ... violence against women among urban youth of working class neighbourhoods of Islamabad, Rawalpindi, and Karachi,.

  3. BACKGROUNDER

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC CRDI

    CARIAA's research agenda addresses gaps and priorities highlighted in the ... Research focuses on climate risk, institutional and regulatory frameworks, markets, and ... The researchers will identify relevant drivers and trends and use develop ...

  4. BACKGROUNDER

    International Development Research Centre (IDRC) Digital Library (Canada)

    Corey Piccioni

    achieving long‐term food security in Africa, with a focus on post‐harvest loss, ... nutrion and health, and the socio‐economic factors that affect food supply ... Water use. Agricultural producvity in sub‐Saharan Africa is the lowest in the world.

  5. Some of the structural and functional features of the autonomic nervous system and diagnosis in clinical practice in the treatment and rehabilitation of patients from diverse backgrounds with vegetative violations

    Directory of Open Access Journals (Sweden)

    N. I. Samosyuk

    2015-03-01

    educational-methodical manual "some structural and functional features of the autonomic nervous system and their Diagnostics in clinical and resort practice in the treatment and rehabilitation of patients from diverse backgrounds with vegetative violations" are known and new data on the operation of the autonomic nervous system. In particular, describes the effect of the left and right hemispheres of the brain, function of the insula sympathetic and parasympathetic divisions of the autonomic nervous system. The manual briefly describes the enteric nervous system, with its powerful vegetative-trophic and immuno-corrective function. An important place in the manual is the modern samples and tests to determine the functional of the autonomic nervous system, which together with the study of variational pulsometry parameters may serve as an objective criterion of the autonomic nervous system. The manual also provides autonomic disorders in different parts of the autonomic nervous system. Manual is intended for a wide range of doctors-clinicians involved in the treatment and rehabilitation of patients with neurological and therapeutic profile, etc.

  6. Diffuse Cosmic Infrared Background Radiation

    Science.gov (United States)

    Dwek, Eli

    2002-01-01

    The diffuse cosmic infrared background (CIB) consists of the cumulative radiant energy released in the processes of structure formation that have occurred since the decoupling of matter and radiation following the Big Bang. In this lecture I will review the observational data that provided the first detections and limits on the CIB, and the theoretical studies explaining the origin of this background. Finally, I will also discuss the relevance of this background to the universe as seen in high energy gamma-rays.

  7. Background current of radioisotope manometer

    International Nuclear Information System (INIS)

    Vydrik, A.A.

    1987-01-01

    The technique for calculating the main component of the background current of radioisotopic monometers, current from direct collision of ionizing particles and a collector, is described. The reasons for appearance of background photoelectron current are clarified. The most effective way of eliminating background current components is collector protection from the source by a screen made of material with a high gamma-quanta absorption coefficient, such as lead, for example

  8. 消化道重复畸形的急性并发症%Acute Abdomen Associated with Duplications of Alimentary Tract

    Institute of Scientific and Technical Information of China (English)

    王义; 张金哲

    1988-01-01

    Eighty-six cases of duplication of alimentary tract were operated on between 1955 and 1986. They were 53 boys and 33 girls,ages ranging from10 days to 13 yrs.There were 93 duplications in 86 patients located in ileum(57),ileocecum(16),colon and rectum (9),jejenum(2),stomach(2),retroperitoni-um (2) and duodenum (1). Pathological pat.tern comprised extraluminal cyst (47),intraluminal cyst (15),diverticulum(19),and double lumen (12). sixty-two cases came to emergency surgery with rectal bleeding (22),intestinal obstruction(19),intussusception(8),intestinal perforation(7),votvulus (4),and constipation with urinary obstruction(1).The other 24 cases presented with abdominal mass(22)and anorectal anomaly(2).This paper disciusses the relation between the clinical manifestations and the underlying pathology. Extraluminal cyst often causing intestinal obstruction,volvulus,or constipation and urinary reteasion,intraluminal cysts are likely to serve as the leading point of intussusception.Usually,patients with diverticulum or double-lumen containing gastric mucosa came with hemor rhage or perforation of intestine.Described in detail in the paper are the clinical manifestations and X-ray findings in acute abdomen associated with duplication of alimentary tract.%本文报告1955年至1986年收治的消化道重复畸形86例,多于婴幼儿期出现临床症状,其中72.1%表现为便血、肠梗阻、肠套叠、肠扭转、肠穿孔等急腹症.作者对该病的临床表现与病理解剖间的关系做了重点探讨.

  9. SU-E-P-11: Comparison of Image Quality and Radiation Dose Between Different Scanner System in Routine Abdomen CT

    Energy Technology Data Exchange (ETDEWEB)

    Liao, S; Wang, Y; Weng, H [Chiayi Chang Gung Memorial Hospital of The C.G.M.F, Puzi City, Chiayi County, Taiwan (China)

    2015-06-15

    Purpose To evaluate image quality and radiation dose of routine abdomen computed tomography exam with the automatic current modulation technique (ATCM) performed in two different brand 64-slice CT scanners in our site. Materials and Methods A retrospective review of routine abdomen CT exam performed with two scanners; scanner A and scanner B in our site. To calculate standard deviation of the portal hepatic level with a region of interest of 12.5 mm x 12.5mm represented to the image noise. The radiation dose was obtained from CT DICOM image information. Using Computed tomography dose index volume (CTDIv) to represented CT radiation dose. The patient data in this study were with normal weight (about 65–75 Kg). Results The standard deviation of Scanner A was smaller than scanner B, the scanner A might with better image quality than scanner B. On the other hand, the radiation dose of scanner A was higher than scanner B(about higher 50–60%) with ATCM. Both of them, the radiation dose was under diagnostic reference level. Conclusion The ATCM systems in modern CT scanners can contribute a significant reduction in radiation dose to the patient. But the reduction by ATCM systems from different CT scanner manufacturers has slightly variation. Whatever CT scanner we use, it is necessary to find the acceptable threshold of image quality with the minimum possible radiation exposure to the patient in agreement with the ALARA principle.

  10. SU-E-P-11: Comparison of Image Quality and Radiation Dose Between Different Scanner System in Routine Abdomen CT

    International Nuclear Information System (INIS)

    Liao, S; Wang, Y; Weng, H

    2015-01-01

    Purpose To evaluate image quality and radiation dose of routine abdomen computed tomography exam with the automatic current modulation technique (ATCM) performed in two different brand 64-slice CT scanners in our site. Materials and Methods A retrospective review of routine abdomen CT exam performed with two scanners; scanner A and scanner B in our site. To calculate standard deviation of the portal hepatic level with a region of interest of 12.5 mm x 12.5mm represented to the image noise. The radiation dose was obtained from CT DICOM image information. Using Computed tomography dose index volume (CTDIv) to represented CT radiation dose. The patient data in this study were with normal weight (about 65–75 Kg). Results The standard deviation of Scanner A was smaller than scanner B, the scanner A might with better image quality than scanner B. On the other hand, the radiation dose of scanner A was higher than scanner B(about higher 50–60%) with ATCM. Both of them, the radiation dose was under diagnostic reference level. Conclusion The ATCM systems in modern CT scanners can contribute a significant reduction in radiation dose to the patient. But the reduction by ATCM systems from different CT scanner manufacturers has slightly variation. Whatever CT scanner we use, it is necessary to find the acceptable threshold of image quality with the minimum possible radiation exposure to the patient in agreement with the ALARA principle

  11. Ct enterography/ct abdomen and pelvis using neutral oral contrast. a new combination of natural products

    International Nuclear Information System (INIS)

    Aslam, M.O.

    2014-01-01

    Our purpose was to assess the performance of a new combination of neutral oral contrast for CT abdomen and CT Enterography in comparison with commercially available neutral oral contrast VoLumen. Seventy three consecutive patients were given sorbitol/CMC (Carboxy Methyl Cellulose) solution or VoLumen as oral contrast agent for abdominal computed tomography (CT) scan. 23 patients were male and 37 females. Age range was between 16 and 67 years. Since the use of CT scan for abdominal pathologies, there was need to separate bowel loops to localize the pathology. Three types of oral contrast can be used in CT-Scan abdomen; Positive, Neutral and negative. The above used contrasts are Neutral contrast these refers to agents that have an attenuation value similar to that of water (0-30 H).Our results show this new combination of Cc and Sorbitol to be equally good as VoLumen, for luminal distension and mural details, in duodenum and jejunum. While better than VoLumen for Ileal distension. (author)

  12. Background subtraction theory and practice

    CERN Document Server

    Elgammal, Ahmed

    2014-01-01

    Background subtraction is a widely used concept for detection of moving objects in videos. In the last two decades there has been a lot of development in designing algorithms for background subtraction, as well as wide use of these algorithms in various important applications, such as visual surveillance, sports video analysis, motion capture, etc. Various statistical approaches have been proposed to model scene backgrounds. The concept of background subtraction also has been extended to detect objects from videos captured from moving cameras. This book reviews the concept and practice of back

  13. Spectrum of clinical presentation and surgical management of intestinal tuberculosis at tertiary care hospital

    International Nuclear Information System (INIS)

    Abro, A.; Siddiqui, F.G.; Memon, A.S.; Akhtar, S.

    2010-01-01

    Background: Tuberculosis can involve gastrointestinal tract anywhere from mouth to anus, the peritoneum and pancreato biliary system. It has varied clinical presentations sometimes mimicking other common abdominal diseases. Tuberculosis continues to be a major problem especially in developing countries, being responsible for 7 - 10 million new cases and 6 per cent of deaths worldwide annually. Objective was to assess and evaluate various clinical presentations and management of intestinal tuberculosis at Liaquat University Hospital, Jamshoro/Hyderabad. Methods: This 3-year descriptive study was conducted on patients with diagnosed intestinal tuberculosis (by histopathology) in Surgical Unit-I, from January 2006 to December 2008. Detailed history and clinical examination was performed in all the cases. Investigations like Blood CP and ESR, Urea, RBS Electrolytes, Serum A/G Ratio, Ultrasound abdomen, X-Ray chest and abdomen were carried out in all the cases while barium meal, follow through and CT Scan abdomen were performed in selected cases. Preoperative assessment of anatomical site and variety of lesions were also noted. Results: A total of 60 patients with diagnosis of intestinal tuberculosis were admitted and operated. Diagnosis was confirmed by histopathology. Among these, 28 (46.7%) were male, and 32 (54.1%) were female. Variable clinical presentations were seen. Majority of patients (46, 76.7%) had abdominal pain, 26 (43.3%) had vomiting; abdominal distension was seen in 22 (36.7%) cases, diarrhoea and constipation in 16 patients (26.7%) and abdominal mass in 14 patients (23.3%). Majority of patients had ulcerostenotic type of tuberculosis. Single stricture of ileum was seen in 15 (25%) while multiple strictures were seen in 13 (21.7%). Ileal perforation was seen in 6 (10%) patients. Weight lo ss was seen in 40 (66.7%) patients, fever 36 (60%), night sweats 30 (50%), anorexia in 30 (50%) and pulmonary tuberculosis in 18 (30%) patients. Resection and

  14. Hanford Site background: Part 1, Soil background for nonradioactive analytes

    International Nuclear Information System (INIS)

    1993-04-01

    The determination of soil background is one of the most important activities supporting environmental restoration and waste management on the Hanford Site. Background compositions serve as the basis for identifying soil contamination, and also as a baseline in risk assessment processes used to determine soil cleanup and treatment levels. These uses of soil background require an understanding of the extent to which analytes of concern occur naturally in the soils. This report documents the results of sampling and analysis activities designed to characterize the composition of soil background at the Hanford Site, and to evaluate the feasibility for use as Sitewide background. The compositions of naturally occurring soils in the vadose Zone have been-determined for-nonradioactive inorganic and organic analytes and related physical properties. These results confirm that a Sitewide approach to the characterization of soil background is technically sound and is a viable alternative to the determination and use of numerous local or area backgrounds that yield inconsistent definitions of contamination. Sitewide soil background consists of several types of data and is appropriate for use in identifying contamination in all soils in the vadose zone on the Hanford Site. The natural concentrations of nearly every inorganic analyte extend to levels that exceed calculated health-based cleanup limits. The levels of most inorganic analytes, however, are well below these health-based limits. The highest measured background concentrations occur in three volumetrically minor soil types, the most important of which are topsoils adjacent to the Columbia River that are rich in organic carbon. No organic analyte levels above detection were found in any of the soil samples

  15. Backgrounds and characteristics of arsonists

    NARCIS (Netherlands)

    Labree, W.; Nijman, H.L.I.; Marle, H.J.C. van; Rassin, E.

    2010-01-01

    The aim of this study was to gain more insight in the backgrounds and characteristics of arsonists. For this, the psychiatric, psychological, personal, and criminal backgrounds of all arsonists (n = 25), sentenced to forced treatment in the maximum security forensic hospital “De Kijvelanden”, were

  16. Measurement of natural background neutron

    CERN Document Server

    Li Jain, Ping; Tang Jin Hua; Tang, E S; Xie Yan Fong

    1982-01-01

    A high sensitive neutron monitor is described. It has an approximate counting rate of 20 cpm for natural background neutrons. The pulse amplitude resolution, sensitivity and direction dependence of the monitor were determined. This monitor has been used for natural background measurement in Beijing area. The yearly average dose is given and compared with the results of KEK and CERN.

  17. Evaluation of dual-source parallel RF excitation for diffusion-weighted whole-body MR imaging with background body signal suppression at 3.0 T.

    Science.gov (United States)

    Mürtz, Petra; Kaschner, Marius; Träber, Frank; Kukuk, Guido M; Büdenbender, Sarah M; Skowasch, Dirk; Gieseke, Jürgen; Schild, Hans H; Willinek, Winfried A

    2012-11-01

    To evaluate the use of dual-source parallel RF excitation (TX) for diffusion-weighted whole-body MRI with background body signal suppression (DWIBS) at 3.0 T. Forty consecutive patients were examined on a clinical 3.0-T MRI system using a diffusion-weighted (DW) spin-echo echo-planar imaging sequence with a combination of short TI inversion recovery and slice-selective gradient reversal fat suppression. DWIBS of the neck (n=5), thorax (n=8), abdomen (n=6) and pelvis (n=21) was performed both with TX (2:56 min) and with standard single-source RF excitation (4:37 min). The quality of DW images and reconstructed inverted maximum intensity projections was visually judged by two readers (blinded to acquisition technique). Signal homogeneity and fat suppression were scored as "improved", "equal", "worse" or "ambiguous". Moreover, the apparent diffusion coefficient (ADC) values were measured in muscles, urinary bladder, lymph nodes and lesions. By the use of TX, signal homogeneity was "improved" in 25/40 and "equal" in 15/40 cases. Fat suppression was "improved" in 17/40 and "equal" in 23/40 cases. These improvements were statistically significant (p3.0 T with respect to signal homogeneity and fat suppression, reduced scan time by approximately one-third, and did not influence the measured ADC values. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. Aluminum as a source of background in low background experiments

    Energy Technology Data Exchange (ETDEWEB)

    Majorovits, B., E-mail: bela@mppmu.mpg.de [MPI fuer Physik, Foehringer Ring 6, 80805 Munich (Germany); Abt, I. [MPI fuer Physik, Foehringer Ring 6, 80805 Munich (Germany); Laubenstein, M. [Laboratori Nazionali del Gran Sasso, INFN, S.S.17/bis, km 18 plus 910, I-67100 Assergi (Italy); Volynets, O. [MPI fuer Physik, Foehringer Ring 6, 80805 Munich (Germany)

    2011-08-11

    Neutrinoless double beta decay would be a key to understanding the nature of neutrino masses. The next generation of High Purity Germanium experiments will have to be operated with a background rate of better than 10{sup -5} counts/(kg y keV) in the region of interest around the Q-value of the decay. Therefore, so far irrelevant sources of background have to be considered. The metalization of the surface of germanium detectors is in general done with aluminum. The background from the decays of {sup 22}Na, {sup 26}Al, {sup 226}Ra and {sup 228}Th introduced by this metalization is discussed. It is shown that only a special selection of aluminum can keep these background contributions acceptable.

  19. JEM-X background models

    DEFF Research Database (Denmark)

    Huovelin, J.; Maisala, S.; Schultz, J.

    2003-01-01

    Background and determination of its components for the JEM-X X-ray telescope on INTEGRAL are discussed. A part of the first background observations by JEM-X are analysed and results are compared to predictions. The observations are based on extensive imaging of background near the Crab Nebula...... on revolution 41 of INTEGRAL. Total observing time used for the analysis was 216 502 s, with the average of 25 cps of background for each of the two JEM-X telescopes. JEM-X1 showed slightly higher average background intensity than JEM-X2. The detectors were stable during the long exposures, and weak orbital...... background was enhanced in the central area of a detector, and it decreased radially towards the edge, with a clear vignetting effect for both JEM-X units. The instrument background was weakest in the central area of a detector and showed a steep increase at the very edges of both JEM-X detectors...

  20. Treatment of a case of emphysematous pyelonephritis that presented with acute abdomen and pneumoperitoneum: a case report.

    Science.gov (United States)

    Park, Sang Hyun; Kim, Ki Hoon

    2015-08-01

    Emphysematous pyelonephritis is a severe, life-threatening infection of the renal parenchyma and perinephric tissues. This condition is primarily encountered in patients with diabetes mellitus or ureteral obstruction, and is characterized by the production of intrarenal and perinephric gas. Emphysematous pyelonephritis is associated with a high degree of morbidity and a high mortality rate. A 72-year-old woman with a history of diabetes mellitus, hypertension, and renal calculi was referred to our emergency department following 6 days of abdominal pain. She suddenly developed pain in the entire abdomen, and was transferred. Physical examination was a distended abdomen with hypoactive bowel sounds. The tenderness was diffuse, but was most prominent in the right upper abdominal quadrant; moreover, rebound tenderness was noted. Laboratory tests revealed a white blood cell count of 4,480/mm(3), platelet count of 17,000/mm(3), creatinine level of 1.64 mg/dl, and serum glucose level of 603 mg/dl. Abdominal computed tomography indicated the presence of free air in the intraperitoneal cavity and right perirenal space, hydronephrosis of the right kidney, and stones in the right distal ureter. After 1 hour, the vital signs changed and she appeared to become drowsy. Therefore, the patient was transferred to the operation room for laparotomy. On exploration of the abdomen, 1.5 L of pus-colored fluid was removed. Although the abdominal viscera and pelvic organs were examined, hollow viscus perforation site could not be observed. Moreover, tissue necrosis and a perforation site were identified at the superior border of the right kidney. Thus, emphysematous pyelonephritis was diagnosed and she underwent right radical nephrectomy. After the surgery, the patient was admitted to the intensive care unit for postoperative management. Follow-up CT performed after 10 days showed fluid collection and hematoma at the nephrectomy site. Hence, percutaneous drainage was performed. Another

  1. Stochastic backgrounds of gravitational waves

    International Nuclear Information System (INIS)

    Maggiore, M.

    2001-01-01

    We review the motivations for the search for stochastic backgrounds of gravitational waves and we compare the experimental sensitivities that can be reached in the near future with the existing bounds and with the theoretical predictions. (author)

  2. Berkeley Low Background Counting Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Sensitive low background assay detectors and sample analysis are available for non-destructive direct gamma-ray assay of samples. Neutron activation analysis is also...

  3. Spectral characterization of natural backgrounds

    Science.gov (United States)

    Winkelmann, Max

    2017-10-01

    As the distribution and use of hyperspectral sensors is constantly increasing, the exploitation of spectral features is a threat for camouflaged objects. To improve camouflage materials at first the spectral behavior of backgrounds has to be known to adjust and optimize the spectral reflectance of camouflage materials. In an international effort, the NATO CSO working group SCI-295 "Development of Methods for Measurements and Evaluation of Natural Background EO Signatures" is developing a method how this characterization of backgrounds has to be done. It is obvious that the spectral characterization of a background will be quite an effort. To compare and exchange data internationally the measurements will have to be done in a similar way. To test and further improve this method an international field trial has been performed in Storkow, Germany. In the following we present first impressions and lessons learned from this field campaign and describe the data that has been measured.

  4. Comparison of visual biofeedback system with a guiding waveform and abdomen-chest motion self-control system for respiratory motion management

    International Nuclear Information System (INIS)

    Nakajima, Yujiro; Kadoya, Noriyuki; Kanai, Takayuki; Ito, Kengo; Sato, Kiyokazu; Dobashi, Suguru; Yamamoto, Takaya; Ishikawa, Yojiro; Matsushita, Haruo; Takeda, Ken; Jingu, Keiichi

    2016-01-01

    Irregular breathing can influence the outcome of 4D computed tomography imaging and cause artifacts. Visual biofeedback systems associated with a patient-specific guiding waveform are known to reduce respiratory irregularities. In Japan, abdomen and chest motion self-control devices (Abches) (representing simpler visual coaching techniques without a guiding waveform) are used instead; however, no studies have compared these two systems to date. Here, we evaluate the effectiveness of respiratory coaching in reducing respiratory irregularities by comparing two respiratory management systems. We collected data from 11 healthy volunteers. Bar and wave models were used as visual biofeedback systems. Abches consisted of a respiratory indicator indicating the end of each expiration and inspiration motion. Respiratory variations were quantified as root mean squared error (RMSE) of displacement and period of breathing cycles. All coaching techniques improved respiratory variation, compared with free-breathing. Displacement RMSEs were 1.43 ± 0.84, 1.22 ± 1.13, 1.21 ± 0.86 and 0.98 ± 0.47 mm for free-breathing, Abches, bar model and wave model, respectively. Period RMSEs were 0.48 ± 0.42, 0.33 ± 0.31, 0.23 ± 0.18 and 0.17 ± 0.05 s for free-breathing, Abches, bar model and wave model, respectively. The average reduction in displacement and period RMSE compared with the wave model were 27% and 47%, respectively. For variation in both displacement and period, wave model was superior to the other techniques. Our results showed that visual biofeedback combined with a wave model could potentially provide clinical benefits in respiratory management, although all techniques were able to reduce respiratory irregularities

  5. Cosmic microwave background, where next?

    CERN Multimedia

    CERN. Geneva

    2009-01-01

    Ground-based, balloon-borne and space-based experiments will observe the Cosmic Microwave Background in greater details to address open questions about the origin and the evolution of the Universe. In particular, detailed observations the polarization pattern of the Cosmic Microwave Background radiation have the potential to directly probe physics at the GUT scale and illuminate aspects of the physics of the very early Universe.

  6. Automatic Bolus Tracking Versus Fixed Time-Delay Technique in Biphasic Multidetector Computed Tomography of the Abdomen

    International Nuclear Information System (INIS)

    Adibi, Atoosa; Shahbazi, Ali

    2014-01-01

    Bolus tracking can individualize time delay for the start of scans in spiral computed tomography (CT). We compared automatic bolus tracking method with fixed time-delay technique in biphasic contrast enhancement during multidetector CT of abdomen. Adult patients referred for spiral CT of the abdomen were randomized into two groups; in group 1, the arterial and portal phases of spiral scans were started 25 s and 55 s after the start of contrast material administration; in group 2, using the automatic bolus tracking software, repetitive monitoring scans were performed within the lumen of the descending aorta as the region of interest with the threshold of starting the diagnostic scans as 60 HU. The contrast enhancement of the aorta, liver, and spleen were compared between the groups. Forty-eight patients (23 males, 25 females, mean age=56.4±13.5 years) were included. The contrast enhancement of the aorta, liver, and spleen at the arterial phase was similar between the two groups (P>0.05). Regarding the portal phase, the aorta and spleen were more enhanced in the bolus-tracking group (P<0.001). The bolus tracking provided more homogeneous contrast enhancement among different patients than the fixed time-delay technique in the liver at portal phase, but not at the arterial phase. The automatic bolus-tracking method, results in higher contrast enhancement of the aorta and spleen at the portal phase, but has no effect on liver enhancement. However, bolus tracking is associated with reduced variability for liver enhancement among different patients

  7. Consolidation whole abdomen irradiation following adjuvant carboplatin-paclitaxel based chemotherapy for advanced uterine epithelial cancer: feasibility, toxicity and outcomes

    International Nuclear Information System (INIS)

    Rochet, Nathalie; Kahn, Rachel S; Niemierko, Andrzej; Delaney, Thomas F; Russell, Anthony H

    2013-01-01

    To evaluate feasibility and preliminary outcomes associated with sequential whole abdomen irradiation (WAI) as consolidative treatment following comprehensive surgery and systemic chemotherapy for advanced endometrial cancer. We conducted a retrospective analysis of patients treated at our institution from 2000 to 2011. Inclusion criteria were stage III-IV endometrial cancer patients with histological proof of one or more sites of extra-uterine abdomen-confined disease, treated with WAI as part of multimodal therapy. Endpoints were feasibility, acute toxicity, late effects, recurrence-free survival (RFS) and overall survival (OS). Twenty patients were identified. Chemotherapy consisted of 3 to 6 cycles of a platinum-paclitaxel regimen in 18 patients. WAI was delivered using conventional technique to a median total dose of 27.5 Gy. No grade 4 toxicities occurred during chemotherapy or radiotherapy. No radiation dose reduction was necessary. Three patients developed small bowel obstruction, all in the context of recurrent intraperitoneal disease. Kaplan-Meier estimates and 95% confidence intervals for RFS and OS at one year were 63% (38–80%) and 83% (56-94%) and at 3 years 57% (33-76%) and 62% (34-81%), respectively. On univariate Cox analysis, stage IVB and serous papillary (SP) histology were found to be statistically significantly (at the p = 0.05 level) associated with worse RFS and OS. The peritoneal cavity was the most frequent site of initial failure. Consolidative WAI following chemotherapy is feasible and can be performed without interruption with manageable acute and late toxicity. Patients with endometrioid adenocarcinoma, especially stage FIGO III, had favorable outcomes possibly meriting prospective evaluation of the addition of WAI following chemotherapy in selected patients. Patients with SP do poorly and do not routinely benefit from this approach

  8. Looking for Cosmic Neutrino Background

    Directory of Open Access Journals (Sweden)

    Chiaki eYanagisawa

    2014-06-01

    Full Text Available Since the discovery of neutrino oscillation in atmospheric neutrinos by the Super-Kamiokande experiment in 1998, study of neutrinos has been one of exciting fields in high-energy physics. All the mixing angles were measured. Quests for 1 measurements of the remaining parameters, the lightest neutrino mass, the CP violating phase(s, and the sign of mass splitting between the mass eigenstates m3 and m1, and 2 better measurements to determine whether the mixing angle theta23 is less than pi/4, are in progress in a well-controlled manner. Determining the nature of neutrinos, whether they are Dirac or Majorana particles is also in progress with continuous improvement. On the other hand, although the ideas of detecting cosmic neutrino background have been discussed since 1960s, there has not been a serious concerted effort to achieve this goal. One of the reasons is that it is extremely difficult to detect such low energy neutrinos from the Big Bang. While there has been tremendous accumulation of information on Cosmic Microwave Background since its discovery in 1965, there is no direct evidence for Cosmic Neutrino Background. The importance of detecting Cosmic Neutrino Background is that, although detailed studies of Big Bang Nucleosynthesis and Cosmic Microwave Background give information of the early Universe at ~a few minutes old and ~300 k years old, respectively, observation of Cosmic Neutrino Background allows us to study the early Universe at $sim$ 1 sec old. This article reviews progress made in the past 50 years on detection methods of Cosmic Neutrino Background.

  9. Pyometra in a Great Dane: A Clinical Case Report

    Directory of Open Access Journals (Sweden)

    Malik Abu Rafee

    2015-04-01

    Full Text Available A 4-year-old Great Dane was admitted with continuous sanguino-purulent vaginal discharge, distended abdomen, and cachexia. The dog was clinically diagnosed with pyometra and successfully cured by ovario-hysterectomy. This is the first case report of pyometra seen in as Great Dane in Bareilly, India.

  10. Neutron background estimates in GESA

    Directory of Open Access Journals (Sweden)

    Fernandes A.C.

    2014-01-01

    Full Text Available The SIMPLE project looks for nuclear recoil events generated by rare dark matter scattering interactions. Nuclear recoils are also produced by more prevalent cosmogenic neutron interactions. While the rock overburden shields against (μ,n neutrons to below 10−8 cm−2 s−1, it itself contributes via radio-impurities. Additional shielding of these is similar, both suppressing and contributing neutrons. We report on the Monte Carlo (MCNP estimation of the on-detector neutron backgrounds for the SIMPLE experiment located in the GESA facility of the Laboratoire Souterrain à Bas Bruit, and its use in defining additional shielding for measurements which have led to a reduction in the extrinsic neutron background to ∼ 5 × 10−3 evts/kgd. The calculated event rate induced by the neutron background is ∼ 0,3 evts/kgd, with a dominant contribution from the detector container.

  11. LOFT gamma densitometer background fluxes

    International Nuclear Information System (INIS)

    Grimesey, R.A.; McCracken, R.T.

    1978-01-01

    Background gamma-ray fluxes were calculated at the location of the γ densitometers without integral shielding at both the hot-leg and cold-leg primary piping locations. The principal sources for background radiation at the γ densitometers are 16 N activity from the primary piping H 2 O and γ radiation from reactor internal sources. The background radiation was calculated by the point-kernel codes QAD-BSA and QAD-P5A. Reasonable assumptions were required to convert the response functions calculated by point-kernel procedures into the gamma-ray spectrum from reactor internal sources. A brief summary of point-kernel equations and theory is included

  12. A definition of background independence

    International Nuclear Information System (INIS)

    Gryb, Sean

    2010-01-01

    We propose a definition for background (in)/dependence in dynamical theories of the evolution of configurations that have a continuous symmetry and test this definition on particle models and on gravity. Our definition draws from Barbour's best matching framework developed for the purpose of implementing spatial and temporal relationalism. Among other interesting theories, general relativity can be derived within this framework in novel ways. We study the detailed canonical structure of a wide range of best matching theories and show that their actions must have a local gauge symmetry. When gauge theory is derived in this way, we obtain at the same time a conceptual framework for distinguishing between background-dependent and -independent theories. Gauge invariant observables satisfying Kuchar's criterion are identified and, in simple cases, explicitly computed. We propose a procedure for inserting a global background time into temporally relational theories. Interestingly, using this procedure in general relativity leads to unimodular gravity.

  13. Pneumonia presenting as acute abdomen in children: a report of three cases.

    Science.gov (United States)

    Vendargon, S; Wong, P S; Tan, K K

    2000-12-01

    From 10th September 1998 till 5th June 1999, the Paediatric and Cardiothoracic Surgery Units of Sultanah Aminah Hospital Johor Bahru managed three children with lung collapse secondary to pneumonia. The dominant initial clinical presentation in all three cases was acute abdominal pain. Basal pneumonia was diagnosed in two cases post-operatively after surgical contributory causes were excluded intra-operatively. Thoracotomy, evacuation of infected debris and decortication of the collapsed lung was done in all three cases. In children presenting with acute abdominal pain, basal pneumonia should be considered as a possible contributory cause.

  14. Generative electronic background music system

    Energy Technology Data Exchange (ETDEWEB)

    Mazurowski, Lukasz [Faculty of Computer Science, West Pomeranian University of Technology in Szczecin, Zolnierska Street 49, Szczecin, PL (Poland)

    2015-03-10

    In this short paper-extended abstract the new approach to generation of electronic background music has been presented. The Generative Electronic Background Music System (GEBMS) has been located between other related approaches within the musical algorithm positioning framework proposed by Woller et al. The music composition process is performed by a number of mini-models parameterized by further described properties. The mini-models generate fragments of musical patterns used in output composition. Musical pattern and output generation are controlled by container for the mini-models - a host-model. General mechanism has been presented including the example of the synthesized output compositions.

  15. Background metric in supergravity theories

    International Nuclear Information System (INIS)

    Yoneya, T.

    1978-01-01

    In supergravity theories, we investigate the conformal anomaly of the path-integral determinant and the problem of fermion zero modes in the presence of a nontrivial background metric. Except in SO(3) -invariant supergravity, there are nonvanishing conformal anomalies. As a consequence, amplitudes around the nontrivial background metric contain unpredictable arbitrariness. The fermion zero modes which are explicitly constructed for the Euclidean Schwarzschild metric are interpreted as an indication of the supersymmetric multiplet structure of a black hole. The degree of degeneracy of a black hole is 2/sup 4n/ in SO(n) supergravity

  16. Background music and cognitive performance.

    Science.gov (United States)

    Angel, Leslie A; Polzella, Donald J; Elvers, Greg C

    2010-06-01

    The present experiment employed standardized test batteries to assess the effects of fast-tempo music on cognitive performance among 56 male and female university students. A linguistic processing task and a spatial processing task were selected from the Criterion Task Set developed to assess verbal and nonverbal performance. Ten excerpts from Mozart's music matched for tempo were selected. Background music increased the speed of spatial processing and the accuracy of linguistic processing. The findings suggest that background music can have predictable effects on cognitive performance.

  17. Children of ethnic minority backgrounds

    DEFF Research Database (Denmark)

    Johansen, Stine Liv

    2010-01-01

    media products and toys just as they will have knowledge of different media texts, play genres, rhymes etc. This has consequences for their ability to access social settings, for instance in play. New research in this field will focus on how children themselves make sense of this balancing of cultures......Children of ethnic minority background balance their everyday life between a cultural background rooted in their ethnic origin and a daily life in day care, schools and with peers that is founded in a majority culture. This means, among other things, that they often will have access to different...

  18. Generative electronic background music system

    International Nuclear Information System (INIS)

    Mazurowski, Lukasz

    2015-01-01

    In this short paper-extended abstract the new approach to generation of electronic background music has been presented. The Generative Electronic Background Music System (GEBMS) has been located between other related approaches within the musical algorithm positioning framework proposed by Woller et al. The music composition process is performed by a number of mini-models parameterized by further described properties. The mini-models generate fragments of musical patterns used in output composition. Musical pattern and output generation are controlled by container for the mini-models - a host-model. General mechanism has been presented including the example of the synthesized output compositions

  19. Influence of ADP on the course of radiation sickness and some metabolic processes in rats after irradiation of abdomen and parenteral feeding

    International Nuclear Information System (INIS)

    Grozdov, S.P.; Fedorovskij, L.L.; Protserova, T.K.

    1985-01-01

    The intrapertitoneal administration of ADP (150-75 mg/kg/day) to rats on days 1-3 after exposure of abdomen to X-rays (13.5 Gy) enhanced the assimilation of glucose, amino acids and electrolytes introduced with the parenteral feeding and increased considerably the survival rate of animals

  20. Identification of Avian and Hemoparasite DNA in Blood-Engorged Abdomens of Culex pipiens (Diptera; Culicidae) from a West Nile Virus Epidemic region in Suburban Chicago, Illinois.

    Science.gov (United States)

    Boothe, Emily; Medeiros, Matthew C I; Kitron, Uriel D; Brawn, Jeffrey D; Ruiz, Marilyn O; Goldberg, Tony L; Walker, Edward D; Hamer, Gabriel L

    2015-05-01

    Multiple mosquito-borne parasites cocirculate in nature and potentially interact. To understand the community of parasites cocirculating with West Nile virus (WNV), we screened the bloodmeal content of Culex pipiens L. mosquitoes for three common types of hemoparasites. Blood-fed Cx. pipiens were collected from a WNV-epidemic area in suburban Chicago, IL, from May to September 2005 through 2010. DNA was extracted from dissected abdomens and subject to PCR and direct sequencing to identify the vertebrate host. RNA was extracted from the head or thorax and screened for WNV using quantitative reverse transcriptase PCR. Seventy-nine engorged females with avian host origin were screened using PCR and amplicon sequencing for filarioid nematodes, Haemosporida, and trypanosomatids. Filarioid nematodes were identified in 3.8% of the blooded abdomens, Plasmodium sp. in 8.9%, Haemoproteus in 31.6%, and Trypanosoma sp. in 6.3%. The sequences from these hemoparasite lineages were highly similar to sequences from birds in prior studies in suburban Chicago. Overall, 50.6% of blood-fed Culex pipiens contained hemoparasite DNA in their abdomen, presumably from current or prior bloodmeals. Additionally, we detected hemoparasite DNA in the blooded abdomen of three of 10 Cx. pipiens infected with WNV. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Low Background Micromegas in CAST

    DEFF Research Database (Denmark)

    Garza, J G; Aune, S.; Aznar, F.

    2014-01-01

    Solar axions could be converted into x-rays inside the strong magnetic field of an axion helioscope, triggering the detection of this elusive particle. Low background x-ray detectors are an essential component for the sensitivity of these searches. We report on the latest developments of the Micr...

  2. Teaching about Natural Background Radiation

    Science.gov (United States)

    Al-Azmi, Darwish; Karunakara, N.; Mustapha, Amidu O.

    2013-01-01

    Ambient gamma dose rates in air were measured at different locations (indoors and outdoors) to demonstrate the ubiquitous nature of natural background radiation in the environment and to show that levels vary from one location to another, depending on the underlying geology. The effect of a lead shield on a gamma radiation field was also…

  3. Educational Choice. A Background Paper.

    Science.gov (United States)

    Quality Education for Minorities Network, Washington, DC.

    This paper addresses school choice, one proposal to address parental involvement concerns, focusing on historical background, definitions, rationale for advocating choice, implementation strategies, and implications for minorities and low-income families. In the past, transfer payment programs such as tuition tax credits and vouchers were…

  4. Kerr metric in cosmological background

    Energy Technology Data Exchange (ETDEWEB)

    Vaidya, P C [Gujarat Univ., Ahmedabad (India). Dept. of Mathematics

    1977-06-01

    A metric satisfying Einstein's equation is given which in the vicinity of the source reduces to the well-known Kerr metric and which at large distances reduces to the Robertson-Walker metric of a nomogeneous cosmological model. The radius of the event horizon of the Kerr black hole in the cosmological background is found out.

  5. Low Background Micromegas in CAST

    CERN Document Server

    Garza, J.G.; Aznar, F.; Calvet, D.; Castel, J.F.; Christensen, F.E.; Dafni, T.; Davenport, M.; Decker, T.; Ferrer-Ribas, E.; Galán, J.; García, J.A.; Giomataris, I.; Hill, R.M.; Iguaz, F.J.; Irastorza, I.G.; Jakobsen, A.C.; Jourde, D.; Mirallas, H.; Ortega, I.; Papaevangelou, T.; Pivovaroff, M.J.; Ruz, J.; Tomás, A.; Vafeiadis, T.; Vogel, J.K.

    2015-11-16

    Solar axions could be converted into x-rays inside the strong magnetic field of an axion helioscope, triggering the detection of this elusive particle. Low background x-ray detectors are an essential component for the sensitivity of these searches. We report on the latest developments of the Micromegas detectors for the CERN Axion Solar Telescope (CAST), including technological pathfinder activities for the future International Axion Observatory (IAXO). The use of low background techniques and the application of discrimination algorithms based on the high granularity of the readout have led to background levels below 10$^{-6}$ counts/keV/cm$^2$/s, more than a factor 100 lower than the first generation of Micromegas detectors. The best levels achieved at the Canfranc Underground Laboratory (LSC) are as low as 10$^{-7}$ counts/keV/cm$^2$/s, showing good prospects for the application of this technology in IAXO. The current background model, based on underground and surface measurements, is presented, as well as ...

  6. Comparison of early surgical alternatives in the management of open abdomen: a randomized controlled study.

    Science.gov (United States)

    Rencüzoğulları, Ahmet; Dalcı, Kubilay; Eray, İsmail Cem; Yalav, Orçun; Okoh, Alexis Kofi; Akcam, Tolga; Ülkü, Abdullah; Sakman, Gürhan; Parsak, Cem P

    2015-05-01

    Abdominal compartment syndrome (ACS) is a clinical syndrome characterized by progressive intraabdominal organ dysfunction resulting from an acute increase in intra-abdominal pressure (IAP). In the absence of prompt treatment, ACS can lead to lethal organ failure. Treatment of ACS is achieved by immediate decompression of the abdominal cavity. As to how and when decompression laparotomy should be performed depends on the clinical condition of the patients. There is limited data regarding outcomes of abdominal closure techiques. The present study aimed to investigate two different temporary closure methods, the vacuum assisted closure (VAC) and Bogota bag techniques, in 40 patients who underwent decompressive laparotomy as part of the management of ACS. The study included 40 patients who developed ACS during follow-up or following trauma and abdominal surgery. As part of the treatment for ACS, these patients underwent decompressive laparotomy at the Cukurova University Medical Faculty, General Surgery Department and followed up in the Intensive Care Unit of the same hospital. VAC and Bogota bag procedures were performed as temporary closure methods for the treatment of ACS. Patients were randomly assigned to each of the two groups according to the temporary closure method performed. Clinical, laboratory, mortality and morbidity results of the patients in both groups were compared. Demographic features of the patients (age, sex, body mass index, co-morbidities) were similar between the two groups. The most common reason of ACS was gastrointestinal perforation in 12 (30%) patients. Decrease in incision width was significantly faster in the VAC group than in the Bogota group. Primary closure of fascia was considered appropriate in 16.9 days in the VAC group and 20.5 days in the Bogota bag group. The decrease in abdominal pressure was similar between the two groups on days 1, 4 and 7 but appeared to be significantly lower on day 14 in the VAC group. 12 patients (30

  7. The Cosmic Infrared Background Experiment

    Science.gov (United States)

    Bock, James; Battle, J.; Cooray, A.; Hristov, V.; Kawada, M.; Keating, B.; Lee, D.; Matsumoto, T.; Matsuura, S.; Nam, U.; Renbarger, T.; Sullivan, I.; Tsumura, K.; Wada, T.; Zemcov, M.

    2009-01-01

    We are developing the Cosmic Infrared Background ExpeRiment (CIBER) to search for signatures of first-light galaxy emission in the extragalactic background. The first generation of stars produce characteristic signatures in the near-infrared extragalactic background, including a redshifted Ly-cutoff feature and a characteristic fluctuation power spectrum, that may be detectable with a specialized instrument. CIBER consists of two wide-field cameras to measure the fluctuation power spectrum, and a low-resolution and a narrow-band spectrometer to measure the absolute background. The cameras will search for fluctuations on angular scales from 7 arcseconds to 2 degrees, where the first-light galaxy spatial power spectrum peaks. The cameras have the necessary combination of sensitivity, wide field of view, spatial resolution, and multiple bands to make a definitive measurement. CIBER will determine if the fluctuations reported by Spitzer arise from first-light galaxies. The cameras observe in a single wide field of view, eliminating systematic errors associated with mosaicing. Two bands are chosen to maximize the first-light signal contrast, at 1.6 um near the expected spectral maximum, and at 1.0 um; the combination is a powerful discriminant against fluctuations arising from local sources. We will observe regions of the sky surveyed by Spitzer and Akari. The low-resolution spectrometer will search for the redshifted Lyman cutoff feature in the 0.7 - 1.8 um spectral region. The narrow-band spectrometer will measure the absolute Zodiacal brightness using the scattered 854.2 nm Ca II Fraunhofer line. The spectrometers will test if reports of a diffuse extragalactic background in the 1 - 2 um band continues into the optical, or is caused by an under estimation of the Zodiacal foreground. We report performance of the assembled and tested instrument as we prepare for a first sounding rocket flight in early 2009. CIBER is funded by the NASA/APRA sub-orbital program.

  8. Colonic injuries and the damage control abdomen: does management strategy matter?

    Science.gov (United States)

    Georgoff, Patrick; Perales, Paul; Laguna, Benjamin; Holena, Daniel; Reilly, Patrick; Sims, Carrie

    2013-01-01

    Background The optimal management of colon injury patients requiring damage control laparotomy (DCL) is controversial. The objective of this study was to assess the safety of colonic resection and anastomosis versus fecal diversion in trauma patients requiring DCL. Methods Patients with traumatic colon injuries undergoing DCL between 2000 and 2010 were identified by the database and chart review. Those who died within 48 h were excluded. Patients were divided into two groups: those undergoing one or more colonic anastomoses with or without distal colostomy (group 1) and those undergoing colostomy only or one or more colonic anastomoses with a protecting proximal ostomy (group 2). Variables were compared using Wilcoxon rank sum, χ2, or Fisher exact tests as appropriate. Results Sixty-one patients were included (group 1, n = 28 and group 2, n = 33). Fascial closure rates (group 1, 50% versus group 2, 61%; P = 0.45), hospital length of stay (29 versus 23 d; P = 0.89), and in-patient mortality (11% versus 12%; P = 1.0) were similar between groups. There were a total of 11 anastomotic leaks, five of which were related to non-colonic enteric repairs. Colonic anastomosis leak rates were 16% overall (six of the 38 patients), 14% in group 1 (four of the 28 patients), and 20% in group 2 (two of the 10 patients). Compared with patients who did not leak, patients who leaked had a higher median age (37 versus 25 y; P = 0.05), greater likelihood of not achieving facial closure before post-injury day 5 (18% versus 2%; P = 0.003), and a longer hospital length of stay (46 versus 25 d; P = 0.003). Conclusions Outcomes after colonic injury in the setting of DCL were similar regardless of the surgical management strategy. Based on these findings, a strategy of diversion over anastomosis cannot be strongly recommended. PMID:22884449

  9. Insights into the background of autonomic medicine.

    Science.gov (United States)

    Laranjo, Sérgio; Geraldes, Vera; Oliveira, Mário; Rocha, Isabel

    2017-10-01

    Knowledge of the physiology underlying the autonomic nervous system is pivotal for understanding autonomic dysfunction in clinical practice. Autonomic dysfunction may result from primary modifications of the autonomic nervous system or be secondary to a wide range of diseases that cause severe morbidity and mortality. Together with a detailed history and physical examination, laboratory assessment of autonomic function is essential for the analysis of various clinical conditions and the establishment of effective, personalized and precise therapeutic schemes. This review summarizes the main aspects of autonomic medicine that constitute the background of cardiovascular autonomic dysfunction. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. [The psychosocial background of sterile patients].

    Science.gov (United States)

    Pusch, H H; Urdl, W; Walcher, W

    1989-01-01

    The psychosocial background of 300 childless couples from the Infertility Clinic of the Department of Gynecology and Obstetrics, University of Graz, was evaluated by means of a questionnaire and statistical analysis of data from their files. Points of special interest were problems such as interactions of the couple, motivations for the desire of children, psychosomatics, andrological investigation within the gynecological department, sexual habits and motivation and compliance concerning investigations and treatment. 72% of the questionnaires were returned. 50% of the sterile couples preferred to attend the infertility clinic together. 26% felt restrictions in their sexual behaviour due to the unrealized desire of children, 48% expected improvements in their partnership if they could have children. Compliance of male partners concerning the regular intake of prescribed medicaments was 83%, 63% accepted to stop smoking in cases of pathospermia.

  11. Whole abdomen radiation therapy in ovarian cancers: a comparison between fixed beam and volumetric arc based intensity modulation

    Directory of Open Access Journals (Sweden)

    Clivio Alessandro

    2010-11-01

    Full Text Available Abstract Purpose A study was performed to assess dosimetric characteristics of volumetric modulated arcs (RapidArc, RA and fixed field intensity modulated therapy (IMRT for Whole Abdomen Radiotherapy (WAR after ovarian cancer. Methods and Materials Plans for IMRT and RA were optimised for 5 patients prescribing 25 Gy to the whole abdomen (PTV_WAR and 45 Gy to the pelvis and pelvic nodes (PTV_Pelvis with Simultaneous Integrated Boost (SIB technique. Plans were investigated for 6 MV (RA6, IMRT6 and 15 MV (RA15, IMRT15 photons. Objectives were: for both PTVs V90% > 95%, for PTV_Pelvis: Dmax Results IMRT and RapidArc resulted comparable for target coverage. For PTV_WAR, V90% was 99.8 ± 0.2% and 93.4 ± 7.3% for IMRT6 and IMRT15, and 98.4 ± 1.7 and 98.6 ± 0.9% for RA6 and RA15. Target coverage resulted improved for PTV_Pelvis. Dose homogeneity resulted slightly improved by RA (Uniformity was defined as U5-95% = D5%-D95%/Dmean. U5-95% for PTV_WAR was 0.34 ± 0.05 and 0.32 ± 0.06 (IMRT6 and IMRT15, 0.30 ± 0.03 and 0.26 ± 0.04 (RA6 and RA15; for PTV_Pelvis, it resulted equal to 0.1 for all techniques. For organs at risk, small differences were observed between the techniques. MU resulted 3130 ± 221 (IMRT6, 2841 ± 318 (IMRT15, 538 ± 29 (RA6, 635 ± 139 (RA15; the average measured treatment time was 18.0 ± 0.8 and 17.4 ± 2.2 minutes (IMRT6 and IMRT15 and 4.8 ± 0.2 (RA6 and RA15. GAIIMRT6 = 97.3 ± 2.6%, GAIIMRT15 = 94.4 ± 2.1%, GAIRA6 = 98.7 ± 1.0% and GAIRA15 = 95.7 ± 3.7%. Conclusion RapidArc showed to be a solution to WAR treatments offering good dosimetric features with significant logistic improvements compared to IMRT.

  12. Whole abdomen radiation therapy in ovarian cancers: a comparison between fixed beam and volumetric arc based intensity modulation

    International Nuclear Information System (INIS)

    Mahantshetty, Umesh; Shrivastava, Shyamkishore; Cozzi, Luca; Jamema, Swamidas; Engineer, Reena; Deshpande, Deepak; Sarin, Rajiv; Fogliata, Antonella; Nicolini, Giorgia; Clivio, Alessandro; Vanetti, Eugenio

    2010-01-01

    A study was performed to assess dosimetric characteristics of volumetric modulated arcs (RapidArc, RA) and fixed field intensity modulated therapy (IMRT) for Whole Abdomen Radiotherapy (WAR) after ovarian cancer. Plans for IMRT and RA were optimised for 5 patients prescribing 25 Gy to the whole abdomen (PTV-WAR) and 45 Gy to the pelvis and pelvic nodes (PTV-Pelvis) with Simultaneous Integrated Boost (SIB) technique. Plans were investigated for 6 MV (RA6, IMRT6) and 15 MV (RA15, IMRT15) photons. Objectives were: for both PTVs V 90% > 95%, for PTV-Pelvis: D max < 105%; for organs at risk, maximal sparing was required. The MU and delivery time measured treatment efficiency. Pre-treatment Quality assurance was scored with Gamma Agreement Index (GAI) with 3% and 3 mm thresholds. IMRT and RapidArc resulted comparable for target coverage. For PTV-WAR, V 90% was 99.8 ± 0.2% and 93.4 ± 7.3% for IMRT6 and IMRT15, and 98.4 ± 1.7 and 98.6 ± 0.9% for RA6 and RA15. Target coverage resulted improved for PTV-Pelvis. Dose homogeneity resulted slightly improved by RA (Uniformity was defined as U 5-95% = D 5% -D 95% /D mean ). U 5 - 95% for PTV-WAR was 0.34 ± 0.05 and 0.32 ± 0.06 (IMRT6 and IMRT15), 0.30 ± 0.03 and 0.26 ± 0.04 (RA6 and RA15); for PTV-Pelvis, it resulted equal to 0.1 for all techniques. For organs at risk, small differences were observed between the techniques. MU resulted 3130 ± 221 (IMRT6), 2841 ± 318 (IMRT15), 538 ± 29 (RA6), 635 ± 139 (RA15); the average measured treatment time was 18.0 ± 0.8 and 17.4 ± 2.2 minutes (IMRT6 and IMRT15) and 4.8 ± 0.2 (RA6 and RA15). GAI IMRT6 = 97.3 ± 2.6%, GAI IMRT15 = 94.4 ± 2.1%, GAI RA6 = 98.7 ± 1.0% and GAI RA15 = 95.7 ± 3.7%. RapidArc showed to be a solution to WAR treatments offering good dosimetric features with significant logistic improvements compared to IMRT

  13. Effect of contrast-enhanced computed tomography on diagnosis and management of acute abdomen in adults

    International Nuclear Information System (INIS)

    Tsushima, Yoshito; Yamada, Shuji; Aoki, Jun; Motojima, Teiji; Endo, Keigo

    2002-01-01

    AIM: To determine the impact of computed tomography (CT) on the diagnosis and treatment plan in patients with acute abdominal pain. MATERIALS AND METHODS: A prospective study was undertaken in 125 adult patients presenting with acute abdominal pain (74 men and 51 women; 40.2 ± 19.3 years; range, 18-92). Changes in diagnosis, gain in percentage diagnostic certainty and changes of treatment plan of the surgeons in the emergency department before and after CT were evaluated. Pre- and post-CT diagnoses were compared with the final diagnoses. RESULTS: CT findings changed the initial diagnosis in 40 (32.0%) patients. The diagnostic certainty was 58.3 ± 22.9% before CT, and its gain after CT was 21.9 ± 18.5 points (P < 0.0001). Post-CT diagnoses were consistent with the final diagnosis in 116 patients (92.8%), while pre-CT diagnoses were correct in 89 patients (71.2%; P < 0.0001). Initial treatment plans were changed in 31 (24.8%) patients after CT. In 57 (45.6%) patients, CT information changed diagnoses and/or treatment plans. No significant differences were observed in the diagnosis, diagnostic certainty and treatment plan among four surgeons. CONCLUSION: Contrast-enhanced CT frequently changed the clinical diagnoses with increased diagnostic certainty and the initial treatment plans. Tsushima, Y. et al. (2002)

  14. Mesenchymal abdominal tumors in children; Mesenchymale Tumoren des Abdomens bei Kindern

    Energy Technology Data Exchange (ETDEWEB)

    Krombach, G.A. [Justus-Liebig Universitaet Giessen, Klinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Giessen, Giessen (Germany)

    2018-01-15

    Mesenchymal tumors in childhood comprise benign and malign entities and differ regarding typical sites of manifestation, age peak and clinical symptoms. In some cases biopsy is mandatory. If nephroblastoma is a possible diagnosis, biopsy must be avoided by all means in order to avoid biopsy tract metastasis. Imaging is used to narrow the differential diagnosis, describe the exact extent of the lesion and deliver complete staging. In pediatric patients sonography and MRI are the most important imaging modalities. Low-dose CT of the thorax serves for assessment of possible pulmonary metastases. (orig.) [German] Mesenchymale Tumoren im Kindesalter umfassen eine Reihe gutartiger und boesartiger Entitaeten, die sich hinsichtlich Praedilektionsort und Altersgipfel sowie bezueglich der klinischen Symptome voneinander unterscheiden. In manchen Faellen ist eine Biopsie unumgaenglich. Ist als Differenzialdiagnose ein Nephroblastom moeglich, darf auf keinen Fall biopsiert werden, um eine Zellverschleppung zu vermeiden. Aufgabe der Bildgebung ist die Eingrenzung der Differenzialdiagnose und die Bestimmung der Ausdehnung, einschliesslich des Stagings. Ultraschall und Magnetresonanztomographie (MRT) stellen diesbezueglich die wichtigsten Modalitaeten dar, die Niedrigdosis-Computertomographie des Thorax wird zum Ausschluss einer pulmonalen Metastasierung herangezogen. (orig.)

  15. Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect

    Directory of Open Access Journals (Sweden)

    Fabio Caviggioli

    2014-01-01

    Full Text Available Reconstruction of open abdominal defects is a clinical problem which general and plastic surgeons have to address in cooperation. We report the case of a 66-year-old man who presented an abdominal dehiscence after multiple laparotomies for a sigmoid-rectal adenocarcinoma that infiltrated into the abdominal wall, subsequently complicated by peritonitis and enteric fistula. A cutaneous dehiscence and an incontinent abdominal wall resulted after the last surgery. The abdominal wall was reconstructed using a biological porcine cross-linked mesh Permacol (Covidien Inc., Norwalk, CT. Negative Pressure Wound Therapy (NPWT, instead, was used on the mesh in order to reduce wound dimensions, promote granulation tissue formation, and obtain secondary closure of cutaneous dehiscence which was finally achieved with a split-thickness skin graft. Biological mesh behaved like a scaffold for the granulation tissue that was stimulated by the negative pressure. The biological mesh was rapidly integrated in the abdominal wall restoring abdominal wall continence, while the small dehiscence, still present in the central area, was subsequently covered with a split-thickness skin graft. The combination of these different procedures led us to solve this complicated case obtaining complete wound closure after less than 2 months.

  16. Efficacy of 3D-positron emission tomography/computed tomography for upper abdomen.

    Science.gov (United States)

    Murakami, Koji; Nakahara, Tadaki

    2014-04-01

    Recent advancement in computed tomography (CT) enables us to obtain high spatial resolution image and made it possible to construct extensive high-definition three-dimensional (3D) images. But a lack of contrast resolution in CT alone is still remained problem. Meanwhile, as fluorodeoxyglucose-positron emission tomography (PET) can visualize tumors in high contrast, we can create 3D images fusing the accumulation in tumors on PET/CT images. Such images can play the role of a "map of body" which makes it easy to understand the anatomical information before surgery. We also try to evaluate segmental liver function by using PET/CT fusion images. By using (11) C-methionine PET/contrast-enhanced CT, superior image quality compared to single photon emission computed tomography/CT can be obtained. CT, especially with contrast enhancement for obtaining anatomical imaging information plus PET for obtaining functional imaging information is a highly compatible combination, and adding these two types information will further increase clinical usefulness. © 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  17. Ultrasonographic anatomy of the healthy southern tigrina ( Leopardus guttulus) abdomen: comparison with domestic cat references.

    Science.gov (United States)

    Müller, Thiago R; Marcelino, Raquel S; de Souza, Livia P; Teixeira, Carlos R; Mamprim, Maria J

    2017-02-01

    Objectives The aim of the study was to describe the normal abdominal echoanatomy of the tigrina and to compare it with the abdominal echoanatomy of the domestic cat. Reference intervals for the normal abdominal ultrasonographic anatomy of individual species are important for accurate diagnoses and interpretation of routine health examinations. The hypothesis was that the echoanatomy of the tigrina was similar to that of the domestic cat. Methods Eighteen clinically healthy tigrina were selected for abdominal ultrasound examination, in order to obtain normal parameters of the bladder, spleen, adrenal gland, kidney, gastrointestinal tract, liver and gall bladder, and Doppler parameters of liver and kidney vessels. Results The splenic parenchyma was consistently hyperechoic to the kidneys and liver. The liver, kidneys and spleen had similar echotexture, shape and dimensions when compared with the domestic cat. The gall bladder was lobulated and surrounded by a clearly visualized thin, smooth, regular echogenic wall. The adrenal glands had a bilobulated shape. The urinary bladder had a thin echogenic wall. The Doppler parameters of the portal vein and renal artery were similar to the domestic cat. Conclusions and relevance The results support the hypothesis that the ultrasonographic parameters of the abdominal viscera of the southern tigrina are similar to those of the domestic cat.

  18. The effect of vacuum-assisted closure in bacterial clearance of the infected abdomen.

    Science.gov (United States)

    Pliakos, Ioannis; Michalopoulos, Nikolaos; Papavramidis, Theodossis S; Arampatzi, Stergiani; Diza-Mataftsi, Eudoxia; Papavramidis, Spiros

    2014-02-01

    Laparostomy with vacuum-assisted closure (VAC) plays an important role in improving survival in the presence of abdominal infection. We conducted a study of the qualitative changes in the bacterial flora of the peritoneal cavity in patients with severe abdominal infection treated with laparostomy and a VAC device. Thirty-nine patients with severe abdominal infection treated with abdominal opening and VAC were registered in a clinical study. When an incidence of 53.8% of hospital-acquired peritoneal infection (HAPI) was found in the study patient population, it was decided to divide the patients in two groups according to whether or not they developed a HAPI. The patients' outcomes were then analyzed. The durations of abdominal opening (p=0.04), length of stay in the intensive care unit (ICU) (p=0.01), and of hospitalization (p=0.04) were significantly greater in patients with HAPI than in those without it, whereas mortality did not differ on the basis of these three variables. Superinfection is common in laparostomy done with a VAC device for managing severe abdominal infection. The data in the present study show that VAC does not alter the quality of the bacterial burden in primary abdominal contamination, nor does it seem to prevent a high incidence of HAPI. However, VAC is as effective in reducing mortality among patients with HAPI as among those without it.

  19. Background radioactivity in environmental materials

    International Nuclear Information System (INIS)

    Maul, P.R.; O'Hara, J.P.

    1989-01-01

    This paper presents the results of a literature search to identify information on concentrations of 'background' radioactivity in foodstuffs and other commonly available environmental materials. The review has concentrated on naturally occurring radioactivity in foods and on UK data, although results from other countries have also been considered where appropriate. The data are compared with established definitions of a 'radioactive' substance and radionuclides which do not appear to be adequately covered in the literature are noted. (author)

  20. Background paper on aquaculture research

    OpenAIRE

    Wenblad, Axel; Jokumsen, Alfred; Eskelinen, Unto; Torrissen, Ole

    2013-01-01

    The Board of MISTRA established in 2012 a Working Group (WG) on Aquaculture to provide the Board with background information for its upcoming decision on whether the foundation should invest in aquaculture research. The WG included Senior Advisor Axel Wenblad, Sweden (Chairman), Professor Ole Torrissen, Norway, Senior Advisory Scientist Unto Eskelinen, Finland and Senior Advisory Scientist Alfred Jokumsen, Denmark. The WG performed an investigation of the Swedish aquaculture sector including ...

  1. The isotropic radio background revisited

    Energy Technology Data Exchange (ETDEWEB)

    Fornengo, Nicolao; Regis, Marco [Dipartimento di Fisica Teorica, Università di Torino, via P. Giuria 1, I–10125 Torino (Italy); Lineros, Roberto A. [Instituto de Física Corpuscular – CSIC/U. Valencia, Parc Científic, calle Catedrático José Beltrán, 2, E-46980 Paterna (Spain); Taoso, Marco, E-mail: fornengo@to.infn.it, E-mail: rlineros@ific.uv.es, E-mail: regis@to.infn.it, E-mail: taoso@cea.fr [Institut de Physique Théorique, CEA/Saclay, F-91191 Gif-sur-Yvette Cédex (France)

    2014-04-01

    We present an extensive analysis on the determination of the isotropic radio background. We consider six different radio maps, ranging from 22 MHz to 2.3 GHz and covering a large fraction of the sky. The large scale emission is modeled as a linear combination of an isotropic component plus the Galactic synchrotron radiation and thermal bremsstrahlung. Point-like and extended sources are either masked or accounted for by means of a template. We find a robust estimate of the isotropic radio background, with limited scatter among different Galactic models. The level of the isotropic background lies significantly above the contribution obtained by integrating the number counts of observed extragalactic sources. Since the isotropic component dominates at high latitudes, thus making the profile of the total emission flat, a Galactic origin for such excess appears unlikely. We conclude that, unless a systematic offset is present in the maps, and provided that our current understanding of the Galactic synchrotron emission is reasonable, extragalactic sources well below the current experimental threshold seem to account for the majority of the brightness of the extragalactic radio sky.

  2. The isotropic radio background revisited

    International Nuclear Information System (INIS)

    Fornengo, Nicolao; Regis, Marco; Lineros, Roberto A.; Taoso, Marco

    2014-01-01

    We present an extensive analysis on the determination of the isotropic radio background. We consider six different radio maps, ranging from 22 MHz to 2.3 GHz and covering a large fraction of the sky. The large scale emission is modeled as a linear combination of an isotropic component plus the Galactic synchrotron radiation and thermal bremsstrahlung. Point-like and extended sources are either masked or accounted for by means of a template. We find a robust estimate of the isotropic radio background, with limited scatter among different Galactic models. The level of the isotropic background lies significantly above the contribution obtained by integrating the number counts of observed extragalactic sources. Since the isotropic component dominates at high latitudes, thus making the profile of the total emission flat, a Galactic origin for such excess appears unlikely. We conclude that, unless a systematic offset is present in the maps, and provided that our current understanding of the Galactic synchrotron emission is reasonable, extragalactic sources well below the current experimental threshold seem to account for the majority of the brightness of the extragalactic radio sky

  3. Backgrounds and characteristics of arsonists.

    Science.gov (United States)

    Labree, Wim; Nijman, Henk; van Marle, Hjalmar; Rassin, Eric

    2010-01-01

    The aim of this study was to gain more insight in the backgrounds and characteristics of arsonists. For this, the psychiatric, psychological, personal, and criminal backgrounds of all arsonists (n=25), sentenced to forced treatment in the maximum security forensic hospital "De Kijvelanden", were compared to the characteristics of a control group of patients (n=50), incarcerated at the same institution for other severe crimes. Apart from DSM-IV Axis I and Axis II disorders, family backgrounds, level of education, treatment history, intelligence (WAIS scores), and PCL-R scores were included in the comparisons. Furthermore, the apparent motives for the arson offences were explored. It was found that arsonists had more often received psychiatric treatment, prior to committing their index offence, and had a history of severe alcohol abuse more often in comparison to the controls. The arsonists turned out to be less likely to suffer from a major psychotic disorder. Both groups did not differ significantly on the other variables, among which the PCL-R total scores and factor scores. Exploratory analyses however, did suggest that arsonists may differentiate from non-arsonists on three items of the PCL-R, namely impulsivity (higher scores), superficial charm (lower scores), and juvenile delinquency (lower scores). Although the number of arsonists with a major psychotic disorder was relatively low (28%), delusional thinking of some form was judged to play a role in causing arson crimes in about half of the cases (52%).

  4. Segmentation of organs at risk in CT volumes of head, thorax, abdomen, and pelvis

    Science.gov (United States)

    Han, Miaofei; Ma, Jinfeng; Li, Yan; Li, Meiling; Song, Yanli; Li, Qiang

    2015-03-01

    Accurate segmentation of organs at risk (OARs) is a key step in treatment planning system (TPS) of image guided radiation therapy. We are developing three classes of methods to segment 17 organs at risk throughout the whole body, including brain, brain stem, eyes, mandible, temporomandibular joints, parotid glands, spinal cord, lungs, trachea, heart, livers, kidneys, spleen, prostate, rectum, femoral heads, and skin. The three classes of segmentation methods include (1) threshold-based methods for organs of large contrast with adjacent structures such as lungs, trachea, and skin; (2) context-driven Generalized Hough Transform-based methods combined with graph cut algorithm for robust localization and segmentation of liver, kidneys and spleen; and (3) atlas and registration-based methods for segmentation of heart and all organs in CT volumes of head and pelvis. The segmentation accuracy for the seventeen organs was subjectively evaluated by two medical experts in three levels of score: 0, poor (unusable in clinical practice); 1, acceptable (minor revision needed); and 2, good (nearly no revision needed). A database was collected from Ruijin Hospital, Huashan Hospital, and Xuhui Central Hospital in Shanghai, China, including 127 head scans, 203 thoracic scans, 154 abdominal scans, and 73 pelvic scans. The percentages of "good" segmentation results were 97.6%, 92.9%, 81.1%, 87.4%, 85.0%, 78.7%, 94.1%, 91.1%, 81.3%, 86.7%, 82.5%, 86.4%, 79.9%, 72.6%, 68.5%, 93.2%, 96.9% for brain, brain stem, eyes, mandible, temporomandibular joints, parotid glands, spinal cord, lungs, trachea, heart, livers, kidneys, spleen, prostate, rectum, femoral heads, and skin, respectively. Various organs at risk can be reliably segmented from CT scans by use of the three classes of segmentation methods.

  5. Trauma no reciente en abdomen cerrado Non-recent abdominal closed trauma

    Directory of Open Access Journals (Sweden)

    Jesús Enrique Montejo Saínz

    2011-09-01

    Full Text Available Entre las urgencias atendidas por traumatismos diversos, en el Centro Diagnóstico Integral "Dr. Salvador Allende", en Caracas, Venezuela, se destacó el caso que se expone, luego de estar 60 días procurando atención médica en diferentes instituciones hospitalarias, sin recibir credibilidad la joven enferma. Se expone la historia de la paciente, y sus eventualidades con los hallazgos laparotómicos. Se corrobora la necesidad laparotómica con la presunción inicial por juicio clínico y se logra el consentimiento informado familiar. Como refuerzo de la praxis se efectuó el procedimiento omentun mayus, que combate la sepsis futura y garantiza la integridad subfrénica. Este caso -"trauma visceral" circunscrito al lóbulo derecho del hígado- favorece, por su carácter y modo, la enseñanza a educandos y especialistas, en caso de afrontar traumas no recientes.Among all the emergencies seen due to different traumata in the "Dr. Salvador Allende" Integral Diagnosis Center in Caracas Venezuela is emphasized the present case, after 60 days seeking medical in different hospital institutions without to receive medical care. Her history is exposed and its eventualities with the laparotomy findings. Laparotomy need is corroborated according an early clinical criterion and the achievement of the family informed consent. As a praxis effort, the omentum mayus procedure was carried out preventing the future sepsis and to guarantee the subfrenic integrity. Present case -"visceral trauma" restricted to liver right lobule, due to its character and mode, favors the teaching to students and specialists when they to face non-recent traumata.

  6. Evaluation of entrance surface-skin doses in animals submitted on exams of abdomen in veterinary radiology using Tl dosimetry

    International Nuclear Information System (INIS)

    Veneziani, G. R.; Matsushima, L. C.; Campos, L. L.; Filho, A. M.

    2014-08-01

    The radiation protection has recently gained considerable attention in human medicine. In veterinary medicine has been some advances in radiodiagnostic and therapy for domestic animal like dogs and cats. It is notable the increase of the costs with domestic animals that are considered, by many people in the whole world, like members of family. However, an important parameter that must be taken into account is the increasing use of computed tomography and other equipment s that uses ionizing radiation, which may lead to comparatively high exposure of critical organs. The radiation dose is determined by the balance between therapeutic benefit and possible damage to surrounding normal tissues. This study aimed the evaluation of entrance surface-skin doses in dogs submitted to radiodiagnostic procedures of abdomen using the technique of thermoluminescent dosimetry (TLD). The radiation doses were measured using thermoluminescent dosimeters of LiF:Mg,Ti (TLD 100) and a dog phantom made with a plastic container, proportional to the dog size, fulfilled with water. (Author)

  7. [Development of image quality assurance support system using image recognition technology in radiography in lacked images of chest and abdomen].

    Science.gov (United States)

    Shibuya, Toru; Kato, Kyouichi; Eshima, Hidekazu; Sumi, Shinichirou; Kubo, Tadashi; Ishida, Hideki; Nakazawa, Yasuo

    2012-01-01

    In order to provide a precise radiography for diagnosis, it is required that we avoid radiography with defects by having enough evaluation. Conventionally, evaluation was performed only by observation of a radiological technologist (RT). The evaluation support system was developed for providing a high quality assurance without depending on RT observation only. The evaluation support system, called as the Image Quality Assurance Support System (IQASS), is characterized in that "image recognition technology" for the purpose of diagnostic radiography of chest and abdomen areas. The technique of the system used in this study. Of the 259 samples of posterior-anterior (AP) chest, lateral chest, and upright abdominal x-rays, the sensitivity and specificity was 93.1% and 91.8% in the chest AP, 93.3% and 93.6% in the chest lateral, and 95.0% and 93.8% in the upright abdominal x-rays. In the light of these results, it is suggested that AIQAS could be applied to practical usage for the RT.

  8. Low-High and High-Low Biphasic Injection Forms in Computed Tomography Examinations of the Upper Abdomen

    International Nuclear Information System (INIS)

    Marti-Bonmati, L.; Arana, E.; Tobarra, E.; Sierra, C.

    2006-01-01

    Purpose: To analyze the influence of different biphasic and monophasic injection rate protocols in abdominal computed tomography (CT). Material and Methods: A randomized, consecutive, parallel group study was designed and conducted in 60 patients studied with the same CT helical protocol. Patients were randomly distributed into three groups: (A) monophasic (120 ml at 2.5 ml/s); (B) low-high biphasic (120 ml, first 60 ml at a rate of 2 ml/s, the other 60 ml at 2.5 ml/s); and (C) high-low biphasic (120 ml, first 60 ml at a rate of 2.5 ml/s, the other 60 ml at 2 ml/s). All patients were injected with 300 mg I/ml non-ionic contrast media at a fixed delay time of 55 s. Contrast enhancement efficacy was evaluated by attenuation coefficient measurements. Results: Although non-significant, monophasic protocol enhancements were higher than biphasic protocol enhancements in all measurements except aortic bifurcation (p = 0.003). At this level, biphasic protocols obtained an increased mean enhancement from 7.6% to 2.5% compared to monophasic protocols. Conclusion: Monophasic contrast agent injection in helical CT of the upper abdomen produces a higher enhancement of parenchymal and venous structures. No significant difference was observed between low-high and high-low biphasic protocols

  9. Contrast-enhanced 3D MR angiography of the chest and abdomen with breath-holding using phase reordering

    International Nuclear Information System (INIS)

    Amanuma, Makoto; Sugimoto, Eiichi; Enomoto, Kyoko; Watabe, Tsuneya; Heshiki, Atsuko; Hirata, Hisashi; Kimura, Toshihiko; Takizawa, Osamu.

    1995-01-01

    This report presents the feasibility of phase-reordered contrast-enhanced three-dimensional MR angiography in 32 consecutive patients with vascular abnormalities in the chest and abdomen. To suppress motion artifacts due to respiratory corruption, a phase-reordering technique was introduced so that the low frequency components of the phase data were obtained first during the imaging period. Image quality and degree of motion suppression were assessed by four radiologists independently without information on breath-holding time. Abnormalities were detected in 30 cases (93.8%), and their extent was correctly assessed in 28 cases (87.5%). More confident assessment was possible in abnormalities of the pulmonary vessels and thoracic aorta than in those of the abdominal aorta and portal venous system. With phase reordering, more than 20 seconds of breath-holding ensured image quality sufficient to correctly assess the vascular abnormalities. While this technique is easy and requires only single breath-holding, it can provide excellent MRA without slice-to-slice spatial misregistration. (author)

  10. Evaluation of entrance surface-skin doses in animals submitted on exams of abdomen in veterinary radiology using Tl dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Veneziani, G. R.; Matsushima, L. C.; Campos, L. L. [Instituto de Pesquisas Energeticas e Nucleares, Gerencia de Metrologia das Radiacoes / CNEN, Av. Lineu Prestes 2242, Cidade Universitaria, 05508-000 Sao Paulo (Brazil); Filho, A. M., E-mail: venezianigr@gmail.com [Centro Universitario de Rio Petro - UNIRP, Rodovia Br 153 (Transbrasiliana), Km. 69 Sao Jose do Rio Preto, Sao Paulo (Brazil)

    2014-08-15

    The radiation protection has recently gained considerable attention in human medicine. In veterinary medicine has been some advances in radiodiagnostic and therapy for domestic animal like dogs and cats. It is notable the increase of the costs with domestic animals that are considered, by many people in the whole world, like members of family. However, an important parameter that must be taken into account is the increasing use of computed tomography and other equipment s that uses ionizing radiation, which may lead to comparatively high exposure of critical organs. The radiation dose is determined by the balance between therapeutic benefit and possible damage to surrounding normal tissues. This study aimed the evaluation of entrance surface-skin doses in dogs submitted to radiodiagnostic procedures of abdomen using the technique of thermoluminescent dosimetry (TLD). The radiation doses were measured using thermoluminescent dosimeters of LiF:Mg,Ti (TLD 100) and a dog phantom made with a plastic container, proportional to the dog size, fulfilled with water. (Author)

  11. Family Background and Educational Choices

    DEFF Research Database (Denmark)

    McIntosh, James; D. Munk, Martin

    enrollments, especially for females. Not only did the educational opportunities for individuals with disadvantaged backgrounds improve absolutely, but their relative position also improved. A similarly dramatic increase in attendance at university for the period 1985-2005 was found for these cohorts when......We examine the participation in secondary and tertiary education of five cohorts of Danish males and females who were aged twenty starting in 1982 and ending in 2002. We find that the large expansion of secondary education in this period was characterized by a phenomenal increase in gymnasium...

  12. Background radiation map of Thailand

    International Nuclear Information System (INIS)

    Angsuwathana, P.; Chotikanatis, P.

    1997-01-01

    The radioelement concentration in the natural environment as well as the radiation exposure to man in day-to-day life is now the most interesting topic. The natural radiation is frequently referred as a standard for comparing additional sources of man-made radiation such as atomic weapon fallout, nuclear power generation, radioactive waste disposal, etc. The Department of Mineral Resources commenced a five-year project of nationwide airborne geophysical survey by awarding to Kenting Earth Sciences International Limited in 1984. The original purpose of survey was to support mineral exploration and geological mapping. Subsequently, the data quantity has been proved to be suitable for natural radiation information. In 1993 the Department of Mineral Resources, with the assistance of IAEA, published a Background Radiation Map of Thailand at the scale of 1:1,000,000 from the existing airborne radiometric digital data. The production of Background Radiation Map of Thailand is the result of data compilation and correction procedure developed over the Canadian Shield. This end product will be used as a base map in environmental application not only for Thailand but also Southeast Asia region. (author)

  13. [Cosmic Microwave Background (CMB) Anisotropies

    Science.gov (United States)

    Silk, Joseph

    1998-01-01

    One of the main areas of research is the theory of cosmic microwave background (CMB) anisotropies and analysis of CMB data. Using the four year COBE data we were able to improve existing constraints on global shear and vorticity. We found that, in the flat case (which allows for greatest anisotropy), (omega/H)0 less than 10(exp -7), where omega is the vorticity and H is the Hubble constant. This is two orders of magnitude lower than the tightest, previous constraint. We have defined a new set of statistics which quantify the amount of non-Gaussianity in small field cosmic microwave background maps. By looking at the distribution of power around rings in Fourier space, and at the correlations between adjacent rings, one can identify non-Gaussian features which are masked by large scale Gaussian fluctuations. This may be particularly useful for identifying unresolved localized sources and line-like discontinuities. Levin and collaborators devised a method to determine the global geometry of the universe through observations of patterns in the hot and cold spots of the CMB. We have derived properties of the peaks (maxima) of the CMB anisotropies expected in flat and open CDM models. We represent results for angular resolutions ranging from 5 arcmin to 20 arcmin (antenna FWHM), scales that are relevant for the MAP and COBRA/SAMBA space missions and the ground-based interferometer. Results related to galaxy formation and evolution are also discussed.

  14. Optical polarization: background and camouflage

    Science.gov (United States)

    Škerlind, Christina; Hallberg, Tomas; Eriksson, Johan; Kariis, Hans; Bergström, David

    2017-10-01

    Polarimetric imaging sensors in the electro-optical region, already military and commercially available in both the visual and infrared, show enhanced capabilities for advanced target detection and recognition. The capabilities arise due to the ability to discriminate between man-made and natural background surfaces using the polarization information of light. In the development of materials for signature management in the visible and infrared wavelength regions, different criteria need to be met to fulfil the requirements for a good camouflage against modern sensors. In conventional camouflage design, the aimed design of the surface properties of an object is to spectrally match or adapt it to a background and thereby minimizing the contrast given by a specific threat sensor. Examples will be shown from measurements of some relevant materials and how they in different ways affect the polarimetric signature. Dimensioning properties relevant in an optical camouflage from a polarimetric perspective, such as degree of polarization, the viewing or incident angle, and amount of diffuse reflection, mainly in the infrared region, will be discussed.

  15. The Cosmic Microwave Background Anisotropy

    Science.gov (United States)

    Bennett, C. L.

    1994-12-01

    The properties of the cosmic microwave background radiation provide unique constraints on the history and evolution of the universe. The first detection of anisotropy of the microwave radiation was reported by the COBE Team in 1992, based on the first year of flight data. The latest analyses of the first two years of COBE data are reviewed in this talk, including the amplitude of the microwave anisotropy as a function of angular scale and the statistical nature of the fluctuations. The two-year results are generally consistent with the earlier first year results, but the additional data allow for a better determination of the key cosmological parameters. In this talk the COBE results are compared with other observational anisotropy results and directions for future cosmic microwave anisotropy observations will be discussed. The National Aeronautics and Space Administration/Goddard Space Flight Center (NASA/GSFC) is responsible for the design, development, and operation of the Cosmic Background Explorer (COBE). Scientific guidance is provided by the COBE Science Working Group.

  16. Low background aspects of GERDA

    International Nuclear Information System (INIS)

    Simgen, Hardy

    2011-01-01

    The GERDA experiment operates bare Germanium diodes enriched in 76 Ge in an environment of pure liquid argon to search for neutrinoless double beta decay. A very low radioactive background is essential for the success of the experiment. We present here the research done in order to remove radio-impurities coming from the liquid argon, the stainless steel cryostat and the front-end electronics. We found that liquid argon can be purified efficiently from 222 Rn. The main source of 222 Rn in GERDA is the cryostat which emanates about 55 mBq. A thin copper shroud in the center of the cryostat was implemented to prevent radon from approaching the diodes. Gamma ray screening of radio-pure components for front-end electronics resulted in the development of a pre-amplifier with a total activity of less than 1 mBq 228 Th.

  17. The cosmic microwave background radiation

    International Nuclear Information System (INIS)

    Wilson, R.W.

    1980-01-01

    The history is described of the discovery of microwave radiation of the cosmic background using the 20-foot horn antenna at the Bell Laboratories back in 1965. Ruby masers with travelling wave were used, featuring the lowest noise in the world. The measurement proceeded on 7 cm. In measuring microwave radiation from the regions outside the Milky Way continuous noise was discovered whose temperature exceeded the calculated contributions of the individual detection system elements by 3 K. A comparison with the theory showed that relict radiation from the Big Bang period was the source of the noise. The discovery was verified by measurements on the 20.1 cm wavelength and by other authors' measurements on 0.5 mm to 74 cm, and by optical measurements of the interstellar molecule spectrum. (Ha)

  18. Polarization of Cosmic Microwave Background

    International Nuclear Information System (INIS)

    Buzzelli, A; Cabella, P; De Gasperis, G; Vittorio, N

    2016-01-01

    In this work we present an extension of the ROMA map-making code for data analysis of Cosmic Microwave Background polarization, with particular attention given to the inflationary polarization B-modes. The new algorithm takes into account a possible cross- correlated noise component among the different detectors of a CMB experiment. We tested the code on the observational data of the BOOMERanG (2003) experiment and we show that we are provided with a better estimate of the power spectra, in particular the error bars of the BB spectrum are smaller up to 20% for low multipoles. We point out the general validity of the new method. A possible future application is the LSPE balloon experiment, devoted to the observation of polarization at large angular scales. (paper)

  19. Étude du comportement interne de l’abdomen lors d’un impact : observations par échographie ultrarapide

    OpenAIRE

    HELFENSTEIN , Clémentine

    2013-01-01

    Due to limitations of observation techniques, past researches in impact biomechanics on the abdomen have been mostly limited to the description of the externals responses. This study focuses on the internal response of abdominal organs using recent observation techniques: ultrafast ultrasound imaging and shearwave elastography. First, the effects of perfusion conditions on the geometrical and internal shear moduli of ex vivo porcine kidneys were evaluated. The considerable effect of the appli...

  20. Adaptive iterative dose reduction (AIDR) 3D in low dose CT abdomen-pelvis: Effects on image quality and radiation exposure

    International Nuclear Information System (INIS)

    Ang, W C; Hashim, S; Karim, M K A; Bahruddin, N A; Salehhon, N; Musa, Y

    2017-01-01

    The widespread use of computed tomography (CT) has increased the medical radiation exposure and cancer risk. We aimed to evaluate the impact of AIDR 3D in CT abdomen-pelvic examinations based on image quality and radiation dose in low dose (LD) setting compared to standard dose (STD) with filtered back projection (FBP) reconstruction. We retrospectively reviewed the images of 40 patients who underwent CT abdomen-pelvic using a 80 slice CT scanner. Group 1 patients ( n =20, mean age 41 ± 17 years) were performed at LD with AIDR 3D reconstruction and Group 2 patients ( n =20, mean age 52 ± 21 years) were scanned with STD using FBP reconstruction. Objective image noise was assessed by region of interest (ROI) measurements in the liver and aorta as standard deviation (SD) of the attenuation value (Hounsfield Unit, HU) while subjective image quality was evaluated by two radiologists. Statistical analysis was used to compare the scan length, CT dose index volume (CTDI vol ) and image quality of both patient groups. Although both groups have similar mean scan length, the CTDI vol significantly decreased by 38% in LD CT compared to STD CT ( p <0.05). Objective and subjective image quality were statistically improved with AIDR 3D ( p <0.05). In conclusion, AIDR 3D enables significant dose reduction of 38% with superior image quality in LD CT abdomen-pelvis. (paper)

  1. The relationship of body mass index and abdominal fat on the radiation dose received during routine computed tomographic imaging of the abdomen and pelvis.

    Science.gov (United States)

    Chan, Victoria O; McDermott, Shaunagh; Buckley, Orla; Allen, Sonya; Casey, Michael; O'Laoide, Risteard; Torreggiani, William C

    2012-11-01

    To determine the relationship of increasing body mass index (BMI) and abdominal fat on the effective dose acquired from computed tomography (CT) abdomen and pelvis scans. Over 6 months, dose-length product and total milliamp-seconds (mAs) from routine CT abdomen and pelvis scans of 100 patients were recorded. The scans were performed on a 64-slice CT scanner by using an automatic exposure control system. Effective dose (mSv) based on dose-length product, BMI, periumbilical fat thickness, and intra-abdominal fat were documented for each patient. BMI, periumbilical fat thickness, and intra-abdominal fat were compared with effective dose. Thirty-nine men and 61 women were included in the study (mean age, 56.3 years). The mean BMI was 26.2 kg/m(2). The mean effective dose was 10.3 mSv. The mean periumbilical fat thickness was 2.4 cm. Sixty-five patients had a small amount of intra-abdominal fat, and 35 had a large amount of intra-abdominal fat. The effective dose increased with increasing BMI (P abdominal fat (P abdominal fat significantly increases the effective dose received from CT abdomen and pelvis scans. Copyright © 2012 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  2. Combing a novel device and negative pressure wound therapy for managing the wound around a colostomy in the open abdomen: A case report.

    Science.gov (United States)

    Sun, Xiaofang; Wu, Shaohan; Xie, Ting; Zhang, Jianping

    2017-12-01

    An open abdomen complicated with small-bowel fistulae becomes a complex wound for local infection, systemic sepsis and persistent soiling irritation by intestinal content. While controlling the fistulae drainage, protecting surrounding skin, healing the wound maybe a challenge. In this paper we described a 68-year-old female was admitted to emergency surgery in general surgery department with severe abdomen pain. Resection part of the injured small bowel, drainage of the intra-abdominal abscess, and fashioning of a colostomy were performed. She failed to improve and ultimately there was tenderness and lot of pus under the skin around the fistulae. The wound started as a 3-cm lesion and progressed to a 6 ×13  (78 cm) around the stoma. In our case we present a novel device for managing colostomy wound combination with negative pressure wound therapy. This tube allows for an effective drainage of small-bowel secretion and a safe build-up of granulation tissue. Also it could be a barrier between the bowel suction point and foam. Management of open abdomen wound involves initial dressing changes, antibiotic use and cutaneous closure. When compared with traditional dressing changes, the NPWT offers several advantages including increased granulation tissue formation, reduction in bacterial colonization, decreased of bowel edema and wound size, and enhanced neovascularization. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  3. MANEJO LOCAL DE UNA FÍSTULA ENTERO-ATMOSFÉRICA EN EL ABDOMEN ABIERTO: CURA EN CHIMENEA PRESENTACIÓN DE CASO

    Directory of Open Access Journals (Sweden)

    Sánchez-Manuel FJ

    2015-01-01

    Full Text Available INTRODUCTION: The open abdomen is both a resource and a surgical sequela after damage-control surgery, that helps saving the live of critically ill patients. It can have significant complications, the most severe one is the entero-atmospheric fistula. CASE REPORT: We report the case of a patient from our hospital, treated with longstanding open abdomen because of a traumatic pancreatitis and development of an enteroatmospheric fistula, handled with a variation of the fistula ring technique: a "fireplace" design in a vacuum system. A review of the literature on the subject is made. RESULTS AND CONCLUSIONS: This strategy proved effective for the management of the fistula until the final repair of the bowel. The management of an enteroatmospheric fistula is a major technical challenge to prevent the leak of intestinal contents on the surrounding exposed bowel and granulation tissue. The "fireplace" design represents a good option for distal ileum fistulas, greatly simplifying the treatment of the patient by maintaining the open abdomen clean and the fistula effluent isolated until the transit repair, which is usually carried out along with the abdominal wall repair, few months later.

  4. 18F-FDG PET as a single imaging modality in pediatric neuroblastoma. Comparison with abdomen CT and bone scintigraphy

    International Nuclear Information System (INIS)

    Choi, Yun Jung; Hwang, Hee Sung; Kim, Hyun Jeong; Jeong, Yong Hyu; Cho, Arthur; Lee, Jae Hoon; Yun, Mijin; Lee, Jong Doo; Kang, Won Jun

    2014-01-01

    The purpose of this study was to evaluate the diagnostic performance of 18 F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) as a single imaging agent in neuroblastoma in comparison with other imaging modalities. A total of 30 patients with pathologically proven neuroblastoma who underwent FDG PET for staging were enrolled. Diagnostic performance of FDG PET and abdomen CT was compared in detecting soft tissue lesions. FDG PET and bone scintigraphy (BS) were compared in bone metastases. Maximal standardized uptake value (SUVmax) of primary or recurrent lesions was calculated for quantitative analysis. Tumor FDG uptake was detected in 29 of 30 patients with primary neuroblastoma. On initial FDG PET, SUVmax of primary lesions were lower in early stage (I-II) than in late stage (III-IV) (3.03 vs. 5.45, respectively, p=0.019). FDG PET was superior to CT scan in detecting distant lymph nodes (23 vs. 18 from 23 lymph nodes). FDG PET showed higher accuracy to identify bone metastases than BS both on patient-based analyses (100 vs. 94.4% in sensitivity, 100 vs. 77.8% in specificity), and on lesion-based analyses (FDG PET: 203 lesions, BS: 86 lesions). Sensitivity and specificity of FDG PET to detect recurrence were 87.5% and 93.8, respectively. FDG PET was superior to CT in detecting distant LN metastasis and to BS in detecting skeletal metastasis in neuroblastoma. BS might be eliminated in the evaluation of neuroblastoma when FDG PET is performed. (author)

  5. Does a Rater's Professional Background Influence Communication Skills Assessment?

    Science.gov (United States)

    Artemiou, Elpida; Hecker, Kent G; Adams, Cindy L; Coe, Jason B

    2015-01-01

    There is increasing pressure in veterinary education to teach and assess communication skills, with the Objective Structured Clinical Examination (OSCE) being the most common assessment method. Previous research reveals that raters are a large source of variance in OSCEs. This study focused on examining the effect of raters' professional background as a source of variance when assessing students' communication skills. Twenty-three raters were categorized according to their professional background: clinical sciences (n=11), basic sciences (n=4), clinical communication (n=5), or hospital administrator/clinical skills technicians (n=3). Raters from each professional background were assigned to the same station and assessed the same students during two four-station OSCEs. Students were in year 2 of their pre-clinical program. Repeated-measures ANOVA results showed that OSCE scores awarded by the rater groups differed significantly: (F(matched_station_1) [2,91]=6.97, p=.002), (F(matched_station_2) [3,90]=13.95, p=.001), (F(matched_station_3) [3,90]=8.76, p=.001), and ((Fmatched_station_4) [2,91]=30.60, p=.001). A significant time effect between the two OSCEs was calculated for matched stations 1, 2, and 4, indicating improved student performances. Raters with a clinical communication skills background assigned scores that were significantly lower compared to the other rater groups. Analysis of written feedback provided by the clinical sciences raters showed that they were influenced by the students' clinical knowledge of the case and that they did not rely solely on the communication checklist items. This study shows that it is important to consider rater background both in recruitment and training programs for communication skills' assessment.

  6. Acute abdomen in AIDS

    International Nuclear Information System (INIS)

    Kuhlman, J.E.; Fishman, E.K.

    1989-01-01

    The CT scans of 80 patients with both AIDS and acute abdominal pain were reviewed. CT identifiable causes of pain included perforation (four); colitides (15); septic infarctions (six); abscesses (10); bowel obstruction due to tumor (four); ascending cholangitis (two); enterovesical fistula (one); and sacral osteomyelitis (one). CT affected management in 40% of patients by narrowing diagnostic possibilities, triaging between surgical versus nonsurgical emergencies, and directing diagnostic procedures. CT was an expeditious triage modality for evaluating the critically ill patient with AIDS and acute abdominal pain

  7. Plenoptic background oriented schlieren imaging

    International Nuclear Information System (INIS)

    Klemkowsky, Jenna N; Fahringer, Timothy W; Clifford, Christopher J; Thurow, Brian S; Bathel, Brett F

    2017-01-01

    The combination of the background oriented schlieren (BOS) technique with the unique imaging capabilities of a plenoptic camera, termed plenoptic BOS, is introduced as a new addition to the family of schlieren techniques. Compared to conventional single camera BOS, plenoptic BOS is capable of sampling multiple lines-of-sight simultaneously. Displacements from each line-of-sight are collectively used to build a four-dimensional displacement field, which is a vector function structured similarly to the original light field captured in a raw plenoptic image. The displacement field is used to render focused BOS images, which qualitatively are narrow depth of field slices of the density gradient field. Unlike focused schlieren methods that require manually changing the focal plane during data collection, plenoptic BOS synthetically changes the focal plane position during post-processing, such that all focal planes are captured in a single snapshot. Through two different experiments, this work demonstrates that plenoptic BOS is capable of isolating narrow depth of field features, qualitatively inferring depth, and quantitatively estimating the location of disturbances in 3D space. Such results motivate future work to transition this single-camera technique towards quantitative reconstructions of 3D density fields. (paper)

  8. Concerning background from calorimeter ports

    International Nuclear Information System (INIS)

    Digiacomo, N.J.

    1985-01-01

    Any detector system viewing a port or slit in a calorimeter wall will see, in addition to the primary particles of interest, a background of charged and neutral particles and photons generated by scattering from the port walls and by leakage from incompletely contained primary particle showers in the calorimeter near the port. The signal to noise ratio attainable outside the port is a complex function of the primary source spectrum, the calorimeter and port design and, of course, the nature and acceptance of the detector system that views the port. Rather than making general statements about the overall suitability (or lack thereof) of calorimeter ports, we offer here a specific example based on the external spectrometer and slit of the NA34 experiment. This combination of slit and spectrometer is designed for fixed-target work, so that the primary particle momentum spectrum contains higher momentum particles than expected in a heavy ion colliding beam environment. The results are, nevertheless, quite relevant for the collider case

  9. Natural background radiation in Jordan

    International Nuclear Information System (INIS)

    Daoud, M.N.S.

    1997-01-01

    An Airborne Gamma Ray survey has been accomplished for Jordan since 1979. A complete report has been submitted to the Natural Resources Authority along with field and processed data ''digital and analogue''. Natural radioelements concentration is not provided with this report. From the corrected count rate data for each natural radioelement, Concentrations and exposure rates at the ground level were calculated. Contoured maps, showing the exposure rates and the dose rates were created. Both maps reflect the surface geology of Jordan, where the Phosphate areas are very well delineated by high-level contours. In southeastern Jordan the Ordovician sandstone, which contain high percentage of Th (around 2000 ppm in some places) and a moderate percentage of U (about 300 ppm), also show high gamma radiation exposures compared with the surrounding areas. Comparing the values of the exposure rates given in (μR/h) to those obtained from other countries such as United States, Canada, Germany, etc. Jordan shows higher background radiation which reach two folds and even more than those in these countries. More detailed studies should be performed in order to evaluate the radiological risk limits on people who are living in areas of high radiation such that the area of the phosphatic belt which covers a vast area of Jordan high Plateau. (author)

  10. Natural background radiation in Jordan

    Energy Technology Data Exchange (ETDEWEB)

    Daoud, M N.S. [National Resources Authority, Ministry of Energy and Mineral Resources, Amman (Jordan)

    1997-11-01

    An Airborne Gamma Ray survey has been accomplished for Jordan since 1979. A complete report has been submitted to the Natural Resources Authority along with field and processed data ``digital and analogue``. Natural radioelements concentration is not provided with this report. From the corrected count rate data for each natural radioelement, Concentrations and exposure rates at the ground level were calculated. Contoured maps, showing the exposure rates and the dose rates were created. Both maps reflect the surface geology of Jordan, where the Phosphate areas are very well delineated by high-level contours. In southeastern Jordan the Ordovician sandstone, which contain high percentage of Th (around 2000 ppm in some places) and a moderate percentage of U (about 300 ppm), also show high gamma radiation exposures compared with the surrounding areas. Comparing the values of the exposure rates given in ({mu}R/h) to those obtained from other countries such as United States, Canada, Germany, etc. Jordan shows higher background radiation which reach two folds and even more than those in these countries. More detailed studies should be performed in order to evaluate the radiological risk limits on people who are living in areas of high radiation such that the area of the phosphatic belt which covers a vast area of Jordan high Plateau. (author). 8 refs, 10 figs, 7 tabs.

  11. Management of the open abdomen using negative pressure wound therapy with instillation in severe abdominal sepsis: A review of 48 cases in Hospital Mexico, Costa Rica.

    Science.gov (United States)

    Sibaja, Pablo; Sanchez, Alfredo; Villegas, Guillermo; Apestegui, Alvaro; Mora, Esteban

    2017-01-01

    Despite the numerous advances in recent years, severe abdominal sepsis (with associated organ failure associated with infection) remains a serious, life-threatening condition with a high mortality rate. OA is a viable alternative to the previously used scheduled repeat laparotomy or continuous peritoneal lavage. The use of Negative Pressure Wound Therapy (NPWT) has been described as a successful method of management of the open abdomen. Adding instillation of saline solution to NPWT in a programmed and controlled manner, could offer the clinician an additional tool for the management of complex septic abdomen. To explore if the concept of active two-way therapy (Negative pressure wound therapy with instillation or NPWT-I) yields superior control of underlying, life-threatening abdominal infections and its effects on survival and morbidity in patients with severe abdominal sepsis when management with an open abdomen is required. A retrospective review of 48 patients with severe abdominal sepsis, who were managed with and open abdomen and NPWT-I was performed. NPWT-I was initiated utilizing the same parameters on all patients, this consisted of cycles of instillation of saline solution, which was removed through negative pressure after a short dwell period. We observed the effects on primary fascia closure rate, mortality, hospital and SICU length of stay and associated complications. Our patient group consisted of 20 (42%) males and 28 (58%) females. Average age was 48 years. Mortality in these patients was attributed to pulmonary embolism (n=1), acute renal failure (n=2) and cardiopulmonary arrest (n=1). Average total hospital stay was 24days, and stay in the SICU (n=26) averaged 7.5days. No acute complications related to the NPWT-I. All patients presenting with abdominal compartment syndrome resolved after initiation of the NPWT-I. A total of 46 patients (96%) patients achieved fascia closure after NPWT-I therapy after an average of 6days. Four patients (8%) died

  12. Hypothyroidism in clinical practice

    Directory of Open Access Journals (Sweden)

    Faiza Qari

    2014-01-01

    Full Text Available Background: Hypothyroidism is the most common endocrine disease that was seen in the clinical practice especially for family physicians. Methods: This review article covered the important practical clinical issues for managing overt hypothyroidism, subclinical hypothyroidism and hypothyroidism during pregnancy. Conclusions: The clinical issues were addressed by clinical scenario followed by questions and stressed on the important clinical points.

  13. Evaluation of dual-source parallel RF excitation for diffusion-weighted whole-body MR imaging with background body signal suppression at 3.0 T

    Energy Technology Data Exchange (ETDEWEB)

    Muertz, Petra, E-mail: petra.muertz@ukb.uni-bonn.de [Department of Radiology, University of Bonn (Germany); Kaschner, Marius, E-mail: marius.kaschner@ukb.uni-bonn.de [Department of Radiology, University of Bonn (Germany); Traeber, Frank, E-mail: frank.traeber@ukb.uni-bonn.de [Department of Radiology, University of Bonn (Germany); Kukuk, Guido M., E-mail: guido.kukuk@ukb.uni-bonn.de [Department of Radiology, University of Bonn (Germany); Buedenbender, Sarah M., E-mail: sarah_m_buedenbender@yahoo.de [Department of Radiology, University of Bonn (Germany); Skowasch, Dirk, E-mail: dirk.skowasch@ukb.uni-bonn.de [Department of Medicine, University of Bonn (Germany); Gieseke, Juergen, E-mail: juergen.gieseke@philips.com [Philips Healthcare, Best (Netherlands); Department of Radiology, University of Bonn (Germany); Schild, Hans H., E-mail: hans.schild@ukb.uni-bonn.de [Department of Radiology, University of Bonn (Germany); Willinek, Winfried A., E-mail: winfried.willinek@ukb.uni-bonn.de [Department of Radiology, University of Bonn (Germany)

    2012-11-15

    Purpose: To evaluate the use of dual-source parallel RF excitation (TX) for diffusion-weighted whole-body MRI with background body signal suppression (DWIBS) at 3.0 T. Materials and methods: Forty consecutive patients were examined on a clinical 3.0-T MRI system using a diffusion-weighted (DW) spin-echo echo-planar imaging sequence with a combination of short TI inversion recovery and slice-selective gradient reversal fat suppression. DWIBS of the neck (n = 5), thorax (n = 8), abdomen (n = 6) and pelvis (n = 21) was performed both with TX (2:56 min) and with standard single-source RF excitation (4:37 min). The quality of DW images and reconstructed inverted maximum intensity projections was visually judged by two readers (blinded to acquisition technique). Signal homogeneity and fat suppression were scored as 'improved', 'equal', 'worse' or 'ambiguous'. Moreover, the apparent diffusion coefficient (ADC) values were measured in muscles, urinary bladder, lymph nodes and lesions. Results: By the use of TX, signal homogeneity was 'improved' in 25/40 and 'equal' in 15/40 cases. Fat suppression was 'improved' in 17/40 and 'equal' in 23/40 cases. These improvements were statistically significant (p < 0.001, Wilcoxon signed-rank test). In five patients, fluid-related dielectric shading was present, which improved remarkably. The ADC values did not significantly differ for the two RF excitation methods (p = 0.630 over all data, pairwise Student's t-test). Conclusion: Dual-source parallel RF excitation improved image quality of DWIBS at 3.0 T with respect to signal homogeneity and fat suppression, reduced scan time by approximately one-third, and did not influence the measured ADC values.

  14. Clinics in diagnostic imaging (171). Caecal volvulus with underlying intestinal malrotation.

    Science.gov (United States)

    Ooi, Su Kai Gideon; Tan, Tien Jin; Ngu, James Chi Yong

    2016-11-01

    A 46-year-old Chinese woman with a history of cholecystectomy and appendicectomy presented to the emergency department with symptoms of intestinal obstruction. Physical examination revealed central abdominal tenderness but no clinical features of peritonism. Plain radiography of the abdomen revealed a grossly distended large bowel loop with the long axis extending from the right lower abdomen toward the epigastrium, and an intraluminal air-fluid level. These findings were suspicious for an acute caecal volvulus, which was confirmed on subsequent contrast-enhanced computed tomography (CT) of the abdomen and pelvis. CT demonstrated an abnormal positional relationship between the superior mesenteric vein and artery, indicative of an underlying intestinal malrotation. This case highlights the utility of preoperative imaging in establishing the diagnosis of an uncommon cause of bowel obstruction. It also shows the importance of recognising the characteristic imaging features early, so as to ensure appropriate and expedient management, thus reducing patient morbidity arising from complications. Copyright: © Singapore Medical Association.

  15. Detection of skeletal muscle metastasis: torso FDG PET-CT versus contrast-enhanced chest or abdomen CT.

    Science.gov (United States)

    So, Young; Yi, Jeong Geun; Song, Inyoung; Lee, Won Woo; Chung, Hyun Woo; Park, Jeong Hee; Moon, Sung Gyu

    2015-07-01

    Skeletal muscle metastasis (SMM) in cancer patients has not been sufficiently evaluated regarding prevalence and proper method of detection. To determine the prevalence of SMM and compare the diagnostic competencies for SMM of torso F-18 fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) and contrast-enhanced chest or abdomen CT. We investigated 18,225 PET-CT studies of 6359 cancer patients performed from 2005 to 2012. The PET-CT studies describing potential SMM were retrieved and the corresponding medical records were reviewed. The gold standard for SMM was histopathologically-proven SMM or imaging study-based disease progression. The detectability of SMM was compared between PET-CT and contrast-enhanced CT. Twenty-six patients had 84 SMM lesions, representing a SMM prevalence of 0.41%. Lung cancer was the most common SMM-associated malignancy (54%) and the gluteal/pelvic girdle muscle was the most frequently involved SMM site (37%). All 84 SMM lesions were visualized on PET-CT (100%). Of these PET-CT positive 84 SMM lesions, 51 lesions were in the CT field of view (FOV) (61%), whereas 33 lesions were out of the CT FOV (39%). Among these 51 lesions, 17 lesions showed rim-enhancing nodules/masses (33%), eight lesions showed homogeneously enhancing nodules (16%), three lesions showed heterogeneously enhancing nodules (6%), and 23 SMM lesions (45%) were non-diagnostic by CT. All 51 SMM lesions within CT FOV were detected on PET-CT (100%), whereas only 28 were visualized on CT (54.9%), resulting in a significant difference (P SMM was revealed by PET-CT. The prevalence of SMM was as low as 0.41% in the current large cohort of cancer patients. Torso PET-CT was a more competent modality than contrast-enhanced CT in the detection of SMM. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  16. Abdomen y corazón. ¿El primer paso del síndrome cardiorrenal?

    Directory of Open Access Journals (Sweden)

    Carlos Ruben Lopez P.

    2017-01-01

    Full Text Available A pesar de los grandes avances en la cardiología en el siglo XX y XXI, la insuficiencia cardiaca sigue suponiendo la principal causa de hospitalización en las personas ancianas y presentando un pronóstico ominoso. Además, a pesar de los múltiples estudios sobre nuevas dianas farmacológicas, apenas hemos avanzado en el campo del tratamiento, tal vez porque aún existen lagunas en su fisiopatología. No debemos olvidar que la insuficiencia cardiaca es un compendio de signos y síntomas que engloban múltiples órganos y sistemas.  Mucho se está investigando sobre la relación entre riñón y corazón en forma de síndrome cardiorrenal.  Algo cada vez más en boga es el papel del abdomen en la disfunción orgánica de la insuficiencia cardiaca. En ese sentido, el sistema venoso contiene el 70% del volumen sanguíneo, siendo almacenado en su mayor parte dentro de las vísceras abdominales. Un aumento del tono simpático supone aumento intenso del retorno venoso tan importante como para  aumentar las presiones de llenado y justificar una descompensación cardiaca. La congestión sistémica determina un aumento en la presión intraabdominal que está correlacionada con la disfunción renal en la insuficiencia cardiaca avanzada. La hipoperfusión tisular intestinal supone microtraslocación bacteriana promoviendo el status proinflamatorio típico de este síndrome. La visión holística e integrada de la insuficiencia cardiaca puede suponer un avance tanto en la estratificación del riesgo como en las estrategias terapéuticas. Grandes pasos se están dando en este sentido con estudios sobre la ultrafiltración, paracentesis, diálisis peritoneal, suero hipertónico o fármacos adsorbentes del sodio.

  17. Clinical Study of Ectopic Pregnancy in a Tertiary Care Hospital in Nepal

    Directory of Open Access Journals (Sweden)

    Narinder Kaur

    2014-12-01

    seventh postoperative day. Conclusion: Ectopic pregnancy can be suspected clinically by history and associated risk factors. Women presenting with acute pain abdomen with a positive urine β-hCG test should be promptly diagnosed and treated without undue delay to reduce maternal morbidity and mortality.

  18. Neutron therapy: The historical background

    International Nuclear Information System (INIS)

    Svensson, H.; Landberg, T.

    1994-01-01

    Neutron therapy was first introduced by Stone et al. in 1938, i.e. more than 10 years earlier than electron beam therapy and only 6 years after the discovery of neutrons. In spite of the impressive accomplishment in generating an adequate therapy beam, time was also found for careful radiobiological studies of neutron beams. However, it was not considered that for a certain early reaction the late effects were much greater with neutrons than with X-rays. The severe late sequelae in proportion to the few good results motivated the closure of this therapy. Neutron therapy was again introduced in Hammersmith hospital at the end of the 1960's. The major reason seems to have been to overcome the oxygen effect. Encouraging results were reported. It was argued that the very favourable statistics on local tumour control were obtained at the expense of more frequent and more severe complications. A clinical trial in Edinburgh seemed to indicate this, but it was not proved in the end as the two trials differed regarding fractionation. Today about 16000 patients have been treated with neutrons. The neutron beams now used differ significantly, both regarding dose distributions and microdosimetrical properties, from those utilized earlier. The advantage of neutrons is still, however, controversial. There are indications that neutron treatment may be favourable for some tumours. A careful cost-benefit study ought to be performed before the creation of a neutron therapy centre in Sweden as the group of patients suitable for neutrons is limited, and there may be new possibilities for improvement of photon and electron treatment with much smaller resources. (orig.)

  19. Etiology, clinical profile, severity and outcome of acute pancreatitis in relation to bed side index for severity of acute pancreatitis bisap and CT severity index [CTSI] scores

    Directory of Open Access Journals (Sweden)

    Bezwada Srinivasa Rao, Matta SreeVani, V.Sarat Chandra

    2014-11-01

    Full Text Available Background: Acute pancreatitis is an inflammatory process of the pancreas with involvement of regional tissues or remote organ systems and with potentially devastating consequences. Early prediction of outcome of acute pancreatitis within 24 hrs by clinically based bed Side Index of Severity of Acute Pancreatitis [BISAP] Score and radiological based CT Severity Index [CTSI] later on being useful in initiation of early treatment, assessing severity, to prevent morbidity and mortality. In those who survive, it can progress to chronic pancreatitis resulting in malabsorption and permanent diabetes. Aim: The aim was to study aetiology, clinical profile, severity, outcome of acute pancreatitis in relation to BISAP Score and CTSI. Materials and Methods: This was an observational and prospective study. The present study enrolled 55 patients who were diagnosed as acute pancreatitis and patients with chronic pancreatitis were excluded from the study. Vital data like pulse rate, blood Pressure, temperature, respiratory rate, conscious level using Glasgow coma scale, serum amylase, lipase, Chest x-ray, US abdomen and CT abdomen [both CECT & NCCT] were done. BISAP Score was obtained at the time of presentation or within 24 hours of presentation and radiological based CT Severity Index [CTSI] was calculated using the Balthazar grading system and Necrosis Scoring system to assess the severity, morbidity and mortality. The results: In this study, the most common aetiology being alcohol intake followed by gall stones. BISAP Score 3 had organ dysfunction and Score 4 had 100% mortality. The relation between CTSI score and Organ dysfunction showed increased organic dysfunction and higher mortality with higher CTSI Scores. p value < 0.0001 was calculated using Pearson Chi-square test and found to be statistically significant. Conclusions: Both BISAP and CTSI scores had positive correlation with morbidity and mortality.

  20. Background radiation and childhood cancer mortality

    International Nuclear Information System (INIS)

    Sakka, Masatoshi

    1979-01-01

    Oxford Survey of Childhood Cancer estimated an ''extra'' cancer risk of 572 per million man-rad of juvenile cancer deaths under 10 years of age. In Hiroshima and Nagasaki 36.9 juvenile cancers were expected out of 64,490 man-rad of exposed mothers. Observed cancer was, however, only one. The discrepancy was explained partly by possible overlapping of confidence intervals of two samples and partly by excessive doses received by exposed fetuses in Japan. If A-bomb radiation sterilized preleukemic cells induced in fetuses, it must also killed those cells in irradiated adults. Leukemogenic efficiency in adults, about 2.10 -5 per rad, is not different either in A-bomb survivors or in irradiated patients. We examined a dose-effect relationship in childhood cancer mortality (0 - 4 yrs) in Miyagi Prefecture Japan. Ninety two cancers were detected out of 1,214,157 children from 1968 to 1975. They were allocated to 8 districts with different background levels. Population at risk was calculated every year for every district. About 4 deaths occurred every 10,000 man-rad, which is comparable with 572 per million man-rad in Oxford Survey. One out of one thousand infants died from severe malformation in every year when they received 9.8 rad in embryonic stage, the doubling dose is estimated as 20 rad. Clinical and biological significance of the statistical data must be examined in future. Fetal death decreased significantly from 110/1,000 in 1962 to 55/1,000 in 1975. Background radiation plays no role in fetal death in Miyagi Prefecture. (author)