WorldWideScience

Sample records for biliares totales elevados

  1. Paso elevado, en Krahnenberg

    Directory of Open Access Journals (Sweden)

    Wittfoht, Hans

    1965-02-01

    Full Text Available A bypass on the general highway is now being built near Andernach, Germany. It is about 1100 m long, and includes an elevated way. The design has been influenced by the poor soil resistance, and the fact that the road is built on a mountainside. The elevated way runs along a curve, with a minimum radius of 475 m, and is subdivided into 34 sections, each 31.75 m long. The deck consists of a box girder, separated into two compartments, and is of prestressed concrete. The deck cantilevers on each side of the longitudinal structure, and has a total width of 18.20 m. This allows for two separate pavements, a central separating section, and two lateral sidewalks. The construction procedure was significant. Owing to the nature of soil, and the need to avoid heavy concentrated loads, the traditional system of formwork was substituted by the Gerber procedure. This consists of 4 metal open girders which rest on the columns, which had been previously constructed. These beams, which are capable of conforming to the curvature of the road, are moved along the axis of the deck, with the aid of hydraulic jacks, as the process of concreting proceeds. A crane, with an operational reach of 35 m served to supply the materials and formwork at the various construction points.En las proximidades de Andernach (Alemania se está construyendo una derivación de la carretera general, con unos 1.100 m de longitud total, que consiste en una especie de puente o paso elevado. Se justifica esta solución particular por la poca consistencia del terreno y el especial trazado a media ladera. El eje del paso elevado sigue una alineación curva con radio mínimo de 475 m, y está subdividido en 34 tramos de 31,75 m de luz. El conjunto que forma el tablero es una viga cajón, bicelular, de hormigón pretensado y grandes salas en voladizo que dan una anchura total de 18,20 m, lo cual permite la habilitación de dos bandas de circulación separadas por un macizo central y dos andenes

  2. Íleo biliar

    OpenAIRE

    Allan Pérez-Baltodano; Marcela Bermúdez-Coto; Madelein Centeno-Rodríguez; William Vargas-Alpízar

    2005-01-01

    El íleo biliar es una entidad clínica difícil de diagnosticar que se produce como resultado de una comunicación anormal entre la vía biliar y el tubo digestivo, con la consiguiente evacuación del cálculo e impactación del mismo distalmente hasta que se presenta como un cuadro de obstrucción intestinal. Reportamos el caso de un paciente de 47 años de edad, sin antecedentes médicos ni quirúrgicos de importancia, que ingresó al servicio de emergencias quirúrgicas con un abdomen agudo, caracteriz...

  3. Íleo biliar

    Directory of Open Access Journals (Sweden)

    Allan Pérez-Baltodano

    2005-01-01

    Full Text Available El íleo biliar es una entidad clínica difícil de diagnosticar que se produce como resultado de una comunicación anormal entre la vía biliar y el tubo digestivo, con la consiguiente evacuación del cálculo e impactación del mismo distalmente hasta que se presenta como un cuadro de obstrucción intestinal. Reportamos el caso de un paciente de 47 años de edad, sin antecedentes médicos ni quirúrgicos de importancia, que ingresó al servicio de emergencias quirúrgicas con un abdomen agudo, caracterizado por dolor en epigastrio e hipocondrio derecho de cinco días de evolución, fiebre y vómitos. El ultrasonido de abdomen reveló una colecistitis aguda. La radiografía simple de abdomen mostró niveles hidroaéreos y una asa fija en el hipocondrio derecho. La laparotomía exploratoria reveló una fístula colecistogástrica asociada a obstrucción intestinal secundaria a un lito biliar enclavado en el íleon terminal. Se le practicó una colecistectomía, enterolitotomía, enterorrafia y reparación de la fístula en un solo tiempo quirúgico. Se realiza una revisión biliográfica de este tema de difícil diagnóstico, con el fin de exponer la controversia que aún existe sobre el manejo quirúrgico del íleo biliar y establecer los diversos criterios de resolución quirúrgica, tanto en uno como en 2 tiempos quirúrgicos.

  4. Íleo biliar

    Directory of Open Access Journals (Sweden)

    Allan Pérez-Baltodano

    2005-01-01

    Full Text Available El íleo biliar es una entidad clínica difícil de diagnosticar que se produce como resultado de una comunicación anormal entre la vía biliar y el tubo digestivo, con la consiguiente evacuación del cálculo e impactación del mismo distalmente hasta que se presenta como un cuadro de obstrucción intestinal. Reportamos el caso de un paciente de 47 años de edad, sin antecedentes médicos ni quirúrgicos de importancia, que ingresó al servicio de emergencias quirúrgicas con un abdomen agudo, caracterizado por dolor en epigastrio e hipocondrio derecho de cinco días de evolución, fiebre y vómitos. El ultrasonido de abdomen reveló una colecistitis aguda. La radiografía simple de abdomen mostró niveles hidroaéreos y una asa fija en el hipocondrio derecho. La laparotomía exploratoria reveló una fístula colecistogástrica asociada a obstrucción intestinal secundaria a un lito biliar enclavado en el íleon terminal. Se le practicó una colecistectomía, enterolitotomía, enterorrafia y reparación de la fístula en un solo tiempo quirúgico. Se realiza una revisión biliográfica de este tema de difícil diagnóstico, con el fin de exponer la controversia que aún existe sobre el manejo quirúrgico del íleo biliar y establecer los diversos criterios de resolución quirúrgica, tanto en uno como en 2 tiempos quirúrgicos.Gallstone ileus is a clinical entity of difficult diagnosis; it is the result of an anomalous communication between the biliary tree and the gastrointestinal tract, with the eventual evacuation of the gallstone which becomes impacted in the distal tract where it causes intestinal obstruction. We report the case of a 47-year-old male, without relevant past medical history, who arrived to the emergency room with epigastric and right upper quadrant pain, fever and vomiting. The abdominal ultrasound showed acute cholecystitis. A conventional abdominal film showed air- filled small bowel loops and a fixed loop in the right

  5. El paso elevado de Dunton, Inglaterra

    Directory of Open Access Journals (Sweden)

    Editorial, Equipo

    1969-09-01

    Full Text Available With a clear sense of modern requirements, the British Ministry of Transport has constructed an elevated pass at Dunton, over highway A 127. In addition to the usefulness it means for highly congested roads, it will avoid further impediments when the new Ford Motor Company factory, which is being built close by, enters into full operation. This elevated structure consists of twin bridges, with all necessary approaches. The length of these approaches is more than 3 km. The length of the pass is 67 m, and the maximum heigth is 6 m. The supporting piles are placed in groups of four, in the form of an inverted pyramid, and joined by a ground cross member. The total cost of the project was 71 million pesetas.Con un amplio sentido del progreso, el Ministerio de Transportes de Inglaterra ha construido un paso elevado en Dunton, sobre la carretera A 127. Además del servicio específico que preste a unas carreteras habitualmente congestionadas, evitará nuevas complicaciones cuando se ponga en servicio una factoría de la Ford Motor Company, que actualmente se construye en las inmediaciones. El paso elevado se compone de dos puentes gemelos, con las desviaciones y accesos necesarios. La longitud de estos puentes rebasa los 3 km. Tienen cuatro tramos, con una longitud total de 67 m y una altura máxima de 6 m. Las pilas son compuestas, formadas por cuatro pilares en forma de tronco de pirámide invertido y unidas por una viga de solera. El costo de la obra rebasó los 71 millones de pesetas.

  6. Osteodistrofia de la cirrosis biliar primaria

    OpenAIRE

    Guañabens Gay, Nuria

    1987-01-01

    [spa] La cirrosis biliar primaria es una enfermedad hepática que se manifiesta por un patrón clínico, bioquímico e histológico de colestasis crónica. Su curso puede complicarse con el desarrollo de una patología metabólica ósea cuyo tipo, frecuencia y mecanismos patogenéticos no están bien establecidos. Esta tesis se ha realizado con el fin de analizar la prevalencia y tipo de enfermedad metabólica ósea que se asocia a la cirrosis biliar primaria (CBP) e investigar los factores que influy...

  7. Paso elevado, en Manchester – Inglaterra

    Directory of Open Access Journals (Sweden)

    Hayes, J.

    1970-09-01

    Full Text Available This is an urban main traffic connection, running south of the civic centre of Manchester, and facilitates communications in the East West directions. It also links the main motor roads entering the city from the South. It involves a viaduct with two traffic directions, with a total length of 975 m, which runs over several highways and pedestrian footpaths. The article describes the structure of this viaduct and its special features, such as an improved type of prestressed concrete dowels and certain construction problems.Se trata de un paso de enlace urbano, situado al sur del centro cívico de Manchester, que descongestiona el tránsito este-oeste actuando como un distribuidor entre las carreteras principales de entrada desde el sur. Incluye un viaducto de dos calzadas, de unos 975,36 m, que pasa por encima de un conjunto de carreteras al nivel del suelo y de pasos de peatones. El artículo describe la estructura elevada con unas notas sobre los aspectos notables del proyecto, como son: las mejoras introducidas en las dovelas de hormigón pretensado y los problemas que se presentaron durante la construcción.

  8. Fatores de risco e conduta nas complicações do trato biliar no transplante hepático Risk factors and management of biliary tract complications in liver transplantation

    Directory of Open Access Journals (Sweden)

    Alexandre Coutinho Teixeira de Freitas

    2000-12-01

    Full Text Available A reconstrução biliar é um dos pontos vulneráveis do transplante hepático apresentando incidência de complicações biliares, variando de 10 a 35%, nos diversos estudos da literatura. Esse trabalho tem por objetivo apresentar a experiência do nosso serviço em relação à incidência e ao manejo das complicações biliares no transplante de fígado. Foram incluídos no estudo 147 transplantes hepáticos ortotópicos, com idade média de 37,3 anos, correspondendo a 88 procedimentos em pacientes do sexo masculino e 59 do sexo feminino. Complicações biliares ocorreram em 27 transplantes (18,36% em 25 pacientes (dois retransplantes. A presença de rejeição celular e de complicações vasculares foi identificada como fator de risco para as complicações biliares. A idade, o sexo, a etiologia da cirrose e a técnica utilizada na reconstrução biliar não foram fatores de risco. No total, foram empregados 52 cursos terapêuticos: tratamento cirúrgico em 23 vezes; tratamento endoscópico em 15 vezes; retransplante em sete vezes; drenagem biliar transparieto-hepática em seis vezes e um paciente está em lista de espera para retransplante. Conclui-se deste estudo que as complicações biliares são freqüentes após o transplante hepático e que as vasculares e a rejeição celular são fatores de risco.Biliary reconstruction is a vulnerable step of liver transplantation, presenting an incidence of biliary complications between 10 to 35% in many studies. Our aim is to present our incidence and treatment of biliary complications, in a total of 147 orthotopic liver transplantations, 88 males and 59 females, with an mean age of 37 years. Biliary complications occurred in 27 transplants (18,36% performed in 25 patients (two retransplants. Cellular rejection and vascular complications were identified as risk factors for biliary complications. Age, sex, etiology of cirrhosis and biliary reconstruction technique were not risk factors. Fifty

  9. Evolución de las complicaciones biliares tras el trasplante hepático

    OpenAIRE

    Ganchegui Madina, Amaia; Grande Posa, Luis; Charco Torra, Ramón

    2012-01-01

    L'anastomosi biliar en el trasplantament hepàtic és una de les causes més freqüents de morbiditat. En aquest treball s'ha analitzat l'evolució de les complicacions biliars després d'un trasplantament hepàtic en adults al llarg de 20 anys, comparant els primers 100 trasplantaments realitzats amb els darrers 200 entre 1985 i 2007. Resultats: la incidència de les complicacions biliars ha disminuït significativament al llarg dels anys, principalment a causa de l'abandonament de l'ús rutinari del ...

  10. Tuberculosis peritoneal con niveles elevados de CA 125

    OpenAIRE

    Andrés José Gómez-Aldana

    2013-01-01

    Resumen La tuberculosis peritoneal hace parte de los diagnósticos diferenciales de ascitis; sin embargo, su documentación está dada por la presencia de granulomas necrotizantes al igual que el crecimiento de micobacterias en las muestras tomadas del peritoneo. Se presenta el caso de una paciente con dolor abdominal y ascitis en quien se documentaron lesiones nodulares en cavidad peritoneal, con niveles marcadamente elevados de "Antígeno Carbohidrato o Antígeno Cáncer" CA 125, sin cambios en o...

  11. Tuberculosis peritoneal con niveles elevados de CA 125

    Directory of Open Access Journals (Sweden)

    Andrés José Gómez-Aldana

    2013-09-01

    Full Text Available Resumen La tuberculosis peritoneal hace parte de los diagnósticos diferenciales de ascitis; sin embargo, su documentación está dada por la presencia de granulomas necrotizantes al igual que el crecimiento de micobacterias en las muestras tomadas del peritoneo. Se presenta el caso de una paciente con dolor abdominal y ascitis en quien se documentaron lesiones nodulares en cavidad peritoneal, con niveles marcadamente elevados de "Antígeno Carbohidrato o Antígeno Cáncer" CA 125, sin cambios en otros órganos, realizando biopsias de peritoneo, con documentación de granulomas necrotizantes y crecimiento de micobacterias en el cultivo, por lo que se instauró tratamiento con adecuada respuesta logrando disminución progresiva de la ascitis y ganancia de peso.

  12. Íleo biliar y fístula colecistoduodenal. Informe de un caso

    OpenAIRE

    Carlos Salazar-Lozano; Erick Rolando Rocha-Guevara; Alberto Vargas-Gismondi; Mauricio de la Fuente-Lira; Rodrigo Ernesto de Obaldía-Zeledón; Carlos Cordero-Vargas

    2006-01-01

    Objetivo: describir un caso de íleo biliar y fístula colecistoduodenal, atendido en el Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS. Caso clínico: hombre de 54 años de edad con diagnóstico de colecistitis aguda, sometido a apendicectomía a los 34 años. Sin historia de enfermedad biliar. Al examen físico se encontraba afebril, abdomen con distensión leve, dolor a la palpación en hipocondrio derecho y Murphy positivo. Los exámenes de laboratorio indicaron leucocitos de 8,9...

  13. Atresia biliar: continuamos operando tarde Biliary atresia: we still operate too late

    Directory of Open Access Journals (Sweden)

    Carlos O. Kieling

    2008-10-01

    Full Text Available OBJETIVO: Analisar a idade na cirurgia de crianças com atresia biliar e a sobrevida sem necessidade de transplante de fígado. O estudo foi realizado no Hospital de Clínicas de Porto Alegre. MÉTODOS: Foram revisados os prontuários dos pacientes operados entre 1982 e 2007, residentes no Rio Grande do Sul. RESULTADOS: Dos 112 casos estudados de crianças com atresia biliar, 38 (33,9% ocorreram de 1982 a 1989, 46 (41,1% de 1990 a 1999 e 28 (25,0% a partir de 2000. Em 12 (10,7% casos, não foi realizada a portoenterostomia. A idade na cirurgia variou de 25 a 297 dias (mediana: 80,5; IIQ25-75: 61,3-109,0 dias; em 20,5% dos casos, a idade das crianças foi menor do que 60 dias. Não houve diferença na idade, no momento do diagnóstico, entre as 3 décadas. Os pacientes do interior do estado (mediana: 87,0; IIQ25-75: 69,0-115,0 dias foram encaminhados significativamente (p = 0,007 mais tarde do que os da região metropolitana de Porto Alegre (RS (mediana: 68,0; IIQ25-75: 55,5-98,0 dias. A proporção de pacientes com menos de 60 dias foi significativamente menor (p = 0,013 nos oriundos do interior. A sobrevida com fígado nativo do total dos pacientes foi de 46,2% em 2 anos, diminuindo progressivamente até 15,3% em 20 anos. Os pacientes operados com menos de 60 dias tiveram maior sobrevida com fígado nativo (log rank OBJECTIVE: To analyze the age at surgery for children with biliary atresia and their survival periods without need for liver transplantation. The study was performed at Hospital de Clínicas de Porto Alegre, in Porto Alegre, state of Rio Grande do Sul, Brazil. METHODS: The medical records of patients operated between 1982 and 2007 who were residents of the state of Rio Grande do Sul were reviewed. RESULTS: Of the 112 cases of children with biliary atresia studied, 38 (33.9% occurred between 1982 and 1989, 46 (41.1% between 1990 and 1999 and 28 (25.0% after 2000. Portoenterostomy was not performed for 12 cases (10.7%. Age at surgery

  14. Importancia de la excreción biliar en la farmacocinética del paracetamol en la rata

    OpenAIRE

    Schaiquevich, Paula S.; Niselman, Ada Viviana; Rubio, Modesto Carlos

    2006-01-01

    El presente trabajo reporta el estudio de la farmacocinética del paracetamol en ratas (100 mg/kg, p.o) con flujo biliar modificado, interrumpido por canulación del conducto biliar o estimulado por acción farmacológica con ácido ursodesoxicólico. A pesar de que el paracetamol sufre recirculación enterohepática y que la excreción biliar de la droga es una vía importante de eliminación en la rata, la alteración del flujo biliar no provocó diferencias estadísticamente significativas en el tiempo ...

  15. Determinación de la efectividad de los sellantes quirúrgicos en la mejora de la resistencia de las suturas de la vía biliar. Estudio en un modelo experimental animal

    OpenAIRE

    González López, José Antonio

    2015-01-01

    Las suturas biliares representan un reto para los cirujanos. La baja tensión superficial de la bilis, asociada a la fragilidad y mala irrigación tisular del conducto biliar, hacen que las fugas biliares sean frecuentes tras esta técnica quirúrgica. La presión intraluminal alta en la vía biliar es uno de los factores de riesgo para la aparición de una fuga biliar tras una sutura. Es por ello que si existe una obstrucción biliar y no se deja un drenaje como mecanismo de descompresión, las fugas...

  16. Plantas transgénicas con alto rendimiento en peso seco y almidón cuyos órganos de reserva presentanelevada textura, elevado contenido en almidón y elevado rendimiento en peso seco

    OpenAIRE

    Pozueta Romero, Javier; Alonso Casajús, Nora; Muñoz Pérez, Francisco José; Baroja Fernández, Miren Edurne

    2007-01-01

    Plantas transgénicas con alto rendimiento en peso seco y almidón cuyos órganos de reserva presentan elevada textura, elevado contenido en almidón y elevado rendimiento en peso seco. La presente invención proporciona plantas transgénicas con alto rendimiento en peso seco y almidón cuyos órganos de reserva presentan elevada textura, elevado contenido en almidón y elevado rendimiento en peso seco.

  17. Serum oxidative stress is increased in patients with post cholecystectomy bile duct injury Aumento del estrés oxidativo en el suero de pacientes con lesiones de vías biliares postcolecistectomía

    Directory of Open Access Journals (Sweden)

    A. G. Miranda-Díaz

    2010-06-01

    Full Text Available Background: post-cholecystectomy bile duct injuries are identified by the onset of jaundice as well as elevated bilirubin and alkaline phosphatase levels during the peri-operative period. It is unknown how serum oxidative stress markers are modified in patients with post-cholecystectomy bile duct injuries. Objective: to determine serum oxidative stress marker levels (lipid peroxidation by-products, nitrites/nitrates and total antioxidant capacity in patients with post-cholecystectomy bile duct injuries. Patients and methods: a prospective, transversal and analytical study was designed with two groups. Group 1: 5 healthy volunteer subjects. Group 2: 52 patients with post-cholecystectomy bile duct injuries (43 female and 9 male. An elective bilio-digestive reconstruction was performed at week 8. The serum oxidative stress marker levels were quantified by colorimetric method. Results: patients with bile duct injuries had a significant increased serum lipid peroxides (malondialdehyde and 4-hydroxy-alkenals and nitric oxide metabolites (nitrites/nitrates levels compared to the control group. In contrast, total antioxidant capacity in patients with bile duct injuries remained similar compared to healthy controls. Conclusions: the results show that oxidative stress is usually associated to bile duct injury.Introducción: las lesiones de las vías biliares postcolecistectomía se establecen por la aparición de ictericia, elevación de las bilirrubinas y de la fosfatasa alcalina durante el periodo perioperatorio. Se desconoce cómo se modifican los marcadores de estrés oxidativo en el suero de los pacientes con lesiones de las vías biliares postcolecistectomía. Objetivo: determinar los marcadores de estrés oxidativo (productos de peroxidación de lípidos, catabolitos del óxido nítrico y capacidad antioxidante total en el suero de pacientes con lesiones de las vías biliares. Pacientes y métodos: se realizó un estudio prospectivo transversal

  18. Atresia biliar: continuamos operando tarde Biliary atresia: we still operate too late

    OpenAIRE

    Carlos O. Kieling; dos Santos, Jorge L.; Sandra M.G. Vieira; Cristina T Ferreira; Ana R. R. Linhares; Andréa L. Lorentz; da Silveira, Themis R.

    2008-01-01

    OBJETIVO: Analisar a idade na cirurgia de crianças com atresia biliar e a sobrevida sem necessidade de transplante de fígado. O estudo foi realizado no Hospital de Clínicas de Porto Alegre. MÉTODOS: Foram revisados os prontuários dos pacientes operados entre 1982 e 2007, residentes no Rio Grande do Sul. RESULTADOS: Dos 112 casos estudados de crianças com atresia biliar, 38 (33,9%) ocorreram de 1982 a 1989, 46 (41,1%) de 1990 a 1999 e 28 (25,0%) a partir de 2000. Em 12 (10,7%) casos, não foi r...

  19. Cirugía laparoscópica biliar Laparoscopic biliary surgery

    Directory of Open Access Journals (Sweden)

    P. Martí-Cruchaga

    2005-01-01

    Full Text Available El siguiente artículo trata de exponer brevemente los posibles nuevos protocolos que se pueden aplicar en la patología biliar, a raíz de los cambios acaecidos con la aparición de las nuevas técnicas de cirugía biliar laparoscópica. Pretende realizar una síntesis de los últimos y más novedosos artículos sobre técnica quirúrgica y manejo en distintas patología biliares tales como coledocolitiasis o colecistitis. Se puede concluir que el manejo diferirá mucho según las capacidades técnicas de un centro sobre el que recaiga una de estas patologías. Por tanto, actualmente no se puede imponer un protocolo estándar para todo el mundo. Las diferencias entre colangiopancreatografía retrógrada endoscópica y colangiografía intraoperatoria laparoscópica, todavía están por demostrar, no pudiéndose generalizar sobre si una técnica tiene más indicación que la otra. Lo mismo se podría decir sobre si el acceso a la vía biliar principal debe hacerse desde el conducto cístico o por el contrario debe realizarse una coledocotomía.The following article briefly sets out the possible new protocols that can be applied in biliary pathology, arising from the changes brought about by the appearance of new techniques of laparoscopic biliary surgery. It offers a synthesis of the latest and most novel articles on surgical technique and management in different biliary pathologies such as Choledocholithiasis and cholecystitis. It can be concluded that management will differ greatly, depending on the technical capacities of the centre that is called upon to deal with one of these pathologies. A standard protocol for everybody cannot thus be established at present. Teh differences between endoscopic retrograde cholangiopancreatography and intraoperative laparoscopic cholangiography have still to be demonstrated, it is not possible to make generalisations about whether one technique is more useful than the other. The same could be said about

  20. Correlação entre hipomotilidade da vesícula biliar e desenvolvimento de colecistolitíase após operação bariátrica Correlation of gallbladder hipomotility and gallstone formation after bariatric surgery

    Directory of Open Access Journals (Sweden)

    Ana Lúcia Fürstenberger Lehmann

    2006-10-01

    Full Text Available OBJETIVO: O objetivo deste estudo foi determinar se existe associação entre a hipomotilidade da vesícula biliar em obesos, antes da cirurgia bariátrica e o desenvolvimento da litíase biliar após perda de peso. MÉTODO: No período de setembro de 2002 a janeiro de 2005, utilizando ultra-sonografia em tempo real, com medidas do volume em jejum e 60 minutos após ingestão de dieta, avaliamos a vesícula biliar de noventa e seis pacientes obesos com indicação de cirurgia bariátrica. Estes pacientes foram reavaliados um ano após a cirurgia com ultra-sonografia para detecção de litíase biliar. RESULTADOS: Vinte e sete (28,12% apresentaram hipomotilidade da vesícula, destes, sete (29,62% apresentaram litíase. Dezoito (18,75% da amostra total, desenvolveram litíase biliar no período pós-operatório. CONCLUSÕES: Não foi encontrada diferença estatisticamente significante no desenvolvimento de litíase no grupo de pacientes com hipomotilidade e naqueles com motilidade normal da vesícula biliar.BACKGROUND: This study wants to establish if there is an association between gallbladder hypomotility in obese patients before bariatric surgery and gallstone development after weight loss. METHODS: From September 2002 to January 2005 using realtime ultrasonography we evaluated fasting and postprandial (60th minute gallbladder volumes and ejection fractions in ninety six morbid obese patients prior to bariatric surgery. These patients were followed one year after bariatric surgery with gallbladder ultrasonography to identify cholelithiasis. RESULTS: There were twenty seven (28.12% with gallbladder hypomotility, seven (29.62% of them had cholelithiasis in the postoperative period. Eighteen of ninety six patients (18.75% had developed gallstones. CONCLUSION: There were no statistical differences between cholelithiasis development both in patients with hypomotility and with normal gallbladder motility.

  1. Ascaridíase biliar complicada: espectro de problemas e táticas cirúrgicas Biliary ascariasis: spectrum of surgical problems and tactics

    OpenAIRE

    Lisieux Eyer de Jesus; Ricardo Pecoraro Raposo; Alexandre Guazelli

    2004-01-01

    OBJETIVO: Discutir as variantes clínicas e táticas para tratamento cirúrgico da ascaridíase biliar complicada. MÉTODO: Trabalho retrospectivo de pacientes operados por complicações de ascaridíase biliar num período de cinco anos. RESULTADOS: São descritos quatro casos de ascaridíase biliar complicada em crianças (três pré escolares e um escolar), expressos através de pseudocisto pancreático, icterícia obstrutiva, colangite e múltiplos abscessos hepáticos, todos tratados cirurgicamente. Descre...

  2. Gallstone ileus: management options and results on a series of 40 patients Íleo biliar: opciones terapéuticas y resultados en una serie de 40 casos

    Directory of Open Access Journals (Sweden)

    D. Martínez Ramos

    2009-02-01

    Full Text Available Introduction: controversy remains about the management of gallstone ileus. While some authors propose enterotomy, others defend the one-stage procedure (simultaneously fistula repair. The objective of the present study was to analyze management options and comparative study their results. Material and methods: retrospective and descriptive study with revision of clinical stories of patients with the diagnosis of gallstone ileus between 1987 and 2008. All the following variables were recorded: dates of hospital admission, surgery and discharge, age, sex, pathological antecedents, preoperative or intraoperative diagnosis, treatment, location of the fistula and location of the obstruction. End-result variables were: postoperative complications, mortality, complications during the follow-up and biliary complications. Results: a total of 40 patients were included of 46,648 admissions. Age, comorbidity, and intraoperative diagnosis were related with poorer short- and long-outcomes. The percentage of postoperative complications was similar for groups with and without fistula repair. Mortality was higher in the group with fistula repair (15vs. 25%. Biliary complications were more frequent in the group without fistula repair (11 vs. 0%. Sex, location of the fistula and location of the obstruction did not be related with the prognosis. Conclusion: one-stage procedure is related with higher mortality rate than enterotomy alone. Nevertheless, fistula repair reduces the number of biliary complications during the follow-up.Introducción: todavía existe gran controversia sobre el mejor tratamiento del íleo biliar. Algunos autores proponen la enterotomía aislada, mientras otros defienden la reparación de la fístula bilioentérica en el mismo acto quirúrgico. El objetivo del presente estudio fue analizar las opciones terapéuticas en estos pacientes y estudiar sus resultados. Material y métodos: estudio retrospectivo y descriptivo, con revisión de las

  3. Tratamento endoscópico das lesões biliares Endoscopic treatment of the biliary injuries

    Directory of Open Access Journals (Sweden)

    Everson L. A. Artifon

    2010-04-01

    Full Text Available As técnicas cirúrgicas convencionais ofertam uma apropriada condição de cura na maioria dos pacientes com estreitamento biliar benigno. Nesta condição, no entanto, o reparo cirúrgico está associado com recorrência tardia da re-estenose em 10% a 30% dos pacientes. Neste contexto, os avanços tecnológicos na endoscopia terapêutica promoveram a possibilidade alternativa do tratamento efetivo destas obstruções benignas. Considerações em relação ao tempo de reospitalização e de procedimentos devem ser averiguados em detalhes e ponderados em relação á cirurgia. Estenoses malignas estão relacionadas á colangite, icterícia e dor e, consequentemente, com as alterações sistêmicas relacionadas com a sepsis biliar. A conduta endoscópica cria uma derivação do suco biliar para o duodeno, sendo uma verdadeira derivação biliodigestiva endoscópica e utilizando-se próteses plásticas ou metálicas. O propósito desta revisão é ofertar aos leitores a eficácia do tratamento endoscópico na estenose benigna e maligna biliopancreática.Standard surgical techniques offer a good chance of cure forthe majority of patients affected by extrahepatic benign biliarystricture. Nevertheless, operative repair has a long-termrecurrence rate of stricture in 10% to 30% of patients. Advancesin endoscopic procedures have provided alternative options ofrelieving biliary obstructions, but prolonged length of treatmentand rehospitalization have to be considered if endoscopy isperformed. Malignant stenoses are an important factor determining cholangitis, jaundice and pain and it's each systemic consequences. The endoscopic approach intends to create a deviation of bile juice to duodenum by means of metal or plastic stents aiming a safe palliation. The purpose of this review is to show to the readerseffectiveness of endoscopic treatments of benign and malignat stenosis of the bile duct and pancreatic.

  4. Flores e frutos imaturos de Crataegus monogyna revelam elevado potencial antioxidante.

    OpenAIRE

    Rodrigues, Sandra; Barreira, João C. M.; Carvalho, Ana Maria; Ferreira, Isabel C. F. R.

    2012-01-01

    A espécie Crataegus monogyna, conhecida vulgarmente como espinheiro, escaramunheiro ou pilriteiro, está entre as plantas do Nordeste de Portugal mais recomendadas pela medicina tradicional e as suas bagas eram consumidas no campo, por serem consideradas nutritivas e saudáveis, sendo também utilizadas como suplemento alimentar, sobretudo para crianças, devido ao seu elevado conteúdo vitamínico [1]. Em diferentes regiões de Portugal, o espinheiro é reconhecido como tendo propriedades de prevenç...

  5. Lesão iatrogênica de vias biliares Iatrogenic bile duct injuries

    Directory of Open Access Journals (Sweden)

    Guilherme Brasileiro de Aguiar

    2005-04-01

    Full Text Available OBJETIVO: O objetivo do presente estudo foi avaliar os casos de lesões iatrogênicas de vias biliares tratados na clínica cirúrgica do Hospital Getúlio Vargas - HGV nos últimos oito anos. MÉTODO: Foi realizada análise retrospectiva dos prontuários dos pacientes internados no HGV, com hipótese diagnóstica de lesão iatrogênica de vias biliares. Foram incluídos pacientes com lesões provenientes do próprio serviço e de outras instituições. Os prontuários foram revisados e obtidas as seguintes variáveis: procedência do paciente, idade, sexo, data da cirurgia inicial, sintomas, tempo de evolução, valores da bilirrubina, fosfatase alcalina, AST e ALT, TAP, creatinina, além da cirurgia realizada para correção da lesão, complicações, permanência hospitalar e condições do paciente na alta hospitalar. RESULTADOS: Foram confirmados 10 casos de lesão iatrogênica de vias biliares. Todos os paciente eram do sexo feminino, com idades variando entre 18 e 49 anos. Os sinais ou sintomas mais freqüentes foram icterícia, colúria e dor abdominal. Em relação à terapêutica cirúrgica, a hepático-jejunostomia em "Y" de Roux foi o procedimento mais empregado. CONCLUSÕES: As lesões iatrogênicas das vias biliares ainda representam um desafio para os cirurgiões e sua ocorrência está mais relacionada a procedimentos realizados em hospitais não especializados, por cirurgiões sem treinamento adequado. A principal medida a ser adotada é a prevenção da lesão. Após sua ocorrência, esta deve ser corrigida em hospitais com equipe médica treinada.BACKGROUND: The objective of this study was to evaluate the cases of iatrogenic lesions of the biliary tract treated in the surgical clinic at Getulio Vargas Hospital - GVH during the last eight years. METHODS: A retrospective analysis of the patients' charts admitted with the diagnosis of iatrogenic lesions of the biliary tract was performed. Patients with iatrogenic lesions

  6. Obtención de sales biliares de magnesio mediante secado por aspersión

    OpenAIRE

    Jorge E Rodríguez Chanfrau; Orestes D López Hernández; Moraima Palmeiro Casanova; Antonio Nogueira Mendoza; Marilyn López Armas

    2014-01-01

    Introducción: la industria farmacéutica cubana, desde la década del 60 del siglo XX, tiene entre sus líneas básicas de producción la obtención de ácidos biliares y sus derivados salinos a partir de la bilis bovina. Este proceso consiste en la saponificación de la bilis y la posterior precipitación del ácido cólico, el cual es transformado en la sal de magnesio mediante un proceso de reacción con hidróxido de magnesio. La materia prima activa obtenida es utilizada como ingrediente farmacéutico...

  7. Myxidium biliare sp. n. (Myxozoa) from gall bladder of Galaxias maculatus (Osmeriformes: Galaxiidae) in Patagonia (Argentina).

    Science.gov (United States)

    Viozzi, Gustavo P; Flores, Verónica R

    2003-09-01

    Myxidium biliare sp. n., a new myxosporean species parasitizing the gall bladder of Galaxias maculatus (Jenyns), in Patagonia, is described. Its coelozoic plasmodia were floating free in the bile. Spores are fusiform 13.7 +/- 0.9 microm long and 6.9 +/- 0.6 microm wide, with rounded ends in frontal view and slightly pointed ends in sutural view; shell with ridges and sinuous sutural line. Both maximum prevalence and maximum percentage of immature plasmodia occurred in summer. In winter the prevalence and the percentage of immature plasmodia fell to their lowest values. Prevalence was independent of host sex but increased with host length. Prevalence in 15 Patagonian Andean lakes (situated from 39 degrees 25'S to 41 degrees 30'S) ranged between 4.2% and 70%. PMID:14535344

  8. Síntesis de Derivados Fotoactivos de Ácidos Biliares para Aplicaciones Biológicas

    OpenAIRE

    Rohacova ., Jana

    2010-01-01

    Los acidos biliares son esteroides biosintetizados en el higado que actuan como tensoactivos, facilitando la digestion de los lipidos. Para ello, circulan y se reutilizan en un movimiento conocido como circulacion enterohepatica, un proceso muy complejo en el que no todas las etapas estan perfectamente entendidas. Con el proposito de estudiar algunos aspectos relacionados con la circulacion enterohepatica, en la presente Tesis Doctoral se planteo preparar derivados fotoactivos de ...

  9. Carcinoma de vesícula biliar “Hospital Universitario del Caribe”. Cartagena - Colombia (2007 -2010

    Directory of Open Access Journals (Sweden)

    Payares-Salgado Manuel A

    2010-06-01

    Full Text Available Objetivo: Realizar un análisis de los casos diagnosticados como carcinoma de vesícula biliar en el laboratorio de anatomía patológica del Hospital Universitario del Caribe.Material y métodos: Se revisaron las historias clínicas de los pacientes con diagnóstico histopatológico de carcinoma de vesícula biliar, que habían sido intervenidos por el servicio de cirugía general del Hospital Universitario del Caribe, en Cartagena, Colombia, entre el 1 de enero del 2007 al 30 de marzo del 2010.Resultados: Se identificaron diez casos con diagnóstico de carcinoma de vesícula biliar, en 538 piezas anatomopatológicas de vesícula biliar. El 90% correspondían a mujeres y 10% a varones. La edad promedio fue de 50.2 años. El 70% de los pacientes consultó por dolor abdominal inespecífico y de éstos el 90% con un tiempo de evolución inferior a 2 meses. El diagnóstico se sospechó en el momento del acto operatorio en el 60% de los casos y fue hallazgo incidental en el 30% de las colecistectomías. El tipo histológico más frecuente encontrado fue el adenocarcinoma bien y moderadamente diferenciado (90%. En el 20% de las historias clínicas no había datos de los estudios de apoyo diagnóstico. En el 80% restante, la ecografía abdominal fue el estudio de imagen más utilizado para el diagnóstico. La estadificación tumoral fue considerada predominantemente en estadios avanzados, IV y V, con compromiso del lecho hepático en el 50% de los casos.

  10. O desenvolvimento do contrato psicológico orientado para desempenhos de elevado rendimento

    Directory of Open Access Journals (Sweden)

    Correia, Rui

    2010-01-01

    Full Text Available O objectivo deste artigo consiste em demonstrar, conceptualmente, a relevância do contrato psicológico para a performance dos indivíduos nas organizações. O contrato de trabalho pode ser percepcionado de duas formas: o contrato formal, explicitado sob a forma de um contrato de trabalho escrito, e outra, informal e implícita, o contrato psicológico. Ambos envolvem direitos, obrigações e expectativas por parte do indivíduo e da organização. A literatura acentua a relevância do contrato psicológico transaccional, em detrimento de um contrato psicológico mais relacional, apesar dos contratos psicológicos assumidos pelos indivíduos se situarem, na realidade, num contínuo entre estes dois tipos de contratos. Neste estudo é apresentado um modelo conceptual explicativo do desenvolvimento dinâmico do contrato psicológico, orientado para performances de elevado rendimento. São analisados os contributos do contrato psicológico para o aprofundar de relações de compromisso, através de um maior envolvimento dos indivíduos no processo de definição de objectivos, e consequentes impactos ao nível da performance. O modelo propõe o estabelecimento de uma relação positiva e significante entre: confiança (cumprimento do acordo e justiça percebida, compromisso (objectivos e performance (elevado rendimento.

  11. Prevalencia de dislipemia y riesgo cardiovascular elevado en pacientes con artritis reumatoide

    Directory of Open Access Journals (Sweden)

    María Jezabel Haye Salinas

    2013-02-01

    Full Text Available Los objetivos del estudio fueron comparar la frecuencia de riesgo cardiovascular (CV elevado y dislipemia (DLP en pacientes con artritis reumatoide (AR y en controles, identificar variables de la enfermedad asociadas a DLP y estimar el porcentaje de pacientes con AR medicados para DLP. Estudio de corte transversal que incluyó 409 pacientes con AR y 624 controles. El riesgo CV se determinó con las clasificaciones NCEP y SCORE modificados por European League Against Rheumatism (EULAR. Para DLP se utilizó la definición de Adult Treatment Panel III (ATP III. La frecuencia de riesgo CV elevado fue similar en pacientes con AR y controles excepto cuando fue definida por NCEP-EULAR (7% vs. 2%; p = 0.00002. La DLP fue encontrada en el 43% de los pacientes con AR y en el 47% de los controles (p = 0.15. Los pacientes con AR y DLP tuvieron más manifestaciones extra-articulares (36% vs. 24%; p = 0.01 y mayor velocidad de sedimentación globular (VSG (21 (13-35 vs. 18 (10-30 mm; p = 0.003. El tratamiento recibido para DLP varió según la definición utilizada (11% a 32%. Se encontró mayor riesgo CV en los pacientes con AR solo cuando se definió por NCEP- EULAR. Los pacientes con AR y DLP tuvieron mayor VSG y manifestaciones extra-articulares. La mayoría de los pacientes con AR y DLP no estaban recibiendo tratamiento hipolipemiante.

  12. Bacterial colonization of the ileum in rats with obstructive jaundice Colonização bacteriana do íleo de ratos com obstrução biliar

    Directory of Open Access Journals (Sweden)

    Ivana Duval-Araujo

    2007-09-01

    Full Text Available Qualitative and quantitative alterations in ileal flora during obstructive jaundice and the role of bile salts were evaluated in rats. Obstructive jaundice was associated with bacterial overgrowth in the ileum. This effect may be due to the reduced concentration of bile salts, since dietary supplementation reduced the small bowel aerobic bacterial flora.As alterações qualitativas e quantitativas da flora ileal na obstrução biliar e o papel dos sais biliares foram avaliados em ratos. Em animais com obstrução biliar houve aumento da população ileal. Esse efeito é provavelmente causado pela ausência de sais biliares no lúmen ileal, uma vez que em animais cuja dieta foi suplementada com sais biliares houve redução da flora ileal.

  13. PANCREATITIS AGUDA COMO PRESENTACIÓN DE UN QUISTE DEL CONDUCTO BILIAR EN EL ADULTO: REPORTE DE CASO Acute pancreatitis as a presentation of bile duct cyst in adults: a case report

    Directory of Open Access Journals (Sweden)

    Lenin Enríquez Domínguez

    2009-01-01

    Full Text Available Paciente adulta se presentÓ en la sala de urgencias con un cuadro de pancreatitis aguda como complicaciÓn de un quiste del conducto biliar colédoco tipo IV, el cual fue diagnosticado por ultrasonograma abdominal durante su estancia intrahospitalaria. El diagnÓstico de quiste de colédoco es más difícil en la edad adulta ya que los pacientes raramente se presentan con la triada clásica de dolor abdominal, masa palpable e ictericia, presentándose principalmente con alguna manifestaciÓn de vías biliares o pancreática benigna. Existen pocas publicaciones en Occidente acerca de este tÓpico. La importancia en cuanto al diagnÓstico temprano, la clasificaciÓn del mismo y al tratamiento quirúrgico con la resecciÓn total del quiste radica en su alta incidencia hacia el desarrollo de colangiocarcinoma.An adult female patient who attended an ER with acute pancreatitis as a complication of bile duct cyst disease is described here; she was diagnosed by abdominal ultrasonogram during her hospital stay. A diagnosis of bile duct cysts is difficult to make in adults, since patients rarely present the classic picture of abdominal pain, palpable mass and jaundice; it is mainly presented as a biliary duct or pancreatic tissue complication. There are few publications on this topic in the west. A diagnosis can be made by ultrasound in many cases and is the image study of choice due to its low cost and accessibility. These are only few western publications concerning this subject. The importance of making an early diagnosis, classification and surgical treatment (total resection of the cyst lies in the high risk of malignancy developing.

  14. 'CRIOLLO-9', UN CULTIVAR DE AJO RESISTENTE A LAS ENFERMEDADES FITOPATÓGENAS Y ELEVADO POTENCIAL DE RENDIMIENTO

    Directory of Open Access Journals (Sweden)

    Humberto Izquierdo Oviedo

    2012-01-01

    Full Text Available Se presentan las principales características del clon 'Criollo-9', saneado y rejuvenecido mediante la técnica de cultivo de meristemos. Este genotipo se mostró resistente ante las plagas y enfermedades que afectan a este cultivo y tuvo un elevado potencial de rendimiento.

  15. Procedimiento quirúrgico para el tratamiento de las neoplasias de vías biliares altas en etapas avanzadas

    OpenAIRE

    Santiesteban Collado, Neila Bertha

    2011-01-01

    El tratamiento quirúrgico del cáncer de vías biliares altas en etapas avanzadas tiene elevada morbilidad postoperatoria y mortalidad, supervivencia baja, grandes costos y poca disponibilidad de los procedimientos utilizados con ese fin. Surge la necesidad de mejorar los resultados de los métodos quirúrgicos (problema científico de la investigación) y se explora el tratamiento de la enfermedad (objeto de estudio), sobre todo de las técnicas quirúrgicas (campo), con el objetivo de elaborar un...

  16. Estudio por ecoendoscopia de la vía biliar extrahepática en pacientes con pancreatitis aguda biliar Endoscopic ultrasonographic examination of the common bile duct in patients with acute biliary pancreatitis

    Directory of Open Access Journals (Sweden)

    A. Repiso

    2008-06-01

    Full Text Available Objetivo: el objetivo de nuestro estudio fue valorar la utilidad de la ecoendoscopia en el estudio de la vía biliar extrahepática en los pacientes diagnosticados de pancreatitis aguda biliar y determinar los factores clínicos y analíticos relacionados con el resultado de la técnica. Material y métodos: se incluyeron en el estudio de modo consecutivo 73 pacientes (31 varones, 42 mujeres; media de edad 64 ± 15 años con pancreatitis aguda biliar remitidos a nuestro servicio para la realización de ecoendoscopia biliopancreática. En todos los pacientes se realizó la técnica seguida de CPRE con esfinterotomía y técnica endoscópica para la extracción de cálculos cuando se identificó por ecoendoscopia la existencia de coledocolitiasis. Se compararon las características clínico-evolutivas de estos pacientes con respecto al resultado obtenido con la ecoendoscopia. Resultados: la media de tiempo transcurrido desde el ingreso hasta la realización de la ecoendoscopia fue de 7 ± 6 días. En 18 pacientes (24% se observó en la ecoendoscopia la existencia de coledocolitiasis y en 17 de ellos se realizó esfinterotomía endoscópica. La presencia de coledocolitiasis fue más frecuente en aquellos pacientes con dilatación de la vía biliar extrahepática (55 vs. 14%; p 0,05. Tampoco se observó esta diferencia en el subgrupo de pacientes con pancreatitis aguda severa (45 vs. 55%; p > 0,05. Conclusiones: la ecoendoscopia es una técnica útil en la selección de los pacientes con pancreatitis aguda biliar que se beneficiarán de la realización de una esfinterotomía endoscópica.Objective: the objective of our study was to evaluate the usefulness of endoscopic ultrasonography (EUS for the study of the common bile duct in patients diagnosed with acute biliary pancreatitis, and to establish clinical and laboratory factors related to this technique. Materials and methods: seventy-three consecutive patients with acute biliary pancreatitis were

  17. Fatores de Risco Associados aos Niveis Pressoricos Elevados em Criancas de Dois a Cinco Anos

    Directory of Open Access Journals (Sweden)

    Paula Azevedo Aranha Crispim

    2014-01-01

    Full Text Available Fundamento: A prevalência de hipertensão arterial em crianças aumentou nas últimas décadas. Diversos fatores de risco estão envolvidos na gênese da hipertensão arterial infantil e sua identificação precoce pode prevenir o desenvolvimento posterior da doença. Objetivos: Avaliar a prevalência de pressão arterial elevada e fatores associados em crianças. Métodos: Estudo transversal de base populacional e domiciliar. Foram avaliadas 276 crianças de dois a cinco anos residentes em Goiânia, Goiás, investigando-se pressão arterial, características sociodemográficas, peso ao nascer, histórico de hipertensão arterial na família, tabagismo passivo, aleitamento materno, alimentação, hábito sedentário e estado nutricional. A regressão de Poisson foi utilizada para avaliar a associação entre os fatores de risco e a pressão arterial elevada. Resultados: A média de idade foi 3,1 ± 0,79 anos, sendo pressão arterial elevada e excesso de peso observados em 19,9% e 11,2% das crianças, respectivamente. Houve associação direta de pressão arterial elevada com idade [razão de prevalência (RP = 2,3; IC95%: 1,2 - 4,8; p = 0,017] e excesso de peso (RP = 2,0; IC95%: 1,2 - 3,6; p = 0,014. As demais variáveis não se associaram a pressão arterial elevada. Conclusões: A prevalência de pressão arterial elevada em crianças foi alta. Aquelas com excesso de peso e mais jovens apresentaram maior prevalência de níveis pressóricos elevados.

  18. Atresia das vias biliares extra-hepáticas: conhecimentos atuais e perspectivas futuras Extrahepatic biliary atresia: current concepts and future directions

    Directory of Open Access Journals (Sweden)

    Elisa de Carvalho

    2007-04-01

    Full Text Available OBJETIVOS: Apresentar uma revisão atualizada sobre atresia das vias biliares extra-hepáticas, com ênfase em etiopatogenia, abordagens diagnósticas e terapêuticas e prognóstico. FONTES DOS DADOS: Foram selecionadas pelos sites de busca médica (MEDLINE e PubMed pesquisas relacionadas à atresia biliar, utilizando as seguintes palavras-chave: biliary atresia,etiopathogenesis, diagnosis, treatment, prognosis, children. SÍNTESE DOS DADOS A atresia das vias biliares extra-hepáticas é a principal indicação de transplante hepático na faixa etária pediátrica. Quanto à etiologia, o citomegalovírus, o reovírus e o rotavírus têm sido os agentes mais estudados como possíveis desencadeadores da obstrução imunomediada da árvore biliar. A resposta imune, especialmente o predomínio da resposta TH1 e do interferon gama, a susceptibilidade genética e as alterações do desenvolvimento embrionário da árvore biliar são aspectos que podem participar na etiopatogênese da obliteração das vias biliares extra-hepáticas. Ainda hoje, o único tratamento disponível é a portoenterostomia, cujos resultados são melhores quando realizada nos primeiros 2 meses de vida. Em relação ao prognóstico, as crianças não tratadas vão a óbito na totalidade, por complicações relacionadas à hipertensão portal e à cirrose hepática, e mesmo os casos tratados necessitam, em sua maioria, do transplante hepático. CONCLUSÃO: A atresia das vias biliares extra-hepáticas continua sendo a principal indicação de transplante hepático em crianças, e a mudança deste panorama depende de um melhor entendimento da etiopatogenia da obstrução biliar nos diferentes fenótipos da doença. Investigações futuras a respeito do papel do interferon gama e de outras citocinas são necessárias para avaliar se esses aspectos seriam potenciais alvos de intervenção terapêutica.OBJECTIVE: To provide an updated review on extrahepatic biliary atresia, focusing

  19. Bacteriemia por Ochrobactrum anthropi en paciente con obstrucción de la vía biliar Bacteraemia by Ochrobactrum anthropi in patient with biliary obstruction

    OpenAIRE

    Sigifredo Ospina; Santiago Atehortúa Muñoz; Juan Zapata

    2009-01-01

    Reporte de caso de bacteriemia por Ochrobactrum anthropi con probable hepatitis bacteriana asociada, en un paciente inmunocompetente, el cual ingresa por sospecha de colangitis y obstrucción biliar. O. anthropi es una bacteria emergente en infecciones intrahospitalarias con notable resistencia antimicrobiana, y es un patógeno inusual en humanos.A case report of bacteraemia by Ochrobactrum anthropi probably associated with bacterial hepatitis, in a inmuno competent patient, who was admitted to...

  20. Depósito elevado Mar de Plata República Argentina

    Directory of Open Access Journals (Sweden)

    Magaldi, Jorge W.

    1974-12-01

    Full Text Available The reservoir has a capacity of 80 m3 and a total height of 20 m. Mixed construction with reinforced concrete —partially prefabricated in the factory and at the site itself— and metal members. The column, the tank, the auxiliary lifting members were constructed with great skill, trying to overcome the many disadvantages of the area that is exposed to strong winds, at times of a speed of 150 km/hour.Tiene capacidad para 80 m3 y una altura total de 20 metros. Construcción mixta, a base de hormigón armado —parcialmente prefabricada en taller y en la propia obra— y elementos metálicos. La columna, la copa, los elementos auxiliares de subida y la basa fueron construidos con gran habilidad e ingenio, procurando vencer los muchos inconvenientes que presentaba el hecho de que la zona es azotada por frecuentes vientos, cuya velocidad alcanza muchas veces los 150 km/hora.

  1. Tratamento cirúrgico das estenoses da via biliar Surgical management of the biliary tract stricture

    Directory of Open Access Journals (Sweden)

    Antônio César Marson

    2004-08-01

    Full Text Available OBJETIVO: As estenoses benignas da via biliar (EBVB decorrem de lesões iatrogênicas em 95% casos. Embora pouco freqüentes seu prognóstico é sombrio, e a prevenção é o melhor tratamento. O objetivo deste trabalho é estudar a conduta cirúrgica nas EBVB e seus resultados. MÉTODO: Foram analisados retrospectivamente, 11 pacientes submetidos à correção de EBVB no Hospital Universitário Regional do Norte do Paraná (HURNP no período de Julho/1992 a Dezembro/2001. RESULTADOS: Nove pacientes eram do sexo feminino e dois do masculino,com média de idade de 43,71 (± 17,05 anos. A cirurgia que originou a lesão foi colecistectomia aberta em 81,8% dos pacientes e por laparoscopia em 18,2%. Os sinais e sintomas mais freqüentes foram icterícia (64,3%, dor (64,3%, e febre (21,4%. O diagnóstico foi confirmado por colangiopancreatografia retrógrada endoscópica (CPRE em 90,9% dos casos e por colangiografia transparieto- hepática (CTPH em 9,1%. Segundo os critérios de Bismuth lesões do tipo I ocorreram em 18,2% dos casos, tipo II em 45,4%, tipo III em 18,2% e tipo IV em 18,2%. O tratamento cirúrgico para as EBVB foi anastomose colédoco-duodenal, anastomose hepático-jejunal em Y de Roux , anastomose hepático-jejunal à Hepp- Couinaud e anastomose hepático-jejunal com enxertia de mucosa (Smith, para as lesões tipo I,II,III e IV, respectivamente. Seis (54,55% pacientes apresentaram complicações pós-operatórias , e dois (18,2% evoluíram para óbito CONCLUSÕES: As correções cirúrgicas das EBVB apresentam altos índices de complicações e devem ser realizadas em centros especializados. Em geral estas estenoses decorrem de lesões iatrogênicas durante colecistectomias.BACKGROUND: Benign stricture of biliary tract (BSBT are iatrogenic in about 95% of the cases. Although rare, its outcome is poor; therefore prevention is the best option. The objective of this study is to evaluate the surgical management and its results in BSBT

  2. Intra and extra hepathic biliary ducts of ducks (Anas boscas Vias biliares intra e extra-hepáticas de marreco-de-pequim (Anas boscas

    Directory of Open Access Journals (Sweden)

    Juarez Cezar Borges de Aquino

    2011-12-01

    Full Text Available A study in 38 liver of adults ducks from Jundiaí, state of São Paulo, was developed. After injection of Neoprene latex 650 colored by green and fixation in aqueous 10% formalin, the material was dissected under dental loupe, photographed and sketched. The intra hepatic bile ducts of the left lobe showed up in 76.3% the samples consisting of three collecting ducts bile; and 23.7% of the cases, there was the presence of one collector originated from caudal segment, draining to the hepatic duodenal duct. In the right lobe, in 100% of samples, were four collecting duct segments: cranium medial superficial, cranium medial deep, lateral and caudal (ventral caudal. With regard to biliary extra hepatic in 36 samples(94.7% it was composed of three ducts visible in hepatic hilum: hepatic duodenal, hepatic cystic and cystic duodenal. In two samples (5.3% was not observed hepatic cystic duct. The hepatic duodenal ductand cystic duodenal duct in 100% of the samples, they reached the duodenum. In six samples (15.8 %, besides the hepatic cystic duct, the gallbladder was achieved directly by bile collecting ducts of the right lobe. The gallbladder was not achieved by hepatic cystic duct in two samples (5.3 %. As vias biliares intra e extra-hepáticas de 38 marrecos-de-pequim adultos, provenientes de Jundiaí,estado de São Paulo, após injeção de Neoprene Látex 650 corado de verde e fixação em solução aquosa de formol a 10%, foram dissecados sob lupa odontológica, fotografados e desenhados esquematicamente. A via biliar intra-hepática no lobo esquerdo mostrou-se constituída por três ductos coletores biliares em 76,3% das amostras e, em 23,7% dos casos, está presente um quarto coletor, originado no segmentocaudal, drenando para o ducto hepatoduodenal. No lobo direito, em 100% das amostras ocorreram quatro ductos coletores dos segmentos craniomedial superficial, craniomedial profundo, lateral e caudal (ventrocaudal. No que se refere à via biliar

  3. Paso elevado sobre la carretera nacional alemana número 42

    Directory of Open Access Journals (Sweden)

    Polensky & Zöllner, Constructora

    1965-07-01

    Full Text Available National Road no. 42 runs along one of the shores of the river Rhine in the neighbourhood of Rhöndorf. It is crossed by a secondary road by means of an elevated crossing, which can carry light vehicles and pedestrians. The crossing is 136.5 m in length, and consists of five spans, whose lengths are 23.6, 32.1, 32.1, 28.7 and 20 m. The width of the deck is 5.5 m, of which 4 m are taken up with the road pavement, and the rest with two lateral footpaths. The structure is a boxgirder. It is a prestressed, continuous beam, which runs along a curve. Access to the bridge is along ramps built on soil embankments. Owing to the curved planform of the crossing, the torsion forces on the structure are relatively important, but the special distributions of the prestressing cables has made it possible to counteract this loading effect in a satisfactory manner. The hollow reinforced concrete supports are trapezoidal in cross-section, and have hinges at the top and 1 bottom. Thus they act as pendules. The tubes containing the prestressing cables are injected with cement after the cables have been stretched, in accordance with the technique of the contractors, Messrs. Polensky & Zöllner; a firm of worldwide reputation.La carretera nacional número 42 se extiende a lo largo de una de las márgenes del río Rin, en las inmediaciones de Rhöndorf; el cruce con un camino secundario se salva mediante un paso superior, para vehículos ligeros y peatones, que tiene 136,5 m de longitud total, subdividida en cinco tramos de 23,6; 32,1; 32,1; 28,7, y 20 m de luz, respectivamente. La anchura del tablero es de 5,5 m, de los que 4 m corresponden a la calzada y 1,50 a dos andenes laterales e iguales. La estructura resistente es una viga-cajón, continua, pretensada, cuyo eje tiene forma de U muy aplanada. Los accesos al paso están constituidos por dos rampas apoyadas sobre terraplenes. A causa del trazado en curva, los efectos de torsión tienen relativa importancia, pero

  4. Diagnostic yield of brush cytology for biliary stenosis during ERCP Rentabilidad diagnóstica de la citología por cepillado de las estenosis biliares durante la CPRE

    Directory of Open Access Journals (Sweden)

    R. Temiño López-Jurado

    2009-06-01

    Full Text Available Aim: to evaluate the diagnostic yield of brush cytology for biliary strictures detected on ERCP when a systematic approach is used. Patients and methods: data on 62 consecutive patients with a biliary stricture on ERCP were collected. Cytological samples were processed immediately after brushing in the endoscopy room, and all were analyzed by the same pathologist. For the statistical analysis specimens were classified as positive, negative, suspicious for malignancy (presence of atypias, and unsatisfactory for evaluation. Final diagnosis was based on either histopathologic (surgery or biopsies by other techniques or clinical/radiographic diagnosis. Results: a total of 71 cytological specimens were included. Definite diagnosis was malignancy in 49 samples, and benign stricture in 22. Three samples were excluded because of insufficient material or processing artifacts. The sensitivity of biliary brushing was 62% (95% CI 0.47-0.77, specificity was 100%, positive predictive value was 100%, and negative predictive value was 58% (95% CI 0.43-0.75. When suspicious samples were included as malignant, sensitivity was 67% (95% CI 0.54-0.81 without changes in the remaining parameters. Eight patients underwent more than one ERCP. Repeated brush cytology exams in these patients yielded a definitive diagnosis in every case. Conclusions: brush cytology has intermediate sensitivity with a high specificity. A systematic approach with a dedicated pathologist and the inclusion of significant atypias as malignant results improves sensitivity. Due to its simplicity brush cytology should be performed in all cases of biliary strictures detected on ERCP, and in case of repeated ERCPs additional cytology brushings are recommended.Objetivo: evaluar la rentabilidad de la citología por cepillado de las estenosis biliares diagnosticadas por CPRE cuando se aplica una metodología sistemática. Pacientes y métodos: se recogieron muestras de 62 pacientes consecutivos con

  5. Concentração iônica plasmática e biliar do "curimbatá" Prochilodus scrofa Steindachner (Osteichthyes, Characiformes) em relação aos estádios de repouso e maduro do ciclo reprodutivo Plasmatic and biliar ionic concentration of the freshwater teleost fish Prochilodus scrofa Steindachner (Osteichthyes, Characiformes), in relation of maturation cycle

    OpenAIRE

    Renata Guimarães Moreira; Olga Martins Mimura; Rossana L.V. Andrade Lima; Geraldo Bernardino

    1998-01-01

    Body fluid ionic content of fishes varies with ambient. Variations in the plasmatic ionic concentration have also been related with sex or maturation cycle, once that reproduction modifies metabolic processes. In fishes, the gallbladder is an important osmoregulatory organ. So, the present work has been focused on the relation of plasmatic and biliar electrolytes with sex and maturation cycle, of the teleost fish Prochilodus scrofa at the resting and mature stages of gonadal cycle. The animal...

  6. Concentração iônica plasmática e biliar do "curimbatá" Prochilodus scrofa Steindachner (Osteichthyes, Characiformes em relação aos estádios de repouso e maduro do ciclo reprodutivo Plasmatic and biliar ionic concentration of the freshwater teleost fish Prochilodus scrofa Steindachner (Osteichthyes, Characiformes, in relation of maturation cycle

    Directory of Open Access Journals (Sweden)

    Renata Guimarães Moreira

    1998-01-01

    Full Text Available Body fluid ionic content of fishes varies with ambient. Variations in the plasmatic ionic concentration have also been related with sex or maturation cycle, once that reproduction modifies metabolic processes. In fishes, the gallbladder is an important osmoregulatory organ. So, the present work has been focused on the relation of plasmatic and biliar electrolytes with sex and maturation cycle, of the teleost fish Prochilodus scrofa at the resting and mature stages of gonadal cycle. The animals (28 males and 30 females were collected at Cachoeira de Emas (Pirassununga, São Paulo and they were fasted for three days before the experiments. Deteminations of Na+, K+, Mg++, and Ca++ were made by spectophotometry and Cl- by microtitulation. Comparisons of ionic content between sex and maturation cycle were assessed using analysis of variance and Student-Newman-Keuls test. In this work it was seen that in males and females at resting and mature stages, there are no difference at ionic plasmatic content. K+ contents were higher in the bile of mature males than in resting ones. Mg++ biliar contents were higher in resting males than in resting and mature males. Na+, Ca++ e Cl- contents have no difference. Na+, K+, Ca++ and Mg++ contents were higher in the bile than in the plasma. Cl- content was higher in plasma than in bile. Variations related with proteic synthesis, and another metabolic processes during cycle, may be the reason of variations in the biliar ionic content.

  7. Duplicación de la vesícula biliar: Vesícula doble de tipo Y operada. Reporte de un caso Gallbladder duplication: Report of one case

    OpenAIRE

    JAVIER ELORZA D; SERGIO LÓPEZ S; BERNARDO ESPINOZA E; FRANCISCO IZQUIERDO M; VÍCTOR CARRIEL A

    2009-01-01

    La patología de la vesícula biliar (VB) ocupa un lugar importante en nuestro país. Las anomalías congénitas más frecuentes incluyen alteraciones en los conductos biliares, arteria cística e infrecuentemente duplicaciones de la VB, con una incidencia de 1 en 3.000-4.000 autopsias. Esta anomalía congénita puede ser detectada preoperatoriamente por estudios imagenológicos, principalmente ecotomografía, siendo en el pasado un hallazgo quirúrgico. El diagnóstico diferencial de la duplicación vesic...

  8. El ácido linoleico conjugado disminuye la hipercolesterolemia pero aumenta el riesgo de litiasis biliar Conjugated linoleic acid lowers hypercholesterolemia but increases the risk for biliary lithiasis

    OpenAIRE

    V. Navarro; M.ª T. Macarulla; M.ª Chávarri; Fernández-Quintela, A.; Rodríguez, V. M.; M.ª Puy Portillo

    2005-01-01

    El término ácido linoleico conjugado (ALC) designa una serie de isómeros del ácido linoleico, presentes en la carne y productos lácteos de rumiantes, que presentan sus dos dobles enlaces en posición conjugada. El objetivo del presente trabajo fue estudiar los efectos de un isómero del ALC, el trans-10, cis-12, sobre la colesterolemia y el riesgo de litiasis biliar en un modelo animal de hipercolesterolemia inducida por dieta. Para ello se utilizaron dos grupos de hámsters alimentados con una ...

  9. Cálculo biliar "perdido": um novo problema para o ginecologista na abordagem do abdome agudo? "Lost" gallstone: a new problem for the gynecologist in acute abdomen management ?

    OpenAIRE

    José Carlos Menegoci; Edson Alcoléa Filho; Álvaro Augusto Germano Gutierres

    1999-01-01

    Os autores relatam o caso de uma paciente com 35 anos de idade, submetida à colecistectomia videolaparoscópica há 1 ano e que apresentou quadro sugestivo de salpingite aguda com abscesso. Durante a laparotomia notou-se um abscesso que era limitado anteriormente pelo peritônio parietal e músculo reto anterior direito do abdome, e posteriormente pelo corno uterino e pelo ligamento redondo à direita. Neste abscesso havia estrutura a seguir identificada como cálculo biliar. São discutidos os aspe...

  10. Biliary tract obstruction secondary to Burkitt lymphoma; Linfoma de Burkitt associado a obstrucao de vias biliares

    Energy Technology Data Exchange (ETDEWEB)

    Mendes, Wellington L.; Bezerra, Alanna Mara P.S.; Carvalho Filho, Nevicolino P.; Coelho, Robson C. [Hospital do Cancer, Sao Paulo, SP (Brazil). Centro de Tratamento e Pesquisa. Dept. de Pediatria; Soares, Fernando A. [Hospital do Cancer, Sao Paulo, SP (Brazil). Centro de Tratamento e Pesquisa. Dept. de Patologia; Pecora, Marcela S. [Hospital do Cancer, Sao Paulo, SP (Brazil). Centro de Tratamento e Pesquisa. Dept. de Imagem; Chapchap, Paulo [Hospital do Cancer, Sao Paulo, SP (Brazil). Centro de Tratamento e Pesquisa. Servico de Cirurgia Pediatrica

    2004-09-01

    The abdomen, in particular the ileocecal region, appendix and colon, is the most common primary site for Burkitt non Hodgkin's lymphoma (NHL). Involvement of the bile duct is rare. The authors describe a patient with abdominal NHL in which jaundice due to bile duct obstruction was the first clinical sign. Case report: a 3 year old white boy presented with one month of progressive jaundice, clay-colored stools, tea colored urine and increase of abdominal volume. Physical examination showed jaundice 3+/4+ and pale mucosa. The abdomen was moderately distended and timpanous and the liver was enlarged. Laboratory examinations confirmed cholestasis with total bilirubin of 8.2 mg/dl (direct bilirubin of 7.8 mg/dl), and microcytic and hypochromic anemia. Ultrasonography (US) and abdominal CT showed two solid tumors in hepatic hilar topography, and dilated intrahepatic biliary tree. The Doppler US showed hepatic artery and portal vein dislocation by the nodules. Comment: although jaundice occurs frequently as a late manifestation of NHL, it is rarely seen as the presenting sign. When jaundice is the first clinical sign and image studies show hepatic hilar tumor and bile duct obstruction, NHL should be considered in the differential diagnosis. (author)

  11. Acidificación biológica de vinos de pH elevado mediante la utilización de bacterias lácticas

    OpenAIRE

    Lucio Costa, Olga

    2014-01-01

    Actualmente, se están observando las consecuencias del cambio climático en la vitivinivultura. En los últimos años se están generando cosechas más tempranas y uvas con una descompensación entre la madurez fenólica y la madurez industrial. Estas uvas generan mostos con una elevada concentración de azúcares y una baja concentración de ácidos, que dan lugar a vinos con una alta concentración de etanol, una baja AT y un elevado pH. Los vinos de pH elevado presentan varios inconvenientes. Son...

  12. La componente de radiación Cherenkov como elemento diferenciador entre cascadas atmosféricas iniciadas por rayos gamma y protones en el rango de energía de 10 [elevado a] 10 - 10 [elevado a] 16 eV

    OpenAIRE

    Portocarrero Pimentel, Ciro Edwin

    1999-01-01

    En este trabajo se presentan resultados obtenidos por simulación de un estudio acerca de las propiedades diferenciadoras de la luz Cherenkov producida en cascadas atmosféricas extensas iniciadas por rayos y por protones. El amplio rango de energías primarias considerado (10 elevado a la -2 y 10 elevado a 4 TeV), cubre los intervalos de mayor interés para telescopios de rayos gamma instalados en tierra, incluyendo el intervalo comprendido entre el límite superior accesible a los satélites y la...

  13. ROLE OF MULTIDETECTO R ROW COMPUTED TOMOG RAPHY IN EVALUATION OF BILIAR Y TRACT OBSTRUCTIVE JAUNDICE

    Directory of Open Access Journals (Sweden)

    Akshaya Reddy

    2015-03-01

    Full Text Available INTRODUCTION: Obstructive jaundice is a type of jaundice in which there is blockage of flow of bile from the liver to the intestine resulting in redirection of excess bile and it’s by - products like bilirubin into the blood. It can lead to complications lik e ascending cholangitis, hepatorenal syndrome and malabsorption, hence requiring urgent surgical intervention. The role of a radiologist therefore is important in early diagnosis and in accurately delineating the level and the cause of obstruction, thus he lping in staging as well as preoperative assessment of tumor resectability. The search for noninvasive diagnostic tools is an emerging medical need, in order to avoid invasive, costly and physician - intensive procedures such as endoscopic retrograde cholang iopancreatography (ERCP . (1 Ultrasound is a non - invasive and cost effective imaging technique available for evaluating biliary tract obstruction. Ultrasound demonstrates the presence of biliary tract obstruction by identifying dilated bile ducts but has a sensitivity of 55% - 95% and specificity of 71% - 96 % . (2 The role of magnetic resonance cholangiography (MRCP is well established in this field as the most reliable noninvasive technique . (3 However, some drawbacks, such as contraindication in patients with pacemakers and ferromagnetic implants, for claustrophobic patients, long examination times exceeding 30 minutes and limited availability of scanners still limit its use. MRCP is expensive and has limitations such as interference from intraluminal gas, pneumobilia and flow artifacts. (4 In the past, axial conventional CT could not provide adequate information of biliary abnormalities since the total depiction of these ducts was not suitable for evaluation in axial planes . (5 MDCT's ability to obtain volume dataset with sub - millimeter spatial resolution allows the optimal display of bile duct by using multiplanar reconstruction (MPR and minimal intensity projection (Min

  14. Estimación de emisiones a la atmósfera provenientes de quemadores elevados de instalaciones petroleras en la Sonda de Campeche

    OpenAIRE

    A. Mendoza Domínguez; M. Graniel Peralta

    2006-01-01

    PEMEX Exploración y Producción (PEP), realiza venteos de gas asociado a través de quemadores elevados tipo antorcha en sus instalaciones de producción de la Sonda de Campeche, lo cual permite controlar las presiones en los separadores y líneas de conducción de dichas instalaciones. Este estudio se centra en cuantificar las emisiones atmosféricas provenientes de los quemadores pertenecientes a la Región Marina Noreste de PEP. Para ello, se elaboró un inventario de emisiones para seis diferente...

  15. Procedimiento de elaboración de leches fermentadas con elevado contenido en oligosacáridos prebióticos, leche fermentada así obtenida

    OpenAIRE

    Martínez-Villaluenga, Cristina; Cardelle-Cobas, Alejandra; Villamiel, Mar; Olano, Agustín; Corzo, Nieves

    2006-01-01

    Procedimiento de elaboración de leches fermentadas con elevado contenido en oligosacáridos prebióticos, leche fermentada así obtenida. La presente invención describe un procedimiento de elaboración de nuevos productos lácteos de leche fermentada (yogur, kéfir o yogur con bifidobacterias) con alto contenido en carbohidratos prebióticos originados durante un proceso de hidrólisis enzimática de la lactosa previo al proceso fermentativo. El producto resultante aporta, además de las cualidades pro...

  16. Evaluación de riesgos en relación a los trabajos en altura en mobiliario urbano elevado. Paneles publicitarios

    OpenAIRE

    Moreno, Paloma

    2012-01-01

    Un elevado porcentaje de los accidentes laborales graves o mortales que se producen, se deben a caídas en altura. Muchos de estos accidentes se podrían evitar si en las empresas se implantaran los debidos programas de prevención. Según ha publicado recientemente una reconocido Servicio de Prevención, la mayoría de estos accidentes se evitarían aplicando medidas preventivas tan sencillas como son, la impartición de una formación teórica y práctica adecuada y un equipamiento básico para los ...

  17. Carcinoma de vesícula biliar mascarado por Síndrome de Mirizzi: relato de caso e revisão da literatura = Carcinoma of the gallbladder masked by Mirizzi Syndrome: case report and literature review

    OpenAIRE

    Kupske, Abrão; Kupske, Raquel; Carlos KUPSKI

    2011-01-01

    Objetivos: este relato de caso visa descrever uma forma pouco comum de apresentação de câncer de vesícula biliar, mascarado pela Síndrome de Mirizzi. Descrição do caso: uma mulher consultou por náuseas, acolia e colúria, que haviam iniciado dois meses antes, e icterícia, de início recente. A ecografia abdominal evidenciou dilatação da via biliar com coledocolitíase e colelitíase. Uma colangiopancreatografia endoscópica retrógrada mostrou obstrução no terço médio do ducto hepático comum, nã...

  18. Pólipos da vesícula biliar. Como e quando tratar? Management of gallbladder polyps

    Directory of Open Access Journals (Sweden)

    Ana Sofia Bento de Matos

    2010-01-01

    Full Text Available OBJETIVO: O objetivo do estudo é saber qual a orientação terapêutica para os doentes com pólipos vesiculares (PVs, que tipo de vigilância realizar, saber diferenciar entre um pólipo benigno e um pólipo maligno e proporcionar uma tranquilização em relação à "cancrofobia". Tipo de estudo: Realizou-se um estudo retrospectivo de cinco anos. Local: O estudo foi realizado nos Hospitais da Universidade de Coimbra, num Serviço de Cirurgia. População: Foram estudados todos os doentes operados no Serviço de Cirurgia II com o diagnóstico pré-operatório de PV, entre janeiro de 2003 e dezembro 2007. MÉTODOS: Foi feita correlação clínico-patológica de todos os doentes. Feita avaliação: de dados demográficos, da apresentação clínica, dos principais sintomas, das patologias associadas e exames complementares de diagnóstico realizados. RESULTADOS: Foram estudados 93 doentes, sendo que em 91 doentes tratava-se de pólipos benignos e em dois doentes de pólipos malignos. Dos 91 pólipos benignos, 73 (78,5% eram pólipos de colesterol, 14 (15% hiperplasias e dois (2,2% adenomas. Em dois (2,2% doentes tratava-se de pólipos malignos, adenocarcinoma da vesícula biliar. O diâmetro médio dos pólipos benignos é de 6 mm, 40 (43% doentes apresentavam lesões múltiplas. Nos pólipos malignos e pré-malignos (adenomas o diâmetro médio é de 18,8 mm, são todas lesões solitárias e a idade média destes doentes é de 57,7 anos. CONCLUSÃO: Conclui-se que o tratamento cirúrgico dos PVs é a colecistectomia e só deve ser realizado quando existe: clínica relacionada com o PV; pólipos de diâmetro superior a 10 mm; crescimento do pólipo num curto espaço de tempo; pólipo séssil ou base de inserção larga; pólipo com longo pedículo; idade do doente superior a 50 anos; coexistência de litíase vesicular; pólipos localizados no infundíbulo da vesícula ou alterações ecográficas na parede vesicular.OBJECTIVE: Appropriate

  19. Gastos elevados em plano privado de saúde: com quem e em quê High expenditure on a private healthcare plan: for whom and in what

    OpenAIRE

    Alberto Hideki Kanamura; Ana Luiza d'Ávila Viana

    2007-01-01

    OBJETIVO: Analisar os gastos e o perfil de beneficiários de um plano de saúde privado e o impacto desses gastos nas finanças do plano e dos beneficiários. MÉTODOS: Estudo descritivo, incluindo 64.219 clientes de um plano de saúde que opera no Estado de São Paulo, no ano de 2003. Foram analisadas as características dos clientes de gastos elevados segundo a distribuição etária, por sexo, natureza dos gastos e doenças relacionadas. RESULTADOS: Dentre todos os clientes, 642 beneficiários (1%) pro...

  20. Cálculo biliar "perdido": um novo problema para o ginecologista na abordagem do abdome agudo? "Lost" gallstone: a new problem for the gynecologist in acute abdomen management ?

    Directory of Open Access Journals (Sweden)

    José Carlos Menegoci

    1999-12-01

    Full Text Available Os autores relatam o caso de uma paciente com 35 anos de idade, submetida à colecistectomia videolaparoscópica há 1 ano e que apresentou quadro sugestivo de salpingite aguda com abscesso. Durante a laparotomia notou-se um abscesso que era limitado anteriormente pelo peritônio parietal e músculo reto anterior direito do abdome, e posteriormente pelo corno uterino e pelo ligamento redondo à direita. Neste abscesso havia estrutura a seguir identificada como cálculo biliar. São discutidos os aspectos relacionados à patogenia, tratamento e prevenção desta complicação que vem sendo relatada com freqüência em virtude do maior uso da cirurgia laparoscópica.The authors report a case of a thirty-five-year-old patient, submitted to videolaparoscopic cholecystectomy one year ago, who appearently had acute salpingitis with abscess. During the laparotomy an abscess was observed, anteriorly limited by parietal peritoneum and the abdominal right anterior rectus muscle, and posteriorly by the horn of the uterus and by the right round ligament. In this abscess there was a structure later identified as gallstone. The aspects related to the pathogenesis, treatment and prevention, which have been reported frequently due to the increasing number of laparoscopic surgeries, are discussed.

  1. Avaliação da contratilidade da vesícula biliar com leite materno e leite de vaca em lactentes Gallbladder contractility after breast milk and cow's milk meals in infants

    Directory of Open Access Journals (Sweden)

    Marise Silva Teixeira

    2004-06-01

    Full Text Available As múltiplas características distintas do leite materno e do leite de vaca fazem com que o esvaziamento gástrico seja mais rápido após ingestão do primeiro. Esta rapidez do esvaziamento gástrico pode estar associada ao esvaziamento da vesícula biliar, também mais rápido. O objetivo do trabalho foi determinar se há diferença na velocidade de esvaziamento da vesícula biliar, por método ultra-sonográfico, após ingestão de leite materno e leite de vaca. Estudamos 47 crianças menores de dois anos, 22 após uma refeição com leite materno e 25 após uma refeição com leite de vaca. A vesícula biliar foi medida após um período de quatro a seis horas de jejum e uma hora após uma refeição (leite materno ou leite de vaca, e a contração da vesícula biliar foi avaliada, em porcentagem, pela diferença de volume da vesícula biliar entre as duas medidas e expressa em porcentagem do volume inicial. As medianas das porcentagens do volume inicial para as crianças alimentadas com leite materno e leite de vaca foram, respectivamente, 92,25% e 53,8%, diferença estatisticamente significativa. Portanto, a contração da vesícula biliar após uma refeição com leite de vaca é muito mais lenta do que aquela após uma refeição com leite materno.Breast milk and cow's milk differ in multiple characteristics that account for a faster gastric emptying time after breast feeding. This faster gastric emptying may be associated with a faster gallbladder emptying. Our aim was to compare gallbladder contraction after breast milk meal and cow's milk meal using ultrasound examination. We studied 22 infants after a breast milk meal and 25 infants after a cow's milk meal. Gallbladder volume was measured after a 4-6 hours fasting and one hour after the meal (breast milk or cow's milk. Gallbladder contractility was calculated by determining the difference between gallbladder volume one hour after the meal and the fasting volume, and expressed as a

  2. Determinación de la concentración micelar crítica (CMC) de sales biliares por el Método de Tensión Superficial

    OpenAIRE

    Volonté, María Guillermina; Marano, Claudia G.; Reinoso, María Isabel

    1989-01-01

    Se determinó la Concentración Micelar Crítica (CMC) de tres sales biliares: colato, desoxicolato y dehidroxicolato de sodio, utilizando el método de tensión superficial. Las condiciones de trabajo fueron seleccionadas en base a las requeridas para ensayos de absorción in vitro, es decir a 37ºC y en solución Krebs a pH fisiológicos. Los resultados obtenidos nos permiten afirmar que el método utilizado para determinar la CMC es rápido y preciso.

  3. Fatores preditivos de coledocolitíase em doentes com pancreatite aguda biliar Predictors of choledocholithiasis in patients sustaining acute biliary pancreatitis

    Directory of Open Access Journals (Sweden)

    José Gustavo Parreira

    2004-12-01

    Full Text Available OBJETIVO: Avaliar o papel da fosfatase alcalina (FA, gama glutamiltransferase (gamaGT e ultra-sonografia (US como fatores preditivos de coledocolitíase em doentes com pancreatite aguda biliar (PAB. MÉTODOS: Os dados foram coletados prospectivamente durante um período de 31 meses. Quarenta doentes foram incluídos, sendo 30 mulheres, com média etária de 49 + 16 anos. Foram registrados os dados de todos os doentes com pancreatite aguda biliar. Aqueles doentes ictéricos e com a forma grave da doença foram excluídos. As dosagens de FA e GGT, assim como a US, eram realizadas na admissão e 48 horas antes da cirurgia. Todos os pacientes foram submetidos à colangiografia intra-operatória (CIO ou à colangiografia retrógrada endoscópica (CPRE pré-operatória, que era definida baseada na probabilidade de coledocolitíase. Com o intuito de identificar os indicadores de coledocolitíase, as variáveis foram comparadas entre os pacientes com ou sem coledocolitíase. Os testes t de Student, Qui-quadrado e Fisher foram empregados para a análise estatística, considerando-se pBACKGROUND: To assess the role of alkaline phosphatase (AP, gamil-glutamyltransferase (gammaGT and abdominal ultrasound (US as predictors of choledocholithiasis in patients sustaining acute biliary pancreatitis. METHODS: Data was prospectively collected during a period of 31 months. Forty patients were included, 30 were female and the mean age was 49 + 16. All patients sustaining acute biliary pancreatitis were enrolled. Patients with clinical jaundice and severe pancreatitis were excluded. Serum content of AP and gGT as well as US were assessed at admission and 48 hours before cholecistectomy. All patients underwent intra-operative cholangiography (IOC or pre-operative endoscopic retrograde cholangiography (ERCP, which was indicated based on the odds of choledocholithiasis. In order to identify the predictors of choledocholithiasis, variables were compared between patients

  4. Use of fully covered self-expanding metal stents for the management of benign biliary conditions Utilización de prótesis metálicas autoexpandibles totalmente recubiertas en procesos biliares benignos

    Directory of Open Access Journals (Sweden)

    J. García-Cano

    2010-09-01

    Full Text Available Background and aim: biliary self-expanding metal stents (SEMS have the advantage of being inserted undeployed with very small sizes and provide, when fully opened, large diameters for biliary drainage. However, their use in benign conditions has been very limited, mainly because of difficulty in their extraction. We present our initial experience with a fully covered SEMS (Wallflex for the management of benign problems of the bile duct. Patients and methods: in a prospective study, stents of 8 mm in diameter and 4, 6 or 8 cm long were inserted by means of ERCP. These SEMS were chosen when according to medical judgement it was thought that diameters greater than 10 French (3.3 mm were needed for proper biliary drainage. Stents were extracted also endoscopically, several months later when deemed clinically appropriate. Results: twenty biliary SEMS were inserted. Reasons for insertion were: large intrahepatic biliary fistula after hydatid cyst surgery (1, perforation of the papillary area following endoscopic sphincterotomy (2, coaxial insertion to achieve patency in obstructed uncovered stents inserted in benign conditions (3, benign strictures (7, multiple and large common bile duct stones that could not be extracted because of tapering and stricturing of the distal common bile duct (7. In all cases, successful biliary drainage was achieved and there were no complications from insertion. Stents were easily extracted after a mean time of 132 days (36-270 in place. Complete resolution of biliary problems was obtained in 14 patients (70%. Conclusions: in our initial experience, the fully covered Wallflex biliary stent was removed without any complication after being in place in the common bile duct for a mean time of over four months. Therefore, it could be used in the management of benign biliary conditions.Introducción y objetivo: las prótesis metálicas autoexpandibles biliares (PMAB tienen la ventaja de introducirse plegadas con calibres muy

  5. Prevalencia de dislipemia y riesgo cardiovascular elevado en pacientes con artritis reumatoide Prevalence of dyslipidemia and elevated cardiovascular risk in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    María Jezabel Haye Salinas

    2013-02-01

    Full Text Available Los objetivos del estudio fueron comparar la frecuencia de riesgo cardiovascular (CV elevado y dislipemia (DLP en pacientes con artritis reumatoide (AR y en controles, identificar variables de la enfermedad asociadas a DLP y estimar el porcentaje de pacientes con AR medicados para DLP. Estudio de corte transversal que incluyó 409 pacientes con AR y 624 controles. El riesgo CV se determinó con las clasificaciones NCEP y SCORE modificados por European League Against Rheumatism (EULAR. Para DLP se utilizó la definición de Adult Treatment Panel III (ATP III. La frecuencia de riesgo CV elevado fue similar en pacientes con AR y controles excepto cuando fue definida por NCEP-EULAR (7% vs. 2%; p = 0.00002. La DLP fue encontrada en el 43% de los pacientes con AR y en el 47% de los controles (p = 0.15. Los pacientes con AR y DLP tuvieron más manifestaciones extra-articulares (36% vs. 24%; p = 0.01 y mayor velocidad de sedimentación globular (VSG (21 (13-35 vs. 18 (10-30 mm; p = 0.003. El tratamiento recibido para DLP varió según la definición utilizada (11% a 32%. Se encontró mayor riesgo CV en los pacientes con AR solo cuando se definió por NCEP- EULAR. Los pacientes con AR y DLP tuvieron mayor VSG y manifestaciones extra-articulares. La mayoría de los pacientes con AR y DLP no estaban recibiendo tratamiento hipolipemiante.The objectives of this study were to compare the frequency of dyslipidemia (DLP and the elevated cardiovascular risk between rheumatoid arthritis (RA patients and a control group, to identify disease-related factors associated with the presence of DLP and to estimate the frequency of RA patients receiving treatment for DLP. This is a cross sectional study that included 409 RA patients and 624 controls. Cardiovascular (CV risk was determined using the Framingham score, National Cholesterol Education Program (NCEP and the Systematic Coronary Risk Evaluation (SCORE adapted versions according to the European League Against

  6. AVALIAÇÃO FÍSICO-QUÍMICA, MICROBIOLÓGICA, SENSORIAL E ATITUDE DO CONSUMIDOR DE GELATINA DE ELEVADO VALOR NUTRICIONAL

    Directory of Open Access Journals (Sweden)

    JANESCA ALBAN ROMAN

    2009-09-01

    Full Text Available

    O objetivo deste trabalho foi o de elaborar formulações a base de gelatina (GM1, GM2 e GM3, com melhor valor nutricional em relação à tradicional, pela adição de isolado protéico de soro de leite (WPI na proporção de 60%, buscando-se um produto com boa aceitabilidade sensorial. As formulações foram caracterizadas quanto sua composição físico-química, perfi l microbiológico e sensorial, além de avaliar a atitude dos consumidores. Uma equipe composta por 65 julgadores avaliou os atributos de cor, sabor, textura, aroma e aparência geral de três formulações. A aceitabilidade das amostras foi superior a 70%. Não houve diferença signifi cativa quanto ao índice de aceitabilidade do produto geleifi cado GM2 em comparação com a gelatina comercial, o que signifi ca um índice satisfatório no mercado consumidor. A freqüência de consumo foi considerada elevada, pois apenas 4% dos entrevistados disseram não consumir gelatina. Foi possível elaborar um produto geleificado, de aceitabilidade sensorial elevada, semelhante à gelatina comercial, mas com teor de proteínas 60% superior e de elevado valor nutritivo, por meio da adição do isolado protéico de soro de leite bovino, na proporção 60:40 WPI:GB.

  7. Indicadores antropométricos de obesidade como instrumento de triagem para risco coronariano elevado em adultos na cidade de Salvador - Bahia

    Directory of Open Access Journals (Sweden)

    Pitanga Francisco José Gondim

    2005-01-01

    Full Text Available OBJETIVO: Comparar vários indicadores antropométricos de obesidade e identificar dentre eles qual melhor discrimina o risco coronariano elevado (RCE. MÉTODOS: Estudo de corte transversal, com amostra composta por 968 adultos de 30 a 74 anos de idade, sendo 391 (40,4% do sexo masculino. Foram construídas diversas curvas Receiver Operating Characteristic (ROC e comparadas às áreas sob as mesmas entre o índice de conicidade (índice C, índice de massa corporal (IMC, razão circunferência cintura-quadril (RCCQ, circunferência de cintura (CC e RCE. Verificou-se também a sensibilidade e especificidade para identificar e comparar o melhor ponto de corte entre os diversos indicadores de obesidade para discriminar o RCE. Foi utilizado intervalo de confiança a 95%. RESULTADOS: A maior área sob a curva ROC foi encontrada entre o índice C e RCE, em indivíduos do sexo masculino, 0,80 (0,74-0,85, diferindo significativamente dos demais indicadores de obesidade. Em mulheres, a maior área sob a curva ROC encontrada foi de 0,76 (0,71-0,81, sendo iguais entre índice C, RCCQ e RCE. CONCLUSÃO: Esses resultados demonstram que o índice C e RCCQ são os melhores indicadores de obesidade para discriminar RCE. A CC tem intermediário poder discriminatório e o IMC foi o indicador antropométrico de obesidade menos adequado para discriminar RCE. Estes dados sugerem que os indicadores de obesidade abdominal são melhores para discriminar RCE que os indicadores de obesidade generalizada.

  8. Complicações da cirurgia videolaparoscópica no tratamento de doenças da vesícula e vias biliares Videolaparoscopy complications in the management of biliary diseases

    Directory of Open Access Journals (Sweden)

    Marcelo Talasso Salim

    2008-12-01

    Full Text Available RACIONAL: O tratamento de escolha para as doenças da vesícula biliar é a colecistectomia, cujo objetivo é o alívio de sintomas e o tratamento e/ou prevenção das complicações. OBJETIVO: Identificar as principais complicações da cirurgia videolaparoscópica no tratamento das doenças da vesícula biliar e vias biliares. MÉTODO: Realizou-se busca eletrônica na base de dados LILACS e Medline desde o ano de 1981 a agosto de 2007; foram encontrados 57 artigos, sendo utilizados para o estudo 31 e três capítulos de livros. RESULTADOS: A produção científica submetida à análise de conteúdo evidenciou os seguintes núcleos temáticos: variações anatômicas (3 artigos, iatrogenias (5 artigos, síndrome pós-colecistectomia (1 artigo, complicações raras (3 artigos, síndrome de Mirizzi (1 artigo, complicações pulmonares (2 artigos e tratamento (1 capítulo de livro e três artigos. CONCLUSÕES: As complicações que podem ocorrer na cirurgia videolaparoscópica da vesícula biliar e das vias biliares têm basicamente duas vertentes: uma é a inexperiência dos cirurgiões com o método laparoscópico (curva de aprendizado e outra, as variações anatômicas com as quais os cirurgiões, mesmo os mais experientes, podem se deparar.BACKGROUND: The treatment of choice for diseases affecting the gallbladder is the cholecystectomy, whose aim is improvement of symptoms, treatment and/or prevention of complications. AIM: Identify the main complications with laparoscopic surgery used to treat diseases affecting the gallbladder and the bile ducts. METHODS: An internet search in the LILACS and Medline database covering the period from 1981 up to August 2007 was carried out and 57 studies were found relevant. The present work draws on 31 of these studies and one textbook chapter. RESULTS: The analysis of the content of the studies selected yielded the following thematic issues: anatomic variations (3 studies, iatrogenies (5 studies, post

  9. A terapêutica endoscópica nas complicações biliares pós-transplante hepático Endoscopic management of biliary complications after liver transplantation

    Directory of Open Access Journals (Sweden)

    Jeany Borges e Silva Ribeiro

    2012-12-01

    Full Text Available RACIONAL: O transplante hepático é o único tratamento efetivo para as hepatopatias crônicas terminais e a taxa de sobrevida tem aumentado nas últimas décadas. No entanto, as complicações biliares têm alta incidência e permanecem como o "calcanhar de Aquiles" do transplante de fígado. OBJETIVO: Avaliar retrospectivamente os resultados do tratamento endoscópico das complicações biliares em pacientes submetidos à transplante hepático. MÉTODOS: Foram avaliados pacientes transplantados hepáticos para realização de colangiopancreatografia retrógrada endoscópica por suspeita de complicação biliar. RESULTADOS: Quinze pacientes (11 homens, média de idade de 49,57 anos foram estudados. Nesse período foram realizadas 36 colangiopancreatografias retrógradas endoscópicas (2,4/paciente. Neste grupo, 100% receberam órgão de doador falecido. Estenose da anastomose coledococoledocociana foi diagnosticada em 13 pacientes e o sucesso da terapêutica endoscópica foi de 53,84% (38,46% ainda em tratamento. Fístula biliar foi diagnosticada em um paciente, sendo resolvida pelo tratamento endoscópico. Disfunção da âmpola hepatopancreaticobiliar com coledocolitíase foi diagnosticada em um paciente, também resolvida pela terapêutica endoscópica. CONCLUSÕES: As complicações biliares pós-transplante hepático são relativamente comuns, com predominância de estenoses. O tratamento endoscópico foi eficaz na maioria dos pacientes desta série.BACKGROUND: Liver transplantation is the only effective treatment for chronic liver diseases and terminal survival rate has increased in recent decades. However, biliary complications have high incidence and remain as the "Achilles heel" for liver transplantation. AIM: To evaluate retrospectively endoscopic treatment outcomes of biliary complications in post-liver transplantations. METHODS: The sample consisted of post-liver transplantation patients for endoscopic retrograde

  10. Índice elevado de ácidos grasos omega 6/omega 3 en niños con neuropatías causa o efecto

    Directory of Open Access Journals (Sweden)

    E. Cortés

    2013-08-01

    Full Text Available Introducción: Los ácidos grasos n-3 y n-6 compiten por las mismas elongasas y desaturasas, siendo muy deficiente la síntesis de ácidos grasos poliinsaturados n-3 a partir de ácido linolénico. Los poliinsaturados n-3 previenen enfermedades y son importantes en el desarrollo y mantenimiento de las actividades neuronales, siendo necesaria una relación adecuada con sus antagonistas n-6. En este trabajo se estudia la proporción de estos ácidos grasos. Material y métodos: Se han analizado los ácidos grasos n-3 y n-6 en sueros y fosfolípidos de membrana de 374 niños con neuropatías y de 34 niños sanos, mediante cromatografía de gases con detector de masas. Se ha realizado el estudio estadístico pertinente. Resultados: Los ácidos grasos n-3 (EPA y DHA en suero y su correspondientes fosfolípidos de membrana correlacionan mejor que los de la familia n-6. Los mayoritarios n-6 (LA y ARA están en igual proporción en sueros, siendo más elevados significativamente en los fosfolípidos de los niños sanos. Los n-3 (EPA y DHA tienen valores más altos en los niños sanos, tanto en suero como en fosfolípidos, su suma se iguala en los fosfolípidos de membrana. El índice n-6/n-3 es mayor en los niños con trastorno neurológico en ambas muestras. Conclusión: No siendo la causa de la neuropatía el alto índice n-6/n-3, sin embargo es aconsejable incrementar la ingesta de n-3, sobre todo DHA en toda la población y en especial en los niños con trastornos neurológicos.

  11. Inmunoexpresión de p53 y ciclina D1 en adenomas de vesícula biliar Immunoexpression of p53 and cyclic D1 in adenomas of the gallbladder

    Directory of Open Access Journals (Sweden)

    F. Arévalo

    2007-12-01

    Full Text Available Introducción: el adenoma de vesícula biliar es una neoplasia infrecuente, cuya relación con el adenocarcinoma es poco conocida, aunque algunos autores han propuesto que la mayoría de adenomas no degeneran en adenocarcinomas, debido a que ambas lesiones presentan vías moleculares diferentes. Material y métodos: el presente trabajo es un estudio transversal que compara las características moleculares del adenoma y adenocarcinoma de vesícula biliar, mediante la medición inmunohistoquímica de la expresión de las proteína p53 y ciclina D1 (ambas reguladoras del ciclo celular en 12 enfermos de cada grupo. Resultados: encontramos una mayor expresión de p53 en los adenocarcinomas (83,3% que en los adenomas (16,6% siendo esta diferencia estadísticamente significativa usando el test de chi cuadrado (p = 0,003, mientras que la expresión de ciclina D1 en ambos grupos fue similar. Conclusión: consideramos que nuestros resultados indican que la alteración en el p53 es un paso importante en el desarrollo de los adenocarcinomas de vesícula biliar, mientras que en el desarrollo de los adenomas, la alteración del p53 sería poco trascendente. Por otro lado, la sobreexpresión de ciclina D1 sería un mecanismo molecular común a ambas lesiones.Introduction: gallbladder adenomas are infrequent neoplasms whose relation to adenocarcinoma is not well understood. It has been suggested that adenomas and adenocarcinomas follow different molecular pathways. Material and methods: this is a comparative, cross-sectional study in which we compared p53 and D1 cyclin expression in adenomas and adenocarcinomas of the gallbladder. Results: we included 12 cases in each group. Expression of p53 occurred in 83.3% of adenocarcinomas and in 16.6% of adenomas (p = 0.003. D1 cyclin was expressed in a similar number of adenomas and adenocarcinomas. Conclusion: our results support the hypothesis that p53 is an important step in the pathogenesis of adenocarcinomas but

  12. Total protein

    Science.gov (United States)

    The total protein test measures the total amount of two classes of proteins found in the fluid portion of your ... nutritional problems, kidney disease or liver disease . If total protein is abnormal, you will need to have more ...

  13. Total protein

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  14. MÉTODO DE INDUÇÃO DE CIRROSE BILIAR SECUNDÁRIA COM USO DE PRÓTESE DE SILICONE METHOD FOR THE EXPERIMENTAL INDUCTION OF SECUNDARY BILIARY CIRRHOSIS IN WISTAR RATS

    OpenAIRE

    A. A. L. de Araujo Lima; A. K. Sankarankutty; L.N.Z. Ramalho; S. Zucoloto; O. de C. Silva Júnior

    2001-01-01

    O objetivo deste experimento foi o desenvolvimento de um modelo de obstrução do ducto biliar comum através da interposição de uma prótese de silicone extrínseca ao ducto com única ligadura sem secção. Desenvolveu-se um modelo experimental alternativo, em ratos Wistar, que provoca a interrupção do fluxo bílio-duodenal com resultado satisfatório, pois houve distorção da arquitetura hepática, caracterizada por fibrose e proliferação ductal além de indicadores bioquímicos da colestase....

  15. MÉTODO DE INDUÇÃO DE CIRROSE BILIAR SECUNDÁRIA COM USO DE PRÓTESE DE SILICONE METHOD FOR THE EXPERIMENTAL INDUCTION OF SECUNDARY BILIARY CIRRHOSIS IN WISTAR RATS

    Directory of Open Access Journals (Sweden)

    A. A. L. de Araujo Lima

    2001-01-01

    Full Text Available O objetivo deste experimento foi o desenvolvimento de um modelo de obstrução do ducto biliar comum através da interposição de uma prótese de silicone extrínseca ao ducto com única ligadura sem secção. Desenvolveu-se um modelo experimental alternativo, em ratos Wistar, que provoca a interrupção do fluxo bílio-duodenal com resultado satisfatório, pois houve distorção da arquitetura hepática, caracterizada por fibrose e proliferação ductal além de indicadores bioquímicos da colestase.

  16. Hepatobiliary alterations in massive biliary ascariasis: histopathological aspects of an autopsy case Lesões hepatobiliares em ascaridíase biliar maciça: aspectos histopatológicos em um caso de autópsia

    Directory of Open Access Journals (Sweden)

    Luiz Carlos da Costa Gayotto

    1990-04-01

    Full Text Available Hepatobiliary alterations found in an autopsy case of massive Biliary Ascariasis, are reported on histological grounds. Severe cholangitis was the main finding, but other changes were also detected, such as pyloric and intestinal metaplasia, hyperplasia of the epithelial lining, with intraductal papillomas and adenomatous proliferation. Remnants of the worm were observed tightly adhered to the epithelium, forming microscopic intrahepatic calculi. Mucopolysaccharides, especially acid, showed to be strongly positive on the luminal border, and in proliferated glands around the ducts. The authors discuss the similarity between such findings and Oriental Cholangiohepatitis, and suggest that inflammation and the presence of the parasitic remnants are responsible for the hyperplastic and metaplastic changes, similarly with what occurs in chlonorchiasis, fascioliasis and schistosomiasis.Os autores apresentam os aspectos histopatológicos encontrados no fígado de um caso de autópsia de Ascaridíase Biliar maciça. A intensa colangite foi o aspecto predominante, mas outras lesões também foram encontradas, tais como metaplasia pilórica e intestinal, hiperplasia epitelial com papilomas intraductais, e por vezes padrão adenomatoso. Restos do helminto foram encontrados fortemente aderidos ao epitélio, sendo intensa a positividade de mucopolissacárides, principalmente ácidos, na borda luminal do epitélio ductal e em glândulas proliferadas ao redor dos ductos. Os autores discutem a semelhança da Ascaridíase Biliar com a Colangio Hepatite Oriental, e sugerem que o processo inflamatório e a presença de restos do verme são responsáveis pelas alterações hiperplásicas e metaplásicas, analogamente ao que ocorre na clonorquíase, fasciolíase e esquistossomose.

  17. Aplicación de las superficies cónicas a la construcción de depósitos elevados

    Directory of Open Access Journals (Sweden)

    Torroja, José Antonio

    1964-02-01

    Full Text Available In Morrocco, recently, four elevated water tanks have been constructed, which are about 30 m above ground level. Parts of them are in prestressed concrete. Their aspect is pleasant, showing a harmonious outline. The four water tanks are fairly similar. One of them has a slender trunk, supporting the upper container. The other three differ from this one mainly in that the number of supporting columns which converge towards the top varies in each one. The water tank itself is made up of eight inverted conically shaped shell surfaces. They are paired symmetrically in four couples. These eight conical surfaces which constitute the bottom of the tank are separated from each other by vertical diaphragms or partitions. These are prestressed, but the compartments resulting from these partitions are connected at the bottom to ensure equal pressure on each side of the diaphragms. The structure, as a whole, constitutes a geometrical pattern whose simplicity and effectiveness can be easily appreciated from its subtle external beauty. Because of the complexity of analysing the strength properties of this structure with precision, an approximate method has been adopted, which is simple but ingenius. It is based on assuming a compression funicular of forces which is the mean of the external surface of the conical shells and provides a prudent margin of safety. The designer has also succeeded in inducing such a state of stress on the shell care to the concrete joints, as is the case in conventional concrete water tanks. These tanks, which are at present in service, have performed very closely as anticipated from the theoretical estimates. This has justified the author in his approximate calculation methods, which appear to be fully acceptable, and avoid the need of undertaking ardous mathematical operations.Recientemente se han construido en Marruecos cuatro depósitos elevados, de hormigón pretensado en alguna de sus partes, de unos 30 m de altura sobre el

  18. EFECTOS DE LA SEPARACIÓN MATERNA TEMPRANA SOBRE EL DESEMPEÑO EN EL LABERINTO EN CRUZ ELEVADO EN RATAS ADULTAS.

    Directory of Open Access Journals (Sweden)

    Duenas Zulma

    2012-04-01

    Full Text Available

    Se ha demostrado que alteraciones en la interacción madre-cría produce efectos duraderos sobre el desarrollo cerebral y comportamental; de esta forma sujetos expuestos a estrés por Separación Materna Temprana (SMT presentan variaciones en los comportamientos indicadores de ansiedad. El objetivo del presente estudio fue el de investigar los efectos específicos del estrés por SMT sobre los comportamientos indicadores de ansiedad en ratas Wistar adultas machos y hembras. Las ratas fueron anidadas con ciclo luz/oscuridad invertido (7 p.m./7 a.m., agua y comida ad libitum. El procedimiento de separación se realizó dos veces diarias durante los días postnatales 1 al 21 (7:30 a.m. a 10:30 a.m. y 1:30 a 4:30 p.m.. Los comportamientos indicadores de ansiedad fueron evaluados por medio del laberinto en cruz elevado (LCE cuando las crías alcanzaron un peso de 230 gramos. Se encontró que el estrés por SMT tiene efectos específicos para cada sexo sobre los comportamientos relacionados con la ansiedad, las hembras separadas maternalmente presentaron un perfil ansioso menor que las no separadas y los machos separados mostraron un mayor conflicto exploración/evitación. Estos resultados validan hallazgos

  19. Suplementação com ácido ascórbico tem efeito citoprotetor na cirrose biliar secundária: estudo experimental em ratos jovens Ascorbic acid supplementation has a cytoprotective effect on secondary biliary cirrhosis: experimental study in young rats

    OpenAIRE

    Cynthia R Matos Silva Passoni; Cláudio Antônio Rabello Coelho

    2008-01-01

    OBJETIVO: Testar se a suplementação com ácido ascórbico tem algum afeito citoprotetor em um modelo de cirrose biliar secundária em ratos jovens. MÉTODOS: Foram estudados 40 ratos Wistar desmamados no 21º dia pós-natal. Cada grupo de 10 foi submetido a um dos seguintes quatro tratamentos, até o 49º dia pós-natal, quando foram submetidos a eutanásia: 1) LC - ligadura dupla e ressecção do ducto biliar comum e administração diária de ácido ascórbico [100 mg/g de peso corporal (pc)]; 2) LA - ligad...

  20. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    1993-01-01

    We define the notion of total algorithms for networks of processes. A total algorithm enforces that a "decision" is taken by a subset of the processes, and that participation of all processes is required to reach this decision. Total algorithms are an important building block in the design of distri

  1. Vulnerabilidad sísmica de los pasos elevados y puentes que forman parte de la red vial del Distrito Metropolitano de Quito : Adaptación y aplicación de la metodología HAZUS®99

    OpenAIRE

    Atiaga, Galo; Demoraes, Florent

    2003-01-01

    En este informe se evalúa la vulnerabilidad estructural de los pasos elevados y puentes que forman parte de la red vial del Distrito Metropolitano de Quito frente a la amenaza sísmica. A fines del estudio se realizó una adaptación al contexto ecuatoriano de la metodología HAZUS®99 diseñada en Estados Unidos, ajustando la que se había implementado en el marco de un estudio anterior (Atiaga y Demoraes, 2002, hal-01283044). Se presenta también los parámetros de construcción levantadas en las 90 ...

  2. Ligadura de ducto biliar como modelo de estudo da síndrome hepatopulmonar e estresse oxidativo Common bile duct ligation as a model of hepatopulmonary syndrome and oxidative stress

    Directory of Open Access Journals (Sweden)

    Juliana Tieppo

    2005-12-01

    Full Text Available RACIONAL: A síndrome hepatopulmonar é caracterizada por uma disfunção hepática e pela existência de dilatações dos vasos pulmonares, levando a alterações nas trocas gasosas, tendo algumas das suas características observadas de forma experimental no modelo de ligadura de ducto biliar. OBJETIVOS: Avaliar o estresse oxidativo no tecido pulmonar de ratos cirróticos por ligadura de ducto biliar comum. MATERIAIS E MÉTODOS: Foram utilizados 12 ratos machos Wistar, pesando entre 200 e 300 g, divididos em dois grupos: controles (Co = 6 e cirróticos (Ci = 6. Foram realizadas avaliações de transaminases, gasometria arterial, avaliação da lipoperoxidação (substâncias reativas ao ácido tiobarbitúrico e quimiluminescência e quantificação da atividade enzimática antioxidante através das concentrações da enzima superóxido dismutase. Os tecidos analisados para avaliação da síndrome hepatopulmonar foram o fígado cirrótico e o pulmão. RESULTADOS: Os animais com ligadura de ducto biliar apresentaram alteração nas transaminases: aspartato aminotransferase, Co = 105,3 ± 43/Ci = 500,5 ± 90,3 alanina aminotransferase, Co = 78,75 ± 37,7/Ci = 162,75 ± 35,4 e fosfatase alcalina, Co = 160 ± 20,45/Ci = 373,25 ± 45,44. Em relação à lipoperoxidação e à resposta antioxidante, estas também apresentaram diferenças estatisticamente significativas quando avaliadas no pulmão (substâncias reativas ao ácido tiobarbitúrico Co = 0,87 ± 0,3/Ci = 2,01 ± 0,9; quimiluminescência Co = 16008,41 ± 1171,45/Ci = 20250,36 ± 827,82; superóxido dismutase Co = 6,66 ± 1,34/Ci = 16,06 ± 2,67. CONCLUSÕES: Os dados obtidos sugerem que no modelo experimental de cirrose por ligadura de ducto biliar há aumento significativo da lipoperoxidação no tecido pulmonar, bem como aumento na atividade da enzima antioxidante superóxido dismutase, sugerindo a presença de dano pulmonar decorrente da cirrose biliar secundária.BACKGROUND: The

  3. Suprapapillary needle puncture for common bile duct access: laboratory profile Punção suprapapilar por agulha para acesso ao ducto biliar comum: perfil laboratorial

    Directory of Open Access Journals (Sweden)

    Everson L. A. Artifon

    2006-12-01

    duodenal papilla of normal aspect. The patients with dilation of the suprapapillary fistula showed the fistula continuing to drain clear bile CONCLUSION: Suprapapillary puncture allows investigative and therapeutic procedures without significant increases in amylase, lipase and C-RP. Patients submitted to diagnostic puncture present complete recovery of the papilla, while dilation of the fistula maintains it pervious later on, but without complications.RACIONAL: A cateterização para acesso às vias biliares na colangiopancreatografia retrógrada pode apresentar dificuldades técnicas, sendo necessário freqüentemente efetuar-se papilotomia, procedimento não isento de complicações como perfuração e pancreatite OBJETIVOS: Demonstrar menor incidência de complicações a partir do perfil laboratorial, através de nova técnica desenvolvida, a punção suprapapilar MATERIAL E MÉTODOS: Após aprovação pelo Comitê de Ética em Pesquisa da instituição, 30 pacientes foram selecionados no período de julho de 2003 a agosto de 2004. Preenchidos os critérios de inclusão e exclusão, os pacientes, após explicação do protocolo e a assinatura do consentimento livre e esclarecido, foram submetidos a colangiopancreatografia retrógrada pela técnica de punção suprapapilar. Após o procedimento, foi feito seguimento com o paciente internado para avaliar possíveis complicações, bem como determinação dos níveis séricos da amilase, lipase e proteína C reativa nas 4 h, 12 h e 24 h subseqüentes e reavaliados 60 dias após. O estudo estatístico foi feito por análise de variância para medidas múltiplas e comparações múltiplas foram feitas por meio do teste de Wald RESULTADOS: O sucesso da técnica ocorreu em 93,4% (28/30 dos pacientes. Não foram observadas alterações estatisticamente significantes no perfil laboratorial. Complicações relacionadas à técnica de punção ocorreram em dois pacientes: um pelo não uso do fio guia e em outro por hemorragia

  4. The influence of treatment access regulation and technological resources on the mortality profile of acute biliary pancreatitis A influência da regulação do acesso aos serviços de saúde e da incorporação tecnológica no perfil de mortalidade da pancreatite aguda biliar

    Directory of Open Access Journals (Sweden)

    Francisco Ribeiro de Carvalho

    2008-01-01

    Full Text Available PURPOSE: The influence of treatment access regulation and technological resources on the mortality profile of acute biliary pancreatitis (ABP was evaluated. METHODS: The cases seen in a tertiary hospital were studied during two periods of time: 1995-1999 and 2000-2004, i.e., before and after the implementation of medical regulation. RESULTS: Among the 727 patients with acute pancreatitis, 267 had ABP and were classified according to APACHE II scores. The cases being referred to the tertiary hospital decreased from 441 to 286 (p 44% was smaller during the second study period (pOBJETIVO: Avaliou-se a influência do acesso aos recursos assistenciais e tecnológicos sobre a mortalidade na pancreatite aguda biliar (PAB. MÉTODOS: Os casos de PAB tratados num hospital universitário foram estudados em dois períodos: 1995 a 1999 e 2000 a 2004, antes e depois da implantação da Regulação Médica. RESULTADOS: Do total de 727 casos com pancreatite aguda atendidos, 267 apresentavam PAB e tiveram a gravidade avaliada pelo escore de APACHE II. Houve redução dos encaminhamentos de casos entre os períodos, de 441 para 286 (p 44 foi menor no segundo período (p < 0,002. O emprego de colangiografia por ressonância magnética, da colecistectomia por videolaparoscopia e do acesso à terapia intensiva foi significantemente maior no segundo período. A maioria dos óbitos ocorreu até os 14 dias de admissão, 73,4% no primeiro período e 81,3% no segundo. CONCLUSÃO:A melhora do suporte tecnológico e clínico não foi suficiente para modificar o perfil de mortalidade na PAB, o que indica a necessidade de avaliar terapêuticas para a sua resposta inflamatória.

  5. Potential limitations for potato yields in raised soil field systems near Lake Titicaca Limitações potenciais para produtividade da batata em solos de campos elevados no Lago Titicaca

    Directory of Open Access Journals (Sweden)

    Diego Sánchez de Lozada

    2006-10-01

    Full Text Available During the last two decades, various non-governmental organizations have strongly encouraged Bolivian farmers in the Altiplano region near Lake Titicaca to resume the ancestral agricultural practice of constructing raised fields. In addition to improved drainage and possibilities this practice affords for sub-irrigation, advocated benefits of this system traditionally include frost mitigation and high crop yields. Until recently, reliable data to assess the extent of these benefits were unfortunately lacking. In this context, field experiments on raised fields were designed and carried out at two locations in the Bolivian Altiplano to obtain reliable potato yield and temperature data. Observed yields ranged from 2.73 to 10.80 t ha-1 at the first site, where salinity caused significant yield variability (R² = 0.79. At the second site, yields per raised platform varied between 8.25 and 33.45 t ha-1. However, comparable yields were obtained in flat control plots in spite of a mid-season frost, and the minimum temperatures differed only by 1ºC in the conventional plots relative to the raised fields. These results suggest that, under the experimental conditions, the potential benefits of raised fields in terms of frost mitigation or increased yields might only be observable in exceptionally bad years, when extreme frosts wipe out entire potato crops on conventional fields. Nevertheless, it is argued that in spite of these marginally supportive observations, raised-field agriculture may still be a viable option for farmers to consider if the water-filled channels between the raised fields are managed for fish and fertilizer production.Nas últimas duas décadas várias organizações não governamentais entusiasmaram lavradores bolivianos da região do Altiplano, próximo ao Lago Titicaca, a reassumir a prática ancestral de construir campos elevados. Além de sua drenagem melhorada e das possibilidades de implementar a sub-irrigação, as vantagens

  6. Estudo prospectivo e comparativo do escovado obtido pela CPER à ecoendoscopia associada à punção aspirativa com agulha fina (EE-PAAF no diagnóstico diferencial das estenoses biliares Prospective comparative study of ERCP brush cytology and EUS-FNA for the diferential diagnosis of biliary strictures

    Directory of Open Access Journals (Sweden)

    Monica Novis

    2010-06-01

    Full Text Available OBJETIVO: Avaliar o desempenho diagnóstico da citologia obtida pela CPER, aquele obtido pela EE-PAAF e a concordância entre patologistas gerais (PG e especialistas (PE em pacientes com estenose biliar. MÉTODOS: Incluímos pacientes com estenose biliar identificados pela CPER. A EE-PAAF foi realizada apenas em áreas com efeito de massa ou da parede espessada do ducto biliar. O padrão-ouro foi a cirurgia, histologia e/ou o seguimento. As amostras teciduais foram consideradas: malignas, suspeitas, atípicas, insuficientes ou benignas. Os espécimes obtidos por cada método foi interpretado (cego por um PG e outro PE. RESULTADO: 46 pacientes foram incluídos (37 malignos e 9 benignos. O diagnóstico final foi de tumor pancreático (26, biliar (11, pancreatite crônica (8 e estenose inflamatória do ducto biliar (1. Sensibilidade e acurácia da CPER foram 43,2% e 52,2% para o PG e 51,4% e 58,7% para o PE. Sensibilidade e acurácia da EE-PAAF foi 52,8% e 58,5% para o PG e 69,4% e 73,2% para o PE. A combinação entre a CPER e EE-PAAF demonstrou maior sensibilidade e acurácia para ambos PG (64,9% e 69,6% e PE (83,8% e 84,8%, respectivamente. CONCLUSÃO: A citologia obtida pelo escovado da via biliar durante a CPER e as amostras teciduais colhidas pela EE-PAAF tem rendimento semelhante para o diagnóstico das estenoses biliares. No entanto, a combinação dos métodos resulta em uma maior acurácia. Além disso, espera-se que a interpretação das amostras ocorra com maior precisão pelo PE se comparado ao PG.OBJECTIVE: To evaluate and to compare the diagnostic yield of ERCP brush cytology (ERCP and EUS-FNA in patients with biliary strictures and evaluates the agreement between general pathologists (GP and expert GI pathologists (GIP in the final diagnosis of biliary strictures. METHODS: Patients with biliary strictures documented by ERCP were included. Brush cytology was performed and during EUS, only visible mass lesions or localized bile duct

  7. Regeneración de aguas contaminadas por plaguicidas (sustancias prioritarias y preferentes), con elevado potencial de lixivación, mediante fotocatálisis solar heterogénea

    OpenAIRE

    Escudero García, José Ángel

    2015-01-01

    La lixiviación (movimiento del agua y los compuestos disueltos a través del suelo) de plaguicidas hacia las aguas subterráneas, derivada de las prácticas agrícolas habituales, está recibiendo una atención creciente en los países europeos, ya que un elevado porcentaje de las mismas se emplea para la obtención de agua potable. Por esta razón, la UE ha establecido límites (0.1 µg L−1 para compuestos individuales y 0.5 µg L−1 para el conjunto de plaguicidas) en agua potable al objeto de salvaguar...

  8. Estado de hidratação de atletas em corrida de rua de 15 km sob elevado estresse térmico

    Directory of Open Access Journals (Sweden)

    Ednei Costa Maia

    2015-06-01

    Full Text Available INTRODUÇÃO: Um adequado estado de hidratação é de suma importância para os participantes de corridas de rua, tanto para um melhor desempenho esportivo, quanto na prevenção dos distúrbios causados pelo calor. OBJETIVO: O estudo visa avaliar o estado de hidratação de indivíduos do sexo masculino em corrida de rua de 15 km. MÉTODOS: A amostra foi composta por 15 indivíduos do sexo masculino (37,67±7,22 anos praticantes habituais de corrida de rua. O estado de hidratação foi avaliado antes e após a corrida através dos seguintes parâmetros: peso corporal, coloração e gravidade específica da urina (GEU, análise da impedância bioelétrica (BIA, níveis de hemoglobina (Hb e hematócrito (Ht. Na análise dos dados, foi utilizado o teste t de Student pareado ou o teste de Wilcoxon, aceitando-se como estatisticamente significante p < 0,01. RESULTADOS: Houve diminuição do peso corporal dos indivíduos após a corrida (p<0,0001, assim como elevação dos níveis de Hb e Ht. Apesar da diminuição observada na GEU após o exercício, não houve melhora significativa do padrão de coloração da urina ou diferença entre o conteúdo inicial e final de água corporal total. A temperatura ambiente (TA e umidade relativa do ar (URA foram de 38,75±1,79°C e 37,37±4,66%, respectivamente. CONCLUSÃO: O exercício no ambiente em questão conduziu os indivíduos a um estado de desidratação, apenas detectado pela análise da variação do peso corporal e de parâmetros sanguíneos através dos níveis de Hb e Ht. Parâmetros urinários como a coloração da urina e GEU, assim como aqueles obtidos através da BIA, provavelmente foram confundidos por variáveis não controladas pelo presente estudo.

  9. Calidad de vida de pacientes con obstrucción maligna del esófago, la vía biliar y la vía urinaria sometidos a intervencionismo radiológico paliativo Informe preliminar Medellín, Colombia

    Directory of Open Access Journals (Sweden)

    Jorge Guzmán Tatis

    2005-02-01

    Full Text Available En el momento de hacer el diagnóstico de los tumores malignos que ocasionan obstrucción del esófago, la vía biliar y el tracto urinario, la mayoría de los pacientes no tiene otras opciones terapéuticas excepto los cuidados paliativos. La presencia de síntomas molestos e incapacitantes, así como la amenaza a la existencia y el miedo a la muerte comprometen la calidad de vida. En este trabajo se realizaron a 25 pacientes procedimientos intervencionistas radiológicos como fueron: prótesis metálicas autoexpandibles en el esófago y en la vía biliar y nefrostomía percutánea. Se evaluaron, antes del procedimiento y a los 1, 3 y 6 meses la evolución de los síntomas clínicos, los criterios paraclínicos, las complicaciones de los procedimientos, el dolor por medio de la escala análoga visual y la calidad de vida por medio del cuestionario SF36. En los 8 pacientes con cáncer del esófago mejoraron el dolor y la disfagia y se mantuvieron el índice de masa corporal y la calidad de vida. En los 11 con obstrucción urinaria mejoraron el nitrógeno ureico, la creatinina y la calidad de vida al primer mes y al tercero. En los 6 que tenían obstrucción maligna de la vía biliar mejoraron los niveles de bilirrubina, el prurito, las náuseas y la calidad de vida al mes, con estabilidad del estado nutricional.

  10. Neonatal administration of fluoxetine did not alter the anxiety indicators, but decreased the locomotor activity in adult rats in the elevated plus-maze Administração neonatal de fluoxetina não alterou os indicadores de ansiedade, mas diminuiu a atividade locomotora em ratos adultos no labirinto elevado em cruz

    Directory of Open Access Journals (Sweden)

    Valdenilson Ribeiro Ribas

    2008-12-01

    Full Text Available The objective of this study was evaluate the anxiety and locomotor activity (LA in 52 Wistar adult male rats, being 26 treated with fluoxetine (10 mg/Kg - sc in the neonatal period. These same rats received foot shock (FS (1.6-mA - 2-s in the 90th day. The anxiety and LA were appraised by plus-maze. The time spent in the open arms was used as anxiety index and the LA was measured by number of entries in closed arms (NECA and the total of entries (TE. T-test was used with pO objetivo deste estudo foi avaliar a ansiedade e a atividade locomotora (AL em 52 ratos Wistar adultos machos, sendo 26 tratados no período neonatal com fluoxetina (10 mg/Kg - sc e no 90º dia, receberam estímulos elétricos nas patas (1,6-mA-2-s. A ansiedade e a AL foram avaliadas por meio do labirinto elevado em cruz. O tempo de permanência dos animais nos braços abertos (BA foi utilizado como índice de ansiedade e a AL medida pelo número de entradas nos braços fechados (NEBF e pelo total de entradas (TE nos BA e BF. O teste t foi utilizado, com (p<0,05 e os dados apresentados em média±erro padrão. Os animais tratados reduziram o NEBF (2,35±0,33 e o TE (3,96±0,61 comparados a seus controles (4,65±0,52 e (6,96±0,94. A administração neonatal de fluoxetina não alterou a ansiedade, mas diminuiu a AL dos animais que receberam EE.

  11. Radioterapia adyuvante en el cáncer de vías biliares intervenido de manera radical: experiencia del Hospital Universitario de Ginebra (Suiza) y revisión sistemática con meta-análisis de estudios observacionales

    OpenAIRE

    Bonet Beltrán, Marta

    2009-01-01

    Objetivo: Los cánceres de las vías biliares extrahepáticas son tumores poco frecuentes, de mal pronóstico y con elevadas tasas de recidiva locorregional (LR). Sin embargo, la ausencia de estudios clínicos aleatorizados hace que los datos disponibles procedan de instituciones aisladas o del análisis retrospectivo de bases de datos poblacionales sin que éstos aporten resultados concluyentes. El propósito del presente estudio es evaluar la viabilidad y el impacto potencial de la RT adyuvante en ...

  12. Resistência à corrosão de pós metálicos em concretos refratários contendo elevado teor de carbono Corrosion resistance of metal powders in high-carbon containing castables

    Directory of Open Access Journals (Sweden)

    V. G. Domiciano

    2006-09-01

    Full Text Available Os benefícios proporcionados pela adição de carbono em concretos refratários têm ampliado a utilização destes materiais em aplicações siderúrgicas. Contudo, um dos problemas que ainda limita o emprego de concretos refratários contendo elevado teor de carbono é a corrosão de pós metálicos comumente empregados para conter a oxidação do carbono a altas temperaturas. Estudos preliminares mostraram que a corrosão das partículas metálicas é diretamente afetada pelas condições alcalinas promovidas pela presença de cimento. Diante disso, o objetivo deste trabalho foi avaliar o efeito da temperatura e a influência de diferentes agentes ligantes sobre a resistência à corrosão de pós metálicos (Al e Si em água e em concretos refratários contendo elevado teor de carbono. Para isso, foi empregada uma técnica capaz de detectar a liberação de gás H2 como produto da reação de corrosão dos metais. Os resultados obtidos revelaram a possibilidade de aplicação dos pós metálicos em concreto refratário através da escolha de um ligante apropriado.The benefits promoted by carbon addition in refractory castables have led to an increase in the use of such materials in the steel making industry. Nevertheless, one of the problems that still hinder the use of high-carbon-containing castables is the corrosion of metal powders commonly used to prevent carbon oxidation at high temperatures. Preliminary studies have pointed out that the metal powders corrosion within the castables is affected by the aggressive alkaline conditions promoted by cement hydration. The present work aimed to evaluate the effect of temperature as well as the influence of different binders on the corrosion resistance of Al and Si powders in water and in high-carbon containing castables. A technique able to detect the H2-gas release was used to identify the metal powders corrosion. The results revealed the possibility of applying Al or Si powders in these

  13. Niveles de plomo elevados en sangre de niños que vivían en casas antiguas de Evansville, Indiana: asociación entre año de construcción de la casa, niveles de plomo en suelo y niveles de plomo en sangre de niños de 1-5 años, entre 1998-2006 Higher blood lead levels among children living in older homes in Evansville Indiana: associations between year house built, soil lead levels and blood lead levels among children aged 1-5 years - 1998 to 2006 Elevados níveis de chumbo no sangue de crianças que vivem em habitações antigas em Evansville, Indiana: associação entre o ano de construção da casa, níveis de chumbo no solo e níveis de chumbo no sangue de crianças de 1-5 anos, entre 1998 - 2006

    Directory of Open Access Journals (Sweden)

    Diane Jackson

    2012-08-01

    Full Text Available En este estudio se evaluaron los niveles de plomo en 18.218 muestras de sangre. Las muestras de 11.719 niños de Evansville, Indiana, de edades comprendidas entre 1 y 5 años se obtuvieron de manera voluntaria entre los años 1998 y 2006. Se evaluaron además los niveles de plomo en el suelo de 35 jardines residenciales correspondientes al domicilio de 81 niños.Durante el periodo de estudio, tanto los niveles de plomo en sangre como el porcentaje de valores elevados para dichos niveles fueron descendiendo. A pesar de ello, los valores de plomo en sangre en Evansville siguieron estando por encima de los nacionales (mediana de niveles de plomo en sangre 3,0 frente a 1,5 μg/dL, respectivamente. Nuestro análisis dio como resultado que vivir en casas antiguas (presumiblemente con pintura que contiene plomo estaba asociado con niveles más elevados de plomo en sangre en los niños. No se encontró una asociación clara de los niveles elevados de plomo en sangre ni con el género ni con los niveles de plomo en el suelo de los jardines.A total of 18,218 blood lead levels (BLLs were assessed. The samples from 11,719 children aged 1-5 years in Evansville, Indiana, were obtained on a volunteer basis between 1998 and 2006. In addition, soil lead levels were also evaluated from 35 residential yards that were matched to the addresses of 81 children.During the study period, both average BLLs and the percentage of elevated BLLs declined. Even so, Evansville’s BLLs still remained higher than national levels (median BLLs of 3.0 vs.1.5 μg/dL, respectively. From our analysis, living in older houses (presumably containing lead paint was associated with higher BLLs in children. No clear association was found between higher BLLs and gender or residential soil lead levels.Neste estudo avaliaram-se os níveis de chumbo em 18.218 amostra de sangue. As amostras de 11.719 crianças de Evansville, Indiana, de idades compreendidas entre 1 e 5 anos obtiveram-se de forma

  14. Níveis de óxido nítrico mais elevados estão associados à atividade da doença em pacientes egípcios com artrite reumatoide

    Directory of Open Access Journals (Sweden)

    Adel Mahmoud Ali

    2014-12-01

    Full Text Available Introdução O estresse oxidativo produzido no interior de articulações inflamadas pode produzir fenômenos autoimunes e destruição articular. As espécies radicais com atividade oxidativa, incluindo espécies reativas de nitrogênio, representam mediadores de inflamação e de lesão cartilaginosa. Objetivos Avaliar o óxido nítrico sérico como marcador de estresse oxidativo em pacientes egípcios com artrite reumatoide e sua relação com a atividade da doença. Métodos 80 com artrite reumatoide foram divididos em dois grupos, de acordo com a pontuação DAS28: Grupo I: 42 pacientes com doença ativa, e Grupo II: 38 pacientes com doença inativa. Quarenta indivíduos equiparados por idade e gênero foram incluídos como grupo controle (Grupo III. Foram realizados exames laboratoriais de rotina e o óxido nítrico foi medido usando Elisa. Radiografias simples das mãos foram feitas para a pontuação do estado radiológico utilizando o método de Sharpe. Resultados A comparação do nível sérico de óxido nítrico entre os três grupos mostrou uma diferença altamente significativa (p < 0,001. Obtiveram-se níveis significativamente mais elevados entre os pacientes com artrite reumatoide em comparação com os controles. Os níveis mais elevados foram obtidos em pacientes com a doença ativa (média±DP 82,38±20,46 em comparação com aqueles com a doença inativa (35,53±7,15. O óxido nítrico no Grupo I exibiu uma correlação positiva significativa com a rigidez matinal (r=0,45, artrite (r=0,43, contagem de plaquetas (r=0,46, velocidade de hemossedimentação (r=0,83, proteína C-reativa (r=0,76 e Índice de Atividade de Doença (r=0,85. O óxido nítrico mostrou uma correlação positiva significativa (r=0,43 com as radiografias das mãos (índice de Sharpe no Grupo I. Conclusão Observa-se um aumento nos níveis séricos de óxido nítrico em pacientes com artrite reumatoide. O óxido nítrico se correlaciona significativamente

  15. Colesterol total e fatores associados: estudo de base escolar no sul do Brasil Colesterol total y factores asociados: estudio de base escolar en el sur del Brasil Associated factors to total cholesterol: school based study in southern Brazil

    OpenAIRE

    Mauren Lúcia de Araújo Bergmann; Gabriel Gustavo Bergmann; Ricardo Halpern; Ricardo Rodrigo Rech; Cristine Boom Constanzi; Lidiane Requia Alli

    2011-01-01

    FUNDAMENTO: Evidências têm sugerido que uma parcela importante de crianças e adolescentes apresenta níveis elevados de colesterol total. OBJETIVO: Estimar a prevalência de hipercolesterolemia e fatores associados em escolares de 7 a 12 anos de idade. MÉTODOS: Estudo transversal de base escolar de uma amostra aleatória composta por 1.294 escolares de 7 a 12 anos, de Caxias do Sul (RS). Os escolares responderam a uma entrevista com informações sobre nível socioeconômico, hábitos alimentares e h...

  16. Recubrimientos micro/nanoestructurados de aleaciones ligeras mediante proyección fría para la protección y reparación de componentes de elevado valor añadido: Estado del arte

    Directory of Open Access Journals (Sweden)

    Bedoya, J.

    2013-06-01

    Full Text Available The Cold Gas Spray - CGS technique has greatly attracted the attention of the researchers in the last decade due to advantages compared to other conventional thermal spray processes. It presents outstanding characteristics such as high density coatings and absence of thermal degradation (oxidation or phase transformation. In addition, CGS is an efficient and green technology. This paper presents a bibliographic review related to micro/nanostructured aluminium-based coatings of by CGS on light alloy substrates. It provides an overview of the feasibility of using the Cold Gas Spray as a technique for the protection, recovery and repair of high value-added components, especially those made of light alloys (aluminium and magnesium base which, by their low density and mechanical properties, are widely used in several industrial sectors such as transport, aerospace and power generation.La técnica de Proyección Fría (Cold Gas Spray - CGS ha atraído considerablemente la atención de los investigadores en la última década dadas sus ventajas respecto a otras técnicas convencionales de proyección térmica, como la obtención de recubrimientos de altísima densidad y sin degradación (ya sea oxidación o cambios de fase, además de su gran potencial a nivel económico y ambiental por ser un proceso más eficiente y respetuoso con el medio ambiente. Este estudio presenta una revisión bibliográfica respecto a la obtención de recubrimientos micro/nanoestructurados base aluminio mediante proyección fría sobre sustratos de aleaciones ligeras, el cual permitirá tener una visión global sobre la viabilidad de utilizar la proyección fría como técnica para la protección, recuperación y restauración de componentes de elevado valor añadido, especialmente aquéllos fabricados con aleaciones ligeras (base aluminio y magnesio los cuales, por su baja densidad y propiedades mecánicas, son ampliamente utilizados en diferentes sectores de la industria

  17. Estabilização de solos siltosos expansivos de São Paulo com ligantes com elevado teor de escória para pavimentação

    Directory of Open Access Journals (Sweden)

    Juliana Kawahashi

    2011-04-01

    Full Text Available

    Resumo: Ocorrências de solos residuais siltosos de rochas de micaxisto e gnaisse em vastas áreas da região de São Paulo representam uma grande dificuldade para a pavimentação de vias em periferias. Tais solos apresentam expansão elevada quando saturados e baixa capacidade de suporte, sendo que sua estabilização é tradicionalmente realizada com emprego de agregados quando não são simplesmente descartados. Isso impõe custos elevados de pavimentação nessas zonas. Neste artigo são apresentadas recentes experiências com a modificação desses solos com cimentos de alto forno, buscando-se controlar sua expansão e com ganhos de capacidade portante. Foram obtidos resultados positivos no controle de expansão com baixos consumos de ligante hidráulico, porém sem melhorias significativas quanto ao módulo de resiliência das misturas. Misturas solo-brita-cimento requereram maior consumo ligante com aumento do módulo de resiliência, com restrições para a resistência à tração do material. Os resultados apontam a viabilidade das misturas estudadas para reforços de subleitos e sub-bases.

    Abstract: Residual silt finely granulated soils from micaschists and gneisses in Sao Paulo represent huge limitations for urban paving in suburban areas. Those soils have high expansion as well as low bearing capacity; its stabilization, whenever possible, is done by means of soil-aggregate mixtures or they are replaced by alternative soils at high excavation and transportation costs. This paper analyses results of soil-cement stabilization for such soils using blast furnace cements aiming at the control of its expansion and improvements on its strength. Nevertheless good results were achieved for controlling expansion with low cement content, resilient modulus did not increase. Soil-aggregate-cement mixtures achieved good improvement on its resilient modulus although the tensile strength of the material

  18. Papel da luminosidade do biotério no comportamento do rato no labirinto em cruz elevado Role of vivarium illumination in rat behavior in the elevated plus-maze

    Directory of Open Access Journals (Sweden)

    Raquel Martinez

    2005-08-01

    Full Text Available Há pouca informação sobre o efeito dos ambientes onde os ratos são mantidos antes de testes. Para investigar o efeito da iluminação do biotério, ratos Wistar machos foram submetidos a um período de 96 h de iluminação contínua, escuridão contínua ou um ciclo claro escuro de 12:12 h e testados no labirinto em cruz elevado em uma sala iluminada (150 lux ou escura (0 lux. Os resultados mostram que nem a iluminação contínua nem a escuridão contínua do biotério afetam o comportamento dos ratos, quando comparados aos sujeitos mantidos no ciclo claro-escuro de 12 h. A condição de luminosidade durante o teste, no entanto, foi importante: independentemente da condição de iluminação do biotério, os animais testados no escuro exploraram mais os braços abertos do labirinto, um resultado já relatado na literatura e interpretado como diminuição da ansiedade nesse aparato.There is little information about the environments where rats are kept before being tested. In order to investigate the role of vivarium illumination, male Wistar rats were submitted to a 96-h period of continuous illumination, continuous dark or a 12:12 h light/dark cycle and tested in the elevated plus-maze in a lit (150 lux or a dark room (0 lux. Results showed that neither vivarium illumination nor darkness for 96 h altered the rats' behavior in comparison to that of rats kept under the 12-h light/dark cycle. Luminosity during the test, however, was important: no matter what the vivarium illumination was, rats tested in the dark room explored more the open arms of the maze, an already reported result which is interpreted as decreased anxiety in this apparatus.

  19. Aspectos clínicos e laboratoriais em ovinos submetidos a dietas com níveis elevados de enxofre com objetivo de indução de polioencefalomalácia

    Directory of Open Access Journals (Sweden)

    Diego J.Z. Delfiol

    2013-04-01

    Full Text Available A polioencefalomalacia (PEM é uma doença neurológica que acomete ruminantes e pode ser desencadeada por diversos fatores, dentre eles o consumo excessivo de enxofre. Este trabalho teve como objetivo verificar a relação entre dietas ricas em enxofre, altos níveis de gás sulfídrico ruminal e a ocorrência de polioencefalomalácia em ovinos. Foram utilizados 18 ovinos, divididos em três grupos (G1, G2 e G3 que receberam diferentes níveis de enxofre na dieta; 0,2%, 0,9% e 1,2%, respectivamente. Exames físicos (frequência cardíaca, frequência respiratória, temperatura retal e motricidade ruminal e complementares (concentração de sulfeto de hidrogênio ruminal, hemogasometria venosa, pH do fluído ruminal, concentração de cobre sérico e hepático, tomografia computadorizada, necropsia e histopatologia foram realizados. A temperatura retal, a hemogasometria venosa e o pH do fluido ruminal permaneceram dentro dos valores de referência para a espécie. A motricidade ruminal estava diminuída nos grupos G2 e G3 em comparação com o G1 (controle. Quanto maior a ingestão de enxofre, menores foram os níveis de cobre sérico e hepático. Valores elevados de sulfeto de hidrogênio ruminal foram detectados nos grupos G2 e G3. Nenhum animal apresentou sinais clínicos de PEM. Nos exames de tomografia computadorizada, necropsia e exame histopatológico do sistema nervoso central (SNC, não foram observadas alterações compatíveis com PEM. É provável que algum outro fator esteja associado ao excesso de enxofre na dieta para o desenvolvimento de PEM em ovinos.

  20. Influence of glutamine on morphological and functional changes of liver in the presence of extrahepatic biliary obstruction in rats Influência da glutamina em alterações funcionais e morfológicas do fígado na vigência de obstrução biliar extra-hepática em ratos

    Directory of Open Access Journals (Sweden)

    Manoel Camelo de Paiva Neto

    2010-08-01

    Full Text Available PURPOSE: To study the influence of glutamine on functional and morphological changes of liver in the extrahepatic biliary obstruction through an experimental model in rats. METHODS: Seventy Wistar rats were divided into four groups: control (group C fictitious operation, (group FO, submitted to laparotomy with handling of bile ducts, but without hepatic duct ligation, (group EBO submitted to laparotomy and hepatic duct ligation, one of them submitted to supplementation with glutamine 2% (group G. The control group consisted of 6 animals. The animals from groups FO, EBO and G were divided into three groups consisting of 6 animals each, being sacrificed at 7, 14 and 21 days after operation, respectively. Blood samples were collected for biochemical analysis and a fragment of liver tissue was collected from the middle lobe for histological analysis. RESULTS: Both for biochemical analysis (BT, aspartate and alanine aminotransferase AST, ALT and alkaline phosphatase FAL and for histopathological changes (fibrosis, portal inflammation, parenchymal inflammation, hepatocytic changes and duct proliferation, no statistical difference between groups submitted to extrahepatic biliary obstruction (EBO with and without treatment with glutamine (G was observed. CONCLUSION: Glutamine supplementation did not alter the prognosis of liver enzymes and histopathological changes in animals submitted to extrahepatic biliary obstruction.OBJETIVO: Estudar a influência da glutamina em alterações funcionais e morfológicas do fígado na obstrução biliar extra-hepática por meio de um modelo experimental desenvolvido em ratos. MÉTODOS: Setenta ratos Wistar distribuídos em quatro grupos: controle (grupo C; operação fictícia (grupo OF, submetido à laparotomia com manuseio das vias biliares, mas sem ligadura do ducto hepático; (grupo OBE, submetido à laparotomia exploradora e ligadura do ducto hepático, sendo um deles submetido à suplementação com glutamina a

  1. Reação peritoneal tardia ao calculo biliar humano, de colesterol, deixado na cavidade abdominal de ratos Late peritoneal reaction to human cholesterol gallstone left into abdominal cavity of rats

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Bertges

    1999-08-01

    Full Text Available Foram avaliados os resultados tardios da colocação de cálculos biliares humanos, de colesterol, na cavidade peritoneal de ratos. Constituíram-se cinco grupos: cinco ratos foram apenas laparotomizados com manuseio da cavidade; cinco foram laparotomizados e receberam um ponto com fio monofilamentar cinco zeros no sulco paracólico direito e mesentério; dez receberam cálculos que foram deixados livres na cavidade peritoneal; em dez, os clculos foram fixados no sulco paracólico direito e, finalmente, dez tiveram clculos fixados no mesentério. Os animais foram mortos após cinco meses de pós-operatório quando se observou a cavidade abdominal e foi coletado material para estudo histopatológico. Concluiu-se que os cálculos não foram absorvidos, desenvolveram uma reação peritoneal do tipo corpo estranho com formação de plastrão e foram envolvidos por tecido fibroso e células inflamatórias.It was evaluated the late results of human gallstones placed into peritoneal cavity of rats. Five groups were created. In the first (group A five rats were submitted only to laparotomy and handling of abdominal cavity, in the second (group B five rats were submitted to laparotomy and a stitch was placed into right abdominal wall and in mesenterium between the ileus and cecum, in the third (group C ten rats received a gallstone left free into abdomen, in the fourth (group D ten rats received a gallstone fixed into right abdominal wall and in the fifth (group E ten rats received a gallstone fixed in mesenterium between the ileus and cecum. One rat in each group was selected to be use as a pilot and were re-laparotomized after 1 month and 3 months, in order to look for any possible alteration. All rats were dead after five months when the abdominal cavity was observed and specimens were collected around the gallstones to histopathology. ln groups A and B there were not important macroscopic alterations. The gallstones were not absorved in groups C, D

  2. Colesterol total e fatores associados: estudo de base escolar no sul do Brasil

    OpenAIRE

    Mauren Lúcia de Araújo Bergmann; Gabriel Gustavo Bergmann; Ricardo Halpern; Ricardo Rodrigo Rech; Cristine Boom Constanzi; Lidiane Requia Alli

    2011-01-01

    FUNDAMENTO: Evidências têm sugerido que uma parcela importante de crianças e adolescentes apresenta níveis elevados de colesterol total. OBJETIVO: Estimar a prevalência de hipercolesterolemia e fatores associados em escolares de 7 a 12 anos de idade. MÉTODOS: Estudo transversal de base escolar de uma amostra aleatória composta por 1.294 escolares de 7 a 12 anos, de Caxias do Sul (RS). Os escolares responderam a uma entrevista com informações sobre nível socioeconômico, hábitos alimentares e h...

  3. EFECTOS DE LA SEPARACIÓN MATERNA TEMPRANA SOBRE EL DESEMPEÑO EN EL LABERINTO EN CRUZ ELEVADO EN RATAS ADULTAS Effects of Early Maternal Separation on The Performance in the Elevated Plus Maze in Adult Rats

    Directory of Open Access Journals (Sweden)

    DIEGO ARMANDO LEÓN RODRÍGUEZ

    2012-04-01

    Full Text Available Se ha demostrado que alteraciones en la interacción madre-cría produce efectos duraderos sobre el desarrollo cerebral y comportamental; de esta forma sujetos expuestos a estrés por separación materna temprana (SMT presentan variaciones en los comportamientos indicadores de ansiedad. El objetivo del presente estudio fue investigar los efectos específicos del estrés por SMT sobre los comportamientos indicadores de ansiedad en ratas Wistar adultas machos y hembras. Las ratas fueron anidadas con ciclo luz/oscuridad invertido (7 p.m./7 a.m., agua y comida ad libitum. El procedimiento de separación se realizó dos veces diarias durante los días postnatales 1 al 21 (7:00 a 10:00 y 13:00 a 16:00 p.m.. Los comportamientos indicadores de ansiedad fueron evaluados por medio del laberinto en cruz elevado (LCE cuando las crías alcanzaron un peso de 230 g. Se encontró que el estrés por SMT tiene efectos específicos para cada sexo sobre los comportamientos relacionados con la ansiedad, las hembras separadas maternalmente presentaron un perfil ansioso menor que las no separadas y los machos separados mostraron mayor conflicto exploración/evitación. Estos resultados corroboran hallazgos preliminares de nuestro laboratorio, en los que se evidencia interacción entre la vulnerabilidad ante desafíos ambientales tempranos y los mecanismos compensatorios del cuidado materno.It has been demonstrated that disruption of mother-pup interaction during early life exerts long-lasting effects on the brain and behavioral development. Therefore subjects exposed to early maternal separation stress (MS show variations in anxiety-like behaviors. The aim of this study was to investigate the specific effects of SMT stress on anxiety-like behaviors in adult male and female Wistar rats. Rats were housed with reversed light dark cycle (light on at 7 p.m., off at 7 a.m., water and food ad libitum. Separation was carried out in postnatal days 1 to 21, twice daily in dark

  4. Niveles elevados de e-selectina soluble en una población infantojuvenil con sobrepeso Elevated Soluble E-selectin levels in an Infant-juvenile Population with Overweight

    Directory of Open Access Journals (Sweden)

    AV Abregú

    2012-09-01

    Full Text Available El sobrepeso infantil se asocia a sobrepeso/obesidad en la edad adulta y constituye un factor de riesgo de diabetes y enfermedad cardiovascular. La disfunción endotelial es la etapa inicial de ateroesclerosis y precede a las evidencias anatómicas más tempranas de la misma. Este proceso está regulado por moléculas de adhesión localizadas en la superficie de leucocitos y células endoteliales y que tendrían un papel importante en la predicción de los eventos cardiovasculares. Entre estas moléculas, la E-Selectina (E-S es una glicoproteína que se expresa exclusivamente en las células endoteliales activadas, en respuesta a citoquinas inflamatorias. Se ha sugerido que niveles aumentados de forma solubles de E-Selectina (sE-S podrían ser marcadores específicos del endotelio vascular dañado. El objetivo de este trabajo fue determinar los niveles plasmáticos de sE-S en niños y adolescentes con sobrepeso y su relación con variables antropométricas y bioquímicas. Se estudiaron 40 niños con sobrepeso, de edades comprendidas entre 7 y 14 años y 20 niños controles de edad y sexo semejantes. Se consideró criterio de inclusión un IMC ≥ al percentilo 85 y menor al percentilo 95 para edad y sexo. Se determinó circunferencia de cintura (CC, IMC, estadio de Tanner y presión arterial. En ambos grupos se analizó: glucemia en ayunas, insulina plasmática, fibrinógeno (Fg, proteína C reactiva ultrasensible (uPCR, sE-S en plasma y perfil lipídico. Los datos se expresaron como mediana y rango intercuartil, empleándose el coeficiente de Spearman para las correlaciones entre variables. En los sujetos con sobrepeso fueron mayores los niveles de sE-S [72,0 (50,5-92,5 vs. 24,0(18,5-35,0 ng/ml; p = 0,0001], uPCR [1,9 (0,8-4,4 vs. 0,3 (0,2-1,1 mg/l; p = 0,001], Fg [350 (315-460 mg/dl vs. 247 (235-265 mg/dl; p = 0,0001]. También resultaron elevados los valores de insulina y triglicéridos. La sE-S se correlacionó con CC (r = 0,40; p = 0,02, u

  5. A model to explain high values of pH in an alkali sodic soil Modelo para explicar valores elevados de pH em um solo sódico alcalino

    Directory of Open Access Journals (Sweden)

    José Guerrero-Alves

    2002-12-01

    feitas fazendo uso de diferentes combinações da pressão parcial de CO2 (P, presença ou ausência de MgCO3, com valores experimentais da porcentagem de sódio trocável (ESP e concentrações de íons em extratos de saturação de um solo sódico alcalino (chamado Pantanal. Um sistema hipotético com condições similars ao solo Pantanal mas com um coeficiente de selectividade de Gapon (KG de 0,01475 (mmol L-1-1/2 foi, também, considerado. Boa concordância foi obtida entre os valores experimentais e os predezidos para o pH e concentração de íons na solução do solo quando o modelo (sem MgCO3 foi aplicado ao solo Pantanal. Porém, valores de KG calculados para o solo Pantanal estiveram muito acima de 0,01475 (mmol L-1-1/2. Além disso, elevados valores de pH e da força iónica foram obtidos quando o KG de 0,01475 (mmol L-1-1/2 foi usado a altos ESP. Valores de KG obtidos para o solo Pantanal e os resultados achados na simulação do sistema hipotético sugerem que um valor maior de 0,01475 (mmol L-1-1/2 poderia ser empregado adequadamente para simular o comportamento do solo Pantanal a baixa força iônica e altos valores de ESP.

  6. Gallstones in children with sickle cell disease followed up at a Brazilian hematology center Litíase biliar em crianças com doença falciforme acompanhadas em um centro de hematologia no Brasil

    Directory of Open Access Journals (Sweden)

    Ana Paula dos Santos Gumiero

    2008-12-01

    ótipos SS (homozigotos e S² (heterozigotos associaram-se a maior risco de litíase biliar, quando comparados aos pacientes com doença falciforme. Cerca de 50% dos pacientes com colelitíase era assintomática, a maioria não foi tratada cirurgicamente e não apresentou complicações relacionadas durante o período de seguimento de 7 anos. A colecistectomia deve ser considerada em pacientes sintomáticos. Em assintomáticos, o manejo conservador parece ser a melhor escolha.

  7. Total parenteral nutrition

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) will help you or your child get ...

  8. Total Knee Replacement

    Science.gov (United States)

    ... following total knee replacement include unlimited walking, swimming, golf, driving, light hiking, biking, ballroom dancing, and other ... to the final success of your surgery. To learn more about the full value of total knee ...

  9. Total iron binding capacity

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003489.htm Total iron binding capacity To use the sharing features on this page, please enable JavaScript. Total iron binding capacity (TIBC) is a blood test to ...

  10. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available GLOBAL AP ANATOMIC TOTAL SHOULDER SYSTEM METHODIST HOSPITAL PHILADELPHIA, PA April 17, 2008 00:00:10 ANNOUNCER: ... you'll be able to watch a live global AP anatomic total shoulder surgery from Methodist Hospital ...

  11. Total well dominated trees

    DEFF Research Database (Denmark)

    Finbow, Arthur; Frendrup, Allan; Vestergaard, Preben D.

    cardinality then G is a total well dominated graph. In this paper we study composition and decomposition of total well dominated trees. By a reversible process we prove that any total well dominated tree can both be reduced to and constructed from a family of three small trees....

  12. Relação lipase/amilase nas pancreatites agudas de causa biliar e nas pancreatites agudas/crônicas agudizadas de causa alcoólica Lipase/amylase ratio in biliary acute pancreatitis and alcoholic acute/acutized chronic pancreatitis

    Directory of Open Access Journals (Sweden)

    Ricardo Custódio Pacheco

    2007-03-01

    Full Text Available RACIONAL: Pancreatites agudas de causas alcoólica ou biliar podem necessitar de abordagens terapêuticas diferentes. OBJETIVO: Verificar a validade da relação lipase/amilase em diferenciar as causas alcoólica ou biliar na pancreatite aguda/pancreatite crônica agudizada. MÉTODOS: Foram avaliados nove pacientes com pancreatite aguda/pancreatite crônica agudizada alcoólica, todos homens, com idade média (desvio padrão de 39,8 ± 7,0 anos (grupo I e 29 com pancreatite aguda biliar, sendo 8 homens e 21 mulheres, com idade média de 43,6 ± 19,9 anos (grupo II. As amilasemias e lipasemias foram determinadas em pacientes com sintomatologia há, no máximo, 48 horas. A relação lipase/amilase foi calculada utilizando-se valores de amilasemia e lipasemia expressas como múltiplos de seus respectivos valores superiores de referência. RESULTADOS: As médias das lipasemias (4.814 ± 3.670 U/L e amilasemias (1.282 ± 777 U/L no grupo I foram semelhantes às do grupo II (2.697 ± 2.391 e 1.878 ± 1.319 U/L, respectivamente, mas a média das relações lipase/amilase foi significantemente maior no grupo I (4,4 ± 3,6 do que no grupo II (2,2 ± 2,2. Relação lipase/amilase >3 foi significantemente mais freqüente no grupo I (66,7% do que no grupo II (24,1% e diferenciou os dois grupos com sensibilidade de 67% e especificidade de 76%. CONCLUSÕES: 1 as amilasemias e lipasemias não diferenciaram os dois grupos avaliados; 2 relação lipase/amilase >3 é mais freqüente na pancreatite aguda/pancreatite crônica agudizada alcoólica do que na pancreatite aguda biliar, e pode ser útil na diferenciação destas duas causas de pancreatite.BACKGROUND: Alcoholic or biliary acute pancreatitis may need different therapeutic approaches. AIM: Assessing the validity of lipase/amylase ratio in differentiating biliary from alcoholic acute pancreatitis/acutized chronic pancreatitis. METHODS: Nine male patients (mean age and standard deviation: 39.8 ± 7.0 years

  13. Controversy Total War

    OpenAIRE

    Segesser, Daniel Marc

    2014-01-01

    Total war is a controversial term used in the past by politicians, publicists and military officers as well as by computer specialists and academics in the present. Since its conception by French politicians during the First World War in a time of severe crisis (1916/17), it has become a term used by historians and other academics to cover a wide array of elements when looking at wars of the past. A real total war was and is impossible. Elements of total war – total war aims, total methods of...

  14. Colesterol total e fatores associados: estudo de base escolar no sul do Brasil

    Directory of Open Access Journals (Sweden)

    Mauren Lúcia de Araújo Bergmann

    2011-07-01

    Full Text Available FUNDAMENTO: Evidências têm sugerido que uma parcela importante de crianças e adolescentes apresenta níveis elevados de colesterol total. OBJETIVO: Estimar a prevalência de hipercolesterolemia e fatores associados em escolares de 7 a 12 anos de idade. MÉTODOS: Estudo transversal de base escolar de uma amostra aleatória composta por 1.294 escolares de 7 a 12 anos, de Caxias do Sul (RS. Os escolares responderam a uma entrevista com informações sobre nível socioeconômico, hábitos alimentares e hábitos de atividade física e de lazer. Foram realizadas medidas de colesterol total, de aptidão cardiorrespiratória, de massa corporal, estatura para o cálculo do índice de massa corporal. Para o tratamento dos dados foram utilizadas as análises univariada, bivariada e multivariada. RESULTADOS: A análise multivariada identificou que indivíduos com o nível socioeconômico alto (OR: 1,70; IC: 1,05-2,75, do sexo feminino (OR: 1,32; IC: 1,03-1,67, e com excesso de peso (OR: 1,40; IC: 1,10-1,77 apresentam chances aumentadas de terem colesterol total aumentado (> 3º tercil. CONCLUSÃO: Elevados níveis de colesterol total em escolares de 7 a 12 anos estão associados ao nível socioeconômico alto, ao sexo feminino e ao excesso de peso. O incentivo a um estilo de vida ativo e a hábitos alimentares adequados pode auxiliar no controle dos níveis de colesterol e diminuir os fatores de risco.

  15. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...

  16. Totalization Data Exchange (TDEX)

    Data.gov (United States)

    Social Security Administration — The Totalization Data Exchange (TDEX) process is an exchange between SSA and its foreign country partners to identify deaths of beneficiaries residing abroad. The...

  17. Fórmulas infantiles hipoalergénicas con alto grado de hidrólisis proteica y elevado contenido de ácidos grasos poliinsaturados de cadena larga para la prevención terciaria en lactantes con alergia a las proteínas de la leche de vaca.

    OpenAIRE

    Matencio Hilla, Esther

    2013-01-01

    OBJETIVOS: Validación e investigación aplicada de una fórmula terapéutica que, cumpliendo las exigencias de la ESPGHAN, tenga como ingredientes claves de acción funcional un elevado contenido en AGPI-CL, DHA y AA, así como una elevada hidrolización de la proteína de la leche de vaca, en la prevención terciaria de la enfermedad. METODOS: La hipoalergenicidad se determinó a partir del análisis de proteína inmunoreactiva (ELISA Test); la distribución de pesos moleculares por cromatografía líq...

  18. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... with regard to longevity of total shoulders versus hips and knees. 00:46:20 GERALD WILLIAMS, MD: ... is almost ten years younger than the average hip or knee replacement patient. But if you look ...

  19. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available GLOBAL AP ANATOMIC TOTAL SHOULDER SYSTEM METHODIST HOSPITAL PHILADELPHIA, PA April 17, 2008 00:00:10 ANNOUNCER: DePuy Orthopedics is continually advancing the standard of orthopedic patient care. In a few ...

  20. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... MD: This is Doug Boardman from Richmond, Virginia. We're here at Methodist Hospital in Philadelphia, where ... will be performing a total shoulder arthroplasty. Before we go to Dr. Williams, I'd like to ...

  1. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... you look anyplace, there's probably six or eight articles in the literature right now that have compared ... Dr. Rockwood, my friend and mentor, published an article that showed pain relief was better in totals. ...

  2. Total parenteral nutrition - infants

    Science.gov (United States)

    Total parenteral nutrition (TPN) is a method of feeding that bypasses the gastrointestinal tract. Fluids are given into a vein to ... babies. It can provide a better level of nutrition than regular intravenous (IV) feedings, which provide only ...

  3. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... We had a question with regard to physical therapy after total shoulder arthroplasty: expectations and limitations. 00: ... opposite. We don't -- we do hardly any therapy at all to reverse. With reverse patients, they ...

  4. Total 2004 results

    International Nuclear Information System (INIS)

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  5. Total Ecosystem Carbon Stock

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — Total ecosystem carbon includes above- and below-ground live plant components (such as leaf, branch, stem and root), dead biomass (such as standing dead wood, down...

  6. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... And we have Dr. Song visiting us from South Korea. This patient is a 78-year-old male ... there's probably six or eight articles in the literature right now that have compared hemis to totals. ...

  7. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... be performing a total shoulder arthroplasty. Before we go to Dr. Williams, I'd like to encourage ... It's always a question about how deep we go with this osteotomy. I tend to go almost ...

  8. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available GLOBAL AP ANATOMIC TOTAL SHOULDER SYSTEM METHODIST HOSPITAL PHILADELPHIA, PA April 17, 2008 00:00:10 ANNOUNCER: DePuy Orthopedics is continually advancing the standard of orthopedic patient ...

  9. Total 2004 results

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  10. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... WILLIAMS, MD: The patients that have a total shoulder replacement will come in on their first postoperative visit and tell you their pain's gone. The hemi arthroplasty without interposition will come ...

  11. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... compared hemis to totals. Even Dr. Rockwood, my friend and mentor, published an article that showed pain ... reasonably good cortices, I get a little more aggressive, but not a lot. This is not a ...

  12. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... to longevity of total shoulders versus hips and knees. 00:46:20 GERALD WILLIAMS, MD: Well, obviously, ... ten years younger than the average hip or knee replacement patient. But if you look at the ...

  13. Total parenteral nutrition

    Science.gov (United States)

    Total parenteral nutrition (TPN) will help you or your child get nutrition from a special formula through a vein in the ... you can also eat and drink while getting nutrition from TPN. Your nurse will teach you how ...

  14. Total Grid Estimation

    OpenAIRE

    R. Kelley Pace

    1998-01-01

    This article provides a matrix representation of the adjustment grid estimator. From this representation, one can invoke the Gauss-Mrkov theorem to examine the efficiency of ordinary least squares (OLS) and the grid estimator that uses OLS estimates of the adjustments (the "plug-in" grid method). In addition, this matrix representation suggests a generalized least squares version of the grid method, labeled herin as the total grid estimator. Based on the empirical experiments, the total grid ...

  15. Evaluation of the mitochondrial respiration of cardiac myocytes in rats submitted to mechanical bile duct obstruction Avaliação da respiração mitocondrial de miócitos cardíacos em ratos ictéricos sumetidos à obstrução do ducto biliar

    Directory of Open Access Journals (Sweden)

    Rafael Kemp

    2008-01-01

    Full Text Available PURPOSE: The objective of the present study was to evaluate the capacity of the myocardium for energy production by the analysis of mitochondrial respiration in rats with jaundice submitted to bile duct ligature. METHODS: Sixteen male Wistar rats were divided into 2 Groups: Group SO submitted to nontherapeutic laparotomy (sham operation and Group IC (icteric group submitted to bile duct ligature. After 7 days, laparotomy was again performed in all animals for cardiac muscle extraction and analysis. Mitochondrial oxygen consumption was determined by stage 3 velocity and stage 4 velocity. The respiratory control ratio (RCR was obtained by the ratio of stage 3 to stage 4 velocity. Statistical analysis was performed by the Mann-Whitney test, with the level of significance set at 5% (pOBJETIVO: A proposta deste trabalho é avaliar a capacidade de produção energética do miocárdio mediante análise da respiração mitocondrial em ratos ictéricos submetidos à ligadura do ducto biliar. MÉTODOS: Foram utilizados 16 ratos Wistar machos divididos em 2 Grupos: Grupo SO , os quais foram submetidos à Laparotomia branca e Grupo IC, os quais sofreram ligadura do ducto biliar para o desenvolvimento de icterícia obstrutiva. Todos os animais após 7 dias de cirurgia foram submetidos à nova laparotomia para extração e análise do músculo cardíaco. O consumo de oxigênio pelas mitocôndrias foi determinado pela velocidade do estado 3 e velocidade do estado 4. A razão do controle respiratório (RCR foi obtida pela relação entre as velocidades dos estados 3 e 4. A análise estatística foi feita pelo teste de Mann-Whitney com nível de significância de 5 % (p<0.05. RESULTADOS: Observou-se queda estatisticamente significante nos valores do consumo de oxigênio do estado 3 da respiração mitocondrial no grupo IC em relação ao SO, no entanto os valores para estado 4 permaneceram basicamente inalterados entre os grupos. Os valores de RCR entre os

  16. Aspectos ultra-sonográficos dos hamartomas dos ductos biliares (complexo de von Meyenburg: resultado de uma busca ativa de oito anos Ultrasonography findings in patients with bile duct hamartomas (von Meyenburg complex: result of an active search of eight years

    Directory of Open Access Journals (Sweden)

    Márcio Martins Machado

    2003-06-01

    Full Text Available A correta identificação de tumores hepáticos benignos é importante, pois a maioria não necessita de conduta intervencionista. Os autores relatam os aspectos ultra-sonográficos dos hamartomas de ductos biliares (complexo de von Meyenburg em 16 pacientes estudados prospectivamente, resultados de uma busca ativa de oito anos. Em 14 pacientes foram identificadas múltiplas lesões menores ou iguais a 0,8 cm, e em dois, apenas duas lesões em cada (medindo de 0,4 cm a 1,3 cm. O aspecto ultra-sonográfico que predominou foi o de múltiplas pequenas imagens hiperecogênicas com ou sem reverberação sonora posterior e margens irregulares (14 pacientes. Menos comumente, foi encontrado o aspecto "em alvo", com centro com maior ecogenicidade que a periferia (dois pacientes com duas lesões cada e margens bem definidas.The recognition and identification of benign liver tumors is important since most of these tumors do not require any intervention. The authors report the ultrasonography findings in 16 patients with bile duct hamartomas (von Meyenburg complex that were evaluated prospectively by an active search of eight years. Multiple lesions with size equal or less than 0.8 cm were identified in 14 patients. Two other patients had only two lesions measuring 0.4 cm to 1.3 cm. The most common ultrasonographic pattern was that of multiple small hyperechogenic lesions (with or without posterior acoustic reverberation with irregular margins (14 patients. A less common finding (two patients with two lesions each was the "target" pattern with echogenic center and well defined limits.

  17. Total Energy Monitor

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, S

    2008-08-11

    The total energy monitor (TE) is a thermal sensor that determines the total energy of each FEL pulse based on the temperature rise induced in a silicon wafer upon absorption of the FEL. The TE provides a destructive measurement of the FEL pulse energy in real-time on a pulse-by-pulse basis. As a thermal detector, the TE is expected to suffer least from ultra-fast non-linear effects and to be easy to calibrate. It will therefore primarily be used to cross-calibrate other detectors such as the Gas Detector or the Direct Imager during LCLS commissioning. This document describes the design of the TE and summarizes the considerations and calculations that have led to it. This document summarizes the physics behind the operation of the Total Energy Monitor at LCLS and derives associated engineering specifications.

  18. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... AP ANATOMIC TOTAL SHOULDER SYSTEM METHODIST HOSPITAL PHILADELPHIA, PA April 17, 2008 00:00:10 ANNOUNCER: DePuy ... you don't make a bunch of small passes at the lesser tuberosity and make it a ...

  19. Total Synthesis of (-)-Cardiopetaline.

    Science.gov (United States)

    Nishiyama, Yoshitake; Yokoshima, Satoshi; Fukuyama, Tohru

    2016-05-20

    The total synthesis of (-)-cardiopetaline, an aconitine-type natural product, has been accomplished. Our synthesis involved a Wagner-Meerwein rearrangement of a sulfonyloxirane that enabled, in a single step, the construction of the bicyclo[3.2.1] system in the aconitine skeleton and effective introduction of oxygen functional groups at the appropriate positions. PMID:27166640

  20. Supravaginal eller total hysterektomi?

    DEFF Research Database (Denmark)

    Edvardsen, L; Madsen, E M

    1994-01-01

    There has been a decline in the rate of hysterectomies in Denmark in general over the last thirteen years, together with a rise in the number of supravaginal operations over the last two years. The literature concerning the relative merits of the supravaginal and the total abdominal operation is ...... indicate a reduced frequency of orgasm after the total hysterectomy compared with the supravaginal operation. When there are technical problems peroperatively with an increased urologic risk the supravaginal operation is recommended....... examined. It is concluded that the risk of developing carcinoma of the cervical stump is low, and no longer a weighty indication for the total in preference to the supravaginal hysterectomy as long as subsequent screening of the cervix is performed. At the same time it is important to inform the women......There has been a decline in the rate of hysterectomies in Denmark in general over the last thirteen years, together with a rise in the number of supravaginal operations over the last two years. The literature concerning the relative merits of the supravaginal and the total abdominal operation is...

  1. Total Cost of Ownership

    DEFF Research Database (Denmark)

    Zachariassen, Frederik

    2007-01-01

    Total Cost of Ownership (TCO), som giver et bud på, hvordan virksomheder kan opnå en bedre indsigt i, hvilke leverandører der forårsager hvilke omkostninger og dermed danne et forbedret beslutningsgrundlag for besparelser i leverandørleddet. I artiklen argumenteres først og fremmest for, hvorfor TCO er...

  2. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... to longevity of total shoulders versus hips and knees. 00:46:20 GERALD WILLIAMS, MD: Well, obviously, if you look at -- it depends upon who you put them in. First of all, the young-- the youngest patient population for joint replacement in the United States by far, by ...

  3. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... Anatomic Total Shoulder surgery, which featured the latest innovation in shoulder surgery from DePuy Orthopedics. OR-Live makes it easy for you to learn more. Just click on the "Request Information" button on your webcast screen and open the door to informed medical care. 01:21: ...

  4. "Total Deposition (TDEP) Maps"

    Science.gov (United States)

    The presentation provides an update on the use of a hybrid methodology that relies on measured values from national monitoring networks and modeled values from CMAQ to produce of maps of total deposition for use in critical loads and other ecological assessments. Additionally, c...

  5. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... put totals in unless they're under the age of 50. But as the patient gets older, ... I'll give you an example: 26-year-old juvenile rheumatoid arthritic. You can pulse-irrigate that, ...

  6. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... advancing the standard of orthopedic patient care. In a few moments, you'll be able to watch a live global AP anatomic total shoulder surgery from Methodist Hospital in Philadelphia. A revolution in shoulder orthopedics, the Global AP gives ...

  7. Total versus subtotal hysterectomy

    DEFF Research Database (Denmark)

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

    2005-01-01

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

  8. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... by almost ten years, is shoulders. So by definition, the average shoulder-replacement patient is almost ten ... Anatomic Total Shoulder surgery, which featured the latest innovation in shoulder surgery from DePuy Orthopedics. OR-Live ...

  9. Total Cross Sections

    OpenAIRE

    G. GiacomelliBologna University and INFN

    2014-01-01

    The measurements of the hadron-hadron total cross sections are the first measurements performed when a new hadron accelerator opens up a new energy region; the measurements were made as function of the incoming beam momentum or c.m. energy and have often been repeated with improved accuracy and finer energy spacing.

  10. CSF total protein

    Science.gov (United States)

    CSF total protein is a test to determine the amount of protein in your spinal fluid, also called cerebrospinal fluid (CSF). ... The normal protein range varies from lab to lab, but is typically about 15 to 60 mg/dL. Note: mg/dL = ...

  11. Total 2004 annual report

    International Nuclear Information System (INIS)

    This annual report of the Group Total brings information and economic data on the following topics, for the year 2004: the corporate governance, the corporate social responsibility, the shareholder notebook, the management report, the activities, the upstream (exploration and production) and downstream (refining and marketing) operating, chemicals and other matters. (A.L.B.)

  12. Total Quality Management Seminar.

    Science.gov (United States)

    Massachusetts Career Development Inst., Springfield.

    This booklet is one of six texts from a workplace literacy curriculum designed to assist learners in facing the increased demands of the workplace. The booklet contains seven sections that cover the following topics: (1) meaning of total quality management (TQM); (2) the customer; (3) the organization's culture; (4) comparison of management…

  13. Total Quality Management Simplified.

    Science.gov (United States)

    Arias, Pam

    1995-01-01

    Maintains that Total Quality Management (TQM) is one method that helps to monitor and improve the quality of child care. Lists four steps for a child-care center to design and implement its own TQM program. Suggests that quality assurance in child-care settings is an ongoing process, and that TQM programs help in providing consistent, high-quality…

  14. Total 2003 Results

    International Nuclear Information System (INIS)

    This document presents the 2003 results of Total Group: consolidated account, special items, number of shares, market environment, 4. quarter 2003 results, full year 2003 results, upstream (key figures, proved reserves), downstream key figures, chemicals key figures, parent company accounts and proposed dividends, 2004 sensitivities, summary and outlook, operating information by segment for the 4. quarter and full year 2003: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refinery throughput by region, refined product sales by region, chemicals), impact of allocating contribution of Cepsa to net operating income by business segment: equity in income (loss) and affiliates and other items, Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  15. Total - annual report 2005

    International Nuclear Information System (INIS)

    This annual report presents the activities and results of TOTAL S.A., french society on oil and gas. It deals with statistics, the managers, key information on financial data and risk factors, information on the Company, unresolved Staff Comments, employees, major Shareholders, consolidated statements, markets, security, financial risks, defaults dividend arrearages and delinquencies, controls and procedures, code of ethics and financial statements. (A.L.B.)

  16. Total Synthesis of Millingtonine.

    Science.gov (United States)

    Brown, Patrick D; Lawrence, Andrew L

    2016-07-11

    Millingtonine is a glycosidic alkaloid that exists as a pair of pseudo-enantiomeric diastereomers. Consideration of the likely biosynthetic origins of this unusual natural product has resulted in the development of a seven-step total synthesis. Results from this synthetic work provide evidence in support of a proposed network of biosynthetic pathways that can account for the formation of several phenylethanoid natural products. PMID:27249628

  17. Total synthesis of teixobactin.

    Science.gov (United States)

    Jin, Kang; Sam, Iek Hou; Po, Kathy Hiu Laam; Lin, Du'an; Ghazvini Zadeh, Ebrahim H; Chen, Sheng; Yuan, Yu; Li, Xuechen

    2016-01-01

    To cope with the global bacterial multidrug resistance, scientific communities have devoted significant efforts to develop novel antibiotics, particularly those with new modes of actions. Teixobactin, recently isolated from uncultured bacteria, is considered as a promising first-in-class drug candidate for clinical development. Herein, we report its total synthesis by a highly convergent Ser ligation approach and this strategy allows us to prepare several analogues of the natural product. PMID:27484680

  18. Total synthesis of ochnaflavone

    OpenAIRE

    Monica M. Ndoile; van Heerden, Fanie R

    2013-01-01

    The first total syntheses of ochnaflavone, an asymmetric biflavone consisting of apigenin and luteolin moieties, and the permethyl ether of 2,3,2'',3''-tetrahydroochnaflavone have been achieved. The key steps in the synthesis of ochnaflavone were the formation of a diaryl ether and ring cyclization of an ether-linked dimeric chalcone to assemble the two flavone nuclei. Optimal experimental conditions for the oxidative cyclization to form ochnaflavone were established.

  19. Total synthesis of ochnaflavone

    Directory of Open Access Journals (Sweden)

    Monica M. Ndoile

    2013-07-01

    Full Text Available The first total syntheses of ochnaflavone, an asymmetric biflavone consisting of apigenin and luteolin moieties, and the permethyl ether of 2,3,2'',3''-tetrahydroochnaflavone have been achieved. The key steps in the synthesis of ochnaflavone were the formation of a diaryl ether and ring cyclization of an ether-linked dimeric chalcone to assemble the two flavone nuclei. Optimal experimental conditions for the oxidative cyclization to form ochnaflavone were established.

  20. Boosting Total Relationship Marketing

    OpenAIRE

    Aykut, Arslan

    2008-01-01

    This paper explores the track of marketing, by referring to the literature, through the advancements in digitalized technological systems particularly Information Technologies (IT), the emergence of a more broadly educated and more discerning consumer with increasing discretionary spending and purchasing power, the adoption of Total Quality Management (TQM) as the biggest competitive issue of 1990s, the growth of the service economy, the increase of competitive intensity and its impact on cus...

  1. Colesterol total e fatores associados: estudo de base escolar no sul do Brasil Colesterol total y factores asociados: estudio de base escolar en el sur del Brasil Associated factors to total cholesterol: school based study in southern Brazil

    Directory of Open Access Journals (Sweden)

    Mauren Lúcia de Araújo Bergmann

    2011-07-01

    Full Text Available FUNDAMENTO: Evidências têm sugerido que uma parcela importante de crianças e adolescentes apresenta níveis elevados de colesterol total. OBJETIVO: Estimar a prevalência de hipercolesterolemia e fatores associados em escolares de 7 a 12 anos de idade. MÉTODOS: Estudo transversal de base escolar de uma amostra aleatória composta por 1.294 escolares de 7 a 12 anos, de Caxias do Sul (RS. Os escolares responderam a uma entrevista com informações sobre nível socioeconômico, hábitos alimentares e hábitos de atividade física e de lazer. Foram realizadas medidas de colesterol total, de aptidão cardiorrespiratória, de massa corporal, estatura para o cálculo do índice de massa corporal. Para o tratamento dos dados foram utilizadas as análises univariada, bivariada e multivariada. RESULTADOS: A análise multivariada identificou que indivíduos com o nível socioeconômico alto (OR: 1,70; IC: 1,05-2,75, do sexo feminino (OR: 1,32; IC: 1,03-1,67, e com excesso de peso (OR: 1,40; IC: 1,10-1,77 apresentam chances aumentadas de terem colesterol total aumentado (> 3º tercil. CONCLUSÃO: Elevados níveis de colesterol total em escolares de 7 a 12 anos estão associados ao nível socioeconômico alto, ao sexo feminino e ao excesso de peso. O incentivo a um estilo de vida ativo e a hábitos alimentares adequados pode auxiliar no controle dos níveis de colesterol e diminuir os fatores de risco.FUNDAMENTO: Evidencias han sugerido que una parte importante de niños y adolescentes presenta niveles elevados de colesterol total. OBJETIVO: Estimar la prevalencia de hipercolesterolemia y factores asociados en escolares de 7 a 12 años de edad. MÉTODOS: Estudio transversal de base escolar de una muestra aleatoria compuesta por 1.294 escolares de 7 a 12 años, de Caxias do Sul (RS. Los escolares respondieron una entrevista con informaciones sobre nivel socioeconómico, hábitos alimenticios y hábitos de actividad física y de ocio. Fueron realizadas

  2. Total Logistic Plant Solutions

    Directory of Open Access Journals (Sweden)

    Dusan Dorcak

    2016-02-01

    Full Text Available The Total Logistics Plant Solutions, plant logistics system - TLPS, based on the philosophy of advanced control processes enables complex coordination of business processes and flows and the management and scheduling of production in the appropriate production plans and planning periods. Main attributes of TLPS is to create a comprehensive, multi-level, enterprise logistics information system, with a certain degree of intelligence, which accepts the latest science and research results in the field of production technology and logistics. Logistic model of company understands as a system of mutually transforming flows of materials, energy, information, finance, which is realized by chain activities and operations

  3. Total Synthesis of Teixobactin.

    Science.gov (United States)

    Giltrap, Andrew M; Dowman, Luke J; Nagalingam, Gayathri; Ochoa, Jessica L; Linington, Roger G; Britton, Warwick J; Payne, Richard J

    2016-06-01

    The first total synthesis of the cyclic depsipeptide natural product teixobactin is described. Synthesis was achieved by solid-phase peptide synthesis, incorporating the unusual l-allo-enduracididine as a suitably protected synthetic cassette and employing a key on-resin esterification and solution-phase macrolactamization. The synthetic natural product was shown to possess potent antibacterial activity against a range of Gram-positive pathogenic bacteria, including a virulent strain of Mycobacterium tuberculosis and methicillin-resistant Staphylococcus aureus (MRSA). PMID:27191730

  4. Total quality accounting

    Directory of Open Access Journals (Sweden)

    Andrijašević Maja

    2008-01-01

    Full Text Available The focus of competitive "battle" shifted from the price towards non-price instruments, above all, towards quality that became the key variable for profitability increase and achievement of better comparative position of a company. Under such conditions, management of a company, which, according to the established and certified system of total quality, strives towards achieving of a better market position, faces the problem of quality cost measurement and determination. Management, above all, cost accounting can help in solving of this problem, but the question is how much of its potential is being used for that purpose.

  5. TOTAL annual report 2003

    International Nuclear Information System (INIS)

    This 2003 annual report of the Group Total provides economical results and information of the society on the following topics: keys data, the corporate governance (Directors charter, board of directors, audit committee, nomination and remuneration committee, internal control procedures, compensation of directors and executive officers), the corporate social responsibility (environmental stewardship, the future of energy management, the safety enhancement, the human resources, ethics and local development), the investor relations, the management report, the upstream exploration and production, the downstream refining, marketing, trading and shipping, the chemicals and financial and legal information. (A.L.B.)

  6. Total Factbook 2003

    International Nuclear Information System (INIS)

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2003. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  7. Total 2004 fact book

    International Nuclear Information System (INIS)

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2004. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  8. Total quality is people

    International Nuclear Information System (INIS)

    Confronted by changing market conditions and increased global competition, in 1983 the Commercial Nuclear Fuel Division (CNFD) of Westinghouse Electric embarked on an ambitious plan to make total quality the centerpiece of its long-term business strategy. Five years later, the division's efforts in making continuous quality improvement a way of life among its more than 2,000 employees gained national recognition when it was named a charter recipient of the Malcolm Baldridge National Quality Award. What CNFD achieved during the 1980s was a cultural transformation, characterized by an empowered work force committed to a common vision. The company's quality program development strategy is described

  9. Immediate total tooth replacement.

    Science.gov (United States)

    Garber, D A; Salama, M A; Salama, H

    2001-03-01

    Successful implant placement at the time of extraction has been documented. Implant placement at the time of extraction was initially performed as a two-stage procedure often with barrier membranes and sophisticated second-stage surgical uncoverings. The authors describe the next generation of this technique, including atraumatic tooth removal with simultaneous root form, implant placement, and temporization at one appointment. This technique of "Immediate Total Tooth Replacement" allows for the maintenance of the bony housing and soft-tissue form that existed before extraction, while at the same time establishing a root form anchor in the bone for an esthetic restoration. PMID:11913258

  10. Total Synthesis of (-)-Daphenylline.

    Science.gov (United States)

    Yamada, Ryosuke; Adachi, Yohei; Yokoshima, Satoshi; Fukuyama, Tohru

    2016-05-10

    Total synthesis of (-)-daphenylline, a hexacyclic Daphniphyllum alkaloid, was achieved. Construction of the tricyclic DEF ring system was initiated by asymmetric Negishi coupling followed by an intramolecular Friedel-Crafts reaction. Installation of a side chain onto the tricyclic core was carried out through Sonogashira coupling, stereocontrolled Claisen rearrangement by taking advantage of the characteristic conformation of the tricyclic DEF core, and the stereoselective alkylation of a lactone. After the introduction of a glycine unit, the ABC ring system was stereoselectively constructed through intramolecular cycloaddition of the cyclic azomethine ylide. PMID:27062676

  11. Effect of sirolimus on renal injury induced by bile duct ligation in rats Efeito do sirolimo na lesão renal induzida pela ligadura do ducto biliar em ratos

    OpenAIRE

    Hulya Ozturk; Akan Terzi; Hayrettin Ozturk; Aysel Kukner

    2010-01-01

    PURPOSE: To evaluate the effects of sirolimus (SRL) on renal injury in rats with bile duct ligation. METHODS: A total of 21 male Sprague-Dawley rats weighing 220-260g were used. Group 1 (Sham-control, n=7) rats were undergone laparotomy alone and bile duct was just dissected from the surrounding tissue. Group 2 rats (BDL/Untreated, n=7) were subjected to bile duct ligation and no drug was applied. Group 3 rats (BDL/SRL, n =7) received a daily dose of sirolimus (0.5 mg·day-1xkg-1 dissolved 1 m...

  12. Total synthesis of atropurpuran.

    Science.gov (United States)

    Gong, Jing; Chen, Huan; Liu, Xiao-Yu; Wang, Zhi-Xiu; Nie, Wei; Qin, Yong

    2016-01-01

    Due to their architectural intricacy and biological significance, the synthesis of polycyclic diterpenes and their biogenetically related alkaloids have been the subject of considerable interest over the last few decades, with progress including the impressive synthesis of several elusive targets. Despite tremendous efforts, conquering the unique structural types of this large natural product family remains a long-term challenge. The arcutane diterpenes and related alkaloids, bearing a congested tetracyclo[5.3.3.0(4,9).0(4,12)]tridecane unit, are included in these unsolved enigmas. Here we report a concise approach to the construction of the core structure of these molecules and the first total synthesis of (±)-atropurpuran. Pivotal features of the synthesis include an oxidative dearomatization/intramolecular Diels-Alder cycloaddition cascade, sequential aldol and ketyl-olefin cyclizations to assemble the highly caged framework, and a chemoselective and stereoselective reduction to install the requisite allylic hydroxyl group in the target molecule. PMID:27387707

  13. Total organic carbon analyzer

    Science.gov (United States)

    Godec, Richard G.; Kosenka, Paul P.; Smith, Brian D.; Hutte, Richard S.; Webb, Johanna V.; Sauer, Richard L.

    1991-01-01

    The development and testing of a breadboard version of a highly sensitive total-organic-carbon (TOC) analyzer are reported. Attention is given to the system components including the CO2 sensor, oxidation reactor, acidification module, and the sample-inlet system. Research is reported for an experimental reagentless oxidation reactor, and good results are reported for linearity, sensitivity, and selectivity in the CO2 sensor. The TOC analyzer is developed with gravity-independent components and is designed for minimal additions of chemical reagents. The reagentless oxidation reactor is based on electrolysis and UV photolysis and is shown to be potentially useful. The stability of the breadboard instrument is shown to be good on a day-to-day basis, and the analyzer is capable of 5 sample analyses per day for a period of about 80 days. The instrument can provide accurate TOC and TIC measurements over a concentration range of 20 ppb to 50 ppm C.

  14. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications. PMID:26868932

  15. Total quality at source

    International Nuclear Information System (INIS)

    The Total Quality at Source philosophy is based on optimizing the effectiveness of people in achieving ZERO-DEFECT results. In this paper a philosophy of what, I have come to perceive, it takes to get people to perform to the very best of their abilities and thereby achieve the best results they can, is presented. In the examples I shall describe I have played an instrumental role since it has become my belief that any job can always be done better provided that the people doing it can themselves become convinced that they can do better. Clearly there are many ideas on how to do this. The philosophy that I am presenting in this paper is based on my own experience, where I have both participated and observed it being applied; its effectiveness may be judged by the results. (author)

  16. Total Integrative Evolutionary Communication

    DEFF Research Database (Denmark)

    Nedergaard Thomsen, Ole; Brier, Søren

    2014-01-01

    and, on the other, Peircean biosemiotics. According to Cybersemiotics, language is primarily a creative process of total integrative evolutionary communication. It comprises three evolutionary stages: (1) biological reflexive languaging (the reflexive foundation of social coordination), (2......). In this inclusive hierarchy language games subsume the other stages, and thus human evolutionary communication is primarily a symbolic-conventional practice. It is intertwined with the practice of living, that is, with different life forms, including other forms of semiotic behavior. Together they form a coherent...... biological and socio-cultural practice. The basic “molecule” of the cybersemiotic model of human communication is a dyad between two linguistic cyborgs, alias natural language users. Single human communicators are thus “atoms”. They are hybrids between nature and nurture, manipulating all sorts...

  17. Total disc replacement.

    Science.gov (United States)

    Vital, J-M; Boissière, L

    2014-02-01

    Total disc replacement (TDR) (partial disc replacement will not be described) has been used in the lumbar spine since the 1980s, and more recently in the cervical spine. Although the biomechanical concepts are the same and both are inserted through an anterior approach, lumbar TDR is conventionally indicated for chronic low back pain, whereas cervical TDR is used for soft discal hernia resulting in cervicobrachial neuralgia. The insertion technique must be rigorous, with precise centering in the disc space, taking account of vascular anatomy, which is more complex in the lumbar region, particularly proximally to L5-S1. All of the numerous studies, including prospective randomized comparative trials, have demonstrated non-inferiority to fusion, or even short-term superiority regarding speed of improvement. The main implant-related complication is bridging heterotopic ossification with resulting loss of range of motion and increased rates of adjacent segment degeneration, although with an incidence lower than after arthrodesis. A sufficiently long follow-up, which has not yet been reached, will be necessary to establish definitively an advantage for TDR, particularly in the cervical spine. PMID:24412045

  18. Total process surveillance (TOPS)

    International Nuclear Information System (INIS)

    Understanding the current operating behaviour of a process or power plant is the key to maximizing the efficiency and safety of operation and the quality of the product. Early detection of plant component or sensor degradation and failure improves operating safety, product quality and plant availability. This paper describes the design and development of a Total Process Surveillance system which assimilates all the sensor information available on a plant to provide the operators with a succinct report on the status of the plant behaviour. The heart of the system is a robust model-based observer which can estimate internal plant states, and provides a residual signal with powerful fault detection and isolation features. Several results are presented which illustrate the performance of the system in detecting and isolating multiple fault scenarios in a fast reactor plant. A structure for the practical implementation of the system is described, and comments are given on its contribution to the final experimental work planned for AEA Technology's Prototype Fast Reactor (PFR). (Author)

  19. Total quality management

    OpenAIRE

    Цветкова, Наталья

    1993-01-01

    В статье рассматриваются пути улучшения качества образования вообще и лингвистического образования в частности посредством использования системы качества Total Quality Management. Охарактеризованы ее четыре этапа - планирование, управление, обеспечение и улучшение. Анализируются основные направления использования системы качества в обучении иностранному языку....

  20. Organic carbon determination in histosols and soil horizons with high organic matter content from Brazil Determinação do carbono orgânico em organossolos e solos com horizontes com elevado conteúdo de matéria orgânica

    Directory of Open Access Journals (Sweden)

    Marcos Gervasio Pereira

    2006-04-01

    Full Text Available Soil taxonomy systems distinguish mineral soils from organic soils based on the amount of soil organic carbon. Procedures adopted in soil surveys for organic carbon measurement are therefore of major importance to classify the soils, and to correlate their properties with data from other studies. To evaluate different methods for measuring organic carbon and organic matter content in Histosols and soils with histic horizons, from different regions of Brazil, 53 soil samples were comparatively analyzed by the methods of Walkley & Black (modified, Embrapa, Yeomans & Bremner, modified Yeomans & Bremner, muffle furnace, and CHN. The modified Walkley & Black (C-W & B md and the combustion of organic matter in the muffle furnace (OM-Muffle were the most suitable for the samples with high organic carbon content. Based on regression analysis data, the OM-muffle may be estimated from C-W & B md by applying a factor that ranges from 2.00 to 2.19 with 95% of probability. The factor 2.10, the average value, is suggested to convert results obtained by these methods.Sistemas taxonômicos distinguem horizontes e/ou camadas minerais das orgânicas baseando-se na quantidade de carbono orgânico. Assim, o procedimento adotado em pesquisas para a quantificação do conteúdo de carbono orgânico é de grande importância para a classificação das terras e correlacionar as suas propriedades com dados de outros estudos. Com o objetivo de avaliar os diferentes métodos para medir o conteúdo de carbono orgânico e de matéria orgânica em Organossolo e solos com elevados teores de matéria orgânica, de diferentes regiões do Brasil, cinqüenta e três amostras de terra foram comparativamente analisadas pelos métodos de Walkley & Black (modificado, Embrapa, Yeomans & Bremner, Yeomans & Bremner modificado, forno mufla, e CHN. O método Walkley & Black modificado (C-W & B md e a combustão de matéria orgânica no forno mufla (MO-Mufla revelaram-se mais satisfat

  1. Níveis séricos elevados de homocisteína em pacientes pediátricos com fenômeno de Raynaud primário Elevated serum homocysteine levels in paediatric patients with primary Raynaud's phenomenon

    Directory of Open Access Journals (Sweden)

    Stepan Kutilek

    2012-02-01

    Full Text Available INTRODUÇÃO: O fenômeno de Raynaud (FR é uma isquemia acral recorrente resultante de resposta vasoespástica arterial anormal ao frio ou ao estresse emocional. A homocisteína, um aminoácido sulfurado, foi relacionada a doenças cardiovasculares e neurodegenerativas, diabetes mellitus, trombose e fragilidade óssea. Também foi relacionada à patogênese do FR, por terem sido observadas elevações nos níveis séricos de homocisteína (S-homocisteína em pacientes com FR. OBJETIVO: Considerando que todas as publicações concernentes à S-homocisteína em casos de FR envolviam apenas pacientes adultos, o objetivo deste estudo foi avaliar a S-homocisteína em crianças e adolescentes com FR. MÉTODOS: Foram recrutados 19 pacientes (dois meninos e 17 meninas; idade média 16,1 ± 2,2 DP com FR primário. Como controles, foram recrutados 51 crianças e adolescentes (21 meninos e 30 meninas; idade média 15,1 ± 1,8 DP. RESULTADOS: O nível de S-homocisteína estava significativamente mais elevado no grupo FR, em comparação com os controles (11,2 ± 2,4 vs. 8,0 ± 2,0 µmol/L; P = 0,00001. Os níveis de S-homocisteína nos participantes com FR não dependeram da idade. CONCLUSÃO: Pacientes pediátricos com FR apresentam níveis elevados de S-homocisteína, sugerindo que a homocisteína desempenha papel importante no desenvolvimento da disfunção vascular, mesmo em pacientes muito jovensINTRODUCTION: Raynaud's phenomenon (RP is a paroxysmal and recurrent acral ischemia resulting from an abnormal arterial vasospastic response to cold or emotional stress. Homocysteine, a sulphured amino acid, has been linked to cardiovascular and neurodegenerative diseases, diabetes, thrombosis, and bone fragility. Homocysteine has been also linked to the pathogenesis of RP, as increased serum homocysteine (S-homocysteine levels were observed in patients with RP. OBJECTIVE: As all publications concerning S-homocysteine in RP involved only adult patients, our

  2. Resolução de equações diferenciais por redes neurais artificiais: problemas com gradientes elevados e domínios arbitrários = Resolution of differential equations with artificial neural networks: high gradients and arbitrary domains problems

    Directory of Open Access Journals (Sweden)

    Luiz Henry Monken e Silva

    2005-01-01

    Full Text Available Neste artigo a habilidade das redes neurais perceptron multicamada eminterpolar foi utilizada para analisar duas classes de problemas de contorno. A primeira classe é formada por equações diferenciais em que a solução pode apresentar gradientes elevados e a segunda classe é formada de equações diferenciais definidas em domínios arbitrários. As metodologias propostas por Lagaris et al. (1998 foram estendidas para casos de equações diferenciais sujeitas às condições de Cauchy e condições de contorno mistas. Os resultados fornecidos pelo método da rede neural se apresentam precisos quando comparados com os resultados analíticos ou por métodos numéricos de resolução deequações diferenciais. A precisão alcançada nos resultados e a facilidade no manuseio do método para resolver estes problemas de contorno encorajaram a continuidade da pesquisa, particularmente no tocante à convergência e estabilidade numérica.In this paper, the ability of the multilayer perceptron neural network (MLP in interpolation was used to analyze two classes of boundary value problems. The first class is formed by differential equations, with solutions which can have high gradients and the second are partial differential equations, defined on arbitrary shaped domain. Also, the methodologies proposed by Lagaris et al. (1998 were enlarged for differential equations subjected to Cauchy and mix boundary conditions type. The results of the artificial neural network method are very precise when comparison to the analytical ones or those of classical numerical methods to solve differential equations. The precision achieved in the results and the ability to handle the method, to solve those boundary value problems, were encouraging to keep the research, particularly on an important direction, concerning convergence and numerical stability.

  3. Anxiolytic-like effect of Rauvolfia ligustrina Willd: ex Roem. & Schult., Apocynaceae, in the elevated plus-maze and hole-board tests Avaliação do efeito ansiolítico de Rauvolfia ligustrina Willd: ex Roem. & Schult., Apocynaceae, nos testes do labirinto em cruz elevado e placa-perfurada

    Directory of Open Access Journals (Sweden)

    Sueli Mendonça Netto

    2009-12-01

    Full Text Available Rauvolfia ligustrina Willd. ex Roem. & Schult. (Apocynaceae, popularly known as "arrebenta-boi" and "paratudo". In behavioral screening ethanol extract of R. ligustrina roots demonstrated depressant effect on the CNS and anticonvulsant properties. The purpose of this study was to characterize the putative anxiolytic-like effects of the ethanol extract of Rauvolfia ligustrina roots (EER using the elevated plus maze (EPM and the hole-board apparatus in rodents. This extract, administered intraperitoneally, in different doses (3.9, 7.8 and 15.6 mg/kg was able to increase significantly the number of entries (p Rauvolfia ligustrina Willd. ex Roem. & Schult. (Apocynaceae é conhecida popularmente como "arrebenta-boi" e "paratudo". Em triagem farmacológica comportamental o extrato etanólico das raízes de R. ligustrina (EER mostrou efeito depressor do SNC e propriedades anticonvulsivantes. O presente estudo buscou avaliar o possível efeito ansiolítico do EER utilizando os testes do labirinto em cruz elevado (LCE e o teste da placa perfurada ("hole-board" em roedores. A administração do EER, por via intraperitoneal (i.p., em diferentes doses (3,9; 7,8 e 15,6 mg/kg foi capaz de aumentar significativamente o número de entradas (p < 0,05, assim como o tempo despendido nos braços abertos do LCE. Além disso, nos animais tratados com o EER (3,9 e 7,8 mg/kg, i.p. ocorreu aumento significativo no número de visitas à borda e mergulho com a cabeça no teste da placa perfurada em comparação com os animais do grupo controle. Estes dados sugerem um possível efeito ansiolítico do EER nos modelos animais testados.

  4. Total Process Surveillance (TOPS)

    International Nuclear Information System (INIS)

    analytical redundancy is of significant importance in order to obtain the maximum amount of information as to the state of the plant. A further logical step in this theory is the accommodation of failed or damaged transducers by deriving their measurement information from the available remaining transducers. A system capable of providing a clear and improved picture of the plant's behaviour under a range of normal and off-normal operating conditions would thus be of significant economical and safety benefit. In summary: A Total Process Surveillance system is under development which can provide, in real-time, additional process information from a limited number of raw measurement signals. This is achieved by using a robust model based observer to generate estimates of the process' internal states. The observer utilises the analytical redundancy among a diverse range of transducers and can thus accommodate off-normal conditions which lead to transducer loss or damage. The modular hierarchical structure of the system enables the maximum amount of information to be assimilated from the available instrument signals no matter how diverse. This structure also constitutes a data reduction path thus reducing operator cognitive overload from a large number of varying, and possibly contradictory, raw plant signals. The TOPS system provides a structured and complete means for plant data management under both normal and off-normal operating conditions and thus will significantly assist the operator during severe accident management

  5. Impacto presupuestario para el Sistema Nacional de Salud de la prevención del tromboembolismo venoso con apixaban en pacientes sometidos a artroplastia total de rodilla o de cadera

    OpenAIRE

    Gómez Arrayas, Inmaculada; Suárez Fernández, Carmen; Gómez Cerezo, Jorge F.; Betegón Nicolás, Lourdes; De Salas-Cansado, Marina; Rubio-Terrés, Carlos

    2012-01-01

    Fundamentos: Debido al elevado coste sanitario del tromboembolismo venoso (TEV) es necesario realizar análisis económicos que determinen la eficiencia de sus diferentes tratamientos farmacológicos. El objetivo del trabajo es estimar el impacto presupuestario para el Sistema Nacional de Salud (SNS) de la prevención del tromboembolismo venoso (TEV) con apixaban en artroplastia total de cadera (ATC) o rodilla (ATR). Métodos: Se consideraron los costes de los diferentes fármacos para la preve...

  6. Total Knee Replacement for Women

    Medline Plus

    Full Text Available ... ll be moderating a Zimmer Gender Solutions total knee, performed by my partner, Dr. Ken Gustke. At ... I’m going to be doing a total knee replacement utilizing the Gender Flex implants on a ...

  7. Prevalence of Helicobacter spp in chronic cholecystitis and correlation with changes on the histological pattern of the gallbladder Prevalência do Helicobacter spp na colecistite crônica calculosa e correlação com as alterações histológicas da vesícula biliar

    Directory of Open Access Journals (Sweden)

    André de Moricz

    2010-06-01

    Full Text Available PURPOSE: Establish the prevalence of Helicobacter spp in chronic cholecystitis and its correlation with the gallbladder's histological findings. METHODS: 100 patients were operated for chronic cholecystitis with cholecystolithiasis. In pathological examination of the gallbladder, were evaluated the presence of metaplasia, dysplasia, lymphoid follicles, anaplasia and tumors that might be related to the presence of Helicobacter plus the presence of the bacilli Giemsa? by optical microscopy. From the DNA extracted from the gallbladder's bile, PCR was performed by using specific primers for the identification of Helicobacter spp with amplification of the 400bp segment of rRNA gene16S, with positive control DNA from Helicobacter pylori. All the cases negative for isolation of genetic material were excluded. The cases of PCRΘ and GiemsaΘ were used as negative control group. The histological findings were compared to the presence of bacilli and PCR data using a chi-square and Fisher's Exact test (CI = 95.0%, p OBJETIVO: Estabelecer a prevalência do Helicobacter spp nos doentes com colecistopatia crônica calculosa e correlacioná-la com as alterações histológicas da vesícula biliar. MÉTODOS: Foram operados 100 doentes portadores de colecistite crônica calculosa. No anátomo-patológico foram avaliadas a presença de, metaplasias, displasias, folículos linfóides, anaplasias e tumores que pudessem se relacionar à presença do helicobacter e a presença de bacilos Giemsa ? à microscopia. A partir do DNA extraído da bile foi realizada PCR utilizando-se primers específicos para identificação de Helicobacter spp com amplificação de segmento de 400bp do gene16S rRNA, com controle positivo de DNA de Helicobacter Pylori. Os casos negativos para isolamento de material genético na bile foram excluídos. Os casos de PCR e Giemsa negativos foram utilizados como grupo controle. Os achados histológicos foram comparados ao Giemsa e à PCR

  8. Using fecal profiles of bile acids to assess habitat use by threatened carnivores in the Maulino forest of central Chile Empleo del perfil de ácidos biliares fecales para evaluar uso del hábitat por carnívoros amenazados en el bosque maulino de Chile central

    Directory of Open Access Journals (Sweden)

    CARLA GUERRERO

    2006-03-01

    central: Galictis cuja, Oncifelis guigna, Pseudalopex culpaeus, Pseudalopex griseus y Puma concolor. Los perfiles de ácidos biliares fecales, establecidos mediante cromatografía de capa fina, resultaron ser especie-específicos, invariantes tanto dentro de muestras de un mismo individuo como entre muestras de diferentes individuos de una misma especie, pero son consistentemente diferentes entre especies. La distribución especial de fecas en áreas de bosque nativo y plantaciones de pino en el bosque costero del Maule se comparó con la distribución esperada en base a estudios previos basados en registro de huellas. Pseudalopex culpaeus usa extensamente plantaciones de pino; Oncifelis guigna prefiere bosque nativo y Pseudalopex griseus usa bosque nativo y plantaciones de pino en proporción a su disponibilidad. Los resultados de la distribución de fecas son similares a los obtenidos por registro de huellas

  9. Ileal loop interposition:an alternative biliar y bypass technique

    Institute of Scientific and Technical Information of China (English)

    Felipe JF Coimbra; Alessandro L Diniz; Heber SC Ribeiro; Wilson L Costa Jr.; Eduardo NP Lima; André L Montagnini

    2010-01-01

    BACKGROUND: Obstructive jaundice is a common condition in advanced digestive cancer. Palliative procedures can improve quality of life and allow patients to attempt a systemic treatment. Bilioenteric anastomosis is still the procedure of choice for patients in many centers. When a surgical bypass is not possible, biliary drainage can be done by placing endoscopic or transparietal stents, which are less durable methods even when an expandable stent is employed. METHODS: A 47-year-old male with an excellent clinical status and a previous cholecystectomy and an exploratory laparotomy for advanced gastric cancer was referred with obstructive jaundice. A preoperative CT scan showed a dilated bile duct and a small mass at the distal hepatic hilum. No other signs of metastasis were found. A surgical bilioenteric anastomosis was indicated. At surgery, a distal choledochal obstruction and a mesenteric retraction by a lymph node mass prevented the jejunum to ascend for a bilioenteric anastomosis. Surgically, an alternative bilioenteric bypass was performed by means of an ileal loop interposition between the bile duct and the jejunum. RESULT: The recovery of the patient was uneventful and his bilirubin levels normalized after one week. The patient was then referred for systemic chemotherapy. CONCLUSIONS: This alternative biliary bypass can be safely and easily performed, and may be a good alternative for patients already referred for surgery because of a better life expectancy and when the jejunum is not an alternative.

  10. Action of nisin and high pH on growth of Staphylococcus aureus and Salmonella sp. in pure culture and in the meat of land crab (Ucides cordatus Ação da nisina e do pH elevado sobre a multiplicação de Staphylococcus aureus e Salmonella sp. em cultura pura e em carne de caranguejo-uçá (Ucides cordatus

    Directory of Open Access Journals (Sweden)

    Teresa Cristina S. de Lima Grisi

    2005-06-01

    Full Text Available The aim of this study was to evaluate the potential of nisin and high pH to inhibit the growth of Staphylococcus aureus and Salmonella sp. in broth culture and when inoculated into meat of land crab. In pure cultures, the growth of S. aureus was bly inhibited by nisin and the growth of Salmonella sp. was inhibited by nisin-EDTA (20 mM. The inhibition of S. aureus lasted for eight hours and Salmonella sp. growth was inhibited throughout the experiment (24 h. The high pH (pH 10.0 and 11.0 with NaHCO3-NaOH buffer was very effective for in vitro inhibition of S. aureus and Salmonella sp. Nisin and high pH, when applied to the contaminated meat, did not yield the same effect. Nisin was not effective in preventing growth of both pathogens in the crab meat, while pH 10.0 showed significant inhibitory effect on Salmonella sp. The results suggest that high pH has a potential as antibacterial agent, and may be useful in chemical preservation of crab meat.O objetivo deste estudo foi avaliar o potencial de inibição de nisina e o pH elevado em relação à multiplicação de Staphylococcus aureus e Salmonella sp. em culturas puras e inoculadas na carne de caranguejo-uçá. Em culturas puras, a multiplicação de S. aureus foi fortemente inibida por nisina e a de Salmonella sp. por nisina-EDTA (20 mM. A multiplicação de S. aureus foi inibida até 8h de incubação, enquanto que a de Salmonella sp. foi inibida durante todo o experimento (24h. O pH elevado (tampão NaHCO3-NaOH, pH 10 e 11 mostrou-se efetivo na inibição da multiplicação de S. aureus e Salmonella sp. Nisina e o pH elevado aplicados na carne contaminada não apresentaram o mesmo efeito. A nisina não mostrou eficiência na inibição dos patógenos quando inoculados na carne de caranguejo, enquanto que o tampão em pH 10 demonstrou inibição significante sobre a multiplicação de Salmonella sp. Estes resultados sugerem que o pH elevado apresenta um potencial como agente antibacteriano

  11. Regular Totally Separable Sphere Packings

    OpenAIRE

    Reid, Samuel

    2015-01-01

    The topic of totally separable sphere packings is surveyed with a focus on regular constructions, uniform tilings, and contact number problems. An enumeration of all regular totally separable sphere packings in $\\mathbb{R}^2$, $\\mathbb{R}^3$, and $\\mathbb{R}^4$ which are based on convex uniform tessellations, honeycombs, and tetracombs, respectively, is presented, as well as a construction of a family of regular totally separable sphere packings in $\\mathbb{R}^d$ that is not based on a convex...

  12. Signed Total Domination in Graphs

    Institute of Scientific and Technical Information of China (English)

    邢化明; 孙良; 陈学刚

    2003-01-01

    Let G=(V,E) be a simple graph. For any real valued function f:V→R, the weight of f is f(V)=∑f(v) over all vertices v∈V. A signed total dominating function is a function f:V→{-1,1} such that f(N(v))≥1 for every vertex v∈V. The signed total domination number of a graph G equals the minimum weight of a signed total dominating function on G. In this paper, some properties of the signed total domination number of a graph G are discussed.

  13. Cogema acquires TOTAL's uranium assets

    International Nuclear Information System (INIS)

    On April 28, France's nuclear fuel cycle conglomerate Cogema and petroleum group TOTAL announced a plan in which Cogema will assume ownership of TOTAL's uranium assets worldwide, and as part of the deal, each firm will acquire shares of the other. On June 2, the agreement will be submitted to shareholders and, assuming it is approved, will go into effect this year. The agreement calls for TOTAL to acquire a 10.8-percent share in Cogema, thus becoming its first private sector shareholder, by underwriting a reserve capital increase of FF1.5 billion (approximately US$283 million). In return, Cogema will pay FF2.52 billion for approximately 4.3 percent of TOTAL, as part of a reserve capital increase totalling FF4.07 billion

  14. Totality eclipses of the Sun

    CERN Document Server

    Littmann, Mark; Willcox, Ken

    2008-01-01

    A total eclipse of the Sun is the most awesome sight in the heavens. Totality: Eclipses of the Sun takes you to eclipses of the past, present, and future, and lets you see - and feel - why people travel to the ends of the Earth to observe them. - ;A total eclipse of the Sun is the most awesome sight in the heavens. Totality: Eclipses of the Sun takes you to eclipses of the past, present, and future, and lets you see - and feel - why people travel to the ends of the Earth to observe them. Totality: Eclipses of the Sun is the best guide and reference book on solar eclipses ever written. It explains: how to observe them; how to photograph and videotape them; why they occur; their history and mythology; and future eclipses - when and where to see them. Totality also tells the remarkable story of how eclipses shocked scientists, revealed the workings of the Sun, and made Einstein famous. And the book shares the experiences and advice of many veteran eclipse observers. Totality: Eclipses of the Sun is profusely ill...

  15. The first Polish total laryngectomies

    OpenAIRE

    Kierzek, Andrzej; Paprocka-Borowicz, Małgorzata; Pozowski, Andrzej; Kuciel-Lewandowska, Jadwiga

    2013-01-01

    The total removal of the larynx (total laryngectomy), performed in 1872 by the well-known Viennese surgeon Christian A. Theodor Billroth (1829–1894), was an epoch-making event in the history of surgery and laryngology. This paper presents the first surgeons who performed this operation. The first Pole who performed a total laryngectomy (1877) was Julian Kosiński (1833–1914), head of the Surgical Clinic of Imperial University Warsaw. It was the 14th operation of this kind in the world. Several...

  16. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... an anterior approach total hip replacement with the patient on a regular OR table supine. My name ... less invasive without being small incision surgery. Obese patients can be easier due to less distribution of ...

  17. Total anomalous pulmonary venous return

    Science.gov (United States)

    TAPVR; Total veins; Congenital heart defect - TAPVR; Cyanotic heart disease - TAPVR ... Fraser CD, Carberry KE. Congenital heart disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 19th ed. Philadelphia, PA: Elsevier ...

  18. Total Knee Replacement for Women

    Medline Plus

    Full Text Available ... at Florida Orthopedic Institute in Tampa, Florida. Tonight I’ll be moderating a Zimmer Gender Solutions total ... the e-mail seen on your screen, and I’ll do my best to sift through those ...

  19. Total Knee Replacement for Women

    Medline Plus

    Full Text Available ... that we feel because of their health and age has the potential for a total knee to ... I can evaluate? Is there any cut-off age that you would put in regular polyethylene or ...

  20. Minimally Invasive Total Knee Arthroplasty

    Medline Plus

    Full Text Available ... Institute. We're going to be doing an MIS total knee arthroplasty with the Zimmer mobile bearing ... this point. And there is many recipes for MIS knee surgery as there are surgeons. What’s kind ...

  1. Total Product Life Cycle (TPLC)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Total Product Life Cycle (TPLC) database integrates premarket and postmarket data about medical devices. It includes information pulled from CDRH databases...

  2. A Choir for Total Communication.

    Science.gov (United States)

    Knapp, Ruth Ann

    1980-01-01

    The Total Communication Choir of the Saginaw, Michigan, public schools integrates deaf and hearing elementary and junior high students in music performance. All students both sign and sing. Methods used to instruct the choir are described. (SJL)

  3. Qualità totale e mobilità totale

    Directory of Open Access Journals (Sweden)

    Giuseppe Trieste

    2010-04-01

    Full Text Available FIABA ONLUS (Italian Fund for Elimination of Architectural Barriers was founded in 2000 with the aim of promoting a culture of equal opportunities and, above all, it has as its main goal to involve public and private institutions to create a really accessible and usable environment for everyone. Total accessibility, Total usability and Total mobility are key indicators to define quality of life within cities. A supportive environment that is free of architectural, cultural and psychological barriers allows everyone to live with ease and universality. In fact, people who access to goods and services in the urban context can use to their advantage time and space, so they can do their activities and can maintain relationships that are deemed significant for their social life. The main aim of urban accessibility is to raise the comfort of space for citizens, eliminating all barriers that discriminate people, and prevent from an equality of opportunity. “FIABA FUND - City of ... for the removal of architectural barriers” is an idea of FIABA that has already affected many regions of Italy as Lazio, Lombardy, Campania, Abruzzi and Calabria. It is a National project which provides for opening a bank account in the cities of referring, in which for the first time, all together, individuals and private and public institutions can make a donation to fund initiatives for the removal of architectural barriers within its own territory for a real and effective total accessibility. Last February the fund was launched in Rome with the aim of achieving a Capital without barriers and a Town European model of accessibility and usability. Urban mobility is a prerequisite to access to goods and services, and to organize activities related to daily life. FIABA promotes the concept of sustainable mobility for all, supported by the European Commission’s White Paper. We need a cultural change in management and organization of public means, which might focus on

  4. Total Liability for Excessive Harm

    OpenAIRE

    Cooter, Robert D; Porat, Ariel

    2005-01-01

    The harm that each individual causes others is unverifiable in some circumstances where the total harm caused by everyone is verifiable. For example, the environmental agency can often measure the total harm caused by pollution much easier than it can measure the harm caused by each individual polluter. In these circumstances, implementing the usual liability rules or externality taxes is impossible. We propose a novel solution: Hold each participant in the activity responsible for all of the...

  5. Total Liability for Excessive Harm

    OpenAIRE

    Cooter, Robert D; Porat, Ariel

    2004-01-01

    In many circumstances, the total harm caused by everyone is verifiable, and the harm caused by each individual is unverifiable. For example, the environmental agency can measure the total harm caused by pollution much easier than it can measure the harm caused by each individual polluter. In these circumstances, implementing the usual liability rules or externality taxes is impossible. We propose a novel solution: Hold each participant in the activity responsible for all of the excessive harm...

  6. Total synthesis of (-)-spinosyn A.

    Science.gov (United States)

    Mergott, Dustin J; Frank, Scott A; Roush, William R

    2004-08-17

    A convergent, highly stereoselective total synthesis of (-)-spinosyn A (1) is described. Key features of the synthesis include the transannular Diels-Alder reaction of macrocyclic pentaene 11 and the transannular Morita-Baylis-Hillman cyclization of 12 that generates tetracycle 26. The total synthesis of (-)-spinosyn A was completed by a sequence involving the highly beta-selective glycosidation reaction of 13 and glycosyl imidate 30. PMID:15173590

  7. The total charm cross section

    OpenAIRE

    R. Vogt

    2007-01-01

    We assess the theoretical uncertainties on the total charm cross section. We discuss the importance of the quark mass, the scale choice and the parton densities on the estimate of the uncertainty. We conclude that due to the small charm quark mass, which amplifies the effect of the other parameters in the calculation, the uncertainty on the total charm cross section is difficult to quantify.

  8. Total body water and total body potassium in anorexia nervosa

    International Nuclear Information System (INIS)

    In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation

  9. Total body water and total body potassium in anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Dempsey, D.T.; Crosby, L.O.; Lusk, E.; Oberlander, J.L.; Pertschuk, M.J.; Mullen, J.L.

    1984-08-01

    In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation.

  10. Total 2004 annual report; TOTAL 2004 rapport annuel

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    This annual report of the Group Total brings information and economic data on the following topics, for the year 2004: the corporate governance, the corporate social responsibility, the shareholder notebook, the management report, the activities, the upstream (exploration and production) and downstream (refining and marketing) operating, chemicals and other matters. (A.L.B.)

  11. Elective hemithyroidectomy during total laryngectomy

    Directory of Open Access Journals (Sweden)

    Soheyla Nikakhlagh

    2009-01-01

    Full Text Available Introduction: Routine hemithyroidectomy during total laryngectomy in the setting of advanced stage of laryngeal carcinoma without clear thyroid involvement remains a controversial issue. This study was conducted to assess the rate of thyroid gland involvement in the patients without obvious clinical involvement who were candidates for total laryngectomy. Materials and Methods: In this cross-sectional study, between 1994 and 2007, 186 patients who underwent total laryngectomy with ipsilateral hemithyroidectomy at Imam Khomeini hospital of Ahwaz Jondishapour university, were investigated for thyroid gland involvement. Results: Of 186 patients, 169 cases were men and 17 were women, with mean age of 63 years. Microscopic tissue study revealed tumor invasion to thyroid gland in 7 patients, all of them had clinically advanced disease. Among these patients, 5 cases had transglottic cancer and 2 cases had subglottic cancer. Moreover, 4 patients had thyroid cartilage invasion and in one patient pyriform sinus was involved. Conclusion: There may be no need for thyroidectomy in all total laryngectomy cases. We recommend hemithyroidectomy with isthmectomy during total laryngectomy only in cases with subglottic tumor extension, thyroid cartilage invasion, and pyriform sinus involvement.    

  12. TOTAL THYROIDECTOMY USING CAPSULAR DISSECTION

    Directory of Open Access Journals (Sweden)

    R. Moldovanu

    2008-01-01

    Full Text Available Total thyroidectomy can be performed with low rate of injuries of the recurrent laryngeal nerves and parathyroid glands, with appropriate techniques. The paper describes the technique of total thyroidectomy using capsular dissection and the indications of this operation. There are some steps which should be respected: good exposure of the thyroid gland, careful dissection of the superior pole using the avascular plane between superior pole and cricothyroid muscle, medial retraction of the gland, ligating the tertiary (third order branches of the inferior thyroid artery, near the surface of thyroid parenchyma. Using this type of dissection, the recurrent laryngeal nerves are protected, as well as the blood supply of the parathyroid glands. Conclusions: Total thyroidectomy using capsular dissection is the procedure of choice for multinodular goiter, because avoid the completion thyroidectomy for recurrence or occult thyroid cancer.

  13. Stereoselective Total Synthesis of Mycalamides

    Institute of Scientific and Technical Information of China (English)

    Masahiro Toyota

    2005-01-01

    @@ 1Introduction Mycalamides A (1a) and B (1b) are potent antiviral compounds from a New Zealand sponge of the genus Mycale. Apart from their antitumor property, mycalamide A (1a) exhibits immunosuppressive action by blocking T-cell activation in mice and is significantly more potent than FK-506 and cyclosporine A. Because of their intriguing biological activity, unique structures and scarce supply of these natural products, mycalamides A (1a) and B (1b) have attracted considerable attention as target molecules for total synthesis, and total, formal, or partial syntheses of this family of compounds have been reported[1,2].

  14. VOICE REHABILITATION FOLLOWING TOTAL LARYNGECTOMY

    Directory of Open Access Journals (Sweden)

    Balasubramanian Thiagarajan

    2015-03-01

    Full Text Available Despite continuing advances in surgical management of laryngeal malignancy, total laryngectomy is still the treatment of choice in advanced laryngeal malignancies. Considering the longevity of the patient following total laryngectomy, various measures have been adopted in order to provide voice function to the patient. Significant advancements have taken place in voice rehabilitation of post laryngectomy patients. Advancements in oncological surgical techniques and irradiation techniques have literally cured laryngeal malignancies. Among the various voice rehabilitation techniques available TEP (Tracheo oesophageal puncture is considered to be the gold standard. This article attempts to explore the various voice rehabilitation technique available with primary focus on TEP.

  15. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... and E-poly antioxidant-infused technology during a hip replacement through the anterior supine intramuscular approach. “OR- ... Dr. Keith Berend perform an anterior approach total hip replacement with the patient on a regular OR ...

  16. Total Synthesis of Propolisbenzofuran B†

    OpenAIRE

    Jones, Brian T.; Avetta, Christopher T.; Thomson, Regan J.

    2014-01-01

    The first total synthesis of propolisbenzofuran B, a bioactive natural product isolated from honeybee propolis resin, is reported. The convergent synthesis makes use of a silicon-tether controlled oxidative ketone–ketone cross-coupling and a novel benzofuran-generating cascade reaction to deliver the core structure of the natural product from readily prepared precursors.

  17. Minimally Invasive Total Knee Arthroplasty

    Medline Plus

    Full Text Available ... the NexGen® LPS-Flex Mobile and LPS-Mobile Bearing Knees March 5, 2009 Welcome to this "OR ... MIS total knee arthroplasty with the Zimmer mobile bearing knee. We invite all of you who have ...

  18. Total Knee Replacement for Women

    Medline Plus

    Full Text Available Zimmer Combines Gender Solutions technology May 27, 2009 Good evening. Welcome to “OR-Live” at Tampa General Hospital. My name is Steve Lyons, ... Tonight I’ll be moderating a Zimmer Gender Solutions total knee, performed by my partner, Dr. Ken ...

  19. Total Knee Replacement for Women

    Medline Plus

    Full Text Available Zimmer Combines Gender Solutions technology May 27, 2009 Good evening. Welcome to “OR-Live” at Tampa General Hospital. My name is ... Florida. Tonight I’ll be moderating a Zimmer Gender Solutions total knee, performed by my partner, Dr. ...

  20. Total Knee Replacement for Women

    Medline Plus

    Full Text Available ... Ken, here’s another question. “Do you utilize highly cross linked polyethylene for all your total knees or just in younger patients? I use the highly cross linked polyethylene in all the knees. I think ...

  1. Totally indefinite Euclidean quaternion fields

    OpenAIRE

    Cerri, Jean-Paul; Chaubert, Jérôme; Lezowski, Pierre

    2014-01-01

    We study the Euclidean property for totally indefinite quaternion fields. In particular, we establish the complete list of norm-Euclidean such fields over imaginary quadratic number fields. This enables us to exhibit an example which gives a negative answer to a question asked by Eichler. The proofs are both theoretical and algorithmic.

  2. Minimally Invasive Total Knee Arthroplasty

    Medline Plus

    Full Text Available ... NexGen® LPS-Flex Mobile and LPS-Mobile Bearing Knees March 5, 2009 Welcome to this "OR Live" ... re going to be doing an MIS total knee arthroplasty with the Zimmer mobile bearing knee. We ...

  3. Edge colouring by total labellings

    DEFF Research Database (Denmark)

    Brandt, Stephan; Rautenbach, D.; Stiebitz, M.;

    2010-01-01

    We introduce the concept of an edge-colouring total k-labelling. This is a labelling of the vertices and the edges of a graph G with labels 1, 2, ..., k such that the weights of the edges define a proper edge colouring of G. Here the weight of an edge is the sum of its label and the labels of its...... two endvertices. We define χ (G) to be the smallest integer k for which G has an edge-colouring total k-labelling. This parameter has natural upper and lower bounds in terms of the maximum degree Δ of G : ⌈ (Δ + 1) / 2 ⌉ ≤ χ (G) ≤ Δ + 1. We improve the upper bound by 1 for every graph and prove χ (G...

  4. CYPRINIDS TOTAL BLOOD PROTEINS DETERMINATION

    Directory of Open Access Journals (Sweden)

    TANŢI PATRICHE

    2013-07-01

    Full Text Available In aquaculture to get a high production is conditioned by awareness and keeping of an unaltered health condition of the biological material. To be aware of the health condition of the biological material in a fish farm allows us to establish the preventive measures required to prevent spreading of a disease and the treatment to be applied in case that a mass disease occurs. The level of the total protein in serum is, first of all, a synthetically indicator of the nutritional condition of the organism, presenting, at the same time, ample qualitative and quantitative variations depending on species, age, sex, stage of sexual maturity, water temperature and especially in correlation with the health condition of fish. Modification in value of the total protein point out some metabolic perturbations in fish body.

  5. Total sternectomy for malignant disease.

    Science.gov (United States)

    París, F; Blasco, E; Tarazona, V; Pastor, J; Zarza, A G; Padilla, J

    1980-09-01

    From 1972 to 1978, six total sternectomies for malignant disease of the sternum were carried out. The clinical data are summarized and the surgical technique is described. After sternectomy, the area of chest wall resection was repaired by suturing a sheet of silicone rubber to the edges of the defect and chest wall stability was assured by using one or two stainless steel struts. Finally the defect was covered with methylmethacrylate prepared and applied inthe operative field. The prosthetic material was shaped until curing by polymerization was complete. We discuss the advantages of this type of reconstruction, the technical details, the use of antibiotics, the surgical drainage, and the need for biopsy prior to carrying out a total sternectomy. PMID:7412352

  6. Outcome after total elbow arthroplasty

    DEFF Research Database (Denmark)

    Plaschke, Hans Christian; Thillemann, Theis M; Brorson, Stig;

    2015-01-01

    BACKGROUND: Total elbow arthroplasties (TEAs) are traditionally grouped into linked and unlinked design. The aim was to analyze the difference in clinical outcomes after TEA based on implant design and indication for surgery and to evaluate primary and revision TEAs. METHODS: A total of 167 TEAs...... (126 primary and 41 revision TEAs) in 141 patients were evaluated with patient-reported outcome measure by the Oxford Elbow Score (OES) and clinically assessed with the Mayo Elbow Performance Score (MEPS), range of motion (ROM), and standard radiographs. RESULTS: The mean follow-up was 10.5 years for...... primary and 7.5 years for revision TEAs. There was no difference in OES or MEPS between linked and unlinked primary TEAs. The OES score in the social-psychological domain was significantly lower in TEAs performed due to fracture (67) compared with rheumatoid arthritis (81; P = .025). ROM in extension...

  7. Total positivity in Markov structures

    OpenAIRE

    Fallat, Shaun; Lauritzen, Steffen; Sadeghi, Kayvan; Uhler, Caroline; Wermuth, Nanny; Zwiernik, Piotr

    2015-01-01

    We discuss properties of distributions that are multivariate totally positive of order two (MTP2) related to conditional independence. In particular, we show that any independence model generated by an MTP2 distribution is a compositional semigraphoid which is upward-stable and singleton-transitive. In addition, we prove that any MTP2 distribution satisfying an appropriate support condition is faithful to its concentration graph. Finally, we analyze factorization properties of MTP2 distributi...

  8. Diastereoselective Total Synthesis of (-)-Galiellalactone.

    Science.gov (United States)

    Kim, Taewoo; Han, Young Taek; An, Hongchan; Kim, Kyeojin; Lee, Jeeyeon; Suh, Young-Ger

    2015-12-18

    An enantioselective total synthesis of (-)-galiellalactone has been accomplished. The key features of the synthesis involve the highly stereoselective construction of the cis-trisubstituted cyclopentane intermediate by a Pd(0)-catalyzed cyclization, the stereospecific introduction of an angular hydroxyl group by Riley oxidation, and the efficient construction of the tricyclic system of (-)-galiellalactone via a combination of diastereoselective Hosomi-Sakurai crotylation and ring-closing metathesis (RCM). PMID:26544529

  9. Total solar eclipse 2001 - Angola

    Czech Academy of Sciences Publication Activity Database

    Marková, E.; Kotrč, Pavel; Křivský, L.; Bělík, M.; Dušek, J.

    Noordwijk : ESA Publication Division, 2002 - (Sawaya-Lacoste, H.), s. 245-248 [Solar Cycle and Space Weather Euroconference /2./. Vico Equense (IT), 24.09.2001-29.09.2001] R&D Projects: GA ČR GA205/01/0420 Institutional research plan: CEZ:AV0Z1003909 Keywords : total solar eclipse * white-light corona Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics

  10. AVALIAÇÃO DAS TÉCNICAS DE DETERMINAÇÃO DE NITROGÊNIO POR CROMATOGRAFIA IÔNICA (IC) E POR TEOR DE NITROGÊNIO TOTAL (TN) POR QUIMILUMINESCÊNCIA

    OpenAIRE

    Lucélia Hoehne; Fernando Afonso Schneider; Simone Stülp; Julia Spellmeyer Tischer; Fábio dos Santos

    2015-01-01

    A determinação de nitrogênio pode ser feita por diferentes técnicas, tais como Kjedahl, Nitrogênio Total (NT) por quimioluminescência, cromatografia iônica (IC), entre outras. A determinação do nitrogênio total proposta por Kjeldahl em 1883, ainda é muito usada por ser uma técnica confiável, porém, tem a desvantagem de gerar resíduos e ter o tempo de análise elevado. Desse modo, outras técnicas recentes podem ser usadas para determinar o nitrogênio, reduzindo os resíduos e tempo de análise. A...

  11. Relação entre a prática da atividade física e os níveis de concentrações séricas do colesterol total em jovens do ensino superior

    OpenAIRE

    Ribeiro, Maria Isabel; Ferreira, Andreia; Domingues, Diana; Padilha, Rita; Martiniano, Susana; Pereira, Olívia R.

    2013-01-01

    Introdução: As doenças cardiovasculares são a principal causa de mortalidade em Portugal. Controlar os fatoreAtividade físicas de risco, entre os quais os níveis de colesterol e dos triglicerídeos é de extrema importância. Níveis mais elevados de prática frequente de atividade física estão associados a concentrações séricas de colesterol total mais baixas. Objetivos: Determinar se existe relação entre a prática de exercício físico e os níveis das concentrações séricas do colesterol total ...

  12. Diverticulosis in total colonic aganglionosis

    International Nuclear Information System (INIS)

    Two infants with total colonic aganglionosis (TCA) extending into the distal part of the ileum are described. Considerable diagnostic delay occurred with the correct diagnosis established first at 3 and 8 months, respectively. Radiologic findings compatible with TCA such as prolonged barium retention, reflux into ileum following barium enema, and foreshortening of colon were not clearly evident initially. Both patients demonstrated multiple acquired colon diverticula which increased both in number and size during the period of observation. These diverticula are probably a late manifestation of the spastic state of the anganglionic colon. Thus demonstration of diverticula supplies a strong evidence of TCA in infants with intestinal obstruction. (orig.)

  13. Total Synthesis of the Ammosamides

    Science.gov (United States)

    Hughes, Chambers C.; Fenical, William

    2010-01-01

    The ammosamides A-C are chlorinated pyrrolo[4,3,2-de]quinoline metabolites isolated from the marine-derived Streptomyces strain CNR-698. The natural products, which possess a dense array of heteroatoms, were synthesized in 17–19 steps from 4-chloroisatin. That the five nitrogen atoms were introduced at the appropriate time and in a suitable oxidation state was key to the success of the total synthesis. Compared to synthetic deschloro ammosamide B, natural ammosamide B is much less susceptible to oxidative degradation. PMID:20131899

  14. Total eclipses of the sun

    CERN Document Server

    Zirker, Jack B

    2014-01-01

    Eclipses have captured attention and sparked curiosity about the cosmos since the first appearance of humankind. Having been blamed for everything from natural disasters to the fall of kings, they are now invaluable tools for understanding many celestial as well as terrestrial phenomena. This clear, easy-to-understand guide explains what causes total eclipses and how they can be used in experiments to examine everything from the dust between the planets to general relativity. A new chapter has been added on the eclipse of July 11, 1991 (the great Hawaiian eclipse). Originally published in 19

  15. Total filmless digital radiology service

    International Nuclear Information System (INIS)

    The completion of a comprehensive picture archiving and communication system (PACS) at Georgetown University Hospital has allowed us to identify a number of technical, administrative, personnel, and operational issues that will affect a total digital radiology service. With a hospital-wide digital imaging network system, computer simulation of communications and storage options, and economic modeling, we have developed a feasibility study and implementation strategy for the smooth transition to a nearly filmless radiology service over the next several years. This paper describes the technical and operational requirements for various database operations, workstations (used in diagnosis, review, and education), and communications. Site and installation planning, personnel training, and transition operations are discussed

  16. First total synthesis of Boehmenan

    Indian Academy of Sciences (India)

    Yamu Xia; Xiaoli Dai; Haixin Liu; Chen Chai

    2014-05-01

    The first total synthesis of dilignan Boehmenan has been achieved. A biomimetic oxidative coupling of the ferulic acid methyl ester in the presence of silver oxide is the crucial step in the synthesis sequence, generating the dihydrobenzofuran skeleton. Hydroxyl group was protected with DHP and reducted with LiAlH4 to afford the intermediate diol. The diol was condensated with the derivative of ferulic acid, then removed the protecting groups, to get Boehmenan. Meanwhile, a study on the ring-opening reaction of the intermediate dihydrobenzofuran neolignan under base conditions was described.

  17. Radiology of total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, H.J.; Lovelock, J.E.; McCollister Evarts, C.; Geyer, D.

    1984-06-01

    The radiology of total hip replacement (THR) and its complications is reviewed in conjunction with a long-term follow-up study on 402 patients with 501 prostheses. The indications, contraindications, biomechanics, and operative management of these patients is discussed. Clinical complications such as deep vein thrombosis, pulmonary embolism, and hemorrhage are mentioned. Postoperative infections including granulomatous pseudotumors, dislocations and fractures, true loosening of the prosthesis, and heterotopic bone formation (HBF) are discussed and illustrated. The importance of differentiating the lucent line from true loosening is stressed. Mechanical and other clinical complications which are largely ignored by radiologists are also discussed. The uses of arthrography and bone scanning are included.

  18. Solar total energy project Shenandoah

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-01-10

    This document presents the description of the final design for the Solar Total Energy System (STES) to be installed at the Shenandoah, Georgia, site for utilization by the Bleyle knitwear plant. The system is a fully cascaded total energy system design featuring high temperature paraboloidal dish solar collectors with a 235 concentration ratio, a steam Rankine cycle power conversion system capable of supplying 100 to 400 kW(e) output with an intermediate process steam take-off point, and a back pressure condenser for heating and cooling. The design also includes an integrated control system employing the supervisory control concept to allow maximum experimental flexibility. The system design criteria and requirements are presented including the performance criteria and operating requirements, environmental conditions of operation; interface requirements with the Bleyle plant and the Georgia Power Company lines; maintenance, reliability, and testing requirements; health and safety requirements; and other applicable ordinances and codes. The major subsystems of the STES are described including the Solar Collection Subysystem (SCS), the Power Conversion Subsystem (PCS), the Thermal Utilization Subsystem (TUS), the Control and Instrumentation Subsystem (CAIS), and the Electrical Subsystem (ES). Each of these sections include design criteria and operational requirements specific to the subsystem, including interface requirements with the other subsystems, maintenance and reliability requirements, and testing and acceptance criteria. (WHK)

  19. Employees in Total Quality Management

    Directory of Open Access Journals (Sweden)

    M. G. Matlhape

    2002-12-01

    Full Text Available Companies have become very disillusioned with Total Quality Management (TQM as a solution to their quality related problems. Part of the problem has been that companies' expectations from TQM is as a solution to their existing problems rather than as a new philosophy towards creating value for shareholders, employees, and customers. Employee involvement is usually the element in the TQM philosophy that is most difficult to manage. Central to employee participation within the TQM philosophy is teamwork. In the attempt to facilitate total quality management, this article explores specific South African challenges to achieving this. These areaffirmative action and divers ity management skills shortages, training and development low levels of employee well-being. Working with people requires fundamental understanding of the uniqueness of each individual with their own identity and set of preferences. It also requires an understanding of teams and the mechanisms of making a group of individuals work well or poorly together. This will assist managers to realise active participation, quality output from their workers through individualised, and team based motivational processes.

  20. Qualidade total: Um novo paradigma?

    Directory of Open Access Journals (Sweden)

    Suzana da Rosa Tolfo

    1999-01-01

    Full Text Available Nos últimos anos, o movimento para a implantação da Gestão da Qualidade Total vem crescendo ao redor do mundo. Em razão disso, há uma diversidade de ações realizadas com o nome de "Qualidade Total'. Uma revisão da teoria é complexa, porque existem muitos autores que tratam da questão. Eles escolhem diferentes perspectivas de análises (teóricas e empíricas e há dificuldades em se identificar um corpo conceitual. Há uma ampla difusão de modelos, ferramentas, técnicas, mercado e consultores. Essa popularidade, muitas vezes, faz com que determinadas organizações adotem essa forma de gestão do trabalho sem o conhecimento necessário das implicações que um modelo dessa ordem representa; especialmente no caso brasileiro, suscetível a proposições importadas. O presente artigo propõe um exame daquilo que os fundadores têm articulado sobre TQM, as principais críticas nesta direção e a avaliação de como vem sendo aplicadono nosso país.

  1. Total Value of Phosphorus Recovery.

    Science.gov (United States)

    Mayer, Brooke K; Baker, Lawrence A; Boyer, Treavor H; Drechsel, Pay; Gifford, Mac; Hanjra, Munir A; Parameswaran, Prathap; Stoltzfus, Jared; Westerhoff, Paul; Rittmann, Bruce E

    2016-07-01

    Phosphorus (P) is a critical, geographically concentrated, nonrenewable resource necessary to support global food production. In excess (e.g., due to runoff or wastewater discharges), P is also a primary cause of eutrophication. To reconcile the simultaneous shortage and overabundance of P, lost P flows must be recovered and reused, alongside improvements in P-use efficiency. While this motivation is increasingly being recognized, little P recovery is practiced today, as recovered P generally cannot compete with the relatively low cost of mined P. Therefore, P is often captured to prevent its release into the environment without beneficial recovery and reuse. However, additional incentives for P recovery emerge when accounting for the total value of P recovery. This article provides a comprehensive overview of the range of benefits of recovering P from waste streams, i.e., the total value of recovering P. This approach accounts for P products, as well as other assets that are associated with P and can be recovered in parallel, such as energy, nitrogen, metals and minerals, and water. Additionally, P recovery provides valuable services to society and the environment by protecting and improving environmental quality, enhancing efficiency of waste treatment facilities, and improving food security and social equity. The needs to make P recovery a reality are also discussed, including business models, bottlenecks, and policy and education strategies. PMID:27214029

  2. Insuficiência renal oculta acarreta risco elevado de mortalidade após cirurgia de revascularização miocárdica Hidden renal dysfunction causes increased in-hospital mortality risk after coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Mathias Alexandre Volkmann

    2011-09-01

    Full Text Available INTRODUÇÃO E OBJETIVOS: Insuficiência renal crônica pré operatória é fator preditivo independente para mortalidade em cirurgia cardíaca. Como creatinina sérica normal não representa obrigatoriamente função renal normal, comparamos as taxas de mortalidade, de permanência hospitalar total e de permanência hospitalar pós-operatória em pacientes submetidos à cirurgia de revascularização miocárdica isolada com creatinina 60 mL/min (Grupo A e 1.226 com INTRODUCTION AND OBJECTIVES: Preoperative chronic renal dysfunction is an independent predictor of mortality in cardiac surgery. As normal range serum creatinine is not representative of normal renal function, we compared mortality rates, total hospital stay and post-surgical hospital stay for patients who underwent isolated coronary artery bypass surgery with serum creatinine 60mL/min (Group A, and 1,226 with <60mL/min (Group B. Group B patients had significantly higher total hospital stay and post-surgical hospital stay than those in Group A (respectively 2.85 and 1.79 more days - P<0.0001. Relative risk of in-hospital death was 2.09 to Group B (95%CI:1.54-2.84 when compared to Group A. CONCLUSIONS: More than one quarter of the patients with serum creatinine <1.5mg/dL had creatinine clearance <60 mL/min. This expressive number of patients, that would not have their renal dysfunction detected by the serum creatinine parameter alone, had double the risk of death, longer total hospital stay and post-surgical hospital stay than the other patients with serum creatinine < 1.5mg/dL

  3. Application Of Total Quality Management In Library

    OpenAIRE

    Vilas A. Kale

    2013-01-01

    The paper focuses on the application of Total Quality Management in Library in different sub-titles such as Need for Quality Management, Total Quantity Management, Basic components of Total Quality Management, Key Elements in Total Quality Management, Total Quality Management and Libraries, Implementation of Total Quality Management in Library. Application of Total Quality Management in Libraries will provide a vital link for managerial decision makers.

  4. Demand: a total nuclear disarmament

    International Nuclear Information System (INIS)

    This bibliographical note presents a book, in which the authors make a plea for a total nuclear disarmament. They think that humanity cannot be found in competition, but in emulation, and examine how we can get rid of the nuclear bomb. They discuss the background of nuclear energy, state that nuclear weapons have always been useless and extremely dangerous, consider arms race as crazy and as a crime against humanity, recall that nuclear weapons already made numerous victims (Hiroshima, Nagasaki, nuclear tests), that they are a sword of Damocles over 7 billions human beings, that nuclear winter would be an apocalypse, that the Non Proliferation Treaty is a decoy. They discuss the political role of nuclear weapons, and outline that the only solution is their abolition. They discuss what has already been done and what is still to be done, and formulate a strategy for the future

  5. Complications after total hip replacement

    International Nuclear Information System (INIS)

    Complications seen after long-term follow-up examinations of total hip replacement should be treated immediately and completely. In the past decade a considerable increase in revisions has been noted. Radiographic assessment may be regarded as an effective means in diagnosing prosthetic complications from the surgeon's point of view. Examples are given. The difficulties in radiographic assessment of complications after cementless implanation or cemented prostheses without contrast media are mentioned. Prosthesis-related complications, such as mechanical loosening, infection with and without loosening, fatigue fractures and wear, fractures of the femur or pelvis, dislocations and surgical failures, are illustrated, as are clinical courses with gross loss of bone stock after repeated surgery and delayed revisions. Complications not related to the prosthesis such as periarticular ossification, muscle deficiencies, and nervous and vascular lesions are also explained using examples. (orig.)

  6. A total safety management model

    International Nuclear Information System (INIS)

    In nuclear organizations, quality and safety are inextricably linked. Therefore, the search for excellence means reaching excellence in nuclear safety. The International Atomic Energy Agency, IAEA, developed, after the Chernobyl accident, the organizational approach for improving nuclear safety based on the safety culture, which requires a framework necessary to provide modifications in personnel attitudes and behaviors in situations related to safety. This work presents a Total Safety Management Model, based on the Model of Excellence of the Brazilian Quality Award and on the safety culture approach, which represents an alternative to this framework. The Model is currently under validation at the Nuclear Engineering Institute, in Rio de Janeiro, Brazil, and the results of its initial safety culture self assessment are also presented and discussed. (author)

  7. Sociologist in the total institution

    Directory of Open Access Journals (Sweden)

    Krstić Željko

    2010-01-01

    Full Text Available On the basis of empirical experience from practical work this paper discusses the real place and role of the sociologist in the prison, as a total institution, where sociologists are employed as educators, along with other professions (psychologists, educationalists, social workers, etc., and usually closely cooperating with lawyers. According to the current work regulations, and on the basis of practice so far, the sociologist can work as classical educator, to be in charge of educational groups of inmates, work in the reception department on assessing incoming inmates, and to organize inmates' leisure time by directing them towards pro-social and creative activities (music, painting, reading, etc.. New reform trends in working with inmates suggest new work methods, such as creative workshops, counselling in the sphere of substance abuse and dependency, or expert teams in working with minors. In the prison, the sociologist is indispensable as a researcher of criminal activities.

  8. Total quality management implementation guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1993-12-01

    These Guidelines were designed by the Energy Quality Council to help managers and supervisors in the Department of Energy Complex bring Total Quality Management to their organizations. Because the Department is composed of a rich mixture of diverse organizations, each with its own distinctive culture and quality history, these Guidelines are intended to be adapted by users to meet the particular needs of their organizations. For example, for organizations that are well along on their quality journeys and may already have achieved quality results, these Guidelines will provide a consistent methodology and terminology reference to foster their alignment with the overall Energy quality initiative. For organizations that are just beginning their quality journeys, these Guidelines will serve as a startup manual on quality principles applied in the Energy context.

  9. Total quality management program planning

    Energy Technology Data Exchange (ETDEWEB)

    Thornton, P.T.; Spence, K.

    1994-05-01

    As government funding grows scarce, competition between the national laboratories is increasing dramatically. In this era of tougher competition, there is no for resistance to change. There must instead be a uniform commitment to improving the overall quality of our products (research and technology) and an increased focus on our customers` needs. There has been an ongoing effort to bring the principles of total quality management (TQM) to all Energy Systems employees to help them better prepare for future changes while responding to the pressures on federal budgets. The need exists for instituting a vigorous program of education and training to an understanding of the techniques needed to improve and initiate a change in organizational culture. The TQM facilitator is responsible for educating the work force on the benefits of self-managed work teams, designing a program of instruction for implementation, and thus getting TQM off the ground at the worker and first-line supervisory levels so that the benefits can flow back up. This program plan presents a conceptual model for TQM in the form of a hot air balloon. In this model, there are numerous factors which can individually and collectively impede the progress of TQM within the division and the Laboratory. When these factors are addressed and corrected, the benefits of TQM become more visible. As this occurs, it is hoped that workers and management alike will grasp the ``total quality`` concept as an acceptable agent for change and continual improvement. TQM can then rise to the occasion and take its rightful place as an integral and valid step in the Laboratory`s formula for survival.

  10. Dosimetry of total body irradiation

    International Nuclear Information System (INIS)

    In the treatment of disseminated malignancies an improvement in the curability and reduction of complication rates require high precision total body irradiation (TBI) and correct reporting of relevant treatment parameters. Optimal TBI dosimetry is the basis. Radiooncological and radiobiological requirements as well as the special physical situation have to be considered. To review the efforts of medical physicists, highlights from TBI workshops and publications are summarized. Additionally, dosimetric data from 34 European radiooncological centres contributing to the recent ESTRO inquiry on TBI are analysed. The topics are: absorbed dose and dose monitor calibration, determination of absolute and relative doses, dose ratios, attenuation data and heterogeneity corrections; TBI dose calculation methods regarding patient position, beam incidence, body shape and thickness, lung size and density; methods of TBI treatment planning including calculated dose modification and of TBI quality assurance. In conclusion, the following recommendations can be given: TBI dosimetry shall be performed under TBI conditions, close to the real treatment situation. The absorbed dose to water must be determined. The dose monitor should be calibrated against dose measurements at the centre of a water equivalent phantom of TBI equivalent size and typical thickness. Photon fluence profiles have to be measured with small phantoms. Influences on the local dose must be investigated systematically. A reproducible AP/PA TBI technique should be used. The TBI dose shall be specified to mid-abdomen and reported in units of gray. The single and total dose and the dose rate to the lungs, the number of fractions and the treatment time schedule must be stated. In vivo dosimetry is required if non-reliable TBI techniques are used. An international TBI dosimetry intercomparison could assist these efforts to improve the treatment of acute leukaemia. (author). 89 refs, 3 figs, 13 tabs

  11. Hypermnesia and total retrieval time.

    Science.gov (United States)

    Mulligan, Neil W

    2006-05-01

    Recall performance sometimes improves over repeated recall attempts, a phenomenon dubbed hypermnesia. A critical theoretical issue is whether hypermnesia is due to repeated testing per se or increased retrieval time. The present experiments investigated by contrasting five testing conditions. All participants were presented with the same study list followed by either two shorter recall tests or a single longer test. In the multiple test conditions, the tests were either separated by a (filled) 7-minute interval (the multiple-split condition), or presented consecutively, with no break (the multiple-immediate condition). In the single test conditions, the test either began at the start of the recall session, after a (filled) 7-minute delay, or with a 7-minute interruption inserted in the middle. The multiple-split condition produced more reminiscence and hypermnesia than the multiple-immediate condition. More importantly, the multiple-split condition produced greater cumulative recall than any of the other conditions (which did not differ among themselves). That is, single and repeated recall tests of equal total duration are not functionally equivalent. PMID:16766451

  12. Total Petroleum Hydrocarbons (TPH): ToxFAQs

    Science.gov (United States)

    ... a state: This map displays locations where Total Petroleum Hydrocarbons (TPH) is known to be present. On ... I get more information? ToxFAQs TM for Total Petroleum Hydrocarbons (TPH) ( Hidrocarburos Totales de Petróleo (TPH) ) August ...

  13. Influence of extraction type on the total phenolics, total flavonoids and total colour change of different varieties of fig extracts

    OpenAIRE

    Jokić, Stela; MUJIĆ, Ibrahim; Bucić-Kojić, Ana; Velić, Darko; Bilić, Mate; Planinić, Mirela; Lukinac, Jasmina

    2014-01-01

    The study examined the influence of ultrasound-assisted extraction and solid-liquid extraction with 80% of aqueous ethanol solution on the total phenolics, total flavonoids and total colour change of extracts from five different varieties of figs (Bjelica, Termenjača, Crnica, Bružetka bijela and Šaraguja). The total phenolic content was determined by using Folin Ciocalteau assay. The content of total flavonoids was measured spectrophotometrically by using the aluminium chloride colourimetric ...

  14. Cataractogenesis after total body irradiation

    International Nuclear Information System (INIS)

    Purpose: To evaluate the prognostic factors and the ophthalmologic follow-up on cataract formation following total body irradiation (TBI) prior to bone marrow transplantation (BMT). Methods and Materials: Between 1980 and 1992, 494 patients were referred to our department for TBI prior to BMT. The mean age was 32 ± 11 (median: 32, range: 2-63) years and the male to female ratio was 1.6 (304:190). The majority of patients were treated for acute leukemia (lymphoblastic, n = 177, 36%; or nonlymphoblastic, n = 139, 28%); 80 (16%) for chronic myeloid leukemia, 60 (12%) for non-Hodgkin's lymphoma, 23 (5%) for multiple myeloma, and 15 (3%) for other malignancies. Two hundred and fifty-four (51%) patients were grafted in the first complete remission (CR), 118 (24%) in second CR. Allogeneic BMT was performed in 210 (43%) patients, and autologous BMT in 284 (57%). Methotrexate combined to steroids (n = 47, 22%) or to cyclosporine (n = 163, 78%) was administered for graft-versus-host disease (GvHD) prophylaxis. In 188 patients (38%), heparin was used in the prevention of veno-occlusive disease (VOD) of the liver. Furthermore, steroid administration was registered in 223 patients (45%). The conditioning chemotherapy consisted of cyclophosphamide (Cy) alone in 332 (67%) patients. Total-body irradiation was administered either in single dose (STBI; 10 Gy in 1 day, n = 291) or in six fractions (FTBI; 12 Gy over 3 consecutive days, n = 203) before BMT. The mean instantaneous dose rate was 0.0574 ± 0.0289 Gy/min (0.024-0.1783). It was < 0.048 Gy/min in 157 patients (LOW group), ≥ 0.048 Gy/min and < 0.09 Gy/min in 301 patients (MEDIUM group), and ≥ 0.09 Gy/min in 36 patients (HIGH group). Results: When considering all patients, 42 (8.5%) patients developed cataracts after 13 to 72 months (median: 42 months) with a 5-year estimated cataract incidence (ECI) of 23%. Thirty-three (11.3%) out of 291 patients in the STBI group, and 9 (4.4%) out of 203 patients in the FTBI group

  15. Niveles de plomo elevados en sangre de niños que vivían en casas antiguas de Evansville, Indiana: asociación entre año de construcción de la casa, niveles de plomo en suelo y niveles de plomo en sangre de niños de 1-5 años, entre 1998-2006 Higher blood lead levels among children living in older homes in Evansville Indiana: associations between year house built, soil lead levels and blood lead levels among children aged 1-5 years - 1998 to 2006 Elevados níveis de chumbo no sangue de crianças que vivem em habitações antigas em Evansville, Indiana: associação entre o ano de construção da casa, níveis de chumbo no solo e níveis de chumbo no sangue de crianças de 1-5 anos, entre 1998 - 2006

    OpenAIRE

    Diane Jackson; Charles Grosse; Gregory M. Zarus; Lourdes Rosales-Guevara

    2012-01-01

    En este estudio se evaluaron los niveles de plomo en 18.218 muestras de sangre. Las muestras de 11.719 niños de Evansville, Indiana, de edades comprendidas entre 1 y 5 años se obtuvieron de manera voluntaria entre los años 1998 y 2006. Se evaluaron además los niveles de plomo en el suelo de 35 jardines residenciales correspondientes al domicilio de 81 niños.Durante el periodo de estudio, tanto los niveles de plomo en sangre como el porcentaje de valores elevados para dichos niveles fueron des...

  16. Olive oil-diet improves the simvastatin effects with respect to sunflower oil-diet in men with increased cardiovascular risk: A preliminary study Las dietas conteniendo aceite de oliva mejoran los efectos de simvastatina respecto a dietas con aceite de girasol en hombres con riesgo cardiovascular elevado: Estudio preliminar

    Directory of Open Access Journals (Sweden)

    F. J. Sánchez-Muniz

    2009-06-01

    órico de la grasa (P = 0,019 y de los AGM (P < 0,001 fue mayor en el grupo que consumía aceite de oliva, mientras que el de AGP (P = 0,001 y alcohol (P = 0,005 fue menor. El cociente colesterol/HDL-colesterol y el riesgo cardiovascular disminuyeron más (P<0.05 en los pacientes consumiendo aceite de oliva. Después de ajustar para IMC y para ingesta caló y de alcohol, el colesterol total y los ratios colesterol/HDL-colesterol y LDL-colesterol/HDL-colesterol y el riesgo cardiovascular ATP-III disminuyeron significativamente más (P < 0,05 en el grupo de aceite de oliva. Conclusiones: Los resultados sugieren que aunque Simvastatina es un fármaco hipolipemiante muy efectivo, la inclusión de aceite de oliva, frente a aceite de girasol, mejora dicho efecto en pacientes con alto riesgo cardiovascular.

  17. A Hierarchy of Totally Ordered Multicasts

    OpenAIRE

    Wilhelm, U. G.; Schiper, A

    1995-01-01

    The increased interest in protocols that provide a total order on message delivery has led to several different definitions of total order. In this paper we investigate these different definitions and propose a hierarchy that helps to better understand the implications of the different possibilities in terms of guarantees and communication cost. We identify two definitions: {\\em weak total order} and {\\em strong total order}, which are at the extremes of the proposed hierarchy, and incorpor...

  18. TOTAL GLOBAL DOMINATION IN FUZZY GRAPH

    OpenAIRE

    Rohini, R.; P.Gladyis; C. V. R. Harinarayanan

    2014-01-01

    Let G be a fuzzy graph without isolated nodes. A subset D of V is said to be a total dominating set if every node in V is dominated by a node in D. A total dominating set D of a graph G= (V,E ) is a total global fuzzy dominating set (t.g.f.d. set) if D is also a total dominating set of G . The total global fuzzy domination number γtgf(G) of G is the minimum cardinality of a t.g.f.d. set for some classes of fuzzy graphs and obtain bounds for the same.

  19. Quality of life (GIQLI and laparoscopic cholecystectomy usefulness in patients with gallbladder dysfunction or chronic non-lithiasic biliary pain (chronic acalculous cholecystitis Calidad de vida (GIQLI y utilidad de la colecistectomía laparoscópica en pacientes con disfunción vesicular o dolor crónico biliar alitiásico (colecistitis crónica alitiásica

    Directory of Open Access Journals (Sweden)

    M. Planells Roig

    2004-07-01

    étodos: evaluación prospectiva de 34 pacientes con el diagnóstico de CCA en comparación con un grupo control de 297 pacientes con CCL. En el presente estudio analizamos: categoría clínica de presentación, repercusión de la enfermedad sobre la calidad de vida determinada mediante el Gastrointestinal Quality of Life Index (GIQLI, cálculo de la utilidad de la intervención terapéutica (incremento de unidades de calidad de vida mediante el GIQLI y efectividad clínica del procedimiento al año de la intervención. Resultados: la incidencia de enfermedad biliar complicada fue superior en el grupo de CCA (27% en comparación con el de CCL (13,8%. El análisis histológico reveló una incidencia de colesterolosis asociada a colecistitis crónica más alta en el grupo de CCA (64,9%. La determinación del GIQLI permitió evidenciar diferencias significativas entre el preoperatorio y el postoperatorio en ambos grupos de pacientes siendo la utilidad del procedimiento similar percentualmente en ambos grupos (73 vs 67.3% implicando una importante mejoría en la calidad de vida de ambos grupos derivada de la intervención terapéutica. Conclusiones: la incidencia de CCA es del 11 por cien en nuestro ambiente con una elevada asociación a colesterolosis en el examen histológico. La repercusión sobre la calidad de vida es comparable a la de la CCL siendo la utilidad de la colecistectomía laparoscópica similar. Dado que la colecistogammagrafía no es un método asequible en la práctica clínica diaria y que la colecistografía oral y la ecografía dinámica son herramientas útiles sólo cuando se obtienen resultados positivos, la evaluación clínica exhaustiva de los pacientes sigue siendo la base que permite la indicación de la CL sin temor al fracaso.

  20. Total Productive Maintenance at Paccar INC

    OpenAIRE

    Ştefan Farkas

    2010-01-01

    This paper reports the application of total productive maintenance method at Paccar Inc. truck’s plant in Victoria, Australia. The total productive maintenance method and total productive maintenance house are presented. The global equipment effectiveness is computed and exemplified. The production structure and organising maintenance are presented. Resultas of the variation of global equipment effectiveness and autonomous maintenance in a two weeks period of time are reported.

  1. Total Productive Maintenance at Paccar INC

    Directory of Open Access Journals (Sweden)

    Ştefan Farkas

    2010-06-01

    Full Text Available This paper reports the application of total productive maintenance method at Paccar Inc. truck’s plant in Victoria, Australia. The total productive maintenance method and total productive maintenance house are presented. The global equipment effectiveness is computed and exemplified. The production structure and organising maintenance are presented. Resultas of the variation of global equipment effectiveness and autonomous maintenance in a two weeks period of time are reported.

  2. Patient Matched Instruments and Total Knee System

    Medline Plus

    Full Text Available Smith & Nephew Technologies: VISIONAIRE™ Patient Matched Instruments and LEGION™ Total Knee System You must have Javascript enabled in your web browser. View Program Transcript Click ...

  3. Total pollution effect of urban surface runoff.

    Science.gov (United States)

    Luo, Hongbing; Luo, Lin; Huang, Gu; Liu, Ping; Li, Jingxian; Hu, Sheng; Wang, Fuxiang; Xu, Rui; Huang, Xiaoxue

    2009-01-01

    For pollution research with regard to urban surface runoff, most sampling strategies to date have focused on differences in land usage. With single land-use sampling, total surface runoff pollution effect cannot be evaluated unless every land usage spot is monitored. Through a new sampling strategy known as mixed stormwater sampling for a street community at discharge outlet adjacent to river, this study assessed the total urban surface runoff pollution effect caused by a variety of land uses and the pollutants washed off from the rain pipe system in the Futian River watershed in Shenzhen City of China. The water quality monitoring indices were COD (chemical oxygen demand), TSS (total suspend solid), TP (total phosphorus), TN (total nitrogen) and BOD (biochemical oxygen demand). The sums of total pollution loads discharged into the river for the four indices of COD, TSS, TN, and TP over all seven rainfall events were very different. The mathematical model for simulating total pollution loads was established from discharge outlet mixed stormwater sampling of total pollution loads on the basis of four parameters: rainfall intensity, total land area, impervious land area, and pervious land area. In order to treat surface runoff pollution, the values of MFF30 (mass first flush ratio) and FF30 (first 30% of runoff volume) can be considered as split-flow control criteria to obtain more effective and economical design of structural BMPs (best management practices) facilities. PMID:19999964

  4. Generalized gravitational entropy from total derivative action

    Science.gov (United States)

    Dong, Xi; Miao, Rong-Xin

    2015-12-01

    We investigate the generalized gravitational entropy from total derivative terms in the gravitational action. Following the method of Lewkowycz and Maldacena, we find that the generalized gravitational entropy from total derivatives vanishes. We compare our results with the work of Astaneh, Patrushev, and Solodukhin. We find that if total derivatives produced nonzero entropy, the holographic and the field-theoretic universal terms of entanglement entropy would not match. Furthermore, the second law of thermodynamics could be violated if the entropy of total derivatives did not vanish.

  5. Generalized Gravitational Entropy from Total Derivative Action

    CERN Document Server

    Dong, Xi

    2015-01-01

    We investigate the generalized gravitational entropy from total derivative terms in the gravitational action. Following the method of Lewkowycz and Maldacena, we find that the generalized gravitational entropy from total derivatives vanishes. We compare our results with the work of Astaneh, Patrushev, and Solodukhin. We find that if total derivatives produced nonzero entropy, the holographic and the field-theoretic universal terms of entanglement entropy would not match. Furthermore, the second law of thermodynamics could be violated if the entropy of total derivatives did not vanish.

  6. Betões eco-eficientes com elevados teores de adições minerais

    OpenAIRE

    Campos, Pedro Gabriel da Silva

    2012-01-01

    Dissertação de mestrado integrado em Engenharia Civil É do conhecimento geral que cada tonelada de cimento produzida é responsável pela emissão de uma tonelada de CO2 para a atmosfera e, considerando o gigantesco volume de cimento produzido mundialmente, qualquer redução significativa na sua produção e consumo, trará vantagens ecológicas significativas. De modo a contribuir para sustentabilidade da construção, a presente dissertação pretende dar um contributo para a redução ...

  7. Design de estruturas têxteis com elevado desempenho fisiológico

    OpenAIRE

    Monteiro, Cátia Sofia Neves

    2009-01-01

    Nos últimos anos, as indústrias têxtil e do vestuário têm exercido grandes esforços para melhorar os resultados em termos de produtividade e competitividade. As exigências dos consumidores em relação aos produtos adquiridos acompanharam as mudanças das tendências da moda. Os consumidores procuram cada vez mais vestuário dito funcional, isto é, com funções acrescidas, com maior qualidade e, consequentemente, com maior valor acrescentado. Sendo a sensação de conforto num...

  8. Tratamiento de agua residual con elevado contenido de nitratos utilizando reactores biomembrana aireados

    OpenAIRE

    Lolmede, Ph.; Jácome, Alfredo; Vidart, T.; Tejero, I.

    2000-01-01

    Se describe la eliminación conjunta de carbono y nitrógeno de un agua residual, llevada a cabo en reactores biomembrana de laboratorio. El agua residual sintética tuvo una composición similar a la que resultaría de la mezcla, en determinadas proporciones, de agua residual urbana con agua de acuífero rica en nitratos. Se utilizaron dos reactores en paralelo, con igual superficie de soporte pero distinto volumen. Aunque se insufló aire a la biopelícula a través del soporte, el seno del agua ...

  9. Timing the total reflection of light

    International Nuclear Information System (INIS)

    We have identified for the first time the absolute delay at total reflection, envisioned by Newton. We show that there are in fact two divergent Wigner delays, depending on the polarisation of the incident light. These measurements give a new insight on the passage from total reflection to refraction

  10. Total cardiovascular disease risk assessment: a review.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2011-09-01

    The high risk strategy for the prevention of cardiovascular disease (CVD) requires an assessment of an individual\\'s total CVD risk so that the most intensive risk factor management can be directed towards those at highest risk. Here we review developments in the assessment and estimation of total CVD risk.

  11. Sexuality after total vs. subtotal hysterectomy

    DEFF Research Database (Denmark)

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

    2004-01-01

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

  12. A note on totally normal spaces

    International Nuclear Information System (INIS)

    In this note we give the necessary and sufficient condition for a topological space X such that the product space X x Y is totally normal for any (non discrete) metric space Y, and we show that a totally normal p-space need not be a perfectly normal in general, which makes Theorem 2 doubtful. (author). 6 refs

  13. Simultaneous and staged bilateral total hip arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Joergensen, Christoffer Calov; Husted, Henrik;

    2013-01-01

    Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days...

  14. 75 FR 22418 - FHA TOTAL Mortgage Scorecard

    Science.gov (United States)

    2010-04-28

    ... URBAN DEVELOPMENT FHA TOTAL Mortgage Scorecard AGENCY: Office of the Chief Information Officer, HUD... samples at FHA's request, and appeals in writing for loss of privilege to use the scorecard. DATES... following information: Title of Proposal: FHA TOTAL Mortgage Scorecard. OMB Approval Number: 2502-0556....

  15. Comparison of Recent Total Irradiance Measurements

    Science.gov (United States)

    Helizon, R.; Pap, J.

    2002-12-01

    Total solar irradiance has been measured since 1978 from various satellites. Since the absolute accuracy of the current irradiance measurements is about 0.2%, one needs to compile composite irradiance time series to study long-term changes and to establish whether there are any secular variations over the last two and half decades. In this paper we compare the UARS/ACRIM II and SOHO/VIRGO total irradiance data as well as the SOHO/VIRGO and ACRIM III total irradiance. Our main goal is to validate the newly processed ACRIM II total irradiance. Comparison of the SOHO/VIRGO and ACRIM III data will also help to establish whether the high total irradiance values for the maximum of solar cycle 23 represent real solar, rather than, instrumental events.

  16. Total dominator chromatic number of a graph

    Directory of Open Access Journals (Sweden)

    Adel P. Kazemi

    2015-06-01

    Full Text Available Given a graph $G$, the total dominator coloring problem seeks a proper coloring of $G$ with the additional property that every vertex in the graph is adjacent to all vertices of a color class. We seek to minimize the number of color classes. We initiate to study this problem on several classes of graphs, as well as finding general bounds and characterizations. We also compare the total dominator chromatic number of a graph with the chromatic number and the total domination number of it.

  17. (d,1)-total labelling of graphs

    OpenAIRE

    Havet, Frédéric; Yu, Min-Li

    2002-01-01

    A $(d,1)$-total labelling of a graph $G$ is an assignment of integers to $V(G)\\cup E(G)$ such that: (i) any two adjacent vertices of $G$ receive distinct integers, (ii) any two adjacent edges of $G$ receive distinct integers, and (iii) a vertex and its incident edge receive integers that differ by at least $d$ in absolute value. The {\\it span} of a $(d,1)$-total labelling is the maximum difference between two labels. The minimum span of a $(d,1)$-total labelling of $G$ is denoted by $\\lambda_...

  18. Synchronous pyoderma gangrenosum and inflammatory bowel disease, healing after total proctocolectomy Pioderma gangrenoso associado a doença inflamatória intestinal, com resolução após proctocolectomia total

    Directory of Open Access Journals (Sweden)

    Pedro Andrade

    2012-08-01

    Full Text Available We present a female patient observed with painful violaceous plaques with central bullae and pustules on the lower limbs, rapidly transformed into ulcers, associated with bloody diarrhea, recurrent oral erosions and hyperthermia in the previous 3 months. Cutaneous biopsy was consistent with pyoderma gangrenosum, and intestinal diagnostic procedures revealed a non-classifiable inflammatory bowel disease with high x-ANCA titers. Soon after admission the patient was submitted to total proctocolectomy following colonic perforation. Complete ulcer healing occurred three months after surgery, without recurrence. Pyoderma gangrenosum is a rare dermatosis frequently associated with inflammatory bowel disease. This case is particularly interesting for the synchronic clinical presentation of cutaneous and intestinal diseases, but also for the prompt regression of the former after total proctocolectomy.Apresentamos uma paciente do sexo feminino observada com múltiplas placas violáceas dolorosas dos membros inferiores, com bolhas e pústulas evoluindo rapidamente para lesões ulceradas, surgindo no contexto de diarreia sanguinolenta, erosões orais recorrentes e febre com três meses de evolução. A biópsia cutânea foi compatível com pioderma gangrenoso; o estudo complementar revelou doença inflamatória intestinal inclassificável com títulos elevados de x-ANCA. Após perfuração cólica, a doente foi submetida a proctocolectomia total, com rápida cicatrização das lesões cutâneas ulceradas em três meses, sem recorrência. O pioderma gangrenoso é uma dermatose rara frequentemente associada a doença inflamatória intestinal. É interessante verificar neste caso a apresentação clínica sincrónica das doenças cutânea e intestinal, bem como a rápida resolução da primeira após proctocolectomia total.

  19. Waardenburg's syndrome associated with total aganglionosis.

    OpenAIRE

    Farndon, P A; Bianchi, A.

    1983-01-01

    A Pakistani child of consanguineous parents had signs of Waardenburg's syndrome and total intestinal aganglionosis. This association seems to be a distinct clinical entity with an autosomal recessive mode of inheritance.

  20. Patient Matched Instruments and Total Knee System

    Medline Plus

    Full Text Available Smith & Nephew Technologies: VISIONAIRE™ Patient Matched Instruments and LEGION™ Total Knee System You must have Javascript enabled in your web browser. View Program Transcript Click Here to view the OR-Live, Inc. Privacy Policy and Legal ...

  1. Enantioselective Total Synthesis of (+)-Gliocladin C

    OpenAIRE

    Overman, Larry E.; Shin, Youseung

    2007-01-01

    The first total synthesis of gliocladin C, a fungal-derived marine alkaloid containing a rare trioxopiperazine fragment, is reported. This asymmetric synthesis establishes the absolute configuration of this structurally novel natural product.

  2. Concise Enantiospecific Total Synthesis of Tubingensin A

    OpenAIRE

    Goetz, Adam E.; Silberstein, Amanda L.; Corsello, Michael A.; Garg, Neil K.

    2014-01-01

    We report the enantiospecific total synthesis of (+)-tubingensin A. Our synthesis features an aryne cyclization to efficiently introduce the vicinal quaternary stereocenters of the natural product and proceeds in only nine steps (longest linear sequence) from known compounds.

  3. Total Knee System with Patient Matched Instrumentation

    Medline Plus

    Full Text Available LEGION™ Total Knee System with VISIONAIRE™ Patient Matched Instrumentation You must have Javascript enabled in your web browser. View Program Transcript Click Here to view the OR-Live, Inc. ...

  4. Total Synthesis of (±)-Hibiscone C

    OpenAIRE

    Ungureanu, Sinziana; Meadows, Maggie; Smith, Joel; Duff, David B.; Burgess, James M.; Goess, Brian C.

    2011-01-01

    A total synthesis of (±)- hibiscone C, one member of the furanosteroid family of natural products that also includes viridin and wortmannin, is reported. Two new pathways for formation of the key diacyl furan subunit are described.

  5. US-Total Electron Content Product (USTEC)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The US Total Electron Content (US-TEC) product is designed to specify TEC over the Continental US (CONUS) in near real-time. The product uses a Kalman Filter data...

  6. Total Hip Replacement (Arthroplasty) (Beyond the Basics)

    Science.gov (United States)

    ... stiffening caused by extra bone formation, also called heterotopic ossification, is a process in which some soft ... replacement (prosthetic) parts, with the goal of relieving pain and improving function. ● Most patients require total hip ...

  7. NESDIS Blended Total Precipitable Water (TPW) Products

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The blended Total Precipitable Water (TPW) product is derived from multiple sensors/satellites. The Percentage of TPW normal (PCT), or TPW anomaly, shows the...

  8. Total renewable energy self-sufficiency strategy

    International Nuclear Information System (INIS)

    To meet required electrical power and transportation fuel, a total renewable energy self-sufficiency strategy needs to be envisaged that will not add to the degradation of our environment. (author). 6 refs., 2 tabs

  9. The total plasmatic estriol on normal gestation

    International Nuclear Information System (INIS)

    The total plasmatic estriol in normal pregnants was determinated by radioimmunological method using estriol labelled with sup(125)I. The obtained results presented similar results in comparison with methods using sup(19)C and sup(3)H. (author)

  10. TOTAL REWARDS MODEL IN ROMANIAN COMPANIES

    Directory of Open Access Journals (Sweden)

    Elena-Sabina HODOR

    2014-04-01

    Full Text Available Total Rewards Management is a subject of major importance for companies, because, by using models for this, firms can achieve their objectives of high performance. In order to analyse a validated total rewards model in Romanian Accounting and Consulting Companies, it is used The WorldatWork Total Rewards Model, which depict what contributes to applicant attraction and employee motivation and retention. Thus, the methodology of the previous survey is adjusted to the local context. The conclusions for the methodological aspects illustrate that the present research involves three strategic steps in order to achieve the objectives presented: the analysis of organizational environment of the companies from the sample, checking if Total Rewards Model proposed in the previous research is applicable for the same romanian companies from the previous survey, the analysing of the differences between results, and, if necessary, the adaptation of the model for Romania.

  11. The First Total Synthesis of Isoliquiritin

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    A first total synthesis of isoliquiritin was accomplished starting from p-hydroxy- benzaldehyde and 2,4-dihydroxyacetylphenone. The key step is condensation reaction. In synthetic process need not protect the hydroxy group of reacting substance.

  12. ROE Total Nitrogen Deposition 1989-1991

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset identifies the amount of wet, dry, and total deposition of nitrogen in kilograms per hectare from 1989 to 1991 at a set of point locations across the...

  13. Total lymphoid irradiation in alloimmunity and autoimmunity

    Energy Technology Data Exchange (ETDEWEB)

    Strober, S.

    1987-12-01

    Total lymphoid irradiation has been used as an immunosuppressive regimen in autoimmune disease and organ transplantation. The rationale for its use originated from studies of patients with Hodgkin disease, in whom this radiotherapy regimen was noted to induce profound and long-lasting immune suppression and yet was well tolerated, with few long-term side effects. Total lymphoid irradiation is a unique immunosuppressive regimen that produces a selective (and long-lasting) reduction in the number and function of helper T cells and certain subsets of B cells. Conventional immunosuppressive drugs show little selectivity, and their effects are short-lived. The most important aspect of total lymphoid irradiation is the potential for achieving transplantation tolerance and permanent remissions in autoimmune disease in laboratory animals. Attempts are being made to achieve similar goals in humans given total lymphoid irradiation, so that immunosuppressive drugs can be ultimately withdrawn from transplant recipients and patients with lupus nephritis. 28 references.

  14. ROE Total Nitrogen Deposition 2011-2013

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset identifies the amount of wet, dry, and total deposition of nitrogen in kilograms per hectare from 2011 to 2013 at a set of point locations across the...

  15. ROE Total Sulfur Deposition 1989-1991

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset identifies the amount of wet, dry, and total deposition of sulfur in kilograms per hectare from 1989 to 1991 at a set of point locations across the...

  16. A scheme for total quantum teleportation

    OpenAIRE

    DelRe, E.; Crosignani, B.; Di Porto, P.

    1999-01-01

    We address the issue of totally teleporting the quantum state of an external particle, as opposed to studies on partial teleportation of external single-particle states, total teleportation of coherent states and encoded single-particle states, and intramolecular teleportation of nuclear spin states. We find a set of commuting observables whose measurement directly projects onto the Bell-basis and discuss a possible experiment, based on two-photon absorption, allowing, for the first time, tot...

  17. A strategic zone for Total's future

    International Nuclear Information System (INIS)

    In 1997, the Total company investments in the Middle East reached 1.2 billions of French Francs. This region is considered as a major growth zone by the French group. This paper summarizes the Total's participations in oil and gas activities and partnerships of Middle East countries (Abu Dhabi, Dubai, Oman, Qatar, Yemen): exploration, production, development, contracts, permits, technical assistance etc.. (J.S.)

  18. Postoperative Autologous Reinfusion in Total Knee Replacement

    OpenAIRE

    A. Crescibene; Martire, F.; Gigliotti, P.; Rende, A.; Candela, M

    2015-01-01

    Surgeries for total knee replacement (TKR) are increasing and in this context there is a need to develop new protocols for management and use of blood transfusion therapy. Autologous blood reduces the need for allogeneic blood transfusion and the aim of the present study was to verify the safety and the clinical efficacy. An observational retrospective study has been conducted on 124 patients, undergoing cemented total knee prosthesis replacement. Observed population was stratified into two g...

  19. The Error in Total Error Reduction

    OpenAIRE

    Witnauer, James E.; Urcelay, Gonzalo P.; Miller, Ralph R.

    2013-01-01

    Most models of human and animal learning assume that learning is proportional to the discrepancy between a delivered outcome and the outcome predicted by all cues present during that trial (i.e., total error across a stimulus compound). This total error reduction (TER) view has been implemented in connectionist and artificial neural network models to describe the conditions under which weights between units change. Electrophysiological work has revealed that the activity of dopamine neurons i...

  20. Total Quality Service and the Business College

    OpenAIRE

    James Perotti

    1995-01-01

    Moving a business college to commit to a total quality service approach is much more difficult than the literature suggests. The commitment to customer satisfaction is the essential focus of total quality service. It is unlikely to occur in business colleges. While small incremental change is readily possible, the values and culture of the faculty and administration prevent the requisite acceptance by the faculty of students as their customers, and acceptance of the faculty as customers of th...

  1. Severe Heterotopic Ossification following Total Knee Replacement

    OpenAIRE

    Dodds, Alexander L.; Keene, Gregory C. R.

    2014-01-01

    Although the incidence of minor heterotopic ossification is probably higher than what is usually expected, severe heterotopic ossification (HO) is an extremely rare event following total knee replacement surgery. We present the case of a 66-year-old woman who initially had achieved an excellent range of motion following bilateral uncemented rotating platform total knee replacement, before presenting with pain and loss of range of motion at 2 months after surgery. Severe HO was diagnosed on X-...

  2. Photoproduction total cross section and shower development

    Science.gov (United States)

    Cornet, F.; García Canal, C. A.; Grau, A.; Pancheri, G.; Sciutto, S. J.

    2015-12-01

    The total photoproduction cross section at ultrahigh energies is obtained using a model based on QCD minijets and soft-gluon resummation and the ansatz that infrared gluons limit the rise of total cross sections. This cross section is introduced into the Monte Carlo system AIRES to simulate extended air showers initiated by cosmic ray photons. The impact of the new photoproduction cross section on common shower observables, especially those related to muon production, is compared with previous results.

  3. Photoproduction total cross section and shower development

    CERN Document Server

    Cornet, F; Grau, A; Pancheri, G; Sciutto, S J

    2015-01-01

    The total photoproduction cross section at ultra-high energies is obtained using a model based on QCD minijets and soft-gluon resummation and the ansatz that infrared gluons limit the rise of total cross sections. This cross section is introduced into the Monte Carlo system AIRES to simulate extended air-showers initiated by cosmic ray photons. The impact of the new photoproduction cross section on common shower observables, especially those related to muon production, is compared with previous results.

  4. Analysis and Accounting of Total Cash Flow

    OpenAIRE

    MELANIA ELENA MICULEAC

    2012-01-01

    In order to reach the objective of supplying some relevant information regarding the liquidity inflows and outflows during a financial exercise, the total cash flow analysis must include the analysis of result cashable from operation, of payments and receipts related to the investment and of financing decisions of the last exercise, as well as the analysis of treasury variation (of cash items). The management of total cash flows ensures the correlation of current liquidness flows as consequen...

  5. Effects of xenobiotics on total antioxidant capacity

    OpenAIRE

    Ferrari, Carlos Kusano Bucalen

    2012-01-01

    The objective of this article was to review the effects of xenobiotics on total antioxidant capacity (TAC). Measurement of TAC is appropriate for evaluation of the total antioxidant defenses of blood, cells, and different kinds of tissues and organs. TAC is reduced by alcoholism, smoking, and exposure to radiation, herbicides, carbon monoxide, carbon tetrachloride, lead, arsenic, mercury, cadmium, aluminum, and other toxic elements. The test is also an important tool in evaluating environment...

  6. Total Ownership Cost -- Tools and Discipline

    OpenAIRE

    Boudreau, Mike; Naegle, Brad

    2011-01-01

    Sponsored Report (for Acquisition Research Program) Control of total ownership cost (TOC) is a continuing initiative to manage costs over the entire life cycle of a weapon system. There are several major categories of costs that contribute to Total Ownership Cost but the principal categories are (1) R&D, (2) Production, (3) Operating and Support, and (4) Disposal. System TOC is the same as Life Cycle Cost (LCC) and must be planned and controlled from requirements definition, system develop...

  7. Management of complications after total shoulder arthroplasty

    OpenAIRE

    Josef K Eichinger; Galvin, Joseph W.

    2015-01-01

    The outcomes of total shoulder arthroplasty (TSA) for painful arthritis of the glenohumeral joint are excellent with significant improvement in pain and function. Increased use of total shoulder arthroplasty over the past decade has led to identification of common complications. Although the complication rate is low, accurate and timely diagnosis, appropriate management, and implementation of methods for prevention are critical to a successful long-term outcome. The most common complications ...

  8. Discrete Total Variation: New Definition and Minimization

    OpenAIRE

    Condat, Laurent

    2016-01-01

    We propose a new definition for the gradient field of a discrete image, defined on a twice finer grid. The differentiation process from the image to its gradient field is viewed as the inverse operation of linear integration, and the proposed mapping is nonlinear. Then, we define the total variation of an image as the l1 norm of its gradient field amplitude. This new definition of the total variation yields sharp edges and has better isotropy than the classical definition.

  9. The Challenge of Total Factor Productivity

    OpenAIRE

    Erwin Diewert

    2000-01-01

    In this article, as part of the symposium on total factor productivity, Erwin Diewert of the University of British Columbia provides a comprehensive discussion of what is needed to develop reliable measures of total factor productivity in terms of output and the different classes of inputs. He concludes that the current system of industry statistics in all advanced countries has not kept up with the evolution of the economy from primary and manufacturing production to the production of servic...

  10. Brauer-Thrall for totally reflexive modules

    CERN Document Server

    Christensen, Lars Winther; Rahmati, Hamidreza; Striuli, Janet; Wiegand, Roger

    2010-01-01

    Let R be a commutative noetherian local ring that is not Gorenstein. It was recently discovered that the category of totally reflexive modules over R is representation infinite, provided that it contains a non-free module. The main goal of this paper is to understand how complex the category of totally reflexive modules can be in this situation. Local rings (R,m) with m^3=0 are commonly regarded as the structurally simplest rings to admit diverse categorical and homological characteristics. For such rings we obtain conclusive results about the category of totally reflexive modules, modeled on the Brauer-Thrall conjectures. Starting from a non-free cyclic totally reflexive module, we construct a family of indecomposable totally reflexive R-modules that contains, for every n in N, a module that is minimally generated by n elements. Moreover, if the residue field R/m is algebraically closed, then we construct for every n in N an infinite family of indecomposable and pairwise non-isomorphic totally reflexive R-mo...

  11. Total lymphoid irradiation and discordant cardiac xenografts

    International Nuclear Information System (INIS)

    Total lymphoid irradiation can prolong concordant cardiac xenografts. The effects of total lymphoid irradiation in a discordant xenograft model (guinea pig to rat) were studied with and without adjuvant pharmacologic immunosuppression. Inbred Lewis rats were randomly allocated to one of four groups. Group 1 (n = 6) served as a control group and rats received no immunosuppression. Group 2 (n = 5) received triple-drug therapy that consisted of intraperitoneal azathioprine (2 mg/kg), cyclosporine (20 mg/kg), and methylprednisolone (1 mg/kg) for 1 week before transplantation. Group 3 animals (n = 5) received 15 Gy of total lymphoid irradiation in 12 divided doses over a 3-week period. Group 4 (n = 6) received both triple-drug therapy and total lymphoid irradiation as described for groups 2 and 3. Complement-dependent cytotoxicity assay was performed to determine if a correlation between complement-dependent cytotoxicity and rejection-free interval existed. Rejection was defined as cessation of graft pulsation and was confirmed by histologic test results. Only groups 1 and 2 showed a difference in survival (group 1, 6.9 +/- 1.0 minutes; group 2, 14.2 +/- 2.7 minutes, p = 0.02). Although total lymphoid irradiation did decrease complement-dependent cytotoxicity, linear regression revealed no correlation between complement-dependent cytotoxicity and graft survival (coefficient of correlation, 0.30). Unlike concordant cardiac xenografts, total lymphoid irradiation with or without triple-drug therapy does not prolong graft survival

  12. Total lymphoid irradiation and discordant cardiac xenografts

    Energy Technology Data Exchange (ETDEWEB)

    Kaplan, E.; Dresdale, A.R.; Diehl, J.T.; Katzen, N.A.; Aronovitz, M.J.; Konstam, M.A.; Payne, D.D.; Cleveland, R.J. (Tufts Univ. School of Medicine, Boston, MA (USA))

    1990-01-01

    Total lymphoid irradiation can prolong concordant cardiac xenografts. The effects of total lymphoid irradiation in a discordant xenograft model (guinea pig to rat) were studied with and without adjuvant pharmacologic immunosuppression. Inbred Lewis rats were randomly allocated to one of four groups. Group 1 (n = 6) served as a control group and rats received no immunosuppression. Group 2 (n = 5) received triple-drug therapy that consisted of intraperitoneal azathioprine (2 mg/kg), cyclosporine (20 mg/kg), and methylprednisolone (1 mg/kg) for 1 week before transplantation. Group 3 animals (n = 5) received 15 Gy of total lymphoid irradiation in 12 divided doses over a 3-week period. Group 4 (n = 6) received both triple-drug therapy and total lymphoid irradiation as described for groups 2 and 3. Complement-dependent cytotoxicity assay was performed to determine if a correlation between complement-dependent cytotoxicity and rejection-free interval existed. Rejection was defined as cessation of graft pulsation and was confirmed by histologic test results. Only groups 1 and 2 showed a difference in survival (group 1, 6.9 +/- 1.0 minutes; group 2, 14.2 +/- 2.7 minutes, p = 0.02). Although total lymphoid irradiation did decrease complement-dependent cytotoxicity, linear regression revealed no correlation between complement-dependent cytotoxicity and graft survival (coefficient of correlation, 0.30). Unlike concordant cardiac xenografts, total lymphoid irradiation with or without triple-drug therapy does not prolong graft survival.

  13. 38 CFR 3.340 - Total and permanent total ratings and unemployability.

    Science.gov (United States)

    2010-07-01

    ... impairment of mind or body which is sufficient to render it impossible for the average person to follow a... Evaluations; Service Connection § 3.340 Total and permanent total ratings and unemployability. (a)...

  14. Usefulness of magnetic resonance cholangiography in the diagnosis of biliary tract lesions in patients with suspected complication following cholecystectomy; Valor da colangiopancreatografia por ressonancia magnetica no diagnostico de lesoes das vias biliares em pacientes com suspeita de complicacao pos-colecistectomia

    Energy Technology Data Exchange (ETDEWEB)

    Cecin, Alexandre de Oliveira [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil); Goldman, Suzan Menasce; Caetano, Simone; Rosas, George de Queiroz; Coelho, Rafael Darahem de Souza [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem; Lobo, Edson Jose [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Gastroenterologia Cirurgica; Abdalla, Nitamar; Szejnfeld, Jacob [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem

    2005-01-15

    Objective: to determine the usefulness of magnetic resonance cholangiopancreatography (MRCP) in the diagnoses of bile duct injuries following cholecystectomy. Material and method: MRCP was retrospectively evaluated in 40 patients with suspected bile duct injury after laparoscopic or conventional cholecystectomy. Eight of these patients had been submitted to biliary reconstruction. All patients were symptomatic (jaundice, fever and chills, weight loss and abdominal pain). The scans were independently reviewed by two radiologists. The results were confirmed by surgery, percutaneous drainage, endoscopic retrograde cholangiopancreatography and clinical follow-up. The level and severity of bile duct injury were rated according to the Bismuth classification. Results: in a total of 40 symptomatic patients, 10 (25%) had normal findings on MRCP; Postoperative complications were seen in 29 (72.5%) patients, seven of them with more than one finding. Pancreatic head neoplasia was diagnoses in one patient. The most frequent finding was sclerosing (41.4%) followed by biliary duct stenosis (34.5%), residual or recurrent biliary stones (31.0%) and fluid collections (17.2%). The images obtained by MRCP were considered of good quality. Conclusion: MRCP is an effective method for the evaluation of patients with suspected postcholecystectomy biliary tract complications. (author)

  15. Cataract incidence after total-body irradiation

    International Nuclear Information System (INIS)

    Purpose: Aim of this retrospective study was to evaluate cataract incidence in a homogeneous group of patients after total-body irradiation followed by autologous bone marrow transplantation or peripheral blood stem cell transplantation. Method and Materials: Between 11/1982 and 6/1994 in total 260 patients received in our hospital total-body irradiation for treatment of haematological malignancy. In 1996-96 patients out of these 260 patients were still alive. 85 from these still living patients (52 men, 33 women) answered evaluable on a questionnaire and could be examined ophthalmologically. Median age of these patients was 38,5 years (15 - 59 years) at time of total-body irradiation. Radiotherapy was applied as hyperfractionated total-body irradiation with a median dose of 14,4 Gy in 12 fractions over 4 days. Minimum time between fractions was 4 hours, photons with a energy of 23 MeV were used, and the dose rate was 7 - 18 cGy/min. Results: Median follow-up is now 5,8 years (1,7 - 13 years). Cataract occurred in (28(85)) patients after a median time of 47 months (1 - 104 months). In 6 out of these 28 patients who developed a cataract, surgery of the cataract was performed. Whole-brain irradiation prior to total-body irradiation was more often in the group of patients developing a cataract (14,3%) vs. 10,7% in the group of patients without cataract. Conclusion: Cataract is a common side effect of total-body irradiation. Cataract incidence found in our patients is comparable to results of other centres using a fractionated regimen for total-body irradiation. The hyperfractionated regimen used in our hospital does obviously not result in a even lower cataract incidence. In contrast to acute and late toxicity in other organ/organsystems, hyperfractionation of total-body irradiation does not further reduce toxicity for the eye-lens. Dose rate may have more influence on cataract incidence

  16. Total lymphoid irradiation of intractable rheumatoid arthritis

    International Nuclear Information System (INIS)

    Eleven patients with intractable rheumatoid arthritis were treated with fractionated total lymphoid irradiation, (total dose 20 Gy). Lasting improvement in clinical symptoms was found in four patients during treatment and the remaining patients experienced similar benefit within 2 months of irradiation. There was marked reduction in exacerbations and number of joints involved. Morning stiffness, joint swelling and tenderness decreased. Complications included severe fatigue during treatment and acute bacterial arthritis in multiple joints in one patient. Four patients have since died, one of renal failure, another of cardiogenic shock following surgery 3 and 24 months after total lymphoid irradiation. Both had generalised amyloidosis. The third patient developed joint empyema and died of toxic cardiac failure. The fourth died 3 months after resection of a Kaposi's sarcoma complicated by wound infection which responded to treatment. Immunologically, total lymphoid irradiation resulted in suppression of the absolute lymphocyte count and reduction in T-helper cells, the number of T-suppressor cells remaining unchanged. These data provide evidence of T-cell involvement in the pathogenesis of rheumatoid arthritis. Total lymphoid irradiation can induce sustained improvement in clinical disease activity, but severe, possibly fatal, side-effects cannot be ignored. (author)

  17. Current status of permanent total artificial hearts.

    Science.gov (United States)

    Davis, P K; Rosenberg, G; Snyder, A J; Pierce, W S

    1989-01-01

    Pneumatic total artificial heats, although demonstrating utility as temporary mechanical circulatory support devices, have not demonstrated a great deal of promise as permanent cardiac replacements. The increasing number of patients who would be candidates for total heart replacement suggests a large role for a permanent implantable total artificial heart. To that end, the Pennsylvania State University is developing an electric motor-driven total artificial heart; the results with implants in calves are encouraging. In this device, a roller-screw mechanism is used to translate the rotation of a brushless direct-current motor into rectilinear motion of a pusher-plate assembly, which in turn empties the blood sacs. The total artificial heart of the future will function under automatic control without percutaneous leads, and this should provide the patient with a nearly normal life-style. Although further experimental efforts are necessary to prepare the device for clinical trials, the technology to provide a safe and reliable electric blood-pump system is at hand. PMID:2912392

  18. Assay development status report for total cyanide

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, B.C. [Westinghouse Hanford Co., Richland, WA (United States); Jones, T.E.; Pool, K.H. [Pacific Northwest Lab., Richland, WA (United States)

    1993-02-01

    A validated cyanide assay that is applicable to a variety of tank waste matrices is necessary to resolve certain waste tank safety issues and for purposes of overall waste characterization. The target for this effort is an assay with an applicable range of greater than 1,000 ppM (0.10 wt%) total cyanide and a confidence level greater than 80%. Figure 1 illustrates the operating regime of the proposed cyanide assay method. The Assay Development Status Report for Total Cyanide will summarize the past experience with cyanide analyses on-tank waste matrices and will rate the status of the analytical methods used to assay total cyanide (CN{sup {minus}} ion) in the tank waste matrices as acceptable or unacceptable. This paper will also briefly describe the current efforts for improving analytical resolution of the assays and the attempts at speciation.

  19. Severe Heterotopic Ossification following Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Alexander L. Dodds

    2014-01-01

    Full Text Available Although the incidence of minor heterotopic ossification is probably higher than what is usually expected, severe heterotopic ossification (HO is an extremely rare event following total knee replacement surgery. We present the case of a 66-year-old woman who initially had achieved an excellent range of motion following bilateral uncemented rotating platform total knee replacement, before presenting with pain and loss of range of motion at 2 months after surgery. Severe HO was diagnosed on X-rays. Treatment consisted of nonoperative measures only, including physiotherapy with hydrotherapy and anti-inflammatories. She eventually regained her range of motion when seen at 8 months after operation. This case illustrates that nonoperative treatment without the use of radiotherapy or surgery can be used to safely resolve stiffness caused by HO after total knee replacement.

  20. Heterotopic bone formation following total shoulder arthroplasty

    DEFF Research Database (Denmark)

    Kjaersgaard-Andersen, P.; Frich, Lars Henrik; Sjøbjerg, J.O.;

    1989-01-01

    the glenohumeral and/or the glenoacromial space. There was no correlation between shoulder pain and the development of ossification. Shoulders with grade III heterotopic bone formation had a limited range of active elevation compared with shoulders without or with only a milder lesion. Men and......The incidence and location of heterotopic bone formation following total shoulder arthroplasty were evaluated in 58 Neer Mark-II total shoulder replacements. One year after surgery, 45% had developed some ectopic ossification. In six shoulders (10%) the ossifications roentgenographically bridged...... patients with osteoarthritis of the shoulder joint were significantly disposed to the development of heterotopic bone. Heterotopic bone formation following total shoulder arthroplasty is frequent, but disabling heterotopic ossifications seem to be rare....

  1. Total reflection X-ray fluorescence analysis

    International Nuclear Information System (INIS)

    In the past few years, total reflection X-ray flourescence analysis (TXRF) has found an increasing number of assignments and applications. Experience of trace element analysis using TXRF and examples of applications are already widespread. Therefore, users of TXRF had the opportunity of an intensive exchange of their experience at the 1st workshop on total reflection X-ray fluorescence analysis which took place on May 27th and 28th 1986 at the GKSS Research Centre at Geesthacht. In a series of lectures and discussions dealing with the analytical principle itself, sample preparation techniques and applications as well as comuter programs for spectrum evaluation, the present state of development and the range of applications were outlined. 3 studies out of a total of 14 were included separately in the INIS and ENERGY databases. With 61 figs., 12 tabs

  2. Total quality management in orthodontic practice.

    Science.gov (United States)

    Atta, A E

    1999-12-01

    Quality is the buzz word for the new Millennium. Patients demand it, and we must serve it. Yet one must identify it. Quality is not imaging or public relations; it is a business process. This short article presents quality as a balance of three critical notions: core clinical competence, perceived values that our patients seek and want, and the cost of quality. Customer satisfaction is a variable that must be identified for each practice. In my practice, patients perceive quality as communication and time, be it treatment or waiting time. Time is a value and cost that must be managed effectively. Total quality management is a business function; it involves diagnosis, design, implementation, and measurement of the process, the people, and the service. Kazien is a function that reduces value services, eliminates waste, and manages time and cost in the process. Total quality management is a total commitment for continuous improvement. PMID:10587600

  3. Total artificial hearts: past, present, and future.

    Science.gov (United States)

    Cohn, William E; Timms, Daniel L; Frazier, O H

    2015-10-01

    A practical artificial heart has been sought for >50 years. An increasing number of people succumb to heart disease each year, but the number of hearts available for transplantation remains small. Early total artificial hearts mimicked the pumping action of the native heart. These positive-displacement pumps could provide adequate haemodynamic support and maintain the human circulation for short periods, but large size and limited durability adversely affected recipients' quality of life. Subsequent research into left ventricular assist devices led to the use of continuous-flow blood pumps with rotating impellers. Researchers have attempted to integrate this technology into modern total artificial hearts with moderate clinical success. The importance of pulsatile circulation remains unclear. Future research is, therefore, needed into positive-displacement and rotary total artificial hearts. PMID:26031698

  4. Total quantum Zeno effect beyond Zeno time

    International Nuclear Information System (INIS)

    In this work we show that is possible to obtain Total Quantum Zeno Effect in an ustable systems for times larger than the correlation time of the bath. The effect is observed for some particular systems in which one can chose appropriate observables which frequent measurements freeze the system into the initial state. For a two level system in a squeezed bath one can show that there are two bath dependent observables displaying Total Zeno Effect when the system is initialized in some particular states. We show also that these states are intelligent states of two conjugate observables associated to the electromagnetic fluctuations of the bath

  5. TOTAL FINA ELF. Annual report 2002

    International Nuclear Information System (INIS)

    This document is the annual report 2002 of Total-Fina-Elf society, great company on the hydrocarbons market. According to the company objective (set the standard not only with the financial performance, but also with stringent requirements in terms of social and environmental responsibility), it presents the Chairman message, the corporate governance, the social and environmental responsibility, the future of energy, the human resources policy, the investor relations, the overview of Total-Fina-Elf fiscal year with financial information and 2002 industrial events. (A.L.B.)

  6. ANALYSIS AND ACCOUNTING OF TOTAL CASH FLOW

    Directory of Open Access Journals (Sweden)

    MELANIA ELENA MICULEAC

    2012-01-01

    Full Text Available In order to reach the objective of supplying some relevant information regarding the liquidity inflows and outflows during a financial exercise, the total cash flow analysis must include the analysis of result cashable from operation, of payments and receipts related to the investment and of financing decisions of the last exercise, as well as the analysis of treasury variation (of cash items. The management of total cash flows ensures the correlation of current liquidness flows as consequence of receipts with the payments ’flows, in order to provide payment continuity of mature obligations.

  7. Distant set distinguishing total colourings of graphs

    OpenAIRE

    Przybyło, Jakub

    2015-01-01

    The Total Colouring Conjecture suggests that $\\Delta+3$ colours ought to suffice in order to provide a proper total colouring of every graph $G$ with maximum degree $\\Delta$. Thus far this has been confirmed up to an additive constant factor, and the same holds even if one additionally requires every pair of neighbours in $G$ to differ with respect to the sets of their incident colours, so called pallets. Within this paper we conjecture that an upper bound of the form $\\Delta+const.$ still re...

  8. Total synthesis of palau'amine

    OpenAIRE

    Namba, Kosuke; Takeuchi, Kohei; Kaihara, Yukari; Oda, Masataka; Nakayama, Akira; Nakayama, Atsushi; YOSHIDA, Masahiro; Tanino, Keiji

    2015-01-01

    Palau'amine has received a great deal of attention in the past two decades as an attractive synthetic target by virtue of its intriguing molecular architecture and significant immunosuppressive activity. Here we report the total synthesis of palau'amine characterized by the construction of an ABDE tetracyclic ring core including a trans-bicylo[3.3.0]octane skeleton at a middle stage of total synthesis. The ABDE tetracyclic ring core is constructed by a cascade reaction of a cleavage of the N–...

  9. TOTAL 2003 activities report in brief

    International Nuclear Information System (INIS)

    This activities report presents the activities of the petroleum industry Group Total for the year 2003. The following topics are detailed: the corporate social responsibility with the environment stewardship, the energy future management, the safety enhancing, the human resources and the ethics and local development; the shareholder information with the Total share and the share-holding structure; the activities with informations on the Group, the main events, the upstream exploration and production,, the downstream refining, marketing, trading and shipping, the chemicals with overview 2003, base chemical and polymers, performance and specialities. (A.L.B.)

  10. Systematic Calculations of Total Atomic Binding Energies

    International Nuclear Information System (INIS)

    We have calculated total atomic binding energies of 3- to 91-electron ions of all atoms with Z=3 to 118, in the Dirac-Fock model, for applications to atomic mass determination from highly-charged ions. In this process we have determined the ground-state configuration of many ions for which it was not known. We also provide total electronic correlation including Breit correlation for iso-electronic series of beryllium, neon, magnesium and argon, using the multiconfiguration Dirac-Fock approach.

  11. Total Mercury in Lake Neusiedl, Austria

    OpenAIRE

    Jirsa F.; Pirker D.; Krachler R.

    2013-01-01

    Between May and September 2011 a total of 361 samples from water, sediment, macrophytes and fish tissues from the shallow, slightly alkaline Lake Neusiedl were measured for their total mercury content with cold vapour atomic absorption spectroscopy (CV-AAS). Hg content of surface water was below the LOD of 0.1 μg/L and the sediments displayed contents between 0.025 and 0.113 μg/g dw, significantly correlated with the proportion of organic components (fig 1). Although these results do not poin...

  12. Total positive curvature of circular DNA

    DEFF Research Database (Denmark)

    Bohr, Jakob; Olsen, Kasper Wibeck

    2013-01-01

    micro-DNAs longer than the minimum length must be concave, a result that is consistent with typical atomic force microscopy images of plasmids. Predictions for the total positive curvature of circular micro-DNAs are given as a function of length, and comparisons with circular DNAs from the literature...... molecules, e.g., plasmids, it is shown to have implications for the total positive curvature integral. For small circular micro-DNAs it follows as a consequence of Fenchel's inequality that there must exist a minimum length for the circular plasmids to be double stranded. It also follows that all circular...

  13. PRIVATE EQUITY INVESTING AND TOTAL QUALITY - UPDATED

    Directory of Open Access Journals (Sweden)

    Nikola Stefanovic

    2013-03-01

    Full Text Available Private equity funds invest money into companies and, in return, receive stakes in the companies' equity, thus becoming the partners who share the business risk. Because of that, private equity funds increase the value of their portfolio companies, by, among other things, improving their internal processes and strengthening their market positions. While doing that, private equity funds place a special emphasis on the implementation of the total quality. In order to do that, they focus on the three key elements for the successful implementation of the total quality: strategy-based organization, focus on consumers, and obsession with quality.

  14. TECAB - Totally Endoscopic Coronary Artery Bypass

    Medline Plus

    Full Text Available ... completely endoscopic coronary artery bypass grafting procedure using robotics. We call this operation a “TECAB,” “Totally Endoscopic ... scrub nurse, also a lot of experience with robotics now. And Dr. Atiq Rahman, fellow here for ...

  15. Total synthesis of insect antifeedant drimane sesquiterpenes.

    NARCIS (Netherlands)

    Jansen, B.J.M.

    1993-01-01

    The investigations described in this thesis deal with the total synthesis of sesquiterpenes of the drimane family, named for their widespread occurrence in the stem bark of South American Drimys species. These compounds contain the bicyclofarnesol nucleus 1 , which is invariably oxi

  16. Herpes zoster ophthalmicus with total ophthalmoplegia

    Directory of Open Access Journals (Sweden)

    Talwar S

    1990-01-01

    Full Text Available A case of unilateral herpes zoster ophthalmicus (HZO is reported with ipsilateral involvement of III, IV and VI cranial nerves which led to extra ocular muscles palsy presenting as total ophthalmopegia along with ptosis, cycloplegia and dilated non reactive pupil.

  17. Dilemmas in Uncemented Total Hip Arthroplasty

    NARCIS (Netherlands)

    Goosen, J.H.M.

    2009-01-01

    In this thesis, different aspects that are related to the survivorship and clinical outcome in uncemented total hip arthroplasty are analysed. In Chapter 2, the survival rate, Harris Hip score and radiographic features of a proximally hydroxyapatite coated titanium alloy femoral stem (Bi-Metric, Bio

  18. TECAB - Totally Endoscopic Coronary Artery Bypass

    Medline Plus

    Full Text Available ... common cardiac problem. The abbreviation we as doctors use for this operation is “TECAB,” meaning “Totally Endoscopic ... point. It’s down. It’s down already. So we use a double-lumen tube. We have those Weitlander. ...

  19. Radiological findings in total colonic aganglionosis

    International Nuclear Information System (INIS)

    The radiological findings pathognomonic of Hirschsprung's disease have been known for quite a long time. However, in addition to those diseases characterized by rectum or rectum-sigmoid aganglionosis (as in the classic form of Hirschsprung's disease), in pediatric pathology of surgical interest severe affections exist characterized by aganglionosis extending from the rectum to the entire colon, and exceptionally as far as the small bowel (ultra-long Hirschsprung's disease). The authors report on the results they obtained in radiological studies of 6 cases of total colonic aganglionosis by means of the current radiological procedures, i.e. plain abdominal films and barium enema. As for total colonic aganglionosis, no diagnostic radiological parameters have been assessed yet. The authors compare their results with those taken from international literature: microcolon with reflux into megaileum (2 out of 6 cases) appears to be the most suggestive X-ray finding for total colonic aganglionosis. Finally, the role is discussed of radiological studies in the diagnostic approach to total colonic aganglionosis. The authors conclude that, even though radiological investigations are indispensable, they are often not conclusive. Therefore, an accurate evaluation of the proximal extension of aganglionosis can be made only at surgery

  20. Stereocontrolled total synthesis of hedyotol A.

    Science.gov (United States)

    Kawabe, Yusuke; Ishikawa, Ryo; Akao, Yusuke; Yoshida, Atsushi; Inai, Makoto; Asakawa, Tomohiro; Hamashima, Yoshitaka; Kan, Toshiyuki

    2014-04-01

    The total synthesis of hedyotol A (1), a natural product isolated from Hedyotis lawsoniae (DC.) Wight et Arn. (Rubiaceae), was accomplished in a highly stereocontrolled manner. Key steps include an L-proline-catalyzed cross-aldol reaction and the biomimetic construction of a furofuran lignan skeleton through a quinomethide intermediate. PMID:24660822

  1. Production Function Geometry with "Knightian" Total Product

    Science.gov (United States)

    Truett, Dale B.; Truett, Lila J.

    2007-01-01

    Authors of principles and price theory textbooks generally illustrate short-run production using a total product curve that displays first increasing and then diminishing marginal returns to employment of the variable input(s). Although it seems reasonable that a temporary range of increasing returns to variable inputs will likely occur as…

  2. The total synthesis of (–)-crispatene

    OpenAIRE

    Miller, Aubry K.; Byun, Daniel H.; Beaudry, Christopher M.; Trauner, Dirk

    2004-01-01

    The total synthesis of the molluscan polypropionate (–)-crispatene is described. The synthesis features a palladium-catalyzed cross-coupling to establish a sensitive conjugated tetraene and its Lewis acid-catalyzed cycloisomerization to yield the bicyclo[3.1.0]hexene core of the natural product. The absolute configuration of (–)-crispatene and related molecules is established.

  3. Enantioselective Total Synthesis of (+)-Salvileucalin B

    OpenAIRE

    Levin, Sergiy; Nani, Roger R.; Reisman, Sarah E.

    2011-01-01

    An enantioselective total synthesis of the diterpenoid natural product (+)-salvileucalin B is reported. Key findings include a copper-catalyzed arene cyclopropanation reaction to provide the unusual norcaradiene core and a reversible retro-Claisen rearrangement of a highly functionalized norcaradiene intermediate.

  4. Total synthesis of (±)-isophellibiline

    OpenAIRE

    Funk, Raymond L.; Belmar, Johannes

    2012-01-01

    The total synthesis of (±)-isophellibiline is described. This represents the first synthesis of a member of the nonaromatic homoerythrinan family of alkaloids. The tetracyclic ring system of the natural product was quickly assembled by a strategy that features a retrocycloaddition/cycloaddition reaction of an amidodioxin, an intramolecular Heck reaction and a 6π-electrocyclic ring closure of a dienoic acid.

  5. Revision Total Hip Replacement: A Case Report

    Directory of Open Access Journals (Sweden)

    Md Hafizur Rahman

    2013-07-01

    Full Text Available Total hip replacement is a reconstructive procedure that has improved the management of those diseases of the hip joint that have responded poorly to conventional medical therapy. Conventional, primary total hip replacement is a durable operation in the majority of patients. A hip replacement is a mechanical device with parts that are assembled before and during the operation. But the possible complications of total hip arthroplasty, and its clinical performance over time, is a challenging occasion to the surgeons, and such a challenge we faced with our presenting patient. A 68 year old lady with history of cemented bipolar hemiarthroplasty done in a tertiary care hospital, due to fracture neck of the left femur having the history of diabetes, chronic kidney disease, heart disease, anaemia, and mental disorders presented with loosened prosthesis, thinning of medial proximal cortex of the femur which had broken within few months after surgery. She complained of painful walking at left hip joint. There was also evidence of chronic infective and degenerative arthritis of acetabular component of the affected hip joint. Cemented revision total hip replacement surgery was performed with expert multidisciplinary involvement. On 2nd postoperative day the patient was allowed to walk on operated limb with the aid of walker. On 12th postoperative day all the stitches were removed and wound was found healthy.

  6. Total Quality Management. ERIC Digest, Number 73.

    Science.gov (United States)

    Weaver, Tyler

    The Japanese success story has made W. Edwards Deming's Total Quality Management (TQM) theory increasingly popular among American managers, from car manufacturers to educational leaders. TQM is based on two tenets: the primacy of customer satisfaction and the necessity of tapping nontraditional sources (especially employee ideas) to institute…

  7. A review of total body irradiation

    International Nuclear Information System (INIS)

    This review of total body irradiation discusses the optimization of the prescription, relevant radiobiological research, cytotoxic drugs and TBI, and the delivery of TBI and its complications, with particular reference to acute effects, neurological sequelae, endocrine effects, cataracts, and secondary malignancies. (U.K.)

  8. Total pressing Indonesian gas development, exports

    International Nuclear Information System (INIS)

    Total is on track to become Indonesia's leading gas exporter by the turn of the century. Total's aggressive development of its Mahakam Delta acreage in East Kalimantan is intended to keep pace with growing liquefied natural gas demand, mainly from Japan but also increasingly from South Korea and Taiwan. A frantic scramble is under way among natural gas suppliers in the Pacific Rim region, particularly those with current LNG export facilities, to accommodate projections of soaring natural gas demand in the region. Accordingly, Total's Indonesian gas production goal is the centerpiece of a larger strategy to become a major player in the Far East Asia gas scene. Its goals also fall in line with Indonesia's. Facing flat or declining oil production while domestic oil demand continues to soar along with a rapidly growing economy, Indonesia is heeding some studies that project the country could become a net oil importer by the turn of the century. The paper describes Total's Far East strategy, the Mahakam acreage which it operates, the shift to gas development, added discoveries, future development, project spending levels, and LNG export capacity

  9. Total Synthesis of (-)-Nemorosone and (+)-Secohyperforin.

    Science.gov (United States)

    Sparling, Brian A; Tucker, James K; Moebius, David C; Shair, Matthew D

    2015-07-17

    A general strategy for the synthesis of polycyclic polyprenylated acylphloroglucinols is described in which a scalable, Lewis acid catalyzed epoxide-opening cascade cyclization is used to furnish common intermediate 4. The utility of this approach is exemplified by the total syntheses of both ent-nemorosone and (+)-secohyperforin, which were each accomplished in four steps from this intermediate. PMID:26125288

  10. Total Synthesis of balanol, Part 2

    DEFF Research Database (Denmark)

    Tanner, David Ackland; Kelly, Nicholas; Tedenborg, Lars;

    1997-01-01

    A convergent enantioselective total synthesis of the natural product (-)-balanol (1) is described. In addition to benzophenone fragment 8, key intermediates are chiral bicyclic aziridine 3 and the corresponding epoxide 4, both of which undergo highly regio- and stereoselective nucleophilic ring...

  11. Enantioselective Total Synthesis of Plectosphaeroic Acid B

    OpenAIRE

    Jabri, Salman Y.; Overman, Larry E.

    2013-01-01

    The first total synthesis of a member of the plectosphaeroic acid family of fungal natural products is reported. Key steps include the late-stage formation of the hindered N6–C9″ bond and stereoselective introduction of the two methylthio substituents.

  12. Transanal total mesorectal excision - a systematic review

    DEFF Research Database (Denmark)

    Bjørn, Maya Xania; Perdawood, Sharaf Karim

    2015-01-01

    dissection. We aimed to evaluate the literature on TaTME. METHODS: We performed a systematic search of the literature in the PubMed and Embase databases. Both authors assessed the studies. All publications on TaTME were included with the exception of review articles. RESULTS: A total of 29 studies (336...

  13. Periprosthetic osteolysis after total wrist arthroplasty

    DEFF Research Database (Denmark)

    Boeckstyns, Michel E H; Herzberg, Guillaume

    2014-01-01

    Background and Literature Review Periprosthetic osteolysis (PPO) after second- or third-generation total wrist arthroplasty (TWA), with or without evident loosening of the implant components, has previously been reported in the literature, but rarely in a systematic way. Purpose The purpose of th...

  14. Application of Total Quality Management in Education

    Science.gov (United States)

    Farooq, M. S.; Akhtar, M. S.; Ullah, S. Zia; Memon, R. A.

    2007-01-01

    The purpose of the paper is to analyzing thoughts of the modern management paradigm "Total Quality Management" (TQM), and its application in the field of education. The basic theme of TQM is participatory approach to address the question(s) of quality in business aswell as in the field of education. Reviewing fresh literature from the internet …

  15. An approach to total quality assurance

    International Nuclear Information System (INIS)

    Total Quality Assurance must be based on amalgamating three quality functions: effective quality control, competent inspection, and regularly audited Quality Assurance programmes. In applying these functions the fuel supplier must regard each of his sub-contractors as part of his own works and ensure a common policy of motivated Quality Assurance throughout his own works and those of his suppliers. (author)

  16. [Open total dislocation of the talus].

    Science.gov (United States)

    Grabski, R S; Sosiński, R

    1992-01-01

    A case of 35 years old patient with open, total, fixed dislocation of the talus reduced with heel traction is presented. The Sudeck syndrome subsided after one year. Weight bearing was not allowed for 7 months. An examination after 2.5 years revealed minor osteoarthritis, full range of movement in the foot but limited walking capability. PMID:7555299

  17. A modified total synthesis of cystothiazole A

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    A modified total synthesis of cystothiazole A is described. In this synthetic strategy, a one-step transformation of acylated oxazolidinone to β-ketoester has been successfully applied, thus making the synthetic route more efficient. This method may also be potentially applied in synthesis of other related β-substituted-β-methoxyl acrylates (bb-MOAs).

  18. Total Quality Management in Higher Education.

    Science.gov (United States)

    Sherr, Lawrence A.; Lozier, G. Gredgory

    1991-01-01

    Total Quality Management, based on theories of W. Edward Deming and others, is a style of management using continuous process improvement characterized by mission and customer focus, a systematic approach to operations, vigorous development of human resources, long-term thinking, and a commitment to ensuring quality. The values espoused by this…

  19. Total internal reflection laser tools and methods

    Energy Technology Data Exchange (ETDEWEB)

    Zediker, Mark S.; Faircloth, Brian O.; Kolachalam, Sharath K.; Grubb, Daryl L.

    2016-02-02

    There is provided high power laser tools and laser heads that utilize total internal reflection ("TIR") structures to direct the laser beam along a laser beam path within the TIR structure. The TIR structures may be a TIR prism having its hypotenuse as a TIR surface.

  20. Riemann surfaces and totally real tori

    OpenAIRE

    Duval, Julien; Gayet, Damien

    2009-01-01

    Given a generic totally real torus unknotted in the unit sphere of the complex plane, we prove the following alternative : either there exists a filling of the torus by holomorphic discs and the torus is rationally convex, or its rational hull contains a holomorphic annulus.

  1. Total Knee Replacement (Arthroplasty) (Beyond the Basics)

    Science.gov (United States)

    ... demonstrate that 80 to 90 percent of total knees will last between 15 to 20 years, early failures may occur due to a variety of reasons. These include loosening of the implants, infection, fractures of the bone around the implants, and instability. ...

  2. Total synthesis of (S)-equol.

    Science.gov (United States)

    Heemstra, Jennifer M; Kerrigan, Sean A; Doerge, Daniel R; Helferich, William G; Boulanger, William A

    2006-11-23

    The first enantioselective total synthesis of (S)-equol is reported. The described route relies on an Evans alkylation to form the stereocenter and an intramolecular Buchwald etherification to generate the chroman ring. Key features of this method include its brevity, its scalability, and the low cost of starting materials. [reaction: see text]. PMID:17107042

  3. Brutally Unfair Tactics Totally OK Now

    DEFF Research Database (Denmark)

    Wilson, Douglas

    2011-01-01

    In this paper, I use a party game that I co-designed, Brutally Unfair Tactics Totally OK Now (B.U.T.T.O.N.), as a case study to suggest some alternative possibilities for the design of digitally-mediated play and games. Specifically, I argue that that intentionally “broken” or otherwise incomplet...

  4. Capital gains, total returns and saving rates

    OpenAIRE

    Michael Hudson

    2013-01-01

    To focus on the dynamics of how financial wealth is created, obtained, and valued, this paper (1) distinguishes capital gains from income by measuring total returns, and (2) contrasts the capitalized value of rentier income (rent extraction rights and privileges from land, natural resources, and monopolies) from that of industrial profits on tangible capital investment.

  5. The total synthesis of pantocin B.

    Science.gov (United States)

    Sutton, A E; Clardy, J

    2000-02-10

    [reaction: see text] Pantocin B, an unusual antibiotic produced by Erwinia herbicola, effectively controls E. amylovora, the pathogen causing the plant disease fire blight. A total synthesis of pantocin B from L-alanine, glycine, and L-malic acid is reported. PMID:10814312

  6. The total synthesis of (-)-cryptocaryol A.

    Science.gov (United States)

    Dias, L C; Kuroishi, P K; de Lucca, E C

    2015-03-28

    A stereoselective total synthesis of (-)-cryptocaryol A (1) is described. Key features of the 17-step route include the use of three boron-mediated aldol reaction-reduction sequences to control all stereocenters and an Ando modification of the Horner-Wadsworth-Emmons olefination that permitted the installation of the Z double bond of the α-pyrone ring. PMID:25695350

  7. Concepts of total quality management in radiology

    International Nuclear Information System (INIS)

    Quality is one of the touch-stones to determine the competitive advantage for a service, product or company. Total Quality Management has a large ambit, which encompasses not only the quality of images and services producing these images, but also the customers satisfaction. In health care patients satisfaction is divided into three parts: patient quality, professional quality and management quality

  8. TECAB - Totally Endoscopic Coronary Artery Bypass

    Medline Plus

    Full Text Available ... as doctors use for this operation is “TECAB,” meaning “Totally Endoscopic Coronary Artery Bypass.” This procedure will ... make sure his vessels are able for bypass, meaning doing the CT angiograph for the peripheral arteries. ...

  9. Isolation of total RNA from pollens.

    Science.gov (United States)

    Bijli, K M; Singh, B P; Sridhara, S; Arora, N

    2001-05-01

    Isolation of total RNA from plant materials has been difficult, due to the presence of complex organic substances and the associated pigmentation. In fact, there is a dearth of standardized protocols for isolating total RNA from pollens. To find a simple and reliable method for isolating total RNA from pollen, four methods, viz. phenol/SDS (PS), guanidine HCl (GH), tri-reagent (TR), and modified SDS-betaME (SB) were tested with fresh pollen of Ricinus communis (procured at -70 degrees C) and pollen dried at 30-37 degrees C. The quality and quantity of RNA was superior for the material processed at -70 degrees C. SB gave the highest RNA yield (2.35 mg/g, OD260/280 >2.0), compared to other methods. The results obtained by the SB method were found to be comparable with the widely used tri-reagent method. This was validated with other pollens of Imperata cylindrica and Xanthium strumarium. The yield obtained from graded amounts of pollen was consistent with SB, compared to the TR method. The RNA isolated by SB gave good quality mRNA for synthesizing cDNA. The SDS-betaME method is simple, efficient, and uses less expensive reagents. Hence, we recommend the modified SDS-betaME method for isolating total RNA from pollens. PMID:11426703

  10. TECAB - Totally Endoscopic Coronary Artery Bypass

    Medline Plus

    Full Text Available ... coronary artery bypass grafting procedure using robotics. We call this operation a “TECAB,” “Totally Endoscopic Coronary Artery ... see 2 the heart beating behind what we call the “pericardium,” the sack where the heart is ...

  11. Revitalizing Space Operations through Total Quality Management

    Science.gov (United States)

    Baylis, William T.

    1995-01-01

    The purpose of this paper is to show the reader what total quality management (TQM) is and how to apply TQM in the space systems and management arena. TQM is easily understood, can be implemented in any type of business organization, and works.

  12. Diagnosing total quality management - Part 1

    NARCIS (Netherlands)

    Bossink, B.A.G.; Gieskes, J.F.B.; Pas, T.N.M.

    1992-01-01

    From extensive literature research a total quality management (TQM) model is developed. This model describes the basic elements of the concept of TQM. It also provides the way in which the basic elements can be made operational in practice. Based on this model a quality-diagnostical instrument is de

  13. Diagnosing total quality management - Part 2

    NARCIS (Netherlands)

    Bossink, B.A.G.; Gieskes, J.F.B.; Pas, T.N.M.

    1993-01-01

    From extensive literature research a total quality management (TQM) model is developed. This model describes the basic elements of the concept of TQM. It also provides the way in which the basic elements can be made operational in practice. Based on this model a quality-diagnostical instrument is de

  14. Coordinating Council. Ninth Meeting: Total Quality Management

    Science.gov (United States)

    1992-01-01

    This report summarizes the 9th meeting of the STI Coordinating Council. The council listened to the speakers' understanding of Total Quality Management (TQM) principles and heard stories of successful applications of these principles. Definitions of quality stated were focused on customer satisfaction. Reports presented by the speakers are also included.

  15. Total dislodgement of the femoral component following cemented total knee arthroplasty: a case report

    OpenAIRE

    Arac, Sukru; Karatosun, Vasfi

    2004-01-01

    Total dislodgement of the components, which is the most severe form of loosening, has hitherto been unreported following total knee arthroplasty. An eighty-four-year-old woman presented with complaints of pain and sensation of insecurity of her right knee after cemented total knee arthroplasty. On physical examination, a clunk was elicited during movements of the knee; however, radiographs appeared normal except for a separated fragment of the medial femoral condyle. Further examination with ...

  16. Overhead Concentration Platform of Total Withdrawal Operation in Cyclic Total Reflux Batch Distillation

    Institute of Scientific and Technical Information of China (English)

    JIANG Zhankun; BAI Peng

    2011-01-01

    The total withdrawal operation is an inevitable section in cyclic total reflux batch distillation.In the operation,an interesting phenomenon "overhead concentration platform"(OCP) appears,which is defined as a period of time with high overhead concentrations when the operation is changed from total reflux to total withdrawal.The OCP phenomenon and its influential factors,such as the theoretical stage number,feed concentration,and feed composition,are examined by simulations and experiments.The experimental equipment is a column with random packings.It is shown that the number of theoretical stages influences the OCP more significantly than the other factors.

  17. Consumo e digestibilidade total e parcial de dietas utilizando farelo de girassol e três fontes de energia em novilhos confinados Intake, total and partial digestibility of diets with sunflower meal and three energy sources in confined steers

    Directory of Open Access Journals (Sweden)

    Ana Rosália Mendes

    2005-04-01

    Full Text Available Avaliaram-se o consumo alimentar, a digestibilidade parcial e total e o balanço de nitrogênio, em novilhos confinados. Foram utilizados três novilhos de corte cruzados, canulados no rúmen e no duodeno, distribuídos em dois delineamentos em quadrado latino 3 x 3. As dietas experimentais foram constituídas de 60% de silagem de milho, tendo como fonte de proteína o farelo de girassol e, como fonte de energia, o milho (MI. O milho foi substituído parcialmente pela casca de soja (CS ou pelo farelo de gérmen de milho (FGM. Quatro indicadores internos (lignina e FDA, FDN e lignina indigestíveis foram submetidos a 144 horas de digestão in vitro, para estimativa da digestibilidade parcial e total das dietas. Houve maior ingestão dos componentes fibrosos na dieta CS, porém não foi observado efeito sobre o consumo de matéria seca. A lignina subestimou significativamente a digestibilidade. A utilização da FDAi, FDNi e lignina-i para estimar a digestibilidade total é viável, no entanto, a FDAi e lignina-i não estimaram adequadamente as digestibilidades parciais. Houve efeito significativo na digestibilidade ruminal da FDA, com valores mais elevados para CS e semelhantes para FGM, em relação à dieta MI. A digestibilidade total da FDA foi maior na dieta CS, porém, as digestibilidades dos demais componentes não foram afetadas pelas diferentes fontes energéticas. Não houve diferença significativa para a digestibilidade da energia e nos valores obtidos de NDT, com média de 61,5%. A casca de soja e o farelo de gérmen de milho, em substituição parcial do milho, mostraram-se fontes alternativas satisfatórias para a inclusão na dieta de bovinos.Feed intake, partial and total digestibility and nitrogen balance were evaluated in confined steers. Three crossbreed steers, rumen and duodenum cannulated, were allotted to two 3 x 3 Latin square experimental design. The experimental diets were composed by corn silage (60% and concentrate

  18. Increasing productivity through Total Reuse Management (TRM)

    Science.gov (United States)

    Schuler, M. P.

    1991-01-01

    Total Reuse Management (TRM) is a new concept currently being promoted by the NASA Langley Software Engineering and Ada Lab (SEAL). It uses concepts similar to those promoted in Total Quality Management (TQM). Both technical and management personnel are continually encouraged to think in terms of reuse. Reuse is not something that is aimed for after a product is completed, but rather it is built into the product from inception through development. Lowering software development costs, reducing risk, and increasing code reliability are the more prominent goals of TRM. Procedures and methods used to adopt and apply TRM are described. Reuse is frequently thought of as only being applicable to code. However, reuse can apply to all products and all phases of the software life cycle. These products include management and quality assurance plans, designs, and testing procedures. Specific examples of successfully reused products are given and future goals are discussed.

  19. Implantation of total body irradiation in radiotherapy

    International Nuclear Information System (INIS)

    Before implementing a treatment technique, the characteristics of the beam under irradiation conditions must be well acknowledged and studied. Each one of the parameters used to calculate the dose has to be measured and validated before its utilization in clinical practice. This is particularly necessary when dealing with special techniques. In this work, all necessary parameters and measurements are described for the total body irradiation implementation in facilities designed for conventional treatments that make use of unconventional geometries to generate desired enlarged field sizes. Furthermore, this work presents commissioning data of this modality at Hospital das Clinicas of Sao Paulo using comparison of three detectors types for measurements of entrance dose during total body irradiation treatment. (author)

  20. Total quality management of cobalt-60 sources

    International Nuclear Information System (INIS)

    Total Quality Management of Cobalt-60 sources by a supplier requires a life cycle approach to source management. This covers various aspects, including design, manufacturing, installation, field inspection, source surveillance and return of cobalt-60 sources at the end of their useful life. The Total Quality Management approach demonstrates a strong industry commitment to the beneficial use of gamma technology for industrial irradiation applications in both developed nations and in those nations who are developing their infrastructure and techniques for the beneficial use of this technology. MDS Nordion continues to demonstrate its support and commitment to the industry by developing and implementing state-of-the-art standards for the safe use of cobalt-60 sources

  1. Pain Management After Total Joint Arthroplasty.

    Science.gov (United States)

    McDonald, Lisa T; Corbiere, Nicole C; DeLisle, Jay A; Clark, Alexander Martin; Kuxhaus, Laurel

    2016-06-01

    Controlling pain after total joint arthroplasty (TJA) is critical to minimizing complications, decreasing costs, and expediting patients' return to function. We implemented a TJA multimodal pain management protocol at a Level III trauma center in a small, rural community in New York. We retrospectively reviewed 266 patient charts and collected patient demographics, pain management information, and discharge data. Our primary goals were to quantify the total number of narcotic medication doses used and length of hospital stay. The multimodal pain management protocol significantly reduced the number of narcotic doses used (P pain management after TJA can reduce narcotic use and hospital length of stay, thereby also reducing the incidence of side effects from narcotics. PMID:27234795

  2. Total economic value of forests in Mexico

    International Nuclear Information System (INIS)

    Failure to account for the numerous functions and economic uses of forests have led to patterns of global forest use with many detrimental environmental consequences. This study demonstrates the economic techniques for estimating the Total Economic Value (TEV) for forests. For the Mexican forest estate, the results show an annual lower bound value of the services of the total forest area to be in the order of USD 4 billion. This aggregate value stems from the nonmarketed services provided by nonconsumptive use; from future potential uses of the genetic resources and from pure existence values; and the largest proportion of economic value coming from the functional values of hydrological and carbon cycling. However, only a proportion of this value can be feasibly be 'captures' within Mexico; much of the benefit of Mexico's forests falls outside the country's borders, and is therefore not considered by forest users or national policy makers. 79 refs, 1 fig, 7 tabs

  3. TOTAL ANTIOXIDANT ACTIVITY OF YEAST SACCHAROMYCES CEREVISIAE

    Directory of Open Access Journals (Sweden)

    Blažena Lavová

    2013-02-01

    Full Text Available Antioxidants are health beneficial compounds that can protect cells and macromolecules (e.g. fats, lipids, proteins and DNA from the damage of reactive oxygen species (ROS. Sacchamomyces cerevisiae are know as organisms with very important antioxidative enzyme systems such as superoxide dismutase or catalase. The total antioxidant activity (mmol Trolox equivalent – TE.g-1 d.w. of Saccharomyces cerevisiae was measured by 2,2´-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid during the yeast cultivation. It was found that the total antioxidant activity was the highest (1.08 mmol TE.g-1 d.w. in the strain Kolín after 32 hours of cultivation and the lowest (0.26 mmol TE.g-1 d.w. in the strain Gyöng after 12 hours of cultivation.

  4. Asymptotic Behaviour of Total Generalised Variation

    KAUST Repository

    Papafitsoros, Konstantinos

    2015-01-01

    © Springer International Publishing Switzerland 2015. The recently introduced second order total generalised variation functional TGV2 β,α has been a successful regulariser for image processing purposes. Its definition involves two positive parameters α and β whose values determine the amount and the quality of the regularisation. In this paper we report on the behaviour of TGV2 β,α in the cases where the parameters α, β as well as their ratio β/α becomes very large or very small. Among others, we prove that for sufficiently symmetric two dimensional data and large ratio β/α, TGV2 β,α regularisation coincides with total variation (TV) regularization

  5. Scientific observations at total solar eclipses

    Institute of Scientific and Technical Information of China (English)

    Jay M.Pasachoff

    2009-01-01

    The occasion of the longest totality of an eclipse in the 18 yr 111/3 d saros cycle leads to taking stock of the scientific value of ground-based eclipse observations in this space age. Though a number of space satellites from the U.S., Europe, Japan, and Russia study the Sun, scientists at eclipses can observe the solar chromosphere and corona at higher spatial resolution, at higher temporal resolution, and at higher spectral resolution than are possible aloft. Furthermore, eclipse expeditions can transport a wide variety of state-of-the-art equipment to the path of totality. Thus, for at least some years to come, solar eclipse observations will remain both scientifically valuable and cost-effective ways to study the outer solar atmosphere.

  6. An unusual case of total ophthalmoplegia

    Directory of Open Access Journals (Sweden)

    Chowdhury Ravindra

    2009-01-01

    Full Text Available An eight-year-old male child presented with drooping of the left eyelid with a history of penetrating injury of hard palate by an iron spoon seven days ago, which had already been removed by the neurosurgeon as the computed tomography scan revealed a spoon in the left posterior ethmoid and sphenoid bone penetrating into the middle cranial fossa. On examination, visual acuity was 20/20 in each eye and left eye showed total ophthalmoplegia. Oral cavity revealed a hole in the left lateral part of the hard palate. We managed the case with tapering dose of systemic prednisolone. The total ophthalmoplegia was markedly improved in one month. Cases of foreign bodies in the orbit with intracranial extension are not unusual, but the path this foreign body traveled through the hard palate without affecting the optic nerve, internal carotid artery or cavernous sinus makes an interesting variation.

  7. Overview of Total Group financial year

    International Nuclear Information System (INIS)

    In 2004, the combination of very high crude oil prices with a strong rise of refining margins, and in the second half of 2004 of the start off again of the rise of petrochemical margins, has led Total Group to reach a record level of 9.04 billion euros for its net adjusted result, which represents a 23% rise with respect to 2003, and this despite a fall of the Dollar exchange rate. Total has also carried on its downstream strategy of natural gas production. This strategy aims at facilitating and optimizing the access to its present day and future productions and reserves, not only to traditional markets but also to markets opened to world competition. (J.S.)

  8. Total Immersion Program学习心得

    Institute of Scientific and Technical Information of China (English)

    郑喜花

    2014-01-01

    经过了本年度的暑假学习生活,真是受益匪浅。在这期间参加了一个Total Immersion Program的学习培训班,在这个培训班中学到了很多东西,也受到了很多的启发。将对在这个培训班所学到的知识和得到的体会分享给大家,为以后从事或者参与这个Total Immersion Program学习时提供借鉴和参考。

  9. Total Cellular RNA Modulates Protein Activity.

    Science.gov (United States)

    Majumder, Subhabrata; DeMott, Christopher M; Reverdatto, Sergey; Burz, David S; Shekhtman, Alexander

    2016-08-16

    RNA constitutes up to 20% of a cell's dry weight, corresponding to ∼20 mg/mL. This high concentration of RNA facilitates low-affinity protein-RNA quinary interactions, which may play an important role in facilitating and regulating biological processes. In the yeast Pichia pastoris, the level of ubiquitin-RNA colocalization increases when cells are grown in the presence of dextrose and methanol instead of methanol as the sole carbon source. Total RNA isolated from cells grown in methanol increases β-galactosidase activity relative to that seen with RNA isolated from cells grown in the presence of dextrose and methanol. Because the total cellular RNA content changes with growth medium, protein-RNA quinary interactions can alter in-cell protein biochemistry and may play an important role in cell adaptation, critical to many physiological and pathological states. PMID:27456029

  10. Temporal bone chondroblastoma totally invisible on MRI.

    Science.gov (United States)

    Hiraumi, Harukazu; Arakawa, Yoshiki; Yamamoto, Norio; Sakamoto, Tatsunori; Ito, Juichi

    2016-08-01

    We report a case of temporal bone chondroblastoma that was totally invisible on MRI. The patient was a 64-year-old man who presented with several months history of vertigo. The CT scan with bone window setting showed destruction of the temporomandibular joint, the floor of the middle cranial fossa, and the superior semicircular canal. Calcific foci were seen within the tumor. On MR imaging, the tumor, situating mainly medial to the temporomandibular joint, showed no signal on both T1- and T2-weighted images. The tumor was not enhanced with gadolinium. In summary, the tumor was totally signal negative or "invisible" on pre- and postcontrast T1- and T2-weighted images. The tumor was resected through transpetrosal - transzygomatic approach. PMID:26743837

  11. Inestabilidad de la Artroplastia Total de Cadera

    OpenAIRE

    Ezquerra Herrando, Laura; Albareda Albareda, Jorge; Seral García, Belén

    2014-01-01

    INTRODUCCIÓN La artroplastia total de cadera (ATC) es un procedimiento muy frecuente en los Servicios de Cirugía Ortopédica y Traumatología, y aunque su efectividad es muy elevada, no está exenta de complicaciones como son el aflojamiento aséptico, luxaciones, infección y fracturas periprotésicas. A pesar de los avances en las técnicas y modelos protésicos, la luxación sigue siendo la segunda complicación más frecuente después del aflojamiento aséptico en las artroplastias totales de cadera. ...

  12. Total Synthesis of (±)-Integrifolin.

    Science.gov (United States)

    Shimomaki, Katsuya; Kusama, Hiroyuki; Iwasawa, Nobuharu

    2016-07-11

    The total synthesis of (±)-integrifolin has been achieved for the first time through the stereoselective preparation of the bicyclo[5.3.0]decane skeleton based on the tungsten-catalyzed cyclization of acyclic trienynes under photoirradiation conditions. Further key transformations of the cyclized product are the Tamao oxidation through cyclic silyl ether, the introduction of two oxygen functionalities by the oxidation of the diene and the construction of three exo-methylene moieties. PMID:27147582

  13. Total Synthesis and Stereochemical Assignment of Callyspongiolide.

    Science.gov (United States)

    Zhou, Jingjing; Gao, Bowen; Xu, Zhengshuang; Ye, Tao

    2016-06-01

    Total synthesis of four callyspongiolide stereoisomers led to unambiguous assignment of relative and absolute stereochemistry of the natural product. Key features of the convergent, fully stereocontrolled route include the use of Krische allylation, Kiyooka Aldol reaction, Kociénski-Julia olefination, Still-Gennari olefination, Yamaguchi macrocyclization, and Sonogashira coupling reaction. Biological evaluation of the synthesized compounds against an array of cancer cells revealed that the stereochemistry of the macrolactone core played an important role. PMID:27227371

  14. Total synthesis of (+)-antroquinonol and (+)-antroquinonol D.

    Science.gov (United States)

    Sulake, Rohidas S; Chen, Chinpiao

    2015-03-01

    The first total synthesis of (+)-antroquinonol and (+)-antroquinonol D, two structurally unique quinonols with a sesquiterpene side chain, is described. The route features an iridium-catalyzed olefin isomerization-Claisen rearrangement reaction (ICR), lactonization, and Grubbs olefin metathesis. The requisite α,β-unsaturation was achieved via the selenylation/oxidation protocol and elimination of β-methoxy group to provide two natural products from a common intermediate. PMID:25679542

  15. Total elbow arthroplasty: a radiographic outcome study

    Energy Technology Data Exchange (ETDEWEB)

    Bai, Xue Susan [University of Washington, Department of Radiology, Box 357115, Seattle, WA (United States); Petscavage-Thomas, Jonelle M. [Penn State Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Ha, Alice S. [University of Washington, Department of Radiology, Box 354755, Seattle, WA (United States)

    2016-06-15

    Total elbow arthroplasty (TEA) is becoming a popular alternative to arthrodesis for patients with end-stage elbow arthrosis and comminuted distal humeral fractures. Prior outcome studies have primarily focused on surgical findings. Our purpose is to determine the radiographic outcome of TEA and to correlate with clinical symptoms such as pain. This is an IRB-approved retrospective review from 2005 to 2015 of all patients with semiconstrained TEA. All available elbow radiographs and clinical data were reviewed. Data analysis included descriptive statistics and Kaplan-Meier survival curves for radiographic and clinical survival. A total of 104 total elbow arthroplasties in 102 patients were reviewed; 75 % were in women and the mean patient age was 63.1 years. Mean radiographic follow-up was 826 days with average of four radiographs per patient. Seventy TEAs (67 %) developed radiographic complications, including heterotopic ossification (48 %), perihardware lucency (27 %), periprosthetic fracture (23 %), hardware subluxation/dislocation (7 %), polyethylene wear (3 %), and hardware fracture/dislodgement (3 %); 56 patients (55 %) developed symptoms of elbow pain or instability and 30 patients (30 %) underwent at least one reoperation. In patients with radiographic complications, 66 % developed elbow pain, compared to 19 % of patients with no radiologic complications (p = 0.001). Of the patients with radiographic complications, 39 % had at least one additional surgery compared to 0 % of patients without radiographic complications (p = 0.056). Radiographic complications are common in patients after total elbow arthroplasty. There is a strong positive association between post-operative radiographic findings and clinical outcome. Knowledge of common postoperative radiographic findings is important for the practicing radiologist. (orig.)

  16. Total Synthesis of (+)-Rubriflordilactone A.

    Science.gov (United States)

    Goh, Shermin S; Chaubet, Guilhem; Gockel, Birgit; Cordonnier, Marie-Caroline A; Baars, Hannah; Phillips, Andrew W; Anderson, Edward A

    2015-10-19

    Two enantioselective total syntheses of the nortriterpenoid natural product rubriflordilactone A are described, which use palladium- or cobalt-catalyzed cyclizations to form the CDE rings, and converge on a late-stage synthetic intermediate. These key processes are set up through the convergent coupling of a common diyne component with appropriate AB-ring aldehydes, a strategy that sets the stage for the synthetic exploration of other members of this family of natural products. PMID:26337920

  17. Counterterrorism and cybersecurity total information awareness

    CERN Document Server

    Lee, Newton

    2013-01-01

    Provides a broad survey of the United States' counterterrorism history, the use of artificial intelligence in data mining, social media and privacy, cyber attacks and prevention, and longstanding issues of war and peace Closely examines how Total Information Awareness, a governmental data mining project focused on scanning public and private data, plays an integral role in cybersecurity Analyzes recent cyberattacks across the globe orchestrated by 'hacktivist' groups, such as Anonymous

  18. Total fact-book 2000-2005

    International Nuclear Information System (INIS)

    TOTAL S.A., a French society incorporated in France on March 28, 1924, together with its subsidiaries and affiliates, is the fourth largest publicly-traded integrated oil and gas company in the world. This document provides statistical data and information on the corporate (highlights, statements), upstream (production, costs,main producing fields, drilling), upstream maps, downstream (refining, distillation, retail gasoline outlets) and chemicals (sales, specialities). (A.L.B.)

  19. Introduction of total knee arthroplasty in Lithuania

    OpenAIRE

    Tarasevicius, Sarunas; Stucinskas, Justinas; Robertsson, Otto; Wingstrand, Hans

    2009-01-01

    Background and purpose We have previously reported that the first 10 years of hip arthroplasty in Lithuania resulted in a higher cumulative revision rate than that observed in Sweden. We thus compared the corresponding results after introduaction of total knee replacement in Lithuania. Methods The 10-year revision rate for the first 595 primary ScanKnee arthroplasties inserted in Klaipeda, Lithuania, was compared to that for the first 1,280 ScanKnee primary arthroplasties inserted in Sweden. ...

  20. Asymptotic behaviour of total generalised variation

    OpenAIRE

    Papafitsoros, Konstantinos; Valkonen, Tuomo

    2015-01-01

    The recently introduced second order total generalised variation functional $\\mathrm{TGV}_{\\beta,\\alpha}^{2}$ has been a successful regulariser for image processing purposes. Its definition involves two positive parameters $\\alpha$ and $\\beta$ whose values determine the amount and the quality of the regularisation. In this paper we report on the behaviour of $\\mathrm{TGV}_{\\beta,\\alpha}^{2}$ in the cases where the parameters $\\alpha, \\beta$ as well as their ratio $\\beta/\\alpha$ becomes very l...

  1. Total Variation Denoising using Iterated Conditional Expectation

    OpenAIRE

    Louchet, Cécile; Moisan, Lionel

    2014-01-01

    We propose a new variant of the celebrated Total Variation image denoising model of Rudin, Osher and Fatemi, which provides results very similar to the Bayesian posterior mean variant (TV-LSE) while showing a much better computational efficiency. This variant is based on an iterative procedure which is proved to converge linearly to a fixed point satisfying a marginal conditional mean property. The implementation is simple, provided numerical precision issues are correctly handled. Experiment...

  2. Fracture of femoral total hip replacement components

    International Nuclear Information System (INIS)

    The biomechanical factors responsible for fatigue fracture of femoral total hip component stems were studied by laboratory loading simulations using implants which were instrumented with strain gauges. Stress levels were low when the prosthesis was rigidly fixed in acrylic along its entire length. Significantly higher stresses were recorded in stems which were loose in the acrylic or which were fixed in their distal portion only

  3. TOTAL ANTIOXIDANT ACTIVITY OF YEAST SACCHAROMYCES CEREVISIAE

    OpenAIRE

    Blažena Lavová; Dana Urminská

    2013-01-01

    Antioxidants are health beneficial compounds that can protect cells and macromolecules (e.g. fats, lipids, proteins and DNA) from the damage of reactive oxygen species (ROS). Sacchamomyces cerevisiae are know as organisms with very important antioxidative enzyme systems such as superoxide dismutase or catalase. The total antioxidant activity (mmol Trolox equivalent – TE.g-1 d.w.) of Saccharomyces cerevisiae was measured by 2,2´-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid) during the yeas...

  4. Locally inertial coordinates with totally antisymmetric torsion

    CERN Document Server

    Socolovsky, M

    2010-01-01

    We show that the necessary and sufficient condition for erecting locally inertial coordinates at a point $p$ of a $U^4$-space, and therefore assuring the validity of the equivalence principle at that point, is the vanishing at $p$ of the symmetric part of the contortion tensor. This fact does not demand a vanishing torsion, but only a totally antisymmetric one. As an application, we derive the geodesic deviation equation; and prove the compatibility with the Newtonian limit.

  5. IFQs and total factor productivity changes

    OpenAIRE

    Solis, Daniel; Agar, Juan J.; Corral Cuervo, Julio Florentino de

    2015-01-01

    This study investigates changes in the total factor productivity (TFP) and identifies the main sources of TFP growth following the adoption of an individual fishing quota (IFQ) program in the Gulf of Mexico red snapper commercial fishery. Utilizing an unbalanced panel of 722 vertical line vessels Malmquist indices were derived from an output-oriented stochastic distance frontier. The analysis shows that the IFQ program had a positive impact on the productivity of the fleet and that most of th...

  6. Laparoscopic total extraperitoneal repair of lumbar hernia

    OpenAIRE

    Lim, Man Sup; Lee, Hae Wan; Yu, Chang Hee; Yang, Dae Hyun

    2011-01-01

    Lumbar hernia is a rare surgical entity without a standard method of repair. With advancements in laparoscopic techniques, successful lumbar herniorrhaphy can be achieved by the creation of a completely extraperitoneal working space and secure fixation of a wide posterior mesh. We present a total extraperitoneal laparoendoscopic repair of lumbar hernia, which allowed for minimal invasiveness while providing excellent anatomical identification, easy mobilization of contents and wide secure mes...

  7. Totally Laparoscopic Gastrectomy for Gastric Cancer

    OpenAIRE

    Theodorous, Arianne N.; Train, William W.; Goldfarb, Michael A.; Borao, Frank J.

    2013-01-01

    Background and Objectives: Recent studies have supported minimally invasive techniques as a viable alternative to open surgery in the treatment of gastric cancer. The goal of this study is to review our institution's experience with totally laparoscopic gastrectomy for the treatment of both early- and advanced-stage gastric cancer. Methods: A retrospective study was conducted to examine the short-term outcomes of laparoscopic gastrectomy performed at Monmouth Medical Center between May 2003 a...

  8. Material Science in Cervical Total Disc Replacement

    OpenAIRE

    Pham, Martin H.; Mehta, Vivek A.; Alexander Tuchman; Hsieh, Patrick C.

    2015-01-01

    Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common ...

  9. Total fact-book 2000-2005

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    TOTAL S.A., a French society incorporated in France on March 28, 1924, together with its subsidiaries and affiliates, is the fourth largest publicly-traded integrated oil and gas company in the world. This document provides statistical data and information on the corporate (highlights, statements), upstream (production, costs,main producing fields, drilling), upstream maps, downstream (refining, distillation, retail gasoline outlets) and chemicals (sales, specialities). (A.L.B.)

  10. Infected total knee arthroplasty treatment outcome analysis

    OpenAIRE

    Radoičić Dragan; Popović Zoran; Barjaktarović Radoslav; Marinković Jugoslav

    2012-01-01

    Background/Aim. Infected total knee arthroplasty (TKA) is a topic of great importance, because its diagnosing and treatment requires a lot of resources, and often has an unsatisfactory outcome. The aim of this study was to analyze the outcome of the treatment of infection developed following TKA. Methods. This retrospective study of infected TKAs was performed in the period from 1998 to 2008 in the Orthopedics & Traumatology Clinic of the Military Medical Academy (MMA) in Belgrade. ...

  11. Future Bearing Surfaces in Total Hip Arthroplasty

    OpenAIRE

    Chang, Jun-Dong

    2014-01-01

    One of the most important issues in the modern total hip arthroplasty (THA) is the bearing surface. Extensive research on bearing surfaces is being conducted to seek an ideal bearing surface for THA. The ideal bearing surface for THA should have superior wear characteristics and should be durable, bio-inert, cost-effective, and easy to implant. However, bearing surfaces that are currently being implemented do not completely fulfill these requirements, especially for young individuals for whom...

  12. Total workday control using Microsoft Outlook

    CERN Document Server

    Linenberger, Michael

    2008-01-01

    Total Workday Control Using Microsoft Outlook is a book for the over-extended office worker whose workday feels out of control. It shows how to regain command of an over-committed workday and an overflowing, unmanaged e-mail in box. It does this by teaching the author's system of time, task, and e-mail management, and it shows how to implement the system in Microsoft Outlook.

  13. Soft tissue balancing in total shoulder replacement

    OpenAIRE

    Mueller, Maike; Hoy, Gregory

    2014-01-01

    Total shoulder arthroplasty is now capable of recreating near anatomic reproduction of native bony shoulder anatomy, but the function and longevity of anatomic shoulder replacement is dependent on a competent soft tissue envelope and adequate motoring of all musculo-tendinous units about the shoulder. Balancing the soft tissues requires understanding of the anatomy and pathology, as well as technical skills. The advent of reverse shoulder biomechanics has brought with it special requirements ...

  14. NASA total quality management 1989 accomplishments report

    Science.gov (United States)

    1990-01-01

    Described here are the accomplishments of NASA as a result of the use of Total Quality Management (TQM). The principles in practice which led to these process refinements are important cultural elements to any organization's productivity and quality efforts. The categories of TQM discussed here are top management leadership and support, strategic planning, focus on the customer, employee training and recognition, employee empowerment and teamwork, measurement and analysis, and quality assurance.

  15. NASA total quality management 1990 accomplishments report

    Science.gov (United States)

    1991-01-01

    NASA's efforts in Total Quality Management are based on continuous improvement and serve as a foundation for NASA's present and future endeavors. Given here are numerous examples of quality strategies that have proven effective and efficient in a time when cost reduction is critical. These accomplishment benefit our Agency and help to achieve our primary goal, keeping American in the forefront of the aerospace industry.

  16. Total body irradiation: current indications; L`irradiation corporelle totale: les indications actuelles

    Energy Technology Data Exchange (ETDEWEB)

    Giraud, P.; Danhier, S.; Dubray, B.; Cosset, J.M. [Institut Curie, 75 - Paris (France)

    1998-05-01

    The choice of dose and fractionation for total body irradiation is made difficult by the large number of considerations to be taken into account. The outcome of bone marrow transplantation after total body irradiation can be understood in terms of tumor cell killing, engraftment, and normal tissue damage, each of these endpoints being influenced by irradiation-, disease-, transplant-, and patient- related factors. Interpretation of clinical data is further hampered by the overwhelming influence of logistic constraints, the small numbers of randomized studies, and the concomitant variations in total dose and fraction size or dose rate. So far, three cautious conclusions can be drawn in order to tentatively adapt the total body irradiation schedule to clinically-relevant situations. Firstly, the organs at risk for normal tissue damage (lung, liver, lens, kidney) are protected by delivering small doses per fraction at low dose rate. This suggests that, when toxicity is at stake (e.g. in children), fractionated irradiation should be preferred, provided that inter-fraction intervals are long enough. Secondly, fractionated irradiation should be avoided in case of T-cell depleted transplant, given the high risk of graft rejection in this setting. An alternative would be to increase total (or fractional) dose of fractionated total body irradiation, but this approach is likely to induce more normal tissue toxicity. Thirdly, clinical data have shown higher relapse rates in chronic myeloid leukemia after fractionated or low dose rate total body irradiation, suggesting that fractionated irradiation should not be recommended, unless total (or fractional) dose is increased. Total body irradiation-containing regimens, primarily cyclophosphamide / total body irradiation, are either equivalent to or better than the chemotherapy-only regimens, primarily busulfan / cyclophosphamide. Busulfan / cyclophosphamide certainly represents a reasonable alternative, especially in patients who

  17. Sign variation, the Grassmannian, and total positivity

    CERN Document Server

    Karp, Steven N

    2016-01-01

    The totally nonnegative Grassmannian is the set of k-dimensional subspaces V of R^n whose nonzero Pluecker coordinates all have the same sign. Gantmakher and Krein (1950) and Schoenberg and Whitney (1951) independently showed that V is totally nonnegative iff every vector in V, when viewed as a sequence of n numbers and ignoring any zeros, changes sign at most k-1 times. We generalize this result from the totally nonnegative Grassmannian to the entire Grassmannian, showing that if V is generic (i.e. has no zero Pluecker coordinates), then the vectors in V change sign at most m times iff certain sequences of Pluecker coordinates of V change sign at most m-k+1 times. We also give an algorithm which, given a non-generic V whose vectors change sign at most m times, perturbs V into a generic subspace whose vectors also change sign at most m times. We deduce that among all V whose vectors change sign at most m times, the generic subspaces are dense. These results generalize to oriented matroids. As an application o...

  18. Total quantum coherence and its applications

    Science.gov (United States)

    Yu, Chang-shui; Yang, Si-ren; Guo, Bao-qing

    2016-06-01

    Quantum coherence is the most fundamental feature of quantum mechanics. The usual understanding of it depends on the choice of the basis, that is, the coherence of the same quantum state is different within different reference framework. To reveal all the potential coherence, we present the total quantum coherence measures in terms of two different methods. One is optimizing maximal basis-dependent coherence with all potential bases considered and the other is quantifying the distance between the state and the incoherent state set. Interestingly, the coherence measures based on relative entropy and l_2 norm have the same form in the two different methods. In particular, we show that the measures based on the non-contractive l_2 norm are also a good measure different from the basis-dependent coherence. In addition, we show that all the measures are analytically calculable and have all the good properties. The experimental schemes for the detection of these coherence measures are also proposed by multiple copies of quantum states instead of reconstructing the full density matrix. By studying one type of quantum probing schemes, we find that both the normalized trace in the scheme of deterministic quantum computation with one qubit and the overlap of two states in quantum overlap measurement schemes can be well described by the change of total coherence of the probing qubit. Hence the nontrivial probing always leads to the change of the total coherence.

  19. Total neutron cross section for 181Ta

    Directory of Open Access Journals (Sweden)

    Schilling K.-D.

    2010-10-01

    Full Text Available The neutron time of flight facility nELBE, produces fast neutrons in the energy range from 0.1 MeV to 10 MeV by impinging a pulsed relativistic electron beam on a liquid lead circuit [1]. The short beam pulses (∼10 ps and a small radiator volume give an energy resolution better than 1% at 1 MeV using a short flight path of about 6 m, for neutron TOF measurements. The present neutron source provides 2 ⋅ 104  n/cm2s at the target position using an electron charge of 77 pC and 100 kHz pulse repetition rate. This neutron intensity enables to measure neutron total cross section with a 2%–5% statistical uncertainty within a few days. In February 2008, neutron radiator, plastic detector [2] and data acquisition system were tested by measurements of the neutron total cross section for 181Ta and 27Al. Measurement of 181Ta was chosen because lack of high quality data in an anergy region below 700 keV. The total neutron cross – section for 27Al was measured as a control target, since there exists data for 27Al with high resolution and low statistical error [3].

  20. Total quality in spent fuel pool reracking

    International Nuclear Information System (INIS)

    The nuclear utility environment is one of strict cost control under prescriptive regulations and increasing public scrutiny. This paper presents the results of A Total Quality approach, by a dedicated team, that addresses the need for increased on-site spent fuel storage in this environment. Innovations to spent fuel pool reracking, driven by utilities' specific technical needs and shrinking budgets, have resulted in both product improvements and lower prices. A Total Quality approach to the entire turnkey project is taken, thereby creating synergism and process efficiency in each of the major phases of the project: design and analysis, licensing, fabrication, installation and disposal. Specific technical advances and the proven quality of the team members minimizes risk to the utility and its shareholders and provides a complete, cost effective service. Proper evaluation of spent fuel storage methods and vendors requires a full understanding of currently available customer driven initiatives that reduce cost while improving quality. In all phases of a spent fuel reracking project, from new rack design and analysis through old rack disposal, the integration of diverse experts, at all levels and throughout all phases of a reracking project, better serves utility needs. This Total Quality environment in conjunction with many technical improvements results in a higher quality product at a lower cost

  1. Total generating costs: coal and nuclear plants

    International Nuclear Information System (INIS)

    The study was confined to single and multi-unit coal- and nuclear-fueled electric-generating stations. The stations are composed of 1200-MWe PWRs; 1200-MWe BWRs; 800-and 1200-MWe High-Sulfur Coal units, and 800- and 1200-MWe Low-Sulfur Coal units. The total generating cost estimates were developed for commercial operation dates of 1985 and 1990; for 5 and 8% escalation rates, for 10 and 12% discount rates; and, for capacity factors of 50, 60, 70, and 80%. The report describes the methodology for obtaining annualized capital costs, levelized coal and nuclear fuel costs, levelized operation and maintenance costs, and the resulting total generating costs for each type of station. The costs are applicable to a hypothetical Middletwon site in the Northeastern United States. Plant descriptions with general design parameters are included. The report also reprints for convenience, summaries of capital cost by account type developed in the previous commercial electric-power cost studies. Appropriate references are given for additional detailed information. Sufficient detail is given to allow the reader to develop total generating costs for other cases or conditions

  2. Total Emissions from Flaring in Kuwait Oilfields

    Directory of Open Access Journals (Sweden)

    K. K. AL-Hamad

    2008-01-01

    Full Text Available Kuwait is a major oil producing country and its economy directly depends on its export of crude and refined products. Kuwait Oil Company (KOC is responsible for all exploration and production of crude oil in Kuwait. These activities result in the emission of gaseous pollutants to the atmosphere, particularly from the flaring of undesirable product and excess gases. For environmental and resource conservation reasons, KOC is required to minimize the amount of gas flared in order to control and reduce the emissions of major pollutants in the State of Kuwait and neighbors countries. In the present study the total emissions of primary pollutants associated from flaring activities from Kuwait oil field have been estimated. An inventory records the annual emissions of air pollutants: NOX, SO2, CO, CO2, Methane and non-methane, Volatile Organic Compounds (VOC: resulting from oil production operations in the Kuwait Oil Fields. The emissions are generated from various point sources and aggregated to have total pollutants load of ambient air. Emissions of flaring pollutants are associated with all operations in Oil fields, Gathering Centers (GC, Boaster Stations (BS, Tank areas and other oil production related activities. The objective of this work was to obtain an accurate estimation of the total flare emission from oil production activities thereby aiding the effective planning of mitigation strategies to control and reduce the pollution from crude related operation.

  3. Revision total elbow arthroplasty with the linked Coonrad-Morrey total elbow arthroplasty

    DEFF Research Database (Denmark)

    Plaschke, Hans Christian; Thillemann, Theis; Belling-Sørensen, Anne Kathrine; Olsen, Bo

    2013-01-01

    In this retrospective study we evaluated the short- to medium-term results after 20 Coonrad-Morrey revision total elbow arthroplasties (TEAs).......In this retrospective study we evaluated the short- to medium-term results after 20 Coonrad-Morrey revision total elbow arthroplasties (TEAs)....

  4. Introduction of total knee arthroplasty in Lithuania

    Science.gov (United States)

    Stucinskas, Justinas; Robertsson, Otto; Wingstrand, Hans

    2009-01-01

    Background and purpose We have previously reported that the first 10 years of hip arthroplasty in Lithuania resulted in a higher cumulative revision rate than that observed in Sweden. We thus compared the corresponding results after introduaction of total knee replacement in Lithuania. Methods The 10-year revision rate for the first 595 primary ScanKnee arthroplasties inserted in Klaipeda, Lithuania, was compared to that for the first 1,280 ScanKnee primary arthroplasties inserted in Sweden. As in the hip replacement study, only patients with osteoarthritis (OA) were included. Primary knee arthroplasties without patellar resurfacing were included, and the endpoint was revision for any reason other than addition of a patellar component. Results We found that the cumulative revision rate was not statistically significantly different between the groups. The revision pattern was different, however, and we observed 24 isolated patellar component additions in Sweden, but none in Klaipeda. Interpretation Contrary to the results of our previous hip arthroplasty study, the cumulative revision rate after total knee arthroplasty was similar in the two groups. This suggests that compared to hip arthroplasty, the outcome of total knee arthroplasty was less dependent on surgical experience. The large difference regarding isolated patellar component additions may be explained by long-term accumulation of severe OA cases in Lithuania. To patients subject to a newly introduced surgical treatment offering great improvement in quality of life, patellofemoral pain may be a minor problem. Furthermore, patellar problems may not have seemed particularly relevant for the surgeons, considering the disability of other patients waiting to be treated. PMID:19297790

  5. Total synthesis of human beta-lipotropin.

    OpenAIRE

    Blake, J; Li, C. H.

    1983-01-01

    The total synthesis of human beta-lipotropin has been accomplished by the new segment-coupling method in aqueous solution. The peptides Ac-Arg-beta-lipotropin-(61-89) (I) and [GlyS60]-beta-lipotropin-(1-60) (II) were synthesized by the solid-phase method. Reaction of peptide I with citraconic anhydride followed by brief digestion with trypsin to remove the acetylarginyl group, gave Ia. Reaction of peptide II with citraconic anhydride gave the citraconyl peptide IIa. Ia and IIa were coupled to...

  6. Total Hip Arthroplasty in Mucopolysaccharidosis Type IH

    Directory of Open Access Journals (Sweden)

    S. O'hEireamhoin

    2011-01-01

    Full Text Available Children affected by mucopolysaccharidosis (MPS type IH (Hurler Syndrome, an autosomal recessive metabolic disorder, are known to experience a range of musculoskeletal manifestations including spinal abnormalities, hand abnormalities, generalised joint stiffness, genu valgum, and hip dysplasia and avascular necrosis. Enzyme therapy, in the form of bone marrow transplantation, significantly increases life expectancy but does not prevent the development of the associated musculoskeletal disorders. We present the case of a 23-year-old woman with a diagnosis of Hurler syndrome with a satisfactory result following uncemented total hip arthroplasty.

  7. PENDEKATAN TOTAL QUALITY MANAGEMENT PRODUK BROILER TOLAKAN

    Directory of Open Access Journals (Sweden)

    Zeetpy Maisana

    2012-11-01

    Full Text Available ABSTRACTThe purpose of this study was to analyze rejected product in slaughterhouse division using total quality management approach. The secondary data were collected from the company archives and judgmental sampling was used to collect primary data from six experienced respondents. The analysis method used was total quality management, include stratification, Pareto diagrams, control charts, fishbone diagrams, and quality function deployment. The findings of this study showed that the use of line production system by the slaughterhouse to produce the product; where products’ redness/bruises, size uniformity, bloodless feature, incorrect delivery, delivery delay, and damaged package were the cause of product rejection. The strategies ordered based on the priority to improve the management quality are: tools repair and replacement, creating quality based projects, build an information system between the production lines, training and seminar. The managerial implications of the study suggested the slaughterhouse to replace or repair the plucker, scalder and automatic weighing machine. It also suggested the slaughterhouse to tighten the span of control in the chilling room to maintain product freshness.Keywords: rejected product analysis, TQM, QFD, chicken slaughterhouse, carcassABSTRAKPenelitian ini bertujuan menganalisis produk tolakan pada rumah potong ayam melalui pendekatan total quality management. Pengumpulan data sekunder penelitian diperoleh dari arsip perusahaan dan judgemental sampling digunakan terhadap enam responden ahli untuk memperoleh data primer penelitian. Metode analisis data yang digunakan total quality management, meliputi stratifikasi, diagram pareto, peta kendali, diagram tulang ikan, dan quality function deployment.  Hasil penelitian menunjukkan penggunaan sistem lini produksi pada proses produksi di perusahaan, dimana memar pada produk, keseragaman ukuran, kesegaran produk, pengiriman tidak sesuai pesanan

  8. TotalFinaElf Factbook 2002

    International Nuclear Information System (INIS)

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2002. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  9. Total down to work for Chtokman's gas

    International Nuclear Information System (INIS)

    In the framework of the exploitation contract signed with Gazprom, Total group, partner of the project with StatoilHydro, has started the feasibility study for the huge Chtokman gas field in Russia (Barents sea). A definitive investment decision should be given within less a year. The pre-project phase started in summer 2008 but nothing has been decided yet. Russia has two big projects in competition: Chtokman and Kharasavey in Yamal province. Considering the extreme climate conditions and the technical challenges, Russia will need the experience of foreign partners. (J.S.)

  10. Total knee arthroplasty in vascular malformation

    Directory of Open Access Journals (Sweden)

    Harish Bhende

    2015-01-01

    Full Text Available In Klippel–Trenaunay syndrome, vascular malformations are not only in skin and superficial soft tissues but also in deep tissues like muscles bones and joints. It is well documemted that these recurrent intraarticular bleeds can cause early arthritis and joint pain. Performing arthroplasty in such patients is difficult and fraught with complications. We describe such a case where navigated total knee arthroplasty was performed with success to avoid the problems of intra medullary alignment used in the presence of intra medullary vascular malformations. We also suggest certain measures when knee arthroplasty is considered in such patients.

  11. Total synthesis of insect antifeedant drimane sesquiterpenes.

    OpenAIRE

    Jansen, B.J.M.

    1993-01-01

    The investigations described in this thesis deal with the total synthesis of sesquiterpenes of the drimane family, named for their widespread occurrence in the stem bark of South American Drimys species. These compounds contain the bicyclofarnesol nucleus 1 , which is invariably oxidized at C-11 and/or C-12 and often at other sites as well (see figure 8.1).A few rearranged drimanes, e.g., (+)-colorata-4(13),8-dienolide 6 , and (-)-muzigadial 7 , are also isolated from natural products. The re...

  12. Total on-line purchasing system (TOPS)

    Energy Technology Data Exchange (ETDEWEB)

    Collins, N.

    1995-11-01

    The Information Management Division (IMD) at LLNL is developing a new purchasing system for the Procurement Department. The first major development of this new system is called, {open_quotes}Total On-Line Purchasing System{close_quotes} (TOPS). TOPS will help speed up the requisitioning process by having requisitions electronically entered by requesters and electronically sent to buyers to be put on Purchase Orders. The new purchasing system will use Electronic Commerce (EC)/Electronic Data Interchange (EDI), to help increase transaction flows for shipping notices, RFQs, Quotes, Purchase Orders, and Invoices. ANSI X.12 is the EDI standard that this new EC will use.

  13. Total Routhian surface calculation for 127I

    International Nuclear Information System (INIS)

    The Total Routhian Surface (TRS) calculation is a very useful and well known way to understand the rotational motion of the atomic nuclei theoretically. The evolution of the deformations during the process of nuclear rotation can be studied theoretically under the framework of TRS. The quadrupole and triaxial deformation play crucial roles in the rotational properties of nuclei. The TRS formalism was developed mainly based on the macroscopic-microscopic model. The aim of the present work is to study the positive parity yrast rotational structure of 127I in terms of deformation, under the framework of macroscopic-microscopic model

  14. Segmental blood pressure after total hip replacement

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Henriksen, Jens Henrik Sahl

    1992-01-01

    Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant...... drop was found in all pressures 1 week postoperatively. The decrease followed the systemic pressure and was restored to normal after 6 weeks. In a group of six patients with preoperatively decreased ankle pressure, a significant transient further decrease in the ankle-toe gradient pressure was found...

  15. Heterotopic ossification following lumbar total disc replacement

    OpenAIRE

    Park, Se-Jun; Kang, Kyung-Jung; Shin, Seong-Kee; Chung, Sung-Soo; Lee, Chong-Suh

    2010-01-01

    The main goal of total disc replacement (TDR) is to preserve motion. Despite reports of good clinical outcomes, various degrees of heterotopic ossification after TDR have been reported. The purpose of this study was to investigate the prevalence and its clinical relevance of heterotopic ossification. We evaluated 65 consecutive patients (82 segments) with mean follow-up duration of 45 months (range, 12–88 months). Two kinds of prosthesis, ProDisc® for 75 segments (91.5%) and CHARITETM for sev...

  16. Vaginal mass following uncemented total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Young-Soo Shin

    2014-01-01

    Full Text Available A 53-year-old woman developed a vaginal mass following an uncemented total hip arthroplasty. The mass was in direct communication with the hip through an acetabular medial wall defect after loosening of the acetabular component. The mass formation was caused simultaneously by changes secondary to polyethylene wear, a tiny delamination of the porous titanium mesh coating and a broken antirotational tab on the acetabular cup, all of which may have served as sources of metal particles. A careful evaluation of the patient′s history, symptoms, X-ray findings and computed tomography scans should always be performed to ensure accurate diagnosis.

  17. Total Syntheses of Periconiasins A-E.

    Science.gov (United States)

    Tian, Chong; Lei, Xiaoqiang; Wang, Yuanhao; Dong, Zhen; Liu, Gang; Tang, Yefeng

    2016-06-01

    The first and collective total syntheses of periconiasins A-E, a group of naturally occurring cytochalasans, were achieved by a series of rationally designed or bioinspired transformations. Salient features of the syntheses include a tandem aldol condensation/Grob fragmentation to assemble the linear polyketide-amino acid hybrid precursor, a Diels-Alder macrocylization to construct the 9/6/5 tricyclic core of periconiasins A-C, and a transannular carbonyl-ene reaction to forge the polycyclic framework of periconiasins D and E. PMID:27121397

  18. Total quality management (TQM) in diagnostic radiology

    International Nuclear Information System (INIS)

    The branch of quality assurance is now taking a new direction towards total quality management (TQM). Being of industrial origin, the concepts and terminologies in TQM are alien to medical and paramedical professionals. However, the impetus it has already made in other areas of health sciences makes medical physicists left out when diagnostic radiology does not encompass TQM. The purpose of this paper is to introduce the terms used in TQM and some aspects of its application to diagnostic radiology. (author). 12 refs., 1 tab

  19. Security Systems Consideration: A Total Security Approach

    Science.gov (United States)

    Margariti, S. V.; Meletiou, G.; Stergiou, E.; Vasiliadis, D. C.; Rizos, G. E.

    2007-12-01

    The "safety" problem for protection systems is to determine in a given situation whether a subject can acquire a particular right to an object. Security and audit operation face the process of securing the application on computing and network environment; however, storage security has been somewhat overlooked due to other security solutions. This paper identifies issues for data security, threats and attacks, summarizes security concepts and relationships, and also describes storage security strategies. It concludes with recommended storage security plan for a total security solution.

  20. Total internal reflection tomography of small objects

    International Nuclear Information System (INIS)

    The multiple signal classification (MUSIC) imaging method is applied to determine the locations of a collection of small anisotropic spherical scatterers in the framework of the total internal reflection tomography. Multiple scattering between scatterers is considered and the inverse scattering problem is nonlinear, which, however, is solved by the proposed fast analytical approach where no associated forward problem is iteratively evaluated. The paper also discusses the role of the polarization of incidence waves, the incidence angle, the separation of scatterers from the surface of the substrate, and the level of noise on the resolution of imaging.

  1. [Bilateral vocal cord paresis after total thyroidectomy].

    Science.gov (United States)

    Dralle, H; Neu, J; Musholt, T J; Nies, C

    2016-01-01

    A 66-year-old female patient complained of hoarseness and dyspnea under exertion following total thyroidectomy. Due to a faulty operating technique both nerves to the vocal cords were damaged. From the operation report it emerged that the dissection was carried out by protecting the border lamellae but the recurrent laryngeal nerve could not be found on both sides. This article presents the external expert opinion, the decision of the arbitration board and the assessment of the case by two specialist physicians. PMID:26683653

  2. Scientific observations at total solar eclipses

    OpenAIRE

    Pasachoff, Jay M.

    2009-01-01

    The occasion of the longest totality of an eclipse in the 18 yr 11⅓ d saros cycle leads to taking stock of the scientific value of ground-based eclipse observations in this space age. Though a number of space satellites from the U.S., Europe, Japan, and Russia study the Sun, scientists at eclipses can observe the solar chromosphere and corona at higher spatial resolution, at higher temporal resolution, and at higher spectral resolution than are possible aloft. Furthermore, eclipse expeditions...

  3. Total Ankle Arthroplasty: An Imaging Overview

    Science.gov (United States)

    Kim, Da-Rae; Potter, Hollis G.; Li, Angela E.; Chun, Ka-Young; Jung, Yoon Young; Kim, Jin-Su; Young, Ki-Won

    2016-01-01

    With advances in implant technology, total ankle arthroplasty (TAA) has become an increasingly popular alternative to arthrodesis for the management of end-stage ankle arthritis. However, reports in the literature do not focus on the imaging features of TAA. Through a literature review, we demonstrate basic design features of the current ankle arthroplasty system, and the normal and abnormal postoperative imaging features associated with such devices. Pre- and postoperative evaluations of ankle arthroplasty mainly include radiography; in addition, computed tomography and magnetic resonance imaging provide further characterization of imaging abnormalities. Familiarization with multimodal imaging features of frequent procedural complications at various postoperative intervals is important in radiological practice. PMID:27134529

  4. Vascular injuries during total hip revision

    International Nuclear Information System (INIS)

    Although most patients undergoing a revision total hip replacement (THR) will have an uneventful procedure, in others the potential of serous vascular injuries is real. Migrating prosthesis or excessive cement may be in compromising positions adjacent or adherent to vessels and pose a particular danger at surgery with inadvertent lacerations of vessels such as the internal and external iliac arteries. In out study of 20 patients with THR, CT with two-dimensional reconstructions is used to define vessel position. In eight of these patients, the hip prosthesis or displaced cement lies within 5 mm of major vessels. In patients with dislocation of the acetabular cup, the potential of vascular injury is highest

  5. A Combination of Varying Column Pressure and Total Reflux—Total Efflux in Batch Distillation Operation

    Institute of Scientific and Technical Information of China (English)

    ZHANGWeijiang; QUHongmei; 等

    2002-01-01

    A novel operation of batch distillation-combination of varying colum pressure and total reflux-total efflux is studied experimentally. In the operation, the product is accumulated at the top of the column under total reflux and then drained off completely, and the column pressure is varying in the whole process. This process has been industrialized successfully with large profits. The conventional mode of batch distillation is improved by this method effectively: the separation eficiency and the yield of product are increased greatly, the operation time is shortened and the production cost is cut down. Moreover, the amount of condensation water is decreased and the over-high reboiler temperature is lowered.

  6. Diagnosis of infection after total hip arthroplasty

    International Nuclear Information System (INIS)

    Forty-eight total hip arthroplasties for which revision surgery was performed were reviewed to determine the accuracy of laboratory tests, plain radiographs, hip aspiration, and technetium-99m MDP and gallium-67 scans in demonstrating the presence or absence of infection of the prosthesis. Six of the 48 hips were diagnosed as having an infection at the revision surgery. The erythrocyte sedimentation rate and the C-reactive protein levels were significantly higher in the patients with infected prostheses. The difference in the white blood cell count was not significant. There was no significant relationship between the presence of infection and the severity of loosening and instability of the implants diagnosed by plain radiographs. The accuracy of hip aspiration in diagnosing the infection was 83%, with a sensitivity of 40% and a specificity of 92%. The accuracy of technetium-99m MDP bone scan was 79%, with a sensitivity of 83%, and a specificity of 79%. Gallium-67 scan had an accuracy of 96%, a sensitivity of 67%, and a specificity of 100%. The findings in the present study indicated that diagnostic tests consisting of laboratory tests and plain radiography, followed by hip aspiration and sequential use of technetium-99m MDP and gallium-67 scintigraphies, are suitable for differentiation between mechanical loosening and infection of total hip arthroplasty. (author)

  7. Imaging of total colonic Hirschsprung disease

    International Nuclear Information System (INIS)

    Hirschsprung disease (HD) is a functional obstruction of the bowel caused by the absence of intrinsic enteric ganglion cells. The diagnosis of total colonic HD (TCHD) based on contrast enemas is difficult in newborns because radiological findings vary. To evaluate the radiographic and contrast enema findings in patients with pathologically proven TCHD. From 1966 to 2007, 17 records from a total of 31 patients with TCHD were retrospectively evaluated for diameter and shape of the colon, diameter of the small bowel, bowel wall contour, ileal reflux, abdominal calcifications, pneumoperitoneum, filling defects, transitional zones and rectosigmoid index. Three colonic patterns of TCHD were found: microcolon, question-mark-shape colon and normal caliber colon. Additional findings included spasmodic colon, ileal reflux, delayed evacuation and abdominal calcifications. Colonic transitional zones were found in eight patients with TCHD. The diagnosis of TCHD is difficult to establish by contrast enema studies. The length of the aganglionic small bowel and the age of the patient can influence the radiological findings in TCHD. The transitional zone and the rectosigmoid index can be false-positive in TCHD. The colon can appear normal. Consider TCHD if the contrast enema study is normal but the patient remains symptomatic and other causes of distal bowel obstruction have been excluded. (orig.)

  8. Imaging of total colonic Hirschsprung disease

    Energy Technology Data Exchange (ETDEWEB)

    Stranzinger, Enno; DiPietro, Michael A.; Strouse, Peter J. [University of Michigan Health System, Section of Pediatric Radiology, Ann Arbor, MI (United States); Teitelbaum, Daniel H. [University of Michigan Health System, Section of Pediatric Surgery, Ann Arbor, MI (United States)

    2008-11-15

    Hirschsprung disease (HD) is a functional obstruction of the bowel caused by the absence of intrinsic enteric ganglion cells. The diagnosis of total colonic HD (TCHD) based on contrast enemas is difficult in newborns because radiological findings vary. To evaluate the radiographic and contrast enema findings in patients with pathologically proven TCHD. From 1966 to 2007, 17 records from a total of 31 patients with TCHD were retrospectively evaluated for diameter and shape of the colon, diameter of the small bowel, bowel wall contour, ileal reflux, abdominal calcifications, pneumoperitoneum, filling defects, transitional zones and rectosigmoid index. Three colonic patterns of TCHD were found: microcolon, question-mark-shape colon and normal caliber colon. Additional findings included spasmodic colon, ileal reflux, delayed evacuation and abdominal calcifications. Colonic transitional zones were found in eight patients with TCHD. The diagnosis of TCHD is difficult to establish by contrast enema studies. The length of the aganglionic small bowel and the age of the patient can influence the radiological findings in TCHD. The transitional zone and the rectosigmoid index can be false-positive in TCHD. The colon can appear normal. Consider TCHD if the contrast enema study is normal but the patient remains symptomatic and other causes of distal bowel obstruction have been excluded. (orig.)

  9. Deformation analysis with Total Least Squares

    Directory of Open Access Journals (Sweden)

    M. Acar

    2006-01-01

    Full Text Available Deformation analysis is one of the main research fields in geodesy. Deformation analysis process comprises measurement and analysis phases. Measurements can be collected using several techniques. The output of the evaluation of the measurements is mainly point positions. In the deformation analysis phase, the coordinate changes in the point positions are investigated. Several models or approaches can be employed for the analysis. One approach is based on a Helmert or similarity coordinate transformation where the displacements and the respective covariance matrix are transformed into a unique datum. Traditionally a Least Squares (LS technique is used for the transformation procedure. Another approach that could be introduced as an alternative methodology is the Total Least Squares (TLS that is considerably a new approach in geodetic applications. In this study, in order to determine point displacements, 3-D coordinate transformations based on the Helmert transformation model were carried out individually by the Least Squares (LS and the Total Least Squares (TLS, respectively. The data used in this study was collected by GPS technique in a landslide area located nearby Istanbul. The results obtained from these two approaches have been compared.

  10. Total body irradiation for children with malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Sanuki, Eiichi; Maeno, Toshio; Kamata, Rikisaburo; Tanaka, Yoshiaki; Mugishima, Hideo [Nihon Univ., Tokyo (Japan). School of Medicine

    1995-12-01

    Total body irradiation combined with high dose chemotherapy has been performed just before bone marrow transplantation in 35 children with advanced malignancies, with the object of achieving successful transplantation and improving the prognosis. Simulation was performed as follows: back scatter, flatness, dose accumulation using randophantom and dose distribution using a thermo-luminescence dosimeter and linac-graphy. The standard error of dose distribution was within 10%. In neuroblastoma, of which there were 14 cases in stage IV and one case in stage III, the 5-year survival rate was 55%. In leukemia, of which all cases were in the high-risk group (7 cases of acute lymphoblastic leukemia and 2 of acute myeloblastic leukemia) the 5-year survival rate was 55%. The 5 cases having first remission survived disease-free while the 4 cases having non-first remission died. In malignant lymphoma (6 cases in stage IV and one case in stage III, with bulky mass) the 5-year survival rate was 67%. Four cases with other diagnoses (severe aplastic anemia, and others) all survived. As yet no side effects resulting from total body irradiation have been recognized in our cases, but a longer follow-up period is necessary to observe possible late side effects. (author).

  11. Preoperative Planning in Primary Total Knee Arthroplasty.

    Science.gov (United States)

    Tanzer, Michael; Makhdom, Asim M

    2016-04-01

    Preoperative planning is of paramount importance in primary total knee arthroplasty. A thorough preoperative analysis helps the surgeon envision the operation, anticipate any potential issues, and minimize the risk of premature implant failure. Obtaining a thorough history is critical for appropriate patient selection. The physical examination should evaluate the integrity of the soft tissues, the neurovascular status, range of motion, limb deformity, and the status of the collateral ligaments to help determine the soft-tissue balancing and constraint strategy required. Standard radiographs, with a known magnification, should be obtained for preoperative total knee arthroplasty templating. Routine standing AP, lateral, and skyline radiographs of the knee can help the surgeon plan the bone cuts and tibial slope as well as the implant size and position at the time of surgery. In certain circumstances, such as severe coronal deformities, bone deficiencies, and/or extra-articular deformities, additional measures are frequently necessary to successfully reconstruct the knee. Constrained implants, metal augments, and bone graft must be part of the surgeon's armamentarium. PMID:26990712

  12. Total quality drives nuclear plant improvements

    International Nuclear Information System (INIS)

    Total quality (TQ) at Carolina Power and Light (CP and L) is fulfilling a 1985 vision of Sherwood H. Smith, Jr., CP and L's chairman, president, and chief executive officer. The TQ concept has provided a way for employees to align their creative energies toward meeting the business needs of the company. Throughout CP and L, TQ has been recognized as the vehicle for reducing operating costs and improving customer satisfaction. Within the nuclear organization, application of the TQ process has helped to improve communications, resolve challenges, and provide more consistent work practices among CP and L's three nuclear plants. Total quality was introduced from the top down, with initial benefits coming from team interactions. Senior management at CP and L defined the corporate expectations and outlined the training requirements for implementing TQ. Management staffs at each organizational level became steering committees for TQ team activities within their departments. Teams of employees most knowledgeable about a given work area were empowered to solve problems or overcome obstacles related to that work area. Employees learned to become better team players and to appreciate the quality of decisions reached through group consensus. Now, formalized methods that started TQ are becoming part of the day-to-day work ethic

  13. Reduction Methods for Total Reaction Cross Sections

    Science.gov (United States)

    Gomes, P. R. S.; Mendes Junior, D. R.; Canto, L. F.; Lubian, J.; de Faria, P. N.

    2016-03-01

    The most frequently used methods to reduce fusion and total reaction excitation functions were investigated in a very recent paper Canto et al. (Phys Rev C 92:014626, 2015). These methods are widely used to eliminate the influence of masses and charges in comparisons of cross sections for weakly bound and tightly bound systems. This study reached two main conclusions. The first is that the fusion function method is the most successful procedure to reduce fusion cross sections. Applying this method to theoretical cross sections of single channel calculations, one obtains a system independent curve (the fusion function), that can be used as a benchmark to fusion data. The second conclusion was that none of the reduction methods available in the literature is able to provide a universal curve for total reaction cross sections. The reduced single channel cross sections keep a strong dependence of the atomic and mass numbers of the collision partners, except for systems in the same mass range. In the present work we pursue this problem further, applying the reduction methods to systems within a limited mass range. We show that, under these circumstances, the reduction of reaction data may be very useful.

  14. Thermoluminescent dosimetry in total body irradiation

    International Nuclear Information System (INIS)

    The aim of this paper was to develop a thermoluminescent dosimetry method for the absorbed dose determination of 6 MeV high-energy electron beams by thermoluminescent dosimetry. Total body irradiation (TBI) was performed using four dual fields angled at 252° and 285° in high-dose rate (HDR) mode. TBI measurements were investigated to estimate the absorbed dose in different anatomical parts of the patient. Experimental results were obtained using thermoluminescent detectors and solid water phantoms. The TL response of the dosimeters, as a function of the high-energy electron beam (HEEB) absorbed dose, was linear, from 0.1 to 500 cGy. The entrance skin dose (ESD) and isodose distribution on the surface of the treatment were investigated graphically. - Highlights: ► The total patient skin electron dose was determined. ► The patient skin dose distribution was measured by TL. ► TBID in treatment planning and QA for radiation therapy are suggested. ► TLD system is a good candidate for TBI dosimetry.

  15. EHV transmission maintenance. A total asset strategy

    International Nuclear Information System (INIS)

    For countries whose economies are rapidly expanding, the demand for power, and in particular electricity, is resulting in rapid expansions of the generation, transmission and distribution of electricity. This means that a new plant is being installed which, apart from some minor post commissioning problems, will be free from major maintenance for several years to come. Consequently, in such cases, maintenance is confined to basic annual shutdown checks and routine online monitoring. As equipment and plant age it is important to commence planning for additional maintenance over and above these basic annual checks; to monitor performance; to monitor faults and defects and to use that information to engineer out design faults, to influence current maintenance techniques and to influence future procurement specifications. Also, provided that sufficient information is available, informed decisions can be taken as to when a power plant should be decommissioned or refurbished. This process can be described as a total asset management strategy covering all decisions from procurement through to commissioning, ongoing maintenance, refurbishment, decommissioning and reappraisal of specifications for future procurement. Based upon the author's experience within the United Kingdom Electricity Supply industry, a total asset strategy will be proposed for EHV transmission plant that will optimise current and future expenditure while maximizing reliability and minimising downtime. 1 ref., 5 figs

  16. Total Economic Value in Investment Analysis

    Directory of Open Access Journals (Sweden)

    Sudarsono Soedomo

    2014-01-01

    Full Text Available Forest ecosystems are often defeated in decisions about investment and economic development.  There is a very wide gap between policy makers and development investment on the one hand and environmentalists on the other hand, who see the forest ecosystem from the perspective of ecology and environment.  The first party considers that forest ecosystems have a low value, while the second party often shows very fantastic figures about the economic value of forests. From the second party's point of view, the first party could be ignorant or having a short-term interest; while from the first party's point of view, the second party loves to produce the figures that are too good to be true.  As a result, the total economic value of ecosystems is not only ignored as a consideration in investment decisions, but the total economic value of ecosystems has been seen as a boring scientific joke.  Why did the gap occur and how to close the gap will be discussed in this paper.  Economic valuation of ecosystem needs to be done more realistically so that the results are more plausible before policy makers. On the contrary, policy makers need to be aware that once a species vanished it never goes back.Keywords: ecosystem, goods and services, value, trade-off, double counting DOI: 10.7226/jtfm.19.3.201

  17. Íleo biliar: presentación en la urgencia quirúrgica

    Directory of Open Access Journals (Sweden)

    Reinaldo Jiménez Prendes

    2011-12-01

    Full Text Available Se presenta el caso de una paciente de 60 años de edad, con antecedentes de litiasis vesicular, que ingresó de urgencia por presentar un cuadro de dolor abdominal, vómitos y distensión en el abdomen con 2 días de evolución. De forma secundaria presentó una deshidratación moderada. En la radiografía simple de abdomen se constataron signos radiológicos de oclusión intestinal. Se corrigió el desequilibrio hidroelectrolítico y se realizó una laparotomía exploradora, en la que se encontró un cálculo grande enclavado en el íleon terminal. Se realizó una enterolitotomía con enterorrafia y resolvió el cuadro oclusivo.

  18. Contrast-free air cholangiography-assisted unilateralplasticstentinginmalignanthilar biliar y obstruction

    Institute of Scientific and Technical Information of China (English)

    Virendra Singh; Gurpreet Singh; Vikas Gupta; Rajesh Gupta; Rakesh Kapoor

    2010-01-01

    BACKGROUND:Endoscopic palliation in malignant hilar biliary obstruction requires endoscopic retrograde cholangio-pancreatography (ERCP), whereas contrast injection leads to cholangitis. Contrast-free metal stenting with or without magnetic resonance cholangiopancreatography (MRCP) has shown encouraging results, but MRCP and metal stents are costly. There have been no reports on the use of air cholangio-graphy. METHODS:We prospectively evaluated the role of air cho-langiography-assisted unilateral plastic stenting in 10 patients with typeⅡmalignant hilar biliary obstruction. A retrospectively analysed group of 10 patients treated with contrast-free unilateral metal stenting served as historical controls. RESULTS:Ten patients with unresectable typeⅡmalignant hilar biliary obstruction were studied. Air cholangiography detected typeⅡobstruction in all patients, similar to MRCP. The patients underwent unilateral stenting. Successful endoscopic drainage was achieved in all patients. The mean patency of the stent was 95.8±17.5 days in the study group and 143.9±115.1 days in the control group (P=0.20). The mean survival was 121.8±41.6 days in the study group and 154.9±122.5 days in the control group (P=0.42). Kaplan-Meier analysis showed an estimated median survival of 100∶95% CI (65.9, 134.1) days in the study group and 98∶95%CI (84.1, 111.9) days in the control group (P=0.62). Cholangitis occurred in none of the patients and there were no 30-day deaths nor major complications. Air cholangiography-assisted unilateral plastic stenting was cheaper than contrast-free unilateral metal stenting. CONCLUSION:Air cholangiography-assisted unilateral plastic stenting is as safe and effective as contrast-free unilateral metal stenting in typeⅡmalignant hilar biliary obstruction for palliating patients, but it is cheaper.

  19. Leiomioma de vesícula biliar em cão

    Directory of Open Access Journals (Sweden)

    Sant?Ana F.J.F.

    2000-01-01

    Full Text Available This report describes the pathological findings of a leiomyoma in the gall bladder of a female 11-year-old Doberman dog. The animal underwent euthanasia due to the poor prognosis of an osteosarcoma of the skull. Grossly, there was a firm smooth whitish nodule in the gall bladder with 0.5 centimeter in diameter. Histologically the nodule was composed of isomorphic and well differentiated leiomyocytes arranged in bundles. The diagnosis was confirmed by Van Gieson staining.

  20. Tratamiento no quirúrgico de la litiasis biliar Non-Surgical treatment of biliary calculi

    Directory of Open Access Journals (Sweden)

    Felipe Franco

    1992-01-01

    Full Text Available

    Se describen diversos procedimientos para el tratamiento no quirúrgico de la colelitiasis: la administración de ácidos billares orales, la litotripsia extracorpórea, la colecistostomía percutánea, la escleroterapia de la vesícula y la litotripsia mecánica; se consignan las indicaciones, ventajas, desventajas y limitaciones de cada uno de ellos.

    Several procedures are described for non-surgical treatment of biliary calculi, namely: oral administration of bile acids, extracorporeal shock-wave lithotrypsy I percutaneous cholecystostomy I gallbladder sclerotherapy

    and mechanicallithotrypsy. lndications, advantages, disadvantages and limitations of each procedure are discussed.

  1. Tratamiento no quirúrgico de la litiasis biliar Non-Surgical treatment of biliary calculi

    OpenAIRE

    Felipe Franco

    1992-01-01

    Se describen diversos procedimientos para el tratamiento no quirúrgico de la colelitiasis: la administración de ácidos billares orales, la litotripsia extracorpórea, la colecistostomía percutánea, la escleroterapia de la vesícula y la litotripsia mecánica; se consignan las indicaciones, ventajas, desventajas y limitaciones de cada uno de ellos.

    Total hemispherical emissivity of Inconel 718

    International Nuclear Information System (INIS)

    Highlights: • We have measured the total hemispherical emissivity for Inconel 718 from about 600–1250 K. • Oxidation in air at 1073 K resulted in an increase in emissivity. • Sandblasting of Inconel 718 was also observed to increase the emissivity. • Coating of graphite powder onto the ‘as-received’ Inconel 718 showed no increase in the emissivity. • Coating of graphite powder onto the 220 grit sandblasted Inconel 718 did show an increase in emissivity. - Abstract: Total hemispherical emissivity for Inconel 718 was measured in anticipation of its application in Very High Temperature Gas Reactors (VHTRs). A majority of current emissivity data for Inconel 718 is in the form of spectral measurements. The data presented here were obtained with an experimental apparatus based on the standard ASTM C835-06 for total hemispherical emittance. Measurements of Inconel 718 were made for four different surface types including: (i) ‘as-received’ from the manufacturer, (ii) oxidized in air and humidified helium, (iii) sandblasted with aluminum oxide powder, and (iv) with a thin coating of nuclear grade graphite powder (grade NGB-18). The emissivity for the ‘as-received’ sample ranged from 0.21 to 0.28 in the temperature interval from 760 K to 1275 K. Oxidation in air at 1073 K resulted in an increase in emissivity into the range from 0.2 at 650 K to 0.52 at 1200 K. There was no dependence on the oxidation times studied here. Oxidation with humidified helium at 1073 K produced less of an increase in emissivity than the oxidation in air but there was an increase up to the range from 0.2 at 600 K to 0.35 at 1200 K. Sandblasting of Inconel 718 was also observed to increase the emissivity up to the range from 0.43 at 780 K to 0.53 at 1270 K when 60 grit sized powder was used and up to the range from 0.45 at 683 K to 0.57 at 1267 K when 120 and 220 grit sized powders were used. Coating of graphite powder onto the ‘as-received’ Inconel 718 showed no increase

  2. Total hemispherical emissivity of Inconel 718

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Benjamin P.; Nelson, Shawn E.; Walton, Kyle L.; Ghosh, Tushar K.; Tompson, Robert V.; Loyalka, Sudarshan K., E-mail: LoyalkaS@missouri.edu

    2015-06-15

    Highlights: • We have measured the total hemispherical emissivity for Inconel 718 from about 600–1250 K. • Oxidation in air at 1073 K resulted in an increase in emissivity. • Sandblasting of Inconel 718 was also observed to increase the emissivity. • Coating of graphite powder onto the ‘as-received’ Inconel 718 showed no increase in the emissivity. • Coating of graphite powder onto the 220 grit sandblasted Inconel 718 did show an increase in emissivity. - Abstract: Total hemispherical emissivity for Inconel 718 was measured in anticipation of its application in Very High Temperature Gas Reactors (VHTRs). A majority of current emissivity data for Inconel 718 is in the form of spectral measurements. The data presented here were obtained with an experimental apparatus based on the standard ASTM C835-06 for total hemispherical emittance. Measurements of Inconel 718 were made for four different surface types including: (i) ‘as-received’ from the manufacturer, (ii) oxidized in air and humidified helium, (iii) sandblasted with aluminum oxide powder, and (iv) with a thin coating of nuclear grade graphite powder (grade NGB-18). The emissivity for the ‘as-received’ sample ranged from 0.21 to 0.28 in the temperature interval from 760 K to 1275 K. Oxidation in air at 1073 K resulted in an increase in emissivity into the range from 0.2 at 650 K to 0.52 at 1200 K. There was no dependence on the oxidation times studied here. Oxidation with humidified helium at 1073 K produced less of an increase in emissivity than the oxidation in air but there was an increase up to the range from 0.2 at 600 K to 0.35 at 1200 K. Sandblasting of Inconel 718 was also observed to increase the emissivity up to the range from 0.43 at 780 K to 0.53 at 1270 K when 60 grit sized powder was used and up to the range from 0.45 at 683 K to 0.57 at 1267 K when 120 and 220 grit sized powders were used. Coating of graphite powder onto the ‘as-received’ Inconel 718 showed no increase

  3. On the total character of finite groups

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Prajapati

    2014-09-01

    Full Text Available For a finite group $G$, we study the total character $tau_G$ afforded by the direct sum of all the non-isomorphic irreducible complex representations of $G$. We resolve for several classes of groups (the Camina $p$-groups, the generalized Camina $p$-groups, the groups which admit $(G,Z(G$ as a generalized Camina pair, the problem of existence of a polynomial $f(x in mathbb{Q}[x]$ such that $f(chi = tau_G$ for some irreducible character $chi$ of $G$. As a consequence, we completely determine the $p$-groups of order at most $p^5$ (with $p$ odd which admit such a polynomial. We deduce the characterization that these are the groups $G$ for which $Z(G$ is cyclic and $(G,Z(G$ is a generalized Camina pair and, we conjecture that this holds good for $p$-groups of any order.

  4. Comparative risk assessment of total energy systems

    International Nuclear Information System (INIS)

    The paper discusses a methodology for total impact assessment of energy systems, ideally evaluating all the impacts that a given energy system has on the society in which it is imbedded or into which its introduction is being considered. Impacts from the entire energy conversion chain ('fuel cycle' if the system is fuel-based), including energy storage, transport and transmission, as well as the institutions formed in order to manage the system, should be compared on the basis of the energy service provided. A number of impacts are considered, broadly classified as impacts on satisfaction of biological needs, on health, on environment, on social relations and on the structure of society. Further considerations include impacts related to cost and resilience, and, last but not least, impacts on global relations. The paper discusses a number of published energy studies in the light of the comparative impact assessment methodology outlined above. (author)

  5. Total chemical management in photographic processing

    Science.gov (United States)

    Luden, Charles; Schultz, Ronald

    1985-01-01

    The mission of the U. S. Geological Survey's Earth Resources Observation Systems (EROS) Data Center is to produce high-quality photographs of the earth taken from aircraft and Landsat satellite. In order to meet the criteria of producing research-quality photographs, while at the same time meeting strict environmental restrictions, a total photographic chemical management system was installed. This involved a three-part operation consisting of the design of a modern chemical analysis laboratory, the implementation of a chemical regeneration system, and the installation of a waste treatment system, including in-plant pretreatment and outside secondary waste treatment. Over the last ten years the result of this program has yielded high-quality photographs while saving approximately 30,000 per year and meeting all Environmental Protection Agency (EPA) restrictions.

  6. STUDY ON TOTAL SEDIMENT TRANSPORT BY FLOW

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Total sediment transport under the action of flow includes generally three forms of sediment transport, suspended load, density current and bed load. How to realize simultaneously these three forms of sediment movement in an identical physical model was studied in this paper. For the suspended load, fall and pickup similarities were used to design sediment gradation, and similarities of sediment-carrying capacity and scouring and depositing time were be insured. For the density current its occurrence condition should be similar, and similarities of sediment concentration and depositing time were insured. For the bed load, sediment gradation was designed by the similarity of incipient motion, and similarities of sediment discharge and scouring and depositing time were satisfied. And a physical model test was conducted.

  7. Segmental blood pressure after total hip replacement

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Henriksen, Jens Henrik

    1992-01-01

    Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant...... drop was found in all pressures 1 week postoperatively. The decrease followed the systemic pressure and was restored to normal after 6 weeks. In a group of six patients with preoperatively decreased ankle pressure, a significant transient further decrease in the ankle-toe gradient pressure was found on...... the operated side. None of the patients had symptoms from the lowered pressure. We conclude that in patients without signs of ischemia, the postoperative segmental pressure decrease is reversible and therefore not dangerous....

  8. Postoperative pain treatment after total hip arthroplasty

    DEFF Research Database (Denmark)

    Højer Karlsen, Anders Peder; Geisler, Anja; Petersen, Pernille Lykke;

    2015-01-01

    Treatment of postoperative pain should rely on results from randomized controlled trials and meta-analyses of high scientific quality. The efficacy of a particular intervention may depend on the type of surgical procedure, which supports the reporting of "procedure-specific" interventions. The aim...... of this systematic review was to document the procedure-specific evidence for analgesic interventions after total hip arthroplasty (THA). This PRISMA-compliant and PROSPERO-registered review includes randomized placebo-controlled trials (RCTs) of medication-based analgesic interventions after THA...... reporting of adverse events, considerable differences in supplemental analgesic consumption, and basic analgesic regimens generally characterized trials. Meta-analyses of non-steroidal anti-inflammatory drugs, local infiltration analgesia, intrathecal opioids, and lumbar plexus block provided a 24-hour...

  9. Total synthesis of (±)-antroquinonol d.

    Science.gov (United States)

    Sulake, Rohidas S; Jiang, Yan-Feng; Lin, Hsiao-Han; Chen, Chinpiao

    2014-11-21

    Total synthesis of (±)-antroquinonol D, which is isolated from very expensive and rarely found Antrodia camphorata and which has potential anticancer properties, was achieved from 4-methoxyphenol. In addition, a Michael addition to dimethoxy cyclohexadienones was studied. The main step involved chelation and substrate-controlled diastereoselective reduction of cyclohexenone and lactonization. Lactone synthesis facilitated the diastereoselective reduction of ketone, which help control the desired stereochemistry at the crucial stereogenic center in the natural product. Other key reactions in the synthesis involved a Michael addition of dimethyl malonate on cyclohexadienone, dihydroxylation, and Wittig olefination. A sesquiterpene side chain was synthesized through coupling with geranyl phenyl sulfide and Bouveault-Blanc reduction. PMID:25375772

  10. Space orientation of total hip prosthesis

    International Nuclear Information System (INIS)

    A method for in vivo determination of orientation and relation in space of components of total hip prosthesis is described. The method allows for determination of the orientation of the prosthetic components in well defined anatomic planes of the body. Furthermore the range of free motion from neutral position to the point of contact between the edge of the acetabular opening and the neck of the femoral component can be determined in various directions. To assess the accuracy of the calculations a phantom prosthesis was studied in nine different positions and the measurements of the space oriented parameters according to the present method correlated to measurements of the same parameters according to Selvik's stereophotogrammetric method. Good correlation ws found. The role of prosthetic malpositioning and component interaction evaluated with the present method in the development of prosthetic loosening and displacement is discussed. (orig.)

  11. Total synthesis of diterpenoid steenkrotin A.

    Science.gov (United States)

    Pan, Saiyong; Xuan, Jun; Gao, Beiling; Zhu, An; Ding, Hanfeng

    2015-06-01

    A concise and diastereoselective total synthesis of the diterpenoid (±)-steenkrotin A is described for the first time. The strategy mainly features three key ring formations: 1) a rhodium-catalyzed O-H bond insertion followed by an intramolecular carbonyl-ene reaction to build up the tetrahydrofuran subunit; 2) sequential SmI2 -mediated Ueno-Stork and ketyl-olefin cyclizations to construct the [5,7] spirobicyclic skeleton; and 3) an intramolecular aldol condensation/vinylogous retro-aldol/aldol sequence to form the final six-membered ring with inversion of the relative configuration at the C7 position. PMID:25891977

  12. The Total Synthesis of Inostamycin A.

    Science.gov (United States)

    Yu, Guangri; Jung, Byunghyuck; Lee, Hee-Seung; Kang, Sung Ho

    2016-02-12

    The first total synthesis of inostamycin A is described. With efficient and stereoselective synthetic routes to aldehyde 3 and ketone 4 developed through asymmetric aldol reactions, addition reactions and reduction, and with chiral building blocks, the two large fragments were coupled with remarkable anti stereoselectivity and efficiency by aldol condensation. The coupling reaction provided the complete carbon skeleton with all the requisite functional groups and stereogenic centers for inostamycin A. The two quaternary carbons at C20 and C16 of ketone 4 were elaborated in a highly stereocontrolled manner by addition reactions of the transmetallated 5 to ethyl ketone 6 and the transmetallated 7 to methyl ketone 8, respectively, in which the use of LaCl3 for transmetallation was critical for high coupling efficiency. PMID:26800259

  13. NASA total quality management 1989 accomplishments report

    Science.gov (United States)

    Tai, Betty P. (Editor); Stewart, Lynne M. (Editor)

    1990-01-01

    NASA and contractor employees achieved many notable improvements in 1989. The highlights of those improvements, described in this seventh annual Accomplishments Report, demonstrate that the people who support NASA's activities are getting more involved in quality and continuous improvement efforts. Their gains solidly support NASA's and this Nation's goal to remain a leader in space exploration and in world-wide market competition, and, when communicated to others through avenues such as this report, foster improvement efforts across government and industry. The principles in practice which led to these process refinements are important cultural elements to any organization's productivity and quality efforts. The categories in this report reflect NASA principles set forth in the 1980's and are more commonly known today as Total Quality Management (TQM): top management leadership and support; strategic planning; focus on the customer; employee training and recognition; employee empowerment and teamwork; measurement and analysis; and quality assurance.

  14. A challenging case of total phalloplasty

    Directory of Open Access Journals (Sweden)

    R Sridhar

    2012-01-01

    Full Text Available Plastic surgery continues to maintain a prominent presence in the evolution of male genital reconstruction. In this case report, we are presenting a case of post-electric burn with a total loss of penis. Sustaining other major injuries following an electric burn with loss of right upper limb and extensive tissue damage to left upper limb, abdomen and both thighs, this young male patient was initially managed from life-threatening problems. With many options closed following a major electric burn and its acute management, penile and urethral reconstruction was a unique and a great challenge in this patient. Heeding to the patient′s wish of male pattern micturition, we had performed a successful reconstruction of urethra and entire phallus with groin flap.

  15. Tissue air ratio in total body irradiation

    International Nuclear Information System (INIS)

    On the basis of dose readings in 102 patients treated with total body irradiation (TBI), a 'tissue air ratio (TAR) curve' has been produced. It could be useful to precalculate treatment time in TBI, for dose prescription to a specific point, provided the same source (60Co) and treatment setting (lateral irradiation; 3 m source-axis distance; reference point at thighs bifurcation, neat the perineum) is used. The TAR curve produced, and the formula relating tissue depth to TAR value, are presented, and compared to preexisting data for 'magna fields' treatments. This curve is exponential, and in semilog representation becomes straight, as every classic TAR curve; it is lower than others, reflecting non full-scatter situation in patient irradiation. (orig.)

  16. Fracture Blisters After Primary Total Knee Arthroplasty.

    Science.gov (United States)

    Halawi, Mohamad J

    2015-08-01

    Fracture blisters are tense vesicles that arise on markedly swollen skin overlying traumatized soft tissue. While this relatively uncommon complication has been well described in the trauma literature, this article reports for the first time a case of fracture blisters after primary total knee arthroplasty. The fracture blisters developed within 36 hours of surgery and were associated with profound swelling and erythema. There was no evidence of vascular injury, compartment syndrome, iatrogenic fracture, or deep venous thrombosis. The patient was treated with leg elevation, loosely applied nonadhesive dressings, and a short course of oral antibiotics after skin desquamation. Blood-filled blisters required longer time to reepithelialization than fluid-filled blisters. Knee stiffness developed because of pain and fear of participation with physical therapy, but the patient was able to resume intensive rehabilitation after resolution of the blisters. Patient factors, surgical factors, and review of the literature are discussed. PMID:26251947

  17. Implant survival after total elbow arthroplasty

    DEFF Research Database (Denmark)

    Plaschke, Hans Christian; Thillemann, Theis M; Brorson, Stig;

    2014-01-01

    BACKGROUND: Total elbow arthroplasty (TEA) is an established treatment for late-stage arthritis of the elbow. Indications have expanded to osteoarthritis and nonunion in distal humeral fractures. Information on implant survival and risk factors for revision is still sparse. The aim of this study...... was to evaluate implant survival and risk factors for revision of TEAs inserted in patients in the eastern part of Denmark in the period from 1980 until 2008. MATERIAL AND METHODS: The Danish National Patient Register provided personal identification numbers for patients who underwent TEA procedures...... from 1980 until 2008. On the basis of a review of medical reports and linkage to the National Patient Register, we calculated revision rates and evaluated potential risk factors for revision, including, age, sex, period, indication for TEA, and implant design. RESULTS: We evaluated 324 primary TEA...

  18. Neck after total laryngectomy: CT study

    Energy Technology Data Exchange (ETDEWEB)

    DiSantis, D.J.; Balfe, D.M.; Hayden, R.E.; Sagel, S.S.; Sessions, D.; Lee, J.K.T.

    1984-12-01

    Computed tomographic scans in 23 patients who had undergone total laryngectomy were analyzed retrospectively to determine normal postoperative appearance and to evaluate the role of CT in assessing recurrent neoplasm. Nine patients without clinical evidence of recurrence illustrated the normal postoperative changes: a round or ovoid neopharynx connecting the base of the tongue with the cervical esophagus and intact fat planes surrounding the neopharynx, neurovascular bundles, and sternocleidomastoid muscles. In the 12 patients with recurrent neoplasm, the CT manifestations included masses involving the internal jugular lymph node chain, tracheostomy site, or paratracheal region. CT supplemented physical examination and indirect mirror examination, providing data regarding presence and extent of recurrent tumor and aiding in planning the mode and scope of therapy.

  19. THE MAIN PRINCIPLES OF TOTAL QUALITY MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Andrei DIAMANDESCU

    2016-06-01

    Full Text Available Nowadays the industry is one of the main economic sectors, with a major contribution to achieving and maintaining a high rate of economic growth. The processing industry operation to high economic performance requires changes in structural terms, the re-engineering of processes and management. In this regard, one of the main actions taken at the level of companies in the manufacturing industry is the implementation of quality systems. Practicing quality management system not only allows businesses to react to changes taking place in business, but also to inflict them by the controlling of the future. This paper aims to analyze the principles of Total Quality Management – TQM and will highlight the advantages that organizations could obtain by applying each principle separately in the process of management.

  1. Material Science in Cervical Total Disc Replacement.

    Science.gov (United States)

    Pham, Martin H; Mehta, Vivek A; Tuchman, Alexander; Hsieh, Patrick C

    2015-01-01

    Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation. PMID:26523281

  2. Material Science in Cervical Total Disc Replacement

    Directory of Open Access Journals (Sweden)

    Martin H. Pham

    2015-01-01

    Full Text Available Current cervical total disc replacement (TDR designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti, and cobalt-chrome (CoCr. These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation.

  3. Single-incision total laparoscopic hysterectomy

    Directory of Open Access Journals (Sweden)

    Sinha Rakesh

    2011-01-01

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

  4. Modeling total expenditure on warranty claims

    CERN Document Server

    Mitra, Abhimanyu

    2010-01-01

    We approximate the distribution of total expenditure of a retail company over warranty claims incurred in a fixed period [0, T], say the following quarter. We consider two kinds of warranty policies, namely, the non-renewing free replacement warranty policy and the non-renewing pro-rata warranty policy. Our approximation holds under modest assumptions on the distribution of the sales process of the warranted item and the nature of arrivals of warranty claims. We propose a method of using historical data to statistically estimate the parameters of the approximate distribution. Our methodology is applied to the warranty claims data from a large car manufacturer for a single car model and model year.

  5. p-MOSFET total dose dosimeter

    Science.gov (United States)

    Buehler, Martin G. (Inventor); Blaes, Brent R. (Inventor)

    1994-01-01

    A p-MOSFET total dose dosimeter where the gate voltage is proportional to the incident radiation dose. It is configured in an n-WELL of a p-BODY substrate. It is operated in the saturation region which is ensured by connecting the gate to the drain. The n-well is connected to zero bias. Current flow from source to drain, rather than from peripheral leakage, is ensured by configuring the device as an edgeless MOSFET where the source completely surrounds the drain. The drain junction is the only junction not connected to zero bias. The MOSFET is connected as part of the feedback loop of an operational amplifier. The operational amplifier holds the drain current fixed at a level which minimizes temperature dependence and also fixes the drain voltage. The sensitivity to radiation is made maximum by operating the MOSFET in the OFF state during radiation soak.

  6. Total body irradiation for bone marrow transplantation

    International Nuclear Information System (INIS)

    Purpose/Objective: The primary goal of this course is to develop an understanding of the rationale for the use of total body irradiation (TBI) as a component of cytoreduction for bone marrow transplantation, the techniques used, and the results of changing important parameters, such as dose, dose rate, and fractionation. Materials and Methods: Basic radiobiological principles relevant to TBI are reviewed; in particular, emphasis is placed on cell and animal studies which suggest means of optimizing TBI delivery to achieve maximum tumor cell kill and immunosuppression along with minimal normal tissue damage. Techniques utilized at various centers are described, with some discussion of achieving homogeneity, as well as inhomogeneity when desired with partial shielding or 'boosting'. A review of clinical studies, both randomized and non-randomized, is done; these are then interpreted in terms of potential optimization of the TBI parameters. Finally, comparison of TBI-containing regimens with chemotherapy-only regimens is done. Results: Radiobiological studies suggest a potential advantage for fractionated TBI over single dose TBI. Clinical studies support this view: highly fractionated regimens have allowed higher total doses to be used to increase malignant cell kill and immunosuppression without increasing toxicity. Randomized studies of TBI combined with VP-16 or cyclophosphamide versus busulfan combined with cyclophosphamide have either shown an advantage with TBI (in acute myelocytic leukemia in first remission) or no difference (in chronic myelogenous leukemia, chronic phase). Conclusion: TBI has been an effective component of cytoreductive regimens for marrow transplantation in patients with malignant disease, especially leukemias, which constitute 73% of all marrow transplants worldwide. Evidence supports fractionated TBI, to doses ≥ 13 Gy, when compared with single dose TBI. Randomized studies support the continued use of TBI in AML, and suggest that

  7. Total Mercury in Lake Neusiedl, Austria

    Directory of Open Access Journals (Sweden)

    Jirsa F.

    2013-04-01

    Full Text Available Between May and September 2011 a total of 361 samples from water, sediment, macrophytes and fish tissues from the shallow, slightly alkaline Lake Neusiedl were measured for their total mercury content with cold vapour atomic absorption spectroscopy (CV-AAS. Hg content of surface water was below the LOD of 0.1 μg/L and the sediments displayed contents between 0.025 and 0.113 μg/g dw, significantly correlated with the proportion of organic components (fig 1. Although these results do not point to an anthropogenic pollution of the lake, considerable amounts of mercury could be measured in fish samples and macrophytes. Both investigated submerged plant species, namely Potamogeton pectinatus and Myriophyllum spicatum show a high potential for bioaccumulation of Hg, presenting mean values of 0.245 ± 0.152 and 0.298 ± 0.115 μg/g dw respectively. Compared to freshwater fish from other unpolluted sites high amounts of Hg could be measured (fig. 2. Biomagnification and significant differences could be observed when comparing muscle samples of the planctivorous fish species rudd Scardinus erythrophthalmus (n = 10, mean = 0.084 μg/g ww with the piscivorous perch Perca fluviatilis (n = 21, mean = 0.184 μg/g ww or pike-perch Sander lucioperca (n=9, mean = 0.205 μg/g ww respectively. Significantly lower values were measured in the muscle of the piscivorous pike Esox lucius (n = 25, mean = 0.135 μg/g ww in which a strong correlation between fish age and Hg content did not occur. In addition the muscle/liver ratio of Hg in pike was significantly lower compared to the other fish species, which points to a different Hg metabolism in pike, maybe under the specific saline alkaline conditions of this lake.

  8. Cataract incidence after total-body irradiation

    International Nuclear Information System (INIS)

    Purpose: The aim of this retrospective study was to evaluate cataract incidence in a homogeneously-treated group of patients after total-body irradiation (TBI) followed by autologous bone marrow transplantation or peripheral blood stem cell transplantation. Methods and Materials: Between 1982 and 1994, a total of 260 patients received either autologous bone marrow or blood stem cell transplantation for hematological malignancy at the University of Heidelberg. Two hundred nine of these patients received TBI in our hospital. Radiotherapy was applied as hyperfractionated TBI, with a median dose of 14.4 Gy in 12 fractions over 4 days. Minimum time between fractions was 4 h. Photons with an energy of 23 MeV were used with a dose rate of 7-18 cGy/min. Ninety-six of the 209 irradiated patients were still alive in 1996; 86 of these patients (52 men, 33 women) answered a questionnaire and could be examined ophthalmologically. The median age at time of TBI was 38.5 years, with a range of 15-59 years. Results: The median follow-up is now 5.8 years, with a range of 1.7-13 years. Cataract occurred in 28/85 patients (32.9%) after a median of 47 months (1-104 months). In 6 of 28 patients who developed a cataract, surgery of the cataract was performed. Whole-brain irradiation prior to TBI had been performed more often in the group of patients developing cataract (14.3%) versus 10.7% in the group of patients without cataract. However, there was no statistical difference (Chi-square, p > 0.05). Conclusion: Cataract is a common side effect of TBI. Cataract incidence found in our patients is comparable to results of other centers using a fractionated regimen for TBI. To assess the incidence of cataract after TBI, a long-term follow-up is required

  9. Infected total knee arthroplasty treatment outcome analysis

    Directory of Open Access Journals (Sweden)

    Radoičić Dragan

    2012-01-01

    Full Text Available Background/Aim. Infected total knee arthroplasty (TKA is a topic of great importance, because its diagnosing and treatment requires a lot of resources, and often has an unsatisfactory outcome. The aim of this study was to analyze the outcome of the treatment of infection developed following TKA. Methods. This retrospective study of infected TKAs was performed in the period from 1998 to 2008 in the Orthopedics & Traumatology Clinic of the Military Medical Academy (MMA in Belgrade. A total of 654 primary and revised TKAs were performed in the said period. We registered and surgically treated 28 infected TKAs (primary TKAs: MMA - 22, other institutions - 6. The incidence of TKA infection in the MMA was 3.36%. The most common pathogens were: Staphylococcus aureus - 14 (50% cases, and Staph. epidermidis - 3 (10.7% cases. Other isolated pathogens were: Enterococcus faecalis, Klebsiella pneum., Klebsiella spp., Streptoccocus viridans, Seratia spp, Micrococcus luteus and Peptostreptococcus spp. In one case we had mixed anaerobic flora, and in 3 cases cultures were negative. We analyzed diagnostic challenges, risk factors (such as age and previous viscosupplementation and treatment outcomes in our series of infected TKAs. Results. In our series 2 infections healed after iv antibiotics and debridement, 1 patient responded to open debridement with component retention, 4 patients responded fully to one-stage reimplantation, 10 cases responded fully to two-stage reimplantation, 11 patients ended with arthrodesis and we had 1 patient with above knee amputation. Conclusion. Two-stage reimplantation remains gold standard for treatment of infected TKA, and we recommend it as treatment of choice for eradication of infection. The antibiotic loaded spacer prothesis concept in most cases allows infection eradication, good function and high patient satisfaction.

  10. Total sleep time severely drops during adolescence.

    Directory of Open Access Journals (Sweden)

    Damien Leger

    Full Text Available UNLABELLED: Restricted sleep duration among young adults and adolescents has been shown to increase the risk of morbidities such as obesity, diabetes or accidents. However there are few epidemiological studies on normal total sleep time (TST in representative groups of teen-agers which allow to get normative data. PURPOSE: To explore perceived total sleep time on schooldays (TSTS and non schooldays (TSTN and the prevalence of sleep initiating insomnia among a nationally representative sample of teenagers. METHODS: Data from 9,251 children aged 11 to 15 years-old, 50.7% of which were boys, as part of the cross-national study 2011 HBSC were analyzed. Self-completion questionnaires were administered in classrooms. An estimate of TSTS and TSTN (week-ends and vacations was calculated based on specifically designed sleep habits report. Sleep deprivation was estimated by a TSTN - TSTS difference >2 hours. Sleep initiating nsomnia was assessed according to International classification of sleep disorders (ICSD 2. Children who reported sleeping 7 hours or less per night were considered as short sleepers. RESULTS: A serious drop of TST was observed between 11 yo and 15 yo, both during the schooldays (9 hours 26 minutes vs. 7 h 55 min.; p<0.001 and at a lesser extent during week-ends (10 h 17 min. vs. 9 h 44 min.; p<0.001. Sleep deprivation concerned 16.0% of chidren aged of 11 yo vs. 40.5% of those of 15 yo (p<0.001. Too short sleep was reported by 2.6% of the 11 yo vs. 24.6% of the 15 yo (p<0.001. CONCLUSION: Despite the obvious need for sleep in adolescence, TST drastically decreases with age among children from 11 to 15 yo which creates significant sleep debt increasing with age.

  11. Free and total GMP (glycomacropeptide contents of milk during bovine lactation Variação dos teores de GMP (glicomacropeptídeo livre e total no leite bovino durante a lactação

    Directory of Open Access Journals (Sweden)

    Andréa Maria Furlanetti

    2003-12-01

    dos problemas sanitários concentrou-se próximo ao parto, com poucas e espaçadas ocorrências de mastites clínicas. Os resultados do teste de CMT mostraram reações compatíveis às fases da lactação. Para o GMP livre as maiores variações ocorreram em função do período de lactação e em conseqüência de mastites clínicas e subclínicas. Valores elevados foram observados no início da lactação (5,87mg de ácido siálico/L de leite, normalizando para valores próximos de 3,30mg/L já ao final do segundo mês e voltando a elevar-se no terço final da lactação. Em média, as mesmas tendências foram observadas para o teor de GMP total liberado pela ação de coalho comercial, iniciando com valores ligeiramente elevados (35,59mg/L, tornando-se normal e assim se mantendo até o sexto mês com valores próximos a 27,15mg/L, e novamente elevando-se gradualmente até o final da lactação, com 58,35mg de ácido siálico/L de leite. Esses resultados mostram-se úteis para a correta interpretação de métodos aplicados à seleção do leite, seja em relação ao "status" proteolítico da matéria-prima ou mesmo para coibição de fraudes por adição de soro ao leite.

  12. Coronal Dynamics at Recent Total Solar Eclipses

    Science.gov (United States)

    Pasachoff, J. M.; Lu, M.; Davis, A. B.; Demianski, M.; Rusin, V.; Saniga, M.; Seaton, D. B.; Lucas, R.; Babcock, B. A.; Dantowitz, R.; Gaintatzis, P.; Seeger, C. H.; Malamut, C.; Steele, A.

    2014-12-01

    Our composite images of the solar corona based on extensive imaging at the total solar eclipses of 2010 (Easter Island), 2012 (Australia), and 2013 (Gabon) reveal several coronal mass ejections and other changes in coronal streamers and in polar plumes. Our resultant spatial resolution is finer than that available in imaging from spacecraft, including that from SOHO/LASCO or STEREO. We trace the eruptions back to their footpoints on the sun using imaging from SDO and SWAP, and follow them upwards through the corona, measuring velocities. The high-resolution computer compositing by Miloslav Druckmüller and Hana Druckmüllerová (2010 and 2013) and Pavlos Gaintatzis (2012) allows comparison of our images with those taken at intervals of minutes or hours along the totality path. Williams College's 2013 eclipse expedition was supported in part by grant 9327-13 from National Geographic Society/Committee for Research and Exploration. Our work on the 2012 eclipse is supported in part by grant AGS-1047726 from Solar Terrestrial Research/NSF AGS. V.R. and M.S. were partially supported by the VEGA grant agency project 2/0098/10 and 2/0003/13 (Slovak Academy of Sciences) and Grant 0139-12 from NG/CRE, and Hana Druckmüllerová by grant 205/09/1469 of the Czech Science Foundation. M.L. was supported by Sigma Xi. C.M. was a Keck Northeast Astronomy Consortium Summer Fellow, supported at Williams College by REU/NSF grant AST-1005024. Partial support was provided by U.S. Department of Defense's ASSURE program. J.M.P. thanks Caltech's Planetary Sciences Department for hospitality. Support for D.B.S. and SWAP came from PRODEX grant C90345 managed by ESA in collaboration with the Belgian Federal Science Policy Office (BELSPO) in support of the PROBA2/SWAP mission, and from the EC's Seventh Framework Programme (FP7/2007-2013) under grant 218816 (SOTERIA project, www.soteria-space.eu). SWAP is a project of the Centre Spatial de Liège and the Royal Observatory of Belgium funded by

  13. Biological problems of total body irradiation

    International Nuclear Information System (INIS)

    We have considered the dose required for meeting the aims of total body irradiation as well as its significance in terms of cell survival for bone marrow stem cells leukaemia, intestinal mucosa and lung. The necessity of a relative protection of the critical tissues with respect to the target populations the irradiation is aiming at, is emphasized. Localized shielding of the lung results in a reduction of the dose to a part of the target population; its biological consequence is discussed. Fractionation and protraction of the irradiation can achieve a significant protection of the critical tissues. Radiobiological data allow estimating the benefit of reducing the fraction size to 1.25 Gy or the dose rate to 0.05 Gy/mn. The benefit of smaller fraction size or dose rate is probably small. Fractionation or low dose rate appear equivalent for the protection of the critical tissues. A larger clinical experience is necessary for a definite comparison of their biological and practical advantages

  14. Total Synthesis of Rubriflordilactone B.

    Science.gov (United States)

    Yang, Peng; Yao, Ming; Li, Jian; Li, Yong; Li, Ang

    2016-06-01

    Taking advantage of a 6π electrocyclization-aromatization strategy, we accomplished the first and asymmetric total synthesis of rubriflordilactone B, a heptacyclic Schisandraceae bisnortriterpenoid featuring a tetrasubstituted arene moiety. The left-hand fragment was accessed through a chiral-pool-based route, and linked to the right-hand fragment by a Sonogashira coupling. The cis geometry of the electrocyclization substrates was established by hydrogenation or hydrosilylation of the alkyne. An electrocyclization-aromatization sequence finally built the multisubstituted arene. The hydrosilylation approach was of significant advantage in terms of reaction scale, reproducibility, and intermediate stability. The structure of synthetic rubriflordilactone B was validated by X-ray crystallographic analysis, and found to be consistent with that reported for the authentic natural product based on an independent X-ray crystallographic analysis. However, obvious differences in the NMR spectra of the synthetic and authentic samples suggest that the authentic samples subjected to X-ray crystallography and NMR spectroscopy were two different compounds. PMID:27121027

  15. Radiologic analysis of total colonic aganglionosis

    International Nuclear Information System (INIS)

    Radiologic findings of Total Colonic Aganglionosis (T.C.A) were analyzed in 15 patients with the results as follows; 1. Male to female ratio was 8:7. 2. There were six cases of small calibered colon, seven cases of normal colon and two cases of megacolon. 3. Free reflux of barium into the small bowel was observed in seven cases out of eight in which retrograde filling was tried. 4. Delayed films (24 hrs or more) were available in eight cases and most of the barium remained in bowel in six cases. 5. There were abnormal colonic contractions in three cases, decreased redundancy in five and five cases or irregular, hypertrophic mucosal wall suggesting enterocolitis. 6. Part of ileum were also aganglionic in five cases. There seems to be no pathognomonic barium enema findings in T.C.A But combination of these findings may suggest the possibility of T.C.A. T.C.A should be considered in differential diagnosis of bowel obstruction in infants. Barium enema should be complete and delayed films always be obtained

  16. Total quality management in blood transfusion.

    Science.gov (United States)

    Smit-Sibinga, C T

    2000-01-01

    Quality management is an ongoing development resulting in consistency products and services and ever increasing customer satisfaction. The ultimum is Total Quality Management. Quality systems and quality management in transfusion medicine have gained considerable attention since the outbreak of the AIDS epidemic. Where product orientation has long been applied through quality control, Good Manufacturing Practice (GMP) principles were introduced, shifting the developments in the direction of process orientation. Globally, and particularly in the more industrialised world people and system orientation has come along with the introduction of the ISO9001 concept. Harmonisation and a degree of uniformity are needed to implement a universally applicable Quality System and related Quality Management. Where the American Association of Blood Banks (AABB) is the professional organisation with the most extensive experience in quality systems in blood transfusion, the European Union and the Council of Europe now are in the process to design a quality system and management applicable to a larger variety of countries, based on a hybrid of current GMP and ISO9001 principles. The International Federation of Red Cross and Red Crescent Societies has developed a more universally to implement Quality Manual, with a pilot project in Honduras. It is recommendable to harmonise the various designs and bring the approaches under one common denominator. PMID:10938970

  17. [Hirschsprung disease. (Except total forms) (author's transl)].

    Science.gov (United States)

    1978-01-01

    This panel discussion was considered for paediatricians attending a specialisation conference. The study eliminates total colonictypes. The first part is devoted to clinical study of symptoms in neonates and enterocolitis. Two different types are advocated, due to different aetiologies : The first to obstruction. The second one to Schwartzman reaction similar as Necrotizing enterocolitis of the premature baby. The second part analyzes the methods of diagnosis. No discussion about pathology and X. Ray. Pellerin trust mainly pressure studies, while Carcassonne never operates on a cases without a biopsy, even if the manometry, is positive. About biopsy he used for 4 years now, the Helen Noblett device with great confidence. Polonovski discusses the differential diagnosis with so called pseudo and false Hirschprung. The third part gives the different trends of the authors in matter of treatment: --Pellerin studies the indications for nursing, while Jaubert analyses his series of Colostomies. -- The curative procedures are shortly discussed : Pellerin using the Swenson-Pellerin procedure, Jauber spliting himself between Senson and Soave, Carcassone using Swenson. Two series of immediate and late results are assessed that prove an improvement of the results with the experience of the surgeons. PMID:729134

  18. Biological basis of total body irradiation

    International Nuclear Information System (INIS)

    A comprehensive understanding of the radiobiological bases of total body irradiation (TBI) is made difficult by the large number of normal and malignant tissues that must be taken into account. In addition, tissue responses to irradiation are also sensitive to associated treatments, type of graft and a number of patient characteristics. Experimental studies have yielded a large body of data, the clinical relevance of which still requires definite validation through randomized trials. Fractionated TBI schemes are able to reduce late normal tissue toxicity, but the ultimate consequences of the fractional dose reduction do not appear to be equivocal. Thus, leukemia and lymphoma cells are probably more radio-biologically heterogeneous than previously thought, with several cell lines displaying relatively high radioresistance and repair capability patterns. The most primitive host-type hematopoietic stem cells are likely to be at least partly protected by TBI fractionation and may hamper late engraftment. Similarly, but with possibly conflicting consequences on the probability of engraftment, the persistence of a functional marrow stroma may also be fractionation-sensitive, while higher rejection rates have been reported after T-depletion grafts and fractionated TBI. in clinical practice (as for performance of relevant clinical trials), the influence of these results are rather limited by the heavy logistic constraints created by a sophisticated and time-consuming procedure. Lastly, clinicians are now facing an increasing incidence of second cancers, at least partly induced by irradiation, which jeopardize the long-term prospects of otherwise cured patients. (authors)

  19. Robot-assisted total hip arthroplasty.

    Science.gov (United States)

    Banerjee, Samik; Cherian, Jeffery J; Elmallah, Randa K; Pierce, Todd P; Jauregui, Julio J; Mont, Michael A

    2016-01-01

    Precise and accurate biomechanical reconstruction during total hip arthroplasty (THA) is essential for durable long-term survivorship. Accurate fit of cementless hip implants is also crucial to reduce micromotion between the bone-implant interfaces to allow for stable osseointegration. Robotic technology aims to minimize potential human errors and improve implant alignment and fit, and address persisting concerns with modern-day cementless THA. Although robotic THA dates back to the early 1990s, concerns with increased operating times, costs, and complications led to its withdrawal. However, semi-active systems have renewed interest in robot-assisted joint arthroplasty. We reviewed the current technology, its potential benefits, and the reported clinical and radiographic outcomes. Early evidence suggests that robotic use may lead to more accurate reconstruction of radiographic parameters, such as implant positioning, fit, center-of-rotation, and leg-length discrepancy. Further research is needed to determine if these will translate into better outcomes and improved implant longevity to justify increased costs. PMID:26592900

  20. Total body irradiation in bone marrow transplantation

    International Nuclear Information System (INIS)

    Total body irradiation was used in 22 patients as part of their conditioning regimen for bone marrow transplantation. Nine patients with acute leukemia received 1000 cGy TBI in addition with chemotherapy. None of them survived and the main cause of death was interstitial pneumonitis (50%). 4 patients received 1000 cGy with a lung shielding of 500 cGy. Two patients with acute leukemia died of leukemia and sepsis, two patients had aplastic anemia, one is surviving, the other died of severe GVHD and infectious complications. Nine patients with severe aplastic anemia strongly immunized by previous blood transfusions received 800 cGy TBI with a lung shielding of 400 cGy. No rejection was observed and 7 patients (63%) are currently alive. One patient died of interstitial pneumonitis probably related to CMV infection, one of subacute necrotizing hepatitis, two of severe acute GVHD. It is concluded from this study that TBI remains the best immunosuppressive conditioning regimen even in strongly immunized patients. It may be a contributing factor of the incidence and severity of interstitial pneumonitis. A reduction of the dose of the lung to 400-500 cGy seems to decrease the severity of this complication