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Sample records for biliares totales elevados

  1. Tratamiento en pacientes operados de estómago con ácidos biliares elevados y Helicobacter pylori positivo Treatment in patients operated on of the stomach with elevated biliary acids and positive Helicobacter pylori

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    Héctor Rubén Hernández Garcés

    2008-04-01

    Full Text Available Se realizó un estudio del tipo experimental, no ciego y aleatorizado, constituido por 30 pacientes adultos de uno y otro sexos con diagnóstico de gastritis crónica alcalina por reflujo duodenogástrico, en resecados de estómago (Billroth I, Billroth II, mediante endoscopia superior, con ácidos biliares totales elevados y Helicobacter pylori positivo. Estos pacientes se distribuyeron en 2 grupos de tratamiento durante 8 semanas. El grupo A, de 15 pacientes, recibió tratamiento con: subcitrato de bismuto coloidal (Q-ulcer, metronidazol y tetraciclina, más ranitidina como antihistamínico H2. El grupo B, de 15 pacientes, se le administró celulosa microcristalina (Microcel. Ambos grupos recibieron metoclopramida como fármaco procinético durante todo el tratamiento. Los índices de erradicación de la infección por H. pylori fueron del 46,7 % para el grupo A y del 42,9 % para el grupo B. La concentración de ácidos biliares totales al final del tratamiento disminuyó en el 53,3% de los pacientes del grupo A y en el 71,4% de los pacientes del grupo B. La concentración de ácidos biliares totales en el remanente gástrico al final del tratamiento, no influyó en la evaluación clínica, endoscópica e histológica de los pacientes en ambos esquemas de tratamiento. No se presentaron efectos adversos secundarios en los pacientes del grupo A y 1 paciente (6,6 % del grupo B abandonó el estudio al empeorar su cuadro clínico, el cual fue intervenido quirúrgicamente, por lo que se considera fracaso del tratamiento. Se concluye que estos esquemas terapéuticos no fueron eficacesA non-blind randomized experimental study was undertaken. It included 30 adults of both sexes with diagnosis of alkaline chronic gastritis due to duodenogastric reflux, in stomach resections (Billroth I, Billroth II, by upper endoscopy, with elevated total biliary acids and positive Helicobacter pylori. These patients were divided into 2 groups of treatment during 8

  2. Paso elevado, en Krahnenberg

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    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

  3. Atresia biliar: una enfermedad grave

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    Ramonet, Margarita; Ciocca, Mirta; Alvarez, Fernando

    2014-01-01

    La atresia biliar es una grave enfermedad que se manifiesta en los recién nacidos, y se desconoce su causa. La inflamación y destrucciónprogresiva de los conductos biliares conducen a la aparición de ictericia, coluria y acolia entre la segunda y sexta semana de vida. Como existen múltiples causas de colestasis neonatal en esta etapa de la vida, es necesario realizar un diagnóstico y derivación precoz para ofrecer un tratamiento quirúrgico, con el fin de restablecer el flujo biliar. Alrededor...

  4. Tumores de los conductos biliares

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    Santiago Triana Cortés

    1955-02-01

    Los tumores benignos de los conductos biliares son relativamente raros. Christopher, que ha revisado recientemente este asunto, sólo pudo encontrar cuarenta y un casos publicados. Los papilomas parecen los más frecuentes, pero se les encuentra con menor frecuencia en los conductos que en la vesícula. Los adenomas son también tumores benignos de los más frecuentes en los conductos; en general, son múltiples y quísticos, y en algunos casos parecen derivar del epitelio de los conductos.

  5. El paso elevado de Dunton, Inglaterra

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    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. Depósito elevado, en Belfast

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    Gibberd Cbe, Felix

    1964-07-01

    Full Text Available An outstanding feature of the buildings which constitute the modern Ulster Hospital, at Dundonald, Belfast, is the elevated tank which supplies the hospital with water. The shape of this tank is pleasant and it provides a charming and smooth outline against the sky: it is reminiscent of a large sized drinking cup. The structure, made of reinforced concrete, is of straighforward design. The central support is used as the chimney stack for the boiler room. The water tank has an overall height of 32.5 m and will hold 450 cubic metres of water. The tank itself is 15.5 m high and has a maximum diameter of 10 m. The walls vary in thickness between 0.32 and 0.15 m. The hoop reinforcement is provided by 19 mm bars, whilst the radial reinforcement consists of 9 mm wires. The central column, or stack, has a wall thickness of 0.15 m, and is of circular cross section. Vertical 35 mm rods provide the metal reinforcement. Externally, this central column has eight ribs, 20 cm wide and 30 cm deep. The whole structure rests on an octogonal slab, with a maximum horizontal dimension of 9 m and is 2 m thick. The maximum tensile strength allowed for the concrete, when working in the most unsatisfactory conditions, is 12 kg/cm2.Entre las distintas construcciones que constituyen el moderno hospital Ulster de Dundonald, en Belfast (Irlanda del Norte, destaca, particularmente, el depósito elevado para el suministro y reserva de agua. Desde el punto de vista arquitectónico, su forma es de plástica agradable y de línea suave y graciosa, puesto que reproduce la silueta de una copa, de gran tamaño, muy utilizada. Su estructura, de hormigón armado, es sencilla y ha permitido aprovechar el núcleo central o soporte, hueco, para chimenea de la sala, de calderas. La altura total del depósito es de 33,50 m y su capacidad de 450 m3. El depósito propiamente dicho tiene 15,5 m de altura y 10 m de diámetro máximo. El espesor de las paredes varía de 0,33 a 0,15 m. Las

  7. Repercussões temporais da ligadura do ducto biliar principal em ratos Wistar

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    Maia Eugenio Lincoln Campos

    2003-01-01

    Full Text Available OBJETIVO: Objetivou-se investigar os efeitos temporais da ligadura do ducto biliar principal, em ratos Wistar. MÉTODOS: Utilizaram-se 48 ratos machos distribuídos em 2 grupos e redistribuídos em 4 subgrupos (n=06, identificados pelo tempo estipulado para a coleta das amostras (12, 24, 48 e 168 horas. Após laparotomia, os animais foram submetidos à dissecção e passagem de dois fios circundando o ducto biliar principal, sem ligadura (Grupo 1 e com ligadura (Grupo 2. RESULTADOS: As concentrações das bilirrubinas séricas (total, direte e indireta quando comparadas ao repectivo grupo controle, aumentaram (p<0,05 nos animais do grupo 2, nos tempos 24, 48 e 168 horas. As concentrações de proteína C reativa e fosfatase alcalina aumentaram (p<0,05 no grupo 2 no tempo 24 horas e nos tempos 24 e 48 horas, respectivamente. Concentrações de albumina e gamaglutamil transferase, não apresentaram diferenças significantes nos dois grupos. Foram observadas, no exame histopatológico, hiperplasia ductal, pericolangite e colangite no grupo 2 e pericolangite no grupo 1. CONCLUSÕES: A ligadura do ducto biliar principal induz aumento das concentrações séricas de bilirrubinas, proteína C reativa e fosfatase alcalina. Hiperplasia ductal, pericolangite e colangite são as principais alterações histológicas encontradas nos fígados dos ratos submetidos à ligadura do ducto biliar principal.

  8. Atresia biliar: a experiência Brasileira

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    Elisa de Carvalho

    2010-12-01

    Full Text Available OBJETIVO: Avaliar as características epidemiológicas, clínicas e prognósticas de crianças com atresia biliar. MÉTODOS: Dados sobre portoenterostomia, transplante hepático (TxH, idade no último seguimento e sobrevida foram coletados dos prontuários de pacientes acompanhados em seis centros no Brasil (1982-2008 e comparados em relação às décadas do procedimento cirúrgico. RESULTADOS: Dos 513 pacientes, 76,4% foram submetidos a portoenterostomia [idade: 60,0-94,7 (82,6±32,8 dias] e 46,6% foram submetidos a TxH. Em 69% dos casos, o TxH foi realizado após a portoenterostomia, enquanto em 31% dos casos o TxH foi realizado como cirurgia primária. Os pacientes da região Nordeste foram submetidos a portoenterostomia mais tardiamente do que as crianças das regiões Sul (p = 0,008 e Sudeste (p = 0,0012, embora, mesmo nas duas últimas regiões, a idade no momento da portoenterostomia tenha sido superior ao desejável. Ao longo das décadas, houve aumento progressivo do número de TxH realizados. A sobrevida global foi de 67,6%. A sobrevida aumentou nas últimas décadas (anos 1980 versus 1990, p = 0,002; anos 1980 versus 2000, p 90 dias, respectivamente. Os pacientes transplantados apresentaram taxas de sobrevida mais elevadas (88,3%. A sobrevida de 4 anos com fígado nativo foi de 36,8%, inversamente correlacionada à idade no momento da portoenterostomia (54, 33,3, 26,6% para 90 dias, respectivamente. CONCLUSÕES: Este estudo multicêntrico demonstrou que o encaminhamento tardio das crianças portadoras de atresia biliar ainda é um problema no Brasil, influenciando a sobrevida destes pacientes. Estratégias que proporcionam o encaminhamento precoce estão sendo desenvolvidas com o objetivo de reduzir a necessidade de transplante hepático nos primeiros anos de vida.

  9. Microcristais biliares na pancreatite aguda idiopática: indício para etiologia biliar oculta subjacente

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    CHEBLI Júlio Maria Fonseca

    2000-01-01

    Full Text Available As principais causas de inflamação pancreática no mundo são a litíase biliar e o alcoolismo crônico. Admite-se que 10 a 30% das pancreatites agudas sejam idiopáticas. Sugere-se que parte destas são causadas por microlitíase ou barro biliar, identificados pela presença de microcristais no sedimento biliar. Neste estudo, realizou-se análise microscópica da bile obtida por colangiopancreatografia endoscópica, em pacientes com pancreatite aguda idiopática, pancreatite aguda biliar e pancreatite crônica alcoólica - 20 em cada grupo. Pacientes com pancreatite aguda idiopática e microcristais na bile foram submetidos a colecistectomia. Naqueles inaptos à cirurgia efetuou-se esfincterotomia endoscópica ou tratamento com ácido ursodesoxicólico. Pacientes com pancreatite aguda idiopática sem cristais não receberam tratamento específico. A prevalência de microcristais biliares em pacientes com pancreatite aguda idiopática (75% e pancreatite aguda biliar (90% foi significativamente maior que naqueles com pancreatite crônica alcoólica (15%. A detecção de microcristais apresentou sensibilidade de 90%, especificidade de 85%, valor preditivo positivo de 85,7%, valor preditivo negativo de 89,4% e acurácia de 87,5% em identificar pancreatite de origem biliar. Nos pacientes com pancreatite aguda idiopática recurrente, cursando com microcristais, houve redução significante dos episódios de pancreatite após tratamento específico. No seguimento deste grupo durante 23,3 meses, recidiva ocorreu apenas naqueles que apresentavam "fator biliar persistente" (coledocolitíase ou microcristais. Todos os pacientes com pancreatite aguda idiopática submetidos a colecistectomia apresentavam colecistite crônica, e microlitíase foi observada em um paciente. No seguimento ultra-sonográfico, colelitíase foi detectada em um dos casos. No subgrupo de cinco pacientes com pancreatite aguda idiopática sem microcristais houve uma recidiva. Estudo

  10. Paso elevado, en Manchester – Inglaterra

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    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.

  11. Paso elevado sobre el ferrocarril, en Cannes Francia

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    Idelberger, Klaus

    1979-12-01

    Full Text Available This article describes the construction in Cannes of the third section of an overpass bridging a number of railway tracks and platforms, achieving the supression of many curves in the coastal highway and this without Interfering with city traffic. For this third section the construction method chosen was a metal structure, despite the fact that the two previous sections were built in concrete. This overpass section has 15 spans, 14 of them are solved with a grid of welded beams supporting reinforced concrete slabs while the remaining span is a grid of laminated beams on concrete. The total amount of steel used was 3360 Tm, aside from the foundations and decking reinforcements.

    Se describe en este artículo la construcción, en Cannes, de la tercera fase de un paso elevado realizado sobre andenes y vías de ferrocarril, con el que se consigue eliminar una serle de curvas de la carretera costera y, además, no interferir el tráfico en la ciudad. Para este tercer tramo se eligió la construcción a base de estructura metálica, a pesar de que los dos tramos anteriores eran de hormigón. Se construyeron 15 vanos, de los cuales 14 de ellos llevan un emparrillado de vigas soldadas con losas de hormigón armado y el otro es un emparrillado de vigas laminadas sobre hormigón. El total de acero utilizado fue de 3.360 t sin contar las armaduras de los cimientos y de los tableros.

  12. Formación de cálculos biliares de colesterol: Nuevos avances científicos

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    Castro-Torres, Ibrahim G

    2012-01-01

    La investigación científica sobre la formación de cálculos biliares de colesterol, ha comprobado la participación de numerosos genes, entre los cuales se encuentran receptores nucleares y transportadores biliares. El desequilibrio fisicoquímico entre los lípidos biliares más importantes produce hipersecreción de colesterol en la bilis, una etapa necesaria para sobresaturar la vesícula biliar. Las sales biliares son insuficientes para solubilizar al colesterol en micelas mixtas, por lo que est...

  13. Atresia das vias biliares extra-hepáticas: conhecimentos atuais e perspectivas futuras

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    Carvalho,Elisa de; Ivantes,Cláudia Alexandra Pontes; Bezerra,Jorge A.

    2007-01-01

    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 in...

  14. Lesiones iatrogénicas de las vías biliares

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    Limaylla-Vega, Himerón; Vega-Gonzales, Emilio

    2017-01-01

    Las lesiones iatrogénicas de las vías biliares (LIVB) representan una complicación quirúrgica grave de la colecistectomía laparoscópica (CL). Ocurre frecuentemente cuando se confunde el conducto biliar con el conducto cístico; y han sido clasificados por Strasberg y Bismuth, según el grado y nivel de la lesión. Alrededor del tercio de las LIVB se reconocen durante la CL, al detectar fuga biliar. No es recomendable su reparación inmediata, especialmente cuando la lesión está próxima a la confl...

  15. El íleo biliar: una revisión de la literatura médica

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    C.F. Ploneda-Valencia

    2017-07-01

    Conclusiones: El objetivo del tratamiento del íleo biliar es liberar la obstrucción, obtenido a través de la enterolitotomía. Esta es la técnica recomendada para el manejo del íleo biliar debido a su morbimortalidad menor, comparada con las otras técnicas.

  16. EFEITO DE CÁLCULOS BILIARES HUMANOS NA CAVIDADE PERITONEAL DE RATOS

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    Torres, Orlando Jorge Martins; Valadão, José Aparecido; Silva, Ailton José Rodrigues; Macau, Rosane Penha; Cintra, Jean Carlos Antunes; Dietz, Ulrich Andreas; Nassif, Paulo Afonso Nunes

    1998-01-01

    Este estudo tem por objetivo analisar experimentalmente as características macroscópicas e microscópicas de cálculos biliares humanos na cavidade peritoneal de ratos. Foram utilizados 32 ratos Wistar, machos, pesando entre 205 e 268 g. Estes animais foram distribuídos em dois grupos e o procedimento cirúrgico foi realizado em cada grupo: no grupo A (n =16), os animais foram submetidos a manipulação intestinal; no grupo B (n=16), cálculos biliares humanos foram colocados na cavidade peritoneal...

  17. Atresia biliar extra-hepática: métodos diagnósticos

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    Cauduro Sydney M.

    2003-01-01

    OBJETIVO: enfatizar a importância do diagnóstico precoce da atresia biliar extra-hepática e sua relação direta com o restabelecimento cirúrgico do fluxo biliar antes do segundo mês de vida, discutindo os diversos métodos complementares utilizados, objetivando selecionar os de maior evidência, evitando retardo diagnóstico e, conseqüentemente, piora do prognóstico. MÉTODO: pesquisa bibliográfica referente ao período de 1985 a 2001, no Medline e MdConsult, através das palavras-chaves: colestase ...

  18. Tratamento cirúrgico postergado da pancreatite aguda biliar

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    Rodrigo Altenfelder Silva

    Full Text Available A análise do tratamento cirúrgico de doentes portadores de pancreatite biliar mostra a existência de controvérsias em relação à oportunidade da intervenção, principalmente se deve ser precoce ou postergada. Do mesmo modo, a possibilidade do emprego de procedimentos endoscópicos no pré, intra ou pós-operatório e o advento da videolaparoscopia, trouxeram novos aspectos à discussão. Não existe consenso sobre a escolha da melhor conduta. Em função disso, analisamos retrospectivamente os resultados imediatos de 107 doentes portadores de forma leve de pancreatite, todos com menos de três sinais de gravidade, segundo o critério de estratificação proposto por Ranson, e que foram submetidos ao tratamento cirúrgico postergado na mesma internação, no período de janeiro de 1988 a maio de 1999, tanto por via convencional como por via laparoscópica. Desses, 80 doentes (75% eram do sexo feminino, 90% da raça branca e a média de idade foi de 46 anos. Os doentes foram operados em média após 9,5 dias de internação e receberam alta hospitalar após 2,9 dias, o que resultou numa permanência hospitalar média de 12,6 dias. A colangiografia intra-operatória foi realizada em 102 casos (96% e a colangiografia endoscópica pré-operatória em 24 doentes (22,4%. Os resultados mostraram incidência de coledocolitíase em 25 casos (23%, taxa de morbidade de 12% e mortalidade nula. Dos 107 casos estudados, 64 (60% foram operados pela via de acesso convencional e 43 (40% pela via laparoscópica. A comparação dos resultados entre as vias de acesso empregadas mostrou diferença estatística significante em relação ao intervalo de tempo pós-operatório, que foi menor nos doentes submetidos à via de acesso laparoscópica. Concluímos, assim, que o tratamento cirúrgico postergado de doentes portadores de pancreatite biliar na forma leve apresenta baixas morbidade e mortalidade e pode ser feito tanto pela via convencional como pela via

  19. Depósito elevado para la Fiat

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    Nervi, Pier Luigi

    1965-07-01

    Full Text Available At the Turin Fiat factory an elevated water tank has been built, with a capacity of 2,000 m3 60 m above the ground, and cup shaped. The structure is reinforced concrete, and prefabricated panels are used, which are supported by a concrete disc, a cylindrical crown and radial ribs. The whole rests on piles. The stem is 8 m in diameter, and has been constructed with the aid of U shaped cylindrical panels, 3 cm in thickness, which served as external formwork for the stem walls. These are 60 cm thick at the bottom, and 50 cm at the top. The tank itself is a paraboloid, made with triangular panels which together form conical circular rings. These also served as formwork, and were supported by a tubular scaffolding. An observation post has been built on top of the tank. It is 25 m in diameter, and is covered with a ribbed spherical cupola, supported by hinged columns, which allow radial deformations, which are not transmitted to the top ring of the tank. The latter, being full of water, is kept at a more uniform temperature than the cupular roof, which is fully exposed to the weather.En la factoría Fiat, de Turín (Italia, se ha construido este depósito elevado, en forma de copa, de 2.000 m3 de capacidad y unos 60 m de altura sobre el suelo. Es de hormigón armado y paneles prefabricados, apoyándose sobre un disco de hormigón, una corona cilíndrica y contrafuertes radiales; todo lo cual descansa sobre pilotes. El fuste, de 8 m de diámetro, se ha construido con la ayuda de una serie de paneles, de superficie cilíndrica y sección transversal en forma de U con alas asimétricas, de 3 cm de espesor, que sirvieron de encofrado exterior en el hormigonado de las paredes, cuyo espesor varía de 60 cm en la zona inferior a 50 cm en la superior. La cubeta es un meridiano parabólico de revolución, constituido por paneles triangulares, formando anillos troncocónicos, que se utilizaron también como encofrado, apoyado sobre un entramado tubular en

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

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    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

  1. 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 ...

  2. A influência do tempo de referencia no tratamento das lesões iatrogênicas da via biliar

    Directory of Open Access Journals (Sweden)

    Fernando Barros

    Full Text Available OBJETIVO: Avaliar o prognóstico dos pacientes com lesão iatrogênica da via biliar (LIVB em relação ao tempo de referencia (TR para a unidade de transplante hepático (TH. MÉTODOS: Foram revisados 51 prontuários de pacientes que sofreram algum tipo de LIVB durante a colecistectomia e que foram encaminhados para a unidade de TH no Hospital Geral de Bonsucesso (HGB. As lesões foram agrupadas de acordo com a classificação de Bismuth. Além da colecistectomia (momento da lesão, também avaliamos o TR e o desfecho. RESULTADOS: Dentre os 51 pacientes estudados encontramos 17 homens e 34 mulheres com uma média de idade de 42,7 anos. Vinte e dois pacientes (43,1% tinham uma lesão do tipo II; 13 (25,5 % do tipo III; 10 (19,6 % do tipo I, 5 (9,8 % do tipo IV; e apenas um (2 % do tipo V. Quarenta pacientes foram operados, sendo que três não retornaram para revisão médica e portanto, 37 foram avaliados em relação ao desfecho. Dentre esses, 25 pacientes (67,6 % tiveram resultados excelentes ou bons com TR médio de 11,5 meses (intervalo: 2-48 meses e 47,2 meses (intervalo: 3-180 meses respectivamente. Os 12 pacientes (32,4 % com resultados ruins tiveram um TR médio de 65,9 meses (intervalo: 3-264 meses, que foi significativamente maior do que o grupo com resultados excelentes ou bons (p=0,004. Sete pacientes foram listadas para fila de TH, porém apenas dois foram realizados. O TR desses sete pacientes foi significativamente mais elevado (p=0,04 do que o daqueles pacientes não listados. Sete pacientes morreram, dos quais seis foram causados por complicações hepáticas. CONCLUSÃO: O TR influenciou significativamente no prognóstico dos pacientes da nossa amostra.

  3. 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

    OpenAIRE

    Pozueta Romero, Javier; Alonso Casajús, Nora; Muñoz Pérez, Francisco José; Baroja-Fernández, 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.

  4. 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

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    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

  5. Betões de elevado desempenho de custo reduzido utilizando materiais correntes

    OpenAIRE

    Camões, Aires; Aguiar, J. L. Barroso de; Rocha, Patrício; Jalali, Said; Pereira, J. C.

    1999-01-01

    Para a produção de betões de elevado desempenho (BED) é genericamente aceite que são necessários materiais criteriosamente seleccionados, obrigando assim a um acréscimo significativo do custo inicial dos BED quando confrontados com betões correntes. Este trabalho pretende abordar duas características: possibilidade de produzir betões de elevado desempenho que incorporam materiais considerados correntes, nomeadamente cinzas volantes com teor de inqueimados superior ao máximo regulamentar e ine...

  6. Ictericia obstructiva secundaria a migración de fragmentos de hepatocarcinoma a la vía biliar

    OpenAIRE

    HEPP K,JUAN; BALBONTÍN M,PAULINA; ARMAS M,RODOLFO; NAVARRETE G,CLAUDIO; RÍOS R,HORACIO; HUMERES A,ROBERTO; RODRÍGUEZ M,GABRIELA; ROA E,IVÁN

    2010-01-01

    La ictericia obstructiva es una presentación poco común en un hepatocarcinoma (HC). Cuando en estos casos existe ictericia, habitualmente se debe a daño progresivo por cirrosis, o a infiltración tumoral extensa. El crecimiento o vaciamiento tumoral hacia la vía biliar se ha descrito ocasionalmente como causa de ictericia obstructiva. En raras ocasiones, puede tratarse de fragmentos de hepatocarcinoma que migran hacia la vía biliar, obstruyéndola. Presentamos un caso de ictericia obstructiva p...

  7. Prevalência e fisiopatologia da litíase biliar em pacientes submetidos a transplante de órgãos Prevalence and physiopathology of gallstone in transplant patients

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    Júlio Cesar Uili Coelho

    2009-06-01

    Full Text Available INTRODUÇÃO: O objetivo do presente estudo é apresentar revisão da prevalência e dos principais mecanismos fisiopatológicos que levam a formação da litíase biliar em pacientes submetidos a transplante de órgãos. MÉTODOS: Revisão da literatura abrangendo 29 publicações obtidas das bases Medline/Pubmed, Scielo e Lilacs com cruzamento dos unitermos "transplante, transplante renal, transplante hepático, cálculo biliar, colecistite.". Vários estudos que utilizaram a ultrassonografia demonstraram aumento na prevalência da litíase biliar em pacientes submetidos a transplante de órgãos. A taxa de formação de cálculos novos após o transplante variou de 10 a 55% e a total (cálculos formados antes e após o transplante de 17 a 68%. Tanto o ganho como a perda de peso rápida, que podem ocorrer após o transplante, predispõem à formação de cálculos biliares. O uso do imunossupressor ciclosporina é considerado como o principal fator que aumenta a incidência de litíase biliar após o transplante. CONCLUSÃO: A prevalência de litíase biliar é maior nos pacientes submetidos a transplante de órgãos do que na população geral. As principais alterações que ocorrem no paciente transplantado que predispõem a formação dos cálculos são as alterações do peso corporal, uso de imunossupressores, diabete melito e hiperlipidemia.INTRODUCTION: The objective of the present study is to review the prevalence and the main physiopathologic mechanisms that result in gallstone formation in transplant patients. METHODS: Literature review with 29 papers included in Medline/Pubmed, Scielo and Lilacs database, crossing key-words "transplantation; kidney transplantation; liver transplantation; gallstone; cholecystitis". Several ultrasonographic studies have demonstrated an increase in gallstone prevalence in transplant patients. The formation rate of new stones after transplantation varied from 10 to 55% and the rate of total stones

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

    OpenAIRE

    Elisa de Carvalho; Cláudia Alexandra Pontes Ivantes; Jorge A. Bezerra

    2007-01-01

    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 in...

  9. Conectores inovadores de elevado desempenho para estruturas mistas aço-betão

    OpenAIRE

    Duarte, Gonçalo Santos

    2015-01-01

    Dissertação de Mestrado Integrado em Engenharia Civil apresentada à Faculdade de Ciências e Tecnologia da Universidade de Coimbra A presente dissertação de Mestrado Integrado apresenta um estudo sobre conectores inovadores de elevado desempenho para estruturas mistas aço-betão. Esta tese tem forte ênfase em ensaios laboratoriais, tendo sido efectuados 8 ensaios push-out no Departamento de Engenharia Civil da Universidade de Coimbra, respeitando as especificações indicadas no Eu...

  10. Tratamento cirúrgico da atresia de vias biliares: a experiência do hospital municipal jesus, 1997-2000

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    Lisieux Eyer de Jesus

    Full Text Available OBJETIVO: Analisar a indicação, resultados e limitações da portoenterostomia para o tratamento da atresia de vias biliares em hospital infantil terciário no Rio de Janeiro-RJ/Brasil. MÉTODO: Foram estudados prospectivamente oito pacientes submetidos à portoenterostomia do tipo Kasai 1, num período de três anos (1997-2000. Todos foram submetidos à antibioticoterapia profilática, uso de colerético, reavaliação médica mensal nos primeiros seis meses de seguimento e reavaliação laboratorial, ultra-sonográfica e através de endoscopia digestiva alta em prazos programados. RESULTADOS: Em cinco pacientes foi possível obter drenagem biliar estável e satisfatória por > 6 meses pós-operatórios. Quatro faleceram no período de observação (um por insuficiência hepática, um por colangite, dois por hemorragias digestivas, inclusive os três pacientes em que não foi obtida drenagem biliar satisfatória. Quatro persistem em bom estado geral, anictéricos, um deles com fibrose hepática residual grave e provável indicação futura de transplante hepático. Detectamos problemas graves com relação ao encaminhamento tardio de doentes para tratamento e para disponibilizar transplante hepático quando necessário. CONCLUSÕES: Os resultados da portoenterostomia são compensadores quando é possível obter bom débito biliar no pós-operatório. Em pacientes em que não é obtida boa drenagem biliar o pós-operatório é tormentoso e o óbito é esperado até o segundo ano de vida sem o uso de transplante hepático. É necessário disponibilizar transplante hepático pediátrico em nosso meio e conscientizar a comunidade médica para o encaminhamento precoce de bebês ictéricos além dos primeiros 15 dias de vida para investigação e tratamento em unidades especializadas.

  11. Primeras experiencias con drenaje biliar percutáneo de urgencia en la colangitis aguda

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    José Luis González González

    Full Text Available Introducción: la obstrucción biliar es motivo frecuente de morbilidad en los pacientes con metástasis hepáticas, adenopatías periportales y cáncer hepatobiliopancreático. La colangitis aguda es la complicación más temida, debido a su mortalidad. En este trabajo se presentan los primeros abordajes percutáneos realizados por cirujanos del Hospital Clínicoquirúrgico "Hermanos Ameijeiras" como herramienta para el tratamiento urgente de esta entidad. Objetivo: caracterizar el drenaje percutáneo transparietohepático de urgencia en pacientes con colangitis aguda e ictericia obstructiva. Métodos: se realizó un estudio descriptivo, prospectivo y aplicado con 30 pacientes atendidos de esta forma en dicha institución entre enero de 2008 y diciembre de 2010. Resultados: el diagnóstico etiológico preponderante fue el de tumor maligno de la cabeza del páncreas. La localización baja de la lesión duplicó a la localización alta. La mejoría clínica de la ictericia se evidenció en la mayoría de los pacientes después de una semana tras el procedimiento: el drenaje percutáneo constituyó el método definitivo en el 73,3 % de los pacientes. Las edades medias para los distintos diagnósticos etiológicos exhibieron diferencias estadísticamente significativas. No hubo complicaciones ni mortalidad relacionadas con el procedimiento. Conclusiones: el drenaje biliar percutáneo guiado por ultrasonido es una herramienta útil y segura para el tratamiento de urgencia de la colangitis aguda. Es un método que pueden realizar los cirujanos generales con entrenamiento adecuado y específico, y tiene asociadas pocas complicaciones.

  12. Morbilidad y mortalidad por afecciones benignas del sistema biliar: Nuestra experiencia

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    Jorge Reyes Cardero

    1997-04-01

    Full Text Available Se realizó un estudio descriptivo y prospectivo sobre morbilidad y mortalidad por enfermedades benignas del sistema biliar en 4 266 pacientes operados en el Hospital Provincial Clinicoquirúrgico Docente "Saturnino Lora" de Santiago de Cuba, en el que se precisó la incidencia de diferentes variables. Las enfermedades más frecuentes fueron las colecistitis y colecistosis, en pacientes del sexo femenino, y un número importante de operados superaba los 60 años. Las complicaciones más comúnmente halladas en el período preoperatorio fueron: la litiasis coledociana y la pancreatitis aguda; en el peroperatorio: sobre la vesícula, la vía biliar y el hígado y en el posoperatorio inmediato las inespecíficas, que prevalecieron sobre las específicas. La mortalidad se consideró dentro de límites aceptables, y como causa fundamental de muerte en los ancianos se destaca el síndrome de disfunción múltiple de órganosA descriptive and prospective study on morbidity and mortality of bening diseases of the biliary tract was performed on 4 266 patients operated on at "Saturnino Lora" Provincial Teaching hospital, Santiago de Cuba with the aim of assessing the incidence of different variables. The most frequent diseases were found to be cholecystitis and cholecystosis in female patients, and a great number of surgically treated patients were over 60 years of age. The most frequently complications found within the preoperative period were: cholelithiasis and acute pancreatitis; during the perioperative period the most common were the complications of the gall bladder, the bile duct, and the liver, and during the immediate portoperative period the most frequent complications were found to be nonspecific which prevailed over the specific ones. Mortality rate was considered to be within acceptable limits, and the syndrome of multiple organ failure was found to be the principal cause of death among aged patients

  13. Análisis experimental de un motor ultrasónico de elevado par

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    Mateo Prous, C.

    1999-12-01

    Full Text Available Ultrasonic engines are useful in several applications due to low weight, small size, good position and speed regulation, and high torque. Nowadays there are only low and medium torque engines. We are working on high torque ultrasonic engines, which can be used as power actuators. Among all possible configurations, we are dealing with a standard piezoelectric ceramic excited one, which works in the no linear zone and resonant mode. A static, modal, harmonic and transitory finite elements analysis is being carrying on. The final goal is to obtain all components design criteria in order to optimise the obtained result. The finite element analysis and motor functioning are explained, showing two prototype results, and describing the improvements of the second one and his reason.

    Los motores ultrasónicos son útiles en diversas aplicaciones debido a su poco peso, pequeñas dimensiones, buena regulación de la posición y velocidad, y elevado par. Hoy en día tan sólo existen motores que desarrollan un par bajo o medio. En esta línea, estamos trabajando en motores ultrasónicos de par elevado, que pueden ser utilizados como actuadores de potencia. Entre todas las configuraciones inicialmente propuestas, se está analizando en detalle una que es excitada por cerámica piezoeléctrica estándar, que trabaja en la zona no lineal y en modo resonante. El análisis, realizado por elementos finitos, abarca el estático y el modal, el armónico y el transitorio. En este artículo se describen el funcionamiento del motor y su análisis por elementos finitos, mostrando los resultados experimentales de dos prototipos, y describiendo las mejoras que aporta el segundo debidamente justificadas.

  14. Morbilidad y mortalidad en pacientes con infarto agudo de miocardio ST elevado en un hospital general

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    Eduardo Carcausto

    2010-10-01

    Full Text Available Objetivo: Determinar la morbilidad y mortalidad de los pacientes con infarto agudo de miocardio ST elevado (IMA STE atendidos en un hospital general y describir sus características demográficas, clínicas y epidemiológicas. Material y métodos: Estudio descriptivo, serie de casos, retrospectivo, en pacientes con IMA STE en el Hospital Nacional Cayetano Heredia, del 1 de enero a 31 de diciembre del 2007. Se registraron variables clínicas y de laboratorio. Resultados: Se incluyeron 30 casos. El 86,7% fueron varones. La edad media fue de 62,8±12,6 años. El antecedente de hipertensión arterial se encontró en 57%, obesidad en 40%, tabaquismo en 40%, y de diabetes mellitus en 30%. El dolor torácico típico ocurrió en 75% de pacientes. El 50% de pacientes tuvieron hipertensión no controlada a la admisión, 33% leucocitosis, y 46% glicemia >110 mg/dl. Sólo 25% recibió terapia de reperfusión, 33,3% de casos de forma exitosa, siendo el tiempo puerta-aguja de 250 ± 114 minutos. Las complicaciones ocurrieron en 26,6% de pacientes, siendo la mortalidad de 13,3%. El 76% ingresó al hospital con un tiempo de dolor menor de 3 horas, Conclusiones: Los pacientes con IMA ST elevado fueron predominantemente varones, mayores de 60 años, ingresaron al hospital con un tiempo de dolor torácico menor de tres horas y un mínimo porcentaje recibió terapia de repercusión. Las arritmias fueron las complicaciones más frecuentes y la mortalidad post IMA alcanzó 13,3 % de los casos.(Rev Med Hered 2010;21:202-207.

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

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    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.

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

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    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

  17. Estudo ultrassonográfico morfométrico do fígado e trato biliar de suínos submetidos a obstrução biliar experimental

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    Aline Gomes de Campos

    2013-04-01

    Full Text Available OBJETIVO: Comparar as alterações anatômicas decorrentes de um quadro de icterícia obstrutiva experimental induzida em suínos nos períodos pré e pós-operatório por meio de exame ultrassonográfico. MATERIAIS E MÉTODOS: Seis suínos da raça Landrace, com 36 dias de idade, foram submetidos a obstrução biliar completa mediante ligadura do ducto colédoco por cirurgia videolaparoscópica. RESULTADOS: Não ocorreram dificuldades na execução dos procedimentos obstrutivos e a recuperação cirúrgica foi eficiente. Decorridos sete dias, os animais apresentaram icterícia, bilirrubinúria e acolia fecal. O exame ultrassonográfico comparativo permitiu visualizar hepatomegalia, colecistomegalia e aumento no calibre do ducto colédoco em todos os animais, assim como alterações decorrentes da colestase. A avaliação morfométrica revelou aumento significativo nos diâmetros da vesícula biliar e do lobo hepático lateral esquerdo. CONCLUSÃO: Os suínos representam um modelo experimental adequado de icterícia obstrutiva, e o exame ultrassonográfico demonstrou-se sensível e relevante no diagnóstico das alterações decorrentes de obstrução biliar extra-hepática nesses animais.

  18. Depósito elevado de agua en Baydon Wiltshire - Gran Bretaña

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    Percey Scherrer, Edmund

    1980-11-01

    Full Text Available The elevated water tank in Baydon, built to supply, among other edifices, a service station located on the M 4 highway, is 18 m high and holds 50,000 liters. It is made up by a central column of in situ concrete, triangular prefabricated beams —which support the tank— and prefabricated aggregate panels for the outside. The choice of neutral colors for the building materials contributed to the preservation of the appearance of the countryside.

    El depósito elevado de agua de Baydon construido para abastecer, entre otras edificaciones, una estación de servicio situada en la autopista M 4, tiene 18 m de altura y 50.000 litros de capacidad. Está formado por una columna central de hormigón in situ, unas vigas prefabricadas triangulares —que soportan el depósito de agua propiamente dicho— y unos paneles prefabricados de árido visto para la parte exterior. La elección de colores neutros, para los materiales de construcción, contribuyó a no deteriorar el paisaje.

  19. Prevalência e fisiopatologia da litíase biliar em pacientes submetidos a transplante de órgãos

    OpenAIRE

    Coelho,Júlio Cesar Uili; Contieri,Fabiana Loss de; Matias,Jorge Eduardo Fouto; Parolin,Mônica Beatriz; Godoy,Jose Luiz de

    2009-01-01

    INTRODUÇÃO: O objetivo do presente estudo é apresentar revisão da prevalência e dos principais mecanismos fisiopatológicos que levam a formação da litíase biliar em pacientes submetidos a transplante de órgãos. MÉTODOS: Revisão da literatura abrangendo 29 publicações obtidas das bases Medline/Pubmed, Scielo e Lilacs com cruzamento dos unitermos "transplante, transplante renal, transplante hepático, cálculo biliar, colecistite.". Vários estudos que utilizaram a ultrassonografia demonstraram au...

  20. Tratamento cirúrgico da atresia de vias biliares: a experiência do hospital municipal jesus, 1997-2000

    OpenAIRE

    Jesus, Lisieux Eyer de; Monteiro, Paulo Cesar Costa

    2001-01-01

    OBJETIVO: Analisar a indicação, resultados e limitações da portoenterostomia para o tratamento da atresia de vias biliares em hospital infantil terciário no Rio de Janeiro-RJ/Brasil. MÉTODO: Foram estudados prospectivamente oito pacientes submetidos à portoenterostomia do tipo Kasai 1, num período de três anos (1997-2000). Todos foram submetidos à antibioticoterapia profilática, uso de colerético, reavaliação médica mensal nos primeiros seis meses de seguimento e reavaliação laboratorial, ult...

  1. 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

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    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

  2. Depósito elevado de hormigón armado, Argentina

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    Editorial, Equipo

    1965-03-01

    Full Text Available The firm S. A. D. E., near Buenos Aires (Argentina, has built an elevated tank, with a capacity of 80 m3, at 21 m height, to supply water to its large industrial installations. The tank is of reinforced concrete. It is shaped as a circular, rather shallow cup, which is subdivided into four compartments, connected in symmetrical pairs with respect to the central axis. This ensures a weight balance when it is filled and emptied. This tank is of interest because of its method of construction, and the prefabrication procedure adopted. The supporting stem is a hollow cylinder, made of prefabricated sections, each 1.60 m long. At the bottom there is a circular slab, which rests on four cylindrical concrete, prefabricated piles, each 15 m long. The system of control valves is placed below the slab. Ascent to the top part is by means of a spiral staircase, whose steps are attached to the stem. To increase its stability, six metal rods, 7.5 cm in diameter, have been added to the cylindrical stem, and the handrail for the steps has been conveniently attached to these. The side thrusts due to wind forces acting on the tank are withstood by means of six radial beams, 5 m in length.Para abastecer de agua a un gran conjunto industrial que construye la Empresa S. A. D. E. cerca de Buenos Aires (Argentina, se ha construido un depósito elevado, de 80 m3 de capacidad y 21 m de altura. La cubeta, de hormigón armado, tiene la forma de una copa aplanada de planta circular y se ha subdividido en cuatro compartimientos comunicados dos a dos, simétricos respecto al eje vertical, con objeto de conservar el equilibrio de cargas durante las operaciones de carga y vaciado. La particularidad de este depósito consiste en su método constructivo y en los procedimientos de prefabricación empleados. El fuste o soporte único central es un cilindro hueco, formado por trozos prefabricados, de 1,60 m de longitud. El de base se apoya sobre una losa circular —que descansa

  3. Inserción de prótesis metálicas autoexpandibles totalmente recubiertas en patología biliar benigna

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    Mariana Omodeo

    Full Text Available RESUMEN Introducción: las enfermedades biliares benignas se han tratado, tradicionalmente, mediante la colocación de prótesis plásticas. Sin embargo, en la actualidad, las prótesis metálicas autoexpandibles totalmente recubiertas están ganando aceptación para el tratamiento de dichas patologías. Objetivo: evaluar la eficacia y las complicaciones de la inserción endoscópica temporal de prótesis metálicas totalmente recubiertas para el tratamiento de patologías biliares benignas. Materiales y métodos: estudio retrospectivo y observacional realizado a partir de una base de datos prospectiva en un centro de tercer nivel entre marzo de 2012 y mayo de 2016. Se incluyeron pacientes a los que se les colocó una prótesis metálica totalmente recubierta por patología benigna de la vía biliar. Se documentaron las indicaciones, las tasas de resolución, las de éxito técnico y los eventos adversos. Resultados: se incluyeron 31 pacientes a los que se insertaron 34 prótesis. Las indicaciones fueron las siguientes: 8 (25% estenosis biliares poscolecistectomía, 11 (31% coledocolitiasis de gran tamaño o múltiple, 3 (8,3% fístulas biliares, 2 (6% estenosis postrasplante hepático, 3 (8,3% estenosis papilares, 2 (6% perforaciones y 2 (6% sangrados. La tasa de éxito global de resolución de la patológica fue del 88%: 87,5% (7/8 en estenosis poscolecistectomía, 73% (8/11 en litiasis gigante, y 100% en el resto de las indicaciones. Se retiraron mediante endoscopia 33 de las 34 tras un promedio de 133 días (rango 10-180 días. No se registraron complicaciones. Conclusión: las prótesis metálicas autoexpandibles totalmente recubiertas son una alternativa efectiva y segura en la resolución de patologías biliares benignas.

  4. A aplicação estrutural de betões de elevado desempenho (HPC e UHPC)

    OpenAIRE

    Fernandes, Diogo Amaro Freitas

    2011-01-01

    Dissertação para obtenção do Grau de Mestre em Engenharia Civil A evolução dos betões, na procura de estruturas com um maior tempo de vida útil, menores custos de reparação e maiores resistências tem sido alvo de pesquisa por investigadores de todo o mundo. No presente trabalho é apresentado o estado da arte dos betões de elevado desempenho (HPCHigh Performance Concrete e UHPC-Ultra High Performance Concrete), betões garantes de maior durabilidade e resistência, com o objectivo de co...

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

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    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

  6. Susceptibilidade da mucosa gástrica à ação lesiva de um sal biliar em ratos chagásicos crônicos

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    Luiz Ernesto de Almeida Troncon

    1987-12-01

    Full Text Available Ratos inoculados previamente com a cepa Y do Trypanosoma cruzi (n = 15 e ratos-controles de mesma idade e sexo (n = 15 foram submetidos a estudo que consistiu no exame da mucosa gástrica após a exposição in vivo da mesma à solução acidificada de um sal biliar, o taurocolato de sódio (TC. Em 10 animais de cada grupo procedeu-se também à contagem dos neurônios do plexo mientérico do estômago e ao exame histopatológico dos corpos neuronais, feito em microscopia óptica convencional. Escores indicativos da gravidade das lesões produzidas pelo TC foram significativamente maiores (P < 0,002 nos ratos chagásicos que nos controles. A área erosada da mucosa gástrica, em % da área total da região glandular do estômago, foi significativamente maior (P0,10 entre os ratos chagásicos (1683,6 ± 449,7 n = 10 e os controles (1732,8 ± 401,1 n = 10. Não houve diferença qualitativa ao exame histopatológico dos corpos neuronais. Estes resultados indicam que, na doença de Chagas experimental crônica, a mucosa gástrica é mais sensível à ação lesiva do TC, o que sugere redução da citoproteção natural do estômago. Esta anormalidade não deve decorrer de alterações da inervação intrínseca que impliquem redução do número de neurônios intramurais do estômago, mas pode ser o resultado de alterações qualitativas não detectáveis à microscopia óptica.

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

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    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

  8. Reação peritoneal tardia ao calculo biliar humano, de colesterol, deixado na cavidade abdominal de ratos

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    Luiz Carlos Bertges

    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.

  9. Atresia biliar extra-hepática: métodos diagnósticos Extrahepatic biliary atresia: diagnostic methods

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    Sydney M. Cauduro

    2003-04-01

    Full Text Available OBJETIVO: enfatizar a importância do diagnóstico precoce da atresia biliar extra-hepática e sua relação direta com o restabelecimento cirúrgico do fluxo biliar antes do segundo mês de vida, discutindo os diversos métodos complementares utilizados, objetivando selecionar os de maior evidência, evitando retardo diagnóstico e, conseqüentemente, piora do prognóstico. MÉTODO: pesquisa bibliográfica referente ao período de 1985 a 2001, no Medline e MdConsult, através das palavras-chaves: colestase neonatal, atresia biliar extra-hepática e hepatite neonatal. Também foram selecionados artigos nacionais e estrangeiros a partir da bibliografia das publicações consultadas e, quando necessário, para melhor entendimento do tema, opiniões emitidas em teses e livros-textos foram referidas. RESULTADOS: a revisão da bibliografia consultada permite afirmar que o diagnóstico precoce das AVBEH e tratamento cirúrgico para restabelecer o fluxo biliar até 60 dias de vida são fundamentais na obtenção de bons resultados. Entre os diversos métodos complementares de diagnóstico, a colangiografia por RM, US e a biópsia hepática são os que proporcionam os maiores índices de acerto. CONCLUSÕES: o encaminhamento de pacientes portadores de AVBEH para centros de referências no Brasil ainda é efetuado tardiamente, provavelmente pela falta de esclarecimento dos médicos de atenção primária, aliada às dificuldades burocráticas e tecnológicas. A experiência da Inglaterra em relação ao programa "Alerta Amarelo", permitiu que o número de crianças encaminhadas para tratamento cirúrgico antes dos 60 dias de vida aumentasse significativamente. Entre os métodos complementares, a colangiografia por RM, a US e a biópsia hepática deverão ser utilizados, dependendo dos recursos tecnológicos das unidades de diagnóstico.OBJECTIVE: to emphasize the importance of precocious diagnosis of extrahepatic biliary atresia and its direct

  10. Paso elevado sobre la carretera nacional alemana número 42

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    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

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

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    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

  12. Acurácia diagnóstica do espessamento ecogênico periportal à ultra-sonografia e da histopatologia no diagnóstico diferencial da atresia biliar

    OpenAIRE

    Roquete,Mariza L. V.; Ferreira,Alexandre R.; Fagundes,Eleonora D. T.; Castro,Lúcia P. F.; Silva,Rogério A. P.; Penna,Francisco J.

    2008-01-01

    OBJETIVOS: Definir a sensibilidade, especificidade e a acurácia do espessamento ecogênico periportal à ultra-sonografia e da histopatologia hepática, isolados ou em conjunto, na distinção diagnóstica entre atresia biliar e as colestases intra-hepáticas. MÉTODOS: Trata-se de estudo retrospectivo realizado entre janeiro de 1990 e dezembro de 2004. Foram analisados 51 casos de atresia biliar e 45 com colestase intra-hepática. A histopatologia foi realizada por uma patologista de forma cega. O es...

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

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    Sigifredo Ospina

    2009-12-01

    Full Text Available 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 the hospital with the diagnostic impression of cholangitis and biliary obstruction. O. anthropi is an emerging bacteria in nosocomial infections with remarkable antimicrobial resistance, being an unusual pathogen in humans.

  14. 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; A. Fernández-Quintela; V. M. Rodríguez; 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 ...

  15. O espassamento ecogênico periportal e a histopatologia hepática no diagnóstico da atresia biliar

    OpenAIRE

    Mariza Leitao Valadares Roquete

    2006-01-01

    A colestase consiste na redução da formação da bile ou do fluxo biliar, cuja conseqüência é a retenção das substâncias excretadas na bile (Moyer et al., 2004). Uma grande parcela das afecções hepatobiliares de diversas naturezas manifestam-se com quadro de colestase. Estima-se que a colestase neonatal ocorra na freqüência de 1:2.500 nascidos vivos (Dick & Mowat, 1985)

  16. Síntesis y caracterización de surfactantes derivados de sales biliares, éteres corona, adamantanos y cadenas hidrocarbonadas

    OpenAIRE

    Trillo Novo, Juan Ventura

    2015-01-01

    La presente Tesis doctoral abarca aspectos relacionados con la Química supramolecular, el Biomimetismo molecular y la Fisicoquímica de coloides. El estudio ha implicado el diseño, la síntesis y la caracterización en disolución acuosa de numerosos compuestos entre los que sobresalen los derivados de las sales biliares, los éteres corona y grupos hidrófobos como los adamantanos y las cadenas hidrocarbonadas. Comparados con los surfactantes clásicos, los nuevos compuestos ev...

  17. Diferències pronòstiques en les pancreatitis agudes greus d'origen biliar i enòlic

    OpenAIRE

    Farré i Font, Roser

    2012-01-01

    Introducció: Les Pancreatitis Agudes (PA) es diagnostiquen amb dos dels tres criteris d'Atlanta: dolor abdominal, elevació d'amilases tres vegades per sobre del valor alt de la normalitat i TAC diagnòstic de PA. L'etiologia més prevalent en el nostre medi és la biliar (40-60%) seguit de l'alcohòlica (10-25%). Un 80% dels casos tenen un curs lleu amb reintroducció de la dieta i alta precoç mentre que un 20% són greus i requereixen tractament intensiu multidisciplinar. En el grup de PAG (pancre...

  18. 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)

  19. FATORES ASSOCIADOS À MORTALIDADE INFANTIL EM MUNICÍPIO COM ÍNDICE DE DESENVOLVIMENTO HUMANO ELEVADO

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    Maria Volpato Kropiwiec

    2017-09-01

    Full Text Available RESUMO Objetivo: Identificar os fatores associados à mortalidade infantil em município com bom desenvolvimento socioeconômico. Métodos: Estudo de coorte retrospectivo com 7.887 nascidos vivos do ano de 2012 registrados no Sistema de Informação sobre Nascidos Vivos (SINASC e associados por meio de linkage com o Sistema de Informações sobre Mortalidade (SIM para identificação dos óbitos ocorridos no primeiro ano de vida. Os fatores de risco foram hierarquizados em três níveis de determinação: distal, intermediário e proximal. Os modelos de regressão logística binomial e o modelo multivariado quantificaram o impacto individual das variáveis testadas e ajustaram o efeito das variáveis de confundimento. A magnitude do efeito das variáveis explicativas foi estimada pelo cálculo do Odds Ratio (OR bruta e ajustada e de seus respectivos intervalos de confiança de 95% (IC95%, sendo significante p<0,05. Resultados: Identificou-se 61 óbitos na coorte e o coeficiente de mortalidade infantil foi de 7,7 por mil nascidos vivos. Mãe adolescente (ORaj 3,75; IC95% 1,40-10,02, duração da gestação <32 semanas (ORaj 12,08; IC95% 2,30-63,38, peso ao nascer <1.500 g (ORaj 8,20; IC95% 1,52-44,23, Apgar no 1º e no 5º minuto de vida <7 (ORaj 4,82; IC95% 2,01-11,55 e ORaj 6,26; IC95% 1,93-20,30, respectivamente e presença de malformação congênita (ORaj 21,49; IC95% 7,72-59,82 constituíram fatores de risco para os óbitos. Conclusões: A menor relevância dos fatores socioeconômicos e assistenciais e a maior importância dos fatores biológicos na determinação dos óbitos infantis podem refletir o efeito protetor do elevado desenvolvimento econômico e social dessa localidade.

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

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    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

  1. Câncer de vesícula biliar: experiência de 10 anos em um hospital de referência da Amazônia

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    Geraldo Ishak

    Full Text Available OBJETIVO: Analisar os aspectos epidemiológicos-cirúrgicos dos pacientes com câncer de vesícula biliar (CAVB atendidos em um Hospital Universitário de Belém/PA, no período de 1999-2009. MÉTODOS: estudo observacional, retrospectivo, descritivo-analítico de fonte secundária dos pacientes com diagnóstico de CAVB, no período de 1999-2009. Foram analisados 75 prontuários, sendo 34 pacientes estudados. As informações coletadas foram utilizadas para o estadiamento tumoral TNM do CAVB e para a caracterização clínico-cirúrgica da população estudada. RESULTADOS: 79% eram do sexo feminino, com média de idade de 66,2±11 anos e tempo de sintomatologia de 10,8±17,2 meses, não obtendo relação estatística com o estadio da doença. Dor no hipocôndrio direito, náuseas e icterícia predominaram como sinais/sintomas. A litíase biliar esteve presente em 91% dos casos, sendo positiva em 100% dos pacientes com estadios I/II. A sensibilidade ultrassonográfica para sugestionar o CAVB no pré-operatório foi 14,28%. A operação mais executada foi a colecistectomia simples, tendo como achado intra-operatório predominante, invasão hepática. O adenocarcinoma foi o tipo histológico preponderante, com destaque para os estadios III e IV. CONCLUSÃO: A série estudada apresentou alta incidência de litíase biliar, o adenocarcinoma com estadio avançado foi o mais prevalente. acarretando um pequeno índice de operações com intenção curativa, 30% dos pacientes operados, e uma taxa de mortalidade de 21%. A valorização dos sintomas e a investigação precoce por exames de imagem poderiam favorecer o tratamento, em fases iniciais do CAVB, proporcionando um melhor prognóstico para os pacientes operados.

  2. ANÁLISE DAS MANIFESTAÇÕES PATOLÓGICAS EM RESERVATÓRIOS ELEVADOS NA CIDADE DE PELOTAS/RS

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    Ariela Silva Torres; Vivian Michele Bandeira da Silva

    2016-01-01

    RESUMO: Reservatórios elevados são construções destinadas a receber água das estações de tratamento através das adutoras ou de reservatórios de maior volume apoiados ou enterrados e distribuí-la até os pontos de consumo. Esta estrutura tem como função principal condicionar e equalizar as pressões nas áreas de cotas topográficas mais altas que não podem ser abastecidas pelo reservatório principal. Este trabalho relata um estudo sobre as manifestações patológicas de reservatórios elevados exec...

  3. Usefulness of endoscopic ultrasonography in the clinical suspicion of biliary disease Utilidad de la ultrasonografía endoscópica en la sospecha clínica de patología biliar

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    David del Pozo

    2011-07-01

    Full Text Available Background and aims: endoscopic ultrasound (EUS is a very sensitive and specific technique for the diagnosis of biliary diseases. This procedure has proven its usefulness in cases of high suspicion of biliary disease (history of gallstones and dilatation of the intrahepatic and/or extrahepatic bile ducts. We know less about its usefulness in cases of low suspicion of biliary pathology. The aim of this study was to assess the diagnostic accuracy of EUS in patients with low suspicion of biliary disease (patients with dilatation of the biliary tract were excluded. Methods: 33 patients with low suspicion of biliary disease were recruited in 12 months. All of them had no biliary findings in a previous abdominal ultrasound and computer tomography scan. All of them underwent EUS and were studied prospectively. The diagnosis was confirmed by surgery and/or by ERCP in patients with positive EUS or clinical follow-up in those with normal EUS. Time of follow-up was 9 months (range, 3-12 months. Results: seventeen patients (51.5% presented with abnormal biliary findings on EUS (7 choledocholithiasis, 3 cholelithiasis, 2 choledocholithiasis + cholelithiasis and 5 microlithiasis. Conclusion: EUS is a useful and safe procedure for diagnosing patients with low suspicion of biliary disease.Antecedentes y objetivos: la ultrasonografía endoscópica (USE es una técnica muy sensible y específica para el diagnóstico de enfermedades biliares. Este procedimiento ha demostrado su utilidad en casos de alta sospecha de enfermedad biliar (historia de colelitiasis y dilatación de la vía biliar intra- y/o extrahepática. Sabemos menos sobre su utilidad en casos de baja sospecha de patología biliar. El objetivo de este estudio fue evaluar la precisión diagnóstica de la USE en pacientes con baja sospecha de enfermedad biliar (los pacientes con dilatación de la vía biliar fueron excluidos. Métodos: 33 pacientes con baja sospecha de enfermedad biliar fueron

  4. Proposal of a new technique for bile duct reconstruction after iatrogenic injury: study in dogs and review of the literature Reconstrução da via biliar após lesão iatrogênica, proposta de nova técnica: estudo em cães e revisão da literatura

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    Eduardo Crema

    2007-06-01

    Full Text Available PURPOSE: Interposition of a jejunal tube between the common bile duct and duodenum. METHODS: Five adult mongrel dogs of both sexes, weighing on average 22.3 kg (18 to 26.5 kg, were used. Obstructive jaundice was induced by ligation of the distal common bile duct. After one week, a 2.5-cm long jejunal tube was fabricated from a segment of the loop removed 15 cm from the Treitz angle and interposed between the common bile duct and duodenum. RESULTS: The animals presented good clinical evolution and no complications were observed. After 6 weeks, complete integration was noted between the bile duct mucosa, tube and duodenum and a significant reduction in total bilirubin and alkaline phosphatase was observed when compared to the values obtained one week after ligation of the common bile duct. CONCLUSION: The jejunal tube interposed between the dilated bile duct and duodenum showed good anatomic integration and reduced total bilirubin and alkaline phosphatase levels in the animals studied.OBJETIVO: Interposição de um tubo de jejuno entre o colédoco e o duodeno. MÉTODOS: Foram utilizados cinco cães adultos, sem raça definida, de ambos os sexos, com peso médio de 22,3 Kg (18 e 26,5 Kg. Após provocar icterícia obstrutiva pela ligadura do colédoco distal, após uma semana, praticou-se confecção do tubo de jejuno de 2,5 cm de extensão, que foi realizado com um segmento de alça retirado a 15 cm do ângulo de Treitz e a interposição do tubo entre o colédoco e o duodeno. RESULTADOS: Os animais tiveram boa evolução clínica e não apresentaram complicações. Notou-se total integração entre a mucosa da via biliar, do tubo e do duodeno e redução significativa dos valores da bilirrubina total e da fosfatase alcalina após seis semanas, quando comparado com os valores após uma semana de ligadura do colédoco. CONCLUSÃO: O tubo de jejuno interposto entre a via biliar dilatada e o duodeno, apresentou boa integração anatômica e reduziu os

  5. Fatores relacionados ao prognóstico da atresia biliar pós-portoenterostomia Factors related to the post-portoenterostomy prognosis of biliary atresia

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    Jorge Luiz dos Santos

    2002-01-01

    Full Text Available Objetivo: o estudo está envolvido com o prognóstico da atresia biliar pós-portoenterostomia, presença de anomalias congênitas associadas à doença e de malformação de placa ductal, área de fibrose hepática e, sobretudo, com a idade dos pacientes por ocasião da cirurgia. O presente estudo verificou numa amostra de atresia biliar as implicações prognósticas destes fatores. Métodos: foram avaliados 47 pacientes com atresia biliar, em estudo de corte transversal. O material histológico dos casos foi marcado com anticorpo anticitoqueratina 19 e CAM 5.2 por método imunoistoquímico, para o estudo das estruturas biliares, e corado com picrossírius para avaliação da área de fibrose. O estudo das estruturas biliares foi realizado por dois patologistas e pelo primeiro autor deste estudo, "cegos" quanto à evolução dos casos. A mensuração da área de fibrose foi quantitativa. Os dados dos pacientes em relação à idade, ocorrência de óbito ou realização de transplante hepático foram pesquisados nos prontuários. Resultados: a idade por ocasião da portoenterostomia variou entre 24 e 251 dias de vida (90,4 + 44,8 dias, e em 32 casos (72% a evolução pôde ser acompanhada. Os 9 casos (19% com anomalias congênitas extra-hepáticas associadas não diferiram quanto ao prognóstico em relação ao restante da amostra. A idade por ocasião da portoenterostomia influenciou o prognóstico (p=0,016. A área de fibrose foi diferente entre pacientes operados com menos de 60 dias de vida e os operados com mais de 90 dias (p= 0,023, mas não influenciou a evolução dos casos. Tampouco a presença de malformação de placa ductal influiu no prognóstico. Conclusões: a idade por ocasião da portoenterostomia foi o único fator que afetou o prognóstico dos casos de atresia biliar. É necessário maior número de pacientes para avaliar a influência da presença de anomalias congênitas extra-hepáticas associadas sobre a evolução p

  6. Effects of albumin administration in serum liver enzymes of rats in the presence of extrahepatic biliary obstruction Efeitos da administração de albumina nos níveis séricos de enzimas hepáticas em ratos com obstrução biliar extra-hepática

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    Jorge Fernando Rebouças Lessa

    2011-01-01

    Full Text Available PURPOSE: To study the influence of albumin on changes of liver function in the extrahepatic biliary obstruction through an experimental model in rats. METHODS: Sixty rats were divided into four groups: Group C (Control: 6 animals. Group M (Fictitious Operation: 18 rats underwent laparotomy and handling of the bile ducts; Groups O (extrahepatic biliary obstruction and A (Treated with 2% albumin: 18 animals in each group underwent ligation of the ductus liver; The animals in groups M, O and A were divided into three subgroups of 6 animals each to be killed in the 7, 14 and 21 days postoperative (POD. Blood was drawn for determination of total bilirubin (TB, indirect bilirubin (IB, direct bilirubin (DB, alkaline phosphatase (ALP, aspartate aminotransferase (AST and alanine aminotransferase (ALT. RESULTS: On POD 7, BI levels were 4.5 mg / dl in group O and 2.1 mg / dl in group A (p = 0.025. On the 14th POD, the levels of PA were 1185.2 U / l in the group and O 458.3 U / l in group A (p = 0.004. ALT levels were 101.7 U / l in the group O and 75.7 U / l in group A (= 0.037. On POD 21, the levels of ALP were 1069.5 U / l in the group O and 468.3 U / l in group A (p = 0, 004. CONCLUSION: The administration of albumin reduced the serum levels of bilirubin in the 7th day of supplementationOBJETIVO: Estudar a influência da albumina em alterações funcionais do fígado na obstrução biliar extra-hepática por meio de um modelo experimental desenvolvido em ratos. MÉTODOS: 60 ratos distribuídos em quatro grupos: Grupo C (Controle: 6 animais. Grupo M (Operação Fictícia: 18 ratos submetidos à laparotomia e manuseio das vias biliares; Grupos O (Obstrução Biliar Extra-hepática e A (Tratados com albumina a 2%: 18 animais, em cada grupo, submetidos à ligadura do ducto hepático; Os animais dos grupos M, O e A foram distribuídos em três subgrupos de 6 animais cada, para serem mortos nos 7°, 14° e 21° dias pós- operatórios (DPO. Foi colhido sangue

  7. Re-diseño de la línea de ejes de turbinas Francis de salto elevado para la mejora de su competitividad

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    GARCÍA MÓNACO, ALEJANDRO

    2015-01-01

    El objetivo de este proyecto es mejorar la línea de ejes de las turbinas Francis de eje horizontal. En especial, se ha trabajado con aquellas máquinas diseñadas para funcionar con saltos de agua elevados. El proyecto surge del conocimiento de importantes ventajas económicas de las turbinas horizontales frente a las verticales y de la voluntad por parte de ALSTOM HYDRO de mejorar los rendimientos de las primeras para hacerlas más competitivas. Los capítulos 3 y 4 son introductorios a la pro...

  8. Preditores organizacionais do engagement no trabalho: o papel das práticas de recursos humanos de elevado desempenho e do clima sociomoral

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    Jacinto, Ana Isabel André

    2013-01-01

    Dissertação submetida como requisito parcial para obtenção do grau de Mestre em Psicologia Social e das Organizações A presente investigação teve como objetivo principal contribuir para uma melhor compreensão do papel das práticas de recursos humanos de elevado desempenho (PRHED) e do clima sociomoral enquanto preditores organizacionais do engagement no trabalho. Através de uma amostra com 181 indivíduos que trabalham em contexto organizacional em diferentes organizações e seto...

  9. Estudo ultrassonográfico morfométrico do fígado e trato biliar de suínos submetidos a obstrução biliar experimental Sonographic morphometry of the liver and biliary tract in porcine models submitted to experimental biliary obstruction

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    Aline Gomes de Campos

    2013-04-01

    Full Text Available OBJETIVO: Comparar as alterações anatômicas decorrentes de um quadro de icterícia obstrutiva experimental induzida em suínos nos períodos pré e pós-operatório por meio de exame ultrassonográfico. MATERIAIS E MÉTODOS: Seis suínos da raça Landrace, com 36 dias de idade, foram submetidos a obstrução biliar completa mediante ligadura do ducto colédoco por cirurgia videolaparoscópica. RESULTADOS: Não ocorreram dificuldades na execução dos procedimentos obstrutivos e a recuperação cirúrgica foi eficiente. Decorridos sete dias, os animais apresentaram icterícia, bilirrubinúria e acolia fecal. O exame ultrassonográfico comparativo permitiu visualizar hepatomegalia, colecistomegalia e aumento no calibre do ducto colédoco em todos os animais, assim como alterações decorrentes da colestase. A avaliação morfométrica revelou aumento significativo nos diâmetros da vesícula biliar e do lobo hepático lateral esquerdo. CONCLUSÃO: Os suínos representam um modelo experimental adequado de icterícia obstrutiva, e o exame ultrassonográfico demonstrou-se sensível e relevante no diagnóstico das alterações decorrentes de obstrução biliar extra-hepática nesses animais.OBJECTIVE: To compare, by means of ultrasonography, pre- and postoperative anatomical changes arising from experimentally induced obstructive jaundice in porcine models. MATERIALS AND METHODS: Six 36-day-old Landrace pigs underwent laparoscopically induced complete biliary obstruction by common bile duct ligation. RESULTS: No difficulty was faced during the procedures and the surgical recovery was uneventful. After seven days, the animals showed jaundice, bilirubinuria and acholic stools. Comparative ultrasonography allowed visualization of hepatomegaly, cholecystomegaly and increased caliber of the common bile duct in all the animals, as well as changes resulting from cholestasis. The morphometric analysis revealed a significant increase in diameter of the

  10. Hábitos dietéticos, peso elevado, consumo de tabaco, lipidemia e hipertensión arterial en adolescentes

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    Remigio Rafael Gorrita Pérez

    Full Text Available Introducción: aunque se conoce que la hipertensión arterial puede tener su origen desde la infancia y adolescencia, en esta etapa no es tan bien valorada como en el adulto. Objetivo: determinar la incidencia de hipertensión arterial en escolares adolescentes, y su relación con hábitos dietéticos, peso elevado, hábito de fumar e hiperlipidemias. Métodos: se realizó un estudio prospectivo y analítico en 532 adolescentes entre 12 y 14 años, de ambos sexos, de la Escuela Secundaria Básica Urbana "Ignacio Agramonte y Loynaz" de San José de las Lajas, durante el curso 2012-2013. Se estableció el riesgo relativo o razón de incidencia para los factores estudiados y la hipertensión arterial. Resultados: se identificaron cifras elevadas de tensión arterial en 21 estudiantes (3,9 %. El 18,6 % eran obesos y sobrepesos, solo el 5,45 % mostró una frecuencia óptima de alimentación posiblemente saludable. Casi la totalidad de obesos y sobrepesos se encontraban entre los que tenían una alimentación no saludable o con riesgo de no serlo. El 95,2 % de los hipertensos recibían alimentación no saludable, o con riesgo de no serlo. El 5 % practicaba el hábito de fumar. El 19,0 y el 14,3 % de los hipertensos tenían cifras elevadas de colesterol y triglicéridos respectivamente, y el 16,1 % de ambos estaban elevados en los obesos. Conclusiones: se estableció la incidencia de hipertensión arterial en adolescentes de una escuela secundaria básica. Se identificaron los hábitos dietéticos inadecuados, el peso elevado y el consumo de tabaco.

  11. Primary biliary cirrhosis and myopathy: an uncommon association Cirrose biliar primária e miopatia: uma rara associação

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    Bruno Cupertino Migueletto

    1999-10-01

    Full Text Available Primary biliary cirrhosis (PBC is a cholestatic liver disease, which is characterized by a chronic inflammatory destruction of intrahepatic bile ducts. It is a rare disorder whose precise etiology is still to be elucidated. Even though the liver is the principal target of PBC, other organ systems also might be affected. Muscular involvement has rarely been described in this disease, and in the majority of cases, muscular weakness has been interpreted as polymyositis. We report the case of a 48-year-old woman suffering from classic PBC, in association with a myopathy whose histological features are distinct from the cases reported before. We also performed a MEDLINE research for PBC and concomitant muscular diseases.A cirrose biliar primária (CBP é uma doença hepática colestática crônica de etiologia desconhecida e rara. Apesar do principal órgão acometido na CBP ser o fígado, outros órgãos podem também ser afetados. O acometimento muscular raramente tem sido relatado em pacientes com CBP e na maioria destes casos, a fraqueza muscular tem sido interpretada como Polimiosite. Nós relatamos o caso de uma mulher de 48 anos com CBP e miopatia com achados histopatológicos distintos dos casos anteriormente descritos e fizemos uma revisão da literatura sobre o acometimento muscular na CBP.

  12. Alterações clínicas e laboratoriais em equinos adaptados a dieta com nível elevado de concentrado e submetidos à sobrecarga dietética com amido

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    Tiago Marques dos Santos

    2011-04-01

    Full Text Available Este trabalho teve como objetivo avaliar o efeito da sobrecarga dietética com amido em equinos adaptados a dieta com nível elevado de concentrado. Seis equinos adultos foram previamente adaptados à dieta composta por feno de coast cross e concentrado na proporção de 60:40 e, posteriormente submetidos à infusão gástrica de 17,6 g amido/kg de peso corporal. Os equinos foram avaliados por meio de exames clínicos e laboratoriais até 36 horas após a sobrecarga. Um equino veio a óbito 32 horas após a sobrecarga, apresentando quadro clínico de endotoxemia e laminite. Não houve diferença (P > 0,05 nas frequências cardíaca e respiratória, temperatura retal, tempo de preenchimento capilar e temperatura superficial dos cascos dos equinos durante o experimento. Houve tendência ao aumento na motilidade intestinal, seguido de aumento na fluidez das fezes. O volume globular e a concentração de proteína plasmática total aumentaram (P < 0,05 24 horas após a sobrecarga quando comparados aos valores basais, de 26,7 a 32,0% e de 7,1 e 8,1 g/dL, respectivamente. Os neutrófilos bastonetes aumentaram (P < 0,05 durante o período de avaliação, com valores variando de 0,1 a 0,7 x 10(3/µL antes da sobrecarga e 24 horas após, respectivamente, enquanto os eosinófilos apresentaram redução. A concentração plasmática de lactato teve aumento discreto com diferença (P < 0,05 antes, 20 e 28 horas após a sobrecarga, com valores de 0,7, 1,0 e 1,2 mmol/L, respectivamente. Conclui-se que equinos consumindo dieta com elevado nível de concentrado e submetidos à sobrecarga dietética com amido apresentam alterações clínicas e laboratoriais moderadas, porém, casos graves, seguidos do óbito, podem ocorrer devido à variação individual.

  13. Prevalência de níveis pressóricos elevados e fatores associados em adultos de Lages/SC Prevalencia de niveles de presión elevados y factores asociados en adultos de la ciudad de Lages/SC Prevalence of high blood pressure levels and associated factors among adults in Southern Brazil

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    Giana Zarbato Longo

    2009-10-01

    Full Text Available FUNDAMENTO: Poucos estudos de base populacional foram realizados em cidades de médio porte para estimar a prevalência de níveis pressóricos elevados e fatores associados. OBJETIVO: Estimar a prevalência dos níveis pressóricos elevados e fatores associados em adultos de Lages, SC. MÉTODOS: Estudo transversal de base populacional em adultos de 20 a 59 anos da zona urbana (n=2.022. A variável dependente foi nível pressórico elevado com valores > 140/90 mmHg. Variáveis independentes: sexo, idade, escolaridade, renda familiar per capita, cor da pele auto-referida, índice de massa corporal, tabagismo, problemas com álcool, atividade física, e diabete melito auto-referida. Para verificar as associações foi usado o teste de qui-quadrado e de tendência linear. A análise múltipla foi realizada por meio da regressão de Poisson RESULTADOS: A taxa de resposta foi de 98,6%. A prevalência de níveis pressóricos elevados foi de 33,7% (IC95% 31,7-36,1 para a população em geral variando de 31,1% nos homens a 38,1% nas mulheres. Após o ajuste por possíveis variáveis de confusão foram associados com nível pressórico elevado: indivíduos do sexo masculino (RP = 1,4 IC 95% 1,2-1,7, aqueles com idades mais avançadas (pFUNDAMENTO: Pocos estudios de base poblacional se llevaron a cabo en ciudades de porte medio para estimar la prevalencia de niveles de presión elevados y de factores asociados. OBJETIVO: Prevalencia de Niveles de Presión Elevados y Factores Asociados en Adultos de la ciudad de Lages, SC MÉTODOS: Estudio transversal de base poblacional en adultos de 20 a 59 años de la zona urbana (n=2.022. La variable dependiente fue un nivel de presión elevado con valores > 140/90 mgHg. Variables independientes: sexo, edad, escolaridad, renta familiar per capita, color de la piel auto-referida, índice de masa corporal, tabaquismo, problemas con alcohol, actividad física, y diabetes mellitus auto-referida. Se utilizó la prueba Chi

  14. 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

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    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

  15. Características ultrassonográficas de fígado, vesícula biliar, rins, vesícula urinária e jejuno em coelhos jovens e adultos

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    Kassy G. da Silva

    Full Text Available RESUMO: O presente trabalho descreveu características e comparou mensurações do fígado, vesícula biliar, rins, vesícula urinária e jejuno de coelhos da raça Nova Zelândia Branco (NZB jovens e adultos. O grupo dos jovens foi composto por 39 coelhos de ambos os sexos (20 machos e 19 fêmeas, desmamados aos 30-31 dias de idade, sendo as avaliações realizadas aos 35, 56 e 77 dias de idade. O grupo dos adultos foi composto por 23 fêmeas e 15 machos, com idade superior a 6 meses, sendo realizada uma avaliação ultrassonográfica por animal. O exame consistiu na avaliação do fígado, vesícula biliar, rins direito e esquerdo, jejuno e vesícula urinária. Todos os animais foram pesados antes dos exames. O peso médio dos animais aumentou (p0,05 da espessura das camadas do jejuno entre as idades, apresentando média de 0,23 cm para todos os animais. Estes são os primeiros dados brasileiros de características ultrassonográficas de fígado, vesícula biliar, rins, jejuno e vesícula urinária para coelhos NZB de 35, 56 e 77 dias de vida e adultos.

  16. Avaliação química e termoanalítica de cálculos biliares e bile vesicular humana de pacientes do sexo masculino

    OpenAIRE

    Cláudia Mônica Tortorelli

    2006-01-01

    Este trabalho teve como meta principal ampliar o estudo anteriormente relatado por Mercuri em 2000, agora com a caracterização química e termoanalítica de cálculos biliares e as biles vesiculares humanas, especificamente, de pacientes do sexo masculino. Para ambos os tipos de caracterização foram utilizadas várias técnicas, como: (a) Análise Elementar (AE), para determinação de teores de C, H e N. (b) Espectroscopia no infravermelho com transformada de Fourier (FTIR), com o objetivo de verifi...

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

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    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

  18. O papel da visão na aversão aos espaços abertos no labirinto em cruz elevado

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    Silvio Morato

    2006-01-01

    Full Text Available O labirinto em cruz elevado é um dos modelos mais usados no estudo da ansiedade, medo e fármacos que alteram esses estados. Apesar da simplicidade aparente do modelo, diversos são os fatores que afetam o comportamento de ratos submetidos a esse modelo. Além disso, não se conhece exatamente quais os estímulos ambientais são os desencadeadores da aversão nesse modelo. O presente trabalho sugere que, em estudos onde os estímulos auditivos e olfativos são controlados, a aversão em ratos é desencadeada pela visão. A hipótese de trabalho é que os mecanismos mediadores da aversão (e estados emocionais concomitantes são deflagrados pela entrada de luz e pela formação de imagens na retina dos animais. Para fundamentar essas hipóteses complementares, vários experimentos são analisados, cujos resultados favorecem uma, outra ou ambas as hipóteses. Finalmente, resultados obtidos com marcação da proteína c-Fos fornecem evidência neurofuncional que apóia as duas hipóteses sugeridas.

  19. 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

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    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

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

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    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

  1. ANÁLISE DAS MANIFESTAÇÕES PATOLÓGICAS EM RESERVATÓRIOS ELEVADOS NA CIDADE DE PELOTAS/RS

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    Ariela Silva Torres

    2016-06-01

    Full Text Available RESUMO: Reservatórios elevados são construções destinadas a receber água das estações de tratamento através das adutoras ou de reservatórios de maior volume apoiados ou enterrados e distribuí-la até os pontos de consumo. Esta estrutura tem como função principal condicionar e equalizar as pressões nas áreas de cotas topográficas mais altas que não podem ser abastecidas pelo reservatório principal. Este trabalho relata um estudo sobre as manifestações patológicas de reservatórios elevados executados em concreto armado na zona urbana da cidade de Pelotas, RS. A etapa de diagnóstico foi feita através de análise visual com registro fotográfico e após comparação com projeto estrutural cedido pelo órgão responsável pelo projeto. Por meio do estudo foi possível identificar manifestações patológicas do tipo: fissuras, sujidade, desplacamentos, corrosão de armaduras e lixiviação. Os resultados das análises das manifestações patológicas demonstraram que, além da falta de manutenção, as especificações de projeto, referentes aos estribos de pilares e vigas, foram decisivas na propagação da corrosão de armaduras, que estão expostas devido à ocorrência de cobrimentos em desacordo com os critérios atuais da norma NBR-6118 (ABNT, 2014 (Projeto de estruturas de concreto armado. O trabalho concluiu que o descaso do poder público com o estabelecimento de processos adequados de manutenção acelerou a degradação da estrutura e ocasionando assim a falha no funcionamento de abastecimento nos bairros que utilizam estes reservatórios. Desta maneira, este trabalho colaborou para o poder público iniciar o processo de estudo da etapa de manutenção destas edificações, com fim de favorecer a comunidade. ABSTRACT: Elevated tanks are buildings designed to receive water treatment plants through pipelines or supported bulk tanks or buried and distribute it to the points of consumption. This structure has the main

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

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    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.

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

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    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.

  4. Íleo biliar:: complicación poco frecuente de la litiasis vesicular Biliary ileum:: an uncommon complication of vesicular lithiasis

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    Gabriel González Sosa

    2010-06-01

    Full Text Available Se presenta el caso de una paciente de 80 años de edad, con antecedentes de diabetes mellitus de tipo II, cardiopatía isquémica y obesidad exógena, que ingresó de urgencia, por presentar un cuadro de dolor abdominal, varios vómitos y distensión abdominal de 3 días de evolución. De forma secundaria presentó una deshidratación moderada. En la radiografía simple de abdomen se constataron signos radiológicos de oclusión intestinal, que corroboraron una ecografía abdominal y una tomografía axial computadorizada de abdomen. 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. A los 16 días del alta, la paciente reingresa con un cuadro similar y al reintervenirla se constató la presencia de otro cálculo y de una fístula colecistogástrica, que involucraba la vesícula biliar y el antro gástrico. Se reparó mediante colecistectomía y gastrorrafia. Al final del transoperatorio la paciente presentó un episodio de fibrilación ventricular, con bradicardia extrema, y finalmente un paro en asistolia. Fue reanimada, pero la situación no se revirtió y la paciente falleció.This the case of a female patient aged 80 with a history of type 2 diabetes mellitus, ischemic heart failure and a exogenous obesity urgently admitted due to abdominal pain, vomiting and abdominal distention of 3 days course. In abdominal simple radiograph radiological signs of intestinal occlusion were confirmed corroborated by abdominal echography and CAT. Hydroelectrolytic imbalance was corrected performing an exploration laparotomy observing the presence of large calculus located in terminal ileum. An enterolithotomy with enterorrhaphy and occlusive picture was resolved. At 16 from discharge, patient is re-admitted with a similar situation and at re

  5. Empleo del modelo animal en la formación en endoscopia diagnóstica y terapéutica de la vía biliar

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    J. Usón-Gargallo

    Full Text Available Objetivo. Mostrar nuestra experiencia en la formación en endoscopia terapéutica de la vía biliar en modelo animal. Materiales y métodos. Esta actividad formativa tiene una duración de 13 horas y comienza iniciando al alumno en las diferencias anatómicas de las especies que se emplean, la porcina y la canina, con respecto a la anatomía humana. Las prácticas consisten en habituar al endoscopista a la visión lateral del duodenoscopio; se realizan en un modelo porcino debido a que es más sencillo atravesar el esfínter pilórico, aunque no suele ser muy adecuado para la canulación de la papila duodenal. Tras superar la primera fase se utiliza el modelo canino, que permite adquirir las habilidades y destrezas propias de esta técnica. La evaluación de los resultados se realiza mediante una encuesta anónima. Resultados. El 76% de los alumnos confirma que ha avanzado mucho con este entrenamiento, un 18% regular y un 6% poco. El 75% considera que, tras realizar esta actividad de formación, se encontraría capacitado para llevar a cabo la técnica en su hospital. El 94% de los alumnos recomendaría esta actividad a sus compañeros. Conclusiones. El empleo del modelo animal en la formación en colangiopancreatografía retrógada endoscópica (CPRE permite la adquisición de habilidades básicas necesarias para la práctica, ya que posibilita la repetición de las maniobras y la tutela continuada. Consideramos que con esta metodología mixta se podría acortar la curva de aprendizaje de la CPRE y disminuiría la iatrogenia en las primeras fases.

  6. Recurrence of hepatocellular carcinoma after liver transplantation presenting as anastomotic biliary stricture Presentación del carcinoma hepatocelular recurrente tras el trasplante de hígado en forma de estenosis biliar anastomótica

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    S. Y. Chen

    2008-07-01

    Full Text Available A 52-year-old man visited our hospital complaining of anorexia and fatigue two months after receiving orthotopic liver transplantation for hepatocellular carcinoma. A laboratory investigation demonstrated a clinical picture of obstructive jaundice. T-tube cholangiography showed biliary stricture over the anastomotic site. Percutaneous transluminal balloon dilatation and stenting was attempted but failed. Magnetic resonance cholangiography showed possible tumor recurrence over the site of the anastomotic biliary stricture. A biopsy sample was obtained via ultrasound-guided aspiration and histopathological study revealed inflammatory and fibrotic changes. With high suspicion of recurrence of the hepatocellular carcinoma, surgical exploration was performed and an intraoperative frozen section proved the recurrence. We thus diagnosed this case as a recurrence of hepatocellular carcinoma after liver transplantation. To our knowledge, there have been no previous reports of early tumor recurrence after liver transplantation being the cause of an anastomotic biliary stricture.Un varón de 52 años visitó nuestro hospital quejándose de anorexia y fatiga a los dos meses de haber recibido un trasplante hepático ortotópico a causa de un carcinoma hepatocelular. La analítica mostró un cuadro clínico de ictericia obstructiva. La colangiografía con tubo en T mostró una estenosis biliar sobre la anastomosis. Se intentó una dilatación transluminal percutánea con globo y colocación de endoprótesis, que fracasó. La colangiografía por resonancia magnética mostró una posible recurrencia tumoral sobre el lugar de la estenosis biliar anastomótica. Se extrajo una muestra de biopsia mediante aspiración bajo guía ecográfica y el estudio histopatológico mostró alteraciones inflamatorias y fibróticas. Al sospecharse la recurrencia del carcinoma hepatocelular, se realizó una exploración quirúrgica; un corte intraoperatorio congelado demostr

  7. 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

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    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.

  8. Cryptosporidiosis of the biliary tract mimicking pancreatic cancer in an AIDS patient Criptosporidiose do trato biliar simulando câncer do pâncreas em paciente com AIDS

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    Lenice do Rosário de Souza

    2004-03-01

    Full Text Available Diarrhea caused by Cryptosporidium sp is frequent in patients with AIDS, but involvement of other organs of the digestive tract is uncommon. We report a case of Cryptosporidium-associated obstruction of the biliary tract mimicking cancer of the head of the pancreas in a 43-year-old woman with AIDS.A diarréia causada pelo Cryptosporidium sp é muito freqüente em pacientes com AIDS, mas o envolvimento de outros órgãos do aparelho digestivo é incomum. Relata-se o caso de uma mulher de 43 anos, que tinha AIDS, que apresentava obstrução das vias biliares associada ao Cryptosporidium, simulando câncer da cabeça do pâncreas.

  9. Resultados del drenaje de la vía biliar por CPRE en pacientes con edad geriátrica Outcomes of bile duct drainage by means of ERCP in geriatric patients

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    J. García-Cano

    2007-08-01

    Full Text Available Antecedentes y objetivo: la colangiopancreatografía retrógrada endoscópica (CPRE es habitualmente la técnica de elección para desobstruir la vía biliar. Una gran parte de los pacientes a los que se realiza esta intervención están en edad geriátrica (mayores de 75 años. Nuestro objetivo ha sido valorar la eficacia de la CPRE en este grupo de pacientes, comparado con los de menor edad. Pacientes y métodos: estudio retrospectivo en el que se han incluido los pacientes a quienes se realizó terapéutica biliar endoscópica mediante CPRE en un periodo de cuatro años (2002-2005. Resultados: se realizó CPRE a 178 pacientes en edad geriátrica y a 159 de menor edad. No hubo diferencias en el éxito del drenaje biliar (97,7-98,7%, en el número de complicaciones (11,8-14,4%, ni en la mortalidad (1,1-0,6%. Por el contrario, en el grupo geriátrico hubo más coledocolitiasis (57,3-39,6%, p = 0,004 y se utilizaron más prótesis metálicas autoexpandibles para drenar la ictericia obstructiva tumoral (47-8%, p = 0,0035. En el grupo de menor edad se repitieron más CPRE a los mismos pacientes (4-10%, p = 0,001. Conclusiones: el éxito y la morbimortalidad para drenar la vía biliar mediante CPRE son similares en los pacientes con edad geriátrica y en los de edad inferior. La coledocolitiasis es más frecuente en los pacientes mayores. No se debe excluir a ningún paciente que precise de una CPRE sólo por la edad.Background and objective: endoscopic retrograde cholangiopancreatography (ERCP is usually the procedure of choice for relieving bile duct obstruction. A large number of patients undergoing this intervention are geriatric population (aged 75 years of age and older. Our aim was to assess the efficacy of ERCP in this group of patients as compared to younger ones. Patients and methods: a retrospective study. All patients in whom a therapeutic biliary endoscopy had been performed over a four-year period of time (2002-2005 were included

  10. Niveis sericos das vitaminas lipossoluveis (A, D e E) em pacientes com atresia biliar e hepatite auto-imune e a relação com o estado nutricional e indicadores clinicos e laboratoriais

    OpenAIRE

    Margareth Lopes Galvão Saron

    2008-01-01

    Resumo: As doenças hepáticas crônicas podem induzir à má-absorção de lipídios e vitaminas lipossolúveis e levar ao comprometimento do estado nutricional. O objetivo da pesquisa foi determinar os níveis séricos de vitaminas lipossolúveis (A, D e E) em crianças e adolescentes com atresia biliar (AB) e hepatite auto-imune (HAI) e verificar a relação com o estado nutricional e indicadores laboratoriais e clínicos. O estudo foi transversal e controlado e foram avaliados os pacientes com HAI (n=25...

  11. Recuperação em órgãos e tecidos de Escherichia coli ATCC 25922, inoculada no íleo terminal de ratos com obstrução biliar prolongada

    OpenAIRE

    Rocha, Sergio Luiz, 1958-

    2013-01-01

    Resumo: O objetivo do presente estudo foi investigar a atividade do sistema retículoendotelial em ratos com obstrução biliar de 21 dias , através da recuperação em órgãos e tecidos de bactérias viáveis, previamente injetadas na luz do íleo terminal. Foram utilizados 45 ratos Wistar, machos, com peso médio de 287g, colocados em 3 grupos. Os ratos foram anestesiados por via inalatória com éter etílico em todos os procedimentos cirúrgicos. O grupo I constituiu-se de 14 ratos hígidos, que através...

  12. 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.

  13. EVOLUÇÃO DA FIBROSE BILIAR SECUNDÁRIA EM RATOS TRATADOS MEDIANTE DERIVAÇÃO BÍLIO-DUODENAL OU BÍLIO-JEJUNAL COM AL��A DE ROUX MEDINDO 5, 10 E 15 CM

    Directory of Open Access Journals (Sweden)

    Pandolfi Jr. H.

    2001-01-01

    Full Text Available A modalidade de derivação bílio-digestiva empregada no tratamento da colestase extra-hepática crônica pode influenciar na reparação das lesões hepáticas. Avaliou-se o desempenho das derivações bílio-duodenal e bílio-jejunal em Y de Roux com alça exclusa de diferentes comprimentos na reparação das lesões morfológicas e funcionais do fígado de ratos com fibrose biliar secundária. Foram utilizados ratos Wistar, com 15 dias de obstrução biliar, alocados em 5 grupos de 6 animais. O grupo OB caracterizou as alterações da fibrose biliar. Os animais remanescentes foram tratados mediante derivação com o duodeno (grupo DBD, e com o jejuno, em alça exclusa de 5cm (grupo DBJ5, 10cm (grupo DBJ10 e 15cm (grupo DBJ15, sendo reavaliados 3 meses depois. Outros 6 animais foram submetidos à intervenção simulada e considerados grupo controle (IS. Todos animais foram submetidos à avaliação morfométrica do fígado, análise bioquímica do sangue e microbiológica da bile, estudo da função mitocondrial hepática e verificação do peso úmido do fígado e do baço. Na análise estatística adotou-se o nível de significância de 5%. Houve aumento significativo do peso estimado, em g/Kg de peso corporal, dos ductos biliares, da fibrose e dos hepatócitos nos animais do grupo OB (medianas de 1,30; 10,03 e 37,0 em relação aos animais controles (IS (medianas de 0,03; zero e 29,37. Após tratamento, ocorreu regressão significativa do peso estimado dos ductos biliares e da fibrose, com valores medianos de 0,22 e 0,22 para o grupo DBD, 0,45 e 3,31 para o grupo DBJ5 e 0,22 e 5,0 para o grupo DBJ15. Houve regressão significativa do peso estimado dos hepatócitos apenas nos grupos derivados com o jejuno, com valores medianos de 31,93; 24,46 e 28,52. Ocorreu aumento significativo do peso úmido do fígado e do baço no grupo OB (medianas em g/Kg de peso corporal de 49,85 e 5,71 em relação ao grupo IS (30,0 e 3,04. Houve regress

  14. 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 ...

  15. 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

  16. Paucity of intrahepatic bile ducts in infancy: experience of a tertiary center Hipoplasia de vias biliares intra-hepáticas na infância: experiência de um serviço terciário

    Directory of Open Access Journals (Sweden)

    Adriana Maria Alves De Tommaso

    2004-09-01

    Full Text Available BACKGROUND: Intrahepatic cholestasis secondary to paucity of bile duct is an alteration of the anatomic integrity of the biliary tract. Can be defined only histologically and, clinically, two categories are recognized: syndromic and non-syndromic, where the prognosis is generally more severe. AIM: To evaluate the history, clinical and biochemical characteristics, etiology and improvement of children who have paucity of intrahepatic bile duct followed at tertiary center. PATIENTS AND METHODS: Eleven children with paucity of intrahepatic bile duct, followed at the Pediatric Hepatology Service of the University Hospital, Campinas, SP, Brazil, were evaluated in the period from 1986 to 2001. RESULTS: Among the patients, three presented the syndromic and eight the non-syndromic form (two with alpha-1-antitrypsin deficiency, one with lues, one secondary to sepsis, three with probable etiology by cytomegalovirus and one without a definite etiology. Referral ranged from 31 to 1185 days. Birth weights ranged from 1920 g to 3590 g. Most of the patients presented pale stools. The median bile duct/portal tract ratio was 0.14. The majority of the children presented a favorable follow-up, regardless of the form of presentation. CONCLUSION: Paucity of intrahepatic bile ducts should be considered in children with cholestasis and its differentiation from extrahepatic causes of neonatal cholestasis is important in order to avoid surgery. Diagnosis of non-syndromic form should not be regarded as unfavorable prognosis, as the evolution is probably related to the etiology in this form of presentation.RACIONAL: A hipoplasia das vias biliares intra-hepáticas é causa de colestase secundária a uma alteração na integridade anatômica do trato biliar. A definição é dada pelo exame histopatológico e, do ponto de vista clínico, pode ser classificada em sindrômica e não-sindrômica onde o prognóstico é, geralmente, mais grave. OBJETIVO: Avaliar a hist

  17. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    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

  18. Gallbladder leiomyoma in absence of immune system disorders: an unusual diagnosis Leiomioma de vesícula biliar en ausencia de patología del sistema inmune: un diagnóstico inusual

    Directory of Open Access Journals (Sweden)

    Juan José Segura-Sampedro

    2012-07-01

    Full Text Available Mesenchymal neoplasms of the gallbladder are rare and in particular leiomyomas of the gallbladder have been rarely reported, all of them in patients with immune system disorders. This is the first report in Spanish of a 23-year-old female patient with a gallbladder leiomyoma without associated immunodeficiency. The patient lacks a previous history of uterine leiomyoma or any other form of neoplasm. She refers several episodes of epygastralgia. A hydatic cyst led to an initial diagnosis and the gallbladder was removed by means of simple cholecystectomy. The abnormal macroscopic aspect of the sample prompted intraoperative biopsy which revealed a benign gallbladder angiomyoma. Subsequent immunohistochemical analysis of the resected sample yielded the diagnosis of intramural endocavitary leiomyoma negative for EBV and C-kit / CD-117. The patient has good general condition and remains asymptomatic 15 months after surgery.Las neoplasias mesenquimales de vesícula biliar son una patología muy poco frecuente, concretamente, son muy pocos los casos descritos de leiomioma de vesícula biliar y todos ellos diagnosticados en pacientes con enfermedades del sistema inmunitario. Se describe por primera vez en la literatura en lengua española el caso de un leiomioma vesicular en una mujer de 23 años sin compromiso inmunitario alguno. La paciente carece de historia de leiomioma uterino o cualquier otra neoplasia. Presenta una historia de epigastralgias de evolución. Se formuló un primer diagnóstico guiado por imagen de quiste hidatídico. La vesícula fue extirpada mediante colecistectomía simple. El aspecto macroscópico anormal motivó una biopsia intraoperatoria que fue informada como angiomioma vesicular benigno. El posterior estudio inmunohistoquímico de la pieza arrojó el diagnóstico de leiomioma intramural y endocavitario negativo para VEB y C-Kit / CD-117. La paciente presenta buen estado general y permanece asintomática 15 meses después de

  19. Acurácia diagnóstica do espessamento ecogênico periportal à ultra-sonografia e da histopatologia no diagnóstico diferencial da atresia biliar Accuracy of echogenic periportal enlargement image in ultrasonographic exams and histopathology in differential diagnosis of biliary atresia

    Directory of Open Access Journals (Sweden)

    Mariza L. V. Roquete

    2008-08-01

    Full Text Available OBJETIVOS: Definir a sensibilidade, especificidade e a acurácia do espessamento ecogênico periportal à ultra-sonografia e da histopatologia hepática, isolados ou em conjunto, na distinção diagnóstica entre atresia biliar e as colestases intra-hepáticas. MÉTODOS: Trata-se de estudo retrospectivo realizado entre janeiro de 1990 e dezembro de 2004. Foram analisados 51 casos de atresia biliar e 45 com colestase intra-hepática. A histopatologia foi realizada por uma patologista de forma cega. O espessamento ecogênico periportal foi pesquisado na ultra-sonografia como único sinal diagnóstico de atresia biliar. Foram calculados os índices de sensibilidade, especificidade e acurácia do espessamento ecogênico periportal e da histologia isoladamente ou associados. O padrão-ouro utilizado para o diagnóstico de atresia biliar foi o aspecto da via biliar extra-hepática à laparotomia. RESULTADOS: O espessamento ecogênico periportal revelou sensibilidade de 49%, especificidade de 100% e acurácia de 72,5%. A histopatologia compatível com obstrução biliar extra-hepática conferiu sensibilidade de 90,2%, especificidade de 84,6% e acurácia de 87,8%. O espessamento ecogênico periportal e a histopatologia isolados ou associados proporcionaram sensibilidade de 93,2%, especificidade de 85,7% e acurácia de 90,3%. CONCLUSÕES: A evidência do espessamento ecogênico periportal na ultra-sonografia é indicação de laparotomia. Se o espessamento ecogênico periportal é negativo, está indicada a biopsia hepática; se a histopatologia revelar sinais de atresia biliar, impõe-se a laparotomia exploradora. Nos casos de espessamento ecogênico periportal negativo com histopatologia de hepatite neonatal ou de outras colestases intra-hepáticas, recomenda-se o acompanhamento ou o tratamento clínico conforme o diagnóstico.OBJECTIVES: To define the sensitivity, specificity and accuracy of the ultrasound triangular cord sign and hepatic

  20. Nutritional status of patients with biliary atresia and autoimmune hepatitis related to serum levels of vitamins A, D and E Estado nutricional de pacientes com atresia biliar e hepatite autoimune e relação com os níveis séricos de vitaminas A, D e E

    Directory of Open Access Journals (Sweden)

    Margareth L. G. Saron

    2009-03-01

    Full Text Available CONTEXT: Chronic liver disease may induce to malabsorption of lipids and fat-soluble vitamins, leading to injury of nutritional status. OBJECTIVES: To evaluate the nutritional status of pediatric-age patients with autoimmune hepatitis and biliary atresia related to serum levels of vitamins A, D and E and the disease severity. METHODS: This controlled transverse study, evaluated the patients with autoimmune hepatitis and biliary atresia and a reference group paired by sex and age. The patients underwent anthropometric evaluation, alimentary inquiry and determination of serum levels of vitamins A, D and E by high performance liquid chromatography. The Mann-Whitney test, Spearman correlation coefficients and variance analysis (ANOVA were utilized for data treatment, regarding significant difference if PCONTEXTO: As doenças hepáticas crônicas podem induzir à má absorção de lipídios e vitaminas lipossolúveis e levar ao comprometimento do estado nutricional. OBJETIVOS: Avaliar o estado nutricional e relacionar com os níveis séricos de vitaminas (A, D e E e a gravidade da doença em pacientes com atresia biliar e hepatite autoimune na faixa etária pediátrica. MÉTODOS: O estudo foi transversal controlado e foram avaliados os pacientes com hepatite autoimune e atresia biliar e um grupo controle pareado por sexo e idade. Foi realizada avaliação antropométrica, aplicação do inquérito alimentar e determinação dos níveis séricos das vitaminas A, D e E pela técnica de cromatografia líquida de alta eficiência. Foram empregados os testes de Mann-Whitney, o coeficiente de correlação de Spearman e análise de variância (ANOVA, sendo considerada diferença significativa se P<0,05. RESULTADOS: O déficit nutricional mais grave foi observado nos pacientes com atresia biliar, principalmente com colestase. Em relação às vitaminas, no grupo controle, constatou-se que os níveis séricos das vitaminas A e E variaram com a idade. Os n

  1. Liver histological, portal flow and plasmatic nitric oxide alterations caused by biliary obstruction and drainage in rats Alterações histológicas, do fluxo portal e do óxido nítrico plasmático em ratos submetidos à obstrução/desobstrução biliar

    Directory of Open Access Journals (Sweden)

    Miguel Angel Dias

    2008-01-01

    Full Text Available PURPOSE: To evaluate liver alterations caused by biliary obstruction and drainage. METHODS: Thirty-nine male Wistar rats were randomly distributed in 4 groups: BO (n=18 bile duct ligation for 20 days, with a periodic evaluation of liver histological alterations, Doppler echography portal flow and measurements of NO and malondialdehyde (MDA; BO/DB (n=13 bile duct occlusion for 20 days followed by biliary drainage by choledochoduodenal anastomosis, 5 days follow-up, same BO group parameters evaluations; group CED (n=4 sham operation and portal flow evaluation trough 20 days; CHB (n=4 sham operation, with hepatic biopsy on 25th day and followed-up trough 25 days, by the same parameters of group BO, with exception of portal flow. Direct bilirubin (DB and alkaline phosphatase (AP were evaluated in the group BO, BO/DB and CHB. RESULTS: The bile duct ligation led to an increase of DB and AP, development of liver histological alterations, reduction of portal flow and increase of plasmatic NO and of MDA levels. The bile duct clearing resulted in a reduction of DB, AP, NO, MDA histological alterations and increase of portal flow. CONCLUSION: The biliary occlusion resulted in cholestasis and portal flow reduction, besides the increase of plasmatic NO and of hepatic MDA levels, and histological liver alterations, with a tendency of normalization after the bile duct clearing.OBJETIVO: Avaliar alterações hepáticas resultantes do processo de obstrução/desobstrução biliar. MÉTODOS: Trinta e nove ratos Wistar foram distribuídos aleatoriamente em 4 grupos: OB (n=18, oclusão biliar, seguimento de 20 dias, avaliação das alterações histológicas hepáticas, do fluxo portal e dosagens de NO e de malondialdeído (MDA; grupo OB/DB (n=13 oclusão biliar por 20 dias seguida de desobstrução biliar por anastomose colédoco-duodenal, seguimento por 5 dias e avaliação dos mesmos parâmetros do grupo BO; grupo CED (n=4 operação simulada, avaliação do

  2. Totally James

    Science.gov (United States)

    Owens, Tom

    2006-01-01

    This article presents an interview with James Howe, author of "The Misfits" and "Totally Joe". In this interview, Howe discusses tolerance, diversity and the parallels between his own life and his literature. Howe's four books in addition to "The Misfits" and "Totally Joe" and his list of recommended books with lesbian, gay, bisexual, transgender,…

  3. Insuficiência renal oculta acarreta risco elevado de mortalidade após cirurgia de revascularização miocárdica

    OpenAIRE

    Volkmann,Mathias Alexandre; Behr,Paulo Eduardo Ballvé; Burmeister,Jayme Eduardo; Consoni,Paulo Roberto; Kalil,Renato Abdala Karam; Prates,Paulo Roberto; Nesralla,Ivo Abraão; Sant'Anna,João Ricardo Michelin

    2011-01-01

    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 < 1,5 mg/dL, de acordo com a depuração estimada, normal ou alterada. MÉTODOS:...

  4. 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...

  5. 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.

  6. 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.

  7. Total Thyroidectomy

    Directory of Open Access Journals (Sweden)

    Lopez Moris E

    2016-06-01

    Full Text Available Total thyroidectomy is a surgery that removes all the thyroid tissue from the patient. The suspect of cancer in a thyroid nodule is the most frequent indication and it is presume when previous fine needle puncture is positive or a goiter has significant volume increase or symptomes. Less frequent indications are hyperthyroidism when it is refractory to treatment with Iodine 131 or it is contraindicated, and in cases of symptomatic thyroiditis. The thyroid gland has an important anatomic relation whith the inferior laryngeal nerve and the parathyroid glands, for this reason it is imperative to perform extremely meticulous dissection to recognize each one of these elements and ensure their preservation. It is also essential to maintain strict hemostasis, in order to avoid any postoperative bleeding that could lead to a suffocating neck hematoma, feared complication that represents a surgical emergency and endangers the patient’s life.It is essential to run a formal technique, without skipping steps, and maintain prudence and patience that should rule any surgical act.

  8. 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

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    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.

  9. Aspectos da produtividade do feijão correlacionados com atributos físicos do solo sob elevado nível tecnológico de manejo

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    Rafael Montanari

    2010-12-01

    Full Text Available No ano agrícola de 2006/07, no município de Selvíria (MS, foi analisada a produtividade do feijão em função de alguns atributos físicos de um Latossolo Vermelho distroférrico, cultivado nas condições de elevado nível tecnológico de manejo pelo sistema plantio direto irrigado com pivô central. O objetivo foi selecionar, entre os atributos pesquisados do solo, aquele com a melhor representatividade para explicar a variabilidade da produtividade agrícola. Foi instalada a malha geoestatística, para a coleta de dados do solo e da planta, com 117 pontos amostrais, numa área de 2.025 m² e declive homogêneo de 0,055 m m-1. Do ponto de vista linear e espacial, a produtividade de feijão foi explicada em função da densidade de partículas e da umidade gravimétrica do solo, respectivamente. Assim, os valores de densidade de partículas entre 1,95 e 2,20 kg dm-3 e de umidade gravimétrica entre 0,205 e 0,239 kg kg-1; ambas coletadas na camada intermediária, resultaram em sítios com as mais elevadas produtividades (2.200-2.600 kg ha-1. Entretanto, para as condições do elevado nível tecnológico de manejo empregado, a produtividade média do feijão não atingiu seu máximo potencial, uma vez que o agravado estado de compactação no qual o solo se encontrava proporcionou à produtividade redução de 26,6 %. Dessa forma, os valores médios da densidade do solo e da resistência do solo à penetração, respectivamente nas faixas de 1,36-1,41 kg dm-3 e de 1,56-3,24 MPa, típicos de solos argilosos compactados, atestaram a substancial queda da produtividade de grãos de feijão.

  10. Water-soluble extract of Coleus barbatus modulates weight gain, energy utilization and lipid metabolism in secondary biliary cirrhosis: an experimental study in young rats Extrato aquoso de Coleus barbatus modula o ganho de peso, o aproveitamento nutricional e o metabolismo lipídico na cirrose biliar secundária: estudo experimental em ratos jovens

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    Ana Paula Ronquesel Battochio

    2005-06-01

    Full Text Available PURPOSE: To test if a water extract of Coleus barbatus (WEB has any effect on weight gain, food energy utilization and lipid metabolism in young rats with obstructive cholestasis. METHODS: Forty 21 day old (P21 Wistar rats, in groups of 10, were submitted to one of the following treatments: a sham operation with daily water or WEB administration, double ligature and resection of the bile duct with daily water or WEB administration. At P49 they were submitted for euthanasia when the following were determined: ingested feed (IF, energy utilization (EU and weight gain (WG from P29 to P49, together with total serum cholesterol (TC and triacylglycerol (TG concentrations, liver wet weight (LWW and fat content (LFC. Two Way ANOVA and the S.N.K. test for paired comparisons were employed to study the effects of cholestasis and those of WEB and their interactions (pOBJETIVO:Testar os efeitos do extrato aquoso de Coleus barbatus (WEB sobre o aproveitamento nutricional e o metabolismo lipídico em ratos jovens com colestase obstrutiva. MÉTODOS: Quarenta ratos machos Wistar com 21 dias de vida (P21, em grupos de 10, foram submetidos a um dos seguintes tratamentos: operação simulada e administração diária de água ou WEB e dupla ligadura e ressecção do ducto biliar com administração diária de água ou WEB. No P49, foram sacrificados e medidos: a ração ingerida (IF, o aproveitamento nutricional (EU e o ganho de peso (WG desde o P29 ao P49, as concentrações séricas do colesterol total (TC e dos triacilgliceróis (TG, o peso fresco (LWW e o teor de gordura do fígado (LFC. A ANOVA com dois fatores e o método de S.N.K para comparações pareadas (p<0,05 foram utilizados para estudar os efeitos, sobre as variáveis, da colestase e do EAB e suas interações. RESULTADOS: A colestase, independentemente do WEB, e o WEB independentemente da colestase diminuíram o WG, a IF e o EU, mas não houve interação significativa entre os dois fatores. A

  11. Psicoterapia positiva para supervivientes de cáncer con elevados niveles de malestar emocional: la facilitación del crecimiento postraumático reduce el estrés postraumático

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    Cristian Ochoa

    2017-01-01

    Full Text Available Antecedentes/Objetivo: La evidencia científica muestra la importante presencia de cambios vitales positivos, como el crecimiento postraumático (CPT, tras afrontar un cáncer. Sin embargo, ninguna intervención ha sido específicamente diseñada para facilitar el CPT en cáncer. En este artículo, describimos y evaluamos los resultados de la Psicoterapia Positiva dirigida a supervivientes de Cáncer (PPC, diseñada para facilitar el CPT como vía para reducir el malestar emocional y estrés postraumático. Utilizamos indicadores interpersonales para validar la autenticidad del CPT. Método: Ciento veintiséis supervivientes de cáncer con elevados niveles de malestar emocional fueron consecutivamente asignados al grupo experimental (PPC o al grupo de lista de espera. Resultados: El grupo de PPC obtuvo significativamente mejores resultados después del tratamiento que el grupo control, mostrando una reducción del malestar psicológico, de los síntomas de estrés postraumático y un incremento del CPT. Los beneficios se mantuvieron a los 3 y 12 meses. El CPT fue corroborado por los seres queridos de los participantes. Conclusiones: La PPC parece promover de forma significativa el CPT y reduce el malestar emocional y el estrés postraumático en supervivientes de cáncer. Además, la facilitación de CPT inducido por la PPC es corroborada por los seres queridos. © 2017 Asociación Española de Psicología Conductual. Published by Elsevier España, S.L.U. This is an open access article under the CC BY−NC−ND license (http://creativecommons. org/licenses/by−nc−nd/4.0/.

  12. Prevalência de níveis pressóricos elevados em escolares de Cuiabá, Mato Grosso Prevalence of high blood pressure among schoolchildren in Cuiabá, Midwestern Brazil

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    Luiz Marcos P Borges

    2007-08-01

    Full Text Available OBJETIVO: As formas de obtenção dos níveis pressóricos basais podem levar a diferentes estimativas de prevalência. O objetivo do estudo foi estimar a prevalência de níveis pressóricos elevados em escolares e comparar médias sistólicas e diastólicas obtidas após três aferições da pressão arterial. MÉTODOS: Estudo transversal, com escolares entre sete e dez anos (N=601, de escolas públicas e privadas da zona urbana de Cuiabá-MT, Brasil, em 2005. A pressão arterial foi aferida três vezes, com intervalo de dez minutos, em visita única. Consideraram-se crianças com níveis pressóricos elevados as que, segundo sexo, idade e percentil de estatura, atingiram pressão sistólica e/ou diastólica maiores ou iguais ao percentil 95 da tabela de referência. Para o cálculo de prevalência, foram considerados separadamente os níveis pressóricos da primeira e terceira medidas. RESULTADOS: Houve diferença estatisticamente significante entre as médias sistólicas e diastólicas nas três medidas do estudo. A pressão sistólica e diastólica média, utilizando a terceira medida do estudo foi de 97,2 (DP=8,68 mmHg e 63,1 (DP=6,66 mmHg, respectivamente. A prevalência de níveis pressóricos elevados foi de 8,7% (IC 95%: 6,4;10,9 na primeira medida e 2,3% (IC 95%: 1,1;3,5 na 3ª medida. Não houve diferença estatística entre as prevalências com relação à idade, sexo, cor da pele e tipo de escola. CONCLUSÕES: A pressão arterial, em estudos de visita única, diminui significativamente entre a primeira e terceira aferição. A terceira medida parece revelar níveis pressóricos mais próximos dos basais.OBJECTIVE: The ways in which basal blood pressure levels are obtained may lead to different prevalence estimates. The objective of the study was to estimate the prevalence of high blood pressure among schoolchildren and to compare systolic and diastolic means obtained from three measurements of arterial pressure. METHODS: This was

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

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    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

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

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    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.

  15. 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

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    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.

  16. Esclerose sistêmica e níveis séricos elevados de organoclorado: uma associação possível? Systemic sclerosis and elevated organochlorine blood levels: a possible association?

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    Odirlei André Monticielo

    2008-02-01

    Full Text Available A patogênese da esclerose sistêmica (ES é complexa e pouco conhecida. Há a participação de ativação imune, dano vascular e excessiva produção de matriz extracelular com deposição de colágeno estruturalmente normal. Fatores genéticos e ambientais contribuem para a expressão da doença nos pacientes. Dentre os fatores ambientais, diversos agentes químicos já foram associados à doença. Descrevemos o caso de uma adolescente de 16 anos, com história prévia de hepatite criptogênica e câncer de lábio, que desenvolveu quadro atípico e rapidamente progressivo de esclerose sistêmica. Inicialmente o quadro era compatível com esclerodermia em placas, porém rapidamente evoluiu para uma forma sistêmica com grave acometimento cardiopulmonar e óbito. Durante a investigação de possíveis fatores etiológicos que pudessem estar relacionados, foram encontrados níveis séricos extremamente elevados de oxiclordano, um agrotóxico organoclorado. Uma possível correlação entre a intoxicação por esse agente químico e o surgimento de ES foi aventada.The pathogenesis of systemic sclerosis (SS is complex and not completely understood. Autoimmune mechanisms, vascular damage, and excessive extracelular matrix with collagen deposition play a significant role. Genetic and environmental factors also are decisive to the disease expression. Among environmental factors many chemical agents have been associated with the development of SS. A 16-year-old white woman, with previous history of cryptogenic hepatitis and cancer of the lips, developed an atypical and rapidly progressive form of SS. Initial sclerodermatous plaques progressed to a systemic form with severe cardiopulmonary involvement and death. Diagnostic workup revealed extremely high blood levels of oxychlordane. A possible association of organochlorine intoxication and SS is proposed.

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

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    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

  18. 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

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    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

  19. Empleo del modelo animal en la formación en endoscopia diagnóstica y terapéutica de la vía biliar Animal model training in diagnostic and therapeutic biliary tract endoscopy teaching

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    J. Usón-Gargallo

    2010-09-01

    Full Text Available Objetivo. Mostrar nuestra experiencia en la formación en endoscopia terapéutica de la vía biliar en modelo animal. Materiales y métodos. Esta actividad formativa tiene una duración de 13 horas y comienza iniciando al alumno en las diferencias anatómicas de las especies que se emplean, la porcina y la canina, con respecto a la anatomía humana. Las prácticas consisten en habituar al endoscopista a la visión lateral del duodenoscopio; se realizan en un modelo porcino debido a que es más sencillo atravesar el esfínter pilórico, aunque no suele ser muy adecuado para la canulación de la papila duodenal. Tras superar la primera fase se utiliza el modelo canino, que permite adquirir las habilidades y destrezas propias de esta técnica. La evaluación de los resultados se realiza mediante una encuesta anónima. Resultados. El 76% de los alumnos confirma que ha avanzado mucho con este entrenamiento, un 18% regular y un 6% poco. El 75% considera que, tras realizar esta actividad de formación, se encontraría capacitado para llevar a cabo la técnica en su hospital. El 94% de los alumnos recomendaría esta actividad a sus compañeros. Conclusiones. El empleo del modelo animal en la formación en colangiopancreatografía retrógada endoscópica (CPRE permite la adquisición de habilidades básicas necesarias para la práctica, ya que posibilita la repetición de las maniobras y la tutela continuada. Consideramos que con esta metodología mixta se podría acortar la curva de aprendizaje de la CPRE y disminuiría la iatrogenia en las primeras fases.Aim. To show our experience in training in therapeutic endoscopy of the biliary tract in animal model. Materials and methods. This training activity has duration of 13 hours and starts initiating the trainee in anatomical differences with regard to human anatomy that occur between species that are used, the swine and canine. The practices consist of endoscopist to habituate the lateral view of

  20. 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

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    Cynthia R. Matos Silva Passoni

    2008-12-01

    Full Text Available 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 - ligadura dupla e ressecção do ducto biliar comum e administração diária de veículo aquoso (1 mL/g pc; 3 SC - operação simulada e administração diária de ácido ascórbico (100 mg/g pc; 4 SA - ligadura dupla e ressecção do ducto biliar comum e administração diária de veículo aquoso (1 mL/g pc. Os ratos eram pesados diariamente. No 27º dia pós-operatório, eles receberam injeção intraperitoneal de 1,5 mg/g pc de pentobarbital sódico, e o tempo de sono induzido pelo pentobarbital foi medido. Coletou-se sangue para determinação de atividade sérica de alanina aminotransferase e de aspartato aminotransferase, níveis de albumina e globulina séricas, e o fígado foi analisado quanto à conteúdo de água e gordura. Os dados foram submetidos à ANOVA two-way, e comparações pareadas entre grupos foram testadas com o método de SNK. O nível de significância foi estabelecido em 0,05. RESULTADOS: A suplementação com ácido ascórbico atenuou os efeitos da colestase: reduziu o tempo de anestesia pelo pentobarbital, globulina sérica e o conteúdo de gordura no fígado. CONCLUSÕES: Nossos resultados corroboram a hipótese de que a suplementação com ácido ascórbico tem um efeito citoprotetor na cirrose biliar secundária.OBJECTIVE: To test whether ascorbic acid supplementation has any cytoprotective effect on a model of secondary biliary cirrhosis in young rats. METHODS: We studied 40 Wistar rats weaned at the 21st postnatal

  1. 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

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    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.

  2. 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.

  3. Differentiation of Xenarthra (Mammalia species through the identification of their fecal bile acid patterns: An ecological tool Diferenciación de especies de Xenarthra (Mammalia a través de la identificación de sus patrones de ácidos biliares fecales: Una herramienta ecológica

    Directory of Open Access Journals (Sweden)

    M. SOLEDAD ARAUJO

    2010-12-01

    conservation and the ecophysiology of the group.El análisis de las heces es una herramienta fundamental para el trabajo de campo, especialmente para identificar la presencia de una determinada especie en un area. Los ácidos biliares fecales y su concentración relativa siguen patrones que son especie-específicos, y pueden ser caracterizados por Cromatografía en Capa Fina (TLC. Esta técnica ha sido utilizada para diferenciar heces de varias especies de mamíferos, pero nunca en Xenarthra. En este trabajo se analizaron 96 heces de especies de Xenarthra a través de TLC, para determinar el patrón de ácidos biliares fecales. Las especies fueron: Zaedyus pichiy (n = 10, Chaetophractus vellerosus (n = 5, Chaetophractus villosus (n = 57, Dasypus hybridus (n = 4, Priodontes maximus (n = 2, Tamanduá tetradactyla (n = 14 y Myrmecophaga tridactyla (n = 4. Se encontraron diferencias entre los patrones de ácidos biliares para todas las especies, pero no entre machos y hembras, ni entre animales de cautiverio y silvestres de la misma especie. Se encontraron siete ácidos biliares conocidos, colesterol y siete compuestos aun no identificados (X1-X7. Todas las especies tuvieron los ácidos taurocólico, glicoquenodeoxicólico y litocólico, y colesterol. Solo C. villosus tuvo ácido deoxicólico (Rf: 0.30 ± 0.01. Z. pichiy, C. vellerosus y C. villosus tuvieron dos o tres bandas de ácido dehidrocólico (Rf entre 0.29 ± 0.06 y 0.45± 0.02, mientras que las otras especies tuvieron una o dos. Z. pichiy tuvo dos compuestos no identificados, X6 (Rf 0.85 ± 0.06 y X7 (Rf: 0.93 ± 0.03, que fueron casi indistinguibles en las otras especies. D. hybridus difirió de Z. pichiy, C. vellerosus y C villosus porque no tuvo ácido quenodeoxicólico y X,. T. tetradactyla fue la única especie que no presentó ácido cólico y difirió de M. tridactyla por la presencia de ácido dehidrocólico. D. hybridus fue la especie con el menor número de compuestos (siete y difirió del resto porque no

  4. 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

  5. Total parenteral nutrition - infants

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  6. 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) is a method of feeding that bypasses ...

  7. Technique of total thyroidectomy

    International Nuclear Information System (INIS)

    Rao, R.S.

    1999-01-01

    It is essential to define the various surgical procedures that are carried out for carcinoma of the thyroid gland. They are thyroid gland, subtotal lobectomy, total thyroidectomy and near total thyroidectomy

  8. 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 ...

  9. 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....

  10. Estimativa da acidez potencial pelo método do pH SMP em solos com elevado teor de matéria orgânica Estimation of potencial acidity by the pH SMP method in soils with higher organic matter content in Brazil

    Directory of Open Access Journals (Sweden)

    Marcos Gervasio Pereira

    2006-01-01

    Full Text Available Apesar do potencial para uso agrícola e das características edáficas peculiares, poucos são os métodos desenvolvidos para a recomendação de adubação e calagem para os solos com elevado teor de matéria orgânica. O objetivo deste estudo foi definir um modelo matemático que estime a acidez potencial (H+Al a partir do pH SMP medido em água e em solução de CaCl2 0,01 mol L-1 em solos com elevado teor de matéria orgânica. Foram utilizadas 41 amostras de horizontes superficiais de solos com elevado teor de matéria orgânica de vários Estados do Brasil. Os resultados demonstraram que a acidez potencial pode ser estimada por meio da regressão da solução-tampão SMP (r =0,85**. Também foi observada correlação significativa (r = 0,65** entre o pH em CaCl2 0,01 mol L-1 e o pH SMP.In spite of agricultural potential for use and the peculiar edaphic characteristics, there are few methods developed for manuring and liming recommendation for soils with high organic matter contents. The objective of this study was to determine a mathematical model that estimates the potencial acidity with pH SMP measured in water and in solution of CaCl2 0.01 mol L-1 in soil with high organic matter content. Forty one surface soil samples of Histosols and other soils whith higher organic matter content of different states of Brazil were utilized. The results showed that potential acidity can be estimated by pH SMP buffer suspension regression ( R=0.85** and that in pH determined in CaCl2 0.01 mol L-1 was significantly correlated (R= 0.65** to pH determined in SMP.

  11. Total Quality Leadership

    Science.gov (United States)

    1991-01-01

    More than 750 NASA, government, contractor, and academic representatives attended the Seventh Annual NASA/Contractors Conference on Quality and Productivity. The panel presentations and Keynote speeches revolving around the theme of total quality leadership provided a solid base of understanding of the importance, benefits, and principles of total quality management (TQM). The presentations from the conference are summarized.

  12. 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...

  13. 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.

  14. Laparoscopic total pancreatectomy

    Science.gov (United States)

    Wang, Xin; Li, Yongbin; Cai, Yunqiang; Liu, Xubao; Peng, Bing

    2017-01-01

    Abstract Rationale: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy. Patients and Methods: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien–Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition. Diagnosis and Outcomes: The indications for laparoscopic total pancreatectomy were intraductal papillary mucinous neoplasm (IPMN) (n = 2) and pancreatic neuroendocrine tumor (PNET) (n = 1). All patients underwent laparoscopic pylorus and spleen-preserving total pancreatectomy, the mean operative time was 490 minutes (range 450–540 minutes), the mean estimated blood loss was 266 mL (range 100–400 minutes); 2 patients suffered from postoperative complication. All the patients recovered uneventfully with conservative treatment and discharged with a mean hospital stay 18 days (range 8–24 days). The short-term (from 108 to 600 days) follow up demonstrated 3 patients had normal and consistent glycated hemoglobin (HbA1c) level with acceptable quality of life. Lessons: Laparoscopic total pancreatectomy is feasible and safe in selected patients and pylorus and spleen preserving technique should be considered. Further prospective randomized studies are needed to obtain a comprehensive understanding the role of laparoscopic technique in total pancreatectomy. PMID:28099344

  15. Estonian total ozone climatology

    Directory of Open Access Journals (Sweden)

    K. Eerme

    Full Text Available The climatological characteristics of total ozone over Estonia based on the Total Ozone Mapping Spectrometer (TOMS data are discussed. The mean annual cycle during 1979–2000 for the site at 58.3° N and 26.5° E is compiled. The available ground-level data interpolated before TOMS, have been used for trend detection. During the last two decades, the quasi-biennial oscillation (QBO corrected systematic decrease of total ozone from February–April was 3 ± 2.6% per decade. Before 1980, a spring decrease was not detectable. No decreasing trend was found in either the late autumn ozone minimum or in the summer total ozone. The QBO related signal in the spring total ozone has an amplitude of ± 20 DU and phase lag of 20 months. Between 1987–1992, the lagged covariance between the Singapore wind and the studied total ozone was weak. The spring (April–May and summer (June–August total ozone have the best correlation (coefficient 0.7 in the yearly cycle. The correlation between the May and August total ozone is higher than the one between the other summer months. Seasonal power spectra of the total ozone variance show preferred periods with an over 95% significance level. Since 1986, during the winter/spring, the contribution period of 32 days prevails instead of the earlier dominating 26 days. The spectral densities of the periods from 4 days to 2 weeks exhibit high interannual variability.

    Key words. Atmospheric composition and structure (middle atmosphere – composition and chemistry; volcanic effects – Meteorology and atmospheric dynamics (climatology

  16. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-06-01

    The present discussion is limited to a presentation of the most recent total photonuclear absorption experiments performed with real photons at intermediate energy, and more precisely in the region of nucleon resonances. The main sources of real photons are briefly reviewed and the experimental procedures used for total photonuclear absorption cross section measurements. The main results obtained below 140 MeV photon energy as well as above 2 GeV are recalled. The experimental study of total photonuclear absorption in the nuclear resonance region (140 MeV< E<2 GeV) is still at its beginning and some results are presented

  17. [Total artificial heart].

    Science.gov (United States)

    Antretter, H; Dumfarth, J; Höfer, D

    2015-09-01

    To date the CardioWest™ total artificial heart is the only clinically available implantable biventricular mechanical replacement for irreversible cardiac failure. This article presents the indications, contraindications, implantation procedere and postoperative treatment. In addition to a overview of the applications of the total artificial heart this article gives a brief presentation of the two patients treated in our department with the CardioWest™. The clinical course, postoperative rehabilitation, device-related complications and control mechanisms are presented. The total artificial heart is a reliable implant for treating critically ill patients with irreversible cardiogenic shock. A bridge to transplantation is feasible with excellent results.

  18. Total 2004 results

    International Nuclear Information System (INIS)

    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.)

  19. Total synthesis of ciguatoxin.

    Science.gov (United States)

    Hamajima, Akinari; Isobe, Minoru

    2009-01-01

    Something fishy: Ciguatoxin (see structure) is one of the principal toxins involved in ciguatera poisoning and the target of a total synthesis involving the coupling of three segments. The key transformations in this synthesis feature acetylene-dicobalthexacarbonyl complexation.

  20. 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.)

  1. 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...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty....

  2. 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...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty. Udgivelsesdato: 2009-Feb-23...

  3. 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....

  4. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Sutherland, D.E.; Ferguson, R.M.; Simmons, R.L.; Kim, T.H.; Slavin, S.; Najarian, J.S.

    1983-01-01

    Total lymphoid irradiation by itself can produce sufficient immunosuppression to prolong the survival of a variety of organ allografts in experimental animals. The degree of prolongation is dose-dependent and is limited by the toxicity that occurs with higher doses. Total lymphoid irradiation is more effective before transplantation than after, but when used after transplantation can be combined with pharmacologic immunosuppression to achieve a positive effect. In some animal models, total lymphoid irradiation induces an environment in which fully allogeneic bone marrow will engraft and induce permanent chimerism in the recipients who are then tolerant to organ allografts from the donor strain. If total lymphoid irradiation is ever to have clinical applicability on a large scale, it would seem that it would have to be under circumstances in which tolerance can be induced. However, in some animal models graft-versus-host disease occurs following bone marrow transplantation, and methods to obviate its occurrence probably will be needed if this approach is to be applied clinically. In recent years, patient and graft survival rates in renal allograft recipients treated with conventional immunosuppression have improved considerably, and thus the impetus to utilize total lymphoid irradiation for its immunosuppressive effect alone is less compelling. The future of total lymphoid irradiation probably lies in devising protocols in which maintenance immunosuppression can be eliminated, or nearly eliminated, altogether. Such protocols are effective in rodents. Whether they can be applied to clinical transplantation remains to be seen

  5. Totally optimal decision rules

    KAUST Repository

    Amin, Talha

    2017-11-22

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  6. Totally optimal decision rules

    KAUST Repository

    Amin, Talha M.; Moshkov, Mikhail

    2017-01-01

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  7. Total volume versus bouts

    DEFF Research Database (Denmark)

    Chinapaw, Mai; Klakk, Heidi; Møller, Niels Christian

    2018-01-01

    BACKGROUND/OBJECTIVES: Examine the prospective relationship of total volume versus bouts of sedentary behaviour (SB) and moderate-to-vigorous physical activity (MVPA) with cardiometabolic risk in children. In addition, the moderating effects of weight status and MVPA were explored. SUBJECTS....../METHODS: Longitudinal study including 454 primary school children (mean age 10.3 years). Total volume and bouts (i.e. ≥10 min consecutive minutes) of MVPA and SB were assessed by accelerometry in Nov 2009/Jan 2010 (T1) and Aug/Oct 2010 (T2). Triglycerides, total cholesterol/HDL cholesterol ratio (TC:HDLC ratio......, with or without mutual adjustments between MVPA and SB. The moderating effects of weight status and MVPA (for SB only) were examined by adding interaction terms. RESULTS: Children engaged daily in about 60 min of total MVPA and 0-15 min/week in MVPA bouts. Mean total sedentary time was around 7 h/day with over 3...

  8. Total versus subtotal hysterectomy

    DEFF Research Database (Denmark)

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Anna Birthe

    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...... women chose total and 105 women chose subtotal abdominal hysterectomy. No significant differences were found between the 2 operation methods in any of the outcome measures at 12 months. Fourteen women (15%) from the subtotal abdominal hysterectomy group experienced vaginal bleeding and three women had...

  9. Qualità totale e mobilità totale Total Quality and Total Mobility

    Directory of Open Access Journals (Sweden)

    Giuseppe Trieste

    2010-05-01

    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

  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 milligrams per deciliter (mg/dL) ...

  11. Total body irradiation

    International Nuclear Information System (INIS)

    Novack, D.H.; Kiley, J.P.

    1987-01-01

    The multitude of papers and conferences in recent years on the use of very large megavoltage radiation fields indicates an increased interest in total body, hemibody, and total nodal radiotherapy for various clinical situations. These include high dose total body irradiation (TBI) to destroy the bone marrow and leukemic cells and provide immunosuppression prior to a bone marrow transplant, high dose total lymphoid irradiation (TLI) prior to bone marrow transplantation in severe aplastic anemia, low dose TBI in the treatment of lymphocytic leukemias or lymphomas, and hemibody irradiation (HBI) in the treatment of advanced multiple myeloma. Although accurate provision of a specific dose and the desired degree of dose homogeneity are two of the physicist's major considerations for all radiotherapy techniques, these tasks are even more demanding for large field radiotherapy. Because most large field radiotherapy is done at an extended distance for complex patient geometries, basic dosimetry data measured at the standard distance (isocenter) must be verified or supplemented. This paper discusses some of the special dosimetric problems of large field radiotherapy, with specific examples given of the dosimetry of the TBI program for bone marrow transplant at the authors' hospital

  12. Total design of participation

    DEFF Research Database (Denmark)

    Munch, Anders V.

    2016-01-01

    The idea of design as an art made not only for the people, but also by the people is an old dream going back at least to William Morris. It is, however, reappearing vigoriously in many kinds of design activism and grows out of the visions of a Total Design of society. The ideas of participation b...

  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 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…

  15. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-01-01

    Experimental methods using real photon beams for measurements of total photonuclear absorption cross section σ(Tot : E/sub γ/) are recalled. Most recent σ(Tot : E/sub γ/)results for complex nuclei and in the nucleon resonance region are presented

  16. Total 2004 annual report

    International Nuclear Information System (INIS)

    2004-01-01

    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.)

  17. Total Water Management - Report

    Science.gov (United States)

    There is a growing need for urban water managers to take a more holistic view of their water resource systems as population growth, urbanization, and current operations put different stresses on the environment and urban infrastructure. Total Water Management (TWM) is an approac...

  18. Total 2003 Results

    International Nuclear Information System (INIS)

    2003-01-01

    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.)

  19. TOTAL PERFORMANCE SCORECARD

    Directory of Open Access Journals (Sweden)

    Anca ȘERBAN

    2013-06-01

    Full Text Available The purpose of this paper is to present the evolution of the Balanced Scorecard from a measurement instrument to a strategic performance management tool and to highlight the advantages of implementing the Total Performance Scorecard, especially for Human Resource Management. The study has been accomplished using the methodology of bibliographic study and various secondary sources. Implementing the classical Balanced Scorecard indicated over the years, repeatedly failure. It can be indicated that the crucial level is determined by the learning and growth perspective. It has been developed from a human perspective, which focused on staff satisfaction, innovation perspective with focus on future developments. Integrating the Total Performance Scorecard in an overall framework assures the company’s success, by keeping track of the individual goals, the company’s objectives and strategic directions. Like this, individual identity can be linked to corporate brand, individual aspirations to business goals and individual learning objectives to needed organizational capabilities.

  20. Totally parallel multilevel algorithms

    Science.gov (United States)

    Frederickson, Paul O.

    1988-01-01

    Four totally parallel algorithms for the solution of a sparse linear system have common characteristics which become quite apparent when they are implemented on a highly parallel hypercube such as the CM2. These four algorithms are Parallel Superconvergent Multigrid (PSMG) of Frederickson and McBryan, Robust Multigrid (RMG) of Hackbusch, the FFT based Spectral Algorithm, and Parallel Cyclic Reduction. In fact, all four can be formulated as particular cases of the same totally parallel multilevel algorithm, which are referred to as TPMA. In certain cases the spectral radius of TPMA is zero, and it is recognized to be a direct algorithm. In many other cases the spectral radius, although not zero, is small enough that a single iteration per timestep keeps the local error within the required tolerance.

  1. Total space in resolution

    Czech Academy of Sciences Publication Activity Database

    Bonacina, I.; Galesi, N.; Thapen, Neil

    2016-01-01

    Roč. 45, č. 5 (2016), s. 1894-1909 ISSN 0097-5397 R&D Projects: GA ČR GBP202/12/G061 EU Projects: European Commission(XE) 339691 - FEALORA Institutional support: RVO:67985840 Keywords : total space * resolution random CNFs * proof complexity Subject RIV: BA - General Mathematics Impact factor: 1.433, year: 2016 http://epubs.siam.org/doi/10.1137/15M1023269

  2. MFTF TOTAL benchmark

    International Nuclear Information System (INIS)

    Choy, J.H.

    1979-06-01

    A benchmark of the TOTAL data base management system as applied to the Mirror Fusion Test Facility (MFTF) data base was implemented and run in February and March of 1979. The benchmark was run on an Interdata 8/32 and involved the following tasks: (1) data base design, (2) data base generation, (3) data base load, and (4) develop and implement programs to simulate MFTF usage of the data base

  3. Total - annual report 2005

    International Nuclear Information System (INIS)

    2006-01-01

    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.)

  4. Total Absorption Spectroscopy

    International Nuclear Information System (INIS)

    Rubio, B.; Gelletly, W.

    2007-01-01

    The problem of determining the distribution of beta decay strength (B(GT)) as a function of excitation energy in the daughter nucleus is discussed. Total Absorption Spectroscopy is shown to provide a way of determining the B(GT) precisely. A brief history of such measurements and a discussion of the advantages and disadvantages of this technique, is followed by examples of two recent studies using the technique. (authors)

  5. Sobredentadura total superior implantosoportada

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.

  6. Total Synthesis of Hyperforin.

    Science.gov (United States)

    Ting, Chi P; Maimone, Thomas J

    2015-08-26

    A 10-step total synthesis of the polycyclic polyprenylated acylphloroglucinol (PPAP) natural product hyperforin from 2-methylcyclopent-2-en-1-one is reported. This route was enabled by a diketene annulation reaction and an oxidative ring expansion strategy designed to complement the presumed biosynthesis of this complex meroterpene. The described work enables the preparation of a highly substituted bicyclo[3.3.1]nonane-1,3,5-trione motif in only six steps and thus serves as a platform for the construction of easily synthesized, highly diverse PPAPs modifiable at every position.

  7. Total quality is people

    International Nuclear Information System (INIS)

    Vogel, C.E.

    1991-01-01

    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

  8. 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.

  9. Total_Aktion

    DEFF Research Database (Denmark)

    Søndergaard, Morten

    2008-01-01

    digitale medier er registreringen og muligheden for at opbevare og håndtere digital data uden begrænsninger. Oplevelse, registrering og bevaring knyttes sammen i en ny museal virkelighed, hvor samlingens særlige dokumentariske karakter og fokus, som er unikt for Museet for Samtidskunst, er i centrum...... at mikse deres personlige drinks. TOTAL_AKTION viser Hørbar#3, som er en videreudvikling af den første version. METASYN af Carl Emil Carlsen: Metadata er centralt for Carl Emil Carlsens projekt, der betragter museets samling som et ”univers” af værker (analoge og digitale), beskrivelser og relationer. I...

  10. 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

  11. Total Factbook 2003

    International Nuclear Information System (INIS)

    2003-01-01

    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.)

  12. Total 2004 fact book

    International Nuclear Information System (INIS)

    2004-01-01

    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.)

  13. TOTAL annual report 2003

    International Nuclear Information System (INIS)

    2004-01-01

    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.)

  14. Total knee arthroplasty

    DEFF Research Database (Denmark)

    Schrøder, Henrik M.; Petersen, Michael M.

    2016-01-01

    Total knee arthroplasty (TKA) is a successful treatment of the osteoarthritic knee, which has increased dramatically over the last 30 years. The indication is a painful osteoarthritic knee with relevant radiographic findings and failure of conservative measures like painkillers and exercise...... surgeon seems to positively influence the rate of surgical complications and implant survival. The painful TKA knee should be thoroughly evaluated, but not revised except if a relevant indication can be established. The most frequent indications for revision are: aseptic loosening, instability, infection...

  15. Fatores associados a níveis pressóricos elevados em escolares de uma cidade de porte médio do sul do Brasil Associated factors in high blood pressure among schoolchildren in a middle size city, southern Brazil

    Directory of Open Access Journals (Sweden)

    Cristine B. Costanzi

    2009-08-01

    Full Text Available OBJETIVO: Verificar a prevalência de níveis pressóricos elevados e fatores associados em escolares de Caxias do Sul (RS. MÉTODOS: Estudo transversal de base escolar avaliou crianças de 7 a 12 anos de ambos os sexos, provenientes das redes privada e pública. Foram realizadas três medidas da pressão arterial em uma única situação. Mensurou-se peso, altura, circunferência da cintura, aptidão aeróbia (teste de corrida de 9 minutos e situação socioeconômica. A estatística foi realizada através de teste do qui-quadrado e regressão logística para controle dos fatores de confusão. RESULTADOS: Participaram do estudo 1.413 crianças. A prevalência de escolares com níveis pressóricos elevados foi de 13,8% (sistólico, diastólico, sistólico/diastólico, e a proporção foi maior (dobro para as crianças obesas e/ou com sobrepeso do que para as com peso normal. Crianças com circunferência da cintura aumentada apresentaram 2,8 vezes mais chance de ter níveis pressóricos elevados do que as com circunferência adequada (intervalo de confiança de 95% 2,513-3,186 e p = 0,000. Já os indivíduos com nível alto no Índice Econômico Nacional apresentaram 2,6 vezes mais chance de terem pressão arterial elevada. CONCLUSÕES: Neste estudo, os escolares de 7 a 12 anos de Caxias do Sul apresentaram uma alta prevalência de níveis pressóricos elevados, e a medida de circunferência da cintura aumentada mostrou-se associada a essa condição, bem como o nível socioeconômico alto e a baixa aptidão física. Sugere-se medidas que possam incentivar a prática de atividade física e controle alimentar para melhoria dos níveis pressóricos e consequente diminuição de fatores de risco.OBJECTIVE: To establish the prevalence of high blood pressure and associated factors among schoolchildren from Caxias do Sul, state of Rio Grande do Sul, Brazil. METHODS: This school-based cross-sectional study assessed boys and girls aged 7 to 12 years

  16. TOTAL user manual

    Science.gov (United States)

    Johnson, Sally C.; Boerschlein, David P.

    1994-01-01

    Semi-Markov models can be used to analyze the reliability of virtually any fault-tolerant system. However, the process of delineating all of the states and transitions in the model of a complex system can be devastatingly tedious and error-prone. Even with tools such as the Abstract Semi-Markov Specification Interface to the SURE Tool (ASSIST), the user must describe a system by specifying the rules governing the behavior of the system in order to generate the model. With the Table Oriented Translator to the ASSIST Language (TOTAL), the user can specify the components of a typical system and their attributes in the form of a table. The conditions that lead to system failure are also listed in a tabular form. The user can also abstractly specify dependencies with causes and effects. The level of information required is appropriate for system designers with little or no background in the details of reliability calculations. A menu-driven interface guides the user through the system description process, and the program updates the tables as new information is entered. The TOTAL program automatically generates an ASSIST input description to match the system description.

  17. 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

  18. Total process surveillance: (TOPS)

    International Nuclear Information System (INIS)

    Millar, J.H.P.

    1992-01-01

    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 reduncancy 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. (orig.)

  19. Total and EDF invest

    International Nuclear Information System (INIS)

    Signoret, St.

    2008-01-01

    So as to prepare the future of their industrial sector,the Total company plans to invest (14 billion Euros in 2008) to increase its production capacities and strengthen in of other activities as the liquefied natural gas and the renewable energies; EDF plans to inject 35 billion Euros over three years to multiply the new projects of power plants (wind turbines, coal in Germany, gas in Great Britain and nuclear power in Flamanville). EDF wants to exploit its knowledge of leader to run more than ten E.P.R.(European pressurized water reactor) in the world before 2020, projects are in examination with China, Great Britain, South Africa and United States. (N.C.)

  20. Total quality at source

    International Nuclear Information System (INIS)

    Chiandone, A.C.

    1990-01-01

    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)

  1. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Effects of structural injure in the bile bacterial contamination after balloon transduodenal sphincteroplasty (papillary dilation in dogs Efeitos da lesão estrutural na contaminação bacteriana biliar após a esfincteroplastia transduodenal (dilatação papilar em cães

    Directory of Open Access Journals (Sweden)

    Martin Zavadinack Netto

    2006-10-01

    gama-glutamil-transferase (GGT para avaliação da colestase. Material colhido da vesícula biliar nos mesmos tempos foi registrado e numerado para ser submetido à cultura em BHI, ágar sangue (meio rico não seletivo, e Mac Conkey (meio seletivo para bacilos Gram-negativos. No 28º. dia três fragmentos da papila forma cortados transversalmente ao eixo do colédoco a 3mm da papila duodenal e os cortes corados em hematoxilina-eosina e tricômio de Masson e avaliados quanto a reação inflamatória. RESULTADOS: As médias da GGT e da FA nos três períodos nos grupos A e B não mostraram diferenças significantes, não sendo caracterizada a colestase. A contaminação bacteriana foi significante maior em GA(2,19 que no GB(1,96; a contaminação foi menor no tempo inicial em relação aos 7 e 28 dias( t0biliar, não associada à colestase. As lesões morfológicas são mais intensas na fase aguda e não correspondem a lesões crônicas mais extensas na fase tardia, não estando associadas a uma eventual estenose da papila.

  3. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    An outline review notes recent work on total lymphoid irradiation (TLI) as a means of preparing patients for grafts and particularly for bone-marrow transplantation. T.L.I. has proved immunosuppressive in rats, mice, dogs, monkeys and baboons; when given before bone-marrow transplantation, engraftment took place without, or with delayed rejection or graft-versus-host disease. Work with mice has indicated that the thymus needs to be included within the irradiation field, since screening of the thymus reduced skin-graft survival from 50 to 18 days, though irradiation of the thymus alone has proved ineffective. A more lasting tolerance has been observed when T.L.I. is followed by an injection of donor bone marrow. 50% of mice treated in this way accepted allogenic skin grafts for more than 100 days, the animals proving to be stable chimeras with 50% of their peripheral blood lymphocytes being of donor origin. Experiments of a similar nature with dogs and baboons were not so successful. (U.K.)

  4. The total artificial heart.

    Science.gov (United States)

    Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

    2015-12-01

    The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

  5. 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

  6. Incapacidad laboral total

    Directory of Open Access Journals (Sweden)

    Orlando Díaz Tabares

    1997-04-01

    Full Text Available Se realizó un estudio longitudinal, descriptivo y retrospectivo con el objetivo de conocer el comportamiento de la incapacidad permanente para el trabajo en el municipio "San Cristóbal" durante el decenio 1982-1991, y se aplicó el método de encuesta por el que se recogieron datos que fueron extraídos del modelo oficial de peritaje médico laboral y de la entrevista con el peritado. Los resultados fueron plasmados en tablas de contingencias donde se relacionan las variables por cada año estudiado, y se aplicó la prueba estadística de chi cuadrado. El número de individuos dictaminados con incapacidad laboral total fue de 693; predominó en reportes el año 1988 con 114 casos y muy discretamente el sexo femenino sobre el masculino, el grupo etáreo de 45 a 54 años con 360 casos y la artrosis como entidad valorada por ortopedia, con análisis estadísticos significativos. No resultó estadísticamente significativo, el predominio de la hipertensión arterial sistémica entre las entidades valoradas por la especialidad de medicina interna como causas de incapacidad laboral. Fue muy significativa la variación del número de dictaminados por la comisión en cada uno de los años estudiados y que el porcentaje de ellos que se encontraban realizando trabajos que demandan esfuerzo físico de moderado a intenso al momento de aplicar la encuesta, ascendió al 64,9.A longitudinal, descriptive and retrospective study was conducted in order to know the behavior of permanent labor disability at the municipality of San Cristóbal during 1982-1991. A survey was done to collect data taken from the official model of medical inspections and from the interview with the disabled worker. The results were shown in contingency tables where the variables are related by every year studied. The chi square statistical test was applied. The number of individuals with labor disability was 693. As for reports, the year 1988 predominated with 114. There was a discreet

  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. Retirada de fasciola hepatica da via biliar principal por coledocoscopia

    OpenAIRE

    Coral, Roberto Pelegrini; Mastalir, Eduardo T.; Mastalir, Fabiane Pinto

    2007-01-01

    The authors present a rare case of hepatic fascioliasis in a female patient 53-years-old, coming from the rural zone of Rio Grande do Sul, a southern State from Brazil. She has presented with biliary colic, fluctuant jaundice and eosinophilia. Abdominal ultrasound has shown a dilated biliary tree with inside heterogeneous images. At surgery we have found inside the biliary tree several Fasciola hepatica, which have been pulled out with the choledocoscope. We have proceeded with biliodigestive...

  10. Cirrosis biliar primaria con neumonía organizada secundaria

    Directory of Open Access Journals (Sweden)

    Almonte Batista WM

    2017-10-01

    Full Text Available Resume: Organized pneumonia, previously called bronchiolitis obliterans with organized pneumonia, is an interstitial lung disea- se that belongs to the group of idiopathic interstitial diseases and was first recognized in 1985. Sometimes it is not rela- ted to a specific cause calleing it in that case cryptogenetic, organized pneumonia but is frequently associated with other etiologies that may be infectious, inflammatory, neoplastic or secondary to drugs, it might also be related to extrapul- monary pathology as is the case of our patient in which is associated with a chronic cholestatic liver disease such as primary biliary cirrhosis.

  11. Pancreatite aguda biliar na infância

    Directory of Open Access Journals (Sweden)

    Flavio Augusto Menin

    Full Text Available Acute pancreatitis is an uncommon condition in childhood. Gallstones rarely cause pancreatitis in children. Instead, the leading causes of pancreatitis tend to be trauma, infecctions, drugs, congenital disorders. One rare case of acute gallstone pancreatitis in children is described, showing the diagnosis clinical/radiologic and surgery treatment (videocolecistectomy.

  12. Retirada de fasciola hepatica da via biliar principal por coledocoscopia

    Directory of Open Access Journals (Sweden)

    Roberto Pelegrini Coral

    Full Text Available The authors present a rare case of hepatic fascioliasis in a female patient 53-years-old, coming from the rural zone of Rio Grande do Sul, a southern State from Brazil. She has presented with biliary colic, fluctuant jaundice and eosinophilia. Abdominal ultrasound has shown a dilated biliary tree with inside heterogeneous images. At surgery we have found inside the biliary tree several Fasciola hepatica, which have been pulled out with the choledocoscope. We have proceeded with biliodigestive anastomosis using the small intestine. The patient remains asymptomatic six months after surgical procedure. Small intestine. The patient remains asymptomatic six months after surgical procedure.

  13. Envolvimento de receptores 5-HT2C do hipocampo ventral em comportamentos de defesa de ratos no labirinto em cruz elevado Involvement of ventral hippocampus 5-HT2C receptors on defensive behaviors of rats in the elevated plus-maze

    Directory of Open Access Journals (Sweden)

    Marília Greidinger Carvalho

    2012-04-01

    Full Text Available A ativação farmacológica dos receptores 5-HT2C induz comportamentos de defesa em modelos animais. O estudo busca investigar se o bloqueio seletivo de receptores 5-HT2C no hipocampo ventral (HV previne comportamentos defensivos induzidos por um agonista de receptor 5-HT2C administrado perifericamente em ratos expostos ao labirinto em cruz elevado (LCE. Quinze minutos após injeções intraperitoniais (IP, 1ml/kg do agonista 5-HT2C WAY-161503, ratos foram microinjetados bilateralmente no HV com o antagonista seletivo de receptores 5-HT2C SB-242084 (0, 0,1, 0,5 ou 1.5μg. Dez minutos após, cada animal foi exposto ao LCE para o registro de categorias de ansiedade. Injeções sistêmicas do WAY-161503 reduziram seletivamente as explorações nos braços abertos e aumentaram padrões de avaliação de risco. Esse efeito foi atenuado de maneira dose-dependente pela microinjeção de SB-242084 no HV, confirmando a ação ansiogênica de agonistas 5-HT2C e sugerindo que esse perfil comportamental seja mediado, pelo menos em parte, por receptores 5-HT2C do HV.Pharmacological 5-HT2C receptor activation induces defensive behaviors in several animal models of anxiety. The present study investigated whether the selective blockade of 5-HT2C receptors in the ventral hippocampus (VH prevents defensive behaviors induced by a 5-HT2C agonist administered systemically in rats exposed to the elevated plus-maze (EPM. Fifteen minutes after intraperitonial (IP, 1ml/kg injections of the selective 5-HT2C receptor agonist WAY-161503 (3 mg/kg, rats were bilaterally microinjected with the selective 5-HT2C antagonist SB-242084 (0, 0.1, 0.5 or 1.5μg into the VH. Ten minutes after, each animal was exposed to the EPM for measuring classical and ethological anxiety measures. IP WAY-161503 injections selectively decreased open-arm exploration while increasing risk-assessment. This anxiogenic-like action was dose-dependently attenuated by intra-VH SB-242084 microinjections

  14. 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

  15. Comparison of Serum Concentrations of Total Cholesterol and Total ...

    African Journals Online (AJOL)

    Tuberculosis (TB) is one of the most dangerous tropical diseases that complicates HIV infection in Nigeria to date. Over two million Nigerians are known to be infected with TB and many more are at risk of the infection. Serum concentrations of total cholesterol and total lipid of 117 female TB patients attending chest clinic at ...

  16. Changes in total and differential white cell counts, total lymphocyte ...

    African Journals Online (AJOL)

    Background: Published reports on the possible changes in the various immune cell populations, especially the total lymphocyte and CD4 cell counts, during the menstrual cycle in Nigerian female subjects are relatively scarce. Aim: To determine possible changes in the total and differential white blood cell [WBC] counts, ...

  17. Relação entre acidez e outros atributos químicos em solos com teores elevados de matéria orgânica Relationship between acidity and other chemical attributes of soils with high organic matter content

    Directory of Open Access Journals (Sweden)

    Adierson Gilvani Ebeling

    2008-01-01

    Full Text Available O elevado teor de matéria orgânica dos Organossolos confere-lhes características edáficas próprias, que podem ser contrastantes em relação ao observado em solos minerais. Devido à forte interação entre a matéria orgânica e os elementos a ela adsorvidos, os métodos de rotina em fertilidade do solo podem não avaliar de forma adequada a acidez nos Organossolos. Os objetivos deste trabalho foram caracterizar e estabelecer relações entre atributos do complexo sortivo e a acidez em solos com alto teor de carbono. Foram avaliados doze perfis, onze Organossolos e um Cambissolo, de diferentes Estados brasileiros, coletados de 2000 a 2002. Os perfis foram separados em ambientes de várzeas e planícies litorâneas e solos de ambiente altimontano e planalto. Além da caracterização dos perfis, segundo métodos da Embrapa, o pH foi analisado por diferentes métodos e foram determinados os teores de C, usando um analisador elementar (C_CHN, e a matéria orgânica pelo método da mufla (MO_mufla. Pelos resultados, verificase que os métodos de determinação de pH em água, em KCl e o pH SMP podem ser usados para expressar a acidez desses solos. Observou-se alta correlação entre o pH SMP e a acidez potencial. Os teores de C_CHN e de MO_mufla tiveram correlação significativa, porém negativa, com o pH em água e positiva com os valores T e H. O comportamento diferenciado da acidez dos solos, em função do ambiente de formação, indica ser importante esta separação no manejo da acidez e na avaliação da fertilidade em Organossolos.The high levels of organic matter in Histosols grant them peculiar characteristics that are contrasting when compared to mineral soils. Due to the strong interaction between organic matter and adsorbed elements, the routine methods in soil fertility may not evaluate properly Histosols soil acidity. The objectives of this study were to characterize and establish relationships between attributes of the

  18. Total hip arthroplasty in Denmark

    DEFF Research Database (Denmark)

    Pedersen, Alma Becic; Johnsen, Søren Paaske; Overgaard, Søren

    2005-01-01

    The annual number of total hip arthroplasties (THA) has increased in Denmark over the past 15 years. There is, however, limited detailed data available on the incidence of THAs.......The annual number of total hip arthroplasties (THA) has increased in Denmark over the past 15 years. There is, however, limited detailed data available on the incidence of THAs....

  19. Congruences of totally geodesic surfaces

    International Nuclear Information System (INIS)

    Plebanski, J.F.; Rozga, K.

    1989-01-01

    A general theory of congruences of totally geodesic surfaces is presented. In particular their classification, based on the properties of induced affine connections, is provided. In the four-dimensional case canonical forms of the metric tensor admitting congruences of two-dimensional totally geodesic surfaces of rank one are given. Finally, congruences of two-dimensional extremal surfaces are studied. (author)

  20. 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...

  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. Nutritional management after total laryngectomy

    African Journals Online (AJOL)

    28 September 2010 with a known diagnosis of cancer of the larynx. The patient, who underwent a total laryngectomy on 13 October, had a tracheostomy inserted .... status, leading to improved quality of life and better response to treatment.4.

  3. Transmandibular approach to total maxillectomy

    OpenAIRE

    Tiwari, R. M.

    2001-01-01

    Total Maxillectomy through transfacial approach has been practiced in the treatment of Cancer for more than a decade. Its role in T3 - T4 tumors extending posteriorly through gthe bony wall is questionable, since an oncological radical procedure is often not possible. Recurrences in the infratemporal fossa are common. Despite the addition of radiotherapy five year survivals have not significantly improved. Transmandibular approach to Total Maxillectomy overcomes this shortcoming by including ...

  4. Leadership and Total Quality Management

    Science.gov (United States)

    1992-04-15

    leadership and management skills yields increased productivity. This paper will focus on the skills required of senior level leaders (leaders at the...publication until it has been cleared by the appropriate mii..-, service or government agency. Leadership and Total Quality Management An Individual Study...llty Codes fAvti1 and/or DltISpecial Abstract AUTHOR: Harry D. Gatanas, LTC, USA TITLE: Leadership and Total Quality Management FORMAT- Individual

  5. Control Rods in high-Flux Swimming-Pool Reactors; Les Barres de Controle dans les Piles Piscines a Haut Flux; Reguliruyushchie sterzhni dlya reaktorov bassejnovogo tipa s vysokoj plotnost'yu nejtronnogo potoka; Las Barras de Control en los Reactores Tipo Piscina de Flujo Elevado

    Energy Technology Data Exchange (ETDEWEB)

    Ageroni, P.; Blum, P.; Denielou, G.; Denis, P.; Meunier, C. [Centre d' Etudes Nucleaires de Grenoble (France)

    1964-06-15

    etudes en cours sur les barres de controle des piles piscine a coeur ouvert fonctionnant dans la bande de 10 a 30 MW. (author) [Spanish] La memoria examina los problemas planteados por las barras de control en los reactores de investigacion de tipo piscina abierta, de alta potencia especifica y elevado flujo, basandose en calculos y experimentos efectuados durante la construccion del reactor SILOE. Expone asimismo la experiencia adquirida con las barras de control mientras el reactor funcionaba a 13 MW. Examina sucesivamente: a) Los balances de reactividad y los valores de esta para los diversos tipos de barras de control que se han ensayado (cadmio, B4C, tierras raras, y combinaciones de estas sustancias); b) los picos de flujo que la presencia de barras de control crea en el cuerpo del reactor, su influencia sobre la potencia especifica, los flujos rapidos que se pueden obtener y los medios para incrementarlos; c) los problemas tecnologicos planteados por la construccion de las barras; d) los problemas de refrigeracion, vibracion, deformacion y tiempo necesario para introducirlos en el reactor. Para terminar, describe someramente loe estudios que se estan realizando con las barras de control de reactores de tipo piscina de cuerpo abierto cuando funcionan en el intervalo de potencias comprendido entre 10 y 30 MW. (author) [Russian] 1. V svete raschetov i jeksperimentov, provedennyh pri postrojke reaktora STLOE , rassmatrivajutsja problemy, voznikajushhie v svjazi s regulirujushhimi sterzhnjami dlja issledovatel'skih reaktorov otkrytogo bassejnovogo tipa s bol'shoj udel'noj moshhnost'ju i s vysokoj plotnost'ju nejtronnogo potoka. Privodjatsja takzhe rezul'taty ispytanija jetogo reaktora pri .moshhnosti 13 mgvt v svjazi s razlichnymi regulirujushhimi sterzhnjami. 2. Posledov atel'no rassmatrivajutsja sledujushhie problemy: a) balans reaktivnosti i reaktivnaja sposobnost' podvergnutyh ispytanijam regulirujushhih sterzhnej razlichnyh tipov (kadmij, B{sub 4}C , redkie zemli

  6. 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.

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

    International Nuclear Information System (INIS)

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

    1984-01-01

    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

  8. 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.)

  9. Calidad total en el ICESI

    OpenAIRE

    González Zamora, José Hipólito

    2010-01-01

    En primer lugar deseo dar la bienvenida esta reunión al ingeniero Francisco Gensini, director ejecutivo de INCOLDA, quien ha sido fuente constante de inspiración para el trabajo relacionado con Control Total de Calidad (C.T.C.) que se ha venido desarrollando en el ICESI. El ingeniero Gensini ha logrado aglutinar alrededor de INCOLDA al grupo de seis empresas de la región, líderes en el estudio y aplicación de los principios del Control Total de Calidad , es decir Rica Rondo S.A., Banco de Oc...

  10. Sobredentadura total superior implantosoportada Superior total overdenture on implants

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.This is the case of a total maxilla edentulous patient seen in consultation of the "Pedro Ortíz" Clinic Implant of Habana del Este municipality in 2009 and con rehabilitation by prosthesis over osteointegration implants added to stomatology practice in Cuba as an alternative to conventional treatment in patients totally edentulous. We follow a protocol including a surgery or surgical phase, technique without or with flap creation and early or immediate load. This is a male patient aged 56 came to our multidisciplinary consultation worried because he had three prostheses in last two years and any fulfilled the requirements of retention to feel safe and comfortable with prostheses. The final result was the total satisfaction of rehabilitated patient improving its aesthetic and functional quality.

  11. Total phenolics and total flavonoids in selected Indian medicinal plants.

    Science.gov (United States)

    Sulaiman, C T; Balachandran, Indira

    2012-05-01

    Plant phenolics and flavonoids have a powerful biological activity, which outlines the necessity of their determination. The phenolics and flavonoids content of 20 medicinal plants were determined in the present investigation. The phenolic content was determined by using Folin-Ciocalteu assay. The total flavonoids were measured spectrophotometrically by using the aluminium chloride colorimetric assay. The results showed that the family Mimosaceae is the richest source of phenolics, (Acacia nilotica: 80.63 mg gallic acid equivalents, Acacia catechu 78.12 mg gallic acid equivalents, Albizia lebbeck 66.23 mg gallic acid equivalents). The highest total flavonoid content was revealed in Senna tora which belongs to the family Caesalpiniaceae. The present study also shows the ratio of flavonoids to the phenolics in each sample for their specificity.

  12. Total Synthesis of Adunctin B.

    Science.gov (United States)

    Dethe, Dattatraya H; Dherange, Balu D

    2018-03-16

    Total synthesis of (±)-adunctin B, a natural product isolated from Piper aduncum (Piperaceae), has been achieved using two different strategies, in seven and three steps. The efficient approach features highly atom economical and diastereoselective Friedel-Crafts acylation, alkylation reaction and palladium catalyzed Wacker type oxidative cyclization.

  13. 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...

  14. What is Total Quality Management?

    Science.gov (United States)

    Bryan, William A.

    1996-01-01

    Provides a general overview of Total Quality Management (TQM) and explains why there is pressure for change in higher education institutions. Defines TQM and the various themes, tools, and beliefs that make it different from other management approaches. Presents 14 principles and how they might be applied to student affairs. (RJM)

  15. A totally diverting loop colostomy.

    Science.gov (United States)

    Merrett, N. D.; Gartell, P. C.

    1993-01-01

    A technique is described where the distal limb of a loop colostomy is tied with nylon or polydioxanone. This ensures total faecal diversion and dispenses with the supporting rod, enabling early application of stoma appliances. The technique does not interfere with the traditional transverse closure of a loop colostomy. PMID:8379632

  16. A generalization of total graphs

    Indian Academy of Sciences (India)

    M Afkhami

    2018-04-12

    Apr 12, 2018 ... product of any lower triangular matrix with the transpose of any element of U belongs to U. The ... total graph of R, which is denoted by T( (R)), is a simple graph with all elements of R as vertices, and ...... [9] Badawi A, On dot-product graph of a commutative ring, Communications in Algebra 43 (2015). 43–50.

  17. Total synthesis of nepetoidin B

    Science.gov (United States)

    The total synthesis of nepetoidin B (the 2-(3,4-dihydroxyphenyl)ethenyl ester of 3-(3,4-dihydroxy¬phenyl)-2-propenoic acid) has been achieved in two steps from commercially available 1,5-bis(3,4-dimethoxyphenyl)-1,4-pentadien-3-one. Tetramethylated nepetoidin B was prepared directly by Baeyer-Villig...

  18. The "Total Immersion" Meeting Environment.

    Science.gov (United States)

    Finkel, Coleman

    1980-01-01

    The designing of intelligently planned meeting facilities can aid management communication and learning. The author examines the psychology of meeting attendance; architectural considerations (lighting, windows, color, etc.); design elements and learning modes (furniture, walls, audiovisuals, materials); and the idea of "total immersion meeting…

  19. First total synthesis of Boehmenan

    Indian Academy of Sciences (India)

    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 ...

  20. MODIFIED TECHNIQUE OF TOTAL LARYNGECTOMY

    Directory of Open Access Journals (Sweden)

    Predrag Spirić

    2010-12-01

    Full Text Available Surgical technique of total laryngectomy is well presented in many surgical textbooks. Essentially, it has remained the same since Gluck an Soerensen in 1922 described all its details. Generally, it stresses the U shape skin incision with releasing laryngeal structures and removing larynx from up to down. Further, pharyngeal reconstruction is performed with different kinds of sutures in two or more layers and is finished with skin suture and suction drainage. One of worst complications following this surgery is pharyngocutaneous fistula (PF. Modifications proposed in this this article suggests vertical skin incision with larynx removal from below upwards. In pharyngeal reconstruction we used the running locked suture in submucosal plan with „tobacco sac“ at the end on the tongue base instead of traditional T shaped suture. Suction drains were not used.The aim of study was to present the modified surgical technique of total laryingectomy and its impact on hospital stay duration and pharyngocutanous fistula formation. In this randomized study we analyzed 49 patients operated with modified surgical technique compared to 49 patient operated with traditional surgical technique of total laryngectomy. The modified technique of total laryngectomy was presented. Using modified technique we managed to decrease the PF percentage from previous 20,41% to acceptable 8,16% (p=0,0334. Also, the average hospital stay was shortened from 14,96 to 10,63 days (t =-2.9850; p=0.0358.The modified technique of total laryngectomy is safe, short and efficient surgical intervention which decreases the number of pharyngocutaneos fistulas and shortens the hospital stay.

  1. Subtotal versus total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Ottesen, Bent; Alling Møller, Lars Mikael

    2015-01-01

    OBJECTIVE: The objective of the study was to compare long-term results of subtotal vs total abdominal hysterectomy for benign uterine diseases 14 years after hysterectomy, with urinary incontinence as the primary outcome measure. STUDY DESIGN: This was a long-term follow-up of a multicenter......, randomized clinical trial without blinding. Eleven gynecological departments in Denmark contributed participants to the trial. Women referred for benign uterine diseases who did not have contraindications to subtotal abdominal hysterectomy were randomized to subtotal (n = 161) vs total (n = 158) abdominal...... from discharge summaries from all public hospitals in Denmark. The results were analyzed as intention to treat and per protocol. Possible bias caused by missing data was handled by multiple imputation. The primary outcome was urinary incontinence; the secondary outcomes were pelvic organ prolapse...

  2. Institutional total energy case studies

    Energy Technology Data Exchange (ETDEWEB)

    Wulfinghoff, D.

    1979-07-01

    Profiles of three total energy systems in institutional settings are provided in this report. The plants are those of Franciscan Hospital, a 384-bed facility in Rock Island, Illinois; Franklin Foundation Hospital, a 100-bed hospital in Franklin, Louisiana; and the North American Air Defense Command Cheyenne Mountain Complex, a military installation near Colorado Springs, Colorado. The case studies include descriptions of plant components and configurations, operation and maintenance procedures, reliability, relationships to public utilities, staffing, economic efficiency, and factors contributing to success.

  3. Total synthesis of (-)- and (+)-tedanalactam

    Digital Repository Service at National Institute of Oceanography (India)

    Majik, M.S.; Parameswaran, P.S.; Tilve, S.G.

    : The Journal of Organic Chemistry, vol.74(16); 6378-6381 1 Total Synthesis of (-) and (+)-Tedanalactam Mahesh S. Majik, † Peruninakulath S. Parameswaran, ‡ and Santosh G. Tilve* ,† Department of Chemistry, Goa University, Taleigao Plateau, Goa 403..., displaying a wide range of biological activities. 1 Piperidones are key synthetic intermediates 2 for the synthesis of piperidine ring due to the presence of keto function which allows the introduction of other groups. Piperidones are also known...

  4. Intrathoracic Hernia after Total Gastrectomy

    Directory of Open Access Journals (Sweden)

    Yoshihiko Tashiro

    2016-05-01

    Full Text Available Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected with the abdominal cavity. A pleural defect was not repaired. Two days after the operation, the patient was suspected of having intrathoracic hernia by chest X-rays. Computed tomography showed that the transverse colon and Roux limb were incarcerated in the left thoracic cavity. He was diagnosed with intrathoracic hernia, and emergency reduction and repair were performed. Operative findings showed that the Roux limb and transverse colon were incarcerated in the thoracic cavity. After reduction, the orifice of the hernia was closed by suturing the crus of the diaphragm with the ligament of the jejunum and omentum. After the second operation, he experienced anastomotic leakage and left pyothorax. Anastomotic leakage was improved with conservative therapy and he was discharged 76 days after the second operation.

  5. NIF total neutron yield diagnostic

    International Nuclear Information System (INIS)

    Cooper, Gary W.; Ruiz, Carlos L.

    2001-01-01

    We have designed a total neutron yield diagnostic for the National Ignition Facility (NIF) which is based on the activation of In and Cu samples. The particular approach that we have chosen is one in which we calibrate the entire counting system and which we call the ''F factor'' method. In this method, In and/or Cu samples are exposed to known sources of DD and DT neutrons. The activated samples are then counted with an appropriate system: a high purity Ge detector for In and a NaI coincidence system for Cu. We can then calculate a calibration factor, which relates measured activity to total neutron yield. The advantage of this approach is that specific knowledge of such quantities as cross sections and detector efficiencies is not needed. Unless the actual scattering environment of the NIF can be mocked up in the calibration experiment, the F factor will have to be modified using the results of a numerical simulation of the NIF scattering environment. In this article, the calibration factor methodology will be discussed and experimental results for the calibration factors will be presented. Total NIF neutron yields of 10 9 --10 19 can be measured with this method assuming a 50 cm stand-off distance can be employed for the lower yields

  6. 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

  7. Reverse hybrid total hip arthroplasty

    DEFF Research Database (Denmark)

    Wangen, Helge; Havelin, Leif I.; Fenstad, Anne M

    2017-01-01

    Background and purpose - The use of a cemented cup together with an uncemented stem in total hip arthroplasty (THA) has become popular in Norway and Sweden during the last decade. The results of this prosthetic concept, reverse hybrid THA, have been sparsely described. The Nordic Arthroplasty....... Patients and methods - From the NARA, we extracted data on reverse hybrid THAs from January 1, 2000 until December 31, 2013. 38,415 such hips were studied and compared with cemented THAs. The Kaplan-Meier method and Cox regression analyses were used to estimate the prosthesis survival and the relative risk...

  8. Total knee arthroplasty in ochronosis

    Directory of Open Access Journals (Sweden)

    Vaibhav G. Patel, MBBS

    2015-09-01

    Full Text Available Alkaptonuria is disorder of tyrosine metabolism due to deficiency of homogentisic oxidase characterized by excretion of homogentisic acid in urine, deposition of oxidized homogensitate pigments in connective tissues and articular cartilages (ochronosis. The result is dark pigmentation and weakening of the tissues resulting in chronic inflammation and osteoarthritis. Management of alkaptonuric ochronic osteoarthritis is usually symptomatic and replacements have comparable outcomes to osteoarthritis in patients without ochronosis. I report a case of a patient with ochronosis of knee treated with total knee replacement and report operative pearls for surgery in this rare disorder.

  9. Total filmless digital radiology service

    International Nuclear Information System (INIS)

    Mun, S.K.; Goeringer, F.; Benson, H.; Horii, S.C.

    1989-01-01

    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

  10. 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.

  11. Testing EDM of Total Stations

    Directory of Open Access Journals (Sweden)

    Cirbus Ján

    2001-03-01

    Full Text Available The paper is devoted to testing electrooptical distance measuring devices (EDM built in total stations, than can be used for various tasks in the contemporary geodetic works. A rich market offer and availability of these universal measuring systems with satisfying distance range, excellent accuracy and other parameters, make total stations as dominant terrestrial geodetic instruments.For succesfully applying these instruments, above all for relliable distance measurements, the stability of the modulation frequency is the most important pre-condition. In the article, therefore, there are given some methods to verify the modulation frequency stability. In addition, some ways for determining the EDM distance constant and periodical corrections of the phase measuring unit are introduced for 4 types of EDM : LEICA 1700L, TOPCON GTS6A, TOPCON GTS2, C.ZEISS ELTA50. It were also investigated their possibilities for precise distance survey. Values of the determined constants and periodical corrections are presented in Tab. 2.Based on the investigation results of the 4 EDM types and using the values m obtained for different distances S, equations of the a posteriori standard deviations in form : m = (a+b.S were derived too.

  12. 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

    2016-07-05

    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.

  13. Total employment effect of biofuels

    International Nuclear Information System (INIS)

    Stridsberg, S.

    1998-08-01

    The study examined the total employment effect of both direct production of biofuel and energy conversion to heat and electricity, as well as the indirect employment effect arising from investments and other activities in conjunction with the production organization. A secondary effect depending on the increased capital flow is also included in the final result. The scenarios are based on two periods, 1993-2005 and 2005-2020. In the present study, the different fuels and the different applications have been analyzed individually with regard to direct and indirect employment within each separate sector. The greatest employment effect in the production chain is shown for logging residues with 290 full-time jobs/TWh, whereas other biofuels range between 80 and 280 full-time jobs/TWh. In the processing chain, the corresponding range is 200-300 full-time jobs per each additional TWh. Additionally and finally, there are secondary effects that give a total of 650 full-time jobs/TWh. Together with the predicted increase, this suggests that unprocessed fuel will provide an additional 16 000 annual full-time jobs, and that fuel processing will contribute with a further 5 000 full-time jobs. The energy production from the fuels will provide an additional 13 000 full-time jobs. The total figure of 34 000 annual full-time jobs must then be reduced by about 4000 on account of lost jobs, mainly in the oil sector and to some extent in imports of biofuel. In addition, the anticipated increase in capital turnover that occurs within the biofuel sector, will increase full-time jobs up to year 2020. Finally, a discussion is given of the accomplishment of the programmes anticipated by the scenario, where it is noted that processing of biofuel to wafers, pellets or powder places major demands on access to raw material of good quality and that agrarian fuels must be given priority if they are to enter the system sufficiently fast. Straw is already a resource but is still not accepted by

  14. Conversion total hip arthroplasty: Primary or revision total hip arthroplasty

    Science.gov (United States)

    Schwarzkopf, Ran; Baghoolizadeh, Mahta

    2015-01-01

    Total hip arthroplasty (THA) is an increasingly common procedure among elderly individuals. Although conversion THA is currently bundled in a diagnosis related group (DRG) with primary THA, there is a lack of literature supporting this classification and it has yet to be identified whether conversion THA better resembles primary or revision THA. This editorial analyzed the intraoperative and postoperative factors and functional outcomes following conversion THA, primary THA, and revision THA to understand whether the characteristics of conversion THA resemble one procedure or the other, or are possibly somewhere in between. The analysis revealed that conversion THA requires more resources both intraoperatively and postoperatively than primary THA. Furthermore, patients undergoing conversion THA present with poorer functional outcomes in the long run. Patients undergoing conversion THA better resemble revision THA patients than primary THA patients. As such, patients undergoing conversion THA should not be likened to patients undergoing primary THA when determining risk stratification and reimbursement rates. Conversion THA procedures should be planned accordingly with proper anticipation of the greater needs both in the operating room, and for in-patient and follow-up care. We suggest that conversion THA be reclassified in the same DRG with revision THA as opposed to primary THA as a step towards better allocation of healthcare resources for conversion hip arthroplasties. PMID:26601055

  15. Instability after total hip arthroplasty

    Science.gov (United States)

    Werner, Brian C; Brown, Thomas E

    2012-01-01

    Instability following total hip arthroplasty (THA) is an unfortunately frequent and serious problem that requires thorough evaluation and preoperative planning before surgical intervention. Prevention through optimal index surgery is of great importance, as the management of an unstable THA is challenging even for an experienced joints surgeon. However, even after well-planned surgery, a significant incidence of recurrent instability still exists. Non-operative management is often successful if the components are well-fixed and correctly positioned in the absence of neurocognitive disorders. If conservative management fails, surgical options include revision of malpositioned components; exchange of modular components such as the femoral head and acetabular liner; bipolar arthroplasty; tripolar arthroplasty; use of a larger femoral head; use of a constrained liner; soft tissue reinforcement and advancement of the greater trochanter. PMID:22919568

  16. A total safety management model

    International Nuclear Information System (INIS)

    Obadia, I.J.; Vidal, M.C.R.; Melo, P.F.F.F.

    2002-01-01

    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)

  17. Demand: a total nuclear disarmament

    International Nuclear Information System (INIS)

    Hessel, Stephane; Jacquard, Albert

    2012-01-01

    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

  18. Total synthesis of mycalamide A.

    Science.gov (United States)

    Sohn, Jeong-Hun; Waizumi, Nobuaki; Zhong, H Marlon; Rawal, Viresh H

    2005-05-25

    This communication describes a concise and efficient total synthesis of mycalamide A by the convergent coupling of pederic acid unit with the mycalamine unit. The left-half, (+)-7-benzoylpederic acid, was synthesized from (2R,3R)-3-methylpent-4-en-2-ol in seven steps and 34.6% overall yield through a route that features a one-step Pd(II)-catalyzed tandem Wacker/Heck cyclization reaction to prepare the tetrahydropyran ring system. The right-half, the mycalamine unit, was synthesized in 21 steps and 10.5% overall yield from diethyl d-tartrate. Effective, stereoselective methods were developed for the assembly of the two parts to yield either mycalamide A or C(10)-epi-mycalamide A.

  19. 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.

  20. 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.

  1. Instability following total knee arthroplasty.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos

    2011-10-01

    Background Knee prosthesis instability (KPI) is a frequent cause of failure of total knee arthroplasty. Moreover, the degree of constraint required to achieve immediate and long-term stability in total knee arthroplasty (TKA) is frequently debated. Questions This review aims to define the problem, analyze risk factors, and review strategies for prevention and treatment of KPI. Methods A PubMed (MEDLINE) search of the years 2000 to 2010 was performed using two key words: TKA and instability. One hundred and sixty-five initial articles were identified. The most important (17) articles as judged by the author were selected for this review. The main criteria for selection were that the articles addressed and provided solutions to the diagnosis and treatment of KPI. Results Patient-related risk factors predisposing to post-operative instability include deformity requiring a large surgical correction and aggressive ligament release, general or regional neuromuscular pathology, and hip or foot deformities. KPI can be prevented in most cases with appropriate selection of implants and good surgical technique. When ligament instability is anticipated post-operatively, the need for implants with a greater degree of constraint should be anticipated. In patients without significant varus or valgus malalignment and without significant flexion contracture, the posterior cruciate ligament (PCL) can be retained. However, the PCL should be sacrificed when deformity exists particularly in patients with rheumatoid arthritis, previous patellectomy, previous high tibial osteotomy or distal femoral osteotomy, and posttraumatic osteoarthritis with disruption of the PCL. In most cases, KPI requires revision surgery. Successful outcomes can only be obtained if the cause of KPI is identified and addressed. Conclusions Instability following TKA is a common cause of the need for revision. Typically, knees with deformity, rheumatoid arthritis, previous patellectomy or high tibial osteotomy, and

  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. 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 ...

  4. Global Drought Total Economic Loss Risk Deciles

    Data.gov (United States)

    National Aeronautics and Space Administration — Global Drought Total Economic Loss Risk Deciles is a 2.5 minute grid of global drought total economic loss risks. A process of spatially allocating Gross Domestic...

  5. Chinese National Strategy of Total War

    National Research Council Canada - National Science Library

    Good, Michael J

    2008-01-01

    ... concept of total warfare. This research seeks to determine if China is currently engaged in a total war with the United States across nontraditional forms of conflict including economic, political, information, financial...

  6. Totally optimal decision trees for Boolean functions

    KAUST Repository

    Chikalov, Igor; Hussain, Shahid; Moshkov, Mikhail

    2016-01-01

    We study decision trees which are totally optimal relative to different sets of complexity parameters for Boolean functions. A totally optimal tree is an optimal tree relative to each parameter from the set simultaneously. We consider the parameters

  7. Asymmetric total synthesis of cladosporin and isocladosporin.

    Science.gov (United States)

    Zheng, Huaiji; Zhao, Changgui; Fang, Bowen; Jing, Peng; Yang, Juan; Xie, Xingang; She, Xuegong

    2012-07-06

    The first asymmetric total syntheses of cladosporin and isocladosporin were accomplished in 8 steps with 8% overall yield and 10 steps with 26% overall yield, respectively. The relative configuration of isocladosporin was determined via this total synthesis.

  8. Global Landslide Total Economic Loss Risk Deciles

    Data.gov (United States)

    National Aeronautics and Space Administration — Global Landslide Total Economic Loss Risk Deciles is a 2.5 minute grid of global landslide total economic loss risks. A process of spatially allocating Gross...

  9. TUW at the First Total Recall Track

    Science.gov (United States)

    2015-11-20

    TUW AT THE FIRST TOTAL RECALL TRACK MIHAI LUPU Abstract. For the first participation in the TREC Total Recall track, we set out to try some basic...significantly and consistently outperformed it. 1. Introduction As the organizers point out, the focus of the Total Recall Track is to evaluate methods to...TUW AT THE FIRST TOTAL RECALL TRACK 3 The only change we made was at a higher level. The Sofia ML library provides 5 more ML algorithms. The following

  10. Defense meteorological satellite measurements of total ozone

    International Nuclear Information System (INIS)

    Lovill, J.E.; Ellis, J.S.; Luther, F.M.; Sullivan, R.J.; Weichel, R.L.

    1992-01-01

    A multichannel filter radiometer (MFR) on Defense Meteorological Satellites (DMS) that measured total ozone on a global-scale from March 1977 - February 1980 is described. The total ozone data measured by the MFR were compared with total ozone data taken by surfaced-based Dobson spectrophotometers. When comparisons were made for five months, the Dobson spectrophotometer measured 2-5% more total ozone than the MFR. Comparisons between the Dobson spectrophotometer and the MFR showed a reduced RMS difference as the comparisons were made at closer proximity. A Northern Hemisphere total ozone distribution obtained from MFR data is presented

  11. Influências do ciclo estral sobre o desempenho de ratos no labirinto em cruz elevado

    OpenAIRE

    Amauri Gouveia Júnior; Silvio Morato

    2002-01-01

    The Elevated plus maze is one of the most popular models to study animal anxiety. Anxiety can be influenced by physiological factors, such as the hormonal state. The aim of the present work is to investigate the relationship between estrus cycle and rat exploratory behavior in the elevated plus maze. The study made use of male (n = 13) and female rats (n = 61). The females had their estral phase identified and were divided into 3 groups according to their hormonal state: Proestrus (N = 23), E...

  12. 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.

  13. 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.

  14. 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.

  15. Operational resource theory of total quantum coherence

    Science.gov (United States)

    Yang, Si-ren; Yu, Chang-shui

    2018-01-01

    Quantum coherence is an essential feature of quantum mechanics and is an important physical resource in quantum information. Recently, the resource theory of quantum coherence has been established parallel with that of entanglement. In the resource theory, a resource can be well defined if given three ingredients: the free states, the resource, the (restricted) free operations. In this paper, we study the resource theory of coherence in a different light, that is, we consider the total coherence defined by the basis-free coherence maximized among all potential basis. We define the distillable total coherence and the total coherence cost and in both the asymptotic regime and the single-copy regime show the reversible transformation between a state with certain total coherence and the state with the unit reference total coherence. Extensively, we demonstrate that the total coherence can also be completely converted to the total correlation with the equal amount by the free operations. We also provide the alternative understanding of the total coherence, respectively, based on the entanglement and the total correlation in a different way.

  16. Total quality management in American industry.

    Science.gov (United States)

    Widtfeldt, A K; Widtfeldt, J R

    1992-07-01

    The definition of total quality management is conformance to customer requirements and specifications, fitness for use, buyer satisfaction, and value at an affordable price. The three individuals who have developed the total quality management concepts in the United States are W.E. Deming, J.M. Juran, and Philip Crosby. The universal principles of total quality management are (a) a customer focus, (b) management commitment, (c) training, (d) process capability and control, and (e) measurement through quality improvement tools. Results from the National Demonstration Project on Quality Improvement in Health Care showed the principles of total quality management could be applied to healthcare.

  17. A note on totally normal spaces

    International Nuclear Information System (INIS)

    Zougdani, H.K.

    1990-10-01

    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

  18. 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.

  19. Total cross section of highly excited strings

    International Nuclear Information System (INIS)

    Lizzi, F.; Senda, I.

    1990-01-01

    The unpolarized total cross section for the joining of two highly excited strings is calculated. The calculation is performed by taking the average overall states in the given excitation levels of the initial strings. We find that the total cross section grows with the energy and momentum of the initial states. (author). 8 refs, 1 fig

  20. 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...

  1. Total internal reflection effect on gyrotropic interface

    Science.gov (United States)

    Glushchenko, Alexander G.; Glushchenko, Eugene P.; Zhukov, Sergey V.

    2018-02-01

    This article considers the physical features of total internal reflection at gyrotropic and isotropic interfaces for two cases: electrical gyrotropy (plasma) and magnetic gyrotropy (ferrite). It is shown that the plasma magnetization may lead to the formation of the total internal reflection effect, which does not occur in isotropic plasma. The threshold values of the magnetic field, which are necessary for the total internal reflection effect, are determined. The total internal reflection effect on a ferrite-dielectric interface for waves emanating from different angles is observed in various frequency ranges and magnetization fields. The study points out the possibility of changing the total internal reflection angle value in large limits due to a change in the external magnetic field magnitude. The calculation results of the total internal reflection angle dependence on the external magnetic field magnitude are presented. The formulas are elaborated for calculating the total internal reflection angles of different interfaces for gyrotropic and isotropic media. The generalized formulas are defined for calculating the Doppler effect in the gyrotropic media. The study demonstrates how the velocity of the media interface affects the limiting angle of total internal refection.

  2. Records Management in Organization and Total Quality

    Directory of Open Access Journals (Sweden)

    Fahrettin Özdemirci

    1999-06-01

    Full Text Available In this article the relationship between total quality management and records managemen t are examined. It has also been indicated that the records mana­gement has vita'ly important part for realizing the total quality management approach.

  3. Vibrational enhancement of total breakup cross sections

    International Nuclear Information System (INIS)

    Haftel, M.I.; Lim, T.K.

    1984-01-01

    This paper considers the role of multi-two-body bound states, namely vibrational excitations, on total three-body breakup cross-sections. Total cross-sections are usually easy to measure, and they play a fundamental role in chemical kinetics. (orig.)

  4. A Total Factor Productivity Toolbox for MATLAB

    NARCIS (Netherlands)

    B.M. Balk (Bert); J. Barbero (Javier); J.L. Zofío (José)

    2018-01-01

    textabstractTotal Factor Productivity Toolbox is a new package for MATLAB that includes functions to calculate the main Total Factor Productivity (TFP) indices and their decompositions, based on Shephard’s distance functions and using Data Envelopment Analysis (DEA) programming techniques. The

  5. Timing the total reflection of light

    International Nuclear Information System (INIS)

    Chauvat, Dominique; Bonnet, Christophe; Dunseath, Kevin; Emile, Olivier; Le Floch, Albert

    2005-01-01

    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

  6. 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....

  7. The total energy policy in Flanders

    International Nuclear Information System (INIS)

    Bouma, J.W.J.

    1994-01-01

    The policy of the Flemish region (Belgium) with regard to the total energy principle are presented. An overview of the main policy instruments to support energy saving and environmental-friendly investments as well as the development of new technologies is given. The total energy policy of the Flanders Region forms part of the general Flemish (energy) policy. (A.S.)

  8. Airway Complications of Total Artificial Heart.

    Science.gov (United States)

    Pathak, Vikas; Donovan, Colin; Malhotra, Rajiv

    2017-02-01

    The total artificial heart is the mechanical device which is used as a bridge to the heart transplant in patients with biventricular failure. Due to the mechanical nature of the device, patients receiving total artificial heart (TAH) require to be on anticoagulation therapy. Hemorrhage and coagulopathy are few of the known complications of TAH.

  9. Total Quality Management in Education. Second Edition.

    Science.gov (United States)

    Sallis, Edward

    Quality is at the top of most agendas, and improving quality is probably the most important task facing any institution. In addition, quality is difficult to define or measure. This book, the second edition of "Total Quality Management in Education," introduces the key concepts of Total Quality Management (TQM) and demonstrates how they…

  10. The Total Quality Movement in Education.

    Science.gov (United States)

    Leuenberger, John A.; Whitaker, Sheldon V., Jr.

    The total quality movement began as a result of the desire of W. Edwards Deming, an American statistician, to permit the economic system to maintain its edge in a growing global market. The 14 points Deming listed as essential to "total quality management" have recently been adapted to the field of education. The success of the total…

  11. Creating the Total Quality Effective School.

    Science.gov (United States)

    Lezotte, Lawrence W.

    This book shows how Deming's Total Quality Management (TQM) theory for organizational management can be integrated with the effective-schools literature. Part 1 compares the 14 principles of TQM with the tenets of effective-schools research. The second part develops a blueprint for creating the total quality effective school. The conceptual…

  12. Totally optimal decision trees for Boolean functions

    KAUST Repository

    Chikalov, Igor

    2016-07-28

    We study decision trees which are totally optimal relative to different sets of complexity parameters for Boolean functions. A totally optimal tree is an optimal tree relative to each parameter from the set simultaneously. We consider the parameters characterizing both time (in the worst- and average-case) and space complexity of decision trees, i.e., depth, total path length (average depth), and number of nodes. We have created tools based on extensions of dynamic programming to study totally optimal trees. These tools are applicable to both exact and approximate decision trees, and allow us to make multi-stage optimization of decision trees relative to different parameters and to count the number of optimal trees. Based on the experimental results we have formulated the following hypotheses (and subsequently proved): for almost all Boolean functions there exist totally optimal decision trees (i) relative to the depth and number of nodes, and (ii) relative to the depth and average depth.

  13. 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)

  14. Total's LNG activities from Algeria to Yemen

    International Nuclear Information System (INIS)

    Vedrenne, J.P.

    1997-01-01

    In March 1995, further to an international tender, Total was awarded the leadership of the first LNG project in Yemen. On January 1997 Total announced the extension of the share-holding of the Yemen LNG Co. to include the companies with interests in the Marib area (Hunt-Exxon-Yukong). The Marib area will supply the gas to the future liquefaction plant. The ratification of these agreements confirms the role of Total as lead shareholder with 36% in the share-holding structure and guarantees gas supply from the Marib licence, operated by Hunt-Exxon. (author)

  15. 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.

  16. Total neutron cross section of lead

    International Nuclear Information System (INIS)

    Kanda, K.; Aizawa, O.

    1976-01-01

    The total thermal-neutron cross section of natural lead under various physical conditions was measured by the transmission method. It became clear that the total cross section at room temperature previously reported is lower than the present data. The total cross section at 400, 500, and 600 0 C, above the melting point of lead, 327 0 C, was also measured, and the changes in the cross section as a function of temperature were examined, especially near and below the melting point. The data obtained for the randomly oriented polycrystalline state at room temperature were in reasonable agreement with the theoretical values calculated by the THRUSH and UNCLE-TOM codes

  17. The total plasmatic estriol on normal gestation

    International Nuclear Information System (INIS)

    Thiesen, A.L.

    1980-01-01

    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)

  18. 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.

  19. Pulmonary nodules secondary to total parenteral alimentation

    International Nuclear Information System (INIS)

    Landry, B.A.; Melhem, R.E.

    1989-01-01

    A seven-year-old male, who had a retroperitoneal alveolar rhabdomyosarcoma and was on total parenteral alimentation (TPN) developed muliple pulmonary nodules, indistinguishable from metastases. These proved to be multiple lipid emboli on open biopsy. (orig.)

  20. Definition of total bootstrap current in tokamaks

    International Nuclear Information System (INIS)

    Ross, D.W.

    1995-01-01

    Alternative definitions of the total bootstrap current are compared. An analogous comparison is given for the ohmic and auxiliary currents. It is argued that different definitions than those usually employed lead to simpler analyses of tokamak operating scenarios

  1. 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.

  2. Can You Depend Totally on Computers?

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 3; Issue 2. Can You Depend Totally on Computers? Computer Security, Availability and Correctness. H N Mahabala. General Article Volume 3 Issue 2 February 1998 pp 35-44 ...

  3. 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...

  4. Establishing a total information management program

    International Nuclear Information System (INIS)

    Hegstrom, K.L.; Fisher, J.

    1982-01-01

    A total information management program manages documents for easy access and identifies data elements commonly found in all documents. The program thus links disparate documents by identifying information they share in common

  5. Safety Precautions for Total Release Foggers

    Science.gov (United States)

    Total release foggers, also known as bug bombs, are pesticide products containing aerosol propellants that release their contents at once to fumigate an area. They can pose a hazard if used incorrectly. Find safety information and videos on this page.

  6. Medicaid Financial Management Data – National Totals

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset reports summary state-by-state total expenditures by program for the Medicaid Program, Medicaid Administration and CHIP programs. These state...

  7. The 1995 total solar eclipse: an overview.

    Science.gov (United States)

    Singh, J.

    A number of experiments were conducted during the total solar eclipse of October 24, 1995. First time efforts were made to photograph the solar corona using IAF jet aircrafts and transport planes ad hot air balloons.

  8. 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...

  9. Total Analysis System for Ship Structural Strength

    OpenAIRE

    Takuya, Yoneya; Hiroyuki, Kobayashi; Abdul M., Rahim; Yoshimichi, Sasaki; Masaki, Irisawa; Technical Investigation and Information Department, Research Center; Technical Investigation and Information Department, Research Center; Singapore Office; Technical Investigation and Information Department, Research Center; Technical Investigation and Information Department, Research Center

    2001-01-01

    This paper outlines a total analysis system for ship hull structures, which integrates a wide variety of analysis functions to realise practical applications of rational methods for assessing ship structural strength. It is based on direct calculation of wave-induced loads as well as three-dimensional structural analysis of an entire-ship or hold structure. Three major analysis functions of the total system are ship motion and wave load analysis, ship structural analysis and statistical analy...

  10. 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...

  11. A strategic zone for Total's future

    International Nuclear Information System (INIS)

    Legros, E.J.

    1997-01-01

    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.)

  12. Studies towards a total synthesis of tagetitoxin

    OpenAIRE

    Mahoney, Brian

    2017-01-01

    Tagetitoxin was first isolated over thirty five years ago and a total synthesis has not been achieved to date. A vast amount of research has been carried out on the biological activity of tagetitoxin with hundreds of literature reports. However, very few papers have been published regarding the synthesis and within this thesis we will explore a number of synthetic pathways some towards tagetitoxin. The first chapter reviews previous developments regarding the total synthesis of...

  13. Expressions for the Total Yaw Angle

    Science.gov (United States)

    2016-09-01

    1. Introduction 1 2. Mathematical Notation 1 3. Total Yaw Expression Derivations 2 3.1 First Derivation 2 3.2 Second Derivation 4 3.3 Other...4 iv Approved for public release; distribution is unlimited. 1. Introduction The total yaw angle, γt , of a ballistic projectile is... elevation angles from spherical coordinates.∗ We again place point A at the end point of V. Now imagine a plane parallel to the y-z plane that includes

  14. Total energy system in the future

    International Nuclear Information System (INIS)

    Hijikata, K.

    1994-01-01

    The possibility of improving the thermal efficiency of energy systems from an exergy point of view is discussed. In total energy systems, we should employ multi-pass recycling consisting of thermal and chemical energies. The recycling system is supported by electrical energy, which is provided by a renewable energy source or by excess commercial electric power. This total energy system should be considered not only in one country, but all around the globe. (author). 6 figs., 4 tabs., 8 refs

  15. Cataract incidence after total-body irradiation

    International Nuclear Information System (INIS)

    Zierhut, D.; Lohr, F.; Schraube, P.; Huber, P.; Haas, R.; Hunstein, W.; Wannenmacher, M.

    1997-01-01

    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. A high performance totally ordered multicast protocol

    Science.gov (United States)

    Montgomery, Todd; Whetten, Brian; Kaplan, Simon

    1995-01-01

    This paper presents the Reliable Multicast Protocol (RMP). RMP provides a totally ordered, reliable, atomic multicast service on top of an unreliable multicast datagram service such as IP Multicasting. RMP is fully and symmetrically distributed so that no site bears un undue portion of the communication load. RMP provides a wide range of guarantees, from unreliable delivery to totally ordered delivery, to K-resilient, majority resilient, and totally resilient atomic delivery. These QoS guarantees are selectable on a per packet basis. RMP provides many communication options, including virtual synchrony, a publisher/subscriber model of message delivery, an implicit naming service, mutually exclusive handlers for messages, and mutually exclusive locks. It has commonly been held that a large performance penalty must be paid in order to implement total ordering -- RMP discounts this. On SparcStation 10's on a 1250 KB/sec Ethernet, RMP provides totally ordered packet delivery to one destination at 842 KB/sec throughput and with 3.1 ms packet latency. The performance stays roughly constant independent of the number of destinations. For two or more destinations on a LAN, RMP provides higher throughput than any protocol that does not use multicast or broadcast.

  17. Total lymphoid irradiation of intractable rheumatoid arthritis

    International Nuclear Information System (INIS)

    Herbst, M.; Fritz, H.; Sauer, R.

    1986-01-01

    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)

  18. Total lymphoid irradiation of intractable rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Herbst, M.; Fritz, H.; Sauer, R.

    1986-12-01

    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.

  19. Use of the total motile sperm count to predict total fertilization failure in in vitro fertilization

    NARCIS (Netherlands)

    Repping, Sjoerd; van Weert, Janne-Meije; Mol, Ben W. J.; de Vries, Jan W. A.; van der Veen, Fulco

    2002-01-01

    Objective: To evaluate the capacity of baseline characteristics and total motile sperm count (TMC) to predict total fertilization failure (TIFF) in patients undergoing IVF. Design: Retrospective cohort study. Setting: University hospital. Patient(s): Eight hundred ninety-two couples with a total of

  20. Chambolle's Projection Algorithm for Total Variation Denoising

    Directory of Open Access Journals (Sweden)

    Joan Duran

    2013-12-01

    Full Text Available Denoising is the problem of removing the inherent noise from an image. The standard noise model is additive white Gaussian noise, where the observed image f is related to the underlying true image u by the degradation model f=u+n, and n is supposed to be at each pixel independently and identically distributed as a zero-mean Gaussian random variable. Since this is an ill-posed problem, Rudin, Osher and Fatemi introduced the total variation as a regularizing term. It has proved to be quite efficient for regularizing images without smoothing the boundaries of the objects. This paper focuses on the simple description of the theory and on the implementation of Chambolle's projection algorithm for minimizing the total variation of a grayscale image. Furthermore, we adapt the algorithm to the vectorial total variation for color images. The implementation is described in detail and its parameters are analyzed and varied to come up with a reliable implementation.

  1. A method for total body irradiation

    International Nuclear Information System (INIS)

    Yasukochi, Hiroshi; Higashi, Shizuka; Okuhata, Yoshitaka; Lee, Keiichi; Ishioka, Kuniaki; Murakami, Koji; Nagai, Jun; Kuniyasu, Yoshio

    1988-01-01

    In these two years, we have treated four infant patients of acute leukemia by Cobalt-60 total body irradiation and bone marrow transplantation. During total body irradiation, thermoluminescence dosimeters were attached to the skin of patients. For four patients, nine dosimetries were performed. Reliability of this method was examined by phantom experiment. Every irradiation for the patient per fraction was 2.4 Gy, that is, 60 cGy for each four positions, right decubitus A-P and PA directions and left decubitus A-P and PA directions under aseptic circumstances. Radiation dose was uniform by this technique for each patient, and average determined dose for surface of the patients was between 87 % and 106 % compared with the air dose of the center of aseptic space (wagon). As the result, we suggest that this method is suitable for the total body irradiation of acute leukemia of infant. (author)

  2. Total reflection X-ray fluorescence analysis

    International Nuclear Information System (INIS)

    Michaelis, W.; Prange, A.

    1987-01-01

    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 [de

  3. Assay development status report for total cyanide

    International Nuclear Information System (INIS)

    Simpson, B.C.; Jones, T.E.; Pool, K.H.

    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 - 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

  4. 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.

  5. Heterotopic bone formation following total shoulder arthroplasty

    DEFF Research Database (Denmark)

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

    1989-01-01

    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...... 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 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....

  6. 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.

  7. Mixed total screening for sulfur isotope

    International Nuclear Information System (INIS)

    Cui Bin; Zhao Lei; Zhan Zhaoyang; He Zhijun

    2003-01-01

    The research on modern economic geology indicates that most ore deposits formed with characters of multi-origin, multi-stage and multi-genesis. Quantificational research of Sulfur isotope origin is a difficult problem that puzzles Geochemists all along. So the formation process of an ore deposit can be taken as the mix or the superposition of multi totals, which can be described by the mathematics model of mixed total screening. In the study of mid-down Yangtze River and Dongpo ore field in Hunan province, the authors successfully applied the mathematics model of mixed total screening, quantificationally resolved the problem of Sulfur isotope origin and mineralizing matter origin, and found out the mineralizing mechanism. This is very valuable. (authors)

  8. Correlations between corneal and total wavefront aberrations

    Science.gov (United States)

    Mrochen, Michael; Jankov, Mirko; Bueeler, Michael; Seiler, Theo

    2002-06-01

    Purpose: Corneal topography data expressed as corneal aberrations are frequently used to report corneal laser surgery results. However, the optical image quality at the retina depends on all optical elements of the eye such as the human lens. Thus, the aim of this study was to investigate the correlations between the corneal and total wavefront aberrations and to discuss the importance of corneal aberrations for representing corneal laser surgery results. Methods: Thirty three eyes of 22 myopic subjects were measured with a corneal topography system and a Tschernig-type wavefront analyzer after the pupils were dilated to at least 6 mm in diameter. All measurements were centered with respect to the line of sight. Corneal and total wavefront aberrations were calculated up to the 6th Zernike order in the same reference plane. Results: Statistically significant correlations (p the corneal and total wavefront aberrations were found for the astigmatism (C3,C5) and all 3rd Zernike order coefficients such as coma (C7,C8). No statistically significant correlations were found for all 4th to 6th order Zernike coefficients except for the 5th order horizontal coma C18 (p equals 0.003). On average, all Zernike coefficients for the corneal aberrations were found to be larger compared to Zernike coefficients for the total wavefront aberrations. Conclusions: Corneal aberrations are only of limited use for representing the optical quality of the human eye after corneal laser surgery. This is due to the lack of correlation between corneal and total wavefront aberrations in most of the higher order aberrations. Besides this, the data present in this study yield towards an aberration balancing between corneal aberrations and the optical elements within the eye that reduces the aberration from the cornea by a certain degree. Consequently, ideal customized ablations have to take both, corneal and total wavefront aberrations, into consideration.

  9. Imaging Total Stations - Modular and Integrated Concepts

    Science.gov (United States)

    Hauth, Stefan; Schlüter, Martin

    2010-05-01

    Keywords: 3D-Metrology, Engineering Geodesy, Digital Image Processing Initialized in 2009, the Institute for Spatial Information and Surveying Technology i3mainz, Mainz University of Applied Sciences, forces research towards modular concepts for imaging total stations. On the one hand, this research is driven by the successful setup of high precision imaging motor theodolites in the near past, on the other hand it is pushed by the actual introduction of integrated imaging total stations to the positioning market by the manufacturers Topcon and Trimble. Modular concepts for imaging total stations are manufacturer independent to a large extent and consist of a particular combination of accessory hardware, software and algorithmic procedures. The hardware part consists mainly of an interchangeable eyepiece adapter offering opportunities for digital imaging and motorized focus control. An easy assembly and disassembly in the field is possible allowing the user to switch between the classical and the imaging use of a robotic total station. The software part primarily has to ensure hardware control, but several level of algorithmic support might be added and have to be distinguished. Algorithmic procedures allow to reach several levels of calibration concerning the geometry of the external digital camera and the total station. We deliver insight in our recent developments and quality characteristics. Both the modular and the integrated approach seem to have its individual strengths and weaknesses. Therefore we expect that both approaches might point at different target applications. Our aim is a better understanding of appropriate applications for robotic imaging total stations. First results are presented. Stefan Hauth, Martin Schlüter i3mainz - Institut für Raumbezogene Informations- und Messtechnik FH Mainz University of Applied Sciences Lucy-Hillebrand-Straße 2, 55128 Mainz, Germany

  10. Failure of aseptic revision total knee arthroplasties.

    Science.gov (United States)

    Leta, Tesfaye H; Lygre, Stein Håkon L; Skredderstuen, Arne; Hallan, Geir; Furnes, Ove

    2015-02-01

    In Norway, the proportion of revision knee arthroplasties increased from 6.9% in 1994 to 8.5% in 2011. However, there is limited information on the epidemiology and causes of subsequent failure of revision knee arthroplasty. We therefore studied survival rate and determined the modes of failure of aseptic revision total knee arthroplasties. This study was based on 1,016 aseptic revision total knee arthroplasties reported to the Norwegian Arthroplasty Register between 1994 and 2011. Revisions done for infections were not included. Kaplan-Meier and Cox regression analyses were used to assess the survival rate and the relative risk of re-revision with all causes of re-revision as endpoint. 145 knees failed after revision total knee arthroplasty. Deep infection was the most frequent cause of re-revision (28%), followed by instability (26%), loose tibial component (17%), and pain (10%). The cumulative survival rate for revision total knee arthroplasties was 85% at 5 years, 78% at 10 years, and 71% at 15 years. Revision total knee arthroplasties with exchange of the femoral or tibial component exclusively had a higher risk of re-revision (RR = 1.7) than those with exchange of the whole prosthesis. The risk of re-revision was higher for men (RR = 2.0) and for patients aged less than 60 years (RR = 1.6). In terms of implant survival, revision of the whole implant was better than revision of 1 component only. Young age and male sex were risk factors for re-revision. Deep infection was the most frequent cause of failure of revision of aseptic total knee arthroplasties.

  11. Radiological evaluation of failed total hip replacement

    International Nuclear Information System (INIS)

    Raspa, V.; Aldrovandi, S.; Pompei, G.

    1988-01-01

    The retrospective study of 50 operated cases of cemented total hip replacement and a review of the literature enabled the authors to define the radiological features of the above-mentioned condition. These features include one or more of the following signs: calcar reabsorption, lacunar erosions, modified relatioships between the prosthesis components, sepsis and loosening, periarticular calcifications dislocation and fracture of prosthesis components. Careful evaluation of these radiological features is extremely important for both an early diagnosis of failed total hip replacement and the choice of an adequate surgical treatment

  12. 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.

  13. Employee benefits in a total rewards framework.

    Science.gov (United States)

    Kwon, Jane; Hein, Pam

    2013-01-01

    Benefits represent one of the largest investments a company makes in its talent. However, our tendency can be to design, deliver and communicate benefits programs independently, without fully considering how those programs fit within a bigger picture of total rewards. Sure, we need to manage and execute individual benefit programs--but not at the expense of getting a real return on our more significant investment in talent. This article provides employers with perspectives on the value of managing benefits within the broader framework of total rewards, why it works and, most importantly, how to make it work.

  14. TOTAL 2003 activities report in brief

    International Nuclear Information System (INIS)

    2004-01-01

    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.)

  15. Total shoulder replacement in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Sneppen, O; Fruensgaard, S; Johannsen, Hans Viggo

    1996-01-01

    A prospective study of 62 Neer mark II total shoulder arthroplasties performed during the period from 1981 to 1990 on 51 patients with rheumatoid arthritis was undertaken to evaluate factors associated with component loosening and proximal humeral migration. Thirty-two (51%) showed proximal......, range of movement, abduction force, or function. The risk of clinical asymptomatic loosening is a relatively late complication that is eventually followed by pronounced bone destruction related to the loose component. Long-term radiographic control of total shoulders with rheumatoid arthritis...... is recommended. Hemiarthroplasty with a cemented humeral prosthesis may be a better treatment in the end stage of rheumatoid arthritis of the shoulder....

  16. Development of kits for total PSA monitoring

    International Nuclear Information System (INIS)

    Suprarop, P.

    1999-01-01

    The development of kits for Total PSA assay has shown promising results. All essential components of the assay were prepared with reproducibility and used to optimize the assay. By choosing two steps method, we could avoid the hook effect and obtain satisfactory Q.C. parameters of the standard curve i.e. blank = 0.8%, maximum binding = 65%. If reference material for calibration of the standard is agree upon, the validation could then be carried out with total confidence. Our final goal is to reduce the step of incubation to just one step with no interference from hook effect

  17. TOTAL FINA ELF. Annual report 2002

    International Nuclear Information System (INIS)

    2003-01-01

    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.)

  18. Determination of total solutes in synfuel wastewaters

    Energy Technology Data Exchange (ETDEWEB)

    Wallace, J.R.; Bonomo, F.S.

    1984-03-01

    Efforts to investigate both lyophilization and the measurement of colligative properties as an indication of total solute content are described. The objective of the work described is to develop a method for measuring total dissolved material in retort wastewaters which is simple and rugged enough to be performed in a field laboratory in support of pollution control tests. The analysis should also be rapid enough to provide timely and pertinent data to the pollution control plant operator. To be of most value, the technique developed also should be applicable to other synfuel wastewaters, most of which contain similar major components as oil shale retort waters. 4 references, 1 table.

  19. Management of hypocalcemia following total thyroidectomy

    International Nuclear Information System (INIS)

    Pahuja, D.N.; Patwardhan, U.N.; Samuel, A.M.

    1999-01-01

    A retrospective analysis of calcemic status of 500 randomly selected patients, who underwent total thyroidectomy (TTx) for differentiated thyroid carcinoma (DTC) was studied. These patients were followed up from a minimum of 2-3 years, to a maximum of 15-20 years, and calcemic status was ascertained at varying times following their surgery and radioiodine ( 131 ) therapy

  20. Predicting thyroxine requirements following total thyroidectomy.

    Science.gov (United States)

    Mistry, Dipan; Atkin, Stephen; Atkinson, Helen; Gunasekaran, Sinnappa; Sylvester, Deborah; Rigby, Alan S; England, R James

    2011-03-01

    Optimal thyroxine replacement following total thyroidectomy is critical to avoid symptoms of hypothyroidism. The aim of this study was to determine the best formula to determine the initiated replacement dose of levothyroxine immediately following total thyroidectomy. Prospective study. All patients were initiated on 100 μg levothyroxine and titrated to within the reference range for TSH and free T4. Correlations to height, weight, age, lean body mass (LBM), body surface area (BSA) and body mass index (BMI) were calculated. One hundred consecutive adult patients underwent total thyroidectomy for non-malignant disease. Comparison between three methods of levothyroxine dose prediction, aiming for a levothyroxine dose correct to within 25 μg of actual dose required. Correlations were seen between levothyroxine dose and patient age (r=-0.346, Pregression equation was calculated (predicted levothyroxine dose=[0·943 × bodyweight] + [-1.165 × age] + 125.8), simplified to (levothyroxine dose= bodyweight - age + 125) pragmatically. Initiating patients empirically on 100 μg post-operatively showed that 40% of patients achieved target within 25 μg of their required dose; this increased to 59% when using a weight-only dose calculation (1.6 μg/kg) and to 72% using the simplified regression equation. A simple calculated regression equation gives a more accurate prediction of initiated levothyroxine dose following total thyroidectomy, reducing the need for outpatient attendance for dose titration. © 2011 Blackwell Publishing Ltd.

  1. Total Quality Management in Libraries. ERIC Digest.

    Science.gov (United States)

    Masters, Denise G.

    Total Quality Management (TQM) is "a system of continuous improvement employing participative management and centered on the needs of customers." Key components of TQM are employee involvement and training, problem-solving teams, statistical methods, long-term goals and thinking, and recognition that the system, not people, produces…

  2. Total spectral distributions from Hawking radiation

    Energy Technology Data Exchange (ETDEWEB)

    Broda, Boguslaw [University of Lodz, Department of Theoretical Physics, Faculty of Physics and Applied Informatics, Lodz (Poland)

    2017-11-15

    Taking into account the time dependence of the Hawking temperature and finite evaporation time of the black hole, the total spectral distributions of the radiant energy and of the number of particles have been explicitly calculated and compared to their temporary (initial) blackbody counterparts (spectral exitances). (orig.)

  3. Accumulation pattern of total nonstructural carbohydrate in ...

    African Journals Online (AJOL)

    Umukoro

    1977-09-09

    Sep 9, 1977 ... 1Instituto Nacional de Tecnología Agropecuaria (INTA), EEA Famaillá, Argentina. 2Department of Plant Sciences, University of California Davis, CA, USA. Accepted 17 October, 2012. The pattern of total nonstructural carbohydrate (TNC) accumulation in strawberry (Fragaria ananassa. Duch.) nursery ...

  4. Concepts of total quality management in radiology

    International Nuclear Information System (INIS)

    Pratik Kumar

    2003-01-01

    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

  5. Total pressing Indonesian gas development, exports

    International Nuclear Information System (INIS)

    Anon.

    1994-01-01

    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

  6. Adapting Total Quality Management (TQM) to Government.

    Science.gov (United States)

    Swiss, James E.

    1992-01-01

    Total quality management will not work well in government agencies because of stress on products, not services; on well-defined consumer groups; on inputs/processes, not results; and on preoccupation with quality. An effective revised version emphasizes client feedback, performance monitoring, continuous improvement, and worker participation. (SK)

  7. 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…

  8. Total hip reconstruction in acetabular dysplasia.

    NARCIS (Netherlands)

    Schller, H.M.; Dalstra, M.; Huiskes, R.; Marti, R.K.

    1993-01-01

    In acetabular dysplasia, fixation of the acetabular component of a cemented total hip prosthesis may be insecure and superolateral bone grafts are often used to augment the acetabular roof. We used finite element analysis to study the mechanical importance of the lateral acetabular roof and found

  9. Total Quality Management in Libraries: A Sourcebook.

    Science.gov (United States)

    O'Neil, Rosanna M., Comp.

    Total Quality Management (TQM) brings together the best aspects of organizational excellence by driving out fear, offering customer-driven products and services, doing it right the first time by eliminating error, and maintaining inventory control without waste. Libraries are service organizations which are constantly trying to improve service.…

  10. The Total Synthesis of Cephalosporin C

    Indian Academy of Sciences (India)

    IAS Admin

    The Total Synthesis of Cephalosporin C. Edited by Setty Mallikarjuna Babu and Subramania Ranganathan. Keywords. Cephalosporin C. The Nobel Prize in Chemistry for 1965 has been awarded for contributions to the art of chemical synthesis. It gives me much pleasure to record here my gratification with the citation, ...

  11. Total Body Opacification 'Technique Neonatal Adrenal Haemorrhage

    African Journals Online (AJOL)

    1971-12-11

    Dec 11, 1971 ... A case is reported illustrating the possible usefulness of total body opacification in the diagnosis of neonatal adrenal haemorrhage. To derive maximum benefit from this principle, the routine use of an early film coupled with high dosage is urged whenever an intravenous pyelogram is performed for ...

  12. [Contents of total flavonoids in Rhizoma Arisaematis].

    Science.gov (United States)

    Du, S S; Lin, H Y; Zhou, Y X; Wei, L X

    2001-06-01

    Comparing the contents of total flavonoides of Rhizoma Arisaematis, which collected in different time, regions, different varieties and processed. Determining the contents by ultraviolet spectro-photometry. The contents were found in the following sequence: 1. the end of July, the begin of July, August, September; 2. Beijing, Shanxi, Sichuan, Anhui; 3. Arisaema erubenscens, A. heterophyllum, A. amurense; 4. unprocessed product, processed product.

  13. Total cross section results for deuterium electrodisintegration

    International Nuclear Information System (INIS)

    Skopik, D.M.; Murphy, J.J. II; Shin, Y.M.

    1976-01-01

    Theoretical total cross sections for deuterium electrodisintegration are presented as a function of incident electron energy. The cross section has been calculated using virtual photon theory with Partovi's photodisintegration calculation for E/subx/ > 10 MeV and effective range theory for E/subx/ 2 H(e, n) reaction in Tokamak reactors

  14. Total hip arthroplasty for giant cell tumour.

    Directory of Open Access Journals (Sweden)

    Kulkarni S

    1996-07-01

    Full Text Available A 32 month follow up of an uncommon case of a Giant Cell Tumour affecting the proximal end of femur is presented. Following a wide excision, the hip was reconstructed using Charnley type of low friction total hip arthroplasty. At a 32 month review, there was no recurrence and the function was good.

  15. 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.

  16. 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.

  17. 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 …

  18. Diagnosing Total Quality Management. Part I

    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

  19. 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

  20. Accumulation pattern of total nonstructural carbohydrate in ...

    African Journals Online (AJOL)

    The pattern of total nonstructural carbohydrate (TNC) accumulation in strawberry (Fragaria ananassa Duch.) nursery runner plants, cv. eCamarosaf, was determined for three growing seasons. Plant growth and fruit production patterns were also evaluated. The experiments were carried out on plants propagated in high ...

  1. 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...

  2. 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

  3. Feasibility study of transanal total mesorectal excision

    NARCIS (Netherlands)

    Velthuis, S.; Boezem, P.B. van den; Peet, D.L. van der; Cuesta, M.A.; Sietses, C.

    2013-01-01

    BACKGROUND: Laparoscopic resection of colorectal cancers is a safe alternative to open surgery. The conversion rate to open surgery remains fairly constant but is associated with increased morbidity. A new approach to the surgical excision of rectal cancer is transanal total mesorectal excision

  4. TOTAL HIP REPLACEMENTS AT KIKUYU HOSPITAL, KENYA

    African Journals Online (AJOL)

    equipments, few trained personnel and the high cost of implants. It is mainly in the ..... function more affected than the sensory a day after. There was a foot drop. .... 60: Issue 2, 217-. 220. 13. NIH Consensus Development Panel on Total Hip.

  5. Total Survey Error for Longitudinal Surveys

    NARCIS (Netherlands)

    Lynn, Peter; Lugtig, P.J.

    2016-01-01

    This article describes the application of the total survey error paradigm to longitudinal surveys. Several aspects of survey error, and of the interactions between different types of error, are distinct in the longitudinal survey context. Furthermore, error trade-off decisions in survey design and

  6. Food safety and total quality management

    NARCIS (Netherlands)

    Barendsz, A.W.

    1998-01-01

    Food safety is a growing global concern not only because of its continuing importance for public health but also because of its impact on international trade. The application of total quality management (TQM) provides the best possible care by continuously improving products and services to meet or

  7. Total pancreatic lipomatosis with malabsorption syndrome

    Directory of Open Access Journals (Sweden)

    Rama Anand

    2011-01-01

    Full Text Available Total fat replacement of the pancreas is rare. Focal fatty replacement is the most common degenerative lesion of pancreas. Focal fatty deposits have no major clinical significance; however, extreme fat replacement is of pathologic significance, as it is associated with marked reduction in exocrine function of pancreas, resulting in malabsorption due to pancreatic enzyme insufficiency.

  8. 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...

  9. Total energy calculations and bonding at interfaces

    International Nuclear Information System (INIS)

    Louie, S.G.

    1984-08-01

    Some of the concepts and theoretical techniques employed in recent ab initio studies of the electronic and structural properties of surfaces and interfaces are discussed. Results of total energy calculations for the 2 x 1 reconstructed diamond (111) surface and for stacking faults in Si are reviewed. 30 refs., 8 figs

  10. Trying and the Arguments from Total Failure

    DEFF Research Database (Denmark)

    Grünbaum, Thor

    2008-01-01

    New Volitionalism is a name for certain widespread conception of the nature of intentional action. Some of the standard arguments for New Volitionalism, the so-called arguments from total failure, have even acquired the status of basic assumptions for many other kinds of philosophers. It is there...

  11. A formal model for total quality management

    NARCIS (Netherlands)

    S.C. van der Made-Potuijt; H.B. Bertsch (Boudewijn); L.P.J. Groenewegen

    1996-01-01

    textabstractTotal Quality Management (TQM) is a systematic approach to managing a company. TQM is systematic in the sense that it is uses facts through observation, analysis and measurable goals. There are theoretical descriptions of this management concept, but there is no formal model of it. A

  12. Multicultural Leadership, Sustainable Total School Environment

    Science.gov (United States)

    Yeung, See-Wai Alison; Lee, Yeung; Yue, K. W. Ryan

    2006-01-01

    Banks (2002) stated that to implement multicultural education successfully, we must think of the school as a social system. Therefore, if educational equity and excellence are to be provided to all students, a systemic Total School Environment [Banks (2001) "Cultural diversity and education: Foundations curriculum and teaching, 4th ed." Allyn and…

  13. Recurrent hemarthrosis after total knee arthroplasty

    NARCIS (Netherlands)

    Rukavina, A.; Kerkhoffs, G.M.M.J.; Schneider, P.; Kuster, M.S.

    2010-01-01

    This report describes a case of spontaneous recurrent hemarthrosis of the knee that presented 4 weeks after total knee arthroplasty. Femoral arteriography showed a false aneurysm of a branch of the inferior lateral geniculate artery. Therapeutic embolization of the arterial branch was performed

  14. An approach to total quality assurance

    International Nuclear Information System (INIS)

    Archer, L.G.

    1976-01-01

    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)

  15. On total noncommutativity in quantum mechanics

    Science.gov (United States)

    Lahti, Pekka J.; Ylinen, Kari

    1987-11-01

    It is shown within the Hilbert space formulation of quantum mechanics that the total noncommutativity of any two physical quantities is necessary for their satisfying the uncertainty relation or for their being complementary. The importance of these results is illustrated with the canonically conjugate position and momentum of a free particle and of a particle closed in a box.

  16. Flavonoid, hesperidine, total phenolic contents and antioxidant ...

    African Journals Online (AJOL)

    Additionally, the antioxidant activities were also determined by ferric reducing antioxidant power (FRAP) and 1,1-diphenyl-2-picryl hydrazyl (DPPH) radical scavenging activity. C. hystrix had the highest flavonoid and total phenolic contents while C. aurantifolia had the highest hesperidine content. The antioxidant activity of ...

  17. Total dissolved carbohydrate in Mahi river estuary

    Digital Repository Service at National Institute of Oceanography (India)

    Bhosle, N.B.; Rokade, M.A.; Zingde, M.D.

    Total dissolved carbohydrate varied from 4.37-15 mg l-1 and 3.71-15.95 mg l-1 in the surface and bottom samples respectively. Highest concentration of carbohydrate was observed at station 1 which decreased downward upto Station 6 which showed...

  18. Total Evidence, Uncertainty and A Priori Beliefs

    NARCIS (Netherlands)

    Bewersdorf, Benjamin; Felline, Laura; Ledda, Antonio; Paoli, Francesco; Rossanese, Emanuele

    2016-01-01

    Defining the rational belief state of an agent in terms of her initial or a priori belief state as well as her total evidence can help to address a number of important philosophical problems. In this paper, I discuss how this strategy can be applied to cases in which evidence is uncertain. I argue

  19. Total and the Algerian shale gas

    International Nuclear Information System (INIS)

    Chapelle, Sophie; Petitjean, Olivier; Maurin, Wilfried; Balvet, Jacqueline; Combes, Maxime; Geze, Francois; Hamouchene, Hamza; Hidouci, Ghazi; Malti, Hocine; Renaud, Juliette; Simon, Antoine; Titouche, Fateh

    2015-01-01

    This publication proposes a rather detailed and discussed overview of the movement of mobilisation of Algerian people (notably those living in the Sahara) against projects of exploration and exploitation of shale gases in Algeria by the Total group. The authors also recall and comment the long and heavy history of hydrocarbon management in Algeria, the role of international firms and of western interests (notably French interests) in this country, and the position of Total regarding the stake related to shale gases. The authors outline problems created by shale gas exploitation regarding water consumption and waste waters. They also notice that the safety of wells is at the centre of the protest. Problems raised by hydraulic fracturing are reviewed: seismic activity, chemical pollution, air pollution and greenhouse gases, landscape destruction. The attitude of the Algerian government is commented. Then, the authors try to identify and describe the action of Total in the Algerian shale gas sector, discuss the possible French influence, and outline the presence of Total all over the world in this sector

  20. LAMBDA p total cross-section measurement

    CERN Multimedia

    CERN PhotoLab

    1970-01-01

    A view of the apparatus used for the LAMBDA p total cross-section measurement at the time of its installation. The hyperons decaying into a proton and a pion in the conical tank in front were detected in the magnet spectrometer in the upper half of the picture. A novel detection technique using exclusively multiwire proportional chambers was employed.

  1. Extracorporeal total artificial heart as bailout surgery.

    Science.gov (United States)

    Perrodin, Stéphanie F; Muller, Olivier; Gronchi, Fabrizio; Liaudet, Lucas; Hullin, Roger; Kirsch, Matthias

    2017-03-01

    We report the use of a total extracorporeal heart for uncontrolled bleeding following a proximal left anterior descending artery perforation, using two centrifugal ventricular assist devices after heart explantation. The literature describing similar techniques and patient outcomes for this "bailout" technique are reviewed. © 2017 Wiley Periodicals, Inc.

  2. Benchmarking, Total Quality Management, and Libraries.

    Science.gov (United States)

    Shaughnessy, Thomas W.

    1993-01-01

    Discussion of the use of Total Quality Management (TQM) in higher education and academic libraries focuses on the identification, collection, and use of reliable data. Methods for measuring quality, including benchmarking, are described; performance measures are considered; and benchmarking techniques are examined. (11 references) (MES)

  3. Salinity: Electrical conductivity and total dissolved solids

    Science.gov (United States)

    The measurement of soil salinity is a quantification of the total salts present in the liquid portion of the soil. Soil salinity is important in agriculture because salinity reduces crop yields by reducing the osmotic potential making it more difficult for the plant to extract water, by causing spe...

  4. Total Quality Management: Implications for Educational Assessment.

    Science.gov (United States)

    Rankin, Stuart C.

    1992-01-01

    Deming's "System of Profound Knowledge" is even more fundamental than his 14-principle system transformation guide and is based on 4 elements: systems theory, statistical variation, a theory of knowledge, and psychology. Management should revamp total system processes so that quality of product is continually improved. Implications for…

  5. 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…

  6. Staff Development and Total Quality Management.

    Science.gov (United States)

    Norris, Gerald L.; Norris, Joye H.

    Professional development is an emerging view of faculty development that places teachers in charge of their own professional growth. The emergence of Total Quality Management (TQM) provides a vehicle for designing professional development to meet the needs of individuals and the organizations that employ them. The eight tenets of Deming's theory…

  7. Curriculum Transformation through Total Quality Management.

    Science.gov (United States)

    Edwards, Barbara; Algozzine, Bob

    1995-01-01

    Describes a massive cultural transformation project at two Charlotte, North Carolina, elementary schools that used Deming's total quality management principles to restructure curricula according to Boyer's eight commonalities of learning. Shows how the FADE (focus, analyze, develop, and execute) model was used to develop a well-coordinated,…

  8. 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…

  9. 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. ...

  10. A Modern Approach to Total Wellbeing

    Science.gov (United States)

    Hadzic, Maja; Chen, Meifania; Brouwer, Rick; Dillon, Tharam

    The events of the last decades have impacted our lives and our health significantly. We expected that the technology boom will improve our lives. While this may be true in a specific context, generally speaking our societies are suffering from moral decays, terrorism fears, wars, financial crisis and unpredictable acts of nature that are increasing in frequency and in intensity. The complex nature of the world we live is impacting our health and wellbeing considerably. Our health is not only determined by our physical health but is the end product of the interplay of the physical, mental, emotional, financial, relational and spiritual events of a lifetime. In this paper we develop a framework that will help us define and measure total wellbeing of individuals in our volatile societies. This framework will help us better understand the complex nature of total wellbeing and develop effective prevention and intervention strategies.

  11. Quality Indicators for the Total Testing Process.

    Science.gov (United States)

    Plebani, Mario; Sciacovelli, Laura; Aita, Ada

    2017-03-01

    ISO 15189:2012 requires the use of quality indicators (QIs) to monitor and evaluate all steps of the total testing process, but several difficulties dissuade laboratories from effective and continuous use of QIs in routine practice. An International Federation of Clinical Chemistry and Laboratory Medicine working group addressed this problem and implemented a project to develop a model of QIs to be used in clinical laboratories worldwide to monitor and evaluate all steps of the total testing process, and decrease error rates and improve patient services in laboratory testing. All laboratories are invited, at no cost, to enroll in the project and contribute to harmonized management at the international level. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Total gastrectomy for non-neoplastic diseases

    DEFF Research Database (Denmark)

    Bjorn, Niels; Ainsworth, Alan Patrick; Mortensen, Michael Bau

    2017-01-01

    Background: The aim of this study was to describe patients who had total gastrectomy for non-neoplastic diseases within a well-defined geographical area. Material and Methods: Retrospective study of patients who had gastrectomy for a non-neoplastic disease at the Department of Surgery, Odense...... University Hospital from 1 January 2005 to 31 December 2014. Results: A total of 268 gastrectomies were performed with the 10-year period. Of these, ten (4%) were done for non-neoplastic diseases. Two were men and eight women with a median age of 51 years (range 31 to 96 years). Six had emergency surgery...... of 10 and 2 of 10, respectively. Histology of the resected specimens showed: Oedema, inflammation and/or necrosis (n=6), Menetrier's disease (n=2) and perforation (n=2). Conclusions: Gastrectomy for non-neoplastic diseases accounts for less than 5% of all gastrectomies. The majority of these cases...

  13. Atomic resonances above the total ionization energy

    International Nuclear Information System (INIS)

    Doolen, G.

    1975-01-01

    A rigorous result obtained using the theory associated with dilatation analytic potentials is that by performing a complex coordinate rotation, r/subj/ → r/subj/e/subi//sup theta/, on a Hamiltonian whose potential involves only pairwise Coulombic interactions, one can show that when theta = π/2, no complex eigenvalues (resonances) appear whose energies have a real part greater than the total ionization energy of the atomic system. This appears to conflict with experimental results of Walton, Peart, and Dolder, who find resonance behavior above the total ionization energy of the H -- system and also the theoretical stabilization results of Taylor and Thomas for the same system. A possible resolution of this apparent conflict is discussed and a calculation to check its validity is proposed

  14. Total: overview of the 2002 financial year

    International Nuclear Information System (INIS)

    Anon.

    2003-01-01

    In a globally less favourable environment than 2001, Total company (the former 'TotalFinaElf') succeeded in limiting the decay of its results thanks to the increase of its hydrocarbons production which reached the record level of 10% and to the implementation of its synergy and productivity programs. The three activity sectors of the group are: the upstream (exploration, production of hydrocarbons, gas electric power and other energies), the downstream (refining, distribution of petroleum products, special products, trading and shipping of crudes and products), and the chemistry (basic chemistry and big polymers, intermediate and performance polymers, special products). This article details the 2002 results of the group for the three sectors: upstream (exploration and development, reserves, production, natural gas sales), gas and electric power integration (Europe, Americas, Asia), electric power and cogeneration. (J.S.)

  15. Asymptotic Behaviour of Total Generalised Variation

    KAUST Repository

    Papafitsoros, Konstantinos; Valkonen, Tuomo

    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

  16. Total quality management of cobalt-60 sources

    International Nuclear Information System (INIS)

    Malkoske, G.R.

    1999-01-01

    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

  17. Total variation-based neutron computed tomography

    Science.gov (United States)

    Barnard, Richard C.; Bilheux, Hassina; Toops, Todd; Nafziger, Eric; Finney, Charles; Splitter, Derek; Archibald, Rick

    2018-05-01

    We perform the neutron computed tomography reconstruction problem via an inverse problem formulation with a total variation penalty. In the case of highly under-resolved angular measurements, the total variation penalty suppresses high-frequency artifacts which appear in filtered back projections. In order to efficiently compute solutions for this problem, we implement a variation of the split Bregman algorithm; due to the error-forgetting nature of the algorithm, the computational cost of updating can be significantly reduced via very inexact approximate linear solvers. We present the effectiveness of the algorithm in the significantly low-angular sampling case using synthetic test problems as well as data obtained from a high flux neutron source. The algorithm removes artifacts and can even roughly capture small features when an extremely low number of angles are used.

  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. 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.

  20. Implantation of total body irradiation in radiotherapy

    International Nuclear Information System (INIS)

    Habitzreuter, Angela Beatriz

    2010-01-01

    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)

  1. Overview of Total Group financial year

    International Nuclear Information System (INIS)

    Anon.

    2003-01-01

    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.)

  2. Total quality management in hotel industry

    OpenAIRE

    Mitreva, Elizabeta; Saneva, Dusica; Miteva, Natasa

    2017-01-01

    Total quality management (TQM) is a systematic management approach aiming at continuous increase of the value offered to consumers through improvement of service quality. In hotel industry, success is achieved through service quality, which stands as a key factor for sustainability in the twenty-first century. Nowadays, quality is the basic factor for survival on the market, better competition, and greater profitability. TQM is a process that starts and ends with the consumer. The aim of this...

  3. Total Quality Management. A Selected Bibliography

    Science.gov (United States)

    1994-03-01

    and Publow, Mark. "Understanding and Managing Authority Relationships : Guidelines for Supervisors and Sub- ordinates." QUALITY PROGRESS, Vol. 25...NEXT OPERATION AS CUSTOMER (NOAC): HOW TO IMPROVE QUALITY, COST AND CYCLE TIME IN SERVICE OPERATIONS. New York: American Management Association, 1991...Keith. HORIZONTAL MANAGEMENT : BEYOND TOTAL CUSTOMER SATISFACTION. New York: Lexington Books, 1991. 211pp. (HD66 D45 1991) Donnelly, James H., Jr. CLOSE

  4. Changing trends in total knee replacement

    OpenAIRE

    Goudie, Ewan; Robinson, Cal; Walmsley, Phil; Brenkel, Ivan

    2017-01-01

    Introduction:  This study evaluates a possible change in the demographics and surgical practice observed in a large cohort of patients undergoing total knee replacement (TKR). Patients and methods:  We performed a retrospective analysis of a prospectively collected data on two groups of consecutive patients undergoing primary TKR. Group one consisted of patients who underwent surgery between 1994 and 1998. Group two consisted of patients who had surgery between 2009 and 2012. Results:  The me...

  5. Total Quality Management (TQM): Group Dynamics Workshop

    Science.gov (United States)

    1990-05-15

    take for these changes to penetrate most OSD agencies. - The unique organizational culture, structure, and functioning of OSD (i.e., a gigantic size...Performing (group problem solving; Performing diagnosing and solving quality problems and sele2cting and implementing solutions). Total Quality Management...Stage, the quality improvement group diagnoses the quality problem/opportunity, gathers the right kind of quantitative data, and formulates, selects, and

  6. Total dissociation cross section of halo nuclei

    Energy Technology Data Exchange (ETDEWEB)

    Formanek, J. [Karlova Univ., Prague (Czech Republic). Fakulta Matematicko-Fyzikalni; Lombard, R.J. [Paris-11 Univ., 91 - Orsay (France). Inst. de Physique Nucleaire

    1996-10-01

    Calculations of the total dissociation cross section is performed in the impact parameter representation. The case of {sup 11}Be and {sup 11}Li loosing one and two neutron(s), respectively, by collision on a {sup 12}C target, which remains in its ground state are discussed. The results are found to depend essentially on the rms radius of the halo wave function. (author). 12 refs.

  7. The First Total Synthesis of Dragmacidin D

    OpenAIRE

    Garg, Neil K.; Sarpong, Richmond; Stoltz, Brian M.

    2002-01-01

    The first total synthesis of the biologically significant bis-indole alkaloid dragmacidin D (5) has been achieved. Thermal and electronic modulation provides the key for a series of palladium-catalyzed Suzuki cross-coupling reactions that furnished the core structure of the complex guanidine- and aminoimidazole-containing dragmacidins. Following this crucial sequence, a succession of meticulously controlled final events was developed leading to the completion of the natural product.

  8. 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

  9. Heisenberg rise of total cross sections

    International Nuclear Information System (INIS)

    Ezhela, V.V.; Yushchenko, O.P.

    1988-01-01

    It is shown that on the basis of the original idea of Heisenberg on the quasiclassical picture of extended particle interactions one can construct a satisfactory description of the total cross sections, elastic cross sections, elastic diffractive slopes and mean charged multiplicities in the cm energy range from 5 to 900 GeV, and produce reasonable extrapolations up to several tens of TeV. 14 refs.; 7 figs.; 2 tabs

  10. 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.)

  11. 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.

  12. Apparatus for measuring total flow in pipes

    International Nuclear Information System (INIS)

    Matthews, H.

    1986-01-01

    To obtain a sample representative of the total flow in a pipe over a given period a Pitot tube is located in the pipe and connected to a collector outside the pipe. The collector is pressurised to a pressure substantially equal to the static head of the flow in the pipe via a line. Liquid is discharged from a collector to a container which is vented to atmosphere. (author)

  13. Total evaporation in thermal ionization mass spectrometry

    International Nuclear Information System (INIS)

    Callis, E.L.; Cappis, J.H.

    1996-01-01

    Experiments were conducted to assess the effects of impurities on the total evaporation method for mass spectrometric measurement of the isotope ratio of uranium. Standard samples were spiked with Na, Ca, Fe, Zr and Ba. The results indicated that only Fe, and possible Na, displayed any interference, and then only at high concentrations. One problem limiting the accuracy of the method is the determination of the relative efficiency of the collectors in the multicollector system. 3 refs., 1 tab

  14. 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.)

  15. Total fact-book 2000-2005

    International Nuclear Information System (INIS)

    2005-01-01

    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.)

  16. Calidad total: fuente de ventaja competitiva

    OpenAIRE

    Tarí, Juan-José

    2000-01-01

    El objeto de este trabajo es analizar la dirección de la calidad estudiando sus pilares básicos como son, la planificación, organización y control por un lado y los aspectos humanos por otro, centrándonos en sus dos elementos clave para desarrollar la calidad total: el liderazgo y la involucración de todos los empleados.

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

    Science.gov (United States)

    Sulake, Rohidas S; Chen, Chinpiao

    2015-03-06

    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.

  18. Multi sensor reanalysis of total ozone

    Directory of Open Access Journals (Sweden)

    R. J. van der A

    2010-11-01

    Full Text Available A single coherent total ozone dataset, called the Multi Sensor Reanalysis (MSR, has been created from all available ozone column data measured by polar orbiting satellites in the near-ultraviolet Huggins band in the last thirty years. Fourteen total ozone satellite retrieval datasets from the instruments TOMS (on the satellites Nimbus-7 and Earth Probe, SBUV (Nimbus-7, NOAA-9, NOAA-11 and NOAA-16, GOME (ERS-2, SCIAMACHY (Envisat, OMI (EOS-Aura, and GOME-2 (Metop-A have been used in the MSR. As first step a bias correction scheme is applied to all satellite observations, based on independent ground-based total ozone data from the World Ozone and Ultraviolet Data Center. The correction is a function of solar zenith angle, viewing angle, time (trend, and effective ozone temperature. As second step data assimilation was applied to create a global dataset of total ozone analyses. The data assimilation method is a sub-optimal implementation of the Kalman filter technique, and is based on a chemical transport model driven by ECMWF meteorological fields. The chemical transport model provides a detailed description of (stratospheric transport and uses parameterisations for gas-phase and ozone hole chemistry. The MSR dataset results from a 30-year data assimilation run with the 14 corrected satellite datasets as input, and is available on a grid of 1× 1 1/2° with a sample frequency of 6 h for the complete time period (1978–2008. The Observation-minus-Analysis (OmA statistics show that the bias of the MSR analyses is less than 1% with an RMS standard deviation of about 2% as compared to the corrected satellite observations used.

  19. TOTAL QUALITY MANAGEMENT AND CONTEMPORARY HOTEL INDUSTRY

    OpenAIRE

    Ivica Batinić

    2013-01-01

    Strong competition in the market has caused the development of a new management approach known as Total Quality Management (TQM). Due to importance that quality plays in achieving competitive advantage, the hotel industry started to apply TQM. During the introduction of these systems, hotel companies may use different approaches to suit their own buseiness requirements. In doing so, 'TQM standards' can be used, or various international standards and models of business ...

  20. Climate Change and Tropical Total Lightning

    Science.gov (United States)

    Albrecht, R.; Petersen, W.; Buechler, D.; Goodman, S.; Blakeslee, R.; Christian, H.

    2009-01-01

    While global warming is regarded as a fact by many in the scientific community, its future impact remains a challenge to be determined and measured. The International Panel on Climate Change (IPCC) assessment report (IPCC, 2007) shows inconclusive answers on global rainfall trends and general agreement on a future drier climate with increased global warming. The relationship between temperature, humidity and convection is not linear and is strongly dependent on regional scale features, such as topography and land cover. Furthermore, the relationship between convective lightning production (thunderstorms) and temperature is even more complicated, being subjected to the cloud dynamics and microphysics. Total lightning (intracloud and cloud-to-ground) monitoring is a relatively new field of observation. Global and tropical total lightning began to be more extensively measured by satellites in the mid 90s. In this scope, the Lightning Imaging Sensor (LIS) onboard of the Tropical Rainfall Measurement Mission (TRMM) has been operational for over 11 years. Here we address total lightning trends observed by LIS from 1998 to 2008 in different temporal (annual and seasonal) and spatial (large and regional) scales. The observed 11-year trends are then associate to different predicted/hypothesized climate change scenarios.

  1. Total generating costs: coal and nuclear plants

    International Nuclear Information System (INIS)

    1979-02-01

    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 Variation Depth for Functional Data

    KAUST Repository

    Huang, Huang

    2016-11-15

    There has been extensive work on data depth-based methods for robust multivariate data analysis. Recent developments have moved to infinite-dimensional objects such as functional data. In this work, we propose a new notion of depth, the total variation depth, for functional data. As a measure of depth, its properties are studied theoretically, and the associated outlier detection performance is investigated through simulations. Compared to magnitude outliers, shape outliers are often masked among the rest of samples and harder to identify. We show that the proposed total variation depth has many desirable features and is well suited for outlier detection. In particular, we propose to decompose the total variation depth into two components that are associated with shape and magnitude outlyingness, respectively. This decomposition allows us to develop an effective procedure for outlier detection and useful visualization tools, while naturally accounting for the correlation in functional data. Finally, the proposed methodology is demonstrated using real datasets of curves, images, and video frames.

  3. Total quality in spent fuel pool reracking

    International Nuclear Information System (INIS)

    Cranston, J.S.; Bradbury, R.B.; Cacciapouti, R.J.

    1993-01-01

    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

  4. Liver failure in total artificial heart therapy.

    Science.gov (United States)

    Dimitriou, Alexandros Merkourios; Dapunt, Otto; Knez, Igor; Wasler, Andrae; Oberwalder, Peter; Koerfer, Reiner; Tenderich, Gero; Spiliopoulos, Sotirios

    2016-07-01

    Congestive hepatopathy (CH) and acute liver failure (ALF) are common among biventricular heart failure patients. We sought to evaluate the impact of total artificial heart (TAH) therapy on hepatic function and associated clinical outcomes. A total of 31 patients received a Syncardia Total Artificial Heart. Preoperatively 17 patients exhibited normal liver function or mild hepatic derangements that were clinically insignificant and did not qualify as acute or chronic liver failure, 5 patients exhibited ALF and 9 various hepatic derangements owing to CH. Liver associated mortality and postoperative course of liver values were prospectively documented and retrospectively analyzed. Liver associated mortality in normal liver function, ALF and CH cases was 0%, 20% (P=0.03) and 44.4% (P=0.0008) respectively. 1/17 (5.8%) patients with a normal liver function developed an ALF, 4/5 (80%) patients with an ALF experienced a markedly improvement of hepatic function and 6/9 (66.6%) patients with CH a significant deterioration. TAH therapy results in recovery of hepatic function in ALF cases. Patients with CH prior to surgery form a high risk group with increased liver associated mortality.

  5. The error in total error reduction.

    Science.gov (United States)

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

    2014-02-01

    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 is correlated with the total error signal in models of reward learning. Similar neural mechanisms presumably support fear conditioning, human contingency learning, and other types of learning. Using a computational modeling approach, we compared several TER models of associative learning to an alternative model that rejects the TER assumption in favor of local error reduction (LER), which assumes that learning about each cue is proportional to the discrepancy between the delivered outcome and the outcome predicted by that specific cue on that trial. The LER model provided a better fit to the reviewed data than the TER models. Given the superiority of the LER model with the present data sets, acceptance of TER should be tempered. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. 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].

  7. The pathogenesis of primary biliary cirrhosis Patogénesis en cirrosis biliar primaria

    Directory of Open Access Journals (Sweden)

    J. A. Solís Herruzo

    2009-06-01

    Full Text Available Primary biliary cirrhosis (PBC would develop when the immune system comes across a microorganism with proteins similar to those in the piruvate dehydrogenase complex E2 (PDC-E2, or a neoantigen resulting from a xenobiotic-modified autoantigen. This would lead to an innate immune response where TLRs would play a pivotal mediating role, which would give rise to a local microenvironment favoring an adaptive immune response. Such response would be particularly strong in individuals with selected genetic characteristics. The genetic characteristics underlying this predisposition remain unknown, but they likely entail small numbers of scarcely-active regulatory T cells. The AE2 anion exchanger, which is deficient in patients with PBC, may reduce the number and activity of regulatory T cells. NK cells are also pivotal in the preparation of an adaptive response, as they release a number of cytokines and chemokines that favor and recruit antigen-presenting cells to activate B and T cells - CD4+ Th1 and CD8+. An activation of the former would increase the production of IgM and anti-mitochondrial IgG and IgA antibodies against PDC-E2. An activation of CD8+ cells, also sensitive to PDC-2 as aberrantly expressed on the surface of BECs and SECs, would result in apoptosis for these epithelial cells, and in small bile-duct destruction. Immune response is likely inadequately suppressed because of the small numbers of scarcely-active regulatory T cells, the latter resulting from low genetic expression and activity of the AE2 transporter.

  8. Vólvulo da vesícula biliar tratado por colecistectomia laparoscópica

    Directory of Open Access Journals (Sweden)

    Júlio Cezar Uili Coelho

    Full Text Available Our objective is to report a case of gallbladder torsion treated by laparoscopic cholecystectomy. A 87 year old patient presented with intense right upper quadrant pain, anorexia, nausea and vomiting. Murphy's sign was present at physical examination. Hemogram showed 9.200 leukocytes/mm³, with six bands. Ultrassonography showed a distended gallbladder, perivesicular fluid collection, wall edema, and sludge with stones inside. At laparoscopic cholecystectomy, there was a complete gallbladder torsion with areas of necrosis. There was no postoperative complication. Pathologic examination confirmed the diagnosis of acute calculous cholecystitis with areas of necrosis.

  9. 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.

  10. 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

  11. 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

  12. Fluorogenic membrane overlays to enumerate total coliforms, Escherichia coli, and total Vibrionaceae in shellfish and seawater

    Science.gov (United States)

    Three assays were developed to enumerate total coliforms, Escherichia coli, and total Vibrionaceae in shellfish and other foods and in seawater and other environmental samples. Assays involve membrane overlays of overnight colonies on non-selective agar plates to detect ß-glucuronidase and lysyl am...

  13. Total Radiosynthesis: Thinking outside "the box".

    Science.gov (United States)

    Liang, Steven H; Vasdev, Neil

    2015-09-01

    The logic of total synthesis transformed a stagnant state of medicinal and synthetic organic chemistry when there was a paucity of methods and reagents to synthesize drug molecules and/or natural products. Molecular imaging by positron emission tomography (PET) is now experiencing a renaissance in the way radiopharmaceuticals for molecular imaging are synthesized, however, a paradigm shift is desperately needed in the discovery pipeline to accelerate in vivo imaging studies. A significant challenge in radiochemistry is the limited choice of labeled reagents (or building blocks) available for the synthesis of novel radiopharmaceuticals with the most commonly used short-lived radionuclides carbon-11 ( 11 C; half-life ~20 minutes) and fluorine-18 ( 18 F; half-life ~2 hours). In fact, most drugs cannot be labeled with 11 C or 18 F due to a lack of efficient and diverse radiosynthetic methods. In general, routine radiopharmaceutical production relies on the incorporation of the isotope at the last or penultimate step of synthesis, ideally within one half-life of the radionuclide, to maximize radiochemical yields and specific activities thereby reducing losses due to radioactive decay. Reliance on radiochemistry conducted within the constraints of an automated synthesis unit ("box") has stifled the exploration of multi-step reactions with short-lived radionuclides. Radiopharmaceutical synthesis can be transformed by considering logic of total synthesis to develop novel approaches for 11 C- and 18 F-radiolabeling complex molecules via retrosynthetic analysis and multi-step reactions. As a result of such exploration, new methods, reagents and radiopharmaceuticals for in vivo imaging studies are discovered. A new avenue to develop radiotracers that were previously unattainable due to the lack of efficient radiosynthetic methods is necessary to work towards our ultimate, albeit impossible goal - the concept we term total radiosynthesis - to radiolabel virtually any molecule

  14. Total urogenital sinus mobilization for ambiguous genitalia.

    Science.gov (United States)

    Jesus, Vinicius Menezes; Buriti, Francisco; Lessa, Rodrigo; Toralles, Maria Betânia; Oliveira, Luciana Barros; Barroso, Ubirajara

    2018-04-01

    Genital ambiguity is a very common phenomenon in disorders of sex development (DSD). According to the Chicago Consensus 2006, feminizing genitoplasty, when indicated, should be performed in the most virilized cases (Prader III to V). Advances in the knowledge of genital anatomy in DSD have enabled the development and improvement of various surgical techniques. Mobilization of the urogenital sinus (MUS), first described by Peña, has become incorporated by most surgeons. However, the proximity of the urethral sphincter prompts concern over urinary incontinence, especially for full mobilization of the urogenital sinus. To retrospectively evaluate the short-term surgical results of feminizing genitoplasty with total mobilization of the urogenital sinus in patients with DSD. Review of medical records of all patients undergoing feminizing genitoplasty with mobilization of the urogenital sinus. We evaluated the rates of complications from surgery and of urinary incontinence, as well as cosmetic results, according to the opinion of the surgeon and the family. A total of 8 patients were included in the study. The mean age at surgery was 51months. Congenital adrenal hyperplasia (CAH) was diagnosed in six patients, and gonadal dysgenesis in the other two. The vagina was separated from the urethra, with suitable distance in all cases. No patient had urinary incontinence after surgery. The mean follow-up of patients was. 20months (3-56months). In all cases, surgeons recorded being satisfied with the aesthetic result of post-surgical genitalia. The family was recorded as satisfied with the aesthetic result of the genitalia after surgery. In every case, there was no need for a second surgical procedure. The total mobilization of the urogenital sinus is a feasible and safe technique. The technique permits good cosmetic results, and urinary incontinence is absent. Therapeutic study. Level III. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Assessment of total efficiency in adiabatic engines

    Science.gov (United States)

    Mitianiec, W.

    2016-09-01

    The paper presents influence of ceramic coating in all surfaces of the combustion chamber of SI four-stroke engine on working parameters mainly on heat balance and total efficiency. Three cases of engine were considered: standard without ceramic coating, fully adiabatic combustion chamber and engine with different thickness of ceramic coating. Consideration of adiabatic or semi-adiabatic engine was connected with mathematical modelling of heat transfer from the cylinder gas to the cooling medium. This model takes into account changeable convection coefficient based on the experimental formulas of Woschni, heat conductivity of multi-layer walls and also small effect of radiation in SI engines. The simulation model was elaborated with full heat transfer to the cooling medium and unsteady gas flow in the engine intake and exhaust systems. The computer program taking into account 0D model of engine processes in the cylinder and 1D model of gas flow was elaborated for determination of many basic engine thermodynamic parameters for Suzuki DR-Z400S 400 cc SI engine. The paper presents calculation results of influence of the ceramic coating thickness on indicated pressure, specific fuel consumption, cooling and exhaust heat losses. Next it were presented comparisons of effective power, heat losses in the cooling and exhaust systems, total efficiency in function of engine rotational speed and also comparison of temperature inside the cylinder for standard, semi-adiabatic and full adiabatic engine. On the basis of the achieved results it was found higher total efficiency of adiabatic engines at 2500 rpm from 27% for standard engine to 37% for full adiabatic engine.

  16. Mesh Excision: Is Total Mesh Excision Necessary?

    Science.gov (United States)

    Wolff, Gillian F; Winters, J Christian; Krlin, Ryan M

    2016-04-01

    Nearly 29% of women will undergo a secondary, repeat operation for pelvic organ prolapse (POP) symptom recurrence following a primary repair, as reported by Abbott et al. (Am J Obstet Gynecol 210:163.e1-163.e1, 2014). In efforts to decrease the rates of failure, graft materials have been utilized to augment transvaginal repairs. Following the success of using polypropylene mesh (PPM) for stress urinary incontinence (SUI), the use of PPM in the transvaginal repair of POP increased. However, in recent years, significant concerns have been raised about the safety of PPM mesh. Complications, some specific to mesh, such as exposures, erosion, dyspareunia, and pelvic pain, have been reported with increased frequency. In the current literature, there is not substantive evidence to suggest that PPM has intrinsic properties that warrant total mesh removal in the absence of complications. There are a number of complications that can occur after transvaginal mesh placement that do warrant surgical intervention after failure of conservative therapy. In aggregate, there are no high-quality controlled studies that clearly demonstrate that total mesh removal is consistently more likely to achieve pain reduction. In the cases of obstruction and erosion, it seems clear that definitive removal of the offending mesh is associated with resolution of symptoms in the majority of cases and reasonable practice. There are a number of complications that can occur with removal of mesh, and patients should be informed of this as they formulate a choice of treatment. We will review these considerations as we examine the clinical question of whether total versus partial removal of mesh is necessary for the resolution of complications following transvaginal mesh placement.

  17. Total internal reflection tomography of small objects

    International Nuclear Information System (INIS)

    Chen Xudong

    2008-01-01

    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.

  18. Qβ measurements with a total absorption detector

    International Nuclear Information System (INIS)

    Shibata, Michihiro; Kawade, Kiyoshi; Shindou, Terumasa; Kojima, Yasuaki; Taniguchi, Akihiro; Kawase, Yoichi; Ichikawa, Shin-ichi

    2003-01-01

    For Q β determination, we have developed a newly total absorption detector that can detect almost all radiation from the radioactive nuclei. The detector is composed of large volume and low background twin BGO scintillation detectors. The estimated efficiency is more than two orders of magnitude larger than those of Ge or Si detectors. The Q β s of some fission products of 235 U were successfully measured using an on-line mass separator for the first time (KUR-ISOL). We have proposed the possibility of determination Q β up to about 10 MeV using the detector without the knowledge of the decay scheme. (author)

  19. Nuclear war would cause total destruction

    International Nuclear Information System (INIS)

    Caldicott, H.

    1985-01-01

    In this paper, the author urges everyone to become better informed about the nuclear hazard humanity faces and challenges the reader to take action to ensure human survival on Earth. The author explains what would happen in the event of a nuclear war. Population centers would be smashed flat. Firestorms would rage over millions of acres. People near the center of the blast would die immediately. Those who survived would reenter a totally devastated world, lacking the life-support systems on which the human species depends. Epidemics would be rampant. Only if we abolish nuclear weapons and permanently halt the nuclear power industry can we hope to survive

  20. Total down to work for Chtokman's gas

    International Nuclear Information System (INIS)

    Labeyre, J.

    2008-01-01

    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.)

  1. Total quality management (TQM) in diagnostic radiology

    International Nuclear Information System (INIS)

    Rehani, M.M.

    1995-01-01

    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

  2. Total ankle arthroplasty: An imaging overview

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Da Rae; Choi, Yun Sun; Chun, Ka Young; Jung, Yoon Young; Kim, Jin Su; Young, Ki Won [Eulji Hospital, Eulji University, Seoul (Korea, Republic of); Potter, Hollis G.; Li, Angela E. [Dept. of Radiology and Imaging, Hospital for Special Surgery, New York (United States)

    2016-06-15

    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.

  3. 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

  4. THE TOTAL SOLAR IRRADIANCE CLIMATE DATA RECORD

    Energy Technology Data Exchange (ETDEWEB)

    Dewitte, Steven; Nevens, Stijn [Royal Meteorological Institute of Belgium, Ringlaan 3, B-1180 Brussels (Belgium)

    2016-10-10

    We present the composite measurements of total solar irradiance (TSI) as measured by an ensemble of space instruments. The measurements of the individual instruments are put on a common absolute scale, and their quality is assessed by intercomparison. The composite time series is the average of all available measurements. From 1984 April to the present the TSI shows a variation in phase with the 11 yr solar cycle and no significant changes of the quiet-Sun level in between the three covered solar minima.

  5. Hyperon magnetic moments and total cross sections

    International Nuclear Information System (INIS)

    Lipkin, H.J.

    1982-06-01

    The new data on both total cross sections and magnetic moments are simply described by beginning with the additive quark model in an SU(3) limit where all quarks behave like strange quarks and breaking both additivity and SU(3) simultaneously with an additional non-additive mechanism which affects only nonstrange quark contributions. The suggestion that strange quarks behave more simply than nonstrange may provide clues to underlying structure or dynamics. Small discrepancies in the moments are analyzed and shown to provide serious difficulties for most models if they are statistically significant. (author)

  6. Asymmetric Total Synthesis of Ieodomycin B

    Directory of Open Access Journals (Sweden)

    Shuangjie Lin

    2017-01-01

    Full Text Available Ieodomycin B, which shows in vitro antimicrobial activity, was isolated from a marine Bacillus species. A novel asymmetric total synthetic approach to ieodomycin B using commercially available geraniol was achieved. The approach involves the generation of 1,3-trans-dihydroxyl at C-3 and C-5 positions via a Crimmins-modified Evans aldol reaction and a chelation-controlled Mukaiyama aldol reaction of a p-methoxybenzyl-protected aldehyde, as well as the generation of a lactone ring in a deprotection–lactonization one-pot reaction.

  7. Contemporary pain management in total knee arthroplasty.

    Science.gov (United States)

    Khanasuk, Yutthana; Ngarmukos, Srihatach

    2012-10-01

    Pain management has become a very important part of postoperative care for total knee arthroplasty patients. Contemporary pain control has evolved from high-dose opioid in the past to state-of-the-art multimodal regimens. These include multiple non-opioid medication such as NSAIDs, COX-2 inhibitors, and gabapentinoid, and novel anesthetic techniques such as preemptive analgesia and ultrasound-guided peripheral nerve blocks. Another method which is gaining popularity is intraarticular injection of anesthetic cocktail during surgery. Pre-op education can also help patients cope with their pain better.

  8. Postoperative pain treatment after total knee arthroplasty

    DEFF Research Database (Denmark)

    Karlsen, Anders Peder Højer; Wetterslev, Mik; Hansen, Signe Elisa

    2017-01-01

    INTRODUCTION: The aim of this systematic review was to document efficacy, safety and quality of evidence of analgesic interventions after total knee arthroplasty (TKA). METHODS: This PRISMA-compliant and PROSPERO-registered review includes all-language randomized controlled trials of medication......), to 19 mm (CI: 8, 31; single FNB), and at 24 hours from 3 mm (CI: -2, 8; gabapentinoids), to 16 mm (CI: 8, 23; continuous FNB). GRADE-rated quality of evidence was generally low. CONCLUSION: A low quality of evidence, small sample sizes and heterogeneity of trial designs prohibit designation...

  9. Total synthesis and biological investigation of (-)-promysalin.

    Science.gov (United States)

    Steele, Andrew D; Knouse, Kyle W; Keohane, Colleen E; Wuest, William M

    2015-06-17

    Compounds that specifically target pathogenic bacteria are greatly needed, and identifying the method by which they act would provide new avenues of treatment. Herein we report the concise, high-yielding total synthesis (eight steps, 35% yield) of promysalin, a natural product that displays antivirulence phenotypes against pathogenic bacteria. Guided by bioinformatics, four diastereomers were synthesized, and the relative and absolute stereochemistries were confirmed by spectral and biological analysis. Finally, we show for the first time that promysalin displays two antivirulence phenotypes: the dispersion of mature biofilms and the inhibition of pyoverdine production, hinting at a unique pathogenic-specific mechanism of action.

  10. Transanal total mesorectal excision - a systematic review

    DEFF Research Database (Denmark)

    Bjørn, Maya Xania; Perdawood, Sharaf Karim

    2015-01-01

    of the 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...... the potential advantages seem to be related to a bulky mesorectum in the male pelvis. The preliminary results are encouraging and the most serious complication is urethral injury. The oncological results are acceptable, although the follow-up is short. CONCLUSION: TaTME is a feasible approach for mid and low...

  11. Efficient total synthesis of (S)-14-azacamptothecin.

    Science.gov (United States)

    Liu, Guan-Sai; Yao, Yuan-Shan; Xu, Peng; Wang, Shaozhong; Yao, Zhu-Jun

    2010-06-01

    An efficient total synthesis of (S)-14-azacamptothecin has been accomplished in 10 steps and 56% overall yield from 5H-pyrano[4,3-d]pyrimidine 8. A mild Hendrickson reagent-triggered intramolecular cascade cyclization, a highly enantioselective dihydroxylation, and an efficient palladium-catalyzed transformation of an O-allyl into N-allyl group are the key steps in the synthesis. This work provides a much higher overall yield than the previous achievement and shows sound flexibility for the further applications that will lead to new bioactive analogues.

  12. Quantum mechanics as total physical theory

    International Nuclear Information System (INIS)

    Slavnov, D.A.

    2002-01-01

    It is shown that the principles of the total physical theory and conclusions of the standard quantum mechanics are not at such an antagonistic variance as it is usually accepted. The axioms, which make it possible to plot the renewed mathematical scheme of the quantum mechanics are formulated within the frames of the algebraic approach. The above scheme includes the standard mathematical apparatus of the quantum mechanics. Simultaneously there exists the mathematical object, which adequately describes the individual experiment. The examples of applying the proposed scheme is presented [ru

  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 this study was to analyze the prevalence, location, and natural history of PPO following a TWA and to determine whether this was associated with prosthetic loosening. Patients and Methods We analyzed 44 consecutive cases in which a RE-MOTION TWA (Small Bone Innovations Inc., Morrisville, PA, USA) had been...

  14. Total lymphoid irradiation in rhesus monkeys

    International Nuclear Information System (INIS)

    Vriesendorp, H.M.; Maat, B.; Hogeweg, B.

    Total lymphoid irradiation (TLI) consists of three contiguous fields, a mantle, an inverted Y and a spleen field. TLI induces a state of immunosuppression in patients with Hodgkin disease or in small rodents. Infusion of allogeneic bone marrow cells into mice after TLI led to the development split haemopoietic chimerism and indefinite survival of skin grafts from the bone marrow donor. A protocol for TLI was developed for rhesus monkeys to attempt to verify these interesting observations in a pre-clinical animal model. (Auth.)

  15. Total-variation regularization with bound constraints

    International Nuclear Information System (INIS)

    Chartrand, Rick; Wohlberg, Brendt

    2009-01-01

    We present a new algorithm for bound-constrained total-variation (TV) regularization that in comparison with its predecessors is simple, fast, and flexible. We use a splitting approach to decouple TV minimization from enforcing the constraints. Consequently, existing TV solvers can be employed with minimal alteration. This also makes the approach straightforward to generalize to any situation where TV can be applied. We consider deblurring of images with Gaussian or salt-and-pepper noise, as well as Abel inversion of radiographs with Poisson noise. We incorporate previous iterative reweighting algorithms to solve the TV portion.

  16. First total synthesis of (-)-AL-2.

    Science.gov (United States)

    Miyakoshi, Naoki; Mukai, Chisato

    2003-06-26

    Treatment of the 3,4-dioxygenated-9-hydroxy-1-nonyn-5-one derivative, derived from diethyl l-tartrate, with a palladium catalyst in methanol under a CO atmosphere effected an intramolecular acetalization and a stereoselective construction of the (E)-methoxycarbonylmethylidene functionality resulting in formation of the core framework of the diacetylenic spiroacetal enol ether natural products. Chemical transformations of the 1,6-dioxaspiro[4.5]decane derivative thus formed led to the first total synthesis of (-)-AL-2. [reaction: see text

  17. TOTAL QUALITY MANAGEMENT AND CONTEMPORARY HOTEL INDUSTRY

    Directory of Open Access Journals (Sweden)

    Ivica Batinić

    2013-04-01

    Full Text Available Strong competition in the market has caused the development of a new management approach known as Total Quality Management (TQM. Due to importance that quality plays in achieving competitive advantage, the hotel industry started to apply TQM. During the introduction of these systems, hotel companies may use different approaches to suit their own buseiness requirements. In doing so, 'TQM standards' can be used, or various international standards and models of business excellence Malcolm Balridge National Quality Award and European Quality Award.

  18. TotalFinaElf Factbook 2002

    International Nuclear Information System (INIS)

    2002-01-01

    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.)

  19. 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.

  20. Lattice-Like Total Perfect Codes

    Directory of Open Access Journals (Sweden)

    Araujo Carlos

    2014-02-01

    Full Text Available A contribution is made to the classification of lattice-like total perfect codes in integer lattices Λn via pairs (G, Φ formed by abelian groups G and homomorphisms Φ: Zn → G. A conjecture is posed that the cited contribution covers all possible cases. A related conjecture on the unfinished work on open problems on lattice-like perfect dominating sets in Λn with induced components that are parallel paths of length > 1 is posed as well.

  1. 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.

  2. Imaging of total colonic Hirschsprung disease

    International Nuclear Information System (INIS)

    Stranzinger, Enno; DiPietro, Michael A.; Strouse, Peter J.; Teitelbaum, Daniel H.

    2008-01-01

    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.)

  3. 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).

  4. EHV transmission maintenance. A total asset strategy

    International Nuclear Information System (INIS)

    Bronsdon, J.A.N.

    1996-01-01

    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

  5. TOTAL QUALITY MANAGEMENT IN ISLAMIC EDUCATION INSTITUTION

    Directory of Open Access Journals (Sweden)

    Indriyenni Indriyenni

    2018-04-01

    Full Text Available There have been five characteristics of a qualified school such as focusing on the customer, total engagement, measurement, commitment, and continuous improvement. Every educational institution including Islamic boarding school (IBS is required to provide the best services to its customers. In this way, IBS need to be supported by a good management system; the existence of a regular mindset (administrative thinking, the implementation of regular activities (administrative behavior, attitude to the task activities well (administrative attitude, and so forth. To answer the various problems that exist in the educational environment the management should have an Integrated or Total Quality Management (TQM. One of its goals is to transform a school institution into a sincere team, without conflict and internal competition to achieve a single goal of satisfying all customers. TQM will provide educators professional solutions to meet today’s challenges and the future. It is because TQM can be used to build alliance between education, business and government. TQM can also shape the community responsive to the changing demands of society in this era of globalization. Besides, TQM form a responsive school and is able to respond to changes that occur in the field of education in order to give satisfaction to stakeholder.

  6. Total quality drives nuclear plant improvements

    International Nuclear Information System (INIS)

    Richey, R.B.

    1991-01-01

    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

  7. METHODS FOR THE DETERMINATION OF TOTAL ORGANIC ...

    Science.gov (United States)

    Organic matter in soils and sediments is widely distributed over the earth's surface occurring in almost all terrestrial and aquatic environments (Schnitzer, 1978). Soils and sediments contain a large variety of organic materials ranging from simple sugars and carbohydrates to the more complex proteins, fats, waxes, and organic acids. Important characteristics of the organic matter include their ability to: form water-soluble and water- insoluble complexes with metal ions and hydrous oxides; interact with clay minerals and bind particles together; sorb and desorb both naturally-occurring and anthropogenically-introduced organic compounds; absorb and release plant nutrients; and hold water in the soil environment. As a result of these characteristics, the determination of total organic carbon (a measure of one of the chemical components of organic matter that is often used as an indicator of its presence in a soil or sediment) is an essential part of any site characterization since its presence or absence can markedly influence how chemicals will react in the soil or sediment. Soil and sediment total organic carbon (TOC) determinations are typically requested with contaminant analyses as part of an ecological risk assessment data package. TOC contents may be used qualitatively to assess the nature of the sampling location (e.g., was it a depositional area) or may be used to normalize portions of the analytical chemistry data set (e.g., equilibrium partitioning).

  8. Total Site Heat Integration Considering Pressure Drops

    Directory of Open Access Journals (Sweden)

    Kew Hong Chew

    2015-02-01

    Full Text Available Pressure drop is an important consideration in Total Site Heat Integration (TSHI. This is due to the typically large distances between the different plants and the flow across plant elevations and equipment, including heat exchangers. Failure to consider pressure drop during utility targeting and heat exchanger network (HEN synthesis may, at best, lead to optimistic energy targets, and at worst, an inoperable system if the pumps or compressors cannot overcome the actual pressure drop. Most studies have addressed the pressure drop factor in terms of pumping cost, forbidden matches or allowable pressure drop constraints in the optimisation of HEN. This study looks at the implication of pressure drop in the context of a Total Site. The graphical Pinch-based TSHI methodology is extended to consider the pressure drop factor during the minimum energy requirement (MER targeting stage. The improved methodology provides a more realistic estimation of the MER targets and valuable insights for the implementation of the TSHI design. In the case study, when pressure drop in the steam distribution networks is considered, the heating and cooling duties increase by 14.5% and 4.5%.

  9. SMED: El camino a la flexibilidad total

    Directory of Open Access Journals (Sweden)

    Cruz, J.

    2004-07-01

    Full Text Available Este artículo presentará la metodología de SMED (Cambio de dados en un dígito de minuto como una alternativa hacia la flexibilidad total, la cuál se propone como una herramienta vital de competencia ante las condiciones del mercado existentes. Se explicarán los pasos a seguir para implementar la herramienta y se presentará un caso de estudio en el cuál la herramienta fue aplicada exitosamente, identificándose como la decisión determinante en la reducción del tiempo de ciclo por cambios de modelo, incrementando así la eficiencia del sistema de manufactura. El mercado hoy en día, está caracterizado por elementos determinantes, tales como: la globalización, una desaceleración económica de nuestro vecino y socio comercial, los Estados Unidos de Norteamérica, y una industria Asiática emergente. Estos factores combinados, impactan de manera total la forma de operar de las empresas, debido a que las empresas requieren implementar diferentes estrategias, tales como: 1 disminuir costos de producción, 2 incrementar la calidad, e 3 incrementar la flexibilidad y tiempo de respuesta.

  10. 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.

  11. Chronic total coronary occlusion: treatment results.

    Science.gov (United States)

    Kirk Christensen, Martin; Freeman, Phillip Fischer; Rasmussen, Jeppe Groendal; Villadsen, Anton Boel; Raungaard, Bent; Eggert Jensen, Svend; Thuesen, Leif

    2017-08-01

    To describe the clinical and procedural coronary chronic total occlusion (CTO) treatment results in a Nordic PCI centre during the implementation of a CTO treatment program. In a retrospective registry study, we assessed; (1) indication for the procedure, (2) Canadian Cardiovascular Society angina pectoris score (CCS)/New York Heart Association (NYHA) heart failure score, (3) lesion complexity and (4) adverse events during hospital stay and three months following the index procedure. The study cohort included 503 patients (594 lesions). From 2010 to 2013 96% of procedures were performed with antegrade wire-escalation technique and 4% performed using retrograde techniques, from 2013-2016 the corresponding numbers were 83% and 17.0%. The procedural success rate was 69%, increasing from 64% before to 72% (p = .06) after routinely using the retrograde approach. No individual patient characteristic, lesion variable or score was strongly associated with procedural success or failure. There were 4% serious procedure related complications. In patients with PCI of a CTO lesion only, 87% were in CCS or NYHA functional class ≥2 before the index procedure vs. 22% at follow-up. Routine use of retrograde techniques tended to increase the procedural success rate. Clinical results after three months were acceptable, but the complication rate was higher than for non-CTO PCI. Individual patient and lesion characteristics had a low predictability for procedural success. Therefore, clinical symptoms, objective signs of myocardial ischemia and procedural risk should be focus points in coronary chronic total occlusion treatment strategies.

  12. Total performance measurement and management: TPM2

    Energy Technology Data Exchange (ETDEWEB)

    Sheather, G. [University of Technology, Sydney, NSW (Australia)

    1996-10-01

    As the rate of incremental improvement activities and business process re-engineering programs increase, product development times reduce, collaborative endeavours between OEMs and out-sourcing suppliers increase, as agile manufacturing responds to the demands of a global marketplace, the `virtual` organisation is becoming a reality. In this context, customers, partners, suppliers and manufacturers are increasingly separated by field geography, time zone, and availability, but linked by distributed information systems. Measuring and monitoring business performance in this environment requires a entirely different framework and set of key performance indicators (KPIs) usually associated with traditional financial accounting approaches. These approaches are critiqued, then the paper introduces a new concept `Total Performance Measurement Management` (TPM2), to distinguish it from the conventional TPM (Total Productive Management). A model for combining both financial and non-financial KPIs relevant to real-time performance measures stretching across strategic, business unit and operational levels, is presented. The results of the model confirm the hypothesis that it is feasible to develop a TPM2 framework for achieving enterprise wide strategic objectives. (author). 6 tabs., 18 figs., refs.

  13. Total body photography for skin cancer screening.

    Science.gov (United States)

    Dengel, Lynn T; Petroni, Gina R; Judge, Joshua; Chen, David; Acton, Scott T; Schroen, Anneke T; Slingluff, Craig L

    2015-11-01

    Total body photography may aid in melanoma screening but is not widely applied due to time and cost. We hypothesized that a near-simultaneous automated skin photo-acquisition system would be acceptable to patients and could rapidly obtain total body images that enable visualization of pigmented skin lesions. From February to May 2009, a study of 20 volunteers was performed at the University of Virginia to test a prototype 16-camera imaging booth built by the research team and to guide development of special purpose software. For each participant, images were obtained before and after marking 10 lesions (five "easy" and five "difficult"), and images were evaluated to estimate visualization rates. Imaging logistical challenges were scored by the operator, and participant opinion was assessed by questionnaire. Average time for image capture was three minutes (range 2-5). All 55 "easy" lesions were visualized (sensitivity 100%, 90% CI 95-100%), and 54/55 "difficult" lesions were visualized (sensitivity 98%, 90% CI 92-100%). Operators and patients graded the imaging process favorably, with challenges identified regarding lighting and positioning. Rapid-acquisition automated skin photography is feasible with a low-cost system, with excellent lesion visualization and participant acceptance. These data provide a basis for employing this method in clinical melanoma screening. © 2014 The International Society of Dermatology.

  14. Telerehabilitation Feasibility in Total Joint Replacement

    Directory of Open Access Journals (Sweden)

    Mark J. Nelson

    2017-11-01

    Full Text Available Despite documented benefits, many Total Joint Replacement (TJR patients find it difficult to access rehabilitation following discharge from hospital. One solution to improve access for TJR patients is telerehabilitation. This study aimed to assess the feasibility of introducing a telerehabilitation program for TJR patients.   TJR patients at QEII Jubilee Hospital were invited to complete a questionnaire regarding their access, feelings towards and preferences in using technology. Seventy-five patients were recruited. Most patients had computer access (72% and internet (69% at home. Sixty-five percent of participants were willing to participate in telerehabilitation. A significant difference was found between older and younger patients. Watching videos on an electronic device was the preferred method for a technology-based home exercise program and phone call the preferred method of communication.  Results indicate telerehabilitation in the TJR population is feasible from the perspective of access to, feelings toward, and preferences for technology. Keywords: Hip replacement, Knee replacement, Telerehabilitation, Telemedicine, Total joint replacement

  15. Renal function after elective total hip replacement

    DEFF Research Database (Denmark)

    Perregaard, Helene; Damholt, Mette B; Solgaard, Søren

    2016-01-01

    Background and purpose - Acute kidney injury (AKI) is associated with increased short-term and long-term mortality in intensive care populations and in several surgical specialties, but there are very few data concerning orthopedic populations. We have studied the incidence of AKI and the prevale......Background and purpose - Acute kidney injury (AKI) is associated with increased short-term and long-term mortality in intensive care populations and in several surgical specialties, but there are very few data concerning orthopedic populations. We have studied the incidence of AKI...... and the prevalence of chronic kidney disease (CKD) in an elective population of orthopedic patients undergoing primary total hip replacement, hypothesizing that chronic kidney disease predisposes to AKI. Patients and methods - This was a single-center, population-based, retrospective, registry-based cohort study...... involving all primary elective total hip replacements performed from January 2003 through December 2012. Patient demographics and creatinine values were registered. We evaluated the presence of CKD and AKI according to the international guidelines for kidney disease (KDIGO Acute Kidney Injury Workgroup 2013...

  16. Phytochemical screening, total phenolic, total flavonoids contents and antioxidant activity of cinchona ledgeriana leaves ethanol extract

    Science.gov (United States)

    Sundowo, Andini; Artanti, Nina; Hanafi, M.; Minarti, Primahana, Gian

    2017-11-01

    C ledgeriana is a medicinal plant that contains alkaloids, especially on the barks for commercial production of quinine as antimalarial. The main alkaloids in this plant are cinchonine, cinchonidine, quinine and quinidine. Besides for antiamalarial this plant is also commonly used to treat whooping cough, influenza and dysentery. Compare to other medicinal plants, nowadays only very few studies were conducted in Cinchona species. Our current study aims to determine the content of phytochemical, total phenol and total flavonoids from C. ledgeriana leaves 70% ethanol extract. The extraction was performed by maceration method using 70% ethanol solvent and then fractionated into hexane, ethylacetate and butanol. Phytochemical screening was performed to determine the content of alkaloids, flavonoids, terpenoids, tannins and saponins. Total phenol and flavonoid contents of the extract were determined by Folin-Ciocalteu and alumunium chloride colorimetric methods using gallic acid and quercetin as standards. The antioxidant activity was determined by using 2, 2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity. The results of phytochemical screening showed that the 70% ethanol extract of C. ledgeriana leaves contained alkaloids, flavonoids, terpenoids, tannins and saponins. The total phenol and total flavonoids analysis showed that ethyl acetate fraction had the highest total phenol (40.23%) and total flavonoids (65.34%).

  17. 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

  18. Radiological evaluation of painful total hip replacement

    International Nuclear Information System (INIS)

    Tehranzadeh, J.; Schneider, R.; Freiberger, R.H.

    1981-01-01

    Ninety-four cases of clinically failed, cemented, total hip prostheses requiring surgery were reviewed to determine the accuracy of preoperative plain radiography, culture of aspirated fluid, arthrography, and bone scanning. When radiopaque cement had been used to embed the prosthesis, plain radiography was highly accurate in detecting a loose femoral component, less so in detecting a loose acetabular component. Culture of aspirated fluid was accurate in diagnosing infection. A positive arthrogram identified loosening with good accuracy; however, a negative arthrogram did not reliably exclude loosening. 99 mTc bone scans frequently differentiated loosening from loosening with infection. The suggested sequence of diagnostic tests is plain radiography followed by bone scanning. If the bone scan shows diffuse augmented uptake, culture of aspirated fluid followed by arthrography is indicated

  19. Tribology of total hip arthroplasty prostheses

    Science.gov (United States)

    Rieker, Claude B.

    2016-01-01

    Articulating components should minimise the generation of wear particles in order to optimize long-term survival of the prosthesis. A good understanding of tribological properties helps the orthopaedic surgeon to choose the most suitable bearing for each individual patient. Conventional and highly cross-linked polyethylene articulating either with metal or ceramic, ceramic-on-ceramic and metal-on-metal are the most commonly used bearing combinations. All combinations of bearing surface have their advantages and disadvantages. An appraisal of the individual patient’s objectives should be part of the assessment of the best bearing surface. Cite this article: Rieker CB. Tribology of total hip arthroplasty prostheses: what an orthopaedic surgeon should know. EFORT Open Rev 2016;1:52-57. DOI: 10.1302/2058-5241.1.000004. PMID:28461928

  20. Neck after total laryngectomy: CT study

    International Nuclear Information System (INIS)

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

    1984-01-01

    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

  1. Quality of life after total knee arthroplasty.

    Science.gov (United States)

    Canovas, F; Dagneaux, L

    2018-02-01

    Total knee arthroplasty (TKA) results in a high degree of patient satisfaction, as it provides patients with considerable medium- and long-term benefits in terms of quality of life, pain relief and function. Nevertheless, the literature reports that up to 30% of patients are dissatisfied. This dissatisfaction is directly related to the patients' quality of life, which they deem insufficient. Their quality of life depends on many physical, behavioural, social and psychological factors that are not taken into account by functional outcome scores. After describing the principles of quality of life evaluation after TKA, we will assess the effects of patient-related factors, the surgical technique and postoperative program through an exhaustive review of the literature. Patient expectations after TKA will then be outlined, particularly return to work and return to sports. Copyright © 2017. Published by Elsevier Masson SAS.

  2. Granulomatous pseudotumors in total joint replacement

    International Nuclear Information System (INIS)

    Griffiths, H.J.; Burke, J.; Bonfiglio, T.A.

    1987-01-01

    Fourteen patients (15 joints) developed a foreign body reaction to methylmethacrylate, polyethylene, or metal adjacent to a total joint implant, a condition we would like to term granulomatous pseudotumors. There were eight male and six female patients. Their average age was 61 years. The hip was involved in 14 joints (femoral component 11 times, acetabulum 7, and greater trochanter once). One patient presented with granulomatous pseudotumors of the knee. The principal findings included increasing pain and radiographic evidence of loosening occurring on average 2.7 years following the implant. This was followed by a characteristic and gradually developing radiographic pattern of discrete rounded lucencies. These developed into large ovoid lytic areas, destroying both methylmethacrylate and bone. Histologically, the appearances were characterized by histiocytic infiltration and the presence of multiple foreign body giant cells. Foreign material was identified in 9 of 11 cases. The pathogenesis is unknown but appears related to micromovement or loosening of the implant. (orig.)

  3. Total quality management in the hospital setting.

    Science.gov (United States)

    Ernst, D F

    1994-01-01

    With the increasing demands on hospitals for improved quality and lower costs, hospitals have been forced to reevaluate their manner of operation and quality assurance (QA) programs. Hospitals have been faced with customer dissatisfaction with services, escalating costs, intense competition, and reduced reimbursement for services. As a result, many hospitals have incorporated total quality management (TQM), also known as continuous quality improvement (CQI) and quality improvement (QI), to improve quality care and decrease costs. This article examines the concept of TQM, its rationale, and how it can be implemented in a hospital. A comparison of TQM and QA is made. Examples of hospital implementation of TQM and problems and issues associated with TQM in the hospital setting are explored.

  4. Regularization by truncated total least squares

    DEFF Research Database (Denmark)

    Hansen, Per Christian; Fierro, R.D; Golub, G.H

    1997-01-01

    The total least squares (TLS) method is a successful method for noise reduction in linear least squares problems in a number of applications. The TLS method is suited to problems in which both the coefficient matrix and the right-hand side are not precisely known. This paper focuses on the use...... schemes for relativistic hydrodynamical equations. Such an approximate Riemann solver is presented in this paper which treats all waves emanating from an initial discontinuity as themselves discontinuous. Therefore, jump conditions for shocks are approximately used for rarefaction waves. The solver...... is easy to implement in a Godunov scheme and converges rapidly for relativistic hydrodynamics. The fast convergence of the solver indicates the potential of a higher performance of a Godunov scheme in which the solver is used....

  5. 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...... 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....

  6. Comparative risk assessment of total energy systems

    International Nuclear Information System (INIS)

    Soerensen, B.

    1982-01-01

    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)

  7. Synchrotron radiation total reflection for rainwater analysis

    International Nuclear Information System (INIS)

    Simabuco, Silvana M.; Matsumoto, Edson

    1999-01-01

    Total reflection X-ray fluorescence analysis excited with synchrotron radiation (SR-TXRF) has been used for rainwater trace element analysis. The samples were collected in four different sites at Campinas City, SP. Standard solutions with gallium as internal standard were prepared for the calibration system. Rainwater samples of 10 μl were putted onto Perspex reflector disk, dried on vacuum and analyzed for 100 s measuring time. The detection limits obtained for K-shell varied from 29 ng.ml -1 for sulfur to 1.3 ng.ml -1 for zinc and copper, while for L-shell the values were 4.5 ng.ml -1 for mercury and 7.0 ng.ml -1 for lead. (author)

  8. 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.

  9. Total is making petroleum rhyme with data

    International Nuclear Information System (INIS)

    Barbaux, Aurelie

    2017-01-01

    Total, the French oil and gas company, which possesses the most powerful industrial supercomputer in the world, is claiming to be 'digital native'. The company has launched a digital transformation plan, under the authority of Gilles Cochevelou as 'chief digital officer'. More than a simple management tool, the plan which is implemented in every branches of the company, is intended to increase safety and generate millions of dollars in savings through a better communication between operation or maintenance teams (with smart rooms in every site), the permanent exchange of data, an enhanced collaboration, etc. However, as G. Cochevelou points out, the main challenge is not to deploy the technologies and tools; it is to get the people to adopt and use them

  10. 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.

  11. Total charge fluctuation in heavy ion collision

    International Nuclear Information System (INIS)

    Mishra, D.K.; Netrakanti, P.K.; Mohanty, A.K.; Garg, P.

    2014-01-01

    Event-by-event fluctuations of positive, negative, total and net charge produced in relativistic nuclear collisions have been of interest to explore phase transition and/or a critical end point (CEP) which is believed to exist somewhere between the hadronic phase and the quark-gluon phase of the QCD phase diagram. The entropy is closely related to the particle multiplicity, and it is expected to be approximately conserved during the evolution of the matter created at the early stage. The entropy fluctuations are not directly observed but can be inferred from the experimentally measured quantities. The final state mean multiplicity is proportional to the entropy of the initial state ( ∼ S). The particle multiplicity can be measured on an event-by-event basis, whereas the entropy is defined by averaging the particle multiplicities in the ensemble of events. Thus, the dynamical entropy fluctuations can be measured experimentally by measuring the fluctuations in the mean multiplicity

  12. 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.

  13. 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. Endpoints were......, and lumbar plexus block reduced nausea and pruritus. The GRADE-rated quality of evidence ranged from low to very low throughout the analyses. This review demonstrated, that some analgesic interventions may have the capacity to reduce mean opioid requirements and/or mean pain intensity compared with controls...

  14. Favorable results after total wrist arthroplasty

    DEFF Research Database (Denmark)

    Boeckstyns, Michel E. H.; Herzberg, G.; Merser, Søren

    2013-01-01

    survival was 0.9 at 5–9 years. Interpretation The clinical results in terms of pain, motion, strength, and function were similar to those in previous reports. The implant survival was 0.9 at 9 years, both in rheumatoid and non-rheumatoid cases, which is an important improvement compared to the earlier......Background and purpose During the past 40 years, several attempts have been made with total wrist arthroplasty to avoid fusion in severely destroyed wrists. The results have often been disappointing. There is only modest clinical documentation due to the small number of patients (especially non......-rheumatoid cases) and short follow-up times. Here we report a multicenter series using a third-generation implant with a minimum follow-up time of 5 years. Methods In 2012, data were retrieved from a registry of consecutive wrist operations at 7 centers with units specialized in hand surgery, between 2003 and 2007...

  15. Total Quality Management in Educational Organisations

    Directory of Open Access Journals (Sweden)

    Edvard Konrad

    2000-12-01

    Full Text Available Movement for Total Quality Management (TQM, which was initially successfully applied in the production of goods, has spread to the service domain including educational organisations. Many of principles and experiences known so far could be creatively transferred to educational situations. Additional research and specific innovations are necessary for successful application of existing knowledge. In this paper we discuss certain topics from the specific nature of the quality of education: the definition of the concept of a consumer, motivation of participants in educational processes, improvement of educational processes, quality of learning and leadership in educational organisations.

  16. TOTAL QUALITY MANAGEMENT IN HIGH EDUCATION

    Directory of Open Access Journals (Sweden)

    Hasan SERİN, Alper AYTEKİN

    2009-01-01

    Full Text Available The approach of Total Quality Management (TQM has been even more common and most recently its use in high education has been discussed. Likewise the enterprises producing various products, universities have also inputs, processes, and outputs. Due to conditions of competition, universities have to improve the qualities of these inputs, processes, and outputs, according to satisfaction, demands, and expectations of internal and external customers. If the TQM has been implemented in the universities with a manner that aims for customer satisfaction (students, lecturers, public and private establishments, and families, supports constant development, ensures participatory approach, and encourages working in groups, it will provide universities with effectiveness, efficiency, dynamics, and economics. In this study, common problems of universities, definitions of quality and TQM in high education, customer concept at universities, and factors affecting the quality of education have been explained. Besides, in order TQM approach to be successfully implemented in the universities, various suggestions have been presented.

  17. 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

  18. 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.

  19. Total Synthesis of (-)-Salvinorin A.

    Science.gov (United States)

    Line, Nathan J; Burns, Aaron C; Butler, Sean C; Casbohm, Jerry; Forsyth, Craig J

    2016-12-12

    Salvinorin A (1) is natural hallucinogen that binds the human κ-opioid receptor. A total synthesis has been developed that parlays the stereochemistry of l-(+)-tartaric acid into that of (-)-1 via an unprecedented allylic dithiane intramolecular Diels-Alder reaction to obtain the trans-decalin scaffold. Tsuji allylation set the C9 quaternary center and a late-stage stereoselective chiral ligand-assisted addition of a 3-titanium furan upon a C12 aldehyde/C17 methyl ester established the furanyl lactone moiety. The tartrate diol was finally converted into the C1,C2 keto-acetate. © 2016 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Total least squares for anomalous change detection

    Science.gov (United States)

    Theiler, James; Matsekh, Anna M.

    2010-04-01

    A family of subtraction-based anomalous change detection algorithms is derived from a total least squares (TLSQ) framework. This provides an alternative to the well-known chronochrome algorithm, which is derived from ordinary least squares. In both cases, the most anomalous changes are identified with the pixels that exhibit the largest residuals with respect to the regression of the two images against each other. The family of TLSQbased anomalous change detectors is shown to be equivalent to the subspace RX formulation for straight anomaly detection, but applied to the stacked space. However, this family is not invariant to linear coordinate transforms. On the other hand, whitened TLSQ is coordinate invariant, and special cases of it are equivalent to canonical correlation analysis and optimized covariance equalization. What whitened TLSQ offers is a generalization of these algorithms with the potential for better performance.

  1. 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.

  2. 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.

  3. Soft-tissue tension total knee arthroplasty.

    Science.gov (United States)

    Asano, Hiroshi; Hoshino, Akiho; Wilton, Tim J

    2004-08-01

    It is far from clear how best to define the proper strength of soft-tissue tensioning in total knee arthroplasty (TKA). We attached a torque driver to the Monogram balancer/tensor device and measured soft-tissue tension in full extension and 90 degrees flexion during TKA. In our surgical procedure, when we felt proper soft-tissue tension was being applied, the mean distraction force was noted to be 126N in extension and 121N in flexion. There was no significant correlation between soft-tissue tension and the postoperative flexion angle finally achieved. To the best of our knowledge, this is the first study to assess the actual distraction forces in relation to soft-tissue tension in TKA. Further study may reveal the most appropriate forces to achieve proper soft-tissue tension in the wide variety of circumstances presenting at knee arthroplasty.

  4. Effect of total pressure on graphite oxidation

    International Nuclear Information System (INIS)

    Burnette, R.D.; Hoot, C.G.

    1983-04-01

    Graphite corrosion in the high-temperature gas-cooled reactor (HTGR) is calculated using two key assumptions: (1) the kinetic, catalysis, and transport characteristics of graphite determined by bench-scale tests apply to large components at reactor conditions and (2) the effects of high pressure and turbulent flow are predictable. To better understand the differences between laboratory tests and reactor conditions, a high-pressure test loop (HPTL) has been constructed and used to perform tests at reactor temperature, pressure, and flow conditions. The HPTL is intended to determine the functional dependence of oxidation rate and characteristics on total pressure and gas velocity and to compare the oxidation results with calculations using models and codes developed for the reactor

  5. Future Prospects for the Total Artificial Heart.

    Science.gov (United States)

    Sunagawa, Gengo; Horvath, David J; Karimov, Jamshid H; Moazami, Nader; Fukamachi, Kiyotaka

    2016-01-01

    A total artificial heart (TAH) is the sole remaining option for patients with biventricular failure who cannot be rescued by left ventricular assist devices (LVADs) alone. However, the pulsatile TAH in clinical use today has limitations: large pump size, unknown durability, required complex anticoagulation regimen, and association with significant postsurgical complications. That pump is noisy; its large pneumatic driving lines traverse the body, with bulky external components for its drivers. Continuous-flow pumps, which caused a paradigm shift in the LVAD field, have already contributed to the rapidly evolving development of TAHs. Novel continuous-flow TAHs are only in preclinical testing or developmental stages. We here review the current state of TAHs, with recommended requirements for the TAH of the future.

  6. Renal toxicity after total body irradiation

    International Nuclear Information System (INIS)

    Borg, Martin; Hughes, Timothy; Horvath, Noemi; Rice, Michael; Thomas, Anthony C.

    2002-01-01

    Purpose: To evaluate the incidence of renal dysfunction after total body irradiation (TBI). Methods and Materials: Between 1990 and 1997, 64 patients (median age 50 years) received TBI as part of the conditioning regimen before bone marrow transplantation (BMT). Five patients with abnormal renal function at the beginning of treatment or with incomplete data were excluded. All patients received a total of 12 Gy (6 fractions twice daily for 3 consecutive days) prescribed to the peak lung dose (corrected for lung transmission) at a dose rate of 7.5 cGy/min. Renal shielding was not used. Renal dysfunction was assessed on the basis of the serum creatinine levels measured at the start and end of TBI and at 6, 12, 18, and 24 months after completion of BMT. Cox proportional hazard analysis was used to evaluate the various factors known to affect renal function. Results: Only 4 patients had elevated serum creatinine levels at 12 months and subsequently only 2 of the 33 surviving patients had persistent elevated renal serum creatinine levels 24 months after BMT. A fifth patient developed proteinuria and mildly elevated serum creatinine levels at 2.5 years. In 2 patients, the elevation coincided with disease relapse and normalized once remission was achieved. In the third patient, the elevation in serum creatinine levels coincided with relapse of multiple myeloma and the presence of Bence-Jones proteinuria. The fourth patient was the only patient who developed chronic renal failure secondary to radiation nephritis at 2 years. The etiology of the fifth patient's rise in creatinine was unknown, but may have been secondary to radiation nephritis. On univariate analysis, but not on multivariate analysis, a significant correlation was found between TBI-related renal dysfunction and hypertension before and after BMT. Conclusion: A dose of 12 Gy at 2 Gy/fraction resulted in only 1 case of radiation nephritis in the 59 patients studied 24 months after the completion of TBI and BMT

  7. Total hip arthroplasty at the rothman institute.

    Science.gov (United States)

    Austin, Matthew S; Higuera, Carlos A; Rothman, Richard H

    2012-07-01

    Total hip arthroplasty (THA) is one of the most successful surgical interventions devised in modern times. Attempts to change the current THA procedure with unproven innovations bring the risk of increased failure rates while trying to improve the benefit of the surgery. This manuscript examines the evolution of THA at the Rothman Institute illustrating the key elements that lead the success of this procedure at this institution. These key elements include femoral stem design, use of highly crossed-linked polyethylene and use of pain and rehabilitation protocols. We attempted to describe the long-term results regarding safety, effectiveness, and durability of specific THA implant designs used at this institution drawing on reported evidence in the literature. The authors performed a review of peer-reviewed articles related to the Rothman Institute's experience with THA. Total hip arthroplasty is an efficient, safe, and durable procedure. It is a highly successful operation to restore function and improve pain. The survivorship of THA procedures at the Rothman Institute is higher than 99% at 10 years based on mechanical failure. The use of collarless, tapered wedge femoral stem, highly crossed-linked polyethylene, and improved pain rehabilitation protocols have contributed to this success. There is a well-documented long-term survivorship after THA. Future innovation in THA should address new challenges with younger and more demanding patients, rather than change current methods that have a proven good survivorship. This innovation depends mainly upon improvements in the bearing surfaces and advances in pain control and rehabilitation.

  8. The "July effect" in total shoulder arthroplasty.

    Science.gov (United States)

    Rao, Allison J; Bohl, Daniel D; Frank, Rachel M; Cvetanovich, Gregory L; Nicholson, Gregory P; Romeo, Anthony A

    2017-03-01

    New medical doctors enter their residency fields in July, a time in the hospital in which patient morbidity and mortality rates are perceived to be higher. It remains controversial whether a "July effect" exists in different areas of medicine and surgery, including in orthopedic surgery. The purpose of this study is to test for the July effect in patients undergoing primary total shoulder arthroplasty (TSA). Patients who underwent primary TSA from 2005-2012 were identified using the American College of Surgeons National Surgical Quality Improvement Program database. Cases were categorized as involving residents or fellows and as occurring during the first academic quarter. Rates of composite and any adverse event outcomes were compared between patient groups using multivariate logistic regression. A total of 1591 patients met the inclusion criteria. Of these cases, 711 (44.7%) had resident or fellow involvement and 390 (24.5%) were performed in the first academic quarter. There were few demographic and comorbidity differences between cases with and without residents or fellows or between cases performed during the first quarter and during the rest of the year. Overall, the rate of serious adverse events was 1.6% and the rate of any adverse events was 6.5%. Using one of the largest cohorts of primary TSA patients, this study could not provide evidence for a July effect. In the context of the recent growth in the volume of TSA procedures, these findings provide important reassurance to patients that it is safe to schedule their elective procedures at training institutions during the first part of the academic year. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  9. Esophageal Dysmotility in Patients following Total Laryngectomy.

    Science.gov (United States)

    Zhang, Teng; Maclean, Julia; Szczesniak, Michal; Bertrand, Paul P; Quon, Harry; Tsang, Raymond K; Wu, Peter I; Graham, Peter; Cook, Ian J

    2018-02-01

    Objectives Dysphagia is common in total laryngectomees, with some symptoms suggesting esophageal dysmotility. Tracheoesophageal (TE) phonation requires effective esophagopharyngeal air passage. Hence, esophageal dysmotility may affect deglutition or TE phonation. This study aimed to determine (1) the characteristics of esophageal dysmotility in laryngectomees, (2) whether clinical history is sensitive in detecting esophageal dysmotility, and (3) the relationship between esophageal dysmotility and TE prosthesis dysfunction. Study Design Multidisciplinary cross-sectional study. Setting Tertiary academic hospital. Subjects and Methods For 31 participants undergone total laryngectomy 1 to 12 years prior, clinical histories were taken by a gastroenterologist and a speech pathologist experienced in managing dysphagia. Esophageal high-resolution manometry was performed and analyzed using Chicago Classification v3.0. Results Interpretable manometric studies were obtained in 23 (1 normal manometry). Esophageal dysmotility patterns included achalasia, esophagogastric junction outflow obstruction, diffuse esophageal spasm, and other major (30%) and minor (50%) peristaltic disorders. The sensitivity of predicting any esophageal dysmotility was 28%, but it is noteworthy that patients with achalasia and diffuse esophageal spasm (DES) were predicted. Two of 4 participants with TE puncture leakage had poor esophageal clearance. Of 20 TE speakers, 12 had voice problems, no correlation between poor voice, and any dysmotility pattern. Conclusions Peristaltic and lower esophageal sphincter dysfunction are common in laryngectomees. Clinical history, while not predictive of minor motor abnormalities, predicted correctly cases with treatable spastic motor disorders. Dysmotility was not associated with poor phonation, although TE puncture leakage might be linked to poor esophageal clearance. Esophageal dysmotility should be considered in the laryngectomees with persisting dysphagia or

  10. Total Percutaneous Aortic Repair: Midterm Outcomes

    International Nuclear Information System (INIS)

    Bent, Clare L.; Fotiadis, Nikolas; Renfrew, Ian; Walsh, Michael; Brohi, Karim; Kyriakides, Constantinos; Matson, Matthew

    2009-01-01

    The purpose of this study was to examine the immediate and midterm outcomes of percutaneous endovascular repair of thoracic and abdominal aortic pathology. Between December 2003 and June 2005, 21 patients (mean age: 60.4 ± 17.1 years; 15 males, 6 females) underwent endovascular stent-graft insertion for thoracic (n = 13) or abdominal aortic (n = 8) pathology. Preprocedural computed tomographic angiography (CTA) was performed to assess the suitability of aorto-iliac and common femoral artery (CFA) anatomy, including the degree of CFA calcification, for total percutaneous aortic stent-graft repair. Percutaneous access was used for the introduction of 18- to 26-Fr delivery devices. A 'preclose' closure technique using two Perclose suture devices (Perclose A-T; Abbott Vascular) was used in all cases. Data were prospectively collected. Each CFA puncture site was assessed via clinical examination and CTA at 1, 6, and 12 months, followed by annual review thereafter. Minimum follow-up was 36 months. Outcome measures evaluated were rates of technical success, conversion to open surgical repair, complications, and late incidence of arterial stenosis at the site of Perclose suture deployment. A total of 58 Perclose devices were used to close 29 femoral arteriotomies. Outer diameters of stent-graft delivery devices used were 18 Fr (n = 5), 20 Fr (n = 3), 22 Fr (n = 4), 24 Fr (n = 15), and 26 Fr (n = 2). Percutaneous closure was successful in 96.6% (28/29) of arteriotomies. Conversion to surgical repair was required at one access site (3.4%). Mean follow-up was 50 ± 8 months. No late complications were observed. By CT criteria, no patient developed a >50% reduction in CFA caliber at the site of Perclose deployment during the study period. In conclusion, percutaneous aortic stent-graft insertion can be safely performed, with a low risk of both immediate and midterm access-related complications.

  11. 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.

  12. Positron interactions with water–total elastic, total inelastic, and elastic differential cross section measurements

    International Nuclear Information System (INIS)

    Tattersall, Wade; Chiari, Luca; Machacek, J. R.; Anderson, Emma; Sullivan, James P.; White, Ron D.; Brunger, M. J.; Buckman, Stephen J.; Garcia, Gustavo; Blanco, Francisco

    2014-01-01

    Utilising a high-resolution, trap-based positron beam, we have measured both elastic and inelastic scattering of positrons from water vapour. The measurements comprise differential elastic, total elastic, and total inelastic (not including positronium formation) absolute cross sections. The energy range investigated is from 1 eV to 60 eV. Comparison with theory is made with both R-Matrix and distorted wave calculations, and with our own application of the Independent Atom Model for positron interactions

  13. Use of total body electrical conductivity (TOBEC) to determine total body water

    International Nuclear Information System (INIS)

    Cochran, W.; Wong, W.; Sheng, H.P.; Klein, P.; Klish, W.

    1986-01-01

    Total body electrical conductivity (TOBEC) has been introduced as a safe and rapid method to estimate body composition in infants and adults. Recently, a second generation instrument that operates in a scanning mode has been developed. A study was undertaken to calibrate this new instrument and to assess the feasibility of its use in estimating total body water. Six healthy adults, 3 males and 3 females, ranging in age from 25 to 57 years, and in weight from 43.3 to 104.7 kg were analyzed. Simultaneously, determinations of total body water were made by standard dilutional techniques using H 2 18 O. A baseline plasma sample was obtained and 60 mg 18 O/kg was given orally as H 2 18 O. Five hr later, a postdose plasma sample was obtained. The 18 O/ 16 O ratio in the plasma samples was determined as CO 2 by gas-isotope-ratio mass spectrometry and used to calculate the H 2 18 O volume of distribution. The total body water values ranged from 26.35 to 58.02 and represented 51 to 58% of body weight. There was good linear correlation between the total body water measurement and its phase average (TOBEC number) with a linear correlation coefficient of 0.998. The standard error of the estimate was 0.98. In addition to estimating fat and fat-free mass, the TOBEC method also estimates total body water with excellent correlation to physical dilutions methods

  14. Total curvature and total torsion of knotted random polygons in confinement

    Science.gov (United States)

    Diao, Yuanan; Ernst, Claus; Rawdon, Eric J.; Ziegler, Uta

    2018-04-01

    Knots in nature are typically confined spatially. The confinement affects the possible configurations, which in turn affects the spectrum of possible knot types as well as the geometry of the configurations within each knot type. The goal of this paper is to determine how confinement, length, and knotting affect the total curvature and total torsion of random polygons. Previously published papers have investigated these effects in the unconstrained case. In particular, we analyze how the total curvature and total torsion are affected by (1) varying the length of polygons within a fixed confinement radius and (2) varying the confinement radius of polygons with a fixed length. We also compare the total curvature and total torsion of groups of knots with similar complexity (measured as crossing number). While some of our results fall in line with what has been observed in the studies of the unconfined random polygons, a few surprising results emerge from our study, showing some properties that are unique due to the effect of knotting in confinement.

  15. Changes in total carbohydrate and total antioxidant activity induced by gamma irradiation of wheat flour

    International Nuclear Information System (INIS)

    Manupriya, B.R.; Shenoy, K. Bhasker; Patil, Shrikant L.; Somashekarappa, H.M.

    2015-01-01

    Wheat is a staple food grain in India after rice and occupies number one position in the world. The wheat crop not only gives food grains but also gives fodder for animals. Among many preservation methods irradiation is a current technique used to overcome infestation, contamination and spoilage of stored grains. The present study is aimed to check the changes in composition of irradiated wheat flour. Wheat flour was exposed to five different irradiation doses (0.25 KGy, 0.5KGy, 1KGy, 5KGy and 10 KGy) by using 60 Co gamma-irradiation chamber. Irradiated flour was stored in air sealed polyethylene pouch and plastic container at room temperature for different time intervals (0 th day, 1 month and 3 months). The stored flour was checked for total antioxidant activity by phosphomolybdate method and total carbohydrates concentration by phenol-sulphuric acid method. On 0 th day total antioxidant activity and total carbohydrate concentration was found to be increased at 0.5KGy (0.113 mg/ml and 0.045 mg/ml respectively) when compared to control (0.79 mg/ml and 39.5 mg/ml). Similarly for 1 month stored samples of air sealed polyethylene pouch total antioxidant activity and total carbohydrate concentration was observed to be increased at 0.5KGy (0.117 mg/ml and 0.045mg/ml respectively) when compared to control (0.096 mg/ml and 0.035 mg/ml). But in case of stored samples of plastic container total antioxidant activity increased at 0.25KGy (0.060 mg/ml) and total carbohydrate increased at 5KGy (0.051 mg/ml). Increased and decreased values were found in both factors for 3 months stored samples of air sealed polyethylene pouch and plastic container. Total antioxidant activity increased at 5KGy (0.072 mg/ml) for polyethylene bag samples and at 0.5KGy (0.137 mg/ml) for plastic container sample. Same way total carbohydrate concentration increased at 0.25KGy (0.046 mg/ml) and at 1KGy (0.045 mg/ml) respectively. This increase is due to affects of γ-irradiation on biomolecules by

  16. Image-guided total marrow and total lymphatic irradiation using helical tomotherapy

    International Nuclear Information System (INIS)

    Schultheiss, Timothy E.; Wong, Jeffrey; Liu, An; Olivera, Gustavo; Somlo, George

    2007-01-01

    Purpose: To develop a treatment technique to spare normal tissue and allow dose escalation in total body irradiation (TBI). We have developed intensity-modulated radiotherapy techniques for the total marrow irradiation (TMI), total lymphatic irradiation, or total bone marrow plus lymphatic irradiation using helical tomotherapy. Methods and Materials: For TBI, we typically use 12 Gy in 10 fractions delivered at an extended source-to-surface distance (SSD). Using helical tomotherapy, it is possible to deliver equally effective doses to the bone marrow and lymphatics while sparing normal organs to a significant degree. In the TMI patients, whole body skeletal bone, including the ribs and sternum, comprise the treatment target. In the total lymphatic irradiation, the target is expanded to include the spleen and major lymph node areas. Sanctuary sites for disease (brain and testes) are included when clinically indicated. Spared organs include the lungs, esophagus, parotid glands, eyes, oral cavity, liver, kidneys, stomach, small and large intestine, bladder, and ovaries. Results: With TBI, all normal organs received the TBI dose; with TMI, total lymphatic irradiation, and total bone marrow plus lymphatic irradiation, the visceral organs are spared. For the first 6 patients treated with TMI, the median dose to organs at risk averaged 51% lower than would be achieved with TBI. By putting greater weight on the avoidance of specific organs, greater sparing was possible. Conclusion: Sparing of normal tissues and dose escalation is possible using helical tomotherapy. Late effects such as radiation pneumonitis, veno-occlusive disease, cataracts, neurocognitive effects, and the development of second tumors should be diminished in severity and frequency according to the dose reduction realized for the organs at risk

  17. Total and inorganic arsenic in foods of the first Hong Kong total diet study.

    Science.gov (United States)

    Chung, Stephen Wai-cheung; Lam, Chi-ho; Chan, Benny Tsz-pun

    2014-04-01

    Arsenic (As) is a metalloid that occurs in different inorganic and organic forms, which are found in the environment from both natural occurrence and anthropogenic activity. The inorganic forms of As (iAs) are more toxic as compared with the organic As, but so far most of the occurrence data in food collected in the framework of official food control are still reported as total As without differentiating the various As species. In this paper, total As and iAs contents of 600 total diet study (TDS) samples, subdivided into 15 different food groups, were quantified by high-resolution inductively coupled plasma mass spectrometry (HR-ICP/MS) and hydride generation (HG) ICP/MS respectively. The method detection limits for both total As and iAs were 3 μg As kg(-1). As the samples were prepared for TDS, food items were purchased directly from the market or prepared as for normal consumption, i.e. table ready, in the manner most representative of and consistent with cultural habits in Hong Kong as far as practicable. The highest total As and iAs content were found in 'fish, seafood and their products' and 'vegetables and their products' respectively. Besides, this paper also presents the ratios of iAs and total As content in different ready-to-eat food items. The highest ratio of iAs to total As was found in 'vegetables and their products'. It is likely that iAs in vegetables maintained its status even after cooking.

  18. Total body irradiation in bone marrow transplantation

    International Nuclear Information System (INIS)

    Gluckman, E.; Devergie, A.; Boiron, M.; Bernard, Jean; Dutreix, A.; Dutreix, J.

    1979-01-01

    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

  19. The Cruciate Ligaments in Total Knee Arthroplasty.

    Science.gov (United States)

    Parcells, Bertrand W; Tria, Alfred J

    2016-01-01

    The early knee replacements were hinge designs that ignored the ligaments of the knee and resurfaced the joint, allowing freedom of motion in a single plane. Advances in implant fixation paved the way for modern designs, including the posterior-stabilized (PS) total knee arthroplasty (TKA) that sacrifices both cruciate ligaments while substituting for the posterior cruciate ligament (PCL), and the cruciate-retaining (CR) TKA designs that sacrifice the anterior cruciate ligament but retain the PCL. The early bicruciate retaining (BCR) TKA designs suffered from loosening and early failures. Townley and Cartier designed BCR knees that had better clinical results but the surgical techniques were challenging.Kinematic studies suggest that normal motion relies on preservation of both cruciate ligaments. Unicompartmental knee arthroplasty retains all knee ligaments and closely matches normal motion, while PS and CR TKA deviate further from normal. The 15% to 20% dissatisfaction rate with current TKA has renewed interest in the BCR design. Replication of normal knee kinematics and proprioception may address some of the dissatisfaction.

  20. Early rehabilitation after elective total knee arthroplasty.

    Science.gov (United States)

    Lisi, Claudio; Caspani, Patrick; Bruggi, Marco; Carlisi, Ettore; Scolè, Donatella; Benazzo, Francesco; Dalla Toffola, Elena

    2017-10-18

    Outcomes after TKA surgery are supposed to be related to the intensity and type of post-operative rehabilitation. Aim of this paper is to describe our early rehabilitation protocol following TKA with mini-invasive surgery in the immediate post-operative period and analyze functional recovery and changes in pain scores in these patients. in this observational study, data were collected on 215 total knee arthroplasty patients referred to Orthopedics and Traumatology inpatient ward from July 2012 to January 2014, treated with the same early start rehabilitation protocol. We recorded times to reach functional goals (sitting, standing and assisted ambulation) and pain after the treatment. length of hospital stay in TKA was 4.6±1.8 days, with a rehabilitation treatment lenght of 3.3±1.3 days. The mean time needed to achieve the sitting position was 2.3±0.7 days, to reach the standing position was 2.6±1.0 days to reach the walking functional goal was 2.9±1.0 days.  Pain NRS scores remained below 4 in the first and second post-operative day and below 3 from the third post-operative day. Our study confirms that rehabilitation started as soon as 24 hours after surgery with mini-invasive approach, enables early verticalization of patients and early recovery of walking with a good control of pain.