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Sample records for antegrade continence enema

  1. Understanding Antegrade Colonic Enema (ACE) Surgery

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    ... Enema (ACE) Surgery Understanding Antegrade Colonic Enema (ACE) Surgery Antegrade colonic enema surgery (ACE) or Malone antegrade ... Email Print What is antegrade colonic enema (ACE) surgery? Antegrade colonic enema surgery (ACE) or Malone antegrade ...

  2. Understanding Antegrade Colonic Enema (ACE) Surgery

    Science.gov (United States)

    ... Enema (ACE) Surgery Understanding Antegrade Colonic Enema (ACE) Surgery Antegrade colonic enema surgery (ACE) or Malone antegrade ... Full Article What is antegrade colonic enema (ACE) surgery? Antegrade colonic enema surgery (ACE) or Malone antegrade ...

  3. The Malone Antegrade Continence Enema (MACE principle in children: is it important if the conduit is implanted in the left or the right colon?

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    Karine F. Meyer

    2008-03-01

    Full Text Available OBJECTIVE: The aim of the study was to determine which was the optimal side for the conduit to be placed (right or left colon for antegrade continence enema implantation. MATERIALS AND METHODS: Between July 1999 and March 2006, 31 patients underwent the construction of a catheterizable conduit using the Malone principle (MACE In 22 cases the conduit was re-implanted in the right colon and in 9 cases in the left colon. There were 20 male patients and 11 female patients, with a mean age of 10.23 years. The follow-up period varied from 3 from 83 months (average 25 months. Right and left implantation of the conduit in the colon were compared with regards to the presence of complications, volume of the solution utilized, frequency of colonic lavage, time needed for performing the enema, and degree of satisfaction. RESULTS: One patient with the conduit in the right colon, using the appendix, lost the mechanism after two month follow-up. Thirty patients remain clean and are all capable of performing self-catheterization. No statistically significant differences were found between the groups regarding the variables studied: complications (p = 1.000, solution volume (p = 0.996, time required (p = 0.790 and patient's rating (p = 0.670. The lavage frequency required for patients with the conduit in the right colon may be lower. CONCLUSION: The MACE principle was considered effective for treating fecal retention and leaks, independent of the implantation site. The success of this surgery appears to be directly related to the patient's motivation and not to the technique utilized.

  4. Simultaneous Malone antegrade continent enema and Mitrofanoff principle using the divided appendix: report of a new technique for prevention of stoma complications.

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    Kajbafzadeh, A M; Chubak, N

    2001-06-01

    We determine the results and complications of continent urinary diversion and simultaneous Malone antegrade continent enema (MACE) and the Mitrofanoff principle using the divided appendix, and report on the VQQ and VQ technique for prevention of complications at the stoma level. Between June 1995 and June 1999, 40 patients 4 to 22 years old (mean age 9.5) underwent Mitrofanoff procedures in conjunction with the MACE and augmentation cystoplasty as primary (5) or salvage (35) therapy. Of the patients 35 had neuropathic bladder, and 5 had bladder and bowel dysfunction without detectable neurological abnormalities. All patients had an antireflux Mitrofanoff channel constructed using distal part of the appendix with its divided mesothelium. The proximal half of the appendix was preserved as a modified MACE. Average length of appendix was 10.3 cm. (range 9 to 15) and no correlation was found between the length of appendix and age of child. The stoma construction was performed as 2 different techniques. The 2 appendix stomas were initially anastomosed with 2 separate triangular posterior V shape skin flaps on the right lower abdominal wall. Both appendix mucosae were completely buried with a single or double quadrilateral skin flap (VQQ and VQ technique). All patients are continent day and night without diapers. Mean followup was 22 months (range 8 to 48) and the overall incidence of complications was 7.5%. Mitrofanoff stomal stenosis due to catheter false passage occurred postoperatively in 1 case, gas leakage from the MACE in 1 and partial mucosal prolapse in 1. The MACE and Mitrofanoff principle have proved invaluable for the treatment of children with urinary and fecal incontinence. The divided appendix with 2 separate mesotheliums is an ideal channel for simultaneous Mitrofanoff and MACE when the appendix length is 9 cm. or more with a suitable branching mesothelium. When the appendix is short we prefer to use it as the Mitrofanoff and create a pediculed tube flap

  5. Retrograde continence enema in children with spina bifida: Not as effective as first thought.

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    King, Sebastian K; Stathopoulos, Lefteris; Pinnuck, Loreto; Wells, Judy; Hutson, John; Heloury, Yves

    2017-04-01

    The aim of the study is to investigate the effectiveness of Peristeen retrograde continence enema (RCE) in the management of faecal incontinence in children with spina bifida. We identified a homogenous group of spina bifida patients in whom RCE was initiated (Jan 2006-July 2013). Confidential assessments included (i) Fecal Incontinence Quality Of Life (FIQOL), (ii) St Marks Faecal Incontinence score, (iii) Cleveland Clinic Constipation score and (iv) Neurogenic Bowel Dysfunction score. Of 20 patients, 11 (mean age 14.5 ± 5.3 years) were male. Of 20 patients, nine were still using RCE (mean follow-up 4.1 years). Three patients ceased RCE within 10 days, six after 4-12 months and two after 36-48 months. Reasons for cessation included balloon difficulties (n = 4), procedure deemed too difficult (n = 4) and pain (n = 3). There were no differences between the groups in length of training time for technique, instillate fluid/volume used and time taken to perform RCE. There were no differences between the groups for quality of life, faecal incontinence or constipation scores. We demonstrated a high rate of cessation with RCE in patients with spina bifida. This could not be explained by associated conditions, or by enema-related parameters. One possible explanation is the lack of ongoing outpatient support for the children and their families. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  6. Experimental antegrade enema: effects on water, electrolyte and acid-base balances with different solutions Enema anterógrado experimental: equilíbrio hídrico eletrolítico e ácido-base em coelhos submetidos a enema com diferentes soluções

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    Laura Helman

    2007-10-01

    Full Text Available PURPOSE: To study the effects on the water, electrolyte, and acid-base balances in rabbits submitted to antegrade enema with different solutions through appendicostomy. METHODS: Forty male New Zealand rabbits were submitted to appendicostomy, and distributed in 4 groups, according to the antegrade enema solution: PEG group, polyethylene glycol electrolyte solution (n=10; ISS group, isotonic saline solution (n=10; GS group, glycerin solution (n=10; SPS group, sodium phosphate solution (n=10. After being weighed, arterial blood gas analysis, red blood count, creatinine and electrolytes were measured at 4 times: preoperatively (T1; day 6 postop, before enema (T2; 4h after enema (T3; and 24h after T3 (T4. RESULTS: In PEG group occurred Na retention after 4h, causing alkalemia, sustained for 24h with HCO3 retention. In ISS group occurred isotonic water retention and hyperchloremic acidosis after 4h, which was partially compensated in 24h. GS group showed metabolic acidosis after 4h, compensated in 24h. In SPS group occurred hypernatremic dehydration, metabolic acidosis in 4h, and hypokalemia, hypocalcemia, hypomagnesemia, and metabolic alkalosis with partially compensated dehydration in 24h. CONCLUSIONS: All solutions used in this study caused minor alterations on water, electrolyte or acid-base balances. The most intense ones were caused by hypertonic sodium phosphate solution (SPS and isotonic saline solution (ISS and the least by polyethyleneglycol electrolyte solution (PEG and glycerin solution 12% (GS.OBJETIVO: Estudar os efeitos no equilíbrio hídrico, eletrolítico e ácido-base, do enema anterógrado com diferentes soluções em coelhos através de apendicostomia. MÉTODOS: 40 coelhos Nova Zelândia, machos, submetidos a apendicostomia, distribuídos em quatro grupos segundo a solução de enema: grupo PEG (n = 10 solução de polietilenoglicol com eletrólitos; grupo SF (n = 10 solução fisiológica; grupo SG (n = 10 solução glicerinada

  7. The effect of malone's procedure with antegrade irrigation on patients with refractory fecal continence%Malone顺行灌肠在治疗顽固性大便失禁中的应用

    Institute of Scientific and Technical Information of China (English)

    王若义; 丁庆光; 刘倩; 陈维秀; 孙小兵; 李金良; 陈雨历

    2011-01-01

    Objective The Malone antegrade colonic enema (MACE) procedure is a minimally invasive therapy for refractory fecal continence.The aim of this study was to assess curative efficacy for patients undergoing MACE via questionnaire investigation.Methods Totally 32 children patients underwent MACE due to fractory fecal continence between 2000 and 2009.The follow-up period was averagely 3.4 years,and all patients filled in the questionnaire form based on scoring system raised by Li-Zheng and Shell.Surgical methods,applications,complications and clinical curative satisfaction as the main content,were involved in questionnaire for evaluation of curative efficacy of MACE.Results 30 patients of all were followed-up after MACE procedure.The clinical satisfaction was 83.3%,and they could administer the enema by themselves.Regarding to the post-operative complications,no significantly statistical difference was seen in procedures with differential techniques and ostomies.57 percent of patients administered the enema once and 28 percent of patients did twice,aiming to keep anal clearance.4 patients were complicated with the anal or stoma soiling,stoma stenosis,skin inflammation,abdominal distension or pain.Further treatment made improvement.Conclusions MACE procedure is a reliable,minimally invasive surgery with low morbidity for refractory fecal continence.%目的 Malone顺行灌肠(MACE)是一种对机体损伤较小的手术方式,通过问卷调查的形式来评估其在顽固性大便失禁治疗的临床疗效.方法 以2000年1月至2009年12月期间接受MACE治疗的32例患儿为研究对象,临床观察和随访时间平均约3.4年,结合李正和Shell的评价项目内容并根据临床实际情况,设计了一张问卷调查,其内容主要包括手术方式、应用情况、术后并发症和临床满意度等方面,通过该问卷综合评价MACE在治疗顽固性大便失禁中的作用.结果 32例手术患儿中30例获得随访,患儿总体满意率为83

  8. Serum electrolyte shifts following administration of sodium phosphates enema.

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    Jacobson, Robert M; Peery, Jessica; Thompson, William O; Kanapka, Joseph A; Caswell, Michael

    2010-01-01

    The misuse of sodium phosphates enemas has resulted in reports of potentially severe metabolic and hemodynamic disturbances. Despite their long availability, these products have not been fully characterized pharmacokinetically. This trial sought to evaluate changes in the metabolic and hemodynamic parameters following the administration of one of two standard sodium phosphates enemas. Enema Casen (250 ml) is available only in Spain, and Fleet Enema (133 ml) is available in 66 countries in six continents of the world. These changes were correlated with scientific literature reports of hyperphosphatemia following phosphate enema use. Forty-five adult participants aged 50 years or older enrolled in the trial. Twenty-five participants were given one Enema Casen, whereas 20 participants received one Fleet Enema. Blood pressure, pulse, and serum chemistries were evaluated at screening; baseline; and 10, 60, and 120 minutes after receiving the enema. Each participant had a bowel movement within 10 minutes of receiving his enema. Asymptomatic, transient hyperphosphatemia was associated with increase in retention time but not with increase in volume of sodium phosphates enemas. Increased serum phosphate concentration and increased area under the curve of serum phosphate were associated with increased enema retention time. The Enema Casen induced a greater mean AUC of serum sodium concentration than did the Fleet Enema. There were no drug-related adverse events. Transient hyperphosphatemia following the use of sodium phosphates enemas correlates with retention time but not with dose. A scientific literature review of serious adverse events revealed that overdose, concomitant use of oral and rectal sodium phosphates products, and use in a contraindicated patient were associated with sodium phosphates enema and hyperphosphatemia.

  9. Percutaneous antegrade pyelography

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    Kim, Chang Guhn; Lim, Bang Eun; Kim, Jae Kyu; Song, Ok Ja; Nah, Byung Sik; Chung, Hyon De [Chonnam National University College of Medicine, Kwangju (Korea, Republic of)

    1985-02-15

    Percutaneous antegrade pyelography guided by ultrasonography and fluoroscopy was attempted in 25 patients with supravesical obstructive hydronephrosis and successful in 23 patients to evaluate the site and nature of urinary obstructions. The etiology of the obstructive uropathies were urinary stricture in 11 cases, urinary Tbc. in 5 cases, urinary stone in 3 cases, uterine prolapse with cystocele, pyonephrosis, ureteral metastatic testicular carcinoma in 1 case respectively. No significant complication of the percutaneous antegrade pyelography was observed. Percutaneous antegrade pyelography provides significant diagnostic information on the obstructive lesion and can be accomplished with ease and safe in patients with obstructive hydronephrosis as a diagnostic procedure of choice in infants and children or as an alternative to a retrograde pyelography.

  10. Antegrade scrotah sclerotherapy and varicocele

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    VincenzoFicarra; AlessandraSarti

    2002-01-01

    Antegrade scrotal sclerotherapy is a simple and easy technique for the treatment of varicocele.The success rate varies between87%and95%,The initlal reflux grade and the number of collateral vessels of the spermatic vein are the most important factors to predict the outcome of the technique.The postoperative complica-tion rate is about7%and the common ones are scrotal hematoma and epididymo-orchitis of slight severity.Testicular athrophy is a rare event(0.6%).This technique offers a considerable cost eduction compared to other therapeutic optione currently available for varicocele.

  11. Retrograde spreading of hydrocortisone enema in inflammatory bowel disease

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    Jay, M.; Digenis, G.A.; Foster, T.S.; Antonow, D.R.

    1986-02-01

    A hydrocortisone suspension enema was radiolabeled with (/sup 99m/Tc)technetium sulfur colloid and administered to four normal subjects and eight patients with varying degrees of inflammatory bowel disease. The extent of enema spreading was monitored using external scintigraphy for a period of up to 4 hr after administration. Pretreatment of normal subjects with an evacuation enema resulted in spreading of the radiolabeled enema throughout the entire colon. In seven of the eight patients studied, the enema migrated a distance equal to or greater than the extent of disease involvement. An in vivo stability study with an indium-111-labeled enema, using the perturbed angular correlation technique, revealed that the enema retains its stability for up to 90 min after administration. These results indicate that the use of hydrocortisone enemas may not be restricted to distal bowel disease, but may also be effective in inflammatory bowel diseases involving proximal regions of the colon.

  12. Beclomethasone dipropionate enema in ulcerative colitis: Is it safe?

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    Luboshitzky, Rafael; Rachelis, Zoia; Nussensone, Elchanan; Ishay, Avraham

    2009-06-02

    Objective: To evaluate the pituitary-adrenal axis (PA axis) reserve in patients with ulcerative colitis (UC) treated with steroid enemas, we performed 1mug ACTH test.Methods: Patients with UC (n=8) given beclomethasone dipropionate enema (Betnesol) for 4 weeks. Fasting serum cortisol and the response at 30 and 60 minutes following an IV 1mug ACTH injection were determined after 2 weeks of Betnesol enemas. Patients were retested, one month after discontinuation of enemas.Results: Fasting and peak cortisol responses to ACTH were suppressed in six patients. Additional patient had suppressed fasting cortisol and another patient had blunted response to ACTH. One month off Betnesol enema, basal and peak cortisol response to ACTH were normal in all but one patient.Conclusion: Betnesol enemas are associated with severe suppression of the PA axis in almost all patients. Caution is required in patients with UC after withdrawal of rectal steroids as adrenal insufficiency can occur.

  13. Predictors of failed enema reduction in childhood intussusception.

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    Fike, Frankie B; Mortellaro, Vincent E; Holcomb, George W; St Peter, Shawn D

    2012-05-01

    Initial management of intussusception is enema reduction. Data are scarce on predicting which patients are unlikely to have a successful reduction. Therefore, we reviewed our experience to identify factors predictive of enema failure. A retrospective review of all episodes of intussusception over the past 10 years was conducted. Demographics, presentation variables, colonic extent of intussusceptions, and hospital course were collected. Extent of intussusception was classified as right, transverse, descending, and rectosigmoid. Episodes were grouped as success or failure of enema reduction and compared using the Student t test for continuous variables and χ(2) test for dichotomous variables. Significance was P less than .05. We identified 405 episodes of intussusception and 371 attempts at enema reduction. There were 285 successful enema reductions. There was no difference between groups in age; sex; or the presence of emesis, fever, or abdominal mass. The failed enema group was more likely to have had symptoms over 24 hours before presentation (P = .006), bloody diarrhea (P Predictors of failed enema reduction of intussusception include presence of symptoms over 24 hours, diarrhea, lethargy, and distal extent of intussusception. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. [Tetany secondary to phosphate enema toxicity, case report].

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    Núñez Sánchez, María José; Leighton Swaneck, Sofía; Díaz, Franco

    2017-06-01

    Phosphate enemas are frequently used in the treatment of constipation. Errors in dosage and administration can lead to severe complications. To report a case of severe toxicity of phosphate enemas in a child with no risk factors. 2 years old female, with functional constipation, was brought to emergency department because abdominal pain. She was diagnosed with fecal impaction and received half a bottle of Fleet Adult® (Laboratorio Synthon, Chile) two times, with no clinical resolution, deciding to start proctoclisis in pediatric ward. Soon after admission, she presented painful tetany, but alert and oriented. Patient was transferred to PICU where severe hyperphosphatemia and secondary hypocalcemia were confirmed. Her treatment included electrolyte correction; removal of residual phosphate enema and hyperhydration. Tetany resolved over 2 hours after admission and no other complications. Proctoclisis was performed and patient was discharged three days after admission with pharmacological management of constipation. Phosphate enemas may cause serious complications in children with no risk factors. Errors in dosage, administration and removal of the enema are causes of toxicity in this group. Pediatricians and health personnel must be aware of risks and signs of toxicity of phosphate enema.

  15. Percutaneous antegrade ureteric stent removal using a rigid alligator forceps.

    LENUS (Irish Health Repository)

    Given, M F

    2008-12-01

    To evaluate the safety and efficacy of percutaneous antegrade ureteric stent removal using a rigid alligator forceps. Twenty patients were included in our study. Indications for ureteric stent insertion included stone disease (n = 7), malignancy (n = 8) and transplant anastomotic strictures (n = 5). Stent retrieval was carried out for proximal stent placement\\/migration in seven patients and encrustation in the remaining 13. Twenty-two stents were successfully retrieved in 20 patients. There was one technical failure (5%). There were no major complications. We had four minor complications, which included nephrostomy site pain (n = 2), periprocedural sepsis (n = 1) and a small urinoma (n = 1). All patients settled with conservative management. Percutaneous radiologically guided antegrade ureteric stent removal with an alligator forceps is safe and effective, particularly when initial surgical removal has failed.

  16. Percutaneous nephrostomy and antegrade ureteral stenting: technique - indications - complications

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    Hausegger, Klaus A. [Klagenfurt General Hospital, Department of Radiology, Klagenfurt (Austria); Portugaller, Horst R. [University Hospital of Graz, Department of Radiology, Graz (Austria)

    2006-09-15

    In this review the technique, indication for and complications of percutaneous nephrostomy (PCN) and antegrade ureter stent insertion are described. In the majority of the cases PCN is performed to relieve urinary obstruction, which can be of benign or malignant nature. Another indication for PCN is for treatment of urinary fistulas. PCN can be performed under ultrasound and/or fluoroscopic guidance, with a success rate of more than 90%. The complication rate is approximately 10% for major and minor complications together and 4-5% for major complications only. Percutaneous antegrade double-J stent insertion usually is performed if retrograde ureter stenting has not been successful. However, especially in malignant obstructions, the success rate for antegrade stenting is higher than for retrograde transvesical double-J stent insertion. In the case of severe infection and bleeding after PCN JJ-stent insertion may be contraindicated so long as there is no sufficient concomitant drainage via a PCN. Lower urinary tract dysfunction should be excluded before stent placement. The complication rate is 2-4%. Consequent stent surveillance with regular stent exchange is mandatory. (orig.)

  17. New puncture needle (Seldinger technique) for easy antegrade catheterization of the superficial femoral artery

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    Saltzmann, J.; Probst, P.

    1987-02-01

    Mainly for anatomical reasons a guide-wire or a catheter has a tendency to turn into the deep femoral artery during antegrade catheterization of the lower limb. To overcome this problem a curved puncture needle has been designed which allows positioning of the guide-wire in an anterior direction. Antegrade catheterization of the superficial femoral artery was achieved in 25 patients without lengthy manipulations or complications. With this technique the rate of complications at antegrade catheterization will probably be reduced.

  18. Antegrade approach for TAVR with total occlusion of the descending aorta.

    Science.gov (United States)

    Levisay, Justin P; Salinger, Michael H; Feldman, Ted

    2014-04-01

    The antegrade approach for aortic valve interventions is well known but has not been widely used for transcatheter aortic valve replacement (TAVR) procedures. We encountered a patient with no possibility of retrograde access due to a totally occluded abdominal aorta who had a failed attempt at apical TAVR. We describe antegrade TAVR despite occlusion of the abdominal aorta, with the arterial limb of the requisite veno-arterial loop created using bilateral arm access, a novel version of the previously described antegrade approach.

  19. Comparative trial of sodium cromoglycate enemas with prednisolone enemas in the treatment of ulcerative colitis.

    Science.gov (United States)

    Grace, R H; Gent, A E; Hellier, M D

    1987-01-01

    A double blind multicentre study comparing sodium cromoglycate (600 mg/100 ml) by enema with prednisolone (20 mg/100 ml) by enema is reported. The study was conducted over a nine week period in the treatment of 70 patients with ulcerative colitis. Analysis of symptoms showed significant decreases in scores for patients in both groups, both at four and eight weeks; the only difference between the two groups was a significantly greater improvement in the reduction of rectal bleeding after four weeks in the prednisolone group. On sigmoidoscopy, both treatment groups showed a highly significant improvement after four and eight weeks with no significant differences being seen between the groups. Histology of the rectal biopsies showed a significant improvement in the inflammation of the mucosa for both treatment groups after four and eight weeks with no differences being observed between the groups. There were no significant changes in eosinophils from baseline and no difference between the groups at four and eight weeks. PMID:3102323

  20. The fluoroscopic barium enema in colonic polyp detection.

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    Teefey, S A; Carlson, H C

    1983-12-01

    The results of 1,500 barium enema studies done by vigorous manual palpation under fluoroscopy were reviewed to determine the adequacy of this technique in detecting polyps above the proctoscopic level. Of the 1,500 patients examined, 103 (7%) were diagnosed radiographically as having a total of 149 polyps. Polyps were found at proctoscopy in about 10% of the 1,500 patients. Colonoscopy or surgery was performed on 35 of the 103 patients. Of the 52 polyps discovered during these procedures, only three were missed at fluoroscopic barium enema study, a false-negative rate of 6%. Fourteen patients whose barium enemas initially were reported as negative for polyps or neoplasia had colonoscopy. Two of the 14 patients had positive findings, for a true-negative rate of 86%. If the detection rate of 7% found at barium enema, taking into account an overlap of 10%, is combined with the rate of 7.5% found at proctoscopy, a frequency of about 14% emerges in detecting polyps in the rectum and in the colon. Thus, the fluoroscopic barium enema when combined with proctoscopy is a sensitive method in the detection of colorectal polyps. In addition, it has the advantage of rapid execution and relatively low cost.

  1. Barium enema findings of milk allergy in infants

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    Kim, Gyoung Ju; Kim, Mi Jeong; Lee, Hee Jung [Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2006-09-15

    We wanted to evaluate the barium enema findings of milk allergy in infants. Retrospective evaluation of the plain abdominal radiography and barium enema findings was performed in fifteen young infants suffering with milk allergy. The presence of gaseous distension, rectal gas, paralytic ileus and mechanical obstruction was evaluated on the plain radiography. The presence of spasm, a transitional zone, a reversed rectosigmoid index and mucosal irregularity was analyzed on the barium enema; the presence of barium retention was also evaluated on 24-hour-delayed plain radiography. Paralytic ileus was the most common finding on the plain radiography (93%). On the barium enema, continuous spasm of the colon, ranging from the rectum to the descending colon, was revealed in ten infants (67%). A transitional zone was observed in one infant and a reversed rectosigmoid index was revealed in four. Mucosal irregularity was observed in two infants. Barium retention was demonstrated in 11 of fifteen cases: throughout the entire colon (n = 3), from the rectum to the descending colon (n = 7), and up to the transverse colon (n = 1). The most common barium enema finding of milk allergy in infants was spasm of the distal colon. The other findings were a transitional zone, a reversed rectosigmoid index, mucosal irregularity and barium retention.

  2. Treatment of humeral shaft fractures with antegrade intramedullary locking nail.

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    Tsourvakas, Stefanos; Alexandropoulos, Christos; Papachristos, Ioannis; Tsakoumis, Grigorios; Ameridis, Nikolaos

    2011-12-01

    Antegrade interlocked humeral nailing for stabilization of humeral fractures was introduced many years ago, and studies on this method in the orthopedic literature have shown mixed results. The purpose of this investigation was to document the clinical outcome and complications associated with the use of an antegrade intramedullary nail (T2, Stryker) for the humeral fractures. Between 2005 and 2008, 52 fractures of the humeral shaft were treated operatively with this intramedullary nail in our department. Eight patients were polytraumatized, and four patients had an open fracture. The mean age of patients was 51.7 years. Forty-eight patients had an adequate duration of clinical follow-up (a mean of 18 months) for analysis. Complications were recorded, and the time to union was measured. Shoulder and elbow functions were assessed using the Constant Score and the Morrey Score, respectively. Forty-six fractures healed, with a mean time to clinical union of 10.3 weeks. Two patients developed pseudarthroses. There were four adverse events: two proximal screws backed out, one superficial infection at the insertion point, and one fracture at the distal end of the nail. Ninety-one percentage of patients had an excellent or good shoulder function. Five further operations were necessary: two for treatment of pseudarthroses, two for removal the backed out proximal screws, and one wound debridement for superficial infection. Antegrade humeral nailing is a valid therapeutic option for stabilization of humeral shaft fractures. By strictly adhering to the operation technique, the number and the severity of complications can be reduced. When good fracture alignment and stability are obtained, uneventful bone healing with good functional results is the rule.

  3. Performance of antegrade suture passers according to tendon thickness

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    Myung-Sun Kim

    2015-01-01

    Full Text Available Purpose: To determine the effect of tendon thickness on the needle penetration ability of four different designs of antegrade suture passers. Materials and Methods: Four antegrade suture passers were tested: (a ExpresSew II (Depuy Mitek Inc., Raynham, MA, (b Arthrex Scorpion (Arthrex, Naples, FL, (c Concept (Linvatec Corp, Largo, FL, and (d ElitePass (Smith and Nephew Endoscopy, Andover, MA. Bovine tendons were divided into five thickness groups: 3, 5, 7, 9 and 11 mm. At each tendon thickness, we performed 15 trials with the suture loaded and 15 unloaded per device. Successful needle penetration was recorded, and in case of success, the exit point of the needle was noted in relation to the superior arm of the grasping component. Results: All tested suture passing devices successfully penetrated tendon thicknesses of 3 and 5 mm. With the suture loaded, one device (Concept only successfully penetrated 7 mm group tendons in 3/15 (20% trials. Success rates at 9 mm with the suture loaded were 40% in ExpresSew II, 53% in Arthrex Scorpion, 0% in Concept and 53% in ElitePass. Among successful passages with a loaded suture in the 7 and 9 mm-groups, about 20-50% of passages were oblique, and the needle came out distal to the superior arm of grasping the component. No trial with any device succeeded with 11 mm tendons in the suture loading condition. Conclusion: Using an antegrade suture passer during arthroscopic rotator cuff repair should be carefully considered when the torn end of the tendon is thicker than about 7-9 mm due to potential failure of needle penetration and/or too oblique a suture passage. Level of Evidence: Controlled laboratory study.

  4. Performance of antegrade suture passers according to tendon thickness

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    Kim, Myung-Sun; Kim, Dong Whan; Choi, Young Eun; Bachman, Larry; Kim, Sae Hoon

    2015-01-01

    Purpose: To determine the effect of tendon thickness on the needle penetration ability of four different designs of antegrade suture passers. Materials and Methods: Four antegrade suture passers were tested: (a) ExpresSew II (Depuy Mitek Inc., Raynham, MA), (b) Arthrex Scorpion (Arthrex, Naples, FL), (c) Concept (Linvatec Corp, Largo, FL), and (d) ElitePass (Smith and Nephew Endoscopy, Andover, MA). Bovine tendons were divided into five thickness groups: 3, 5, 7, 9 and 11 mm. At each tendon thickness, we performed 15 trials with the suture loaded and 15 unloaded per device. Successful needle penetration was recorded, and in case of success, the exit point of the needle was noted in relation to the superior arm of the grasping component. Results: All tested suture passing devices successfully penetrated tendon thicknesses of 3 and 5 mm. With the suture loaded, one device (Concept) only successfully penetrated 7 mm group tendons in 3/15 (20%) trials. Success rates at 9 mm with the suture loaded were 40% in ExpresSew II, 53% in Arthrex Scorpion, 0% in Concept and 53% in ElitePass. Among successful passages with a loaded suture in the 7 and 9 mm-groups, about 20-50% of passages were oblique, and the needle came out distal to the superior arm of grasping the component. No trial with any device succeeded with 11 mm tendons in the suture loading condition. Conclusion: Using an antegrade suture passer during arthroscopic rotator cuff repair should be carefully considered when the torn end of the tendon is thicker than about 7-9 mm due to potential failure of needle penetration and/or too oblique a suture passage. Level of Evidence: Controlled laboratory study. PMID:25937714

  5. Effects of high volume saline enemas vs no enema during labour – The N-Ma Randomised Controlled Trial [ISRCTN43153145

    Directory of Open Access Journals (Sweden)

    Bernal María

    2006-03-01

    Full Text Available Abstract Background Enemas are used during labour in obstetric settings with the belief that they reduce puerperal and neonatal infections, shorten labour duration, and make delivery cleaner for attending personnel. However, a systematic review of the literature found insufficient evidence to support the use of enemas. The objective of this RCT was to address an identified knowledge gap by determining the effect of routine enemas used during the first stage of labour on puerperal and neonatal infection rates. Methods Design: RCT (randomised controlled trial; randomized clinical trial. Outcomes: Clinical diagnosis of maternal or neonatal infections, labour duration, delivery types, episiotomy rates, and prescription of antibiotics Setting: Tertiary care referral hospital at the Javeriana University (Bogotá, Colombia that attended 3170 births during study period with a caesarean section rate of 26%. Participants: 443 women admitted for delivery to the obstetrics service (February 1997 to February 1998 and followed for a month after delivery. Inclusion criteria were women with: low risk pregnancy and expected to remain in Bogotá during follow up; gestational age ≥ 36 weeks; no pelvic or systemic bacterial infection; intact membranes; cervix dilatation ≤7 cm. Intervention: 1 litre saline enema, versus no enema, allocated following a block random allocation sequence and using sealed opaque envelopes. Results Allocation provided balanced groups and 86% of the participants were followed up for one month. The overall infection rate for newborns was 21%, and 18% for women. We found no significant differences in puerperal or neonatal infection rates (Puerperal infection: 41/190 [22%] with enema v 26/182 [14%] without enema; RR 0.66 CI 95%: 0.43 to 1.03; neonatal infection 38/191 [20%] with enema v 40/179 [22%] without enema; RR 1.12, 95% CI 95% 0.76 to 1.66, and median labour time was similar between groups (515 min. with enema v 585 min. without

  6. Steerable antegrade stenting: a new trick of the trade

    Directory of Open Access Journals (Sweden)

    Udo Nagele

    2007-06-01

    Full Text Available INTRODUCTION: Whereas a retrograde attempt to insert an indwelling stent is performed in lithotomy position, usually renal access is gained in a prone position. To overcome the time loss of patient repositioning, a renal puncture can be performed in a modified lithotomy position with torqued truncus and slightly elevated flank. There is a two-fold advantage of this position: transurethral and transrenal access can be obtained using a combined approach. In the present study, this simple technique is used to position a floppy guide wire through a modified needle directly through the renal pelvis into the ureter. MATERIALS AND METHODS: The kidney is punctured in the modified lithotomy position under sonographic control using an initial three-part puncture needle. A floppy tip guide-wire is inserted into the collecting system via the needle after retrieving the stylet. The retracted needle is bent at the tip while the guide-wire is secured in the needle and the collecting system. The use of the floppy tip guide-wire helps to insert the curved needle back into the kidney pelvis, which becomes the precise guidance for the now steerable wire. The desired steerable stent is positioned under radiographic control in a retrograde fashion over the endoscopically harbored tip of the guide-wire. Two patient cohorts (newly described method and conventional method were compared. RESULTS: The presented steering procedure saves 16.5 mean minutes compared to the conventional antegrade stenting and 79.5 Euros compared to the control group. CONCLUSION: The described combined antegrade-retrograde stent placement through a bent three-part puncture needle results in both clinical superiority (OR time, success rate and financial benefits.

  7. Antegrade common bile duct (CBD stenting after laparoscopic CBD exploration

    Directory of Open Access Journals (Sweden)

    Bandyopadhyay Samik

    2007-01-01

    Full Text Available Laparoscopic common bile duct exploration (LCBDE has been found to be a safe, efficient and cost-effective treatment for choledocholithiasis. Following LCBDE, the clearance may be ascertained by a cholangiogram or choledochoscopy. The common bile duct (CBD may be closed primarily with or without a stent in situ or may be drained by means of a T-tube or a biliary enteric anastomosis. Materials and Methods: In our series of 464 patients of choledocholithiasis, 100 patients underwent closure of the CBD with an indwelling antegrade stent following LCBDE. LCBDE was performed by direct massage of CBD, saline lavage, direct pickup with choledocholithotomy forceps or by basketing. Fragmentation of impacted stones in situ was performed in a few patients. Completion choledochoscopy was performed by means of a pediatric bronchoscope. A 10-cm, 7 Fr. double-flap biliary stent was placed in situ after LCBDE. Results: There was no mortality in the series. There was no conversion either. The median duration of the operation was 75 min. The mean postoperative hospital stay was 3.5 days. One patient had a minor postoperative biliary leak. One patient had a right sub-hepatic collection. Four patients developed postoperative port infection. The stents were removed endoscopically after 4 weeks. Sixty-eight patients could be followed up till 1 year. There has been no incidence of residual disease and the patients on follow-up are asymptomatic. Conclusion: In our experience, a single stage laparoscopic treatment of cholelithiasis with choledocholithiasis is a safe, viable and cost-effective option. Closure of the CBD over an antegrade stent is a feasible option but requires advanced skills in minimal access surgical techniques, especially endosuturing. The procedure may be performed safely in expert hands without mortality and with negligible morbidity.

  8. Antegrade common bile duct (CBD) stenting after laparoscopic CBD exploration.

    Science.gov (United States)

    Bandyopadhyay, Samik Kumar; Khanna, Shashi; Sen, Bimalendu; Tantia, Om

    2007-01-01

    Laparoscopic common bile duct exploration (LCBDE) has been found to be a safe, efficient and cost-effective treatment for choledocholithiasis. Following LCBDE, the clearance may be ascertained by a cholangiogram or choledochoscopy. The common bile duct (CBD) may be closed primarily with or without a stent in situ or may be drained by means of a T-tube or a biliary enteric anastomosis. In our series of 464 patients of choledocholithiasis, 100 patients underwent closure of the CBD with an indwelling antegrade stent following LCBDE. LCBDE was performed by direct massage of CBD, saline lavage, direct pickup with choledocholithotomy forceps or by basketing. Fragmentation of impacted stones in situ was performed in a few patients. Completion choledochoscopy was performed by means of a pediatric bronchoscope. A 10-cm, 7 Fr. double-flap biliary stent was placed in situ after LCBDE. There was no mortality in the series. There was no conversion either. The median duration of the operation was 75 min. The mean postoperative hospital stay was 3.5 days. One patient had a minor postoperative biliary leak. One patient had a right sub-hepatic collection. Four patients developed postoperative port infection. The stents were removed endoscopically after 4 weeks. Sixty-eight patients could be followed up till 1 year. There has been no incidence of residual disease and the patients on follow-up are asymptomatic. In our experience, a single stage laparoscopic treatment of cholelithiasis with choledocholithiasis is a safe, viable and cost-effective option. Closure of the CBD over an antegrade stent is a feasible option but requires advanced skills in minimal access surgical techniques, especially endosuturing. The procedure may be performed safely in expert hands without mortality and with negligible morbidity.

  9. Fecal Continence Revisited : The Anal External Sphincter Continence Reflex

    NARCIS (Netherlands)

    Broens, Paul M. A.; Penninckx, Freddy M.; Boix Ochoa, Jose

    2013-01-01

    BACKGROUND: None of the current theories on fecal incontinence can explain fecal continence adequately. OBJECTIVE: This study aims to evaluate the mechanism controlling fecal continence. DESIGN: Anal electrosensitivity, anorectal pressures, and rectal pressure volumetry tests were performed in 17

  10. Solar eclipse sign of intussusception on barium enema.

    Science.gov (United States)

    Raveenthiran, V

    2002-01-01

    The colographic appearance of intussusception is variously described as a claw sign, pincer defect, shouldering effect, and coiled-spring pattern. This report adds a new radiographic sign to the list. An end-on view of an intussusception on barium enema shows a ring of contrast resembling a solar eclipse. Familiarity with this bizarre appearance is desirable, lest it may be mistaken for spillage of barium due to a colonic perforation.

  11. Diagnostic and therapeutical aspects of antegrade uretero-pyelography in percutaneous nephro-pyelostomy in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, K.; Helmig, F.J.; Wisser, J.; Fendel, H.

    1986-12-01

    In a sample of 18 children aging one day to eighteen years 21 percutaneous nephrostomies and 27 antegrade pyelographies were performed using sonography and fluoroscopy. Thirteen patients had both nephrostomy and pyelography and 5 had only pyelography. Three of 13 patients needed bilateral nephrostomies. The results indicate that the combination of percutaneous nephrostomy and antegrade pyelography is helpful in diagnosis and treatment of various obstructive disorders of the urinary tract especially in the newborn period.

  12. [Diagnostic and therapeutic aspects of antegrade ureteropyelography and percutaneous nephropyelostomy in childhood].

    Science.gov (United States)

    Schneider, K; Helmig, F J; Wisser, J; Fendel, H

    1986-12-01

    In a sample of 18 children aging one day to eighteen years 21 percutaneous nephrostomies and 27 antegrade pyelographies were performed using sonography and fluoroscopy. Thirteen patients had both nephrostomy and pyelography and 5 had only pyelography. Three of 13 patients needed bilateral nephrostomies. The results indicate that the combination of percutaneous nephrostomy and antegrade pyelography is helpful in diagnosis and treatment of various obstructive disorders of the urinary tract especially in the newborn period.

  13. Where the continent ends

    Science.gov (United States)

    Paris, Paul J.; Walsh, J. P.; Corbett, D. Reide

    2016-12-01

    The Earth's continents and islands are bordered by shallow ocean plains that are arguably the most environmentally, economically, and politically important parts of the sea. Yet in spite of this, they remain poorly defined and understood. A quantitative approach is employed here to map and analyze these plains, or shelves. The Earth's ocean bathymetry was used to determine the continent-ocean basin transition at 1200 m and then parsed with a novel geospatial terrain classification concept/method borrowed from the field of image analysis: the geomorphic phonotype, or geomorphon. The technique is less subjective than visual interpretation and digitization and here illustrates that the ocean coastal plains are deeper, wider, and more steeply sloped than previously recognized. Their variable form is related to tectonics and latitude and ultimately affects function and habitat.

  14. Multicompartmental Pharmacokinetic Model of Tenofovir Delivery to the Rectal Mucosa by an Enema

    Science.gov (United States)

    Gao, Yajing; Katz, David F.

    2017-01-01

    Rectal enemas that contain prophylactic levels of anti-HIV microbicides such as tenofovir have emerged as a promising dosage form to prevent sexually transmitted HIV infections. The enema vehicle is promising due to its likely ability to deliver a large amount of drug along the length of the rectal canal. Computational models of microbicide drug delivery by enemas can help their design process by determining key factors governing drug transport and, more specifically, the time history and degree of protection. They can also inform interpretations of experimental pharmacokinetic measures such as drug concentrations in biopsies. The present work begins rectal microbicide PK modeling, for enema vehicles. Results here show that a paramount factor in drug transport is the time of enema retention; direct connectivity between enema fluid and the fluid within rectal crypts is also important. Computations of the percentage of stromal volume protected by a single enema dose indicate that even with only a minute of enema retention, protection of 100% can be achieved after around 14 minutes post dose. Concentrations in biopsies are dependent on biopsy thickness; and control and/or knowledge of thickness could improve accuracy and decrease variability in biopsy measurements. Results here provide evidence that enemas are a promising dosage form for rectal microbicide delivery, and offer insights into their rational design. PMID:28114388

  15. The use of a cutting balloon in contemporary reverse controlled antegrade and retrograde subintimal tracking (reverse CART) technique.

    Science.gov (United States)

    Nakabayashi, Keisuke; Okada, Hisayuki; Oka, Toshiaki

    2016-07-11

    The key concept of reverse controlled antegrade and retrograde tracking (CART) technique is retrograde puncture with a tapered wire to an antegrade balloon (contemporary reverse CART) or new connections between the antegrade and retrograde subintimal space (classical reverse CART). In our case, a 75-year-old man with severe chronic total occlusion of the right coronary artery, reverse CART with conventional balloons could not be accomplished. Externalization wiring was completed by contemporary reverse CART using a cutting balloon as an antegrade balloon to improve the fenestration force of the retrograde guidewire. Thus, the use of a cutting balloon for contemporary reverse CART might be promising.

  16. Coffee enema for preparation for small bowel video capsule endoscopy: a pilot study.

    Science.gov (United States)

    Kim, Eun Sun; Chun, Hoon Jai; Keum, Bora; Seo, Yeon Seok; Jeen, Yoon Tae; Lee, Hong Sik; Um, Soon Ho; Kim, Chang Duck; Ryu, Ho Sang

    2014-07-01

    Coffee enemas are believed to cause dilatation of bile ducts and excretion of bile through the colon wall. Proponents of coffee enemas claim that the cafestol palmitate in coffee enhances the activity of glutathione S-transferase, an enzyme that stimulates bile excretion. During video capsule endoscopy (VCE), excreted bile is one of the causes of poor preparation of the small bowel. This study aimed to evaluate the feasibility and effect of coffee enema for preparation of the small bowel during VCE. In this pilot study, 17 of 34 patients were assigned to the coffee enema plus polyethylene glycol (PEG) 2 L ingestion group, whereas the 17 remaining control patients received 2 L of PEG only. The quality of bowel preparation was evaluated in the two patient groups. Bowel preparations in the proximal segments of small bowel were not differ between two groups. In the mid and distal segments of the small intestine, bowel preparations tend to be better in patients who received coffee enemas plus PEG than in patients who received PEG only. The coffee enema group did not experience any complications or side effects. Coffee enemas may be a feasible option, and there were no clinically significant adverse events related to coffee enemas. More prospective randomized studies are warranted to improve small bowel preparation for VCE.

  17. Retrograde versus Antegrade Approach for the Management of Large Proximal Ureteral Stones

    Science.gov (United States)

    Mykoniatis, Ioannis; Isid, Ayman; Gofrit, Ofer N.; Rosenberg, Shilo; Hidas, Guy; Landau, Ezekiel H.; Pode, Dov; Duvdevani, Mordechai

    2016-01-01

    Objective. To evaluate and compare the efficacy and safety of retrograde versus antegrade ureteroscopic lithotripsy for the treatment of large proximal ureteral stones. Patients and Methods. We retrospectively analyzed the medical records of patients with proximal ureteral stones >15 mm, treated in our institution from January 2011 to January 2016. Intraoperative parameters, postoperative outcomes, and complications were recorded and compared between the two techniques. Results. Our analysis included 57 patients. Thirty-four patients (59.6%) underwent retrograde and 23 patients (40.4%) underwent antegrade ureteroscopy. There was no significant difference in patients' demographics and stone characteristics between the groups. Stone-free rate was significantly higher (p = 0.033) in the antegrade group (100%) compared to retrograde one (82.4%). Fluoroscopy time, procedure duration, and length of hospitalization were significantly (p < 0.001) lower in retrograde approach. On the other hand, the need for postoperative stenting was significantly lower in the antegrade group (p < 0.001). No difference was found between the groups (p = 0.745) regarding postoperative complications. Conclusions. Antegrade ureteroscopy is an efficient and safe option for the management of large proximal ureteral stones. It may achieve high stone-free rates compared to retrograde ureteroscopy with the drawback of longer operative time, fluoroscopy time, and length of hospitalization. PMID:27766263

  18. Daily Enema Regimen Is Superior to Traditional Therapies for Nonneurogenic Pediatric Overactive Bladder

    Directory of Open Access Journals (Sweden)

    Steve J. Hodges MD

    2016-03-01

    Full Text Available Our objective was to evaluate the efficacy of daily enemas for the treatment of overactive bladder (OAB in children. This study was a prospective, controlled trial of 60 children with nonneurogenic OAB. The control patients (40 were treated with standard therapies, including timed voiding, constipation treatment with osmotic laxatives, anticholinergics, and biofeedback physical therapy, whereas the treatment patients (20 received only daily enemas and osmotic laxatives. On assessment of improvement of OAB symptoms, only 30% of the traditionally treated patients’ parents reported resolution of symptoms at 3 months, whereas 85% of enema patients did. At the onset of the study, the average pediatric voiding dysfunction score of all patients was 14, whereas on follow-up, the average scores for traditionally treated patients and enema-treated patients were 12 and 4, respectively. This study demonstrated that daily enema therapy is superior to traditional methods for the treatment of OAB.

  19. Observing across Continents

    Science.gov (United States)

    Lomb, Nick; Klinglesmith, Daniel A., III; Kotoski, James

    Real-time use of remote telescopes can bring the excitement of professional observing into the classroom. By linking with remote telescopes across time zones and continents it is possible to carry out observations during normal school hours. In this paper we report on collaborations between Sydney Observatory which has a 20-cm remote telescope on top of the Powerhouse Museum in Sydney New Mexico Tech which has a 35-cm telescope at its Etscorn Observatory and the Metropolitan Madison School District in Wisconsin which has an observatory with a 35-cm telescope. Four classes of year 7 students at Spring Harbor Environmental Middle School in Madison successfully controlled the Sydney telescope via the Internet over two series of observing session in 2001 and 2002. The presence of a trained observer in the telescope dome in text communication with the students via the NetMeeting program greatly added to the educational value of the sessions. Teachers

  20. Profunda Anchor Technique for Ipsilateral Antegrade Approach in Endovascular Treatment of Superficial Femoral Artery Ostial Occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei, E-mail: druei@yahoo.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore)

    2015-04-15

    Endovascular treatment of the superficial femoral artery (SFA) is challenging in the presence of flush ostial occlusion. One of the main challenges is the availability of access sites for intervention. Contralateral retrograde femoral access followed by cross-over and antegrade intervention while commonly used, may not be feasible in cases of altered iliac anatomy (e.g. kissing iliac stents). Ipsilateral antegrade intervention using common femoral artery (CFA) access in these instances while possible is typically challenging due to inadequate working length of the CFA for interrogation of the SFA ostium, compounded by the lack of sheath stability. The “profunda anchor” technique uses a buddy wire in the profunda femoris artery (PFA) to stabilize the sheath and allow catheter manipulation for antegrade intervention at the level of the SFA ostium. The PFA is further used as a conduit for deployment of closure device to avoid interference with the treated SFA.

  1. Paleomagnetism continents and oceans

    CERN Document Server

    McElhinny, Michael W; Dmowska, Renata; Holton, James R; Rossby, H Thomas

    1999-01-01

    Paleomagnetism is the study of the fossil magnetism in rocks. It has been paramount in determining that the continents have drifted over the surface of the Earth throughout geological time. The fossil magnetism preserved in the ocean floor has demonstrated how continental drift takes place through the process of sea-floor spreading. The methods and techniques used in paleomagnetic studies of continental rocks and of the ocean floor are described and then applied to determining horizontal movements of the Earth''s crust over geological time. An up-to-date review of global paleomagnetic data enables 1000 millionyears of Earth history to be summarized in terms of the drift of the major crustal blocks over the surface of the Earth. The first edition of McElhinny''s book was heralded as a "classic and definitive text." It thoroughly discussed the theory of geomagnetism, the geologicreversals of the Earth''s magnetic field, and the shifting of magnetic poles. In the 25 years since the highly successful first editio...

  2. Extent of the Antarctic Continent.

    Science.gov (United States)

    Press, F; Dewart, G

    1959-02-20

    Group velocities of eartquake-generated Love and Rayleigh waves for certain transantarctic paths are abnormally high when compared with data from other continents. For these paths, the data indicate that at most only three-fourths of the antarctic ice sheet is underlain by continent, the remaining area being oceanic in structure.

  3. Addition of methyl cellulose enema to double-contrast barium imaging of sigmoid diverticulosis

    Energy Technology Data Exchange (ETDEWEB)

    Olsson, R. [Malmoe Univ. Hospital (Sweden). Dept. of Diagnostic Radiology; Adnerhill, I. [Malmoe Univ. Hospital (Sweden). Dept. of Diagnostic Radiology; Bjoerkdahl, P. [Malmoe Univ. Hospital (Sweden). Dept. of Diagnostic Radiology; Ekberg, O. [Malmoe Univ. Hospital (Sweden). Dept. of Diagnostic Radiology; Fork, F.T. [Malmoe Univ. Hospital (Sweden). Dept. of Diagnostic Radiology

    1997-01-01

    Double-contrast barium enema has a reduced sensitivity in patients with severe sigmoid diverticulosis. Therefore a carboxy methyl cellulose enema was employed after the conventional double-contrast examination in 15 patients with sigmoid diverticulosis. A significant increase in lumen diameter and a superior removal of barium residue from the diverticulas facilitated the interpretation of the sigmoid loops. Conclusion: The addition of methyl cellulose enema to double-contrast barium imaging improves diagnostic imaging in diverticulosis by expanding the lumen and emptying the diverticulas. (orig.).

  4. A Novel Risk Score in Predicting Failure or Success for Antegrade Approach to Percutaneous Coronary Intervention of Chronic Total Occlusion: Antegrade CTO Score.

    Science.gov (United States)

    Namazi, Mohammad Hasan; Serati, Ali Reza; Vakili, Hosein; Safi, Morteza; Parsa, Saeed Ali Pour; Saadat, Habibollah; Taherkhani, Maryam; Emami, Sepideh; Pedari, Shamseddin; Vatanparast, Masoomeh; Movahed, Mohammad Reza

    2017-06-01

    Total occlusion of a coronary artery for more than 3 months is defined as chronic total occlusion (CTO). The goal of this study was to develop a risk score in predicting failure or success during attempted percutaneous coronary intervention (PCI) of CTO lesions using antegrade approach. This study was based on retrospective analyses of clinical and angiographic characteristics of CTO lesions that were assessed between February 2012 and February 2014. Success rate was defined as passing through occlusion with successful stent deployment using an antegrade approach. A total of 188 patients were studied. Mean ± SD age was 59 ± 9 years. Failure rate was 33%. In a stepwise multivariate regression analysis, bridging collaterals (OR = 6.7, CI = 1.97-23.17, score = 2), absence of stump (OR = 5.8, CI = 1.95-17.9, score = 2), presence of calcification (OR = 3.21, CI = 1.46-7.07, score = 1), presence of bending (OR = 2.8, CI = 1.28-6.10, score = 1), presence of near side branch (OR = 2.7, CI = 1.08-6.57, score = 1), and absence of retrograde filling (OR = 2.5, CI = 1.03-6.17, score = 1) were independent predictors of PCI failure. A score of 7 or more was associated with 100% failure rate whereas a score of 2 or less was associated with over 80% success rate. Most factors associated with failure of CTO-PCI are related to lesion characteristics. A new risk score (range 0-8) is developed to predict CTO-PCI success or failure rate during antegrade approach as a guide before attempting PCI of CTO lesions.

  5. Hypothesis That Urethral Bulb (Corpus Spongiosum Plays an Active Role in Male Urinary Continence

    Directory of Open Access Journals (Sweden)

    Peter Rehder

    2016-01-01

    Full Text Available The proximal urethral bulb in men is enlarged, surrounds the bulbous urethra, and extends dorsally towards the perineum. During intercourse engorgement takes place due to increased blood flow through the corpus spongiosum. Antegrade ejaculation is facilitated by contraction of the bulbospongiosus muscles during climax. Micturition during sexual stimulation is functionally inhibited. Supporting the bulb may indirectly facilitate continence in a certain subset of patients with postprostatectomy incontinence. During physical activity with increased abdominal pressure, reflex contraction of the pelvic floor muscles as well as the bulbospongiosus muscles occurs to support sphincter function and limit urinary incontinence. Operations to the prostate may weaken urinary sphincter function. It is hypothesized that the distal urinary sphincter may be supported indirectly by placing a hammock underneath the urethral bulb. During moments of physical stress the “cushion” of blood within the supported corpus spongiosum helps to increase the zone of coaptation within the sphincteric (membranous urethra. This may lead to urinary continence in patients treated by a transobturator repositioning sling in patients with postprostatectomy incontinence. This paper describes the possible role of the urethral bulb in male urinary continence, including its function after retroluminal sling placement (AdVance, AdVance XP® Male Sling System, Minnetonka, USA.

  6. Sonography-guided gastrografin enema for meconium plug syndrome in premature newborns: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo; Kim, Ki Soo; Kim, Rhan Ellen Ai; Pi, Soo Young; Yoon, Chong Hyun [Asan Medical Center, Seoul (Korea, Republic of)

    2004-04-01

    To evaluate the usefulness of sonography-guided Gastrografin enema for the diagnosis and treatment of meconium plug syndrome in premature newborns in a neonatal intensive care unit (NICU). Fifteen premature newborns underwent 23 sonography-guided Gastrografin enemas on the 8th day of life on average (range: 3 days-21 days). The gestational age and birth weight (mean{+-}standard deviation) of the patients were 29{+-}2 weeks and 999{+-}148 g, respectively. The diagnosis of meconium plug syndrome was based on relevant clinical and radiological findings. Diluted Gastrografin (1:3, 17-45 ml) was administered through a rectal tube under the guidance of sonography until it reached to the cecum. Thereafter, immediate post-procedure and delayed portable abdominal radiographs were taken. All the procedures were done within the NICU. We reviewed the dates of meconium evacuation and the first feeding after the last enema from the clinical data. Radiologically, the timing of the radiographic improvement after the last enema was checked. In cases of distended distal ileum with meconium on preenema sonography, follow-up sonography was performed to determine the interval change after gastrografin enema. None of the sonography-guided Gastrografin enemas performed within the NICU caused procedure-related complications. Meconium was evacuated within one day in all patients. In 14 patients, on average, feeding was started on the 7th day and radiographic improvement was observed on the 3rd day. Four of the five patients showing a distended distal ileum with meconium revealed a decrease in ileal distension on follow-up sonography. On the other hand, the other patient, who did not show such a decrease on follow-up sonography, was found to have ileal stenosis during subsequent surgery. Sonography-guided Gastrografin enema is a safe and effective bedside procedure, when performed in the NICU for the diagnosis and treatment of meconium plug syndrome.

  7. Colonic diverticulosis: evaluation with double contrast barium enema

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Jae Kook; Lee, Jong Koo; Yun, Eun Joo; Moon, Hee Jung; Shin, Hyun Ja [Korea Veterans Hospital, Seoul (Korea, Republic of)

    1997-02-01

    To evaluate the pattern of colonic diverticulosis according to age and sex, and recent trend. The authors retrospectively reviewed 120 cases of colonic diverticulosis in 1,020 patients who had undergone a double contrast barium enema examination between January 1st, 1993, and December 31st, 1995, and analyzed the frequency, size, multiplicity and anatomical site, according to age and sex. Diverticulum size was classified into one of three groups : less than 5mm, 5-10mm, over 10mm in diameter. The overall incidence of colonic diverticulosis was 120 cases among 1,020 patients(11.8%) with an incidence 5.3 times higher in males than in females. Peak incidence was in the fifth decade, with 19 cases (15.8%) among males, and after the sixth decade, with four cases(3.3%) among females. Mean age was 57.7 years. Diverticulum size of 5-10mm in diameter was predominant (2% of cases); average diameter was 5-6mm. The incidence of colonic diverticulosis was 5.1 times more frequent in the right colon (101 cases) than in the left (20 cases). The overall incidence of colonic diverticulosis has continually increased; in addition it has also recently increased slightly in left-sided colon. This is thought to be due to various factors, both congenital and acquired, including longer life with good health care, constipation, irritable bowel syndrome, stress and the tendency of eating patterns to more closely resemble those of the west.

  8. Abdominal actinomycosis: barium enema and computed tomography findings.

    Science.gov (United States)

    Uchiyama, N; Ishikawa, T; Miyakawa, K; Iinuma, G; Nakajima, H; Ushio, K; Yokota, T; Akasu, T; Shimoda, T

    1997-02-01

    A case of abdominal actinomycosis is described in a woman with recurrent right lower abdominal pain and low-grade fever without history of appendectomy. Past history included the use of an intrauterine device (IUD) until 10 years before manifestation of these symptoms. We followed up the patient, via diagnostic imaging, for 7 months. On initial barium enema, a polypoid lesion was visualized at the bottom of the cecum and there was constriction of the sigmoid colon; the appendix was not seen. Seven months later, poor extension at the cecum, severe constriction in the sigmoid colon, and narrowing of the terminal ileum were also visualized. On computed tomography (CT), the lesion was initially localized only in the ileocecal region adjacent to the sigmoid colon. After 7 months, the lesion had infiltrated adjacent anatomic components and showed direct infiltration of the pelvic space. Differential diagnosis was difficult, as it was not obvious whether this was a pelvic abscess due to inflammation or appendiceal carcinoma. Laparotomy was performed. Macroscopically, the lesion was not limited to the ileocecal region, but involved the right ureter, tubes the Fallopian and ovary, bladder, psoas muscle, and abdominal wall. Pathology findings showed, chronic inflammatory tissue with evidence of actinomycosis. Although previous reports have described a lack of specific findings in this disease. When actinomycosis is suspected, CT is recommended to define its extent.

  9. Suitability of Exoseal Vascular Closure Device for Antegrade Femoral Artery Puncture Site Closure

    Energy Technology Data Exchange (ETDEWEB)

    Schmelter, Christopher, E-mail: christopher.schmelter@klinikum-ingolstadt.de; Liebl, Andrea; Poullos, Nektarios [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany); Ruppert, Volker [Klinikum Ingolstadt, Department of Vascular Surgery (Germany); Vorwerk, Dierk [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany)

    2013-06-15

    Purpose. To assess the efficacy and safety of the Exoseal vascular closure device for antegrade puncture of the femoral artery. Methods. In a prospective study from February 2011 to January 2012, a total of 93 consecutive patients received a total of 100 interventional procedures via an antegrade puncture of the femoral artery. An Exoseal vascular closure device (6F) was used for closure in all cases. Puncture technique, duration of manual compression, and use of compression bandages were documented. All patients were monitored by vascular ultrasound and color-coded duplex sonography of their respective femoral artery puncture site within 12 to 36 h after angiography to check for vascular complications. Results. In 100 antegrade interventional procedures, the Exoseal vascular closure device was applied successfully for closure of the femoral artery puncture site in 96 cases (96 of 100, 96.0 %). The vascular closure device could not be deployed in one case as a result of kinking of the vascular sheath introducer and in three cases because the bioabsorbable plug was not properly delivered to the extravascular space adjacent to the arterial puncture site, but instead fully removed with the delivery system (4.0 %). Twelve to 36 h after the procedure, vascular ultrasound revealed no complications at the femoral artery puncture site in 93 cases (93.0 %). Minor vascular complications were found in seven cases (7.0 %), with four cases (4.0 %) of pseudoaneurysm and three cases (3.0 %) of significant late bleeding, none of which required surgery. Conclusion. The Exoseal vascular closure device was safely used for antegrade puncture of the femoral artery, with a high rate of procedural success (96.0 %), a low rate of minor vascular complications (7.0 %), and no major adverse events.

  10. Comparison of Ultrasound-Guided and Fluoroscopy-Assisted Antegrade Common Femoral Artery Puncture Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Slattery, Michael M.; Goh, Gerard S.; Power, Sarah; Given, Mark F.; McGrath, Frank P.; Lee, Michael J., E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland)

    2015-06-15

    PurposeTo prospectively compare the procedural time and complication rates of ultrasound-guided and fluoroscopy-assisted antegrade common femoral artery (CFA) puncture techniques.Materials and MethodsHundred consecutive patients, undergoing a vascular procedure for which an antegrade approach was deemed necessary/desirable, were randomly assigned to undergo either ultrasound-guided or fluoroscopy-assisted CFA puncture. Time taken from administration of local anaesthetic to vascular sheath insertion in the superficial femoral artery (SFA), patients’ age, body mass index (BMI), fluoroscopy radiation dose, haemostasis method and immediate complications were recorded. Mean and median values were calculated and statistically analysed with unpaired t tests.ResultsSixty-nine male and 31 female patients underwent antegrade puncture (mean age 66.7 years). The mean BMI was 25.7 for the ultrasound-guided (n = 53) and 25.3 for the fluoroscopy-assisted (n = 47) groups. The mean time taken for the ultrasound-guided puncture was 7 min 46 s and for the fluoroscopy-assisted technique was 9 min 41 s (p = 0.021). Mean fluoroscopy dose area product in the fluoroscopy group was 199 cGy cm{sup 2}. Complications included two groin haematomas in the ultrasound-guided group and two retroperitoneal haematomas and one direct SFA puncture in the fluoroscopy-assisted group.ConclusionUltrasound-guided technique is faster and safer for antegrade CFA puncture when compared to the fluoroscopic-assisted technique alone.

  11. New concept for CTO recanalization using controlled antegrade and retrograde subintimal tracking: the CART technique.

    Science.gov (United States)

    Surmely, Jean-François; Tsuchikane, Etsuo; Katoh, Osamu; Nishida, Yasunori; Nakayama, Mutsuo; Nakamura, Shigeru; Oida, Akitsugu; Hattori, Eijiro; Suzuki, Takahiko

    2006-07-01

    To demonstrate the safety and feasibility of a new concept for CTO recanalization using a controlled antegrade and retrograde subintimal tracking technique (CART technique). A successful percutaneous recanalization of chronic coronary occlusions results in improved survival, as well as enhanced left ventricular function, reduction in angina, and improved exercise tolerance. However, successful recanalization of CTOs is still not optimal, and needs further improvements. Ten patients with a CTO underwent the CART procedure. This technique combines the simultaneous use of the antegrade and retrograde approaches. A subintimal dissection is created antegradely and retrogradely, which allows the operator to limit the extension of the subintimal dissection in the CTO portion. A retrograde approach means that the occlusion site is approached in a retrograde fashion through the best collateral channel from any other patent coronary artery. The occlusion site was located in the RCA in 9 patients, and in the LAD in 1 patient. CTO duration varied from 7 to 84 months. Vessel recanalization was achieved in all patients. In all cases, the subintimal dissection was limited to the CTO region. No complications occurred in the collateral channel used for the retrograde approach. There were no in-hospital major adverse cardiac events. The CART technique is feasible, safe, and has a high success rate.

  12. Laparoscopic common bile duct exploration and antegrade biliary stenting: Leaving behind the Kehr tube

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    Darío Martínez-Baena

    2013-03-01

    Full Text Available Introduction: single-stage laparoscopic surgery of cholelithiasis and associated common bile duct stones (CL-CBDS has shown similar results when compared to laparoscopic cholecystectomy combined with ERCP. Classically, choledochorrhaphy has been protected by a T-tube drain to allow external bypass of bile flow. However, its removal is associated with a significant complication rate. Use of antegrade biliary stents avoids T-tube removal associated morbidity. The aim of this study is to compare the results of choledochorrhaphy plus T-tube drainage versus antegrade biliary stenting in our series of laparoscopic common bile duct explorations (LCBDE. Material and methods: between 2004 and 2011, 75 patients underwent a LCBDE. Choledochorrhaphy was performed following Kehr tube placements in 47 cases and transpapillary biliary stenting was conducted in the remaining 28 patients. Results: postoperative hospital stay was shorter in the stent group (5 ± 10.26 days than in the Kehr group (12 ± 10.6 days, with a statistically significant difference. There was a greater trend to grade B complications in the stent group (10.7 vs. 4.3 % and to grade C complications in the Kehr group (6.4 vs. 3.6 %. There were 3 cases of residual common bile duct stones in the Kehr group (6.4 % and none in the stent group. Conclusions: antegrade biliary stenting following laparoscopic common bile duct exploration for CL-CBDS is an effective and safe technique that prevents T-tube related morbidity.

  13. Moderate Versus Deep Hypothermia With Unilateral Selective Antegrade Cerebral Perfusion for Acute Type A Dissection.

    Science.gov (United States)

    Leshnower, Bradley G; Thourani, Vinod H; Halkos, Michael E; Sarin, Eric L; Keeling, William B; Lamias, Mark J; Guyton, Robert A; Chen, Edward P

    2015-11-01

    Despite improved results with surgical therapy for acute type A aortic dissection (ATAAD), there remains a lack of consensus regarding the optimal method of cerebral protection and circulation management during ATAAD. The purpose of this study is to determine whether in the setting of antegrade cerebral perfusion, moderate hypothermic circulatory arrest (MHCA) provides equivalent cerebral and visceral protection as deep hypothermic circulatory arrest (DHCA) for patients undergoing emergent ATAAD repair. A review of the Emory aortic surgery database from 2004 to 2014 identified 288 patients who underwent ATAAD with right axillary artery cannulation, unilateral selective antegrade cerebral perfusion (uSACP), and hypothermic circulatory arrest (HCA). In all, 88 patients underwent HCA at 24 °C or lower (DHCA), and 206 patients underwent HCA at more than 24 °C (MHCA). Major adverse outcomes of death, stroke, temporary neurologic dysfunction, and dialysis-dependent renal failure were examined. The groups were well matched for age and major comorbidities. The DHCA patients underwent HCA at lower temperatures (DHCA 21.6 ± 3.1 °C vs MHCA 27.4 ± 1.6 °C, p 0.05). Moderate HCA with uSACP is an effective circulation management strategy that provides excellent cerebral and visceral protection during emergent ATAAD repair. In the setting of antegrade cerebral perfusion, deep hypothermia does not provide any additional benefit. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Perforation and mortality after cleansing enema for acute constipation are not rare but are preventable

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    Niv G

    2013-04-01

    Full Text Available Galia Niv,1 Tamar Grinberg,2 Ram Dickman,3 Nir Wasserberg,4 Yaron Niv1,3 1Risk Management and Quality Assurance, 2Emergency Department, 3Department of Gastroenterology, 4Department of Surgery B, Rabin Medical Center, Beilinson Hospital and Tel Aviv University, Tel Aviv, Israel Objectives: Constipation is a common complaint, frequently treated with cleansing enema. Enemas can be very effective but may cause serious adverse events, such as perforation or metabolic derangement. Our aim was to evaluate the outcome of the use of cleansing enema for acute constipation and to assess adverse events within 30 days of therapy. Methods: We performed a two-phase study: an initial retrospective and descriptive study in 2010, followed by a prospective study after intervention, in 2011. According to the results of the first phase we established guidelines for the treatment of constipation in the Emergency Department and then used these in the second phase. Results: There were 269 and 286 cases of severe constipation in the first and second periods of the study, respectively. In the first study period, only Fleet® Enema was used, and in the second, this was changed to Easy Go enema (free of sodium phosphate. There was a 19.2% decrease in the total use of enema, in the second period of the study (P < 0.0001. Adverse events and especially, the perforation rate and the 30-day mortality in patients with constipation decreased significantly in the second phase: 3 (1.4% versus 0 (P = 0.0001 and 8 (3.9% versus 2 (0.7% (P = 0.0001, for perforation and death in the first and second period of the study, respectively. Conclusion: Enema for the treatment of acute constipation is not without adverse events, especially in the elderly, and should be applied carefully. Perforation, hyperphosphatemia (after Fleet Enema, and sepsis may cause death in up to 4% of cases. Guidelines for the treatment of acute constipation and for enema administration are urgently needed. Keywords

  15. Indiana continent catheterizable urinary reservoir.

    Science.gov (United States)

    Castillo, O A; Aranguren, G; Campos-Juanatey, F

    2014-01-01

    Radical pelvic surgery requires continent or incontinent urinary diversion. There are many techniques, but the orthotopic neobladder is the most used. A continent catheterizable urinary reservoir is sometimes a good alternative when this derivation is not possible or not indicated. This paper has aimed to present our experience with the Indiana pouch continent urinary reservoir. The series is made up of 85 patients, 66 women and 19 men, with a mean age of 56 years (31-77 years). Variables analyzed were operating time, estimated blood loss, transfusion rate, hospital stay and peri-operatory complications. The main indication in 49 cases was resolution of complications related to the treatment of cervical cancer. Average operation time was 110.5 minutes (range 80-130 minutes). Mean blood loss was 450 cc (100-1000 cc). Immediate postoperative complications, all of which were treated medically, occurred in 16 patients (18.85%). One patient suffered anastomotic leakage. Hospital stay was 19 days (range 5-60 days) and there was no mortality in the series. Late complications occurred in 26 patients (32%), these being ureteral anastomotic stenosis in 11 cases, cutaneous stoma stenosis in 9 cases and reservoir stones in 6 cases. The Indiana continent catheterizable urinary reservoir is a valid option for the treatment of both urological and gynecological malignancies as well as for the management of pelvic morbidity related to the treatment of pelvic cancers. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  16. [A case of the complications following glycerin enema which suggested malignant hyperthermia].

    Science.gov (United States)

    Maeda, Emi; Mori, Yumiko; Amano, Eizo; Akamatsu, Tetsuya; Okada, Toshiki

    2010-07-01

    We experienced a case of the complications following glycerin enema which suggested malignant hyperthermia. A 73-year-old man with knee osteoarthritis was scheduled for total knee arthroplasty under general and epidural anesthesia. The patient received glycerin enema before surgery. After epidural catheterization, anesthesia was induced with thiopental, fentanyl, vecuronium and sevoflurane. The trachea was intubated and the patient was ventilated with sevoflurane-air-oxygen. Then, cola-like urine was drained and he became febrile up to 37.9 degrees C. Although there were no other symptoms suggesting malignant hyperthermia, the surgery was cancelled. We suspected not only hemolysis by the color of the serum and the blood chemistry, but also rhabdomyolysis by increased levels of serum creatine phosphokinase and myoglobin as well as urine myoglobin. He recovered uneventfully. On the third day, perirectal abscess and anal fissure were diagnosed, which were considered to be the cause of the fever. It is well-known that glycerin enema could cause hemolysis, but rabdomyolysis as a complication of glycerin enema has rarely been reported. We speculate that injection of hypertonic glycerin into the perirectal tissue could have caused rhabdomyolysis as well as hemolysis, which led to cola-like urine. The complications following glycerin enema can be incorporated to a differential diagnosis of malignant hyperthermia.

  17. Dose optimisation of double-contrast barium enema examinations.

    Science.gov (United States)

    Berner, K; Båth, M; Jonasson, P; Cappelen-Smith, J; Fogelstam, P; Söderberg, J

    2010-01-01

    The purpose of the present work was to optimise the filtration and dose setting for double-contrast barium enema examinations using a Philips MultiDiagnost Eleva FD system. A phantom study was performed prior to a patient study. A CDRAD phantom was used in a study where copper and aluminium filtration, different detector doses and tube potentials were examined. The image quality was evaluated using the software CDRAD Analyser and the phantom dose was determined using the Monte Carlo-based software PCXMC. The original setting [100 % detector dose (660 nGy air kerma) and a total filtration of 3.5 mm Al, at 81 kVp] and two other settings identified by the phantom study (100 % detector dose and additional filtration of 1 mm Al and 0.2 mm Cu as well as 80 % detector dose and added filtration of 1 mm Al and 0.2 mm Cu) were included in the patient study. The patient study included 60 patients and up to 8 images from each patient. Six radiologists performed a visual grading characteristics study to evaluate the image quality. A four-step scale was used to judge the fulfillment of three image quality criteria. No overall statistical significant difference in image quality was found between the three settings (P > 0.05). The decrease in the effective dose for the settings in the patient study was 15 % when filtration was added and 34 % when both filtrations was added and detector dose was reduced. The study indicates that additional filtration of 1 mm Al and 0.2 mm Cu and a decrease in detector dose by 20 % from the original setting can be used in colon examinations with Philips MultiDiagnost Eleva FD to reduce the patient dose by 30 % without significantly affecting the image quality. For 20 exposures, this corresponds to a decrease in the effective dose from 1.6 to 1.1 mSv.

  18. Epidermal growth factor enemas for induction of remission in left-sided ulcerative colitis

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    Hugo Nodarse-Cuní

    2013-03-01

    Full Text Available Introduction: ulcerative colitis is a little known chronic inflammatory disease in colonic mucosa. The positive effect of epidermal growth factor was shown in a previous report, with enema use for treatment of mild to moderate left-sided manifestation of the disease. This evidence provided the basis for evaluating the efficacy and safety profile of a viscous solution of this product. Methods: thirty-one patients were randomized to three groups for daily medications during 14 days. Twelve received one 10 mg enema of epidermal growth factor dissolved in 100 mL of viscous solution whereas nine were treated with placebo enema; both groups also received 1.2 g of oral mesalamine per day. The other group included ten patients with 3 g / 100 mL of mesalamine enema. Primary end point was clinical responses after two weeks of treatment, defined as a decreased of, at least three points from baseline, the Disease Activity Index and endoscopic or histological evidences of improvement. Results: remission of disease was observed in all patients in the epidermal growth factor group, and six in both, mesalamine enema and placebo group. All the comparisons between groups showed statistically significant superiority for epidermal growth factor, the only product with significant reduction in disease activity index as well as the presence and intensity of digestive symptoms in patients after treatment. None adverse event was reported. Conclusions: the results agree with previous molecular and clinical evidences, indicating that the epidermal growth factor is effective to reduce disease activity and to induce remission. A new study involving more patients should be conducted to confirm the efficacy of the epidermal growth factor enemas.

  19. Study on Effectiveness of Barium Enema in the Diagnosis of Hirschsprung Disease

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    M. Karami Chanlah

    2005-08-01

    Full Text Available Introduction & Aims: The study aims to investigate barium enema accuracy in diagnosing Hischsprung's disease (HD. Patients & Methods: This study was performed on 58 patients diagnosed with Hischsprung's disease later confirmed by pathology; the patients had undergone surgical operation in the last 3 years. The radiographs were reached from their medical records and were later assessed by a skilled pediatric radiologist. Bar-ium enema findings were also evaluated. Rectosig-moid index with the sign of transitional zone (TZ, and barium evacuation of delayed radiographs were recorded by a radiologist. Results: We measured accuracy of rectosigmoid index in these patients to be 94.8%, the sign of TZ to be 70.7%, and the barium evacuation of delayed radio-graphs to be 100% for diagnosis of HD. Fifty percent of the cases were neonates, 42% infants, and 7% more than 2 years old. Of all the patients, 76% were male and 24% were female. The most common diseases accompanying HD were cardiac abnormalities. We did not find any total aganglionosis. Conclusion & Discussion: Half of the patients were newborn infants. The fact that the ratio is more than usual shows timely diagnosis of the condition by phy-sicians of this center. Barium enema findings in new-borns of our study contradicted significantly the re-searches done in other countries. In this study, it was found that with increasing age, barium enema find-ings would be defined in such a way that in in-fantsover 2 years, it can reach a diagnosis accuracy of up to 100%. Regarding the availability of barium en-ema and its lower costs than other diagnostic meth-ods, its accuracy seems very promising. Our study emphasizes that perhaps with barium enema, we may operate these infants in one stage so that they can get rid of multiphasic operation difficulties.

  20. Development of in situ gelling and bio adhesive 5-Fluorouracil enema.

    Science.gov (United States)

    Wang, Lu-Lu; Zheng, Wen-Sheng; Chen, Shao-Hua; Fang, Xia-Qin

    2013-01-01

    In this study, a novel 5-Fluorouracil (5-FU) enema with good bio adhesion and temperature sensitivity was developed using in situ gelling technology. The preparation was formulated as a free-flowing liquid before use, while a layer of gel film was quickly formed when administered in the rectum, with a large contact surface area. It also demonstrated good biocompatibility, appropriate gel strength and bio adhesive force with excellent adhesion to rectal mucosa and prolonged action time, allowing more effective drug absorption and diffusion to surrounding tissues. Poloxamer 407 and poloxamer 188 were applied to adjust the gelling temperature. With the addition of carbopol and polycarbophil (bio adhesive substances), the solubility of 5-FU and gel strength increased, the temperature of gelation and the surface area of drug contact on mucous epithelium decreased. Decreased adhesive force between the preparation and the mucous membrane of the rectum was demonstrated with improving carbopol and polycarbophil's concentration. In vitro release demonstrated that 5-FU in situ gelling enema with different bases had a rapid and almost complete drug release. We used an optimized formulation of P407/P188/polycarbophil/5-FU (17/2.5/0.2/1.0) for animal experiments. The result showed that the drug evenly covered the surface of the rectum and there was no leakage in 6 hours. The in situ gelling enema showed significantly higher rectal tissue levels of 5-FU compared with suppository and intravenous administration, indicating that 5-FU could be well absorbed due to the enlarged releasing area, longer retention time and larger amount of dissolved active ingredients. Systemically, 5-FU levels in the enema group were similar to those in the suppository group and significantly lower than the intravenous group. The enema was not associated with morphological damage to rectal tissue. These results suggest that the bio adhesive and in situ gelling enema could be a more effective rectal

  1. Development of in situ gelling and bio adhesive 5-Fluorouracil enema.

    Directory of Open Access Journals (Sweden)

    Lu-Lu Wang

    Full Text Available In this study, a novel 5-Fluorouracil (5-FU enema with good bio adhesion and temperature sensitivity was developed using in situ gelling technology. The preparation was formulated as a free-flowing liquid before use, while a layer of gel film was quickly formed when administered in the rectum, with a large contact surface area. It also demonstrated good biocompatibility, appropriate gel strength and bio adhesive force with excellent adhesion to rectal mucosa and prolonged action time, allowing more effective drug absorption and diffusion to surrounding tissues. Poloxamer 407 and poloxamer 188 were applied to adjust the gelling temperature. With the addition of carbopol and polycarbophil (bio adhesive substances, the solubility of 5-FU and gel strength increased, the temperature of gelation and the surface area of drug contact on mucous epithelium decreased. Decreased adhesive force between the preparation and the mucous membrane of the rectum was demonstrated with improving carbopol and polycarbophil's concentration. In vitro release demonstrated that 5-FU in situ gelling enema with different bases had a rapid and almost complete drug release. We used an optimized formulation of P407/P188/polycarbophil/5-FU (17/2.5/0.2/1.0 for animal experiments. The result showed that the drug evenly covered the surface of the rectum and there was no leakage in 6 hours. The in situ gelling enema showed significantly higher rectal tissue levels of 5-FU compared with suppository and intravenous administration, indicating that 5-FU could be well absorbed due to the enlarged releasing area, longer retention time and larger amount of dissolved active ingredients. Systemically, 5-FU levels in the enema group were similar to those in the suppository group and significantly lower than the intravenous group. The enema was not associated with morphological damage to rectal tissue. These results suggest that the bio adhesive and in situ gelling enema could be a more

  2. A prospective randomized single blind trial of Fleet phosphate enema versus glycerin suppositories as preparation for flexible sigmoidoscopy.

    Science.gov (United States)

    Underwood, D; Makar, R R; Gidwani, A L; Najfi, S M; Neilly, P; Gilliland, R

    2010-03-01

    This study compared the efficacy and patient acceptability of two methods of bowel preparation for flexible sigmoidoscopy. Patients attending for outpatient flexible sigmoidoscopy were prospectively randomized to receive one Fleet ready-to-use enema or 2 x 4 g glycerin suppositories, 2 h preprocedure. Patient and endoscopist questionnaires were used to compare the outcomes. From November 2000 to August 2001, 203 (male = 95; female = 108) patients were randomized. Patient data available for 163 patients (enema = 93; suppository = 70) revealed: ease of use (enema = 52; suppository = 25; P suppository = 3; P suppository = 44; P suppository = 24; P = 0.016, Fisher's exact). Endoscopist data available for 151 patients (enema = 76; suppository = 75) revealed: average depth of insertion (enema = 53.6 +/- 11.6 cm; suppository 46.3 +/- 13.7 cm; P suppository = 34 (45.3%); P suppositories.

  3. Continence after posterior sagittal anorectoplasty.

    Science.gov (United States)

    Langemeijer, R A; Molenaar, J C

    1991-05-01

    Posterior sagittal anorectoplasty (PSARP) was introduced in 1982 by Peña and De Vries as a new operation for patients with a high anorectal malformation. The degree of postoperative continence is reported to be high. During the past decade, too, new insights have been gained into the embryology of anorectal malformations. Evaluation of PSARP in relation to current understanding of the development and anatomy of the anorectum and the pelvic floor has led us to conclude that optimal continence cannot be expected. Fifty patients with a high anorectal malformation underwent PSARP between June 1983 and May 1990. Postoperative follow-up consisted of anamnesis (subjective) and electrostimulation, defecography, and anorectal manometry (objective). All patients are alive, and all but one are being evaluated regularly. Subjectively, the majority of patients were more or less incontinent, with soiling of pants at least once a day. On the basis of objective criteria, virtually all patients appeared to be incontinent, and in only one patient was the mechanism of defecation almost unimpaired after PSARP. From this study, we conclude that although PSARP provides a good aesthetic result, patients will never acquire normal continence.

  4. Antegrade bowel intussusception after remote Whipple and Puestow procedures for treatment of pancreas divisum

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    To date, antegrade intussusception involving a Roux-en-Y reconstruction has been reported only once. We report a case of acute bowel obstruction due to an intussusception involving two Roux-en-Y limbs in a 40-year-old woman with a history of chronic pancreatitis due to pancreas divisum. Four years preceding this event, the patient had undergone a Whipple procedure, and three years prior to that, a Puestow operation. The patient was successfully treated with bowel resection and a side-to-side anastomosis between the most distal aspect of the bowel and the most distal Roux-en-Y reconstruction, which preserved both Roux-en-Y reconstructions.

  5. [Prolonged Disturbance of Consciousness following Preoperative Glycerin Enema in an Elderly Patient].

    Science.gov (United States)

    Ishizaki, Tsuyoshi; Hayashi, Hideaki; Matsumoto, Tomoyuki

    2016-03-01

    A 94-year-old female patient with femoral neck fracture received 60 ml glycerin enema prior to surgery, according to the preoperative preparation protocol. She was found unconscious and unresponsive 60 minutes after the treatment. Vital signs were checked and ECG monitoring was started. The results were unremarkable and similar to those recorded at the time of admission. A neurologist was consulted, and a thorough evaluation was performed. None of physical and neurological examination, laboratory testing and urgent intracranial imaging revealed significant abnormalities or lesion responsible for the depressed consciousness. Vasovagal reflex triggered by enema and the consequent hypotension was thought to be the most likely cause of transient cerebral hypoperfusion resulting in loss of consciousness. The patient remained unresponsive for the next 2 hours, and came to open her eyes with tapping stimuli. She took another hour to fully regain consciousness without any residual neurologic deficit. Her surgery was cancelled. Vasovagal reflex is known to be one of the potential complications associated with enema. Our experience suggests that the necessity of glycerin enema for preoperative bowel preparation in elderly patients should be cautiously determined and it should be given, if necessary, under adequate vigilance.

  6. Semi-continent becomes electrified

    Energy Technology Data Exchange (ETDEWEB)

    Lanz, K.

    1976-04-01

    The most costly kWh is the one which is lacking. This has become most painfully apparent recently among the development areas of the semi-continent which has actually progressed farthest, viz. Iberoamerica. Here the financial help from the Interamerican Development Bank (Banco Interamericano de Desarrollo) which was set up to promote the extension of the power supply system has proved absolutely indispensable. In addition it has stimulated export from the industrial countries, in particular from the Federal Republic of Germany. Between the supranational credit institute in Washington and the German Federal Government in Bonn collaboration will become still closer and this will develop sales from German Industry.

  7. Adding a custom made pressure release valve during air enema for intussusception: A new technique

    Directory of Open Access Journals (Sweden)

    Hosni Morsi Ahmed

    2015-01-01

    Full Text Available Background: Non-surgical reduction remains the first line treatment of choice for intussusception. The major complication of air enema reduction is bowel perforation. The authors developed a custom made pressure release valve to be added to portable insufflation devices, delivering air at pressures accepted as safe for effective reduction of intussusception in children under fluoroscopic guidance. The aim of this study was to develop a custom made pressure release valve that is suitable for the insufflation devices used for air enema reduction of intussusception and to put this valve into regular clinical practice. Materials and Methods: An adjustable, custom made pressure release valve was assembled by the authors using readily available components. The valve was coupled to a simple air enema insufflation device. The device was used for the trial of reduction of intussusception in a prospective study that included 132 patients. Results: The success rate for air enema reduction with the new device was 88.2%. The mean pressure required to achieve complete reduction was 100 mmHg. The insufflation pressure never exceeded the preset value (120 mmHg. Of the successful cases, 58.3% were reduced from the first attempt while 36.1% required a second insufflation. Only 5.55% required a third insufflation to complete the reduction. In cases with unsuccessful pneumatic reduction attempt (18.1%, surgical treatment was required. Surgery ranged from simple reduction to resection with a primary end to end anastomosis. No complications from air enema were recorded. Conclusions: The authors recommend adding pressure release valves to ensure safety by avoiding pressure overshoot during the procedure.

  8. Granulomatous colitis: findings on double contrast barium enema and follow-up studies

    Energy Technology Data Exchange (ETDEWEB)

    Song, Jong Gi; Han, Joon Koo; Kim, Seung Hoon; Choo, Sung Wook; Kim, Seung Cheol; Choi, Byung Ihn [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1995-10-15

    To evaluate the radiologic findings of granulomatous colitis on double contrast barium enema and changes on follow-up studies. Serial double contrast barium enema of six patients with granulomatous colitis confirmed by endoscopic biopsy were reviewed. We analyzed the radiologic findings and their follow-up changes, including aphthous ulcers, lymphoid hyperplasia, deep ulcers, cobble stone appearance, geographic ulcers, asymmetric involvement of ulcers, skip lesions, sinus tract, fistula formation, pseudosacculation, focal stricture, and small bowel involvement. Pretreatment double contrast barium enema findings were aphthous ulcers in five patients, deep ulcer in six, cobble stone appearance in five, longitudinal geographic ulcers in two, fistulas in one, pseudosacculations in two, focal stricture in one, and pseudopolyps in six. Also, anal ulcers were observed in two patients, asymmetric involvement of ulcers in three, skip lesions in four, and small bowel involvement in five in five patients proved to have inactive disease after treatment, aphthous ulcers and deep ulcers disappeared. Geographic ulcers of two patients and anal ulcer of one patients decreased in size or depth. Pseudosacculation in one patient disappeared. Pseudopolyps decreased in two patients, increased in one, and decreased after increase in two. One patient whose disease remained active after treatment showed maintenance or increase of ulcers or fistula. And their pseudosacculation or focal stricture unchanged and pseudopolyps decreased. The major radiologic findings of chronic granulomatous colitis on double contrast barium enema are aphthous ulcer, deep ulcer, cobble stone appearance, discontinuity of the lesion and coexistence of ulcers and pseudopolyps. And, double contrast barium enema is good follow-up modality because its findings correlate with clinical course of the granulomatous colitis after treatment.

  9. Glycerin enemas and suppositories in premature infants: a meta-analysis.

    Science.gov (United States)

    Livingston, Michael H; Shawyer, Anna C; Rosenbaum, Peter L; Williams, Connie; Jones, Sarah A; Walton, J Mark

    2015-06-01

    Premature infants are often given glycerin enemas or suppositories to facilitate meconium evacuation and transition to enteral feeding. The purpose of this study was to assess the available evidence for this treatment strategy. We conducted a systematic search of Medline, Embase, Central, and trial registries for randomized controlled trials of premature infants treated with glycerin enemas or suppositories. Data were extracted in duplicate and meta-analyzed using a random effects model. We identified 185 premature infants treated prophylactically with glycerin enemas in one trial (n = 81) and suppositories in two other trials (n = 104). All infants were less than 32 weeks gestation and had no congenital malformations. Treatment was associated with earlier initiation of stooling in one trial (2 vs 4 days, P = .02) and a trend towards earlier meconium evacuation in another (6.5 vs 9 days, P = .11). Meta-analysis demonstrated no effect on transition to enteral feeding (0.7 days faster, P = .43) or mortality (P = 0.50). There were no reports of rectal bleeding or perforation but there was a trend towards increased risk of necrotizing enterocolitis with glycerin enemas or suppositories (risk ratio = 2.72, P = .13). These three trials are underpowered and affected by one or more major methodological issues. As a result, the quality of evidence is low to very low. Three other trials are underway. The evidence for the use glycerin enemas or suppositories in premature infants in inconclusive. Meta-analyzed data suggest that treatment may be associated with increased risk of necrotizing enterocolitis. Careful monitoring of ongoing trials is required. Copyright © 2015 by the American Academy of Pediatrics.

  10. Metabolic Characteristics of Human Hearts Preserved for 12 Hours by Static Storage, Antegrade Perfusion or Retrograde Coronary Sinus Perfusion

    Science.gov (United States)

    Cobert, Michael L.; Merritt, Matthew E.; West, LaShondra M.; Ayers, Colby; Jessen, Michael E.; Peltz, Matthias

    2014-01-01

    Objective(s) Machine perfusion of donor hearts is a promising strategy to increase the donor pool. Antegrade perfusion is effective but can lead to aortic valve incompetence and non-nutrient flow. Experience with retrograde coronary sinus perfusion of donor hearts has been limited. We tested the hypothesis that retrograde perfusion could support myocardial metabolism over an extended donor ischemic interval. Methods Human hearts from donors rejected or not offered for transplantation were preserved for 12 hours in University of Wisconsin Machine Perfusion Solution by: 1. Static hypothermic storage 2. Hypothermic antegrade machine perfusion or 3. Hypothermic retrograde machine perfusion. Myocardial oxygen consumption (MVO2), and lactate accumulation were measured. Ventricular tissue was collected for proton (1H) and phosphorus-31 (31P) magnetic resonance spectroscopy (MRS) to evaluate the metabolic state of the myocardium. Myocardial water content was determined at end-experiment. Results Stable perfusion parameters were maintained throughout the perfusion period with both perfusion techniques. Lactate/alanine ratios were lower in perfused hearts compared to static hearts (pperfused groups. High energy phosphates were better preserved in both perfused groups (pperfused (80.2±.8%) compared to both antegrade perfused (76.6±.8%, p=.02) and static storage hearts (76.7±1%, p=.02). Conclusions In conclusion, machine perfusion by either the antegrade or the retrograde technique can support myocardial metabolism over long intervals. Machine perfusion appears promising for long term preservation of human donor hearts. PMID:24642559

  11. Functional Outcome After Antegrade Femoral Nailing : A Comparison of Trochanteric Fossa Versus Tip of Greater Trochanter Entry Point

    NARCIS (Netherlands)

    Moein, Chloe Ansari; ten Duis, Henk-Jan; Oey, Liam; de Kort, Gerard; van der Meulen, Wout; Vermeulen, Karin; van der Werken, Christiaan

    2011-01-01

    Objectives: This study was performed to explore the relationship between entry point-related soft tissue damage in antegrade femoral nailing and the functional outcome in patients with a proximal third femoral shaft fracture. Design: Retrospective clinical trial. Setting: Level I university trauma c

  12. Retrograde endovenous laser ablation through saphenopopliteal junctional area for incompetent small saphenous vein; Comparison with antegrade approach

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jun Seok; Park, Sang Woo; Yun, Ik Jin; Hwang, Jae Joon; Lee, Song Am; Chee, Hyun Keun; Hwang, Jin Ho [Konkuk University Hospital, Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2016-06-15

    To evaluate the safety and efficacy of retrograde endovenous laser ablation (EVLA) and to compare it with the conventional antegrade EVLA for incompetent small saphenous vein (SSV). Small saphenous vein was cannulated via two approaches under ultrasound-guidance. One method involved puncturing the SSV cranially at mid-calf (the antegrade group). If the antegrade puncture into the SSV failed twice, the other approach for puncture was selected that involved puncturing the SSV toward the ankle (the retrograde group). Patients were evaluated in terms of technical and clinical success, closure rates of the SSV, and complications including pain, bruising, or paresthesia at all follow-up visits. The 1470 nm endovenous laser was used in all limbs. Technical success was seen in all limbs in both groups (100%). Closure rate in both groups showed about 95%, without significant difference (p = 0.685). Similar linear endovenous energy density was supplied during the EVLA in both groups (p = 0.876). Three frequent complications including bruising, pain, and paresthesia did not show statistical significance between groups (p = 0.465, 0.823, 1.000, respectively). Major complications were absent in both groups. The EVLA for the incompetent SSV using a retrograde approach is safe and effective and should be considered the alternative method if the antegrade access fails due to vasospasm or small SSV diameter.

  13. Revascularization of a central vein total occlusion via antegrade and retrograde approach in a patient with hemodialysis access.

    Science.gov (United States)

    Fang, Hsiu-Yu; Hsieh, Yuan-Kai; Wu, Chiung-Jen

    2010-12-01

    The occurrence of central vein total occlusion results in upper arm edema, pain, and hemodialysis access failure in uremic patient. Previous studies have proven the effectiveness of percutaneous balloon angioplasty for central vein total occlusion. Here, we report a rare case of successful revascularization of central vein total occlusion via antegrade and retrograde approach. Copyright © 2010 Wiley-Liss, Inc.

  14. mproved enema method glycerine enema 200ml%改良的开塞露200 ml的灌肠方法

    Institute of Scientific and Technical Information of China (English)

    张洪越; 叶兰凤

    2014-01-01

    cosmeticsurgeryafterthecustomerduetotheimpactofpain,diet,activity,livingenvironment,andotheraspectsofthepostoperativeabdominaldistension,oftenexistsand is not easy to bowel symptoms,including we commonly used solution:enema 20-40ml anus,oral phenolphthalein tablet,Maren Pil s,told customers eat crude fiber foods for example,celery, sweet potato,taro;fruit:kiwi fruit,dragon fruit,apple,banana etc..The 200ml glycerine enema,the conventional method is to use the 50ml injection of glycerine enema syringe nipple aspira-tion after connected with a sputum suction tube inserted into the anus after lubrication,divided into four times operation steps,sputum suction tube is hard,insert the anus,customers wil not comfortable,my branch uses the method of enema with Kaiselu 200ml improved,after the clinical use,the ef ect is bet er,introduce as fol ows now.%I美容整形手术后顾客因术后疼痛、饮食、活动、居住环境、麻药等方面的影响,往往存在腹胀、不易排便的症状,我院现常用的解决方法包括:开塞露20-40ml纳肛、口服酚酞片、麻仁丸、嘱顾客多食粗纤维食物例如:芹菜、红薯、芋头等;水果有:猕猴桃、火龙果、苹果、香蕉等。200ml开塞露灌肠,以往常规方法是用50ml注射器抽吸开塞露后,注射器乳头接吸痰管,润滑后插入肛门,分四次进行操作,步骤多,吸痰管较硬,插入肛门,顾客会有不舒适感,我科采用了改良的开塞露200ml的灌肠方法,经过临床使用,效果较好,现介绍如下:

  15. Intra-individual comparison of patient acceptability of multidetector-row CT colonography and double-contrast barium enema

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, S.A. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom)]. E-mail: csytaylor@yahoo.co.uk; Halligan, S. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom); Burling, D. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom); Bassett, P. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom); Bartram, C.I. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom)

    2005-02-01

    AIMS: To compare the subjective acceptability of CT colonography in comparison with barium enema in older symptomatic patients, and to ascertain preferences for future colonic investigation. MATERIALS AND METHODS: The study population comprised 78 persons aged 60 years or over with symptoms suggestive of colorectal neoplasia, who underwent CT colonography followed the same day by barium enema. A 25-point questionnaire was administered after each procedure and an additional follow-up questionnaire a week later. Responses were compared using Wilcoxon matched pairs testing, Mann-Whitney test statistics and binomial exact testing. RESULTS: Participants suffered less physical discomfort during CT colonography (p=0.03) and overall satisfaction was greater compared with barium enema (p=0.03). On follow-up, respondents reported significantly better tolerance of CT colonography (p=0.002), and were less prepared to undergo barium enema again (p<0.001). Of 52 subjects expressing an opinion, all preferred CT to barium enema. CONCLUSION: Patient satisfaction was higher with CT colonography than barium enema. CT colonography caused significantly less physical discomfort and was overwhelmingly preferred by patients.

  16. Contrast enema depiction of small-bowel volvulus in complicated neonatal bowel obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Navarro, Oscar M.; Daneman, Alan; Miller, Stephen F. [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)

    2004-12-01

    About one-half of patients with meconium ileus (MI) present with a complication such as volvulus, atresia, meconium peritonitis or giant cystic meconium peritonitis. The treatment of these complications requires surgery. However, the preoperative diagnosis of complicated MI is difficult. We describe two neonates with complicated small-bowel obstruction, one with MI related to cystic fibrosis and the other not related to cystic fibrosis. In both, contrast enema depicted a spiral appearance of the distal small bowel, which at surgery proved to be the result of volvulus associated with antenatal bowel perforation. This appearance of the small bowel on contrast enema in this clinical setting has not been previously described. The recognition of this spiral appearance of the distal small bowel suggests the need for surgery. (orig.)

  17. Use of butyrate or glutamine in enema solution reduces inflammation and fibrosis in experimental diversion colitis

    Institute of Scientific and Technical Information of China (English)

    Rodrigo Goulart Pacheco; Christiano Costa Esposito; Lucas CM Müller; Morgana TL Castelo-Branco; Leonardo Pereira Quintella; Vera Lucia A Chagas; Heitor Siffert P de Souza

    2012-01-01

    AIM:To investigate whether butyrate or glutamine enemas could diminish inflammation in experimental diversion colitis.METHODS:Wistar specific pathogen-free rats were submitted to a Hartmann's end colostomy and treated with enemas containing glutamine,butyrate,or saline.Enemas were administered twice a week in the excluded segment of the colon from 4 to 12 wk after the surgical procedure.Follow-up colonoscopy was performed every 4 wk for 12 wk.The effect of treatment was evaluated using video-endoscopic and histologic scores and measuring interleukin-1β,tumor necrosis factor-alpha,and transforming growth factor beta production in organ cultures by enzyme linked immunosorbent assay.RESULTS:Colonoscopies of the diverted segment showed mucosa with hyperemia,increased number of vessels,bleeding and mucus discharge.Treatment with either glutamine or butyrate induced significant reductions in both colonoscopic (P < 0.02) and histological scores (P < 0.01) and restored the densities of collagen fibers in tissue (P =0.015; P =0.001),the number of goblet cells (P =0.021; P =0.029),and the rate of apoptosis within the epithelium (P =0.043; P =0.011) to normal values.The high levels of cytokines in colon explants from rats with diversion colitis significantly decreased to normal values after treatment with butyrate or glutamine.CONCLUSION:The improvement of experimental diversion colitis following glutamine or butyrate enemas highlights the importance of specific luminal nutrients in the homeostasis of the colonic mucosa and supports their utilization for the treatment of human diversion colitis.

  18. [The role of enemas in the small intestine in the study of ileal subocclusion].

    Science.gov (United States)

    Cirillo, L C; Maurano, A; Noviello, A; de Lutio di Castelguidone, E

    1986-05-01

    In mechanical subocclusions, when there isn't immediate urgency, is it possible and necessary to probe radiologic examination, for a better surgical evaluation. The authors describe their own experience, achieved in about 3 years, on small bowel double contrast enema. They examined 143 patients; 16 of them were suboccluded. The security and the diagnostic reliability of used method are stressed by the authors to define lesions' morphology and localization.

  19. Colorectal neoplasm: Magnetic resonance colonography with fat enema-initial clinical experience

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To assess Magnetic resonance colonography with fat enema as a method for detection of colorectal neoplasm. METHODS: Consecutive twenty-two patients underwent MR colonography with fat enema before colonoscopy. T1-weighted three-dimensional fast spoiled gradientecho with inversion recovery sequence was acquired with the patient in the supine position before and 75 s after Gadopentetate Dimelumine administration. Where by, pre and post MR coronal images were obtained with a single breath hold for about 20 s to cover the entire colon. The quality of MR colonographs and patients' tolerance to fat contrast medium was investigated. Colorectal neoplasms identified by MR colonography were compared with those identified on colonoscopy and sensitivity of detecting the lesions was calculated accordingly. RESULTS: MR colonography with fat enema was well tolerated without sedation and analgesia. 120 out of 132 (90.9%) colonic segments were well distended and only 1 (0.8%) colonic segment was poor distension. After contrast enhancement scan, mean contrast-to-noise ratio (CNR) value between the normal colonic wall and lumen was 18.5 ± 2.9 while mean CNR value between colorectal neoplasm and lumen was 20.2 ± 3.1. By Magnetic resonance colonography, 26 of 35 neoplasms (sensitivity 74.3%) were detected. However, sensitivity of MRC was 95.5% (21 of 22) for neoplasm larger than 10 mm and 55.6% (5 of 9) for 5-10 mm neoplasm. CONCLUSION: MR colonography with fat enema and T1-weighted three-dimensional fast spoiled gradientecho with inversion recovery sequence is feasible in detecting colorectal neoplasm larger than 10 mm.

  20. ANTEGRADE INTRAMEDULLARY FIXATION OF HUMERAL SHAFT FRACTURES WITH INTERLOCKING NAIL - AN ANALYSIS OF COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    Arvinder

    2013-11-01

    Full Text Available ABSTRACT : Fractures of the humeral shaft account for 3% of all the fractures . Primary cause of these fractures i s high energy traumas. Goals in managing these fractures are osseous union, minimal deformity and return of maximal extremity function. The union rate of simple fractures of humerus treated conservatively is over 90%. Surgical management of these fractures is preferred in Segmental fractures, Polytrauma patients, Pathological fractures, Open fractures , Failed conservative treatment, Associated progressive neurological deficit , Vascular injury, Morbid obesity. We analysed intraoperative and postoperative com plications in twelve patients with humeral shaft fractures managed with antegrade interlocking nails. There were seven males and five females. Their ages ranged between 20 – 60 years with an average of 32.6 years. There were 11 close and one Gustilo grade I open fractures. There were six comminuted , four transverse, and two oblique fractures. Nine fractures were in middle third one in proximal third and two in distal third. Five patients had associated injuries. We faced difficulty in localizing entry port al in 2 patients . There was difficulty in reduction in 2 patients We had one patient with iatrogenic comminution . Three patients had improper locking screw size. One had nail protrusion proximally , one patient had distraction at the fracture site . There we re two superficial entry portal skin infections and one deep proximal cross screw infection. We had two patients with shoulder and one patient with elbow stiffness. Chronic rotator cuff irritation was present in three patients. We recorded three delayed un ions, one nonunion and one rotatory malunion The results of the present study indicate that antegrade intramedullary interlocked nailing is one of the best method of treatment among the currently available methods.

  1. Factors influencing the detection of abnormalities in barium enemas performed by junior radiologists

    Energy Technology Data Exchange (ETDEWEB)

    Vehmas, T. [Department of Occupational Medicine, Finnish Institute of Occupational Health, Helsinki and Department of Radiology, Helsinki University Central Hospital, Helsinki (Finland)]. E-mail: tapio.vehmas@ttl.fi

    2006-03-15

    Aim: To study the effects of patient variability, technical examination and radiologist-related factors on the radiological diagnosis of barium enema studies. Materials and Methods: Twenty-one residents (12 women and nine men, age 26-39 years) performed 523 double contrast barium enemas in a university hospital. Diagnoses were classified as normal (n=203), diverticulosis (n=224), polyps (n=25), tumours (n=20) and other (n=46); five were missing diagnoses. Binary and multinomial logistic regressions were used to study the relations between the independent variables and the radiological diagnoses. Results: Patients' advanced age (p<0.001) and obesity (p=0.041) were significant positive predictors for the detection of any abnormalities, as was good or moderate study quality (p=0.023). However, patients' obesity was negatively associated with the detection of polyps (p=0.037). Pathological findings were associated with higher dose-area products (p=0.047) than normal cases. Residents' advanced age (p=0.029) and experience (a high number of previously performed barium enemas; p=0.009) were negative predictors for the detection of pathological findings. Conclusion: Patients' obesity hampers polyp detection, possibly due to decreased image quality or coexisting diverticula. The most experienced and oldest residents missed positive findings, possibly due to insufficient consultation of supervising radiologists, emphasizing the need for their optimal cooperation.

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

    Directory of Open Access Journals (Sweden)

    Heshmatollah Azhar

    1995-06-01

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

  3. Constipation and Outcomes of Cecostomy.

    Science.gov (United States)

    Arya, Shruti; Gupta, Nancy; Gupta, Rahul; Aggarwal, Arun

    Constipation, defined as delay or difficulty in defecation, present for 2 or more weeks, is a common problem encountered by both primary and specialty medical providers. There are no randomized controlled trials on the use of antegrade enemas in the pediatric population. Most published papers are based on the experience at a particular center. The aim of this article is to describe the pathophysiology of constipation, review the contribution of colonic manometry to the diagnosis of constipation, summarize the advancements in the management of constipation through the use of antegrade enemas, and study the outcomes of cecostomy at different centers. This study is a comprehensive literature review generated by computerized search of literature, supplemented by review of monographs and textbooks in pathology, gastroenterology, and surgery. Literature search was performed using the publications from 1997 to 2012. The search included publications of all types presenting or reviewing data on cecostomy. The antegrade continence enema is a therapeutic option for defecation disorders when maximal conventional therapy is not successful. Symptoms of defecation disorders in children with different underlying etiologies improve significantly after a cecostomy is created. In addition, there is a benefit on the patients' physical activity, healthcare utilization, and general well-being. Based on the review of published literature it seems that antegrade enemas are a successful therapeutic option in children with severe constipation and/or fecal incontinence. With the advent of cecostomy buttons, patient compliance and the overall cosmetic appearance have improved.

  4. Percutaneous Antegrade Varicocele Embolization Via the Testicular Vein in a Patient with Recurrent Varicocele After Surgical Repair

    Energy Technology Data Exchange (ETDEWEB)

    Guevara, Carlos J., E-mail: guevarac@mir.wustl.edu; El-Hilal, Alexander H., E-mail: elhilala@mir.wustl.edu; Darcy, Michael D., E-mail: darcym@mir.wustl.edu [Washington University in St. Louis, Department of Radiology, School of Medicine (United States)

    2015-10-15

    This is a case report of an adolescent male who underwent surgical ligation for a left-sided varicocele that recurred 2 years later. Standard retrograde embolization via the left renal vein was not possible, because there was no connection from the renal vein to the gonadal vein following surgical ligation. The patient was treated via antegrade access of the spermatic vein at the inguinal level with subsequent coil embolization.

  5. The Use of ExoSeal Vascular Closure Device for Direct Antegrade Superficial Femoral Artery Puncture Site Hemostasis

    Energy Technology Data Exchange (ETDEWEB)

    Rimon, Uri, E-mail: rimonu@sheba.health.gov.il; Khaitovich, Boris, E-mail: borislena@012.net.il [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Yakubovich, Dmitry, E-mail: Dmitry.Yakubovitch@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Bensaid, Paul, E-mail: paulbensaid@hotmail.com; Golan, Gil, E-mail: gilgolan201@gmail.com [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Silverberg, Daniel, E-mail: Daniel.Silverberg@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel)

    2015-06-15

    PurposeThis study was designed to assess the efficacy and safety of the ExoSeal vascular closure device (VCD) to achieve hemostasis in antegrade access of the superficial femoral artery (SFA).MethodsWe retrospectively reviewed the outcome of ExoSeal VCD used for hemostasis in 110 accesses to the SFA in 93 patients between July 2011 and July 2013. All patients had patent proximal SFA based on computer tomography angiography or ultrasound duplex. Arterial calcifications at puncture site were graded using fluoroscopy. The SFA was accessed in an antegrade fashion with ultrasound or fluoroscopic guidance. In all patients, 5–7F vascular sheaths were used. The ExoSeal VCD was applied to achieve hemostasis at the end of the procedure. All patients were clinically examined and had ultrasound duplex exam for any puncture site complications during the 24 h postprocedure.ResultsIn all procedures, the ExoSeal was applied successfully. We did not encounter any device-related technical failure. There were four major complications in four patients (3.6 %): three pseudoaneurysms, which were treated with direct thrombin injection, and one hematoma, which necessitated transfusion of two blood units. All patients with complications were treated with anticoagulation preprocedure or received thrombolytic therapy.ConclusionsThe ExoSeal VCD can be safely used for antegrade puncture of the SFA, with a high procedural success rate (100 %) and a low rate of access site complications (3.6 %)

  6. Continent cutaneous diversion for bladder exstrophy in adults

    Directory of Open Access Journals (Sweden)

    J.E. Mensah

    2013-06-01

    Conclusion: Bladder neck closure in conjunction with continent cutaneous diversion is a reliable and safe method for achieving continence in adults presenting with bladder exstrophy. Total continence can be achieved without resorting to multiple complex and expensive surgeries.

  7. Antegrade delivery of stent grafts to treat complex thoracic aortic disease.

    Science.gov (United States)

    Roselli, Eric E; Soltesz, Edward G; Mastracci, Tara; Svensson, Lars G; Lytle, Bruce W

    2010-08-01

    Thoracic aortic disease involving the aortic arch presents a challenge to cardiovascular surgeons. The purpose of this study was to establish the safety and efficacy of antegrade delivery techniques of aortic stent grafting for the treatment of high-risk, complex thoracic aortic disease. From April 2007 to December 2009, 38 patients underwent stent graft repair of complex thoracic aortic diseases not otherwise amenable to standard retrograde delivery. Chart review, query of the Social Security Death Index, and three-dimensional analysis of computed tomography was performed. Indications were elective (n = 17), urgent (n = 11), or emergent (n = 10). Causes included coarctation (n = 1), acute aortic dissection (n = 4), traumatic transection (n = 2), and aneurysm or pseudoaneurysm (n = 31), of which 6 were ruptured. Sites of delivery included axillary (n = 4), ascending aorta (n = 18), and direct aortic placement (frozen elephant trunk, n = 16). Eleven were performed off-pump, 4 were performed on pump with a beating heart, 3 with cardiac arrest, and 20 under deep hypothermic circulatory arrest. Delivery was facilitated by transesophageal echocardiography alone (n = 14), or with fluoroscopy (n = 24). All devices used were commercially available (TAG, 18; Talent, 1; TX2, 19). Concomitant procedures were performed in 26 patients including 17 ascending repairs, 16 coronary artery bypass graftings, and 4 aortic valve replacements. Technical success was achieved in 97% (37 of 38 patients). Hospital mortality was 10% (n = 4), and serious complications included stroke (n = 4), paraparesis (transient n = 3, persistent n = 1), renal failure (n = 4), and respiratory failure (n = 12). Mean length of hospital stay was 14.7 days (range, 4 to 36 days), and 6.7 days (range, 1 to 20 days) in the intensive care unit. Overall survival was 74% at median follow-up of 1.2 + or - 0.8 years. Ten endoleaks in 9 patients (8 type II, 2 type I) required 3 late reinterventions. Antegrade delivery

  8. Rebamipide enema therapy for left-sided ischemic colitis patients accompanied by ulcers: Open label study

    Science.gov (United States)

    Matsumoto, Satohiro; Tsuji, Kenichiro; Shirahama, Satoshi

    2008-01-01

    AIM: To attempt rectal administration of rebamipide in the treatment of ischemic colitis patients with ulcers, and evaluate its effects. METHODS: We compared 9 ischemic colitis patients (2 men, 7 women) with ulcers treated by bowel rest only from 2000 to 2005 (conventional therapy group), with 6 patients (2 men, 4 women) treated by rebamipide enema therapy in 2006 (rebamipide enema therapy group) and analyzed the mean duration of fasting and hospitalization, degree of ulcer healing, and decrease in WBC count for the two groups. RESULTS: The mean duration of fasting and hospitalization were 2.7 ± 1.8 d and 9.2 ± 1.5 d in the rebamipide group and 7.9 ± 4.1 d and 17.9 ± 6.8 d in the control group, respectively, and significantly reduced in the rebamipide group (t = -2.915; P = 0.0121 and t = -3.054; P = 0.0092). As for the degree of ulcer healing at 7 d after admission, the ulcer score was reduced by 3.5 ± 0.5 (points) in the rebamipide group and 2.8 ± 0.5 (points) in the control group (t = 1.975; P = 0.0797), while the decrease in WBC count was 120.0 ± 55.8 (× 102/μL) in the rebamipide group and 85.9 ± 56.8 (× 102/μL) in the control group (t = 1.006; P = 0.3360). CONCLUSION: In left-sided ischemic colitis patients with ulcers, rebamipide enema therapy significantly reduced the duration of fasting and hospitalization, recommending its use as a new and effective therapeutic alternative. PMID:18609691

  9. Preliminary study on MR colonography with air enema in detection of colorectal neoplasms

    Institute of Scientific and Technical Information of China (English)

    LUO Ming-yue; LIU Li; YAN Fu-hua; SHEN Ji-zhang; YAO Li-qing; ZHOU Kang-rong

    2010-01-01

    Background The few studies on MR colonography with air enema involved feasibility of bowel distention and imaging quality and lacked detection sensitivity of colorectal neoplasms. The purpose of this prospective study was to assess the detection sensitivity of colorectal neoplasms with the three-dimensional Fourier transform fast spoiled gradient-recalled MR colonography with air enema.Methods A total of 30 patients scheduled for optical colonoscopy due to rectal bleeding, positive fecal occult blood test results or altered bowel habits were recruited and successfully underwent entire colorectal examinations with three-dimensional Fourier transform fast spoiled gradient-recalled MR colonography and subsequent optical colonoscopy on the same day. Detection sensitivity of colorectal neoplasms with MR colonography was statistically analyzed on a per-neoplasm size basis by using findings from optical colonoscopy and histopathological examinations as the reference standards.Results Seventy-six neoplasms were detected with optical colonoscopy, consisting of 1 mm-5 mm (n=11), 6 mm-9 mm (n=29) and >10 mm (n=36) in diameter. Detection sensitivities of 1 mm-5 mm, 6 mm-9 mm, ≥10 mm and >6 mm colorectal neoplasms with MR colonography were 9.1%, 75.9%, 100% and 89.2%, respectively; overall detection sensitivity for all sizes colorectal neoplasms was 77.6%.Conclusions Detection sensitivity of three-dimensional Fourier transform fast spoiled gradient-recalled MR colonography with air enema is low for 1 mm-5 mm colorectal neoplasms, but the detection sensitivity is 89.2% for ≥6 mm neoplasms, and all ≥10 mm neoplasms could be detected.

  10. Rectal colonic mural hematoma following enema for constipation while on therapeutic anticoagulation

    Science.gov (United States)

    Rentea, Rebecca M.; Fehring, Charles H.

    2017-01-01

    Causes of colonic and recto-sigmoid hematomas are multifactorial. Patients can present with a combination of dropping hemoglobin, bowel obstruction and perforation. Computed tomography imaging can provide clues to a diagnosis of intramural hematoma. We present a case of rectal hematoma and a review of current management literature. A 72-year-old male on therapeutic anticoagulation for a pulmonary embolism, was administered an enema resulting in severe abdominal pain unresponsive to blood transfusion. A sigmoid colectomy with end colostomy was performed. Although rare, colonic and recto-sigmoid hematomas should be considered as a possible diagnosis for adults with abdominal pain on anticoagulant therapy. PMID:28108634

  11. Early manifestation of Yersinia colitis demonstrated by the double-contrast barium enema

    Energy Technology Data Exchange (ETDEWEB)

    Aspestrand, F.

    1986-11-01

    A 19-year old female with a bloody, diarrheal illness of acute onset where Crohn's disease primarly was suspected is presented. The double-contrast barium enema revealed multiple, diffusely scattered aphthous erosions of the colonic mucosa: the rectum was scarcely affected. Biopsies taken by endoscopy demonstrated nonspecific inflammatory changes of the mucous membrane. However, routinely taken stool cultures revealed an infectious colitis due to Yersinia enterocolitica. Our case demonstrates the necessity to consider Yersinia enterocolitis in the radiographic differential diagnosis when the diagnosis of Crohn's disease or ulcerative colitis seems obvious.

  12. INSIGHTS INTO AVICENNA'S KNOWLEDGE OF GASTROINTESTINAL MEDICINE AND HIS ACCOUNT OF AN ENEMA DEVICE.

    Science.gov (United States)

    Nezhadi, Golnoush Sadat Mahmoudi; Dalfardi, Behnam; Ghanizadeh, Ahmad; Golzari, Samad E J

    2015-01-01

    Avicenna (980-1037 AD), also known as Sheikh or-Raeis, was an Muslim philosopher, physician, surgeon, astronomer, politician, encyclopedist, and mathematician. Avicenna's writings comprise of five books, know as the Al-Qanun fi al-Tibb (The Canon of Medicine) and the canon covers a wide variety of medical issues. This canon of medicine was the main reference for medical education in Western countries up until the 16th century and in the Middle East until the 19th century. Several chapters of the 3rd book of the Canon are devoted to a detailed description of gastrointestinal diseases including bowel obstruction, hemorrhoids anal fissures, perianal fistulas and perianal itching. Additionally, that same volume contains an illustration of an enema device. The aim of this paper was to present a brief review of Avicenna's 11th century views on bowel obstruction and to present his description of an enema device that has remained relatively unnoticed until now. Finally, this article illustrates similarities between Avicenna's explanation and modern medical science that celebrate Avicenna as an important contributor to medieval knowledge on gastrointestinal diseases, the science of which has been passed on to later generations.

  13. Clinical and Experimental Study on Treatment of Infantile Autumn Diarrhea by Retention Enema with Qilian Liquid (

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    :Objective:To find out the effective treatment for infantile autumn diarrhea(IAD).Methods:Retention enema with Qilian Liquid(QLL) was applied to 106 patients of IAD with positive antigen of rotavirus in stool,and the result in the treated group was compared with that in the control group(82 patients) in aspects of clinical effect, negative conversion rate of rotavirus in stool and change of serum immunoglobulin. Animal experimental study was also conducted.Results:The disappearance time of principal symptoms, negative conversion rate of rotavirus in stool and serum levels of IgA and IgG in the treated group were significantly better than those in the control group (P<0.01, P< 0.05). Experimental study showed that QLL not only has the anti-viral effects to stop diarrhea, but also has effects in enhancing immune function and protecting intestinal mucous membrane. Conclusion:Retention enema with QLL is an effective therapy for the treatment of IAD.

  14. Development of White Jade Mushroom Enema%白玉菇灌肠的研制

    Institute of Scientific and Technical Information of China (English)

    高倩倩; 贾艳林

    2011-01-01

    With white jade mushroom and pork as raw material,soy protein and starch as accessories,by single factor experiments and orthogonal test to research the best formula for white jade mushrooms enema,the effect of fat thin ratio,white jade mushrooms,soybean protein,the adding amount of starch on the quality of white jade mushroom enema were mainly researched.The results showed that fat thin ratio of 2:8 was the best ratio of products,the optimum adding amount of white jade mushroom was 20%,the optimum adding amount of Soybean protein was 8%,and the optimum adding amount of starch was 8%.%以白玉菇和猪肉为原料,以大豆蛋白和淀粉为辅料,通过单因素试验和正交试验对白玉菇灌肠最佳配方进行研究,主要研究了肥瘦比、白玉菇、大豆蛋白、淀粉添加量对白玉菇灌肠品质的影响。其产品的最佳配比,肥瘦比为2:8,白玉菇的用量为20%,大豆蛋白的用量为8%,淀粉的用量为12%。

  15. [Traditional enema for newborns and infants in Bobo Dioulasso: health practice or socialisation].

    Science.gov (United States)

    Huygens, Pierre; Konaté, Blahima; Traoré, Abdullaye; Barennes, Hubert

    2002-01-01

    Kanki demonstrated a high prevalence and frequency of enema practised with newborns in the South-West of Burkina Faso. Little is known about the risks on children's health possibly associated with this practice and about its impact on other treatments in paediatrics. In this study, the authors describe daily administered enema (DAE) and analyse local conceptual frameworks underlying this practice through in-depth-interviews and focus group discussions with 30 mothers, 5 traditional healers and 5 health agents. Various medications are used to compose the liquid introduced by the mothers in the child's anus. Many of these substances are prone to irritate intestinal mucus, others are simply toxic. Practically, enema aims at curing or preventing a variety of diseases caused by an accumulation of impurities (nògò) in the intestines due to the consumption of inappropriate food. With newborns, diseases are transmitted by mothers through breastfeeding after eating food which is too sweet or too fat. In addition to provoking diseases, the nògò also "block" the child's physical and psychic development during his/her first year of life. Therefore, as soon as the child has excreted for the first time, most mothers give enema daily both to protect their children from diseases and to speed their development. In fact, beside prophylaxy and therapy lies a "didactic" function of enema as a medication used to help the child to stand up, to get teeth..., to gain independence from his/her mother. DAE therefore plays an important role in the process of acquiring bio-social aptitudes, i.e., important educational virtues to achieve a successful first step in the socialisation process. Exploring more deeply local perceptions explaining the origin of the n g , the authors found an interesting relationship with religious taboos. Beside prohibited food, the n g are also due to transgression of various taboos surrounding birth and breastfeeding and even suggest a religious, rather than

  16. Predictors of Interventional Success of Antegrade PCI for CTO.

    Science.gov (United States)

    Luo, Chun; Huang, Meiping; Li, Jinglei; Liang, Changhong; Zhang, Qun; Liu, Hui; Liu, Zaiyi; Qu, Yanji; Jiang, Jun; Zhuang, Jian

    2015-07-01

    This study aimed to identify significant lesion features of chronic total occlusions (CTOs) that predict failure of antegrade (A) percutaneous coronary intervention (PCI) using pre-procedure coronary computed tomography angiography (CTA) combined with conventional coronary angiography (CCA). The current predictors of successful A-PCI in the setting of CTOs are uncertain. Such knowledge might prompt early performance of a retrograde (R)-PCI approach if predictors of A-PCI failure are present. Consecutive patients confirmed to have at least 1 CTO of native coronary arteries underwent coronary CTA- and CCA-guided PCI in which computed tomography and fluoroscopic images were placed side by side before or during PCI. The study included 103 patients with 108 CTOs; 80 lesions were successfully treated with A-PCI and 28 lesions failed this approach, for an A-PCI success rate of 74%. A total of 15 of 28 failed cases underwent attempted R-PCI. Only 1 case also failed R-PCI; thus, the total PCI success rate was 87%. By multivariable analysis, the factors significantly predictive of failed A-PCI included negative remodeling (odds ratio [OR]: 137.82) and lesion length >31.89 mm on coronary CTA (OR: 7.04), and ostial or bifurcation lesions on CCA (OR: 8.02). R-PCI was successful in 14 of 15 patients (93.3%), in whom good appearance of the occluded distal segment and well-developed collateral vessels were present. Morphologic predictors of failed A-PCI on the basis of pre-procedure coronary CTA and CCA imaging may be identified, which may assist in determining which patients with CTO lesions would benefit from an early R-PCI strategy. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  17. [Conversion of a retrograde access to an antegrade access for bilateral femorocrural intervention in one session].

    Science.gov (United States)

    Neumann, C; Dorffner, R

    2012-05-01

    Evaluation of the feasibility as well as the success and complication rates of a change of access direction in patients with PAOD for bilateral intervention. Over the course of one year, 239 patients referred to our department for intervention of the iliac and femorocrural vessels were evaluated for an ipsilateral change of access direction. In 38 patients (16%), the symptoms indicated a bilateral femorocrural intervention. Three patients (8%) had to be excluded due to elevated creatinine level. In the remaining 35 patients, an attempt was made to change the cross-over access to an antegrade access in the same session. The procedure was accomplished by drawing a sidewinder catheter in the ipsilateral CIA, pushing a hydrophilic guide wire into the SFA and repositioning the sheath. Sonographic and clinical controls followed the next day. In 32 patients (91%), the procedure was successful, and in 3 cases (9%), it failed. One major hematoma (3%), which could be treated conservatively, occurred. In 2 cases (6%) pseudoaneurysms developed and were treated by compression or thrombin injection. 3 minor hematomas (9%) were documented. In one patient (3%) a stroke occurred during the intervention after a brain stem infarction some weeks before, which could not be related to the intervention (total rate of minor complications 9%, major complications 12%). The bilateral intervention of femorocrural vessels in one session by changing the access direction ipsilaterally is feasible and associated with acceptable complication rates. It offers the opportunity to optimize endovascular therapy economically. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Antegrade scrotal sclerotherapy of internal spermatic veins for varicocele treatment: technique, complications, and results

    Directory of Open Access Journals (Sweden)

    Alessandro Crestani

    2016-01-01

    Full Text Available Varicocele repair is mainly indicated in young adult patients with clinical palpable varicocele and abnormal semen parameters. Varicocele treatment is associated with a significant improvement in sperm concentration, motility, morphology, and pregnancy rate. Antegrade scrotal sclerotherapy (ASS represented one of the main alternatives to the traditional inguinal or suprainguinal surgical ligation. This article reviews the use of ASS for varicocele treatment. We provide a brief overview of the history of the procedure and present our methods used in ASS. In addition, we review complication and success of ASS, including our own retrospective data of treating 674 patients over the last 17 years. Herein, we analyzed step by step the ASS technique and described our results with an original modified technique with a long follow-up. Between December 1997 and December 2014, we performed 674 ASS. Mean operative time was 14 min (range 9 to 50 min. No significant intraoperative complications were reported. Within 90 days from the procedure, postoperative complications were recorded in overall 49 (7.2% patients. No major complications were recorded. A persistent/recurrent varicocele was detected in 40 (5.9% cases. In 32/40 (80% cases, patients showed preoperative grade III varicoceles. In patients with a low sperm number before surgery, sperm count improved from 13 × 10 6 to 21 × 10 6 ml−1 (P < 0.001. The median value of the percentage of progressive motile forms at 1 h improved from 25% to 45% (P < 0.001. Percentage of normal forms increased from 17% before surgery to 35% 1 year after the procedure (P < 0.001. In the subgroup of the 168 infertile patients, 52 (31% fathered offspring at a 12-month-minimum follow-up. Therefore, ASS is an effective minimal invasive treatment for varicocele with low recurrence/persistence rate.

  19. Efeito de diferentes soluções de enema sobre os parâmetros clínicos de eqüinos Effect of different enema solutions on clinical parameters of equines

    Directory of Open Access Journals (Sweden)

    U.P. Melo

    2008-06-01

    Full Text Available Avaliou-se o efeito de diferentes soluções de enema sobre os parâmetros clínicos de eqüinos hígidos. Foram utilizados 15 eqüinos adultos, distribuídos em três grupos de cinco animais cada: grupo 1 - tratados com água de torneira mais sabão neutro; grupo 2 - tratados com solução isotônica e grupo 3 - tratados com água de torneira mais vaselina. O efeito das soluções de enema sobre os parâmetros clínicos variou em função do tipo de solução infundida. A solução com menor efeito sobre os parâmetros clínicos foi a isotônica. A solução de água de torneira e sabão neutro desencadeou um aumento da temperatura retal e edema da mucosa retal. Embora as três soluções tenham se mostrado efetivas em hidratar e amolecer as fezes, a solução de água com sabão foi a que apresentou o melhor efeito.The effect of three different enema solutions on clinical parameters of equines was studied using 15 healthy adult animals. They were alloted into three groups of five animals each: group 1 - treated with tap water associated with neuter soap; group 2 -treated with isotonic solution; and group 3 - treated with tap water associated with vaseline. Effects of enema solutions on clinical parameters were observed. Isotonic solution caused less alteration on clinical parameters. Tap water and soap enema induced inflammatory reaction on colon mucosa. Even though all three solutions showed effectiveness in hydrating and softening the feces, the treatment with water plus soap showed the best results.

  20. Effect of adjuvant lactulose enema therapy on outcome and intestinal mucosal barrier function in patients with acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Ling Gao; Ming-Quan Li

    2016-01-01

    Objective:To analyze the effect of adjuvant lactulose enema therapy on outcome and intestinal mucosal barrier function in patients with acute pancreatitis.Methods: A total of 98 patients with acute pancreatitis were randomly divided into observation group and control group, control group received conventional symptomatic treatment, observation group received symptomatic treatment + adjuvant lactulose enema therapy, and differences in levels of inflammatory cytokines, RAAS system-related molecules and mucosal barrier function-related indexes in serum as well as intestinal flora quantity in stool samples were compared between two groups after treatment.Results:Serum inflammatory cytokines IL-1β, IL-6, IL-8, PCT and TNF-α levels of enema group were significantly lower than those of control group; serum RAAS system molecules R, AngI, AngII and ALD levels were significantly lower than those of control group; serum mucosal barrier function indexes D-lactate, LPS, I-FABP and DAO levels were significantly lower than those of control group; the quantity of bifidobacterium and lactobacillus in stool samples were significantly more than those of control group while the quantity of enterobacterium, enterococcus and E. coli were significantly lower than those of control group.Conclusion:Adjuvant lactulose enema therapy can promote the improvement of acute pancreatitis, and restore patients’ intestinal mucosal barrier function.

  1. Obesity: An Independent Risk Factor for Insufficient Hemostasis Using the AngioSeal Vascular Closure Device After Antegrade Puncture

    Energy Technology Data Exchange (ETDEWEB)

    Minko, Peter, E-mail: peterminko@yahoo.com; Katoh, Marcus [University Hospital Saarland, Department of Diagnostic and Interventional Radiology (Germany); Graeber, Stefan [University Hospital Saarland, Institute of Medical Biometry, Epidemiology and Medical Informatics (Germany); Buecker, Arno [University Hospital Saarland, Department of Diagnostic and Interventional Radiology (Germany)

    2012-08-15

    Purpose: This study was designed to investigate the efficacy of the AngioSeal vascular closure device after antegrade puncture of the femoral artery. Methods: In a prospective study, 120 consecutive patients underwent lower limb vascular intervention by an antegrade access to the common femoral artery (CFA). After intervention, a 6F (n = 88) or an 8F (n = 32) AngioSeal vascular closure device was used to achieve hemostasis. The technical success or the cause of failure was documented. In addition, the coagulation status (platelets, INR, prothrombin time, atrial thromboplastin time (PTT)), hypertonus, locoregional habitus of the groin, body mass index (BMI), presence of calcifications, and history of previous surgical interventions of the CFA were evaluated. Results: Hemostasis was achieved in 97 patients (81%). In 12 patients (10%), persistent bleeding of the puncture site required manual compression. In another nine patients (8%) a kink of the sheath obviated the passage of the collagen plug toward the vessel, and in two patients the anchor dislodged out of the vessel, requiring manual compression. There were no significant differences between the groups of successful and unsuccessful sealing regarding the mean platelets (241 vs. 254 * 10{sup 9}/l; P = 0.86), INR (1.06 vs. 1.02; P = 0.52), prothrombin time (90% vs. 90%; P = 0.86), and PTT (30 vs. 31 s; P = 0.82). However, unsuccessful sealing was more likely in obese patients with an increased BMI (26.6 vs. 28.8 kg/m{sup 2}; P = 0.04). Conclusions: Obesity seems to be an independent risk factor for insufficient sealing using the AngioSeal vascular closure device after antegrade puncture of the CFA. In 8% of our patients, hemostasis could not be achieved due to kink of the flexible sheath.

  2. Routine enema before urodynamics has no impact on the quality of abdominal pressure curves: Results of a prospective controlled study.

    Science.gov (United States)

    Rigole, H; Senal, N; Damphousse, M; Brochard, C; Manunta, A; Kerdraon, J; Tondut, L; Alimi, Q; Hascoet, J; Siproudhis, L; Peyronnet, B; Bonan, I

    2016-12-01

    The presence of stools in the rectum might affect the quality of the abdominal pressure curve during filling cystometry, but, to date, no study has evaluated the impact of bowel preparation before urodynamics. We evaluated the influence of a sodium phosphate enema before urodynamics on the quality of the abdominal pressure curve. A prospective, controlled, single-blind study was conducted in a single center from May to June 2013. The patients were divided into 2 consecutive groups: patients seen in outpatient clinics during the first 6 weeks (group A) who underwent urodynamics without bowel preparation and patients seen in outpatient clinics during the second 6 weeks (group B) who had a prescription of sodium phosphate enema before urodynamics. The primary endpoint was the quality of the abdominal pressure curve evaluated independently by three physicians who were blinded to the study group. The following data were also collected: age, gender, the presence of a neurological disorder, complicated nature of urodynamics and bother related to preparation for it, assessed using a Likert scale (0 to 10), and the equipment used. A per protocol analysis and an intent-to-treat analysis were conducted. One hundred and thirty-nine patients were included: 54 in group A and 85 in group B. One-third of patients had neurological conditions. 14 patients in group B did not perform their scheduled enema. Thus, 68 patients performed an enema before urodynamics and 71 did not. There was no difference between groups A and B regarding the complicated nature of urodynamics (Likert scale: 3.12 vs. 3.18; P=0.91) or bother related to preparation for it (Likert scale: 3.46 vs. 2.97; P=0.43). In the per protocol analysis, the abdominal pressure curve was considered perfectly interpretable (PI) in 69% of patients who did not receive an enema before urodynamics and in 65% of patients who did (P=0.61). The between-group difference was not statistically significant in intent-to-treat analysis (P

  3. [Practical experiences with antegrade local chemolysis of struvite/apatite, uric acid and cystine calculi in the kidney].

    Science.gov (United States)

    Weirich, W; Frohneberg, D; Ackermann, D; Alken, P

    1984-03-01

    In 18 patients (20 kidneys) with struvite/apatite-, uric acid- and cystine stones antegrade local chemolysis was performed via percutaneous or operative nephrostomy. Complete stone dissolution was achieved in 11 kidneys, while in six kidneys partial dissolution of stones was performed. In these six cases added instrumental manipulations shortened the time of therapy. In three cases chemolysis was unsuccessful. Average irrigation time was 21 days per renal unit. Only minor complications like dysuria and skin rashes were seen. Due to long time of irrigation we recommend chemolitholysis mainly as an additional form of therapy in case of residual stones after operative or percutaneous nephrolithotomy.

  4. Europe the continent with the lowest fertility

    NARCIS (Netherlands)

    Baird, D. T.; Collins, J.; Evers, J. L. H.; Leridon, H.; Lutz, W.; Velde, E. Te; Thevenon, O.; Crosignani, P. G.; Devroey, P.; Diedrich, K.; Fauser, B. C. J. M.; Fraser, L.; Geraedts, J. P. M.; Gianaroli, L.; Glasier, A.; Sunde, A.; Tarlatzis, B.; Van Steirteghem, A.; Veiga, A.

    2010-01-01

    INTRODUCTION: Although fertility rates are falling in many countries, Europe is the continent with the lowest total fertility rate (TFR). This review assesses trends in fertility rates, explores possible health and social factors and reviews the impact of health and social interventions designed to

  5. African Universities Tackle the Continent's Agricultural Crisis

    Science.gov (United States)

    Lindow, Megan

    2009-01-01

    Pests, population growth, and depleted soil have wreaked havoc on agriculture in Africa, so universities across the continent are rethinking how they teach the topic. Some African universities have been building their own networks and pooling their limited resources to train more agricultural scientists and improve their responsiveness to the…

  6. Colorectal cancer screening: a community case-control study of proctosigmoidoscopy, barium enema radiography, and fecal occult blood test efficacy.

    Science.gov (United States)

    Scheitel, S M; Ahlquist, D A; Wollan, P C; Hagen, P T; Silverstein, M D

    1999-12-01

    To examine the effectiveness of screening proctosigmoidoscopy, barium enema radiography, and the fecal occult blood test (FOBT) in decreasing colorectal cancer mortality in a community setting. In this population-based case-control study, cases comprised 218 Rochester, Minn, residents who died of colorectal cancer between 1970 and 1993. Controls were 435 age- and sex-matched residents who did not have a diagnosis of colorectal cancer. Screening proctosigmoidoscopy, barium enema radiography, and FOBT results were documented for the 10 years prior to and including the date of diagnosis of fatal colorectal cancer in cases and for the same period in matched controls. History of general medical examinations and hospitalizations was also recorded. Within the 10 years prior to diagnosis, the percentages of cases vs controls with at least 1 screening proctosigmoidoscopy were 23 (10.6%) of 218 cases vs 43 (9.9%) of 435 controls; at least 1 screening barium enema radiographic study was done in 12 (5.5%) of 218 vs 25 (5.7%) of 435. Within 3 years prior to diagnosis, the percentages of cases vs controls with at least 1 screening FOBT were 27 (12.4%) of 218 vs 44 (10.1%) of 435. Adjusted odds ratios were 1.04 (95% confidence interval [CI], 0.21-5.13) for proctosigmoidoscopy (distal rectosigmoid cancers only), 0.67 (95% CI, 0.31-1.48) for barium enema radiography, and 0.83 (95% CI, 0.45-1.52) for FOBT over the above time periods. In this case-control study within a community setting, a colorectal cancer-specific mortality benefit could not be demonstrated for screening by FOBT, proctosigmoidoscopy, or barium enema radiography. Screening frequency was low, which may have contributed to the lack of measurable effects.

  7. Water enema CT examination of rectum cancer by reduced amount of water

    Energy Technology Data Exchange (ETDEWEB)

    Palko, A.; Gyulai, Cs.; Fedinecz, N. [Szeged Univ. (Hungary). Dept. of Radiology; Balogh, A. [Szeged Univ. (Hungary). Dept. of Surgery; Nagy, F. [Szeged Univ. (Hungary). Faculty of General Medicine

    2000-11-01

    To define whether volume of water, administered during water enema CT (WE-CT) for local staging of rectal cancer, may be reduced without compromising the diagnostic value of the examination. Materials and Methods: 29 patients with rectum cancer underwent preoperative WE-CT. Contrast-enhanced CT (equilibrium phase) measurements were performed after i.v. injection of smooth muscle relaxant and rectal administration of 400 - 500 ml lukewarm tap water. Quality of the obtained scans was evaluated and the images were analyzed for depth of tumor invasion. Results of the CT examinations were compared to findings at surgery. Results: Despite reduced dose of water enema, 19/29 examinations were of excellent quality, 6/29 good, and 4/29 poor, but still diagnostic. We achieved sensitivity (90.1), specificity (70.1) and accuracy (86.2) in differentiating tumors confined to the bowel wall from those extending beyond it. Conclusion: Large volume of water enema administered during CT examination of the rectum may cause complaints and increases the risk of complications. Our results prove that using lower amount of water does not impair the quality of examination and accuracy of local staging of rectum carcinomas. (orig.) [German] Beurteilen, ob die in der Hydro-CT (H-CT) rektal applizierte Wassermenge reduziert werden kann, ohne den diagnostischen Wert der Untersuchung im lokal-Staging des Rektumkarzinoms zu mindern. Material und Methode: 29 Patienten mit Rektumkarzinom wurden praeoperativ mit H-CT untersucht. Nach i.v. Praemedikation zur Darmparalyse wurden rektal ca. 400 - 500 ml lauwarmes Wasser appliziert, und i.v. kontrastverstaerkte CT-Untersuchungen durchgefuehrt. Die Qualitaet der CT-Scans und die Tiefe der invasion des Tumors in die Darmwand wurden analysiert. Die computertomographischen Befunde wurden mit den Operationsbefunden verglichen. Ergebnisse: Trotz der reduzierten Menge des Einlaufswassers, 19/29 Untersuchungen hatten ausgezeichnete, 6/29 gute, und 4/29 schwache

  8. Enemas, suppositories and rectal stimulation are not effective in accelerating enteral feeding or meconium evacuation in low-birthweight infants: a systematic review.

    Science.gov (United States)

    Kamphorst, Kim; Sietsma, Ydelette; Brouwer, Annemieke J; Rood, Paul J T; van den Hoogen, Agnes

    2016-11-01

    Early full enteral feeding in preterm infants decreases morbidity and mortality. Our systematic review covered the effectiveness of rectal stimulation, suppositories and enemas on stooling patterns and feeding tolerance in low-birthweight infants born at up to 32 weeks. It comprised seven studies published between 2007 and 2014 and covered 495 infants. Suppositories were ineffective in shortening the time to reach full enteral feeding, and the evidence on enemas was contradictory. Enemas and rectal stimulation did not shorten the time until complete meconium evacuation was reached. Further research into safe, effective interventions to accelerate meconium excretion is needed. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  9. Treatment of 15 Cases of Chronic Pelvic Inflammation by Acupuncture plus Herbal Enema

    Institute of Scientific and Technical Information of China (English)

    SHEN Jian

    2005-01-01

    Fifteen cases of chronic pelvic inflammation were treated by needling Guanyuan (CV 4), Qihai (CV 6), Sanyinjiao (SP 6), Zhongji (CV 3), Shidao (ST 28), Diji (SP 8), Zusanli (ST 36), Shenshu (BL 23), Dachangshu (BL 25) and Ciliao(BL 32) in combination with herbal enema effective to clear heat and relieve toxin, activate blood and resolve stagnant blood.After 2-course treatment, 13 cases were cured and 2 cases were improved.%针刺关元,气海,三阴交,中极,水道,地机,足三里,肾俞,大肠俞和次髎穴,同时用清热解毒和活血化瘀中药进行保留灌肠,治疗了15例慢性盆腔炎患者,经过2个疗程治疗,13例痊愈,2例有效.

  10. [Clinical and experimental study on using Cassia angustifolia extract as enema after abdominal operation].

    Science.gov (United States)

    Wang, M; Yan, S; Wang, J

    1998-09-01

    To investigate the curative effect and mechanism of using Cassia angustifolia extract (CAE) in treating gastrointestinal tract dysfunction after abdominal operations. Enema administration of CAE (Clyster method) was used. The result of 130 patients was very effective in reducing the rate of gastrointestinal decompression, accelerating the restitution of borborygmi and the time of exhaustion. Animal experiment showed the CAE function is very obvious in enhancing the bowel movement of rats (P < 0.05). It can enhance peristalsis and contraction amplitude of vibration in the isolated ileum of rats (P < 0.05). It can push on the charcoal powder in intestinal tract of mice obviously (P < 0.05). CAE could regulate disordered function of gastrointestinal tract after abdominal operations.

  11. Surgical outcome of pancreatic cancer using radical antegrade modular pancreatosplenectomy procedure

    Institute of Scientific and Technical Information of China (English)

    Ye Rim Chang; Sung-Sik Han; Sang-Jae Park; Seung Duk Lee; Tae Suk Yoo; Young-Kyu Kim; Tae Hyun Kim

    2012-01-01

    To evaluate the surgical outcomes following radical antegrade modular pancreatosplenectomy (RAMPS)for pancreatic cancer.METHODS:Twenty-four patients underwent RAMPS with curative intent between January 2005 and June 2009 at the National Cancer Center,South Korea.Clinicopathologic data,including age,sex,operative findings,pathologic results,adjuvant therapy,postoperative clinical course and follow-up data were retrospectively collected and analyzed for this study.RESULTS:Twenty-one patients (87.5%) underwent distal pancreatectomy and 3 patients (12.5%) underwent total pancreatectomy using RAMPS.Nine patients (37.5%) underwent combined vessel resection,including 8 superior mesenteric-portal vein resections and 1 celiac axis resection.Two patients (8.3%) underwent combined resection of other organs,including the colon,stomach or duodenum.Negative tangential margins were achieved in 22 patients (91.7%).The mean tumor diameter for all patients was 4.09 ± 2.15 cm.The 2 patients with positive margins had a mean diameter of 7.25 cm.The mean number of retrieved lymph nodes was 20.92 ± 11.24 and the node positivity rate was 70.8%.The median survival of the 24 patients was 18.23 ± 6.02 mo.Patients with negative margins had a median survival of 21.80 ± 5.30 mo and those with positive margins had a median survival of 6.47 mo (P =0.021).Nine patients (37.5%) had postoperative complications,but there were no postoperative mortalities.Pancreatic fistula occurred in 4 patients (16.7%):2 patients had a grade A fistula and 2 had a grade B fistula.On univariate analysis,histologic grade,positive tangential margin,pancreatic fistula and adjuvant therapy were significant prognostic factors for survival.CONCLUSION:RAMPS is a feasible procedure for achieving negative tangential margins in patients with carcinoma of the body and tail of the pancreas.

  12. Renal transplantation using external continent urinary diversion.

    Science.gov (United States)

    Lucon, A M; Sabbaga, E; Ianhez, L E; Chocair, P R; Pestana, J O; Arap, S

    1994-02-01

    A 29-year-old man born with bladder exstrophy presented with end stage renal failure many years after ileal conduit diversion. Bilateral nephrectomy and continent external urinary diversion were performed, and 1.5 months later a cadaveric kidney was grafted into the right iliac fossa. The patient was well at 18 months with a serum creatinine level of 1.2 mg./dl. and he was completely dry with 4 or 5 daily catheterizations. Although followup is still short, renal transplantation with drainage into an external continent urinary diversion permits excellent quality of life and good renal function. Therefore, this alternative is worth consideration whenever other reconstructive alternatives are not possible in candidates for renal transplantation.

  13. Effects of Chinese herbal enema therapy combined basic treatment on BUN,SCr,UA,and IS in chronic renal failure patients

    Institute of Scientific and Technical Information of China (English)

    邹川

    2012-01-01

    Objective To assess the clearance role and safety of Chinese herbal enema therapy (CHET) in clearing enterogenic uremic toxins in chronic renal failure (CRF) patients,thus providing evidence for further optimizing the comprehensive treatment. Methods Using nonrandomized concurrent control

  14. Korea Peninsula Landscape Extends from Continent End

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ The Korea peninsula extends southward from the eastern end of the Asian continent. It is divided just slightly north of the 38th parallel. The peninsula is roughly 1020 km(612 miles) long and 175 km(105 miles) wide at its narrowest point. Korean people are big sports fans. During the past 20 years, Korea has hosted many international sports events including the 1988 Seoul Olympic Games and the 2002 FIFA World Cup, and has achieved excellent results in various sports competitions.

  15. Spreading continents kick-started plate tectonics.

    Science.gov (United States)

    Rey, Patrice F; Coltice, Nicolas; Flament, Nicolas

    2014-09-18

    Stresses acting on cold, thick and negatively buoyant oceanic lithosphere are thought to be crucial to the initiation of subduction and the operation of plate tectonics, which characterizes the present-day geodynamics of the Earth. Because the Earth's interior was hotter in the Archaean eon, the oceanic crust may have been thicker, thereby making the oceanic lithosphere more buoyant than at present, and whether subduction and plate tectonics occurred during this time is ambiguous, both in the geological record and in geodynamic models. Here we show that because the oceanic crust was thick and buoyant, early continents may have produced intra-lithospheric gravitational stresses large enough to drive their gravitational spreading, to initiate subduction at their margins and to trigger episodes of subduction. Our model predicts the co-occurrence of deep to progressively shallower mafic volcanics and arc magmatism within continents in a self-consistent geodynamic framework, explaining the enigmatic multimodal volcanism and tectonic record of Archaean cratons. Moreover, our model predicts a petrological stratification and tectonic structure of the sub-continental lithospheric mantle, two predictions that are consistent with xenolith and seismic studies, respectively, and consistent with the existence of a mid-lithospheric seismic discontinuity. The slow gravitational collapse of early continents could have kick-started transient episodes of plate tectonics until, as the Earth's interior cooled and oceanic lithosphere became heavier, plate tectonics became self-sustaining.

  16. Target ballon-assisted antegrade and retrograde approach for recanalization of thrombosed fem-pop bypass graft using the outbreak catheter

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Jung Won; Chung, Hwan Hoon; Lee, Seung Hwa; Yeom, Suk Keu; Cha, Sang Hoon [Dept. of Radiology, Korea University College of Medicine, Ansan Hospital, Ansan (Korea, Republic of)

    2016-01-15

    The subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique is reportedly effective in severe peripheral vascular disease that cannot be treated with standard endovascular techniques including subintimal angioplasty. In this report, we used a target balloon with the Outback catheter to recanalize a thrombosed bypass graft that could not be treated successfully with SAFARI.

  17. Epidermal growth factor enemas for induction of remission in left-sided ulcerative colitis Enemas de factor de crecimiento epidérmico para inducir la remisión de la colitis ulcerosa izquierda

    Directory of Open Access Journals (Sweden)

    Hugo Nodarse-Cuní

    2013-03-01

    Full Text Available Introduction: ulcerative colitis is a little known chronic inflammatory disease in colonic mucosa. The positive effect of epidermal growth factor was shown in a previous report, with enema use for treatment of mild to moderate left-sided manifestation of the disease. This evidence provided the basis for evaluating the efficacy and safety profile of a viscous solution of this product. Methods: thirty-one patients were randomized to three groups for daily medications during 14 days. Twelve received one 10 mg enema of epidermal growth factor dissolved in 100 mL of viscous solution whereas nine were treated with placebo enema; both groups also received 1.2 g of oral mesalamine per day. The other group included ten patients with 3 g / 100 mL of mesalamine enema. Primary end point was clinical responses after two weeks of treatment, defined as a decreased of, at least three points from baseline, the Disease Activity Index and endoscopic or histological evidences of improvement. Results: remission of disease was observed in all patients in the epidermal growth factor group, and six in both, mesalamine enema and placebo group. All the comparisons between groups showed statistically significant superiority for epidermal growth factor, the only product with significant reduction in disease activity index as well as the presence and intensity of digestive symptoms in patients after treatment. None adverse event was reported. Conclusions: the results agree with previous molecular and clinical evidences, indicating that the epidermal growth factor is effective to reduce disease activity and to induce remission. A new study involving more patients should be conducted to confirm the efficacy of the epidermal growth factor enemas.Introducción: la colitis ulcerosa es una enfermedad inflamatoria crónica de etiología poco conocida, que afecta la mucosa del colon. El efecto positivo del factor de crecimiento epidérmico fue reportado en estudio previo con uso de

  18. 21 CFR 876.5320 - Nonimplanted electrical continence device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonimplanted electrical continence device. 876... Nonimplanted electrical continence device. (a) Identification. A nonimplanted electrical continence device is a device that consists of a pair of electrodes on a plug or a pessary that are connected by an...

  19. [A case of pseudomembranous colitis with febrile neutropenia induced by chemotherapy and effectively treated by vancomycin enemas].

    Science.gov (United States)

    Tsuchida, Kazuhito; Hayashi, Tsutomu; Hayashi, Shigeya; Sawazaki, Sho; Jin, Yasuyuki; Hasuo, Kimiatsu; Suzuki, Hiroharu; Rino, Yasushi; Masuda, Munetaka

    2010-09-01

    Pseudomembranous colitis, an antibiotic-associated diarrhea, needs early diagnosis and treatment for the high fatality rate in severe cases. We report a case of pseudomembranous colitis following the use of antibiotics in febrile neutropenia (FN). A 74-year-old man with non-curative resected sigmoid colon cancer was treated with cefepime in FN induced by chemotherapy. Complications of diarrhea were seen on day 2. Paralytic ileus and disseminated intravascular coagulation were also complications. He was diagnosed as pseudomembranous colitis for Clostridium difficile toxin-positive. Vancomycin enemas were administered because oral administrations were impossible, and the effect was provided. Vancomycin enemas are an effective therapy for patients with severe pseudomembranous colitis unable to tolerate oral medications because of ileus.

  20. Diagnostic accuracy of the double-contrast enema for colonic polyps in patients with or without diverticular disease.

    Science.gov (United States)

    Morosi, C; Ballardini, G; Pisani, P; Bellomi, M; Cozzi, G; Vidale, M; Spinelli, P; Severini, A

    1991-01-01

    The accuracy of the double-contrast enema for the diagnosis of polypoid lesions in the presence or absence of diverticula was evaluated by retrospectively reviewing the medical records of 202 patients subjected to examination and endoscopy. Analysis of the data on 215 polypoid lesions showed that (a) the diagnostic accuracy of the examination is not affected significantly by the presence of diverticula; (b) the sensitivity of the examination is highly dependent on the size of the polyps (smaller or larger than 0.5 cm) but not on the form (sessile or pedunculated); and (c) the positive predictive value is higher in patients without diverticula. The double-contrast enema was confirmed to be a valid method for the diagnosis of polypoid lesions.

  1. Role of the double-contrast barium enema in rectal stenosis due to suppositories containing paracetamol and acetylsalicylic acid

    Energy Technology Data Exchange (ETDEWEB)

    Tannouri, F.; Lalmand, B.; Zalcman, M.; Gansbeke, D. van; Gevenois, P.A.; Struyven, J. [Department of Radiology, Hopital Erasme, University of Brussels (Belgium); Peny, M.O. [Department of Pathology, University of Brussels (Belgium); Gossum, A. van [Department of Gastroenterology, University of Brussels (Belgium)

    1998-09-01

    Self-treatment of chronic headache with suppositories containing paracetamol and acetylsalaicylic acid may lead to serious complications. We report the radiological features of five cases of rectal stenosis following the use of such suppositories. The role of the double-contrast barium enema in suggesting the diagnosis of this complication of a chronic and often unrecognized self-treatment is emphasized. (orig.) With 6 figs., 20 refs.

  2. The Use of the 'Preclosure' Technique for Antegrade Aspiration Thrombectomy with Large Catheters in Acute Limb Ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Funke, C., E-mail: claas_funke@hotmail.com; Pfiffner, R. [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology (Switzerland); Husmann, M. [University Hospital Zurich, Clinic of Angiology (Switzerland); Pfammatter, T. [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology (Switzerland)

    2013-04-15

    This study was designed to assess retrospectively short- and mid-term outcomes of the use of a suture-mediated closure device to close the antegrade access in patients undergoing percutaneous aspiration thrombectomy with large catheters for acute leg ischemia. Between November 2005 and February 2010, a suture-mediated active closure system (ProGlide{sup Registered-Sign} 6F, Abbott) was placed before arterial sheath (mean 9 F, range 6-12 F) introduction in 101 patients (74 men, 73 %, mean age 70.1 {+-} 12.6 years standard deviation). Data regarding mortality, complications, and factors contributing to vascular complications at the access site was collected for 6 month after the intervention to detect device-related problems. As a coincidence, 77 patients had follow-up visits for a duplex ultrasound. There were a total of 19 vascular complications (19 %) at the puncture site, all of which were of hemorrhagic nature and none of which consisted of vessel occlusion. Two major outcome complications (2 %) occurred. A retroperitoneal hematoma and a serious inguinal bleeding required additive treatment and did not result in permanent sequelae. Nine cases involved death of which eight were not attributable to the closure and one remained unclear. Successful closure was achieved in 95 patients (94 %); additional manual compression was sufficient in the majority of the remaining patients. Numerous factors contributing to vascular complications were encountered. With acceptable short- and mid-term outcomes, the 'preclose' technique can be a reliable option for the closure of a large antegrade femoral access even for patients at a high risk of vascular complications, such as those undergoing aspiration thrombectomy.

  3. Staging of colorectal carcinoma by spiral CT with water enema : correlation with pathologic staging using new AJCC classification

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyoung Jung; Lee, Dong Ho; Ko, Young Tae [Kyunghee Univ. Hospital, Seoul (Korea, Republic of)

    1999-05-01

    In cases of colorectal cancer, to correlate the spiral CT staging with water enema with the pathologic staging according to the new AJCC classification. Ninety four patients with pathologically proven carcinoma of the colon who had undergone spiral CT with water enema were evaluated. CT scans were obtained after enema involving about 600-1,200mL of water. Scanning was performed from the diaphragmatic dome to the symphysis pubis using 10mm collimation thickness, 12mm table feed, and 10mm reconstruction interval. The TNM stage, as seen on spiral CT, was determined without reference to the pathologic results. Staging was performed according to the new AJCC cancer staging manual(1997). The pathologic T-stage was T1 in four cases(4.3%), T2 in 11(11.7%), T3 in 72(76.6%), and T4 in seven(7.4%). The pathologic N-stage was N0 in 57 cases(60.6%), N1 in 25 cases(26.6%), and N2 in 12(12.8%). The pathologic M-stage was M0 in 90 cases(95.7%) and M1 in four(4.3%). The detection rate of colon cancer using spiral CT with water enema was 97.9%. At the T-stage, pathologic correlation was good in 68.1% of cases(64/94). Nine patients(9.6%) were overstaged and 21(22.3%) were understaged. At the N-stage, pathologic correlation was good in 54.3% of cases(51/94), with 27 patients(28.7%) overstaged and sixteen(17.0%) understaged. At the M-stage, pathologic correlation was good in 95.7% of cases(90/94). Four patients(4.3%) were overstaged. The accuracy of staging of colorectal carcinoma by spiral hydro-CT was 68.1% at the T-stage, 54.3% at the N-stage, and 95.7% at the M-stage. As seen on spiral CT with water enema, the T-stage tended to wards understaging and the N-stage towards overstaging.

  4. Contribution of Computed Tomography Enema and Magnetic Resonance Imaging to Diagnose Multifocal and Multicentric Bowel Lesions in Patients With Colorectal Endometriosis.

    Science.gov (United States)

    Belghiti, Jeremie; Thomassin-Naggara, Isabelle; Zacharopoulou, Chrysoula; Zilberman, Sonia; Jarboui, Lamia; Bazot, Marc; Ballester, Marcos; Daraï, Emile

    2015-01-01

    To evaluate the diagnostic contribution of the computed tomography (CT) enema and magnetic resonance imaging (MRI) for multifocal (multiple lesions affecting the same segment) and multicentric (multiple lesions affecting several digestive segments) bowel endometriosis. Prospective cohort study (Canadian Task Force classification II-2). Eighty-five patients. Tenon University Hospital, Paris, France. All patients received a preoperative CT enema and underwent MRI interpreted by 2 radiologists. Patients underwent colorectal resection for colorectal endometriosis from February 2009 to November 2012. Nineteen patients (22%) had multifocal lesions, and 11 patients (13%) had multicentric lesions. Six patients (7%) had both multifocal and multicentric lesions. The sensitivity, specificity, and positive and negative likelihood ratios (LRs) of MRI for the diagnosis of multifocal lesions were 0.58, 0.84, 3.55, and 0.5, respectively. The sensitivity, specificity, and positive and negative LRs of the CT enema for the diagnosis of multifocal lesions were 0.64, 0.86, 4.56, and 0.4, respectively. The sensitivity, specificity, and positive LR of MRI for the diagnosis of multicentric lesions were 1, 0.88, and 8.4, respectively. The sensitivity, specificity, and positive and negative LRs of MRI for the diagnosis of multicentric lesions were 0.46, 0.92, 5.6, and 0.59, respectively. No difference was observed between MRI and the CT enema for the diagnosis of multifocal and multicentric colorectal endometriosis. The interobserver agreement was good for MRI and the CT enema (κ = 0.45 and 0.45) for multifocality, and it was poor for both MRI and the CT enema (κ = 0.32 and 0.34) for multicentricity. Both MRI and the CT enema were able to diagnose multifocal and multicentric bowel endometriosis with similar accuracy. Copyright © 2015. Published by Elsevier Inc.

  5. Rectal perforations and fistulae secondary to a glycerin enema: closure by over-the-scope-clip.

    Science.gov (United States)

    Mori, Hirohito; Kobara, Hideki; Fujihara, Shintaro; Nishiyama, Noriko; Kobayashi, Mitsuyoshi; Masaki, Tsutomu; Izuishi, Kunihiko; Suzuki, Yasuyuki

    2012-06-28

    Rectal perforations due to glycerin enemas (GE) typically occur when the patient is in a seated or lordotic standing position. Once the perforation occurs and peritonitis results, death is usually inevitable. We describe two cases of rectal perforation and fistula caused by a GE. An 88-year-old woman presented with a large rectal perforation and a fistula just after receiving a GE. Her case was further complicated by an abscess in the right rectal wall. The second patient was a 78-year-old woman who suffered from a rectovesical fistula after a GE. In both cases, we performed direct endoscopic abscess lavage with a saline solution and closed the fistula using an over-the-scope-clip (OTSC) procedure. These procedures resulted in dramatic improvement in both patients. Direct endoscopic lavage and OTSC closure are very useful for pararectal abscess lavage and fistula closure, respectively, in elderly patients who are in poor general condition. Our two cases are the first reports of the successful endoscopic closure of fistulae using double OTSCs after endoscopic lavage of the debris and an abscess of the rectum secondary to a GE.

  6. Rectal perforations and fistulae secondary to a glycerin enema: Closure by over-the-scope-clip

    Institute of Scientific and Technical Information of China (English)

    Hirohito Mori; Hideki Kobara; Shintaro Fujihara; Noriko Nishiyama; Mitsuyoshi Kobayashi; Tsutomu Masaki; Kunihiko Izuishi; Yasuyuki Suzuki

    2012-01-01

    Rectal perforations due to glycerin enemas (GE) typically occur when the patient is in a seated or lordotic standing position.Once the perforation occurs and peritonitis results,death is usually inevitable.We describe two cases of rectal perforation and fistula caused by a GE.An 88-year-old woman presented with a large rectal perforation and a fistula just after receiving a GE.Her case was further complicated by an abscess in the right rectal wall.The second patient was a 78-year-old woman who suffered from a rectovesical fistula after a GE.In both cases,we performed direct endoscopic abscess lavage with a saline solution and closed the fistula using an over-the-scope-clip (OTSC) procedure.These procedures resulted in dramatic improvement in both patients.Direct endoscopic lavage and OTSC closure are very useful for pararectal abscess lavage and fistula closure,respectively,in elderly patients who are in poor general condition.Our two cases are the first reports of the successful endoscopic closure of fistulae using double OTSCs after endoscopic lavage of the debris and an abscess of the rectum secondary to a GE.

  7. Pirenzepine versus scopolamine methyl bromide in double-contrast barium enema study of large bowel.

    Science.gov (United States)

    Marraccini, P; Braccini, G; Marrucci, A; Boraschi, P; Bertellotti, L; Testa, R

    1996-01-01

    To evaluate the usefulness of pirenzepine for diagnostic double-contrast barium enema study of the large bowel, pirenzepine and scopolamine methyl bromide (SMB) were compared in a single, blind, randomized trial. Sixty consecutive patients were enrolled in the study. Quantitative analysis of bowel distention was done by measuring the maximum diameter of the transverse colon before and after drug administration. Four independent observers blindly evaluated distention and mucosal coating of the large bowel and global quality of the images. No differences were found in the diagnostic performance between the two drugs. However, pirenzepine induced a slight but significantly larger distention of the large bowel (68 +/- 12 vs. 65 +/- 8 mm, p = 0.02). Heart rate and rhythm during the study were recorded by ECG. SMB induced tachycardia in all patients (from 72 +/- 15 to 98 +/- 24 beats/min, p pirenzepine did not (from 76 +/- 13 to 78 +/- 20, p = NS). After SMB, one-patient exhibited faintness, and some patients complained of visual accommodation defects, dryness of the mouth, and dizziness. Pirenzepine had a diagnostic performance similar to SMB in avoiding adverse effects elicited by SMB.

  8. Diverticulitis of the sigmoid colon. A comparison of CT, colonic enema and laparoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Stefansson, T. [Univ. Hospital, Uppsala (Sweden). Dept. of Surgery]|[Univ. Hospital, Uppsala (Sweden). Dept. of Epidemiology; Nyman, R. [Univ. Hospital, Uppsala (Sweden). Dept. of Diagnostic Radiology; Nilsson, S. [Univ. Hospital, Uppsala (Sweden). Dept. of Diagnostic Radiology; Ekbom, A. [Univ. Hospital, Uppsala (Sweden). Dept. of Surgery]|[Univ. Hospital, Uppsala (Sweden). Dept. of Epidemiology; Paahlman, L. [Univ. Hospital, Uppsala (Sweden). Dept. of Surgery

    1997-03-01

    Purpose: To evaluate the use of laparoscopy, CT, colonic enema (CE), and laboratory tests (white blood cell count (WBC), sedimentation rate (SR), and C-reactive protein (CRP)) in diagnosing diverticulitis of the sigmoid colon. Material and Methods: The diagnostic methods were prospectively evaluated in 88 patients, 30 of whom were referred for laparoscopy. Results: Fity-two patients were found to have sigmoid diverticulitis: 20 patients by lanparoscopy, 21 by CT, and 11 by CE combined with one positive laboratory test. Laparoscopy proved to be superior to the other diagnostic methods in diagnosing diverticulitis of the sigmoid colon. CT had a high specificity (1.0; 95% CI: 0.92-1.0) but low sensitivity (0.69; 95% CI: 0.56-0.79) in detecting diverticulitis. CE had a higher sensitivity (0.82; 95% CI: 0.71-0.90) but a lower specificity (0.81; 95% CI: 0.67-0.91) than CT. Conclusion: CT was the best method for diagnosing abdominal pathology outside the colon. CT can be recommended as the first examination in seriously ill patients where abscesses and other causes of the symptoms than diverticulitis must first be rule out. Laparoscopy is probably the most accurate method in diagnosing diverticulitis. (orig.).

  9. Contrast Enema and Risk of Sepsis in Premature Babies: A 12-Year Retrospective Study.

    Science.gov (United States)

    Agarwal, Arpit; Ogwara, Frederick; Homel, Peter; Filipov, Panayot

    2017-02-01

    Objective The objective of this study was to investigate the association between contrast enema (CE) and clinical sepsis (CS) in premature babies (PB) and the role of antibiotics (ABs) in its prevention. Study Design A retrospective electronic chart review of preterm babies, who underwent CE during their stay in the neonatal intensive care unit. Group I includes CEs of babies exposed to AB during or within 48 hours of the procedure. Group II represents CEs of babies, not exposed to AB. Variables for both groups were collected and analyzed. Results There were 161 CEs performed in 133 babies. The overall incidence of CS after CE in preterm babies was 21/160 cases (13%). The incidence was significantly lower in Group I (1/79, 1.2%), compared with Group II (20/81, 24.7%) (p babies from Group II had positive blood culture and all 20 required AB after the CE. There were no statistical differences in the variables between the two groups. Conclusion There is a possible association between CE and CS in preterm babies. ABs given during or before the procedure prevent this complication.

  10. Do self-reported 'integrated' continence services provide high-quality continence care?

    Science.gov (United States)

    Wagg, Adrian; Lowe, Derek; Peel, Penny; Potter, Jonathan

    2009-11-01

    systematic collection of clinical outcome data remains the most difficult task in the measurement of clinical effectiveness. However, the examination of the relationship between organisational and clinical process of care may provide a surrogate measure of quality in care. data from the 2006 National Audit of Continence Care for Older People were used to examine whether there was an association between organisational structure and standard of continence care for older people. 'Quality' scores were produced and the relationship between scores was examined. there were statistically significant correlations between organisational and process scores for continence care. Primary care scored higher than hospitals or care homes in regard to service organisation [median (IQR): 57 (45-68) vs 48 (36-65) vs 50 (38-55), P = 0.001]. Differences were less with clinical process scores for urinary incontinence (UI) [median (IQR): 42 (32-52) vs 40 (29-49) vs 43 (34-52), P = 0.06] and for faecal incontinence (FI) [median: 42 (34-53) vs 45 (36-55) vs 47 (41-53), P = 0.12]. those with an integrated service provide higher quality care to older people. The provision of high-quality care for continence appears to be dependent upon well-organised services with personnel who have the appropriate training and skills to deliver the care.

  11. The ribbon continent of northwestern South America

    Science.gov (United States)

    Altamira-Areyan, Armando

    The tectonic structure of the Plate Boundary Zone (PBZ) between the Caribbean Plate (CARIB) and the South American Plate (SOAM) is interpreted using models that require CARIB motion from the Pacific into the Atlantic. Those models can be subdivided into: (1) those in which the island arc rocks that are now in the CARIB-SOAM PBZ have collided with the northern South America margin, either obliquely or directly during the Cretaceous or during the Cenozoic, and (2) those in which the island arc rocks now in the CARIB-SOAM PBZ collided with the west coast of South America during the Cretaceous and were transferred to the northern margin by transform motion during the Cenozoic. Magnetic anomalies were first rotated in the Central and South Atlantic, holding Africa fixed to establish how much NOAM had converged on SOAM during the Cenozoic. WSW convergence was discovered to have been accommodated in the northern boundary of the CARIB. There is no evidence of convergence in the form of Cenozoic island arc igneous rocks on the north coast of South America. Those results are consistent only with models of Class (2) that call for transform movement of material that had collided with the west coast of South America along the CARIB-SOAM PBZ on the northern margin of South America. 40Ar/39Ar ages of island arc rocks from northern Venezuela were found to be older than ca 70 Ma, which is consistent with a requirement of models of Class (2) that those rocks are from an island arc which collided with the west coast of South America during Cretaceous times. Testing that conclusion using data from Ecuador, Colombia, Venezuela, the Netherlands Antilles, Trinidad and Tobago has led to the construction of a new ribbon continent model of the northwestern Cordillera of South America. Because the part of the ribbon continent on the north coast of South America has been experiencing substantial deformation in the Maracaibo block during the past 10 m.y., structures in that body have had to be

  12. A technique for long term continent gastrostomy.

    Science.gov (United States)

    Locker, D L; Foster, J E; Craun, M L; Torma, M J

    1985-01-01

    The use of the continent gastrostomy described herein offers several advantages: 1, the elimination of an indwelling catheter; 2, prevention of soiling at skin level; 3, long term access to the normal gastrointestinal track for alimentation without fear of tube erosion; 4, little compromise to gastric volume, and 5, ease of stoma care. We recommend this operation in instances when long term tube feedings are indicated either because of damage to the central nervous system or as a palliative treatment for patients with higher obstructing gastrointestinal malignant disease. The procedure may also be useful for patients in whom esophagogastric continuity has been interrupted (surgically or traumatically) and in whom reconstruction of the gastrointestinal tract would not seem feasible within a three to six month interval.

  13. Young Africans Tackle Their Continent's Environmental Issues

    Science.gov (United States)

    Olwoch, Jane Mukarugwiza

    2008-11-01

    Young African Scientists Session at the Fourth International Geosphere-Biosphere Programme Congress; Cape Town, South Africa, 7 May 2008; Africa is often described as a unique and diverse continent. This is reflected in its biodiversity, economic and social circumstances, and diversity in culture and environment. The Young African Scientists (YAS) session at the International Geosphere-Biosphere Programme Congress was one of the congress's highlights. Global environmental change research in Africa was presented to an audience that included visiting international and national scientists, policy makers, and a group of schoolchildren. From the uniqueness of Africa's paleoclimate to the diversity and complexity of current and future impacts of environmental change on Africa, the session not only provided an overview of current projects but also highlighted the problems that are intertwined with poverty. This session was sponsored by the Global Change System for Analysis, Research, and Training (START).

  14. Sodium butyrate enemas in the treatment of acute radiation-induced proctitis in patients with prostate cancer and the impact on late proctitis. A prospective evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Hille, Andrea; Herrmann, Markus K.A.; Kertesz, Tereza; Christiansen, Hans; Hermann, Robert M.; Hess, Clemens F. [University Hospital, Goettingen (Germany). Department of Radiotherapy and Radiooncology; Pradier, Olivier [University Hospital, Brest (France). Department of Radiotherapy and Radiooncology; Schmidberger, Heinz [University Hospital, Mainz (Germany). Department of Radiotherapy and Radiooncology

    2008-12-15

    To evaluate prospectively the effect of sodium butyrate enemas on the treatment of acute and the potential influence on late radiation-induced proctitis. 31 patients had been treated with sodium butyrate enemas for radiation-induced acute grade II proctitis which had developed after 40 Gy in median. During irradiation the toxicity was evaluated weekly by the Common Toxicity Criteria (CTC) and subsequently yearly by the RTOG (Radiation Therapy Oncology Group) and LENT-SOMA scale. 23 of 31 patients (74%) experienced a decrease of CTC grade within 8 days on median. A statistical significant difference between the incidence and the severity of proctitis before start of treatment with sodium butyrate enemas compared to 14 days later and compared to the end of irradiation treatment course, respectively, was found. The median follow-up was 50 months. Twenty patients were recorded as suffering from no late proctitis symptom. Eleven patients suffered from grade I and 2 of these patients from grade II toxicity, too. No correlation was seen between the efficacy of butyrate enemas on acute proctitis and prevention or development of late toxicity, respectively. Sodium butyrate enemas are effective in the treatment of acute radiation-induced proctitis in patients with prostate cancer but have no impact on the incidence and severity of late proctitis. (orig.)

  15. Seismic evidence for very deep roots of continents

    OpenAIRE

    J. Gossler; Rainer Kind

    1996-01-01

    A major problem in geodynamics with seismic data is discussed: How deeply do the continents penetrate into the mantle? Differential travel times of underside reflections from mantle discontinuities that appear as precursors to SS, in large parts of the globe, show a clear correlation with oceans and continents. They are significantly larger beneath the Asian and North American continents than underneath the neighbouring Pacific. From this observation we conclude that the Asian and North Ameri...

  16. Enema reduction of intussusception: the success rate of hydrostatic and pneumatic reduction.

    Science.gov (United States)

    Khorana, Jiraporn; Singhavejsakul, Jesda; Ukarapol, Nuthapong; Laohapensang, Mongkol; Wakhanrittee, Junsujee; Patumanond, Jayanton

    2015-01-01

    Intussusception is a common surgical emergency in infants and children. The incidence of intussusception is from one to four per 2,000 infants and children. If there is no peritonitis, perforation sign on abdominal radiographic studies, and nonresponsive shock, nonoperative reduction by pneumatic or hydrostatic enema can be performed. The purpose of this study was to compare the success rates of both the methods. Two institutional retrospective cohort studies were performed. All intussusception patients (ICD-10 code K56.1) who had visited Chiang Mai University Hospital and Siriraj Hospital from January 2006 to December 2012 were included in the study. The data were obtained by chart reviews and electronic databases, which included demographic data, symptoms, signs, and investigations. The patients were grouped according to the method of reduction followed into pneumatic reduction and hydrostatic reduction groups with the outcome being the success of the reduction technique. One hundred and seventy episodes of intussusception occurring in the patients of Chiang Mai University Hospital and Siriraj Hospital were included in this study. The success rate of pneumatic reduction was 61% and that of hydrostatic reduction was 44% (P=0.036). Multivariable analysis and adjusting of the factors by propensity scores were performed; the success rate of pneumatic reduction was 1.48 times more than that of hydrostatic reduction (P=0.036, 95% confidence interval [CI] =1.03-2.13). Both pneumatic and hydrostatic reduction can be performed safely according to the experience of the radiologist or pediatric surgeon and hospital setting. This study showed that pneumatic reduction had a higher success rate than hydrostatic reduction.

  17. Percutaneous retrograde crossing of a near-occluded celiac trunk via the superior mesenteric artery as an adjuvant maneuver for antegrade stenting

    Directory of Open Access Journals (Sweden)

    Martin Andreas Geiger

    2016-03-01

    Full Text Available Abstract We describe the case of a 63-year-old woman with chronic mesenteric ischemia, persistent postprandial upper abdominal pain and progressive weight loss. Retrograde recanalization was performed via the superior mesenteric artery in order to achieve the goal of crossing the near-occlusion, showing that retrograde catheterization of the celiac trunk can be a feasible approach in challenging cases in which an antegrade approach fails as a single maneuver.

  18. 21 CFR 876.5270 - Implanted electrical urinary continence device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implanted electrical urinary continence device... Implanted electrical urinary continence device. (a) Identification. An implanted electrical urinary device is a device intended for treatment of urinary incontinence that consists of a receiver implanted...

  19. Prevalência, classificação e características do refluxo cecoileal diagnosticado pelo enema opaco Prevalence, classification and characteristics of the coloileal reflux diagnosed by barium enema

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    Wellington Monteiro Machado

    2006-04-01

    Full Text Available OBJETIVO: Verificar, retrospectivamente, a prevalência do refluxo cecoileal diagnosticado pelo enema opaco, caracterizar sua distribuição etária e sexual e classificá-lo conforme o grau de intensidade. MATERIAIS E MÉTODOS: Foram revistos 715 enemas opacos, incluindo 268 homens e 447 mulheres com idade média de 54 anos. RESULTADOS: Dos 715 casos examinados, 46,5% apresentaram refluxo cecoileal, sendo 45% do tipo leve, 37,5% do tipo moderado e 17,5% do tipo severo. Refluxo cecoileal esteve presente em 48,3% das mulheres e em 43,6% dos homens. A distribuição percentual do refluxo cecoileal por faixa etária mostrou 46,1% nos indivíduos com menos de 21 anos, 42,1% nos indivíduos entre 21-40 anos, 49,8% nos indivíduos entre 41-60 anos e 44,7% nos indivíduos com mais de 60 anos. CONCLUSÃO: Refluxo cecoileal foi achado relativamente freqüente em nosso material, correspondendo os graus moderado e severo a 25% do material examinado. Aparentemente, não há associação entre seu surgimento e sexo ou idade. A etiopatogenia e conseqüências do refluxo cecoileal são ainda pouco conhecidas. Alguns estudos sugerem que o comprometimento de componentes da junção ileocecal, como os ligamentos, pode favorecer seu aparecimento. Entre as conseqüências prováveis, incluem-se a contaminação e alteração motora ileais, resultantes do material refluído do ceco.OBJECTIVE: Retrospectively determining the coloileal reflux prevalence at the barium enema examination, characterizing its distribution by sex and age range and classifying it according to the intensity degree. MATERIALS AND METHODS: 715 barium enemas were reviewed, being 268 of male patients and 447 of female patients, with average age of 54 years. RESULTS: Of the 715 enemas performed, 46.5% showed coloileal reflux, classified as mild (45%, moderate (37.5% and severe (17.5%. Coloileal reflux was present in 48.3% of female and in 43.6% of male patients. The coloileal reflux distribution

  20. EUS-Guided Antegrade Transhepatic Placement of a Self-Expandable Metal Stent in Hepatico-Jejunal Anastomosis

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    Everson LA Artifon

    2011-11-01

    Full Text Available Context To demonstrate an EUS-guided biliary drainage in patient with gastrointestinal tract modified surgically. Case report An EUS guided access to the left intra hepatic duct, followed by an antegrade passage of a partially self-expandable metal stent that was removed by using an enteroscope, in one patient with hepatico-jejunal anastomosis. There were no early or delayed complications and the procedure was effective in relieving jaundice until the self-expandable metal stent was removed, 3 months later. A cholangiogram was obtained via enteroscopy, after removal of self-expandable metal stent, and found to be normal. The patient had an uneventful evaluation afterwards. Conclusion The indication of these procedures must be made under a multidisciplinary view while sharing information with the patient or legal guardian. EUS-guided biliary drainage is feasible when performed by professionals with expertise in biliopancreatic endoscopy and advanced echo-endoscopy and should be performed currently under rigorous protocol in educational institutions.

  1. Orthotopic bladder substitution in men revisited: identification of continence predictors.

    Science.gov (United States)

    Koraitim, M M; Atta, M A; Foda, M K

    2006-11-01

    We determined the impact of the functional characteristics of the neobladder and urethral sphincter on continence results, and determined the most significant predictors of continence. A total of 88 male patients 29 to 70 years old underwent orthotopic bladder substitution with tubularized ileocecal segment (40) and detubularized sigmoid (25) or ileum (23). Uroflowmetry, cystometry and urethral pressure profilometry were performed at 13 to 36 months (mean 19) postoperatively. The correlation between urinary continence and 28 urodynamic variables was assessed. Parameters that correlated significantly with continence were entered into a multivariate analysis using a logistic regression model to determine the most significant predictors of continence. Maximum urethral closure pressure was the only parameter that showed a statistically significant correlation with diurnal continence. Nocturnal continence had not only a statistically significant positive correlation with maximum urethral closure pressure, but also statistically significant negative correlations with maximum contraction amplitude, and baseline pressure at mid and maximum capacity. Three of these 4 parameters, including maximum urethral closure pressure, maximum contraction amplitude and baseline pressure at mid capacity, proved to be significant predictors of continence on multivariate analysis. While daytime continence is determined by maximum urethral closure pressure, during the night it is the net result of 2 forces that have about equal influence but in opposite directions, that is maximum urethral closure pressure vs maximum contraction amplitude plus baseline pressure at mid capacity. Two equations were derived from the logistic regression model to predict the probability of continence after orthotopic bladder substitution, including Z1 (diurnal) = 0.605 + 0.0085 maximum urethral closure pressure and Z2 (nocturnal) = 0.841 + 0.01 [maximum urethral closure pressure - (maximum contraction amplitude

  2. Dietary Geraniol by Oral or Enema Administration Strongly Reduces Dysbiosis and Systemic Inflammation in Dextran Sulfate Sodium-Treated Mice.

    Science.gov (United States)

    De Fazio, Luigia; Spisni, Enzo; Cavazza, Elena; Strillacci, Antonio; Candela, Marco; Centanni, Manuela; Ricci, Chiara; Rizzello, Fernando; Campieri, Massimo; Valerii, Maria C

    2016-01-01

    (Trans)-3,7-Dimethyl-2,6-octadien-1-ol, commonly called geraniol (Ge-OH), is an acyclic monoterpene alcohol with well-known anti-inflammatory, antitumoral, and antimicrobial properties. It is widely used as a preservative in the food industry and as an antimicrobial agent in animal farming. The present study investigated the role of Ge-OH as an anti-inflammatory and anti-dysbiotic agent in the dextran sulfate sodium (DSS)-induced colitis mouse model. Ge-OH was orally administered to C57BL/6 mice at daily doses of 30 and 120 mg kg((-1)) body weight, starting 6 days before DSS treatment and ending the day after DSS removal. Furthermore, Ge-OH 120 mg kg((-1)) dose body weight was administered via enema during the acute phase of colitis to facilitate its on-site action. The results show that orally or enema-administered Ge-OH is a powerful antimicrobial agent able to prevent colitis-associated dysbiosis and decrease the inflammatory systemic profile of colitic mice. As a whole, Ge-OH strongly improved the clinical signs of colitis and significantly reduced cyclooxygenase-2 (COX-2) expression in colonocytes and in the gut wall. Ge-OH could be a powerful drug for the treatment of intestinal inflammation and dysbiosis.

  3. Dietary geraniol by oral or enema administration strongly reduces dysbiosis and systemic inflammation in dextran sulphate sodium-treated mice.

    Directory of Open Access Journals (Sweden)

    Luigia eDe Fazio

    2016-03-01

    Full Text Available (Trans-3,7-Dimethyl-2,6-octadien-1-ol, commonly called geraniol (Ge-OH, is an acyclic monoterpene alcohol with well-known anti-inflammatory, antitumoral and antimicrobial properties. It is widely used as a preservative in the food industry and as an antimicrobial agent in animal farming. The present study investigated the role of Ge-OH as an anti-inflammatory and anti-dysbiotic agent in the dextran sulphate sodium (DSS-induced colitis mouse model. Ge-OH was orally administered to C57BL/6 mice at daily doses of 30 and 120mg kg(-1 body weight, starting six days before DSS treatment and ending the day after DSS removal. Furthermore, Ge-OH 120 mg kg(-1 dose body weight was administered via enema during the acute phase of colitis to facilitate its on-site action. The results show that orally or enema-administered Ge-OH is a powerful antimicrobial agent able to prevent colitis-associated dysbiosis and decrease the inflammatory systemic profile of colitic mice. As a whole, Ge-OH strongly improved the clinical signs of colitis and significantly reduced cyclooxygenase-2 (COX-2 expression in colonocytes and in the gut wall. Ge-OH could be a powerful drug for the treatment of intestinal inflammation and dysbiosis.

  4. Clinical and Experimental Study on Treatment of Infantile Autumn Diarrhea by Retention Enema with Qilian Liquid (芪连液)

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective:To find out the effective treatment for infantile autumn diarrhea(IAD).Methods:Retention enema with Qilian Liquid(QLL) was applied to 106 patients of IAD with positive antigen of rotavirus in stool,and the result in the treated group was compared with that in the control group(82 patients) in aspects of clinical effect, negative conversion rate of rotavirus in stool and change of serum immunoglobulin. Animal experimental study was also conducted.Results:The disappearance time of principal symptoms, negative conversion rate of rotavirus in stool and serum levels of IgA and IgG in the treated group were significantly better than those in the control group (P<0.01, P< 0.05). Experimental study showed that QLL not only has the anti-viral effects to stop diarrhea, but also has effects in enhancing immune function and protecting intestinal mucous membrane. Conclusion:Retention enema with QLL is an effective therapy for the treatment of IAD.

  5. Free fatty acid suppositories are as effective as docusate sodium and sorbitol enemas in treating constipation in children.

    Science.gov (United States)

    Ormarsson, Orri Thor; Asgrimsdottir, Gudrun Marta; Loftsson, Thorsteinn; Stefansson, Einar; Lund, Sigrun Helga; Bjornsson, Einar Stefan

    2016-06-01

    A well-documented, clinically proven per rectum treatment for childhood constipation is needed. This phase two clinical trial evaluated the efficacy of suppositories containing free fatty acids (FFA) compared with Klyx docusate sodium and sorbitol enemas. A randomised, controlled, single-blind study was undertaken on 77 children aged between one and 17 who presented to an emergency department in Iceland and were diagnosed with constipation. In stage one, 23 patients were randomised to receive lower dose FFA suppositories or Klyx (n = 33). In stage two, 21 different patients were randomised to receive higher dose suppositories and compared with the same Klyx control subjects. The suppositories were effective at bowel emptying in 39% of the group who received the lower FFA doses and 81% of the group receiving higher doses, compared with 88% in the Klyx control group. Symptom relief was obtained in 30% of the group receiving the lower doses and 71% of the group receiving the higher doses, compared with 73% in the control group. The higher dose FFA suppositories were as effective as the Klyx enemas with regard to bowel emptying and symptom relief and might provide an important and less invasive alternative for childhood constipation. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  6. Inflammatory diseases of the large intestine. Colon contrast enema and CT; Entzuendliche Dickdarmerkrankungen. Kolonkontrasteinlauf und CT

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    Antes, G. [Klinikum Kempten-Oberallgaeu GmbH, Kempten (Germany). Abt. fuer Radiologie

    1998-01-01

    Among the many inflammatory diseases of the colon, Crohn`s disease and ulcerative colitis occur most frequently. For primary evaluation, endoscopy has widely replaced the barium enema (BE) as diagnostic method. BE, however can provide important additional informations in the differential diagnosis of chronic inflammatory colonic diseases. Purpose of this article is the demonstration of typical, but also of atypical radiological changes in different stages of Crohn`s disease and ulcerative colitis, as well as calling attention to the importance of CT. A BE demands a refined examination technique using double contrast. All CT-examinations have to be scrutinized for changes of the bowel and mesentery. A dedicated spiral-CT examination might be indicated in a known disease in order to obtain special information. The advantage of a BE over endoscopy is a clear and reproducible demonstration of the patterns of distribution and character of the disease as well as the detection of fistulae. The classification into one or the other disease entity can be better accomplished. CT is superior in detecting bowel wall thickening, extraintestinal disease and complications. In diagnostic imaging of chronic inflammatory bowel diseases, endoscopy and radiologic techniques are used complementarily. (orig.) [Deutsch] Unter den vielen entzuendlichen Dickdarmerkrankungen sind Morbus Crohn und Colitis ulcerosa bei weitem am haeufigsten. Die Endoskopie hat den Kolonkontrasteinlauf (KE) in der Primaerdiagnostik weitgehend abgeloest. Dennoch kann der KE bei der Differentialdiagnose entzuendlicher Dickdarmerkankungen wichtige Zusatzinformationen liefern. Ziel dieser Arbeit ist die Demonstration der typischen, aber auch atypischen roentgenologischen Veraenderungen in den verschiedenen Stadien bei Morbus Crohn und Colitis ulcerosa sowie der Hinweis auf die Bedeutung der CT. Der KE erfordert eine ausgefeilte Untersuchungstechnik im Doppelkontrast. Bei allen CT-Untersuchungen muessen der Darm und

  7. ANTI INFLAMMATORY EFFECT OF BASTI THERAPY (MEDICATED ENEMA IN THE PATIENTS OF PSORIASIS (EK KUSTHA

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    Singh Akhilesh Kumar

    2012-01-01

    Full Text Available Ek kustha is a type of kshudra kustha described in different Ayurvedic classics. It is a vata-kaphaj disorder. The clinical symptom of Ek kustha described in Ayurveda resembles with the clinical symptom of Psoriasis. The clinical feature of Ek kustha described by Kashyap represents remission, relapse and seasonal variation, which are present in Psoriasis. Psoriasis like other skin disorders is challenge to the medical sciences. In modern medicine there is no definite treatment for this disease. The medicines, which are available to treat the disease, are not very effective and cannot be used for long-term management because of their local and systemic side effect as well as toxicity. Medicines, which are used in Ayurveda, are safe and being practiced since thousands of year. A large number of drugs and measures are described in Ayurveda for the treatment of Kustha. This study was designed to access the anti-inflammatory activity of Basti Therapy (Medicated Enema in the treatment of Ek kustha (psoriasis. The study was randomized open phase clinical trial. Basti planned for the therapy was Yoga-basti Karma in which Anuvasana basti was given using Mahanarayan tail while Niruh basti was given using Dashmula quath in accordance with Aharya Charak as mentioned in Siddhi Sthana 1/25. Keeping this view in mind we have started basti therapy in the patients of osteoarthritis and found encouraging results. The patients of age group 18 to 60 were selected on the basis of Ayurvedic signs and symptoms of Ek kustha. Observations were recorded for sharply defined erythemo-squamous lesions varying in size; presence of erythema, scaling and induration in the lesions; surface consists of non-coherent scales; positive Auspitz sign – (Bleeding occurs after scratching of scales; positive onion peeling sign/candle grease sign (after scratching the scales fall like peels of onion. The laboratory values of TLC, DLC, ESR and CRP were also recorded before and after the

  8. Enema reduction of intussusception: the success rate of hydrostatic and pneumatic reduction

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    Khorana J

    2015-12-01

    Full Text Available Jiraporn Khorana,1 Jesda Singhavejsakul,1 Nuthapong Ukarapol,2 Mongkol Laohapensang,3 Junsujee Wakhanrittee,4 Jayanton Patumanond5 1Division of Pediatric Surgery, Department of Surgery, 2Division of Gastroenterology, Department of Pediatrics, Chiang Mai University Hospital, Chiang Mai, 3Division of Pediatric Surgery, Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, 4Division of Pediatric Surgery, Department of Surgery, Thammasat University Hospital, 5Center of Excellence in Applied Epidemiology, Thammasat University Hospital, Pathumthani, Thailand Purpose: Intussusception is a common surgical emergency in infants and children. The incidence of intussusception is from one to four per 2,000 infants and children. If there is no peritonitis, perforation sign on abdominal radiographic studies, and nonresponsive shock, nonoperative reduction by pneumatic or hydrostatic enema can be performed. The purpose of this study was to compare the success rates of both the methods.Methods: Two institutional retrospective cohort studies were performed. All intussusception patients (ICD-10 code K56.1 who had visited Chiang Mai University Hospital and Siriraj Hospital from January 2006 to December 2012 were included in the study. The data were obtained by chart reviews and electronic databases, which included demographic data, symptoms, signs, and investigations. The patients were grouped according to the method of reduction followed into pneumatic reduction and hydrostatic reduction groups with the outcome being the success of the reduction technique.Results: One hundred and seventy episodes of intussusception occurring in the patients of Chiang Mai University Hospital and Siriraj Hospital were included in this study. The success rate of pneumatic reduction was 61% and that of hydrostatic reduction was 44% (P=0.036. Multivariable analysis and adjusting of the factors by propensity scores were performed; the success rate of pneumatic reduction

  9. Therapeutic effects of human amnion-derived mesenchymal stem cell transplantation and conditioned medium enema in rats with trinitrobenzene sulfonic acid-induced colitis

    Science.gov (United States)

    Miyamoto, Shuichi; Ohnishi, Shunsuke; Onishi, Reizo; Tsuchiya, Ikuki; Hosono, Hidetaka; Katsurada, Takehiko; Yamahara, Kenichi; Takeda, Hiroshi; Sakamoto, Naoya

    2017-01-01

    Cell therapy with mesenchymal stem cells (MSCs) is expected to provide a new strategy for the treatment of inflammatory bowel disease (IBD). Large amounts of MSCs can be obtained from human amnion. Therefore, we investigated the effect of transplantation of human amnion-derived MSCs (hAMSCs) or enema of conditioned medium (CM) from hAMSCs into rats with 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis. In the first experiment, 10-week-old male Sprague-Dawley rats were intravenously injected with hAMSCs (1 × 106 cells) 3 h after rectal administration of TNBS (45 mg/kg). In the second experiment, rats with TNBS-induced colitis received CM by enema into the colon for 3 days. Colitis was investigated by endoscopy, histology, immunohistochemistry, and by measuring mRNA expression of inflammatory mediators. Administration of hAMSCs or CM enema significantly improved the endoscopic score. In addition, these two interventions resulted in significantly decreased infiltration of neutrophils and monocytes/macrophages and decreased expression levels of TNF-α, CXCL1, and CCL2. In conclusion, transplantation of hAMSCs and CM enema provided significant improvement in rats with TNBS-induced colitis. CM from hAMSCs and hAMSCs may be new strategies for the treatment of IBD.

  10. Clinical Study on Chinese Herbal Enema in Adjuvant Treatment of Uremia%中药灌肠辅助治疗尿毒症的临床研究

    Institute of Scientific and Technical Information of China (English)

    吕丽萍

    2015-01-01

    Objective: To investigate effect of Chinese herbal enema with hemodialysis in adjuvant treatment of uremia.Method: Patients (76 cases) with uraemia in telophase were randomly divided into two groups: Chinese herbal enema with hemodialysis group (n=38), and conventional hemodialysis group (n=38). Chinese herbal enema with hemodialysis group reduced hemodialysis times and prolonged hemodialysis interval for 4 weeks to observe the changes of every clinical parameters.Result: There was no significant difference between the two groups (P>0.05). Chinese herbal enema with hemodialysis group was better than conventional hemodialysis group in protecting residual renal function (P0.05);辅助治疗组较透析对照组透析时间间隔明显延长,治疗后对残余肾功能保护作用明显优于对照组,比较差异有统计学意义(P<0.05)。结论:中药灌肠辅助治疗配合血液透析在不影响透析效果的前提下,较单纯的血液透析明显改善了患者生活质量,显著延长透析时间间隔,并可以适度延缓残余肾功能恶化的进展。

  11. Oral 5-Aminosalicylate, Mesalamine Suppository, and Mesalamine Enema as Initial Therapy for Ulcerative Proctitis in Clinical Practice with Quality of Care Implications

    Directory of Open Access Journals (Sweden)

    James M. Richter

    2016-01-01

    Full Text Available Background. Ulcerative proctitis (UP is typically treated initially with oral 5-aminosalicylate (“5-ASA”, mesalamine suppository, or mesalamine enema (“UP Rx”. Little is known about their effectiveness in practice. Methods. Using a US health insurance database, we identified new-onset UP patients between January 1, 2005, and December 31, 2007, based on the following: (1 initiation of UP Rx; (2 endoscopy in prior 30 days resulting in diagnosis of UP; and (3 no prior encounters for ulcerative colitis or Crohn’s disease. We examined the incidence of therapy escalation and total costs in relation to initial UP Rx. Results. We identified 548 patients: 327 received mesalamine suppository, 138 received oral 5-ASA, and 83 received mesalamine enema, as initial UP Rx. One-third receiving oral 5-ASA experienced therapy escalation over 12 months, 21% for both mesalamine suppository and enema. Mean cumulative total cost of UP Rx over 12 months was $1552, $996, and $986 for patients beginning therapy with oral 5-ASA, mesalamine enema, and mesalamine suppository, respectively. Contrary to expert recommendations the treatments were often not continued prophylactically. Conclusions. Treatment escalation was common, and total costs of therapy were higher, in patients who initiated treatment with oral 5-ASA. Further study is necessary to assess the significance of these observations.

  12. Oral 5-Aminosalicylate, Mesalamine Suppository, and Mesalamine Enema as Initial Therapy for Ulcerative Proctitis in Clinical Practice with Quality of Care Implications.

    Science.gov (United States)

    Richter, James M; Arshi, Nabeela K; Oster, Gerry

    2016-01-01

    Background. Ulcerative proctitis (UP) is typically treated initially with oral 5-aminosalicylate ("5-ASA"), mesalamine suppository, or mesalamine enema ("UP Rx"). Little is known about their effectiveness in practice. Methods. Using a US health insurance database, we identified new-onset UP patients between January 1, 2005, and December 31, 2007, based on the following: (1) initiation of UP Rx; (2) endoscopy in prior 30 days resulting in diagnosis of UP; and (3) no prior encounters for ulcerative colitis or Crohn's disease. We examined the incidence of therapy escalation and total costs in relation to initial UP Rx. Results. We identified 548 patients: 327 received mesalamine suppository, 138 received oral 5-ASA, and 83 received mesalamine enema, as initial UP Rx. One-third receiving oral 5-ASA experienced therapy escalation over 12 months, 21% for both mesalamine suppository and enema. Mean cumulative total cost of UP Rx over 12 months was $1552, $996, and $986 for patients beginning therapy with oral 5-ASA, mesalamine enema, and mesalamine suppository, respectively. Contrary to expert recommendations the treatments were often not continued prophylactically. Conclusions. Treatment escalation was common, and total costs of therapy were higher, in patients who initiated treatment with oral 5-ASA. Further study is necessary to assess the significance of these observations.

  13. TECHNICAL CHARACTERISTICS OF RADICAL PROSTATECTOMY FOR EARLY CONTINENCE RECOVERY

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    V. A. Perepechay

    2014-07-01

    Full Text Available The paper presents the technical characteristics of radical prostatectomy (RPE for early continence recovery in patients with prostate cancer. Restoration of the fascial structures of the small pelvis after RPE has been found to promote early urinary continence recovery. A method for total restoration of the fascial structures of the small pelvis (an operation after A. Tewari and a procedure for performing posterior suspension of urethrocystic neoanastomosis in Denonvilliers’ fascia length deficit are considered, which show the similar results in the time of continence recovery.

  14. The upper mantle structure of the Tibetan Plateau and its implication for the continent-continent collision

    Institute of Scientific and Technical Information of China (English)

    WU; Qingju; ZENG; Rongsheng; ZHAO; Wenjin

    2005-01-01

    The upper mantle structures of Himalayas-Tibet have been obtained from the migration of receiver functions of the teleseismic events recorded by INDEPTH-III. The result of migration imaging shows a dipping interface subducting northward from the depth of 100 km to the 410-km discontinuity underneath southern Tibet. It indicates that the lithospheric mantle of the Indian continent had been detached from the crust and deeply subducted to the upper mantle of Eurasia during the Indo-Eurasian collision. This kind of continent-continent collision process is fundamentally different from the oceanic collision.

  15. Induction of spermatogenesis in men with azoospermia or severe oligoteratoasthenospermia after antegrade internal spermatic vein sclerotherapy for the treatment of varicocele

    Institute of Scientific and Technical Information of China (English)

    Vassilis Poulakis; Nikolaos Ferakis; Rachelle de Vries; Ulrich Witzsch; Edward Becht

    2006-01-01

    Aim: To evaluate the treatment outcome of antegrade internal spermatic vein sclerotherapy in men with non-obstructive azoospermia or severe oligoteratoasthenospermia (OTA) as a result of varicocele. Methods: Between September 1995 and January 2004, 47 patients (mean age 33.8 ± 6.3 years) underwent antegrade internal spermatic vein sclerotherapy for the treatment of varicocele with azoospermia (14 patients) or severe OTA (33 patients). Testicular core biopsy was also performed in complete azoospermic patients who provided informed consent. The outcome was assessed in terms of improvement in semen parameters and conception rate. Results: Forty-two (89.4%) of 47patients had bilateral varicocele. Serum follicle stimulating hormone (FSH) did not differ between patients with azoospermia and severe OTA. After the follow-up of 24.8 ± 9.2 months, significant improvement was noted in mean sperm concentration, motility and morphology in 35 patients (74.5%). Comparison between groups during the follow-up revealed significantly higher values of sperm concentration, motility and normal morphology in the severe OTA group. Pregnancy was achieved in 14 cases (29.8%). Testicular histopathology of the azoospermic patients with postoperative induction of spermatogenesis revealed maturation arrest at spermatid stage, Sertoli-cell-only (SCO)with focal spermatogenesis or hypospermatogenesis. None of the patients with pure SCO pattern or maturation arrest at spermatocyte stage achieved spermatogenesis after the treatment. Preoperative serum FSH levels didn't relate to treatment outcome. Conclusion: Antegrade internal spermatic vein sclerotherapy is an easy and effective treatment for symptomatic varicocele. It can significantly reverse testicular dysfunction and improve spermatogenesis in men with severe OTA, as well as induce sperm production in men with azoospermia, improving pregnancy rates in subfertile couples.

  16. Computed tomography-based prediction of the straight antegrade humeral nail's entry point and exposure of "critical types": truth or fiction?

    Science.gov (United States)

    Euler, Simon A; Hengg, Clemens; Boos, Matthias; Dornan, Grant J; Turnbull, Travis Lee; Wambacher, Markus; Kralinger, Franz S; Millett, Peter J; Petri, Maximilian

    2017-05-01

    Straight antegrade intramedullary nailing of proximal humerus fractures has shown promising clinical results. However, up to 36% of all humeri seem to be "critical types" in terms of the potential violation of the supraspinatus (SSP) tendon footprint by the nail's insertion zone. The aims of this study were to evaluate if a computed tomography (CT) scan could reliably predict the nail's entry point on the humeral head and if it would be possible to preoperatively estimate the individual risk of iatrogenic violation of the SSP tendon footprint by evaluating the uninjured contralateral humerus. Twenty matched pairs of human cadaveric shoulders underwent CT scans, and the entry point for an antegrade nail as well as measurements regarding critical distances between the entry point and the rotator cuff were determined. Next, gross anatomic measurements of the same data were performed and compared. Furthermore, specimens were reviewed for critical types. Overall, 42.5% of all specimens were found to be critical types. The CT measurements exhibited excellent intra-rater and inter-rater reliability (intraclass correlation coefficients >0.90). Similarly, excellent agreement between the CT scan and gross anatomic measurements in contralateral shoulders (intraclass correlation coefficients >0.88) was found. Assessing the uninjured contralateral side, CT can reliably predict the entry point in antegrade humeral nailing and preoperatively identify critical types of humeral heads at risk of iatrogenic implantation damage to the SSP tendon footprint. This study may help surgeons in the decision-making processon which surgical technique should be used without putting the patient at risk for iatrogenic, implant-related damage to the rotator cuff. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  17. Retrograde pedal access with a 20-gauge intravenous cannula after failed antegrade recanalization of a tibialis anterior artery in a diabetic patient: a case report

    Directory of Open Access Journals (Sweden)

    Yucel Colkesen

    2015-08-01

    Full Text Available Retrograde tibiopedal approach is being used frequently in below-the-knee vascular interventions. In patients with diabetic foot pathology, complex anatomy often requires a retrograde technique when the distal vascular anatomy and puncture site is suitable. The dorsalis pedis and posterior tibial arteries can be punctured because of their relatively superficial position. We report a retrograde puncturing technique in patients with chronic total occlusions. After failed antegrade recanalization, puncturing and cannulation of a tiny dorsalis pedis artery with a narrow bore [20-gauge (0.8 mm] intravenous cannula is described.

  18. Accuracy of double contrast barium enema and sigmoideoscopy in the detection of polyps in patients with diverticulosis

    Energy Technology Data Exchange (ETDEWEB)

    Stefansson, T. (Depts. of Surgery and Diagnostic Radiology, Univ. Hospital, Uppsala (Sweden)); Bergman, A. (Depts. of Surgery and Diagnostic Radiology, Univ. Hospital, Uppsala (Sweden)); Ekbom, A. (Depts. of Surgery and Diagnostic Radiology, Univ. Hospital, Uppsala (Sweden)); Nyman, R. (Depts. of Surgery and Diagnostic Radiology, Univ. Hospital, Uppsala (Sweden)); Paahlman, L. (Depts. of Surgery and Diagnostic Radiology, Univ. Hospital, Uppsala (Sweden))

    1994-09-01

    The sensitivity between double contrast barium enema (DCBE) and sigmoideoscopy in diagnosing neoplastic lesions in the sigmoid colon was compared in patients with diverticulosis. In 52 patients with severe diverticulosis ([>=] 15 diverticulas) the DCBE detected one out of 4 polyps found by sigmoideoscopy. In the remaining 54 patients with mild diverticulosis (< 15 diverticulas) DCBE detected 7 out of 10 polyps found by sigmoideoscopy. Successful bowel preparation did not influence the outcome of the DCBE. Sigmoideoscopy was incomplete in 17 (16%) of the patients; females were more difficult to examine than males (p=0.012), as were those with a previous pelvic operation (p=0.032). We conclude that neither DCBE nor sigmoideoscopy alone is sufficient to detect all neoplastic lesions in the sigmoid colon in patients with sigmoid diverticulosis of the colon. (orig.).

  19. Accuracy of water-enema multidetector computed tomography (WE-MDCT) in colon cancer staging: a prospective study.

    Science.gov (United States)

    Sibileau, E; Ridereau-Zins, Catherine; Vanel, D; Pavageau, A H; Bertrais, S; Metivier-Cesbron, E; Venara, A; Aubé, C

    2014-10-01

    To assess the accuracy of water-enema multidetector computed tomography (WE-MDCT) in extra-rectal colon cancer staging. Fifty-three patients (mean age 70 years) with extra-rectal colon cancer proven by colonoscopy and biopsy were prospectively evaluated by preoperative WE-MDCT. CT scans were both intraluminal (water enema or WE) and intravenous (iodinated) contrast enhanced (CE). All patients underwent surgery. Tumors were classified with the TNM staging system. Noted CT features were: tumor size and location; tumor form and edges; spread to the pericolic fat or neighboring organs; thickening of retroperitoneal fascia; number, size, and enhancement of the peritumoral lymph nodes. Tumors were classified on CT into 3 T-stage groups: T1/T2, T3, and T4. Lymph nodes were classified by their density after injection [positive over 100 Hounsfield units (HU)]. Tumor localization to the specific colon segment was correct in all the cases. The agreement between WE-MDCT staging and histopathology staging was good (k = 0.64). An irregular and bowl-shaped aspect of the external edges of tumor provided excellent sensitivity for T3/T4 inclusion (Se 97.7%, NPV 85.7%). Thickening of a fascia or the abdominal wall provided good specificity for T4 stage (Sp 88.1%, NPV 94.9%). Enhancement over 100 HU of at least one peritumoral lymph node was the best criterion of N+ staging (Sp 67.7%, NPV 87.5%). WE-MDCT permits good staging of colon cancer based on objective features.

  20. Effect of rectal enemas on rectal dosimetric parameters during high-dose-rate vaginal cuff brachytherapy. A prospective trial

    Energy Technology Data Exchange (ETDEWEB)

    Sabater, Sebastia; Andres, Ignacio; Sevillano, Marimar; Berenguer, Roberto; Aguayo, Manuel; Villas, Maria Victoria [Complejo Hospitalario Universitario de Albacete (CHUA), Department of Radiation Oncology, Albacete (Spain); Gascon, Marina; Arenas, Meritxell [Hospital Universitari Sant Joan, Department of Radiation Oncology, Reus (Spain); Rovirosa, Angeles; Camacho-Lopez, Cristina [University of Barcelona, IDIBAPS, Gynecological Cancer Unit, Radiation Oncology Department, ICMHO, Hospital Clinic, Barcelona (Spain)

    2016-04-15

    To evaluate the effects of rectal enemas on rectal doses during postoperative high-dose-rate (HDR) vaginal cuff brachytherapy (VCB). This prospective trial included 59 patients. Two rectal cleansing enemas were self-administered before the second fraction, and fraction 1 was considered the basal status. Dose-volume histogram (DVH) values were generated for the rectum and correlated with rectal volume variation. Statistical analyses used paired and unpaired t-tests. Despite a significant 15 % reduction in mean rectal volume (44.07 vs. 52.15 cc, p = 0.0018), 35.6 % of patients had larger rectums after rectal enemas. No significant rectal enema-related DVH differences were observed compared to the basal data. Although not statistically significant, rectal cleansing-associated increases in mean rectal DVH values were observed: D{sub 0.1} {sub cc}: 6.6 vs. 7.21 Gy; D{sub 1} {sub cc}: 5.35 vs. 5.52 Gy; D{sub 2} {sub cc}: 4.67 vs. 4.72 Gy, before and after rectal cleaning, respectively (where D{sub x} {sub cc} is the dose to the most exposed x cm {sup 3}). No differences were observed in DVH parameters according to rectal volume increase or decrease after the enema. Patients whose rectal volume increased also had significantly larger DVH parameters, except for D{sub 5} {sub %}, D{sub 25} {sub %}, and D{sub 50} {sub %}. In contrast, in patients whose rectal volume decreased, significance was only seen for D{sub 25} {sub %} and D{sub 50} {sub %} (D{sub x} {sub %} dose covering x % of the volume). In the latter patients, nonsignificant reductions in D{sub 2} {sub cc}, D{sub 5} {sub cc} and V{sub 5} {sub Gy} (volume receiving at least 5 Gy) were observed. The current rectal enemas protocol was ineffective in significantly modifying rectal DVH parameters for HDR-VCB. (orig.) [German] Beurteilung der Auswirkungen von rektalen Dosen waehrend postoperativer High-Dose-Rate-(HDR-)Brachytherapie an der Scheidenmanschette (''vaginal cuff brachytherapy'', VCB). An

  1. On Continent-Continent Point-Collision and Ultrahigh-Pressure Metamorphism

    Institute of Scientific and Technical Information of China (English)

    董树文; 武红岭; 刘晓春; 薛怀民

    2002-01-01

    Up to now it is known that almost all ultrahigh-pressure (UHP) metamorphism of non-impact origin occurred in continent-continent collisional orogenic belt, as has been evidenced by many outcrops in the eastern hemisphere. UHP metamorphic rocks are represented by coesite- and diamond-bearing eclogites and eclogite facies metamorphic rocks formed at 650–800°C and 2.6–3.5 Gpa, and most of the protoliths of UHP rocks are volcanic-sedimentary sequences of continental crust. From these it may be deduced that deep subduction of continental crust may have occurred. However, UHP rocks are exposed on the surface or occur near the surface now, which implies that they have been exhumed from great depths. The mechanism of deep subduction of continental crust and subsequent exhumation has been a hot topic of the research on continental dynamics, but there are divergent views. The focus of the dispute is how deep continental crust is subducted so that UHP rocks can be formed and what mechanism causes it to be subducted to great depths and again exhumed to the shallow surface. Through an analysis of the continental process and mechanical boundary conditions of the Dabie collisional belt—an UHP metamorphic belt where the largest area of UHP rocks in the world is exposed, this paper discusses the variations of viscous stresses and average pressure in the viscous fluid caused by tectonism with rock physical properties and the contribution of the tectonic stresses to production of UHP. Calculation indicates that the anomalous stress state on the irregular boundary of a continental block may give rise to stress concentration and accumulation at local places (where the compressional stress may be 5–9 times higher than those in their surroundings). The tectonic stresses may account for 20–35% of the total UHP. So we may infer that the HP (high-pressure)-UHP rocks in the Dabie Mountains were formed at depths of 60–80 km. Thus the authors propose a new genetic model of UHP

  2. Clinical analysis of diabetic nephropathy by rhubarb-based medicine enema%大黄为主中药灌肠治疗2型糖尿病肾病的研究

    Institute of Scientific and Technical Information of China (English)

    郭俊; 陈莉明; 常宝成; 郑妙艳; 温娟娟; 孙红喜

    2011-01-01

    of type 2 diabetic patients with renal insufficiency by rhubarb-based medicine enema and analyze the related factors affecting the therapeutic effect. Methods 140 type 2 diabetic patients with both type 2 diabetic nephropathy and chronic renal insufficiency were randomly divided into four groups,conventional treatment group(32 cases) sconventional oral drug treatment,rhubarb enema group 1 (38 cases): conventional therapy plus rhubarb enema two times per day,rhubarb enema group 2 (33 cases):conventional therapy plus rhubarb enema once per day, mixed enema group (37 cases) : conventional therapy plus rhubarb enema once per day and an enema of medicinal carbon tablets per day. Results The total effective rate of rhubarb enema group 1 .mixed enema group, rhubarb enema group 2 was 84. 2%, 78. 4% , 66. 6% , respectively, the total effect of rhubarb enema group 1 was significantly greater than the conventional treatment group( P <0. 05). After treatment,BUN in rhubarb enema group 1 and mixed enema group were lower than that in conventional treatment group, rhubarb enema group 1 (8. 54±3. 02) mmol/L vs mixed enema group (9. 04±2. 77) mmol/L vs conventional treatment group (10. 85 ±3. 79) mmol/L,respectively) 24 urine total protein was lower in rhubarb enema group 1, mixed enema group and rhubarb enema group 2 than that in conventional treatment group,rhubarb enema 1 and mixed enema group less than rhubarb enema 2,rhubarb enema groupl (1.66±0.46) g vs mixed enema group (1.81±0.43) g vs rhubarb enema group 2 (2. 05±0. 53) g vs conventional treatment group (2. 35±0. 57) g. Glomerular filtration rate which in rhubard enema group 1 and mixed enema group more than rhubarb enema group 2,rhubard enema group 1 (45. 83±8. 43) ml/min vs mixed enema group ( 39. 68 ± 7. 95) ml/min vs rhubarb enema group 2 ( 37. 53 ± 7. 85 ) ml/min vs conventional treatment group (35. 23 ± 8. 82) ml/min, respectively ( P <0.01). Multivariate non-conditional logistic regression analysis

  3. Mean Elevation of Continents and Survival of Islands

    Science.gov (United States)

    Zhang, Y.

    2009-12-01

    Continental mean elevation is controlled by tectonic uplift (including all solid earth processes and volcanic activities) and erosion, so is the mean thickness of continents. Assuming that a continent is large enough so that various tectonic processes can be averaged to behave similarly, the balance between uplift and erosion results in a steady state mean elevation that increases with the area of a continent (Zhang, 2005). The model fits the mean elevation of continents well, but many islands depart from the curve of mean elevation versus land area. Here I explore the elevation and survival of the islands. An island is small so that one cannot assume it would display average character in terms of tectonic processes. Oceanic islands are there largely because of recent volcanic activities leading to an uplift rate much higher than the average uplift rate. On the other hand, once such special conditions fade away, islands are eroded rapidly. Based on the modeling of Zhang (2005), the half-erosion time to erode an island is roughly proportional to the square root of the land area of the island. Hence, scaling from the half-erosion time of the largest continent (about 100 Myr, Harrison, 1994), the half-erosion time for islands once tectonic activity stops can be estimated. For example, the half-erosion time for Hawaii Island is estimated to be 1.3 Myr, roughly consistent with the rate of disappearing of older Hawaiian Islands. The half-erosion time is 0.16 Myr for the present-day Easter Island, and 10 Myr for Madagascar once uplift stops. In view of the short erosion time scale, the islands are present and survive because of special tectonics, such as volcanic activities, recent separation from continents, etc. References: C.G.A. Harrison (1994) Geol. Rundsch. 83, 431-447. Y. Zhang (2005) Earth Planet. Sci. Lett. 237, 524-531.

  4. Small skills of infants using glycerine enema%婴幼儿使用开塞露灌肠的小技巧

    Institute of Scientific and Technical Information of China (English)

    陈金珠

    2015-01-01

    The improvement method of infants using glycerine enema was applied in the clinical practice.The method is relatively simple, can reduce the patient’s pain and precise control drug dose, full play the effective role of glycerine enema, is worthy of applying in the clinical practice.%通过在临床实践中应用婴幼儿使用开塞露灌肠的改良方法,发现该方法相对简单,既可减轻患儿的痛苦,又能精确控制药物剂量,充分发挥开塞露的有效作用,值得在临床推广应用。

  5. Effects of budesonide and probiotics enemas on the colonic mucosa of rats with experimental colitis Efeito de enemas contendo budesonida e probióticos na mucosa colonica de ratos com colite experimental

    Directory of Open Access Journals (Sweden)

    Mardem Machado de Souza

    2007-02-01

    Full Text Available PURPOSE: To investigate the effect of enemas containing probiotics and budesonide on the colonic mucosa in experimental colitis. METHODS: Fifty male Wistar rats with experimental colitis induced by 10% acetic acid enema were randomized to five groups (10 rats each according to the treatment: group 1 - saline solution, group 2 - budesonide (0.75 mg/kg/day, group 3 - probiotics (1mg/day, group 4 - probiotics plus budesonide, and group 5 - control, with not-treated rats. The following variables were studied: body weight, macroscopic and microscopic score of the colonic mucosa, and DNA content of the mucosa. RESULTS: All animals lost weight between the beginning and the end of the experiment (280+ 16 mg versus 249+21 mg, pOBJETIVO: Investigar o efeito da administração retal de probióticos e budesonida na mucosa colônica de ratos com colite experimental. MÉTODOS: Cinquenta ratos Wistar com colite experimental induzida pelo ácido acético à 10% foram randomizados em 5 grupos (n=10 por grupo para diferentes tratamentos: grupo 1 - solução fisiológica; grupo 2 - budesonida (0,75mg/kg/dia; grupo 3 - probióticos (1 g/dia; grupo 4 - probióticos associados a budesonida; e finalmente grupo 5 - controle, composto por ratos sem tratamento. As seguintes variáveis foram estudadas: peso corporal, aspecto macroscópico e microscópico da mucosa e conteúdo de DNA da mucosa colônica. RESULTADOS: Todos os animais perderam peso entre o início e o fim do experimento (280±16 vs 249±21g; p<0.001. Não houve diferença estatística significativa entre os grupos em relação a macroscopia e histologia. O grupo budesonida + probiótico apresentou conteúdo de DNA maior que o grupo controle (1,24±0,15 versus 0,92±0,30 g/100g de tecido; p=0,01. CONCLUSÃO: A associação de budesonida com probióticos acelera o trofismo mucoso na colite experimental.

  6. Effects of budesonide and probiotics enemas on the systemic inflammatory response of rats with experimental colitis Efeito de enemas contendo budesonida e probióticos na resposta inflamatória sistêmica de ratos com colite experimental

    Directory of Open Access Journals (Sweden)

    Mardem Machado de Souza

    2007-01-01

    Full Text Available PURPOSE: The aim of this study was to investigate the effect of enemas containing probiotics and budesonide on the systemic inflammatory response in experimental colitis. METHODS: Fifty male Wistar rats with experimental colitis induced by 10% acetic acid enema were randomized to five groups (10 rats each according to the treatment: group 1 - saline solution, group 2 - budesonide (0.75 mg/kg/day, group 3 - probiotics (1mg/day, group 4 - probiotics plus budesonide, and group 5 - control, with not-treated rats. The following variables were studied: body weight, serum levels of albumin, C-reactive protein and interleucine-6 (IL-6. RESULTS: All animals lost weight between the beginning and the end of the experiment (280+ 16 mg versus 249+21 mg, p0.05. Only probiotic rats presented a significant decrease of IL-6 than controls (0,30±0,08 mg/dL vs. 0,19±0,03 mg/dL; pOBJETIVO: Investigar o efeito da administração retal de probióticos e budesonida na resposta inflamatória de ratos com colite experimental. MÉTODOS: Cinqüenta ratos Wistar com colite experimental induzida pelo acido acético à 10% foram randomizados em 5 grupos (n=10 por grupo para diferentes tratamentos: grupo 1 - solução fisiológica; grupo 2 budesonida (0,75mg/kg/dia; grupo 3 - probióticos (1 g/dia; grupo 4 - probióticos associados a budesonida; e finalmente grupo 5 - controle, composto por ratos sem tratamento. As seguintes variáveis foram estudadas: peso corporal, dosagens séricas de albumina, proteína C reativa (PCR e interleucina-6 (IL-6. RESULTADOS: Todos os animais perderam peso entre o inicio e o fim do experimento (280±16 vs 249±21g; p0.05. As comparações entre o grupo controle (0,30±0,08 mg/dL e outros mostraram que houve uma queda significante nos níveis de IL-6 apenas no grupo probiótico (0,19±0,03 mg/dL; p<0.01. CONCLUSÃO: Probióticos são efetivos na diminuição do estado inflamatório mediado pela IL-6 na colite experimental.

  7. A Geological Model for the Evolution of Early Continents (Invited)

    Science.gov (United States)

    Rey, P. F.; Coltice, N.; Flament, N. E.; Thébaud, N.

    2013-12-01

    Geochemical probing of ancient sediments (REE in black shales, strontium composition of carbonates, oxygen isotopes in zircons...) suggests that continents were a late Archean addition at Earth's surface. Yet, geochemical probing of ancient basalts reveals that they were extracted from a mantle depleted of its crustal elements early in the Archean. Considerations on surface geology, the early Earth hypsometry and the rheology and density structure of Archean continents can help solve this paradox. Surface geology: The surface geology of Archean cratons is characterized by thick continental flood basalts (CFBs, including greenstones) emplaced on felsic crusts dominated by Trondhjemite-Tonalite-Granodiorite (TTG) granitoids. This simple geology is peculiar because i/ most CFBs were emplaced below sea level, ii/ after their emplacement, CFBs were deformed into relatively narrow, curviplanar belts (greenstone basins) wrapping around migmatitic TTG domes, and iii/ Archean greenstone belts are richly endowed with gold and other metals deposits. Flat Earth hypothesis: From considerations on early Earth continental geotherm and density structure, Rey and Coltice (2008) propose that, because of the increased ability of the lithosphere to flow laterally, orogenic processes in the Archean produced only subdued topography (atmosphere and mantle systems, and did not contribute significantly to the sedimentary records. 2/ These continents evolved under the possibly episodic drive of plate tectonic processes, and certainly also under the drive of the density inversion imposed by the greenstone/TTG stratigraphy. Thébaud and Rey (2013) emphasized that sagduction was able to drive crustal-scale deformation in the interior of continents, away from plate margins. Since this process occurred on flooded continents, an infinite fluid reservoir was available to feed crustal-scale hydrothermal circulations promoting the formation of craton-wide metal deposits in the interior of continents

  8. A study of brain protection during total arch replacement comparing antegrade cerebral perfusion versus hypothermic circulatory arrest, with or without retrograde cerebral perfusion: analysis based on the Japan Adult Cardiovascular Surgery Database.

    Science.gov (United States)

    Okita, Yutaka; Miyata, Hiroaki; Motomura, Noboru; Takamoto, Shinichi

    2015-02-01

    Antegrade cerebral perfusion and hypothermic circulatory arrest, with or without retrograde cerebral perfusion, are 2 major types of brain protection that are used during aortic arch surgery. We conducted a comparative study of these methods in patients undergoing total arch replacement to evaluate the clinical outcomes in Japan, based on the Japan Adult Cardiovascular Surgery Database. A total of 16,218 patients underwent total arch replacement between 2009 and 2012. Patients with acute aortic dissection or ruptured aneurysm, or who underwent emergency surgery were excluded, leaving 8169 patients for analysis. For the brain protection method, 7038 patients had antegrade cerebral perfusion and 1141 patients had hypothermic circulatory arrest/retrograde cerebral perfusion. A nonmatched comparison was made between the 2 groups, and propensity score analysis was performed among 1141 patients. The matched paired analysis showed that the minimum rectal temperature was lower in the hypothermic circulatory arrest/retrograde cerebral perfusion group (21.2°C ± 3.7°C vs 24.2°C ± 3.2°C) and that the duration of cardiopulmonary bypass and cardiac ischemia was longer in the antegrade cerebral perfusion group. There were no significant differences between the antegrade cerebral perfusion and hypothermic circulatory arrest/retrograde cerebral perfusion groups with regard to 30-day mortality (3.2% vs 4.0%), hospital mortality (6.0% vs 7.1%), incidence of stroke (6.7% vs 8.6%), or transient neurologic disorder (4.1% vs 4.4%). There was no difference in a composite outcome of hospital death, bleeding, prolonged ventilation, need for dialysis, stroke, and infection (antegrade cerebral perfusion 28.4% vs hypothermic circulatory arrest 30.1%). However, hypothermic circulatory arrest/retrograde cerebral perfusion resulted in a significantly higher rate of prolonged stay in the intensive care unit (>8 days: 24.2% vs 15.6%). Hypothermic circulatory arrest/retrograde cerebral

  9. A note on continents and the Earth's Urey ratio

    Science.gov (United States)

    Lenardic, A.; Cooper, C. M.; Moresi, L.

    2011-09-01

    The Urey ratio (mantle heat production divided by heat loss) is a key constraint for thermal history models. Recent Urey ratio estimates are in the range of 0.21-0.49. It has been well noted in the literature that classic thermal history models predict a larger value. The extent of the discrepancy is considered significant enough to be deemed a paradox. The 'Urey ratio paradox' has motivated a number of studies and some considerable debates. Classic thermal history models, and the majority of those that have followed, do not explicitly consider the effects of continents. For consistency, the present day observations they seek to match should be adjusted to account for continents. We use mantle convection simulations with continents to argue that the adjusted ratio shifts to 0.33-0.76. Classic thermal history models predict a Urey ratio that, although at the high end, is within this range. This suggests that the 'paradox' has been exaggerated. It also points toward a first-order role for continents in the Earth's thermal evolution

  10. Heat flow distribution in Chinese continent and its adjacent areas

    Institute of Scientific and Technical Information of China (English)

    Wei Tao; Zhengkang Shen

    2008-01-01

    Using a compilation of 6980 heat flow measurements, we produce a new heat flow map for the Chinese continent and its adjacent areas. We develop an objective and integrated method to interpolate the heat flow data, taking into account both the uniformity within geological units and coherency of regional heat flow. The geologic units are outlined based on Zhang et al.'s active tectonic block model.Our heat flow model is presented in two formats: a contour map and a heat flow dataset with values on a 1 × 1° grid for the Chinese continent and its adjacent areas, reflecting detailed variations in some regions. Also provided is a resolution map which helps understand the reliability of the heat flow model. Our results reveal that (1) Heat flows in the eastern part of the Chinese continent are relatively higher than those in the western part except that in the Tibetan Plateau area. (2) Heat flows in the Ordos and North China blocks are around 60 mW/m2, and are 50-55 mW/m2 in South China except for the continental marginal sea regions. (3) Heat flow is the lowest in the Jtmggar Basin, only 35-45 mW/m2, and is 45-55 mW/m2 in the Tarim Basin. The results of this study provide an important data-set for studies on thermal and rheological structures of the Chinese continent and its adjacent areas.

  11. The ContiNet of the International Continence Society.

    Science.gov (United States)

    Lim, P H; Fonda, D

    1997-01-01

    This is an account of the International Continence Society's ContiNet--the web server linking up continence organisations worldwide with provision to upload or download vast data stores of information on continence via e-mail, FTP, mailing lists, and special tools to seek information using "search engines." Special communication devices using internet voice/phone mail and real-time "text" or "voice" chats permit conversation globally over normal phone lines linked to the Net at local telephone rates. Special features of ContiNet include announcements of upcoming conventions, information for professionals and laypeople, and the capability to conduct research via the net and conduct consultations and discussions via newsgroups. In-built devices requiring special IDs and passwords permit privacy and security for users. Simple instructions are provided on how to get your PC up and running and get connected to fellow members of ICS, link up with national continence societies, or simply surf for professional enrichment and leisure. With the advent of advanced multimedia capabilities, the current poor quality videoconferencing on the Net will be replaced by excellent videophones by 1998.

  12. Mitrofanoff procedure: A versatile method of continent catheterisable urinary diversion

    Directory of Open Access Journals (Sweden)

    Tejanshu P Shah

    2002-01-01

    Conclusions: Mitrofanoff procedure is a versatile tech-nique. The extension of this principle can provide conti-nence mechanism to variety of patients, with or without total or partial substitution of bladder, in whom there is no usable urethra or sphincter or both.

  13. Choosing and using disposable body-worn continence pads.

    Science.gov (United States)

    Gilbert, Rachel

    Disposable, body-worn pads are the product most commonly chosen to contain and absorb urine and faeces (Pomfret, 2000). The cost to the NHS of supplying continence pads has been estimated at 80 million pounds per annum (Euromonitor, 1999) and is a huge financial burden on local services.

  14. Regulating continent growth and composition by chemical weathering.

    Science.gov (United States)

    Lee, Cin-Ty Aeolus; Morton, Douglas M; Little, Mark G; Kistler, Ronald; Horodyskyj, Ulyana N; Leeman, William P; Agranier, Arnaud

    2008-04-01

    Continents ride high above the ocean floor because they are underlain by thick, low-density, Si-rich, and Mg-poor crust. However, the parental magmas of continents were basaltic, which means they must have lost Mg relative to Si during their maturation into continents. Igneous differentiation followed by lower crustal delamination and chemical weathering followed by subduction recycling are possible solutions, but the relative magnitudes of each process have never been quantitatively constrained because of the lack of appropriate data. Here, we show that the relative contributions of these processes can be obtained by simultaneous examination of Mg and Li (an analog for Mg) on the regional and global scales in arcs, delaminated lower crust, and river waters. At least 20% of Mg is lost from continents by weathering, which translates into >20% of continental mass lost by weathering (40% by delamination). Chemical weathering leaves behind a more Si-rich and Mg-poor crust, which is less dense and hence decreases the probability of crustal recycling by subduction. Net continental growth is thus modulated by chemical weathering and likely influenced by secular changes in weathering mechanisms.

  15. Effect of the modified nerve-sparing technique in open antegrade radical prostatectomy for 30 patients with prostate cancer%改良的保留神经根治性前列腺癌切除术30例

    Institute of Scientific and Technical Information of China (English)

    朱再生; 付强; 徐礼臻; 罗荣利; 张春霆; 刘全启; 陈良佑

    2015-01-01

    目的 探讨改良的保留神经根治性前列腺癌切除术的临床疗效.方法 30例前列腺癌患者采用改良根治性保留神经的前列腺切除术.改良的关键点:采用注水分离前列腺周围筋膜的方法,将Veil保留神经技术应用于开放手术中(即改良Veil保留神经技术);扩大分区(9区5组)盆腔淋巴结清扫;完整保留膀胱颈;集束捆扎背深静脉复合体;跳针套叠技术行膀胱与尿道的吻合.术后行控尿及勃起功能国际问卷-5(IIEF-5)随访.结果 患者平均年龄62岁,前列腺特异性抗原(PSA)水平平均11.9 ng/ml,手术时间平均150 min(75~240 min),术中出血量平均350 ml(100~1 600 ml),术前IIEF-5评分平均为21分,病理分期pT18例、pT2a 15例、pT2b4例、pT3a 3例.Gleason评分5分2例、6分7例、7分20例、8分1例.手术切缘阳性4例,其中2例为T2期,占T2期的10.5%(2/19),2例为T3期.无围手术期严重并发症.平均随访19个月(6-48个月),术后1个月完全控尿27例(90%),3个月达100%.术后3个月和6个月IIEF-5评分分别为13、19分,分别恢复到术前水平的40%和70%.结论 对选择性的前列腺癌患者,改良的保留神经根治性前列腺切除术较完整保留了前列腺周围所有的筋膜神经,使术后控尿及性功能得到早期、快速恢复,切缘阳性发生率低,疗效可靠.%Objective To evaluate the clinical value of the modified nerve-sparing open antegrade retropubic radical prostatectomy (MNS-ORP).Methods MNS-ORPs were performed in 30 patients with clinically localized prostate cancer.The modified technique included: endopelvic fascia was not incised, the prostate capsule was freed laterally from surrounding fasciae and dorsally;using the method of separating the peripheral fascia of the prostate, the Veil technique was applied to the open operation, that is, the modified Veil perserving nerve technology;pelvic lymph node dissections (9 regions and 5 groups) were extended;bladder neck

  16. The effect of timing of intravenous muscle relaxant on the quality of double-contrast barium enema

    Energy Technology Data Exchange (ETDEWEB)

    Elson, E.M.; Campbell, D.M.; Halligan, S.; Shaikh, I.; Davitt, S.; Bartram, C.I

    2000-05-01

    AIM: To determine whether the timing of buscopan administration during double-contrast barium enema examination (DCBE) affects diagnostic quality. MATERIALS AND METHODS: In a prospective setting, 100 consecutive adult out-patients referred for DCBE received 20 mg buscopan (hyoscine-N-butylbromide) intravenously, either before infusion of barium suspension (Group A) or after barium infusion and gas insufflation (Group B). A subjective assessment of ease of contrast medium infusion was made at the time of examination and the films subsequently analysed by two radiologists unaware of the mode of relaxant administration, who noted the quality of mucosal coating and made subjective and objective measurements of segmental distension. RESULTS: There was no significant difference in screening times, infusion difficulty or colonic contrast medium coating between the two groups. Subjective assessment of distension of the caecum, ascending colon, transverse colon and rectum were not significantly different. Patients receiving intravenous relaxant after barium and gas infusion had less subjective descending (P = 0.05) and sigmoid (P = 0.04) colon distension, but there was no significant difference with respect to maximal bowel diameter in any of the segments measured. CONCLUSION: The timing of intravenous administration during DCBE is likely to have no significant effect on the diagnostic quality of the study. Elson, E.M. (2000)

  17. Hereditary nonpolyposis colorectal cancer: not just a barium enema{exclamation_point} Radiographic manifestations and screening tools

    Energy Technology Data Exchange (ETDEWEB)

    Foster, L.; Jeon, P. [Health Sciences Center, Diagnostic Imaging, St. John' s, Newfoundland (Canada)]. E-mail: u43dlb@mun.ca; Green, J. [Health Sciences Center, Discipline of Genetics, Faculty of Medicine, St. John' s, Newfoundland (Canada)

    2007-10-15

    Hereditary nonpolyposis colorectal cancer (HNPCC) is an autosomal dominant trait characterized by presentation of colorectal cancer (CRC) at an early age and by an increased risk of other primary malignancies, including those of the endometrium. ovaries, stomach, small bowel, upper biliary tract, skin, and brain, as well as by transitional cell carcinoma (TCC) that especially involves the renal pelvis and ureter. Because specific genetic mutations causing HNPCC have been recently discovered, genetic screening options have been developed for some families. Subsequently, radiology has an increasing role in surveillance for and management of these HNPCC-associated tumours. Although colonoscopy is the mainstay of a screening regimen for colon cancer, the barium enema has been a standard radiologic investigation. Further, computed tomography (CT) colonography (now practised in various centres) will, with further refinement, prove to be of increasing value. Ultrasonography is a standard investigation for endometrial and ovarian cancer, with CT and magnetic resonance (MR) imaging often playing a central role. As for TCC, intravenous urography (IVU) had been a standard investigation tool. However, with continued evolution of multidetector row CT with postprocessing manipulation (CT urography [CTU]), the role of IVU is diminishing in most centres. Newfoundland has a high prevalence of HNPCC exhibiting a broad range of manifestations. In this article, radiologic images of various tumours from individuals with HNPCC demonstrate a radiologic spectrum of this fascinating hereditary disease. Screening implications and specific screening methods are reviewed. (author)

  18. Balloon-Occluded Antegrade Transvenous Sclerotherapy to Treat Rectal Varices: A Direct Puncture Approach to the Superior Rectal Vein Through the Greater Sciatic Foramen Under CT Fluoroscopy Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Ono, Yasuyuki, E-mail: onoyasy@hirakata.kmu.ac.jp; Kariya, Shuji, E-mail: kariyas@hirakata.kmu.ac.jp; Nakatani, Miyuki, E-mail: nakatanm@hirakata.kmu.ac.jp; Yoshida, Rie, E-mail: yagir@hirakata.kmu.ac.jp; Kono, Yumiko, E-mail: kohnoy@hirakata.kmu.ac.jp; Kan, Naoki, E-mail: kanna@takii.kmu.ac.jp; Ueno, Yutaka, E-mail: uenoyut@hirakata.kmu.ac.jp; Komemushi, Atsushi, E-mail: komemush@takii.kmu.ac.jp; Tanigawa, Noboru, E-mail: tanigano@hirakata.kmu.ac.jp [Kansai Medical University, Department of Radiology (Japan)

    2015-10-15

    Rectal varices occur in 44.5 % of patients with ectopic varices caused by portal hypertension, and 48.6 % of these patients are untreated and followed by observation. However, bleeding occurs in 38 % and shock leading to death in 5 % of such patients. Two patients, an 80-year-old woman undergoing treatment for primary biliary cirrhosis (Child-Pugh class A) and a 63-year-old man with class C hepatic cirrhosis (Child-Pugh class A), in whom balloon-occluded antegrade transvenous sclerotherapy was performed to treat rectal varices are reported. A catheter was inserted by directly puncturing the rectal vein percutaneously through the greater sciatic foramen under computed tomographic fluoroscopy guidance. In both cases, the rectal varices were successfully treated without any significant complications, with no bleeding from rectal varices after embolization.

  19. Similar cerebral protective effectiveness of antegrade and retrograde cerebral perfusion during deep hypothermic circulatory arrest in aortic surgery: a meta-analysis of 7023 patients.

    Science.gov (United States)

    Guo, Shasha; Sun, Yanhua; Ji, Bingyang; Liu, Jinping; Wang, Guyan; Zheng, Zhe

    2015-04-01

    In aortic arch surgery, deep hypothermic circulatory arrest (DHCA) combined with cerebral perfusion is employed worldwide as a routine practice. Even though antegrade cerebral perfusion (ACP) is more widely used than retrograde cerebral perfusion (RCP), the difference in benefit and risk between ACP and RCP during DHCA is uncertain. The purpose of this meta-analysis is to compare neurologic outcomes and early mortality between ACP and RCP in patients who underwent aortic surgery during DHCA. PubMed, EMBASE, and the Cochrane Library were searched using the key words "antegrade," "retrograde," "cerebral perfusion," "cardiopulmonary bypass," "extracorporeal circulation," and "cardiac surgery" for studies reporting on clinical endpoints including early mortality, stroke, temporary neurologic dysfunction (TND), and permanent neurologic dysfunction (PND) in aortic surgery requiring DHCA with ACP or RCP. Heterogeneity was analyzed with the Cochrane Q statistic and I(2) statistic. Publication bias was tested with Begg's funnel plot and Egger's test. Thirty-four studies were included in this meta-analysis, with 4262 patients undergoing DHCA + ACP and 2761 undergoing DHCA + RCP. The overall pooled relative risk for TND was 0.722 (95% CI = [0.579, 0.900]), and the z-score for overall effect was 2.9 (P = 0.004). There was low heterogeneity (I(2) = 18.7%). The analysis showed that patients undergoing DHCA + ACP had better outcomes than those undergoing DHCA + RCP in terms of TND, while there were no significant differences between groups in terms of PND, stroke, and early mortality. This meta-analysis indicates that DHCA + ACP has an advantage over DHCA + RCP in terms of TND, while the two methods show similar results in terms of PND, early mortality, and stroke.

  20. Human duodenal phase III migrating motor complex activity is predominantly antegrade, as revealed by high-resolution manometry and colour pressure plots.

    Science.gov (United States)

    Andrews, J M; O'donovan, D G; Hebbard, G S; Malbert, C H; Doran, S M; Dent, J

    2002-08-01

    Abstract Late phase III migrating motor complex activity has been said to be primarily retroperistaltic but has not been assessed with high resolution manometry or three-dimensional colour pressure plots (pressure/time/distance). Duodenal phase III was examined in healthy young volunteers (seven male, two female) with a 20-lumen assembly. With the most proximal sidehole in the distal antrum, after a 4.5-cm interval 18 sideholes at 1.5-cm intervals spanned the duodenum with a final sidehole 3 cm beyond. Fasting pressures were recorded until phase III occurred. Comparisons were made between proximal (P) and distal (D) duodenum during early (E) (first 0.5-1 min) and late (L) (last 0.5-1 min) phase III. With colour pressure analysis, 121 of 180 pressure wave (PW) sequences were purely antegrade, two purely retrograde and 57 bidirectional. Ten of fifty-seven bidirectional PW sequences were complex, branching to become two separate sequences. Bidirectional sequences occurred more frequently in late than early phase III (L 43 vs. E 14 of 57), but their occurrence did not differ between proximal and distal duodenum (P31 vs. D 24 of 57). Antegrade propagation velocity was faster in late compared with early phase III (L 28.50 vs. E 17.05 mm s(-1); P = 0.006), but did not differ between proximal and distal duodenum. Colour pressure analysis also indicated an intermittent segmental pattern to phase III, with each subject exhibiting a change in velocity or direction, or a relative failure of peristalsis somewhere along the duodenum during part of phase III. Duodenal phase III is not homogenous and, in contrast with previous studies, does not primarily constitute a retroperistaltic pump. Colour pressure analysis is useful in interpreting intraluminal pressure profiles and may improve the sensitivity and specificity of clinical studies.

  1. Feasibility and Safety of Vascular Closure Devices in an Antegrade Approach to Either the Common Femoral Artery or the Superficial Femoral Artery

    Energy Technology Data Exchange (ETDEWEB)

    Gutzeit, Andreas, E-mail: andreas.gutzeit@ksw.ch; Schie, Bram van, E-mail: Bram.vanschie@hotmail.com; Schoch, Eric, E-mail: eric.schoch@ksw.ch [Cantonal Hospital Winterthur, Department of Radiology (Switzerland); Hergan, Klaus, E-mail: k.hergan@salk.at [Paracelsus Medical University Salzburg, Department of Radiology (Austria); Graf, Nicole, E-mail: graf@biostatistics.ch; Binkert, Christoph A., E-mail: christoph.binkert@ksw.ch [Cantonal Hospital Winterthur, Department of Radiology (Switzerland)

    2012-10-15

    Introduction: The purpose of the present study was to analyze complications following antegrade puncture of the common femoral artery (CFA) and the superficial femoral artery (SFA) using vascular closure systems (VCS). Methods: A single-center, retrospective study was performed after obtaining approval from the institutional review board and informed consent from all patients. At our center, the CFA or SFA are used for arterial access. All patients were evaluated clinically on the same day. If there was any suspicion of an access site problem, Duplex ultrasound was performed. Results: Access location was the CFA in 50 patients and the SFA in 130 patients. The sheath size ranged from 4F to 10F. Two patients had to be excluded because of lack of follow-up. Successful hemostasis was achieved in 162 of 178 cases (91 %). The following complications were observed in 16 patients (8.9 %): 4 pseudoaneurysms (2.2 %), 11 hematomas (6.2 %), and 1 vascular occlusion (0.5 %). The two pseudoaneurysms healed spontaneously, in one case an ultrasound-guided thrombin injection was performed, and one aneurysm was compressed manually. No further medical therapy was needed for the hematomas. The one vascular occlusion was treated immediately with angioplasty using a contralateral approach. No significant difference was noted between the CFA and the SFA group with respect to complications (p = 1.000). Conclusions: The use of closure devices for an antegrade approach up to 10F is feasible and safe. No differences in low complication rates were observed between CFA and SFA.

  2. Two-dimensional Numerical Modeling Research on Continent Subduction Dynamics

    Institute of Scientific and Technical Information of China (English)

    WANG Zhimin; XU Bei; ZHOU Yaoqi; XU Hehua; HUANG Shaoying

    2004-01-01

    Continent subduction is one of the hot research problems in geoscience. New models presented here have been set up and two-dimensional numerical modeling research on the possibility of continental subduction has been made with the finite element software, ANSYS, based on documentary evidence and reasonable assumptions that the subduction of oceanic crust has occurred, the subduction of continental crust can take place and the process can be simplified to a discontinuous plane strain theory model. The modeling results show that it is completely possible for continental crust to be subducted to a depth of 120 km under certain circumstances and conditions. At the same time, the simulations of continental subduction under a single dynamical factor have also been made, including the pull force of the subducted oceanic lithosphere, the drag force connected with mantle convection and the push force of the mid-ocean ridge. These experiments show that the drag force connected with mantle convection is critical for continent subduction.

  3. Commissioning continence services--turning policy into action.

    Science.gov (United States)

    Thomas, Sue

    2004-05-18

    Incontinence of urine and faeces is a major issue in health care today. The financial cost is enormous with the NHS purchasing an annual 80 m Pounds worth of absorbent products alone (Euromonitor, 1999). But the financial cost is only part of the equation. Incontinence also has a considerable impact on the quality of life of those who experience it. The nature and impact on quality of life varies among individuals. However, where expert services are available cure rates can exceed 50 per cent (Royal College of Physicians, 1995). This suggests that specialist continence services have a vital role to play in helping patients improve their incontinence or manage their continence problems more effectively.

  4. Extreme events in gross primary production: a characterization across continents

    Directory of Open Access Journals (Sweden)

    J. Zscheischler

    2014-01-01

    Full Text Available Climate extremes can affect the functioning of terrestrial ecosystems, for instance via a reduction of the photosynthetic capacity or alterations of respiratory processes. Yet the dominant regional and seasonal effects of hydrometeorological extremes are still not well documented. Here we quantify and characterize the role of large spatiotemporal extreme events in gross primary production (GPP as triggers of continental anomalies. We also investigate seasonal dynamics of extreme impacts on continental GPP anomalies. We find that the 50 largest positive (increase in uptake and negative extremes (decrease in uptake on each continent can explain most of the continental variation in GPP, which is in line with previous results obtained at the global scale. We show that negative extremes are larger than positive ones and demonstrate that this asymmetry is particularly strong in South America and Europe. Most extremes in GPP start in early summer. Our analysis indicates that the overall impacts and the spatial extents of GPP extremes are power law distributed with exponents that vary little across continents. Moreover, we show that on all continents and for all data sets the spatial extents play a more important role than durations or maximal GPP anomaly when it comes to the overall impact of GPP extremes. An analysis of possible causes implies that across continents most extremes in GPP can best be explained by water scarcity rather than by extreme temperatures. However, for Europe, South America and Oceania we identify also fire as an important driver. Our findings are consistent with remote sensing products. An independent validation against a literature survey on specific extreme events supports our results to a large extent.

  5. What is important for continent catheterizable stomas: angulations or extension?

    Directory of Open Access Journals (Sweden)

    Marcelo L. Vilela

    2007-04-01

    Full Text Available OBJECTIVE: We developed an experimental ex-vivo model to define factors that may influence continence of catheterizable channels by urinary and colonic stomas based on the principle of imbrication of the outlet tube. MATERIALS AND METHODS: From 20 pigs, colon specimens with 25 cm length were obtained and a transverse flap with 3.0 cm length x 1.5 cm width in the average point of the intestine was tubulated to create an efferent tube. With the tube configured, it was embedded by 3 seromuscular stitches far 0.5 cm each other. A pressure study of both intra-luminal surface and channel was then conducted during the filling of the submerse piece with environmental air in a water container, to define the efferent channel continence. The study was repeated after the progressive release of suture stitches until only one stitch remains. RESULTS: Channel continence analyzed in each segment in three different valve length situations, making a total of 20 segments, revealed that with 3 stitches (1.5 cm valve the maximum average pressure prior to overflow was 54 cm H2O; 53.65 cm H2O with 2 stitches (1.0 cm of valve, and 55.45 cm H2O with only one stitch (0.5 cm of valve, which are the same values. The record at the segment explosion pressure was 67.87 cm H2O. CONCLUSION: The study showed that angulation of channel with colon, maintained by only one stitch (0.5 cm imbrication was more important than a larger extension of the valve, represented by 3 suture stitches (1.5 cm imbrication in order to allow continence to the efferent channel.

  6. OxyContin, prescription opioid abuse and economic medicalization

    OpenAIRE

    Poitras, Geoffrey

    2012-01-01

    Geoffrey PoitrasFaculty of Business Administration, Simon Fraser University, Vancouver, BC, CanadaAbstract: This paper examines the relevance of OxyContin diversion and abuse to the economic medicalization of substance abuse and addiction. Given that medicalization is the general social process of nonmedical problems being transformed into medical problems, economic medicalization occurs where the motivation for the transformation is commercial profitability or, in a corporate context, achiev...

  7. Surgical management of the neurogenic bladder and bowel

    Directory of Open Access Journals (Sweden)

    Mingin Gerald C.

    2003-01-01

    Full Text Available Spina bifida and myelodysplasia are associated with neurogenic abnormalities of the bladder and bowel function. All children with myelodysplasia require an evaluation of their urinary tract with ultrasound and urodynamics to confirm normal bladder and kidney function. Patients with anatomical and functional abnormalities require treatment, the mainstay being intermittent catheterization and anticholinergic medication. The treatment goals for patients with a neurogenic bladder are the preservation of the upper urinary tract, bladder and bowel continence, independence, autonomy, and facilitation of self-esteem. A minority of children will not respond to conservative therapy and will ultimately require surgical intervention. This review will discuss the surgical options for bladder augmentation, bladder neck reconstruction and closure, as well as the methods for the creation of continent catheterizable stomas. The timing, indications, and description for each procedure will be addressed. Finally, the antegrade continence enema procedure will be described for the management of refractory fecal incontinence.

  8. Observational Evidence of Changes in Soil Temperatures across Eurasian Continent

    Science.gov (United States)

    Zhang, T.

    2015-12-01

    Soil temperature is one of the key climate change indicators and plays an important role in plant growth, agriculture, carbon cycle and ecosystems as a whole. In this study, variability and changes in ground surface and soil temperatures up to 3.20 m were investigated based on data and information obtained from hydrometeorological stations across Eurasian continent since the early 1950s. Ground surface and soil temperatures were measured daily by using the same standard method and by the trained professionals across Eurasian continent, which makes the dataset unique and comparable over a large study region. Using the daily soil temperature profiles, soil seasonal freeze depth was also obtained through linear interpolation. Preliminary results show that soil temperatures at various depths have increased dramatically, almost twice as much as air temperature increase over the same period. Regionally, soil temperature increase was more dramatically in high northern latitudes than mid/lower latitude regions. Air temperature changes alone may not be able to fully explain the magnitude of changes in soil temperatures. Further study indicates that snow cover establishment started later in autumn and snow cover disappearance occurred earlier in spring, while winter snow depth became thicker with a decreasing trend of snow density. Changes in snow cover conditions may play an important role in changes of soil temperatures over the Eurasian continent.

  9. Crohn's disease recurrence in patients with ileocolic anastomosis: Value of computed tomography enterography with water enema

    Energy Technology Data Exchange (ETDEWEB)

    Paparo, Francesco [Department of Radiology, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa (Italy); Revelli, Matteo; Puppo, Cristina [School of Radiology, University of Genoa, Via Leon Battista Alberti 4, 16132 Genoa (Italy); Bacigalupo, Lorenzo; Garello, Isabella [Department of Radiology, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa (Italy); Garlaschi, Alessandro [School of Radiology, University of Genoa, Via Leon Battista Alberti 4, 16132 Genoa (Italy); Biscaldi, Ennio [Department of Radiology, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa (Italy); Rollandi, Ludovica [School of Medicine, University of Genoa, Via Leon Battista Alberti 4, 16132 Genoa (Italy); Binda, Gian Andrea [Division of General Surgery, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa (Italy); Rollandi, Gian Andrea, E-mail: rollandi@galliera.it [Department of Radiology, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa (Italy)

    2013-09-15

    Objectives: the main objective of the present work was to determine the diagnostic value of CT-enterography with water enema (CTe-WE) in the assessment of the ileocolic anastomosis in patients with Crohn's disease (CD). The prevalence of synchronous inflammatory lesions (SILs) involving gastrointestinal segments distinct from the anastomosis was also determined. Further, the association between the type of ileocolic anastomosis and the behavior (i.e. inflammatory, stricturing, penetrating) of CD recurrence was evaluated. Methods: 51 patients were retrospectively included (26 [51%] male and 25 [49%] female; mean age: 52.88 years ± 13.35). Ileocolic anastomoses were: 18 (35.3%) stapled side-to-side, 17 (33.3%) end-to-side, and 16 (31.4%) end-to-end. CTe-WEs were reviewed in consensus by two gastrointestinal radiologists. Endoscopy and medical records were used as reference standards. Results: CTe-WE yielded 95.35% sensitivity (CI 95%: 84.19–99.43%), 75.00% specificity (CI 95%: 34.91–96.81%), and 92.15% diagnostic accuracy (CI 95%: 81.31–98.02%). Anastomotic recurrence was found in 41/51 (80.4%) patients, including 30/41 (73.2%) cases of isolated anastomotic recurrence, and 11/41 (26.8%) cases of anastomotic recurrence with a SIL. A significant lower prevalence of stricturing recurrence was observed in patients with stapled side-to-side anastomoses (p = 0.033). Conclusions: CTe-WE provides a good distension of both sides of ileocolic anastomoses allowing the detection of SILs.

  10. Use of the contrast-enhanced CT enema in the management of penetrating trauma to the flank and back.

    Science.gov (United States)

    Phillips, T; Sclafani, S J; Goldstein, A; Scalea, T; Panetta, T; Shaftan, G

    1986-07-01

    There have been few innovations in the management of penetrating trauma of the flank and back since that reported by Peck and Berne in 1981. During 1984-1985 our Trauma Service treated 119 patients with injuries in these areas. In 56 patients management was based on the results of the contrast-enhanced CT enema (CECTE), a computerized tomographic technique designed to delineate all of the retroperitoneal viscera by simultaneously opacifying the small bowel, duodenum, colon, GU tract, and major vessels. Specific radiographic findings were present on 44 scans. Twelve scans were negative. Six scans were considered indications for angiography because of the proximity of the identified missile wounds or their hematomas to major vascular structures. One of these arteriograms revealed a renal artery pseudoaneurysm which would otherwise have remained undiagnosed. In 30 cases the penetrating wounds were well delineated by CECTE, and their nature and location were considered appropriate for nonoperative management. None required subsequent exploration. In eight cases CECTE demonstrated that the wounds were located so as to place specific viscera at risk for significant injury, but no definite injury was identified. Five of these patients were successfully managed by further evaluation and close observation, two were explored, and one signed out of the hospital. No scan demonstrated extravasation from a hollow viscus. Overall, 52 of our 56 patients (92%) were successfully managed nonoperatively on the basis of the interpretation of their CECTE findings. CECTE can be useful in the management of stable patients with penetrating trauma to the back and flank by identifying the nature and location of the resulting retroperitoneal injuries.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Comparison between CT Colonography and Double-Contrast Barium Enema for Colonic Evaluation in Patients with Renal Insufficiency

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Sun Young; Park, Seong Ho; Lee, Seung Soo; Lee, Ju Hee; Kim, Ah Young; Park, Su Ki; Han, Duck Jong; Ha, Hyun Kwon [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    To compare the CT colonography (CTC) and double-contrast barium enema (DCBE) for colonic evaluation in patients with renal insufficiency. Two sequential groups of consecutive patients with renal insufficiency who had a similar risk for colorectal cancer, were examined by DCBE (n = 182; mean {+-} SD in age, 51 {+-} 6.4 years) and CTC (n = 176; 50 {+-} 6.7 years), respectively. CTC was performed after colon cleansing with 250-mL magnesium citrate (n = 87) or 4-L polyethylene glycol (n = 89) and fecal tagging. DCBE was performed after preparation with 250-mL magnesium citrate. Patients with colonic polyps/masses of {>=} 6 mm were subsequently recommended to undergo a colonoscopy. Diagnostic yield and positive predictive value (PPV) for colonic polyps/masses, examination quality, and examination-related serum electrolyte change were retrospectively compared between the two groups. Both the CTC and DCBE were positive for colonic polyps/masses in 28 (16%) of 176 and 11 (6%) of 182 patients, respectively (p = 0.004). Among patients with positive findings, 17 CTC and six DCBE patients subsequently underwent a colonoscopy and yielded a PPV of 88% (15 of 17 patients) and 50% (3 of 6 patients), respectively (p = 0.089). Thirteen patients with adenomatous lesions were detected in the CTC group (adenocarcinoma [n = 1], advanced adenoma [n = 6], and non-advanced adenoma [n = 6]), as compared with two patients (each with adenocarcinoma and advanced adenoma) in the DCBE group (p = 0.003). Six (3%) of 176 CTC and 16 (9%) of 182 DCBE examinations deemed to be inadequate (p 0.046). Electrolyte changes were similar in the two groups. In patients with renal insufficiency, CTC has a higher diagnostic yield and a marginally higher PPV for detecting colorectal neoplasia, despite a similar diagnostic yield for adenocarcinoma, and a lower rate of inadequate examinations as compared with DCBE.

  12. TCM Sequential Enema Treat Acute Gouty Arthritis%中药序贯灌肠治疗急性痛风性关节炎临床观察

    Institute of Scientific and Technical Information of China (English)

    李晓霞; 赵威

    2013-01-01

    [Objective] To observe the clinical effect of sequential enema treatment on acute gouty arthritis. [Method]60 patients were divided randomly in two groups named traditional Chinese medicine enema in the treatment of group sequential and the control group of Western Medicine. Observation of the two groups before and after treatment syndrome of traditional Chinese Medicine, the clinical curative effect is related to the changes of parameters. [Result] The treatment group in syndrome of traditional Chinese Medicine, the overall clinical efficacy, blood uric acid ( BUA ) ,erythrocyte sedimentation rate(ESR),Creaction protein(CRP),white blood cell(WBC),liver and kidney function are superior to that of control group. [Conclusion] Chinese medicine sequential enema in the treatment of acute gouty arthritis is an effective method in treating this disease.%[目的]观察序贯灌肠治疗急性痛风性关节炎的临床疗效.[方法]采用随机对照的方法,将60例患者分为中药序贯灌肠治疗组与西药对照组,观察两组治疗前后中医证候、临床疗效及各项相关指标的变化.[结果]治疗组在中医证候、临床总体疗效、血尿酸(Blood uric acid,BUA)、血沉(Erythrocyte sedimentation rate,ESR)、C反应蛋白(C reaction protein,CRP)、血白细胞(White blood cell,WBC)、肝肾功能等方面优于对照组.[结论]中药序贯灌肠治疗急性痛风性关节炎疗效满意,是治疗本病的有效方法之一.

  13. 直肠癌术后放射性肠炎的灌肠护理%Colorectal cancer postoperative radiation enteritis of enema nursing

    Institute of Scientific and Technical Information of China (English)

    潘娜

    2013-01-01

    Objective:To prevent and reduce the occurrence of rectovaginal fistula with Traditional Chinese and western pharmaceutical enema treatment of rectal cancer postoperative radiation enteritis .Methods:Twenty patients with colorectal cancer after radiotherapy and radioactive enteritis patients using metronidazole 100 ml to yunnan baiyao 1.0,dexamethasone 10 mg mixed into irrigation intestinal juice retention enema,1 times/day,treatment 2 weeks,and at the same time protect liver inflammation infusion drug therapy .Results:No recto-vaginal fistula happen ,radioactive enteritis patients and patients recovered after all .Conclusion:Metronidazole yunnan baiyao enema treat-ment of radioactive enteritis ,patients tolerance and medical from sex might be good ,easy to use safety ,the effect of obvious ,no bad reaction takes place .%目的:中西药灌肠治疗直肠癌术后放射性肠炎,预防和减少直肠阴道瘘的发生。方法:对20例直肠癌术后放疗并发放射性肠炎的病人采用甲硝唑100ml中加入云南白药1.0,地塞米松10mg混合成灌肠液保留灌肠,1次/d,疗程2周,同时输注消炎保肝药物治疗。结果:无直肠阴道瘘发生,放射性肠炎患者20例全部治愈出院。结论:甲硝唑云南白药灌肠治疗放射性肠炎,患者耐受性和医从性较好,使用方便安全,效果明显,无不良反应发生。

  14. Effects of a 250-mL enema containing sodium phosphate on electrolyte concentrations in healthy volunteers: An open-label, randomized, controlled, two-period, crossover clinical trial*

    Science.gov (United States)

    Sédaba, Belén; Azanza, Josh R.; Campanero, Miguel A.; Garcia-Quetglas, Emilio; Muñoz, Maria Josh; Marco, Santiago

    2006-01-01

    Background: Enemas are used by individuals with constipation and are often required before certain medical diagnostic procedures and surgical interventions. However, abnormalities in serum electrolyte concentrations have been associated with enema use. Objective: The aim of this study was to determine the changes in serum electrolyte concentrations (phosphorus, calcium, sodium, and potassium) and urinary phosphorus elimination after the administration of a sodium phosphate enema. Methods: Healthy volunteers aged 35 to 70 years were eligible for this open-label, randomized, controlled, 2-period, crossover clinical trial at the Clinical Research Unit of the University Hospital of Navarra, Pamplona, Spain. The study comprised 2 one-day periods separated by a 7-day washout. All subjects were randomly assigned in a 1:1 ratio to 1 of 2 study sequences: (1) a single dose of Enema Casen® 250 mL in the first period followed by no treatment (control) in the second period, or (2) no treatment in the first period followed by a single dose of the study drug in the second period. The sequence of treatment was assigned using a randomization table that was prepared before the beginning of the study. Serum concentrations of phosphorus, sodium, potassium, and calcium were measured in both periods. Urinary phosphorus elimination was measured for 12 hours after enema administration (Ae0–12) in a subset of the subjects in the second period. Adverse events (AEs) were monitored by the investigators throughout the study. Normal ranges for the electrolytes were as follows: phosphorus, 2.5 to 5 mg/dL; calcium, 8.5 to 10.5 mg/dL; sodium, 135 to 145 mEq/L; and potassium, 3.5 to 5 mEq/L. Results: Twenty-four subjects (12 men, 12 women; mean [SD] age, 47.8 [9.6] years [range, 36–68 years]) participated in the study. All of the subjects were white and none were smokers. Twelve hours after enema administration, mean serum phosphorus and sodium concentrations increased by a mean of 1.18 mg

  15. How Do People Make Continence Care Happen? An Analysis of Organizational Culture in Two Nursing Homes

    Science.gov (United States)

    Lyons, Stacie Salsbury

    2010-01-01

    Purpose: Although nursing homes (NHs) are criticized for offering poor quality continence care, little is known about the organizational processes that underlie this care. This study investigated the influence of organizational culture on continence care practices in two NHs. Design and Methods: This ethnographic study explored continence care…

  16. Polysorbate 80 and low-osmolality water-soluble contrast medium enema in diagnosis and treatment of faecal obstruction in malignant phaeochromocytoma. Report of a case

    Energy Technology Data Exchange (ETDEWEB)

    Ratcliffe, J.F.

    Stercoral obstruction in a young woman with disseminated phaeochromocytoma was diagnosed and treated successfully using an enema of isosmolar iohexol (Omnipaque) and 1% polysorbate 80 (Tween 80) without complication. Surgical intervention was thus avoided. A low osmolality water-soluble contrast medium (iohexol 150 mg I/ml) with a wetting agent (1% Tween 80) was used because a barium suspension would have inspissated, exacerbating the constipation and a hyperosmolar contrast medium might have precipitated a hypertensive crisis and destablished her critical salt and water balance.

  17. Design of a multicentre randomized trial to evaluate CT colonography versus colonoscopy or barium enema for diagnosis of colonic cancer in older symptomatic patients: The SIGGAR study

    Directory of Open Access Journals (Sweden)

    Edwards Rob

    2007-10-01

    Full Text Available Abstract Background and Aims The standard whole-colon tests used to investigate patients with symptoms of colorectal cancer are barium enema and colonoscopy. Colonoscopy is the reference test but is technically difficult, resource intensive, and associated with adverse events, especially in the elderly. Barium enema is safer but has reduced sensitivity for cancer. CT colonography ("virtual colonoscopy" is a newer alternative that may combine high sensitivity for cancer with safety and patient acceptability. The SIGGAR trial aims to determine the diagnostic efficacy, acceptability, and economic costs associated with this new technology. Methods The SIGGAR trial is a multi-centre randomised comparison of CT colonography versus standard investigation (barium enema or colonoscopy, the latter determined by individual clinician preference. Diagnostic efficacy for colorectal cancer and colonic polyps measuring 1 cm or larger will be determined, as will the physical and psychological morbidity associated with each diagnostic test, the latter via questionnaires developed from qualitative interviews. The economic costs of making or excluding a diagnosis will be determined for each diagnostic test and information from the trial and other data from the literature will be used to populate models framed to summarise the health effects and costs of alternative approaches to detection of significant colonic neoplasia in patients of different ages, prior risks and preferences. This analysis will focus particularly on the frequency, clinical relevance, costs, and psychological and physical morbidity associated with detection of extracolonic lesions by CT colonography. Results Recruitment commenced in March 2004 and at the time of writing (July 2007 5025 patients have been randomised. A lower than expected prevalence of end-points in the barium enema sub-trial has caused an increase in sample size. In addition to the study protocol, we describe our approach to

  18. Nursing experience of lactulose retention enema in the treatment of hepatic encephalopathy%乳果糖保留灌肠治疗肝性脑病的护理体会

    Institute of Scientific and Technical Information of China (English)

    余文英

    2014-01-01

    目的:分析讨论乳果糖保留灌肠治疗肝性脑病的效果。方法:随机将78例肝性脑病患者分为观察组和对照组,两组均用保肝降酶及抗肝昏迷处理。观察组采用乳果糖保留灌肠,并改进保留灌肠方法,对照组采用生理盐水保留灌肠方法,观察两组治疗及护理效果。结果:改进保留灌肠方法后,延长了乳果在肠道内的保留时间,血氨浓度下降明显。结论:乳果糖保留灌肠,提高了肝性脑病的治疗效果。%Objective:To analyze and discuss the effect of lactulose retention enema in the treatment of hepatic encephalopathy. Methods:78 patients with hepatic encephalopathy were randomly divided into the observation group and the control group.The two groups were given protecting liver and reducing enzyme and resisting hepatic coma treatment.The observation group were given lactulose retention enema,and the retention enema method was improved.The control group were given normal saline retention enema method.The treatment effect and nursing of two groups were observed.Results:After improving retention enema method,it prolonged the retention time of lactulose in the intestine,the blood ammonia concentration decreased significantly.Conclusion:Lactulose retention enema improves the treatment effect of hepatic encephalopathy.

  19. The clinical analysis of 81 cases with glycerin suppositories nonretention enema treatment for acute constipation%甘油不保留灌肠治疗便秘81例临床分析

    Institute of Scientific and Technical Information of China (English)

    宋建亭; 郑文宁; 贾晨光

    2008-01-01

    Objective To explore the glycerin suppositories nonretention enema treatment and the clinical ef- ficacy on acute constipation induced by a variety of unknown reasons. Methods 164 patients were randomly divided into two groups: observed group (81 cases) and the control group (83 cases ). Observed group used enema by 80ml glycerin suppositories retention. Control group used excessive traditional liquid soap retention enema. Effects of differ- ent methods of enema were compared according to fecal condition 5~20min after operation. Results The glycerin suppositories retention enema was much better than soap water retention enema with the total effective rate of 97.5 % and 81% respectively. The glycerin suppositories retention enema solution to the overflow and the occurrence of adverse reactions were significantly lower than those of the control group. There were significantly statistical dif- ferences(P < 0. 01). Conclusion Using the glycerin suppositories retention enema for the constipation, has no side effects,skin and beds contamination and patients are more willing to accept it.%目的 探讨甘油不保留灌肠治疗因各种原因引起的急性便秘的临床疗效.方法 将164例患者随机分为观察组(81例)和对照组(83例).观察组采用甘油80 ml灌肠,对照组采用传统的大量肥皂液不保留灌肠,根据操作后5~20 min粪便排出情况比较不同方法的灌肠效果.结果 观察组总有效率97.5%,对照组总有效率81%,观察组不良反应和溶液自行溢出的发生率均明显低于对照组.结论 甘油灌肠法用于急性便秘患者,无副作用,皮肤床铺元污染,优于肥皂液灌肠.

  20. Clinical effect of preoperative bowel preparation with glycerin enema in colorectal cancer%甘油灌肠剂用于结直肠癌术前肠道准备的效果观察

    Institute of Scientific and Technical Information of China (English)

    胡锦秀

    2011-01-01

    Aim To observe the clinical effects of preoperative bowel preparation with glycerin enema in colorectal cancer. Methods A total of 60 colorectal cancer patients who needed preoperative cleaning enema and hospitalized in our department from April, 2009 to June,2010 were randomly divided into experimental group( n = 30 )and control group( n = 30 ). The patients in the experimental group received glycerin enema while the traditional enema( 0.1% ~ 0.2% soapsuds )was applied in the control group. Results The effectiveness of enema and the restoration of gastrointestinal function in the test group were superior to those of the control group. In addition, sideeffects in the test group were relatively little. Conclusion Glycerin enema is convenient, safe and effective,what' s more ,it also can avoid the pain resulting from the normal cleaning enema. It can substitute the conventional cleaning enema and be recommended in clinic.%目的 观察甘油灌肠剂用于结直肠癌术前清洁灌肠的临床效果.方法 将我科2009年4月~2010年6月收治的60例结直肠癌患者术前肠道准备随机分为两组,每组各30例,实验组以甘油灌肠剂灌肠,对照组以传统方法(0.1%~0.2%肥皂水)灌肠.结果 实验组较对照组肠道准备彻底,并发症少,术后肠道功能恢复快.结论 甘油灌肠剂使用方法简便、安全、肠道准备彻底,病人痛苦明显减少,是一种值得推广的可以替代传统方法(0.1%~0.2%肥皂水)的灌肠剂.

  1. Groundwater systems of the Indian Sub-Continent

    Directory of Open Access Journals (Sweden)

    Abhijit Mukherjee

    2015-09-01

    Full Text Available The Indian Sub-Continent is one of the most densely populated regions of the world, hosting ∼23% of the global population within only ∼3% of the world's land area. It encompasses some of the world's largest fluvial systems in the world (River Brahmaputra, Ganges and Indus Basins, which hosts some of the highest yielding aquifers in the world. The distribution of usable groundwater in the region varies considerably and the continued availability of safe water from many of these aquifers (e.g. Bengal Basin is constrained by the presence of natural contaminants. Further, the trans-boundary nature of the aquifers in the Indian Sub-Continent makes groundwater resource a potentially politically sensitive issue, particularly since this region is the largest user of groundwater resources in the world. Indeed, there is considerable concern regarding dwindling well yield and declining groundwater levels, even for the highly productive aquifers. Though irrigation already accounts for >85% of the total ground water extraction of the region, there is a mounting pressure on aquifers for food security of the region. Highly variable precipitation, hydrogeological conditions and predicted, impending climate change effects provide substantial challenges to groundwater management. The observed presence of natural groundwater contaminants together with the growing demand for irrigated food production and predicted climate change further complicate the development of strategies for using groundwater resources sustainably. We provide an introduction and overview of 11 articles, collated in this special issue, which describe the current condition of vulnerable groundwater resources across the Indian Sub-Continent.

  2. Hadean Earth and primordial continents: The cradle of prebiotic life

    Directory of Open Access Journals (Sweden)

    M. Santosh

    2017-03-01

    Full Text Available The Hadean history of Earth is shrouded in mystery and it is considered that the planet was born dry with no water or atmosphere. The Earth-Moon system had many features in common during the birth stage. Solidification of the dry magma ocean at 4.53 Ga generated primordial continents with komatiite. We speculate that the upper crust was composed of fractionated gabbros and the middle felsic crust by anorthosite at ca. 21 km depth boundary, underlain by meta-anorthosite (grossular + kyanite + quartz down to 50–60 km in depth. The thickness of the mafic KREEP basalt in the lower crust, separating it from the underlying upper mantle is not well-constrained and might have been up to ca. 100–200 km depending on the degree of fractionation and gravitational stability versus surrounding mantle density. The primordial continents must have been composed of the final residue of dry magma ocean and enriched in several critical elements including Ca, Mg, Fe, Mn, P, K, and Cl which were exposed on the surface of the dry Earth. Around 190 million years after the solidification of the magma ocean, “ABEL bombardment” delivered volatiles including H2O, CO2, N2 as well as silicate components through the addition of icy asteroids. This event continued for 200 Myr with subordinate bombardments until 3.9 Ga, preparing the Earth for the prebiotic chemical evolution and as the cradle of first life. Due to vigorous convection arising from high mantle potential temperatures, the primordial continents disintegrated and were dragged down to the deep mantle, marking the onset of Hadean plate tectonics.

  3. Antegrade and retrograde perfusion in minimally invasive mitral valve surgery with transthoracic aortic clamping: a single-institution experience with 1632 patients over 12 years.

    Science.gov (United States)

    Murzi, Michele; Cerillo, Alfredo G; Gasbarri, Tommaso; Margaryan, Rafik; Kallushi, Enkel; Farneti, Pierandrea; Solinas, Marco

    2017-03-01

    The aim of the present study was to evaluate the impact of a retrograde arterial perfusion (RAP) strategy versus an antegrade arterial perfusion (AAP) strategy in a consecutive, large cohort of patients who underwent minimally invasive mitral valve surgery with transthoracic aortic clamping through a right minithoracotomy. Between 2003 and 2015, 1632 consecutive patients underwent first-time minimally invasive mitral valve surgery with transthoracic aortic clamping at our institution; 141 (8.6%) of these patients received retrograde perfusion with femoral artery cannulation, whereas 1421 (91.4%) received antegrade perfusion with ascending aorta cannulation. Logistic regression was used to evaluate outcomes and risk factors for death and stroke between groups. The overall frequency of 30-day mortality was 0.7% (13/1632) and was similar between groups (retrograde arterial perfusion RAP 0.7% vs AAP 0.8%; P  = 0.903). The overall postoperative stroke rate was 1.3% (22/1632). The stroke rate was significantly higher in patients receiving retrograde perfusion (3.5% vs 1.1%; P  = 0.005). Risk factors for death were advanced age (odds ratio (OR) = 1.3; P  = 0.004), mitral valve replacement (OR = 3.9; P  = 0.05), emergent procedure (OR = 3.4; P  = 0.014) and conversion to sternotomy (OR = 3.7; P  = 0.001). Multivariable regression analysis revealed that retrograde perfusion was an independent risk factor for stroke (OR = 3.3; P  = 0.004). Other risk factors were conversion to sternotomy (OR = 12; P  = 0.001), active endocarditis (OR = 5.8; P  = 0.07) and hypercholesterolaemia (OR = 2.4; P  = 0.048). Interaction modelling revealed that the only significant risk factor for a neurological event was the use of retrograde perfusion in patients older than 70 years with an atherosclerotic burden (OR = 6.4; P  = 0.033). Minimally invasive mitral valve procedures can be performed with low morbidity and

  4. Cetraria (Parmeliaceae and some related genera on the African continent

    Directory of Open Access Journals (Sweden)

    I. Kärnefelt

    1987-12-01

    Full Text Available Four species are reported new for the lichen flora of southern Africa:  Bryoria fuseescens (Gyeln. Brodo & D. Hawksw.,  B. motykae (D. Hawksw. Brodo & D. Hawksw.,  Cetraria chlorophylla (Humb. Vain, and  Platismatia glauca (L. Culb. & Culb. (Parmeliaceae, found at high elevations in Natal and south-west Cape.  B. fuscescens, B. motykae and  P. glauca were previously known from a few localities, also at high elevations, in east Africa. The genus Cetraria s. str. was previously unknown on the African continent.

  5. The continent ileal reservoir--an experimental study.

    Science.gov (United States)

    Meijer, D W

    1992-01-01

    This thesis describes new concepts pertaining to the continent ileostomy. The aim of the study was twofold: to counter valve desinvagination and to simplify pouch construction. In Chapter 1 a survey is given of the history, the present situation of the technique and the complications of the continent ileostomy. It appears that on the one hand the operation improves the quality of the patient's life, but on the other hand the operation gives rise to many complications. The number of complications quoted in the literature varies and has been reported to be as high as 43%. Most of the time this led to repeat surgery, with equally uncertain results. This is the reason why the operation is not very frequently performed. Most of the time the complications concern the valve system and to a lesser degree the reservoir. In order to obtain a better insight into the origin of and possible gain better control over these complications an investigation was carried out on laboratory animals. This investigation involved: the complications of the valve system, the effect of the suturing method on the function of the reservoir and the simplification of the construction of the reservoir. In Chapter 2 the aim of the investigation was formulated in three questions. 1. Is it possible to diminish the chance of complications of the valve system of the continent ileostomy? 2. Does the method of suturing influence the function of the reservoir? 3. Is it possible to simplify the construction of the reservoir, so that the duration of the operation can be shortened? Chapter 3 is the general materials and methods section. Chapter 4 is about the research on the valve system. Up to now, no method of suturing the valve has consistently produced results good enough to make subsequent re-operations unnecessary. In this study two types of valve experiments have been carried out. First the feasibility of circumventing the problems of the nonpermanent form of the valve was investigated combining a

  6. [Morpho-functional evaluation of the small intestine patients with Crohn disease. Enema of the small intestine versus post-heparin plasma diamine oxidase].

    Science.gov (United States)

    Fondacaro, R; Maurano, A; Cirillo, L C; Noviello, A; Ciacci, C; D'Agostino, L; Tamburrini, O

    1987-03-01

    Our study was directed not only towards the diagnosis of small bowel Crohn's disease, but especially to a quantitative analysis, for a correct therapeutical approach. This experimental trial is based on the relationship between radiological evidence, measured during small bowel enema, and the seriousness of the morphological and functional damage to the intestinal mucosal membrane, evaluated with a post-heparin diamine-oxidase activity test. With this method we studied 35 selected patients; 16 of them were affected by the disease with an exclusive localization in the small bowel and 5 have been considered separately, because 3 patients had already been operated and the other 2 showed different localizations. In our results, the two parameters were not constantly related to each other. In other words the enema's morphological data sometimes do not accord with the mucosal membrane integrity index expressed by the enzyme. Anyway the importance of this study is the attempt of making an objective comparison between an anatomic situation and its functional consequence. These aspects have a great significance in Crohn's disease.

  7. Small bowel enema - indications and diagnostic yield in a ten year material; Roentgen tynntarm med sonde - indikasjoner og diagnostisk utbytte i et tiaarsmateriale

    Energy Technology Data Exchange (ETDEWEB)

    Husnes, Kjell Vidar; Kildahl-Andersen, Odd; Kildahl-Andersen, Randi

    2001-07-01

    Background. We wanted to evaluate the indication for ordering small bowel enema and whether specific clinical symptoms and signs are associated with the diagnostic yield. Material and methods. Medical charts and requisition slips for 241 patients examined with small bowel enema at Harstad Hospital from 1986 to 1995 were reviewed. Results. The most common symptom leading to small bowel radiography was pain, registered in almost three fourths of the patients, about one half reported diarrhoea. Elevated sedimentation rate and occult blood in the faeces were reported in one fourth of the patients. For a large proportion of the patients there was no information about adequate preliminary tests in the medical charts. Normal radiography was reported in three fourths of the patients. Lesions consistent with Crohn's disease were found in one of eight patients. No symptoms or signs except for elevated sedimentation rate, clearly indicate a positive diagnostic finding. Many requisition slips did not contain available information. Interpretation. Small bowel radiography is performed on wide indications. It is difficult to make a careful selection of patients based on reported symptoms and signs. However, some preliminary tests are helpful and should be done.

  8. Reinforcing the continent mechanism of continent cutaneous diversions by wrapped rectus abdominis muscle flap: a preliminary experimental study

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xin-ru; XU Yue-min; FENG Chao; YU Jian-jun; SONG Lu-jie; FEI Xiao-fang

    2009-01-01

    Background Continent cutaneous diversion (CCD) has been widely used in almost any lower urinary reconstruction. We have been continually trying to modify this procedure because of the high complications rate, especially as they relate to the efferent tube. In this study, we reported a modified procedure with a tapered ileum wrapped by the rectus abdominalis flap (RAMF) and assessed the feasibility of this new technique to achieve urinary continence. Methods A procedure in which two ileal segments were tapered and connected to a U-shaped reservoir was performed in ten dogs. A RAMF with its blood supply was wrapped around one of the tapered ileum, in control groups, the tapered ileum was brought to the abdominal skin. Urodynamic studies were conducted In the 1st, 3rd and 6th months post-operatively. The data of maximum inner pressure (MIP) and functional pressure length (FPL) in every group at each phase were recorded. Retrograde radiograms of the efferent limbs were performed before sacrifice.Results MIP in the study group was significantly higher than that in the control group at each phase (P<0.05). However, no significant differences in MIP or FPL were found in the study group between an empty and full reservoir. In the control group, MIP increased (P<0.05) and FPL decreased significantly (P<0.05) compared with an empty and full reservoir. Retrograde radiograms confirmed that efferent limbs were positioned straigh beneath the abdominal wall. Histological examination of the study group demonstrated a layer of striated muscle around the outside surface of the ileum.Conclusion The continent mechanism of tapered ileum can be enhanced by extra support from wrapped RAMF.

  9. Optimization of Nutitional Enemas with Wheat Germ using Orthogonal Experiment%麦仁营养灌肠的研制

    Institute of Scientific and Technical Information of China (English)

    高晓平; 付进华; 黄现青; 赵改名; 柳艳霞; 梁红伟

    2011-01-01

    为研究麦仁营养灌肠的制备工艺和配方,采用传统配料和现代工艺,经腌制、斩拌和烘烤研制麦仁营养灌肠.以麦仁、大豆组织蛋白,改性玉米淀粉作为基料,设计正交试验,研究不同添加量对麦仁营养灌肠感官评定和质构特性的影响.试验结果表明:麦仁添加量对灌肠感官和成型质量影响最大,而玉米改性淀粉对其影响最小;大豆组织蛋白对复合灌肠感官特性和组织质量起关键作用;最佳配比为麦仁5%、大豆组织蛋白6%、玉米改性淀粉8%,产品因麦仁的添加达到去腥除腻,适当增加灌肠的硬度、胶着性和咀嚼性,产品的风味独特、组织结构和质地良好.%Wheat germ was used as raw materials, enemas with wheat germ was produced by combination of traditional ingredients and modem technology. The wheat germ, soybean tissue protein, com starch modified were selected as a single-factor, designing a orthogonal experiment to study the effects of different concentrations on sensory assessment and texture characteristics. The results showed the effect of wheat germ concentration was the biggest, but the influence of com starch modified was minimum; and soybean tissue protein played a critical role on sensory characteristica and texture quality. The optimum ratio was wheat germl 5%, soybean tissue protein 6%, corn starch modified 8%.

  10. Climate control of terrestrial carbon exchange across biomes and continents

    Energy Technology Data Exchange (ETDEWEB)

    Yi Chuixiang; Wolbeck, John; Xu Xiyan [School of Earth and Environmental Sciences, Queens College, City University of New York, NY 11367 (United States); Ricciuto, Daniel [Environmental Sciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831 (United States); Li Runze [Department of Statistics, Pennsylvania State University, University Park, PA 16802 (United States); Nilsson, Mats [Department of Forest Ecology, Swedish University of Agricultural Sciences, SE-901 83 Umeaa (Sweden); Aires, Luis [CESAM and Department of Environmental Engineering, School of Technology and Management, Polytechnic Institute of Leiria (Portugal); Albertson, John D [Department of Civil and Environmental Engineering, Duke University, Durham, NC 22708-0287 (United States); Ammann, Christof [Federal Research Station Agroscope Reckenholz-Taenikon, Reckenholzstrasse 191, 8046 Zuerich (Switzerland); Arain, M Altaf [School of Geography and Earth Sciences, McMaster University, Hamilton, ON, L8S 4K1 (Canada); De Araujo, Alessandro C [Instituto Nacional de Pesquisas da Amazonia, Programa LBA, Campus-II, Manaus-Amazonas 69060 (Brazil); Aubinet, Marc [University of Liege, Gembloux Agro-Bio Tech, Unit of Biosystem Physics, 2 Passage des Deportes, 5030 Gembloux (Belgium); Aurela, Mika [Finnish Meteorological Institute, Climate Change Research, FI-00101 Helsinki (Finland); Barcza, Zoltan [Department of Meteorology, Eoetvoes Lorand University, H-1117 Budapest, Pazmany setany 1/A (Hungary); Barr, Alan [Climate Research Division, Environment Canada, Saskatoon, SK, S7N 3H5 (Canada); Berbigier, Paul [INRA, UR1263 EPHYSE, Villenave d' Ornon F-33883 (France); Beringer, Jason [School of Geography and Environmental Science, Monash University, Clayton, Victoria 3800 (Australia); Bernhofer, Christian [Institute of Hydrology and Meteorology, Dresden University of Technology, Pienner Strasse 23, D-01737, Tharandt (Germany)

    2010-07-15

    Understanding the relationships between climate and carbon exchange by terrestrial ecosystems is critical to predict future levels of atmospheric carbon dioxide because of the potential accelerating effects of positive climate-carbon cycle feedbacks. However, directly observed relationships between climate and terrestrial CO{sub 2} exchange with the atmosphere across biomes and continents are lacking. Here we present data describing the relationships between net ecosystem exchange of carbon (NEE) and climate factors as measured using the eddy covariance method at 125 unique sites in various ecosystems over six continents with a total of 559 site-years. We find that NEE observed at eddy covariance sites is (1) a strong function of mean annual temperature at mid- and high-latitudes, (2) a strong function of dryness at mid- and low-latitudes, and (3) a function of both temperature and dryness around the mid-latitudinal belt (45 deg. N). The sensitivity of NEE to mean annual temperature breaks down at {approx} 16 deg. C (a threshold value of mean annual temperature), above which no further increase of CO{sub 2} uptake with temperature was observed and dryness influence overrules temperature influence.

  11. Climate control of terrestrial carbon exchange across biomes and continents

    Energy Technology Data Exchange (ETDEWEB)

    Ricciuto, Daniel M [ORNL; Gu, Lianhong [ORNL

    2010-07-01

    Understanding the relationships between climate and carbon exchange by terrestrial ecosystems is critical to predict future levels of atmospheric carbon dioxide because of the potential accelerating effects of positive climate carbon cycle feedbacks. However, directly observed relationships between climate and terrestrial CO2 exchange with the atmosphere across biomes and continents are lacking. Here we present data describing the relationships between net ecosystem exchange of carbon (NEE) and climate factors as measured using the eddy covariance method at 125 unique sites in various ecosystems over six continents with a total of 559 site-years. We find that NEE observed at eddy covariance sites is (1) a strong function of mean annual temperature at mid- and high-latitudes, (2) a strong function of dryness at mid- and low-latitudes, and (3) a function of both temperature and dryness around the mid-latitudinal belt (45 N). The sensitivity of NEE to mean annual temperature breaks down at ~ 16 C (a threshold value of mean annual temperature), above which no further increase of CO2 uptake with temperature was observed and dryness influence overrules temperature influence.

  12. Continents as lithological icebergs: The importance of buoyant lithospheric roots

    Science.gov (United States)

    Abbott, D.H.; Drury, R.; Mooney, W.D.

    1997-01-01

    An understanding of the formation of new continental crust provides an important guide to locating the oldest terrestrial rocks and minerals. We evaluated the crustal thicknesses of the thinnest stable continental crust and of an unsubductable oceanic plateau and used the resulting data to estimate the amount of mantle melting which produces permanent continental crust. The lithospheric mantle is sufficiently depleted to produce permanent buoyancy (i.e., the crust is unsubductable) at crustal thicknesses greater than 25-27 km. These unsubductable oceanic plateaus and hotspot island chains are important sources of new continental crust. The newest continental crust (e.g., the Ontong Java plateau) has a basaltic composition, not a granitic one. The observed structure and geochemistry of continents are the result of convergent margin magmatism and metamorphism which modify the nascent basaltic crust into a lowermost basaltic layer overlain by a more silicic upper crust. The definition of a continent should imply only that the lithosphere is unsubductable over ??? 0.25 Ga time periods. Therefore, the search for the oldest crustal rocks should include rocks from lower to mid-crustal levels.

  13. Pressure injury prevention: continence, skin hygiene and nutrition management.

    Science.gov (United States)

    Roosen, Kerri; Fulbrook, Paul; Nowicki, Tracy

    2010-08-10

    To prevent pressure injuries research indicates the importance of focusing on three key areas of practice: continence, skin hygiene and nutrition. These are a synergistic trio and many patients require considered management in all three areas. In addition to targeting specific aspects of nursing care in these areas, it is also crucial that there is organisational buy-in for strategic initiatives. Some of the ways that we achieved this are outlined below: Support from managerial level by presenting evidence and education to senior nurses and directors. Nurse unit managers completed individual ward action plans outlining their individual commitments to reducing pressure injuries. Providing support and education to staff to choose and use continence products effectively. Support from allied health colleagues in prevention of pressure injuries. After implementing the actions described above, pressure injury prevalence at the Prince Charles Hospital in Brisbane decreased from 13.78% in 2008 to 5.15% in 2010, representing a 62% reduction overall. Of these pressure injuries, 53% were stage one.

  14. Riverine nitrogen export from the continents to the coasts

    Science.gov (United States)

    Boyer, Elizabeth W.; Howarth, Robert W.; Galloway, James N.; Dentener, Frank J.; Green, Pamela A.; VöRöSmarty, Charles J.

    2006-03-01

    We present an overview of riverine nitrogen flux calculations that were prepared for the International Nitrogen Initiative's current global assessment of nitrogen cycles: past, present, and future (Galloway et al., 2004). We quantified anthropogenic and natural inputs of reactive nitrogen (N) to terrestrial landscapes and the associated riverine N fluxes. Anthropogenic inputs include fossil-fuel derived atmospheric deposition, fixation in cultivated croplands, fertilizer use, and the net import in human food and animal feedstuffs. Natural inputs include natural biological N fixation in forests and other noncultivated vegetated lands, and fixation by lightning. We use an empirical model relating total N inputs per landscape area to the total flux of N discharged in rivers based on watershed data from contrasting ecosystems spanning multiple spatial scales. With this approach, we simulate riverine N loads to the coastal zone and to inland waters from the continents. Globally, rivers exported about 59 Tg N yr-1, with 11 Tg N yr-1 transported to dry lands and inland receiving waters, and 48 Tg N yr-1 transported to the coastal zone. Rates of riverine N loss vary greatly among the continents, reflecting the regional differences in population and the associated anthropogenic N inputs. We compare our estimates to other approaches that have been reported in the literature. Our work provides an understanding of the sources of N to landscapes and the associated N fluxes in rivers, and highlights how anthropogenic activities impact N cycling around the world.

  15. Archean komatiite volcanism controlled by the evolution of early continents.

    Science.gov (United States)

    Mole, David R; Fiorentini, Marco L; Thebaud, Nicolas; Cassidy, Kevin F; McCuaig, T Campbell; Kirkland, Christopher L; Romano, Sandra S; Doublier, Michael P; Belousova, Elena A; Barnes, Stephen J; Miller, John

    2014-07-15

    The generation and evolution of Earth's continental crust has played a fundamental role in the development of the planet. Its formation modified the composition of the mantle, contributed to the establishment of the atmosphere, and led to the creation of ecological niches important for early life. Here we show that in the Archean, the formation and stabilization of continents also controlled the location, geochemistry, and volcanology of the hottest preserved lavas on Earth: komatiites. These magmas typically represent 50-30% partial melting of the mantle and subsequently record important information on the thermal and chemical evolution of the Archean-Proterozoic Earth. As a result, it is vital to constrain and understand the processes that govern their localization and emplacement. Here, we combined Lu-Hf isotopes and U-Pb geochronology to map the four-dimensional evolution of the Yilgarn Craton, Western Australia, and reveal the progressive development of an Archean microcontinent. Our results show that in the early Earth, relatively small crustal blocks, analogous to modern microplates, progressively amalgamated to form larger continental masses, and eventually the first cratons. This cratonization process drove the hottest and most voluminous komatiite eruptions to the edge of established continental blocks. The dynamic evolution of the early continents thus directly influenced the addition of deep mantle material to the Archean crust, oceans, and atmosphere, while also providing a fundamental control on the distribution of major magmatic ore deposits.

  16. Antegrade Rush nailing for fractures of humeral shaft- an analysis of 200 cases with an average follow up of 1 year

    Directory of Open Access Journals (Sweden)

    Gadegone W

    2006-01-01

    Full Text Available Background : The incidence of humeral fracture has significantly increased during the recent times due to the rising age of the population and the number of automobile accidents. In order to achieve a stable fixation and early mobilization, numerous surgical implants have been devised. Method : We carried out a prospective analysis of the data of 200 consecutive patients who had closed fractures of the humeral shaft treated with ante-grade closed Rush nails at our institute. Patients with preoperative radial nerve injury were excluded from this study. In 186 patients we achieved close to anatomic reduction of the fracture fragments. In 14 patients we had to resort to limited open reduction. Results : Fracture united in 186 of 188 patient followed up for one year. Complications occurred in 26 patients. We strongly advise a careful surgical technique and modification as per the individual fracture pattern to reduce the complications. Conclusion : Osteosynthesis with multiple Rush nails features the advantages of rotational stability of the head-neck fragment to the diaphysis, an unreamed implantation technique without any special instruments, the speed of execution and minimal economic burden so important for the developing country like ours.

  17. Strategies for Successful Percutaneous Revascularization of Chronic Total Occlusion of the Femoropopliteal Arteries When the Antegrade Passage of a Guide Wire Fails

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hui Jin; Park, Sang Woo; Chang, So Il; Jeon, Hae Jeong; Park, Jeong Hee [Konkuk University Hospital, Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2012-07-15

    To evaluate the efficacy of various strategies for revascularization of chronic total occlusion of femoropopliteal arteries when the guide wire does not pass in an anterograde direction. Twenty-four patients with totally occluded femoropopliteal arteries (mean occlusion length 13.75 cm; range, 6-22 cm) were treated by using a retrograde approach and two novel catheters. After successful recanalization or reentry, balloon angioplasty followed by stent placement was performed to complete the revascularization. In 16 cases in which to cross the occlusion via intraluminal or subintimal route was failed, we used Frontrunner catheters in five cases and Outback catheters in 11 cases. In eight cases in which to reenter after subintimal passage of the guide wire was failed, we used Outback catheters. Successful recanalization was achieved intraluminally or subintimally in all cases. One perforation occurred during subintimal passage of the guide wire that was controlled by recanalization of another subintimal tract. There were no cases of distal thromboembolism or other complications. A retrograde approach and using the Frontrunner and Outback catheters are safe and effective for successful revascularization of chronic total occlusion of femoropopliteal arteries. In particular, they are useful when the initial antegrade attempts at recanalization have failed.

  18. Comparison of different evaporation estimates over the African continent

    Directory of Open Access Journals (Sweden)

    P. Trambauer

    2013-07-01

    Full Text Available Evaporation is a key process in the water cycle, with implications ranging from water management, to weather forecast and climate change assessments. The estimation of continental evaporation fluxes is complex and typically relies on continental-scale hydrological or land-surface models. However, it appears that most global or continental-scale hydrological models underestimate evaporative fluxes in some regions of Africa, and as a result overestimate stream flow. Other studies suggest that land-surface models may overestimate evaporative fluxes. In this study, we computed actual evaporation for the African continent using a continental version of the global hydrological model PCR-GLOBWB, which is based on a water balance approach. Results are compared with other independently computed evaporation products: the evaporation results from the ECMWF reanalysis ERA-Interim and ERA-Land (both based on the energy balance approach, the MOD16 evaporation product, and the GLEAM product. Three other alternative versions of the PCR-GLOBWB hydrological model were also considered. This resulted in eight products of actual evaporation, which were compared in distinct regions of the African continent spanning different climatic regimes. Annual totals, spatial patterns and seasonality were studied and compared through visual inspection and statistical methods. The comparison shows that the representation of irrigation areas has an insignificant contribution to the actual evaporation at a continental scale with a 0.5° spatial resolution. The choice of meteorological forcing data has a larger effect on the evaporation results, especially in the case of the precipitation input as different precipitation input resulted in significantly different evaporation in some of the studied regions. ERA-Interim evaporation is generally the highest of the selected products followed by ERA-Land evaporation. The satellite based products (GLEAM and MOD16 do not show regular

  19. A Zn isotope perspective on the rise of continents.

    Science.gov (United States)

    Pons, M-L; Fujii, T; Rosing, M; Quitté, G; Télouk, P; Albarède, F

    2013-05-01

    Zinc isotope abundances are fairly constant in igneous rocks and shales and are left unfractionated by hydrothermal processes at pH isotopes in sediments can be used to trace the changing chemistry of the hydrosphere. Here, we report Zn isotope compositions in Fe oxides from banded iron formations (BIFs) and iron formations of different ages. Zinc from early Archean samples is isotopically indistinguishable from the igneous average (δ(66) Zn ~0.3‰). At 2.9-2.7 Ga, δ(66) Zn becomes isotopically light (δ(66) Zn 1‰ during the ~2.35 Ga Great Oxygenation Event. By 1.8 Ga, BIF δ(66) Zn has settled to the modern value of FeMn nodules and encrustations (~0.9‰). The Zn cycle is largely controlled by two different mechanisms: Zn makes strong complexes with phosphates, and phosphates in turn are strongly adsorbed by Fe hydroxides. We therefore review the evidence that the surface geochemical cycles of Zn and P are closely related. The Zn isotope record echoes Sr isotope evidence, suggesting that erosion starts with the very large continental masses appearing at ~2.7 Ga. The lack of Zn fractionation in pre-2.9 Ga BIFs is argued to reflect the paucity of permanent subaerial continental exposure and consequently the insignificant phosphate input to the oceans and the small output of biochemical sediments. We link the early decline of δ(66) Zn between 3.0 and 2.7 Ga with the low solubility of phosphate in alkaline groundwater. The development of photosynthetic activity at the surface of the newly exposed continents increased the oxygen level in the atmosphere, which in turn triggered acid drainage and stepped up P dissolution and liberation of heavy Zn into the runoff. Zinc isotopes provide a new perspective on the rise of continents, the volume of carbonates on continents, changing weathering conditions, and compositions of the ocean through time. © 2013 Blackwell Publishing Ltd.

  20. A double-blind randomised, placebo-controlled trial evaluating the influence of oral long-acting muscle relaxant (Mebeverine MR), and insufflation with CO{sub 2} on pain associated with barium enema

    Energy Technology Data Exchange (ETDEWEB)

    Lowe, A.S.; Chapman, A.H.; Wilson, D.; Culpan, A.G. [Department of Radiology, St. James' s University Hospital, Beckett Street, LS9 7TF, Leeds (United Kingdom)

    2003-07-01

    Previous investigators have shown significant benefit using CO{sub 2} for bowel insufflation. Others have suggested that the long-acting smooth muscle relaxant, Mebeverine, may be of benefit. We subjected this to a randomised double-blind trial. A total of 181 outpatients were randomised to receive either Mebeverine or placebo as pre-medication, and either air or CO{sub 2} for bowel insufflation, thus creating four treatment groups. Visual-analogue lines were used to record pain scores before, during, and up to 8 h following the enema. All groups showed increased pain scores during the enema, with peak pain scores at the end of the examination, falling to baseline scores by 8 h. Patients receiving the combination of C0{sub 2} and placebo had significantly lower pain scores at 1 and 4 h (P=0.00 and P=0.014, respectively; Kruskal-Wallis test) compared with all other groups. Having Mebeverine as a pre-medication did not significantly lower pain scores compared with placebo, and decreased the amount of benefit received from the CO{sub 2}. We confirm that CO{sub 2} is of benefit in decreasing pain during barium enema, and we recommend its routine use to improve the comfort of patients. Mebeverine is not of benefit, and its use as a pre-medication for enemas is not recommended. (orig.)

  1. Here be Dragons: The Unexplored Continents of the CMSSM

    CERN Document Server

    Cohen, Timothy

    2013-01-01

    The Higgs boson mass and the abundance of dark matter constrain the CMSSM/mSUGRA supersymmetry breaking inputs. A complete map of the CMSSM that is consistent with these two measured quantities is provided. Various "continents," consisting of non-excluded models, can be organized by their dark matter dynamics. The following mechanisms manifest: well-tempering, resonant pseudo-scalar Higgs annihilation, neutralino/stau coannihilations and neutralino/stop coannihilations. Benchmark models are chosen in order to characterize the viable regions. The expected visible signals of each are described, demonstrating a wide range of predictions for the 13 TeV LHC and a high degree of complementarity between dark matter and collider experiments. The parameter space spans a finite volume, which can be probed in its entirety with experiments currently under consideration.

  2. Asynchronous extinction of late Quaternary sloths on continents and islands

    Science.gov (United States)

    Steadman, David W.; Martin, Paul S.; MacPhee, Ross D. E.; Jull, A. J. T.; McDonald, H. Gregory; Woods, Charles A.; Iturralde-Vinent, Manuel; Hodgins, Gregory W. L.

    2005-01-01

    Whatever the cause, it is extraordinary that dozens of genera of large mammals became extinct during the late Quaternary throughout the Western Hemisphere, including 90% of the genera of the xenarthran suborder Phyllophaga (sloths). Radiocarbon dates directly on dung, bones, or other tissue of extinct sloths place their “last appearance” datum at ≈11,000 radiocarbon years before present (yr BP) or slightly less in North America, ≈10,500 yr BP in South America, and ≈4,400 yr BP on West Indian islands. This asynchronous situation is not compatible with glacial–interglacial climate change forcing these extinctions, especially given the great elevational, latitudinal, and longitudinal variation of the sloth-bearing continental sites. Instead, the chronology of last appearance of extinct sloths, whether on continents or islands, more closely tracks the first arrival of people. PMID:16085711

  3. Social Work in a Developing Continent: The Case of Africa

    Directory of Open Access Journals (Sweden)

    Christopher Chitereka

    2009-11-01

    Full Text Available Social work is a professional approach to ameliorating social problems. It is generally understood as a helping profession that utilizes professionally qualified personnel who use its knowledge base to help people tackle their social problems (Mupedziswa, 2005. Nevertheless, in developing countries, social work is a relatively young profession which was influenced by colonialism in its formation. The type of social work practiced in these countries largely mirrors the one that is being practiced in Britain, France and Portugal among others. Utilizing the continent of Africa as a case study, this article argues that social work practice in Africa tends to be curative or remedial in nature and is not adequately addressing people’s problems. It therefore proposes a paradigm shift from remedial to a social development paradigm if it is to make an impact in the 21st century.

  4. Clustered and transient earthquake sequences in mid-continents

    Science.gov (United States)

    Liu, M.; Stein, S. A.; Wang, H.; Luo, G.

    2012-12-01

    Earthquakes result from sudden release of strain energy on faults. On plate boundary faults, strain energy is constantly accumulating from steady and relatively rapid relative plate motion, so large earthquakes continue to occur so long as motion continues on the boundary. In contrast, such steady accumulation of stain energy does not occur on faults in mid-continents, because the far-field tectonic loading is not steadily distributed between faults, and because stress perturbations from complex fault interactions and other stress triggers can be significant relative to the slow tectonic stressing. Consequently, mid-continental earthquakes are often temporally clustered and transient, and spatially migrating. This behavior is well illustrated by large earthquakes in North China in the past two millennia, during which no single large earthquakes repeated on the same fault segments, but moment release between large fault systems was complementary. Slow tectonic loading in mid-continents also causes long aftershock sequences. We show that the recent small earthquakes in the Tangshan region of North China are aftershocks of the 1976 Tangshan earthquake (M 7.5), rather than indicators of a new phase of seismic activity in North China, as many fear. Understanding the transient behavior of mid-continental earthquakes has important implications for assessing earthquake hazards. The sequence of large earthquakes in the New Madrid Seismic Zone (NMSZ) in central US, which includes a cluster of M~7 events in 1811-1812 and perhaps a few similar ones in the past millennium, is likely a transient process, releasing previously accumulated elastic strain on recently activated faults. If so, this earthquake sequence will eventually end. Using simple analysis and numerical modeling, we show that the large NMSZ earthquakes may be ending now or in the near future.

  5. Laparoscopic Mitrofanoff continent catheterisable stoma in children with spina bifida

    Directory of Open Access Journals (Sweden)

    Mallikarjun N Reddy

    2015-01-01

    Full Text Available Background: In 1980, Mitrofanoff described the creation of an appendicovesicostomy for continent urinary diversion. This procedure greatly facilitates clean intermittent catheterisation in patients with neurogenic bladder. The purpose of our study was to determine the clinical efficacy of the laparoscopic Mitrofanoff catheterisable stoma for children and adolescents with spina bifida. Materials and Methods: Review of hospital records revealed that 11 children with spina bifida underwent a laparoscopic Mitrofanoff procedure with at least 1-year of follow-up. A four-port transperitoneal laparoscopic approach was used to create a Mitrofanoff appendicovesicostomy. The child was followed-up in the urology clinic at 6 weeks, 3 months, 6 months, 1-year, and then semiannually after that. Questionnaires were administered to determine, from the children′s perspective, the level of satisfaction with catheterisation and the psychosocial implications of catheterisation before and after the creation of the Mitrofanoff continent catheterisable stoma. Results: Of the 11 children, six were female, and five were male. The mean age at presentation to Paediatric urological services was 11 × 3.22 years. Overall the mean operative time was 144.09 × 17.00 min. Mean estimated blood loss was 37.36 × 11.44 cc. None of the cases needed conversion to open. Patient satisfaction with their catheterisation was measured at 2.18 × 0.98 preoperatively, Post-operatively, this improved to 4.27 × 0.46. Statistical analysis using paired t-test showed significance with P < 001. Conclusions: Laparoscopic Mitrofanoff catheterisable stoma is feasible in children with spina bifida and is associated with reasonable outcome with early recovery, resumption of normal activities and excellent cosmesis.

  6. Earth's first stable continents did not form by subduction.

    Science.gov (United States)

    Johnson, Tim E; Brown, Michael; Gardiner, Nicholas J; Kirkland, Christopher L; Smithies, R Hugh

    2017-03-09

    The geodynamic environment in which Earth's first continents formed and were stabilized remains controversial. Most exposed continental crust that can be dated back to the Archaean eon (4 billion to 2.5 billion years ago) comprises tonalite-trondhjemite-granodiorite rocks (TTGs) that were formed through partial melting of hydrated low-magnesium basaltic rocks; notably, these TTGs have 'arc-like' signatures of trace elements and thus resemble the continental crust produced in modern subduction settings. In the East Pilbara Terrane, Western Australia, low-magnesium basalts of the Coucal Formation at the base of the Pilbara Supergroup have trace-element compositions that are consistent with these being source rocks for TTGs. These basalts may be the remnants of a thick (more than 35 kilometres thick), ancient (more than 3.5 billion years old) basaltic crust that is predicted to have existed if Archaean mantle temperatures were much hotter than today's. Here, using phase equilibria modelling of the Coucal basalts, we confirm their suitability as TTG 'parents', and suggest that TTGs were produced by around 20 per cent to 30 per cent melting of the Coucal basalts along high geothermal gradients (of more than 700 degrees Celsius per gigapascal). We also analyse the trace-element composition of the Coucal basalts, and propose that these rocks were themselves derived from an earlier generation of high-magnesium basaltic rocks, suggesting that the arc-like signature in Archaean TTGs was inherited from an ancestral source lineage. This protracted, multistage process for the production and stabilization of the first continents-coupled with the high geothermal gradients-is incompatible with modern-style plate tectonics, and favours instead the formation of TTGs near the base of thick, plateau-like basaltic crust. Thus subduction was not required to produce TTGs in the early Archaean eon.

  7. Plasmodium vivax Diversity and Population Structure across Four Continents.

    Directory of Open Access Journals (Sweden)

    Cristian Koepfli

    Full Text Available Plasmodium vivax is the geographically most widespread human malaria parasite. To analyze patterns of microsatellite diversity and population structure across countries of different transmission intensity, genotyping data from 11 microsatellite markers was either generated or compiled from 841 isolates from four continents collected in 1999-2008. Diversity was highest in South-East Asia (mean allelic richness 10.0-12.8, intermediate in the South Pacific (8.1-9.9 Madagascar and Sudan (7.9-8.4, and lowest in South America and Central Asia (5.5-7.2. A reduced panel of only 3 markers was sufficient to identify approx. 90% of all haplotypes in South Pacific, African and SE-Asian populations, but only 60-80% in Latin American populations, suggesting that typing of 2-6 markers, depending on the level of endemicity, is sufficient for epidemiological studies. Clustering analysis showed distinct clusters in Peru and Brazil, but little sub-structuring was observed within Africa, SE-Asia or the South Pacific. Isolates from Uzbekistan were exceptional, as a near-clonal parasite population was observed that was clearly separated from all other populations (FST>0.2. Outside Central Asia FST values were highest (0.11-0.16 between South American and all other populations, and lowest (0.04-0.07 between populations from South-East Asia and the South Pacific. These comparisons between P. vivax populations from four continents indicated that not only transmission intensity, but also geographical isolation affect diversity and population structure. However, the high effective population size results in slow changes of these parameters. This persistency must be taken into account when assessing the impact of control programs on the genetic structure of parasite populations.

  8. GOCE observations for Mineral exploration in Africa and across continents

    Science.gov (United States)

    Braitenberg, Carla

    2014-05-01

    The gravity anomaly field over the whole Earth obtained by the GOCE satellite is a revolutionary tool to reveal geologic information on a continental scale for the large areas where conventional gravity measurements have yet to be made (e.g. Alvarez et al., 2012). It is, however, necessary to isolate the near-surface geologic signal from the contributions of thickness variations in the crust and lithosphere and the isostatic compensation of surface relief (e.g. Mariani et al., 2013) . Here Africa is studied with particular emphasis on selected geological features which are expected to appear as density inhomogeneities. These include cratons and fold belts in the Precambrian basement, the overlying sedimentary basins and magmatism, as well as the continental margins. Regression analysis between gravity and topography shows coefficients that are consistently positive for the free air gravity anomaly and negative for the Bouguer gravity anomaly (Braitenberg et al., 2013; 2014). The error and scatter on the regression is smallest in oceanic areas, where it is a possible tool for identifying changes in crustal type. The regression analysis allows the large gradient in the Bouguer anomaly signal across continental margins to be removed. After subtracting the predicted effect of known topography from the original Bouguer anomaly field, the residual field shows a continent-wide pattern of anomalies that can be attributed to regional geological structures. A few of these are highlighted, such as those representing Karoo magmatism, the Kibalian foldbelt, the Zimbabwe Craton, the Cameroon and Tibesti volcanic deposits, the Benue Trough and the Luangwa Rift. A reconstruction of the pre-break up position of Africa, South and North America is made for the residual GOCE gravity field obtaining today's gravity field of the plates forming West Gondwana. The reconstruction allows the positive and negative anomalies to be compared across the continental fragments, and so helps

  9. Reviewing definitions of urinary continence in the contemporary spina bifida literature: a call for clarity.

    Science.gov (United States)

    Lloyd, Jessica C; Nseyo, Unwanaobong; Madden-Fuentes, Ramiro J; Ross, Sherry S; Wiener, John S; Routh, Jonathan C

    2013-10-01

    Urinary continence is a common goal for children with spina bifida and their physicians. However, definitions of urinary continence vary widely across published studies. We systematically assessed the utilization of common definitions of urinary continence in the spina bifida literature. We searched library databases for reports (2000-2012) describing urinary continence outcomes in children with spina bifida. We assessed various patient-level factors such as age, lesion level, surgical history, and use of additional therapies, as well as study-level factors such as study design, country of origin, continence definition(s), and method of data collection. Of 473 identified articles, 105 met inclusion criteria, comprising a total of 3209 patients. Of these, 1791 patients (56%) were deemed continent by the study authors. Only 60 studies (57%) clearly defined what they considered to be "continent". The most common definition, used in 24% of all reports, was "always dry". There was no association between journal of publication (p = 0.13), publication year (p = 0.86), study size (p = 0.26), or study country (p = 0.43) and likelihood of a continence definition being included in the manuscript. The most frequent definition of urinary continence in the spina bifida literature is "always dry". However, definitions were highly variable, and many authors did not define continence at all. Clinicians and researchers alike would be better able to apply research findings toward improving patient care if continence definitions were more explicitly reported and less variable. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  10. Study on ecological structures of coastal lakes in Antarctic continent

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Coastal region on the Antarctic continent, where it is under the influences both of ocean and ice sheet, as well as frequent human activities, could be considered as a fragile zone in Antarctic ecological environment. There are many lakes in coastal region, showing much differences from each other in physical-chemical features because of individual evolutionary history in their geographical environments, and suffering from different outside factors, such as climate changes and precipitation. Thus, it results in respective biological distribution and ecological structure in lakes. The present paper reports the results from the studies of chemical components, species distributions and community structures, which mainly consisted of planktons in lakes in the Vestfold Hills (68°38'S, 78°06'E), and the Larsemann Hills (69°30'S, 76°20'E), East Antarctica. It also treats the biological diversities and nutrient relationships of these different types of lakes. So as to provide more scientific basis for monitoring of climate changes and environmental protection in Antarctica.

  11. Volcanic passive margins: another way to break up continents.

    Science.gov (United States)

    Geoffroy, L; Burov, E B; Werner, P

    2015-10-07

    Two major types of passive margins are recognized, i.e. volcanic and non-volcanic, without proposing distinctive mechanisms for their formation. Volcanic passive margins are associated with the extrusion and intrusion of large volumes of magma, predominantly mafic, and represent distinctive features of Larges Igneous Provinces, in which regional fissural volcanism predates localized syn-magmatic break-up of the lithosphere. In contrast with non-volcanic margins, continentward-dipping detachment faults accommodate crustal necking at both conjugate volcanic margins. These faults root on a two-layer deformed ductile crust that appears to be partly of igneous nature. This lower crust is exhumed up to the bottom of the syn-extension extrusives at the outer parts of the margin. Our numerical modelling suggests that strengthening of deep continental crust during early magmatic stages provokes a divergent flow of the ductile lithosphere away from a central continental block, which becomes thinner with time due to the flow-induced mechanical erosion acting at its base. Crustal-scale faults dipping continentward are rooted over this flowing material, thus isolating micro-continents within the future oceanic domain. Pure-shear type deformation affects the bulk lithosphere at VPMs until continental breakup, and the geometry of the margin is closely related to the dynamics of an active and melting mantle.

  12. Convective Transport of Trace Gases in the Maritime Continent

    Science.gov (United States)

    Harris, Neil

    2015-04-01

    Passage of air through the Tropical Tropopause Layer (TTL) is the major route for troposphere to stratosphere transport. The UK CAST (Co-ordinated Airborne Studies in the Tropics) campaign took place in the West Pacific in January/February 2014. The field campaign was based mainly in Guam (13.5oN, 144.8oE) and had three components: CAST with the NERC FAAM BAe-146 research aircraft; the NASA ATTREX project based around the Global Hawk; the NCAR-led CONTRAST campaign based around the Gulfstream V (HIAPER) aircraft. Together, these aircraft were able to make detailed measurements of atmospheric structure and composition from the ocean surface to 20 km. The CAST team also made ground-based and ozonesonde measurements at the ARM site on Manus Island in Papua New Guinea during February 2014, and halocarbon measurements were made at several West Pacific sites. I will present an overview of the CAST campaign along with the results of high resolution global Unified Model studies and NAME (Numerical Atmospheric-dispersion Modelling Environment) trajectory calculations to look at the transport of air into the TTL in convective systems over the Maritime continent and West Pacific. I will focus on the transport of air from in and around the boundary layer and will assess the possible importance of natural and anthropogenic emissions for TTL composition.

  13. 21 CFR 876.5280 - Implanted mechanical/hydraulic urinary continence device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implanted mechanical/hydraulic urinary continence....5280 Implanted mechanical/hydraulic urinary continence device. (a) Identification. An implanted... application of continuous or intermittent pressure to occlude the urethra. The totally implanted device...

  14. The value of cystography in the prediction of early urinary continence after radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Yi-Huei Chang

    2016-12-01

    Conclusion: Postoperative cystography can provide information on VUAL and bladder neck condition which can predict recovery of urinary continence after radical prostatectomy. A higher VUAL and bladder neck closure were associated with a higher rate of early recovery of urinary continence.

  15. APPLICATION OF GLYCERINE ENEMA BY USING THE ULTRASOUND CONTRAST ON FALLOPIAN TUBE%输卵管超声造影前使用开塞露的意义

    Institute of Scientific and Technical Information of China (English)

    刘红艳; 章兰英; 文娟; 刘丽丽

    2015-01-01

    目的:探讨输卵管超声造影前使用开塞露对造影图像清晰度的影响。方法收集我院不孕门诊病人945例,其中肠胀气182例,采用随机方法把肠胀气患者分为开塞露组( A组90例)和未使用开塞露组( B组92例)。 A组在输卵管超声造影前1小时前使用开塞露2支纳肛。观察两组患者超声造影时超声图像的清晰度,根据输卵管超声造影中图像显像是否清晰评价使用效果。结果 A组病人输卵管超声图像较B组明显改善,差异有统计学意义(87.8%vs 13.0%,p <0.01)。结论输卵管超声造影术前1小时应用开塞露,尤其是肠胀气患者,可明显改善其超声造影图像清晰度。%Objective To investigate the effect of the glycerine enema , by using the ultrasound contrast on fallopian tube .Methods In the 945 infertility outpatients , there were 182 outpatients with intestinal tympanites , and the others without .182 outpatients with intestinal tympanites were randomly divided into 2 groups ( group A/B):Group A (90 patients) underwent the ultrasound contrast on fallopian tube with the glycerine enema in the anus of the patients one hour before;Group B(92 patients) without the glycerine enema.We observed the definitions of ultra-sound contrast images in all groups , and thus compared the effect of the glycerine enema .Results After using the glycerine enema, compared with group B(13.0%), the definitions of ultrasound images in group A (87.8%) were significantly improved(p<0.01).Conclusion It will significantly improve the definitions of ultrasound images with the glycerine enema in the anus of the patients one hour before , especially with intestinal tympanites .

  16. Thermomechanical consequences of Cretaceous continent-continent collision in the eastern Alps (Austria): Insights from two-dimensional modeling

    Science.gov (United States)

    Willingshofer, Ernst; van Wees, J. D.; Cloetingh, S. A. P. L.; Neubauer, F.

    1999-10-01

    We use two-dimensional numerical modeling techniques to investigate the thermomechanical consequences of closure of the Meliata-Hallstatt ocean and consequent Cretaceous continent-continent collision in the eastern Alps (Austria). In the modeling a lower plate position of the Austro-Alpine (AA) continental block is adopted during collision with the Upper Juvavic-Silice block. The thermal structure of the lithosphere was calculated for major AA tectonic units (Upper, Middle, and Lower Austro-Alpine) by integration of the transient heat flow equation along an approximately NW-SE cross section east of the Tauern Window. Indications of the rheological evolution of the AA were determined by calculating strength profiles at key stages of the Cretaceous orogeny, making use of the thermal modeling predictions combined with rock mechanics data. Cooling in the upper plate and lower greenschist facies metamorphism within footwall parts of the lower Upper Austro-Alpine (UA) plate, related to SE directed underthrusting of the UA beneath the Upper Juvavic-Silice block at circa 100 Ma, were predicted by the numerical model. The observed pressure-temperature path for deeply buried Middle Austro-Alpine (MA) upper crustal units and their subsequent isothermal exhumation are best reproduced assuming a pressure peak at 95 Ma and exhumation rates ranging between 4 and 7.5 mm yr-1. From the modeling results, we deduce that the temperature evolution during eclogite exhumation is primarily dependent on rates of tectonic movements and largely independent of the mode of exhumation (thrusting versus erosion). Furthermore, very rapid postmetamorphic exhumation of southern Lower Austro-Alpine (LA) units is predicted in order to account for subsequent cooling. This is constrained by 40Ar/39Ar data. The cooling paths of MA and LA rocks appear to be primarily controlled by their near-surface positions at the end of the Cretaceous rather than by other processes such as concurrent underthrusting

  17. Representations of OxyContin in North American Newspapers and Medical Journals

    Directory of Open Access Journals (Sweden)

    Emma Whelan

    2011-01-01

    Full Text Available Following the approval of OxyContin (Purdue Pharma, Canada for medical use, the media began to report the use of OxyContin as a street drug, representing the phenomenon as a social problem. Meanwhile, the pain medicine community has criticized the inaccurate and one-sided media coverage of the OxyContin problem. The authors of this study aimed to contribute to an understanding of both sides of this controversy by analyzing the coverage of OxyContin in newspapers and medical journals. The analyses revealed inconsistent messages about the drug from physicians in the news media and in medical journals, which has likely contributed to the drug’s perception as a social problem. The authors suggest ways to address the lack of medical consensus surrounding OxyContin. The results of this study may help resolve the concerns and conflicts surrounding this drug and other opioids.

  18. 待产妇应用改良式开塞露灌肠法的效果观察%The effect observation of application of modified glycerine enema method for expectant mother

    Institute of Scientific and Technical Information of China (English)

    牛建佩

    2014-01-01

    目的:探讨待产妇应用改良式开塞露灌肠法的临床效果。方法:将60例符合灌肠指征的待产妇随机分为对照组与观察组各30例。观察组采用60ml注射器抽吸开塞露60ml,连接一次性呼吸道用吸引导管,润滑管的前端后,行小量不保留灌肠;对照组使用一次性灌肠包,温肥皂水灌肠。根据两组待产妇灌肠的舒适度、接产中有无污染,操作方便易行性,比较二组灌肠法的灌肠效果。结果:对照组灌肠液外流发生率30%,观察组3.3%,两组比较,差异有统计学意义(χ2=7.680,P<0.01);对照组排便强烈感发生率26.7%,观察组6.7%,差异具有统计学意义(χ2=4.320,P<0.05);对照组接产中排便发生率20%,观察组13.3%,差异具有统计学意义(χ2=3.256,P<0.05)。结论:待产妇应用改良式开塞露灌肠法灌肠,能有效避免灌肠液的外流情况,减轻待产妇灌肠时的排便刺激感,且减少接产中排便的情况,有效避免接产中粪便污染的几率,保证良好的灌肠效果。%Objective:To explore the clinical effect of application of modified glycerine enema method for expectant mother. Methods:60 cases with enema indication were randomly divided into the control group and the observation group with 30 cases in each.In the observation group,we took 60ml of glycerine enema by 60ml syringe,connected with suction catheter for disposable respiratory tract.The observation group were given no retention enema after the lubrication of the front end of the pipe.The control group received warm soapy water enema using a disposable enema bag.We compared the effect of enema of the two groups according to enema comfort,with or without pollution in labor,easy and convenient.Results:In the control group,the enema spillover occurrence rate was 30%,and the observation group was 3.3%.The difference was statistically significant(χ2=7.680,P<0.01).In the control group,a strong

  19. Wetland dynamics influence mid-continent duck recruitment

    Science.gov (United States)

    Anteau, Michael J.; Pearse, Aaron T.; Szymankski, Michael L.

    2013-01-01

    Recruitment is a key factor influencing duck population dynamics. Understanding what regulates recruitment of ducks is a prerequisite to informed habitat and harvest management. Quantity of May ponds (MP) has been linked to recruitment and population size (Kaminski and Gluesing 1987, Raveling and Heitmeyer 1989). However, wetland productivity (quality) is driven by inter-annual hydrological fluctuations. Periodic drying of wetlands due to wet-dry climate cycles releases nutrients and increases invertebrate populations when wet conditions return (Euliss et al. 1999). Wetlands may also become wet or dry within a breeding season. Accordingly, inter-annual and intra-seasonal hydrologic variation potentially influence duck recruitment. Here, we examined influences of wetland quantity, quality, and intra-seasonal dynamics on recruitment of ducks. We indexed duck recruitment by vulnerability-corrected age ratios (juveniles/adult females) for mid-continent Gadwall (Anas strepera). We chose Gadwall because the majority of the continental population breeds in the Prairie Pothole Region (PPR), where annual estimates of MP exist since 1974. We indexed wetland quality by calculating change in MP (?MP) over the past two years (?MP = 0.6[MPt – MPt-1] + 0.4[MPt – MPt-2]). We indexed intra-seasonal change in number of ponds by dividing the PPR mean standardized precipitation index for July by MP (hereafter summer index). MP and ?MP were positively correlated (r = 0.65); therefore, we calculated residual ?MP (?MPr) with a simple linear regression using MP, creating orthogonal variables. Finally, we conducted a multiple regression to examine how MP, ?MPr, and summer index explained variation in recruitment of Gadwall from 1976–2010. Our model explained 67% of the variation in mid-continent Gadwall recruitment and all three hydrologic indices were positively correlated with recruitment (Figure 1). Type II semi-partial R2 estimates indicated that MP accounted for 41%, ?MPr

  20. The Rise of Continents and the Transition Archean to Proterozoic

    Science.gov (United States)

    Rey, P. F.; Flament, N.; Coltice, N.

    2011-12-01

    Terrestrial planets evolve in part via partial melting and gravitational differentiation, and in part via fluid/rock interactions at the surface. Mass and energy transfers across their various envelopes depend on the mode of convective motion, which may involve stagnant or mobile lid systems, for which plate tectonics is a possible mode; one promoting the coupling between exogenic and endogenic envelopes. In the other hand, fluid/rock interaction at the surface depends on the planet hypsometry and availability of weathering agents such as liquid water. It also depends on fluid/rock interaction at mid-oceanic ridge and therefore on the mode of convection. Hence, from 4.54 to 2.5 Ga the interplay between deep and surface processes under the forcing of secular cooling was such that the Earth differentiation was non-linear with sudden crises that punctuated periods of relative quietness. The Earth secular cooling impacted on deep and surface processes through the modulation of the Earth's hypsometry. This modulation occurred via cooling and strengthening of the lithosphere (Rey and Coltice, Geology, 2008), and via the deepening of oceanic basin, which lowered the mean sea level forcing the continents to emerge (Flament et al., EPSL, 2008). Stronger lithospheres are able to sustain higher orogenic belts and orogenic plateaux, the erosion of which lead to stronger fluxes towards the ocean. Secular strengthening and emergence conspired to enhance weathering and erosion of the continents and therefore to enhance the geochemical coupling between the endogenic and exogenic Earth's envelopes (Rey and Coltice, Geology, 2008). The shift to the aerobic world, at the Archean to Proterozic transition, took place at a time when exogenic envelopes recorded major shifts in composition (eg. Taylor and McLennan, Rev. of Geophys., 1995; Veizer and Compston, Geochem. Cosmochem Acta, 1976; Valley et al., Contrib. to Mineral. Petrol., 2005) that are consistent with the progressive exposure

  1. Organic geochemistry of mid-continent Ordovician oils

    Energy Technology Data Exchange (ETDEWEB)

    Palmer, S.E.

    1985-01-01

    Early Paleozoic oils retain the biochemical imprint of oceanic life prior to evolution of land plants and vertebrates. Thus, these oils have geochemical features which make them unique with respect to younger oils, but also share some common properties with the latter. Characteristic mid-continent Ordovician oil features include predominance of n-C/sub 14/ to n-C/sub 19/ over n-C/sub 20/+ alkanes in the C/sub 15/+ saturate hydrocarbon fraction, low amounts of isoprenoids and abundant C/sub 27/ and C/sub 29/ diasteranes relative to normal steranes. Properties common to both Ordovician and younger oils are: nearly equal amounts of C/sub 15/+ n-alkanes, cycloalkanes, and aromatics and pristane/phytane ratios of 0.7 to 1.6. Collectively, these Ordovician oils have a relatively negative stable carbon isotopic composition but are not unique with respect to other marine oils. Although terpane distributions are generally similar to geologically-younger oils, the Ordovician oils contain significant amounts of C/sub 19/, C/sub 20/, and C/sub 21/ tricyclic diterpanes relative to the C/sub 23/ homolog as well as large contributions by C/sub 31/+ pentacyclic triterpanes. Presence of long-chained n-alkanes, C/sub 29/ steranes, and C/sub 24/ tetracyclic terpanes, which are generally accepted as input from land plants in, e.g., Tertiary deposits, are also present in Ordovician oils. The characteristics listed above describe oils from the Williston and Michigan basins as well as Ordovician oils from Kansas and Oklahoma.

  2. Preparation of northern mid-continent petroleum atlas

    Energy Technology Data Exchange (ETDEWEB)

    Gerhard, L.C.; Carr, T.R.; Watney, W.L.

    1997-02-13

    The prototype Digital Petroleum Atlas (DPA) Project is part of a long-term effort to develop a new methodology to provide efficient and timely access to the latest petroleum data and technology for the domestic oil and gas industry, public sector research organizations and local governmental units. The DPA provides real-time access through the Internet using widely available tools such as World-Wide-Web browsers. The latest technologies and information are published electronically when individual project components are completed removing the lag and expense of transferring technology using traditional paper publication. Active links, graphical user interfaces and database search mechanisms of the DPA provide a product with which the operator can interact in ways that are impossible in the paper publication. Contained in the DPA are forms of publication that can only be displayed in an electronic environment (for example, animated exploration histories through time). Improvement in data and technology access for the domestic petroleum industry represents one of the best and cost-effective options that is available for mitigating the continued decline in domestic production. The prototype DPA concentrated on developing methodologies and computerized procedures to generate and to publish a limited set of field and play studies concentrated in Kansas and to a lesser extent the Northern Mid-continent. Access is provided through the DPA to previously existing and new regional, play, field and individual well information. Methodologies, developed in year one of the prototype DPA Project, provide a published product and ongoing technology transfer activity that is continuously updated with the latest information and technology.

  3. Cerebral Metabolic Profiling of Hypothermic Circulatory Arrest with and Without Antegrade Selective Cerebral Perfusion: Evidence from Nontargeted Tissue Metabolomics in a Rabbit Model

    Institute of Scientific and Technical Information of China (English)

    Li-Hua Zou; Jin-Ping Liu; Hao Zhang; Shu-Bin Wu; Bing-Yang Ji

    2016-01-01

    Background:Antegrade selective cerebral perfusion (ASCP) is regarded to perform cerebral protection during the thoracic aorta surgery as an adjunctive technique to deep hypothermic circulatory arrest (DHCA).However,brain metabolism profile after ASCP has not been systematically investigated by metabolomics technology.Methods:To clarify the metabolomics profiling of ASCP,12 New Zealand white rabbits were randomly assigned into 60 min DHCA with (DHCA+ASCP [DA] group,n =6) and without (DHCA [D] group,n =6) ASCP according to the random number table.ASCP was conducted by cannulation on the right subclavian artery and cross-clamping of the innominate artery.Rabbits were sacrificed 60 min after weaning off cardiopulmonary bypass.The metabolic features of the cerebral cortex were analyzed by a nontargeted metabolic profiling strategy based on gas chromatography-mass spectrometry.Variable importance projection values exceeding 1.0 were selected as potentially changed metabolites,and then Student's t-test was applied to test for statistical significance between the two groups.Results:Metabolic profiling of brain was distinctive significantly between the two groups (Q2y =0.88 for partial least squares-DA model).In comparing to group D,62 definable metabolites were varied significantly after ASCP,which were mainly related to amino acid metabolism,carbohydrate metabolism,and lipid metabolism.Kyoto Encyclopedia of Genes and Genomes analysis revealed that metabolic pathways after DHCA with ASCP were mainly involved in the activated glycolytic pathway,subdued anaerobic metabolism,and oxidative stress.In addition,L-kynurenine (P =0.0019),5-methoxyindole-3-acetic acid (P =0.0499),and 5-hydroxyindole-3-acetic acid (P =0.0495) in tryptophan metabolism pathways were decreased,and citrulline (P =0.0158) in urea cycle was increased in group DA comparing to group D.Conclusions:The present study applied metabolomics analysis to identify the cerebral metabolic profiling in rabbits with ASCP

  4. Computer-assisted three-dimensional correlation between the femoral neck-shaft angle and the optimal entry point for antegrade nailing.

    Science.gov (United States)

    Anastopoulos, George; Chissas, Dionisios; Dourountakis, Joseph; Ntagiopoulos, Panagiotis G; Magnisalis, Evaggelos; Asimakopoulos, Antonios; Xenakis, Theodore A

    2010-03-01

    Optimal entry point for antegrade femoral intramedullary nailing (IMN) remains controversial in the current medical literature. The definition of an ideal entry point for femoral IMN would implicate a tenseless introduction of the implant into the canal with anatomical alignment of the bone fragments. This study was undertaken in order to investigate possible existing relationships between the true 3D geometric parameters of the femur and the location of the optimum entry point. A sample population of 22 cadaveric femurs was used (mean age=51.09+/-14.82 years). Computed-tomography sections every 0.5mm for the entire length of femurs were produced. These sections were subsequently reconstructed to generate solid computer models of the external anatomy and medullary canal of each femur. Solid models of all femurs were subjected to a series of geometrical manipulations and computations using standard computer-aided-design tools. In the sagittal plane, the optimum entry point always lied a few millimeters behind the femoral neck axis (mean=3.5+/-1.5mm). In the coronal plane the optimum entry point lied at a location dependent on the femoral neck-shaft angle. Linear regression on the data showed that the optimal entry point is clearly correlated to the true 3D femoral neck-shaft angle (R(2)=0.7310) and the projected femoral neck-shaft angle (R(2)=0.6289). Anatomical parameters of the proximal femur, such as the varus-valgus angulation, are key factors in the determination of optimal entry point for nailing. The clinical relevance of the results is that in varus hips (neck-shaft angle shaft angle between 120 degrees and 130 degrees , the optimal entry point lies just medially to the trochanter tip (at the piriformis fossa) and the use of stiff implants is safe. In hips with neck-shaft angle over 130 degrees the anatomical axis of the canal is medially to the base of the neck, in a "restricted area". In these cases the entry point should be located at the insertion of the

  5. MONTI as continent catheterized stoma using serosal-lined trough "Ghoneim Abolenin" technique in ileocystoplasty

    Directory of Open Access Journals (Sweden)

    Mohammed T Sammour

    2011-01-01

    Full Text Available It is a great challenge to select and perform continent mechanism in a stoma for urinary reservoir. A new technique by combining MONTI ileal conduit with the serosal lined trough in order to achieve continent catheterizable stoma to the umbilicus as a part of augmentation ileocystoplasty. We applied serosal-lined trough as a continent mechanism with MONTI ileal tube in 12 years smart girl underwent ileocystoplasty for neuropathic bladder due to meylomeningocele in whom continence failed to be achieved by using Mitrofanoff with submucosal tunnel of the bladder as continent mechanism before, also the previous operation included left to right transuretero-ureterostomy, ureterocystoplasty and reimplantation of the right ureter. The patient became completely continent; she was able to do self-catheterization easily through the umbilical stoma using 16-French catheter and was able to wash the mucous easily. The capacity of the augmented bladder was 300ccs. She became independent from her mother and stopped using diapers, anticholinergic and antibiotics. Combining MONTI conduit with serosal-lined extramural valve trough (The Ghoneim technique is an effective continent technique and gives wider channel for catheterization and washing out the mucous.

  6. Effects of Glycerine Enema on Alleviating Urinary Retention after Gynecologic Operation%开塞露在妇科手术后缓解尿潴留的效果观察

    Institute of Scientific and Technical Information of China (English)

    王晓春

    2014-01-01

    Objective:To investigate the effect of glycerine enema on alleviate urinary retention after gynecological operation. Methods:60 patients with urinary retention after gynecologic operation were randomly divided into the ob-servation group and the control group, with 30 cases in each group. The control group received traditional inducing urination while the observation group received glycerine enema admitted to anus in additional to the traditional inducing urination. Results:The observation group showed significantly higher incidence of self-control urination than the control group. Conclusion:Glycerine enema can be used to alleviate urinary retention after gynecological operation.%目的:探讨开塞露在妇科手术后缓解尿潴留效果。方法:将60例妇科手术后并发尿潴留患者随机分为观察组和对照组,对照组实施传统诱导排尿,观察组在传统诱导排尿基础上加用开塞露塞肛。结果:观察组自行排尿率明显高于对照组。结论:开塞露缓解尿潴留效果显著。

  7. The change of radiation doses to the patient when switching from conventional technique to digital technique without films in barium enema and IVU examinations. Final report SSI research project P933

    CERN Document Server

    Sjöholm, B

    2003-01-01

    X-ray examinations of the colon (barium enema) and the kidneys (IVU) are combined with rather high radiation doses to the patients when using analogue technique with film-screen systems. It is therefore of great interest to see if the change from analogue to digital technique involves a reduction of doses. Barium enema and IVU examinations were monitored with DAP-meters before and after the X-ray department changed to digital techniques. For IVU also the change from storage phosphor plates to a Direct Digital detector is included. The study comprises between 53 and 87 patients for each modality of the two examinations. A considerable dose reduction was observed. In barium enema the overview images with large field sizes were omitted when using digital technique. On the other hand the number of spot images was increased from 6 to 22. The fluoroscopy time was increased from 4 minutes to 6 minutes. The DAP value was reduced from 54,3 Gy cm sup 2 to 21,9 Gy cm sup 2. For IVU a dose reduction from 44,5 Gy cm sup 2...

  8. The “potato road” and biogeographic history of potato cyst nematode populations from different continents

    Directory of Open Access Journals (Sweden)

    Or Violeta

    2014-01-01

    Full Text Available The general opinion about the introduction of potato in Europe is the one regarding the direction from South America to Spain and subsequent distribution to other continents. Some historical data point out an alternative road. The potato spread from its place of origin to other continents in the light of parasite-host relationship, relying on nematode molecular data, is discussed in the present work. Biogeographic history of potato cyst nematode populations from different continents is in congruence with historical records. [Projekat Ministarstva nauke Republike Srbije, br. TR 31018 i br. III 46007

  9. Quaternary Reorganization of North American Mid-continent Drainage Systems

    Science.gov (United States)

    Carson, E. C.; Rawling, J. E., III; Attig, J. W.; Bates, B. R.

    2013-12-01

    Identification of ancestral drainage systems in the North American mid-continent has been a topic of research and debate among geologists since the middle of the 19th Century. Over time our understanding of the significance of Quaternary glaciations in reshaping drainage patterns has grown. The ancestral Teays River, which drained large areas of the central Appalachians and flowed westward across Indiana and western Illinois, was dammed multiple times by Quaternary glaciers before finally being rerouted to the course of the modern central Ohio River. Similarly, the northward-flowing ancestral Pittsburgh River was dammed by pre-Illinoian glaciers; subsequent stream piracy converted this river system into the modern Allegheny, Monongahela and uppermost Ohio Rivers. Deposits and geomorphic features along the westward-flowing lower Wisconsin River indicate that the modern upper Mississippi River and Wisconsin River may have experienced a similar history of ice blockage, stream piracy, and radical rerouting. Coring into the Bridgeport strath terrace along the lower Wisconsin River reveals that the bedrock surface dips to the east, indicating the valley was cut by an eastward-flowing river. We believe the most likely scenario following this interpretation is that an ancestral river flowing along the modern upper Mississippi River valley made a sharp bend at Prairie du Chien, WI, and flowed eastward along the valley occupied by the modern lower Wisconsin River. This river, referred to here as the Wyalusing River, likely flowed northeastward into the Great Lakes (St. Lawrence) drainage until that path was blocked by ice advancing from the northwest. Subsequent stream piracy immediately south of the modern confluence of the Mississippi and Wisconsin Rivers rerouted these streams, converting them to the headwaters of the greater Mississippi drainage. The combined rerouting of these river systems into entirely different drainage basins necessitates significant fundamental

  10. BRICS: challenges of cooperation on the African continent

    Directory of Open Access Journals (Sweden)

    Vladimir Ivanovich Yurtaev

    2016-12-01

    Full Text Available The happening paradigm shift of development both the kernel of world economy, and its periphery appearing by the hostage of limitation of financial resources updates task of judgment of the happening processes, especially with participation of the Brazil, Russia, India, China and South Africa (BRICS or the countries of the “big economies” which are looking for new formats of entry into worldwide policy. Also the problem of correlation of the monopolar structure of a world economic system which has arisen in the conditions of globalization of economies at the end of the 20th century with processes of forming of the new centers of world economic power is actual, including - in Africa, under the influence of an exit to the world scene of China and other countries of BRICS, disappearance of the so-called “second world”, opposition mitigation “East-West” and increase of contradictions on an axis “North-South”. The countries of Africa at the beginning of the second decade of the third millennium are more and more considerably involved in process of globalization which signs can be found everywhere on the African continent. First of all, it is necessary to pay attention on much the increased dynamics of political process, especially in North Africa where under the influence of “the Arab spring” scales and depth of the happened transformation of a socio-political context were shown, civilization breaks and perspective scenarios of development were more accurately designated. To conformably new challenges questions of regional integration have come under the spotlight in Africa, search of solutions of global problems of mankind in Africa is conducted (poverty, hunger, diseases, refugees, etc. new formats of interaction of the states for the benefit of effective development are developed. It is possible that in so dynamic and turbulent socio-political and economic situation regional vector of interaction and interregional international

  11. Prevention of ventriculoperitoneal shunt complications after intraperitoneal urological surgeries.

    Science.gov (United States)

    Ikeda, Takashi; Akiyama, Sayaka; Kim, Woo Jin; Ito, Susumu; Yamazaki, Yuichiro

    2017-07-01

    To evaluate perioperative management for the prevention of postoperative shunt infection and malfunction after intraperitoneal urological surgery in patients with myelodysplasia and a ventriculoperitoneal shunt. From 2005 to 2015, 20 consecutive patients with myelodysplasia and a ventriculoperitoneal shunt who underwent intraperitoneal urological surgeries were managed with the same perioperative regimen. Intraperitoneal surgeries involved opening gastrointestinal tracts, including bladder augmentation by enterocystoplasty, creating continent catheterizable channels and Malone antegrade continent enema. We compared results with those from seven previous reports regarding postoperative shunt complications, surgical histories of previous shunt revisions, management of bacteriuria before surgery preoperative bowel preparation, antibiotic regimens, and duration of indwelling drain. Of 20 patients, 18 received prior shunt revisions, and 14 had positive urine culture before surgery that was managed with oral antibiotics. Thirteen patients underwent bladder augmentation with ileum, and one underwent augmentation with sigmoid colon. Nineteen patients underwent Malone antegrade continent enema using the appendix. All parenteral antibiotics were stopped on postoperative day 2.5. Mean duration of indwelling peritoneal drain was 2.7days. Mean follow-up period was 59.8months. Neither postoperative shunt infections nor intraperitoneal shunt malfunctions were recognized during follow-up period. This is the first study to evaluate postoperative ventriculoperitoneal shunt complications in patients with myelodysplasia who underwent intraperitoneal urological surgeries with a specific perioperative regimen. Shunt complications are greatly reduced by rigorous perioperative management, including preoperative control of bacteriuria, appropriate administration of prophylactic antibiotics, and early removal of intraperitoneal drains. The type of study: Case series with no comparison group

  12. The dual influences of age and obstetric history on fecal continence in parous women.

    LENUS (Irish Health Repository)

    Eogan, Maeve

    2011-02-01

    To assess whether women who underwent forceps delivery were more likely than those who delivered either normally (spontaneous vaginal delivery [SVD]) or by cesarean to experience deterioration in fecal continence as they aged.

  13. Bibliography of sandy beaches and sandy beach organisms on the African continent

    CSIR Research Space (South Africa)

    Bally, R

    1986-01-01

    Full Text Available This bibliography covers the literature relating to sandy beaches on the African continent and outlying islands. The bibliography lists biological, chemical, geographical and geological references and covers shallow marine sediments, surf zones off...

  14. The Aristotelian continence: channeling of righteous actions in the scientist´s experiments with animals

    Directory of Open Access Journals (Sweden)

    Luis Fernando Garcés Giraldo

    2014-06-01

    Full Text Available In Aristotelian ethics, the virtue of continence is responsible for mastering the soul and direct it towards the right reason; thus the continent, knowing that passions are bad does not follow them because of the reason; this virtuous is the one who subdues the passions, since both, reason and passions, oppose each other. For Aristotle the desire is the beginning of the action, followed by the discussion leading to choose the best and the most perfect virtuous action. It is important for bioethics that the virtue of continence applies to the actions of scientists who use animals for experimentation and that all their actions are mediated by the good actions. This article will deal with the virtue of continence as the channeling of actions mediated by right reason in the scientist who is experimenting with animals.

  15. 神经内科便秘患者应用甘油灌肠剂的护理探讨%Nursing Observation of Medical Application of Glycerine Enema in Patients with Constipation in Department of Neurology

    Institute of Scientific and Technical Information of China (English)

    段秋改; 成巧梅; 葛运利; 宋爱华

    2015-01-01

    目的:探讨神经内科便秘患者应用甘油灌肠剂的护理措施。方法选取该院神经内科2012年1月—2013年5月收治的120例有便秘症状的患者,对照组60例不应用甘油灌肠剂,观察组60例应用甘油灌肠剂进行护理,观察患者12 h排便情况。结果观察组12 h排便总有效率为100%,对照组12 h排便总有效率为7%,两组比较差异有统计学意义(P<0.01)。结论对神经内科便秘患者应用甘油灌肠剂进行护理,可有效提高便秘的治愈率,促进疾病康复,减轻了护理工作负担,提升了护理质量。%Objective To investigate and summarize the nursing experience of medical application of glycerine enema in patients with constipation in the Department of Neurology.Methods The present study enrolled 120 cases with constipation in the Department of Neurology in our hospital from January 2012 to May 2013. They were divided into the control group (n=60) who were not given glycerin enema for nursing and the observation group (n=60) who were given glycerin enema for nursing. The 12 h defecation was observed in the patients after application of glycerin enema.Results The total effective rate of 12 h defecation was 100% in the observation group and 7% in the control group, and the difference between the two groups was statistically significant(P<0.01).Conclusion Medical application of glycerin enema in nursing of patients with constipation in the Department of Neurology can effectively improve the cure rate of constipation, promote the recovery from disease, reduce the burden of nursing work, and enhance the quality of nursing.

  16. Long-term Outcomes After Continent Ileostomy Creation in Patients With Crohn's Disease.

    Science.gov (United States)

    Aytac, Erman; Dietz, David W; Ashburn, Jean; Remzi, Feza H

    2017-05-01

    Patients with Crohn's disease have a higher failure rate after ileal pouch surgery compared with their counterparts with ulcerative colitis. We hypothesized that risk of continent ileostomy failure can be stratified based on the timing of Crohn's disease diagnosis and aimed to assess long-term outcomes. This was a retrospective cohort study. The investigation took place in a high-volume, specialized colorectal surgery department. Patients with Crohn's disease who underwent continent ileostomy surgery between 1978 and 2013 were evaluated. Functional outcomes, postoperative complications, requirement of revision surgery, and continent ileostomy failure were analyzed. There were 48 patients (14 male patients) with a median age of 33 years at the time of continent ileostomy creation. Crohn's disease diagnosis was before continent ileostomy (intentional) in 15 or made in a delayed fashion at a median 4 years after continent ileostomy in 33 patients. Median follow-up was 19 years (range, 1-33 y) after index continent ileostomy creation. Major and minor revisions were performed in 40 (83%) and 13 patients (27%). Complications were fistula (n = 20), pouchitis (n = 16), valve slippage (n = 15), hernia (n = 9), afferent limb stricture (n = 9), difficult intubation (n = 8), incontinence (n = 7), bowel obstruction (n = 7), valve stricture (n = 5), leakage (n = 4), bleeding (n = 3), and valve prolapse (n = 3). Median Cleveland global quality-of-life score was 0.8. Continent ileostomy failure occurred in 22 patients (46%). Based on Kaplan-Meier estimates, continent ileostomy survival was 48 % (95% CI, 33%-63%) at 20 years. Continent ileostomy failure was similar regardless of timing of diagnosis of Crohn's disease (p = 0.533). This study was limited by its retrospective and nonrandomized nature. Outcomes of continent ileostomy in patients with Crohn's disease are poor, regardless of the timing of diagnosis. Very careful consideration should be given by both the surgeon and the

  17. Radiologic evaluation of the continent (S-pouch) ileal reservoir with anal anastomosis

    Energy Technology Data Exchange (ETDEWEB)

    Hennild, V.; Kjaergaard, H.; Kuld Hansen, L.

    A radiologic investigation was performed in 26 patients subjected to colectomy, mucosal proctectomy and endorectal ileo-anal anastomosis after the creation of an ileal reservoir. The patients had suffered from ulcerative colitis or familial polyposis. The reservoir and its efferent leg was best demonstrated by contrast enema. The size and position of the reservoir and the efferent leg was demonstrated, and stenoses, abscesses and fistulae could be identified. Examination of the small bowel with a contrast medium showed slight dilatation of the ileum orally to the reservoir in all instances and one patient had a stenosis at the junction of the afferent leg of the reservoir. Erect and supine projections of the abdomen showed gas in the intestine and fluid levels in the reservoir. These radiographic findings should not be confused with ileus or pelvic abscess. Radiology was of great value in disclosing postoperative complications.

  18. Correlation between mobile continents and elevated temperatures in the subcontinental mantle

    Science.gov (United States)

    Jain, Charitra; Rozel, Antoine; Tackley, Paul

    2016-04-01

    Rolf et al. (EPSL, 2012) and Coltice et al. (Science, 2012) have previously shown that continents exert a first order influence on Earth's mantle flow by affecting convective wavelength and surface heat flow. With stationary continents, Heron and Lowman (JGR, 2014) highlighted the decreasing role of continental insulation on subcontinental temperatures with higher Rayleigh number (Ra). However, the question whether there exists a correlation between mobile continents and elevated temperatures in the subcontinental mantle or not remains to be answered. By systematically varying parameters like core-mantle boundary (CMB) temperature, continental size, and mantle heating modes (basal and internal); we model thermo-chemical mantle convection with 2D spherical annulus geometry (Hernlund and Tackley, PEPI 2008) using StagYY (Tackley, PEPI 2008). Starting with a simple incompressible model having mobile continents, we observe this correlation. Furthermore, this correlation still holds when the model complexity is gradually increased by introducing internal heating, compressibility, and melting. In general, downwellings reduce the mantle temperature away from the continents, thereby resulting in correlation between mobile continents and elevated temperatures in the subcontinental mantle. For incompressible models (Boussinesq approximation), correlation exists and the dominant degree of convection varies with the continental distribution. When internal heating is switched on, correlation is observed but it is reduced as there are less cold regions in the mantle. Even for compressible models with melting, big continents are able to focus the heat underneath them. The dominant degree of convection changes with continental breakup. Additionally, correlation is observed to be higher in the upper mantle (300 - 1000 km) compared to the lower mantle (1000 - 2890 km). At present, mobile continents in StagYY are simplified into a compositionally distinct field drifting at the top of

  19. Impact of metabolic syndrome on early recovery of continence after robot-assisted radical prostatectomy.

    Science.gov (United States)

    Nishikawa, Masatomo; Watanabe, Hiromitsu; Kurahashi, Toshifumi

    2017-09-01

    To evaluate the impact of metabolic syndrome on the early recovery of urinary continence after robot-assisted radical prostatectomy. The present study included a total of 302 consecutive Japanese patients with clinically localized prostate cancer who underwent robot-assisted radical prostatectomy. In this study, postoperative urinary continence was defined as no leak or the use of a security pad. The continence status was assessed by interviews before and 1 and 3 months after robot-assisted radical prostatectomy. Metabolic syndrome was defined as follows: body mass index ≥25 kg/m(2) and two or more of the following: hypertension, diabetes mellitus and dyslipidemia. The effect of the presence of metabolic syndrome on the continence status of these patients was retrospectively examined. A total of 116 (38.4%) and 203 (67.2%) of the 302 patients were continent at 1 and 3 months after robot-assisted radical prostatectomy, respectively. A total of 31 (10.3%) patients were judged to have metabolic syndrome. Despite the operative time being longer in patients with metabolic syndrome, no significant differences were observed in the remaining preoperative, intraoperative or postoperative variables between patients with or without metabolic syndrome. On multivariate logistic regression analysis, metabolic syndrome and the duration of hospitalization were significantly correlated with the 1-month continence status. Similarly, metabolic syndrome and estimated blood loss during surgery were independent predictors of continence rates at 3 months after robot-assisted radical prostatectomy. These findings suggest that the presence of metabolic syndrome could have a significant impact on the early recovery of urinary continence after robot-assisted radical prostatectomy. © 2017 The Japanese Urological Association.

  20. The Dynamics of Trade Affinities : An Assessment of the Globalization of the European Continent

    OpenAIRE

    2008-01-01

    This thesis is an assessment of the dynamics of trade affinities and how they have influenced trade flows in the European continent. The focus is how trade affinities have altered over a time span of four time periods stretching from the 1970s up to today and how these alterations have influenced globalization. A total of 41 countries belonging to the European continent have been selected. Furthermore four variables were selected to represent trade affinities; distance, border, colony, and la...

  1. The continent-ocean transition of the Pearl River margin

    Science.gov (United States)

    Cameselle, A. L.; Ranero, C. R.; Franke, D.; Barckhausen, U.

    2013-12-01

    Rifted continental margins form by lithospheric extension and break-up. The continent to ocean transition (COT) architecture depends on the interplay between tectonic and magmatic processes, and thus, to study the COT variability of different systems is key to understand rifting. We use MCS data and magnetic lineations across the Pearl River margin (PRM) of South China Sea to investigate a previously poorly defined COT. The structure of the PRM presents different amounts of extension allowing the study of conjugate pairs of continental margins and their COT in a relative small region. We reprocessed about 2250 km of MCS data along 4 regional, crustal-scale lines and found that 3 of them possibly display the COT. The time-migrated seismic sections show differences in internal reflectivity, faulting style, fault-block geometry, the seismic character of the top of the basement, in the geometry of sediment deposits, and Moho reflections, that we interpret to represent clear continental and oceanic domains. The continental domain is characterized by arrays of normal faults and associated tilted blocks overlaid by syn-rift sedimentary units. The Moho is imaged as sub-horizontal reflections that define a fairly continuous boundary typically at 8-10 s TWT. Estimation of the thickness of the continental crust using 6 km/s average velocity indicates a ~22 km-thick continental crust under the uppermost slope passing abruptly to ~9-6 km under the lower slope. Comparatively the oceanic crust has a highly reflective top of basement, little-faulting, not discernible syn-tectonic strata, and fairly constant thickness (4-8 km) defined by usually clear Moho reflections. The COT occurs across a ~5-10 km narrow zone. Rifting resulted in asymmetric conjugate margins. The PRM shows arrays of tilted fault blocks covered by abundant syn-rift sediment, whereas the conjugate Macclesfield Bank margin displays abrupt thinning and little faulting. Seismic profiles also show a change in the

  2. Comparison of beclomethasone dipropionate (2 and 3 mg) and prednisolone sodium phosphate enemas (30 mg) in the treatment of ulcerative proctitis. An adrenocortical approach.

    Science.gov (United States)

    Mulder, C J; Endert, E; van der Heide, H; Houthoff, H J; Wiersinga, W; Wiltink, E H; Tytgat, G N

    1989-08-01

    Twenty-three patients with attacks of distal ulcerative colitis were treated randomly with either 2 or 3 mg of topically administered beclomethasone dipropionate (BDP) or 30 mg of prednisolone sodium phosphate (PP). The effect of the steroid enemas on adrenocortical function was assessed by ACTH tests, which were performed before and after treatment. Endoscopic, clinical and histological scores were comparable in the three treatment groups in this pilot trial. Fasting cortisol in the PP group decreased significantly from 0.47 +/- 0.12 mumol/l before to 0.22 +/- 0.14 mumol/l (P less than 0.05) after therapy; in the BDP group no significant changes were found. Urinary cortisol excretion in the PP group was not detectable after therapy; in the BDP group no changes were found. It is concluded that in the topical treatment of ulcerative colitis, BDP may be preferable to PP because it exerts a promising anti-inflammatory action without affecting adrenocortical function.

  3. 妇科术前应用不同灌肠方法的对照研究%The control study of application of different enema methods before gynecological operation

    Institute of Scientific and Technical Information of China (English)

    张晓霞

    2016-01-01

    Objective:To explore the effect of application of different enema methods before gynecological operation. Methods:Selected 100 cases of gyneco-logical patients with surgical therapy in our hospital from February 2013 to February 2015,and equally divided them into observation group and control group at random. The control group was treated traditional enema method before operation,and the observation group was treated with modified enema method be-fore operation. Then compared the two groups of patients for their defecating desire,degree of abdominal pain,intestinal cleaning effect,intra-operative flat-ulence, the number of times of enema needed under the enema standard. Results:The defecating desire and degree of abdominal pain after enema of the ob-servation group was lower than that of the control group,while the intestinal cleaning effect of observation group was obviously better than that of the control group. The difference bad statistical significance (P<0. 05). Conclusion:The application of modified enema method before gynecological operation can ef-fectively lessen the patient's pain and discomfort and rapidly improve the intestinal cleaning effect. Consequently it can improve the nursing quality at periop-erative period and possess relatively high application value.%目的:探讨妇科手术前应用不同灌肠方法的效果.方法:选取我院收治的2013年2月~2015年2月100例行手术治疗的妇科患者,随机等分成观察组与对照组,对照组患者在术前应用传统灌肠法;观察组术前应用改良灌肠法,对比两组患者的灌肠后的便意感、腹部疼痛程度及肠道清洁效果、术中胀气发生情况、达到灌肠的标准所需灌肠次数.结果:观察组患者灌肠后的便意感、腹部疼痛程度轻于对照组患者,观察组肠道清洁效果优良率明显高于对照组,差异具有统计学意义(P<0.05);观察组患者术中胀气发生率及灌肠次数均明显低于对照

  4. 顺行区域性切除腮腺浅叶良性肿瘤可行性分析%Analysis of antegrade partial superficial parotidectomy in treating benign parotid gland tumor 47 cases

    Institute of Scientific and Technical Information of China (English)

    孙永强; 杨雯雯; 梁宪斌

    2011-01-01

    Objective To explore the feasibility of anterograde dissections in superficial parotid-ectomy for benign tumor of the parotid gland. Methods Clinical data of 47 patients who underwent an-tegrade partial superficial parotidectomy of benign superficial parotid gland tumor was analyzed retrospectively from January 1995 to December 2006. Results Of the 47 patients, 8 patients had a temporary facial deficit and not a permanent facial nerve paralysis. Frey syndrome was found in 4 patients. None of them had salivary gland fistula, seroma formation and apparent face deformity. The lesion did not recurred after operation in 6 month to 5 year follow - up study. Conclusions It is quite safe and effective that benign parotid gland tumor is removed by antegrade partial superficial parotidectomy.%目的 探讨腮腺浅叶良性肿瘤顺行区域性切除的可行性.方法 回顾分析了1995年1月至2006年12月间收治的47例经顺行区域性切除的腮腺浅叶良性肿瘤患者的病例资料.结果 47例患者中并发暂时性面瘫的8例,无永久性面瘫;Frey综合症4例;无腮腺瘘及皮下积液;面部无明显畸形;随访6个月~5年无复发.结论 顺行区域性切除在腮腺浅叶良性肿瘤治疗中是一种安全、可靠的方法.

  5. Quality audit--a review of the literature concerning delivery of continence care.

    Science.gov (United States)

    Swaffield, J

    1995-09-01

    This paper outlines the role of quality audit within the framework of quality assurance, presenting the concurrent and retrospective approaches available. The literature survey provides a review of the limited audit tools available and their application to continence services and care delivery, as well as attempts to produce tools from national and local standard setting. Audit is part of a process; it can involve staff, patients and their relatives and the team of professionals providing care, as well as focusing on organizational and management levels. In an era of market delivery of services there is a need to justify why audit is important to continence advisors and managers. Effectiveness, efficiency and economics may drive the National Health Service, but quality assurance, which includes standards and audit tools, offers the means to ensure the quality of continence services and care to patients and auditing is also required in the purchaser/provider contracts for patient services. An overview and progress to date of published and other a projects in auditing continence care and service is presented. By outlining and highlighting the audit of continence service delivery and care as a basis on which to build quality assurance programmes, it is hoped that this knowledge will be shared through the setting up of a central auditing clearing project.

  6. INVESTIGATION OF URINARY CONTINANCE AGES OF HEALTHY CHILDREN AND ENURETIC CHILDREN

    Directory of Open Access Journals (Sweden)

    Sezgin BILBAN

    2006-02-01

    Full Text Available Objective: In this study, it was aimed to determine the age of urinary continance of primary school students who had no enuresis problem and had secondary enuresis. Material and Method: This cross-sectional study was carried out on four primary schools of Meram district which were selected by using simple random sample method. Totally, 1399 students who had no enuresis and had secondary enuresis were included to the study. The age of urinary continance of the students and presence of diurnal, nocturnal and continual enuresis in the secondary enuresis group were investigated. Results: The mean urinary continance age of the students was 22.0 ± 7.1 months. Urinary continance age of the male students was 1.2 months bigger than the female students. The prevalance of secondary enuresis was found as 5.6 %. The frequency of secondary enuresis in male students was 2.1 fold higher than in female ones. Of the 87 students with secondary enuresis, 18.4% was diurnal, 60.9 % was nocturnal and 20.7 % was continual enuresis. Conclusion: Toilet education should be given to children by their parents starting before 22 months of age, which was obtained as urinary continance age of primary school students. [TAF Prev Med Bull 2006; 5(1.000: 41-49

  7. How dry is dry? A review of definitions of continence in the contemporary exstrophy/epispadias literature.

    Science.gov (United States)

    Lloyd, Jessica C; Spano, Shannon M; Ross, Sherry S; Wiener, John S; Routh, Jonathan C

    2012-11-01

    Definitions of continence following surgery in children with exstrophy-epispadias complex vary widely. We assessed the most common definitions of continence and evaluated the clinical significance of usage patterns for those definitions. We searched MEDLINE and EMBASE (2000 to 2011) for English language reports describing postoperative continence outcomes in children with exstrophy-epispadias complex. Articles were evaluated and data were abstracted by 2 reviewers. We assessed patient level factors such as age, preoperative diagnoses and use of additional therapies, as well as study level factors such as continence definition(s), country of origin and method of data collection. We identified 884 articles, of which 87 met inclusion criteria. In total these studies included continence outcomes data on 2,681 patients (57% male). Only 59 studies (68%) clearly defined the term "continence." The most common definition of continence was dry with voiding/catheterization every 3 hours (used in 23 studies, or 39%, defining continence). There was no association between publication date (p = 0.17), study location (p = 0.47) or study size (p = 0.81) and continence definition. There was a trend toward improved reporting of methods for continence ascertainment in more recent years (p = 0.02). Of the 2,681 children included 1,372 (51%) were dry by the definition used in their study. The most frequent definition of continence was "dryness with voiding or catheterization at 3-hour intervals." However, definitions were highly variable and many authors did not define continence at all. To better define outcomes, we recommend that a standardized definition of continence be established and used in future reports. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  8. Is carbon dioxide as an insufflation agent for double contrast barium enema still worthwhile after a same-day flexible sigmoidoscopy?

    Energy Technology Data Exchange (ETDEWEB)

    Asao, Takayuki; Fujita, Kin-ichi; Nakamura, Jun-ichi; Morinaga, Nobuhiro; Shoji, Hisanori; Ide, Munenori; Hirayama, Isao; Kuwano, Hiroyuki

    2002-06-01

    PURPOSE: The aim of the study was to evaluate the efficacy of a double-contrast barium enema (DCBE) with CO{sub 2} as a distending gas after a screening flexible sigmoidoscopy for reducing abdominal distension after an examination. PATIENTS AND METHODS: A total of 165 DCBEs for patients with positive faecal occult blood tests were randomly allocated to a CO{sub 2} group (n = 83) and a control group (n = 82) using air. Abdominal radiograph were taken before the DCBE, immediately following it, and 30 minutes later to determine residual bowel gas. The degree of abdominal discomfort was recorded using a scoring system. RESULTS: The patients in the CO{sub 2} group had significantly smaller amounts of residual gas 30 minutes after the DCBE than did the control group, both in the colon (P < 0.02) and in the small intestine (P < 0.001). There was significantly less abdominal distension after the DCBE in the CO{sub 2} group compared to the control group (P < 0.001). The abdominal discomfort score at 30 minutes after CO{sub 2} correlated with the residual gas in the small intestine(r = 0.390,P = 0.003) but not in the colon(r = 0.155, P 0.15). The quality of the images and the number of polyps detected did not differ between two groups. CONCLUSIONS: We concluded that using CO{sub 2} when administering a DCBE after a screening sigmoidoscopy was useful for relieving abdominal discomfort following the examination; furthermore, it did not impair the diagnostic ability of the DCBE. Asao, T. (2002)

  9. Observer variation in the detection of colorectal neoplasia on double-contrast barium enema: Implications for colorectal cancer screening and training

    Energy Technology Data Exchange (ETDEWEB)

    Halligan, S. E-mail: s.halligan@imperial.ac.uk; Marshall, M.; Taylor, S.; Bartram, C.; Bassett, P.; Cardwell, C.; Atkin, W

    2003-12-01

    AIM: To assess inter-observer error for the diagnosis of neoplasia on double contrast barium enema (DCBE) in the light of claims that no additional interpretative training would be needed for implementation in a national screening programme. MATERIALS AND METHODS: 10 experts, 10 consultants, and 10 experienced trainees each reported 20 DCBE studies, of which two showed cancer, three showed large polyps, four showed small polyps, and 12 were normal. Inter-observer variation was compared using odds ratios with the trainee group as reference (baseline group). RESULTS: Experts were significantly more likely to correctly identify neoplasia on DCBE than trainees. The odds of a correct diagnosis for experts were 2.79 (95% CI 2.04, 3.81) for cancer, 2.36 (1.88, 2.97) for large polyps, and 3.50 (1.98, 6.18) for small polyps. While consultants were more likely to correctly diagnose a large polyp than trainees, 1.45 (1.15, 1.84), there was no significant difference between these two groups for the correct diagnosis of either cancer, 1.24 (0.52, 2.96), or small polyps, 1.26 (0.83, 1.90). A cancer was missed by 6 (60%) experts, 9 (90%) consultants, and 8 (80%) trainees. Large polyps were missed by 4 (40%) experts, 5 (50%) consultants, and 6 (60%) trainees. There was no significant difference between any group when false positive diagnoses were considered. CONCLUSIONS: There is considerable inter-observer perceptive error for the diagnosis of neoplasia on DCBE. Experts performed significantly better than other observers but the overall standard of performance was poor, even amongst experts.

  10. Presentación: La Historia continúa

    Directory of Open Access Journals (Sweden)

    Julio Perez Serrano

    2008-11-01

    Full Text Available Por fortuna para quienes humildemente cultivamos este conocimiento, la Historia continúa. Las utopías finalistas que hace sólo una década inundaron el mercado de la letra impresa han sido borradas de un plumazo por la tozudez de los hechos. Aunque parezca increíble, en muchos aspectos nuestro futuro es hoy más incierto de lo que lo era hace veinte, treinta o cincuenta años. En lógica correspondencia con ello, el presente ha recobrado un impetuoso protagonismo. Siempre cambiante, punta de flecha del tiempo, el presente no puede dejar de ser visto en nuestros días sino como una angosta ventana hacia el futuro. Por esta ventana se han asomado ya desde antiguo, en tiempos de crisis, literatos y filósofos, y más recientemente lo han hecho periodistas, sociólogos, demógrafos, politólogos, economistas, físicos, bioquímicos, ecólogos y muchos otros científicos. También el ciudadano de la calle vive y entiende su presente como producto del pasado e indicio de lo que habrá de depararle el porvenir. No es más que el reflejo de hasta qué punto carece de sentido fijar fronteras impenetrables en el ámbito temporal.Son todavía pocos, sin embargo, los historiadores que han osado acercarse al presente con esta perspectiva. Algunos más lo han hecho buscando el anclaje con el pasado más próximo, quizá como forma de asegurar una continuidad con lo que hasta hace poco, y aun actualmente, se ha considerado propio de este oficio: el estudio del pasado. La Historia del Tiempo Presente ha ido tomando cuerpo así como un campo específico de la Historia centrado en el análisis del pretérito inmediato, un tiempo que subsiste en la memoria de las generaciones vivas y que, por influencia de éstas, es considerado propio (presente por el conjunto de la sociedad[1]. Ciertamente en este terreno los avances teóricos no son desdeñables, y superan con creces a las realizaciones prácticas, aunque quizá éste no sea el principal obstáculo que se

  11. Clinical Analysis of Anti Mildew Spirit Retention Enema in Treating Infantile Mycotic Enteritis%抗霉灵保留灌肠治疗小儿霉菌性肠炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    李先鹏

    2015-01-01

    目的:探讨抗霉灵保留灌肠治疗小儿霉菌性肠炎的疗效。方法选择我院临床诊断为霉菌性肠炎的患儿90例,随机分成治疗组和对照组,治疗组采用抗霉灵保留灌肠、对症支持治疗。对照组采用给予酮康唑片口服及对症支持治疗,疗程5~10d。结果治疗组和对照组总有效率分别为97.2%、68.3%(<0.01)。结论抗霉灵保留灌肠治疗小儿霉菌性肠炎,可快速缓解治愈病情,缩短治疗时间,无明显副作用,有明显疗效。%Objective To study the anti mildew the curative ef ect of retention enema in treatment of pediatric mould enteritis. Methods Our hospital clinical diagnosis of fungal enteritis children with 90 cases randomly divided into treatment group and control group, treatment group mildew resistant retention enema, symptomatic treatment. Control group adopts give ketone health zun piece of oral and suit the support treatment. The course of 5~10 days. Results The treatment group and control group total ef ectiveness 97.2%, 68.3%respectively ( <0.01). Conclusion Retention enema in treatment of pediatric mould enteritis anti-mildew spirit, can rapid relief to cure the il ness, shorten the treatment time, no obvious side ef ects, has obvious curative ef ect.

  12. A clinical study on treating exogenous fever in children by enema%自拟灌肠协定方治疗小儿外感发热的临床研究

    Institute of Scientific and Technical Information of China (English)

    周进

    2014-01-01

    To observe clinical effects of enema on exogenous fever in children. Methods:140 patients were randomly divided into two groups, the control group was received conventional western medicine, and the observation group was given enema. Results: The total efficacy in observation group was 92.9%, significantly higher than that in the control, with a statistically significant difference between two groups (P<0.05). Conclusion: Enema for exogenous fever in children with confirmed efficacy, shorter course, quicker results, and no side effects, no pain in children, easy to operate, is worthy of clinical application.%目的:观察并探讨小儿外感发热病例接受灌肠协定方治疗的临床效果。方法:取本院收治的140例外感发热患儿为本次研究对象,随机将其均分为参照组与观察组各70例,参照组患儿接受常规西药治疗方案,观察组患儿则接受灌肠协定方灌肠治疗。观察两组治疗效果并作对比。结果:观察组治疗总有效率为92.9%,明显高于参照组,组间差异具有统计学意义(P<0.05)。结论:灌肠协定方用于小儿外感发热治疗具有确切疗效,疗程较短、见效较快、且无毒副作用、患儿无痛苦,易于操作,应在临床上予以推广使用。

  13. 钡灌肠在小儿肠梗阻诊断中的应用%The Use of Barium Enema in the Diagnosis of Bowel Obstruction among Children

    Institute of Scientific and Technical Information of China (English)

    王万通; 关立夫

    1988-01-01

    本文报道经钡灌肠检查的89例肠梗阻病例.该检查有助于区别机械性与麻痹性肠梗阻及完全性与不完全性肠梗阻,有时还可发现造成肠梗阻的原发病变,对配合临床确定手术指征,选择合适治疗方案起重要作用.提出了钡灌肠X线特点、检查方法、适应证和禁忌证等.%Eighty-nine children with bowel obstruction were diagnosed with the help of barium enema and their diagnoses were confirmed by operation. The major findings are as follows: the high contrast barium-filled colon can be readily recognized among intestinal loops of different contrasty in the abdomen on the film. It is easy to make a differential diagnosi between a complete mechanical obstruction and a paralytic ileus. With the former, the contrast between a smaller gas-free colon and the gas-distended bigger small intestine with fluid-levels will be seen on the film;while with the latter, a gas-disteuded colon with barium-levels should be present on the film:Among the small intestines, the prestence of "coffee bean sign", "concentric loop" shadow, long air-fluid-level in a hypotonic loop, and the presence of peritoneal fluid should call attention to the possible strangulation of the intestine. Some of the primary causes of intestinal obstruction can also be shown on the film by using barium enema, such as the specific "cupping" shadow in intussusception, widening of interloop opacity in necrotic enteritis, microcolon in intestinal atresia of newborn, and spastic colon segment in Hirschsprung's disease. Methods, indications and contraindications of the use of barium enema are discussed in detail in the text.

  14. Effect of nurse -patient communication in nursing skill with the clean enema%护患沟通在清洁灌肠操作中的应用效果

    Institute of Scientific and Technical Information of China (English)

    方文; 梁霞; 吴霞; 吴丽英

    2009-01-01

    目的 探讨护患沟通在清洁灌肠操作中的应用效果.方法 分别运用护患沟通的人性化护理和单纯性护理行清洁灌肠操作,观察两种操作方法患者的舒适度、焦虑的发生率、患者对疾病知识的了解程度及满意度等情况.结果 运用护患沟通的人性化护理组优于单纯性护理组,两者比较(P<0.01),差异有统计学意义.结论 运用护患沟通的人性化护理实施清洁灌肠操作可减轻患者因灌肠而造成的痛苦,使患者的焦虑心理减轻,提高了患者的满意度及对疾病知识的了解程度.%Objective To investigate the effect of nurse -patient communication in nursing skill with the clean enema. Methods Patients with the clean enema were divided into nurse -patient communication group and simple nursing group. Several items of patients such as the comfortable degree, the incidence of anxiety and comprehension and satisfaction with the disease knowledge were observed respectively in the two groups. Results The effect of nurse -patient communication group wee better than that of simple nursing group (P <0. 01) . Pa-tients were more satisfactory with nursing staffs'operation than before obviously. Conclusions The nurse -patient communication humane care skill can relieve the suffering caused by clean enema, reduce anxiety and enhance patient satisfaction and the knowledge of disease.

  15. Early biochemical recurrence, urinary continence and potency outcomes following robot-assisted radical prostatectomy

    DEFF Research Database (Denmark)

    Berg, Kasper Drimer; Thomsen, Frederik Birkebæk; Hvarness, Helle

    2014-01-01

    OBJECTIVE: The aim of this study was to describe recovery of urinary continence and potency and report oncological and functional outcomes using the survival, continence and potency (SCP) system for patients undergoing robot-assisted radical prostatectomy (RARP). MATERIAL AND METHODS: From 2009...... with preoperative ESI, 77.6% (67.9-86.1) and 34.4% (24.1-47.5) maintained ESI 12 months postoperatively after bilateral and unilateral nerve-sparing surgery (NS), respectively. NS (p .... Using the SCP system and defining potency as ESI, functional and oncological success 12 months after surgery was achieved in 69 out of 135 (51.1%) preoperative continent and potent patients who underwent unilateral or bilateral NS, and did not require adjuvant treatment; when defining potency as IIEF...

  16. Depth distribution of Moho and tectonic framework in eastern Asian continent and its adjacent ocean areas

    Institute of Scientific and Technical Information of China (English)

    TENG; Jiwen; (滕吉文); ZENG; Rongsheng; (曾融生); YAN; Yafen; (闫雅芬); ZHANG; Hui; (张慧)

    2003-01-01

    With the results of interpretation of seismic sounding profiles acquired in the past 30 years in the continent of China and its adjacent countries andocean regions, such as Russia, Kazakhstan, Japan, India, Pakistan, Philippine ocean basin, Pacific and Indian Ocean, we compiled a 2D Moho distribution map forthe continent and its adjacent areas of eastern Asia. From the features of depth distribution and undulation of Moho, it is suggested that the eastern Asian region can be divided into 18 gradient belts with different sizes, 18 crustal blocks, 20 sediment basins and depression zones. The depth of Moho varies smoothly in each block, while the boundary (separating different blocks) delineates the abrupt variation of Moho depth. Then, some subjects,such as oregen and sediment basin, fault system and rift, plate boundary, ocean-continent coupling and tectonic framework, are discussed based on the distribution gradient belts and block partition features of Moho depth in the eastern Asia and its adjacent regions.

  17. Overactive bladder is a negative predictor of achieving continence after robot-assisted radical prostatectomy.

    Science.gov (United States)

    Yamada, Yuta; Fujimura, Tetsuya; Fukuhara, Hiroshi; Sugihara, Toru; Miyazaki, Hideyo; Nakagawa, Tohru; Kume, Haruki; Igawa, Yasuhiko; Homma, Yukio

    2017-10-01

    To investigate predictors of continence outcomes after robot-assisted radical prostatectomy. Clinical records of 272 patients who underwent robot-assisted radical prostatectomy were investigated. Preoperative Overactive Bladder Symptom Score, International Prostate Symptom Score and clinicopathological factors were investigated, and relationships between factors and recovery of continence after robot-assisted radical prostatectomy were assessed. The presence of overactive bladder was defined as having urgency for more than once a week and having ≥3 points according to the Overactive Bladder Symptom Score. Age (≤66 years) was significantly associated with continence within 6 months after robot-assisted radical prostatectomy (P = 0.033). The absence of overactive bladder and lower Overactive Bladder Symptom Score (robot-assisted radical prostatectomy, Kaplan-Meier curves showed earlier recovery in "age ≤66 years," "prostate weight ≤40 g" and "overactive bladder symptom score robot-assisted radical prostatectomy. © 2017 The Japanese Urological Association.

  18. What caused the recent ``Warm Arctic, Cold Continents'' trend pattern in winter temperatures?

    Science.gov (United States)

    Sun, Lantao; Perlwitz, Judith; Hoerling, Martin

    2016-05-01

    The emergence of rapid Arctic warming in recent decades has coincided with unusually cold winters over Northern Hemisphere continents. It has been speculated that this "Warm Arctic, Cold Continents" trend pattern is due to sea ice loss. Here we use multiple models to examine whether such a pattern is indeed forced by sea ice loss specifically and by anthropogenic forcing in general. While we show much of Arctic amplification in surface warming to result from sea ice loss, we find that neither sea ice loss nor anthropogenic forcing overall yield trends toward colder continental temperatures. An alternate explanation of the cooling is that it represents a strong articulation of internal atmospheric variability, evidence for which is derived from model data, and physical considerations. Sea ice loss impact on weather variability over the high-latitude continents is found, however, to be characterized by reduced daily temperature variability and fewer cold extremes.

  19. Freshwater fishes distribution in Taiwan and continent of China and its biogeographical significance

    Institute of Scientific and Technical Information of China (English)

    陈宜瑜; 何舜平

    2001-01-01

    Through the comparative analysis of primary freshwater fishes in Chinese continent and the Taiwan Island, we summarize the three distinctions of distribution of freshwater fishes in these areas: (i) there exists a high similarity of freshwater fish fauna between Taiwan and the southeastern shore of the continent; (ii) some species of freshwater fish are found both in the Taiwan Island and East Himalayans; (iii) different freshwater fishes have different distributions in island arch of western Pacific where Taiwan is located, but the distribution pattern shows a similarity to that of adjacent continent. The characteristic distributions of the fishes are closely related to the change in paleogeography and geology in the area. The parsimony analysis of endemicity (PAE analysis) indicates that the three distribution patterns can be explained by the vicariance theory.

  20. Impact of abuse-deterrent OxyContin on prescription opioid utilization.

    Science.gov (United States)

    Hwang, Catherine S; Chang, Hsien-Yen; Alexander, G Caleb

    2015-02-01

    We quantified the degree to which the August 2010 reformulation of abuse-deterrent OxyContin affected its use, as well as the use of alternative extended-release and immediate-release opioids. We used the IMS Health National Prescription Audit, a nationally representative source of prescription activity in the USA, to conduct a segmented time-series analysis of the use of OxyContin and other prescription opioids. Our primary time period of interest was 12 months prior to and following August 2010. We performed model checks and sensitivity analyses, such as adjusting for marketing and promotion, using alternative lag periods, and adding extra observation points. OxyContin sales were similar before and after the August 2010 reformulation, with approximately 550 000 monthly prescriptions. After adjusting for declines in the generic extended-release oxycodone market, the formulation change was associated with a reduction of approximately 18 000 OxyContin prescription sales per month (p = 0.02). This decline corresponded to a change in the annual growth rate of OxyContin use, from 4.9% prior to the reformulation to -23.8% during the year after the reformulation. There were no statistically significant changes associated with the sales of alternative extended-release (p = 0.42) or immediate-release (p = 0.70) opioids. Multiple sensitivity analyses supported these findings and their substantive interpretation. The market debut of abuse-deterrent OxyContin was associated with declines in its use after accounting for the simultaneous contraction of the generic extended-release oxycodone market. Further scrutiny into the effect of abuse-deterrent formulations on medication use and health outcomes is vital given their popularity in opioid drug development. Copyright © 2014 John Wiley & Sons, Ltd.

  1. The effects of size, configuration and distribution of continents on the efficiency of heat transport

    Science.gov (United States)

    Cooper, C. M.; Moresi, L. N.; Lenardic, A.

    2011-12-01

    The addition of continents to the surface of a planet alters its interior dynamics; understanding this alteration is critical to understanding the thermal evolution of the Earth. Specifically, the increase in temperature induced by continental insulation can be compensated by an increase in the heat loss through the overturn of the oceanic lithosphere, thus contradicting the predicted reduction of global heat loss due to presence of continents (e.g., Lenardic et al, 2005; Cooper et al, 2006; Lenardic et al, 2011). We reconfirm this counterintuitive result with three-dimensional simulations. In addition, we explore variations in the configuration of continents on the surface. Within simulations with equivalent continental coverage, but varying configuration, there is a competition between the lateral size of the blocks and the natural horizontal scale of the convection pattern which influences the stability of the models over time, and the efficiency of heat transport. Smaller continental blocks tend to induce a stable planform with upwellings permanently avoiding the blocks. However, in cases with larger continental blocks, the imposed scale is larger than the preferred scale of the convection pattern and upwellings are unable to avoid the blocks altogether. The dependency on stability and efficiency of heat transport within the Earth on continental coverage and configuration suggests continents can play a significant role in the Earth's heat budget and thermal history. Cooper, C.M., A. Lenardic, and L.-N. Moresi "Effects of continental insulation and the partioning of heat producing elements on the Earth's heat loss." Geophys. Res. Lett., 33 ,10.1029, 2006; Lenardic, A., C.M. Cooper, and L.-N. Moresi "A note on continents and the Earth's Urey ratio", Physics of the Earth and Planetary Interiors, 2011; Lenardic, A., L.-N. Moresi, A.M. Jellinek, and M. Manga "Continental insulation, mantle cooling, and the surface area of oceans and continents." Earth Planet. Sci

  2. 溃疡性结肠炎灌肠液治疗溃疡性结肠炎的临床疗效观察%Observation on Clinical Curative Effect of Kuijie Enema in Treating Ulcerative Colitis

    Institute of Scientific and Technical Information of China (English)

    任毅; 文华; 张振忠; 赵洪波; 马树梅; 李远; 梁斌强; 刘宁州; 豆小妮; 万照良

    2013-01-01

    Objective:To observe the clinical curative effects of Chinese herbal medicine enema in treating ulcerative colitis .Methods:Sixty patients with ulcerative colitis were given the treatment of self-made enema .They were given the detection of serum cytokines ,such as IL-1 β,TNF-αand Nos-3/eNos to observe the clinical curative effects of the Chinese herbal medicine enema on ulcerative colitis . Results:After a course of treatment,the total effective rate was 93.33%.The level of IL-1βwas promoted by 19.7% on average,and the level of TNF-αwas reduced by an average of 14.7%.The level of Nos-3/e Nos was decreased by 20.8%.Conclusion:In the treat-ment of UC ,Chinese medicine Kuijie enema shows the advantages of reliable curative effect ,easy application ,and low cost ,which is worth of clinical application .%目的:观察中草药灌肠对溃疡性结肠炎的临床疗效。方法:将60例溃疡性结肠炎患者给予自拟灌肠液治疗,检测血清细胞因子水平白介素1β( Interleukin-1β,IL-1β)、肿瘤坏死因子( Tumor Necrosis Factor -α,TNF-α)、一氧化氮合酶-3(内皮型)( Nitric Oxide Synthase-3,Nos-3/eNos)的变化趋势以观察中草药液灌肠对溃疡性结肠炎的临床疗效。结果:治疗1个疗程后,总有效率达93.33%,IL-1β平均提升了19.7%,TNF-α平均降低了14.7%,Nos-3/eNos平均降低了20.8%。结论:溃疡性结肠炎灌肠液在防治溃疡性结肠炎方面,疗效可靠,使用方便,造价低廉,值得临床推广。

  3. Un vasto campo: «Les langues du nouveau continent»

    Directory of Open Access Journals (Sweden)

    Trabant Jürgen

    1998-06-01

    Full Text Available

    Con esta frase de sencillez clásica comienza el bello ensayo en lengua francesa, de Wilhelm von Humboldt, «Essai sur les langues du nouveau continent», texto escrito en 1812 en Viena, que iba a constituirse en epílogo de su obra Voyage aux régions équinoxiales du nouveau continent, pero que quedó inconcluso como muchas otras obras suyas. Vale recordar que el «Gran Libro» sobre las lenguas americanas, tantas veces comenzado, nunca se terminó.

  4. Rotational Inerfia of Continents: A Proposed Link between Polar Wandering and Plate Tectonics.

    Science.gov (United States)

    Kane, M F

    1972-03-24

    A mechanism is proposed whereby displacement between continents and the earth's pole of rotation (polar wandering) gives rise to latitudinal transport of continental plates (continental drift) because of their relatively greater rotational inertia. When extended to short-term polar wobble, the hypothesis predicts an energy change nearly equivalent to the seismic energy rate.

  5. Examination of 2015 Human Development Index in Terms of Education: Comparison of the Continents and Turkey

    Science.gov (United States)

    Nartgün, Senay Sezgin; Sezen-Gültekin, Gözde; Limon, Ibrahim

    2017-01-01

    This study aims to compare Turkey to the first three countries from each continent in terms of educational indicators in 2015 Human Development Report. In line with this aim, it is a case study utilizing document review method. Analysis of the data has been carried out on a single document which is United Nations Development Report (2015). To…

  6. NACr14: A 3D model for the crustal structure of the North American Continent

    NARCIS (Netherlands)

    Tesauro, Magdala; Kaban, Mikhail; Mooney, Walter; Cloetingh, Sierd

    2014-01-01

    Based on the large number of crustal seismic experiments carried out in the last decadeswe create NACr14, a 3D crustal model of the North American continent at a resolution of 1° × 1°. We present maps of thickness and average velocities of the main layers that comprise the North American crystalline

  7. Distribution and diversity of rhizobia nodulating agroforestry legumes in soils from three continents in the tropics

    NARCIS (Netherlands)

    Bala, A.; Murphy, P.; Giller, K.E.

    2003-01-01

    The natural rhizobial populations of Calliandra calothyrsus, Gliricidia sepium, Leucaena leucocephala and Sesbania sesban were assessed in soils from nine sites across tropical areas of three continents. The rhizobial population size varied from undetectable numbers to 1.8 x 104 cells/g of soil depe

  8. NACr14: A 3D model for the crustal structure of the North American Continent

    NARCIS (Netherlands)

    Tesauro, Magdala; Kaban, Mikhail; Mooney, Walter; Cloetingh, Sierd

    2014-01-01

    Based on the large number of crustal seismic experiments carried out in the last decadeswe create NACr14, a 3D crustal model of the North American continent at a resolution of 1° × 1°. We present maps of thickness and average velocities of the main layers that comprise the North American crystalline

  9. Australia going down under : Quantifying continental subduction during arc-continent accretion in Timor-Leste

    NARCIS (Netherlands)

    Tate, Garrett W.; McQuarrie, Nadine; van Hinsbergen, Douwe J.J.; Bakker, Richard R.; Harris, Ron; Jiang, Haishui

    2015-01-01

    Models of arc-continent accretion often assume that the period of subduction of continental lithosphere before plate boundary reorganization is fairly short lived, yet the timescale of this period is poorly constrained by observations in the geologic record. The island of Timor is the uplifted accre

  10. High diversity of picornaviruses in rats from different continents revealed by deep sequencing

    DEFF Research Database (Denmark)

    Arn Hansen, Thomas; Mollerup, Sarah; Nguyen, Nam-Phuong;

    2016-01-01

    ) collected from two continents by analyzing 2.2 billion next-generation sequencing reads derived from both DNA and RNA. Among other virus families, we found sequences from members of the Picornaviridae to be abundant in the microbiome of all the samples. Here we describe the diversity of the picornavirus...

  11. An exploration of the effects of introducing a telemonitoring system for continence assessment in a nursing home.

    Science.gov (United States)

    Yu, Ping; Hailey, David; Fleming, Richard; Traynor, Victoria

    2014-11-01

    To explore the effects of introducing a telemonitoring and care planning system for urinary continence assessment in a nursing home and adherence by care staff to urinary continence care plans. Only a few studies have explored the effect of introducing telemonitoring system on urinary continence care, none for older people in nursing homes. Pre- and postintervention repeated measures design. Data for the study were collected from August-October 2011. Care staff were trained in the use of a telemonitoring system for continence assessment. Voiding events for each older person were recorded using the system during a 72-hour urinary continence assessment, and the data were used to prepare an individualised care plan. After two weeks of using the new care plan, a second assessment was carried out for each older person, using the telemonitoring system. The participants were on average 81 years old and assessed as having high care needs. The statistically significant outcomes were as follows: reduced volume of urine voided into continence aids, reduced number of prescribed toileting visits, increased number of actual toilet visits, increased number of successful toileting events and increased adherence to urinary continence care plans by staff. During a 12-week trial, urinary continence assessment and management of older people were improved. This suggests that the introduction of a suitably designed telemonitoring system combined with staff training can improve urinary continence care. The results suggest that nursing homes can improve continence assessment and management practices by adopting an appropriately designed mobile, wireless telemonitoring system for continence assessment and providing the associated staff training programmes. © 2014 John Wiley & Sons Ltd.

  12. Clinical experience of antegrade radical retropublic prostatectomy in 30 patients%耻骨后顺行前列腺癌根治术30例临床体会

    Institute of Scientific and Technical Information of China (English)

    张军晖; 邢念增; 平浩

    2010-01-01

    目的 总结耻骨后顺行前列腺癌根治术的手术经验及疗效.方法 采用耻骨后顺行前列腺癌根治术治疗前列腺癌患者30例.平均年龄64(51~73)岁.T_1 8例、T_2 15例、T_3 7例.手术采用先离断前列腺底部和膀胱颈,游离舣侧精囊及输精管并顺行向下分离直至前列腺尖部,紧贴前列腺尖部切断尿道,将尿道与膀胱颈重新吻合. 结果 30例手术顺利,手术时间平均150(75~240)min,术中出血量平均350(100~1600)ml,无直肠、输尿管等周围脏器损伤,无围手术期严重并发症.术后病理报告均为前列腺腺癌,切缘阳性4例.30例平均随访25(6~48)个月,均存活,排尿通畅,无尿失禁者.术前13例有勃起功能者术后7例(54%)恢复勃起功能. 结论 耻骨后顺行前列腺癌根治术并发症发生率低、出血量少,切缘阳性率低,手术效果良好.%Objective To discuss the experience of antegrade radical retropublic prostatectomy. Methods Thirty cases of prostate cancer were treated by antegrade radical retropublie prostateeto-my. The mean age of patients was 64 years. There were 8 cases of T_1, 15 cases of T_2, and 7 cases of T_3. The surgery included following procedures: Firstly the vesical neck was divided. Then the seminal vesicle and the prostate were freed from above downward. After the urethra was separated from the prostatic apex, the proximal end of urethra was sutured to the new vesical neck. Results All the 30 laparoscopic surgeries were accomplished successfully. The mean operative time was 2.5 hours. The mean blood loss was 350 ml in the operation. No ureteral injury, rectal injury and other severe compli-cation was observed. Histopathologic study showed prostate cancer for all the cases. Four cases had positive surgical margins. All cases were followed up from 6 to 48 months (average 25 months) with-out dysuria and permanent incontinence. No death occurred. Sexual function recovered in 7/13(54%) cases after the operation

  13. 儿童急性肠套叠空气灌肠治疗及X线分析%Analyses of air enema and radiographic film for acute intussusception in children

    Institute of Scientific and Technical Information of China (English)

    郭万亮; 周珉; 汪健; 盛茂

    2010-01-01

    Objective To analyze the different success rates of air enema in intussusception cases at different ages and evaluate the value of plain film in assessing the pathogenetic condition of intussusception and intussusception with vascular compromise in children. Methods A retrospective analysis was performed on the success rates of air enema in 1119 pediatric cases of intussusception at different ages. The radiographic findings of 190 cases were analyzed. Air enema reduction failed in 95 cases. And 95 control cases were randomly selected for reduction by air enema. Their operative and pathological data were analyzed and compared with the findings of plain film. Intestinal obstruction with vascular compromise was analyzed by a comparison of plain film and pathology. The plain films of patients were analyzed by two experienced radiologist independently. Whenever there was dissension, they discussed and reached an agreement. Results In all cases of intussusception, the successful reduction rate was 91.5%. The cases within l-year-old were 627 cases, air enema success rate was 87.1% and the success rate of air enema was 97.2% in beyond 1-year-old group. There was significant difference between two groups (x2 = 36. 01, P <0. 01). In 95 cases of failed air enema reduction, 14 cases were ileoileal, 10 ileocaecal and 25 ileocolic.And 44 cases were ileoilealcolic and 2 ileocoliccolic. Eleven cases had intestinal necrosis. Four cases had small bowel duplication cyst and 3 with Meckel's diverticulum. Intestinal obstruction with vascular compromise in plain film had a high concordance with pathology (kappa = 0. 7128). The pathology type was somewhat correlated with the finding of plain film (P < 0. 01). As assessed by plain film, there were intussusceptions with vascular compromise (n = 30) with a coffee-bean sign or banana sign, a paucity of bowel gas (n = 36), quadrant gas (n = 51) and mass or crescent (n = 73). Through an analysis between plain film signs and the onset of

  14. Effect of colon dialysis combined with retention enema in treatment of chronic renal failure%结肠透析联合保留灌肠治疗慢性肾衰竭的疗效观察

    Institute of Scientific and Technical Information of China (English)

    赵翠; 丁芳; 林海英; 冉蕾; 张俊霞; 牛洪琳

    2011-01-01

    目的 观察结肠透析联合保留灌肠治疗慢性肾衰竭的临床疗效.方法将我院109例慢性肾衰竭患者(血肌酐>133μmol/L未进行血液透析或腹膜透析者)且结肠透析次数>5次(2~3次/周)观察2周.其中将应用结肠透析联合保留灌肠治疗的69例慢性肾衰竭患者定为治疗组(其中血肌酐值在>500~1 167μmol/L范围31例,血肌酐值在133~500μmol/L范围38例).将只应用药用炭胶囊或尿毒清颗粒保留灌肠(1次/d)的40例患者定为对照组,其中应用药用炭胶囊灌肠组20例,应用尿毒清灌肠组20例.均共观察2周.分别观察两组治疗前后的临床症状、血肌酐、尿素氮、血磷、血尿酸来观察结肠透析联合保留灌肠的疗效.结果①所有患者食欲不振、恶心呕吐、乏力症状改善明显.②所有患者经治疗后血肌酐、尿素氮、血磷、血尿酸均较前改善,且结肠透析联合保留灌肠组疗效明显优于只应用尿毒清或药用炭灌肠组(P<0.05).③治疗组中所有患者经治疗后血肌酐、尿素氮、血磷、血尿酸均显著下降,差异有统计学意义(P<0.05),而血肌酐133~500μmol/L组与血肌酐>500~1 167 μmol/L组相比,对于血肌酐及尿素氮的降低疗效更显著,差异有统计学意义(P<0.05),而对于血磷及血尿酸的改变差异无统计学意义(P>0.05).结论①与单纯保留灌肠相比,结肠透析联合保留灌肠对于改善慢性肾衰竭患者的临床症状以及对血肌酐、尿素氮、血磷、尿酸的降低均有较明显的效果;②结肠透析联合保留灌肠尤其对于早、中期(血肌酐值在133~500 μmol/L范围)慢性肾衰竭患者的疗效更为显著;③结肠透析联合保留灌肠治疗慢性肾衰竭的过程中未出现任何不良反应,且疗效确切.%Objective To observe the effect of colon dialysis combined with retention enema in patients with chronic renal failure(CRF). Methods 109 cases with CRF in the

  15. Analysis of the Environmental Management System based on ISO 14001 on the American continent.

    Science.gov (United States)

    Neves, Fábio de Oliveira; Salgado, Eduardo G; Beijo, Luiz A

    2017-09-01

    The American continent is in broad economic and industrial development. Consequently, a more detailed discussion of the impacts generated by such development is needed. Moreover, there is an increase in the number of ISO 14001 certificates issued to this continent. Given the above, no studies were found that bridge the gap to identify the influence of different factors on ISO 14001 in the Americas. Thus, this article has as its main aim to check which economic, environmental and cultural factors have influence on ISO 14001 Certification in the American Continent. The data were collected in the ISO Survey, World Bank, United Nations Development Programme and International Energy Agency. Among the countries of that continent, thirteen were analyzed and only two did not show the economic factors as the influence factor in the multiple regression models fitted with Brazil and the United State. In these models, all presented environmental factors as influencing factors. Only in Brazil the index HDI presented as cultural factor in multiple regression model fitted. The economic factors: Gross Domestic Product and exports of goods and services and environmental: Carbon Dioxide (CO2) and fossil fuel consumption were the most influential in ISO 14001 certification. Venezuela, Uruguay, Colombia and the United States were countries that had factors dependent on each other, featuring the environmental marketing. Briefly, this study brings up several implications: to the academy, with the proposal of new concepts and guidance on the factors that assist in ISO 14001 certification in the American Continent. Additionally, taking into account the industry, the factors serve as efficiency parameters for the implementation of ISO 14001 standard, and for the Government to improve through factors that do not fit in multiple regression models. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. The impact of prior prostatic surgery on urinary continence in patients undergoing orthotopic ileal neobladder

    Directory of Open Access Journals (Sweden)

    Homero O. de Arruda

    2003-12-01

    Full Text Available OBJECTIVE: To establish if previous surgery for benign prostatic hyperplasia (transurethral resection of the prostate or open prostatectomy, age, and preservation of prostatic apex can influence postoperative urinary continence in patients submitted to radical cystectomy and orthotopic ileal neobladder. PATIENTS AND METHODS: We analyzed 62 patients with bladder cancer who were treated with radical cystectomy and orthotopic ileal neobladder between 1987 and 1998 and had been followed for at least 24 months. The average age and median follow up were 61 years and 53 months, respectively. Postoperative urinary continence was correlated with 3 factors: patient age, preservation of prostatic apex during surgical excision and prior prostatic surgery for benign disease. Patients were defined as incontinent when they had to use more than 1 protective pad at the daytime. RESULTS: The overall incidence of urinary incontinence was 12.9% (8 out of 62 patients. The only statistically significant factor that impacted upon urinary continence was previous prostatic surgery, with respectively 33% versus 7% rate of incontinence for patients previously operated on and for those without previous operation (p = 0.023 odds ratio = 6.5, 95% confidence interval. Preservation of prostatic apex did not reach difference, 12% versus 13%, for those with and without preservation, and age also did not influence the postoperative continence rate. CONCLUSIONS: Prior prostatic surgery for benign prostatic hyperplasia probably can increases the risk for postcystectomy incontinence and preservation of prostate apex did not affect the continence rate. This issue deserves to be considered by the surgeon and must be discussed previously with the patients when planning an orthotopic bladder replacement.

  17. Is "Warm Arctic, Cold Continent" A Fingerprint Pattern of Climate Change?

    Science.gov (United States)

    Hoerling, M. P.; Sun, L.; Perlwitz, J.

    2015-12-01

    Cold winters and cold waves have recently occurred in Europe, central Asia and the Midwest to eastern United States, even as global mean temperatures set record highs and Arctic amplification of surface warming continued. Since 1979, Central Asia winter temperatures have in fact declined. Conjecture has it that more cold extremes over the mid-latitude continents should occur due to global warming and the impacts of Arctic sea ice loss. A Northern Hemisphere temperature signal termed the "Warm Arctic, Cold Continent" pattern has thus been surmised. Here we use a multi-model approach to test the hypothesis that such a pattern is indeed symptomatic of climate change. Diagnosis of a large model ensemble of historical climate simulations shows some individual realizations to yield cooling trends over Central Asia, but importantly the vast majority show warming. The observed cooling has thus likely been a low probability state of internal variability, not a fingerprint of forced climate change. We show that daily temperature variations over continents decline in winter due to global warming, and cold waves become less likely. This is partly related to diminution of Arctic cold air reservoirs due to warming-induced sea ice loss. Nonetheless, we find some evidence and present a physical basis that Arctic sea ice loss alone can induce a winter cooling over Central Asia, though with a magnitude that is appreciably smaller than the overall radiative-forced warming signal. Our results support the argument that recent cooling trends over central Asia, and cold extreme events over the winter continents, have principally resulted from atmospheric internal variability and have been neither a forced response to Arctic seas ice loss nor a symptom of global warming. The paradigm of climate change is thus better expressed as "Warm Arctic, Warm Continent" for the NH winter.

  18. Systematic evaluation on curative effect of traditional Chinese medicine retention enema for patients with factitial proctitis%中药保留灌肠治疗放射性直肠炎疗效的系统评价

    Institute of Scientific and Technical Information of China (English)

    王馨曼; 安颂歌; 张磊; 王国豪; 孟繁洁

    2016-01-01

    Objective:To systematically evaluate the curative effect of retention enema of Chinese traditional medicine for patients with factitial proctitis.Methods:Randomized controlled trial about traditional Chinese medicine retention enema in the treatment of radiation proctitis were searched in the Cochrane Library, PubMed,EMBASE,EBSCO,ISI,CNKI,VIP,Wanfang Data and CBM databases.The retrieval time was from inception to May 2014,and literature screening,data extraction,quality evaluation and cross check were conduc-ted by two researchers independently in accordance with the inclusion and exclusion standard,and then Meta a-nalysis was carried out by using RevMan5.3 software.Results:A total of 14 randomized controlled trials(RCT) were included,and Meta analysis included 10 RCTs totally 702 patients.Meta analysis showed that the total effi-ciency of traditional Chinese medicine retention enema was higher for patients with radiation proctitis compared with that in control group,RR=4.83,95%CI(2.98,7.84),P<0.000 01;four study results showed that tradi-tional Chinese medicine retention enema improving the clinical symptoms was better than that in control group. Conclusion:Implementation traditional Chinese medicine of retention enema intervention in patients with radia-tion proctitis could improve the total efficiency of the treatment and relieve the clinical symptoms.%[目的]系统评价中药保留灌肠治疗放射性直肠炎的疗效。[方法]计算机检索 The Cochrane Library,PubMed,EMbase,EBSCO, ISI,CNKI,VIP,WanFang Data和CBM数据库中关于中药保留灌肠治疗放射性直肠炎的随机对照试验,检索时限均从建库至2014年5月,由两名研究者按照纳入排除标准独立进行文献筛选、资料提取、质量评价并交叉核对后,采用RevMan5.3软件进行Meta分析。[结果]共纳入14个随机对照试验(RCT),进行Meta分析的有10项RCT,共702例病人。Meta分析显示,与对照组相比,中药保留灌肠治疗放射性直

  19. Effects of Different Depth of Cannula in Drug Enema on Radiation Proctitis%不同插管深度对药物灌肠治疗放射性直肠炎效果的影响

    Institute of Scientific and Technical Information of China (English)

    仇雅静

    2014-01-01

    Objective To analyze and explore the actually clinical effect of different depth of cannula in drug enema on radiation proctitis. Methods 40 cases with radiation proctitis admitted in our hospital from January 2013 to June 2013 were selected as the subjects and equally divided into the observation group and the control group with 20 cases in each according to age, course of disease and other indexes. In clinical treatment, the control group was given routine method of drug enema, the catheter was in-serted 15~20 cm, and the observation group was given the drug enema by the method of reducing the depth of the inserted catheter, and the patients took semipronation and semi Fowler's position alternately for retaining the liquid drug. Two groups of patients had to retain the drug over 2h after the drug enema, and the effect was observed. Results The total effective rate of the observation group was 90.0%, higher than 65.0%of the control group, the difference in the total effective rate was statistically sig-nificant (P<0.05). Conclusion Drug enema given to radiation proctitis patients by reducing the length of intubation, and retaining the liquid drug by semipronation and semi Fowler's position alternately, the treatment effect will be better, and the drug can be re-tained longer in the lesions of patients. This treatment is worth popularizing widely.%目的:分析探讨不同的插管深度对药物灌肠治疗放射性直肠炎临床治疗效果的实际影响。方法选取该院2013年1-6月所收治的40例放射性直肠炎患者为研究对象,并按照年龄﹑病程等指标将其平均分为观察组和对照组,每组20例患者。其中在临床治疗中,对照组采取采取常规的方法对患者进行灌肠,并插入导管为15~20 cm;观察组则采取减少插管深度的方法,并让患者采取半俯卧位以及半坐卧位交替的姿势,就患者这两种姿势保留药液进行灌肠治疗。两组患者

  20. 40 CFR Table 3 to Subpart Uuu of... - Continous Monitoring Systems for Metal HAP Emissions From Catalytic Cracking Units

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Continous Monitoring Systems for Metal... Units Pt. 63, Subpt. UUU, Table 3 Table 3 to Subpart UUU of Part 63—Continous Monitoring Systems for... CFR 60.102 a. Over 20,000 barrels per day fresh feed capacity Electrostatic precipitator Continuous...

  1. 77 FR 39696 - Atlas Pipeline Mid-Continent WestTex, LLC; Pioneer Natural Resources USA, Inc.; Notice of Intent...

    Science.gov (United States)

    2012-07-05

    ...-000] Atlas Pipeline Mid-Continent WestTex, LLC; Pioneer Natural Resources USA, Inc.; Notice of Intent...-Continent WestTex, LLC and Pioneer Natural Resources USA, Inc. (Atlas and Pioneer), as joint applicants, in...: Geology and soils; Land use; Water resources, fisheries, and wetlands; Cultural resources; Vegetation and...

  2. A detrital record of continent-continent collision in the Early-Middle Jurassic foreland sequence in the northern Yangtze foreland basin, South China

    Science.gov (United States)

    Qian, Tao; Liu, Shaofeng; Wang, Zongxiu; Li, Wangpeng; Chen, Xinlu

    2016-12-01

    The Mesozoic northern Yangtze foreland basin system was formed by continental collision between the North China and South China plates along the Mianlue suture. Synorogenic stratigraphic sequences of Late Triassic to Early-Middle Jurassic age were developed in the northern Yangtze foreland basin. The upper Middle Jurassic Shaximiao Formation consists mainly of thick-bedded terrestrial successions that serve as the main body of the basin-filling sequences, suggesting intense tectonism in the peripheral orogeny of the foreland basin. Laser-ICP-MS U-Pb analysis of 254 detrital zircon grains from sandstone samples and several published Lower-Middle Jurassic samples, detrital compositions, petrofacies, and paleocurrent reconstructions in the northern Yangtze foreland basin indicate that discrete source areas included the Qinling-Dabieshan ranges and the Mianlue suture zone to the north, and the South China plate to the south. The stratigraphic succession and sediment provenance of the foreland basin imply that the early Mianlue oceanic basin, magmatic arc, and nonmarine molasse foreland basin during the period of deposition were modified or buried by the subsequent continent-continent collision between the North China-Qinling-Dabieshan plate and the Yangtze plate during the Jurassic, which followed the oblique amalgamation between these plates during the Middle-Late Triassic.

  3. Development of a computer-based system for continence health promotion.

    Science.gov (United States)

    Boyington, Alice R; Wildemuth, Barbara M; Dougherty, Molly C; Hall, Elizabeth Palena

    2004-01-01

    Computer-based systems (CBS) can provide information to help individuals analyze their health care needs and make decisions about management of health problems. This article discusses the development of a CBS that delivers an individualized educational intervention for continence health promotion. System development included cycles of prototype design, testing, analysis, and redesign. Knowledge acquisition, representation methods, and design decisions are discussed. Participants completed 4 rounds of usability testing and a pilot test, which resulted in enhancements to both the CBS and the expert system feature that produced individualized feedback. This iterative design process involved users throughout system development. User involvement resulted in a tutorial to explain navigation and other features of the CBS, graphics to enhance the written message, and clarification of continence-related content. The procedures resulted in an informative, usable product; they can be used to develop systems that provide information about symptom self-management for other health conditions.

  4. The development of a physiotherapy continence promotion program using a customer focus.

    Science.gov (United States)

    Chiarelli, Pauline; Cockburn, Jill

    1999-01-01

    Health promotion programs provide information, education for health and opportunity for the development of the skills that people need to make healthy choices. The current climate of health care practice also directs its focus to the needs and wants of the health care consumers. This entails active input from the target group. The present study used focus groups in an attempt to ensure input from women in early postpartum into the development of a postpartum continence promotion program. The focus groups revealed anomalies in women's perceived susceptibility to, and knowledge about, urinary incontinence and pelvic floor exercises, while highlighting other areas of need. Focus groups proved an invaluable tool in the development of a more effective physiotherapy continence promotion program.

  5. Checking of seismic and tsunami hazard for coastal NPP of Chinese continent after Fukushima nuclear accident

    Institute of Scientific and Technical Information of China (English)

    Chang Xiangdong; Zhou Bengang; Zhao Lianda

    2013-01-01

    A checking on seismic and tsunami hazard for coastal nuclear power plant (NPP) of Chinese continent has been made after Japanese Fukushima nuclear accident caused by earthquake tsunami.The results of the checking are introduced briefly in this paper,including the evaluations of seismic and tsunami hazard in NPP siting period,checking results on seismic and tsunami hazard.Because Chinese coastal area belongs to the continental shelf and far from the boundary of plate collision,the tsunami hazard is not significant for coastal area of Chinese continent.However,the effect from tsunami still can' t be excluded absolutely since calculated result of Manila trench tsunami source although the tsunami wave is lower than water level from storm surge.The research about earthquake tsunami will continue in future.The tsunami warning system and emergency program of NPP will be established based on principle of defense in depth in China.

  6. Sea level and vertical motion of continents from dynamic earth models since the Late Cretaceous

    OpenAIRE

    Spasojevic, Sonja; Gurnis, Michael

    2012-01-01

    Dynamic earth models are used to better understand the impact of mantle dynamics on the vertical motion of continents and regional and global sea level change since the Late Cretaceous. A hybrid approach combines inverse and forward models of mantle convection and accounts for the principal contributors to long-term sea level change: the evolving distribution of ocean floor age, dynamic topography in oceanic and continental regions, and the geoid. We infer the relative importance of dynamic v...

  7. Impact of aerosols from the Asian Continent on the adjoining oceanic environments

    Indian Academy of Sciences (India)

    K Parameswaran; Sandhya K Nair; K Rajeev

    2008-02-01

    Aerosol optical depth (AOD) at 630nm wavelength over the oceanic regions adjoining the Asian Continent is examined using a seven-year long data base derived from the Advanced Very High Resolution Radiometer (AVHRR) on board NOAA satellite to study the mean spatial and temporal variations as well as to understand the impact of aerosols advecting from the continent. Depending on the prevailing meteorological conditions and nature of synoptic circulation, the AOD over the oceanic region shows a systematic annual variation. This annual pattern inturn also shows an inter-annual variability because of the corresponding variations in the meteorological features over the continent as well as small-scale deviations in the nature of synoptic circulation. The annual variation over the oceanic regions also shows a pronounced spatial heterogeneity depending on the influence of continental aerosols. Making use of the wind speed dependence of sea-salt AOD at far-oceanic environments and monthly mean wind speeds at small grids of size 5° × 5°, the annual variation of sea-salt AOD at different locations is studied to understand the spatial heterogeneity of this component. The residual component obtained by subtracting this from the measured AOD is the non-oceanic component due to advection from continent. The source regions for major continental advections are delineated from the analysis of air-mass back trajectories at appropriate locations identified from the annual pattern of non-oceanic component. The long-term effect of the continental impact is examined from the mean trend of AOD over the three major oceanic regions. This study shows that the continental influence is most significant over the Arabian Sea, followed by the Bay of Bengal and is almost insignificant in most of the regions over the Southern Hemispheric Indian Ocean, except for the effect of smoke aerosols over a few locations near Indonesia and Madagascar.

  8. The Diurnal Cycle over the Maritime Continent and its Interaction with the MJO

    Science.gov (United States)

    Matthews, A. J.; Peatman, S.; Baranowski, D. B.; Stevens, D. P.; Heywood, K. J.; Flatau, P. J.; Schmidtko, S.

    2014-12-01

    The complex land-sea distribution and topography of the maritime continent acts to disrupt or even completely block the eastward propagation of the Madden-Julian Oscillation (MJO) from the Indian Ocean to the western Pacific. This leads to changes in tropical latent heat release and subsequent impacts on global circulation. Convection over the maritime continent is dominated by the diurnal cycle. Where the mean diurnal cycle is strong (over the islands and surrounding seas), 80% of the MJO precipitation signal in the maritime continent is accounted for by changes in the amplitude of the diurnal cycle. The canonical view of the MJO as the smooth eastward propagation of a large-scale precipitation envelope also breaks down over the islands of the Maritime Continent. Instead, a vanguard of precipitation jumps ahead of the main body by approximately 6 days or 2000 km. Hence, there can be enhanced precipitation over Sumatra, Borneo or New Guinea when the large-scale MJO envelope over the surrounding ocean is one of suppressed precipitation. This behaviour is discussed in terms of an interaction between the diurnal cycle and the MJO circulation. The diurnal cycle is also strong in the ocean. Seaglider measurements taken during the CINDY/DYNAMO campaign show the existence of a diurnal warm layer in the upper few metres of the ocean. This has a significant effect on the surface fluxes, of an order of Watts per square metre. The diurnal warm layer is favoured during the inactive phase of the MJO and may act to help precondition the atmosphere to convection. The activities of the MJO Task Force and Subseasonal to Seasonal Prediction project will be discussed in this context.

  9. Model calculations of the age of firn air across the Antarctic continent

    OpenAIRE

    2004-01-01

    The age of firn air in Antarctica at pore close-off depth is only known for a few specific sites where firn air has been sampled for analyses. We present a model that calculates the age of firn air at pore close-off depth for the entire Antarctic continent. The model basically uses four meteorological parameters as input (surface temperature, pressure, accumulation rate and wind speed). Using parameterisations for surface snow density, pore close-off density and tortuosity, ...

  10. Globalization in Urology: A Bibliographical Analysis of Cross-Continent Publication between 2002 and 2012.

    Science.gov (United States)

    Mani, Jens; Juengel, Eva; Bartsch, Georg; Filmann, Natalie; Ackermann, Hanns; Nelson, Karen; Haferkamp, Axel; Engl, Tobias; Blaheta, Roman A

    2015-01-01

    Asian scientists have now increasingly begun to contribute to globalization; yet it is not clear whether publishing in the field of urology is paralleled by elevated cross-continental scientific publishing. An exemplary bibliometric analysis of urologic journals from 3 different continents was conducted between 2002 and 2012. Based on the ISI Web of Knowledge Journal Citation Reports, 2 urologic journals with similar impact factors (IFs) in 2013 were selected from Europe ('British Journal of Urology International', 'World Journal of Urology'), Asia ('International Journal of Urology', 'Asian Journal of Andrology') and North America ('Urologic Oncology-Seminars and Original Investigations', 'Urology'). The home continent of the journal, the workplace continental affiliation of the last author, article type (clinical, experimental or review) as well as the IF were documented. Most authors published their manuscripts in journals from the same continent in which they worked. However, a significant increase in cross-continental publishing was apparent from 2002 to 2012. Asians publishing in North America increased from 17% in 2002 to 35% in 2012. Europeans also increased the number of articles they published in North American journals, while publications from North American authors were shifted towards both European and Asian journals. Experimental and clinical articles showed significant increases in cross-continental publishing, while review publishing showed no significant change. The average IF for authors from all 3 continents increased from 2002 to 2012 (p < 0.001). The largest increase in the IF was found for Asian authors (0.11 per year). Cross-continental publication significantly increased during the period from 2002 to 2012. The impact that the Asian authors have experienced was found to be gradually impacting the North American and European colleagues. © 2015 S. Karger AG, Basel.

  11. Mantle flow beneath the Asian continent and its force to the crust

    Institute of Scientific and Technical Information of China (English)

    孙荀英; 张怀; 梁国平

    2002-01-01

    The mantle unsteady flows, which are in an incompressible and isoviscous spherical shell, are investigated by using algorithms of the parallel Lagrange multiplier dissonant decomposition method (LMDDM) and the parallel Lagrange multiplier discontinuous deformation analyses (LMDDA) in this paper. Some physical fields about mantle flows such as velocity, pressure, temperature, stress and the force to the crust of the Asian continent are calculated on a parallel computer.

  12. Clinical Observation on Rhubarb Decoction Retention Enema in Treatment of Minimal Hepatic Encephalopathy%大黄煎剂保留灌肠治疗轻微肝性脑病临床研究

    Institute of Scientific and Technical Information of China (English)

    姚春; 姚凡; 谢武; 何燕; 韦玉仙; 付蕾

    2013-01-01

    目的:观察大黄煎剂保留灌肠对轻微肝性脑病患者内毒素、血氨及数字连接试验(NCT)、肝功能的影响.方法:共选取80例乙肝肝硬化并发轻微肝性脑病患者,随机分为空白对照组(A组)、中药组(B组)、乳果糖组(C组)、安慰剂组(D组),每组各20例,4组均采用基础治疗,B、C、D组在基础治疗的基础上分别加用大黄煎剂(大黄、乌梅)、乳果糖、安慰剂保留灌肠.结果:中药组在降低内毒素、血氨、NCT及改善肝功能方面均优于其他3组(P<0.01).结论:大黄煎剂保留灌肠治疗轻微肝性脑病安全、有效.%Objective; To observe the retention enema with Rhubarb decoction in the treatment of minimal hepatic encephalopathy in patients with cirrhosis endotoxin, blood ammonia and number connection test ( NCT) ,and liver function. Methods-.A total of 80 cases of liver cirrhosis complicated with minimal hepatic encephalopathy were randomly divided into control group (group A) , Chinese medicine group( group B) ,lactulose group( group C) ,the placebo group( D group) ,20 cases in each group. The 4 groups were given the basic treatment, besides, B, C and D groups were treated with retention enema by Rhubarb decoction, lactulose, placebo respectively. Results;Traditional Chinese medicine group was better than the other three groups in the reduction of endotoxin, blood ammonia, NCT and improvement of hepatic function ( P < 0. 01). Conclusion; Rhubarb decoction retention enema in the treatment of minimal hepatic encephalopathy is safe and effective.

  13. Traditional Chinese medicine enema in the treatment of children cold fever in 52 cases%中药灌肠治疗小儿感冒发热52例临床疗效

    Institute of Scientific and Technical Information of China (English)

    齐青青; 沈湘妹

    2016-01-01

    目的:观察自拟中药灌肠治疗小儿感冒发热的临床疗效。方法:收治感冒发热患儿102例,随机分为治疗组52例和对照组50例,均在一般常规治疗上,治疗组用自拟中药灌肠退热,对照组用布洛芬悬混液退热,观察两组患儿的体温下降情况及住院天数。结果:治疗组的患儿退热时间显著早于对照组(P<0.05),住院天数显著少于对照组(P<0.05),治疗组总有效率高于对照组(P<0.05)。结论:中药灌肠是治疗小儿感冒发热的有效方法。%Objective:To observe the clinical curative effect of self-made traditional Chinese medicine enema in the treatment of children cold fever.Methods:102 children patients with cold fever were selected.They were randomly divided into the treatment group with 52 cases and the control group with 50 cases.In the general routine treatment,the treatment group was given self-made traditional Chinese medicine enema for defervescence.The control group was given ibuprofen suspension liquid for defervescence. The temperature decrease situations and hospitalization days of two groups were observed.Results:The defervescence time of the treatment group was significantly earlier than that of the control group(P<0.05);the hospitalization day was significantly less than that of the control group(P<0.05).The total effective rate of the treatment group was higher than that of the control group(P<0.05). Conclusion:Traditional Chinese medicine enema is a effective method for the treatment of children cold fever.

  14. Curative Effect observation on 52 Cases of Infantile Viral Enteritis by Using Herbal Enema and Acupuncture%中药灌肠并针灸佐治小儿病毒性肠炎60例疗效观察

    Institute of Scientific and Technical Information of China (English)

    李雪梅

    2011-01-01

    Objective: To observe the clinical therapeutic efficacy of using herbal enema and acupuncture to treat the infantile virus enteritis.Methods: 110 cases of infantile virus enteritis were divided randomly into two groups, The control group (n=50) to correct water electrolyte and acid-base balance disturbance, but no using antibiotics; the treatment group (n=60)was treated combined herbal enema and acupuncture.Results: The efficacy rate of the treatment group (96.7% ) was significantly higher than that (68.0% ) in the control group (P<0.05).Conclusions: Herbal enema and acupuncture is more efficient than the control group to treat the infantile virus enteritis, and can reduce side effect of hormones, simple operation and easy to use.%目的:观察中药灌肠并针灸对小儿病毒性肠炎的疗效.方法:临床上将110例病儿随机分为治疗组和对照组,对照组不用抗生素,纠正水电解质及酸碱平衡紊乱,并常规口服思密迭1/2包~1包;治疗组:在对照组相同治疗的基础上加用中药30ml~50ml灌肠2次/d,针灸1次/d,观察患儿治疗后症状缓解情况.结果:治疗后,治疗组总有效率96.7%,对照组总有效率68.0%,疗效明显优于对照组,且减少了不良反应.结论:中药灌肠并针灸治疗小儿病毒性肠炎操作简单,使用方便,不良反应少的优点,可明显提高治愈率.

  15. 思密达保留灌肠治疗小儿腹泻的疗效分析%Smecta Retention Enema Efficacy of Treatment of Children with Diarrhea

    Institute of Scientific and Technical Information of China (English)

    吴宏丽; 郝春梅

    2015-01-01

    Objective:Smecta enema for treatment of children with diarrhea were analyzed clinical effects .Methods:The 168 cases of diarrhea were randomly divided into observation group (84 cases) and control group (84 cases) ,two groups of children probiotics herein are anti‐diarrhea ,rehydration ,correct acid‐base balance disorders ,fever and other basic treatment ,observation group was given treatment on the basis of this smecta retention enema ,control group was treated on the basis of smecta .Treatment effect observed two groups of children .Results:Time of observation in the treatment group was significantly shorter than the control group ,the total efficiency in the treatment group was signifi‐cantly higher than that observed ,comparison between groups was statistically significant difference(P<0 .05) .Conclu‐sion:Smecta retention enema to treat diarrhea in children with significant efficacy .%目的:对思密达保留灌肠治疗小儿腹泻的临床效果进行分析。方法:将168例腹泻患儿随机分为观察组(84例)与对照组(84例),两组患儿均予抗腹泻的微生态制剂、补液、纠正酸碱平衡紊乱、退热等基础治疗,观察组在此基础治疗上给予思密达保留灌肠治疗,对照组在此基础上口服思密达。观察两组患儿的治疗效果。结果:在治疗时间上观察组明显短于对照组,在治疗总有效率上观察组明显高于对照组,组间比较差异有统计学意义(P<0.05)。结论:思密达保留灌肠治疗小儿腹泻疗效显著。

  16. Safety Analysis of Vinegar Enema in Hepatic Encephalopathy Complicated with Metabolic Acidosis%食醋灌肠在肝性脑病合并代谢性酸中毒中的安全性分析

    Institute of Scientific and Technical Information of China (English)

    魏晓广; 郑佳

    2016-01-01

    目的:分析食醋灌肠在肝性脑病合并代谢性酸中毒中的安全性。方法选取我院收治的48例肝性脑病合并代谢性酸中毒患者作为研究对象,随机分为两组,各24例。对照组采用乳果糖治疗,观察组采用食醋灌肠进行治疗。对比观察两组患者治疗效果及不良反应发生情况。结果观察组总有效率为91.67%,明显优于对照组70.83%,差异显著(P<0.05);对照组不良反应发生率为25.0%,观察组未见不良反应,组间比较差异显著(P<0.05)。结论对肝性脑病合并代谢性酸中毒患者实施食醋灌肠的方法进行治疗,临床效果显著,且不良反应发生率低,安全有效,值得推广运用。%Objective To analyze the safety of vinegar enema in hepatic encephalopathy complicated with metabolic acidosis. Methods 48 cases of patients with hepatic encephalopathy and metabolic acidosis were randomly divided into two groups, each of 24 cases. The control group was given lactulose treatment, the observation group was treated with vinegar enema treatment. The treatment effect and adverse reaction of the two groups were compared and observed.ResultsThe total effective rate of the observation group was 91.67%, which was significantly better than that of the control group (70.83%), and the difference was signiifcant (P<0.05); The adverse reaction rate of control group was 25.0%, no adverse reaction was observed in the observation group, and the difference was signiifcant (P<0.05).Conclusion In patients with hepatic encephalopathy complicated with metabolic acidosis implementation vinegar enema method of treatment, significant clinical effect and adverse reactions occurred rate is low, and is safe and effective, worthy of popularization and application.

  17. 中药灌肠结合拔罐治疗小儿难治性肺炎%Traditional Chinese Medicine Enema Combined With Cupping Therapy in Treatment of Children Refractory Pneumonia

    Institute of Scientific and Technical Information of China (English)

    李健

    2016-01-01

    Objective Traditional Chinese medicine enema combined with cupping therapy clinical curative effect for the treatment of children refractory pneumonia.MethodsSelected 64 cases with refractory pneumoniaour hospital from January 2015 to January 2016, which were randomly divided into control group and observation group, the control group adopts azithromycin treatment, observation group adopt traditional Chinese medicine enema combined with cupping therapy, compare two groups therapeutic effect. Results The control group total effective rate 78.13%, observation group total effective rate 96.88%. Observation group total effective rate is signiifcantly higher than the control group, the difference was statistically signiifcant (P<0.05).Conclusion The children refractory pneumonia children using traditional Chinese medicine enema combined with cupping therapy,can effectively improve the efficiency of children with treatment.%目的:探讨中药灌肠结合拔罐治疗小儿难治性肺炎的临床疗效。方法选取我院2015年1月~2016年1月接收的小儿难治性肺炎患儿64例,随机分成对照组和观察组,对照组均采用阿奇霉素治疗,观察组均采用中药灌肠结合拔罐治疗,对比2组治疗效果。结果对照组总有效率78.13%;观察组总有效率96.88%。观察组总有效率高于对照组,差异有统计学意义(P<0.05)。结论对小儿难治性肺炎患儿采用中药灌肠结合拔罐治疗,可有效提高患儿治疗效率。

  18. 甘油灌肠剂灌肠在妇科腹部手术前肠道准备中的临床应用%Glycerine enema sausage befor gynecology department abdomen surgery in intestinal tract preparation clinical practice

    Institute of Scientific and Technical Information of China (English)

    黄娟; 杨颖; 黄瑜; 黄亚雪

    2015-01-01

    Objective The discussion of glycerine enema sausage uses in the clinical practice value which before the gy‐necology department abdomen surgery the intestinal tract prepares .Methods October ,2013- - June ,2014 ,210 example gynecology department abdomen surgery patient stochastically divides into the control group of 105 examples and the experi‐mental group of 105 examples ,The experimental group gives the glycerine enema sausage ,The control group gives the tra‐ditional soapy water sausage ,After two kind of sausage method sausage time ,the sausage number of times ,pour into the liquid volume ,the intestinal tract cleanliness ,patient's comfort level ,the complications ,the technique aspects and so on anus exhaust time carry on the observation contrast .Results Experimental group's effect surpasses the control group obvi‐ously ,Two groups of comparisons have the remarkable statistics significance (P<0 .05) .Conclusion When the glycerine enema sausage operate easily ,the patient comfort level is high ,the complication are few ,and merit quickly ,In the intestinal tract preparation has the important clinical practice value before the gynecology department abdomen surgery .%目的:探讨甘油灌肠剂灌肠用于妇科腹部手术前肠道准备的临床应用价值。方法将我科2013年10月~2014年6月210例妇科腹部手术患者,随机分为对照组和实验组,各105例。实验组予甘油灌肠剂灌肠。对照组予传统肥皂水灌肠。并对两组灌肠时间、灌肠次数、灌入液量、肠道清洁度、患者舒适度、术后肛门排气时间进行比较。结果两组灌肠时间、灌肠次数、灌入液量、肠道清洁度、患者舒适度及术后肛门排气时间比较,有显著性差异(P<0.05)。结论甘油灌肠剂灌肠具有操作简便、节时,患者舒适度高,并发症少,术后恢复快等优点,在妇科腹部手术前肠道准备中具有重要的临床应用价值。

  19. Reduction in oxidative stress levels in the colonic mucosa without fecal stream after the application of enemas containing aqueous Ilex paraguariensis extract Redução dos níveis de estresse oxidativo na mucosa cólica sem trânsito intestinal após aplicação de enemas contendo extrato aquoso de Ilex paraguariensis

    Directory of Open Access Journals (Sweden)

    Fernando Lorenzetti da Cunha

    2011-08-01

    Full Text Available PURPOSE: To evaluate the antioxidant effects of enemas containing aqueous extract of Ilex paraguariensis, comparing segments with and without fecal stream and correlating the segments with the duration of intervention. METHODS: Twenty-six Wistar rats were subjected to a diversion of the fecal stream in the left colon by a proximal colostomy and distal mucosal fistula. The rats were distributed randomly into two experimental groups of 13 animals each based on the time of sacrifice after surgical procedure (two or four weeks. Each group was then divided into two experimental subgroups that received either second daily enemas containing 0.9% saline solution or aqueous extract of Ilex paraguariensis at 0.2g/100g. Colitis was diagnosed by histopathological analysis and the detection of oxidative tissue damage by measuring the levels of malondialdehyde. The Mann-Whitney test was used to compare the tissue levels of malondialdehyde between colon segments with and without fecal stream in each experimental group, and the Kruskal-Wallis test was used to verify the variance between the levels of oxidative stress according the duration of the irrigation; both tests determined significance at 5% (pOBJETIVO: Avaliar os efeitos antioxidantes de clisteres contendo extrato aquoso de Ilex paraguariensis comparando segmentos com e sem trânsito fecal e correlacionando com o tempo de intervenção. MÉTODOS: Vinte e seis ratos Wistar machos foram submetidos à derivação do trânsito no cólon esquerdo pela confecção de colostomia proximal e fístula mucosa distal. Foram divididos de forma randomizada em dois grupos experimentais de 13 animais, de acordo com o sacrifício ser realizado após duas ou quatro semanas do procedimento cirúrgico. Cada grupo foi dividido em dois subgrupos experimentais segundo a aplicação diária ter sido realizada com enemas diários contendo solução fisiológica a 0,9% ou extrato aquoso de Ilex paraguariensis na concentra

  20. Parallel Evolution of Copy-Number Variation across Continents in Drosophila melanogaster

    Science.gov (United States)

    Schrider, Daniel R.; Hahn, Matthew W.; Begun, David J.

    2016-01-01

    Genetic differentiation across populations that is maintained in the presence of gene flow is a hallmark of spatially varying selection. In Drosophila melanogaster, the latitudinal clines across the eastern coasts of Australia and North America appear to be examples of this type of selection, with recent studies showing that a substantial portion of the D. melanogaster genome exhibits allele frequency differentiation with respect to latitude on both continents. As of yet there has been no genome-wide examination of differentiated copy-number variants (CNVs) in these geographic regions, despite their potential importance for phenotypic variation in Drosophila and other taxa. Here, we present an analysis of geographic variation in CNVs in D. melanogaster. We also present the first genomic analysis of geographic variation for copy-number variation in the sister species, D. simulans, in order to investigate patterns of parallel evolution in these close relatives. In D. melanogaster we find hundreds of CNVs, many of which show parallel patterns of geographic variation on both continents, lending support to the idea that they are influenced by spatially varying selection. These findings support the idea that polymorphic CNVs contribute to local adaptation in D. melanogaster. In contrast, we find very few CNVs in D. simulans that are geographically differentiated in parallel on both continents, consistent with earlier work suggesting that clinal patterns are weaker in this species. PMID:26809315

  1. Contrasting introduction scenarios among continents in the worldwide invasion of the banana fungal pathogen Mycosphaerella fijiensis.

    Science.gov (United States)

    Robert, S; Ravigne, V; Zapater, M-F; Abadie, C; Carlier, J

    2012-03-01

    Reconstructing and characterizing introduction routes is a key step towards understanding the ecological and evolutionary factors underlying successful invasions and disease emergence. Here, we aimed to decipher scenarios of introduction and stochastic demographic events associated with the global spread of an emerging disease of bananas caused by the destructive fungal pathogen Mycosphaerella fijiensis. We analysed the worldwide population structure of this fungus using 21 microsatellites and 8 sequence-based markers on 735 individuals from 37 countries. Our analyses designated South-East Asia as the source of the global invasion and supported the location of the centre of origin of M. fijiensis within this area. We confirmed the occurrence of bottlenecks upon introduction into other continents followed by widespread founder events within continents. Furthermore, this study suggested contrasting introduction scenarios of the pathogen between the African and American continents. While potential signatures of admixture resulting from multiple introductions were detected in America, all the African samples examined seem to descend from a single successful founder event. In combination with historical information, our study reveals an original and unprecedented global scenario of invasion for this recently emerging disease caused by a wind-dispersed pathogen. © 2012 Blackwell Publishing Ltd.

  2. Integrated Mid-Continent Carbon Capture, Sequestration & Enhanced Oil Recovery Project

    Energy Technology Data Exchange (ETDEWEB)

    Brian McPherson

    2010-08-31

    A consortium of research partners led by the Southwest Regional Partnership on Carbon Sequestration and industry partners, including CAP CO2 LLC, Blue Source LLC, Coffeyville Resources, Nitrogen Fertilizers LLC, Ash Grove Cement Company, Kansas Ethanol LLC, Headwaters Clean Carbon Services, Black & Veatch, and Schlumberger Carbon Services, conducted a feasibility study of a large-scale CCS commercialization project that included large-scale CO{sub 2} sources. The overall objective of this project, entitled the 'Integrated Mid-Continent Carbon Capture, Sequestration and Enhanced Oil Recovery Project' was to design an integrated system of US mid-continent industrial CO{sub 2} sources with CO{sub 2} capture, and geologic sequestration in deep saline formations and in oil field reservoirs with concomitant EOR. Findings of this project suggest that deep saline sequestration in the mid-continent region is not feasible without major financial incentives, such as tax credits or otherwise, that do not exist at this time. However, results of the analysis suggest that enhanced oil recovery with carbon sequestration is indeed feasible and practical for specific types of geologic settings in the Midwestern U.S.

  3. A study on the birth and globalization of sports originated from each continent.

    Science.gov (United States)

    Lee, Byung Jin; Kim, Tae Young

    2016-02-01

    The purpose of this research is to see how continent specific sports rose to its modern-day status through globalization. This research focuses on the historical background of how England's football, America's national pastime, baseball, Japan's Judo, and Korea's Taekwondo developed into sports in addition to the reasoning behind its globalization. Promoted by England and the rest of the European continent, Soccer is considered to be one of the world's most popular sports and has served its function as a form of cultural imperialism. It has also advanced alongside commerce, missionary work and other types of cultural clashes. In America, baseball was used to integrate its multicultural society and developed so that the team captain leads the rest of his team. The sports of Oriental countries were reborn through modernization that was influenced by the modern rationality, education etc. of its Western counterparts. Judo and Taekwondo were introduced globally through the Olympic Games. As mentioned above the birth of sporting events has a close connection to a nation's cultural background and globalization has taken different forms depending on which continent it originated from.

  4. Persistent shift of the Arctic polar vortex towards the Eurasian continent in recent decades

    Science.gov (United States)

    Zhang, Jiankai; Tian, Wenshou; Chipperfield, Martyn P.; Xie, Fei; Huang, Jinlong

    2016-12-01

    The wintertime Arctic stratospheric polar vortex has weakened over the past three decades, and consequently cold surface air from high latitudes is now more likely to move into the middle latitudes. However, it is not known if the location of the polar vortex has also experienced a persistent change in response to Arctic climate change and whether any changes in the vortex position have implications for the climate system. Here, through the analysis of various data sets and model simulations, we show that the Arctic polar vortex shifted persistently towards the Eurasian continent and away from North America in February over the past three decades. This shift is found to be closely related to the enhanced zonal wavenumber-1 waves in response to Arctic sea-ice loss, particularly over the Barents-Kara seas (BKS). Increased snow cover over the Eurasian continent may also have contributed to the shift. Our analysis reveals that the vortex shift induces cooling over some parts of the Eurasian continent and North America which partly offsets the tropospheric climate warming there in the past three decades. The potential vortex shift in response to persistent sea-ice loss in the future, and its associated climatic impact, deserve attention to better constrain future climate changes.

  5. A study on the birth and globalization of sports originated from each continent

    Science.gov (United States)

    Lee, Byung Jin; Kim, Tae Young

    2016-01-01

    The purpose of this research is to see how continent specific sports rose to its modern-day status through globalization. This research focuses on the historical background of how England’s football, America’s national pastime, baseball, Japan’s Judo, and Korea’s Taekwondo developed into sports in addition to the reasoning behind its globalization. Promoted by England and the rest of the European continent, Soccer is considered to be one of the world’s most popular sports and has served its function as a form of cultural imperialism. It has also advanced alongside commerce, missionary work and other types of cultural clashes. In America, baseball was used to integrate its multicultural society and developed so that the team captain leads the rest of his team. The sports of Oriental countries were reborn through modernization that was influenced by the modern rationality, education etc. of its Western counterparts. Judo and Taekwondo were introduced globally through the Olympic Games. As mentioned above the birth of sporting events has a close connection to a nation’s cultural background and globalization has taken different forms depending on which continent it originated from. PMID:26933653

  6. Two-step rise of atmospheric oxygen linked to the growth of continents

    Science.gov (United States)

    Lee, Cin-Ty A.; Yeung, Laurence Y.; McKenzie, N. Ryan; Yokoyama, Yusuke; Ozaki, Kazumi; Lenardic, Adrian

    2016-06-01

    Earth owes its oxygenated atmosphere to its unique claim on life, but how the atmosphere evolved from an initially oxygen-free state remains unresolved. The rise of atmospheric oxygen occurred in two stages: approximately 2.5 to 2.0 billion years ago during the Great Oxidation Event and roughly 2 billion years later during the Neoproterozoic Oxygenation Event. We propose that the formation of continents about 2.7 to 2.5 billion years ago, perhaps due to the initiation of plate tectonics, may have led to oxygenation by the following mechanisms. In the first stage, the change in composition of Earth's crust from iron- and magnesium-rich mafic rocks to feldspar- and quartz-rich felsic rocks could have caused a decrease in the oxidative efficiency of the Earth's surface, allowing atmospheric O2 to rise. Over the next billion years, as carbon steadily accumulated on the continents, metamorphic and magmatic reactions within this growing continental carbon reservoir facilitated a gradual increase in the total long-term input of CO2 to the ocean-atmosphere system. Given that O2 is produced during organic carbon burial, the increased CO2 input may have triggered a second rise in O2. A two-step rise in atmospheric O2 may therefore be a natural consequence of plate tectonics, continent formation and the growth of a crustal carbon reservoir.

  7. [Physics of materials and female stress urinary continence: New concepts: I) Elasticity under bladder].

    Science.gov (United States)

    Guerquin, B

    2015-09-01

    Improving the understanding of the adaptation to stress of urinary continence. A transversal analysis between physics of materials and the female anatomy. Laws of physics of the materials and of their viscoelastic behavior are applied to the anatomy of the anterior vaginal wall. The anterior vaginal wall may be divided into two segments of different viscoelastic behavior, the vertical segment below the urethra and the horizontal segment below the bladder. If the urethra gets crushed on the first segment according to the hammock theory, the crushing of the bladder on the second segment is, on the other hand, damped by its important elasticity. The importance of this elasticity evokes an unknown function: damping under the bladder that moderates and delays the increase of intravesical pressure. This damping function below the bladder is increased in the cystocele, which is therefore a continence factor; on the other hand, it is impaired in obesity, which is therefore a factor of SUI. It is necessary to include in the theory of stress continence, the notion of a damping function below the bladder. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  8. Dimensions of continents and oceans - water has carved a perfect cistern

    Science.gov (United States)

    Whitehead, John A.

    2016-11-01

    The ocean basins have almost exactly the correct surface area and average depth to hold Earth's water. Two processes are responsible for this. First, Earth's continental crust is thinned by erosion so that average elevation is a few hundred meters above sea level. Second, the crust is thickened by lateral compression from mountain formation and sediments and water lost in subduction is resupplied at least in part by voclanics. The resulting continents are approximately tabular in cross section, resulting in the well-known double hypsometric curve for Earth's elevation. Therefore, erosion and mountain building have enabled water to carve its own cistern in the form of all the ocean basins. A theoretical fluid model, suggested partly by laboratory experiments, produces such a tabular continent with a surface above sea level. A simple hydrostatic balance gives a first approximation for the average depth and area of oceans and continents for present Earth as a function of material volumes and densities. Using a wide range of possible crust volumes with the present water volume, the average continental crust thickness exceeds 22 km and ocean area exceeds 25% of the globe. Other volumes of water produce a wide range of areas and depths of oceans and crust.

  9. Accumulation of 'anti-continent' at the base of the mantle and its recycling in mantle plumes

    Science.gov (United States)

    Tatsumi, Yoshiyuki; Suzuki, Toshihiro; Ozawa, Haruka; Hirose, Kei; Hanyu, Takeshi; Ohishi, Yasuo

    2014-10-01

    The continental crust is a unique reservoir of light elements in the solid Earth; it possesses an intermediate composition and is believed to have been created principally along volcanic arcs, which are major sites of terrestrial andesitic magmatism. Mantle-derived arc magmas are, however, generally mafic or basaltic. A simple mechanism to overcome this apparent dilemma and generate andesitic melts in such a setting is through the partial remelting of an initial mafic arc crust by heat supplied from underplating basaltic magmas. An antithesis to the formation of continental crust in this way should be the production of refractory melting residue, here referred to as 'anti-continent'. This anti-continent is likely to detach from arc crust as a result of a density inversion and descend into the upper mantle. High-pressure experiments demonstrate that sinking anti-continent is, in contrast to the subducting oceanic crust, always denser than the surrounding mantle, suggesting that it penetrates through the upper-lower mantle boundary, without stagnation, and accumulates at the base of the mantle to form a 200-400 km thick mass known as the D″ layer. Geochemical modeling provides further evidence that this accumulating anti-continent contributes to a deep-seated hotspot source. Therefore, through complementary processes, Earth creates buoyant continents and dense anti-continents at the top and the base of the mantle, respectively, and has recycled portions of anti-continent in mantle plumes.

  10. Minimal preparation computed tomography instead of barium enema/colonoscopy for suspected colon cancer in frail elderly patients: an outcome analysis study

    Energy Technology Data Exchange (ETDEWEB)

    Kealey, S.M.; Dodd, J.D.; MacEneaney, P.M.; Gibney, R.G.; Malone, D.E. E-mail: d.malone@st-vincents.ie

    2004-01-01

    .18 [0.43], negative predictive value 0.97 [0.96], positive likelihood ratio result 1.6 [5.63], negative likelihood ratio result 0.27 [0.29], kappa 0.31 [0.43]. Tumour prevalence was 12%. A graph of conditional probabilities was generated and analysed. A variety of unsuspected pathology was also found in this series of patients. CONCLUSIONS: MPCT should be double-reported, at least initially. 'Possible' lesions should be ignored. Analysis of the graph of conditional probability applied to a group of frail, elderly patients with a high mortality from all causes (33% in our study) suggests: (1) if MPCT suggests definite or probable carcinoma, regardless of the pre-test probability, the post-test probability is high enough to warrant further action, (2) frail, elderly patients with a low pre-test probability for CRC and a negative MPCT should not have further investigation, (3) frail, elderly patients with a higher pre-test probability of CRC (such as those presenting with rectal bleeding) and a negative MPCT should have either double contrast barium enema (DCBE) or colonoscopy as further investigations or be followed clinically for 3-6 months. MPCT was acceptable to patients and clinicians and may reveal significant extra-colonic pathology.

  11. Application Value of Ultrasound-Guided Hydrostatic Enema in Treatment of Pediatric Intussusception%超声引导下水压灌肠治疗小儿肠套叠的应用价值

    Institute of Scientific and Technical Information of China (English)

    钟万霖; 肖宗浩

    2016-01-01

    目的:分析超声引导下水压灌肠治疗小儿肠套叠的应用价值。方法选取2012年11月至2014年11月我院儿科收治的120例小儿肠套叠患儿,按照患儿的年龄进行分组: A组(<3个月)、 B组(3~6个月)、 C组(7个月~5岁),每组40例。比较三组患儿的水压灌肠情况,并观察不同病症类型患儿的治疗效果。结果三组患儿进行水压灌肠所需的最大水压由低到高分别为A组enema in treatment of pediatric intussusception. Methods 120 cases of children with intussusception treated in pediatrics department of our hospital from November 2012 to November 2014 were selected and divided into three groups according to children's age:group A (<3 months), group B (3~6 months), group C (7 months ~ 5 years), with 40 cases in each group. The conditions of hydrostatic enema in three groups were compared, the treatment effects of different types of children were observed. Results The maximum water-pressure of hydrostatic enema in three groups from low to high was group A < group B < group C, the difference in three groups was statistical (P <0.05). Of 120 children with intussusception, 117 cases reset successfully, the treatment success rate was 97.5%, and the average hospitalization time was (1.2 ± 0.3) d. One case was treated by surgery due to reset failure, one case had intestinal rotation and one case had severe multiple intussusception. Conclusions For children

  12. 美沙拉嗪联合灌肠综合治疗慢性溃疡性结肠炎的疗效观察%Clinical observation of Mesalazine combined with enema in the treatment of chronic ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    陈跃

    2012-01-01

    目的 观察美沙拉嗪结合灌肠治疗慢性溃疡性结肠炎的临床疗效.方法 将40例患者随机分为两组,每组各20例.对照组给予柳氮磺吡啶1 g/次,4次/d;治疗组给予美沙拉嗪口服,1 g/次,3次/d,同时配合灌肠(将庆大霉素16万U、思密达6 g及地塞米松5 mg加入60 mL生理盐水),保留灌肠40 min,2次/d,2周为1个疗程.共观察2个疗程.结果 两组疗效比较,对照组总有效率为60.0%,治疗组达85.0%,差异有统计学意义(P < 0.05).两组患者治疗前后结肠镜下评分比较,治疗组较对照组明显改善(P < 0.05).不良反应情况观察,对照组高达45.0%,治疗组为15.0%,较对照组明显降低(P < 0.05).结论美沙拉嗪结合灌肠综合治疗慢性溃疡性结肠炎有较好的临床疗效,毒副作用小,患者依从性好,值得进一步研究推广.%Objective To observe the clinical efficacy of Mesalazine combined with enema in the treatment of chronic ul-cerative colitis. Methods 40 patients were randomly assigned to two groups, with 20 cases in each group. Patients in the control group were given Sulfasalazine 1 g every time, 4 times a day; patients in the treatment group were given oral administration of Mesalazine (1 g every time, 3 times a day), in conjunction with enema (gentamicin 160 000 U, Smectite up to 6 g and Dexamethasone 5 mg added to 60 mL of normal saline). Enema was retained 2 times a day, 40 min each time and 2 weeks each treatment course. The two groups were observed for two courses. Results Total effective rate was 60.0% in the control group and 85.0% in the treatment group, showing significantly differences (P < 0.05). Colonoscopy score improvement was significantly better in the treatment group than in the control group (P < 0.05). Treatment group showed significantly lower adverse reactions rate (45.0%) than seen in the control group (15.0%)(P < 0.05). Conclusion Mesalamine combined with enema shows good treatment efficacy in the treatment of

  13. Observation of combined oral mesalazine enema for ulcerative colitis 120 Cases%美沙拉嗪口服联合灌肠治疗溃疡性结肠炎120例疗效观察

    Institute of Scientific and Technical Information of China (English)

    魏晓广; 高春献; 古劼劼; 张苏颖

    2011-01-01

    目的 观察美沙拉嗪口服联合灌肠治疗溃疡性结肠炎的疗效.方法 选择240例轻、中度溃疡性结肠炎患者,随机分为两组:治疗组120例予口服美沙拉嗪,1.0g/次,3次/d,同时给予美沙拉嗪灌肠剂(莎尔福灌肠剂,4g/60ml,用时稀释到100ml)4g/100ml,1次/晚,保留灌肠,8周为1疗程;对照组120例,予口服柳氮磺吡啶片(Alicylazosulfapyridine,SASP)1.Og,4次/d.疗程为8周.结果 治疗8周后,治疗组显效率和总有效率明显优于对照组,差异有统计学意义(P<0.05);两组均有不良反应的发生,治疗组发生13例,发生率10.8%,对照组发生68例,发生率56.7%,治疗组明显低于对照组,差异有统计学意义(P<0.05).结论 美沙拉嗪了治疗溃疡性结肠炎临床疗效显著,且不良反应小.%Objective To observe the combined oral mesalazine enema for ulcerative colitis. Methods Totally 240 patients with mild to moderate ulcerative colitis were randomly divided into two groups: treatment group, 120 patients to oral mesalazine, 1. Og / time, 3 times/d, while giving the mesalamine enema (Sa Fu enema, 4g/60ml, when diluted with 100ml) 4g/100ml, 1 times/night, retention enema, 8 weeks as a course; The control group of 120 patients to oral sulfasalazine tablets ( Alicylazosulfapyri-dine, SASP) 1. 0g, 4 times / d. Treatment for 8 weeks. Results After 8 weeks, the treatment group efficiency and total efficiency is better than the control group, the difference was statistically significant (P <0. 05) ; the incidence of adverse reactions of both groups, the treatment group occurred in 13 cases, incidence 10. 8% , in the control group of 68 patients, the incidence of 56. 7% , treatment group was significantly lower than the control group, the difference was statistically significant (P < 0.05). Conclusions Mesalazine has good clinical efficacy in treatment of ulcerative colitis, and less adverse reactions.

  14. Prevention of mannitol renal damage by enema of Tongfu Xiezhou Fang in 22 cases%通腑泻浊方灌肠预防甘露醇肾损害22例临床观察

    Institute of Scientific and Technical Information of China (English)

    陈可为; 白慧梅; 郭家奎; 张津玮

    2012-01-01

    Object To investigate the effect of enema of Tongfu Xiezhou Fang in prevention of mannitol renal damage during treatment in the patients with severe cerebral infarction without reducing the dose of mannital in order to keep the curative effect. Methods The patients (n =48) with severe cerebral infarction (Glasgow Coma Score≤8) were randomly divided into treatment group ( n = 22) and control group ( n = 26). Mannitol was used conventionally as main dehydrating agent, and treatment group was given retention enema of Tongfu Xiezhou Fang for 30 minutes (once a day) at the same time of applying mannitol, and control group was not given enema. The levels of serum cystatin C and serum creatinine (SCr), blood urea nitrogen (BUN) and 24-hour urine output were detected in two groups before treatment and on the 5 th day of treatment. Results There were 2 cases with mannitol renal damage in treatment group (9.1%). There was one dead case due to cerebral edema and 10 cases with mannitol renal damage in control group (38. 5% ). The difference between two groups had statistical significance after statistical comparison ( P <0.05). The comparison in indexes of kidney function showed that the results were better in treatment group than those in control group ( P < 0. 05 ). Conclusion The retention enema of Tongfu Xiezhou Fang has reliable curative effect of preventing mannitol renal damage in the patients with severe cerebral infarction.%目的 探讨治疗重症脑梗死患者在不减低甘露醇剂量以保持疗效的前提下,利用通腑泻浊方灌肠预防甘露醇肾损害的疗效.方法 将48例重症脑梗死患者(格拉斯哥昏迷评分≤8分)随机分为治疗组22例和对照组26例,常规应用甘露醇作为主要脱水剂,治疗组在应用甘露醇的同时加以中药保留灌肠30 min,1日1次;对照组用甘露醇时不予以灌肠.监测2组患者治疗前、治疗第5天血清胱抑素C、血肌酐、尿素氮、24 h尿量等.结果 治

  15. 中药保留灌肠治疗重症抗生素相关性腹泻的临床分析%Retention-enema treatment of severe antibiotic associated diarrhea:a clinical analysis

    Institute of Scientific and Technical Information of China (English)

    段淑红

    2011-01-01

    目的 探讨中药保留灌肠治疗重症抗生素相关性腹泻(伪膜性肠炎)的临床疗效.方法 将临床24例重症抗生素相关性腹泻患者随机分为两组,治疗组12例,中药煎剂100ml保留灌肠,连用10d;对照组12例,用甲硝唑+万古霉素,连用10d,两组患者年龄、性别、基础疾病差异无统计学意义.结果 两组患者治疗前后综合疗效分析,治疗组12例,显效5例、有效6例,总有效率91.67%,对照组12例,显效6例、有效4例,总有效率83.33%,中药保留灌肠方法治疗效果明显优于对照组,两组疗效差异有统计学意义(P<0.01)结论,中药保留灌肠方法简便易行,不良反应少,经济花费少,性价比高,药物直接进入肠道,显效快、破坏少,特别对于伴有频繁呕吐的危重症及昏迷患者更为适用,为临床治疗抗生素相关性腹泻开辟了一条新的治疗方法.%OBJECTIVE To explore the effects of retention enema for severe antibiotic-associated diarrhea (pseudomembranous colitis) in clinical efficacy.METHODS Totally 24 patients with severe clinical antibiotic associated diarrhea patients were randomly divided into two groups (treatment group, 12 cases, Chinese medicine 100ml reservations enema 1 to 2 times, each time 20-30 minutes once a 10 days; control group, 12 cases with metronidazole 25mg, Q6h, po, + vancomycin 250mg Q6h, po, Continued with 10 days).There was no differrence between two groups of age, sex, underlying disease.RESULTS The integrated effect of the two groups of patients before and after the treatment group 12 cases were cured, markedly in 5, effective in 6 cases and 1 ineffective, the total effective rate 91.66%, control group 12 cases, 6 cases were markedly effective in 4 cases and ineffective in 2 cases The total effective rate was 83.3 %.CONCLUSION The retention enema for the treatment of Chinese medicine is better than the control group, differences between two groups was significant (P<0.01), and Chinese

  16. 钡剂灌肠在婴幼儿便秘诊断中的临床价值%The value of batium enema in constipation diagnosis in infants and young children

    Institute of Scientific and Technical Information of China (English)

    赖华; 贺明礼

    2012-01-01

    Objective To study the value of barium enema in constipation diagnosis in infants and young children. Methods 100 cases with constipation in infants and young children were undergone barium enema to investigate the pattern and transit time of colon, and also regressively analyse the relationship between the radiologic manifestation and clinic symptoms. The age under 1 year were 67cases, 13 months to 3 years old 17 cases, more 3 years old 16 cases, average I. 4 years old. Results Organic constipation 6( midgul malrotation 2, rectal stenosis 3, sigmoid colonic stenosis 1) , non-organic constipation 94. Among the 94 cases of non-organic constipation, there were 41(43.61%) cases barium emptying completely within 24 hours ,84 (89. 36% ) cases barium emptying completely within 48 hours, 91 (96. 80% ) cases barium emptying completely within 72 hours. 72(769.5%) of 94 cases were followed up by telephon 3 to 5 months after barium enema exam and 54(75% ) of72 cases' constipation symptoms disappeared, 13( 18. 10% ) of 72 cases' constipation symptoms improved, 5(6. 90% ) of 72 cases' constipation symptoms didn' t improve. Conclusion Barium enema can be considered as a screening methods for differentiating organic constipation from non-organic constipation. More than 75% of non-organic constipation in infancy could be cured by regulating dietary construction and defaecating training.%目的 探讨钡灌肠在婴幼儿便秘诊断中的临床意义.方法 因便秘就诊的患儿100例(排便次数≤2次/周)行钡剂灌肠观察结肠、直肠形态及排空时间.其中≤1岁67例,13个月一3岁17例,>3岁16例,平均1.4岁.结合患儿随访结果回顾分析其钡剂灌肠所见与临床联系.结果 器质性便秘6例(中场旋转不良2例,节段性肠管持续狭窄4例),非器质性便秘94例.94例非器质性便秘患儿24h钡剂完全排空41例(43.61%),48h完全排空84例(89.36),72h完全排空91例(96.80%).94例中72例(76.95%)3~5个

  17. A Meta-analysis on the curative effects of Chinese herbal retention enema on radiation enteritis%中药保留灌肠治疗放射性直肠炎疗效的Meta分析

    Institute of Scientific and Technical Information of China (English)

    邹文爽; 安颂歌; 熊壮; 池海勇; 刘铁军

    2015-01-01

    目的:应用Meta分析方法评价中药保留灌肠治疗放射性直肠炎的疗效。方法计算机检索The Cochrane Library、PubMed、EMbase、EBSCO、ISI、CNKI、VIP、WanFang Data和CBM数据库中关于中药保留灌肠治疗放射性直肠炎的随机对照试验,并追溯纳入文献的参考文献,检索时限均从建库至2014年5月。由2名研究者按照纳入排除标准独立进行文献筛选、资料提取、质量评价并交叉核对后,采用RevMan5.3软件进行Meta分析。结果纳入25个随机对照试验,其中进行Meta分析的有21个共1575例患者。 Meta分析显示,干预14 d后[RR=1.25,95%CI(1.10,1.42),P=0.0006]、20 d后[RR=1.19,95%CI(1.08,1.32),P=0.0007]、28 d后[RR=1.37,95%CI(1.21,1.54),P<0.00001]、30 d后[RR=1.63,95%CI (1.32,2.01),P<0.00001]中药保留灌肠治疗放射性直肠炎的总有效率高于对照组;干预10 d后[RR=1.23,95%CI=(0.93,1.63),P=0.15]、60 d后[RR=1.22,95%CI(0.94,1.56),P=0.13]中药保留灌肠治疗放射性直肠炎的总有效率与对照组相比差异无统计学意义。结论对放射性直肠炎患者实施中药保留灌肠干预2周以上能提高治疗的总有效率,减轻临床症状。但仍需要大样本、高质量的临床试验做进一步研究,观察长期效果。%Objective It is to evaluate the effect of Chinese herbal retention enema on radiation enteritis using Meta-anal-ysis method.Methods The Cochrane Library, PubMed, EMbase, EBSCO, ISI, CNKI, VIP, WanFang Data and CBM data-bases were searched to collect the randomized controlled trials ( RCTs) from the inception to May, 2014 about Chinese herbal retention enema on radiation enteritis, and the references of the included literature were also retrieved.Two reviewers inde-pendently screened the literatures according to the inclusion and exclusion criteria

  18. About the Mid-Continent Ecology Division (MED) of EPA's National Health and Environmental Effects Research Laboratory

    Science.gov (United States)

    The Mid-Continent Ecology Division (MED) conducts innovative research and predictive modeling to document and forecast the effects of pollutants on the integrity of watersheds and freshwater ecosystems.

  19. Management guidelines of the Central, Mississippi, and Pacific Flyways for the Mid-continent Population of sandhill cranes

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This plan sets forth guidelines for the cooperative management of the Mid-continent Population of sandhill cranes (hereafter MCP). The range of the MCP is extensive...

  20. Análise histológica da cicatrização da anastomose colônica, em ratos, sob ação de enema de Aroeira-do-sertão (Myracrodruon urundeuva fr. all. a 10% Histologic analysis of colonic anastomotic healing, in rats, under the action of 10% Aroeira-do-sertão (Myracrodruon urundeuva fr. all. enema

    Directory of Open Access Journals (Sweden)

    Annya Costa Araújo de Macedo Goes

    2005-04-01

    Full Text Available OBJETIVO: Avaliar, do ponto de vista histológico, a ação do extrato aquoso da aroeira-do-sertão na cicatrização da anastomose colônica, em ratos Wistar. MÉTODOS: Foram utilizados 48 ratos da linhagem Wistar, machos, com peso médio de 320g, distribuídos em dois grupos, com 24 animais, cada. Todos os animais foram submetidos à secção transversa completa do cólon descendente, seguida de anastomose colônica. Os ratos do grupo A receberam diariamente no pós-operatório enemas de veículo à base de carboximetilcelulose (CMC. Os animais do grupo B receberam no pós-operatório enemas de extrato aquoso de aroeira-do-sertão a 10% em veículo à base de CMC, até a data da eutanásia. Nas datas 3, 7, 14 e 21 do experimento, seis ratos de cada grupo foram submetidos à remoção de segmento colônico, incluindo a anastomose, destinado à apreciação histológica e análise qualitativa da resposta celular inflamatória e cicatricial. RESULTADOS: A análise morfológica revela diferença significante entre os grupos, no dia 7 (ñ PURPOSE: Evaluate, from a histologic view point, the action of the aqueous extract of aroeira-do-sertão on the healing of colonic anastomosis, in Wistar rats. METHODS: There were used 48 Wistar rats, males, with average weight of 320g, distributed in two groups, with 24 animals, each. All animals were subjected to a complete transverse section of the descending colon, followed by colonic anastomosis. The rats on group A received daily post-operative enemas of carboxymethylcellulose (CMC based vehicle. The animals on group B received post-operative enemas of 10% aqueous extract of aroeira-do-sertão in CMC based vehicle, until the date of euthanasia. On days 3, 7, 14 and 21 of the experiment, six rats in each group were subjected to removal of a colonic segment, including the anastomosis, destined to histological evaluation and qualitative analysis of inflammatory and healing cell response. RESULTS: The

  1. Impacts of winter-NAO on March cooling trends over subtropical Eurasia continent in the recent half century

    Science.gov (United States)

    Yu, Rucong; Zhou, Tianjun

    2004-06-01

    At odds with global warming trends, surface air temperature over large subtropical Eurasia continent in spring March exhibits unique strong cooling over the last half century. The cause for this cooling is shown to be related to Winter (DJF) North Atlantic Oscillation (W-NAO). Positive values of W-NAO provoke cooling signals in northern Africa continent simultaneously from surface to tropopause. The W-NAO generated signals barotropically extend eastward over most of subtropical Eurasia and reaches eastern China in March.

  2. Initial Experience and Feasibility of the New Low-Profile Stingray Catheter as Part of the Antegrade Dissection and Re-Entry Revascularization Strategy for Coronary Chronic Total Occlusions.

    Science.gov (United States)

    Maeremans, Joren; Palmers, Pieter-Jan; Dens, Joseph

    2017-01-31

    BACKGROUND During antegrade dissection re-entry (ADR) of chronic total occlusions (CTO), the first-generation Stingray catheter requires the use of large-bore guides (sheathless 7.5 Fr or 8 Fr), which increases the risk for access site-related complications and compromises radial approaches. Smaller guiding sizes necessitate long guidewires (e.g., 300 cm) or guidewire extensions for catheter advancement or removal. However, friction between guides and the Stingray catheter can result in unstable guidewire position or unintentional removal. Furthermore, failure to deliver the catheter at the distal re-entry zone is a common problem. To overcome issues of deliverability and reduce the need for pre-dilatations, with its inherent risk of creating subintimal hematomas, the Stingray low-profile (LP) balloon catheter was developed. CASE REPORT We describe 3 cases of successful application of the novel Stingray LP catheter during ADR. In all cases, 7 Fr guiding catheters were successfully used in combination with the device. The lower profile facilitated a good exchange and delivery of the device, without the need for balloon pre-dilatations in 2 cases. This resulted in a limited subintimal plane, enabling a smooth puncture into the true lumen. One case presented with extreme levels of calcification and tortuosity, resulting in a high degree of friction, despite the lower catheter profile. No in-hospital coronary or access site-related complications occurred. CONCLUSIONS This case report illustrates the feasibility of the Stingray LP catheter for the treatment of CTOs via the ADR technique. The lower profile of the catheter potentially increases the deliverability, safety, and exchangeability of the device.

  3. The progression of the boreal winter monsoon through the western Maritime Continent as differentiated by ENSO phase

    Science.gov (United States)

    Lee, Shao-Yi; McBride, John L.

    2016-08-01

    The impact of global ENSO on the regional monsoon onset over the Maritime Continent is examined, using satellite-derived scatterometer surface winds over the sea channel from the South China Sea, through the Karimata Strait into the Java Sea. An index of monsoon onset, fracsign, is defined based on a positive dot-product between the monthly wind at each gridpoint and the "basis-wind" or climatological wind at the peak of the relevant monsoon season.Rather than being delayed throughout the Maritime Continent during El Niño years, the monsoon is seen to arrive faster at and remain longer over the western Maritime Continent, and therefore delayed for the eastern Maritime Continent. The wind-based diagnostic can be further decomposed into two components that reflect the monsoon wind strength and the location of the wind convergence zone, respectively. During El Niño years, the monsoon strength post-onset is weaker than normal over the eastern maritime continent. However, there is no ENSO-related differentiation in monsoon strength post-onset over the western Maritime Continent.

  4. Methane over the North American Continent - INTEX-NA, Summer 2004

    Science.gov (United States)

    Karen, B.; Blake, D.; Meinardi, S.; Blake, N.; Sachse, G.; Slate, T.

    2005-12-01

    During July and August of 2004, the INTEX-NA mission was flown over the North American continent as a part of the integrated ICARTT campaign. Its primary focus was to examine the intercontinental transport and transformation of chemically and radiatively important trace gases and aerosols across the region. As a part of the mission, methane (CH4) was sampled using both canisters and a fast response tunable diode laser, the DACOM instrument. Agreement between the two techniques was excellent. Sources of methane are both natural (wetlands, wildfires) and anthropogenically controlled (landfills, ruminants, petroleum production and use, coal mining). Although natural biogenic emissions would be expected to be near seasonal maximums, the majority of North American wetlands are located in Canada and Alaska, and were difficult to isolate during the mission. Overall distributions were well correlated with C2Cl4, a tracer of industrial and urban activity, and reflect the widespread impact of anthropogenic emissions. As expected for a gas with surface continental sources, variability was greatest in the near-surface atmosphere and decreased with increasing altitude and distance from the continent. Summer convective activity over the region resulted in elevated concentrations measured at altitudes above 6 km. Enhanced levels with distinctive trace gas signatures were observed for a variety of sources, including petroleum mining and distribution, coal mining, Canadian wildfires, and aged Asian plumes advected across the Pacific. Several flights during the mission were flown along the U.S. east coast to sample air masses transported off the continent to the Atlantic. In the near-surface over the ocean, clean boundary layer air with mixing ratios comparable to background CMDL levels at this time were encountered. At altitudes above about 4 km, CH4 was enhanced by roughly 20-50 ppb.

  5. The tropical rain belts with an annual cycle and a continent model intercomparison project: TRACMIP: TRACMIP

    Energy Technology Data Exchange (ETDEWEB)

    Voigt, Aiko [Institute of Meteorology and Climate Research - Department Troposphere Research, Karlsruhe Institute of Technology, Karlsruhe Germany; Lamont-Doherty Earth Observatory, Columbia University, New York New York USA; Biasutti, Michela [Lamont-Doherty Earth Observatory, Columbia University, New York New York USA; Scheff, Jacob [Lamont-Doherty Earth Observatory, Columbia University, New York New York USA; Bader, Jürgen [Max Planck Institute for Meteorology, Hamburg Germany; Bordoni, Simona [California Institute of Technology, Pasadena California USA; Codron, Francis [Sorbonne Universités, UPMC Univ Paris 06, Laboratoire d' Océanographie et du Climat, Paris France; Dixon, Ross D. [University of Wisconsin-Madison, Madison Wisconsin USA; Jonas, Jeffrey [Center for Climate Systems Research, Columbia University, New York New York USA; Kang, Sarah M. [School of Urban and Environmental Engineering, Ulsan National Institute of Science and Technology, Ulsan South Korea; Klingaman, Nicholas P. [National Centre for Atmospheric Science-Climate and Department of Meteorology, University of Reading, Reading UK; Leung, Ruby [Pacific Northwest National Laboratory, Richland Washington USA; Lu, Jian [Pacific Northwest National Laboratory, Richland Washington USA; Mapes, Brian [Rosenstiel School of Marine and Atmospheric Sciences, University of Miami, Miami Florida USA; Maroon, Elizabeth A. [Department of Atmospheric Sciences, University of Washington, Seattle Washington USA; McDermid, Sonali [New York University, New York New York USA; Park, Jong-yeon [Max Planck Institute for Meteorology, Hamburg Germany; Roehrig, Romain [Centre National de Recherches Météorologiques, UMR 3589, Meteo-France/CNRS Toulouse France; Rose, Brian E. J. [University at Albany (State University of New York), Albany New York USA; Russell, Gary L. [NASA Goddard Institute for Space Studies, New York New York USA; Seo, Jeongbin [School of Urban and Environmental Engineering, Ulsan National Institute of Science and Technology, Ulsan South Korea; Toniazzo, Thomas [Uni Research, Bjerknes Centre for Climate Research, Bergen Norway; Wei, Ho-Hsuan [California Institute of Technology, Pasadena California USA; Yoshimori, Masakazu [Faculty of Environmental Earth Science and Arctic Research Center, Hokkaido University, Sapporo Japan; Vargas Zeppetello, Lucas R. [Lamont-Doherty Earth Observatory, Columbia University, New York New York USA

    2016-12-02

    This paper introduces the Tropical Rain belts with an Annual cycle and a Continent Model Intercomparison Project (TRACMIP). TRACMIP studies the dynamics of tropical rain belts and their response to past and future radiative forcings through simulations with 13 comprehensive and one simplified atmosphere models coupled to a slab ocean and driven by seasonally-varying insolation. Five idealized experiments, two with an aquaplanet setup and three with a setup with an idealized tropical continent, fill the space between prescribed-SST aquaplanet simulations and realistic simulations provided by CMIP5/6. The simulations reproduce key features of the present-day climate and expected future climate change, including an annual-mean intertropical convergence zone (ITCZ) that is located north of the equator and Hadley cells and eddy-driven jets that are similar to the present-day climate. Quadrupling CO2 leads to a northward ITCZ shift and preferential warming in Northern high-latitudes. The simulations show interesting CO2-induced changes in the seasonal excursion of the ITCZ and indicate a possible state-dependence of climate sensitivity. The inclusion of an idealized continent modulates both the control climate and the response to increased CO2; for example it reduces the northward ITCZ shift associated with warming and, in some models, climate sensitivity. In response to eccentricity-driven seasonal insolation changes, seasonal changes in oceanic rainfall are best characterized as a meridional dipole, while seasonal continental rainfall changes tend to be symmetric about the equator. This survey illustrates TRACMIP’s potential to engender a deeper understanding of global and regional climate phenomena and to address pressing questions on past and future climate change.

  6. This is Africa: an introduction to medical operations on the African continent.

    Science.gov (United States)

    Givens, Melissa L; Lynch, James H

    2014-01-01

    This article regarding Special Operations Forces (SOF) medical operations in Africa is an introduction to a follow-on series of articles that will address in more detail pertinent medical topics which pertain to operations on the African continent. Medical operations in Africa require dynamic and systematic approaches that consider the myriad challenges, yet offer flexible solutions applied as situations and environments dictate. We believe this series of articles will be of high interest to readers and provide key information that will be germane to future SOF operations.

  7. Stability, continence and breathing: the role of fascia following pregnancy and delivery.

    Science.gov (United States)

    Lee, D G; Lee, L J; McLaughlin, L

    2008-10-01

    Pregnancy-related pelvic girdle pain (PRPGP) has a prevalence of approximately 45% during pregnancy and 20-25% in the early postpartum period. Most women become pain free in the first 12 weeks after delivery, however, 5-7% do not. In a large postpartum study of prevalence for urinary incontinence (UI) [Wilson, P.D., Herbison, P., Glazener, C., McGee, M., MacArthur, C., 2002. Obstetric practice and urinary incontinence 5-7 years after delivery. ICS Proceedings of the Neurourology and Urodynamics, vol. 21(4), pp. 284-300] found that 45% of women experienced UI at 7 years postpartum and that 27% who were initially incontinent in the early postpartum period regained continence, while 31% who were continent became incontinent. It is apparent that for some women, something happens during pregnancy and delivery that impacts the function of the abdominal canister either immediately, or over time. Current evidence suggests that the muscles and fascia of the lumbopelvic region play a significant role in musculoskeletal function as well as continence and respiration. The combined prevalence of lumbopelvic pain, incontinence and breathing disorders is slowly being understood. It is also clear that synergistic function of all trunk muscles is required for loads to be transferred effectively through the lumbopelvic region during multiple tasks of varying load, predictability and perceived threat. Optimal strategies for transferring loads will balance control of movement while maintaining optimal joint axes, maintain sufficient intra-abdominal pressure without compromising the organs (preserve continence, prevent prolapse or herniation) and support efficient respiration. Non-optimal strategies for posture, movement and/or breathing create failed load transfer which can lead to pain, incontinence and/or breathing disorders. Individual or combined impairments in multiple systems including the articular, neural, myofascial and/or visceral can lead to non-optimal strategies during

  8. High diversity of picornaviruses in rats from different continents revealed by deep sequencing

    DEFF Research Database (Denmark)

    Arn Hansen, Thomas; Mollerup, Sarah; Nguyen, Nam-Phuong

    2016-01-01

    Outbreaks of zoonotic diseases in humans and livestock are not uncommon, and an important component in containment of such emerging viral diseases is rapid and reliable diagnostics. Such methods are often PCR-based and hence require the availability of sequence data from the pathogen. Rattus......) collected from two continents by analyzing 2.2 billion next-generation sequencing reads derived from both DNA and RNA. Among other virus families, we found sequences from members of the Picornaviridae to be abundant in the microbiome of all the samples. Here we describe the diversity of the picornavirus...

  9. Study on the Antipyretic Effection of Qingkaitong Enema and Its Influence on the Changes of Vasoactive Intestinal Peptide(VIP)and Interleukin-2 (IL-2) in Endotoxin-induced Febrile Rabbits%清开通灌肠液对内毒素性发热兔的退热效应及对血管活性肠肽、白介素-2的影响

    Institute of Scientific and Technical Information of China (English)

    刘亚娟; 张思超; 王晓君; 孙敬昌

    2012-01-01

    目的:观察基于“脑-肠轴”学说组方的清开通灌肠液,对内毒素性发热兔的退热效应及VIP、IL-2在发热中的变化.方法:日本大耳白家兔60只,随机分成4组:正常组、模型组、清开灵组和清开通组.模型组、清开灵组及清开通组,各组经耳缘静脉注射无热源生理盐水稀释的内毒素,建立兔内毒素性发热模型.同时清开灵组、清开通组分别予以清开灵、清开通灌肠液灌肠.注射内毒素2h后,清开灵组、清开通组再予灌肠1次.4h后,各组动物随机抽取10只,采集脑、肠及外周血标本,用放射免疫法检测脑、肠及血浆中VIP、IL-2含量.持续观察每组另外5只动物体温变化情况,每间隔l0min记录1次体温,连续测温12h.结果:清开灵组和清开通组动物的体温与模型组相比都有明显降低(P<0.01),但清开通组降低比清开灵组更为显著(P<0.05).脑肠及血浆中VIP和IL-2的含量都显著低于模型组(P<0.01),尤其清开通组较清开灵组降低幅度更大,二者有显著差异(P<0.05).结论:“清开”与“通腑”合治,较单一清开法在退热及提高机体免疫方面效果更著,VIP和IL-2在发热中起正调节作用.%Objective: To investigate the antipyretic effect of Qingkaitong enema according to the theory of brain - gut axis in endotoxin - induced febrile rabbits, and observe changes of vasoactive intestinal peptide ( VIP) and interleukin - 2 (IL - 2 ) in different tissues. Methods: Sixty Japanese White Rabbits were randomly divided into following four groups: normal control group,model group,Qingkailing enema group and Qingkaitong enema group. The Escherichia coli endotoxins were injected into marginal ear veins of the rabbits of model group, Qingkailing enema group and Qingkaitong enema group to induce the rabbit febrile model. Qingkailing enema group and Qingkaitong enema group were immediately treated with Qingkailing enema and Qingkaitong enema respectively after

  10. Continent-wide survey reveals massive decline in African savannah elephants

    Directory of Open Access Journals (Sweden)

    Michael J. Chase

    2016-08-01

    Full Text Available African elephants (Loxodonta africana are imperiled by poaching and habitat loss. Despite global attention to the plight of elephants, their population sizes and trends are uncertain or unknown over much of Africa. To conserve this iconic species, conservationists need timely, accurate data on elephant populations. Here, we report the results of the Great Elephant Census (GEC, the first continent-wide, standardized survey of African savannah elephants. We also provide the first quantitative model of elephant population trends across Africa. We estimated a population of 352,271 savannah elephants on study sites in 18 countries, representing approximately 93% of all savannah elephants in those countries. Elephant populations in survey areas with historical data decreased by an estimated 144,000 from 2007 to 2014, and populations are currently shrinking by 8% per year continent-wide, primarily due to poaching. Though 84% of elephants occurred in protected areas, many protected areas had carcass ratios that indicated high levels of elephant mortality. Results of the GEC show the necessity of action to end the African elephants’ downward trajectory by preventing poaching and protecting habitat.

  11. Polychlorinated terphenyl patterns and levels in selected marine mammals and a river fish from different continents.

    Science.gov (United States)

    Rosenfelder, Natalie; Vetter, Walter

    2014-01-01

    Polychlorinated terphenyls (PCTs) are a class of persistent organic pollutants which have been used from the 1920s to the 1980s for similar purposes as polychlorinated biphenyls (PCBs). Comparably little data was available on the PCT distribution in the environment mainly due to analytical difficulties in their determination. By means of a calculation algorithm recently developed we now studied the PCT pattern in individual marine mammal samples and one fish sample from different continents. Altogether, 97 PCTs were detected in eight samples and twelve to 66 tetra- to nonachloroterphenyl (tetra- to nonaCT) congeners were detected in individual samples. PCTs were present in all marine mammal samples which originated from four continents, but the PCT pattern was varied. TetraCTs were dominant in the sample from Africa, Australia, Spitsbergen (European Arctic) and in a sample from the Baltic Sea, heptaCTs in samples from the North Sea and octaCTs in a sample from Iceland. The abundance of sumPCTs relative to PCB 153, estimated from the GC/ECNI-MS response corrected for the degree of chlorination, ranged from 0.9 to 8.8%, corresponding with ~0.22-2.2% of the total PCB content. The highest PCT level detected was 980 mg/kg lipid in a harbour seal from the North Sea, Germany. The results from this study indicated that samples from certain areas, e.g. the North Sea may still be polluted with PCTs.

  12. Urethral sensory threshold and urethro-anal reflex latency in continent women.

    Science.gov (United States)

    Cavalcanti, Geraldo de Aguiar; Bruschini, Homero; Manzano, Gilberto M; Giuliano, Lydia P; Nóbrega, João Antônio M; Srougi, Miguel

    2007-01-01

    The sensory evaluation of the lower urinary tract is summarized in the bladder proprioceptive sensitivity during cystometry. Experimental studies suggest that abnormalities of the urethral innervation and micturition reflex can be related to the presence of continence disturbances. This study aimed to measure the urethral sensory threshold and the urethro-anal reflex latency in healthy volunteers, establishing reading criteria, comparing the results and technique used with the literature and verifying the effect of physiological factors. Thirty healthy female volunteers were studied. They had an absence of genital or urinary complaints and had undergone no previous pelvic or vaginal procedures. The measurement of the urethral sensory threshold and urethro-anal reflex latency were performed as described. The determination of the urethral sensory threshold and urethro-anal reflex latency were obtained in 96.6% of the volunteers. The electrophysiological parameters did not correlate with age, parity or number of vaginal deliveries. There was a positive association of the urethral sensory threshold with height. Technical aspects were considered and compared with those in the literature as well as the advantages and limitations of the method. The measurement of the urethral sensory threshold and urethro-anal reflex latency presented consistent recordings. The urethral sensory threshold should be analyzed carefully in individuals with height above the population average. Subsequent observations are necessary to clarify their function in patients with continence disturbances and to measure the urethral function, but these values can be used as normal parameters for comparison.

  13. Does structural complexity determine the morphology of assemblages? An experimental test on three continents.

    Directory of Open Access Journals (Sweden)

    Heloise Gibb

    Full Text Available Understanding how species will respond to global change depends on our ability to distinguish generalities from idiosyncrasies. For diverse, but poorly known taxa, such as insects, species traits may provide a short-cut to predicting species turnover. We tested whether ant traits respond consistently to habitat complexity across geographically independent ant assemblages, using an experimental approach and baits. We repeated our study in six paired simple and complex habitats on three continents with distinct ant faunas. We also compared traits amongst ants with different foraging strategies. We hypothesised that ants would be larger, broader, have longer legs and more dorsally positioned eyes in simpler habitats. In agreement with predictions, ants had longer femurs and dorsally positioned eyes in simple habitats. This pattern was most pronounced for ants that discovered resources. Body size and pronotum width responded as predicted for experimental treatments, but were inconsistent across continents. Monopolising ants were smaller, with shorter femurs than those that occupied or discovered resources. Consistent responses for several traits suggest that many, but not all, aspects of morphology respond predictably to habitat complexity, and that foraging strategy is linked with morphology. Some traits thus have the potential to be used to predict the direction of species turnover, changes in foraging strategy and, potentially, evolution in response to changes in habitat structure.

  14. Rapid magmatic processes accompany arc-continent collision: the Western Bismarck arc, Papua New Guinea

    Science.gov (United States)

    Cunningham, Heather; Gill, Jim; Turner, Simon; Caulfield, John; Edwards, Louise; Day, Simon

    2012-11-01

    New U-Th-Ra, major and trace element, and Sr-Nd-Pb isotope data are presented for young lavas from the New Britain and Western Bismarck arcs in Papua New Guinea. New Britain is an oceanic arc, whereas the latter is the site of an arc-continent collision. Building on a recent study of the Manus Basin, contrasts between the two arcs are used to evaluate the processes and timescales of magma generation accompanying arc-continent collision and possible slab detachment. All three suites share many attributes characteristic of arc lavas that can be ascribed to the addition of a regionally uniform subduction component derived from the subducting altered oceanic crust and sediment followed by dynamic melting of the modified mantle. However, the Western Bismarck arc lavas diverge from the Pb isotope mixing array formed by the New Britain and the Manus Basin lavas toward elevated 208Pb/204Pb. We interpret this to reflect a second and subsequent addition of sediment melt at crustal depth during collision. 238U and 226Ra excesses are preserved in all of the lavas and are greatest in the Western Bismarck arc. High-Mg andesites with high Sr/Y ratios in the westernmost arc are attributed to recent shallow mantle flux melting at the slab edge. Data for two historical rhyolites are also presented. Although these rhyolites formed in quite different tectonic settings and display different geochemical and isotopic compositions, both formed from mafic parents within millennia.

  15. Organic geochemistry of Mid-Continent middle and Late Ordovician oils

    Energy Technology Data Exchange (ETDEWEB)

    Longman, M.W.; Palmer, S.E.

    1987-08-01

    Ordovician oils in Mohawkian and Cincinnatian reservoirs of the US Mid-Continent retain the biochemical imprint of Middle and Upper Ordovician oceanic life before the evolution of land plants and most vertebrates. Thus, these oils have some geochemical features that distinguish them from younger oils. These features include (1) a predominance of n-C/sub 15/, n-C/sub 17/, and n-C/sub 19/ alkanes in the saturated hydrocarbon fraction, (2) relatively low amounts of longer chain n-alkanes, (3) low amounts of chlorophyll-derived isoprenoids, such as pristane and phytane, and (4) abundant C/sub 29/ sterane relative to C/sub 27/ with rearranged forms (diasteranes) predominant over normal steranes. Ordovician oils also generally contain little sulfur and have a somewhat variable light stable carbon isotopic composition with delta/sup 13/C/sub sat/ and delta/sup 13/C/sub aro/ values of -28 to -31 per thousand (PDB), but these features are typical of many marine oils. The unusual chemistry of these Ordovician oils supports the interpretation of Reed, Illich, and Horsfield (1986) that prokaryotic organisms provided the organic matter for most Ordovician oils. Although their claim for Gloeocapsamorpha (a problematic unicellular prokaryote, possibly a blue-green alga or an unusually large bacterium) cannot be proven from oil chemistry alone, knowing that indigenous Mid-Continent Ordovician oils were derived from prokaryotic organisms may aid in future exploration for these reservoirs. 7 figures, 3 tables.

  16. Continent-wide survey reveals massive decline in African savannah elephants

    Science.gov (United States)

    Schlossberg, Scott; Griffin, Curtice R.; Bouché, Philippe J.C.; Djene, Sintayehu W.; Elkan, Paul W.; Ferreira, Sam; Grossman, Falk; Kohi, Edward Mtarima; Landen, Kelly; Omondi, Patrick; Peltier, Alexis; Selier, S.A. Jeanetta; Sutcliffe, Robert

    2016-01-01

    African elephants (Loxodonta africana) are imperiled by poaching and habitat loss. Despite global attention to the plight of elephants, their population sizes and trends are uncertain or unknown over much of Africa. To conserve this iconic species, conservationists need timely, accurate data on elephant populations. Here, we report the results of the Great Elephant Census (GEC), the first continent-wide, standardized survey of African savannah elephants. We also provide the first quantitative model of elephant population trends across Africa. We estimated a population of 352,271 savannah elephants on study sites in 18 countries, representing approximately 93% of all savannah elephants in those countries. Elephant populations in survey areas with historical data decreased by an estimated 144,000 from 2007 to 2014, and populations are currently shrinking by 8% per year continent-wide, primarily due to poaching. Though 84% of elephants occurred in protected areas, many protected areas had carcass ratios that indicated high levels of elephant mortality. Results of the GEC show the necessity of action to end the African elephants’ downward trajectory by preventing poaching and protecting habitat. PMID:27635327

  17. Convergence across a continent: adaptive diversification in a recent radiation of Australian lizards.

    Science.gov (United States)

    Blom, Mozes P K; Horner, Paul; Moritz, Craig

    2016-06-15

    Recent radiations are important to evolutionary biologists, because they provide an opportunity to study the mechanisms that link micro- and macroevolution. The role of ecological speciation during adaptive radiation has been intensively studied, but radiations can arise from a diversity of evolutionary processes; in particular, on large continental landmasses where allopatric speciation might frequently precede ecological differentiation. It is therefore important to establish a phylogenetic and ecological framework for recent continental-scale radiations that are species-rich and ecologically diverse. Here, we use a genomic (approx. 1 200 loci, exon capture) approach to fit branch lengths on a summary-coalescent species tree and generate a time-calibrated phylogeny for a recent and ecologically diverse radiation of Australian scincid lizards; the genus Cryptoblepharus We then combine the phylogeny with a comprehensive phenotypic dataset for over 800 individuals across the 26 species, and use comparative methods to test whether habitat specialization can explain current patterns of phenotypic variation in ecologically relevant traits. We find significant differences in morphology between species that occur in distinct environments and convergence in ecomorphology with repeated habitat shifts across the continent. These results suggest that isolated analogous habitats have provided parallel ecological opportunity and have repeatedly promoted adaptive diversification. By contrast, speciation processes within the same habitat have resulted in distinct lineages with relatively limited morphological variation. Overall, our study illustrates how alternative diversification processes might have jointly stimulated species proliferation across the continent and generated a remarkably diverse group of Australian lizards. © 2016 The Author(s).

  18. Onset of oxidative weathering of continents recorded in the geochemistry of ancient glacial diamictites

    Science.gov (United States)

    Gaschnig, Richard M.; Rudnick, Roberta L.; McDonough, William F.; Kaufman, Alan J.; Hu, Zhaochu; Gao, Shan

    2014-12-01

    Glacial diamictites deposited in the Mesoarchean, Paleoproterozoic, Neoproterozoic, and Paleozoic eras record temporal variations in their average compositions that reflect the changing composition of the upper continental crust (UCC). Twenty six of the 27 units studied show elevated chemical index of alternation (CIA) and low Sr abundances, regardless of their age, documenting pervasive weathering of the average UCC. Lower abundances of transition metals reflect a shift towards more felsic crustal compositions after the Archean. Superimposed on this chemical difference is the signal of the rise of oxidative weathering of the continents, recorded by changes in the absolute and relative abundances of the redox sensitive elements Mo and V. Neoproterozoic and Paleozoic diamictites show pervasive depletion in Mo and V, reflecting their loss from the continents due to increasing intensity of oxidative weathering, as also recorded in some of the Paleoproterozoic diamictites. A few of the Paleoproterozoic diamictites deposited after the Great Oxidation Event show no depletion in Mo and V (e.g., Gowganda), but such signatures could be inherited from their provenance. In contrast, the pre-GOE Duitschland diamictite (ca. 2.3-2.5 Ga) from South Africa reveals evidence of intense oxidative weathering (i.e., large depletions in Mo), supporting a growing body of observations showing the presence of measurable atmospheric oxygen prior to permanent loss of the mass independent fractionation signal in sulfur isotopes.

  19. Origin of tectonic stresses in the Chinese continent and adjacent areas

    Institute of Scientific and Technical Information of China (English)

    ZHU ShouBiao; SHI YaoLin

    2007-01-01

    Based on data of principal stress orientation from focal mechanism and of geological features in China, we made pseudo-3D genetic algorithm finite element (GA-FEM) inversion to investigate the main forces acting on the Chinese continent and adjacent areas which form the Chinese tectonic stress field. The results confirm that plate boundary forces play the dominant role in forming the stress field in China, as noticed by many previous researchers. However, we also find that topographic spreading forces, as well as basal drag forces of the lower crust to the upper crust, make significant contribution to stresses in regional scale. Forces acting on the Chinese continent can be outlined as follows: the collision of the India plate to the NNE is the most important action, whereby forces oriented to the NW by the Philippine plate and forces oriented to the SWW by the Pacific plate are also important. Topographic spreading forces are not negligible at high topographic gradient zones, these forces are perpendicular to edges of the Tibetan Plateau and a topographic gradient belt running in the NNE direction across Eastern China. Basal drag forces applied by the ductile flow of the lower crust to the base of upper crust affect the regional stress field in the Tibetan Plateau remarkably, producing the clockwise rotation around the eastern Himalaya syntax.

  20. [The 4-stage continence-micturition cycle. The presentation of a urodynamic, diagnostic and therapeutic abacus].

    Science.gov (United States)

    Lardennois, B; Clément, T; Coulon, J M; Brandt, B

    1990-01-01

    The complexity of the mode of operation of the bladder and urinary sphincter has led to the development of a number of temporospatial physiologic models that divide the process of micturition into several stages in order to facilitate investigations. Ten years ago, the authors described a two-stage continence-micturition model intended to improve the accuracy of studies of urodynamic disorders and thus contribute to the development of more effective and more rational therapeutic solutions. A large number of diseases can affect the distal urinary tract and recent advances in neurophysiology [10] have made the selection of the appropriate therapy extremely complex. Consequently, the authors have developed a decision analysis system that simultaneously confronts diseases, urodynamic manifestations, risks for the patient, and the main therapeutic approaches available. In 1985, they increased the number of stages in their continence-micturition model from two the four. This four-stage model has provided satisfactory result when used with an abacus for modeling observed biologic phenomena. In addition to offering simulation exercises for teaching purposes, this abacus provides the means for studying the instantaneous urodynamic situation (correspondences between cycle time points, symptoms, and effects of treatments) and determining the effect of various medicosocial events on the course of the bladder and sphincter dysfunction. The authors hope this abacus will be an attractive aide to the understanding of the complex function of the distal urinary tract.

  1. Continent-wide survey reveals massive decline in African savannah elephants.

    Science.gov (United States)

    Chase, Michael J; Schlossberg, Scott; Griffin, Curtice R; Bouché, Philippe J C; Djene, Sintayehu W; Elkan, Paul W; Ferreira, Sam; Grossman, Falk; Kohi, Edward Mtarima; Landen, Kelly; Omondi, Patrick; Peltier, Alexis; Selier, S A Jeanetta; Sutcliffe, Robert

    2016-01-01

    African elephants (Loxodonta africana) are imperiled by poaching and habitat loss. Despite global attention to the plight of elephants, their population sizes and trends are uncertain or unknown over much of Africa. To conserve this iconic species, conservationists need timely, accurate data on elephant populations. Here, we report the results of the Great Elephant Census (GEC), the first continent-wide, standardized survey of African savannah elephants. We also provide the first quantitative model of elephant population trends across Africa. We estimated a population of 352,271 savannah elephants on study sites in 18 countries, representing approximately 93% of all savannah elephants in those countries. Elephant populations in survey areas with historical data decreased by an estimated 144,000 from 2007 to 2014, and populations are currently shrinking by 8% per year continent-wide, primarily due to poaching. Though 84% of elephants occurred in protected areas, many protected areas had carcass ratios that indicated high levels of elephant mortality. Results of the GEC show the necessity of action to end the African elephants' downward trajectory by preventing poaching and protecting habitat.

  2. Comparing determinants of alien bird impacts across two continents: implications for risk assessment and management

    Science.gov (United States)

    Evans, Thomas; Kumschick, Sabrina; Dyer, Ellie; Blackburn, Tim

    2014-01-01

    Invasive alien species can have serious adverse impacts on both the environment and the economy. Being able to predict the impacts of an alien species could assist in preventing or reducing these impacts. This study aimed to establish whether there are any life history traits consistently correlated with the impacts of alien birds across two continents, Europe and Australia, as a first step toward identifying life history traits that may have the potential to be adopted as predictors of alien bird impacts. A recently established impact scoring system was used in combination with a literature review to allocate impact scores to alien bird species with self-sustaining populations in Australia. These scores were then tested for correlation with a series of life history traits. The results were compared to data from a previous study in Europe, undertaken using the same methodology, in order to establish whether there are any life history traits consistently correlated with impact across both continents. Habitat generalism was the only life history trait found to be consistently correlated with impact in both Europe and Australia. This trait shows promise as a potential predictor of alien bird impacts. The results support the findings of previous studies in this field, and could be used to inform decisions regarding the prevention and management of future invasions. PMID:25165531

  3. Observation on curative effect of Chinese medicine hot package combining with retention enema for ulcerative col itis patients%中药热奄包配合中药保留灌肠治疗溃疡性结肠炎的疗效观察

    Institute of Scientific and Technical Information of China (English)

    黄雪芬; 屈伟荣

    2014-01-01

    Obj ective:To observe the effect of Chinese medicine hot package combining with retention enema for ulcerative colitis patients.Methods:A to-tal of 62 UC patients were randomly divided into observation group and control group,3 1 cases in each,patients in control group received Chinese medicine re-tention enema treatment and patients in observation group were given Chinese medicine hot package combining with retention enema treatment,lasting for 2 1 days.Then the curative effect was compared between both groups.Results:the total effective rate was respective 93.55% in treatment group and 61.29% in control group.There was statistically significant difference(P<0.05).Conclu-sion:The clinical effect of Chinese medicine hot package combining with reten-tion enema is obvious for ulcerative colitis patients.%[目的]观察中药热奄包配合保留灌肠治疗溃疡性结肠炎(UC)病人的效果。[方法]将62例溃疡性结肠炎病人随机分为观察组和对照组各31例,对照组采用中药保留灌肠治疗,观察组加用中药热奄包治疗,连续治疗21 d,比较两组病人的疗效。[结果]观察组与对照组总有效率分别为93.55%和61.29%,经比较差异有统计学意义(P<0.05)。[结论]中药热奄包配合保留灌肠治疗溃疡性结肠炎疗效明显。

  4. Afriflu2--second international workshop on influenza vaccination in the African continent--8 November 2012, Cape Town (South Africa).

    Science.gov (United States)

    Schoub, Barry D; Gessner, Bradford D; Ampofo, William; Cohen, Adam L; Steffen, Christoph A

    2013-08-02

    The second meeting of the Afriflu conferences took place in Cape Town, South Africa, with over 60 participants from 15 countries in Africa and also outside the continent. Significant progress in surveillance has been made in better understanding the illness burden of influenza on the continent, which limited evidence suggests is greater than that in the developed world. In southern Africa HIV and TB coinfections play a major role in increasing hospitalisation and mortality, while elsewhere in Africa other cofactors still need to be determined. There is currently no indigenous vaccine production in sub-Saharan Africa and only one facility, based in South Africa, capable of filling imported bulk. Innovative vaccine strategies will need to be explored, such as maternal immunisation, and also the possibility of other influenza vaccine options, such as live attenuated influenza vaccine for young children. Sustained indigenous vaccine production is essential for the continent to have vaccine security in the event of a pandemic even though establishing local production faces considerable challenges especially ensuring adequate markets on the continent. There is an urgent need to develop effective communication messages for decision makers as well as healthcare workers addressing the importance of influenza even in the face of the major competing health burdens of the continent.

  5. The mechanism of action of rhubarb Chinese medicine enema treatment of chronic renal failure%大黄中药灌肠治疗慢性肾功能衰竭的作用机制研究

    Institute of Scientific and Technical Information of China (English)

    任燕

    2015-01-01

    Objective Explore the rhubarb the clinical curative effect of traditional Chinese medicine enema treatment of chronic renal failure.Methods Kidney disease in a hospital treated 92 cases of chronic renal failure patients as the research object, with the method of grouping study, its according to different treatment can be divided into control group and observation group, control group for clinical routine treatment, observation group based on the given rhubarb is given priority to the traditional Chinese medicine enema treatment, two groups of patients were 4 weeks treatment, compared two groups of patients at the end of the treatment of therapeutic effect.Results Treatment the total effective rate was 95.7%, the observation group was obviously higher than that of control group 75.1%(P<0.05); Group of clinical symptoms was observed is better than that of control group(P<0.05); Urea nitrogen, creatinine, two groups of patients was improved, the but the observation group after treatment to improve the situation of urea nitrogen, creatinine, was better than control group, the difference was statistically significant(P<0.05).Conclusion Rhubarb Chinese medicine enema in the treatment of chronic renal failure clinical curative effect significantly, mainly by improving blood urea nitrogen and serum creatinine is to protect the patient's kidney function, can improve the patient's quality of life and prolong the survival period.%目的 探讨大黄中药灌肠治疗慢性肾功能衰竭的临床疗效.方法 以某院肾病科收治的92例慢性肾功能衰竭患者为研究对象,采用分组研究的方式,将其根据治疗方式不同分为对照组与观察组,对照组给予临床常规治疗,观察组在此基础上给予大黄为主的中药灌肠治疗,两组患者均治疗4周,在治疗结束后对比分析两组患者的治疗效果.结果 观察组治疗总有效率为95.7%,明显高于对照组的75.1%(P<0.05);观察组临床症状

  6. 大黄水灌肠对急性胰腺炎患者肠道功能恢复的影响%Effect of rhubarb water enema on the recovery of bowel function in patients with acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    章昱; 刘朝晖; 俞晶; 陈素钻

    2014-01-01

    目的:探讨大黄水灌肠对急性胰腺炎患者早期肠道功能恢复的影响。方法收集汕头大学医学院第一附属医院住院治疗的急性胰腺炎患者118例,随机分为两组,对照组给予常规胰腺炎治疗,治疗组在常规治疗的基础上加用大黄水灌肠,对比两组患者腹部胀痛持续时间及首次排便时间,比较两组APACHE II评分、中转手术率、病死率、住院天数及住院费用。结果治疗组与对照组腹部胀痛持续时间分别为(4.0±1.5)d、(6.0±1.8)d,首次排便时间分别为(7.0±2.1)d、(10.0±2.6)d,两组比较差异有统计学意义( P ﹤0.05);治疗后治疗组 A-PACHEⅡ积分、中转手术率、病死率、住院天数及住院费用均明显低于对照组(P﹤0.05)。结论大黄水灌肠可以明显缩短患者因肠道功能衰竭引起的腹部胀痛及首次排便时间,改善各项临床指标,值得临床推广应用。%Objective To study the effect of rhubarb water enema on the early recovery of bowel function in patients with acute pancreatitis. Methods One hundred and eighteen patients with acute pancreatitis in the first affiliated hospital of Shantou university medical college were randomly divided into two groups,the patients in control group received conventional pancreatitis treatment,and the patients in treatment group were added with rhubarb water enema based on the conventional treatment. The duration of abdominal pain and the first defecation time were compared between the two groups,and APACHE Ⅱscore,operation rate,mortality,hospital stay and hospital costs were also compared between the two groups. Results The duration of abdominal pain was( 4. 0 ± 1. 5 )d in the treatment group and (6. 0 ± 1. 8 )d in the control group,the first defecation time was( 7. 0 ± 2. 1 )d in the treatment group and(10. 0 ± 2. 6)d in the control group,there were significant differences(P﹤0. 05);The A-PACHE

  7. Contemporary crustal deformation of the Chinese continent and tectonic block model

    Institute of Scientific and Technical Information of China (English)

    王敏; 沈正康; 牛之俊; 张祖胜; 孙汉荣; 甘卫军; 王琪; 任群

    2003-01-01

    We obtain the preliminary result of crustal deformation velocity field for the Chinese con-tinent by analyzing GPS data from the Crustal Motion Observation Network of China (CMONOC), particularly the data from the regional networks of CMONOC observed in 1999 and 2001. We de-lineate 9 tectonically active blocks and 2 broadly distributed deformation zones out of a denseGPS velocity field, and derive block motion Euler poles for the blocks and their relative motionrates. Our result reveals that there are 3 categories of deformation patterns in the Chinese conti-nent. The first category, associated with the interior of the Tibetan Plateau and the Tianshan oro-genic belt, shows broadly distributed deformation within the regions. The third category, associatedwith the Tarim Basin and the region east of the north-south seismic belt of China, shows block-likemotion, with deformation accommodated along the block boundaries only. The second category, mainly associated with the borderland of the Tibetan Plateau, such as the Qaidam, Qilian, Xining(in eastern Qinghai), and the Diamond-shaped (in western Sichuan and Yunnan) blocks, has thedeformation pattern between the first and the third, i.e. these regions appear to deform block-like,but with smaller sizes and less strength for the blocks. Based on the analysis of the lithosphericstructures and the deformation patterns of the regions above, we come to the inference that thedeformation modes of the Chinese continental crust are mainly controlled by the crustal structure.The crust of the eastern China and the Tarim Basin is mechanically strong, and its deformationtakes the form of relative motion between rigid blocks. On the other hand, the northward indentation of the Indian plate into the Asia continent has created the uplift of the Tibetan Plateau and the Tianshan Mountains, thickened their crust, and raised the temperature in the crust. The lower crust thus has become ductile, evidenced in low seismic velocity and high

  8. Pandemic Vibrio parahaemolyticus O3:K6 on the American Continent

    Directory of Open Access Journals (Sweden)

    Jorge eVelazquez-Roman

    2014-01-01

    Full Text Available Vibrio parahaemolyticus is one of the most important seafood-borne bacterial in recent years and is the leading causal agent of human acute gastroenteritis, primarily following the consumption of raw, undercooked or mishandled marine products. Until 1996, infections caused by V. parahaemolyticus were generally associated with diverse serovars. However, in February 1996, a unique serovar (O3:K6 of V. parahaemolyticus with specific genetic markers (tdh, toxRS/New and/or orf8 appeared abruptly in Kolkata, India. In subsequent years, O3:K6 isolates similar to those isolated in Kolkata have been reported from food borne outbreaks in Southeast Asia, as well as in the Atlantic and Gulf coasts of the United States (U.S. More recently, there have been reports in Europe, Africa and Central and South America. Specifically, in the American continent, some countries have reported cases of gastroenteritis due to the pandemic O3:K6 strain and its serovariants; the pandemic strain was first detected in Peru (1996, >100 cases, subsequently spreading to Chile in 1998 (>16,804 human cases, to the U.S. in 1998 (>700 cases, to Brazil in 2001 (>18 cases and to Mexico in 2004 (>1200 cases. The arrival of the pandemic clone on the American continent may have resulted in a significant shift on the epidemic dynamics of V. parahaemolyticus. However, although O3:K6 is the predominant serovar of the recognized clinical strains in some countries in the Americas, a decrease in clinical cases caused by O3:K6 and an increase in cases associated with a new serotype (O3:K59, Chile have been recently reported. The emergence and worldwide dissemination of O3:K6 and other pandemic strains since 1996 have come to represent a threat to public health and should concern health authorities. This review focuses on the presence, distribution and virulence factors of the V. parahaemolyticus O3:K6 pandemic clone and its serovariants in clinical and environmental strains on the American

  9. Pandemic Vibrio parahaemolyticus O3:K6 on the American continent.

    Science.gov (United States)

    Velazquez-Roman, Jorge; León-Sicairos, Nidia; de Jesus Hernández-Díaz, Lucio; Canizalez-Roman, Adrian

    2014-01-02

    Vibrio parahaemolyticus is one of the most important seafood-borne bacterial in recent years and is the leading causal agent of human acute gastroenteritis, primarily following the consumption of raw, undercooked or mishandled marine products. Until 1996, infections caused by V. parahaemolyticus were generally associated with diverse serovars. However, in February 1996, a unique serovar (O3:K6) of V. parahaemolyticus with specific genetic markers (tdh, toxRS/New and/or orf8) appeared abruptly in Kolkata, India. In subsequent years, O3:K6 isolates similar to those isolated in Kolkata have been reported from food borne outbreaks in Southeast Asia, as well as in the Atlantic and Gulf coasts of the United States (U.S). More recently, there have been reports in Europe, Africa and Central and South America. Specifically, in the American continent, some countries have reported cases of gastroenteritis due to the pandemic O3:K6 strain and its serovariants; the pandemic strain was first detected in Peru (1996, >100 cases), subsequently spreading to Chile in 1998 (>16,804 human cases), to the U.S. in 1998 (>700 cases), to Brazil in 2001 (>18 cases) and to Mexico in 2004 (>1200 cases). The arrival of the pandemic clone on the American continent may have resulted in a significant shift on the epidemic dynamics of V. parahaemolyticus. However, although O3:K6 is the predominant serovar of the recognized clinical strains in some countries in the Americas, a decrease in clinical cases caused by O3:K6 and an increase in cases associated with a new serotype (O3:K59, Chile) have been recently reported. The emergence and worldwide dissemination of O3:K6 and other pandemic strains since 1996 have come to represent a threat to public health and should concern health authorities. This review focuses on the presence, distribution and virulence factors of the V. parahaemolyticus O3:K6 pandemic clone and its serovariants in clinical and environmental strains on the American continent.

  10. Parallel Extension Tectonics (PET): Early Cretaceous tectonic extension of the Eastern Eurasian continent

    Science.gov (United States)

    Liu, Junlai; Ji, Mo; Ni, Jinlong; Guan, Huimei; Shen, Liang

    2017-04-01

    The present study reports progress of our recent studies on the extensional structures in eastern North China craton and contiguous areas. We focus on characterizing and timing the formation/exhumation of the extensional structures, the Liaonan metamorphic core complex (mcc) and the Dayingzi basin from the Liaodong peninsula, the Queshan mcc, the Wulian mcc and the Zhucheng basin from the Jiaodong peninsula, and the Dashan magmatic dome within the Sulu orogenic belt. Magmatic rocks (either volcanic or plutonic) are ubiquitous in association with the tectonic extension (both syn- and post-kinematic). Evidence for crustal-mantle magma mixing are popular in many syn-kinematic intrusions. Geochemical analysis reveals that basaltic, andesitic to rhyolitic magmas were generated during the tectonic extension. Sr-Nd isotopes of the syn-kinematic magmatic rocks suggest that they were dominantly originated from ancient or juvenile crust partly with mantle signatures. Post-kinematic mafic intrusions with ages from ca. 121 Ma to Cenozoic, however, are of characteristic oceanic island basalts (OIB)-like trace element distribution patterns and relatively depleted radiogenic Sr-Nd isotope compositions. Integrated studies on the extensional structures, geochemical signatures of syn-kinematic magmatic rocks (mostly of granitic) and the tectono-magmatic relationships suggest that extension of the crust and the mantle lithosphere triggered the magmatisms from both the crust and the mantle. The Early Cretaceous tectono-magmatic evolution of the eastern Eurasian continent is governed by the PET in which the tectonic processes is subdivided into two stages, i.e. an early stage of tectonic extension, and a late stage of collapse of the extended lithosphere and transformation of lithospheric mantle. During the early stage, tectonic extension of the lithosphere led to detachment faulting in both the crust and mantle, resulted in the loss of some of the subcontinental roots, gave rise to

  11. 乳果糖联合食醋保留灌肠治疗肝性脑病的效果观察%Lactulose combined with vinegar enema in treatment of hepatic encephalopathy

    Institute of Scientific and Technical Information of China (English)

    刘慧; 廖丽容; 罗伟燕; 凌小容

    2015-01-01

    目的:观察乳果糖联合食醋保留灌肠治疗肝性脑病的临床疗效。方法将69例肝性脑病患者随机分为观察组34例和对照组35例,两组均采用护肝、抗肝昏迷、降酶、退黄治疗,观察组在此基础上加上乳果糖、食醋、生理盐水保留灌肠。结果总有效率观察组为77.1%,对照组为47.1%,平均清醒时间观察组为2.8d,对照组为4.5d,两组比较差异有统计学意义(P<0.05)。结论乳果糖联合食醋保留灌肠在治疗肝性脑病的临床疗效显著。%Objective To observe the clinical effect of clysis therapy for hepatic encephalopathy of lactulose and vinegar.Methods 69 cases of hepatic encephalopathy were randomly divided into observation group of 34 cases and a control group of 35 cases, two groups were treated with liver protection, anti hepatic coma, reducing enzyme, therapy, based on the observation group with lactulose, vinegar, normal saline retention enema.ResultsThe total efficiency was 77.1% in the observation group, the control group was 47.1%, the average time of observation group was 2.8d, 4.5d in the control group, there were significant differences between the two groups (P<0.05).Conclusion Lactulose and vinegar retention enema significant clinical efficacy in the treatment of hepatic encephalopathy.

  12. The peopling of the African continent and the diaspora into the new world.

    Science.gov (United States)

    Campbell, Michael C; Hirbo, Jibril B; Townsend, Jeffrey P; Tishkoff, Sarah A

    2014-12-01

    Africa is the birthplace of anatomically modern humans, and is the geographic origin of human migration across the globe within the last 100,000 years. The history of African populations has consisted of a number of demographic events that have influenced patterns of genetic and phenotypic variation across the continent. With the increasing amount of genomic data and corresponding developments in computational methods, researchers are able to explore long-standing evolutionary questions, expanding our understanding of human history within and outside of Africa. This review will summarize some of the recent findings regarding African demographic history, including the African Diaspora, and will briefly explore their implications for disease susceptibility in populations of African descent.

  13. Seismic site evaluation practice and seismic design guide for NPP in Continent of China

    Energy Technology Data Exchange (ETDEWEB)

    Hu Yuxian [State Seismological Bureau, Beijing, BJ (China). Inst. of Geophysics

    1997-03-01

    Energy resources, seismicity, NPP and related regulations of the Continent of China are briefly introduced in the beginning and two codes related to the seismic design of NPP, one on siting and another on design, are discussed in some detail. The one on siting is an official code of the State Seismological Bureau, which specifies the seismic safety evaluation requirements of various kinds of structures, from the most critic and important structures such as NPP to ordinary buildings, and including also engineering works in big cities. The one on seismic design of NPP is a draft subjected to publication now, which will be an official national code. The first one is somewhat unique but the second one is quite similar to those in the world. (author)

  14. Boris Choubert: The forgotten fit of the circum-Atlantic continents

    Science.gov (United States)

    Kornprobst, Jacques

    2017-01-01

    Boris Choubert was a strong supporter of Wegener's continental drift theory. In 1935, he published a very accurate fit of the circum-Atlantic continents, which was based on continental edges instead of coastlines; in the same paper, he interpreted the Palaeozoic belts as the result of horizontal movements of the Precambrian blocks; so, he greatly expanded the role of continental drift through time. This original and very prophetic work was almost completely ignored by his contemporaries. Thirty years later (1965), Bullard, Everett and Smith published in turn a similar but more sophisticated fit; they did not acknowledge Choubert's initial work. Bullard's fit was met with immediate and tremendous success. The present paper analyses the reasons why Boris Choubert was frustrated of his pioneering role. This lack of recognition is related to: (1) a great evolution in the geological concepts between 1935 and 1965, and (2) a poor choice of Choubert, regarding the title of his 1935 article.

  15. A complex empirical orthogonal function for combining two different variables over Indonesian maritime continent

    Science.gov (United States)

    Nuryanto, Danang Eko

    2016-02-01

    The spatiotemporal patterns of Indonesian Maritime Continent (IMC) convective activity was documented by using two different variables i.e. cloud and wind datasets. In this study, a Complex Empirical Orthogonal Function (CEOF) was used to combining that variables. This method was applied to representing the land-sea-atmosphere interaction of diurnal convective activity in IMC. This study used pseudo-vector to define complex signals from convective index (cloud) as complex part and convergence (wind) as real part. The results showed that the phase patterns of CEOF were more consistent than those of pseudo-vector. Both CEOF1 and CEOF2 have shown semi-annual and annual cycles, respectively. Spatially, CEOF1 represents common patterns, whereas CEOF2 was more toward local patterns and tends to be in random.

  16. Major influences on buying decision processes by international university students. Differences by continent of origin.

    Science.gov (United States)

    Tirelli, Christian; Pilar Martínez-Ruiz, María; Gómez-Ladrón-De-Guevara, Ricardo

    2013-12-01

    To analyze how food values and other variables related to dietary acculturation affect international university students' food buying decisions, this article provides an in-depth review of relevant literature related to the food buying decisions of groups of sojourners, which suggest several research hypotheses. The data collection targeted international university students in Spain and used factorial analysis of the main components together with linear parametric regressions. The resulting findings offer distinct insights, according to sojourners' continent of origin. Specifically, whereas European students exhibit a higher propensity to value sustainable production practices in the food choices, American students emphasize flavor and exhibit a greater degree of adaptation. These findings in turn suggest some key managerial recommendations and research guidelines for both private and public operators in related fields. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Consistent response of bird populations to climate change on two continents

    Science.gov (United States)

    Stephens, Philip A.; Mason, Lucy R.; Green, Rhys E.; Gregory, Richard D.; Sauer, John R.; Alison, Jamie; Aunins, Ainars; Brotons, Lluís; Butchart, Stuart H.M.; Campedelli, Tommaso; Chodkiewicz, Tomasz; Chylarecki, Przemyslaw; Crowe, Olivia; Elts, Jaanus; Escandell, Virginia; Foppen, Ruud P.B.; Heldbjerg, Henning; Herrando, Sergi; Husby, Magne; Jiguet, Frédéric; Lehikoinen, Aleksi; Lindström, Åke; Noble, David G.; Paquet, Jean-Yves; Reif, Jiri; Sattler, Thomas; Szép, Tibor; Teufelbauer, Norbert; Trautmann, Sven; Van Strien, Arco; van Turnhout, Chris A.M.; Vorisek, Petr; Willis, Stephen G.

    2016-01-01

    Global climate change is a major threat to biodiversity. Large-scale analyses have generally focused on the impacts of climate change on the geographic ranges of species and on phenology, the timing of ecological phenomena. We used long-term monitoring of the abundance of breeding birds across Europe and the United States to produce, for both regions, composite population indices for two groups of species: those for which climate suitability has been either improving or declining since 1980. The ratio of these composite indices, the climate impact indicator (CII), reflects the divergent fates of species favored or disadvantaged by climate change. The trend in CII is positive and similar in the two regions. On both continents, interspecific and spatial variation in population abundance trends are well predicted by climate suitability trends.

  18. Subcutaneous blood flow in man during sleep with continous epdural anaesthesia

    DEFF Research Database (Denmark)

    Sindrup, JH; Petersen, Lars Jelstrup; Kastrup, Jens;

    1996-01-01

    BACKGROUND: Subcutaneous blood flow increases during sleep and we evaluated if this increase is affected by epidural anaesthesia. METHODS: Lower leg subcutaneous blood flow was determined by 133Xenon clearance in ten subjects during continous epidural anaesthesia at L2-L3 including eight hours...... of sleep, while the opper abdominal subcutaneous blood flow served as control. RESULTS: Epidural anaesthesia to the level of the umbilicus was followed by an increase in the lower leg subcutaneous blood flow fra 3.4 (1.8-6.3) to 7.8 (3.6-16.9) ml min-1 (median and range; P...-1 100 g-1 after 34 (29-70) min (Pepidural anaesthesia induced only a temporary increase in lower leg subcutaneous blood flow, it hindered the rise in subcutaneous blood flow normally manifest...

  19. Consistent response of bird populations to climate change on two continents.

    Science.gov (United States)

    Stephens, Philip A; Mason, Lucy R; Green, Rhys E; Gregory, Richard D; Sauer, John R; Alison, Jamie; Aunins, Ainars; Brotons, Lluís; Butchart, Stuart H M; Campedelli, Tommaso; Chodkiewicz, Tomasz; Chylarecki, Przemysław; Crowe, Olivia; Elts, Jaanus; Escandell, Virginia; Foppen, Ruud P B; Heldbjerg, Henning; Herrando, Sergi; Husby, Magne; Jiguet, Frédéric; Lehikoinen, Aleksi; Lindström, Åke; Noble, David G; Paquet, Jean-Yves; Reif, Jiri; Sattler, Thomas; Szép, Tibor; Teufelbauer, Norbert; Trautmann, Sven; van Strien, Arco J; van Turnhout, Chris A M; Vorisek, Petr; Willis, Stephen G

    2016-04-01

    Global climate change is a major threat to biodiversity. Large-scale analyses have generally focused on the impacts of climate change on the geographic ranges of species and on phenology, the timing of ecological phenomena. We used long-term monitoring of the abundance of breeding birds across Europe and the United States to produce, for both regions, composite population indices for two groups of species: those for which climate suitability has been either improving or declining since 1980. The ratio of these composite indices, the climate impact indicator (CII), reflects the divergent fates of species favored or disadvantaged by climate change. The trend in CII is positive and similar in the two regions. On both continents, interspecific and spatial variation in population abundance trends are well predicted by climate suitability trends.

  20. Integration of health and environment through health impact assessment: cases from three continents.

    Science.gov (United States)

    Negev, Maya; Levine, Hagai; Davidovitch, Nadav; Bhatia, Rajiv; Mindell, Jennifer

    2012-04-01

    Despite the strong linkage between environment and health, institutions responsible for these fields operate in largely fragmented ways with limited interaction. As illustrated in the recent engagement between health and urban planning institutions, inter-institutional cooperation could support more effective and politically acceptable solutions for both local and global problems. Analysis of three case-studies, from three different continents, shows that HIA might serve to promote synergies among health and environmental disciplines in different local contexts, and could lead to institutional and procedural changes that promote health. Case examples provided supportive evidence for these effects, despite differences in approaches to HIA and governance levels. Obstacles to the use of HIA for inter-institutional integration also differed between countries. Lessons learned could support cooperation in other common interests of health and environment disciplines such as research, training and preparedness, and mitigation of public health emergencies related to the environment.

  1. Benefit and cost competitiveness analysis of wind and solar power inter-continent transmission under global energy interconnection mode

    Science.gov (United States)

    Wei, Xiaoxia; Ding, Jian; Liu, Jie; Wei, Tiezhong

    2017-01-01

    Relying on the global energy Interconnection, considering the energy implementation, carrying out clean energy alternative is mainly to use the clean energy to take place of fossil energy. Under the green development scenario, This research gives the global energy interconnection development model, makes the Artic and the Equation as the connection points, gives the Northern hemisphere interconnection model and equator interconnection model unite the whole world energy. This research also identifies the factors effecting the transmission changes cost, including generation cost, transmission cost and landing cost. And take two continents connection as the prediction example, estimate these two continents cost benefit and variable power-jointed scheme cost competitiveness. It showed that under the global energy interconnection mode, the trans-continent mode had better benefit, and the landing cost is good to be used, can solve the pollution and energy restriction.

  2. Numerical simulation of the collision between Indian and Eurasian Plates and the deformations of the present Chinese continent

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    In this paper the continental lithosphere of the East Asia is regarded as a continuum in a power law rheology. It lays on a relative soft upper mantle and limited in a trapezoid geological frame. The movement of the Indian Plate at the rate of 5 cm/a is assumed to be the main driving force for the Tibet Plateau(s uplift and the lithosphere deformation of the Chinese continent. The numerical simulation shows that the predicted horizontal deformation model of the Chinese continent is comparable with the results of the GPS observation. It implicates that the collision and compression between India and Eurasia Plates is the main driving force of the horizontal deformations of the Chinese continent. It is also shows that the patterns of the continental deformation are controlled by many factors such as the dynamical parameters of the lithosphere and the boundary conditions as well.

  3. Drying projection over western maritime continent during Southwest and Northeast monsoon seasons

    Science.gov (United States)

    Kartika Lestari, R.

    2017-04-01

    In the maritime continent, the precipitation variability is large and recently, this region experiences longer dry season and more number of severe drought events that are threatening the human life, such as, water supply for daily life and agriculture, and unhealthy air quality due to the increased number of wildfires. Global warming has been known to contribute to the rainfall anomalies around the world, and present study investigate the extent to which the drying conditions are going to be happened in 21st century over western part of the maritime continent (WMC), where the population is much larger than the eastern part, during both active Southwest (SW) and Northeast (NE) monsoon seasons. A future change in the precipitation over WMC is suggested from our analyses of the Coupled Model Intercomparison Project Phase 5 (CMIP5) models. In addition to CMIP5, we analyse the downscaled data of nine selected CMIP5 models to examine if there is modification in the drying projection when higher resolution data are used. While the north and south of equator show out of phase in the precipitation change, the region around equator shows decreased precipitation during both the SW monsoon in June-July-August-September (JJAS) and the peak of NE monsoon in February (FEB). The drying projection is robustly shown in FEB when Intertropical Convergence Zone (ITCZ) shift to the southern hemisphere, but the same robustness is not shown in JJAS when the monsoon over South China Sea is active. The detail results, including the mechanisms and the impacts of tropical climate features (such as, warming Pacific Ocean, monsoon, ITCZ) that drive the drying projection, and the possible reasons causing different degree in the robustness between two seasons, will be shown in the presentation.

  4. The role of continents in modulating the whole Earth carbon and oxygen cycles

    Science.gov (United States)

    Lee, C. T.

    2015-12-01

    That Earth owes its oxygenated atmosphere to its presently unique claim on life is clear, but how its atmosphere evolved from an initially oxygen-free state remains unresolved. Here, we show that continents underwent a transformation from mafic to felsic compositions at about 2.7-2.5 Ga. We show that the generation of large amounts of felsic magmas requires hydrous parental magmas, which can only be generated by introduction of water into the mantle source of the hydrous parents. This suggests that this compositional shift in crust marked a switch from stagnant lid to a mobile lid (plate tectonics) convective regime. This compositional transformation resulted in a decrease in the oxidative weathering efficiency of the Earth's surface, which allowed atmospheric O2 to rise rapidly to a new steady state after ~2 Ga. Over the next billion years, steady accumulation of carbon deposited on continental shelves resulted in a gradual increase in the total CO2 inputs into the ocean and atmosphere system as metamorphic and magmatically induced degassing of the growing continental carbon reservoir amplified that from the mantle. Because oxygen production is formed by net organic carbon burial, which scales with total CO2 production, the increasing CO2 inputs to the ocean and atmosphere results in increasing O2 production. This causes slow build-up of atmospheric O2 until a threshold is reached at which atmospheric O2 levels run away, culminating in the oxygenated atmospheric conditions of the Phanerozoic. A two-step rise in atmospheric O2 is thus a necessary consequence of plate tectonics, continent formation and the growth of a crustal carbon reservoir. A provocative prediction of this work is that atmospheric CO2 concentrations may not have been as high in the Archean and Proterozoic as seems required to compensate for the faint young sun.

  5. Hierarchical genetic analysis of German cockroach (Blattella germanica populations from within buildings to across continents.

    Directory of Open Access Journals (Sweden)

    Edward L Vargo

    Full Text Available Understanding the population structure of species that disperse primarily by human transport is essential to predicting and controlling human-mediated spread of invasive species. The German cockroach (Blattella germanica is a widespread urban invader that can actively disperse within buildings but is spread solely by human-mediated dispersal over longer distances; however, its population structure is poorly understood. Using microsatellite markers we investigated population structure at several spatial scales, from populations within single apartment buildings to populations from several cities across the U.S. and Eurasia. Both traditional measures of genetic differentiation and Bayesian clustering methods revealed increasing levels of genetic differentiation at greater geographic scales. Our results are consistent with active dispersal of cockroaches largely limited to movement within a building. Their low levels of genetic differentiation, yet limited active spread between buildings, suggests a greater likelihood of human-mediated dispersal at more local scales (within a city than at larger spatial scales (within and between continents. About half the populations from across the U.S. clustered together with other U.S. populations, and isolation by distance was evident across the U.S. Levels of genetic differentiation among Eurasian cities were greater than those in the U.S. and greater than those between the U.S. and Eurasia, but no clear pattern of structure at the continent level was detected. MtDNA sequence variation was low and failed to reveal any geographical structure. The weak genetic structure detected here is likely due to a combination of historical admixture among populations and periodic population bottlenecks and founder events, but more extensive studies are needed to determine whether signatures of global movement may be present in this species.

  6. Continent-wide risk assessment for the establishment of nonindigenous species in Antarctica.

    Science.gov (United States)

    Chown, Steven L; Huiskes, Ad H L; Gremmen, Niek J M; Lee, Jennifer E; Terauds, Aleks; Crosbie, Kim; Frenot, Yves; Hughes, Kevin A; Imura, Satoshi; Kiefer, Kate; Lebouvier, Marc; Raymond, Ben; Tsujimoto, Megumu; Ware, Chris; Van de Vijver, Bart; Bergstrom, Dana Michelle

    2012-03-27

    Invasive alien species are among the primary causes of biodiversity change globally, with the risks thereof broadly understood for most regions of the world. They are similarly thought to be among the most significant conservation threats to Antarctica, especially as climate change proceeds in the region. However, no comprehensive, continent-wide evaluation of the risks to Antarctica posed by such species has been undertaken. Here we do so by sampling, identifying, and mapping the vascular plant propagules carried by all categories of visitors to Antarctica during the International Polar Year's first season (2007-2008) and assessing propagule establishment likelihood based on their identity and origins and on spatial variation in Antarctica's climate. For an evaluation of the situation in 2100, we use modeled climates based on the Intergovernmental Panel on Climate Change's Special Report on Emissions Scenarios Scenario A1B [Nakićenović N, Swart R, eds (2000) Special Report on Emissions Scenarios: A Special Report of Working Group III of the Intergovernmental Panel on Climate Change (Cambridge University Press, Cambridge, UK)]. Visitors carrying seeds average 9.5 seeds per person, although as vectors, scientists carry greater propagule loads than tourists. Annual tourist numbers (∼33,054) are higher than those of scientists (∼7,085), thus tempering these differences in propagule load. Alien species establishment is currently most likely for the Western Antarctic Peninsula. Recent founder populations of several alien species in this area corroborate these findings. With climate change, risks will grow in the Antarctic Peninsula, Ross Sea, and East Antarctic coastal regions. Our evidence-based assessment demonstrates which parts of Antarctica are at growing risk from alien species that may become invasive and provides the means to mitigate this threat now and into the future as the continent's climate changes.

  7. The connectivity of Mytilus galloprovincialis in northern Morocco: A gene flow crossroads between continents

    Science.gov (United States)

    Ouagajjou, Yassine; Presa, Pablo

    2015-01-01

    Previous population genetic studies on the Mediterranean mussel Mytilus galloprovincialis have shown the existence of two well differentiated sets of populations around Southern European coasts, one Atlantic and another Mediterranean. Those two population pools are kept apart by the Almería - Oran Oceanographic Front (AOOF), an oceanographic discontinuity acting either as a cause of such differentiation or simply as a means of maintaining two historically differentiated gene pools. The role of the Gibraltar Strait at shaping mussel larval flow entering the Alboran Sea has been much less addressed, especially regarding mussel swarms inhabiting the northern coast of Morocco. The present study applies seven microsatellite markers to describing the genetic status of northern Moroccan populations of M. galloprovincialis and their relationship with the two well-characterized mussel gene pools from southern Europe. We show that the Atlantic Iberia gene pool extending continuously from the Cantabrian Sea (NE Iberia) to the Alboran Sea (SE Iberia) up to the AOOF is well differentiated from the Atlantic Moroccan mussel. Either an oceanographic barrier or a limited larval dispersal or both, are required to explain this unexpected intercontinental differentiation regarding previous studies on this species. Populations from Atlantic Morocco conformed to a single gene pool (FST ± SD = 0.012 ± 0.007) as opposed to the reported latitudinal barrier to gene flow at Cape Ghir in western Morocco. Additionally, a significant restriction to gene flow was observed between Atlantic Morocco and Alboran Morocco (FST ± SD = 0.038 ± 0.010) in contrast to the reported mussel genetic continuity along the Iberian coast up to AOOF. Three major mussel gene pools appear to meet at this crossroads between continents and between seas, namely, a Mediterranean European subpopulation, an Atlantic Iberia subpopulation including the Alboran Sea, and an Atlantic Morocco subpopulation. Knowledge on

  8. Um continente entortado (América Latina The lopsided continent (Latin America

    Directory of Open Access Journals (Sweden)

    Kelly Hoffman

    2006-11-01

    Full Text Available Em todo o mundo, a América Latina é a região que apresenta a mais desequilibrada distribuição de recursos. O artigo define um conjunto comum de elementos que caracterizam as estruturas sociais do continente, sugere algumas linhas de análise e teorização e defende a integração dos estudos regionais nas discussões mais amplas a respeito da estratificação. Na primeira parte, examina-se a situação do continente como um todo, com uma breve discussão sobre a relação entre pobreza e desigualdade, e sobre o problema da disponibilidade de dados. Em seguida, analisa-se classe, gênero e raça. A conclusão identifica três fatores críticos que explicam a desigualdade latino-americana: sua posição no interior do sistema econômico global, o colonialismo interno que mantém as categorias raciais e o subdesenvolvimento das estruturas estataisLatin America has the most unbalanced distribution of resources of all regions in the world. This review defines a set of common elements characterizing social structures on this continent, suggests some approaches for analysis and theorizing, and supports the integration of regional studies into broader discussions of stratification. An overview of the situation on the continent as a whole, including a short discussion of the relationship between poverty and inequality, allows to address some concerns with data availability. We then devote a section each to class, gender, and race, and conclude by identifying three critical factors that explain Latin American inequality: its position within a global economic system, internal colonialism with maintenance of racial categories, and the underdevelopment of state structures.

  9. Exploration of tectonic structures with GOCE in Africa and across-continents

    Science.gov (United States)

    Braitenberg, Carla

    2015-03-01

    The gravity anomaly field over the whole Earth obtained by the GOCE satellite is a revolutionary tool to reveal geologic information on a continental scale for the large areas where conventional gravity measurements have yet to be made. It is, however, necessary to isolate the near-surface geologic signal from the contributions of thickness variations in the crust and lithosphere and the isostatic compensation of surface relief. Here Africa is studied with particular emphasis on selected geological features which are expected to appear as density inhomogeneities. These include cratons and fold belts in the Precambrian basement, the overlying sedimentary basins and magmatism, as well as the continental margins. Regression analysis between gravity and topography shows coefficients that are consistently positive for the free air gravity anomaly and negative for the Bouguer gravity anomaly. The error and scatter on the regression are smallest in oceanic areas, where it is a possible tool for identifying changes in crustal type. The regression analysis allows the large gradient in the Bouguer anomaly signal across continental margins to be removed. After subtracting the predicted effect of known topography from the original Bouguer anomaly field, the residual field shows a continent-wide pattern of anomalies that could be attributed to regional geological structures. A few of these are highlighted, such as those representing Karoo magmatism, the Kibalian foldbelt, the Zimbabwe Craton, the Cameroon and Tibesti volcanic deposits, the Benue Trough and the Luangwa Rift. A reconstruction of the pre-break up position of Africa and South America (the plates forming West Gondwana) is made for the residual GOCE gravity field. The reconstruction allows the positive and negative anomalies to be compared across the continental fragments, and so helps identify common geologic units that extend across both the now-separate continents.

  10. Clinical application of OxyContin hydrochloride controlled release tablets in treatment of pain suffered from advanced cancer

    Institute of Scientific and Technical Information of China (English)

    Wenwu Wang; Xuenong OuYang; Zongyang Yu; Zhangshu Chen

    2012-01-01

    Objective: The aim of this study was to evaluate the efficacy and adverse reactions of OxyContin hydrochloride controlled release tablets in the treatment of moderate or severe pain in patients with terminal cancer and to observe any improvement on the cancer patients' quality of life. Methods: Sixty-eight patients with moderate or severe cancer pain were treated with OxyContin hydrochloride controlled release tablets. The initial dose was 5 mg/12h, or 1/2 that of the standard morphine regimen. During the course of treatment, the dosage was adjusted according to the patients' condition until the pain completely disappeared or nearly did so. Each patient received a treatment for at least 15 days. At the same time, adverse reactions, the quality of life and scores for the intensity of pain were observed and recorded [1]. Results: The final titrated dosage of OxyContin was as follows: the patients in 30 cases (44.1%) received a dosage of ≤ 30 mg/d, those in 16 cases (23.5%) received a dosage of 31 to 60 mg/d, those in 18 cases (26.5%) received a dosage of 61 to 120 mg/d and those in 4 cases (5.9%) received a dosage of ≥ 120 mg/d. The overall rate of relief from pain was 95.6%, among which the rates of excellent, effective and moderate relief were respectively 39.7%, 48.5% and 7.4%. OxyContin had mild adverse reactions and patients' quality of life was markedly improved. Conclusion: OxyContin is effective in treatment of moderate and severe cancer pain. The adverse reactions of OxyContin are mild, and the drug can significantly improve the quality of life of patients with cancer pain.

  11. Developing an internationally-applicable service specification for continence care: systematic review, evidence synthesis and expert consensus.

    Directory of Open Access Journals (Sweden)

    Adrian S Wagg

    Full Text Available Global demographic trends suggest that the incidence of both urinary and faecal incontinence will rise in the coming years, bringing significant health and economic implications for both patients and payers. There is limited organisational evidence to guide payers and providers about service configuration which will deliver efficient guideline-compliant, high-quality patient care.To create, using evidence from a systematic review, qualitative data and expert consensus an internationally applicable service specification for continence care.Evidence was obtained from a systematic and grey literature review of published randomised controlled trials and quasi-experimental studies reporting efficacy of continence service design at the level of the community dwelling patient with either bladder or bowel incontinence, governmental reports and policy frameworks supplemented by data from 47 semi-structured interviews with clinicians, patients, patient-representatives and policy experts from four geographies broadly representative of different healthcare systems.A number of themes related to current and potential future organisation of continence care were identified from the data. A modular service specification with eight core components was created including case detection, initial assessment and treatment, case co-ordination, caregiver support, community-based support, specialist assessment and treatment, use of containment products, and use of technology. Within this framework important key recommendations are: ensure robust referral pathways, shift assessment for case coordination to nurses specializing in continence care, promote self-management and technology, use comprehensive assessment tools and service performance targets based on outcome and operational measures.This study has defined practice gaps in the provision of continence services and described eight core components of a service specification for incontinence that commissioners and

  12. Fistulotomy in the tertiary setting can achieve high rates of fistula cure with an acceptable risk of deterioration in continence.

    Science.gov (United States)

    Tozer, P; Sala, S; Cianci, V; Kalmar, K; Atkin, G K; Rahbour, G; Ranchod, P; Hart, A; Phillips, R K S

    2013-11-01

    Surgery is the mainstay of treatment of anal fistulas. Low fistulas are often laid open, but higher fistulas present a more difficult problem. Patient choice centres on a compromise between risk of recurrence and risk of impairment of continence. We aimed to determine the efficacy and safety of fistulotomy at a tertiary referral centre, in particular the additional risk of impairment of continence following fistulotomy of the often recurrent, multiply-operated patients seen. Patients undergoing surgery under the senior author (RKSP) for an anal fistula during the study period (2005-2006) were identified, and a thorough review of the patients' clinical records was undertaken. Demographic, fistula anatomy, treatment and follow-up data were obtained. Eighty-four patients underwent either fistulotomy (50), insertion of permanent loose (drainage) seton (28) or EUA with or without drainage of abscess. Mean length of follow up was 11 months (SD 14.22). In the fistulotomy group, we found an overall success rate of 93 %. Secondary extensions were associated with failure to achieve cure (P = 0.008). Nine patients (20 %) suffered deterioration in continence after surgery. A longer time to referral was associated with impaired final continence. In the group referred from a surgeon in secondary care, 91 % of patients were cured, and continence impairment (mostly minor) rose from 32 % at referral to 40 % after surgery. We have shown that it is safe and reasonable to offer fistulotomy to appropriate patients despite previous surgery and within the tertiary setting. By so doing, a very high rate of healing can be achieved in patients who have previously failed. The additional risk of impairment of continence is around one in five, and in the majority will represent only minor incontinence.

  13. Influence of bladder neck suspension stitches on early continence after radical prostatectomy: a prospective randomized study of 180 patients

    Institute of Scientific and Technical Information of China (English)

    Jens-Uwe Stolzenburg; Evangelos Liatsikos; Martin Nicolaus; Panagiotis Kallidonis; Minh Do; Anja Dietel; Tim H(a)fner; George Sakellaropoulos; James Hicks; David Nikoleishvili

    2011-01-01

    Several techniques have been introduced to improve early postoperative continence.In this study,we evaluated the impact of bladder neck (vesicourethral anastomosis) suspension on the outcome of extraperitoneal endoscopic radical prostatectomy (EERPE).In this research,a total of 180 patients underwent EERPE.Group 1 included patients who underwent nerve-sparing EERPE (nsEERPE) (n=45),and Group 2 included patients who underwent nsEERPE with bladder neck suspension (BNS,n=45).Groups 3 (n=45) and 4 (n=45) included patients who received EERPE and EERPE with BNS,respectively.Patients were randomly assigned to receive BNS with their nsEERPE or EERPE procedure.Perioperative parameters were recorded,and continence was evaluated by determining the number and weight of absorbent pads (pad weighing test) on the second day after catheter removal and by a questionnaire 3 months postoperatively.Two days after catheter removal,11.1% of Group 1,11.1% of Group 2,4.4% of Group 3 and 8.9% of Group 4 were continent.The average urine loss was 80.4,70.1,325.0 and 291.3 g for the each of these groups,respectively.At 3 months,76.5% of Group 1 and 81.3% of Group 2 were continent.The continence figures for Group 3 and 4 were 48.5% and 43.8%,respectively.Similar overall rates were observed in all groups.In conclusion,although there are controversial reports in the literature,early continence was never observed to be significantly higher in the BNS groups when compared with the non-BNS groups,regardless of the EERPE technique performed.

  14. Rifting of the northern margin of the Australian continent and the origin of some microcontinents in Eastern Indonesia

    Science.gov (United States)

    Pigram, C. J.; Panggabean, H.

    1984-08-01

    Continental Australia is bounded on the east, south and west sides by passive margins, and the geological histories of these are well documented (Falvey and Mutter, 1981). The northern margin of the Australian continent is now an active collision margin. Its previous history as a passive margin has rarely been examined. This paper shows how the Late Palaeozoic to Mesozoic sequence which forms the northern margin of the Australian continent, in the island of New Guinea, is readily related to the tectonic stages of a rift-drift sequence. Rifting (start of breakup) began at about 230 m.y. ago at the Permian-Triassic boundary. The onset of seafloor spreading is marked by a post-breakup unconformity and ranges in age along the northern margin of the continent, from 185 m.y. in Papua New Guinea to 170 m.y. in Irian Jaya. From there the age of the post-breakup unconformity continues to young in a southwesterly direction along the western margin of the Australian continent reflecting the opening of the Indian Ocean off Western Australia. The timing of the onset of spreading in central Papua New Guinea is consistent with the timing of the initiation of spreading in the proto-Pacific ocean proposed by Nur and Ben Avraham (1977). By the end of the Jurassic the northern margin of the Australian continent faced a seaway which linked the proto-Indian and proto-Pacific oceans. This newly formed ocean was separated from the pre-existing oceans of the Neo-Tethys and Panthalassa by a screen of continents or microcontinents. The identity of this screen is discussed and it is suggested that part of it is preserved in the microcontinents of Eastern Indonesia.

  15. Promoting continence: A clinical and research resource Promoting continence: A clinical and research resource Kathryn Getliffe and Mary Dolman Elsevier £39.99 352pp 9780443103476 044310347X [Formula: see text].

    Science.gov (United States)

    2009-06-22

    As a comprehensive and detailed resource this book explores all aspects of continence care in a specific and focused way. From the first page, the book makes clear and constant reference to current and up-to-date research that underpins this clinical specialty.

  16. 1.4%Sodium Bicarbonate Retention Enema on Scavenging Channel Bezoars in Contrast to Digest%1.4%的碳酸氢钠保留灌肠清除小儿下消化道粪石对比研究

    Institute of Scientific and Technical Information of China (English)

    谢立新

    2014-01-01

    Objective To investigate the 1.4% sodium bicarbonate retention enema on road bezoar clear under the ef ect of digestion in children. Methods 70 patients in our department from 2012 January to selection method in 2013 December during hospitalization as evaluation object, Were randomly divided into experimental group and control group, two groups were given conventional anti infection,Spectrum ir adiation for two times a day to promote intestinal peristalsis, The experimental group adopted the first 1.4%sodium bicarbonate retention enema for half an hour after reflux enema once a day, The control group adopted reflux enema once a day, to compare the treatment ef ect of the two groups. Results The experimental group remove bezoar is bet er than the control group, The experimental group of independent defecation time earlier than the control group ( <0.5). Conclusion Sodium bicarbonate retention enema for half an hour after reflux enema than simple reflux enema can accelerate the bezoar ileus bezoar discharge, Reduce the bezoar ileus complications, reduce the conservative treatment is invalid for the incidence of operation, Shorten the hospitalization time, improve the cure rate of bezoar ileus.%目的探讨1.4%的碳酸氢钠保留灌肠对清除小儿下消化道粪石的效果。方法选取我科2012年1月~2013年12月期间住院的70例患儿作为评估对象,随机分为实验组及对照组,两组均给予常规抗感染,频谱仪照射2次/d促进肠蠕动,实验组采取先1.4%的碳酸氢钠保留灌肠30min后再回流灌肠1次/d,对照组采取回流灌肠1次/d,对两组的治疗效果进行对比分析。结果实验组清除粪石的效果优于对照组,实验组自主排便的时间早于对照组﹙<0.5﹚。结论碳酸氢钠保留灌肠30min后再回流灌肠比单纯回流灌肠更能加快粪石性肠梗阻的粪石排出,降低粪石性肠梗阻的并发症的发生,减少因保守治疗无效需做手术的发病率,缩短住院时间,提

  17. Spatial and temporal variability of stable isotope composition of precipitation over the south american continent

    Directory of Open Access Journals (Sweden)

    1995-01-01

    Full Text Available VARIABILITE SPATIALE ET TEMPORELLE DE LA COMPOSITION EN ISOTOPES STABLES DE LA PRECIPITATION SUR LE CONTINENT SUDAMERICAIN. L’Agence Internationale de l’Energie Atomique, en coopération avec l’Organisation Météorologique Mondiale, exploite un réseau mondial de stations pour la prise d’échantillons mensuels de précipitation. Actuellement, à peu près 60 stations fournissent des informations sur la composition isotopique de la précipitation sur le continent sudaméricain. Ces dernières années plusieurs réseaux d’échantillonnage d’un caractère national (Argentine, Brésil, Chili, Equateur, Pérou ont été initiés. Les données apportées par ces réseaux contribuent au réseau mondial de l’AIEA/OMM. Ces travaux se concentrent sur l’étude de la variabilité spatiale et temporelle de la composition isotopique stable de la précipitation sur le continent. Dans cette étude, est examinée en détail la relation entre la composition isotopique de la précipitation dans la région et quelques paramètres climatiques, tels que la quantité de précipitation et la température de l’air. VARIABILIDAD ESPACIAL Y TEMPORAL DE LA COMPOSICIÓN DE ISÓTOPOS ESTABLES DE LA PRECIPITACIÓN EN EL CONTINENTE SUDAMERICANO. El Organismo Internacional de Energía Atómica (OIEA, en colaboración con la Organización Meteorológica Mundial (OMM, está llevando a cabo un estudio a escala global de la composición isotópica de la precipitación a partir de muestras mensuales de lluvia recogidas en estaciones meteorológicas. En la actualidad alrededor de 60 estaciones proporcionan información sobre la composición isotópica de la precipitación en el continente sudamericano. Durante los últimos años se han establecido en la región varias redes de control con carácter nacional (Argentina, Brasil, Chile, Ecuador, Perú. Los datos aportados por estas redes representan una valiosa contribución a la red mundial del OIEA/OMM. Este trabajo se

  18. Intermediate crust (IC); its construction at continent edges, distinctive epeirogenic behaviour and identification as sedimentary basins within continents: new light on pre-oceanic plate motions

    Science.gov (United States)

    Osmaston, Miles F.

    2014-05-01

    Introduction. The plate tectonics paradigm currently posits that the Earth has only two kinds of crust - continental and oceanic - and that the former may be stretched to form sedimentary basins or the latter may be modified by arc or collision until it looks continental. But global analysis of the dynamics of actual plate motions for the past 150 Ma indicates [1 - 3] that continental tectospheres must be immensely thicker and rheologically stiffer than previously thought; almost certainly too thick to be stretched with the forces available. In the extreme case of cratons, these tectospheric keels evidently extend to 600 km or more [2, 3]. This thick-plate behaviour is attributable, not to cooling but to a petrological 'stiffening' effect, associated with a loss of water-weakening of the mineral crystals, which also applies to the hitherto supposedly mobile LVZ below MORs [4, 5]. The corresponding thick-plate version of the mid-ocean ridge (MOR) process [6 - 8], replacing the divergent mantle flow model, has a deep, narrow wall-accreting axial crack which not only provides the seismic anisotropy beneath the flanks but also brings two outstanding additional benefits:- (i) why, at medium to fast spreading rates, MOR axes become straight and orthogonally segmented [6], (ii) not being driven by body forces, it can achieve the sudden jumps of axis, spreading-rate and direction widely present in the ocean-floor record. Furthermore, as we will illustrate, the crack walls push themselves apart at depth by a thermodynamic mechanism, so the plates are not being pulled apart. So the presence of this process at a continental edge would not imply the application of extensional force to the margin. Intermediate Crust (IC). In seeking to resolve the paradox that superficially extensional structures are often seen at margins we will first consider how this MOR process would be affected by the heavy concurrent sedimentation to be expected when splitting a mature continent. I reason

  19. Les Cinq Continents, a antologia de Goll: apelo (poético cosmopolita

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Barbosa

    2011-12-01

    Full Text Available Este artigo trata de alguns trabalhos poéticos de Ivan Goll, publicados em alemão, francês e inglês, nos quais o diapasão cosmopolita e o apelo a uma poesia supranacional representaram um grito marginal de resistência frente às tendências totalizantes e às categorias nacionais da primeira metade do século XX. Busca-se compreender se o grito encontra respaldo nas reflexões atuais, pensando-o como um antecedente questionador de taxonomias de gênero literário e de forma artística, um transgender. Assinala que o modernista brasileiro Mário de Andrade não somente acompanhou a querela entre Goll e Breton sobre a herança do conceito Surréalisme legado por Apollinaire, como também se correspondeu e trocou livros com o poeta alsaciano, tendo recebido com entusiasmo a antologia Les Cinq continents. Ao final, este artigo apresenta a tradução de dois poemas afinados com a noção cosmopolita: "O Negro do Teatro de Variedades" e "A Canção de João Sem-Terra, O Duplo".Esta comunicación trata sobre algunos trabajos poéticos de Ivan Goll, publicados en alemán, francés e inglés, en los cuales el tono cosmopolita y el llamamiento a una poesía supranacional representaron un grito marginal de resistencia frente a las tendencias totalizantes y a las categorías nacionales de la primera mitad del siglo XX. El artículo busca comprender si el grito reverbera y encuentra respaldo en las reflexiones actuales, pensándolo como un antecedente cuestionador de taxonomías de género totalitario y, de forma artística, como un "transgender". El texto también incide en la relación establecida con el escritor modernista brasileño Mário de Andrade, que no sólo acompañó la querella entre Goll y Breton sobre la herencia del concepto "Surréalisme" legado por Apollinaire, sino que mantuvo contacto epistolar e intercambio de libros con el poeta alsaciano, y recibió con entusiasmo la antología Les Cinq continents. Finalmente, este art

  20. High-resolution mapping of biomass burning emissions in tropical regions across three continents

    Science.gov (United States)

    Shi, Yusheng; Matsunaga, Tsuneo; Saito, Makoto

    2015-04-01

    Biomass burning emissions from open vegetation fires (forest fires, savanna fires, agricultural waste burning), human waste and biofuel combustion contain large amounts of trace gases (e.g., CO2, CH4, and N2O) and aerosols (BC and OC), which significantly impact ecosystem productivity, global atmospheric chemistry, and climate . With the help of recently released satellite products, biomass density based on satellite and ground-based observation data, and spatial variable combustion factors, this study developed a new high-resolution emissions inventory for biomass burning in tropical regions across three continents in 2010. Emissions of trace gases and aerosols from open vegetation burning are estimated from burned areas, fuel loads, combustion factors, and emission factors. Burned areas were derived from MODIS MCD64A1 burned area product, fuel loads were mapped from biomass density data sets for herbaceous and tree-covered land based on satellite and ground-based observation data. To account for spatial heterogeneity in combustion factors, global fractional tree cover (MOD44B) and vegetation cover maps (MCD12Q1) were introduced to estimate the combustion factors in different regions by using their relationship with tree cover under less than 40%, between 40-60% and above 60% conditions. For emission factors, the average values for each fuel type from field measurements are used. In addition to biomass burning from open vegetation fires, the emissions from human waste (residential and dump) burning and biofuel burning in 2010 were also estimated for 76 countries in tropical regions across the three continents and then allocated into each pixel with 1 km grid based on the population density (Gridded Population of the World v3). Our total estimates for the tropical regions across the three continents in 2010 were 17744.5 Tg CO2, 730.3 Tg CO, 32.0 Tg CH4, 31.6 Tg NOx, 119.2 Tg NMOC, 6.3 Tg SO2, 9.8 NH3 Tg, 81.8 Tg PM2.5, 48.0 Tg OC, and 5.7 Tg BC, respectively. Open

  1. The urethral closure function in continent and stress urinary incontinent women assessed by urethral pressure reflectometry.

    Science.gov (United States)

    Saaby, Marie-Louise

    2014-02-01

    Stress urinary incontinence (SUI) occurs when the bladder pressure exceeds the urethral pressure in connection with physical effort or exertion or when sneezing or coughing and depends both on the strength of the urethral closure function and the abdominal pressure to which it is subjected. The urethral closure function in continent women and the dysfunction causing SUI are not known in details. The currently accepted view is based on the concept of a sphincteric unit and a support system. Our incomplete knowledge relates to the complexity of the closure apparatus and to inadequate assessment methods which so far have not provided robust urodynamic diagnostic tools, severity measures, or parameters to assess outcome after intervention. Urethral Pressure Reflectometry (UPR) is a novel method that measures the urethral pressure and cross-sectional area (by use of sound waves) simultaneously. The technique involves insertion of only a small, light and flexible polyurethane bag in the urethra and therefore avoids the common artifacts encountered with conventional methods. The UPR parameters can be obtained at a specific site of the urethra, e.g. the high pressure zone, and during various circumstances, i.e. resting and squeezing. During the study period, we advanced the UPR technique to enable faster measurement (within 7 seconds by the continuous technique) which allowed assessment during increased intra-abdominal pressure induced by physical straining. We investigated the urethral closure function in continent and SUI women during resting and straining by the "fast" UPR technique. Thereby new promising urethral parameters were provided that allowed characterization of the closure function based on the permanent closure forces (primarily generated by the sphincteric unit, measured by the Po-rest) and the adjunctive closure forces (primarily generated by the support system, measured by the abdominal to urethral pressure impact ratio (APIR)). The new parameters enabled

  2. Emergence of silicic continents as the lower crust peels off on a hot plate-tectonic Earth

    Science.gov (United States)

    Chowdhury, Priyadarshi; Gerya, Taras; Chakraborty, Sumit

    2017-09-01

    The rock record and geochemical evidence indicate that continental recycling has been occurring since the early history of the Earth. The stabilization of felsic continents in place of Earth's early mafic crust about 3.0 to 2.0 billion years ago, perhaps due to the initiation of plate tectonics, implies widespread destruction of mafic crust during this time interval. However, the physical mechanisms of such intense recycling on a hotter, (late) Archaean and presumably plate-tectonic Earth remain largely unknown. Here we use thermomechanical modelling to show that extensive recycling via lower crustal peeling-off (delamination but not eclogitic dripping) during continent-continent convergence was near ubiquitous during the late Archaean to early Proterozoic. We propose that such destruction of the early mafic crust, together with felsic magmatism, may have caused both the emergence of silicic continents and their subsequent isostatic rise, possibly above the sea level. Such changes in the continental character have been proposed to influence the Great Oxidation Event and, therefore, peeling-off plate tectonics could be the geodynamic trigger for this event. A transition to the slab break-off controlled syn-orogenic recycling occurred as the Earth aged and cooled, leading to reduced recycling and enhanced preservation of the continental crust of present-day composition.

  3. 77 FR 35959 - Atlas Pipeline Mid-Continent WestTex, LLC; Pioneer Natural Resources USA, Inc.; Notice of...

    Science.gov (United States)

    2012-06-15

    ... Federal Energy Regulatory Commission Atlas Pipeline Mid-Continent WestTex, LLC; Pioneer Natural Resources...Tex, LLC (Atlas) and Pioneer Natural Resources USA, Inc. (Pioneer), filed in the above referenced..., Pioneer Natural Resources USA, Inc., 5205 North O'Connor Blvd., Suite 200, Irving, TX 75039, by...

  4. Evaluation of pelvic floor muscle strength before and after robotic-assisted radical prostatectomy and early outcomes on urinary continence.

    Science.gov (United States)

    Manley, Lauren; Gibson, Luke; Papa, Nathan; Beharry, Bhawanie Koonj; Johnson, Liana; Lawrentschuk, Nathan; Bolton, Damien M

    2016-12-01

    The aim of the study was to evaluate the effect of pelvic floor muscle (PFM) assessment and training before and after robot-assisted laparoscopic radical prostatectomy (RARP) in improving PFM strength and urinary continence. We performed an analysis of a database of patients who underwent robot-assisted laparoscopic radical prostatectomy (RARP) performed by two urologists from 2011 to 2013. Pelvic floor muscle (PFM) activation and strength were graded by a trained pelvic floor physiotherapist. Patients were given an exercise program, grouped according to the strength of their pelvic floor as graded by assessment, to complete before and after surgery. PFM strength was recorded preoperatively, 4 days post-catheter removal and 4 weeks post-catheter removal. Continence was recorded at 4 weeks postop and was defined as the requirement of no continence aids. A total of 98 patients had RARP and a preoperative physiotherapy assessment plus postoperative appointments at around 1 and 4 weeks post-RARP. The majority of men improved their PFM strength regardless of preoperative strength with no significant predictors of postoperative strength found. Age was the only significant predictor of postoperative incontinence. In this pilot study, a majority of patients increased their pelvic floor strength with time. Pelvic floor physiotherapy is an important modifiable patient factor, which does have an impact in improving patients' urinary continence by strengthening the pelvic floor muscles. Patient age influences response to pelvic floor physiotherapy.

  5. Modeling and Interpreting CHAMP Magnetic Anomaly Field over China Continent Using Spherical Cap Harmonic Analysis

    Institute of Scientific and Technical Information of China (English)

    Fu Yuanyuan; Liu Qingsheng; Yang Tao

    2004-01-01

    Based on the CHAMP Magsat data set, spherical cap harmonic analysis was used to model the magnetic fields over China continent. The data set used in the analysis includes the 15′×15′ gridded values of the CHAMP anomaly fields (latitude φ=25°N to 50°N and longitude λ=78°E to 135°E). The pole of the cap is located at φ=35°N and λ=110°E with half-angle of 30°. The maximum index (Kmax) of the model is 30 and the total number of model coefficients is 961, which corresponds to the minimum wavelength at the earth's surface about 400 km. The root mean square (RMS) deviations between the calculated and observed values are ~ 4 nT for ΔX, ~ 3 nT for ΔY and ~ 3.5 nT for ΔZ, respectively. Results show that positive anomalies are found mainly at the Tarim basin with ~6- 8 nT, the Yangtze platform and North China platform with ~4 nT, and the Songliao basin with ~4-6 nT. In contrast, negative anomaly is mainly located in the Tibet orogenic belt with the amplitude ~ (-6)-(-8) nT. Upward continuation of magnetic anomalies was used to semi-quantitatively separate the magnetic anomalies in different depths of crust. The magnetic anomalies at the earth's surface are from -6 to 10 nT for upper crust, middle crust -27 to 42 nT and lower crust -12 to 18 nT, respectively. The strikes of the magnetic anomalies for the upper crust are consistent with those for the middle crust, but not for the lower crust. The high positive magnetic anomalies mainly result from the old continental nucleus and diastrophic block (e.g. middle Sichuan continental nucleus, middle Tarim basin continental nucleus, Junggar diastrophic block and Qaidam diastrophic block). The amplitudes of the magnetic anomalies of the old continental nucleus and diastrophic block are related to evolution of deep crust. These results improve our understanding of the crustal structure over China continent.

  6. Model calculations of the age of firn air across the Antarctic continent

    Directory of Open Access Journals (Sweden)

    K. A. Kaspers

    2004-01-01

    Full Text Available The age of firn air in Antarctica at pore close-off depth is only known for a few specific sites where firn air has been sampled for analyses. We present a model that calculates the age of firn air at pore close-off depth for the entire Antarctic continent. The model basically uses four meteorological parameters as input (surface temperature, pressure, accumulation rate and wind speed. Using parameterisations for surface snow density, pore close-off density and tortuosity, in combination with a density-depth model and data of a regional atmospheric climate model, distribution of pore close-off depth for the entire Antarctic continent is determined. The deepest pore close-off depth was found for the East Antarctic Plateau near 72° E, 82° S, at 150±15 m (2σ. A firn air diffusion model was applied to calculate the age of CO2 at pore close-off depth. The results predict that the oldest firn gas (CO2 age is located between Dome Fuji, Dome Argos and Vostok at 43° E, 78° S being 148±23 (1σ or 38 for 2σ years old. At this location an atmospheric trace gas record should be obtained. In this study we show that methyl chloride could be recorded with a predicted length of 125 years as an example for trace gas records at this location. The longest record currently available from firn air is derived at South Pole, being 80 years. Sensitivity tests reveal that the locations with old firn air (East Antarctic Plateau have an estimated uncertainty (2σ for the modelled CO2 age at pore close-off depth of 30% and of about 40% for locations with younger firn air (CO2 age typically 40 years. Comparing the modelled age of CO2 at pore close-off depth with directly determined ages at seven sites yielded a correlation coefficient of 0.90 and a slope close to 1, suggesting a high level of confidence for the modelled results in spite of considerable remaining uncertainties.

  7. Intraseasonal Variability of δ18O of Precipitation in The Indonesia Maritime Continent

    Science.gov (United States)

    Belgaman, H. A.; Ichiyanagi, K.; Tanoue, M.; Suwarman, R.; Yoshimura, K.; Mori, S.; Yamanaka, M. D.; Kurita, N.; Syamsudin, F.

    2014-12-01

    The Indonesian maritime continent (IMC) consists of many islands in a warm pool of sea water and is located between two great oceans—the Pacific Ocean and Indian Ocean, and two major continents—the Asian and Australian continents. This tropical region also influenced by many regional and local climate and weather phenomenon which causes high spatial and temporal rainfall variability. These factors may produce unique variability of isotopic precipitation. The isotopic content (d18O and dD) in precipitation have been known to have important role for reconstructing the atmospheric circulation, hydrological cycle, and paleoclimate. Using daily data from six observation station across the IMC (Bukit tinggi, Jambi, Denpasar, Makasar, Manado, and Palau Island), the variability of δ18O was explored. Observation times for each station were different. Bukit Tinggi (GAW) was from Jan. 2001 - Mar. 2010, Jambi (JMB) was from Apr. 2001 - Dec. 2005, Denpasar (DPS), Makassar (MKS), Manado (MND) were from Nov. 2002 - Mar. 2010, and Palau Island (PLL) was from Dec. 2001 - May 2007. Daily average value of δ18O were -7.57‰, -5.41‰, -3.15‰, -6.12‰, -5.49‰ and -4.26‰ for GAW, JMB, DPS, MKS, MND and PLL respectively. Daily value of δ18O in GAW has the lowest value compare with the other station was because the location of GAW station located at high altitude. High correlation of variability of δ18O and Madden-Julian Oscillation (MJO) was observed at western part of the IMC (GAW and JMB), and northern part of the IMC (MKS, MND, and PLL), meanwhile δ18O variability at DPS was less correlated with MJO compare with other stations. Preliminary result from Color Moisture Analysis (CMA) model revealed that precipitable water at GAW and JMB stations was mostly occupied by water vapor evaporated from the Indian Ocean. However, precipitable water at other stations was mostly composed of water vapor evaporated from the Java Sea and the Pacific Ocean. These findings indicate

  8. A Geophysical Overview of the Structure and Evolution of the Crust of the Mid-Continent Region of North America

    Science.gov (United States)

    Keller, G. R., Jr.

    2015-12-01

    A variety of geophysical data, including newly released 3-D seismic reflection data, show us that the crustal structure of the Mid-Continent region of North America is very complex. The dimensions of many of the crustal structures is very large by global standards, and thus, they are a tectonic puzzle because of their size, structural complexity, and distance from active plate margins that usually create the driving mechanisms for intraplate deformation evident. The crust of the Mid-Continent region formed during a period of continental growth that extended from about 1.8 to 0.9 Ga. The impressive Mid-Continent rift system (MCRS) tried to interrupt this period of continental growth at about 1.1 Ga but it its western arm failed even though it modified the crust massively. However, the supercontinent resulting from this growth did not survive long and began to break up by ~700 Ma. This period of rifting established the structural framework of the southern Mid-Continent region, subsequent Early Paleozoic basin development, and at least partly, the formation of the Ancestral Rocky Mountains in the late Paleozoic. The Southern Oklahoma aulacogen (SOA) is an impressive example of this rifting event. The deformation that formed the Ancestral Rocky Mountains resulted in massive inversion of SOA rift structures and is due to a plate collision in the late Paleozoic whose origin is under debate. There has been increased emphasis on the use of gravity, magnetic, seismic, drilling, and remote sensing data in studies of the Mid-Continent region. For example, the MCRS is traditionally viewed as ending in central Kansas and the SOA can be interpreted as ending in the Texas panhandle. However, we used enhancement of gravity and magnetic data, seismic data, geologic mapping, and deep-drilling data to study its southern extent, and it appears that the MCRS could extend further southward beneath the much younger Anadarko basin of Oklahoma to abut the SOA.

  9. Maritime Continent rainfall variability during the TRMM era: The role of monsoon, topography and El Niño Modoki

    Science.gov (United States)

    As-syakur, Abd. Rahman; Osawa, Takahiro; Miura, Fusanori; Nuarsa, I. Wayan; Ekayanti, Ni Wayan; Dharma, I. Gusti Bagus Sila; Adnyana, I. Wayan Sandi; Arthana, I. Wayan; Tanaka, Tasuku

    2016-09-01

    Rainfall is among the most important climatic elements of the Maritime Continent. The Maritime Continent rainfall climate is uniquely located in the world's most active convective area. Satellite data measured by the Tropical Rainfall Measuring Mission (TRMM) 3B43 based high-resolution rainfall products represent monthly Maritime Continent rainfall characteristics over 16 years. Several statistical scores were employed to analyse annual means, linear trends, seasonal means, and anomalous Maritime Continent rainfall characteristic percentages. The effects of land and topography on rainfall quantities were also studied and compared with the Global Precipitation Climatology Project (GPCP) gridded precipitation estimates which has low-resolution. Comparison also applied on linear correlation and partial correlation techniques to determine the relationship between rainfall and the El Niño Modoki and El Niño-Southern Oscillation (ENSO; hereafter conventional El Niño). The results show that north-south Maritime Continent precipitation is associated with and generated by the northwest and southeast monsoon patterns. In addition, the large-scale circulations are linked with heavy rainfall over this land-ocean region due to large-scale island-topography-induced convective organization. The rainfall responses to El Niño Modoki and conventional El Niño clearly indicated the times at which the conventional El Niño had a higher impact than El Niño Modoki, especially during northern winter and spring, and vice versa during northern fall, and similarly affect during northern summer. Furthermore, the dynamic movements of rainfall anomaly that are caused by El Niño Modoki and the conventional El Niño events spanned from the southwest during June-July-August (JJA) to throughout the northeast ending in March-April-May (MAM).

  10. Anal fistula plug: a prospective evaluation of success, continence and quality of life in the treatment of complex fistulae.

    Science.gov (United States)

    Adamina, M; Ross, T; Guenin, M O; Warschkow, R; Rodger, C; Cohen, Z; Burnstein, M

    2014-07-01

    Curing complex anal fistula without compromising continence can be extremely challenging. This study investigated the healing rate, continence and quality of life of patients after treatment of complex anal fistula of cryptoglandular origin with a bioprosthetic plug. Consecutive patients were prospectively followed in four referral centres. Following seton conditioning, a bioprosthetic plug was inserted into the fistula and sutured to the anal sphincter. Clinical evaluation was performed at 10 days, 6 weeks and 6 months after surgery, and was completed by telephone interviews. Anal continence and quality of life were evaluated using the Fecal Incontinence Score Index and the Short Form-36 Health Survey, version 2 (SF-36 v2) questionnaire. Forty-six patients presenting with a complex anal fistula and a median of three previous fistula surgeries were included. The 6-month recurrence rate was 30.7% (95% CI: 15.9-42.8%), increasing to 48.0% (95% CI: 30.6-61.1%) after 2 years. Follow up was continued for a median of 68.1 months, and 26 (56.5%) recurrences were identified. Anal continence improved from a median of 19 points to 12 points at 6 months of follow up (P = 0.008). Quality of life markedly improved in all scales. The physical summary score increased from 47.2 to 56.2 (P fistula plug demonstrated a healing rate close to 50% in complex cryptoglandular fistula. Also, it markedly improved anal continence and quality of life. These data support the use of a bioprosthetic plug as first-line therapy for complex fistula instead of more aggressive and potentially debilitating surgical options. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  11. Antegrade Versus Retrograde Cerebral Perfusion in Relation to Postoperative Complications Following Aortic Arch Surgery for Acute Aortic Dissection Type A%双侧顺行与上腔逆行脑灌注在A型主动脉夹层中应用效果对比的临床研究

    Institute of Scientific and Technical Information of China (English)

    吴智勇; 王志维; 夏军; 张遵严; 陈雪芬; 邓宏平; 徐鹏; 李罗成; 王杰

    2011-01-01

    Objective Antegrade or retrograde cerebral perfusion ( RCP) , is a well - established method of brain protection in aortic arch surgery. In this retrospective study, we compard the two methods of brain perfusion. Methods From Oct 2008 to Jan 2011,63 consecutive patients were urgently operated for acute type A aortic dissection and underwent arch replacement under deep hypothermic circulatory arrest (DHCA). Our patient cohort was divided into those protected with antegrade cerebral perfusion ( ACP) (group A, n = 54) and those protected with RCP (group B, n = 9). Results There was no siguificant difference in operative time, cardiopulmonary bypass - time, myocardial blocking time, cerebral - perfusion time between groups B and A, but the incidence of temporary neurologic dysfunction, the mean extubation time,the mean ICU -stay,the hospital -stay increased. Conclusion The antegrade perfusion was related with significantly lower incidence of temporary neurological complications, earlier extubation, shorter ICU - stay, and hospitalization.%目的 深低温停循环(DHCA)的同时顺行或逆行脑灌注,是一种行之有效的脑保护方法.在这个回顾性研究中,我们比较顺行、逆行两种方法的临床疗效.方法 从2008年10月~2011年1月,63例患者行Stanford A型主动脉夹层手术,均在深低温停循环下行全弓置换.其中选择双侧顺行脑灌注的A组病人54例,B组采用上腔静脉逆灌(RCP)脑保护的病人9例.结果 B组与A组比较在手术时间、体外循环时间、心肌阻断时间、脑灌注时间差异不明显,而B组短暂脑神经功能障碍发生率、拔管时间、ICU滞留时间、住院时间有所增加.结论 顺行脑灌注较上腔逆灌降低短暂脑神经功能障碍发生率从而拔管早,缩短ICU及住院时间.

  12. Early onset of industrial-era warming across the oceans and continents.

    Science.gov (United States)

    Abram, Nerilie J; McGregor, Helen V; Tierney, Jessica E; Evans, Michael N; McKay, Nicholas P; Kaufman, Darrell S

    2016-08-25

    The evolution of industrial-era warming across the continents and oceans provides a context for future climate change and is important for determining climate sensitivity and the processes that control regional warming. Here we use post-ad 1500 palaeoclimate records to show that sustained industrial-era warming of the tropical oceans first developed during the mid-nineteenth century and was nearly synchronous with Northern Hemisphere continental warming. The early onset of sustained, significant warming in palaeoclimate records and model simulations suggests that greenhouse forcing of industrial-era warming commenced as early as the mid-nineteenth century and included an enhanced equatorial ocean response mechanism. The development of Southern Hemisphere warming is delayed in reconstructions, but this apparent delay is not reproduced in climate simulations. Our findings imply that instrumental records are too short to comprehensively assess anthropogenic climate change and that, in some regions, about 180 years of industrial-era warming has already caused surface temperatures to emerge above pre-industrial values, even when taking natural variability into account.

  13. Land-Use Change and Emerging Infectious Disease on an Island Continent

    Directory of Open Access Journals (Sweden)

    Rosemary A. McFarlane

    2013-06-01

    Full Text Available A more rigorous and nuanced understanding of land-use change (LUC as a driver of emerging infectious disease (EID is required. Here we examine post hunter-gatherer LUC as a driver of infectious disease in one biogeographical region with a compressed and documented history—continental Australia. We do this by examining land-use and native vegetation change (LUCC associations with infectious disease emergence identified through a systematic (1973–2010 and historical (1788–1973 review of infectious disease literature of humans and animals. We find that 22% (20 of the systematically reviewed EIDs are associated with LUCC, most frequently where natural landscapes have been removed or replaced with agriculture, plantations, livestock or urban development. Historical clustering of vector-borne, zoonotic and environmental disease emergence also follows major periods of extensive land clearing. These advanced stages of LUCC are accompanied by changes in the distribution and density of hosts and vectors, at varying scales and chronology. This review of infectious disease emergence in one continent provides valuable insight into the association between accelerated global LUC and concurrent accelerated infectious disease emergence.

  14. Long aftershock sequences within continents and implications for earthquake hazard assessment.

    Science.gov (United States)

    Stein, Seth; Liu, Mian

    2009-11-05

    One of the most powerful features of plate tectonics is that the known plate motions give insight into both the locations and average recurrence interval of future large earthquakes on plate boundaries. Plate tectonics gives no insight, however, into where and when earthquakes will occur within plates, because the interiors of ideal plates should not deform. As a result, within plate interiors, assessments of earthquake hazards rely heavily on the assumption that the locations of small earthquakes shown by the short historical record reflect continuing deformation that will cause future large earthquakes. Here, however, we show that many of these recent earthquakes are probably aftershocks of large earthquakes that occurred hundreds of years ago. We present a simple model predicting that the length of aftershock sequences varies inversely with the rate at which faults are loaded. Aftershock sequences within the slowly deforming continents are predicted to be significantly longer than the decade typically observed at rapidly loaded plate boundaries. These predictions are in accord with observations. So the common practice of treating continental earthquakes as steady-state seismicity overestimates the hazard in presently active areas and underestimates it elsewhere.

  15. Galicia Bank ocean-continent transition zone: New seismic reflection constraints

    Science.gov (United States)

    Dean, S. L.; Sawyer, D. S.; Morgan, J. K.

    2015-03-01

    The West Iberia continental margin is a type locale for magma-poor rifting, and studies there have been instrumental in changing the classical view of the ocean-continent transition (OCT) from a discrete boundary juxtaposing continental and oceanic crust, into a more complicated zone of varying width that can include exhumed mantle. This study examines two new seismic lines in the Galicia Bank area extending west of the Peridotite Ridge, showing high resolution images of five new ridges. These ridges could be hyperextended continental crust, exhumed continental mantle, or rough ultra-slow spreading oceanic crust. There are no tilted fault blocks with pre-syn rift stratigraphy that would indicate continental crust. There are also no faults indicating mid-ocean spreading with seismic layer stratigraphy indicating normal oceanic crust. The ridges have no coherent internal seismic structure, and some resemble the topographic profile of the Peridotite Ridge. Therefore, it is likely the western ridges are also mainly composed of serpentinized mantle. These western ridges are also similar to small oceanic core complexes observed along the active part of the Mid-Atlantic Ridge, which also contain exhumed serpentinized mantle. This implies that there is a gradual transition within our study area from continental extension to seafloor spreading. Exhumation of continental mantle results in the formation of peridotite ridges, then transitions to episodic volcanism, which produces local thin basaltic crust, and exhumation of oceanic core complexes. Asymmetric processes during initial rifting and spreading result in contrasting structures on the two resulting margins.

  16. Threats and Re-emergence of Chickungunya Fever in Indian Sub-continent

    Directory of Open Access Journals (Sweden)

    Mahajan S

    2009-02-01

    Full Text Available Zoonoses are among the most frequent and dreaded risk to which mankind is exposed today, human health is inextricably linked to animal health and production. Over the past 6 years, a number of zoonotic and vector borne viral diseases were recorded in South-east Asia and the Western Pacific and there was sudden upsurge in the number of emerging and re-emerging zoonotic diseases in Indian Sub-continent and Chikungunya fever is one of them. The precise reasons for the re-emergence of Chikungunya in the Indian subcontinent as well as the other small countries in the southern Indian Ocean are an enigma. Although, it is well recognized that re-emergence of viral infections are due to a variety of social, environmental, behavioural and biological changes, which of these contributed to the re-emergence of Chikungunya virus would be interesting to unravel. Chikungunya is generally spread through bites of infected mosquitoes; mosquitoes become infected when they feed on a animal infected with CHIK virus. Monkey and possibly other wild animals may serve as reservoirs of infection. [Vet. World 2009; 2(1.000: 40-42

  17. Biogeochemistry of hypersaline springs supporting a mid-continent marine ecosystem: an analogue for martian springs?

    Science.gov (United States)

    Grasby, Stephen E; Londry, Kathleen L

    2007-08-01

    Hypersaline springs that host unique mid-continent marine ecosystems were examined in central Manitoba, Canada. The springs originate from a reflux of glacial meltwater that intrudes into underlying bedrock and dissolved buried salt beds. Two spring types were distinguished based both on flow rate and geochemistry. High flow springs (greater than 10 L/s) hosted extensive marine microbial mats, which were dominated by algae but also included diverse microbes. These varied somewhat between springs as indicated by changes in profiles of fatty acid methyl esters. Culture studies confirmed the presence of sulfate-reducing bacteria in sediments at the high flow sites. In contrast, low flow springs were affected by solar evaporation, increasing salinity, and temperature. These low flow springs behaved more like closed nutrient-limited systems and did not support microbial mats. Direct comparison of the high and low flow springs revealed interesting implications for the potential to record biosignatures in the rock record. High flow springs have abundant, well-developed microbial mats, which desiccate and are cemented along the edges of the spring pools; however, the high mass flux overwhelms any geochemical signature of microbial activity. In contrast, the nutrient-limited low flow sites develop strong geochemical signatures of sulfate reduction, even in the absence of microbial mats, due to less dilution with the lower flows. Geochemical and physical evidence for life did not correlate with the abundance of microbial life but, rather, with the extent to which the biological system formed a closed ecosystem.

  18. Resource tracking within and across continents in long-distance bird migrants

    KAUST Repository

    Thorup, Kasper

    2017-01-05

    Migratory birds track seasonal resources across and between continents. We propose a general strategy of tracking the broad seasonal abundance of resources throughout the annual cycle in the longest-distance migrating land birds as an alternative to tracking a certain climatic niche or shorter-term resource surplus occurring, for example, during spring foliation. Whether and how this is possible for complex annual spatiotemporal schedules is not known. New tracking technology enables unprecedented spatial and temporal mapping of long-distance movement of birds. We show that three Palearctic-African species track vegetation greenness throughout their annual cycle, adjusting the timing and direction of migratory movements with seasonal changes in resource availability over Europe and Africa. Common cuckoos maximize the vegetation greenness, whereas red-backed shrikes and thrush nightingales track seasonal surplus in greenness. Our results demonstrate that the longest-distance migrants move between consecutive staging areas even within the wintering region in Africa to match seasonal variation in regional climate. End-of-century climate projections indicate that optimizing greenness would be possible but that vegetation surplus might be more difficult to track in the future.

  19. Genetically similar isolates of Klebsiella pneumoniae serotype K1 causing liver abscesses in three continents.

    Science.gov (United States)

    Turton, Jane F; Englender, Hilary; Gabriel, Samantha N; Turton, Sarah E; Kaufmann, Mary E; Pitt, Tyrone L

    2007-05-01

    The magA gene was sought in hypermucoviscous isolates of Klebsiella spp., the Klebsiella K serotype reference strains and in isolates of the K1 serotype of Klebsiella pneumoniae from the UK, Hong Kong, Israel, Taiwan and Australia. Only K1 isolates were PCR positive for magA; this gene was found in all such isolates tested. Hypermucoviscosity was not confined to magA positive isolates, nor was it found in all magA positive isolates. Comparison of XbaI PFGE profiles revealed that most (19/23) of the magA positive isolates clustered within 72 % similarity, with a further subcluster of isolates, from three different continents, clustering within >80 %. All of the 16 isolates tested within the main cluster had the same sequence type (ST 23) by multilocus sequence typing, with the exception of one isolate, which had a single nucleotide difference at one of the seven loci. This study indicates that a genotype strongly associated with highly invasive disease in Taiwan, where large numbers of cases have been reported, is geographically very widespread.

  20. Early onset of industrial-era warming across the oceans and continents

    Science.gov (United States)

    2016-08-01

    The evolution of industrial-era warming across the continents and oceans provides a context for future climate change and is important for determining climate sensitivity and the processes that control regional warming. Here we use post-AD 1500 palaeoclimate records to show that sustained industrial-era warming of the tropical oceans first developed during the mid-nineteenth century and was nearly synchronous with Northern Hemisphere continental warming. The early onset of sustained, significant warming in palaeoclimate records and model simulations suggests that greenhouse forcing of industrial-era warming commenced as early as the mid-nineteenth century and included an enhanced equatorial ocean response mechanism. The development of Southern Hemisphere warming is delayed in reconstructions, but this apparent delay is not reproduced in climate simulations. Our findings imply that instrumental records are too short to comprehensively assess anthropogenic climate change and that, in some regions, about 180 years of industrial-era warming has already caused surface temperatures to emerge above pre-industrial values, even when taking natural variability into account.

  1. High diversity of picornaviruses in rats from different continents revealed by deep sequencing.

    Science.gov (United States)

    Hansen, Thomas Arn; Mollerup, Sarah; Nguyen, Nam-Phuong; White, Nicole E; Coghlan, Megan; Alquezar-Planas, David E; Joshi, Tejal; Jensen, Randi Holm; Fridholm, Helena; Kjartansdóttir, Kristín Rós; Mourier, Tobias; Warnow, Tandy; Belsham, Graham J; Bunce, Michael; Willerslev, Eske; Nielsen, Lars Peter; Vinner, Lasse; Hansen, Anders Johannes

    2016-08-17

    Outbreaks of zoonotic diseases in humans and livestock are not uncommon, and an important component in containment of such emerging viral diseases is rapid and reliable diagnostics. Such methods are often PCR-based and hence require the availability of sequence data from the pathogen. Rattus norvegicus (R. norvegicus) is a known reservoir for important zoonotic pathogens. Transmission may be direct via contact with the animal, for example, through exposure to its faecal matter, or indirectly mediated by arthropod vectors. Here we investigated the viral content in rat faecal matter (n=29) collected from two continents by analyzing 2.2 billion next-generation sequencing reads derived from both DNA and RNA. Among other virus families, we found sequences from members of the Picornaviridae to be abundant in the microbiome of all the samples. Here we describe the diversity of the picornavirus-like contigs including near-full-length genomes closely related to the Boone cardiovirus and Theiler's encephalomyelitis virus. From this study, we conclude that picornaviruses within R. norvegicus are more diverse than previously recognized. The virome of R. norvegicus should be investigated further to assess the full potential for zoonotic virus transmission.

  2. Continent catheterizable conduit for urinary diversion in children: Applicability and acceptability

    Directory of Open Access Journals (Sweden)

    Shailesh Solanki

    2015-01-01

    Full Text Available Background: Continent catheterizable conduit (CCC has made clean intermittent catheterization (CIC painless and easy. It is applicable in diverse clinical conditions. Nonetheless, convincing the parents for the need of conduit procedure is still difficult. Materials and Methods: A prospective study, included children who underwent CCC procedure from March 2008 to February 2013. The data were assessed for; diagnosis, type of conduit, number of preoperative counselling sessions before acceptance, role of "self-help group" in decision making, parental concern and satisfaction for the procedure. Results: Twenty-nine patients (males; 24, females; 5 underwent CCC procedure for various clinical conditions. The multiple preoperative counselling sessions and creation of "self-help groups" were helped them for decision making. The main concerns among parents were: (1 Impact of procedure on future fertility and sexual life. (2 Patency of native urethral channel. (3 Permanent urinary stoma over the abdomen. Conclusion: CCC procedures are applicable to a wide array of clinical situations with a good outcome. The acceptability of the CCC procedure improves with preoperative counselling of parent/child, initiation of preoperative per urethral CIC and creation of self-help groups.

  3. Climate as a driver of continent-wide irruptions in boreal seed-eating birds (Invited)

    Science.gov (United States)

    Strong, C.; Zuckerberg, B.; Betancourt, J. L.

    2013-12-01

    Boreal seed-eating birds regularly breed and overwinter throughout Canada and Alaska, but every few years these species demonstrate impressive irruptive migrations out of the boreal forest and into more southerly regions. It is thought that irruptive migrations are inversely dependent on a circumboreally synchronized pattern of seed crop fluctuations in boreal trees; seed-eating boreal birds stay in the north when food is plentiful, but sojourn south when food is scarce. Because both seed production and bird irruptions are characterized by periodicity ranging from biennial to decadal cycles, there is a strong possibility that these ecological phenomena are driven by climate variability. Using over twenty years of data from Project FeederWatch (a national citizen science project), we found that 'super irruptions' are correlated with continent-wide irruptive events in pine siskin population, and that these irruptions are associated with multi-decadal climate variability of Pacific origin. We also investigate how climate variability may influence the distribution of boreal bird species across different regions of North America during winter, and evaluate results in the context of limited banding data to assess possible geographic pathways of irruptions.

  4. Sensitivity of the Maritime Continent precipitation to horizontal resolution in a coupled regional model

    Science.gov (United States)

    Li, Yue; Jourdain, Nicolas; Taschetto, Andréa; Gupta, Alex Sen; Masson, Sébastien; Cai, Wenju

    2015-04-01

    The Maritime Continent (MC) is centred at one of the major monsoon systems in the world. Characterized by massive tropical heating and precipitation, it is strongly influencing both the Hadley and Walker circulations. However, there are significant challenges in correctly represent climate of this region because of the complex topography and the arrangement of lands and seas. It is often argued that improved representation of the diurnal cycle over islands and the complex mesoscale circulation associated with land-sea contrast is important to energy and hydrological cycles of this region. To investigate the sensitivity of precipitation over the MC to model horizontal resolution, we perform three regional numerical experiments using the coupled NEMO-OASIS-WRF model at different horizontal resolutions of 3/4°, 1/4° and 1/12° in both atmosphere and ocean components. The 3/4° and 1/4° experiments are run on a large MC domain for 21 years (1989 to 2009), and the 1/12° experiment is nested within the 1/4° domain using two-way interactive nesting over 5 years. Increasing the resolution reduces biases in mean SST and mean precipitation. The precipitation distribution is also improved at higher resolution, particularly in coastal areas. A part of these improvements are related to different behaviours of the model physical schemes across the three resolutions. Other changes are interpreted in terms of land-sea breeze, that we describe through a new comprehensive method.

  5. Diamictite from Nimrod Glacier area, Antarctica: Possible Proterozoic glaciation on the seventh continent

    Science.gov (United States)

    Stump, Edmund; Miller, Julia M. G.; Korsch, Russell J.; Edgerton, David G.

    1988-03-01

    Late Proterozoic glacial deposits have been found on all continents except Antarctica. Here we describe four units of Late Proterozoic diamictite, with a total thickness of about 10m, from Panorama Point, Nimrod Glacier area, Antarctica, which have characteristics compatible with glaciogenic origin. The diamictite occurs within the Goldie Formation, a sequence of marine turbidites, and is associated with a unit of mafic pillow lavas. The diamictite is commonly structureless and in places laminated. Coarse clasts occur as scattered pebbles and cobbles and as pebbly pods and beds. No striated or faceted clasts were found. A few pebbles may pierce the laminae, but a drop-stone origin is uncertain. Deformation and metamorphism have obscured subtleties of original sedimentary structure. Outsize clasts in laminated sandy siltstone (now schistose) suggest a glaciogenic origin for these diamictites, but deposition by mass-flow processes cannot be ruled out. The discovery in Antarctica of possible Late Proterozoic glaciogenic deposits extends their geographic distribution to all of the major continental masses.

  6. Velocity structure of uppermost mantle beneath China continent from Pn tomography

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    39473 Pn travel times are inverted to tomographically image both lateral variation and anisotropy of uppermost mantle velocities beneath China continent. The result indicates that the overall average Pn velocity of uppermost mantle in the studied region is 8.0 km/s and the regional velocity fluctuation varies from -0.30 km/s to +0.35 km/s. Pn velocities higher than 8.2 km/s are found in the regions surrounding Qingzang Plateau, such as Junggar Basin, Tarim Basin, Qaidam Basin and Sichun Basin. Pn velocities slightly lower than the average are found in western Sichuan and Yunnan, Shanxi Graben and Bohai Bay region. A Pn velocity as low as 7.8 km/s may exist in the region striding the boundary between Guangxi and Guangdong provinces. In general, Pn velocity in tectonically stable region like cratonic platform tends to be high, while that in tectonically active region tends to be low. The regions in compressive setting usually show higher Pn velocity, while extensional basins or grabens generally display lower one. Anisotropy of Pn velocity is seen in some regions. In the southeastern region of Qingzang Plateau the directions of fastest Pn velocity show a rotation pattern, which may be related to southeastward escape of the plateau material due to the collision and compression of Indian Plate to Asia along Himalaya arc. Notable anisotropy also exists around Bohai Bay region, likely indicating crustal extending and possible magma activity therein.

  7. Depressive symptoms and psychosocial stress at work among older employees in three continents.

    Science.gov (United States)

    Siegrist, Johannes; Lunau, Thorsten; Wahrendorf, Morten; Dragano, Nico

    2012-07-20

    To assess whether an association of psychosocial stress at work with depressive symptoms among older employees is evident in a set of comparable empirical studies from Europe, North America and Asia. Cross-sectional and longitudinal multivariate regression analyses of data from 4 cohort studies with elder workers (2004 and 2006) testing associations of psychosocial stress at work ('effort-reward imbalance'; 'low control') with depressive symptoms. Cross-sectional analyses from 17 countries with 14.236 participants reveal elevated odds ratios of depressive symptoms among people experiencing high work stress compared to those with low or no work stress. Adjusted odds ratios vary from 1.64 (95% CI 1.02-2.63) in Japan to 1.97 (95% CI 1.75-2.23) in Europe and 2.28 (95% CI 1.59-3.28) in the USA. Odds ratios from additional longitudinal analyses (in 13 countries) controlling for baseline depression are smaller, but remain in part significant. Findings indicate that psychosocial stress at work might be a relevant risk factor for depressive symptoms among older employees across countries and continents. This observation may call for global policy efforts to improve quality of work in view of a rapidly aging workforce, in particular in times of economic globalization.

  8. Warm Arctic—cold continents: climate impacts of the newly open Arctic Sea

    Directory of Open Access Journals (Sweden)

    James E. Overland

    2011-12-01

    Full Text Available Recent Arctic changes are likely due to coupled Arctic amplification mechanisms with increased linkage between Arctic climate and sub-Arctic weather. Historically, sea ice grew rapidly in autumn, a strong negative radiative feedback. But increased sea-ice mobility, loss of multi-year sea ice, enhanced heat storage in newly sea ice-free ocean areas, and modified wind fields form connected positive feedback processes. One-way shifts in the Arctic system are sensitive to the combination of episodic intrinsic atmospheric and ocean variability and persistent increasing greenhouse gases. Winter 2009/10 and December 2010 showed a unique connectivity between the Arctic and more southern weather patterns when the typical polar vortex was replaced by high geopotential heights over the central Arctic and low heights over mid-latitudes that resulted in record snow and low temperatures, a warm Arctic—cold continents pattern. The negative value of the winter (DJF 2009/10 North Atlantic Oscillation (NAO index associated with enhanced meridional winds was the lowest observed value since the beginning of the record in 1865. Wind patterns in December 2007 and 2008 also show an impact of warmer Arctic temperatures. A tendency for higher geopotential heights over the Arctic and enhanced meridional winds are physically consistent with continued loss of sea ice over the next 40 years. A major challenge is to understand the interaction of Arctic changes with climate patterns such as the NAO, Pacific North American and El Niño–Southern Oscillation.

  9. The role of mucoregulatory agents after continence-preserving urinary diversion surgery.

    Science.gov (United States)

    Covert, Wendy M; Westin, Shannon N; Soliman, Pamela T; Langley, Ginger D

    2012-03-15

    The postsurgical use of N-acetylcysteine, octreotide, and other agents to reduce mucus accumulation after urinary diversion procedures is described. Patients undergoing continence-sparing bladder resection are at risk for infection and stone formation due to mucus accumulation. In addition to N-acetylcysteine, agents studied for mucoregulatory control in such patients include aspirin, urea, ranitidine, and octreotide. N-acetylcysteine has high mucolytic activity in vitro, and positive outcomes with instillations of 20% N-acetylcysteine solution have been reported in some patients. Significant mucus reductions were reported in small numbers of patients treated with oral ranitidine 300 mg daily or instillations of 30 mL of urea 40% solution, while the benefits of aspirin are more questionable. To date, there has been only one randomized controlled trial comparing various agents for mucus reduction after reconstructive bladder surgery; the results indicated no significant benefits with the use of N-acetylcysteine, aspirin, or ranitidine. In one small study (n = 40), the use of subcutaneous octreotide immediately before and for 15 days after surgery was reported to yield significant reductions in mucus production, the need for bladder irrigation to clear blockages, and the mean duration of hospital stays. Various agents evaluated for mucus control after urinary diversion procedures (oral ranitidine or aspirin, N-acetylcysteine or urea instillations, and subcutaneous octreotide), while reportedly effective for some patients, remain of questionable benefit. More research is needed to define the optimal role of these agents for this indication.

  10. China’s Island Frontier: Geographical Ideas on the Continent-based Nationalist Narratives on Taiwan

    Directory of Open Access Journals (Sweden)

    Peter Kang

    2011-05-01

    Full Text Available This paper explores how nationalist narratives from Taiwan grappled with incorporating their ‘island frontier’ into conceptions of a Chinese unitary state. In the post World War II era, after the Chinese Nationalist government-in-exile re-established itself on the island of Taiwan, US-dominated scholarship strategically framed Taiwan as a convenient substitute for the study of China. This framing went hand in hand with the re-sinicization project on the island vigorously pursued by the Nationalists after they took control over the island after the collapse of the Japanese Empire. The Nationalist agenda emphasized the historical connection between the island and mainland China in order to politically create an imagined, and imagining, national community across the Strait. This paper critically investigates how continent-based nationalist narratives have sought to incorporate offshore islands into their unitary framework. It does so by deploying the concepts of geobody, geomancy, geochronology, geosymmetrical analogies, and regional demarcation to explore the geographical ideas on the construction of the postwar national imaginary.

  11. Three Continents Claiming an Archipelago: The Evolution of Aegean’s Herpetofaunal Diversity

    Directory of Open Access Journals (Sweden)

    Petros Lymberakis

    2010-02-01

    Full Text Available The area of the Aegean can be described as one of nature’s most active laboratories. The contemporary geomorphology of the Aegean is a result of diverse and still ongoing geological events, which coupled with climate changes, have created mountains and thousands of islands. The Aegean bridges three continents, where human activity has been recorded for at least 10,000 years. Herpetofauna diversity offered early researchers the possibility of describing patterns in the Aegean, especially as the distributional limit for several species and faunal elements. The patterns initially described at a rather coarse scale formed the frame on which the application of new techniques opened new views and permitted finer analyses. Here, we assess recent works on the Aegean’s herpetofauna, outlining the role of sea barriers, especially the Mid Aegean Trench (MAT. We propose four basic patterns (pre-MAT, post-MAT, newcomers, and that of an outlier and discuss exceptions to these patterns, to interpret the diversity recorded. The interdisciplinary study of taxonomy helps explaining the observed diversity and provides powerful arguments for how exploring diversity can be used to explain more than biological processes.

  12. Time series analysis of Carbon Monoxide from MOPITT over the Asian Continent from 2000-2004

    Science.gov (United States)

    Bhattacharjee, P. S.; Roy, P.

    2005-12-01

    The human population continues to grow and large parts of the world industrialize rapidly, causing changes in the global atmospheric chemistry. Carbon monoxide (CO) is a poisonous gas in the troposphere when highly concentrated, and is produced by fossil fuel combustion, biomass burning and through natural emissions from plants. It is also an important trace gas in the atmosphere and plays a major role in the atmospheric chemistry. We present a study of CO from the measurement of MOPITT (Measurement of Pollution in the Troposphere-Level 3 gridded data) instrument on NASA Terra satellite over India and Eastern Asia for the period of 2000-2004. Day- and night-time total column CO measurements are considered over the selected regions in India, China, Thailand and Japan. The selected regions comprise of industrial cities in the Asian continent which form the source of high CO in the atmosphere. The time series data do not show an overall increasing or decreasing trend, but CO is affected by seasonal variations, wind, and precipitation patterns. East Asian regions have higher and wider seasonal fluctuations than the Indian region. CO total column values over the Bay of Bengal are also high and can be explained through wind patterns from the land towards the ocean. Although the sources of CO are mostly confined to the land, it is transported globally through the atmosphere, and has high concentrations over the ocean.

  13. Depressive symptoms and psychosocial stress at work among older employees in three continents

    Directory of Open Access Journals (Sweden)

    Siegrist Johannes

    2012-07-01

    Full Text Available Abstract Background To assess whether an association of psychosocial stress at work with depressive symptoms among older employees is evident in a set of comparable empirical studies from Europe, North America and Asia. Methods Cross-sectional and longitudinal multivariate regression analyses of data from 4 cohort studies with elder workers (2004 and 2006 testing associations of psychosocial stress at work (‘effort-reward imbalance’; ‘low control’ with depressive symptoms. Results Cross-sectional analyses from 17 countries with 14.236 participants reveal elevated odds ratios of depressive symptoms among people experiencing high work stress compared to those with low or no work stress. Adjusted odds ratios vary from 1.64 (95% CI 1.02-2.63 in Japan to 1.97 (95% CI 1.75-2.23 in Europe and 2.28 (95% CI 1.59-3.28 in the USA. Odds ratios from additional longitudinal analyses (in 13 countries controlling for baseline depression are smaller, but remain in part significant. Conclusion Findings indicate that psychosocial stress at work might be a relevant risk factor for depressive symptoms among older employees across countries and continents. This observation may call for global policy efforts to improve quality of work in view of a rapidly aging workforce, in particular in times of economic globalization.

  14. Spatial and temporal snowpack variation in the crown of the continent ecosystem

    Science.gov (United States)

    Selkowitz, D.J.; Fagre, D.B.; Reardon, B.A.

    2002-01-01

    Snowpack related ecosystem changes such as glacier recession and alpine treeline advance have been documented in the Crown of the Continent Ecosystem (CCE) over the course of the previous 150 years. Using data from the Natural Resource Conservation Service's SNOTEL sites and snow course surveys, we examined the spatial and temporal variation in snowpack in the region. SNOTEL data suggest CCE snowpacks are larger and more persistent than in most regions of the Western U.S., and that water year precipitation, rather than mean temperature, is the primary control on April 1 snow water equivalent (SWE). Snow course data indicate a statistically significant downward trend in mean April 1 SWE for the period 1950-2001 but no statistically significant trend in mean May 1 SWE for the longer period 1922-2001. Further analysis reveals that variations in both April 1 and May 1 mean SWE are closely tied to the Pacific Decadal Oscillation, an ENSO-like interdecadal pattern of Pacific Ocean climate variability. Despite no significant trend in mean May 1 SWE between 1922-2001, glaciers in Glacier National Park receded steadily during this period, implying changing climatic conditions crossed a threshold for glacier mass balance maintenace sometime between the Little Ice Age glacial maxima and 1922.

  15. 中西药灌肠治疗溃疡性结肠炎的对比研究%The comparison of enema treatment of ulcerative colitis between traditional chinese medicine and western medicine

    Institute of Scientific and Technical Information of China (English)

    罗葵良; 黄生林; 蓝珍; 苏兰菊; 蒋义生; 蓝艳春

    2001-01-01

    This study investigated that the efficacy of a chinese herb decoction (containing Natural indigo, Frankincense, Myrrh, Chinese Nut-gall and Honeysuckle Flower) on the treatment of ulcerative colitis by retention-enama. 124 patients with light and middle grade of ulcerative colitis were randomly divided into the therapeutic group (traditional chinese medicine group, TCM group) and the control group (western medicine group, WM group). In addition to routine treatment, patients in the TCM group received the treatment of Chinese herb decoction of 200ml plus Dexamethasone (DXM) injection fluid 5mg by retention-enema, once every night for 14 days, and those in the WM group were given the treatment of Gentamicin 16,000U, DXM injection fluid 5mg, Smecta powder 6g and normal saline 100ml by retention enama, once every night for 14 days. Results showed that total effective rates were 91.93% and 72.58% in TCM group and WM group, respectively, and there was a statistically significant difference (P<0.01). This study indicates that the chinese herb enema on the treatment of ulcerative colitis has those advantages of abundant sources of medicine, low price, simplicity, accurate therapeutic efficacy, less side effects and low recurrences, etc.%为观察中药青黛、乳香、没药、五倍子、银花煎水灌肠治疗溃疡性肠炎的疗效,将124例临床分型为轻、中度的溃疡性结肠炎病人随机分为治疗组(中药组)与对照组(西药组),在对症支持治疗的基础上,治疗组用中药水剂200ml,地塞米松注射液5mg,保留灌肠,每晚1次,连用14天。对照组用庆大霉素注射液16万U,地塞米松注射液5mg,思密达粉剂6g,生理盐水100ml,保留灌肠,每晚1次,连用14天。结果治疗组总有效率91.93%,对照组为72.58%,差异有高度显著性(P<0.01)。认为中药灌肠治疗溃疡性结肠炎,具有药源广泛,价格便宜,方法简单,疗效确切,副作用少,复发率低等优点。

  16. The efficacy evaluation of enema therapy and biofeedback training for constipation%生物反馈训练和灌肠治疗便秘的比较研究

    Institute of Scientific and Technical Information of China (English)

    吴青眉; 张爱群; 林婕

    2014-01-01

    Objective To compare the effect of biofeedback training and enema therapy for constipation.Methods All 140 cases of constipation patients were divided randomly into the control group and experimental group with 70 cases in each group.In control group,enema therapy was used for constipation and in the experimental group biofeedback training method was used.The clinical symptoms and psychological assessment were applied to evaluate the efficacy of two methods for constipation patients.Results After treatment,the improvement of clinical symptoms in patients with constipation was 22.9% (16/70)and the total effective rate was 70.0% (49/ 70) in the control group.The total effectiveness of biofeedback training in the experimental group was more than in the control group.The phenomena of depression and anxiety of patients in the experimental group were lower than in the control group.Conclusion Biofeedback training can improve the clinical symptoms of functional constipation patients and the mental health.%目的 比较生物反馈训练与灌肠治疗便秘的疗效.方法 将140例接受便秘治疗的患者完全随机分为灌肠组(70例)和生物反馈组(70例).灌肠组采用灌肠法治疗,生物反馈组采用生物反馈训练治疗法治疗.通过比较患者临床症状和心理评估来评定2种方法对便秘患者的疗效.结果 治疗后,灌肠组患者的临床症状显效率为22.9%(16/70),有效率为47.1%(33/70),总有效率为70.0%(49/70);生物反馈组显效率为37.1% (26/70),有效率为52.9%(37/70),总有效率为90.0% (63/70);生物反馈组的总有效率明显高于灌肠组,差异有统计学意义(P<0.05).生物反馈组患者治疗后的焦虑自评量表和抑郁自评量表分值均较灌肠组治疗后分值低,差异有统计学意义[焦虑自评量表评分:(33±7)分比(40±8)分,抑郁自评量表评分:(45±8)分比(53±9)分,均P<0.01].结论 生物反馈训练在改善功能性便秘患者的临床症状方

  17. Intestinal preparation for colon enema with fosfo-soda fleet versus the conventional method; Preparazione intestinale per clisma del colon mediante fosfo-soda fleet: studio comparativo con il sistema tradizionale

    Energy Technology Data Exchange (ETDEWEB)

    Vecchioli Caldazza, A.; Celi, G.; De Franco, A.; Parrella, A.; Minordi, L.M.; Marano, P. [Rome Univ. Cattolica del Sacro Cuore, Rome (Italy). Ist. di radiologia

    1999-05-01

    The authors evaluate the possible optimization of a well-tolerated and versatile method of intestinal preparation able to adequately free the lumen and consequently improve diagnostic results with a lower risk of prolonged hospital stay for incorrectly prepared patients. They examined 40 patients, namely 20 men and 20 women referred to the Institute of radiology of the 'Sacro Cuore' Catholic University of Rome (Italy), Gastrointestinal tract unit, to undergo double contrast colonic enema. The statistical analysis of all data was performed with Wilcoxon test. Intestinal preparation with fosfo-soda fleet appeared to be definitely better than the conventional method relative to tolerance, while providing similarly satisfactory data relative to the other parameters. [Italian] Lo studio si propone di valutare la possibilita' di ottimizzare una tecnica di preparazione intestinale estremamente tollerabile e versatile che permetta di ottenere l'adeguata liberazione del lume del contenuto con conseguente miglioramento del risultato diagnostico e riduzione del rischio del prolungamento della durata dell'ospedalizzazione dei pazienti non idoneamente preparati. Sono stati valuati 40 pazienti, 20 maschi e 20 femmine, afferenti alla struttura dell'Istituto di radiologia dell'Universita' Cattolica del Sacro Cuore-Unita' apparato gastrointestinale, per essere sottoposti a clisma del colon con doppio mdc. Tutti i dati sono stati valutati statisticamente mediante test di Wilcoxon. La preparazione intestinale effettuata somministrando fosfo-soda fleet si e' dimostrata superiore rispetto a quella tradizionale per la variabile tollerabilita', fornendo contemporaneamente dati sovrapponibili a quelli del sistema tradizionale, soddisfacenti in assoluto, riguardo agli altri parametri esaminati.

  18. A Efficacy Observation on Aluminum Phosphate Gel in Enema Treatment of Ulcerative Colitis%磷酸铝凝胶保留灌肠治疗溃疡性结肠炎的疗效观察

    Institute of Scientific and Technical Information of China (English)

    富翠芹

    2013-01-01

    Objective To boserve the efficacy of Aluminum Phosphate Gel in enema treatment of ulcerative colitis. Mehtod 70 cases of ulcerative colitis from our hospital were randomly divided into two groups to Clinical prospective study, 35 patients treated with aluminum phosphate Gel, Kangfuxin solution, mesalazine slow release tablets;the control group,35 patients were treated by Kangfuxin solution, mesalazine slow release tablets. Result The aluminum phosphate gel for ulcerative cilitis compared with the control group have a better effect, as a worthy treatment.%  目的探讨磷酸铝凝胶保留灌肠治疗溃疡性结肠炎的疗效。方法选择我院2011年5月至2012年5月收治的70例溃疡性结肠炎患者,随机分为实验组(n=35)与对照组(n=35)。实验组用磷酸铝凝胶、康复新液配制的灌肠液保留灌肠并口服美沙拉嗪肠溶片,对照组用康复新液灌肠并口服美沙拉嗪肠溶片。结果磷酸铝凝胶灌肠治疗溃疡性结肠炎效果优于对照组。磷酸铝凝胶治疗溃疡性结肠炎有效。

  19. Cooling and exhumation of continents at billion-year time scales

    Science.gov (United States)

    Blackburn, T.; Bowring, S. A.; Perron, T.; Mahan, K. H.; Dudas, F. O.

    2011-12-01

    The oldest rocks on Earth are preserved within the continental lithosphere, where assembled fragments of ancient orogenic belts have survived erosion and destruction by plate tectonic and surface processes for billions of years. Though the rate of orogenic exhumation and erosion has been measured for segments of an orogenic history, it remains unclear how these exhumation rates have changed over the lifetime of any terrane. Because the exhumation of the lithospheric surface has a direct effect on the rate of heat loss within the lithosphere, a continuous record of lithosphere exhumation can be reconstructed through the use of thermochronology. Thermochronologic studies have typically employed systems sensitive to cooling at temperatures <300 °C, such as the (U-Th)/He and 40Ar/39Ar systems. This largely restricts their application to measuring cooling in rocks from the outer 10 km of the Earth's crust, resulting in a thermal history that is controlled by either upper crustal flexure and faulting and/or isotherm inflections related to surface topography. Combining these biases with the uplift, erosion and recycling of these shallow rocks results in a poor preservation potential of any long-term record. Here, an ancient and long-term record of lithosphere exhumation is constructed using U-Pb thermochronology, a geochronologic system sensitive to cooling at temperatures found at 20-50 km depth (400-650 °C). Lower crustal xenoliths provide material that resided at these depths for billions of years or more, recording a thermal history that is buried deep enough to remain insensitive to upper crustal deformation and instead is dominated by the vertical motions of the continents. We show how this temperature-sensitive system can produce a long-term integrated measure of continental exhumation and erosion. Preserved beneath Phanerozoic sedimentary rocks within Montana, USA, the Great Falls Tectonic Zone formed when two Archean cratons, the Wyoming Province and Medicine

  20. La ri-codificazione corporea nella Commedia dell'Arte di Claudia Contin

    Directory of Open Access Journals (Sweden)

    Riccardo Benfatto

    2010-12-01

    Full Text Available Abstract – IT Questo articolo è il frutto di una tesi di Laurea triennale in Antropologia dello Spettacolo. In particolare viene analizzato il percorso che Claudia Contin e Ferruccio Merisi hanno compiuto per giungere ad una ricodificazione corporea delle Maschere della Commedia dell'Arte. Attraverso lo studio dei documenti disponibili, sia scritti che di tipo iconografico, i due artisti si soffermano dapprima sul personaggio di Arlecchino per poi espandere la ricerca a tutti i restanti Caratteri. Lo scopo è quello di ritrovare la struttura archetipica di ogni personaggio della Commedia dell'Arte, cioè di trasformare ogni atteggiamento psicologico, e quindi soggettivo, in atteggiamento corporeo, più universale. Diventa quindi fondamentale la costruzione di una maschera corporea che possa tradurre in deformazioni fisiche quelle caratteristiche che i personaggi di Commedia dell'Arte si trascinano da secoli. Ciò richiede un enorme lavoro sul corpo dell'attore, il quale deve letteralmente indossare questa maschera corporea prima ancora della maschera di cuoio. Il viaggio nel mondo di Arlecchino si compone di molteplici tappe che arricchiscono ciascuna la qualità del lavoro, così ché si evidenzieranno in alcuni personaggi tratti di codificazioni provenienti da altre culture. Ecco che, per esempio, elementi del Kathakali e delle Tarante del “nostro” Sud possono convivere con sereno conflitto all'interno di uno stesso Carattere. Si tratta di acquisire precisione da chimico affinché si renda possibile la reazione tra sostanze profondamente diverse. Il lavoro più che ventennale dell'attrice friulana ha portato alla costituzione di un linguaggio diverso per ogni Carattere, linguaggio insegnabile, trasmissibile e codificato. In una parola: duraturo. Abstract – EN This article is the result of an undergraduate thesis in Anthropology of the Show. Particularly, it analyzes the path covered by Claudia Contin and Ferruccio Merisi to reach a

  1. Petrology and tectonics of Phanerozoic continent formation: From island arcs to accretion and continental arc magmatism

    Science.gov (United States)

    Lee, C.-T.A.; Morton, D.M.; Kistler, R.W.; Baird, A.K.

    2007-01-01

    Mesozoic continental arcs in the North American Cordillera were examined here to establish a baseline model for Phanerozoic continent formation. We combine new trace-element data on lower crustal xenoliths from the Mesozoic Sierra Nevada Batholith with an extensive grid-based geochemical map of the Peninsular Ranges Batholith, the southern equivalent of the Sierras. Collectively, these observations give a three-dimensional view of the crust, which permits the petrogenesis and tectonics of Phanerozoic crust formation to be linked in space and time. Subduction of the Farallon plate beneath North America during the Triassic to early Cretaceous was characterized by trench retreat and slab rollback because old and cold oceanic lithosphere was being subducted. This generated an extensional subduction zone, which created fringing island arcs just off the Paleozoic continental margin. However, as the age of the Farallon plate at the time of subduction decreased, the extensional environment waned, allowing the fringing island arc to accrete onto the continental margin. With continued subduction, a continental arc was born and a progressively more compressional environment developed as the age of subducting slab continued to young. Refinement into a felsic crust occurred after accretion, that is, during the continental arc stage, wherein a thickened crustal and lithospheric column permitted a longer differentiation column. New basaltic arc magmas underplate and intrude the accreted terrane, suture, and former continental margin. Interaction of these basaltic magmas with pre-existing crust and lithospheric mantle created garnet pyroxenitic mafic cumulates by fractional crystallization at depth as well as gabbroic and garnet pyroxenitic restites at shallower levels by melting of pre-existing lower crust. The complementary felsic plutons formed by these deep-seated differentiation processes rose into the upper crust, stitching together the accreted terrane, suture and former

  2. Genetic Variation of Functional Components in Grains of Improved Barley Lines from Four Continents

    Institute of Scientific and Technical Information of China (English)

    Yawen ZENG; Xiaoying PU; Jing ZHANG; Juan DU; Ganggang GUO; Tao YANG; ChunyanZHAO; Shuming YANG; Dawei ZHAO; Junjie TANG; Ping JIA

    2012-01-01

    [Objective] The study was to analyze functional components in improved barley grains. [Method] Genetic variations of functional components in grains among 629 barley improved lines from four continents were determined with DU640-type ul- traviolet spectrophotometry (BECKMAN). [Result] The contents (mg/100 g) of total flavones and GABA in grains of Asian barley lines (123.09_+29.56, 9.49_+4.34) were significantly higher than that of American barley lines (103.85_22.33, 7.38_+3.59), while no significant difference was observed between Asia/Americas and Europe (115.47_+11.41, 9.66-+3.98) and Australia (104.20-+4.76, 8.83-+3.41); furthermore, there was no significant difference of resistant starch content (%) in barley grains among four continents [Asia (1.63_+1.44), America (1.54_+1.13), Europe (1.20+0.85) and Aus- tralia (0.27_+0.26)]. The contents (%) of resistant starch in grains of two-rowed barley (ssp. Hordeurn distichon Koern., 1.45_+1.20) was significantly lower than that of poly- rowed barley (ssp. Hordeum vulgare Orlov., 1.95_+1.24). On the contrary, the content of total flavones in two-rowed lines (111.43_+27.79 mg/100 g) wa, s significantly higher than that of poly-rowed lines (102.15_+14.95 mg/100 g), and the content of GABA in two-rowed lines (8.55+_3.73 mg/100 g) was also significantly higher than that of poly-rowed lines (5.96_+3.95 mg/100 g). There was the most significant correlation between GABA content and resistant starch (-0.21)/total flavones content (0.12 , P〈0.01, n=-629). There were great genotype differences among the functional compo- nents in barley grains. The coefficient of variation (78.60%) and range (0-9.29%) of resistant starch (1.56_+1.22%) were relatively large, including 11 high-resistant starch lines above 5%; the coefficient of variation (49.00%) and range (0-30.67 mg/100g) of GABA (8.00-

  3. Present-day groundwater recharge estimation in parts of the Indian Sub-Continent

    Science.gov (United States)

    Bhanja, S. N.; Mukherjee, A.; Wada, Y.; Scanlon, B. R.; Taylor, R. G.; Rodell, M.; Malakar, P.

    2015-12-01

    Large part of global population has been dependent on groundwater as a source of fresh water. The demand would further increase with increasing population and stress associated with climate change. We tried to provide regional-scale groundwater recharge estimates in a large part of Indian Sub-Continent. A combination of ground-based, satellite-based and numerical model simulated recharge estimates were presented in the densely populated region. Three different methods: an intense network of observational wells (n>13,000 wells), a satellite (TRMM) and global land-surface model (CLM) outputs, and a global-scale hydrological model (PCR GLOBWB) were employed to calculate recharge estimates. Groundwater recharge values exhibit large spatial variations over the entire region on the basis of aquifer hydrogeology, precipitation and groundwater withdrawal patterns. Groundwater recharge estimates from all three estimation techniques were found to be higher (>300 mm/year) in fertile planes of Indus-Ganges-Brahmaputra (IGB) river basins. A combination of favorable hydrogeologic conditions (porosity, permeability etc.), comparatively higher rates of precipitation, and return flow from rapidly withdrawn irrigation water might influence occurrence of high recharge rates. However, central and southern study area experiences lower recharge rates (recharge estimates show good matches in some of the areas. Recharge estimates indicate dynamic nature of groundwater recharge as a function of precipitation, land use pattern, and hydrogeologic parameters. On a first hand basis, the estimates will help policy makers to understand groundwater recharge process over the densely populated region and finally would facilitate to implement sustainable policy for securing water security.

  4. Continent-arc collision in the Banda Arc imaged by ambient noise tomography

    Science.gov (United States)

    Porritt, Robert W.; Miller, Meghan S.; O'Driscoll, Leland J.; Harris, Cooper W.; Roosmawati, Nova; Teofilo da Costa, Luis

    2016-09-01

    The tectonic configuration of the Banda region in southeast Asia captures the spatial transition from subduction of Indian Ocean lithosphere to subduction and collision of the Australian continental lithosphere beneath the Banda Arc. An ongoing broadband seismic deployment funded by NSF is aimed at better understanding the mantle and lithospheric structure in the region and the relationship of the arc-continent collision to orogenesis. Here, we present results from ambient noise tomography in the region utilizing this temporary deployment of 30 broadband instruments and 39 permanent stations in Indonesia, Timor Leste, and Australia. We measure dispersion curves for over 21,000 inter-station paths resulting in good recovery of the velocity structure of the crust and upper mantle beneath the Savu Sea, Timor Leste, and the Nusa Tenggara Timur (NTT) region of Indonesia. The resulting three dimensional model indicates up to ∼25% variation in shear velocity throughout the plate boundary region; first-order velocity anomalies are associated with the subducting oceanic lithosphere, subducted Australian continental lithosphere, obducted oceanic sediments forming the core of the island of Timor, and high velocity anomalies in the Savu Sea and Sumba. The structure in Sumba and the Savu Sea is consistent with an uplifting forearc sliver. Beneath the island of Timor, we confirm earlier inferences of pervasive crustal duplexing from surface mapping, and establish a link to underlying structural features in the lowermost crust and uppermost mantle that drive upper crustal shortening. Finally, our images of the volcanic arc under Flores, Wetar, and Alor show high velocity structures of the Banda Terrane, but also a clear low velocity anomaly at the transition between subduction of oceanic and continental lithosphere. Given that the footprint of the Banda Terrane has previously been poorly defined, this model provides important constraints on tectonic reconstructions that

  5. Prevalence, Treatment, and Control Rates of Conventional and Ambulatory Hypertension Across 10 Populations in 3 Continents.

    Science.gov (United States)

    Melgarejo, Jesus D; Maestre, Gladys E; Thijs, Lutgarde; Asayama, Kei; Boggia, José; Casiglia, Edoardo; Hansen, Tine W; Imai, Yutaka; Jacobs, Lotte; Jeppesen, Jørgen; Kawecka-Jaszcz, Kalina; Kuznetsova, Tatiana; Li, Yan; Malyutina, Sofia; Nikitin, Yuri; Ohkubo, Takayoshi; Stolarz-Skrzypek, Katarzyna; Wang, Ji-Guang; Staessen, Jan A

    2017-07-01

    Hypertension is a major global health problem, but prevalence rates vary widely among regions. To determine prevalence, treatment, and control rates of hypertension, we measured conventional blood pressure (BP) and 24-hour ambulatory BP in 6546 subjects, aged 40 to 79 years, recruited from 10 community-dwelling cohorts on 3 continents. We determined how between-cohort differences in risk factors and socioeconomic factors influence hypertension rates. The overall prevalence was 49.3% (range between cohorts, 40.0%-86.8%) for conventional hypertension (conventional BP ≥140/90 mm Hg) and 48.7% (35.2%-66.5%) for ambulatory hypertension (ambulatory BP ≥130/80 mm Hg). Treatment and control rates for conventional hypertension were 48.0% (33.5%-74.1%) and 38.6% (10.1%-55.3%) respectively. The corresponding rates for ambulatory hypertension were 48.6% (30.5%-71.9%) and 45.6% (18.6%-64.2%). Among 1677 untreated subjects with conventional hypertension, 35.7% had white coat hypertension (23.5%-56.2%). Masked hypertension (conventional BP hypertension rates. Higher social and economic development, measured by the Human Development Index, was associated with lower rates of conventional and ambulatory hypertension. In conclusion, high rates of hypertension in all cohorts examined demonstrate the need for improvements in prevention, treatment, and control. Strategies for the management of hypertension should continue to not only focus on preventable and modifiable risk factors but also consider societal issues. © 2017 American Heart Association, Inc.

  6. Precipitation over urban areas in the western Maritime Continent using a convection-permitting model

    Science.gov (United States)

    Argüeso, Daniel; Di Luca, Alejandro; Evans, Jason P.

    2016-08-01

    This study investigates the effects of urban areas on precipitation in the western Maritime Continent using a convection-permitting regional atmospheric model. The Weather Research and Forecasting model was used to simulate the atmosphere at a range of spatial resolutions using a multiple nesting approach. Two experiments (with and without urban areas) were completed over a 5-year period (2008-2012) each to estimate the contribution of cities to changes in local circulation. At first, the model is evaluated against two satellite-derived precipitation products and the benefit of using a very high-resolution model (2-km grid spacing) over a region where rainfall is dominated by convective processes is demonstrated, particularly in terms of its diurnal cycle phase and amplitude. The influence of cities on precipitation characteristics is quantified for two major urban nuclei in the region (Jakarta and Kuala Lumpur) and results indicate that their presence locally enhances precipitation by over 30 %. This increase is mainly due to an intensification of the diurnal cycle. We analyse the impact on temperature, humidity and wind to put forward physical mechanisms that explain such changes. Cities increase near surface temperature, generating instability. They also make land-sea temperature contrasts stronger, which enhances sea breeze circulations. Together, they increase near-surface moisture flux convergence and favour convective processes leading to an overall increase of precipitation over urban areas. The diurnal cycle of these effects is reflected in the atmospheric footprint of cities on variables such as humidity and cloud mixing ratio and accompanies changes in precipitation.

  7. Resolution dependence of the simulated precipitation and diurnal cycle over the Maritime Continent

    Science.gov (United States)

    Li, Yue; Jourdain, Nicolas C.; Taschetto, Andréa S.; Gupta, Alex Sen; Argüeso, Daniel; Masson, Sébastien; Cai, Wenju

    2016-08-01

    The Maritime Continent is a region of intense rainfall characterised by a strong diurnal cycle. This study investigates the sensitivity of rainfall characteristics to resolution in a coupled regional climate model configuration, in particular focusing on processes that modulate the diurnal cycle. Model biases are resolution dependent. Increasing resolution from 3/4° to 1/4° improves the mean state sea surface temperature and precipitation biases. However, at higher resolutions (1/12°) rainfall becomes too strong in most areas. Daily maximum rainfall is simulated about 2-4 h earlier than in observations over both the land and the ocean, with only small improvements over high topography at higher resolution. We develop a technique to examine cross-coastal processes associated with the rainfall diurnal cycle along all coastlines. This is used to investigate the sensitivity of the diurnal cycle to resolution and to the direction of the prevailing wind. During offshore prevailing winds, most land rainfall is confined near the coastline and associated with a shallow land-sea breeze circulation at all resolution (though rainfall partly develops directly inland at 1/12°). During onshore prevailing winds, rainfall propagates from the coastline to the island interior at 1/4° and 1/12°, whereas it appears directly over the island interior at 3/4°, and this is associated with a deep convective cell across the coastline for all resolutions. Oceanic rainfall propagates far offshore during offshore prevailing winds at all resolutions, whereas it tends to remain confined near the coastline under onshore prevailing winds condition, particularly at higher resolution.

  8. Bacteria Community in the Terrestrial Deep Subsurface Microbiology Research of the Chinese Continent Scientific Drilling

    Science.gov (United States)

    Wang, Y.; Xia, Y.; Dong, H.; Dong, X.; Yang, K.; Dong, Z.; Huang, L.

    2005-12-01

    Microbial communities in the deep drill cores from the Chinese Continent Scientific Drilling were analyzed with culture-independent and dependent techniques. Genomic DNA was extracted from two metamorphic rocks: S1 from 430 and S13 from 1033 meters below the ground surface. The 16S rRNA gene was amplified by polymerase chain reaction (PCR) followed by cloning and sequencing. The total cell number was counted using the 4',6-diamidino-2-phenylindole (DAPI) staining and biomass of two specific bacteria were quantified using real-time PCR. Enrichment was set up for a rock from 3911 meters below the surface in medium for authotrophic methanogens (i.e., CO2 + H2). The total cell number in S13 was 1.0 × 104 cells per gram of rock. 16S rRNA gene analysis indicated that low G + C Gram positive sequences were dominant (50 percent of all 54 clone sequenced) followed by the alpha-, beta, and gamma-Proteobacteria. Within the low G + C Gram positive bacteria, most clone sequences were similar to species of Bacillus from various natural environments (deserts, rivers etc.). Within the Proteobacteria, our clone sequences were similar to species of Acinetobacter, Acidovorax, and Aeromonas. The RT-RCP results showed that biomass of two particular clone sequences (CCSD1305, similar to Aeromonas caviae and CCSD1307, similar to Acidovorax facilis) was 95 and 1258 cells/g, respectively. A bacterial isolate was obtained from the 3911-m rock in methanogenic medium. It was Gram negative with no flagella, immobile, and facultative anaerobic, and grows optimally at 65oC. Phylogenetic analysis indicated that it was closely related to the genus of Bacillus. Physiological tests further revealed that it was a strain of Bacillus caldotenax.

  9. Dealing with the other between the ethical and the moral: albinism on the African continent.

    Science.gov (United States)

    Imafidon, Elvis

    2017-04-01

    Albinism is a global public health issue but it assumes a peculiar nature in the African continent due, in part, to the social stigma faced by persons with albinism (PWAs) in Africa. I argue that there are two essential reasons for this precarious situation. First, in the African consciousness, albinism is an alterity or otherness. The PWA in Africa is not merely a physical other but also an ontological other in the African community of beings, which provides a hermeneutic for the stigmatising separateness or difference of the PWA. The second reason hinges on a distinction drawn by Jürgen Habermas between the ethical point of view and the moral point of view. While the former consists of the ethos, customs, or idea of the good shared by a group of persons with a shared tradition or way of life, the latter consists of what is good for all and transcends particular traditions or ways of life. Consequently, the African ethical point of view, the ethics of solidarity, justifies within the African worldview the established alterity and, by implication, stigmatization of PWAs. On this view, actions that promote harmony and prevent discord and disequilibrium among accepted beings in the African community are permissible. I further show that unless there is a change in the physical and ontological conception of PWAs and a leap from the ethical point of view to the moral point of view, the negative attitudes toward PWAs will not change. The leap to the moral point of view does not suggest an abandonment of the ethical point of view but only recommends that the two meet halfway in respect for universally accepted norms of human actions. To achieve this, I will show that much needs to be done in the areas of policy formulation, law, health care services, and education.

  10. Impact of Ocean-Continent Distribution over Southern Asia on the Formation of Summer Monsoon

    Institute of Scientific and Technical Information of China (English)

    JIN Qihua; HE Jinhai; CHEN Longxun; ZHU Congwen

    2006-01-01

    Using the CCM3/NCAR, a series of numerical experiments are designed to explore the effect of ocean-land interlaced distributions of Africa-Arabian Sea-India Peninsula-Bay of Bengal (BOB)-Indo-China PeninsulaSouth China Sea on the formation of the Asian summer monsoon circulation (ASMC). The results show that the thermal difference between African or Indian Subcontinent and nearby areas including the Indian Ocean,Arabian Sea, and part of BOB is the primary mechanism that maintains the Indian monsoon circulation.In the experiment getting rid of these two continents, the Indian monsoon system (IMS) members, i.e., the Somali cross-equatorial jet (40°E) and the southwesterly monsoon over the Arabian Sea and BOB, almost disappear. Moreover, the Hadley circulation weakens dominantly. It also proves that Africa has greater effect than Indian Subcontinent on the IMS.However, the existence of Indo-China Peninsula and Australia strengthens the East Asian monsoon system (EAMS). The thermal contrast between Indo-China Peninsula and SCS, Australia and western Pacific Ocean plays an important role in the formation of the tropical monsoon to the south of the EAMS. When the Indo-China Peninsula is masked in the experiment, the cross-equatorial flow (105°E and 125°E) vanishes,so does the southwesterly monsoon usually found over East Asia, and EAMS is enfeebled significantly. In addition, the impacts of these thermal contrasts on the distribution of the summer precipitation and surface temperature are investigated.

  11. Relating Precipitation Phenomena with MODIS Detected Hot Spots in the Maritime Continent

    Science.gov (United States)

    Ramirez, E. M.; Reid, J. S.; Xian, P.; Hyer, E.; Turk, J.; Flatau, M.; Zhang, C.

    2009-12-01

    Recent studies of land use practices in SE Asia’s Maritime Continent (MC) have raised questions over potential meteorological implications including smoke-cloud interaction and changes in the regional radiation budget. Land management practices on Java, Sumatra, Sulawesi, Borneo, and the Malay Peninsula include biomass burning to clear primary forest as well as to maintain oil palm plantations. Burning is also employed for clearing unwanted remains from previous crops, rice stubble for example. However, burning activity is often dictated by weather, in particular precipitation. We studied 5 years of MODIS active fire hot spot and satellite precipitation data to investigate how observed burning activity correlated with precipitation features at four major scales: 1) Intraseasonal El Nino-Southern Oscillation (ENSO) and Indian Ocean Dipole (IOP); 2) Seasonal migration of the Intertropical Convergence Zone (ITCZ); 3) the 30-90 day Madden Julian Oscillation (MJO); and 4) regional convection from localized weather phenomenon (e.g., orographic, isolated thermal convection, sea breeze, etc…). It was found that observed burn patterns from each of the islands of the MC had differing responses to these four forcings. Observed burning activity on the islands of Borneo and Sulawesi correlated strongly with the ENSO and ITCZ indicies, whereas Sumatra was more influenced by the phase and strength of the MJO. Java, showing a mix of influence, exhibited strong fire activity in the morning rather than afternoon which is unusual for most burning regions. We hypothesize that these observed relationships reflect both physical land use differences and contextual bias/observability issues associated with the region’s heavy cloud cover. For further studies on smoke-meteorology interaction, our findings point to the need for a clear understanding of the meteorological context of satellite observations.

  12. Emerging rabbit haemorrhagic disease virus 2 (RHDV2) at the gates of the African continent.

    Science.gov (United States)

    Martin-Alonso, Aarón; Martin-Carrillo, Natalia; Garcia-Livia, Katherine; Valladares, Basilio; Foronda, Pilar

    2016-10-01

    Until the beginning of this decade, the genetic characterization of rabbit haemorrhagic disease virus (RHDV) from Iberian Peninsula had revealed the existence of two genogroups, G1 and sporadically G6. In 2010, the new emerging rabbit haemorrhagic disease variant, RHDV2 or RHDVb, was described in France, from where it has rapidly spread throughout Europe, including Iberian Peninsula countries. Nevertheless, although cases of rabbit haemorrhagic disease (RHD) have been reported in the Canary Islands, a Spanish archipelago located 100km off the coast of Morocco, no genetic characterization of RHDV had been carried out. Consequently, in order to identify the circulating RHDV strains in this archipelago, liver samples of six farm rabbits and fifteen wild rabbits were collected from several areas of the largest island, Tenerife, and analyzed for the presence of RHDV by antigen capture double antibody sandwich ELISA. In case of positive ELISA result, we amplified and sequenced two fragments of the vp60 gene, which were concatenated for phylogenetic purposes. The sequences analysis revealed the presence of RHDV2 in both farm and wild rabbits from several areas of Tenerife. This result constitutes the first finding of RHDV2 in the Canary Islands. These RHDV2 strains found in Tenerife shared two exclusive SNPs that have not been observed in the rest of RHDV2 strains. The identification of RHDV2 and the absence of classic RHDV strains in this study suggest that RHDV2 may be replacing classic strains in Tenerife, as has been also proposed in Iberian Peninsula, France and Azores. Given the proximity of the Canary Islands to the African continent, this result should raise awareness about a possible dispersal of RHDV2 from the Canary Islands to the North of Africa.

  13. Crustal recycling at active convergent margins and growth of the continents

    Energy Technology Data Exchange (ETDEWEB)

    Morris, J. (Washington Univ., St. Louis, MO (United States). Dept. of Earth and Planetary Sciences Carnegie Institution of Washington, DC (United States)); Zheng, S.H. (Univ. of California, Irvine, CA (United States). Dept. of Geological Sciences)

    1993-03-01

    Subduction of continental materials at active convergent margins provides an opportunity to evaluate mechanisms and magnitude of subduction-driven crustal recycling and its potential role in continental growth. Continental materials, in the form of detrital sediments and elements adsorbed out of seawater onto settling sediment particles, are continuously supplied to subduction trenches. The sediments may be accreted and re-attached to the continental crust through collisional processes subducted to depth and subsequently involved in arc magma generation (magmatic recycling) or subducted past the arc into the deep mantle. Cosmogenic 10Be, which is strongly adsorbed onto settling sediment particles, may be used to investigate all aspects of sediment recycling. Because of its atmospheric source and short half-life, the high 10Be concentrations observed in many volcanic arc magmas require that the uppermost part of the sediment column be subducted to depth and some part of it returned to the surface in arc magmas within the measurable 10Be lifetime, effectively a few million years. In the Aleutians, Middle America and Marianas, 10Be is present only in the upper 12m, 100m and 25m, respectively of the subducting oceanic sediment column. Using von Huene and Scholl's 1991 estimate of oceanic sediment supply to trenches, the authors evidence for sediment bypassing of accretionary margins, and the limited recycling of most major elements in arc volcanism, estimates of sediment subduction are nearly equal to those required in a steady-state, recycling model for growth of the continents through time.

  14. Big Data and Ecological Forecasting: Integrating NEON Observational and Sensor Data from Reach to Continent

    Science.gov (United States)

    Vance, J. M.; Goodman, K. J.; Lunch, C. K.; Fitzgerald, M.

    2015-12-01

    The ability to forecast the response of varied ecosystems to changes in climate and land use will be crucial for the management of resources and ecosystem services. Ecological forecasting presents many significant challenges within each of the aspects of data capture, assimilation, and modeling. High space-time resolution sampling is required to address the challenges of scaling from the site level to the continent. Determining the uncertainty of data used for model input and parameterization is critical for constraining the model for accurate representation. The National Ecological Observatory Network (NEON) is poised to greatly expand the scale and availability of biogeochemical and aquatic ecological data. NEON is a continental-scale facility designed to collect and disseminate data that addresses the impacts of climate change, land-use, and invasive species on ecosystem structure and function. Using a combination of standardized observational sampling and sensor measurements, NEON will provide a rich source of biogeochemical and biophysical data from 34 aquatic and 47 terrestrial sites spatially distributed across the US, including Alaska, Hawaii and Puerto Rico for 30 years. Sites were selected to be representative of major ecosystems and maximize scalability. In addition to standardizing measurements, NEON is determining the quantitative uncertainty of each data product making them well suited to constrain models. NEON aquatic data will not only serve to baseline aquatic ecology in major ecosystems but also presents opportunities to bolster Hydrologic Models as well as incorporate aquatic biogeochemical cycling into Land Surface Models. Here we present examples of published and provisional data currently available from deployed aquatic sites, as well as an overview of the full scope and release schedule of the open source ecological data to be published on the NEON web portal. Several use cases, such as whole stream metabolism, groundwater exchange, high

  15. Rayleigh Wave Tomography of Mid-Continent Rift (MCR) using Earthquake and Ambient Noise Data

    Science.gov (United States)

    Aleqabi, G. I.; Wiens, D.; Wysession, M. E.; Shen, W.; van der Lee, S.; Revenaugh, J.; Frederiksen, A. W.; Darbyshire, F. A.; Stein, S. A.; Jurdy, D. M.; Wolin, E.; Bollmann, T. A.

    2015-12-01

    The structure of the North American Mid-Continent Rift Zone (MCRZ) is examined using Rayleigh waves from teleseismic earthquakes and ambient seismic noise recorded by the Superior Province Rifting EarthScope Experiment (SPREE). Eighty-four broadband seismometers were deployed during 2011-2013 in Minnesota and Wisconsin, USA, and Ontario, CA, along three lines; two across the rift axis and the third along the rift axis. These stations, together with the EarthScope Transportable Array, provided excellent coverage of the MCRZ. The 1.1 Ga Mesoproterozoic failed rift consists of two arms, buried under post-rifting sedimentary formations that meet at Lake Superior. We compare two array-based tomography methods using teleseismic fundamental mode Rayleigh waves phase and amplitude measurements: the two-plane wave method (TPWM, Forsyth, 1998) and the automated surface wave phase velocity measuring system (ASWMS, Jin and Gaherty, 2015). Both array methods and the ambient noise method give relatively similar results showing low velocity zones extending along the MCRZ arms. The teleseismic Rayleigh wave results from 18 - 180 s period are combined with short period phase velocity results (period 8-30 s) obtained from ambient noise by cross correlation. Phase velocities from the methods are very similar at periods of 18-30 where results overlap; in this period range we use the average of the noise and teleseismic results. Finally the combined phase velocity curve is inverted using a Monte-Carlo inversion method at each geographic point in the model. The results show low velocities at shallow depths (5-10 km) that are the result of very deep sedimentary fill within the MCRZ. Deeper-seated low velocity regions may correspond to mafic underplating of the rift zone.

  16. Decreased diversion by doctor-shopping for a reformulated extended release oxycodone product (OxyContin).

    Science.gov (United States)

    Chilcoat, Howard D; Coplan, Paul M; Harikrishnan, Venkatesh; Alexander, Louis

    2016-08-01

    Doctor-shopping (obtaining prescriptions from multiple prescribers/pharmacies) for opioid analgesics produces a supply for diversion and abuse, and represents a major public health issue. An open cohort study assessed changes in doctor-shopping in the U.S. for a brand extended release (ER) oxycodone product (OxyContin) and comparator opioids before (July, 2009 to June, 2010) versus after (January, 2011 to June, 2013) introduction of reformulated brand ER oxycodone with abuse-deterrent properties, using IMS LRx longitudinal data covering >150 million patients and 65% of retail U.S. prescriptions. After its reformulation, the rate of doctor-shopping decreased 50% (for 2+ prescribers/3+ pharmacies) for brand ER oxycodone, but not for comparators. The largest decreases in rates occurred among young adults (73%), those paying with cash (61%) and those receiving the highest available dose (62%), with a 90% decrease when stratifying by all three characteristics. The magnitude of doctor-shopping reductions increased with increasing number of prescribers/pharmacies (e.g., 75% reduction for ≥2 prescribers/≥4 pharmacies). The rate of doctor-shopping for brand ER oxycodone decreased substantially after its reformulation, which did not occur for other prescription opioids. The largest reductions in doctor-shopping occurred with characteristics associated with higher abuse risk such as youth, cash payment and high dose, and with more specific thresholds of doctor-shopping. A higher prescriber and/or pharmacy threshold also increased the magnitude of the decrease, suggesting that it better captured the effect of the reformulation on actual doctor-shoppers. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.