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Sample records for arrest refractory retroperitoneal

  1. Use of the novel hemostatic textile Stasilon® to arrest refractory retroperitoneal hemorrhage: a case report

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    Jones Samuel W

    2010-01-01

    Full Text Available Abstract Introduction Stasilon® is a novel hemostatic woven textile composed of allergen-free fibers of continuous filament fiberglass and bamboo yarn. The development of this product resulted from controlled in vitro thrombogenic analysis of an array of potentially hemostatic textile materials and it has been cleared for both external and internal use by the United States Food and Drug Administration for the arrest of hemorrhage. The goal of the study was to assess the hemostatic and adhesive properties of Stasilon® in the setting of life-threatening refractory hemorrhage. Case presentation A 39-year-old Caucasian man presented with severe necrotic pancreatitis that failed multiple aggressive attempts to control associated bleeding with electrocautery, suture ligation, and sequential anatomic packing with cotton-based sponges. Subsequent retroperitoneal packing with Stasilon® produced a non-adherent wound-dressing interface and resulted in the achievement of persistent hemostasis in the operative field. Conclusion In our patient, Stasilon® was demonstrated to be effective in the arrest of refractory hemorrhage.

  2. Retroperitoneal inflammation

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    ... page: //medlineplus.gov/ency/article/001255.htm Retroperitoneal inflammation To use the sharing features on this page, please enable JavaScript. Retroperitoneal inflammation is swelling that occurs in the retroperitoneal space. ...

  3. Fibrosis retroperitoneal

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    Claudio Orlich-Castelán

    2005-07-01

    Full Text Available Se reporta el caso de una mujer de 61 años de edad, con antecedente de tuberculosis pélvica en la adolescencia, que se presentó con insuficiencia renal aguda y dolor lumbar y a quien se le diagnosticó fibrosis retroperitoneal. Se revisa la bibliografía reciente y los principales aspectos de esta enfermedadRetroperitoneal fibrosis. is an uncommon disease complicated by ureteral entrapment causing hydronephrosis and obstructive renal failure. We herein report a case recently diagnosed at our institution and review the literature on this topic

  4. Retroperitoneal Sarcomas.

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    Porpiglia, Andrea S; Reddy, Sanjay S; Farma, Jeffrey M

    2016-10-01

    Retroperitoneal sarcomas are rare tumors, representing only 15% of all sarcomas. The mainstay of therapy is surgical resection with negative margins. However, this is challenging because of the late presentation of many of these tumors and involvement with adjacent structures. Decisions on radiation therapy and chemotherapy should be made in a multidisciplinary setting at a tertiary referral center.

  5. Fibrosis retroperitoneal

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    Claudio Orlich-Castelán

    2005-07-01

    Full Text Available Se reporta el caso de una mujer de 61 años de edad, con antecedente de tuberculosis pélvica en la adolescencia, que se presentó con insuficiencia renal aguda y dolor lumbar y a quien se le diagnosticó fibrosis retroperitoneal. Se revisa la bibliografía reciente y los principales aspectos de esta enfermedad

  6. [Retroperitoneal fibrosis].

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    Babski, Paweł; Wojtuń, Stanisław; Gil, Jerzy

    2007-05-01

    Retroperitoneal fibrosis is a rare clinical entity characterised by the presence of patologic collagen tissue in a retroperitoneal space. The fibrous mass covers abdominal organs causing their disfunctions. RPF was described at the begining of XX century but its etiology is not clear yet. Usually it causes an ureter obstuction and hydronephrosis, that is why most commonly is diagnosed by urologists and nephrologists. However, retroperitoneal fibrosis can be multifacial disease. In some patients localisation of fibrosis is atypical and manifestationns can be varied. Gastrological symptoms like jaundice, bowel obstuction, ascites can occure. Besides, some early signs of RPF are nonspecific and can imitate alarming symptoms of neoplasma, e.g.: weight loss, anemia, malaise, anorexia, fever. This force us to initiate gastrological investigation. The awareness of this disease is important. The early diagnosis and treatment improves prognosis and alows to avoid heavy complications. In typical cases radiology is often enough for diagnosis. However, histological examination is needed in many cases, especialy when patological mass is located atypical. A treatment is made up of farmacology and surgery. The first one is based on steroids, immunossuppressant and tamoxifen. Surgery is needed to eliminate organs obstruction.

  7. 腹膜后腹腔镜治疗难治性输尿管结石45例分析%Retroperitoneal laparoscopy in the treatment of 45 cases with refractory ureteral calculi

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    廖祥钧

    2015-01-01

    Objective To explore the clinical efficacy of retroperitoneal laparoscopy in the treatment of refractory for ureteral stones.Methods From January 2010 to January 2015,the clinical data of 45 patients with refractory ureteral stones were retrospectively analyzed.The manner,duration of surgery,complications and length of stay and other indicators were summarized,and the treatment effect was evaluated.Results 45 patients were success-fully operated,of which 38 patients taken simple lithotomy,7 cases received simultaneous resection and anastomosis of ureter stenosis,the surgery time was 35 -135 minutes,5 -15 days in the hospital after surgery.Postoperative compli-cations:urinary fistula in 3 cases and 2 cases of wound infection was curable with appropriate treatment.Postoperative follow -up 3 -24 months,3 cases of recurrent calculus,2 patients with mild stenosis of ureter.Conclusion The retroperitoneal laparoscopy in treatment of refractory ureteral calculi trauma has quicker recovery and fewer complica-tions,which is currently the preferred method for treatment of refractory for ureteral calculi.%目的:探讨腹膜后腹腔镜治疗难治性输尿管结石的临床疗效。方法回顾性分析2010年1月至2015年1月收治的45例难治性管结石输尿患者的临床资料,总结手术方式、手术时间、并发症及住院时间等指标,评价治疗效果。结果45例患者均顺利完成手术,其中38例采取单纯切开取石术,7例同时行狭窄段输尿管切除吻合术,手术时间35~135 min,术后住院时间5~15 d。术后并发症:3例发生尿瘘,2例发生切口感染,均通过相应治疗后治愈。术后随访3~24个月,3例结石复发,2例并发输尿管轻度狭窄。结论腹膜后腹腔镜治疗难治性输尿管结石创伤小,恢复快,并发症少,是目前治疗难治性输尿管结石的首选方法。

  8. [Giant retroperitoneal liposarcoma].

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    Mezzour, Mohamed Hicham; El Messaoudi, Yasser Arafat; Fekak, Hamid; Rabii, Redouane; Marnissi, Farida; Karkouri, Mehdi; Salam, Siham; Iraki, Moulay Ahmed; Joual, Abdenbi; Meziane, Fathi

    2006-02-01

    The authors report a case of giant retroperitoneal liposarcoma. The diagnosis was suspected after scanography and magnetic resonance imaging and confirmed by the histological analysis of the extracted piece after surgical treatment. Postoperative evolution was favourable after one year without recurrence or distant metastasis. The authors discuss the pathologic and therapeutic aspects and the prognosis of retroperitoneal liposarcoma.

  9. Calcified retroperitoneal fibroma.

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    Illuminati, G; Bertagni, A; Montesano, G; Soda, G; Baiocchini, A; Melis, M; Vietri, F

    1997-01-01

    A case of 31-year-old male with a retroperitoneal tumor is described. Abdominal ultrasound revealed a left para-aortic calcific mass, adjacent to the left lobe of the liver and to the upper pole of the left kidney. A CT-scan of the abdomen showed the mass to originate from the left adrenal gland. At operation, a large, retroperitoneal mass, adherent to the left kidney and the spleen, but not infiltrating, was excised. Histologically the tumor was diagnosed as a calcified osteo-producing fibroma. Benign retroperitoneal tumors represent about 25% of all retroperitoneal neoplasm. This reported case represents a retroperitoneal tumor of slow growth and benign clinical course whose characteristic consists of the heavy calcifications which are normally absent in a fibroma type mass.

  10. Novel approach for independent control of brain hypothermia and systemic normothermia: cerebral selective deep hypothermia for refractory cardiac arrest

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    Wang, Chih-Hsien; Lin, Yu-Ting; Chou, Heng-Wen; Wang, Yi-Chih; Hwang, Joey-Jen; Gilbert, John R; Chen, Yih-Sharng

    2017-01-01

    A 38-year-old man was found unconscious, alone in the driver's seat of his car. The emergency medical team identified his condition as pulseless ventricular tachycardia. Defibrillation was attempted but failed. Extracorporeal membrane oxygenation (ECMO) was started in the emergency room 52 min after the estimated arrest following the extracorporeal cardiopulmonary resuscitation (ECPR) protocol in our center. The initial prognosis under the standard protocol was ECMO and CSDH circuits demonstrated independent control of cerebral and core temperatures. Nasal temperature was lowered to below 30°C for 12 hours while core was maintained at normothermia. The patient was discharged without significant neurological deficit 32 days after the initial arrest. PMID:28108436

  11. Idiopathic Retroperitoneal Hematoma

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    Tomoyuki Abe

    2010-09-01

    Full Text Available A 34-year-old female presented with sudden onset of severe abdominal pain in a flank distribution. A large mass was palpable in the right upper quadrant on physical examination. Abdominal contrast-enhanced computed tomography showed a well-defined, right-sided, retroperitoneal cystic lesion located between the abdominal aorta and the inferior vena cava (IVC. The tumor size was 55 × 58 mm, and it compressed the gallbladder and the duodenum. Upper gastrointestinal radiography revealed a stricture of the second portion of the duodenum by the tumor. T2-weighted magnetic resonance imaging showed that the whole part was hyperintense with hypointense rims, but the inner was partially hypointense. Based on the radiological findings, the preoperative differential diagnosis included retroperitoneal teratoma, Schwannoma, abscess, and primary retroperitoneal tumor. On laparotomy, the tumor was located in the right retroperitoneal cavity. Kocher maneuver and medial visceral rotation, which consists of medial reflection of the upper part of right colon and duodenum by incising their lateral peritoneal attachments, were performed. Although a slight adhesion to the IVC was detected, the tumor was removed safely. Thin-section histopathology examination detected neither tumor tissues nor any tissues such as adrenal gland, ovarian tissue, or endometrial implants. The final pathological diagnosis was idiopathic retroperitoneal hematoma; the origin of the bleeding was unclear. The patient was discharged without any complication 5 days after the operation.

  12. Retroperitoneal inflammatory myofibroblastic tumor

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    Bapsy Poonamalle P

    2005-10-01

    Full Text Available Abstract Background Inflammatory myofibroblastic tumor (IMT is a neoplasm of unknown etiology occurring at various sites. By definition, it is composed of spindle cells (myofibroblasts with variable inflammatory component, hence the name is IMT. Case presentation The present case is of a 46 years old woman presented with a history of flank pain, abdominal mass and intermittent hematuria for last 6 months. The initial diagnosis was kept as renal cell carcinoma. Finally, it turned out to be a case of retroperitoneal IMT. The patient was managed by complete surgical resection of the tumor. Conclusion IMT is a rare neoplasm of uncertain biological potential. Complete surgical resection remains the mainstay of the treatment.

  13. Retroperitoneal Cystic Lymphangioma

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    Ş.Sevil Altunrende

    2010-03-01

    Full Text Available Abdominal cystic lymphangioma is a rare, benign, congenital tumor. It is an developmental abnormality of the lymphatic system. Males are relatively more affected and 90% of the cases are under 5 years of age. Multilocular cystic lesion with septations is seen on abdominal ultrasonography. As echogenicity can vary depending on the content of the cyst like cellular debris, hemorrhage or chylous, liquid-liquid or fat-liquid levels can be observed. Definitive treatment is total excision. Cyst aspiration is not an effective method and nearly always ends with recurrence. Computerized tomography and magnetic resonance imaging findings of sonographically detected retroperitoneal cystic lymphangioma in a newborn girl with abdominal distention are discussed in this paper. (The Medical Bulletin of Haseki 2010; 48: 47-9

  14. [Laparoscopic treatment of retroperitoneal fibrosis].

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    Joual, Abdenbi; Rabii, Redouane; El Mejjad, Amine; Fekak, Hamid; Debbagh, Adil; El Mrini, Mohamed

    2004-04-01

    The authors report a case of idiopathic retroperitoneal fibrosis (RPF) in a 38-year-old man presenting with obstructive acute renal failure. The initial management consisted of urinary diversion by bilateral double-J ureteric stenting. After restoration of normal renal function, CT urography demonstrated retroperitoneal fibrosis surrounding the two ureters. Surgical treatment was performed by laparoscopy using four trocars. The operation consisted of detachment of the ascending and descending colon followed by release of the ureters from the lumbar segment to the pelvic segment and finally intraperitonealization of the ureters. The operating time was six hours, the postoperative course was uneventful and the double-J stents were removed at the third week. Laparoscopic treatment of RPF is a treatment option providing all of the benefits of minimally invasive surgery. In the light of this case and a review of the literature, the authors describe the laparoscopic treatment of idiopathic retroperitoneal fibrosis.

  15. Reevesioside A, a cardenolide glycoside, induces anticancer activity against human hormone-refractory prostate cancers through suppression of c-myc expression and induction of G1 arrest of the cell cycle.

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    Wohn-Jenn Leu

    Full Text Available In the past decade, there has been a profound increase in the number of studies revealing that cardenolide glycosides display inhibitory activity on the growth of human cancer cells. The use of potential cardenolide glycosides may be a worthwhile approach in anticancer research. Reevesioside A, a cardenolide glycoside isolated from the root of Reevesia formosana, displayed potent anti-proliferative activity against human hormone-refractory prostate cancers. A good correlation (r² = 0.98 between the expression of Na⁺/K⁺-ATPase α₃ subunit and anti-proliferative activity suggested the critical role of the α₃ subunit. Reevesioside A induced G1 arrest of the cell cycle and subsequent apoptosis in a thymidine block-mediated synchronization model. The data were supported by the down-regulation of several related cell cycle regulators, including cyclin D1, cyclin E and CDC25A. Reevesioside A also caused a profound decrease of RB phosphorylation, leading to an increased association between RB and E2F1 and the subsequent suppression of E2F1 activity. The protein and mRNA levels of c-myc, which can activate expression of many downstream cell cycle regulators, were dramatically inhibited by reevesioside A. Transient transfection of c-myc inhibited the down-regulation of both cyclin D1 and cyclin E protein expression to reevesioside A action, suggesting that c-myc functioned as an upstream regulator. Flow cytometric analysis of JC-1 staining demonstrated that reevesioside A also induced the significant loss of mitochondrial membrane potential. In summary, the data suggest that reevesioside A inhibits c-myc expression and down-regulates the expression of CDC25A, cyclin D1 and cyclin E, leading to a profound decrease of RB phosphorylation. G1 arrest is, therefore, induced through E2F1 suppression. Consequently, reevesioside A causes mitochondrial damage and an ultimate apoptosis in human hormone-refractory prostate cancer cells.

  16. Misleading diagnosis of retroperitoneal actinomycosis

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    Berchtenbreiter, C.; Bruening, R.; Reiser, M. [Inst. of Diagnostic Radiology, University Hospital Grosshadern, Ludwig Maximilians University, Munich (Germany); Auernhammer, A. [Medical Clinic II, Univ. Hospital Grosshadern, Ludwig Maximilians University, Munich (Germany)

    1999-07-01

    A 34-year-old woman presented with a left-sided suprarenal space-occupying lesion on sonography. Culture of material obtained during sonographic-guided puncture of the retroperitoneal lesion yielded a mixed flora of Actinomyces and Peptostreptococcus. Initially, a misleading diagnosis of an adrenal pheochromocytoma was initiated by highly positive metaiodobenzylguanidine scintigraphy after chemical chemistry vanillylmandelic acid (VMA) test showed elevated values for adrenaline and its derivatives. Retroperitoneal actinomycosis with yet unproven spread into thoracic and cervical compartments is a particular unusual presentation of an infection with these organisms. Because it may mimic subacute infections or malignant masses in terms of clinical and laboratory findings, radiological diagnosis of this entity may be difficult. The diagnosis was based on results of culture and the response of the patient to long-term penicillin-derivate therapy after surgical drainage of the suprarenal abscess formation. (orig.)

  17. Retroperitoneal lipomas: A case report.

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    van der Byl, G; Cerica, A; Sala, M G

    2012-12-01

    Lipomas are mesenchymal tumors characterized by the abnormal proliferation of adipocytes. We describe a case of retroperitoneal lipomas in a patient with chronic lymphatic leukemia, who was referred to our sonography unit for a regular (6-month) follow-up scan. She had no abdominal symptoms of note. The sonographic examination revealed two well-defined, hyperechoic, oval-shaped masses: the first situated between the posterior wall of the stomach, the duodenum, and the head of the pancreas; the second lying craniomedial to the left kidney. Neither of the masses exhibited intralesional vascularization on color Doppler imaging. Retrospective examination of previous CT scans revealed that the lesions had been present for the past 4 years. Their slow growth was consistent with the suspicion of retroperitoneal lipomas, and this diagnosis was confirmed by magnetic resonance imaging. CT and MRI are the imaging studies of choice for diagnosing retroperitoneal lipomas, but ultrasonography is ideal for the follow-up of these patients because it is repeatable and relatively low in cost.

  18. Cardiac arrest

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    ... Article.jsp. Accessed June 16, 2014. Myerburg RJ, Castellanos A. Approach to cardiac arrest and life-threatening ... PA: Elsevier Saunders; 2011:chap 63. Myerburg RJ, Castellanos A. Cardiac arrest and audden aardiac death. In: ...

  19. Retroperitoneal Schwannoma: A Rare Case

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    Murat Kalaycı

    2011-01-01

    Case Presentation. A 38-year-old woman was admitted to the emergency service with the complaints of progressive abdominal pain and nausea for the last 24 hours. Abdominal examination was compatible with acute abdomen. Acute appendicitis was diagnosed by CT. During CT evaluation, a round shaped soft-tissue mass at the retroperitoneal area inferior to the right kidney was detected, The mass was resected and histology revealed schwannoma. Conclusion. Rare tumoral lesions with benign course such as schwannoma can be detected incidentally.

  20. [Renal angiomyolipoma complicated by retroperitoneal hematoma].

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    Rabii, R; Fekak, H; Moufid, K; Joual, A; Benjelloun, S; Khaleq, K; Idali, B; Harti, A; Barrou, L

    2002-07-01

    Renal angiomyolipoma (AML) is a benign tumor, they are generally asymptomatic or can manifested by abdominal pain, palpable mass or hematuria. We report an uncommoun case of 65 years old women who consulted for retroperitoneal hemorrhage by spontaneous rupture of renal AML with palpable mass. The ultrasound and CT abdominopelvic scan were performed in the preoperative diagnosis and showed a typical right renal AML with retroperitoneal hematoma. The right nephrectomy by transperitoneal approach was performed with a good follow-up. The histological examination confirmed the diagnosis for renal AML. About this case, the authors discuses the diagnosis and the management for AML with retroperitoneal hemorrhage.

  1. Retroperitoneal Cyst: An Uncommon Presentation of Filariasis

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    Senthil Ganesan

    2015-01-01

    Full Text Available Primary retroperitoneal parasitic cysts are rare. Here we report about a middle aged male patient from rural north India with a recent onset of central abdominal retroperitoneal lump, pain, and fever. After surgical resection due to diagnostic uncertainty, at histopathology, it turned out be a filarial cyst. After receiving a course of diethylcarbamazine, the patient is asymptomatic at 4 months’ follow-up.

  2. Atypical retroperitoneal extension of iliopsoas bursitis

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    Coulier, B.; Cloots, V. [Department of Diagnostic Imaging, Cliniques St. Luc, Rue St Luc 8, 5004, Bouge, Namur (Belgium)

    2003-05-01

    We report two rare cases of iliopsoas bursitis extending into the retroperitoneal space. The first lesion contained much gas, mimicking a retroperitoneal abscess, and the second was responsible for atypical inguinal pain. The diagnosis was made by contrast-enhanced CT in both cases and arthrography in the first case. Iliopsoas bursitis in these two patients, it is hypothesized, extended into the retroperitoneum, at least in part, by way of intraneural or perineural structures. (orig.)

  3. Daily Arrests

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    Montgomery County of Maryland — This dataset provides the public with arrest information from the Montgomery County Central Processing Unit (CPU) systems. The data presented is derived from every...

  4. Surgical anatomy of the retroperitoneal spaces, Part IV: retroperitoneal nerves.

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    Mirilas, Petros; Skandalakis, John E

    2010-03-01

    We present surgicoanatomical topographic relations of nerves and plexuses in the retroperitoneal space: 1) six named parietal nerves, branches of the lumbar plexus: iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator, femoral. 2) The sacral plexus is formed by the lumbosacral trunk, ventral rami of S1-S3, and part of S4; the remainder of S4 joining the coccygeal plexus. From this plexus originate the superior gluteal nerve, which passes backward through the greater sciatic foramen above the piriformis muscle; the inferior gluteal nerve also courses through the greater sciatic foramen, but below the piriformis; 3) sympathetic trunks: right and left lumbar sympathetic trunks, which comprise four interconnected ganglia, and the pelvic chains; 4) greater, lesser, and least thoracic splanchnic nerves (sympathetic), which pass the diaphragm and join celiac ganglia; 5) four lumbar splanchnic nerves (sympathetic), which arise from lumbar sympathetic ganglia; 6) pelvic splanchnic nerves (nervi erigentes), providing parasympathetic innervation to the descending colon and pelvic splanchna; and 7) autonomic (prevertebral) plexuses, formed by the vagus nerves, splanchnic nerves, and ganglia (celiac, superior mesenteric, aorticorenal). They include sympathetic, parasympathetic, and sensory (mainly pain) fibers. The autonomic plexuses comprise named parts: aortic, superior mesenteric, inferior mesenteric, superior hypogastric, and inferior hypogastric (hypogastric nerves).

  5. Refractory vasculitis

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    Rutgers, Bram; Kallenberg, Cees G. M.

    2011-01-01

    Refractory vasculitis occurs in 4-5% of patients with anti-neutrophil cytoplasmic antibody associated vasculitis (AAV). Differences between therapies used for refractory disease are mostly reflected in the percentages of complete and partial remissions, but also in the number of serious side effects

  6. A Rare Case of Retroperitoneal Leiomyoma

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    Mahendru, Rajiv; Gaba, Geetinder; Yadav, Shweta; Gaba, Gurmeet; Gupta, Chinky

    2012-01-01

    Introduction. Leiomyoma uteri is one of the most common benign conditions for which women undergo hysterectomy every year. Fibroids found retroperitoneally are a rare entity, especially, primary retroperitoneal fibroid. Case Presentation. We report a case of 42-year-old para 1 who presented to our hospital with recurring retention of urine, lower abdominal and pelvic pain, and dyspareunia . Provisional diagnosis on the basis of examination and imaging was large subserosal fibroid with mild right-sided hydroureteronephrosis, due to pressure effect of the fibroid. Abdominal hysterectomy was done for the patient, and intraoperatively, a bulky uterus was found with multiple small fibroids on anterior and posterior walls, and a large fibroid approx. 10 × 8 cm was found arising from the posterior surface at the level of internal os retroperitoneally, which was confirmed by histopathology as leiomyoma. Conclusion. Retroperitoneal fibroids are rare neoplasms and treatment is surgical removal. Preoperative imaging can only give provisional diagnosis and can be misguiding. Final diagnosis of retroperitoneal fibroid can be made only intraoperatively. PMID:22900220

  7. A Rare Case of Retroperitoneal Leiomyoma

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    Rajiv Mahendru

    2012-01-01

    Full Text Available Introduction. Leiomyoma uteri is one of the most common benign conditions for which women undergo hysterectomy every year. Fibroids found retroperitoneally are a rare entity, especially, primary retroperitoneal fibroid. Case Presentation. We report a case of 42-year-old para 1 who presented to our hospital with recurring retention of urine, lower abdominal and pelvic pain, and dyspareunia . Provisional diagnosis on the basis of examination and imaging was large subserosal fibroid with mild right-sided hydroureteronephrosis, due to pressure effect of the fibroid. Abdominal hysterectomy was done for the patient, and intraoperatively, a bulky uterus was found with multiple small fibroids on anterior and posterior walls, and a large fibroid approx. 10×8 cm was found arising from the posterior surface at the level of internal os retroperitoneally, which was confirmed by histopathology as leiomyoma. Conclusion. Retroperitoneal fibroids are rare neoplasms and treatment is surgical removal. Preoperative imaging can only give provisional diagnosis and can be misguiding. Final diagnosis of retroperitoneal fibroid can be made only intraoperatively.

  8. [Retroperitoneal perforations of the colon. Apropos of 2 cases].

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    Jurczak, F; Likholatnikov, D; Courant, O; Hamy, A; Visset, J; Paineau, J

    1994-01-01

    The retroperitoneal perforation of the colon is rare and our observations illustrate its two modes of revelation: a retroperitoneal suppuration; it must be traited quickly in order to decrease the mortality. Note that the abscess of the thigh is exceptional. Retroperitoneal perforations during colonoscopy whose treatment (initially medical) become surgical if there is no clinical improvement.

  9. Laparoscopic resection of retroperitoneal benign neurilemmoma

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    Park, Joon Seong; Kang, Chang Moo; Yoon, Dong Sup; Lee, Woo Jung

    2017-01-01

    Purpose The aim of this study was to verify that laparoscopic resection for treating retroperitoneal benign neurilemmoma (NL) is expected to be favorable for complete resection of tumor with technical feasibility and safety. Methods We retrospectively analyzed 47 operations for retroperitoneal neurogenic tumor at Yonsei University College of Medicine, Severance Hospital and Gangnam Severance Hospital between January 2005 and September 2015. After excluding 21 patients, the remaining 26 were divided into 2 groups: those who underwent open surgery (OS) and those who underwent laparoscopic surgery (LS). We compared clinicopathological features between the 2 groups. Results There was no significant difference in operation time, estimated blood loss, transfusion, complication, recurrence, or follow-up period between 2 groups. Postoperative hospital stay was significantly shorter in the LS group versus the OS group (OS vs. LS, 7.00 ± 3.43 days vs. 4.50 ± 2.16 days; P = 0.031). Conclusion We suggest that laparoscopic resection of retroperitoneal benign NL is feasible and safe by obtaining complete resection of the tumor. LS for treating retroperitoneal benign NL could be useful with appropriate laparoscopic technique and proper patient selection.

  10. Retroperitoneal liposarcoma associated with small plaque parapsoriasis

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    Polichetti Paolo; Sgueglia Monica; Blasi Sara; Tartaglia Francesco; Tromba Luciana; Berni Alberto

    2007-01-01

    Abstract Background Extremely rare cases of paraneoplastic syndromes or ectopic production of proteins associated with liposarcoma are reported in literature. Production of Granulocyte-Colony Stimulating Factor, alpha-fetoprotein, paraneoplastic pemphigus and leucocytosis, Acrokeratosis paraneoplastica (Bazex's syndrome) are reported. The present report describes a case of retroperitoneal liposarcoma associated with small plaque parapsoriasis. Our search in the English literature of such a ki...

  11. [Retroperitoneal fibrosis and multiple myeloma: fortuitous association?].

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    Sinapi, I; Caers, J; Connerotte, T; Koutaissoff, S; Lambert, M

    2010-05-01

    We report a 59-year-old man presenting with retroperitoneal fibrosis (RF) associated with IgG lambda multiple myeloma. Recent clinical and immunohistochemical findings suggest that RF might be a particular expression of plasma cell/lymphoid dyscrasia, and that this association is not merely fortuitous. We review the pathophysiological evidence supporting this hypothesis.

  12. Retroperitoneal abscess: an extra-abdominal manifestation.

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    Mallia, Alvin James; Ashwood, Neil; Arealis, George; Galanopoulos, Ilias

    2015-01-09

    Retroperitoneal abscesses are unusual occurrences with occult and insidious presentations. There is often a lack of abdominal signs, leading to delays in drainage and high mortality rates. We report a case of thigh emphysema in an 88-year-old patient with diabetes. Prior to admission the patient reported a vague 4-week history of left thigh pain and an inability to fully weight bear. She presented to our emergency department with sepsis and acute kidney impairment. An X-ray of her left femur revealed widespread gas between muscular planes. A retroperitoneal abscess involving the left renal fossa, psoas, iliacus and upper thigh muscles was revealed on an urgent CT scan. The patient was transferred to intensive care unit (ICU) and underwent an emergency drainage. Despite ICU the patient died 2 days after admission.

  13. Lymphoplasmacytic Sclerosing Pancreatitis and Retroperitoneal Fibrosis

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    Nigel K. F. Koo Ng

    2008-01-01

    Full Text Available Although cases of lymphoplasmacytic sclerosing pancreatitis (LSP associated with idiopathic retroperitoneal fibrosis have been reported, the association is rare. We describe a 74-year-old man who presented with obstructive jaundice and weight loss. Nineteen months earlier, he had been diagnosed with idiopathic retroperitoneal fibrosis and treated with bilateral ureteric stents. Initial investigations were suggestive of a diagnosis of LSP, however, a malignant cause could not be ruled out. He underwent an exploratory laparotomy and frozen sections confirmed the diagnosis of LSP. An internal biliary bypass was performed using a Roux loop of jejunum, and the patient made an uneventful recovery. This case illustrates the difficulty in distinguishing LSP from pancreatic carcinoma preoperatively.

  14. Paraneoplastic retinopathy associated with retroperitoneal liposarcoma

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    Mineo Kondo

    2010-03-01

    Full Text Available Mineo Kondo1, Kumiko Mokuno2, Ai Uemura1, Shu Kachi1, Makoto Nakamura1, Atsuya Kondo3, Hiroko Terasaki11Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan; 2Department of Ophthalmology, 3Department of Urology, Kariya Toyota General Hospital Kariya, JapanAbstract: We report a case of paraneoplastic retinopathy associated with a retroperitoneal liposarcoma. A 42-year-old man was referred to our hospital with complaints of night blindness and blurred vision in the peripheral field. Electroretinograms showed a progressive amplitude reduction in his both eyes. Abdominal magnetic resonance imaging showed a large retroperitoneal mass, and pathologic examination revealed a dedifferentiated liposarcoma. Western blot analysis showed an antiretinal antibody in the serum of our patient, and his serum reacted with the photoreceptors of a bovine retina. To the best of our knowledge, this is the first case of paraneoplastic retinopathy associated with a liposarcoma.Keywords: paraneoplastic retinopathy, retroperitneal liposarcoma, electroretinogram, cancerassociated retinopathy

  15. Pelvic compartment syndrome caused by retroperitoneal hematoma of pelvic fracture

    Institute of Scientific and Technical Information of China (English)

    ZHANG Feng-qi; ZHANG Ying-ze; PAN Jin-she; PENG A-qin; WANG Hui-juan

    2005-01-01

    @@ Retroperitoneal hematoma is an obligatory complication in pelvic ring fracture.1 In most cases, the bleeding originates from venous vessels of the presacral plexus, small arteries and veins from fracture fragments. External fixation of the pelvis can control blood loss by reducing diastasis and dramatically decreasing the volume of the pelvis. But this tamponade effect can not prevent the presence of hematoma in the adjoining retroperitoneal space. It is well known that complication of retroperitoneal hematoma is infection and sepsis.

  16. [Diagnostic-therapeutic approach for retroperitoneal tumors].

    Science.gov (United States)

    Cariati, A

    1993-12-01

    After a careful review of the Literature, diagnostic and therapeutic strategies for Primary Retroperitoneal Tumours (PRT) are reported. The Author analyzes the experience of the Institute of Clinica Chirurgica "R" (Chief: Prof. E. Tosatti) as well as that of Anatomia Chirurgica (Chief: Prof. E. Cariati),--University of Genoa--in the management of PRT, stressing the importance of preoperative staging for a correct surgical approach.

  17. Haemoperitoneurn Secondary to Rupture of Retroperitoneal Variceal

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    M. Molina-Perez

    1997-01-01

    Full Text Available A 45-year-old alcoholic male patient presented with hypovolemic shock and intense anemia (Hemoglobin 04.7 g/dl, and was operated on. A bleeding retroperitoneal varix located near the right colon was responsible for the clinical picture and was sutured. After operation the patient developed haemodynamic instability and pneumonia a situation which was reverted with intensive medical therapy. The patient is now doing well.

  18. The Value of Surgery for Retroperitoneal Sarcoma

    Science.gov (United States)

    Gholami, Sepideh; Jacobs, Charlotte D.; Kapp, Daniel S.; Parast, Layla M.; Norton, Jeffrey A.

    2009-01-01

    Introduction. Retroperitoneal sarcomas are uncommon large malignant tumors. Methods. Forty-one consecutive patients with localized retroperitoneal sarcoma were retrospectively studied. Results. Median age was 58 years (range 20–91 years). Median tumor size was 17.5 cm (range 4–41 cm). Only 2 tumors were <5 cm. Most were liposarcoma (44%) and high-grade (59%). 59% were stage 3 and the rest was stage 1. Median followup was 10 months (range 1–106 months). Thirty-eight patients had an initial complete resection; 15 (37%) developed recurrent sarcoma and 12 (80%) had a second complete resection. Patients with an initial complete resection had a 5-year survival of 46%. For all patients, tumor grade affected overall survival (P = .006). Complete surgical resection improved overall survival for high-grade tumors (P = .03). Conclusions. Tumor grade/stage and complete surgical resection for high-grade tumors are important prognostic variables. Radiation therapy or chemotherapy had no significant impact on overall or recurrence-free survival. Complete surgical resection is the treatment of choice for patients with initial and locally recurrent retroperitoneal sarcoma. PMID:19826633

  19. The Value of Surgery for Retroperitoneal Sarcoma

    Directory of Open Access Journals (Sweden)

    Sepideh Gholami

    2009-01-01

    Full Text Available Introduction. Retroperitoneal sarcomas are uncommon large malignant tumors. Methods. Forty-one consecutive patients with localized retroperitoneal sarcoma were retrospectively studied. Results. Median age was 58 years (range 20–91 years. Median tumor size was 17.5 cm (range 4–41 cm. Only 2 tumors were <5 cm. Most were liposarcoma (44% and high-grade (59%. 59% were stage 3 and the rest was stage 1. Median followup was 10 months (range 1–106 months. Thirty-eight patients had an initial complete resection; 15 (37% developed recurrent sarcoma and 12 (80% had a second complete resection. Patients with an initial complete resection had a 5-year survival of 46%. For all patients, tumor grade affected overall survival (=.006. Complete surgical resection improved overall survival for high-grade tumors (=.03. Conclusions. Tumor grade/stage and complete surgical resection for high-grade tumors are important prognostic variables. Radiation therapy or chemotherapy had no significant impact on overall or recurrence-free survival. Complete surgical resection is the treatment of choice for patients with initial and locally recurrent retroperitoneal sarcoma.

  20. Endoscopic Retroperitoneal Adrenalectomy for Adrenal Metastases

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    Gintaras Simutis

    2014-01-01

    Full Text Available Objectives. To evaluate whether retroperitoneal approach for adrenalectomy is a safe and effective treatment for adrenal metastases (AM. Methods. From June 2004 to January 2014, nine consecutive patients with AM were treated with endoscopic retroperitoneal adrenalectomy (ERA. A retrospective study was conducted, and clinical data, tumor characteristics, and oncologic outcomes were acquired and analyzed. Results. Renal cancer was the primary site of malignancy in 44.4% of cases. The mean operative time was 132 ± 10.4 min. There were 5 synchronous and 4 metachronous AM. One patient required conversion to transperitoneal laparoscopic procedure. No mortality or perioperative complications were observed. The median overall survival was 11 months (range: 2–42 months. Survival rates of 50% and 25% were identified at 1 and 3 years, respectively. At the end of the study, 4 patients were alive with a mean observed follow-up of 20 months. No patients presented with local tumor relapse or port-site metastases. Conclusions. This study shows that ERA is a safe and effective procedure for resection of AM and advances the surgical treatment of adrenal disease. The use of the retroperitoneal approach for adrenal tumors less than 6 cm can provide very favorable surgical outcomes.

  1. Ormond's disease or secondary retroperitoneal fibrosis? An overview of retroperitoneal fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Heckmann, M.; Uder, M.; Kuefner, M.A.; Heinrich, M.C. [Universitaetsklinikum Erlangen (Germany). Radiologisches Inst.

    2009-04-15

    Retroperitoneal fibrosis represents a rare inflammatory disease. About two thirds of all cases seem to be idiopathic (= Ormond's disease). The remaining one third is secondary and may be ascribed to infections, trauma, radiation therapy, malignant diseases, and the use of certain drugs. Up to 15 % of patients have additional fibrotic processes outside the retroperitoneum. The clinical symptoms of retroperitoneal fibrosis are non-specific. In sonography retroperitoneal fibrosis appears as a retroperitoneal hypoechoic mass which can involve the ureters and thus cause hydronephrosis. Intravenous urography and MR urography can demonstrate the typical triad of medial deviation and extrinsic compression of the ureters and hydronephrosis. CT and MRI are the modalities of choice for the diagnosis and follow-up of this disease. The lesion typically begins at the level of the fourth or fifth lumbar vertebra and appears as a plaque, encasing the aorta and the inferior vena cava and often enveloping and medially displacing the ureters. In unenhanced CT, retroperitoneal fibrosis appears as a mass that is isodense with muscle. When using MRI, the mass is hypointense in T1-weighted images and of variable intensity in T2-weighted images according to its stage: it may be hyperintense in early stages, while the tissue may have a low signal in late stages. After the administration of contrast media, enhancement is greatest in the early inflammatory phase and minimal in the late fibrotic phase. Dynamic gadolinium enhancement can be useful for assessing disease activity, monitoring response to treatment, and detecting relapse. To differentiate retroperitoneal masses, diffusion-weighted MRI may provide useful information. (orig.)

  2. Liposarcoma retroperitoneal gigante. Reporte de caso (Giant retroperitoneal liposarcoma. Case report

    Directory of Open Access Journals (Sweden)

    Eduardo Reyna-Villasmil

    2015-01-01

    Full Text Available Soft tissue sarcomas represent less than 1% of all human neoplasms. One-third of malignant tumors that arise in the retroperitoneum are sarcomas and liposarcoma is the most common retroperitoneal sarcoma and is known to grow to giant sizes, slow progress and few late symptoms. We report the case of a 40 year old woman with a giant retroperitoneal liposarcoma. A laparotomy was performed and a multilobulated tumor of 20 centimeters of diameter arising from retroperitoneum. The histological features were suggestive of pleomorphic liposarcoma weighing 8.5 Kilograms

  3. Pancreatic liposarcoma: case report with review of retroperitoneal liposarcomas.

    Science.gov (United States)

    Elliott, T E; Albertazzi, V J; Danto, L A

    1980-04-01

    A case report of a large pancreatic liposarcoma is presented showing a five-year survival with aggressive surgical excision as the only treatment. The medical literature of the subject is reviewed. This is the only reported case of retroperitoneal liposarcoma which is limited to the pancreas. A discussion of the current types of treatment for retroperitoneal liposarcomas is included.

  4. Retroperitoneal abscesses in two western lowland gorillas (Gorilla gorilla gorilla).

    Science.gov (United States)

    Hahn, Alicia; D'Agostino, Jennifer; Cole, Gretchen A; Raines, Jan

    2014-03-01

    This report describes two cases of retroperitoneal abscesses in female western lowland gorillas (Gorilla gorilla gorilla). Clinical symptoms included perivulvar discharge, lameness, hindlimb paresis, and general malaise. Retroperitoneal abscesses should be considered as part of a complete differential list in female gorillas with similar clinical signs.

  5. CT characteristics of primary retroperitoneal neoplasms in children

    Energy Technology Data Exchange (ETDEWEB)

    Xu Yufeng; Wang Jichen [Department of Radiology, Peking University First Hospital, No. 8, Xishike Street, Xicheng District, Beijing 100034 (China); Peng Yun [Imaging Center, Beijing Children' s Hospital Affiliated to Capital Medical University, 56, Nanlishi Road, Xicheng District, Beijing 100045 (China); Zeng Jinjin, E-mail: jzeng5567@yahoo.co [Imaging Center, Beijing Children' s Hospital Affiliated to Capital Medical University, 56, Nanlishi Road, Xicheng District, Beijing 100045 (China)

    2010-09-15

    Primary retroperitoneal neoplasms are uncommon in children. Retroperitoneal neoplasms are either mesodermal, neurogenic, germ cell ectodermal or lymphatic in origin. In general, primary retroperitoneal neoplasms in children have different spectrum and prevalence compared to those in adults. Neuroblastoma, rhabdomyosarcoma, benign teratoma and lymphoma are the common retroperitoneal neoplasms. In this review, the clinical and CT futures of common retroperitoneal neoplasms in children are described. Coarse, amorphous, and mottled calcification are very common in neuroblastoma. Paraganglioma tends to show marked and early enhancement and may present with clinical symptoms associated with the excess catecholamine. Sarcomas are often very large and have heterogeneous appearance. Imaging cannot be reliably used to identify the type of retroperitoneal sarcomas due to overlapped radiographic features. In children, lipoblastoma is the most common lipomatous tumor in the retroperitoneum. The percentage of visible fat in tumor varies depending on the cellular composition of the lesion. The CT characteristics of teratoma are quite variable, which may be cystic, solid, on a combination of both. Typically teratoma appears as a large complex mass containing fluid, fat, fat-fluid level, and calcifications. Lymphoma is often homogeneous on both enhanced and unenhanced CT scans. Necrosis and calcification are rare on CT. In conclusion, making a final histological diagnosis of retroperitoneal tumor base on CT features is not often possible; however, CT can help to develop a differential diagnosis and determine the size and extent of the retroperitoneal neoplasms.

  6. Recurrent thymoma in the retroperitoneal space: a rare case report

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    Jun Yang

    2015-06-01

    Full Text Available Thymoma is an epithelial neoplasm of the thymus, which commonly lies in the anterior mediastinum and recurrences of thymoma generally are locally, and retroperitoneal recurrence is considered to be rare. A 46-year old Asian woman with invasive thymoma had undergone thymectomy 10 years ago. Computed tomography demonstrated a wellcircumscribed mass in the left retroperitoneal space. The patient had not any symptom including myasthenia gravis. Because on the anterior mediastinum area shows no sign of tumor recurrence and the mass adjacent to the vertebral body, neurogenic tumor was suspected. Surgical resection was performed using a retroperitoneal approach, which revealed the tumor adhering neighboring diaphragm. The tumor was histologically diagnosed to be type B1 thymoma according to the World Health Organization classification. The retroperitoneal mass was an unusual local recurrence after thymectomy. The patients whose had under invasive thymectomy should be evaluated carefully when finding retroperitoneal mass during follow-up.

  7. Multimodality Local Therapy for Retroperitoneal Sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Paryani, Nitesh N.; Zlotecki, Robert A.; Swanson, Erika L.; Morris, Christopher G. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Grobmyer, Stephen R.; Hochwald, Steven N. [Department of General Surgery, University of Florida College of Medicine, Gainesville, FL (United States); Marcus, Robert B. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); University of Florida Proton Therapy Institute, Jacksonville, FL (United States); Indelicato, Daniel J., E-mail: dindelicato@floridaproton.org [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); University of Florida Proton Therapy Institute, Jacksonville, FL (United States)

    2012-03-01

    Purpose: Soft-tissue sarcomas of the retroperitoneum are rare tumors comprising less than 1% of all malignancies. Although surgery continues as the mainstay of treatment, the large size of these tumors coupled with their proximity to critical structures make resection with wide margins difficult to achieve. The role and timing of radiotherapy are controversial. This study updates our institutional experience using multimodality local therapy for resectable retroperitoneal sarcoma and identifies prognostic factors impacting disease control and survival. Methods and Materials: Between 1974 and 2007, 58 patients with nonmetastatic retroperitoneal sarcoma were treated with surgery and radiation at University of Florida. The median age at radiotherapy was 57 years old (range, 18-80 years). Forty-two patients received preoperative radiotherapy and 16 received postoperative radiotherapy. Nineteen patients received 1.8 Gy once daily and 39 patients received 1.2 Gy twice daily. Variables analyzed for prognostic value included age, grade, kidney involvement, histology, de novo versus recurrent presentation, tumor diameter, margin status, radiotherapy sequencing (preoperative vs. postoperative), total radiation dose, fractionation scheme, and treatment era. Results: The 5-year overall survival, cause-specific survival, and local control rates were 49%, 58%, and 62%, respectively. Nearly two-thirds of disease failures involved a component of local progression. On multivariate analysis, only margin status was significantly associated with improved 5-year local control (85%, negative margins; 63%, microscopic positive margins; 0%, gross positive margins; p < 0.0001) and 5-year overall survival (64%, negative margins; 56%, microscopic positive margins; 13%, gross positive margins; p = 0.0012). Thirty-one Grade 3 or greater toxicities were observed in 22 patients, including two treatment-related deaths (3%). Conclusion: For retroperitoneal sarcoma, local control remains a

  8. Quiste retroperitoneal: Reporte de un caso

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    Néstor Moisés Tineo Araque

    2010-01-01

    Full Text Available Los quistes retroperitoneales son tumoraciones benignas o malignas originadas en el espacio retroperitoneal, la gran mayoría de ellos presentan características de benignidad, predominan en el sexo femenino y se clasifican fundamentalmente en base a su tejido de origen. El tratamiento depende de la histopatología, sin embargo la mayoría de los autores coinciden en realizar resección quirúrgica. Se presenta el caso de paciente femenina de 48 años de edad quien acude a consulta por presentar dolor persistente en hemiabdomen derecho, a la evaluación paraclínica con ultrasonido abdominal se evidenció tumor quístico en flanco derecho de 12 por 14 centímetros. La tomografía axial computarizada reportó imagen retroperitoneal que se extiende desde la fosa ilíaca derecha hasta hipocondrio derecho. Se realizó laparotomía exploradora, hallándose quiste de retroperitoneo de 15 por 20 centímetros con cápsula definida y de contenido líquido (de consistencia gelatinosa que se clasifica posteriormente como un hamartoma retroperitoneal. Debido a su baja incidencia, el conocimiento y estudio de este tipo de patología se ha visto truncada en la práctica médica, razón por la cual es de difícil diagnóstico trayendo como consecuencia que en muchos casos el paciente es ingresado a quirófano con un diagnóstico errado.

  9. Quiste retroperitoneal: Reporte de un caso

    OpenAIRE

    2012-01-01

    Los quistes retroperitoneales son tumoraciones benignas o malignas originadas en el espacio retroperitoneal, la gran mayoría de ellos presentan características de benignidad, predominan en el sexo femenino y se clasifican fundamentalmente en base a su tejido de origen. El tratamiento depende de la histopatología, sin embargo la mayoría de los autores coinciden en realizar resección quirúrgica. Se presenta el caso de paciente femenina de 48 años de edad quien acude a consulta por presentar dol...

  10. Retroperitoneal abscess: an extra-abdominal manifestation

    OpenAIRE

    Mallia, Alvin James; Ashwood, Neil; Arealis, George; Galanopoulos, Ilias

    2015-01-01

    Retroperitoneal abscesses are unusual occurrences with occult and insidious presentations. There is often a lack of abdominal signs, leading to delays in drainage and high mortality rates. We report a case of thigh emphysema in an 88-year-old patient with diabetes. Prior to admission the patient reported a vague 4-week history of left thigh pain and an inability to fully weight bear. She presented to our emergency department with sepsis and acute kidney impairment. An X-ray of her left femur ...

  11. Retroperitoneal liposarcoma associated with small plaque parapsoriasis

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    Polichetti Paolo

    2007-07-01

    Full Text Available Abstract Background Extremely rare cases of paraneoplastic syndromes or ectopic production of proteins associated with liposarcoma are reported in literature. Production of Granulocyte-Colony Stimulating Factor, alpha-fetoprotein, paraneoplastic pemphigus and leucocytosis, Acrokeratosis paraneoplastica (Bazex's syndrome are reported. The present report describes a case of retroperitoneal liposarcoma associated with small plaque parapsoriasis. Our search in the English literature of such a kind of association did not reveal any case reported. Case presentation A 74 year male patient was admitted to our hospital because of the presence of an abdominal mass in right iliac fossa. He also complained of a two-year history of psoriasiform eruptions. The CT scan showed a retroperitoneal pelvic mass. Therefore surgical resection of the tumor was performed. After surgery, the skin eruptions disappeared completely in seven days and so a diagnosis of parapsoriasis syndrome was done. Conclusion Parallel disappearing of skin eruptions after surgery, typical clinical picture and not specific histology of the cutaneous lesions suggest the diagnosis of small plaque parapsoriasis. Therefore we propose to add Small Plaque Parapsoriasis to the list of paraneoplastic syndromes associated to liposarcoma.

  12. [Retroperitoneal sarcoma: report of 6 cases].

    Science.gov (United States)

    Joual, A; Faik, H; Rabii, R; Hafiani, M; Bennani, S; el Mrini, M; Benjelloun, S

    2000-06-01

    Retroperitoneal soft tissue sarcomas (RPS) are uncommon tumors. The diagnosis is frequently made later in the evolution of the disease due to the absence of specific symptomatology. Surgery with total resection of the tumor is the treatment of choice, but is only possible in 38 to 75% of cases. Six cases of RPS have been retrospectively reviewed; the mean time to diagnosis was 5 months; diagnosis was established via CT scan, which determined the retroperitoneal tumor location and its relationship to the neighboring organs. The most common symptoms were the presence of an abdominal mass and accompanying abdominal pain; signs of urinary and vascular compression were not found until later. Surgery with total resection was performed in 4 cases, and with partial resection in 2 cases. The histological findings were as follows: 3 liposarcomas, 2 rhabdomyosarcomas, and 1 fibrosarcoma. Tumor recurrence developed in 2 cases (liposarcomas), necessitating further surgery and complete resection. Two patients were lost to follow-up. RPS are characterized by locoregional relapse and metastases. Disease outcome depends on the histological type, tumor grade, and on the possibility of carrying out complete resection.

  13. Giant retroperitoneal liposarcoma: A very rare case report

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    R S Mohil

    2014-01-01

    Full Text Available Soft-tissue sarcomas are very rare entity, seen in <1% of all malignancies. Sarcoma accounts for about one-third of all retroperitoneal malignancies. Management of retroperitoneal sarcoma is challenge for surgeons because of its rare presentation and no standard guidelines for it. A 65-year-old male presented to surgery out-patient department with the complaints of abdominal distention and pain in abdomen since 3 years. On imaging, he was diagnosed as case of retroperitoneal tumor and managed by radical surgery including resection of the tumor with left kidney, spleen, and descending colon. Postoperative period was uneventful.

  14. Retroperitoneal Gastrointestinal Type Schwannoma Presenting as a Renal Mass

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    Susan J. Hall

    2015-11-01

    Full Text Available Retroperitoneal schwannomas are extremely rare, and unreported in Urology. Often thought to be malignant from imaging the diagnosis is often delayed until Histology. We report a case of retroperitoneal schwanoma thought to be a malignant renal mass. Seventy three year old lady presented with abdominal pain. Imaging showed a mass attached to the renal pelvis thus she underwent a radical nephrectomy. Histology reported retroperitoneal schwannoma. Malignant forms are rare however treatment for these is surgical excision. Awareness of the existence of these tumors may help in avoiding unnecessary radical surgeries by opting for biopsy preoperatively.

  15. Surgical anatomy of the retroperitoneal spaces, Part III: Retroperitoneal blood vessels and lymphatics.

    Science.gov (United States)

    Mirilas, Petros; Skandalakis, John E

    2010-02-01

    In this article, we discuss the surgical anatomy of the blood vessels and the lymphatic vessels and lymph nodes found in the retroperitoneum. Retroperitoneal blood vessels include the aorta and all its branches--parietal and visceral--from the diaphragm to the pelvis, and the inferior vena cava and its tributaries. The retroperitoneal lymphatics form a very rich and extensive chain. As a general rule, lymphatics follow the arteries and named lymph nodes are found at the root of the arteries. Retroperitoneal nodes of the abdomen comprise the inferior diaphragmatic nodes and the lumbar nodes. The latter are classified as left lumbar (aortic), intermediate (interaorticovenous), and right lumbar (caval). These nodes surround the aorta and the inferior vena cava. Around the aorta lie the paraortic nodes, preaortic nodes (include celiac, superior mesenteric, inferior mesenteric nodes collecting lymph from the splanchna supplied by the homonymous arteries), and retroaortic nodes. Similarly, around the vena cava lie the paracaval, precaval, and retrocaval nodes. Pelvic nodes include the common iliac, external and internal iliac, obturator, and sacral nodes.

  16. Extracorporeal life support for refractory ventricular tachycardia

    Science.gov (United States)

    Joseph, Nicholas; Hofmann, James P.; Saranteas, Theodosios; Papadimos, Thomas J.

    2017-01-01

    Extracorporeal life support (ECLS) is a very effective bridging therapy in patients with refractory ventricular tachycardia (VT) associated with cardiogenic shock. A moribund patient in extremis, is not amenable to optimization by standard ACC/AHA guidelines. New approaches and novel salvage techniques are necessary to improve outcomes in patients with refractory clinical settings such as malignant ventricular arrhythmias, cardiac arrest, cardiogenic shock and/or pulmonary failure until further management options are explored. Data base searches were done using key words such as ECLS, VT, cardiac arrest, VT ablation, venoarterial extra-corporeal membrane oxygenation (VA-ECMO). The use of ECLS has been described in a few case reports to facilitate VT ablation for incessant VT refractory to medical therapy. For patients with, out-of- hospital ventricular fibrillation (VF) and VT, Minnesota Resuscitation Consortium has implemented emergent advanced perfusion and reperfusion strategy, followed by coronary angiography and primary coronary intervention to improve outcome. The major indications for ECLS are cardiogenic shock related to acute myocardial infarction, myocarditis, post embolic acute cor pulmonale, drug intoxication and post cardiac arrest syndrome with the threat of multi-organ failure. ECLS permits the use of negative inotropic antiarrhythmic drug therapy, facilitates the weaning of catecholamine administration, thereby ending the vicious cycle of catecholamine driven electric storm. ECLS provides hemodynamic support during ablation procedure, while mapping and induction of VT is undertaken. ECLS provides early access to cardiac catheterization laboratory in patients with cardiac arrest due to shockable rhythm. The current evidence from literature, supports the use of ECLS to ensure adequate vital organ perfusion in patients with refractory VT. ECLS is a safe, feasible and effective therapeutic option when conventional therapies are insufficient to support

  17. Contemporary Management of Retroperitoneal Soft Tissue Sarcomas.

    Science.gov (United States)

    Olimpiadi, Yuliya; Song, Suisui; Hu, James S; Matcuk, George R; Chopra, Shefali; Eisenberg, Burton L; Sener, Stephen F; Tseng, William W

    2015-08-01

    Management of retroperitoneal soft tissue sarcomas (RP STS) can be very challenging. In contrast to the more common extremity STS, the two predominant histologic subtypes encountered in the retroperitoneum are well-differentiated/dedifferentiated liposarcoma and leiomyosarcoma. Surgery remains the mainstay of treatment for RP STS. Preoperative planning and anticipation of the need for resection of adjacent organs/structures are critical. The extent of surgery, including the role of compartmental resection, is still controversial. Radiation therapy may be an important adjunct to surgery to provide locoregional disease control; this is currently being evaluated in the preoperative setting in the EORTC STRASS trial. Systemic therapy, tailored to the specific histologic subtype, may also be of benefit for the management of RP STS. Further investigation of novel therapies (e.g., targeted therapies, immunotherapy) is needed. Overall, multi-institutional collaboration is important moving forward, to continue to better understand and optimize management of this disease.

  18. Primary retroperitoneal mucinous cystadenocarcinoma: report of two cases

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    Villavicencio-Valencia Verónica

    2007-01-01

    Full Text Available Abstract Background Retroperitoneal cystadenocarcinomas are rare lesions, the majority of cases presented as one-patient reports. Methods We present two cases of retroperitoneal cystadenocarcinoma, both in women of reproductive age: one with aggressive behavior, and the remaining case, with a more indolent clinical evolution. Results One case presented as pelvic tumor, was treated with surgical resection of the disease, but manifested with recurrent disease a few months later despite use of chemotherapy. The second case involved a patient with diagnosis of abdominal tumor; during laparotomy, a retroperitoneal tumor was found and was totally removed. At follow-up, the patient is disease-free with no other treatment. Conclusion The behavior and treatment of retroperitoneal cystadenocarcinoma are controversial. We suggest aggressive surgery including radical hysterectomy and bilateral salpingoopherectomy with adjuvant chemotherapy in these cases.

  19. A patient with combined mediastinal, mesenteric and retroperitoneal fibrosis.

    Science.gov (United States)

    Graal, M B; Lustermans, F A

    1994-06-01

    We report a patient with combined mediastinal, mesenteric and retroperitoneal fibrosis who first presented with signs of a superior vena cava syndrome. She was successfully treated with corticosteroids. The aetiology, clinical picture, and possible therapy of idiopathic fibrosclerosis are discussed.

  20. Measurement of visceral fat: should we include retroperitoneal fat?

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    Chi-Sheng Hung

    Full Text Available OBJECTIVE: Whether retroperitoneal fat should be included in the measurement of visceral fat remains controversial. We compared the relationships of fat areas in peritoneal, retroperitoneal, and subcutaneous compartments to metabolic syndrome, adipokines, and incident hypertension and diabetes. METHODS: We enrolled 432 adult participants (153 men and 279 women in a community-based cohort study. Computed tomography at the umbilicus level was used to measure the fat areas. RESULTS: Retroperitoneal fat correlated significantly with metabolic syndrome (adjusted odds ratio (OR, 5.651, p<0.05 and the number of metabolic abnormalities (p<0.05. Retroperitoneal fat area was significantly associated with blood pressure, plasma glycemic indices, lipid profile, C-reactive protein, adiponectin (r =  -0.244, P<0.05, and leptin (r = 0.323, p<0.05, but not plasma renin or aldosterone concentrations. During the 2.94 ± 0.84 years of follow-up, 32 participants developed incident hypertension. Retroperitoneal fat area (hazard ration (HR 1.62, p = 0.003 and peritoneal fat area (HR 1.62, p = 0.009, but not subcutaneous fat area (p = 0.14 were associated with incident hypertension. Neither retroperitoneal fat area, peritoneal fat area, nor subcutaneous fat areas was associated with incident diabetes after adjustment. CONCLUSIONS: Retroperitoneal fat is similar to peritoneal fat, but differs from subcutaneous fat, in terms of its relationship with metabolic syndrome and incident hypertension. Retroperitoneal fat area should be included in the measurement of visceral fat for cardio-metabolic studies in human.

  1. Giant Primary Retroperitoneal Teratoma in an Adult: A Case Report

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    Poonam Mathur

    2010-01-01

    Full Text Available Teratomas are bizarre neoplasms derived from embryonic tissues that are typically found only in the gonadal and sacrococcygeal regions of adults. Retroperitoneal teratomas are rare and present challenging management options. We report here the case of a histologically unusual retroperitoneal tumor detected on computed tomography during the workup of abdominal pain in a 32-year-old male. The evaluation and treatment of this condition and a review of the literature are included in this paper.

  2. Chronic Low Back Pain due to Retroperitoneal Cystic Lymphangioma

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    Asieh Sadat Fattahi

    2014-03-01

    Full Text Available Abdominal cystic lymphangioma is a rare benign neoplasm. Less than 1% of lymphangiomas is in the retroperitoneum. Lymphangioma is mostly asymptomatic. Chronic symptoms were reported in retroperitoneal type more than others. Acute symptoms due to complications like infection, cyst rupture or hemorrhage may occur. We report an 18-years-old girl with low back pain from 6 months ago with huge pelvic mass and diagnosis of retroperitoneal cystic lymphangioma.

  3. Chronic Low Back Pain due to Retroperitoneal Cystic Lymphangioma

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    Asieh Sadat Fattahi

    2014-03-01

    Full Text Available   Abdominal cystic lymphangioma is a rare benign neoplasm. Less than 1% of lymphangiomas is in the retroperitoneum. Lymphangioma is mostly asymptomatic. Chronic symptoms were reported in retroperitoneal type more than others. Acute symptoms due to complications like infection, cyst rupture or hemorrhage may occur. We report an 18-years-old girl with low back pain from 6 months ago with huge pelvic mass and diagnosis of retroperitoneal cystic lymphangioma.

  4. Retroperitoneal Necrotizing Fasciitis Masquerading as Perianal Abscess - Rare and Perilous.

    Science.gov (United States)

    Amaranathan, Anandhi; Sahoo, Ashok Kumar; Barathi, Deepak; Shankar, Gomathi; Sistla, Sarath Chandra

    2017-01-17

    Necrotizing fasciitis is one of the uncommon presentations of a rapidly spreading subcutaneous tissue infection. Although the actual cause is unclear in many cases, most of them are due to the rapid proliferation of microorganisms. Retroperitoneal necrotizing fasciitis is extremely rare. It is a potentially lethal infection that requires immediate and aggressive surgical care. Early diagnosis is the key to a better prognosis. The possibility of retroperitoneal necrotizing fasciitis should be suspected in patients with symptoms of sepsis that are disproportionate to clinical findings. The rapid deterioration of the patient also gives a clue towards the diagnosis. We report a 35-year-old male with perianal abscess who had been progressed to retroperitoneal necrotizing fasciitis. The patient was managed successfully with aggressive debridement and drainage after laparotomy. Appropriate antibiotics were used to combat the sepsis. The patient recovered well at follow up, three months after discharge. Another patient, a 45-year-old male with a retroperitoneal abscess, progressed to retroperitoneal necrotizing fasciitis, and extra peritoneal drainage and debridement was done. Antibiotics depending upon the culture and sensitivity were used to control sepsis. But the patient succumbed to death 45 days after surgery due to uncontrolled sepsis. Necrotizing fasciitis of any anatomical site needs aggressive surgical care with early intervention. But retroperitoneal necrotizing fasciitis needs an extra effort for diagnosis. After diagnosis, it needs timely surgical intervention and appropriate antibiotic therapy for the recovery of the patients.

  5. Giant retroperitoneal abscess following necrotizing pancreatitis treated with internal drainage

    Institute of Scientific and Technical Information of China (English)

    Ludmil Marinov Veltchev; Manol Anastasov Kalniev

    2009-01-01

    BACKGROUND: Retroperitoneal abscess is a dangerous complication of the inflammatory process in organs. The pancreas reacts by enzymatic autodigestion and inflammation to external and internal factors: alcohol abuse, trauma, biliary stones, and viral infections. Chronic pancreatitis and formation of pseudocysts are late complications. The diffuse spread of pancreatic inflammation may form a retroperitoneal phlegmon. A better outcome is the limitation of the process by capsule formation-retroperitoneal abscess. METHODS: A 62-year-old man, with a history of alcohol abuse, was admitted for intermittent abdominal pain, fever, and significant weight loss. Previous medical consultations (laboratory tests, US, CT) confirmed chronic pancreatitis with pseudocyst formation. A new CT depicted a giant retroperitoneal abscess. RESULTS: After preoperative preparation with antibiotics, laparotomy and internal drainage-longitudinal cystoje-junostomy with Roux-en-Y loop were performed. At the 8th postoperative day the patient was in good condition. CONCLUSIONS: Giant retroperitoneal abscess is a dangerous pathology with significant mortality and morbidity. Diagnosis strongly necessitates operative intervention in order to evacuate and drain the space. These conditions include one internal drainage (in the GI tract) with the stomach, duodenum, or jejunum, which does not cause early and late GI discomfort and will gradually liquidate the cavity. We propose internal drainage with Roux-en-Y jejunal loop as the only method for accomplishing these conditions in cases of giant retroperitoneal abscesses.

  6. A Case of Huge Retroperitoneal Ganglioneuroma

    Directory of Open Access Journals (Sweden)

    Ali Akbarzadeh Pasha

    2009-01-01

    Full Text Available "nIntroduction: Ganglioneuroma is a rare, benign, fully differentiated tumor that contains mature schwann cells, ganglion cells, fibrous tissue and nerve fibers. This tumor has no immature elements, atypia, mitotic figures, intermediate cells or necrosis. This lesion can occur almost anywhere along the paravertebral sympathetic ganglia and sometimes in the adrenal medulla. This tumor can arise de novo and result from the maturation of a ganglioneuroblastoma or neuroblastoma; it may also develop within a neuroblastoma treated by chemotherapy. Metastasis is exceedingly rare. "nCase Presentation: The patient is a 7 year-old-girl living in Bam, Iran, presented with an abdominal mass 6 months ago. Physical examination revealed a very large, firm and painless abdominal mass in the right side of the abdomen with extension to the left side. She was otherwise well. In sonography, a very large heterogeneous retroperitoneal mass was seen arising on the right side crossing the midline. Dimensions were at least 170×160 mm. The right kidney and liver were displaced downward and upward, respectively. No liver metastasis or ascites was seen. In the colour Doppler ultrasonography, the lesion was hypervascular with a low resistance flow. The aorta was completely encased and displaced anteriorly but not invaded. Urinary VMA, bone marrow aspiration and biopsy were normal. A poor quality noncontrast CT scan revealed no more information than sonography (a hypodense noncalcified mass. The patient had tolerated two periods of chemotherapy with the impression of neuroblastoma without tissue diagnosis. Spiral CT scan performed at Pasteur hospital in Bam revealed a very large hypervascular hypodense retroperitoneal mass with complete encasement of the aorta and a large vessel originating from the aorta. The right kidney and liver were displaced downward and upward, respectively and the bowel loops were displaced to the left side. Sonography-guided needle biopsy was

  7. Retroperitoneal liposarcoma presenting a indirect inguinal hernia.

    Directory of Open Access Journals (Sweden)

    Noguchi H

    2001-02-01

    Full Text Available A 60-year-old man was admitted to our hospital with a right inguinal swelling that had been growing in size without any pain for 7 months. We diagnosed the growth as a right inguinal hernia and operated on him. The growth, however, was found to be a tumor it situated along the spermatic cord and testicular vessels. We diagnosed it as a lipoma. The tumor was resected near part of the internal inguinal ring. Histopathological diagnosis showed well-differentiated liposarcoma of the sclerosing type. Postoperative computed tomography (CT revealed a large residual tumor in the retroperitoneum. We believed that the tumor was a retroperitoneal liposarcoma and that it developed in the inguinal region. The residue of the liposarcoma was resected onto the right inguinal tract. A periodic follow up has been performed and no evidence of recurrence or metastasis has been seen in the 4 years and 9 months since the second surgery. No adjuvant therapy was performed. Inguinal liposarcomas are relatively rare and in most cases these tumors are thought to originate in the spermatic cord. The origin of the tumor is believed to be the retroperitoneum.

  8. Isolated Retroperitoneal Hydatid Cyst Invading Splenic Hilum

    Directory of Open Access Journals (Sweden)

    Safak Ozturk

    2014-01-01

    Full Text Available Introduction. Hydatid disease (HD is an infestation that is caused by the larval stage of Echinococcus granulosus. The liver is affected in approximately two-thirds of patients, the lungs in 25%, and other organs in a small proportion. Primary retroperitoneal hydatid cyst is extremely rare. The most common complaint is abdominal pain; however, the clinical features of HD may be generally dependent on the location of the cyst. Case Presentation. A 43-year-old female was admitted with the complaint of abdominal pain. Her physical examination was normal. Computed tomography (CT revealed a 17 × 11 cm cystic lesion, with a thick and smooth wall that is located among the left liver lobe, diaphragm, spleen, tail of the pancreas, and transverse colon and invading the splenic hilum. Total cystectomy and splenectomy were performed. Pathological examination was reported as cyst hydatid. Discussion. Cysts in the peritoneal cavity are mainly the result of the spontaneous or traumatic rupture of concomitant hepatic cysts or surgical inoculation of a hepatic cyst. Serological tests contribute to diagnosis. In symptomatic and large hydatid peritoneal cysts, surgical resection is the only curative treatment. Total cystectomy is the gold standard. Albendazole or praziquantel is indicated for inoperable and disseminated cases. Percutaneous aspiration, injection, and reaspiration (PAIR technique is another nonsurgical option.

  9. ROLE OF ULTRASOUND IN EVALUATION OF RETROPERITONEAL LESIONS

    Directory of Open Access Journals (Sweden)

    Harshita Pant

    2016-07-01

    Full Text Available BACKGROUND The retroperitoneum contains the adrenals, kidneys and ureters, the duodenal loop, pancreas, great vessels with their branches and associated lymph node chains, ascending and descending portions of the colon including the caecum, the retroperitoneal sonographic images are frequently degraded by bowel gas, thick muscles, fat, ribs, the lower lungs. AIMS AND OBJECTIVES To study the various features of retroperitoneal lesions by ultrasonography and assess its role. MATERIALS AND METHODS Fifty patients presenting with signs and symptoms suggestive of retroperitoneal pathology were evaluated over a period of 12 months using machine Siemens Sonoline Omnia/Siemens Sonoline G50 with 3.5 MHz convex and 5-10 MHz multifrequency linear transducer. OBSERVATIONS The maximum numbers of cases–17 (34% were of renal origin. This was followed by pancreatic lesion - 14 cases (28%, USG correctly detected 46 out of 50 cases thus having an accuracy of 92% for the detection and evaluation of retroperitoneal lesions. CONCLUSIONS Ultrasound provides a safe, quick, reliable, non-invasive and cost effective tool for screening for retroperitoneum. We recommend ultrasound as the primary diagnostic tool for various retroperitoneal lesions.

  10. Primary retroperitoneal mucinous cystadenocarcinoma. A case report and review of the literature

    DEFF Research Database (Denmark)

    Jørgensen, L J; Vibits, H

    1991-01-01

    A case of a primary retroperitoneal mucinous cystadenocarcinoma in a 38-year-old female is presented. The literature concerning primary retroperitoneal cystadenocarcinomas is reviewed and it is concluded that close postoperative follow-up is necessary.......A case of a primary retroperitoneal mucinous cystadenocarcinoma in a 38-year-old female is presented. The literature concerning primary retroperitoneal cystadenocarcinomas is reviewed and it is concluded that close postoperative follow-up is necessary....

  11. CT-Guided Radioactive {sup 125}I Seed Implantation Therapy of Symptomatic Retroperitoneal Lymph Node Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zhongmin, E-mail: wzm0722@hotmail.com [Shanghai Jiaotong University School of Medicine, Department of Nuclear Medicine, Renji Hospital (China); Lu, Jian; Gong, Ju; Zhang, Liyun [Shanghai Jiaotong University School of Medicine, Department of Radiology, Ruijin Hospital Luwan Branch (China); Xu, Yingjia [Shanghai Jiao Tong University, Department of Cardiology, Shanghai Chest Hospital (China); Song, Shaoli [Shanghai Jiaotong University School of Medicine, Department of Nuclear Medicine, Renji Hospital (China); Chen, Kemin [Shanghai Jiaotong University School of Medicine, Department of Radiology, Ruijin Hospital (China); Liu, Fenju [Soochow University, School of Radiation Medicine and Public Health (China); Gang, Huang, E-mail: huanggang0722@hotmail.com [Shanghai Jiaotong University School of Medicine, Department of Nuclear Medicine, Renji Hospital (China)

    2013-04-12

    PurposeThis study explored the clinical efficacy of CT-guided radioactive {sup 125}I seed implantation in treating patients with symptomatic retroperitoneal lymph node metastases.MethodsTwenty-five patients with pathologically confirmed malignant tumors received CT-guided radioactive {sup 125}I seed implantation to treat metastatic lymph nodes. The diameter of the metastatic lymph nodes ranged from 1.5 to 4.5 cm. Treatment planning system (TPS) was used to reconstruct the three-dimensional image of the tumor and then calculate the corresponding quantity and distribution of {sup 125}I seeds.ResultsFollow-up period for this group of patients was 2–30 months, and median time was 16 months. Symptoms of refractory pain were significantly resolved postimplantation (P < 0.05), and Karnofsky score rose dramatically (P < 0.05). Most patients reported pain relief 2–5 days after treatment. Follow-up imaging studies were performed 2 months later, which revealed CR in 7 patients, PR in 13 patients, SD in 3 patients, and PD in 2 patients. The overall effective rate (CR + PR) was 80 %. Median survival time was 25.5 months. Seven patients died of recurrent tumor; 16 patients died of multiorgan failure or other metastases. Two patients survived after 30 months follow-up. Two patients reported localized skin erythema 1 week postimplantation, which disappeared after topical treatment.ConclusionsCT-guided radioactive {sup 125}I seed implantation, which showed good palliative pain relief with acceptable short-term effects, has proved in our study to be a new, safe, effective, and relatively uncomplicated treatment option for symptomatic retroperitoneal metastatic lymph nodes.

  12. Treatment of severe acute pancreatitis through retroperitoneal laparoscopic drainage

    Institute of Scientific and Technical Information of China (English)

    Chun Tang; Baolin Wang; Bing Xie; Hongming Liu; Ping Chen

    2011-01-01

    A treatment method based on drainage via retroperitoneal laparoscopy was adopted for 15 severe acute pancreatitis (SAP) patients to investigate the feasibility of the method.Ten patients received only drainage via retroperitoneai laparoscopy,four patients received drainage via both retroperitoneal and preperitoneal laparoscopy,and one patient received drainage via conversion to laparotomy.Thirteen patients exhibited a good drainage effect and were successfully cured without any other surgical treatment.Two patients had encapsulated effusions or pancreatic pseudocysts after surgery,but were successfully cured after lavage and B ultrasound-guided percutaneous catheter drainage.SAP treatment via retroperitoneal laparoscopic drainage is an effective surgical method,resulting in minor injury.

  13. Retroperitoneal hematoma after manual reduction of indirect inguinal hernia.

    Science.gov (United States)

    Xu, Xiequn; Hong, Tao; Li, Binglu; Liu, Wei; Zheng, Chaoji; He, Xiaodong

    2013-07-01

    This report presents the case of a 59-year-old man with sudden severe pain in the right lower abdomen after manually reducing the right indirect inguinal hernia who had bilateral indirect inguinal hernia for 5 years. A subsequent contrast computed tomography scan with contrast of the abdomen and pelvis revealed a significant extensive retroperitoneal hematoma at the abdomen and pelvis of the right side. There was contrast leaked out, which was suspected from inferior epigastric artery. He underwent successful laparotomy. The bleeding ruptured inferior epigastric artery at the interior side of the deep inguinal ring was found, the deep inguinal ring was avulsed, ligature of the inferior epigastric artery and removal of the retroperitoneal hematoma were done, and the patient was discharged from hospital on the seventh postoperative day. This is the first report in the literature on retroperitoneal hematoma caused by manual reduction of indirect inguinal hernia.

  14. Retroperitoneal haematoma and related organ injury--management approach.

    Science.gov (United States)

    Madiba, T E; Muckart, D J

    2001-05-01

    Retroperitoneal haematoma following blunt or penetrating trauma may arise from injuries to bone, major vascular structures, hollow viscera or solid organs. Clinical significance varies from inconsequential to fatal. Although the guidelines for exploration are clear-cut during laparotomy for associated intra-abdominal injuries, this is not the case with isolated retroperitoneal haematoma. Lateral and pelvic haematomas may be selectively explored and central haematomas always need exploration. All penetrating wound tracts should be explored, irrespective of the site of the haematoma, to exclude vital structural injury.

  15. A huge renal capsular leiomyoma mimicking retroperitoneal sarcoma

    Directory of Open Access Journals (Sweden)

    Lal Anupam

    2009-01-01

    Full Text Available A huge left renal capsular leiomyoma mimicking retroperitoneal sarcoma presented in a patient as an abdominal mass. Computed tomography displayed a large heterogeneous retro-peritoneal mass in the left side of the abdomen with inferior and medial displacement as well as loss of fat plane with the left kidney. Surgical exploration revealed a capsulated mass that was tightly adherent to the left kidney; therefore, total tumor resection with radical left nephrectomy was performed. Histopathology ultimately confirmed the benign nature of the mass. This is the largest leiomyoma reported in literature to the best of our knowledge.

  16. Demonstration of the route of embryo migration in retroperitoneal ectopic pregnancy using contrast-enhanced computed tomography.

    Science.gov (United States)

    Liang, Changhu; Li, Xueli; Zhao, Bin; Du, Yinglin; Xu, Shifeng

    2014-03-01

    Retroperitoneal abdominal pregnancy is exceptionally rare. An unusual retroperitoneal pregnancy has a high risk of severe bleeding. Abdominal ultrasonography and whole abdominal computerized tomography scanning should be performed for the early diagnosis of ectopic pregnancy. A case of retroperitoneal ectopic pregnancy located very close to large retroperitoneal blood vessels and treated with resection is presented. Many unusual features of retroperitoneal ectopic pregnancy were highlighted as providing further evidence in support of the main proposed embryo migration mechanism via lymphatic vessels.

  17. Idiopathic retroperitoneal fibrosis: A challenging case in a rare disease

    Directory of Open Access Journals (Sweden)

    Charat Thongprayoon

    2014-01-01

    Full Text Available Context: Retroperitoneal fibrosis is a rare but severe disease. The diagnosis is usually late when a patient is evaluated for renal insufficiency. Untreated cases may develop serious complications or advance to end-stage renal disease. Case Report: We report a 66-year-old man who presented with worsening kidney function. He was successfully given the diagnosis of idiopathic retroperitoneal fibrosis. Prednisone (1 mg/kg per day was initiated. The patient′s symptoms continued to improve at 1 month with stable kidney function. Conclusion: Clinicians should have high index of suspicion for retroperitoneal fibrosis when patients present with an elevated erythrocyte sedimentation rate (ESR or C-reactive protein (CRP and renal insufficiency from obstructive uropathy. The diagnosis of retroperitoneal fibrosis is primarily made from imaging by computed tomography (CT scan. Biopsy should be performed in patients who do not have typical findings on CT scan and to exclude the possibility of immunoglobulin G4 (IgG4-related disease.

  18. A retroperitoneal neuroendocrine tumor in ectopic pancreatic tissue.

    Science.gov (United States)

    Okasha, Hussein Hassan; Al-Bassiouni, Fahim; El-Ela, Monir Abo; Al-Gemeie, Emad Hamza; Ezzat, Reem

    2013-07-01

    Ectopic pancreas is the relatively uncommon presence of pancreatic tissue outside the normal location of the pancreas. We report a case of abdominal pain due to retroperitoneal neuroendocrine tumor arising from heterotopic pancreatic tissue between the duodenal wall and the head of the pancreas. Patient underwent surgical enucleation of the tumor.

  19. Primary retroperitoneal Merkel cell carcinoma: Case report and literature review

    Science.gov (United States)

    Quiroz-Sandoval, Osvaldo A.; Cuellar-Hubbe, Mario; Lino-Silva, Leonardo S.; Salcedo-Hernández, Rosa A.; López-Basave, Horacio N.; Padilla-Rosciano, Alejandro E.; León-Takahashi, Alberto M.; Herrera-Gómez, Ángel

    2015-01-01

    Background Merkel cell carcinoma (MCC) is an aggressive cutaneous neuroendocrine carcinoma that affects elderly patients and typically arises in sun-exposed skin. The disease is very rare and only few cases present with no apparent skin lesion. In the retroperitoneum there are only two cases reported in the literature. Case presentation We report a case of a 54-year-old Mexican male with MCC, which presented as a large retroperitoneal mass. Pathological and immunohistochemical analysis of the transabdominal CT-guided biopsy specimen revealed a MCC. The patient underwent preoperative chemotherapy followed by a laparotomy and the mass was successfully excised. Discussion There are two possible explanations for what occurred in our patient. The most plausible theory is the retroperitoneal mass could be a massively enlarged lymph node where precursor cells became neoplastic. This would be consistent with a presumptive diagnosis of primary nodal disease. Moreover, metastasis to the retroperitoneal lymph nodes has been reported as relatively common when compared to other sites such as liver, bone, brain and skin. The less probable theory is the non-described “regression” phenomena of a cutaneous MCC, but we are not found a primary skin lesion. Conclusion Preoperative chemotherapy and excision of the primary tumor is the surgical treatment of choice for retroperitoneal MCC. We propose that further studies are needed to elucidate the true efficacy of chemotherapy in conventional and unconventional patients with MCC. PMID:26708276

  20. A Giant Retroperitoneal Abscess Mimicking Incarcerated Inguinal Hernia

    Directory of Open Access Journals (Sweden)

    Naciye Sinem Gezer

    2015-06-01

    Full Text Available An 82-year-old man was admitted to the emergency room with an acute left-sided groin pain and scrotal swelling. He has suffered from a groin hernia for two years. Abdominal x-ray demonstrated air-fluid levels in the left upper quadrant suggesting an intestinal obstruction (Figure 1. Abdominal computed tomography (CT scan was obtained with an initial diagnosis of an incarcerated inguinal hernia. However, it showed multiple perirenal abscesses and a giant-sized retroperitoneal abscess extending from the retroperitoneal space into the scrotum through the inguinal canal (Figure 2 and 3. Retroperitoneal abscesses are most frequently seen in the 3rd to 6th decades of life (1. Gram-negative bacteria, most commonly E. coli, are the cause of infection which usually develops secondary to pyelonephritis, urinary stasis or immune suppression. The onset of clinical manifestations of the infection, including flank, abdomen and groin pain, chills, fever, tachycardia, weakness and anorexia are often insidious (2,3. Laboratory findings include leukocytosis, increased serum creatinine levels and pyuria. The literature emphasizes the possibility of diagnostic delay and postponed treatment of retroperitoneal abscess due to the fact that its prodrome phase may be long.

  1. Pittsburgh Police Arrest Data

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Arrest data contains information on people taken into custody by City of Pittsburgh police officers. More serious crimes such as felony offenses are more likely to...

  2. Cardiac arrest - cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    Basri Lenjani; Besnik Elshani; Nehat Baftiu; Kelmend Pallaska; Kadir Hyseni; Njazi Gashi; Nexhbedin Karemani; Ilaz Bunjaku; Taxhidin Zaimi; Arianit Jakupi

    2014-01-01

    Objective:To investigate application of cardiopulmonary resuscitation(CPR) measures within the golden minutes inEurope.Methods:The material was taken from theUniversityClinical Center ofKosovo -EmergencyCentre inPristina, during the two(2) year period(2010-2011).The collected date belong to the patients with cardiac arrest have been recorded in the patients' log book protocol at the emergency clinic.Results:During the2010 to2011 in the emergency center of theCUCK inPristina have been treated a total of269 patients with cardiac arrest, of whom159 or59.1% have been treated in2010, and110 patients or40.9% in2011.Of the269 patients treated in the emergency centre,93 or34.6% have exited lethally in the emergency centre, and176 or 65.4% have been transferred to other clinics.In the total number of patients with cardiac arrest, males have dominated with186 cases, or69.1%.The average age of patients included in the survey was56.7 year oldSD±16.0 years.Of the269 patients with cardiac arrest, defibrillation has been applied for93 or34.6% of patients.In the outpatient settings defibrillation has been applied for3 or3.2% of patients.Patients were defibrillated with application of one to four shocks. Of27 cases with who have survived cardiac arrest, none of them have suffered cardiac arrest at home,3 or11.1% of them have suffered cardiac arrest on the street, and24 or88.9% of them have suffered cardiac arrest in the hospital.5 out of27 patients survived have ended with neurological impairment.Cardiac arrest cases were present during all days of the week, but frequently most reported cases have been onMonday with32.0% of cases, and onFriday with24.5% of cases. Conclusions:All survivors from cardiac arrest have received appropriate medical assistance within10 min from attack, which implies that if cardiac arrest occurs near an institution health care(with an opportunity to provide the emergent health care) the rate of survival is higher.

  3. Silica Refractory Bricks

    Institute of Scientific and Technical Information of China (English)

    Yu Lingyan; Peng Xigao

    2011-01-01

    @@ 1.Scope This standard specifies the classification,technical requirements,test methods,quality appraisal procedures,packing,marking,transportation,storage,and quality certificate of silica refractory bricks.This standard is applicable to silica refractory bricks with single weight≤40 kg.

  4. Developing Refractories for Exporting

    Institute of Scientific and Technical Information of China (English)

    PANShang-xin

    1996-01-01

    The total output of China refractory products and export volume of China refractory raw materials rank the first in the world,In future the task is to improve the quality of the products to enlarge the variety and to expand export.

  5. [Severe Acute Myocardial Infarction during Induction Chemotherapy for Retroperitoneal Germ Cell Tumor : A Case Report].

    Science.gov (United States)

    Sakka, Shotaro; Kawai, Koji; Tsujimoto, Ippei; Kurobe, Masahiro; Ichioka, Daishi; Kantori, Shuya; Kojima, Takahiro; Suetomi, Takahiro; Jouraku, Akira; Miyazaki, Jun; Hoshi, Tomoya; Nishiyama, Hiroyuki

    2016-09-01

    A 37-year-old man presented at our hospital. Pathological examination of a right orchiectomy specimen, radiographic examination, and tumor marker profile resulted in a diagnosis of retroperitoneal nonseminomatous germ cell tumor (intermediate risk according to IGCC classification). Laboratory testing revealed mild elevation of low density lipoprotein cholesterol. Induction chemotherapy with bleomycin, etoposide and cisplatin (BEP) was started, but he complained of chest pain on day 10 of the second cycle of BEP. We immediately started cardiac monitoring. One hour later, he suffered cardiac arrest due to ventricular fibrillation. Fortunately, sinus rhythm was restored after defibrillation. A diagnosis of acute myocardial infarction (AMI) with total occlusion at the mid-portion of the left anterior descending coronary artery was established by coronary angiography. After percutaneous transluminal coronary angioplasty was successfully performed, he recovered uneventfully. The induction chemotherapy was re-started 19 days after AMI. To avoid endothelial damage by bleomycin, we elected to treat with etoposide, ifosfamide, and cisplatin (VIP). After two further courses of VIP, the patient underwent resection of retoperitoneal tumor and achieved complete remission. The patient has remained disease-free during 3 years follow up without recurrence of AMI.

  6. Development of improved refractories

    Energy Technology Data Exchange (ETDEWEB)

    Wereszczak, A.A.; Ferber, M.K.; Liu, K.C. [Oak Ridge National Lab., TN (United States); Moore, R.E. [Univ. of Missouri, Rolla, MO (United States)

    1997-04-01

    The goal of the proposed project is to provide expertise and facilities for the high temperature mechanical properties characterization of refractory materials which are of interest to the US DOE`s Office of Industrial Technologies Advanced Industrial Materials Project. Initially the project would establish dedicated refractory testing facilities which would be capable of generating representative engineering creep and high temperature modulus of elasticity (MOE) data to a temperature of 3300{degrees}F (1815{degrees}C) in ambient air. The generated engineering creep and MOE data would serve R&D requirements of refractories-manufacturers and its glass-manufacturer end-users and designers. The relevance of this effort to the refractory and glass-making industries would be ensured by coordinating the research activities through a membership with Alfred University`s Center for Glass Research (CGR) Satellite Center at the University of Missouri-Rolla (UMR), an NSF Center. Valid engineering creep and high temperature MOE data currently do not exist for almost all commercial refractories. Refractory end-users such as glass-manufacturers require such data for efficient and economical design of their various glass-melting furnace superstructures (e.g., furnace crowns). Refractories in glass production furnaces may be subjected to extreme temperatures as high as 3200{degrees}F (1760{degrees}C). With the simultaneous imposition of mechanical and thermal stresses, creep deformation of the refractory material will assuredly occur as a consequence. Designers must ensure that the structural integrity is maintained, so these high temperature deformations must be considered for successful glass furnace superstructure design. These criteria can only be satisfied with the utilization of representative engineering creep and high temperature MOE data for the refractory materials that are chosen for the design of the refractory superstructures.

  7. Autoimmune pancreatitis metachronously associated with retroperitoneal fibrosis with IgG4-positive plasma cell infiltration

    Institute of Scientific and Technical Information of China (English)

    Terumi Kamisawa; Pong Yui Chen; Yuyang Tu; Hitoshi Nakajima; Naoto Egawa

    2006-01-01

    Retroperitoneal fibrosis is an uncommon disorder characterized by the formation of a dense plaque of fibrous tissue in the retroperitoneum, and its etiology remains unknown. Autoimmune pancreatitis is a rare type of chronic pancreatitis characterized by fibrosis with abundant infiltration of IgG4-positive plasma cells and lymphocytes and obliterative phlebitis in the pancreas. We present a case of autoimmune pancreatitis that developed 10 mo after the occurrence of retroperitoneal fibrosis. Histological findings of the resected retroperitoneal mass were marked periureteral fibrosis with abundant infiltration of IgG4-positive plasma cells and lymphocytes and obliterative phlebitis.These findings suggest a common pathophysiological mechanism for retroperitoneal fibrosis and autoimmune pancreatitis in this case. Some cases of retroperitoneal fibrosis might be a retroperitoneal lesion of IgG4-related sclerosing disease.

  8. Surgical anatomy of the retroperitoneal spaces, Part V: Surgical applications and complications.

    Science.gov (United States)

    Mirilas, Petros; Skandalakis, John E

    2010-04-01

    Knowledge of the surgical anatomy of the retroperitoneum is crucial for surgery of the retroperitoneal organs. Surgery is essential for treatment of retroperitoneal pathologies. The list of these diseases is extensive and comprises acute and chronic inflammatory processes (abscess, injury, hematoma, idiopathic fibrosis), metastatic neoplasms, and primary neoplasms from fibroadipose tissue, connective tissue, smooth and striated muscle, vascular tissue, somatic and sympathetic nervous tissue, extraadrenal chromaffin tissue, and lymphatic tissue. The retroperitoneum can be approached and explored by several routes, including the transperitoneal route and the extraperitoneal route. The retroperitoneal approach to the iliac fossa is used for ectopic renal transplantation. Safe and reliable primary retroperitoneal access can be performed for laparoscopic exploration. The anatomic complications of retroperitoneal surgery are the complications of the organs located in several compartments of the retroperitoneal space. Complications may arise from incisions to the somatic wall, somatic nerves, blood and lymphatic vessels, lymph nodes, visceral autonomous plexuses, and neighboring splanchna.

  9. Retroperitoneal schwannoma mimicking metastatic seminoma:case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Shi-Qiang Zhang; Song Wu; Kai Yao; Pei Dong; Yong-Hong Li; Zhi-Ling Zhang; Xian-Xin Li

    2013-01-01

    If a testicular cancer pat ient has a mass in the retroperitoneum,a metastasis is often the first suspicion,probably leading to improper diagnosis and overtreatment.Here we report a case of retroperitoneal schwannoma mimicking metastatic seminoma.A 29-year-old man,who had a history of seminoma,presented with a single retroperitoneal mass suspected to be a metastasis.Because the patient refused radiotherapy,3 cycles of cisplatin,etoposide,and bleomycin were offered.Post-chemotherapy computed tomography scan revealed persistence of the retroperitoneal mass,with no change in tumor size or characteristics.Subsequently,retroperitoneal lymph node dissection was performed.The dissected tissue contained negative lymph nodes but a single mass in the attached fat.Pathology revealed retroperitoneal schwannoma,which was confirmed by immunohistochemistry.Thus,clinicians should be aware of retroperitoneal schwannoma and its distinction from metastatic seminoma to avoid misdiagnosis and ensure proper treatment.

  10. Retroperitoneal fibrosis - the state-of-the-art.

    Science.gov (United States)

    Runowska, Marta; Majewski, Dominik; Puszczewicz, Mariusz

    2016-01-01

    Retroperitoneal fibrosis (RPF) is a rare disease, hallmarked by inflammation and deposition of fibrous tissue around the abdominal aorta. This process may spread contiguously and involve adjacent structures, leading to many complications, among which the most frequent and most severe is ureteral obstruction. The condition usually has idiopathic origin (idiopathic retroperitoneal fibrosis - IRF), but can also develop secondarily to a number of factors. The etiology of the disease remains unclear. Current research suggests that about half of the cases of IRF may be a symptom of a recently discovered, clinically heterogeneous immunoglobulin G4-related disease (IgG4-RD). Corticosteroids are the first-line treatment for IRF, but effective attempts to use immunosuppressants are also made. This paper presents the current state of knowledge on the etiopathogenesis, clinical presentation, diagnosis and therapeutic possibilities in different forms of RPF. Based on the latest research, an analysis of the relationship between IRF and IgG4-RD was performed.

  11. Retroperitoneal calcifying fibrous tumor mimicking an adrenal tumor.

    Science.gov (United States)

    Prochaska, Erica C; Sciallis, Andrew P; Miller, Barbra S

    2016-06-01

    Establishing the etiology of a retroperitoneal tumor may be difficult due to close proximity of multiple organs. Evaluation of retroperitoneal tumors often leads to surgery, many times to obtain a definitive diagnosis and rule out malignancy. Calcifying fibrous tumors (CFT) are very rare soft tissue tumors occurring most often in young patients. They are most often found arising in the thoracic cavity, mediastinum, abdominal cavity and extremities and usually have a benign clinical course. Macrocscopically, the tumors are well circumscribed and firm with a white-tan appearance. Histologically, CFT comprised a hypocellular proliferation of bland spindle cells, densely hyalinized collagen, chronic lymphoplasmacytic inflammation and dystrophic calcifications. Other considerations in the pathologic differential diagnosis include solitary fibrous tumor and inflammatory myofibroblastic tumor.

  12. [Aspergillosis located on polycystic kidney treated with retroperitoneal nephrectomy].

    Science.gov (United States)

    Rabii, R; Hoznek, A; Salomon, L; Bourg, S; Chopin, D K; Abbou, C C

    2001-03-01

    We reported an uncommon case of 40 years old man, cardiac transplant recipient with chronic renal faillure who consulted for infected left polycystic renal. The serum creatinine level was 750 mmol/L, and urine culture isolated a E. Ecol germe. The abdominopelvic computed tomography showed a bilateral large polycystic renal cortex and suspected the infected cyst in lower pole of left kidney. The retroperitoneal laparoscopic nephrectomy was performed confirming a renal invasive aspergillosa. About this case we should have a high index of suspicion for fungal aetiology in kidney infection in transplant patients and the management of non functioning infected polycystic kidney can use laparoscopic retroperitoneal nephrectomy. This approach can offers a minimal morbidity and alternative to open surgery.

  13. Left retroperitoneal hydatid cyst disease and the treatment approach

    Directory of Open Access Journals (Sweden)

    Alper Avcı

    2013-12-01

    Full Text Available Hydatid disease is one of the oldest diseases known to mankind. In 85-95% of the cases, the liver and/or the lung are involved and in only 5-15% the cyst occurs at the other sites. Echinococcal cysts are mostly found in the liver (60%-70% of cases, followed by the lungs (10%-25%, spleen, ovaries, kidneys, brain, bones and heart, but rarely elsewhere in the body. 1-3 Retroperitoneal location of hydatid cyst is encountered rarely and only occasional case reports have appeared since Lockhart and Sapinza first reported this entity in 1958. 4-6 Primary retroperitoneal hydatid cyst is extremely rare. Hydatid disease in extrahepatic locations usually remains asymptomatic unless the cyst grows and produces.

  14. Retroperitoneal Pararenal Mass; Castleman Disease: A Case Report

    Directory of Open Access Journals (Sweden)

    Alper Ozorak

    2016-05-01

    Full Text Available Castleman%u2019s disease is a heterogeneous group of lymphoproliferative disorders with unknown etiology presenting with lymphadenopathy. Although Castleman%u2019s Disease may occur anywhere along the lymphatic chain, the mediastinum is the most common location (70%. We represent 36-year-old male patient with homogeneous retroperitoneal mass that interrelated with renal hilum of the right kidney in abdominal tomography. Surgical complete resection performed and histopathological diagnosis of the resected tissue was hyaline-vascular type of Castleman%u2019s disease It is histologically and prognostically distinct from malignant lymph-node hyperplasia. Although Castleman%u2019s disease is rare condition, it should always be kept in mind in the differential diagnosis of retroperitoneal tumors.

  15. Giant recurrent retroperitoneal liposarcoma presenting as a recurrent inguinal hernia

    Directory of Open Access Journals (Sweden)

    Ajay H. Bhandarwar

    2011-11-01

    Full Text Available Retroperitoneal liposarcoma presenting as an inguinal hernia is a rare entity. We present the first case of Giant recurrent liposarcoma presenting as a recurrent inguinal hernia in a 40-year-old male. Physical examination showed an irreducible lump in the right inguinal region and a scar in the right lumbar and right inguinal region. Computed tomography (CT scan of abdomen revealed it to be a retro peritoneal mass extending into the right inguinal region along and involving the cord structures. Wide local excision of the tumour with right orchidectomy and inguinal hernioplasty was performed. Histo-pathology confirmed it to be a liposarcoma. Patient received postoperative radio therapy. Follow up of two years has shown him to be disease free. Retroperitoneal liposarcoma can grow along cord structures into the inguinal canal and mimic an irreducible indirect inguinal hernia.

  16. Dedifferentiated retroperitoneal liposarcoma presenting as right inguinal hernia: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Myung; Lee, Su Lim; Ku, Young Mi [Dept. of Radiology, Uijeongbu St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu (Korea, Republic of); Choi, Moon Hyung [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2016-01-15

    Retroperitoneal liposarcomas usually present as painless, slow-growing abdominal masses. When masses grow large enough to compress surrounding structures, symptoms may occur. Retroperitoneal liposarcoma clinically manifesting as inguinal hernia is a very rare entity; only 11 cases have been reported. Herein, we present radiographic features of a 37-year-old male with a painless palpable mass in the right groin that was identified as dedifferentiated retroperitoneal liposarcoma herniated through the right inguinal canal.

  17. Pulmonary hyalinizing granuloma and retroperitoneal fibrosis in an adolescent

    Energy Technology Data Exchange (ETDEWEB)

    Young, Adam S.; Binkovitz, Larry A.; Adler, Brent H. [Columbus Children' s Hospital, Children' s Radiological Institute, Columbus, OH (United States); Nicol, Kathleen K. [Columbus Children' s Hospital, Department of Pathology, Columbus, OH (United States); Rennebohm, Robert M. [Columbus Children' s Hospital, Department of Rheumatology, Columbus, OH (United States)

    2007-01-15

    We describe a 15-year-old boy who developed pulmonary hyalinizing granuloma (PHG) and retroperitoneal fibrosis (RPF). His PHG and RPF were not associated with histoplasmosis or tuberculosis and appeared to represent idiopathic autoimmune phenomena. This is the first reported case of PHG in a pediatric patient and the fourth reported co-occurrence of PHG and RPF. The use of F-18 fluorodeoxyglucose positron emission tomography in the diagnostic and follow-up evaluation of PHG is reported. (orig.)

  18. Recent Progress in the Management of Retroperitoneal Sarcoma

    Directory of Open Access Journals (Sweden)

    Rona Cheifetz

    2001-01-01

    Full Text Available Retroperitoneal sarcomas (RPS are rare tumours that typically present late and carry a poor prognosis even following grossly complete resection. In an attempt to improve the outlook for patients with RPS, sarcoma specialists have employed various adjuvant therapies, including extermal beam radiation, intraoperative radiation, brachyradiation and systemic chemotherapy. This article reviews the presentation and prognosis of RPS, and focuses on the results of new treatment strategies compared with conventional management.

  19. Giant Primary Mature Retroperitoneal Teratomain in Adult Male Patient

    OpenAIRE

    R. Ebrahimian; D. Tasa

    2015-01-01

    Introduction: Teratomas are congenital tumors consisting of derivatives from the ectoderm, endoderm and mesoderm germ cell layers. A teratoma is considered to be a non-seminomatous germ cell tumor and is typically located in either the sacrococcygeal region or in the gonads. Giant retroperitoneal teratomas in adults are even rarer, with only a few cases previously described in the literature. Case report: A 35-year-old male patient with severe nausea and vomiting was taken to the emergency wa...

  20. [Retroperitoneal fibrosis with eye-drops containing timolol].

    Science.gov (United States)

    Delorme, E; Vial, T; Rabilloud, M; de Carlan, H; Evreux, J C

    1990-01-01

    Retroperitoneal fibrosis occurred in a 62-year-old man who had been treated during 4 years eye-drops containing timolol. The disease was diagnosed after a sudden episode of nephritic colic. The recovery was progressive and uneventful. No corticosteroid therapy was used. Six months later the patient remained free of symptoms. Although an idiopathic origin could not be excluded, the causal relationship with timolol treatment is likely due to the chronology of events and the lack of other causes.

  1. Retroperitoneal endodermal sinus tumor patient with palliative care needs

    Directory of Open Access Journals (Sweden)

    Surbhi Kashyap

    2016-01-01

    Full Text Available This article is a case reflection of a personal encounter on the palliative care treatment required after the removal of a complicated case of a primary extra-gonadal retro-peritoneal endodermal sinus tumor (yolk sac tumor. This reflection is from the perspective of a recently graduated MD student who spent one month with an Indian pain management and palliative care team at the Institute Rotary Cancer Hospital (IRCH, All India Institute of Medical Sciences (AIIMS, New Delhi

  2. A case of retroperitoneal liposarcoma after delivery with expression of estrogen receptor: Report of a case

    Directory of Open Access Journals (Sweden)

    Hiroaki Kasashima

    2015-01-01

    Conclusion: Retroperitoneal liposarcoma has a high local recurrence rate due to the difficulty in complete surgical resection; therefore, additional hormone therapy is important for improving the prognosis.

  3. Spontaneous retroperitoneal hemorrhage after hemodialysis involving anticoagulant agents

    Institute of Scientific and Technical Information of China (English)

    Wen-xing FAN; Song-min HUANG; Ping FU; Zheng-xu DENG; Fang LIU; Rong-bo LIU; Ling HE; Bogati AMRIT; Li ZANG; Jing-wen LI; Xian-rong LIU

    2012-01-01

    In this paper,we described the symptoms and treatment of a patient with diabetic nephropathy accompanied by spontaneous retroperitoneal hemorrhage after hemodialysis.An elderly female patient with diabetic nephropathy presented with severe pain,numbness,and an increasing swelling in the left hip and left thigh after six sessions of hemodialysis involving the use of an antiplatelet drug and an anticoagulant agent.Her hemoglobin decreased to 46 g/L.An abdominal ultrasound showed a hematoma in the left retroperitoneal space,and computed tomography (CT) findings revealed a 6 cm×8 cm×10 cm hematoma in the left psoas muscle.After aggressive supportive therapy [the administration of packed red blood cell transfusion,carbazochrome sodium sulfonate injection,and continuous venovenous hemofiltration (CWH)],the patient's vital signs stabilized and her hemoglobin increased to 86 g/L.Repeat CT showed that the hematoma had been partially absorbed after two weeks.Eventually,the patient was discharged with stable vital signs.Physicians should be aware of the possibility of spontaneous retroperitoneal hemorrhage,particularly in patients with diabetic nephropathy undergoing hemodialysis involving the use of anticoagulant agents.

  4. Two Case Reports and Actual Treatment Approachs of Retroperitoneal Fibrosis

    Directory of Open Access Journals (Sweden)

    Eymen Gazel

    2013-06-01

    Full Text Available Retroperitoneal fibrosis (RPF is a rare disease of unclear etiology, which is characterized by a chronic non specific inflammation of the retroperitoneum. This inflammation of the retroperitoneum may entrap and obstruct retroperitoneal structures, particularly the ureters. Patients with RPF show non specific clinical symptoms, including poorly localized back pain, general malaise, weight loss, anemia, features of renal failure and occasionally, mild fever. The early symptoms are non specific and an accurate diagnosis is often achieved only subsequent to urological obstruction or the occurrence of renal failure. Although a number of scientific journals devoted to RPF are present in the litera¬ture, there is no accepted diagnostic or therapeutic strategy for this disease. However, there are several therapeutic strate¬gies which have been proven to be effective. Hereby, we reported two cases of retroperitoneal fibrosis which had similar symptoms and findings but different responses to medical treatment .We aimed to discuss challanges of RPF%u2019s diagnosis and the treatment protocol.

  5. Retroperitoneal unicentric Castleman's disease (giant lymph node hyperplasia: case report

    Directory of Open Access Journals (Sweden)

    Jaques Waisberg

    Full Text Available CONTEXT AND OBJECTIVE: Castleman's disease, or giant lymph node hyperplasia, is a rare disorder of the lymphoid tissue that causes lymph node enlargement. It is considered benign in its localized form, but aggressive in the multicentric type. The definitive diagnosis is based on postoperative pathological findings. The aim here was to describe a case of retroperitoneal unicentric Castleman's disease in the retroperitoneum. CASE REPORT: A 61-year old white male with weight loss and listlessness presented with moderate arterial hypertension and leukopenia. Abdominal tomography revealed a 5 x 4 x 5 cm oval mass of low attenuation, with inner calcification and intense enhancement on intravenous contrast, located in the retroperitoneal region, between the left kidney and the aorta, at the renal hilus. Exploratory laparotomy revealed a non-pulsatile solid oval mass situated in the retroperitoneum, adjacent to the left renal hilus. The retroperitoneal lesion was removed in its entirety. Examination of frozen samples revealed benign lymph node tissue and histopathological examination of the surgical sample revealed hyaline-vascular giant lymph node hyperplasia (Castleman's disease. The patient was discharged on the 12th day without significant events. Two months after the operation, the patient was readmitted with severe cardiac insufficiency, acute renal failure and bronchopneumonia, which progressed to acute respiratory insufficiency, sepsis and death.

  6. The European Arrest Warrant

    Directory of Open Access Journals (Sweden)

    Minodora-Ioana Balan-Rusu

    2012-05-01

    Full Text Available In the paper it is generally examined the institution of the European arrest warrant according to the latest changes and additions through the adoption of a new European legislative act. The paper is a continuation of research in the area of judicial cooperation in criminal matters in the European Union. It may be useful to the judicial bodies with the responsibilities of issuing and executing a specific European arrest warrant and to academics and students in law schools. The research results, the essential contribution, the originality consist of the general examination of the institution, the critical remarks and proposals for amending and completing certain provisions insufficiently clear.

  7. Fireclay Refractory Bricks

    Institute of Scientific and Technical Information of China (English)

    Zhang Xiaohui

    2010-01-01

    @@ 1 Scope This standard specifies the classification,brand,shape,dimension,technical requirements,test methods,quality appraisal procedures,packing,marking,transportation,storage,and quality certificate of fireclay refractory bricks.

  8. Refractory duodenal ulcer

    Directory of Open Access Journals (Sweden)

    Al Freihi Hussein

    1995-01-01

    Full Text Available Refractory or intractable ulcer is defined as an ulcer that fails to heal completely after eight to twelve weeks, despite appropriate treatment with a modern antiulcer therapy in a compliant patient. Refractory ulcer should be suspected in individuals diagnosed to have peptic ulcer if their symptoms persist longer than usual: occurrence of complications or simply their ulcers fail to heal, since up to 25% of such patients remain asymptomatic. Conditions associated with refractory ulcer include noncompliance, continuous consumption of nonsteroidal anti-inflam-matory drugs, acid hypersecretion, smoking. male gender and other factors with questionable role like advanced age, large ulcer size, prolonged duration of symptoms and the presence of complication like bleeding. Nonpeptic ulcers like tuberculosis, malignancy, Crohn′s disease and primary intestinal lymphoma should always be considered in the differential diagnosis. Colonization with H. pylori which is well-known as a cause of frequent recurrences, has not been linked with refractoriness. Patients with refractory ulcers must undergo thorough re-evaluation including repeated endoscopies, obtaining biopsies for microbiology and histology and determination of serum-gastrin level. Once diseases with identifiable etiologies have been ruled out, aggressive medical management with single or multiple antiulcer drugs should be instituted. Such treatments will virtually heal all refractory ulcers. Surgery should be reserved for patients whose ulcers fail to respond to optimal medical therapy or those who develop com-plications necessitating surgical intervention.

  9. Runway Arrested Landing Site (RALS)

    Data.gov (United States)

    Federal Laboratory Consortium — The Runway Arrested Landing Site includes an underground complex located on a Mod 2, Mod 3, and Mod 3+ arresting gear and are located under the runway and accurately...

  10. Concomitant mediastinal and extrarenal retroperitoneal angiomyolipomas in a patient who previously underwent ipsilateral radical nephrectomy

    Directory of Open Access Journals (Sweden)

    Carl Sheng-Chen Wen

    2014-12-01

    Full Text Available The association of the tuberous sclerosis complex with angiomyolipoma (AML arising from the retroperitoneum and mediastinum has not been reported in the literature. We present the first case in which a patient presented with a combined retroperitoneal extrarenal and posterior mediastinal AML. Interestingly, the ipsilateral retroperitoneal AML emerged 15 years after radical nephrectomy for the left renal AML.

  11. Differential routes of carboplatin administration influence lymphocyte apoptosis in retroperitoneal lymph nodes.

    Science.gov (United States)

    Huang, Yong-Wen; Zeng, Zheng; Li, Su; Liu, Ji-Hong

    2012-12-01

    We aimed to investigate carboplatin distribution in retroperitoneal lymph nodes and its effect on lymphocyte apoptosis following intravenous (IV), intra-arterial (IA), and retroperitoneal (RP) administration. Sixty-three healthy female canines were randomly assigned as IV, IA, or RP administration of carboplatin. At 0.5, 1, 2, 4, 8, 24, and 72 h after carboplatin treatment, retroperitoneal lymph nodes (n = 6 at each time point) were collected and high-performance liquid chromatography was employed to measure the carboplatin content. The differences in carboplatin pharmacokinetics of the three administration routes were compared. Terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) was carried out to measure the lymphocyte apoptosis of the retroperitoneal lymphocytes. The peak concentration of carboplatin in plasma following IV administration was the highest among all approaches; as to the peak time, RP administration was longer than the other two administrations. Concentration for carboplatin in the retroperitoneal lymph node was highest following IA administration at early time points, but at higher time points, concentration was significantly higher following RP administration. Penetration of carboplatin into the retroperitoneal space was higher following RP administration. Following RP administration, the level of apoptotic lymphocytes in the retroperitoneal lymph nodes was significantly greater than either IV or IA. Following RP administration of carboplatin, the concentration, area under the curve of carboplatin and the number of apoptotic lymphocytes were significantly higher than those following IV and IA administration. This suggests that RP administration of carboplatin is beneficial for the treatment of retroperitoneal lymph node metastasis.

  12. Simpatectomia lombar por pneumoretroperitonioscopia (SLPR Retroperitoneal endoscopic lumbar sympathectomy

    Directory of Open Access Journals (Sweden)

    Wander Eduardo Sardinha

    2007-12-01

    Full Text Available CONTEXTO: A simpatectomia ainda encontra indicação no tratamento de várias doenças, tais como a insuficiência arterial periférica crônica aterosclerótica grau IV (Fontaine sem condições de revascularização, úlceras hipertensivas e o fenômeno de Raynaud acompanhado de lesões tróficas. A cirurgia clássica é realizada através do acesso retroperitoneal, mas também pode ser realizada por meio de técnicas minimamente invasivas. OBJETIVO: Este trabalho tem o objetivo de mostrar os resultados da simpatectomia lombar por pneumoretroperitonioscopia. MÉTODOS: Trinta e um pacientes foram submetidos a simpatectomia lombar por pneumoretroperitonioscopia (22 homens e nove mulheres, com média de idade de 48 anos (41-70. Vinte eram pacientes com insuficiência arterial periférica crônica, sem possibilidade de revascularização, todos com lesões (necroses ou úlceras; sete pacientes eram portadores de tromboangeite obliterante; três tinham úlcera hipertensiva; e um apresentava fenômeno de Raynaud secundário. As cirurgias foram realizadas por pneumoretroperitoneoscopia, sendo feita a exérese do segundo ao quarto gânglio da cadeia lombar. RESULTADOS: Não houve complicações intra-operatórias, havendo necessidade de apenas uma conversão para cirurgia convencional por dificuldade técnica. A duração média do procedimento foi de 103 minutos e o tempo médio de internação foi de 2 dias. CONCLUSÃO: A simpatectomia pode ser realizada por pneumoretroperitonioscopia com as vantagens de uma cirurgia minimamente invasiva.BACKGROUND: Sympathectomy can still be performed in the treatment of many diseases, such as chronic atherosclerotic peripheral arterial disease stage IV without conditions of revascularization, hypertensive ulcer and necrosis associated with Raynaud phenomenon. The classical treatment is performed through retroperitoneal access, but can also be performed through minimally invasive techniques. OBJECTIVE: This study

  13. Gastroesophageal cancer and retroperitoneal fibrosis: Two case reports and review of the literature.

    Science.gov (United States)

    Peixoto, Renata D'Alpino; Al-Barrak, Jasem; Lim, Howard; Renouf, Daniel

    2013-03-15

    Retroperitoneal fibrosis secondary to malignant disease is a rare condition associated with a dismal prognosis. We herein present the first ever reported case of retroperitoneal fibrosis related to esophageal adenocarcinoma in a 63-year-old patient who developed bilateral ureteral obstruction due to extensive retroperitoneal fibrosis 18 mo after having completed neoadjuvant chemoradation followed by surgery for a pT3N0 adenocarcinoma of the distal esophagus. We also report the case of a previously healthy woman who presented with bilateral ureteral obstruction and diffuse narrowing of the common biliary duct and was found to have extensive retroperitoneal fibrosis as a consequence of metastatic gastric adenocarcinoma. Both patients had poor performance status and were unsuitable for palliative chemotherapy. This paper shows that urinary and biliary obstructive symptoms might represent retroperitoneal fibrosis as a consequence of gastroesophageal malignancy.

  14. A large tuberculous abscess mimicking a retroperitoneal cystic mass: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kwang Suk; Cha, Seung Hwan; Ahn, Ji Hyun; Cho, Mi Yeon [Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju (Korea, Republic of)

    2015-03-15

    Large cystic masses originating from the retroperitoneal space are rare, and cystic tumors are often considered preferentially in the differential diagnosis. However, it is difficult to make a correct diagnosis. A 55-year-old man presented with a palpable abdominal mass. A computed tomography (CT) scan detected a mass mimicking a large cystic tumor in the retroperitoneal space anterior to the psoas muscle. The mass had an enhanced outer margin, an irregular inner margin, and several surrounding necrotic lymph nodes. However, histopathologic examination followed by an exploratory laparotomy confirmed that the mass was consistent with a tuberculous (TB) abscess. A retroperitoneal TB abscess without spinal or active pulmonary TB is very rare. To the best of our knowledge, there are no published reports of a retroperitoneal TB abscess confirmed by both CT scan and surgical pathology in the Korean literature. We report a rare case of a huge retroperitoneal TB abscess that can mimic a cystic tumor.

  15. Retroperitoneal fibrosis and obstructive uropathy due to actinomycosis: case report of a treatment approach.

    Science.gov (United States)

    Yagmurdur, Mahmut Can; Akbulut, Sami; Colak, Aysel; Aygun, Cem; Haberal, Mehmet

    2009-01-01

    An actinomycotic retroperitoneal infection usually occurs in the presence of an intrauterine device (IUD). It can result in pelvic inflammatory disease and diffuse retroperitoneal fibrosis. A 39-year-old patient was admitted to the emergency unit with left flank pain. A computed tomography scan of the abdomen showed bilateral hydroureteronephrosis and a retroperitoneal malignant mass. Other tumors were excluded with a colonoscopy and an upper gastrointestinal endoscopy. Results of a fine needle aspiration biopsy showed fibrosis compatible with retroperitoneal mesenteritis. Double-J stents were placed in both ureters, and immunosuppressive therapy was started. The patient had clinical and radiologic responses to the therapy. A bilateral ureterolysis and sigmoid colon resection were done. The pathology report showed fibrosis and Actinomyces israelii infection. Parenteral and oral penicillins were administered. The probability of an Actinomyces infection in patients with retroperitoneal fibrosis should be kept in mind, especially in cases in which the patient has an intrauterine device.

  16. RHI Refractories Opens Dalian Plant

    Institute of Scientific and Technical Information of China (English)

    Stefan Pirker

    2004-01-01

    @@ End of November the opening ceremony of the RHI Refractories Dalian plant took place in the presence of 250 guests from China and Europe. RHI Refractories welcomed highly official guests from the Dalian City and the Dalian Development Area, the Supervisory Board of RHI, the company's biggest shareholder, the Board of Management, representatives of customers in China as well as Professors of China's refractory academic field. The ceremony' s highlight was the speech of Professor Zhong Xiangchong from Zhengzhou University, member of the China Academy of Science, who pointed out RHI Refractories' long and successful history of refractory innovations during the last decades and the future possibilities of collaboration with RHI Refractories.

  17. Retroperitoneal ancient schwannoma: Review of clinico-radiological features

    Energy Technology Data Exchange (ETDEWEB)

    Loke, T.K.L.; Lo, K.K.L.; Lo, J.; Chan, J.C.S. [United Christian Hospital, Kwun Tong, (Hong Kong). Department of Diagnostics Radiology; Yuen, N.W.F. [United Christian Hospital, Kwun Tong, (Hong Kong). Department of Histopathology

    1998-05-01

    A case is reported here of an ancient schwannoma in the retroperitoneum. The findings of abdominal ultrasound and CT in a patient with a retroperitoneal ancient schwannoma are presented, and the clinical and radiological features of this unusual tumour are reviewed. The presence of a large, well-delineated complex cystic mass in the deep soft tissues should raise the possibility of an ancient schwannoma. It is important to recognize these tumours as benign with excellent prognosis so as to avoid unnecessary radical surgery. Copyright (1998) Blackwell Science Pty Ltd 12 refs., 2 figs.

  18. [Unilateral spontaneous adrenal hematoma: an unusual cause of retroperitoneal hemorrhage].

    Science.gov (United States)

    Vendrell, J R; Alcover, J; Alcaraz, A; Llopis, J; Gutierrez, R; Barranco, M A; Carretero, P

    1996-01-01

    Presentation of one case of spontaneous retroperitoneal haemorrhage in a 72 year-old male, his first symptom being a left retrothoracic pain of sudden onset. The supplementary studies performed (ultrasound, CAT and MNR) pointed to the adrenal gland as the origin of the haemorrhage. Faced eith the uncertainty of the etiological diagnosis, a left supra-renalectomy was conducted which confirmed the pathological anatomy of the piece and the presence of massive haematoma of the suprarenal gland with no other pathological data. The clinical, diagnostic and therapeutical aspects are discussed.

  19. [Hibernoma: brown fat retroperitoneal tumor. Report of a pediatric case].

    Science.gov (United States)

    Collado, Laura; Sierre, Sergio; Bosalec, Andrea; Lipsich, José

    2011-12-01

    Hibernoma is a rare benign tumor of soft tissue, composed of brown fat. This tissue is predominant in hibernating animals and hence its name. Because of its rarity in Pediatrics and difficult diagnosis, we report a 3 month-old patient with a diagnosis consistent with an abdominal tumor. Ultrasound and computed tomography exams showed an infiltrative retroperitoneal tumor, with hypervascular and lipomatous features. After tumor excision, histopathological exam confirmed the diagnosis of hibernoma or brown fat tumor. This presentation describes the characteristics of this type of tumor, rare in children, and reviews the fatty tumors, according to their frequency in pediatric patients.

  20. Retroperitoneal Lipoma Presenting with Nutcracker-Like Phenomenon

    Directory of Open Access Journals (Sweden)

    Seiichi Saito

    2013-01-01

    Full Text Available Retroperitoneal lipoma presenting with a nutcracker-like phenomenon is extremely rare. I experienced a case of a 65-year-old man presenting with left flank pain and macrohematuria intermittently for 3 years. Computed tomography revealed a lipoma at the left pedicle of the kidney, 30 mm in diameter, causing a curving of the left renal artery and dilatation of the left renal vein. This patient was treated successfully by retroperitoneoscopic resection of the lipoma. There have been no symptoms for 10 years after the operation.

  1. Refractory peptic ulcer disease.

    Science.gov (United States)

    Napolitano, Lena

    2009-06-01

    Refractory PUD is a diagnostic and therapeutic challenge. Optimal management of severe or refractory PUD requires a multidisciplinary team approach, using primary care providers, gastroenterologists, and general surgeons. Medical management has become the cornerstone of therapy. Identification and eradication of H pylori infection combined with acid reduction regimens can heal ulceration and also prevent recurrence. Severe, intractable or recurrent PUD and associated complications mandates a careful and methodical evaluation and management strategy to determine the potential etiologies and necessary treatment (medical or surgical) required.

  2. Retroperitoneal fibrosis – the state-of-the-art

    Science.gov (United States)

    Majewski, Dominik; Puszczewicz, Mariusz

    2016-01-01

    Retroperitoneal fibrosis (RPF) is a rare disease, hallmarked by inflammation and deposition of fibrous tissue around the abdominal aorta. This process may spread contiguously and involve adjacent structures, leading to many complications, among which the most frequent and most severe is ureteral obstruction. The condition usually has idiopathic origin (idiopathic retroperitoneal fibrosis – IRF), but can also develop secondarily to a number of factors. The etiology of the disease remains unclear. Current research suggests that about half of the cases of IRF may be a symptom of a recently discovered, clinically heterogeneous immunoglobulin G4-related disease (IgG4-RD). Corticosteroids are the first-line treatment for IRF, but effective attempts to use immunosuppressants are also made. This paper presents the current state of knowledge on the etiopathogenesis, clinical presentation, diagnosis and therapeutic possibilities in different forms of RPF. Based on the latest research, an analysis of the relationship between IRF and IgG4-RD was performed. PMID:27994271

  3. Benign retroperitoneal schwannoma presenting as colitis: A case report

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    We report a case of a patient presenting with clinical, radiological and endoscopic features of colitis due to a compressive left para-aortic mass. Total open surgical excision was performed, which resulted in complete resolution of colitis. Histopathology and immunohistochemistry revealed benign retroperitoneal schwannoma. These neural sheath tumors rarely occur in the retroperitoneum. They are usually asymptomatic but as they enlarge they may compress adjacent structures, which leads to a wide spectrum of nonspecific symptoms, including lumbar pain, headache, secondary hypertension, abdominal pain and renal colicky pain. CT and MR findings show characteristic features, but none are specific. Schwannoma can be isolated sporadic lesions, or associated with schwannomatosis or neurofibromatosis type Ⅱ (NF2). Although they vary in biological and clinical behavior, their presence is, in nearly every case, due to alterations or absence of the NF2 gene, which is involved in the growth regulation of Schwann cells. Both conditions were excluded by thorough mutation analysis. Diagnosis is based on histopathological examination and immunohistochemistry. Total excision is therapeutic and has a good prognosis. Schwannomatosis and NF2 should be excluded through clinical diagnostic criteria. Genetic testing of NF2 is probably not justified in the presence of a solitary retroperitoneal schwannoma.

  4. Angiomiolipoma renal masivo como causa de sangrado retroperitoneal espontáneo Massive renal angyomiolipoma as a cause of spontaneous retroperitoneal bleeding

    Directory of Open Access Journals (Sweden)

    Lilia M. Uriburu

    2008-09-01

    Full Text Available Introducción: El angiomiolipoma (AML es un tumor renal benigno, compuesto por una cantidad variable de tejido adiposo, músculo liso y vasos sanguíneos; que habitualmente crece dentro del espacio perinéfrico y suele complicarse con hemorragia intratumoral y menos frecuentemente perinéfrica y retroperitoneal, la cual se encuentra condicionada por el tamaño de la lesión. Objetivos: Evaluar dentro de las diferentes causas de sangrado retroperitoneal espontáneo al AML masivo, en confrontación con otras causas. Material y Métodos: Se estudiaron 3 pacientes con AML masivo previamente desconocidos y sangrado retroperitoneal. Dos de ellos fueron estudiados con resonancia magnética, en secuencias de T1 SE, T2 TSE con supresión grasa, T1 TSE con supresión grasa sin y con gadolinio. Uno fue estudiado con tomografía computada (TC pre y post administración de contraste EV. Resultados: De los 3 pacientes estudiados, todos presentaron masas renales cuyos tamaños variaron entre 10 y 26 cm. de diámetro mayor, las cuales presentaron sangrado intratumoral y retroperitoneal de jerarquía. Conclusión: El AML masivo como causante de hemorragia retroperitoneal espontánea es por lo tanto una patología a tener en cuentaIntroduction: The angyomiolipoma (AML is a benign renal tumor formed by a variable amount of adipose tissue, soft tissue and blood vessels; it generally grows within the perinephric space and it usually may complicate with intra-tumoral bleeding and less frequently with perinephric and retroperitoneal bleeding, which is conditioned by the size of the lesion. Objectives: To evaluate according to the different causes of spontaneous retroperitoneal bleeding the massive AML in contrast to other causes. Material and Methods: Three patients with massive AML who presented retroperitoneal bleeding were studied. Two of them were studied by MRI with T1 and T2 sequences, after and before the administration of gadolinium, with fat supression

  5. Refractory Minerals in Henan Province

    Institute of Scientific and Technical Information of China (English)

    JIN Qinguo; LI Jing; LIU Jiehua; LIU Yanjun

    2004-01-01

    Henan province is very rich in refractory minerals of many varieties including silica, dolomite, graphite,pearlite, sepiolite, olivine, and sillimanite group minerals, besides the abundant reserves of fireclay and bauxite,which lay a good foundation for the development of the refractories industry of the province. The paper introduces the reserves, distribution and character of the refractory minerals in Henan province.

  6. Dynamic Testing of Gasifier Refractory

    Energy Technology Data Exchange (ETDEWEB)

    Michael D. Mann; Wayne S. Seames; Devdutt Shukla; Xi Hong; John P. Hurley

    2005-12-01

    The University of North Dakota (UND) Chemical Engineering Department in conjunction with the UND Energy & Environmental Research Center (EERC) have initiated a program to examine the combined chemical (reaction and phase change) and physical (erosion) effects experienced by refractory materials under slagging coal gasification conditions. The goal of this work is to devise a mechanism of refractory loss under these conditions. The controlled-atmospheric dynamic corrodent application furnace (CADCAF) was utilized to simulate refractory/slag interactions under dynamic conditions that more realistically simulate the environment in a slagging coal gasifier than any of the static tests used previously by refractory manufacturers and researchers. High-alumina and high-chromia refractory bricks were tested using slags obtained from two solid fuel gasifiers. Testing was performed at 1475 C in a reducing atmosphere (2% H{sub 2} in N{sub 2}) The CADCAF tests show that high-chrome refractories have greater corrosion resistance than high-aluminum refractories; coal slag readily diffuses into the refractory through its grain boundaries; the refractory grains are more stable than the matrix in the tests, and the grains are the first line of defense against corrosion; calcium and alkali in the slag are more corrosive than iron; and silicon and calcium penetrate the deepest into the refractory. The results obtained from this study are preliminary and should be combined with result from other research programs. In particular, the refractory corrosion results from this study should be compared with refractories removed from commercial gasifiers.

  7. Refractory chronic migraine

    DEFF Research Database (Denmark)

    Martelletti, Paolo; Katsarava, Zaza; Lampl, Christian

    2014-01-01

    The debate on the clinical definition of refractory Chronic Migraine (rCM) is still far to be concluded. The importance to create a clinical framing of these rCM patients resides in the complete disability they show, in the high risk of serious adverse events from acute and preventative drugs...

  8. The clinical implications of variants of vena cava inferior and aorta on retroperitoneal surgery

    Directory of Open Access Journals (Sweden)

    S. V. Mukhtarulina

    2014-12-01

    Full Text Available Objective: to study variants of retroperitoneal vascular structure and its clinical implications on retroperitoneal surgery in patients with cervical cancer IA–IIB stage.Materials and methods. 101 patients who underwent paraaortic and bilateral pelvic lymphadenectomy were included in this study. 10 patients of the first group with anomalies of inferior vena cava, renal arteries and veins, common iliac vein and ovarian vessels were compared with 91 patients of the second group without anomalies.Results. Variants of major retroperitoneal vascular structure were present in 10 (9.9 % patients. Supernumerary renal arteries and veins observed in 5 (4.9 % patients; retroaortic left renal vein type I and II – in 3 (3.0 % patients. Double vena cava inferior detected in 1 (1.0 % patient. Patients with variants of retroperitoneal vascular structures hadn’t vessel injury. There was no difference in intraoperative hemorrhage, transfusion red blood cell, rate of intraoperative hemoglobin and removed paraaortic lymph nodes between the groups. Risk factors for intraoperative bleeding in patients with cervical cancer, depending on the presence or absence of anomalies of retroperitoneal vessels had no significant difference.Conclusion. Despite the fact that the variants of retroperitoneal vascular structures are rare (9.9 %, the success of retroperitoneal surgery is associated with the knowledge of vascular variations which decrease serious, life-threatening complications.

  9. The clinical implications of variants of vena cava inferior and aorta on retroperitoneal surgery

    Directory of Open Access Journals (Sweden)

    S. V. Mukhtarulina

    2014-01-01

    Full Text Available Objective: to study variants of retroperitoneal vascular structure and its clinical implications on retroperitoneal surgery in patients with cervical cancer IA–IIB stage.Materials and methods. 101 patients who underwent paraaortic and bilateral pelvic lymphadenectomy were included in this study. 10 patients of the first group with anomalies of inferior vena cava, renal arteries and veins, common iliac vein and ovarian vessels were compared with 91 patients of the second group without anomalies.Results. Variants of major retroperitoneal vascular structure were present in 10 (9.9 % patients. Supernumerary renal arteries and veins observed in 5 (4.9 % patients; retroaortic left renal vein type I and II – in 3 (3.0 % patients. Double vena cava inferior detected in 1 (1.0 % patient. Patients with variants of retroperitoneal vascular structures hadn’t vessel injury. There was no difference in intraoperative hemorrhage, transfusion red blood cell, rate of intraoperative hemoglobin and removed paraaortic lymph nodes between the groups. Risk factors for intraoperative bleeding in patients with cervical cancer, depending on the presence or absence of anomalies of retroperitoneal vessels had no significant difference.Conclusion. Despite the fact that the variants of retroperitoneal vascular structures are rare (9.9 %, the success of retroperitoneal surgery is associated with the knowledge of vascular variations which decrease serious, life-threatening complications.

  10. Status epilepticus: Refractory and super-refractory.

    Science.gov (United States)

    Dubey, Deepanshu; Kalita, Jayantee; Misra, Usha K

    2017-01-01

    Status epilepticus (SE) is an important neurological emergency. It is defined as seizures lasting for 5 minutes or more or recurrent seizures without recovery of consciousness to baseline between the attacks. Refractory SE (RSE) is defined as SE persisting despite sufficient dose of benzodiazepines and at least one antiepileptic drug (AED), irrespective of time. Super refractory SE (SRSE) is defined as SE that continues for 24 hours or more after the use of anesthetic therapy, including cases that recur on weaning of the anesthestic agent. RSE occurs in 23%-48% of the patients and SRSE in approximately 22% of the patients with SE. In general, RSE occurs in patients with new-onset seizures rather than in patients with chronic epilepsy. The etiology of RSE in developing countries is dominated by central nervous system (CNS) infections and head injury compared to stroke and drug withdrawal in the developed countries. The treatment of RSE and SRSE is not evidence based. Following benzodiazepines, the second line antiepileptic drugs include sodium valproate, phenytoin, levetiracetam, and anesthetic drugs such as midazolam, phenobarbital, and propofol. Most intravenous anesthetic drugs produce hypotension and respiratory suppression; therefore, patients with RSE are managed in intensive care units (ICUs). In RSE patients, electroencephalogram (EEG) burst suppression with interburst interval of 2-20 s or even flat EEG has been tried. Recently, concerns have been raised on the safety of burst suppression in RSE and SRSE. The paucity of ICUs in developing countries limits the use of these management protocols. There is a need to explore intravenous AEDs with safer cardiovascular and respiratory profile for the management of SE.

  11. Femoral nerve dysfunction after retroperitoneal hemorrhage: pathophysiology revealed by computed tomography.

    Science.gov (United States)

    Reinstein, L; Alevizatos, A C; Twardzik, F G; DeMarco, S J

    1984-01-01

    In three patients receiving anticoagulation therapy who developed retroperitoneal hemorrhage computed tomography (CT) clearly localized the resulting hematoma in each case. Three distinct syndromes are described. A hemorrhage within the iliacus muscle resulted in femoral nerve dysfunction. A large hemorrhage within the iliacus muscle which extended into the psoas muscle produced both femoral and obturator nerve dysfunction. A retroperitoneal hemorrhage extrinsic to both the iliacus and psoas muscles did not produce peripheral nerve dysfunction. The pathophysiology of peripheral nerve dysfunction in retroperitoneal hemorrhage is reviewed in detail.

  12. Intra-operative haemodynamic volatility in a patient undergoing retroperitoneal cyst excision

    Directory of Open Access Journals (Sweden)

    Thrivikrama Padur Tantry

    2012-01-01

    Full Text Available Excision of a suspected retroperitoneal, duodenal duplication cyst was performed in a pre-operatively normotensive patient under combined epidural and general anaesthesia. Intraoperatively, the cystic tumour was discovered to be a retroperitoneal mass, free from duodenal or adrenal origin. Development of severe arrhythmias, ST segment changes and hypertensive spikes during cyst handling and dissection suggested the possibility of a catecholamine-secreting tumour. These were managed effectively with pharmacological agents. Subsequently, histopathology of the specimen revealed a paraganglioma. Vasoactive tumour has to be suspected in every patient undergoing anaesthesia for retroperitoneal cystic lesion.

  13. Retroperitoneal "triton" tumor. Report of a case and review of literature

    Directory of Open Access Journals (Sweden)

    Palacios Acosta José Martín

    2014-07-01

    Full Text Available The triton tumor was described in 1932 by Masson, as a peripheral nerve sheath malignancy with rabdomioblástica differentiation. The retroperitoneal location is extremely rare, only nine cases have been reported in children. The clinical picture depends on the size of the tumor and the organs involved, their retroperitoneal location is usually asymptomatic. The mainstay of treatment is the surgical excision of the tumor. We report the case of a child with retroperitoneal location of the tumor. A complete resection of it was performed. The patient had an uneventful postoperative course. He is currently under control. There is no evidence of relapse.

  14. Refractory headache: classification and nomenclature.

    Science.gov (United States)

    Levin, Morris

    2008-06-01

    There are a number of reasons to attempt to define and classify refractory headache disorders. Particularly important are the potential benefits in the areas of research, treatment, and medical cost reimbursement. There are challenges in attempting to classify refractory forms of headaches, including the lack of biological or other objective markers and a lack of consensus among practitioners as to what qualifies as refractoriness, or even if a separate category for refractory migraine and other refractory headaches needs to be established. A definition of refractory migraine has been proposed by Schulman et al in this issue ("Defining Refractory Migraine [RM] and Refractory Chronic Migraine [RCM]: Proposed Criteria for the Refractory Headache Special Interests Section of the American Headache Society"), which should be tested for validity and usefulness. It seems reasonable to consider adding this defined syndrome to the International Classification of Headache Disorders, second edition (ICHD-II). In this article, options for adding refractory headache syndromes to the ICHD are discussed with pros and cons for each. Two "best" options for adding the disorder "refractory migraine" to the ICHD are presented along with an illustrative case example.

  15. Retroperitoneal extra-adrenal paraganglioma: a rare but important diagnosis.

    LENUS (Irish Health Repository)

    Ahmad, S

    2012-01-31

    BACKGROUND: Extra-adrenal paragangliomas of the retroperitonium are infrequently diagnosed. Their malignant behaviour cannot be predicted on initial clinical and histological assessment. These tumours have higher propensity for subsequent metastasis compared with pargangliomas at other sites. AIM: We aim to describe a case report of an incidental finding of left retroperitoneal paraganglioma in a young man who presented with right flank pain. We also aim to emphasize the importance of diagnosis and the malignant potential of these tumours. METHOD: Patient\\'s clinical notes, operative findings, imaging studies and laboratory investigations including histology results were reviewed. A literature search was done to look into the incidence, presentation, follow-up plan and treatment options for these tumours. CONCLUSION: Surgical resection is the only available curative option for extra-adrenal paragangliomas. Metastasis is observed years after surgery, hence long-term follow-up is required.

  16. Retroperitoneal Paraganglioma – a rare cause of arterial hypertension

    Directory of Open Access Journals (Sweden)

    Isabel Silva

    2017-03-01

    Full Text Available Paragangliomas are rare neuroendocrine tumours, most commonly found in adults. These differ from pheochromocytomas in that their location is extra-adrenal, and they are responsible for about 1% of arterial hypertension aetiologies. We report the case of a 30-year-old female whose past medical history was unremarkable. However, her arterial hypertension led to further examination in search of secondary aetiologies, in which a retroperitoneal mass and an increase in levels of catecholamines were detected; findings that led to the final diagnosis of paraganglioma. A multidisciplinary team, whose approach was to use pharmacological alpha-adrenergic blocking agents and a surgical resection of the lesion, treated the patient. The patient is clinically well but will continue to be monitored as an outpatient, and genetic testing is being encouraged.

  17. Idiopathic retroperitoneal fibrosis causing unilateral ureteral and sigmoid colon obstruction

    Science.gov (United States)

    Yan, Ting; Wang, Yujuan; Liu, Zhijun; Zhang, Xiaolei; Wu, Qian; Xi, Mingrong

    2017-01-01

    Abstract Objective: The present report aimed to present a unique case of idiopathic retroperitoneal fibrosis (RPF) presenting features of unilateral ureteral and sigmoid colon obstruction. RPF is a rare disorder with unclear etiology. Case report: A 43-year-old female had a 10-day history of lower right abdominal and lumbar pain. Gynecological examination, ultrasound, and computed tomography (CT) were all suggestive of right ovarian tumor. An enhanced CT showed right-sided hydronephrosis. The patient was diagnosed as having ovarian cancer. Ten days after hospitalization, a right intraureteral stent with a double-J catheter was inserted. Upon exploring the abdomen, unyielding RPF was encountered. A partial sigmoidectomy and colostomy were performed. Postoperative pathological results suggested idiopathic RPF. She received steroid treatments. Conclusion: RPF is a rare disease that can be misdiagnosed. Our understanding about its presentation has to be improved and it should be considered as a differential diagnosis for patients presenting with abdominal diseases. PMID:28207528

  18. Transformação carcinomatosa de endometriose retroperitoneal

    Directory of Open Access Journals (Sweden)

    João Augusto dos Santos Martines

    2012-08-01

    Full Text Available Os autores apresentam o caso de uma paciente de 45 anos de idade, portadora de dor abdominal crônica, sendo evidenciada massa retroperitoneal cuja biopsia por agulha revelou tratar-se de endometriose. Submetida a ooforectomia bilateral. A paciente evoluiu, durante 4 anos, sem controle do quadro álgico, com perda de peso e aumento das dimensões da massa tumoral. A exérese cirúrgica total da massa tumoral não foi possível devido às aderências às estruturas vasculares. O pós-operatóriofoi complicado com quadro séptico evoluindo a óbito. O resultado anatomopatológico fornecido pela autópsia foi de adenocarcinoma de padrão endometrióide.

  19. Refractory gastroesophageal reflux disease

    OpenAIRE

    Joaquim Prado P. Moraes-Filho

    2012-01-01

    CONTEXT: Gastroesophageal reflux disease (GERD) is a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Its pathophysiology, diagnosis and treatment have frequently been analyzed but it is interesting to review some aspects of the GERD refractory patients to the proton pump inhibitors treatment. The treatment encompasses behavioral measures and pharmacological therapy. The majority of the patients respond well to proton pump inhibito...

  20. Colectomy for refractory constipation

    DEFF Research Database (Denmark)

    Raahave, Dennis; Loud, Franck Bjørn; Christensen, Elsebeth;

    2010-01-01

    OBJECTIVE: This study evaluated the type of colectomy, postoperative complications, functional results, and satisfaction in patients with constipation refractory to conservative therapy. Further, colonic transit time (CTT), faecal load (coprostasis), and colon length (redundancies) were compared...... had at hemicolectomy, 11 patients a subtotal colectomy and 3 patients an ileostomy. Two patients had an anastomotic leak and one died. In 11 patients, further surgery was necessary, because of recurrent constipation. Abdominal pain disappeared and defecation patterns improved significantly to 1-4 per...

  1. Organ Preservation in a Case of Retroperitoneal Ganglioneuroma: A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Santosh Kumar

    2016-01-01

    Full Text Available The retroperitoneum is a closed space harbouring vital organs including the great vessels, kidneys and adrenal glands, ureters, and the ascending and descending colon. Surgical management of retroperitoneal pathologies may need multiorgan resection in order to achieve complete surgical resection while preservation of surrounding organs should be attempted, especially in case of benign tumors. We present a case of 15-year-old girl with an 11 × 6 × 5 cm retroperitoneal ganglioneuroma displacing the right kidney, renal vein, and ureter and abutting the IVC which was excised in toto preserving the right kidney and ureter with careful dissection around the great vessels. We also attempt to review the various surgical options available while dealing with these benign retroperitoneal tumors which are often detected incidentally and usually surround important retroperitoneal organs and vessels.

  2. Refractory status epilepticus

    Directory of Open Access Journals (Sweden)

    Sanjay P Singh

    2014-01-01

    Full Text Available Refractory status epilepticus is a potentially life-threatening medical emergency. It requires early diagnosis and treatment. There is a lack of consensus upon its semantic definition of whether it is status epilepticus that continues despite treatment with benzodiazepine and one antiepileptic medication (AED, i.e., Lorazepam + phenytoin. Others regard refractory status epilepticus as failure of benzodiazepine and 2 antiepileptic medications, i.e., Lorazepam + phenytoin + phenobarb. Up to 30% patients in SE fail to respond to two antiepileptic drugs (AEDs and 15% continue to have seizure activity despite use of three drugs. Mechanisms that have made the treatment even more challenging are GABA-R that is internalized during status epilepticus and upregulation of multidrug transporter proteins. All patients of refractory status epilepticus require continuous EEG monitoring. There are three main agents used in the treatment of RSE. These include pentobarbital or thiopental, midazolam and propofol. RSE was shown to result in mortality in 35% cases, 39.13% of patients were left with severe neurological deficits, while another 13% had mild neurological deficits.

  3. CT and MRI features and pathological charateristics of retroperitoneal localized Castleman’s disease

    Institute of Scientific and Technical Information of China (English)

    王春

    2014-01-01

    Objective To analyze the CT and MRI findings and pathological characteristics of retroperitoneal localized Castleman’s disease and discuss the diagnostic and differential value of CT and MRI.Methods CT,MRI and clinical data of retroperitoneal localized Castleman’s disease,proved by surgery and pathology,13 patients were reviewed.Among them,all the 13 cases received CT,and4 cases received MRI examination.Results Among the

  4. IVC filter limb penetration of the caval wall during retroperitoneal surgery/lymph node dissection.

    LENUS (Irish Health Repository)

    Goh, Gerard S

    2012-12-01

    Optional inferior vena cava (IVC) filters are being increasingly used for protection against pulmonary embolism in patients with deep vein thrombosis where anticoagulation is contraindicated. We describe two cases during retroperitoneal surgery where the IVC filters were found to have perforated the cava wall and were subsequently removed intra-operatively. Cava wall penetration by filter limbs poses a significant danger during retroperitoneal lymph node dissection and filters should be removed preoperatively.

  5. Retroperitoneal Necrotizing Fasciitis Masquerading as Perianal Abscess – Rare and Perilous

    Science.gov (United States)

    Amaranathan, Anandhi; Barathi, Deepak; Shankar, Gomathi; Sistla, Sarath Chandra

    2017-01-01

    Necrotizing fasciitis is one of the uncommon presentations of a rapidly spreading subcutaneous tissue infection. Although the actual cause is unclear in many cases, most of them are due to the rapid proliferation of microorganisms. Retroperitoneal necrotizing fasciitis is extremely rare. It is a potentially lethal infection that requires immediate and aggressive surgical care. Early diagnosis is the key to a better prognosis. The possibility of retroperitoneal necrotizing fasciitis should be suspected in patients with symptoms of sepsis that are disproportionate to clinical findings. The rapid deterioration of the patient also gives a clue towards the diagnosis. We report a 35-year-old male with perianal abscess who had been progressed to retroperitoneal necrotizing fasciitis. The patient was managed successfully with aggressive debridement and drainage after laparotomy. Appropriate antibiotics were used to combat the sepsis. The patient recovered well at follow up, three months after discharge. Another patient, a 45-year-old male with a retroperitoneal abscess, progressed to retroperitoneal necrotizing fasciitis, and extra peritoneal drainage and debridement was done. Antibiotics depending upon the culture and sensitivity were used to control sepsis. But the patient succumbed to death 45 days after surgery due to uncontrolled sepsis. Necrotizing fasciitis of any anatomical site needs aggressive surgical care with early intervention. But retroperitoneal necrotizing fasciitis needs an extra effort for diagnosis. After diagnosis, it needs timely surgical intervention and appropriate antibiotic therapy for the recovery of the patients. PMID:28229030

  6. Does negative retroperitoneal CT in adolescents with paratesticular rhabdomyosarcoma preclude the need of retroperitoneal lymph node dissection?; A tomografia de retroperitoneo normal em adolescentes com rabdomiossarcoma paratesticular afasta necessidade de linfadenectomia?

    Energy Technology Data Exchange (ETDEWEB)

    Damazio, Eulalio [Hospital Lucano, Teresina (PI) (Brazil); Caran, Eliana [Instituto de Oncologia Pediatrica, Universidade Federal de Sao Paulo - UNIFESP, Sao Paulo, SP (Brazil); Ortiz, Valdemar; Macedo Junior, Antonio, E-mail: macedo.dcir@epm.br [Departamento de Urologia, Universidade Federal de Sao Paulo - UNIFESP, Sao Paulo, SP (Brazil)

    2011-07-01

    We report on a 16-year-old male with paratesticular rhabdomyosarcoma who underwent retroperitoneal lymph node dissection due to a stage I tumor (normal retroperitoneal computed tomography). The surgical finding was three enlarged nodes, positive for metastatic disease. Patient was referred to adjuvant chemotherapy. This case suggests that the Intergroup Rhabdomyosarcoma Study Group IV protocol is subject to questions regarding adolescents with paratesticular rhabdomyosarcoma, and that negative retroperitoneal CT does not preclude the need of lymph node dissection. (author)

  7. Metoclopramide-induced cardiac arrest

    Directory of Open Access Journals (Sweden)

    Martha M. Rumore

    2011-11-01

    Full Text Available The authors report a case of cardiac arrest in a patient receiving intravenous (IV metoclopramide and review the pertinent literature. A 62-year-old morbidly obese female admitted for a gastric sleeve procedure, developed cardiac arrest within one minute of receiving metoclopramide 10 mg via slow intravenous (IV injection. Bradycardia at 4 beats/min immediately appeared, progressing rapidly to asystole. Chest compressions restored vital function. Electrocardiogram (ECG revealed ST depression indicative of myocardial injury. Following intubation, the patient was transferred to the intensive care unit. Various cardiac dysrrhythmias including supraventricular tachycardia (SVT associated with hypertension and atrial fibrillation occurred. Following IV esmolol and metoprolol, the patient reverted to normal sinus rhythm. Repeat ECGs revealed ST depression resolution without pre-admission changes. Metoclopramide is a non-specific dopamine receptor antagonist. Seven cases of cardiac arrest and one of sinus arrest with metoclopramide were found in the literature. The metoclopramide prescribing information does not list precautions or adverse drug reactions (ADRs related to cardiac arrest. The reaction is not dose related but may relate to the IV administration route. Coronary artery disease was the sole risk factor identified. According to Naranjo, the association was possible. Other reports of cardiac arrest, severe bradycardia, and SVT were reviewed. In one case, five separate IV doses of 10 mg metoclopramide were immediately followed by asystole repeatedly. The mechanism(s underlying metoclopramide’s cardiac arrest-inducing effects is unknown. Structural similarities to procainamide may play a role. In view of eight previous cases of cardiac arrest from metoclopramide having been reported, further elucidation of this ADR and patient monitoring is needed. Our report should alert clinicians to monitor patients and remain diligent in surveillance and

  8. Refractories Utilizability for Slagging Gasifiers

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Slagging coal gasification process became a highlight of coal chemical industry in China during the last decade. Refractory lining's life of slagging gasifiers is one of the most critical factors for a cost -effective operation. The paper introduces current status of coal gasification in China, lining structure of slagging gasifiers and performance of refractory lining. It also summarizes the major factors impacting on refractory wear in slagging coal gasifiers in four Chinese chemical plants, based on ten years of industrial experience. The utilizability is discussed in terms of cost -effectiveness of high chromia refractories and possibility of the alternatives.

  9. [Arrest of maturation in spermatogenesis].

    Science.gov (United States)

    Francavilla, S; Bellocci, M; Martini, M; Bruno, B; Moscardelli, S; Fabbrini, A; Properzi, G

    1982-07-30

    The ultrastructural aspects of the germinal epithelium of 10 infertile men affected by maturative arrest of spermatogenesis were studied. We noted an increased number of malformed germinal cells. Marginal nuclear vescicles were present in spermatogonia of patients affected by spermatogonial arrest. The few spermatid present in the germinal epithelium of the patients affected by a spermatidic arrest presented changes of the nuclear condensation, the acrosome, and the tail. The Sertoli cells presented an immature aspect of the nucleus and changes of the "mantle". A possible correlation between the Sertoli cells changes and the altered spermatogenesis was proposed.

  10. Refractoriness in human atria

    DEFF Research Database (Denmark)

    Skibsbye, Lasse; Jespersen, Thomas; Christ, Torsten

    2016-01-01

    drugs. Cardiomyocyte excitability depends on availability of sodium channels, which involves both time- and voltage-dependent recovery from inactivation. This study therefore aims to characterise how sodium channel inactivation affects refractoriness in human atria. METHODS AND RESULTS: Steady......-state activation and inactivation parameters of sodium channels measured in vitro in isolated human atrial cardiomyocytes were used to parameterise a mathematical human atrial cell model. Action potential data were acquired from human atrial trabeculae of patients in either sinus rhythm or chronic atrial...... in pharmacological management of chronic atrial fibrillation....

  11. Orind Refractories Limited

    Institute of Scientific and Technical Information of China (English)

    Mr R. Mishra; Group Manging Director

    2005-01-01

    @@ "Sight can be acquired, Vision cannot". Orind Refractories Limited (ORIND), China was formed with this rare vision. At a time when the world was testing the tepid waters of China; Mr. Ravin Jhunjhunwala, Chairman of ORIND and the management of ORIND India had looked over the Great Wall to begin a journey of success. Incorported on 18th August 1994 with an initial investment of USD 5 million, ORL caters to the ever-demanding needs of the steel industry and beyond. Incidentally ORIND was the first wholly owned India company to set up base in China. Pesently, ORIND China has a 616 strong work force including 23 expatriates.

  12. Development of Refractories for Continuous Casting

    Institute of Scientific and Technical Information of China (English)

    TIAN Shouxin; JIN Congjin; YAO Jinfu; LI Zeya

    2004-01-01

    The paper introduces refractories for continuous casting, especially, refractories for continuous casting for clean steel in baosteel. Developing direction of refractories for continuous casting has been pointed out to satisfy the new metallurgical operating practice.

  13. Approaches to refractory epilepsy

    Directory of Open Access Journals (Sweden)

    Jerome Engel

    2014-01-01

    Full Text Available Epilepsy is one of the most common serious neurological conditions, and 30 to 40% of people with epilepsy have seizures that are not controlled by medication. Patients are considered to have refractory epilepsy if disabling seizures continue despite appropriate trials of two antiseizure drugs, either alone or in combination. At this point, patients should be referred to multidisciplinary epilepsy centers that perform specialized diagnostic testing to first determine whether they are, in fact, pharmacoresistant, and then, if so, offer alternative treatments. Apparent pharmacoresistance can result from a variety of situations, including noncompliance, seizures that are not epileptic, misdiagnosis of the seizure type or epilepsy syndrome, inappropriate use of medication, and lifestyle issues. For patients who are pharmacoresistant, surgical treatment offers the best opportunity for complete freedom from seizures. Surgically remediable epilepsy syndromes have been identified, but patients with more complicated epilepsy can also benefit from surgical treatment and require more specialized evaluation, including intracranial EEG monitoring. For patients who are not surgical candidates, or who are unwilling to consider surgery, a variety of other alternative treatments can be considered, including peripheral or central neurostimulation, ketogenic diet, and complementary and alternative approaches. When such alternative treatments are not appropriate or effective, quality of life can still be greatly improved by the psychological and social support services offered by multidisciplinary epilepsy centers. A major obstacle remains the fact that only a small proportion of patients with refractory epilepsy are referred for expert evaluation and treatment.

  14. Refractory Celiac Disease

    Directory of Open Access Journals (Sweden)

    K Khatami

    2014-04-01

    Full Text Available Refractory celiac disease (RCD is when malabsorption symptoms and villous atrophy persist despite strict adherence to a gluten free diet (GFD for more than 12 months and other causes of villous atrophy have been ruled out.  RCD is considered a rare disease and almost exclusively occurs in adults. Persistent diarrhea, abdominal pain, weight loss are the most common symptoms in RCD. Also, anemia, fatigue, malaise, thromboembolic events and coexisting autoimmune disorders are frequent. Diagnosis of RCD is based on other causes of unresponsiveness to the GFD, particularly collagenous sprue, ulcerative jejunitis, and enteropathy-associated T-cell lymphoma. Many disorders such as autoimmune enteropathy, tropical sprue, common variable immunodeficiency, and intolerance to non-gluten dietary proteins may have similar histological findings but not necessarily identical with CD and therefore should be excluded. Repeat intestinal biopsy may help to differentiate causes of non-responsive CD associated with ongoing villous atrophy (e.g., gluten contamination, small-bowel bacterial overgrowth, RCD. There are 2 subtypes of RCD according to absence (type I or presence (type II of an abnormal intraepithelial lymphocyte population. RCD type 1 usually becomes better with a combination of aggressive nutritional support, adherence to GFD, and pharmacologic therapies such as prednisone, budesonide and azathioprine. For RCD type 2, more aggressive therapeutic approach is needed since clinical response to therapies is less certain and may evolve into aggressive enteropathy associated T-cell lymphoma and the prognosis is poor.   Key words: Celiac Disease, Refractory.  

  15. [A case of seronegative spondylarthropathy with iritis and retroperitoneal fibrosis].

    Science.gov (United States)

    Takahashi, M; Ishikawa, A; Kondo, H

    1999-02-01

    In 1985 a 41-year old male visited a local hospital because of congestion in the bulbar conjunctiva, which was diagnosed as iritis. In August 1990, right coxalgia and arthralgia of metatarsophalangeal joints appeared, with recurrence of iritis. In October, stiffness in the hands and arthralgia of proximal interphalangeal joints also started. In July 1991, the right coxalgia worsened, resulting in walking difficulty. He was admitted to the Kitasato University Hospital. He presented with bilateral iritis, polyarthritis with limited ranges of motion and sacroilitis. The Schober's test was positive at 3 cm. Serological tests for rheumatoid factor and HLA-B 27 were negative. Abdominal computer tomographic scan revealed low density lesion around the aorta. PSL 10 mg was initiated, and iritis and arthritis remitted. Progression of the periaortic lesion was not observed during the subsequent 5 years. In this case, iritis preceded limited ranges of motion in the vertebrae and sacroilitis. From these findings, seronegative spondylarthropathy with peripheral arthritis was diagnosed. The periaortic lesion seen in this case probably corresponds to chronic periaortitis recently reported as a subset of idiopathic retroperitoneal fibrosis. The two lesions observed in the present case may be interpreted as caused by inflammation of the connective tissue initially either at the vertebrae or around the aorta, which had advanced to involve the other lesion.

  16. Rare case of deep pelvic retroperitoneal mature cystic teratoma

    Directory of Open Access Journals (Sweden)

    Shalini Mahana Valecha

    2013-06-01

    Full Text Available Mature cystic retroperitoneal teratomas are typically rare childhood tumours. Less than 20% of these occur in adults more than 30 yrs of age. Our adult patient presented with such a tumour, which had grown to a disproportionately large extent. It was deeply embedded in the true pelvis extending laterally to the pelvic wall and inferiorly till the ischiorectal fossa and was adherent to the surrounding structures displacing all. A provisional diagnosis was made after MRI scan and patient was posted for exploratory laparotomy. After extensive blunt and sharp dissection, the cyst wall could be separated from the surrounding structures and successfully excised. Histopathology confirmed the diagnosis. Being such a rare tumour, it is essential to have a high degree of suspicion in such cases that can be supported by advanced imaging modality. Early diagnosis and complete surgical removal are the mainstay of management that provide an excellent prognosis for such patients. [Int J Reprod Contracept Obstet Gynecol 2013; 2(3.000: 460-462

  17. Giant Primary Mature Retroperitoneal Teratomain in Adult Male Patient

    Directory of Open Access Journals (Sweden)

    R. Ebrahimian

    2015-07-01

    Full Text Available Introduction: Teratomas are congenital tumors consisting of derivatives from the ectoderm, endoderm and mesoderm germ cell layers. A teratoma is considered to be a non-seminomatous germ cell tumor and is typically located in either the sacrococcygeal region or in the gonads. Giant retroperitoneal teratomas in adults are even rarer, with only a few cases previously described in the literature. Case report: A 35-year-old male patient with severe nausea and vomiting was taken to the emergency ward of Hamadan Be’sat Hospital. He had not been feeling well, and had suffering from abdominal pain for a month. A physical examination showed some concretion in the right side of his abdomen. A CT scan of his abdomen and pelvis with IV and oral contrast re-vealed that the concretion was formed by aggregates of solid, cystic, and calcareous compo-nents. It compressed stomach and caused the rotation of the stomach around its longitudinal axis. Conclusion: Following the diagnosis, we performed a laparotomy and respected a concretion with dimension 20?25?22cm. Interestingly, we found out all mature tissues within the con-cretion in the pathology examination of an adequate sample (such as trachea, bone, GI lu-men…. (Sci J Hamadan Univ Med Sci 2015; 22 (2: 165-169

  18. Surgical management of 143 patients with adult primary retroperitoneal tumor

    Institute of Scientific and Technical Information of China (English)

    Yuan-Hong Xu; Ke-Jian Guo; Ren-Xuan Guo; Chun-Lin Ge; Yu-Lin Tian; San-Guang He

    2007-01-01

    AIM: To analyze the surgical management of adult primary retroperitoneal tumors (APRT) and the factors influencing the outcome after operation.METHODS: Data of 143 cases of APRT from 1990 to 2003 in the First Affiliated Hospital of China Medical University were evaluated retrospectively.RESULTS: A total of 143 cases of APRT were treated surgically. Among them, 122 (85.3%) underwent complete resection, 16 (11.2%) incomplete resection,and 3 (3%) surgical biopsies. Twenty-nine (20.2%)underwent tumor resection plus multiple organ resections. Ninety-five malignant cases were followed up for 1 mo to 5 years. The 1-year, 3-year, and 5-year survival rates of the patients subject to complete resection was 94.9%, 76.6% and 34.3% and that of patients with incomplete resection was 80.4%, 6.7%,and 0%, respectively (P < 0.001). The Cox multi-various regression analysis showed the completeness of tumor,sex and histological type were associated closely with local recurrence.CONCLUSION: Sufficient preoperative preparation and complete tumor resection play important roles in reducing recurrence and improving survival.

  19. Gestational trophoblastic neoplasia with retroperitoneal metastases: A fatal complication

    Directory of Open Access Journals (Sweden)

    Dimopoulos Athanassios-Meletios

    2010-12-01

    Full Text Available Abstract Background Gestational Trophoblastic Neoplasia (GTN is a pathologic entity that can affect any pregnancy and develop long after the termination of the pregnancy. Its course can be complicated by metastases to distant sites such as the lung, brain, liver, kidney and vagina. The therapeutic approach of this condition includes both surgical intervention and chemotherapy. The prognosis depends on many prognostic factors that determine the stage of the disease. Case Report We present a woman with GTN and retroperitoneal metastatic disease who came to our department and was diagnosed as having high risk metastatic GTN. Accordingly she received chemotherapy as primary treatment but unfortunately developed massive bleeding after the first course of chemotherapy, was operated in an attempt to control bleeding but finally succumbed. Conclusion This case demonstrates that GTN, while usually curable, can be a deadly disease requiring improved diagnostic, treatment modalities and chemotherapeutic agents. The gynaecologist should be aware of all possible metastatic sites of GTN and the patient immediately referred to a specialist center for further assessment and treatment.

  20. Three cases of retroperitoneal schwannoma diagnosed by EUS-FNA

    Institute of Scientific and Technical Information of China (English)

    Taiki Kudo; Hiroshi Kawakami; Masaki Kuwatani; Nobuyuki Ehira; Hiroaki Yamato; Kazunori Eto; Kanako Kubota; Masahiro Asaka

    2011-01-01

    Schwannomas are peripheral nerve tumors that are typically solitary and benign. Their diagnosis is largely based on surgically resected specimens. Recently, a number of case reports have indicated that retroperitoneal schwannomas could be diagnosed with endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)We report the diagnosis of three cases of schwannoma using EUS-FNA. Subjects weree two males and one fe-twomale,ages 22, 40, and 46 years, respectively, all of whom were symptom-free. Imaging findings showed well-circumscribed round tumors.However, as the tumors could not be diagnosed using these findings alone, EUS-FNA was performed. Hematoxylin-eosin staining of the resulting tissue fragments revealed bland spindle cells with nuclear palisading. There was no disparity in nuclear sizes.Immunostaining revealed S-100 protein positivity and all cases were diagnosed as schwannomas. Ki-67 indexes were 3%-15%,2%-3%,and 3%, respectively. No case showed any signs of malignancy.As most schwannomas are benign tumors and seldom become malignant, we observed these patients without therapy. All tumors demonstrated no enlargement and no change in characteristics.Schwannomasa are almost always benign and can be observed following diagnosis by EUS-FNA.

  1. Large solitary retroperitoneal echinococcal cyst: A rare case report

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Echinococcal disease remains a problem within some endemic areas. Echinococcal cysts usually involve the liver and lungs,but any other organ can potentially be involved.Extrahepatic localization is reported in14%-19% of all cases of abdominal hydatid disease. We report the case of a large echinococcal cyst localized in the lower pelvis. A 28-year-old woman was admitted to a surgical ward with lower abdominal pain and discomfort lasting for a month. Ultrasonography and computed tomography scanning revealed a large retroperitoneal cystic mass (9 cm×4 cm) in contact with the left ovary and leftureter. There were no cysts in any other location.Serological tests were positive for Echinococcus. The patient was operated on and the entire cyst was excised intact. Histopathological results confirmed the diagnosis of chinococcosis.ntihelminthics were administered postoperatively and the patient was discharged after 6 d,and is now being closely followed up. Total cystectomy when possible represents the treatment of choice for large extrahepatic echinococcal cysts.

  2. Effect of Cross-Sex Hormonal Replacement on Antioxidant Enzymes in Rat Retroperitoneal Fat Adipocytes

    Science.gov (United States)

    Velázquez Espejel, Rodrigo; Cabrera-Orefice, Alfredo; Uribe-Carvajal, Salvador; Pavón, Natalia

    2016-01-01

    We report the effect of cross-sex hormonal replacement on antioxidant enzymes from rat retroperitoneal fat adipocytes. Eight rats of each gender were assigned to each of the following groups: control groups were intact female or male (F and M, resp.). Experimental groups were ovariectomized F (OvxF), castrated M (CasM), OvxF plus testosterone (OvxF + T), and CasM plus estradiol (CasM + E2) groups. After sacrifice, retroperitoneal fat was dissected and processed for histology. Adipocytes were isolated and the following enzymatic activities were determined: Cu-Zn superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione-S-transferase (GST), and glutathione reductase (GR). Also, glutathione (GSH) and lipid peroxidation (LPO) were measured. In OvxF, retroperitoneal fat increased and adipocytes were enlarged, while in CasM rats a decrease in retroperitoneal fat and small adipocytes are observed. The cross-sex hormonal replacement in F rats was associated with larger adipocytes and a further decreased activity of Cu-Zn SOD, CAT, GPx, GST, GR, and GSH, in addition to an increase in LPO. CasM + E2 exhibited the opposite effects showing further activation antioxidant enzymes and decreases in LPO. In conclusion, E2 deficiency favors an increase in retroperitoneal fat and large adipocytes. Cross-sex hormonal replacement in F rats aggravates the condition by inhibiting antioxidant enzymes. PMID:27630756

  3. Invasive lobular carcinoma of the breast presenting as retroperitoneal fibrosis: a case report

    Directory of Open Access Journals (Sweden)

    Al-Haddad Sahar

    2010-06-01

    Full Text Available Abstract Introduction Invasive lobular carcinoma of the breast represents approximately 6.3% of mammary malignancies. Distant metastasis of invasive lobular carcinoma to the peritoneum or retroperitoneum has been reported fairly frequently. Case presentation We report the case of a 59-year-old Caucasian-Canadian woman with invasive lobular carcinoma of the breast presenting with retroperitoneal fibrosis and bilateral ureteral obstruction. Intra-operative pathology consultation did not reveal malignancy. The diagnosis, however, was confirmed on permanent sections by histological appearance in addition to immunohistochemistry. To the best of our knowledge, this is the first reported case of invasive lobular carcinoma of the breast presenting with retroperitoneal fibrosis. Conclusion In a case of unexplained ureteric obstruction and retroperitoneal fibrosis, more comprehensive physical examination and additional ancillary studies may be warranted to rule out malignancy as an underlying etiology. This case also emphasizes that intra-operative frozen section consultation cannot always be fully relied upon to exclude a malignancy as the etiology of retroperitoneal fibrosis. Moreover, in permanent histopathology sections, immunohistochemistry testing can be of value to rule out metastatic disease where the morphology is not salient. There is a need for a thorough physical examination of patients with retroperitoneal fibrosis, including the breast and gynecological organs.

  4. Refractory chronic cluster headache

    DEFF Research Database (Denmark)

    Mitsikostas, Dimos D; Edvinsson, Lars; Jensen, Rigmor H

    2014-01-01

    Chronic cluster headache (CCH) often resists to prophylactic pharmaceutical treatments resulting in patients' life damage. In this rare but pragmatic situation escalation to invasive management is needed but framing criteria are lacking. We aimed to reach a consensus for refractory CCH definition...... for clinical and research use. The preparation of the final consensus followed three stages. Internal between authors, a larger between all European Headache Federation members and finally an international one among all investigators that have published clinical studies on cluster headache the last five years....... Eighty-five investigators reached by email. Proposed criteria were in the format of the International Classification of Headache Disorders III-beta (description, criteria, notes, comments and references). Following this evaluation eight drafts were prepared before the final. Twenty-four (28...

  5. A case of testicular tumor with uncommon clinical course: testicular lesion that was initially not palpable led to a wrong diagnosis of huge retroperitoneal hematoma due to trauma

    OpenAIRE

    沖, 守; 由井, 康雄; 吉田, 和弘; 秋元, 成太

    1984-01-01

    A case of testicular tumor with uncommon clinical course is presented. Although the patient underwent abdominal trauma and was diagnosed as having retroperitoneal hematoma, a retroperitoneal bulky tumor was revealed at surgery. After that left orchiectomy was performed because the testicular swelling gradually developed. The retroperitoneal tumor was confirmed to be a secondary lesion metastasized from left testicular carcinoma.

  6. Sample Preparation for Monolithic Refractories Part 1: Refractory Castables

    Institute of Scientific and Technical Information of China (English)

    Zhang Xiaohui; Peng Xigao

    2010-01-01

    @@ 1 Scope This standard specifies the definition and test methods of flowability of dense and insulating refractory castables,and moulding equipment,moulding methods,curing and drying conditions of castables samples.

  7. Retroperitoneal primitive neuroectodermal tumor in an adult: A rare case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Kavita Mardi

    2016-01-01

    Full Text Available Primitive neuroectodermal tumor (PNET and Ewing's sarcoma (EWS are small round cell tumors occurring mainly in children and adolescents. Their occurrence in adults is rare. The abdominal cavity and retroperitoneal PNET/EWS are also relatively rare, grow rapidly in size, compressing surrounding organs/large vessels, and make surgical resection difficult. We report one such rare occurrence of a retroperitoneal PNET in 41-year-old male who presented with abdominal pain and constipation. Contrast enhanced computed tomography abdomen showed large lobulated necrotic hypodense enhancing lesion extending from epigastrium to hypogastrium and involving entire abdomen. Excision of retroperitoneal mass with omentectomy was done. Microscopic examination revealed a malignant small round cell tumor with homer wright rosettes and the tumor cells were positive for CD99.

  8. Massive Retroperitoneal Hemorrhage as an Initial Presentation of a Rare and Aggressive Form of Multiple Myeloma

    Directory of Open Access Journals (Sweden)

    Aydah Alawadhi

    2016-01-01

    Full Text Available Multiple myeloma, a plasma cell neoplasm, presents most commonly with anemia, hypercalcemia, renal failure, and bone pain. Only few cases of clinical aggressive presentation associated with bleeding were reported in the medical literature. The reported cases included gastrointestinal bleeding and cardiac tamponade. Spontaneous retroperitoneal haemorrhage as initial presentation has not been so far reported. We hereby report a case of a 64-year-old female who was found to have catastrophic hemorrhage in the retroperitoneal region that extended into intrathecal space causing cord compression. The case posed a significant diagnostic and management dilemma. This case emphasizes the need to think broadly and include multiple myeloma in the diagnosis of unexplained massive retroperitoneal bleeding.

  9. Surgical anatomy of the retroperitoneal spaces--part I: embryogenesis and anatomy.

    Science.gov (United States)

    Mirilas, Petros; Skandalakis, John E

    2009-11-01

    Embryologically, the retroperitoneal (extraperitoneal) connective tissue includes three strata, which respectively form the internal fascia lining of the body wall, the renal fascia, and the covering of the gastrointestinal viscera. All organs, vessels, and nerves, that lie on the posterior abdominal wall, along with their tissues and surrounding connective and fascial planes, are collectively referred to as the retroperitoneum. The retroperitoneal space is the area of the posterior abdominal wall that is located between the parietal peritoneum and the fascia. Within the greater retroperitoneal space, there are also several small spaces, or subcompartments. Loose connective tissue and fat surround the anatomic entities, and, to a variable degree, occupy the subcompartments. The multilaminar thoracolumbar (lumbodorsal) fascia begins at the occipital area and terminates at the sacrum.

  10. Primary retroperitoneal transitional cell carcinoma presenting as a dumb-bell tumour.

    Science.gov (United States)

    Basu, S; Ansari, M; Gupta, S; Kumar, A

    2009-11-01

    We report a retroperitoneal transitional cell carcinoma arising from the primitive urogenital remnants of a 56-year-old married Indian woman. She presented with a huge cystic mass in the hypogastrium and right iliac fossa, which extended into the right thigh as a massive dumb-bell tumour. On exploration, it was found not to be arising from any known retroperitoneal structure. The mass was excised, and the histopathology confirmed transitional cell carcinoma with positive margins. Though she received postoperative chemotherapy with cyclophosphamide, adriamycin and cisplatin, she developed extensive local recurrence and hepatic secondaries, and succumbed to the disease after ten months of follow-up. We highlight the rarity of the disease, its atypical presentation as a cystic dumb-bell lump, its diagnostic challenges and aggressive behaviour, and review the literature on primary retroperitoneal transitional cell carcinomas.

  11. Retroperitoneal liposarcomas: a representative literature review occasioned by a rare case of laterelapse abdominal liposarcoma.

    Science.gov (United States)

    Pisani, Michela; Al-Buheissi, Salah; Whittlestone, Tim

    2016-05-24

    Soft tissue sarcomas (STS) are rare and heterogeneous tumours representing approximately 0.7%-1% of all adult tumours. In the adults and among the retroperitoneal sarcomas (RPS), Liposarcoma (LS) is the most common variant accounting for 12% -20% of all sarcomas and up to 45% of sarcomas at retroperitoneal localization. A rare case of LS relapsed after 15 years is giving the occasion to review the published literature and emphasise the followings concepts: 1) Despite extensive surgery remains the mainstay of treatment for localized STS at present, anatomical complexity and occult localization result in local recurrence in the majority of patients; 2) The role of imaging and tumour markers is still limited; 3) Indefinite prolonged surveillance is a key point of treatment; 4) Referral to tertiary centres with dedicated Retroperitonal Surgeons and Oncology expertise is mandatory.

  12. Present Situation of Refractories for Baosteel

    Institute of Scientific and Technical Information of China (English)

    TAI Li; SHEN Keyin

    2004-01-01

    The paper reviews the present situation of refractories for Baosteel, including refractories for iron-making system, converters, ladles and tundishes. Descriptions have been also conducted on the environment protection and reutilization of refractories in Baosteel, together with somesuggestions for refractories suppliers to meet the advancement in iron and steel making technology of Baosteel.

  13. Effect of retroperitoneal lymphadenectomy on prognosis of patients with epithelial ovarian cancer

    Institute of Scientific and Technical Information of China (English)

    王泽华; 熊宙芳; 王世宣

    2003-01-01

    Objective To evaluate prognostic factors which have an influence on overall survival and to assess the rational application of retroperitoneal lymphadenectomy in patients with epithelial ovarian cancer. Methods The data of 131 patients treated between January 1990 and December 1998 in Union Hospital and Tongji Hospital were analyzed retrospectively. Survival was calculated using the Kaplan-Meier method and comparisons were performed using Log-rank test. Independent prognostic factors were identified by the Cox proportional hazards regression model. Results Univariate analysis showed that age, general conditions, menopausal status, stage, pathological types, location of the tumor, residual tumor and retroperitoneal lymphadenectomy were prognostic factors. Multivariate analysis showed that age, stage, residual tumor, retroperitoneal lymphadenectomy and the number of courses of chemotherapy were the most important prognostic factors. The survival rate could not be improved through retroperitoneal lymphadenectomy in the patients in early stage, advanced stage with residual tumor >2 cm or those with mucinous adenocarcinoma (P>0.05). Among patients in advanced stage cancer with a residual tumor ≤2 cm, 5-year survival was 65% and 30% for patients who did and did not undergo lymphadenectomy, respectively (P<0.01). Among patients with serous adenocarcinoma, 5-year survival was 61% and 31% for patients who did and did not undergo lymphadenectomy, respectively (P<0.01). Conclusions The prognosis of the patients with epithelial ovarian cancer may be influenced by age, stage, residual tumor, retroperitoneal lymphadenectomy and the number of courses of chemotherapy. Although retroperitoneal lymphadenectomy could improve the survival rate, it should be carried out selectively.

  14. Primary retroperitoneal teratomas in children: A single institution experience

    Directory of Open Access Journals (Sweden)

    Aggarwal S

    2010-01-01

    Full Text Available Objective: This study aims to highlight the clinical features, investigations and treatment outcome of retroperitoneal teratomas (RPT in children. Materials and Methods: A total of eight patients (six males and two females, age range between 6 months−10 years of RPT admitted in the department of Paediatric Surgery, PGIMS, Rohtak, between 1996−2008, were studied. The patients were investigated with hematology, x-ray, ultrasound, and computerised tomography (CT of abdomen and serum alpha-fetoprotein levels in pre and postoperative period. All patients underwent complete surgical resection. In one patient, the tumour had malignant component (yolk sac and was given postoperative chemotherapy. Postoperative follow-up included serum alpha-fetoprotein in addition to clinical examination and radiological assessment to detect recurrences. Results: The tumours were located on both sides in almost equal proportion (four on right, three on left, and one bilateral]. All tumours could be excised completely preserving the kidneys in all patients. But in one patient injury to inferior vena cava (IVC occurred which was repaired successfully. Majority (7 out of 8 were histological benign, and in one yolk sac tumour was malignant component which needed chemotherapy. All children were on follow-up and one patient with malignancy lost to follow-up after three cycles of chemotherapy. In rest there was no tumour recurrence. Conclusion: RPT are rare paediatric neoplasms. As majority are benign, a complete excision preserving the kidneys, is usually curative. Serum alpha-fetoprotein is a reliable method of assessing recurrence. Malignancy in the tumour may warrant further chemotherapy.

  15. Robot - assisted laparoscopic retroperitoneal lymph node dissection in testicular tumor

    Science.gov (United States)

    Torricelli, Fabio C. M.; Jardim, Denis; Guglielmetti, Giuliano B.; Patel, Vipul; Coelho, Rafael F.

    2017-01-01

    ABSTRACT Introduction and objective Retroperitoneal lymph node dissection (RPLND) is indicated for patients with non-seminomatous germ cell tumor (NSGCT) with residual disease after chemotherapy. Although the gold standard approach is still the open surgery, few cases of robot-assisted laparoscopic RPLND have been described. Herein, we aim to present the surgical technique for robot-assisted laparoscopic RPLND. Patient and method A 30 year-old asymptomatic man presented with left testicular swelling for 2 months. Physical examination revealed an enlarged and hard left testis. Alpha-fetoprotein (>1000ng/mL) and beta-HCG (>24.000U/L) were increased. Beta-HCG increased to >112.000U/L in less than one month. The patient underwent a left orchiectomy. Pathological examination showed a mixed NSGCT (50% embryonal carcinoma; 30% teratoma; 10% yolk sac; 10% choriocarcinoma). Computed tomography scan revealed a large tumor mass close to the left renal hilum (10x4x4cm) and others enlarged paracaval and paraortic lymph nodes (T2N3M1S3-stage III). Patient was submitted to 4 cycles of BEP with satisfactory response. Residual mass was suggestive of teratoma. Based on these findings, he was submitted to a robot-assisted RPLND. Results RPLND was uneventfully performed. Operative time was 3.5 hours. Blood loss was minimal, and there were no intra- or postoperative complications. The patient was discharged from hospital in the 1st postoperative day. Pathological examination showed a pure teratoma. After 6 months of follow-up, patient is asymptomatic with an alpha-fetoprotein of 2.9ng/mL and an undetectable beta-HCG. Conclusion Robot-assisted laparoscopic RPLND is a feasible procedure with acceptable morbidity even for post chemotherapy patients when performed by an experienced surgeon.

  16. Analysis of Crack Arrest Toughness.

    Science.gov (United States)

    1988-01-15

    vload(m) vp tn(m) Vertical Source Load (kN) on wedge HY80 Finite Element 0.0122 0.0099 3.81x10 -4 144 Steel Calculations Experiment 0.0122 --- 3.74x10-4...curve, are bona fide measures of the fracture arrest capability of tough ductile steels . The second is that the J-values represent the crack driving...fibrous mode of crack extension. (b) A new test method for studying fast fracture and arrest in tough steels . (c) Measurements of fast fracture and crack

  17. Retroperitoneal neoplasm with perivascular epithelioid cell differentiation:A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Min Zhao; Jin Huang; Jin Wang

    2013-01-01

    The retroperitoneal neoplasm with perivascular epithelioid cel differentiation (PEComa) is an extremely rare path-ological entity. In this article, we reported one case of a 45-year-old woman who was admitted to our hospital (The Second People’s Hospital of Hefei, China) for retroperitoneal neoplasm with perivascular epithelioid cel dif erentiation. The B ultra-sonic examination showed echopoor in the region of cavitas pelvis. The histologic characteristics and immunohistochemical phenotype both revealed the neoplasm with perivascular epithelioid cel differentiation.

  18. Primary retroperitoneal mucinous cystadenoma: Report of a case and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Sheng-Lei Yan; HO Lin; Chien-Long Kuo; Hurng-Sheng Wu; Ming-Ho Huang; Yueh-Tsung Lee

    2008-01-01

    Primary retroperitoneal mucinous cystadenomas (RMCs) are very rare and their biological behavior and histogenesis remain speculative.An accurate preoperative diagnosis of these tumors is difficult because no effective diagnostic measures have been established.We describe a 29-year-old woman with abdominal pain and a palpable mass.Computed tomography (CT) of the abdomen revealed a retroperitoneal cystic mass which was resected successfully at laparotomy.Histopathological examination of the resected mass confirmed the diagnosis of RMC.There was no evidence of disease 2 years after surgery.

  19. [Retroperitoneal germinal tumor: extragonadal or burned out phenomenon of testicular primary? Presentation of a clinical case].

    Science.gov (United States)

    Borrego Hernándo, J; Guinda Sevillano, C; Laguna Pes, M P; Zazo, A; Gimeno, A; Cuesta, R; Amigo, A

    1998-02-01

    Clinical record case of a retroperitoneal seminoma with "burned-out" phenomenon in the testicular primary, in a 38 year old male with no background of interest who consults for a picture of left nephritic colic. The ipsilateral testis study detects a fibrotic area with hyalinosis and hemosiderin deposits, although there are no tumoral debris, compatible with the "burned-out" phenomenon. Management is through surgery plus a chemotherapy protocol. Discussion of the diagnostic algorithm of retroperitoneal tumours and the literature on extragonadal germinal tumours.

  20. Retroperitoneal fibrosis: A rare cause of both ureteral and small bowel obstruction

    Institute of Scientific and Technical Information of China (English)

    Faisal Aziz; Srinivasulu Conjeevaram; Than Phan

    2006-01-01

    Retroperitoneal fibrosis (RPF) is a rare condition of unclear etiology. It can cause ureteral obstruction. We present the unique case of a 54 years old female, who initially presented with spontaneous perforation of the cecum. Upon exploring the abdomen, the classical glistening white, unyielding retroperitoneal fibrosis was encountered. A right hemicolectomy was performed.Subsequently, the patient presented with bilateral ureteral obstruction, and later on with small bowel obstruction. Ureteral obstruction was treated with stents,and small bowel obstruction was treated with bypass.To our knowledge no case of idiopathic RPF presenting with features of both bilateral ureteral and small bowel obstruction has been reported in the literature.

  1. Self-flow Refractory Castables

    Institute of Scientific and Technical Information of China (English)

    Zhang Xiaohui; Peng Xigao

    2010-01-01

    @@ 1 Scope This standard specifies the term and definition,classification, technical requirements, test methods,quality appraisal procedures, packing, marking, transportation, storage, and quality certificate of self-flow refractory castables.

  2. Alumina-magnesia Refractory Castables

    Institute of Scientific and Technical Information of China (English)

    Wang Jing

    2010-01-01

    @@ 1 Scope This standard specifies the classification,technical requirements,test methods,quality appraisal procedures,packing,marking,transportation,storage,and quality certificate of alumina-magnesia refractory castables.

  3. Intestinal duplication and retroperitoneal teratoma in child hoof: a case report; Duplicacao intestinal e teratoma retroperitoneal na infancia: relato de caso

    Energy Technology Data Exchange (ETDEWEB)

    Atzingen, Augusto Castelli Von; Bazzano, Felix Carlos Ocariz; Tiburzio, Nicolas Biagione; Grande, Rogerio Mendes; Juntolli Netto, Joao Diniz [Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, MG (Brazil). Hospital das Clinicas Samuel Libanio (HCSL)]. E-mail: augvonatzingen@bol.com.br; augvonatzingen@hotmail.com

    2007-07-01

    The authors present a case of intestinal duplication and retroperitoneal teratoma in a 7-year-old patient with evident mass and abdominal pain to explain; that it was submitted to study conventional X-ray, ultrasonography, computed tomography and subsequent exploiting laparotomia. The anatomopathological study verified intestinal duplication and ripe teratoma. In the existent medical literature it was not found any similar case. (author)

  4. Impact of alternate fuels on industrial refractories and refractory insulation applications. An Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Wei, G.C.; Tennery, V.J.

    1976-09-01

    The effects of use of alternate fuels such as distillate oils, residual oils, coal, producer gas, and electricity on refractory insulation are evaluated. Sections are included on alternate fuels for 1976 to 1980, assessment by industry of fuel conversion impact on industrial refractories in the period 1976 to 1980, interactions of alternate fuel combustion products with refractories and refractory insulation, and analysis of degradation mechanisms in refractories and refractory materials. (JRD)

  5. [Factors predictive of retroperitoneal lymph node metastasis in endometrial cancer].

    Science.gov (United States)

    Urzal, Cecília; Sousa, Rita; Baltar, Vítor; Correia, Paulo; Cruz, Eugénia; Pereira da Silva, Daniel

    2014-01-01

    Introdução: Tem sido sugerido que o estadiamento completo possa ser omitido com segurança em doentes com carcinoma do endométrio e baixo risco de metástases ganglionares. Os objectivos do nosso trabalho foram a exploração do significado prognóstico de factores patológicos para disseminação ganglionar pélvica e para-aórtica e a validação do algoritmo da Clínica Mayo, de forma a identificar as doentes em que a linfadenectomia possa ser dispensada.Material e Métodos: Efectuámos um estudo retrospectivo incluindo 208 doentes, para a avaliação de variáveis tumorais patológicas e metástases ganglionares. A análise estatística foi realizada através dos testes qui-quadrado, exacto de Fisher e t de Student.Resultados: A invasão miometrial > 50% (p citologia peritoneal positiva (p = 0,03) constituíram preditores significativos de disseminação ganglionar retroperitoneal. A metastizaçãoganglionar pélvica foi preditiva de metastização ganglionar para-aórtica (p < 0,001).Discussão: O algoritmo da Clínica Mayo identificou as doentes sem metástases nos gânglios pélvicos ou para-aórticos com um valor preditivo negativo de 98,4% (61/62). A combinação de invasão miometrial ≤ 50% e ausência de invasão cervical ou linfovascular apresentou um valor preditivo negativo de 98,8% (79/80).Conclusão: Apesar de os critérios da Clínica Mayo predizerem uma probabilidade muito reduzida de metástases ganglionares retroperitoneais, a combinação de invasão miometrial ≤ 50% e ausência de invasão cervical ou linfovascular teria evitado a linfadenectomia num número superior de mulheres.

  6. Radiation Effects in Refractory Alloys

    Science.gov (United States)

    Zinkle, Steven J.; Wiffen, F. W.

    2004-02-01

    In order to achieve the required low reactor mass per unit electrical power for space reactors, refractory alloys are essential due to their high operating temperature capability that in turn enables high thermal conversion efficiencies. One of the key issues associated with refractory alloys is their performance in a neutron irradiation environment. The available radiation effects data are reviewed for alloys based on Mo, W, Re, Nb and Ta. The largest database is associated with Mo alloys, whereas Re, W and Ta alloys have the least available information. Particular attention is focused on Nb-1Zr, which is a proposed cladding and structural material for the reactor in the Jupiter Icy Moons Orbiter (JIMO) project. All of the refractory alloys exhibit qualitatively similar temperature-dependent behavior. At low temperatures up to ~0.3TM, where TM is the melting temperature, the dominant effect of radiation is to produce pronounced radiation hardening and concomitant loss of ductility. The radiation hardening also causes a dramatic decrease in the fracture toughness of the refractory alloys. These low temperature radiation effects occur at relatively low damage levels of ~0.1 displacement per atom, dpa (~2×1024 n/m2, E>0.1 MeV). As a consequence, operation at low temperatures in the presence of neutron irradiation must be avoided for all refractory alloys. At intermediate temperatures (0.3 to 0.6 TM), void swelling and irradiation creep are the dominant effects of irradiation. The amount of volumetric swelling associated with void formation in refractory alloys is generally within engineering design limits (>10 dpa). Very little experimental data exist on irradiation creep of refractory alloys, but data for other body centered cubic alloys suggest that the irradiation creep will produce negligible deformation for near-term space reactor applications.

  7. 14 CFR 1203b.103 - Arrest authority.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Arrest authority. 1203b.103 Section 1203b.103 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SECURITY PROGRAMS; ARREST AUTHORITY AND USE OF FORCE BY NASA SECURITY FORCE PERSONNEL § 1203b.103 Arrest authority. (a) NASA...

  8. 33 CFR 154.822 - Detonation arresters, flame arresters, and flame screens.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Detonation arresters, flame arresters, and flame screens. 154.822 Section 154.822 Navigation and Navigable Waters COAST GUARD... BULK Vapor Control Systems § 154.822 Detonation arresters, flame arresters, and flame screens. (a)...

  9. Primary retroperitoneal mucinous tumor of low malignant potential in a Persian woman.

    Directory of Open Access Journals (Sweden)

    Hayedeh Haeri

    2014-09-01

    Full Text Available Primary retroperitoneal mucinous tumor (PRMT of low malignant potential (border line is an uncommon neoplasm with fewer than 50 reported cases. Uncertain diagnostic imaging results make diagnosis of its origin difficult, preoperatively. Later treatment planning and prognosis would be affected by exact diagnosis of the tumor origin. This study presents a case of Persian woman with diagnostic, histological and immunohistochemical specifications.

  10. Systemic immunologic and inflammatory response after transperitoneal versus retroperitoneal laparoscopic donor nephrectomy: A prospective observational study.

    Science.gov (United States)

    Gogoi, Debojit; Pal, Dilip Kumar; Bera, Malay K

    2016-01-01

    Laparoscopic donor nephrectomy (LDN) can be performed via either transperitoneal or retroperitoneal approach. Very few studies have been carried out till now, comparing immunologic and inflammatory responses in donors after these two approaches. This is a prospective observational study. Selection of approach was decided by the operating surgeon. All patients underwent peripheral venous blood sampling preoperatively and 24 h postoperatively for the measurement of C-reactive protein (CRP), interleukein-6 (IL-6), total leukocyte count (TLC), blood urea nitrogen (BUN), and serum creatinine (SCr). Operative time, warm ischemia time, hospital stay, requirement of analgesia, and complications were also recorded. From February 2013 to January 2015, we performed 54 LDNs (38 transperitoneal and 16 retroperitoneal). There were 49 females and five males. Mean operative time was not significantly different in these two approaches, but warm ischemia time was significantly less in the retroperitoneal laparoscopic donor nephrectomy (RLN) group. Postoperative inflammatory markers' (IL-6, CRP, and TLC) levels, BUN, and SCr rise in both of these approaches, but there was no significant difference observed between these two approaches. RLN is a safe and effective approach to preserve a longer right renal vein. It combines the benefit of both hand assistance and retroperitoneal approach. Warm ischemic time is significantly less in RLN group.

  11. Systemic immunologic and inflammatory response after transperitoneal versus retroperitoneal laparoscopic donor nephrectomy: A prospective observational study

    Directory of Open Access Journals (Sweden)

    Debojit Gogoi

    2016-01-01

    Full Text Available Laparoscopic donor nephrectomy (LDN can be performed via either transperitoneal or retroperitoneal approach. Very few studies have been carried out till now, comparing immunologic and inflammatory responses in donors after these two approaches. This is a prospective observational study. Selection of approach was decided by the operating surgeon. All patients underwent peripheral venous blood sampling preoperatively and 24 h postoperatively for the measurement of C-reactive protein (CRP, interleukein-6 (IL-6, total leukocyte count (TLC, blood urea nitrogen (BUN, and serum creatinine (SCr. Operative time, warm ischemia time, hospital stay, requirement of analgesia, and complications were also recorded. From February 2013 to January 2015, we performed 54 LDNs (38 transperitoneal and 16 retroperitoneal. There were 49 females and five males. Mean operative time was not significantly different in these two approaches, but warm ischemia time was significantly less in the retroperitoneal laparoscopic donor nephrectomy (RLN group. Postoperative inflammatory markers′ (IL-6, CRP, and TLC levels, BUN, and SCr rise in both of these approaches, but there was no significant difference observed between these two approaches. RLN is a safe and effective approach to preserve a longer right renal vein. It combines the benefit of both hand assistance and retroperitoneal approach. Warm ischemic time is significantly less in RLN group.

  12. Retroperitoneal Laparoscopic Nephroureterectomy for Tuberculous Nonfunctioning Kidneys: a single-center experience

    Directory of Open Access Journals (Sweden)

    Xiquan Tian

    2015-04-01

    Full Text Available Purpose To present our surgical techniques and experiences of retroperitoneal laparoscopic nephroureterectomy for the treatment of tuberculous nonfunctioning kidneys. Materials and Methods From March 2005 to March 2013, a total of 51 patients with tuberculous nonfunctioning kidney underwent retroperitoneal laparoscopic nephroureterectomy at our medical center. The techniques included early control of renal vessels and dissection of the diseased kidney along the underlying layer outside the Gerato’s fascia. The distal ureter was dissected through a Gibson incision and the entire specimen was removed en bloc from the incision. Patient demographics, perioperative characteristics and laboratory parameters as well as postoperative outcome were retrospectively reviewed. Results Retroperitoneal laparoscopic nephroureterectomy was successfully performed in 50 patients, whereas one case required conversion to open surgery due to non-progression of dissection. The mean operating time was 123.0 minutes (107-160 minutes and the mean estimated blood loss was 134 mL (80-650 mL.The mean postoperative hospital stay was 3.6 days (3-5days and the mean return to normal activity was 11.6 days (10-14days. Most intra-operative and post-operative complications were minor complications and can be managed conservatively. After 68 months (12-96 months follow-up, the outcome was satisfactory, and ureteral stump syndrome did not occur. Conclusions Retroperitoneal laparoscopic nephroureterectomy as a minimally invasive treatment option is feasible for treatment of tuberculous nonfunctioning kidneys.

  13. Masas retroperitoneales en el período perinatal Retroperitoneal masses in the perinatal period

    Directory of Open Access Journals (Sweden)

    Nelda María Castagnaro Rosini

    2011-03-01

    Full Text Available Objetivo: identificar las causas más frecuentes de masa retroperitoneal durante el período fetal y neonatal e ilustrar los hallazgos imagenológicos basados en los resultados obtenidos de nuestra experiencia. Material y método: estudio retrospectivo observacional de las causas de masas retroperitoneales en recién nacidos (RN. Se analizaron historias clínicas y hallazgos radiológicos y ultrasonográficos de 487 neonatos a los que se les había realizado ecografía abdominal entre enero de 2008 y diciembre de 2009. Se seleccionaron 47 RN con diagnóstico de lesión retroperitoneal, respetando los siguientes criterios: Inclusión: pacientes con diagnóstico ecográfico prenatal de masa intraabdominal retroperitoneal y neonatos que presentaron al examen físico masa abdominal palpable y fueron estudiados con diferentes técnicas de diagnóstico por imagen. Exclusión: neonatos con patología abdominal gastrointestinal e intraperitoneal. Resultados: del total de pacientes (n =47, 42 presentaron masas de origen renal (89% y 5 retroperitoneal extrarrenal (11%. Las patologías prevalentes fueron hidronefrosis con 36 casos (76% y displasia renal multiquística con 4 (9%. Se registró un caso de nefroma mesoblástico congénito y 1 con enfermedad poliquística autosómica recesiva. Se detectaron 3 RN con hemorragia suprarrenal (6% y 2 con neuroblastoma (4%. Conclusión: la incidencia de Masas Retroperitoneales en la población estudiada fue del 9,65%, coincidente con la bibliografía. El presente trabajo destaca el valor del US prenatal, importante para definir conducta obstétrica, y la coordinación entre la ecografía pre y posnatal para lograr una mayor aproximación al diagnóstico. El rol fundamental de la TC para definir conducta quirúrgica en el nefroma mesoblástico congénito y para estadificación en los casos de neuroblastoma.Purpose: To identify the most frequent causes of retroperitoneal mass during the fetal and neonatal period, and

  14. Robot-assisted laparoscopic retroperitoneal lymph node dissection for stage IIIb mixed germ cell testicular cancer after chemotherapy.

    Science.gov (United States)

    Lee, Sang Hyub; Kim, Dong Soo; Chang, Sung-Goo; Jeon, Seung Hyun

    2015-07-01

    Laparoscopic retroperitoneal lymph node dissection, especially when performed with the da Vinci Surgical System (Intuitive Surgical), has shown excellent cosmetic results with similar oncologic outcomes to those of open surgery. In this study, we present a case of robot-assisted retroperitoneal lymph node dissection performed in an 18-year-old man who was diagnosed with a stage IIIb mixed germ cell tumor and who was initially treated with radical orchiectomy, followed by chemotherapy. This case shows that robot-assisted retroperitoneal lymph node dissection is technically feasible, safe, and cosmetically favorable, even when performed on patients with high-stage disease or after chemotherapy.

  15. Neurologic management following cardiac arrest.

    Science.gov (United States)

    Bircher, N G

    1989-10-01

    Optimal neurologic outcome after cardiac arrest requires careful attention to the details of both intracranial and extracranial homeostasis. A high index of suspicion regarding the potential causes and complications of cardiac arrest facilitates discovery and treatment of problems before they adversely affect neurologic outcome. The future is bright for resuscitation research: Our fundamental understanding of cerebral ischemia and its consequences has dramatically improved, and this knowledge can hopefully be transferred to clinical useful modes of therapy. However, the transition from a promising, therapeutically effective intervention in animals to the demonstration that treatment is effective following cardiac arrest in humans is an important and difficult step. The patient population is heterogeneous before the insult, the duration and severity of the insult are variable, and the effectiveness of cardiopulmonary resuscitation varies among institutions. Therefore, the only means of demonstrating clinical efficacy is the performance of a large clinical trial. The Resuscitation Research Center at the University of Pittsburgh has developed and coordinated a multicenter, multinational team of investigators who have completed one definitive trial of postarrest barbiturate therapy and are currently completing a similar trial using a calcium entry blocker. Despite the formidable obstacles posed by such comprehensive efforts, they provide the mechanism for determining whether the cost of a new treatment modality is justified by the likelihood of improved mortality or morbidity.

  16. SINTERED REFRACTORY TUNGSTEN ALLOYS. Gesinterte hochschmelzende wolframlegierungen

    Energy Technology Data Exchange (ETDEWEB)

    Kieffer, R.; Sedlatschek, K.; Braun, H.

    1971-12-15

    Dependence of the melting point of the refractory metals on their positions in the periodic system - alloys of tungsten with other refractory metals - sintering of the alloys - processing of the alloys - technological properties.

  17. Company Profile Dengfeng Chunsheng Refractories Co., Ltd.

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ Dengfeng Chunsheng Refractories Co., Ltd. is an industrial enterprise integrating refractories research, design, manufacturing and engineering service into one and was entitled as one of China's high-quality silica bricks production and export bases.

  18. Magnesia-Chrome Refractories for Flash Furnace

    Institute of Scientific and Technical Information of China (English)

    LI Yong; CHEN Kaixian; LU Xinghua; LIU Jianlong; SUN Jialin; HONG Yanruo

    2002-01-01

    The rapid development of our country's heavy nonferrous metallurgical technology and the revolution in new type of heavynon-ferrous metallurgical furnace have imposed more critical demand on the refractory materials ,i. e. high quality and long service life. This paper presents the domestic status of the refractories for flash furnace , briefly describes the wear of the refractory used , and it is considered that the domestic in refractories for flashfurnace can be surely realized.

  19. Reuse and Reproduction of Used Refractories

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The paper analyzed the recycle condition and developing trend of used refractories China and other countries, including research achievements of recycles of used refractories such as MgO-C bricks, Al2O3-MgO-C bricks, Al2O3-SiC-C castable and MgO-Cr2O3 bricks. Recycled refractories exhibit the same or even better properties as compared with the original. In addition, prospects for recycle of used refractories are also discusseded.

  20. Combined management of retroperitoneal sarcoma with dose intensification radiotherapy and resection: Long-term results of a prospective trial.

    LENUS (Irish Health Repository)

    Smith, Myles J F

    2014-01-07

    Late failure is a challenging problem following resection of retroperitoneal sarcoma (RPS). We investigated the effects of preoperative XRT plus dose escalation with early postoperative brachytherapy (BT) on long-term survival and recurrence in RPS.

  1. Castleman Disease in the Kidney and Retroperitoneum Mimicking Renal Cell Carcinoma with Retroperitoneal Lymphadenopathy: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Hee Sun; Woo, Ji Young; Hong, Hye Suk; Jung, Ah Young; Yang, Ik; Lee, Yul [Dept. of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of)

    2012-09-15

    Castleman disease, or angiofollicular lymph node hyperplasia, is a fairly rare benign tumor of lymphoid origin with unknown etiology. Castleman disease arises mostly in the mediastinum, and some cases of renal and retroperitoneal involvement have been reported. However, Castleman disease that simultaneously involves the kidney and regional lymph nodes has not been reported in radiologic literature. We report a case of renal and pararenal Castleman disease, mimicking renal cell carcinoma with retroperitoneal lymphadenopathy.

  2. Refractory disease in autoimmune diseases

    NARCIS (Netherlands)

    Vasconcelos, Carlos; Kallenberg, Cees; Shoenfeld, Yehuda

    2011-01-01

    Refractory disease (RD) definition has different meanings but it is dynamic, according to knowledge and the availability of new drugs. It should be differentiated from severe disease and damage definitions and it must take into account duration of adequate therapy and compliance of the patient. It c

  3. Management of chronic refractory cough.

    Science.gov (United States)

    Gibson, Peter G; Vertigan, Anne E

    2015-12-14

    Chronic refractory cough (CRC) is defined as a cough that persists despite guideline based treatment. It is seen in 20-46% of patients presenting to specialist cough clinics and it has a substantial impact on quality of life and healthcare utilization. Several terms have been used to describe this condition, including the recently introduced term cough hypersensitivity syndrome. Key symptoms include a dry irritated cough localized around the laryngeal region. Symptoms are not restricted to cough and can include globus, dyspnea, and dysphonia. Chronic refractory cough has factors in common with laryngeal hypersensitivity syndromes and chronic pain syndromes, and these similarities help to shed light on the pathophysiology of the condition. Its pathophysiology is complex and includes cough reflex sensitivity, central sensitization, peripheral sensitization, and paradoxical vocal fold movement. Chronic refractory cough often occurs after a viral infection. The diagnosis is made once the main diseases that cause chronic cough have been excluded (or treated) and cough remains refractory to medical treatment. Several treatments have been developed over the past decade. These include speech pathology interventions using techniques adapted from the treatment of hyperfunctional voice disorders, as well as the use of centrally acting neuromodulators such as gabapentin and pregabalin. Potential new treatments in development also show promise.

  4. Gigantic retroperitoneal hematoma as a complication of anticoagulation therapy with heparin in therapeutic doses: a case report

    Directory of Open Access Journals (Sweden)

    Daliakopoulos Stavros I

    2008-05-01

    Full Text Available Abstract Introduction Spontaneous retroperitoneal hemorrhage is a distinct clinical entity that can present as a rare life-threatening event characterized by sudden onset of bleeding into the retroperitoneal space, occurring in association with bleeding disorders, intratumoral bleeding, or ruptures of any retroperitoneal organ or aneurysm. The spontaneous form is the most infrequent retroperitoneal hemorrhage, causing significant morbidity and representing a diagnostic challenge. Case presentation We report the case of a patient with coronary artery disease who presented with transient ischemic attack, in whom anticoagulant therapy with heparin precipitated a massive spontaneous atraumatic retroperitoneal hemorrhage (with international normalized ratio 2.4, which was treated conservatively. Conclusion Delay in diagnosis is potentially fatal and high clinical suspicion remains crucial. Finally, it is a matter of controversy whether retroperitoneal hematomas should be surgically evacuated or conservatively treated and the final decision should be made after taking into consideration patient's general condition and the possibility of permanent femoral or sciatic neuropathy due to compression syndrome.

  5. Cognitive impairment after sudden cardiac arrest

    OpenAIRE

    Jaszke-Psonka, Magdalena; Piegza, Magdalena; Ścisło, Piotr; Pudlo, Robert; Piegza, Jacek; Badura-Brzoza, Karina; Leksowska, Aleksandra; Hese, Robert T.; Gorczyca, Piotr W.

    2016-01-01

    Aim To evaluate the incidence and severity of the impairment of selected cognitive functions in patients after sudden cardiac arrest (SCA) in comparison to patients after myocardial infarction without SCA and healthy subjects and to analyze the influence of sociodemographic and clinical parameters and the duration of cardiac arrest on the presence and severity of the described disorders. Material and methods The study group comprised 30 cardiac arrest survivors, the reference group comprised ...

  6. Rare Aggressive Behavior of MDM2-Amplified Retroperitoneal Dedifferentiated Liposarcoma, with Brain, Lung and Subcutaneous Metastases

    Science.gov (United States)

    Ben Salha, Imen; Zaidi, Shane; Noujaim, Jonathan; Miah, Aisha B.; Fisher, Cyril; Jones, Robin L.; Thway, Khin

    2016-01-01

    Dedifferentiated liposarcoma (DDL) is a histologically pleomorphic sarcoma, traditionally defined as well-differentiated liposarcoma with abrupt transition to high grade, non-lipogenic sarcoma. It can occur as part of recurrent well-differentiated liposarcoma, or may arise de novo. DDL most frequently occurs within the retroperitoneum, and while it is prone to local recurrence, it usually has a lower rate of metastasis than other pleomorphic sarcomas. We describe a case of retroperitoneal dedifferentiated liposarcoma in a 63-year-old male, who showed MDM2 amplification with fluorescence in situ hybridization, which displayed unusually aggressive behavior, with brain, lung and subcutaneous soft tissue metastases. As previous reports of metastatic liposarcoma have largely grouped DDL in with other (genetically and clinically distinct) liposarcoma subtypes, we highlight and discuss the rare occurrence of brain metastasis in MDM2-amplified retroperitoneal liposarcoma.

  7. Massive retroperitoneal ganglioneuroma presenting with small bowel obstruction 18 years following initial diagnosis.

    LENUS (Irish Health Repository)

    Cronin, E M P

    2012-02-03

    BACKGROUND: Ganglioneuroma is a rare tumour of neural crest origin, which arises from maturation of a neuroblastoma. While previously considered to be non-functioning, they are now known to be frequently endocrinologically active. AIMS AND METHODS: We report a case of a massive retroperitoneal ganglioneuroma presenting with small bowel obstruction in an adult, 18 years after initial diagnosis. Urinary dopamine levels were elevated, but other catecholamines were within normal limits. This is the first report in the English-language literature of a retroperitoneal ganglioneuroma presenting with or causing intestinal obstruction. We also review the metabolic, radiological, and histological features of these tumours. Relevant publications were identified from a Medline search using the MeSH headings \\'ganglioneuroma\\

  8. Retroperitoneal abscess and acute acalculous cholecystitis after iatrogenic colon injury: report of a case

    Science.gov (United States)

    Dong, Chengwei; Wang, Yuxu; Hu, Sanyuan; Du, Futian; Ding, Wei

    2015-01-01

    Acute acalculous cholecystitis has a high mortality rate due to the difficulties in early diagnosis and high rate of complications like empyema, gangrene and perforation. We report a case of 20-year-old male with acute severe pancreatitis, acute renal failure and acute peripancreatic fluid collection who was transferred to our department after blood filtration treatment in ICU. After percutaneous catheter drainage for 20 hours, the patient got a high fever. Computed tomography revealed retroperitoneal colon injury. In this case, percutaneous catheter drainage was performed again and the pus cavity was flushed regularly, after which the patient’s state gradually improved. Unpredictably, septic shock appeared on the 51st day. Repeated computed tomography revealed acute acalculous cholecystitis and abscess formation. After percutaneous transhepatic gallbladder catheterization and drainage, the patient got better gradually. Three months later the retroperitoneal catheter was removed. Four months later, ultrasound examination showed normal gallbladder and the catheter was removed. PMID:26131252

  9. Retroperitoneal Abscess Formation as a Result of Spilled Gallstones during Laparoscopic Cholecystectomy: An Unusual Case Report

    Directory of Open Access Journals (Sweden)

    Grigoris Chatzimavroudis

    2012-01-01

    Full Text Available One of the complications of laparoscopic cholecystectomy for gallstone disease that seems to exceed that of the traditional open method is the gallbladder perforation and gallstone spillage. Its incidence can occur in up to 40% of patients, and in most cases its course is uneventful. However in few cases an abdominal abscess can develop, which may lead to significant morbidity. Rarely an abscess formation due to spilled and lost gallstones may occur in the retroperitoneal space. We herein report the case of a female patient who presented with clinical symptoms of sepsis six months following laparoscopic cholecystectomy. Imaging investigations revealed the presence of a retroperitoneal abscess due to retained gallstones. Due to patient’s decision to refuse abscess’s surgical drainage, she underwent CT-guided drainage. The 24-month followup of the patient has been uneventful, and the patient remains in good general condition.

  10. Acute retroperitoneal bleeding due to inferior mesenteric artery aneurysm: Case report

    Directory of Open Access Journals (Sweden)

    Ferrón JA

    2010-06-01

    Full Text Available Abstract Background Visceral artery aneurysms (VAA, although uncommon, are increasingly being detected. We describe a case of spontaneous retroperitoneal hemorrhage from a ruptured IMA aneurysm associated with stenosis of the superior mesenteric artery (SMA and celiac trunk, successfully treated with surgery. Methods A 65-year-old man presented with abdominal pain and hypovolemic shock. Abdominal CT scan showed an aneurysm of the inferior mesenteric artery with retroperitoneal hematoma. In addition, an obstructive disease of the superior mesenteric artery and celiac axis was observed. Results Upon emergency laparotomy a ruptured inferior mesenteric artery aneurysm was detected. The aneurysm was excised and the artery reconstructed by end-to-end anastomosis. Conclusions This report discusses the etiology, presentation, diagnosis and case management of inferior mesenteric artery aneurysms.

  11. Retroperitoneal Leiomyosarcoma Presenting as Lower Gastrointestinal Bleeding: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Dominic G. Ventura

    2011-01-01

    Full Text Available We report the first known case of a retroperitoneal leiomyosarcoma that presented with an endoscopically defined source of gastrointestinal bleeding in the colon. A 68-year-old male with a history of diverticulosis, hypertension, and hypercholesterolemia who complained of a 3-month history of abdominal pain, nausea, and intermittent hematochezia presented for evaluation of large volume hematochezia and lightheadedness. Colonoscopy revealed left-sided diverticulosis and rectal varices without stigmata of recent bleed. CT scan showed a 26 × 20 × 13 cm heterogeneous retroperitoneal mass and multiple hypodense hepatic lesions. Liver biopsy revealed leiomyosarcoma. In summary, although surgery is the mainstay of treatment, resectability has not improved significantly. Early recognition and aggressive surgery are keys to long-term survival.

  12. Chromia refractory brick with carbon treatment

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, James P.; Kwong, Kyei-Sing

    2017-03-21

    The disclosure provides a refractory brick system comprising a chromia refractory brick for operation in the slagging environment of an air-cooled gasifier. The chromia refractory brick comprises a ceramically-bonded porous chromia refractory having a porosity greater than 9% and having carbon deposits residing within the pores. The brick may be further comprised of Al.sub.2O.sub.3. The air-cooled gasifier generates a liquefied slag in contact with the refractory brick and generally operates at temperatures between 1250.degree. C. and 1575.degree. C. and pressures between 300 psi to 1000 psi, with oxygen partial pressures generally between 10.sup.-4 and 10.sup.-10 atm. The refractory brick performs without substantial chromium carbide or chromium metal formation in the low oxygen partial pressure environment. The inclusion of carbon without chromium carbide formation provides for significant mitigation of slag penetration and significantly reduced refractory wear.

  13. Primary retroperitoneal melanoma presented in a rare extracutaneous site for malignant melanoma

    Directory of Open Access Journals (Sweden)

    Mohamed Alsharedi

    2016-10-01

    Full Text Available Malignant melanoma, as the name implies, is a malignant tumor of melanocytes, found in the skin, eyes, meningeal lining and the mucosal epithelium of the aero-digestive and genitourinary tracts. Malignant melanoma is typically skin malignancy, which rarely presents at extracutaneous site. Here we present a rare case of primary retroperitoneal melanoma and review the findings in comparison with other cases described in literature.

  14. Giant retroperitoneal lipoma: a case report Lipoma gigante do retroperitônio: relato de caso

    Directory of Open Access Journals (Sweden)

    Carlos Augusto Real Martinez

    2003-12-01

    Full Text Available BACKGROUND: Retroperitoneal lipoma is an extremely rare neoplasm. AIMS: The authors report a case of giant retroperitoneal lipoma in a 32-year-old white female, with a history of pain and an abdominal mass over a 2-year period. Total abdominal ultrasonography and barium enema showed a large mass located in the retroperitoneal space behind the ascending colon. Laparotomy showed a large encapsulated tumor measuring 20 x 13 x 10 cm and weighing 3.400 g. The histological study revealed a benign neoplasm of fatty cells. CONCLUSION: The patient remains well 17 years after surgery, without recurrentce of the disease.RACIONAL: O lipoma é a neoplasia mesenquimal mais freqüente, raramente localizada no retroperitônio. Na maioria das vezes, o diagnóstico diferencial pré-operatório com os lipossarcomas de baixo grau de malignidade é difícil de ser estabelecido. OBJETIVO: Apresentar um caso de lipoma gigante retroperitoneal em mulher de 32 anos que há 2 anos apresentava história de dor e tumor abdominal palpável. A ultra-sonografia abdominal e o enema opaco mostraram grande massa localizada no retroperitônio, que deslocava o ceco e o cólon ascendente. A laparotomia mostrou tumor encapsulado com 20 x 13 x 10 cm e 3.400 g de peso. O estudo histopatológico mostrou presença de lipoma retroperitonial. A paciente encontra-se bem, sem recidiva da doença, 17 anos após a cirurgia.

  15. Acute torsion of a retroperitoneal renal transplant mimicking renal vein thrombosis.

    Science.gov (United States)

    Winter, Thomas C; Clarke, Andrea Lynn; Campsen, Jeffrey

    2013-09-01

    When imaging a renal transplant, the combination of absent flow in the main renal vein and reversed diastolic flow in the intrarenal arteries is considered highly suggestive of renal vein thrombosis. We present a case of torsion of a transplant kidney presenting with identical findings. Renal transplant torsion in general is a rare entity, previously described only in intraperitoneally placed organs; this case is the first that we are aware of with torsion occurring in a retroperitoneally placed graft.

  16. Classification of acute pancreatitis based on retroperitoneal extension: Application of the concept of interfascial planes

    Energy Technology Data Exchange (ETDEWEB)

    Ishikawa, Kazuo [Osaka Prefectural Senshu Critical Care Medical Center, 2-24 Rinku-Ourai-Kita, Izumisano-shi, Osaka 598-0048 (Japan)]. E-mail: ishikawa@sccmc.izumisano.osaka.jp; Idoguchi, Koji [Osaka Prefectural Senshu Critical Care Medical Center, 2-24 Rinku-Ourai-Kita, Izumisano-shi, Osaka 598-0048 (Japan)]. E-mail: idoguchi@sccmc.izumisano.osaka.jp; Tanaka, Hiroshi [Department of Traumatology and Acute Critical Care Medicine, Osaka University Hospital, 2-15 Yamada-Oka, Suita-shi, Osaka 565-0871 (Japan)]. E-mail: tanaka@hp-emerg.med.osaka-u.ac.jp; Tohma, Yoshiki [Osaka Prefectural Nakakawachi Medical Center of Acute Medicine, 3-4-13 Nishi-Iwata, Higashiosaka-shi, Osaka 578-0947 (Japan)]. E-mail: tohma@nmcam.jp; Ukai, Isao [Department of Traumatology and Acute Critical Care Medicine, Osaka University Hospital, 2-15 Yamada-Oka, Suita-shi, Osaka 565-0871 (Japan)]. E-mail: isaoukai@nifty.com; Watanabe, Hiroaki [Osaka Prefectural Senshu Critical Care Medical Center, 2-24 Rinku-Ourai-Kita, Izumisano-shi, Osaka 598-0048 (Japan)]. E-mail: hiwatana@sccmc.izumisano.osaka.jp; Matsuoka, Tetsuya [Osaka Prefectural Senshu Critical Care Medical Center, 2-24 Rinku-Ourai-Kita, Izumisano-shi, Osaka 598-0048 (Japan)]. E-mail: matsuoka@sccmc.izumisano.osaka.jp; Yokota, Jyunichiro [Osaka Prefectural Senshu Critical Care Medical Center, 2-24 Rinku-Ourai-Kita, Izumisano-shi, Osaka 598-0048 (Japan)]. E-mail: jyokota@sccmc.izumisano.osaka.jp; Sugimoto, Tsuyoshi [Ryokufukai Hospital, 1-16-13 Setoguchi, Hirano-ku, Osaka-shi, Osaka 547-0034 (Japan)]. E-mail: ts-sugi@ryokufukai.or.jp

    2006-12-15

    Objective: This study aimed to provide a classification system for acute pancreatitis by applying the principle that the disease spreads along the retroperitoneal interfascial planes. Materials and methods: Medical records and computed tomography (CT) images of 58 patients with acute pancreatitis treated between 2000 and 2005 were reviewed. The retroperitoneum was subdivided into 10 components according to the concept of interfascial planes. Severity of acute pancreatitis was graded according to retroperitoneal extension into these components. Clinical courses and outcomes were compared with the grades. The prognostic value of our classification system was compared with that of Balthazar's CT severity index (CTSI). Results: Retroperitoneal extension of acute fluid collection was classified into five grades: Grade I, fluid confined to the anterior pararenal space or retromesenteric plane (8 patients); Grade II, fluid spreading into the lateroconal or retrorenal plane (16 patients); Grade III, fluid spreading into the combined interfascial plane (8 patients); Grade IV, fluid spreading into the subfascial plane beyond the interfascial planes (15 patients); and Grade V, fluid intruding into the posterior pararenal space (11 patients). Morbidity and mortality were 92.3% and 38.5% in the 26 patients with Grade IV or V disease, and 21.9% and 0% in the 32 patients with Grade I, II, or III disease. Morbidity and mortality were 86.7% and 33.3% in patients with disease classified 'severe' according to the CTSI, and 37.5% and 9.4% in patients with disease classified 'mild' or 'moderate'. Conclusion: Classification of acute pancreatitis based on CT-determined retroperitoneal extension is a useful indicator of the disease severity and prognosis without the need for contrast-medium enhanced CT.

  17. A Rare Cause of Acute Urinary Retention: Retroperitoneal Ganglioneuroma and Concurrent Mediastineal Schwannoma

    Directory of Open Access Journals (Sweden)

    Salih Budak

    2013-04-01

    Full Text Available The underlying prior cause at the old male patients refered with acute urinary retention is frequently benign prostatic hypertrophy and urethral pathologies. Acute urinary retention can develop with obstruction as well as neurogenic causes. Neurogenic tumors develops from the cells which takes its origin from the neural crest and they can be seen every neural tissue. In this study rarely seen retroperitoneal ganglioneuroma which causes acute urinary retention and coexisting asymptomatic mediastineal schwannoma case is presented.

  18. Arresting relaxation in Pickering Emulsions

    Science.gov (United States)

    Atherton, Tim; Burke, Chris

    2015-03-01

    Pickering emulsions consist of droplets of one fluid dispersed in a host fluid and stabilized by colloidal particles absorbed at the fluid-fluid interface. Everyday materials such as crude oil and food products like salad dressing are examples of these materials. Particles can stabilize non spherical droplet shapes in these emulsions through the following sequence: first, an isolated droplet is deformed, e.g. by an electric field, increasing the surface area above the equilibrium value; additional particles are then adsorbed to the interface reducing the surface tension. The droplet is then allowed to relax toward a sphere. If more particles were adsorbed than can be accommodated by the surface area of the spherical ground state, relaxation of the droplet is arrested at some non-spherical shape. Because the energetic cost of removing adsorbed colloids exceeds the interfacial driving force, these configurations can remain stable over long timescales. In this presentation, we present a computational study of the ordering present in anisotropic droplets produced through the mechanism of arrested relaxation and discuss the interplay between the geometry of the droplet, the dynamical process that produced it, and the structure of the defects observed.

  19. Asymptomatic diaphragmatic rupture with retroperitoneal opening as a result of blunt trauma

    Directory of Open Access Journals (Sweden)

    Narci Adnan

    2010-01-01

    Full Text Available Blunt traumas of the abdomen and thorax are important clinical problems in pediatric ages. Severity of trauma may not always be compatible with the patients′ clinical situation. A 2-year-old male child was admitted to our emergency clinic as a result of tractor crash accident. Physical examination of the child was normal. The abdominal and thoracic ultrasonography (USG examination performed in the emergency clinic was normal. In thoracic computed tomography (CT scan of the patient, there was irregularity of the right diaphragmatic contour that was described as micro perforation-rupture (the free air was just in the perihepatic and retroperitoneal area, which was not passing through the abdomen. The patient was followed-up for 1 week in the hospital with a diagnosis of retroperitoneal diaphragmatic rupture. It is not appropriate to decide the severity of trauma in childhood on the basis of clinical findings. Although severe trauma and sustaining radiological examinations, the patients′ clinical pictures may be surprisingly normal, as in our patient. In such cases, there may not be any clinical symptom. CT scan examination must be preferred to USG for both primary diagnosis and follow-up of these patients. According to the current literature, there is no reported case with retroperitoneal rupture of the diaphragm.

  20. Prospective assessment of MRI for imaging retroperitoneal metastases from testicular germ cell tumours

    Energy Technology Data Exchange (ETDEWEB)

    Sohaib, S.A. [Department of Radiology, Institute of Cancer Research and Royal Marsden Hospital, Sutton, Surrey (United Kingdom)], E-mail: aslam.sohaib@rmh.nhs.uk; Koh, D.M. [Department of Radiology, Institute of Cancer Research and Royal Marsden Hospital, Sutton, Surrey (United Kingdom); Barbachano, Y. [Department of Computing and Statistics, Royal Marsden Hospital, Institute of Cancer Research and Royal Marsden Hospital, Sutton, Surrey (United Kingdom); Parikh, J.; Husband, J.E.S. [Department of Radiology, Institute of Cancer Research and Royal Marsden Hospital, Sutton, Surrey (United Kingdom); Dearnaley, D.P.; Horwich, A.; Huddart, R. [Department of Academic Urology Unit, Institute of Cancer Research and Royal Marsden Hospital, Sutton, Surrey (United Kingdom)

    2009-04-15

    Aim: To determine the sensitivity of magnetic resonance imaging (MRI) in the detection of retroperitoneal lymph nodes in patients with testicular germ cell tumours (TGCT). Methods and materials: A prospective study of 52 patients (mean age 34 years, range 18-54 years) was performed. Imaging of the retroperitoneum was performed using multidetector computed tomography (CT) and 1.5 T MRI systems. The CT and MRI images were read independently by three observers. The number, size, and site of enlarged nodes ({>=}10 mm maximum short axis diameter) were recorded. Retroperitoneal nodal detection on MRI was compared to CT. Results: Twenty-two (42%) of the 52 patients had no retroperitoneal disease; in remaining 30 patients 51 enlarged nodes were identified. On a per patient basis readers 1, 2, and 3 identified nodal disease in 28 of 29, 29 of 30, and 24 of 30 patients, respectively, using MRI compared to CT. Thus for experienced radiologists (readers 1 and 2) MRI is comparable to CT for nodal detection (i.e., this study excludes MRI being inferior to CT with 80% power and 5% type 1 error). Conclusion: MRI offers an alternative method for staging the retroperitoneum in young patients being followed for TGCT and has the major advantage of avoiding exposure to ionizing radiation.

  1. Case report of subcutaneous entomophthoromycosis with retroperitoneal invasion Relato de caso de entomoftoromicose subcutânea com invasão retroperitoneal

    Directory of Open Access Journals (Sweden)

    Leonora Maciel de Souza Vianna

    2005-08-01

    Full Text Available The authors describe a case of entomophthoromycosis in a previously healthy patient, who presented with an abscess in the right buttock. After surgical drainage it evolved into a retroperitoneal tumor. The patient improved clinically after resection of the mass and ketoconazole treatment. The histopathological analysis showed the Splendore-Hoeppli phenomenon, suggesting Basidiobolus ranarum infection, a zygomycosis generally restricted to the subcutaneous tissue, with rare gastrointestinal involvement.Os autores descrevem um caso de entomoftoromicose em paciente previamente saudável, que apresentou abscesso em nádega direita, evoluindo, após drenagem cirúrgica, para tumoração retroperitoneal. Após ressecção da massa, o paciente obteve melhora clínica, em uso de cetoconazol. A análise histopatológica evidenciou fenômeno de Splendore-Hoeppli, sugerindo infecção por Basidiobolus ranarum, uma zigomicose geralmente restrita ao tecido subcutâneo, com raro comprometimento gastrintestinal.

  2. Alloimmune refractoriness to platelet transfusions.

    Science.gov (United States)

    Sandler, S G

    1997-11-01

    Patients who are transfused on multiple occasions with red cells or platelets may develop platelet-reactive alloantibodies and experience decreased clinical responsiveness to platelet transfusion. This situation, conventionally described as "refractoriness to platelet transfusions," is defined by an unsatisfactory low post-transfusion platelet count increment. If antibodies to HLAs are detected, improved clinical outcomes may result from transfusions of HLA-matched or donor-recipient cross-matched platelets. Because refractoriness is an expected, frequently occurring phenomenon, prevention of HLA alloimmunization is an important management strategy. Prevention strategies include efforts to decrease the number of transfusions, filtration of cellular components to reduce the number of HLA-bearing leukocytes, or pretransfusion ultraviolet B irradiation of cellular components to decrease their immunogenicity. Other investigational approaches include reducing the expression of HLAs on transfused platelets, inducing a transient reticuloendothelial system blockade by infusions of specialized immunoglobulin products, or transfusing semisynthetic platelet substitutes (thromboerythrocytes, thrombospheres) or modified platelets (infusible platelet membranes, lyophilized platelets).

  3. Iron refractory iron deficiency anemia

    OpenAIRE

    De Falco, Luigia; Sanchez, Mayka; Silvestri, Laura; Kannengiesser, Caroline; Muckenthaler, Martina U; Iolascon, Achille; Gouya, Laurent; Camaschella, Clara; Beaumont, Carole

    2013-01-01

    Iron refractory iron deficiency anemia is a hereditary recessive anemia due to a defect in the TMPRSS6 gene encoding Matriptase-2. This protein is a transmembrane serine protease that plays an essential role in down-regulating hepcidin, the key regulator of iron homeostasis. Hallmarks of this disease are microcytic hypochromic anemia, low transferrin saturation and normal/high serum hepcidin values. The anemia appears in the post-natal period, although in some cases it is only diagnosed in ad...

  4. Understanding and treating refractory constipation

    Institute of Scientific and Technical Information of China (English)

    Gabrio; Bassotti; Corrado; Blandizzi

    2014-01-01

    Chronic constipation is a frequently encountered disorder in clinical practice. Most constipated patients benefit from standard medical approaches. However, current therapies may fail in a proportion of patients. These patients deserve better evaluation and thorough investigations before their labeling as refractory to treatment. Indeed, several cases of apparent refractoriness are actually due to misconceptions about constipation, poor basal evaluation (inability to recognize secondary causes of constipation, use of constipating drugs) or inadequate therapeutic regimens. After a careful reevaluation that takes into account the above factors, a certain percentage of patients can be defined as being actually resistant to first-line medical treatments. These subjects should firstly undergo specific diagnostic examination to ascertain the subtype of constipation. The subsequent therapeutic approach should be then tailored according to their underlying dysfunction. Slow transit patients could benefit from a more robust medical treatment, based on stimulant laxatives (or their combination with osmotic laxatives, particularly over the short-term), enterokinetics (such as prucalopride) or secretagogues (such as lubiprostone or linaclotide). Patients complaining of obstructed defecation are less likely to show a response to medical treatment and might benefit from biofeedback, when available. When all medical treatments prove to be unsatisfactory, other approaches may be attempted in selected patients (sacral neuromodulation, local injection of botulinum toxin, anterograde continence enemas), although with largely unpredictable outcomes. A further although irreversible step is surgery (subtotal colectomy with ileorectal anastomosis or stapled transanal rectal resection), which may confer some benefit to a few patients with refractoriness to medical treatments.

  5. Psychopathology in Women Arrested for Domestic Violence

    Science.gov (United States)

    Stuart, Gregory L.; Moore, Todd M.; Gordon, Kristina Coop; Ramsey, Susan E.; Kahler, Christopher W.

    2006-01-01

    This study examined the prevalence of psychopathology among women arrested for violence and whether the experience of intimate partner violence (IPV) was associated with Axis I psychopathology. Women who were arrested for domestic violence perpetration and court referred to violence intervention programs (N=103) completed measures of IPV…

  6. Physeal arrest of the distal radius.

    Science.gov (United States)

    Abzug, Joshua M; Little, Kevin; Kozin, Scott H

    2014-06-01

    Fractures of the distal radius are among the most common pediatric fractures. Although most of these fractures heal without complication, some result in partial or complete physeal arrest. The risk of physeal arrest can be reduced by avoiding known risk factors during fracture management, including multiple attempts at fracture reduction. Athletes may place substantial compressive and shear forces across the distal radial physes, making them prone to growth arrest. Timely recognition of physeal arrest can allow for more predictable procedures to be performed, such as distal ulnar epiphysiodesis. In cases of partial arrest, physeal bar excision with interposition grafting can be performed. Once ulnar abutment is present, more invasive procedures may be required, including ulnar shortening osteotomy or radial lengthening.

  7. Refractories Quality Improvement for Glass Industry Upgrading

    Institute of Scientific and Technical Information of China (English)

    ZENG Dafan

    2009-01-01

    @@ 1 Glass Industry and Refractories Industry Closely Connect 1.1 Glass Development Drives Refractories Progress Refractories are indispensable to glass industry; the rapid development of glass industry drives the growth of refractories industry. China's glass industry developed slowly before the mid 1980s. The kilns and furnaces were backward and small-scale with furnace life of only 2-3 years; glass was produced with extremely low efficiency and poor quality. During that period, refractories for glass melting furnaces had very limited varieties and inferior quality. The fused cast refractories for advanced glass melting furnaces were imported, for the materials made in China could not meet the requirements, which seriously restrained the technical progress of China's glass industry.

  8. Idiopathic retroperitoneal fibrosis with particular perirenal and intrarenal extension associated with left renal artery stenosis. The atheromatous periaortitis with retroperitoneal fibrosis suggests a pathogenic relationship between atherosclerosis and fibrosis?

    Science.gov (United States)

    Gluhovschi, Gheorghe; Bozdog, Gheorghe; Miclaus, Gratian; Puscasiu, Tudor; Gluhovschi, Cristina; Bob, Flaviu; Velciov, Silvia; Petrica, Ligia; Trandafirescu, Virginia; Gadalean, Florica

    2011-02-01

    We present a case of idiopathic retroperitoneal fibrosis (RPF) in a female patient of 45 years, obese (BMI = 39 kg/sqm), hypertensive since 2005, with diabetes mellitus treated with diet and diabetes insipidus in whom, during a routine control, the following has been found: serum creatinine 1.74 mg/dl, and an inflammatory syndrome associated with fever. Spiral-CT (Multi-slice-Sensation 64) scan shows retroperitoneal fibrosis in relation with periaortitis that affects the thoracic and abdominal aorta. RPF is extending perirenally and at the level of the renal hilum with subsequent calyceal dilations (hydrocalycosis) associated with left renal artery stenosis. The particularity of the case is represented by the perirenal and intrarenal evolution of fibrosis with left renal artery stenosis with moderate impairment of renal function reversible under treatment with Tamoxifen. This case, with chronic periaortitis subsequent to an extended aortic atherosclerosis with retroperitoneal fibrosis can be representative for the pathogenic relationship between atherosclerosis and fibrosis.

  9. Chromosomal Aneuploidies and Early Embryonic Developmental Arrest

    Directory of Open Access Journals (Sweden)

    Maria Maurer

    2015-07-01

    Full Text Available Background: Selecting the best embryo for transfer, with the highest chance of achieving a vital pregnancy, is a major goal in current in vitro fertilization (IVF technology. The high rate of embryonic developmental arrest during IVF treatment is one of the limitations in achieving this goal. Chromosomal abnormalities are possibly linked with chromosomal arrest and selection against abnormal fertilization products. The objective of this study was to evaluate the frequency and type of chromosomal abnormalities in preimplantation embryos with developmental arrest. Materials and Methods: This cohort study included blastomeres of embryos with early developmental arrest that were biopsied and analyzed by fluorescence in-situ hybridization (FISH with probes for chromosomes 13, 16, 18, 21 and 22. Forty-five couples undergoing IVF treatment were included, and 119 arrested embryos were biopsied. All probes were obtained from the Kinderwunsch Zentrum, Linz, Austria, between August 2009 and August 2011. Results: Of these embryos, 31.6% were normal for all chromosomes tested, and 68.4% were abnormal. Eleven embryos were uniformly aneuploid, 20 were polyploid, 3 were haploid, 11 displayed mosaicism and 22 embryos exhibited chaotic chromosomal complement. Conclusion: Nearly 70% of arrested embryos exhibit chromosomal errors, making chromosomal abnormalities a major cause of embryonic arrest and may be a further explanation for the high developmental failure rates during culture of the embryos in the IVF setting.

  10. [Cardiopulmonary resuscitation in cardiac arrest following trauma].

    Science.gov (United States)

    Leidel, B A; Kanz, K-G

    2016-11-01

    For decades, survival rates of cardiac arrest following trauma were reported between 0 and 2 %. Since 2005, survival rates have increased with a wide range up to 39 % and good neurological recovery in every second person injured for unknown reasons. Especially in children, high survival rates with good neurologic outcomes are published. Resuscitation following traumatic cardiac arrest differs significantly from nontraumatic causes. Paramount is treatment of reversible causes, which include massive bleeding, hypoxia, tension pneumothorax, and pericardial tamponade. Treatment of reversible causes should be simultaneous. Chest compression is inferior following traumatic cardiac arrest and should never delay treatment of reversible causes of the traumatic cardiac arrest. In massive bleeding, bleeding control has priority. Damage control resuscitation with permissive hypotension, aggressive coagulation therapy, and damage control surgery represent the pillars of initial treatment. Cardiac arrest due to hypoxia should be resolved by airway management and ventilation. Tension pneumothorax should be decompressed by finger thoracostomy, pericardial tamponade by resuscitative thoracotomy. In addition, resuscitative thoracotomy allows direct and indirect bleeding control. Untreated impact brain apnea may rapidly lead to cardiac arrest and requires quick opening of the airway and effective oxygenation. Established algorithms for treatment of cardiac arrest following trauma enable a safe, structured, and effective management.

  11. Theory of dynamic arrest in colloidal mixtures.

    Science.gov (United States)

    Juárez-Maldonado, R; Medina-Noyola, M

    2008-05-01

    We present a first-principles theory of dynamic arrest in colloidal mixtures based on the multicomponent self-consistent generalized Langevin equation theory of colloid dynamics [M. A. Chávez-Rojo and M. Medina-Noyola, Phys. Rev. E 72, 031107 (2005); M. A. Chávez-Rojo and M. Medina-Noyola, Phys. Rev. E76, 039902 (2007)]. We illustrate its application with a description of dynamic arrest in two simple model colloidal mixtures: namely, hard-sphere and repulsive Yukawa binary mixtures. Our results include observation of the two patterns of dynamic arrest, one in which both species become simultaneously arrested and the other involving the sequential arrest of the two species. The latter case gives rise to mixed states in which one species is arrested while the other species remains mobile. We also derive the ("bifurcation" or fixed-point") equations for the nonergodic parameters of the system, which takes the surprisingly simple form of a system of coupled equations for the localization length of the particles of each species. The solution of this system of equations indicates unambiguously which species is arrested (finite localization length) and which species remains ergodic (infinite localization length). As a result, we are able to draw the entire ergodic-nonergodic phase diagram of the binary hard-sphere mixture.

  12. Post traumatic retroperitoneal fibrosis as a cause of low-back pain Fibrosis retroperitoneal postraumática como causa de dolor lumbar

    Directory of Open Access Journals (Sweden)

    A.M. Hidalgo-Ovejero

    2011-12-01

    Full Text Available We present the case of a male patient with post traumatic retroperitoneal fibrosis whose main clinical expression was low-back pain. Diagnosis was established using CAT-scan and MRI, which revealed a large mass of soft tissue that almost entirely enveloped the abdominal aorta. Treatment with 40 mg of prednisone every 24 hours was established. This dose was reduced gradually, and progressive remission of clinical signs and symptoms was achieved, with a significant improvement of subsequent imaging-test results. Treatment was continued for one year. Two and a half years later the patient remains symptom-free, with no recurrence of his condition.Se presenta el caso de un paciente varón afecto de una fibrosis retroperitoneal postraumática, a cuyo diagnóstico se llegó a partir de dolor lumbar como síntoma principal. El diagnóstico se efectuó en base a los estudios mediante CT y RM, los cuales demostraron una gran masa de tejido de partes blandas que rodeaban la aorta. El tratamiento consistió en dosis de prednisona que inicialmente se instauró a 40 mg cada 24 horas, y posteriormente se fue reduciendo de forma gradual hasta la remisión de los signos y síntomas, y consecuentemente de los estudios de imagen. El tratamiento con corticoides se mantuvo durante un año. Dos años y medio el paciente está libre de síntomas sin recidiva de su proceso.

  13. Cardiac Arrest: Obstetric CPR/ACLS.

    Science.gov (United States)

    Cobb, Benjamin; Lipman, Steven

    2017-01-10

    In contrast with other high-resource countries, maternal mortality has seen an increase in the United States. Caring for pregnant women in cardiac arrest may prove uniquely challenging given the rarity of the event coupled by the physiological changes of pregnancy. Optimization of resuscitative efforts warrants special attention as described in the 2015 American Heart Association's "Scientific Statement on Maternal Cardiac Arrest." Current recommendations address a variety of topics ranging from the basic components of chest compressions and airway management to some of the logistical complexities and operational challenges involved in maternal cardiac arrest.

  14. Common bile duct obstruction due to fibrous pseudotumor of pancreas associated with retroperitoneal fibrosis:A case report

    Institute of Scientific and Technical Information of China (English)

    Mei-Fen Zhao; Yu Tian; Ke-Jian Guo; Zhi-Gang Ma; Hai-Hui Liao

    2004-01-01

    One 63-year-old woman, who presented with cholestatic jaundice due to common bile duct compression produced by primary retroperitoneal fibrosis, is studied. The patient was operated six years ago because of hydronephrosis,when the disease was first diagnosed. Magnetic resonance cholangiopancreatography (MRCP) revealed the presence of extrahepatic bile duct obstruction, which once was considered to be pathognomonic of pancreatic cancer. CTscan demonstrated the change of retroperitoneal fibrosis around left kidney, atrophy of right kidney, and obstruction of extrahepatic bile duct (pancreatic head). An explorative laparotomy was performed, and the retroperitoneum and pancreas were grayish-white and hard, the fibrotic pancreatic head compressed the common bile duct. Bile duct stricture was managed by Rouxen-Y hepatocholangio-jejunostomy.To the best of our knowledge, few similar cases of retroperitoneal fibrosis have been reported.

  15. Genetics Home Reference: iron-refractory iron deficiency anemia

    Science.gov (United States)

    ... refractory iron deficiency anemia iron-refractory iron deficiency anemia Enable Javascript to view the expand/collapse boxes. ... All Close All Description Iron-refractory iron deficiency anemia is one of many types of anemia , which ...

  16. The role of CT in pelvic fracture. CT finding of retro-peritoneal hematoma and indication of transcatheter arterial embolization

    Energy Technology Data Exchange (ETDEWEB)

    Igarashi, Tsuneo; Hoshikawa, Yoshikazu; Saeki, Mitsuaki; Nakajima, Yasuo [St. Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine

    1998-10-01

    Although retro-peritoneal hematoma accompanying a pelvic fracture has been treated by arterial ligation formerly, it is associated with a high mortality rate and a transcatheter arterial embolization has now become the first choice of treatment. Meanwhile, the usefulness of computed tomography (CT) in traumatized patient has been reported frequently. Our hospital also employs CT positively as an examination following plain radiography in the cases with pelvic fracture. However, while indication of angiography is seen in several reports, the amount of retro-peritoneal hematoma as an index has not been reported. In the present study, we examined 112 patients given CT at the time of examination at the emergency center of our hospital between April 1, 1988, and June 30, 1997, and classified the amount of retro-peritoneal hematoma on CT into 5 groups to discuss indication of angiography. In the cases with moderate or massive amount of retro-peritoneal hematomas, cases with shock state exceeded 60% and the amount of hematoma was considered to reflect the circulation profile to a certain extent. As the amount of retro-peritoneal hematoma increased, the number of cases given embolization also increased; embolization was performed in 29 cases (61.7%) among those which had moderate or massive amount of hematoma. From the above findings, it was predicted that the amount of retro-peritoneal hematoma could be one of the deciding factors for indication of angiography. However, as there are cases falling into a shock state due to gradual increase of hematoma or associated with injuries in other organs, careful observation is needed for the cases judged out of indication. (author)

  17. One-Step Posterior and Anterior Combined Approach for L5 Retroperitoneal Schwannoma Eroding a Lumbar Vertebra

    Directory of Open Access Journals (Sweden)

    Giancarlo D’Andrea

    2016-01-01

    Full Text Available We report the case of a large lumbar schwannoma eroding the vertebra and originating from spinal canal with invasion of the retroperitoneal space. We also review all the cases in literature reporting lumbar schwannomas eroding the vertebral bodies and invading the retroperitoneal space focusing on the surgical strategies to manage them. Spinal CT-scan revealed a 44 mm×55 mm inhomogeneous soft-tissue mass arising from the right L5-S1 neural foramen and its most anterior portion had a clear colliquative aspect. Magnetic resonance image showed a neoplastic lesion with homogeneous low signal in T1WI, heterogeneous signal in T2WI, and strong enhancement in postgadolinium examination. It developed as well in the retroperitoneal space, posteriorly to the iliac vein, up to the psoas muscle with wide erosion of the omolateral conjugate foramen. We performed a one-step combined approach together with the vascular surgeon because the lesion was too huge to allow a complete resection via a posterior approach and furthermore its tight relationship with the psoas muscle and the iliac vessels in the retroperitoneal space should be more safely managed via a retroperitoneal approach. We strongly suggest a 1-step surgery first approaching the dumbbell and the intraspinal schwannomas posteriorly achieving the decompression of the spinal canal and the cleavage of the tumor cutting the root of origin and the vascular supply and valuating the stability of the spine for potential artrodesis procedure. The patient must be then operated on via a retroperitoneal approach achieving the complete en bloc resection of the tumor.

  18. Nitrogenous subcutaneous emphysema caused by spray application of fibrin glue during retroperitoneal laparoscopic surgery.

    Science.gov (United States)

    Matsuse, Shinji; Maruyama, Atsushi; Hara, Yoshiki

    2011-06-01

    We report a case of a patient treated by retroperitoneoscopic partial nephrectomy who developed nitrogenous subcutaneous emphysema (SCE) as a complication. The use of a nitrogen gas-pressured fibrin tissue adhesive applied as a spray caused excessively increased pressure in the closed retroperitoneal space and resulted in widespread SCE with protracted clinical course. To the best of our knowledge, this is the first report of nitrogenous SCE associated with pneumoperitoneum. The clinical significance of nitrogenous SCE is emphasized, and the risks associated with the use of fibrin glue as a spray during laparoscopic surgery are discussed.

  19. Idiopathic retroperitoneal fibrosis involving a unilateral renal sinus: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seul Bi; Yoon, Jung Hee; Kim, Seung Ho; Lee, Ye Daum; Kim, Suk Jung; Lim, Yun Jung; Jung, Hyun Kyung; Lee, Jin Soo [Dept. of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2016-06-15

    Idiopathic retroperitoneal fibrosis (RPF) is a rare disease entity and its etiology is uncertain. We report two similar cases which showed an uncommon presentation of idiopathic RPF. A 66-year-old woman and an 80-year-old man presented with incidental findings of left renal pelvic mass-like lesions. Computed tomography revealed a soft tissue density mass replacing the left renal pelvis, which was suspicious for renal pelvic cancer, and the diagnosis of idiopathic RPF was surgically confirmed. To the best of our knowledge, a few cases of idiopathic RPF presenting with features of a localized unilateral renal pelvic mass mimicking renal pelvic cancer have been reported.

  20. [Giant retroperitoneal hematoma in the peripartum of a normal delivery, "expectative attitude"].

    Science.gov (United States)

    Vanlieferinghen, S; Piketty, M; Blumental, Y; Jouannic, J-M; Desfeux, P; Benifla, J-L

    2011-03-01

    We describe a case involving spontaneous retroperitoneal hematoma complicating a normal delivery in a context of a Disseminated Intravascular Coagulation (DIVC) at the end of the pregnancy. Given the defaced symptomatology, an abdomino-pelvic scanner and an examination with a general anaesthesia made it possible to diagnose and to monitor the hematoma in intensive care. The correction of the hemostasis troubles and of the anemia, without another invasive intervention, allowed a return to home at the eighth day. The pathophysiological mechanisms underlying development and practicable treatments of this post-partum hematoma are discussed.

  1. Idiopathic retroperitoneal fibrosis associated with Hashimoto's thyroiditis in a patient with a single functioning kidney

    Directory of Open Access Journals (Sweden)

    Byung Sun Kim

    2013-12-01

    Full Text Available Retroperitoneal fibrosis (RPF is a rare disease characterized by the presence of fibroinflammatory tissue around the abdominal aorta and ureteral entrapment in most cases. Idiopathic RPF is frequently reported in association with autoimmune diseases; however, there have been few reports of idiopathic RPF associated with Hashimoto's thyroiditis. Here, we report a case of idiopathic RPF with Hashimoto's thyroiditis in a patient with a single functioning kidney, which was successfully treated by corticosteroid therapy and transient intraureteral stent insertion with a double-J catheter.

  2. Retroperitoneal and pelvic infections complications; Les manifestations genito-urinaires de la maladie de Crohn

    Energy Technology Data Exchange (ETDEWEB)

    Schmutz, G.R.; Racette, R.; Chapuis, F. [Sherbrooke Univ., PQ (Canada); Regent, D. [Centre Hospitalier Universitaire, 54 - Nancy (France); Hannequin, F. [Centre Medical Mgen, 67 - Strasbourg (France); N`Guyen, D. [Clinique Adassa, 67 - Strasbourg (France)

    1995-12-31

    Retroperitoneal and pelvic infections complications are the major types of genito-urinary complications in Crohn`s disease. CT has been shown to be a sensitive, non invasive method of documenting these infectious complications. On the other hand, conventional studies are more sensitive than CT to detect genitourinary fistulae. Some complications may manifest few or no symptom as urinary obstruction and nephrolithiasis, detected easily by sonography. For these reasons, it is important for radiologists to be aware of the genito-urinary complications of Crohn`s disease. (authors). 42 refs., 20 figs.

  3. Retroperitoneal migration of a self-inflicted ballpoint pen via the urethra

    Directory of Open Access Journals (Sweden)

    Jose Cury

    2006-04-01

    Full Text Available Numerous accounts documenting the introduction of foreign bodies into the urinary bladder have been reported. These foreign bodies are typically self-inserted via urethral but migration from adjacent organs by an ulcerative process and penetrating injuries are also reported. However, "contrary" migration of a self-inflicted vesical foreign body to the retroperitoneum was not previously reported in literature. We report here a case of a ballpoint pen self-inserted via urethral by a female patient, which was identified in retroperitoneal position years later.

  4. [Retroperitoneal laparoscopic nephrectomy in children younger than nine years-old: state of the art

    OpenAIRE

    Moreira-Pinto, J.; Osório, A.,; Pereira, J.; Enes, C.; J. Ribeiro-Castro; Reis, A

    2011-01-01

    Introdução e Objectivos: Em Portugal, a experiência em retroperitoneoscopia pediátrica é escassa. Os autores apresentam a primeira série portuguesa de nefrectomias realizadas por esta via, em crianças com idade inferior a nove anos, e uma revisão da literatura sobre o tema. Material e Métodos: Análise retrospectiva dos processos das crianças submetidas a nefrectomia laparoscópica retroperitoneal (NLR), de Janeiro de 2009 e Dezembro de 2009, num Departamento de Cirurgia Pediátri...

  5. Management of refractory cardiogenic shock.

    Science.gov (United States)

    Reyentovich, Alex; Barghash, Maya H; Hochman, Judith S

    2016-08-01

    Cardiogenic shock is a life-threatening condition that occurs in response to reduced cardiac output in the presence of adequate intravascular volume and results in tissue hypoxia. Cardiogenic shock has several underlying aetiologies, with the most common being acute myocardial infarction (AMI). Refractory cardiogenic shock presents as persistent tissue hypoperfusion despite administration of adequate doses of two vasoactive medications and treatment of the underlying aetiology. Investigators of the SHOCK trial reported a long-term mortality benefit of emergency revascularization for shock complicating AMI. Since the publication of the SHOCK trial and subsequent guideline recommendations, the increase in community-based use of percutaneous coronary intervention for this condition has resulted in a significant decline in mortality. Despite these successes in the past 15 years, mortality still remains exceptionally high, particularly in patients with refractory cardiogenic shock. In this Review, we discuss the aetiology and pathophysiology of cardiogenic shock and summarize the data on the available therapeutics and their limitations. Although new mechanical circulatory support devices have been shown to improve haemodynamic variables in patients with shock complicating AMI, they did not improve clinical outcomes and are associated with high costs and complications.

  6. [Retroperitoneal dedifferentiated liposarcoma extending into the iliocostal muscle and the quadratus lumborum muscle accompanied with bone formation: case report].

    Science.gov (United States)

    Matsuura, H; Sakurai, M; Arima, K

    2001-12-01

    A 72-year-old man with back pain on the left side was admitted. Imaging analysis revealed a retroperitoneal mass and a mass in the left iliocostal muscle and the left quadratus lumborum muscle. The two masses could not be resected en bloc, and were resected separately. The clinicopathological findings of these tumors revealed dedifferentiated liposarcoma. The primary dedifferentiated liposarcoma appeared to have originated from the retroperitoneal space extending into the iliocostal muscle and the quadratus lumborum muscle. Then the mass was thought to have formed accompanied with osteogenesis.

  7. Successful Management of Gastrointestinal Haemorrhage Associated with Ischaemic Colonic Ulceration in Acute Pancreatitis with Video Assisted Retroperitoneal Debridement

    Directory of Open Access Journals (Sweden)

    Yogesh Puri

    2011-05-01

    Full Text Available Context Colonic involvement is an uncommon but potentially lethal complication of severe acute pancreatitis and has received little attention in the surgical literature. Such complications can range from localized colonic pathology to widespread ischaemic pancolitis. Treatment options have historically been limited to resection of the affected segment. Case report We describe the successful role of video assisted retroperitoneal pancreatic debridement in the management of two cases presenting with major gastrointestinal haemorrhage due to localised colonic ulceration on the background of acute necrotising pancreatitis. Conclusion Video assisted retroperitoneal debridement should be considered early in the management of local colonic complications associated with severe acute necrotising pancreatitis.

  8. RETROPERITONEAL NECROTIZING FASCIITIS WITH ADNEXITIS PRESENTING AS ACUTE ABDOMEN IN A 40 YEAR UNMARRIED FEMALE PATIENT: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sribatsa Kumar

    2014-12-01

    Full Text Available Retroperitoneal Necrotizing Fasciitis is a rare variant of Necrotizing fasciitis (NF which is fulminant and potentially lethal. Although NF is a common occurrence in Indian Subcontinent due to low standard of living and poor hygiene Necrotizing fasciitis of retroperitoneum is extremely rare and only few cases have been reported till now. Herein we report a case of a 40yr unmarried female patient presenting to emergency department for acute abdomen and on exploratory laparotomy it was found out to be a case of extensive retroperitoneal necrotizing fasciitis with pregangrenous right ovary and adjacent fallopian tube.

  9. Primary retroperitoneal teratoma and crossed fused renal ectopia with turner's syndrome -a case report-

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yun Jung; Hong, Ki Ung [St. Francisco General Hospital, New York (United States)

    1988-02-15

    In 1938, Turner described a clinical entity in phenotype females characterized by sexual infantilism, congenital webbed neck and cubitus valgus. After then, the occurrence of renal anomalies in patients with Turner's syndrome has been recognized. Associated crossed fused renal ectopia is very rare. Primary retroperitoneal teratoma is also rare and usually during childhood. The authors report a case of primary retroperitoneal teratoma and crossed fused renal ectopia with Turner's syndrome (mosaic type). The clinical, pathological and radiographical findings are reviewed.

  10. Giant Mature Primary Retroperitoneal Teratoma in a Young Adult: Report of a Rare Case and Literature Review

    Directory of Open Access Journals (Sweden)

    Walid Sasi

    2014-01-01

    Full Text Available Teratomas are neoplasms of the embryonic tissues that typically arise in the gonadal and sacrococcygeal regions of adults and children. Primary adult retroperitoneal teratomas are rare and demand challenging management options. We report a case of a unilateral primary retroperitoneal mature cystic teratoma mimicking an adrenal mass in a 28-year-old female patient. Complete resection of the mass was performed by a laparotomy approach. Because of the risk of malignancy, follow-up radiographic studies were performed to ensure the oncologic efficacy of resection. The patient remains free of recurrence to date.

  11. Case 40. Misdiagnosis of refractory macrocytic anemia.

    Science.gov (United States)

    Stringaris, Kate; Bain, Barbara

    2008-11-01

    A diagnosis of myelodysplastic syndrome, refractory anemia subtype, was made in an elderly Indian woman on the basis of a refractory macrocytic anemia with normal vitamin B(12) and folate assays, normal thyroid function, essentially normal liver function and normal cytogenetic analysis. Disease evolution revealed that the diagnosis was erroneous.

  12. Research on High Performance New Refractories

    Institute of Scientific and Technical Information of China (English)

    Zhong Xiangchong

    2007-01-01

    @@ At the age of 86,Prof.Zhong Xiangchong has his new book-"Research on High Performance New Refractories" published by Henan Science and Technology Publishing House to commemorate his 65 years service in the refractories science and technology including the recent 6 years at High Temperature Ceramics Institute which he founded in Zhengzhou University in 2001.

  13. Spectral reflecting characteristics of dinas refractory

    Energy Technology Data Exchange (ETDEWEB)

    Zapechnikov, V.N.; Pushkin, V.T.; Zen' kovskii, A.G.

    1987-09-01

    This article outlines a nondestructive testing format which uses spectral reflectance to assess the remaining service life, the thermal degradation, and the insulating effectiveness of refractories used as insulating liners in glass melters. Thermal as well as mechanical influences on the reflectance behavior of several refractories are discussed.

  14. Modern technologies of refractory glaucoma treatment. Review

    Directory of Open Access Journals (Sweden)

    A. Yu. Rascheskov

    2014-07-01

    Full Text Available this article presents a review of available literature concerning basic directions of refractory glaucoma treatment. the surgical management of refractory glaucoma is presented by two main groups of surgical techniques: filtering surgery (including surgery with the use of antimetabolites and implants and cyclodestructive procederes. types of glaucoma drainages are described, modern valve drainage system is presented.

  15. Refractory Pellet for Hot Blast Stove

    Institute of Scientific and Technical Information of China (English)

    Wang Jing; Peng Xigao

    2011-01-01

    1 Scope This standard specifies the term,definition,classification,specification,technical requirements,test methods,quality appraisal procedures,packing,marking,transportation,storage,and quality certificate of refractory pellet for hot blast stove.This standard is applicable to refractory pellet for hot blast stove.

  16. The obesity paradox in cardiac arrest patients.

    Science.gov (United States)

    Chalkias, Athanasios; Xanthos, Theodoros

    2014-02-01

    Evidence from clinical cohorts indicates an obesity paradox in overweight and obese patients who seem to have a more favorable short-term and long-term prognosis than leaner patients. Although obese cardiac arrest victims are theoretically more difficult to be resuscitated due to difficulties in providing adequate chest compressions, ventilation, and oxygenation, research so far has shown that there is an obesity paradox in cardiac arrest.

  17. Surface Electrocardiogram Predictors of Sudden Cardiac Arrest

    Science.gov (United States)

    Abdelghani, Samy A.; Rosenthal, Todd M.; Morin, Daniel P.

    2016-01-01

    Background: Heart disease is a major cause of death in industrialized nations, with approximately 50% of these deaths attributable to sudden cardiac arrest. If patients at high risk for sudden cardiac arrest can be identified, their odds of surviving fatal arrhythmias can be significantly improved through prophylactic implantable cardioverter defibrillator placement. This review summarizes the current knowledge pertaining to surface electrocardiogram (ECG) predictors of sudden cardiac arrest. Methods: We conducted a literature review focused on methods of predicting sudden cardiac arrest through noninvasive electrocardiographic testing. Results: Several electrocardiographic-based methods of risk stratification of sudden cardiac arrest have been studied, including QT prolongation, QRS duration, fragmented QRS complexes, early repolarization, Holter monitoring, heart rate variability, heart rate turbulence, signal-averaged ECG, T wave alternans, and T-peak to T-end. These ECG findings have shown variable effectiveness as screening tools. Conclusion: At this time, no individual ECG finding has been found to be able to adequately stratify patients with regard to risk for sudden cardiac arrest. However, one or more of these candidate surface ECG parameters may become useful components of future multifactorial risk stratification calculators. PMID:27660578

  18. Sex Disparities in Arrest Outcomes for Domestic Violence

    Science.gov (United States)

    Hamilton, Melissa; Worthen, Meredith G. F.

    2011-01-01

    Domestic violence arrests have been historically focused on protecting women and children from abusive men. Arrest patterns continue to reflect this bias with more men arrested for domestic violence compared to women. Such potential gender variations in arrest patterns pave the way to the investigation of disparities by sex of the offender in…

  19. REFRACTORY FOR BLACK LIQUOR GASIFIERS

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Jun Wei

    2005-03-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  20. Refractory for Black Liquor Gasifiers

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Xiaoting Laing

    2005-10-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  1. C. T. criteria of the differential diagnosis in primary retroperitoneal masses

    Energy Technology Data Exchange (ETDEWEB)

    Pistolesi, G.F.; Procacci, C.; Caudana, R.; Bergamo Andreis, I.A.; Manera, V.; Recla, M.; Grasso, G.; Florio, C.

    1984-05-01

    This personal series of 44 primary retroperitoneal masses (P.R.P.M.) studied by C.T. is analyzed. The reliability of C.T. in the identification (44/44), characterization (43/44) and origin evaluation (41/44) of P.R.P.M. has been absolutely satisfactory. In particular, those criteria of C.T. diagnosis which may be utilized in the evaluation of the origin of upper abdominal masses are thoroughly described. The evaluation of the involvement (non invasive; invasive) of adjacent viscera has been achieved in 22/38 P.R.P.M. verified at operation. The evaluation of tumour resectability has been less reliable due to the high incidence of under-diagnosis (60% in our personal experience). C.T. may be used in addition as an aid to different diagnostic techniques (percutaneous guided needle biopsy) or to therapy (drainage of retroperitoneal abscesses). C.T. is absolutely necessary in the follow-up of P.R.P.M. after surgery, radiotherapy or chemotherapy.

  2. Malignant retroperitoneal teratoma in a young girl: a rare case report

    Directory of Open Access Journals (Sweden)

    Maneesha Anil Patwardhan

    2014-02-01

    Full Text Available Of all primary retroperitoneal teratomas, less than four percent occur in children and 90% are benign. Here we report a case of malignant retroperitoneal teratoma (dermoid in a 15 year old girl who presented to our hospital - Acharya Vinoba Bhave Rural Hospital (AVBRH. She presented with a tender, large, irregular mass with variegated consistency in the entire left side of abdomen crossing midline. Ultrasound of abdomen suggested a complex intra-abdominal mass with septations and lobulations. It was not feasible to use other imaging modalities for evaluation due to poor socio-economic status and illiteracy. Patient underwent exploratory laparotomy with tumor resection along with left kidney and part of the descending colon which was densely adhered to tumor. Histopathological examination of tumor was suggestive of immature teratoma. Post operative recovery was uneventful and patient was discharged from the institution. Tissue adherence which can be observed in both benign and malignant form of teratomas, requires extended surgery for removal of adhered organ for the completeness of surgery and good prognosis. [Int J Res Med Sci 2014; 2(1.000: 362-364

  3. Multidetector Computed Tomography Features in Differentiating Exophytic Renal Angiomyolipoma from Retroperitoneal Liposarcoma

    Science.gov (United States)

    Wang, Qiushi; Juan, Yu-Hsiang; Li, Yong; Xie, Jia-Jun; Liu, Hui; Huang, Hongfei; Liu, Zaiyi; Zheng, Junhui; Saboo, Ujwala S.; Saboo, Sachin S.; Liang, Changhong

    2015-01-01

    Abstract This study aims to evaluate the multidetector computed tomography (CT) imaging features in differentiating exophytic renal angiomyolipoma (AML) from retroperitoneal liposarcoma. We retrospectively enrolled 42 patients with confirmed exophytic renal AML (31 patients) or retroperitoneal liposarcoma (11 patients) during 8 years period to assess: renal parenchymal defect at site of tumor contact, supply from branches of renal artery, tumoral vessel extending through the renal parenchyma, dilated intratumoral vessels, hemorrhage, non–fat-containing intratumoral nodules with postcontrast enhancement, calcification, renal sinus enlargement, anterior displacement of kidneys, and other associated AML. Renal parenchymal defect, renal arterial blood supply, tumoral vessel through the renal parenchyma, dilated intratumoral vessels, intratumoral/perirenal hemorrhage, renal sinus enlargement, and associated AML were seen only or mainly in exophytic renal AML (all P value < 0.05); however, non–fat-attenuating enhancing intratumoral nodules, intratumoral calcification, and anterior displacement of the kidney were more common in liposarcoma (all P value < 0.05). AMLs reveal renal parenchymal defect at the site of tumor contact, supply from renal artery, tumoral vessel extending through the renal parenchyma, dilated intratumoral vessels, intratumoral and/or perirenal hemorrhage, renal sinus enlargement, and associated AML. Non–fat-attenuating enhancing intratumoral nodules, intratumoral calcifications, and anterior displacement of kidney were more commonly seen in liposarcoma. PMID:26376398

  4. A Rare Coexistence of Retroperitoneal Pararenal Castleman's Disease with Focal Nodular Hyperplasia

    Directory of Open Access Journals (Sweden)

    Theodosios Theodosopoulos

    2013-01-01

    Full Text Available Castleman's disease is a distinct form of lymph node hyperplasia divided into a solitary and a multicentric type. The solitary type occurs most commonly in the mediastinum and is usually asymptomatic. We present a patient with Castleman's disease of the hyaline-vascular solitary type located in the retroperitoneum. The patient was a 38-year-old male, who presented to our hospital with fever. The imaging workup revealed a retroperitoneal mass, measuring 4 × 6 cm, located lateral to the aorta, inferior to the left renal artery and vein, and posterior to the left testicular vein. At workup, a solid hepatic lesion, 3 cm in diameter, located in the left lobe of the liver, segment IV, was also identified. Both lesions were surgically excised. The retroperitoneal tumor had the features of angiofollicular hyperplasia (Castleman's disease, hyaline-vascular type, whereas a diagnosis of focal nodular hyperplasia was made for the hepatic lesion. The patient is well at fourty months followup postoperatively. Surgical excision is the treatment of choice for unifocal Castleman's disease.

  5. Spontaneous retroperitoneal hematoma associated with anticoagulation therapy and antiplatet therapy: Two centers experiences

    Directory of Open Access Journals (Sweden)

    Abdulmuttalip Simsek

    2014-12-01

    Full Text Available Background: To analyze the characteristics of the patients with diagnosis of spontaneous retroperitoneal hematoma associated with anticoagulation therapy and antiplatet therapy. Methods: From January 2006 to March 2013, 9 patients (6 from Haseki Training and Research Hospital - Urology Department and 3 from Istanbul Medical Faculty - Gynecology and Obstetric Department were included in the study. Patients charts including sex, age, comorbidities, main complaint, and medication intake were examined. Also initial hemoglobin level, initial International Normalized Ratio level, red blood cells and fresh frozen plasma units transfused were evaluated. Results: Median age was 60 year-old. Abdominal pain and flank pain were common symptoms. Eight patients were taking only anticoagulation therapy, 2 only antiplatet therapy and 1 both anticoagulation and antiplatet therapy. Median initial hemoglobin value was 9,0 g/dL and median International Normalized Ratio level was 3.2 Patients were evaluated by abdominal ultrasonography or abdominal computer tomography. Seven patients were treated conservatively. Only one patient died because of septic shock with a mortality ratio of 11%. Conclusion: Despite benefits of anticoagulation and antiplatet theraphy these agents have serious side-affects as retroperitoneal hemorrhage in elderly patients taking multi-drug medication.

  6. La linfadenectomía retroperitoneal para el cáncer testicular

    Directory of Open Access Journals (Sweden)

    Jaime Gutiérrez-Góngora

    2001-03-01

    Full Text Available Históricamente, los pacientes diagnosticados con enfermedad neoplásica testicular B (II han sido tratados con una disección primaria de ganglios retroperitoneales con la opción de aplicar quimioterapia adyuvante. Recientemente, varios autores han optado por la quimioterapia como tratamiento primario con la linfadenectomía retroperitoneal reservada para los pacientes que no lograban una remisión completa después del tratamiento con quimioterapia. El objetivo de este trabajo es definir por qué la linfadenectomía retroperitoneal (LR es realizada siempre en el Servicio de Urología del Hospital San Juan de Dios en el tratamiento del cáncer testicular de células germinales no seminomatosas estadio clínico A (I y B (II. Se presenta el sustento científico que avala esta práctica y se hace una breve reseña del estadiaje, del procedimiento quirúrgico utilizado.

  7. A rare case of retroperitoneal malignant triton tumor invading renal vein and small intestine

    Directory of Open Access Journals (Sweden)

    Mijović Žaklina

    2013-01-01

    Full Text Available Introduction. Malignant Triton tumor is a very rare malignant peripheral nerve sheath tumor with rhabdomyosarcomatous differentiation. Most of those tumors occur in patients with von Recklinghausen’s disease or as a late complication of irradiation and commonly seen in the head, neck, extremities and trunk. Case report. We reported retroperitoneal malignant Triton tumor in a 57-year-old female patient. Skin lesions were not present, and there was no family history of neurofibromatosis or previous irradiation. The presented case is one of a few recorded in the specialized literature that occurs in the retroperitoneal space in sporadic form. In this case, tumor consisted of a multilobular mass was in close relation with the abdominal aorta and inferior vena cava and involved the renal vein with gross invasion of the small intestine. The patient underwent total resection of the tumor and left nefrectomy was performed. The small intestine 10 cm in length was also resected and end-to-end anastomosis was conducted. The postoperative course was uneventful and the patient was discharged from the hospital ten days after the surgery. Conclusion. Diagnostically, it is crucial to recognize this uncommon histological variant because malignant Triton tumor has a worse prognosis than classic malignant peripheral nerve sheath tumor does. The use of the immunohistochemistry is essential in making the correct diagnosis. Only appropriate pathological evaluation supported by immunostaining with S-100 protein and desmin confirmed the diagnosis. Aggressive surgical management treatment improves the prognosis of such cases with adjuvant radiotherapy.

  8. REFRACTORY FOR BLACK LIQUOR GASIFIERS

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Xiaoting Liang; Alireza Rezaie

    2004-10-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  9. REFRACTORY FOR BLACK LIQUOR GASIFIERS

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Xiaoting Liang; Jun Wei

    2005-04-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  10. REFRACTORY FOR BLACK LIQUOR GASIFIERS

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Xiaoting Liang; Jun Wei

    2005-01-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  11. Refractory for Black Liquor Gasifiers

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Xiaoting Liang

    2005-10-01

    The University of Missouri-Rolla identified materials that permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project was to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study attempted to define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials were selected/developed that either react with the gasifier environment to form protective surfaces in

  12. REFRACTORY FOR BLACK LIQUOR GASIFIERS

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Xiaoting Liang

    2005-07-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  13. Refractory for Black Liquor Gasifiers

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Alireza Rezaie; Xiaoting Liang; Musa Karakus; Jun Wei

    2005-12-01

    The University of Missouri-Rolla identified materials that permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project was to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study attempted to define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials were selected or developed that reacted with the gasifier environment to form protective surfaces in

  14. Refractory for Black Liquor Gasifiers

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick; Musa Karakus; Alireza Rezaie

    2004-03-30

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  15. Refractory for Black Liquor Gasifiers

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Alireza Rezaie

    2003-08-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the materials problems encountered during the operation of low-pressure high-temperature (LFHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  16. Refractory for Black Liquor Gasifiers

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Alireza Rezaie

    2003-12-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the materials problems encountered during the operation of low-pressure high-temperature (LFHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  17. REFRACTORY FOR BLACK LIQUOR GASIFIERS

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Xiaoting Liang; Alireza Rezaie

    2004-07-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  18. REFRACTORY FOR BLACK LIQUOR GASIFIERS

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr.; Alireza Rezaie

    2004-04-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the materials problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  19. Refractory for Black Liquor Gasifiers

    Energy Technology Data Exchange (ETDEWEB)

    Robert E. Moore; William L. Headrick; Alireza Rezaie

    2003-03-31

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the materials problems encountered during the operation of low-pressure high-temperature (LFHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  20. REFRACTORY FOR BLACK LIQUOR GASIFIERS

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr.; Alireza Rezaie

    2003-12-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the materials problems encountered during the operation of low-pressure high-temperature (LFHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  1. Primordial Compositions of Refractory Inclusions

    Energy Technology Data Exchange (ETDEWEB)

    Grossman, L; Simon, S B; Rai, V K; Thiemens, M H; Hutcheon, I D; Williams, R W; Galy, A; Ding, T; Fedkin, A V; Clayton, R N; Mayeda, T K

    2008-02-20

    Bulk chemical and oxygen, magnesium and silicon isotopic compositions were measured for each of 17 Types A and B refractory inclusions from CV3 chondrites. After bulk chemical compositions were corrected for non-representative sampling in the laboratory, the Mg and Si isotopic compositions of each inclusion were used to calculate its original chemical composition assuming that the heavy-isotope enrichments of these elements are due to Rayleigh fractionation that accompanied their evaporation from CMAS liquids. The resulting pre-evaporation chemical compositions are consistent with those predicted by equilibrium thermodynamic calculations for high-temperature nebular condensates but only if different inclusions condensed from nebular regions that ranged in total pressure from 10{sup -6} to 10{sup -1} bar, regardless of whether they formed in a system of solar composition or in one enriched in OC dust relative to gas by a factor of ten relative to solar composition. This is similar to the range of total pressures predicted by dynamic models of the solar nebula for regions whose temperatures are in the range of silicate condensation temperatures. Alternatively, if departure from equilibrium condensation and/or non-representative sampling of condensates in the nebula occurred, the inferred range of total pressure could be smaller. Simple kinetic modeling of evaporation successfully reproduces observed chemical compositions of most inclusions from their inferred pre-evaporation compositions, suggesting that closed-system isotopic exchange processes did not have a significant effect on their isotopic compositions. Comparison of pre-evaporation compositions with observed ones indicates that 80% of the enrichment in refractory CaO + Al{sub 2}O{sub 3} relative to more volatile MgO + SiO{sub 2} is due to initial condensation and 20% due to subsequent evaporation for both Type A and Type B inclusions.

  2. A Giant Retroperitoneal Liposarcoma Encasing the Entire Left Kidney and Adherent to Adjacent Structures: A Case Report

    Directory of Open Access Journals (Sweden)

    Sung Don  Oh

    2016-06-01

    Full Text Available Retroperitoneal liposarcoma is a rare tumor. The dimension and weight of liposarcoma are variable; those over 20 kg are called ‘giant liposarcoma’. Herein, we report giant retroperitoneal liposarcoma measuring 45 cm in diameter and 25 kg in weight encasing the entire left kidney and adherent to adjacent structures. A 71-year-old woman presented for a regular checkup. Image study revealed a huge mass probably indicative of retroperitoneal liposarcoma encasing the entire left kidney and adherent to adjacent structures. We performed an organ-preserving surgical removal. The pathologic report was liposarcoma. At postoperative month 16, a follow-up CT revealed a locally recurrent tumor. The patient underwent surgical removal of the newly discovered mass. After the second surgery, the patient underwent regular follow-up CT for approximately 12 months, and to date, there has been no evidence of tumor recurrence. High-grade liposarcoma shows sensitivity to radiation therapy. However, the toxic effect of radiation therapy limits this option by treatment modality. The use of chemotherapy is also controversial. As a result, complete resection is the gold standard treatment. Here, we report a giant retroperitoneal liposarcoma encasing the entire left kidney and adherent to adjacent structures, describe successful organ-preserving surgical removal and discuss prognosis.

  3. Laparoscopic treatment for retroperitoneal hyaline-vascular type localized Castleman's disease (LCD) in the iliac vessel region.

    Science.gov (United States)

    Le, Aiwen; Shan, Lili; Wang, Zhonghai; Dai, Xiaoyun; Xiao, Tianhui; Zhuo, Rong; Yuan, Rui

    2015-01-01

    To improve the understanding, diagnostic levels, and therapeutic levels of retroperitoneal hyaline vascular type LCD in the iliac vessel region. Diagnostic and therapeutic processes of 4 patients with retroperitoneal LCD in the iliac vessel region were retrospectively analyzed. The median ages of the research patients was 31.3 years old, Pelvic vascular dual-source computed tomography (CT) indicated an abnormal pelvic irregular cloddy intensity shadow with heterogeneous densities and punctate calcified lesions. The enhanced scanning showed significantly enhanced lesions and multiple tortuous vascular images inside and around the lesions. Patients' preoperative diagnoses were all "pelvic mass with unknown characteristics", and retroperitoneal masses were successfully stripped off after the laparoscopic surgery. Intra operative findings indicated 1 mass located at the left obturator nerve, 1 at the left internal iliac artery, and 2 at the right external iliac artery. The postoperative pathological reports suggest a diagnosis of Castleman's disease. Retroperitoneal LCD in the iliac vessel region is generally asymptomatic. Preoperative imaging data may help with the diagnosis, but a confirmed diagnosis depends on the results of the pathological examination. Iliac artery embolization is performed prior to laparoscopic mass stripping if the masses have abundant blood supply, while lymphadenectomy is also applied to those with enlarged lymph nodes.

  4. Retroperitoneal necrotizing fasciitis presenting with peritonism in a 33-year-old Nepalese man: a case report

    Directory of Open Access Journals (Sweden)

    Giri Smith

    2012-02-01

    Full Text Available Abstract Introduction Retroperitoneal necrotizing fasciitis is a rare, fulminant, and potentially lethal complication of intra-abdominal suppuration. A retroperitoneal origin is very rare and very few cases have been reported in the literature. To the best of our knowledge, this case is only the fourth case reported of successful management following retroperitoneal necrotizing fasciitis. Case presentation A 33-year-old Tamang man presented to our facility with a history of five days of fever and vomiting and eight days of severe left loin pain. On examination, he had features of peritonism. A laparotomy was performed, revealing extensive necrotizing fasciitis of the retroperitoneum extending to the anterior abdominal wall. Our patient survived following extensive debridement of the necrotic tissues and supportive care. Conclusions Retroperitoneal necrotizing fasciitis can rarely present with features of peritonism, and hence should be included as a possible differential diagnosis for anyone presenting with peritonism. Although a fatal condition, early intervention and aggressive management can save the life of a patient.

  5. Ultrasound and ultrasound guided biopsy, CT and lymphography in the diagnosis of retroperitoneal metastases in testicular cancer

    DEFF Research Database (Denmark)

    Damgaard-Pedersen, K; von der Maase, H

    1991-01-01

    A retrospective study of bipedal lymphography (BL), computed tomography (CT) and ultrasonography (US) of retroperitoneal lymph nodes has been carried out in 95 patients with newly diagnosed testicular cancer. Twenty-one patients had abnormal lymph nodes at the time of staging. The diagnostic...

  6. Refractories for Industrial Processing. Opportunities for Improved Energy Efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Hemrick, James G. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hayden, H. Wayne [Metals Manufacture Process and Controls Technology, Inc., Oak Ridge, TN (United States); Angelini, Peter [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Moore, Robert E. [R.E. Moore Associates, Maricopa, AZ (United States); Headrick, William L. [R.E. Moore Associates, Maricopa, AZ (United States)

    2005-01-01

    Refractories are a class of materials of critical importance to manufacturing industries with high-temperature unit processes. This study describes industrial refractory applications and identifies refractory performance barriers to energy efficiency for processing. The report provides recommendations for R&D pathways leading to improved refractories for energy-efficient manufacturing and processing.

  7. Thoracic Stent Graft Implantation for Aortic Coarctation with Patent Ductus Arteriosus via Retroperitoneal Iliac Approach in the Presence of Small Sized Femoral Artery

    Directory of Open Access Journals (Sweden)

    Ozge Korkmaz

    2016-01-01

    Full Text Available Endovascular stent graft implantation is a favorable method for complex aortic coarctation accompanied by patent ductus arteriosus. Herein, an 18-year-old woman with complex aortic coarctation and patent ductus arteriosus was successfully treated by endovascular thoracic stent graft via retroperitoneal approach. The reason for retroperitoneal iliac approach was small sized common femoral arteries which were not suitable for stent graft passage. This case is the first aortic coarctation plus patent ductus arteriosus case described in the literature which is treated by endovascular thoracic stent graft via retroperitoneal approach.

  8. Combined Application of Circulatory Assist Devices Following Cardiac Arrest in Patients after Cardiac Surgery

    Institute of Scientific and Technical Information of China (English)

    Huang Huanlei; Xiao Xuejun; Wu Ruobin; Ruixin; Cheng Anheng; Zhang Xiaohua; Luo Zhengxiang

    2006-01-01

    Objectives To evaluateretrospectively the potential benefits of combined utilization of various assisted circulation devices in cardiac arrest patients who did not respond to conventional cardiopulmonary cerebral resuscitation (CPCR). Methods Assisted circulation devices,including emergency cardiopulmonary bypass (ECPB), intra-aortic balloon pump (IABP), and left ventricular assist device (LVAD), were applied to 16 adult patients who had cardiac arrest 82 min~56 h after open heart surgery and did not respond to 20 min or longer conventional CPCR. ECPB was applied to 2 patients, ECPB plus IABP to 8 patients, ECPB plus IABP and LVAD to 6 patients. Results One patient recovered fully and one patient died. Of the other 14 patients, 13 resumed spontaneous cardiac rhythm and one did not; none of them could be weaned from ECPB.Further treatment of the 14 patients with combinations of assisted circulation devices enabled 6 patients to recover. One of the 7 recovered patients died of reoccurring cardiac arrest after 11 days; the other 6 were discharged in good condition and were followed up for 3~49 months (mean =22 months). Of the 6 discharged patients one suffered cerebral embolism during LVAD treatment, resulting in mild limitation of mobility of the right limbs; the other 5 never manifested any central nervous system complications. There was no late deaths giving a 37.5% (6/16) long-term survival rate. Conclusions ECPB could effectively reestablish blood circulation and oxygen supply, rectify acidosis,and improve internal milieu. The combined utilization of ECPB, IABP, and LVAD reduces the duration of ECPB, improves the incidence of recovery, and offers beneficial alternatives to refractory cardiac arrest patients.

  9. Outcome of pancreaticoduodenectomy with extended retroperitoneal lymphadenectomy for adenocarcinoma of the head of the pancreas

    Institute of Scientific and Technical Information of China (English)

    YANG Yin-mo; WAN Yuan-lian; TIAN Xiao-dong; ZHUANG Yan; HUANG Yan-ting

    2005-01-01

    Background Nowadays, there is a remarkable rise in resectability rate of periampullary adenocarcinoma and the mortality and morbidity of the pancreaticoduodenectomy procedure have been reduced remarkably, while the 5 year survival rates of patients with carcinoma of the head of the pancreas are still below 25%. We conducted this retrospective study to evaluate the clinical outcome of radical pancreaticoduodenectomy with extended retroperitoneal lymphadenectomy as a surgical therapy for adenocarcinoma of the head of the pancreas.Methods Twenty cases with adenocarcinoma of the head of the pancreas were treated by standard pancreaticoduodenectomy (removing only the peripancreatic lymph nodes en bloc with the tumour) from 1994 to 1997, and 46 cases with the same disease underwent extended retroperitoneal lymphadenectomy associated with standard pancreaticoduodenectomy from 1998 to 2002. The patients for whom there were insufficient follow-up data, or who had received postoperative adjuvant therapy, were excluded from the analysis. Clinical and pathological parameters of both groups were reviewed. The postoperative morbidity, mortality and survival data were compared statistically. Results Demographic and histopathological characteristics were similar in the two groups of patients. Performance of the extended lymphadenectomy lengthened the procedure. The mean total number of lymph nodes resected was significantly higher in the radical group (P< 0.05). Of the 46 cases in the radical group, 26% (12/46) had metastatic adenocarcinoma in the resected retroperitoneal lymph nodes. There was one perioperative death in the standard group, and two in the radical group. Postoperative diarrhoea and lymphatic leakage were only observed in the radical group. Transfusion requirements and postoperative morbidity rates did not differ between the two groups. The 1-, 2- and 3-year survival rates were 63%, 32% and 21% respectively in the standard group, and 66%, 38% and 21% in the radical

  10. Alumina Carbon Refractory Products for Continuous Casting

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ 1 Scope This standard specifies the classification.techni-cal requirements,test methods,inspection rules,packing,marking,transportation,storage and quality certificate of alumina carbon refractory products for continuous casting.

  11. Ultra High Temperature Refractory Materials Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Legacy refractory materials that have origins dating to the original Saturn program are commonly used in current launch facilities. Although they failure to meet the...

  12. Ultra High Temperature Refractory Materials Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Legacy refractory materials that have origins dating to the original Saturn program are commonly used in current launch facilities. Although they fail to meet the...

  13. Fireclay Refractory Bricks for Hot Blast Stove

    Institute of Scientific and Technical Information of China (English)

    Wang Jing; Zhang Yongfang; Chai Junlan

    2008-01-01

    @@ 1 Scope This standard specifies the classification, shape, dimension, technical requirements, test method,inspection rules, packing, marking,transportation,storage and quality certification of fireclay refractory bricks for hot blast stove.

  14. Spalling Resistance Fast-drying Refractory Castables

    Institute of Scientific and Technical Information of China (English)

    Wang Jing; Peng Xigao

    2010-01-01

    @@ 1 Scope This standard specifies the term and definition,classification, technical requirements, test methods,quality appraisal procedures, packing, marking, transportation, storage, and quality certificate of spalling resistance fast-drying refractory castables.

  15. Prognostic Factors for Refractory Status Epilepticus

    Directory of Open Access Journals (Sweden)

    J. Gordon Millichap

    2013-03-01

    Full Text Available Researchers at the Mayo Clinic, Rochester, MN studied the outcome and identified prognostic factors for refractory status epilepticus (RSE in 54 adult patients, median age 52 years [range 18-93].

  16. Role of the retinoblastoma protein in cell cycle arrest mediated by a novel cell surface proliferation inhibitor

    Science.gov (United States)

    Enebo, D. J.; Fattaey, H. K.; Moos, P. J.; Johnson, T. C.; Spooner, B. S. (Principal Investigator)

    1994-01-01

    A novel cell regulatory sialoglycopeptide (CeReS-18), purified from the cell surface of bovine cerebral cortex cells has been shown to be a potent and reversible inhibitor of proliferation of a wide array of fibroblasts as well as epithelial-like cells and nontransformed and transformed cells. To investigate the possible mechanisms by which CeReS-18 exerts its inhibitory action, the effect of the inhibitor on the posttranslational regulation of the retinoblastoma susceptibility gene product (RB), a tumor suppressor gene, has been examined. It is shown that CeReS-18 mediated cell cycle arrest of both human diploid fibroblasts (HSBP) and mouse fibroblasts (Swiss 3T3) results in the maintenance of the RB protein in the hypophosphorylated state, consistent with a late G1 arrest site. Although their normal nontransformed counterparts are sensitive to cell cycle arrest mediated by CeReS-18, cell lines lacking a functional RB protein, through either genetic mutation or DNA tumor virus oncoprotein interaction, are less sensitive. The refractory nature of these cells is shown to be independent of specific surface receptors for the inhibitor, and another tumor suppressor gene (p53) does not appear to be involved in the CeReS-18 inhibition of cell proliferation. The requirement for a functional RB protein product, in order for CeReS-18 to mediate cell cycle arrest, is discussed in light of regulatory events associated with density-dependent growth inhibition.

  17. Situation of China's Refractories Industry in Last Sixty Years

    Institute of Scientific and Technical Information of China (English)

    HUO Jiangping; PAN Shangxin; LI Chaowen

    2009-01-01

    The annual output of China's refractories in 1949 was 74 thousand tons, and was 29.11 million tons in 2007, which was 65% of the world total refractories output. The export of China's refractory products and raw materials in 2008 was 6.18 million tons, which were exported to hundreds of countries and regions in the world. China is a big country in the field of refractories production and refractories export, which has devoted a lot to relative high temperature industry.

  18. Refractory Seizures in Tramadol Poisoning: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohammad Majidi

    2014-09-01

    Full Text Available Background: Tramadol, an analgesic drug abused by opioid addicts, is also abused accidentally or for suicidal purposes. Tramadol poisoning can induce CNS depression, seizures, coma, and ultimately death. Case: In this report, a 30-year-old male was admitted to the emergency department due to suicidal attempt with ingestion of 14000 mg (140 tablet 100 mg of tramadol. He had history of suicidal attempts in past years as well as depression in his past medical history, but he had not abused tramadol and other drugs in his history. There was no history of epilepsy or head trauma in. He presented with generalized seizures two hours post ingestion, and, then, he was referred to hospital four hours later. Generalized seizures were poorly controlled by multiple medications. Due to respiratory arrest, endotracheal tube was inserted and he was admitted to the ICU immediately. At admission, he experienced hypovolemic shock, hypoglycemia, coma, apnea, refractory seizures, muscle spasms, acute respiratory distress syndrome, coagolative disorder, rhabdomyolysis, and acute renal failure. Despite medical managements, he died 38 days after ingestion. Conclusion: In this report, despite using inhalational anesthetic drugs, seizures continued and were very poorly controlled. Cause of death in this patient can be seen as the side effects of tramadol poisoning.

  19. The modified atkins diet in refractory epilepsy.

    Science.gov (United States)

    Sharma, Suvasini; Jain, Puneet

    2014-01-01

    The modified Atkins diet is a less restrictive variation of the ketogenic diet. This diet is started on an outpatient basis without a fast, allows unlimited protein and fat, and does not restrict calories or fluids. Recent studies have shown good efficacy and tolerability of this diet in refractory epilepsy. In this review, we discuss the use of the modified Atkins diet in refractory epilepsy.

  20. Neuromodulation in refractory epilepsy: Brazilian specialists consensus

    Directory of Open Access Journals (Sweden)

    Vera Cristina Terra

    Full Text Available ABSTRACT Epilepsy is a potentially devastating brain disorder characterized by a predisposition to spontaneous epileptic seizures. In patients with medically refractory epilepsy, new non-pharmacological therapeutic approaches may be considered. In this scenario, palliative surgery such as vagus nerve stimulation (VNS or deep brain stimulation (DBS may be indicated in a subset of patients. In this paper we make recommendations for the use of VNS and DBS in patients in Brazil with refractory epilepsy.

  1. The Modified Atkins Diet in Refractory Epilepsy

    Directory of Open Access Journals (Sweden)

    Suvasini Sharma

    2014-01-01

    Full Text Available The modified Atkins diet is a less restrictive variation of the ketogenic diet. This diet is started on an outpatient basis without a fast, allows unlimited protein and fat, and does not restrict calories or fluids. Recent studies have shown good efficacy and tolerability of this diet in refractory epilepsy. In this review, we discuss the use of the modified Atkins diet in refractory epilepsy.

  2. Refractory migraine in a headache clinic population

    Directory of Open Access Journals (Sweden)

    Fernandez-Torron Roberto

    2011-08-01

    Full Text Available Abstract Background Many migraineurs who seek care in headache clinics are refractory to treatment, despite advances in headache therapies. Epidemiology is poorly characterized, because diagnostic criteria for refractory migraine were not available until recently. We aimed to determine the frequency of refractory migraine in patients attended in the Headache Unit in a tertiary care center, according to recently proposed criteria. Methods The study population consisted of a consecutive sample of 370 patients (60.8% females with a mean age of 43 years (range 14-86 evaluated for the first time in our headache unit over a one-year period (between October 2008 and October 2009. We recorded information on clinical features, previous treatments, Migraine Disability Assessment Score (MIDAS, and final diagnosis. Results Overall migraine and tension-type headache were found in 46.4% and 20.5% of patients, respectively. Refractory migraine was found in 5.1% of patients. In refractory migraineurs, the mean MIDAS score was 96, and 36.8% were medication-overusers. Conclusions Refractory migraine is a relatively common and very disabling condition between the patients attended in a headache unit. The proposed operational criteria may be useful in identifying those patients who require care in headache units, the selection of candidates for combinations of prophylactic drugs or invasive treatments such as neurostimulation, but also to facilitate clinical studies in this patient group.

  3. REFRACTORY THROMBOCYTOPENIA AND NEUTROPENIA: A DIAGNOSTIC CHALLENGE

    Directory of Open Access Journals (Sweden)

    Emmanuel Gyan

    2015-02-01

    Full Text Available Background. The 2008 WHO classification identified refractory cytopenia with unilineage dysplasia (RCUD as a composite entity encompassing refractory anemia, refractory thrombocytopenia (RT, and refractory neutropenia (RN, characterized by 10% or more dysplastic cells in the bone marrow respective lineage. The diagnosis of RT and RN is complicated by several factors.  Diagnosing RT first requires exclusion of familial thrombocytopenia, chronic auto-immune thrombocytopenia, concomitant medications, viral infections, or hypersplenism. Diagnosis of RN should also be made after ruling out differential diagnoses such as ethnic or familial neutropenia, as well as acquired, drug-induced, infection-related or malignancy-related neutropenia. An accurate quantification of dysplasia should be performed in order to distinguish RT or RN from the provisional entity named idiopathic cytopenia of unknown significance (ICUS. Cytogenetic analysis, and possibly in the future somatic mutation analysis (of genes most frequently mutated in MDS, and flow cytometry analysis aberrant antigen expression on myeloid cells may help in this differential diagnosis. Importantly, we and others found that, while isolated neutropenia and thrombocytopenia are not rare in MDS, those patients can generally be classified (according to WHO 2008 classification as refractory cytopenia with multilineage dysplasia or refractory anemia with excess blasts, while RT and RN (according to WHO 2008 are quite rare.These results suggest in particular that identification of RT and RN as distinct entities could be reconsidered in future WHO classification updates.

  4. Advances in Modern Refractory Castables

    Institute of Scientific and Technical Information of China (English)

    ZHOU Ningsheng; HU Shuhe; ZHANG Sanhua

    2004-01-01

    Recent developments in terms of binding system, new material system, installation method and pre-cast shapes of refractory castables are introduced and discussed. In authors view, binding system is advancing on the one hand towards "purification" to minimize impurity components from binder materials, and on the other hand "stabilization" to minimize the structure destroy by volatility and decomposition of binder materials. Challenges of higher service temperature, slag resistance, clean steel production and better thermal shock resistance have promoted the booming of new varieties of castables including MgObased, natural flake graphite containing and non-oxides like Si3 N4, AlON and SiAlON containing castables. Installation technique is developing towards convenience,simplification and high efficiency. Advancement in installation and dry-out is of an incentive to the boost of selfflow castables, shotcreting castables, infiltration casting,quick dry-out castables and pre-cast shapes. Along with the increased adoption of pre-cast shapes of castables, the boundary between "shaped" and "unshaped" is becoming vague.

  5. Advances in Modern Refractory Castables

    Institute of Scientific and Technical Information of China (English)

    ZHOUNingsheng; HUShuhe; ZHANGSanhua

    2004-01-01

    Recent developments in terms of binding system, new material system, installation method and pre-cast shapes of refractory castables are introduced and discussed. In authors' view, binding system is advancing on the one hand towards "purification" to minimize impurity components from binder materials, and on the other hand "stabilization" to minimize the structure destroy by volatility and decomposition of binder materials. Challenges of higher service temperature, slag resistance, clean steel production and better thermal shock resistance have promoted the booming of new varieties of castables including MgO based, natural flake graphite containing and non-oxides like Sis N4, AION and SIMON containing castables. Installation technique is developing towards convenience, simplification and high efficiency. Advancement in installation and dry-out is of an incentive to the boost of selfflow castables, shotcreting castables, infiltration casting, quick dry-out castables and pre-cast shapes. Along wit hthe increased adoption of pre-cast shapes of castables, the boundary between "shaped" and " unshaped " is becoming vague.

  6. Retroperitoneal laparoscopic pyelolithotomy versus extra corporeal shock-wave lithotripsy for management of renal stones

    Directory of Open Access Journals (Sweden)

    Chander Jagdish

    2010-01-01

    Full Text Available Aim: The purpose of this study was to evaluate the role of retroperitoneal laparoscopic pyelolithotomy (RPPL and its comparison with extra corporeal shock wave lithotripsy in the management of renal calculi. Materials and Methods: The study was carried out in the Department of surgery, Maulana Azad Medical College, New Delhi, India. The study included 86 cases of solitary renal calculi in the retroperitoneoscopic (RPPL group and 82 cases in the shock wave lithotripsy (SWL group. The parameters compared were stone clearance, hospital stay, number of postoperative visits, mean time to resume normal activities, number of man days lost, and analgesic requirement. Results : The RPPL group showed better stone clearance, fewer hospital visits, low analgesic requirement, fewer number of man days lost, and early resumption of normal activities, as compared to the SWL group. Conclusions : Shock wave lithotripsy, being a noninvasive modality, is an established procedure all over the world. However RPPL achieves comparable or better results in high volume centers.

  7. Endovascular aortic graft infection resulting in retroperitoneal abscess: report of a case

    Directory of Open Access Journals (Sweden)

    Salvatore Di Somma

    2010-06-01

    Full Text Available Infection is a rare complication of aortoiliac endovascular procedures, with an incidence inferior to 0.5%, and it may result in a retroperitoneal abscess potentially evolving to sepsis and gastrointestinal bleeding. In more than 50% of cases endovascular aortoiliac prosthetic grafts infection occur months or years after the procedure. The growing number of endovascular procedures, and as the actually midterm follow up in most cases, septic sequelae will no doubt continue to occur with increased frequency and may represent an emerging problem in the ED for the emergency physician. Endovascular graft infection begins with unspecific clinical manifestations. An high index of suspicion in any patient with an aortic stent graft presenting prolonged or recurrent fever and or abdominal or back pain and a low threshold for obtaining CT scan should increase the clinician’s ability to make a timely diagnosis in the ED setting.

  8. Predictors of viable germ cell tumor in postchemotherapeutic residual retroperitoneal masses

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    Khalid Al Othman

    2014-01-01

    Full Text Available Objective: The aim of this study was to identify predictors of viable germ cell tumor (GCT in postchemotherapeutic residual retroperitoneal masses. Materials and Methods: The pertinent clinical and pathologic data of 16 male patients who underwent postchemotherapeutic retroperitoneal lymph node dissection (PC-RPLND at King Faisal Specialist Hospital and Research Centre between 1994 and 2005 were reviewed retrospectively. It was found that all patients received cisplatin-based chemotherapy for advanced testicular GCT. Results: Out of the 16 male patients, 2 (13%, 8 (50%, and 6 (37% had viable GCT, fibrosis, and teratoma, respectively. Ten (10 of the patients with prechemotherapeutic S1 tumor markers did not have viable GCT, and two of the six patients who had prechemotherapeutic S2 tumor markers have viable GCT. All tumor marker levels normalized after chemotherapy even in patients with viable GCT. Four patients had vascular invasion without viable GCT. Furthermore, four patients had more than 60% embryonal elements in the original pathology, but only 1 had viable GCT at PC-RPLND. Four of the five patients with immature teratoma had teratoma at PC-RPLND but no viable GCT; however, out of the four patients with mature teratoma, one had viable GCT and two had teratoma at PC-RPLND. Of the two patients with viable GCT, one had 100% embryonal cancer in the original pathology, prechemotherapeutic S2 tumor markers, history of orchiopexy, and no vascular invasion; the other patient had yolk sac tumor with 25% embryonal elements and 40% teratoma in the original pathology, and prechemotherapeutic S2 tumor markers. Conclusion: None of the clinical or pathological parameters showed a strong correlation with the presence of viable GCT in PC-RPLND. However, patients with ≥S2 may be at higher risk to have viable GCT. Further studies are needed to clarify this.

  9. Juvenile Arrests, 2007. Juvenile Justice Bulletin

    Science.gov (United States)

    Puzzanchera, Charles

    2009-01-01

    This Bulletin summarizes 2007 juvenile crime and arrest data reported by local law enforcement agencies across the country and cited in the FBI report, "Crime in the United States 2007." The Bulletin describes the extent and nature of juvenile crime that comes to the attention of the justice system. It serves as a baseline for comparison for…

  10. Heterozygous M1V variant of ELA-2 gene mutation associated with G-CSF refractory severe congenital neutropenia.

    Science.gov (United States)

    Setty, Bhuvana A; Yeager, Nicholas D; Bajwa, Rajinder P

    2011-09-01

    Severe congenital neutropenia is an autosomal recessive disorder characterized by maturation arrest at the promyelocyte/myelocyte phase in the bone marrow, absolute neutrophil count ELA-2 have been described. We report the case of a premature male infant with congenital neutropenia, associated with multiple infections, refractory to treatment with granulocyte colony stimulating factor who subsequently underwent matched sibling donor stem-cell transplant. He was found to be heterozygous for the M1V variant of the ELA-2 gene that we postulate to be causative for his severe neutropenia

  11. Cardiac arrest: comparison of paramedic and conventional ambulance services.

    OpenAIRE

    1983-01-01

    A prospective study conducted in the Greater Vancouver area compared survival rates in prehospital cardiac arrest managed by an advanced life support (paramedic) service with those in cardiac arrest managed by conventional ambulance service. Management by the paramedic service was associated with higher survival rates for patients found in cardiac arrest but not for patients who suffered the arrest while the ambulance was present. Cardiopulmonary resuscitation by bystanders was associated wit...

  12. Modes of induced cardiac arrest: hyperkalemia and hypocalcemia - Literature review

    OpenAIRE

    Oliveira,Marcos Aurélio Barboza de; Brandi, Antônio Carlos; dos Santos, Carlos Alberto; Botelho, Paulo Henrique Husseini; Cortez, José Luis Lasso; Braile, Domingo Marcolino

    2014-01-01

    The entry of sodium and calcium play a key effect on myocyte subjected to cardiac arrest by hyperkalemia. They cause cell swelling, acidosis, consumption of adenosine triphosphate and trigger programmed cell death. Cardiac arrest caused by hypocalcemia maintains intracellular adenosine triphosphate levels, improves diastolic performance and reduces oxygen consumption, which can be translated into better protection to myocyte injury induced by cardiac arrest.

  13. Analysis on the Causes for Refractory GERD

    Institute of Scientific and Technical Information of China (English)

    陈婕; 许军英; 徐勇; 谢小平; 易粹琼; 侯晓华

    2002-01-01

    To analyze the causes of failure in conventional treatment to refractory gastroesophageal reflux diseases (GERD) patients, 16 refractory GERD patients (group R) and 16 eases of GERD primarily diagnosed (group P) were studied. Endoscopy, pathologic examination and 14C urea breath test were conducted in every patient. 24 h ambulatory pH and bilirubin monitoring were performed with Digitrapper MI Ⅲ and Synetics Bilitec 2000. It was found that esophagitis in group R was more severe than in group P. The rate of Helicobacter pylori infection in group R was significantly lower than in group P. Fraction time pH below 4. 00 was not longer while the bile reflux represented by fraction time abs above 0. 14 was greater for patients in the group R as compared with those in the group P. The mixed refluxes and pure bile refluxes between the two groups had significant difference. The reflux episodes in the group R mainly occurred during nights. These results indicated that severe esophagitis, especially Barrett's esophagus with complications makes it difficult to control GERD. Severe duodenogastroesophageal refluxes (DGER) are often accompanied by refractory GERD. Mixed refluxes aggravate the esophageal injuries. Pure bile refluxes and nocturnal refluxes may cause failure of administration of proton pump inhibitors (PPI) in the morning. Helicobacter pylori infection and acid refluxes may not be the direct cause of refractoriness. Individual refractory GERD patient without abnormal results on pH or bile reflux recently should be diagnosed again.

  14. Identification of platelet refractoriness in oncohematologic patients

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    Aline Aparecida Ferreira

    2011-01-01

    Full Text Available OBJECTIVES: To identify the occurrence and the causes of platelet refractoriness in oncohematologic patients. INTRODUCTION: Platelet refractoriness (unsatisfactory post-transfusion platelet increment is a severe problem that impairs the treatment of oncohematologic patients and is not routinely investigated in most Brazilian services. METHODS: Forty-four episodes of platelet concentrate transfusion were evaluated in 16 patients according to the following parameters: corrected count increment, clinical conditions and detection of anti-platelet antibodies by the platelet immunofluorescence test (PIFT and panel reactive antibodies against human leukocyte antigen class I (PRA-HLA. RESULTS: Of the 16 patients evaluated (median age: 53 years, nine (56% were women, seven of them with a history of pregnancy. An unsatisfactory increment was observed in 43% of the transfusion events, being more frequent in transfusions of random platelet concentrates (54%. Platelet refractoriness was confirmed in three patients (19%, who presented immunologic and non-immunologic causes. Alloantibodies were identified in eight patients (50% by the PIFT and in three (19% by the PRA-HLA. Among alloimmunized patients, nine (64% had a history of transfusion, and three as a result of pregnancy (43%. Of the former, two were refractory (29%. No significant differences were observed, probably as a result of the small sample size. CONCLUSION: The high rate of unsatisfactory platelet increment, refractoriness and alloimmunization observed support the need to set up protocols for the investigation of this complication in all chronically transfused patients, a fundamental requirement for the guarantee of adequate management.

  15. [DESCRIPTION OF A RETROPERITONEAL ACCESS ROUTE TO THE VESSELS OF THE SPLEEN FOR SPLENORENAL ARTERIAL AND VENOUS ANASTOMOSIS].

    Science.gov (United States)

    Gil-Vernet Vila, José María

    2014-01-01

    To perform arterial or venous spleno-renal anastomoses, surgeons have so far systematically used the transperitoneal way whic is burdened by a high mortality an morbility percentage. On the basis of anatomo-surgical considerations, a retroperitoneal approach has been found reaching the hilus of the spleen via the lumbar region; the first arterial spleno-renal anastomosis by this way was performed in 1972 and the first venous spleno-renal anastomosis due to portal hipertension also by this way was performed in 1974, the alter proving to be the least aggresive by avoiding damaging the páncreas, the most surgical and direct for reaching the splenic vessels thereby enabling a better exposure and an easier performing of the anastomoses. By being retroperitoneal, the loss or infección of the ascitic liquid in the cirrhotic patient is prevented.

  16. RETROPERITONEAL LYMPH NODE DISSECTION AFTER INDUCTION CHEMOTHERAPY IN METASTATIC TESTICULAR NON-SEMINOMA

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    V. B. Matveev

    2014-07-01

    Full Text Available Objective: to evaluate the outcome of retroperitoneal lymph node dissection (RLND in disseminated testicular non-seminoma patients with residual metastases after induction chemotherapy. Material and methods. The RLND performed in 1983 to 2007 were analyzed in 367 testicular non-seminoma patients with residual retroperitoneal masses after ineffective induction chemotherapy. The median age was 26.06.9 years. Orchidectomy was performed in all patients. Category N1 was regarded in 12 (3.3% patients, N2 in 79 (21.5%, N3 in 238 (64.9%, Nx in 38 (10.4%. Distant metastases were present in 133 (36.2% cases. The baseline tumor marker level was elevated in 328 (89.4% patients (S1 in 169 (46.0%, S2 in 108 (29.4%, S3 in 51 (13.9%, Sx in 39 (10.6%. According to the IGCCCG prognostic model, 149 (40.6% patients were classified as good prognostic group, 100 (27.2% as moderate, 77 (21.0% as poor ones; the prognostic group was not defined in 41 (11.2% cases who had started treatment at another facility due to data unavailability. After orchifuniculectomy, all patients received induction cisplatin-based chemotherapy which resulted in tumor shrinkage <50% in 70 (19.1%, 51-90% in 166 (45.2%, and >90% - in 29 (7.9% cases. The response was not properly assessed in 102 (27.8% cases. CT scan revealed residual retroperitoneal masses after chemotherapy in all patients (<2 cm - 52 (14.2%, 2-5 cm - 166 (45.2%, >5 cm - 149 (40.6%. The tumor markers level remained elevated following chemotherapy in 70 (19.1% cases. All patients underwent RLND (complete in 295 (80.4% cases. Radical RLND demanded resection of adjacent organs in 22 (5.9% cases. Extraretroperitoneal metastases were removed simultaneously with retroperitoneal tumor in 22 (5.9% patients. Postoperative chemotherapy was administered in 100 (27.2% cases. The median followup was 82.1 (3-188 months. Results. Complications developed in 31 (8.5% of the 367 of patients. Mortality rate was 0.6% (2/367 cases. Resection of

  17. Imaging findings of perirenal epithelioid angiomyolipoma mimicking a malignant retroperitoneal tumor: A case report with imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Youn; Woo, Ji Young; Shin, Mi Kyoung; Lee, Yul; Hwang, Ji Young; Kim, Hee Yeong [Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of); Park, Sung Bae [Dept. of Surgery, Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2016-09-15

    Epithelioid angiomyolipoma (EAML) is an uncommon, variant type of angiomyolipoma with a possibility of metastatic transformation and distant spread. Angiomyolipomas, including epithelioid variant type, are mostly renal in origin. EAML originating from extrarenal location is very rare and imaging findings are not well described. Herein, we reported a very rare case of EAML arising from the perirenal space that mimicked a malignant retroperitoneal tumor, in a 39-year-old female.

  18. Massive retroperitoneal hemorrhage from a giant renal angiomyolipoma treated by selective arterial embolization with an Amplatzer Vascular Plug II

    OpenAIRE

    Teichgräber, Ulf KM; de Bucourt, Maximilian

    2012-01-01

    We report on a 36-year-old Caucasian woman who presented to the emergency department with post-traumatic retroperitoneal bleeding diagnosed by computed tomography. After clinical stabilization of the patient, selective arterial embolization was performed. The angiomyolipoma's feeding artery was successfully treated with an 8-mm Amplatzer Vascular Plug Type II. The upper pole of the left kidney, which was supplied by a separate upper renal artery, was conserved. Consequently, the renal angiomy...

  19. Topical cidofovir for refractory verrucae in children.

    Science.gov (United States)

    Gupta, Monique; Bayliss, Susan J; Berk, David R

    2013-01-01

    Warts are common and are a challenge to treat in some children, especially immunocompromised children and those who fail or cannot tolerate salicylic acid preparations and cryotherapy. Cidofovir, a nucleotide analogue with antiviral activity, has demonstrated promising results when compounded into a topical form to treat refractory warts. We present a retrospective institutional review of 12 children with refractory verrucae treated with 1% to 3% topical cidofovir compounded in an unscented moisturizing cream, applied every other day to daily. In our institutional series, only three patients (25%) demonstrated complete clearance of their verrucae. An additional four patients (33%) demonstrated partial clearance. Our experience using topical cidofovir has been less successful than previous institutional reviews, possibly because we used a lower concentration and less-frequent dosing. More studies are needed to better characterize the efficacy, safety, and dosing of topical cidofovir for the treatment of refractory warts.

  20. Refractory Behaviors of Magnetite-Kaolin Bricks

    Science.gov (United States)

    Adeosun, S. O.; Akpan, E. I.; Gbenebor, O. P.; Taiwo, O. O.; Eke, I. J.

    2016-11-01

    In this work, the suitability of using kaolin-magnetite-plastic clay to produce refractory bricks has been experimentally explored. Thirty bricks of different compositions were produced and fired at 1200°C. The density, shrinkage moisture content, loss on ignition, porosity and permeability of the bricks were examined. Results show that the bricks remained stable during firing and thus possess good insulating characteristics. The highest (2.23 g/cm3) and lowest (2.00 g/cm3) bulk densities obtained in this study are higher than the highest bulk density reported for Al dross-filled refractories (1.23 g/cm3). The bricks also possessed very low effective moisture content (10-23%) and very high compression modulus (16-100 MPa) desirable in insulating refractory bricks with high resistance to abrasion.

  1. Dramatic response to infliximab in refractory neurosarcoidosis

    Directory of Open Access Journals (Sweden)

    Chintamaneni Sreekanth

    2010-01-01

    Full Text Available Sarcoidosis is a systemic disease characterized by noncaseating granulomas in the involved organs. Neurologic manifestations involving the central and/or peripheral nervous system occur in about 5% of patients. Neurosarcoidosis is often refractory to conventional treatment and therefore more effective treatment options are needed. While the etiology of the disease is still unknown, there is now a better understanding of its pathogenesis on a molecular level. It is clear that tumor necrosis factor-α (TNFα plays a pivotal role in the development of the granulomas and it is believed to be a key cytokine involved in the pathogenesis of the disease. Taking advantage of this better understanding of disease pathogenesis, anti-TNFα agents are being increasingly used to treat refractory sarcoidosis. We report a patient with refractory neurosarcoidosis who showed dramatic improvement in the clinical and radiological manifestations following treatment with infliximab; he suffered a relapse upon discontinuation of the medication.

  2. Fast access and early ligation of the renal pedicle significantly facilitates retroperitoneal laparoscopic radical nephrectomy procedures: modified laparoscopic radical nephrectomy

    Directory of Open Access Journals (Sweden)

    Yang Qing

    2013-01-01

    Full Text Available Abstract Background The objective of this study was to develop a modified retroperitoneal laparoscopic nephrectomy and compare its results with the previous technique. Methods One hundred retroperitoneal laparoscopic nephrectomies were performed from February 2007 to October 2011. The previous technique was performed in 60 cases (Group 1. The modified technique (n = 40 included fast access to the renal pedicle according to several anatomic landmarks and early ligation of renal vessels (Group 2. The mean operation time, mean blood loss, duration of hospital stay conversion rate and complication rate were compared between the groups. Results No significant differences were detected regarding mean patient age, mean body mass index, and tumor size between the two groups (P >0.05. The mean operation time was 59.5 ± 20.0 and 39.5 ± 17.5 minutes, respectively, in Groups 1 and 2 (P P P >0.05. Conclusions Early ligature using fast access to the renal vessels during retroperitoneal laparoscopic radical nephrectomy contributed to less operation time and intraoperative blood loss compared with the previous technique. In addition, the modified technique permits the procedure to be performed following the principles of open radical nephrectomy.

  3. Simultaneously anterior decompression and posterior instrumentation by extrapleural retroperitoneal approach in thoracolumbar lesions

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    Jain Anil

    2010-01-01

    Full Text Available Background: Anterior decompression with posterior instrumentation when indicated in thoracolumbar spinal lesions if performed simultaneously in single-stage expedites rehabilitation and recovery. Transthoracic, transdiaphragmatic approach to access the thoracolumbar junction is associated with significant morbidity, as it violates thoracic cavity; requires cutting of diaphragm and a separate approach, for posterior instrumentation. We evaluated the clinical outcome morbidity and feasibility of extrapleural retroperitoneal approach to perform anterior decompression and posterior instrumentation simultaneously by single "T" incision outcome in thoracolumbar spinal trauma and tuberculosis. Patients and Methods: Forty-eight cases of tubercular spine (n = 25 and fracture of the spine (n = 23 were included in the study of which 29 were male and 19 female. The mean age of patients was 29.1 years. All patients underwent single-stage anterior decompression, fusion, and posterior instrumentation (except two old traumatic cases via extrapleural retroperitoneal approach by single "T" incision. Tuberculosis cases were operated in lateral position as they were stabilized with Hartshill instrumentation. For traumatic spine initially posterior pedicle screw fixation was performed in prone position and then turned to right lateral position for anterior decompression by same incision and approach. They were evaluated for blood loss, duration of surgery, superficial and deep infection of incision site, flap necrosis, correction of the kyphotic deformity, and restoration of anterior and posterior vertebral body height. Results: In traumatic spine group the mean duration of surgery was 269 minutes (range 215-315 minutes including the change over time from prone to lateral position. The mean intraoperative blood loss was 918 ml (range 550-1100 ml. The preoperative mean ASIA motor, pin prick and light touch score improved from 63.3 to 74.4, 86 to 94.4 and 86 to 96 at

  4. Office Procedures in Refractory Chronic Rhinosinusitis.

    Science.gov (United States)

    Thamboo, Andrew; Patel, Zara M

    2017-02-01

    Office procedures in chronic rhinosinusitis (CRS) can be considered before and after medical management, as well as before and after surgical management. This article focuses specifically on refractory CRS, meaning those patients who have failed medical and surgical management already. The options available in the management of refractory CRS depend on the personnel, equipment, and instrumentation available in the office setting; surgeon experience; and patient suitability and tolerability. This article provides readers with possible procedural options that can be done in their clinics with indications, patient selection, potential complications, and postoperative considerations.

  5. Refractory Materials for Flame Deflector Protection System Corrosion Control: Refractory Ceramics Literature Survey

    Science.gov (United States)

    Calle, Luz Marina; Hintze, Paul E.; Parlier, Christopher R.; Curran, Jerome P.; Kolody, Mark; Perusich, Stephen; Whitten, Mary C.; Trejo, David; Zidek, Jason; Sampson, Jeffrey W.; Coffman, Brekke E.

    2009-01-01

    Ceramics can be defmed as a material consisting of hard brittle properties produced from inorganic and nonmetallic minerals made by firing at high temperatures. These materials are compounds between metallic and nonmetallic elements and are either totally ionic, or predominately ionic but having some covalent character. This definition allows for a large range of materials, not all applicable to refractory applications. As this report is focused on potential ceramic materials for high temperature, aggressive exposure applications, the ceramics reviewed as part of this report will focus on refractory ceramics specifically designed and used for these applications. Ceramic materials consist of a wide variety of products. Callister (2000) 1 characterized ceramic materials into six classifications: glasses, clay products, refractories, cements, abrasives, and advanced ceramics. Figure 1 shows this classification system. This review will focus mainly on refractory ceramics and cements as in general, the other classifications are neither applicable nor economical for use in large structures such as the flame trench. Although much work has been done in advanced ceramics over the past decade or so, these materials are likely cost prohibitive and would have to be fabricated off-site, transported to the NASA facilities, and installed, which make these even less feasible. Although the authors reviewed the literature on advanced ceramic refractories 2 center dot 3 center dot 4 center dot 5 center dot 6 center dot 7 center dot 8 center dot 9 center dot 10 center dot 11 center dot 12 after the review it was concluded that these materials should not be ' the focus of this report. A review is in progress on materials and systems for prefabricated refractory ceramic panels, but this review is focusing more on typical refractory materials for prefabricated systems, which could make the system more economically feasible. Refractory ceramics are used for a wide variety of applications

  6. Refractory disease in antineutrophil cytoplasmic antibodies associated vasculitis

    NARCIS (Netherlands)

    Rutgers, Abraham; Kallenberg, Cornelis

    2012-01-01

    Purpose of review Induction treatment of antineutrophil cytoplasmic antibodies (ANCA) associated vasculitis (AAV) is not always successful and nonresponding patients are considered refractory. Recent findings Refractory disease should be subdefined to the treatment that was received. Cyclophosphamid

  7. Nuclear reactor melt arrest and coolability device

    Energy Technology Data Exchange (ETDEWEB)

    Theofanous, Theo G.; Dinh, Nam Truc; Wachowiak, Richard M.

    2016-06-14

    Example embodiments provide a Basemat-Internal Melt Arrest and Coolability device (BiMAC) that offers improved spatial and mechanical characteristics for use in damage prevention and risk mitigation in accident scenarios. Example embodiments may include a BiMAC having an inclination of less than 10-degrees from the basemat floor and/or coolant channels of less than 4 inches in diameter, while maintaining minimum safety margins required by the Nuclear Regulatory Commission.

  8. Dental Calculus Arrest of Dental Caries

    Science.gov (United States)

    Keyes, Paul H.; Rams, Thomas E.

    2016-01-01

    Background An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. Materials and methods A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Results Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. Conclusions These observations further document the potential protective effects of dental calculus mineralization against dental caries. PMID:27446993

  9. Rheology and structural arrest of casein suspensions

    OpenAIRE

    Dahbi, Louisa; Alexander, M.; Trappe, Véronique; Dhont, J. K. G.; Schurtenberger, Peter

    2010-01-01

    The rheology of milk powder suspensions is investigated up to very high concentrations, where structural arrest occurs. The main component of the milk powder investigated is casein, so that the suspensions can be regarded as casein suspensions. Four concentration regimes are identified. For effective casein volume fractions less than 0.54 the concentration dependence of the zero-shear viscosity is similar to that of hard-sphere suspensions. However, due to the elastic deformation of the casei...

  10. Developing retroperitoneal anaplastic carcinoma with choriocarcinoma focus after ovarian non-gestastional choriocarcinoma: Case report

    Directory of Open Access Journals (Sweden)

    Nikolić Branka

    2012-01-01

    Full Text Available Introduction. Choriocarcinoma is a malignant form of gestational trophoblastic neoplasm (GTN. It is a rare event but also a curable malignancy. In the majority of instancies it developes after any gestational event. In some cases it developes as non-gestational extrauterine malignancy. Prognosis of choriocarcinoma is poor when invasion and metastases appear early and spread fast. This form of choriocarcinoma can lead to incurable and letal outcome. Case report. We presented a 20-year-old patient with abdominal and retroperitoneal malignancy - anaplastic carcinoma combined with choriocarcinoma metastases in. Tumor developed three months after left adnexectomy which had been done because of adnexal tumor. Choriocarcinoma was immunohistochemicaly confirmed in adnexal masses. Two courses of chemotherapy, metotrexate + folic acid (MTX+FA regimen, were administrated. The initial serum beta human chorionic gonadotropin level stayed unknown as well as the last one after the treatment. The patient came from the other country and was hospitalized because of pelvic and abdominal pain and palpable abdominal masses in hypogastrium with progressive anemia. The human chorionic gonadotropin level was 38 mIU/L. Tumor biopsy was done and choriocarcinoma metastases were immunohistochemicaly confirmed with predominant anaplastic carcinoma. Five day course of MTX + cyclophosphamide regimen was administrated and the patient was prepared for operative treatment. Relaparotomy was perforemed and tumor completely exceeded. Tumor mass mostly developed retroperitonely and partialy in abdominal cavity infiltrating intestinal wall with rupture of sigmoid colon. Anaplastic carcinoma, with large fields of necrosis and bleeding, was confirmed after histological examination. Immunohistochemical examination excluded choriocarcinoma in tumor mass. After 20 blood units transfusion, one course of chemotherapy and tumor excision, the patient left hospital on the 9th postoperative day

  11. Mycophenolate mofetil combined with steroids: New experiences in the treatment of idiopathic retroperitoneal fibrosis

    Directory of Open Access Journals (Sweden)

    Obrenčević Katarina

    2007-01-01

    Full Text Available Background/Aim. Idiopathic retroperitoneal fibrosis (IRF is an uncommon disease characterized by a retroperitoneal fibrotic tissue that often involve the ureters, leading to the obstructive nephropathy and variable impairment of renal function. Findings strongly suggest an autoimmune etiology. Surgery, medical treatment with immunosuppressive drugs, or a combination of both are proposed. The optimal treatment has not been established yet. The aim of this study was to present our experience with combined immunosuppressive therapy of IRF, steroids (S and mycophenolate mofetil (MMF. Methods. We prospectively followed four patients with IRF from January 2004 to December 2006. Three patients had an active disease with bilateral hydronephrosis. In the two of them acute renal failure was presented, and ureteral catheters were inserted in one in order to manage ureteral obstruction. One patient has came to our unit with a relapse of IRF and incipient chronic renal failure after the prior therapy with ureterolysis and immunosuppressive drugs (azathioprine and tamoxifen. All patients received steroids and MMF. Two patients were treated with intravenous methylprednisolone pulses (250 mg each, for three consecutive days, followed by oral prednisone 0.5 mg/kg/day. The other two patients received oral prednisone at the same dose. Prednisone was gradually tappered to a maintenance dose of 10 mg/kg/day. Simultaneously, all patients received MMF, initially 1 g/day with the increase to 2 g/day. Results. After four weeks of the therapy all symptoms disappeared, as well as a hydronephrosis with a decrease of erythrocyte sedimentation rate and Creactive protein (CRP to normal level in all patients. Three patients remain in remission untill the end of the follow up. One patient had a relapse because of stopping taking the therapy after six months. He was treated by oral prednisone 0.5 mg/kg/day, which was gradually decreased. After twelve weeks hydronephrosis

  12. Aerodynamically generated noise by lightning arrester

    Directory of Open Access Journals (Sweden)

    Váchová J.

    2007-10-01

    Full Text Available This paper presents the general solution of aerodynamically generated noise by lightning arrester. Governing equations are presented in form of Lighthill acoustic analogy, as embodied in the Ffowcs Williams-Hawkings (FW-H equation. This equation is based on conservation laws of fluid mechanics rather than on the wave equation. Thus, the FW-H equation is valid even if the integration surface is in nonlinear region. That’s why the FWH method is superior in aeroacoustics. The FW-H method is implemented in program Fluent and the numerical solution is acquired by Fluent code.The general solution of acoustic signal generated by lightning arrester is shown and the results in form of acoustic pressure and frequency spectrum are presented. The verification of accuracy was made by evaluation of Strouhal number. A comparison of Strouhal number for circumfluence of a cylinder and the lightning arrester was done, because the experimental data for cylinder case are known and these solids are supposed to be respectively in shape relation.

  13. Arrest scenarios in concentrated protein solutions - from hard sphere glasses to arrested spinodal decomposition

    Science.gov (United States)

    Stradner, Anna; Bucciarelli, Saskia; Casal, Lucia; Foffi, Giuseppe; Thurston, George; Farago, Bela; Schurtenberger, Peter

    2014-03-01

    The occurrence of an arrest transition in concentrated colloid suspensions and its dependence on the interaction potential is a hot topic in soft matter. Such arrest transitions can also occur in concentrated protein solutions, as they exist e.g. in biological cells or are increasingly used in pharmaceutical formulations. Here we demonstrate the applicability of concepts from colloid science to understand the dynamics of concentrated protein solutions. In this presentation we report a combination of 3D light scattering, small-angle X-ray scattering and neutron spin echo measurements to study the structural properties as well as the collective and self diffusion of proteins in highly concentrated solutions on the relevant length and time scales. We demonstrate that various arrest scenarios indeed exist for different globular proteins. The proteins chosen are different bovine lens crystallins. We report examples of hard and attractive glass transitions and arrested spinodal decomposition directly linked to the effective pair potentials determined in static scattering experiments for the different proteins. We discuss these different arrest scenarios in view of possible applications of dense protein solutions as well as in view of their possible relevance for living systems.

  14. An Overview on China's Refractories-Market and New Demands

    Institute of Scientific and Technical Information of China (English)

    LIU Jiehua; ZHOU Ningsheng

    2004-01-01

    Based on the authors' information sources and personal viewpoints, this paper provides updated information on China s refractories situation in terms of output, consumption in main refractory using sectors, exportation and importation of refractory products and raw materials,structural change, future prosperity and new demands .From authors understanding, some analyses have also been given.

  15. Export and Import Situation of Refractories in China

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    China has been the biggest country in production and exporting of refractories. The article describes the problems in the export and import and suggestions on development of refractories. In the future, China will expand its cooperation with world refractories community in science, technology, economy and trade to play a more important role in the international and domestic markets.

  16. Tungsten and other refractory metals for VLSI applications II

    Energy Technology Data Exchange (ETDEWEB)

    Broadbent, E.K.

    1987-01-01

    This book presents papers on tungsten and other refractory metals for VLSI applications. Topics include the following: Selectivity loss and nucleation on insulators, fundamental reaction and growth studies, chemical vapor deposition of tungsten, chemical vapor deposition of molybdenum, reactive ion etching of refractory metal films; and properties of refractory metals deposited by sputtering.

  17. Total lymphoid irradiation therapy in refractory rheumatoid arthritis. Fifteen- to forty-month followup

    Energy Technology Data Exchange (ETDEWEB)

    Brahn, E.; Helfgott, S.M.; Belli, J.A.; Anderson, R.J.; Reinherz, E.L.; Schlossman, S.F.; Austen, K.F.; Trentham, D.E.

    1984-05-01

    Twelve patients with refractory rheumatoid arthritis were treated with total lymphoid irradiation (TLI) to a total cumulative dose of 3,000 rads. Post-TLI morbidity/mortality included 8 patients with xerostomia, 4 with weight loss of greater than 10 kg, 3 with loss of 4 or more teeth, 3 with herpes zoster, 4 with bacterial infection that was fatal in 2, 3 with hypothyroidism, 1 with cutaneous vasculitis, and death from myocardial infarction in 1 patient and cardiorespiratory arrest in another. Ten of the patients were reevaluated 15-40 months (mean +/- SE, 30 +/- 2) after completion of TLI, and significant improvement was noted in several disease parameters including number of swollen joints, duration of morning stiffness, and 50-foot walking time. Blood lymphopenia and a decrease in helper T cells (T4) were also noted. These data suggest that changes in immunoregulation induced by TLI can produce longlasting alterations in rheumatoid arthritis, although adverse effects may limit its efficacy.

  18. Arrest History and Intimate Partner Violence Perpetration in a Sample of Men and Women Arrested for Domestic Violence.

    Science.gov (United States)

    Shorey, Ryan C; Ninnemann, Andrew; Elmquist, Joanna; Labrecque, Lindsay; Zucosky, Heather; Febres, Jeniimarie; Brasfield, Hope; Temple, Jeff R; Stuart, Gregory L

    2012-01-01

    Intimate partner violence (IPV) is a serious and prevalent problem throughout the United States. Currently, individuals arrested for domestic violence are often court mandated to batterer intervention programs (BIPs). However, little is known about the arrest histories of these individuals, especially women. The current study examined the arrest histories of men (n = 303) and women (n = 82) arrested for domestic violence and court-referred to BIPs. Results demonstrated that over 30% of the entire sample had been previously arrested for a non-violent offense, and over 25% of the participants had been previously arrested for a violent offense other than domestic violence. Moreover, men were arrested significantly more frequently for violence-related and non-violent offenses than their female counterparts. In addition, men were more likely than women to have consumed binge-levels of alcohol prior to the offense that led to their most recent arrest and court-referral to a BIP. Lastly, arrest history was positively associated with physical and psychological aggression perpetration against an intimate partner for men only, such that more previous arrests were associated with more frequent aggression. These results provide evidence that many men and women arrested for domestic violence have engaged in a number of diverse criminal acts during their lifetimes, suggesting that BIPs may need to address general criminal behavior.

  19. Synthetic Raw Materials for Refractories in China

    Institute of Scientific and Technical Information of China (English)

    SHIGan; YUEWeidong

    2001-01-01

    The development and status of synthetic raw materials for refractories in China are reviewed,including magne-site-based materials,alumina ,ullite,calcium alumi-nate cement ,ultrafine powder,spinel,silicon carbide and cordierite.The research work on calcium zirconate and sialon materials are also introduced.

  20. Arresting developments: trends in female arrests for domestic violence and proposed explanations.

    Science.gov (United States)

    Deleon-Granados, William; Wells, William; Binsbacher, Ruddyard

    2006-04-01

    This article represents an effort to generate more systematic and specified discussion on the topic of unintended consequences in the movement to decrease violence against women. In this case, the consequence is increases in female arrests for domestic violence. This article builds on recent discussions by first using a sample of data to examine felony domestic violence arrest rates for men and women. The data support the conclusion that domestic violence arrests of women have increased. Second, the article presents six explanations that are derived from existing literature. Although the authors do not offer empirical tests of these explanations, this presentation can play an important part in better understanding the outcomes of criminal justice policies that are aimed at increasing victim safety.

  1. Tissue expander placement and adjuvant radiotherapy after surgical resection of retroperitoneal liposarcoma offers improved local control.

    Science.gov (United States)

    Park, Hyojun; Lee, Sanghoon; Kim, BoKyong; Lim, Do Hoon; Choi, Yoon-La; Choi, Gyu Seong; Kim, Jong Man; Park, Jae Berm; Kwon, Choon Hyuck David; Joh, Jae-Won; Kim, Sung Joo

    2016-08-01

    Given that retroperitoneal liposarcoma (LPS) is extremely difficult to completely resect, and has a relatively high rate of recurrence, radiotherapy (RT) is the treatment of choice after surgical resection. However, it is difficult to obtain a sufficient radiation field because of the close proximity of surrounding organs. We introduce the use of tissue expanders (TEs) after LPS resection in an attempt to secure a sufficient radiation field and to improve recurrence-free survival.This study is a retrospective review of 53 patients who underwent surgical resection of LPS at Samsung Medical Center between January 1, 2005, and December 31, 2012, and had no residual tumor detected 2 months postoperatively. The median follow-up period was 38.9 months.Patients were divided into 3 groups. Those in group 1 (n = 17) had TE inserted and received postoperative RT. The patients in group 2 (n = 9) did not have TE inserted and received postoperative RT. Finally, those in group 3 (n = 27) did not receive postoperative RT. Multivariate analysis was performed to identify the risk factors associated with recurrence-free survival within 3 years. Younger age, history of LPS treatment, and RT after TE insertion (group 1 vs group 2 or 3) were significantly favorable factors influencing 3-year recurrence-free survival.TE insertion after LPS resection is associated with increased 3-year recurrence-free survival, most likely because it allows effective delivery of postoperative RT.

  2. Laparoscopic Partial Nephrectomy: Is It Worth Still Performing the Retroperitoneal Route?

    Directory of Open Access Journals (Sweden)

    Idir Ouzaid

    2012-01-01

    laparoscopic partial nephrectomy versus RLPN (retroperitoneal. Patients and Methods. From 1997 to 2009, a retrospective study of 153 consecutive patients who underwent TLPN or RLPN for suspicious renal masses was performed. Complications, functional and oncological outcomes were compared between the 2 groups. Results. With a mean followup of 39 and 32 months, respectively, 66 and 87 patients had TLPN and RLPN, respectively. Tumor location was more often posterior in the RLPN and more often anterior in the TLPN. Mean operative time and mean hospital stay were longer in the TLPN group with 190±85 min versus 154±47 (=0.001 and 9.2±6.4 days versus 6.2±4.5 days (<0.05, respectively. Transfusion and urinary fistulas rates were similar in the 2 groups. After 3-year followup, chronic kidney failure occurred in 6 and and 4% (=0.67 in after TLPN and RLPN, respectively. After 3-year followup, recurrence free survival was 96.7% and 96.6% (=0.91 in the TLPN and RLPN groups, respectively. Conclusion. Our study confirmed that TLPN had longer operative time and hospital stay than RLPN. The complication rates were similar. Furthermore, mid-term oncological and functional outcomes were similar.

  3. Rapid Decline of Follicular Lymphoma-Associated Chylothorax after Low Dose Radiotherapy to Retroperitoneal Lymphoma Localization

    Directory of Open Access Journals (Sweden)

    Lien Van De Voorde

    2014-01-01

    Full Text Available Chylothorax is caused by disruption or obstruction of the thoracic duct or its tributaries that results in the leakage of chyle into the pleural space. A number of interventions have been used to treat chylothorax including the treatment of the underlying disease. Lymphoma is found in 70% of cases with nontraumatic malignant aetiology. Although patients usually have advanced lymphoma, supradiaphragmatic disease is not always present. We discuss the case of a 63-year-old woman presenting with progressive respiratory symptoms due to chylothorax. She was diagnosed with a stage IIE retroperitoneal grade 1 follicular lymphoma extending from the coeliac trunk towards the pelvic inlet. Despite thoracocentesis and medium-chain triglycerides (MCT, diet chylothorax reoccurred. After low dose radiotherapy (2×2 Gy to the abdominal lymphoma there was a marked decrease in lymphadenopathy at the coeliac trunk and a complete regression of the pleural fluid. In this case, radiotherapy was shown to be an effective nontoxic treatment option for lymphoma-associated chylothorax with long-term remission of pleural effusion.

  4. Perioperative Endocrine Therapy for Patients with Cushing's Syndrome Undergoing Retroperitoneal Laparoscopic Adrenalectomy

    Directory of Open Access Journals (Sweden)

    Xiaobo Cui

    2012-01-01

    Full Text Available Objectives. To investigate the efficacy and safety of perioperative endocrine therapy (PET for patients with Cushing’s syndrome (CS undergoing retroperitoneal laparoscopic adrenalectomy (RLA. Methods. The novel, simplified PET modality of 82 patients who underwent RLA procedures for CS were studied. Clinical manifestations were observed for all patients on days 1 and 5 postoperatively, and clinical data, such as blood pressure (BP, levels of serum cortisol, adrenocorticotropin (ACTH, blood glucose, and electrolytes, were acquired and analyzed. Results. Supraphysiological doses of glucocorticoid were administered during the perioperative period, and the dosage was reduced gradually. In all 82 cases, the RLAs were performed successfully without any perioperative complication, such as steroid withdrawal symptoms. The patient’s symptoms and signs were improved quickly and safely during the hospital days. The serum cortisol and potassium levels were rather stable on days 1 and 5 postoperatively, and most were within the normal range. The clinical manifestations, serum levels of cortisol, ACTH, and potassium in most patients restored to normal gradually after several months (mean, 6.7 ± 1.2 months, except for one patient undergoing bilateral adrenalectomy. Conclusions. This perioperative endocrine therapy for patients with Cushing’s syndrome (mainly for adrenocortical adenoma undergoing retro-laparoscopic adrenalectomy is both effective and safe.

  5. Burned-out testis tumour that metastasized to retroperitoneal lymph nodes: a case report

    Directory of Open Access Journals (Sweden)

    Yucel Mehmet

    2009-05-01

    Full Text Available Abstract Introduction Burned-out testicular tumour is a very rare clinical entity. There is no clinical finding in the testicle, because it regresses spontaneously with no treatment, and generally presents with metastases. Abdominal masses in young male patients may sometimes be caused by a metastatic burned-out testicular tumour. We report a patient with a burned-out testicular tumour that metastasized to retroperitoneal lymph nodes. Case presentation A 28-year-old man complained of an abdominal mass and continuously increasing pain over the previous 2 months. A midabdominal mass, atrophy and minimal induration in the right testis were revealed on physical examination. Ultrasound findings revealed focally increased echogenicity, which is typical of burned-out tumours. Inguinal orchiectomy was performed, and the histological examination of the biopsy specimen revealed a large area of hyalinization, tubular hyalinization, interstitial fibrosis and focal Leydig cell hyperplasia, with no abnormal pathological findings in the epididymis and spermatic cord. The final pathological diagnosis was concluded as "burned-out" testicular tumour. Surgical treatment was followed by appropriate chemotherapy and in the follow-up, the abdominal mass was observed to regress. The patient is currently free of disease 5 years after diagnosis. Conclusion For the detection of intratesticular lesions, especially in patients with extragonadal metastatic involvement and normal palpation findings for the testis, scrotal sonography is very important. A burned-out testicular tumour should be considered and testis biopsies should be performed if there is any risk factor of malignancy.

  6. Rare complication after a transrectal ultrasound guided prostate biopsy: a giant retroperitoneal hematoma.

    Science.gov (United States)

    Chiancone, Francesco; Mirone, Vincenzo; Fedelini, Maurizio; Meccariello, Clemente; Pucci, Luigi; Carrino, Maurizio; Fedelini, Paolo

    2016-05-24

    Common complications related to transrectal ultrasound (TRUS) guided prostatic needle biopsy are hematuria, hematospermia, and hematochezia. To the best of our knowledge, we report the second case of a very large hematoma extending from the pelvis into the retroperitoneal space in literature.A 66-year-old man with a serum prostate-specific antigen (PSA) of 5.4 ng/ml was admitted to our department for a TRUS-guided prostatic needle biopsy. Laboratory values on the day before biopsy, including coagulation studies, were all normal. The patients did not take any anticoagulant drugs. No immediate complications were encountered. Nevertheless, 7 hours after the biopsy, the patient reached our emergency department with severe diffuse abdominal pain, hypotension, tachycardia, and confusional state. He underwent an ultrasonography and then a computed tomography (CT) scan that showed "a blood collection in the pelvis that extending to the lower pole of left kidney associated with a focus of active contrast extravasation, indicating active ongoing prostate bleeding." Consequently, he underwent a diagnostic angiography that showed no more contrast extravasation, without the need of embolization. Management of hematoma has been conservative and hematoma was completely reabsorbed 4 months later.

  7. Conservative management of a retroperitoneal hemorrhage following a ruptured renal angiomyolipoma in pregnancy.

    Science.gov (United States)

    Gyimadu, Adam O; Kara, Ozgur; Basaran, Derman; Esinler, Ibrahim

    2011-02-01

    Retroperitoneal hemorrhage following ruptured renal angiomyolipoma is usually managed surgically or by embolization. But when the same episode occurs in pregnancy, surgery which predisposes to preterm delivery and its subsequent sequelae, the unknown influences of radiation exposure on the fetus makes the management of such cases very challenging. A 21-year-old woman was seen in the emergency unit at the 25th week of her pregnancy with complaints of sudden onset left flank pain radiating to the back, nausea and hematuria. Abdominal magnetic resonance imaging (MRI) revealed masses consistent with angiomyolipoma in the upper pole of the left kidney with evidence of recent bleeding and the center of the right kidney measuring 11.5 × 9.5 cm and 3.5 cm, respectively. The patient received three units of red blood cell concentrate due to fall in hematocrit level resulting in hemodynamically stable condition until term. At term, an infant weighing 3510 g was delivered through elective cesarean section. To avoid iatrogenic preterm delivery and unnecessary fetal exposure to radiation, conservative management of ruptured angiomyolipoma in pregnancy may be considered as a treatment option in hemodynamically stable patients.

  8. Retroperitoneal Sarcoma Involving Unilateral Double Ureter: Management, Treatment and Psychological Implications

    Directory of Open Access Journals (Sweden)

    Vito Leanza

    2014-05-01

    Full Text Available The case of a 45-year-old woman who was admitted to our university hospital for polymenorrhea, weight gain and pain in the left iliac region is reported. An abdominal ultrasound revealed a 9.5 × 5.2-cm, hypoechoic and inhomogeneous mass located on the left side of the pelvis and behind the ovary. The patient underwent surgery. The pelvic mass was firmly anchored to the small intestine, colon, sigma and uterine fundus. After removing the adhesions, double ureters, which had been incorporated in the mass, were observed on the left side. Resection of the unilateral double ureters was necessary in order to remove the entire mass, and thereafter, a left salpingoophorectomy was performed. A histological examination showed a malignant retroperitoneal mass. Termino-terminal ureteral anastomosis with two double-J stents was carried out. Total hysterectomy with preservation of the right adenexum and regional lymphadenectomy was performed. The purpose of this case report is to discuss the physical and psychological implications related to the combination of two rare entities: leiomyosarcoma and a double ureter located within the mass. A literature review on the clinical management and psychological aspects from a female cancer patient's perspective undergoing surgery with the aforementioned disorders will be discussed.

  9. Arrests of women for driving under the influence.

    Science.gov (United States)

    Shore, E R; McCoy, M L; Toonen, L A; Kuntz, E J

    1988-01-01

    Police records of arrests of women in Wichita, Kansas for driving under the influence (DUI) of alcohol for a 5-year period (1980-1984) were studied. The proportion of arrests of women increased from 10.6 to 14.5% of total arrested. Women in their 20s comprised the largest age group; single women were greatly overrepresented. More than one-half of the arrested women were employed outside the home; a substantial proportion (30.8%) were unemployed at the time of arrest. The average blood alcohol level of those tested was 183 mg/dl. Characteristics of arrestees are discussed in terms of changes in the social roles and expectations of women. Although time of arrest was similar to that of men (i.e., night), arrests of women were more evenly spread across the days of the week. Within the 5-year period, the rate of recidivism for DUI was 7.43%. The implications of arrest and recidivism patterns are discussed. A change in legal and arrest procedures was found to have the same effect on arrests of women as it had on those of men, suggesting that the changes did not produce differential treatment by police.

  10. Clinical Analysis of 81 Cases of Benign Retroperitoneal Schwannoma%81例良性腹膜后神经鞘瘤临床分析

    Institute of Scientific and Technical Information of China (English)

    李强; 高春涛

    2006-01-01

    Objective: To analyze the clinical manifestations of retroperitoneal schwannoma in order to improve the diagnosis and treatment of this rare disease. Methods: Between January 1951 and September 2004, 81 patients with retroperitoneal schwannoma were retrospectively analyzed. Results: All cases received operative therapy. Sixty cases (74.1%) received a total resection; 12 cases (14.9%) subtotal resection, and 9 cases (11.1%) exploration. During the surgical operation, a single tumor was found in 77 cases (95.1%), and multiple tumors in 4 cases (4.9%). Most of the retroperitoneal schwannomas located beside the spine. The tumor was a fusiform, round or oval mass that was sharply circumscribed and encapsulated. Pathologic results showed all 81 cases were benign schwannoma. In the 4 cases of multiple tumors,2 (2.5%) were diagnosed as double-primary tumors associated with ascending colon adenocarcinoma and lung squamous-cell cancer. One case recurred postoperatively. Conclusion: Retroperitoneal schwannoma was rare and preoperative diagnosis was difficult. Most of retroperitoneal schwannoma were benign and the surgical treatment was the first choice.

  11. Hydroxylated PBDEs induce developmental arrest in zebrafish

    Energy Technology Data Exchange (ETDEWEB)

    Usenko, Crystal Y., E-mail: Crystal_usenko@baylor.edu; Hopkins, David C.; Trumble, Stephen J., E-mail: Stephen_trumble@baylor.edu; Bruce, Erica D., E-mail: Erica_bruce@baylor.edu

    2012-07-01

    The ubiquitous spread of polybrominated diphenyl ethers (PBDEs) has led to concerns regarding the metabolites of these congeners, in particular hydroxylated PBDEs. There are limited studies regarding the biological interactions of these chemicals, yet there is some concern they may be more toxic than their parent compounds. In this study three hydroxylated PBDEs were assessed for toxicity in embryonic zebrafish: 3-OH-BDE 47, 5-OH-BDE 47, and 6-OH-BDE 47. All three congeners induced developmental arrest in a concentration-dependent manner; however, 6-OH-BDE 47 induced adverse effects at lower concentrations than the other congeners. Furthermore, all three induced cell death; however apoptosis was not observed. In short-term exposures (24–28 hours post fertilization), all hydroxylated PBDEs generated oxidative stress in the region corresponding to the cell death at 5 and 10 ppm. To further investigate the short-term effects that may be responsible for the developmental arrest observed in this study, gene regulation was assessed for embryos exposed to 0.625 ppm 6-OH-BDE 47 from 24 to 28 hpf. Genes involved in stress response, thyroid hormone regulation, and neurodevelopment were significantly upregulated compared to controls; however, genes related to oxidative stress were either unaffected or downregulated. This study suggests that hydroxylated PBDEs disrupt development, and may induce oxidative stress and potentially disrupt the cholinergic system and thyroid hormone homeostasis. -- Highlights: ► OH-PBDEs induce developmental arrest in a concentration-dependent manner. ► Hydroxyl group location influences biological interaction. ► OH-PBDEs induce oxidative stress. ► Thyroid hormone gene regulation was disrupted following exposure. ► To our knowledge, this is the first whole organism study of OH-PBDE toxicity.

  12. 2011 China's Refractories Raw Materials Symposium Held in Zhengzhou

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    @@ On April 20-22,2011,China's Refractories Raw Materials Symposium,co-sponsored by Refractories Branch of The Chinese Society for Metals and China Henan Refractory Industry Association,was held successfully in Zhengzhou,Henan Province.Over 150 delegates from 100 refractory raw materials and products enterprises,testing equipment manufacturers,raw materials trade companies,institutes,universities,testing institutions,and industrial organizations attended the symposium.Wang Shouye,secretary-general of Refractories Branch of The Chinese Society for Metals and vice president of Sinosteel Luoyang Institute of Refractories Research Co.,Ltd.,made the address of welcome.Zhang Yazhong,vice chairman of Henan Committee of the Chinese People's Political Consultative Conference and honorary chairman of China Henan Refractory Industry Association,gave a speech.

  13. Predictors for outcome among cardiac arrest patients

    DEFF Research Database (Denmark)

    Wibrandt-Johansen, Ida Maria; Norsted, Kristine; Schmidt, Henrik;

    2015-01-01

    BackgroundIn the past decade, early treatment of cardiac arrest (CA) victims has been improved in several ways, leading to more optimistic over all prognoses. However, the global survival rate after out-of-hospital CA (OHCA) is still not more than 5-10%. With a better knowledge of the predictors...... determined the 90-day mortality and neurological outcome at discharge for CA patients treated with therapeutic hypothermia (TH), in regard to determine the importance of the predictors for mortality and neurological outcome, with emphasize on combining initial rhythm and time to return of spontaneous...

  14. A case of thyroid storm with cardiac arrest

    Directory of Open Access Journals (Sweden)

    Nakashima Y

    2014-05-01

    Full Text Available Yutaka Nakashima,1 Tsuneaki Kenzaka,2 Masanobu Okayama,3 Eiji Kajii31Department for Support of Rural Medicine, Yamaguchi Grand Medical Center, 2Division of General Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan; 3Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Shimotsuke, JapanAbstract: A 23-year-old man became unconscious while jogging. He immediately received basic life support from a bystander and was transported to our hospital. On arrival, his spontaneous circulation had returned from a state of ventricular fibrillation and pulseless electrical activity. Following admission, hyperthyroidism led to a suspicion of thyroid storm, which was then diagnosed as a possible cause of the cardiac arrest. Although hyperthyroidism-induced cardiac arrest including ventricular fibrillation is rare, it should be considered when diagnosing the cause of treatable cardiac arrest.Keywords: hyperthyroidism, ventricular fibrillation, treatable cardiac arrest, cardiac arrest, cardiopulmonary arrest

  15. Pancreatitis autoinmune asociada a fibrosis retroperitoneal: evolución tras dos años de seguimiento Autoimmune pancreatitis associated with retroperitoneal fibrosis: outcome after 24 months of follow-up

    Directory of Open Access Journals (Sweden)

    M. Romero

    2008-10-01

    Full Text Available Introducción: la pancreatitis autoinmune es un tipo de pancreatitis crónica caracterizado por un infiltrado linfoplasmocitario y una elevación de IgG e IgG4, que se ha descrito asociada a diversas manifestaciones extrapancreáticas y enfermedades autoinmunes, lo cual apoya la teoría de un mecanismo autoinmune fisiopatólogico de base. Caso clínico: presentamos el caso de un varón que debutó simultáneamente con una pancreatitis autoinmune asociada a fibrosis retroperitoneal y lesión de la vía biliar extrapancreática, con respuesta total tras tratamiento con corticoides durante 4 meses y ausencia de recurrencia tras 24 meses de seguimiento. Discusión: la pancreatitis autoinmune es un tipo de pancreatitis crónica que probablemente forme parte de un proceso sistémico autoinmune, cuyas manifestaciones extrapancreáticas más frecuentes son la fibrosis retroperitoneal y las lesiones de la vía biliar extrapancreática. Su correcto diagnóstico e inicio precoz del tratamiento puede favorecer la resolución completa de las lesiones, principalmente en los casos de bajo grado de actividad, con menor probabilidad de recurrencia.Introduction: autoimmune pancreatitis is a kind of chronic pancreatitis characterized by the presence of lymphoplasmacytic infiltration and severely elevated serum IgG and IgG4, which has been associated to many extrapancreatic lesions and other autoimmune disorders, leading to the theory of an autoimmune mechanism involved in the pathogenesis of this disease. Case report: we report the case of a man who simultaneously presented with autoimmune pancreatitis associated with retroperitonal fibrosis, and a lesion of the extrapancreatic bile duct, with total response to corticosteroid treatment for 4 moths and absence of recurrence after 24 months of follow-up. Discussion: autoimmune pancreatitis is a kind of chronic pancreatitis that is probably a part of a systemic autoinmune disease, with retroperitoneal fibrosis and

  16. Electrothermal model for complete metal-oxide surge arresters

    Energy Technology Data Exchange (ETDEWEB)

    Costa, E. Guedes da; Naidu, S.R. [UFPB, Dept. of Electrical Engineering, Campina Grande, PB (Brazil); Lima, A. Guedes de [CEFET-PB, Dept. of Mechanical Engineering, Joao Pessoa, PB (Brazil)

    2001-01-01

    A computational, electrothermal model for a complete metal-oxide surge arrester based on the implicit form of the finite-differences method is presented. The model is used to calculate the cooling curve after the application of overvoltages and the temperature variations during standard test. The model has been checked against experiments carried out on a test section and a complete surge arrester and the behaviour of a hypothetical surge arrester during standard tests simulated. (Author)

  17. Postoperative cardiac arrest in children with congenital heart abnormalities

    OpenAIRE

    2013-01-01

    BACKGROUND The exact survival rates and markers of survival after postoperative cardiac arrest in children with congenital heart abnormalities are unknown. METHODS In this one-year study, we identified children younger than seven years of age with postoperative cardiac arrest in our pediatric cardiac intensive care unit database. Parameters from perioperative, pre-arrest, and resuscitation periods were analyzed for these patients. Comparisons were made between survivors and non-survivors afte...

  18. [The assesment of significance of the retroperitoneal lymph node dissection in proximity of metastatic tumor with main vessels in patients with germ cell testicular tumors].

    Science.gov (United States)

    Tereshin, O S; Zotov, S P; Vazhenin, A V; Mamonova, A O

    2013-01-01

    The therapeutic approach should be defined more exactly in proximity of residual retroperitoneal metastases of germ cell testicular tumor and main vessels (left after chemotherapy). The data of 29 (24%) patients were analyzed over a period of time since 2003 till 2011. The general survival was 82% in the group without lymph node dissection (17 patients) in median observation of 27.5 months. The proximity with main vessels was registered in half of the cases in the group of operated patients (12 people), a single vascular reconstruction was required. The general survival was 97% in median observation for 35 months. The involvement of main vessels of retroperitoneal space significantly complicated the retroperitoneal lymph node dissection, but didn't have negative prognostic value.

  19. Primary retroperitoneal mucinous cystadenoma with a sarcoma-like mural nodule: an immunohistochemical study with histogenetic considerations and literature review.

    Science.gov (United States)

    Demirel, Dilaver; Gun, Ismet; Kucukodaci, Zafer; Balta, Ahmet Ziya; Ramzy, Ibrahim

    2013-01-01

    Primary retroperitoneal mucinous cystadenomas (PRMCs) are extremely rare tumors and their association with sarcoma-like mural nodules (SLMNs) has not been described thoroughly. The aim of this study is to characterize the gross and microscopic features and the immunohistochemical profile of the first case of PRMC with SLMN and to discuss the differential diagnosis of SLMNs. The literature related to primary retroperitoneal mucinous tumors is reviewed in an attempt to clarify the histogenesis of the epithelial and sarcomatoid components of the associated mural nodules. A 34-yr-old woman presented with a 14-cm retroperitoneal cystic lesion with a 6-cm mural nodule. An immunohistochemical study with a panel of 19 antibodies and a histochemical study for mucin stains were performed. The epithelial component of the PRMC showed positive staining for cytokeratin (CK) 7, CK AE1/3, epithelial membrane antigen, carcinoembryonic antigen, and calretinin. The neoplasm was not immunoreactive for CK 20, CK 5/6, and the other antibodies used in this study. In addition, it stained positively for mucin by mucicarmine, periodic acid-Schiff, and Alcian blue. The stromal cells of the cyst showed estrogen receptor positivity. SLMN cells were negative for all CKs and other epithelial markers used in the study, but they showed diffuse positive staining for vimentin and CD68, and positive staining for Ki-67 was demonstrated in 25% of these cells. The immunohistochemical and histochemical profiles of PRMC were similar to those of ovarian mucinous neoplasms and the mesothelium. The formation of SLMNs seems to be related to subepithelial hemorrhage and some reactive epithelial changes near the mural nodules. The specific immunohistochemical and morphologic features of SLMNs are helpful in differentiating them from malignant mural nodules, including true sarcomas, osteoclast-rich undifferentiated carcinomas, and carcinosarcomas. Such a differentiation is critical in view of its significant

  20. Partial nephroureterectomy in duplex renal system: preoperative 3D virtual rendering and retroperitoneal laparoscopic approach in children

    Directory of Open Access Journals (Sweden)

    Molinaro F.

    2013-10-01

    Full Text Available Introduction: the aim of this study is to presents the results of our preliminary series of 8 partial nephroureterectomy performed by retroperitoneoscopy using harmonic scalpel with a preoperative 3D virtual reconstruction of bidimensional magnetic resonance images in children affected by duplication of the renal system. Materials and methods: We perform a retrospective study in our Pediatric Surgery Unit from January 2007 to January 2012 of all children affected by duplication of the renal system treated by retroperitoneal laparoscopic approach. Images collected were reconstructed using IRCAD VR render software. Data include: sex, age at surgery, clinical and radiological features, surgical procedure, follow-up and complications. Results: retroperitoneal laparoscopic partial nephroureterectomy was performed in 8 children (6 males and 2 females. All patients had a non-functioning moiety of a duplex kidney and in addition recurrent urinary tract infections. Two cases were associated with ureterocele; of them in one case we performed a previous endoscopic incision of the obstructing ureterocele. All patients underwent radiological evaluation prior to surgery, by ultrasound, voididng cystourethrography, renal scintigraphy and contrast-enhanced MRI evaluations. Images collected were reconstructed using IRCAD VR render software. Patients were treated by a 3-4 trocars technique and parenchymal section was performed using harmonic scalpel. The mean operative time was 180 minutes; no cases required open conversion. The mean hospital stay was 5 days. The mean follow-up was 38 months. No cases of secondary atrophy of the lower pole were observed. Discussion: Volume rendering gives high anatomical resolution and it can be useful to guide the surgical procedure. Laparoscopic retroperitoneal partial nephrectomy is a safe and feasible procedure in children for experienced pediatric laparoscopic surgeons.

  1. Radical pancreatoduodenectomy combined with retroperitoneal nerve,lymph,and soft-tissue dissection in pancreatic head cancer

    Institute of Scientific and Technical Information of China (English)

    SHAO Qin-shu; YE Zai-yuan; LI Shu-guang; CHEN Kan

    2008-01-01

    Background Recent studies have revealed that the reason for the low surgical resection rate of pancreatic carcinoma partly lies in its biological behavior,which is characterized by neural infiltration.This study aimed to investigate the clinical significance of radical pancreatOduodenectomy combined with retroperitoneal nerve,lymph,and soft-tissue dissection for carcinoma of the pancreatic head.Methods Forty-six patients with pancreatic head cancer were treated in our hospital from 1995 to 2005.The patients were divided into two groups:radical pancreatoduodenectomy combined with retroperitoneal nerve,lymph and soft-tissue dissection (group A,n=25) and routine Whipple's operation (group B,n=21).There were no significant differences between the two groups in relation to age,gender and preoperative risk factors,and perioperative conditions,pathological data and survival rates were studied.Results There were no significant differences in tumor size,surgical procedure time,postoperative complications,and time of hospitalization.However,the number and positive rate of resected lymph nodes in group A were significantly higher than those in group B (P<0.05).The 1-and 3-year survival rate in group A were 80% and 53%,respectively,which was higher than those in group B (P<0.05).There were significant differences in the survival rates between patients with and without nerve infiltration in group A (P<0.05).Conclusions Radical pancreatoduodenectomy combined with retroperitoneal nerve,lymph and soft-tissue dissection,can effectiveoly remove the lymph and nerve tissues that were infiltrated by tumor.Meanwhile,this method can reduce the local recurrence rate so as to improve the long-term survival of patients.

  2. EXTRASOLAR REFRACTORY-DOMINATED PLANETESIMALS: AN ASSESSMENT

    Energy Technology Data Exchange (ETDEWEB)

    Jura, M.; Xu, S., E-mail: jura@astro.ucla.edu, E-mail: sxu@astro.ucla.edu [Department of Physics and Astronomy, University of California, Los Angeles, CA 90095-1562 (United States)

    2013-02-01

    Previously published observations of 60 externally polluted white dwarfs show that none of the stars have accreted from intact refractory-dominated parent bodies composed mainly of Al, Ca, and O, although planetesimals with such a distinctive composition have been predicted to form. We propose that such remarkable objects are not detected by themselves because, unless they are scattered outward from their initial orbit, they are engulfed and destroyed during the star's asymptotic giant branch evolution. As yet, there is at most only weak evidence supporting a scenario where the composition of any extrasolar minor planet can be explained by blending of an outwardly scattered refractory-dominated planetesimal with an ambient asteroid.

  3. [Liposteroid therapy for refractory epileptic spasms].

    Science.gov (United States)

    Shimono, Kuriko Kagitani; Imai, Katsumi; Idoguchi, Rie; Kamio, Noriko; Okinaga, Takeshi; Ozono, Keiichi

    2003-11-01

    Liposteroid was administered intravenously to 6 patients with refractory epileptic spasms. In one case, the spasms initially disappeared but then reappeared after three months. Another case had a transient and slight decrease of epileptic spasms. In the only patient in whom spasms disappeared, EEG abnormalities were greatly improved with diffuse spikes and waves changing into focal spikes. Two cases displayed hyperexcitability, insomnia and acting out behavior, and the therapy was discontinued in one of them. One case had appetite loss and another showed an increase in tonic seizures. No patient had serious adverse effects such as infection, edema, subdural hematoma and brain shrinkage. Although liposteroid therapy has been recommended as an easy, useful and safe alternative for ACTH, we found considerable adverse effects and only a small effect on refractory spasms, and conclude that the regimen should be modified.

  4. Midazolam and pentobarbital for refractory status epilepticus.

    Science.gov (United States)

    Holmes, G L; Riviello, J J

    1999-04-01

    Status epilepticus, a serious, life-threatening emergency characterized by prolonged seizure activity, occurs most commonly in pediatric patients. Although initial therapies with agents such as diazepam, phenytoin, or phenobarbital generally terminate seizure activity within 30-60 minutes, patients with refractory status epilepticus (RSE) lasting longer require additional intervention. High-dose pentobarbital has been the most commonly prescribed agent for the management of RSE in children; however, midazolam has emerged as a new treatment option. This review compares the use of midazolam with pentobarbital in published reports of pediatric RSE. Both drugs effectively terminated refractory seizure activity, although pentobarbital use was complicated by hypotension, delayed recovery, pneumonia, and other adverse effects. Midazolam use was effective and well tolerated, affirming its value in pediatric RSE management.

  5. Open surgery versus retroperitoneal laparoscopic nephrectomy for renal tuberculosis: a retrospective study of 120 patients

    Directory of Open Access Journals (Sweden)

    Su Zhang

    2016-11-01

    Full Text Available Background Laparoscopic renal surgery has been widely used in the treatment of renal diseases. However, there is still little research about its application in addressing renal tuberculosis. The purpose of this study is to retrospectively investigate the surgical results of laparoscopic and open surgery for nonfunctional tuberculous kidneys. Methods Between May 2011 and June 2016, 120 nephrectomies were performed in patients with a nonfunctional tuberculous kidney. Of these, 69 patients underwent retroperitoneal laparoscopic nephrectomy, and 51 patients underwent open nephrectomy. Data about the patients’ characteristics and surgical outcomes were collected from their electronic medical records. Outcomes were compared between these two groups. Results Our results showed that a number of renal tuberculosis patients presented no significant symptoms during their disease. Lower urinary tract symptoms (LUTS were the most common at a rate of 73/120, followed by flank pain or accidently discovery (66/120, urine abnormality (30/120 and fever (27/120. Patients who underwent open surgery were similar to laparoscopic patients with regard to sex, BMI, location, previous tuberculous history, grade, anemia, adhesion, hypertension, diabetes and preoperative serum creatinine level, but were generally older than laparoscopic patients. There were no significant differences between open and laparoscopic surgery in estimated blood loss, transfusion, postoperative hospital days and perioperative complication rate. However, the median operation time of laparoscopic operation was much longer than open surgery (180 [150–225] vs 135 [120–165] minutes, P < 0.01. Seven of the 69 laparoscopic operations were converted to open surgery because of severe adhesions. Conclusion Laparoscopic nephrectomy is as an effective treatment as open surgery for a nonfunctional tuberculous kidney, although it requires more time during the surgical procedure. No significant

  6. Treatment Guidelines for Preoperative Radiation Therapy for Retroperitoneal Sarcoma: Preliminary Consensus of an International Expert Panel

    Energy Technology Data Exchange (ETDEWEB)

    Baldini, Elizabeth H., E-mail: ebaldini@partners.org [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Wang, Dian [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); Haas, Rick L.M. [Department of Radiotherapy, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Catton, Charles N. [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Indelicato, Daniel J. [Department of Radiation Oncology, University of Florida Medical Center, Jacksonville, Florida (United States); Kirsch, David G. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Roberge, David [Department of Radiation Oncology, Centre Hospitalier de l' Université de Montreal, Montreal, Quebec (Canada); Salerno, Kilian [Department of Radiation Oncology, Roswell Park Cancer Institute, Buffalo, New York (United States); Deville, Curtiland [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Sidney Kimmel Cancer Center, Washington, DC (United States); Guadagnolo, B. Ashleigh [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); O' Sullivan, Brian [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Petersen, Ivy A. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Le Pechoux, Cecile [Department of Radiotherapy, Institut Gustave-Roussy, Villejuif (France); Abrams, Ross A. [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2015-07-01

    Purpose: Evidence for external beam radiation therapy (RT) as part of treatment for retroperitoneal sarcoma (RPS) is limited. Preoperative RT is the subject of a current randomized trial, but the results will not be available for many years. In the meantime, many practitioners use preoperative RT for RPS, and although this approach is used in practice, there are no radiation treatment guidelines. An international expert panel was convened to develop consensus treatment guidelines for preoperative RT for RPS. Methods and Materials: An expert panel of 15 academic radiation oncologists who specialize in the treatment of sarcoma was assembled. A systematic review of reports related to RT for RPS, RT for extremity sarcoma, and RT-related toxicities for organs at risk was performed. Due to the paucity of high-quality published data on the subject of RT for RPS, consensus recommendations were based largely on expert opinion derived from clinical experience and extrapolation of relevant published reports. It is intended that these clinical practice guidelines be updated as pertinent data become available. Results: Treatment guidelines for preoperative RT for RPS are presented. Conclusions: An international panel of radiation oncologists who specialize in sarcoma reached consensus guidelines for preoperative RT for RPS. Many of the recommendations are based on expert opinion because of the absence of higher level evidence and, thus, are best regarded as preliminary. We emphasize that the role of preoperative RT for RPS has not been proven, and we await data from the European Organization for Research and Treatment of Cancer (EORTC) study of preoperative radiotherapy plus surgery versus surgery alone for patients with RPS. Further data are also anticipated pertaining to normal tissue dose constraints, particularly for bowel tolerance. Nonetheless, as we await these data, the guidelines herein can be used to establish treatment uniformity to aid future assessments of efficacy

  7. Retroperitoneal liposarcoma; The role of adjuvant radiation therapy and the prognostic factors

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hong Seok; Yu, Jeong Il; Lim, Do Hoon; Kim, Sung Joo [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2016-09-15

    To evaluate the benefit of adjuvant radiation therapy (RT) for retroperitoneal liposarcoma (RPLS) following gross tumor removal. We reviewed 77 patients with primary RPLS surgically treated between January 2000 and December 2013. Cases with gross residual disease were excluded. Tumor grade was evaluated according to the French Federation of Cancer Centers Sarcoma Group (FNCLCC) system. Adjuvant RT was delivered to 32 patients (42%) using external beam RT alone. Median follow-up time was 36 months (range, 5 to 169). Among 77 patients, 33 (43%) presented with well-differentiated, 31 (40%) with de-differentiated, 8 (10%) with myxoid/round and 4 (5%) with pleomorphic morphology. The RT group included less well-differentiated subtype than surgery group (28% vs. 53%). During follow up, 34 patients (44%) showed local recurrence. Local recurrence rate was lower in the RT group (38%) compared to the surgery group (49%). The 3-year local control rate (LC) was 55.6%, and the 3-year overall survival (OS) was 82.1%. Tumor histology and FNCLCC grade were significantly associated with local recurrence. There was no statistical significance of adding adjuvant RT in LC (p = 0.312). However, patients with tumor histology other than well-differentiated subtype showed marginally decreased local recurrence rate after adjuvant RT (3-year LC, RT 43.9% vs. no RT 35.3%; p = 0.087). RPLS patients receiving RT experienced less local recurrence. We suggest that the addition of adjuvant RT may be related to improvement of LCs, especially in patients with non-favorable histologic subtypes.

  8. Combined Modality Management of Retroperitoneal Sarcomas: A Single-Institution Series of 121 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Bishop, Andrew J.; Zagars, Gunar K. [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); Torres, Keila E.; Hunt, Kelly K.; Cormier, Janice N.; Feig, Barry W. [Department of Surgical Oncology, MD Anderson Cancer Center, Houston, Texas (United States); Guadagnolo, B. Ashleigh, E-mail: aguadagn@mdanderson.org [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, MD Anderson Cancer Center, Houston, Texas (United States)

    2015-09-01

    Purpose: The purpose of this study was to investigate local control, survival outcomes, and complication rates of patients treated with aggressive surgery and radiation therapy (RT) for retroperitoneal sarcomas (RPS). Methods and Materials: We reviewed the medical records of 121 consecutive patients treated for RPS with surgery and RT between 1965 and 2012. The most common histology was liposarcoma (n=42; 35%). The median follow-up was 100 months (range: 20-467 months). Eighty-six patients (71%) were treated for initial presentation of RPS, and 35 patients (29%) presented with and were treated for RPS recurrence. RT was preoperative in 88 patients (73%; median dose: 50.4 Gy) and postoperative in 33 patients (27%; median dose: 55 Gy). Results: Five-year local control and overall survival rates were 56% and 57%, respectively. Two factors were associated with higher risk of any intra-abdominal recurrence at 5 years: positive or uncertain margins (58% vs 30% for negative margins, P<.001; hazard ratio [HR]: 2.7; 95% confidence interval [CI]: 1.6-4.8) and disease recurrence after previous resection (76% vs 31% for de novo RPS, P<.001; HR: 4.4; 95% CI: 2.5-7.5). The 10-year complication rate was 5%, and RT-related complications were associated with postoperative RT (P<.001) and RT dose of ≥60 Gy (P<.001). Conclusions: Intra-abdominal RPS recurrence continues to be a significant challenge despite the use of aggressive surgery and radiation therapy. Given the complications associated with postoperative radiation therapy, we recommend that preoperative radiation therapy is the preferred strategy when combined modality therapy is recommended.

  9. Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement Among NRG Sarcoma Radiation Oncologists

    Energy Technology Data Exchange (ETDEWEB)

    Baldini, Elizabeth H., E-mail: ebaldini@partners.org [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Abrams, Ross A. [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); Bosch, Walter [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); Roberge, David [Department of Radiation Oncology, Centre Hospitalier de l' Universite de Montreal, Montreal, Quebec (Canada); Haas, Rick L.M. [Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam (Netherlands); Catton, Charles N. [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Indelicato, Daniel J. [Department of Radiation Oncology, University of Florida Medical Center, Jacksonville, Florida (United States); Olsen, Jeffrey R. [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); Deville, Curtiland [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Chen, Yen-Lin [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Finkelstein, Steven E. [Translational Research Consortium, 21st Century Oncology, Scottsdale, Arizona (United States); DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Wang, Dian [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States)

    2015-08-01

    Purpose: The purpose of this study was to evaluate the variability in target volume and organ at risk (OAR) contour delineation for retroperitoneal sarcoma (RPS) among 12 sarcoma radiation oncologists. Methods and Materials: Radiation planning computed tomography (CT) scans for 2 cases of RPS were distributed among 12 sarcoma radiation oncologists with instructions for contouring gross tumor volume (GTV), clinical target volume (CTV), high-risk CTV (HR CTV: area judged to be at high risk of resulting in positive margins after resection), and OARs: bowel bag, small bowel, colon, stomach, and duodenum. Analysis of contour agreement was performed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. Results: Ten radiation oncologists contoured both RPS cases, 1 contoured only RPS1, and 1 contoured only RPS2 such that each case was contoured by 11 radiation oncologists. The first case (RPS 1) was a patient with a de-differentiated (DD) liposarcoma (LPS) with a predominant well-differentiated (WD) component, and the second case (RPS 2) was a patient with DD LPS made up almost entirely of a DD component. Contouring agreement for GTV and CTV contours was high. However, the agreement for HR CTVs was only moderate. For OARs, agreement for stomach, bowel bag, small bowel, and colon was high, but agreement for duodenum (distorted by tumor in one of these cases) was fair to moderate. Conclusions: For preoperative treatment of RPS, sarcoma radiation oncologists contoured GTV, CTV, and most OARs with a high level of agreement. HR CTV contours were more variable. Further clarification of this volume with the help of sarcoma surgical oncologists is necessary to reach consensus. More attention to delineation of the duodenum is also needed.

  10. Evaluation of CT findings for the differentiation of benign from malignant primary retroperitoneal tumors

    Institute of Scientific and Technical Information of China (English)

    Zhu Zheng; Zhao Xinming; Zhao Yanfeng; Yang Lei; Zhao Jing; Dai Jingrui; Zhou Chunwu

    2014-01-01

    Background Benign and malignant primary retroperitoneal tumors (RT) have different pathological manifestations,and overlapping imaging characteristics.This study aimed to evaluate the value of computed tomography (CT) for differentiating benign from malignant RT.Methods One hundred and ninety-four patients with clinical and radiographic data were evaluated retrospectively following surgical resection of primary RT.There were 38.1% (n=74) benign lesions and 61.9% (n=120) malignant lesions.Categorical variables were tested with a chi-square test or Fisher's exact test for the diagnostic indexes and sensitivity and specificity of CT characteristics.Results In univariate analysis,the differences in ill-defined margins,irregular surfaces,long diameter >6.75 cm,short diameter >6.25 cm,and solid or mixed texture had statistical significance; the sensitivity and specificity were 44.2% and 91.9%,70.0% and 62.2%,68.8% and 60.7%,59.7% and 74.2%,87.5% and 35.1%,respectively.In multivariate analysis,a combination of all the above indexes was the best model for differentiating malignant tumors,resulting in the most accurate diagnosis of malignancies with a sensitivity of 77.2% and a specificity of 81.1% (P<0.0001) when the score was 4.The differences in other findings including CT attenuation,number,and calcification had no statistical significance.The unique characteristics included the spotted enhancement (mottled high density)in schwannoma (P<0.0001),adipose tissue in liposarcoma (P<0.0001)and paravertebral location in neurogenic tumors (P<0.0001).Conclusions More accurate differential diagnosis of primary RT can be made through comprehensive analysis of the combined diagnostic indexes of CT.Some specific characteristics of CT can assist in preoperative planning.

  11. Complete recovery after the removal of an ectopic testicle in a case of primary reninism and retroperitoneal hemangioma

    Institute of Scientific and Technical Information of China (English)

    Bernhard Glodny; Alexandar Tzankov; Germar-Michael Pinggera; Johannes Petersen; Ralf Herwig

    2006-01-01

    A 32-year-old man recovered completely from hypokalemic hypertension that had been caused by primary reninism after the ablation of an ectopic left testis, epididymis and ductus deferens. For several years, severe hypertension has been resistant to treatment, even the concurrent administration of up to seven antihypertensive agents. In this case,cryptorchidism was associated with an indirect inguinal hernia and an open peritoneo-vaginal process on both sides,aplasia of the posterior wall of the inguinal canal on the right side, an umbilical hernia, and a retroperitoneal tendrillar hemangioma.

  12. 腹膜后纤维化的影像学表现%Imaging manifestation of retroperitoneal fibrosis

    Institute of Scientific and Technical Information of China (English)

    倪瑞军

    2009-01-01

    腹膜后纤维化(Retroperitoneal fibrosis,RPF)临床少见,现有文献仅笼统提及RPF分布于腹膜后,侵犯以腹主动脉(Abdominal aorta,AO)为主的空腔脏器,其详细分布及形态特点未见有文献专门论述。本文主要分析RPF这方面的特点。

  13. Molecular sidebands of refractory elements for ISOL

    Energy Technology Data Exchange (ETDEWEB)

    Kronenberg, A. [Oak Ridge Associated Universities, Oak Ridge (United States)], E-mail: kronenberga@ornl.gov; Spejewski, E.H.; Carter, H.K.; Mervin, B.; Jost, C. [Oak Ridge Associated Universities, Oak Ridge (United States); Stracener, D.W. [Oak Ridge National Laboratory, TN 37831 (United States); Lapi, S. [TRIUMF (Canada); Bray, T. [Auburn University (United States)

    2008-10-15

    The formation of molecular sidebands of refractory elements, such as V, Re, Zr, Mo, Tc, is discussed. The focus is on in situ sideband formation and its advantage for the release process. An atomic {sup 48}V beam has been produced in a two step process, forming the oxide in situ, transporting it through the target-ion source as a chloride and destroying the chlorine sideband in the ion source. The sideband formation of Re, Zr, Mo, Tc is discussed.

  14. Molecular Sidebands of Refractory Elements for ISOL

    Energy Technology Data Exchange (ETDEWEB)

    Kronenberg, Andreas [Oak Ridge Associated Universities (ORAU); Spejewski, Eugene H. [Oak Ridge Associated Universities (ORAU); Carter, H Kennon [Oak Ridge Associated Universities (ORAU); Mervin, Brenden T. [Oak Ridge Associated Universities (ORAU); Jost, Cara [Oak Ridge Associated Universities (ORAU); Stracener, Daniel W [ORNL; Lapi, Suzanne [TRIUMF, Canada; Bray, T. H. [Auburn University, Auburn, Alabama

    2008-01-01

    The formation of molecular sidebands of refractory elements, such as V, Re, Zr, Mo, Tc, is discussed. The focus is on in situ sideband formation and its advantage for the release process. An atomic 48V beam has been produced in a two step process, forming the oxide in situ, transporting it through the target-ion source as a chloride and destroying the chlorine sideband in the ion source. The sideband formation of Re, Zr, Mo, Tc is discussed.

  15. Posaconazole treatment of refractory eumycetoma and chromoblastomycosis.

    Science.gov (United States)

    Negroni, Ricardo; Tobón, Angela; Bustamante, Beatriz; Shikanai-Yasuda, Maria Aparecida; Patino, Hernando; Restrepo, Angela

    2005-01-01

    Eumycetoma and chromoblastomycosis are chronic, disfiguring fungal infections of the subcutaneous tissue that rarely resolve spontaneously. Most patients do not achieve sustained long-term benefits from available treatments; therefore, new therapeutic options are needed. We evaluated the efficacy of posaconazole, a new extended-spectrum triazole antifungal agent, in 12 patients with eumycetoma or chromoblastomycosis refractory to existing antifungal therapies. Posaconazole 800 mg/d was given in divided doses for a maximum of 34 months. Complete or partial clinical response was considered a success; stable disease or failure was considered a nonsuccess. All 12 patients had proven infections refractory to standard therapy. Clinical success was reported for five of six patients with eumycetoma and five of six patients with chromoblastomycosis. Two patients were reported to have stable disease. As part of a treatment-use extension protocol, two patients with eumycetoma who initially had successful outcome were successfully retreated with posaconazole after a treatment hiatus of > 10 months. Posaconazole was well tolerated during long-term administration (up to 1015 d). Posaconazole therapy resulted in successful outcome in most patients with eumycetoma or chromoblastomycosis refractory to standard therapies, suggesting that posaconazole may be an important treatment option for these diseases.

  16. Barrier Coatings for Refractory Metals and Superalloys

    Energy Technology Data Exchange (ETDEWEB)

    SM Sabol; BT Randall; JD Edington; CJ Larkin; BJ Close

    2006-02-23

    In the closed working fluid loop of the proposed Prometheus space nuclear power plant (SNPP), there is the potential for reaction of core and plant structural materials with gas phase impurities and gas phase transport of interstitial elements between superalloy and refractory metal alloy components during service. Primary concerns are surface oxidation, interstitial embrittlement of refractory metals and decarburization of superalloys. In parallel with kinetic investigations, this letter evaluates the ability of potential coatings to prevent or impede communication between reactor and plant components. Key coating requirements are identified and current technology coating materials are reviewed relative to these requirements. Candidate coatings are identified for future evaluation based on current knowledge of design parameters and anticipated environment. Coatings were identified for superalloys and refractory metals to provide diffusion barriers to interstitial transport and act as reactive barriers to potential oxidation. Due to their high stability at low oxygen potential, alumina formers are most promising for oxidation protection given the anticipated coolant gas chemistry. A sublayer of iridium is recommended to provide inherent diffusion resistance to interstitials. Based on specific base metal selection, a thin film substrate--coating interdiffusion barrier layer may be necessary to meet mission life.

  17. IMPROVED CORROSION RESISTANCE OF ALUMINA REFRACTORIES

    Energy Technology Data Exchange (ETDEWEB)

    John P. Hurley; Patty L. Kleven

    2001-09-30

    The initial objective of this project was to do a literature search to define the problems of refractory selection in the metals and glass industries. The problems fall into three categories: Economic--What do the major problems cost the industries financially? Operational--How do the major problems affect production efficiency and impact the environment? and Scientific--What are the chemical and physical mechanisms that cause the problems to occur? This report presents a summary of these problems. It was used to determine the areas in which the EERC can provide the most assistance through bench-scale and laboratory testing. The final objective of this project was to design and build a bench-scale high-temperature controlled atmosphere dynamic corrosion application furnace (CADCAF). The furnace will be used to evaluate refractory test samples in the presence of flowing corrodents for extended periods, to temperatures of 1600 C under controlled atmospheres. Corrodents will include molten slag, steel, and glass. This test should prove useful for the glass and steel industries when faced with the decision of choosing the best refractory for flowing corrodent conditions.

  18. [Renal replacement therapy for refractory heart failure].

    Science.gov (United States)

    Schwenger, V; Remppis, A B

    2012-07-01

    After broad cardiological and nephrological evaluation and consideration of optimal conservative options according to national and international guidelines, renal replacement therapy might be helpful in patients with refractory heart failure even if they are not dialysis-dependent. This is even more important as renal failure is a strong predictor for mortality in patients with severe congestive heart failure (CHF) and CHF is one of the fastest growing morbidities in western countries. Although peritoneal dialysis (PD) is frequently used in patients with CHF its role remains unclear. Acute chronic volume overload in refractory CHF is still an unresolved clinical problem. In patients with acute heart and renal failure with need of management in an intensive care unit, extracorporeal ultrafiltration or a dialysis modality should be preferred. In patients with chronic refractory CHF, volume overload and renal failure, peritoneal dialysis should be the therapy of choice. Due to the limited data available, treatment and outcome parameters should be recorded in the registry of the German Society of Nephrology (http://www.herz-niere.de).

  19. Synchronous transperitoneal laparoscopic resection of right retroperitoneal schwannoma and left kidney monotypic PEComa in the presence of a duplicated inferior vena cava (IVC).

    Science.gov (United States)

    Yang, Bo; Wang, Linhui; Wu, Zhenjie; Li, Mingmin; Wang, Huiqing; Sheng, Jing; Huang, Jun; Liao, Songbai; Sun, Yinghao

    2012-07-01

    A 21-year-old female presented with a retroperitoneal mass in the right side and a centrally located renal mass in the left kidney with an aberrant vascular anatomy of a double inferior vena cava. The 2 tumors were radically excised by a transperitoneal laparoscopic approach in one session. Histopathologic examination revealed the right retroperitoneal lesion to be a schwannoma and the renal mass to be a cluster of monotypic neoplasms with perivascular epithelioid cell differentiation (PEComas). The latter is a rare tumor.

  20. Comprehensive Creep and Thermophysical Performance of Refractory Materials

    Energy Technology Data Exchange (ETDEWEB)

    Ferber, M.K.; Wereszczak, A.; Hemrick, J.A.

    2006-06-29

    Furnace designers and refractory engineers recognize that optimized furnace superstructure design and refractory selection are needed as glass production furnaces are continually striving toward greater output and efficiencies. Harsher operating conditions test refractories to the limit, while changing production technology (such as the conversion to oxy-fuel from traditional air-fuel firing) can alter the way the materials perform [1-3]. Refractories for both oxy- and air-fuel fired furnace superstructures (see Fig. 1) are subjected to high temperatures that may cause them to creep excessively or subside during service if the refractory material is not creep resistant, or if it is subjected to high stress, or both. Furnace designers can ensure that superstructure structural integrity is maintained if the creep behavior of the refractory material is well understood and well represented by appropriate engineering creep models. Several issues limit the abilities of furnace designers to (1) choose the optimum refractory for their applications, (2) optimize the engineering design, or (3) predict the service mechanical integrity of their furnace superstructures. Published engineering creep data are essentially nonexistent for almost all commercially available refractories used for glass furnace superstructures. The limited data that do exist are supplied by the various refractory suppliers. Unfortunately, the suppliers generally have different ways of conducting their mechanical testing, and they interpret and report their data differently. This inconsistency makes it hard for furnace designers to draw fair comparisons between competing grades of candidate refractories. Furthermore, the refractory suppliers' data are often not available in a form that can be readily used for furnace design or for the prediction and design of long-term structural integrity of furnace superstructures. As a consequence, the U.S. Department of Energy (DOE) Industrial Technology Program

  1. Export and Import Situation of Refractories and Refractory Raw Materials in China

    Institute of Scientific and Technical Information of China (English)

    PANShangxin; ZHANGZhongqi; 等

    2000-01-01

    The article states China is a great nation in producing and exporting refractories and refractory raw materials,which, has earned much foreign exchange for our country ,only a few advanced refactory material, zircon and chrome ore are needed to be imported.The ar-ticle points out the problems in the export and import,and raises suggestions on development.After the entry of WTO,China will expand its co-operations with other countries in science,technology,economy and trade to play a more important role in the world market.

  2. Development and Application of Refractory Materials for Molten Aluminum Applications

    Energy Technology Data Exchange (ETDEWEB)

    Hemrick, James Gordon [ORNL; Headrick, William [University of Missouri, Rolla; Peters, Klaus-Markus [ORNL

    2008-01-01

    Two new refractory materials have been developed for use in molten aluminum contact applications which exhibit improved corrosion and wear resistance, along with improved thermal management through reduced heat losses. The development of these materials was based on understanding of the corrosion and wear mechanisms associated with currently used aluminum contact refractories through physical, chemical, and mechanical characterization and analysis performed by Oak Ridge National Laboratory (ORNL) and the University of Missouri, Rolla (UMR) along with their industrial partners, under the ITP Materials project "Multifunctional Metallic and Refractory Materials for Energy Efficient Handling of Molten Metals". Spent castable refractories obtained from a natural gas fired reverberatory aluminum alloy melting furnace were analyzed leading to identification of several refractory degradation mechanisms and strategies to produce improved materials. The newly developed materials have been validated through both R&D industrial trials and independent commercial trials by the refractory manufacturers.

  3. Resuscitation, prolonged cardiac arrest, and an automated chest compression device

    DEFF Research Database (Denmark)

    Risom, Martin; Jørgensen, Henrik; Rasmussen, Lars S;

    2010-01-01

    The European Resuscitation Council's 2005 guidelines for cardiopulmonary resuscitation (CPR) emphasize the delivery of uninterrupted chest compressions of adequate depth during cardiac arrest.......The European Resuscitation Council's 2005 guidelines for cardiopulmonary resuscitation (CPR) emphasize the delivery of uninterrupted chest compressions of adequate depth during cardiac arrest....

  4. Evolution of the dragonfly head-arresting system

    Science.gov (United States)

    Gorb, S. N.

    1999-01-01

    The arrester or fixation system of the head in adult Odonata is unique among arthropods. This system involves the organs of two body segments: the head and the neck. It consists of a skeleton–muscle apparatus that sets the arrester parts in motion. The parts comprise formations covered with complicated microstructures: fields of microtrichia on the rear surface of the head and post-cervical sclerites of the neck. The arrester immobilizes the head during feeding or when the dragonfly is in tandem flight. Thus, it may serve as an adaptation to save the head from violent mechanical disturbance and to stabilize gaze in a variety of behavioural situations. This study shows the evolutionary trend of the arrester in the order Odonata by using scanning electron microscopy and measurements of arrester structures in 227 species from 26 odonate families. The arrester design occurring in the Epiophlebiidae, Gomphidae, Neopetaliidae, Petaluridae and Chlorogomphinae is suggested to be the basic one. Two convergent pathways of head-arrester evolution among Zygoptera and Anisoptera are proposed. The possible functional significance of the arrester system is discussed.

  5. Predictive Value of Brain Arrest Neurological Outcome Scale (BrANOS) on Mortality and Morbidity After Cardiac Arrest

    Science.gov (United States)

    Şahutoğlu, Cengiz; Uyar, Mehmet; Demirağ, Kubilay; İsayev, Hasan; Moral, Ali Reşat

    2016-01-01

    Objective There are several prediction scales and parameters for prognosis after a cardiac arrest. One of these scales is the brain arrest neurological outcome scale (BrANOS), which consists of duration of cardiac arrest, Glasgow Coma Scale score and Hounsfield unit measured on cranial computed tomography (CT) scan. The objective of this study is to investigate the effectiveness of BrANOS on predicting the mortality and disability after a cardiac arrest. Methods We retrospectively investigated cardiac arrest patients who were hospitalized in our intensive care unit (ICU) within a 3-year period. Inclusion criteria were age over 18 years old, survival of more than 24 hours after cardiac arrest and availability of cranial CT. We recorded the age, sex, diagnosis, duration of cardiac arrest and hospital stay, mortality, Glasgow Outcome Score (GOS) and BrANOS score. The primary endpoint of the study was to establish the relationship between mortality and BrANOS score in patients who survived for more than 24 hours after a cardiac arrest. The secondary endpoint of the study was to determine the 2-year life expectancy and GOS after cardiac arrest. Results The mean age of the patients was 57±17 years (33 females, 67 males). ICU mortality rate was 57%. The BrANOS mean score was 10.3±3.2. There was a significant difference between survivors and non-survivors in terms of the BrANOS score (8.8±3.2 vs. 11.6±2.7; p14 predicted death with 100% accuracy. All the patients without disability had a BrANOS score of <10. The BrANOS score also correlated well with GOS (p<0.001). The 2-year life expectancy rate was 31% in patients who survived more than 24 hours after a cardiac arrest. Conclusion In this study, we demonstrated that BrANOS provided reliable data for prognostic evaluation after a cardiac arrest. PMID:28058140

  6. Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Wissenberg, Mads; Lippert, Freddy K.; Folke, Fredrik

    2013-01-01

    resuscitation was attempted were identified between 2001 and 2010 in the nationwide Danish Cardiac Arrest Registry. Of 29 111 patients with cardiac arrest, we excluded those with presumed noncardiac cause of arrest (n = 7390) and those with cardiac arrests witnessed by emergency medical services personnel (n...

  7. Retroperitoneal bronchogenic cyst presenting paraadrenal tumor incidentally detected by {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Ye Ri; Choi, Ji Youn; Lee, Sang Mi; Kim, Yeo Joo; Cho, Hyun Deuk; Lee, Jeong Won; Jeon, Youn Soo [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

    2015-03-15

    A follow-up 18F-fluorodeoxyglucose ({sup 18}F-FDG) PET/CT scan of a 57-year-old asymptomatic male who had undergone total thyroidectomy for thyroid cancer revealed a 5.0 x 4.0-cm, well-defined, ovoid-shaped mass around the left adrenal gland without definite FDG uptake. On the adrenal CT scan, the left paraadrenal tumor showed high attenuation on the precontrast scan without enhancement. The average Hounsfield unit (HU) was 58.1 on the precontrast scan and 58.4 on the postcontrast scan. The patient underwent laparoscopic adrenalectomy for resection of the left paraadrenal tumor. The final histopathologic examination revealed a bronchogenic cyst. Although retroperitoneal bronchogenic cysts are rare, they should be considered in the differential diagnosis of retroperitoneal cystic tumors. The preoperative diagnosis is difficult, but a contrast-enhanced CT scan or {sup 18}F-FDG PET/CT scan may be useful for differentiating hyperattenuated cysts from other soft tissue masses.

  8. Ginkgo biloba Extract Improves Insulin Signaling and Attenuates Inflammation in Retroperitoneal Adipose Tissue Depot of Obese Rats

    Directory of Open Access Journals (Sweden)

    Bruna Kelly Sousa Hirata

    2015-01-01

    Full Text Available Due to the high incidence and severity of obesity and its related disorders, it is highly desirable to develop new strategies to treat or even to prevent its development. We have previously described that Ginkgo biloba extract (GbE improved insulin resistance and reduced body weight gain of obese rats. In the present study we aimed to evaluate the effect of GbE on both inflammatory cascade and insulin signaling in retroperitoneal fat depot of diet-induced obese rats. Rats were fed with high fat diet for 2 months and thereafter treated for 14 days with 500 mg/kg of GbE. Rats were then euthanized and samples from retroperitoneal fat depot were used for western blotting, RT-PCR, and ELISA experiments. The GbE treatment promoted a significant reduction on both food/energy intake and body weight gain in comparison to the nontreated obese rats. In addition, a significant increase of both Adipo R1 and IL-10 gene expressions and IR and Akt phosphorylation was also observed, while NF-κB p65 phosphorylation and TNF-α levels were significantly reduced. Our data suggest that GbE might have potential as a therapy to treat obesity-related metabolic diseases, with special interest to treat obese subjects resistant to adhere to a nutritional education program.

  9. RESULTS OF SECOND-LOOK LAPAROTOMY WITH EXTENSIVE DISSECTION OF RETROPERITONEAL LYMPH NODE IN OVARIAN CANCER PATIENTS

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To evaluate retrospectively the results of extensive lymphadenectomy during second-look laparotomy on patients with ovarian cancer. Methods: A total of 63 patients with ovarian malignancies received second-look laparotomy (SLL). Retroperitoneal lymph nodes, including pelvic and para-aortic lymph nodes below the level of left renal vein, were extensively dissected. Results: Of the 63 patients, residual tumor was found in 24 (38.0%) on SLL. The frequency of residual tumor was positively correlated with the clinical stage and with the amount of tumor left after initial debulking but not with degree of differentiation of tumor cells. Lymph node metastasis(LNM) was pathologically confirmed in 19 cases (30.2%), of which no residual tumor was found in 8 patients. Tumor recurred in only 4 of the 39 patients (10.3%) with negative SLL. The overall 3- and 5-year survival rate were 75.0% and 68.0%, respectively. Conclusion: Extensive retroperitoneal lymph node dissection was recommended during SLL. It favored a decrease in recurrence rate in ovarian cancer patients negative on SLL.

  10. Technology Progress of Refractories for Iron Making in China

    Institute of Scientific and Technical Information of China (English)

    CHAI Junlan; CHENG Qingxian; SHEN Keyin

    2005-01-01

    This paper reviews the present development situation of refractories for iron making system in China, which includes blast furnace, hot blast stove and coke dry quenching, etc. Varieties and performances of refractories used by the top steel and iron groups such as Baosteel, Wuhan I&S Group and Anshan I&S Group for iron making were exemplified and concerned problems were analyzed,together with solutions and suggestions for future refractories R&D work.

  11. Sublingual Microcirculation is Impaired in Post-cardiac Arrest Patients

    DEFF Research Database (Denmark)

    G. Omar, Yasser; Massey, Michael; Wiuff Andersen, Lars;

    2013-01-01

    AIM: We hypothesized that microcirculatory dysfunction, similar to that seen in sepsis, occurs in post-cardiac arrest patients and that better microcirculatory flow will be associated with improved outcome. We also assessed the association between microcirculatory dysfunction and inflammatory...... markers in the post-cardiac arrest state. METHODS: We prospectively evaluated the sublingual microcirculation in post-cardiac arrest patients, severe sepsis/septic shock patients, and healthy control patients using Sidestream Darkfield microscopy. Microcirculatory flow was assessed using...... the microcirculation flow index (MFI) at 6 and 24h in the cardiac arrest patients, and within 6h of emergency department admission in the sepsis and control patients. RESULTS: We evaluated 30 post-cardiac arrest patients, 16 severe sepsis/septic shock patients, and 9 healthy control patients. Sublingual...

  12. Out-of-Hospital Cardiac Arrest in Denmark

    DEFF Research Database (Denmark)

    Wissenberg Jørgensen, Mads

    challenges, due to the victim’s physical location, which brings an inherent risk of delay (or altogether absence) of recognition and treatment of cardiac arrest. A low frequency of bystander cardiopulmonary resuscitation and low 30-day survival after out-of-hospital cardiac arrest were identified nearly ten......BACK COVER TEXT Cardiac arrest is an emergency medical condition characterized by the cessation of cardiac mechanical activity; without immediate and decisive treatment, a victim’s chances of survival are minimal. Out-of-hospital cardiac arrest is a particular arrest subgroup that poses additional...... years ago in Denmark. These findings led to several national initiatives to strengthen bystander resuscitation attempts and advance care. Despite these nationwide efforts, it was unknown prior to this project whether these efforts resulted in changes in resuscitation attempts by bystanders and changes...

  13. Performance of metal oxide gapless surge arresters for HVDC systems

    Energy Technology Data Exchange (ETDEWEB)

    Diseko, N.L.

    1990-09-01

    An examination of the electrical stresses which may be imposed upon metal oxide surge arresters in a dc converter station is undertaken by means of simulation of the dc system and associated ac systems in the time domain using a digital computer program. Detailed models of a dc link are developed for temporary overvoltage stresses and steep front stresses. The most critical stresses for each type of dc station arrester due to converter faults and converter malfunctions are identified. The energy stresses were generally determined to be dependent on the converter control and protection strategies adopted during the faults. The arrester energy stresses for faults on both the line side and valve side busses of the converter transformer were determined to be sensitive to the instant of fault application and the duration of the fault. The arrester stresses for ac bus faults were analyzed in detail to determine their statistical distribution relative to the point on wave at which the fault occurred in each affected phase, and to the instant of fault clearance in each phase. Generally, the highest stresses occur for sequential fault occurrence in the phases compared with simultaneous faults. The studies indicate that the stresses in the arresters in a dc pile experiencing the worst duty depend on the number of arresters represented. Modelling only one arrester of a series-connected group does not provide correct results when the fault condition imposes duty on more than one of the arresters in the group. The study also indicates that the highest stresses do not necessarily occur in the single arrester connected across the valve with the highest prospective overvoltage. Hence the capability to represent all valve arresters within one pole is necessary when determining the most onerous stresses. 11 refs., 79 figs., 28 tabs.

  14. Handbook of industrial refractories technology principles, types, properties and applications

    CERN Document Server

    Caniglia, Stephen

    1989-01-01

    Encompasses the entire range of industrial refractory materials and forms: properties and their measurement, applications, manufacturing, installation and maintenance techniques, quality assurance, and statistical process control.

  15. Refractory Coated/Lined Low Density Structures Project

    Data.gov (United States)

    National Aeronautics and Space Administration — This project addresses the development of refractory coated or lined low density structures applicable for advanced future propulsion system technologies. The...

  16. Properties of Refractory Concrete in Tension and Compression

    Science.gov (United States)

    Sampson, Jeffrey

    2009-01-01

    Refractory concrete on the LC-39A Flame Deflector has been damaged during multiple Space Shuttle launches (e.g. STS-124, STS-126, STS-119, and STS-125, STS-127). These events have prompted a better understanding of the system via an analytical model of the Flame Deflector assembly to include the Fondu Fyre refractory concrete. This model requires test data inputs of the refractory concrete's mechanical properties, which include stress versus strain curves in tension and compression, modulus of elasticity, and Poisson's ratio. Sections of Fondu Fyre refractory concrete removed from the LC-39A Flame Deflector were provided for this testing.

  17. Bendamustine Plus Alemtuzumab for Refractory Chronic Lymphocytic Leukemia (CLL)

    Science.gov (United States)

    2013-08-20

    Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Stage III Chronic Lymphocytic Leukemia; Stage III Small Lymphocytic Lymphoma; Stage IV Chronic Lymphocytic Leukemia; Stage IV Small Lymphocytic Lymphoma

  18. Bulk Vitrification Castable Refractory Block Protection Study

    Energy Technology Data Exchange (ETDEWEB)

    Hrma, Pavel R.; Bagaasen, Larry M.; Beck, Andrew E.; Brouns, Thomas M.; Caldwell, Dustin D.; Elliott, Michael L.; Matyas, Josef; Minister, Kevin BC; Schweiger, Michael J.; Strachan, Denis M.; Tinsley, Bronnie P.; Hollenberg, Glenn W.

    2005-05-01

    Bulk vitrification (BV) was selected for a pilot-scale test and demonstration facility for supplemental treatment to accelerate the cleanup of low-activity waste (LAW) at the Hanford U.S. DOE Site. During engineering-scale (ES) tests, a small fraction of radioactive Tc (and Re, its nonradioactive surrogate) were transferred out of the LAW glass feed and molten LAW glass, and deposited on the surface and within the pores of the castable refractory block (CRB). Laboratory experiments were undertaken to understand the mechanisms of the transport Tc/Re into the CRB during vitrification and to evaluate various means of CRB protection against the deposition of leachable Tc/Re. The tests used Re as a chemical surrogate for Tc. The tests with the baseline CRB showed that the molten LAW penetrates into CRB pores before it converts to glass, leaving deposits of sulfates and chlorides when the nitrate components decompose. Na2O from the LAW reacts with the CRB to create a durable glass phase that may contain Tc/Re. Limited data from a single CRB sample taken from an ES experiment indicate that, while a fraction of Tc/Re is present in the CRB in a readily leachable form, most of the Tc/Re deposited in the refractory is retained in the form of a durable glass phase. In addition, the molten salts from the LAW, mainly sulfates, chlorides, and nitrates, begin to evaporate from BV feeds at temperatures below 800 C and condense on solid surfaces at temperatures below 530 C. Three approaches aimed at reducing or preventing the deposition of soluble Tc/Re within the CRB were proposed: metal lining, sealing the CRB surface with a glaze, and lining the CRB with ceramic tiles. Metal liners were deemed unsuitable because evaluations showed that they can cause unacceptable distortions of the electric field in the BV system. Sodium silicate and a low-alkali borosilicate glaze were selected for testing. The glazes slowed down molten salt condensate penetration, but did little to reduce the

  19. Launch Pad Flame Trench Refractory Materials

    Science.gov (United States)

    Calle, Luz M.; Hintze, Paul E.; Parlier, Christopher R.; Bucherl, Cori; Sampson, Jeffrey W.; Curran, Jerome P.; Kolody, Mark; Perusich, Steve; Whitten, Mary

    2010-01-01

    The launch complexes at NASA's John F. Kennedy Space Center (KSC) are critical support facilities for the successful launch of space-based vehicles. These facilities include a flame trench that bisects the pad at ground level. This trench includes a flame deflector system that consists of an inverted, V-shaped steel structure covered with a high temperature concrete material five inches thick that extends across the center of the flame trench. One side of the "V11 receives and deflects the flames from the orbiter main engines; the opposite side deflects the flames from the solid rocket boosters. There are also two movable deflectors at the top of the trench to provide additional protection to shuttle hardware from the solid rocket booster flames. These facilities are over 40 years old and are experiencing constant deterioration from launch heat/blast effects and environmental exposure. The refractory material currently used in launch pad flame deflectors has become susceptible to failure, resulting in large sections of the material breaking away from the steel base structure and creating high-speed projectiles during launch. These projectiles jeopardize the safety of the launch complex, crew, and vehicle. Post launch inspections have revealed that the number and frequency of repairs, as well as the area and size of the damage, is increasing with the number of launches. The Space Shuttle Program has accepted the extensive ground processing costs for post launch repair of damaged areas and investigations of future launch related failures for the remainder of the program. There currently are no long term solutions available for Constellation Program ground operations to address the poor performance and subsequent failures of the refractory materials. Over the last three years, significant liberation of refractory material in the flame trench and fire bricks along the adjacent trench walls following Space Shuttle launches have resulted in extensive investigations of

  20. “颠簸疗法”治疗腹膜后脓肿%The"mild vibration therapy"for the treatment of retroperitoneal abscess

    Institute of Scientific and Technical Information of China (English)

    钟记华; 王斌; 梁惠文; 徐伟熙

    2013-01-01

      目的探讨腹膜后脓肿引流的有效方法。方法回顾性分析1998年—2012年我院收治13例腹膜后脓肿行腹膜后置管引流患者的临床资料。结果“颠簸疗法”的引流效果优于常规引流组,且治愈时间也短于常规引流。结论“颠簸疗法”治疗腹膜后脓肿可以取得较好的临床疗效。%Objective The present study aims to investigate the effectiveness of various approaches of retroperitoneal abscess drainage. Methods The clinical data obtained from the patients, who underwent retroperitoneal abscess drainage with retroperitoneal catheters between 1998 and December 2012,were reviewed retrospectively. Results The difference in the efficacies between the “jolt therapy”group and the conventional drainage group was statistically significant(P<0.05),i.e. the patients in the“jolt therapy”group presented better therapeutic outcomes than those in the conventional drainage group. Conclusion In the treatment of retroperitoneal abscess,“jolt therapy” was proved to produce relatively better therapeutic outcomes.

  1. Solitary Bone Plasmacytoma Progressing into Retroperitoneal Plasma Cell Myeloma with No Related End Organ or Tissue Impairment: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Gargi Tikku

    2014-09-01

    Full Text Available Solitary bone plasmacytomas and plasma cell myeloma are clonal proliferations of plasma cells. Many patients with solitary bone plasmacytomas develop plasma cell myeloma on follow-up. We present a case of a 70-year-old man who presented with fracture and a lytic lesion in the subtrochanteric region of the left femur and was assigned a diagnosis of solitary bone plasmacytoma. He received local curative radiotherapy. However, 4 months later his serum M protein and β2-microglobulin levels increased to 2.31 g/dL and 5.965 mg/L, respectively. He complained of abdominal fullness and constipation. Ultrasound and non-contrast CT imaging revealed multiple retroperitoneal masses. Colonoscopic examination was normal. Biopsy of the a retroperitoneal mass confirmed it to be a plasmacytoma. Repeat hemogram, blood urea, serum creatinine, skeletal survey, and bone marrow examination revealed no abnormalities. This is an unusual presentation of plasma cell myeloma, which manifested as multiple huge extramedullary retroperitoneal masses and arose from a solitary bone plasmacytoma, without related end organ or tissue impairment and bone marrow plasmacytosis. The patient succumbed to his disease 8 months after the appearance of the retroperitoneal masses. This case highlights the importance of close monitoring of patients diagnosed with solitary bone plasmacytoma with increased serum M protein and serum β2-microglobulin levels, so that early therapy can be instituted to prevent conversion to plasma cell myeloma.

  2. Gastroesophageal Reflux in Children with Refractory Asthma

    Directory of Open Access Journals (Sweden)

    Alaa S. Deeb

    2010-07-01

    Full Text Available Objectives: To investigate the association between clinical and macroscopic findings of GER and severity of refractory asthma (statistical study.Methods: A prospective study in a university-based practice of 75 children who were diagnosed with refractory asthma because they exhibited no satisfactory response for at least three months of treatment. Medical history, physical examination, spirometrical measurements and prick skin test were conducted on all patients. Endoscopic and macroscopic evaluations for esophagitis were performed on all patients regardless of the presence of GER symptoms.Results: Endoscopy was done for 75 children with refractory asthma. GER was symptomatic in 65% of all patients with no statistical significance (p>0.05 and the most frequent symptom was abdominal pain (67%. The frequency of these symptoms was 50% in mild asthma, 58% in moderate asthma and 72% in severe asthma with no statistical significance (p>0.05. The frequency of macroscopic esophagitis was 71%, distributed in three asthmatic groups as in order of 75% in mild asthma, 58.3% in moderate asthma and 76.6% in severe asthma (p>0.05. Regarding the relationship between GER and nocturnal attacks or spasmodic cough, the frequency of the latest was 66.7%. The differences have no statistical significance regarding GER symptoms (p>0.05, but they are statistically significant regarding the reflux esophagitis (p<0.05. Also endoscopic reflux was as frequent as76.3% in non allergic patients, and this result is statistically significant (p<0.05.Conclusion: In spite of the fact that there was no relationship between the severity of asthma and the symptoms of GER, or its endoscopic findings, the frequency of GER in asthmatic children was higher than its frequency in other children.

  3. Refractory thrombotic thrombocytopenic purpura following acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Ebisa Bekele; Bethel Shiferaw; Alexandra Sokolova; Arpan Shah; Phillip Saunders; Alida Podrumar; Javed Iqbal

    2016-01-01

    Thrombotic thrombocytopenic purpura (TTP) is a rare blood disorder with an estimated incidence of 4–5 cases per million people per year. It is characterized by small-vessel platelet-rich thrombi that cause thrombocytopenia, microangiopathic hemolytic anemia and organ damage. There are reports in literature that TTP and acute pancreatitis are associated, indicating each can be the cause of the other. However, acute pancreatitis triggering TTP is very rare. A 71 years old female presented with abdominal pain of 3 days, followed by dark urine. She had icteric sclera, petechial rash and mild epigastric tenderness. Lab findings were significant for hemolytic anemia, thrombocytopenia and elevated lipase. CT of abdomen showed evidence of pancreatitis and cholelithiasis. After admission, patient developed symptoms of stroke. Further investigation showed elevated lactate dehydrogenase and normal coagulation studied with peripheral blood smear showed 5–6 schistocytes/high power field. Disintegrin and metalloproteinase with thrombospondin motifs-13 (ADAMTS13) activity showed less than 3% with high ADAMTS13 inhibitor 2.2. Patient required 6–7 weeks of daily plasmapheresis until she showed complete response. Our patient presented with clinical features of pancreatitis prior to having dark urine and petechial rash. Therefore, we strongly believe that our patient had pancreatitis which was followed by TTP. Patient's ADMTS13 activity was 6%after 10 plasma exchanges, signifying refractory TTP and higher risk for morbidity and mortality. There are limited data and consensus on the management of refractory TTP. TTP and acute pancreatitis are associated. However, refractory TTP following acute pancreatitis is rarely mentioned in the literature. We would like to emphasize the importance of having higher clinical suspicion of the association of both disease entities.

  4. Deoxyspergualin in relapsing and refractory Wegener's granulomatosis

    DEFF Research Database (Denmark)

    Flossmann, O; Baslund, B; Bruchfeld, A

    2008-01-01

    at entry and prednisolone doses adjusted according to clinical status. Deoxyspergualin, 0.5 mg/kg per day, was self-administered by subcutaneous injection in six cycles of 21 days with a 7-day washout between cycles. Cycles were stopped early for white blood count less than 4000 cells/mm(3). The primary......-threatening (> or = grade 3) treatment-related adverse events occurred in 24 (53%) patients mostly due to leucopaenias. CONCLUSIONS: Deoxyspergualin achieved a high rate of disease remission and permitted prednisolone reduction in refractory or relapsing Wegener's granulomatosis. Adverse events were common but rarely led...

  5. Flow and Flow Decay of Refractory Castables

    Institute of Scientific and Technical Information of China (English)

    CHEN Zhiqiang; Bjom Myhre; Bjorn Sandberg

    2003-01-01

    Installation of refractoty castables depend not only on flow, but also on how soon the flow is lost because of setting. The loss of flow (flow decay) has always been one of the main problems of refractory castable manufacturers,a problem that has not been too well described in literature. The flow decay has been studied for a castable system based on alumina, pointing out some general trends. The flow decay was found very temperature sensitive, being strongly accelerated by termperature increases. To compensate for excessive flow loss, a retarder like citric acid may be used. Thus flow decay was measured as a function of citric acid (retarder) addition at 35 ℃ .

  6. Refractory leg ulcers associated with Klinefelter syndrome.

    Science.gov (United States)

    Yabuno, Yuto; Tosa, Mamiko; Iwakiri, Itaru; Nomoto, Shunichi; Kaneko, Mayuko; Kuwahara, Kousuke; Hyakusoku, Hiko; Murakami, Masahiro

    2015-01-01

    We present a man with refractory leg ulcers, bilateral varicosis of the lower extremities, and Buerger disease. Autoimmune work-up was negative. However, chromosome analysis showed Klinefelter syndrome (48 XXY). Ulcerative lesions of the lower extremities are a complication of Klinefelter syndrome. To date, the pathogenesis of ulcers in Klinefelter syndrome has not been clarified, but several factors, such as abnormalities of fibrinolysis and prothrombotic states, might be involved. Our present case emphasizes the importance of considering Klinefelter syndrome in the differential diagnosis of a male patient with nonhealing ulcers of the lower extremities.

  7. Management in refractory epilepsy: Beyond epilepsy surgery...

    Directory of Open Access Journals (Sweden)

    Roop Gursahani

    2008-01-01

    Full Text Available Although definititions of refractory epilepsy vary, about 40% of prevalent cases of epilepsy are not controlled by anti-epileptic drugs. A substantial proportion of this population requires palliative therapy since only a minority are candidates for epilepsy surgery. Drug therapy can be optimised after accurate classification of the epilepsy. Monotherapy is often as effective as polytherapy with fewer adverse effects. Depression and CNS adverse effects significantly impact quality of life and must be systematically screened for and treated. The ketogenic diet and vagal nerve stimulation provide substantial seizure control in a significant number of cases and may be used synergistically. Deep brain stimulation is another promising modality.

  8. Relationship between Intrauterine Bacterial Infection and Early Embryonic Developmental Arrest

    Institute of Scientific and Technical Information of China (English)

    Shao-Fei Yan; Xin-Yan Liu; Yun-Fei Cheng; Zhi-Yi Li; Jie Ou; Wei Wang; Feng-Qin Li

    2016-01-01

    Background:Early embryonic developmental arrest is the most commonly understudied adverse outcome of pregnancy.The relevance of intrauterine infection to spontaneous embryonic death is rarely studied and remains unclear.This study aimed to investigate the relationship between intrauterine bacterial infection and early embryonic developmental arrest.Methods:Embryonic chorion tissue and uterine swabs for bacterial detection were obtained from 33 patients who underwent artificial abortion (control group) and from 45 patients who displayed early embryonic developmental arrest (trial group).Results:Intrauterine bacterial infection was discovered in both groups.The infection rate was 24.44% (11/45) in the early embryonic developmental arrest group and 9.09% (3/33) in the artificial abortion group.Classification analysis revealed that the highest detection rate for Micrococcus luteus in the early embryonic developmental arrest group was 13.33% (6/45),and none was detected in the artificial abortion group.M.luteus infection was significantly different between the groups (P < 0.05 as shown by Fisher's exact test).In addition,no correlation was found between intrauterine bacterial infection and history of early embryonic developmental arrest.Conclusions:M.luteus infection is related to early embryonic developmental arrest and might be one of its causative factors.

  9. Development of a Refractory High Entropy Superalloy

    Directory of Open Access Journals (Sweden)

    Oleg N. Senkov

    2016-03-01

    Full Text Available Microstructure, phase composition and mechanical properties of a refractory high entropy superalloy, AlMo0.5NbTa0.5TiZr, are reported in this work. The alloy consists of a nano-scale mixture of two phases produced by the decomposition from a high temperature body-centered cubic (BCC phase. The first phase is present in the form of cuboidal-shaped nano-precipitates aligned in rows along <100>-type directions, has a disordered BCC crystal structure with the lattice parameter a1 = 326.9 ± 0.5 pm and is rich in Mo, Nb and Ta. The second phase is present in the form of channels between the cuboidal nano-precipitates, has an ordered B2 crystal structure with the lattice parameter a2 = 330.4 ± 0.5 pm and is rich in Al, Ti and Zr. Both phases are coherent and have the same crystallographic orientation within the former grains. The formation of this modulated nano-phase structure is discussed in the framework of nucleation-and-growth and spinodal decomposition mechanisms. The yield strength of this refractory high entropy superalloy is superior to the yield strength of Ni-based superalloys in the temperature range of 20 °C to 1200 °C.

  10. Status epilepticus: Analysis of refractory cases

    Directory of Open Access Journals (Sweden)

    B. P. Gladov

    2016-01-01

    Full Text Available Objective: to analyze refractory status epilepticus (SE cases.Patients and methods. Fifteen female patients aged 21 to 62 years with refractory SE were comprehensively examined using long-term electroencephalography monitoring. The investigators evaluated the efficiency of treatment regimens with intravenous antiepileptic drugs (AEDs, such as diazepam (DZP; valproic acid (VPA; levetiracetam; and lacosamide and their combinations, at the prehospital and hospital stages, as well as SE therapy complications noted only in the intravenous administration of narcotics (propofol, sodium thiopental.Results and discussion. A fetal outcome due to multiple organ dysfunction indirectly related to SE was recorded in 2 (13.3% patients with acute symptomatic status. SE was abolished in the other 13 cases. The preliminary findings may suggest that it is appropriate to prescribe VPA just at the prehospital stage. The co-administration of VPA and DZP substantially enhances the efficiency of SE therapy. The maximum acceptable doses of AEDs using the whole available therapeutic arsenal should be administered within the first hours of acute symptomatic SE.

  11. Liposteroid therapy for refractory seizures in children.

    Science.gov (United States)

    Yoshikawa, H; Yamazaki, S; Abe, T; Oda, Y

    2000-10-01

    Liposteroid is dexamethasone palmitate incorporated into liposomes and was developed as an anti-inflammatory drug for targeting therapy mainly for rheumatoid arthritis. Recently, it was reported that liposteroid might be effective for the treatment of West syndrome, with fewer side effects than those of corticotropin therapy. We describe three patients, a 2-month-old boy with early infantile epileptic encephalopathy, a 4-month-old girl with symptomatic West syndrome, and a 2-year-old girl with symptomatic localization-related epilepsy, whose refractory seizures were treated with liposteroid according to the original method reported by Yamamoto and colleagues in 1998. Uncontrollable seizures ceased completely in two patients and the seizure frequency decreased markedly in the other patient. Electroencephalograms revealed marked improvement in all patients. They showed no relapse of the seizures, and all showed no adverse effects except for mild brain shrinkage in one patient. Our experience with these three patients suggests that liposteroid therapy might be a new option for the treatment of refractory seizures in children, as well as for West syndrome.

  12. [Iron-refractory iron deficiency anemia].

    Science.gov (United States)

    Kawabata, Hiroshi

    2016-02-01

    The major causes of iron deficiency anemia (IDA) include iron loss due to bleeding, increased iron requirements, and decreased iron absorption by the intestine. The most common cause of IDA in Japanese women is iron loss during menstruation. Autoimmune atrophic gastritis and Helicobacter pylori infection can also cause IDA by reducing intestinal iron absorption. In addition to these common etiologies, germline mutations of TMPRSS6 can cause iron-refractory IDA (IRIDA). TMPRSS6 encodes matriptase-2, a membrane-bound serine protease primarily expressed in the liver. Functional loss of matriptase-2 due to homozygous mutations results in an increase in the expression of hepcidin, which is the key regulator of systemic iron homeostasis. The serum hepcidin increase in turn leads to a decrease in iron supply from the intestine and macrophages to erythropoietic cells. IRIDA is microcytic and hypochromic, but decreased serum ferritin is not observed as in IDA. IRIDA is refractory to oral iron supplementation, but does respond to intravenous iron supplementation to some extent. Because genetic testing is required for the diagnoses of IRIDA, a considerable number of cases may go undiagnosed and may thus be overlooked.

  13. Pollution performance of 110 kV metal oxide arresters

    Energy Technology Data Exchange (ETDEWEB)

    Chrzan, K.; Pohl, Z. [Technical Univ. of Wroclaw (Poland). Dept. of Electrical Engineering; Grzybowski, S. [Mississippi State Univ., MS (United States). Dept. of Electrical and Computer Engineering; Koehler, W. [Univ. of Stuttgart (Germany). Dept. of Electrical Engineering

    1997-04-01

    Pollution test results of single unit 110 kV metal oxide surge arresters with porcelain housing according to the solid layer and salt fog methods are presented. During 6 hours of testing, the internal and external charge and maximum temperature along the varistor column were measured. The formation of single stable dry bands on the housing was often observed, especially during salt fog tests. In such cases, the varistor temperature can reach about 70 C. The simple electrical model of the arrester enabling calculations of voltages and currents as a function of arrester and pollution parameters is shown.

  14. Evolution of the dragonfly head-arresting system

    OpenAIRE

    Gorb, S. N.

    1999-01-01

    The arrester or fixation system of the head in adult Odonata is unique among arthropods. This system involves the organs of two body segments: the head and the neck. It consists of a skeleton–muscle apparatus that sets the arrester parts in motion. The parts comprise formations covered with complicated microstructures: fields of microtrichia on the rear surface of the head and post-cervical sclerites of the neck. The arrester immobilizes the head during feeding or when the dragonfly is in tan...

  15. The value of {sup 18}F-FDG PET/CT in the assessment of active idiopathic retroperitoneal fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Moroni, Gabriella; Longhi, Selena; Messa, Piergiorgio [Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Division of Nephrology, Milan (Italy); Castellani, Massimo; Martinelli, Isabella; Gerundini, Paolo [Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Department of Nuclear Medicine, Milan (Italy); Balzani, Aurora; Bonelli, Nicola [Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Department of Radiology, Milan (Italy); Dore, Roberto [University of Pavia, Institute of Radiology, IRCCS Foundation, San Matteo Medical Center, Pavia (Italy)

    2012-10-15

    The different stages in idiopathic retroperitoneal fibrosis (IRF) are generally assessed by assay of inflammatory markers and analysis of contrast-enhanced CT images of the retroperitoneal mass. We investigated the potential role of {sup 18}F-FDG PET/CT in this clinical setting. {sup 18}F-FDG uptake was assessed visually and semiquantitatively (using maximum standardized uptake values, SUVmax) in images of the abdominal mass in 22 patients prospectively enrolled from June 2008 to December 2010 who underwent a total of 33 PET/CT studies. The accuracy in discriminating active from inactive disease was calculated assuming as reference a biochemical instrumental evaluation of patients with IRF mostly based on the level of inflammatory indices and contrast enhancement (CE) of the mass at the time of each PET study. In particular, the relationship between SUVmax and CE, the latter calculated from the change in radiodensity (Hounsfield units) between the basal and postcontrast venous portal phases, was evaluated on a three-point scale (0 <20 HU, 1 20-30 HU, 2 {>=}30 HU). SUVmax and CE scores were correlated with the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels. The value of PET/CT in assessing the variation of disease activity over time was also investigated by analysing the changes in metabolic volume (MV) of the retroperitoneal lesion between repeat patient studies. PET/CT accurately discriminated (93.9 %) active from inactive disease. Significant agreement (p < 0.01) was observed between visual and semiquantitative analysis of {sup 18}F-FDG uptake, and CE score. A significant correlation (p < 0.01) was found among SUVmax, CRP levels (rho = 0.54) and ESR (rho = 0.55). Corresponding variations in MV and CE score were observed in patients with multiple studies (p < 0.01; rho = 0.68). {sup 18}F-FDG PET/CT may be considered an alternative imaging method for the assessment of different stages of IRF. (orig.)

  16. Abrasion Resistant Refractory Materials GB/T 23294-2009

    Institute of Scientific and Technical Information of China (English)

    Yu Lingyuan

    2009-01-01

    @@ 1 Scope This standard specifies the definition, classification, technical requirements, test methods, quality appraisal procedure, packing, marking, transportation, storage, and quality certificate of abrasion resistant refractory materials. This standard is applicable to abrasion resistant refractory materials for circulating fluidized bed boilers, daily waste incinerator, industrial waste incinerator, medical waste incinerator, ordinary solid waste incinerator, hazardous waste incinerator, etc.

  17. Intraepithelial lymphocytes in refractory celiac disease : lost in transition

    NARCIS (Netherlands)

    Schmitz, Frederike

    2014-01-01

    Refractory coeliac disease type II (RCDII) is a severe complication of coeliac disease. Whereas celiac disease can successfully be treated by the strict avoidance of gluten, refractory celiac patients show no remission despite a gluten-free diet. The pathology of RCDII is only partially understood,

  18. Refractory Degradation by Slag Attack in Coal Gasification

    Science.gov (United States)

    2009-02-01

    REFRACTORY DEGRADATION BY SLAG ATTACK IN COAL GASIFICATION Jinichiro Nakano 1,2 , Sridhar Seetharaman 1,2 , James Bennett 3 , Kyei-Sing...00-2009 4. TITLE AND SUBTITLE Refractory Degradation by Slag Attack in Coal Gasification 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM

  19. Bortezomib for refractory antibody-mediated cardiac allograft rejection.

    Science.gov (United States)

    Eckman, Peter M; Thorsgard, Marit; Maurer, David; Kim, Youngki; Alloway, Rita R; Woodle, E Steve

    2009-01-01

    This experience demonstrates that a bortezomib-based regimen provided effective therapy for late, refractory AMR in an adult heart transplant recipient and was well tolerated. This remarkably positive experience despite the refractory nature of the AMR episode argues strongly for continued evaluation of bortezomib use in this patient population.

  20. Thirty Years' Reform and Development in China's Refractories Industry

    Institute of Scientific and Technical Information of China (English)

    XU Dianli; CHEN Jianxiong

    2009-01-01

    @@ 1 Development of Refractories Industry Since the People's Republic of China Founded Refractories is mainly used in high temperature industries,such as metallurgy,building materials,nonferrous,chemical,mechanical,electric power industries,which is the important fundamental material for high temperature industries.

  1. ZrO2-Containing Refractories for Cement Rotary Kilns

    Institute of Scientific and Technical Information of China (English)

    YE Guotian; XU Yanqing

    2002-01-01

    ZrO2-containing refractories have been increasingly used for cement rotary kilns. This paper discusses how the properties and performance of ZrO2-containing. Refractories are inwroved in terms of chemical attack resistance, thermal shock resistance, thermal conductivity and mechanical stress.

  2. Neurological and circulatory outcomes of cardiopulmonary resuscitation in progress: influence of pre-arrest and arrest factors.

    Science.gov (United States)

    Jørgensen, E O

    1998-01-01

    Possible correlations between the circulatory and neurological responses to cardiopulmonary resuscitation (CPR) and the influence of pre-arrest factors (demographic data, medical history and aetiology of circulatory arrest) and arrest factors (location of arrest, ECG configurations, and duration of resuscitation) on the course of circulatory and neurological recovery were investigated in 111 victims of circulatory arrest. At the start of resuscitation 57 patients (Group I) had some brain function and 54 (Group II) had no brain function. Sixty nine patients (62%) had circulation restored but 54 (78%) were left with heart failure. Forty one patients (39%) survived the first day, 26 (63%) with heart failure; only 34 (31%) were alive after 48 h, 17 (50%) with heart failure. Half of the patients surviving 24 or 48 h had awakened. Consciousness returned in 32 patients (29%) during the first 48 h, more frequently in Group I than in Group II. Patients in Group I had a higher incidence of in-hospital arrest and had their circulation restored more often than those in Group II. Survival and post-resuscitation heart failure was alike in the groups. The pre-arrest factors explored did not modify the circulatory or neurological outcome whereas initial ventricular fibrillation was significantly related to recovery of consciousness. The revivability of spontaneous circulation and of neurological functions was found thus mainly to be determined by global ischaemia sustained prior to and during CPR.

  3. From stellar nebula to planets: the refractory components

    CERN Document Server

    Thiabaud, Amaury; Alibert, Yann; Cabral, Nahuel; Leya, Ingo; Mezger, Klaus

    2013-01-01

    We computed the abundance of refractory elements in planetary bodies formed in stellar systems with solar chemical composition by combining models for chemical composition and planet formation. We also consider the formation of refractory organic compounds, which have been ignored in previous studies on this topic. We used the commercial software package HSC Chemistry in order to compute the condensation sequence and chemical composition of refractory minerals incorporated into planets. The problem of refractory organic material is approached with two distinct model calculations: the first considers that the fraction of atoms used in the formation of organic compounds is removed from the system (i.e. organic compounds are formed in the gas phase and are nonreactive); and the second assumes that organic compounds are formed by the reaction between different compounds that had previously condensed from the gas phase. Results show that refractory material represents more than 50 wt % of the mass of solids accret...

  4. Diagnosis and Treatment of Refractory Gastroesophageal Reflux Disease (GERD

    Directory of Open Access Journals (Sweden)

    Selfie

    2015-12-01

    Full Text Available Gastroesophageal reflux disease (GERD was a damage in mucosal layer caused by gastric acid reflux. GERD was found about 10-20% in Western Countries and less in Asia, about 2,6-6,7%. Among different type of GERD, refractory GERD was a problem found in daily clinical practice. This terminology was used in patients with regurgitation and heartburn symptoms which is not responsive to 8 weeks proton pump inhibitor (PPI therapy. There were several mechanisms underlying the etiology and pathophysiology of refractory GERD. In general, refractory GERD diagnosis was based on clinical findings, objective endoscopic examination, ambulatory reflux monitoring, and response to antiacid-secretion therapy. Reevaluation of patients compliance should be the first step in refractory GERD management. A further treatment strategies could be started, consist of medical and surgical therapies. A basic clinical knowledge of refractory GERD would help clinician in deciding the best approach for diagnosis and therapy.

  5. Refractory alloy technology for space nuclear power applications

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, R.H. Jr.; Hoffman, E.E. (eds.)

    1984-01-01

    Purpose of this symposium is twofold: (1) to review and document the status of refractory alloy technology for structural and fuel-cladding applications in space nuclear power systems, and (2) to identify and document the refractory alloy research and development needs for the SP-100 Program in both the short and the long term. In this symposium, an effort was made to recapture the space reactor refractory alloy technology that was cut off in midstream around 1973 when the national space nuclear reactor program began in the early 1960s, was terminated. The six technical areas covered in the program are compatibility, processing and production, welding and component fabrication, mechanical and physical properties, effects of irradiation, and machinability. The refractory alloys considered are niobium, molybdenum, tantalum, and tungsten. Thirteen of the 14 pages have been abstracted separately. The remaining paper summarizes key needs for further R and D on refractory alloys. (DLC)

  6. NOvel Refractory Materials for High Alkali, High Temperature Environments

    Energy Technology Data Exchange (ETDEWEB)

    Hemrick, J.G.; Griffin, R. (MINTEQ International, Inc.)

    2011-08-30

    Refractory materials can be limited in their application by many factors including chemical reactions between the service environment and the refractory material, mechanical degradation of the refractory material by the service environment, temperature limitations on the use of a particular refractory material, and the inability to install or repair the refractory material in a cost effective manner or while the vessel was in service. The objective of this project was to address the need for new innovative refractory compositions by developing a family of novel MgO-Al2O3 spinel or other similar magnesia/alumina containing unshaped refractory composition (castables, gunnables, shotcretes, etc) utilizing new aggregate materials, bond systems, protective coatings, and phase formation techniques (in-situ phase formation, altered conversion temperatures, accelerated reactions, etc). This family of refractory compositions would then be tailored for use in high-temperature, highalkaline industrial environments like those found in the aluminum, chemical, forest products, glass, and steel industries. A research team was formed to carry out the proposed work led by Oak Ridge National Laboratory (ORNL) and was comprised of the academic institution Missouri University of Science and Technology (MS&T), and the industrial company MINTEQ International, Inc. (MINTEQ), along with representatives from the aluminum, chemical, glass, and forest products industries. The two goals of this project were to produce novel refractory compositions which will allow for improved energy efficiency and to develop new refractory application techniques which would improve the speed of installation. Also methods of hot installation were sought which would allow for hot repairs and on-line maintenance leading to reduced process downtimes and eliminating the need to cool and reheat process vessels.

  7. Stimulus-dependent refractoriness in the Frankenhaeuser-Huxley model.

    Science.gov (United States)

    Morse, R P; Allingham, D; Stocks, N G

    2015-10-01

    Phenomenological neural models, such as the leaky integrate-and-fire model, normally have a fixed refractory time-course that is independent of the stimulus. The recovery of threshold following an action potential is typically based on physiological experiments that use a two-pulse paradigm in which the first pulse is suprathreshold and causes excitation and the second pulse is used to determine the threshold at various intervals following the first. In such experiments, the nerve is completely unstimulated between the two pulses. This contrasts the receptor stimuli in normal physiological systems and the electrical stimuli used by cochlear implants and other neural prostheses. A numerical study of the Frankenhaeuser-Huxley conductance-based model of nerve fibre was therefore undertaken to investigate the effect of stimulation on refractoriness. We found that the application of a depolarizing stimulus during the later part of what is classically regarded as the absolute refractory period could effectively prolong the absolute refractory period, while leaving the refractory time-constants and other refractory parameters largely unaffected. Indeed, long depolarizing pulses, which would have been suprathreshold if presented to a resting nerve fibre, appeared to block excitation indefinitely. Stimulation during what is classically regarded as the absolute refractory period can therefore greatly affect the temporal response of a nerve. We conclude that the classical definition of absolute refractory period should be refined to include only the initial period following an action potential when an ongoing stimulus would not affect threshold; this period was found to be about half as long as the classical absolute refractory period. We further conclude that the stimulus-dependent nature of the relative refractory period must be considered when developing a phenomenological nerve model for complex stimuli.

  8. Hybrid simulation of metal oxide surge-arrester thermal behaviour

    Energy Technology Data Exchange (ETDEWEB)

    Huang, L.; Raghuveer, M.R. [Manitoba Univ., Winnipeg, MB (Canada). Dept. of Electrical and Computer Engineering

    1996-01-01

    A finite-difference-based technique for simulating the thermal behaviour of a metal oxide surge arrester (MOSA) was described. The improved hybrid thermal modelling technique was claimed to accurately represent heat-transfer modes. Fin theory was used to represent arrester sheds. The proposed model, which relies on simple measurements at the arrester terminals, yields the temporal variation of temperature in a MOSA in both the axial and radial direction. The thermal behaviour of a MOSA under steady-state and transient conditions can be simulated using such a model under different environmental conditions. The accuracy of the modelling technique was demonstrated experimentally by measurements conducted on an arrester. 15 refs., 7 figs.

  9. Endothelial Dysfunction in Resuscitated Cardiac Arrest (ENDO-RCA)

    DEFF Research Database (Denmark)

    Meyer, Anna Sina P; Ostrowski, Sisse R; Kjaergaard, Jesper;

    2016-01-01

    BACKGROUND: Morbidity and mortality following initial survival of cardiac arrest remain high despite great efforts to improve resuscitation techniques and post-resuscitation care, in part due to the ischemia-reperfusion injury secondary to the restoration of the blood circulation. Patients...... resuscitated from cardiac arrest display evidence of endothelial injury and coagulopathy (hypocoagulability, hyperfibrinolysis), which in associated with poor outcome. Recent randomized controlled trials have revealed that treatment with infusion of prostacyclin reduces endothelial damage after major surgery...... and AMI. Thus, a study is pertinent to investigate if prostacyclin infusion as a therapeutic intervention reduces endothelial damage without compromising, or even improving, the hemostatic competence in resuscitated cardiac arrest patients. Post-cardiac arrest patients frequently have a need...

  10. Arrest of cytoplasmic streaming induces algal proliferation in green paramecia.

    Directory of Open Access Journals (Sweden)

    Toshiyuki Takahashi

    Full Text Available A green ciliate Paramecium bursaria, bearing several hundreds of endosymbiotic algae, demonstrates rotational microtubule-based cytoplasmic streaming, in which cytoplasmic granules and endosymbiotic algae flow in a constant direction. However, its physiological significance is still unknown. We investigated physiological roles of cytoplasmic streaming in P. bursaria through host cell cycle using video-microscopy. Here, we found that cytoplasmic streaming was arrested in dividing green paramecia and the endosymbiotic algae proliferated only during the arrest of cytoplasmic streaming. Interestingly, arrest of cytoplasmic streaming with pressure or a microtubule drug also induced proliferation of endosymbiotic algae independently of host cell cycle. Thus, cytoplasmic streaming may control the algal proliferation in P. bursaria. Furthermore, confocal microscopic observation revealed that a division septum was formed in the constricted area of a dividing paramecium, producing arrest of cytoplasmic streaming. This is a first report to suggest that cytoplasmic streaming controls proliferation of eukaryotic cells.

  11. Stroke volume variation and pleth variability index to predict fluid responsiveness during resection of primary retroperitoneal tumors in Hans Chinese.

    Science.gov (United States)

    Fu, Q; Mi, W D; Zhang, H

    2012-02-01

    Respiration variation in arterial pulse pressure (ΔPP) and pulse oximetry plethysmographic waveform amplitude (ΔPOP) are accurate predictors of fluid responsiveness in mechanically ventilated patients. We hypothesized that stroke volume variation (SVV) and pleth variability index (PVI) can predict fluid responsiveness in mechanically ventilated patients during major surgical procedures in Hans Chinese. This prospective study consisted of fifty-five Hans Chinese patients undergoing resection of primary retroperitoneal tumors (PRPT). During the surgical procedures, hemodynamic data [central venous pressure (CVP), cardiac index (CI), stroke volume index (SVI), SVV, and PVI] were recorded before and after volume expansion (VE) (8 ml•kg-1 of 6% hydroxyethyl starch 130/0.4). Fluid responsiveness was defined as an increase in SVI ≥ 10% after VE. Four patients were excluded from analysis for arrhythmia or obvious hemorrhage during VE. Baseline SVV correlated well with baseline PVI and the changes in SVV was correlated with the changes in PVI (p Chinese.

  12. An uncommon clinical presentation of retroperitoneal non-Hodgkin lymphoma successfully treated with chemotherapy: A case report

    Institute of Scientific and Technical Information of China (English)

    Chiara Fulignati; Pietro Pantaleo; Greta Cipriani; Marianna Turrini; Rosalia Nicastro; Roberto Mazzanti; Bruno Neri

    2005-01-01

    We report the case of apetient affedted by an extra-nodal non-Hodgkin lymphoma presenting as a unique, large retroperitoneal mass with an unusual clinical presentation mimicking gastric peptic or neoplastic disease. The patient was successfully treated with a first generation therapy, CHOP modified regimen (cyclophosphamide 600 mg/m2 intravenously on d 1, epirubicin 55 mg/m2 intravenously on d 1, vincristine 1.2 mg/m2 intravenously on d 1, prednisone 60 mg/m2 on d 1-5), and a complete response was achieved. The (18)F-fluorodeoxyglucose positron emission tomography was used to assess the therapy outcome. A brief review of literature is provided.

  13. [Correlation of cytologic and pathohistologic findings in ultrasonically-guided thin-needle biopsy of abdominal and retroperitoneal organs].

    Science.gov (United States)

    Bokun, R; Tatomirović, Z; Lakić-Trajković, Z; Lisanin, L; Pesić, V; Zica, D; Lukac, S; Kupresanin, S; Spasić, V; Ilić, S; Dimitrijević, J

    1997-01-01

    The ultrasonically guided fine needle biopsy is cheap, very sensitive and specific method for the diagnosis of nonpalpable deep-seated lesions. During 1992 in the institute of Radiology of Military Medical Academy in Belgrade 87 biopsies of abdominal and 81 biopsies of retroperitoneal organs were performed for the cytological and histopathologic analysis. Deficient material was obtained in 15.4% of the cases. A good correlation between cytologic and histopathologic findings was observed, with diagnostic concordance in 90.8%. In 9 cases with falsely positive cytological diagnosis at the first examination, the diagnosis of malignancy was later confirmed by other diagnosis procedures. Diagnostic difficulties and the significance of adequate biopsy were particularly stressed.

  14. Anesthetic management of a patient with 10 l of blood loss during operation for a retroperitoneal mass

    Directory of Open Access Journals (Sweden)

    Xueqin Zhu

    2015-04-01

    Full Text Available Bleeding is a common problem during resection of a retroperitoneal mass. Massive bleeding may occur in case of injury of an adjacent major vessel or organ. This case report describes a successful anesthetic management of a patient with 10 l of blood loss within three hours surgery. A 44-year-old woman who underwent an operation for resection of a retroperitoneal mass, went to a hypovolemic shock, due to acute life-threatening intra-operative bleeding, and was successfully rescued with a combination of measures, including control of surgical bleeding, supportive treatment with rapid fluid infusion, massive transfusion of blood products and administration of intravenous vasoactive agents for maintaining tissue perfusion and oxygenation, utilizing intraoperative autologous blood salvaged via cell saver, as well as prevention and treatment of complications. The patient received a total of 22 units of Packet Red Blood Cells (PRBCs, 18 units of Fresh Frozen Plasma (FFP, 10 units of cryoprecipitate, 3750 ml of her own salvage blood. Postoperatively, she was transferred to the intensive care unit (ICU with mechanical ventilator support, where she received another 5.4 units of FFP, 10 units of cryoprecipitate. The patient developed features of early acute lung injury such as fever and hypoxemia, and was managed successfully with mechanical ventilator support for a few days. At a three-month follow-up, the patient was doing very well. This paper explores the pathogenesia, implications, prevention and treatment of the transfusion-associated complications such as acidosis, hypothermia, electrolyte abnormalities, and transfusion-related acute lung injury (TRALI. Particular attention is given to the prevention of secondary coagulopathy of the patient requiring massive blood transfusion. This case study presents a good reference for similar anesthetic scenario in the future.

  15. Laparoscopic and open postchemotherapy retroperitoneal lymph node dissection in patients with advanced testicular cancer – a single center analysis

    Directory of Open Access Journals (Sweden)

    Busch Jonas

    2012-05-01

    Full Text Available Abstract Background The open approach represents the gold standard for postchemotherapy retroperitoneal lymph node dissection (O-PCLND in patients with residual testicular cancer. We analyzed laparoscopic postchemotherapy retroperitoneal lymph node dissection (L-PCLND and O-PCLND at our institution. Methods Patients underwent either L-PCLND (n = 43 or O-PCLND (n = 24. Categorical and continuous variables were compared using the Fisher exact test and Mann–Whitney U test respectively. Overall survival was evaluated with the log-rank test. Results Primary histology was embryonal cell carcinomas (18 patients, pure seminoma (2 cases and mixed NSGCTs (47 patients. According to the IGCCCG patients were categorized into “good”, “intermediate” and “poor prognosis” disease in 55.2%, 14.9% and 20.8%, respectively. Median operative time for L-PCLND was 212 min and 232 min for O-PCLND (p = 0.256. Median postoperative duration of drainage and hospital stay was shorter after L-PCLND (0.0 vs. 3.5 days; p 500 ml was almost equally distributed (8.6% vs. 14.2%: p = 0.076. No significant differences were observed for injuries of major vessels and postoperative complications (p = 0.758; p = 0.370. Tumor recurrence occurred in 8.6% following L-PCLND and in 14.2% following O-PCLND with a mean disease-free survival of 76.6 and 89.2 months, respectively. Overall survival was 83.3 and 95.0 months for L-PCNLD and O-PCLND, respectively (p = 0.447. Conclusions L-PCLND represents a safe surgical option for well selected patients at an experienced center.

  16. Usage of Lightning Arrester Line to Feed Light Electrical Loads

    Directory of Open Access Journals (Sweden)

    Hani B. Odeh

    2009-01-01

    Full Text Available In remote areas, light loads (tens of kilowatts are scattered and situated in the field of high voltage lines (66KV and above. These loads are very far from the main feeders/sub-stations (33KV-0.380KV. Feeding such loads in the traditional ways like provision of Diesel-Powered Stations, installation of new distribution lines from the Feeding Centers, or building new Sub-Stations are not practical ways from the economical point of view, because it requires huge additional expenses and will increase electrical power losses. These expenses are not worthy for such loads and therefore, it is necessary to search for other methods to supply them. One of these methods is to use the lightning arrester line as capacitive divider to supply the light loads. In this research, the induced voltage of the lightning arrester line was calculated when it is isolated from the earth. We found the capacitance between lightning arrester line versus the phases and lightning arrester. It was also found the selective power out of the lightning arrester line and the required length which is to be isolated from the earth keeping the main function of the lightning arrester line. When economically comparing between supplying the light electrical loads by traditional ways and the method of lightning arrester, it was found the advantage of using lightning arresters to supply such loads. Also, by using the traditional methods, it was noted that there is a power loss in the power transmission lines by a percentage of 1.8%.

  17. Al-Qaeda arrest casts shadow over the LHC

    CERN Multimedia

    Dacey, James

    2010-01-01

    "Cern remains on course for the imminent switch-on of the Large Hadron Collider (LHC) despite the media frenzy following the recent arrest of a physicist who had been working at the facility. The researcher in question is a 32-year-old man of Algerian descent who is expected to face trail in France - the country in which he was arrested" (0.5 page)

  18. Talimogene Laherparepvec and Nivolumab in Treating Patients With Refractory Lymphomas or Advanced or Refractory Non-melanoma Skin Cancers

    Science.gov (United States)

    2017-01-31

    Adenoid Cystic Carcinoma; Adnexal Carcinoma; Apocrine Carcinoma; Eccrine Porocarcinoma; Extraocular Cutaneous Sebaceous Carcinoma; Hidradenocarcinoma; Keratoacanthoma; Malignant Sweat Gland Neoplasm; Merkel Cell Carcinoma; Microcystic Adnexal Carcinoma; NK-Cell Lymphoma, Unclassifiable; Non-Melanomatous Lesion; Paget Disease; Papillary Adenocarcinoma; Primary Cutaneous Mucinous Carcinoma; Refractory Anaplastic Large Cell Lymphoma; Refractory Cutaneous T-Cell Non-Hodgkin Lymphoma; Refractory Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma; Refractory Mycosis Fungoides; Refractory T-Cell Non-Hodgkin Lymphoma; Sezary Syndrome; Signet Ring Cell Carcinoma; Skin Basal Cell Carcinoma; Skin Basosquamous Cell Carcinoma; Skin Squamous Cell Carcinoma; Spiradenocarcinoma; Squamous Cell Carcinoma of Unknown Primary Origin; Stage III Skin Cancer; Stage IV Skin Cancer; Sweat Gland Carcinoma; Trichilemmocarcinoma; Vulvar Squamous Cell Carcinoma

  19. Monitoring of Refractory wall recession using radar technique

    Energy Technology Data Exchange (ETDEWEB)

    University of missouri

    2003-12-30

    Furnaces are the most crucial components in the glass and metallurgical industry. Like any other components in an industry, furnaces require periodic maintenance and repair. Today, furnaces are being operated at higher temperatures and for longer periods of time thus increasing the rate of wear and tear on the furnace refractory lining. As a result of the competitive market facing these industries, longer furnace lifetime with shorter maintenance downtime are increasingly required. Higher fuel consumption, low production and safety are issues that accompany delayed maintenance. Consequently, there is a need to know the state of a refractory wall to prevent premature or unnecessary maintenance shutdowns. For many years the observation skills of an experienced operator has been the primary source of evaluating the wear associated with a refractory wall. The rate of regression of a refractory lining depends on the type of the refractory lining, the materials Monitoring of Refractory Wall Recession Using Frequency-Modulated Continuous-Wave (FM-CW) Radar Techniques: A Proof-of-Concept Study, Final Report, Submitted to the Department of Energy (DOE), September 2003. being melted, seepage, mechanical stresses, and temperature. Moreover, the regression of a refractory lining is also not uniform throughout a furnace and it is more prominent at the metal line along the sidewalls as this region is exposed to hot gaseous byproducts and flowing molten material. Hence, more accurate measurement techniques are required to determine the local residual thickness of a refractory lining so as to utilize the refractory lining to the maximum extent possible. The use of isotope radiators, thermocouples and endoscopes has also been investigated for monitoring regression. These techniques are capable of providing scanned thermal images showing the profile of the refractory wall. However, these techniques can only provide relative profile information and cannot provide absolute thickness

  20. Respiratory Arrest in an Obese Pregnant Woman with Hyperemesis Gravidarum

    Directory of Open Access Journals (Sweden)

    Ayumi Iwashita

    2015-01-01

    Full Text Available A pregnant, non-Japanese-speaking Peruvian, and, thus, with communication difficulty, suffered hyperemesis gravidarum and had respiratory arrest, requiring cardiopulmonary resuscitation. The obese pregnant woman (prepregnancy weight: 107 kg had vomited and lost 15 kg in bodyweight over appropriately 2 weeks prior to the arrest but had not complained due to communication difficulty, which, together with her obesity, prevented a Japanese obstetrician from noticing her severe condition. 1,000 mL of low potassium fluid plus thiamine was administered. She became unable to stand, suggesting lower-extremity-proximal-muscle weakness, and then respiratory arrest occurred. Hypopotassemia (2.3 mEq/L, pulseless electrical activity, and muscle weakness suggested the presence of severe potassium deficiency, which may have caused respiratory muscle paralysis, leading to the respiratory arrest. Hypercapnea was severer than expected for compensatory hypoventilation, indicating the presence of concomitant severe hypoventilation, which may also have contributed to respiratory arrest. She recovered with electrolyte and volume replacement. Respiratory arrest can occur with hyperemesis gravidarum, and obesity and communication difficulties can prevent the early detection of severe conditions.

  1. Cardiac arrest due to lymphocytic colitis: a case report

    Directory of Open Access Journals (Sweden)

    Groth Kristian A

    2012-03-01

    Full Text Available Abstract Introduction We present a case of cardiac arrest due to hypokalemia caused by lymphocytic colitis. Case presentation A 69-year-old Caucasian man presented four months prior to a cardiac arrest with watery diarrhea and was diagnosed with lymphocytic colitis. Our patient experienced a witnessed cardiac arrest at his general practitioner's surgery. Two physicians and the emergency medical services resuscitated our patient for one hour and four minutes before arriving at our university hospital. Our patient was defibrillated 16 times due to the recurrence of ventricular tachyarrhythmias. An arterial blood sample revealed a potassium level of 2.0 mmol/L (reference range: 3.5 to 4.6 mmol/L and pH 6.86 (reference range: pH 7.37 to 7.45. As the potassium level was corrected, the propensity for ventricular tachyarrhythmias ceased. Our patient recovered from his cardiac arrest without any neurological deficit. Further tests and examinations revealed no other reason for the cardiac arrest. Conclusion Diarrhea can cause life-threatening situations due to the excretion of potassium, ultimately causing cardiac arrest due to hypokalemia. Physicians treating patients with severe diarrhea should consider monitoring their electrolyte levels.

  2. Associates of Cardiopulmonary Arrest in the Perihemodialytic Period

    Directory of Open Access Journals (Sweden)

    Jennifer E. Flythe

    2014-01-01

    Full Text Available Cardiopulmonary arrest during and proximate to hemodialysis is rare but highly fatal. Studies have examined peridialytic sudden cardiac event risk factors, but no study has considered associates of cardiopulmonary arrests (fatal and nonfatal events including cardiac and respiratory causes. This study was designed to elucidate patient and procedural factors associated with peridialytic cardiopulmonary arrest. Data for this case-control study were taken from the hemodialysis population at Fresenius Medical Care, North America. 924 in-center cardiopulmonary events (cases and 75,538 controls were identified. Cases and controls were 1 : 5 matched on age, sex, race, and diabetes. Predictors of cardiopulmonary arrest were considered for logistic model inclusion. Missed treatments due to hospitalization, lower body mass, coronary artery disease, heart failure, lower albumin and hemoglobin, lower dialysate potassium, higher serum calcium, greater erythropoietin stimulating agent dose, and normalized protein catabolic rate (J-shaped were associated with peridialytic cardiopulmonary arrest. Of these, lower albumin, hemoglobin, and body mass index; higher erythropoietin stimulating agent dose; and greater missed sessions had the strongest associations with outcome. Patient health markers and procedural factors are associated with peridialytic cardiopulmonary arrest. In addition to optimizing nutritional status, it may be prudent to limit exposure to low dialysate potassium (<2 K bath and to use the lowest effective erythropoietin stimulating agent dose.

  3. Exploration of the arrest peptide sequence space reveals arrest-enhanced variants.

    Science.gov (United States)

    Cymer, Florian; Hedman, Rickard; Ismail, Nurzian; von Heijne, Gunnar

    2015-04-17

    Translational arrest peptides (APs) are short stretches of polypeptides that induce translational stalling when synthesized on a ribosome. Mechanical pulling forces acting on the nascent chain can weaken or even abolish stalling. APs can therefore be used as in vivo force sensors, making it possible to measure the forces that act on a nascent chain during translation with single-residue resolution. It is also possible to score the relative strengths of APs by subjecting them to a given pulling force and ranking them according to stalling efficiency. Using the latter approach, we now report an extensive mutagenesis scan of a strong mutant variant of the Mannheimia succiniciproducens SecM AP and identify mutations that further increase the stalling efficiency. Combining three such mutations, we designed an AP that withstands the strongest pulling force we are able to generate at present. We further show that diproline stretches in a nascent protein act as very strong APs when translation is carried out in the absence of elongation factor P. Our findings highlight critical residues in APs, show that certain amino acid sequences induce very strong translational arrest and provide a toolbox of APs of varying strengths that can be used for in vivo force measurements.

  4. Refractoriness in sustained visuo-manual control: is the refractory duration intrinsic or does it depend on external system properties?

    Directory of Open Access Journals (Sweden)

    Cornelis van de Kamp

    Full Text Available Researchers have previously adopted the double stimulus paradigm to study refractoriness in human neuromotor control. Currently, refractoriness, such as the Psychological Refractory Period (PRP has only been quantified in discrete movement conditions. Whether refractoriness and the associated serial ballistic hypothesis generalises to sustained control tasks has remained open for more than sixty years. Recently, a method of analysis has been presented that quantifies refractoriness in sustained control tasks and discriminates intermittent (serial ballistic from continuous control. Following our recent demonstration that continuous control of an unstable second order system (i.e. balancing a 'virtual' inverted pendulum through a joystick interface is unnecessary, we ask whether refractoriness of substantial duration (~200 ms is evident in sustained visual-manual control of external systems. We ask whether the refractory duration (i is physiologically intrinsic, (ii depends upon system properties like the order (0, 1(st, and 2(nd or stability, (iii depends upon target jump direction (reversal, same direction. Thirteen participants used discrete movements (zero order system as well as more sustained control activity (1(st and 2(nd order systems to track unpredictable step-sequence targets. Results show a substantial refractory duration that depends upon system order (250, 350 and 550 ms for 0, 1(st and 2(nd order respectively, n=13, p<0.05, but not stability. In sustained control refractoriness was only found when the target reverses direction. In the presence of time varying actuators, systems and constraints, we propose that central refractoriness is an appropriate control mechanism for accommodating online optimization delays within the neural circuitry including the more variable processing times of higher order (complex input-output relations.

  5. Electrochemical Corrosion of Carbon—Containing Refractories

    Institute of Scientific and Technical Information of China (English)

    CHENZhao-you

    1994-01-01

    The electrochemical examination on the cor-rosion of carbon or carbon containing refractiories at molten slag-liquid interface has been carried out.The electromotive force(E.M.F)of cells with different molten slags:C|molten slag | Fe at elevated temperatures has been measured by means of potentiometer and it is in the range from 250 to 450mV .It is found that the carbon electrode in these cells is anode and whn a counter E.M.F.is applied externally to the cel,the corrosion of carbon electrode will be sup-pressed entirely.Test results show that the local corrosion of carbon containing refractories at slag-metal interface is mainly caused by the mechanism of electrochemical corrosion.

  6. Alemtuzumab in refractory Sézary syndrome*

    Science.gov (United States)

    Reifs, Carmen María Alcántara; Salido-Vallejo, Rafael; Garnacho-Saucedo, Gloria María; la Corte-Sánchez, Sofía De; González-Menchen, Alberto; García-Nieto, Antonio Vélez

    2016-01-01

    Sézary syndrome is a primary cutaneous T-cell lymphoma characterized by the triad of erythroderma, lymphadenopathy and circulating atypical cells. The emergence of new molecular targets has enabled the development of drugs such as alemtuzumab, an anti-CD52 monoclonal antibody, which has shown promising results in the treatment of this entity. We report the case of a 70-year-old male with refractory Sézary syndrome in whom treatment with alemtuzumab achieved an 80% skin lesion clearance with complete haematologic and radiologic response. The treatment was discontinued after 4 months due to adverse effects, with the patient showing a sustained response without disease progression after 13 months of follow-up. PMID:27828640

  7. Iron-Refractory Iron Deficiency Anemia

    OpenAIRE

    Ebru Yılmaz Keskin; İdil Yenicesu

    2015-01-01

    Demir, oksijenin taşınması, DNA sentezi ve hücre çoğalması gibi çeşitli biyolojik reaksiyonlar için vazgeçilmez olduğundan, yaşam için zorunludur. Demir metabolizması ve bu elementin düzenlenmesiyle ilgili bilgilerimiz, son yıllarda belirgin şekilde değişmiştir. Demir metabolizması ile ilgili yeni bozukluklar tanımlanmış ve demirin başka bozuklukların kofaktörü olduğu anlaşılmaya başlamıştır. Hemokromatozis ve demir tedavisine dirençli demir eksikliği anemisi (IRIDA; “iron-refractory iron def...

  8. IgG4-related retroperitoneal fibrosis: A case report and literature review%IgG4相关性腹膜后纤维化病例报告并文献复习

    Institute of Scientific and Technical Information of China (English)

    王聪; 赵忺; 田建立; 巩路

    2015-01-01

    Clinical data of one patient diagnosed as IgG4-related retroperitoneal fibrosis was analyzed."IgG4" and "retroperitoneal fibrosis" were used as the key words to search literatures from PubMed and Wanfang Database.Clinical data of 27 cases with IgG4 retroperitoneal fibrosis,including clinical manifestation,diagnostic basis,therapeutic method and prognosis,which were retrieved through literatures,were analyzed.A 82-year-old male patient presented with urinary tract obstruction and renal insufficiency.Imaging examination revealed a retroperitoneal irregular lump shadow,and showed chronic inflammation of soft tissues in posterior peritoneum with fibrosis by biopsy pathology.The IgG4-positive plasmocyte infiltration was found by immunohistochemical method.The serum level of IgG4 was significantly increased,which was in accord with IgG4-related retroperitoneal fibrosis.After treatment with methylprednisolone,retroperitoneal lump shadow was obviously dissipated.The serum level of IgG4 became normal.27 cases with IgG4-related retroperitoneal fibrosis were searched through literature retrieval,with 19 confirmed cases,3 suspected cases,and 5 suspicious cases.Male accounted for 92.6% (25/27),and the average age was 67.6 years old.The cases with the involvement of extraperitoneal organs accounted for 37.0% (10/27).The misdiagnosis rate was 55.6% (15/27).23 cases took effective therapy with glucocorticoids.IgG4-related retroperitoneal fibrosis is an orphan disease,which can be misdiagnosed easily.The diagnosis is made with histopathological examination and determination on the serum level of IgG4.The therapy with glucocorticoids is effective.

  9. Pegloticase: in treatment-refractory chronic gout.

    Science.gov (United States)

    Lyseng-Williamson, Katherine A

    2011-11-12

    Intravenous pegloticase offers a novel approach to treating chronic gout refractory to conventional therapy. Pegloticase is a recombinant polyethylene glycol-conjugated form of uricase (a uric acid-specific enzyme lacking in humans) that catalyses the oxidation of uric acid to allantoin. In randomized, placebo-controlled, double-blind, 6-month, phase III trials, intravenous pegloticase 8 mg every 2 or 4 weeks provided sustained reductions in plasma uric acid levels to less than the therapeutic target of 6 mg/dL in a substantial proportion of patients with chronic gout who were refractory to, or intolerant of, conventional urate-lowering therapy. Pegloticase 8 mg every 2 weeks was associated with disease-modifying benefits relative to placebo, as shown by significant improvements from baseline in tophi resolution, frequency of gout flares and tender joint count, and clinically relevant and statistically significant improvements from baseline in health-related quality-of-life parameters related to disability, pain and physical function. Pegloticase 8 mg every 4 weeks was also significantly more effective than placebo with regard to most, but not all, of these endpoints. Preliminary data from an open-label extension of the phase III trials indicate that long-term treatment with pegloticase 8 mg every 2 or 4 weeks may maintain plasma uric acid normalization in patients who experienced a sustained uric acid response during the phase III trials. The most common serious adverse events associated with pegloticase are gout flares, infusion reactions and anaphylaxis. In addition, exacerbation of pre-existing congestive heart failure was reported in 2% of patients receiving pegloticase 8 mg every 2 weeks in the phase III trials.

  10. Esquizofrenia refratária Refractory schizophrenia

    Directory of Open Access Journals (Sweden)

    Helio Elkis

    2007-10-01

    Full Text Available OBJETIVO: O propósito deste artigo é o de revisar vários aspectos da esquizofrenia refratária levando em conta questões relacionadas à definição, aspectos clínicos, correlatos psicobiológicos, tratamentos farmacológicos e não farmacológicos, assim como preditores de resposta terapêutica. MÉTODO: Pesquisa no Medline, assim como artigos dos autores. RESULTADOS E CONCLUSÕES: Pelo menos um terço dos pacientes com esquizofrenia são refratários a tratamento com antipsicóticos e as evidências apontam a clozapina em monoterapia como a principal opção nesses casos. A politerapia com antipsicóticos não tem apoio em evidências. Ensaios clínicos recentes mostraram que a potencialização da clozapina com outros antipsicóticos não é superior ao placebo.OBJECTIVE: The aim of the present paper is to review the various aspects of refractory schizophrenia regarding issues such as definitions, clinical aspects, psychobiological correlates, pharmacological and non-pharmacological treatment options and predictors of treatment response. METHOD: Medline search as well as articles of the authors. RESULTS AND CONCLUSIONS: Refractory schizophrenia affects at least one third of patients with schizophrenia and the best evidence shows that is monotherapy with clozapine remains the mainstay for the treatment of such condition. Antipsychotic polipharmacy is not supported by current evidence and recent clinical trials have shown that clozapine augmentation with antipsychotics has no benefit over placebo.

  11. Greater omentum in reconstruction of refractory wounds

    Institute of Scientific and Technical Information of China (English)

    沈余明; 沈祖尧

    2003-01-01

    Objective: To evaluate the clinical efficacy of greater omentum in reconstruction of refractory wounds. Methods: From August 1988 to May 2001, 20 patients with refractory wound underwent pedicle or microvascular free transfer of the greater omentum. Indications of surgery were electrical injury of the wrist and hand in 9 patients, electrical injury of the scalp and cranial bones in 3, avulsion injury of the scalp in 2, radiation-related ulcer of the chest wall in 2, ulcer and osteomyelitis following resection of the sternum sarcoma in 1, electrical injury of the abdomen in 1, bone and soft tissue defects following compound fracture of the leg in 1, and extensive scar and ulcer of the leg and footdrop following trauma in 1. Severe infection and extensive tissue necrosis were present prior to surgical operation in 12 patients. Eleven patients were treated with pedicled omental flaps, and 9 patients with free omental flaps. The size of the omental flaps ranged from 20 cm×12 cm to 38 cm×23 cm. Results: All the omental flaps survived. Healing at the first intention of the wounds was achieved in 17 cases. The on-top skin grafts resulted in partial necrosis of lipid liquefaction developed in the omentum and healed with dressing change in 2 cases. A sinus tract of osteomyelitis occurred in one case and healed after delayed excision of the necrosed bone. Follow-up study of all cases from 3 to 24 months showed no recurrent wounds and post-operative abdominal complication. Recovery with acceptable appearance and restoration of function was satisfactory. Conclusions: Greater omentum provides a well-vascularized tissue with lymphatic ducts for wound coverage. It has strong resistance against infection. It is very malleable and can be molded easily. Therefore it is an ideal tissue in filling cavities and repairing defects, especially in covering large and irregular defects that can not be treated with skin or muscle flaps.

  12. Brain stimulation for treatment of refractory epilepsy

    Institute of Scientific and Technical Information of China (English)

    GE Yan; HU Wei; LIU Chong; ZHANG Jian-guo; MENG Fan-gang

    2013-01-01

    Objective We review the targets of the deep brain and the responsive neurostimulation system (RNS) to identify the best optimal stimulation parameters and the best mode of stimulation,whether cyclical,continuous,or smarter.Data sources This review is based on data obtained from published articles from 1950 to 2013.To perform the PubMed literature search,the following keywords were input:deep brain stimulation (DBS),RNS,and refractory epilepsy.Study selection Articles containing information related to brain stimulation or RNS for the treatment of refractory epilepsy were selected.Results The currently available treatment options for those patients who resist multiple antiepileptic medications and surgical procedures include electric stimulation,both direct and indirect,of brain nuclei thought to be involved in epileptogenesis.The number of potential targets has increased over the years to include the anterior nucleus of the thalamus,the centromedian nucleus of the thalamus,the hippocampus,the subthalamic nucleus,the caudate nucleus,and the cerebellum,among others.The results of a randomized controlled trial and the RNS trial were published to reveal the effectiveness.Conclusions Although statistically significant reductions in seizures have been observed using several different stimulation techniques,including vagus nerve stimulation,DBS,and RNS,these effects are currently only palliative and do not approach the efficacy comparable with that seen in resection in appropriately selected patients.More research is needed to determine optimal stimulation targets and techniques as well as to determine which epilepsy patients will benefit most from this technology.

  13. High-Density Infrared Surface Treatments of Refractories

    Energy Technology Data Exchange (ETDEWEB)

    Tiegs, T.N.

    2005-03-31

    Refractory materials play a crucial role in all energy-intensive industries and are truly a crosscutting technology for the Industries of the Future (IOF). One of the major mechanisms for the degradation of refractories and a general decrease in their performance has been the penetration and corrosion by molten metals or glass. Methods and materials that would reduce the penetration, wetting, and corrosive chemistry would significantly improve refractory performance and also maintain the quality of the processed liquid, be it metal or glass. This report presents the results of an R&D project aimed at investigating the use of high-density infrared (HDI) heating to surface treat refractories to improve their performance. The project was a joint effort between Oak Ridge National Laboratory (ORNL) and the University of Missouri-Rolla (UMR). HDI is capable of heating the near-surface region of materials to very high temperatures where sintering, diffusion, and melting can occur. The intended benefits of HDI processing of refractories were to (1) reduce surface porosity (by essentially sealing the surface to prevent liquid penetration), (2) allow surface chemistry changes to be performed by bonding an adherent coating onto the underlying refractory (in order to inhibit wetting and/or improve corrosion resistance), and (3) produce noncontact refractories with high-emissivity surface coatings.

  14. Successful treatment of severe refractory lupus hepatitis with mycophenolate mofetil.

    Science.gov (United States)

    Tagawa, Y; Saito, T; Takada, K; Kawahata, K; Kohsaka, H

    2016-04-01

    Systemic lupus erythematosus-related hepatitis, known as lupus hepatitis, is a rare manifestation of systemic lupus erythematosus, and is usually subclinical with mild abnormalities of serum liver enzymes. While cases with clinically significant and refractory lupus hepatitis are uncommon, treatment options for lupus hepatitis are to be established. Here, we report the case of a 45-year-old man with progressive lupus hepatitis accompanied by autoimmune haemolytic anaemia. Lupus hepatitis of this patient was refractory to tacrolimus, azathioprine and cyclophosphamide, but was successfully treated by mycophenolate mofetil. Mycophenolate mofetil might be an effective therapeutic option for refractory lupus hepatitis.

  15. RESEARCH ON REFRACTORY SUPERALLOYS IN THE HTM 21 PROJECT

    Institute of Scientific and Technical Information of China (English)

    Y.F.Gu; Y.Yamabe-Mitarai; C.Huang; H.Harada

    2005-01-01

    It was proposed that a new class of alloys based on platinum group metals (PGMs) were called refractory superalloys.These refractory superalloys have an fcc and LI2 coherent two-phase structure (similar to that of Ni-based superalloys), high melting temperatures and good potential as structural materials used at temperatures up to 1800℃.Our recent results on the microstructure evolution, deformation and fracture behavior of some of these refracotry superalloys, especial Ir- and Rh-base refractory superalloys were reported.

  16. [Fever-induced refractory epileptic encephalopathy of children].

    Science.gov (United States)

    Sivkova, S N; Bogdanov, E I; Zaĭkova, F M; Morozova, E A; Aiupova, V A; Zabbarova, A T; Shaĭmardanova, R M

    2013-01-01

    Fever-induced refractory epileptic encephalopathy of school-age children is a rare epileptic syndrome that causes difficulties in diagnosis at the initial stage of disease. It is characterized by sudden onset with multifocal refractory status epilepticus in previously healthy children with normal development. Later, children suffer from resistant focal epilepsy in the combination with cognitive deficit and behavioral difficulties. Authors describe a clinical case of fever-induced refractory epileptic encephalopathy of school-age children in a child of 7 years old. Aspects of etiology, pathogenesis, clinical manifestation, differential diagnosis, treatment and prognosis of the disease are discussed.

  17. Pilot study of Bortezomib for Patients with Imatinib-Refractory Chronic Myeloid Leukemia in Chronic or Accelerated Phase

    Science.gov (United States)

    Santos, Fabio P S; Kantarjian, Hagop; McConkey, David; O'Brien, Susan; Faderl, Stefan; Borthakur, Gautam; Ferrajoli, Alessandra; Wright, John; Cortes, Jorge

    2015-01-01

    Background Proteasome inhibitors are anticancer compounds that disrupt the proteolytic activity of the proteasome and lead to tumor cell growth arrest and apoptosis. Bortezomib is a proteasome inhibitor that is currently approved for use in multiple myeloma and mantle cell lymphoma. It induces apoptosis of chronic myeloid leukemia (CML) cells in vitro, but the activity of bortezomib in patients with imatinib-resistant CML is unknown. Methods We conducted a pilot trial to evaluate the activity of single agent bortezomib in CML. Seven patients with imatinib-refractory CML were treated with bortezomib at a dose of 1.5 mg/m2 on days 1, 4, 8 and 11 every 3 weeks. Results The median number of cycles received was 2. No patient had a hematologic or cytogenetic response. Three patients had a temporary decrease in basophil counts associated with therapy with bortezomib. Six patients developed grade 3-4 nonhematological toxicities. Conclusion Bortezomib had minimal efficacy and considerable toxicity in patients with imatinib-refractory CML. Further studies should focus on alternative approaches to employ proteasome inhibitors in the treatment of CML, such as in combination with tyrosine kinase inhibitors or as a strategy to eradicate leukemic stem cells. PMID:21816374

  18. Nursing students’ knowledge about arrest rhythms and their treatment

    Directory of Open Access Journals (Sweden)

    Aikaterini Kyrgianidou

    2014-04-01

    Full Text Available Cardiovascular diseases are one of the leading causes of death worldwide. Knowledge of health professionals for the arrest rhythms, is considered particularly important for the early recognition and proper treatment. Aim: The purpose of the present study was to assess the knowledge of nursing students on arrest rhythms and how to treat them. Material and Methods: The sample studied included 151 students from the Department of Nursing A' (n = 60, 40% and B' (n = 91, 60%, TEI of Athens, of whom 83% (n=125 were women and 17% (n=26 were men with a mean age of 23 years. Data collection was performed with specially designed questionnaire, that apart from demographics and students’ education level, it included ten questions about arrest rhythms’ knowledge and also self-assessment questions of their level of knowledge. The data were analyzed with the SPSS package v.19, using the criteria t-Test and χ2. Results: Of all the participants in the research, 95% (n = 144 did not answer correctly more than 6 questions from a total of 10. The students of the Department of Nursing A’ recognized with greater accuracy the arrest rhythms (p = 0.003. Those studying in lower semester acknowledged best the arrest rhythms (p = 0.002. Students who had recently attended course in basic or advanced resuscitation recognized best the arrest rhythms (p = 0.006. Older students knew better right treatment of the arrest rhythms (p = 0.037. Also, students who had attended the course of cardiac nursing in the last year, knew better the right treatment (p <0.001. Finally, the level of self-assessment was in line with the actual level of knowledge of students (p = 0.05. Conclusions: Continuous attendance of courses, education on certified programs and refresh courses help to maintain a good level of knowledge for longer periods.

  19. The stringent response and cell cycle arrest in Escherichia coli.

    Directory of Open Access Journals (Sweden)

    Daniel J Ferullo

    2008-12-01

    Full Text Available The bacterial stringent response, triggered by nutritional deprivation, causes an accumulation of the signaling nucleotides pppGpp and ppGpp. We characterize the replication arrest that occurs during the stringent response in Escherichia coli. Wild type cells undergo a RelA-dependent arrest after treatment with serine hydroxamate to contain an integer number of chromosomes and a replication origin-to-terminus ratio of 1. The growth rate prior to starvation determines the number of chromosomes upon arrest. Nucleoids of these cells are decondensed; in the absence of the ability to synthesize ppGpp, nucleoids become highly condensed, similar to that seen after treatment with the translational inhibitor chloramphenicol. After induction of the stringent response, while regions corresponding to the origins of replication segregate, the termini remain colocalized in wild-type cells. In contrast, cells arrested by rifampicin and cephalexin do not show colocalized termini, suggesting that the stringent response arrests chromosome segregation at a specific point. Release from starvation causes rapid nucleoid reorganization, chromosome segregation, and resumption of replication. Arrest of replication and inhibition of colony formation by ppGpp accumulation is relieved in seqA and dam mutants, although other aspects of the stringent response appear to be intact. We propose that DNA methylation and SeqA binding to non-origin loci is necessary to enforce a full stringent arrest, affecting both initiation of replication and chromosome segregation. This is the first indication that bacterial chromosome segregation, whose mechanism is not understood, is a step that may be regulated in response to environmental conditions.

  20. Changing the guard: Polymer replaces porcelain for surge arresters

    Energy Technology Data Exchange (ETDEWEB)

    Skytt, T.; Gleimar, H. E. G.

    2002-07-01

    Surge arresters are safety devices which quickly and effectively limit the over voltages that can arise in transmission networks following lightning, switching and other transient events. The earliest forms of overvoltage protection, a simple air gap between electrodes, have long since been replaced by a new generation of gapless arresters with series-connected, non-linear zinc oxide varistors contained in a porcelain housing. Now these porcelain type surge arresters are being replaced by a new type, called PEXLIM (Polymeric EXcellent LIMiter), which uses the same block of zinc oxide as the porcelain type, but its housing is made of silicon rubber, a polymer. The new lightweight insulation material shows a number of properties superior to the porcelain, such as enhanced product safety and ease of handling. It is also more durable, resilient, yet solid and compact, water-repellent, lightweight, resistant to aging or light or ultra-violet radiation, as well as fire, has good electrical properties, and is environmentally friendly since it does not contain any substances harmful to the environment. These properties make this new type of surge arrester highly suitable for use in earthquake-prone areas; it can also replace more expensive and maintenance-intensive equipment. Having successfully broken into the lower voltage systems, these new type of surge arresters are now rapidly gaining ground at the higher voltage levels. ABB, the developer of PEXLIM, has already supplied these arresters to North America for use in an 800-kV grid. As further proof of its growing popularity, last year PEXLIM made up over half of the surge arrester production for applications up to and including 245 kV. 1 tab., 6 figs.

  1. Biliary Duct-to-Duct Reconstruction with a Tunneled Retroperitoneal T-Tube During Liver Transplantation: a Novel Approach to Decrease Biliary Leaks After T-Tube Removal.

    Science.gov (United States)

    Navez, Julie; Mohkam, Kayvan; Darnis, Benjamin; Cazauran, Jean-Baptiste; Ducerf, Christian; Mabrut, Jean-Yves

    2017-04-01

    The benefit of placing a T-tube for duct-to-duct biliary reconstruction during orthotopic liver transplantation (OLT) remains controversial because it could be associated with specific complications, especially at the time of T-tube removal. While the utility of T-tube during OLT represents an eternal debate, only a few technical refinements of T-tube placement have been described since the report of the original technique by Starzl and colleagues. Herein, we present a novel technique of T-tube placement for duct-to-duct biliary reconstruction during OLT, using a tunneled retroperitoneal route. On the basis of our experience of 305 patients who benefitted from the reported technique, the placement of a tunneled retroperitoneal biliary T-tube appears to be safe and results in a low rate of biliary complications, especially at the time of T-tube removal.

  2. Peptide receptor radionuclide therapy with lutetium-177 DOTATATE in a case of recurrent extradrenal retroperitoneal malignant paraganglioma with nodal and bone metastasis

    Directory of Open Access Journals (Sweden)

    Koramadai Karuppusamy Kamaleshwaran

    2015-01-01

    Full Text Available Extra-adrenal retroperitoneal paragangliomas (PGLs are rare tumors causing considerable difficulty in both, diagnosis and treatment. They can be unicentric or multicentric, tend to be locally invasive and therefore have a high incidence of local recurrence. PGLs shows somatostatin receptor positivity, which can be imaged with technetium-99m (Tc-99m-hydrazinonicotinyl-Tyr3-octreotide (HYNIC-TOC and can be treated with lutetium-177 (Lu-177 DOTATATE. We present a case of recurrent unresectable retroperitoneal PGL with nodal and bone metastases in a 27-year-old male, 6 months postsurgery detected with Tc-99m-HYNIC-TOC and was administered with peptide receptor radionuclide therapy using Lu-177 DOTATATE.

  3. Femoral neuropathy due to retroperitoneal bleeding. A red herring in medicine complicates anticoagulant therapy and influences the Russian Communist Revolution (Crown Prince Alexis, Rasputin).

    Science.gov (United States)

    Willbanks, O L; Willbanks, S E

    1983-02-01

    Femoral neuropathy occurs when occult retroperitoneal bleeding impinges on the appropriate nerve roots. The syndrome involves the acute onset of groin and thigh pain with characteristic flexion and external rotation of the hip. It may mimic other conditions such as acute arterial occlusion. Thorough knowledge of the anatomy of the femoral nerve explains the clinical features and leads the clinician to suspect the occurrence of this syndrome. Three cases have been reviewed that exhibited this condition as a result of retroperitoneal bleeding, a complication of systemic heparin therapy. The hemophilia that afflicted Alexis, the Crown Prince of Russia and son of Tsar Nicholas and Tsarina Alexandra, resulted in this clinical syndrome. The consequences enabled the sinister starets, Gregory Rasputin, to become intimately involved with the royal family, influencing the response of the Tsar to the political events in Russia, thereby playing an important role in setting the stage for the 1917 Russian communist revolution.

  4. Diagnostic Value of Multislice Computed Tomography and Magnetic Resonance Imaging in the Diagnosis of Retroperitoneal Spread of Testicular Cancer: A Literature Review

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, J. (Dept. of Medical Physics, Aarhus Univ. Hospital, Aarhus Sygehus, Aarhus (Denmark)); Jurik, A.G. (Dept. of Radiology, Aarhus Univ. Hospital, Aarhus Sygehus, Aarhus (Denmark))

    2009-11-15

    Testicular cancer is the most frequent malignant disorder in men aged 15-35 years. Generally, diagnosing and follow-up include computer tomography (CT) examinations to detect possible retroperitoneal spread (abdomen and pelvis), resulting in at least eight CT examinations. This patient group is thereby exposed to a non-neglectable radiation dose, increasing the risk of future radiation-induced secondary cancer. This is especially problematic in potentially surgically cured patients with stage 1 testicular cancer. Thus, it can be beneficial to substitute CT with magnetic resonance imaging (MRI), provided there is valid evidence that the diagnostic value of MRI is at least comparable to current multislice CT (MSCT). The purpose of this study was to analyze whether there is evidence to recommend a substitution of MSCT with MRI in the diagnosis of retroperitoneal spread of testicular cancer. A literature search on the diagnostic accuracy, specificity, and sensitivity of MSCT and MRI in the diagnosis of retroperitoneal spread of testicular cancer was performed in the following databases: PubMed, EmBase, and ISI Web of Science. The search was limited to include the period from 2000 to September 2008, and to human and English-language publications. Forty-four publications were obtained for formal review (27 from PubMed, 15 from EmBase, two from ISI Web of Science). None of the publications reviewed encompassed diagnostic specificity and sensitivity of MSCT, and they lacked systematic comparison of MSCT and MRI. Only one study included sensitivity and specificity of MRI compared to single-slice CT. Both methods had a sensitivity and a specificity of approximately 70%. The literature review did not reveal valid data regarding diagnostic accuracy of MRI compared with MSCT for diagnosing retroperitoneal spread of testicular cancer. A prospective blinded comparative study is needed to provide valid evidence

  5. Visualizing Vpr-induced G2 arrest and apoptosis.

    Directory of Open Access Journals (Sweden)

    Tomoyuki Murakami

    Full Text Available Vpr is an accessory protein of human immunodeficiency virus type 1 (HIV-1 with multiple functions. The induction of G2 arrest by Vpr plays a particularly important role in efficient viral replication because the transcriptional activity of the HIV-1 long terminal repeat is most active in G2 phase. The regulation of apoptosis by Vpr is also important for immune suppression and pathogenesis during HIV infection. However, it is not known whether Vpr-induced apoptosis depends on the ability of Vpr to induce G2 arrest, and the dynamics of Vpr-induced G2 arrest and apoptosis have not been visualized. We performed time-lapse imaging to examine the temporal relationship between Vpr-induced G2 arrest and apoptosis using HeLa cells containing the fluorescent ubiquitination-based cell cycle indicator2 (Fucci2. The dynamics of G2 arrest and subsequent long-term mitotic cell rounding in cells transfected with the Vpr-expression vector were visualized. These cells underwent nuclear mis-segregation after prolonged mitotic processes and then entered G1 phase. Some cells subsequently displayed evidence of apoptosis after prolonged mitotic processes and nuclear mis-segregation. Interestingly, Vpr-induced apoptosis was seldom observed in S or G2 phase. Likewise, visualization of synchronized HeLa/Fucci2 cells infected with an adenoviral vector expressing Vpr clearly showed that Vpr arrests the cell cycle at G2 phase, but does not induce apoptosis at S or G2 phase. Furthermore, time-lapse imaging of HeLa/Fucci2 cells expressing SCAT3.1, a caspase-3-sensitive fusion protein, clearly demonstrated that Vpr induces caspase-3-dependent apoptosis. Finally, to examine whether the effects of Vpr on G2 arrest and apoptosis were reversible, we performed live-cell imaging of a destabilizing domain fusion Vpr, which enabled rapid stabilization and destabilization by Shield1. The effects of Vpr on G2 arrest and subsequent apoptosis were reversible. This study is the first to

  6. Compressive Creep and Thermophysical Performance of Mullite Refractories

    Energy Technology Data Exchange (ETDEWEB)

    Hemrick, JG

    2002-04-01

    Compressive creep testing of ten commercially available mullite refractories was performed at 1300-1450 C and at static stresses between 0.2-0.6 MPa. These refractories were examined because they are used in borosilicate glass furnace crowns and superstructures along with in sidewall applications. Additionally, despite their high cost ({approx}$500/ft{sup 3}) they are cheaper than other refractories such as chrome alumina ({approx}$3000/ft{sup 3}) or fusion-cast alumina ({approx}900/ft{sup 3}) which are used as replacements for traditional silica refractories in harsh oxy-fuel environments. The corrosion resistances of these ten materials were also evaluated. In addition, measurements were made that tracked their dimensional stability, phase content, microstructure, and composition as a function of temperature and time. The techniques used for these characterizations and their respective analyses are described. An intent of this study was to provide objective and factual results whose interpretations were left to the reader.

  7. Fused Cast Alumina Refractory Products for Glass Tank Furnace

    Institute of Scientific and Technical Information of China (English)

    SHEN Keyin

    2006-01-01

    @@ 1 Subject and Scope The standard specifies the requirement, testing method, inspection rule and requirements for the labeling, packing, shipping and storing of the fused cast alumina refractory products for glass tanks.

  8. Refractory, Abrasive, and Other Industrial Minerals Operations - Direct Download

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This map layer includes refractory, abrasive, and other industrial minerals operations in the United States. The data represent commodities covered by the Minerals...

  9. High Alumina Refractory Bricks for Electric Arc Furnace Roofs

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ 1 Scope This standard specifies the sort, technical requirement, test method, inspection rules, marking, packing, transportation, storage and quality certification of high alumina refractory bricks for electric arc furnace roofs.

  10. Refractory Gunning Material for Inner Lining Maintenance of Blast Furnace

    Institute of Scientific and Technical Information of China (English)

    Yu Lingyan; Peng Xigao

    2010-01-01

    @@ 1 Scope This standard specifies the term and definition,classification, technical requirements, test methods,quality appraisal procedures, packing, marking, transportation, storage, and quality certificate of refractory gunning material for inner lining maintenance of blast furnace .

  11. Rituximab Efficacy during a Refractory Polyarteritis Nodosa Flare

    Directory of Open Access Journals (Sweden)

    Emmanuel Ribeiro

    2009-01-01

    Full Text Available Polyarteritis nodosa (PAN is a systemic vasculitis whose severe forms are treated with glucocorticoids and cyclophosphamide. Refractory patients are exposed to many complications, notably accelerated atherosclerosis. We report a case report of 71-year-old man followed for polyarteritis nodosa refractory to glucocorticoids and cyclosphosphamide. Systemic vasculitis relapses are followed to accelerated atherosclerosis: severe ischemic lesions led to amputation of lower limbs. Remission of refractory PAN is obtained with rituximab. Disappearance of biological inflammatory is allowed to regression of ischemic lesions in upper limbs. In this situation, we recommend a systematic vascular work-up for patients suffered from refractory vasculitis. On the other hand, therapeutic trials are needed to determine the real efficacy and place of rituximab in the treatment of polyarteritis nodosa.

  12. Fireclay Refractory Mortars GB/T 14982-2008

    Institute of Scientific and Technical Information of China (English)

    Zhang Xiaohui; Chai Junlan

    2009-01-01

    @@ 1 Scope This standard specifies the classification, techni-cal requirements, test methods, quality appraisal pro-cedure, packing, marking, transportation, storage and quality certificate of fireclay refractory mortars.

  13. High Alumina Refractory Mortars GB/T 2994-2008

    Institute of Scientific and Technical Information of China (English)

    Wang Jing; Chai Junlan

    2009-01-01

    @@ 1 Scope This standard specifies the classification, techni-cal requirements, test methods, quality appraisal pro-cedure, packing, marking, transportation, storage and quality certificate of high alumina refractory mortars.

  14. Refractory Coated/Lined Low Density Structures Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The innovation in this proposed effort is the development of refractory coated or lined low density structures. Lightweight structures are desirable for space...

  15. Recycling MgO-C refractory in electric arc furnaces

    Energy Technology Data Exchange (ETDEWEB)

    Conejo, A.N. [Metallurgy Department, Morelia Technological Institute, Morelia (Mexico); Lule, R.G.; Lopez, F. [Process Engineering Department-Steelmaking Shop, Lazaro Cardenas City (Mexico); Rodriguez, R. [Refractories Department, Lazaro Cardenas City (Mexico)

    2006-11-15

    MgO-C refractory recycling from electric arc furnaces and ladle furnaces has been carried out during the melting of direct reduced iron (DRI). Metallurgical trials to define the effects of refractory recycling on energy consumption, melting time, flux consumption and refractory consumption are reported in this work. The method of preparation as well as the method of injection is also included in this study. Based on current results, the practice of recycling spent refractory is highly recommended. Visual inspection indicates the potential benefits in slag foaming which starts to form at the beginning of the heat thus allowing the use of full power transformer and in turn results in faster melting rates. (author)

  16. Sculpting Pickering Emulsion Droplets by Arrest and Jamming

    Science.gov (United States)

    Burke, Christopher; Wei, Zengyi; Caggioni, Marco; Spicer, Patrick; Atherton, Tim

    Pickering emulsion droplets can be arrested into non-spherical shapes--useful for applications such as active delivery--through a general mechanism of deformation followed by absorption of additional colloidal particles onto the interface, relaxation of the droplet caused by surface tension and arrest at some point due to crowding of the particles. We perform simulations of the arrest process to clarify the relative importance of diffusive rearrangement of particles and collective forcing due to surface evolution. Experiment and theory are compared, giving insight into the stability of the resulting capsules and the robustness of the production process for higher-throughput production in, for example, microfluidic systems. We adapt theoretical tools from the jamming literature to better understand the arrested configurations and long timescale evolution of the system: using linear programming and a penalty function approach, we identify unjamming motions in kinetically arrested states. We propose a paradigm of ``metric jamming'' to describe the limiting behavior of this class of system: a structure is metric-jammed if it is stable with respect to collective motion of the particles as well as evolution of the hypersurface on which the packing is embedded. Supported by a Cottrell Award from the Research Corporation for Science Advancement.

  17. Case of H syndrome with massive skin involvement, retroperitoneal fibrosis and Raynaud's phenomenon with a novel mutation in the SLC29A3 gene.

    Science.gov (United States)

    Fujita, Etsuko; Komine, Mayumi; Tsuda, Hidetoshi; Adachi, Akimasa; Murata, Satoru; Kamata, Yasuyuki; Minota, Seiji; Ohtsuki, Mamitaro

    2015-12-01

    We describe a case of H syndrome with massive skin involvement, retroperitoneal fibrosis and Raynaud's phenomenon. A 48-year-old man with parents of a consanguineous marriage, first appeared with decreased urine output, skin sclerosis on his inner thighs and short stature (142 cm, 47 kg). The patient had suffered from hearing loss since the age of 1 year, and his secondary sexual characteristics had not developed. Computed tomography showed periaortic fibrosis, bilateral ureteral stenosis, hydronephrosis and sclerosis of the germinal cords. A biopsy from the retroperitoneal mass revealed remarkable fibrosis with chronic inflammatory cells. Biopsies from the skin lesion showed thick collagen bundles through the dermis and lymphohistiocytic infiltration with numerous plasma cells. Serum inflammatory markers, such as C-reactive protein, vascular endothelial factor, transforming growth factor-β and soluble interleukin-2 receptor, were elevated. Prednisolone was effective in treating skin lesions and in lowering serum inflammatory markers. After a long period of follow up, genomic DNA of the patient was obtained, and we identified a homozygous mutation in exon 5, c.625G>A, which caused transition of glycine to arginine, p.Gly208Arg, in the patient, but not in DNA samples from another 50 healthy individuals. This is the first case of H syndrome with Raynaud's phenomenon and retroperitoneal fibrosis, and the first Japanese case of H syndrome reported in the English published work with a novel mutation in the SLC29A3 gene.

  18. Study on the influence of retroperitoneal laparoscopic surgery for the body antioxidant capacity and pain stress state of patients with localized renal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Yang-Tao Xu; Yan Pan; Zhi-Qing Sun; Chen-Xi Liu

    2016-01-01

    Objective:To study and analyze the influence of retroperitoneal laparoscopic surgery for the body antioxidant capacity and pain stress state of patients with localized renal carcinoma. Methods:A total of 56 patients with localized renal carcinoma in our hospital from January 2014 to August 2015 who were treated with surgery were divided into two groups according to the differences of surgery, 28 cases in control group were treated with open surgery, 28 cases in observation group were treated with retroperitoneal laparoscopic surgery, then the related indexes of antioxidant capacity and pain stress state of two groups before the surgery and at first, fifth and tenth day after the surgery were compared. Results:The related indexes of antioxidant capacity and pain stress state of two groups before the surgery all had no significant differences, while the related indexes of antioxidant capacity and pain stress state of observation group at first, fifth and tenth day after the surgery were all better than those of control group, the differences were all significant. Conclusion:The influence of retroperitoneal laparoscopic surgery for the body antioxidant capacity and pain stress state of patients with localized renal carcinoma is more active, so it is more suitable for the treatment of localized renal carcinoma.

  19. New Applications of Some High Technologies i Refractories

    Institute of Scientific and Technical Information of China (English)

    WUYiquan; ZHANGYufeng; 等

    2001-01-01

    The potential applications of some high tenologies in refractories,such as,nanotechnology,in-situ synthesis,self-propagating high-temperature synthesis,functional gradient materials,computer assisted design and some new advanced refactories in Si-Al-O-N system are briefly described.The characteristics and preparation processes of these new refractories areintroduced,and the remaining problems awaiting effective solutions are pointed out .Some suggesions on future diection of research and development are fitly made.

  20. Thoughts on Strategic Development of China's Refractories Industry

    Institute of Scientific and Technical Information of China (English)

    ZHONG Xiangchong

    2003-01-01

    For China' s refractories industry, the first two decades in the new century would be a period of structural optimization with reorganization of refractories enterprises,reconstruction of manufacturing plants and restructuring of product varieties. An important strategic measure should be to develop high quality synthetic raw materials and high performance functional products mainly based on our rich natural resources to cope with new demands of advanced high temperature technologies.

  1. Salvage abdominal irradiation for refractory non-Hodgkin′s lymphoma

    Directory of Open Access Journals (Sweden)

    Akoum Riad

    2007-01-01

    Full Text Available Background: Abdominal irradiation, as a part of treatment, is often ignored in the management of refractory non-Hodgkin′s lymphoma (NHL. Objective: To evaluate the efficacy and the toxicity of this approach after failure of chemotherapy. Materials and Methods: 27 patients with intraabdominal lymphoma underwent salvage irradiation between 1982 and 2001. All patients were treated with a Cobalt-60 machine. The total dose administered to the abdomen was 18-20 Gy at the rate of 1.5-1.8 Gy per daily fraction, followed by a boost to gross disease up to 20 Gy. All patients had previously been heavily pretreated with chemotherapy. Fourteen patients, nine with follicular and five with diffuse lymphomas, had primary refractory tumors that had never achieved remission. Thirteen patients, six with follicular and seven with aggressive tumors, had refractory relapsed tumors after achieving one or more complete remissions. Results: The response rate was 77%. The median follow-up was 53 months. The 5-year and 10-year survival rates were 25 and 17%, respectively. The in-field and out-of-field recurrence rates were 22 and 33%, respectively. Survival rates were significantly better for patients with refractory relapse compared to those with primary refractory lymphoma (P < 0.01. There was no significant difference in terms of response, recurrence, or survival rates between follicular and aggressive types. Out-of-field recurrence occurred more frequently in initial stage III and IV disease. Toxic deaths occurred in three patients (11%. Conclusion: Salvage radiotherapy for refractory abdominal NHL is a feasible alternative for both follicular and diffuse subtypes and may provide significant palliation and prolongation of survival. It is less effective in patients with primary refractory NHL than in those with refractory relapsed NHL.

  2. Refractory absence epilepsy associated with GLUT-1 deficiency syndrome.

    LENUS (Irish Health Repository)

    Byrne, Susan

    2011-05-01

    GLUT-1 deficiency syndrome (GLUT-1 DS) is a disorder of cerebral glucose transport associated with early infantile epilepsy and microcephaly. We report two boys who presented with refractory absence epilepsy associated with hypoglycorrhachia, both of whom have genetically confirmed GLUT-1 DS. We propose that these children serve to expand the phenotype of GLUT-1 DS and suggest that this condition should be considered as a cause of refractory absence seizures in childhood.

  3. Ketogenic diet in 3 cases of childhood refractory status epilepticus

    DEFF Research Database (Denmark)

    Sort, Rune; Born, Alfred P; Pedersen, Karen N.;

    2013-01-01

    Refractory status epilepticus (RSE) in children is associated with a significant risk of death or neurological morbidity. Recently attention has been drawn to the ketogenic diet (KD) as an acute treatment, as it has shown promise in controlling seizures in otherwise refractory status epilepticus...... in several cases. We have listed these and reviewed all cases of KD used in RSE at our centre. KD was given as 4:1 fat:carbohydrate-protein solution....

  4. Severe aortic coarctation in a patient with refractory hypertension

    OpenAIRE

    Hiram Tápanes Daumy

    2015-01-01

    Idiopathic hypertension is common in adults, and some patients are considered resistant or refractory to treatment. In such cases it is often associated with a patho-logical process which hinders its control, in spite of changes in lifestyle and the proper use of drugs. This article is about an adult female patient with refractory hypertension due to aortic coarctation. CT scan and angiographic images are shown.Key words: Hypertension, Treatment, Aortic coarctation

  5. Chronic lymphocytic leukemia: treatment options for patients with refractory disease.

    Science.gov (United States)

    Motta, Marina; Wierda, William G; Ferrajoli, Alessandra

    2009-09-01

    Patients with purine analogue-refractory chronic lymphocytic leukemia (CLL) have short survival and limited treatment options. Defining the best salvage strategies for this population is challenging, because limited data are available from clinical trials, and because studies have enrolled mixed populations (patients with recurrent and refractory disease or patients with refractory disease and Richter transformation). Moreover, patients with refractory CLL have a high incidence of unfavorable molecular and clinical features, such as high-risk genomic profiles, unmutated immunoglobulin heavy-chain genes, expression of zeta-chain-associated protein kinase 70, and bulky lymphadenopathies. These patients are also severely immunosuppressed because of the underlying disease and the treatments received, and experience a high rate of infectious complications that pose an additional difficulty in selecting treatment. Despite these challenges, in parallel with better characterizations of the biologic features of refractory CLL, the number of available treatment modalities for this population has increased. Several chemoimmunotherapy combinations have been developed, and novel agents with a different mechanism of action are being investigated in clinical trials. Furthermore, allogeneic stem cell transplantation with nonmyeloablative conditioning regimens is a therapeutic strategy that is increasingly offered to patients with refractory CLL.

  6. Refractory ceramic fibers activate alveolar macrophage eicosanoid and cytokine release.

    Science.gov (United States)

    Leikauf, G D; Fink, S P; Miller, M L; Lockey, J E; Driscoll, K E

    1995-01-01

    Refractory ceramic fiber has been developed for industrial processes requiring materials with high thermal and mechanical stability. To evaluate the biological activity of this fiber, rat alveolar macrophages were exposed for < or = 24 h to 0-1,000 micrograms/ml of refractory ceramic fiber, crocidolite asbestos, silica (fibrogenic particles), or titanium dioxide (a nonfibrogenic particle), and eicosanoid, tumor necrosis factor-alpha (TNF), and lactate dehydrogenase release were measured. Particle dimensions were determined by electron microscopy. Radioactivity coeluting with leukotriene B4 (LTB4) and immunoreactive LTB4 and TNF release increased after refractory ceramic fiber and were similar in magnitude after asbestos but less than after silica. For example, the total [3H]eicosanoid release increased 3.9-fold after refractory ceramic fiber, 4.6-fold after asbestos, and 8.7-fold after silica. Refractory ceramic fiber and asbestos also have similar particle dimensions (diameter, length, and surface area). Inasmuch as macrophage-derived LTB4 and TNF are potent mediators in inflammatory events, including migration and activation of neutrophils, these findings suggest that refractory ceramic fiber can activate macrophages in vitro to release mediators relevant to in vivo findings of inflammation and fibrotic lung disease in laboratory animals.

  7. Mobilization of refractory chronic schizophrenics with haloperidol.

    Science.gov (United States)

    Psaras, M; Zissis, N P; Mouzakis, D; Lyketsos, G

    1980-01-01

    Adequate high doses of haloperidol have been administered to 24 chronic, refractory to standard antipsychotic treatment, schizophrenics (16 male, 8 female, mean age 32.9 years) to investigate the possibility of mobilizing and releasing these patients from the hospital. Treatment was started with 20 mg haloperidol and optimal doses were determined for each patient. The median daily optimal dose at the end of the trial was 100mg. All patients were followed up for 16 weeks. Evaluating criteria were the BPRS, the Discharge Readiness Questionnaire, a side-effect rating scale, a CGI scale and the number of patients able to leave the hospital. 3 patients were evaluated as able to leave the hospital. 87.4% of the patients were subjectively evaluated as improved. High doses of haloperidol did not correlate with a higher incidence of unwanted effects. On the contrary antiparkinson treatment was discontinued or decreased in 14 patients. It is concluded that nonresponsive chronic schizophrenics can profit from adequate high doses of haloperidol.

  8. Lenalidomide for relapsed or refractory multiple myeloma

    Directory of Open Access Journals (Sweden)

    S. S. Bessmeltsev1

    2012-01-01

    Full Text Available We report the activity of lenalidomide (revlimide – R, lenalidomide plus dexamethasone (Rd, lenalidomide plus bortezomib plus dexamethasone (RVd in 34 patients with relapsed and refractory myeloma. For patients who received lenalidomide the overall response rate was 70.5 %. 38 % patients achieved very good partial response (VGPR + complete response (CR. Median overall survival (OS was 48 months. Lenalidomide may overcome the poor prognostic impact of various factors, particularly elevated beta (2-microglobulin. Lenalidomide is highly active in elderly patients (> 65 years. Significantly increased OS with a lenalidomide-based induction and lenalidomide maintenance therapy was revealed. The median duration of the overall response without lenalidomide maintenance therapy was 10 months. The median duration of the overall response with lenalidomide maintenance therapy was 20 months (р < 0,05. Median OS with lenalidomide maintenance therapy was not reached. Median OS without lenalidomide maintenance therapy was 36 months (р < 0.05. Side effects were predictable and manageable. The most common adverse events reported were neutropenia (38.3 % and thrombocytopenia (23.7 %. Serious adverse events were rare.

  9. Iron-refractory iron deficiency anemia.

    Science.gov (United States)

    Yılmaz Keskin, Ebru; Yenicesu, İdil

    2015-03-05

    Iron is essential for life because it is indispensable for several biological reactions, such as oxygen transport, DNA synthesis, and cell proliferation. Over the past few years, our understanding of iron metabolism and its regulation has changed dramatically. New disorders of iron metabolism have emerged, and the role of iron as a cofactor in other disorders has begun to be recognized. The study of genetic conditions such as hemochromatosis and iron-refractory iron deficiency anemia (IRIDA) has provided crucial insights into the molecular mechanisms controlling iron homeostasis. In the future, these advances may be exploited to improve treatment of both genetic and acquired iron disorders. IRIDA is caused by mutations in TMPRSS6, the gene encoding matriptase-2, which downregulates hepcidin expression under conditions of iron deficiency. The typical features of this disorder are hypochromic, microcytic anemia with a very low mean corpuscular volume of erythrocytes, low transferrin saturation, no (or inadequate) response to oral iron, and only a partial response to parenteral iron. In contrast to classic iron deficiency anemia, serum ferritin levels are usually low-normal, and serum or urinary hepcidin levels are inappropriately high for the degree of anemia. Although the number of cases reported thus far in the literature does not exceed 100, this disorder is considered the most common of the "atypical" microcytic anemias. The aim of this review is to share the current knowledge on IRIDA and increase awareness in this field.

  10. Refractory diarrhea: A paraneoplastic syndrome of neuroblastoma.

    Science.gov (United States)

    Han, Wei; Wang, Huan-Min

    2015-07-01

    Neuroblastoma (NB) is the most common extracranial solid tumor in children. Diarrheal NB is quite rare and is not easy to diagnose in the early stage. Six cases of diarrheal NB in our hospital treated from 1996 to 2006 were retrospectively analyzed, including characteristics such as electrolyte imbalance, pathologic features, vasoactive intestinal peptide (VIP) immunohistochemical staining results, treatment, and prognosis. All patients were boys with 3-8 loose or watery stools each day and routine fecal tests were normal. Abdominal tumors were identified by B-ultrasound. Drugs were ineffective. Three patients underwent surgery, and the remaining three patients received surgery and chemotherapy. Diarrhea stopped after treatment in five patients. Two patients died due to intractable hypokalemia. The tumor was located in the adrenal gland in four patients, in the upper retroperitoneum in one patient, and in the presacral area in one patient. Pathologic findings were NB and ganglioneuroblastoma. Five patients were at clinical stage I-II, and one was at stage III. Four patients survived (followed-up for 6 mo to 4 years). Immunohistochemical staining for VIP was positive. Refractory diarrhea is a paraneoplastic syndrome of NB and is rare. Patients aged 1-3 years who present with chronic intractable diarrhea should be followed closely. Intractable diarrhea, hypokalemia, and dysplasia are the initial clinical manifestations. Increased VIP is characteristic of this disease. Potassium supplementation plays a vital role in the treatment procedure, especially preoperatively. The prognosis of diarrheal NB is good following appropriate treatment.

  11. Iron-Refractory Iron Deficiency Anemia

    Science.gov (United States)

    Yılmaz Keskin, Ebru; Yenicesu, İdil

    2015-01-01

    Iron is essential for life because it is indispensable for several biological reactions, such as oxygen transport, DNA synthesis, and cell proliferation. Over the past few years, our understanding of iron metabolism and its regulation has changed dramatically. New disorders of iron metabolism have emerged, and the role of iron as a cofactor in other disorders has begun to be recognized. The study of genetic conditions such as hemochromatosis and iron-refractory iron deficiency anemia (IRIDA) has provided crucial insights into the molecular mechanisms controlling iron homeostasis. In the future, these advances may be exploited to improve treatment of both genetic and acquired iron disorders. IRIDA is caused by mutations in TMPRSS6, the gene encoding matriptase-2, which downregulates hepcidin expression under conditions of iron deficiency. The typical features of this disorder are hypochromic, microcytic anemia with a very low mean corpuscular volume of erythrocytes, low transferrin saturation, no (or inadequate) response to oral iron, and only a partial response to parenteral iron. In contrast to classic iron deficiency anemia, serum ferritin levels are usually low-normal, and serum or urinary hepcidin levels are inappropriately high for the degree of anemia. Although the number of cases reported thus far in the literature does not exceed 100, this disorder is considered the most common of the “atypical” microcytic anemias. The aim of this review is to share the current knowledge on IRIDA and increase awareness in this field. PMID:25805669

  12. Electron microscopy study of refractory ceramic fibers.

    Science.gov (United States)

    MacKinnon, P A; Lentz, T J; Rice, C H; Lockey, J E; Lemasters, G K; Gartside, P S

    2001-10-01

    In epidemiological studies designed to identify potential health risks of exposures to synthetic vitreous fibers, the characterization of airborne fiber dimensions may be essential for assessing mechanisms of fiber toxicity. Toward this end, air sampling was conducted as part of an industry-wide study of workers potentially exposed to airborne fibrous dusts during the manufacture of refractory ceramic fibers (RCF) and RCF products. Analyses of a subset of samples obtained on the sample filter as well as on the conductive sampling cowl were performed using both scanning electron microscopy (SEM) and transmission electron microscopy (TEM) to characterize dimensions of airborne fibers. Comparison was made of bivariate fiber size distributions (length and diameter) from air samples analyzed by SEM and by TEM techniques. Results of the analyses indicate that RCF size distributions include fibers small enough in diameter ( 60 microm) may go undetected by TEM, as evidenced by the proportion of fibers in this category for TEM and SEM analyses (1% and 5%, respectively). Limitations of the microscopic techniques and differences in fiber-sizing rules for each method are believed to have contributed to the variation among fiber-sizing results. It was concluded from these data that further attempts to characterize RCF exposure in manufacturing and related operations should include analysis by TEM and SEM, since the smallest diameter fibers are not resolved with SEM and the fibers of longer length are not sized by TEM.

  13. Nonlinear Refractory Plasmonics with Titanium Nitride Nanoantennas.

    Science.gov (United States)

    Gui, Lili; Bagheri, Shahin; Strohfeldt, Nikolai; Hentschel, Mario; Zgrabik, Christine M; Metzger, Bernd; Linnenbank, Heiko; Hu, Evelyn L; Giessen, Harald

    2016-09-14

    Titanium nitride (TiN) is a novel refractory plasmonic material which can sustain high temperatures and exhibits large optical nonlinearities, potentially opening the door for high-power nonlinear plasmonic applications. We fabricate TiN nanoantenna arrays with plasmonic resonances tunable in the range of about 950-1050 nm by changing the antenna length. We present second-harmonic (SH) spectroscopy of TiN nanoantenna arrays, which is analyzed using a nonlinear oscillator model with a wavelength-dependent second-order response from the material itself. Furthermore, characterization of the robustness upon strong laser illumination confirms that the TiN antennas are able to endure laser irradiation with high peak intensity up to 15 GW/cm(2) without changing their optical properties and their physical appearance. They outperform gold antennas by one order of magnitude regarding laser power sustainability. Thus, TiN nanoantennas could serve as promising candidates for high-power/high-temperature applications such as coherent nonlinear converters and local heat sources on the nanoscale.

  14. Levetiracetam in children with refractory status epilepticus.

    Science.gov (United States)

    Gallentine, William B; Hunnicutt, Addie S; Husain, Aatif M

    2009-01-01

    The objective of this study was to investigate the utility of levetiracetam (LEV) in children with refractory status epilepticus (RSE). Records of children with RSE who received LEV as adjunctive therapy were reviewed. Over a 7-year period, 11 children had received LEV for RSE. Age ranged from 2 days to 9 years (median = 2.5 months). Prior to administration of LEV, the number of anticonvulsants used to treat RSE ranged from 2 to 7 (median = 3). Starting doses of LEV ranged from 15 to 70 mg/kg (median = 30 mg/kg). LEV was felt to be of benefit in 45% (5/11) of cases, resulting in either resolution of RSE or successful weaning of patients off continuous infusions of other anticonvulsants. In 27% (3/11), response to LEV was unclear as other medications were either added or increased concomitantly with LEV use. The median latency to cessation of RSE following LEV initiation was 1.5 days (range = 1-8 days). All responding patients were on LEV doses >or= 30 mg/kg/day (median 40 mg/kg/day). No significant adverse effects of LEV were reported. LEV may be an effective and safe adjuvant therapy in children with RSE.

  15. Investigating Different ZnO Arresters Models against Transient Waves

    Directory of Open Access Journals (Sweden)

    A. Babaee

    2011-12-01

    Full Text Available Metal oxide surge arresters have dynamic characteristics that are significant for over voltage coordination studies involving fast front surges. Several models with acceptable accuracy have been proposed to simulate this frequency-dependent behavior. In this paper, various electrical models are presented for surge arrester performance simulation against lightning impulse. The desirable model is obtained by using simulation results of the existing models and experimental tests. The IEEE proposed model is a proportional model can give satisfactory results for discharge currents within a range of time to crest for 0.5 to 45 :s but due to no existing residual voltage resulting switching current on the manufacture's datasheets decrease its performance generally. In this study the maximum residual voltage due to current impulse is analyzed too. In additional, the amount of discharged energy by surge arrester is focused.

  16. Numerical study of fracture arrest on snow cover

    Directory of Open Access Journals (Sweden)

    B. Frigo

    2010-10-01

    Full Text Available Under the hypothesis of a perfectly brittle phenomenon, avalanche triggering can be investigated numerically by means of Linear Elastic Fracture Mechanics (LEFM. Since, however, the real phenomenon is intrinsically dynamical, another aspect to investigate is represented by dynamic fracture propagation. In this paper, we model dynamic crack propagation into a dry snow slab and we investigate the possibility to arrest the crack propagation through the presence of weak zones distributed along the extension of the snow slope. Assuming that the weak layer is almost collapsed, we simulate the efficiency of artificial voids in the slab to arrest fracture propagation, into the framework of Dynamical Fracture Mechanics. We put forward here a new philosophy for the use of artificial discontinuities (void into the snowpack able to perform as crack arresters distributed along the snow slope area: the target is to split a large avalanche slab into smaller slabs, causing small avalanches to propagate with less catastrophic effects.

  17. Alphaherpesvirus Subversion of Stress-Induced Translational Arrest

    Directory of Open Access Journals (Sweden)

    Renée L. Finnen

    2016-03-01

    Full Text Available In this article, we provide an overview of translational arrest in eukaryotic cells in response to stress and the tactics used specifically by alphaherpesviruses to overcome translational arrest. One consequence of translational arrest is the formation of cytoplasmic compartments called stress granules (SGs. Many viruses target SGs for disruption and/or modification, including the alphaherpesvirus herpes simplex virus type 2 (HSV-2. Recently, it was discovered that HSV-2 disrupts SG formation early after infection via virion host shutoff protein (vhs, an endoribonuclease that is packaged within the HSV-2 virion. We review this discovery and discuss the insights it has provided into SG biology as well as its potential significance in HSV-2 infection. A model for vhs-mediated disruption of SG formation is presented.

  18. Alphaherpesvirus Subversion of Stress-Induced Translational Arrest

    Science.gov (United States)

    Finnen, Renée L.; Banfield, Bruce W.

    2016-01-01

    In this article, we provide an overview of translational arrest in eukaryotic cells in response to stress and the tactics used specifically by alphaherpesviruses to overcome translational arrest. One consequence of translational arrest is the formation of cytoplasmic compartments called stress granules (SGs). Many viruses target SGs for disruption and/or modification, including the alphaherpesvirus herpes simplex virus type 2 (HSV-2). Recently, it was discovered that HSV-2 disrupts SG formation early after infection via virion host shutoff protein (vhs), an endoribonuclease that is packaged within the HSV-2 virion. We review this discovery and discuss the insights it has provided into SG biology as well as its potential significance in HSV-2 infection. A model for vhs-mediated disruption of SG formation is presented. PMID:26999187

  19. Small bowel toxicity after high dose spot scanning-based proton beam therapy for paraspinal/retroperitoneal neoplasms

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, R.A.; Albertini, F.; Koch, T.; Ares, C.; Lomax, A.; Goitein, G. [Paul Scherrer Institute PSI, Villigen (Switzerland). Center for Proton Therapy; Vitolo, V. [Fondazione CNAO, Pavia (Italy); Hug, E.B. [Paul Scherrer Institute PSI, Villigen (Switzerland). Center for Proton Therapy; ProCure Proton Therapy Centers, New York, NY (United States)

    2013-12-15

    Purpose: Mesenchymal tumours require high-dose radiation therapy (RT). Small bowel (SB) dose constraints have historically limited dose delivery to paraspinal and retroperitoneal targets. This retrospective study correlated SB dose-volume histograms with side-effects after proton radiation therapy (PT). Patients and methods: Between 1997 and 2008, 31 patients (mean age 52.1 years) underwent spot scanning-based PT for paraspinal/retroperitoneal chordomas (81 %), sarcomas (16 %) and meningiom (3 %). Mean total prescribed dose was 72.3 Gy (relative biologic effectiveness, RBE) delivered in 1.8-2 Gy (RBE) fractions. Mean follow-up was 3.8 years. Based on the pretreatment planning CT, SB dose distributions were reanalysed. Results: Planning target volume (PTV) was defined as gross tumour volume (GTV) plus 5-7 mm margins. Mean PTV was 560.22 cm{sup 3}. A mean of 93.2 % of the PTV was covered by at least 90 % of the prescribed dose. SB volumes (cm{sup 3}) receiving doses of 5, 20, 30, 40, 50, 60, 70, 75 and 80 Gy (RBE) were calculated to give V5, V20, V30, V40, V50, V60, V70, V75 and V80 respectively. In 7/31 patients, PT was accomplished without any significant SB irradiation (V5 = 0). In 24/31 patients, mean maximum dose (Dmax) to SB was 64.1 Gy (RBE). Despite target doses of > 70 Gy (RBE), SB received > 50 and > 60 Gy (RBE) in only 61 and 54 % of patients, respectively. Mean SB volumes (cm{sup 3}) covered by different dose levels (Gy, RBE) were: V20 (n = 24): 45.1, V50 (n = 19): 17.7, V60 (n = 17): 7.6 and V70 (n = 12): 2.4. No acute toxicity {>=} grade 2 or late SB sequelae were observed. Conclusion: Small noncircumferential volumes of SB tolerated doses in excess of 60 Gy (RBE) without any clinically-significant late adverse effects. This small retrospective study has limited statistical power but encourages further efforts with higher patient numbers to define and establish high-dose threshold models for SB toxicity in modern radiation oncology. (orig.)

  20. Comparison of intensity-modulated radiotherapy with conventional conformal radiotherapy for postoperative retroperitoneal soft tissue; Etude theorique d'une radiotherapie postoperatoire avec modulation d'intensite d'un sarcome retroperitoneal

    Energy Technology Data Exchange (ETDEWEB)

    Musat, E.; Kantor, G.; Caron, J.; Lagarde, P.; Laharie, H.; Angles, J.; Gilbeau, L. [Centre Regional de Lutte Contre le Cancer, Institut Bergonie, Dept. de Radiotherapie, 33 - Bordeaux (France); Stoeckle, E. [Centre Regional de Lutte Contre le Cancer, Institut Bergonie, Dept. de Chirurgie, 33 - Bordeaux (France); Bui, B.N. [Centre Regional de Lutte Contre le Cancer, Institut Bergonie, Dept. de Medecine, 33 - Bordeaux (France)

    2004-08-01

    External postoperative radiation therapy for retroperitoneal sarcoma is an example of treatment using large fields for complex shaped volumes of irradiation, Prescribed dose is limited by tolerance of adjacent organs at risk (OAR). From a recent case treated by conventional conformal radiotherapy (3D-CRT), we evaluate the benefit of five theoretical IMRT plans. Criteria used are calculated from DVH related to delineated PTV and OAR, IMRT should permit to enhance the prescribed dose without increasing dose in the OAR (especially residual kidney, spinal cord and small bowel). This theoretical study show the feasibility of a dose escalation from a treatment dose of 45 Gy delivered by 3D-CRT up to a planning dose of 54 Gy calculated by IMRT with: - for the PTV: an improvement of the dose homogeneity about 5% (range 2 %) and moreover the coverage factor (CF) about 13% (range 9 6%); - for the OAR: an improvement of the protection factor (PF) about 20% (range 11-24%); - and thus an improved conformity index (CI = CF x PF) about 25% (range 15-32%). (author)